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Home My WebLink About121 Camp St #099 Building PermitsWPS - Permit Pagp I (if I zj1NS"TAR • WPS - Permit • • Work Order Information UMFA>WOMZ M5223M Date: 05242MB Carrpamy L11NIDATAVAHES Rqc Report By: YAR 121 CAMP ST L159 VILLAGES AT CAMP ST Status: PLAN Service: NEW Type: RES Nature of Work NEW 100A UG TO HH TO TRANS #P150A..... THIS IS MILLPOND VILLAGE AT CAMP ST.... 1400 SQ FL HT/HW..... ELEC RANGE dr DRYER ....NO AIC.—NO JACUZZI OR HOT TUB" EHERGIZED PER ELECTRICM"* Service Information - There is no Service Infomration. Permit Information Permit #: E06-1065 Meters: 1 Reseal (YIN): Y Date: 07/052005 Inspector. WI0060 Description: Search 17 Detail r Contacts NSTAR Home WPS Logon WPS Help Comments WO Request WPS News NAir Copyright 2003 NSTAR, 800 Boylston Street, Boston MA USA. AN rights reserved. Reproduction in whole or In part of any gsaplric; images, text or other content at this web site must be granted by NSTAR, Boston, MA, USA. Unauthorized modification of any fiiosma6on stored at this site may result In criminal prosecution. http://www.nstaronline. com/apps/wps/wpspermit.cfm?Page=Permit&Unique={ts_'2006-07-... 7/5/2006 • r APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 AP �t20061 TH (OFFICE USE ONLY) By JUN 0 6 Fee: $) PERMIT NO. —fib—Qh. (PLEASE PRINT IN INK ORS ALL INFORMATION) To the Inspector of Wires: By this application theX1undersigned gives not work described below. Location (Street & ber C- Owner or Tenant c Owner's Address Is this permit in conjunZI&AaA—) with a building permit?� Yes ONo Purpose of Building Utility Existing Service Amps / Volts Overhead New Service LOED Number of Feeders and Location and Nature of Proposed electrical or her intention to perform the electrical r Tele one ZJ (Check Appropriate Box) Authorization Undgrd C1 No. of Meters No. of Meters Cmmnlutinn nftha fnllnwino Mhla mm, ho wnivod h., tho h.o .. mt of U'.,. No. of Recessed Fixtures No. of Ceil: Sus . Paddle Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above n- Swimming Pool Md. gmd. ❑ No. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. o Detection an Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: um er — Tons — — — — No. of Self -Contained Detection/Alerting Devices No. of Dishwashers S ace/Area Heating KW P g Local Q Municipal Connection Other No. of Dryers Heating Appliances KW Secutity Systems: No. of Devices or Equilivalent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. H dromassa a Bathtubs Y g No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent Attach additional detail iJ desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued unless the licensee provides proof of liability insurance including "compI ed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in ,•-'force, and has exhibited proof of same to a permit issuing office. v�CHECK ONE: INSURANCE BOND � OTHER (Specify:) ��tttttt E Estimated Vale of Electrical Work: _Work to Start I ections to be reglre�tedj SI certify, unde the p' s and p n t of p 'ury, l � N censee: � .�. �(If applicab r "e�c se umbi Address OWNER'S INSURA CE WAIVER: I am aware that the below, I hereby waive this requirement. I am the (check �Owner/Agent - Signature [Rev. 04/00] ( xptrat ton Date) (When required by municipal policy.) rdance Vth MEC Rule 10, and upon completion. j 4 i4f, a�tyen! his p lication is true and complete. V -�l _ LIC. NO. Signa re f \43,\J LIC. NO. line.) C Bus. Tel. No.: Alt. Tel. No.: :ensee doe not have the liability insurance coverage normally required by law. By my signature owner ❑ owner's agent. Telephone APPLICATION FOR PERMIT TO DO GASFITTING TOWN OF YARMOUT (OFFICE USE ONLY) By LRE I V E D Fee: $ 1 2006 I PERMIT NO.tr— 07DateBuildoIN oEP Owner',`AT: LocatS % Name Lf//_-. Type of Occupancy,L New [X Renovation ❑ Replacement ❑� Plans Submitted Yes ❑ No fk iA CIO rcc e Z tff W W v uTl z J Q Ce W F Q Y m �r t_ Z i W N co c� W a= Z `n o O u W y Z Q= LC UA S W 0 1- 1- F= Ucc Q y N= Q W > a W cc Z Q M Q ca 0 "t IO U� tr x 0 0 x a 0 0 < � 0 ¢: to S a. O SUB-B MT. BASEMENT " 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Check One: Installing Company Name-i-�tlG'rs - (-r, of {�•a rn i��1�_ ❑Corp. Address . I G �61-- i_ ❑ Partnership -- irm/Company---Y„FR1 Business Telephone -2 �3 7 --3L4 --_---- — / Name of Licensed Plumber or^,itter__ 'a GIN^_rD INSURANCE COVERAGE: Check One l_ •'- l.have a'Current..liability insurance policy or its substantial equivalent. Yes f'No ❑ If you have checked yes,'please indicate t e type of coverage by checking the appropriate box. . A liability insurance policy Other type of indemnity i] Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit appiicatioft waives this requirement-. Check One' *,.., . _ - --- - ----- -- - -= - .�- -- -Owner ❑ Agen! Q t .. _ Signature of Owner or Owner's Agent r-- 1 hereby certify that all of the details and information I have submitted Signatureo Licensed (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and Installations performed Plumber or Gasfitter 2,1 S 1 45 under Permit. issued for this application will be In compliance with all pertinent provisions of the Massachusetts State Plumbing Code and License Number _. , -_ I.. .. _ TWO t 1rcucc. S84'27'16=W DRIVEWAY EXISTING FOUNDATION /� C 20.7— L=196.95 R 238 70 L=7 LOT 100 EXISTING FOUNDATION �� .3.3' 5' :16.5-1 Co 45.00' Ui 19.00' S84-23'45"W Oph o I CERTIFY THAT THE FOUNDATION IS F� LOCATED IN FLOOD PLAIN ZONE C AS SHOWN ON FLOOD INSURANCE RATE MAP',, COMMUNITY PANEL NO. 250015 0005D AND THAT FLOOD PLAIN ZONE C IS NOT A SPECIAL FLOOD HAZARD *� 3 2V40 DATE REGISTERED ROFESSIONAL LAND SURVEYOR NOTICE Unless and until such time as the original (red) stamp of the responsible Professional Engineer, or Professional Land Surveyor appears on this plan: (A) no person or persons, including any municipal or other public officials, may rely upon the information contained herein; and (B) this plan remains the property of Holmes do McGrath. Inc. N6 3 I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE LOT AS SHOWN, AND THAT ITS LOCATION CONFORMS TO THE MINIMUM SETBACK REQUIREMENTS 9F THE 40B SPECIAL PERMI re,b 3 050'1,0 DATE REGISTERED PROFESSIONAL LAND SURVEYOR GRAPHIC SCALE 1 inch = 20 M AS —BUILT PLAN holmes and mcgrath, inc. OF LOT 99 civil engineers and land surveyors PREPARED FOR 362 gifford street MILL POND VILLAGE falmouth, ma. 02540 IN YARMOUTH, MA JOB NO: 201197 DRAWN: LMC SCALE: 1 "=20' DATE: 2-3-06 DWG. NO.: A2549A CHECKED: OF V TOWN OF YARMOUTH 'Building Department BUILDING i (508) 398-2231 ext.261 PERMIT NO B-0!3-442!---- ____-_ PERMIT 4... a ISSUE DATE ; 9/29/2005 ; PROPOSED USE _ - APPLICANT _Funk cap_ra_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ JOB WEATHER CARD PERMIT TO New Construction ' AT (LOCATION) 00121CAMP ST Unit 99-1 ZONING DIS SUBDIVISION MAP LOT BLOCK 044.21.1.C99 BUILDING IS TO BE: LOT SIZE O R-2 Bldg. Type: Residential CONST TYPE 5-B USE GROUP new construction - Affordable: 3 baths, 2 bedrooms, 1 familyroom/diningroom area, 1 kitchen as REMARKS per plans dated 08/29/05. AREA (SQ FT) EST COST ($ I$154,080.00 PERMIT FEE ($) 1$0.00 OWNER lVillages 0 Camp Street, LLC U)LDING DEPT BY ADDRESS 11600 Falmouth Road #25 Centerville I MA 102632 Certificate Issue Date CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 MA 02632 `CERTIFICATE W,QCCUPANCY v Departmental Approval for Certificate of Occupancy and Compliance Insnpctnr Date Permit Number Approved By Remarks L' _,i ELECTRICAL a To be filled in by each division indicated hereon upon completion of its final inspection. aF �� TOWN OF YARMOUTH Building Department BUILDING 4 (508) 398-2231 ext.261 PERMIT NO 8-05-443 - PERMIT .� ISSUE DATE ;- 9/29/2005 _ ; PROPOSED USE _ _ _ _ _ _ _ _ _ _ APPLICANT Frank Capra JOB WEATHER CARD --------------------------- PFPRAIT TC1 ' Nww Construction AT (LOCATION) 100121CAMP ST Unit 99 ZONING DISTRIC R-2 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 1044.21.1.C99 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE new construction - Affordable: 3 baths, 2 bedrooms, 1 familyroom/diningroom area, 1 kitchen as REMARKS per plans dated 08/29/05. AREA (SQ FT) EST COST ($ 1$154,080.00 PERMIT FEE (4i) 14iU.uU OWNER lVillages @ Camp Street, LLC BUILDING DEPT BY . ADDRESS 11600 Falmouth Road #25 Centerville I MA 102632 CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 INSPECTION RECORD FIELD COPY �� YARD ONE-& TWO FAMILY ONLY — BUILDING PERMIT APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING Ts ` _ Town of Yarmouth Building Department {i t MATTACMCC$ 1146 Route 28 • Yarmouth, MA 02664-4492 Tel: (508) 398-2231 x261 • Fax: (508) 398-0836 c f? Section 1"-Site lnformation Use Group: R-4 Type: 5-B 1.1 Property Address: 1.2. Zoning Information: Z l G ey P St r` �� .. /4 Zoning District Proposed Use 1 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard Reauired I Provided Required I Provided Required I Provided 1.4 Water Supply (M.G.L. c. 40. S 54) Public Private Section 2 = Property Ownership/Authorized Agent 2.1 w0 r of Record: l �ld-4 ��v��i^�/il! M �u 3 Name pri/n/t)�� Mailing Addres / Signature Telephone 2.2 Authoriz4dfAgent: %%f� rsf J� o,, Na print) Mailing Addressc,f�yrvl� 6� mum r s-- �-�a 3 Signature Telephone j'jU Section-3 Construction Services 3.1 Licensed Construction Supervisor: NO b I M r G *moorr v� Not Applicable ❑ �,,h,�j_ Cd i'� !C' License Number Addr Expiration Date �� Signature Telephone 3.2 Registered.Home;Improvement 'Contractor -- Company Name Not Applicable License Number Address Expiration Date Signature Telephone 9- 15-99 1 Or . ,-A 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 .......... Section`S'- Description of PmnnSPrf-1Nnrk tchark ail nnnrrnhiAl New Construction Existing Bldg. ❑ No. of Bedrooms 2 No. of Bathrooms Z Repair(s) ❑ Alterations ❑ Addition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: f l/� G cS 2 '�- IM hereby authorize my behalf, in all I Check Below ❑ Conservation -Commission Filing (if'applicable). ❑ Old Kings Highway & Historical Commission approval (if applicable) , as owner of the subject property r t. 'V-- to act on rela ' e tow rk authorized by this building permit application. Date I,/�i/.�/(! /� c�rGr" ✓` 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 Prin ame Sig ealoof ned gent ' Date G 9-15-99 2 of 2 as1—N V The Commonwealth of Massachusetts Department of Industrial Accidents Of esO/IMS110111ess 600 Washington Street Boston. Mass. 01111 Workers' Compensation Insurance Affidavit U i am a nomeow•ner periormmg all work myself. I. am a sole proprietor an.'' ha%e no one working in any capacity lam .an employer pro,. iding workers' compensation for my employees working on this job company name: address: city: phone ++ iir surnnee co. policy 0 (9/1 am a sole proprietor. general contractor. or homeowner (circle onej and have hired the contractors listed below who ha%e city: phone N insurance co.. policy N company name: address- city- phone rauure to secure coverage as required underSection 25A of MGL 152 cam lead to the impois'don of erimizal penalties of a line up -to S1,00.00 and/or one ,Years' imprisonment as well as civil penaldeti in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. i understand that a copy of this statement may be forwarded to the Office of investigations of the D1A for.eoverage verification. I do -hereby terrify er the gains ar e !ties of pedury that the information provided above is vue and eorrea. k Signature Print name Phone 8 T ofiici2l use only do not +rite in this area to be completed by city or town official city or town: YnxMonT$ _ .permitAicense N r lluilding Department C3Ucensing Board (] check if immediate response is required 261 OSeleetmen's Ofrice contact person: phone N: _ C508) 398-2231 eStOHcaltb Department . rJOther. L 1 � . - mitt -�inmecxweailii s�✓ . BCARorofBUILDING. REGULATION& License;: C;ONSLREJC lOP18URER�lISOR - 4 - Number": tl12430; . Bict�ieTafe . _ , O6€€6f20ati, Tr. no:259,26. FRANK Imcap CEUTE> zv LLE, VA . a2e�3� . Commissione[ - - N t 00 - 35;DWdendosed.space- (Mcd C.i1ZS:fioL) - . to - Masoprjs oBlq, i }-,:!-�ftFaE ii•Lyi-lomes FailurefopossessaairienGedi6on otMe Massa&iwettrStafe Builtling,Code : 4 is-cause:forrevocatforLof-b&gcense. DIG SAFE CALLCENTER: 1888)r344-7133 L x X } }. 1 v WIN car YARMOUTH � ....,.,.... x BUILDING DEPARTMENT CONSTRUCTION SUPERVIISOR FORM PLEASE PRINT: I D- I A v jobLocation: l 0. J Glf / vL Owner of Property: Number v ` (` Street ``Q- 1. Village S�. LL Construction Supervisor: vx' 00L O so - - 669 f (- Address: / p 0 Name +,, �^ �� 1/!�f' "' - License No. �P%hone No. ` Sv�s4t 3-5 Ca/IkdIUk th Licensed Designee: (If other than Supervisor) 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 shall willfullyviolate subsections 2.15.1, 2.1-5.2 or 2.15.3 or anyother section of these rules and regulations and any procedures, as amended, shall be subject to revocation or suspension of license by the board. 2.16 All building permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise those persons engaged in construction, reconstruction, alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and these rules and regulations. In the event that such licensee is no longer supervising said persons, the work shall immediately cease until a successor license holder is substituted on the records of the building department. 2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may be deemed a violation of the permit conditions. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with section 109.1.1 of the state building code. I understand the construction inspection procedures and the specific inspection as called for by the building official. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes Lz�( No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond OWNER'S INSU NCE WAffala aware that the licensee does not have the insurance coverage required by Chapte 1 o ass. and that my signature on this permit application waives this requirement. Check one: Signat re of er or Owner's Agen Owner ❑ Agent Signature: Building Official Approval: TOWN OF YARMOUTH ��CA 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 026;T 1 GAS Telephone (508) 398-2231, FxL 261 — Fax (508) 398-2365 PLUMBING SIGNS BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting fromtheproposed work/demolition to be conducted at 5+ Work Ad ess 4 is to be disposed of at the following location: r\ O 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. CORD.; CERTIFICATE OF LIABILITY INSURANCE 07/1 M/2005 07/19/loos PRODUCER* (508) 790-1919 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION a ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Sandpiper Ins. Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 12 Enterprise Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis MA 02601- INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: First Financial Insurance Filho, Antonio DBA BR ROOFING INSURER R. Po BOX 1231 INSURER C: 136 Stevens st INSURER D' TTvanniG MA 02601- INSURERS n`f1V FRAf:FS THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREU NAmizu Anuvc rum i nc .-•-- • •--. ----- - --. -- - - - --- 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. POLICY EFFECTIVE POLICY EXPIRATION LIMITS INSR ADO'L LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDIYY) DATE (MMIDDTYY) EACH OCCURRENCE $ 1,000,000 A GENERAL LIABILITY DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY - PREMISES Ea occurrence) S 100,000 F—IOCCUR 491F002639 06/21/2005 06/21/2006 MED EXP (Any one pers ) S 5,000 CLAIMS MADE PERSONAL 8 ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POUCY JECTPRO- 71 LOC AUTOMOBILE LIABILITY / / - / / COMBINED SINGLE LIMIT (Ea acciderrt) $ ANY AUTO ALL OWNED AUTOS (Perpe INJURY (Per person) S SCHEDULED AUTOS HIRED AUTOS / / BODILY INJURY (Per accident) S - NON-0NMEO AUTOS •. / I I I PROPERTY DAMAGE (Per accident) $ GARAGELIABILITY ANY AUTO 7 AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC AUTO ONLY: AGG S S EXCESSIUMBRELL.A LIABILITY / / / / EACH OCCURRENCE S OCCUR (❑ CLAIMS MADE AGGREGATE - S $ DEDUCTIBLE S " RETENTION S WORKERS COMPENSATION AND / / / / _ ORY LIMITS OER ACH ACCIDENT S EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? / / / % rF-1LSEASE- EA ETAPLOYE S SEASE- POLICY LIMIT Is If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONStLOCATIONSNEHICLEStEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS SIDING AND ROOFING. (508) 778-5603 GATEWOOD HOMES 1600 FALMOUTH RD SUITE 25 ACORD 25 (2001108) q,w INS025 (01w).m MA 02632- SHOULD ANY OF THE ABOVE DESOKIIJt VULP-io 00 �.nn�.cuc,+ o.-. ..•� •••- EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPO O OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REP SENTATNES. AUTHORIZED ELECTRONIC LASER FORMS, INC. - © ACORD CORPORATION 1931 Page 1 of: ii i MASSACHUSETTS ASSIGNED RISK POOL REQUEST FOR CERTIFICATE OF INSURANCE Case this form to request a Certificate of Insurance from an Assigned Risk Pool Carrier. M Please provide all of the requested information, including the facsimile nurntegs) Of the person or persons to whom the Certificate of Insurance' should be issued. If this form is fully and accura,�eRj completed, the Certificate of Insurance will be issued and distributed by facsimile to each fax number provided below, mztba i two (2) business days of the car-,.—'s receipt. This Form may be mailed or faxed to the Assioned Risk Pool Carrier. To obtain each caWer's contact information refer to the Certificates of Insurance section located in the Producer Corncri. n; 'section of the 8ureau's web;;;e (wvrN. ,vr bma.oro). 1: Name, address, tel phone numberand facsimil number of the INSURED: Name: Mailino Address:_ Physic,! Address: /Name: — -- . - — Fax: adoress telephone number andfacsimile number of the CERTIFICATE HOLDER: WD - Mailing Address: � (, � CC-v3 - V,% ` --- _ Physical Address: Phone: Fax: 3. Name, address, contact person, telephone number and facsimile number of the PRODUCER: Name: S:,nrl�g=Der T_P_5 L'2"d L1Ce AQericw' inc. MailinoAddress: 12 Enterrise Road Hyannis, MA 02601 Contact Person: —_ hri s or Phone: 508-790-1919 Fax: 508-790-3560 4. Policy Number, Policy Effective Date and Policy Expiration Date If a Certificate of Insurance is needed for more than one policy term, provide the -Policy Number, Effective Date and Expiration Date for each policy term. If the policy has not yet been issued, you must attach a copy of the Notice of Assignment. Policy Number: Effective Date: /, C� Expiration Date: a, /7 .r% 5. List any special requests for optional coverages I endorsements (see Page 2 for listing of coverages available in the pool and the conditions of availability) or additional inf; rmation (including changes in exposure not yet reported to the carrier) that will assist the carrier in the issuance of the Certificate of Insurance. NOTE: An additional insured(s) shall not be listed on any Certificate of Insurance unless such additional insured(s) is a named insured on the policy. )ate: 5/5/1?005 Time: 3:02 PM To: 0 150877SS601 Pann. nnn_nn� 1 /� /1 D(� }T� L.uent,:. za3sT�s 1/�� ,7p� �v�/' /��{CAPECD4READY .AC.'Qf' Di C.PE TIFM A 7 E" OF LIr BJU 7 ! INSURANCE DATE (MMND YYYn a P90DUCEF't THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Feitelberg Company ONLY A!1D. CONFERS NO PLIGHTS UPON THE CEFrroCATE 222 Milliken Blvd. HOLDER. THISC€RTI€ICATEDOES NOTAMEND,-EXTEND OR- P.O. Box 3220 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fail River, MA 02722 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Acadia insurance Companies Cape Cod Ready. Miz Inc. PO Box 393 INSURER R: Construction Industries Compensatlon INSURER C Ortears, 111,A 02653 INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMEDABOVE FOR THE POLICY PERJ00 INDICATED. NOTAirn-tSTANOING-- ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENTWITH RESPECTTO WHICH THIS CERTIFICATE MAY SE ISSUEIIOA- MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCEOLBY PAID CLAIMS.- LTR NSR TYPE OF INSURANCE POUCYNUMBER POTCYEFFECTIVE IMMfDDfYY1 POE LJCYEXPIRATION UNITS A GENERAL LIABILITY CCMMEROALGENERAL LIABILITY CLAIMS MADE Q OCCUR CPA0132468t0- .. _ /Ot/e5'_ - 0110t/M ._ EACH OCCURRENCE St 000 000 X DAMAGE SiORENTED PEII'MIPPMED $100000 EXP (Ary me pawn) $5 000 PERSONAL 6 ADV INJURY Si o00 o00 GENERAL AGGREGATE S2 000 000 GEN"L AGGREGATE LIMIT APPLIES PER POLICY PRO- LCC PRODUCTS . cm—mptoP AGG s2 O00 000 A _ AurOMOBILE UABIUTY ANY .AUTO ALL OWNED AUTOS SCHEDULEDAUTOS HJREDAUTOS - NON-GWNED.AUTCS MAA013246$10 01/01/OS 01101/06 - COMBINED SINGLE LIMIT (ta acacerrcJ S1,000,000 . BCOILY INJURY Sar ILY N S X X BCDILY INJURY acace ) S X PROPE-ITYDAMA02 �3 aatCmU S A B GARAGE LIABILITY ANY AUTO - EXCESS.NMBREL.LALIABILITY X OCCUR CLAIMS MADE ' RS DEDUA7TISL—. XS FETENT!ON so WORKERS COMPENSATION AND EMW_OYfR�LJA51UPy- - ANY PRCPRJETCPVPARTNERIEXECJTNE OFFICERIMEMSER EXCLUDED? Ryes, �Ibawiog L�I..I., CUA013247010 WC0009255 1/01/05 r , 01/O1/l0.5 01/01/D^o 01/01/08 ,X ALTO ONLY • EA ACCIDENT S O OTHER THAN EA AC— AUTO ONLY: AGO EAC-fOC IPRENCE S $ s1000000 AGGREGATE S- - -%r"'�'srArU, oTH. _ - S _ EI.EACHACCIDENT S500O00- E L. DISEASE - EA EMPLOYEE 5500 000 E.L.TXSEASE-POUCYUMIT s5000L0- ERLPFO{gSIONC OTHER OTHER DESCRPTION OF OPERATIONS (LOCATIONS /VEHICLES [EXCLUSIONS ADDED BTENOORSE'MENFj SPELTAt PROVISIONS r FVTCIr ATC un� nre Gatewood Homes Inc. 1600 Falmouth Road Suite 25 Centerville, MA 02632 crnanxts 4I e, . LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF; THE -ISSUING INSURER WILL ENDEAVOR TO MAIL An DAYS WRITTEN - 5 TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL ;E No OSUGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR AH1 0 ACORD CORPORATION 1988 Ub/lCbi2©05 09:38 5084204474 EDWARD A GRAZUL PAGE 02 ' >r. � ti 0--RD, - CEfITIFICATE Off' LIABlUrf- ltkl& RANCE.. OnTE1MMIDOfryTVI 05,W-0 PRODUCER THIS CERTIFICATE IS "ISSUED AS A ONLY AND .CONFERS NO RIGHTS MATTER OF INFORMATION UPON THE CERTIFICATE Ed.Erd A. Gmmll Aga-,YT Itc. HOLDER. THIS CERTIFTCATE*DOES t4OT AMEND; EXTEND--OR-- .Ire ALTER THE-COVERAGEAFFORDED -BY THE POLICIES. BELOW_ r. M�� rft�s, VA axs If--iNSIIREAS.AFFORDING_COVERAGE _ � NAIL# INSURED - - ..—• II NSI,MiERA:-- r�IaGa..CasLa]_rY.�., _ . �T,,,,lds WSURER II' _ III J '•mtt 14 INSLIRERC. Mar Um Ally MAffA - MSURER E VVVCITFLLAC, THE POLICIES' OF: INSURANCE LISTED -BELOW .HAVE SEEN ISSUED TO TW2 INSURED NAMED ABOVE FOR iHB POLICY PERIOD INDICATED. NOTWITHSTANDING ANY RcQUIREM£NT,.TERM.OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH AESPE'CT TO -WHICH -THIS CERTIRCATI--M" BE ISSUED -OM. MAY PERTAIN. THE'INSURANCE.AFFORDED BY THE POtiCLES OCSCRtSEDHEREIN IS SUBJECT TO ALL THE TERMS —'EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. ACCREGATELIMITSSHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - -, IH,.a I POLICY NUMBER POLICY EF}ECTIVE VOLICYEYPIITATION— LIM!T9 GEHERALLIAWLM f /yy� (yam EACH OCCURRENCE_ S1700DItA,y. .. fI COWERCIALGENEAALLIA&LITY I —.t,- SETD'uEPTED'... S PQEMISE9 (En,Qeewencel. ��I CLAIMS MALE /EOC.'UR f MEDE7.R(Agm??eaoN_l,C�O_ FGErEmZONA,L&A0VN.IUR_y�•7��jjNEeAE6GGAtoATE4/2 AI OE•N+.AGGAEOA L!MR APPLIES PEM• AJ�.)M69 4M/05 ... .."• ""'.ODvOTS•-COMWOP POLICY PAg- F ltx r- At7TCMOWLE Ua9LLT'I CONBINRD SINOLF LIMIT ANY AUTO �- (EA ePddnnll .. I AUOWNEDAUTOS I I �(BoO.D.wILYaINJURY s 9CHEOULEO AUTOS I ;ODILY INJURY (Pn. xe�AnO HIRED AUTOS NON-04WlEDAUTOS - = PRCPEi1TYDAMAOE-' (Pee mcid" S. _� GA_RAOEUAhn-IT/ { I AUTOONLY-F-AACC'•DENT —EA S S ANY AUTO I ` EA ACC -- 13 1 AUTOONLY: A03 (j L A LtADNdYY EacNaxtIRRENCE 15 1 FEEXCESWIDIGREL LJ OGCUrr -'_� CUBAS 6tADE .. AGGREGATE I� DEDUCTIBLE I ! I �7 S RE RETENTION S WORKERS COMPE143ATIONANp... I {{{{{ M(GCiTA7l1 - DTI+ �TORY LD.iI,L3 ,ER�, EMPLOYERT LIAMUTY E.L'cACN ACCIDENT ANY PROPMLiO"ARTNERtinECU+iVE _II7 _- OF.FICETMEMBEA E%CLUOEDT I E:L. DISEASE -EA EMPI•OYEEr i- S PRQVnOa SPECUK PAOV(5(ONSnalaw SPE SPECIAL ( E.L. DISEASE•POUCY LIMR I{ I f DESCRIPTION OF OPEAATIONS I LOCATIONS I VEHICLES/ EXCLUSIONS ADDED BY ENDORSERENTI SPECIAL►AOVfSRM' - ��++_� tI� QteaW-c'c'd limI s, 11--CE ch Bell Tom M^ - SHOOLD ANV a THE ABOVE I E RLBED POLICIES BE CANCELLED BEFORE THE♦)(PIVIATION DATE Tt}EAE05 THE ISBVINGIb.SWEA MALL ENDEAVOR TO MAIL DAYS WRITTEN N=CG TQTH£ CERLLFKATE HOLDER NAMF.O TO THE LEFT, OUT FAILURETO DO SQ SHALL Hte 2m- I.GmIf....` villeT VIA L��:J.??2 /�L: FPX: 1-5 -778 �titJ #APOSE-NO-0BLtGA=0N.041LiBUTY. OF. ANY. KIND. UPON THE INSURE rf5`-A6fNifrBR--- RERt(EAEWATNES. AUTRO ED REPRESENTATrvE AcoHuas(avvT(Ds�-. . i6+Rcvn:JLCVnI't-3PSA'+fIG+P�aaen CERTIFICATE OF INSURANCE ISSUE D]AE:1M:M1DD1YY1 • PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Harold H Williams Ins Agcy Inc CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE 81 Bassett Lane POLICIES BELOW. Hyannis, MA 02601 COMPANIES AFFORDING COVERAGE INSURED Stephen M Childs 145 Cammett Road COMPANY A.I.M. Mutual Insurance Co LETTER A Marstbns Mills, MA 02648 i COVERAGES 1-1115 IS TO CERTIFY THAT 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 RESPECTTO 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRI TYI'li OF 1NSL'P_?NCE POLICY NUSSBER I POLICY EFFECTIVE DATE(MM/DD/YY) POLICY EXPIRATIO I DATE(MM/DD/YY) LIMITS .GENERAL LIABILITY I (GENERAL AGGREGATE S j COMMERCIAL GENERAL LIABILITY I I PRODUCTS-COMP/OP AGG. I S CLAIMS MADE=1DCCUR ; OWNER'S Sc CONTRACTOR'S PROT. I (PERSONAL& ADV. INIURY S EACI4 OCCURRENCE S 'FIRE DAMAGE (Any one tire) 3 MED. EXPENSE (Any one person) 3 I I LIABILITY COMBINED SINGLE S PANY AUTO PALL LIMIT 1 ALL OWNED AUTOS BODILY INIURY SCHEDULED AUTOS (Per Person) - S HIRED AUTOS r—� NON -OWNED AUTOS I i ((PBODILY INIURY ' er xcideno ' S GARAGE LIABILITY I (PROPERTY I DAMAGE i S EXCESS LIABILITYFIU h1uRELLA (EACH OCCURRENCE � E AGGREGATE I S FORM I ^— OTHER THAN UMBRELLA FORM 'FVOItFER'S COMPENSATIONAND X ,ATUTORY OTHER LIMITS A iMI'LOYERS' LIABILITY [THE PROPRIETOR/ INCL 7115713112004 12/13/2004 12/13/2005 ELE.ACH ACCIDENT S 100,000 EL DISEASE —POLICY LIMB 3 500,000 j'ARTNERS/EXECUTIVE )DFFICERS ARE: �X EXCL I IEL DISEASE —EACH EMPLOYEE S 100,000 IO'ITHi t I I I DHSCRIVrION OF OI'I'R,%I'IONS/LOCATIONS/VEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Gatewood Homes EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR Bell Tower Mall Rte 8 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. Centerville, MA 02632 AUTHORIZED REPRESENTATIVE ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID K DATE(MM/DDIYYYY) CROWC50 06/06/05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Sullivan , Garrity & Donnelly ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 508-754-1767 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 10 Institute Rd - PO Box 15010 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Worcester MA 01615-0010 Phone:508-754-1767 Fax:508-754-1885 Crowell Construction, Inc. PO Box 309 So. Dennis MA 02660 vWvaR IZQ INSURERS AFFORDING COVERAGE NAIC # INSURER A: ALEA NORTH AMERICA INS CO INSURER B: Hanover Insurance Co 22292.. INSURER C: INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. uU LTR NSR TYPE OF INSURANCE POLICY NUMBER DATIY E (MM/DDY) FFECTIVEPDATE (MMlDDM' LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 B X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR ZHN700714102 05/01/05 05/01/06 PREMISES(Eaoccurence) $100,000 MED EXP(Any one person) S5,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEML AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG s2,000,000 POLICY 7 PE0. LOG B AUTOMOBILE LIABILITY ANY AUTO AFN7001142-02 05/01/05 05/01/06 COMBINED SINGLE LIMIT (Ea accident) It BODILY INJURY (Per Person) $ 1 OOO OOO r r ALL OWNED AUTOS SCHEDULED AUTOS X J HIRED AUTOS NON -OWNED AUTOS X BODILY INJURY (Per accident) $ 1,000,000 X PROPERTYDAMAGE (Per accident) $ 500000 r GARAGE LIABILITY AUTO ONLY - EA ACCIDENT It ANY AUTO OTHER THAN EA ACC 1 $ $ - AUTO ONLY: AGG RELLA LIABILITY CLAIMS MADE EACH OCCURRENCE $ AGGREGATE II$$ IL IBLE ON $ $ A WORKERS COMPENSATION AND ANY PREMPLOYERS'IETORILITY ANYPROPRIETOR/ EXCLUDR/FXECUTNE and EXCLUDED? U yes, describe under Oyes, describe WC1049858 03 22 / /OS I 03/22/06 'EL TORY LIMITS X it E.L. EACH ACCIDENT $SOO, OOO DISEASE - EA EMPLOYEE $50O 000 r E.L. DISEASE -POLICY LIMIT $500, 000 SPECIAL PROVISIONS below OTHER B Property Section DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Subject to policy forms, conditions and exclusions. CERTIFICATE HOLDER r.ANlr1=1 I ATInM GATEWOO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Gatewood Homes NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 1600 Falmouth Road Suite 25 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR Centerville MA 02632 REPRESENTATIVES. _ ACORD 25 (2001/08) (7 ACORO CORPORATION 19RR JUN 16 '05 04:03PM SANDPIPER INS PRO "MR-D. CERTIFICATE OF LIABILITY INSUIRANCC PRQDUCEA (SOO) 790-1919 THIS CERTIFICATE IS ISSUEI Hand i ez Ina. Agency, Inc.ONLY AND CONFERS NO �. P P A4 Y r HOLDER. THIS CERTIFICATE 12 Enterprise Road ALTER THE COVERAGE AFFOi m 02601— INSURED Oualberto, Paulo Z.. 21 Quinoish Rd cnVF0AnFc P.li2 DATE (MWDDIYYYY) 09I1s 2005 OF INFORMATION THE CERTIFICATE TEND EXTEND OR x.-CIS BELOW. IAIC 9 THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 70 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTCA 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.[NOR an W-99 TYPB OP INSURANCE POLICY NUMBER POLICY EFFECTIVE �/ EXp�RA NI WTC£ M. ONY) LIMITS A GENERAL LIABIUTY 1t COMMERUALOENciiAL1IA8ILITY CLAIMS MACEL�j OCCUR =0427793Y5 - / J 11/20/2006 I I 11/20/2D05 EACH OCCURRENCE S 1,000,000 PREMISES vaE -h mD ftwl 00,000 VIED EXP Am oneo M f 10,000 PERSONAL A ADV INJURY S 1,000,000 GENERAL AGGREGATE [ 2,000,000 GENL AGGREGATE PPQ URMT APPLIES PER: POLICY Tar LOC' PRODUCTS - COMPIOP AGO S 2,000,000 AUTOMOBRELIABILITY ANY AUTO ALL OWNED AUT03 SCHEDULED AUTO$ MIRED ALTOS NON-OYNSQ AU70$- I J I / J I I I I / - J I CONSINEDSINQLELYAIT (FA Weick M f BODILY INJURY (PxoereoA) f BODILY INJURY (PeY ierAdenO PROPERTY DAMAGE (Per=Iden0 GARAGE"' ANY AUTO I J J I AUTO ONLY. EAACCIDENT = OTHERTHAN EA ACC AUTO ONLY. ADa is Is FSCESSPUMBRELU 4uBIlITY I OCCUR CLAIMS MADE DECUCT19LE RErSWrON s / / / / / J / / CAWOCCLURRENCE AGGREGATE S S s s WORKERS COMPENSATION AND EMPLOYERS• LIABILITY ANY PROPRIE CR)PARTNFR1%XECUTVE OFFICERRAE.MBER EYr4JJV ? If yes. ee6aae iPfle/ SPECIAL PROVM90NS b, / / / / E.L EACH ACCIDENT S C.L.QI9EA9E - EA EMPLOYE f E.L. L'SEASE - POLICY LIMB S OTHER DESCRIPTION OF OPERATIONeiT.00AGONBNEHICLEZMXCLUSIONi ADDED BY ENDORSEMENTIBPECIAL PROVISIONS 74TS21031, A= MX7Zg1CR DAZ:12ZNG — (509) 778-5$03 SHOULD ANY OF THE ABOVE CESCRIBEO POLICIES BE CANCELLW BEFCRB THB EXPIRATION DATE THEREOF, THE ISSUIN/GQ^ INSURER WILL • ENOSAVOR TO MAIL R 10 DAYS WITTEN NOTICE TO THE CERJIFICIATL WXV-0R NAMED TO THE LEFT. DUT 3difia,� OD riD23sE FAILURE 70 DO SO SMALL IMPOSE NO 0 OAT( JN OR LIABILITY Of ANY WIND UPON THE 1600 SA:,`v CTY :D SUITE 25 WgURERt ITS AGENTS pR REPRESENT ES AUTHORIZED REPREaENTATNE CENTERVILLE MA 02632— ACORO 2512001102) f~T Q ACORD CORPORATION Tess Vtn INS02S (oios s ELECTRONIC USER FORMS, INC. - (111=327-0145 Page i ce I TE,MMD,Y» A4:/:1:11e CERTIFICATE OF INSURANGE DA-05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 'r. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE SANDPIPER INS AGCY INC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 12 ENTERPRISE ROAD ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE HYANNIS MA 02601 COMPANY 27BCN A HARTFORD UNDERWRITERS INSURANCE COMPANY INSURED COMPANY GUALBERTO, PAULO L B 20 FERN BROOK LANE CENTERVILLE MA 02632 COMPANY C , COMPANY D COVE RAG ES THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMU)D1YY) POLICY D(PIRATIO DATE (MM1D0\YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE S PRODUCTS-COMP/OP AGG. $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR. PERSONAL & ADV. INJURY S EACH OCCURRENCE S OWNER'S & CONTRACTOR'S PROT. FIRE DAMAGE (Anyone fire) S MED. EXPENSE (Any one person) $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ BODILY INJURY ALL OWNED AUTOS SCHEDULEDAUTOS (Per Person) - $ BODILY INJURY (Per Accident) S HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE S GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S OTHER THAN AUTO ONLY: ANY AUTO EACFHACCIDENT S _ AGGREGATE S EXCESS LIABILITY EACH OCCURRENCE S UMBRELLA FORM AGGREGATE S OTHER THAN UMBRELLA FORM AWORKER'S COMPENSATION AND EMPLOYER'S LIABILITY (LIB-0243648-0-04) 11-22-04 11-22-05 STAMCRY UMITS .:.........___...._..__:..::: EACH ACCIDENT S 100,000 THE PROPRIETOR/ � INCL PAn'TNERS/EXECUTIVE OFFICERS ARE: X EXCL DISEASE -POLICY OMIT S 500,000 DISEASE -EACH EMPLOYEE S 100 , 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER C ANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE GATEWOOD HOMES 1600 FALMOUTH RD - SUITE 25 EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR CENTERVINE MA 02632 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 41COR0250(3193) SAC ?ORATION:1gal.:'. A"g-02-05 01:25P 1 a Al /\ f11r\ P.02 i.It-lUA tt---Ul--LMkt9LFTY INSURANCE uTf 8 0ro PRODUCER Serial # A1530 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION BUCSY INSURANCE AGENCY, IN:. P.O. BOX S30 - Bd1 PUTNAM PBAI . GREETNVILLE. RI 02828 ..... - - ONLY"ANEY CONFERS- NO RIGHTS UPON THE CERTIFICATE - HOLDER: TWS CERTW7CATE- DOES NOT AMEND. EXTENCr OR ALTER THE COVERAGEAFFORDED BY THE POLICIES BELOW. MUREM AFFORDING COVERAGE NAICM INSURED MURERA: NATT FIRE INSURANCECO. OF HARTFORD HOLMES AND MCGRATH, IN, ;. INSURER B: VALLEY FORGE INSURANCE CO. 362 GIFFORD STREET FALMOUTH, MA 02540 wSuRerc- CONTINENTAt INSURANCE CO. INSURER O. COVERAGES THEP-OLOMCF V4URANCE LISTED BELOW 1 AVE BEEN ISSUED .IQ T3E KWIEiI.WAKOMOVEFCR.THEEOLICY PERJQQ INDICATED. NOTWITHSTANDMG ANY REAWREW-UT. TERM OR CONDITION OF ANY CONTRACT C&.anep DOCUMENT Mn' RESPECT TC. 9YL/1CFi.THL4 CERTIFICATE MAY BE Lecl wn OR _ MAY PERTAN, THE INSURANCE AFFORDED BY THE POLCES DESCRIBED HEREIN IS'S713xCT TC ALL THE TERMS. EXCLUSIONS AND CONCfTXJNS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY W 0E BEEN REDUCED BY PAD CLAIMS. Avs TYPEOFIM3lMAMCE - POLICy NUMBER EATfCT EJmWilOM 10/06105 [naTTS A GENERAL LIABILITY X COMMERCIAL GENERAL LIA8HRY CLAIMS WOE m OCCUR - 10: 40132434 10A06J04 EACH OCCURRENCE i 1000,000 ANAL O RENTH7 i FIRE 259. 0= ym F7w ar s 10,000 PERS0NAL&ADYT4LRy i 1.000,000 GENERAL AGGREGATE i 2,000,000 GENL AGGREGATE LIMIT APPLIES PER PCY.ICf PRO LOC PMODUGTS - Cpe P AGG ! 2 000-.000 ' AUTOMOCILE Ly "J" - - ANY AUTO COMN2I€OSING:E CUM (Ea w>�0 S ALLOWNED AUTOS SCHEIXAED AUTOS p LPG; Y S HIRED AUTOS - NON.OWNEDAUTOS lPec"LYy%JURY PRC4�HTY DNAAGE S OARAOE ARTAUTO LUBK7IY UI - AUTO ONLYEA ACCIDENT i OTHER THAN EA ACC AUTO ONLY AGO S S �LIm OCCUR Cl CIAA"S MADE EAC"OfXURRENEE i AGGREGATE t. S. DEDUC718LE i RETENTION i WORKEi ODMPERSA710F1 AND WCSTA7LL R EMPLOYERS B ANY PROPRIE MIPARTNER/EXECU WE 211. 7445273- 09/01M4.. ... O91DtJ0s EL EACH ACCIDENT i T 007 QQO' OFFICERNMEMBER EXCLUDED? a yyeeqq aeaeKba � r EL DISEASE . EA EMPLOYE= s 1 OOO O00 SPF£VIL PROYLSIDN3 below .. Er OISEAM. POLICY t wn.. it 1 000 000. OTHER C PROFESSIONAL LIABILITY AE4 00 43133 38_ . 7L73R5. t 000,= PER CLAIW. AGGRETGATE- OESGRIPTIOM OF OPERAigNAILy:ATg11iA/pleC(]<ylEj 1USIONS ADGED BY El4DON5EMO/T/3PECU1 PROVISMGeLE AGGREGATE OMITS ARE PER THE TER WS AND COWfTIONS.OE THE 6OLr-JES. CERTIFICATE HOLDER CANCELLATION ATION SHOLX11ANY OF THE ABOVE DESCRIBED POLICIES SE CANCELLED SEhR£THE EXPRATION GATEWOOD HOMES. DATE THEREOF. THE ISSUNG IN9/RER WILL ENDEAVOR To MAIL pAYs MNRfTTEN 16M FALMOUTH RD., STE. , 5 NMTO'TWCM"TXATFHO[DERNAMED TO THE LEFT. Our FAILURE TO oasusmm CENTERVILLE, MA 02632 IMPOSE NO 08-ICATCN OR LIABIL[T' OF ANY KIND UPON 'T a INSURER. ITS AGENTS OR . REPRESOa=AES.PREWXrATfft A�UKW Aa TfYV NVA) ' c ACORD CORPORATION is= C-XFMPROICERTPROS.FP5 ACURD„ CERTIFICATE OF L ABUT f lil+�Sk11�ANCE MIDOMM DATEWz/os PRODUCER • United Insurance ACrancyi..Inc. 199 Main Street P.O. Box 1013 Buzzards Bay, SSA 02532 THIS CBMFICATE IS ISS(,ED AS A MATTER OF INFORMATION: OWYAND-FS CONREASNORIGNUPONT}ISCERTFICATE... . HOLDS TitIS CIRTIRCATEDOES NOT **E?JFS, EXTEND OR ALTER THE COV ERAGE AFFORDED BY THE POLICIES BMCW. INSURERS AFFORDING COVERAGE NAIC M INSUR® Patton Electric, Inc. 128 Scituate Road. Mashpae, MA 02649 INSDRER-A: T.73rtcIT-KA _ INSURER fl Commorro Insurance Co. - INBURERO:-Li Mutual -Ins. Co: INSURER O: LABORER-z.... a. v vw. THE -POLICIES OF.INSURANCE LISTED- BF10w_MAVE BHPM ISSUED. TO.RREWSURED. NAMM_6jWVEFOR. THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY. REOUIREMENT. TERM OR CONDITION OF ANY COUTRACI OR OTHER OOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCR18E0 HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN TYPEpOLCYNVMBER P.,ICY-6F tTLIlw- IOUCY DN CIMffS GENERAL LABILITY - - FACHOCCURRENCE 2 1 00Q 000 PREM1BEs X 3 3Q0,000 S 101000 A COMMERCIALGENERALLIACUTY CLAMS MADE aOCCUR `SCP424-15ag-9- 7/30/0-5 7/30/06 MED EXP(A one Sal PEUWNALS ADV INJURY $ 1�QQQ�.QOp- HX OENERALAGGREGATE $ 2,000.000 GCN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG S '� QQO ca POLICY F7 PE o LOC AUTOMOBILE LIABILITY ANYAUTO GOMBwED BwOLE LWIt (E' SVJdM) 9nn" Y INJURY IpNPw'ml F SOO,OOTT B ALL OWNED AUTOS SCHEDULED AUTO& YW9338 10/3/04 10/3/05 HFRFDAUTOS NON-OY0NED AUTOS QOOILVI�RY ¢ 30Q,00C PROPERTY DAMAGE (Pw =Idw+y i 100,000- ti I GARAGE LIABILITY AUTO ONLY -CA ACCIDENT- S OTHER THAN EAACC ONLr. AGO S ANYAUTO RAUTO .S EXCESSIUMBRELLA LABILITY EACH OCCURRENCE S AGOREOATE S 'I I ,OCCUR CLNMSMAOE. - _^ S p� DEDUCTIBLE S t RETENTION S C WORK 9lSC0IIIPEN"dAT10N ANDOFq EMPLOYERS-UAHLRY ANY PRORR IETOR,PARTNER/CXECUTIIE OPFICERMIEMBER EXCLUDED? WC2315353049014 12/10/04 12110105 TH- E.L�C„ACCIOENT s 10C OIIO E.L DISEASE• UEMPLOYEE S 500,000 $pEb°,u,pgpu<3 SpSpw X EL DISEASE POLICY LIMIT t 100 000 OTHER D1�CRMTIONOFOPERATWN3/LOCATIORS/YERAE37FJfCCTAfONSAODEIIIITENCORl�'IMT/OPEdAL ►ROVISMMA"' slectrieal CERTIFTCATEHOLM CAWe! LATION-- cat9M00d memos SHOULD ANYOF THEASOVE DESCRIBED POLCIEBBECANCELLED BEFORE THE EXPIRATION Fax No. (508) 778-5603 .DATE311IMME, THEISSIUMMU BDBERW XL ENDEAYCBTO MAIL . _j2_nAYswRRTEN 1600 Falmouth Road NOTICETOTHE CERTIFICATE HOLDER NAMED TO THELCFr, BOTMUBETOrITOWSHALL Suite 25 IMPOSEN008LJOAMN OR LAABLITY OF ANY KIND UPON THEINSURER.T8 AGENTS OR Centavilla, MD. 02632 s AUTHORIZED REPRESENT ACORD 25 (200108) . RV CORPORATION 1988 CORD CERTIFICATE OF LIAB[L1TY:INSURANCE °AT`MMo°"Y' I ; 9/15/04 ; _A, PRooucERx.THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Chatfield, Whitman & Young HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 549 Washington Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 850963 COMPANIES AFFORDING COVERAGE Braintree, MA 02185-096 COMPANY A Harleysville Worcester Ins Co INSURED COMPANY - - - Lawrence Robinson Masonry B 5 Fresh Hole Road Hyannis, MA 02601 COMPANY C COMPANY D COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD y 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OFINSURANCE POLICY NUMBER POLICY EFFECTNE DATE(MM/DDrr0 POLICY EXPIRATION DATE(MWDD/YY) LIMITS A GENERAL LIAMUTY COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR OWNER'S & CONTRACTOR'S PROT CB 7E 32 32 9/07/04 9/07/05 GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMPIOP AGG $ 2,000,000 PERSONAL & ADV INJURY $ 1,000,000 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Arty one fire) $ 100,000 MED EXP (Any one person) 1 $ 5 , 0 0 0 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS _ BODILY INJURY (Par accident) $ NON -OWNED AUTOS PROPERTYDAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: - ANY AUTO EACHACCIDENT S AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ FORM O LIMIT OTH- TORY LIMITS ER I$ - RiUMBRELLA OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND - EL EACH ACCIDENT Is EMPLOYERS' LIABILITY EL DISEASE -POLICY LIMIT IS THE PRO PRIETORf INCL PARTNERSlEXECUTIVE OFFICERS ARE: EXCL I i EL DISEASE - EA EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSA/EHICLEWSPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION ._._. _. H. .. ._. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Gatewood Homes EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 1600 Falmouth Road 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Suite 25 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UABIU Centerville, MA 02632 OF ANY KIND UPON THE COMPANY ENTS R£SENTA S. AUTHORIZED REPRESENTATIVE Robert E. Chatfield ACORD 25� (1/95) ". - O ACORD CORPORATION.1988='. `A'CORD. CERTIFICATE OF LIABILITY INSURANCE R076 09-27-2004 PRODUCER PAYCHEX AGENCY INC. 210706 P: (877)287-1312 F: (877)287-1315 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 308 FARMINGTON AVE FARMINGTON CT 06032 INSURED INSURERA:TWln City Fire Ins Co INSURER B: INSURER C: LAWRENCE ROBINSON MASONRY INC INSURER D: 5 FRESH HOLE ROAD INSURERE: HYANNIS MA 02601 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. /NSR LTR TYPE OF INSURANCE PoL/CY NUMBER PoL/CY EFFEG7Nf DATE MM/DDTYY PoL/CY EXPIRATION DATE MM D/YY I LIMITS GENERAL LIABILITY EACH OCCURRENCE g FIRE DAMAGE (Any one fire) g COMMERCIAL GENERAL LIABILITY CLAIMS MADE FIOCCUR MED EXP (Any one perwn) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE g GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG g POLICY PEQ LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) g BODILY INJURY : (Per person) - g ALL OWNED AUTOS SCHEDULED -AUTOS ' BODILY INJURY -(Per accident) - g - HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE• f (Per accident) g . GARAGE LIABILITY I AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO g AUTO ONLY: AGO EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE I$ OCCUR CLAIMS MADE 9 g DEDUCTIBLE e RETENTION 9 f A WORKERS COMPENSATION AND EMPLOYERS'L/AB&frY 76 WEG NQ5620 09/06/04 09/06/05 X WC STATU- OTH- VLIM E.L. EACH ACCIDENT $100 000 E.L. DISEASE - EA EMPLOYEE $10 0 , 0 O 0 E.L. DISEASE - POLICY LIMIT s500, OOO OTHER I DESCRIP770M OF OPERA TIOA=OCA 710NSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPEC/AL PROVISIONS Those usual to the Insured's Operations. I.CLII Iri.. I C MULIJCIt I I AUUIIIUNAL/NSUREU; INSURER LETTER: UAINUInLLAI IUN GATEWOOD HOMES 1600 FALMOUTH ROAD, SUITE 25 CENTREVILLE MA 02632 OULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE DIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE LDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO LIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 'RESENTATIVES. ACORD 25-S (7/97) 0 ACORD CORPORATION 1988 '12/02/04 13:36 FAX 5087900249 GOLDMAN ASSOC [A 02 � /� a r e+ a r ra r �}- >< �a-g-��- _ ^"� lay"^"•`^• V_- ,Sac�rgD _�,','ERTiFlCAT� OF LIABUTYINSSU � TAVARR A 12/02 04 -- 74ttJJCErt TY,IS CERr.FICATE IS !_SUED AS A AP.ATrER OF INFORO—L Ar.ON _ GOLDMnN & ASSOCIATES INS"SSLti-=a FINAUNCIAL SSItVICBS =C - 111III 933 F='MOU1'H RD, GNLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER: THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ASTER THE COVEPAGE AFFORDED 9Y TUE POUCIE5 BELCY!- _ _ - .- INSURERS AFFORDING COVERAGE 1 I NAICA HYANNIS MA 02601 Rhona: 508-775-6010 Fax:508-790-0249 INsuP.ED INSURERA MARYLAND CASUALTY COMPANY INSURER B: j RODNI!7 TAVAATO DBA D!G3CHANICAL SYSTEMS WSURERC: INSURER D: I 110 EOLDaR LA37a FI SAFNSTABL8 MA 02668 INSURER I_ CAVFRAnFA THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REDUIREMGNT, TGRM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE IN$:jRANCE AFFORDED BY THE POLICIES DE$CRIMP HEREIN IS SVNECT T9 ALL THE TEAMS, E KCLUMNS AND CONDMONS OF SUCH ' POLICIES AGGREGATE LIMTTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS., LTR INSRU TYPE OF INSURANCE POLICY NU&SBER GATE MMID DA-,t(MWDOfYYIi LIMITS GENERALLY.BI.ITY I -I EACH OCCURRENCE I S 1000000 A I X COMMEIRCIALGENERAL LIABILITY 1000372088 11/21/04 11/21/05 i a 300000 CLFJMS MADE 17 OCCUR MED EXP (M+Y ma Pel"->PR) I s 10000 PERSONALtACV INJURY 131000000 1 i GENERAL AGGREGATE S 2000000 I GEN'L AGGREGATE LIMB APPLIES PER: PRODUCTS -COMPIOP AGG 13 2000000 PRO - POLICY 1_7 JECT LOC 1 IANY AUTOMOB r ummm`/ AUTO I COMBINED SINGLE LIMIT 3 (Ea 2pCer+t) BODILY INJURY ALL OWNED AUTOS I j I I SCHEDULED AUTOS ! (P4I Psrtnn) BODILY INJURY S IPM acdda t) IIV-^-I HIRED AUTOS NON -OWNED AUTOS ' � PROPERTY DAMAGE S (PM aCOeeei) 1 1 i 1 1 GARAGE LINALRY f 4 ( AUTO ONLY -EA ACCIDENT i— - ,ANY AlI1T] _ CTHERTHAN FAACC S I AUTO ONLY: AGG S ( EKrE35RIL_IRE LA LUUALITY i EACH OCCURRENCE is ;; OCCUR ❑ CLAIMS MADE i AGGREGATE is S -1 t—ieR- l W]PoSER3 COMPTI13AT10N AMD I! - 1 TDRYLIMITS I ER I LAWLOYERWIJABI_ Y I I` ANYPROP rEtI:ARTNER/E%ECUTNE OFFICERP.aEtABER EXCLUDED? E.L EACH ACCIDENT S I E.L DISEASE -EA EL+PI.O 3 I Xy� SP5CIAL pRDViygyg yelev I El. CISEASE-POLICY LIMIT S OTHER OEaCR: I IDAI CF OFT,^.A'T=3 / F&EX-ONE I L'iN.::LC.S I QXC...-,. __ w.. -.-........-..--... , :.�C.T..:. F^�. k�-- rP"TTSIrATF UnLEIER CANCELLATION ? C_ETRhTAA _ SHOULD ANY OF THE ABOVE CESCIUZED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO AIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FALURE TO DO SO SHALL - - - IMPOSE NO OHLGATION OR LIABRtiY OF ANY KIND UPON THE INSURER ITS AGENTS OR 53 3INC 7 8 FA7C SO$-778-5503 FAx5 08 1600 FALMOUTH ROAD SUITS 25 REPRESENTATIVES, AUTOO QFD REPRESENTATIVE ANN I III11S C=IIRVILLE MA 02632 ACORO 25 (2001108) - V ACUNU cUKFUNAI IUN I VMa 0 PROPERTY ADDRESS: /;?/ :ALCULATlON FOR PERMIT COST qo AD �/� 73I zsst �RATIONs BATH B� a?�• ' CEl DE4 ID D DQ FOUNDATION ONLY I I D GARAGE NO.OF BAYS - - MUD ROOM OFFICE Y PORCH CLG }'ORCH OPf REROOFING SHED STORAGE h FA Temp Permit No.: Applicant Name: Applicant Phone: Building Location: TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398.2231 ext.261 BUILDING PERMIT TRANSMITTAL T-06-060 Frank Capra 5087789669 00121 CAMP ST Unit 99 Owner's Name: Villages @ Camp Street, LLC Owner's Addres 1600 Falmouth Road #25 Centerville MA 02632 i Owner's Telephone: (508) 778-9669 (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $0.00 Payment Type: Check ChkNo.: 0 Net Owed: $0.00 Application Date: 8/15/2005 Issue Date: Expiration Date Comments: Map/Lot: 044.21.1.0 new construction - Affordable: ZONING APPROVED REVIEWED BY: ✓1. WATER DEPARTMENT: 2. ENGINEERING DEPARTMENT: 3. CONSERVATION: ✓4 HEALTH DEPARTMENT: ✓5. BUILDING DEPARTMENT: 6. FIRE DEPARTMENT: COMMENTS: DATE: DATE: DATE: DATE: DATE: DATE: PLEASE NOTE N/A: N/A: N/A: N/A: N/A: N/A: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: Date Printed: 8/22/2005 i Temp Permit No.: Applicant Name: Applicant Phone: Building Location: Owner's Name: Owner's Addres TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BUILDING PERMIT TRANSMITTAL T-06-060 Frank Capra 5087789669 00121 CAMP ST Unit 99 Villages @ Camp Street, LLC 1600 Falmouth Road #25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 REVIEWED BY: 1. WATER DEPARTMENT: (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $0.00 Payment Type: Check ChkNo.: 0 Net Owed: $0.00 Application Date: 8/15/2005 Issue Date: Expiration Date Comments: new construction - Affordable: DATE: 1212@190 W [9D AUG 2 4 2005 HEALTH DEPT. N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT: < DATE: % �� N/A: 5. BUILDING DEPARTMENT �_ DATE: N/A: 6. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: 044.21.1.0 T Date Printed: 8/22/2005 is TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-06-060 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Unit 99 Owner's Name: Villages 0 Camp Street, LLC Owner's Addres 1600 Falmouth Road #25 Centerville MA 02632 i Owner's Telephone: (508) 778-9669 (OFFICE USE ONLY Recorded By: is Permit Fee: $0.00 Deposit Rec: $0.00 Payment Type: Check ChkNo.: 0 Net Owed: $0.00 Application Date: 8/15/2005 Issue Date: Expiration Date Comments: Map/Lot: 044.21.1.0 Q new construction - Affordable: 0 REVIEWED BY: f 1. WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT: DATE: N/A: 5. BUILDING DEPARTMENT: DATE: N/A: 6. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: Date Printed: 8/22/2005 Page 1 of 1 . Cipro, Linda • From: Damiecki, Gary Sent: Tuesday, September 13, 2005 12:27 PM To: Cipro, Linda Subject: RE: transmittal sign -off @ 121 Camp St # 99 • • Hello MS. Linda, Please consider it signed off. It is good to go. Gary From: Cipro, Linda Sent: Tuesday, September 13, 2005 11:23 AM To: Damiecki, Gary Subject: transmittal sign -off @ 121 Camp St # 99 Gary — I have the Water Department's transmittal sign -off sheet for 121 Camp St, # 99 but it doesn't have your signature on it? Did you mean to sign off, if so what was the date? Thanks - Linda Linda Cipro Building Department Administrative Assistant 9/13/2005 GMS9/GCS9 .SERVES 93% AFUE Multi-Tositionv Single-Stage/Multi-Speed Gas Fumace. -- Heating Capacity; . 46,000-115,000 BTUH L.: �ama _ a . Standard Features Cabinet Eartstractiocr • Corrosion -resistant, aluminized -steel tubular heat • Heavy -gauge, reinforced, fully insulated steel cabinet exchanger and stainless -steel recuperative coil fog with durable baked-eriamel finish - maximum efficiency • Attractive architectural gray paint finish • Designed for multi -position instaltition---GMS9:" . Foil -face insulation lined heat exchanger upflow, horizontal right or left; GCS9: downflow, compartment horizontal tight or left • Coil and furnace fit flush for easy installation • Energy -saving, reliable Hot Surface ignition system, • Convenient left or right connection for gas and featuring a Norton' Mini•Igrtiter with patented electric service adaptive learning algorithm to maximize igniter life • Bottom or side air inlet (GMS9) • Aluminized -steel inshot burners • Removable. solid -bottom block -off (GMS9 • Energy -saving P= inula-ipeecF, direct drive blower motor • Quiet. cotrosion-resistant induced -draft Accessories blower assembly • L.P. Conversion Kit (LPTOOA) • Integrated furnacecontrol_with•improved.......-f,:p-GasLow Pressure- Kit' (LPLP01) diagnostics • High Altitude Natural Gas/LT Kits (HANG11, • Low voltage terminal blocks HANG12, HALP10) • Multiple flame toU.out switches, blower door safety . High Altitude Pressure Switch Kit (HAPS27) switch, outlet aitdimit switch and pressure switch for . ExternalFilterlkackIUR01.) proof of combustion air Horizontal Concentric Vent Kit (HCVK) • 40VA transformer for heating and air conditioning Vertical Concentric Vent -Kit (VCVK) ... control service Internal Filter Retention Kit—upiipw, horizontal Combination redundant gas valve and regulator IRFt�180) • Top venting -is standard;' alterrtate-ffudverzrlocated- Internal Filter Retention on right side Kit —do,, n low • Completely. assembled.fauoWun-testedfurnace.for...... (RFDOOtB11 49.1 heating or combination heatirWcooling application • All models comply with California NOx Standards Thermostats Blower Motors • Suitable for direct vent (2-pipe) or non -direct vent CHSATG, HCHAYT) , (I -pipe) applications W,•wgoodmanmfg.com bp4 . SS•377D Air-Can&Wonirtg-& i-teatrrtg. The GMS91=9 single -stage, multi-spree&gas furnaces offeY— installation .versatility. . R PRQQUQT SPECIFICA TIONS Nomenclature E M S 8 ..0 0 A OE Goodman® 9 art ' F'l Gooano Brand A:.lrwkl&l.ReI Air Flow Direction Ox S on )kUpftowlHorizontal...... N: Natural Gas C. 20d Revision D: Dedicated Downftow X-. Low NOX C: Downflow/Horizontat Trbinet Width W. HIAir Flow A: 14- Description 17A" C:IV.Single Stage/Multi-speed P; 2414" :Two Stage/Variable-spetF8: :-. v mFreim,,cum r 91 j 1 5: 2.000 045'. 45,000 070; 70,000 090'. 90,000 115:115,000- 140.140,000 PRODUCT SPECIFICA GCS9 Dimensions VIEW W FROIrl NEW a saoE VIEW VRRNR) y Vewiftua ME a,na rwo CONDENSATE DRaat TRRI ,. r tow votr.oe 1 , •..cr sut taxWanc.... EIECTRK.t mokt ie•T STi0�E1 MG V0.hpF ELECTRICALNett 2• ,a aTe TER".TE_ uNlnatYE ••i- taGtTga � 4TERWTE ...... It Yet ...rain _ ... NRII,TaIt■.tDCRTIaµ • auw rsm owe t fa sna f ,e l• am,n61 .. . RIGHT N"DEE D a i n 4 natE1 r tys tlTERWTE CV V tasCWaoe NR V<22 %»DAAL I tTh" G65907038Xn 16" 12Uh" 16^ G 1TYS" W. 12... ..W e". .... C59fA04CXA ... ._. 27" 19yt" 16s/." 16" GC591155DXA 24yr" 18" 19V Ncr s: 23"._. 20'Ge...... 2114" .. 23 " 1. Installer must tuPPIV one or two PVC pipes: anc for comhuscluttsi�l 2" or 3' in diameter, depending upon furnace input; uPtn length ■nd t, anc rdte-flae outlet r 2 pi teii). Veni pipe mst be either Air Pipe is dependent on insn8ationkode mquiTm ant$ and m stt be 2or 3" diameter PVC. The (1 or 2 pipes). The optional Combuge c stion Z. Line voltage wiring can enter through the r ar lek 3. Conversion kits for high ■(t4ude natural gas operation asfdtee■�vithe furnace.* i ble. Contact yputGoodma-irinduct bucp�rtohr j p Ht her idetails. �t sidu of furnace. 4. Installet must supply (",,owing gas line fittings, according to which mtnnceiaused: �h—T.•o 90a elbmvs. vne close nipple; straight pipe Right —Straight pipe to reach gas valve Minimum Clearances to Combustible Material. ^•... P." on comoustible goof, the floor MUST be wood ONLY. NC = Non -Combustible: q combustible floor subbase must be used fix installation on combustible Roaring NOTES: • For smiting or cleaning, a 36" front clearance is recommended. • Unit connections (electrical, flue and drain) may necessitate greater clearance■ thao.tht m"Mumekarartce■ lIseed below ' In all nw, accuaibilUy tkar■nce must take precedence over cleanneea.fm n the endoture whate accessibility clearances are gtemer. 5 PRODUCT SPEC_ IE[CATIONS Blower Performance Specifications . N. • J s- t - J �.7 ••••• 1,318 .-• , I a 1,260 . iCp1E E. F 1,202 ....... HIGH 3.0 1,352 G_5904538XA MED 2.5 11214 1,172 •- 1,123 1,064 (LOW) MED-LO 2.0 997 -•--•- 994 •---•- 960 35 923 36 LOW_ - .1:5.. .757. µ . -.753- 44-- 734 . _ 45 -- 70¢- "47-' HIGH 3.0 1,449 36 1,409 37 1,326 39 1,273 41 G_5907038XA MED 2.5 1,192 43 1,172 44 1,141 45 1,094 47 (MED-I'll)' ' ' MED-LO 2.0 '981 53' '962 54 943 55 '917 56 LOW 1.5 1 750 730 1 ------ 714 •----- 692 - - G_590904CXA NiGll.. MED ...4.0• • 3.5 1,970 1,713 .-- 39 1.474 1,650 --35 40 I;757 1,572 •'X- 42 1;667 1,510 -40,- 44 (MED-LO) MED-LO 3.0 1,439 46 1,412 47 1,370 48 1,327 50 Sj... UA LOW-- '2'.S 1 TS] '56" 1'15S 'ST" 1 In '59- i t08 .54 -60 HIGH 5.0 2,134 40 2,103 40 2,029 42 1,941 44-.,. G 591155DXA , MED 4-0 t,g7b ...51 1.,641 _ 52, 1 643 •52..11,191 1. 577 . 54.. 11 (MED-HI) MED•Lp 3.5 1,453 58 1,440 59 1,426 59 lr363 62 {)1 ' f •" -- . LOW ..3.0... 1 259 _6T -1239 _68_. 220 .70_.. -•-••• A�11): NOTES: 1 • CFM in chart is without filter(s). Filters do not.*Np.with.this furnace but muxt ls¢.ptuvitledbythe. itaualltm If the-itun;j*e setiuites twoaeyum3. dip chart tusumrs hoch fihera are installed. 1 2. All furnaces ship as high speed cooling. Inscdler must adjust blower crOing speed as needed. - 3- For most jobs. aMor 400 CFM per tun when ciw9ing is dvsirtble. 4. INSTALLATION 15 TO BE AIIJU5TED TO OBTAIN TEMPERATLIRF• RISE WITHIN ME RANGE SPECIFIED ON'rHE RATING PLATE. 5. The chart is fin Inftnmatksn only. For satisfactory operamm, external static pressure most not exeeed value shown mi ,Imp ratingI;,We- The shaded area indicates ranim,- in execs of maximum static pressure allowed when heating. 6. The dashed (•••-) areas indicate a ttntperattrerissrnut recommended {rW A*"m. eL__ 7. The above chart is fix U.S. furnaces insmlled at 0' • 2A00. At higher altitudes, a property de -rated unit will have approxanately the same temperature tilt at a p,rticular CFM,.whilc ESP at the CFM wdlbe-hewer..-... ` J ME PRODUCT SPECIFICATIONS Accessories LPT-OOA L.P. Conversion Kit ✓ LPLPOt L.P. Gas Low Pressure Kit ✓ ✓ f HANG1 1 High Altitude Natural Gas Kit 1 1 1 1 HANG12 High Altitude Natural Gas Kit 2 2 2 2 HALMO High Altitude L.P. Gas Kit 3. _.. 3..... 1.._ 3_. _ HAPS27 Nigh Altitude Pressure Switch Kit 3 3 3 3 ..EER01.. External Filter.Ractt_..... . -...._ ✓... _.. ..._ ...._ ✓..... _ .,c_._ DCVK-20 Horizontal/vertical Concentric Vent Kit (2") ✓ ✓ DCVK-30 Horizontal /VerticalEoncentrie Vent Kit. try- ✓ ✓ tivwIaMe for Mis model (I) T,C01'tiY 9,Q00' (2) 9,001' to I I, (3) 7,001' to I LO00' Note: All Instellativra above 7,000'require a pressure switch ehangr Fix inst. atiorr in Canada, furnaces are certified only it) 4,500'. DownOmv floor Bane: When the C<,;9 model is installed directly on it woad floor, a downBow flout base must be wtd..l7ruua model ruiniheta- am: CFB17, CFBI1 and C'FBZ4. Thermostats CHTIO-60 Cooling/Heating, Mechanical CH70TG Cooting/Heating, Digital, Non -programmable CHSATG.... i^g atin4: MechdnPcat .. Coot /He N20TWR Heating Only, Mechanical MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.01 Release 2 CITY: Yarmouth STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric -Resistance) DATE: 4-26-2004 DATE OF PLANS: 04/21/04 TITLE: The Osprey PROJECT INFORMATION: Mill Pond village Camp Street Yarmouth, MA. COMPANY INFORMATION: Northside Design Assoc. 141 Main Street Yarmouth Port, MA. 02675 COMPLIANCE: PASSES Required UA = 288 Your Home = 158 I I I Permit # I I Checked by/Date I Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 740 30.0 30.0 13 WALLS: wood Frame, 16" O.C. 1700 15.0 15.0 75 GLAZING: windows or Doors 101 0.340 34 GLAZING: Windows or Doors 40 0.340 14 DOORS 40 0.086 3 FLOORS: over unconditioned Space 740 19.0 19.0 19 ----------------------- I------------------------------------------------------- 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 ]4.4. Builder/Designer Date `qja//az Massachusetts Energy Code MAscheck software version 2.01 Release 2 The osprey DATE: 4-26-2004 Bldg.l Dept.l use I CEILINGS: [ ] I 1. R-30 + R-30 Comments/Location WALLS: [ ] I 1. Wood Frame, 16" O.C., R-15 + R-15 i Comments/Location I WINDOWS AND GLASS DOORS: [ ] I 1. U-value: 0.34 For windows without labeled u-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Locatio [ ] I 2. u-value: 0.34 For windows without labeled u-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location I DOORS: [ ] I 1. U-value: 0.086 Comments/Location I FLOORS: [ ] I 1. over unconditioned space, R-19 I Comments/Locatio I AIR LEAKAGE: [ ] I joints, penetrations, and all other such openings in the building I 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 I inside of the recessed fixture and ceiling cavity and sealed or I 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 Lfs) 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 i difference and shall be labeled. I VAPOR RETARDER: [ ] I Required on the warm -in -winter side of all non -vented framed I ceilings, walls, and floors. MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating I I Cl Cl I and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. DUCT INSULATION: Ducts shall be insulated per Table J4.4.7.1. 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 78004R 1310 and 74.4. SWIMMING POOLS: All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. HVAC PIPING INSULATION: HVAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in.): PIPE SIZES (in.) HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 Low temperature 120-200 0.5 1.0 1.0 1.5 Steam condensate any 1.0 1.0 1.5 2.0 COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.75 1.0 refrigerant below 40 1.0 1.0 1.5 1.5 CIRCULATING HOT WATER SYSTEMS: insulate circulating hot water pipes to the following levels (in.):. PIPE SIZES (in.) NON -CIRCULATING CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F): RUNOUTS 0-1" 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only) ------------------------- HUI,, 1:>. GbM 14f; 14Y1'1 SHtYLtY SHLtS NO.469 P.z VK KQ CEI: ' 1(.T1DMrM�1R=EPCMi —US. Monday, August 15, 2C.05-4 AS Single 11-718" AJSTm 20 .M. SR . c: JC2 FP:e Nsmoea Jab Name: Deserptio Address:. Spec"lion. City. State, Zip: , Customer: Designer.ra Company: SHEPLEY WOOD PRODUCTS Code reports: 1SR-1141 N%c: 80, 1-112- 51, 1-11T 400 Ibs LL.__. 40olbs tb., -100 bs Dl _ 1001ba DL Genoral Data Version:... US Imperial Member Type, Joist Number-of-Spans-1 Left Cantilever: No . Right Cantilever No Slope: 0112 OCSpecinw- 12" Repetitive: Yes Construction Typc: Glued Live Load: 40 psf Dead Load; 10 psf Partition Load-* 0 psf Duration: 100 Oisclosure The completeness and accuracy of the input must be vafufied by anyone who would rely on the output as evidence of suitability for a .. . Particular application. The output above is based upon building code -accepted dosijM propedkW ... and analysis methods. Installation of BOISE engineered snood products must be in accordance with the currant Instailatlan Guide and the. applicable building. codns... To obtain an Irstallatlan Guile or it you have any questions, please call (800)23U788 before beginning' product installation. BC CALCds, RC FRAMER0, BCIV; BC RIM BOARD^", SC OSS RIM BOARDTM, BOISE GLULAM7"', VEP.SA-LAM'D, VERSA -RIM®, VERSA -RIM PLUS®, VERSASTRANDTM, VERSA-STUM ALLJOISTO and AJST" are traderlaft of Botse Cadcade Corporation. Page 1 of Y Total Noriaont�FLength - 20.0"0 Load Summary ID • Description- Load-lype-..Re4: Start-- Erw-. Type... S Standard Load Unf. Area Left 00.00-00 20-oaoo Live Dead Controls Summary Control -Type--- Value,- — Moment 2500 it-ibs Neg, Moment 0 ft-lbs End Reaciien S00'U Total Load Defl. U521 (0.4610) Live Load Deft...... 1.05 Max DeO, 0.4510 Span r Depth 20.2 Na Allewab*- Duration 56.8% 190°% Ate 100% 43.7°% 100% 46.1 °,5 73.7°% ..... 46. t°iv n/a Valtm Ot;S - Dur. . 40 par 12' 100% lops! . 12' So% Lead£aae— SpVrtoaattott-, 2 1 - internal 2 1 -Let 2 1 2... V 2 1 Notes Design meets Code Minimum (L240) Total load deflection criteria. D®stgn meeta User spedyied (U480) Live load deflection criteria. Design meets arbitrary (1") Maximum load deflection criteria. Min'kmum.hsadnglength:for 130.is_t-ltr_ Minimum be;ringtengih forBt it 1-tt2". EntsradlDisplayed Horizontal Span Length(s) = Clear Span + 112 min. end bearing + 12 intermediate bearing nw. ice. enM 11f;1Q rt bHLVLLY SHLLS NO.469 P.3 MCAL= 2003DESIMMEPoRT - UE Monday, Auguat 15, 2acs 11:17 Quadruple 1314" x-11 718" VERSA;LAMS 3100r.SP-.. File Name: OSPREY.8CC : FB01 Job Name: Dsscript!on: Address:.. Specifier City, State, Zip:. Designer, Joe Madera Cuslorner. Company: SHEPLEY WOOD PRODUCTS Cede reports: IC80 5512, NER 629 Migc; no et 2340 Ib5 LL 2340 Ibs LL 1033 ibs OL 1983-lbs DL- v FIM"r►+a Version: US imperial Member Typa: Floor Beam Number of Spans: 1 Left CantLever... Na. Right Caitilevor. No. Slope: 0112 Tributary: 12.00-00 Livs Load:.... 20 pst . . Dead Load: 10 psf Padition Load: 0 psf Duraton-- 100 Disclosure Thn coawl'eienes.and ac=,acy of the input must be verified by anyone Who woutd_rely on the output as • - evidence of suitability fora particularapplication. The output above is based upon building coda -adapted design properties and analysis methods.. installation. . of BOISE angineered wood products must be in acccrdanc with the current Installation Guide- - and the applicable building codes. To obtain an Installation Guide or if you have any questions, pleass call (BOO)232.0788 before beginning product installation. BC CALC®, BC FRAMERO, SCIO, SC RIM. BOARD^"; BC OSS RIM - BOARDT", BOISE GLULAM^', VERSA-L4M®, VERSA -RIMS, VERSA -RIM PLUS0, VERSA-STRANDTM, VERSASTUDO, ALLJCIST-and AJSTM are trademarks of Boise Cascade Corporation, Page 1 of 1 Total Horizontal Length-19.0&00 I Deaeription Load Type Rif. Start End Type Valuo Tole. our. Standard Load Unf. Area Left o0.00.00 h9-09-00- Live. .. 20-pat... 1Z.0Q-00-1myk, Dead 10 PSI 1ZOO.00. 90% Unt Lin. Left 00-00-00 19416.00 Live 0 plf n1a 90% Dead. Wpif Ma- 90%, Controls SUMM21ry Control Type Value. Moment 21074 ft-Ibs Nag. Moment.._ Oft-lbs.. End Shear 5Wf<xr Total Load Dell. 11317 (0.738") Live Load -Deft. L1588 (0:4"r Max Dell, 0.738" % Aliowabla 49.5% 100% n/a-_ 100%.... .. 24.2% 100% 75.7% 61.5%, 73.8% LadCasa3 Span Location 2 1 - Intsmat 2 1 - Left 2 1 2.... r: 2 1- Rates ' Design meets Code minimum (L240) Total load defection criteria. Design meetaCodo-minimurlr(L/368}Livaleact defleetitxferkeris., Design meet, arbitrary (117IO UM= toad deflection criteria. Minimum bearing length for BO is 1-v2". Maiimum bearing !math W Ell N 1=12'.- Entered/Displayed Horizontal Span Lanath(s) = Clear Span + 112 min. and bearing + 1/2 intemtodipte bearing Connection Disgfam Consult project design professional of record or BOISE technical representative for connection derlgn lioarns7 fnoheswida wiB Insassumad to be a the -top -loaded envy, or equally loaded from each sloe: Bolls are assumed to be Grade 5 ar higher. Member has no side Toads. Connectors are: 112 in, Staggered Through Bait 3-2" b -- 2.1/2" c �7-718" - dc24" "U(2.IJ.t)MI'LLY 5HLL5 No.489 P.4 11Ce CALCM 2W3 QE�It✓K Monday, Al° �pia.R L . L� teuEt.li2.11S 1'L17 DOUbfe 9 3/4" x 11-7/8" VER3A=kAW1031WSP Piwr::me: asap .seC:Js1 Job Name: Address:... Description: City, State, Zip:, Specifier: CuMomar. Designer: Joe Madera Coderepord: IC8O5512: NER 029- Company: SHEPLEY WOOD PRODUCTS Mist BO, 1.314" 923 Ibs LL 745:Ibs OL General Data Load Summary version:.. US Imperial... ID- - De.:;.r,p Member Tine: Joist tion- Loa6Typa--Rc4, Star4.. End. _ T 5 Standard Load UnitArea Left 00.00-00 19-0"0 Livee Numberofspons l Lett Cantilever: No Right Cantilever. No Slope: 0112 Or- Spacing:.... 127. P.epetlUve:. yas Construction Type: Glued Live Load: 40 pet Dead Load: 10 psf Partition Load: 0 psf Duration: 100 Disclosure The completeness and accuracy of the input must be verltiad by anyone! who would rely on the output as evidence of suitability for a particularapplication. The output above Is eased upon building cod&QCCepled design propenles -- and anatysis methods. Installation of BOISE engineered wood Products must beinaccordance with the current Installation Guide and the applicable building Codas.. . To obtain an Installation Guide or if You have any questions, please calf (800)232-0788before beginning product installation. BC CALCA 13C FRAMERZ- SC10- BC RIM BOARDTM BC OSB RIM " BOARD' , BOISE GLULAMTM, .. . VERSA -LAM®, VERSA-RIMO, VERSA -RIM PLUS®, VERSA-STRANOTM . VERSA -STUD®, ALLJOISTta and AJSTM are trademarks of Boise Cascade Corporation. Page.1 of 1 .V--- Unt.Lln: teft. 06-(rz--M 2.. Unf, Lin. Left . - 05-()Z'DO Controls-Surnmary Control Type Value Moment 10513 ft-Ibs Neg. Moment 0 ft-lbe End Shear 1607lbs Total.Load1W,..- 11323(0.Z24")... . Live Load Dag. U,%7 Max Dell. 0.724" Span Y Depth • Tg:7' Dead 1340--W- Live Dead 13 r 10-00 ... Live... Dead Allowable Duration 42.5% 115% We 100% 17.4% 115% 74:2°/r. 60,3% 72.4% Ma 718lbsDl Value-- Cx s- Der - 40 psf 1Z" I= 10 psf 12" 90% 0 pit n1a Go%- 60 plf Na 90% 1-20a ... n1a.._. tT5%, e0 p* nit 90% Load Casa Span Location 3 ... 1 - Internal 3 1 - left 3•._ 1, 3 1 3� 1 r Ueslgn meets Code•minimum L/240}Total lead depseti"er,'teria. Design meets Coda minimum (L/360) Live load deflection criteria. f]es grt meets arbitrary (Y } M entarie-_ Minimum bearing length for Mis 1-1/Z'. Minimum bearing length for 81 is 1-1/Z", > dtered/Displayod Horizontal Span Length(s) - Clear Span + 112 min. end bearing + 1/2 Intsnnadldts beating Connector Manufacturer. Simpson Strong -Tie® Company Inc. Connection Diagram Consuft project design professional of record or BOISE technical representative for connection de:;ign Batts are assumed to-ba-Grade 5 or huller. Member has no side loads. Connecters are.' 1Wn. e-Ja;;eted Through ftt l-a =-2". . b = 2-112' c = 7-7/8" -d�24" - b- --d. C r i E SEE SLEEVING NOTE BELOW PROPOSED 4" SEWER LATERAL S84'27'16"W 38.84' 00 LOT 99 13.230t� S.F. IIFE LOT 98 50.00' PROPOSED` HOUSE OSPREY F = 24.0 GW=14 GRAPHIC SCALE ( IN FEET ) 1 inch = 20 & Mc Z_ • . —PROPOSED WATER SERVICE PROPOSED SEWER MAIN �11-- - - =196.95 R=2 PROPOSED HOUSE EGRET GW_ 24.5 — 14 LOT 100 s' UJ %. ,1�, 45 00' S84'23'45"W 70 L NOTE: ® SEWER LATERAL SHALL BE SLEEVED IN ACCORDANCE WITH TITLE V IF WITHIN 10FT. OF WATER MAIN. A+ri E Unless and ant`I time os the original (red) stcr%, a re:.ponsible Profesatcrn.l cnyinoer, cr Professlor,nl Lend Sarva+-x a+:uewra on this pfon: (.A) no person er persons, inc'ddlrg cny municipai or oth�- Pik;c officials, may rely •;oon the infnr.n^Fcn con FaineJ +,HI .his plan .-em.i thx prop"_+.y cf Hol:nsa PLOT PLAN holmes and mcgrath, inc. d.` OF LOT 99 PREPARED FOR civil engineers and land surveyors ?'SAN es� j v MILL POND VILLAGE 362 gifford street No.4TCS .450 CIVIL IN falmouth, ma. 02540 9p -1 IS7EA�� 11 F`°S/pNAUt YARMOUTH, MA JOB N0: 201197 DRAWN: LMC SCALE: 1 "=20' DATE: 3-23-05 DWG. NO.: A2549 CHECKED:y," APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 OF Y49.tyg (OFFICE USE ONLY) = TOW By 1UTTACNEESE mo MAY 2 006 Fee: $ PERMIT NO.�c-06_13 15- LD DEtlf (PLEASE PRINT IN INK OR Date: D To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. � �/ L L /QJrCri / I ;l f4� -z`- l iU Location (Street & Number /4 �4 627-, JflOwner or Tenant G TelephoneNo. Owner'sAddress A*e,-Wer�e6d Is this this permit in conjunction with a building permit? es QNo (Check Appropriate Box) ^� xs: �t Purpose of Building i / �� Utility Authorization No. Existing Service Amps / Volts OverheadO Undgrd C] No. of Meters New Service � O Amps ZW ✓2l' Volts Overhead Undgrd Or No. of Meters w Number of Feeders and Ampacity ; 3'AA Location and Nature of Proposed electrical Work: Com letion of thefollowing table may be waived b the Inspector o Wires No. of Recessed Fixtures No. of Ceil: Sus . Paddle Fans No. of Tota Transformers KVA No. of Li htin Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above n- SwimmingPool d. md. No. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. o etecnon an Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat um Totals: um er — — Tons — — K — No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Municipal Local ❑ Connection Other No. of Dryers Heating Appliances KW Secutity Systems: No. of Devices or Equilivalent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. H dromassa a Bathtubs y g No. of Motors Total HP Telecommunications Wiring: No. of Devices or uivalent pp.. Attach additional detail iJ desired, or as required by the inspector of Wires. `v INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE nr� BOND OTHERC) (Specify:) U�l C� Apr (Expiration Date) %\iEstimated Value of Electrical Work: �,�Gy (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under th ains and penalties of perjury, that the information on this application is true and complete. RM ].]AME;� .fv� Clt "Ld LIC. NO. censee: Irc— r2 Signature LIC. NO. (If applicabl enter "exempt" in the lic nse n er Im* e,)) Bus. Tel. No.: Address: �� t ry �✓/ 227d �� /�E %�G�� Alt. Tel. No.: �-r OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) owner ❑ owner's agent. Owner/Agent Signature Telephone [Rev. 04/00]