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HomeMy WebLinkAbout121 Camp St #086 Building Permits�l Af`bF r TOWN OF YARMO_UTH Building Department BUILDING - - - - - (508) 398-2231 ext.261 PERMIT NO B_06-1402 ,a02- - PERMIT - - - ISSUE DATE ; - 5/26/2006 - ; PROPOSED USE ; APPLICANT'F�ankcapra----------------------ki JOB WEATHER CARD ---------------------------. PERMITTO 'New Construction AT (LOCATION) 100121CAMP ST Unit 86 ;; ZONING DISTRICT R-2 SUBDIVISION MAP LOT BLOCK 044.21.1.C86 BUILDING IS TO BE: CONST 1 LOT SIZE Bldg. Type: Residential 5-A I USEGROUPI R-4 new construction - Affordable: 3 baths, 2 bedrooms, 1 familyroom/diningroom, 1 kitchen, 1 livingroom as per REMARKS plans dated 05116/06. AREA (SO FT) EST COST ($ $154,080.00 PERMIT FEE ($) $0.00 OWNER Villages @ 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 5087789669 A. FIELD COPY Date Note Progress - Corrections and Remark Inspector L L 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 OfficeUse Only Perrnit No tl` j�l/lp f T Perrniffee "� $ r� zl DepDSlt RBC'd �,.- O'rDate Net DUe r $ Planning Board tnformation Ian Type Endorsement Date` t . i � Recording Date% y� , ;Othej r Assessors.71 Department Informations , Map ;x cot,' ' �.Z O1r91 � Y IveW 1 4 Property Dimensions u . � �. (sf Lot a e ) �• l sontage {ft) LotCoverage f d?his Section for Office- Use Ohl Buildin :Per it ilm er .,.?v _. _,, Date-lssd. le' `. SignatureCertifi0p, f Occupancy Y ��{�"'� . is is not re wired q f x Bwdin Official , �.� t 9 Date ._„ Section.l =:Site lfiformation' Use Group: R-4 Type: 5-B 1.1 Property Address:. 1.2 Zoning Information: IZZ 5- / Zoning District Proposed Use 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Requireg Provided 1.4 Water Supply (M.G.L. c. 40. S 54) Public Private2one 1-5•.FloodZone formation v I Comments BFE,. ,< s Section`2-.Property;Dwnership/Authorized Agent 2.1 Owne of Record: %syaes Lt"Y/a- bow �Z�S Name (pn t Mailing Addresr',;, l�`It-lk a 2 (o Z Signa ure Telephone 2.2 Authorized Agent: Name (print) Mailing Addre Signature Telephone Fax %JAVr' . s r r By. Section 3 -' Construction Services 3.1 Licensed Construction Supervisor. �✓' Not Applicable ❑ License Number 0`Z� a Address 0a4-3 Expiration Date ��/ Signat re Telephone 3.2iRegistered'Honie;Improvement. Contractor.: Company Name Not Applicable ❑ Address Signature Telephone License Number Expiration Date 9-15-99 1 of 2 OVER ___ — ..i.— a.. .. .vim vim. %VJ _:, - Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of t e issuance of the building permit. Signed Affidavit Attached Yes ... K. No .......... New ConstructimA Existing Bldg. ❑ I No. of Bedrooms - No. of Bathrooms Repair(s) ❑ Alterations ❑ Addition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: n / < 7/ Check Below ❑ Conservation -Commission Filing (if applicable) ❑ Old Kings Highway & Historical Commission approval (if applicable) 1, 1�1' /1; ALX4 , as owner of the subject property hereby authorize Got z-, x- 1`�'Onc�.S� (llti �. rlt J to act on my behal in all matters relative to work authorized by this building permit application. GGo6 signatu a bfowAer 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 perjury. Print name 11 // ��� sign re of O er/Agent Date 9-15-99 2 of 2 �3 AQDRESSa /,7/ ,ALCULATION FOR pERMI T CO; S?� 3oS go 73/ Zss. OKI g7 O FOUNDATION O1� �" c�AGE NO OF ,of'YgR,� / C TOWN OF YARMOUTH PLEASE PRINT: job Location: _ BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM Number Owner of Property: Construction Supervisor: t a-t% Name r0, _e� License No. trio L^- ty\ C J�;o�--» g-9 (0 69 Phone No. Address: A b O �Gl ( yo Ot.��C� � � Suit 2� L1Cr� Licensed Designee: (If other than Supervisor) Name License No. 2.15 Responsibility of each license holder: f'y� (le mA oIb3„ 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 shallwillfullyviolate 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 iability 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 INSURAN AIVE am aware that the licensee does not have the insurance coverage required by Chapter of th en aws, and that my signature on this permit application waives this requirement. Check one: f Owner or wner's Agent Owner [� Signatureo g . Agent Signature: Building Official Approval: M The Commonwealth of Massachusetts Department of Industrial Accidents o - Omcaollevest/pfl/�is 600 Washington Street ' Boston. Mass. 02111 Workers' Compensation Insurance Affidavit Applicant information: ko location- /'ZI GQ'a�t7 i � .. . r I am a homeowner performing all work myself. lam a sole proprietor and 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 0 insurance co, noiicv tl I am a sole proprietor.:enerai contractor. or homeowner (circle onei and have hired the contractors listed below s.ho hase the.folluwin_ porkers' compensation olices: company name: address - city: �i/t / / GY V (/ _" nhnne H• �—,07 company name. Failure to secure coverage as required under Section 2SA of MGL 152 can Ind to the imposition of etimimd penalties of a fiat ap to St,500A0 aad/or one years' imprisonment is well as civil penalties io the form of a STOP WORK ORDER aid a tine of S100A0 a day against me. I understand that a copy of this statement may be forwarded to the Once of Investigations of the DIA for coverage verification. I do -hereby certify under the pains and penalties of perjuty that the information provided above is true and correct S/Zignature Date �O Print name one N OM621 use only do not write in this area to be completed by city orowa olfieial city or town: YARMOUT$ _ permit/license N nBuilding Department. OLicensing Board Q check if immediate response is required 261 QSelectmen's Office OHealth Department contact person: phone N: _ (508) 398,2231 eat. rIOther Information and Instructions Massachusetts General Laws chapter 152 section 25•requires all emplovers to provide workers' compensation for their entpIo%ees. As quoted from the "Ia%% an employee is defined as every person in the service of another underany contract of hire, express or implied, oral or written. An emplut•er is defined as an indi% idual..partnership, association. corporation or other legal entity, or any M-o or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the recei%er or trustee of an individual . partnership: association or other legal entity, employing employees. However the ox%ner of a dwellink= house hay 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 _rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. %IGI_ chapter 1:= section also states that even• 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 commom%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 authoritn. Applicants Please till in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying compam. 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 %%orkers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number.. The affidavits may be returned to She Department by mail or FAX unless other arrangements have been made. The Office of lnvestigafions would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. - . • : The Department's address, telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office If lmstivi ess 600 Washington Street Boston, Ma. 02111 fax #: (617) 727-7749 phone #: (617) 7274900 ext. 406, 409 or 375 _ FROM :PELLA INSURANCE AGENCY INC FAX NO. :161778701E5 Aug.�08 2005 01:19PM P1 / pm-W-2005 12:24 F.I.PATNoDE INS.AGY - iArT„ `--- 2 2. —I Acm,r Cr.H 4IFI.CATE OF �AeIUTY Miut 1CAfE $1i6U8C A MA TER OC INF.WIPIOnMA ON AT �( t�pt DER On TtUS r, ►jvnt;ICAT! CONMRS WO DOES O AMEND, �T[6It'pCl� A1dCa.. EH E FOROEO B7 T"f POIICI _s nEl W. PEI.I.A JNSU LANCE ,&GIENCY, ALTV I - A.WILSE111Vc'CC/N SrTi6si Ams ASFOPMMG 4cwlmAG �'R)Gli'TUN.N1Ao2i�s'�592�_ it Pr tectio,�_. '—"1 , a . nVetlpaAa xcn Diatnantopoalor --- _—' —t u�VA e usa 1t0Dait plumbing cyoyaEa 25 Anthony Road Ys h 2 ` roa AOE M,suAED NMAEO aa0� � Y �fDa.4o�?50. HOTWITNYIANvO�NG_ D 0{,'I.OW HAVE BEEN -- ;- To THE MENT WRH OW FO T -M WIIICN T us CAR'* OWE NGV RC'159UE 'I hE POKY Of tl'Ia1RNNGE WIi „EREM'{ 19 SU9,IEt:1 10 ALI,SfiE Y611NA, C%OU79tONS Iwo coN WT10N8 Of TUCµ ANY aGCt1,FENM1MSY, TEAM OR•.CV I�ITION'� ANY.CONT 800&8CRM0 OOOu (J gy.PAlb CLlUYB.y �• r IIAV PE4ITAW. THE 7: Lq.Gi1�OWN CMAY HAV89EEpN•00 �t v yv •^ T tuuif PO _ GA ;_�- PO�,cY NWH1F.a oa yrm ocy (t SOOi.Qd��i V —r. a. :v s S-9~Qq�: WV%AL INyL1Y� Dq r �yLO n emY.MML_ j Xl�,o. enevrccN ltwnur• - W1QExPt �plm*l _It sU L i 1 owwwDE rX� °�F 0?-20^OS 07-20-Q6 h6asaN,u �nov NNRY. i SQ�i1'S ! _ 1I¢w PO1lci .6ENSAu �eoaer>A,E t 1, o�@L0 4 A I ... • � • • -. --': moa,cTs::owo..uo c,•� EfET, O6tY f I — T - I-aeN't A" CWtE In/RI�.UE9 ►EE; .. ."� i.... POLICY pa t[,f. I I pia ku N0JLIMB !1 —.... AWAWTQ Mr Q C1LY ,NN TY �. I1Ll O�N15Y.0!W'I06 __ .Mr}p"M i ra WJU%)&Hell soatv,N ua^: c r NONCWMED/rNTOn i PFj1PfAMAoE C jjN)TO OirtY•FIRWOENT_ f.. . i 5 ELu�ilLiiY ....... .. .. -. •••• n. �OTNEATNLN EaAGG ��..—_. �.. luOL rFAAw .. ,WtltEfNlr •r.F.� C- I ��¢EsnweaEL��Nd�T• IwaRec -t a —4 r. pEDuOtI$tt ` � IA ; �yYtNIRESSrAMPENBIKIONArm C.L 61tG...00�'? }'�•.—••�—..— awLOYEfYtwfL�TY.. E.�ouTr�.oe,� r►tMotovt t ..�� �h,� El:OIGGh[E•POUCTIM,T s r p@*MENI, 3prZIALPROVt4, O1 I 'citlC rONpFDpEpu7ror91tocuY ,vEwcixA�Ex -.Ne naomWENDO Gatew.00d HOTOBT- itl� 1600 Falmouth Road tente) ;V .1`±.e.. yA 02632 Fux .�..306=77it-5603 . ACpTTD?SI109t) :AN I.ATTON '. .. CNOULO.NY O� TMQ.ppYt 0E�,n+oEO roUG'i9 DE c+'><fLLt�16EFORE Tl4F��= Nik. � .. OATS TMEPEOF• SMEKBUMJQ �MP� W NF Ev4O TO MNL 1 O p.rt{ M Y,T T•� U371ce TO TaE r.MricAYi NplOEa WAMko TO THE LEST Nut' FA*tm To M! Y] Ea. N0 UOLW.Ild5 •66NT9 Pr , am 01T DF �r ION ONON iNE YttluT+ .. _ .. _. TOTAL P-OZ TIP 2" CERTIFICATE OF LIABILITY INSURANCE PRDouCER Unitad Insurance Agency, Inc. THISCBiT1i1CATE13iS31E 199 Main Street F OLD9i TH13C�IFICAFG TTE p.0. Box ID23 ALTB2THECOVERAGEAFR Buzzards Bay, MA 02532 4N3URStS AFFORdWa COVER Patton Electric, Inc. WeURERA:Zurich NA P,O. Box 1525 WBuRERB I.ibart Nutua., Mashpae, HA 02649 NISURER C: NSURCR 0: THE Pot,,...- ANY REQUIREMENT, " �'aeco BELOW HAVE BEEN ISSUED TO THE INSURED NAMM ASG TERM OR CONOITIN A DATEIMMIODryTYY) N POLICIES. MAY PERTAIN, THE INSURANCE AFFORDEDOF AGGREGATE LIMITS SHOWN MAY ANY CONTRACTOR OTHER DOCUMENT BY THE POLICIES DESCRIBED HAVE BEEN REDUCED BY PAID WITH RE6PECT M WHICH THIS CERTIFICATEINDICATED D. HEREIN 14 SUBJECT TO ALL THE TERMS. EXCLUSIONS AN 8E CLAIMS, D CONDITIONS NOTWITHSTANDING ISSUED OR Oc'SUt7f ... . A GENERAL LIABILITYLIMRE X COMMERCIALOENERALUASILTTY 7 CLAMS MADE [� OCCUR I ^J POLICYNUMEER SCP42415399 POLICY CP RIC 71 U B(P OM EACH OCCURRENCE 7/ 7/30/05 30/06 PReMIsEe FA Pm PTA{ $ 1 000 000 L 300 000 MID EXP IA^TUMPNwrM S 10 000 — PERSONAL CADVW,IVRV { 1 000 000 rXN'LAOGAECATCLWffAi'PI.N'S PER: X POLICY JPIEI-0h LOC GENRIMAGORIGATE PROOUCTS.COMP/OPACG { 2 00•Qon S 2 000 000 AUTOMOS4E LIABILITY - = ANYAUTO COMBINED SINGLE LIMIT IEa{lamq ALL OVWED AUTOS S SCHEDULEDAUTOS - BOOILYWJVRY (PY P-S" HMEDAUTOS - S NON•ONNEOAUTOS 60DILQY 1IPPRRO�PERTYDAMA9E ' .—'—..• _ (Pr Ea d-9 E GARAGE LIABILITY ANYAUTO AUTO ONLY, EA ACC DENT S AUTO ONLT: EA ACC AUTO ONLY: AGO S EXCEMUIRORELLAUABS.ITY EACH OCCURRENCE f OCCUR CLAIMS MADE AGGREGATE { ... _.�-__.. .... S OEDVCTBLE S.__ RETENTION { S B MIORKORSCOMPENSATgN ABED EMPLOYERS*UASIUry ANY PROPR IETORMAR TNERIELECUTAE OFFICER)MEMBER EX0.UDEDl Wypna 0"esto~ X. SKCJALPROY190NSEeDR WC2319353049014 12/10/05 - 12/10/06 TATU- OTH. f { 100,000 { 500,000 S 200,000 S.LFACHgGCWENf C.L. OISEASE. EA EMPLOYEE E.L. DISEASE• POLICY LIMIT OTHER OMtCRWM"OF OPERATIONS ILOCATIONS/ VEHICLES I EXCLUPONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Electrical Catewood Homes Fax No. 509-778-5603 1600 Falmouth Road Suite 25 Centerville, MA 02632 SHOULD ANY OF THE ABOVE DESCRIBED FOLICRCEBE CANCELLED E@ORE INC EXFlRATIDM DATE THEREOF, THEISBOWa WEURER WILL ENDEAVOR TO MAIL 10 OAYAWRTTTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT, BUT FAILURE 7000 OSMALL•- IMPOSENOORLIGATION OR LIABILITY QF ANY KIND VFOM THE W WJR ER, nS AOEMTB OR 0 ACORD CORPORATION 1968 02/16/2006 16:18 5084204474 EDWARD A GRAZLL PAGE 01 ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE (MMIOD/VYYY) 1.02 16 06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Edward A. Grazul 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 02649 INSURERS AFFORDING COVERAGE NAIC# MSURGD MSURERA:af�,j� �]T,,glj$j1C1P,_COITtan American Foundation Co., Inc. INBIIRERB: Savers Property- &_Casua ty 43 Phinney's Lane INSUAERC: Centerville, MA 02632 INSURER _ .... _. _........_._ ...._... . . I INSURER E•. THE POT.=E'S OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIRI,MENT, TEAM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT' WITH RESPECT TO WHICH THIS CERTIFICATE MAY RE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POI.ICIEw. AGGREGATE LIMITSSHOWN MAY HAVR.6F_EN FIEDUCED BY PAID CLAIMS. ' N+GR'A00' ... .. ... ... ..... ..... ......... .. ._... .. i LTR in R SSiMNtE I iPOLI4YlFrC POLICY EXPIRATION .DAISQMDar) OA MIDO LIMITS GEAEAAL uaD1LIY7 EACH OCLYIRPF.NOF S �v�q X I COMMCAP,IAI.OENERAL1IA8ILITY i ! 7PREAAMSE�RL�ttDnrr .• - f 1OO OOO. hAIM3 MADE , I'; OCCUR i.. .._ 1_.._. - )._. A ' BP 00006134 I 10/05/05 10/05/06 MEDEXP(A"epeteunl : PEnSONALLADViwURY :. 10-,OOE1;. 000 000 ' I GEN _RALAGOREGATI! S QDQj c�ie.Fy GEN'I,AGOREOATE UMITAPPLIL-S PER: .. 1 PROOMTS-COMP/OPAGG S ..2 , 2, OOO, OOO. PRO. i LOC I Pl)l_ICY AUTOMOBLLE LIABILITY COMBMEDSMCLELMIIT E ANV AUTO _ I I (Ef M:OOenq AI.I_OwNED AUTOS ' • . ' BODILY INJURY S 3GNEUULED AUTOS irrP oAr. � HIREonutos __.....--_-_. __..._.. �_ ....._..._._._. BODILY INJURY S NON-OWN£OAU109 IPM"Ctd&VJ ( I . OAMAt:E . S (Per acnden� GARAGELIABLRY 1 AUTO ONLY- EAACCIOENT .. _ .. S . • I ANY AM E OTNRUTERONLY: THAN ?'. a« S _. , AOO S EXCESStUMBRGMA IABIITY"CmOC i 4IENCE CLAAASMAOE 0 RF.000P ; S .... DEDUCT ELE ----_ L..r_...._..' RETENTION , - .. — IWORKERSCOMPENSATiONAND WCSTATU- II OTH- EMPLOYERS•LIABILITY ANY PAOPRIETOPtPARTNE!VEXECUTNr El OFFK EpRdEMBEREXCLLDEDt 0001630 ET.. EACH ACC.=NT I�yyee de WC 04/O1/05 04/01/06 E_L DISEA4£`FA EMPo.OYFF : MLPROVL:IO10 under _ _—.._..... .. .. .. _._. ..PECN^j (ylp,r E.l.. OISChAC•POI.IOY UMR 1 OTHER_T OEGCRIPTION OF OPERATIONS/ LOCATIOMS/VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT/SPFCIAL rRQVISKMS GANGELLATION GAtewood HOMES SHOULD ANY OF THE ABOVE DESCRIBED POLICIES in CANCELLEO REFORE THE EXPIRATION' 1600 Falmouth Road � DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAX. ,---, DAYS WRITTEN Centerville, MA 02632 NOMCTO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURET090-SOSHAL4- IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR FAXTr�(. SO$"7%8-S6O3 REPRESENTATNSS. AUYMD O REPRCSENTATIYC_ 1 25(200t/08) 0AC ROCORPORATION1988 J ACORD CERTIFICATE OF LIABILITY INSURANCE 1512'°D' 1 5 26 1006 PRODUCER FAX Select Financial Group 1574 Nasbington Street Ho111BtOgL IITA 01746 THIS CERTIFICATE IS ISSUED AS A MATTER ONLY 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 NAICN' CURED PC Carpentry Inc. a 625 Normandy Drive Norwood IRA 02062 WeXRERA:Western World INSURERB: IRSURERC: INSURER O: INSURER E: COVERAGES THB 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 CLAW. INSR LTR AOO INSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE, DATE (MMIDDIVYY POLICY EXPIRATION DATE IMWDD L"" GENERAL LIABILITY . EACH OCCURRENCE f 11000,000 A X COMMERCULOENCRALI-IAOILRY CLAM MADE OCCUR MPPIOIS227 12/2B/2005 12/29/2006 Ap RNMyE D PR MINES Ea Pccurnnee f S0,D00 MEDEXp � e„ 3 5,000 PERSONAL S ADV VVUR 1 11000, 000 GENERAI. AGGREGATE f 2.000.000 GF-NL AGGREGATE UNIT APPLIES PER: PRODUCTS-COIAptoPAGG 1 1,000,000 X1 POLICY M T Mtee ' AUTOMOBILE LIABILITY ANY AUTO COMI)WEO SINGLE LAW (so Ftt Wn1) f .BODILY INJURY (Prpe ) 1 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per mclderlq f HIRED AUTOS NONUWNED AUTOS PROPERTY DAMAGE (Per eeeldenq 1 GARAGE LIABILITY AUTO ONLY -EA ACCIDEW 1 OTHER THAN fAACC S ANY AUTO AUTO ONLY: AGO 1 EXCESSR)MBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE 1 AGGREGATE 1 s 1 DEDUCTIBLE 1 RETENTION S WORKVM COMPENIATION AND EMPLOYERS' LIABILITY EA. EACH ACCIDENT 1 ANY PROPRIETORIPARTNERIEXECUTNE - OFFICERIMEMBER EXCLUDED? EL DISEASE. EA ELPLDYEE ! K Yes. de,vl0e ~ _ E.L DISEASE -POLICY u f SPECIAL PROVISIONS below OTHER T-T DESCRIPTION OF WERATIONBILOCATIGNSNENr-LM=CLUSION1 ADDED BY ENODREEMENTIBPECIAL PROVISIONS General liability is provided for the above insured as Carpentry - reeideaLLal not exceeding 3 etories in beigbt (subject to deductible $230) 778-5603 Gatewood Homes 1600 Falmouth Rd Suite 25 Centerville, HA 02632 ACORO 25 Rwe40(0100.06 AM4 SHOULD ANT OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE TMEREOP. TIRE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMEO TO THE LEFT. BUT FAILURE TO 00 SO SHAD. RMPOSS NO OBLIGATION OR LMBItITY OF ANY KIND UPON THE AUTNORMED REPRESE WATT1 Nlchael Susco/KATHY VMP MMgpge SeNbeln, Inc (817013274LUS IDACORD Pegs 1 *12 APR-20-2006 THU 10:33 All R & K INSURANCE FAX N0, 508 991 5461 P. 02/03 CriR 3 CERTIFICATE v� #.I>�BiL1 i Y i�L'SUr'�N�.z ua/2o/z PRODUCER (508)994-9688 FAX (SO099� FLAGSHIP INSURANCE INC 414 COUNTY STREET NEW BEDFORD. MA 02740 -S461 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 POLIGIES BELOW. INSURERS AFFORDING COVERAGE NAiC A INSURED Frank Capra PO Box: 664 West Hyannisport, MA 02672 wsuRERA: Providence Mutual . 15040 INSURER B: OneHeacon 20621 INSURER C: INSURER O: INSURER E: Y THE POLICIES OF INSURANCE LISTED BROW HtnVE !iE ANY REOUIR£MEN7, TEEM OR CONDITION OF ANY CONT. MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLI POLICIES. AGGREGATE LIMITS SHOWY MAY HA',% BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD #KMCATED. N01WITMSTANDINI CT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCWSIONS AND CONDITIONS OF SUCH I tEDUCED BY PAID CLAIMS. 'RAVOI TYPE OF INSURANCE POULI NUMBER POLICY EFFECTNE POLICY EXPIRATION . S A G�ncRAL uAmJTY X =V-ERCM1OEL-P.ALUQIUTY Cl,Af f& MA ED DCCIIR C-1-POOS313103 12/13/200S 12/13/2005 Lsc"OCCURRENCE S 1.000.00 T -RENTED MED EXP (Any one pmun) S 50.00 S 15.000. PERSONAL S AOV INJURY S 1 000.00 GENERAL AGGREGATE f 2,000,00( GERLAWWSATEI.MT.APPI," PER POLICY M.ACT LOC PRODUCTS• COMPIOPADG ! 2,000,00( B ABTONOBILE UABIUTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NGN-OWNEOAUTOS CB1E63796 02/14/2006 02/14/2007 COMONW SPIGALDu� (to io w") f 1 000 Doc X 8000Y IN"y (Pe pww) = X BODLY MAJRY (Pe/AWeeM) f X PROPERTYOAM-AGE - (For omdeM S GARAGE LIABILITY ANYAUTO AUTO ONLY -EA ACCIDENT f OTHER THAN EA ACC AUTOONLY: AGO f S A EXCESSI MBREIJAUABfJTY OCCUR aCLA All MADE DEDUCTIBLE RETENTION S 000$0264 01 22/13/2005 01/13/2006 EACH OCCURRENCE S 2 000 0 AGGREGATE f 2.000 0O f S f WORK£R&COMPEN£ATSTIIMIS - EMPLDYEW L"lUTY ANY PROPRIETOIVPARTNERIEXECUTNE OFFICEJIAaMDER EXCLUDED? f ee. daeiri00 uleef SPECIAL PROVISKINS below WC Ji7ATIl• 07H• Et EACHACCEtENT i ELOISEASE-EAEMPLOVE f et.. DivEASE •POLICY LfAT I f OTNER DMPPTID10 OF DPiRATANtf rLOCAnONS/VEHICLES I EXCLUSIONS WOED BY ENDORSEMENT SPECIAL PROV18IONS Pcorlcf!'ATF LLAl nGR I CAMOFI I ATIYTN SHOULD ANY OF THE ABOVE O wrmEO POLICIES B£ CANCELLED BEFORE THE EXPIRATION GATE THEREOF, THE ISSUZIC INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFIGTE MOLDER NAMED TO THE LEFT. GATEM)ODD mu --BE IK. BUT FAILURE TO MAR. SUCH NOTICE &HALL BIPO&E NO OBUGATOM OR LIABILITY 1600 FALMOUTN ROAD, SUITE 25 OF ANY FOND UPON THE INSURER ITS AGENTS OR RE►RES&NTATTYES. AUTHORIZED ffjt2FA0TATfK CENTERYILLET MA 02601 ACORD 28 (2001Ri8) FAX: (506)776-S603 ` Im$TION 1958 , AACORD- CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) 02/16/06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling & O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency 222 West Main St. PO Box 1990 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis, MA 02601 INSURERS AFFORDING COVERAGE i NAIC # INSURED Assurance Construction, Inc. A/O Assurance Excavation, Inc. 550 Willow Street West Yarmouth, MA 02673 INSURERA. St Paul Travelers Insurance Company INSURER B: INSURER Q INSURER D: INSURER E: GUVL:KAUL5 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 INSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATEMFFE POLICY EXPIRATION DATEIMM/DDIM UNITS A GENERAL LIABILITY 16808387A9841ND05 08/01/05 08/01/06 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDPREMISES (Fa E300OOO MED EXP (Any one person) $5; OOO CLAIMS MADE O OCCUR PERSONAL &ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 52000000 POLICY PE O- CT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) E HIRED AUTOS BODILY INJURY NON -OWNED AUTOS (Per accident) $ PROPERTY DAMAGE E (Peraccident) GARAGE LIABILrfY - AUTO ONLY - EA ACCIDENT $ OTHERTHAN EA ACC S ANY AUTO $ AUTO ONLY: AGO EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE E AGGREGATE $ OCCUR CLAIMS MADE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC S7ATU- ER EMPLOYERS' LIABILITY E.L. EACH ACCIDENT S ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE S OFFICERIMEMBER EXCLUDED? If yes• describe under E.L. DISEASE - POLICY LIMIT I $ SPECIAL PROVISIONS below 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 I ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION IEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL I III_ 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 AUTHORIZED AI:UKU ZD (LUUT/Uti) 1 of 2 #41713 LS1 0 ACORD CORPORATION 1988 A -CORD CERTIFICATE OF LIABILITY INSURANCE i2i20/2005 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. INSURERA: COMMERCE ` INSURER B: - P.O BOX 2903 INSURER C: HYANNIS, MA 02601 t0 INSURER0. ' 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. MR irn naao FIN NC POLICY NUMBER POLICY EFFECTIVE DATE MM/DD POLICYEXPIRATION DATE MM/DD LIMITS GENERAL LIABILITY - EACH OCCURRENCE S i r 0 r 0 O COMMERCIAL GENERAL LIABILITY DAMAGE TO RFNTEU — PREMISES 'Ea a rsnae - Sir 000, 000 CLAIMS MADE OCCUR MED EXP(Any one person) S5r 000 PENDING 12/17/05 12/17/06 PERSONAL& ADV INJURY $1, 00, 000 GENERAL AGGREGATE S 2 r 0 0 0 r 000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $1 r 0 0 0, 0 0 0 POLICY E T LOC . - AUTOMOBILELIABILITY ANYAUTO - COMBINED SINGLE LIMIT (Eaacciderd) - $ - . ._._.. BODILYINJURY � (Per person) $ ALLOWNEDAUTOS SCHEDULED AUTOS .. :. BOOILYINJURY (Peraccidenp $ HIRED AUTOS NON-OWNEDAUTOS PROPERTY DAMAGE (Peraccident) S - GARAGE LIABILITY AUTO ONLY. EA ACCIDENT S OTHER THAN EAACC $ ANYAUTO S AUTOONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMSMADE AGGREGATE 3 S • $ DEDUCTIBLE S RETENTION $ WORKERS COMPENSATIONAND IA EMPLOYERS' LIABILITY WCSTATU- OTH- RY M ITS ER Wf PRWRJEro ARTNERu EctmvE E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S �BER E%QUOEDT Iyes,describeunder SPECIAL PROVISIONS below f El. DISEASE -POLICY LIMB S OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS /\IV IIVLV LI\ VMI\VCLL!\IIVI\ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION GATERWOOD HOMES DATE THEREOF, THE ISSUING IN URR NAMED IL ER WILL ENDEAVOR TO MA _ DAYS WRITTEN 1600 FALMOUTH ROAD IJLL p 25 NOTICE TO THE CERTIFI ATE H ETO THE LEFT, BUT FAILURE TO DO 50 SHALL CENTERVILLE, MA 02 632 IMPOSE NO OBLIGATIO OR U ILITY OF ANY KI D UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRES TIVE ACORD25(2001108) OACORD CORPORATION 1988 TOWN OF YARMOUTH ��C,L 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS O26644451 GAS Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365 PLUMBING SIGNS BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at CA-v-1,D -S4- QSt��C,fOlJ/"C� Work A ess r is to be disposed of at the following location: 1 V�M� oo .i�//I� �Qt•.L'rl l _ Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. All //,A e /� Signature of Applicant Date Permit No. BOARB.OE., BUILDING REGULATIONS Eicense CONSTRUGTIONSUPERMSOR: .. z NumbejE= Q1Z4ZU . a Birtli3aafe _ 4Q gemfg2©06, Tr: no:- 25$26 EPANK.G 4(YCOPPER CEUTEPWILLE, ruTA 0263� Commiss // :i ' a 00-35;00actenclosed .space E (MGLC_ttZS.S0L) i tA-MasopfKonlg -; tG':= 4 �Z Farmiyiiomes Failure ta•-possessaa6rce tkition ctthe-. t : Messac4iusetttS6te Baldnq-Code. ''- is, rauserforreviceation:bF1hislcense. ^j r DIG SAFE:CALLCENTER: (888) 344-7133 r L3( @P��7�® TOWN OF YARMOUTH r, HEALTH DEPARTMENT 200 HEM^,+ ?' Qr-r.,, PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: /21 ST Map No.: Lot No.:79 Proposed Improvement: 65TRrY Af�o�DRBtF Applicant:.�,.9L,/x Z4AA4 7��i/�� /�Lislc'� Tel. No.:Sa� 778 y66�9 Address: �cWii c/G4�7Date Filed: **Ifyou would like e-mail notification ofsign off, please provide e-mail address: Owner Name: z Owner Address: Old f �is9D✓Ti/l�9 �c�VTb)Z✓/UGC/!/�O?63L Owner Tel. No.: %7,F RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. Please submit four (4) copies of plans, to include: (L) Site Plan showing existing buildings, water line location, and septic system location; (2.) Floor plan labeling ALL rooms within building (all existing and proposed) — Note: Floor plans not required for decks, sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED BY: A2 0K26V DATE: �;-w PLEASE NOTE ..,✓lr,Y�—Nc�f. Nr3 So$ 2go -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 / P sr- Map #: Lot #: '82— 9/ Proposed Improvement: Applicant: Vt A-,L^ G &-S A-rGA M P S r— /6OD FA1t-NM01J7-0 P-b Address: Tel. #: so? 7�8 - 9 c 6 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 DM5 N: g Sir PLEASE NOTE: COMMENTS: Signature Of Applicant Date: MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2.01 Release 2 Checked by/Date CITY: Yarmouth STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 HEATING SYSTEM TYPE: DATE: 4-16-2004 or 2 Family, Detached Other (Non -Electric Resistance) DATE OF PLANS: 04/16/04 PROJECT INFORMATION: Mill Pond Village Camp Street Yarmouth, MA .02673 COMPANY INFORMATION: Northside Design Assoc. 141 Main Street Yarmouth Port, MA. 02675 COMPLIANCE: PASSES HOUSE MODEL: MALLARD Required UA = 245 Your Home = 140 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 865 30.0 30.0 15 WALLS: Wood Frame, 160 O.C. 1631 15.0 15.0 72 GLAZING: Windows or Doors 109 0.340 37 GLAZING: Windows or Doors 40 0.340 14 DOORS 20 0.086 2 --------------------------------------------------------- ---------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date Massachusetts Energy Code MAScheck Software Version 2.01 Release 2 DATE: 4-16-2004 Bldg Dept Use I CEILINGS: 1. R-30 + R-30 Comments/Location WALLS: 1. Wood Frame, 160 O.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/Location 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. �.9 TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-06-469 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Unit 86 Owner's Name: Villages @ Camp Street, LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $0.00 Payment Type: Check ChkNo.: 0 Net Owed: $0.00 Application Date: 5/5/2006 Issue Date: Expiration Date Comments: Map/Lot: 044.21.1.0 new construction - Affordable:' ZONING APPROVED REVIEWED BY: 1. WATER DEPARTMENT: 2. ENGINEERING DEPARTMENT: 3. CONSERVATION: 4. HEALTH DEPARTMENT: 5. BUILDING DEPARTMENT: 6. FIRE DEPARTMENT: ( i COMMENTS: DATE: DATE: DATE: DATE: DATE: DATE: PLEASE NOTE N/A: N/A: N/A: N/A: N/A: N/A: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: Date Printed: 5/8/2006 MPD4540 MPD4035 Standard' • 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 Oppons see • Choice of standing pilot (works in a Fower failure) or pilotless electronic ntermittent) 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 Uent (rigid) or Secure Flex Iflexble) 4.5' ianer/7.5' outer coaxial venting system, and include a 20-year limited warranty. - Note: Due to Lennox' ongoing commitment to quality, all^specifications, ratings and dimensions are subject to editions, such as elevation, wind, vent configu- nice of fuel will affect the overall appearance Hersey (J20006711) Warnock Hercey CM �zn uS (00J�4' rft�nu MPD3530 MPD3328 The first two model number digits indicate frame width, the last two digits indicate glass width. All are A.F.U.E.-rated high efficiency vented gas fireplace heaters, certified under ANSI Z21.88 and CSA 2.33-M99. DIMENSIONS (Rear vent model shown) 3328 MODELS (This model comes as a top or rear vent only) Front Face 35,40 & 45 MODELS op These models come with a top and rear vent) o I rH D I D B e^ E � ( Front FIREPLACE & FRAMING DIMENSIONS Right Side 3328 331/8 301/s 17 271 t 331/8 195/s 217 103/4 3�� 3 U LiJIIIIIII 13 3530 351/8 32Y8 19 291`2 351/8 2111A6 2478 12%6 351/4 351/4 16 4035 401/8 371/s 24 3411/2 401/8 2611A6 29h 14% 401/4 401/4 16 4540 401/8 371/8 24 39% 451/8 2611A6 343t 17%6 451/4 401/4 16 332ST NG 17,500 45 ` 64 62 332ST LP 17,500 49 66 64 3328R NG 17 500 53 63 61 3328R LP 17 500 55 66 64 3530 NG 20,000 53 64 62 3530 LP 20,000 55 62 60 4035 NG 27,000 59 69 67 4035 LP 27,000 60 69 67 4540 NG 29,000 59 69 67 4540 LP 29,000 59 69 67 'Intermittent ignition systems Look for the EnerGulde Gas Fireplace Energy Efficiency Rating In this brochure TYPICAL ROOM APPLICATIONS MPD3328 MPD3530 MPD4035 33' fireplace w/opt. (lush face 3S' fireplace w/brusbed stainless 40' fireplace w/polisbed brass w 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-,rnrJ� Oho-3 PRODUCT SPECIFICATIONS GMS9/GCS9 SERIES 93% AFUE Multi -Position, SingleoStage/Multi-Speed Gas Furnace Heating Capacity: 46,000-115,000 BTUH tIM ITkD �yx�Vf4afnAN4ER:� WA RRAN TY� �i odCar110amal ITI Vj Ink (D ENERGY $Tqq 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 • Aluminized -steel inshot bumers • 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 heating/cooling application • All models comply with California NOx Standards • Suitable for_direct vent (2-pipe) or non -direct vent (I -pipe) applications 0101012010 Air Conditioning & Heating The GMS9/GCS9 single -stage, 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 (EFRO1) • Horizontal Concentric Vent Kit (HCVK) • Vertical Concentric Vent Kit (VCVK) • Internal Filter Retention Kit—upflow, horizontal (RF000180) • Internal Filter wRetention T Kit—donflow (RF000181) 40 • Thermostats Blower Motors (CHT18-60, CH70TG, CHSATG, H20TWR) SS•377D www.goodmanmfg.com 6/04 I LOT 79 LOT 78 !� LOT 80 N84'19'0.3_'E �8,20� —1 24.69 N AFFORDABLE Op- S77y , I.LOT 871 LOT 86 S 62 3,862t S.F. ' 9.97 l 3' cD i19.5 ./ t0i W LOT 85 1�/ N :2.6.3 2= / I PROPOSED J 0 OSPREY LLJ ' S 3' ,0 611. a N I CS - 24.5 0 cO Q, Ci GW i� = 14 W>- ? 0 .0D co of f SFO fT Z' ' 19.5' �� a y z I 27' 4� GW a 14S,0 i E 1 PROPOS D a` A rf�p El QED WATER SER CE 8 32 ID VA, c> ° M L=17.43- 45.72, 5 2006 3 0 s R=278.7C� 278.7 E I ;., M �J 0 E PROPOSED L. � 4" SEWER LATERAL SEE SLEEVING [ M NOTE BELOW 8" SDR-35 MAY 0 2 2006 I OP SFWCo ...... 145 L.F. NOTE:\` MM SEWER LATERAL SHALL BE / ' SLEEVED IN ACCORDANCE WORK MUST I FORM TO ALL TOWN H OF WITH TITLE V IF WITHIN, BYLAWS ULATIOALS ono .cBAEL LOFT. OF WATER MAIN. GRAPHIC SCALOM �" vATER DEPT / t>A s� ci TER L ( IN FEET ) I inch = 20 ft 0 140TI0E -wr—.ate Unleas and until sucb time as the original (red) stamp cf lhn respansit,!^ Proiesshrd Engineer, cr Professional Land Surveyor cpp�-lrn m th e lian: (Al no p•,.: ;n or persons, in•.Du-iing any muni,.ipgl or „�h, rri�y rely •:pon !h�+ ;nf` malion eonta'.ned htre,r; n-.d (0) lh i. pl•jn ramoina the yrnperty of Holmes Fa 61crrat- , inc, PLOT PLAN holmes and mcgrath, inc. OF bl,gs9 OF LOT 86 PREPARED FOR civil engineers and land surveyors rb''P �o' 0, d TIMOTHYM. R MILL POND VILLAGE 362 gifford street S NTOS NO. 45076 ti IN falmouth, ma. 02540 d CIVIL o �4: YARMOUTH, MA JOB NO: 201197 DRAWN: LMC P�F FGfSTEP� SCALE: 1 "=20' DATE: 3-24-05 DWG. NO.: A2554 CHECKED: 7� L� 0 Commonwealth of Massachusetts ° Usc °i�Y L L Permit No. _ E `-6� r77 epartment of Fire Services Ocaipancy and Fee Checked 0. BOA D FIRE PREVENTION REGULATIONS . 11/991 ve bunk NQ�122ffl APPL C TION FOR PERMIT TO PERFORM ELECTRICAL WORK waft be perfonaed in acoadawe withthe Massachusetts Ecadcal Code (MC), 527 12.00 Date: . Z 1 2- D ��)fl TYPEALZWFZ7RMATTONJ ey. 1ty or Town of: YARMOUrx To the Inspector ofWires: _ By this application the undersigned gives notice of his or her intend. to perform the electrical work described below Location (Street & Number) MILL POND VIISAGE., 121 Cmp St Bldg # Owner or Tenant Gatewood Hanes/ Jeff Sollows TelephoneNo.508-7789669 Owner's Address .1600 Fa7moutti Rd. r 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 / Volta Overhead ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ Na of Meters Undgrd ❑ Na of Meters NumberofFeeders and Ampacity Location and Nature of Proposed Electrical Work Fise Alarm System (low Voltage control panel) with h. ckim h t ry 'centrally monitored - . n____�.-__. _f.t_l JJ,.. .. r..J.Je ,Fu vvnve?7•hv the TrzmeerfnrnlIi7i>ve Na of Recessed Fixtures No. of Cul�usp. (Paddle) Faros o. o oral Transformers KVA Na of Lighting Outlets No. of Hot Tubs Generators KVA of Lighting Fixtures 2ffNo. Swimming Pool grzid e •❑ d. BatteryUni7-1 No. of Em�ts�cY g No. of Receptacle Outlets No. of OR Burners F= AT •ARMC No. of Zones —1— Na of Switches No. of Gas Burners No-55TDetection.an 7 Wtiating Devices Na of Ranges al Na of Air Cond. Tons No. of Alerting Devices of Waste Disposers t �p Hcallo. Totals: , um er, ors Detection/Alerting Devices 7 No. of Dishwashers S ace/Area Heatin KW p g Local unncip• [ Other ., No. ofDryers Heating Appliances KW yyConnection Security of Devices orE ivalent No. o afar KW Heaters o. o o. o . Signs Ballasts Data Wiring: No. of Devices or E uivalent No. H •drvmassa Bathtubs y ge No. of Motors Total HP ommunrcations usng No. of Devices or uivalent OTBEIL• At(aen aaa+ganac awa+r� geatrsa,, w as .syr.rw ey.... w.,,.r..wr y .. u.a. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" .coverage or its substantial equivalent The undersigned certifies that such coverage is in force, and has exhibited proof of same tothe permit issuing office. CH MONE: INSURANCE ® BOND p 'OTOM O (Sly) (EViration to Estimated value of Beearicai Work $750.00 (When required by municipal policy.) Work to Start: Inspections tobe requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete FIRM NAME: Baltic Security, Inc LIC. NO.: 117�_ Licensee: Jonas R Bielkevicius Signature —�" LIC.No.: 499D (Ifapphaible, otter "a mpt" in the licenseSaridw�c . =k .litre 02563 Bus. TeL No: 508-833-0996 Addr{ss: PO Box .) 609 , Alt Tel. No.: 508508��%6-3347 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 PERMIT FEE: $ 40 ,'00. Signature. Telephone No. APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 TOWN OF YARMOUTH -(OFFICE USE ONLY) By Fee: $��s PERMIT NO.E"0%1 It - (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 29�06 To the Inspector of Wires: By this application the undersigned gives notice of his or her inten on to perform the electrical \ work described below. %Location (Street & Numbed coo ! 2 / &tr,� S7 Voi, 7-� 1o OwnerorTenant 40/vytes Telephone No.sO�'77 Owner's Address 16? 60 G,9-Lm ov $lf Rolf-ib 57-6- 7Z 9 &N Il ls1$ 07-6 3 L i Is this permit in conjunction with a building permit? 'es 0 ate Box)30 i `-� Purpose of Building �jn11-1 A4-I+I 1-f Utility Authorization No. -1 Existing Service Amps / Volts Overhead gr No. of Meters New Service 100 Amps / Zo / I q6 Volts Overhead Undgrd5r--�N o. of Meters_ Number of Feeders and Ampacity. Location and Nature of Proposed electrical Work: / 00.-,M,0 ✓Nde2l c)r W//W b No. of I I Total 1.-Sus . Paddle Fans Transformers t G DEPT. ny: No. of Li htin Outlets No. of Hot Tubs Generators A ove n- No. of Emergency Lighting No. of Lighting Fixtures SwimmingPool md. md. BatteryUnits No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones o. o etecnon an No. of Switches No. of Gas Burners Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices eat Pump um er — — Tons K_W No. of Self -Contained No. of Waste Disposers Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Municipal Other Local Connection No. of Dryers Heating Appliances KW Secutity Systems: No. of Devices or ui valent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent Telecommunications Wiring: No. Hydromassage Bathtubs No. of Motors Total HP No. of Devices or E uivalent No. of Recessed Fixtures No. of Cei lj Attach additional detail tf 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 force, and has exhibited proof of same to t permit issuing office. v CHECK ONE: INSURANCE BOND OTHERC] (Specify:) (Expiration Date) Estimated Value of lectrical Work: (When required by municipal policy.) Work to Start: Zh 0& Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under th�ep ain and penalties of perry, that the information on this application is true and complete. AIRM NAME: W, 20mac) 4 Li✓O; LIC. NO. / 7 -Z censee: /Nr�t'>L.¢�L G57f&—gf _Signature LIC.NO.�f(vS3 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 36 Z— lfl9V Address- 1 4-T/fW2O S G �t/, .1311'a �-S7?9-?&6 r2[� Alt. Tel. No.:�1t/-/�Srf �O// 2- OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the [ability 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 Telephone [Rev. 04/00] WPS - Permit 4' • • • WPS - Permit Work Order Information Utility Auth/WO #: 01543074 Date: 09/15/2006 Company BEA LORD Rep: Report By: YAR 121 CAMP ST U86 VILLAGES AT CAMP ST LLC Status: ACTIVE Service: NEW Type: RES Nature of Work: CONNECT 100A 120/240V UG IN HH150B Service Information: There is no Service Information. Permit Information Page 1 of 1 Permit #: E07-214 Meters: 1 Reseal (Y/N): Y Date: 09/20/2006 Inspector: W10060 Description: Search,' DetailContacts, NSTA..RR Home WPS Logon WPS Help Comments. WO Request WPS News I�WI 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.comlapps/wpslwpspermit.cfm?Page=Permit&Unique= f ts_'2006-0... 9/20/2006 Ix OF yq MA HEESE m APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 TOWN OF YARMOUTH By. PERMIT NO. (OFFICE USE ONLY) (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 do work described below. c Location (Street & n er v -�� GQ"/ IS Owner or Tenant LS ' Owner's Address `l ../ L Is this permit in conjun&-Iy�� with a bu ilding permit?.Ir Yes ONo (Check Appropriate 1 Purpose of Building Utility Authorization No. Existing Service Amps / Volts OverheadQ Undgrd New Service I a1z) Amps Volts OverheadD Number of Feeders and Ampacity lcc-D t� Location and Nature of Proposed electrical Work: LM perform the electrical C E I V "«"ry,X '"Um nro a wurvea oy ine ins ecror oj wires No. of Tota No. of Recessed Fixtures No. of Ceil.-Sus . Paddle Fans Transformers KVA No. of Li Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above In- SwimmingPool md. ❑ md. No. of Emergency Lighting BatteryUnits No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. o Detection an Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Num er Tons K Totals: — — No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area HeariKW Local Q Municipal 0 Connectiong n Other No. of Dryers rY Heating Appliances KW Secutity Systems: No. of Devices Equilivalent No. of Water Heaters KW No. of No. of Signs Ballasts or Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring No. of Devices or E uivalent Attach additional detail zf 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 force, and has exhibited proof of sametothe permit issuing office. CHECK ONE: INSURANCR OND C] OTHERC3 (Specify:) (Expnanon Dale) Estimated Value EI trical Work: (When required by municipal policy.) Work to Start: Inspe ions to be requested in accordance with MEC Rule 10, and upon completion. I certify, underlth ` a and pena!eof p4uzy, that the information on this a plication is true and co let (If the OWNER'S INSURAlCE WAIVER: I am aware that the below, I hereby waive this requirement. I am the (check Owner/Agent LIC. NO. e LIC. NO. r Bus. Tel. No.: Alt. TelNo.: �s not have the liability insurance coverage normally required by law. By my signature 0 owner's agent. 0 Signature [Rev. 04/00] Telephone APPLICATION FOR PERMIT TO DO PLUMBING TOWN OF YARMOUTH (OFFICE USE ONLY) WITACNEE - B Z�-: E EIVED y Fee:`,Q rJ12 AUG 12 �� PERMIT NO. / '�O�%� Q/ BUILDING DEPT. Date 20_ By: Building / Owner's C3t t' CK% S AT: Location (_! I Mi —% Name l.ac Z Type of Occupancy / New Renovation ❑ Replacement ❑ Plans Submitted Yes ❑ No ❑ Z N z I'e lY (►In y N Z N Q Ix y O z F z z p O y LU a LU OJ N U) W y N=VLU) ~ = V W Y y LL Z Z F- �I/{ O Q Luz N G J 2 d 0. Q 2' O LL W W M Q W y I V' Q H> H O y y N 2 O p to 2 Z W Lu O U 2 7/ ` `1 J m N p G J 3 S H rn LL C9 7 G Q e: ca O SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Check One: Installing Company Name 1106 fil'f2% � T ❑ Corp. Address �, / �A/ % I7(jN �f � � ❑ P rship 1 ��Q� Firm/Company irm/Company Business Telephone —7% � / 5-5 "%Name of Licensed Plumber INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes Z 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. 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 Lic4 Type: Master ❑ 2S/ 9 % License Number Journeyman G TOWN OF YARMOUTH OADT j5"L APPLICATION FOR PERMIT TO DO GASFITTING Fee: PERMIT NO. Building 4wl xAT: Location // New ❑ Renovation ❑ Replacement ❑ Plan!, S ed Yes ❑ No ❑ (OFFICE USE ONLY) Date Owner's T, Type of Occupancy / 1 Vl oo N ¢ Cn w\ �% .\ to to y V Z ¢ _ y ¢ ,Q\v \N =� cc ¢ W O Q} C1 Z Z 0i m FQWNmW Lu ¢ W W W QQQ ¢ W WW O W- Lu f., x¢ ¢ W Z > ¢ W Z W W Q O> O Wj W JQ W SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Installing Company Name Address Business Telephone Name of Licensed Plumber or Gasfitter INSURANCE COVERAGE: Check One: ❑ Corp. ❑ Pa ship — Firm/Company _ Check To i have a current liability insurance policy or its substantial equivalent. Yes ZI 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. Check One: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and Information I have submitted Signature of Lic nsed (or entered) in above application are true and accurate to the best of Plumber or Gasfitter 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 License Number Ty TYPE LICENSE- Chapter 142 of the General Laws. 'U Gasfitter Journeyman TOWN OF 451, Building AT. Location New [Y Plans Submitted Novo ��Z3 UILDING DEPT. Renovation ❑ Yes ❑ No Ik APPUCA71ON FOR PERMIT TO DO GASFITTING (OFFICE USE ONLY) By. Fee: $ -- PERMIT NO. — ���✓�/ Replacement ❑ owner, Namelic Type of Occupancy_ 52M / l9 to Y W W W Cr O V Nt y tj m t J a m N W ~ pp= W u Fa- W W ui ui Q - W>m Cc N Z 0 FW W J y Ra = O O S O V¢> C F SUB•BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) �� Check One: Installing Company Name -�UU w 4,,, ,T& 'T) ❑ Corp. Address __�_O G f }A _S7_ ❑ P 9 Partnership 1ilL t,s_. A Q2 ( EI Firm/Company— — —,— Business Telephone 5�cfla 7 Name of Licensed Plumber of r -- a O r-i INSURANCE COVERAGE: Check One I have a current liability insurance policy or its substantial equivalent. Yes ETNo ❑ If you have checked yes, please indicate t e type of coverage by checking the appropriate box. A liability insurance policy Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check One: — — --- Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and Information 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 Qnah jqk-,l 22...Ap-A Signature o Ucensed Plumber or Gasfitter 2r s t0% License Number TVOQ I IPCMCF. . LOT 79 LOT 78 N8419'03"E LOT 80 J .I LOT 86 �E N izo 011. CD 19.5 w .n I 59 97: bo LOT 85 2. 6.2 12.5't� tEXISTING o FOUNDATION aW' 0 0 I� M _ .00 �^ o z N EXISTING ' 15. 1 FOUNDAT 26.6'— ?e 4 3.3' LOT 87 N ' L 17.43,E L=45.72' I tv / R=278.70 R= _ r � �9.3s • Lei' 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 60040 G :;� .4 DATE REGISTEREEY PROFESSIONAL LAND SURVEYOR 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 (8) this plan remains the property of Holmes dt McGrath, Inc I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE LOT AS SHOWN, AND THAT ITS LOCATION CONFORMS TO THE MINIMUM SETBACK REQUIREMENTS OF THE 40�� SPECIAL PERMIT. DATE REGISTERED PROFE IONAL LAND SURVEYOR GRAPHIC SCALE ( IN FEET ) 1 inch = 20 fL AS —BUILT PLAN holmes and mcgrath, inc. ��I" of M OF LOT 86 civil engineers and land surveyors o`'� rrtetlgE+y PREPARED FOR 362 gifford street t ELMILL POND VILLAGE s M�RATH y IN falmouth, ma. 02540 o No.289m sr YARMOUTH, MA JOB NO: 201197 DRAWN: LMC SCALE: 1"=20' DATE: 6-19-06 1 DWG. NO.: A2554A CHECKED- LOT 79 LOT 78 LOT 80 N84'19'03"E . �r— -8.200 —1 24.69 t— AFFORDABLE ��I�� S77 LOT 871 N LOT 86 S s'2` 3,862f S.F. I 9.97• 3' cD -19.5 to LOT 85 0 Iz 0 '0 iC5 k (A •OD E JSED -\ WATER SER) I wA,( �� I .L=17.43 R=278.7 PROPOSED 4" SEWER LATERAL PROPOSED HOUSE FF OSPREY ;cu = 24.5 w GW = 14 � Os IN Q�l� C:) .� i 19.5' Q� I a a /, 3 1=445.72' =2 8 o "" SDR-35 0 ��9 SEE SLEEVING NOTE BELOW 45 L.F. NOTE: ME SEWER LATERAL SHALL BE SLEEVED IN ACCORDANCE WITH TITLE V IF WITHIN \NORK MUST C R TO ALL 700 1OFT. OF WATER MAIN. sYi tiW AND u 20 10 0 GRAPHIC SCALE DATE YARMOUTH WATER DEFT 20 60 T�T( T(-I- Uniess end anti! „ch time ai the oriyincl (red) stamp cf tba resronsible Profeusion^_I Enginenr, or Land Surveyor opp- li s on this aion: (A) no p . eon or persons any munl. jpgj of o•h.. n. ul c,ay rely :par, th, canton 1 here-;; :,nn (9) thi.i plan rentcdns th, prcprrty of Holmes is He rutn, Av, PROP GOVOF D RET w 25.0 i �4 ( IN FEET ) 1 inch = 20 ft. PLOT PLAN OF LOT 86 PREPARED FOR MILL POND VILLAGE IN YARMOUTH, MA SCALE: 1 "=20' DATE: 3-24— 5 2006 11011111M, Y 0 2 2006 holmes and mcgrath, inc. `� °` - s, civil engineers and land surveyor sF rlr.,oTHYnC,'^�, 362 gifford street h� TCS 45078 falmouth, ma. 02540 �� q 9 clvlL JOB NO: 201197 DRAWN: LMC DWG. NO.: A2554 CHECKED: -fm A of r TOWN OF YARMOUTH. Building Department BUILDING �?} (508) 398-2231 ext.261 PERMIT NO 8-06-ia92_ PERMIT ISSUE DATE ; _ 5/26/2006 _ ; PROPOSED USE ; APPLICANT _Frank Capra - JOB WEATHER CARD _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ PERMIT TO New Construction ' AT (LOCATION)' 100121CAMP ST Unit Be a ZONING DISTRICT R_2 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 1044.21A.C86 BUILDING IS TO BE: CONST TYPE 5-A USE GROUP R-4 LOT SIZE new construction - Affordable: 3 baths, 2 bedrooms, 1 familyroom/diningroom, 1 kitchen, 1 livingroom as per REMARKS plans dated 05116/06. CONTRACTOR LICENSE 012430 (Capra, Frank 1600 Falmouth Road #25 AREA (SO FT) EST COST ($ $154,080.00 PERMIT FEE ($) $0.00 Centerville MA 02632 5087789669 OWNER Villages ® Camp Street, LLC UILDING DEPT BY ADDRESS 11600 Falmouth Road If 25 r - Centerville MA 02632 (� PHONE 5087789669 Certificate Issue Date - —_-" 05�ao % CERTIFICATE of OCCUPANCY Departmental Approval for Certificate of Occupancy and Compliance Inspector Dates . Permit Number Approvep By Remarks IBM ®©Al FW4 1/ e To be filled in by each division indicated hereon upon completion of its final inspection.