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HomeMy WebLinkAbout121 Camp St #088 Building Permitsr L I OF yq �G YA"ACHEESE APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK Q }� To the Inspector of Wires: By this work described below. Location (Street & N ber Owner or Tenant Owner's Address (OFFICE USE ONLY) .B _ y EOF YARMOUTH ^� �II1 Fee: $ c c CEP 2 0 2006�� PERMIT NO. Date: 2U I &D tscoko gives notice of his or her inte ion to pe form the electrical Is this permit in conju ction with a building permit?,2"Yes QNo Purpose of Building_ lee I& L. Utility Existing Service Amps / Volts Overhead New Service NtRED Amps t2$D Volts Overhead❑ Number of Feeders and Ampacity. Location and Nature of Proposed electrical Work: (Check Appropriate Box) Authorization No. Undgrd C] No. of Meters Undgrd 93'� No. of Meters C.'mmnletinn nfthe fnIhminv tahle may he waived by the hunector of Wires No. of Recessed Fixtures No. of Ceil: Sus . Paddle Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above In- SwimmingPool md. rnd. No. of Emergency Lighting Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. ot Detection an Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Num er — — Tons — — — No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Municipal Local Connection Other No. of D Dryers ry Heating Appliances KW g PP Security Syystems: No. of Devices or E ui valent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. H dromassa a Bathtubs y g No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent 01— Attach additional detail if 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 th permit issuing office. CHECK ONE: INSURANCE BOND C] OTHERC] (Specify:) stimated Work to S I certify, r (If applicabje(gtnr "eVeqjijft"lrin the (Expiration Date) (When required by municipal policy.) to be requested in accordance with MEC Rule 10, and upon completion. v. that the in im i n n thi agglication is true and convilete. OWNER'S INSURANCE WAIVER: I am aware that thk Licet below, I hereby waive this requirement. I am the (check one) Owner/Agent Signature [Rev.04/00] Tow _ • `r S E does not have the liability insurance coverage normally required by law. By my signature owner's agent. ❑ Telephone N 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 YARMO,UTH NEW ,? OCT 1 8 Z006 mil; (PLEASE PRINT IN INK OR To the Inspector of Wires: By work described below. Location (Street & (OFFICE USE ONLY) By Fee: $ PERMIT NO. O7 — 407 . Date: gives notice of his or her intention to perform the electrical Owner or Tenant ^��t ACT a2— Telephone No. 72� 59 Owner's Address/��/ Is this permit in conjunction with a'buuillding permit? L� Yes [7) No (Check Appropriate Box),,, - Purpose of Building ��,77t �✓�eZ1k Utility Authorization No. Existing Service 4-31 Amps / Volts OverheadO Undgrd C1 / No. of Meters New Service /D D Amps 2 O:�f /�G Volts Overhead Undgrd Lam' No. of Meters Number of Feeders and Ampacity 21e�-5 f%'; p10X Location and Nature of Proposed lectrical mnv No. of Recessed Fixtures No. of Ceil.-Sus . Paddle Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above In SwimmingPool md. ❑ rnd. No. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. ot Detection an Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: um er — — Tons — — K — — No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Municipal Local Connection Other No. of Dryers Heating Appliances KW Secutity Systems: No. of Devices or E ui valent No. of Water Heaters KW No. of No. of Signs Ballasts 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 if 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 "compl ed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to a pemtit issuing office. }' ? CHECK ONE: INSURANCE BOND OTHER (Specify:) (Specify:) (/%�/��� ��� `1 p (Expiration Date) Estimated Value of Electrical Work: (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 pajils and penalties o perjury, that the information on this application is true and complete.!— NAME: r c /J LIC. NO. /` ?J 3� S censee: Signature LIC. NO. (If applicable, enter.�axempt" in the licyse�tumj�er/line.) Bus. Tel. No.: Address: f yl t: fi r!� d,N_ e Lt t` /' Co `w Alt. Tel. No.: 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/Agent Signature [Rev. 04/00] owner's agent. Telephone No. WPS - Permit Page 1 of 1 iW-.NST7M • WPS - Permit Work Order Information Utility Auth/WO #: 01543084 Date: 09/15/2006 Company BEA LORD Rep: ReportBy: YAR 121 CAMP ST U88 VILLAGES AT CAMP ST LLC Status: ACTIVE Service: NEW Type: RES Nature of Work: CONNECT 100A 120/240V UG IN HH190C Service Information: There is no Service Information. Permit Information Permit #: E07-0000 Meters: 1 Reseal (Y/N): Y Date: 10/18/2006 Inspector: W10060 Description: Search I E Detail Contacts NST_AR_Home WPS LQ90nW..PS Help Comments WO._Request WPS.News 1h (aLin F op 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.com/apps/wps/wpspermit.cfm?Page=Permit&Unique= { ts_'2006-... 10/18/2006 • Official Use Only Commonwealth of Massachusetts E —61, 73 Z • permit No. Department of Fire Services O=payandFeeChecked$yo,oCJ BOARD OF FIRE PREVENTION REGULATIONS . il/99.1 veblank ` APPLICATION FOR PERMIT TO PERFORM ELECTRICAL ��Ty All w0&to be performed in accvrd=ce widLthe Msssarhuscus Fledrical code (MEC), 527 C MR O U y (PLEASEPRINTLV MKORY7TEALLINFORII-1AT701V Date: City or Town of: YAPM U.rx To the Inspector of W • . By this application the undersigned eves notice of his or her intention to pen`orm tFie electrical wo cubed below�— Location (Street & Number) MML 'POND Vll r 121 C� St OwnerorTenant Gatewcod Homes/ Jeff Sollows Telephone No.508-7789669 Owner's Address .1600 Falmouth Rd., Suite 25, Centerville, Ma. 02632 is this permit in conjunction with a building permit? Yes X❑ No ❑ (Cheep Appropriate Box) Purpose of Building single family residence Utility Authorization No. Existing Service Amps / volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / volts Overhead ❑ Undgrd ❑ Na of Meters Number of Feeders and Ampacity Location and Nature ofPruposed Electrical Work Fire Alarm System (low voltage control panel) �. -._]. _�.r._� tt�a.......1.1........F..:nn;o.?7•hvthRTnmorfi�rn�r�ixt o. ° otal No. of Recessed Firtures No. of Cerl-susp. ( addle) Fans Transformers KVA Na of Lighting Outlets No. of Hot Tubs KVA No. of Lighting Fixtures Swimming Pool Move a . ❑ d. o. o enc Bette Units y g No. of Receptacle Outlets No. of Oil Burners FIRRALARrdS No. of Zones —1—' Na of Switches No. of Cass Burners o. of Detection.an 7 IniHatin Devices No. of Ranges No. of Air Coud. Tons No. of Alerting Devices No. of Waste Disposers Tot�alsP um er ins Dete ction/Aler nnDevices 7 No. ofDishwashets Space/Area KW Local 0 Conntion Other No. of Dryers .. Heating Appliances KW security pystems: No. of Devices brE ivalent No. of Water KW Heaters o. o o• o . Si s Ballasts Data Wirin g. No. of lfeviees orE uivalent=ecoi. No. H idrumassa a Bathtubs y g No. of Motors Total HP No. of eViceons g: No. of DevicesorE uivaleat OTHER: iYwv.Y .... .>.. ....y ... ..yr. Jx— ter— ..�.. .... INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" .coverage or its substantial equivalent The undersigned certifies that such coverage is in force, and has exhibited proof of same to.the permit issuing office. CREM ONE: INSURANCE [2 BOND- E] 01HER O (Spar•) _ (Eiqiiin Estimated value of Electrical Woda $750. 00 (When required by municipal policy.) Work to Start Inspections to. be requested in accordance with MEC Rifle 10, and upon completion. rcer*, under thepains andpenalties ofpertury, that the information on this application is true and compIde FIRK NAMME: Baltic Security, Inc LIC. NO.: 117T C Licensee: Jonas R Bielkevicius Signature LIC. NO.: 499D (jjapp11xb1e aster 'exempt" in the Itcense.numke .li* , Bus. Tel. No:�5 8-8 , �33-0996 Addrt_ts: ' PO -Box .k609. :,9a.. .t . 02563 Alt. TeL No.. 508-776-3347 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 OwnedAgeat PERM=' FEE: $ 40.'00. Signature. Telephone No. Page 1 of 1 is Elliott, Ken From: Brandolini, Jim Sent: Friday, September 14, 2007 1:14 PM To: Bates, Kenneth; Cipro, Linda; DeFreitas, Peter, Elliott, Ken; Spallina, Jane; Stone, Bill Cc: Murphy, Bruce; Sherman, C Randall;'jspalt@verizon.net' Subject: FW: Inspection request for unit #88 Since it appears I am receiving good cooperation with this principal owner, I will suspend the hold on inspections on a unit by unit basis. Therefore, Unit 88 may be scheduled for final inspection when it is ready. Mr. Splat should call for that. Jim From: jim Spalt [mailto:jspalt@verizon.net] Sent: Friday, September 14, 2007 10:27 AM To: Brandolini, Jim Subject: Inspection request for unit #88 Jim, Let this letter serve to notify you of The Villages at Camp Street's need to request final inspections for Plumbing ,Electric ,Building ,which will ultimately allow you to issue a CO for unit #88. 1 am fully aware of the stop work order in the project but we have a P&S agreement on that unit scheduled to •close on Sept 27th and would greatly appreciate any assistance you can provide me toward that end. Thank you, Jim Spalt q(tdo7 N44-, c N-5p e--LT70/�,J 47- • 9/15/2007 n LOT 76 LOT 77 _ • . _ • - 50.00 N84'19'0 � . 54.00' — J 54.06 1 to LOT 88 I 4.7 a I Z 6 3' 27.0' I Z 29.2! t uQ EXISTING �, a P° PUMP N FOUNDATION N wIc � STATION EXISTING O FOUNDATION 4_0, vi 2 21.0' 36.0' 7.0' N J LOT 89 I -`• - 51 54.00' 1g9.71' _ 54.00' I NB4'27'32"E PROPOSED EDGE OF PAVEMENT 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 E . DATE REGISTE ED PROFESSIONAL LAND SURVEYOR Unless and until such time as the original (red) stamp of the responalble 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 & McGrath. Inc AS -BUILT PLAN OF LOT 88 PREPARED FOR MILL POND VILLAGE IN YARMOUTH, MA CALE: 1"=20' DATE:6-19-06 I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE LOT AS SHOWN, AND THAT ITS LOCATION CONFORMS TO THE MINIMUM SETBACK REQUIR ENTS F THE 40� SPECIAL PER IT DATE a EGISTER FESSIONAL LAND SURVEYOR GRAPHIC SCALE ( IN FEET ) 1 inch = 20 & holmes and mcgrath, inc. AN OF civil engineers and land surveyors ,� 362 gifford street g falmouth, ma. 02540t� ►� JOB NO: 201197 DRAWN: DWG. NO.: A2556A CHECKE r� TOWN OF YARMOUTH Building Department BUILDING. �+ (508) 398-2231 ext.261 PERMIT NO �- 6-06-1404- � PERMIT ISSUE DATE :- 5/26/2006 PROPOSED USE ; APPLICANT �FrankCapra JOB WEATHER CARD PERMIT TO New Construction ; AT (LOCATION) -) 00121CAMP ST Unit 88 ZONING DISTRICT R-25 Bldg. Type: jResldential SUBDIVISION MAP LOT BLOCK 1044.21.1.C88 BUILDING IS TO BE: LOT SIZE CONST TYPE 5-B USE GROUP R-4 new construction: 2 baths, 3 bedrooms, 1 kitchen, 1 laundryroom, 1 livingroom as per plans dated 05116/06. REMARKS AREA (SO FT) EST COST ($ I$117,024.00 PERMIT FEE ($) 1$427.00 CONTRACTOR LICENSE 012430 Capra, Frank —� 1600 Falmouth Road #25 Centerville MA 02632 5087789669 OWNER I Villages @ Camp Street, L I /UILDING DEPT BY ADDRESS 1600 Falmouth Road # 25 _ Centerville MA 22632 PHONE 5087789669 Certificate Issue Date �� 9 f - �'�T/ CERTIFICATE of OCCUPANCY; Departmental Approval for Certificate of Occupancy and Compliance Inspector Date . Permit Number 4p ovedj4y,,/ Remarks ,,r���� Del' ��7lrENGINEERING To be filled in by each division indicated hereon upon completion of its final inspection. TOWN OF YARMOUTH Building Department B U I LDI N� , _ _ _ _ _ _ _ _ (508) 398-2231 ext.261 1 PERMIT NO -14_ PERMIT ISSUE DATE : _ - - - - - 00 - _ ; PROPOSED USE - APPLICANT .'Frank Cnkbapapra ---------------------' JOB WEATHER CARD ----------------------------- PERMIT TO ' New Construction ' ------------ AT (LOCATION) 100121CAMP ST Unft 88 ZONING DISTRICT R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C88 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE REMARKS new construction: 2 baths, 3 bedrooms, 1 kitchen, 1 laundryroom, 1 livingroom as per plans dated 05/16/06. ;� �%M n� A z7 4 -- A AREA (SO FT) EST COST ($r $117,024.00 OWNER Villages ® Camp Street, LLC ADDRESS 1600 Falmouth Road # 25 Centerville I MA 102632 J PERMIT FEE ($) $427.00 BUILDING DEPT BY 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 E �---a Q ONE & TWO FAMILY ONLY BUILDING PERMIT APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING Town of Yarmouth Building Department 1146 Route 28 • Yarmouth, MA 02664-4492 Tel: (508) 398-2231 x261 • Fax: (508) 398-0836 Office Useonly��` E Permit No d Ztl ate `� � ` PermitFee DepASlt ReC'dPioperty Ue et 1)r $ , �' anrnng Board Information Type t F�dorsementD"ate � Recording ate ' Plan Assessors Department Information ` m+� F e ors t Map' ` ` Lor �� t avew �> Dimensions j er _ - >x T , taJ-Area (sf) Froptage (ft) _ z LotCovera ge v �" r • "iThis-Section foe office Use Btaildlri "Per r µ r Dateassued. a'= Signature Certificate of Occupancy ; �sis not �" required -guilding Official , . , y .;, c, Date, `- Section'.1 - Site Information' Use Group: R-4 Type: 5-13; - 1.1 Property Address: 1.2 Zoning Information: Zoning District Proposed Use 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1A Water Supply (M.G.L e. 40. S 54) Public Private 1 5'Flood Zone Irnatiom Y Comments S A � 2one. ,'� ux.BFE Sdct 6n_22- Property,OCvnerstiip/Authorized Agent 2.1 Owner of Record: �s A'Y' het ei' LGAlo 0rv- .y6vi cl Name (print) Mailing Addrest!_ , 1/c`�j�- a -Z G Z Signature Telephone CFI 2.2 Authorized Agent: EIVEDI Name (print) �I� Mailing Addres MAY 15 2006 Signature Tele\ d o Fax BLI DING nF:PT Section 3; Constr"uction:Services� Far. aG` 3.1 Licens�e✓d' Construction Supervi or• Not Applicable ❑ License Number al Address �Z G 7.- �� Expiration Date ignature Telephone 3.2'Registered Nome Improvement. Contractor: - Company Name Not Applicable Address Signature Telephone License Number Expiration Date FF 9-15-99 t 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 of t e issuance of the building_permit. Signed Affidavit Attached Yes ..: ..... No .......... New Construction No. of Bedrooms Z. No. of Bathrooms_ Existing Bldg. ❑ Repair(s) ❑ Alterations ❑ Addition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: Sectron 1"i •� FRtImAfPft C.rtnctn Irfinn i`.nefc; Item Estimated Cost (Dollars) to be completed by permit applicant 1. Building OQ 2. Electrical 000 3. Plumbing / Gas 000 4. Mechanical (HVAC) 5. Fire Protection 15700 6.Total=(1 +2+3+4+5) $. F. Total Square Ft. (new houses & additions) Z / / . Check Below ❑ Conservation -Commission Filing (if applicable) ❑ Old Kings Highway & Historical Commission approval (if applicable) , as owner of the subject property hereby authorize G.�7`�lL1C� !�4 S��j%F�+rit — to act on my behalf, i II matters re iv rk thorized by this building permit application. Signature of caner 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. Z. Print name /k/:Z' 71- Z� fZc�� Signature of Owner/Agent Date 9-15-99 2 of 2 TOWN OF YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: Job Location: _ Owner of Prop Construction Supervisor: Address: / b Ci O Gl V14 O LAt& � � Sull C� UC►1�r�/ i ((� m A 0).10 3 Licensed Designee: (If other than Supervisor) Name License No. 2.15 Responsibility of each license holder: 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 Anylicenseewho shall willfullyviolate subsections 2.15.1, 2.15.2 or 2.15.3 or anyother 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 yes, please indicate the type coverage by checking the appropriate box.' A liability insurance policy all***' Other type of indemnity ❑ Bond ❑ OWNER'S IN ANCE WAIVE m aware that the licensee does not have the insurance coverage required by Chapter o aws, and that my signature on this permit application waives this requirement. Check one: Signat a of owne or wners Agent Owner BOO' Agent Signature: Building Official Approval: 4.- The Commonwealth of Massachusetts Department of Industrial Accidents 011lceo/Im►est/Osdi�s 600 Washington Street ' Boston. Mass. 02111 V " Workers' Compensation Insurance Affidavit AR�icant information: P►eseepRi}V'Tfedehitr name .S Cp ��, ib' r��r2�L� LL•� location / z / C!i ,,r7/- t it% //'//t+I�/�'L(' fJ Y`�l� phone d 14-2 r 7 I am a homeowner performing all work myself. I am a sole proprietor ,; J ha%e no one working in any capacity 1 am an employer pro% iding workers' compensation for my employees working on this job. company name - address, city phone N• insurance co, policy N &�l am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below who hase the.followin_ %%orkzrs• .ompensation olices: com2any add r in c.. r•.nrn rn / ./7L'�i/�) NI )A f—/ C:�;6// yI C5 /14: 645 company name: Failure to secure coverage as required under Section 25A of MGL 152 an lead to the imposition of criminal penalties of a fine np to S1.SN.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 11100.00 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 veri0ation. I do hereby certify under the pains and penalties ojpelittry that the information provided above is trueandeorred/ Signature ;Lv ��C sitl Date Print name oRcial use onhV do not write in this area to be completed by city or town official city or town YARMODT$ O cheek irimmediate response is required i permitAfcense N nBuilding Department pl.icensing Board 261 E3selectmen's Office (508) ion 2231 t 011ealth Department contact person: phone N: _ ea . t-tOther Information and Instructions Massachusetts General I_a++s chapter 152 section 25-requires all emplovers to provide workers' compensation for their entpIo%ees. As quoted from the "la++ an entplot-ee is defined as every person in the service of another under any contract of hire, express or implied. oral or written. An ernphr ver is defined as an indi+ idual. partnership• association, corporation or other legal entity, or any two or more of the foreuoing enuaged 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 o++ner of a dwelling: house ha%ine not more than three apartments and who resides therein, or the occupant of the dwelling house of another +vho 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. %IG[_ chapter 15= section 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 commom+ealth nor any of its political subdivisions shall enter into any contract for the performance of public ++ork until acceptable evidence of compliance with the insurance requirements of this chapter ha+e been presented to the contracting authority. Applicants Please till in the +vorkers' 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 ++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 affJdavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. ' The Department's address, telephone and fax number - The Commonwealth Of Massachusetts Department of Industrial Accidents Office of ltlles>deadeas 600 Washington Street Boston. Ma. 02111 fax #: (617) 727-7749 phone #: (617) 7274900 eft. 406, 409 or 375 Of X x e Temp Permit No.: Applicant Name: Applicant Phone: Building Location Owner's Name: Owner's Addres TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BUILDING PERMIT TRANSMITTAL T-06-471 Frank Capra 5087789669 00121 CAMP ST Unit 88 Villages @ Camp Street, LLC 1600 Falmouth Road # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 ' REVIEWED BY: 1. WATER DEPARTMENT: 2. ENGINEERING DEPARTMENT: 3. CONSERVATION: 4. HEALTH DEPARTMENT: 5. BUILDING DEPARTMENT: 6. FIRE DEPARTMENT: COMMENTS: RECEIPT OF COPY: (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 PLEASE NOTE SIGNATURE OF APPLICANT: Comments: Map/Lot: 044.21.1.0 new construction: ZONING APPROVED DATE: N/A: DATE: N/A: DATE: N/A: DATE: N/A: DATE: N/A: DATE: N/A: DATE: Date Printed: 5/8/2006 FROM :PELLA IMSL72ANCE AGENCY INC FAX NO. :16177870105 Aug.�08 2005 01:19PM Pi / AUG- -Z00s ia�tyz4 F.I.PATf��DpE• rNSS..AGY: . _ .---- 2 2 —F V/ A -CM, :CER prICA Q� �+,/ ��IU 1 E 1� VO TE fi6UE0 AS A YATTEA or I. CEMA?CON ,A.CUVCEa _ - ' - 0rn r nWD conPPAs 7e DOE O NOT o, 6�xTt6C o orbi HOLOEH TI s YEH E� FOAOED BY Tt1E POEIq .s PEGAW' , INC' �� . j... 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I eMtOT¢AM LIAIPLIT,•/„ g.LO�TJ,9l-rl, EkoIOYE �... yyrrFiM•W�==�'96•PDLCT L GAO" ElOISWptllT i- i u«w rH�✓�OYIFu MIM1,„ i VEIN,I:LHi%�-- N9 ADDCD ITN ENppR9MMENT,'WMALPRCVISIOtIS- p�Ey.�fAN Oi.OPL�PAlIOr91tACA. 1 • h .. - 1 IP1uRlbiag .Mirk .. CAN 1ATTON enout0 ANY Oe r1Q A/OrL 0E9emne0 PouGti O[ awCAL�„ eesoaE Te+FI I LEl7TPICATEROLDBA 10 AY9VIMITf' I DATE TNERWF. THE 16BUNN"W.;WR w lk EMIFAY04 TD MNL-� C NOTICE To The GERTIFIC•ATG NpLi�ER w1Me) TO THE LL�j bUT FAAL+iK TO Al u s'�•*r I Gateaovd Holaes Iqc OF, r DN fuE YNtl�EA• IT! AGENIY E'� ' C pyNy9Exo u1xaAtloN oRUA�*T'� - 1 160o Valmoubh Road , I Cenl:etVLU_e.. yA 02632 i � �pOORD POHI.TtON 77 l% • Pax,f-Soe-478-5601. , AACCo'RD25{�OOt i TOTAL P—.• ACORflE CERTIFICATE OF LIABILITY 114SURANCE GDuCEe United Insurance Agency, THIS CBtTIFjr-ATE IS IS9lel 199 Main Street B� Inc. ONLTAIr�Cif►aNOR1G P.O. Sox 1013 ALTER THE V6tAGEAFN Buzearda Hay, MA 025-12 lMR8t3AFMMNOCOVEt Patton Electric, Inc. INSURERA P.O. Box 1525 INSURERS HaohPoe, MA 02649 INSURERC: HSURER 0: THE POLICIES. F IN LISTED BELOW HAVE BEEN ISSUED To T/c IMa, ANY RF[lluoc¢.,T — OATE(MM/DDM 2120/OS M POLICIES. MAY PERTAIN- " Go UITIDN THE INSURANCE AFFORDED AGGREGAtE LIMITS SHOWN MAY OF ANY CONTRACTOR OTHER OOCVMENT BY THE POLICIES DESCRIBED HEREIN HAVE BEEN REDUCED BY PAID WI7H RFbPE'Vrt IS SUBJECT CLAIMS. IHT: POLICY TO ALL THE TERMS. WHICH PERIOD INDICATED. NOTWITHSTANDING FxCLUSnoNS ANMAY BE D CONDITIONS tSSUEO OR OF SVCM "' GENERAL LIABILITY POLICYNUMBER POLICY SFFECTI U a /BoN LIMITS A XcoML.eRcALDenERALwe)arY 7 ClAA1 Mope OCCUR SCP42415399 7/30/05 7/30/06 EACHOCcuRRENCE PREMISES EAanaFMYA f 1 000 000 f 300 000 f 10,000 MTD EXP `--- PERSONAL SAOV wjURv { i 00G 000 GGNERALAGOPECATG { 2 00.-QQ0 GEN'L AGGREGATE LIMIT APPLIES PER: PRO.PRODUCTS. X POLICY �JFCT LOC COMPIOPACG f 2 000 000 AUTOINOSLELVAILI7Y ANYAUTO . COMdNGD SiNmE uLIR IEA AroePN = ALL CVWED AW06 SCHEOULEOAUTOS (PPw pIFNa,yJURY f HIRED carps NON-O'ANED AUTOS (pir INJURY t EERTYE DAMAO S OARAGE LIABILITY AUTO ONLY, EA ACCIDENT S ANYAUTO OTHER THAN EAACC AUTO ONLY: Apo f E EXCESBNMBRELLA LIABILITY EACNOCCURRENCE 6 OCCUR CIAIMSMAOE AGGREGATE a — -_-- f S•— OtOUCTOLE S RETENTION f WOPMETSCOMPENSRION AID TATU• Oho H EMPLOYERS*LMaLm ANY PROPRIETOR/PAt TNER,fl(ECUTM OffrERRPEMSER EXCLUDED? SPECIAL RWSCNS bob. X WC231S353049014 22/10/05 12/10/06 f 100,000 S 500,000wyn.d- S 100,000 ELEACHACCIDENT EL DISEASE. EA EMPLOYEE G,L. DISGASG- POLICY LIMIT OTHER DISCRFTIONOF OPERATIONS/LOCATIONS/VEHICLES/ EACL VEIONE ADDM By MDORZirLNT/ SPECIAL PRGVIaONS Electrical Cateuood Homes Fax No. 509-778-5603 1600 Falmouth Road Suite 25 Centerville, MA 02632 SHOULD ANY GF THE MOVE DESCRIBED POLKRSBE CANCELLED BEFORE THE WMINATEIN DATE THEREOF, THE IBSDNO INSURER WILL ENDEAVOR TO MAIL 10 DAYSWRRTEN NOTIC E TO THE CERTIFICATE MOLDER NAMED TO THE LIFT. BUT FAILURE TOOOSA WALL- •- I{vOSENOOBLIGATION OR LIABILITY Of AM KIND UPON THE 0EUM ER. ITS AOENTE OR 0 ACORD CORPORATION 1906 02/16/2006 16:18 5084204474 PAGE 01 ACORb CERTIFICATE OF LIABILITY INSURANCE DAT[(0lY 02 16 06 PRODUCER THIS CERTIFICATE IS 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 ALTER THE COVERAGE AFFORDED BV THE POLICIES BELOW. P.O. SOX. 337 Marstons Mills, MA OZ648 INSURERS AFFORDING COVERAGE NAIC# WflURFO wsuRERa _, :tyin..rin- e_ OIT188ny..:_..._. . American Foundation Co., Inc. NeuAeR3_ Savers Property_ & Casualty 43 Phinney's Lane IN.^auRER C: Centerville, MA 02632 INSURER0: I INSURER E: :OVERAGES THE POt TaE'S 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 DOCUMENT WITH RESPECT TO WHICH THIS cEHTIFICATK MAY RE ISSUFD OA MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POIJCM,A+ AGGAEGATE LIMITS SHOWN MAY HAVR. EP_EN REDUCED BY PAID CLAIMS. LTR INSR TYPE OfjLIf.V,MAN" I POUCYNUMBEA iDAT &HaDIDVE PDATE( MI OTKMN LIMITS I GENERALUAWLITY EACHOCCIIRRFNCE w�q i. 1_yvtlV7Of?fY_, i I X I CCMMf.RGIM,OENERALgLLNIAWLITY -0;kVADETLTRL— -..... FRE,AMSE3jEa accum'cc�_,._. .. ' . '4_.... ZOOS . I I ! h.AAM3 MADE •+>f OCCUR; j MCDEXP(M"ep"Mf -, _ nM•.. S- 10,, v1,'V ., A i BP OW06134 10/05/05 10/05/06 PEnsowuaAgVINJURY .:._ 1,Q00�000., • I G[N[RALAGOn.aATq ,__ _.. l:s��ir. GENT, ACOREOATE LIMIT APPLIES PER: i PRODUCTS-COMP/OPAGG S 29000,000. MAICY PFto• LOCI AUTOMOBILE LIABILITY _ - COMBINED SINGLE LIMIT I S ANVAUTO I 1 tEe etCwcrA) I i AI.L OWNED AUTOS BODILYINJURY ' S ;CHEDULEO AUTOS- NtRED AUTOS BODaruuuRr S 14ON-OWNEO AUTOS (Per ecelUakl I j . PROPERTY DAMACIj f (Par acHaam) GARAOELIAOILRY - ! AUTO ONLY -EAACCIOCNT - f • ANY AVM OTHER THAN RUT ONLY: AUO S EXCESSNMORELW LU_(RIQTY - ' UCHOCCURRENCE I S CM,•CVR L • ! CLAMSMADE AOORFOAPP S DEDUCTRLE RETENTION S S IWORKEILTCOMPSILPry MDiAND WC STATU, I DTI+ • TORYLIMLTAL._ EC. ......_. _....... EMPLOYEPS'LIABILMY ,WYPPOPRIP,TItNPFRTNEf1+E%ECUTIY¢ [L.[ACH ACCIDENT - S• 9 OFFICFRIMMSEREXCLUDED? WC 0001630 04/01/05 04/01/06 E.L.OIaEASE•F.A4MPI.OYEE f I� ea.deceribew.dar �CIAL ZMS, PROM INIVH • [.L. OISEAA[ POLICY LIMIT S OTHER OEECRIPTION Of OPERATION;/ LOCATIONS I YEHICLEB/ EXCLUSIONS ADDED DY ENOOREEMENT/SrgmAL PROVISIONS Gatewood Homes SHOULD ANY OFTHEAOOVE DESC"tD POMrff$ OE CANCELLED AFORE THE EXPIRATION- I 1600 Falmouth Road, DATE THEREOF. THE ASUWO WSURER WILL ENDEAVOR TO MAX ,—._- DAYS WRRTCN NOTICE TO THE QERTFH:ATE HOLDER NAMED TO THE LEFT. OUT FAILURE TO DS-30 Sir 1.er Centerville, MA 02632 IMPOSE NO OBLIGATION OR ABILITY OF ANY KIND UPON THE INSURER, ITS AGF,NTS OR FAX# 508-•778-5603 REPRESENTATIVES. _ 1 AcoRD . CERTIFICATE OF LIABILITY INSURANCE °"�'�°'YYYY' 1 s 2006 PRODUCER FAX select Financial Group 1574 Washington Street Holliston- KA 01746 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# INSURED - \`JLJµ-".c-+Lrv..., rC Carpentry Inc. 625 Normandy Drive Norwood KA 02062 WAMERA:9Pe8tern World WSURER8: INSURER INSURER 0 INSURERS a Vvcrw Qa THB POLICIES 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD INSR TYPE OF INSURANCE POLICY NUMBER DATFYMMEI�DTYYE POATE MM D° TwN l GENERAL LIABILITY. X COMMERCUL OEM RAL VAINUTY EACH OCCURRENCE S 1.000,000 PREMI56T Eat sxNnee f 50.000 MEDEXP enr en f 5.000 A CLAIMS MADE Qx oeevR RrPi0151» 12/20/2005 12/29/2006 PERSONAL E ADV tNAM f 1,000,000 GENERALAGGREGATE f 2.000.000 GENL AGGREGATE LIMIT APPLESPER: PROOUCYS• COMPIOP AGO f 1,060,000 X1 POLICY M SPETT toe AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ee ArtMent) f BODILY INIMY (Po Pe ) f ALLOWNEDAUTOS SCHEOVLED AUTOS BODILY WOMY (Per ealdwQ f HIRED AUTOS NON-0MINED AUTOS PROPERTYDAMAGE (Pot eoelden° s GARAGE LIABILITY AUTO ONLY • EA ACCIDENT S OTHER THAN EAACC f ANY AUTO f - AUTO ONLY: ADO EXCESSA)MBRELLA LIABILITY EACH OCCURRENCEs OCCUR CLAIMS MADE AGGREGATE S ' 3 f RDEDUCTIBLE D S RETENTION f WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTNE - I q E.L. EACH ACCIDENT f 61. DISEASE. FA EMPLOYEE 9 OFFICERMEMBER EXCLUDED? RYe%. delaae undM SPECIAL PROVI910N9 bet" F.L. DISEASE • POLICY LIMIT f OTHER DESCRIPTION OF OPERATIONWLOCATONSNEMICLESIEXCW SIONE ADDED BY ENDORSEMENTIEPN7AL PROVISIONS General liability is provided for the above insured as carpeetzy - residential not exceeding 3 &taxies in Haight (subject to deductible $250) (508) 778-5603 SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE Clatewood Homes EXPIRATION DATE THEREOF. THE ISSUING INSURER WALL ENDEAVOR TO MAIL 1600 Falmouth Rd 10 DAYS WINTTER NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT Suite 25 FAILURE TD 00 BO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE Centerville, MA 02632 INSURER RI AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Michael Susco/KATHY ACORD 2S (2001103) CACORD CORPORATION 19W INS026 (0100).00 AIMS VMP Mtenpepe 5010an. Inc (0001327C5e5 Pepe 1 012 APR-20-2006 THU 10:33 All R & K INSURANCE FAX NO. 508 991 5461 P. 02/03 w — —. ^ ., ^ r�CORA CER T IriCA E tir .■ ■ T !• ■ ■'■ E r UABiL1 T Y UNISmU'�r�NCE2 DATE (MMIDOIYYYY) 04/20/2006 PRODUCER (50E)994-9559 FAX (50E)99� FLAGSHIP INSURANCE INC 414 COUNTY STREET NEW sEOFORD, MA 02740 -$461 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFER NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOER NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC R INSURED Frank Capra PO Box 664 West Hyannisport, MA 026n RSURERk Providence MUtYal 15040 INSURER B: OOOBeaCOn 206ZI INSURER RLSYIREA D' INSURER E. C THE POLICIES Of INSURANCE LISTED BELOW R4VEBE tSSUED TO THE tfISURED NAMED ABOVE FOR THE POLICY PERIOD ROUCATED. NOTWITHSTAND:FN ANY REQUIREMENT, IERM OR CONDITION OF ANY CONT AFFORDED BY THE POLI r OR OTHER DOCUMENT WITH RESPECT TO WHICH EXCLUSIONS AND CHIS CER-11FIrATE ONDITIONS OBE ISSUED Oft IES ORHEREIN IS SUBJECT TO ALL THE TERMS, UCH MAY PERTAIN. THE INSURANCE POLiCtEES. AGGREGATE tiMTTS SHOWN MAY HAV% BEEN FOUCED BY PAIDCLAIMS. man TYPE CF*2URANCE NUMBEN POLICY EFFECTIVE POLICY EXPIRATION L„aTS G�w'ERAL LIABILITYL.DF'^I 53132 D3 12/13/200S 12/1312046 eAu*otGu»RLNCF i 1,0OO,OD DAMA T RENTED j SO,OO X COMMEWlALOEMEMLIA9Ri7Y 1 5.00 OLABLS MJLOE Q OCCUR MED EXP Wy cm Pww) PERSONAL S ADV INJURY S 1,000100 A GENERAL AGGREWTE 1 - 2.000.01 G£M'tAGGR£GAT£U!JIT.AP.PIASKa PRODUCTS. COMPrCA ADO S 2,000,000 PRO - POLICY JECT LOC - AUTOMOBILEUAWLITY CBIE61796 02./14/2006 02/14/2007 COMBINED edNGIE L"T i (EB■codFm) 1 000 000 ANY BODILY INJURY i. - ALL OWNED AUTOS X SCHECLAEO AUTOS (Pm Pawn) B X HIRED AUTOS BODILY INJURY i X NON -OWNED AUTOS (Pa Ae4d■nI) PROPERTY DAMAGE i - (Pw w "V) OARA06 LIABXJTY AUTO ONLY_ EA ACCIDENT S OTHER TMAN EAACC S ANYAUTO i AliTOG&Y: AGG EXCEILUMBRELLA LYBIMTY OI 12/23/2005 01/13/2006 EACH OCCURRENCE 1 2,()00,()Gc AGGREWTE i 2,000,000 OCCUR 1 CLAMS MADE 1 A 7s0264 i DEDUCTIBLE 1 RETENTION i WCfiTATII OTH- WOSNERE COYFENSATIOl1 AND E.t.EACHICCIVENT S EMPLOYEWLIAR5=TY ANY PROPAIBTOROPARTNERIEXECUTIVE OFFKER44MOER EXCL110E09 £i_ DISEASE • fA EMPLOYE i f.[. DISEAS`c •POCKY LI+X7 S 1V". d■.aiOA M1dw SPECIAL PROVISIONS blow DTPJER - DEBCRP'CDM OF DPFBABOHS/ LOCATIONS I VEHICLES I EXCLUSIONS MED BY ENDORIEMENTI SPECIAL PROVISIONS C - - 6HO LLD ANY OF THE ABOVE PUCRBOED POLICIES BE CANCELLED ■EFORB THB EXPIRATION OATS THEREOF, THE 43UWG INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. GATE iIWJS, INC- BUT FAILURE TO MAIL SUCH NOTICE SHALL WPOSE NO ONtIGATION OR LIASILRY 1600 FALMOUTH ROAD, SUITE 25 OF ANY RIND UPON THE WBURER ITS AGENTS OR REFREWNTATWES, AUTIaRIZED rAmre 42 CENTERVILLE, MA 02601 ACORD26)2OOlM8) FAX: (506)776-56.03 I y1�YHM-�`/� �PD TION7PSS 2ASSURANCECO CORD, CERTIFICATE OF LIABILITY INSURANCE oti,s/Is°"YYY' PRODUCER Dowling & O'Neil Insurance Agency 222 West Main St. PO Box 1990 Hyannis, MA 02601 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 # INSURED - Assurance Construction, Inc. A/O Assurance Excavation, Inc. 550 Willow Street West Yarmouth, MA 02673 INSURER A. St Paul Travelers Insurance Company INSURER 8: INSURER C: INSURER D: INSURERS V THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INbK LTR N SR TYPE OF INSURANCE POLICY NUMBER P ATEYMMIDO M POLICY DATE MIDD M LIMITS A GENERAL LIABILITY 16808387A9841ND05 08/01/05 08/01/06 EACH OCCURRENCE $1.000,000 DAMAGES ( RENTED $300 000 X COMMERCIAL GENERAL LIABILITY MED EXP (Any one penwn) SS' 000 CLAIMS MADE Ex-] OCCUR PERSONAL E ADV INJURY $1 000 000 GENERAL AGGREGATE f2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO 52000000 POLICY PRO- LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per Person) f ALL OWNED AUTOS SCHEDULED AUTOS - BODILY INJURY (Per accident) f HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Peraccident) $ GARAGE LIABILITY AUTO ONLY -EA ACCIDENT f OTHER THAN EA ACC $ ' ANY AUTO S AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S AGGREGATE $ OCCUR CLAIMS MADE f $ DEDUCTIBLE $ RETENTION $ WC STATU- I OTH- WORKERS COMPENSATION AND E.L. EACH ACCIDENT $ EMPLOYERS' LIABILITY - ANY PROPRIETORMARTNERIEXECUTIVE OFFICEWMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ E.L.DISEASE - POLICY LIMIT $ - If yes, describe under SPECIAL PROVISIONS betow OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Operations performed by the named insured subject to policy conditions and exclusions. Gatewood Homes, Inc. 1600 Falmouth Road, Suite 25 Centerville, MA 02632 LO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WALL ENDEAVOR TO MAIL 10_ DAYS WRITTEN :E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL iE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR AUTHORIZED C. ACORD 25 (2001108) 1 of 2 #41713 L51 w /+ Wnu ..vnr W. ..v.. ....... ACQ.R CERTIFICATE OF LIABILITY INSURANCE 122/20/ 02 05 PRODUCER PANTANO INSURANCE AGENCY, INC 220 BROADWAY, SUITE 202 LYNNFIELD, MA 01940 781-581-3100 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# INSURED CENTURY PAINTING & DRYWALL INC. - P: O c BOX 2903 I' HYANNIS, MA 02601Oh'�� -" INSURERA: COMMERCE INSURER B: NSURER C: NsuRERD: 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 Lrn NSRo E FINSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY POLICY NUMBER POLICYEFFECTIVE DATE MM/DD POLICYEXPIRATION DATE MM/DD LIMITS EACH OCCURRENCE $, 0 0 / 0 PREMISES MR o mcei sit 000, 000 MEDEXP(Anycneperson) S51000 OLAIMSMADE OCCUR PENDING 12/17/05 12/17/06 PERSONAL& ADV INJURY $1, 000, 000 GENERAL AGGREGATE s2,0001 000 GENT. AGGREGATE LIMIT APPUES PER: PRODUCTS -COMP/OPAGG $1, 000, 000 ri POLICY PRO - Jr - CT LOC AUTOMOBILELUIBILIT' ANYAUTO . ; _ _ _ _ _ COMBINED SINGLE LIMIT (Eaaccidera) $ BODILYINJURY -' (Per person) .._ . $ ALLOWNEDAUTOS SCHEDULED AUTOS BODILYINJURY (Peraccident) $ HIRED AUTOS NON-OWNEDALITOS PROPERTY DAMAGE (Peraccident) " $ GARAGE LIABILITY AUTOONLY-EAACCIDENT S OTHERTHAN EAACC $ ANYAUTO S AUTOONLY: AGG EXCESSIUMBREl1A LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMSMADE S S DEDUCTIBLE $ RETENTION $ WCSTATU- OTH- WORKERSCOMPENSATIONAND T RY MIFR E.L EACH ACCIDENT S EMPLOYERS' LIABILITY ,wY aaoraEroamnan+eaA�oumn_ oFCereMEMaER EXCIJ ov E.L. DISEASE - FA EMPLOYEE $ IyeS,dee ''beu der SPEC IALPROMSIONSbelow E.L.DISEASE-POLICY LIMB E OTHER DESCRIPTION OF OPERATIONS /LOCATIONSIVEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE NT]I ❑FR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEI I ED BEFORE THE EXPIRATION GATERWOOD HOMES DATE THEREOF, THE ISSUING IN URER WILL ENDEAVOR TO MAIL _ DAYS WRITTEN 1600 FALMOUTH ROAD # 25 NOTICE TO THE CERTIFl ATE H ER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL CENTERVILLE, MA 02 632 IMPOSE NO OBUGAnO OR IUTY OF ANY KI D UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRES THE ACORD25(2001/08) ©ACORD CORPORATION 1SBU ov.n%rt TOWN OF YARMOUTH } �cA BUILDING DEPARTMENT ;..•:,:�� 1146 Route 28, South Yarmouth, NIA 02664 508-398-2231 ext. 260 HOMEOWNER LICENSE EXEMPTION PLEASE PRINT: / DATE: JOB LOCATION: NAME "HOMEOWNER" NAME PRESENT MAILING ADDRESS STREET ADDRESS HOME PHONE SECTION OF TOWN WORK PHONE CITY OR TOWN STATE ZIP CODE The current exemption for `Homeowner' was extended to include owner — occupied dwellings of one or two units and to allow such homeowners to engage an individual for hire who does not possess a license, provided that such homeowner shall act as supervisor. (State Building Code Section 108.3.5.1) Definition of Homeowner: Person(s) who owns a parcel of land on which he / she resides or intends to reside, on which there is or is intended to be, a one or two family attached or detached structure assessory to such use and / or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner; such "homeowner" shall submit to the building official, on a form acceptable to the building official, that he / she shall be responsible for all such work performed under the building permit. (Section 108.3.5.1) The undersigned `homeowner' assumes responsibility for compliance with the State Building Code and other applicable codes, by-laws, rules and regulations. The undersigned `homeowner' certifies that he / she understands the Town of Yarmouth Building Department minimum inspection procedures and requirements and that he / she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch 142. Yes ❑ No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ hlomeownrlicexemp BUILDING TOWN OF Y A R M O U T H ELECTRICAL 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 026644451 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 a Work Adqress r /( is to be disposed of at the following location: ( Uln 041�80 %ir'l2 bap l u Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Signature o Applicant Permit No. zG � Date B'OEiRQT CF-, BUILDINGREGULtAMONS; p License': CONSTRUCTIONSUPEWSOR Numbe;�,,C�S: 012430- 06 f200E, Tr. na 25926 tit. . ResLrfd=:, FRANK G 40:C.CFPER'FJk CEh rMaLLF- 9G4.OZ63 commissioner _ ... - - a00-A00adendased.space. - -- p IA-143ioprkopfg ' � 48:�k&�Fasiilyliomes Falure topossesS_ZLcu Medifion offt MassactiusedsState=86ldngC6de; . iscause;for,7evoptioeot8lslcense. ' DIG.SAFE:CRLLCENFER: {888);344-Z233 6 P 12(9@Rnd12D TOWN OF YARMOUTH MAY U 'L 2006 c HEALTH DEPARTMENT HEALTH DEPT. PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant. - Building Site Location:1Z/ Z41V,47 No.: Lot No.:95 Proposed Improvement:3 F>eD9cry 7, S Applicant:, �e �i�A�f! �r T�LvL`� pL.d!L Tel. No.: "e� Address:ILdoAL�ovTiY,� lra?��s%L1E /'/.t ©263L Date Filed: **Ifyou would like e-mail notification ofsign off, please provide e-mail address. Owner Name: fy c L l / irJO Srrta�T Owner Address:,6dv 1'U c-IW Owner Tel. No.: 2zF g66g- OZ6.3L 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: DATE: PLEASE NOTE . Sv$ 2'�0•'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: / 2- P S r. Map #: Lot #: X2- 9/ Proposed Improvement: Applicant: AT LAM /-, S t- 400 r-aLMOdTr► Rb Address: Mq o 2 e 3 Z Tel. #: 50g T7_ g� Date Filed: 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 Ads; i.e. If Lot(s) Border any Type of Wetiands, Streams, n, Bogs, Bays, Marshland, Etc.. Health Department Determines Ponds, es Compliance toStat 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: COMMENTS: Signature Of Applicant PLEASE NOTE: Date: PROPERTY ADnotss, R.ZIIAWI �P- -�) -pAU;ULAT.10N.FQR PERMIT COST TYPE OF R, ETC NO I 9g;L 290-76 ADDITION ALTERATIONS tDER A2. RTIZATE OF OCCtJPAMel--v 70,Z4 Q6. DEN y ii ,RON ONLY OPEN The first two model number digits indicate frame width, the last two digits indicate glass width. All are A.EU.E.-rated high efficiency vented gas fireplace heaters, certified under ANSI Z21.88 and CSA 2.33-1499. MP04540 MPD4035 MPD3530 MP03328 Standard Features DIMENSIONS (Rear vent model shown) • 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 power 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 iflexble) 4.5' inner/7.5' outer coaxial venting system, and include a 20-year limited warranty. Note: Due to L mox' ongoing commitment to quality, all speafications, ratings and dimensions are subject to iditious, such as elevation, wind, ventconfigu- oice of fuel will affect the overall appearance Hersey U20006711) Wamoek Hersey CUS ipppry°���f4 Utho USA 33M MODELS (Tbis model comes as a top or rear vent only) [ED F_ A 1 I T &tyiB" L � r-trzatrri Front Face 35,40 & 45 MODELS Top (These models come with a top and rear vent) FIREPLACE & FRAMING DIMENSIONS R Right Side 13 3530 351/8 32t/s 19 291t 351/8 211A6 24Y8 12N6 351/4 351/4 16 4035 401/8 37t/e 24 341/z 401/8 2611h6 29A 14% 401/4 401/4 16 4540 401/8 371/8 24 391/z 451/8 26l1h6 34%8 17%6 45/4 40Y4 16 M®® 3328T NG 17,500 45 64 62 3328T LP 17,500 49 66 64 3328R NG 17,500 _ 53 63 61 3328R LP 17,500 55 66 64 3530 NG 20,000 53 64 62 3530 LP 20,000 55 62 60 4035 NG 27,000 59 69 67 4035 LP 27.000 iun 9q 1:7 4540 NG 29,99f ,C� N3 5,k 69 67 Look for the EmrGuids Gas Fireplace Energy Efflelency Rating In this brochure TYPICAL ROOM APPUCAnONS MPD3328 MPD3530 MPD4035 33' fireplace w/opt. flush face 3S' fireplace w/brushed stainless 40' fireplace w/polished brass louver and door trim trim arch door kit Beauty, efficiency, convenience and reliability. Just some of what you'll find in our Lennox Merit® Plus Series direct -vent gas fireplaces. Our combo DV configuration, with both top and rear outlets, allows for top or rear venting (except. our 33" units which have either a top or rear outlet). Standard features include a deluxe pan burner that produces big yellow flames and glowing embers, brickaded interiors and Hi/Lo flame opera- tion. And; these models are even easier to warm to when you select one of our optional remote controls, or r I I MAScheck COMPLIANCE REPORT I I -t Massachusetts Energy code I Permit # I MAscheck software version 2.01 Release 2 I I I I Checked by/Date I I 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 Plover 1,pt gg �Zl �'�� 5 t/-e(2.r PROJECT INFORMATION: Mill.Pond village Camp Street Yarmouth, MA 02673 COMPANY INFORMATION: Northside Design ASSOC. 141 Main Street Yarmouth Port, MA. 02675 RECEIVEIDI MAY 0 5 2006 BUILDING DEPI ey: COMPLIANCE: PASSES Required UA = 237 Your Home = 133 Area or Cavity Cont. Glazing/Door Perimeter R-value R-value U-value UA ------------------------------------------------------------------------ CEILINGS 823 30.0 30.0 14 WALLS: wood Frame, 16" O.C. 1588 15.0 15.0 70 GLAZING: windows or Doors 97 0.340 0.340 33 14 GLAZING: windows or Doors 40 0.086 2 DOORS 20 - --------------------------------------------------------------------------- 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. Date Builder/Designer OGO-3 PRODUCT ICATIONS GMS9/GCS9 SERIES 93% AFUE Multi -Position, Single-Stage/Multi-Speed Gas Furnace PARSLIMITED WARRRANTRANT xFh a(MIL T.eRi,�x� ' •`i � ink G 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 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 heating/cooling application • All models comply with California NOx Standards • Suitable for direct vent (2-pipe)'or non -direct vent (I -pipe) applications 0I0I010010 Air Conditioning & Heating r � t , 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 (LPLP01) • High.Altitude Natural Gas/L.P Kits (HANGI I, HANG12, HALP10) • High Altitude Pressure Switch Kit (HAPS27) • External Filter Rack (EFR01) • 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 V w .goodmanmfgxom 6/04 LOT 76 I LOT 77 » _ N8�9'0_ 54.00# ' I ..00 �'� LOT 88 LOT 89 31685t S.F. I Cn E w Z ..26.7 A ILn PROPOSED HOUSE O O OPOSED rn O PLOVER ,p CS �N0/ tu {OUSE 1ERON Ln N J Iv 23.5 �W - 14 W� I.0 =23.0 1 = 14 ,� �ot- �'� o, �,, •, a 36` 7- o E L. •w Q p OPOS D >. co I o W R SE VICE �3 I o� I G319@R0wCE10 MAY 0 2 2006 HEALTH DEFT. �OPOSED__� 4» gEWER LATERAL -- NOTE: ® SEWER LATERAL SHALL BE WORK MUST SLEEVED IN ACCORDANCE BYLAWS AND WITH TITLE V IF WITHIN 1OFT. OF WATER MAIN. GRAPHIC SCA ( IN FEET ) 1 inch = 20 it TO ALL TOWN ILATiONS DEPT *DAT •1 6 0 rn v: � � wI0 0 I�z 50.00 PUMP STATION No. OF b�w�o 1 Cn+=ss ona unii! .;::.:h time as �r�'IG�IANQ ��'"'a:n� r:f <y., reop.-,:sih:a Prc`ss+swA c'ngi•-�==r, nr G'ro X. .nd �ur/eyCr nppsare nn thia p :n (e) •..� per i nr ^r= r-. ir�br'ing uoy munkipci or-:J-..,- �.::'l: n...., aip-:n thn inf-.rmotion cent ❑mod h„r.'_'^ (H} *.hi.; pl. n rna:.is 1,hcf Hofine • M;LCmir, '-.c. PLOT PLAN t ` holmes and mcgrath, inc. OF LOT 88 civil engineers and land surveyors''c` PREPARED FOR MILL POND VILLAGE 362 gifford street ha 45078 y IN falmouth, ma. 02540 1 v, o"'L 0'"F cC/STEPE� F``r� YARMOUTH, MA s oNAt JOB N0: 201197 DRAWN: LMC SCALE: 1 "=20' DATE: 3-24-05 DWG. NO.: A2556 CHECKED: MS Q LOT 76 LOT 77 _ — 50.00 N8�9'03 4.Op' �� ..00' '� 4� LOT 88 3,685t S.F. I PUMP LOT 89 TATION E Z /.26.7 Z ego A 0 .28.2 Ln PROPOSED I L rn I HOUSE �' aai `� pD O q q OPOSED PLOVER ) Q° Ip {OUSE j I J � = 23.5 °i W ' ® iERON 14 O v s GW a�/ .. i °' r+y = 23.0 1 .�p Ln QI 1 14 I I v;, '� 7 .. E � P OPOS D I } I n��/� w W R SE CE \\\\\\ ct- e ao � 4.00' 199.71 5 }.00' 4. " a�@ MAY 0 2 2006 SEE _ E`A- -- V e'D PRASE NOTE BELOW HEALTH DEPT. 4" SEWER LATERAL MA �rC6 5pnP0SED SEWER MAIN NOTE: ® SEWER LATERAL SHALL B SLEEVED IN ACCORDANCE WITH TITLE V IF WITHIN 1OFT. OF WATER MAIN. GRAPHIC 20 10 0 20 E WORK MUST CO' TO ALL TOWN BYLAWS AND G LAT16 A AAp H WATER DEPT GAT Wy SCE .E 4Y- Vnl=na and anti! :cch time as tie crirginol (red) stamp a! 4,1-.: reaconslb!e Pro`^s-2nnol Eng:n=er. or Fro Fe"Ionni Land pt..Sur e,— nppear� on thin pl n �. FEET iAr r3 Nr' y .r p..... r ir.!adn3 any m�vnir"! or ni .r _. . _ is i Y_;n .., rnr r. y -in.n the in?nrmr.Uon cnntrnaj her',; 1 inch 20 ft. (J) thin ,Ian rnrnolr., th<: prop?rty cf Hoimes & 4isSrath, -. �.♦ PLOT PLAN holmes and mcgrath, inc. jH of 414Ss4� OF LOT 88 civil engineers and land surveyors TIMOTHVM. 5 � PREPARED FOR 362 gifford street SANTOS No MILL POND VILLAGE .s falmouth, ma. 02540 a 9 9 CIVIL VIL ti IN °Fo�c;,,STcF YARMOUTH, MA JOB NO: 201197 DRAWN: LMC NALF"�> SCALE: 1 "=20' DATE: 3-24-051 DWG. NO.: A2556 CHECKED: AS p MAscheck COMPLIANCE REPORT Massachusetts Energy Code MAscheck software Version 2.01 Release 2 CITY: Yarmouth STATE: Massachusetts HDD: 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 I I I I I Permit # I I I I I checked by/Date I TITLE: The Plover �p �8 �Z� C�-,�b st/`ecy— 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 = 237 Your Home = 133 RECEIVED MAY 0 5 2006 BUILDING DEPT. By: Area or Cavity Cont. Glazing/Door ------------------------------------------------------------------------------- Perimeter R-Value R-Value U-Value UA CEILINGS 823 30.0 30.0 14 WALLS: Wood Frame, 16" O.C. 1588 15.0 15.0 70 GLAZING: Windows or Doors 97 0.340 33 GLAZING: Windows or Doors 40 0.340 14 DOORS ------------------------------------------------------------------------------- 20 0.086 2 COMPLIANCE STATEMENT: The proposed building design described here is consistentwith 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 The Plover DATE: 4-21-2004 Bldg Dept Use I I I I I I I I CEILINGS: 1. R-30 + R-30 Comments/Locati WALLS: 1. Wood Frame, 16" 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/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. TOWN OF YARMOUTH UN1 r 4K ding ition ,❑ Renovation ❑ itted Yes ❑ No ❑ APPLICATiON FOR PERMIT TO DO GASFITTING (OFFICE USE ONLY) Fee: PERMIT NO. CD "-01/' Replacement ❑ Date U Owner's Name Type of Occupancy rn N W (A W )Y ¢ F N r^ OIM Lu J Cn Q 2 Wa O Q> V m Z 1�N- Z O = to W Q W W W W a> Z W N W 0 2 y W Cm7 Z F a= 'FW�'�'7- R W W W O Q 2 O> W ILL W W -j y W i I H j 2 F W m I H mix W> Q W j 2 Q 3 Q Q g O 0 O x> W¢ c O a. W I- o \ o c� X. a 0 0.0 SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) t yJ� Installing Cony Name � /'[ Address 141 Ah Business Telephone Name of Licensed Plumber or Gasfitter INSURANCE COVERAGE: Check One: ❑ Corp. ❑ Pa ship — Firm/Company _ Check 7`0,, 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 Plumber or Gasfitter (or entered) in above application are true and accurate to the best of 2� jrg 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 TYPE LICENSE Chapter 142 of the General Laws. 13'Plumber Gasfitter Journeyman