Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
121 Camp St #004 Building Permits
<C�x_ Commonwealth of Massachusetts Official Use only � Department of Fire Services Permit No. - oal= )—• 1 1j0j BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked /�S [Rev. 11/991 leave blank I APPLICATION FOR PERMIT TO PERFORM ELECTRICAL,'1t1�ORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR Ik' Y 17J /a�e t„ (PLEASE PRINT IN INK OR TYPE ALL INFORMA NCity or Town of:ir�d� 3 By this application the undersigned gives notice of his or o Location (Street &Number) `� o4 Owner or Tenant 0 E' Owner's Address W Is this permit in conjunction with a building permit? Purpose of Building Existing Service Amps / Volts Date: •lF130 J To the Inspector of Wire : OG I to perform th/electrical wirk deAibed bel�w. 1 z004 1 _ - i - Telephone Yes ❑ No ❑ (Check Appropriate Box) Utility Authorization No. Overhead ❑ Undgrd ❑ No. of Meters New Service 1,va Amps /Zv/ G®PVolts Overhead ❑ Undgrd C�' No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: yr° Gt/ Completion o the ollowin table may be waived by the Inspector of li'ires. H E d d A A w N W H fin ra" No. of Recessed Fixtures No. of Ceil: (Paddle) Fans of TransSusp. Trsformers Total KVA No. of Lighting Outlets 3 No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- find. find. ❑ cy fig o. o Baste Units rng No. of Receptacle Outlets Y� No. of Oil Burners FIRE ALARMS No. of Zones No, of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges % No. of Air Cond. Tonsl No. of Alerting Devices No. of Waste Disposers Heat Pum Totals _ um_ber ........- Tons _ ....... __ __ - o. ofSelf-Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security of Devices or Equivalent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or E uivalenta No. H dromassa a Bath ubs Y g _ No. of Motors Total HP Telecommunications Wiring: No. of Devices or E uivalent OTHER: ��� Is C ff I' �F l5 L11 i� n I �) �� I (� 1.�i/•1 I I Attach additional detail y desired, or as required by the Inspector of tares. INSURANCE CO ljn�ss2$Ai� e�b the owner, no permit for the performance of electrical work may issue unless w w he licensee provide proof of liability insurance ncluding "completed operation" coverage or its substantial equivalent. The d undersigned certifie that sgchcov=gcJ e, and has exhibited proof of same to the permit issuing office. A A HECK ONE: IN `-"E� z--B OTHER ❑ (Speci ) —Z.Ni fy: f G Z4�,e1 1i W7 9WSJ (Expiration Date) Estimated Value of Electrical Work: ioav D • `� (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. certify, under the p • s and petralties of perjury, that the information on this application is true and complete. IRM NAME: L[C. NO.: W icensee: / Signature o/ C. NO.: O c4 (/japplicable, ens r emp ' in the li etue number lir e.J // L�us. Tel. No.: w Address: l �';�� /�v9PJ _M�%�fJ���19 •� !Alt. Tel. No. x OWNER'S INSURANCE WAIVER: I am aware that th icensee des no have the liability insurance coverage normally 04 U required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's acent. H aOwn Signature Telephone No. � TOWN OF YARMOUTH 1! Ij u iJ NOV 0 1 2 0 Q APPLICATION FOR PERMIT TO DO GASFITTING (OFFICE USE ONLY) By *rf . Fee: $ 3M,a7z PERMIT NO.Q:-< 5 ^ ';S% 1 Date ��` - Building owner' A7' C'' S AT: Location A }� S T Name�� �1�7 LO Type of Occupancyoe l New EX Renovation ❑ Replacement ❑ IF Plans Submitted Yes ❑ No I' Cn W W \ V1 J c~ 0 a} 0 M Z Z 1¢- N ~ w f fP� z 0 m H W 0 0 ¢ w Q n w¢ w ►- N a O > w `C w z W a y w= J z a a= CC '= Q tr 0 N 0 m W z 0 W z V w x p y y= cc .. ¢ Cr w z¢ aC ¢¢ 0 0 w °C O w ►- ¢ w> x 0 0 x D U. > O a F- 0 SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) �� Installing Company Name DUGTS - (IA/1,t t v% 17efD Address 19 G 14A8 E S 't' f4e 9 NN1S MA n 2 C,0 1 Business Telephone sD '! 7,3 7 `" 3 6' 4 Check One: ❑ Corp. ❑ Partnership L Firm/Company Name of Licensed Plumber orter N L INSURANCE COVERAGE: Check One I have a current liability insurance policy or its substantial equivalent. Yes E�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 1 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 Qt0j) Signature o Licensed Plumber or Gasfitter ZtS)�s License Number TVDF 1IrF:MCF- TOWN OF YARMOUTH purr 3 0 2N. e APPLICATION FOR PERMIT TO DO PLUMBING (OFFICE USE ONLY) By Fee: $ 5- 40 p� l[, PERMIT NO. P 05 r QIf�'-T Date 6 / 30 20---C9 BUf�C{r;3 CFT. Owner's C4 a w ai6 d Cl 4-16mes AT: Location Name �tr —/ Type of Occupancy New w Renovation ❑ Replacement ❑ Plans Submitted Yes ❑ No ❑ a z Y ~ \ rn Y r) QM Cn aF 0 Z 0 C W CC W M ���l,J(• ED O Cn W fA � 2 N (A LL.Z 3 f>.C' UWm W W M Q Q N a o. Q LWLL O rs WW¢ WZO O a a a° a°°CC o °ax 3 3= Q 3 o 2 m 0 Y J m 0 0 0 J H U) LL C3 :3 t] SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) �" Installing Company Name "I IUbafP VVWLIIOQ Address And Icy 96 r Check One: ❑ Corp. ❑ Partnership NUILMOLAID M, 0 -L S �j Fir ompany Business Telephone 77 Ll u L % (55 Name of Licensed Plumber- Den r' 1T�a�V INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes 22' 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 ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance voerage 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 Chapter 142 of the General Laws. Check on Owner ❑ Agent ❑ Signature of Licensed Plumber 2-i-�IA-7 License Number Type: Master El JourneymanL7 &I V137.i F FLUE CUR � 46.91 co N 80-47'49 E �_ s' CA 4 4. ' 9.5' 25.0' 2.3 r �22,�'z 1� o SO Iro � EXISTING Z EXISTING U! FOuNDA�ON 0;_PP: rn FOUNDATION p 0000 J _ , I 0 � 0 1 I LOT 3 N I IN" o W 107 LOT4 I" o ► L_51.6c I 132.4 53.70' 8274046 54.83' L=3.82' D DRIVEWAY 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 A A. / DATE` REGIS ED PROFESSIONAL LAND SURVEYOR GRAPHIC SCALE ( IN FEET ) 1 inch = 20 & ar91- I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE LOT AS SHOWN, AND THAT ITS LOCATION CONFORMS TO THE MINIMUM SETBACK REQUIREMENTS OF THE 40B6ySjPPEECIAL PERMIT DATE / REGISTERED PR6FESSI6NAL LAND SURVEYOR Imwf_� 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 public officials, may rely upon the Informatlon contained herein; and (B) this plan remains the property of Holmes & McGrath, Inc. AS —BUILT PLAN holmes and mcgrath, inc. ;,= y �� � �,►,, OF LOT 4 civil engineers and land surveyors �, �fillcHlef. PREPARED FOR 362 gifford street 3!b EL MILL POND VILLAGE falmouth, ma. 025401' IN rim r YARMOUTH, MA JOB No: 201197 DRAWN: LMC SCALE: 1 "=20' DATE: 6-09-04 DWG. NO.: A2503A CHECKE , ,. OF r TOWN OF YARMOUTH Building Department - - - - - - - , (508) 398-2231 a BUILDING r PERMIT NO B-04-1375- ,� a ISSUE DATE ; --619/2004• - ; PROPOSED USEP PERMIT --- -------------------- U.- JOB WEATHER CARD APPLICANT Frank Capra ------------------------------ PERMIT TO ; New Construction ' AT (LOCATION) 100121CAMPST#4 ZONING DISTRIC R-25 SUBDIVISION MAP LOT BLOCK 044.21.1.C4 BUILDING IS TO BE: CONST 1 LOT SIZE Bldg. Type: Residential 5-B I USE new construction: 2 baths, bedrooms, 1 greatroom, 1 kitchen as per plans dated 04/01/04 and REMARKS BOA # 3546. AREA (SO FT) EST COST ($ $141,600.00 PERMIT FEE ($) $516.00 OWNER Villages at Camp St., LLC B ILDING DEPT BY ADDRESS 11600 Falmouth Road # 25 0 / Centerville I MA IF2632 CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 Certificate Issue Date _,( 7 �v CERTIFICATE of OCCUPANCYt Departmental Approval for Certificate of Occupancy and Compliance Inspector Date Permit Number Approved By Reapirks BUILDING PLUMBING/GAS ELECTRICAL ENGINEERING i4 rcL j e ✓- Il- wj-r d OTHER F;P-er 3 Q5 7X, _e 3 a To De tilled In Dy eacn division Inaicateo nereon upon compietwn oT its Tmai inspection. s. E ` rPWN OF YARMOUTH Building Department B U I L D I N G - - - - - _ _ _ _ _ , (508) 398-2231 ext.261 1` + PERMIT NO B-041375 _ PERMIT ISSUE DATE ; _ _ - - - - - - _ ; PROPOSED USE _ _ _ _ _ _ APPLICANT -'Frankbapra JOB WEATHER CARD -------------------------------- PERMIT TO ; New Construction ; AT (LOCATION) 00121CAMP ST # 4 ZONING DISTRIC R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C4 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE O I CONTRACTOR new construction: 2 baths, bedrooms, i greatroom, 1 kitchen as per plans dated 04/01/04 and REMARKS BOA # 3546. AREA (SO FT) EST COST ($ r$141,600.00 PERMIT FEE ($) I$516.00 OWNER lVillages at Camp St., LLC BUILDING DEPT BY ADDRESS 11600 Falmouth Road # 25 Centerville MA 02632 INSPECTION RECORD LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 FIELD COPY Date Note Progress - Corrections and Remarks Inspector . oy p -o of d 0 TOWN OF YARMOUTH j_ ,r. Building Department t ' Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT APPLICATION RECEIPT Temp Permit No.: T-04-436 Applicant Name: Frank Capra Location: 00121 CAMP ST # 4 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: lc: Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 614 Net Owed: ($50.00) Application Date: 3/8/2004 Issue Date: Expiration Date Comments: yf / 41- /. C 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. 2 � f- 1- 3 Date Printed: 3/15/2004 /1 oF'YgR,� 01 y MATTwCj1E[s� a� 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 Onl , `� 3' N Permd No �'� ate; P { j DepOSlt ReC'd $ h3te J Net Due, Planning Board Information Plan Type ° ` Endorsement Date ecording Date = Plan No"�: J)ther' } Assessors Department Information lvlap =� tot a' at , NeweeermitFr 1 4 Property Dimensions a Lot Area (st) Frontage MY -'-Lot Coverage z - Sfiis Seotion for"Office Use.Onl r fssUed .... SI natrr ertifl ate of Occupancy is is not ` 7equira 9 Building Official ; Date Section l:�Site,lnformation'i, Use Group: R-4 Type: 5-13 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) Public Private 1 5'Flood Zone Information` Comments } r t 'Zone.'BFE_, Section 2.-. Property Ownership/Authorized Agent' 2.1 Owne of Record: it lea !t �- LLc, Ao(o u N me 4printk , Mailing Address C &-, ( 0 PJAM— Signature v Telephone 0 d Agent: �� C 2.2 TWO J 01� J Vndress Name (print) (` �.,� P a 6jSignature Telephone MAR Section.3 = Construction':Services 3.1 Licensed Construction Supervisor: O(� Not Applicable ❑ License Number � �\(yl� u✓�� � �� ���� 1�( � �a Address dress 7g- ��loe< V1 Expiration Date V b " �6 —Q Si nature Telephone r 3.2 Registered Home improvement; Contractor; Company Name 1�\M' 4Expiration pplicable ❑Yr Address tt'�se Signature Telephone Number Date M WA �(le;r�f 9- 15-99 1 of 2 OVER Section 4`- Workers'. C6mpensatidh Insurance Affidavi#.(M.G;f . c.:f 52..S,25G,(sj- 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. Y Signed Affidavit Attached Yes .......... No .......... Secti0ri 5 =Description of F?ioposed_WorK{check°a[Ilappgcable New Construction No. of Bedrooms No. of Bathrooms Existing Bldg. ❑ Repair(s) ❑ I Alterations ❑ Addition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: c I ✓� r In.` !� � � V 1 a Costs / Section6 =.Estimated Cortstnictiori Item Estimated Cost (Dollars) to be completed by permit applicant Check Below ❑ Conservation -Commission Filing (if applicable) ❑ Old Kings Highway & Historical Commission approval (if applicable) 1. Building 2. Electrical ',� ( 3. Plumbing / Gas I ZL— 4. Mechanical (HVAC) Aacp 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) ( a p 7. Total Square Ft. (new houses & additions) jt3 To be Completed. a iY` Sectiort- a Owner Authorization''- Owner's A' enfar;ContractorA ties.forBuitding'Pe I, V e.r hereby authorize riAe5 a�owner of the subject property rA, to act on m ben , in all matters elative to work authorized by this building permit ppl'cattinion..[ Signature of Owner Date Sectionrr7b'-;Owner/A`Uthorized Agent Declaration' Vv N I ixv�-, sPw er/Au I, 1 �-�-'C-1 ,. 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. t l I k' &P,, Print a L Signa ure of Owner/Agent ` 03 _ o� Date M •P u 9- 15-99 2 of 2 Oy t'9ki 0 TOWN OF YARMOUTH k PLEASE PRINT: Job Location: _ V. r BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM Owner of Property: Construction Supervisor: Address: Licensed Designee: (If other than Supervisor) Name 2.15 Responsibility of each license holder: �1'14e License No. aa63�L 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 (( No ❑ If you have checked yes, 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 OfflceofIereSON&Ois 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit cif, (:k �'& lk- , W1A on q �o$- / 70-� 4o W I am a homeowner performing all work myself. I am a sole proprietor and ha%e no one working in any capacity O 1 am an employer pro%iding workers' compensation for my employees working on this job. company name, address: city: phone N: insurnnce co. nolicv 0 am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below «ho ha%e city' phone to: insurance co. policy N Failure to secure coverage as required under Secnoo 25A of MGL 152 cam lead to the imposition of criminal penalties of a Pat up to 11,500.00 and)or one years' Imprisonment as well is civil penalties in the form of a STOP WORK ORDER and a Bat otS100.00 a day against use. I andentaad'that a copy of this statement may be forwarded to the Me of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and cornet k Si Print name oliicial use only do not write in this area to be completed by city or town ofBeial ciry or town: YARMODTIJ Cl check if Immediate response is required contact person: Z4 tf097 z'-,, � P permitnicense 0 nBuilding Department ❑Lleeasing Board 261 ❑Selectmen's Offlee r ❑Healtb Department phone at _ i OS) 398'2231 eat. pother. ... .y. - .< 1141 I ^� ✓iie i0ow,,,n nu�ealtlt o1,Aawae1uae& BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 012430 ?j Birthdate:06/16/1940 Expires: 06/1612004 Tr. no: 25823 Restricted: 00 FRANK G CAPRA 40 COPPER LN �2r,r,'� CENTERVILLE, MA 02632 Administrator 00 - 35,000 d enclosed space (MGL C.112 S.60L) to - 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 TOWN OF YARMOUTH 1146ROUTE28 SOUT'HYARMOUTH MASSACHUSETTS02664.4451 Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT BUILDING ELECTRICAL GAS PLUMBING SIGNS 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` S P . Work Ad4ress is to be disposed of at the following location: y%WM&k,, l.-,-d Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Signature fApplicant Date Permit No. UtK I WIL ATE OF LIABILITY INSURANCE oiz?i2 0 PROq"S, rCEfj (508) 994-9688 FAX (508) 991-5461 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION RUTKOWS,KI & KESTENItAUM 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 INSURED Frank Capra JNSURERA. Providence Mutual_ PO Box 664 INSURER B: OneBeacon West Hyannisport, MA 02672 INSURERC. Continental Casualty.Co...:.., INSURER!}..-_ ' - - ' "' 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, POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. EXCLUSIONS AND CONDITIONS OF SUCH 1M TYPE OF INSURANCE POLICY NUMBER POLICY FECTNE POLIC EXPIRATION 12/13/2003 LIMITS GENERAL LIABILITY CPPOO53131 00 12/13/2002 EACH OCCURRENCE s 1,000,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one Ore) E 50,00( A CLAIMS MADE I OCCUR MED EXP (A (Any one person) S $ r 00O PERSONAL & ADV INJURY E 1,000,00i GENERAL AGGREGATE E 2 , 000., 000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS • COMPlOP AGG $ 2 , OOO , 000 POLICY JET LOC AUTOMOBILE LIABILITY CBXE48125 02/14/2003 02/14/2004 ANY AUTO COMBINED SINGLE LIMB (Ea aceldenl) E ALL OWNED AUTOS BODILY INJURY (Per person) E B X SCHEDULED AUTOS HIRED AUTOS 2 50100 000 BODILY INJURY (Per accident) E NON-0OWNED AUTOS .... 500,000 PROPERTY DAMAGE -�' (Per accldenq 100 GARAGE LIABILITY .000 ,. •. _'-. - ..- -AUTO.ONLY-.EAACCIDENT. S OTHER THAN EA ACC I . ,. - ... ... AUTO ONLY: AGG E EXCESS LIABILITY OCCUR F CLAIMS MADE EACH OCCURRENCE E. AGGREGATE E DEDUCTIBLE E RETENTION s E WORKERS COMPENSATION AND S59UB861X751603 03/22/2003 O3/22/2004 $ EMPLOYERS' LIABILITY TORY LTA IMBS ER C EL EACH ACCIDENT E SOO , OOO _ .._.... EL DISEASE - EA EMPLOYE $ 500 , 000 OTHER ELDI .SEAS#-POLILYuMrt s 50Q �QO DESCRIPTION OF OPERATIONSILOCATIONS LHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER ennrnnuwr ,.,e„s Gatewood Homes Inc 1600 Falmouth Road Ste 25 Centerville, MA 02632 ...._...... -..-.•-rv�v�rrf�rrV1Y 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 i iriVA /17/03 t OF LIABILITY INSURANCE D0TE(MM/DDIYYYY, 1PRODlµER j THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION �)owling & 0' Nell Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency, Inc. , 4 t 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 INSURED INSURERS AFFORDING COVERAGE NAIC # Bayside Electrical Contractors, Inc. INSURERA: Travelers insurance Company 372 Yarmouth Road INSURERB: Guard Insurance Group Hyannis, MA 02601 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 DAT MMlDD Y —DATEMM/DD LIMITS A GENERAL LIABILITY 16801484A82ACOF03 10/05/03 10/05/04 EACH OCCURRENCE E X COMMERCIAL GENERAL LIABILITY 1 OOO OOO PR DAMAGE TO RENTED $300 000 CLAIMS MADE O OCCUR MED EXP (Am one namnnt ltrnnn [Xi OCP r=r UNAL S AUV INJURY S1 OOO 00( GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE E2 000 OOQ POLICY PRO. LOC PRODUCTS•COMP/OPAGG E2 OOO OOO A AurG MOBILE LIABILITY ANY AUTO ALL OWNED AUTOS 18102601W5611ND03 10/05/03 10/05l04 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X SCHEDULED AUTOS HIRED AUTOS ' BODILY INJURY (Per person) E X X NON -OWNED AUTOS Other Car BODILY INJURY (Per accident) $ XLANY PROPERTY DAMAGE (Per accident) E GABILITY AUTO ONLY • EA ACCIDENT S TO OTHER THAN EA ACC UTO AONLY: AGG $ S EXCESSNMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE $ "DEDUCTIBLE - $ RETENTION S S E B WORKERS EMPLOYERS' COMPENSATION AND LIABILITY BAWC436910 08/18/03 08/18/04 WC STATU• OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $1 OO 0OO If es, SPECIAL describe under PROVISIONS below E.LDISEASE- EAEMPLOYE $IOO,000 OTHER E.L. DISEASE. onnry t w, .Snn Ann 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 #M31942 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL iE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED ACORD CORPORATION 1988 u�:t�•1' 2 F = CATE OF 2 NSURANCE Issue date: 7/22/03 -� 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 IMAN ST 41HYAMA 02601 ----- - COMPANIES AFFORDING COVERAGE ------------------------------------------------------------------ Code: Sub -code: I ------------------------------------------------------------------------------------------------------------------------------------ Co Ltr A: ARBELLA PROTECTION Insured: ---- -- Co Ltr----- --- B: ARBELLA PROTECTION RJ BEVILACOUA ------------------- ---- --------------- Co Ltr C: P 0 BOX 62B FORESTDALE MA 02644 I----------- Co Ltr D: ARBELLA PROTECTION ------------------------------- -- -- ---------------------- I ------------------------------------------------------------------------------------------------------------------------------------ Co Ltr E: COVERAGES This is to certify that policies of insurance listed below indicated notwithstanding any requirement, term have been issued to the insured named above for the policyr period or condition certificate may be issued or may ertaint the insurance afforded of any contract or other document with respect to vhich this 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 I I Ltrl Type of Insurance I Policynumber leffective --A -------------------I--8500018147----I----7/15/03----I----7/15/04----lGeneral Policy date ---------------------------------------------------- Policy I -P ez ration datel All limits in thousands ENERAL LIABILITY Commercial general liability I -------------- aggregate:21000 �( Claims madeOccur Products-comp/ops aggrey: Personal/advertising inj:kner s 8 contractor Prot Each occurrence: 10000 I I I (Fire damage: 100 --B ---------------------------------------------------------------------------------------------------------- Medical expense: 5 (AUTOMOBILE LIABILITY I 06852400001 1 2/21/03 2/21/04 (Combined 1 An auto rr All owned autos i Bodily inmur: 250/500 Scheduled autos I person): Hired autos Non-ovned autos I cPer odily injury. (Per accident): Garage liability I 11'roperty ----IX ---- - ---------------- -----------------� damage; ESS LIABILITY I I -------5-0--0 ---------I ---- Each Each - I I ----I— ------------------------------------I----------------I---------------I------------------------------------------------------- Other than umbrella form I Aggregate D I WORKER'S COMPENSATION I 9089600403 4/27/03 4/27/04 I----------------------------- EMPLOYERS' LIABILITY I I I I (StatutoryT too Each accident) S00 Disease -policy limit) ----------------------------------------------------- 100_ Disease -each emp.loyee.J... IOTHER - Description of operations/locations/vehicles/restrictions/special items: CERTIFICATE HOLDER CANCELLATION I Should any of the above described policies be cancelled before the GATEWOOD HOMES expiration mail f0 date thereof, the issuing company rill days written notice to the certificate endeavor to holder named to the 1600 FALMOUTH RD STE 35 IWO FALMOURVILLE MA 02632 CENTliability I left, but failure to mail such notice shall impose kind no obligation or ------------------------------------------------------------------------ of any upon the company, its agents or representatives. Authorized representative: JOAN M MARTIN JA 4/89 VtK FIFICATE OF, LIABILITY INSURA CN E 'ROD CER SOS-398-6033 den ,«. FAx SOS- a11"led American Insurance Agency LLC 1 Atlantic Ave' SO Yarmouth MA 02664 762 Falmouth Road Hyannis NA 02601 JEU AS A MATTER OF RIGHTS UPON THE CE TE DOES NOT AMII INSURERS AFFORDING COVERAGE UJ U AA: Arhella Protection I MU Re. DATE IMMIDDlyI 07/21/2003 TFOR ION NAIC ii msURER D: OV A S MSURERE THE POLICIES E INSURANCE CONDITION OF ANY LISTED BELOW NAVE BEEN ISSUED TO THC INSURED NAMED ABCT OR OTHOVE FOR [HE POLICY PERIOD INDICATED. NOTWITHSTANOIN MAY PERTA N TEFi jNSURgNCE AFFORDED BY THE POLICIES DESCRIBED REIN S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID C I FIR DOCUMIENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR SR DID TYPE OF INSURANCE LAMS. POLICY NUMBER POLICY FE TIVE OUCY EXPIRATION GENERAL COMUABMERCIAL 7500000373 12/13/2002 12/13/2003 EAONOCCURRENCE LIMITS X COMMERCIAL GENERAL LIABILITY S 1 OOO , OI A ClA1MSMADE DX OCCUR PMAGE ORENIEO $ SD OI r GENL AGGREGATE URUITAPPLIES PER: X POLICY jEOa AUTOMOBILE LIABILITY AWAUTO ALL OWNED AUTOS ' SCHEDULED AUTOS I HDIEDAUTOS NON.OWNEDAUTOS GARAGE LABILITY ANY AUTO EXCESSIUMBFUI UABIUTY OCCUR EICLAIMS MADE DEOUCnBLE WORKERS COMPENSATION AND EMPLOYERS' LIABILITY B ANY PROPRIETORIPARTNERIEXECUTrvE OFFICERIMEMBER EXCLUDED? ADDED MID EXP (AI one IIII $ 5 PERSONAL A AOV INJURY $ 1 DDD GENERAL AGGREGATE 1 2 000 PRODUCTS -COMPIOP AGG S )I nnn COMBINED SINGLE LM I IEa PCtI S BOOILY'NiVRY (Per P-y"H) S . BODILY INJURY IPfr.-deny S PROPERTY DAMAGE IP., eecodfn0 _ 1 AUTO ONLY ACCDENT S OTHER THAN FA ACC f AUTO ONLY. AGO S lgCH OCCURAFNCE S AGGREGATE S f S E.LeACHACCIDENT S E.L DISEASE - G EMPLOYE S El DISEASE -POLICY LIMIT S Evidence Of Insurance for work performed within the Insured's scope of normal operations C E LD C C SHOULD ANY OF THE ABOVE DESCRIBED POLICIES Of CANCELLED EXPIRATION DATE THEREOF, BEFORE MAIL THE THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, GdLCWOOd Homes.. BUT FAILURE TO MAIL SUCH NOTICE SHgµ IMPOSE NO OBUGATIDN OR LIABILITY 1600 Falmouth Road 02j Centerville, MA 02632 OF ANY KIND UPON THE INSUAER, ITS AGENTS OR REPRRSENTATIV AUTHORIZE1) RESENTATIV 4CORD 25 (2001/08) FAX: (508) 778-S603 OACORD CORPORATION HISS AcoRD_ CERTIFICATE OF LIABILITY INSURANCE OPID Ad DATE (MM/DDM YY) CROWC50 07 25 03 PRogcEr; THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ullivan, Garrity & Donnelly ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 508-754�1767 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 10 Institute' Rd - PO Box 15010 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Worcester MA 01615-0010 Phone: 508-754-1767 Fax: 508-754-1885 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Hanover Insurance Co 22292 INSURER B: Arch Insurance Com an Crowell Construction, Inc. INSURER C: PO Box 309 So. Dennis MA 02660 INSURER D: INSURER E: CnVFRAn9R 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 POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CONDITIONS OF SUCH CLAIMS. TRSR LTR INSR TYPE OF INSURANCE POLICYNUMBER LIMITS GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY ZHN7007141 H OCCURRENCE $1000000 CLAIMS MADE X] OCCUR MISES Ea occurence $100000 EXP (Any one person) S 50 00SONAL 779W B ADV INJURY $1000000ERAL AGGREGATE LIMIT APPLIES PER:PRODUCTS AGGREGATE S 2000000GERL AGG $2000000 '.PRO- POLICY 'JECT LOC AUTOMOBILE LIABILITY A ANYAUTO .' .. ABN7001142 05/01/03 05/01/04 COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS X BODILY INJURY (Per person) $lOOOOOO SCHEDULED AUTOS X HIRED AUTOS X BODILY INJURY (Per accident) $1000000 NON -OWNED AUTOS - PROPERTY DAMAGE' (Per accident) S SOOOOO GARAGE UABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EAACC S AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE URRENCE S TE S DEDUCTIBLE $ RETENTION $ S WORKERS COMPENSATION AND S B EMPLOYERS' LIABIUTY J03 H. LIMITS iANY PROPRIETOR/PARTNER/EXECUTNE IRWCIOOlOO 03/22/03ACCIDENT OFFICER/MEMBER EXCLUDED? SSOOOOO Ryes; deembe under PROVISIONS belowOTHER E-EA EMPLOYE S 500000SPECIAL E. POLICY LIMIT $500000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Fax #508-778-5603 CERTIFICATE HOLDER .., .. . GATEWOO SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATIO Gatewood Homes DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL .10 DAYS WRITTEN 1600 Falmouth Road NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE -LEFT. BUT FAILURE TO DO SO SHALL Suite 25 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND -UPON THE INSURER. ITS AGENTS OR Centerville MA 02632 REPRESENTATIVFs_ ACORD 25 (2001/08) ©ACORD.CORPORATION 198 ATM CERTIFICATE OF LIABILITY INSURANCE =DATOrmPROLUCER Dowling & O'Neil Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling ,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE AgencyHOLDER 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 INSURED INSURERS AFFORDING COVERAGE NAIC # Gutter Pro Enterprises, Inc. INSURER A: Travelers Insurance Company P.O. Box .1197 INSURER B: Guard Insurance Group Plymouth, MA 02362 INSURER C: INSURER D: CnVPAAf_M0 _I INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY NDING PERED IOD INDICAT. NOTWITHSTAA ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OFOR SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .TR NSR TYPE OF INSURANCE POLICY NUMBER POUCY EFFECTIVE POLICY EXPIRATION A GENERAL LIABILITY DATE MM/DO DATE MM/DD/Yl' LIMITS 1680459H3118TCT03 11107/03, 11/07/04 EACH OCCURRENCE S1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED CLAIMS.MADE O DCCUR 000,000 MED EXP (Any one person) $5 000 PERSONAL A ADV INJURY $1 OOO OOO GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE t2 OOO OOO POLICY PRO I I..... PRODUCTS-COMPrt'o er_r_ .o nnn n.... ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CAGE LIABILITY ANY AUTO ESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE B IWORKERS COMPENSATION AND GUWC440685 11/07/03 EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? OTHER 11/07/04 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Operations performed by the named insured subject to policy condition's and exclusions. Gatewood Homes 1600 Falmouth Road, Suite 25 Centerville, MA 02632 ACORD 25 (2001/08) 1 of 2 #32273 CO BIKED SINGLE LIMIT S BODILY INJURY (Per person) $ BODILY RY (Perraccident) $ PROPERTY DAMAGE (Per acddent) $ AUTO ONLY. EA ACCIDENT S OTHER THAN EA ACC S AUTO ONLY: qGG $ E.L. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHn DAYS ALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR AUTHORIZED ACORD CORPORATION 1988 10.11 rn1 OU57900249 GOLDMAN ASSOC CAI 01 DATE- .. GOl crrarr s ASSO ns nWUR eCE ONLY AN CONF E I F1rAaC2�t. s$�cvzcsS 1tiC. ONLY ANDCONFsR5 933 FALDiWTA FD. HOLl3ER THIS C€RTiF ALTER.THE-COXERAG HYAWIS !A 02601 Phoaa: 505-775-6020 €aa:508-790-0249 INSURERS;,y¢pRs"c.NG ROONEY TAVANO xsua£ke OBA NECULVICAL S=STZMS. 110 HOLDER LINKS N'BARNSTAME NA 0266e 24SURERQ :.oRv . THE a TWE PCA vie. OF eaxwrE LETM emDw NAWE M94 6"=70 TM *aLF= NAMHD AMN FOR TM M= PERI[>D ArOiGT ANY REOtY�M. TEEWCR CONWEN OF ANY CQi1R&cr OROtl.M DOC rW"WRLVECrToMCHTlffi ANOQG CETtTQ7CATEIMY IMYPERTA(7.iFeA6UR/N7CYI�FAORDED BP TF� �'WM MOM=!iF,RENQ VAMCTTOALL THE 7FIaO ElCl1S AAV 1�uEDOR POUCE4 AGOREGLtTE LBiri SHMNN WAY NANEIIEEEN FEXX Ur PAD CLAIM CFSUCH LTA P mE CS rxt'mmft= PCL=f Nuumm ^� t%TE Liirrb 7Ewm WL8172 11/21/03 11/21/04 ac Au"Ce s 1000000L�ftY i50000 ®ocast _��� EXPQLnvA pm" i5000 0PALAAUV UW i 1000000 "i'2000U=' cGEM •,...¢_-1r GAQYAPPLFE PER A00MG M $ 2000000 fir, PP"G- Loc -COMPRCPAOO FCT AWVW0^=LAM rrr 'ANYAUM aiXULBAT i ALLOwrEnAurm a sa�Lt7tmAUrtW' Yid Pn ) a NtricwrE,�aAuras • Y2: ,aoeaq . DAMAGE ..—.. . GARAGE LfAmal Y ANYArrrO. ONLY-EAACLDEM 7 rAw EAACC ClKyl. AGO a EXCEUKAENtELLALWALIN OCQAi FI ClAB6 MADE a TE 3 A CEUCTIEKE ft- aU7:lt i _ a TaLrtE.ai W".R^33ATY"l Ats i $ 9727EA34403 05/03/03 05/03/04 EACMAICCrAWr i100000 i.a•dato6w vdv F oQ F CVSJC E� MEAM-FAEtVLOYE_f S SO0000 tTiNiit ELd6EAQE-R11C/LiAR 9500000 t Ti]N OF OPE91770t15rLOCdT7OiIvBtTaSylE7CLUitptti Mown 0=�JwwIIALiilOMKrOttd CERTWICATs HOLDER .• w wwr r... .. CA=WOOD Foes nm FAX 508-778-5603 1600 FAI)OXM RoAD- CENTERVILLE !A 02632 GATEWW. SH7mwAttxa Uumw NoOetraATm OR UAearrY ROE►xxTOWAL 10 DAYS MftrrO -TO RE LErrJRM FARIM TOQOWS ALL OM L"W THE SWURErL nAGENn GR }ic_oRD,. CERTIFICA 9 EOF LIABILITY INSURANCE �ols� S2�D�o3 O1lCER .. 508 672 2997 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION JOAO,M OLS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE DIAS INSURANCE HCtD R; FHtS-- CERTIFICATE DOES. NOT AAdfND.' EXTEND. QR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOri. 535 BRAYTON AVE FALL RIVER. MA 02721 INSURERS AFFORDING COVERAGE NA7Ctt IISURERA: GRANITE STATE INSURANCE COMPAPIY WC 484 48-85 INSURED JOEL FERREIRA OEALMEIDA *tSuRERE: NAUTTUS-INSURANCE COMPANY FNC2275806- —{•--- DBA EJJA CONSTRUCTION 50-PICKERING ST. APT 17 INSURERC: FALL RIVER, MA 02720 wsuRERO: — NSURER E: — — I COV@RAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURCO NAMED ABOVE FOR THE POLICY PERIOD INDICATE J. NOTWITHSTANDING ANX.REOILREMENT, TERM OR CONDITION OF ANY CCNTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBEDHEREIN-aSUBJECT TG ALL THSTERMS, EX0 1 I510N5.AN0. CONDITtQN4 OF SUCH POLICIES. AOGREGAT£ L.IMTTS SHOWN UAY HAV E BEEN REDUCED BY PAID CLAIMS. Eq rOO• FOU�'NVMBER EFF[CTrvG POUCYDFIRATION LRITS CENEMLLIABIL{TY ! f,000.000' X CAMMERCIALOtwliR LIABILITY NC27580E f{ 0i1 W003 06/262004 0MACHOCCURIMPICE 1D0000 i CUIMSMAOG OCCUR XP(APYaI.V"R ) PERSONAL S AUv INJURY I3 GEN[FACA'OGAEGATE- S• 2,000.00D. I fSNIL AGCREGATE LIMIT APPLIES PER: PRODUCTS. COMPgP M:;G .S 2000000 roLICY PRO' LOG A�OTOMOBIEUMRlTv [jEcT I 'µYAUTO Rt COMBED tAROLR LSAT {E�scearnq S i ' ALL OWNED.AUTOS SCHEDULED AUTOS 900ILYIWURV (Pb OMSG^) --I --. S VAPEDALMOS HONO"F.QUTOS j EO�R�tiU.Y I PROPERTY DAMAGE is P'rf ax:GaM{ GARAGI LIABILITY _.. AUTODRLYT FrTACC10Et+?' S' I ANY AUTO OTNERTLY: AUTOONLV: —� S. I EXCESSAMBRELL�A''l�1A81IJTY EACMOCCLFERCNCE -- 4f ._ J OCCUR L__,J CLNMS MADE I AOGRECAr^ TE DEDUCTteLE s __ I RETENTION S S YNM1NGRacoMPEN"TIONAND EINPLOYLRS'LWILITY WC" 4S4%4H-SS Ytf08IO3' 1iiDSJO+' wC SiATih. iTN)I Tn RV LIMITS R _ ELEACRACCIOGNT S T;000;00E>— AWPROPRIETORNfA�RTNERAYECLTIVE OPPICGPA#ELWREXCLUDEDi ryypyy,, eeaMDo v^aa SPECULLPROVIB104a 0.L. wCCACG • EA EMF�:NGE S i 000,00 EL 0I3EASEi POtFM NIT t 1-000�'00- Mbr OTHER DESCRIPTum OFOFER*l#O"l LOCAT10NSlVESICLES/EXCLU6=SAOa RY EYOORSEMENT!SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SNOVLOANY OFTHE ABOVE oP3CRf6Eo ►oL w-S B1 CANCS.LEvBCPORBTHEE) DATE TMEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAL 10 DAYS WRITTEN GATEWOOD HOMES HOnCiT?TNEY£RT FrGITtMpkDERNAMED TO THE L6R, ItOL EJ 6ASRETh ^^ ��� L i �f�L/trOUT(-I RD. UP031 NO OBLIGATION OR LIABILITY OF ANY NWO UFoN THE INSURER, ITS AGENTS OR CENTER VILLE, MA 02632 "� E• AWHORIZEDR t ESEMA/ AIIVKY 25 ItVVTfVPI U ' ACORO CORPORATIOWfHr - • CERTIFICATE QF W, PRODUCER Passaro Levorone & Buckley Insurance Agency Inc P 0 Box 160 Dennisport, MA 02639 INSURED Patrick K Orcutt dba P & S Concrete 37 Ladys Slipper Lane Mashpee, MA 02649 DA rs UPON EXTEND COMPANIES AFFORDING COVERAGE A A.I.M. Mutual Insurance Co CavERACFs - THLS LS 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 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE ANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO WHICH THIS AFFORDED EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BY THE POLICIES DESCRIBED HEREIN IS SUBIECP TO ALL THE TERMS, BEEN REDUCED BY PAID CLAIMS. co L TYPE Or INSURANCE POLICY NUMBER POWCYEMCTIVE POLICY EXPMATIO DATE(MM/DD/YY) DATE(MM/DD/YY) LITS GENERAL LIABILITY OMMERCIAL GENERAL WAHIWTY ENERALAGGREGATE S PRODUCTS-COMP/OP AGO. S IMS MADE WNER'S & CONTRACTOR'S PROT. PERSONAL & ADV. INJURY $ EACH OCCURRENCE S - RE DAMAGE (Any arc fin:) f UTOMOBILE LIABILITY ED. EXPENSE (Any one person) S NY AUTO MBINED SINGLE LIMIT S A LL OW NED AUTOS EDULED AUTOS BODILY INJURY S person) IRED AUTOS' NON-0WNSErAUTOS ODILY INJURY S accidm) GARAGE LIABILTY PROPERTY DAMAGE $ . XCESS LIABILITY CH OCCURRENCE S MBRELLA FORM AGGREGATE S THAN UMBREWA FORM EMPLOY'SCOMPENSATION AND EMPLOYERS' WABIUTY WC STATU. X OTT{_ 6006181012003 1021/2004 A THE PROPRIETOR/ I s I10/21/2003 IN0. PARTNERS/EXECVr7VER OFFICERS ARE, EL DISEASE —POLICY LIMIT S 1 000 000 OT1 I EL_DISEASE—EA EMPLOVEF I S i nnn nnn 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 LL'16H1TY OF ANY HIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE A RDn CERTIFICATE OF LIABILITY INSURANCE DATE (M0 DNYYY) OPL'c THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling 8 O' 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 Busy Bee, Inc.. INSURERA: Hanover Ins. Company INSURER B: Safety Insurance Company . ' P.O. Box . INSURERc: Associated Employers Insurance Compa East Sandwwich, MA 02537 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 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. LTR INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD POLICY EXPIRATION DATE MM/OD/YY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FXI OCCUR X PDDed:250 OHN643998501 06/14/03 06/14/04 EACH OCCURRENCE 1$1.000.000 DAMAGE TO RENTED MED EXP (Any one person) f300O00 s15.000 PERSONAL aADVINJURY $1000000 GENERAL AGGREGATE f2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC PRODUCTS - COMP/OP AGG f2 OOO OOO B AUTOMOBILE LIABILITY ANY AUTO _ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 3175394 01/14/03 _ ... "' 01/14/04 '....: COMBINED SINGLE LIMIT (Ea acddent) $ (PffPerson) BODILY INJURY (Per p S10O 000 , X X BODILY INJURY. (Per accident) - - f300 000 � X PROPERTY DAMAGE '(Per accidwt) $100,000 GARAGE LIABILITY ANY AUTO ..- .... - - ` " AUTO ONLY- EA ACCIDENT f ' OTHER THAN EA ACC AUTO ONLY: AGG S $ EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION S EACH OCCURRENCE $ AGGREGATE S f S S- C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE ffY I. dR/MEMBER EXCLUDED? dyes. desaibe under � SPECIAL PROVISIONS below OTHER WCC5002932012003 - 06/27/03 06/27/04 WcsTATu- oTH- rR E.L. EACH ACCIDENT f1OO,000 E.L. DISEASE -EA EMPLOYE f100 000 r E.L. DISEASE - POLICY LIMIT s500,000 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. i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Gatewood Homes DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN 1600 Falmouth Road Suite 25 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 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 , O�ACORD CORPORATION 1988 i P.O1 L LSD- CERTIFICA i E ©F LIABILITY INSURANCE DATE(MMMDIY9) PRODUCER THiS CERTIFICATE IS 133UE0 AS A MSATTER OF INFORMATION ZSCShea insurance Agency, Inc, ONLY AND CONFERS No RIGHTS UPON THE CERTIFICATE. 749 Main Street, Suite#H HOLDER THIS COVERAGE AFFORDED DOES OTTAM ND EXTEND OR Osteavilla, Ma. 02655 $ 0 8-A 2 0 -opt 1 INSURERS AFFORDING COVERAGE INsunm Casperaon overhead DooreaER RA fiat-oarl Grasset ^d Cn`. . INSURER � Box 517 INS c East Falmouth, MA 02536R E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTAAIDEdr, ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICtf 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. jR TYPE OFNSURANCE POUCY HLUDER POOAT£YvEFFEmfoCTNE PO: C'IEMPIRATION GENERAL LIABILITY LDMTE COMM=III GENERAL LIA81UfY EACH OCCURRENCE ! CLAWSMADE bl OCCUR FIR! DAMAGE, JAM ma nrol S $00 A IAEDCXP(Anvmepws S `wQ848352 05/28/03 05/28/04 PtRSGNALA DV INJURY Conn " OEN'L AGGREUAIE LKAITAPPLItS PER AUTOMOBILE LIABILRT ANY AVID ALL OWNED AUTOS SCHEDLAFOAUTOS HIRED AUTOS NOMOWNCDAU70S- GARAOC LIABILITY OCCUR CLAIMS MADE OtOUCTKILC RETENTION WORKERS COMPENSATION AND EMP.OYERY LIABILITY A (;ate07B,y Home3 1600 Fad-Icut.*i ;road-. 'suit e ?SA Centerville, HA 02632 778 5603 (7197) GENERAL AGGREGATE PROOUCTS.COMPNPAC IEA BODILY INJURY IPa 0M ) S BODILY INJURY (Pe ft&d") S PROPERTY DAMAGE (POI Aw"w) S AUTO ONL�,CIDENT S oTI.IER.TH,w-• . EA S AUTO ONLY: A00 S EACH OCCURRENCF S 12/22103 02/21/04 =�.LL-E-A�Acc&;r EASE, f 000.000 DATE THEREOF. THE ISSUNO INSURER WILL ENDEAVOR TO MAIL' IQ� DAYS WRITTEN NOi10EFO-FNE{•Eg��RAUM¢n ... ---`----nDRer"080$HALL NOSE NO OBLIGATK)N OR LIABKJTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR weseeee........__ 0 ACORD CORDORATIoN Tsaa , ¢s 1 SF7H 564 7272 P.91i©1 O'O -EE NOLDEfi TNtS CERTIF]m RIDEFZ.'RISK SPECIALISTS ALTER THS CCVEAdG6 1 INSURANCE AGENCY, INC. P.O-BOX 115 COMPANIES CATAUMET MA 02534-0115 COMPANY NauRED A US LZABILiTS MONUMENT INSULATION, INC. COMP Ah,'ERICAh' fi0 223 COUNTY ROAD BOUR, MIA 02532 COMPANYCOMPANYNE C COMPANY D THIS is TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BEL6y4 HAVE BEEN f" "�` INDICATED. NOTWITHGTANDING ANY REOU ISSUED TO THE INSURED CERTIFICATE MAY BE ISSUED OR MAY PERT1 AK THE 1NsuFtANCE AFFORDED EMON OF �TPOLC CONTRACT R OTHER 9E O r'�f. CLLISIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM'. I ME of INSURANCE POUCYNUMBEN PWCYWeC71YE POL14YEMA47M DATE(ummotm iTA7EQIKIDQIYYI GENERAL UA,ILI7Y x •MM"MAL3ENEtAL LIABILITY CLAIMS MADE ® OCCUR . A k. OWNER'S=coNY AcTCRSPROT CLI235745 8/23/03 8/23/04 i AMMON." UASWW ANYAUTO ALL OWNED AUTDS S0iEDJUWAU7b3 . MMM AUTCS NONOWNEDAUTOS CAPS ImmUTY AWALmr EKLMN UABILI Y UMBRELLA FCRM OTHER THAN UMBRELLA FORM WORKM COMPENSATION AND . EuftDYEp' UAWAr.Y PTWC `� DN 7 WC 782 61 72 9/5/03 4/5/04 GATEWOOD HOMES,INC 1600 FALMOUTH ROAD 025 CENTERVILLE, MA 02632 508 778-5603 ABOVE FOR THE POUCY PERjDd T WITH RESPECT TO WHICH THIS IS SUWECT TO ALL THE TERMS. U=-.X COMBINED 61NGLE LIMIT s .rPWRY s PROPERTY DAIUAGG. Is AUTO W&Y. FA AmrxENT 13 S 7 mt SHOULD ANY OF THE ABOVE 0E3CMBED PCUCTE6 BE CANCELLED SDFONE TICC ay B(Q AMN DATE TNEAEOF. THE ISSUING a M►ANN WELL OWAVOR TO MAIL e DAYS WRITTEN NOTICE 70 THE COMFICNE HOLDER NAUWTD-TTNr�FTt BUT FAILURE 7D wA� NOTrcE SHALL D3 MD oeuDATroM OR UABIU7Y TOTi;L P.01 OR PROPERTY ADDRESS; 47? Cal% -ALCULATION FOR PERMIT COST' TYPE OF ROOM, ETC �,, ADDITION Oral ALTERATIONS BATH BED RO&M----� CERTIFICATE 'OFGGCUpAi LUECK WITH ROOF IDEMOUTION DEN DINING ROOM FAMILY ROOM FIREPLACE FOUNDATION ONLY GARAGE NO. OF. BAYS GREAT ROOM KITCHEN LAUNDRY ROOM LIVING ROOM MUD ' ROOM - OFFICE PORCH CLOSED PORCH OPEN REROOFING SHED STORAGE AREA SUN' ROOM HEATED SUN ROOM UNHEATED SWIMMING POOL AS07VE ..SWIMMING POOL INGROI WINDOW REPLACEMENT NO 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) 21.1C4 Street 121 CAMP ST #4 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 iAw i o• -•0�� O H �. TOWN OF YARMOUTH BUILDING DEPARTMENT `� - •� BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET Building Site Location: L�;4.7 .57f �f `� Lv !/ Map No: Lot No: llell Proposed Improvement: /Lg,,�j i Address: 77? yGd J : 77X 9GG S Date Filed: 3 �/ 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. ---------------------------------•------------------ -�+ •---------- ------------------------ REVIEWED BY: vt. WATER DEPARTMENT: ���4.e�DATE 3�N/A: V 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A V 4• HEALTH DEPARTMENT: DATE: N/A: INDUS��/OR COMMERC�PERMITS/OR COMMERC�PERMITS S. WIRWG 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 - Buildmg Dept - Pwk cM - WaW Dept - S'eiiow CWY - HWdl Dept• - Pink Copy - Engioming DTL - Goldenrod - Fire DTW_wvvvadw ..1.—*.. �'1cMY:V`..�+.'=T4s r...t.`i i.�l:.. a\'A'«..#'�-v .r.. .. ..-�aV"Y..•vy.,�.•"l id W�,-1"la..:-.�...... -ti�.�r rai.s:I.c.f4Vl�: f:.VMM-.li'..-.+.a Building Site Location: Proposed Improvement: Address: The Built applicable departments. TOWN OF YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET Map No: yy Lot No: 77F s66y 77- 546 9 Date Filed: 3 G your plans and or application to the following 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: Vt. WATER DEPARTMENT: DATE: N/A: t12. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: V 4. HEALTH DEPARTMENT: Pep- t�/�lr l S7E 741-D DATE: �% N/A: T INDUSTRIAL AND/OR COMMERCIAL PERMITS S. WIRING INSPECTOR DATE: N/A: 6. PLUMBING INSPECTOR: DATE: N/A: 9. FIRE DEPARTMENT: DATE: -NIA- PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: White copy - Building Dept - Pink copy - Water Dept. - Yellow Copy - Health Dept. - NA Copy - Engiweriag D� - Goldenrod - Fire DepUCoavavation 04/27/2004 08:41 5083625269 NORTHSIDE DESIGN PAGE 02 a I MAScheck COMPLIANCE REPORT I Massachusetts Energy Code I Permit # MAScheck Software Version 2.01 Release 2 I I I I I Checked by/Date d CITY: Barnstable I I STATE: Massachusetts HDo: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 4-26-2004 DATE OF PLANS: 04/21/04 TITLE: The Sandpiper 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 = 265 Your Home = 159 Area or Cavity Cont. Glazing/Door ------------------------------------------------------------------------------- Perimeter R-value R-Value U-Value UA CEILINGS 845 30.0 30.0 14 WALLS: wood Frame, 16" D.C. 1415 15.0 15.0 62 GLAZING: Windows or Doors 93 0.340 32 GLAZING: windows or Doors 80 0.340 27 DOORS 40 0.086 3 FLOORS: Over unconditioned space ------------------------------------------------------------------------------- 845 19.0 19.0 21 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 14.4. Builder/Resigner Date MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # 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 Sandpiper 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 = 227 Your Home = 137 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 850 30.0 30.0 14 WALLS: Wood Frame, 16" O.C. 1447 15.0 15.0 64 GLAZING: Windows or Doors 174 0.320 56 DOORS 36 Q.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 Masspchusetts Energy Code MABcheck Software Version 2.01 Release 2 The Sandpiper DATE: 6-20-2002 Bldg.l Dept.) Use I CEILINGS: [ J I 1. R-30 + R-30 Comments/Location I WALLS: [ J 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 I 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 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. OUCT4Cd4STRUCTION: 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.): PIPE SIZES (in.) HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2' 2.5-4" Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 Low temperature 120-200 0.5 1.0 1.6 1.5 Steam condensate any 1.0 1.0 1.5 2.0 COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.75 1.0 refrigerant below 40 1.0 1.0 1.5 1.5 CIRCULATING HOT WATER SYSTEMS: Insulate circulating hot water pipes to the following levels (in.): PIPE SIZES (in.) NON -CIRCULATING 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)------------------------- 1 m CEF'CIENCY • • • • cEERnflED nik amaAir Conditioning & Heating <,STEo 92.6% AFUE MULTI -POSITION CONDENSING GAS FURNACE GMNT SERIES 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. Go., L.P., 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.goodmamnfg.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 51,000 926 35-65 080 4 80,000 73,500 73,000 1,000 926 35-65 100-4 100,000 92,000 92,000 85,000 926 40-70 120-5 120,000 110,000 111,000 1 102,000 92.6 40-70 BEFORE PURCHASING THIS APPLIANCE, READ IMPORTANT ENERGY COST AND EFFICIENCY DATA AVAILABLE FROM YOUR RETAILER. SPECIFICATION DATA CI....F.:....1 ..L..".nw�eri i..c• 4 4 r/4 /An (_fte enniinn r nnnrtinn 1/" i=PT Model Number Motor Blower Vent* Dia. Combustion* Air Filter Size In Perm. / Disp. Electrical Ship Weight HP Spd. Dia. Width FLA Max Fuse 040-3 1/3 1 3 10 6 2' 2' 290 / 580 5.2 15 170 060-3 113 3 10 6 2' T 290 / 580 5.2 15 180 080-4 1/2 3 10 8 3" 3" 385 / 770 7.8 15 205 100-4 1/2 3 1 10 10 1 T 3- 385 / 770 7.8 15 225 120 5 314 3 1 11 1 10 1 3- 3" 480 / 960 9.2 15 265 `Note: Vent ana Comousnon airalameiers may vary uepenuing uporl VVIR ienguI. %AiecnMUI HIbLIULAW11o, W1111A accompany the furnace. 28" A 585" 3„ 195- 6" 7„ ,-- -� 48 B 4 3 T 4Tj 4 „ COMB. AIR INLET GAS INLET 51„ .4 VENT • n LOW VOLTAGE 4" ELEC. 104 " Model GMNT A B Combustible Floor Base 040-3 8 060-3 14" 12'W SBM14 080-4 17 % 160 SBM17 100-4 210 19'/z SBM21 120-5 24 % 23" SBM24 SS-312D 123" COMB. AIR INLET 8 i i i i i ' GASINLEr i i r i ,• i _ O VENT 2081" LOW VOLTAGE ELEC. CLEARANCES FROM COMBUSTIBLE MATERIALS Sides Rear Front* Vent Top 1' 0' 3' 0' ill 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'/' 21' 24'i' Coil Model Number Coil Width U-18 14' X U-29 14' X U-30 17% X(1) X(2) U-31 14' X U-32 17 %{ X (1) X (2) U-35 14' X U-36 17 Y:' X (1) X (2) U-32 17'/:' X(1) X(2) U-47 17Y2' 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 24'/i 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 2045 1945 1850 GMNT 120-5 MED 1815 1750 1 1710 1660 1 1600 1 1545 1480 1415 LOW 1275 1215 1 1190 1145 1 1110 1 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 V'Z VPIi T NOTICE v 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.jzoodmamnfiz.com for information on: • Goodman products • Warranties • Customer Services • Parts • Contractor Programs and Training • Financing Options SS-312D 4 46.91 . ' - E N '— N 804749" E 52.38 4 3,811 ±S.F. 5.3 0) °' 2 PROPOSED i,+ (It7-HOUSE I 9' � 2.3 .00 / (OSPRE( ) 26 24.4 o 0i J Z I(P PROPOSED O o N Qi w HOUSE N J �L (SANDPIPER) I HPO�SED Oct JO ;EGRET) 'Co /., N 1a.5/ IU' 3,461 ±S.F. 2 2 23'--� w L�.8�' LOT 3 0 �1.07' I LOT 4I jL=51.60' 10 i, 2 43 MAN' 53.70' W —S82*40'46")N 54.84' L,40.00' MAW „ SERV10EOp OSE SEWER W ER no pROFOSLATERAL SEWER SLEEK W SEE BELO NOTE 'i p' 46" E 54. — L=37.02' N —' 82 i �I 36.90 `' Q� nPR C. ER LATERAL SHALL BE SLEEVED IN ACCORDANCE WITH TITLE V IF WITHIN 0y 10FT. OF WATER MAIN. GRAPHIC SCALE 20 10 0 20 60 Unless and until such time(TICE as the original (red) stamp of the responsible Professional Engineer, or Professional land Surveyor appears an this plan: IN FEET (A) no person or persons. Including any municipal or other public officials, may rely upon the information contained herein; and (8) this plan remains the property of Holmes k McGrath. Inc. 1 inch = 20 ft PLOT PLAN holmes and mcgrath, inc. >d'A' V; ,tH SS. OF LOT 4 PREPARED FOR civil engineers and land surveyors y a,P y�- TIMOTHY MILL POND VILLAGE 362 gifford street falmouth, ma. 02540 U SANTOS a+� "�°'° C IN \� YARMOUTH, MA JOB NO: 201197 DRAWN: LMC SCALE: 1 "=20' DATE: 1-22-03 DWG. NO.: A2503 CHECKED: „ N gp'47'49 j- 52.31 o ' �,�22' i19.5 i�% 4 3,811 ±S.F. 5.3 n? 9' °�', 2 Z wOU PROPOSED 9' 24.4 2.3.00 (pSPREY) LAICP 26 o � OPOSED N Z � Op ' O PROPOSED ro s HOUSE (SANDPIPER) I HOUSE REGRET) t,, aD JO 19.5' to � 1s.5'� i.. h 3,461 ±S.F. 26 2 23'--� L.82 LOT 3. I �1.07' I LOT 4� I� • L=51.60' I 2. MiN 53.70' W � _ A PER SERVICE OSE SEWER M p1N ED 4” PROP �ROPOSLA-ORAL SEWER SEE SLEEVING NOTE BELOW N 82 0' 46" E 54. 1 93' •— L= 37.OZ 1 36.90' �� I 1 NOTE: q d ® EWER LATERAL SHALL BE LEEVED IN ACCORDANCE WITH TITLE V IF WITHIN GRAPHIC SCALE 3y 1 OFT. OF k ; • o `i 11111E. 20 10 0 20 60 Unless and until such time as the original (redIstam i o the responsible Professional Engineer. !or Professional Land Surveyor appears on this plan.- I (A) no person or persons,•,including-any municipal_ or other (IN FEET public officials, may rely upon lthe Inform atia"�contalned herein;l and (B) this plan remains the - property -of -Holmes-&-mcGraiFy..ine. 1 inch = 20 M PLOT PLAN ���'�� holmes and mcgrath, inc. a/y C, OF LOT 4 civil engineers and land surveyors PREPARED FOR 362 gifford street TIMOT"�,�I s MILL POND VILLAGE SF'1iO' falmouth, ma. 02540 l NO `5078 IN \ ;y) YARMOUTH, MA JOB N0: 201197 DRAWN: LMC SCALE: 1 "=20' DATE: 1-22-03 DWG. NO.: A2503 CHECKED: • ;tiro Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Permit No. EG -" —1 %0 Occupancy and Fee Checked - O b t.ev. 11/991 (leave blan10 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL All wo&to be petfb®ed in aaordance with the Mmarhusetts Electrical Code (MEQ, 527 (PMSEPIUNlININKORTYPE ALL WFORMA77O) Date:. City or Town of: YARMOUTH To the Inspector of By this application the undersigned gives notice of his or her intention to pelfonn the electrical work Location (Street & Number) MILL POND VILLAGE, Carrp Street ,�C1X 940 W 17 Aida 4t . 2004 Owner or Tenant Gatewood Hares/ Jeff Sollows Telephone No. 508-7789669 OwneesAddress 1600 Falmouth Rd., Suite 25, Centerville, Ma. 0263.2 Is this permit in conjunction with a building permit? Yes ] No ❑ (Check Appropriate Box) Purpose of Building single family residence Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Vndgrd ❑ Na of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ Na of Meters Number ofFeeders and Ampacity Location and Nature of Proposed Electrical Work Fire Alarm System (low voltage control panel) ydt—h backtM battery. centrally monitored - - n_--1_.:,.:. ..l.i..f fl....,:..sn.l.le.«.... Iw iurrivel7•hv fire Titmecter afrViret No. of Recessed Fixtures No. of Ceil (Paddle) Fans P (P ) o• o of al Transformers KVA Na of Lighting Outlets No. of Hot Tubs Generators RVA No. of Lighting Fixtures ove - Swimming Pool d. • ❑ and. o. o Emergency g Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE. ALARMc No. of Zones —1—' No. of Switches No. of Gas Burners o. o Detection D as 7 Initiating Devices No. of Ranges Na of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Totals: umber. Tour Detection/AlertingoSelf-ContainedDevices 7 No. ofD'uhwashers SpacelAreaHeating KW Local ❑ Municipal Connection M Other • , Dryers No. of DDevices ty Heating Appliances RW liNo. Securityo. pstem of Devicee s orE Equivalent o. of ater KW•o, Heaters o o. o Signs Ballasts Data Wiring: No. of Devices or uivaleat No. H dmmassa a Bathtubs y g No. of Motors Total HP Telecommunications iring No. of Devices or E uivaleat OTHER: nu m ""w"a s " W & r#J aurrw., w "i rsy.".w .r "......r....w. y ........ INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical wotic 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. CBECKONE: INSURANCE ® BOND 0 On-IER 0 (Specify:) (Expiration to Estimated Value of Electrical Work $750.00 (When required by municipal policy.) Work to Start S 0 Inspections to be requested in accordance with MSC Rule 10, and upon completion. Ices*, under thepains and penalder ofperjury, that the information on this application it true and complete FU NAME: Baltic Security, Inc LIC. NO.: 1178C M Licensee: Jonas R BielkQvicius Signature ; " LIC. NO.: 499D {Ifapp&able, enter "exempt' in die licensenwnbe 253 Bus TeL No.• 508-833-0996 Addrtss: po'Box.)609 Sandwic Alt. TelNay 5087 OWNER'S INSURANCE WAIVER .I am aware that the Iacensee 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) 0 owner ❑ owner's agent Owner/Agent PERMIT FEE: $ 40.00 Signature, Telephone No.