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Home My WebLink About121 Camp St #001 Building PermitsFINAL INSPECTIONS SKETCHES BELOW FOR OFFICE USE ONLY FEE NO. APPLICATION FOR PERMIT TO DO PLUMBING NAME l TYPE OF BUILDING LOCATION OF BUILDING PLUMBER E. F. V) A7 S Lo V1% P + 44 yti H-S-t- rL L t c '7 9 3 9 PERMIT GRANTED DATE �19 PLUMBING INSPECTOR i PROGRESS INSPECTIONS - Comm°ofiwealth of Massachusetts Use ""`y Permit No. C .65—,103 - Department of Fire Services Occupancy and Fee Checked —AJ�d BOARD OF FIRE PREVENTION REGULATIONS gtzv. 11/991(leaveblaj- • I APPLICATION FOR PERMIT TO PERFORM ELECTRICAL All worlcto be pedo®ed in &=dance with the Massachusetts Electrial Code (MEGA, 527 CMR 2.Ob (PLWEPRINTWINKOR=EALLINFORWTIOAA Date: o « City or Town of: YARMOUPH To the Inspector of {{r�es: LIu4 By this application the undersigned gives notice of his or her intention to perform the electrical wodes_ ed belo Location (Street & Number) MILL POND VILLAGE, Camp Street AL D Cl l I� OwnerorTenant Gatewood Homes/ Jeff Sollows Telephone No.508-7789693-4 Owner°sAddress 1600 Fa]moutti Rd., Suite 25, Centerville, Ma. 0263.2 Is this permit in conjunction with a building permit? Yes X❑ No ❑ (Check Appropriate Box) Purpose of Building single family residence Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Amparity Location and Nature of Proposed Electrical Work Fire Alarm System ( low voltage control panel) with ba ktM battery'centrally mo&tgrecl n,.—..J.«..:..dA..r.,n..a..etnmfflM�hoUV7iVrghVART reeemrotl�ixs No. of Recessed Futures No. of Ceil.-Sus . (Paddle) Fans P r ° Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Futures ove - Swimming Pool d. • ❑ d, ❑ o. o Emergency g Battery Units No. of Receptacle Outlets No. of Or'1 Burners FIRE.ALARMS No. of Zones -1- No. of Switches No. of Gas Burners o. of Detection.an 7 Initiatin Devices No. of Ranges tal No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers el P Totals: umber. [Number.ectionAlerting Tons ntameP DetDevices 7 No. of Dishwashers SpacdArraHeating KW 14cal Connai ection ® Other , Dryers No. of D Heating Appliances xW ecu psteme Noo.. of Devices 6rEquivalent o. of Water ICOV Heaters o. o o. o Signs Ballasts Data Wiring; No. of Devices orEquivalent No. H drumassa Bathtubs y t;e No. of Motors Total HP Wiring, eco . ofDev ces or No. of Devices or E uivalent OTHER: - - Aiiae/1 anal"onaa "�ma .J aesrrsq w as requ.rr" uy uis uasyccwr y ...rc.. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE M BOND ❑ OTHER ❑ (Specify-1 Mgmation Date Estimated Value of Electrical Work $750.00 (When required by municipal policy.) Work to Start Z7 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, an the airs and penafiies of perjury, that the information on this application is true and complete FIRM NAME: Baltic Security, Inc LIC. NO.: 1178C Licensee: Jonas R Bielkevicius Signature �'' LIC. NO.: 499D (Ijapplictzble enter "exempt" in the lieensenum0e . Bus Tel.No.• 508-833-0996 Address: PO l3ox .) 609. Sandwicrhr lha• 02563 Alt. TeL No.: 508�7 OWNER'S INSURANCE WAIVER .I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement I am the (check one) ❑ owner ❑ owner's agent Owner/Agent PERIIIIT FEE: $ 40.00. Signaturi. Telephone No. 50. N w w LOT 2 1 R�'30i N g0•47' 49" E F\NOP-ON oR,a�W p,�l I CERTIFY THAT THE FOUNDATION IS LOCATED IN FLOOD PLAIN ZONE C AS SHOWN ON FLOOD INSURANCE RATE MAP COMMUNITY PANEL NO. 250015 0005D AND THAT FLOOD PLAIN ZONE C IS NOT A SPECIAL FLOOD HAZARD AREA. DATE REGISTERED PROFESSIONAL LAND SURVEYOR 10 0 GRAPHIC SCALE ( IN FEET ) 1 inch = 20 fL AS -BUILT PLAN OF LOT 1 PREPARED FOR MILL POND VILLAGE IN YARMOUTH, MA 1 "=20' DATE: 6— LOT 1 I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE LOT AS SHOWN, AND THAT ITS LOCATION CONFORMS TO THE MINIMUM SETBACK REQUIREMENTS OF THE 40B SPECIAL PERMIT. ?X DATE REGISTERED P FES9 NAL LAND SURVEYOR NOTICE Unless and until such timethe original (red) stamp of the responsible Professional Engineer. or Professional Land Surveyor aDPea?A n pier�on�or persons, Including any municipal or other public lofficials. may rely upon the Information contained herein; and (B) this plan remains the property of Holmes & McGrath. Inc. hoimes and mcgrath, inc. civil engineers and land surveyors 362 gifford street. falmouth, ma. 02540 JOB NO: 201197 DRAWN: LM DWG. NO.: A2500A CHECKED;N,, ? OF Y49� TOWN OF YARMOUTH YATTACHHEESE CJ �p II L JUN 3 0 200 IBUILDING DEPT. iBY APPLICATION FOR PERMIT TO DO PLUMBING (OFFICE USE ONLY) By ,ee: $ `os PERMIT NO. Date Building Owner's ID 1I3QI�� AT: Location Name I t` Q c Type of Occupancy t 1 l New Lam' Renovation ❑ Replacement ❑ Plans Submitted Yes ❑ No ❑ z \\\/� co (n O Y V r Y J Q z �' z Z cs z to z W x¢ a W O Z u) y F N W x ryM Ft- V 0 t/f X Y Q ¢ t/! O Z ¢ a a 0 F� �e Y7Y` o a o� o Q 2 W a V5 a. Q N z x¢ x -J w x F' w vi O W y M H Q Y Ose Y U. W W Q F Q Q = y N Z=� Q Q Q a Q. 0u z O Q F Y J m U) G a J x F(n u. O O Q tJC to 0 SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Installing Company Name Address Business Check One: ❑ Col . ❑ artnership u ny Name of Licensed Plumber 'LIq INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes No ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance voerage required the Mass. General laws, and that my signature on this permit application waives this reAuirement. n A i Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Bond ❑ Chapter 142 of ` PILrber License Number Type: Master❑ Journeyman OP Y,493oi TOWWOF YARMOUTH I YA�TACME10 C �. � , dq-� �p � 3q �� eEF10 E �I`F\Kj L lJ i1 L NOV 0 1 2004 FULc;rN�G-PI,. FM APPLICATION FOR PERMIT TO DO GASFITTING (OFFICE USE ONLY) B,�rrr Fee: $ 39 0 PERMIT NO. CT'05 - NnI Date Building- -."i Owner'p AT: Location 2 '. C�Qi11 j� S % Name,- — Type of Occupancy_- / New ELK Renovation ❑ Replacement ❑ Plans Submitted Yes ❑ No �k W Cn w Z cc z cc p IIIZyccIM = a. � W -yx a w> s w z a Q o J°o w 3 a o? o o. o LL M x o a x LL M c 0 -j 0M> r SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) "�� Installing Company Name -uUGTS ` /�/�1 i^� ►TE'17 Check One: ❑ Corp. I F C. dASE S l� ❑ Partnership -'-TA /1/NIS M A t7 2. &ej I L Firm/Company Business Telephone Name of Licensed Plumber order :S:7 © IAN N Gz- INSURANCE COVERAGE: Check One I have a current liability insurance policy or its substantial equivalent. Yes Ero'No ❑ If you have checked yes, please indicate pe type of coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check One: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Signature o Licensed Plumber or Gasfitter 2ISEms License Number Tvoc 1 1r9;NCG- Daniel E. Braman, PE 189 Harbor Point Road Cummaquid, MA 02637-0361 Phone (508) 362-0016 -F �- August 16, 2004 James Brandolini, Building Commissioner Town of Yarmouth 1146 Route 28 South Yarmouth, MA 02664 Project: 22604 Mill Pond Village Camp Street Yarmouth, MA Today, I made a site visit to the above property ct an inspec ' o floor joists with holes for plumbing. This was in E et, Lot #1 a d in Clo r, Lot #2. The floor joists are 2x10's @ 16" o.c. and have been ith 3/4" CD plywood each side. The holes in the joists, Lot #1, over the kitchen area, are near the ends and would be a shear concern, not moment. The holes in the joists, Lot #2,over the bathroom area, are also near the end and are further supported by the closet walls. I believe that these details are structurally sound. Daniel E. Braman, PE Of L � 0 51nuv�� V e�a .. _'ref Q►� fsuanm. t OF r TOWN OF YARMOUTH Building Department. BUILDING 61 - - - - - - _ - - - (508) 398-2231 ext.261 j PERMIT NO B.04.1372_ PERMIT --- -- ISSUE DATE ;--6/9/2004- _ ; PROPOSE APPLICANT Frank Capra U ; ___ ------- - JOB WEATHER CARD ------------- PERMIT TO ; New Construction ; AT (LOCATION) 0012 CCAMP ST # 1 ZONING DISTRIC R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C1 BUILDING IS TO BE: CONST TYPE CB USE GROUP R-4 LOT SIZE CONTRACTOR new construction: 2 baths, 3 bedrooms, 1 diningroom, 1 kitchen, 1 livingroom as per plans dated REMARKS 03/31/04 and BOA # 3546. AREA (SO FT) EST COST ($ 1$148,896.00 PERMIT FEE ($) 1$543.00 OWNER Village at Camp St., LLC DING DEPT BY p ADDRESS 11600 Falmouth Road #25 -- -- LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 Certificate Issue Date /% 1 7o CERTIFICATE of OCCUPANCY;* Departmental Approval for Certificate of Occupancy and Compliance Inspector Date Permit Number A proved By RerRarks BUILDING 3'7-a PLUMBING/GAS ELECTRICAL 0 S ENGINEERING 4 t' L-In 3 c bs st41r- -bC - Izt/r.- -bq4�rA 3 1 os OTHER !/L Jhk-AL �0 313/a 10 0e nueu in Uy eau i umblun a iuivawu I we. ' I upv....0... r.o......... ........ . ...... i E OF r� TOWN OF YARMOUTH Building Department BUILDING' s (508) 398-2231 ext.261 F PERMIT NO B-04-1372Narmauft _ ISSUE DATE ; _ _ 619/2004_ - APPLICANT .'Frank Capra ; PROPOSED USE _ _ _ _ - - ' PERMIT --------------------- JOB WEATHER CARD C_ PERMIT TO ' New Construction ' AT (LOCATION) 00121CAMP ST # 1 ZONING DISTRIC R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C1 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE new construction: 2 baths, 3 bedrooms, 1 diningroom, 1 kitchen, 1 livingroom as per plans dated REMARKS 03/31/04 and BOA # 3546. .AREA (SQ FT) EST COST ($ 1$148,896.00 PERMIT FEE ($) 1$543.00 OWNER lVillage at Camp St., LLC BUILDING DEPT BY ADDRESS 11600 Falmouth Road # 25 Centerville I MA 02632 INSPECTION RECORD CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 6087789669 a FIELD COPY Date Note Progress - Corrections and Remarks Inspector �moe J 0 • OF Yq�� w O O —H Hwrr cnacs 1 x ONE & TWO FAMILY ONLY - BUILDING PERMIT APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING . Town of Yarmouth Building Department 1146 Route 28 • Yarmouth, MA 02664-4492 Tel: (508) 398-2231 x261 • Fax: (508) 398-0836 /Office Use Only �jQ� -� /3 �Q ' Permit No. L/{�C' �lte Permit Fee Deposit Rec'd., $5p Dat Net Due $. / Planning Board Information Plan Type Endorsement Date Recording Date `' n No. Other Assessors Department Information: Map Lot .Map Lot Old New 1.4 Property Dimensions: Lot Area (sf) Frontage (ft) Lot Coverage " This Section for Office Use Only Buildinq Peng Number: Date Issued: Signature: 3^3�_�' Certific a of Occupancy is is not ` required Building Official Date Section 1 - Site Information Use Group: R-4 Type: 5-B 1.1 Property 5rty Address: 11 -1rf- t� 1.2 Zoning Information: 9as Zoning District Proposed Use in ig19,C 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.4 Water Supply (M.G.L. c. 40. S 54) Public Private 1.5 Flood Zone Information: Comments: Zone: BFE: Section 2 - Property Ownership/Authorized Agent 2.1 Owner of Record: L It T C S. LLCM Name(print Signature 1AAS AQ,r A OO M 0✓` N Mailing Address CQL'N v;\ Telephone 2.2 Authorized Agent: Name (print) Mailing Address Signature Telephone Section 3 - Construction Services 3.1 Licensed Construction Supervisor: iaAR Not Appli ble ❑ oa License Number b Adop8s -7-7 xpirat_io, D e — Signature Telephone 3.2 Registered Home Improvement Contractor: Company Name JUN Q o ica Numbe Address By License Expiration Date Signature Telephone 9-15-99 1 of 2 OVER �14 w 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_ L permit. Signed Affidavit Attached Yes .......... No .......... Section 5 - Aescriotion'of ProDosed Work check all aoolicablel`' New Construction No. of Bedrooms No. of Bathrooms o2 Existing Bldg. ❑ Repair(s) ❑ Alterations ❑ Addition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: e � _ w °� a-w.t i 1A,; �I o V a Item Estimated Cost (Dollars) to be Check Below completed by permit applicant 1. Building O b O -' — 2Electrical ElConservation-CommissionFiling . r O (if applicable) 3. Plumbing / Gas O 4. Mechanical (HVAC) O ❑ Old Kings Highway & Historical % 5. Fire Protection / (o Commission approval 6. Total = (1 + 2 + 3 + 4 + 5) po O (if applicable) 7. Total Square Ft. (new houses & additions) Section 7a - Owner Authorization To be Completed Wh n"'17// Owner's A ent or Contractor Applies for Building Per i f V er I.. t ai^'` 2 as owneec of the subject prop, erty �C hereby authorize - �� `� disf to ton my ehalImall elative to work authorized by this building permit application. &Q-47-- Sign M re of Owner Date I, as Cw;w/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the, pains and penalties of perjury. W, Print n e A A(_ ll-� �- L13 Signatur Owner/Agent Date 9-15-99 2 of 2 The Commonwealth of Massachusetts Department of Industrial Accidents exce 01I Msdpsdess 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit O 1 am a homeowner performing all work myself. 0 1 am a sole proprietor _r.j ha,.e no one N%orkine in any capacity I am an employer pro% iding workers' compensation for my employees working on this job. company name• address ems•• phone q• insurance co policy 0IYI - am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below tsho hase city phone p• Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of erimiaal penalties of a flat up to s14ov.09 aamor one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and Is fine of S100.110 a day against me. I understand that a copy of this statement maybe forwarded to the Office of Investigations of the DU for coverage verification. l do.hereby cenif�under the pains and penalties ojperjury that the information provided above is true and correct k Signature �/ ate X % Z /?J /� Print name \ ` a—t^�p 1 Phone0�—7��/�`�i I fficial use only do not write in this area to be completed by city or town official city or town: YARMOOTfi _ permittileease 0 nBuilding Department -- ❑Licensing Board check if immediate response is required 261 C3Seleetmen's Office C3Healtb Department contact person: phone N: _ (508) 398-2231 eat. riOther Information and Instructions Massachusetts General I_a%%s chapter 152 section'_5 requires all employers to provide workers' compensation for their eniplo%ees. As quoted from the " la%% an entp1gree is defined as every person in the service of another under any contract of hire. express or implied. oral or written. An emp/ut•er is defined as an indi% idual. partnership. association. corporation or other legal entity, or any two or more of the foreuoin: engaged in a joint enterprise. and including the legal representatives of a deceased employer. or the recei%er or trustee of an indi% idual . partnership. association or other legal entity, employing employees. However the o%%ner of a dwelling= house ha% ine not more than three apartments and who resides therein. or the occupant of the dwelling house of another v ho employs persons to do maintenance . construction or repair work on such dwelling house or on the _rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. %1G1_ chapter 152 section 'S also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any :applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionallx. neither the cominom%ealtla nor any of its political subdivisions shall enter into any contract for the performance of public %%ork until acceptable evidence of compliance with the insurance requirements of this chapter ha%e been presented to the contracting authoriq. APPIic.:nts Please fill in the workers' compensation affidavit completely. by checking the box that applies to your situation and supply ink_ company names. address and phone numbers as all affidavits max• be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affida% it should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial accidents. Should you have any questions regarding the "law" or if you are required to obtain a %%orkers' compensation policy. please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of investigations has to contact you regarding the applicant. _Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address. telephone and fax number. The. Commonwealth Of Massachusetts Department of Industrial Accidents Me of Ievesdoldees 600 Washington Street Boston, Ma. 02111 fax #: (617) 727-7749 phone 4: (617) 7274900 ext. 406, 409 or 375 po �� / .,�•� ✓{ee TOanY�nolMl/¢aL!/i aI �G�aLac%uaead 'I BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 012430 r! Birthdate: 06116/1940 Expires: 06/16/2004 Tr. no: 25823 Restricted: 00 FRANK G CAPRA �� 40 COPPER LN Z2,.....i CENTERVILLE, MA 02632 Administrator 00 - 35,000 cf enclosed space (MGL C.112 S.60L) 1 A - Masonry only 1 G -1 6 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code Is cause for revocation of this license. DIG SAFE CALL CENTER: (888) 344-7233 r DATE (MM/DD/ y' i ir-IL ATE OF LIABILITY INSURANCE 07/22 22003 PRODUCER (508) 994-9688 FAX (508) 991- 5461 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION RI KOWSKI & KESTENBAUM ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE J 4 COUNTY STREET HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NEW BEDFORD, MA 02740 INSURERS AFFORDING COVERAGE INSURED.Frank Capra, 1NSURERA. Providence Mutual PO Box 664 INSURERB: OneBeacon West* Hyannisport, MA 02672 INSURERC: Continental Casualt ..Co...:.., .._.. .._.. .. _ .,. INSURERD, __ INSURERS COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR NSR TYPE OF INSURANCE POLICY NUMBER PO C EFFECTIVE DATE (MMIDDIYY) POLICY EXPIRATION DATE (MMIDD(YYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX OCCUR CPPOO53131 00 12/13/2002 12/13/2003 EACHOCCURRENCE s 1,000,000 FIRE DAMAGE (Any one fire) S 50 , 00O MED EXP (Any one person) $ 5,00( PERSONAL & ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2,000,00( GENL AGGREGATE LIMIT APPLIES PER: POUCY SECT 0 LOC PRODUCTS-COMP/OP AGO $ 2,000100( AUTOMOBILE LIABILITY ANY AUTO CBXE48125 02/14/2003 02/14/2004 COMBINED SINGLE LIMB (Ea accident) $ ALL OWNED AUTOS B " SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per person) S 250.000 X NON -OWNED AUTOS �... BODILY (Per (Per accident) I-Peraceldengf $ $00 000 PROPERTY DAMAGE ..-. . .. 10m,000 GARAGE LIABILITY ,. .. ... _ -- - . _ ... -AUTGONLY-EA ACCIDENT. - $ . ANY AUTO '�n�'••. _ . ... ... OTHER THAN EA ACC AUTO ONLY: AGG I $ EXCESS LIABILITYEACH OCCUR CLAIMS MADE OCCURRENCE S. AGGREGATE $ s DEDUCTIBLE s RETENTION S S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 6S59UB863.X751603 03/22/2003 03/22/2004 TORYLIMITS ER E.L. EACH ACCIDENT S S00, 000 C _ E.L. DISEASE -EA EMPLOYEE $ 500.000 OTHER LC Dt$EASE-Pouffu ift $ SOO '0OO DESCRIPTION OF OPERATIONSR.00ATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CFRTIFICATF Idnl nFo 1 1 .- ......... ..... .___ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Catewood Homes Inc 1600 Falmouth Road Ste 25 Centerville, MA 02632 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF NTHE COMPANY AGE S R EPR NTATIVES. AUTHORIZED R TATIVE /zTac, fw� ACORD 25-5 (7/97) �w vvr""v,V�I1V1Y IJOO • i iriLA t OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ` PRODUCER Dowling & O'Neil Insurance Agency, Inc. 222 West Main St. PO Box 1990 01 1/7/03 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURERA: Travelers Insurance Company NAIC # Hyannis, MA 02601 INSURED - Bayside Electrical Contractors, Inc. 372 Yarmouth Road INSURER B: Guard Insurance Group INSURER C: Hyannis, MA 02601 INSURER D: INSURER E: COVERAGES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MR LTR A16801484A82ACOF03 S RROCP E L LIABILITY OCCUR POLICY NUMBER POLICY EFFECTIVE D TE MM/DD 10/05/03 POLICY EXPIRATION DA MM/D 10/05/04 LIMITS EACH OCCURRENCE S1 ODO OOO DAMAGE TO RENTED MED EXP (Any one person) $3O0 000 15 000 PERSONAL 8 ADV INJURY $1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 52 000000 PRODUCTS-COMP/OP AGG $2 000 000 POLICY jE�a LOC A AUTO MOBILE LIABILITY ANY AUTO 18102601W5611ND03 10/05/03 10/05/04 COMBINED SINGLE LIMIT (Ea accident) S1,000,000 ALL OWNED AUTOS X BODILY INJURY (Per person) S SCHEDULED AUTOS HIRED AUTOS X X BODILY INJURY (Peraccident) $ NON -OWNED AUTOS Drive Other Car X PROPERTY DAMAGE - (Par accident) $ GARAGE LIABILITY $ ANY AUTO AUTO ONLY. EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: S EXCESS/UMBRELLA LIABILITY AGG $ S OCCUR CLAIMS MADE EACH OCCURRENCE AGGREGATE $ $ "DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATION AND BAWC436910 OS/1$/03 08/18/04 $ EMPLOYERS' LIABILITY WC STATU• OTH- ANY PROPRIETORIPARTNER/EXECUTNE E.L.FR OFFICERIMEMBER EXCLUDED? EACH ACCIDENT $1 O0 OOO Des describe under E.L. DISEASE . EA EMPLOYE $100,000 SPECIAL PROVISIONS below OTHER E.L.DISEASE- POLICY LIMIT S500000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Operations performed by the named Insured subject to policy conditions and exclusions. CERTIFICATE HOLDER CANCELLATION Gatewood Homes 1600 Falmouth Road Suite 25 Centerville, MA 02632 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _ In DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUr FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESEMTenvo ACORD 25 (2001/08) 1 of 2 #M31942 LS1 © ACORD CORPORATION 1988 = F 2 CATE OF' 2 LV SURANCE Issue date: 7/22/03 _..J,------------------------------------------------------------------------------------------------------------------------------------ Producer: I This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, SOUTHEASTERN INS AGCY I------------------------------------------------------------------------- extend or alter the coverage afforded by the policies below. 641 MAIN ST COMPANIES AFFORDING COVERAGE HYANNIS MA 02601 I---------- ------------------------------------------------------------- Code: Sub -code: I ----------------------------------------------------------------------------------------------------------------------------------- Cc Ltr A: ARBELLA PROTECTION Insured: Co Ltr B; ARBELLA PROTECTION ----------- --- ----- -- — — — — — — --- ----------------------- ---------------- — -- Co Ltr C_ RJ BEVILACOUA -------- - - ----------------------------------------------------- P 0 BOX 62B I Co Ltr D: ARBELLA PROTECTION FORESTDALE MA 02644 I------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ I Cc Ltr E: COVERAGES This is to certify that policies of insurance indicated notwithstanding listed below have been issued to the insured named above for the policr eriod term this any requirement, or condition of any contract or other document with respect to which certificate may be issued or may pertainx exclusions, and conditions of such policies. the insurance afforded by the policies described herein is subject to all the terms, Limits shown may have been by ------------------------------------------------------------------------------------------------------------------------------------ reduced paid claims. Cc I I ! Policy I - Policy I Ltrl Type of Insurance I ----------------=------------------------------------------------------------------------------------------------------------------- Policy number leffective date lexpiration date) All limits in thousands A LIABILITY I 8500018147 7/15/03 7/15/04 aggregate: 21000 JJEIERAL Commercial general liability I I (General Products-comp/o s aggre9: ( Claims made ( ) Occur kner s 8 contractors prat l Personal/advertising inl: Each occurrence: 11000 I I (Fire damage: t00 ---------------------- ----------------------------------------------------------------------Medical- expense: 5 - B (AUTOMOBILE LIABILITY 1 86852400001 2/21/03 1 2/21/04 - ---- ------ ------------ (Combined i An auto All owned autosinjury i (Single limit: 250/500 Scheduled autos Per person): Hired autos I Bodily inlurr Nen-owned autos I I (Per accident): liability I ----- I! ----Garage I! -------------------------------------------------------------------------------------------------------------------------- I I Property damage; 500 IEX ESS LIABILITY I I I I Each [[ 1[ Other than umbrella form I ------------------------------------------------------------------------------------------------------------------------------------ I Occurrence Aggregate I I I I D I WORKER'SACCOOMPENSATION I 9089680403 4/27/03 4/27/04 I----------------------------- I I IStatutorT S00 (Each accident) EMPLOYERS' LIABILITY 500 Disease -policy limit) --------------------- " -----------". -----"-------L -----------------I 10 sesveach empl.cyee.f.. (OTHER I ----------------I ----------------I --------------------- I I Description of operations/locations/vehicles/restrictions/special items: CERTIFICATE HOLDER CANCELLATION Should any of the above described policies be cancelled before the expiration date thereof, the issuing compact will endeavor to GATROOD HOMES mail 10 days written notice to the certificate holder named to the 1600 FALMOUTH RD STE 35 I left, but failure to mail such notice shall impose no obligation or CENTERVILLE MA 02632 liability of any kind upon the company, its agents or representatives. ----------------------------------------------------------------------- Authorized representative: --------------------------------------------------------I JOAN M MARTIN ----------------- JA 4/89--------------------- ------------------------------- 1-+�� UtK TIFICATE OF, LIABILITY INSURANCE :[bATE,MM°DM(YV) PRODUCER 508-399 5033 FAX SOS-760-1667 07/21/2003 All led American Insurance Agency LLC ONLYANDICONF IS-ISSUED NO RIGHTS UPON THE CERTIFICATE ION 1 Atlantic Ave HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR Sb Yarmouth MA 02664 ALTER THE COVERAGE AFFORDEn pv Tuc INSURERS AFFORDING COVERAGE NAIL IY Cape o Custom Floors 762 Falmouth Road INSURERA Arbella Protection Ins Company Hyannis MA 02601 INSURER& Hartford INSURER C INSURER D: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY NAVE BEEN REDUCED BY PAID CLAIMS. VS D TYPE OF INSURANCE POLICY NUMBER POLICY E F TIVE OLICY EXPtRATION GENERAL uaBILM LIMnS 7500000373 11/13/2002 12/13/2003 EACNoceuRRENee f 1 000,0( X COMMERCIAL GENERAL LIABILITY AMAGE TO RENTED CLAIMS MADE D OCCUR $ S0, 0( A MED !XP (Any Ma paRpnl S S , O( PERSONAL A AOV INJURY S 1 000, Cc CENL AGGREGATELRIMITAPPQFS PER: GENERAL AGGREGATE f 23000.01 X POLICY JPT6 LOC PRODUCTS-COMP(OFAGG S Z DOD OI AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE LIMIT f ALL OWNED AV107 ' Ira acelaanl) SCHEDULED AUTOS BODILY WJVRy S " HIRED AUTOS (Par P°DOA) NON -OWNED AUTOS BODILY INJURY S (PH aaldeny PROPERTY DAMAGE S ' IPaf aeotlan 0 GARAGE LABILITY ANY AUTO AUTO ONLY - EA ACCIDENT S OTHER THAN EL ACC S lXCESBIVMBRELLA LIABILITY AUTO ONLY: AGO S OCCUR CLAIMS MADE EACH OCCURRENCE S AGGREGATE $ DEDUCTIBLE S RETENTION f S WORKER9COMPBILITY COMPENSATION AND EMPLOYERS' EMPLOYERS' LIABILITY OSWECKLI007 05/2S/2003 OS 25 200�4 X / / wC STATU• OTH- g � E R OIFICERPR0IMEMD excLuDEDi F.L. EACH ACCIDENT S IDO, OOI S yEC 0' SPECIAL deAL PROVISIONS undo,VISIONS bNpw E.L DISEASE - EA EMPLDYE S 100,001 OTHER EL DISEASE -POLICY LIMIT S 500,00( DESCRIPTION OP OPERATIDNB I LOCATIONS 1 VEHICLES I EXCLUSIONS ADDEO BY ENDORSEMENT I SPECIAL PROVISIONS Evidence of Insurance for work performed within the Insured's scope of normal operations C 6WER C C SHOULD ANY OF THE ABOVE DESCRIBED POLICIP3 Be CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL GateWOOd Homes.. 10 DAYS WRRTEN NOTICETO THE CERTIFICATE HOLDER NAMED TO THE LEiT, 1600 Falmouth Road F2S BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUCATION OR LIABILITY Centerville, MA 02632 of ANY KIND UPON TNS INSURER, ITS AGENTS -OR REPRASFUTATMES. AUTHORIZED RESENT::, ACORD25(2001/08) FAX: (508)778-S603 ®ACORD CORPORATION 1988 A ACORD CROW50 07 25 03 CERTIFICATE OF LIABILITY INSURANCE OP C Al DaTE(MM 5/03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Sullivan, Garrity & Donnelly ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1508-754-1767 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 10 Imstitute Rd - PO Box 15010 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Worcester MA 01615-0010 Phone:508-754-1767 Fax:508-754-1885 Crowell Construction, Inc. PO Box 309 So. Dennis MA 02660 COVERAGES INSURERS AFFORDING COVERAGE NAIC # INSURER A. Hanover Insurance Co 222S INSURER B: Arch Insurance Company INSURER C: INSURER D: 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L7R NSR TYPE OF INSURANCE POLICY NUMBER POLICY DATE MMIDDIYY DATE MMIDDIYI• LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR - ZHN7007141 05/01/03 05/01/04 EACH OCCURRENCE $1000000 PREMISES Ea occurence $100000 MED EXP (Any one person) $5000 PERSONAL 3 ADV INJURY $1000000 ' GENERAL AGGREGATE S 2000000 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY •,JP O- LOC PRODUCTS -COMPIOPAGG s2000000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ABN7001142 05/01/03 05/01/04 ' COMBINED SINGLE LIMIT (Ea accident) 9 BOr person) (Par person) $SOOOOOO X X BODILY INJURY (Pet accident) $IOOOOOO }( PROPERTY DAMAGE (Par accident) $500000 GARAGE LIABILITY ANY AUTO AUTO ONLY -EA ACCIDENT S OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION S EACH OCCURRENCE S AGGREGATE $ $ S S B -- WORKERS COMPENSATION AND EMPLOYERS'LIABILTfY ANY PROPRIETORlPARTNER/EXECU7NE OFFICERIMEMBER EXCLUDED? :It yes; deacibe under SPECIALPROVISIONSbelow IRWCI00100 03/22/03 - 03/22/04 TORY LIMITS ER E.LEACHACCIDENT $500000 E.L. DISEASE - EA EMPLOYE $500000 — E.L DISEASE, POLICY LIMIT S 500000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Fax #508-778-5603 L:CKI II'IGA I C KULUtK GANGEL.LATIUN Gatewood Homes 1600 Falmouth Road Suite 25 Centerville MA 02632 GATEWOO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL .10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBUGATION OR LIABILITY OF ANY KINDUPON THE INSURER, ITS AGENTS OR ACORD 25 (2001108) © ACORD.CORPORATION 198 AVRIQ� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYY PRODUCER 11/14/03 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Qowling •& O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 222 West Main St. PO Box 1990 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC # INSURED Gutter Pro Enterprises, Inc. INSURERA: Travelers Insurance Company P.O. Box.1197 INSURERB: Guard Insurance Group Plymouth, MA 02362 INSURER C: INSURER D: INSURER E: - 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _TR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE MM/DD DATE MM/DD/YY LIMITS A GENERAL LIABILITY 1680459H3118TCT03 11/07/03 11/07/04 EACH OCCURRENCE s1-nnn nnn CLAIMS.MADE I X I OCCUR LIMIT APPLIES PER: ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESSAIMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION E B WORKERS COMPENSATION AND GUWC440685 EMPLOYERS' LIABILJTY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER 11/07/03 111/07/04 DESCRIPTION OF OPERATIONS I LOCATIONS t VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Operations performed by the named Insured subject to policy conditions and exclusions. Gatewood Homes 1600 Falmouth Road, Suite 25 Centerville, MA 02632 MED ExP (Arty one person) I s5, 000 PERSONAL R ADV INJIMY 1 e4 Ann nnn COMBINED SINGLE LIMIT E (Ea accident) BODILY INJURY E (Per person) BODILY INJURY (Per accident) E PROPERTY DAMAGE E (Per accident) AUTO ONLY - EA ACCIDENT E AC C OTHER THAN EA E AUTO E E E.L DISEASE -EA EMPLOYEg S1OO DDD E.L DISEASE. PAI Iry I u" thnn nnn SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 n DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED ACORD 25 (2001/08) 1 of 2 #32273 LS1 0 ACORD CORPORATION 1988 .( `\_ 11/•1I VJ 10.11 rAA DUdT900249 GOLDMAN ASSOC 001 ®g�QP.D. C= TIFIC TE OF t 1ABILITY INSURANCE I Call AB o.,�, ►.+r... PRODUCER TAVAN50 11 17 03 GOLL3i*.iI i A58CCIATEb I1ybORANCE TFi1$t.F�r.tCA►—Etst A iTiATTER AF lliraweaarrnw _ FINA:iCIAI. SERVICES INC. ONLY AND CONFIM3 NO RIJqKT3 UPON THE CERTIFICATE HOLDER. THIS CERTIFICATEIDOES NOT AMEND. E rrMD OR 933 FALMWIA RD. ALTER THECOVERAGE APFORDBD-BY.THE POLtCM&SEL0� .. HYANNIS MA 02601 ?;tone: 50E9-775-6010 Fax: 50S-7S0-0249 MMURfR. :.FrrCR NG C�,IE.�6CE NA.:. s RODNEY TAVANO "V DEW MECHANICAL SYSTEM. aaswEzc 110 HOLDER LAB W-SAMiSTABZE MPL 02668 :.o.Ao M%,S9Ar:CQ RL 7HEPOUCX4 OF MJRANCX LWn9D eM.OVVHAVEWENg"ZOTO TIG PiCIir&O HAAFED ABGVE FOR T€PClL1'PERICa PND['JOEO. AMOPG ANY REDIl�EM,TERYOR GOtt/TIW OFANr CDNiRACi OR OIMM DmA!uffVMM fE9PECTTO WraCHTFa7CfRiF7CATEHAY IBEUED OR NAYP¢RTP".THETOUAMMAR40FtOEDBYTWPOLK=OESClGBFDhV"6a.�iEc TDAITwTaas,Er¢ta�nANO cps GAfWREOATE L8YT5 SFL1MJwrwvETstfN PtF2ll®8C PADGMB. GH TrP:CPPsal.�A-"LS=.L.1721,I121/03 A X wim®a-xcr UMUlmm tY° 11/21/OGs50000 s 1000000 �E+Tm�nrPenmE isaoo ON4LAADVS1SAgr $1000000 TEUWrAPPL=PER: Pa=y F-1 PPRRO-- -FIC+, AOOREGATE S'ZOOQOOQ'GtNLy-`E� AOO $ 2000000 ..I� wi ANYADTO ALLU EDAUTO33 AUTOS- ligEDAi7P09 NOMESMEaAUi06 mar seq=L" R T RAW ..P�j S r ., ;air s DAMAGE GARAGEUABX= ANrALTTO. IAffO*&Y-EAA=vuir i fil�N EAACO OHLY AGG f i tfR�.fiY fY a Fj CLASS YAM T�nucrat PE18df7d+ f WOOMM gTpCLSAT"��! AND AM ARnffR� OFFKMqNAEMMREXCUJ Sjg-du Te�°iage.d OTHER $727aAS4903 OS/03/03 - 05/03/04 � L'Cf.7.So�^ S � S S ER S EAQ1ApGOENr s 100000 S MPASE-EAEcfPUMM 1100000 016EA5E-POL=LXff 5500000 OESc15+vT3[7(Y Gf OP'E'HTIOFA! l,AfdTT67�f Vwr+ sa/�"n . rwr ADDm 6Y OM�IKE7EMf W%ci L iA[Ari cm CERTIFICATE_ HOLDER ,.... ,... . c�irgseo� a►aus�AaYTOT O4TETHEAEOF, GAVEVICOD Bm= nx - Pun= oncrsmnmuTENanu FAX 508-778-5603 malow NO COLMAT"OR ummm ISW FALMOUTH RQAD- ATTKt CENnRVILLE MA 02632 • T NWAVORTOWL 10 DAT3 WRITTEN i.TOTkELEFrJWF/L lW TODOEOWW" taco 1ACNTHE ABIArFR m •GEntts G7t ACQED, CEl 1 IFICA 9 E O LIABILITY INSURANCE DATE ' 0=8=0 PROOUCER 568 672 2997 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION JOA4M-OIAS ONLY AND CONFERS NO RIGHTS UPON 'THE CERTIFICATE OIAS INSURANCE HOLDER: THfS" CER-TWICATE DOES NOI AO�ENOT E]CiENQ OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 535 BRAYTON AVE FALL RIVER. MA 02721 INSURERS AFFORDING COVERAGE NA1C1C PISURERA: GRANITE STATE INSURANCE COMPANNY ! WC 49448-85 INsuREo JOEL FERREIRA DEALMEIDA y)suRERB: NAUTILUS'fIVSURANCE COMPANY- NC27580& DBA EJJA CONS T RUCTION i 50 PICKERING ST. APT 17 *1SURERCI FALL RIVER, MA 02720 —.S ,R E: —_— COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ACLY.. REQLOREMENT, TEITM OR CONDITION OF ANY CCNTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TH13 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCKI5ED-HEREMFt9SU04E6T TO ALL Tf 6TERMS, EX0 IISIONSANU CDNQITtO.NS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR on- POUC]rNUMBFR EFFECTNt "Ucy PtAnON LBdIT3 CE14 MLLIA51UTY 'eACHOCCURF:eNCe S 117,91311.000- X cOMMERCIALOt+eRALwB0.m NC27580E G6/26/2CO3 06/26/2004 v s oaunPcn eI 100,000 I. tEOEXP(APyone0eleoe) i ,CIANASMADG OOCCUR II'S, S;BOE} I S 1,000,000 rONAL&At)VINt&,RV ; rAGGREGAiE- �S- Z,000.000_ I ----_ f.EMLACCREGATE LIMIT APPLIES PER: PRODUCTS. COMPIOP W. ,S 2000000 POLICY 17 PROcT . .LOC AUTOUOBSE WABI ITY T� COMEINm TaNC:E Ir'M1T i s 1 ANY AUTO (Ee seCGEnI) T fR]DRYIW URY 4!,L! ,191 —}— 1 •—^ I i ALL OWNED AUTOS SCNEBLILED AIR0.5 W RG7 AUTOS NOwowNEanuros FF . _ I S y{j •--. I BOaLYIWURY IPv+°c'°e'NI PROPERTY DAMAGE I I PYr a.—tGsne) 1 GARAGE LIABILITY AUTODNLYY EtACCIDeI+T i omER THAN FAACC S i ANY AUTO I AUTOONLY: �� eXCE33NM6RELLA UA9 EACHOCCURRENCE J. S If J OCCUR CLAIMS MADE I AGGREGATE I S S _ OEDUCTtBLE S I (RETENTWN S MW RNERACOYRENBATION AND EMPLOYEBILRY WC' 494'4$-85' Tt/08/03• I 1'NOHJO4 ELEACHACCWENT ISY,00B;O0E7- ANV PROPRImETOero R/ PAATNERIEX'n{LiNE E-L. WCCAGG.EA EMPL:TYGF S TOOO,O OPPICGRA+ENBER EXCLUDED? •••//��yy,, delUBOIP100+ SPECIAI,PROV1910NEe+br IEL01WASE1POf:CMWh fl, I-OOO-am OTHER DESCRIPTIONOFOFERATIDRS/ LOCATIONSI VEHIGLGS/ EXC1 USIA" AIMPN RY ENDORSEMENT!SPECIAL PRDVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OFTHE ABOVE ouCRtSID POMMS BE CANC&XE79WQRETNE EXPIRk"ON- DATE THEREOF, THE ISSUING IN3VRER WILL ENOEAVOR TO MAL 10 DAYS YRRTTGN GATEWOOD HOMES xOT1CiT?T11CC£RTaMATtNptDER NAMEDTO THE LER, im=V., UK T^ a T^ T« 1600 FALMOUTH RD. IMPDSE NO OBLIGATION OR LIABILITY Of ANY RP+o VroN me WaURER, In AGBNTS an CENTER VILLE. MA 02632 REPRESENTATIVE& AYTHORQEDR ElENTA try AV VKU ZR (bVVTIVOI U 4 ACORD CORPORATIOWMI37- r rI CERTIFICATEOF I S LE ISSUE DATE (MWDD/YY) 11/10/2 PRODUCER Passaro Leyerone & Buckley Insurance Agency Inc P 0 Box 160 Dennisport, MA 02639 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND ORALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY A A.I.M. Mutual Insurance Co INSURED Patrick K Orcutt dba P & S Concrete 37 Ladys Slipper Lane Mashpee, MA 02649 COVERAGES . 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 RESPECTTO 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. CO I. TYPE OF INSURANCE POLICY NUMBER POLICY. . EFFEcTrvr DATE(MM/DD/YY) POLICY EXPI ATio DATE(MM/DD/YY)LAIITS LIABILITY MMERCIAL GENERAL LIABILITY IMS MADE�C CTOR'SPROT. ENERAL AGGREGATE S PRODUCTS-COMP/OP AGC. S PERSONAL&ADV. INJURY S 9WNER'S&CONTPA EACH OCCURRENCE S FIREDAMAGE(Mryomfim) S MED. EXPENSE (Any one Person) S ILE LIABn iTY AUTO AUTOS ED AUTOSODILY AGE LIABILITY _BODILY COMBINEDSINGLE LIMIT S _ INJURYEDULED Person) RALLOWNEDAUTOS INJURY-0WNED`AUTOS Pere qdm) [PROPERTY DAMAGE S EXCESS LIABILITY MBRELLA FORM - THAN UMBRELLA FORM CH OCCURRENCE $ CCREGATE S A WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR/ PARTNERS/EXECUTIVE INCL OFFICERS ARE: REXCL I OTHER 6006181012003 10/712003 _ 1021/2004 WCSTATU- X Or $ . EL DiSEASE—POLICY LIMIT S 1000 000 EL DISEASE —EA EMPLOYEE S I OOO OOO DESCRIPTION OF OPERATIONS/LOCATIONSNEHIr'I S/SPECIAL ITEMS CERTIFICATE HOLDER GANCELI S2.. ON _ Gatewoods Homes 1600 Falmouth Road Centerville, MA 02632 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPR%SENTA7��7 1 508 564 7272 P.01i01 ONLY RIDER. RISK SPECIALISTS HOLM INSURANCE AGENCY, INC. AU IER F.O.BO% 115 CATAUMET, MA 02534-0115 COMPANY tNaunED 1 MONUMENT INSULATION, INC. 8j 223 COUNTY ROAD ;ANY BOURNE, MA 02532 M OA .......,^..".9....'i........-•ywr..w.w .."^.'^• THIS IS TO CERTIFY THAT THE POUCIEB OF WBURANCE U3TED BELOW HAVE eEr7J ISSUED TO THE INSURED NAMED ABOVE FOR THE PoU y pgmOD��'" INDICATED, NOTWRNSTANDWG ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CEF iCATE MAY BE ISSUED OR MAY PERTAIN. THE INSL.,A.YcE AFFORDED BY THE POLICIES D-.SCR= WERE1N IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. UMIT6 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 0111 Type OF LNLURANCE POLICY NONBEA ICY' um POYCY £OIIIi co IDATE(MMi 00.7E 011VDD/YY) P--' rAOAEAGALOETI6TAL CWM9 M ®g owNEas E CONTRACTORS PROT CLI135 745 AUTOM0842 LUHIUTY ANYAUTO ALL OWNED AUTOS SCNE'DU MAUKS m"m Ai NON-OWh'EDAUTCS chr-lOE UADLLLTT ANYAfJlQ' UMBR9IA FCi7A OTHER THAN UMBRELU FORM WORN£rt4 cWLpEL FLOYlRUALY71Q WC 7�FIwr F 82 61 72 "ns GATEWOOD HOMES IINC 1600 FALMOUTH ROAD 125 CENTERVILLE, MA 02632 508 778-5603 8/23/03 18/23/04 COMBINED SINGLE UMf7 s wYr.a,"a jJfP• E r s PROPERW OAMAGC s AUTD OM.Y • EA ACCM0 3 S S 9/5/03 19/5/04 E11 AMY OF THE ADM DF3CAIEm POUCLLT: BE CANCELLED EEpONE 71TE' 004MTLOII RATE TNFAEOF. THE IEEDIN6 COMPANY WLLL ENDEAVOR To MALL ,1 yam Dan WRITTEN NOTICE TO DIE CXRrFLCATE HOUiEA NAMFYTD-TAFLFFT DUT FARtinE 7 LIAR . Nonce ENALL IN" MO ODUOIIDOM OA UAEIU7Y TOTAL P.01 .+ -v- v4: A4Y .: A.. LSCJ`[i.AA./,n CERTIFICATE OF LIABILITY INSURANCE DATE tMMIDUYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION L1c3hea .insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE.. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 749. Main Street, Suite#H ALTER THE COVERAGE AFFORDED By THE POLICIES BELOW. Osterville, Ma. 02655 54fl,,T0=9011 INSURERS AFFORDING COVERAGE rlH6uae0 Casperson Overhead Doors - INSURER A• � INSURERR.� Box 517 INSURER I, East Falmouth, MA 02536 INsuaERS INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANOMG- 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. T TYPE Of INSURANCE POLICY NUMBER NdR .LTR uEwnE i iW CY A ION O�A1E DATE E� LIMITS GENERAL LIABILITY COM EACH OCCURRENCE E . i500000 E IBAyLEL ��q FIRE DAMAOF.(Ay onaAtelCLAWS A `�-� MED SIP (Arty We preen) S �,.. , MPP48352 05/28/03 05/29/04 PtRSONAL a.ADV INJUAY E 0 A) E LIMIT AITUtS PER: DEN AGGrAUTOMOB&C GENERAL AGGREGATE LCC PgODUCTS • COMMP AGO - ^^ ^^^ S 0.,�.JL+.IL�Y.. JO' ABILITYY COM ED SMGLG LPMi AUT09DAUTOS IMLY INJURYIPw Prato) SD AUICMW - BODILY VINRY _ _ - (Pr.eaaeM) PROPFATY DAMAGE (Pr W f=m) S GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S EA ACC E EICES?tlAMtfTY- AUTO ONLr; AOO i OCCUR CLAMS MADE EACH OCCURRENCE S S AGGREGATE 04OUCTIOLC �..• S _ METEMmu- s WORKERS COMPENSATION AND S EMPLOYERS LIABILITY MC'Fd8352- TDRY LIMITS ER A 02/22/03_ 02/22/04 EL•EACNACMENT s500.000 . E.L. DISEASE . EA EMPLOY OTHER E.L. DISEASE - POLICY LIMIT F DESCRIPTION Of OPERATION�JL AIIUNWV2HICLEEIEXCLUBIONS ADDED BY ENDORSEMENTISPECUL PROVISION& CERTIFICATE HOLDER ADDITIONAL INSURES iwmInFP,1 v.. w,....�..-..._-. Gateway gomes 1500 Fal-south- moacr, Suite 253C Carterville, MA 02632 778 5603 r ACORD 25-S (7197) DATE THEREOF. THE L4SUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOfICETO-TNEfEgTIF10AT6.1101,DEn ••�••�•• SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINP UPON THE INSURER, ITS AGENTS OR ACORD CORPORATION TSSO T, DATE A RDn CERTIFICATE OF LIABILITY INSURANCE 07/1 S/71181M,D°"' ' D3 ODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION s QoWling & 0' Neil Insurance ' ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 222 West Main St..PO Box 1990 Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: Hanover Ins. Company Busy Bee, Inc. - INSURER e: Safety Insurance Company . P.O. Box 50 . INSURERc: Associated Employers Insurance Compa East Sandwich, MA 02537 INSURER D: - NSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INbK LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE M IDDIM POLICY EXPIRATION DATE MM/DD/YY LIMITS A GENERAL LIABILITY OHN643998501 06/14/03 06/14/04 EACH OCCURRENCE S1000000 X COMMERCIAL GENERAL LIABILITY 'CLAIMS MADE a OCCUR DAMAGE TO RENTED n $300 000 MED EXP (Any one person) -$15 000 X PD Ded:250 PERSONAL & ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GENT. AGGREGATE LIMIT APPLIES PER POLICY 7 JECCT LOC PRODUCTS-COMP/OP AGG S2000000 B AUTOMOBILE LIABILITY ANY AUTO 3175394 01/14/03 01/14/04 COMBINED SINGLE LIMIT (Ea aeddent) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY (Perpenai)U� S100,000 1XX HIREDAUTOSBODILY NON -OWNED AUTOS '" ' INJURY. (Per accident) S30O 000 PROPERTY DAMAGE .(Per accident) S1 OO,000 GARAGE LIABILITY .... - ^ ` " AUTO ONLY - EA ACCIDENT S ANY AUTO OTHER THAN EA ACC $ S AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE S AGGREGATE S S DEDUCTIBLE ' S S RETENTION S C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY WCC5002932012003 06/27/03 06/27/04 WC ORY LI - oTH- E.L. EACH ACCIDENT $100,0.00 ANY PROPRIETOR/PARTNER/EXECUTNE OFFICER/MEMBER EXCLUDED? If yes, descdbe under E.L. DISEASE -FA EMPLOYEE $100000 E.L. DISEASE - POLICY LIMB S5OO,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Operations performed by the named insured subject to policy conditions and exclusions. i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION GBYBWOOd HOTneS DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1f)_ DAYS WRITTEN 1600 Falmouth Road Suite 25 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO OO SO SHALL Centerville, MA 02632 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) 1 of 2 #30822 0. KJS O ACORD CORPORATION 1986 TOWN OF YARMOUTH ` (OFFICE USE ONLY � Building Department Town Hall Recorded By: IC Yarmouth, MA 02664 (508) 398-2237 ext.261 Permit F@@: $�.O[) Deposit Rec: $50.00 B BUILDING PERMIT Payment Type: Check ChkNo.: 614 Net Owed: ($50.00) APPLICATION RECEIPT Application Date: 3/8/2004 Issue Date: Temp Permit No.: T-04-440 Expiration Date Applicant Name: Frank Capra Comments: CW! 0 71,(:iz. Location: 00121 CAMP ST # 1 new construction: Owner's Name: Village at Camp St., LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 This is NOT a building permit. Application subject to plan review. Contact Building Department for permit status. Official Building Permit will be issued upon plan review completion, approval, and complete payment of Net Owed on Permit Fee. Date Printed: 3/15/2004 TOWN OF YARMOUTH WATER DEPARTMENT 99 Buck Island Road West Yarmouth, MA 02673 Telephone: (508) 771-7921 • Fax: (508) 771-7998 Date of Issue : Mar 18, 2004 Letter of Water Availability 1. Single Family Dwelling x 2. Duplex Family Dwelling 3. Condominium Dwelling 4. Commercial / Industrial 5. Other (Specify) Reference; Massachusetts General Laws Chapter 40, Section 54 To : Town of Yarmouth Building Inspector Please be advised that the Town of Yarmouth Public water supply is available to service lot/parcel(s) 21.1C1 Street 121 CAMP ST #1 as shown on Assessors sheet/map # 44 Issuance of this Letter of Availability is subject to the following provisions/restrictions. (1) The property owner agrees to comply with all Federal, State, and Local Laws, Rules and Regulations as they pertain to the use of the Public water Supply. ' (2) The Yarmouth Water Department shall have exclusive rights as to the size, number, type and location of all water service lines, fire service lines or appurtenant items connected to the water distribution system. (3) The Yarmouth Water Department reserves the right to require, at the property owners expense, the installation of water mains and appurtenant items to meet water demand requisites within any structure relevant to this Letter of Availability. (4) This Letter of Availability will expire 180 days from the date of issue. I have read and understand the provisions/restrictions of this Letter of Water Availability. Reference VILLAGES AT CAMP STREET FRANK CAPRA 1600 FALMOUTH RD #25 CENTERVILLE, MA 02632 owner (Sign) J I Yarmouth Water Department of YAR �c . qqo TOWN OF YARMOUTH 0 • / BUILDING DEPARTMENT O bi"A bsBUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF +..ow.• TRANSMITTAL SHEET Building Site Location: /,9 / Proposed Improvement: Annlicant: No: . &--LotNo• P./• (:f _77e yid Address: Tel.No.: '7%� 1`GGt> Date Filed: 3 { The Building Department will be responsible for assisting the app 214dispatching your plans and or application to the following applicable departments. RESIDENTIAL AND/OR COMMERCIAL BUILDING WATER DEPARTMENT: Determines Compliance of Water Availability and or existing location. ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage. CONSERVATION COMMISSION: Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. -------------------------------------------------------------- -----------------------•--•--------------------- ..-.-..------------------------------ REVIEWED BY: l%1. WATER DEPARTMENT:: DATE: /% O N/A V2. ENGINEERING DEPARTMENT: DATE: N/A 3. CONSERVATION: DATE: N/A V4. HEALTH DEPARTMENT: DATE: N/A INDUSTRIAL AND/OR COMMERCIAL PERMI" S. VARING INSPECTOR DATE: N/A 6. PLUMBING INSPECTOR: DATE: 7. FIRE DEPARTMENT: DATE: N/A PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: White copy - BuAdmg Dept. - Pmk copy - Wata Dept - Yellow Copy - Haahh Dept. - Pink Copy - Eognecriog Dept. - Goldanod - Fite Dept vafiw ,.. _ sw..r•u..�..\b_tiaS wli . �'�..�i is lr+Va. W.:w.r-�.+'c. .. �J ..-..-. _•ten-�....•:,...�F-Ja-... F ."��.+o..w a..r--�-,....- _..v....�.i�'*yay.-. �+.. ai.-......�.v�--..-_..... Building Site Location: Proposed Improvement: TOWN OF YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET � / eolc�'o J l / / iN q Map No: f/y Lot No: #*/• -77Z 94�Z Address: &27) 1 �p �il/illt � CV45 1&A,Za Tel -77g �`/ Date Filed: 3 y 0 The Building Department will be responsible for assisting the appi&'y\dispatching your plans and or application to the following applicable departments. RESIDENTIAL AND/OR COMMERCIAL BUILDING WATER DEPARTMENT: Determines Compliance of Water Availability and or existing location. ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage. CONSERVATION COMMISSION: Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. REVIEWED BY: ✓1. WATER DEPARTMENT: DATE: N/A: V2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: HEALTH DEPARTMENT: Yam" 7'I �Z'D DATE:Z� N/A 9 z3-off INDUSTRIAL AND/OR COMMERCIAL PERMITS S. WIRING INSPECTOR: DATE: N/A: 6. PLUMBING INSPECTOR: DATE: N/A: 7. FIRE DEPARTMENT: DATE: N/A COMMENTS: RECEIPT OF COPY: PLEASE NOTE SIGNATURE OF APPLICANT: DATE: White copy - Baild'mg DepL - PWk Copy - Wow DepL - Ydbw Copy - H=M DepL - Pmk Copy - Engrg DepL - GoMWYW - Fire DvWM oavcvation 04/27/2004 08:41 5083625269 NORTHSIDE DESIGN PAGE 03 MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck software Version 2.01 Release 2 CITY: Barnstable STATE! Massachusetts HOD: 6137 CONSTRUCTION TYPE: 1 Or 2 HEATING SYSTEM TYPE: Other DATE: 4-26-2004 DATE OF PLANS: 04/21/04 TITLE: The Egret PROJECT INFORMATION: Mill Pond village camp street Yarmouth, MA. COMPANY INFORMATION: Northside Design ASSOC. 141 Main street Yarmouth Port, MA. 02675 COMPLIANCE: PASSES Required UA - 258 Your Home = 144 Family, Detached (Non -Electric Resistance) I I I I Permit # I I 'I I Checked by/Date I I I Area or Cavity Cont. Glazing/Door -------------------------------- Perimeter R-value R-Value U-Value uA CEILINGS 832 30.0 30.0 14 WALLS: Wood Frame, 16" D.C. 1409 15.0 1S.0 62 GLAZING: Windows or Doors 87 0.340 30 GLAZING: windows or Doors 40 0.340 14 DOORS 40 0.086 3 FLOORS: Over unconditioned space 832 19.0 19.0 21 COMPLIANCE STATEMENT: The proposed building design described here is - consistent with the building plans, submitted with specifications, and other calculations the permit application. The proposed building designed to meet has been 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 125% of the design load as specified in Sections 780CMR 1310 and 34.4. Builder/Designer Date • EFFlCIENCY RATNG FT. M CERTFlED LTI - L --- ama C I V C 1� Air Conditioning &Heating 92.6% AFUE MULTI -POSITION CONDENSING GAS FURNACE GMNT SERIES U*'4_.rr_J Description / Application • All models design certified by ITS to be in compliance with ANSI Z21.47 and CAN/CGA 2.3 (Canada) safety standards • Completely assembled, factory run -tested furnace, for heating or combination heating/ cooling application • For utility room, closet, alcove, basement or attic application • Vertical or horizontal venting with 2" PVC for 40k, 60k, and 3" PVC for 80k, 100k and 120k • Capable of multi -position installation — upflow, downflow or horizontal • For direct vent (2 pipe) or non -direct vent (1 pipe) installations Construction • Heavy gauge, reinforced, wrap -around insulated steel cabinet with durable baked enamel finish • Tubular heat exchanger (Primary) • Bottom or side air inlet • Aluminized steel inshot burners • Convenient left or right hand connection for gas, electric service, combustion air and vent • Removable solid bottom block -off Standard Equipment • Energy saving PSC, multi -speed, direct drive blower motors • Quiet operating, sound isolated blower assembly • 40VA transformer for heating and air conditioning control service • Combination redundant gas valve and regulator • Integrated furnace control with diagnostics • Blower door safety switch • Energy saving Hot Surface Ignition system • Multiple flame roll -out switches • Outlet air limit switch • Pressure switch for proof of air • Complies with California NOX Standards • Completely insulated cabinet • Corrosion resistant 294C secondary heat exchanger that extracts energy from the gas and converts it to usable heat • Quiet, corrosion resistant plastic induced blower assembly • Drain kit contains vent screens, drain trap, hoses & clamps Optional Equipment • L. P. Conversion Kit (LPT-01) • Concentric Vent Kit (CVK-00) As an Energy Star Partner, Goodman Mfg. Co., LP., has determined that this product meets the Energy Star guidelines for energy efficiency Information contained herein is subject to change without notice. Made in the USA by: Goodman Manufacturing Company, L.P. SS-312D 2550 North Loop West, Suite 400 - Houston, Texas 77092 GMNT Series 10/01 www.izoodmanmfg.com PERFORMANCE RATINGS Model Number GMNT Natural Gas Input BTUH Natural Gas Output BTUH Propane Gas Input BTUH Propane Gas Output BTUH DOE AFUE Temp. Rise 040-3 40,000 37,000 37,000 34,000 926 25-55 060-3 60,000 55,000 55,000 51,000 92.6 35-65 080-4 80,000 73,500 73,000 73,000 926 35-65 100-4 1 100,000 1 92,000 1 92,000 85,000 926 40-70 12M I 120,000 1 110,000 1 111,000 102,000 926 40-70 BEFORE PURCHASING THIS APPLIANCE, READ IMPORTANT ENERGY COST AND EFFICIENCY DATA AVAILABLE FROM YOUR RETAILER. - SPECIFICATION DATA i1�J.:....1 ..L.......J...:..i:.... 44C/4 icxn C.nA^A Mnnm,4;^n 1/-O GPT Model Number Motor Blower Vent* Dia. Combustion* Air FilterSizeire Perm. / Disp. Electrical Ship Weight HP Spd. Dia. Width FLA Max Fuse 040-3 1/3 3 10 6 Y 2' 290 / 580 52 15 170 0603 1/3 3 10 6 Y Y 290 / 580 52 15 180 080-4 1/2 3 10 8 3' 3' 385 / 770 7.8 15 205 100-4 1 1/2 3 10 10 1 T 3' 385 / 770 7.8 15 225 120.5 1 314 3 11 10 1 3- 3' 480 / 960 92 15 265 "Note: Vent ana comnusnon air aiameters may vary oepenaing upon vent lengui. % IMX;K vnul 11MU uouvl I P, WI11W I accompany the furnace. 28" A 58" 4.. 198.. 47 B � 47„ 4••r r 8., COMB. AIR INLET i 128" COMB. AIR INLET GAS INLET 51,11 4 , i • GAS INLET LOW VOLTAGE 4" J i ELEC. 104" 11 Model GMNT A B Combustible Floor Base 0403 & 0603 14' 12 Ys SBM14 0804 17 %. 16, SBM17 1004 21' 19 Y; SBM21 120 5 24 % 23" SBM24 SS-312D 2011, 8 Pl3ui LOW VOLTAGE CLEARANCES FROM COMBUSTIBLE MATERIALS nt* Vent Top 1' D' 3' 0' 1' Sides Rear Fro Approved for line contact in the horizontal position. *36' clearance for serviceability recommended. 2 CASED (U) COIL APPLICATION OPTIONS Furnace Model Number GMNT040-3 & GMNT060-3 GMNT080-4 GMNT100-4 GMNT120-5 Furnace Width 14" 17Y27 21" 24'/Z Coil Model Number Coil Width U-18 14" X U-29 14" X U-30 17Y2* X (1) X (2) U-31 14" X U-32 17'/:" X(1) X(2) U-35 14" X U-36 17'/z" X(1) X(2) U-42 17'/� X(1) X(2) U-47 17'/i X U-49 21" X(1) X(2) U59 21" X(1) X(2) U-60 24Y2* X(1) X(2) U-61 24'/:' X(1) X(2) U-62 21" X (1) X (2) (1) Using the factory installed bottom cabinet filler plates (2) Discard bottom cabinet filler plates Due to the rating mix/match of various coils with outdoor units it is important to match the furnace air flow for the total system capacity. Refer to furnace, heat pump and/or condensing unit specification sheets. AIRFLOW DATA CFM - NO FILTERS MODEL STATIC .1 .2 .3 .4 .5 .6 .7 .8 HI 1370 1315 1260 1200 1140 1070 1000 925 GMNT 040-3 MED 1210 1170 1130 1085 1040 980 920 860 LOW 895 880 870 840 825 780 725 680 HI 1360 1300 1250 1190 1135 1065 1000 930 GMNT 060-3 MED 1200 1170 1130 1080 1035 975 925 880 LOW 910 895 885 855 835 790 750 700 HI 1865 1800 1735 1660 1590 1510 1415 1320 GMNT 080-4 MED 1690 1645 1600 1545 1485 1410 1345 1245 LOW 1450 1400 1390 1360 1325 1270 1200 1125 HI 2010 1945 1875 1800 1715 1620 1510 1400 GMNT MED 1725 1700 1670 1615 1550 1475 1375 1275 100-4 LOW 1430 1390 1350 1315 1285 1245 1160 1070 HI 2360 2325 2300 _ 2170 2125 2045 1945 1850 GMNT 120-5 MED 1815 1750 1710 1660 1600 1545 1480 1415 LOW 1275 1215 1190 1145 1110 1055 985 925 Values indicated by shaded areas represent airflows that are too low for heating temperature rise. SS-312D 3 NOTE: SPECIFICATIONS AND PERFORMANCE DATA LISTED HEREIN ARE SUBJECT TO CHANGE WITHOUT NOTICE, It . N Quality Makes the Difference! All of our systems are designed and manufactured with the same high quality standards regardless of size or efficiency. Our designs virtually eliminate the most frequent causes of product failure. They are simple to service and forgiving to operate. We use the highest quality materials and components available because if a part fails then the unit fails. Finally, every unit is run tested before it leaves the factory. That's why we know... There's No Better Quality. Visit our web site at www.goodmanmfe.com for information on: • Goodman products • Warranties • Customer Services • Parts • Contractor Programs and Training • Financing Options SS-312D 4 I MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.01 Release 2 CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 HEATING SYSTEM TYPE: DATE: 6-20-2002 TITLE: The Egret or 2 Family, Detached Other (Non -Electric Resistance) PROJECT INFORMATION: Mill Pond Village 1600 Falmouth Rd. Unit 25 Centerville, MA. 02632 COMPANY INFORMATION: Northside Design Assoc. 141 Main Street Yarmouth Port, MA.02675 COMPLIANCE: PASSES Permit # Checked by/Date Required UA = 219 Your Home = 121 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA CEILINGS 832 ------------------- 30.0 30.0 14 63 WALLS: Wood Frame, 16" O.C. 1432 15.0 15.0 0. 41 GLAZING: Windows or Doors 128 0.086 86 3 DOORS 40 COMPLIANCE STATEMENT:- Theproposedbuilding design described here is calculations consistent with the the building plans, specifications, application. The and other proposed building has been submitted with permit 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 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date e Massachusetts Energy Code MASpheck Software Version 2.01 Release 2 The Egret DATE: 6-20-2002 Bldg.l Dept.l Use I CEILINGS: [ ] I 1. R-30 + R-30 Comments/Location I WALLS: [ ) I 1. Wood Frame, 16" O.C., R-15 + R-15 Comments/Location I WINDOWS AND GLASS DOORS: [ ] I 1. U-value: 0.32 I For windows with labeled U-valueThermalrie Break?a[ue ]yes [ ] No # Panes Frame Type I Comments/Location I I DOORS: [ ] I 1. U-value: 0.086 I Comments/Location I I AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: I 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled, VAPOR RETARDER: [ ] I Required on the warm -in -winter side of all non -vented framed I ceilings, walls, and floors. I MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can a I a determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be I provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. I DUCT INSULATION: [ ] I Ducts shall be insulated per Table J4.4.7.1. •I ] I I I I I I I I I ) I I I I I ) I I I I I l I I I I I ] I I I I I I I I I I I I i ) I I I I I I I I I DUCT CONSTRUCTION: All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or 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 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 20% 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.): HEATING SYSTEMS: Low pressure/temp Low temperature Steam condensate COOLING SYSTEMS: Chilled water or refrigerant PIPE SIZES (in.) TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" 201-250 1.0 1.5 1.5 2.0 120-200 0.5 1.0 1.0 1.5 any 1.0 1.0 1.5 2.0 40-55 0.5 0.5 0.75 1.0 below 40 1.0 1.0 1.5 1.5 CIRCULATING HOT WATER SYSTEMS: Insulate circulating hot water pipes to the following levels (in.): HEATED WATER TEMP 170-180 140-160 100-130 PIPE SIZES (in.) NON -CIRCULATING I CIRCULATING (F): RUNOUTS 0-1" I 0-1.25" 0.5 I 1.0 0.5 I 0.5 0.5 I 0.5 MAINS & RUNOUTS 1.5-2.0" 2.0+" 1.5 2.0 1.0 1.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only)------------------------- i�—V ■ MPD4540 MPD4035 • Louvered face design P Charred split oak gas log set • Deluxe pan burner for big yellow flames and glowing embers • Charcoal black exterior powder coat finish • Realistic brickaded interior panels • Combo top/rear direct -vent outlets (except 3328 models, which have either a top or rear outlet) • Hi/Lo flame operation • Pre -wired for wall switch • Choice of standing pilot (works in a ower failure) or pilotless electronic (pintermittent) ignition • Decorative polished brass or brushed stainless accessories (arch door kit, door trim, louvers, hood) • Wireless remote controls • Blower kits (including a temperature control version) • Screen panel kit (heat guard) • Radiant panel kits (for a clean face look) Merit Plus Series direct -vent gas fireplaces utilize either sure Vent (rigid) or Secure Flex (flexible) 4.5" er/7.5" outer coaxial venting system, and include a year limited warranty. Note: Due to Lennox' ongoing commitment to quality, specifications, ratings and dimensions are subject to nge without notice. Local conditions, such as elevation, wind vent configu- on and choice of fuel will affect the overall appearance he fire. Warnock Hersey U20006711) Warnock Hersey W/ C ■—iT US _ems The first two model number digits ' indicate frame width, the last two digits indicate glass width. All are A.F.U.E: rated high efficiency vented gas fireplace heaters, certified under ANSI Z21.88 and CSA 2.33-M99. MPD3530 MPD3328 DIMENSIONS (Rear vent model shown) 3328 MODELS (This model comes as a top or rear vent only) D B T 6.13/18" 7-1/2' atn" Front Face Top 35,40 & 45 MODELS ,a',R I 3" H C 9 Q. Lim D + A. F op6a nei E g„ bctncal 8" 8" 1 t Eectr ca 1-6/8" Inbt 7-1M" 41/2" _3L ETZ1 V8" Front Face Right Side (These models come with a top and rear vent) FIREPLACE & FRAMING DIMENSIONS Side 211/2 103/4 331/4 331/4 3530 351/8 321/8 19 291/2 351/8 2111A6 2478 12%6 351/4 351/4 16 4035 401/s 371/8 24 341/2 401/8 2611/16 29%8 1415/16 401/4 401/4 16 4540 401/8 371/s 24 391/2 451/8 2611A6 34N 17%6 451/4 401/4 16 .. m� TYPICAL ROOM APPLICATIONS 3329T NG 17,500 45 64 62 3328T LP 17,500 49 66 64 3328R NG 17.500 53 63 61 lT9 �P 3328R LP 17,500 55 66 64 3530 3530 NG LP 20,000 20,000 53 55 64 62 62 60 v® 0 4035 4035 NG LP 27,000 27,000 59 60 69 69 67 67 4540 NG 29,000 59 69 67 4540 LP 29.000 59 69 67 'Intermittent ignition systems Look for the EnerGuide Gas Fireplace Energy Efficiency Rating in this brochure U6n USA ]a9REM aw.3 WO minno�HmrM Pmducn exit Bowl m CSA PA1-a2 Visit us at wwwLelno>+i earthProducts.com MERIT PLUS - ew SERIES Direct -Vent Gas Fireplaces owve iEwwox � f.,�;;� MPD3328 MPD3530 MPD4035 33' fireplace w/opt. flush face 35' fireplace w/brushed stainless 40' fireplace w/polished brass louver and door trim trim arch door kit Beauty, efficiency, convenience and reliability. Just some of what you'll find in our Lennox Merit® Plus Series direct -vent gas fireplaces. Our combo DV configuration, with both top and rear outlets, allows for top or rear venting (except our 33" units which have either a top or rear outlet). Standard features include a deluxe pan burner that produces big yellow flames and glowing embers, brickaded interiors and Hi/Lo flame opera- tion. And, these models are even easier to warm to when you select one of our optional remote controls, or polished brass or brushed stainless trim options. � wqlmq �p I * � 0 P.M. MIT 0 1 J R 2 Vc ro:5� 30-00 N PRO ER SERVICE rA M'D NOTE: ® SEWER LATERAL —SHALL BE SLEEVED W ACCORQANCE WITH TITLq VIF WITHIN 10FT. OF WATER MAIN. ,r;r( 1 r 2004 GRAPHIC SCALE Y2rmouthLVa;;rDzpt. 20 10 0 20 60 OTICE Unless and until such time as the original (red) stamp of the responsible Professional Engineer, or Professional Land Surveyor appears on this plan: (A) no person or persons, Including any municipal or other ( IN FEET) public officials, may rely upon the information contained herein: and 1 inch = 20 ft REVISED: 3-2-04 (B) this plan remains the property of Holmes h McCrcth, Inc. PLOT PLAN►- '�+1 holmes and mcgrath, inc. OtA OF 41, q, OF LOT 1 civil engineers and land surveyors � S' PREPARED FOR 362 gifford street TIMOTHYM. MILL POND VILLAGE SANTOS falmouth ma. 02540 S No. 4eo7a IN 0 9 CIVIL o YARMOUTH, MA JOB NO: 201197 DRAWN: LMC O� F /ST SCALE: 1 =20 DATE: 1-22=03 DWG. NO.: A2500 CHECKED: j k5 Pe 2 3o 0'00 �EGRE 3,387 ±S.F\ LOT 1 A N PROPER SERN\CE orl IL*N A N. o OP Volt,W pR ( SRO �8, 0� SEE EEC wG NOSE BE �„ PROP R LP�ERPE L=21.67' � SEWE GRAPHIC SCALE ( IN FEET ) 1 inch = 20 ft -ED `N AZER oA NOTE: v ® SEWER LATERAL SHALL BE SLEEVED IN ACCORDANCE WITH TITLE V IF WITHIN 1OFT. OF WATER MAIN. OTIC Unless and until such time as the original (red) stamp of the responsible Professional Engineer. or Professional Land Surveyor appears on this plan: (A) no person or persons, including on y municipal or other public officials, may rely upon the Information contained herein; and (8) this plan remains the property of Holmes do McGrath. Inc. REVISED: 3-2-04 PLOT PLAN a�slw_�a OF LOT 1 holmes and mcgrath, inc. ' j� OF PREPARED FOR civil engineers and land surveyors 7♦.�F? sqs MILL POND VILLAGE 362 gifford street C o�_ TI v0THY M. Gm IN falmouth, ma. 02540'_ "Ocvloia YARMOUTH, MA JOB NO: 201197 DRAWN: LMC SCALE: 1 "=20' DATE. 1-22-03 DWG. NO.: A250O CHECKED: TOWN BUILDING OF CONSTRUCTION IPiEASE PRINT: 121 job Location: -ef, Owner of property: Construction Supervisor* Address: .YARMOUT 14 DEPARTMENT SUPERVISOFORM R M Village oaG3:)— Licensed Desigrv. ) Name (If other than Sup ervising• of each license holder: code and the drawings 2.15 Responsibility letel responsible for all work for which he is su le for sethat all work is done pursuant to the state building 2.15.1 The license In shall be fully and come Y ction, alteration, official. e construction, reconstru pursuant to He shall be resp the building offieincial' e1Vise the and structures onlyp as approved by responsible to sup h he) the license the structural elements of building onwe gth, even though 2.15.2 The license holderoto invo involving a comm e ermit holder. repair, removal or dem able laws of the of any code and all other aPP a subcontractor or contractor to the P of the discovery the state building s building official in wt. . holder, is not the permit holder but only the building permit- y ing other section of these 2.15.3 The license holder shall immediately pe 51 2.15.2 or 2.15.3 or an suspension of violations which are covered by ended, as am shall be subject to revocation or 5. }Any licensee Who shaaln llf°ocedurets, subsmend d, ha ,number of the rules regulation and Y P rules and regu signature and license re ons�ction, the board. the name, in construction, rules and license by hcations shall contain ersons engaged 1 building permit app ervise those pimmediately 2.16 Al supervisor who is to sup ose I by section 109.1.1 of the e code shall imm e1yisingsaidpersons, ent. construction sup removal of demolition as regullongated su e building dePartm alteration, repair, e records of th requesting all required inspections. Failure to do so may regulations. In ccessor license holderat substituted on the cease until a onsible for regulations for licensing construction e permit conditions. e rules and a construction 2.17 The license holder shall be res code. I understand th be deemed a violation of the p res onsibilities undee State building official. sesp , 109.1.1 of the building I have read and understand withancr eco rc inspection as called for by the --- supervisors in andaccorand the specific inspection p FChapterl COVERAGE: policy o r its substantial equivalent which meets the requirements of MGL Ch.15 ent/liability ►nsu Noce P❑ y the appropriate box. a coverage by checking lease indicate the type Bond ❑ hecked, P Other type of indemnity ❑ overage required by policy requirement. lity insurance p Y application waives this req AIVER: si nature on this permit app W Ian, aware that the9 licensee does th heck one: a c I INSURANCE C 2 of the Mass. General Laws, and that Y Agent ------ Owner ❑ Owner oror o Signature: Building Official Approval: BUILDING TOWN OF Y A R M O U T H ELECTRICAL GAS 1146ROUTE28 SOUTHYARMOUTH MASSACHUSETTS02664-4451 Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365 PLUMBING SIGNS BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at a td-lM � S�- Work Address is to be disposed of at the following location: 'D (�'✓� X a��= �� Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. i Signature of Applicant Permit No. D to 310-"q PROPERTY ADDRESS: Ila ALCULATlON FOR PERMIT COST TYPE OF ROOM ETC ADDITION 7 /q 2S/.6S T`fERATlONS BATH �1�.2. � BED ROOM 7 CERTIFICATE OF OCCUPAN( COMPUTER ROOM DECK naawr !1 rvu 4 ION ONLY GARAGE NO. OF BA GREAT ROOM KITCHEN OPEN SHED STORAGE AREA SUN ROOM HEATED SUN ROOM UNHEAT SWIMUNNG POOL AE NO MASSACHUSc==S UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) D 0 O6 r �� _. Mass. Date c Permit Building Location �"�'�r/cc�i— ' r Owners Name Drt� /S ,/l� 7i%�=1y-w Type of Occupancy' �C New ❑ Renovation ( Replacement ❑ Plans Submitted: Yes ❑ No ❑ / FIXTURES " 2 r OY. 4 .. ttl , as m O z ~ W 'S mil` ti�o� V 2 tu O y 7 F ¢ W Cosur y �- V Q ¢ r- to Y ? Q p y 0. AC N tL O ¢ a¢ O W=¢O H Q Y W It Y W II N I- Z O O v7 2 Q W �' O U 2 3 O toII II J S r... N 4. O II II d ¢ m Q SUB—BSMT. I I BASEMENT I I I 1ST FLOOR II I I I 2HD FLOOR I I SRO FLOOR 4TH FLOOR STH FLOOR I I 6TH FLOOR I I 7TH FLOOR I I STH FLOOR Installing Company Name E. F• w1NSLEL,J pLuw'r3i w t-4GfrTialr Checkone: Certificate Address 8 RE q-2Do N Cr 2c ►.E Corporation 04 - Z g4b 193 .So • YA(Zm o u T(+ M Y} O 2 664 ❑ Partnership Business Telephone (5•D 8) 394 — `77 7 8 ❑ Prat/Co. Name of Licensed Plumber E i111 f M S Lc W INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes Ir No ❑ If you have checked ves, please indicate the type coverage by checking the appropriate box. A liability insurance policy ❑ Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws. and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ I hereby certify that all ofthe details and information I have submitted (or entered) in above application are true and accurate to knowiedge and that all plumbing work and installations performed under the permit issued for this applfcati 'II comphz pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Signature of Licensed Plumber Title Type of License: Master Z Journeyman ❑ FPR0xn APRO� Ok APVED (OFFIC'E f!S-cONLY License Number 7939 ! � 6 a� . I. of my all