Loading...
36-348 (3) 147 DUNPHY DR BP-2017-0954 cls#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36-348 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Ina-round Pool BUILDING PERMIT Permit# BP-2017-0954 Project# JS-2017-001641 Est.Cost: $44395.00 Fee: $75.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: JULIANO'S POOLS 139826 Lot Size(sq.ft.): 141177.96 Owner: STANLEY ROBERT DIRK& LEAH zoning: Applicant: JULIANO'S POOLS AT: 147 DUNPHY DR Applicant Address: Phone: Insurance: 321 TALCOTTVILLE RD (860) 870-1085 WC VERNONCT06066 ISSUED ON:5/3/2017 0:00:00 TO PERFORM THE FOLLOWING WORK:24'x40' in ground swimming poolwith high safety fence with self closing & self latching gates **EXCAVATION MUST BE INSPECTED PRIOR TO POOL INSTALLATION** POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 5/3/2017 0:00:00 $75.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner 0 R. 4> File N BP-2017-0954 mitEte occult APPLICANT/CONTACT PERSON JULIANO'S POOLS SE G;0044 ppg ADDRESS/PHONE 321 TALCOTTVILLE RD VERNON (860)870-1085 GNB UST _J1fl5 PROPERTY LOCATION 147 DUNPHY DR MAP 36 PARCEL 348 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid 1' Building Permit Filled out Fee Paid Typeof Construction: 24'x40'in ground swimming poolwith high safety fence with self closing&self latching gates New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 139826 3 sets of Plans/Plot Plan THE FOLLOWING CTION HAS BEEN TAKEN ON THIS APPLICATION BASED ONNpgg: pg-0 eo s6 f, INFQRMATIOSENTED: Approved dditional permits required(see below) FOOL, LO CAT 66 Fl bN— PLANNING BOARD PERMIT REQUIRED UNDER:§ - cROAC({ES 0 M Wf,TLAN Intermediate Project: Site Plan AND/OR Special Permit With Site Plan 14.13A.‘ d(; co o(4, Major Project: Site Plan AND/OR Special Permit With Site Plan / f ZONING BOARD PERMIT REQUIRED UNDER: § CSEE P Se* Z42.1 Pi 4� Finding Special Permit Variance* .{ Received&Recorded at Registry of Deeds Proof Enclosed toe3 I 0 tJ /sA05T�D Other Permits Required: 5" Ii7 Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health I 6 Y---- .Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay 2/23117 Signature of Building Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. * Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of / Planning& Development for more information. r n d f d rZ r /J 9't' Department use only.. City of Northampton Status of Permit Building Department Curb Cut/Driveway Pernrit 212 Main Street Sewer/Septic AVeilability Room 100 WaterNyen Availability Northampton, MA 01060 Two Sets of.Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address' This section to be completed by office /517DunphyWoad Map Lot Unit F/Ort/7!e, MA samba zone overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: and/eah Slemle / /517 ,Dunphy eadot Name(Print) Current Medinass: N' .J 34//— 3809 Telephone Signature 2.2 Authorized Anent: /1/i/a/. Nnntarc( SP/ Ti,/rot/v7(n goaX Name(Print) Current Mailing Address: j� an//a, SL 51/9- ,NP-3770Si at re Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS 1y/r/ . 95 Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 4/a Sen (a)Building Permit Fee 2. Electrical ay QQd (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5.Fire Protection 4, /( 6. Total=(1 +2+3+4+5) 94/391. 6L Check Number at ✓7� _ 4i6 This Section For Official Use Only Building Permit Number: Date Issued. Signature: Building Commissioner/Inspector of Buildings Date Section 4. ZONING AIL Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Depemnent Lot Size Frontage Setbacks Front /00 Side L:. R: L:?PS' R: 23S/ Rear / z Building Height Bldg.Square Footage Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW ei YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO © DONT KNOW C YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained ef Obtained O , Date Issued: C. Do any signs exist on the property? YES O NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House n Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors O Accessory Bldg. ❑ Demolition ❑ New Signs [01 Decks [0 Siding[O] Other /4_Swimming Brief DescriptionR f Degasef • Work: d x40 in,yvtrld skunln y pad pi Yi r r hstet "ma miterf-el Y,r./�'r y Alteration of existing bedroom Yes ✓ No `.l Adding new bedroom Yes ✓ No Self/Q� ,7 Attached Narrative Renovating unfinished basement Yes k/ No / Plans Attached Roll -Sheet Ga.If New house and or addition to existing housing. complete the following: a. Use of building:One Family t./ Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. 792. '// .1I- Dimensions d'r/'.r r/o r e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank I, City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I. as Owner of the subject property hereby authorize �l i�1QV103 Pools to act on my behalf, in ail rr-tters relative to work authorized by this building permit application. Signature of Owner ,/ Date ,Vaivarti� /./rA/iano Poo/s LLC • as Owner/Authorized Agent hereby declare that the statemen d information on the foregoing application are true and accurate,to the best of my knowledge ana belief. Signed under the painsai� and penalties of perjury. /7/ret .14.07/Lor / Print Name 427 Signatu of Agent date N IGH N tco Le 2 SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder Bno.njU IIQnn r T5ulinnor?ools License Number 3.01 —ED Ico-H,Al4 itooel VPma) rr otaow It Addre•• 4001 Expiration Date // home--189-b 8 Sig al° Telephone b 9.Registered Home Improvement Contractor: J3gJ9.o`� Not Applicable 0 L%rt/ianoa /`�ai/s 7$rian,�.r!inn; /398aL Company Name ((// Registration Number ,92/ 7z/rofgzr'fie . Van°n Cr O(#Gf, ro 8/P7/9Or7 Address Expiration Date Telephone 8bD-VD 167.5 SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(MAI.c.152,§25C(8)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes a/ No 0 11. — Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(I) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner: Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official that he/she shall be responsible for all such work performed under the building permit As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153(Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature _ __ LIL .luewLpeingz !8%09NIjZYdw439=yapp18/Le5LN98Eb Gmscil. te496ePeL9eab=NGtssasgyompeue_=uopedpwryergAupo eegsewogtwwwwisdaq FEB ITal — -_ Jae oh, Styof Jepampton titatus 51 Pont Soldrrig Department J212Street .ACp4t_U Gy Room 100 ADoetA Ppnn4n M01060 SAP masII_OpraP_ ers phone 413587-124 0 FaA 413-SBP-12]2 �o'Sne Rao Ciner9ye:ry it--.- APPLICATION TO CONSTROLT,ALLER,REPAIR,RENOVATE OR DEMOLISH ONE OR TWO EAMILYOWELLIHG ON SITS INFORMATION PrvPoNY Address i avw.p Y o 11 517.1)4,4pny Na,"f Map Lot — A-77.692f A U.w. Zone Overlay olm:ct `TON x-PROPERTY OWNERSNpAUTHORREO AGENT t()Amer of Record Pi ' m'a,)_/%ntiti ,ry7.U✓ hy[7.,- n 33 pNhodxed Kiln/n frn,.Yn BMs Addy r✓ I(////o, vnll w f-.Y> SECTION 1- STIMgTCC CONSTRUCTIONSO55 - 9y< _._.. _ u7 i_J.✓_ Iten Esi me et Cos.,_ .. Tcook ed perm.app Eoid;9 125/ Z/55 r. /Eel • d.. ..:mss a9 Pa pec I :ea P'OLFOO1 — 111 5795- Sst awuno T.05 Section F °Moat UsaOny (92E•ORPZ)1!ew LI.OZr5L2 l/l "]p0wy LISISZµ4!8X0ONHZVarleieP=tePPMSSLEBeit La1eq 9L496RPei•gw6 !SSD yleuyOgre_r)OV0eillew/ask/wGrPwlsxwW'6wWWW/EdLI SECTION S DEscRIPTION OF PROPOSED WORK(check all cane) New House ❑ I Addition ❑ Roptecunent sl ❑'I fiy Q Or Wo ❑ Om All 1 I Accessory Bldg ❑ a av4c ❑ iNew Si Decks = 30"19 I 0,h,1} idada,/ . --, fall ryhadn't taytnnt, ft;syst. ... trent< A err vm _ ry Aab a ood ehh Yes A ,msAd Noe 9 c P.ep � fi n uCesar e r Plano ryacnM Rpl Sheet sat If New house and or addition to exisEna houainp complete the following Use'of oimarn., One rami = .,c 55uly ("net_ _._. NUrneet of looms s oats tarty., m_.— Ndrnber of ear-,ems Is Setea Sera acad-ed._ Pmmed sl. .ne ft-Gladea i ew 00d5Yddltdd ,.' r tq.< Done-rums a Number of r MB%W or hearty_ _._ FircoIaoiw WcaGsmve5 Number of each __ 9 tnergY ConseneLton Comanance d 3vcgyC 'Orin atacheC T/ee a'construcbm,_ i :5-outsets.notnn.iP of nm. Yea _.uun.0i in 0 , flours-vs Yes Ses i. Death of basemen o.Cellar an"de Ce.hsed gieue kWn,x.Gingc o heS.Jlha m _ ing regu alo'me. Septic ✓�an,seWV „Rte _ Cty a!e,Sup{JS SECTION AGENT O CONTRACTOR CITORI APPLIES FOR RUILOP G ERMI a E D N OWNERS AGENT OR RPPVES FOR BVILOING PERMIT I LeAtA Slam tutted,, r � . . myb afau k t14 05 bid id t. o f . son d _ Sunny-endnot penny IN I� _ 7/d A p cci, as aynertAnturnec iAgentredeclarenat 9e St016111,1tyld infamtation on roe feu:Gino apoiutm are dun end xo.ac to the rm;enorleon+ aria note( Stgned node.the pens end Mme; re,rvn CIL 4r'2.✓ �y,i o 2-a %Ci; (On x0110Z)Rew LLOZSLZ City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work: /5/7 Dunphy An/ The debris will be transported by: , /u/ianoj Po di The debris will be received by: 4 'an.2 /do/s , .moi ia/-o61,,'ICo,Fr) Verna?, cr- Building permit number: Name of Permit Applicant male/knee,/ Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations nu‘ ]° 1— 1 Congress Street,Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information .r- Please Print Legibly Name (Business/Organization/Individual):__ jj�%dn/1 C �ML Li,C _ Address: / Tnico4 bllp__tI'p2. ___. City/State/Zi.: 'alt ,i Phone it a _/-I ['//B$ ..... _ Are you an employer? Check the appropriate box: Type of project(required): I.IZ lam a employer with </S' _ 4. ❑ I am a general contractor and I 6 ®'New construction employees(full andtor part-time).` have hired the sub-contractors listed on the attached sheet. 7, 0 Remodeling 2.❑ (em a sole proprietor or palmar- ship and have no employees These sub-contractors have g. 0 Demolition working for me in any capacity. employees and have workers' 9 0 Building addition [No workers' comp, insurance comp. insurance., required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' right of exemption per MGL y comp. 120 Roof repairs insurance required] ` c. 152,§I(4),and we have no employees. [No workers' 13.13'Other /•(,—./7 comp.insurance required.) "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t I lomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractor,that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees, If the sub-contractors haveemployees,they must provide their workers'comp.policy number. >d tam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. // / Insurance Company Name: eparisrPUrc dl„/ /PO/7Circ Policy#or Self-ins. Lie.#: ` AA ° i r , Expiration Date: O y'/!%'Ol- Job Site Address: ///7 Pan by toad/....... _City/State/Zip: F�021'tLdy IVI l9 LI(Q(r�j 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 Rewarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature,;_, cee-i .... Date: Oo?////Q0/7 Phone 4: h//3-89b-33?b __.. ,. 4 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# _ Issuing Authority(circle one): i I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing inspector 6.Other Contact Person: Phone#: 148 151 5.71411/4-) In ic;11/2_ -4:. It '34 143 11 2- 4 ce 211 / 124 1,3 . R Le is& 71 1 . , 195 -..\.............„ U119-I t 7t)q f b?114124 PV91 Aqduog_ Lhl /.mraili JULIA-1 OP ID:ME A ORO CERTIFICATE OF LIABILITY INSURANCE °12129/ATE "12016 12/29/ 8 ' 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 tenor 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 Evans,Pires 8 Leonard v OEMarine Evans NE FAX _. 121 Roberts Street (FNC.No.oar 860-289.6816 INC,NoI 860-291-8848 East Hartford,CT 06108 EMAIL mevanseevans-insurance.com mo Tithy J Evans ADDRESS-. INSURER(S)AFFORDING COVERAGE NAICX INSURER A Regent Insurance Company 24449_ INSURED Juliano's PoolLLC INSURER e:General Casualty Company of WI 24414 321 Taleottville Road INSURER C Vernon,CT 06066 INSURER 0: INSURERE'. __ ___-__.__ ____ __ 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 CLAIMSIHSR . GENERAL LIABILITY OF INSURANCE ABEL POICYEFF Md$YE%P )..... LIMITS LTR DD wvo POLICY NUMBER 1MMmPTEYYI (POUCYTYYII EACH OCCURRENCE s 1,000,000 A X COMMERCFAL GENERAL LIABILITY CC11220708 01/01/2017 01/01/2018 pEEOERanDenr<) $ 100,000 I CLAMS-MADE [OCCUR MED EXP( y one person) $ 5,000 PERSONAL S ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN AGGREGATE LIMIT APPLIES PER PRODUCTS.EOMPnv AGG $ 2,000,000 POLICY JPO F T 1... . LOC I $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea keno $ 1,000,000 , A X ,.ANY AUTO CBA1220708 01/01/2017 01/0112018 Bo0ILY INJURY(Per person) $ ... ALL OWNED SCHEWLED BODILY INJURY(Per acddent) $ AUTOS AUTOS NON OwNeoPROPERTYDAMAGE s HIRED AUTOSAUTOS IPER ACCIDENT) X UMBRELLA LIAR X OCCUR I EACH OCCURRENCE '..S 2,000,000 B EXCESS LIPS CLAIMS MADE. CCU 1220108 1 01/01/2017 01/01/2016 I AGGREGATE $ 2,000,000 DED I X_.RETENTION s 10,000 5 WORKERSCOMPENSATION IpqA . CI _ U _ R AND EMPLOYERS LIABILITY A ANY PROPRETOIPPRTNERIEXECUTNE YIN CWC11%606 0411012016 04/10/2017 EL EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED', N N/A (Mandatory In NH) I E I. DISEASE EA EMPLOYEE S 1,000,000 odescrbe ender e6stalmgry of OPERATIONSbelow r EL.DISEASE.POLICY LIMn is 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD'01.Additional Remarks Schedule,E morespace,s required) CERTIFICATE HOLDER CANCELLATION EVIDENC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORRED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Pb JI f. 1/ tfr/ob 136 39' ...........�..��....7.... 2 c,--- U• `s ____The ! w ! - iGroup.m.. Ia -- - _ BNLDIN6 ENVELOPE i I i RESTOREQ PITCH ��_ - s...�...v_ ». ! � Y / EryXANOEOWETLANP AREA i I$ a a _ i :. / / 5ILTFENCE col P �� LOT 2 Pi ! I �i �, �"" �'� � ,r 141,184± SQ. FT. �.i a,24 I 3.2411± ACRES i _ ! oI • / PROPOSED SINGLE-FAMILY HOME White On Woods w �! / AffftO IiL 119 4 91•99.114.1r I 9 10 • I 4246" w PROPOSED ! I: I 1 1 . BIT.CONC.DRIvevAY c� b� i ,, -I TFT)4'24'06" w Fm..c.lmlN _ Proposed sae �p+p a7]0' 29'27 Plan I V 2t F;1? /cr. an7,7"� '��000� __ N 04'2406 WN. �w _16.9 � .. 1L 00 �� bb i T. I \ :� . - . m 104 ... ANJ7k . « yyy os % ' , + t * Z/a \ --7,,7^ < Silsti 9c: 4:7; 2;4._ « l211 r. ir: se . m y>ot a y » . ,, --- 195 � * lyk, \ ' 9co )4 � 1 Hayward 1;1YWA111,Pool Products .INc mIz'.. A Keyword Inctries,Inc.CoMLan9 336-712.9900 www.taywudnetcoe CERTIFICATION OF COMPLIANCE Contains: WG1048E or WG1048EW Description 8"Round Suction Outlet Cover Ratings: Floor. 125 GPM Wall: 72 GPM Open Area: Li stria C crrified to Comply with Section 1404 of the Virginia Graeme Baker Act(VGB)Pool&Spa Safety Act Test Results can be obtained from:www.figywardnet.com and/or htto/Avwwnsf.org/Certified/PooLs Manufactured: After December 20,2008, by Hayward Pool Products in Jiangsu Province,China and C'Icmmons,NC Divisions of Hayward Industries,inc. 620 Division Street,Elizabeth,NJ 07207,Phone 908- ;155-'995 08-.. '995 Date of Mfr:The Lot Number shown on the product label contains the Year&Month of manufacture.The frit number represents the year(ex 8 a 2008)and the second eharaeter die month(A=lan,t-Feb,H=Aug,I is skipped.)=Sep,etc) Tsted 10 ANSI/ASME 112.19.8-2007(addendum 8a-2008)per Section 1404 of the Virginia Graeme Bake Act 1VGB)Pool &Spa Safety Act. Certified by NSF international, 789 N.D`uboro,Road,Arm Arbor,MI. 48105 1(800)-NSF-MARX. Dare of Installation: 1SWG1048C0C Rev B o" —h SPACING BETWEEN F•— HMOUNTiG hO`-ES i I uSED ON FOLLOWING SERIES: /r '.0.�•p�• ... WG1030AY PAK2 5►1030AVPAK2 • •000• •' WG104KAVPAK2 SP10411AVPAK2 ..• •0000• • .. 0000000 '•'- _ WG1049AVPAK2 SP1049AV PAK2 3,7:1(4" •0000• •000 O.': ,; WG7051 AV PAK2 SP 1051 AV PAK2 =-J` OUTLET ! <-1,.00000• ••:O•a�S••:„::, , . WG1052AVPAK2 SP1052AV PAU ER'A G'.t'Sa8E , •0400ocias WG1053AVPAK2 Srlo53AVMK2 000000-10 WG10S AVPAK2 SP1054AVPAK2 000•.-•.0• •00 WG1153AV PAK2 SPI 153AV PAE2 :.• WG1154AVPAK2 5P I154AVPAK2 G "algal KArta rtbaneauot One source. Ever).pc