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121 Camp St #094 Building Permits
TOWN OF YARMOUTH Building Department (508) 398-2231 ext.261 PERMIT NO B.o�.B - PERMIT ISSUE DATE ; _ 1/11/2007 _ ; PROPOSED USE _ _ _ _ _ _ _ _ - - - • k - C- JOB WEATHER CARD APPLICANT ,Franapra ------ ----------- - ------- PERK41T Trl ' maw OnnStruvtion BUILDING AT (LOCATION) 00121CAMP ST Unit 94 ZONING DISTRIC R-2 Bldg. Type: lResidential SUBDIVISION MAP LOT BLOCK 044.21.1.C94 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP F R-4 LOT SIZE new construction - affordable: 2 baths, 3 bedrooms, 1 diningroom, 1 kitchen, 1 livingroom as per plans REMARKS dated 11/14/06. AREA (SO FT) EST COST ($ $148,896.00 PERMIT FEE OWNER lVillages rd Camp Street, LLC ADDRESS 11600 Falmouth Road # 25 Centerville MA 02632 BUILDING DEPT BY CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 PHONE 15087789669 THIS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK R ANY PART ENCROA HIMENTS ONSPUB IC PROPERTY, NOT SPECIFICALLY PERMITTED UNOTHEREOF, PERMANENTLY. UNDER BUILDING MUST CODE,, S E APPROVED BY THE JURISDICTION. LOCATIONSTREET OR ALLEY GRADES AS WELL AS DEPTH AND OBTAINED WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT ANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1) FOUNDATIONS OR FOOTINGS. 2) PRIOR TO COVERING STRUCTURAL MEMBERS (READY FOR LATH OR FINISH COVERING) 3) FINAL INSPECTION BEFORE OCCUPANCY 4) REFER TO DETAILED INSPECTION APPROVED PLANS MUST BE RETAINED ON WHERE APPLICABLE SEPARATE PERMITS ARE JOB AND THIS CARD KEPT POSTED UNTIL FOR ELECTRICAL FINAL INSPECTION HAS BEEN MADE. PLUMBIREQUIRED AND WHERE A CERTIFICATE OF OCCUPANCY IS MECHANICAL INSTALLATIONS. MECHANICAL I REQUIRED, SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. SCHEDULE POST THIS CARD SO IT IS VISIBLE FROM STREET t3U1LUING INSPECTIONS t%rr Kwvnw 2 2 2 OTHER: 3 1 2 5 3 4 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 ice Use ©nl .. Planning Boardlnfornation Assessors department lnformaftort k �Y Permlt / I Wrap for z, ei p 'aex- Na Y Fes, Y Tor 2 Permft Fee ndorsement ISate Deposit- ee'd ;Aet s K 1 4 eroperty mensrons r R z x u u Plallo'y`Y§ate x r% u`as cr z x= Ne# Due$g ar W iher r'" ram'' Franla"ge ' �� for Co"uera e .- - „,LntAreas , .�.., ., -�s �.- •_�:.;: u+ „ffsisSectiar g- O:ffice llse Oh nS r- �. Buildi P.er'` tiirt6er Date,tssvetl fy 1xLa Y) YF SY M x„ T iqt Y�6 Sw JiF !�rx ±�v .>1...,+A r +< .{s . + f3e r� �' Signature t /„)r _.i i i CR: :.ta r .? k its.. .-•` 1 r � � . i$ S 11Tx 7 u i i 4 y Sectf6rf St#e'tratoFm tion : Use Group: R-4 Type: 5-B 1.11- Property Address: 1.2 Zoning Information`. Zoning District Proposed Use �ly 1.3 Building Setbacks (ft) C� Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.4 Water Supply (M.G.L e. 40. S 54) 1 SFIoodZone;lnformation Y t, a ` Comments r Uzi, r Public Private Sectionx2" Property O+ynershipfAuthorizedAgent 2 ,w0gr of Record: Name (print)am /f Mailing Address` f-`orl///`1Q M dz.4 3 Signature Telephone 2.2 AuthorizgdsAAgent, Na print) Mailing Address � � e2,40 CGr' v g � 3 Signature IVTelephone Fax Section �3' Coristrut tion'Services E% C E 3.1 Licensed Construction Supervisor: otApplicable 006 ,•r+,4;u Cs�-�lr'A- NOV 0 Liensu. I�DtYagUEPT. -�`w!fcev��/C' a — Add r — �� Expiration Date Signature Telephone ZJ9Z,1 /1—,Z ©0 6r 3 �„Regis#eredl=lorrieMli>ip[overnent�,Coritractor �: - Company Name Not Applicable License Number Address Expiration Date Signature - Telephone Z 9- 15-99 1 of 2 OVFR �SL'CttO(t 4"4 Wd.CkerS'-COriiLlehsatfon Iric�tr�nra`Affiaiiit°t6,f"f� Y K.' ix� c"+srr%'rt+r k 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... Sectio) 5,'„ Descrption of PropoSeci,Work` check�a([ apjalica6lej` New Construction No. of Bedrooms No. of Bathrooms Z Existing Bldg.. ❑ Repair(s) ❑ Alterations ❑ Addition ❑ I. Accessory Bldg. ❑ Type - Demolition Other Specify: Brief Description of Proposed Work: G cS' e- Section'& Estimat6&CansiRtct6 Costs' Item Estimated Cost (Dollars) to be Check Below completed by permit applicant ❑ Conservation -Commission Filing 1. Building 0 pQ 2. Electrical oO (if applicable) . ❑ Old Kings Highway & Historical Commission approval (if applicable) 3. Plumbing / Gas 4. Mechanical (HVAC) Q 5. Fire Protection 7,� 6. Total = (1 + 2 + 3 + 4 + 5) 7. Total Square Ft. (new houses & adddions) Section 7a Ow nerAdthnrrzaiidrr> Owwe Agent=.or CarifractorRpp tes Ta iae'Completed Wherry or BAldling-Perrtiit l as owner of the subject property �.�R—�/��{-- hereby authorize r`'% to act on my behalf, in all mpers rela '' erk authorized by this building permit application. Sig tur of wner Date 5ecfiott�76�,"OwctertgWthonzzeed,Agent-[) cdatioi 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. . Prinrrnaine Sig a of0 ner/ /U�ateZ,::54 A7 gent 9-15-99 2 of 2 i v w iN . ur YARMOUTH X x PLEASE PRINT.• Job Location: _ BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM Owner of Property: V ` ` Construction Supervisor: Address: Licensed Designee: (If other than Supervisor) 0 Street n Village fQL-�, k P J�K, 02L I So b :�2 669 Name License No. Phone No. Name 2.15 Responsibility of each license holder: 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, 2.1-5.2 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 LP( No ❑ If you have checked eyLs, 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 1V 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: C;ks"\ The Commonwealth of Massachusetts = Department of Industrial.4ccidents Olflce o//avesdpithrs 600 Washington Street >•'= Boston, Mass. 02111 Applicant inform2tion: Workers'.Compensation insurance AMdavit nnmr location"-�/-Z1 on /� G�hl�/ L('� nhone 0 S 1 am a homeowner penotmm,v all work myself. lam a sole proprietor _r..1 ha%a no one workin_ in any capacity I am an. emplover pro,6 iding work- ers• compensation for my employees working on this job. comnanv name awl d ress city ,hone # insurance co. policy # I am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below who hat: the .follow in_ workers' ;ompensation olices: plc riA company "amel. insurnnceco. C�DV�/�>�.t��/dcs(,/f' �� policy comnanv name* Failure to secure coverage as required under Section 25A of MGL 152 an lead to the imposition of criminal penalties of a fine up to 51,500.00 aad/o ''one years' imprisonment as well as civil penalties in the forth of a STOP WORK ORDER and a fine of S1t10.00 a day against me. [ understand that i copyof this statement may be forwarded to the Office of investigations of the DIA for coverage verification. t do -hereby cerrify under the paints and penalties of perjury that the information provided above is true and rorrem Signature ��1�C�t�X pate Print name of 621 use only do not w rite in this area to be completed by city or town oMcial city or town: Yax>KonT$ _ .permiNicensc# nBuilding Department L3Ucensiag Board C3 check if immediate response is required 261 C3Seieetmen's Ofrce (508) 39.8-2231 eSt_ C3HealthDepartment contact person: phone #; _ mOther Client#: 18434 `^ "^" " _ ACORDa. CERTIFICATE OF LIABILITY INSURANCE 1010/ s° ' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION AND CONFERS NO RIGHTS UPON THE CERTIFICATE Dowling 8r O'Neil Insurance Agency ONLY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # 222 West Main St. PO Box 1990 Hyannis, MA 02601 INSURED Assurance Construction, Inc. INSURER A.. Travelers Insurance Company INSURER B: INSURER C: A10 Assurance Excavation, Inc. INSURERD. - 550 Willow .Street INSURER E: WestYarmouth,MA 02673 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 IESAGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFECTIVE POLICY EXPIRATION ' . __.OMRS.. _._. L7R OF INSURANCE _.... POLICY NUMSrA ATE MMlDD Y ATE AVdlCU — - - $1 000 000 - POM-11-oc ALITY 16808387A9841ND06 OS/O1/O6 : - OS/O1/O7 - EACH OCCURRENCE DAMAGE TORENTED $300 000 IALGENERALLIABIIIIY-.. S MADE � OCCUR -... - - - - -- - ' PREM MED EXP (Any one person) E5 000 PERSONALBADVINJURY $1000000 GENERAL AGGREGATE E2 000 000 PRODUCTS. COMPIOPAGG E2 00O 000 ' ATE LIMIT APPLIES PER: JET LOC MOBILE LIABILITY - - - - - COMBINED SINGLE LIMIT (Ea accident) E - - NY AUTO LL OWNED AUTOS (O�DILper INJURY E <.CHEOULED:AUTOS._IREDAUTOS _(Per BODILYdent) acddenq....ON-OWNED E AUTOS JEX PROPERTY DAMAGE (Per accident)AUTO E ONLY -EA ACCIDENT E GE LIABILITYEA ACCNYAUTO OTHER THANAUTO ONLY: AGG E SSIUMBRELLA LIABILITY EACH OCCURRENCE E AGGREGATE E OCCUR �CWMS MADE E E DEDUCTIBLE E RETENTION E WC STATU- OTH- WORKERSCOMPENSATION AND -... .. EMPLOYERS' LIABILITY E.L.EACH ACCIDENT_ _. _.. E. _ .... _. . E.L.DISEASE - EA EMPLOYEE E ANY PROPRIETORIPARTNERIEXECUTNE OFFICER/MEMBER EXCLUDED? - _ EL. DISEASE -POLICY LIMIT.. E .... - ._. Iyea,dwcdbe-deNr1 SPECIAL PROVISIONS bebw OTHER .. _ ... .. .. DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS - Operations performed by the named insured subject to policy conditions and exclusions. Gatewood Homes, Inc. 1600 Falmouth Road, Suite 25 Centerville, MA 02632 ACORD 25 (200110s) 1 of 2 9447US SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _ice. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED . �. n ncORn CORPORATION 19BE e..4.wamm UCK i INIUA I c yr InIA121 V1 I ! ^^.. ' THIS CERTII'ICA h ]p'111 R N5-1p.ANcE AGIENCYr XNC. TOToinl<R T S 585A WASHINGTON STILEET - TLT>;IOI{ITC3N. MA olL35-lSp2 Tel, (6L7) 787-o6L7 Bea Dinmantopoulos, DHA Hobart Ylumbihq - j; 'A'aa;tl.ng .... 25 Anthony Road Wo!gt YBITMOut1i;-m-02673 - - AVERAGES THE POLEl0R OF INWMNOE LISTED BELOW HAVE BEEN'$SUEDTo THE I ANY REOQi U904T. TERM OR CONOMON OF M CONTRACT OR�OT I a sae I_.. PORTHBPOLICYPORIOD INOIOATEO NOTWfTNSTANDINO - - - PECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR 11 I TNE'TERMS, EXCLUSIONS AND CONDITIONS OF SUCH EACH6CWPRENCE!'-' 5007m RELaFe I v ocwn� s 0 O (IN .. MED41rn - AAAnaI•JIIf)- Ot•. _... �'.. 0 /06 7/20/07 PEPSONnL8A0VMJURY S 0��00 . .. OENfiRPL'AOOAELATE-. Q..]- PRooucrs•eorAPiavnao e ` iNE�p BIwpLE LMR � BOOUYQ+AJRT ! ... IPMPAn10M BDOQ,YIN.AlRY i {PArAAei D pp0►eR7V dV.IACiE Q ( MAWItlAAI) AUTOONLV.EAACCP)ENT i aTNBA'rnAN - .. EAR ! WRDONLN AC6 ! EACH aCCURRENCfi ! AGCREq:AYC B s EL EACH AOGDEM ! .... E.L. DIAEnQ! • QA EtMI-bVEt !" - . �L. DICEAtiP-POLX:l LAAIi ! vEDUILvaovL4roNA ANCSLLATION SHOULD ANt LF-TME�A� ��EQPANp>EA eQ CANCELLGD GUM TM c7cmRaTtoN DATE THEREOF. TNG MSUV4 MeuPGR WML ENDEAVOR TO NAAao DAYS VAITMN )IDS 74 hIE CERTIFICATE NOLOER.wWED t0 TNC LEFT, BUT FAILURETO DO QD RKALL MPOQE NO)OQL�"�"�''�� LII{BICITY{OA M U r!"trFll TM I49UP6A.'ITS ACEM! OR REPRESPRTA 9 �' UT"ORPAD n AT aL _ a A QPNPRA4 LIAR4RV .cow4 P.IAL (S. ..RAL LQ irnr- CLAIM4MADE 1...° OCCUR .... 8S00031617 .. 7/2 arYL A*MtCtATE LAAf APPLIES ► ' Pa LAC AurDAroeM1ELIAen m AAITAUTO ALL evim" AUT00 . _ - - 2CKMULEO AUTO! NIRQO AUTOS NONOwNEONlT09 mAITADE LIMIllTY AmyAurro - [xcEBBAAiIERr LIABQJ[Y OCCUR CLAMWAM i DEDUCTIBLE R7TENTbM Q WOAXERSCOMPENQATION ANO E}APLOYERIT LUBQ.ITY Alw Monnl�TePE'ARrtIInJCxCCY+AAI _ . amT =RA c&�wy-yA�e.xcLuns�r 3DECULL�VRON41QN4 NNr - - OTHER PIAMING WORK ATW- PI-MrP C,ODT9 LVp-S GPTE1;000b Bolan .. - - 1600 FAU40MM RD -STE 25 CENTERS Llp-, . MA 02 632 I =# 508-778-5603 " ,. TOTAL Plea- Clinn{$• 11 4AG `ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/�YY) o8129106 PRODUCER Dowling & O'Neil Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency 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 INSURERS AFFORDING COVERAGE NAIC # INSURED M. t, Inc D/B/A INSURER A St Paul Travelers Insurance Company INSURER a: Associated Employers Insurance Compa B BarnstableElectric INSURER C: 71 Lothrop's Lane INSURER D: West Barnstable, MA 02668 INSURER E: rnvconr_cc DING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISS THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWj0F MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIOUCHPOLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DAT MMIDDIYY POLICY EXPIRATION DATE MM/DD LIMITSA GENERALLIABILTry COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR 1680305OA587COF06 07/19106 07/19/07 - EACH OCCURRENCE 000X DAMAGE TO RENTED PREMISES (Ea occi.irrencei00 MED EXP (Any one Person) $5 000 PERSONAL d ADV INJURY $1 00O 000 GENERALAGGREGATE $2 000 000 GENL AGGREGATE LIMIT APPLIES PER: POLICY PET LOC PRODUCTS -COMPIOP AGG $2 DOD OOO AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY - (Per Person) $ NJURY BODILY acci ent) (Per ecddeM) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC AUTO ONLY: AGG S $ B EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERlEXECUnVE OFFICER/MEMBER EXCLUDED? K yee, descdbe under SPECIAL PROVISIONS below OTHER WCC5000804012006 01/15/06 01/15/07 EACH OCCURRENCE $ AGGREGATE $ $ $ We STATU. I OTH. $ _ E.L. EACH ACCIDENT $500000 E.L. DISEASE • FA EMPLOYEE $500,000 E.L. DISEASE -POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Insurance coverage is limited to the terms, conditions, exclusions, other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered, waived, or extended the coverage provided by the policy provisions. Gatewood Homes 1600 Falmouth Road, Suite 25 Centerville, MA 02632 Arnwn'Ja /inni/ne.. - I ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION IEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10_ DAYS WRITTEN TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 30 SHALL NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED 7 LS1 G ACORD CORPORATION 1988 nr)ytu—tuutl Irlu lu:-�,l finX & & IFiUXANGE FAX N0, 508 991 5461 P. 02/03 f�C QRb CERTIFICATE t P LIA I i � WSURANC`�DATE 04� 0/zo PRODUCER (S08)99$-9633 FAX (503)9911-5461 FLAGSHIP INSURANCE. INC 414 COUNTY STREET NEW BEDFORD. MA 02740 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NORf0HTSUPON THECFRTI€ICATE- t4oLDER. THIS CERTIFICATE DOES HOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLI ES SELOW. INStIRERS AFFORDING COVERAGE NAIC A INSURED Frank Capra PO Box 664 West Hyannisport, MA 02,672 . INSURER& Providence Mutual 13040- INSURER e: OneBeacon 20621 INSURER- INSU RERV. 1NSGRCR I. v THE POLICIES OF INSURANCE LI=8VLOW ttnVE BEEN=UED ANY REOULRZMENT, TERM OR CONDITION OF ANY CONTACT MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES POLICIEES.AGGREGATE LIMITS SHOWNMAYHAiT9EEid TV THE INSURED NAMED ABOVE fOR THS POLICY PERIO04JDICATED- MM W7TIMSTAINDINI OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CEImFIC4TE,NAY BB ISSUED OR DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH DUCEDOYPACCLAIMS. ER TYPEOFMSORANCE RUMBC-g POUCY EFFECTIVE DATE DW&MMIM POLICY ID(MRATgN DATE jusunaryin LUSTS A -NERALLuauiY LLAM!$ MA-- L ^ L CRIPAD053231 LD3 22/13/200S 12/23l2006 L cxDtcullll i 3 LAD00 OD DAMAGE RENTED MED EXP Wv we pm" i 50.00 S 5.00 PERSONALSADVRJURY S 11000.00 GENERAL AGGREGATE $ 2.000.0 GEMLACGR.EyATEVMff.APF- I0.PF;R. POLICY JECT LOC PRODUCTS•COMPtOPAaO S 2.000.00 B AUTOMORILRUABIUTr ANY AUTO ALL OWNED AUTOS X SCHEDULED AUTOS X HIRED AUTOS X NO"WNEO AUTOS CBIE63796 - 02/14/2006 - 02/141/2007 y�g p ID„F (t' av0""1 s 1 000 0 BODILY INJURY (Pwpwa ) i BODILY "JURY (Par aedde ) S PROPERTY DAMAGE (For wa[arei ; DAMOI UASRITY ANYAUTO AUTO ONLY -EA ACCIDENT is OTHER THAN EAACC AUTDONL;". AG. S S A EXCESSIUMBRELIALNSNATY OCCUR Q CLAIMS MADE DEDUCTIBLE RETENTION S U C0OS0264 01 12/13/2005 1t 01/23/2006 FACHOCCURRENCE S 2,000,0(M AGGREGATE i 21000.0001 s WOAKERSCOMPENSATMAND EMPLOVEW LIAARdTY ANY PROPRIBTORIPARTNERMNECUTNE OFFXOERRdIM^vER EXCLLT.cOT SP `c119 PA OIOVIS mmaw. WLbTATIJ• OTH. £L EACKACCOWT S £LOISEASE•EA 6KPtOYE i £L DfBIASE •POLICY LY+XT S aTHER DSSCIU"W)OOF OPFRATONS / LOCATK)NSI VEIRCLES / EXCLUSIONS ADDED BY ENDORSE;ENT I SPECW. PROVISKINS CERTIFICATE HE3(_EIFFi I eAMT`CI I ATUVJ SHOULD ANY OF THE ABOVE DESERMED POU=&AS "WELLED SIFDRE THE EOPRAVON DATE THEREOP. THE ISSUING INSURER WILL EkDEAVOR TO MAIL 10 DAYS wmTTEH NOTICE TO THe CERTRICATE NOLDEN NAMED TO THE LEFT. - CATEWDOD tlW S, INCi 617 FAILURE TO MAIL SUCH NOTICE SHALL MIPOBE NO OBLIGATION OR LIABILRY 1600 FALM UTH ROAD, SUITE 25 OF ANY IIND UPON THE USURER ITS AGENTS OR REPRESENTATRIES. CENTERVILLE, MA 02601 AUTHORIZED RLM91ENTATIVE ACORD251200IMS) FAA: (500175-56D3 ' I TIONma Aii-21-2006 FRI 10.06 Rif R & K }N"URM CE r APR 21 ZOOS 09,27 FR 407 ;388 7049 CIRTWCATE OF FAX NO. 508 991 5461 P. 02 407 389 7848 To 915089915481 p_g1ig1 Issue Date 4a1r4 0 Contlaelstsl CasasltyCompany Produce PLACISHW INSURANCE INC 414 COUNTY ST NEW DEDFORD MA 02740 Insured CAPRA, -AWKG DBACAPRAHOMEUDRDVEKDM PO DOX6 63 WEST HYANPiT—SPORT UA 0267 cams.0" 7MS IS TD CERTIFY THAT THE LNSURED NAMED ABOVE FOR TERM 0I.1cros OF INSIMANCE LlSM BELOW HAVE am 1esm TO. in POLICY PMOD INDICATED, NO1W1THSTANDING OR CONDMON QP ANY CI+,.RTl 11CATI SLAY BE IS&M OR Hi?ttFMISSIJBIECITOALLTHE ANY REQMSWN7 f i11IRACT OR OTHER DOCUMENT WrrH RS>1PECT TO WHICH THIS Y PoRTAM, THb 1Tt3URANCE AfF06i7ED HY fH8 P4LICMS DBSCRJ98p ,LS'C1. $$-SAY 40ONOrI:ONSCFsucHpouaB$. MAY HAVE BEEN RWUCBD BY P CLA(M3. LiM sffOWN 'ijlpe of Innnuce F olley Number Vali-y Elf. Date Polley FAp, Date wonarmes,cowENSAT:O'N 84IX73106 4V121o6 03rlv07 Workers' COmPewatiON 40d IMIP loyers LiablUty Ltmlft EACH ACCMWr E I,000 000 DISBA3E.FDUCYI1MIT s looccoa DISEASE EACH aeLOyFX S 4000,000 TF.E P^OPRW0R/PARTNl)d1 l OPPiaMVj g" • INCL Deserlptlas of 4perxHo p/Ye�v:-ala':r ns oss Added by Endoriementrapedsi Prbvwoas cmwcate Hotde n OATsVwD HOMES DIC 1600 FAIMOUIE ROAD CSN UVIUR MA M01 Caneellatftln SI O'= ANY OF TIII AEOVE D TASREOP, no Issma COMP SLa -M POLICIES. BE CANCELLED BEFORE 7H8 1�4RAIION DA7E CERTIFICATE HOLDER NAMISp OBLIGATION OR LIA81L1TY OP WILL £NDEAYCR TO MAIL W' BUT FAILURE To H-U WRn-M N=CL, T16 TIDE SE NO ANY 1ND UPON THS COMPANY, ITS AGRMB RBPMENrATVM A.e.Sarired R!►reseataetve I TOM flan AMQnt M=agw Vhdan►Atsr ** TOTAL PRGE.81 ** �/++ J DATE(MMIDDIYYYY) /' Q-_d Qn CERTIFICATE OF LIABILITY THNSU IF�,vvEICATE IS SUED AS A MATTER OF INFORMAT ONOOS //�{, IS IRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE PANTANO INSURANCE AGENCY/ INC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 220 BROADWAY, SUITE 202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. LYNNFIELD, MA 01940 INSURERS AFFORDING COVERAGE NAIC# 781-581-3100 COMMERCE INSURED CENTURY PAINTING & DRYWALL INC. INSURER INSURER B: P.O. BOX 2903 41 1, NSURER C: HYANNIS/ MA 02601 �M dkA'bGdjLa INSURERD: NSURER E: COVERAGES FTHEOEQUIREMENT, TERMCOR (CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT HSTANDING TO ERMSWHICTHLS SIONCERTFIC D C MAY B S OF SU HERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.CY EFFECTNE POAJ�YEMPmR�Am1IN LIMITS n N RANC POLICY NUMULK EACH OCCURRENCE S L , U U U , v v l, 0 0 0/ 000 ,ENERAL LIABILITY PREMISES 'Ea oaurence f 5 0 0 COMMERCIAL GENERAL LIABILITY DOCCUR MED EXP (Ar/ one person) / 0 6 INJURY f , $1 / O O 0 / 0 O O CLMMSMADE PENDING 12 � 17 / 0 5 12 / 17 PERSONAL 8 ADV 2 000,000 S / GENERAL AGGREGATE f1/ 0 0 0' 0 0 0 PRODUCTS -COMPIOP AGG GENL AGGREGATE UMIT APPLIES PER: .. POLICY J COT- LOC COMBINED SINGLE LIMIT $ AOTOMOBILEU ABSJTY - (Ea accident) .. ANYAUTO _: - _ BODILYINJURY $ ALLOWNEDAUTOS ---- (Per person) .. __. SCHEDULED AUTOS - - -- BODILYINJURY $ HIRED AUTOS (Peracddenq NON-OWNEDAUTOS PROPERTY DAMAGE S (Peraoddeny GARAGE LIABILITY tAAtiV a OTHERTHAN ANYAUTO - AUTOONLY: AGO S EACH OCCURRENCE S EXCESSIUMBRELLA UTABSJTY AGGREGATE $ OCCUR El CLAIMSMADE $ S DEDUCTIBLE _ $ WORKERSCOMPENSATIONAND EMPLOYERS• LIABILITY ANY PROPMEJONPARTREREMCUTWE OFFlCERNE m EXCI.UCEC9 OTHER GATERWOOD HOMES 1600 FALMOUTH ROAD # 25 CENTERVILLE, MA 02632 E.L EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE $ E.L DISEASE -POLICY LIMIT S SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING IN F URER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFI ATE HCfMER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATIOq ORIiUApLrTY OF ANY KITD UPON THE INSURER, ITS AGENTS OR December 21, 2005 GATEWOOD HOMES 1600 FALMOUTH RD STE 25 CENTERVILLE, MA 02632- RE: Certificate of Workers Compensation Insurance Liberty Mutual Group PO Box 7202 Portsmouth, NH 03802-7202 Telephone (800) 653-7893 Fax (603) 431-5693 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 Employers 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. E9dA+oq� y_ AUTHORIZED REPRESENTAME LIBE RTY MUTUAL INSURANCE GROUP This Cettiticme is executed by LMERT Y h4UTUAL LNSUIUNCE GROUP ss respects such insurance a 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 iv2v2oo5 coemrr: 4597 ACORD- CERTIFICATE OF CCINSUL MIDD/YYYY) LIABILITY INSURANCE F08/30/O6 PRODUCER Rogers & Gray Ins. Agency, Inc 434 Route 134 P. O. BOX 1601 81301 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. South Dennis, MA 02660-1601 INSURED INSURERS AFFORDING COVERAGE NAIC # Cape Cod Insulation Inc 455 Yarmouth Road INSURER A Peerless Insurance INSURER B: American Home Assurance INSURER C: Hyannis, MA 02601 INSURER D: COVERAGES 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. LTR A INSR1 TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR POLICY NUMBER POALICYLEM� CTNE 04/16/06 - POLAICY MrPo TION DATE 04/16/07 L1MIT3 EACH OCCURRENCE E1 00O 000 DAMAGE TO RENTED MED EXP (Any one Person) $1 O0 OOO S$ QQQ PERSONAL &ADV INJURY E1 00O 000 AGGREGATE LIMIT APPLIES PER JECT OLICY PRO- LOC GENERALAGGREGATE E2 000 000 PRODUCTS-COMP/OP AGG E2 OOO O00 AMOBILE tA LIABILITY NY AUTO BA9587917 04/10/06 04/10/07 COMBINED SINGLE LIMIT (Ea acpderd) E LL OWNED AUTOS BODILY INJURY (Par person) EZSO ,000 CHEDULED AUTOS HIRED AUTOS X X NON -OWNED AUTOS Y INJ (Per aLnt))RY $500,000 PROPERTY DAMAGE (Peraccidenl) E1OO OOO , GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT E OTHER THAN EAACC AUTO ONLY: AGG E E EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE E AGGREGATE S ES DEDUCTIBLE RETENTION $ B WORKERS COMPENSATION AND EMPLOYER5 LUUBILnY WC8962496 06/30/06 06/30/07 X WC S7ATU- O7H- E ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $500 000 H yeeSPE, describe under OTHER PROVISIONS below E.1- DISEASE -POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Insulation Installation & siding CERTIFICATE HOLDER CANCELLATION GateWOod Homes 1600 Falmouth Rd., Suite 25 Centerville, MA 02632 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE amen n �J . AO..�f'raw.yea� J aaaz4U6a1Mz3464 CBR o ACORD CORPORATION 198a -ACORD CERTIFICATE OF LIABILITY INSURANCE NUOPID o DATE ( 31 0 PRODUCER GOLDMAN & ASSOCIATES INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE FINANCIAL SERVICES INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 933 FALMOUTH RD . ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. HYANNIS MA 02601 Phone:508-775-6010 Fax:508-790-0249 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: PENN-AMERICA INS. CO. NUGNES ENTERPRISES INC INSURERB: PETER NUGNES INSURER C: WESTCBARNSTABLE MA 02668 INSURER0: INSURER E: - rnvpoArre _ 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. TNSIT ADM LTR INSRE TYPE OF INSURANCE POLICY NUMBER DATE YlMM/DD/YY DATE MMIDEN Y LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE XO OCCUR PAC6593654 07/24/06 07/24/07 EACH OCCURRENCE S 300000 X PREMISES Ea atcurence) $50000 MED EXP(Any one person) s5000 PERSONAL &ADV INJURY $300000 GENERAL AGGREGATE $600000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY F1 PE0. LOC PRODUCTS-COMP/OP AGG $300000. - AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS - HIRED AUTOS NON -OWNED AUTOS - COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY. (Per person) i BODILY INJURY (Per accident) $ PROPERTYDAMAGE (Per accident) _ $ GARAGE LIABILITY ANYAUTO AUTO ONLY- EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESSAIMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION III EACH OCCURRENCE $ AGGREGATE y $ $ $ WORKERS COMPENSATION AND EMPLOYERS, LIABILITY ANY PROPRIETOR/PARTNEWEXECUTIVE OFFICERIMEMBER FXCLUDED7 Iyes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS CARPENTRY RESIDENTIAL CERTIFICATE HOLDER __..._._-. _ TORY LIMITS ER E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S E.L.DISEASE -POLICY LIMIT S +ATLVQO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO 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 LU%BILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1600 FALMOUTH ROAD REPRESENTATIVES. CENTERVILLE MA 02632 AU I MUMLMP REpRESENTATWO t TOWN OF YARMOUTH 1146ROUTE28 SOUTHYARMOUTH MASSA=SETTS026644451 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 lwork/ demolition to be conducted at A \ 5+ Work Ad s is to be disposed of at the following location: Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Signature of Applicant Date Permit No. UCt Ub Ub UU:48a Hudson Corp 1 508 775-2310 p,1 �. Ea�t.9al�L�tlet� asKa3u�`a.aa NONE VAPROVEUENT CONTRACTOR Replstn!(an tt0021.... Expkatlow 10MG12005 - CAPRA HOME IMPROVEMENTS. FRANK CAPRA Q COPPER LANE ri--sr��.✓ rrnlrF��in t.P, MA 02632 .1AmirFetrctn. License or registration valid for individul use only before the tipiration date: IIfovnd retnrn-k:., Board of Building Regulations and Standards One Ashburton Placo Rat-Li01: Boston, Ma. 02109 - Not ralidwithout-sienature P h. fz -7 TOWN OF YARMOUTH e HEALTH DEPARTMENT NOV 0 2 2006 PERMIT APPLICATION SIGN OFF TRANSM&MINPT. To be completed by Applicant. Building Site Location: /Z, 1—'-A-",U Ales Map No.: Lot No.q- q Proposed Improvement:N.i? M2� Applicant: �`//.�p� ��d� ��}"� C�i Tel. No.K� Z�ti/ Owner Address: Owner Tel. No.: RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. Please submit four (4) copies of plans, to include: (1.) Site Plan showing existing buildings, water line location, and septic system location; (2.) Floor plan labeling ALL rooms within building (all existing and proposed) — Note. Floor plans not required for decks, sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED BY: DATE: i l G 0 PLEASE NOTE COMMENTS/CONDITIONS: IeI � V�E G R c-Tl i 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 1. 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.IC.94; Street: 121 CAMP STREET, UNIT 94 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) Ll-e�- �;Z 'ek� toYarmouth Water Department Of VTOWN OF YARMOUTH Building Department _ Town Hall eA a Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-07-217 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Unit 94 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: 2. ENGINEERING DEPARTMENT: 3. CONSERVATION: 4. HEALTH DEPARTMENT: 5. BUILDING DEPARTMENT: 6. FIRE DEPARTMENT: COMMENTS: RECEIPT OF COPY: (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: Payment Type: Check ChkNo.: 0 Net Owed: Application Date: 11/7/2006 Issue Date: Expiration Date PLEASE NOTE SIGNATURE OF APPLICANT: Comments: Map/Lot: 044.21.1.( new construction - affordable: ZONING APPROVED DATE: N/A: DATE: N/A: DATE: N/A: DATE: N/A: DATE: N/A: DATE: N/A: DATE: Date Printed: 11/9/2006 'l SPECIFICt4TIONS... GMS9/GCS.9 SERIES. . 93% AFUE Multi-Position;- Single-Stage/Multi-Speed-.• Gas Furnace..-... Heating Capacity;.. 46,000-115,000 BTUH kir-C:QncUfrortirrg-&tieat'rrrg-\ The GMS91=9 single -stage multi.;S Fee _gas frzrrraces installation .versatility Standard Features eabinereonstractiver • Corrosion -resistant, aluminized -steel tubular heat • Heavy -gauge, reinforced, fully insulated s exchanger and stainless -steel recuperative coil for withdnrablebaked-enamel finish - maximum efficicncy • Attractive architectutal gray paint finish • Designed for multi -position itistaltation---GMS9:- • Foil -face insulation -lined heat exchanger upflow, horizontal right or left; GCS9: downflow, horizontal right -or left Energy -saving, reliable Hot Surface Ignition system, featuring a Norton® Mini•lgniter.with Patented adaptive learning algorithm to maximize igniter hfe- • Ahtminized-steel inshot burners • Energy -saving PSC�inulii-speed, direct drive blower motor • Quiet. corrosion -resistant iodated -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; alterrtate-flue/vertrlocated- on right side • Completely.assembled,factor�sua:tesudfurnace.for...... heating or combination heating/cooling application • All models comply with California NOx Standards • Suitable for direct vent (2•pipe) or non -direct vent 0-pipe) applications compartment Coil and furnace fit (lush for easy installation Convenient left or right connection for gas and electric service Bottom or side air inlet (GMS9) Removable, -solid -bottom bloek-off (GM59). A&essodi s L.P. Conversion Kit (LPT-OOA) •- L. R Gas- Loa- Pressurc-Kit• (LPLPO I ) High Altitude Natural Gas/L.F. Kits (HANG11. HANG12, HALP10) • ... . • High Altitude Pressure Switch Kit (HAPS27) • Extema1FiltecRacic(EFROI). . • Horizontal Concentric Vent Kit (HCVK) . • Vertic-AConcentr;c Vent_Kit (VCVK).... Internal Filter Retention Kit—upBow, horituntal (RFOW180) ..... • Internal Filter Retention Kit--downflow (RF000181) .. • Thermostats Blower Motors (CHT18.60, CH70TG,. CHSATG, H20TWR) SS•3770 ww•.gowmanmfgcom __ 6104, PRODUCT SPECIFICATIONS Nomenclature 070 3 EA- Rewl Goodman® tranTj LU Mon Ak-Inkfami" Air Flow Direction Nox a: ig Rewosfon M: Upflowl"orizantat.... H, Natural Gas C. Z� Revision ,)(-. Low Nox D: Dedicated Downflow, EiE C: Downftow/Horizonzal W. Flow Cib*et Width A: 14" Description 8: 17yj" e StAge/Multi-speed C.,2e-.. - I Two " FssTiz,Stage/Variable-speed D: M11 AFUE B.-80% 9,90% 4; 1,600 1 5: 2.000 045' 45,000 .... 670: 70,000 090: 90,000 140:140,000 kl:—) GCS9 Dimensions LM eFIE . VWw �y w aR ORM Near We 710E VIEW g1j I* R WTARCMPe R'11VTr PVc ,2n1sCaltmeaTE DRAW MAI, OaTA6E 11•Wa -PvcrCAa ^Ole.. ..•Mto"J Iamin- MatE 2/ 1• ylq koCATIoN la[wigMr ... ... - .. /s tq .. 2Mni kmracre aAeEtouowu,sueM an :»//` am n t2 "" _'teli0i Fsi •w s11M Q e n 4 �J� MatEs _. !ii '"-j �ttvtrurl Gay b n• 3DFoA.waeywP._ o.r,.Mua .... "'"`"••'..+ut^^c►-.`. .. amra.,mk of'-1e Yn ��j EttDSD INppFE v 0,3CwR��uR GCS9045JflxA 17%t" 16" GCS907038XA t4Yr" 16^ 1755" � t6"..... GCS90904CA ... .._. 12'/•0' ... ...- 14p1"..... 21^ 191'4" a . ..... 16". GCS911350XA t6/. 18. 191.i^ 24Yt" NOTES- 2J"..._. 20G...... .. 211f^ ... 23P I Installer must supply one a two pVC pipes: one for combustpMyr (o 2" or 3" 61 diameter. depending upon furnaceinputouglet ; numberof clbowy h of rruua ncr natalleno (1 orr p ye j)•' W ppo t "f a he either Air Pipe is dependent on inytallatlorJcode Pro must be tither Z• Line voltage wiring cen enter'll awgls drequttements and must be 2" or 3" diarnetet pVC 3. Cnnvers on kin far (.j altitude C s 11 the-rightrrida ehhe fumate: L6at votiege ,wing cam enter through The r;ght M left side of furnace. 4. Inualler must supply follow( gus operatlun an available. Contact your Goodman distributor or dealer fro details. Left— nt Cos Uae flttivgs, according to which cntranceia used. 7"'t• 90a epuwt, acne cl ga Vap(c:,itialght pipe Ri ht g-�S[ray(ht pipe so rich gas valve Minimum Cle6raaces to Combustible Materials 0ownflow 0" 0" Horizontal 1'... .. 0" 4.. C w Combusttbk: ((placed on tombustib)e Roue the &or?4U$Tbe woodON1Y' NC = Noo.Combmtib(e: A combustlbte floor subbase must be used fw iona8etion on cembusnble flooring NOTES: • Fur re"king w cleaning, a 36" front clearance is recommended. Unit coruic tsonf (electrical. flue and drain) may necessitate greater elearaaceathan.t6eanMsiewmekRrattEa Iluedblow .. • Zn atl asee, accesfibillty sdemeice must Take preeedence.ovgslearaMer kom the enclosure where acceaibiGty cle•r.ocn are Beater. 5 •er Blower Performance Specifications ION 1,.352 t ,318 F HIGH 3.0 r--• t,260 1,20Z G-S90453BXA MED 2.5 t,214 %$72 ----- 1,123 .- ... 1,064 3' (LOW) MED-LO 2.0 997 ••--•• 994 ...... 960 - 35 923 3. .. r . •LOW.. - 1:5_ ..757 - �- 4k•...753-. ..44-_ .334 - _ a5--- . 70r` ' 4T ' ., :: � 41. � Vi G 5907038XA - HIGH MED 3.0 2.5 1,449 1 192 36 4 3 1,409 1 172 37 44 1,326 39 t,273 MED-LO 2.0 981 ' 53 , 962 54 1,141 943 45.. SS 1,094 917 47. , 56 ;• LOW 1.5 750 730 714 G_590904CXA .HIGH. MED .-4A.O•- 3.5 11.,970 1,713 -_•-.. 39 t,874 1,650 --35 1;757. -38- 11667 (MED-LO) MED-1-0 3.0 1439 46 1,412 40 47 1,572 42. 1,510 4.1- ' ' LOW -• 2.5 1 T83 '56'..1"15S -'ST-. 7,370 1'122 48 '59- 1,327 1106. 50 -.d0.. ._' )... LS ,: G S91155DXA HIGH . MED 5.0 4.0 2 134 1,678 40 2, 003 1.,643 40 52, .42 t,941 as ',_._ ,,.:.:,•. _ -_,, (MED•Nq MEO•LO 3.5 1,453 „51 58 1,440 _ 59 1.643 1,426 1,426 _52. 59 11,363 1,363 ..54.. 62 LOW ..3.0... 1,759 ..67.. 1,239 -68... 220. .. 70. _ t�t81"-- _..... _ .�. NOTES: I 1 • CFM in char[ it wit6ou[ fitar(s). Fil[cra d0 tMt ship.wi[h this Eumaca hue mua[ lsu ptuvidtd..by the iaxallas.lEehe-hunxvaet>vizxa cum•rer�n3. o'»s chart assumes finch filters are irismiled. 2. All furnaces ship a high speed ennling. InsrAICr must adjust hinw%r cnpll"X speed as needed. " .3. Fur tmsa jstbs. ahior 460 CM per tun when en,>ling is drsir:tbla. 4. INSTALLATION 15 TO BE ADJUSTED TO OBTAIN TEMPERATURE RSE WITHIN TNk RgNp) SPECIFIED ON rHji RgT1NG PLATE. 5. The chart is fur inhxmaticm tidy. For satisfactory operaHun, external antic pressure MOM not exeeed value shl>wn na ,hr.ating plate- The shaded art% indicates ranges in exeeu of maximum static pre", I,sdluaed when heating. 0. The dashed (•-•-) arcm indicate is ttwMattvelix nut meummended for-d.tsna.dal._, 7. The above chasm is fix US. fumaces installed a[ Cr • 2A00'. At higher altitudes. a properly de•rated unit will have aprrueana<elly the same temperature rise at a r, rtWar CFM,. while ESP at rite CFM willbe.htwer.... . 6 `f. M •a. PRODUCT SPECIFICATIONS Accessories LPT-OOA L.P. Conversion Kit J J J J LPLPOI L.P. Gas Low Pressure Kit J J J f HANGI I HANGt2 HALPIO HAPS27 ..EEROt.. High Altitude Natural Gas Kit High Altitude Natural Gas Kit High Altitude L.P. Gas Kit 114igh Altitude Pressure Switch Kit External Filter.Rack.. ..... 1 2 3. .......__ 3 _..... J. ... ... t 2 3..... 3 ..._ J.. t Z .....3..... 3 ... .J..... I 3 11 DCVK-20 Horizontal/Verticai Concentric Vent Kit (2^) J J DCVK-30 Narfzontal/Vertical6oncentricVent Kit p-y- .... _._ .. ._ .., ..... J .... . 1 (1) r ccl,1 b' 9,9=� (2) 9,001'to I I10W' (3) 7,001, to i 1.000' Note: All inata0atitms above 7,000- requite a pre"ure sattch elta a hx ctsestlatioein Cpnada, lvrttaees are cerzifie j pulp to 4,500'. arvfloor Base: When the G(�9 model is installed directly ds a wood floor, a do flnw Ksxn base must t, wad..T. %,,, mudat uumbe.u- arc: CFBJ A17, CfB17 and C:FB24- , Thermostats CHT1 B-60 CH70TG CHSATG - 14207WR Cooling/Heating, Mechanical Cooting/Heating, Digital, Non -programmable 7 Heating Only, Mechanical 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 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 I I I I Permit # I I I I I checked by/Date I I I Area or Cavity Cont. Th ng/ 6r Perimeter R-Value R-Value 1 CEILINGS 832 30.0 30.0 Zvi WALLS: wood Frame, 16" O.C. 1409 15.0 15.0 10 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 34.4. Builder/Designer U Date A Massachusetts Energy Code MAscheck software version 2.01 Release 2 The Egret DATE: 4-21-2004 Bldg.l Dept.l use I I CEILINGS: [ ] I 1. R-30 + R-30 comments/Location WALLS: [ ] I 1. wood Frame, 16" O.C., R-15 + R-15 Comments/Location WINDOWS AND GLASS DOORS: [ ] I 1. U-value: 0.34 For windows without labeled U-values, describe features: # Panes Frame TypeThermal Break? [ ] Yes [ ] No Comments/Location [ ] I 2. u-value: 0.34 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? C ] Yes [ ] No I comments/Location I DOORS: [ ] I 1. U-value: 0.086 Comments/Location AIR LEAKAGE: [ ] I joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. when I 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 i shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: [ ] I Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: ' [ ] I Materials and equipment must be identified so that compliance can i be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. insulation R-values and glazing u-values must be clearly marked on the building plans or specifications. I I I I I I I DUCT INSULATION: Ducts shall be insulated per Table 34.4.7.1. DUCT CONSTRUCTION: All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in Sections 780CMR 1310 and 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.): 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" 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)--------------- FILE COPY SEWER MAIN PROP PROPOSED SEE SLEEVING 4" SEWER LATERAL NOTE BELOW i S84'19'0 •— 46.00' W EM S84-19'03"W o 54.009 S84'19'03 PROPOSE_Q 40.45' t,, tWn I � PROPOSED pRIVEWA I I 0>- 0 5 DRIVEWAY I 3 a� 3 a� w N n_ 0— 32 ,12 PROPOSED 721 PROPOSED N HOUSE 18.5 iZo / ro °: PLOVER PROPOSED v; EGRET °i tp FF 150 V HOUSE 0 FF = 24.4 GW SANDPIPER oo Ut GW = 15 26.7 FF 24.8 % 19.1 J , " M r 21' iw GW = 15 a, I .3 ,w M ? 94 ;, I 5.3 3 675t S F. LOT 95 W LOT 93 AFFORDABLE 46.00' 54.58, 6 5.3' — '8'06'47� W 14.00_ 54.00' S84'23'45"W Yarmouth 117 Health Department �p APPR® D f 16�UC FF = DENOTES FIRST FLOOR ELEVATION G�� tip% Date GW = DENOTES APPROXIMATE ELEVATIO 4^ �e SEWER LATERAL SHALL BE OF GROUND WATER BOA G° SLEEVED IN ACCORDANCE WITH TITLE W V IF WITHIN GRAPHICS C®P WORK MUSTICON6Ri�1,1 TffAF&*AIN. e+ gyLAWS AND REGULATt0.IS 20 10 0 20 60 f / � dOTICh a a 6 l� as tred) stamp of the respbnstbfe; P1rafe¢s&jol` rrg or Prof I Land Surveyor appears9 on this Ian: (A) no person or persons. Including any municipal or other ( IN FEET) public ofiictals, may rely upon the information contained herein; and 1 inch = 20 ft. (e) this plan remains the property of Holmes & Mcrroth. Inc. 0 OT PLANT 94 holmes and mcgrath, inc. ��`" OF civil engineers and land surveyors �� MICHAEl.� PREPARED FOR 8. MILL POND VILLAGE 362 gifford street McG13ATH H IN folmouth, ma. 02540 9 N• 26878 YARMOUTH, MA � AFc `` JOB NO: 201197 DRAWN: LMC SCALE: 1 "=20' DATE: 8-4-06 DWG. NO.: A2565 CHECKED- oP r� TOWN OF YARMOUTH Building Department BUILDING - _ _ - - _ _ _ , (508) 398-2231 ext.261 PERMIT NO _8-07-asa _ _ - PERMIT ISSUE DATE ;. 1/11/2007 _ ; PROPOSED USE ; APPLICANT:FunkCapra --------------------- JOB WEATHER CARD PERMIT TO New Construction IAT (LOCATION) 00121CAMP ST Unit 94 ZONING DISTRIC R-2 Bldg. Type: Residential I • SUBDIVISION MAP LOT BLOCK 044.21.1.C94 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE new construction - affordable: 2 baths, 3 bedrooms, 1 diningroom, 1 kitchen, 1 livingroom as per plans REMARKS dated 11/14/06. AREA (SQ FT) EST COST ($ I$148,896.00 PERMIT FEE ($) 1$0.00 OWNER lVillages @ Camp Street, LLC BUILDING DEPT BY ADDRESS 11600 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