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HomeMy WebLinkAbout121 Camp St #097 Building Permitsor TOWN OF YARMOUTH Building Department BUILDING + = (508) 398-2231 ext.261 PERMIT NO ==B-o�-887 - - - - PERMIT ...,.� ISSUE DATE : _ 1/11/2007 - ; _ _ _ - - • PROPOSED USE • Frank Capra a---------------------' APPLICANT • Frank C JOB WEATHER CARD PERMIT TO ; New Construction ; AT (LOCATION) ZONING DISTRIC R-25 Bldg. Type: Residential 0012 CCAMP ST Unit 97 SUBDIVISION MAP LOT BLOCK 044.21.1.C97 BUILDING IS TO BE: CONST TYPE 5-B USE LOT SIZE new construction: 2 baths, 3 bedrooms, 1 greatroom, 1 kitchen as per plans dated 11/17/06. REMARKS AREA (SQ FT) EST COST ($ OWNER lVillages G Camp Street, LLC ADDRESS 1600 Falmouth Road # 25 Centerville I MA R632 PERMIT FEE ($) $516.00 BUILDING DEPT BY R-4 CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 PHONE 15087789669 THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM INSPECTIONS REQUIRED FOR ALL APPROVED PLANS MUST BE RETAINED ON WHERE APPLICABLE SEPARATE PERMITS ARE CONSTRUCTION WORK: 1) FOUNDATIONS OR JOB AND THIS CARD KEPT POSTED UNTIL REQUIRED FOR ELECTRICAL FOOTINGS. 2) PRIOR TO COVERING STRUCTURAL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS PLUMBING/GASAND MEMBERS (READY FOR LATH OR FINISH REQUIRED. SUCH BUILDING SHALL NOT BE MECHANICAL INSTALLATIONS. COVERING) 3) FINAL INSPECTION BEFORE OCCUPIED UNTIL FINAL INSPECTION HAS OCCUPANCY 4) REFER TO DETAILED INSPECTION BEEN MADE. SCHEDULE POST THIS CARD SO IT IS VISIBLE FROM STREET IILDING INSPECTIONS 2 2 � % 2 OTHER: f 3 1 2 3 4 5 WORK SHALL NOT PROCEED PERMIT WILL BECOME NULL AND VOID IF INSPECTIONS INDICATED ON THIS CARD UNTIL THE INSPECTOR HAS CONSTRUCTION WORK IS NOT STARTED WITHIN SIX CAN BE ARRANGED FOR BY TELEPHONE APPROVED THE VARIOUS MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED OR WRITTEN NOTIFICATION. STAGES OF CONSTRUCTION ABOVE. oF.YgR ONE & TWO FAMILY ONLY - BUILDING PERMIT '. •$C . APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING o y Town of Yarmouth Building Department N .ATT;,C„«, 2 1146 Route 28 ° Yarmouth, MA 02664-4492 Tel: (508) 398-2231 x261 ° Fax: (508) 398-0836 r ' Office Use Only s ; 't Av Planning Board Inforfation Assessors Departmerit lnformatrorc r h < Map Permlt N Date w ` t PermiEee _ 'i ,ct E arsement Date, .r r Mew ieOiSrdir�giDatP..7 Deposit Fier' ' $ r date . t .vx z� sr P13[INOi.•'x' n S� Net Due $ r Qthet L1 7' za ~' LotArea(st)*> Frontageft),� Coverage :, } y ry w'n-"7his Sectlorlar Office Use Q51 x, �4 �� �r Btillciln n fi'CertfflCate of Occupancyri is ° is nat - required u�r ae h, x Fes. K,.�Builtl�ng.Officials r. Section""*1,=Site.lnformatf6rif' Use Group: R-4 Type: 5-B 1.1 Property Address: 1.2. Zoning Information: Iasi Zoning Distr' Proposed Use 1.3 Building Setbacks (ft) I) C r Front Yard Side Yards Rear Yard Required Provided Required Provided ILJk6q it o! �'rovi IRV 1.4 Water Supply (M.G.L e. 40. S 54) a a 4.5'FloodZorie tnformaton z t# T ,` ' t Com r " an' S 7.. x y t"`• a c'S { r a P y x -r a r ,r rF'1 n" s `x'{.4. .: J. Public Private Section 2a Property SJwriersl f61Autlfde#&-�,Agent 2.1P7 r of Record/: ) / // Name(pnnt) r Mailing Addres§6cw f-aek;/`/C2j i—/ QZ4l, L � Signature Telephone 2.2 AuthorizsdrAgent: Na print) Mailing AddressC,.,y9,2t.-1yjw -% , b e) ,d Signature Telephone Fax Section 3 ,Construction Service`s'- 3.1 Licensed Construction Supervisor. ' ble I'1 C UI 17NG DEP OrT. Addr 0 Expiration Date Signature Telephone 3:2;Registeed Homeklmprovement,Cgntractdr--: Company Name _ Not Applicable License Number Address Expiration Date Signature Telephone I 9-15-99 1of2 . OVFR Foundation Location Approved DRIVEWAY PROPOSED EDGE OF PAVEMENT 8A,7'1 "E T 13.76' N N LOT 96 �- 9.0! 1 .0- J O o O � EXISTING JI 41.9 2. FOUNDATION Q7I00 I CERTIFY THAT THE FOUNDATION IS LOCATED IN FLOOD PLAIN ZONE C AS SHOWN ON FLOOD INSURANCE RATE MAP COMMUNITY PANEL NO. 250015 00050 AND THAT FLOOD PLAIN ZONE C IS NOT A SPECIAL FLOOD HAZARD AREA. HOLMES AND McGRATH. INC. 9�w MICHAEL B. McGRATH DATE REGISTERED PROFESSIONAL LAND SURVEYOR NOTICE Unless and until such time as the original (red) stomp of the "eapansible Professional Engineer, or Professional Land Surveyor appears an this plan., (A) no person or persons, ncluding any municipal or other public officials, may rely upon the information contained tierein; and (8) this plan remains the property of Holmes & McGrath, Inc. AS —BUILT PLAN OF LOT 97 PREPARED FOR MILL POND VILLAGE IN YARMOUTH, MA _ N84-2,7'16"E _ 50.00' m• c 18.5' G DRAINAGE EXISTING c I AREA FOUNDATION I .7 a I J IN LOT 97 50. 1 4s.00' I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE LOT AS SHOWN, AND THAT ITS LOCATION CONFORMS TO THE MINIMUM SETBACK REQUIREMENTS OF r THE 4013 SPECIAL PERMIT. MINIMUM SETBACK REQUIREMENTS OF THE 408 SPECIAL PERMIT. HOLMES AND McGRATH. INC. / 5?�7 MICHAEL B. McGRATH DATE REGISTERED PROFESSIONAL LAND SURVEYOR GRAPHIC SCALE ( IN FEET ) 1 inch = 20 ft holmes and mcgrath, inc. civil engineers and land surveyors 362 gifford street falmouth, ma. 02540 JOB NO: 201197 DRAWN: PJR DWG. NO.: A2567A CHECKED: a SCALE: 1"=20' DATE:7-5-07 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 Section.S- Descnpttcrn _i000sed.Work=tci,ectc New Construction No. of Bedrooms No. of Bathrooms Z Existing Bldg. ❑ I ReDair(s) ❑ I Alterntinns ❑ I e in r�,,., r k Accessory Bldg. ❑ Type Demolition Other Specify: P fy: Brief Description of Proposed Work: Q hereby authorize my behalf, in all r 0 MMZA Check Below ❑ Conservation -Commission Fling (if applicable) . - ❑ Old Kings Highway & Historical Commission approval (if applicable) , as owner of the subject property to act on 7relaN,e to w rk authorized by this building permit application. Date ,. as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. C M I, Ill IUIFIU SigKati.Wof O ned gent Date 9-15-99 2 of 2 It, 41 f lvwIN car YARMOUTH �y BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: I Job Location: Owner of Property. Construction Supervisor: Address: 100 k Licensed Designee: (If other than Supervisor) lAl sq. Name d . License Nc Name 2.15 Responsibility of each license holder: Village LL c Phone No. 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 2� No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box.' A liability insurance policy 1.7 - Other type of indemnity ❑ Bond ❑ OWNER'S INSU NCE WA VER: 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: Signal re of ner or Owners Agen Owner ❑ Agent Signature: Building Official Approval: G i The Commonwealth of Massachusetts Department of Industrial Accidents - Offlceol/mstlp�tfi�s ► 600 Washington Street Boston. Mass. 02111 v � Workers' Compensation Insurance Affidavit Applicant inform2tion- •Z r I am a homeowner performing all work myself. I am a sole _proprietor =a.4ha\ a no one corking in any capacity O lam an. employer pro, iding workers' compensation for my employees working on this job. comi2any na address: city phone 0 insurnnee co, policy k I am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below w ho hay: the.follc�ssin_ corkers'-ompensation 0 iC company narn S city: lam{_ phone N:d eomoanv name• a Failure to secure coverage as required under Section 25A of MGL 152 call Ind to the imposition of criminal penalties of a flat op to S1.500.00 audio one years' imprisonment as well as civil penalties in the forth of a STOP WORK ORDER and a fine of S300.00 a day against me. I andetstasd that i copyof this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby cerrify under the pains and penalties ojpery'ury that the information provided above is vueand correm Signature / ate 5� z G i Print name i►lX/LI�Cs �iy� Phone I official use only do not.. rite in this area to be completed by city or town ofBeial city or town: YARI?oIITIJ _ permi0license N nBuilding Department I]Licensiog Board check if immediate response is required Z61 Selectmen's Me [313ealth Department contact person: Phone A.. (508) 39.8-=31 eat. nOther. nweOIIMAUi CrA cuenta- T04J4 -- ---- ACORDIn, CERTIFICATE OF LIABILITY INSURANCE �a 101 s°""'"' PRODUCER Dowlieg &O'Neil Insurance Agency 222 West Main St. PO Box 1990 Hyannis, MA 02601 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Assurance Construction, Inc. A/O Assurance Excavation, Inc. 550 Willow Street West Yarmouth, MA 02673 INSURERA Travelers Insurance Company INSURER B. INSURERC: INSURER D: INSURERS 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 CERTIFICATEMAY 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 TYPE OF. INSURANCE _.... POLICYNUMSFR CY EF POLIFECTIVE DATE MM/DD POLICY EXPIRATION AT MM/CD — - - .. -.-LMIT2._ _.._. A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY_. CLAIMS MADE D OCCUR I6608387A984IND06 __. - - - -- 08/01/06 08/01/07 ' EACH OCCURRENCE $1 000 000 DAMAGE TO REPRFMI-ReS (Fa NTED S3OO OOO - MED EXP (Any one person) $S 000 PERSONAL 6 ADV INJURY $1000000 GENERAL AGGREGATE S2 000 000 PRODUCTS-COMP/OP AGG 52000000 GENL AGGREGATE LIMIT APPLIES PER: POLICY PEO- LOC .' - . AUTOMOBILE LIABILITY - ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS._.__ ._.. .. " rro .. HIREDAUTOS .._...: .. .. NON -OWNED AUTOS -. .. - - - COMBINED SINGLE LIMB' (Ea accident) -$-' - - - - BODILY INJURY (Par Person) $ BODILY INJURY ": •. (Peraccident) ' .. _ _.. - __ _ . ... -.- __. ..... .. _.. .. r , :-. PROPERTY DAMAGE Per accident) - $ - .. GARAGE LIABILITY ANYAUTO AUTO ONLY -EA ACCIDENT $ OTHER THAN EAACC AUTO ONLY: AGG $ S EXCESSAIMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND. _ .. EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDEDT IfXm describeundef'+ SECIALPROVISIONS below EACH OCCURRENCE S AGGREGATE $ S S WC STATU• OTH• S E.L. EACH ACCIDENT...:. ' E.L DISEASE -__EMPLOYEE E.L DISEASE, :ICYLIMIT_ S .. - OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Operations performed by the named Insured subject to policy conditions and exclusions. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Gatewood Homes, Inc. DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Ill DAYS WRITTEN 1600 Falmouth Road, Suite 25 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Centerville, MA 02632 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES. AUTHORIZED R€PRESENTATNE `7✓f4 /^� ACORD 25 (2001/08) 1 of 2 #44705 "' 7HI8 CERTIFICATE IS-ISSUM AS A MATTER OF INFOR.FIATION - �PE.LLA �NSi4LZANCR AGIENCX, INC- HOLAER DTHS CERTIFICATE � NOT 2 NO RIGHTS AMFJJD� ��0 OR ,SyA wASHTNG TO �1 sT L r " ALTER -THE COVERAGE AFFORDED. BY THE PC03 ES BELOW. . Tdr imi TON, MIL o2rr'2592 TMAICO • Tol. (617) 787-0617 1NguR�-AFFORDWO COYERAGt: . INSURED Hen DiamA.ntopou109 INsuRERA: p>mo12a r=ettletierl xx+e Co ORA Robazt Flumblbg" r- 'lloat'ng INlUR6R A • - j wsURERa 25 Anth.OnY Road 1 West y9ormouttr;-Y.R"0�6i3 " msu nuwAMRXR EA a 6 COVERAGES THE ANY OLICIS OF IT. uURA 4 CONOTTION OF ANY CONTRACT OR OTHER DOCUatENT6wDiTH EB?5Cf TO TN15 CERT TE E UE�D�R AAAv PERTA{N THE INSURANCE /LFFDRDED BY THE pp�IEgOE$CR18ED HEREIN tS.SUB.AeGT TO ALL THE TFRMB EX FRAY AND CONDIT10N9 OF SUCH POLICIES. AGGREGATE LILIITS SHOWN NULYHAVE BEEN REDUCEDRY PAID CLANS. ITIn.. POGCY NUMBER POLIGY E b QINP.oh, LIAIULLLY S .COpY/,SR JA clFNERnAI. UTAOMxnr - .... CWM2MME 01 OCCUR A _ 8500031617 7/20/06 7/20/01 Rr)rL A(IMEoATE LW APM.ICI 1EA' FoLryr LOD nuTDMooaELUeILrtY .. ANfAYTO - ALL DuuNBoKnot - - - - ICNEDULCOAUTOS HIM ALIT04 RON•OWNEO.VJTO! CMAXIft MI MI ANTAUTo - - - - EXCES MrreAELLA LIABilfY OCCUR ❑ CLA64M M - DEDOCTSM R2TEnmw . -1- . WOR%EASCOMPENSATIONANO IMPLOYEA(f WIILITY .. . Ain pA0rI1FTgIr`ARrrIeAExCCYrA'LI - emiaAAltupfA ExCLLTfr�r s�"bAc•e'trvri0°o�llcNs Me. • - OTHER pimmmG WORK ATTN: Pmtst C,OTT8nvr-3 GATEW1001) BOMC9... 1600 FAI2WMjl RD STE 25 CENTERY mm. — HA 02632 E-M# 508-778-S809 -ACN OCyC4OMWeE ... S . Eg— MED41Ip eMOef!sl_ _ e'-... . MRSONAL&ADVOWVgil bENERAL'AOOAEGATrRoOuCTs-COMwop W�Me1NE NDLE LIWT A to II u6 s B00B.Y S IPAreeei AAo pROreRTY OAMAOE e L Ix�nolennR AUTO ONLY-EAACCIOENT S I.6Tf1OLTm". EACC S EL .. -SHpOLD MNLF-TNE AROUI; nartsme0 P.QUOIEO BO CANCFV,GD WOMTHE Ezpm&TION DATE TIIEREDf. 7ME t=04 MPuft" WRL ENDEAVOR TO MAti,- DAY1 WRITTEN - NOTIGG 70 THE eERTI[Tent _140LMA NAMED TO T'HE LEFT. WT FAW AE TO DO QO RHALL "a odLock.TIS ACENT! OR pirOlE NOreLiinU�"Lii(91LITV'�I AUTHOR AU R10R2FP p AT `. - •, : • -tAACORD CORRORJ4Tlo6l=IgQ. TOTAL Ploz. rl:e..He• ���eD aM A MKICI `ACC7RD,a CERTIFICATE OF LIABILITY INSURANCE D°"Y"' 812910 08/29/06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION DeWling & O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency 222 West Main St. PO Box 1990 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC # INSURED M. Ostrowski, Inc D/B/A Barnstable Electric 71 Lothrop's Lane West Barnstable, MA 02668 INSURER A: St Paul Travelers Insurance Company INSURER e: Associated Employers Insurance Compa INSURERC: INSURER D: INSURER B 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. N LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE DATE MM/DD POUCYEXPIRATION DATE MM/DD LIMITS A GENERAL LIABILITY 1680305OA587COF06 07/19/06 07/19/07 EACH OCCURRENCE $1 OOOOOO X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR DAMAGE TO RENTED 5300 OOO MED EXP (Any one person) $5 000 PERSONAL &ADV INJURY S1000000 GENERAL AGGREGATE E2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000000 - POLICY PROT LOC JEC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) - $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Peraccidenl) $ GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE E AGGREGATE S OCCUR CLAIMS MADE S - E DEDUCTIBLE $ - RETENTION $ B WORKERS COMPENSATION AND WCC5000804012006 01/15/06 01/15/07 OR IIMIT O P EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTNE E.L. EACH ACCIDENT ESOO OOO E.L. DISEASE - EA EMPLOYEE $500,000 OFFICERIMEMBER EXCLUDED? - I es, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT S500,000 OTHER DESCRIPTION OF OPERATIONS 1 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 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 SO SHALL NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR AUTHORIZED RYPRESENTATIVE -/ `7` Nl wnu AD TLUU I/U8f 'I of 2 044180 LS1 0 ACORD CORPORATION 1988 nr>;-.V-4VU0 InU MI X & h IN�iMN6E FAX N0. 5D8 n! 5461 P. 02/03 PRR uCER (508)994-9533 FAX 003)9911-5461 FLAGSHIP INSURANCE INC 414 COUNTY STREET NEW REDFORD, MA 02740 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANDCOUFE" vO-RIGHTS i MN Tii;E C@RrxFZA; is AALLTER THE COVERAGE AFFODRDFD 8 THEE OL�ICIE BELOOW. INSURERS AFFORDING COVERAGE NAIC S INSURED Frank Capra PO Box 664 west Hyannisport, T4A 02672 Nsufak Providence Mutual 130401 INSURER B! OneBeacon 20621 INSURER C: INSURER D. INSURER I- THE POUCIES OF INSURANCELIS'iEDBELOWHAVESE£ ANY REOUIRMAENT TERM OR CONDITION OFANY CONT&WCT MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIff1Eu^ POLICfES.AGGREQATEiiWTSSKGVYWVAYMA*&V.EfN tSSUEDTO T*IEINSURED NAMED ASOW-FOR THE P0UCYPERM4NOrATE[t A 07WTMSTANDINI OR OTHER DOCUMENT VVITH RESPECT TO WHICH THIS CERTIFICATE PUAY BE ISSUED OR DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH EOUCEOBYPAiDCLAIMS. 9R. TEE OFINSURANCE POLICY EFFECTNE POLICY EXPULATiON DATE rumburry, L .TS A GENERALLIARRITY CCLWERCYi13EHERAlW4!k.lTy -CLAW uanc nCtUR L"53131 03 12/13/2005 12/13/OQS Z ZACKOCCURREMCB 3 11=100 0Gr TO RENTED MED EXP (A^Y one P+rwn) t 50,00 S 5 QO PERSONAL & ADV INJURY S 1 000.00 GENERAL AGGREGATE S 2,000,000 GENT-ACGR.E.GATEJ.IN.R AP.K4$.P¢{: POLICY JECT LOC PROOi7CT5•CO&WJOP AGG S 2,000,000 - AUTOMOMLEUANUTY ANY AUTO ALL OWNED AUTOS SCHEOULEDAUTOS HIRED AUTOS NON-OWNEO AUTOS - CB1E63796 . 02/14/2006 02/14/2007 tOLHNNED EUHGLBLBNt Me wlc4 ) 3 1 000 0 BODILY INJURY IPerP«wl) t X X BODILY INFIRM fear Aerlewl) S X PROPERTY DAMAGE (For &-Ww ( t OARAOE LIABILITY ANYAUTO ` AUTO ONLY -EAACCIOEN[ t OTHER THAN EAACC AUTM*NLY; AGG 3 t A EXCERNMORELLALuewTY OCCUR nCLAM MADE DEDUCTIBLE RETENTION t C0050264 01 12/13/2005 01/13/2006 EACH OCCURRENCE S Z QQQ Q AGGREGATE S 21000 0 ! s S WORKENSCOMPENtATKNLAND IiMPLDYERCLMBJTY. ANY PROPRIETORIPARTHERJEXECUTNE CFFICERIMEMUREXCWAIRD? !7rw. dawlDs utlH SPECAL PROVISIONS W. - WC STATU• DTH• £L EACHACCmw s HLt.OISEASE-EA EINi.OYE $ Et DISEASE•PCLiCYt$4tT S OTHER F DiSCJWW)d OF0.►FRAT10/1;LLOCATNNSIVEMCLESIOCLUSMSijWOED BY ENOORSEMENTI SPECIAL PROVISIONS CFRT'IFICATF HMnF-Q 1 f AMrFI I AlMnre SHOULD ANY OF THE ADOVE DESCRIBED POLICIES OS CAN=,LED BUM THE EXPIRATION DATC. THERECF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS YJRITTEN NOTICE TO THE CERTPIr ATE HOLDER NAMED TO THE LEFT, GATE IM&S, li . BUT FAILURE TO MAR SUCH NOTICE SHALLWWR NO OBLIGATION OR LIABILITY 1600 FALFi M ROM, SUITE 25 OF ANY KIND UPON THE INSURER ITS AGENTS DR RE►RESENTATIYES. CENTERVILLE, MA 02601 AUTNORQED ATNE ACORD 25 {2Go1105) FAIL: (506)776-5603 I .( *AWAWG&ROftTION 1959 FAX N0, 509 991 5461 P. 02 HR--21-2006 FRI 10106 AM R & K INSURANCE Pk 21 E00& 89!27 FR 407 388 7849 CIRTVICATS OF Produces FLAGSHIP 24SURANCII INC 414 COUNTY ST NEW BEDFORD MA 02740 Insured CArRA, -r AhX c I PO BOX fit WEST HYANNI.0.OIT b A C Caverages 407 386 7848 To 915089915481 P_01/01 Ire -to Date 4M 46% Vital Casualty company TmS 15 TO CERTIFY THAT THE LICTSS OF INSII;ZAp10E LISTED BELOW HAYS Bl T ISSUED TO THE INSURED NAMED ABOVE FOR POLICY PERIOD INDICATED, NOTWI7}iSTANoma ANY R$QunuNm i TERM OR CONDITION OF ANY Ci141RACI' OR OTHML DOCUMENT WITH RRSPECT TO WHICH THIS CERTIPIC�IT$MAY SB ISSUED OR Y PERTAIN, In MURANCE AFFO&M E1Y TM POLICIES DESC11M HEREIN IS SUBzcr TO ALL THE , TXC SIOLS AMCONDt .ONS OF SUCH POl=$. I.iE U SHOWN MAY HAVE aUN REDUCED BY P . CLAIMS. Irm oflumnace alley Namber Peliq Etf. Date Polley Elgt. Date WORK—URVC014PENSAVON 16IX731606 0313210E 034V07 Workers' Compeasatioa rand 8m Ayers LiabWty Ltm1t EACH ACCID Wr 31,ampo DISEASEPOLICYLIMrr 2 i taoow DISEASE EACH MeLOYEE $1,000,000 THEPROPRMTO"ARTNMEXECOmCmtS/mLmzm .INCL Descrlotloa of Sfpernllogs/E.oes" erye:l:��„ :c;=;,'o Added 1 y Zndm*meatl/ePedg prbvw4Im Certttleate 891dera OATSINOOD HOldES u C 1600 FALMOUTS ROAD CENTBRVIU.B MA 02601 caaoeilattaa SHOULD ANY OF T€M AXOO" ISSUING CO)Ap'NY S{ ,oBD POLICIES BE CANCEUM BEFORE 77$ EXPIRATION DATE CERTiFiCAAIS NOLDER NAMED OVE, BUT FAILURE TO AMA1 WILL ENDEAVOR 70 MIL it DAYm wRrrmNQL1TW To TIM OR LIABIi IT Y OF Aor. ONOSE No AID UPON THE COMPANY, M AOHNTB OR RBPRESpffATIYES, Aat�oeiaad RepreseatatNe } TOM 1113" (I Aeseaat M=a$ar Uaderwrtttr ** TOTAL PAGE.01 ** ���. CERTIFICATE OF LIABILITY INSURANCE 12/20/ 02 05 PRODUCER PANTANO INSURANCE AGENCY, INC 220 BROACWAY, SUITE 202 LYNNFIELD, MA 01940 781-5$1-3100 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED CENTURY PAINTING & DRYWALL INC. P: 0: BOX 2903 HYANNIS, MA 02601O�-t� ' - - INSURERA: COMMERCE INSURER B: INSURER C: NsuRERD: INSURER E: — -- COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MR LTR NSRo TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DDIYY POLICYEXPIRATION DATE MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE - S 1 T 0 0 T COMMERCIAL GENERAL LIABILITY PREMISES 'Ea occurence $1, 0 0 0, 0 0 0 CLAIMSMADE F-IOCCUR MED EXP(Any one person) S5y 000 PENDING 12/17/05 12/17/06 000, 000 PERSONAL BADVINJURY $1, GENERAL AGGREGATE 5 2, 0 0 0, 0 0 0 GEWL AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OPAGG S i T 0 0 0 7 0 0 0 -- POLICY PECT F LOC . AUTOMOBILELIABILRY COMBINED SINGLE LIMIT S ' ANYAUTO- -- (Ea accident) ALLOWNEDAUTOS .. BODILYINJURY— - -. $ . SCHEDULED AUTOS - (Per person) - BODILYINJURY HIRED AUTOS"- NON-OWNEDAUTOS (Peracddent) S PROPERTY DAMAGE S (Peracrldent) GARAGE LIABILITY AUTOONLY-EAACCIDENT S OTHER THAN EAACC $ ANYAUTO $ AUTOONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S AGGREGATE $ OCCUR CLAIMS MADE S S DEDUCTIBLE S RETENTION $ WORKERSCOMPENSATIONAND WCSTATU- I OTH- EMPLOYERS' LIABILITY TORYLI IT E.L. EACH ACCIDENT $ ANY MWRIETORRARnffR�CVINE E.L. DISEASE - EA EMPLOYEE S oscrcEw SER ocMw II,ee,do—'bewder E.LDISEASE-POLICY LIMB S SPEDIALPROVISIONS below OTHER DESCRIPTION OF OPERATIONSILOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS 6tKIIFIUAIt HULUtK CANCFII ATIT)N SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION GATERWOOD HOMES yJL 1600 FALMOUTH ROAD # 25 CENTERVILLE, MA 02 632 DATE THEREOF, THE ISSUING IN URER WILL ENDEAVOR TO MAIL _ DAYS WRITTEN NOTICE TO THE CERTIFICATE H ER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATIO OR U IUTY OF ANY KIND UPON THE INSURER ITS AGENTS OR ES. REPRESENTATIV AUTHORIZED REPRES THE ©ACORD CORPORATION 1988 _ Liberty Liberty Mutual Group ' mutum. PO Box 7202 Portsmouth, NH 03802-7202 Telephone (800) 653-7893 December 21, 2005 Fax (603) 431-5693 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: 1215 /2005 Expiration: 12/5 /2006 Coverage afforded under Workers Compensation Law of the following state(s): Employers Liability MA Bodily Injury By Accident: $ 100,000 Each Accident Bodily Injury liyDisease. $ 100,000 Each Person Bodily Injury by Disease: $ 500,000 Policy Limits As of this date, the above -re poOlicy listed above. ferenced policyholder is insured by Liberty Mutual Fire Insurance Co under the 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 This certificate is issued as a matter of information only and confers no right upon ou the c This certificate is not an insurance policy and does not amend, extend, or alter the coverage afforded bh the Y certificate holder. Policy listed above: If this policy is cancelled before the stated expiration cancellation. date, Liberty Mutual will endeavor to not ify you of such This Ceait;cate is esecur,� h-r I AUTHORIZED REPRESENTATIVE LIBERTY MUTUAL INSURANCE GROUP - .. i... t L' t 1.NSL7UNCE GROUP as respects such insurance as is afforded by those companies. cc: Insured: CENTURY PAINTING AND DRYWALL INC PO BOX 2903 HYANNIS, MA 02601 12/21/2005 Producer of Record: SANDPIPER INS AGCY INC 12 ENTERPRISE ROAD HYANNIS, MA 02601 Client#: 4597 CCINSUL ACORD,a CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDONYM PROD ER 08/30/06 Rogers &Gray Ins. Agency, Inc 434 Route 134 - P. O. Box 1601 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INAIC # South Dennis, MA 02660-1601 INSURED Cape Cod Insulation Inc A INSURERPeerless Insurance INSURER B: American Home Assurance 455 Yarmouth Road INSURERA Hyannis, MA 02601 INSURER D: - COVERAGES INSURER E. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN I -SUED 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. wMTKM LTR A INSRI TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR POLICY NUMBER CBP9587416 POLICYEFFECTIVE ATE MMIDD 04/16/06 POLICY EXPIRATION MMtDD 04/16/07 LIMITS EACH OCCURRENCE $1000000 DAMAGE TO RENTED MED EXP (Any one person) E1000O0 $5 00O PERSONAL E ADV INJURY E1 00O 000 GENL AGGREGATE UMR APPLIES PER: GENERAL AGGREGATE E2 000 000 PRODUCTS-COMP/OPAGG $2000000 POUCY PRO-LOC A AUTOMOBILE UABILnY ANYAUTO BA9587917 04/10/06 04/10/07 COMBINED SINGLE LIMIT (Ea acddent) $ ALL OWNED AUTOS X Ip DILL ))URY $250,000 SCHEDULED AUTOS HIRED AUTOS X X BODILY INJURY (Per accident) $500,000 NON -OWNED AUTOS PROPERTY DAMAGE (Peraccident) $100,000 GARAGE LIABILITY ANY AUTO AUTO ONLY -EA ACCIDENT $ OTHER THAN EAACC AUTO ONLY: S EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE EACH O$ AGGRE$ %LT DEDUCTIBLE RETENTION $ - B WORKERS COMPENSATION AND LIABILITYO6/30/O6 WC8962496EMPLOYERS 06/30/07 X W ORY LIMITS MITS ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERtMEMBER EXCLUDED? E.L. EACH ACCIDENT $500,000 EL DISEASE -EA EMPLOYEE s500,000 M yea deacdboeM-der - SPECIAL PROVISIONS below E.LDISEASE-POUCYUMIT 1$500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Insulation Installation & siding CERTIFICATE HOLDER CANCELLATION GateWOod Homes 1600 Falmouth Rd., Suite 25 --TREPRESENTATIVES. Centerville, MA 02632 Y OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION OF. THE ISSUING INSURER WALL ENDEAVOR TO MAIL 10_ DAYS WRnTEN HE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL BLIGATION OR LIABILITY OF ANY AND UPON THE INSURER. ITS AGENTS OR IZED REPRESENTATIVE - ACORD 25 (2001/08) 1 n/9 Ncelneveene.w. CBR Q ACORD CORPORATION 1928 ACORD CERTIFICATE OF LIABILITY INSURANCE PRODUCER OPID C DATE(MMIDDryyyy) GOLDMAN &ASSOCIATES INSURAD7CE THIS CERTIFICATE IS ISSUED AS A MAJTTER OF INFORMATION1 06 FINANCIAL 6SS ES INC. ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE 933 FALMOUTH RD HOLDER. THIS CERTIFICATE DOES NOT AMEND HYANNIS MA 02601 ALTER THE COVERAGE AFFORDED BY THE POLEICs BE OW, Phone'508-775-6010 Fax:508-790-0249 INsuRED INSURERS AFFORDING COVERAGE INSURER A- pE_ NAIC# NUGNES ENTERPRISES INC AMERICA INS. CO. INSURER B: PETER NUGNES 805 CEDAR ST INSURERC: WEST BARNSTABLE MA 02668 INSURERD: 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 TA 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.OR R NSR TYPEOFINSURANCE GENERALLIABILITY A X COMMERCIAL GENERAL LIABILITY PAC6593654 CLAIMS MADE a OCCUR GEN'L AGGREGATE LIMITAPPLIES PER POLICY n PECT n LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY -1 ANY AUTO EXCESSIUMBRELLA LIABILITY OCCUR ❑ CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? It Vee. `cn IIONS I LOCATIONS CARPENTRY RESIDENTIAL. CERTIFICATE HOLDER _ ....... _"• • ' LIMITS EACH OCCURRENCE 07/24/06 07/24/07 $300000 PREMISES Eao=rence) E 50000 MED EXP(Any one person) $5000 PERSONAL B ADV INJURY $300000 GENERAL AGGREGATE $600000 PRODUCTS-COMP/OP AGG S 300000: COaMBIINdEeD SINGLE LIMIT S BODILY URYmParm) S BODILY INJURY (Per eoeidel)PROPERTY S (Per accidentDAMAGE E AUTO ONLY -EA ACCIDENT E OTHER THAN EA ACC S AUTO ONLY: AGG E EAGGREGATE OCCURRENCE S EES_ S E,L EACH ACCIDENT S E.L DISEASE- EA EMPLOYE S E.L DISEASE -POLICY LIMIT S GATEWOO I SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 O DAYS WRITTEN NOTICE 70 THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL GATEWOOD HOMES INC IMPOSE NO OBLIGATION OR LIABILRY OF ANY KIND UPON THE INSURER ITS AGENTS OR 1600 FALMOUTH ROAD CENTERVILLE MA 02632 REPRESENTATNES. AUTHOR REDRFCcurw.n r. 1 TOWN OF YARMOUTH 1146ROUTF-28 SOUTHYARMOUTH MASSACHUSETTS02664-4451 Telephone (508) 398-2231, EXL 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 theposed work/demolition to be conducted at \ 7 Work Ad / 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. .1 Signature of Applicant Permit No. Date uct Ub Ub uH:415a r Hudson Corp 1 508 775-2310 p_1 ae caa +.ne.�. �se.e`° wadil x HONE #ApROVElMENT CONTRACTOR ' ftB321.... . Explraport;..101 =05 - CAPRAHOME IMPROVEMENTS. FRANK CAPRA 40COPPER LANE ,,��jca✓ CcNT. FRVII I.F. MA 02632 .�!1«irtelT:fnr License or registration valid for IndivWul use only before the c4iratlon date: Iffouad vetarrr6e Board of Building Regulations and Standards Out Ashburton Placo RmXIU Boston, Ma. 02108 . - Not valid witboutsigns� re 6ja J u �; TOWN OF YARMOUTH NOV o 2 2006 HEALTH DEPARTMENT HEALTH DEP T . PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: � Map No.: Lot No.: Proposed Improvement:__ Z=24LD p eo— Applica J;;e a C`�6fz5-7— f Tel. No.:( Address:��e-J/W479AADate Filed: /© o **Ifyou would like e-mail notification ofsign off, Please provide e-mail address. © 3 Z ✓' �� 6 Owner Name:_ 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: COMMENTS/CONDITIONS: PLEASE NOTE It.UaVA C .TE: t 1 /& /o C", 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 S. 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.9J; Street: 121 CAMP STREET, UNIT 97 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) Aft ! � %4Yarmouth Water Department TOWN OF YARMOUTH ` Building Department _ Town Hall �y Yarmouth, MA02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-07-220 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Unit 97 Owner's Name: Villages 0 Camp Street, LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02632 ' Owner's Telephone: (508) 778-9669 REVIEWED BY: (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: Map/Lot: 044.21.1.0 new construction: ZONING APPROVED 1. WATER DEPARTMENT: DATE: 2. ENGINEERING DEPARTMENT: DATE: 3. CONSERVATION: DATE: 4. HEALTH DEPARTMENT: DATE: 5. BUILDING DEPARTMENT: DATE: 6. FIRE DEPARTMENT: DATE: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: N/A: N/A: N/A: N/A: N/A: N/A: DATE: Date Printed: 11/9/2006 a MASEheck COMPLIANCE REPORT Massachusetts Energy Code .MAScheck Software version 2.01 Release 2 CITY: Yarmouth STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING. SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 4=21-2004 DATE OF PLANS: 04/21/04 TITLE: The Sandpiper PROJECT INFORMATION: Mill Pond village 12,j Camp Street C)D/ �� Yarmouth, MA 02673 COMPANY INFORMATION: Northside Design ASSOC. 141 Main Street Yarmouth Port, MA. 02675 COMPLIANCE: PASSES Required uA = 223 Your Home = 138 Area or Perimeter -------------- i Permit # I • I I checked by/Date R �N� pEpT. Cavity Cont. R-value R-Value --------------- Glazing/Door u-value CEILINGS 845 30.0 30.0 WALLS: wood Frame, 16" O.C. 1415 15.0 15.0 GLAZING: windows or Doors 93 0.340 GLAZING: windows or Doors 80 0.340 DOORS 40 0.086 ----------- -------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date lq_1 14 62 32 27. 3 'F7 0- amassachusetts Energy Code MAscheck software version 2.01 Release 2 The sandpiper DATE: 4-21-2004 Bldg. Dept. use I [] I [] I [] [] I CEILINGS: 1. R-30 + R-30 Comments/Locati WALLS: 1. wood Frame, 16" o.C., R-15 + R-15 Comments/Location WINDOWS AND GLASS DOORS: 1. U-value: 0.34 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location 2. U-value: 0.34 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: 1. U-value: 0.086 Comments/Locati AIR LEAKAGE: joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. when installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into.the unconditioned space. 2. Type Ic rated, in accordance with standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. 4 1.1 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 34.4. 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) TIONS- . QMS9/GCS.9..SER1ES . . 93% AFUE Multi.Tositionj� Single-Stage/Multi-Speed-.. Gas Furnace...-... Heating Capacity;.. 46,000-1 is,000 sTUH airCanctltiarriW& Heatrrtg\ The GMS9/GCS9 single -stage, multi; speed -gas furnaces offer—� J irutaHation Standard Features Caber crrstractiotr • Corrosion -resistant, aluminized steel tubular heat • Heavy -gauge, reinforced. fully insu exchanger and stainless -steel recuperative coil for with durable baked -enamel finish - Maximum cfficicrrcy • Attractive architectural gray paint • Designed for multi -position installation--GMS9:" • Foil -face insulation -lined heat excl G upflow, horizontal right or left GCS9: downflow, horizontal right or left - compartment Encrgysaving, reliable Hot Surface Ignition system, • Coil and furnace fit flush for easy installation featuring a Norton® Mini-lgniter.with patented • Convenient left or right connection for gas and adaptive learning algorithm to maximize igniter life- electric service • Aluminized steel inshot burners • Bottom or side air inlet (GMS9) • Energy -saving P.SC, multi-ipecd, direct dr'iSc • Removable; solid•bottom block=off (GM59) blower motor • Quiet, corrosion -resistant induced -draft ' Accesaori�s blower assembly • Integrated furnace control with.improved_..... diagnostics • law 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 hearing and air conditioning control service • Combination redundant gas valve and regulator • Top venting -is standard; alrerr*terfiue/venr locate& . on right side Completely. assembled factotxxua tested farnace.for..... . heating or combination hearing/cooling application All models comply with California NOx Standards • Suitable for direct vent (2•pipe) or non•duect vent (1-pipe) applications LP. Conversion Kit (LPT-OOA) L:P-Gas-LowPressumKit• (LPLPOI) High Altitude Natural Gas/L.E Kits (HANG11, HAN012, HALPIO) ..... • High Altitude Pressure Switch Kit (HAPS27) • External Filter Rack Mull.). . • Horizontal Concentric Vent Kit (HCVK) . • Vertical Concenrric VentYlt (VCVK) . • Internal Filter Retention Kit—upfluw, )wriwntal MF000IW) ..... • Internal Filter Retention Kit—downilow (RFOXIS1) ` • Thermostats Blower Motors (CHTI&60. CH70TG.. CHSATG, H20T'WR) SS•377D -• loodmanmfg=m 6N4 , i I I PRQDUQT SPECIFICATIONS Nomenclature 7M 5 8 070 IGoodman® Brand ev % an Air Flow Direection NOX 1� Revision )k UpflowIllorizantal...... H* Natural. GasNMI C; 2" Revision D: Dedicated Downflow X-. Low NOX C. DownflowlHorizontat If.'Hi'Air flow Cabinet Width Description B: 17A" . S: Single Stage/ Multi.speed V: Two Stage/Variable-speed P; 2411" Maximum CFM AF (V 0.5" ESP 2:-1,20Q.. t 8-.80% 4; 1.600 9:90% 5: 2.000 045, 4Sr000 1770:70,000 090., 90,000 I<j GCS9 Dimensions C LE/T aiOE . NEW w ww MEW iPe IaEtw AtA410c L. aHq q.wTanF iff - = a Q a q /OLDe dataMaaEAet slaw sloe VIEW V"*Lus mn r.vc r toWvotrAea -1 eLELTaKAt MO1! EteCTgKy MOIE MATE- 2 Hnf " ALTERHATe WAK94ocFnpM H+e MYW tv1 ruse �u n N f NBLED urep"re we va.�TVeaJOiA 1277(h" 161'.... ..... ..t2.j.•.»_ ... 616GC5907038XA 1^ 14'ri- ....... ..- ._... t6^ GC5904t1^ GCCA 9t6a/" 591155DXA zav^ 18" 191M O' 2f"NOSES h 1. Installer must supply one or two PVC pipes: one for cvmbuswnaia(uptionaN ■ Ai or p i s dependea depending upDn furnace input; ombuss of elbows. length of �s p o�� o r�c1x ))owe t Pipe nowt be either Air Pipe is dependent on imtaliationkode requhements and must be 2" or 3" din tar PVC, optional Combustion 2. Line voltage E (Of canht9 triter de natural al elks operation are furnace Lti i v sfuge -icing can enter through the right cv left side of furnace. 3. Conversion kin pp high al (ne E natucal gas operacbn ate available. Contact your Goodman ducribuwt or dealer for details. <• bs it must supply folksvling gas line fittings, according to which entrance it used\ Left—TWn 90e elbowA. erne close nipple: straight pipe - . Right—St+aight pipe to reach gas valve Minimum Ceararices to Combustible Materinic MUST be woodONLY. NC = Non-Combust''ble: A�wmbustil4e spoor wbbast� be used lw anacion on combustible Q'sonng NOTES: • For servicing of cleaning," 36" front citseence is recommended. • Unit c'no" 0M (decnical. flue and drain) may necessitate greater cleoranceichaochemIinimuneelearanea. hued blow: . In all sawv accesai6ility clearapce must take precedence o""Iearacter from the cmdonrre where accmibiiity cleesaelces are gtcasar. 5 . Blower Performance Specifications � � NOTES: T I. OFM in chart is s b0d't f terlar butaa do ti(ft elup.>vith this f rmaet lout mua[.b'nPrUvidcd.by theJnAAIIdr.Jfthe- furnace retmfea.twn.re[utna. e5is chart nrarunes both filters are irtamped. 2. All 6smaeea chip as high speed cooling. J ooflor court sdjust blower c0a,717n J. For [resit jobs. a6oar 400 C'FM per tun when co olio to K spetnl as needed. - - 4. INSTALLATION 15 TO BE AUIUSTEA TO OBTAIN TTEMPERATIIRF, RISE wITHIN THk SPECIFIED ON fHl: RATING PLATE. RANOE 5. The chart is fur infsamatism only. For satisfactory operation, external etutic pressure mvM woe exceed value shtswn on ,hp .;.ring plate. The shaded arcs indicares ranste. in excess of maximum stoic 00ture allowed when hearing. 0. The dashed (---) areas indieire a rempr:saetue�ixt,ut reeumssrerrdedfnr-rlr7trscdel._. 1. The above cJtart lr fin U.S. furnaces instilled at O'. 2='. At higher altitudes- a prtgxrly deaated unit will have app uxaua<ely the waic retnperamre rise At a panlculur CFM, while ESP at the OFM will be lower,... . t,_ 14. MM PRODUCT SPECIFICATIONS • Accessories LPT-OOA - L.P. Conversion Kit ` LPLPOt L.P. Gas Low Pressure Kit HANG11 HANG12 HALP10 HAPS27 . E£RDt... High Altitude Natural Gas Kit High Altitude Natural Gas Kit High} Attitude L.P. Gas Kit High altitude Pressure Switch Kit External Fllter.Rack....... 1 2 3. .........._ 3 �....,.. 1 2 3..... 3 _... 1 Z ..... 3....... 3 ..=.. 1 2 3 �._. DCVK•70 Horizontal Nertical Concentric Vent Kit (1") DCVK•30 Nwlznntal/Vertical6oncentrfe-VentKiCry)- .... _.. .. �..... �. (2) 9.001' 10 ] 1!OW, (3) 7,001' to i l,OW Non: All Insn0ations above 700' require a ptessutt sateeh cltaMgt Frx hurtaganotrin C'Inada, kmaees ara certified only to 4,500'. DownAow floor Base. When the GCS9 McKie] is installed directly on a wood Hoar, a do flo- fluor Ease must be usad..Thom model nurabera. am! CFB)7, CFBZI and C:FBZ4. - Thermostats CHTia-60 Cooling/Heating, Mechanical CH70TG Cooling/Heating, Digital, Non•programrnayle CHSATG. CoolingIi4eatirrg Mechanicat - H2OTWR Heating Only, Mechanical 7 ADDRESS* W llm (PROPOSED 4" SEWER LATERAL N 84'27'16"E 13.76' i JPROPOSED`, HOUSE OSPREY 3' FF = 23.5 GW=14 LOT 9 w WA 84-27'16"E 09,1 11//118.5 IO ED •� - I0 R .24 •v 4.4' f o I2 LOT 97 3,135t S.F. 1 S84023'45"W FF. = DENOTES FIRST FLOOR ELEVATION PROPOSED SEWER MAIN ICE =N84-277'16"E50.00PAD E ELECTRIC BOX Iz O DRAINAGE 90 I-4 tOp U li NOV o 1 7101 BY plu 1f. GW = DENOTES APPROXIMATE ELEVATION ® SEWER LATERAL SHALL BE OF GROUND WATER SLEEVED IN ACCORDANCE WITH TITLE V IF WITHIN GRAPHIC SCALE 1OFT. OF WATER MAIN. 20 10 0 20 60 ROTIC Unless and until such time as the original (red) stamp of the responsible Professional Engineer, or Professional Land Surveyor IN FEET) appeo($ on tnls plan: no per9on or persons. Including any municipal or other 1 inch= •,ZD ii~ Public officials, may rely upon the information contained herein; and (B) this plan remains the Property of Holmes do McGrath, Inc PLOT PLAN OF LOT 97 holmes and mcgrath, inc. PREPARED FOR civil engineers and land surveyors `p�tiW OF y� MILL POND VILLAGE 362 gifford street Qo�� Mtp�a>:�y�N IN falmouth, ma. 02540 YARMOUTH, MA R SCALE: 1 "=20' JOB NO: 201197 DRAWN: LMw�C DATE: 8-4-06 DWG. NO.: A2568 CHECKFn/�11 ►. TOWN OF YARMOUTH Building Department BUILDING - - - - - - _ _ _ _ , (508) 398-2231'ext 461 '- PERMIT NO _-B-o7-887 - - = - - PERMIT ISSUE DATE 1A1/2007 PROPOSED USE APPLICANT 'Frank Capra JOB WEATHER CARD -----•---------------------- ------------ PERMIT TO New Construction ' AT (LOCATION) 100121CAMP ST Unit 97 ZONING DISTRIC R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK I044.21A.C97 I BUILDING IS TO BE: LOT SIZE u CONST TYPE EB USE GROUP R-4 REMARKS new construction: 2 baths, 3 bedrooms, 1 greatroom, 1 kitchen as per plans dated 11/17/06. AREA (SO FT) EST COST ($ $141,600.00 1 PERMIT FEE-4) $fi16.00 OWNER lVillages @ Camp Street, LLC BUILDING DEPT BY ADDRESS 1600 Falmouth Road # 25 Centerville MA 102632 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 PART THEREOF, 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 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 SCHEDULE APPROVED PLANS MUST BE RETAINED ON JOB AND THIS CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED, SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. POST THIS CARD SO IT IS VI IdUILUIN(a INSYtG I IVNS AF'F'HOVALS WHERE APPLICABLE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL PLUMBING/GAS AND MECHANICAL INSTALLATIONS. 'FROM STREET 2� �i�l p � � 1T 7 2 f f 2 3 t OTHEF3: 3 3� °� 3 4 I 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.