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121 Camp St #090 Building Permits
i LOT 74 Na4 - 54.( LOT 90 n LOT 75 EXISTING FOUNDATION I 17 rn 00' ofL4 13.0" s 'o �i LOT 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 ZON IS N A SPECI L f 0 D HAZARD A. DATE TE REGISTERED'PROfESSIONAL LAND SURVEYOR NOTICE Unless and until such time as the original (red) stamp of the responsible Professional Engineer, or Professional Land Surveyor appears an this plan: (A) no person or persons, Including any municipal or other public officials, may rely upon the information contained herein; and (B) this plan remains the property of Holmes dt McGrath. Inc. 13.16' I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE LOT AS SHOWN, AND THAT ITS LOCATION CONFORMS TO E MINIMUM SETBACK REQUIRE 0v THE 4�B SP CI P M DATE REGISTERED FkAOFESSIONAL LAND SURVEYOR GRAPHIC SCALE ( IN FEET ) 1 inch = 20 ft. C AS —BUILT PLAN holmes and mcgrath, inc. OF OF LOT 90 civil engineers and land surveyors te PREPARED FOR 362 gifford street M �tAU MILL POND VILLAGE Falmouth, ma. 02540 IN No. YARMOUTH, MA JOB NO: 201197 DRAWN: LMC SCALE: 1 "=20' DATE: 6-5-06 DWG. NO.: A2558A CHECKED:. pqI LAtL 7 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 UseOnl Planning Board Information Assessors Department Information 1 n T a Map Lot (ft i. Permit Nate f r M pC�Lot ► 7 �✓ vp f t Permltfee /,: Endorsement Date ecordingProperty Dimensions R�r a- , Ueposlt edd $ Date t)ttier N ` " t of,4rea jsf) Frontage (ft) LotCov,aragai" This`Section for Office l7se'Onl rs s Braildln �P,er " Nu`' ber. s'.�. ,.,. " ' •: "Date�lsstied i {..., . _$ . Signature "` v Certificate of Occupancy > ' Y �Y • F is - isxiot required �Buii ingpfticial t _ s iDate .. - , s_ Section.l -Site Information; Use Group: R-4 Type: 5-13 - 1.1 Property Address: �� Jzr CW s�-���-T L� �- 1.2 Zoning Information: - 2z5- Zoning District Proposed Use 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Requireo Provided 1.4 Water Supply (M.G.L. c. 40. S 54) Public � Private 1.5 ;Flood Zone I ormation* comments,; ,., e, i S ' 7 ei a� Zone:=:,BFE.;' ,E ;:.'{ Section'2'= Property Ownership/Authorized Agent 2.1 Owner of Record: /1 AT Name Mailing Addres�9t j� ,vl�- e z G Z Signature Telephone 2.2 Authorized Agent: LW Name (print) Mailing Address % 430, Signature Telephone Fax Section 3 ' Construction Services== 3.1 Licensed Construction Supervisor: Not) I ' � //.r�:•l,-l—� 0� �Z � G�,y �CiY/,!/�y i /4' � License NumberP./-Z t ` O 7 iV1 Addres � QZ /i 7j 7 /` CiG �q Expiration Date / CO�Gf nature Telephone 3.2,Registered Horrid Improvement, Contrdctor Company Name Not Applicable License Number Address Signature Telephone Expiration Date ''01 9 - 15 - 99 1 of 2 OVER ;:iectton-4 ':WOrKersy.CtsmpE?n5tton Irisuranc6Affidavit°(M:G L:152 525C (6}"' 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 .......... Section:5 'Description of Proposed NO* Bieck ap,appU&able) New Construction No. of Bedrooms No. of Bathrooms Existing Bldg. ❑ Repair(s) ❑ Alterations ❑ Addition ❑ Accessory Bldg.. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: c e- f = rza ,Section 6,.="EsVmkted Construct%on'Costs Item Estimated Cost (Dollars) to be Check Below completed by permit applicant ❑ Conservation -Commission Filing 1. Building g 2. Electrical (if applicable) ❑ Old Kings Highway & Historical Commission approval (if applicable) 3. Plumbing / Gas 4 4. Mechanical (HVAC) QD 5. Fire Protection 0 6. Total = (1 + 2 + 3 + 4 + 5) 7. Total Square Ft. (new houses & ad(rdions) �TQ Sectior} 7a ,OwnerAuthorization' To be Completed When; Owner's A 6hfor.Contractor•A�`'`iesfor.BuildingPermit : ,' I, , as owner of the subject property /�� J� � i hereby authorize 6.*fxr�' l�`4 �5����z. > r7�' to act on my behalf, i II matt rs relati to work authorized by this building permit application. Signaturef6f ner f Date Secti66`7b ,,,Ow`ner/AuthoriiedAgent.Deciarition� 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.. yl� Print name Signatur of wner/Agent Date 9-15.99 2 of 2 SN The Commonwealth of Massachusetts ` = Department of Industrial Accidents _ O!/Iceellevestl�sdirs 600 Washington Street ' Boston. Mass. 02111 Workers' Compensation Insurance Affidavit Applicant information: �{�}, P► +tsePRil9Tirg t. name* 1�/� A —d pis. n7 location- /Z/ CA-K1t7 07-/e,�,4'- A n r 1 am a homeowner performing all work myself. lam a sole. proprietor 2ni h3%e no one %vorkina in any capacity I am-an.emplover pro%iding workers' compensation for my employees working on this job. comrani name• address, city phone u insurance co. nolicv # I am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below ho ha%e the.foilowing %corker• compensation olices: �K ''II comp,�nv name: comoanv name - Failure to secure coverage as required under Section 25A of MGL 152 can Ind to the imposition of criasinal penalties of a time up to S1.S00.0o and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a floe of S1011.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DU for coverage verificatim f do hereby certify under the pains/and penalties ojperjury that the information provided above is vue and eorrem Signature Print name official use only do not write in this area to be completed by city or town official city or town: YARMOOTR _ permit/lieease M nBuildiag Department OLicensing Board p check if immediate response is required 261 C3Seltetmen's Olrce CHealth Department contact person: phone#; _ (SUB) 398�zz31 eEt. nOther. Information and Instructions Massachusetts General Lays chapter 152 section 25-requires all emplovers to provide workers' compensation for their entplo%ees. As quoted from the " law", an emplom•ee is defined as every person in the service of another under any contract of hire. express or implied. oral or written. An enmpl( tver is defined as an indi% idual. partnership. association, corporation or other legal entity, or any two or more of the foretming engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual . partnership: association or other legal entity, employing employees. However the o%%ner of a dwellink= house having 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 I _ = ,ection 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. additional]%. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha%e been presented to the contracting_ authorit%. Applicants Please till in the workers' compensation affidavit completely. by checking the box that applies to your situation and supplyingcompany names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affida% it should be returned to the city or town that the application for the permit or license is being requested. not the Department of industrial .accidents. Should you have any questions regarding the "law" or if you are required to obtain a workers' '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 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 Indtutrial Accidents f IflCO Oi 16YOttllnlfltfr>= 600 Washington Street Boston, Ma. 02111 fax #: (617) 727-7749 phone th (617) 7274900 ext. 406, 409 or 375 FROM :PELLA INSURANCE AGENCY INC FAX NO. '16177870185 Aug.08 2005 01_19PM PI / AUG-08-2005 12:24 F.1.PATNODE INS.AGY: r 2 1� V/ �NtMiAr ur OF LIABluN icaTJ: i61y60e0 Aa a YAT TEA OL IMFOAAIATIOM :CER�IFIGATE c conw'�+s'NO me +*s u�oN•n�E- r,EaTli'iCAT6 ` t/Of.DER. Vas oEttTTFlCAi! q�OED BYTTHMEEVO�cl S PE W. . ACTEA. Ea E FO L.. Ac�NC,t, INC. . , PICILLA �7HSukzA NacA ..._� }n w� sax:vc ramp s rRcslr MSURERS AFFOaD-`t'G— awe _ iapcuTUKMI�az��5-zSvz.. _ V,teua!A � Ar --- .»wee , . •• .. — plNupEla a _ .�.,�.-•.. , . -_._ .,._ ---•� iSCn DlatDantOpog101c p18UPCriC _�. .. Dsa tlobait PLumbi n9 a a a += w 25 Anthony RoadIEq a. — Ya h wft 2 HpTANDING� . - PAY-pp11ODr,D�tAT60.NOTWCT�_��EOOP-- r,OV ' pQE dVsuFIED NAMED AaO� ART �y TH15 C 10"g C D C wa f a1&JRANCt Lp ED Bt1Dw !MYL BEBN RhCT T OiPQOI oOM NT WITH g8bFE1CT 't lyE PODS O C�NMTtON•OF Pt1Y.CONTRACT OR NEREIN IY 5U8•�Ct IO ALLt 75MrA. E%Olus/t1w3 AND CONWT10N8 0rt'� . ANY PSC ARE► r0r. TcaM OP'. AFC flL1ED 6V THE pOWIE&DiBCWBla ^` ' ►LAYPEFCtAKTNb1H8(JpAf1C�' MNMTHAV4�SEEN,REOIJ p�'.PMDGM��o, LGTV P .^ u►nr�s' �' PO�A=6 ADOREGA19 LlMIS8i1iOW_, DaumOq �{,+S Occu��MTEM�GE .+y- sao". u. _ T .Pa {tea .!�M. .7d..�,-. �w�enKwsuYY � � - - xv y,wpfreuAl _I! �.l1UU ccNdAn1 G , Wi0 E W K . 1AAIu r 1 �_�.��� • ' �... �pwV13MADE r,,,,�� .;.• pV M (IEatptfAG�nJUP �D?-20-05 07-20-06 uU lieu Policy. oENfau AaoaecR,e ! 1. 0�1-- w { OrtNL A6Gp8GATE L,yR I POWG'r Gc. • I COMtliNL,»OU tjwf ! �ayO�E.IIAYLtir. ALL QW"9 w,o9 . 1 ,1onauliu,NjtQd- • • .. EOpCYMUUAIr'. - ! �_ � . i „oN. pAyTon - •.; PapPEg1YDAMAOE a (�EAAGO f Qo— -- --•. j WPA4EL1A0wi�V .. ••'.. _ .` 1 YAU QpOM .. Arc, tJ. • I fNrAUTO � ..1111� , I LL lA 6iAB1t1Tr _ i' p{pINOwOE r -- 1 •j1LRBR10N S ... J-._- � �.� �_ �.+tl NeAT10NAN0 t.L6wG+A001Di�. 1 WO'1ME56COMPE E.L04'iJ•4t� EA fMOLdYE l ..--•� ' e►Yl0'ffPr.UWg1TY.. ... IA\r N'AMIAL:Wr/FiM� E1R14Ghik•P*L�C1 1 yr�uf,Er•MtMpYCiI s>O+ - i � CTNe° - �. • --j QNdAO= nY FNDOagWENT, 3Pf0jPR0VKIQAS { . i T t��FwQi,Mllx •- cl�qN of ML'Pd1roN9i WcP' .. .. I 1 41u=a9 .Nork'.. ;.. CIW LATTON „aevoaeiwFiuwA:loN 1 ' CEtl FICATE HOLDER 9""DANYOrT ABOV&OE9Gmoe0rou4tieEe'w4f�uNL10 oAVll are*r•. , OATe rNEPiOF. TIC 168UMO�p? M wnr. r g&AVQa TO M nfa 1AW16l To TN E I,t�T NUT FA06K TO M1 S�]bw: I NOTICE TO THE GEPri}ICATG N�' or- V.IQN ON (wE µiwjf EP. PTO AIifiM9 C ,NI• ' . Gate!!oo,l liotges.- Inc pyeENooaLaAYuu/oxuAmvRw _. 1600 Fal>ooutl! Road CenteS"VS 11C A . bA 02632 €E. ,0 �ppp PofU►TION 17W1 Pax.�.See-178-5603.. r . pCpp0254Z00t1�) �� _ _ . �� TOTAL. P.02 ACOR©� CERTIFICATE OF LIABILITY INSURANCE DATE IMMI PROpUCFit United Insurance A en 9 Inc. 2/10 TM CER7IFlCATEISISSLEDASA MATTEROPINFORMATIOI 199 Main Street ON.YANDCONFERSNORIGHTSLPONTHECERTIFICATE HOLDER. THIS CERTIFICATEOOES NOT AMM P.O. Box 1013 EXTEND OR ALTERTMCCVFPAr,,EAF�p®�,ms�ICISEg,OW. Buzzards BaY, MA 02522 INBURER3AFfOROINOCOVMAGE Patton Electric, Inc. NAIC9 MauRERp Zurich NA P.O. Box 1525 MDURERw Libor Mutual Ina, Co. HaDhpae, MA 02649 I+$URERc: INSURER D: -COVERAGES wBUREN E' THEANY POLICI RFOIIIES OF INSURANCE LISTBb BELOW HAVE SEEN ISSUED TO TMc wcI Iecn D c..cu. MAY POLICIES. PERTAIN. .+•. �unulnON OF ANY CONTRACTOR OTHER DOCUMENT THE INSURANCE AFFORDED BY 711E POLICIES DESCRIBED HEREIN AGGREGATE LIMTTS SHOWN Mpy HAVE BEEN REDUCED BY PAID ....^_ WITH R 14 SUBJECT CLAIMS, RESPECT pE "'I` Iht POLICY TO WHICH TO ALL THE TERMS. PERIOD INDICATED. THIS CERnFICATE MAY 8E El(CLUSION6 AND CONDITIONS NOTWITHSTANDING t$SVEO OR OF'SUCH "' POLICYNUMBER DERMAL LIABILITY POUCYEF fEC 71 TV f1d"M POLO BI ON LIMITS A X COMMERCLALGENERALUABIVTY SCP42415399 7 CLAMS MADE � OCCUR 7/30/05 7/30/06 EACH OCCURRENCE PREMISES CAaxuwp I 1 000 000 f 300 00o S 10 000 MEDEIVrARFauA..mM -- PERSONAL SADVMJURV M 1 000 000 GENERAL AGORECATS f 2 000. OQ0 CEtPL ACGRECATC LMRAFPLIES PER: X POLICY PRO, Loc JFCTAIJTOMO1I1LEL1AB4ITV PROOUCTS•COMPIOPAGG I 2 000 000 ANYAUTO COMdNED$INOLELIMM tEa sow" = ALL OANED AUTO $ _ SCHEDULED AUTO$ BODILYWJVRY(Pwpw-" $ HIRED AUTOS NON-OVWEO AUTOS IAE �" INJURY E PROPAMALC I DAME LIABILITY AUTO ONLY, EA ACC DENT S ANY AUTO OTHER THAN EAACC AUT ONLY: AGO f S - E(CESSNMBRELLALMLLITY EACH OCCURRENCE S - - OCCUR CIAIMSMAOE AGGREGATES • f OEGUCTIME S RETENTION I WO tKQ SLOMPENSATION AND TATU. I VC MMITM OTK H EMPLOYERS'LIABILM ANY PROR( IETORIPAR TNERE(ECUTAE OFFICERRAEMSER FJ(CLVOEO! WG�04=14 S CPbr X WC231S353049014 - 22/10/05 12/10/06 I 100,000 f 500,000 100,000 ELEACHACCIOENT El. DISEASE . EA EMPLOYEE E.LDISFASE•P000YLMIT It OTHER D IiCRIPTIONOF OPERATIONS ALOCADONS AVFHEYES / EACLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVIaONE Electrical Catewood Homes Pax No. 508-778-5603 1600 Falmouth Road Suite 25 Centerville, MA 02632 TION SHOULD ANY OF THE ABOVE DESCRIBED POLKRSBE CANCELLED BEFORE THE ERPIRAT WN DATE THEREOF, THE 18SUINO INSURERWLL ENDEAVOR TO MAIL 10 DAVSWRITTEN NOTIC E TO THE CERTFICATE HOLDER MAIMED TO THE LEFT, BUT FAILURE 700414110 SMALL- IMPOSENOOBLIGATION OR LIABILITY OF ANY HIND UPON THE MVJREIII ITS AGENTS 94 02/16/2006 16:18 5084204474 EDWARD A GRAZLN_ PAGE 01 ,4CORD„. CERTIFICATE OF LIABILITY INSURANCE j DATE WM" o�Y' AS Edward A. Grazul Insurance Agency, Inc. MULUEH, THIS GEHTIFIGATH UUC, NUi AMCNU, CAICNU P.O. SOX 337 ALTER THE COVERAGE AFFORDED BY THE POLICIES SELI Marstons Mills, MA 02646 INSURERS AFFORDING COVERAGE y NAIC11 INSURED Foundation Co., Inc. ^^ Ne wcRg__5 Savers _ per ye& Calnsualty WSURFRA S 43 Phinney's Lane WrUREAC: Centerville, MA 02632 WSURERO: I INSURER C-: OVERAGES THE POf=r-S OFINSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIRI:MENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY RE ISSUED O/1 MAY PF_RTAtN, THE INSURANCE AFFORDED RY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH MACIEB. AGGREGATE LIMITS SHOWN MAY HAVE__ VELN REDUCED BY PAID CLAIMS. - .46R'ADO' .... .. . . -1 ... _... _... ...._.... ....._ . . ........ . POLICY EXPIRATION LTR Sn R SVRANCE POLICY LAUNDER I T. D DATI(MMIDDIrO LIMITS I .p TyPPOU4YEEffFfCTIVE GENERAL UADfUTY I � EACHOCCtIHRP,nK;E S _ X I CCMMEACIAI.GENERALLIABILITY FREMSESjEivccumrccl_....?..... _ ICLAIMS MADE I, XOCCUR� I MEDEXP(AA,DAl pn"' n{�n!�A!'.. S 10., 000;. A 00 J _ i $P 006134 10/05/05 10/05/06 PERSGN_ALaADY1wuRY f 1�(700,_000.. l I a.NCRALAGGMEGATE - S Z,, ��E%E}�EJF%�}r• GEN'I,AGCIREDATE UMITAPPLIES PEA: .. PRODUCTS-COMP/OPAGG S 2,000,000. PRD• LOC I POLICY AUTOMODILEUAWLITY COMBINED SINGLE LIMIT ANVAUTD I {EA utIO[m) IS , I I I i ALI-OWNFOAUTOS BDDfLY INJURY ' S SCHEDULED AUTOS (Pn pnnorQ _ HIRED AUTOS BODILY WJURY NON-OWNEOAUTOS {Per uel4alR1 ... ..... - PROPERTY OAMARE S (PerfrcHpallt) GARAGELIABRITT ! AUTO ONLY• EAACCIOENT S • ( ANY AVI-0 ptHER THAN At1T ONLY: ADO S EXCESSIUMIaRELLA LIABRJ" ' EACH OCCURAENCE f CLAIMS MAOE A00FIRiATP____'"_.! S .. . OEOUCTIELE �_ may___ I �~S "_._.-•. .'. . . RETENTION f _y. WORKERS COMPENSATION AND - WCSTATU. OTI+ TgRXLIMU.SI_ EMPLOYER ;•LIAEIUYY ANY H.I6WM5 RI PFRTNHRIEXECUTryE g OFC CEO MEM�REACLVOED7 WC OW1630 04/01/05 .EB. r E.L EACHACCIDENT 04/01/06 ......_. _._.... . - S. d*- II( E.L.0U'-FASE-F.A EMPI.OYFF �__�____..._ - S _ _ _ ...... .. _.._. . Ct to under C'AL PROVLSION$ bawH E.L. OISCABE • POLICY LIMrT S OTHER OESCRIPTION OFOPERATIONS/ LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL, ►ROYISIONE Gatewood Homes SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLER BEFORE THE EXPIRATION' I 1600 Falmouth Road? DATE THEREOF, THE ISEUINO WSURER WILL ENDEAVOR TO MAIL DAYS WRITTGN 6 3 Z NornE To TlIE CERTIFICATE HOLDER NAKED TO THE LEFT. BIJr FABURETO D@ Sff31N1Lk Centerville , MA 0 Z IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR FAX* 508-778-5603 REPRESENTATIVES. ACORD 25 (200T/O8) 0 AC RO CORPORATION 1988 J . CERTIFICATE OF LIABILITY INSURANCE ACORD i s` �006 " PRODUCER FAX select Financial Group 1574 Washington Street Holliston NA 01746 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR HOLDER. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC0 MURED PC Carpentry Inc. 625 Normandy Drive Norwood MA 02062 WSURERA:Weatern World INSURERS: INSURERa INSURER D: INSURER E: �VYCRAVGA THC POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANOING ANY REOUIREMENT. TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICES 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 ADO iNSR TYPE OF INSURANCE POLICY NUMBER ATE tummD�E aLTE MNMADTWN LIMITS GENERAL LIABILITY. COMMERCULOENERALLAIRRY EpACHOURE 11000,000 MnM�6mX na $ 50,000 LIEDERP onr f 5.000 A CLAIMS MADE OCCUR NPPIGI5227 12/28/2005 12/29/2006 PERSONAL S ADV INJURY f 1,000,000 GENERAL AGGREGATE f 2.000.000 GPM AGGREGATE LIMIT APPLIES PER: PRO CT .COMPIOPAGG S 1,000,000 L POLICYM JPEfyLOG AUTOMOBILE LIABILITY COMBINHO SINGLE LIMIT ISO Mntaent) $ ANY AUTO 'BODILY INJURY (Pr person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Fa suldwtj $ HIRED AUTOS NON4WNEO AUTOS PROPERTY DAMAGE (Px edekenti $ GARAGE LIABILITY AUTO ONLY -EA ACCIDENT { OTHERTHAN EAACC $ ANY AUTO - s AVTOONLY: AGO EXCESWMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE f OCCUR CLANS MADE - s f RRDEDUCTIBLE $ ETENTION f WORNERD COMPENSATION AND EMPLOYERY UADILITY ANY PROPRIETORIPARTNEWEXECUTNE W TO R E.L. EACH ACCIDENT $ EX. DISEASE. FA EMPLOYEE! OFFICERIMEMBER EXCLUDED? N Ye-+. Oe,CMbe ~ SPECIAL PROVISIONS below E.L. DISEASE. POLICY LIMIT { OTHER DESCRIPTION OF OPERATIONMOCATIONSNEHMLESMXC WSIONS ADDED BY ENDORSEMENTSPECIAL PROVISIONS GewesBl liability is provided for the above insured an carpentry - residential not exceeding 3 etoriee in height (subject to deductible $250) 778-5603 Oatewood Hoaxes 1600 Falmouth Rd Suite 25 Centerville, NSA 02632 FICORD 25 INS025 (0+00).00 AM SHOULD ANY OF INK ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE TNEREOP. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WWMM NOTICE TO THE CERTIFICATE HOLDER NAMED TO TIIE LEFT, BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TIE AUTHORIZED REPRESENTATIVE Wicheel Susco/KATHY VMP MWIpge SoN6dm, Ma (11COP27450 mACORD Page I of 2 APR-20-2006 THU 10:33 A19 R & K INSURANCE FAX NO. 508 991 5461 P. 02/03 .v � .� .. f CIMM CERTIFICATE .- ..�. r F LIABILITY INSURANCE DATE IMM/DD/YYYI') 04/2O/2006 PRODUCER (508)994-9583 FAX (SOS) 991 FLRGSHiP INSURANCE INC 414 COUNTY STREET NEW BEDFORD, MA 02740 -5461 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THECFRTIRICATE k=ER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE _ NA1C @ INSURED Frank Capra PO Box 664 West Hyannisport, MA 02672 - WSURERA Providence Mutual 1SO40 INSURER B! Onc5eaCOn 20621 INSURER C: INSURER V.. SiBUiLER E: V THE POLICIES OF INSURANCE LISTED BELOW )LIVE BE ANY REOUIRONAT, TERM OR CONDITION OF A19Y CONT MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLI POLICIES. AGGREGATE LIMITS SMOW14M'AYHAI&SEEN -I ISSUED TO THE INSURED NAMED ABOVE FOR THEPOLICY PERIOD NJOWATED. NO11%1THSTAND" TOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH tEDUCEDBYPAID CLAIMS. hwl TYPE OF II iummim NUMBER POLICY EFFECTIVE POLICY EXPIRATION Lms GeaERALuAmly L.IlYO0S3:33 03 12/13/2005 12/13/ZO06 rACHOCCURRENCE ; 1,000,00 DGE TO RENTED S 50,00 X CONI.ERCIALOENERALVASKM I CUM MA Q OCCUR . LED EXP (Air oAA Pw m) s 1 S.0001 PERSONAL 6 AOV INJURY ! 1 000 a 00 A GENERAL AGGREGATE ! 2 000 D GEMLA00MOATELIMR.APPLIES PER: PRWUCTS• COMPIOP AGO S 2,000,00( POLICY F1 ACT F1 LOC AUTa+OBUEwmuTV ANY AUTO CB1E63796 02/14/2006 02/14/2007 COMBINED SINGLE UNIT (E"G°0i") ! 1,000,00c BODILY XLA/RY (Par POLL) ! - B ALL OWNED AUTOS X SCHEDULEO AUTOS X HIRED AUTOS X NON -OWNED AUTOS 9wIy "MIRY (Pu&cddem) ! PROPERTY DAMAGE (Per Ae "v S. OAPAOELIABIITY AUTO ONLY. EA ACCIDENT i OTHER THAN EA ACC AUTOONT.Y: AM S ANY AUTO . S EXCESBRMBRELLA LIABILITY CDD50264 01 12/13/2005 01/13/2006 EACH OCCURRENCE S 2,000,00c OCCUR ❑ CLAIMS MADE AGGREGATE ! 2,000,00c ! A S - DEOUCTIBLE ! RETENTION ! INORI(ERSCOWENSATMAND 0 bTATLL OTM. E.L EACHILCCS)ENi S EMPLOYERS' IIABRJTY ANY PROPRIETDRlPARTNEIVEIf curvE O")C€RVEMOEREXCLL'^ED? fI-WSEASE: -EAEMPLOVE E $ i mdowiba under SPECIAL PROVISIONS bNow Et. DISEASE• POLICY LINT ! OTHER f1 DEWPWTJQMOFDPFRAMNSILOCAnONSIVEMCLEB/SXCLUSION5 DED BY ENDORSEMENT I SPECIAL PROMSDNS rra- YcNrATF Unl nFR ' I CANCFLL ATION . SHOVLO ANY OF THE ABOVE DESCRIBED POLIpES B£ CANCELLED OEFCRE THX EXPIRATION DATE THSRSOP, THE ISSUING INSURER WALL ENDEAVOR TO MAIL 10 DAYS vmrmu NOTICE TO THE CERTvwATE HOLDER NAMED TO THE LEFT. GATEWOOD HOMES, INC. BUT FAILURE TO MAR SUCH NOTICE SHALL IMPOSE NO ORUSIITIOM OR WBX.OY 1600 FALMOUTH ROAD, SUITE 25 OF ANY RIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES, AUTHO#=D REEAEMTATNC CENTERVILLE, MA 02601 I ACORD 25 (200710E) FAX: (509)779-S603 411100AW04A"TION 1958 �AeenOAurcen {+Il Cllllf. IYYJ► — --- CORD, CERTIFICATE OF LIABILITY INSURANCE oti;6, 6°"YY' PRODUCER Dowling & O'Neil Insurance Agbncy 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 NAIL # INSURED Assurance Construction, Inc. A10 Assurance Excavation, Inc. 550 Willow Street West Yarmouth, MA 02673 INSURER A: St Paul Travelers Insurance Company INSURER B: INSURERC. INSURER D: INSURER E: VVYGRNOGJ 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. INSR L R NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD POLICY EXPIRATION DATE MMIDD - LIMITS A GENERALLIABILITY X COMMERCIAL GENERAL LIABILITY 16808387A9841ND05 08/01/05 08/01/06 EACH OCCURRENCE E.1 OOO OOO DAMAGE TO RENTED S300OOO MED EXP (Any one person) $ 000 CLAIMS MADE FROCCUR PERSONAL &ADV INJURY $1000000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGO $2000000 POLICY PEO- J LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) i- GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGO f�CCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE $ S DEDUCTIBLE $ RETENTION S WC'TATU- OTH- WORKERS COMPENSATION AND E.L. EACH ACCIDENT S EMPLOYERS' LIABILITY - ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT 1 $ IT yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS - Operations performed by the named insured subject to policy conditions and exclusions. GCKIIr'Il:A1C ►IVLUGR ��� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Gatewood Homes, Inc. DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _10_ DAYS WRITTEN 1600 Falmouth Road, Suite 25 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Centerville, MA 02632 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZEDREPRESENTATIVE ` /, I"`^�DR/ �f wTlnwl 4 e4e ACORD 25 (2001108) 1 of 2 #41713 — ---• -- - --_. ACORD CERTIFICATE OF LIABILITY INSURANCE 12/20/ 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.00. BOX 2903 �' /r HYANNIS, MA 02601 :. .....-- INSURERA: COMMERCE INSURER B: INSURER C: INSURER D: INSURER E: .... _. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MR LTe xaRo E F INSURANCE GENERAL LABILITY COMMERCIAL GENERAL LABILITY CLAIMS MADE OCCUR POLICY NUMBER - PENDING POUCYEFFECTIVE DATE MM/DD 12�17/05 POLICYEXPIRATION DATE MM/DD 12/17/06 LIMITS EACH OCCURRENCE sil000r 0DAMAGETORENILU PREMISES 'Ea oomrence $1/ O O O, O O O MEDEXP(Arryoneper ) s5/ OOO PERSONAL& ADV INJURY sl/ 000, 000 GENERAL AGGREGATE s2,000,000 - GENT. AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $1 , O O 0 , O O O POLICY PE 7 LOC AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE LIMIT (Eaaccident) $ BODILYINJURY- ---' (Per person) $ ALLOWNEDAUTOS SCHEDULED AUTOS - BODILYINJURY (Peracddenq s- HIREDAUTOS - NON-OWNEDAUTOS PROPERTY DAMAGE (Peraccident) $ " - GARAGE LABILITY AUTOONLY-EA ACCIDENT S OTHERTHAN EAACC S ANYAUTO $ AUTOONLY: AGG EXCESSNMBRELLA LABILITY EACH OCCURRENCE S AGGREGATE S OCCUR CLAIMSMADE s S DEDUCTIBLE - S RETENTION $ - STATUj OTH- WORKERSCOMPENSATIONAND TWCR YLIMIMIT E.L EACH ACCIDENT S EMPLOYERS' LIABILITY mrr MR ErolwsaraER,>:.xEc OrnceleuEVBER UMUDE E.L. DISEASE - FA EMPLOYEE $ E.L.DISEASE -POLICY LIMB $ tfyes.descnbeunder SPECAL PROVISIONS belay OTHER DESCRIPTION OF OPERATIONS/ LOCATIONSIVEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS cAMccl I AyInM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEL I W BEFORE THE EXPIRATION GATERWOOD HOMES DATE THEREOF, THE ISSUING IN URER WILL ENDEAVOR TO MAIL _ DAYS WRITTEN �JLL 1600 FALMOUTH ROAD 4 25 NOTICE TO THE CERTIFI ATE H ER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL CENTERVILLE, MA 02 632 IMPOSE NO OBLIGATIOP OR RfTY OF ANY KI D UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORQED REPRES THE ACORD25(2001/08) UACUMUL:UI FUKAlIUNTypo �4•YgR^r TOWN OF YARMOUTH PLEASE PRINT: Job Location: _ Owner of Prop Construction S BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM Address: O Licensed Designee: (If other than Supervisor) Name 0LAA( 1z d 2.15 Responsibility of each license holder: License No. .0 0163 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 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 Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter of th s. Gen er I s, hat my signature on this permit application waives this requirement. Check one: Signature of O� or Owner's Agent Owner BOO' Agent Signature: Building Official Approval: TOWN. OF YARMOUTH 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT BUILDING ELECTRICAL GAS PLUMBING SIGNS Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 1 �IM p Work AcMress r �( is to be disposed of at the following location: ' 0 P2 O�o %jKfl 2 Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. wo MAIrow Date Permit No. .%ueaf� a A�ll& BOARD O . BFALDING REGULAFtONS License—NSTRUCRON SUPERVISOR zw. NumbewS, t14243Q . Tr: n6: 25$26. ResirrctEd ����, FRANK CAPER" —= 46COPPER.M CEUTERWLLE. MA 0263 Commissioner _ a 00 - 35;OOO c t enclosed space (MGLC.f1Z&G0L) - ' IG=A- KZ F6ff* Homes Failure:topossess;acur .ren0.edition offt MassaetiosettsStatesBuldixj:Code, is-cause:for revoe9ti6u:'of tins license, A f DIG SAFE CALLCENTER: (888) 344-7M3 L m n)-}- O Go- 3 GMS9/GCS9 SERIES MultioPosition, Single-Stage/Multi-Speed Gas Furnace Heating Capacity: 46,000-115,000 BTUH 11FETIINE 4 PRiS u�uTED wARRANiC LIMITED ,:1•FA9, FA[f1AN4CMyJL WARRANTY: 1�� Y podCar- ® ENvETAR RGYS e+ n 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 (1-pipe) applications 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.E Kits (HANG11, HANG12, HALP10) • High Altitude Pressure Switch Kit (HAPS27) • External Filter Rack_ (EFROI) • Horizontal Concentric Vent Kit (HCVK) • Vertical Concentric Vent Kit (VCVK) • Internal Filter Retention Kit—upflow, horizontal (RFO00180) • Internal Filter Retention Kit-downflow (RF000181) • Thermostats Blower Motors (CHT18-60, CH70TG, CHSATG, HZOTWR) SS•377D www.goodmanmfg.com 6/04 • //-v , & 6 TOWN OF YARMOUTH 6 �' U HEALTH DEPARTMENT MAY `0 2 2006 PERMIT APPLICATION SIGN OFF TRANSMITTAL S ALTH DEPT. To be completed by Applicant. - Building Site Location: / 7, CAMS 5 !/Zcrk"T Map No.: Lot No.: c O Proposed Improvement: e- 3 �Ly lZod."r0"!j Applicant: �/2.4/V ,L e A A2914 lrfl TE-7AW n 40 L. A4 c--5 Tel. No.: So F W gtS�S' Address:-/v�OD piac.ModTN /20111) 4: riew7 ' eVILCC IWA Date Filed: OZ6 3 Z **Ifyou would like e-mail notification of sign off,' please provide e-mail address: Owner Name: slT CAMP 157RGE-rT Owner Address: /600 F LMvo77f LZD �'7�l✓icL� �%_OIdSZOwner Tel. No.:Sojr 77Y 49 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. REVIEWED BY: Please submit four (4) copies of plans, to include: (1.) Site Plan showing existing buildings, water line location, and septic system location; (2.) Floor plan labeling ALL rooms within building (all existing and proposed) — Note. Floor plans not required for decks, sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. PLEASE NOTE -5=46 ,✓lr:�'N�G Nr'3 +So$ 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 / CAM P Sr. Map #: Lot #: -X2- If Proposed Improvement: Applicant: Sr- /6D0 rr P-a Address:41A o 7- 6 3 Z Tel. #: 5o7 778 - 9 c 6 9 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; Le. If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Ocean, Bogs, Bays, Marshland, Etc.. Health Department Determines Compliance to Stat and town Regulations' i.e., Requirements for Septage Disposal and other Public Health Activities. Fire Department: Determines Compliance to State and Town Requirements for Personal Safety, roperty Protection; i.e. Smoke Detectors, Sprinkler Systems, Etc.. REVIEWED BY A R D N: PLEASE NOTE: COMMENTS: Signature Of Applicant Date: OF 1, TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-06-473 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Unit 90 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: $50.00 Payment Type: Check ChkNo.: 9939 Net Owed: ($50.00) Application Date: 5/5/2006 Issue Date: Expiration Date Comments: Map/Lot: 044.21.1.0 new construction: ZONING APPROVED._, REVIEWED BY: 1. WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT: DATE: N/A: 5. BUILDING DEPARTMENT: DATE: N/A: 6. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: Date Printed: 5/8/2006 MAscheck.COMPLIANCE REPORT Massachusetts Energy code MAScheck software version 2.01 Release 2 CITY: Yarmouth STATE: Massachusetts HOD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: other (Non -Electric Resistance) DATE: 4-21-2004 DATE OF PLANS: 04/21/04 TITLE: The Egret l q 7 PROJECT INFORMATION: Mill Pond village 121 Camp Street Yarmouth, MA 02673 COMPANY INFORMATION: Northside Design Assoc. 141 Main Street Yarmouth.Port, MA. 02675 COMPLIANCE: PASSES Required UA = 216 Your Home = 123 Permit # checked by/Date RECEIVED MAY 0 5 20H BUILDING DEPT. By: Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-value UA ------------------------------------------------------- CEILINGS 832. 30.0 30.0 14 WALLS: wood Frame, 16" O.C. 1409 15.0 15.0 62 GLAZING: windows or Doors 87 0.340 30 GLAZING: windows or Doors 40 0.340 14 DOORS 40 0.086 3 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer, I Date Massachusetts Energy Code •MAscheck software version 2.01 Release 2 The Egret DATE: 4-21-2004 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-valuer 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: M86 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. ( DUCT INSULATION: [ ] ( Ducts shall be insulated per Table 34.4.7.1. ( DUCT CONSTRUCTION: [ ] I All accessible joints, seams, and connections of supply and return ( ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the ( manufacturer's installation instructions. Mesh tape may be ( omitted where gaps are less than 1/8 inch. Duct tape is not ( permitted. The HVAc system must provide a means for balancing ( air and water systems. TEMPERATURE CONTROLS: [ ] ( Thermostats are required for each separate HvAc system. A manual ( or automatic means to partially restrict or shut off the heating ( and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] ( Rated output capacity of the heating/cooling system -is not greater than 125% of the design load as specified ( in Sections 78004R 1310 and 74.4. SWIMMING POOLS: [ ] ( All heated swimming pools must have an on/off heater switch and ( require a cover unless over 20% of the heating energy is from ( non-depletable sources. Pool pumps require a time clock. ( HVAC PIPING INSULATION: [ ] ( HVAC piping conveying fluids above 120 F or chilled fluids ( below 55 F must be insulated to the following levels (in.): I I PIPE SIZES (in.) ( HEATING SYSTEMS: TEMP (F) 2" RUNOUTS .0-1" 1.25-2" 2.5-4" ( Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 ( LOW temperature 120-200 0.5 1.0 1.0 1.5 ( steam condensate any 1.0 1.0 1.5 2.0 ( COOLING SYSTEMS: chilled water or 40-55 0.5 0.5 0.75 1.0 ( refrigerant below 40 1.0 1.0 1.5 1.5 ( CIRCULATING HOT WATER SYSTEMS: [ ] ( insulate circulating hot water pipes to the following levels (in.): PIPE SIZES (in.) NON -CIRCULATING ( CIRCULATING MAINS & RUNOUTS ( HEATED WATER TEMP (F): RUNOUTS 0-1" I 0-1.25" 1.5-2.0" 2.0+" ( 170-180 0.5 I 1.0 1.5 2.0 ( 140-160 0.5 I 0.5 1.0 1.5 ( 100-130 0.5 I 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department use only)---------------- 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 ®Optl,ons • Choice of standing pilot (works in a (ower failure) or pilotless electronic intermittent) ignition • Decorative polished brass or brushed stainless accessories (arch door kit, door trim, louvers, hood) • Wireless remote controls • Blower kits (including a temperature control version) • Screen panel kit (heat guard) • Radiant panel kits (for a clean face look) All Merit Plus Series direct -vent gas firepplacjes utilize either a Secure inner/7.5vouterent �coaxialS venting system,includein lude a 20-year limited warranty. . Note: Due to Leaoox' ongoing commitment to quality, all specifications, ratings and dimensions are subject to change without notice. Local conditions, such as elevation, wind vent configu- r ftion and choice of fuel will affect the overall appearance Warnock Hersey (J2000671I) Wamock Hersey C � ID N1AY � 5 2006 g gV11.DIN�' DEPT. 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 (These models come with a top and rear vent) Right Side Front FaceTop To Ri htSide FIREPLACE & FRAMING DIMENSIONS e G / 7l ss rs iy /s 21'/z 10'/t 33 t/4 33t/4 13 3530 35t/8 32t/s 19 2%t 351/8 21% 24%s 12%6 35t/4 351/4 4035 40t/8 37t/s 24 34tfa 401/8 2611A6 29Ya 1415A6 16 403/4 4540 40t/8 37t/s 24 393t 451/8 2611h6 34%s 17%36 .403/4 451/4 16 404 16 r r a m= TYPICAL ROOM 3328T NG 17 500 45 64 62 APPLICATIONS 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 Elm 4035 NG 27,000 59 69 67 4035 LP 27 000 60 69 67 4540 NG 29,000. 59 69 - 67r�_ *Intermittent ignition systems Look for the EnerGulde Gas Fireplace Energy Effieleney.Rating In this brochure MPD3328 MPD3530 MPD4035 33' fireplace w/opt. flush face 35' fireplace w/brusbed stainless 40' fireplace w/polished brass louver and door trim trim arch door kit Beauty, efficiency, convenience and reliability. Just some of what you'll find in our Lennox Merit® Plus Series direct -vent gas fireplaces. Our combo DV configuration, with both top and rear outlets, allows for top or rear venting (except.our 33" units which have either a top or rear outlet). Standard features include a_deluxe pan burner that produces big yellow flames and glowing embers, brickaded interiors and Hi/Lo flame opera- tion. And, these models are even easier to warm to when you select one of our optional remote controls, or polished brass or brushed stainless trim options. MUST i fS AND H WATER 20 10 LOT 75 LOT 74 ki N84'19�03"E T 5 8�9�0- —�' 54.00�, 'LOT 88 14.00 LOT 90 p 5.3• LOT 91 3,672f S.F. 5'3 I ZA `° sco w .28.2 Z �h PROPOSED jl�RON IZ HOUSE rn PROPOSED p HERON U; v, �° p EGRET L j N FF = 23.0 p hFF = 23.5GW14 GW = 5 4, �_ 8a15 I I Ono o 0-o\,� I TO ALL W,1 ONS -��19& DA E GRAPHIC C. 11 _ PROPOSED 4" SEWER LATERAL—�� I a-w LI 02i: a- 0 LL- LL. J 3.16' 1 , �. 54.00' �=��EIVEU MAY '0 2 2006 NOTE: ® SEWER LATERAL SHALL BE SLEEVED IN ACCORDANCE WITH TITLE V IF WITHIN 1OFT. OF WATER MAIN. 1 20 60 h101117ti Unless and uot;l such time as the original (red) stamp of :he ra s,:cna bla Profassimel Engineer, or Professional Land Surver-r oppears on this p IN FM ) (A) no pi!rsnlnan; or persons, incladln •3 any maricl;cl or oth-r c Uhli.• official s, may rely upon the infnrrnatbvi r_cntninaj herein; c^ 1 inch = 20 ft. (C) this plea renllns the property of Halmos .°a McCrai-, !�:•;- PLOT PLAN OF LOT 90 PREPARED FOR MILL POND VILLAGE IN YARMOUTH, MA SCALE: 1 "=20' DATE: 3-24— holmes and mcgrath, inc. civil engineers and land surveyors 362 gifford street falmouth, ma. 02540 JOB NO: 201197 DRAWN: LMC DWG. NO.: A2558 CHECKED: --IA' �J �t\t U` M1f�sc9� .` cy TIMOTHY M. �m SANTOS No.45078 to CIVIL FSSgnA�EN�' . SCALE: LOT 75 LOT 74 8_9'0- 14.00' ki N84-19'03"E g ' 54.00� -- L T 88 -" i LOT 90.— I 5.3' 91 3,672f S.F. 5.3 M ------- 4 _ SEWER � ( IN FEET ) 1 inch = 20 ft. PLOT PLAN OF LOT 90 PREPARED FOR MILL POND VILLAGE IN YARMOUTH, MA 1 "=20' DATE: 3-24-05 NOTE: ® SEWER LATERAL SHALL BE SLEEVED IN ACCORDANCE WITH TITLE V IF WITHIN 10FT. OF WATER MAIN. NOTICE Unless and until such time os the original (red) stamp of :he ;F ansible Professional Engineer, or Professional Land Surveyor pears on this plan: (A) no pnreon or parsons, including any municipal or other puolle nfficial3, may rely upon th^ infcrmatlon cr talned herein; c- 1 (J) thin plan remains the property of Holmes & AlcCraih. !n.;, holmes and mcgrath, inc. civil engineers and land surveyors 362 gifford street falmouth, ma. 02540 JOB NO: 201197 DRAWN: LMC DWG. NO.: A2558 CHECKED: TRVIOTHY M. �� S„tiTOS rao.a5078 CIVIL \F STZV`F 1 FS... TOWN OF YARMOUTH Building Department BUILDING (508) 398-2231 ext.261 ---- PERMIT NO B-06-1496_ _ - - - _ PERMIT _-___--- ISSUE DATE ; 5/26/2006 ; APPLICANT Frank CPROPOSED USE _ _ -apra ----------------------- JOB WEATHER CARD PERMIT TO ' New Construction ; ------------ AT (LOCATION) 100121CAMP ST Unit 90 ZONING DISTRICT R-2 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 1044.21A.C90 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE new construction: 2 baths, 3 bedrooms, 1 diningroom, 1 kitchen, 1 livingroom as per plans dated 05/16/06. REMARKS AREA (SO FT) EST COST ($ $148,896.00 I PERMIT FEE ($) 1$543.00 OWNER lVillages @ Camp Street, LLC BUILDING DEFT BY ADDRESS 1600 Falmouth Road # 25 Centerville I MA 102632 INSPECTION RECORD CONTRACTOR LICENSE 1 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 PHONE 15087789669 '1 FIELD COPY .:Note Progress IP IN