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121 Camp St #093 Building Permits
o� r� TOWN OF YARMOUTH Building Department BUILDING + _ (508) 398-2231 ext.261 PERMIT NO B.o�-es3 - PERMIT ISSUE DATE ; _ 1h 1/2007 _ ; _ _ _ . _ _ _ _ PROPOSED USE . APPLICANT FrannkkCapra .----------------------' C JOB WEATHER CARD PERMIT TO ' New Construction ' AT (LOCATION) 100121CAMP ST Unit 93 ZONING DISTRICT Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C93 LOT SIZE REMARKS BUILDING IS TO BE: CONST TYPE 5-B USE GROUPC new construction: 2 baths, 3 bedrooms, 1 greatroom, 1 kitchen as per plans dated 11/14/06. AREA (SQ FT) EST COST ($ $141,600.00 OWNER lVillages @ Camp Street, LLC ADDRESS 11600 Falmouth Road # 25 Centerville I MA 162632 PERMIT FEE ($) $516.00 BUILDING DEPT BY CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 PHONE 15087789669 THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PARTTHEREOF, EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM INSPECTIONS REQUIRED FOR ALL APPROVED PLANS MUST BE RETAINED ON WHERE APPLICABLE SEPARATE PERMITS ARE CONSTRUCTION WORK: 1) FOUNDATIONS OR JOB AND THIS CARD KEPT POSTED UNTIL REQUIRED FOR ELECTRICAL FOOTINGS. 2) PRIOR TO COVERING STRUCTURAL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS PLUMBINGlGAS AND MEMBERS (READY FOR LATH OR FINISH REQUIRED, SUCH BUILDING SHALL NOT BE MECHANICAL INSTALLATIONS. COVERING) 3) FINAL INSPECTION BEFORE OCCUPIED UNTIL FINAL INSPECTION HAS OCCUPANCY 4) REFER TO DETAILED INSPECTION BEEN MADE. SCHEDULE POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING 2 2 � % 2 3 OTHER: 1 2 3 4 5 WORK SHALL NOT PROCEED PERMIT WILL BECOME NULL AND VOID IF INSPECTIONS INDICATED ON THIS CARD UNTIL THE INSPECTOR HAS CONSTRUCTION WORK IS NOT STARTED WITHIN SIX CAN BE ARRANGED FOR BY TELEPHONE APPROVED THE VARIOUS MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED OR WRITTEN NOTIFICATION. STAGES OF CONSTRUCTION ABOVE. 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 il r Vie, CJse Onl r, w Plannm Board Information' g Assessors a De p rtment infomration a il Perrrllt NO 4 Y� t 77ypp' c. '„Napa' '� Loft r _ f" �dorsernentfiAie f3� t fF r t2ia� �g Permit fee�Y t s k x a5 x x > ,,� �a-x i *Recordibg Date - ;D1teX ¢�a� Bulldin Per t "uriil� r�� t �" D:ate�ls`sued'wfi=,�F Signature < vst , ,".. -,, Certiilate of Occupancy ; , _ uiiding30fficialx"f" Section 1 Sife lnfor`rnatiiin; Use Group: R-4 Type: 5-13 1.1 Property Address: J 2 t C4-x1 P �� Y` � 1.2 Zoning Information: v A L>� 9l3 ZC t g is ric ri posed Use 1.3 Building Setbacks (ft) JaN+ 1 n c Front Yard Side Yards Rear Y rd Required Provided Required Provided 18 Provided 1.4 Water Supply (M.G.L c. 40. S 54) 1 S1EIoodZorie'Information` ]� � ✓V`j �,p s`d t,, i '�"x- t'a.�. i F"4^.,-,3 k� n � � i � �S � " �r � r �.:2 S��s`s`�. {-f�i't� t�.. Public Private t i ectlon2 ,„�rgperty,p�ivrTersliip%Authorized Rgent 2.1 w r of Recordd- Name (print) Mailing AddressOwg-an" ,0Zz 16 4 �^��z_ - 7 78 - Signature7 Telephone 2.2 AuthorizpdtAgent: Z6 �CfeCPd�Tidl1 tl-S�i�<��Gl'J t g Na print Mailing Address Signature Telephone Fax Sectioi"t13 Corastructlot Se"tutees: L 3A Licensed Construction Supervisor. V111, e r �o`NG� ell Addr D - ` Expiration Date Signature jr Telephone /jp — L tC _ 3.2 J3egtsteretjl-lorpe, [mpro�eTrrent' Contricta�;;, Company Name _ Not Applicable Address License Number Expiration Date Signature Telephone "-�� 1 oft OVFR\% Section'4°Workers' Compensation Irisifrartce AffidavitM.G L y:52 S 25C;)`' Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes ......... No .......... Sectitart S = Descnptton°ofrProposed.Worki check•Aft applicab — New Construction No. of Bedrooms 12 No. of Bathrooms Existing Bldg. ❑ Repair(s) ❑ Alterations ❑ Addition ❑ Z Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: G cS Giist'S0 5e6tian;6 = Estima#ed".Gonstru� Item Estimated Cost (Dollars) to be completed by permit applicant Check Below ❑ Conservation -Commission Filing_ (if'applicable) . ❑ Old Kings Highway & Historical Commission approval (if applicable) 1. Building O-190 2. Electrical 3. Plumbing / Gas 10 4. Mechanical (HVAC) - p 5. Fire Protection , a a0 6. Total = (1 + 2 + 3 + 4 + 5) F Z00. F. Total Square Ft. (new houses & add•Rions) Sectio,n a �O*hdrAuthorizatib6,� Owner's,AgentbrContractorApptie o be Compteted,When or-,Buiftltng;Permtt , as owner of the subject property hereby authorizey`", c J�'�� to act on JV my behalf, in all m rs vela ' e' a to�horized by this building permit application. Sig tur of wner Date Sectibri'"/7b/%Ow�ieri.4iiitiar'ized � gent= DecJ ara#ioh .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. /the pains and penalties of perjury. . Signed /under Prin ame Sig a of O ner/ gent Date 9. 15-99 2 of 2 �r x u1v WINyr YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: Job Location: Owner of Property: Construction Supervisor: Address: Name Licensed Designee: (If other than Supervisor) Name 2.15 Responsibility of each license holder: Village LL G ly-:�o 9U09 No. rho. A u,. G License No. 2.15.1 The license holder shall be fully and completely responsible for all work for which he is supervising. He shall be responsible for seeing that all work is done pursuant to the state building code and the drawings as approved by the building official. 2.15.2 The license holder shall be responsible to supervise the construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of building and structures only pursuant to the state building code and all other applicable laws of the commonwealth, even though he, the license holder, is not the permit holder but only a subcontractor or contractor to the permit holder. 2.15.3 The license holder shall immediately notify the building official in writing of the discovery of any violations which are covered by the building permit. 2.15.4 Any licensee who 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 liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes No ❑ If you have checked Yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity Bond OWNER'S INSURANCE WAVER: I aware that the licensee does not have the insurance coverage required by Chapte 1 o ass. al a s, and that my signature on this permit application waives this requirement. Check one: Signat re of er or Owners Agen Owner ❑ Agent Signature: Building Official Approval: f �\ The Commonwealth of Massachusetts Department Of Industrial Accidents - o O111C0o/laYest/psdfiOs 600 Washington Street Boston, Mass. 02111 % �r Workers' Compensation Insurance Affidavit m• ❑ I am a homeowner pertorming all work myself. O 1 am a sole _proprietor zn.4 ha,.e no one working in any capacity O 1 am an.employer pro% idino workers' compensation for my employees working on this job comnanv name: address: city: phone # insurnnee co. policy!! I am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contactors listed below who ha%; the follow'ina workers' .ompensation ice �� ri �,�,• atldreac: L117/Of'/ Pn - company name, a - Failure to secure coverage as required under Section 25A of MGL 1S2 am lad to the imposition of criminal penalties of a fine cap to S1,500.00 and/o 'one years' imprisonmth ent as well as Civil penalties in the forof a STOP WORK ORDER and fine of S100.00 a day against me. I understand that i copyof this statement may be forwarded to the Olfee of investigations of the DU for coverage verification. t do-herehy cerrify under the pains and penaltics of pciyury that the information provided above is trueand cor"= signature , _�� !� ate Z G a Print names* fXl1 GC=/#�/ ' 1. Phone N official use only do not %rite in this area to be completed by city or town oMcial city or town: YARMOIIT$ _ permit/license N r-1Building Department (]Licensing Board 0 check if immediate response is required 261 QSelectmen's Orrice C)Healtb Department contact person: Phone/fit_ (508j 398�2231 eat. nOthcr Client#: 18434 2ASSURANCECO ACORM CERTIFICATE OF LIABILITY INSURANCE , 6DNYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling 8: O'Neil Insurance Agency 9 y ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 222 West Main St. PO Box 1990 Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A Travelers Insurance Company Assurance Construction, Inc. A/O Assurance Excavation, Inc. 550 Willow Street West Yarmouth, MA 02673 INSURERB: INSURERC INSURER D: INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR '. : * MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH " - POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR HSF, - TYPE OF INSURANCE _-_ POLICY NUM.SFA POLICY EFFECTIVE DATE rAMlDD POLICY EXPIRATION DATE MIA/CD — - - _. _LIMR4_. .._.. A GENERAL LIABILITY 16808387A9841ND06 08/01/06 08/01/07 - EACH OCCURRENCE $1,000,000 PREMISES (Ea �" DAMAGE TO RENTEDnmi $300 BDD X COMMERCIAL GENERAL LIABILITY .... .... _ __, - -- - CLAIMS MADE a OCCUR MED EXP (Any one person) $5 000 PERSONAL S ADV INJURY $1 00O 000 GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO s2000O00 POLICY PO - JET LOC AUTOMOBILE LIABILITY - ANY AUTO -. .. - COMBINED SINGLE LIMIT (Ea accident) .S_. - BODILY INJURY (Per Parson) $ ALL OWNED AUTOS SCHEDULED.AUTOS.._ _. BODILY INJURY - (Peracdtlent) . -HIREDAUTOS . .. ..... .. .NON -OWNED AUTOS PROPERTY DAMAGE - (Per accident) - - - S -' - - - - GARAGE LIABILITY AUTO ONLY -EA ACCIDENT S OTHER THAN EA ACC $ ANY AUTO S AUTO ONLY: AGO EXCESS/l1MBRELLA LIABILITY EACH OCCURRENCE Is OCCUR CLAIMS MADE AGGREGATE $ S $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND -. .. WC STATU- OTH- E.L. EACH ACCIDENT._ EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER(EXECUTIVE E.L. DISEASE -EA EMPLOYEE S OFFICERIMEMBER EXCLUDED? Ifyes; descrlbelndef='�-. SPECIAL PROVISIONS belov E.L. DISEASE .-POLICYLIMIT. S _ 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 ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION IEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL , n DAYS WRITTEN TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED G ACORD 25 (2001/08) 1 of 2 #44705 LS1 © ACORD CORPORATION 1988 e.*jQ /.► m VLF I INU^ 1 rr wr wt%mmi 1 T 11��7u►�t���vv - . T14M CERTIFICATE IS.ISSUED AV A MATTER OF IWORIUATION �+�• ]p Ei INSURANCE AGENCY, INC' ICATENO R AMEND. EXTENFD OR ONLY IHO 1LA PL'R THIS C011FAND ER NOT 58yA WASHINGTON STTC ET ALTER THE C01/EIZAG& AFFORDED. BY THE POLICIES BELOW. nxIGHTON, MA 0213S-2542 T01. (617) 737 0617 IN9URERS.AFFORDW(i COVERAGE . yAtCk INSURER A: JLz$o21a RroTaCtieln 219 CO wisum D teen OiamentOpaulog 13DA Rabatt plumbing, A "$Aatjmrr . iftimcR B:. . . - ... - w3UREA Ch 25 Anthony Road welt Yommouttr; "L'.dL-02673 . - - - - B+EUAARD: INSLIAER- 6 COVERAGES " THE POLICIn OF INSURANCE LISTED BELOW HAVE DEEM 12SUCOTO THE INSUR@0 NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING • • DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ANY REcvIREhqENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER MAYFERTAIN THE INSURANCE AFFORDEDBYTHEPOLICIESD6SCRt8EDNERE1NL43lr TT0ALL1H2TERmS,E71CLtSONSANDCONDITIONSOFSUCH POLICIES, AGGREGATE LIMITS SHOWN MAY14AVE BEEN REDUCEDBY PAIOCLA'NS. • _..- POLICY NUMMA .. .. ._ EACH 60"MWCE... S' 300708 4WMAt LIAA4m ASMI E. :101000 _ _ .Oor�Rr.InLc+ENc.AALuaDem_ .... .. .. 5` CLWAMAOE OCCUR A SS00031617 7/20106 -1/20/07 PBAsoNnuA,rfBtmAY s 0�000 - - GENERAL' AOOAEGATE _ . S • -1- rrKAODAEOATEL APPLIES BEAD _ .... PRODUCTS•CONPeDPAW [ - OOO 000 17 POL LOC AutOW0IL!UABILITY _.. -. )NE�DIIIBMOLE LIKT ANYAUTO ALL OVARM AUTOO _ DOOILYWJURY 3 ICHEDULEO AUTOS HIRDOALTOR BODB.YINJl1A'f 3 NON. OWNEDNJr09 pF-IROPnIxdoyOPMAOE mm) 1 _ _ _ (PM'w GAAAOP LIAOILITY AUTO ONLY- EAACCIOENT 3 ANYALTfO - - - OTALTmAm. . . EAACC AUTDONLY: - AC6 I 2 ' EXCESSONACLLAL"ILITY "' EACN OCWARENC6 3 .. AGCAE4AYC . B OCCUR MAIM9MADE 3 DEOUCTR.E _ _ R27EI7rION - -r WOAXEASCOWENSATION ANO ewtWEAN LIA81L1Tf _ _ EL EACH ACGOEM 2 E.L. OISEAAE • DA EMPLDYEB S _ .... . ANy DROPAKT - .... OXCLU.MdfO.TRMI a��raarccpwR+w��l�cpAglp1NClleeOf siECtAG�9RCv1Mp4tQN4 Debt - - - _ _ S.L. DD:6116E-pOLiCY lA11 3 OTHER I 1 106e0AmTON OF [roERATOHSILDOAt10N/ f%CN, 3I EXCLUSIOh3AMED BYEN00JUIDAC TISPECIPLPROIAMNR PXAMMG WORK ATTN- Amtft C, MALvrs GATS7IP00D g0m9... 160 0 FASdd0I u AD M 25 C£NT2r=x&r,, . NA 02632 FAX# SOB-779-SS03 iANCEiLLAT10N - BHOU�D OF.7 ,Ap Nac(smCO p¢y101E0 BO CANCUrm"irmur EXPMATION DATE TNEREOF. "Ir, MSSUINO p+AuABA WILL ENDEAVOR TO MA1410 DAYS WRITTF•N NOTICE T4 3NE CERTIFICATG"OLOER NwMED TO TK LEFT, BUT FALLUAE TO tm BO AHALI impoBE Aarii&w�TJOrE�t1l91CITN6A THD NMUAEA:'m AGENTS 09 AEPAEb6NTA S. '4*4 TMPA.- 102. Client#: 11149 ACORDn CERTIFICATE OF 2BARNEL LIABILITY INSURANCE °"�(M""'°°^) PRODUCER Dowling & O'Neil Insurance 08/29/IO THIS CERTIFICATE IS ISSUED A MATTER OF INFORMATION Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE T HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 222 West Main St. PO Box 1990 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis, MA 02601 INSURED INSURERS AFFORDING COVERAGE NAIC # M. Ostrowski, Inc D/B/A INSURER A St Paul Travelers Insurance Company INSURER B: Associated Employers Insurance Compa Barnstable Electric INSURER C: 71 Lothrop's Lane INSURER D: West Barnstable, MA 02668 INSURER E: COVFRAf:Fs - 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. EMTNSRE A TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR POLICY NUMBER 1680305OA587COF06 OLICYDATE(MMIDD/VYE 07/19/06 POLICDATE MM%DDTION 07/19/07 - LIMBS EACH OCCURRENCE E1 000 000 DAMAGE TO RENTED MED EXP (Any one person) $3OO OOO E5 OOO PERSONAL INJURY E1 000 000 GENL AGGREGATE LIMB APPLIES PER: POLICY PET LOC GENERAL AGGREGATE E2 000 000 PRODUCTS-COMP/OPAGG E2 000 000 . AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS - COMBINED SINGLE LIMIT (Ea accident) E BODILY INJURY (Par person) . E BODILY INJURY (Per accident) E PROPERTYDAMAGE (Par accident) E GARAGE LIABILITY ANY AUTO AUTO ONLY -EA ACCIDENT E OTHER THAN EA ACC AUTO ONLY: E EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION E- AGO EACH OCCURRENCE E E AGGREGATE E E E B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTNE OFFICERIMEMBER EXCLUDED? N yes, tlesrfibe under - SPECIAL PROVISIONS below OTHER WCC5000804012006 01/15/06 01H5/07 WC STATLL OTF+ E E.L. EACH ACCIDENT $SOO OOO E.DISEASE . EA EMPLOYEE E500,000 E.L DISEASE •POLICY LIMIT E500.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Insurance coverage is limited to the terns, conditions, exclusions, other limitations and endorsements. Nothing contained In the certificate of insurance shall be deemed to have altered, waived, or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER _..__.. •____ Gatewood Homes 1600 Falmouth Road, Suite 25 Centerville, MA 02632 A"' ZD (ZUUI/08) 1 of 2 #44180 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR To MAIL 10_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 30 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVE& AUUTHOO/RIZPRESENTATIVE A - C. LS1 0 ACORD CORPORATION 1988 R -JlrA.-Su-4uU0 114U Ill.ss fill X !� IPZlJMUL FAX N0, 508 991 5461 P. 02/03 r I J StQZS CF-RT! iiAT= i" LIASIL! 1 (r iN;ro%URANCiDATE (Mv N/20/z� 00 PRODUCER (508)994-9633 FAX (SOS)9- FLAGSHIP INSLTMCE INC 414 COUNTY STREET NEW REDFORD, MA 02740 -S461 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANDCONFERS NO-RfGHT$ UPON rM.CFrt' TI€ICATE HOLDER, TM CERTIFICATE DOES HOT AIfND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE DLICIES SELOW. INSURERS AFFORDING COVERAGE NAICS INSURED Frank Capra PO Box 664 West llyannisport, MA 02672 l+SURER& Providence Mutual IS040- INSURER BI OneBeacon 20621 INSURER C: a-IsuRERa INSURERS; AGES THE POUCIES OF INSURANCE LISTED BELOW RAVESEMISSUEO ANY RF_OULRfMENL TERM OR CONDITION OF ANY CONTpWCT MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES MlCtES. AGGREGATE LIMITS SHOM MAY HAVE BEE TO THE INSURED NAMED ABOVE FOR Tt1E POLICY PERK)D INDICIITECJ. U71MYTMSTANDINI OR OTHER DOCUMENT W1TH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH FOLIOED 8Y PA#}C!"& W SR TlPE Oi1NSURARCE {, ,- 7 Wl1CY EFFECTNE POLICY EXPIRATION 12/13/2006 b A CDMM£T'.CUlL OERER+4.lJABS.ITY CLAMS MADE DLCUR 53132 03 12/13/200S mchoccuRRENcs 3 1,A00,DD TO RENTED MED EXP WIT oM PMARi) 3 - 5.0001 PERSONALSADVRIAIRY 3 11000.00( GENERAL AGGREGATE S 2,000,00( GEN1-'AG.Gft5ATEVMD`APP�IES.PER.: POLICY PRO. -%CT LOC PRODUCTS•caLmx c i 2.000.00( B ADTOMDRAEuAMUTr ANY AUTO ALL OWNED AUTOS sr:.>lfattcea AUTa6 HIRED AUTOS NON -OWNED AUTOS - CBlEG3796 - 02./14./2006 - 02/14/2007 �yIEp DEN yA, fE■ "pa'"J 3 1,000.0 BOOLY INJURY fPRP«FA"J 3 X X (Pa aODLi dd" INJURY f X PROPERTY DAMAGE (For �afq I OARAOE UAWAM ANYAUTO AUTO ONLY. EA ACCIDENT ! OTHER THAN EA ACC AUTO'ONLY: AM ! i A "CESUMBREUALIAMUTY OCCUR 0CLAIMS MADE DEDUCTIBLE RETENTION i OS0264 01 T 12/13/2005 01/13/2006 EACH OCCURRENCE 7 Z 000 D AGGREGATE : 211000 s 3 WORKIRSCOMPS)"TIORAND EMPLDYERVIUAPS Y ANY PROPRIETORMARTNERIEXECUTNE :3Ff,'CER/N�IS€R EXCLLIaEDT - f� SPEGALLIMMU ONE S.W. WCbSAT1Y DiM• EL EACKACCIOENT S £.t DISEASE •£A EXSM.oY€ ; Et. DISEASE -POLICY t."a"T i OTJI^`R DEECBP'IDIIDFDPFRAT*NP/IDCATWkSIVEHICLESIEXCLUSIONS DEDBYENDORSEMENTISPECIALPRONSIONS SHOULD ANY OF THE ABOVE OESCRMD POUCIE9 DI CANCSLLFD BI MM THE EXPIRATION DATa "RECP. THE IS3UWC INSURER WLL ElIDEAVOR To MAIL I 10 DAYS WRITTEN ROME TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. GATEMM fl .S, JK. BUT FAILURE TO MAIL SUCH NOTICE WALL HIPOBB NO OBLIGATION OR UABILIT/ 1600 FALMOVTN ROAD, SUITE 25 CENTERVILLE, MA 02601 OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESEWATNEi AUTHORIZED TAM amen eR �DD4roa FAX• (SOS)773-5603 I ) TION 1988 flfl�—R1-2M FR1 10:06 AM R & K INSURANCE APR Z1 ZOOS 09127 FR 487 {?68 7848 CiRTM-CATE OF Produces +4LAQSHIP DwRANCR We 414 COUNTY ST NEW EBDFORD MA 02740 Insured WRA, FRANK G PO BOX " WB,S'7' iMANNIMPORT MA C FAX NO. 508 991 5461 P. 02 407 388 7848 To 815089915481 P_81,01 1110MEWROVFMENTB Istra Dafe 4J2i/2o% Coatiseatal casasityCompaay Coverages THIS 4T TO CERTIFY THAT THE LICES OF INSURANCE LM7ED BRAY HAVE BP.EN ISSLW TO THe 24SURW NAWD ABOVE FOR POLICY PERIOD INDICATED, NOTWITHSTANDING ANY RPQ1)t Z4M TERM OR C TTION C117ANY CiITTRACT OR OTHER DOCUMENT WITHYBBIS=DORkgPECT TO WHICH THIS HERF 1S SUBISCS TO ALI. TH3R Y PERTAIN, THS INSURANCE AFTQ9M BY 7�IB POLICIES DESaUM . UAY HAVs aEF,N R Dviceo By P . CLAIIMs EXCLUSIONS o�' ci<suatt POLtctss Lt rsslia�rr TM oflasarance woRx' w*' COw2FbN$AT70°N Workers' Compeasadon atnd EACH ACCMWr DISSASBP0L1CYLD= DISEASE 84CH McLOYEP HE PTO(PRJAlZ7W--,;tVl! Description Certificate Holder. 1600 FALMOLrM1SAAD CB4T1iIcVRU MA OU01 Cliftee$atioa SHO= ANY OF TIM At*" TkEREOP, THB ISSUING Cowl CERTIFICATE HOLDER NjkMED OBU CIATIONORLIABILITYOFAr Autbeeired ItePiresaatatlie TON nZA AMot Ma Mw thtdarwrfw >llty Number Pelity Eff. Date Foley FAp. Date ealxni606 03�sv06 03r=v07 Ltabliity s t,00e000 S i,00H,00d S 1,000,000 . INCL Added by Endoinemeatl6peetai Proftow 71-12W POLICIES fW CANCE= BEFORE THB B7Q7RATION DATE WILL 8ND3AYCR 7O MAIL ifC-BAyM WRf1-M N=CH TO TIM N$ BUT FAILURE TO MAIL S= NOTICS NO L ND UPON THt COMPANY, tM ACRNTS OR RBP=qy$HALL P 11KPFOSE ** TOTAL PAGE.OI ** + 1 � t'ORD CERTIFICATE OF LIABILITY INSURANCE 12/20/ 02 05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PANTANO INSURANCE AGENCY, INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 220 BROADWAY, SUITE 202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. LYNNFIELD, MA 01940 781-581-3100 INSURERS AFFORDING COVERAGE NAIC# INSURED CENTURY PAINTING & DRYWALL INC. INSURFRA- COMMERCE P:O: BOX 2903 !, HYANNIS, MA 02601 Off' -tie Gh'c 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. wart M Naeo FINSURANCEPOLICY NUMBER POUCY EFFECTIVE DATE MMIDD POUCYEXPIRATION DATE MMIOD LIMITS GENERAL LABILITY COMMERCIAL GENERAL LIABILITY - EACH OCCURRENCE $1 / 0 ! 0 00 PREMISES 'Ea omirence MEDEXP(Arymeperson) $5, 000 CLAIMSMADE OCCUR PENDING 12/17/05 12/17/06 PERSONAL BADVINJURY $1, 000, 000 GENERAL AGGREGATE S 2! Q O O/ Q 0 O GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMPIOPAGG S 1! 0 0 0/ o O Q - POLICY PE OT LOC AUTOMOBILELIABILITY ANYAUTO .. COMBINED SINGLE LIMB (Eaacdoent)... $ BODILYINJURY — (Per person) - - ALLOWNEOAUTOS SCHEDULED AUTOS - - - - - - BOOILYINJURY (PeracUEenQ S HIREDAUTOS NON-OWNEOAUTOS PROPERTY DAMAGE (Peraccident) - S - GARAGE LABILITY AUTO ONLY-EAACCIDENT $ OTHERTHAN EAACC [AUTOONLr. $ ANYAUTO S AGO EXCESSNMBRELLA LABILITY EACH OCCURRENCE S AGGREGATE S OCCUR CLAIMSMADE S S DEDUCTIBLE S RETENTION S WORKERSCOMPENSATIONAND WCSTATU- OTH- IMIT E.L. EACH ACCIDENT $ EMPLOYERS' LABILITY AHY PRO RIETOIWARTNERIeXEGUINE E.L. DISEASE - EA EMPLOYEE $ o EWI!IISER E WIIW Ityes,describeunEer SPECIAL PROVISIONS below - E.L. DISEASE -POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONSI LOCATIONS /VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION GATERWOOD HOMES 1600 FALMOUTH ROAD # 25 CENTERVILLE, MA 02632 I ACORD25(20011081 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING IN URER WILL ENDEAVOR TO MAIL _ DAYS WRITTEN NOTICE TO THE CERTIFI�I{ATE H r ER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBUGATIOry ORt ILRY OF ANY KI�1D UPON THE INSURER, ITS AGENTS OR REPRESENTATIVE3� I • I A AUTHOR17ED REPRESBNT@TIVE Liberty Mutual Group PO Box 7202 Portsmouth, NH 03802-7202 Telephone (800) 653-7893 Fax (603) 431-5693 December 21, 2005, GATEWOOD HOMES 1600 FALMOUTH RD STE 25 CENTERVILLE, MA 02632- RE: Certificate of Workers Compensation Insurance Insured: CENTURY PAINTING AND DRYWALL INC PO BOX 2903 HYANNIS, MA 02601 Policy Number: WC2-31S-349702-015 Effective: 12/5 /2005 Expiration: 12/5 /2006 Coverage afforded under Workers Compensation Law of the following state(s): MA Emolovers Liability: Bodily Injury By Accident: $ 100,000 Each Accident Bodily Injury by Disease: $ 100,000 Each Person Bodily Injury by Disease: $ 500,000 Policy Limits As of this date, the above -referenced policyholder is insured by Liberty Mutual Fire Insurance Co under_ the policy listed above. The insurance afforded by the listed policy is subject to all the terms, exclusions and conditions. and is not altered by any requirement, term or condition of any or other documents with respect to which this certificate maybe issued. This certificate is issued as a matter of information only and confers no right upon you, the certificate holder. This certificate is not an insurance policy and does not amend, extend, or alter the coverage afforded by the policy listed above: - If this policy is cancelled before the stated expiration date, Liberty Mutual will endeavor to notify you of such cancellation. `-I„ AUTHORIZED REPRESENTATIVE LIBERTY MUTUAL INSURANCE GROUP This Certificate is executed by LIBERTY NIL"I iAL INSURANCE GROUP as respects such insurance as is afforded by those companies. cc: Insured: CENTURY PAINTING AND DRYWALL INC PO BOX 2903 HYANNIS, MA 02601 Producer of Record: SANDPIPER INS AGCY INC 12 ENTERPRISE ROAD HYANNIS, MA 02601 ivn/2005 r Client$• d5Q7 : all L-T IF ACORD,a CERTIFICATE OF LIABILITY INSURANCE 0830/ s°""""' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rogers & Gray Ins. Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 434 Route 134 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. O. Box 1601 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. South Dennis, MA 02660-1601 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: Peerless Insurance Cape Cod Insulation Inc INSURER B: American Home Assurance 455 Yarmouth Road INSURER C:INSURER Hyannis, MA 02601 D: INSURER E. CC) THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE fMMfDDfYY)DATE POLICY EXPIRATION MM/DD LIMBS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY W CLAIMS MADE O OCCUR CBP9587416 - 04/16/06 04/16/07 EACH OCCURRENCE $11 OLIO 000 DAMAGE TO RENTED $1 OO OLIO MED EXP (Any one Person) $$ 000 PERSONAL S ADV INJURY E1 OLIO OLIO GENERAL AGGREGATE 32 000 000 GENT. AGGREGATE LIMIT APPLIES PER POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGO 52000000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BA9587917 04/10/06 04/10/07 - COMBINED SINGLE LIMIT (Ea acdtle t) $ URY (PerPerson) $250,000 X X BODILY INJURY (Pat accident) $50O OLIO r X PROPERTY DAMAGE (Par accident) $1OO OLIO , GARAGE LIABILITY ANY AUTO - AUTO ONLY- EA ACCIDENT S OTHER THAN EA ACC AUTO ONLY: AGG S $ EXCESSAIMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION S EACH OCCURRENCE $ AGGREGATE $ S $ $ B WORKERS COMPENSATION AND EMPLOYERIETORIUTY ANY PROPRIETOR/PARTNERIEJQ:CUTNE OFFICERIMEMBER EXCLUDED? Ifxdescribe under ECIAL PROVISIONS below WC8962496 06/30/06 06/30/07 X WCSTATU- OTH- E.L.LIMrTS EACH ACCIDENT $500,000 E.L DISEASE -EA EMPLOYEE $500000 E.L. DISEASE -POLICY LIMIT 1000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Insulation Installation & siding Gatewood Homes 1600 Falmouth Rd., Suite 25 Centerville, MA 02632 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1_ DAYS WRITTEN :E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL iE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR ACORD 25 (2001/08) 1 of 2 kQ9dDf6/IU94d9d vvr� � ���+.••�•.v.•r vrv�„vr� mea RCORD_ CERTIFICATE OF LIABILITY INSURANCE OP ID C DATE(MMIDD"YYY) NUGNP50 07 31 06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION GOLDMAN & ASSOCIATES INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE FINANCIAL SERVICES INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 933 FALMOUTH RD . I ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. HYANNIS MA 02601 Phone:508-775-6010 Fax:508-790-0249 NUGNES ENTERPRISES INC PETER NUGNES 805 CEDAR ST WEST BARNSTABLE MA 02668 %' V V Cr(A6C0 INSURERS AFFORDING COVERAGE NAIC # INSURER A.' PENN-AMERICA INS. CO. INSURER B: INSURER C: INSURER D: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - LTR INSR TYPE OF INSURANCE POLICY NUMBER POLICYEFFFCTIVE DATE MM/DDIYY POLICY EXPIRATION DATE MMIDD LIMITS GENERAL LIABILITY - EACH OCCURRENCE s 300000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OOCCUR PAC6593654 07/24/06 07/24/07 PREMISES (Ea ocourence)$ 50000 MED EXP(Any one Person) $5000 PERSONAL &ADV INJURY $300000 GENERAL AGGREGATE $ 600000 GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $300000` - POLICY JE 0. 71 LOC AUTOMOBILE LIABILITY ANY AUTO MBINED ANGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) s HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Par accident) $ - GARAGE LIABILITY AUTO ONLY -EA ACCIDENT s ANY AUTO OTHER THAN EA ACC $ $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ E DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY TWC LIMBS ER E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNER/EXECUTWE OFFICERIMEMBER EXCLUDED? If yes, describe under E.L.DISEASE -EA EMPLOYE s E.L. DISEASE - POLICY LIMIT s SPECIAL PROVISIONS below OTHER 7 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS CARPENTRY RESIDENTIAL "� VAIYI.CLLA I IVIV GATEW00 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATI01 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL GATEWOOD HOMES INC IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1600 FALMOUTH ROAD REPRESENTATIVES. CENTERVILLE MA 02632 AUTHOR RRRESENTAT� ACORD 25 (2001108) ©ACORD CORPORATION TOWN OF YARMOUTH 1146ROUTE28 SOUTHYARMOUTH MASSACHUSETTS02564.4451 Telephone (508) 398.2-931, Eat. 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 CMP, Chapter 1, Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 1 �, 3 2 �j work Add` is to be disposed of at the following location: r\ Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Signature ofA.pplimnt Date Permit No. ucr.,,ub ub uu: 4ua Hudson Corp 1 508 775-2310 P.J. Eoennt"W "Wag =:9ddtas ,41 HOME WPROVEUENT CONTRACTOR Replstntlatr 118321- .. . ExphUon:_,100 2012006 USA_ CAPRAHOMEIMPROVEMENTS. FRANK CAPRA 40 COPPER LANE Z�...--��rru✓ ccmTFRVII MA 02632 .1tt«�trtetrc.n. License or registration valid for individul an only before the e4irstion date: Iffovad-ntnro-� Board of Building Regulations and Standards One Athberton Placs Rm.1301 Boston, Ma. 02108 Not valid withoutsignatore TOWN OF YARMOUTH WATER DEPARTMENT 99 Buck Island Road West Yarmouth, MA 02673 Telephone: (508) 771-7921 • Fax: (508) 771-7998 Letter of Water Availability Date of Issue: 10-31-06 I. Single Family Dwelling X 4. Commercial / Industrial 2. Duplex Family Dwelling 5. Other (Specify) 3. Condominium Dwelling Reference; Massachusetts General Laws Chapter 40, Section 54 To: Town of Yarmouth Building Inspector Please be advised that the Town of Yarmouth public water supply is available to service lot / parcel (s) 21.1C.93; Street: 121 CAMP STREET, UNIT 93 As shown of Assessors sheet / map 50. Issuance of this Letter of Availability is subject to the following provisions / restrictions: (1) The property owner agrees to comply with all federal State, and Local Laws, Rules and Regulations as they pertain to the use of the public water supply. (2) The Yarmouth Water Department shall have exclusive rights as to the size, number, type and location of all water service lines, fire service lines or appurtenant items connected to the water distribution system. (3) The Yarmouth Water Department reserves the right to require, at the property owner's expense, the installation of water mains and appurtenant items to meet water demands requisites within any structure relevant to this Letter of Availability. (4) This Letter of Availability will expire 180 days from the date of issue I have read and understand the provisions / restrictions of this Letter of Water Availability. Owner (sign) toYarmouth Water Department TOWN OF YARMOUTH HEALTH DEPARTMENT hu y (� PERMIT APPLICATION SIGN OFF TRANS MTIT Fi EST= To be completed by ADDlicant. Building Site Proposed Improvement:fh, 4 I Map No.: Lot No.: 1:7 3 .No.4z�?-_?(06 Date Filed: nZ 04 **Ifyou would like e-mail notification of sign of please provide e-mail address: -� 1 9Q+% �� �O Q \� l tV' C �► 1 Owner Name - Owner Address: RESIDENTIAL AND/OR COMMERCIAL BUILDING Tel. No.: HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. Please submit four (4) copies of plans, to include: (1.) Site Plan showing existing buildings, water line location, and septic system location; (2.) Floor plan labeling ALL rooms within building (all existing and proposed) — Note. Floor plans not required for decks, sheds, windows, roofing; (3.) If necessary, Title 51 application signed by licensed installer with fee. REVIEWED BY: CONIlMIENTS/CONDITIONS: DATE: 1 I6 /0 G wj �s OF �� TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-07-216 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Unit 93 Owner's Name: Villages @ Camp Street, LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 REVIEWED BY: 1. WATER DEPARTMENT: (OFFICE USE ONLY Recorded By. Ic Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 5304 Net Owed: ($50.00) Application Date: 11/7/2006 Issue Date: Expiration Date Comments: new construction: Map/Lot: 044.21.1 ZONING APPROVED_ DATE: e / 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: 11/9/2006 RTY ::- 04e 77 �0N FO1t _ter �. � a�Z / 8+• 7� TERAi�c�.tQ --ter �•... J WPM CATIONS GMS9/GCS9 .SERIES 93% AFUE Multit Position;- Single-Stage/Multi-Speed-- Gas Fumace...... Heating Capaciiy;.. 46,000-115,000 BTUH XrCandWolniW& ffeatirr� The GMS9/GCS9 single -stage, muter;spree&gas furrraces offei— ins taliation .versatility.. . Standard Features Cam • Corrosion -resistant, aluminized -steel tubular heat • Heavy -gauge, reinforced. fully insulated steel cabinet exchanger and stainless -steel recuperative coil fox with dumbkbaked-enamel finish - maximum efficiency • Attractive architectural gray paint finish Designed for multi -position insralydtion---GMS9: • Foil -face insulation -lined heat exchanger upflow, horizontal right or left, GCS9: downflow, horizontal tight or left Energy -saving, reliable Hut Surface Ignition system, featuring a Norton® Mini•igniter.with patented adaptive learning algorithm to maximize igniter life • Aluminized -steel inshot burners • Energy -saving P.5C;'mula-speed, dficct drive blower motor • Quiet, corrosion resistant rn&ced-draft blower assembly • Integrated fumacecontrol.with-imptcved_..... diagnostics • Low voltage tetminal blocks • Multiple flame toll -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; alrerrtatrfltie/vemlocate&.. on right side • Completely. assemh%d.factot;<.tumtestedfumace.far...... heating or combination heating/cooling application All models comply with California NO% Standards • Suitable for direct vent (2-pipe) or non•direcc vent (I -pipe) applications compartment Coil and furnace fit flush for easy installation Convenient left or right connection for gas and electric service Bottom of side air inlet (GMS9) Removable; solid-bottorn block -off (GMS9)` Accessories L.P. Conversion Kit (LPT-OOA) •-L.P--Gas Low•Prc»tsre-Kic' (LPLPOI -19 High Altitude Natural Gas/L.P- Kits HAN012, HALP10) .... . High Altitude Pressure Switch Kit • ExtemaI,FiltexRacic(EFROI). Horizontal Concentric Vent Kit (HC 1, • Vertical CorimatricVent-Kit(VCVK). Internal Filter Retention Kit—uptluw, horn =000180) ..... • Internal Filter Retention Kit—downflow (RF000181) • ip� -'I Thermostats Blower Motors (CHT18.60. CH7(YTG,_ CHSATG, H20TWR) �C X 11, 2Qp6 nl(1V © 7 SS-377D Ww«;ovdmaamfg tom 6/04. PRODUCT SPECIFICATIONS Nomenclature S a 070 3 'A- N A' Goodman® Brand ev I on . ir ow Direction NOX 13: 1x Revfsfon At Upflowthonzanw. . H* Natural Gas C: Z" Revision D: Dedicated Down low C: Downflow/Hortzontat X.. Low NOX It HIAir Flow -!;abjnet Wi A:14" Description 8: 1W S.Single Stage/Multi-speed yTo Stage/Variable-speed d P; 201" AFUE 8; W% 9:90% 5,00 : 2,000 045' 45,000 ... 670: 70,000 090.. 90,000 115:-115,000— IMM GCS9 Dimensions LE" ams.. . Vow view P e N ,nE.t VIEW�E Y. �+■ W aw Iq tNrNPl� IRE'NR.IAW) W Y�f.T1rLNt rVF r ft Pvc rpvc CONVENaATE Ei taaT"`".ae • ' Waaw �' , r low wL*Aot 1 °L1cNAR°E.. EUCTWAL NCLE J e IsE`OT aam L L iIGOV LIA MOIE „. +IIeN rR1A§e a........ RNA ELECTA"Nq•g as I� VFMiFIye ••±_ lOeATI°N rtN r .. .. ..... . fern . . atlns ALM,,Te LE-7 soil a ". AM WAK644CA11014. rNNWLWE Isla If IN a% RAIM IOLEe TWL efAN nV!Q °ANO fv4� . 11 •.. �.�tWE aNP•LrNaa .ve e+ u 0 a e n N •_ Ye 1- +ettEt ... ... t�"� ♦ITEANATE 6V 1(� ..._. _.... .. _ .... ...... sLrrty v°Le_ u+•aoso >L wtxs scNARo A"t . ""t y AOL°E° MNoes �� - CIJPMII°EMq _ 2" or 7" in diamnar, d nfi • - y P+pes: °M rot combusttun Air Pipe is dependent a "fist p upon furnace input; numbtrof c tnvs�Q h of s � o d) Q�rc"ted); Vent pipe qMT be either 2. Line vora wiring can soar WR3ugb the iv requhelefr ments and must be 2" or J" diameter PVC. ( pipes). The optlonal Combu.tion 3. Conversion kits for high altitude natural n8ht ora re f-thovane furnace: Cctir votnge `iringcan enter through the right Pr hit side offurnace. 4. tnualler must supply followingOperation,accoact available. Coricact your Goodman distributor I2G—T-N. 90• elbows. ant CloseeifltPpk stieL fittings, accord to which entrance is used: or dealer hlr details. ght—Srra f Y)hi P+Vc ro reach gar valve g pipe - Minimum Clearances to Combustible Materials rx"Tlnp""M� C � Combustible: lfplm d on tumbustibie floor, the 4� NC w Non.Combmtible: A combustible floor su6W c be u b wwood ONLY. NOTES:sed manll4don on combustible flooring • fur rerllcing of cleaning, a 36" front cleannct a reconuumded. (elec ' I nit c rises, arcs sibUi y ClI t)ue ee drain) may nectrsitaa greater clearances thao.tLemp,imumckararscalisted below .. In all c■res,accesEibi)Iry claar•nee must take Precedence ov"Acaruaaes from the enclosure where acctuibi)ify cle■r■oces ax yteattr. 5 Blower Performance Specifications` `t• NOTES: --� I. CFM in t a" is wi[huut herl(ar filters do eMr ship.with this furnace but muar.l .psuvideJ by. [he iwcsBrc.Jf the.fwtsacereyueres.nwnrewtr a. brtis than asaum:a both fi1[e✓a are installed. 2. All Furnaces ship as high speed cooling. Installct must adjust blower cooling speed as needed. J. I'm snout jobs. aMn.r 400 CFM per tun when cooling is drsirable. 4. INSTALLATION IS TO BE ADJUSTED TO OBTAIN TEMPERATURE RISE WITHIN THE RANGE SPECIFIED ON -rHE RATING PLATE. 5. Tht chart is fur infsxmation only. For sacisfacrory operatitar, external static pretes,re most nun "feed "IM shown nn Jsc .acing plate. The shaded area indicarat ranRp. in excess of maximum static pressure :dkmed when heating. d. Thu dashed (....) areas indieart a ttsnperatufrvi not reeurnw& ded {t nl,ym, tie6 . 7. The about chu[ is fix US. furnaces installed er T • 2-COO'. At higher altitudes, a prupttly dt-rated unit will have appnuaaattly the same temperature rise at a Particular CFM,.while ESP at the CFM willbe.krwea... . Accessories v LPT-OOA L.P. Conversion Kit r - LPLPOI L.P. Gas Low Pressure Kit r r J MANG11 High Altitude Natural Gas Kit r r J r HANG12 High Altitude Nat lsal Gas Kit 1 1 t 1 HALP10 High Altitude L.P. Gas Kit z, z z 2 HAPS27 Nigh Altitude Pressure Swftch Kit 3 3 1 ' "' fEROt External Fllter.Rack...... 3 3 3 3 _... DCYK•20 Horizontal/Vertical COnr.."iC Vent .. J. ..... _... J .. ... .J..... _ DCVK•30 HorizontallverticalfoncentAt-Vent•sett•try- Available for this nxidel (1) 7;call ku, 9,pq(w)0' (3) 7,001, to 11.000' Note: AD Instaflatinns above 7,000' 2quUe a preuurc sutKh diangt Fur imeaRa osr in C ana, De vr>llo.. door Hasa When the C(:,SO mo,lel Is Installed directly a. a vp>n,f fluor, daturstaees as certified only 4.500'. arc: CFB77, CFBIt and C:FB24. s cl nflnw float Ease must he used- T wMa Model, Rutnbats_ Thermostats u 7 I I MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit # MAScheck Software Version 2.01 Release 2 I I • i I I checked by/Date 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 TITLE: The Sandpiper PROJECT INFORMATION: Mill Pond village 17,1 Camp Street "'o I t g Yarmouth, MA 02673 RECEIVED COMPANY INFORMATION: Northside Design Assoc. ZCC6 141 Main street NOV 0 7 Yarmouth Port, MA. 02675 COMPLIANCE: PASSES Required UA = 223 Your Home = 138 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value ------------------------------------------------------------------------------- U-Value UA CEILINGS 845 30.0 30.0 14 WALLS: wood Frame, 16" O.C. 1415 15.0 15.0 62 GLAZING: windows or Doors 93 0.340 32 GLAZING: windows or Doors 80 0.340 27 DOORS 0 [--------------------------------------- 4 086 --------------------0_-------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, andthe 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 34.4. Builder/Designer Date re i �,, Massachusetts Energy Code MAscheck Software version 2.01 Release 2 The Sandpiper DATE: 4-21-2004 CEILINGS: 1. R-30 + R-30 Comments/Locati WALLS: 1. wood Frame, 16" D.C., R-15 + R-15 Comments/Location WINDOWS AND GLASS DOORS: 1. U-value: 0.34 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location 2. U-value: 0.34 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: 1. U-value: 0.086 Comments/Locati AIR LEAKAGE: Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. when installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into -the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. ti•� I I I I I I I DUCT INSULATION: Ducts shall be insulated per Table 74.4.7.1. DUCT CONSTRUCTION: All accessible joints, seams, and connections Of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in sections 780CMR 1310 and J4.4. SWIMMING POOLS: All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. HVAC PIPING INSULATION: HVAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in.): PIPE SIZES (in.) HEATING SYSTEMS: TEMP (F) 2" RUNOUTs 0-1" 1.25-2" 2.5-4" LOW pressure/temp. 201-250 1.0 1.5 1.5 2.0 LOW temperature 120-200 0.5 1.0 1.0 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 I CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F): RUNOUTS 0-1" 1 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 1 1.0 1.5 2.0 140-160 0.5 1 0.5 1.0 1.5 100-130 0.5 1 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only)---- 1SEED RET = 25.1 = 15 Yarmouth SEWER M PRO OS D SEEi SL EVING ��• 4" SE R LATERAL g84•19'03W NOfE ELOW �0. 00 1 40.45� v w L 12.35 to I S 0>- PROPOSED w w UJ.< I DRIVEWAY I M a3N Cw Of ��0 t7• to' tr o- 0 L! n h LOT 35 op O e: lth Departmen LI® 1 YD N PROPOSED HOUSE SANDPIPER FF = 24.8 GW = 15 47 W LOT 931 3,734f S.F., 14.06 k I —k 54.00,1 i PROPOSED HOUSE EGRET FF = 24.4 GW - 15 LOT 94 S84' 'eC �' FF = DENOTES FIRST FLOOR ELEVATION NOTE:��� GW = DENOTES APPROXIMATE ELEVATION lv` ® SEWER LATERALS A OF GROUND WATER SLEEVED IN ACCOR CE.. WITH TITLE V IF WI WORK I&I�QQN'� GRAPHIC SCALE BYLAWS AND' Ri Gln� N 20 10 0 20 60 A 3 °6 YMUG IJ1WAafiRt ' s the orig `led) stomp of the responsible Professional Engineer, or Professional Land Surveyor cppecrs on thle Ian: (A) no per�on or persons. Including any municipal or other IN FEET 1 inch = 20 ft. public officials, may rely upon the information contained herein; and (8) this plan remains the property of Holmes & McGrath, Inc. PLOT PLAN LOT 93olmes hOF and me rath, inc. PREPARED FOR civil engineers and lad surveyors ��`UCHAELX MILL POND VILLAGE 362 gifford street IN falmouth, ma. 02540 Ma NO. y YARMOUTH, MA J08 NO: 201197 DRAWN: LMC a SCALE: 1,. =20 DATE: 8-4-06 DWG. NO.: A2564 CHECKE4rI�P �- of r� TOWN OF YARMOUTH Building Department BUILDING _ _ _ _ _ _ _ _ _ _ , (508) 398-2231 ext.261 PERMIT NO 6-07-883- ______ M PER1T a+. ISSUE DATE ; _ 1/11/2007 _ ; PROPOSED USE _ APPLICANT _FrankCapra____________________ OB WEATHER CARD / PERMIT TO ' New Construction ' IAT (LOCATION) 100121CAMP ST Unit 93 ZONING DISTRICT Bldg. Type: Residential I SUBDIVISION MAP LOT BLOCK 044.21.1.C93 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE REMARKS new construction: 2 baths, 3 bedrooms, 1 greatroom, 1 kitchen as per plans dated 11/14/06. AREA (SQ FT) EST COST ($ I$141,600.00 PERMIT FEE ($) $516.00 OWNER lVillages @ Camp Street, LLC BUILDING DEPT BY ADDRESS 1600 Falmouth Road # 25 Centerville I MA 102632 CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 PHONE 15087789669 INSPECTION RECORD FIELD COPY