Loading...
HomeMy WebLinkAbout121 Camp St #003 Building PermitsCOMMONWEALTH OF MASSACHUSETTS i OF..ELECTRICIANS REGISTEREDISS�SsYSTHISEMNSE TE�CHNICIAN i JONAS R BIELKEVICIUS 2 SWANN HILL LANE SANDWICH MA 02563=1897' yqq D 07/S1/07 997069 COMMONWEALTH OF MASSACHUSETTS OF El CU CSA S. � RCCISI'EREDuS SisEceNSE CC TRACTORISS? BALTIC SECURITY INC 2DSWANN HILLKLANEIUS SANDWICH MA 02563-1897 k, 997070 LICENSE NO. EXPIRATION DATE SERIAL N0. e% eiammotuuealCia a�./tiaaaad DEPARTMENT OF PUBLIC SAFETY License SEC SYS CONTRACTOR Number ,SS,CO 000275 Birthdate; 08/28/1,952 Expires:t08/28/2Q04 Tr. no: 22 Restricted i00`l JONAS R BIELKEVICIUS �p 2 SWANN HILL LNX? h A- 47�11� SANDWICH, MA 0266 Commissioner 07408/2004 23:24 5089461162 J K OLIVIERI INS AGY PAGE 01/01 4 OPID J DATE(MWDDmrvY) gIO.RD. CERTIFICATE OF LIABILITY INSURANCE sALTS, 07 09 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE J.K. Olivieri • Ins , Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR SOX 1270 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, ,�dleboro MA 02316 Phone : 508-947-193 8 INSURERS AFFORDING COVERAGE NAIC i1 uaiinen INSURER A. Surplex Underwriters Inc. Baltic Selurity, Inc. P.O. Sox 609 Sandwich IIA 02563-1609 INSURER C: INSURER 0: INSURER E: Commerce COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HA%r; BEEN I35VED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR C )NDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE 4FORDEO BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL. THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS S 10WN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INUM LTR NSR TYPE OFMSIRANCE ^w POLICY NUMBER DATE MMIDD/YY DATE MMIDDIYY LIMITS A GENERALLMILITY X COMMHRCWLGEIIERALLIABILITY CLAIMS MAGI XX OCCUR PAC6392104 05/06/04 OS/06/05 EACH OCCURRENCE 41,000OOO PREMISES Eeoccurence -S 50 GOO. MED EXP (Any a Perwn) S 5000 , PERSONAL SADVINJURY $1 OOO OOO GENERAL AGGREGATE 52,000 000 GE91LAGGREGATEL16iTAPPLIESPER: POLICY J& T LOC PRODUCTS. COMPIOP AGO s2,000,000, H AUTOMOBILE LIABIL)T r ANY nuro QVZ562 ALL OWNED AUTCS 1 SCHEDULED AUTI-S HIREDAIJT03 NON-OWNEDAUT)S '•"•" 10/07/03 10/07/04 COMBINED SINGLE LIMIT (Ea accident) S BODILY INJURY (ParPAraon) $SOOOOO X X BODILY INJURY (Pereocltlenq 'PROPERTY S 300000 X DAMAGE (Par ooddont) $100000 GARAGE LIABILITY ANY AUTO AUTO ONLY. EA ACCIDENT S OTHER THAN EA ACC AUTO ONLY: AOG S S EXCESSAIMERRILA U MILITY 1-1 OCCUR CLAIMS MADE DEDUCTIBLE RETENTION S EACH OCCURRENCE $ AGGREGATE S D S - S WORKERS COMPENSATION I ND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERI:XECUTPA OFFICERIMEMBER EXCLUDE[ T . } yyea, ceaanoe undor SIX 8PECIAL PROVISIONS below - ITORY LIMITS I I ER E.L. EACH ACCIDENT S _ E.L.DICEA6E - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT I S OTHER DESCRIPTION OF OPERATIONS I LC :ATIONS I VEHIC4.E9I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS 4 CK I Ir•IIiA 1 C ry V LUCK UANLJELLA I I V N GATE9P01 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 Gatewood Homes IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS DR 1600 ralmouth Rd Centarvillm MA 026.12 REPRESENTATNEB. ACORD 25 (2001108) Commonwealth of Massachusetts UulDepartment of Fire Services BOARD OF FIRE PREVENTION REGULATIONS - Official Use Only Permit No. F— a5 — 5�E�� Occupancy and Fee Checked [Rev. 11/991 leave blank r APPLICATION FOR PERMIT TO PERFORM ELECTRICA All work to be performed in accordance with the Massachusetts Electrical Code (M C), 527 CMR l: r , (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: H City or Town of: �irlp�. To the Inspector of Wires. 3 By this application the undersigned gives notice of his or her intention to perform the electrical work descr' wo Location (Street & Number) Px Owner or Tenant 65;hl- e o Owner's Address w Is this permit in conjunction with a building permit? Cn izi Purpose of Building I Telephone No. 1UG 1 1 2004 low. Yes Er No ❑ (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps 1 Z / Lo�'Volts Overhead ❑ Undgrd ❑/ No. of Meters Number of Feeders and Ampacity Cocation and Nature of Proposed Electrical Work: Cmmnlptinn nfthp fnllnwino mblp mmi hp wn:vpd by ,he .d IL'*. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans o. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ rnd. r ❑ cy ig ing o. ond. BatteryUnits No. of Receptacle Outlets j) No. of Oil Burners FIRE ALARMS No, of Zones No. of Switches L� No. of Gas Burners / o• o Detection and Initiating Devices No. of Ranges No. of Air Cond. TotaTons l No. of Alerting Devices No. of Waste Disposers Heat Pum Totals um er Tons K ................. o. of elf- ontained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Muni ectio El Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of o. of Signs Ballasts Data Wiring: 3 No. of Devices or Equivalent No. Hydromassage Bathtubs l o�oLMo rs Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: l U ` ` "" t U Attach additional detail if desired. or as required by the Inspector of Wres. J]he NSURANCE COVEAU11 EU IJEel t�i���y t wrier, no permit for the performance of electrical work may issue unless w licensee provides proof of liability insurancin-, "completed operation" coverage or its substantial equivalent. The d undersigned certifies tha�gflsuch ��ctiverage fs in'dPde�'an has exhibited proof of same to the permit issuing office. a a HECK ONE: INSURAA(�``3 N ER ❑ (Specify:) —Z.o*ryG 41 •7 (Expir lion Date) Estimated Value of Electrical Work: Py • (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. certify, under the is and petralties of peyr ,drat the information on this application is true and complete. IRM NAME: p /S OYt G/ LIC. NO.: 3V ZZGSAZ w icensee: — ' / ,f G/ Signature .� LIC. NO.:�O?�6 a (Ijappla. . . icble, e/ toy`esemp " in !h license num er li�.J BusTelNo w 3Address: `�T � � L✓G�� Af_,2�,�� .alp d2.szl�Alt. Tel. No.lrZ,—> ��o r y xOWNER'S INSURANCE WAIVER: 1 am aware that the License does riot have the liability insurance coverage normally a required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's acent. tw, 0Owner/Agent Signature Telephone No. PERMIT FEE. 5 MILL POND VILLAGE CONDOMINIUM CAMP STREET, YARMOUTH, MASSACHUSETTS PURCHASE AND SALE AGREEMENT UNIT 3 OSPREY PART A: References: [Affordable Unit] The following terms which are capitalized and marked in quotations in this Part A shall have the meanings set forth below wherever such terms are used in Part B hereof, and this Agreement shall consist of both Parts A and B and all exhibits hereto: A. The "Date of this Agreement" is , 2005. B. The "SELLER" is: Villages at Camp Street, LLC, a Massachusetts limited liability company, with an address of 1600 Falmouth Road, Suite 25, Centerville, MA 02632, or its successors and assigns. C. The 'BUYER" is: Teresa J. Quirk of 38 Hillcrest Road, Yarmouth port, MA 02675 D. Notice. Any and all notices or other communications required or permitted by this Agreement to be served on or given to any party hereto by any other party hereto shall be in writing and shall be deemed duly served and given when personally delivered to the party to whom it is directed, or in lieu of personal service, three (3) days after deposit in the United States Mail, first class and postage prepaid, or one day after deposit with a reputable overnight courier, addressed to the BUYER and SELLER at their respective addresses as listed above. E. The "Unit" to be conveyed hereby is: Unit # 3 OSPREY, as such is further shown on the plans attached hereto as Exhibit A, which plans include a unit floor plan (Exhibit A-1) and a Designated Use Easement Area showing the Unit's Maintenance Easement Area and Exclusive Use Easement Area (Exhibit A-2). F. The "Percentage Interest" in the Common Areas referred to in paragraph 2 of this Agreement will be determined upon the completion of the phasing in of the Phase of the Condominium containing said Unit and will be so determined in accordance with the provisions of the Master Deed described herein. See also paragraph 27 of this Agreement. G. The "Purchase Price" referred to in this Agreement is: One Hundred Twenty -Six Thousand and 00/100 Dollars ($126,000.00), which is calculated as follows: $126,000.00 (base price) + $ 0 (options and upgrades further described in paragraph I of this Agreement) PURCHASE PRICE: = $126,000.00 of which: $ 1.00 have been paid as a deposit as of this day, $ 0 have been paid previously, and $ 0 are to be paid at commencement of Unit construction $125,999.00 are to be paid at the time of the delivery of the deed in cash, or by certified, cashiers, treasurer's or bank checks. $126,000.00 TOTAL DUE H. The "Time for Performance" shall be at 10 a.m. on the 31 st day of January, 2005, at the place referred to in paragraph 7 of this Agreement. I. Options and Upgrades. The following items will be included in or eliminated from the Unit to be delivered hereunder and the costs or credits thereof are included in the purchase price set forth in paragraph G hereof- J. Commission. A commission fee for professional services specified in this paragraph is due from SELLER to Housing Assistance Corporation,(HAC) but only if, as and when the SELLER receives the full purchase price pursuant to this Agreement and the BUYER accepts and records the SELLER'S deed and not otherwise. Commission Due: $2,312.00 .2- GSDOCS-1282281-1 Pi JUN 3 04� /YR411JG D PT. Building �I P1l2Jj6 Oy AT: Location m to 5�t 1-� a av APPLICATION FOR PERMIT TO DO PLUMBING pp (OFFICE USE ONLY) By Fee: PERMIT NO. P OS J O6Y� Date O /50 20J�� Owner's &a -leptyoci Holmes Name g610 ((11Fj� Type of Occupancy +--r ' New Renovation El Replacement El A) I ePlans Submitted Yes ❑ No ❑ z z N to O W W _ X W Y J M Q V Z Q Cl)z Z Z M t, en M a cc \. l�v\� ` N O Z y y ut y F y W x 2 F- 2~ C1 uj Cn y Q to O u Z Z a Z s 7 X U m¢ y w �' a W z c a m O¢ a a O u w Z¢ x Q= 3 3 o z= Y a p r°C- a 4 Q w LL U. w r V> F- O x a Z< Cn H Z 0- 0 m Z Z w F O U x Y J m y G G J �i S F N LL 0< G Q 0_ m 0 SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Installing Company Check One: ❑ Corp. Address e1 "D y ❑ Partnership 1, �O MO Ut q 6• 6 !/ 3 Firm/Company Business Telephone ?7y y g7 �S ! Name of Licensed Plumber INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes WNo ❑ 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 the Mass. General Laws, and that my signature on this permit application waives this requiir�/{�Ient. Check qVf (3Wner 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 ❑ by C4epter 142 of Licensed 2�z)IA7 License Number Type: Master El Journeyman APPLICATION FOR PERMIT TO DO GASFITTING TOWN-OF—YA OUTH 2FFICE USE ONLY) h By n` 2q Fee: $ 34 NOV 01 2 1 ✓ PERMIT NO. C?"—O5'" 370 EU:LCc':G .;APT. DateTI Bui in Owner / AT: Location %-2 G z41-h j� S 7— Name/%lf��fC A7' �itshl� S Type of Occupancy I l� New EX Renovation ❑ Replacement ❑ Plans Submitted Yes ❑ No �k rA v7 W 0) N co YZ U m tN = J Cn U r N Z O M Q I Z O f W Q m LijFW- ~ W W O O a O Q� W~ 1/ W Q _ Z F- fJl O41 Uj f•" O ►W- Z J F- Z W W O O m Z U. O H Z V R- J 0 H W -• Q M w> x w Z Q¢ � Q J > a W= F LL 2 0 a x t�i 7 C 0 0 M O 0 SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) � Installing Company Name DuCTS" U A]1,f to ITe--D Check One: ❑ Corp. 1 FL G i4As E S 1- ❑ Partnership I - N/V 1 S 1'Yl !7 Z (e d ( CJ Firm/Company Business Telephone SD F-7 3 7 r 3 6 9 4 Name of Licensed Plumber o, r :S: c�o 1A LA W G' INSURANCE COVERAGE: Check One I have a current liability insurance policy or its substantial equivalent. Yes ET- No If you have checked yes, please indicate toe type of coverage by checking the appropriate box. A liability insurance policy Er Other type of indemnity ❑ C, 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. 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 Check One: Owner ❑ Agent ❑ Signature o Licensed Plumber or Gasfitter 2,1 S j 0s License Number TVOC 1 ld'=PJCG. 20 PILL, GUYS 50 N 80.47-49" 46.91 c' ' i2.38 I 10.0' 6 .5 , J 4. ' .2 22,3 . EX15 f, °' 12.33 FOUNC 25.0' 2.3 r �22•fiZ w N1 ci• 0 I0 0- EXISTING U'I ro EXISTING `' Ut c7! FOUNDA�ON z. FOUNDATION � 1 \ to w I 0 wo \ LOT 3 1 I N I I� ►W O N 1 LOT 4 i 1' fi.t! i I. 11�644 54.83' pR��WAY L =3. 82' 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 GRAPHIC SCALE 10 0 20 ( IN FEET ) 1 inch = 20 ft 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 � DATE REGISTERED ROFESSIONAL LAND SURVEYOR 60 NOTICE Unless and until such time as the original (red) stamp of the responsible Professional Engineer, or Professional Land Surveyor appeon on this plan: (A) no person or persons, including any municipal or other public officials, may rely upon the Information contained herein; and (B) this plan remains the property of Holmes & McGrath, Inc. AS —BUILT PLAN holmes and mcgrath, inc. ✓ �w OF pl- PREPARED LOT FOR civil engineers and land surveyors o MICHIFl -, MILL POND VILLAGE 362 gifford street MCCRATH H falmouth, ma. 02540 ;� No. o , IN �� PF STE YARMOUTH, MA JOB NO: 201197 DRAWN: LMC SCALE: 1 "=20' DATE: 6-09-04 DWG. NO.: A2502A CHECKED ^ a of r TOWN OF YARMOUTH Building Department (508) 398-2231 ext.261 BUILDING '- )) PERMIT NO B-04-1374_ ISSUE DATE ; _ _ 6/9/2004_ - ; PROPOSED USE APPLICANT ,Frank C(P) PERMIT rankb -apra --------------------- JOB WEATHER CARD PERMIT TO ' New Construction ; AT (LOCATION) 1001121CAMPST#3 ZONING DISTRIC R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C3 BUILDING IS TO BE: CONST LOT SIZE new construction: 3 baths, 2 bedrooms, 1 familyroom, 1 diningroom, 1 kitchen, 1 livingroom as REMARKS per plans dated 04/01/04 and BOA # 3546. AREA (SQ FT) EST COST ($ $154,080.00 PERMIT FEE ($) OWNER Ivillages at Camp St., LLC IUILDING DEPT BY USEGROUPI R-4 CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 ADDRESS 116UU Falmouth Road # 25 > Centerville I MA 102632 Certificate Issue Date �j tA,�r/� o) e-I 3 ,CERTIFICATE of OCCUPANCYi Departmental Approval for Certificate of Occupancy and Compliance Inspector Date Permit Number Approved By Remarks BUILDING .3-7-6 PLUMBINGIGAS ELECTRICAL ENGINEERING 14to cam, D (F'0 Iz 7/cr Awl cr 3 jo OTHER 3��3,/a5 ro be filled in by each division indicated hereon upon completion of its final inspection. MOW ►� TOWN OF YARMOUTH Building Department BUILDING (508) 398-2231 ext.261 PERMIT NO B-04-1374_ ISSUE DATE :::619/2004:: ; PROPOSED USE : PERMIT APPLICANT ;Funk Capra - - - - - - - - - - - - - - - - - JOB WEATHER CARD --------------------------- PERMIT TO ' New Construction ' AT (LOCATION) 100121CAMPST#3 ZONING DISTRIC R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C3 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE new construction: 3 baths, 2 bedrooms, 1 familyroom, 1 diningroom, 1 kitchen, 1 livingroom as REMARKS per plans dated 04/01/04 and BOA # 3546. AREA (SO FT) EST COST ($ $154,080.00 PERMIT FEE ($) OWNER Ivillages at Camp St., LLC BUILDING DEPT BY ADDRESS 11600 Falmouth Road 425 Centerville I MA 02632 INSPECTION RECORD CONTRACTOR LICENSE F 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02832 5087789669 FIELD COPY Date Note Progress - Corrections and Remdrks Inspector �(�=v �em� O/ _ TOWN OF YARMOUTH y Building Department _ - Town Hall e Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT APPLICATION RECEIPT Temp Permit No.: T-04-441 Applicant Name: Frank Capra Location: 00121 CAMP ST # 3 Owner's Name: Villages at Camp St., LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $0.00 Payment Type: Check ChkNo.: 0 Net Owed: $0.00 Application Date: 3/8/2004 Issue Date: Expiration Date Comments: new construction: 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 a OF Y'9R,� NMATTACM[CS� 4Mrn0 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 iise nnly'- Planning Board I mationT Assessors Department Information Pe If Now � to � z Plan Type Map: Lof Map Lot PermlYFee $ EndorsementDate r 01f1 New t= ' - Recording Date 1 4 Propeily Dlmer�sions i ` ` Deposit Reed,, $ Date � F Plan No r NetDUe !� `Q� Other Lot Area(sfl ; ; Frontage(ft) LoYCoverage „' This'86ctio6 for Office Use din P., . ,;I umb r .,:: DAt6,1SSUed.<, .,,x,` Gettlficate of Occupancy _> Building Officia(ia : ' = ., „ ;Date !s � 16not "" required Section 1 , .Srteanformafion;: Use Group: R-4 Type: 5-B 1.1 Property Address: 1.2 Zoning Information: Zoning District Proposed Use 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) 1.5 Flood Zone' Information Comments ;- _ Public Private 'Section 2`? Property OwnershiO/Auttiorized"Agent' 2.1 Owneko 11 Record: �L //OV isV ll b , N me �prinq Mailing Address I�^ ( of �� J2 t — — Signature elephone 2.2 uthoOrizegent: ss Name (print) I Address tioo� g, _ a �1 Signature Telephone Fax Section ''COnStructlon=SeNlces3 3.1 Licensed ConstructionSupervisor.. / Not Applicable ❑ gy License Number (� '3'� O 0 ✓��✓I 0 �Address 7 �+ / / � �� r 7 / Z —i rC�' Expiration Date L) b -- 6 �C) Si natureSi nature Telephone 3.2 Registered Horh6,1r provement. Contractor;;, Company Name Not Applicable ❑ License Number Address Expiration Date Signature Telephone C3 '11��M/ 9- 15-99 1 of 2 OVER Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial f the issuance of the building permit. z Y Signed Affidavit Attached Yes .......... No .......... New Construction Lff I No. of Bedrooms No. of Bathrooms Existing Bldg. ❑ Repair(s) ❑ Alterations ❑ Addition ❑ Accessory Bldg. ❑ Type Demolition Brief Description of Proposed Work: N Item Estimated Cost (Dollars) to be completed by permit applicant 1. Building . O O 2. Electrical J?'2 e 3. Plumbing / Gas ' b o 4. Mechanical (HVAC) tO 5. Fire Protection 186 6.Total = (1 +2 +3 +4+ 5) q r, 600 7. Total Square Ft. (new houses & addidions) b e 16 I Other Specify: 1 I Check Below I ❑ Conservation -Commission Filing (if applicable) ❑ Old Kings Highway & Historical Commission approval (if applicable) , as;owner of the subject property hereby authorize 0 a -f` r to act on m beh , in all matters elative to work authorized by this building permit Application. o Signature of Owner Date Sectio`ri 7b' Owner/Authorized Agent Declaration' � ( y -1 (I t Dt w, 1P_ d �2i' r as Qwner/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. IN i i I a-P, I o '12.- Print n me Signature of Owner/Agent Date 9-15.99 2 of 2 _ o=" T l c In C F 13 PLEASE PRINT: Job Location: _ TOWN.OF YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM C Owner of Property: y V ` t. Construction Supervisor: 0 Address: 0 Licensed Designee: (If other than Supervisor) Ln^ pi ST+ Street Village LL G QtPrx� Dal Sob 669 Name License No. Phone No. �- � r!MP � � ��,� �� C1tn'�✓, U:e,1til A oa G 3� Name 2.15 Responsibility of each license holder: License No. 2.15.1 The license holder shall be fully and completely responsible for all work for which he is supervising. He shall be responsible for seeing that all work is done pursuant to the state building code and the drawings as approved by the building official. 2.15.2 The license holder shall be responsible to supervise the construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of building and structures only pursuant to the state building code and all other applicable laws of the commonwealth, even though he, the license holder, is not the permit holder but only a subcontractor or contractor to the permit holder. 2.15.3 The license holder shall immediately notify the building official in writing of the discovery of any violations which are covered by the building permit. 2.15.4 Any licensee who shall willfullyviolate subsections 2.15.1, 2.15.2 or 2.15.3 or any other section of these rules and regulations and any procedures, as amended, shall be subject to revocation or suspension of license by the board. 2.16 All building permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise those persons engaged in construction, reconstruction, alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and these rules and regulations. In the event that such licensee is no longer supervising said persons, the work shall immediately cease until a successor license holder is substituted on the records of the building department. 2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may be deemed a violation of the permit conditions. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with section 109.1.1 of the state building code. I understand the construction inspection procedures and the specific inspection as called for by the building official. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes IE( No ❑ If you have checked ygs, 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 152 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ Signature: Building Official Approval: The Commonwealth of Massachusetts Department of Industrial Accidents Of essflsresUpsvoss 600 Washington Street Boston, Mass. 02111 Workers' Compensation insurance Affidavit nit, [.!Xt�gervoUk- , MA nhnnpa<0$-77MC0 O 1 am a homeowner performing all work myself. I am a sole proprietor oral ha%e no one working in any capacity O 1 am an employer pro%iding workers* compensation for my employees working on thisjob. comnanv name: address cites phone a, insurance co. noliev to 0/1 am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below uho hase city, phone K: iinsurnrice co. policy # insurance co. policy": milinal Failure to secure coverage as required under Section 25A of MGL 152 earn lad to the imposition of criminal penalties of a One op to S1500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of investigations of the DU for coverage verification. 1 do hereby Ecerdunder the pains enalties of perjury that the information provided above is true and COMA sr k Signature natc %(VV Print name �a—� t\ one K official use on1hdo not write in this area to be completed by city or town official city or town: YARMOIIT$ _ permiNieease K nBuilding Department aLicensing Board C3 check if immediate response is required 261 OSeleetmen's Omee C3Ilesltb Departmtot contact person: phoneM: _ (508) 398-2231 eat. nOthcr. TOWN OF YARMOUTH BUILDING GAS 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 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 1 \ p . Work AA4ress is to be disposed of at the following location: �L✓►� d� 10�.d� �� Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. �zz� -/ Date Permit No. ✓ite 'toanrireoruura a�✓C�auaciwaeQa t BOARD OF BUILDING REGULATIONS t _ 3 License: CONSTRUCTION SUPERVISOR y, Number: CS 012430 :. Birthdate: 06/1611940 Expires: 06/1612004 Tr. no: 25823 Restricted: 00 FRANK G CAPRA 40 COPPER LNG CENTERVILLE, MA 02632 Administrator 00 - 35,000 d enclosed space (MGL CA 12 S.601.) to - Masonry only 1 G -1 3 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 H.�urcua �:thc I It -IL ATE OF LIABILITY INSURANCE oiiMMO 0 L RoevcER (508) 994-9688 FAX (508) 991- 5461 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION RUTKOWSKI & KESTENBAUM ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 414 COUNTY STREET HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR NEW BEDFORD, MA 02740 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. _ INSURERS AFFORDING COVERAGE JNSURERA Providence Mutual. PO Box 664 INSURERB: OneBeacon INSURER Continental Casual ty - Co ...: West Hyannisport, MA 02672 Q ._.. .._.. ._ _ .., .. _.._ INSURERD— .. - :. .. . _ _.._. _ .�..... INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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 POLIC EFFEC IVE POLICY I TION GENERAL LIABILITY PP0053131 00 12/13/2002 12/13/2003 LIMITS EACH X COMMERCIAL GENERAL LIABILITY OCCURRENCE S 1,000,00 CLAIMS MADE O OCCUR FIRE DAMAGE (Anyone fire) S 50,00( A MED EXP (Any one person) S 5 OW PERSONAL & ADV INJURY $ 10000,00( GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00( POLICY ECaT LOC PRODUCTS- COMP/OP AGG S 2,000,00( AUTOMOBILE LIABILITY BXE48125 02/14/2003 02/14/2004 ANY AUTO COMBINED SINGLE LIMB S (Ea acddena ALL OWNED AUTOS B X SCHEDULED AUTOS BODILY INJURY S HIRED AUTOS (Per person) 250r 000 NON -OWNED AUTOS BODILY INJURY (Per aeddeny S µ 500,000 .. _.._. PROPERTYDAMAGE f ... GARAGE LIABILITY er or 100_ .000 - 'ANY AUTO - - AUTO ONLY -EA ACCIDENT. S . ,. t - . ... ... OTHER THAN EA ACC I . AUTO ONLY: AGG S EXCESS LIABILITY OCCUR O CLAIMS MADE EACH OCCURRENCE t AGGREGATE S DEDUCTIBLE S RETENTION S S WORKERS COMPENSATION AND EMPLOYERS'LIABILITY S59UB861X7516O3 03/22/2003 O3/22/2004 $ TORY LIMITS ER C - E.L. EACH ACCIDENT $ 500,00( ---.... EL DISEASE - EA EMPLOYE $ 500 , OOO OTHER EL DISEASE- F'O1,CY LIM1(r $ SOO 0OO DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESIEXCLUSIDNS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CANCELLATION CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER 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, Gatewood Homes Inc 1600 Falmouth BUT FAILURE To MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Road Ste 25 Centerville, MA 02632 OF NTHECOMPANY AMOLIV4 EPRE NTATIVES. AUTHORMEDR R T11A�TIV��E ACORD 25S Il/u/I __ _ JM � ©ACORD CORPORATION 1988 rHyannis, kIII i INUAlt OF LIABILITY INSURANCE DAT17/03D/YYYY)ER 0/E'Mng & O'Nell Insurance ONLY S ISSUED CONFERS NO RIG AS A MATTER OF INFORMATION y, Inc. tHOL ER THISCERTI CATE DOES NOT AMEND. EEXTENOR est Main St. PO Box 199D ALTER THECOVERAGE AFFORDED BY THE POLICIES BELOWMA 02601 INSURED INSURERS AFFORDING COVERAGE Bayside Electrical Contractors, Inc. NAIC # INSURERA: Travelers Insurance Company 372 Yarmouth Road INSURERB: Guard Insurance Group Hyannis, MA 02601 INSURER C, INSURER D: COVERAGES 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 MAY PERTAIN, WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. AND CONDITIONS OF SUCH LTR A NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD Y POLICY EXPIRATION GENERAL LIABILITY 16801484A82ACOF03 10/05/03 DAT MMR)D LIMITS X COMMERCIAL GENERAL LIABILITY 10/OS/04 EACH O OCCURRENCE $1 OOO OOO CLAIMS MADE O DAMAGE TO RENTED OCCUR §300 OOO ' MED EXP (Any one person) §5 000 X OCP PERSONAL B ADV INJURY $1000000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE §2000000 POLICY PRO- LOC PRODUCTS-COMP/OP AGG §2 000 000 A AUTOMOBILE LIABILITY 18102601W5611ND03 10/05/03 ANY AUTO 10/05/04 COMBINED SINGLE LIMIT ALL OWNED AUTOS (Ea accident) $1,000,000 X SCHEDULED AUTOS - BODILY INJURY X HIRED AUTOS (Per person) § X NON -OWNED AUTOS BODILY INJURY X Drive Other Car (Per accident) § PROPERTY DAMAGE GARAGE LIABILITY (Par accident) § ANY AUTO AUTO ONLY - EA ACCIDENT § OTHER THAN EA ACC § EXCESS/OMBRELLA LIABILITY AUTO ONLY: AGG § OCCUR CLAIMS MADE EACH OCCURRENCE § AGGREGATE § 'DEDUCTIBLE § RETENTION § § B WORKERS COMPENSATION AND BAWC436910 LIABILITY SEMPLOYERS' 08/18/03 08/18/04 WTU- OTH. ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? E.L. EACH ACCIncur .inn nnn OTHER DESCRIPTION OF OPERATIONS! LOCATIONS / 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 ACORD 25 (2001/o8) 1 of 2 #M31942 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 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 REPRESENTATWES. AUTHORIZED REPRFccurenvv LS1�I ACORD CORPORATION 1988 0 Producer: SOUTHEASTERN INS AGCY 641 MAIN ST HYANNIS MA 02601 Code: Insured: RJ BEVILACOUA P 0 BOX 628 FORESTDALE MA 02644 Sub —code: OF 2 N sui:zn VCE Issue date: 7/22/03 This certificate is issued as a matter of information only and confers no ri hts u on the certificate holder. This certificate does not amend, ezten� or a�ter the coverage afforded by the policies below. ---------------------------------------------------------------------- ---------- COMPANIES AFFORDING COVERAGE I Co Ltr A: ARBELLA PROTECTION ------------------------------------------ --:----- Co Ltr B_ ARBELLA PROTECTION — — ----------------------- Co Ltr C: -------------------=--------------------- -------- Co Ltr D_ ARBELLA PROTECTION — — ----------------------- I Co Ltr E: COVERAGES This is to certify that policies of insurance listed below have been issued indicated notwithstanding any requirement, term or to the insured named above for the polic/ period certificate may be issued or may ertaint condition of any contract the insurance afforded by the or other document with respect to which this policies described herein is subject to all the terms, exclusions, and conditions of suA policies. Limits shown may have been — reduced by paid claims. Cc I I Ltrl Type of Insurance I I Policy Policynumber leffective date — --------------------------------------- I Policy I ez iration datel All limits in thousands A I ENERAL LIABILITY I Commercial general liability 8500018147 I 7/15/03 I 7/15/04 (General aggregate: 21000 ( Claims made ( ) Occur kner's 8 contractor's rot i P I I Products—comprt s nggreg: Personal/advertising inj: (Each occurrence: ION I (Fire damage: 100 ---------------------------------------------------------------------------------- Medical expense: 5 B (AUTOMOBILE LIABILITY 1 An 86852400001 1 2/21/03 ------------------------------------------------- I 2/21/04 (Combined rr auto All owned autos I I (Single limit: 250/500 Scheduled autos Hired autos I I Bodily inju Per persony : Non —owned autos Garage liability I odily injury (Per accident): _ ---- 500 IX�ESS LIABILITY ---(Property —damage: ---------------- Each —I Other than umbrella form I — ------------------------------------------------------------------------------------------------------------------------------- I I I I Occurrence Aggregate D I WORKERS COMPENSATION I AND 9088680403 4/27/03 I 4/27/04 Statutory I----------------------------- EMPLOYERLIABILITY I_ I I I 100 500 Each accident) (Disease —policy limit) .. — 1D0. (Disease. —each emp-l-oy.ee.)_.. IOTHER ------------------------ Description of operations/locations/vehicles/restrictions/special items: CERTIFICATE HOLDER CANCELLATION Should any of the above described policies be cancelled before the GATEWOOD HOMES expiration mail date thereof, the issuing company rill noti ce to the certificate days vto endeavor to holder to the 1600 FALMOUTH RD STE 35 CENTERVILLE MA 02631 left, but ut man failure to mail such notice shall impose named no obligation or --liability—of—any—kind—upon the company, its agents -------------------------------------------- or representatives. Authorized representative: ------------------------- I JOAN M MARTIN JA 4/89 z"4m1.� laK TIFICATE ORLIABILITY INSURANCE ODBCER Wit -Tall __ Allied"' American Insurance Agency LLC 1 Atlantic Ave SO Yal~mouth MA 02664 762 Falmouth Road Hyannis MA 02601 THIS DATE(MMl00/YYYY) 07/21/2003 A MATTER OF INFORMATION UPON THE CERTIFICATE S NOT AMEND, EXTEND OR INSURERS AFFORDING COVERAGE IusuRCRA Artie la Protection I muRERB: Hartford NISURER C. INSURER D: INSURER E: NA►C i/ THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE EDIT THE POLICY PERIOD INDICATED. NOTWITHSTANDIry ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY N ISSUED TA 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.OR D TYPE Of INSURANCE' POLICY NUMBER POLICY EFFE TIVE POLICY GXPIRATION GENERALLIAMLhY 7S00000371 12/13/2002 12/13/2003 EACHOCCURRENCE LIMITS X COMMERCIAL GENERAL LIABILITY S 1 00I I OI CLAIMS MADE DAMAGE TO RENTEO S D OCCUR SO.O( A GENL AGGREGATE LwirAPll PEP X POLICY 0 PPGTT ETLOC AUTOMOBILE LABILITY ANYALfTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON-OWNEDAUTOS GARAGE LIABILITY IANY AUTO EgBNMaRELLA LIABILITY OCCUR 11 CLAIMS MADE DEDUCTIBLE RETENTION 3 WORKERS COMPENSATION AND EMFLOYERg• LIABILITY B ANY PROPRIETOR/PARTNEWEXECVl OFFICEWMEMBER EXCLUDED? OF OPERATIONS MED EXv (I one pawn) S S PERSONAL4ADVWJURY S 1 OOO GENERALAGGREGATE. S 2,000 PROOVCT$.COMP/Op AGG S ) Ann COMBINED SINGLE LIMIT S IGa aeUdeRq BODILY INJURY (Pa Penon) S BODILY Il (Pal acvdenq S PROPERTY DAMAGE 3 (Per acv'dv q AUTO ONLY - FA ACCIDENT S OTHERTHAN EA ACC f AUTO ONLY: A00 i EACN OCCURRENCE 3 AGGRGGATE 3 s S E-LEACH ACCIDENT is 100 E.L. DISEASE - FA EMPLOYE S 1 nn Evidence of Insurance for work performed within the Insured's scope of normal operations C C SHOULD ANY OF THE ABOVE DESCRIBED Foul BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENOCAVOR TO MAUL 10 DAYS WRITTEN NOTICETO THE CERTIFICATE MOLDER NAME[)TO THE LEFT, Gatewood Homes.. BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR LIABILITY 1600 Falmouth Road #2S OF ANY KIND UPON INSURER, ITS AGENTS OR REOOBLITATN Centerville, MA 02632 AUTHORIZED RESENTATI 4C0RD25(2DD1/08) FAX: (508)778-5603 a' OACORD CORPORATION 1983 ACORD_ CERTIFICATE OF LIABILITY INSURANCE GP ID AC4 DATE(MMIDDIYYYY) CROWC50 1 07 25 03 ,. -PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Sullivap, Garrity & Donnelly ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 508-754-1767 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 10 Institute R$ - PO Box 15010 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Worcester MA 01615-0010 Phone:508-754-1767 Fax:508-754-1885 INSURED Crowell Construction, Inc. PO Box 309 So. Dennis MA 02660 COVERAGFR INSURERS AFFORDING COVERAGE I NAIC # INSURER A. Hanover Insurance Co 2225 INSURER B: Arch Insurance Company 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. IN5K ADD1 LTR INSRI TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIYY DATE MMIDDIYY LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE X❑ OCCUR ZHN7007141 05/01/03 - 05/01/04 EACH OCCURRENCE $1000000 X PREMISES Eao reme $100000 MED EXP (Any one person) $ 5000 PERSONAL d ADV INJURY $1000000 GENERAL AGGREGATE $ 2000000 GENT. AGGREGATE LIMIT APPLIES PER . LOC POLICY �PE T PRODUCTS -COMPIOP AGG $2000000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ARN7001142 05/01/03 05/01/04 - COMBINED SINGLE LIMIT (Ea acCidenl) = (Per (Per person) on) $1000000 X X (Per BODILY IN acIN (Per$ 1000000 X PROPERTY DAMAGE (Per =idenl) S SOOOOO GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC AUTO ONLY: AGG S $ EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION S EACH OCCURRENCE S AGGREGATE $ S S $ B -- WORKERS COMPENSATION AND EMPLOYERS'LIABIUTY ANY PROPRIETORIPARTNERIEXECUTWE OFFICER/MEMBER EXCLUDED? :Myyes; describe under PROVISIONS OTHER OTHER IRWCIOOS OO 03/22/03 03/22/04 -TORYLIMITS ER E.LEACHACCIDENT $500000 E.L DISEASE - EA EMPLOYEE S500000 E.LDISEASE .POLICY LIMIT $500000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS Fax #508-778-5603 CERTIFICATE Hnl nEa 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 Gatewood Homes NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 1600 Falmouth Road Suite 25 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND U06N THE INSURER, ITS AGENTS OR Centerville MA 02632 REPRESENTATIVES. 25 (2001/08) Ac,R CERTIFICATE OF LIABILITY INSURANCE =DATEIDDIY"YY+ PRODUCER Dow' & O' Neil Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION AMEND Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 222 West Main St. PO Box 1990 ALTER THE COVERAGE AFFORDED BHOLDER. THIS CERTIFICATE DOES OY THE POLICCIT AMEND, ES BELOW. Hyannis, MA 02601 INSURED INSURERS AFFORDING COVERAGE NAIC # Gutter Pro Enterprises, Inc. INSURERA: travelers Insurance Company P.O. Box .1197 INSURER B: Guard Insurance Group Plymouth, MA 02362 INSURER C: OVERAGES INSURER E: THE POLICIES OF INSURANCE LISTFn RPI nw ue.v ANY REQUIREMENT, TERM NC CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TOHWHICH THIS CERTIFNCA A DING MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES E MAY BE ISSUED POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.OR DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH _TR NSR A TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE Po Cy EXPIRATION DATE MM/DD GENERAL LIABILITY DATE MM/DD LIMITS 1680459H3118TCT03 11/07/03 X COMMERCIAL GENERAL LIABILITY 11/07/04 EACH OCCURRENCE E1 OOO QQQ CLAIMS.MADE Q DAMAGE TO RENTED P OCCUR I urr n $300 000 MED EXP (Any one person) $5 000 PERSONAL &ADV INJURY S1 QQQ QQQ GEN•L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2 QQQ QQQ POLICY E T .LI PRODUCTS-COMP/OP AGG $2 QQQ QQQ AUTOMOBILE LIABILITY , ANY AUTO CO BSINGLE LIMIT ALL OWNED AUTOS Ilia accident)S SCHEDULED AUTOS BODILY INJURY HIRED AUTOS - (Perperaw) S NON -OWNED AUTOS BODILY INJURY (Peraccident) $ PROPERTY DAMAGE GARAGE LIABILITY (Per accident) $ ANY AUTO AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC $ EXCESS/UMBRELLA LIABILITY AUTO ONLY: AGG $ OCCUR CLAIMS MADE EACH OCCURRENCES DEDUCTIBLE B WORKERSCOMPENSATIONAND GUWC440685 S EMPLOYERS' LIABILITY 11/07/03 11/07/04 WC STATU- OTT.I_ t ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? E.L. EACH ACCIDENT S j S yes, describe under E.L. DISEASE - EA EMPLOYE 51 SPECIAL PROVISIONS below OTHER _ E.L. DI$FAAF _ .e DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Operations performed by the named Insured subject to policy conditions and exclusions. Gatewood Homes 1600 Falmouth Road, Suite 25 Centerville, MA 02632 ACORD 25 (2001/08) 1 of 2 #32273 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL in DAYS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FALLLURE TO DO SO SHALLN IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR RFPRFQ=U .,--- AUTHORIZED ACORD CORPORATION 1988 4..ALIV4 10.11 r9a a0e7800248 GOL.AMAN ASSOC A C P. CERTIFICATE OF LIABILITY 9NtQUp,Ap?Cc: 1. PLROMJCVR 002M !1 S A88CCSA?SS 223Sammm -rpm CrERM. CA Eks.i F1NR:7CIAL 4=vi 88 SNC. ONLY AND CONF7WM I ,.7iz 933 :wum RD. HOLDER- THIS CERW HYANNIS 2A 02601 ALTERMEGQiI M2 ? 6nW 508-775-6010 €ax: 505-790-0249 'N2URERS AFFORs"➢, Rid s RODNEY DEA C$ M CAL SYSTEM 110 HOWER IAIZm F• SARNSTAME !!A 0266a US RER c THE POLCES a DZURA cE Lnnn MB 00 WY£ wp4= JE0 TO T}$.P1 FM WMED Amm FOR 11R PO(1�( PER¢ *l=T%o ANY REOL M,TEAYCRCOt=MOFANYCONTRACTORUFMMDO089 WFTMT85PECrTD LRLT�f7LbSCFRf1FIGTE LNY MN7FE S. AG T GATE /NI SHO" AYPAVE PCtJC$SC� Ur rFAD CLAI'1®bS,�.SCI'TDAIi TiETF3B8iQQtS�OW NACO! PCLA:E&ADCYIEQATE L8YT5 S1dMI MAYWVE ■EF7l1�0['SD lr(PAID CLAD, A I 0 comet I FVL8172 W-J*C'LAP4m ra ALLOWNEnAUTCM GCPCEDtt=At= HN%MALA VO i A--T WALLYO. .em uUAMNAY cccm ❑CLAMb"DE DECUCr F'e70,rxw s "VftgRS C0=4ftl3AT—"AM 9NPLCTE L LET' $72793S4403 C-AT£4+OS,+A 80m—p8 nx FAX SOS-778-5603 11500 FAr143oag Rom.. CZNTZRVI Y•4 !A 02632 11121/03 I 11/21/04 OS/03/03 I 05/03/04 GATZVVW 11 DA,mno3ww nL&as+NAQML KFI s ■u -13 _n � s 001 'uEM0MMToaft 10 OAUVOUTrO N= T0IIR LE rr.= PA[3RE 7C W W vjALL Arn Sao UiCMY1R �R Rf A0E1tIS OR - vJ! aIL f ar [gJr71 L.w..r b11-tj L3�Li i llilv1uKFiSlV� ►ROGUCER JOAO M-0IAS 508 672 2997 THIS CERTIFICATE IS ISSU ONLY AND CONFERS NO ,DIAS INeURANCE HCtDER: 7 fS-- COVERAGE�A 535 BRAYTON AVE ALTER THE JOEL FERREIRA OEALMEIDA DBA EJJA CONSTRUCTION 50 PICKERING ST. APT 17 FALL RIVER, MA 02720 DATE F•RRIOOIYYYY) 08/08/2003 INFORMATION CERTIFICATE 1, EXIENQ OR COVERAGES - .I THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATE I. NOTWITHSTANDING AKY.REDWREMENT. TERM OR CONDITION Or ANY CCNTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES OESCRIBEDt#ERE1N'L4SUBJE6T TO ALL. THSTERMS, EXCL I SION.ANp. CDPIOITLDNZ or SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. aq go -IT POU EFieCTIYG rOUCYEArIRATION ' rOUI�'NVMBER L�[ITS GENERAL LIABLIrY 'LACHOCCURRGNCE I f'wTow- X CoMMERCtALOtT+EITALuABIUTY NC27580E =26/2003 O6/2&2004 oceu�RaL s 100,000 I , CUIMS MAD6 Q OCCUR I P.P.N. zsu........,.__. e.rnn PER:I I I1•AAUUTOMOBLE W6RJTY ) L 'µVAUTO COMewcptl""EquyT I I i {EP Peoaanl) ALL OWNEDAUTQS C I SCHEDMEDAVTO BODLYIN �U—Y --� Clw4QQ0AUTO3 (Pbpsson s . I NOAwQ- AUT05 � IPROOP-LEyIINJURY '��I f '—•�-- I (YR i:LV-12) I GARAG[LIAGNTY ` AUTOONLYTEtACCtoE1+P i ANY AUTO TOONLY, FaJ.C^ 1= AU — ExCESSIWABRELLA UAB1LfTY EACHOCCURRENCE If - J OCCUR 0 CLAIMS MADE I AOGR£WTE I S OEDUCTIEIE � RETENTION 3 1 _ s S M'OgNERBCDMfE11[.LTIONAND �'M5_Tpl -- EMPLOYERS' LIABILITY i WC 43¢48.85' tY10$/03 i 1H08104 Ljl I0fGR6RCL ENECNE DD? I E.L EACHACC3094T s rf�l'JQ;$Bo- Vr$.eeaaMQ~ [-l-IN=ASL."A , WCC a LM nnn SHOULD ANY OFTHE A80v[ 09SCRLBW ►OL m,4 B[ CANCEI:ED'ELFORETN! DATE THEREOF, THE tSSUWG'"URI:R WILL EMOEAVOR TO MAL 10 DAYS WRITTEN GATEWOOD HOMES goT rTO•TIE'CERT/FICATE-HOWE*WMED•TO THE LEl3„ IIIlIFMO.tWEIOdO sn �,.�„ 1600 FANIOUTH RD. IMP03E NO OBLIGATION OR LIABILITY of AHY KWO UroN 7'Ne WOURER, rTS ACEHT[ 04 CENTER VILLE. MA 02632 ■ErRESHRATNES. I V4U 564 7272 CERTIFICATEISISS ONLY ANO CONFERS N RIDER. RISK SPECIALISTS PO THIS c WURANCE AGENCY, INC. ALTEq THE Cov P-0-nox 115 COMPANIES C TAIIIIET, MA 02534-0115 OOMPAW mm A - US LIABILITI MONUMENT INSULATION, INC. a COMPAW 223 COUNTY ROAD AMERICANHoN COMPAW BOURNE, MA 02532 C COMPANY THIS Is TO CEATIPY THAT THE PouClis OF INSURANCE BELOW HAVE BEEN ISSUED TO THE WSURED INDICATED. NOTWITHSTANDING ANY FtEOUIREMEW, TERM OR CONDITION OF ANY CONTRACT OR OTHER Do CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURAIICE AFFORDED BY EXCLUSIONS AND CONDITIONS; OF SUCH pOUCIE3. LIMITS SHOWN THE POLICIES DESCRIBED1, MAY HAVE BEEN REDUCED By PAID CLAIM 00 Type a CE LTA PO.L=YNUNB POUCYZPPRC7r4% POjj4yCtPlAA7Wu T" N OR QUERAL UAARM X awmmuL aDOW UAMU7y CLAMS MADE MV A' OWNFJrS A CONMTPIACMTORS pF;OT LL113S745 8/23/03 8/23/04 naftwe I --olury 7 ANrAUTC?- umBR _tLMEU.AFcm4 MXi�n�TL H�==WRELIA FMC WON" COMPEN3A7MX AND Ew4Awmm*uAw.m B. I FV7 mcLIWC 782 61 72 GATEWOOD HOMES.,INc 1600 FALMOUTH ROAD 925 CENTERVILLE,f MA 02632 508 778-5603 9/5/03 19/5/04. [-�a ABOVE FOR THE POUCY paTO6 r WITH RESPECT TO WHICH THIS 13 SUBJECT TO All THE TERMS. uzalm MMSOqm 61NGLELUT scw-ywjuw irw amco) %pw s PF019M Dom#= 3 AM ONLY . EA A=n&'JT 13 LIE EHOUW My OF THE ABOVE 093=8ED POLICIES BE CANCEUJM BoopM nM- 1 M 0RAr*N DATE TNOWOF' THE M"Na COMPANY ""LL ENDEAV011 TO MAIL 0 OAY3 WRITTEN NOT'Cf To THE CEfrnnCATE HOLM AfAMlRrT*-nWLlrr BUT FAlUiFj �Ts'M� s,*NOTICE Skau sm", asuamm OR UADfUTY TOTAL p.01 CERTIFICATE OF W- E o •[P-RODUCER THLSCRTIFICATE IS ISSUED ASassaro Leverone & Buckl CONS NO RIGHTS TIPON "M ey Insurance Agency Inc P 0 Box 160 Dennisport, MA 02639 INSURED Patrick K Orcutt 6a P & S Concrete 37 Ladys Slipper Lane Mashpee, MA 02649 COMPANIES AFFORDING COVERAGE A A.I.M. Mutual Insurance Co KTo RATEDFICASIONS AND CONDITIONS OF SUCH POLICIES. LII�f1TS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPEor INSURANCE POLICY NUMBER POLICY EFFECTTVE POLICY EXPIRATIO------------ IIABILTTY DATE(MM/DD/YY) DAT'E(MM/DD/YY) LVAITS HMERCIAL GENERAL LIABILITY ENERAL AGGREGATE S ::�LAIMS MADE�7C PRODUCTS-COMP/OP AGO. S NER'S & CONTRACTOR'S PROT. RSONAL & ADV. INJURY S ` EACH OCCURRENCE S FIRE DAMAGE (Airy one fin:) S LE LIABILITY ED. EXPENSE (Any orie pesos) S 'AUTO COMBINEDSINGLE LIMIT $ OWNED AUTOS EDULED AUTOS BODILY INJURY perms) S D AUTOS OWNED`AUTOS BODILY INJURY S \GE LIABILITY) PROPERTY DAMAGE S XCESS LIABuXrY MBRELLA FORM EACH OCCURRENCE S THAN UMBRELLA FORM GGREGATE $ WORKER'S COMPENSATION AND EMPLOYERS LIABILITY WC STATU- X OTH- A THE PROPRIETOR/ 6006181012003 I 10121/2003 10/212004 $ PARTNERS/EXECUTIVE INCL OFFICERS ARE: EL DISEASE —FOCI Y LIMY S EX IOTM:ER EL DISEASE —EA EMPI MY= S 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 MAH. 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL McOSE NO OBLIGATION OR LL4'Bu-rry OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE P. ,p .�.CC3}�D,- CERTIFICATE OF LIABILITY INSURANCE DATE C..7'L'mutL) O + I'� ► PRODUCER DALTER IS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION McShea Xnpurance AgenCy, IncLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE. 749! 'Lain Street, Suite#ALDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR THc COVr�-RAGE A E DOEp O THE POLICES 9t:L0lN. 09tarville, Na. 02655 5 1L�-d_30=991.3 INSURERS AFFORDING COVERAGE INSURED Casperson Overhead DoER A'Nit.,ER g,+_, Caa_.Sox 517R cEast Falmouth, MA 0253RD R E: _ THE POLICIES OF INSURANCE TERM E LISTED BELOW HAVE BEEN ISSUED TO THE INSVREO NAMED ABOVE FOR THE F'OLICV PERIOb INDIC,LTEO. NOTWtTHSTANDNG_ ANY REQUIREMENT. I TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICtl 7H15 CERTIFICATE MAY WI ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CERTIFICATE OO IS U SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. T R TYPE OF WSURANCF POLICY M ul POLICY EFFECTIVE POLICY EXMRATION GENtAAL LIABILITY DATE aloe A IUE LIMITS COMMERCIAL DENERAL LIABRifv EACH OCCURRENCE S CLAIMS MADE l.lL�OCCUR FIRE DAMAOF( ane nrel t500. 000 _ JL wt2$8352 MEpEXP(AN" PPalsa^) s aa� OS/28/03 05/28/04 PtRSONAL&-AGV INJURY E o OtNl AGGREOAIE LIMIT Arn tS PER GENERAL AGGREGATE El, DQ n00 POLICY I LOC _ PRODUCT_ ,OP AGG s AUTOMOBILE LMeILITY Are AU10 ALL OWNEDAUTOS SCHEDIA FO AUTOS MACD Amos N6N'OWNCOAUTOr GARAGE LIABILITY mTYAvrD-' EXCFStpABRtTi'" OCCUR CLAIMS MADE OFAUCTWLC HETENTIDIY_ WORKERS COMPENSATION AND EL:PLOYERV LLLdLITY A By LETTER: gateway, Homes 1600 Fa1--foutri Road-, Suite 2SIC Centerville, tA1► 02632 776 5603 ACORO --, (7/g71 02/22/03. BOOZY INJURY (Pa Faxon) i BOOZY NJURY (a...eaaenq E PROPtRTYOAMAGE TO, Amfool AUTO ON.�-CIOENT S 04EA3NAN_. EA ACC S AUTOONLr. Fao s F`CN OCCURRENCE S S TORY Ul Gq /22/0$ E.L.EACHACCIDENT ` EL AEMPLOY s E.O00 E.I. DLSEASE•POLICY LIM17 ZICAA nww DATE THEREOF. THE ISSUING W6URER wcrvn�+Na.uI+JRAnO WILL ENDEAVOR TO MAIL 14_ DAYS WRITTEN NOTICE-TLYTNE6Epi7pOATg.HOLDE GDO90 DAIN)SE NO OBLIGATION OR KIND UPON THE U481UTY OF ANY SNALI IN" ITS AGENTS OR �- � Fh?1i..Pn 0 ACORD CORPORATION 1988 A RPn CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDn�YM 0 OpUCER 7/18/03THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION fowling & O' Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 222 West Main A. -PO Box 1990 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis, MA 02601 :::JINSURERE: SURERS AFFORDING COVERAGE INSURED � � NAIL ii Busy Bee, Inc... suRERA: Hanover Ins. Company P.O. Box 50 . SURER B: Safety Insurance Company . East Sandwich, MA 02537 SURERC: Associated Employers Insurance Compa SURER D: COVERAGES TUC Cnl Iricc ne uin in....� . .. ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TOHWHICH THIS CERPOLICY TIFICATE INDICATMAY BE ISSUED OR DING 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. JR NSR TYPE OF INSURANCE POUCYNUMBER POLICY DATE EFFE nVE nPERSONAL OfyA GENERAL unslLITY OHN643998501 06/14/03 CURRENCE E1 000 000 X COMMERCIAL GENERAL LIABILITY TO RENTEDS3OOOOO CLAIMS MADE OCCUR (Any one person) - $15 000 X PD Ded:250 3 ADV INJURY s9 nnn nnn GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC JECT B AUTOMOBILE LIABILITY 3175394 ANY AUTO ALL OWNED AUTOS X SCHEDULED AUTOS X HIRED AUTOS X NON -OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE KtIENTION S C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? S yes, describe under SPECIAL PROVISIONS below OTHER 01/14/03 01/14/04 COMBINED SING4GE (Ea accidwi)BODILY INJURY(Per person)0,000 BODILY INJURY.0OOa (Per accident),PROPERTY DAMO '(Per accidwi), 000 ZDISEASE* N EA ACC E : AGG S RRENCE -S SEES.2003 06/27/03 06l27/04ATU- oTTi-CIDENT f1-EA EMPLOYE s1 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Operations performed by the named insured subject to policy conditions and exclusions. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA71ON ' Gatewood Homes — DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL AYS wRnTrN 1600 Falmouth Road Suite 25 FAILURE DO NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 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 - �- KJS 0 ACORD CORPORATION 1988 MERIT PLUS - 1eN/ p....SERIES Direct -Vent Gas Fireplaces MPD3328 MPD3530 MPD4035 33' fireplace w/opt. flush face 35' fireplace w/brushed stainless 40" fireplace w/polisbed 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. 14 1 � mvq 10 1) wm � -;�F- Sa m .D, ,i MPD4035 MPD3530 L"F�nr�^ir•1 Ge»4„reic DIMENSIONS Is Louvered face design Is 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) Is Hi/Lo flame operation • Pre -wired for wall switch Is Choice of standing pilot (works in a ower failure) or pilotless electronic intermittent) ignition • Decorative polished brass or brushed stainless accessories (arch door kit, door trim, louvers, hood) Is Wireless remote controls • Blower kits (including a temperature control version) • Screen panel kit (heat guard) • Radiant panel kits (for a clean face look) All Merit Plus Series direct -vent gas fireplaces utilize either a Secure Vent (rigid) or Secure Flex (flexible 4.5" inner/7.5" outer coaxial venting system, and include a 20-year limited warranty. Note: Due to Lennox' ongoing commitment to quality, all specifications, ratings and dimensions are subject to change without notice. Local conditions, such as elevation, wind vent configu- ration and choice of fuel will affect the overall appearance of the fire. Warnock Hersey U20006711) Warnock Hersey C ■ �e us LftusA ]6Pr8M RV2 W QLmnm He Pvi.M2Dl3 In The first two model number digits indicate frame width, the last two digits indicate glass width. All are A.EU.E.-rated high efficiency vented gas fireplace heaters, certified under ANSI Z21.88 and CSA 2.33-M99. MPD3328 (Rear vent model shown) 3328 MODELS (This model comes as a top or rear vent only) H D 6-tY,6" 7-1/2" 4-V2" Front Face Top 35,40 & 45 MODELS (These models come with a top and rear vent) H C D g 1 7-, 2 4-vr- E Front Face '1 FIREPLACE & FRAMING DIMENSIONS Right Side Side 3328 33t/8 308 17 271/2 33t/8 195/s 21i/z 103/4 33t/4 33i/4 13 3530 351/8 321/8 19 291/2 351/8 2111A6 24%s 12%6 35Y4 351/4 16 4M5 401/8 371/8 24 341/2 401/8 2611A6 29%8 1415A6 40Y4 401/4 16 4540 401/8 37Y8 24 391/2 45t/8 2611A6 34N 17%6 404 404 16 m� TYPICAL ROOM APPLICATIONS 3328T NG 17,500 45 64 62 3328T LP 17,500 49 66 64 3328R NG 17,500 53 63 61 3328R LP 17,500 55 66 64 3530 NG 20,000 53 64 62 3530 LP 20,000 55 62 60 4035 NG 27,000 59 69 67 4035 LP 27,000 60 69 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 Visit us at wwwLenno)+iearthProducts.com VERTICAL s TOWN OF YAR*OU EI BIDING DEPARTAIENT PLAN R 'W ,& BURMI NG P=An ApPUC-4TION REVIEW NOTES . ADDR& �S: 3 Map f Ltd,7, t.�. •�-/--oy` orb. _ dD NOTES_ naiconi i%e propased - des a Special pmo t fmmthe? Board ofAppeaLs- Other Code Denial �xfapp�able) - H �3 L PROPERTY ADDRESS; CALCULATION FOR PERMIT COST TYPE OF ROOM ETC NO ADDITION �3� 2.SS, ]ALTERATIONS �f1 BATH 3 BED ROOM j - a?�CERTIFICATE OF OCCUPANCY 100 Jf DECKOP770 EN R ROOM EN DECK WITH ROOF (. DEMOLITION DEN DINING IROGM FAMILY ROO FIREPLACE FOUNDATION ONLY IUD �o GARAGE NO. OF. BAYS 1 GREAT ROOM KITCHEN LAUNDRY ROOM LIVING ROOM MUD ROOM OFFICE ' PORCH CLOSED PORCH OPEN REROOFING , ... . SHED STORAGE AREA SUN ROOM 14EATED SUN ROOM UNHEATED SWIMMING POOL ABOVE GRO SWIMMING POOL INGROUND WINDOW REPLACEMENT 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) 21.1C3 Street 121 CAMP ST #3 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. Owner (Sign) Reference : VILLAGES AT CAMP STREET : FRANK CAPRA : 1600 FALMOUTH RD #25 : CENTERVILLE, MA 02632 . -. _ �� _ .�'. ,"ter... � - ,. -� r. .. ... -.. .• 1!':� U t/L/ I'// Building Site Location: Proposed Improvement: Address: & r17% , TOWN OF YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET a/./. C 3 3 C/ �� Map No: Lot No: Tel.No.: %%�( la % Date The Building Department will be responsible for assisting the applicant bYdispatching Your plans and or application to the following applicable departments. RESIDENTIAL ANDMR 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. PREVIEWED BY: 141. WATER DEPARTMENT: DATE: I G N/A .ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: (,,4. HEALTH DEPARTMENT- DATE: N/A: INDUSTRIAL AND/OR COMMERCIAL PERMITS 5. 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 - Bufldmg DrpL - Pink copy - Water Dept - Yellow Copy - Heah'h DePL - Pink COPY - Enema g Dept - Goldenrod - Fire Dept/CoavQvation Y -ty .y _-_.-r %.w...-y, .v..sy,.y!'y,.-. y.`.y':'.Y ih. YY../r-. V..�.I"+OJ4 f�iM./.M•'\'.'M"�'1:.:ti- V ,04 Y't�4 /, - o y' L/ �� TOWN OF YARMOUTH BUILDING DEPARTMENT O H BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET Building Site Location: /'� Proposed Improvement: Address: No Y% Lot No: a/'/ C3 Tel.No.: %72 ya % Date 777 f6� y 63 The Building Department will be responsible for assisting the applicant by 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. BY: PREVIEWED V 1. WATER DEPARTMENT: DATE: N/A: ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: l HEALTH DEPARTMENT: ��' //LAN/ i1i/.t DATE: 3.�, 4a N/A INDUSTRLAL 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 - Budding DepL - Pink copy - Waw DepL - Yc low Copy - Haft DepL - Pink Coff - Engi og Dept - Gokkmod - Fim DqA Conxrvaflm MAScheck COMPLIANCE REPORT I permit # Massachusetts Energy Code MAScheck Software Version 2.01 Release 2 Checked by/Date CITY: Barnstable STATE: Massachusetts HOD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 6-20-2002 TITLE; The Osprey PROJECT INFORMATION: Mill Pond Villages 1600 Falmouth Rd. Unit 25 Centerville, MA. 02632 COMPANY INFORMATION: Northside Design Assoc. 141 Main Street Yarmouth Port, MA. 02675 COMPLIANCE: PASSES Required UA = 257 Your Home = 134 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 731 30.0 30.0 12 WALLS: Wood Frame, 16. O.C. 1758 15.0 15.0 77 GLAZING: Windows or Doors 132 0.320 42 DOORS 40 0.086 3 --------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date, Massachusetts Energy Code MAScheFk Software Version 2.01 Release 2 The Osprey DATE: 6-20-2002 Bldg.l Dept.) Use I CEILINGS: [ ] I 1. R-30 + R-30 Comments/Location I WALLS: [ ] I 1. Wood Frame, 160 O.C., R-15 + R-15 Comments/Location I WINDOWS AND GLASS DOORS: [ ] I 1. U-value: 0.32 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: [ ] I 1. U-value: 0.086 Comments/Location AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. I VAPOR RETARDER: [ ] I Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. I MATERIALS IDENTIFICATION: I l I Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. I DUCT INSULATION: [ ] I Ducts shall be insulated per Table J4.4.7.1. DUCT CONSTRUCTION: All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or 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 o►` 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.): PIPE SIZES (in.) NON -CIRCULATING CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F): RUNOUTS 0-1" 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only)------------------------- CALL US DIRECT AT: Delivery (508) 477-5868 Sales (508) 477-6575 GA -- umm CONTRACTOR DIVISION CONTRACTOR DIVISION Bowdoin Road, Mashpee, MA 02649 Mailing Address: P.O. Box V, Osterville, MA 02655 CALLUS DIRECT AT - Toll Free (800) 834-3132 FAX (508) 477-4279 SOLD TO: LAUNIE GROUP LTD ACCT-PRJ: 13297-000 13 HEATHER DRIVE INVOICE #: 031009242859 MILTON, MA 02186 DATE: 10/30/03 TIME: 09:42:28 SHIP TO: MILL POND VILLAGE SALES ID: NAOMI K. OSPREY BUILDING DELIVERY: 11/28/03 FRAMING LUMBER ROUTE: QUOTE PH#617-698-9383 1000-24 PAGE i ------------------------------------ RTE 3 NORTH - TO EXIT 13 - RIGHT OFF EXIT - AT LIGHTS TAKE RIGHT ONTO RTE 123 - FOLLOW TO RTE 3A - TAKE A LEFT ONTO RTE 3A - JOB SITE IS ON RIGHT - LOOK FOR BOTELLO SIGNS --- ------------------- -------------------- ITEM OTY OTY U/M DESCRIPTION U-PRC PER NET AMT ------------------------ QUOTE ID: OSPREY BCI EXPIRATION DATE - 11/28/03 PURCHASER: CORMICAN, BRIAN ALL SPL BC FRAMING LUMBER IS BASED ON DIRECT SHIPMENT TO SITE DELIVERY TRUCK. MUST HAVE ACCESS TO SITE OR ADDITIONAL CHARGES WILL APPLY !! **MODULE A.IST FLR - 10/30/03** SPL 820 EACH BC45012 1-3/4X11-7/8 1.860 EACH 1525.20 33/20' 5/18' 4/16' 2/3' LVL11 106 LNFT 1 3/4"X 11 7/8" LAMINATED BEAM 3.367 LNFT 356.90 4-20',2-101,1-69 SPL 80 EACH VLRIMI2 1-1/16X11-7/8 2.740 EACH 219.20 SOLD 201 LENGTHS ONLY SHGUS410 2 EACH SIMPS DBL FACE MNT HNGR 9 1/2" 23.530 EACH 47.66 15/CTN SIUT11 14 EACH 1 3/4 X 11 7/8 FACE MOUNT HANG 2.010 EACH 28.14 **MODULE A.1ST FLR TOTAL 82176.50** **MODULE B.2ND FLR - 10/30/03** SPL 804 EACH DC45012 1-3/4X11-7/8 1.860 EACH 1495.44 33/20' 9/16' LVL11 98 LNFT 1 3/4"X 11 7/8" LAMINATED BEAM 3.367 LNFT 329.97 4-20°,2-9' SPL 80 EACH VLRIMI2 1-1/16X11-7/8 2.740 EACH 219.20 SHGUS410 2 EACH SIMPS DBL FACE MINT HNGR 9 1/2" 23.530 EACH 47.06 15/CTN SIUT11 7 EACH 1 3/4 X 11 7/8 FACE MOUNT HANG 2.010 EACH 14.07 Fax us your orders 24 hours a day n (IS DIRECT AT: . flvery (508) 477-5868 Sales (508) 477-6575 CONTRACTOR DIVISION CONTRACTOR DIVISION Bowdoin Road, Mashpee, MA 02649 Mailing Address: P.O. Box V, Osterville, MA 02655 SOLD TO. LAUNIE GROUP, LTD 13 HEATHER DRIVE MILTON, MA 021BG SHIP TO: MILL POND VILLAGE OSPREY BUILDING FRAMING LUMBER PH#617-698-9383 CALL US DIRECT AT - Toll Free (800) 834-3132 FAX (508) 477-4279 ACCT-PRJ: 13297-000 INVOICE #: 031009242&;9 DATE: 10/30/03 TIME: 09:42:28 SALES ID: NAOMIA DELIVERY: 11/28/03 ROUTE: QUOTE 1000-24 PAGE 2 RTE 3 NORTH - TO EXIT 13 - RIGHT OFF EXIT - AT LIGHTS TAKE RIGHT ONTO RTE 123 - FOLLOW TO RTE 3A - TAKE A LEFT ONTO RTE 3A - JOB SITE IS ON RIGHT - LOOK FOR BOTELLO SIGNS -------------- --• U/M ITEM — --- DESCRIPTION U-PRC PER NET AMT ----—---------- ------------------- ------------------ SMIT411.88 i EACH 3 9/16"X 11 7/8"TOP MOUNT HANG 3.530 EACH 3.53. **MODULE B.2ND FLR TOTAL $2109.27** SUB TOTAL 4285.77 MA 5.0009 SALES TAX 214.29 TOTAL 4500.06 Fax us your orders 24 hours a day REVISIONS JIM. 1 rks1A1 II IT •Cl/10. Irmp1 _. _ 115pW5�J—j IF �Wj 2 1141 1rvv 11nu Ldd++ First Floor i 1?•VV t1VB SC FRAME" 27G2 9G'E IAP•P-0' 10J01200f Or. Rick Lose Fk& Lmrte,MR Vi0 1 aJ 1 sMEEr 1/J Fket FNor Fnmirq 6oMdula-NalrinaeaM If•rk Oty Oeaaiptlan L•npN t 17 It)T eaf/ewp lPP f • 11 iT •Clf/Wr•I IV f / 111T eew/eo. sF IfP / f 111T ecrua ev JP / 1W'[11 iTVEkSAIAYffIW dP 10P • f IWall /TVEI1S1.lAMf ]1W ep IPP 1 1 1]N'a 11 )TVEeSAUAM 11Wp fP e n 1'a 11 >T YEfS4kIMOW 1JP FlrN Floor AeuxdySGwAuN Mirk Qly MWWNauler Pretlud Dewlptlon n1 f snf.r.9ewglk ea nuM/lo slrsa►wro uvl.. Faa. Maf• w w enelW a,mf»M urlt ta11a11-1nw.w •Clf Faee Yan• Pm]N 1 i as No Second Floor Framing Plan 17. V-O" laal aa. p ..1WWM 11,4]N] P Wa,.. � 1W10 11,4]N.1 ............. '....................... S.cad FMlor Fnminp Schedule -11milnaRted Mark ay Dswdppon lanpih 1 1] 117Twn444aw ]]P ] a II ]T aCIf �AOaN IfP ] � IY]'a 111T VERMr1AW ]IN BP MP ] 7 11M111TWWR8MNM3I011BI fP a n I•R117TVERfA#MIPN 1TP 112 Mee NNE xq I-- NA arNpyCI t�4'�nMmx eN.,dw eNx sae waxro (I-Sj %��\ nm.wtwxauNnr.p•aap w Y. e ' ARE IaN orr. Wa rae.w ar+Eer: aia tWo: 103M niNom: �onencweairn ................................................................................................................................................................................................. ........ BC CALC® 2001 DES fGfCI!US Thursday, October 30, 2003 08:12 Single 117/8" BCI® 45Os SP File Name: Tutorial Proto-2: Floor 1U_14 Job Name: Mill Pond -Osprey Bldg. Description: Address: 1600 Falmouth Rd. Unit 25 Specifier. Rick Lowe City, State, Zip: Centerville, Ma. Designer. Customer: Launie Company, _BotellaLumberGo-Jac. Code reports: NER 594, ICBO 5208 Misc BO, 3-12" B1, 3-12" 387 Ibs LL 387 Ibs LL 97 Ibs DL 97 Ibs DL General Data Version: US Imperial Member Type: Joist Number of Spans: 1 Left Cantilever. No Right Cantilever. No Slope: 0/12 OC Spacing: 12" Repetitive: Yes Construction Type: Glued Live Load: 40 psf Dead Load: 10 psf Partition Load: 0 psi Duration: 100 Disclosure The completeness and accuracy of the input must be verified by anyone who would rely on the output as evidence of suitability for a particular application. The output above is based upon building code -accepted design properties and analysis methods. Installation of BOISE engineered wood products must be in accordance with the current Installation Guide and the applicable building codes. To obtain an Installation Guide or if you have any questions, please call (800)232-0788 before beginning product installation. BC CALC®, BC FRAMER®, BCI®, BC RIM BOARDTM, BC OSB RIM BOARDT , BOISE GLULAMw, VERSA -LAMS, VERSA -RIMS, VERSA -RIM PLUS®, VERSA,STRANDTM, VERSA -STUD®, ALLJOISTO and AJS"m are trademarks of Boise Cascade Corporation. Total Horizontal Length-19-04-00 Load Summary ID Description Load Type Ref. Stan'. End Type S Standard Load Unf. Area Left 00-00-00 19-04-00 Live Dead Controls Summary Control Type Value Moment 2335 ft4bs Neg. Moment 0 ft4bs End Reaction 483 Ibs Total Load Defl. 11519 (0.447") Live Load Defl. L/649 (0.357-) Max Defl. 0.447" Span / Depth 19.5 %Affowable. Duratica 562% fodv;z " nle- 100% 33.3% 100% 462% 73.9% 44.7% n/a Value OCS Dur. 40 psf 12' 100% 10 psf 12" 90% Load Case Span Location 2 1 - Internal 2 1 -Left 2 1 2 1 2 1 1 Notes Design meets Code minimum (1-240) Total load deflection criteria. Design meets User specified (11480) Live load deflection criteria. Design meets arbitrary (1") Ma dmum load deflection criteria. Minimum bearing length for 80 is 3-12". Minimum bearing length for B1 is 3-12". Entered/Displayed Horizontal Span Length(s) = Clear Span + 12 min. end bearing + 12 intermediate bearing Single 14 7Ar' ECIO 450S Sp Job Name: Mill Pond -Osprey Bldg. Address: 1600 Falmouth Rd. Unit 25 City, State, Zip: Centerville, Me. Customer. Launie Code reports: NER 594, ICBO 5208 BC CALC® 2003 DESIGN REPORT - US Thursday, October 30, 2003 08:11 File Name: Tutorial Proto -2: Floor 2U_20 Description: Specifier. Rick Lowe Designer. Company, Botello Lumber Co. Inc. 387 Ibs LL B1, 1-3/4^ 97 ms OL 387 Ibs LL 97 Ibs DL Total Horizontal Length - 19-04-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End T S Standard Load Unt. Area Left 00-00-00 19-04-00 Live 4p Value 1120 100OCS % Member Type: Joist Number of Spans: 1 Dead 10 psf 12^ 90% Left Cantilever. No Controls Summary Right Cantilever. No Control Type Value Moment 2335 ft-Ibs %Allowable Duration Load Case Span Location Scope: 0/12 5621a 100 2 1 -Internal OC Spacing: 12^ Neg. Moment 0 ft-Ibs n/a 100°.5 Repetitive: ye End Reaction 483 lbs 40.3% 100% 2 1 -Left Construction Type: Glued Total Load Deft. IJ519 (0.447-) 462% 2 1 Live Load Defl. IJ649 (0.357') 73.9% 2 1 Live Load: 40 psf Max Dell. 0.447^ 44 7% 2 1 Dead Load: 10 p� Sean /Depth 19.5 n/a 1 Partition Load: 0 psf Notes Duration: 100 Design meets Code minimum (L/240) Total load deflection criteria. Disclosure Design meets User specified (U480) Live load deflection criteria. The completeness and accuracy of Design meets arbitrary (1") Mabmum load deflection criteria. the input must be verified anyone Minimum bearing length for BO is 1-0/4 Minimum bearing length for B1 is 1-3/4• who would rely on the output evidence of suitability fora Entered/Displayed Horizontal Span Length(s) =Clear Span + 12 min. end bearing + 12 intermediate bearing particular application. The output above is based upon building code -accepted design properties and analysis methods. Installation of BOISE engineered wood Products must be in accordance with the current Installation Guide and the applicable building codes. To obtain anInstallation Guide you have any call questions, please call (800)232-0788 before beginning Product installation. BC CALC®, BC FRAMER®, SCI®, I; BC RIM BOARDTM, BC OSS RIM BOARDTM BOISE GLULAM'u I VERSA-L Alvm, VERSA-RIM4D,' I VERSA -RIM PLUS®, VERSA-STRANDTM, VERSA-STUDO, ALLJOISTO and AJSTM are trademarks of Boise Cascade Corporation. Page 1 of 1 A' ® LjI . ' ■ Air Conditioning & Heating �ISTEo ® LISTED 92.6% AFUE MULTI -POSITION CONDENSING GAS FURNACE GMNT SERIES ��wuo0� 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 bumers • 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.goodmamnfe.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 92.6 25-55 0603 60,000 55,000 55,000 51,000 92.6 35-65 080-4 80,000 73,500 73,000 73,000 92.6 35-65 100-4 1oo,000 92,000 92,000 85,000 92.6 40-70 120-5 120,000 110,000 111,000 102,000 92.6 40-70 as " BEFORE PURCHASING THIS APPLIANCE, READ IMPORTANT ENERGY COST AND EFFICIENCY DATA AVAILABLE FROM YOUR RETAILER. SPECIFICATION DATA Electrical Characteristics 115/1/60 Gas service connectinn 1/z" FPT Model Number Motor Blower Vent* Dia. Combustion' Air Filter Size In Perm. / Disp. Electrical Ship Weight HP Spd. Dia. Width FLA Max Fuse 0403 1/3 3 10 6 7 7 290 / 580 52 15 170 0603 1/3 3 10 6 7 2' 290 / 580 5.2 15 180 080-4 1/2 3 10 8 T T 385 / 770 7.8 15 205 100-4 1/2 3 10 10 3' T 385 / 770 7.8 15 225 120-5 3/4 3 11 10 T 3" 480 / 960 9.2 15 265 -Note: Vent and COrr1DUStion air OiameterS may. Vary oepenaing upon vent iengtn. uneCK witn instructions, wnicn accompany the furnace. 28" A 5" 4 � 8 I' B 4$ 4$" 4 r i� I 4 COMB. AIR IN GAS IN: 51" VENT T i 27" LOW VOLTAGE ' , 4" ELEC. 104'-" Model GIMNT A B Combustible Floor Base 0403 & 060-3 14' 12 IN SBM14 080-4 17 % 16' SBM17 100-4 21' 19'/:' SBM21 1205 24'% 23' SBM24 SS-312D i"+ 128" i COMB. AIR INLET 201" 8 GASINLET LOW VOLTAGE ELEC. CLEARANCES FROM COMBUSTIBLE MATERIALS Sides Rear Front` Vent Top 1' 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" 17 Yi 21' 24 W 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 17Ym" X(1) X(2) U-35 14" X U-36 17 Yi X (1) X (2) U-42 17Y:' X(1) X(2) U-47 17 Y: X U-49 21" X(1) X(2) U-59 21" X(1) X(2) U-60 24 W X(1) X(2) U-61 24Y2' 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 100-4 MED 1725 1700 1670 1615 1550 1475 1375 1275 LOW 1430 1390 1350 1315 1285 1245 1160 1070 HI 2360 2325 2300 2170 2125 M45 1945 1850 GMNT 120-5 MED 1815 1750 1710 1660 1600 1545 1480 1415 LOW 1275 1215 1 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' .. • 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.goodmantnfe.com for information on: • Goodman products • Warranties • Customer Services • Parts • Contractor Programs and Training • Financing Options SS-312D 4 . • a t] ISED SE PIPER) L=�:3. OT 4� ,. N S0'47 3.574 fs F S SE`NJ ER AWN R LATERAL SHALL BE `� D IN ACCORDANCE ,`y� W� 1 TLE V IF WITHIN GRAPHIC SCALE �� 1 F F WATER MAIN. � o � 2��4 20 10 0 20 6 nkPR o CE Unless aid until as the original (red) stamp of the responsible Profs gineer, or Professional Land Surveyor IN FEET appears on: By o pman or persons, Including any municipal or other c officials, may rely upon the information contained herein; and 1 inch = 20 ft. (8) this plan remains the property of Holmes k McGrath, Inc. REVISED: 3-2-04 PLOT PLAN holmes and mcgrath, inc. N�H OF digSdAp_ OF LOT 3 civil engineers and land surveyors��P PREPARED FOR 362 gifford street TIMC?r11'i.'. sav?cs MILL POND VILLAGE falmouth, ma. 02540 No 45n,g IN , YARMOUTH, MA JOB NO: 201197 DRAWN: LMC FGIs1� s' SCALE: 1"=20' DATE: 1-22-03 DWG. NO.: A2502 CHECKED:7k or �Pg ez�>in N S0'47 L =�;3. OT 4I .6^ E 54. GRAPHIC SCALE 20 3,574 tS.F b9pong,lb's nless and until such time as the original (red) stamp of the Professional 1 or Professional Land Surveyor on thi d on or persons. including any municipal or other F; IN FEET officials, may rely upon the Information contained herein; and I inch = 20 it. (B) this plan remains the property of Holmes x McGrath, Inc. REVISED: 3-2-04 PLOT PLAN holmes and mcgrath, inc. d„e 1' f4SS OF LOT 3 PREcivil engineers and land surveyors o� °yG, TIMOTHY 0.7. PARED FOR 362 gifford street -SANT S A MILL POND VILLAGE Falmouth, ma. 02540 "c78 w1 N°v ♦• % /STELE YARMOUTH, MA JOB NO: 201197 DRAWN: LMC SCALE: 1"=20' DATE: 1-22-03 DWG. NO.: A2502 CHECKED:-roo i • • • Commonwealth of Massachusetts Permit No. Department of Fire Services Occupancy and Fee -t- I T-J" BOARD OF FIRE PREVENTION REGULATIONS . 11/99j vet APPLICATION FOR PERMIT TO PERFORM ELECTRICAL V All workto be pedo®ed in accadm= with the Massachusetts Electrical Code (MEC), 527 (PLWEPREiTlY 1VKORnTEALLINFORMA770NJ Date:__%� City or Town of. YAPMUTH To the Inspector of IP By this application the undersigned gives notice of his or her intention to perform the electrical work Location (Street & Street too 6 res. fescnbed 3 OwnerorTenant Gatewood Homes/ Jeff Sollows Telephone No.508-7789669 Owner's Address 1600 Fallmuth 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 Ampacity Location and Nature of Proposed Electrical Work Fire Alarm System (law voltage control panel) w; h ba k = battery, centrally monitored. in.nnTeNmi nrthe Alb"M table may he ivaivdjhv the liueector aPl�ires No. of RFixtures No. of Cer1-SuS Fans . (Paddle) ) al r ° otA Trof ansformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool a e . ❑ d. ❑ Battery Uni175. ts g No. of Receptacle Outlets No. of OR Burners FME..ALARMS No. of Zones —1—' No. of Switches No. of Gas Burners o. o InitiatingDeeteDenNf 7 vices No. of Ranges No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers �Totg , um er. ons Det�tion/Aloerting Devices 7 No. of Dishwashers S ace/ArraHeatin KW P g Local ❑ "umc'P• ®Other .., No. of Dryers .. Heating Appliances KW SecuritySystems: uNo of Devices orE ivalent o. of Water KW Heaters o. o o. o Signs Ballasts Data Wiring: No. of Devices or trivalent No. H dromassa a Bathtubs y g No. of Motors Total HP TelecommunicationsfDeivirmg: No. of Devices or uivaleat OTHER: Aaacn aaaaomi aermi rj acirrea. or = regrarea oy orcmirpecror q acres. 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 exlubited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OnIE R ❑ (SPAY) (Expiation to Estimated Value of Electrical Work $750.00 (Wben required by municipal policy.) Work to Start Z`j b Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the in. formation on this applica don is Prue and complete . FIRMNAME: Baltic Security, Inc LIC.NO.: 1178C Licensee: Jonas R Bielkevicius Signature LIC. No. 499D 0 02563 OWNEWS INSURANCE WAIVER- .I am aware that the Licensee does nothave the lrat required by law. By my signature below, I hereby waive this requirement I am the (check Owner/Agent Signature. Telephone No. 1 Bus. Tel No.- 508-833-0996 Alt. TeL No.: 508-776-33 7 insurance coverage normally ) I-1 owner n owner's aeent. PERMIT FEE: $ 40.00