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HomeMy WebLinkAbout121 Camp St #104 Building PermitsTOWN R E C �U �G172`�'" BUIL ING DEPT. Buildin sY: AT: Location /Y New [ Renovation ❑ Plans Submitted Yes ❑ No fk APPLICATION FOR PERMIT TO DO GASFITTING (OFFICE USE ONLY) Fee: ------ PERMIT NO. 6-07-_1`t_ i Replacement ❑ Date Owner's Name?��-au��—.'�r� Type of Occupancy�jjAve 441 to N Ike W z N 0 W O 0 V y3 N Co Z w Q ell;�j L M W W w S w Z O oo. CC > U) UJI ccO y W= o V y Q Ltr 0 W =N a i N J Z W a= 40 Z W a =O Q W> m O U. W W V w CC u x > o 0 x 5 OrC O O o LL L 1 u. > o a t- sus-BSMT. BASEMENT 1ST FLOOR 2NO FLOOR 3RD FLOOR (PRINT OR TYPE) l Installing Company Name !uLT� _�in(hl dl'% Address 0 Business Telephone , 0-F-2 � -- Check One: ❑ Corp. ❑ Partnership Pr'-Firm/Company Name of Licensed Plumber or _—_.—', N— — INSURANCE COVERAGE: Check One I have a current liability insurance policy or its substantial equivalent. Yes ElowoNo ❑ 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 ❑ 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 I hereby certify that all of the details and Information t 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 Qt0h jvee�,,�D Signature9 Licensed Plumber or GasfMar 2tSis� License Number Tvoe r irONCR. ' EXISTING FOUNDATION LOT 103 DRIVEWAY Lr�1'46-28'tO651dOL130.69I tr EXISTING FOUNDATION i co N 1 N83'ST388mW 1 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 I NOT SPECIAL FLOOD HAZARD A. DATE REGISTERED PR FESSIONAL LAND SURVEYOR Unless and until such timeON 1a'sICE original (red) stomp of the 2 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 do McGrath, Inc. LOT 104 EXISTING FOUNDATION 26 15 u � 1 C 6 005 1 r N 155ti55 I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE LOT AS SHOWN. AND THAT ITS LOCATION CONFORMS TO THE MINIMUM SETBACK REQUIREMENTS O� THE 40B SPECIAL PERMIT. �15 6- DATE REGISTERED 'PROFL6SSIONAL LAND SURVEYOR GRAPHIC SCALE ( IN FEET ) 1 inch = 20 ft AS —BUILT PLAN holmes and mcgrath, inc. P�f : `= �. OF LOT 10L civil engineers and land surveyors s�;_, , ICHAEL PREPARED FOR gifford street s4 � ;'• MILL POND VILLAGE, y� `,, McGill IN falmouth, ma. 02540 - -No. 2E=% YARMOUTH, MA JOB NO: 201197 DRAWN: LMC SCALE: 1"=20' DATE:12-15-05 DWG. NO.: A2544A CHECKED; OF ••v TOWN OF YARMOUTH Building Department BUILDING - - -.- - _ _ _ (508) 398 2231 ext.261 PERMIT NO 6-06-448 _ PERMIT ISSUE DATE ; _ 9/29/2005 _ ; PROPOSED USE - - - - - - - - - APPLICANT -Frank Capra ----------------' JOB WEATHER CARD PERMIT TO ' New Construction ' IAT (LOCATION) ` 00121CAMP ST Unit 104 j ZONING DISTRIC R-2 Bldg. Type: Residential I SUBDIVISION MAP LOT BLOCK I044.21.1.C104 1 BUILDING IS TO BE: LOT SIZE new construction: 3 baths, 3 bedrooms, 1 diningroom/familyroom, 1 firep REMARKS 1 livingroom , 1 kitchen as per plans dated 08/30/0 AREA (SO FT) EST COST ($ $169 OWNER I Villages 0 Camp Street, LLC ADDRESS CONSTTYPE 5-B USEGROUP garage, PERMIT FEE ($) $617.00 CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 Certificate Issue Date �i4'elo,u--�` a9 ERTA `CIFICT. _ E"of;OCCUPNC AY= - ATu Departmental Approval for Certificate of Occupancy and Compliance Inspector Date Permit Number Approved By Remarks I//�m, i i �%AM � 0 W/wAE r spill NNW m To be filled in by each division indicated hereon upon completion of its final inspection. Page 1 of 1. i� Cipro, Linda From: Sherman, C Randall Sent: Friday, August 25, 2006 4:21 PM To: Cipro, Linda; Kelleher, Robert; Raiskio, Peter Subject: RE: final for occupancy @ 121 Camp Street Unit 104 This inspection was done this P.M. by Lt. Bearse and passed, all set. I am heading now to 27 Commercial St. but know that I will not reach Town Hall before 4:30. C. Randall Sherman -Chief Yarmouth Fire Department 96 Old Main Street S. Yarmouth, MA 02664 W 508 398 2212 Fx 508 760 4861 C 508 294 2457 From: Cipro, Linda Sent: Friday, August 25, 2006 10:22 AM To: Kelleher, Robert; Raiskio, Peter, Sherman, C Randall Subject: final for occupancy @ 121 Camp Street Unit 104 Linda Cipro Building Department Administrative Assistant The Building Department is scheduled to conduct a final for occupancy inspection @ 121 Camp St, Unit 104 today 8125106 in the afternoon and would like for you to attend. Thanks - Linda r 8/25/2006 �F .' e TOWN OF YARMOUTH Building Department BUILDING (508) 398-2231 ext.261 PERMIT NO B-06-448 _ ISSUE DATE 9/29/2005 _ ; PROPOSED USE ; Q _ _ _ _ _ _ PERMIT APPLICANT -rFrankCapra ,-P JOB WEATHER CARD ------------------` PERMIT TO ;New Construction ; AT (LOCATION) 00121CAMP ST Unit 104 ZONING DISTRIC R-2 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C104 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE new construction: 3 baths, 3 bedrooms, 1 diningroom/familyroom, 1 fireplace, 1 one bay garage, REMARKS 1 livingroom , 1 kitchen as per plans dated 08/30/05. AREA (SO FT) EST COST ($ 1$169,536.00 PERMIT FEE ($) 1$617.00 OWNER I Villages @ Camp Street, LLC BUILDING DEPT BY ADDRESS 11600 Falmouth Road # 25 Centerville I MA 102632 INSPECTION RECORD CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 FIELD COPY .:Note Progress FM ,HI AS NSA M N a ONE & TWO FAMILY ONLY - BUILDING PERMIT APPLICATION TO CONSTRUCTrREPAIR; RENOVATE OR DEMOLISH A ONE OR.TWO FAMILY DWELLING A O . - y Town of Yarmouth Building Department MA .;,C"°E 1146 Route 28 • Yarmouth, MA 02664-4492 Tel: (508) 398-2231 x261 • Fax: (508).398-0836 icet se Only" Permit No te� / Permit Fee$y� ,r DeposltRec'd $� also NttDUe Planning Board Information Type ` P nT`eIA orsement Date R rdmg Date Ian No Assessors Department Information Map_ for for r Old' New 1 4 Property Dimensions LfltArealsf) Frontage{ft) Lot Coverage T, " This Section for Office Use Ohl " Buildin `Permit; b r._ ,. _ j,'Date'JSsueti - SI nature Certificate of Occupancy - q is not required Building Official .0 Ate', Section 1 `- Site'fnformation' Use Group: R-4 Type: 5-B 1.1 Property Address: 2J 1 C �y � S1 Y` ee 1.2 Zoning Information: 14 � )2e6 Zoning District Proposed Use 1/ 0 / 1_/;L �� 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided _Bequired Provided 1.4 Water Supply (M.G.L. c. 40. S 54) Public Private 1.5 Flood Zone Informal ntl Corrm t.z ; Zone. ' 13 ZQD u y T. Secti6n'2-.Property Ownership/Adthbrized Agent 2.1 w% r of Record: Name (print)0 Mailing AddresS�jcw-a{^///ld2 /fJZe -2 Signature Telephone 2.2 AuthorizpdrAgent: Na print) i ss��fvj� Signature Telephone n Section`3 =Construction -Services 3.1 Licensed Construction Supervisor: % Not Applicable ❑ License Number Addr Expiration Date Signature IV Telephone 12 Registered Home Improvement Contractor: . Company Name Not Applicable License Number Address Signature Telephone Expiration Date dt CAP 9 9- 15-99 1 of 2 OVER Workers Compensation Insurance affidavit must be o3mpletad and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. 4 a Signed Affidavit Attached Yes ..%� No .......... New Construction Existing Bldg. ❑ No. of Bedrooms V9 No. of Bathrooms Z Repair(s) ❑ Alterations ❑ Addition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: V Check Below ❑ Conservation -Commission Filing (if applicable) . ❑ Old Kings Highway & Historical Commission approval (if applicable) , as owner of the subject property hereby authorize / %fitZO� c e.4 P:- n— to act on my behalf, in all mgRers rela ' e to Prk authorized by this building permit application. Sig tur of wner Date , as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. . r Prinffirne Sig at of O ner/ gent Date 9-15-99 2 of 2 1 U W ur YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PR11VT. Job Location: _ Owner of Property: Construction Supervisor: Address: � 00 Street Village U j—' Oaly�o Name License No. Phone No. z` k Licensed Designee: (If other than Supervisor) Name License No. 2.15 Responsibility of each license holder: 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 shallwillfullyviolate subsections 2.15.1, 2.1-5.2 or 2.15.3 or any other section of these rules and regulations and any procedures, as amended, shall be subject to revocation or suspension of license by the board. 2.16 All building permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise those persons engaged in construction, reconstruction, alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and these rules and regulations. In the event that such licensee is no longer supervising said persons, the work shall immediately cease until a successor license holder is substituted on the records of the building department. 2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may be deemed a violation of the permit conditions. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with section 109.1.1 of the state building code. I understand the construction inspection procedures and the specific inspection as called for by the building official. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes FEr No El If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy G lo�Other type of indemnity ❑ Bond OWNER'S INSURANCE WAIVER: I aware that the licensee does not have the insurance coverage required by Chapte 1 2Aoass. al a s, and that my signature on this permit application waives this requirement. Check one: Signal re ofner's Agen Owner ❑ Agent ❑ i Signature: Building Official. Approval: ;' k �I wJ,> A 0,0 The Commonwealth of Massachusetts Department of Industrial Accidents OfAes ollaresgo2ffiis 600 Washington Street Boston, Mass. o2111 Workers' Compensation Insurance Affidavit Cif, <Q� vQ �� 14A I am a homeowner performing all work myself. ❑ lam a sole proprietor and have no one corking in any capacity I am .an employer pro% iding workers' compensation for my employees working on this job. comi2an ram •rddrec : city: nhnn• # insurnneeco. nolicv # 19a1 am a sole proprietor. general contractor. or homeowner (circle onei and have hired the contractors listed below %%ho ha%e the following workers' compensation polices: ' Rhone # insurnnce co.. polies # comnanv name- address - Failure. to secure coverage as required underSeenon 25A of MCL 152 an lead to the im position of etiminai penalties of a titre up, to S1.5N.00 aad/or one years' imprisonment as well as civil penaltled in the form of a STOP WORK ORDER and r fine of SI00.00 s day itainst me. I saderstaad'that a COPY of this statement may be forwarded to the Met of investigations of the DU for. coverage verification, I do -hereby terrify t tr the airs at a !ties ojperan jury that the information provided above is trues d correct Signature ate /X b>�r�/OJT Print name \ + 0—t�Phone N r��, 7;�F^/d6 official use only do not w rite in this area to be completed by city or town official city or town: YARMOUM permittlicense # MBuilding Department cheek if immediate response ❑Licensing Board D ponne is required �Seleetmen's Ottiee contact person: 261 Health Department phone #: _ (508) 398�Z231 eat. nOther .....� '' P.,. BUII.DING TOWN OF YARMOUTH ELE=CAT 1146ROUTE28 SOUTHYARMOUTH MASSACHUSETrS02664-4451 GAS Telephone (508) 398-2231, Eat. 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 debrisresulting fromtheproposed work/demolition to be // conducted at �` `gyp Sf Work Ad ess ( I is to be disposed of at the following location: Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Z FAV FA moww Permit No. b Date R •J ���,06 Tr. na' 25526 - . Res trFEi�E I ` — v -- FR2ANKG,. CAPRf i 4(} CIZOPER Lk CEUTERNWALLE. MA BZ63 Commissfoner '4 00-35XG—ctendosed.space _ __-- (MGL C.M.8a3OL) - fA - Masppry+atltT fG=I 4±,Fam".omes Failurelopossessa+airtenfeditionofthe t :Massaetmsett StatmBuildinq.Code.. - �'. is-cause:for-:rewgtfon:vtitlis-license. DIG SAFE CALL CENTER: 1888):344-7.233 DATE (MMIDDIYYYY) ACORD� CERTIFICATE OF LIABILITY INSURANCE 07/19/2005 'JUE ISOF R DU4R t508) 790-1919 ONILYCANDFICONFERSSSUED NO RIGHTS UPONAS ARNFORMATI THE (CERTFIICAOTE Sandpiper Ins. Agency, Inc. HOLDER. L ERCOVERAGE RTHE IIIAF AFFORDED BY THE POLICIES BELOCATE DOES NOT AMEND, W. 12 Enterprise Road Hyannis MA 02601- INSUREF INSURERA: INSURED Filho, Antonio DBA BF{ ROOFING INSURER8: po BOX 1231 INSURER C'. 136 Stevens St INSURER D' 1 annis --- _ :OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO 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. POLICY EFFECTIVE POLICY EXPIRATION LIMITS JSR AOUL TYPE OF INSURANCE POLICY NUMBER DATE(MM/DDIYY) DATE (MMIDDIYY) .TR INSRD s 1,000,000 A GENERAL LIABILITY / / DAMAGE TORENTE DAMAGE TO RENTED S 100,000 PREMISES (Ea occurrence) }[ I COMMERCIAL GENERAL LIABILITY 06/21/2005 06/21/2006 MED EXP (Any one person) S 5,000 CLAIMS MADE OCCUR 491FOO2639 $ 1,000,000 AL 8 ADV INJURY GEN'L AGGREGATE LIMIT AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS PER: GARAGELIABILITY - ANY AUTO EXCESSIUMBRELLA LIABILITY OCCUR '❑ CLAIMS MADE DEDUCTIBLE R 'I I RETENTION S WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERAIEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS SIDING AND ROOFING. (508) 778-5603 GATEWOOD HOMES 1600 FALMOUTH RD SUITE 25 r&L JT 'DlTTT.T.r.. MA 02632- ACORD 25 (2001108) ] r INS025 (0108).05 PERSON GENERAL AGGREGATE $ 2,000,000 .,.,..n, ll- rne.1PMPAnG $ 2,000,000 COMBINED SINGLE UMIT S (Ea accident) BODILY INJURY S (Per person) BODILY INJURY $ - (Per accident) PROPERTY DAMAGE $ (Per accident) f NLY CCIDFJT OTHERTHAN EC G CAru (X_rURRENCE I5 / / / / AGGREGATE S S S 5 WC STATU- GTH- TORY LIMITS ER E.L EACH ACCIDENT 5 E.L. DISEASE - EA EMPLOYE S E.L DISEASE- POUCY LIMIT S SHOULD ANY OF THE ABOVE Utscrou", rvu..,�... ..�--•------ ---- 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 REPRESEN T ELECTRONIC LASER FORMS, INC. - ©ACORDCORPORALIUIN TV04 Page 1 d: rr ,r MASSACHUSETTS ASSIGNED RISK POOL REQUEST FOR CERTIFICATE OF INSURANCE l se this form to request a Certificate of Insurance from an Assigned Risk Pool Carrier. ' Please provide all of the requested information, including the facsimile numb:, s) of the person or persons io whom 'he Certificate of Insurance°should be issued. If this form is fully and accur&,-l� cc npieted, the Certificate of Insurance will be issued and distributed by facsimile to each fax number provided below, sat ,,,..,vo (2) business days of the came. s receipt. This Form may be mailed or faxed to the Assigned Risk Pool Carrier. ra obtain each carrier's c;.ntact information refer to the Certificates of Insurance section located in the Producer Comrrt(ndy section, of the Bureau's web;ile (unsN. wcdbma.Ora). 1. Name, address, teI phone number and facsimil . number of INSURED: AA) �n n l ilo. FI L l 1 [V 6 K „ Mailino Address:_ Physic! .Address Pho ': 2. ame, address, Name: Mailing Address:, Physical Address: Phone: i� 66�/ rlrl e number and�acsimile number of the CEP.TIFICATE HOLDER: Fax: \rI/ /ram ,j�n 3. Name, address, contact person 4te ephone number and facsimile nu mber of the PRODUCER: Name: Sand-'io r Insurance Aaerlcy.',° Inc. MailinoAddress: 12 Enterprise Road Hyannis, MA 02601 Contact Person: Chri_-nZr Andrea Phone: 5088-79_0-1919 _ 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: 3_L___�� � (") Effective Date: ^_ Expiration Date: 5. List any special requests for optional coverages 1 endorsements (see Page 2 for listing of coverages available in the pool and the conditions of availability) or additional inf; !-oration (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. Date: 5/5/2005 Time: 3:02 PM To: a 15097795602 Partn. nn�_nn� /� /^'�/��j(� +�. c+w� (:AYttiUfii�ERiTY - . i1Lt'1.r;r D: +..+LPTIFIs,AT=" 0} Lli-ABIU�'7 $ IINSURA�.ICA5 DATE(MMIDD/YYYY) WMQ5X5-' PRODUCER • THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION +itA± Fe'f.�iberg Company- OP''Y AND CONF�S NO RIGHTS UPON TH.HCERTMCATE 222 Milliken Blvd. HOLDER: THIS C€RTMCAT-EDOES NOT AMEND, --EXT€NUOR- P.O. Box 3220 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. FaA River, MA 02722 INSURERS AFFORDING COVERAGE NAIC 4 INSURED INSURER A: Acadia Insurance Companies Cape Cod Ready. Y:"z Inc. PO Bay 3SS I INSURER B: Construction Industries Compensation NSURER C Orlears, :'A 02553 NSURER D: rnvenArrc nc ��uL,,to Qr INUHA,NCLUSTLD BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTW71-STANOW, ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENTWITH RESPECTTO WHICH THIS CERTIFICATE MAY BEI5SUE60A- MAY PERTAIN, THE INSURANCEAFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUB) ECT TO ALL THETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE L'MITS SHOWNMAY HAVE BEEN RED CED-EYPAIDCLAIMS- LTR NSRI TYPE OF INSURANCE POUCYNUMBER POLICY EFFECTIVE DATE WM POUCY EXPIRATION AT LIMITS A GENERALL'ABIUTY X COMMER(DALGENERAL LIABIUTY OAIMS MADE.�OCOJR CPA0132463iD- .. ;'Sit/p5-. - 01/Ot/M EACH OCCURRENCE S1000000 O MAGGETO ENTE1) FS PqFMIME SI00000 C EXP AN me pawn) S5000 PERSONAL 3 AOV INJURY $1 000 000 GENERAL AGGREGATE S20000D0 GEN2AGG=1EGA7E UWT APPLIES PER: aCUCY � LOC PRODUCTS - CMP/OP AGG s2 000 000 �A _ AUTOMOSILELIABILITY -.ANY AUTO ALL CWNED AL'TCS C+L S.Ern,OALITOS HIREDAUTOS NON-OWAUTOS MAA0132461M - 01/01/05, 01101/06 WMSINEDSINGLE UMIT lca a�cerxj S1,001O,—Mul O LY IN jrJ Per pe- INJURY X X BODILYINJURYNED Per acOert) S X PROPERTYDAMAOEPer amfcat) - S A ,B 1 GARAGE LIABILITY ANY.AUTO EXCESS,UMBRELLALIABILTtt IMAD13247010 X OCCJR Fj C.AIMSM DE DEDUCTIBLE X RETENTION 90 WORKERS COMPENSATION AND E.MPLO.YER LlABAJ'Pf ANY PRCRRIETCFJPARTNEP./EXECIi NE OFFICERIME:MBER EXCLUDED? Ify� dewibe wlxr cpct_ AL ppOV!giONe Mew OTHER WC0009255 - r 1/01/0 01/01/D5 1/01/06 r 01/01/06 .X AUTO ONLY - EA ACCIDENT S OTHER THAN - EA ACC AUTO ONLY: AG, EACH OCCURRENCE - S S 51000000 AGGREGATE S. S - STAU E.L. EACH AC'TCENT SSCO-00[f EL.DISEA F'-FAEEMPLO"= S500000 FOUCI' UMI T 5500 0Z`0- DESCRIPTION OF OPERATIONS / LOCATIONS (VEHCLES (EXQ_USIONS ADDED B rENOORSEHEW I S TCTAt PROMSIONS CF%RTIMnATC U^1 nro Gatewood Homes Inc. 1600 Falmouth Road Suite 25 Centerville, MA 02632 AEORn',Kf m!nn\ . LO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF THE ISSUING INSURER WILL ENDEAVOR TOMAIL An DAYSWRITTEN :E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL :E NO OBUCATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR -' - "'""""""!'"""""� AH1 © ACORD CORPORATION 1988 05/06/2005 09:38 5084204474 EDWARD A GRAZUL PAGE 02 , t T ..CERTIFICATEF �..IABlUT 1. II-3U'R�CL. 05/06/T7 r THIS C£RT1FiCATE IS ISSUED AS A MATTER OF INFORMATION rAocucER ONLY AND CONFERS NO RIGHTS UPON THE CEfiTIflCATE Iti HOLDER. THIS CERTiFfCATE'DOES 'NOT AMEND; E3EFe!!$O. E zd A. C'raail.InY.z Ply, - ALTER Tt{E -COVERAGE AFFORDED .BY THE POLICIES. BELVI. PO ax337 t M tr3s Ibis, MA C2648 IKsuREl3saFFO1;> IrsG C>;VeaaGs � valor WSUREO _ •.—. —_.• �INsuRE?iA:-._�QULrsLtlrii•. ✓t �- �L.,, T V++-� �NS IAERC-_ 145 Camtt Fbad NusuRERD•. �^ Mmtcrs MilJsT mA 02648 NSUR�a� COVERAGES _ __ THE POLICIU OF:INSURANCE LIST�J.B'e104V.HAVE'aecTJ l$SUED 70 THe IR)SURED IL;Iti,ED A90VE FOP. T'r.?c 7CLICY PERIOD' IrJDICATED. NOTWITHSTANDING ANY REQUIREM M Y PERTAIN, THE �NSURAANCE.AF AFFORDED 9Y THE POLICIES IIESCRtOTHER >3EDNEREDOCUMENT (N 5 SUBJECT O TH HE Z`R.`. <CLUSIOHSN DTCOP•f0ITIC 5 OF SUCH POUCES: AG6R GATE.UMRS SHOWN MAY HAVE BEEN REDUGED BY PAID CLAIMS LIART9 ' POLICY EFTECTYE POLICVEYP(RATIQN ' lii9RT -, TY I POLICY NUmDER _ //yyyy�� ryryyy�� EACH OCCURRENCE.,l.W}4VY-- •�I-G-E�ERAL LIA81Lt1Y .... �t>�F40"FE47E[�-.. ! _ 1� QOMMERCIALGEN£RALUABILITY �I CLAIMSMAD2 �XT - .Ua I {. — COCM69- A I �OEN'L AGGAECATEL:MRR?P.IES PER AUTOOBILE LIABILITY '}!MANYAUTD � u � OW NED RUTCS SCHECULED AUTOS HIRED AUTOS r ! NON-0^150 AIJTOS GARAOELIABILITY F ANY AUTO I IEXC'e5SmmaR UAvnua Fr - I- CCCUA" - L7 CLAIMS MADE .. . i DEDUCTIBLE RETEHTON S -� ttlOAKERS COMPEH9A71oNAND- I ! EMPLOYEATIJABILITY 1 `t ANY PROM elrORiPARTNEP$XF=lvs I OF 4FR/MEMBER SXCLUCED? CESOAI9SiON OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUS10N5 ADDFD BY ENDORSEMENT/ Gate Uood fbTEST irc. C/4 Bd1_7aAo7_tbU . Rte 28-. Our" );VALET m CG.T FAX: 11-508- -178 -crEQ3 /'�•7]'/y _ GENERAEArGREOATE I �1.�r( yF 4/Giy CA`.. PRODUCi9•'COM1�OP AQG :2.;, Ka C .. l COMBINED 51N01 F LIMIT � — (Ee ec�IdeAil . i BODILY INJURY g — IIrF (earaa+aw�l I I BODILY RJJUPY S � IPnr�C'—nU PRCPEHTY OTMA13E- a _ (Pee wcld5ro) f I.. AUTO ONLY. ;A �ACC; DENT i .. OTNERTHAN EAACC S I.. AUTO ONLY: A s -- i c,runrv-itA4r�NLE I s I AC;GRGGATE IF EACH ACC E:L. DfBEASE- SHOULO ANY OL THE ABOVLDESCRIDE2 POLICIES OC GANCFLLED BFFOaETHZ EXPIRATION SATE HIEAEOF: THE ISBWNGINSUREA "LL ENDEAVOR TO mdiL _.DAYS WRITTEN NOTICE• TCLT1E CERTIFICATE HOLDER NAMF.O TO THE LEFT, OUT FAILURE M 00 SQ SHALL IMPOSE N6fiE;lW-=ON-D0.LIA5ffZY. OF. ANY. KIND UPON TE IN-J — - ITS-ASENTS'9R REPRESENTATIVES. AUTTOPf IZE.D A§rRSSENTATINIE _>)-- CERTIFICATE OF INSURANCE ISSUE DATE(MM/DD/YY) 05/06/2005 THIS CERTIFICATE IS ISSUED AS A NATTER OF INFORMATION ONLY AND - P ODACER. CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE Harold H Williams Ins Agcy Inc DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY TILE POLICIES BELOW. 81 Bassett Lane COMPANTIES AFFORDING COVERAGE Hyannis, MA 02601 INSURED Stephen M Childs COMPANY A.I.M. Mutual Insurance Co A 145 Camrnett Road LETTER Marstbns Mills, MA 02648 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 CONTRACTOR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE NIAY 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 LTRI TYPl7 OF 1NSZR? NCE POLICYW :SEER I I POLICY EFFECTIVE DATE(MM/DDIYY) POLICY EXPIRATIO DATE(MMIODIYY) - LIMITS OL•'N/iRAL LIABILITY I I IGENERAL AGGREGATE ; S COMMERCIAL GENERAL LIABILITY - - I PRODUCTS-COMP/OP AGG. S CLAIMS MADE CCUR PERSONAL&ADV.INJ URY $ OWNER'S& CONTRACTOOT. EACH OCCURRENCE S - FIRE DAMAGE (Any one lire) $ MED. EXPENSE (Any one person) I S �AUI'DA'IOISILE LIABILITY COMBINEDSINGLE $ I MANY AUTO LIMIT i BODILY INJ UR Y S ALL OWNED AUTOS SCHEDULED AUTOS (Per person) (BODILY INJURY "S HIRED AUTOS. I NON-OWNEDAUTO$ I I (Per:kciAanU I GARAGE LIABILITY I (PROPERTY DAMAGE i S �EXCESS LIABILITY (EACH OCCURRENCE S I ___1JMIIRF:LLA FORM - AGGREGATE S ^-17THER THAN UMBRELLA FORM w S:ATUT RY THER X I AVORKER'S COMPENSATION AND �iNIPLOYERS' LIABILITY I 7015793012004 12/13/2004 12/132005 EL EACH ACCI DENT S 100,000 EL DISEASE -POLICY LIMIT S 500,000 APIF PROPRIETOR! INCL APARTNERFFICERSSA It CECUTiVE � EXCL I IEL DISEASE -EACH EMPLOYEE S 100,000 OTIIfR I I I i U4:SCR1111'ION OFOI'IiR,\TIONS/LOCAI'IONSIVEIIICLES/SPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE GateFVDO(I 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. AUTHORIZED REPRESENTATIVE Centerville, MA 02632 9 DATE (MM/DD/YYYY) AcoRD CERTIFICATE OF LIABILITY INSURANCE CROOWC5o1 06/061 PRODUCER - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Syll,tvan, Garrity & Donnelly ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 508-754-17 67 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 15010 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 10 Institute Rd - PO Box Worcester MA 01615-0010 Phone:508-754-1767 Fax:508-754-1885 - Crowell Construction, Inc. PO Box 309 So. Dennis MA 02660 INSURERS AFFORDING COVERAGE INSURER& ALEA NORTH AMERICA INS CO INSURER B: Hanover Insurance Co INSURER C: INSURER D: NAIC # 22292. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR 1NSR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DO/Y') POLICY IMM/DD/YY EXPIRATION LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADEK OCCUR ZHN700714102 I 05/01/05 05/01/06 EACH OCCURRENCE $ 1 , 000 , 000 PREMISES (Ea ocwrence) $100,000 MED EXP (Any one person) $5,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 PRODUCTS - COMP/OP AGG 1 $2, 000,000 GEML AGGREGATE LIMIT APPLIES PER: 1-1 POLICY PROECT- LOC J B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS - NON -OWNED AUTOS AFN7001142-02 05/01/05 05/01/06 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ 1,000,000 X X BODILY INJURY (Per accident) $1,000,000 X PROPERTY DAMAGE (Per accident) . s 500,000 GARAGE LIABILITY ANY AUTO n AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ kEXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION s EACH OCCURRENCE $ AGGREGATE $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABIUTY ANY PROPRIETOR/PARTNER/EXECUTNE OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below WC1049858 03/22/05 03/22/06 TORY LIMITS X ER E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEEI $500,000 E.L. DISEASE -POLICY LIMIT 1 $500,000 B OTHER Property Section DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Subject to policy forms, conditions and exclusions. Gatewood Homes 1600 Falmouth Road Suite 25 Centerville MA 02632 GATEWOO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR © ACORD CORPORATION 1988 �`f �JUN 15 '05 04:03PM SANDPIPER INS �j +� PR 0-0—RDa CERTIFICATE OF LIABILITY 1 INSURANCE i (BOG) 190-1919 THIS CERTIFICATE IS ISSL'EI t ONLY AND CONFERS NO Sandpiper Ins. Agency, Inc. HOLDER. THIS CERTIFICATE 12 EnterpriBe @Cad ALTER THE COVERAGE AFFO tm 02601- _ INSURERS .A.FFCRO!"MCO`dERA Oualberto, Paulo L-._ 21 Qniapish Ad -A-<l..,a,. mA 02 PINiCDARPC P. 1/2 DATE (MWDDIYYYY) oa/ia/2aos OR. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURL U NAFetD AeoVE I'UK me rvLly T "Illy + 1.1 +, , • =+ . --. TO VVHICH THIS CERTIFICATE MAY BE ISSUED •" •, - . . •-•• -- - - - OR MAY PERTAIN. REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT HEREIN. 13 SUBJECT TO ALL THS TERMS. EXCLUSIONS AND COi:Di.TICN$. OF.SL'CH-PCUctES- THE INSURANCE AFFORDED MY THE PVJCIES DESCRIBED AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INBR ADD'L I TYPE OP INSURANCE 7 POLICY NUMBER POLICY EFFECTIVE POLIO ExPIRA710N BATE MMIDD/YY D9?_!M'NOOlY LIMITS '' 'to / % / %I EACH OCCURRENCE i 1,000,000 A GENERALLI&BRJTY CA:MADETO RENTED ; 300,000 X COMMERCIAL OENE.RAL LIABILITY LREM'4E91Ea c^ew>•ert 10,000 - 11/20/2(Y04'11t2a/2OD3 MM EXP jArYone aemw) $ CLAIM3 MADE OCCUR .1CP0427793TS - PERSONA' A ADM INJURY S 1,000,000 ' GS"NERALAOAte AT— It 2,000,000 PRCOUCT3-CCMPYJO AGG S 2,000,000 CM AGOREDATSPPURRMQQR APPUEa'P I` POLICY JECT LCC COMBWEO V41.1! LIMIT AUTOMOBILE LIABILITY f ANY AUTO BODILY INJURY ALL OWNED AUTOS (Psr¢a11w) s. �HEDULEOAUT08 HIRED AUTOS BODILY INJURY Ter aCm@RO S - NOKOWNcO AUTO6' PROPERTY DAMAGE 3 (Per seetaea0 ! I .J�RAG'c L!AD!UTY AUTO ONLY• EA ACCIDENT S OTHER THAN EA ACC % 3 ANY AUTO AUTO DNLY: AOG II�;j--II��--C(1EaBl11MBRlLL1 i,milaRI' EAC}I CCC.:R.'i�VCE �S A R-MATE ;�f OCCUR CLAIM'S MADE s DEDUCTIBLE / / / / "�--"�� S I RETENTION S WORXERSCOMPENSATIONAND EMPLOYERS' LIABIJTY E.L. EACH ACOCENT S ANY PROPRIETORIPARTNERISXECJTL'E OFFICERH.9EM8ER EXCLUDEW / / / / E.L D19EA9E- MA EVP0yC- S E.J. DISEASE. POLICY LIMB S N V". deeG:ae Ode/ ' SPECIAL PROMIfiONS Mlo DEa'CR(PTION OF OPERATIONw10CATION9h'EHICLESlEYCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROMISIONS ==CR A=I mX-1 R 1CR VASNTL'3G 779-Sd03 GA a.-0D Ho m.S 1500 7A•w'-e:TITH pU SUZM 25 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELL59 OFFOR9 THY - EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL • ENDEAVOR TO '.RAIL 10 DAYS WRITTEN NOTICE TO THE CE11< Ti HOLDER NAMED TO THE LEFT. BUT FAILURE TO 00 10 $HALL IMPOSE NO 07OA71/ N OR W8ILITY Of ANY KIND UPON THE �Ra 35 (3901/O>t) -Y - - -- 9 ACORO CORPORATION 1981 - INS02S (D?DS).05 ELECTRONIC LASER FORMS, INC. • ($DLT327.014$ Pape T dL' Aug-02-05 01:25P C n -> ACQR2. CERTIFtCAT� - - IL} INSU ��CE- ° e,0 PRODlJ6Er7 Serial # A1530 THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION SIXSY WSURA►dCE AGEMY, IV :. P.O. BOX 830-851PUTNAMPIKI' - GREENVILLE. RI 02M .. . . ONtt'A*& CONFERS - NO RIG UPON 'THE' CERTIFICATIE . PIOLDER ThIS CERTMICATE DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. MURIERS AFFCRDM COVERAGE NA= INSURW wsuRm A: MATT FIRE "INSURANCE CO. OF HARTFORD' . HOLMES AND MCGRATH, IN,;. wsuRER a VALLEY FORGE INSURANCE CO. 362 GIFFORD STREET INSURerc'- CONTWENTAt INSURANCE CO'. FALMOUTH. M,'� 02540 24 JRER D. R rn�REx a COVERAGES - THEPOLICIFS.CF INSURANCE LISTED BELOW 1 AVEBEEN ISSUED.TQTHE.YJSURED KAMEDABOVEFOR.THEPOUCY PERM INDICATED. NOTWITHSTANOM ANY RECLUM-NEMT. TERM OR CONDITION OF UVY CONTRACT C&ATW_q- D= a WRri RESPECT TO- WH10ELTHIS CERTIFICATE MAY BE. ISSUER.OR MAY PERTAIN. THE INSURANCE AFFORDED BY IHE POLICES DESCRISED HEREIN 6SUB.IECT TO ALL THE TERMS, EXCLIMCM AND CONDIT)CtJS OF SUCH POUC?ES. AGGREGATE LMTS SHC W N MAY W JE BEEN REDUCED 9Y PM CLAM. ' AL =. TYPE OF mSURANCE FVLICYN(mmi '4 EFFt�=w >e�4Tw1s LIMITS EACH OCCURRENCE 1 OOOO SJj A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY eulMs MADe QX Gcelxx 10' d08243d 10/06104 10/06/05 AMAG O ENTHJ S F RE 25O,20E 7® EXP e r f 10 000 PERSONAL S•ADV WADY S 1.00D.00O GENERAL AGGREGATE. f 2,000,000 GENL AGGREGATE LIMIT APPLIES PER POLICY PRO LOC PRCOUCTS - COUPIOP AGG S 2 OOO,000� AUT0UOeJLE LIABILITY ANY AUTO C'pvt84gD SIPIGLE LAa2 (Ea act�eelnl S. ALL OWNED AUTOS SCHEDULED AUTOS � LR�N.RX7Y S ' HIRED AUTOS - NON -OWNED AUTOS (per S . PRCPEHTY DAMAGE ((��e�ac<teeewYY 5 GARAGE LIAMITY ARTAUTG, AUTO ONLY -EA ACCIDENT f OTHER THAN EA ACC S' AUTO ONLY AGG S EXC`�M®REL1.A'L7ADIUT)' OCCUR CLA"S MACE EACHOECURRENEE- f AGGREGATE S L DEDUC79LE _ S RETENTION f - s EMPLOYER5O1��TIDM AlM x WCSTATLL TH- B ANY PROPRMTOWPARTNER)EXEdR1VE 2117445273Z 09JE M4 .. ... mottos- ' EL EACH ACCIDENT f T OOO'DOD-' CFFICER/MEMBER E7(CLUDEM - Mde be urger - EL DISEASE- FA EMPLOYEE S 1 OOO OOO OTHER RA PgfIVL51CWg belor .... g DISEASE . POLICY LOW, O7N 1 C PROFESSIONAL UABILITY AE4 00431 33 3a- . 71131M. 071t3Rii t,000 CQ0 PEl2CLAtAdI. AGGRETGATE- DESCRIPTICN OF OPERA7fONyLOCATIONSNEHrr c«. 1USXWS ADOED BY EMOORSEMEMTISPECIAL PROW y: AGGREGATE UWTSARE PER THE TER WS AND CONDITIONS -OF THE POLICIES CERTIFICATE HOLDER CAMCFI I LTKW SHOULO ANY OF THE ABOVE DESCRISEO POLCCES S£ CANCELLED BEr'ORETHE OIPIRATION GATEWOOD HOME'S DATE THpIE-OF• THE MaX4G *SURER WILL ENDEAVOR TO MAIL _PAYS%A mTEN 1600 FALMOUTH RD., STE.; 5 NOTcETQTWCERW REHOmER'NAMED TO THE LEFT. 8DTFAILlA7E TOL1OsusrAa CENTERV ILLE. MA 02632 "POSE NO OBLIGATICN OR LIARAIP7 OF ANY KIND UPON'TME MSURER, ITS AGENTS OR REPR£SO4"TUES. AUT ATNE 1 ACORD 25 (20011081 I V RUI IKU cURPOKATIDN 19n C:V'MPR0ICERTPROS.FPS s ACiJ!` DI. CERTIi—ICA f E OF-LMEHLI7 -Y- VATE(MMND"" ILY'oiUR/'tNCE .. .. 8/2/QS PRDDMCKn THIS CERVIF)CATEISISSLEDASA MATTER OFMRMAT)ON United Insurance Agoncy-,--Inc. - ') CNLYAM&-COPE€RSNORrAM UPONTHECERTFICATE-.. . 199 Main Street HOLDEFt71-SCERTIPCATEDOESNOT A-M&4E},EXTEDOR P.O. Box 1013 ALTER THE COVERAGE AFFORDIDBYTHEPOLICIE9 MOW. Buzzards nay, i%1iP. 02532 INSURERS AFFORDING COVERAGE NAIc x INSURED Patton Electric, Inc. IIY$OREwk Zurich -NA INWPERR Commarcm Insurancs Co. 128 Scituat0 Road, INSURER Mutual -Ins. Co: ,, Msshpes, MA 02649 INSURER C: - aVBUREfiE..... rnvcaA r_cc . 714E-POLICIES OF.INSURANCE LISTED.BELOW.HAVEBEEN.ISSUE D.TO.THEINSURD. NAMED AgOVEFOP, THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY MAY PERTAIN. OTHE INSURANCE AFFEMENT. TERM OR OITION OF ANY ORDED BY THE POLICIES DESCR18 D HEREIN 15 SU E T TOTH ECT ALLTO WHICH THIS THE TERMS, EXCLUSIONS AND CONDITIONS OFFICATE MAY BE ISSUED F SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. N Cpfmlf- FOLfCYNUMBER PQfIr:v 6F:EL4LE POLICY ON A CWNPRALLIABIUTY _COMMERCIALGENERALLIA.09ITY FRICLAMS MADE OCCUR SCP4243539-9- 7/30/05 I -A/30/06 LIMITS' EACH OCCURRENCE ! T OOO OOQ STUEevusn ! �O, G" ! 10,000 MED EXP µn me !lTw1 - - PF850NALd ADV INJURY S 1,000,-OM OENERMAGGREGATE ! 2,QOO,000 s 2 QQQnd�- OCN'L AOGRGGATE LIMIT APPLES PER' X POLICY E T LOC PROOUCTB-COMPA]P AOG AUTOMOBILE LIAMLITY ANY AUTO COAIBWIEDSWIOLELINT (E! NYIdw) ! ALL O20O AUTOS H SCHEDULED AUTOS YW;338 10/3/04 10/3/O5 BODILY INJURY (P"P0 A> X IGO,Car- HIRED AUTOS I . I NON-Ow#+ED AUTO$ - BODILY INJURY (Pw sceld") I¢ 3G0, 00& PROP RTYOAMAGE (Pw rcldwdl SQQ0- 1 I('-y1 IEJCP83UMERELIALLApILRY GMAGELIMILITY ZANY AUTO OCCUR CLAIMSMAOE. AUTO ONLY- CA ACCIDENT S OTHER THAN EAACC AUTO ONLY. AGO EACH OCCURRENCE ! ! AGGREGATE S A 1p OEDUCTIBLE RETENTION ! ! C WOIIX EAE COMPPNMION AND EMPLOYM-LUMLITY ANY PR OPP M70RJPAR TNCRS(ECUTRE OF FIC£RAIELMBER EXCLU DEEP WC23141353049014 12(10%04 Sa%I0lOS V.0 STATLF OTH- F E LEACHACCIOENT I SOQ, D.QQ E.L DISEASE • PA EMPLOYpE ! 50 0 , O a I'+er�dLL sSy `A( 5�6 .. A DISEASE• PCLICYLVdR ! 1QQ 00Q OTHER DESiCRIPTIONGPOPERATfONSILOCATRSNSryPNL[Eg7EXCC1g10NSADOE6QTENppNJEMENf/Dp[OMt, MpTTypltl,. . Electrical C B7f IFICATE HOLDER _.... _. _.. Gataxood Homes Fax No. (508) 778-5603 1600 Falmouth Road Suits 25 CAJTLt497Tilh, Ma 02632 ACOR0 25 SHOULD ANY OF THE ASOVE DESCRIBED POUCIEBBE CANCELLED BEFORE THE EXPIRATION DATETNEUMF, THEISSU01111MNRERYTXl ENDEAYCR.TO MAIL. i0 DRSWRITTEN -M071C E TO THE CERTIFICAMMIDER NAMED TO TH ELEFr 8U'rMUBE1000'ECENALC IMPOSENO OBLIW I i0N OR IJABIL17Y OF ANY HIND UPON THE INSURER• ITB AGERTE OR AC�RD CERTIFICATE OF LIABILITY:INSURANCE DATE(MMI°°"' -,� 9/15/04 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER Chatfield, Whitman & Young 4 549 Washington Street ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 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 CERTIFYTHATTHE 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MM/DD/Y4) POLICY EXPIRATION DATE(MM/DONY) LIMITS A GENERAL LIABILITY 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 - COMP/OP AGO $ 2,000,000 PERSONAL & ADV INJURY. $ 1,000,000 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) $ 100,000 MED EXP (.My one person) $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 8 ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS _ - BODILY INJURY (Per accident) $ NON -OWNED AUTOS PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY. ANY AUTO ' EACHACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM STATU- OTH- TORWC Y LIMITS ER $ .- OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EL EACH ACCIDENT $ EMPLOYERS' LIABILITY . EL DISEASE - POLICY LIMIT $ T—I THE PROPRIETOR/ INCL PARTNERS/EXECUTIV'E OFFICERS ARE: EXCL i EL DISEASE - EA EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS&OCATONSNEHICLESISPECIAL ITEMS CERTIFICATE HOL',DER .a �..... CANCELLATION:. - 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, Spite 25 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY, Centerville, MA 02632 OF ANY KIND UPON THE COMPANY ENTS qR O SENTATI S. AUTHORIZED REPRESENTATIVE Robert E. Chatfield _.ACORD 25-S (1/95}" - a ACORD CORPORATlON.1988' } AC Mr. CERTIFICATE OF LIABILITY INSURANCE Ro 6 09-27-2004 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 8: LAWRENCE ROBINSON MASONRY INC INSURER C: 5 FRESH HOLE ROAD INSURER D: HYANNIS MA 02601 INSURERE: Cfl\/FRA(:FC 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. INSR LTR rypE Of INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE 1MM1DDVYY1 POLICY EXPIRATION DATE MM DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) e CLAIMS MADE OCCUR PERSONAL& ADV INJURY $ GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PECROT LOC J A U7OMOB/LE LIABILITY ANY AUTO COMBINED SINGLE LIMIT Me accident) S BODILY INJURY (Per person) S ALL OWNED AUTOS SCHEDULED AUTOS _ .I - BODILY INJURY accidenq $ HIRED AUTOS NON -OWNED AUTOS - - --(Per PROPERTY DAMAGE- (Per accident) - $ GARAGEL/ABBTTY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC S ANY AUTO $ - AUTO ONLY: AGO EXCESS LIABILITY i EACH OCCURRENCE $ AGGREGATE 4 OCCUR CLAIMS MADE S $ R. DEDUCTIBLE $ RETENTION $ - A WORKERS COMPENSAT/ON AND EMPLOYERS'LIABILITY 76 WEG NQ5620 09/06/04 09/06/05 X WC STATU- OTH- RV IMI E.L. EACH ACCIDENT 1$100,000 E.L. DISEASE - EA EMPLOYEE $10 0 , 000 - I E L DISEASE - POLICY LIMIT 9500, 000 OTHER I I DESCRIPTION Of OP£RATIONS/L 0CA TIONSNfH1CLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Those usual to the Insured's Operations. GATEWOOD HOMES 1600 FALMOUTH ROAD, SUITE 25 CENTREVILLE MA 02632 UNIV I. CLLH I IUIV ;HOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE IXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE IOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO )BUGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR IEPRESENTATIVES. AUTHOR/ZED R£PRES£NTA ACORD 25-5 (7/97) 0 ACORD CORPORATION 1988 12/02/04 13:36 FAX 5087900249 COLDMAIN ASSOC NE. I naTE yuinrmrvv. ��' �� 4f•lill A T �-± �- - LR +ai� URA Qs% ,. 7 9 ii ➢w✓ATE O � � a i Y aMroURs"ii CE: m CSR AS .AV_ANSO 12/02 04 PRpOUCER Tu:S CEMTIFIC.a.T 1S MSUED AS A.'-.A.wATTER OF INFORu..,�T:O:! w..auo.vy : ASSOCIATES :rNSuacALvCB - fXlLY AND CONFERS NO RIGHTS UPON THE CERT1rrICATE FIXNNCIAL SERVICES INC. 'HOLDER. THIS CERTIFICATE GOES NOT ?.MEND, EXTEND OR 933 F=nOV7T RD. ALTER THE COVERAGE AFrORDFD BY THE POL'CIES BELO - EY-20MS MA 02601 D}Lcnel 308-775-9610 7$x:30$-790-0249 INSURERS AAFFORD)NGCOVERAGE I NAIC9 INSURED ' P_OD*79^I '^9Va*70 DBA-MECHANICAL SYSTEMS 110 I:OLImR LAP„ A :Q BA527STABLB MA 02668 INSURERA: MARYLAND CASUALTY COMPANY INSURER S: j INSURERC: :INSURER D_ INSURER E: COVERAGF3 THE POLICIES OF INSU-ANC-- LISTED BELOW HAVE SEEN ISSUED TO !'HE INSURED NAMED ABOVE FOR TYIE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OT.IER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN; THE MS:IRANGE AFFORDED BY THE POLICIES DESCRIBED HF IN I,S SVNF4;T TO ALL THJ TERMS; D(CLUSIONS AND CONDITIONS OF SUCH - POLLCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR WSRO TYPEOFINSURANCE I POLKY NUMB" OATS (MAND111M DATE (MWOOrM VATS I GENERALLUZAJT( EACH OCCUPIRE E I S 1000000 A X COMMEJICIALGENERAL LLAOLITY 1000372088 11/21/04 11/21/05 PP M Si atteu:arr2) S 300000 CIJdMS MADE L 1 OCCUR I MED EXP (Ary me p8 ) I S 10 0 0 0 I PERSONAL LADVINJURY $1000000 I I I GENERAL AGGREGATE S 2000000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS• COMPIOP AGG i E 2000000 POLICY ! �� LOC AUTOMOSAI: LIABILITY COMBINED SINGLE LIMIT 3 ANY AUTO I - (E3 accident) ALL OWNED AUTOS BODILY NjURY I SCHEDULED AUTOS (Per Person) 1 HIRED AUTOS b'OOiLY INJURY I S 1 I NOW -OWNED AUTOS ,Per accident) DAMAG-E = I IPROPERTY (Peracmd"t) OAAAI�E LUVALITY J I. AUTO ONLY -&1ACCIDENT $— - OTHER THAN EAACC S I� ANY AUTO I I I AUTO ONLY: AGG S L EXCESSKJ�.RE.LA LLWL)TY EACH OCCURRENCE S I OCCUR CLAIM'S MADE I AGGREGA F I S I I I I= LED"I S.LE I I_ 1 _ . 11: ETENTON • S J I Is WOR%=_R3 COIL ENSATTON AND I ( I a TORYLIM S ER EAiPLOYERS' LABLY11/ E.L EACH ACCIQENT I ; ANY PROPRIETORIPE ARTNERJXECUTNE ` OFFICEPJMENIBER I XCLUCEDT I - E.LOISEASE-EAEMPLOYEJS .Y yam, Oriel. a IricIa SPECIAL PROV1SIO IG bell. I I EL. DISEASE - POLICY LIMIT I S OTHER ) ..T.."'.:' C. vfEM'T.....5! L............-./ :-.,....E31 y......-..".%.-.-..."..E9y `........�'.�:.: Wit.". 'f �� C.....- CERMCATE HOLVER CANCELLATION ? r_nrxwnn SHOULD ANY OF THE ABOVE OEP.."^SEDP^—)C:ESBECANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN lNOTICE TO THE CERTIFICATE HOLDER NAMED TO THIE LEFT. BUT FAILURE TO DO SO SHALL FAX 50$-778-5603 FAz 5 08 - 7 8 - 56 3 IMPOSE NO OBLIGATION OR LIABILITY OF ANY IOND UPON THE INSURER ITS AGENTS OR 1600 7AL=13TH ROAD SIIIT3 25 REPRESENTATIVES. AUIHcjR REPRESENTATIVE Ai I SIIi3' C=T:RVILLE MA 02632 ACORD 25 (20011081 TILE ACL7K6GORFOFa[TIOTTi88H.. PROPERTY ADDRESS: /�/ �,�1• 7 ALCULATION FOR PERMIT COgY TYPE OF ROOM ETC 3 dS, 4D ADDITION AL-TERATIONS BATH S$ i BED ROOM CERTIFICATE OF OCCUPANCY COMPUTER ROOM DECK OPEN DECK WITH ROOF ` �'Q DEN — /Jy Sb DINING ROOM FAMILY Room 5.3 6 FIREPLACE FOUNDATION ONLY GARAGE NO. OF BA GREAT ROOM LAUNDRY ROOM LIVING ROOM MUD ROOM OFFICE PORCH CLOSED PORCH OPEN REROOFING SHED _ .. STORAGE AREA SUN ROOM HEATED OF V TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-06-065 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Unit 104 Owner's Name: Villages @ Camp Street, LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 �iEVIEWED BY: 1. WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 1033 Net Owed: ($50.00) Application Date: 8/15/2005 Issue Date: Expiration Date Comments: Map/Lot: 044.21.1 new construction: ZONING APPROVED V. ✓4. HEALTH DEPARTMENT: DATE: N/A: 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 Of V 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-06-065 Frank Capra 5087789669 00121 CAMP ST Unit 104 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: $50.00 Payment Type: Check ChkNo.: 1033 Net Owed: ($50.00) Application Date: 8/15/2005 Issue Date: Expiration Date Comments: Map/Lot: 044.21.1 new construction: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT: DATE: 9-6,-p4�- N/A: 5. BUILDING DEPARTMENT V DATE: N/A: 6. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE 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., #104 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 Ya outh Water Department of 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-06-065 Frank Capra 5087789669 00121 CAMP ST Unit 104 Villages @ Camp Street, LLC 1600 Falmouth Road # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 1033 Net Owed: ($50.00) Application Date: 8/15/2005 Issue Date: Expiration Date Comments: new construction: REVIEWED BY: `1: WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: 4. HEALTH DEPARTMENT: 5. BUILDING DEPARTMENT: 6. FIRE DEPARTMENT: COMMENTS: RECEIPT OF COPY: PLEASE NOTE SIGNATURE OF APPLICANT: DATE: DATE: DATE: DATE: N/A: N/A: N/A: N/A: DATE: 044.21.1.0 /N Date Printed: 8/22/2005 ODUCT SPECIFICATI GMS9/GCS9.SERIES .. 93% AFUE Muld-Tositionj.. Single-Stage/Multi-Speed. . Gas Furnace...... Heating Capacity;_ 46,000-115,000 BTUH 0 YTr tt __ A l--Can&WortiW& ffea W&,-\ The GMS9/GCS9 single -stage, multi,Ved-gas fuyrr m offer- installation.versatility, . . Standard Features Cabinet ecris"UcticTr • Corrosion -resistant, aluminized steel tubular heat • Heavy -gauge. reinforced, fully insulated steel cabinet exchanger and stainless -steel recuperative coil for witlt durable baked -enamel finish maximum efficiency • Attractive architectural gray paint finish • Designed for multi -position installation—GM59: . Foil -face insulation lined heat exchanger upflow, horizontal right or left; GCS9: downflow, horizontal tight or left • • Energy -saving, reliable Hot Surface Ignition system, , featuring a Norton® Mini•lgt er with patented adaptive learning algorithm to maximize igniter life • Aluminized- steel inshot burners • Energy -saving PSC; mull -speed-, direct drive blower motor • Quiet, corrosion -resistant induced -draft blower assembly • Integrated fumacecontrol.with•improved..... diagnostics • Low voltage terminal blocks • Multiple flame toll -out switches, blower door safety switch, outlet air•lirrtit 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; alternatrfluefvenrlocated- on right side • Completely. assembled..factom-run- tested furnace.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 compartment Coil and furnace fit flush for easy installation Convenient left or right connection for gas atid electric service Bottom or side air inlet (GMS9) Removable, solid bottom block -off (GM59). Accessories L.P. Conversion Kit (LPTOOA) •- L: P.-Gar l,ow Pressure Kit-(LPLP01) High Altitude Natural Gas/L.F. Kits (HANOI1. HANG12, HALP10) • High Altitude Pressure Switch Kit (HAPS27) • Externa1Filter Rack (EFROI). . • Horizontal Concentric Vent Kit (HCVK) • Vertical Concentric Vent -Kit (VCVK) ... internal Filter Retention Kit—upflow, horizonul (RF000180) ..... . • Internal Filter Retention Kit—downflow (RF000181) • mor Thermostats Slower Motors (CHT38.60. CH70TG, CHSATG, HZOTWR) SS-377D Ww goud=nmfgcoin 6N4 PRQQUCT SPECIFICATIONS Nomenclature G M S 8 474 3 A' i�t ieC Goodman®Brand Revision NOx 8: tx Revision ,r ow Direction N: Natural Gas C: Z"° Revision M: UpflowLHo[iznn[at.. _.. ... . _ . - ....... ...._ . ..... ..X7 l.oivNCix D: Dedicated Downtlow C: Downflow/Horizontat a met Width It. Hi'Air Flaw . . A 14" `. S: Single Stage/Multi-speed V: Two State/Variable•spee 8i 80% 9: 90% 8: 17A" D: 241V Maximum CFM ® 0.5" ESP 3:1,200..... 4: 1.600 5: 2,000 s-.. KBTUH 045: 45,000 070: 70,000 090: 90,000 1t5,000-- 2- U PRODUCT SPECIFICATIONS GCS9 Dimensions U"ImE . . NEW va r1ta0a wtwT 310E VIEW iaE'rUa".ia) VEWT?Wa rrE rout a eras coaDfMas.Tf r lOW VOITanE m tc I nl sw'rve t lLECTaleµ lt0\! .... WOMaaa.... IF Ia10aT Olt �,rG1t VOLi.Ci- 0 rao[o rsartaEa d7ewaof set GCS90453OXA GC590703BXA GCS90904CXA GCS91155DXA Nf1TES. 17tfi" 1T34" 21" 24Yt" 16" 167.... .. __.. 19➢f" ... 22'._. 1ZsA" ........12iL". .... 16%" ..... i0sh".._ .. U%r" ...... ram•..... 18" 2154.".... 16^ - 16" 19AO .. �,. I. installer must 1uPP1v One or two PVC Pipes: one or comhuvjm air_(optional) and one furthe Aae outlet (requited): VenF pipe must he elther 2" or 3" in diameter. depending upon furnaceinputf numberof elbows, length of run and'installation (1 or 2 pipes). The optional Combunon Air Pipe is dependent on installation/code rtqutTement3 and must be 2' of 3' diameter PVC. Z. Line voltage wiling can enter thnwgh the -right or leksfdeoftite furnace Cow Voltage wising can enter through the nghr or leftside of furnace. 3. Conversion kits for htgh altitude natural gas eperadon are available. Contact your Goodman distributor w dealer for details. 4. installer must supply following Gres line fittings, according to which cntranceit tsW� left—T-190e clbuws, unc close nipple'. straight pipe Right --Straight pipe to reach gas valve Minimum Clearances to Combustible Materials C . Combustible: If placed on etsmbdstiblefour. the Moor b1U$T be wood ONLY. NC - Non•Combusttble: A combustible floor subbase must be used for installation on combustible flooring NOTES: • For servicing or cleaning, a 36" front clearance is recommended. • Vnit cttnncctions (electrical. Flue and drain) may necessitate greater elearamcea thao.them(nsmumekarasteeslisted baow, • in all c ssea, accessibility clearance meat tape precedence over-clearanees from the endoture where accessibility clearsma are greater. 5 PRODUCT SPECIFICATIONS Blower Performance Specifications ttx .r •. 1 tips.' 2 - N. q: 1s3S2 .-.... t,318 r r•• t,260 -•--.. 1.202 ON _..,.. r •G_5904578XA HIGH 3.0 MED 2.5 t,214 ty172 ------ 1,123 •••••• 1,064 •- •3 (LOW) MED-LO 2.0 997 •••••• 994 ------ 960 35 923 36 LOW.. ..1:5.. ..757... 44-...753- -44-- 734.. 45.. 70t 47 HIGH 3.0 1.449 36 1,409 37 1,326 39 1,273 Al ;. G_590703BXA MED 2.5 1,191 43 1,172 44 1,141 45 1,094 47 (MED-HI) ' ' MED'-CO ' '2.0 �981 53 �96Z " 54 943 '55 Low 1.5 1 750 730 7114 .40, iuGH.. —4.01. 1,97 L,-974-..-35... 1;757 .3&- %d%L MED1.5 10 , , , StG_590904CXA , n... M (MED-LO) MED-LO 3.0 1,439 46 1,412 47 1,370 48 1,327 SO "LOW""2.5'- 1 T83 '56'..1'155' -'ST-' 1,122 '59- 1.109 60 HIGH 5.0 2,134 40 2,103 40 2,029 42 1,941 44 G 5911550XA MED 4.0 I ffl ..51 1,643 _ 52. 1,643 .57. 1.,577 ..54.. (MED-MI) MED•LO 3.5 1,453 58 1,140 59 1,426 59 1,363 62 - j ..3.0....1 759 ..67. .1 739 -68... 220 -70... 1 19t t%N, • ...... ` 5�1t�: ' , NOTES: I. CFM in chnrc is without filter(¢). Fdtcrs des not sltip.with slvs fumau but moat lx.yruvulelby [ha itlstall ir..1(ehe ftunactiaquirux two retu�tS. chip chart assumes both filters are installed. 2. All (urnue" ship as high speed cooling. Installer must adjust blower clr:tll"x speed as needed. .3. For worst jobs. abour 400 CFM per tan when cm-Aing it dws:table. 4. INSTALLATION IS TO BE ADJUSTED TO OBTAIN TEMPERATLYRF. RISE WITI I1N i Hk: RAMC,15 SPECIFIED ON'f THE RATINO PLATE. 5. The chart is for Infurmuian only. For sactsfacawl operadtm, external static pressure mere not exeeed value shown tan the rating plate. The shaded area indicates rani¢,. In excess of maximum static pressure idlowed when heating. 6. The dashed ( ---- ) areas indicme a ttntperatureiise, mt teeummended 4,rA*rmnde6.. 7. The above chart is htt US. furnnces instilled at 0' • 2A00'. At higher aIntudcc. a properly de -rated unit will have appKwunataly the into temperature rive at a por ivular CFM,. while ESP at Elie CFM willbe.htwer...... M PRODUCT SPECIFICATIONS Accessories LPT-OOA L.P. Conversion Kit LPLPOT L.P. Gas Low Pressure Kit r j HANG11 High Altitude Natural Gas Kit 1 1 1 1 HANG12 High Altitude Natural Gas Mt 2 2 2 2 HALP10 High Altitude L.P. Gas Kit 3.. ... 3..... 1 .... 3 _. _ HAPS27 Nigh Altitude Pressure Switch Kit 3 3 3 3 .. EERO1.. External filter -Rack.. ._ .. ........ 4 - _ .. ..... .i ...... i..... _ . 1..... OCVK-20 Horizontal/Vertical Concentric Vent Kit (2") I DCVK•30 Horizontal/VerticalEoncentrleVer*Kit ^J- _...._. .. , .... - n.auaorc tvr rots nsnoei (1) T,071'to 9,Q00' (2) 9,001' to I1,000• (3) 7,001' to 11,OOa Note: All installations above 7,000' tegvlre a pressure switch eltangec Ftm etstafletiotrin Chnada, (arnaces are certified only to 4,500'. am: CF ov , CFBlooir Base; When the CJir1Q males is installed directly vn a wood floor, s downflnw hove base must be used. Thtvc model numbers, atc� CFB17, CFB27 and C:FB2�. Thermostats CHT18-60 Cooling/Heating, Mechanical CH70TG Cooling/Heating, Digital, Non -programmable CHSATG �i C0olt^4/+{eatin4: Methdntcat . N20TWR Heating Only, Mechanical a r 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: 5-7-2004 DATE OF PLANS: 05/07/04 TITLE: The Tern 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 = 354 Your Home = 190 Permit # Checked by/Date Area or Cavity Cont. Glazing/Door Perimeter R-value R-value U-value UA CEILINGS 1030 30.0 30.0 18 WALLS: wood Frame, 16" O.C. 2043 15.0 15.0 90 GLAZING: windows or Doors 115 0.340 39 GLAZING: windows or Doors 40 0.340 14 DOORS 40 0.086 3 FLOORS: over Unconditioned Space 1030 19.0 19.0 26 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR 1310 and J4.4. Builder/Designer Date MasSachuvetts Energy Code MAscheck software version 2.01 Release 2 The Tern DATE: 5-7-2004 Bldg.l Dept.i use I CEILINGS: [ ] I 1. R-30 + R-30 Comments/Location WALLS: [ ] I 1. wood Frame, 16" O.C., R-15 + R-15 Comments/Location I WINDOWS AND GLASS DOORS: C ] I 1. U-value: 0.34 I For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location [ ] I 2. U-value: 0.34 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location I DOORS: C ] I 1. U-value: 0.086 Comments/Location I FLOORS: [ ] I 1. over unconditioned Space, R-19 Comments/Location I AIR LEAKAGE: C ] I 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 I 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. I VAPOR RETARDER: [ ] I Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. I MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I I I I 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 74.4.7.1. DUCT CONSTRUCTION: All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in Sections 780CMR 1310 and 34.4. SWIMMING POOLS: All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. HVAC PIPING INSULATION: HVAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in.): PIPE SIZES (in.) HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 Low temperature 120-200 0.5 1.0 1.0 1.5 Steam condensate any 1.0 1.0 1.5 2.0 COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.75 1.0 refrigerant below 40 1.0 1.0 1.5 1.5 CIRCULATING HOT WATER SYSTEMS: insulate circulating hot water pipes to the following levels (in.): PIPE SIZES (in.) NON -CIRCULATING I CIRCULATING MAINS & RUNOUTS. HEATED WATER TEMP (F): RUNOUTS 0-1" I 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 I 1.0 1.5 2.0 140-160 0.5 I 0.5 1.0 1.5 100-130 0.5 I 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department use Only) H�GKLC� iO SiW,' REPORT -US Thursday, Juns24T200¢14r38 Tripie 1- 314" r 11 718" VERSA-LkPASI3100-S?- . Job Name: Milt Pond Village DilaName: 2nd fl be m under a Address:. . Description, : 2nd tl beam under dormer west City, State, Zip. Yarmouth, Ma one Bill Customer. Gatewood Homes Designer. BillCampbell Code reports! - ICBO 5512; NER 629 Company: Shepley Wood Products 6Tis= 7701bc LL B'h, 8031bSDL 770lbs LL Mlt:L4 PL Total Horizontal Length-19-oo-00 GeneraFData - Version: US Imperial Member Type; Floor Beam Number of Spans: 1 Lett Cantjlovec... No ... Right Can4fiever Na Slope. -. 0/12 - Tributary: 01.00.00 Live Load:.. .. 40 ptf.. . Dead Load: 10 psf Partition Load: 0 psf Duration:100' Disclosure .. . . The completeness and accuracy of Me input must be verified by anyone whowoutd relyon-the outputac . evidence of suitability for a particular application. The output above is based upon building code -accepted design properties and anatysrsmoLlods..Installation . of BOISF engineered wood products must be in accordance with the currentfnstWfaftnr Guide - and the applicable building codes. To obtain an installation Guide or if you have any questions, plesse call (800)232-0788 before beginning productInstalkMom ... BC CALCO, BC FRAMER®, BCI®, BC RIM BOARD^ ,•BC OSS RIM' BOARD'", DOISE GLLILAMTM, VERSA-LAMO, VERSA-RIM0, VERSA -RIM PLUSS, VERSA -STRAND'", VFRSA-STUDO, ALL JOIfiTtt and. AJS74 are trademarks of Boise Cascade Corporation. Page 1 of 1 Laad-Stmmimy ID Description Load Type Ref. PS...Standard Load_ Ilaf. Area... Lett _ 1 dormer watt Unf. Lin, Left 2 Roof Unf, Area Left Controis Summary Control Type- ....Vatuo- Moment 9880 ft-Ibs ' Neg. Moment 0 ft-Ibs End Shear 1503tbs Total Load Deft. 1./543 (0.42") Live.Load Defi _ L/1144 (0199_'1... Max Daft 0.42" Start End Type Value Trib, Dur. DQ00-�0.... 13-0040_ uva__ 40-pcf-- -0tA0.00-100;rL Dead^ 10 psf otAM_00 90% 05-02-00 13.10-00 Live 0 ptf n/a 90% Dead 60"pir nfe S01%. 05-02-00 13-10-00 Live 30psf 03,00-001D0% Dead 15 psf _ 03.00-00 90% °/--Alfowal+fe Duration Load Case SpaiTLaaatfan� 31.0 100% 2 _ 1 - InternalWe 1 12.6% 100°/, 2 442% 2 1 31.5% . z.. 1.. 42x% - 2 1 Note*-_ - Design meets Code minimum (L/240) Total load deflection critoris. Design meets Code minimum (U360) Live toad deflection criteria. Design meets arbitrary (1") Maximum load deflection criteria. Minimum bearing length for 80 is 1-1l2". Minimum bearing IoQQU1 fair 61 is 1 1/2". Entarad/Displayed Horizontal Span Length(s) = Clear Span + 1/2 min. end bearing + 112 intermediate bearing Connectiary Magra rk" Nailing schedule applies to both sides of the member. Membarhas no side_toads, Connectors are: 16d Sinker Nails a=2" b=3" c = 7-778" .... a d=12" e 3 T p " O. . T- L—f —1 h_ ME a.... . IC -t. s o p 22 "MCA � I. ZQQ QES( �� � ' USThursday. Jurm24, 200.414:17� DOW& 13/$" X 11 7/8"r VER Sk+LAM& MO.SP File Name: Mill PWAV I!2r--BCC-: FB04 Job Name: Mill Pond Village Address:.. Description: 2nd 11 beam over garage picking up wall City, State, Tip: Yarmouth, Ma Spscifior: Designer. Jeff.. .. Bill Campbell Customer: Gatswood Homes Company: Shepley Wood Products Code reports: - ICi O 5512, NER 629 • Misc: 80 g.r- 280 ibs LL 280 Ibs LL 572 [be OL $72 Ibs DL Gerwral Data Version: US Imperial Member Type:. Flcor beam Number of spans: i Left -Cwwlever:... No.. . RightCanhiever. NQ Stops: 0/12 Tributary: 01.00.00 Live Load: 40 psf Dead Load: 10 psf Partition Load: 0 psf Duratrdn: 100 WSCIOSUrB .. . The colnplet3�and accuracy of the input must be verified by anyone, who-woeld-rely eR the eutputas evidence of suitability for a particular application. The output above is based upon building code -accepted design properties and analysis methods.. Installation. . of BOISE en-Asersd wood products must be in accordance with the current htstallotion Guide and the applicable building codes. To obtain an Installation Guide or if you Nava any questions, please (all (800)232-0788 before bo;inning product instahlion... . BC CALC®, BC FRAMER®, HCIO, BC RiM BOARD-, SC OSB RIM, BOARDITM, BOISP GLULAM^+, VHRSA-LAM17, VERSA -RIM®, VERSA -RIM PLUS®, VERSA-STRANDIM, VERSA -STUD@, ALLIOISTOand . . AJSTM ere tredemarlrs of Boise Cascade Corporation. Pagel of 1 Total Horizontal Length - 14-DO.00 t toacYSttnsm�ry- ID Description Load Type Ref. Start End Type Value Trib. Dur. S StandaniLoad,Unf..Area - .. Left.. 0oam-00. .ta-pa00_- Live- . 4Gpst. Qt00041M%_ Do" 10 psf 014MO 90% 1 wall Unf. Lin. Left 00-00-00 14-00-00 Live 0 pit WE So% Dead 60 plf- - Na 9096-. I Cortrols Sutntnary, ... Control Type Valus- %. Allowable DumUcin Load Case SpitaLocz4on Moment 2981 ft-i.bs 14,0% 100% 2 1 - Internal Neg: Moment.... .0 ft4bs-..... Ma-- - 100%- End Shear 731 Ibs 0.1°% 1013% 2 1 - Left Total Load Deft. L11560 (0-108") 15.4% .. .. � 2 1 Liva Load Deff.-..... L7474T(0.MF7_ _ T604:... 2 1.... Max Den, 0.108- 10.8% 2 1 Rrotes Design meets Code minimum (LJ240) Total food deflection criteria. �Desigrt meet, Code-mfnimurrr�tl36LT) �ive-leaddeflactalrtriteria>, Design meets arbitrary (11) Maximum load deflection criteria. - MlnlinuM bearing length for BO is 1-11Z. -Minimum bearinglenath for R1 is 1-1/2'. Entered/Displayed Horizontal Span Lengh(s) = Clear Span + 1/2 min. end bearing * 112 intermediate bearing Connection Dlogttttll . Member has no side loads. Connectors are: 16d Sinker Nails 211 b=3" c� 7-7/8"- d=12" MeRC'CALCO ='DES=REPORT - US Thumday,dum2il, MU 14:37 Double 1 3/4"X 417/3" VERSA -LA 3WO-SP File Name: Min Pond Vivage.eCC : P603 Job Name: Mill Pond Village Description: 1st fl beams ddfining fire place Address: swlfrao:- Jeff . . City, State, ,Zip: Yarmouth, Ma Designer. Bill Campbell Customer. Gatawood Homes Company: Shepley Wood Products Code reports. ICBO 5512; NER 629 Misc. so ale Ibs LL 457 Ibs OL Versions.. US Imperial Member Type; Floor Boom Number ofSparts: t Lett Cantilever. No Right Cantilever. No Slope: 0112 Tributary:- . 01-00.00 • Live Load: 40 psf Dead Load: 15 psf Partition Load: 0 psf Duration: 100 Disclosure The completeness and accuracy of the input must be verified by anyone who would rely on 00 output as evidence of suitability fora . . particylar application. The output above is based upon byilding code-eecepted design properties and analysis mothods. Installation of BOISE engineered wood products must be in accordance with the current Installation Guide and the applicable,bui{iiing codes... To obtain an Installation Guide or If you have any questions, please call (800)232-07&5-befom beginning - product installation. BC CALCO, BC FRAMERS, SCIO. BC RIM BOARDTM, SC OSS RIM BOARO^", BOISE.GLULAMTM,. . VERSA-LAMO, VERSA -RIM©, VERSA -RIM PLUS®, VERSA-STRANDTM, VERSA -STUDS, ALLJOISTS and AJSw are trademarks of Bolse Cascade Corporation. Pogo 1 of 1 7.40 pef I Tota4Honzont4 Load Summary 0. DeacrlpU04- Load-Type.--R4. Start- S Standard Load- Upf. Area Left 00-00.00- End-- .. Type..-... t5-W-OO' Live Dead - T FB02 Pt1Aad Cone. Pt:'- Left' " 01 09.02- 01-09=03- Live Dead Controls Summary Control Type Value Moment' - 21r1T'f=lbs Neg. Moment 0 ft-Ibs End Shear 13061bs Total Load Dell. U1482 (0.121" j Live Load Deft. 112322 (0.0781-) Max Daft. 0.121" - % Allowable Duration t3:5Ri+ _ 100% nla 100% 16.3% 100% 16.2% 15.5% 12.1 %..... al 354 IDS Lt 235 lbs DL - Value- -Tr is Dw� 40 psf 01.jOOAO 100% 15 psf 01.00-00 90% 700-Ibs nt; 100%-- 292lbs nle 90% Load Case Spnn Location 2 1-Intemsr-- 2 1 -Left 2 1 2 1 2 1- Notes Desigh masts Code minimum (11240)Totai toad def6dton criteria. Dasign meats Coda minimum (11360) Live bad deflection criteria. Design meets arbitraty_(1") Mavimumloaddettacuon critaltia_ Minimum bearing length for SO Is 1-1/21. Minimum bearing length for B1 is 1-1/2". EnteredrDlepieye¢iforizorttaFSpantongth(sY CfeiwSpan + 1/2-mh end bearing r 1/2'intormedtata-beats)ng Connection Diagram Member has no side loads.. Concentrated loads are not considered in side load analysis. Connoetors are: 16d Singer Nails 6._21...... b=3" rl.= 7-7/3" a d = 12" +- ow 07- "- RC -Gee LCG'DESMU KPORT -US Thursday, June24, 20114 ma7� DOrubfrt: 1 3/4" X 'F 1 7/8" VERSA-t:AN 3tWSR- File Name: Mi4Pond Villago,SCC : Fso2 Job Name: Mill Pond Village Description: 1st fl beard fire plax header Address:.... Specifier•.. Je8-. . City, Stela, Zip: Yarmouth, Pla Designer: Bill Campbell Customer: Gatewood Homes Company: Shepley 1Nood Products Codo-reports: ICBO 5512. NER629 Mtsc CIO Bi 700 @s. LL 700lbc+L- 2921bs DL Z9Zlbs DL Tatar torizontal Lwsgth- OS-0O-DO - General Data Load summary version: "- US Imperial- ID Description- Load Type- fief-. _Stsrl . Erv&- ... S Standard Load Unf. Area Left" 00-00,00 OS00-06 Member Type: Floor Beam NumberofSpattr. 1 Left Cantilever.; No Right Cantilever: No Slope: 0112 Tributary;- 07-00-00- live Load: 4D psf Dead Load: 15 psf Partition Loan 0 psf Duration 100 Discieaure The completeness and accuracy of the Input must be verified by anyone who would rely on the output as evidancaotsuil:abitity.forn ... particular application. The output above Is based upon building code-acceptvOderr properties' and analysis methods, Installation of BOISE engineered wood products must be in accordance with the Current Installation Guide and the appfiCablabt llding codes. To obtain an Instillation Guide or if you have any questions. please can (800)232-0788 beforerbeginning product installation. BC CALCO, BC FRAMERO, BCI(&, BC RIM BOARD"', BC OSB RIM BOA)2D-M, BOISEGLIJI-AXIIT', .. . VERSA-LAMO, VERSA -RIM®, VI_RSA-RIM PLUS®, VERSA-STRANDT", VERSA -STUDS. ALLJOIST& and AJST" are trademarks of Boise Cascade Corporation. Page 1 of 1 Controls Summary Type' Value- Trf x.- Dim-, Live 40 psf 07.00-00 100% Dead 15 psf 07"00.00 90% Control Types,.. value-._ . •/rAflovvaWe.. Duration Load Caae- Sprpn-Loczdan, Moment 1240 ft-lbs 5.8% 100% 2 1 - Internal- Neg. Moment 0 ft-lbs n!a 100% Ei d SbeAr 5°9T6"s T5"k 1008% 2 1- Left Total Load Dell. U70503 (0.00s) 2.3% 2 1 Uve.LosdDefl. . U14Ba5(O.OD4")..... 2.40k_.__ 2...... 1 Max Dejl. 0.006, 0,6% 2 1 Notm Design meets Code minimum (Li240) Total load deflection criteria. Desigp meets Code minimum (WOO) Live load deflection criteria. Design meets arbitrary (1") Maximum toad tlenectioa r Minimum bearing length for BO is 1.112". Minimum beering teagth far tit is-1-IM . Entered/Displayed Horizontal Span Lengths) = Clear Span + 12 min. and bearing + 1/2 Intermedtaw beartm Member has no side loads. - Conneanra are: 16d SirrkeF Nails .g=21,... .. C _ 7-7/81 a d 124..... �_.. BG CALM2=L' MGaREPOR - US Thursdays. Jun&2.4.2011414:37 - Quadruple 1 31411 x 41 7/8" VERSA=-LA1&3100-SP File Name:. MMPond Vil}age•6CC: FBw Job Name: Mill Pond Village Description: 2nd fl beam under bearing wall Address: Specifier.. Jeff ..... City, State, Zip: Yarmouth, Ma Designer. Bill Campbell Customer. Gatewood Homes Company: Shepley Wood Products Code reports: ICSO 5512, NER 629 Mist �r BO bs 2122 lbs LL B 1 1758 Ibt75B s DL 2t22lOle_ -Ibs DL Genera! Data Version: US imperial Member Type:. . Floor Beam.... Numb" of Spans: 1 Left Ce Clever. No Right-CanlHover... No. Slope: 0112 Tributary: 01-00-00' Live Load: 40 ptf Dead Load: 10 p3f PsAition.Load: 0 psf DuFatim: 100 piseloaura- The completeness and accuracy of the input must be verified 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 design properties and analysis methods: lnstaltallon' of SOISE engineered wood products must be In accordance with the current Installation Guide and the applicable building codes. To optain ari-Installation Gultloor If you have any questions, please call (800)232-078B before beginning Product itlstsiratron: BC CALC®, BC FRAMERO, BCIO. SC RIM BOARD u. BC OSS RIM BOARDTM, DOISE GLULAMTM, VERSA -LAMA VERSA-RIMQ - VERSA -RIM PLUS, VERSA -STRAND^" VERSA -STUD®. ALLJOiST®and' AJSTM ere trademark4 of Boise Cascade Corporation. Page 1 of 1 19-00-p0 Load Summary ID • DescHpfion Coad type ' Ref. Start F_nd. Tye Value Trip. Duz- S Standard Load Unf. Area Left 00.00-00 1940-00 Live 40list 01-00-00 100% Da,1 _ 1 - o l 2nd n wa+ Unf. Lh Left 00-00-DO 1 e-00.00 o lief.. � 90% Dead 60 pit Nti 90% 2'' csilirtg- ... UrfiArea.... Lefr Oo-00-00 - MoiMi - Live 29031_..Otr07-GO-TOO. - Dead 10 pat 09•02.00 90% Controls Summary.. Controt Type Vatuo % Allowable Duiation Load Case Spun Lacatiun Moment 18423 ft-Ibs 43.3% 100% 2 1 - Internal Neg, Moment. 0 ft4bs ..... We . .. IOao� ... . End Shear 34751ps 21.6% 100% 2 1-- Eeft Toil Load Deft. U372 (0.613") 6C5% 2 1 Live Load De(L. LIa68 (0.335"} 52.9% 2, 4� Max Dell. 0.613" 61.3% 2 1 Notes Design meals Code minimum (U240) Total load defection criteria. Design meataGodsminimum (U3W0 Live -bad defteetion• criteriar- Design meets arbitrary (1'l Maximum load d0fiection criteria. Minimum bearing length for 80 is 1-1/2". Minimum bearing length for ST is-T-VV -. Entered/Dlaplayed Horizontal Span Langth(s) = Clear Span + 112 min, end bearing + 112 intsennedlate bearing CQnnectlon Diagram Beams 7 inches wide will be assumed to to either top -loaded only, or equally loaded from each sips. Boils areassumedtobe-Grade 5 orhigher. Member has no side loads. Connectors are: 112 in. StaW=dTbrougb Hoff a=Z.. b 2.1a" c = 7-718" c E1C aAL= 2= ?EWr3LU REPORT -US Thursday, June- 24, 2004.14:38 Sjnale 11718" AJSTm 10 APG File Name; M4Pond Vdlne.BCC: J02 Job Name: Mill Pond Village Description: joist over garage Address:... SpMW... Jeff... City State, Zip: Yarmouth, Ma Designer. Bill Campbell Customer Gatewood Homes Cargpany: Shepley Wood Products Code reports; BOCA 22-09, SBCCI 97070, fCBCYPFG5504- fc: 371 cu, s-LL- 93fps LL.... 373lbsLL- 93 ups Dt 93 Ibs DL ._74-00-W ... General Data Load Summery Vees6on .... US Irnparial ...f 10Description- Loa,&TVre Ref:. Start.. S Standard LoadUnt Area Left 00-00-00 MefnberType: Joist NumbereSpans: - t . Left Cantilever. No Right Cantilever. No Slope: 0/12 OC-Spacing:.... 161 ... Repetitive: Yes Construction Type: Glued Lfva Load: 40 psf Dead Load. 10 Psi Panition Load: 0 Psi Duration: 100 Disclosure The completeness and accuracy of the IrtWt must be verif* 4 by anyone' who would rely on the output as eY,dsnce.nf suitability for a .... partiWarappkewion. Th"UtpLI above is based upon building code -accepted design properties and analysis methods. Installation of BOISE anglneered wood products must be in accordance with the current Installation Guide and the appticabte building codes . . To obtain an Installation Gulde or if You have any questions, plaass tall (800)232-0788 before-haginning , product installation. 13C CALCO, BC FRAMER®, SCIV, BC RIM BOARD*^, BC OSB RIM BOARD?", BOISEGLU(AMT", VERSA -LAMS, VERSA-RIM^.7, VERSA -RIM PLUSQ, VERSA-STRANDT1 VERSA -STUDS, ALLJOISTS and AJS'" are trademarks of Boise Cascade Corporation. page 1 of 1 Controls Summary End- Typo. vaWe- Ot:S Dvt.\ 14-00.00 Live 40 psi 16 100% Deed 10 psf 16' 90% Control Type--..Vah4 _ - 0/-Allowable-.DuraEiwr.. _ LoaefCase- SryxrLocati®n, Moment 1633 ft4bs 44.6% 1'M70 2 i - Intemat Neg. Moment 0 ftdbs n/a ice% End Reaction. 4e7tbs 40.801i 100 e 2 1 - Left - Total Load Dell. U1081 (0,155') 22.2% 2 1 Live. Load Defl. U1351 (0.124")_.. 35.5%..... 2 .. 1 Max Dap. 0.1554 15.5`/a 2 1 Span / Depth 14.1 n/a 1 Notes Design meet3 Code minimum (U240) Total load deflection criteria. Dasyn meets User specified (IJ490) Live load deflection criteria. Design meets arbitrary (V) Maximum load deflection criteria. Minimt-wt bearing. length for Fair. 1--Z. Minimum bearing lend far&I is 1-1f7. Efit ared/Displayed Horizontal Span Longth(s) = Clear Span + 1/2 min, end bearing + 112 intermed;ate bearing a . HC EALC9 2= DESIGN REPQRT'- US Thursday, June 24. 200414:37 Single 11 718" AJST% 10 APG FIWName� Mill Pond BCC : J01 Job Name; Milt Pond Vlllaoe Description: 1st and 2ndd floor joist main house Address:. I 1 City, S'.-te, zip: Yarmouth, Ma Specifier - Jeff - Customer. Gatewood Homes Designer. Bill Campbell Cods reports; BOCA 22-09, SBCCt 0707D,1CBt7PFC E504 '" Company: Shepley Wood Products Misc: 1 � � t 1 I �. .. _5!sntlard Leae-R�psrl B0, 1-1/2'1 3110 Lhs-LL 143 lbs DL General Data Version:.. US Imperial Member Type: Joist Nu"arafSpans. 1 :. Left Cantilever. No Rigryt Cantilever. No Slope: 0/12 OC.Spacings- .. 12" Repetitive: Yes Construction Type: Glued Live Load: 40 psf Dead Load: 15 psf Partition Load: 0 psf Duration: 100 Disclosure The completeness and accuracy of the input must be verified by anyone who would rely on the output as evidence of suitabiltV fora .. . pz icuiar ttppHeat err Ttte output above is based upon pupding code-accapied design properties' and analysis methods. installation of BOISE engineered wood products must be in accordance with the current installation Guide j and rho apP.Q=ble building codas. - To obtain an Installation Guide or if you have any questions, please cap (600)232.0788 before' beginning - product installation, BC CAWO, 9G_FRAMERV, BCIV, BC RIM BOARDw. BC OSB RIM BOARDTM, BOISE GLUt AMT%% VERSA -LAM®, VERSA -RIM®, VERSA -RIM PLUS®, VERSA-STRANDTu,- VERSA-STUDO, ALLJOISTS and AJSTM are trademarks of Boise Cascade Corporation Fagg 1 of 1 Load Summary 10 • Descripfiort' Loa4 ype. Ref: - Stzrrt-. End S Standard Load Unf, Area Left 00-00-00 10-00-00 Controls Summary Co traTyps.- -. V9 Moment' - - 2462ft-fbs Neg, Moment 0 ft.lbs End Reaction 6 Its Total Load Defl. 1./51a (0.416") Live Load Detl. U753. (0.303" ). Max Deli. 0.41 W Span / Depth 19.2 Bt, 1-112" 380-Ibs LG 143 lbs DL Type -. Value- 01.S Dim - Live 40 psf 12" 100% Dead 15 psf 12, 90% %s Allowable-- Drrratiott 6T,7% 100% n!a 10Q% 45.7% 100% 43.0% 63.7%.... . 41.6% n/a Load Case- Spi�kocation� Z 1 - Internal 2 1 - Left 2 1 2.. 1 2 1 1 Notes Design rr,aets Code minimum (1.1240) Total load deflection criteria.. Design meet&Use-speciriert(U4114 Live. loadde8ectoa.criteria. Design meets arbitrary (111) Maximum load deflection criteria. -Wnlmum FwarktS 6 far Bair. t hlinmuar bear ng{erfgtfrfor gt Is 1-t2". ` Entered/Displayed Horizontal Span Length(s) = Clear Span + V2 min. and bearing + 112 interned ate bearing _ EEC-CALC&2 DES{G*N!-REPORT—US Th;,rsdsy auns24,200-;.14:3e Triplal 3/4" x 11 7f8" VERSA-LAPA9310TSP- FilsNamo: Mi4PondVilkn&.BCC: FS05 Job Name: Mill Pond Village Description: 2nd fl beam under dormer wall Address... Specifier:...Jeff ...... City, State, Zip. Yarmouth. Ma Designer. Bill Campbell Customer: Gatewood Homes Campsny: Shepley Wood Products Code reports:• ICBO 5512; NER 629 SO- f31-. 770lbs LL 7701tts LL 801ibA �L 803 FtrS f:l Total Horizontal Length-19.00-00 Ganoraf Data - version: US Imperial Member Type; Floor Beam Number of Spans: 1 Len Caatl;over.... No .. . Right C . r. No Slope. - 0/12 ' Tributary: 01-00-00 Live Load:.. 40 psf- . . Dead Load: 10 psf Partition Load: 0 psf Duration: 100' Disclosure .. . The completeness and accuracy of the input must be verified by anyone who, woulet rely -on -the output as evidence of suitability for a particular application. The output above is based upon building code -accepted design properties end analyamethods, . Installation of BOISF engineered wood products must be in accordance with the currentfnsteihtttonGuide and the applicable building codes. To obtain an Installation Guide or if You have any questions, please Cal (800)232-0788 before beginning product1 nsta!latirm..... . BC CALCO, SC FRAMER®, SCI®. BC RIM BOARD —,-BC OSS RIM- BogRDTM, BOISE GLULAMm. VERSA-LAM0, VERSA -RIMS, . VERSA -RIM PLUS&, V�RSA.STRANDTM VFRSA-STUDO,ALI JOISTOand AJSTM are trademarks of Boise Cascade Corporation. Page 1 of 1 Load-Summirwy -- ID Description Load Type Ref. -6... Standard Load. Unf..Area.... Lef - 1 dormer wall Lin". Lin, Left 2 Roof Unf. Area Left 1..... Start End Type M-Qfim00._ t9=00"00- LWa-.. Deed' 05-02-00 13-IMO Live Dead....... 05-02-00 13-10-00 Live Dead Value Trlb. Dur. 40 pcf--..01-00.00-1 ncul 10 psf- et-o -00 90% 0 pif n/8 90% 60 pit' n/6 M%_ 30 psf 03, 00-00 100% 15 psf 03, 00-00 90% Controls Summary Control Type- . Value- %--Allowat4&e Du,atiorr LoadCos-or Sparrtouation�. Moment 9880 ft-Ibs 31.0% 100% 2 1 - Internal Neg. Moment 0 ft-Ibs We 100% End Shear T50TIbs 12.6%- 1CO% 2 1-Left Total Load Dafl. U543 (0.42") 44.2% 2 1 Liye.Load Defl. _ 111144 31.5°A - 2... t., Max Dail. 0.42" 42.o% 2 1 . Notmr - Design meets Code minimum (L1240) Total load deflection criteria. Design meets Code minimum (U360) Live load deflection criteria. Design meets arbitrary (1") Maximum load deflection Criteria_ Minimums bearing length for BO Is 1-1/2". minimum boarin%lenglh for 131 is 1 112": Entered/Displayed Horizontal Span Length(s) = Clear Span + 12 min. end bearing + 1/2 intarmedtgts bearing Ccrt ffecforrM=jram,, Nailing schedule applies to both sides of the member. l Member has no sid.--toads, Connectors are: 16d Sinker Nails a - 2" ---- d a d=12" -. T. e�3- .. o... .. C 22 :-c,.'" � OIL= Z= DE,S[MREPORT - US Thursday, L=24, 20Q414W1 Double- 1'3/4" x 11 7/8" NERSA=LAWI&3100 SP File Name: Min PoadViBage.RCC. FE04 Job Name: Mill Pond Village Description: 2nd fl beam over garage picking up wall Address:. Specifiers ..Jeff.... . City, State, Zip. Yarmouth, fda Designer Bill Campbell Custornep Gatewood Homes Company: Shepley Wood Products Code repoAs: • ICDO 5512i NER 629 Misc: Do 280 Ibs LL L s $721b$72 Its a OL L 72 Its OL Gv�raPt]at? Version: US Imperial Member Type_. Floor Ream Number or spans: 1 Lela Car`4lever.... No .... . Righ anfilever. Nar Slope: 0112 Tributary: 01.00.00 Live Load: 40 psf Dead Load: 10 psf Partition Load: 0 psf Duration:...... Ica'' " Dlactosurs .. . The comp!etsnese end accuracy of the input must be verified by anyone Who -would" oaths cut-.%tas evidence of suitability for a particular application. The output above is based upon building Code -accepted design properties and analysis mathods..Installation. of BOISE erginserad wood products must be in accordance with the current tnstattclion Guide and the applicable building codes. To obtain an Installation Guide or ii you have any questions, please call (B00)232-0788 before beginning product iaztaL'stion.... . BC CALC®, BC FRAMER®. SCIG. BC RIM BOARDT' . BC OSB RIM'' BOARDT", 00IS9 GLULAMw. VERSA -LAM 0. VERSA-R!MZ, VERSA -RIM PLUS®, VERSA-STRANDIM, VERSA STUD'D. ALUO1ST@and .. AJSTF are tredemarloi of Boise Cascade Corporation. Page 1 of 1- Total Horizontal Length - 14-00.00 t Load -Summary IID Description Load Type Ref. Start End Type Value Trlb. Dur. S StandartLLoad_LIK.Area _. Left . Oa.M.00...14-00-00-. Live_ 40pst . at,00-0II 1009_ Dead 10 pSF 01•A0-00 Me 1 well Unf. Lin. Left 00-00-00 14.00-00 Live 0 plf We 90% Dead 60 pit n/a 00%-. Controls Summary. _ Control Type Valus % Allovrabte Duration Load Case SptmLoca;:lon Moment 2981 f 4bs 14.0% 100% 2 1 - Internal -Neg: Moment 0 ft4bs- rda • - 100%- End Shear 731 Ibs 9.1% 100% 2 1 - Left . Total Load Defl. Ul560 (0.109") 15A% 2 1 'Live Load De'R." U4747-(T.03V7 7.6% 2 1' Max Defl, 0.108" 10.3% 2 1 Notea Design meets Code minimum (I.J240) Total load deflection criteria. DasignmeetsCede-mtghm mi. {113e0)"Joa7daAschorcritz—, , Design meets arbitrary (1") Maximum toad deflection criteria, - Mlnlmum Gearing 18ngai for 50 is 1-112°. Minimum beadng.[=th for BI is 1-1/2". Entered0spfayed Horizontal Span Lengths) = Clear Span + 112 min. end bearing * 1/2 intermediate bearing Connection Dingian . Member has no side loads. Connectors are: 16d Sinker Nails b=3" f c-7-7/B"- d = 12" t M. � CA LCG 2='0EWW RgP_QR1- .. US Thursday, June 24, 200A 14:37 Double 1 314" x 417181, VERSA-=LAi11IID 311DI-SR File Nsma: Min Pond Vinaga.BCC: FD03 Job Name: Milt Pond Village Description: 1st fl beams defining fire place Address. Spoeitior.- Jeff City, State, zip: Yarmouth, Me Designer. Bill Campbell Customer Gatswood Homes Company: Sbepley Wood Products Code reports: ICSO 5512; NER 629- ' Mire: c� so 0-15 Ibs LL 457 Ibs DL General Data Versiam .. US Imperial Member Type: Floor Beam Number of Spans: t - Le#Cantilever. No Right Cantilever. No Slope: 0112 Tv,ba'zryr 01-00.00 Live Load: 40 pat Dead Load: 15 psf Partition Load: 0 psf Duration: . 100 Disclosure The completeness and accuracy of the input must be verified by anyone who would rely on the output as evidence of suitability fora . . pal icglar application. The output above is based upon building coda -accepted dazign properties ' and analysis methods. Installation of BOISE engineered wood products must bs in accordance with the current Installation Guide and the appiteahle. building codes. To obtain an Installation Guide or you have any questions, please call (800)232-0785-before beginning - product installation. BC CALC®, SC FRAMERO, BCI®. SC RIM BOARDTM, BC OSS RIM BOARO'"", BOISE GLULAMm,. . VERSA-LAMO, VERSA -RIM*. VERSA -RIM PLUS®, VERSA-STRANDTM, VERSA -STUD®, ALLJOISTO and AJSw we trademarks of Bolse Cascade Corporation. Page 1 of 1 Total-Honzontal Length-15-00-=- Load Summary ID . Deacrip0m .. Load-Typc.._Rof..... Start _ End-. _ _ Type- 8 Standard Load- Unf. Area Left 00-0007 15.00'-Otr Live Dead T FB02PttDad ' Conc. Pc Lett oT;;W-Wr 01=0&06- Live Dead Controls Summary Control Type Value Moment 2870101)3­ Neg. Moment 0 ft-lbs End Shear 13081bs Total Load Deli. U1482 (0.1211q Live Load Deft. L/2322 (0,078") Max Ds% 0.121e . . % Allowable Duration TT.57D ` 1001 We 100% 16.3% 100% 16.2% 15.6% 12.1%- ... dotes Design masts Code minimum (LIZ40) Total load de(ioction criteria: Design meals Coda minimum (11360) Live bad deflection criteria. Design meetsarbkrarK(1 MaximumloeddstlertmRciite ia� Minimum bearing length for SO Is 1-112° Minimum hearing length for 51 is 1-1f2", B1 384 IDS LL 235 lbs DL - Value -Trip. DrM, 40 pst 01,W-W 100% '. 15 psf 01•.00-00 90% 700-lbs nra 109W_ 292lbs 1* 90% Load Case Span Lac_tion 2 . 1 - lntemar'- 2 1 -Left 2 1 2 1 2 1_ ClearSpan * 1f2 min; end bearing t 1/2'intetmedtat� Connection Diagram Member has no side loads.. Concentrated loads are not considered in side load analysts. Connectom are: 16d SjnKcr Nails a 2"- b=3" , t=.7-713" d = I Z' +c1- @G'OACCCIZQIIzQF.S[Ot� RE; PORT -US Thursday. , A24,20II41-4:37% . Double 1 3/4" X `t 1.7/8" VERSA- LALAfJ �3tWSP- File Name: f.4i$Pond Villago.SCC : F802 Job Name: Mill Pond Village Description: lstfl beard fireplace header Address:... Spec tier.. Jett . . City, State, Zip: Yarmowl' Me Designer: Bel Campbell Cystomer: Gatewood Homes Codeteports: ICBO 5512. NER629 Company: Shepley Wood Products Mac: Ba 7001ba. LL ... 2921bs DL General Data Version:.. US Imperial... MelnberType: Floor Beam Number of Spans: 1 Left Cantilever: No Right Cantilever. No Slope: 0112 Tnbutary>- 07-00.00 Live Load: 40 psf Dead Load; 15 psf Partition Load 0 psf Duration: 100 Disclosure The completeness and accuracy of the Input must be verified by anyone who would rely on the output as evirtpnra rr suitabaity.for a... . particularapplication. Thecutput above Is based upon building code-axepfe¢desiM propertles- and analysis methods, Installation of BOISE #engineered wood Products must be in accordance With the current Installation Guide and the applicable building codes. - . To obtain an Installation Guide or If You have any questions, please can (800)232-0788 before,* beginning' product installation. SC CALCO, SC FRAMER®f, SCIS, BC RIM BOARD*, BC OSB RIM BOARD^", BOISE GLULAM"", .. . VERSA -LAMS, VERSA -RIM®, VERSA -RIM PLUS®, VERSA -STRAND^", VERSA -STUDS. ALLJOIST® and AJS*" are trademarks of Boise Cascade Corporation. Page 1 of 1 B1' 700lbvtb Z9Z ISs DL Tatat Horizontal Load Summary ID Deseription._ Load Type- Ref Start-.... 6n4 7YPe- Vatne-- Trfb;— Drm S Standard Load Unf. Area thfr 00-01700' 05-00:D0 Live 40 psf 07.0D-00 100% Dead 15 psf 07.00-00 90% Controls Summary i Carttrol'tYpO— Moment Value-- 124D ft-Ibs s/e-AFt vliab e_ Duration Load Caen $ptFrt Leestkir� 5.0% 100% 2 1 - fntemaC Neg. Moment 0 &Ibs n/a 100% End Shbar 69915s 7 5% 1006% 2 1- Left Total Load Den. U10509 (0.00B.� 2.3% 2 1 LIve.Load DO. . U74aa5 (o QD4") . _ .. 240A___. 2_ 1 Max W. 0.006, 0.6% 2 .. 1 Notm Design meets Code minimum (U240) Total load deflection criteria. Design meets Code minimum (L/3e0) Live load deflection criteria. Design meets arbitrary (11 Maximum load clenactjmcrilerft Minimum bearing length for 801s 1-1/2". Minim=bearing.teagttia Entared(Displayed Horizontal Span Length(s) = Clear Span + 112 min. and bearing + 112 Igtermedtatia bearing Member has no side loads. - Connectors are: 16d SinkeF Nails b=3" c = 7-7/8^ a rw W-CAMS 20=LiMGU REPORT - US Thursday. -June.2.4.=14:�7 ` ,Quaurupac 1 314" x ti 718" VERSA=LAMMO-SP File Name,- Ma Pond V 92ge.BCG: MI Job Name: Mill Pond Village Description: 2nd P beam under bearing wall Address: Specifier... Jeff..... City, State, Zip: Yarmouth. Ma Desigpsr. Rio Campbell Customer. Gatewood Homes Company: Shepley Wood Products Coda reports: IC8O 5512; NER 629 Misc s0 61 2122 The LL 21224bs.LL ._ 1758 Ibs DL 1758 Wit DL General Data Version: US Irlperial Member Type:. . Floor Beam.... NumbeF of Spsps: 1 Left Cantilever. No Right -Cantilever:.. No Slope: 0112 Tributary: 01-00-00 Live Load: 40 psf Dead Load: 10 psf Pertifon.Load:. 0 psf DuFation_ 100 piaelcmWe The completeness and accuracy of the input must be verified 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 design properties and analysis methods. Instaltation of BOISE engineered wood products must be In accordance with the current Installation Guide and the applicable building cedes. To obtain an -Installation Guldtaor If you have any questions, please call (800)232.0788 before beginning product IrsteRation: BC CALCO, BC FRAMERV. B0I0. BC RIM SOARDTM, BC OSS RIM BOARD'm, BOISE GLULAMTM, VERSA -LAMA VERSA-RIMA VERSA -RIM PLUS©, VERSA -STRAND^" VERSA-STUDO, ALLJOIST®and' AJSTM are trademarks of Boise Cascade Corporation. Page 1 of 1 19-00-W - Load Summary ID ' 063cription Load lYpe ref. Start End- Type. Value Trip. Dur; S Standard Load Unf. Area Lek 00.00-00 19.00-00 Live 40 psf 01-00.00 100% Dead- 10p3f.... of-0040- W/1 - 1 2nd fl we& Unf. Lin. Left 00-00-00 18-00.00 Ova-0 pif rth 90% Dead 6o pit Nei 90% 2-- cRiling- UnF Aran-. Left- 00=00=00 • 1s�-00 " ttve 20 psf. MOT--0t 10o"r Dead 10pat 09-02.00 90% Controls Summer i- Control Type lratuo % Allowable Duration Load Case Sprtn LocafiQn Moment 18428 ft-lbs 43.3% 100% 2 1 - Internal Neg. Moment 0ft4hs .. _.. n/a . .. 'Iow/... . End Shear 3475 ibs 21.6% 100% 2 1.. Left Total Load Defl. U372 (0.613") 64.5% . 2 1 Live LDad Defl: t1686(@:335°) 52.9% 21 1� Max Dell. 0,613" 61.3% 2 1 - Notes Design meets Coda minimum (U240) Total load deflection criteria. Design Meats -Cods, minimum (U360} Lwa-load deflection enteris— Design meets arbitrary (11 Maximum load deflection criteria. Minimum bearing length for B0 is 1-1/2". Minimum bearing fengtti for5T 19"14tr.-, Entered/Dlsplayed Horizontal Span Length(s) = Clear Span + 112 min. end bearing + 112 intermediate bearing Cornectlon Diagram Beams 7 incheswide will be assumed to tie either lop -loaded only, or equ@8y loaded from each side. Bolts are-assumcd to be -Grade 5-erhigher. Member has no side loads. Conneclors are:12 in. StagzarodThrough flolr a=2:'..._ b = 2.1r2' c = 7-718" a 6C CAL= 2=EIMGU REPORT --US Thursday, June.24, 2Dti414:38 ,Single 117/8" AJS;Ok 10 APG' File Names M4Pond V4W9e.5CC: J02 Job Name: Mill Pond Village Description: joist over garage Addross:... Special. Jeff - Ciy, State, Zip: Yarmouth, Ma Designer. Bill Campbell Customer. Gatewood Homes Corrlpany: Shepley Wool Products Code reports: BOCA 22-09. SDCCt 97071); ICDI7PFG550t-- Mice 00, 1-1/2" 81, 1.1/2" 373lbs-LL. 373"lbs Lt` 93 Ips DL 93 Ibs DL General Data Load Summary Vorsionc.... US I,nrperial ... tD • Deaeriptiom LoadType--RA- Start- End...__ Typ&... _ Maine-of:S- Dtx.,, S Standard Load Urtt Area Left 00-00-00 14.00-00 Live 40 psf 16' 100% . Member Mine. Joist Dead 10psf 16' 90% Numbs, of-Sparm't. Left Cantilever. No Right Cantilever. No Slope: 0112 OC-Spacing:.... 16':. . Repetitive: Yes Construction Type: Glued Live Lead: 40 psf Dead Load. 10 psf Partition Load: 0 psf Duration: 100 D13cloaum The completeness and accuracy of the input must be verifisq by anyone Who would rely on the output as evideec&,of suitability for a ... . particular appli m—fiort. Ttra-output above is based upon building coda -accepted design properties and analysis methods. Installation of BOISE englneered wood products must be in accordance with the current Installation Guide and Ots applicabte.bW14ing cedes . . To obtain an Installation Guide or if you have any questions, please call (800)232-0788 before baginning' product installation. BC CALCO, DC FRAMERO. SCIS, DC RIM DOARDw, BC OSS RIM 80AWm.., BOISE GLULAM?"!. . . VERSA-LAMO, VERSA-RIVV. VERSA -RIM PLUSQ, VERSA-STRANG}' . VERSA -STUD®, ALLJOISTS and AJSTM are trademarks of 86isa Cascado Corporation. Page 1 of 1 Controls Summary Control Type .....VAtus-.. %Anovvahtw Duration Loa C9*e Sp,3rt-Local4on Moment 1633 ft-Ibs 4416% t00% 2 1- Intemar" Nero. Moment 0 ftdbs n/a 10e% End Reaction 4Mbs 40.8"/0 100 �a 2 1 - Left Total Load Del. U1081 (0.155') 22.2% 2 1 ►.ive. Load Deft. U1351 (0.124" )_ . 35.5%..... 2 - 1 Max Dap. 0.155" 15.5% 2 1 . Span / Depth 14.1 n/a 1 Notes Design meets Code minimum (U240) Total lead deflection criteria. Design meets User specified (U480) Live load dattection coterie. Design meets arbitrary (1") Maximum load deflection criteria. Minlmuglbearing.l ng h''or EO SY1t2" Minimum besr nglet g forB1 is 1-1)7 Entered/Displayed Horizontal Span WPM a Clear Span + 1/2 min, end bearing + 1/2 intermediate bearing FsC CALCe 2= DeSI W REPQRT= US Thursday, June 24. 200414:37 U Single 11 718" AJSTM 10 APIS' Job Name: Mill Pond Vlliaoe Flle-Nam w Mill Pond l WV&.DCC : J01 Address:. Description: 1st and 2nd floor joist main house City, Sk-,te, Zip: Yarmouth, Ma Spsn5ar, Jeff - Customer. Gatewood Homes Designer. 13111 Campbell Cede rePorts: BOCA 22-09. SBCCt 9707D,1080-PFC-504 ' ' Company; Shepley Wood Rroduds Mist: BO, 1-1/2" 3130Ibs-LL . 143 ips DL General Vclsial : US Imperial -�1D S Member Type: Joist Number'af Spans y ... Left Cantilever. Na Right Cantilever: No Slops: 0112 OGSpacing. _ . 12" Repetitive: Yes Construction Type: Glued Live Load: 40 psf Dead Load: 15 p5f Partitiort Load: 0 psf Duration: 100 Ofsetosure The completeness. and accuracy of the input must be verified by anyone who would rely on the output as evide= of suitabil ty fora ... . particularappNeatratr. The output above is based upon pullding code -accepted design properties'' and analysis methods. Installation of BOISE engineered wood Products must be in accordance with the current installation Guide and thaappt building codes. - To ahtain an Installation Guide or it you have any questions, please call (800)232.0788 beforebeginning- product installation, 6C CALC®, BC FRAMER®, SCIA SC RIM SOARDTM, BC OS13 RIM BOARD74, BOISEGLUtALV',. VERSA-LAM0, VERSA -RIM®, VERSA -RIM PLUSO, VERSA-STRANDru, VERSA -STUDS, ALLJOISTS and AJW" are trademarks of Boise Cascade Corporation Page 1 of 1 SfehderdLeaa-�t— a sr t5 sf �OCSa" f2«.. .. . --. .. P �� . P P Gng 81. 1-1/2" 3ZTfbs LL 143 ibs OL Total Horizontal Larwfh-. t-ti rxr.rin --. d Summary i - � Description- Load Type- Ref: Start- End TyIns v2lue' ocs Dar, Standard load Unf. Area Left 00-00-00 10-00.00 Live 40 psi 12^ 1 DO% Dead 15 psf 12" 90% Controls Summary Corttrol Type.._ Kalae-_ . % Allowable- DwMiort - Moment' - " 24atfr--lbs LeadtCsse- SpflrPLcrcsti*n, 77%, 100'/a Neg. Moment 0 ft,lbs n/a 100% 2 1 - interne[ Cnd Reaction - 52; the 45.7% 100% Total Load Dell. 1.1549 (0.416") 43.8% 2 1 - Left Live Load Defi. L1753.(0.303°). 617519 2 1 2 . 1 Max Defl. 0.416' 41.6% 2 1 Span 1 Depth 19.2 n/a 1 Notes i Design meets Code minimum (L/240) Total toad deflection criteria,_ Design maeW User speciLed(L14&2) LivWcaddefiectioA criteria.. Design meets arbitrary (ill Maximum toad deflection criteria. _Minimum FKac nS.tenS tl WSO-is..t-10, Mini" -nun be ngiengtlrfar Bt is 1-12-. Entered/ Displayed Horizontal Span Length(s) = Clear Span + 112 min. and bearing + 1/2 interned ate bearing LOT 103 3oF SEE SLEEVING NOTE BELOW 4,4 Rq4 G Ar a, L=*30.69' o � m m� 1 0� O tl� ?i• 0 m I3' 14 ui 2.3' � 5 20' N�P� J' / �/ Zo. (0 co' n PROPOSED- 1U1 5 Z ,� HOUSE � W TERN p S ILi FF = 24.5 W 103 / GW = 14 0 N.4 6.3' N � f n 19' ' , LOT 105 NOTE: ' N LOT 104 1 ® SEWER LATERAL SHALL BE 4,683t S.F. SLEEVED I RDANCE f 1 WITH TI �S QF4 IIN 1OFT. ., � r�'IN./ \ B. N8357'38"W �. McG TH GRAPHIC SCALE 'L' ��`{'``�`tr� NOTICE, 20 10 0 20 60 U;bra and unU such tine as the arigtnal (red) stem, ct i;:> r,:.PonAW Prcfaaslnnnl Enginser, or Professional Land Surveyor .::rs cn f Is rtlan (A) no parson psrsone in Huang cny 2ur.letpol r a,,,..- ) ofnaJ m.Ov rely npcn 'h. nforma nn contaiml h r IN FEET .. 0) this pain [. n...ns `he prcpsrty ^f Hnlmes �. 1kt, nFt X 1 inch = 20 M ' p PLOT PLAN holmes and mcgrath, inc. OF LOT 104 civil engineers and land surveyors e' TIMOTHY m. PREPARED FOR SANTOS y { MILL POND VILLAGE 362 gifford street @I 45078 N falmouth, ma. 02540 � -� 9 clVi- o IN ('/SSTEP� YARMOUTH, MA JOB No: 201197 DRAWN: LMC ONAL hG` SCALE: 1"=20' DATE: 3-23-05 DWG. NO.: A2544 CHECKED: -in.%, APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 (OFFICE USE ONLY) TOWN (PLEASE PRINT IN INK OR M `0 To the Inspector of Wires: By this erstgned gives notice of his or her intention to perform the electrical work described below. ,,fir A vi�(y9� Location (Street & Number < �Q/a9/� pt 0 /7 t r 1 /0 7 � Owner or Tenant Telephone No. -52k 22?' 96 6 \�,Owner'sAddress 16 1W C -eA A-< v' Ile S,-' i 4� a S— Is this permit in conjunction with a building permit? 9Kes O No Purpose of BuildingUtility Existing Service Amps / Volts OverheadO New Service ZdU Amps A yG / /'sa Volts Overheadcl (Check Appropriate /B� ? Authorization No. [ S et �') iS l Undgrd No. of Meters Undgrd No. of Meters__ Number of Feeders and Ampacit/> /?l / Location and Nature of Proposed electrical Work: ct 'Ie0tyr�el IleCmm�letinn nf[hv l(nwina tnhly mnv ha wnivaii by thv /nenartnr of Wiroc 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- Swimming Pool gmd. 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 Deers o. o eDe an Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat mp Totals: Num er — — ons — — — — No. of Self -Contained Detection/Alerting Devices No. of Dishwashers S ace/Area Heating KW P g Local Q Municipal Other Connection No. of Dryers Heating Appliances KW Securityys of Devices or Equipvalent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or uivalent 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 office. e ,to the permit issuing oce. t CHECK ONE: INSURANCE C3' BONDO OTHER (Specify:) 2 ���Cf% ��`� 6 ? V (Expiration Date) D' 5 Estimated Value of Electrical Work: /J ZU (When required by municipal policy.) Q� Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under thWains and penalties of perjury, that the information on this application is true and complete. rNAME: n -f �✓j t /)I LIC. NO. I � c < ;2 censee: Sa, Signature LIC. NO. (If applicable, enter "exempt" in the license, number line.) Bus. Tel. No.: Address: �� C �` M t�X /g d %i7� 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 agent. Owner/Agent Signature Telephone [Rev. 04/001 • • WPS - Permit Work Order Information AM ,NSTAR WPS - Permit Page 1 of 1 Utility AuthMO M 01522857 Date: 0524/2006 Company LINDA TAVARES Rep: Report By.- YAR 121 CAMP ST U104 VILLAGES AT CAMP ST Sham= PLAIW sarii= MEIN T"w RES Natme of UlfotrlC NEW 100A LPG TO 111-1 TO TRANSM001-. THS IS MILLPOND VILLAGE AT CAMP ST DEVELOPMENI:_._1400 SQ FT —GAS KrMW„„.„ELEC RANGE & DRYER ....... NO AC .... NO JACUZZI OR HOT TUB" ENERGIZED PER ELECTRICIAN" Service Information: There is no Service Information. Permit Information PennR1E E06-1054 refer3c1 Reseal(YfM)c Y Dale: 071102006 rspecloc YIl0060 Desaipfioc •, Search 7—Detail Contacts NSTARRHHome WPS 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.comlappslwpslwpspermit.cfm?Page=Permit&Unique={ts '2006-0... 7/10/2006 b.. APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 TOWN (PLEASE PRINT IN INK OR TYPE To the Inspector of Wires: By this a] work des Location Owner o Owner's (OFFICE USE ONLY) By 6 20�6 Fee: $ g sd JUN o(C PERMIT NO. — b — I[O Date: 6 G ion the undersigned gives notice of his or her intention to perform the electrical Is this permit in conjunction with a building permit? 0 Yes []No rpose of Building_Utility Existing Service Amps / Volts Overhead New Service WD Amps Volts Overhead Number of Feeders and Amnacitv 744 * 1 \CxJ Location and Nature of Proposed electrical (Check Appropriate Box) Authorization No. G Undgrd [D No. of Meters Undgrd No. of Meters_ 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- SwimmingPool d. md. ID Nao o Emergency Lighting Btte 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: Number — — ors — K K — No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Municipal Local Connection C1 Other No. of Dryers Heating Appliances KW Security Sysm tes: 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 E uivalent 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 th permit issuing office. CHECK ONE: INSURANCE BOND C] OTHERO (Specify:) (Expiration Date) Estimated Valu —e nas�aal Work: (When required by municipal policy.) Work to Start: neM Inspe tions to be requested in accordance with MEC Rule 10, and upon completion. I certify, unde the a ns and a ies erj e i fo ation on this application is true and complete. A&RM NAM ' LIC. NO. censee: Signature LIC. NO. ftLfaff (If applicablg\ t "exe t ' the license n be line.) Bus. Tel. No.: Address- tt Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee oes 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] • LW. -ram CJ • : - Commonwealth of Massachusetts ° use only Department of Fire Services Permit No. '06' ADD Occupancy and Fee Checlmd VV BOARD OF FIRE PREVENTION REGULATIONS Aev. 1Y991 veblmk APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be petfotmed in aecordaam with the Mmadmsetts Mectrial Code (MEC), 527 CUR 2.00 (PiEASEPR 1YEW KOR 2TPEAU fflFVRMAT10A9 Date: City or Town of: YAR 40UIH To the Inspector of Wires:.. Jo applicatioheesin (Street &Numbr)orTenantsAddr+ess .1600 Falmouth Rd., Suite 25, Centerville, Ma. 02632 permit in conjunction with a building permit? Yes X❑ No ❑ (Check Appropriate Box) rcofBuilding single family residence Utility Authorization No. Service Amps / Volts Overhead ❑ Undgrd ❑ Na of Meters vice Amps / Volts Overhead ❑ Undgrd ❑ Na of Meters 7raherof Feeders and Amp acity Location and Nature of Proposed Electrical Work: Fire Alarm System (low voltage control panel) with backim battery..Centrally monitored. r amnleffmt ofthe follawinv, table may he is iwplY-A , the rnma mp. rw:... Na of Recessed Fixtures Na of Cc&-Susp. (Paddle) Fans °' of Total Transformers KVA Na of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool d e • d. ergency g Butte Units Na of Receptacle Outlets No. of Oil Burners FIRRALARMC - No. of Zones -177 Na of Switches No. of Gas Burners o. or Detection.and7 InitiatingDevices Na of Ranges Na of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers t amp Totals: 1,Number.Tons I KW I No. oSelf-Contained Detection/Alertine Devices 7 No. of Dishwashers Space/Area Heating KW Local 0 unrcap ® Other Connection .., No. of Dryers .. Heating Appliances I{R, ecunty stems: No. o evices or Equivalent No. of Water , Heaters o. o o. of Si Ballasts Data Wiring: No. of Devices or 1,guivalent Na Hydromassage Bathtubs No. of Motors Total HP econmuarcatrons ?nag: No. of Devices or ivalent OT�I2: Atmcn aaaiao= aatmt v aestre4. or as regwred by the DLTector ofWir= 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 exlubited proof of same tothe permit issuing office. CRECK ONE: INSURANCE M BOND ❑ ' OIHM p (specify ) (Exp:ratton rr Estimated Value of Electrical Work: $750 .00 (When required by municipal policy.) Work to Start Inspections to be requested in accordance with MEC Rule 10, and upon completion. rcertify, under thepains and penalties ofperjury, thatthe information on this application is True and complete FIRM NAME: Baltic Security, Inc LIC. NO: 1178C Licensee: Jonas R Bielkevicius Signature,, LIC. NO.: 49 D (Ifapplicable,enter 'lezmpt"inthe fteensenwoe. BusTeLNo. • 508-833-0996 Addrfss:_ PO Box .1609 Sandw�c� 02563 Alt, TeL Na• 508-7 -3 7 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 an the (check one) ❑ owner ❑ owner's agent Owner/Agent Signature. Telephone No. PERWTFEE:3 40.00 O� OF Y,09�Oc TOWN OF YARMOUTH W CHE1ESE ". � � �, III •..� P,6T, Building L r AT: Location C�%rJ // ,.J APPLICATION FOR PERMIT TO DO PLUMBING (OFFICE USE ONLY) B- - ' Fee: $-10910 d tl- Obao PERMIT NO. P ob —70 t Owner's Name_ Date 20 Type of Occupancy New F�ertovation ❑ Replacement EloL,..o C„hmitfcri Yes NO ❑ lU {,� 5 1 r_ w y? (Jj w Y Z W Y m W O ~~� Q= J W m O m J is fA Q' W O= (A N w N Q G W- W 0 O a. C ¢ F- W Z= 7 J z 'z . = U y Y H W Fw- Q I•- 2 Cn (n W � z F m Y Z to a. O (A z O O O U- m n. t- U)z C9 (n J ¢ 7 z z O (+- Z �C z 0 z G ¢ W Q O a IL w r y z u O K > o. 3 U-w Y 0 m W K U. w x 0 UB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Installing Company Name Check One: ❑ Corp. Address ❑ Partnership •��f�O��d ✓� Fir Company Business Telephone �� 7 LA 7 1ss� Name of Licensed Plumbero.o,- -- ��VLO) INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes 7� 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. 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: 23tg7 License Number Journeyman Master ❑