HomeMy WebLinkAbout0070 BISHOPS TERRACE i
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„ . Town of Barnstable Building
'_ Post Th�s�Cad�So Thatit;s Visible From She Street A roved Plans:Mustbem,Retamed,on�Joband,this Card Must:be Ke ,t
BARNSTASL� • � �� � � � ,� xi ��". ,,., Permit
WAS& Posted Until Final Inspection Has Been Made, r� � A � �� '��i' � y � �
3 P .,_;: 3 ”:. g .`, ,•.. t a: ter, ,a,.r
�° Where a Certificate o Occupancy Regwured,such�Bu�ldingshall Not;be Occ�up,ed�u nt�l a Fnalnspectlonhas�b�een�made� a
Permit No. B-18-1011 Applicant Name: Neal Holmgren Approvals
Date Issued: 04/30/2018 Current Use: Structure
Permit Type: Building-Solar Panel-Residential Expiration Date: 10/30/2018 Foundation:
Location: 70 BISHOPS TERRACE, HYANNIS Map/Lot 251-212 Zoning District: SPLIT Sheathing:
Owner on Record: SPRINGER DAVID W n Contractor-Name:. NEAL F HOLMGREN Framing: 1
AV
Address: 70 BISHOPS TERRACE „AA
Contractor License CS=088921 2
x
HYANNIS, MA 02601 � ' Est Protect Cost: $16,800.00 Chimney:
A -Fe
Description: Installation of 24 LG 350watt solar modules to bevflush mo`'unted on Permit Fee: 1 .
35 68
$
FeePaitl
Insulation:
existing roof. `
$ 135.68
7.68kw
Final: f Z fZb
s
Date 4/30/2018
Project Review Req
Plumbing/Gas
Rough Plumbing:
Building Official
" Final Plumbing:
hb Rough Gas:
This permit shall be deemed abandoned and invalid unless the work authorizedrby this permit is commenced within six months after issuance. g
All work authorized by this permit shall conform to the approved application and the"approved construction documents or'. hlc this permit has been granted.
All construction,alterations and changes of use of any building and str�u`cturesfshall be in compliance with the local zo�nlrig by lawsanel codes. Final Gas:
77
This permit shall be displayed in a location clearly visible from access street orroad and shall be maintained open for pu lic inspection for the entire duration of the
work until the completion of the same. �� � � � Electrical
64
The Certificate of Occupancy will not be issued until all applicable signatures�by;the Build ni gland Flre Officials acre provlde_d on this permit. Service:
Minimum of Five Call Inspections Required for All Construction Work 3 Rou h:
1.Foundation or Footing . ' k
. - .--3� �,-.. .• g
2.Sheathing Inspection Final:
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough:
5.Prior to Covering Structural Members(Frame Inspection)
6.Insulation Low Voltage Final:
7.Final Inspection before Occupancy
Health
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations.
Work shall not proceed until the Inspector has approved the various stages of construction. Final:
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department
Building plans are to be available on site Final:
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ON�t.+
�Asc. S F•+'T
to 1` f P4
Town of Barnstable
o�TME'+ ti Regulatory Services '
Richard V.Scali,Director
MAS& Building Division
Paul Roma,Building Commissioner.
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
PERMIT _ I FEE: $35.00
SHED REGISTRATION
RESIDENTIAL ONLY
200 square feet or less
Location of shed(address) Villake
349 013
Property owner's name '14 Telephone number
06
Size of Shed 4/0,0" '?2 Map/Parcel#
Signature Date
Hyannis Main Street Waterfront Historic District? h p
Old King's Highway Historic District Commission jurisdiction? n
You must file with Old King's Highway
Conservation Commission(signature r
Sign off hours for Conse •on>' 8:00-9:30&3:30-4:30
PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE
COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE.
PLIJA§E SEE THE APPROPRIATE COMMISSION FOR DETAILS.
THIS FORM MUST BE ACCOMPANIED BY A
PLOT PLAN
Q-forms-shedreg
REV:06/20/16 '
g90SSz d� a - _
145.03
1 N
ui
18'X 3G'
- IN-GROUND
POOL
7/7
Ise
I - INo.70 n
t N 1 STY.WD.FR. N
•N
APN 25 1-21 2
15,003±5F
145.00
BISHOPS (40'WIDE) TERRACE,
f
BENCNMARK:MAG NAIL SET
1
ELEV.=50.00 (ASSUMED)
I HEREBY CERTIFY THAT, TO THE BEST OF MY PROFESSIONAL
KNOWLEDGE, AND IN MY PROFESSIONAL OPINION, THE LOCATION OF
THE PROPOSED SWIMMING POOL, A5 SHOWN HEREON, CONFORMS
WITH THE HORIZONTAL SETBACK REQUIREMENTS OF THE ZONING BY
LAW OF THE TOWN OF BARN5TABLE.
A5-51JILT POOL LOCATION JOB No.: 1614G
DATE: 09NOV I G
IN
SCALE: 1" = 20'
BARNSTABL'E HYANN15 MA
PREPARED FOR �P�10
DAVID SPRINGER o RICHARD y�
J.
rlchard j. hood, PI5 N HOOD
o �
land surveyors - c1v111 englneer5 1 IAND
12 settlers path - 5andwich - ma 025G3
Ph: 508.833.7100 - Email: rikhood@gmail.com
a
{ TOWN OF BARNSTABLE BUILDING PERMIT APPLICA-110
. r
Map Parcel Application,# /�✓J��c>
Health Division Date Issued 0�311/b
Conservation Division Application Fee
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation/ Hyannis
Project Street Address 70 0
Village A UM0 21
Owner P ,X CfL- Address 7O E 1 ,�,z Pll-rcA Cc—
Telephone( _ '� 3
Permit Request c fS UL)oD S'ur/`v„N
Qo � I e- 1' 7 d4A" In I' bLh 1P qE11t , H ob w0 x
r kkn g11.W i t1
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation (900 Construction Type
Lot Size �' Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new Half: existing new
Number of Bedrooms: existing _new
Total Room Count (not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑ Gas . ❑ Oil ❑ Electric ❑ Other
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: ❑ existing ❑ new size Pool: ❑existing new sizeAO� arn: O ex 1isting L new�ize_
1
Attached garage: ❑ existing El new size _Shed: ❑ existing ❑ new size _ Other: ,' '1 =;
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes ❑ No If yes, site plan review #
Current Use Proposed Use ° 3
APPLICANT INFORMATION
- (BUILDER OR HOMEOWNER)
Name I cLt\c/,S O n''r Telephone Number
Q �0�Address � � ego License #
Home Improvement Contractor#--&-}f 7031
Email NE s Pi2)Q(N-\0L%t —corn Worker's Compensation # W WC 319 3 J1 a 9,
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE-TAKEN TO CaP V0ZQ- -
SIGNATURE TE
C
FOR OFFICIAL USE ONLY
".y APPLICATION #
DATE ISSUED
MAP/ PARCEL NO.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
",'FOUNDATION Poet °L- 2- ( U Q�U)D 0.
FRAME
r INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
j
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
l
t
1'he Comriiofrwealth of Massachusetts
Department of Industrial Accidents
tee of Investigations: '
600 Waslungton Street
Boston;MA02111'
ivfvw pwss govldia
Workers'Compensation Insurance Afffdavlt:General Budrimes
Ap iliont Information Plea!W hint Le
BusinesUOrga ization Name. i�ar c t E n+P r r tses [nr
Address: L S OX G Q
citylstatefzi E- -ree-ioLjn' MA oz!,(( •l ;Ph6iid 50ss `T63 050;
Are rou an employer?.Check the appropriate hoxc Budhm ype-(requ1md):
._ s p Rotail
-1.0 -tam a ernployer wtth- ,� employees(full addt
or part-tune)? 6 p Rcstaurant/ uffiating Establishment
1,❑ i am a sole proprietor or rirnicisttip and have.no 7 p Office am_Saks Ond.oral estate,auto,etc:)
employees working for me-in atiy .capacity:
8 p Nan-profit
iNo workLrs't:ot*insurance required}
3:p We arc a corpoialron and its dfficers haiic exercised. 9 :p Entratatnmcnt
their right of excmptson per c.I52,§1(4) and we have 1 Q❑Manufacturing:
no employees:[No work as'comp insurance rcgwrcd] 11.11].H,calfh Carc
4. We are a non profit organization staffed;by volunteers:
with no employ-tNo'worl•� :comp:insurance rrrq.j 11,0 Other
°Any aptttirttti Ilia cltccl-.lmz 5t mnat alrn fill:cuit tbc,arda�n Itclira•_�hn�•ingiticir norkeis'cuttry>L�cation�rilicy iakKn►aliury •
"if t1w yr m1';Uirk mha�ccucngriatdn-�usrhr�.burthscur�wtationhairLtuturelnploycm-awiAw: cnmjwwwion:F"ivy1sm-quuW mid such..un.
013wizuion x1mauld deck b=9t.:, _
I am an employer that Is pmv``tdfi++tg+r6rkers'compensatioe insrutance far my employees Bdaw*the pagq W forma ion.
insuranccCompanyNamc W2�cO �(\St)fCtfIC2. �onmTlf"titu
p
Insurer's Addm,,-s,F `. 0
City/StateMp-, E<L 4 O a•71
t,
PolicyorSelf-iris.Ltc`# W W C 3�qN?2' - Facpiration Date: Qt4 164 20 17_
Attach a copy of the: roirkcrs7 compensation pdicy declaration page(show:jng the.policy ngrntwr and expiration date)..
FitiIurc to wxurc covcrag�as:rcquiri d:undcr scsdion 25A of MGL c. 152 can i d to the;mposition of criminal penalties of a
fiae:up to 81300.0D'and/or ottaycar imps isonment-'as well as civil penalties in the fo t`of a STOP WORK ORDEk and a find
of up to$250.00 a.day'against t e vidlator-:Bc:advised that a<copy of 04&ateriectt:ai5y lie forWarded.to tlie:offce of
Investigations of the DIA:for insurance covci itge'v&ification:
l.do Hereby 44vfi er dwpal `andpen,rhiv rjury drat Nte 1gformat n»*-,vided.ghoae_is trtre and correct:
Si aturr• Date 10p3 �6
Official usr only. Do noYrvrite rii'thit aria,to be.completed by clfy:or tOwli.0 al
Ctt or 7 orvit:: Pcrmit/license
IsslrTmg Aiority(clyde:one):
1.Board of HeWth.2— �Btgd Depar�euE 3.CitslTown;Cierk 4 Licensing Board 5 Sdec men's 0®ce>
. ..,,
bOther_ .
American t�egatNel,9�c:
ContactPcrsan:: :.. _ _.. Pholw&
w•,rw•�,:Sr�rid'q�
.. _
Office of CO Whet Affairs and Business Regulation
10 Park Plaza.-:S.uite.5.170
Boston, Massachusetts,;021-16;
Home Improvement Contractor Registration
Regshation: 117031.
a Type: Private`Corpot-atiori;
Ezpirattow. 8/17/2018 Trd 419M
NARCISO ENTERPRISES; INC: kw,
CARLOS NARCISO
F.O. BOX 680 � 4 k �
EAST FREETOWN, MA 02717
Address and retpro card.Mark,reason for change..
{7:Addrew rl Renewal �..Employtnent Q:Lost Gard
SCA 1 G MM-0ytt ,
7Lc�iUerr�niea�� License or aonvand foru►dmdual nse on
Office of Consumer Affairs&.Business Regulation registra only
HOME IMPROYEME@!T CONTRACTOR before the expiration date. If found return to: 4
F Office of ConsuinerAffairs and Usine Regulation
- Registranon 117031 Tom;.
Expiration 8�172018 Private Corporation 10 Park Plaza-;Spite 5170
<y * 3oston,MA 02116.
NARC SO ENTERPRISES_INC7 =
CARLOS NARCISO '}
9 EDNA CIR '=
FREETOWN,MA 02717
Undersecretary of valid out a
i
�,W
OWN-,
WOW
OF A ,,7 0 111-40, Al,io--
P .........
-1 3/4" 4 to 8 137'-1 11/4.
;/4"
Diaaonals I to 2 32'-0" 2 to 3 12'-10" 3 to 5 14'
Sl toS2 116'-0" 1 to 3 34-3 2 to 4 114!-1 3 3 to 6 36'-9 1/4" 5 to 6 137-0"
H1toH2 11 V-0" 1 to 4 36-9 1/4" 2 to 5 116'-U" 3 to 7 37'-1 11/4" 5 to 7 134!-314"
sl -0 1 to 5 36-9 PI/4" 2 to 6 136-911 3 to 8 36'-0" 5 8 136-9 1/4" Part number Description QTY QTY QTY QTY
toHl 114' 1/4'. 4 to 5 2'-10" 6 to 7 17-10" 81 —
S2toH2 114'-0 1 to 6 16'-0" 2 to 7 139-9 ST0960002X 6 —5, 5 3
S1toH2 121'-3" 1 to T- 4 1 3/4" 2 to 8 13,V-3/4" 4 to 6 3N-3/4" 6 to 8 114'-1 3 ST0960002' 8'SKIMMER 1 1 1 1
-H-1—to S 2 [2l'-3" 1 to 8 121-10" 3 to 4 IIZ-0" 1 4 to 7 136W 7to8 —
ST0960002 8'RETURN 2 2 2 2
ST078000IX 6-6" 2
ST0600001X 5 2 2 2 2
ST0480001X 4' 1 - -
ST036000OX 3' - 2
ST0240000* 2'LIGHT 1 1
ST024000OX 2' - - 2
CN0380241X 2'Rx32" 4 4 4 2
Brace Brace 17 18 18 14
IPC-STKPK25 REBAR STAKE 18"25PC 2 2 2 2
IPC-HDWSTRT150 BOLT STR 3/8.16X1'CM NUT 15OPC 2 2 2 2
ST6018B THKSHT STEP STR 6' -
36' ST8024B THKSHT STEP STR SIT N STEP 8'
SSK-ST192STR2 FE STEEL STEP STR-2-RAD GN 3 TRD 16'
21 B
2 3
-----------
co
4----------- ----------
00 4------------ J
---
c D
2'-0- 34'-0" 37'-7 16'-1 1/2"
2'0 2 1 M-O" 2-0" 16'-1 1/2" 37'-7'
5 4 A B
3 36'-3/4" 2'-0" 14'-0" 38'-7 1/2"
39 7 11T 14'-0" 36'-3/4"
5 37'-7" 16A 1/2" 2'-0" 34'-0"
6 16'-1 1/2" 37'-7" 34- 2'-0'
7 14!-0" 38W 112" 36'-3/4"-- 1 2'-0"
38'-T 1/2" 1 14'-Q" --I
' ZOO { 1
THE CONSTRUCTION METHODS ILLUSTRATED APPLY
RNER BRACKETONLY TO NORMAL GROUND CONDITIONS. IF UNUSUAL o
SOIL CONDITIONS ARE ENCOUNTERED (I.E. HIGH z F.- W ! j
ORGANIC MATERIAL, HIGH WATER LEVEL) ADDITIONAL q w o "
(- MEASURES MUST BE TAKEN TO PROVIDE SUBSURFACE o!25
CONDITIONS WITHIN THE STRUCTURAL CAPABILITIES � ¢
OF THE PANEL. ANY ADDITIONAL PRECAUTIONS OR
METHODS OF CONSTRUCTION ARE THE RESPONSIBILITY w A
OF THE CONTRACTOR. (NOTE: DECK SUPPORTS ARE A '
OPTIONAL.) q o
BIG VEE + 0 u� 4
6' RAD. INSERT POOL DECK A u
o ( '
RADIUS CORNER y �' o F u
COPING °_ w o w Lu
x
_
CORNER DETAIL _ (t
NGULAR POOLS) LLJj o u {
a w ;
It 0
MIN., 6" THICK CONCRETE COLLAR LA- Q W al mow,
° w v w
REO 0. AT BASE OF WALL PANELS ° :-_- _ 3�� � �0.
DRIVERODS THROUGH " o o - o az o f
0 Q up H Uw0a :
HOLES IN PANELS ° ° �' o W
INTO UNDISTURBED EARTH. ° �u 00 w �¢z
2" SAND OR VERM. CONC. ° 11
w
- CURVED CORNER o i
COPING
LINDISTRUBED
EARTH i
BACKFILL SHALL BE FREE-DRAINING
CLEAR GRANDULAR MATERIAL SUCH
AS SAND, TRACE CLAY OR TRACE SILT,
TYP. LINER INSTALLATION DET.
3/8" x 2" BENT BOLT
W/NUT & 2 WASHERS _
(7 PER JOINT) _
MER DETAIL
POOLS) s
DL AT RIGHT ANGLES TO SLOPE M
N OF DECK TO BE 1'00" ABOVE x � M
RADE Q
20UND UP-HILL SIDE OF DRAIN:
AWAY FROM POOL. a
;HOULD SLOPE MIN. 1/4" PER 'FOOT Q
►L. (A w o
SHED BY OWNER TO SHOW POOL !1! e I i
:NCLOSURE.BING AND FENCING TO CONFORM TO CARDINAL S Y S TT
E M S .
250. RT. 61 S. (570) 385-4733
D. BY SITE CONDITIONS OR
SCHUYLKILL HAVEN. PA. (570) 385-1318 FAX.
REO
BY OWNER. DATE: 4 7 11 T'n ONSTR. DET. SHT.
ANS OF EGRESS SHALL BE PROVIDED. SCALE:
NONE UNG LINER STL. POOL
OR .LADDER OPAWN: SED RLE NAME: CONSTDET
3/8" x 1" BOLT WITH
NUT & 2 WASHERS
(TYP. 14 EA. CORNERol
(-
10
• 3/8 x 1" BOLT WITH
NUT & 2 WASHERS
• (7 PER JOINT REQ'D.)
10
•
•
WALL — STEEL 14 GA. TYP I CA
• W/2oz. (G235)GALVANIZING
0
(REC
e10
o ,
•
• •
•
_ o
•
3/8" x 2 1/2" BOLT W/.
REINF. ROD
SUPPORT SUPPORT MAY BE
BRACE TIE BOLTED TO THE ANGLE \
POST IN ANY OF THE PRE— ' \
PUNCHED HOLES. \
d i \
TYPICAL WALL BRACE ASSEMBLY `� IL
r CORNER BRACKET
CONCRETE DECK REQ'D.
TYPICAL C
RIM—LOK COPING (GRECI
#12-14 x 1" SELF DRILLING EXTRUDED ALUMINUM PLANNING N(
FASTENER (18" O.C.) SET WIDTH OF
FINISHED ELEV)
SURROUNDIN(
7YN YLL LINER PROVIDE SWALE
(HUNG) SURFACE WA
CONCRETE DEC
AWAY FROM
o PLOT PLAN FU
POOL WALL PANEL -. LOCATION AN
RIM-LOK COPING DETAIL " ELECTRICAL,SPI
OPTIONS- EXTR)
E' WHEN SPECII
AT LEAST ONE
OPTIONAL ST
PG DAPT-2 Manual 021115:1-ayout 1 2/12/15"12:15 PM Page 1 - - -
Mill
When the 9-volt battery is low,the door alarm horn will chirp once every •Supervise children at all times. CONNECTING DOOR ALARM TO SENSOR SWITCHES
10 seconds-this means it is time to install a new battery,Battery life Is •Never permit swimming alone.Never leave a child alone,even READ THE DOOR ALARM MANUAL FOR INSTALLATION ON ONE DOOR FIRST:
approximately 1 year.Test your door alarm weekly by opening the door to answer the telephone. - THE SENSOR WIRES ARE PERMANENTLY.CONNECTED TO THE DOOR
and ellOWln the al8fm t0 Sound. •Aiwa s remove the entire solar cover from a 001 bBfore ALARM.CONNECT BOTH SENSOR WIRES COMING FROM THE DOOR ALARM
9 y .p - TO THE SENSOR SWITCH ON THE DOOR FRAME.THEN USE THE SUPPLIED MODEL DAPT'2
swimming. MEETS UL 2017 SIGNALING
•Remember that alcohol and water safety do not mix. JUMPER WIRES TO CONNECT TO THE SCREEN DOOR SENSOR SWITCH RAM BELOW).THE TWO SENSORS SHOULD BE HOOKED UP IN Ti _� ---
:Remember
your pool area fenced and the gale locked t0 prevent PARELLEL WITH EACH OTHER. - U
unauthorized entry to the pool,and install a gate alarm. ' •THE PLASTIC COVERS ON THE SENSOR SWITCHES&SENSOR -
POOLGUARD is sold with a-limited warranty to cover defects in parts •Lock and secure all doors In the house which permit easy .MAGNET MUST BE REMOVED BEFORE INSTALLATION I SENSOR 000gnunrn M
and workmanship for one year from dale of purchase.(Retain proof of access to the pool,and Install a tlOOr alarm. •SWITCHES GO ON THE FRAME BY THE DOOR 5WITCH US ED
purchase).If POOIgUard exhibits a detect,please call our Dl1SlOmef •HeVO a responsible adult teach Swimming and Water safety t0 •MAGNETS GOON THE DOOR ITSELF-SEE PICTURE IN MANUAL - ` ._�' Peo1gaM ,
Service department at 1.800-242.7163.Unauthorized returns will not be your Children, EQUIPMENT NEEDED -
aCcepled.Proper repair is only ensured when the unit Is returned to the •Maintain clean,clear water In the pool. A.ONE DOOR ALARM AND 2 MOUNTING SCREWS tro
manufacturer. Visit our Webslte at www.puutguard.com to fill out your •Do not swim during electrical storms. B.ONE SET OF SENSOR SWITCH AND SENSOR MAGNET AND 4 SCREWS _ I v
warranty registration Information. - •Do not permit bottles glass, or sharp objects to be used FOR DOOM FnAME&DOOR s " • °swOac'A .
C.ONE SET OF SENSOR SWITCH AND SENSOR MAGNET,JUMPER WIRES,around the pool. - - AND 4 SCREWS
rC ^
_ -Ask your pool dealer how you can,improve your pool xoRN
Safety—they WIII be glad t0 ae918t you. -FOR SCREEN DOOR FRAME AND SCREEN DOOR
•Above all: remember that Common sense, awareness, and IF YOU HAVE ANY QUESTIONS CALL US AT 1-BOP242-T763 p r
SCREEN DOOR MAIN DOOR
caution will allow you to enjoy your pool. . - SwIREs
S"RSE5rMH DOOR ALARM Figure 1
nERiw INDUSTRIES,INC. �. aalgard+ The horn is85dB at 10feet
P.O.Box 658 LED PASSTHRU ••NORTH VERNON,IN 47265rr• g+ • SWITCH • • ••• ••' '812-346-2648 ooIgV®rV ZTheproduct has been designed to aid in the detection of unwanted
® HORN .intrusions into unsu ervised areas. POOLGUARD DAPT-2 ISAOOlguard PBMINDUSTRIE8,INC. UBrd.00111 p , a
p 9 WIRES SAFETY ALARM SYSTEM AND NOT A LIFE SAVING DEVICE. It
MADE IN THE USA should be used in conjunction with the safety equipment currently In use
REV.02-15 Figure 5, SEN5INGJ. and should not affect existing safety procedures.
WIRES
PG DAPT-2 Manual 021115:1-ayout 1 2/12/15 12:15 PM Page 2
A.Determine the best location.The door alarm must be installed at least 1 1 . 11 1 oo igua rd`
54"above the threshold of the door. _ -
B.With a pencil,mark 2 spots 2 1 "apart vertically(up&down)where
9v,&pIka-fi,o battery.Energizer• , Duracell 522 or • - 1/2"'the alarm will be mounted.These 2 marks are where the 2 larger The POOLGUARD DOOR ALARM uses two delay modes which allow
A Remove the assembly screw from the back of the door alarm and - supplied screws will be Inserted Into the wall to hang the door alarm. the user to exit and enter the door without the alarm sounding.These - - -
remove the top cover.(See Figure 2) C.Insert the 2larger supplied screws into the wall on the 2 marks.Leave two modes are explained below, '!
B.Pull down the battery spring and install the 9v battery(see figure 2).. about 5/32"(not including the head of the screw)of the screw from. A. FIRST DELAY MODE: When the door is opened the alarm r -
NOTE:if the battery spring Is not in the correct position under the the wall. automatically goes into the first delay mode which gives you 7
battery,the alarm will not go back together. D.Hang the door alarm on the mounted screws and pull downward until seconds after the door Is opened to push the pass thru switch.if the
C.When the 9v battery is installed,the LED will flash once every 10 the screws are positioned in the small end of the hanger holes in the pass thou switch is not pushed within 7 seconds the alarm will sound _
seconds.When the alarm sounds,the LED will flash once every back of the alarm. with the door open or closed. To silence the alarm dose the door
second. E.If you purchased the OPTIONAL Screen Door KR see section 6.(Figure 5) then push the pass thru switch. )
D.Reassemble the door alarm with the assembly screw.NOTE:Once B.SECOND DELAY MODE:When the door is opened and the pass thou
the battery is Installed the alarm may sound accidentally until the 111' •' switch is pushed within 7 seconds,this puts the door alarm in the
sensors are connected properly. second delay mode which allows you 14 seconds to-go through theP4"
A.The Door Alarm comes with,one sensor switch and one sensor door and close it. When the door is closed within 14 seconds,the
•1OLGIARD DOOR magnet;ramuve the covers from both of th000 parts by using your _ alarrn will automatically reset. If tho door is not closed within 14 'SAFETY BUOY"
,„oorUse T , fingernail or small tool to unclip the cover from the bottom side and seconds,the alarm will sound. -` - ABOVE GROUND POOL ALARM
sliding it off the sensor. SENSOR IN GROUND POOL ALARM
Your Poolguard Door Alarm is designed to be installed within 12"of the B.Each sensor has 2 holes for mounting(Note:Do not mount the Figure 4 SWITCH PLASTIC COVER
sensor switch for the sensor wire connection.To mount the door alarm sensors on the side of the door that is Hinged).The sensor magnet WITH REMOTE RECEIVER
on wall next to door: usually goes on the door and the sensor switch Is usually mounted to
SATTERYSPRINO' BATTEflY the dodo}fame.
PASSTXRU ewrteH. C.Metal framed doors may need a space between the sensors and the
door using a small piece of wood or double sided foam tape.
n
Figure Z �o � D.Install the Sensors Vertically(as shown in Figure 1)or Horizontally. x
HORN Maximum space between sensors Is 1+1/4". IMPORTANT:.If you
install the sensors Horizontally at the top of a SLIDING door,spacing
between the sensors needs to be between 1"and 1+1/4".
t _ E.Loosen the two terminals on the sensor switch by loosening the: `
F HANGER HOLE. SCfeWs(hen lace either wire end coming from the door alarm' -NOTE:If the alarm sounds for approximately 5 minutes and the door is GATE ALARM Poolguard's -
+. r _ P 9 , - Family of Products
between each of the terminals.It doesn't matter which wire goes to: still open.The alarm horn will start to pulsate,5 seconds ON and 5 Helps PoAct Your FarNryl,
ASSEMBLY SCREW HOLE which terminal,Replace Plastic Covers. seconds OFF.The alarm will continue to do this until an adult closes ,
Note:If the cover for the sensor switch does not lock into place because the door and pushes the PASS THRU switch on the door alarm to - www.po6iguard.com
HANGER HOLE of the sensor wires,remove the knockout from the side of the sensor" silence the alarm. If the alarm sounds for approximately 5 minutes "
switch cover.(See Figure 4) and the door is closed,the alarm will reset. - -
r —
CERTIFICATE OF LIABILITY INSURANCE. ° /20" s°""'"'
THIS CERTIFICATE IS.ISSUED AS A MATTER OF INFORMATIOWONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER:.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELYLAMENDI EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW.THIS CERTIFICATE OF INSURANCE GOES 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¢es)must be.endorsed. SUBROGATION IS WAIVED;subject to
the terms and-conditions of the policy,certainpollcles may require an endorsement: A statement onahfs certificate does not confer rights to.the
certificate holder in lieu of such endorsements.'
RODUCER CONTACT Paychex,nsurance Agency!ns'
PAYCHEX INSURANCE AGENCY,INC: PHONE FAX:
150 SAWGRASS DRIVE 877-266,6850. . . 585=389-7426
ROCHESTER,NY 14620 E-MA(: -
Cerfs@paychex;com
1NSURER(S)AFFORDING COVERAGE NAIC 0
4SURED MSURER A. We=insurance Company% 2501.1
NARCISO ENTERPRISES INC. ,,INSURER B
PO BOX 680
EAST FREETOWN,MA 02717 i MIS URER C:
iNSURER:D.:
INSURER.E:
INSURER F•
{� "OVERAGES CERTIFICATE NUMBER:: REVISION NUMBERc
i THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE'LISTE0 BELOW HAVE_BEEN ISSUEDTO THE INSURED NAMED ABOVE FOR THE POLICY:PERIOD
I INDICATED.NOTWITHSTANDING ANY REQUIRENIENT,.TERM OR CONDITION OF ANY GONTRACT:OR OTHER DOCUMENT WITH RESPECT TO:WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES.DESCRIBED HEREIN IS'SUMECY:TO ALL THE TERMS,
' EXCLUSIONS AND CONDITIONS OF SUCH POLICIES:LIMITS SHOWN MAY HAVEBEEN REDUCED BY PAID CLAIMS..
S TYPE OF INSURANCE DL UBR POLICY NUMBER POLICY EFF. POLICY EXP LIMITS
R NSR M/DONYyyj (MMIODIYYYY)
GENERALIIABILITY EACH OCCURRENCE- S .
COMMERCIAL GENERAL LIABILITY DAMAGE TO-RENTED
. S(Faoarirtreoci4a �S
�LAIMS•MADE�CCUR MED EXP(Arty one person) S
PERSONAL&ADV.INJURY
"GENERAL AGGREGATE` $
ENt AGGREGATE LIMIT APPLIES PER;
POLICY Q PROJECl�IOC. PRODUCTS-=COMPtOPAGG... y- -
AUTOMOBILE'LIABILITY COMBINED SINGLELIMIT
ANY AUTO (Ea Dodddrd) S: ..
ALL OWNED ��---7i SCHEDULED BODILY INJURY: S;
ALTOS Ilif__JJ111 N O NED (P-PSn)
u � BODILYINJ
HHTRFDAUTOS dent) .. .. .§..FIR DAMAGE;
r'aaidont) , a
UMBRELLAUAB:=OCCUR ... EACH OCCURRENCE S. ..
EXCESS UAB: MAIM34AME. AGGREGATE .S .-
DED RETfNitO$a
WORKERS COMPi'l7SAT10N AND' .. - -..... - ..., X...._WCSTATU�:.... _,OTM-.
w pwyw umuxr. W WC3193422 04/04/2016 04/04/2017_
r EL.:EACHACCIDENT S 100.000.00
ANY PROPRIETOWPARTNE1 V(ECUTWE.
6F ICERIMUGER EXCAUDED? y�(� E.L.DISEASE-EA EMPLOYEE S 100 000.00.
ryandatory m►airy U `N/A E L DISEASE-POLICY LIMIT S 500,000.00.
If yes,dascitn w ar
ESC!UPT10N OF OPERATIONS/LOCATIONS I VEHICLES
. _.......(netaefiACORD101;AddttienafReLoarks_ScheQlate,Narroie:space.isiuqulma>)
ERTIFICATE HOLDER CANCELLATION
PROOF OF COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE i CANCELLED BEFORE.THE EXPIRATION
DATE. ERE THOF;NOTTC E WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY I
PROVISION .BUT FAILURE To MAIL SUCM NOTICE SHALL:IMPOSENO OBLIGATION:09'
UAMUTY OF ANY,IOND UPON THE COMPANY,rTS AGENTS OR REPRES i
ENTATIVES. I
AUTHORIZED REPRESENTATIVE p,
WORD 25(2010105) 1988`2010 ACORD CORPORATION. All rights reserved.
;The ACORD`name'and IDgo:are.reglstered'marks of RD ACO . '
-. . .,
i
. aeos5� dam. •- _ ,
_ 512°34'30'W
° ° 145.03 °
EXISTING CONCRETE PATIO ,.
o EXISTING SEPTIC SYSTEM
• - - I - , COMPONENT5 5HOWIN A5 PER _ -
''e PROPOSED I8 X 36' �''•` RECORD INFORMATION. a ,
IN-GROUND
POOL o
' - DOORS TO BE EQUIPPED
o: WITH ALARM.5
W FENCE(4'MIN.)TO BE
' - EQUIPPED MTh 5ELF- _ ? -
e �. LATCHING GATES. No.70 `
in N J 5TY-WD.M N
CID
�+-
(n r
w Z
APN 25 1 -212 .
15,003±5F, ` f
proposed lot coverage: 10.2
LOCUS 15 NOT IN'A SPECIAL
FLOOD HAZARD ZONE.
LOCI-15 15 NOT IN THE
` d WIND-BORNE DEBRIS ZONE.
145.00'., ..
10,
N 1 1°25'46"E
BI5HOP5 c4o'`w1DE> TERRACE
• � .,, � r 6ENCHMARK:MAG NAIL SET y , * _. - v -
. - ELEV.—.50.00 (ASSUMED} ,
I HEREBY CERTIFY THAT, TO THE BEST OF MY PROFESSIONAL
KNOWLEDGE, AND IN MY PROFESSIONAL OPINION, THE LOPCATION
OF THE PROPOSED SWIMMING POOL, A5:5HOWN HEREON,
CONFORMS WITH THE HORIZONTAL SETBACK'REQUIREMENTS OF THE
ZONING BY LAW OF THE TOWN OF BARNSTABLE..
SITE PLAN JOB No.: I G 14G
k DATE: 070GT I G
IN _
20�
BARNSTABLE HYANN!15 MA SCALE: ICI =`
PREPARED FOR
DAVID SPRINGER
rlchard j. hood, p15 ;
land surveyors - chill engineers
12 5ettler5 path - sandwich - ma 025G3
Ph: 508.833,7100 - Email: rlkhocd@mal.com
7.
�" Town of Barnstable
Regulatory Services
Richard V.Scali,Director
MAM
Building Division,
Paul Roma,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 Q i -so I as Owner of the subject property
V Ili
hereby authorize ki a- rs 1 G c> to act on,my behA
in all matters relative to work authorized by this building permit application for.
�( 0 cry S Ill
(Address of Job)
**Pool fences and alarms are the responsibility of the applicant Pools
are not to be filled or utilized before fence is installed and all final
inspections are performed and accepted.
Signature of Signature of Applicant
Print Name Print Name
Date
QYORMS:OWNERPERhOSIONPOOLS
I
.> Town of Barnstable
Regulatory Services
oFt Richard V.Scali,Director
Building Division
sAantsrnas. Paul Roma BuildingCommissioner
MASS
1639. M� 200 Main Street, Hyannis,MA 02601
p www.town.barnstable.ma.us
Office: 508-862-4038 . Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION:
number street village
"HOMEOWNER":
name home phone# work phone#
CURRENT MAILING ADDRESS:
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow
homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-
family dwelling,attached or detached structures accessory to such use and/or farm structures.'A person who constructs more than one
home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form
acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section.
109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,
bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection
procedures and requirements and that he/she will comply with said procedures and requirements.
Signature of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code
Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt
from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner
engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor
(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often
results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot
proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is
ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the
permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page
this.issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in
your community.
Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc
06/20/16
�. Town of Barnstable *Permit#
Expires 6 mont from issue dote
Regulatory Services Fee
• IMENSTnst e, •
Thomas F.Geiler,Director
i639 ��
FD MA't
Building Division
Tom Perry,CBO, Building Commissioner
.200 Main Street,Hyannis,MA 02601
www.town.bamstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number
Property Address
Residential Value of Work$ ^.S'��b Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address 4/�V 1fii�Wy
Contractor's Name a*l— Telephone Number
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance NOV 12 2013
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner TOWN OF BARNSTABLE
I have Worker's Compensation Insurance
Insurance Company Name ��j��f �j`�,J'ta►ZS -,�tQ'
Workman's Comp.Policy# J✓A4.-- 7'21 _'Zo G
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to__
Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
Re-side
Replacement Windows/doors/sliders.U-Value •.35-- (maximum.35)#of windows t'
#of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
Separate Electrical&Fire Permits required.
"Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
re fired.
SIGNATURE:
JA 44-
C:\Users\decollik\AppData\L icrosoft\Windows\Temporary Internet Files\Content.Outlook\8R76BDVA\EXPRESS.doc
"Revised 061313 -�
r —
The Commonwealth of Massachusela
Department of Indushial Accidents
Office of Investigadons
600 Washington,Street
Boston,MA 02111
Workers' Compensation Insurance Affidavit: Build
A licant Informadon Contractors/Electricians/Plumbers
_ Please it L bi
Name(Rtasi :/ izadan/Tndividnal): A4. J ru Ar�!f�
Address:
City/State/Zip: S M 02At Phone
F
s employer?Check the appropriate box:
a employer with 4. Q I am a general contractor and IType of pr°ject(required):
oyees(full and/or part-time).* have hired the subcontractors 6. 0 New construction
a sole proprietor or partner- listed on the attached sheet. 7. 0and have no employees These sub-contractors have Remodeling
ing for me in any capacity. employees and have workers' $ Q Demolition
workers'comp. insurance comp-insurance.t 9. 0 Building addition
3.❑ r l d:] 5. Q We area corporation and its 10.0 Electrical r
I am a homeowner doing all work officers have exercised their repairs or additions
myself.[No workers'comp. ' right of exemption per MGL 11.0 Plumbing repairs or additions
3a.❑ insurance required.]t C. 152,§1(4),and we have no 12.Q Roof repairs
I am a homeowner acting as a employees-[No workers' I3. Other !� }.�.
general contractor(refer to#4)
comp.insurance required-)
'�Y applicant that checks box#1 must also fill out the section below showing their workers'rood'
t informIUM
Hom wnms who submit this affidavit indicating they are doing all work and then hire outside contractors must submit ,
tConMwtM that check this box must attached an additional sheet showin the affidavit indicating such.
�PloY It the sub-contractors have employees, 'must provide their workers'c� trar�ers and' 0 whether or not those entities have
i
°°�.policy number.
I am an employer that isproviding workers'compensation haurance for aa3'employees. Below is the policy and fob site
information,
Insurance Company Name:
Policy#or Self-ins.Lic.#: 020 IS
Expiration Date:_
Job Site Address:_D 3rS1 s �
City/State/Zip.
Attach a copy of the workers'compensation policy declaration page(showing the policy nun r and ea
Failure to secure coverage as expiration date).
� mud under Section 25A of MGL c. 152 can lead to the imposition of criminal
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties of a
of up to$25Q00 a day against the violator. Be advised that a co of this statement orm of a STOP WORK ORDER and a fine
Investigations of the DIA for insurance coverage verification. Y be forwarded to the Office of
do hereby c under the
Pa—s an--penalltes ofperjwy that the infarmadon provided above is litre and eormt
I `
7
i
O,Q'tclal we only. Do not write in the area,to be costplend by chy or tower q,�claj
City or Town:
Permit/License#
Issuing Authority(circle one):
I• DORM of health 2.Building Department ICity/I'own Clerk 4,
6.Other Electrical Inspector S.Plumbing Inspector
Contact Person
:
Phone#•
III
I
Massachusetts -Department-of Public Safety
Board of Building Regulations and Standards
Construction Supen-isor '
ca License: CS-081139
MICHAEL J NARO, ..�i
299 WHITES PA�H fi
South Yarmouth RA
Expiration
Commissioner 09/16/2015
Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
-- Registration: 135887
Type: Ltd Liability Corpor
Expiration: 5/16/2014 Tr# 222824
•F t
„
M J NARDONE CARPENTRY LLC.
MICHAEL NARDONE 4
299 WHITES PATH
SOUTH YARMOUTH, MA 02664
,. ...
%'Update Address and return card.Mark reason for change.
Address Renewal Employment Lost Card
SCA 1 0 20M-05/11
(1e Woml" m"`eal&10e 'jacXiLd� License or registration valid for individul use only
Office of Consumer Affairs&Busi ess Regulation g Y
ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
egistration: �35857 Type: Office of Consumer Affairs and Business Regulation
"xpiration: ,,5L1 fi/2014,;; Ltd Liability Corpor 10 Park Plaza-Suite 5170
1 = Boston,MA 02116
M J NARDONE CARPET>LTY
MICHAEL NARDONE�.
299 WHITES PATH
!V
SOUTH YARMOUTH,MA"02664- Undersecretary valid without signature
f
�n+e
xgrABM _
MAW h 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: 508-8624038 , Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
I (9- 6rqJa, as Owner of the subject property
hereby authorize yV 6 • 4 dk,� to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
OWN-
P
e of Date
17'9•y �� St�21�1(�e�n.
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\8R76BDVA\E)CPRESS.doc
Revised 061313 ,
Client#.-43622 2MJNA
ACORD. CERTIFICATE OF LIABILITY INSURANCE UA I t(MNW U/YYYY)„/08/2013
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).
PHODUCtK CONTACT
NAME:
Dowling&O'Neil PHONE 508 775-1620 PAll 5087781218
(AtC,Nu,Ex1►: (AIC,NO:
Insurance Agency t-MAIL
ADDRESS:
973 lyannough Rd., PO Box 1990 INSURER(S)AFFORDING COVERAGE NAIL A
Hyannis, MA 02601 INSUKhKA:National Grange Mutual Insuranc
INSUKLD - INSURER B:Associated Employers Insurance
M J Nardone Carpentry, LLC
INSUKtK C
299 Whites Path
INSURER D:
South Yarmouth, MA 02664-1214
INSUKtK h
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.
INSK TYPE OF INSURANCE AUU UUK POLICY hPP POLICY txF LIMITS
LIK INSR WVD POLICYNUMBER (MM/UUIYYYY) (MM/DD/YYYY)
A stNtKALLIAd'ulY MPT1209E 3/26/2013 03/26/201 PACHC)CCLIKHPN01- $1 000000
X COMMERCIAL GENERALtIABILITY P DKAMAGET^RENTED
PMI:iP:i Pn nr.:urt ncr. $50O OOO
CI AIMS.MAI1F n 0c4,11H MP-1)PXP(Any nnc pmmnn) $10,000
PPH I.)V INAIKY i()NAI KA $1 000 000
GENERALAGGREGATE s2,000,000
C;PN'I ALiIiHHriAI P I IMI I APPI IP:i PPH: - PH 0I111C I R-CO MPIQP AGr, $2,000,000
POLICY 7 PKb- LOC $
A AUI OMOtldt UAHILl1Y M9T1209E 8/25/2013 08/25/201 (EI UMHINPiI-IN'I I-I IMN 11 0001 000
n ncuJnnl) $
ANY AUTO BODILY INJURY(Pnl ywaun) $
ALL OWNED X SCHEDULED HC)I)II Y INJI PRY(Prr.w..Irlcnl) $
AI11O:i AI)I Oh
X MIRED AUTOS X NC)IJ-OWNPII PKOPPH I Y UAMAhH
All i)i Pnl d;iU ,I
$
A X UMBRELLA LIAR X occun CUT1209E 3/26/2013 03/26/2014 PAC:H 0C:C:uKKPNCP $5,000,000
EXCESS LIAR CLAIMS-MADE AGGREGATE $5 000 000
DED I X1 RETENTION 10000 $
AND EMPLOYERS'LIAHILI IY
13 WORKERS COMPENSATION 4/25/2013 04/25/201 X IC"HY IAN�i �K"
ANY PROPHIP IOH/PAKINPK/PXPb1111VP YIN - E.L EACH ACCIDENT $500 000
OFFICER/MEMBER EXCLUDED? F 7N N/A
(Mandatory In NH) P.I. I11,;PA.^,P-PA PMPI OYPP $500 OOO
It Vne,dnesulibn unJnl
I1PfiCKIPI ION bPOPPHAIIONfi,".nw E.L.DISEASE-POLICY LIMIT $500,000
DESCHIP I PON OP OPERA I IONS/LOCAI IONS/VFHICL:S(AtUch ACOKD 101,Additional Hamarks Schadula,If morn space Is raqulrad)
Insurance coverage is limited to the terms, conditions,exclusions,other limitations and endorsements.
Nothing contained in the certificate of insurance shall be deemed to have altered, waived,or extended the
coverage provided by the policy provisions.
CERTIFICATE HOLDER CANCELLATION
Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
367 Main Street ACCORDANCE WITH THE .POLICY PROVISIONS.
Hyannis, MA 02601
AU I HOKILED KEFKESEN I A I IVE
@ 1988-2010 ACORD CORPORATION.All rights reserved.
ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S1205551M120554 EAM
• t
= t
'�OME . IMPROVEMENT CONTRACTORS REGISTRATION t
;. Board of Building Regulations and Standards t
-One Ashburton Place - Room 1301 t
I
'Boston, t•tassachusetts 02106 t
'Ci'c IMPROVEMENT CONTRACTOR -�'--------------------------------
t
ecstratiort 100740 Expiration 06/23•/98
iy?e - PRIVATE CORPORATION
' � •� HOME Ih°ROYE:!EV C?YT2ACT0R
- F �� Re;ist:ratiat I0e7a0
CAPIZZI HOME IMPROVEMENT, INC. I i;pe - FRIYATE CORPORAT.py
Thomas Capizzi , Sr . : UpiraLiaa 46l3/98
1645 Newton Rd . I
Cot-Ui t MA 02635 t CAP.ILT HOME L".FMYUDT, IHC
I Cotutt (!A O_b__
i
t;:'x=w:- .,"_ :r DCPARTHCNT
ONE A5(4130 t
-; = CiOSTUN,
'kUC_i.-iQW-,SUPERVISOR LICENSC
Expires: _ •
-
Lcted: IU: lUU
�ScGIIRIT:Y:?���: 030-5a- •d 9d�_��'•_�{. .. . ' . . ' .. .. • - - ..
St1
The Conlntonwealth of'Mactiachusctts
DepartnicntoflndustrialAccidents
i Office nflnvesfigations
600 WashiirA•ton Street
Boston,Ma.u. 02111
Workers'Compensation Insurance Affidavit
r.: ePR —��i 1:,,f..,...._- �., ., ;-•_.—:_�--- —
am • / Z = Lt2r7yJGY��
location:
citN Ci077//i— , ��G 33 phone yL,Y!7rl
I am a homeowner performing all work myself.
I am a sole proprietor and have no one working in any capacii
`' _
1 am an employer providing workers' compensation for my employees working on this job.
comnanv name:
address:
city:
• s— r
insur•nce co
I am a sole proprietor, general contractor,or homeowner(circle one) and have hired the contractors listed below who have
the following workers' compensation polices:
comnanv name:
address:
cirv- phone#•
insurance co. Polio,#
comnanv name:
address: -
-
citv: phone 9-
insurance co. polio."
t?\ttach aJdtttonal sheet tf nccessa .w c�-:n::-:�.::c�>-;�<;�:r,`�„�,r�;;_:...�'`-"":',^.,^,,,-." T-`""•" --�--T--r-i
_.. _.-- -- _�.:..�y^""^ __,emu_ _ -���.y�+:�_ '+� '�%-�<fs. is�dw.-�.lr ����...s:�..c'ri•�_..
Failure t—o secure..— covera._... -,c as required under Section 25A of dICL 152 can lead to the imposition c•:criminal penalties ora Gne up to SI.a00.00 and/or
one years*imprisonment as well as civil penalties in the form of a STOP N1.ORK ORDER and a Fite of Sl00.00 a day against me. I understand that a
copy of this statement may be ronvarded to the OMcc of I nvesti-a tians of the D'IA for covcra-e VH-fication.
I(to hereha•certifi•turd• ;I=fgins and Jtallies of perjury that the information provided e:ovc is true and correct.
Si:nature
13_tc
Print name i /�— l Fhone'I'
official use unh_ do not write in this area to he completed by eih or town official
cin-or town: crmiNiccnsc
P r ,3uilding Department
' QLicensin-,Board
C]check if immediate response is required C]5dectmen's Office
0I1calth Department
contact person: phone t (Other
(recced3 PJAI - - - --- - -
°F SHE
The Town of Barnstable
• a
• BARNnABIZ •
Department of Health Safety and Environmental Services
lFD nn►'�" Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
For office use only
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization,
conversion, improvement, removal, demolition, or construction of an addition to any pre-existing
owner occupied building containing at least one but not more than four dwelling units or to
structures which are adjacent to such residence or building be done by registered contractors, with
certain exceptions,along with other requirements.
!r
Type of Work. l '96 efrg2,9,C Est.Cost . 0,0y
Address of Work: 2O VA�Zt !�
Owner's Namei�J� 17�G�!3
Date of Permit Application:
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job under$1,000.
Building not owner-occupied
Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
1-10-197
Date ontrajto! N me Registration No.
OR
Date Owner's Name
Engineering Dept. (3rd floor) Map 2 S—/ Parcel .2/Z Permit# ,5;20 `11?7
House# 7o Zelv Date Issued 3 '9
Board of Health(3rd floor)(8:15 -9:30/1:00-4:30-)
Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) j� SYSTEMMV�j Be
Planning Dept.(1st floor/School Admin. Bldg.)
Defi e n Approved by Planning Board 19
TOWN � 9� • �AND
TOWN OF BARNSTABLE
Building Permit Application
Project Street Address
Village
Owner Address 7D
Telephone
Permit Request t.✓ Ld� 6 „'
First Floor square feet Second Floor square feet
Construction Type
Estimated Project Cost $ !Z CID
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House ❑Yes I�o On Old King's Highway ❑Yes 21N/o
Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing New Half: Existing New
No.of Bedrooms: Existing New
Total Room Count(not including baths): Existing New First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other
Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
❑None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes I"No If yes, site plan review#
Current Use Proposed Use
/ Builder Information
Name L /��/ ✓f�. Telephone Number
Address ,�r' i% License# Q,51-9 J2 Z
A- azz,/ �''J Home Improvement Contractor# /®O 741 a
7-4 I �j' '725/- D Worker's Compensation# 41,e�ffeV JJ4*�;
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
• SIGNATURE DATE
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
FOR OFFICIAL USE ONLY
a r
PERMIT NO. 2z
DATE ISSUED
r
MAP/PARCEL NO.
t
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING OUGH FINAL
GAS: OGH FINAL
FINAL B
DATE CLOS' .,
ASSOCIATI " ANC