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0031 HARVEST LANE
_3j j�igVI s L � �� 31 '�✓�� � � Town of Barnstable Building �� Post This�Card So That rt is:VisibleFrom the'Street Approved=Plans-Must be'Retamed ort Job and�;th�s Card,Must be Kept� � � - anxxsrwetB, �_ b `� Posted UntlFinal Inspection Has Bee°n¢Made� � ��'a 4 � � �� � ,,� Permit a Where�Certificate:of Occuypacys Required,such Building shall Not'be Occupied until�Fnallnspectiohas been made a Permit No. B-17-3394 Applicant Name: SHORELINE POOLS INC Approvals Date Issued: 10/18/2017 Current Use: Structure Permit Type: Building-Pool-Inground Expiration Date: 04/18/2018 Foundation: Location: 31 HARVEST LANE,CENTERVILLE Map/Lot: 2097067-001 Zoning District: RC Sheathing: Owner on Record: DAVIDSON,WILLIAM G&KATHLEEN R Contractor:Name'' SHORELINE POOLS INC Framing: 1 Address: 351 MANNING STREET # Contractor License 161240. 2 NEEDHAM, MA 02492 k Est�Pro�ect Cost: $75,000.00 Chimney: Description: Install Private Inground Pool/Spa.with ASTM Safidty Cover and Pool Permit Fee: $175.00 Code Fencing.4'aluminum fence enclosure per swimming pool fiz Insulation: enclosure code Fee Paid $ 175.00 Date 10/18/2017 . Final Project.Review Req: Plumbing/Gas A, _.. _ Rough Plumbing: - Building Official Final Plumbing: Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this Permit is commenced within six,months.after;ssuance. g All work authorized by this permit shall conform to the approved application and the;epproved construction documentsfor whichthis permit has been granted. All construction,alterations and changes of use of any building and st uctures shall be in compliance with the local zoning by a�ws'and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or'road and shall be maintained open four public mspectJon for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing ,... . . .. . .,d. . r 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 - I 1 y — TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 3 Map Parcel Application q Health Division Date Issued®0 l8 l?�2,G(&` Conservation Division •� Application Fee Planning Dept. Perrmit Fee C ` Date Definitive Plan Approved by Planning Board �` "► Historic - OKH Preservation/ Hyannis '?'' l/ — O � 0 Project Street Address 3_ 4. Village &AaNS�' Owner B%CLL, Address :?I L 4^14_::, Telephone 7 1;1 32-7 Permit Request ,W!2f C .E--J6 2GX'%k6 S P- �`� vI V � uM �eper co Square feet: 1 st floo . existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 7s,ODD Construction Type Lot:Size _�.D S A-C 2G52'5 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: GYGas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑existing Uk**new size — Barn: ❑existing ❑ new size— Attached garage: ❑existing ❑ new size —Shed: ❑ existing ❑ new size — Other: Z0 IX t/S' l Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ClkxS ?.T'r2 H 0 Telephone Number ,5W— 92 2-39q� Address ZaZ &k�e`' �4�'''�F �� License# 1Zy4!:p Home Improvement Contractor# Email CW_rs 2 S rr6a�►EA."Ots zJC_ CoAl Worker's Compensation # WV 6132S 2 g (o -'BALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE . DATE �• FOR OFFICIAL USE ONLY .APPLICATION # i DATE ISSUED t> MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: rl FOUNDATION FRAME INSULATION FIREPLACE d-Q ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL f FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. - r .w table Regumtor cm :,Ces RAM i Eft . Prop eadw -� -- wown..:: 5sto. ' d € rq- - ,&Maud= :} a nvpebmit . . kA 43 LA **Pod _ th.C7 map Or- %"A 71L&�LW , 0 g_ USS 11e s® es�..: - j' •Mogaetttaify tr�gered Ootc�n� •Koy,luchable sotety ltir tnodi Y ' %Adjusts horuont y cndvenccgy na •Patented:,"Lost tWahon!Technology a� *®u1ck and easy to nistoll . .,tv day (aow vnth conve>iiemt sa drillang sae�+sl aroter edrncote. all . 10LNABlf ,�� � •Pato�tmagnaUseH loth ,y Ng med�iwl(ommmg dares } •bsce0dsa&er�tidnclborrDO mtetyaW pntademwreGcbd+ $safety ' � ' � _ •Aut�tiR+ia>�I�palyregs fl slaa�tess steel`�Nv ruslat�,61�ing ar 9a `` lackalda{Tap PuH 8 vertwd Petit rddtsotaly and Baca of ? 1 �.Uookty Asmrorioe 150 4001 mangiadurer Gfarsma%dints' �' •En9ina for ease of mstaNat�oo Redrted autalbhcp time tcasts3 t 1 Lahltes 3n 1he"lodied"khan`: fatepfmnal mR 4 rehab ow ag`I rt ngoga from sbokmg&P&MO Gai'1 ba forced open •Unp ered"d adryna�ilily ' Easy to rnstall andfitnmaaa •tested to A00000 rydas PrO to tot l VICt e1tans a ',t�{t:$Oi�_8li�tp � n Rt&t1°A01 atratsatP ` ra�can, �� kart ,;urt�s� ro��° r.rsart.� r�a�e.aa wv,i{fv 1 t !•#A�t�A•iaiT PSafetn Gnit Lalth s my a mslat revolutiyna,v bmkkihmut h in, to Ing5 tiuniy rm " gnleg around swimmuig paam jipmcs and chid a snrctysreac Pnwcrcd t v super ztritng Acrmanent Aaa[inets' " uhichnzrcrta<ctxiwer ttusequai,ytatchrsifrur ate, w r Ito meclwit,tal,nuirfcrw,ex to rinsum andsgotter [[ unpre icmedml'utbhty .§hietyacidclntd :i a rQ5is1unC4. : t •YlHtifAL Pit®u�9 Tha papilar Tap Auif insul�l fn desy;heat i"etr aria :aoieR aspt.rially Iarsuimnti++e p0tti g5trs t7ut s<rort Lam:: futrd to n}gt k where chtltl sttfelti is imponant Thr ahancr 4rmcat th.A murkt s,.ctomriki4d tc2ryalesal leas;s(ISmg tall.This madei isafao l kflow"-nsIbe`pel_tanrh,cmit prim des,c Cprpri Sage[?s��it• #IGi IWL ¢p all latches adapt audit}to rna C,iesS ar eziating a°d+l F gaftisa9 any gate Inaien�Lfisa.madrlsarc�ey ttmkuble for added safcir T iaWst c e*. lutrlk�ran>zeadattsicat it`trm/4-in ninatlt,inen3urrsafe teliahlc latching at ratty time dunng in otter utalluuan Vemical admatment is qultt sad esg lwusr the 4tA6NA+L9llNlms&eh sYS la[rh badyxhdrz up atld dawn dovetati scytc tracka I�ieitlomara!toot fareabrr.an,rdrarnistaltauOn � Q�ryd j l F„�onsonial tus_tinet�rtsaehkSedb}adlash+n5a ice : � ` ssmn withmihe Sir�kerHod egauagatestol� r y'sCEU�ithe�Viker [�asr .: can be uljusied acroas.gutr ranging Cramp's 9'Yt sdldasiag aalselfldl+ng fi kfrthhim, # (4 37tnie b tifeugtcdtaid000nAe4Agw ( Tlte.. �, mrzdtis proMide+tua nnpatt taeetshMlalemot�tml��elyttales. rt�iStar,csarnl duiirbilt}^on larger gali5 apd aIS, ..against,heavypt+deStnan trai is The*kaimtt R,stAd,{am The kit tnnWdes adapau M/R!! iif lf+tfFlLtd r Kn i an t�ft�xll lui lttr tvskcnml,hm to it]root N'�R['�ij� irgl.i.i#1 mtmitt7n¢Rragnof.u(rhimmnnriinlrairaadtaHinhr Tap P ll ar t4 4r f Inlsi d amth rr -Pet�eurity : Gate latch rya htunalpa& also suitab far haus and garden#dlc s aherc i ptl vcunly,and pet s 3' c acrc�sconunlnne a r,� i Pr84Y4hJI �lINjt jowtyaadke - 1'an QltinMm It.a?"Safi ta.trinS.Ss-C m9'+Ia,li}tatai tl�tt,ialehomcnmaBeda rues�;: t alt 3l9eeenl t lsmm)i c Laioanh 1 :+(d +tmuai .k: tr4'Cf1s'"GL§Yhb'(fNt�t6tl.�&{e3t�,6.i�62a'�'Pj'{t i�l.�( LOA amf A— Z .141 E a _ � : = Qunk and ea3y installation.: '� � log a+ r _rib r o l�Fa � INSTALLATION REQUIREMENTS SAfETT NOTE (Fop Pa9 t.Yertiml Pdl moddel � k " , a; Alhlym 1 Fit wk ft pinland eiger om t god aroNtfro*[odmandSta�r� ,z ��dncvedro �YdiehBowi�regrea�eslx x e F fs •Tlm pool:gate west opcn CQJW aeeaY trim Nro Pat is the btdE aarst $ � � se lfim AregmeEaminzs ro z be Atted to the wt of tfie 9QQt Bcle s _ °� tdhE sdMosaapd `' •T6e I ;t�eose knab h to be m{ao#t �§ �� 60'ItSDQolmt`a6orsl'�isltedgro>md'_ s Fau;fieEg6t to 5a iRiallAOED 48 i IlT00mnilohavet'misheLgra�tnd E �, � �.� 1� '� � b A.6m 1 nYmu EEesx r"wantems w lt� _ F, eppto{eiatekeallm�orsaTryah^3ia; Yaw arearegulmk s rmY i>etaH Ika lcr Imd+In otrsrnce etlfi femat . a i ` C� kaatapr�o • pq" aert"Pd model " sfi .RWV4�6�aR/atpQryvse Aemef�''t-ant4��T� 4 C p •-ylVk `"�'��- i> cxTAef�}9��O�+D�e��Alsn��rififar' i s>o��. 1�"" � �a�s mo�u)dwkmrsa�gur�a• FIe to orb vm�eM i �• a � ! e4am•f.�y_ etm���adR ; aa�� f► ,#. vHiaiamdm�p�kd3igfesmmmh�vwlutAn,cwma�+`: •, aagksl+�Imuu6aacadropreaad�mauhgtadEles: , I t 1 ( til4PS�6Ap�lSaJelp�m �,,,p � tAsk�te�nm�ifrohx'�o6P+�' t 1 modelwdtteigmeteapnn�ABlim��y r- "� i ' t�:aoendswt�engpa�n�A�lddotetPm�.Ahem s —'-J Wit--' ;arr mu�l�ilahhfmihef�kymd T 1lgkydddiettl mcymtkIIdmgtrromtc�agFmi ns6tcoiarodaswe k naa�(a�y '..;ii} .�,-'� :a�us��eh�txxtl6mfP!wiEmeaymcm�e a t mid lm�gm t�uhk pedaamoce 10a mn9 gotmmd ale motnickidml,iar�teltence �untvt� lt�cr cff�`ItSlnaiJa�are � ( �� �c Cam:btd�hslsrlp��umsmmemtm!h�Eremaus x � Cads ApQ�cWlaiu a Calm �V�I �' �� � ktiP4;M1GA^f �fd� BledyYJ�te r �+ '� - De�pAaeihemmtpa�m�roi4tthm�-4w�ed • af�k: [� SF - �Joidllaralalyg"c0.5mamdar�nmfigl�sm�d�l. '� m(arys�md�ara�as, � 1 �� M'gMpduidi�ma m�xirch�ia� ree= i,c, l taei&�bdtuiu %1a�i $ br+�' �• � �� vmi+ atJ�npa�semxacsaranir�md�nsr. PoSmdpiwdm ,als.fiengakjle®, � � 1�66�BidmdlarCE`tt , ,Jg�,t[encmmiha3 t } ma�i �dml��ae�isdnld��� : tss jl f r �t >a ',f tl�drNi; ��� � t aass�mrmlyp�l�bs. dad 4taie�lat,i 1t� jt _ � _ _ ��� �lrjaa�a1�•c�z��11�����. 1!- ���c���fcc�=u _ = a Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite-5170 Boston, Massachusetts 02116 Home Improvement-:Contractor Registration Type: - Corporation SHORELINE POOLS INC ! Registration: ist24o 202 QUEEN ANNE RD Expiration: 10/06/2018 HARWICH, MA 02645 Update Address and return card. Mark reason for change. A.1 =, .wwl �..wnnf 1-1(n�c�f`a�fi /:VIM _= Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only Type: Corporation before the expiration date. if found return to: Registration iration Office of Consumer Affairs and Business Regulation 161240 10/06/2018 10 Park Plaza-Suite 5170 Boston,MA 02116 SHORELINE POOLS,INC=_ CHRISTIAN D077RICH 202 QUEEN ANNE RD.. HARWICH,MA 0264t' Undersecretary _ Not v thout signature ACC& CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD""") 9/19/2017 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 endorsements. PRODUCER CONTACT NAME: Rogers&Gray Ins. -Dennis Branch PHONE FAX -816-2156 877 434 Rte 134 IAI E-MAIL A/c No South Dennis MA 02660 ADDREss: INSURERS AFFORDING COVERAGE NAIC# INSURER A INSURED - SHORPOO-01 - INSURER B.WeSCO Insurance Company 25011 Shoreline Pools Inc INSURER C: 202 Queen Anne Road Realty Trust INSURER D: 202 Queen Anne Road Harwich MA 02645 INSURER E: INSURER.F: - - COVERAGES CERTIFICATE NUMBER:453917568 REVISION NUMBER: . THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR - POLICY EFF POLICY EXP - LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MMIDD/YYYY A GENERAL LIABILITY 8500052096 7/26/2017 7/26/2018 EACH OCCURRENCE $1,000,000 X _ DAMAGE TO RENTED _ COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $100,000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 1-1 POLICY X PRO- LOC - $ A AUTOMOBILE LIABILITY COMBINED 9nTGrl!Tr9Tr_ 1020013830 2/972017 2/9/2018 Ea accident $1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED Ix SCHEDULED BODILY INJURY(Per accident) $ w-AUTOS AUTOS NON-OWNED - - 'PROPERTYDAMAGE X HIRED AUTOS AUTOS Per accident $ $ A X UMBRELLA LIAB OCCUR 4600052138 7/26/2017. 7/26/2018 EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS-MADE - - AGGREGATE $2,000,000 DED I X I RETENTION$10,000 $ B WORKERS COMPENSATION WWC3252946 2/10/2017 2/10/2018 X I WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N - - - I TORY LIMITS ER ANYPROPRIETOR/PARTNER/EXECUTIVE - -E.L.EACH ACCIDENT , $1,000,000 OFFICER/MEMBER EXCLUDED? [ N/A " (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Additional Insured status is included under the General Liability Coverage when required by written contract CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Bill and Kathy Davidson THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 31 Harvest Lane ACCORDANCE WITH THE POLICY PROVISIONS. Centerville MA 02645 " AU ZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD N 31 HARVEST LANE C g�AITI F-<J ►��� . j i� cs• _ 4s' ;^ L EXIST. FOUND. `.tie-- �•_ IFS� J. / J1 n� a y, ' pal6� to 1 f OWN IFIED PLOT." PLAN oN czRTis" THAT ISLOCATED OONTHE FOUNDATINSHTHE FOR GROUND AS SHOWN AND THAT IT CONFORMS LOT 5 HARVEST LANE CENTERVILLE, ,MA. TO THE MINIMUM BUILDING SETBACK REQUIREMENTS OF THE TOWN OF BARNSTABLE. PREPARED-FOR BAYSIDE BUILDING INC . �ytH OF M._ SCALE: 1" = 60' DATE: APRIL 30,2001 ?� o STEVEN W � o u m 5 h WELLER & ASSOCIATES AND 1645 FALMOUTH RD. — SUITE 4C CENTERVILLE, MA 02632 su _ (508) 775-0735 F.'n 4 . Ile Commonwealth of Vassachusetts .� Depastmvit a,f btdustrial A.ccide?ds - - Qfrce a 'Ixritigatioxu . . ' 600 Washington Street - Baston,? A 021II t ' �t�tvt�.:>F�tass_gflvfdin . NNTorkers' Campensation Insurance Affidavit:BmldersiC�6ntractarslElectricians�Plumbers ` Applicant Infan atkin / Please Print LegibIv Nana e(Sas®esstOrganizationllndi`�id�l�: �;�� �'r�c ��[-� ^� Address-- ZDZ Q.kOP-) 4^h'6 W/9-✓-.� . Are yo employer?Check the appropriate box: ' Type of project(required): - I. am a e.m lo' with 4. ❑I am a general contractor and I p � � 6_ ❑New construction , employees(full and/or pact-time)-* have lured the sub-contrac cos 2.E I am a sole proprietor orpartner- listed on the attached sheet. I ❑Remodeling. ship and have no employees Theme sub-contractors have S.,❑Demolition woddn for in any capacity it _ employees and have.worlcers' t5` g..❑Building addition jNo ttiurkrrs' camp.insurance comp_insurastmi r ed_ 5. ❑.We we a corporation and its 10-0 s Electrical repairs or addition "13-❑ I am.a homeowner doing all work officers have esercised their iL❑Plumbingrepairs or additions myself.[No workers'camp- right of exemption per MGL ` 12-❑ ofrepairs insurance required-]o c.152, §1(4h and we have no �g employees.[No workers' 13_ ther camp-insurance required_) W •rmyappEicantfat checks box fEl must also ffiooE the section bg wshawingdueirworkers'compeasatinupoliicyinformsaao- &omem merswho submit this afBda«r indicating thay are wing sllworst and.rhea him outside contractors mast submit anew affidavit indication such- fCaut<atfirs th12 checY this b ax mast attached as additional street showing the name of the stir-ccn=t rs.aad state whether at not ibase entities bane employees.Ifthesub-contractarshive enrptoyeas,they nnutpnn ide their workers'romp.policy mbar_ I a�n an sitigloy�r that is pra��ding�varkers'coirrperisahirri insurance far my employees Be£oav is iffie poHey and job sb`ir information. S _ Irisiu mce Company Name: . Pflficy,4 or Self--ins.Lic.A 4/W L 175 2-9 CI Evpiratioa Date: O Z it Job Site Address: 31 LA-JC City/Staf&2r p: ��} 6 Z�i.3 Attach a copy of the workers'compensationpolicy declaration page(showing the policy number andexpiration date).- Failure to secure coverage as requireduuder Section?.aA of MGL a 152 can lead to the imposition of airninal penalties of a fine up to$1,50D.OD anWor one-year m4msonmenk as well as civil penalties.in the fom of a STOP WORK ORDERand a time of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Iestgatians of the D4 for inset an covferage v-ecsficm I dro her.Rby ccerfif,ander t i n 's fp ry'that a inronnaffimprmiffed abotIff is s an correct Signature: Date / Phone Official use only. Du not write in this area,to be cainp£etesd by city artonm a,fjactat City or Town: Permit/License;9 Issuing Authority(tile one): 1.Board of Health-2.l uRding Department 3.CitylTovm Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other` Contact Person: Phone#: InforMation. and lastructious Massachusetts General Laws chapter 152 requires all employers to provide woli='compensation for their Employ6es- purmantto this statutp,an arpLuyae is defined as_"..every person in the service of another under any contract of line, express or implied,oral or wrifirn." An ernplayer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint entmpiise,and inch ding the legal representatives of a deceased employer,or the receiver or trustee of an individnal,partnership,association or other Iegal entity,employing employees. However the owner of a dwellinghorse havingnotmore thm tbr'ee aparfineats andwho resides.flimcia,or tho occupant ofthe - dwelling house of another who employs pets=,to do mafiftumce,construction or repair woik on such dwelling house or on the grounds or building app nzattjiereto shall not because of such employment be deemed t o be an employer." MGL chapter 152,§25C(t7 also sides that"every state or IocaI licensing agency shall withhold ffie issuance or renewal of a license or permit to operate a business or to contract i)ufldmgs in the commonwealth for any applicant who has not produced acceptable evidence,of compliance with the insurance.coverage req=ed." Additionally,MGL chapter 152, §25CM sfiates-Ntither the commonwealth nor airy of ifs political subdivisions shall enter MtD any,contract for the perfo=o=M ofpubhr,wotic uatol acceptable evidence of compliance with the insurance._ req�meats of Bois chapterhave beenpresentedtD the confracting anfhDaty_" 3 '` Applicants �k Please fa oil the woikms'compensation affidavit completely,by chec;® ffie boxes that apply to your sifnation and,if necessary,supply sub-onfracter(s)name(s), address(es)and phone numbers) alongwith their cmfficate(s)of h,entrance. Limited Liability Companies(LLC)or Limited Liability-Pa tamships(LLP)with no employees other than the members or panders,are not reTu to cauy wormers' compensation insurance. If an LLC or LLP does have employees,a policy is required.. Be advised that thus aflzda:vk may be submitted to the Departmmt of Inds-s dal Accidents for confamation ofiner nce coverage Also he sure to sign and date-the affidavit. The affidavitshould be-r$tmnned to;he city or town that the application for the permit or license is being r-,quested,not the Department of . ions time law or if on.are to obtain a workers' Ti�rh�efriaT Accmden�.s. Shouldyonbave any quesh g Y req�d r co aeries should enter their o pelf-insured at the numb er li_sted Wow.afon oh lease call the D arum out mP co ens �y, eP m.P P P s elf-insarace license number on the appropriate line. City or Town Oflzcials f - Please be sine f -at the affidavit is complete and pried legibly. '7he Department has provided a space at the bottom 0 you to fill out in tiro event the Office of Investigations has to coznact you regarding the applicant of time affidavit for - P lease b e sure to fill.in the pemzitlri umber which.will be en used as a referce number. In addition, an applicant that must submit multiple pennitiUcense applications in any given year,need only submit one affidavit indicating r-.rn e t u olicv in' nation(if necessary)and under"Job Site Address"the applicant shoT�Id W e"aII locators n ( Y or _� ed or marked b the or tows maybe rove ded to the town)-"A co of the-affidavit, be n officially stamp Y �y P PY der ' must b e filed out each e frtnre' ermifs or hcenses Anew affi vrt applicant as prooflhat a valid affidavit is on ffi for p. ,, year.Where a home owner or citizen is obtaining a license or permit not related to'any business or commercial vent n-e Y affida t i_e_ a dog license or pemnit to burn leaves ern.)said person is I�IQT requrred m complete this Yz ( The Of of Investigations would hke to thank you in.advance for your cooperation and should you have any q•estions, please do not hesitate to give us a call The Department's address,telephone and fax number:. T1L-C�D.Mmca th of Massach tts j :a Ilepat tmmt of Iliclustdal Acfcz� n `� 600 washiizon S A Bastua.,MA Rill T6L 4 617` 7-4900 Qxt 4-06 Gr 1-9 MAS AFE Fax#617`27-7M Revised 4-24-07 p � s Swim' CtearM #Y — d MULTI—ELEMENTc =; CARTRIDGE FILTERS $; _ z High performance. Operational,convenience. 3 Hayward®SwimClear reaches new horizons in cartridge filter technology. Industry-leading hydraulic performance with maximum flow through all cartridge elements vaa a top manifold configuration ensures superior water clarity, extended time between maintenance and maximum:energy savings.A cluster of reusable polyester cartridge elements :: x provides a choice of 225,325,425,525 and now 700 square feet of heavy-duty, dirt-holding capacity andzextra- long filter cycles.SwimClear filter tanks are made from a _ reinforced co-polymer material for the ultimate in strength rPWA o durability and long life-even for the toughest applications r ° and environmental conditions Discover the crystal clear `` a results and reliable performance of SwimClear by Hayward; `� L4 the first choice of poolyprofesslonals g . .7 s -, x-s y x , r� , 1 ' -tc ti c > `"k * s +� h a at �1: k�a � ' �• �- -„..,: - r ', ,.+ti u3 � - a C4.�4. A � n '�'r 7 '�� �$ k7t•e� s� Ufa: z -y � � _ r W 1 jh mu.. _s...ax:ayrt x S Y�.,t'".w°`' ,''�U c+u .«mum is+t ,,,V c. tr ..:�` xr `c**..a� '•^' -.., f'x ::1, iY+' ,.sw'q "` .'.'d. Y a `� ii2r7•��®= -x.-xz "'�-a"'.^be- vx,..c,ga �.. � '.s';:+"s.�:w. axe. * r*�^ ".�� ,..y.. '-�+�:,.•�.- Y,- - .• �,—,gym-^.. r' X FLeI i of Combination Pressure and aP ac ity, rapid release valve Cleaning-Cycle-Indicator Gauge quick quarterturn � } air with a q gives visual indication when cartridge filter elements need cleaning. ne industry Is best energy-saving hydraulic I; I Cartridge Elements 3 jCe and utilizes the entire cartridge I, provide 225,325,425,525 or(the intlustry's •ea to maximize time between cleaning. I largest)700 ft2 of filter area and extra ,ty, Tamper-Proof, One-Piece Clamp dirt-holding capacity for long filter cycles. s Precision-engineered core provides extra ;antens tanI< top and bottom together ins =- g strength and superior flow. is q u i cK access to all internal nts without disturbing piping or f, Self-Aligned Tank Top and Bottom ins_ make servicing cartridge elements en gtlh Filter Tank n quick and easy. from durable, glass-reinforced Ir; ler to meet the demands of the llll Il�r L apPlications and environmental II CPVC Union Coupling Connection in cleaning systems. provides options of 2"or 2%2 ns, including ` . plumbing with 2"full flow l Low-Profile Tank Base Design u internal plumbing for maximum -ern oval of cartridge - hydraulic performance, Its fast and simple. ,e -� �/2' Integral Drain �a" - _. n Noryl®Bulkhead Fittings ,s fast clean-out and flushing. provide extra strength and heat resistance. Cartridge elements: TYPE 225,325,425,and 525 ftA2(4 cartridge elements) 700 ftA2(8 cartridge elements) CPVC Union \\ # Connections � . Strength Inieetlon Molded durable glass reinforced copolymer TAN4CT ` ELEMENT Reinforced polyester >. �RMp;NCE RANGE , 8,4 to 150 GPM 31,8 to 568 GPM C2030 24"W x 32%2"H(58 cm x 81 cm) Pressure and C3030-24"W x 34%2"H(58 cm x 87 cm) °- Cleaning Gauge NSI O N S C4030-24"W x 40 th"H(58 cm x 102 cm) C5030-24"W x 461h"H(58 cm x 117 cm) C7030-24"W x 52 th"H(58 cm x 134 cm) contains eight(8)cartridge elements r r :`TURNOVER " \ \\\ EFFECTIVE FILTRATION AREA DESIGN FLOW RATE* MODEL a ¢} ,GALLONS 4 KILOLITERS SUM BER a ft2 m2 GPM LPM 8 hrs. 10 hrs. 8 hrs. 10 hrs. "``"'- 225 20.9 84* 318 40,320 50,400 153 191 C203O C303O 325 30.2 122* 462 58,560 73,200 222 277 C4030 . 425 39.5 150** 568 72,000 90,000 273 341 C5O30 525 48.8 150** 568 72,000 90,000 273 341 700 65.0 150** 568 72,000 90,000 273 341 C7O30 -ad on NSF recommended rate for commercial use at.375 GPAI -term in ad by pump size and piping system hydraulics;2"piping is recommended for flow rates equal to or greater than 90 GPM(341{PM).Hayward doesn't recommend flow rates above 150 GPM. To take a closer look at other Hayward products,go to ,Clear Filters are listed by: Nsf. hayward.com or call 1-888-HAYWARD. and an d Hayward Energy solutlons are registered trademarks ,mClear isatrademarkof Hayward thertrIndustries,emarkInc. HA AR®© rt5 Hayward Industries,Inc.All other trademarks not (�._�_ � d by H ayward are the property of their respective owners. llrSWC16 ,ard is not affiliated with or endorsed by those third parties. • - • ••T RISTAR"WAT E R FALL PUMP HIGH-PERFORMANCE PUMP SERIES F .'Gt'z�`t,_{.'_.�. _- _. A s. :rAa,.ks" ..�, •. . .--ks�* „s.. �c.� -- '. _ .� � %a:.s.:.;w- .a .�. .". .�.�,.:�s,�'': �., a�' s�'� .. �..d:.:.: - r `y Z i? e ,Spectacularly quiet, y powerful & energy efficient. -- Waterfalls are truly one of nature's most impressive feats, even the small ones. The shimmering cascade of water over rock is at once exciting and soothing. It's no Pumps , . wonder backyard versions are so popular. Tt Our new low-head/high-flow TriStar Waterfall Pumps Filters are specifically designed for large-volume waterfall and negative-edge applications. Offered in two sizes, Heaters 75 gpm and 120 gpm, they run 60/ quieter and use 60% less electricity than standard single-speed pumps. Heat Pumps _ � p "S tar Cleaners Lighting Controls Electronic Chlorine Generators { Total System NewTriStar Waterfall Pump = • Designed specifically for waterfalls and negative-edge applications • Runs 60% quieter and uses 60% less electricity than a standard single-speed pump w • Made for in-ground waterfalls that require low head applications and 75 or 120 gallons per minute • Features heavy-duty, high-performance, energy-efficient motor and pump technology • Airflow ventilation for quieter, cooler operation • Motor is desert-rated to operate in temperatures TV,#- tarTM up to 140°F MODELP O 1 OF HEAD) FULL RATED • Easy to install, service and maintain ' SP36075EE 83 63 1 47 - - • Supersize basket with extra leaf-holding _ SP36120EE ll0 97 79 41 capacity extends time between cleanings • Exclusive no-rib design ensures easy debris removal SP36075EE 75 ll5/206/230 2x21/2 131/s 1 50! • See-through strainer cover shows when basket SP36120EE 120 115/208/230 2x21/2 131/e 1 SO lbs. needs emptying 114I 10.20 • Exclusive Tri-lock strainer cover seals with just a 1/4 turn • Test feature allows line pressure test to 1636 50 PSI maximum _ 1092 • All components are molded of corrosion-proof reinforced thermoplastic for extra durability 1051� 16.92 _I and long life (IAD WIDE • Tall mounting base provides dry, stable, 30.0 stress-free support 25.0 • Heat-resistant, industrial-size ceramic seal ,°.° d • Rugged one-piece housing with 2"x 2.5" ports ; C 15.0 • Service-ease design provides unimpeded access to all internal parts 0 5.0 S1136075EE SP36120EE NSFL 0.0 10.0 30.0 SOA 70.0 90.0 110.0 130.0 150.0 0 Flow(gpm) Non-self-priming pump. www.haywardnet.com HAYWARD®Pool Products �®Zo6Haywad'd�st�°�.P841011/0�e»°ema °'""TeD"'Inc. 1-888-HAYWARD One source. Every pool. UUSWM6 f — •� { �:z+ k 'rye �} � �x'aa �,�u.� R �, � P '�$�, � s'k #e:m ,, �'; � �.- may. "��. �: k 3 f A IN - Gr �(^y' -�_[y�,. dk'� t45 - a s Mir kW- „� -fit,,' •' '�* fir"'� v��'�f� ' � .� ° °�_ � .''� y •� T Y LY-3r •:t ` �!. 'ice`* ,t�� a-`�.Yet • ;,r... E4`� rs- p,' ztoo r aU `- v w ; Topguide Ls � x �"� i � � : ,.p 7°�Y }"6 m§�e'�� � `tee. ��..r f t} ,+y� ,'' �• _- �q,..t� �>-. 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'dr '" 4 -•�♦. I/ I I- - I -iN*v,. n• � `„ CO -+� �.-zz��a; r�,p,4'i � �-,at"f` ,.xw.� � 4 ,� ,�.,��,,• T k �r ..p., -"�„n .k r y�'k ��k, y"`7' Yr -C'-° rs r I •$ I/ r r r 1 _..y� "� r .r� r I I - I •r �� �.c � .:«, �s r«�,�u'e, r �, ��'r�'.FI as��� �` � �� t •• `� '£ r s I I r- w �' r`i:, -, "t .ray . �j,��a,a �:L- ��, -�' '�� " a�J� Ads*k. Ary��*�'�;,.�, °•°�°�,,:' '�'`'��x+ �^ � � � � � '°' •�a �,f >< �� � w.a,�,,.. �� ,�.�� =+S �ks� .r..d�,,� r�� �. �'sF<� .,,`.,.. ..�r: s'` -®I r 'I r r a ;�r..,3s_,, ,. «x p Z �Pv Aram R � y : - x ... Y z • ... tsh"-�+ :.. _if 4,., -� - � _ !s; �'ki �tSE+<ra'' ��'� 'r »r.� �. :t`a a. .fit � � - _ .;,-.. .+•_.�'a. ," �-..�- xra.. d.: '�s"- r r I r S � . x' �....�"`�t E .,i r* - 7' - r'•' I ', , I r �' .,h rw s 7 1 44 Ea �+ `Ih.Y , r e• r '��x.: ,q5"�k": }` � 'r �a. ��sy t.K `F,i i_. � 4 fr T��:t•< *�yz�s :.r�' .•1•S#7,�1 � �+i, i. r - n , V i Inspection Report — Building Department Date Address 4wusr— Referred By U i yyf1 111i poi co m f Purpose of Call/Inspection Reported to Site with Observations & Notes 6n 2L,1f6 0 it -J� ll w�� l ti� �No. Fee A�w �3CS `THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes ►Y!`/ PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,, MASSACHUSETTS zlpprtralion or . igpo aY 7AII g n�AWCt. u�ction Permit 1 Application for 3,Yermit to C6nstruct'� _ Repair rjraBean onplete System ❑Individual Components Location Address or Lot No. S t-Td "d&a/? Owner',,Name,Addres�l.Np. -7 77/" eQ 1116 Assessor's Map/Parcel Installer's Name,Address,and Tel..No. , Designer's Name,Address and Tel.No. ' 31.E- 4Y7y Type of Building: ' Dwelling - No.of Bedrooms Lot Sizes F /3� sq.ft. Garbage Grinder(�� Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures G Design Flow d gallons per day. Calculated daily flow zlic/d gallons. Plan Date /?- — qjumber f sh�ef is �� �,,R/eevvii�sion Date Title 5 T R r 66 Ad �/J-( 'f�CL/ ice`rx{' Size of Septic Tank / " Type of S.A.S. Description of Soil 6 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees nsure e construction and mai to ance of the afore described on-site sewage disposal system in accordance with the prVvisions of Title viro en ode and not to place the system in operation ul a Ce 'fi- cate of Compliance h 6 b issued by t ' f H ' ned Date ' Application Approved by Date—-- �3-e Application Disapproved for the following reasons Permit No. Q i! Date Issued 6 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CATTY,that t e On-site Sewage Disposal System Constructed( KRepaired( )Upiaded( ) Abando ed )by C at YV4 5 f1, /3 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. !V!a d,00 dated'//. Installer Designer t The issuance of this permit si t,all be construed as a guarantee that the syste ll fu votesigne Date ` Inspector ---------------------------------------- No. Fee THE COMMONWEALTH OF MASSACHUSETTS - PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS Zigpogar bpgtem Congtruction Permit Permission is hereby g anted to Construct( l/�Re air( )U grade( )Abandon( ) System located at and as described in the above Application'fdDispbsal�ystdm Construction Permit.The applicant recognizes his/her duty to .- comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this p t. Date: 7 D Approved by TOWN OF BARNSTABLE.BUILDING PERMIT APPLICATION ANMap Parcel r 0 Q Application # Health Division '-Date Issued Conservation Division Application Fee Planning Dept. - Permit Fee > Date Definitive Plan Approved by Planning Board Ae 0�11,zJ (o/2- fb` Historic - OKH _ Preservation / Hyannis Project Stre t Address Y I ct y # Village Owner n Address. Telephone �•Z� '1 307-- Permit Request Q-" Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay YProject Valuation fa Construction Type Lot Size I_I� 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) _Q&9 Number of Baths: Full: existing new Half: existing mow . �4 Number of Bedrooms: existing new Total Room Count (not including baths): existing new First Floor Room Count) L Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑ Other -A '.9 Central Air: X 12 Yes ❑ No Fireplaces: Existing New Existing woogcoal stove: Us ❑ No a:D i-M Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing 'L] new size_ Attached garage:X existing ❑ new size —Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑JYes No If yes, site plan review# Current Use 4JI, n����11� _ __ - -:Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 1 Telephone Number � �U � Address �UI J C il, i� y�. 1,�. License # 09- Home Improvement Contractor# . Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING F OM THIS PROJ CT WILL BE TAKEN TO SIGNATURE SATE �i ,t FOR OFFICIAL USE ONLY APPLICATION# _:.DATE ISSUED_-:' c DA a=•;MAP./PARCEL NO.--'---' ADDRESSJ- - VILLAGE -- OWNER i : y DATE OF INSPECTION: r 1*`;FOUNDATION � r FRAME '�INSULATIONJ� - ��� 7�t 3' FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH q w, _.j*• FINAL C a FINALwBUILDING�_ �± to � 3. 9' �9$�►3 V'Kil3 - ` A"DATE CLOSED;_O. ASSOCIATION PLAN NO.; The Commonwealth`ofMassachusetts Department of 1iidustriiil Accidents., Office,of InO6 igations 600 Was htngfon Street • Boston MAV2111 www.mass.gov%dia z Workers' Compensation Insurance Affidavit. Builders/Contractors/Electricians/Plumbers Applicant Information rl�q Please Print Le iblName (Business/Organization/individual): � .(i{a ! � I Address: City/State/Zip: Zr��r° . NA QW1� Phone#: ��� ` ' f Are you an employer? Check the ppropriate box: Type of project(required): l. I am a employer with 4. ❑ l am a general contractor and I New construction employees (full and/or part-time).* have hired the sub- 6. contractors ❑ 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees and have workers' y9. ❑.Building addition [No workers' comp. insurance comp. insurance. required.] 5. oration and its 10.❑ Electrical repairs or additions ❑ We are a corporation 3.❑ l am a homeowner doing all work officers have exercised their 1 l.❑ Plumbing repairs or additions mysefE [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152,§1(4),and we have no }- employees. [No workers' 13. Other- 1 � comp. insurance required.] *Any applicant that checks box#1 must.also till out the section below showing their workers'compensation policy inforniation. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.' *Contractors 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. yin `l Insurance Company Name: ow Policy#or Self ins. Lic. #:W01- y -110 Expiration Date: Job Site Address: City/State/Zip. � ; 07, �2,, 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$1,500.00 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 D1A for insurance coverage verification. I do hereby ertify«n fer t painsf and penalties of perjury that the information provided above is true and correct. Signature• ,c Date: Phone#: "Jy7-���p lU Official use only. Do not write in this area, to be completed by city or town officic►l. 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#: i Ac o� CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDNM) `...•-� 06/29/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR,ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Germani Insurance Agency aHOON E , 508 428-9194 a/c No: 508 428-3068 908 Main Street E-MAIL Osterville,MA 02655 D INSURERS AFFORDING COVERAGE NAIC A INSURERA:SAFETY INS CO - INSURED INSURER B Scott Peacock Building&Remodelling,Inc. P.O.BOX 171 INSURERC:. Osterville,MA 02655 INSURERD: Commerce&Industry Ins.Co. 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. IN SR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS POLICY NUMBER MM/DDIYYYY MM/DD/YYYY A GENERAL LIABILITY CP00001152 7/5/2011 7/5/2013 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL 1,ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 17 POLICY F PRO- LOC $ AUTOMOBILE LIABILITY Ee eBcINED SINGLE LIMIT ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE` $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ D WORKERS COMPENSATION WC 005-81-5464 6/22/2012 6/22/2013 WC STATU- OTH- AND EMPLOYERS'LIABILITY Y I N TORY LIMITS I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT - $ - 100,000 OFFICER/MEMBER EXCLUDED? F—] NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEd$ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Scott Peacock Building&Remodeling,Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL ,.8E DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fax#508-428-7625 Scott_Peacock@verizon.net AUTHORIZED REPRESENTATIVE - ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD r - UMassachusetts-Department of Public,Safety Board of Building Regulations and Standards Construction Supervisor -License: CS-094500 JAMES S PEACO!'K PO BOX 171 r�'1 OSTEVILLE MA,02G32ig{ M ✓..�.� J1gc, '" Expiration Commissioner 07/22/2014 I c%/r,`/f'niirurrirrrr'rr�/�r, n orrce„rC111151111111.Artiaias&Busi less Reguj,11[ioo`� License or registration valid for in ' -, it L F 0ME IMPROVEMENT CONTRACTOR dividul use only egistration: before the expiration date. If found return to: 151853 Type: Office of Consumer Affairs an y xpiration: 7/7/2014 d Business Regulation ,' Private Corporatism 10 Park Plaza-Suite 5170 SCOTT PEACOCK BUILDING& REMODELING INC Boston,MA 02116 JAMES PEACOCK 1046 MAIN STREET SUITE:T DSTERVILLE,MA 02655 Undersecre_tary. ' --- -- Not valid without signature - - Town of Barnstable sAerrsrAei,s, MASS. 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 -r Property Owner Must Complete and Sign This Section If Using A Builder' , as Owner of the subject property hereby authorize ��0�'c ��C-C to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) igna Kofner Date, 6� \- , A ' Print Name - 1 Q:Forms:buildingpermits/express Revised 123107 a �O Town of Barnstable *Permit# tF1E 0 Expires 6 months from issue date Regulatory Services Fee • �xsr�+sre. ; MASS. Thomas F.Geiler,Director 1639. Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma us Office: 508-862-403 8 Fax:.508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address r Residential Value of Wor Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) /C;z a X-PRESS PERMIT Construction Supervisor's License#(if applicable) 0workman's Compensation Insurance APR 19 2013 Check one: ❑ I am a sole proprietor ❑ I am the Homeowner TOWN OF BARNSTABLE (�] I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# U Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) �� 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 #of doors ❑ Replacement Windows/doors/sliders.U-Value - (maximum.35)#of windows ❑ 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 th req e Home Improvement Contractors License&Construction Supervisors.License is uir SIGNATURE: i The aCrrmurommedth of msachuseft D�epwhnent of In dustrid Accide m(s Office Of Invesfigations 600 Washington Street Boston,MA l#2111 www rrias&gov1dia TrVnrkers' Coinpen�ai ion I>v. -.ancQ Affidavit BuaderslConlracturs/ElechicianstPhimb�ers Applicant Information Please /Print Ikw`blv Name Musiness�z+a on/lntiivi � :f�'�'� �0 - Address: Sb AMI-�7 col cs �. City/State/Zip: P:homik Are n au employer?Cfierk the appropriate box Type of project(required): p 4oyer with - ❑ I am a genera ctontractor and I 6_ ❑Idt� frucfiion l to lfull �_ * have hired the sa�b-contractors �{ part�ime]. listed on the attached sheet` y- ❑Remodeling2.❑ I am a sole pmpriekai or partner- ship and have no employees These sob-contrartars have S. ❑Demolition wedinn forme in any capacity. �pl`��and have deers' g ❑Building addition ,o wG&='comp_inca4rance Camp_mer,ranr�I req►rired] re 5. ❑ We a a eoiporatiau and its 10-❑ repairs or additions I❑ I am a hometrwner doing all WCdc officers have exercised timeir 1l_❑Plumbing repairs or additions right of exemption per MOL r tYrys�eS€[No workers'comp- i.�. repairs inc�e required,]T c.152,§1(4),andwe have no 13❑otheremp��-INo workers' camp.insurance required.}. ;Amy vpIk=that checks boa#1 nmst also till oat the section belam shonriag their wcK&e&c=pensat—policy infb�— IIomeawaers who submit this afiidsvd inducting they Rm damg an work and then hue outside cantmcto6 mast sabmu a near'Mdavd MdwAt n snob. tCan=ctas ffiat c6ecB this boat mast attached an maitionsi skeet showing the mate of the and stare whether of not moose endties h=ee emgloy�. Ifthe mb-c�ns have m*cyee-%they=mFmvide their wnrkere comp.policy n—ber_ I run all employer that ispr�vidirrg.wortrers'cnmparaiisrr irrsurre for�riy�etrgaIo3 Belniv is!#reps Licy,and job site informaiiVIL . Insurance Company Name: Policy#or Self--ins.Lic # 3 t� f Expiration Date: 21 4S Job Site Address- 7 Zf�'l/Lr GityfStatrl2ip:( �'y1L��(/l °'� `��' Z A t ach a copy of the workers'compensation petPcy d�aratio:a page(slwwing the p F member and eaQiratittn elate). Failure to secure coverage as required under Section 25A of miGL c_ 152 can lead to the imposition of criminal penalties of a fine up to S 1,500-00 andfor one-year impriso>ment,as wen as t Gvil penalties in the forte of a STOP WORK'ORDER and a fine of up to$250-00 a day against the violator. Be mhised that a copy of this statement snaay be forwarded to the Office of It¢v-estsgations ofthe D1A for a coverage vttion_ i do hereby eerie tit.a ' s pass ofpetjury Brat the Wormatka prupided is true Ord correct Si late: Phone#: c ©} ciai me rrxi[y: Do not awrke i this area,to be c ietevt by cite or tostt�a o . City or Town: PermiMcewe# lsming Authoriity(circle one): . 1.-Board.of H:ed It 2.Bw'lding Departmteut 3.Gty f`tswn Clerk d.Electrical inspector 5.Phmbiug Inspectetr 6.other.. _ * BARxsrnsr i639 ,�� Town of Barnstable prfp Mp't A 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 ' I6042 t= ;as Owner of the subject"property hereby authorize U� to act on my behalf, in all matters relative to work authorized by this building permit application for: 3 ( ddress of Job) Signature of Owner ate Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on;the reverse.side. 0-kUrPFTT Coo.4-- .. .. - . f ! �oFTa,, Town of Barnstable 0 Regulatory Services B"RNSTABLF. " Thomas F.Geiler, Director MASS>'Q 1 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.m.a.us Office:. 508-862-403 8 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 resRoonsible f6r all such work Rerformed under the building permit. (Section 109.1.1) t 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 ti Note: Three-family dwellings containing 15,000 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 of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. . s MMPIM FTo: E. ANDERSON CONSTRUCTION, LLC,. Pth =e�npeosdner l�MAM Proposal ==,�,aer ,ztia,:oorn 508=280 7326 , n Bartlett From- Sean Anderson Subject: 31 Harvest Lane: roof re=do Date: 04/09/2013. Job Description: • Remove/dispose of existing asphalt roof-shingles. r Ice&water shield installed along 1st 3'of roof deck,-in valleys,.around chimney and around all penetrations. Grace®.Td:-Flex®cooling undedayment installed along remainder of roof deck a 8"white,drip-edge installed along roof-edge • All pipe flanges removed/replaced with new,aluminum flanges. Certainteed®Landmark®roof shingles installed over newly papered deck(color:to be decided). • Roof:vented tr code using,Cobr&ridge-vent Roofdeckopened at ridge if/where necessary. • job area cleaned and magnetized for nails daily. • All surrounding surfaces covered for debris: Cost for described work $ 18,300.00 (includes all materials,labor and disposal) Notes: We guarantee all:ofour workmanship-For ten years. Please call anytime ifyou have any questions. Pay schedule- 1/3 of noted price due with agreement 2nd 1/.3 due at commencement of work and delivery of matenals. Balance.. due at completion: — - - - Acceptance of Proposal: Thcaboveprice`and speeifications:are - Customer's signature IJ" j S,`atisfactoy and hereby aoeeptxet In"the'event of'non-paymcntr.the customer shall be resporisibit for all cgsts of collection, Sean F.Anderson: including`statutogr intenest.and reasonable fta0_aWecodnet seanandtrsJ'sonconarucfion.cotn 1 S 2$t)7325 r` ✓�ze -wow" anweacth a�✓alezfaachuaella License or re istration valid for individul use only Office of Consumer Affairs&JBdsiness Regulation. + ., g. y HOME IMPROVEMENT CO!lT2ACTOR before the expiration date. If found return to: Registration 41,28778 Type: . Office of Consumer Affairs and Business Regulation Expiration S-/16/2013 Individual . 10 Park Plaza Suite Boston;MA 62116 VSSEINDER8-0 1 SEAN ANDERSOt I ' 50 TRO'WBRIDGE R',TFK —. ✓� li B� !� W.YARTMOUTH, MA Undersecretary Not vd'withoutstgna Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-074101 SEAM E ANDERSQ'N ' Y. 50 TROWBRIDGE PA s WEST YARMOV'rH MA 26 i AA Expiration Commissioner 02/24/2015 I From:Kathy Geddis FaAD: Page 2 of 2 Date:4/222013 10:05 AM Page:2 of 2 VDAC WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER: (GS60UB-4235P39-7-12) RENEWAL OF (6S60UB-4235P39-7-11 ) INSURER: HARTFORD UNDERWRITERS INSURANCE COMPANY 1 NCCI CO CODE: 80411 INSURED: PRODUCER: SEAN E ANDERSON CONSTRUCTION NORTHWOOD INS AGENCY INC LLC 540 MAIN STREET 50 TROWBRIDGE PATH STE 9 W YARMOUTH MA 02673 HYANNIS MA 02601 Insured is A LIMITED LIABILITY COMPANY Other work places and identification numbers are shown in the schedule(s) attached. 2. The policy period is from 05-21 -12 to 05-21 -13 12:01 A.M. at the insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of the state(s) listed here: MA B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: o� Bodily Injury'by Accident: $ 500000 Each Accident Bodily Injury by Disease: $ 500000 Policy Limit o Bodily Injury by Disease: $ 500000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, If any, listed here: COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06A D. This policy includes these endorsements and schedules: SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE o� 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All required information is subject to verification and change by audit to be made ANNUALLY. DATE OF ISSUE: 05-30-12 LA ST ASSIGN: MA OFFICE: ORLANDO DA HTFD 05G PRODUCER: NORTHWObD INS AGENCY INC 73SHL 002812 I. From:Kathy Geddis FaxID: Page 2 of 2 Date:4/22/2013 09:55 AM Page:2 of 2 ANDER-5 OP ID: KG '4�o�rro� CERTIFICATE OF LIABILITY INSURANCE D04/22/2013ATE Y) 04l22/2013 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 CER11FICATE 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). CONTACT PRODUCER Phone: 508-771-1632 NAME: Northwood Ins.Agency,Inc. Fax:508-393-2955 PHONE F 540 Main Street,Suite 9 (A/C,No Ext: (A IOC',No: Hyannis, MA 02601 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC M INSURER A:General Casualty Insurance Co. 24414 INSURED Sean E Anderson Const, LLC INSURERB:Hartford Insurance Co 50 Trowbridge Path W Yarmouth, MA 02673 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 WFFH 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. ILTR NSR TYPE OF INSURANCE POLICY EXP INSR WVD POLICY NUMBER MMIDD,YYFF MMIDDYYYY LIMITS GENERAL LIABILITY EACH.OCCURRENCE $ 1,000,000 A COMMERCIAL GENERAL LIABILITY CCX0396093 04/13/2012 04/13/2013 A AI 0 RENTED PREMISES Ea occurrence $ 100,000 CLAIMS-MADE 7 OCCUR MED EXP(Any one person) $ 5,00 X Business Owners PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY jRC0f LOC I CSL $ 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Perperson) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY RY LIMITS R B ANY PROPRIETOR/PARTNER/EXECUTVE YIN CERT WILL FOLLOW FROM 05/21/2012 05/21/2013 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N!A (Mandatory in NH) CO W/IN 5 DAYS E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATION I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION TOWNBAR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE.CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 230 Main Street Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD s TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION lap ;20q Parcel G 6 7 F� d Permit A Health Division ?�— �2 �/ me Date Issued 2 "� 20 a. ti S+ a ®� &*1V l Z9l�� Fee Conservation Division Tax Collector. Z3�01 V SEOTIC SYSTEM MUST DE Treasu a INST A 1-l-ED IN COMP LIANCE Planning Dept. ONMENTAL CODE AND Date Definitive Plan Approved by PI nninVoard y` vo WN REGULATIONS o � e ,Cre'y Historic-OKH Preservation/Hyannis `3 Z 0 1 .J 1 Project Street Address — — r Village MAR 2, ,' Owner 1-3—a d- ee Address ,o,,;/a`3,5.,�:!►!�:...,. Telephone 2 71 `Q`//I Permit Request /0 af 30 5- Square feet: 1st floor: existing proposed O �S 2nd floor: existing proposed Total new , Valuation : / Zoning District 9 e- Flood Plain C Groundwater Overlay 1410 Construction Type �° �✓LG. .� Lot Size A D S 19Uf3' Grandfathered: ❑Yes /No If yes, attach supporting documentation. Dwelling Type: Single Family Y Two Family ❑ Multi-Family(#units) Age of Existing Structure .�� Historic House: ❑Yes ®'No On Old King's Highway: ❑Yes 41No Basement Type: l�Full ❑Crawl '2'Walkout ❑Other Basement Finished Area(sq.ft.) (D �S Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new 1 Number of Bedrooms: existing new _y Total Room Count(not including baths): existing new // First Floor Room Count Heat Type and Fuel: 9/Gas ❑Oil ❑ Electric ❑Other Central Air: IH Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes CB'l�Jo Detached garage: ❑existing ❑new size Pool: ❑existing ❑new size Barn:Cl existing ❑new size Attached garage:Cl existing knew sizeXXOW Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ ❑ f Commercial Yes �No If yes, site plan review# Current Use 1/Q,��l%y Proposed Use BUILDER INFORMATION Name // � Ze J 4e_ Telephone Number Address nn__ ,�.__�--S� License# L� > Lm Home Improvement Contractor# Worker's Compensation# Tr_1 91 q MOW ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE el ! DATE Z'a,2— Q/ FOR OFFICIAL USE ONLYCkl 513Z PERMIT NO. , DATE ISSUED" i G MAP/PARCEL NO.- ADDRESS VILLAGE JAB OWNER;- DATE OF INSPECTION FOUNDATION ' FRAME INSULATION r FIREPLACE y ELECTRICAL: ROUGH _ Y FINAL PLUMBING: ROUGH sz — FINAL GAS: ROUG'H� on pig, FINAL 04 nib. FINAL BUILDING DATE CLOSED OUT , ASSOCIATION PLAN NO.! i ® ' L r " F il F J F D r G F tl 6 9 F 9 F Western Surety A g G G g G y LICENSE AND PERMIT BOND tl F For County,City,Town or Village Only-Not Valid for Bonds Required by the State.Not Valid for Contract, ; Performance,Maintenance,Subdivision,Agent to Sell Hunting and Fishing Licenses or Utility Guarantee Bond. n F KNOW ALL MEN BY THESE PRESENTS: BOND No. L& P-4 3 0 910 `J 8 F . A p That we, Bayside Building inc . of the Village of Centerville State of Massachusetts , as Principal, and WESTERN SURETY COMPANY, a corporation duly licensed to do business in the State of Massachusetts , as Surety, are held and firmly bound unto the Town of Barnstable , State of Massachusetts , Obligee, in the amount (Valid only when a County,City,Town or Village is named as Obligee) of Seven Hundred Twenty Dollars and no cents DOLLARS ($ 720 .00 ), (NOT VALID FOR MORE THAN$25,000) lawful money of the United States, to be paid to the said Obligee, for which payment well and truly to be made, we bind ourselves and our legal representatives, jointly and severally. THE CONDITION OF THIS OBLIGATION IS SUCH, That whereas, the Principal has been licensed to construct a single family frame at Lot #5 Harvest Lane Centerville , MA 02632 frontage 180 , by the Obligee. NO W T�E4REFORE, if the Principal shall faithfully perform the duties and comply with the laws and orduiance.( c`u ng all amendments), pertaining to the license or permit, then this obligation to be void, of eiw'se to rein ran-an full force and effect for a period commencing on the 2 2 n d day of ,� F dam"?.n " �m February 2 0 0 1, and ending on the 2 2 n d day F e b r u a r y , 2 0 0 2 unless renewed by continuation certificate. 3TJiis bond may be&erminated at any time by the Surety upon sending notice in writing to the Obligee and to �. the ncipal in care o3f the Obligee or at such other address as the Surety deems reasonable, and at the expira- tion>�o ttlrL-ty3= i re""#(�35 days from the mailing of notice or as soon thereafter as permitted by applicable law, whicheVe ,,",-,this bond shall terminate and the Surety shall be relieved from any liability for any subsequent acts or omissions of the Principal. Dated this 2 2 n d day of February , Principal Principal Court rs1 ed WESTERN SU ETY CO NY F T F F F By By o n n a S e v i o u r Resident Agent President G ACKNOWLEDGMENT OF SURETY STATE OF SOUTH DAKOTA 1 (Corporate Officer) County of Minnehaha f ss On this day of ,before me, the undersigned officer,personally appeared Stephen T.Pate ,who acknowledged himself to be the aforesaid officer of WESTERN F SURETY COMPANY,a corporation, and that he as such officer,being authorized so to do,executed the foregoing F instrument for the purpose therein contained,by signing the name of the corpor ' n by himself as such officer. ; IN WITNESS WHEREOF, I have hereunto set my hand and official se G , J. RHONE r NOTARY PUBLIC �� ,� n u s1MAL SOUTH DAKOTA S � otary Public, South Dakota G r My Commission Expires 6-12-2004 f Western Surety Company • 101 S. Phillips Ave. G Form 849-A—12-97 Sioux Falls, SD 57104 • 1-605-336-0850 ' F il F ACKNOWLEDGMENT OF PRINCIPAL (Individual or Partners) F 1 9 STATE OF J F ss J f County of " F y F il f " � 6 On this day of ,before me personally appeared il J F F p il known to me to be the individual described in and who executed the foregoing instrument and F , Facknowledged to me that—he_executed the same. F il My commission expires i F Notary Public ACKNOWLEDGMENT OF PRINCIPAL (Corporate Officer) STATE OF ss County of On this day of ,before me, personally appeared , who acknowledged himself to be the of , a corporation, and that he as such officer being authorized so to do, executed the foregoing instrument for the pur- poses therein contained by signing the name of the corporation by himself as such officer. My commission expires Notary Public k p ` " " T " p E F F � • � • ' F p W R F p � F z A FAj a p IL O F� z +' i J �.uy O 9 W a 1� t1 O u e• F � a "� J i9 p e i ESTIMA TED PROJECT COST WORKSHEET Value `LIVING SPACE square feet X $-5-57sq. foot = GARAGE (UNFINISHED) 910 square feet X $25/sq. foot = 13 , S40 PORCH d`15o2 square feet X $20/sq. foot = Sa ZQ DECK b 47 square feet X $15/sq. foot = /✓1/ 1 '�D c OTIIER�&aud V5 square feet X $4Wsq. foot Total Estimated Project Cost q&/, For Office Use Only lnclusionary Affordable Housing Fee Residential [j Commercial" Property Owner's Name Project Location Project Value Permit Number "Existing Sq. Et. "Proposed New Sq. Ft. Fee $ IAIIFORM 1/3/00 1 BOARD OF BUILDING REGULATIONS � License: CONSTRUCTION SUPERVISOR A Number: CS _Q.05645 Birthdate:A 9"1956 Expire /04/19/2002 T no: 18679 Restricted To: 0 BRIAN T DACEY _ 62 FERNBROOK LN CENTERVILLE, MA 02632 Administrator 00-35,000 cf enclosed space (MGL C.112 S.60L) 1A-Masonry only 1G-1&2 Family Homes Failure to possess a current edition of the Massachusetts Slate Building Code is cause for revocation of this license. DIG SAFE CALL CENTER: (080)344-7233 1 A4 — - COMMONtVEA-L,TII OF M..ASS11.CHUSETTS D EI'A IZi-i1 fElr'T O F IND US"IRIAL ACCI D ENTS 600 WASHINGTON STREET ames Cam2oe1: BOSTON, MASSACHUSETTS 02111 Coca-nas�cne' WORKERS' COM ENSATIONINSURANCEAFFIDAVIT 1, i3 I-JAI T %-)/*-- C= Y (licenseelperrnincc) with a principal placc of business/residcncc ac (City/Stacelzip) do hereby certify, undcr tllc pains and penalties of perjury, Char: [� 1 am an employe: providing dic following worl(c:s' con1pcns:Jo❑ coverage for my crnploycns working On ulis lob. A10P r1Je2AJ 1,c/s. arc /t/.Y. 7"c I g D q / Insurance Company Policy Numbcr [ ] 1 am a sole proprietor and havc no onc working for mc- [ ] 1 am a sole propricror, general contractor or horrlcowncr (cirdc onc) and havc'llircd the contra ctors listed Lc:--«- who havc the following woriccrs' eompcnsarion insurance police Narnc of Conrnctor Insunncc Cornpany/Policy Nurnbc: Namc of Contractor Insurance Company/Policy Nurnbc: Namc of Contmaor Insurance Company/Policy Nurnbc: 1 am a homcownc. performing all dic work myself: NOTE. PIC1JC be aware tbat while homeowners who employ persons to-do maintenance,construction or repair work on . d,,Oing of not more than three uniu in which the homeowner also resides or on the grounds appurtenant thereto art not genes y considered to be emplovers under the Worlten' Compensation Act (GL C 152,sect- 1(5)), application by a homeowner for a lice_sc or permit may evidence the legal sutus of an employer under the Workers' Compensation Act- 1 unde-st:-Id that a copy of this starement will be forwarded to the Depar-..c.::of Industrial Accidents' Office of Insurance for cove::s: ve..... i ion and th:t failure to secure coverage as required under Section 25A o;MGL 152 can )cad to the imposition of crim r.iinal pe 1n eonsisdng of a fine of up to S1500.00 and/or imprisonment of up•to one yc::-nd civil penaldes in the form of a Stop Work Order: Fine of 5100.00 a d:v against me. r Siuicd this day of , 19 Liccascc'i'crmirtcr Liccasor/Pcrrnittor 3 SUBCONTRACTOR' S INSURANCE BAYSIDE BUILDINNG: (L) ZURICH - SCPM31195788 (W) NORTHERN INS N.Y. - TC1 91911041 ENGINEEER: BAXTER & NYE ENG: (L) KEMPER - 7CQ27676000 (W) EVANSTON INS - AE802232 WELLER & ASSOC: (L) NAT' L GRANGE MUT. - MSP45246 LAND CLEARING: PETER GOVONI : (L) CNA INS CO - C179997230 (W) CNA INS CO WC179997244 EXCAVATION & SEPTIC: ROBERT J. OUR (L) U S F & G - 1MP30109550901 (W) U S F & G - 771521695 NORTHERN SEALCOAT (L) TRAVELERS - 660364K8342 ' (W) LIBERTY MUTUAL - 312446298044 FOUNDATION: GARDNER CONCRETE FORMS : (L) ST. PAUL - BFS00000169269 (W) ST. PAUL - 7717171998 WELLS : DENNIS SCANNELL (L) TRAVELERS - 660873E5627COF92 (W) WAUSAU - 151300062926 CELLAR/GARAGE FLOORS: MASON WORKS : (L) TRAVELERS - 1680204Y4465TCT FRAMERS : ROBERT DORRER: (L) TRAVELERS - 680526K991A (W) ST. PAUL FIRE & MARINE INS CO. - 6S16UB-510X322-3-99 MIKE DUFFLEY: (L) COMMERCIAL UNION - NBF821356 (W) LIBERTY MUTUAL - WC1312492127024 . DAVID HILL: (L) COMMERCIAL UNION - NBF821356 (W) LIBERTY MUTUAL - WC1312492127024 MASON: SHERMAN, WAYNE: (L) COMMERCE INS CO - N60689 (W) WAUSAU INS - TO BE ASSIGNED FERNANDES WAYNE: (L) HINGHAM MUTUAL - ART9800896 DANNY TORTORA: (L) ZURICH - SCP 31874051 (W) WAUSAU INS - TO BE ASSIGNED GAS PIPING: BAYSTATE PIPING: (L) CRUM & FORSTER - 5031766863 (W) CRUM & FORSTER - 4086081999 ELECTRICIAN: CHAVES ELECTRIC: (L) MISC. INS . ZDN5245913 (W) MISCELLANEOUS INS CO. - WCP0006299 AMES ELECTRIC: L NORTHERN INS . - NBF418165 (W) AMERICAN EMPLOYERS- QBH2O8297 BAYSIDE ELECTRIC : (L) ST PAUL INS. - BFS00000400422 (W) EASTERN CASUALTY - WC98695063 PLUMB & HEAT: WHITELY PLUMBING: (L) TRAVELERS - 660365K1782COF9 (W) EASTERN CASUALTY - POLICY IN MAIL ALARM SYSTEM: BALTIC SECURITY: (L) HANOVER INS - PAC105393 (W) WORKERS RISK - WCS-80414040 INTERCITY ALARM: (L) FIRST FINANCIAL - FF0131 G400831 (W) COMMERCIAL UNION - CB0743379 CENTRAL VAC: VACUUM HOUSE: MERRIMACK MUTUAL - SBP1.608045 INSULATION: MAP INSULATION: (L) AMERICAN STATES 02CC326435-3 (W) U S F & G - 7711099932 SHEETROCK: MEL REED: (L) WORCESTER INS - CB817530. (W) COMMERCIAL UNION CBH55738.7 INTERIOR TRIM: DAVID' S REMODELING: (L) CGU - NBFB40738 M & R CARPENTRY (L) MARYLAND INS. GRP- SCP30235965 (W) CIGNA PROP & CAS . - C80049997 K FITZPARRICK: (L) MARYLAND INS . GRP- SCP30235965 (W) CIGNA PROP & CAS . - C80049997 OAK INSTALLER: ROBERT BUDDEN: (L) COMMERCIAL UNION - NBF824090 (W) . LEGION INS . - WC30024039 PAINTING: CAMPBELL PAINTING: (L) TRAVELERS - 1680251K4083COF (W) ASSOC INDUSTRIES OF MA. MUTUAL - AWC 7000126-01-99 GARAGE DOORS : ALL CAPE GARAGE DOOR: (L) U S F & G BFS000000348188 (W) TRAVELERS INS CO - 1810336H8138T1A99 f STORMS & GUTTERS : ALUMINUM PRODUCTS : (L) CNA INSURANCE - 1074079839 (W) CNA INSURANCE - WCC174080411 OAK FINISHER: AMERICAN FLOORS : (W) EASTERN CASUALTY - WCV3001745 CARPET, VINYL & TILE : CARPET BARN: (L) TRAVELERS - ' 1680625Y1691TILOOS (W) MA. RETAIL MERCHANTS - 8100-06 TILE INSTALLER: TONY AVERINOS : (L) ASSURRANCE CO. - CFP26528977 (W) HARTFORD FIRE - 77WZCY2409 WIRE SHELVING: CAPE COD CLOSETS : (L) ARBELLA - NBF8410782 (W) TRAVELERS - 7PJUB-521X529-4-99 APPLIANCES : KITCHEN APPL MART: (L) FIREMENS FUND - AZC80453098 (W) HARTFORD INS CO - 77WZNB1603 MIRRORS & SHOWER DOORS : ' L & M GLASS : (L) COMMERCIAL' UNION - ' CBR409003 r (W) U S F & G - 0071439933 LANDSCAPE & SPRINKLER: COY' S BROOK: (L) TRAVELERS 6880937D0453 (W) RENNAISSANCE INS - TBD DRIVEWAYS : NORTHERN SEALCOAT: (L) MARYLAND CASUALTY- EPA18716945 (W) THE PHOENIX - UB387K530 SUSPENDED CEILINGS : ATC CEILINGS: (L) TRUST INS CO - TMP1005666 (W) SAVERS PROPERTY - WC0000873 RUBBER ROOFS : CAZEAULT CO. (L) AMERICAN EQUITY - ACC 060106R-1 SIDEWALLER: STEPHEN CRESSWELL: (L) MARYLAND INS - SCP29031342 k . i .. 7 MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2.01 Checked by/Date CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 2-22-2001 DATE OF PLANS: 1/28/01 TITLE: SHAPIRO RESIDENCE PROJECT INFORMATION: HARVEST MEADOWS, CENTERVILLE COMPANY INFORMATION: BAYSIDE BUILDING, INC. COMPLIANCE: PASSES Required UA = 842 Your Home = 761 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value . -U-Value UA ------------------------------------------------------------------------------- CEILINGS 2835 30.0 0.0 100 WALLS: Wood Frame, 24" O.C. 4358 19.0 0.0 255 GLAZING: Windows or Doors 715 0.360 257 GLAZING: Skylights 40 0.350 14 FLOORS: Over Unconditioned Space 2835 19.0 0.0 135 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations . submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125t of the design load as, specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 SHAPIRO RESIDENCE DATE: 2-22-2001 Bldg. Dept. Use CEILINGS: [ ] 1. R-30 Comments/Location WALLS: [ ] 1. Wood Frame, 24" O.C., R-19 Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0.36 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location SKYLIGHTS: [ ] 1. U-value: 0.35 For skylights without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location FLOORS: [ ] 1. Over Unconditioned Space, R-19 Comments/Location AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. �. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: [ ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, ,and floors. MATERIALS IDENTIFICATION: [ ] _ Materials and equipment must be identified so that compliance can . be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating.equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. DUCT INSULATION: [ l Ducts shall be insulated per Table J4.4.7.1. DUCT CONSTRUCTION: [ ] All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or P g Y joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not . permitted. The HVAC system must provide a means for balancing air and water systems. : TEMPERATURE CONTROLS: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] Rated output capacity of' the heating/cooling system is not greater than 125% of the design load as specified - I . in Sections 780CMR 1310 and J4.4. [ ]., SWIMMING POOLS: All heated swimming pools must have an on/off heater switch and require a cover unless over 20t of the heating energy is from non-depletable sources. Pool pumps require a time clock. [ ] HVAC PIPING INSULATION: HVAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in.) : PIPE SIZES (in.) HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-411 Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 Low temperature 120-200 0.5 1.0 1.0 1.5 Steam condensate any 1.0 1.0 1.5 2.0 COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.75 1.0. refrigerant below 40 1.0 1.0 1.5 1.5 [ ] CIRCULATING HOT WATER SYSTEMS: Insulate circulating hot water pipes to the following levels (in.) : PIPE SIZES (in.) NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F) : RUNOUTS 0-111 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 1.0 1.5 2.0 , 140-160 0.5 0.5 1.0 1.5 . I 100-130 0.5 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only)---------=--------------- I, k , .� - i r 4, T STANDARD FORM PURCHASE AND SALE AGREEMENT This NINTH day of FEBRUARY 20 01 I L• PARTIES BRIAN T. DACEY,TRUSTEE OF OLD POST ROAD DEVELOPMENT TRUST AND MAILING P.O. BOX 95, CENTERVILLE, MA 02632 ADDRESSES hereinafter called the SELLER, agrees to SELL and GARY L. &BARRYANNE SHAPIRO 441 MAIN STREET-RTE 6A YARMOUTHPORT, MA 02675 hereinafter called the BUYER or PURCHASER, agrees to BUY, upon the terms hereinafter set forth,the 2. DESCRIPTION following described premises: LOT#5 OLD POST ROAD, CENTERVILLE, MASS AS SHOWN ON PLAN BOOK 558 PAGE 73. FOR TITLE REFERENCE SEE DEED RECORDED IN BOOK 12869 PAGE 096 AT THE BARNSTABLE COUNTY REGISTRY OF DEEDS. SAID LOT CONTAINS APPROXIMATELY 45,730 SQ. FT AND TO BE BUILT ON SAID LOT WILL BE A 4 BEDROOM, 2 AND ONE HALF BATH RANCH/CAPE STYLE HOME WITH A 2 CAR GARAGE ATTACHED. 3. BUILDINGS Included in the sale as a part of said premises are the buildings, structures, and improvements now f ; STRUCTURES, thereon, and the fixtures belonging to the SELLER and used in connection therewith including, if any, all IMPROVEMENTS, wall-to-wall carpeting,drapery rods, automatic garage door openers, venetian blinds, window shades, FIXTURES screens, screen doors, storm windows and doors, awnings, shutters, furnaces, heaters, heating r equipment, stoves, ranges, oil and gas burners and fixtures appurtenant thereto, hot water heaters, (fill in or delete) plumbing and bathroom fixtures,garbage disposers, electric and other lighting fixtures, mantels, outside television antennas, fences, gates, trees, shrubs,'plants, and, ONLY IF BUILT IN, refrigerators, air conditioning equipment,ventilators,dishwashers,washing machines and dryers; and but excluding 4. TITLE DEED Said premises are to be conveyed by a good and sufficient quitclaim deed running to the BUYER, or to the nominee designated by the BUYER by written notice to the SELLER at least seven days Include here by specific before the deed is to be delivered as herein provided, and said deed shall convey a good and clear reference any restrict- record and marketable title thereto, free from encumbrances,except tions, easements, rights (a) Provisions of existing building and zoning laws; and obligations in party (b) Existing rights and obligations in party walls which are not the subject of written agreement; walls not included in(b), (c) Such taxes for the then current year as are not due and payable on the date of the delivery of leases, municipal and such deed; - other liens, other encum- (d) Any liens for municipal betterments assessed after the date of this agreement; brances, and make pro- (e) Easements, restrictions and reservations of record, if any, so long as the same do not prohibit vision to protect or materially interfere with the current use of said premises; SELLER against BUYER's '(f) breach of SELLER'S covenants in leases, where necessary. 5. PLANS If said deed refers to a plan necessary to be recorded therewith the SELLERshall deliver such plan with the deed in form adequate for recording or registration. 6. REGISTERED In addition to the foregoing, if the title to said premises is registered, said deed shall be in form sufficient TITLE to entitle the BUYER to a Certificate of Title of said premises, and the SELLER shall deliver with said deed all instruments, it any, necessary to enable the BUYER to obtain such Certificate of Title. 7. PURCHASE PRICE The agreed purchase price for said premises is $775,000.00 (fill in);space is SEVEN HUNDRED.AND SEVENTY FIVE.THOUSAND.............................................. ...........::.......dollars, of which allowed to write out the amounts $ 116,250.00 have been paid as a deposit this day and 1 if desired $ $ 658,750.00 are to be paid at the time of delivery of the deed in cash, or-by certified, cashier's,treasurer's or bank check(s). $ $ 775,000.00 TOTAL f i4 8. TIME FOR Such deed is to be delivered at 2:00 o'clock P. M. on or before the TWENTY-SEVENTH(27TH)day of PERFORMANCE; SEPTEMBER 2001, at the Barnstable County DELIVERY OF Registry of Deeds, unless otherwise agreed upon in writing.It is agreed that time is of the essence of this DEED(fill in) agreement. 9. POSSESSION AND Full possession of said premises free of all tenants and occupants,except as herein provided, is to be CONDITION OF delivered at the time of the delivery of the deed, said premises to be then(a)in the same condition as PREMISE. they now are, reasonable use and wear thereof excepted, and b)not in violation of said building and (attach a list of zoning laws, and(c)in compliance with provisions of any instrument referred to in clause 4 hereof. The exceptions, if any) BUYER shall be entitled personally to inspect said premises prior to the delivery of the deed in order to determine whether the condition thereof complies with the terms of this clause.(D) IN A FULLY CLEANED AND COMPLETED CONDITION. 10. EXTENSION TO If the SELLER shall be unable to give title or to make conveyance, or to deliver possession of the pre- PERFECT TITLE mises, all as herein stipulated, or if at the time of the delivery of the deed the premises do not conform OR MAKE with the provisions hereof,then any payments made under this agreement shall be forthwith refunded and PREMISES all other obligations of the parties hereto shall cease and this agreement shall be void without recourse to CONFORM the parties hereto, unless the SELLER shall use reasonable efforts to remove any defects in title,or to (Change period of deliver possession as provided herein,or to make the said premises conform to the provisions hereof, as time if desired). the case may be, in which event the SELLER shall give written notice thereof to the BUYER at or before the time for performance hereunder, and thereupon the time for performance hereof shall be extended for a period of thirty days. 11. FAILURE TO If at the expiration of the extended time the SELLER shall have failed so to remove any defects in title, PERFECT TITLE deliver possession, or make the premises conform, as the case may be, all as herein agreed, or if at any OR MAKE time during the period of this agreement or any extension thereof,the holder of a mortgage on said pre- PREMISES mises shall refuse to permit the insurance proceeds, if any, to be used for such purposes,then any pay- CONFORM, etc. ments made under this agreement shall be forthwith refunded and all other obligations of the parties hereto shall cease and this agreement shall be void without recourse to the parties hereto. 12. BUYER's The BUYER shall have the election, at either the original or any extended time for performance,to accept ELECTION TO such title as the SELLER can deliver to the said premises in their then condition and to pay therefore the ACCEPT TITLE purchase price without deduction, in which case the SELLER shall convey such title,except that in the event of such conveyance in accord with the provisions of this clause, if the said premises shall have been damaged by fire or casualty insured against,then the SELLER shall, unless the SELLER has previously restored the premises to their former,condition,either (a) pay over or assign to the BUYER, on delivery of the deed, all amounts recovered or recoverable on account of such insurance, less any amounts reasonably expended by the SELLER for any partial restoration, or (b) if a holder of a mortgage on said premises shall not permit the insurance proceeds or a part thereof to be used to restore the said premises to their former-condition or to be so paid over or assigned, give to the BUYER a credit against the purchase price,on delivery of the deed, equal to said amounts so recovered or recoverable and retained by the holder of the said mortgage less any amounts reasonably expended by the SELLER for any partial restoration. 13. ACCEPTANCE The acceptance of a deed by the BUYER or his nominee as the case may be, shall be deemed to e a OF DEED full performance and discharge of every agreement and obligation herein contained or expressed, except" such as are, by the terms hereof, to be performed after the delivery of said deed. 14. USE OF To enable the SELLER to make conveyance as herein provided,the SELLER may, at the time of delivery MONEY TO of the deed, use the purchase money or any portion thereof to clear the title of any or all encumbrances or CLEAR TITLE interests, provided that all instruments so procured are recorded simultaneously with the delivery of said deed. 15. INSURANCE Until the delivery of the deed,the SELLER shall maintain insurance on said premises as follows: *Insert amount Type of Insurance Amount of Coverage (list additional types of insurance (a) Fire and Extended Coverage *$ and amounts as (b)Builder's Risk agreed) 16. ADJUSTMENTS ien, FneFtgage inteF water and sewer use charges, operating expenses any)aeeerding te (list operating ex- the seliedule attaehed herete er set feFth bele , and taxes for the then current fiscal year, shall be ap- penses, if any, or portioned and fuel value shall be adjusted, as of the day of performance of this agreement and the T attach schedule) ameunt thereef shall be added te eF dedueted fFOFA,-aS the ease may be,the puFehase priee payable by ihe BUYER at the fime ef deliveFy ef the deed. Uneelleeted Fents fer the euFrent rental peried shall be appeFtien�d 9-and when eelleeted by either pa�y. I • 17. ADJUSTMENT If the amount of said taxes is not known at the time of the delivery of the deed,they shall be apportioned OF UNASSESSED apportioned on the basis of the taxes assessed for the preceding fiscal year,with a reapportionment as AND as the new tax rate and valuation can be ascertained; and, if the taxes'which are to be apportioned shall .ABATED TAXES thereafter be reduced by abatement,the amount of such abatement, less the reasonable cost of obtaining the same, shall be apportioned between the parties, provided that neither party shall be obligated to institute or prosecute proceedings for an abatement unless herein otherwise agreed. T8. BROKER's FEE A Broker's fee for professional services of (-0-) (fill in fee with is due from SELLER to NONE dollar amount or percentage;also name of Brokerage firm(s)) the Broker(s) herein, but if the SELLER pursuant to the terms of clause 21 hereof retains the deposits made hereunder by the BUYER, said Broker(s)shall be entitled to receive from the SELLER an amount equal to one-half the amount so retained or an amount equal to the Broker's fee for professional services . according to this contract,whichever is the lesser. 19. BROKER(S) The Broker(s) named herein NONE WARRANTY warrant(s)that the Broker(s)is(are)duly licensed as such by the Commonwealth of Massachusetts, (fill in name) 20. DEPOSIT All deposits made hereunder shall be held by SELLER (fill in name) subject to the terms of this agreement and shall be duly accounted for at the time for performance of this agreement. In the event of any disagreement between the parties,the escrow agent may retain all deposits made under this agreement pending instructions mutually given by the SELLER and the BUYER. 21. BUYER'S If the BUYER shall fail to fulfill the BUYER's agreements herein, all deposits made hereunder by the DEFAULT; shall be retained by the SELLER as liquidated damages unless within thirty days after the time for , DAMAGES performance of this agreement or any extension hereof,the SELLER otherwise notifies the BUYER in writing and this shall be Seller's sole remedy at law and in equity. 22. RELEASE BY HUSBAND OR etheF Fights and said WIFE 23. BROKER AS The Broker(s)named herein join(s)in this agreement and become(s)a party hereto, insofar as any provi PARTY sions of this agreement expressly apply to the Broker(s), and to any amendments ormodifications of such provisions to which the Broker(s)agree(s)in writing. 24. LIABILITY OF If the SELLER or BUYER executes this agreement in a representative or fiduciary capacity, only the. TRUSTEE, principal or the estate represented shall be bound, and neither the SELLER or BUYER so executing, nor. SHAREHOLDER, any shareholder or beneficiary of any trust, shall be personally liable for any obligation,express or implied BENEFICIARY,etc. hereunder. 25. WARRANTIES AND The BUYER acknowledges that the BUYER has not been influenced to enter into this transaction nor has REPRESENTATIONS he relied upon any warranties or representations not set forth or incorporated in this agreement or pre- (fill in;if none, viously made in writing,except for the following additional warranties and representations, if any, made by state "none';if either the SELLER or the Broker(s): SELLER WARRANTEES HOME FREE FROM ALL any listed, indicate STRUCTURAL DEFECTS FOR ONE YEAR FROM THE DATE OF THE CLOSING. by whom each war- ranty or represen- tation was made 26. MORTGAGE In eFdeF te help finanee the aecluisitien ef said premises,the BUYER shallapply feF a eenvenfiena'bank CONTINGENCY er ether instltatienalFnertgage lean of$ at-prevailing-Fates CLAUSE (omit if not provided for in Offer to Purchase) paFties herete. in ne event will the BUYER be deemed te have used diligent efferts te tain eh eemmotment unless the BUYER submits a,eemplete mortgage lean applieatien eenferming te the feFegeingPFevisieAS an er befere, 1g 27.CONSTR,UCTION This instrument, executed in multiple counterparts,is to be construed as a Massachusetts contract, is to OF AGREEMENT take effect as a sealed instrument, sets forth the entire contract between the parties, is binding upon and enures to the benefit of the parties hereto and their respective heirs,devisees, executors, administrators, successors and assigns, and may be canceled, modified or amended only by a written instrument executed by both the SELLER and the BUYER. If two or more persons are.named herein as BUYER their obligations hereunder shall be joint and several. The captions and marginal notes are used only as a matter of convenience and are not to be considered a part of this agreement or to be used in determining the intent of the parties to it. 213.LEAD PAINT The parties acknowledge that, under Massachusetts law,whenever a child or children under six years of LAW age resides in any residential premises in which any paint, plaster or other accessible material contains dangerous levels of lead,the owner of said premises must remove or cover said paint, plaster or other material so as to make it inaccessible to children under six years of age. 29. SMOKE The SELLER shall, at the time of the delivery of the deed,deliver a certificate from the fire department of DETECTORS the city or town in which said premises are located stating that said premises have been equipped with approved smoke detectors in conformity with applicable law. 30.ADDITIONAL The initialed riders, if any, attached hereto, are incorporated herein by reference. - PROVISIONS 1. PLEASE SEE SPECIFICATIONS ATTACHED HERETO AND MADE A PART OF THIS AGREEMENT. NOTICE: This is a legal document that creates binding obligations. if not understood,consult an at hey. OLD POS DEVELOP ENT UST" SELLER(or pouse) RIAN T. D CEY,If RUS E BUY R GAR . SHAPI O BUYER BAIARYANNE SHAPIMS Broker(s) EXTENSION OF TIME FOR PERFORMANCE Date The time for the performance of the foregoing',agreement is extended until o'clock M.on the day of 19 time still being of the essence of this agreement as extended.- In all other respects,this agreement is hereby ratified and confirmed. This extension, executed in multiple counterparts, is intended to take effect as a sealed instrument. SELLER(or spouse) SELLER BUYER BUYER Broker(s) a ' QUITCLAIM DEED w . eD ALIA PANZERA of, 396 Greenwood Street, M�lbury, Worcester County, MA, 01527 and VIOLETA KAVALIAUSKAS of 44 Fleetwood Drive,New Fairfield-,Fairfield County ,CT, 06812, for consideration paid of TWO HUNDRED FORTY-FOUR THOUSAND ($244,000.00) DOLLARS. grant to BRIAN T. DACEY,TRUSTEE of OLD POST ROAD DEVELOPMENT TRUST u/d/rl' dated 2/23/99 and recorded in the Barnstable County Registry of Deeds in Book 12081, Page 226, of 1645 Falmouth Road, Centerville, Barnstable County, MA 02632, with quitclaim covenants, the land in Barnstable(Centerville)Barnstable County, MA bounded acid described as follows: NORTHERLY by the County Road as shown on a plan hereinafter mentioned four hundred ninety (490.00) feet, more or less; NORTHEASTERLY and EASTERLY by land now or formerly of Stanley M. Crosby, three hundred seventy-four and 99/100 (374.99) feet, more or, less; EASTERLY again by land of Robert F. Gross and John Sirra, four hundred fifty-six and 66/100 4 (456.66) feet; SOUTHERLY by land of one Gorga and John Johnson, three hundred forty-eight and 12/100 (348.12) feet; WESTERLY by land of Felix Childs, two hundred eighty-six and 43/100 (286.43) feet; SOUTHERLY again of Felix Childs, fifty-three and 78/100 (5.3.78) feet; , WESTERLY again by land formerly of Ruth C. Greenough, Mamie Hallett and Chester Holway by various courses and distances, as shown on said plan. CONTAINING five and 3/10 (5.3)acres more or less. FOR a more particular description of the above described premises,see plan entitled "Plan of Land in Centerville, Massachusetts, as surveyed for Stanley M. Crosby, and Nelson Beasre. C.E.,dated April 7, 1937 and recorded with Barnstable Registry of Deeds. Plan Book 55,Page 37. EXCLUDING and excepting however from the described premises above so much as was conveyed to John H. Johnson by deed dated May 19, 1941, recorded in said Registry of Deeds,. Book 729, Page 52, and so much as was conveyed to Nicholi Harmansky et ux by deed dated June 11, 1958, and recorded with said Registry of Deeds, Book 1007, Page 230. - BEING the same premises conveyed to us, by deed of Eleonora Matulevicius dated November 19, 1983 and recorded with the Barnstable Registry of Deeds, Book 3 95 1, Page 325. PROPERTY ADDRESS: OLD POST ROAD, CENTERVILLE, MA 02632 WITNESS my hand and seal this SSA Day of February 2000. f ` DALIA PANZERA COMMONWEALTH OF MASSACHUSETTS Worcester, ss. February Z$c12000 Then personally appeared the above named DALIA PANZERA and acknowledged the foregoing instrument to be her free act and deed before me. N TARY PUBLIC Nty commission Expires, t,j v 'ii;lhrl�S: i i`i i=X,�iRE _ , I } k y _ , WITNESS my hand and seal this -�,��-Day of February 2000 VIOLETA KAVALIAUSKAS STATE OF CONNECTICUT F'ASRFTEIA COUNII ss• February 2 ,2000 Then personally appeared the above named VIOLETA KAVALIAUSKAS and acknowledged the foregoing instrument to be her free act and deed before me. NOTARY PUBLIC My commission Expires: KAREN T.BROWNE Notary Public My Cmm*sion Expires May 31,200 i t '7low- TOWN OF BARNSTABLE • ` CERTIFICATE OF OCCUPANCY PARCEL ID 000 000 215 GEOBASE ID ADDRESS 31 HARVEST LANE PHONE CENTERVILLE ZIP — LOT 5 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT PERMIT 57049 DESCRIPTION C/O FOR SFH BUILT UNDER PERMIT #52326 PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: ! ARCHITECTS: Department of Health, Safety and Environmental Services I TOTAL FEES: BOND IME CONSTRUCTION COSTS $.00 �•� 756 CERTIFICATE OF OCCUPANCY . 1 PRIVATE P"#f. s I * BARNSTABLF, • MASS. i639• BUILDIN741 DIVI�SIQ BY (i� DATE ISSUED 11/08/2001 EXPIRATION DATE SRCMr- f b 006_-.000. 216 PRESS 3f HARVEST LANE PHONE CENTERVILLE z1.p � R C L33 t ii2k T O 3. S r�Ia.G '4;RMIT 52326 DESCRIII IO'N Nr' 4 BDRM S;'ING.FAM.14-ON3E SEWPT:42000-W PERMIT TYPE v BUILD� ' BUILDING, r TITLE � � RIESIDENTIK[., BLDC PMT r�)LY F.4*.L'a V'J.\.I:C1A7 S7C�YSIAJ.G .UIJ'1. .1.49`rl _ . ,tCx ' :cs' . Department of Health, Safe � Ta � `EJS: ;s y and Environmental Service ;'�JNSTWJCTION. .COSTS, $41' 1;215.t3U. . �ttff SINGLE T'AM riU�l�ll. DETACHED 1 , PRIVATE I,j I 'R., Qi► _ i iAAN3TABLE� * ,. MAS& EGA BUILDING DIVISION lA'i" 1S �JJ1) €J3f3f2�?01. EXPIRATIOND��`J."i BY .-� THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MFOR (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. a ECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. t ® o ® 903 e BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 z 2 A)A 40 F, 3 1 AEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 217 s 9.°d/ 00_ARD. HEALTH J � ER. SITE PLAN REVIEW APPROVAL `) WOR14 SHALL NOT'PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY i VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS . TELEPHONE OR WRITTEN NOTIFICA- l f 1 E ,<r� r - 31 HARVEST LANE e �v-rr�J r��F M 1 - lip a EXIST. FOUND. �Z V� J .;3. 7f3 IFIED PLOT PLAN I CERTIFY. THAT THE FOUNDATION SHOWN ON THIS PLAN IS LOCATED ON THE FOR GROUND AS SHOWN AND.THAT IT CONFORMS LOT 5 HARVEST LANE CENTERVILLE , MA. TO THE MINIMUM BUILDING SETBACK REQUIREMENTS OF THE TOWN OF BA�RNSTABLE. PREPARED-FOR BAYSIDE BUILDING INC tH OF SCALE: 1" = 60' DATE: APRIL ,30,2001 STEVEN W N UMBA� WELLER & ASSOCIATES ��FESSIONP �. 1645 FALMOUTH RD. - SUITE 4C CENTERVILLE, MA 02632 (508) 775-0735 r L gs� 1ENT ► • Ta"� ~ V L�T �N fit'°t�7X c7ac� a OF SARNSTAB JOINIH LE 9 SMOKE DETECTORS REVIEWED t 4'tfJ>,T P_E BUILDii�G DEPT. DATE FIRE DEPARTMENT UATE , I EOTH SIGNATURES.ARE REQUIRED FOR UNPIN t ARE P\ TFUU- ' e ry - — • , -177 I s a _ p Mr �''mY#-• 1 'a 1 .e1YtHt93 :�ro�o,al -i.wl� - _ 'o.ffi ju la t ' .. ,I t Imam r. rr` a L, `e .8 • F It • v • �s- , . c , .�t k ✓:.rV�('.''` {•'"' t� 1. l Vo lo am Fg , fi • � ,.- -3�' :is':ram_::';• - _ f z. 5. r_•:n., - r-1 r-� '�r�a-i.-.-�. t,tF�it•'•,�'. �L*.�,.��_�"'•'�'"F�C'•,"•P:• "�'- H:�k,•.Ck • Q;' _ ,. 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KVd DATE- 2/4{Oi 0 u hl X-aJ P y �BEi w,03� RIDGE VENT F9 q 12 • 'lXl2 RIDGE BOARD- �i0 W/ZXlbo 4 N"C.C.O.C. C'J '� yQ, ASPHALT SNMGLES s. 2A2 W. art"COW SNEATNaG ��+ 5 P VELUX VS SOS SKY LrRT OC JOB TO TRILISS HERE P 16" C. 9UPPPORT TxQ .R90.Ff..=L191LL.. _ _ 2WU12 a= "r r IOv 2Xa f K O.C. OFFICE Y V11"FS SOa SKY LGNT a MAINTAIN AFL SPADE Ns TRAPPING - " II E i i Itl .t. E i A'-O'IUM WALL y e a B i Y a YCONT.YET GE bZ VENTING DRIP ED A9GAJ W1fQ.1 STEEL I6 C 2XIOs f Ie"O,C 6:1 SECOND MR'®ER a BEAM 2-t9 VA'LVL't ALUM C.VI'TERS ION'SPOUTS ba FRIESE BOARD/MOULDW.S d BREAKFAST KITCHEN TF W TD GFEAT ROOM - Twill TO FOYER v S v GREAT 2X6 EXT.STUDS f I6"O.G. o _ _ BEDROOTS y BEYDIm 6'F.G.INsuL. eEYOND I V HALF WALL a ; LYHOCI SWEATNaG VQRXID 7� FM19N FLOOR CEDAR CLAPBOARDS IN FRONTfT FaIISN FLOOR T Sm.PLY SUBFLOM W.C.SWIGLE9 SIDES i REM9✓A"PLY BUBFLOOR i p G"FIBERGLASS INSUL. G'FIBERGLA"QMX. i 2XI0.f War- U 2X10'.1 W O.G 2.10E f IYO.C. 8,-2XI2 Gail P.T.2X6 91LL+911E SEAL 9-2x12 Gail (S)9 1/Y LVL'.FLUSH ir..7_ _ AT 4 O.C.MAX - - 9 1/2"STEEL COLUMNS -_ - 9 I/Y I�lll-Y CO{.IRf19 d REC_ BASEMENT l^ .,o- a4 T-v"CONCRETE WALL -I c BASEMENT o DAMP PROOF BELOW GRADE O ; I If-b - • to-O' i4-b ♦'-b 6'-0' LLi 9 V2'CON- IL SL O SLAB S W CO . AB W 11 k— � q z 2W-O` N O 9r o" nAa+GABLE 111 V A SECTION H SECTION �p SCALE-VA' • 1'-W 6 t3LALM 1140 0 11-0 � N Q N sw�r A 6 • .roe=. • er= icv' L Al I / :4 a o z 2 Sti . )a y8 l • /v 7-c I LJ I r AUL.L ll.vk-s ' Tiri�/S BUT DOES G/,G DATE: /'FJry SOIL EVALUATOR: ,"," WITNESS: P, fir'/ci2r,�tiA PERC RATE: y A 4 . 9� 6 Z °G ioye /2 M ce All �J� l�/a GG.r97E/Z E�✓Cca v.�JTC'.ZE.a DESIGN DATA DAILY FLOW: OP DRMS. z 110 GPD=��o GPD SEPTIC TANK: 6Y(>GPD z 200%=//C>a.. GPD USE: /,Sc-o GALLON PRECAST SEPTIC TANK LEACHING FACILITY: � z-1- 5oorr,Q2}/�U�GGS 1 CAPACITY: . ' SIDEWALL: 2Y - ,/6,Z,4R / °5 v BOTTOM: 0 TOTAL: /•"gp C� DGLi f NOTES: �P��w OF M� 1. ALL PIPE TO BE 4"DIA.SCII 40 PVC, 9c 2. PIPE TO BE LAID LEVEL FOR V OUT OF DISTRIBUTION, o� DANa L S'G BOX. - - %RAMAN '. :N.. CIVIL 3. RAISE ALL APPLICABLE MANHOLE COVERS TO WITHIN 6"OF FINISH GRADE O "v. 4. SEPTIC SYSTEM IS NOT DESIGNED FOR THE USE OF A GARBAGE DISPOSAL. « I C 5. SEPTIC TANK AND DISTRIBUTION BOX TO BE INSTALLED NA ON A 6"LAYER OF STONE.. 9 6. INSTALL GAS BAFFLE IN OUTLET TEE. 2"LAYER OF Sri"PEASTONE OVER 3/4".1 UP WASHED STONE ALL 1 AROUND TOP OF FOUND. (�EL. 5$1c, lo" »• 1 .O P 41 21s y9410 , N ` SEPTIC SYSTEM PROFILE SITE SEWAGE'PLAN GENERA ,NOTES FOR 1. CONTRACTOR TO BE RESPONSIBLE FOR THE LOCATION OF ALL UTILITIES,ABOVE AND UNDERGROUND,PRIOR a r .�c. /�� G� ✓>p�7"�.� TO ANY EXCAVATION OR CONSTRUCTION. 2. SEPTIC SYSTEM TO BE INSTALLED IN COMPLIANCE WITH PREPARED FOR 310 CMR I5.00:TITLE V. 1 TNIS PLAN IS NOT TO BE USED FOR PROPERTY LINE --..1436.`fi�,D DETERMINATION. 4. ALL DISTURBED AREAS TO LOAMED AND SEEDED. DATE:.:._,D�'�. Z< /l SCALE:�4SaTE,v 5. CONTRACTOR TO PROVIDE 24 HOUR NOTICE FOR ANY - REQUIRED INSPECTIONS. WEEUR & ASSOCIATES I 1645 FALMOUTH ROAD' CENTERVILLE, MA. 02632 TF.I,: (508) 775-0735 FAX: (508) 77.5-0754 ��. TEST HOLE LOG T /S COT 4D065 �/d 7- L/� /i✓ DATE: plc. /3 /yyy P-9G.38 �9•J O!/C/zG.gY Q�ST?/C�"" SOIL EVALUATOR: b '�ocyyG�.✓, cs� WITNESS: .a, �//a2�•vA i PERC RATE: --�-Z Mi c1%G✓GA1 b` A .- 3 L, 5, 4 Z-d Z,S 8�� S•t,v.fl �Ujz NO Gtii►7E/Z ��/Gn u.JTc7ZE,p ���•� " Z//CGS DESIGN DATA DAILY FLOW: (y)BDRMS.a 110 GPD GPD SEPTIC TANK. y(/OGPD a 200% o GPD USE: /.So o GALLON PRECAST SEPTIC TANK LEACHING FACILITY: � USE:..<3)Sxe„3'a- Z-�. So�,O/Zy�U�ccs r�ly'o� s�.vc CAPACITY: 7 SIDEWALL:IAJ �c A D BOTTOM: TOTAL: ys.7� y , Co Cu 5 F NOTES: OF 1. ALL PIPE TO BE 4"DIA.SCH 40 PVC. 2. PIPE TO BE LAID LEVEL FOR V OUT OF DISTRIBUTION p DANIEL E. BOX. BRAMAN 3. RAISE ALL APPLICABLE MANHOLE COVERS TO WITHIN c. cl y 686 y. 6"OF FINISH GRADE. V No.32 C 4. SEPTIC SYSTEM IS NOT DESIGNED FOR THE USE OF A GARBAGE DISPOSAL T' ``' E. 5. SEPTIC TANK AND DISTRIBUTION BOX TO BE INSTALLED ry ON A 6"LAYER OF STONE. 6. INSTALL GAS BAFFLE IN OUTLET TEE. 2"LAYER OF 318"PEASTONE OVER 314"-1 112"WASHED STONE ALL 1 AROUND TOP OF FOUND. S/9 . EL. S�i/o / 10" 14" ;.. V .. Sao o .GS S/�o0 So.o o Y92s 7/,,00 i y3,00 SEPTIC SYSTEM PROFILE i Z -30.99 SITE - SEWAGE PLAN GENERAL NOTES FOR I. CONTRACTOR TO BE RESPONSIBLE FOR THE LOCATION OF ALL UTILITIES,ABOVE AND UNDERGROUND,PRIOR [DATE:. T Jo— SA€�� L,D ,ao SCALE:vS ,,ea, TO ANY EXCAVATION OR CONSTRUCTION. 2. SEPTIC SYSTEM TO BE INSTALLED IN COMPLIANCE WITH PREPARED FOR 310 CMR IS.00:TITLE V. 3. THIS PLAN IS NOT TO BE USED FOR PROPERTY LINE DETERMINATION. 4. ALL DISTURBED AREAS TO LOAMED AND SEEDED. .-_�4'"�, Z9 �j'J /�S �TE,o S. CONTRACTOR TO PROVIDE 24 HOUR NOTICE FOR ANY REQUIRED INSPECTIONS. WELLER &ASSOCIATES 1645 FALMOUTH ROAD CENTERVILLE, MA. Q2632 ` I TEL: (508)7754735 FAX: (508)775-0754 AVVl2nVWn RV- y - V9. . y U �7 0 0� F. 1.0 Ike O Ems• p • � 1 • �. � ^ p�ti�tipb9 �° � P � (� ' fill 0 ='`�OR CO co O AS ca 02 000 . r / �J pup'p i° �� x --- . Rn��Sja,.z 3 ODD 47' 33' B — g Go d �00• � /�� tovv Z� 4' S1.22 �Z � ..S� 8i•i� N d� a�'e 9 3 � g w�a• 07 !►• \\ *E Q .,o ro 9 0 0 go rs -•.� sz 9q9 tie , �� " n zo. g m tie q4 �<vQ w \ � 88 20f Q + .,I r :. 5 .0; N to do• oroneo �. + o b W .CZ ooma 0 g c o CIO a .a4 csi THE ENGINEER'S STAMP ON THIS DRAWING QUALIFIES THE STRUCTURAL DESIGN ONLY AND CONTINUOUS BOND BEAM @ ASSUMES THAT THE FOUNDATION/FOOTING BEARING SURFACE IS UNDISTURBED, OR TOP OF WALL w/(3) #4 BARS PROPERLY COMPACTED, NON-ORGANIC SOIL POOL DECK &, CAP BY (TYP.) WITH A MINIMUM BEARING ALLOWABLE OF 3000 OTHERS (TYP.) PSF AND THAT ALL CONSTRUCTION WILL BE WATER SURFACE PERFORMED BY QUALIFIED CRAFTSMEN IN 8 ACCORDANCE WITH THE 8TH EDITION OF THE MASSACHUSETTS BUILDING CODE. ALL CONTINUOUS BOND BEAM @ ! DIMENSIONS AND ELEVATIONS ARE FOR DESIGN 00 TOP OF WALL w/ (4) #4 BARS Y8" MIN. WHITE 'MARLITE' AND REFERENCE PURPOSES ONLY AND SHOULD (TYP.) - POOL FINISH TYP. BE VERIFIED AND APPROVED BY THE OWNER, POOL DECK GAP BY O ( ) CONTRACTOR AND FRAMER. ON SITE OTHERS (TYP.) N 4„ VERIFICATION OF CONSTRUCTION IS LIKELY WATER SURFACE % REQUIRED. IT IS THE CONTRACTOR'S OR 2" MIN. CLR. OWNER'S RESPONSIBILITY TO EMPLOY PHELAN NOTE: LOCATION OF SKIMMERS, LIGHTS, ETC. SHOWN 3/g" MIN. WHITE 'MARLITE' - - j (TYP. -WATER SIDE) ENGINEERING TO PERFORM ON SITE FOR ILLUSTRATIVE PURPOSES ONLY. ACTUAL a °° ; f POOL FINISH (TYP.) VERIFICATION IF REQUIRED OR DESIRED. IT IS FREE-DRAINI ALSO THE OWNER'S OR CONTRACTOR'S LOCATIONS PER CONTRACTOR. SEE SHORELINE POOL o 2" MIN. CLR. STRUCTURAL RESPONSIBILITY TO ASSURE THAT TIMELY SUBMITTAL FOR ADDITIONAL INFORMATION cv �C (TYP. - WATER SIDE) FILL (TYP.) #3 @ 6" O.C. (VERT. AXIS) NOTIFICATION OF THE PROJECT PROGRESS IS 4n PROVIDED SO THAT ADEQUATE ON SITE #3 @ 1211 O.C. EACH WAY ENGINEER PRESENCE IS OBTAINED. LIABILITY IS (TYP.) ' #3 @ 12" O.C. (HORIZ. AXIS) SEVERELY DIMINISHED IF ENGINEER ON SITE l VERIFICATION IS NOT PERFORMED. IN ADDITION, NOTHING IN THIS STATEMENT RELIEVES THE FREE-DRAINING �1Z 3" MIN. CLR. ti��5 CONTRACTOR OF HIS/HER RESPONSIBILITY STRUCTURAL �' (TYP. - SOIL SIDE) ���1 REGARDING THE PROVISIONS OF 780 CMR 107. FILL (TYP.) �;," OF MASS I 3" MIN. CLR. 1 1 (TYP. - SOIL SIDE) 04 VALum E�,N `"Tit POOL WALL (TYP.)) I �` o STRu. 311 I I � � no �n no �o � 3 10" MIN. 'GUNITE' FCISTE�`�` PROVIDE ROCK PACK. SEE SECTION $" MIN. 'GUNITE' THICKNESS (TYP.) LIGHT (TYP.). SEE DETAIL '14/S-1' FOR I I I I/S-I' FOR MORE INFO. THICKNESS (TYP.) MORE INFORMATION. LOCATION PER POOL CONTRACTOR I I DESIGN&PLANNING POOL STAIRS. SEE SECTION I I 'l l/S-I'FOR MORE INFO. I w WALL DETAIL 7_„ , �..,n o REVISIONS 12 MAIN DRAIN. SEE DETAIL I - qjARX.L=O S 5/8" = 1'-0" PROVIDE ROCK PACK. SEE SECTION O DATE I DESCRIPTION I 'I5/S-F FOR MORE INFO. I c ' 1 1/S- I ' FOR MORE INFO. I I I o 0 13 I I I I Q �P.X.HPROPOSED POOL 1 : I � I I I SKIMMER(TYP.). SEE DETAIL I COPING PLASTER TIGHT TO RING ANTI-VORTEX COVER '16/S-F FOR MORE INFO. I I SEE DETAIL '12 & I Y FOR TYP. POOL WALL REINF. PROVIDE#3 TIE BAR AS SHOWN E INRER G HYDROSTATIC VALVE PROVIDE ADD'L #3 '' BENT BARS AS SHOWN 45'-0" PROVIDE 3/4" O CONDUIT - (3 EA. WAY - 6 TOTAL) STRUCTURAL & TO DECK BOX 12" MIN. - EDGE OF GUNITE ' ABOVE WATER LEVEL CIVIL CONSULTANTS COLLECTION TUBE 76 CARLISLE ROAD PL PLAN NEW POOL LIGHT 2" LINE VACUUM BREAKER S_A�R. = '- 11 (I IOV 500W). TO 2nd MAIN SDE UCTON RAIN OR %Z" STONE WESTFORD, NIA SCALE: 1/4 1 0 GROUND PER LIGHT PROVIDE ADD'L#3 BENT NOTE: DRAIN COVERS MANU. SPECS. - BARS AS SHOWN (2 EACH SHALL BE VGB COMPLIANT TEL. (978) 256-4014 WAY -4 TOTAL) ���INDRAIN DETAI LALE: N.T.S. 14 POOL LIGHT DETAIL NOTES: APPROX. SCALE: N.T.S. 1. FOR ADDITIONAL POOL INFORMATION SEE POOL SUBMITTAL PROJECT FILE BY THE POOL INSTALLER. 45'-0" MAX. LENGTH 2. POOL TO BE CONSTRUCTED IN ACCORDANCE WITH THE 8TH SWIMMING POOL EDITION OF THE SHORELINE POOLS 20'-0" MAX. WIDTH MASSACHUSETTS BUILDING CODE,APPENDIX 'G'. 6'-0" MIN. 15'-0"±MIN. DEEP END 3. POOL STRUCTURE TO BE CONSTRUCTED ON UNDISTURBED SHALLOW END TRANSITION PROOFROLLED NONORGANICAND NON-EXPANSIVE SOIL WITH A MINIMUM BEARING ALLOWABLE OF 3000 PSF AND WATER LEVEL A MIN. 4" LAYER OF 1%2" COMPACTED STONE. ALL WORK TO COPING SKIMMER CAP SHALL BE FLUSH BE IN COMPLIANCE WITH DAVIDSON RESIDENCE 6x8%6" SKIMMER WEIR WITH COPING & CONRETE SLAB THE AMERICAN CONCRETE INSTITUTE ACI-318-02. 31 HARVEST LANE a 4. SKIMMER, MAIN DRAIN, POOL LIGHT&RELATED DETAILS @ CENTERVILLE, MA MAX SLOPE �� '� �` � POOL STRUCTURE TO BE 3 WATER LEVEL f3" -H DESIGNED BY OTHERS AS REQ'D. R1'-0" 1 0 SKIMMER BASKET MAX. oc 5. THE SHAPE AND DIMENSIONS OF THE POOL MAY BE ALTERED WITH THE FOLLOWING CAVEATS: A. THE MAXIMUM LENGTH WILL BE 45'-0". PROVIDE (2) #3 TIES B. THE MAXIMUM WIDTH WILL BE 20'-0". ROCK PACK: PROVIDE 4 MIN. THICKNESS � AS SHOWN C, THE SHAPE MAY BE RECTANGULAR OR IRREGULAR. SCALE: AS NOTED OF 1%z" STONE @FLOOR OF POOL(TYP.) D. THE DEPTH SHALL NOT EXCEED 8'-0". DO NOT SCALE OFF DRAWING E. THE RADIUSES SHOWN FOR THE DEEP END AND SHALLOW END SHALL BE AS SHOWN BUT MAY BE INTERPOLATED TO DEPTH. DATE: 09/14/2017 F. THE PITCH FROM THE SHALLOW END TO THE DEEP END CONC. WALL/FLOOR(TYP.). 2" 0 PVC PIPE SHALL NOT EXCEED THE PITCH SHOWN. DRAWING TITLE SEE DETAILS '12&13/S-1' OUT TO PUMP FOR MORE INFO. EQUALIZER (COMMERCIAL ONLY) PROVIDE ADD'L #3 6. THE POOL CONSTRUCTION IS TO BE IN FULL COMPLIANCE POOL PLAN BENT BARS AS SHOWN WITH THE 8TH EDITION OF THE MASSACHUSETTS @ 6" O.C. BUILDING CODE, APPENDIX G. LISTED IN SECTION AG108 OF �+ 11 POOL SECTION APPENDIX G ARE THE ADDITIONAL SECTIONS APPROX. SCALE: 1/4" = 1'-0" STANDARDS THAT WILL BE ADHERED TO, INCLUDING BUT 9 NOT LIMITED TO THE FOLLOWING. AND DETAILS AG 104.1-ANSI/NSPI-3, STANDARD FOR PERMANENTLY SKIMMER SECTION INSTALLED SPAS.AG103.1-ANSI/NSPI-5, 1 6 APPROX. SCALE: N.T.S. STANDARD FOR RESIDENTIAL IN-GROUND SWIMMING POOLS.AG106.1-ANSI/APSP-7, STANDARD FOR SUCTION ENTRAPMENT AVOIDANCE IN SWIMMING POOLS, CONSTRUCTION DRAWINGS WADING POOLS, SPAS, HOT TUBS AND CATCH BASINS.AG103.3-ASCE/SEI-24, FLOOD RESISTANT DESIGN AND DRAWING NUMBER CONSTRUCTION.AG105.2, AG105.5- STM F 1346, PERFORMANCE SPECIFICATION FOR SAFETY MENTS FOR ALL COVERS COVERS OR SWIMMING OOLS, SPAS AND HOT TUBS.AG 105.2-UL-2017, STANDARD FOR GENERAL- 17223 — S- 1 PURPOSE SIGNALING DEVICES AND SYSTEMS