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HomeMy WebLinkAbout121 Camp St #083 Building PermitsG TOWN OF YARMOUTH APPLICATION FOR PERMIT TO DO GASFITTING (OFFICE USE ONLY) By Fee: $ ad PERMIT BuildingAwlAT: Location_ L- A1Rj �14I/I1 /_11/� New ❑ Renovation ❑ Replacement ❑ Plans Submitted Yes ❑ No ❑ iWA Date C/ f Owner's Name uonK Type of Occupancy ! A5i&" N Y Z 11 %%Ji R O CCy W 2 O C1 m ►- = N JPN��2�1 M WUJI a ° a OE a1NG W W Z! W O Q S 0 C F S W �UU Q Z W J F Q 2 M W H> W N O> MQ Z U. O H Z V W J O Fy Y R S O 2 LL 3 C V ¢ 111 G a O C¢7 CQ7 J FW- SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 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: 1 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 Chapter 142 of the General Laws. Check One: Owner ❑ Agent ❑ Signature of Lic used Plumber or Gasfitter License Number TYPE LICENSE• Plumber Gasfitter Journeyman ww. r� TOWN 0 Building AT: Location New IX Plans Submitted NOV I 3 0 , BUILDING L Renovation ❑ Yes ❑ No t' APPUCATION FOR PERMIT TO DO GASFITTING (OFFICE USE ONLY) Fee: $ - PERMIT NO.� Date // Owner�� AT �� 5 Name Type of Occupancy _?F5,L-- Reptacement ❑ Y rA (A H C> z � � N 4 �-Ay ra Z ¢ cc m W Q= W H to ap > W N ? Q= W W u. y¢� Wki y W (7 -j Oaa > F W g V LL ¢= O a= G C7 J U oOC >W T3 a F- O SUB•BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Installing Company Name-✓UC-��' +U f�f M tTE1�_ Address Check One: ❑ Corp. ❑ Partnership _ erm/Company Business Telephone _5�7_a 7 3 7 4 Name of Licensed Plumber order 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 t e type of coverage by checking the appropriate box. A liability insurance policy 2 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 ❑ owner Signature of Owner or Owner's Agent I hereby certify that all of the details and Informatlon I have submitted V Signature R Licensed Plumber or Gastitter (or entered) in above application are true and accurate to the best of Z my knowledge and that all plumbing work and Installations performed under Permit Issued for this application will be In compliance with all License Number pertinent provisions of the Massachusetts State Plumbing Code and _. .._ ... .. TVOF 1 It'r-MCIP. . LOT 82 / 892��. LOT 84 LOT 83 :W a .0^ �q)/�0 a } ^`'v o 0 3 O 2`S0• 0 EXISTING _22.5- - ry 2LU Z w o FOUNDATION `� O N oN / (a 0 iL 40 / 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 t�BT SPECIAL FLOOD HAZARD e-1 DATE REGISTERE PR ESSIONAL .LAND SURVEYOR .. NOTICE 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 information contained herein; and (B) this plan remains the property of Holmes & McGrath. Inc. I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE LOT AS SHOWN, AND THAT ITS LOCATION CONFORMS TO THE MINIMUM SETBACK REQUIREMENTS THE 40BAL PERMIT. 90e%TE EGI TERED PRO I AL LAND SURVEYOR GRAPHIC SCALE ( IN FEET ) 1 inch = 20 ft. AS —BUILT PLAN holmes and me rath, inc. OF LOT 83 civil engineers and lad surveyors e of b PREPARED FOR 362 gifford street MI �AEi. yGr MILL POND VILLAGE Falmouth, ma. 02540 MCC-' IN YARMOUTH, MA JOB NO: 201197 DRAWN: LMC SCALE: 1"=20' DATE: 6-5-06 DWG. NO.: A2551A CHECKED: LAN .fl TOWN OF YARMOUTH Building Department (508) V8-2231 ext.261 PERMIT NO B-06-1400_ ISSUE DATE 5/26/2006 ; PROPOSED USE APPLICANT _Frank Capra _ _ _ _ ....... . AT (LOCATION)' 100121 CAMP ST Unit 83 Z IIQG DI SUBDIVISION MAP LOT BLOCK 044.21.1.C83 BUILDING IS TO BE: LOT SIZE BUILDING PERMIT JOB WEATHER CARD PERMIT TO NewConsVuctian ; RICT Bldg. Type. Residential CONSTTYPE 5-B USEGROUP R-4 new construction: 2 baths, 3 bedrooms, 1 greatroom, 1 kitchen as per plans dated 05/15/06. REMARKS AREA (SQ FT) EST COST ($ $141,600.00 PERMIT FEE ($) 1$515.00 OWNER IVillages 0 Camp Street., LLC ILDING DEPi BY ADDRESS 1600 Falmouth Road # 25 Centerville MA 102632 i CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 PHONE 15087789669 Certificate Issue Date Q,. 7 JZOp CERTIFICATE of -OCCUPANCY Departmental Approval for Certificate of Occupancy and Compliance Insnectnr Date Permit Number ADDroved By Remarks v� V IRWRI To be filled in by each division indicated hereon upon completion of its final Inspection. F r TOWN OF YARMOUTH Building Department BUILDING r+ - - 1508) V8-2231 ext.261 � PERMIT NO �-B-06-1400_� _--:-___••; PERMIT ISSUE DATE : 5/26/2006 ; PROPOSED USE _ • ..••--••--------------- APPLICANT Frank Capra JOB WEATHER CARD PERMIT TO New Construction ; AT (LOCATION) 100121CAMP ST-Unit 83- ZONING DISTRICT R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C83 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE new construction: 2 baths, 3 bedrooms, 1 greatroom, 1 kitchen as per plans dated 05/15106. REMARKS AREA (SQ FT) EST COST ($ $141,600.00 PERMIT FEE ($) $515.00 OWNER IVillages @ Camp Street., LLC BUILDING DEPT BY ADDRESS 1600 Falmouth Road # 25 Centerville I MA 102632 INSPECTION RECORD CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 PHONE 15087789669 FIELD COPY Date Note Progress - Corrections and Remark Inspector �0•'f•o6 Jv I 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 ffice Use Only x i o Pern)ItNO�� ate' Permit R6 �,t DeposttRec'd: Nefl)ue !arming Board information �— F�a�f7TYDe �7 Endorsement Date Recording Date Plan Att er m' Assessors Department Informal on Map $ ;Lot ti, Map Lot; N NeW 1 d Property Dimensions r ,_''. lotArea(sf) ;<'s l rootage (ft) f i Lot Coverage =; ...k ,T Section for;Off a SignatureCertificate f O"ccupancy required Building OffIclal '; Date, Section,l =,,`Site lnfoimation` Use Group: R-4 Type: 5-B 1.1 Property Address: 1.2 Z/onniing Information: " Zoning District Proposed Use 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Require Provided I A Water Supply (M.G.1— c. 40. S 54) Public Private 1.5 'Flood Zone (Inf`ormation Comments ;> ' i Zone `—� BFE, sr,. a Section 2;=: Property Ownership/Authorized`Agent 2.1 Owne of Record: /� / �V� wd e 5 AT C .4 �b �f-l�ei;�LC lee /a— .r�6U/gam. ' �J Name (print) ,�J MailingAddresCF Signal p Telephone I 2.2 Authorized Agent: cv, � .L `L L 0 % `` E' J R Name (print) �lL MA.t 2 fj 2 6 Wall'g Address MAY 006 Signature Telep n v�" U ` t' 903 ax Section 3 :- Cori'struction Services: By: 3.1 Licens�e✓d' Construction Supervisor. Not Applicable ❑ LicenseNumberZ . O/ a Ad OZ43 �Qg 779— �? Expiration at /� O/_ �Sl'igiiature Telephone 3.2iRegistered Home',Improvement= Contractor:' Company Name Not Applicable ❑ Address Signature Telephone License Number Expiration Date 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 olttie issuance of the building permit. Signed Affidavit Attached Yes ... ..... No .......... Section 5, Descrlption of Proposed Work (check,alJAppOcable) New Construction Existing Bldg. ❑ No. of Bedrooms_ No. of Bathrooms Repair(s) ❑ Alterations ❑ Addition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: G a-i✓ s - Item Estimated Cost (Dollars) to be completed by permit applicant 1. Building -5-0620 2. Electrical 3. Plumbing / Gas 4. Mechanical (HVAC) 5. Fire Protection ` 6. Total = (1 + 2 + 3 + 4 + 5) 7. Total Square Ft. (new houses & adddions) t ii, I Check Below ❑ Conservation -Commission Filing (if applicable) ❑ Old Kings Highway & Historical Commission approval (if applicable) , as owner of the subject property hereby authorize Gam%' �/� !>'D�Lca�.S�(.tc, �- rl�" to act on my behalf, i II Matters relative_tq work authorized by this building permit application. Signatu a of 6wner Date , as Owner/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 perj I Print name 9-15-99 2 of 2 X/�6 /� Date pf'YN�i� C *s TOWN OF YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: Job Location: Number Owner of Property: Construction Supervisor: % t a'x Name Address: / b b O IQ ( � Licensed Designee: (If other than Supervisor) Name rs S Street License No. ot^A� d S�k 2.15 Responsibility of each license holder: to.-V I r 1 o w l v\ tillage LLC o 9�-o�--7-7 �9 Phone No. 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 lability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes No ❑ If you have checked Les, please indicate the type coverage by checking the appropriate box. A liability insurance policy ae", Other type of indemnity ❑ Bond ❑ OWNER'S S RAN VE 1: 1 am aware that the licensee does not have the insurance coverage required by Chapter as eneral Laws, and that my signature on this permit application waives this requirement. Check one: Signat of OwWer or Owner's Agen Owner Er Agent Signature: Building Official Approval: The Commonwealth of Massachusetts Department of Industrial Accidents J ONCOofifimstllsdoss 600 Washington Street ' Boston. Mass. 02111 Workers' Compensation Insurance Affidavit Applicant information: �{/ P► nsepR-it./�pr� location-•�J�/IZI / . cut\ //'/A't�� i`-�f/L�- nhnnn d 1`� � / �7 7,9 r-01iY. I am a homeowner performing all work myself. 0 1 am a sole proprietor =r..'. ha\e no one working in any capacity I am -an. employer pro\ iding workers' compensation for my employees working on this job. company name' address: city _phone +t• insuranceco. policy!! At, am a sole propriet r. general contractor. r homeowner (circle one) and have hired the contractors listed below t.ho have the.followin_ workers comp Ices: m vn !/K Yi-A address: /zl company name, Failure to secure coverage as required under Secoon 25A of MGL 152 an lad to the imposition oteriminal penalties of a One op to 51.500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a line 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 DIA for coverage verification. l do hereby cerify under the pains and penalties of perjury that the information provided above is true and corrax Signature ./e_ ��/�.�t�t�f Date Print name / i�fXIZ �S /� -t%/ ' Phone N 'z*3" 7—/ oRcial use only do not write in this area to be completed by city or town ofndal city or town: YARMODT$ _ permiNieeme p nBuildiag Department pLicensiog Board check if immediate response is required 261 OSeleetmen's Office (508) 398-2231 eat. ❑health Department contact person: phoneN:_ nOther. Information and Instructions Massachusetts General [-a%%s chapter 152 section 25•requires all emplovers to provide workers' compensation for their entplo%ees. As quoted from the "law an employee is defined as every person in the service of another under any contract of hire, express or implied. oral or written. An employer is defined as an indi% idual. partnership, association. corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise. and including the legal representatives of a deceased employer, or the receiver or trustee of an individual . partnership: association or other legal entity, employing employees. However the ov ner of a dwell inn house ha% ine not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed tote an emplo%er. NIG1_ chapter 152 ;ection =5 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to.operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionall%. neither the commonw ealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha%e been presented to the contracting authorit%. Applicants Please till in the workers' compensation affidavit completely. by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial ,accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affida% it should -be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial accidents. Should you have any questions regarding the "law" or if you are required to obtain a workers' �cotnpensation policy. please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit license number which will be used as a reference number. The affidavits may be retuned to the Department by mail or FAX unless other arrangements have been made, _ The Office of Investigations would like to thank you in advance for please do not hesitate to give us a call. you cooperation and should you have any questions. The Department's address, telephone and fax number. The Commonwealth Of Massachusetts Department -of Industrial Accidents fftice of imst ivadeas 600 Washington Street Boston, Ma. 02111 fax if: (617) 727-7749 phone 9: (617) 727-4900 ext. 406, 409 or 375 FPOM :PE.LA INSURANCE AGENCY INC FAX NO. :16177870185 Aug. 08 2005 01:19PM PI / Aw_QA-2005 12:24 F.I.PATNOt 1NS.AGY AC � :C�RtiF1GATE Of LIABU INSUt�Anc:r Wig.- R7lF1CATE 10 tY6tlt:0 +� RATTER Or INFO MIFIC N Dm r AND CONPPRS 'N RI ;HTS `UPON -THE- CEgtIPIG►T6 �oOUGEa - cEH,TipICAT! DQBS NOT AMEND, kxT6N0 On J[NC HOLDER. THIS EN E FORCED 8Y THE Pot".6 nElpW, .I PEEL& INSUP-A'NL Ac>ErIeY, AkTi=A AWdISH1i1000N5TRL6T NAICA �sticK rarL nzn ael�s ssvz tersUPEps nsFonon+e �sWe .� — INcua!A� 11rh®21a Pr.Dteot3o�-- -._— a HCn Di.1tB8ntOj1001oi _— _'— - t 418UPEri C Daa ltobaxt Plumbing 25 Anthony Road 2, Na�Eq C. th.COV AQE ppLIGVPERIOOarD!CAT6D.NOTNRHYTAK OpG gO BF,T.OW HAVE BEB 4ISSUES TO TN( IN6UR NAMEDkieNT rc 7 oT WINCH TW6 CERtP'iGfE NUV B['155UEo- OR' .I ME POUG64 OF 1N=u�t yjNMTTON'OF ANY-COKif WGY OP OTHta DDOT+ ANY(TGCtAFENq�Nr• TF.AIA OR. MEitEk1I96U9.IEG1 IOALLT+bi 78RM5. �%OLt391C7NS ANC CONW ' MAY PERTAIN. THE NYSURAN •AFWRC�EO.BV BE�PO4m Q' ncB,,g, �T v P '7f " ••' G:nrt! ,�...1 POUC:SS AQ(iREGAT: L9OT71 iHOWNMAT MAVC _�_• ..: Pacr fxrwfra Oa .. 6� OGGUV>>FNGE �• SOO�.Q•OU M r /�/�ry, ewwcnAl,U.A 611f : .Pw vi ..^WuwnenL. Xv i �•}�.�,....-. j X�ew.�,enertiecNawvuur.. ►WOExvTA"kT"'�1°0"1 1s 4 U � p�r3NADF fJ occur 07-20-05 07-20-06 'PdRschAi,!�DV NMIr '• s SQm , •1 -- IteW policy. A. OENEQAI ACAPEGatB i 1�U�@,UV� 7 P,ppwTs-�gypQAAlso s��.tfa:0tw f _ � -prtNl A66PEOATE IndRA�'E=►6E; — i �. EiaWWl OLENavi anawexE.�w�tn.Y. -`i . L. ANT AUTO Ory•V INJVAY i 1 l A;.sownrOwt09 .::(Palr�.�I _J 1 ti vcwwu %)aUT6a eOaLYw,URY' E Act I NONOWNWAUTOB _— _ . , •.,.... PFpPErjI'Y DAW41! 4 (pwdu.aMAI G_(AAnEtJAiIgTY 4 • 10niEarNAN AUTeONt�:... �. - s. . occur+RF.ae s __.._ --_�. I- �F.GEs�wieauui�ueuT. t"O s.--,_.-.-r i�--'Ot,Tx,A 1. �DI/dMYWOE ....:.r•--••"_ _.._. . i — ...� . .... oF0o0rlC ` 7 r�VOORKEF04OMPENOATrOWA 0 E1.siw7+AooiDiM ►'- r �wegy"IUA T-Y. E�ow ee wEM�ovE i q,r WNI'�:vwV+Afnfive�eWT ��,; 1 u^Iv4k•�«T'raEll 4mwr[Di El., D14Gni4 • POUC+ INdT s - yp fM OMq MMM 1 �z "WENT "WrOALPROVIS, ` � T ,YEwIGUAr— E%O���p°Om {TI FNDO .. . i CAN .... a19EiORF1WFF�T , A EA FICATE 140 Pit Ghoul) ANY 0c T"t40* r6 OE�GAroEO P000 Ei eE O "Thu 10 Avb M Hrt rr : QATe TwERCOF. TME 68UMxi�NO' E'^ Wrkt (R•+O('AVOf1 TO U✓•'�� O xOT�CE TO THE GymFlDATL h"4 wwt'4 TO THE r,E�t bUT FAkURF TO CNl d] S+wa: 1 Gate+!ood }loaues. Inc wopeENo u21.0aT10N OW VAti,r*,D ON iw ,NyuAEA, T� (u:Grny cr 1600 Falmouth Road - CenWe V1.11e(. YA OZ632 a 1i jpp� oRa PORAnoN t w 1 pax5603.. ACoMMS01/08) TOTAL P-02.. , CERTIFICATE OF LIABILITYiVSURANCE o'.. I United Insurance Agency, Inc. THIS CEiMVIUATE13ISSLEI 199 Main Street ONLY AND CONIMMNOR1C P.O. Sox 1013 KLTERT"EOVEPAGEAFR Buzzards Hay, MA 02532 INSURERS AFFOmw COVEPj Patton Electric, Inc,. INSURERA Zurich NA P - 0 - Box 1525 • BuRsR B Libort Mutua] Mashpee, MA 02649 INSURERC: INSURER O. THE PoucIFv ANY REOUIREMENT_ TERN &; frnunm,�LUW� HAVE BEEN ISSUED TD THE INSURED NAMFn Aen 0 NAIC III ^ T VtK IAIN. THE IN$URAN CE AFFORDED POLICIES. AGGREGATE IINET$ SHOWN �•� ""^''EAU T UR OTHER DOCUMENT WITH RESPECT 70 WHICH THIS PERIODNOTWITHSTANDING CERTIFICATE- 8Y THE POLICIES Or HEREIN 13 SUBJECT TE MAY Be ISSUED E LFAY OR TO ALL THE TERMS EXCLUSIONS AND CONDITIONS HAVE BEEN REDUCED BY PAID CLAIMS, OFO-SUCtf "' GENERAL LIABILITYLEEhE POLICYNUNBER POUCYEPMCTI ADIJ BIP ON A X COMMERCIAL GENERAL LIABILITY SCP42415399 EACHOCCURRENCE t 1 000 000 7/30/05 7/30/06 CLAPAS MADE � OCCUR PREMISES FAa¢ugps t 300 000 LIEDEXPfA,gaNPwAN11 t 10.000 .� FERSONALAADV,NJURV S 1 000 000 GEN'L AGGREGATE LWITAPPLIeS PER; GENERAL AGGREGATE A 2 00 0 1( POLICY �PIEICOT. LOC - PRODUCT$-COMPIOPAGG i 2 000.000 AUTOMOStE LIABILITY ANYAUTO COMBINED SINGLE UNIT IEA CAI = ALL GAINED AUTOS SCHEDULED AUTO$ DODILYINJVRY i IPar pswq NEIED AUTp6 ' NON.OANEO AUTOS BODR�Y INJURY E .—��..•—� — - PROP ATYDAMAOE E (PIA omdwq OAR/GELIABLI7Y AUTO ONLY, EA ACCIDENT t ANY AUTO EAACC t AV7000Vr'N1H►NLY; NAGO t EXCEBBNMORELLALM LITY EACH OCCURRENCE t OCCUR CLAIMS MADE AGGREGATTi E DEGucTsle t RETENTION / i WORKCRSCOMPE SAIIII0NAND TATU• OM B M EMPLOYERS'LSLm WC2313353049014 22/10/05 FR 12/30/06 ANY PROFR IETORIPAR TNERIEXECUTftE ELEACNAINIfTs T t 100,000 YOFFICFJLRAEMSER EXCLUDED' PROVISWSEsbv X E.L DISEASE • EA EMPLOYEE E 500,000 SPECJALi G.L DISEASE - POLICY OMIT t 100,000 OTWR D WCRMTIGNOF OPERATIONS f LOCATION!/ VENCLES f EXCLUOIONOADDED ET ENDQEEMENT f SPECIAL PROVISIONS Electrical Catewood Homes Fax No. 509-779-5603 1600 Falmouth Road Suite 25 Centerville, MA 02632 12001108) WOULD ANY OP THE ABOVE DESCRIBED POLICatBE CANCELUM BEFORE THE WIRAT*M DATE THEREOF, THEUMUNIa INSURER WILL ENDEAVOR TO MAL 10 DAVSWERTEN NOTIC E TO THE COITIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE T00050 WALL. IMPOEENO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, hE AWAITS OR 02/16/2006 16:18 5084204474 EDWARD A GRAZLL PAGE 01 -'AC©RD„ CERTIFICATE OF LIABILITY INSURANCE DATE(NNIOWYYYY) 02 36 06 PRODUCER THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Edward A. G.razul Insurance Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. SOX 337 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Marstons Mills, MA OZ648 INSURERS AFFORDING COVERAGE NAICJ! INEUAFO - Co.,INSURFRA: S • _....__.__���tY_.IL!S4)<,rS1SL0_�41nt�?1 ..�_....... Ameri:ean Foundation Inc. INSORCAB: Savers Property &Casualty 43 Phinney's Lane IN^aURER G: Centerville, MA 02632 INsuRERD: I INSURED G: THE POI TCIES OFINSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIRI;MENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOGUNIL"-NI' WITH RESPECT TO WHICH THIS CEFITIPICA'(E MAY RE ISSUED Oil MAY PF_'RTAIN, rHE IN^,uRANICE AFFORDED By THE POLICICS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCF1 F•OL ICIF_':t. AGGREGATE LIMITS SHOWN MAY HAVF_ SF_EN R_EDU_CED BY PAID CLAIMS. wmR'AOOa .... .. , LYN VN R S.URANCE I.... • -• POQCYNVMBER ,.^ ' POLICYEFFECTIVE POLICY EXPIRATION yDJ M&MLgo A M LIMITS uaDlurY i EACH DCCUHPFNC,F, %, 1 X I COMMEArIM. OENERAL LMILITv i CRELMSESjEaxcumnccj --. � 100, 000 i CLAMSMADE I � I, �� OCCUR, j � $P 00006134 •_•.• _ _ MED EIIP (AA, OAl PeICPnI ., 5 10,, �1,. A _ 10/05/06 FERSONALdADVINJURY : 1,t7Q0,000. 110/05/05 GENERAL AGaMCGAT-- s GEN'I,AGOREOATELIMITAP_PLIESPER:i .. PRODUCTS-COMPIOPAGG S 2,000,000. PRO' LOC I 1'DI.ICY AUTOMOBILE LIABILITY COMS94ED SIN CLE LRAIT _ ANY AUTO I I lEE ALCU1Mf) ALI_ OW NFD AUTOS ' 1 SCHEDULED AUTOS CDDILY INJURY Os HIRED AUTOS .__....._____. __... .... _...._..._. _._. MON•OWNEOAWDS BODILY INJURY fPillROPERTY DAMAGE S F9I8GrIPMII , GARAGELIABNgY - I AUTO ONLY• EA ACCIDENT ..- .... S ' IANYAVtO .. OTT RTHAN EA 4CL . S ..... ..._.. _ AUToNLr: A00 s EXCESSNMBRFLU IJAeP1iY : EACH OccuRRENCE 4 . I CICLiJR . I CLAIMS MADE - 1 A00PFOATP ' S 5 _ RETENTION } � �—_.._-.L=_._._......_. .. WORKE - EMPLOfl3S'LIAStSATK71'1ANO EMPLOYED^a'lIAE1LITY _ TgfiV LIMLTdL_ .Eij................. .... MY PAOFA.fTOlYPFRTNERIEXECUTFJE g UfFIgEH?AEMSEREXCLUDEDT WC 0001630 El EACYACCIDENT S IIyyC bnJnr 04/01/05 04/01/06 S.I OI:.FASF,•F.A EMPI.QYF.E S CIALPZ SPECML PROVLSIOMj FHow .__��_—__...._ ' F.L. O15EA.°E • POLICY LIM17 __........... ....._. S OTHER , DOCRIPTION OFOPERATIONS/ LOCATIONS I VEHICLES /EXCLUSIONS ADDED MY ENDORSEMENYI S►FCIAL PROVISONS PG�TIlIP wTG �ro wwew Gatewood Homes 1600 Falmouth. Road: Centerville, MA 02632 FAX# 508-778-5603 SHOULD ANY OF THE ABOVE DESCRIBED FOU095 BE CANCELLED REFORE THE EXPIRATION OAT! THEREOF, THE ISSUWO "SURER WILL ENDEAVOR TO MAIL „—. _. DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT. 8VT FAILURE TOOB-305HAL4 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR TION 1988 ACORD CERTIFICATE OF LIABILITY INSURANCE oxm(Moftyrn 1/5/ "2006'° 1 5 06 PRODUCER FAX Select Financial GroupONLY 1574 Washington Street Holliston KA 01746 THIS CERTIFICATE 13 ISSUED AS A MATTER AND CONFERS NO RIGHTS UPON HOLDER. THIS CERTIFICATE DOES NOT AMEND, ALTER THE COVERAGE AFFORDED BY THE OF INFORMATION THE CERTIFICATE EXTEND OR POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC0 WSURED FC Carpentry Inc. 625 Normandy Drive Norwood SEA 02062 INSURER A: Wes tern World - INStRER8: INSUREDC: MSUaER D: INSURERS: COVERAGES The POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOVIREMENT. 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 13 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED SY PAID CLAW. INSR LTR ADO 1NSR TYPE OF MSURAIICE POLICY NUMBER ►OLLCY EFFECTIVE DATE MMMDIYY POLIO DATEEMADXPIRATION LOAM GENERAL LIABJUTY. EACH OCCURRENCE 1 1.0001000 A % COMMERCIALOENERALLIARAITY CLAIMS MADE a)OCCuR NPP1015127 12128 2005 / 12/29/2006 A�M•G�ETORENTED PREMISES EP txzwnnen 1 50,000 LIEDEXP en f S.OAD PER90M AL S ADV INJURY 1 1,000,000 GENERA&AGGREDATE f 2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: -COMPAPAGG 1 1,000,000 L POLICY T LOC AUTOMOBILE LIABAU T ANY AUTO COMBINEO SINGLE LIMIT (98 ww"t) I BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS BODILY MUURY (Pwmldenq . S HRED AUTO$ NON-OV^W AUTOS PROPERTY DAMAGE (►ff ecekentt s - riRAGE LIABRUTY AUTO ONLY -EA ACCIDENT 1 OTHER THAN EAA C f ANY AUTO AUTO ONLY: AGO s EXCESSNMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE s AGGREGATE S S RRDEDUCTIBLE --- S ETENTION S WORN6R8 COMPENSATION AND EMPLOYERT UABILRY EA. EACH ACCIDENT S ANY PROPRIETORIPARTNERJEXECUTNE OFFICERIMEMBER EXCLUDED? N Ye:. dRooto undM G.L. DISEASE. CA EMPLOYEE S E.L DISEASE -POLICY LIMIT S SPECIAL PROVISIONS below OTHER DESCRIPTION OF ppERATgNBILOCATIONSNEMICiESEXCLUSIONS ADDED BY ENOORSIN ENTISPECW. PROVISIONS Geseral liability is pror'lded for the above insured as carpentzy - residential not exceeding 3 stories in height (Subject to deductible 82SO) 778-5603 Gatewod Homes 1600 Falmouth Rd suite 25 Centerville, KA 02632 SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE .ISSUING MEURER HAIL ENOCAVOR TO MAR. 10 DAYS WWMN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FALURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIADRJTY OF ANY KIND UPON THE 20 REPRESENTATIVE SUscolKATHY CORPORATnM TBRB IIv.4U2, (0106).06 AM9 VMP MWIP96 SONIIae, Inc. (Ra0)327a545 - Page I N 2 APR-20 2006 THU 10:33 A19 R & & INSURANCE FAX NO, 508 991 5461 P. 02/03 ACG� CER l IFICATE '" LIABILITY !NSURAN E. 04/z /z O ' PRODUCER (508)994-9688 FAX (S08)991 FLAGSHIP INSUR&MCE INC 414 COUNTY STREET NEW BEDFORD. MA 02740 -5461 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES, NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC a INSURED Frank Capra PO Box- 664 West Hyannisport, MA 02672 INSURER& Providence Mutual 15040 INSURERBI OneHeacon 206ZI' INSURERC, TSURER D! THE POLICIES OF INSURANCE LISTED On WfLnVEBE ANY REOUIR£MENT. TERM OR CONDITION OF ANY CONT. MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLI POLICIES. AGGREGATE LIMITS SHOWUMAY HAN E BEEN iSSiiEaTOTHE)NSUREDNAMEDABOVEFORTHEPOtICYFERWD)NDCATED.NO-MRTHSTAND" CT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE fJAY BE ISSUED OR IES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH JEDUCED BY PAID CLAIMS. M ^_R ITR13ENVIAL TYPE OF INSURANCE fflmnW POIJCYEFFECTM P°LICYEXPIRATION UMTS A LUAmurly X COMMERCIALOEHEPJALLIABLITY ctA1Ms MADE E O -m 01P00S3131 03 12/13/ZOOS 12/13/2OD6 tAc»OCCliRRENCE 11 1,000,00 OAMA__TORENTED LIED EXP Uvj om pamorl) 3 50 ,000 3 5.0001 PERSONAL & AOV INJURY 3 1 000,0 GENERAL AGGREGATE S 2,000.0 GEMLACMDATE 1WIT.APPIJE3 PER: POLICY F1JECT 0LOC PRODUCTS. COW'01, OG $ 2 000 0 B AUTOIIOINI.EWAMLIn ANY AUTO ALL OWNED AUTOS SCHEOLAEDAUTOS HIRED AUTOS NONFOWNEDAUTOS CB1E63796 02/14/2006 02/14/2007 CDMB9IED b1NGLfe LDVT (tomoDdsn) $ 1,000,0 X BODILY INJURY War Porm-) 3 X BODILY INJURY (pk AermoN) 3 X PROPERTY DAMAGE (Pa am" j MARAMI UASRm ANYAUTO I AUTO ONLY. EA ACCIDENT S OTHER THAN EA ACC AUTOOINLY: AGG 3 S A EICESSIUMBRELLALIAB3JTY OCCUR aCLANS WADE DEDUCTIBLE - RETENTION 3 - S0264 01 12/13/2005 01/13/2006 EACH OCCURRENCE S 2,000,00C AGGREGATE 6 2,000 00 3 S - ! WORXEiIt COMPENSATIM AND FMIRLOVOWLIABILITY ANY PROPRIETOR7PARTNERIMCUTNE O")CERAAEA)S€R EXCLUDED? Y TN. do,aRa w-Am SPECIAL PROVISIONS below I a STATLL OTH. EL EACHALCE)ENT S E.L. DISEASE• EAf+APLOYE i ft. OIS€A$€•POLICY LM91T S OTHER D)D)CAMMiNDFOPFN)ATWN5/LOCATIONSIVENICLFAIDCLUSION6 WDED BY ENDORSEMENT) SPECIAL PROVASMS GATEkbOD HOyES, INC. 1600 FALMOUTH ROAD, SUITE 25 CENTERVILLE, MA 02601 SHOULD ANY OF THE ABOVE DESCRIBED POILICIES BE CANCELLED BEFORE THE EXPIRATION OATS THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MALL ILO DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MALL SUCH NOTICE SHALL OPPOSE NO OBLIGATION OR LIABILITY OF ANY )DNO UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. ACORD28f2001108) I -AA: (505)178-5S,-UJ I 1J�1MA-���C Lt¢p nom1988 "ACOR-Dn. CERTIFICATE OF LIABILITY INSURANCE 0216106°�" "' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling & O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR g y ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 222 West Main St. PO Box 1990 Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC # INSURED Assurance Construction, Inc. INSURER B: A/O Assurance Excavation, Inc. INSURER 550 Willow Street INSURER D- West Yarmouth, MA 02673 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 NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMfDDffYI POLICY EXPIRATION DATE MM/DD LIMITS A GENERAL LIABILITY 16808387A9841ND05 08/01/05 08/01/06 EACH OCCURRENCE E7 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED E300OOO CLAIMS MADE FZ OCCUR MED EXP (Any one person) E5; 000 PERSONAL & ADV INJURY E1 000 000 - GENERAL AGGREGATE E2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000000 POLICY FE O- LOC - AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) E BODILY INJURY (Per person) E ALL OWNED AUTOS SCHEDULED AUTOS - - BODILY INJURY (Peraccident) E - HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE. (Per accident) E - GARAGE LIABILITY AUTO ONLY -EA ACCIDENT E OTHER THAN EA ACC E ANY AUTO E AUTO ONLY: AGO EXCESSAIMBRELLA LIABILITY EACH OCCURRENCE E OCCUR CLAIMS MADE AGGREGATE E E E ' DEDUCTIBLE E RETENTION E WORKERS COMPENSATION AND TH- OR LIMIT ER EMPLOYERT LIABILITY ANY PROPRIETORlPARTNER/EXECUTNE E.L. EACH ACCIDENT E E.L. DISEASE - EA EMPLOYEE E OFFICER/MEMBER EXCLUDED? - If yes, describe under SPECIAL PROVISIONS below E. DISEASE - POLICY LIMIT 1 E OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Operations performed by the named insured subject to policy conditions and exclusions. Gatewood Homes, Inc. 1600 Falmouth Road, Suite 25 Centerville, MA 02632 1 ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION IEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR AUTHORIZEDREPRESENTATIVE --wl --J,-7 & G ACORD 25 (2001/08) 1 of 2 #41713 LS1 o ACORD CORPORATION 1988 ACORD CERTIFICATE OF LIABILITY INSURANCE °ATE`MM DD/YYYY) v 12/20/2005 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PANTANO INSURANCE AGENCY, INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 220 BROADWAY, SUITE 202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. LYNNFIELD, MA 01940 781-581-3100 INSURERS AFFORDING COVERAGE NAIC# INSURED CENTURY PAINTING & DRYWALL INC. INSURER A: COMMERCE INSURER B: P:0 BOX 2903 ^ �I �r INSURER C: HYANNIS, MA 02601 a 1a�Cta �-aC.C_ b INSURER0: 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. MR Lrn NSRD E OFIN NCE POLICY NUMBER POUCYEFFECTIVE DATE MM/DD POLICYEXPIRATION DATE(MMfDOfYYl LIMITS GENERAL LIABILITY EACH OCCURRENCE $1, O y 0 0 0 COMMERCIAL GENERAL LIABILITY CLAIMS MADE DOCCUR " a PREMISES 'EaNTFU to S 1 / 000 / 0 MEDEXP(Anyoneper ) S5F 000 PENDING 12/17/05 12/17/06 PERSONAL 3ADV INJURY SlF 000♦ 000 - GENERAL AGGREGATE $2, 0 0 0, 0 0 0 - GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $1 I 0 0 0, 0 0 0 POLICY PRO- LOC CT AUTOMOBILE LIABILITY ANYAUTO - - COMBINED SINGLE OMIT (Eaaccldent) .. ' S BODILYINJURY"-_- (Perpmm) .. $ ALLOWNEDAUTOS SCHEDULED AUTOS - - - - BODILYINJURY (Peraccident) S HIRED AUTOS NON-OWNEDAUTOS PROPERTY DAMAGE (Peraccident) $ GARAGE LIABILITY AUTO ONLY-EAACCIDENT S OTHER THAN EAACC $ ' ANYAUTO S AUTOONLY: AGG EXCESS/UMBRELLA LIABILITY OCCUR CLAIMSMADE EACH OCCURRENCE S AGGREGATE $ S $ DEDUCTIBLE S RETENTION $ WORKERSCOMPENSATNAND K) EMPLOYERS' LIABILITY WCSTATU- OTH- RY IM ITS ER E.LEACHACCIDFNT S un RR�oRmwrNewe>Q:currvE E.L DISEASE - EA EMPLOYEE S OFRce MBDt FXCLU ? Nyea,doa _beun derONSbelm EL. DISEASE -POLICY LIMIT S SPECIALPROM OTHER DESCRIPTION OF OPERATIONS/ LOCATIONSI VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS GATERWOOD HOMES 1600 FALMOUTH ROAD # 25 CENTERVILLE, MA 02632 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING TULLITY RER WILL ENDEAVOR TO MAR _ DAYS WRITTEN NOTICE TO THE CEIr ATE HER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATIOI�OR1LI OF ANY KIgD UPON THE INSURER, ITS AGENTS OR AUTHORIZED (,�;rr pFCf)RDnRATITIN 1 QRR LDIN TOWN OF Y A R M O U T H ELLEEcnuCAL GAS 1146ROUTE28 SOUTHYARMOUTH MASSACHUSETTS02664-4451 Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365 PLUMBING SIGNS BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting fromtheproposed work/demolition to be conducted at C Inn J thr- Work AdAress is to be disposed of at the following location: 1 O rn Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. / v Signature of Applicant Permit No. Date �!>'a @19aWLgu Jt" Y^k TOWN OF YARMOUTH MAY 0 2 2006 �x c HEALTH DEPARTMENT HEALTH DEPT. �II.yy PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant. - Building Site Location: /_Z / GA/l� i7.;Vi7%7� Map No.: Lot No.: F3 Proposed Improvement:: Anoop,p(.75- 3 6 en zo6erls Applicant:_e'dWl4t 4 liArZW-r-V0 Tel. No.: % e 5F"? Address:/ `r�llfyTi/ 1W O73 Z. Date Filed: **lfyou would like e-mail notification of sign of); please provide e-mail address: Owner Name: P"', ic4a-cv� Owner Address:/600 o� Owner Tel. No.: . OldS� RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. Please submit four (4) copies of plans, to include: (1.) Site Plan showing existing buildings, water line location, and septic system location; (2.) Floor plan labeling ALL rooms within building (all existing and proposed) — Note. Floor plans not required for decks, sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED BY: GCUQ l&; DATE: - —5��- -- - PLEASE NOTE w . sv$ 2°So "796q TOWN OF YARMOUTH WATER DEPARTMENT 99 Buck Island Road West Yarmouth, MA 02673 Telephone: (508) 771-7921 • Fax: (508) 771-7998 BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET Bldg. Site Location: / Z / <fA M P S T- Map #: Lot #: -X2- 9/ Proposed Improvement: —� Applicant: Vi« AG &-S A--- LA M /-z S,-- /�D D r=t�"n a., r r► K O Address:�t 1A o26 37_ Tel. #: sov 7_8-9c6 q Date Fled: 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, Ocean, Bogs, Bays, Marshland, Etc.. Health Department Determines Compliance to Stat 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, roperty Protection; i.e. Smoke Detectors, Sprinkler Systems, Etc.. REVIEWED BY A R D N: PLEASE NOTE: COMMENTS: Signature Of Applicant Date: y X Bf7ARD.CF., BUILDING -REGULATIONS License,^ C?NSTRUG-PON SUPERMSOR. Numbi�_ 012430= Bitt�t�ala~�06L'€€i�'E9.40 ExptEes 6i 6f2C706 Tr. no: 25$26 Restrccsed FRPdVKG.eAPRfF =— ' 4000PPERcr�„���—.:�f x CENITEFULLE, tiiA .0263� Commissioner - a00- 35;000 ct enclosed space --- e to - Masoprj_o0lg r ZFain ". . owes Failure to�possew&c6rrentedilon otthe t : Massachusetts-SWm Bidding Code: - '' is-causefor•Tevccators:vEtAis-lcense. '— DIG. SAFE CALL.CENMR: 1888) 344-7233 TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BUILDING PERMIT TRANSMITTAL Temp Permit No.: T-06-466 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Unit 83 Owner's Name: Villages @ Camp Street., LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 ' REVIEWED BY: (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 9939 Net Owed: ($50.00) Application Date: 5/5/2006 Issue Date: Expiration Date Comments: Map/Lot: 044.21.1.0 new construction: ZONING APPROVED 1. WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT: DATE: N/A: 5. BUILDING DEPARTMENT: DATE: N/A: 6. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: Date Printed: 5/8/2006 ADDRESS; 2Te 29'. s4e -0-'y • MAScheck COMPLIANCE REPORT Massachusetts Energy code MAScheck Software version 2.01 Release 2 CITY: Yarmouth STATE: Massachusetts HOD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 4-21-2004 DATE OF PLANS: 04/21/04 TITLE: The sandpiper PROJECT INFORMATION: Mill Pond village Camp Street Yarmouth, MA 02673 COMPANY INFORMATION: Northside Design Assoc. 141 Main Street Yarmouth Port, MA. 02675 COMPLIANCE: PASSES Required UA = 223 Your Home = 138 Permit # Checked by/Date G ` G '� eO J:tC MPS �510 i 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" O.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 ------------------------------------------------------------------------------- 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 74.4. Builder/Designer Date Massachusetts Energy Code MAscheck Software version 2.01 Release 2 The sandpiper DATE: 4-21-2004 [] I CEILINGS: 1. R-30 + R-30 Comments/Locati WALLS: 1. wood Frame, 16" D.C., R-15 + R-15 Comments/Location WINDOWS AND GLASS DOORS: 1. U-value: 0.34 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location 2. u-value: 0.34 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: 1. U-value: 0.086 Comments/Locati AIR LEAKAGE: joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. when installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. I I I I I I I DUCT INSULATION: Ducts shall be insulated per Table 34.4.7.1. 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 34.4. 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 1.0 1.5 Steam condensate any 1.0 1.0 1.5 2.0 COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.75 1.0 refrigerant below 40 1.0 1.0 1.5 1.5 :IRCULATING 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)-- Standard Features I • Louvered face design • Charred split oak gas log set • Deluxe pan burner for big yellow flames and glowing embers • Charcoal black exterior powder coat finish • Realistic brickaded interior panels • Combo top/rear direct -vent outlets (except 3328 models, which have either a top or rear outlet) • Hi/Lo flame operation • Pre -wired for wall switch Options • 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) • 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 fire aces utilize either a Secure Vent (rigid) or Secure Flex il]211e14.50 inned7.5" 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, win vent configu- ration and choice of fuel will affect the over appearance of the fire. Warnock Hersey" Q20006711) Wamoek Henwy 'C� �0 us The first two model number digits indicate frame width, the last two digits indicate glass width. All are A.EU.E.-rated high efficiency Front Face Top Right Side - 35,40 & 45 MODELS Front (These models come with a top and rear vent) FIREPLACE & FRAMING DIMENSIONS Side 3328 33 /s 301/a 17 271h 331/s 195/s 211h aaa;....��:L 103/a 333a �.,:r 33t/a 1Knyer:� 35M 351/8 32/s 19 291t 351/8 2111h6 24Y8 12%6 3S3/4 35i'a 13 16 4035 401/8 373's 24 341h 401/8 2611h6 29h 1415h6 40Y4 401/4 16 4540 401/8 37% 24 391h 451/8 2611A6 34%8 17%6 451/4 404 16 rra ®® 3329T NG 17 500 4S 64 62 332ST LP 17,500 . 49 66 64 3328R NG 17,500 S3 63 61 3328R LP 17,500 S5 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 TYPICAL ROOM APPLICATIONS Look for the EnerGulde Gas Fireplace Energy Efficiency Rating In this brochure MPD3328 MPD3530 MPD4035 33' fireplace w/opt. flush face 3S' fireplace w/brusbed stainless 40' fireplace w/polished brass louver and door trim trim arch door kit Beauty, efficiency, convenience and reliability. Just some of what you'll find in our Lennox Merit® Plus Series direct -vent gas fireplaces. Our combo DV configuration, with both top and rear outlets, allows for top or rear venting (except.our 33" units which have either a top or rear outlet). Standard features include a deluxe pan burner that produces big yellow flames and glowing embers, brickaded interiors and Hi/Lo flame opera- tion. And, these models are even easier to warm to when you select one of our optional remote controls, or L-w.n3i- oGo-3 Y, PRODUCT SPECIFICATIONS GMS9/GCS9 SERIES 93% AFUE - Multi -Position, Single-Stage/Multi-Speed Gas Furnace Heating Capacity: 461000-115,000 BTUH � 6_1 Mama a EIV Standard Features • Corrosion -resistant, aluminized -steel tubular heat exchanger and stainless -steel recuperative coil for maximum efficiency • Designed for multi -position installation--GMS9: upflow, horizontal right or left; GCS9: downflow, horizontal right or left • Energy -saving, reliable Hot Surface Ignition system, featuring a Norton® Mini -Igniter with patented adaptive learning algorithm to maximize igniter life Aluminised -steel inshot burners • Energy -saving PSC, multi -speed, direct drive blower motor • Quiet, corrosion -resistant induced draft blower assembly • Integrated furnace control with improved diagnostics • Low voltage terminal blocks • Multiple flame roll -out switches, blower door safety switch, outlet air -limit switch and pressure switch for proof of combustion air • 40VA transformer for heating and air conditioning control service • Combination redundant gas valve and regulator • Top venting is standard; alternate flue/vent located on right side Completely assembled, factory run -tested furnace for heating or combination hearing/cooling application • All models comply with California NOx Standards • Suitable for direct vent (2-pipe) or non -direct vent (1-pipe) applications •101gI@'IT4 Air Conditioning & Heating Ti multi -speed gas furnaces offer installation versatility. . Cabinet Construction • Heavy -gauge; reinforced, fully insulated steel cabinet with durable baked -enamel finish • Attractive architectural gray paint finish • Foil -face insulation -lined heat exchanger ` compartment • Coil and furnace fit flush for easy installation • Convenient left or right connection for gas and electric service • Bottom or side air inlet (GMS9) Removable, solid -bottom block -off (GMS9) Accessories • L.P. Conversion Kit (LPT OOA) • L.P. Gas Low Pressure Kit (LPLPOI) • High Altitude Natural Gas/L.P Kits (HANG11, . HANG12, HALP10) • High Altitude Pressure Switch Kit (HAPS27) • External Filter Rack (EFROI) • Horizontal Concentric Vent Kit (HCVK) • Vertical Concentric Vent Kit (VCVK) • Internal Filter Retention Kit—upflow, horizontal (RF000180) • Internal Filter Retention Kit—downflow (RF000181) • Thermostats Blower Motors (CHT18-60, CH70TG, CHSATG, H20TWR) SS-377D www.goodmanmfg.com 6/04 Y APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 T (PLEASE PRINT IN INK OR To the Inspector of Wires: B} SEP 2 1 H (OFFICE USE ONLY) By Fee: $_ Ald •� PERMIT NO, L :�-10 U_ Date: 5/_-2//G gives notice of his or her intention to perform the electrical 2work described below. Location (Street & Numberl �� l Cc h?Q �� Owner or Tenant / i mac? -i�� /�/�y,?�� Telephone No. Cwner'sAddress 6 r� /�-xa vr{l>< 17 vi//e �"�� 3f E NIs this permit in conjunction with a building permit? Yes QNo (Check Appropriate Box) Purpose of Building U 6IeZo'z f '� Utility Authorization No. ! s / T G Existing Service Amps / Volts OverheadO Undgrd 0 No. of Meters New Service Amps �OyG //3li Volts . OverheadO Undgrd M-- No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed electrical Work: No. of Recessed Fixtures v tom reaon No. of Ceil: Sus . Paddle Fans o the ouowin table m be waived the Ins ector o Il iru ota To Transformers KVA No. of Lighting Outlets No. of Lighting Fixtures No. of Hot Tubs Swimming Pool d.e md. ❑ Generators KVA No. of Emergency Li ting BatteryUnits No. of Receptacle Outlets No, of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o.of InitDetectioniating and No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers eat Totmap. II um er ons W No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection 13 Other No. of Dryers No. of Water Heaters KW No. Hydromassage Bathtubs Heating Appliances KW No. of No. of Signs Ballasts No. of Motors Total HP Security Systems: No. of Devices or E ui valent Data Wiring: No. of Devices or Equivalent Telecommunications Wiring: No. of Devices or uivalent \_ Attach additional detail f desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued unless the licensee provides �_ proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in W force, and has exhibited proof of same to the rmit issuing office. CHECK ONE: INSURANCE BONDC] OTHER (Specify:) 2�/le%y Estimated Value of Electrical Work:_ t Gd (Expiration Date) (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pp��i�n�s and penalties of perjury, that the information on this application is true and complete. �1RM NAME: _y 4��,jP� (' /r ;1 �.0 LIC. NO. �� 1 icensee: �, Signature ���' LIC. NO. (If applicable, enter "exempt" in the license num er lige.) Bus. Tel. No.: Address `/� r'�r�js yJl Alt. Tel. No.: e2�fU� OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) owner ❑ owner's agent. ❑ Owner/Agent Signature [Rev. 04i001 Telephone APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEQ, 527 CMR 12.00 •Fg f D (OFFICE USE ONLY) C �.�J= W�TT<CIIEESE TOWN OF YARMOUTH By 'LY9fl Fee: $ rrr PERMIT NO. — 07 — (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: To the Inspector of Wires: By this application the undersigned gives notice of his or her inte work described below. l p tioti perform the electrical Location (Street & Nu er 3 ALI' Owner or Tenant C Owner's Address Tel one No. ^ Is this permit in conjunc i n with a building permit?;'Yes No (Check Appropriat x Purpose of BuildingUtility Authorization Auth No. UG 14 2006 Existing Service Amps_ / Volts OverheadO Und rd New Service L0 Amps �� ZV ]ts Overhead g e &? Number of Feeders and Ampacity Undgrd No. of Meters Location and Nature of Proposed electrical Work: w (O No. of Recessed Fixtures Com letion o the ollowinZ table maybe waived by the Inspector o Wires Total No. of Ceil.-Sus . Paddle Fans Transformers KVA No. of Li htin Outlets No. of Hot Tubs Generators KVA Above No. of Li htin Fixtures Swimmin Pool mill. In- No. o Emergency Lighting md. Batte No. of Receptacle Outlets No. of Oil Burners Units No. of Switches No. of Gas Burners FIRE ALARMS o• o erection an No. of Zones ' No. of Ranges No. of Air Cond. Tota Initiating Devices No. of Waste Disposers Heat Pmp uals: Tot Num er Tons To ns No. of Alerting Devices K No. of Self -Contained No. of Dishwashers Space/Area Heating KW Detection/Alerting Devices Local Q Municipal C No. of D Dryers Heating Appliances KW N Security Systems:onnection Other o. o Water No. of No. of evices or E ui valent Nb Heaters KW Si No. of Data Wiring: v s Ballasts No, of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: Q No. of Devices or E uivalent `a �i INSURANCE COVERAGE: Unless waived by the owner, no permit r for the performance a of electricalzw k may be sued unless t enlicensee p ov des of Vir proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such force, and has exhibited proof of same to th permit issuing office. coverage is in CHECK ONE: INSURANCE BOND [71 OTHE (Specify:) (P fY:) Estimated Val El 'cal Work: (Expaanon Date) Work to Start: (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, unde the p$i d pe Itie pe at the information on this application is true and complete. � RM censee: LIC. NO. t M/�—�. Signature LIC. NO. (If applica er a pt" in th license ber line.) Address• Bus. Tel. No.: OWNER'S INSURANCE WAIVER: I am aw, a that th Licensee does not have the liability insuranelt. coverage normally required by law By in signature below, I hereby waive this requirement. I am a chec one owner Owner/Agent ( ) ❑ owner's agent. Signature [Rev.04/00] Telephone No. - - Commonwealth of Massachusetts Offi'al use only + /vb Department of Fire Services Peimit No. —D OccOBOARD OF FIRE PREVENTION REGULA71ONS .11/99991 and Fee Checked yp •. _ 1 ve blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All warcto be peafo®ed in ac=daaee with the Musachoutts EtCC14 a! Code (MEC); sr 1Z00] (PLEASEPRINTlYBII RT1TEALLINFi7RMRTl0A9 Date: 77Z /0 (o City or Town of: YAPMUrH To the Inspector of Wires:.. this application the undersigned gives notice of his or her imendon to perform the electrical work described below. T,oca .0 treet & Number) MILL POND VIILAGE, 121 C p St Bldg # 3 owner Tenant Gatewood Homes/ Jeff Sollows Telephone No.5U8-7789669 tiOw.Aer' Address .1600 Falmouth Rd., Suite 25, Centerville, Ma. 02632 Is t it in conjunction with a building permit? Yu X No ❑ (Check Appropriate Box) c z P& of Building single family residence Utility Authorization No. g Service Ames / Volts Overhead ❑ Undgrd ❑ No. of Meters N ervice Amps / Volts Overhead . ❑ IIndgrd ❑ Na of Meters er of Feeders and Ampaciiy Location and Nature of Proposed Electrical Work Fire Alarm System (low voltage control panel) withharktm centrally = ored Cam letton of the ollowin table be r Of iaaive?l the ectol7&M No. of Recessed Fixtures No. of CeM-Susp. (Paddle) Fans 0.0 otal Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool gnmtie.❑ ernd. ❑Butte II0.0 e ency g No. ofRemptade Outlets No. of Oil Burners III A. LePiJYJS No. of Zones -1-- No. of Switches No. of Gas Burners o. o etectaon.an 7 laitiatin Devices No. ofRanges No. of AirCond. Tons No. of Alerting Devices No. of Waste Disposers Totalsp W. er. ors o. o ontarne Detection/Alertin Devices 7 �( No. of Dishwashers Space/AmaHeatingKWucal ci unicipal Connection M Other oNa. ofDryers Heating Appliances XW ecunty ystems: o. o ater No. of Devicesor E ivalent C*JHeaters °' ° ° ° Data ng; 1 KW Si Ballasts No. ofDevices orE nivalent d% : No. Hydromassage Bathtubs No. of Motors Total HP a eco =Dge-vices o inng: OTHER: No. of Devices or E uivalent INSURANCE COVERAGE: Unless waived by the owner no.permitfortheperEo�lnnaneeofelaeCtrlCalredb I+upecmrgWIM issue the licensee provides proof of liability insurance including "completed operation" .coverage or its substantial a quivalent The unless undersigued certifies that such coverage is in force and has exiubited roof of satire to. CHECK ONE: INSURANCE P permit issuing office. • ® BOND ❑ OTHER ❑ (Specify;) . Estimated Value of IIectrical Woric $750. 00 ^ (Wb= required by municipal policy.) �uar,on r` Work to Start - I certify, Inspections to. be requested in accordance with MEC Rule 10, and upon Completion. under thepains andpenal8es ofperfuty, that the information on th FMMNAME: Baltic Security, Inc is application is true and complete LIC. NO.: 1178C Licensee: Jonas R Bielkqvicius Signature �-- --- •(1lq7ylkvbk suer"exempt"wtirelieense. LIC.NO.: 499D AddrEss: ' ,Box .1,609. Sarre, �7a. 02563 Bus Td No:• 508-8— 3=0996 OWNER'S tSURANCE WAIVER .I am aware that the Licensee does not have the liabiliAit: TeL No.• 508-7 -3 7 regcired�by law. By my signature below, I hereby waive this ree imuuanCe Coverage normally . S��regent requirement I am the {Chtxlc one) 0 owner ❑ owner's agent Telephone No. PER111ITFEE: $ 40.'00. MAY 0 1 2006 PROPOS/D WATER SERVICE fg • / �� LOT 84 NOTE: SEWER LATERAL SHALL BE SLEEVED IN ACCORDANCE WITH TITLE V IF WITHIN 1OFT. OF WATER MAIN. GRAPHIC SCAL' LAVVS AM ..20 10 0 • ( IN FEET ) 1 inch = 20 fk PLOT PLAN OF LOT 83 PREPARED FOR MILL POND VILLAGE IN YARMOUTH, MA SCALE: 1 "=20' DATE: 3-2,e LOT 82 to to \4 \• 9 92. \ Z I LOT 83 6,163f S.F. " SEWER LATERAL _RfATE:n.I ;until a:ch tlrr,e a3 ttm nrir ir,cl - n: a i :. ;eseiornl Engineer. or Frofn-s.nicnul (rid) Sjevnj c-, , .. nd ��r v n, y^, (A} no pm _n nr parsons, io Nu: 'ng eny muriclpnl or ctr.er fl 'if -,y rely upon tha ir.iorm�ticn contmc.=.i her.:^: (.9) the pi::n remcns t}a property of fHG'nlsg 11c;.r holmes and mcgrath, inc civil engineers and land surveyors 362 gifford street falmouth, ma. 02540 JOB NO: 201197 DRAWN: LMC DWG. NO.: A2551 CHECKED: -7n AY 0 2 2006 LOT 82 f LOT 84 /' EALTH DEPT. ,• 49.9 o ti r� LOT 83 z ti ,a'�•, 6,163f S.F. Q � M � 17 icy gyp• LU / \-Cb sFyA°o =_wPROPOSj/,pSgti0i31Lu oWATER�SRVICE �W 7BS-ly: FOP c�v M o ' R cc � 0 '"•S ti Co Pj a c� / — d z3 = — z �o J a] 0LLJ � 10N iS� O�� W O 2) •0�, 9S �. �� Qo��J % h" V E P OPOSED 2006 4 SEWER LATERAL ro• Y rm Hen BplN artment �-UIL �o YP DEpT NOTE: - — SEWER LATERAL SHALL BE SLEEVED IN ACCORDANCE WITH TITLE V IF WITHIN 1OFT. OF WATER MAIN. GRAPHIC SCA ���tH OF\,` T ALL T ' o�o� MICCHAEL C r ,� CIS ik a P10Tin ohaI LAND S !'Ne.ns anA �n,til s:: -h tm,o as tha oriyinc.t t�mp r. wi rr,pon,lbla Profesaionol Eng9n;er, or Pr c fesoicnal Land riaj zt,mpa,f 0"p'ary on th!a -,:On: (A) no per§an or persons• inN.uding any municipal ,r c ar rsc ii.: nt^;:i^is, luny rely upon tha information contairst IR) !,-' pion remains +}.� proF.xrt'y of Hclm=s 1 inch = 20 ft. PLOT PLAN holmes and mcgrath, inc. ►►�°""` RE LOT 83 civil engineers and land surveyors �" o, PREPARED FOR MILL POND VILLAGE 362 gifford street TI"AOTHYM R folmouth, ma. 02540 1 sANTO7 � S No. 45c78 ca YARMOUTH, MA CIVIL JOB NO: 201197 DRAWN: LMC �OX SCALE: 1 "=20' DATE: 3-24-051 WG. NO.: A2551 CHECKED: -7o,._ . WPS - Permit Page 1 of 1 • • �NSTAR WPS - Permit Work Order Information UtilityAuth/WO #: 01543070 Date: 09/152006 Company BEA LORD Rep: Report By: YAR 121 CAMP ST U83 VILLAGES AT CAMP ST LLC Status: ACTIVE Service: NEW Type: RES Nature of Work: CONNECT 100A 120240V UG IN HH100C Service Information: There is no Service Information. Permit Information Permit #: E07-304 Meters: 1 Reseal (YIN): Y Date: 11/032006 Inspector: W10060 Description: T Search Detail Contacts NSTAR Home WPS Logon WPS Helo Comments WO Request WPS News V 0 Copyright 2003 NSTAR, 800 Boylston Street, Boston MA USA. All rights reserved. Reproduction in whole or in part of any graphics, images, text or other content at this web site must be granted by NSTAR, Boston, MA, USA. Unauthorized modification of any Information stored at this site may result in criminal prosecution. http://Www.nstaronline. comlappstwpslwpspermit.cfm?Page=Pennit&RequestTimeout=l0... 11/6/2006 TOWN OF YARMOUTH APPLICATION FOR PERMIT TO DO PLUMBING Fee: PERMIT NO. (OFFICE USE ONLY) Date Bui, !, Owner's C AT: Locion J %- Name Ne Renovation ❑ Plans Submitted Yes ❑ No ❑ F Type of Occupancy Replacement ❑ dtJp�Q� r Z I N Y > W Y J fA y O U Q y M t7 NJ Q' LU W IL y m W Q 0. (= O X (• W O O Q' W Q N IW-U Q (� W 2 y J Z G a p J LL LL 1 3(/ / ~ V> H O 2 p O U 2o J QQ H Iz Y m N G 0 J = 0 LL Q: 00 0 SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Installing Company Name Check One: ❑ Corp. Address / V V/ V Y 4 ❑ Partn Ip Firm/ pany 01 Business Telephone7:77 a of Licensed Plumber INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes No ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ 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 Chapter 142 of the General Laws. Check on Owner,,�7 Agent ❑ Signature of License Number Type: Master❑ Journeyman