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121 Camp St #101 Building Permits
0 • r-I L WPS - Permit Page 1 of 1 0111, NST7M WPS - Permit Work Order Information Utility Auth/WO #: 01514550 Date: 04/12/2006 Company JESTINA LABRECK Rep: Report By: YAR 121 CAMP ST UNIT101 VILLAGES AT CAMP ST Status: PLAN Service: NEW Type: RES Nature of Work: NEW 100AMP UG TO HANDHOLE (VISABLE) - MILL POND RES DEV - CROSS ST IS BUCK ISLAND RD-1200SQ FT - NO A/C - ELEC RANGE & DRYER - GAS HT & WATER - NO JACUZZI - XFORMER #25-223 - PENDING INSP..... Service Information: There is no Service Information. Permit Information Permit #: E06-926 Meters: 1 Reseal (Y/N): Y Date: 08/25/2006 Inspector: W10060 Description: Search 1 Detail 'Contacts NSTARHomeWPS Logon WPS Help Comments WO Request WPS News Copyright 2003 NSTAR, 800 Boylston Street, Boston MA USA. All rights reserved. Reproduction in whole or in part of any graphics, Images, text or other content at this web site must be granted by NSTAR, Boston, MA, USA. Unauthorized modification of any information stored at this site may result in criminal prosecution. http://www.nstaronline.com/apps/wps/wpspermit.cfm?Page=Permit&Unique= f ts_'2006-0... 8/25/2006 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 4 WWII' JUN 0 6 2006 RM (PLEASE PRINT IN INK OR T To the Inspector of Wires: By this application the work described below Location (Street `&,,Nit Owner or Tenantm Owner's Address E� (OFFICE USE ONLY) By Fee: $��� PERMIT Date: l 10 gives notice of his or her intention to perform the electrical Is this permit in conj ton with a building permit?,,43 Y s ONo (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts OverheadQ New Service 1L�'7 Amps 1'� Volts Overhead[] Number of Feeders and Ampacity��� Location and Nature of Proposed electrical Work: &&6M\3 G Undgrd Q No. of Meters Undgrd No. of Meters Completion ofthe followine table may be waived by the Inspector of hires 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 In SwimmingPool md. rnd. 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. ot Detection an Initiating Devices No. of Ranges No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Num er — — ons — _ — — 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 Equivalent Attach additional detail if 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 "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 BOND OTHER (Specify:) (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Startt:the —OXInsp ctions to be requested 'n a dance ith MEC Rule 10, and upon completion. I certify, undep i s and p t es of etjury, at i fo ton on thi application is true and completeRMN LIC. NO. Wcensee: Signa re LIC. NO. (If applicab "ex �i the license ber line.) Bus. Tel. No.: Address• �L Alt. Tel. No.: OWNER'S INSURANCE WAI R: I am aware that the Lic see do not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one caner owner's agent. Owner/Agent Signature Telephone No. [Rev. 04/00] APPLICATION FOR PERMIT TO DO QUITTING TOWN OF (OFFICE USE ONLY) E D By %zi AUG 17 2006 Fee: $ S PERMIT NO. & --7 — I3 UIL I G DEPT. Date Building sY: Owner'$ _ i/ � AT �A , 5 AT: Location S Name Type of Occupancy F/y1t1 / Ago, New [X Renovation ❑ Replacement ❑ Plans Submitted Yes ❑ No IR N Lu U) tlf U z H N x F Z J Lu }ZZ O cc W m W r w Lu 0 0 w > Q ," Lu > 0 Z Q W J Q 0: F- H } (A m Z O ~ Z W O O F y W x .. 2. 0 W J a F x 0 x 0 0 0 V¢> 0 O SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Installing Company NameUGTS Address i4As E S I� Check One: ❑ Corp. ❑ Partnership — L�7 Firm/Company Business Telephone .50 F-7 3 % c3 IiA N cD- L-� C� Name of Licensed Plumber offer INSURANCE COVERAGE: Check One I have a current liability insurance policy or its substantial equivalent. Yes �No ❑ If you have checked yes, please indicate Uie type of coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check One: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent Q QM a 1 hereby certify that all of the details and information I have submitted Signature o 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 } �S under Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and License Number Chapter 142 of the General Laws. � TYPE LICENSE: orlumber ❑ Gasfitter ❑ Master ILSJourneyman i 0 - Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Permit No. —57` 3 6 Occupancy and Fee Checked ' 00 tsv.111991 Heave blank) - APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WO C All wodcto be performed in ac=d=w with the 1!1ee•&USCtts Eactricat code (MEGA, 527 CUR 1100 (PLEASEPRWT lYDX OR TYPEALL INFORMA77ONJ Date: Z D SFR 0 62� City or Town of: YARMOUrH To the Inspector of Wires. By this application the undersigned gives notice of his or her intention to pelonn ti'ie electrical work des cn below. 3�1� ,MP Bld Location (Street &Number) MILL POND VII�GEr 131 St =� g . Owner or Tenant Gatewood Homes/ Jeff Sollows Telephone No. 508-7789669 Owner's Address .1600 Falmouth Rd. r Suite 25r Centerville, Ma. 0263.2 B this permit in conjunction with a building permit? Yes 0, No ❑ (Check Appropriate Box) purpose of Building single family residence Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meten New Service ,Amps / Volts Overhead ❑ = _ Undgrd ❑ .. No of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Woric Fire Alarm System (low voltage control panel) with backi battery, -'centrally ri. Completion ojthe following table may be ieaivedl •Ly the keector of IYlxs t No. of Recessed Firtnres No. of Ceti.-susp. (Paddle) Fans P10. Or i V LAl Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators _ KVA No. of LightingFiztures Above - Swimming Pool d. .❑ d.- o. orEmergencyl g Batte Units No. of Receptacle Outlets No. of Or'1 Burners FIRRAI ARMS No. of Zones -1— No. of Switches No. of Gas Burners o. o etection.an 7 IultiatlnLr Devices . No. of Ranges No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers B'catTotals: �P , um er. ons No. ofed Detecction/AloertinnDevices 7 No. of Dishwashers Space(AreaHeating KW Local 0 Conn�piou ® Other No. of Dryers .. HeatingApPuances y ecuri ystems: No. of Devices orE uivalent o. of Water KW Heaters o. o o. o Signs BallastsNo. Data Wiring: of Devices orE uivalent No. H ydromassa Bathtubs y ge No. of Motors Total HP ecommunrcahans rang No. of Devices or Equhvilent INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue 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 exblited proof of same to -the permit issuing office. CBE(x ONE: INSURANCE M BONDp OTMM ❑ (Specif):) cptration Estimated Value of Electrical Wodc $ 750.00 (When required by municipal policy.) Wade to Start: Inspections to. be requested in accordance with NIEC Rule 10, and upon completion. Icerlify, under thepaitu and penalties ofperjury, that the information on this application is true and complete FIRM NAME: Baltic Security, Inc LIC. NO.: 117T Licensee: Jonas R Bielkevicius Signature' . LIC. NO.: 499D (j%applievble, truer 'exempt" in the 13raue.nwnke .line Bus. Tel. No.- �08-833-0996 Address: - FO -Box .1609. :5au- s c. r 02563 Alt. Tel. No.- 508-776 T7 OWNER'S INSURANCE WAIVER .1 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 OwnedAgeat PERMIT FEE: $ 40.'00. Stgnatnre. Telephone No. ►°�� of Yg9�o� _ TOWN OF_YARMOUTH pq� l� Buildingd9�� ST AT: Location � -J New /No enovation [IPlans Submitted Yes 0 APPLICATION FOR PERMIT TO DO PLUMBING y (OFFICE USE ONLY) By jX k� - Fee: $ 9 c 1 t +L- c3bao PERMIT NO. r-0i,— Date20 tV Owner's1- Name Type of Occupancy % Replacement ❑ fIP -ad �(�l3 Z Z OCaa CoCoZ � 9 = ''y Z = O ZQ yQ Z¢°OOw a0 OX: Lr W d LL nZ. O M w w ¢2 N w y �Zo a LL0 °ILa°°a u O �d IL O w u-Z U. ww o 5 a aj O 7 C o W m 0 H N LL Q SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINTORTYPE) Installing Company Name t Check One: ❑ Corp. Address � �� d ❑ Partnership irm/Company Business Telephone Name of Licensed Plumberz5zw wll �� (�� INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes 0 No ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. C Signature of Owneror Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Type Master❑ Journeyman L =196.95 L_71.51 LOT 100 32.0 EXISTING FOUNDATION 19.000 �- C LOT 101 EXISTING FOUNDATION o� Fie I CERTIFY THAT THE FOUNDATION IS LOCATED IN FLOOD PLAIN ZONE C AS SHOWN ON FLOOD INSURANCE RATE MAP COMMUNITY PANEL NO. 250015 0005D AND THAT FLOOD PLAIN ZONE C IS NOT A SPECIAL FLOOD HAZARD AR 1,7e4274; Fo✓5' .01, DATE REGISTERED PROFESSIONAL NOTICE SURVEYOR Unless and until such time ashe 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 (8) this plan remains the property of Holmes dt McGrath, Inc EwsTIF FOUND/ ryy. LOT 102 llr I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE LOT AS SHOWN, AND THAT ITS LOCATION CONFORMS TO THE MINIMUM SETBACK REQUIREMENTS OF THE 408 SPECIAL PERMIT. /z6.Z774% DATE REGISTERED PROFESSIONAL LAND SURVEYOR GRAPHIC SCALE 1 inch = 20 ft A —B ILT101AN holmes and mcgrath, inc. civil engineers and land surveyorsT�L�y of a�gssgc�, PREPARED FOR ``' eJlcKAZEL y MILL POND VILLAGE 362 gifford street. a IN falmouth, ma. 02540 b t�ecq�T� y n 5:0. YARMOUTH, MA Job No: 201197 DRAWN: LMC SCALE: 1 "=20' DATE:12-27-0 DWG. NO.: A2547A CHECKEDeOL "a I] of r TOWN OFYARMOUTH Building Department BUILDING - - - - - - - - , (508) 398-2231 ext.261 PERMIT _/29/20B-06-445_PERMIT ISSUE DATE ; _ 9/29/2005 - ; PROPOSED USE -------- APPLICANT _Fran Capra______________________' JOB WEATHER CARD PERMIT TO ; New Construction ' IAT (LOCATION f 00121CAMP ST Unit 101 ZONING DISTRIC 2 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C101 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE CONTRACTOR new construction: 2 baths, 3 bedrooms, 1 kitchen, 1 laundryroom, 1 livingroom as per plans LICENSE 012430 REMARKS dated 08/29105. Capra, Frank AREA SO 1600 Falmouth Road #25 ( � EST COST ($ $117,024.00 PERMIT FEE ($) $427.00 OWNER Villages 0 Camp Street, LLC Centerville MA 02632 B LDING DEFT BY 5087789669 ADDRESS 11600 Falmouth Road # 25 l Certificate Issue Date _ �.��./L�r>�.0 `_tz.:57.0 0S- „- . --- _-. -- - ., - •-- - --- - -CERTIFICATE;of ;OCCUPANCY; Departmental Approval for Certificate of Occupancy and Compliance mspecior Date Permit Number Annrnvarl Rv DamaAL. a BUILDING ELECTRICAL lull I, ENGINEERING HEALTH ,� ,. I►. .�1r To be filled in by each division indicated hereon upon completion of its final inspection. OF t. TOWN OF YARMOUTH Building Department BUILDING ` _ _ _ - _ _ _ _ _ _ , (508) 398-2231 ext.261 PERMIT NO B-06-445 _ PERMIT ISSUE DATE ; - 9/29/2005 _ ; PROPOSED USE . ; APPLICANT Fran Capra --------------------- (j JOB WEATHER CARD PERMIT TO ' New Construction ' AT (LOCATION) 100121CAMPSTUnii101 ZONING DISTRIC R•2 Bldg. Type: lResidential SUBDIVISION MAP LOT BLOCK 044.21.1.C101 I BUILDING IS TO BE: CONST TYPE 5•B USE GROUP R-4 LOT SIZE new construction: 2 baths, 3 bedrooms, 1 kitchen, 1 laundryroom, 1 livingroom as per plans REMARKS dated =29/05. AREA (SQ FT) EST COST ($ 1$117,024.00 PERMIT FEE ($) 1$427.00 OWNER Villages 0 Camp Street, LLC BUILDING DEPT BY ADDRESS 1600 Falmouth Road # 25 Centerville I MA 102632 INSPECTION RECORD CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 FIELD COPY �.Note Progress.- WMAN = — � r ONE & TWO FAMILY ONLY - BUILDING PERMIT $ n: [ APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING O — y Town of Yarmouth Building Department —MA ^«C. " 1146 Route 28 • Yarmouth, MA 02664-4492 Tel: (508) 398-2231 x261 • Fax: (508) 398-0836 ice Use Only Planning Boartf Tnformation Assessors Department Information Permit No.orsD Pe z ' Map Lot a LaY i mentDate Permit Fee $ _ New cording Date. �. pz a Dimensions 'Deposit Rec'd ,. $ U pates � 1 4 Property, �r Net Due r" er lot 4reajsf) Faontage (ft) :� klot Coverage - This Section -for Office Use Anl - ` c r N Buildln 'Pe ' it frT r.'. Date Issued ' _� Signature "' - . •_ Bui ding Official " =Date Certificate of Occupancy x is is fiot ` _ required __. _. Section 1;=:Site lnformation" Use Group: R-4 Type: 5-13 1.1 Property Address: 121 G4-�P 5-tr � � 1.2 Zoning Information: T�si Zoning District Proposed Use 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Require r vo ided Required Provided 1.4 Water Supply (M.G.L. c. 40. S 54) Public Private 1.5 Flood Zon ,'fo pJr7 Q - Q5 C mments r ;•Zone., FE, Sectio2'-ropey Ownrsip/Athoriedgen :J �r of Record: 44(" ®C/ Mailin Addres Name (print) ���/ s �7r7�1d� 78 - G Signature Telephone 2.2 AuthorizgdJAgent: Mailing Address�� N"� ���Vl � 7 7 Signature Telephone Section 3-" Construction SerVices' 3.1 Licensed Construction Supervisor: AUG 1 s 2 0 Not Applicable ❑ License Number 0 Expiration Date y ©p L� Signature Telephone 3.2 Registered'Homeamprovement Contractor.:' Company Name OC Not Applicable Address License Number Signature Telephone Expiration Date 9 - 15 - 99 1 of 2 OVER 7 jd/ tw 'Section 4 =,Workers' Compensation"Insurance Affidavit (M.G-t-: c:15215 25C (6) 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 5'-,Description of Proposed Work' check,all applicable) New Construction No. of Bedrooms No. of Bathrooms y Existing Bldg. ❑ Repair(s) ❑ Alterations ❑ Addition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: Sectf6n76,,=Estim6ted: Construction Costs' Item Estimated Cost (Dollars) to be completed by permit applicant Check Below ❑ Conservation -Commission Filing (if applicable) . ❑ Old Kings Highway & Historical Commission approval (if applicable) 1. Building VDU 2. Electrical S 3. Plumbing / Gas Qe-e—d' 4. Mechanical (HVAC) Q 5. Fire Protection � � 6.Total=(1+2+3+4+5) 7. Total Square Ft. (new houses&additions) Section 7a - OwnerA.uthonzatioh Owner's Agenf or Contractor Ap' 1e' To"be'Compteted When' or;;Building "Permit--' 1 .P—Cl�� as owner of the subject property hereby authorize %` J�`�'� to act on my behalf, in all m rs rela ' e to w rk authorized by this building permit application. Sig tur of wne Date Section 7b'_ Owner/Authorized Agent Declaration'' 1�f j,�jt� ��,��� , 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. m Prin ae Sig a of O ner/ gent Date 9-15-99 2of2 k o. PLEASE PRINT: job Location: _ 1uWI Ut YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM Owner of Property: Construction Supervisor: Address: Licensed Designee: (If other than Supervisor) Street /�"Village - A-l' L.OeLnp c IF Name License No. Phone No. Name 2.15 Responsibility of each license holder: License No. 2.15.1 The license holder shall be fully and completely responsible for all work for which he is supervising. He shall be responsible for seeing that all work is done pursuant to the state building code and the drawings as approved by the building official. 2.15.2 The license holder shall be responsible to supervise the construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of building and structures onlypursuant 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, 2.15.2 or 2.15.3 or any other section of these rules and regulations and any procedures, as amended, shall be subject to revocation or suspension of license by the board. 2.16 All building permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise those persons engaged in construction, reconstruction, alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and these rules and regulations. In the event that such licensee is no longer supervising said persons, the work shall immediately cease until a successor license holder is substituted on the records of the building department. 2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may be deemed a violation of the permit conditions. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with section 109.1.1 of the state building code. I understand the construction inspection procedures and the specific inspection as called for by the building official. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes Er No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy 31-� Other type of indemnity ❑ Bond ❑ OWNER'S INSUPANCE WA VER: I aware that the licensee does not have the insurance coverage required by Chapte otass. a] s, and that my signature on this permit application waives this requirement. Zr Check one: Signature of Mner or Owner's -Agent(/ Owner ❑ Agent ❑ Signature: Building Official Approval: G. =Ml The Commonwealth of Massachusetts Department of Industrial Accidents Of/lee011n 12fisss 600 Washington Street Boston, Mass 02111 Workers' Compensation Insurance Affidavit IA,e cit, (pt��ervQllk-7$���O� O I am a homeowner pertormin, all work myself. phone e O Lam a sole proprietor z-d ha%e no one corking in any capacity O 1 am .an employer pro, idino workers' compensation for my employees working on this job. comizan na addres : •t .. k• ins ur. n i !J am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below who ha,e the following ,corker' compensation o►ices; ciny: nhnn. q in urnn e m an n e• address• i►� a a� Failure to secure coverage as required underSeenon 25A of MGL 152 can Ind to the tm ooe yeah' imprisonment t m as well as elvil penalt(ea in the form of a STOP WORK ORDER and a fine ofSI00m day against mMail'" Of R fisc e- to I nader and'tbat a00 rt COPY of this statement may be forwarded to the OMce of investigations of the DIA for.eoverage verifiesdoa. 1 do •herehy certifj t er the pinta a Ifies o%perjury that the information provided above is cue and correct SignatureO- Print name -t7L-v,, 1� Gl fps lone I! official use only do not %rite in this area to be completed by city or town oftieial city or town: YARMOM .permit/licenae N _ nBuilding Department ❑ check if immediate response is required QLieensing Board 261 C]Selectmen's Office contact person: phone p: _ (508) 398�2231 eat, ❑Health Department -- — nOther t. of 'Yak j[ TOWN OF YARMOUTH O 1146ROUTE28 SOUTHYARMOUTFI H NATTACHEES �4 MASSACHUSETTS026644451 `^+ro.,to•� 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 the proposed work/demolition to be conducted at 1; 1 Si±- WorkAdAress is to be disposed of at the following location: n O U!l'i'l 4�—' Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Signature of Applicant Permit No. Date ti V GMS9/GCS9. SERIES 93% AFUE Multi-Tosrtionj- Single-Stage/Multi-Speed-. . Gas Furnace-. Heating Capacity;_. 46,000-115,000 BTUH OR •HIV Standard Features • Corrosion -resistant, aluminized -steel tubular heat exchanger and stainless -steel recuperative coil for maximum efficiency • Designed for multi -position insraltition--GMS9:' upflow, horizontal right or left; GCS9: downflow, horizontal right or left • Encrgy-saving, reliable Hot Surface Ignition system, featuring a Norton* Mini•lgrtiter.with patented adaptive learning algorithm to maximize igniter life • Aluminized -steel inshot burners • Enetgy-saving PSC; iriult3=speed-, direct drive blower motor • Quiet. corrosion•resistant induced -draft blower assembly • Integrated furnace control _with improved diagnostics • Low voltage terminal blocks • Multiple flame toll -out switches, blower door safety switch, outlet air limit switch and pressure switch for proof of combustion air • 40VA transformer for heating and air conditioning control service Combination redundant gas valve and regulator • Top venting -is standard; alterrtat& uelvenrlocated- on right side Completely. assemhled.factoqurun-tested ftunace.for.. heating or combination heating/cooling application All models comply with California NOx Standards • Suitable for direct vent (2•pipe) or non -direct vent (1•pipe) applications air-CanditiarriW& tteat'rrrg-, The GMS9/GCS9 single -stage, multi:speed--gas furrraces offer- ins taktion.versatility, . CabinerCanstractiotr • Heavy -gauge. reinforced. fully insulated steel cabinet with dterable baked enamel finish • Attractive architectural gray paint finish • Foil -face insulation -lined heat exchanger compartment • Coil and furnace fit flush for easy installation • Convenient left or right connection for gas and electric service • Bottom or side air inlet (GMS9) • Removable; solid-bortom block -off (GM59), Accessoriis' • L.P. Conversion Kit (LPT--OOA) --L-P-Gas Low PressumKit- (LPLP01) • High Altitude Natural Gas/L.F Kits (HANOI 1. HANGt2, HALP10) • High Altitude Pressure Switch Kit (HAPS27) • ExtemalFiltu..Rack (EFRO1) • Horizontal Concentric Vent Kit (HCVK) • VerticalCGnmatric Vent -Kit (VCVK)... • Internal Filter Retention Kit—upflow, horizontal (RF000180)..... • Internal Filter Retention Kit—downflow • Thermostats Blower Motors (CHTI8.60, CH70TG, CHSATG, H20TWR) SS-3770 W� Evudmanmfs tom 704 PRQDUQT SPECIFICATIONS Nomenclature G M S 8 070 3 A NJ'FA Goodman® Brand I w Ir"tion �1"Orj=tg - I -.. Air flow Irectson Natural Gas C: Z"° Revision Ak Upflowl"orlzontg...... i LowNOx D: Dedicated Downflow E Downflow Dowriftow/Horizontat low r7MGn;t!fidth W. HtAir Flow A; 14 - 17�" Description8' -21_.. . _ C S: Single Stage/Multi-speed D: 24$V V: Two Stage/Variable-speed Ar 8. 411,600 9: aLl 1 5: 2.000 045'. 45,000 070; 70,000 090: 90,000 115:11s,000- 140:140,000 L PRODUCT SPECIFICATIONS GCS9 Dimensions LE EaaiE .. Rtetrt nDE FWMEENW - wrw w scat _. ief � IRfilvrw AiR) Ya nOrs rLpvc. r lne DRANIRCONDENSATE DRAWTM► •- r w awpvc T IOw VOIiaOF ELECTwCAI Coto mcwRor.... ... . -. .,..... a poc*ir OR NOW VOLTAGAV to.? slm) ELECT111M »YLr TER»AT l_ IOGATgx 2 rani • 4TERNATe ....... to>M ... • ..... AN aOAtw.aOCAi1O11 I o Vrs Nw. =� nUre . .. '. • -CRaim tauwt AWL" ...� a O stA� NrcwRaEA»t rR ill0 ,,J wtlE! f (a rat r �L*eR"ATE a^t o�OtaaMiC' . GCS90453BXA 16" 11'ri' - 16" GCS90703BXA 7IN" 17Ys" 16'.'.... ... 716" _.. i4H»...... .. .. .. GCS90904CtA IY 19Yt" 18" 19Yr"GCS9115SDXA Mt C. 24%" Z3`._. Z1rh" 23" 1. Inuallu must supply one or two PVC pipes: one for combustim a(F(uptinaa)) andpte {ortheyot oudec (requited): Vent pipe .oust be tither 2" or 3" in diameter. Depending upon furnace input; numbtrof elbows, length of run and'instalistion (1 or 2 pipes). The optional Combustion Air Pipe is dependent on installationkode requoliments and must be 2" of 3" diameter PVC. Z. Lint volggc wiring can enter through the -right or lefrWc-of-the forme: Cow voltage wiring can enter through the right pr left side of furnace. 3. Conversion kits for h%h altitude natural gas operation an available Contact your Goodman duaibutor or dealer fin dctails. 4. (nsn!!e[ must supply (ollowing fires line frttiags, according to which entranceia used: Left —Two 904 elbows, one time nipple; streight pipe Right-4trxight pipe to mach gas valve Minimum Clearances to Combustible Materials C R• Combustible: If placed on combustible flan, the Boor MUST be wood ONLY. NC - Non•Combusuble: A combustible floor subbase moat be used fur installation on combustible Roofing NOTES: • For servicing or cleaning, a 36" front clearance is recommended. • Unit connections (electrical. Rue and drain) may necessitate gceamr cleorameadno.d aminimutwel re,".ces listed below • In all Corset, accessibility clearance must take precedence over clearances from the mdoeuee where acceaerbility clelwam" an greater. 5 .PRODUCT SPECIFICATIOMS Blower Performance Specifications 'Fee 1'. n t 1 '-'}!F •1 ,• 11352 -•••• 1,318 _• •• T,26A •... 1,202 •••--• HIGH 3.0 G_S904538XA MED 2.5 1,214 •••••. 1,172 •• --• 1,123 ••• 1,064 ...... (LOW) MED-LO 2.0 997 •---•- 994 ...... 960 35 923 36 LOW.. 1.5.. ..757 • .• 44-...753- 44-. 734 45 - 704- -'47' HIGH 3.0 1,449 36 1,409 37 1,326 39 1,273 41 G 590703BXA MED 2.5 1,t92 al 1 172 44 1,u1 45 1,094 47 �': :: �; ii '' (MED-HI) " MED'-LO 2.0 -981 ' 53' 962 54 943 . 55 917 56 3 i;..., ` ' LOW 1.5 1 750 •-•--- 1 730 •...•. 7M ...... 692 •• •-- ::` j a ' . HIGH. _ 4.0• • 1,970 1,474- •-35 1,757 -35- 1166T 40-- G_590904CXA MED 1.5 1,713 39 1,650 40 1,572 42 1,510 44 (MED-LO) MED•LO 3.0 1,439 46 1,412 47 1,370 48 1,327 50 .j '6.,. ,.A LOW-. " 2'.5 1 T83 ' 56 - 1"15S -.5T- 1 'tn2 597' 1 109 `60 a HIGH 5.0 2,134 40 2,103 40 2,029 42 1 1,941 44 G_591155DXA ,MED 4.0 1,¢78. ,.51. 1.,643 _ 52. 1 643 .52. 1.,577 ..54.. (MED-MI) MED-1-0 3.5 1,453 58 1,440 59 11426 59 1,363 62 . LOW ..3.0....1 254 ..67. .1 274 _68_ 220 -.70 t i8t -•••-- ` A{tAtl f NOTES! I. CFM in chart is withuuc fdtcr(s). Filters do 1111t slup.wich this fumace. huc mtu[.bu.pruvided..hy the inicethw If she furnace requires own-rer Cns. this chart assumes both filters cue Installed. - _1 2. All hltnaces ship as high speed conling. lrwAltr moat adjxnt blowtr clr,ling speed as needed. .3. For roue( jobs. 3Mvr 400 CFM per tun when cmiling is desirable. 4. INSTALLATION IS To 7 BE ADJUSTED TO OBTAIN TEMPERATURF. RISE WITHIN'I•HE RANGE SPECIFIED ON THE RATINO PLATE. 5. The chart in fur Information only. For sacis(acrory operatitn, external static premvre n+vst tint "teed value shown on Ihu .;Icing plow The shaded area indicates ranirty in excess of maximum static pa-ssare allowed when heating. 6. The dashed (•••-) areas indicate a tentperanitetix nut mcumnrended fr+rt 'b-mr+del—. 7. The above chiut is fix U.S. furrinces installed at 0' • 2.000'. At higher altitudes. a proptrly de•roted unit will have appnrxiosuttly the same temperature rut at n port(cular CFM,. while ESP at dse CFM willbe.4twer...... _ ` J PRODUCT SPECIFICATIONS Accessories LPT-00A L.P. Conversion Kit ,r I ♦ LPLPOi L.P. Gas Low Pressure Kit r ♦ f HANG11 High Altitude Natural Gas Kit 1 1 1 1 HANG12 High Altitude Natural Gas Kit 2 2 2 2 HALP10 HighAltltudeL.P.Gas Kit .. 3.. _.. ...._. 3..... .....1.... _. ..3�. HAPS27 114ish Altitude Pressure Switch Kit 3 3 3 3 ..FFRgt.. External Fllter.Rack...... _...... i....... ..... .i ...._ 1..... - .�._- DCVK40 Horizontal/vertical Concentric Vent Kit (2") DCVK•30 Horizontal /VerticalConcentrteVenCittC(Y)- 1• • tivviat+ie ttm mu ousel (1) 9,001to R000' (2) 9,001'r11,000' (3) 7,001' to 1 L000' Note: A➢ installations above 7,000' tequire a preasurc switch change.: Ftm utstatlatiorrin Canada, furnaces are certified only to 4,500'. Do -inflow floor Base: When the C<,;9 maiel is installed directly oi, a wood floor, a downfl" flax base muscle used. TljtkO modal tusmbet&' ace CFBi 7, CFB2t anJ CFB24. Thermostats CHT18-60 Cooling/Heating, Mechanical CH70TG Cooting/Heating, Digital, Non•programmable CHSATG • .. Coot / fn4 Heatirfg,-Mectrarsical.. H20TWR Heating Only, Mechanical 7 c7z- "O�omvmasxu�eafliti o�,,.!�%aoaF/eaaell3 Bt7ARD•.OF BUILDING REGULATIONS >R Licensez. CONSTRUCTION SUPERVISOR Nufnbee ,ES 01.243U- Birtfid"al-'M_ �4 Exp[resr Off i'Tr. no: 25926 M. . Restcieteda�;�: FRAMED CAPRA t 40-COPPER LNt CENTEMALLE- !utA 02632� /s commissioner 00-35;00adendosedspace - -- (MGLC-1-42SfiOL) - - - tA- Wodomy otrlg ' ' - �! fG'=:4 �ZFamyrHomes - Failure to*sseWaICU-rienteditian of the : Massac6iusetttSW BulCfng'Code: is cause::idrmvocaliana m-ricense. -F i t. DIG SRFE:CALL CENTER: (888) 344-7.233 •L A *,ACORD , CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) 07/19/2005 PRODUCER (508) 790-1919 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 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 INSURERA:F1rst Financial Insurance Filho, Antonio DBA BR ROOFING INSURERS: Po BOX 1231 INSURER C: 136 Stevens st INSURER D: Fvannic MA 02601— INSURERS rnllFRAnFC THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOU IINUIOA I tU. NU IVVI Ina I NLJIN� ran r REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR A ADO'L INSRD TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMSMADE F—JOCCUR POLICY NUMBER ' 491FOO2639 POLICY EFFECTIVE DATE (MM/DD/YY) / / _ 06/21/2005 POLICY EXPIRATION DATE (MM/DD/YY) / / 06/21/2006 LIMITS EACH OCCURRENCE S 1,000,000 DAMAX PREMISES RENTED PREMISES Ea occurrence) S 100,000 MEDEXP(Any one pemn) 5 5,000 PERSONAL& ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000,000 PRO. POLICY JECT LOC AUTOMOBILE LIABILITY / / / / COMBINED SINGLE LIMIT (Ea accident) S ANY AUTO BODILYINJURY (Per person) S ALL OWNED AUTOS . / / / / SCHEDULED AUTOS BODILY INJURY (Per accident) S - HIRED AUTOS / / / / NON -OWNED AUTOS PROPERTY DAMAGE (Per acciderd) S •- / / / / GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC AUTO ONLY: - AGG 5 ANY AUTO / / / / S EXCESSIUMBRELLA LIABILITY / / / / EACH OCCURRENCE S AGGREGATE S OCCUR .� CLAIMS MADE S $ DEDUCTIBLE / / / / RETENTION S WORKERS COMPENSATION AND - / / / / STATU- TORY LIMITS OER E.L. EACH ACCIDENT S EMPLOYERS' LIABILITY ANY PROPRIEfOR/PARTNER/D(ECUTIVE OFFICER)NEMBER EXCLUDED? / / / / E.L. DISEASE- EA EMPLOYEd S E.L. OISEASE- POUCY LIMIT S If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS SIDING AND ROOFING. CERTIFICATE HOLDER UANOtLLA IIUN ( ) - (508) 778-5603 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT GATEWOOD HOMES FAILURE TO DO SO SHALL IMPO O OBLIGATION OR LIABILITY OF ANY KIND UPON THE 1600 FALMOUTH RD SUITE 25 INSURER ITS AGENTS OR REP SENTATNES. CENTERVI ACORD 25 (2001108) q INS025 plos).as AUTHORIZED MA 02632- ELECTRONIC LASER FORMS, INC. - © ACORD CORPORATION 1981 Page 1 d: MASSACHUSETTS ASSIGNED RISK POOL REQUEST FOR CERTIFICATE OF INSURANCE li,se this form to request a Certificate of Insurance from an Assigned Risk Pool Carrier. M1 Please provide all of the requested information, including the facsimile numbr,ss) of the person or persons to whom he Certificate of Insurance should be issued. If this form is fully and accurelvUij comipleted, the Certificate of Insurance will be issued and distributed by facsimile to each fax number provided below, uitf t; two (2) business days of the carries receipt. This Form may be mailed or faxed to the Assigned Risk Pool Carrier. To obtain each catrier's c-.ntact information refer to the Certificates of Insurance section located in the Producer Coarr rrr y section of the Bureau's web,i;e (w ^w. wcribma.cro). 1: Name, address, tel phone numberand facsimil number of the INSUR,51b: Name: —_ � �� 1� 666I -AWMailing Address: Physic! Address:_ Pho -- — ---- Fax: — — --- j 2. ame, adoress, telephone number and dcsimile number of the CEP,TIFICATE HOLDER: 7 Name: ✓��_ _—_. _ Mailing Address: L� _ _`y % 7 r26 CG— /C. F t± '�_ " Physical Address: Phone: Fax: 3. Name, address, contact person, telephone number and facsimile number of the PRODUCER: Name: Sani1cer Insurance ACteRcyy inc. MailinoAddress: 12 Enterprise Road Hyannis, PEA 02601 � M1 Contact Person: -j.ri G -r , n.=-e� 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 be en issued, you must attach a copy of the Notice of Assignment. Policy Number: 1/V tfC�_�t� Effective Date: —_=�__ Expiration Date: 5. List any special requests for optional coverages / 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: 5/5/2005 Time: 3:02 PM To: @ 15087785603 Page: 002-003 Client" 24359 CAPECOOREADY PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Feitelhe.T Company- 222 Milliken Blvd. - CN-Y AND CONFERS NO P.IGHTS UPONTV. ECERTIRCATE HOLDER: THIS C€RTUPICATEDOES NOTAMEND;EXT€ OR- ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Boer 3220 Fall River, MA 02722 INSURERS AFFORDING COVERAGE NAIC it INSURED INSURER A: Acadia Insurance Companies Cape Cod Ready.:"ix Inc- ;NSURER B: Construction Industries Compensation PO Box 32S Orleans, M : 02553 INSURER a INSURER D- INSURER E: ' COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSU ED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING - ANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACTOR OTHER DOCUMENTWITH-RESPECTTO WHICH THIS CERTIFICATE MAY BE fSSUE'OR- MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.- LTR NSR TYPEOFINSURANCE POLICYNUMBER DATErfMEMIDDIMFFECTIV DATE (MM/QOrfY) POLICYEXPIRATION LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE .O O(-=R CPA01324681-0- 01-/017/05'. - 01"/m/ce- _ _ EACH OCCURRENCE - Si 000 ODO FApMAGE GO REi TEED 5100 000 MED EXP Any me Pason) S5 000 FERSONAL 8 ADV INJURY $1 000 D00 GENEPALAGO EGATEE S2 D00000 GEMLAGGAEGATE POLICY LIMIT APPLIES PER LCC rgxUCTS- COMPiOP AGG E2000000 A AUTOMOBILE_UABIUTY .ANY AUTO ALL OWNED AUTO' SCHEDULED AUTOS HIREDAUTOS NON-CWNEDAL'TOS - MAA013246310 01/01/05 01101/06 COMBINED SINGLE OMIT (Ea acacerrtj 11100(—nm " BODILY IN:AIRV S X X BODILY INJJRY - (Pg acd--Gm7 $ X PROPERTY DAMAGE - �, am t7 S GARAGE LIABILITY ANY AUTO AUTO ONLY • EA ACODENT S OTHER THAN EA A� AUTO ONLY: AGG S ' S A 'UM&iELLALIABILITY CGCAIMS MADE TENTION S 0 CUA013247010 01/01/OS 01/01/0^u EEACHOCOJRPENt~ 00 Si 0000 AGGREGATE S NXDI SOEOUCTILt:S i B WORKERS COMPENSATION AND EMPLQYEFI�% UA31>JJ1-I- - ANY PRCFR)ETCRZ/PARTNEP/EXECUTIVE OFFiCERIMEMSER EXCLUDED" If yes Cesmba wdw cPE-AL PROVSIONS bdI- WC0009255 01/01/i6 01/01,06 .X -WOY rATU• 01p4• _ E.L. EACH ACCIDENT S500 000' E.L. DISEASE - EA EMPLOYEE 5500000 El. DISEASE. PD!1 YLIMIT 5500 Ott OTHER DESCRIPTION OF OPERATIONS / L ocAnoNs tVEHICLES (EXCL SIONS ADDED BFENDORSE,TE Wj SPEC= PROVISIONS Gatewood Homes Inc. 1600 Falmouth Road Suite 25 Centerville, MA 02632 LO ANY OFTHE ABOVE DESCRIBED POUOES SE CANCELLED BEFORE THE EXPIRATION THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL *A DAYS WRITTEN :E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL :E NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR I OT Z 9568995/M66526 AH1' I) ACORD CORPORATION 1988 Q5/06/2005 09:38 5084204474 EDWARD A GRAZUL PAGE 02 OATEIMMlCOMfYV! A ..ORD, - CERTIFICATE OF UABUTY. IRSURANCE.. rACDucER THIS CERTIFICATE IS ISSUED AS A CLATTER Of lNFORIUTATIOP ONLY AND .CONFERS NO RIGHTS UPON THE CERTIFICAT: Ed,ard A. Cmnll.Iruxa= Aga Y, Itc• HOLDER. THIS CERTIFICATE PCEBOEND;-EXN1 F:0 ffi3�/' ALTER EAA6E A FOD THE BELOW Martcms M11iS, VA 02543 iN&URERS AFFORDINr=VI_RAGE NAIL # I INSURERG,.-Shcil_CasLa1>:y.Irs•- INSURED _ s Childs wSunEA 9,- - 145 Cam�tt NsuAEae_ Marstais Mills, q4 C�18 NSUREF D• 1 ws(iF=A c COVERAGES THE POLICIES-OF:INSURANCE LI$TE[r.OELOWNAVEr2SEN ISSUED TO THE INSURED OR OTHER NAMED ABOVE DOCUMENT WITH FOR THE POLICY RESPECTTOWHtCH PERIOD INDICATED.NOTWITHSTANDING THIS CIERTIRCATEM" BE ISSUED <M-. ANY REQUIREMENT, TERM, OR CONDITION THE'INSUIiANGE.AFFOFIDED OF ANY CONTRACT 8Y THE POLIGIES,OCZCR18EONEREIN IS SUBJECT TO ALL THe TERMS. 0CLUSIONS At' CONOFTIC IS OF SUCH MAY PERTAIN, POLICIES: AOOREGATF—LIWTS SHOLVN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I NUL79EA IOU �Y EFTECTIVE POLICYESoIQ'ATION — U"TS lN9fl'y1 SUAbU;E L1ABOF IN POUDT I EACH OCCURRENCE I �yy, S1, GEHfAAl .... 'DtET6REATEA. PREMISES(EayN_WenC8) S COMMERCIALGENFRALLIASR7TY I I . MC-D€XR (Agsn60erPunL + �.IJ,IwJ.J�_ I CLAIMS MACE OC.—UR IY PERONAblABG ENEMA Rfi-�2-�o ai A '`LO� �eeryAe: dt� _ M- il GEN AGGAEOATEUM TAPlES PEFi• GADRV€DINA.TUET PRODJCTs-COMPCPAO; .. POLICY vEPT i� AUTOMOBILE LIASILTTY I - Ill CONHWEDSINOLFUMIT (EP PCddPM) _, ANvnJTD 1 ALL OWNED AUTOS I �8OOJLYINJURY S F E � HIRED AUTOS HIRED AUTOS � I .^,ODB.Y INJURY .. x I ���---------!�� NON-OWNEDAUT113 ri• I PROFErTYOAMAGt S lPxecGdenq I AUTOONLY-FAACC:DENT i i GARADELIABILITY S -- ANY AUTO I I AC OrAERTHA A00iS EXCF33d7TA9RELL4 UROM1I.TY EACHOCCURRENCI � —+— S AOGREG �ATE C=Jrr - L7 CLANS MADE I ?< I� OECUC7IELE I �. 1- RETENTION I WO&TATU: - OTH-I T^,RYL 11- S WORIfEASCOMNffATIONAND... PE .ERL„ c'MPLOYERTLIAMUTY E.L'cAC%IACCIDEM { ANY OF.FtCEMMEMBER PROPWrTOA/PARTNErv:XECUT[W - F.XCLUOED? ( - E:L. DISEASE- ER EMPI.OYS H VeA.0 IcAEe VAtler I E.L. DISEASE-v,UOY UZES SPECIAL PROVISIOnstw� _ (I OTHER r I f DESCRIPTION OF OPERATIONS I LOCATIONSIVEHICLES IEXCLIISIONS ADDED BY ENDORSEMEMlSPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION --- SHOULD ANV OF THE ABOVEDESCAIBED POLICIEP, eC 9ANCELLED DBFDRE SHE ZXPIRAMON Gae Wccd Ih=s5Im DATE Ri ZQ0 . THE ISDViNG-WSUAEA WALL ENDEAVOR TO MAIL RATS WRITTEN c/o E�,AdpL.LaAei U1 � NOTICL• Tc THE CER'URCATE HOLDER NAMED TO THE LEFT. aUT FA4.URX TO DO SO SHALL L Rte - .. IMPOSE 400-cm GATION.Oa .UAWLrrY. OF. ANY. WNC.UPON THE :N fCR?AGElFTfr9A-- antt€j^ti ille, -1%A C.26.3 REPAE9ENYATIVES. FAX:. 1508-7/8 --%M AUTAOPRED AEPRESENTATIVC ACORQ25(YOOTic13� 0ACOR"ORPORATtO4.1888 •, CERTIFICATE OF INSURANCE ISSUE DATE(MM,°D/YY) 05/06/2005 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Harold H Williams Ins Agcy Inc CONFERS NO RIGIITS 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 COMPANY A.I.K. Mutual Insurance Co A 145 Cammett Road LETTER Marstbns Mills, MA 02648 i V I i i I COVERAGES 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 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. CO TYPE OF INSURANCE LTRI POLICY NL:•SBER I POWCY EFFECTIVE POLICY E:CPIRATIO LIMITS DATE(MM/DD/YY) DATE(MM/DD/YY) I ,GENERAL LLUSILITY - I iGENERAL AGGREGATE S !PRODUCTS-COMP/OP AGG. I <_ 1 COMMERCIAL GENERAL LIABILITY I I CLAIMS MADEE:]DCCUR - !PERSONAL do ADV. INJURY I S OWNER'S $ CONTRACTOR'S PROT. EACH OCCURRENCE S I (FIRE DAMAGE (Any ore tire) S —J MED. EXPENSE (Any oneperson) E AU romOISILE LIABILITY � InNY AUTO COMBINED SINGLE i S LIMIT ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) S HIRED AUTOS BODILY BODILY INJURY I S I NON OWNED AUTOS 1 _ Per INJ I GARAGE LIABILITY . i ' (PROPERTY DAMAGE i S 'ISXCL•'SS LL\Ii11,ITY FORM 1EACH OCCURRENCE $ AGGREGATE S ,___'6113RELLA Dl'IiLR THAN UMBRELLA FORM iWORKER'S COMPENSATION AND X wCSTATUTGRYj OTHER EMPLOYERS' LIABILITY Al 7015793012004 12/13/2004 I12/13/2005 EL EACH ACCIDENT S 100,000 FTHEPROPRIETOR/ INCLPARTNERsExECUTVE EL DISEASE —POLICY LIMIT 500,000 OFFICERS X FXCL i IEL DISEASE —EACH EMPLOYEE S 100,000 O"ITDiR j D ESCH119ION OF UI'Iil1ATIONS/LOCATIONS/VE$IICLES/SPECIAL ITEb1S CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Gatewood IIomes 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 onrE(MM// CROWC50 06/06f0505 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 a. V=R Uca INSURERS AFFORDING COVERAGE I NAIC # INSURERA 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 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRINSR TYPE OF INSURANCE POLICYNUMBER DATE (MMIDOM) FFECTtVE_PDATE(MM/DDIYY OLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 B X COMMERCIALGENERAL LIABILITY ZHN700714102 - 05/01/05 05/01/06 PREMISES (Ea occurence) $100,000 CLAIMS MADE OCCUR MED EXP(Anyone person) $ 5,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 P POLICY RO- PRO-ECT LOC AUTOMOBILE LIABILITY B COMBINED SINGLE LIMIT $ ANY AUTO AFN7001142-02 05/01/05 05/01/06 (Ea accident) ALL OWNED AUTOS SCHEDULEDAUTOS BODILY INJURY (Per person) $ 1 OOO OOO r r ]XX HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Par accident) $ 1,000,000 X PROPERTYDAMAGE (Per accident) $ SOO OOO r GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ANY AUTO A OTHER THAN EA ACC $ $ AUTO ONLY: AGG E%CESSIUMBRELLA LIABILITY EACH OCCURRENCE Is OCCUR CLAIMS MADE AGGREGATE $ $ $ PDEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND X A EMPLOYERS' LIABILITY TORY LIMBS ER E.L EACH ACCIDENT $SOO,000 ANY PROPRIETOR/PARTNER/EXECUTVE WC1049858 03/22/05 03/22/06 EXCLUDED? Oyes, E.L. DISEASE - EA EMPLOYE $500,000 If yes, describe under describe and I E.L. DISEASE -POLICY LIMIT $500, 000 SPECIAL PROVISIONS below OTHER B Property Section DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Subject to policy forms, conditions and exclusions. CERTIFICATE HOLDER rAIDCFI I ATlnrd Gatewood Homes 1600 Falmouth Road Suite 25 Centerville MA 02632 ACORD 25 (2001/08) GATEWOO I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR © ACORD JUN 16 '05 04:03PM SANDPIPER INS . 4,0-80. CERTIFICATE OF LIABILITY INSURANCE !' eR000CER (509) 790-1919 THIS CERTIFICATE IS ISSUE] Sandpiper Ina. Agency, Inc. ONLY AND CONFERS NO HOLDER. THIS CERTIFICATE 12 Ento=rise Road i ALTER THE COVERAGE AFFO I4M 02501- Gualberto, Paula L.. 21 Quippish Rd P.1i2 DATE (MMIODIYYYY) 06/16(2005 RATTER OF INFORMATION UPON THE CERTIFICATc- 9 THE POUCIE3 OF INSURANCE LISTED BELOW HAVE BEEN )SSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED. 6Y THE POUCIZS DESCRIBED HEREIN. 13 SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CCNIDITIONS. OF SUCH POLICIES. AGGREGATE LWITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS - TYPE OF INSURANCE POLICYNUMBER POLICY PDATE(MMIDOOMI DA7CE M-WOONT) UNRs .� GEMERALIIABILITY / / / / SACHOCCURRENCE i 1,000,000 CAMAG PREMI ER E]eeewr_ETD RENTED . 30O ODO i � CC COMMERUAL0ENERALUABILITT VC-0 GXA fAny 0ro*M A i 10,000 CLAIMS MADE ❑ OCCUR SCP04277331-S- 11/20/2004 YI/20/2005 PERSONAL 6 ADV INJURY 3 1,000,000 ' OENE.RAL AOOR--ZA. s 2,000,000 CENL AGGREGATELIMITAPPLIES AEA: PRODUCTS-COMPIOP AGO S 2,000,000 POLICY JECT LCC' AUTOMOBILE LIABILITY / / / ! COM.9INEO SINGLE LIMIT (EA ACfJderl() i ANY AUTO ROOILY INJURY (Per "mw) s ALL OWNED AUTOS / I / I SCk SDUL°O AUTCS ECOILY INJURY (Pet aeemerm S HIRED AUTOS / / / / NON-OWNcDAV709 PROPERTY DAMAGE (Per sce10es0 f I ' CARAGEUABILITY AUTO ONLY •EA ACCiGENT f I OTHER THAN EA ACC ! f ANY AUTO I / I / f AUTO ONLY: AGG EXCEBSl11MBRIgLA LIABILITY I / / / / EACH OC M'RRENCE AGGRB,n IE I3 OCCUR L--._7 CLAIMS MADE s DEDUCTIBLE RETENTION f WORKERS GDMPEN41ATIDN AND E.L. EACH ACCIDENT is 1 EMPLOYERS LIABILITY ANY PROPRIETOWPARTNEPISXECUTIVS C.L. DISSASE- CA EMPLOYE., f OFFICERWEN,OER EXCLUCED.T / / / / E.L. n1A"_ - POUaY IIMr 1 is If Y.S. eesa:oe wtLw sFECI.L PRovIaONs e.m DTHeR I / f f DESCRIPTION OF OPERATIONQLOCATIONSMENICLESIF=LUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS ::3':'*-.'iTTC'R, A_= 9XTYAiCA PAIN2ING (508) 779-5603 GASfi3C0010 mollms 1600 FALL. r`L'TN = Sui= 25 RD 2S (2001102) IN802S (DIoaps mA 02532— SNCULD ANY Of! THE ABOVE DESCRIBED POLICIES SE CANCELLED 9EYDRS Trr EXPIRATION DATE THEREOF, THE ISSUING ^ INSURER WILL • ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CEpJIF�ITE MOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SMALL IMPOSE NO ORRIOATION OR UiBUJTY OF ANY KIND UPON THE INSURER 175 AGENTS OR REPRESENTA / ,ITeenenen eeene.cu....,s T ELECTRONIC LASER FORMB, INC. - (e=327-M45 ra ON 1091 Page'I el' e nl -9Sp p-n7 ACORD,. - CEI��!'IRCATE-O.. -I-TY INSURANCE ATE j%vAeDoNy) 08lDwmS ROCLCFR Serial # A153D THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION BIX9Y 4`dSURANCE AGENCY, Df Z. ONtIt -AND, CONFERS-' N0- RW41 S UPON � THE, CERTIFICATE HOtDETt THIS CERTWICATE' DOES NOT AMEND. EXTEND' OR P.O. BOX 830 -661 PUTNAM PIKV ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. GREENVILLE. RI 02=2 ... MURERS APFORDIIOG COVERAGE NAIC>l INSURED NsuRER A_ MATT FIRE INSURANCE CO. OF HARTFORD' -. . INSURER B: VALLEY FORGE INSURANCE CO. HOLMES AND MCGRATH, IN, :. xserc.' COWWENTAt INSURANCE CO. 362 GtFFORD STREET INSURER D- FALMOUTH. MA 02540 oslRCT: 5 COVERAGES THE.PoLr-Ma OF. INSURANCE LISTED BELOW I AVEBEEN ISSUED TQTW W5URED KAMMABOVE.FOR THE POl1C Y PER)0Q INDICATED. NQTWITHSTANDW[' ANY REQUIREMENT, TERM OR CONDITION OF I NY CONTRACT MOTHER. DOCUmC= MTN RESPECT TO. VaO LTHM CEErnFICATE MAY BE ISS IFn OR MAY PERTAIN, THE INSURANCE AFFORDED BY n E POLICES DESCRIBED HEREIN ISSUB.ECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICES, AGGREGATE LIMITS SHOW MAY W JE BEEN REDUCED BY PAID CLAW. la A®s TYPE OF INSURANCE POI.IOytKIMSER E:x&-cTIMF LIMITS GENERALUABAMY EACH OCCURRENCE s 1,000,000 X CDMMERCIALGENERAL LLe8IUTY AMAG O RENTID t FKtE 2%,= A CLAIMS MADE Q OCCUR 10-. 4082434 101DISM4 1 OAXV05 mm EIw IApjw s 10,000 PERSONAL &ADV IN.MY S GENERAL AGGREGATE 5 2,000,000 GENL AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPA7P AGG S 2 QOO,0Qt7` PCULY Fl PRD LOC AUTOMGBBE LIAeRRY COMB2D SAWG:E Cdbft r ANY AUTO (& BOdLY NiAXiY 5 ALLOMWED AUTOS SCHEDULEDAUTOS T-P—) BCQY_YIIRA2Y 5 HIRED AUTOS - NONAWNED AUTOS lPn accroeMT PfiCPETSTV QAfAAGE ' S ' - GARAGE LIAWTY MftO CWY • EA ACCIDENT S OTHER THAN Elf ACC' S' ANrAUTO S AUTO ONLY AGO EXC556NMBRELLAIIABILITY EACifOCCUlRREMEE� - 5 OCCUR CLA*AS MADE AGGREGATE s i S OEOUG718LE RETENTION $ - - s- WORRER'S COMP£NSATM AND X I VYC STATU. iM B EMPLOYERS TOMPA ANY PROPRIETORlPARTNEFIEXECfDVE 207445273- 00h01 4 .. ... O910WOrJ' El EACH ACCIDENT EL DISEASE- EA EMPLOYEE S 1,000,000 OFFICIERIMEMBER EXCLUDED' ! rasdescribe V r SPECIAL PROVLSIONS belmv .... - Et DSEASE . POUCY Lwn" 1 00O COO.. OTHER C PROFESSIONAL LIABILITY AE4 00 43l 33 3& . 7113R5. 07tt3m -t 00 ow PER-CLAlw- AGGRETGATE' OE..CRIPTgN OF OPERATIONSILOCATpILNEHCL IMICI XUSIONS AODEO NY EJW 00.5p1p1[/3PEGIAL PROVISX)6M AGGREGATE LIMITS ARE PER THE TER IAS AND CONDMONS-OF THE POUCIES. CERTIFICATE HOLDER CANCELLATIOk SNOULOANY OF THE ABOVE DESCRISED POLICIES SE CANCELLED BEFORE 'HE EXPIRATION GATEWOOD HOMES DATE THIERECF. THE ISDANG INSURER PAIL ENDEAVOR TO MAIL PAYS WMREN 1600 FALMOUTH RD., STE. •5 - NOTICE TaYRECE"ICKTE"HOMERNAMED TO THE LEFT. BUT FXLURE TUDOSaSfAM CENTERVILLE, MA 02632 NPOSE NO Da:GATICN OR LUBIutt OF ANY KIND UPON THE INSURER, ITS AGENTS OR RER{E58NL4A+/E5 R ATNE MV VKU 40 tiUVIMS) C:ThAPRaCERTPROS.FPS I l / f J ACORD CORPORATION 18aa q ACORDr: CERTIFICATE or-�:MMLIT�F INSIRA►I+ICE , DATE(MM DDM(YYI FRcbUIER THIS CERTIFCATEISISSUED ASAMATTER OF; MRMATION - United Insurance AgonCyy Ina. C-NLYAlD-CONFERSNORi6N UPONTFECERTIFiCATE... 199 twain Street . HOLDER TIi1S CE TIRCATEDOESNOT A*E?-a EXTEND On P.O. Box ID13 ALTI R THECOVERAGEAFFORDED &YTHE POLICII3 88 OW. Buzzards nay, r3A 02532 INSURERS AFFORDING COVERAGE NAiC x I NSUR G7 Patton Electric, Inc. INSVR67A: Zurictr'NA IN6UPERa Commerce Insurance Co. 12H Scituate Road. INSURER Of -Liberty- Mutual -ins. Mashpes, MA 02649 INSURER D: N6URER"E..... rnv[aA r_cc - THE -POLICIES OF JNSURANCE LISTED BELOW HAVE SEEM ISSUED _TO.THEWSUREA. NAMEDA6DVE-FOR. THE POLICY PERIOD INDICATE.NOTWITHSTANDING ANY RECLUREMENT• TERM OR CONDITION OF ANY CONTRACT O3 OTHER DOCUMENT IAD.TH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES OrSCRISED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN POUCYN"arm POI1Ly Ef FECIl� IOLLCT DN LIMTFS A GENERALLIA810TY X COMMERCVILGENERALUADRRY CLAMS MADE xOCCUR SCP424-15399- 7/30/05 7/30/06 EACH )CCURRENCE 3 1,000,000 P�EM3Es c 3 30a,(}aQ S 10,000 MED IXP(An xe !m PERSONAL3ADVINJURY 3 1,OOa,DaO- - OENEAµ AGGREGATE 3 2,000,000 S 2- Qa.O _ G( %ACC=aATE • APPLIES PER: PAD POLICY F-1 E T LOC PROOVCTB-COMPMPAGG AVTOMOBLE LIABILITY ANYAUTO COM9w1FD 364LE LIMIT (Ed@w6m) 3 ALL OATIED AUTOS B SCHECULMAVT06 YSP9338 10/3/04 10/3/05 Rnpm Y INJURY (P"P"sw) T 100,00'0' HIRED AUTOS I NON-CUNEDAUT06 BODILY INJURY (Pwmaid") i} 3QQ,000- P�DAMAGE 3 loa,aaa I����EX-C111TUMMBRELLA GARAGE LIMILITV ANY AUTO LABILITY pOCCUR CLAIMS.MACE. AUTO ONLY -EA ACCIDENT d OTHER THAN EAACC AUTO ONLY• AGG EACHOGCURRENCE 3 _ S ; AGGREOATE S 5 DEDUCTIBLE RETENTION 3 3 } C WOIMER3 'LIAMU6ATION AND EMROYERF.TOPJPm ANVPPORGM2ERPXCLUDE)(ECVTIL£ OFFICFAdVIE M(iER EXCLUDED? WC231S35304901a 12[10%04 12iI0j05 NL A7U- TH- F.LIEACNACCWENT 3 SOQ aQO E.I DISEAS[-EA EMPLOYEE F - 500,000 X "sb�sb"'u.Pao 9dl3 .. - E.LDISEASE-POLICYL811T S SOO OOO Mew OTHER D eiCRIPTIONCFOSERATION3/LOC4IRAlSIyERCLE3TQCCt310N3ADOCDBTpMdISEM[NTf BpEOpY FRpyfyOb,.. ts'leCtrl Cal CE7TIFICATEHOLDF7R GAtmwood Homoe Fax No. (50e) 778-5603 1600 Falmouth Road Suite 25 C4*ntevi119, M.a 02632 h SHOULD ANY OF THE ABOVE DESCRIBED POLJCIESBE CANCELLED BEFORE THE EXPIRATION RAlF 1"EREOF, THE IS =(XrlEUBERVV ILL EN DEAVOBTO MAIL 10 DAYDWRITTEN -U071C ETD THE CERTIFICATE)IIOLOER NAMCD TO THELEFT, BDTFAIEURETO'DC•=VfALL- ] IMPOSENO OBLIGATION OR L'IABUTY OF ANY RINO UPON TRElN6UREli, iTB AGENTS OR .. .. ,.,. _.. DATE(MM/DDIYY) •: ACORD �. CERTIFICATENCE 9/15/04 '•°' �. OF LI�iBtLITY INSURA -� - �.� ......._.....�:, PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Chatfield, Whitman & Young ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 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 COMPANY 5 Fresh Hole Road Hyannis, MA 02601 C COMPANY I D G COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD .., INDICATED, NOTVVITHSTANDING 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 7ypE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MM/DD/YY) POLICY EXPIRATION DATE(MM/DD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OP AGG $ 2,000,000 A COMMERCIAL GENERAL LIABILITY CB 7E 32 32 9/07/04 .9/07/05 PERSONAL 8 ADV INJURY $ 1,000,000 CLAIMS MADE a OCCUR I EACH OCCURRENCE $ 1,000,000 OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any one fire) $ 100,000 MED EXP (Any one person) $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per aooioent) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ GARAGE LIABILITY - AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: ANY AUTO ' EACHACCIDENT S AGGREGATE S EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLAFORM $ OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND - WC OTH- LIMIT TORV LIMITS I I ER - EL EACH ACCIDENT $ EMPLOYERS'LIABIUTY EL DISEASE -POLICY LIMIT S THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS ARE: I EXCL I i EL DISEASE - EA EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS P. CERTIFICATE HOLDER - - �,.. y 7.1 �. CANCELLATION .�z, _ _. 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 GAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Suite 25 Centerville, MA 02632 BUT FAILURE 70 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UABIL13`f OF ANY KIND UPON THE COMPANY ENTS SENTA ES. AUTHORIZED REPRESENTATIVE Robert E. Chatfield ACORD>25S (1I95) - ` ` f-'" `` Y O"ACORD CORPORATION 1988;' t /r A ACORD. CERTIFICATE OF LIABILITY INSURANCE Ro 6 09-27A 2004 PRODUCER THIS CERTIFICATE IS ISSUED AS A.MATTER OF INFORMATION PAYCHEX AGENCY INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 210706 P: (877)287-1312 F: (877)287-1315 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 308 FARMINGTON AVE FARMINGTON CT 06032 INSURERS AFFORDING COVERAGE INSURED INSURERA:TWln City Fire Ins Co INSURER B: LAWRENCE ROBINSON MASONRY INC INSURER C: 5 FRESH HOLE ROAD INSURER D: HYANNI S MA 02601 INSURER E: UUVEHAUEt i 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 CTR TYPEOFINSURANCE POLICYNUMBER POL/CYEFFECTNE DATE (MMVOtYY1 POL/CYEXP/RAT/ON DATE MMDD/YY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR EACH OCCURRENCE a I RITE DAMAGE (Any one tire) a MED EXP (Any one person) a I PERSONAL & ADV INJURY a GENERAL AGGREGATE a GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- F T LOC PRODUCTS - COMP/OP AGO a AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULEDAUTOSI. HIRED AUTOS NON -OWNED AUTOS - COMBINED SINGLE LIMIT (Ea accident) a BODILY INJURY (Per person) a -BODILY INJURY � I -(Par accident) a PROPERTY DAMAGE' (Per accident) - a GARAGE LIABILITY ANY AUTO I AUTO ONLY - EA ACCIDENT a OTHER THAN EA ACC AUTO ONLY: AGG 9 a EXCESS LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION a EACH OCCURRENCE a AGGREGATE a a 9 _ a A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 76 WEG NQ5620 09/06/04 - 09/06/05 I X WC STATU- OTH- E.L. EACH ACCIDENT $100 000 E.L. DISEASE - EA EMPLOYEE a 10 0 I 0 0 0 E.L. DISEASE - POLICY LIMIT a5 0 0 0 0 0 O TNER I DESCRIPTION OF OPERA TIONS/L0 CA TIONSIVENICL£SIEXCL USIONS ADDED 8Y END PROVISIONS Those usual to the Insured's Operations. ..... .—...—.... �...—.. ...............�.........�... .,..a..ncn ac„cn. I.MIVI.CLLM I IVIV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE 110 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE GATEWOOD HOMES HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO 1600 FALMOUTH ROAD SUITE 25 OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR I REPRESENTATIVES. CENTREVILLE MA 02632 AL:UHD 25-5 (7/97) 'D ACORD CORPORATION 1988 12/02/04 13:36 FAX 5087900-149 COLDMAN ASSOC 90 . 1 so � 4' T %C J3 TT" !� T ! g.L}4.+� a.��S r�sy� .Hare{aw _.nmrvN_ � .��i».16�Z LiR 3 lT'idA i E4�a �1��1�1 � �I li�a7U1'7ir V T�,VSD.2R'IS�- 12/02 04 PRODUCER THIS C-¢T)FICATE IS ?CSLIED AS A MATTER OF 11"FORNIATION Gv^La..ioru+ m «S >Ov2«TES Iiin CS _ ONLY AND COMERS NO RIGHTS UPON THE CERTIFICATE II'IMLYCIAL SERVICES Zmc. HOLDER: THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 933 ':O'.J1°E RD. ALTER THE COVEP.AGE AFFORDED BY THE POLICIES EELO:Y. LrYANNI9 MA 02 601 P3 =81 508-775-6010 Sax:308-790-0249 INSURERS AFFORDING COVERAGE I NAIC9 INSURED ROD?dn7 TAVAMO DBA b03CSANICAL SYSTMO 110 EOLDUR LAIM W ]SAMSTA31I3 MA 02668 INSURERA: MARYLAND CASUALTY C INSURER B: INSURER C: INSURER 0: THE POLICIES OF MSU°.ANC= LIST. EO 9£LOW HAVE BEEN ISSUED TO THE INWRED NAMEDAP.OVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIRSM6NT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSJRANCE AFFORDED BY THE POLICIES DESCRIBFP KnIN IS SUtLAXT Tq ALL TH§TERMS, EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTR INSR TYPE OF INSURANCE POLICY NUMBER DATE MFF ECTIVE POLICY DATE FX LIMITS ' A GENERAL UlJ60.RY _ B COMMERCNLGEINERALLIABILITY CLJJMS MADE F7 CCCUR I 000372088 - 11/21/04 11/21/05 EACH OCCURRENCE I s1o_O oo00 w--=Mt,tlw`=5(Ea a rwn ) j S 300000 I MEDEXP(AnymePerj I s 10000 PERSONAL i ADV INJURY 1111000000 GEllZLAGORECATE 12000000 i GENI AGGRL:GJITE LIMIT APPLIES PEii POLICY 77 �PERGCT- LOC PROWCTS-COMPIOP AGG 12000000 LIABILRYCOMBINED nOMOBIL11 ANY AUTO - SINGLE LIMIT (Ea a=id-"t)ALL 6WNED AU es I SCir.EDULE- AUTOS BODILY INJURYI (Per Parsm) i HIRED AUTOS I WON -OWNED AUTOS i BODP Y NJ V RY 1 ! lPef ecdCenU PROPERTY DAMArE (Per aaleent) 1 `OARADELWRLITY ANY AU7'CJ I I. ` AUTO ONLY -EA ACCIDENT t--- OTHER THAN FA ACC 1 AUTO ONLY: AGG 1 � ESWUMERRELULIABILRY OCCUR C C1AlIi5 MADE I I EACH OCCURRENCE S AGGREGATE S �1 �i DEOUCTIw,E I RETENTkON , 1 J I( ' i I I I EMPLC0+®Ei-ITS HAND EMPLFiYERS VABIJTi' I ANY PROPRIETORIPARTNEWEXECUTNE OFF!CERJME:BER --' CWDEO? Ifye6, �� �,�. SPECIAL. PROVIZnLS belo« TORS UMITS 'R I e E.L. EACH ACCIDENT � S E.L. DISEASE - EA EMPLOYEd S E.L DISEASE -POLICY LIMIT 13 OTHER FAX 508-778-5603 1600 P«LMOUT8 ROAD SLTITZ 25 C3NTERVILLS MA 02632 an_T_ R_ W_ n_ n _ SHOULD ANY OFTY,E ABOVE DESC HEED POI-ILIEs BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY YJND UPON THE INSURER ITS AGENTS OR ONLY AND CO HOLDER THIS ALTER Inc COVrKAUL AFFORDED BY THE POLCC COMPANIES AFFORDING COVERAGE AS COMPANY A AMERICAN ZURICH INSURANCE COMPANY COMPANY B COMPANY C COMPANY D tXTEND OR BELOW. 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. I TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MM\DD\YY) DATE (FAWDD\YY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL UASIUTY GENERALAGGREGATE S CLAIMS MADE OCCUR. PRODUCTS-COMP/OPAGG. $ OWNER'S & CONTRACTOR'S PROT. PERSONAL & ADV. INJURY $ EACH OCCURRENCE S FIRE DAMAGE (Any one fire) S AUTOMOBILE LIABILITY MED. EXPENSE (Any one person) S ANY AUTO COMBINED SINGLE ALL OWNED AUTOS OMIT S SCHEDULED AUTOS BODILY INJURY (Per Person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per Accident) S GARAGE LIABILITY PROPERTY DAMAGE S ANY AUTO AUTO ONLY - EA ACCIDENT S ' - OTHER 71-IAN AUTO ONLY: -- - EACH ACCIDENT S EXCESS LIABILITY AGGREGATE $ UMBRELLA FORM EACH OCCURRENCE $ ' OTHER THAN UMBRELLA FORM AGGREGATE S A WORKER'S COMPENSATION AND EMPLOYER'S LIABILITY (UB-7278AS4-9-05) 05-03-05 05-03—OG STATUTORY UMITS THE PROPRIETOR/ PARTIERa/I9ci i mE INCL EACH ACCIDENT _ S 100 OOC OFFICERS ARE: I X EXCL DISEASE —POLICY UMT S 500 , O00 OTHER DISEASE —EACH EMPLOYEE $ 100.000 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-06-062 Fran Capra 5087789669 00121 CAMP ST Unit 101 Villages @ Camp Street, LLC 1600 Falmouth Road # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 e (OFFICE USE ONLY Recorded By: IC Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 1034 Net Owed: ($50.00) Application Date: 8/15/2005 Issue Date: Expiration Date Comments: Map/Lot: 044.21.1 new construction: ZONING APPROVED REVIEWED BY: I-1/WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: ✓SVHEALTH 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 aF ►� TOWN OF YARMOUTH Building Department _ Town Hall e.. a Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-06-062 Applicant Name: Fran Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Unit 101 Owner's Name: Villages @ Camp Street, LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 ' REVIEWED BY: 1. WATER DEPARTMENT: (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 1034 Net Owed: ($50.00) Application Date: 8/15/2005 Issue Date: Expiration Date Comments: Map/Lot: 044.21.1.0 new construction: DATE: E 19@R9W[99pAUG 2 4 2005EALTH 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: Date Printed: 8/22/2005 TOWN OF YARMOUTH WATER DEPARTMENT 99 Buck Island Road West Yarmouth, MA 02673 Telephone: (508) 771-7921 • Fax: (508) 771-7998 Date of Issue : Aug 25, 2005 Letter of Water Availability 1. Single Family Dwelling X 2. Duplex Family Dwelling 3. Condominium Dwelling 4. Commercial / Industrial 5. Other (Specify) 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) 21.1 Street 121 Camp St., #101 as shown on Assessors sheet/map # 44 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 owners expense, the installation of water mains and appurtenant items to meet water demand 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 th Water Availability. Reference Gatewood Homes 1600 Falmouth Rd., #25 Centerville, MA 02632 Water Department VL� TOWNOF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BUILDING PERMIT TRANSMITTAL Temp Permit No.: T-06-062 Applicant Name: Fran Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Unit 101 Owner's Name: Villages @ Camp Street, LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 REVIEWED BY: -I. WATER DEPARTMENT: '• 2. ENGINEERING DEPARTMENT: 3. CONSERVATION: 4. HEALTH DEPARTMENT: 5. BUILDING DEPARTMENT: 6. FIRE DEPARTMENT: COMMENTS: RECEIPT OF COPY: (OFFICE USE ONLY, Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 1034 Net Owed: ($50.00) Application Date: 8/15/2005 Issue Date: Expiration Date PLEASE NOTE SIGNATURE OF APPLICANT: Comments: Map/Lot: 044.21.1.13 new construction: DATE: N/A: DATE: N/A: DATE: N/A: DATE: N/A: DATE: N/A: DATE: Date Printed: 8/22/2005 PROPERTY ADDRESS: :ALCULATION FOR PERMIT COS1 �ci�..C/iot - 86z- Z80.7d ,?mI arc, yf 1- / y� SAS y�1,� �17,Oz4q TYPE OF ROOM ETC NO ADDITION ALTERATIONS BATH Z BED ROOM CERTIFICATE OF OCCUPANCY COMPUTER ROOM DECK OPEN DECK WITH ROOF DEMOLITION DEN DINING ROOMA FAMILY ROOK! FIREPLACE FOUNDATION ONLY GARAGE NO, OF BAYS GREAT ROOM KITCHEN / LAUNDRY ROOM / LIVING ROOM / MUD ROOM OFFICE PORCH CLOSED PORCH OPEN REROOFING SHED STORAGE AREA SUN ROOM 14EATED SUN ROOM UNDATED SWIMMING POOL ABOVE Gib SWIMMING POOL WGROtfM WINDOW REPLACFiT M PROPOSED -- NOTE: ® SEWER LATERAL SHALL BE SLEEVED IN ACCORDANCE WITH TITLE V IF WITHIN 10FT. OF WATER MAIN. GRAPHIC SCALE 20 ( IN FEET ) 1 inch = 20 ft PLOT PLAN OF LOT 101 PREPARED FOR MILL POND VILLAGE IN YARMOUTH, MA SCALE: 1 "=20' DATE: 3-23— SEE SLEEVING NOTE BELOW 51 LOT 102 NrTrCi `"'� ,.n+ii v,,h tin. i as tp., orVnol (reJ)..i:, respr•rs i - ivi Engineer, nr Pro'eG sional Lcn J a ver?r rppears on thia pier: (A) no parson or persen<, including cny moniciral nr othc.- puh!i- nffcic!=_, may nay upon 'he in Formc'ion ccntair. J h-r,,; a (9) this plea r=m ins 0,3 ;^ooerty of holmes and mcgrath, inc. civil engineers and land surveyors 362 gifford street falmouth, ma. 02540 JOB NO: 201197 DRAWN: LMC DWG. NO.: A2547 CHECKED:-f'w&S �n TI,'v10THYM � Sf��ti'TQS. No. s5078 9 q civil Co r MAScheck COMPLIANCE REPORT Massachusetts Energy code MAScheck Software version 2.01 Release 2 CITE': 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 Plover PROJECT INFORMATION: Mill Pond village Camp Street Yarmouth, MA 02673 COMPANY INFORMATION: Northside Design Assoc. 141 Main Street Yarmouth Port, MA. 02675 COMPLIANCE: PASSES Required UA = 237 Your Home = 133 i I Permit # 1 I 1 Checked by/Date I Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value -------------------------------------------------------------------------- CEILINGS 823 30.0 30.0 WALLS: wood Frame, 16" O.C. 1588 15.0 15.0 GLAZING: windows or Doors 97 0.340 GLAZING: windows or Doors 40 0.340 DOORS 20 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 34.4. Builder/Designer Datp UA 14 70 33 14 2 r Massachusetts Energy code MAScheck software version 2.01 Release 2 The Plover DATE: 4-21-2004 Bldg Dept Use I I I [] 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/Location AIR LEAKAGE: Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. when installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM_E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. PROPOSED NOTE: ® SEWER LATERAL SHALL BE SLEEVED IN ACCORDANCE WITH TITLE V IF WITHIN 10FT. OF WATER MAIN. GRAPHIC SCALE 20 10 ( IN FEET ) 1 inch = 20 ft. PLOT PLAN OF LOT 101 PREPARED FOR MILL POND VILLAGE IN YARMOUTH, MA SCALE: 1 =20 DATE: 3-Z SEE SLEEVING NOTE BELOW ups sse9, As�� LOT 102 o —T. n *urs c3 wp onnnc! (rad) s'-_�nc c respei5s� �a r rc iessi.;nol Ern�inecr. cr Professional Lend Surveynr op pen,, on this pbm: (A.) no person or parson, including any municipal or n��bli; oiFcids, moy rely upan the ir.!urmc'ion can tnin�-J h=ro. . 9) this n;en r?rnrzins the f.roparty of Homes idc.cir-A" inn:. UF.- holmes and mcgrath, inc./ r -\� civil engineers and land surveyors TIMOTHY rd. 362 gifford street 9 o s,Nres ,� No. 45078 � falmouth, ma. ,02540 9 9 aVIL o 0, �Q/STEPS 44. JOB NO: 201197 DRAWN: LMC FPS DWG. NO.: A2547 CHECKED:-,ex.c CoOfficial Use Only `�- Commonwealth of Massachusetts w Department of Fire Services Permit No. P O h— _1r� a h BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IaS . ev.11/99] eaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 4/12/2006 Lcf�� 0co By �? o Lo N o ap Ov -' ON z 0- Is Pu • City or Town of: YARMOUTH, MA To the Inspector of Wires: application the undersigned gives notice of his or her intention to perform the electrical work described below. on (Street & Number) 121 CAMP ST., UNIT 101 • or Tenant GATEWOOD HOMES Telephone No. -'s Address 1600 FALMOUTH RD UNIT 25 CENTERVILLE MA 02632 permit in conjunction with a building permit? Yes X No ❑ (Check Appropriate Boa) se of Building SINGLE FAMILY DWELLING Utility Authorization No. 1514550 Service Amps / Volts New Service 100 Amps 120/240 Volts Number of Feeders and Ampacity Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd X Location and Nature of Proposed Electrical Work: WIRE HOUSE, INSTALL SERVICE No. of Meters No. of Meters 1 hn ,.,..ivod by the lncnertnr nfWires- No. of Recessed Fixtures No.P (Paddle) No. of Ceil: Sus . addle Fans r ° Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No._of Lighting Fixtures In- Swimming Pool Above rnd. El ❑ o. omergencyiging No-. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. o Detection and No. of Switches No. of Gas Burners Initiating Devices No. of Ranges Vo— No. of Air Cond. Tonal No. of Alerting Devices Heat ump Number Tons No. oSelf-Contained No. of Waste Disposers P Totals: "' -__........__..____ Detection/Alerting Devices No. of Dishwashers S ace/Area Heating KW P g Local ❑ Municipal ❑ Other Connection Dryers No. of D ry Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water, No. o o. of-- Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent Telecommunications Wiring: No. H dromassa a Bathtubs y g No. of Motors Total HP No. of Devices or Equivalent OTHER: W' Attach additional detail ifdesired or as required by the Inspector of Tres. a INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue 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 X BOND ❑ OTHER ❑ (Specify:) 10/31/2006 (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with NEC Rule 10, and upon completion. II certify, under the pains and penalties of perjury, that the information on this application is true and completeIRM NAME: PATTON ELECTRIC INC LIC. NO. A15542 icensee: RICHARD PATTON Signature LIC. NO.: (Ifapplicable, enter "exempt" in the license number line.) Bus. Tel. No508 539 0200 Address: PATTON ELECTRIC INC. PO BOX 1525, MASHPEE, MA 02649 Alt. Tel. No.: 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 a ent. Owner/Agent PERMIT FEE. $125, 00 Signature Telephone No.