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121 Camp St #107 Building Permits
3'? OF rg9�0 TOWN OF -MOUTH ~ X VY MA�TRCMEEESE {, t1 ` • 1, z 90pZ 6 p�NdC j,'V1, i t APPLICATION FOR PERMIT TO DO PLUMBING (OFFICE USE ONLY) i cal /V - Fee: $ `7l�IC�b �" PERMIT NO. P- O b — 4 Building J n Owner's AT: Locationl//' <% Name_ Type of Occupancy�1 Replacement ❑ New Dinnc Cnhmitfad Renovation ❑ Yac ❑ No ❑ Date SIP c—i�,e� 1` wy U a in Zix W v r Y W IX a= Q J fn M a= m �m a Cn= W 0= ai a c N oa m o } f- Z g Z �a ¢ ai a w Q 0 o x fn W Y Q f- Y N 0. o of ti Z ga 00 o u- a y a c� J z z o LL Z Y. o zsQQ O w o: a t�wmm z r a 3 z '-' 0 0 n o. it O� Z) a m _ 0 SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Check One: Installing Company Name ! ❑ Corp. Address ❑ P nership /L Firm/Company- -7 Business Telephone ��_ -7 � Name of Licensed Plumb INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes No El If you have checked YES, please indicate the type of coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. C Signature of Owner or Owner's Agent 1 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. Z3r8 7 � License umber / Type: Master❑ Journeymam R EXISTING N n FOUNDATION O � N ►- d- 31.0= — LU 22.1= ' y� a LOT 108 a Q i 3 LL 0 OR 71.53cly o _ LOT 107 28.0 f0 r ` EXISTING FOUNDATION S88'09'22"E 76.55' \ LOT 106 ?s o �224,� Qi EXISTING 11 0, FOUNDATION I CERTIFY THAT THE FOUNDATION IS LOCATED IN FLOOD PLAIN ZONE C AS SHOWN ON FLOODANSURANCE RATE MAP COMMUNITY PANEL NO. 250015 0005D AND THAT FLOOD PLAIN ZONE IS Ng A SPECIAL FL00 HAZARD E . i�� DATE 'REGIsT_ERj�',PRQM§SIONAL LAND SURVEYOR NOTICE Unless and until such time as the original (red) stamp of the responsible Professional Engineer, or Professional Land Surveyor appears on this plan: (A) no person or persons, Including any municipal or other public officials, may rely upon the Information contained herein; and (B) this plan remains the property of Holmes k McGrath. Inc. AS —BUILT PLAN OF LOT 107 PREPARED.FOR MILL POND VILLAGE IN YARMOUTH, MA SCALE: 1 "=20' DATE: 11-21 20 0 in to LNG 4.9' lei 30.1= — I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE LOT AS SHOWN. , A DA AE61STERED PRO S NAL LAND SURVEYOR GRAPHIC SCALE ( IN B'L' 6f ) 1 inch = 20 ft holmes and mcgrath, inc.V nt;cHAeL civil engineers and land surveyors e. 362 gifford street WGRATH No. 2;Zlj� falmouth, ma. 02540 JOB NO: 201197 DRAWN: LMC DWG. NO.: A2541A CHECKED: ' • 'r WWI MET rt. tibbletts 716 Courity5treek TaurionMA02790 Carp. CONSULTING ENGINEERS Tel, (509) 822-6934 Fax. (508) 880-7811 FieldDensitif Test Report - Sand Cone Method (ASTM D1556 Client: Gatewood Homes Job No. 10980.010 1600 Falmouth Road, Suite 25 Date: 11/3/2005 Centerville, MA 02632 Report No.: 6 Project Mill Pond Village, West Yarmouth Test No. Location of Field Density Test FD5307A Unit #105 - N Center - Footing Grade - Sandy Material FD5307B Unit #105 - S Center - Footing Grade - Sandy Material FD5307C Unit 0106. SW Comer - Fooling Grade - Sandy Material FD5307D Unit #106 - NE Corner - Footing Grade - Sandy Material FD5307E Unit #107 - W Center - Footing Grade - Sandy Material FD5307F Unit #107 - E Center - Fooling Grade - Sandy Matenal Tabulation Field Density Test Results Date: Test No. Proctor I.D. Req. % Obtained Meets Moisture Dry Wt Max Dry optimum Compt. Compaction Specs. Content P.C.F Wt. PCF Moisture 1113/2005 FD5307A PR4252E 95 99.3 Yes 8.2 125.5 ' 126.4 82 11/3/2005 FD5307B PR4252E 95 99.6 Yes 6.9 125.9 ' 126.4 8.2 11/312005 FD5307C PR4252E 95 97A Yes 66 123.3 ' 126.4 8.2 11/3/2005 FD5307D PR4252E 95 994 Yes 7.6 125.7 ' 126.4 8.2 111312005 FD5307E PR4252E 95 99.0 Yes 6.6 125.1 ' 126.4 8.2 11/3J2005 FD5307F PR4252E 95 98.2 Yes 6.5 124.1 ' 1264 8.2 Remarks: All tests met the specified minimum 95% compaction. Corrected for Oversize Particles in accordance with ASTM D-4718. M. White Walter P. Galuska Laboratory Technician Laboratory Supervisor J OF r TOWN OFYARMOUTH Buiid�tgDepartment BUILDING (508) 398-2231 ext.261 (!PERMIT NO _ _B-06-451_ - PERMIT sec M ISSUE DATE , - 9/29/2005 _ PROPOSED USE ; APPLICANT 'Funk Capra_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _. JOB WEATHER CARD ----- '•------ PERMIT TO ; New Construction AT (LOCATION) 100121CAMP ST Unit 107 ;i ZONING DISTRIC R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK I044.21 A.C107 I BUILDING IS TO BE: LOT SIZE CONST TYPE 5-B USE GROUP R-4 new construction: 1 bath, 2 bedrooms, 1 kitchen, 1 livingroom as per plan dated 08/31105. REMARKS NOTE: SUBJECT TO COMPACTION AND PROCTOR TESTS. AREA (SO FT) EST COST ($ I$105,024.00 PERMIT FEE ($) �$383.00 OWNER Villages @ Camp Street, LLC UILDING DEPT Y ADDRESS 11600 Falmouth Road # 25 CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 MA 02632 Centerville I MA 102632 Certificate Issue Date— / ;CERTIFICATE of;OCCUPANCYj Depart ental Approval for Certificate of Occupancy and Compliance Permit Number Approved By Remarks BUILDING �L✓d `�1/ RUN WXWMA — To be filled in by each division indicated hereon upon completion of its final inspection. of, a TOWN OF YARMOUTH Buiidilgg Department BUILDING (508) 398-2231 ext.261 1- PERMIT NO 6-06-45_ _ PERMIT -==-------------- ISSUE DATE 9/29/2005 ; PROPOSED USE APPLICANT .'Frank Ca kCapra ---------------------- JOB WEATHER CARD PERMIT TO New Construction-' IAT (LOCATION) 00121 CAMP ST Unit 107 ZONING DISTRIC R-25 Bldg. Type: Residential I SUBDIVISION MAP LOT BLOCK 044.21.1.C107 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE CONTRACTOR new construction: 1 bath, 2 bedrooms, 1 kitchen, 1 IMngroom as per plan dated 08/31/05. LICENSE 012430 REMARKS NOTE: SUBJECT TO COMPACTION AND PROCTOR TESTS. Capra, Frank 1600 Falmouth Road #25 AREA (SO EST COST ($ $105,024.00 PERMIT FEE ($) $383.00 Centerville MA 02632 OWNER lVillages @ Camp Street, LLC BUILDING DEPT BY 5087789669 ADDRESS 1600 Falmouth Road # 25 Centerville I MA 102632 INSPECTION RECORD FIELD COPY .. ,Note Progress 07 oF'YgR ONE & TWO FAMILY ONLY - BUILDING PERMIT 1 ,1$ " ' ;gyp APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING Town of Yarmouth Building Department � „.:.;� cei 1146 Route 28 • Yarmouth, MA 02664-4492 Tel: (508) 398-2231 x261 • Fax: (508) 398-0836 } Office iJSe Only ` { Planning Board Information ll ' Assessors Department Informafwn Map Lot ap of Per N, 0, �SLDate 'l � } y - Permit v pe � .Erfdorsement Dale , �/ 1 '~ r { RecordingDate Dimensions Deposd#iec'd -$ Property j� P1anTlo} x' _ �w 'LoiArea is! ),„ Frontage ft) _ ,dot overagesi -This Sectionfor:Office Use'Onl Buildin `Per it ber Date -issued t t Certlflcate,of Occupancy` ; - �s is.not`. required r Signature%; ` ^• Building Official ..: t -..,Date, , �' Section,];=Sitelnformaiton-' Use Group: R-4 Type:5-13 1.1 Property Address: S1re,6T' 1.2 Zoning Information: j2 P7-(4� Ps",�, Zoning District Proposed Use 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.4 Water Supply (M.G.L. c. 40. S 54) 1,5 Flood Zone Information Comments { Public Private -Zone., Section.2=`.Property, Ownership/Authorized Agent 2.1 w0 r of Record - MailingAddresSc111_43^f//lje2j 1J�G Name G (print) - 7 7•S 6 Signature Telephone 2.2 AuthorizpdrAgent: /J-Zb� ferc cQfi2ir�=S� =� >� r s� `j _. Na print Mailin dress6w9"��//� � (�J i �W 77� ��lo� �. �� Signature Telephone Fax Se6ti6h-3,,'-,CQr1Strd6ti6h Services 3.1 Licensed Construction Supervisor: 0 Not Applicable ❑ ,r-Y,4141 A License Numb/ear / l:L Addr gA 40Z, Expiration Date rp pp Signature IV Telephone'` i7 3 2'Regisfered Hortieamprovement- ontractof_% L Company Name Cf( SFP Not Applicable 2 8 2005 License Number r Address v jJ i__7 Expiration Date Signature Telephone 9 - 15 - 99 1 of 2 OVER Section 4 =:Workers' Compensation Insurance Affidavit (M G:'L c: 752525C (6)' Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes......... No .......... Section 5 = Description�of Proposed Work check alt applicable) New Construction No. of Bedrooms No. of Bathrooms Z Existing Bldg. ❑ Repair(s) ❑ Alterations ❑ TAddition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: 2 'e_ Section 6 -, Estimated Construction Costs] Item Estimated Cost (Dollars) to be completed by permit applicant Check Below ❑ Conservation -Commission Filing (if applicable) ❑ Old Kings Highway &Historical Commission approval (if applicable) 1. Building 2. Electrical 3. Plumbing /Gas B aze9 4. Mechanical (HVAC) 5. Fire Protection &qe'� 6. Total = (1 + 2 + 3 + 4 + 5) 1 7. Total Square Ft. (new houses & additions) Q Section 7a== OwnerAuthorization Owrier'sAgentor conteactorApplie - To be Completed When or Building Permit. as owner of the subject property hereby authorize to [ ��bi/�— to act on my behalf, in all m rs rela • e to w rk authorized by this building permit application. Sig fur of Mwnerr Date Section�7b-=Owner/Afitharizbdd Agent Declaration 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. . Prin ame Sig a of O ner/ ent Date0� 9-15-99 2 of 2 k x -.� 1 �-. vwly ur YARMOUTH r-��-...$ LN BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT.• I ( /� Ca S � A, Job Location: o ` , Owner of Property um�/ ( `� � Street I Village Sy (L G Construction Supervisor: C (%a'L oa o So 8:::2 9a9 Address: l � � � Name �� P � License No. Phone No. .. v >� '� ��' �.►��, djk 04 as G 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 only pursuant to the state building code and all other applicable laws of the commonwealth, even though he, the license holder, is not the permit holder but only a subcontractor or contractor to the permit holder. 2.15.3 The license holder shall immediately notify the building official in writing of the discovery of any violations which are covered by the building permit. 2.15.4 Any licensee who shallwillfullyviolate subsections 2.15.1, 2.15.2 or 2.15.3 or any other section of these rules and regulations and any procedures, as amended, shall be subject to revocation or suspension of license by the board. 2.16 All building permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise those persons engaged in construction, reconstruction, alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and these rules and regulations. In the event that such licensee is no longer supervising said persons, the work shall immediately cease until a successor license holder is substituted on the records of the building department 2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may be deemed a violation of the permit conditions. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with section 109.1.1 of the state building code. I understand the construction inspection procedures and the specific inspection as called for by the building official. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes No If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy al-� Other type of indemnity ❑ Bond OWNER'S INSU NCE WA VER: I aware that the licensee does not have the insurance coverage required by Chapte 1 o ass. al a s, and that my signature on this permit application waives this requirement. Check one: Sign at re of ner or Owners Agen Owner ❑ Agent Signature: Building Official Approval: k aslo.� The Commonwealth of Massachusetts Department Of Industrial Accidents oflleeof/eyesaffmiirs 600 Washington Street Boston. Mass 02111 Workers' Compensation Insurance Affidavit name- /Jl`j 2 In%J� J dD- , k lam a homeowner pertormmg all work myself. 3:L ni,nnr a `� a O � 7 1 am a sole proprietor 2n,', ha,6e no one working in any capacity I am .an employer pro% idino workers* compensation for my employees working on this job. mnanv na addres cih^ nhnn if insurance co. p4liev q am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below who have the following worker' compensation olicesr city: Rhone k insurance co.. n�ltra # c_o_mnanv name - address: rsuure to secure coverage as required under Section 25A of MGL IS2 can lead to the imposition of criminal penaltles of a not ap.to 51r00 00 and/or one Years, imprisonment as well as eiril penaidej in the form of a STOP WORK ORDER and dine ofS100.00 a day against me, i understand' that a copy of this statement may be forwarded to the Office of investigations of the DtA for.eoverate veriflcatloa. 1 dd •hereby cerrif}} t er the airs ar a lrfes of perjury that the information provided above is true and come! / Signature (� r'T t Print name rl 0.V�, official use only do not w rite in this area to be completed by city or town official city or town: YARMOUM ❑ cheek if immediate response is required contact person: N x�g 77R^/&6 F permit/llccnse a riBuilding Department OLkensing Board 261 pSclectmen's Office phone a; _ (508) 398,2231 eat. ❑Health Department nOther 7/19/2005f ;aCo1?D,�, CERTIFICATE OF LIABILITY INSURANCE 0MlDD7/1os PRODUCER (508) 790-1919 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Sandpiper Ins. Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 12 Enterprise Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. MA 02601- INSURED INSURERA:FirSt Financial Insurance Filho, Antonio DBA BR ROOFING INSURER 8: Po BOX 1231 INSURER C: 136 Stevens St INSURER D' FTvannit MA 02601— - INSURER E: Crl\/FPArFS NAIC # THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INUICA I tU. NU I VVI IrIS IANIJINV ANT REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR Il ADO'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMlDDlYY) POLICY EXPIRATION DATE (MMlDD/YY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY / / _ / / EACH OCCURRENCE $ 1,000,000 PREMI ES( RENTED PREMISES Ea occurrence) S 100,000 MED EXP(Any one person) S 5,000 CLAIMSMADE ❑ occuR 491FOO2639 06/21/200.5 06/21/2006 PERSONAL 3 ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000,000 POUCY JECT LOC AUTOMOBILE LIABILITY / / / / COMBINED SINGLE LIMIT (Ea accident) S ANY AUTO BODILY INJLRY (Per person) S ALL OWNED ALTOS _ / / / / SCHEDULED AUTOS BODILY INJURY (Per accident) S - HIRED AUTOS / / / / NON -OWNED AUTOS rPROPERTY DAMAGE acidentj S GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC S ANY AUTO / / / / S AUTO ONLY: AGO LIABILITYEACH LIABILITY OCCURRENCE S AGGREGATE 3S OCCUR ,❑CLAIMS MADE RESSIUMBRELLA S DEDUCTIBLE S •I RETENTION S WORKERS COMPENSATION AND WC STATU- ITORY LIMITS I I ER E-L EACH ACCIDENT S EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L DISEASE- EA EMPLOYE S OFFICER/MEMBER EXCLUDED' / / / / E.L. DISEASE- POLICY LIMIT S If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS SIDING AND ROOFING. CERTIFICATE HOLDER CANUtLLA I IUN ( ) - (508) 778-5603 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT GATEWOOD HOMES FAILURE TO DO SO SHALL IMPO O OBLIGATION OR LIABILITY OF ANY KIND UPON THE 1600 FALMOUTH RD SUITE 25 INSURER, ITS AGENTS OR REP SENTATNES. ACORD 25 (2001108) qT, INS025 (01w).m AUTHORIZED MA 02632- ELECTRONIC LASER FORMS, INC. - © ACORD CORPORATION 1981 Page 1 of: r f l l t MASSACHUSETTS ASSIGNED RISK POOL REQUEST FOR CERTIFICATE OF INSURANCE 4,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 namte. s) of the person or persons to whom the Certificate of Insurancz should be issued. If this form is fully and accurelel!lj cc-mipleted, the Certificate of Insurance will be issued and distributed by facsimile to each fax number provided be!ow, witfi;, tNo (2) business days of the carrier's receict. This Form may be mailed or faxed to the Assioned Risk Pool Carrier. To obtain each carrier's contact information ref'er to the Certificates of Insurance section located in the Producer Comm rrsiy section of the 3ureau's webci:e fw fN. wcribma.ord). 1: Name, address, telephone number and Name: Mailinc Address: _fi --�- — Physic,! .Address: ;ame, o 2. address, telephone number and Name:l/(/�J� Mailing Address: �;-_�' 1, Physical Address: _ J Phone: / number of the INSURED: Fax- - number of the CERTIFICATE HOLDER: _1 Fax: 3. Name, address, contact person,�te/ephone number and facsimile number of the PRODUCER Name: Ord per Insurance Acrericy Inc. Mailing Address: 12 Enterprise Road Hyannis_, MA 02601 Contact Person: Chr'i sir Andrei__ Phone: 508-790-1919 Fax: 508-790-3560 4. Policy Number, Policy Effective Date and Policy Expiration Date If a Certificate of Insurance is needed for more 'than one policy term, provide the'Policy Number, Effective Date and Expiration Date for each policy term. If the policy has not yet been issued, you must attach a copy of the Notice of Assignment. Policy Number: _ (Jii ��tL_-0 3 Effective Date: <�) `/111- Expiration Date: 5. List any special requests for optional coverages l endorsements (see Page 2 for listing of coverages available in the pool and the conditions of availability) or additional infcn-nation (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. vate: $15/2005 Time: 3:02 PM To: 0 15087785603 Page: 002.003 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION I The Feltei'oerg Compamt ON,Y AND CONFERS NO RIGHTS UPON THE CERTIFICATEk9 222 Milliken Blvd. HOLDER: THIS C€RTCAT€-DOES -NOTAMEND,- EXTEND OR- ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW- P.D. Box 3220 Fall River, MA 02722 INSURED Cape Cod Ready. "fix Ire. PO Box 39SI OrlEans, : 02S5S 'UVtHAGtS INSURERS AFFORDING COVERAGE NAIC # I INSURER0: Construction industries Compensation i i INSURER C: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTTHSTANDW, ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENTWITH RESPECT TO WHICH THIS CERTIFICATE MAY BEISSUEDOR- MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUSUECT TO ALL THETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUGED.BY PAID CLAIMS - LTA NSR TYPE OFINSURANCE POLICY NUMBER POLICYEFFFCTIVE AT fMMfDDNn POLICY EXPIRATION DATE LIMITS A GENERAL'UABIUTY CPA0132466to- Ottotf 5- 0110t/ce EACH OCCURRENCE Si 000000 X COMMERCIAL GENERAL LIABIUTY DAMAGE TO RENTED SIOODDO MEC E7(P 9" we Person) $S 000 O..NMS MACE F-X� OCCJR _ PERSONAL 8 ADV INJURY Si 000 ODD GENEPALAGGREGATE S2 000,M0 -_ - GEN'LAGGREGATE UMITA_PPLIES PER PRODUCTS - COMR;OP AGG s2000000 "- POLICYPQO LIDO A _ AUTOMOBILE_ LIABILITY .ANY.AUTO MAA013246tM D1J01/05 .. 01101/06 OCM8;NED SINGLE UMIT (Ea=de-rt) S1 1000"M 9tXIILY INJURY P'a c5��7 - S . ALL OWNED AUTOS SC+.ECULED AUTOS . - X X HIRED AUTOS - NCN-CWNED.AUTOS BODILY INJURY ��OmI S N PROPERTY DAMAGE pw ao3derll S GARAGE UABILITY AUTO ONLY - EA ACCIDENT S OTHER THAN EA AC S ANY AUTO - - - - S AUT0 ONLY: AGG A EXC-SSiUMBRELLALIABILITY X IGUA013247010 OCCUR CLAIMS MACE _ 01/01/05 0110V06 EACHO=RRENCZ S1000000 AGGREGATE g _ S S CECUCTIBLE - X . R<-ELATION so B WORKERS COMPENSATION AND rfLRT WC00=55 -- 01101im 01/01,'06 _X r CSTATU- O^T. - E.L. EACH ACX7CENT 5500;000 ANYPROPPI TORW ANYCERIMEMBER AC EXCLUDED? Ify I R/MEMBER EXG:�UDED? Ryas, CencilxunCer .. F.L.OISFASE EAEMFLOYE 5500600 EL.CSEASE-FOUCYUMIT SSW DOS c?c0ALPQrjVSir_.Ncbdn- OTHER DESCRIPTION OF OPERATIONS I LOCATIONS ( V EHELES i EXCLUSIONS ADDEDBFENDORSEMENry SPECMt PROVISIONS Gatewood Homes Inc. -- 1600 Falmouth Road Suite 25 Centerville, MA 02632 ) ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION HEREOF THE ISSUING WSURER WILL ENDEAVOR TO MAIL �M DAYSWRFr'rEN TO THE CERAFICATE HOLDER NAMED TO THE LEFT, SUr FAILURE TO DO SO SHALL NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR oT t sDbdUUb/M66SZ6 AH1 0 ACORD CORPORATION 1988 bJ/bb/'Lbbb by: 38 5084204474 EDWARD A GRAZUL PAGE 02 ........ _.._..... _. _ ...... OnTE1MMmOmrYt =AL-TER ATE IS ISSUED AS A MATTER flF INFOSIIUlAT10N PRODUCER NFERS NO RIGHTS UPON THE CERTIFICATE EO�d A. �l jnam-a s: Y, TLtO• CER11FICATE D0£S C AMEND;- HET6NB Oti VF—RAGF-AFFFORDED BY THE POLICIES. BELOW. 0:0 137-X 3.77' t Marstrrs Mils, Ma C2648 �INSURETISAFFORDINCCOV_ERAGE .. I NAIC# _ INSURED- 111 �L� tNSUREA 9_ I vt T LA LL�i35 INSURERC_ _ 145 CanmLt,,t, Ili�y� /��//���..�' iSJRERD•_ 1jj— — Marstmms i"i ll s, Vi A UL33 V INevilEA E, C[]VEFiAGES naev+n ,eIFIC•ATFn NCOTWITHSTANDING THE POLICIES'OF,INSURANCELIST—;UBELOW.HAVEeccNlbbUt-J ANY RcflUIREM2NT, •TFSM• OR.CONDITION I U I n OF ANY CONTRACT.OR OTHER DOCUMENT WITH _ AESFECT TO"WHICHQHIB TO ALL THP !MRMs. CERTIFfCAF =tYCLUSIONS .AND CONDITIONS - - - OF SUCH MAAY PERTAIN, THE7NSUAANGE.AFF+jflDED BY THE POLr4ES-DCSCRISED+IEREIN IS SUBJECT POLICIES: AGGREGA.TE_UMRS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POUCT NUM^ER - -' ryy� 3 ,,`dvS!• POLICY EFF_CT1VE c POLICYEMAIRATION - LIMITS EACHoCCURRBnCE iri�A _ s ilnd• AL GFNERLIASILRY COMMERCIALGENERALLIASIUTY .... - '�' I T�E6 PREMISESIERpceurenCel . MFS EXP(Arw.N o06MWL S S MADE I OCCUR I F-F�I CLAIM9 N* PPRSONALAADVRJ.IURY - I... . - r .. i4t6I 4f IfY 4fla/c& S 'rZi{�;Ei GENEBAEAGGRE/3ATE .. PRWVCfS'.cDrraarAo -ik �OENt AGGREOA';?_C:MR APP!IES P>fi Pq6 ' I POLICY ioc 1iWTOts?OB3LE L1A91LS77 COMBINED SIN01•F LIMIT IIf I_f ANY AUTO 111 g MCA? I —�. SCHEDULED AUTOS I �BOOILYIN man)LOWNEDAUTOS (Pxoa u HIRED AUTOS I BODILY INJURY I Pern11 NON-OWVNED:`UTOS ' I I PROPERTYOAseAYiE S — I � IL l?x ecUderAl 1I AUTO ONLY -EA ACCIDENT S. .. GA_RAOE UADgM I EA ACC OTWERTMAN i --' 1 S r ANY AUTO i }AUTO ONLY', AO3 1 ESCESSS{MSRELL4 UA8N17Y F-ACMcm_ U-S'NC2 �.. 'AfG?FGATE S CLAIMS MADE I i I� DEDucr.>3LE I g < [ RETENTION S WORKERS COMPENSATION AND EMPLOYE9SLIA9IUTY ` I I.. WC6'.7A71A - OTH-I rTQRY L'x-71-LOT. �.ERL., E.L EACH ACCIDENT _I S _- ANYPRCPRtETOR.�PARTNEii,�X'cC1C:VE � I fE.L. DISEASE- EA EMPI.OYSS t3 OEFICE:WMEMBER EXCLUOEDT I I - POLICY LIMIT t S 11 yea. aeecrlM ul!tlef E.L. DISEASE• SPE(i1AL PROYt5bN3bely» - OTME.q I r � r � f OEdRIPT7014 OF OPERATIONS I LOCATIONS / VEH{CLESi ExcL.OSIDNS ADDED BY ENDORSEMENT/ SPECIALPVFOV(BIORS" CERTIFICATE HOLDER CANCELLATION - SHOULD ANY OF THE AeOVF_ sSRIBE2 POLICIES BE CANCELLED ovORE?'4ZZXPInanON SHOULD ��� �tE?TT'��g�o�c�d 1"S.7w im, SATE TH:REOF: THE 133OMIC,-INSURER V+ L 940"VOR TO MAIL DAYS wR7TEN G(Q ALL .LQaIE� 1 i1 - NQTICL• TCLTHE CERIMICATE HOLDER NAMED TO THE LZF r- bU7 FAILUP.E TO OO 30 SHALL Kte23_ .•I. IMPOSE NO-OBLIGST{ON-CR .UABLL1TY. OF -ANY. KMO UPON THE IN�R:'R`Y•�EttTS_`B*-- ry��� L^.m-,gL� vdi le, 1,J%���63T2 PEPRE9ENTATIVE9. _ AJTO10R2ED P.EPRESENTATIVE_ ', �VIAp FAX. 1'�7/L` �603 S ` CERTIFICATE OF INSURANCE ISSUE DATE (i\4M/DD/YY) - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND PRODUCER 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 THE POLICIES BELOW. 81 Bassett Lane COMPANIES AFFORDING COVERAGE Hyannis, MA 02601 INSURED Stephen M Childs COMPANY A.I.M. Mutual Insurance Co 145 Cammett Road LETTER A Marstbns Mills, MA 02648 i i r COVERAGES THIS IS TO CERTIFYTHAT 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 MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF!NSl12P ^!CE POLICY POLICY NU;.IBER I EFFECTIVE POLICYEXPIRATIO - LIMITS LTR II I DATE(MM/DD/YY) DATE(MM/DD/YY) GENERAL LIABILITY I GENERAL AGGREGATE 5 PRODUCTS-COMP/OP AGG. 1 5 COMMERCIAL GENERAL LIABILITY j ( CLAIMS MADEC)'DCCUR I PERSONAL Br. ADV. INJURY I S S. CONTRACTOR'S PROT. EACIi OCCURRENCE S ;OWNER'S (FIRE DAMAGE (Any one Jim) I S MED. EXPENSE (Any one person) j $ U1'ONIOISILL'J.lABILITY COMBINED SINGLE $ I—�ANY AUTO LIMIT BODILY INJURY S .ALL OWNED AUTOS j—SCHEDULED AUTOS HIRED AUTOS (Per person) (BODILY INJURY 1' S �7 NON -OWNED AUTOS I I I (Per x6&n1) i (PROPERTY DAMAGE i S I GARAGE LIABILITY I I :EXCESS LIABILITY � iEACH OCCURRENCE I S ' AGGREGATE I S �IMURELLA FORM UTHER THAN UMBRELLA FORM X w ATUTORY THE 1 :WORKER'S COMPENSATION AND EL EACH ACCIDENT S 100,000 I I)--m PLDI'ERS' LIABILITY I 7015793012004 12/13/2004 12/13/2005 EL DISEASE -POLICY LIMIT S 500,000 A jrJ IE PROPRIETOR/ INCL ?'.ARTNEI EXECUTIVE OFFICERS ARE: ix EXCL j IEL DISEASE --EACH EMPLOYEE S 100,000 A911UR I i I I I i DESCRII' AON OF OI'Iilinl'IONS/LOCATIONS/VEIIICLES/SPECIAL ITEMS CERTIFICATE (SOLDER CANCELLATION SHOULD .ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO GateWood homes 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 414coRo CERTIFICATE OF LIABILITY IN OP ID K DATE(MM/DDf(YYY) CROWC50 06/06/05 PaooucER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Sullivan, Garrity & Donnelly ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 508-754-1767 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 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 A: ALEA NORTH A 4ERICA INS CO INSURER B: Hanover Insurance Co INSURER C: INSURER D: INSURER E: NAIC # 92 V V V GrV\ V LJ 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. LTRINSRq TYPE OF INSURANCE POLICYNUMBER DATE MMDD/YY)PO EFFE E PDATE MMfDD/YYN LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 PREMISES :Ea occurence) $100r000 B X COMMERCIAL GENERAL LIABILITY ZHN700714102 - 05/01/05 05/01/06 MED EXP-(Any one person) $ 5,000 CLAIMS MADE FK OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG 1 $2, 000,000 POLICY PEa LOC $ AUTOMOBILE LIABILITY ANY AUTO AFN7001142-02 05/01/05 05/01/06 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $1,000,000 ALL OWNED AUTOS SCHEDULED AUTOS - X X BODILY INJURY (Per accident) $ 1,000,000 HIRED AUTOS NON -OWNED AUTOS X PROPERTYDAMAGE (Per accident) $500,000 AUTO ONLY -EA ACCIDENT $ OTHERTHAN EAACC $ PGARAGELIABIUTY ANY AUTO $ ' AUTO ONLY: AGG EXCESSIUMBRELUI LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE $ $ DEDUCTIBLE $ RETENTION $ - WORKERS COMPENSATION AND TORY LIMITS X I ER E.L EACH ACCIDENT $500,000 A EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERfEXECUTIVE OFFICERIMEMBER EXCLUDED? WC1049858 03/22/05 03/22/06 E.L. DISEASE - EA EMPLOYEE $ 500 , 000 E.L DISEASE -POLICY LIMIT I $ 5 0 0 , 000 If yes, describe under SPECIAL PROVISIONS below , OTHER - B Property Section DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Subject to policy forms, conditions and exclusions. GATEWOO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Gatewood Homes NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 1600 Falmouth Road IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR Suite 25 Centerville MA 02632 REPRESENTATIVES. A EPRESEN T AL,UKU Zb JZUUT/UbJ JUN 16 '05 04T03PM SANDPIPER INS • (PA-00 CERTIFICATE OF LIABILITY INSURANCC RODUCERRD (508) 790-1919 THIS CERTIFICATE IS ISSUED 5 { Band i ez Ins. Agency, ONLY AND CONFERS NO I 2 Y I Ina. HOLDER. THIS CERTIFICATE f 12 Enterprise 'Road ALTER THE COVERAGE AFFOI NIA 02601- INSURED Oualberto, Paulo L.. 21 Quippish Rd rntJaanrxve Cons DATE (MWOOIYYYIT THE POUCIE3 OF INSURANCE USTED Be LOW HAVE BEEN ISSUED TO THE INSURED NAMED A80VE FOR THE POLICY PERIOD INDICATED. NOTYwTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TH13 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN• THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN. 13 SUBJECT TO ALL THP TERMS. EXCLUSIONS AND CONDITIONS. OF SUCH POLICIES. AGGREGATE LIMITS SHGWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INBR I R IADO'L RA TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE IIATF MMfOLVYY POLIO] EXPIRATION OAT IMMl9DlY LIMITS A GENERAL LIAB11J7Y I / J I -ACHOrr_VRRENCE R 1, 000, 000 PRFMi9E4E �nn� nr i 300,000 `X COMMEZiOIALGENERALI1ABIUY CLAIMS MADE ❑OCCUR SGP04ST793T5 11/20/2000 Y1P20/20D5 HEOExP Anveroaenee S 10,000 MERSONAL A ADV INJURY 'a 1,000,000 OSNERALA00r,=AT—. ! 2,000,000 GSML AGOREGATE UMR APPLIES PER. PRCDVCTS-CCMPMAAGG is 2,000,000 POLICYmar Lac AUTOMOBILE LIABILITY ANY AUTO J J J J COMBINE-D31NGLELIMIT (EA W=dOnQ ! BODILY INJURY (Pat Mfg") ! ALL CV.NED AUTOS SCHEOUIEDAUTOB J J J J ' BODILY INJURY (Ptf 2G.iceRa ! HIRED AUTOS NON-ONNcD AU706' / J / _ / PROPERTY DAMAGE (Pe =Iden0 ! J J I J J GAAACE LIAB:UTY AUTOONLY.EAACCICENT- I! I CTHE.RTHAN EA ACC-7 IS ANY AUTO / / / I ! H AUTO ONLY: AGG ElLfUMBRELLA LusILITY I / / / / EACH OCCURREN'OE �E AGGR'_:OATE ! OCCUR CfIMS MADE ! I r^I DEDUCTIBLE REIENP.ON E WORXERSCCMPENSATIONANa EMPLOYEAT UABLI ANY PROPRIErOWPARTNFA/:OUTIVS E.L. EACH ACCIDENT Ti =.L Di8°ASE- EA EMPLOYE„! EMBER ExCLU OFFICER04 D�? / / / / If)-S. eeswae weer SPECIAL PROVIRONE bofaw E.L. DISEASE- =OUCY LIMIT 13 OTHER DESCRIPTION OF OPEAATIONWLCCATIONSIVCHICLESI ICLUSIONt3 ADDED BY ENOORsEMENTISPECIAL PROVISIONS . =C`,-It aXTIMOR YAIN=110 GATfinn�a Hoban 1600 7AU40UTH RD SOMT£ 25 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCE"ZO BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL • ENOEAVOR TO :TAIL 10 DAYS WRITTEN NOTICE TO THE CESIIF Ti FOLDER NAM© TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO O CA71ON OR LIABILITY OF ANY XIMO UPON THE m9WRER, ITSAGENTS OR REPRESENTX, UTMr7O12Gn 0EOR""TATIV9 / DRD 24 (2001108) ! ` T ,•iN$02S 9T RR t93).m ELECT LASER FORMS, INC. -(8DLT327-D115 Pape 1 IA' Aug-02-05 01:25P P_f» /��cVTid.s . - CERTIFIC RE -OP _ - IL9 Oi'��3URANCE DOB/0 ... PRICER , sera # A1530 THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION BIXBY ASURANCE AGENCY, W :. P.O. SOX 8S0 - 9d1 PLlTNAM PIRCI GREENWLLE, RI 02M - ONLY' -AND' CONFERS - NO RIGFffS UPON THE CERTIFICATE - HOLDER THIS CERTIFICATE' DOES NOT AMEND. EXTEND' OR . ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. MURERS AFFCRDM COVERAGE NAICX 94s`R INSURER A: NATZ FIRE INSURANCE CO. OF HARTFORD' HOLMES AND MCGRATH, IN,' INSURER B: VALLEY FORGE INSURANCE CO. 362 GIFFORD STREET NSUR5TC7 CONTINENTAL INSURANCE CO'. FALMOUTH, MA 02540 INSURER 0: wSUREm� COVERAGES THE-POLICIE4QF INSURANCE. LISTED BELOW I AVE-BEEN ISSU€D.TQ THEYdSURED.WhED.ABOVEFOR..THE POLICY PERIQD WOlCATED. NQFWITHSTANONG ANY RE=RElREt1T, TERM OR CONCITION OF V4Y CONTRACT CR-QTIER DOCUMENT WLAi RESPECT To- Wo:ELTHS CERTIFICATE MAY BE ISSUED -OR MAY PERTAIN. THE INSURANCE AFFORDED BY RHE POLICES DESCRIBED HEREIN IBEU&HECT TD ALL THE TERMS, FXCLUSICNS AND CONIMIONS OF SUCH - POUCHES, AGGREGATE LAWS SHOWN MAY W VE BEEN REDUCED BY PAID CLAM. , _LT Ar4 TYPE OF INSURANCE POLICY wilmsER F3!<ECTIVE RJcpJYTloY L LfM115 A GENERAL LIAHKnY X CCMNERGAL GENERAL LIASIITY CLAIMS UADE QX OCCUR 10' 4082434 10106104 1 OJOW5 EACH OCCURRENCE S 1000,000 AMAG ORENTHO F RE 2 MED EXP w $ D 000 PERSONAL 6-ADVM.XPv s 1.000,O00- GENERAL AGGREGATE S 2,000,OOO GENT AGGREGATE LIMIT APPLIES PER POLICY ElPRO LCC vR000OT5 - COYPgP AGG i 2 000,OOV AUTOMONIME LLAgtUPY ANY AUTO CCMU34CD SINGLE LIMB (Ea U S' ALL GINNED AUTOS SCHELIAEOALITOS EODKYIWURY S 8Cd1-Y RJ.IURY (PH xcWeMl s . HIRED AUTOS NON-0WNED AUTOS - . PROPERTY DAMAGE- S GARAGE UAB?UTY AUTO ONLY -EA ACCIDENT S ARTAUTG OT}IER T14A61 EA ACC AUTO ONLY' AGO s' S EXCES6RNb18RE Llt"UTY- OCCUR CLAIMS MADE EACli0ECt1RR5rEE- i AGGREGATE S S DECLICTRLE RETENTION S - S S 8 MURKEA'S COMPENSATION AND ENPLDYERSLWBY7'iY ANY ERNEMTOR EXCLU RIEXEGUPVE OFFiCERRAEMBER EXCIWED? Ism. LPgO uwer llAlav 20'.7445273- .. 09/M*4 .. ...Q9JOt�FJ - X WC STATLL TH- E7. F�ILJi ACCIDENT S TOOQ COO. EL pSEASE•EA EMPLOYE=_ f I OOO OOO EL DISEASE. POLICY Law, .. 1000000.. OTHEiA<'PRovLhans OTNER C PROFESSIONAL LIABILITY AE4 00 431 33 3S.. 7M/05- t,000,000 PER-CLAIMC- AGGRETGATE- DESCRIPTKON OF OPERAiIONSKOGTgINsfVEHICLE4o :LusK]RS AOMM gY @IOORSEMEkT15PEN.1Al pRa4tSK*ys AGGREGATE UMLTS ARE PER THE TER MS AND CONDMONS•OF THE POUCIES. CERTIFICATE HOLDER CANCF11 eTKW SNOULC ANY OF THE ABOVE OESCRIOED PMI MES BE CANC91.1 0 B&r,RE THE EXPIRATION GATEWOOD HOMES. _ DATE T}rti2EOF. THE IsaXNG INSURER WILL ENDEAVOR TO WJL DAYS WRITTEN 1600 FALMOUTH RD.. STE.: S NOTICE TUrPCCE NIFHCATE+KZEorT4AMED TO THE LEFT BUTFAILURE TQOOSUSNALL CENTERVILLE, MA 02632 IMPOSE NO OBLIGATION OR LIABAITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESO"4TWES R ATIVE ..TMP �C RTPR0S ! / ID ACORD CORPORATION ign . C:+Fh4PRO10ERTPRQS FP5 AgkRD.. CERTIFICATE OF -LIABILITY INSURANCE DATE(MMIDOMM a/2/OS PRODUCER THE CERTIACATEISISSLEDASA MATTER OFMRMATION United Insurance A"ncyy'-I=, 199 gain Street P.O. Box 1013 ONLYAMCOWFASNORrGN UPONTHECERTFICATE_ HOLIOMTMtSCERTIPCATEDOESNOT A*SYD,,EXTEND OR ALTER THE COVfRAGEAFFORDMBYTHE POLICiS BELow. WILIRIERS AFFORDING COVERAGE NAIC M - Buzzards Bay, MA 02532 INSURE? Patton Electric, Inc. 128 8cituato Road. Mashpea, to 02649 INSURER-4 ZurSCti NA . _ . INSURER Commarce Insurance Co. NsuRERc Liber Mutual `Ins. Co.— INR0.. m1SUER � - THE -POLICIES OF INSURANCE LISTED . BELOW .HAVE. BEEN ISSUED_ TO.THEWSUREO. NAMEDABOVEFOAL THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY RECUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR 07HER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRICED HEREIN 15 SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN GFNPRAL LIABIUTY POLICYNUMBER 90liLY fiF FECILLE {OLLCY EYP ON - LiMRg' EACHOCCURRENCE 1 1,10001000 A COMMERCIALGENERALLIADILRY CLAMS MAOE a$ OCCUR $CP424-15a55- � 7/30/05 7/30/06 P►EMISEg 10,000 ME EXP(A n.9 nn) PERSONAL& ADV INJURY S 1, ODD,-QD.O- OENERµ AGGREGATE 1 2,000.000 OCN'L AGGRLOATE LIMIT APPLIES DER' X LI 7POLICY Pp"T LOC PRODUCTS-COMPpP AOG S 2- Q q.�QAQ AUTOMOER.E LIARIUTY I ANYAU70 - C DMgIxED 5.04LC LMAIT (El swiwI) ALL OUNED AUTOS B scHEDULFawios Ysv9338 10J3/04 10/3/05 ROOP we"'INJURY ( T 100 /0= HIRED AUTO$ NON-OViNEDAUTO$ GO Cid")RY I= 304 OOtr PROPKDAMAGE S 10a, 000L RAGELIARHUTY AUTO ONLY-EAA=10ENT. S I �hCA 1ANYAUTO I OTHER THAN EAACC AUTO ONLY, AGO 1 f 1 EXCUSIUMRELEAAL481UTY OCCUR CUIIMS.MACE. €iCHOCCURRNCE f AOOREOATE r 1 DEDUCTIBLE RETENTION 1 ? C WORN9ISCOMPECAUION AMC ANY ROM,UTORIPAR ANY PROM, I6TOR,P EXCLUDED? OF FICERR+� MSER EkCtu OED? WC2313353049014 12J10/04 I 12%SOJOS Vv0 STA7UTORY - OTH- E. L'EACH ACGGENT ; SOD. OIlO ELDISEASE-EAEMPLOYEE _ It 500,000 IFmr a„ere,,,,9n, - X $E(}ALPRpvI .. E.LDISEASE- POUCYLIMIT 1 100 00O ,.Sb. OTHER D 25CRIP710NCF O i-RATONg /LOCA7R3Naf VEIICLE37E7ICLY.3IONSADOLD ET ENOQgP71IENTygpE074i ►ROVW*NS•. . Z lQctrl cal Catexood Homes Fax No. (508) 778-5603 1600 Falmouth Road Suit& 25 014-nt,Rvi1149, Ma 02632 SHOULD ANY OF THE ABOVE DESCRIBED POLICIEa OC CANCELLED BEFORE THE ERPIRATION D1IE7NE3LEIIE. TBEISSLIIISO.INSIIRERri RL ENDEAYORTO MNL 10_OAYSWRITTEN 'NOTICETO THE CERTIFCATEHOLOER NAMED TO THELEFT, SOTCAICUffMCOWgN,:LL 1 IMFOSENO OBUGATION OR LIASA.I7Y OF ANY KIND UPON TUZ INSURER,, � S AGENTS OR AUTHORIZED 25 (2001108) 5 A RD CORPORATION 1988 I •� ,. ., DATE (MMIODNY) ' ACORD CERTIFICATE OF LIABILITY: I\1SURANCE - 9/15/D4 _. �. -� :.._. PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Chatfield, Whitman & Young HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 549 Washington Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 850963 COMPANIES AFFORDING COVERAGE Braintree, MA 02185-096 COMPANY A Harleysville Worcester Ins Co INSURED COMPANY B Lawrence Robinson Masonry 5 Fresh Hole Road Hyannis, MA 02601 COMPANY C COMPANY. D COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS. CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFAFOUCYRATION LIMIT$ CO TYPE OF INSURANCE POLICYNUMBER PATE (MMID/YY) LTR GENERAL LABILITY COMMERCIAL GENERALLIA131LITY CLAIMS MADE � OCCUR OWNERS & CONTRACTOR'S PROT CB 7E 32 32 9/07/04 9/07/05 GENERAL AGGREGATE $ 2,000,000 A PRODUCTS-COMP/OPAGG $ 2,000,000 PERSONAL & ADV INJURY $ 1,000,000 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) $ 100,000 MED EXP (Any one person) $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIREDAUTOS BODILY INJURY (Per accident) $ NON -OWNED AUTOS PROPERTY DAMAGE $ AUTO ONLY - EA ACCIDENT $ GARAGE LIABILITY ANY AUTO ' OTHER THAN AUTO ONLY: EACHACCOENT $ AGGREGATE $ EXCESS LIABILITY E UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' UABILITY EACH OCCURRENCE $ AGGREGATE $ TATU- OTH- TORYWCSLIMITS ER $ _ EL EACH ACCIDENT $ EL DISEASE - POLICY LIMIT $ THE PROPRIETOR/ INCL PARTNERSIEXECUTIVE OFFICERS ARE EXCL EL DISEASE - EA EMPLOYEE S OTHER DESCRIPTION OF OPERATIONSILOCATICNSNEHICLES/SPECIAL ITEMS I CERTIFICATE HOLDER .. n ��~ 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, Suite 25 Centerville, MA 02632� BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABIU//T3Y OF ANY KIND UPON THE COMPANY ENTS SENTATIVES- AUTHORIZED REPRESENTATIVE Robert E. Chatfield ACORD-25=S (1195) - RATION 1988` (a ACORD CORPO ACOPDTN CERTIFICATE OF LIABILITY INSURANCE R076 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 THEPOLICI' 308 FARMINGTON AVE INSURERS AFFORDING COVERAGE FARMINGTON CT 06032 INSURED INSURERA:TW1n City Fire Ins Co' INSURER B: LAWRENCE ROBINSON MASONRY INC INSURER C: 5 FRESH HOLE ROAD INSURER D: 'OVERAGES v 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 TYPE OF INSURANCE POLICYNUMBER POLICY EFFECTIVE DATE(MMIDD/YY POLICY EXPIRATION DATE MM DO&Y LIMITS GENERAL LIABILITY EACH OCCURRENCE S FIRE DAMAGE (Any one fire) $ COMMERCIAL GENERAL LIABILITY MED EXP (Any one Person) S CLAIMS MADE O OCCUR PERSONAL & ADV INJURY S GENERAL AGGREGATE S GEWL AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGO 9 POLICY PRO- LOG JECT AUTOMOSILELIABILOY ANY AUTO - COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY Person) 3 ALL OWNED AUTOS SCHEDULEDAUTOS1 _ .:(Per BODILY INJURY f-(Per accident) 9 HIRED AUTOS NON -OWNED AUTOS - PROPERTY DAMAGE - h (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S THER THAN EA ACC S ANY AUTO 9 AUTO ONLY: AGG EXCESS LIABILITY IF EACH OCCURRENCE S AGGREGATE S - OCCUR ,CLAIMS MADE $ 9 DEDUCTIBLE S RETENTION 9 WORKERS COMPENSATION AND X WCy ThTU- OTH- EA_ EACH ACCIDENT $100 000 A EMPLOYERS'LIASQ?Y 76 WEG NQ5620 09/06/04 09/06/05 E.L. DISEASE - EA EMPLOYEE $1 0 0 , 000 E.L. DISEASE - POLICY LIMIT $5 0 O, 0 0 0 OTHER j DESCRIPTION OF OPERA TIONS20CA TIONSIVEHICLESIEXCLUSIONS ADDED BY END ORSEMENTISPECIAL PROVISIONS Those usual to the Insured's Operations. J`CMTICII`,t TC Unt MCD I I -Ir., „ T'AAIT`FI I ATITIN - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE GATEWOOD HOMES HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1600 FALMOUTH ROAD, SUITE 25 REPRESENTATIVES. CENTREVILLE MA 02632 EAU—T�HORI7FD RE�PRIESEMI(= ACUHD 25-5 17197) Q ACOHD CUHI'UHAI IUN 1 y160 12/02/04 13:36 FAX 50879009-49 GOLDMALN ASSOC WE ) d I�vJF `I� 9o7i ` CSR AS-. --- — ---- -- - ---- - Tv_�LrrSo 12/02/04 FWODUCER I THIS CERTIFICATE 1S MSUED A - A T# Lb&EP. OF tueOvu.::TC : ' wa,...=u.Aa� s AS->vCa'w1sS A.riauasAivCS I ONLY AND CONFERS NO RIGHTS UPON THE C£RTIFFCATE FINA—%�IZZAL SERVICES S23C. HOLOM THIS CERT)MATE DOES NOT. AMEND, EXTEND OR 933 ?*.:.'-°.^,i;^i'3 =. - ALTER THE COVERAGE AFFORDED BY THE P^,UC.:ES SELCtV. I T'71ANNI9 MA 0501 PiLonai 504-775-5010 fax:508-790-0249 )NSURERSAFFORDiNGCOVERAGE NA)C0 INSURED N 1 SURERA Vd RY"UID C zlu=Y COMPANY T�vA.vO INSURER B: I DBA NEECSAMCAL SYSTEMS INSURER C: 110 EOLDc^ti L:AiYA )NSURER D W BABNSTASLE MA 0255E I INSURER E: I .VYCI<AVCL THE POLICIES OF !NSU?RNCE LISTED BELOW HAVt SEEN 18ftED TO THE IY.SUREO NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT WITHSTANDING ANY CMQUIRSNSNT. TIAM OR CONDITION CC ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INS'JRANOE AFFORDED BY THE POLIGIE$ DE$ERI$ED HER£IN IS SUWECT TQ ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH -' POLICIES. AGGREGATE. LIMrrS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INS RD TYPE OF INSllRANCE FOl`.CY NUMBER DATE MMJiI DA E MILD LIMITS A I EL LUZILITY MMERCIAL GENERAL LIABILITY CLJJMS MADE L I OCCUR I 000372088 11/21/04 11/21/03 EACH OCCURRENCE t S 1000000 I;300000 MED EXP (Any one pe ) I ; 10 0 0 0 PERSONAL L AOV INJURY 1 s l000000 GENERAL AGGREGATE 132000000 GE.N'L AGGREGATE LIMIT APPLIES PER: POLICY ! , CDR - LOC El PRO CifLTS-COMPIOP AGG 132000000 j j AUTD-ORI 9: UANUTY ANY AUTO ALL OWNED AUTOS I SCtuD:LED AUTOS HIRED AUTOS 1 NON -OWNED AUTOS I - � .. ... t . COMBINED SINGLE LINK (E3 ac:da:l) S BODILY INJURY Pas9n) ! E(Par BODILY INJURY (Peraccldwt) ; PROPERTY OA:1AC-E t {Per aatcenq I DAAP_4E LIAUILIT/ I� ANY AUTO I I AUTO ONLY -EA ACCIDENT ;--- OTHER THAN EA ACC S AUTO ONLY: AGG S ___1 ' i - ..i. �E7^CiES3AwRELIA LIABILITY ODr•JR I L-LAINS MADE Di ic-sLC 1 RETENT.QN , S I I I I !AGGREGATE EACH OCCURRENCE S I; - _ j +!JOPXERS CO?'?EIdtATION AND j I EckWLOYERSLIABI Js1 ANY PROPR ETOR/PARTNER/DIECUTNE `OFFICERPJE'--ER 1EXCLUDED9 I .YyG da —..bo Ixea' SPECIAL PROVISIONS h.ke I l In - TO RN LINES ER E.L EACH ACCIDENT ; E.L. DISEASE - EA EMPLOYEE! S E.L DISEASE -POLICY LIMB I S OTHER I j - liA18:IVV�L! EtJC65j 1:1 tr - PAX 508-778-5603 1600 FALMODTHIT IROAD SUITE 25 C-iY1WILLS MA 02632 r_aTr n_n _ SHOULD ART OF THE APA`!@DE.9.^.M EDP'--_IC,'ESPEaANCELLEDSEFORET14EEXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRRTEN LNOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SMALL IMPOSE NO CQLIGAT!CN OR LIAMTY OF ANY RIND UPON THE INSURER. ITS AGENTS OR 0 krbleam PRODUCER GOLDMAN & ASSOC INS FIN .jr 933 FALMOUTH RD RTE 28 HYANNIS MA 02GO12319 28HPP INSURED TAVANO, RODNEY DBA: MECHANICAL SYSTEMS 201 CAPES TRAIL - - WEST BARNSTABLE MA 02668 V'-Vb-Ub THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY A AMERICAN ZURICH INSURANCE COMPANY COMPANY B COMPANY C COMPANY D .: IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAM1tED 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 TR TYPE OF INSURANCE I I DATE (MMIDDIYY) POLICYEFFECT[VE I DATE (PAM\DD\YY)ONI LTR POLICY NUMBER LIMITS IGENERALTY AL GENERAL LIABILITY S MADE =OCCUR. CONTRACTOR'S PROT. GENERAL AGGREGATE S PRODUOTS-COMP/OP AGG. $ PERSONAL & ADV. INJURY $ EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ MED. EXPENSE (Any one person) S AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS - COMBINED SINGLE UMIT $ BODILY INJURY (Per Person) $ BODILY INJURY (Per Accident) $ PROPERTY DAMAGE S GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT S OTHER THAN AUTO ONLY: EACH ACCIDENT S AGGREGATE $ EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM - _ EACH OCCURRENCE S AGGREGATE $ ' A WORKER'S COMPENSATION AND EMPLOYER'S LIABILITY THE PROPRIETOR/ PARTNER IEXECUTNE INCL OFFICERS ARE X EXCL orHER (UB-7278A84-9-05) - OS-03—O5 05-03-06 STATUTORY UMITS EACH ACCIDENT $ 100 000 DISEASE —POLICY LliVLT S 500,000 DISEASE —EACH EMPLOYEE $ 100.000 OF THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL GATEW00D HOMES INC _ 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 1600 FALMOUTH RD SUITE 25 LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR CENTERVILLE MA 02632 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE i Y BO'ARD, OF BUILDING REGULATIONS .° License=. CONSTRJGTIONSUPERVISOR , Number (11243Q 06i�8_�20i]6• Tr: no:25926. ResLricted�;�+ FRANK G CAPPA CEKEME LLF— MA Q263 Commissroner ` $ 00-35)000ctenclosedspace - IA- Mai0my-ofkig . F 4Gk K±Flauritilyflomes "Failure lopossess-aairiertGeditionottha - - '' - MassaefwseftSWmBuldinq-Code. is• cause.for.Two ormfthis-lcense. M1' DIG SAFE:CALL.CENTER: (888) 344-7233 TOWN OF YARMOUTH 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT BUILDING ELECTRICAL GAS PLUMBING SIGNS Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 1 �1 C:Q�Wp 3+ Work AAckess is to be disposed of at the following location: n Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. llve�/l br © v Signature of Applicant Date Permit No. Ca /14 PROPERTY ADDRESS: �PULATION FOR PERMIT T COS ACLT" 1 1 t 33 3. -TYPE OF Ri AMmoN ALTERATIoNs BATH BED ROOM CERTIFICATE OF DEN DINING FAMILY T N ONLY . OF BAYS C NO OF ., TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-06-068 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Unit 107 Owner's Name: Villages @ Camp Street, LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 R VIEWED BY: WATER DEPARTMENT: 2. ENGINEERING DEPARTMENT: 3. CONSERVATION: . HEALTH DEPARTMENT: V 5• BUILDING DEPARTMENT: 6. FIRE DEPARTMENT: COMMENTS: RECEIPT OF COPY: (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 1033 Net Owed: ($50.00) Application Date: 8/15/2005 Issue Date: Expiration Date Comments: Map/Lot: 044.21.1 new construction: ZONING APPROVED DATE: DATE: DATE: DATE: DATE: DATE: PLEASE NOTE SIGNATURE OF APPLICANT: N/A: N/A: N/A: N/A: N/A: N/A: DATE: Date Printed: 8/22/2005 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-06-068 Frank Capra 5087789669 00121 CAMP ST Unit 107 Villages 0 Camp Street, LLC 1600 Falmouth Road # 25 (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: Centerville MA 02632 @ Owner's Telephone: (5os) ns ssss AUG 2 4 2005 REVIEWED BY: 1. WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT:' ��h�( DATE: �� N/A: 5. BUILDING DEPARTMENTr DATE: N/A: 6. FIRE DEPARTMENT: DATE: N/A: COMMENTS: RECEIPT OF COPY: PLEASE NOTE 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., #107 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 ou h Water Department Am to r of o •� TOWN OF YARMOUTH 1' Building Department Town Hall ...� an Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-06-068 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Unit 107 Owner's Name: Villages 0 Camp Street, LLC Owner's Addres 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: Map/Lot: 044.21.1.0 new construction: REVIEWED BY: 1_WATER DEPARTMENT. DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT: DATE: N/A: 5. BUILDING DEPARTMENT: DATE: N/A: 6. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: Date Printed: 8/22/2005 GMS9/GCS9..SER1ES . 93% AFUE Mold-Tosition; Single-Stage/Multi-Speed-. . Gas Furnace..... Heating Capacity:.. 46,000-115,000 BTUH ma :ECGG Standard Features • Corrosion -resistant, aluminized steel tubular heat exchanger and stainless -steel recuperative tail for maximum efficiency • Designed for multi -position installation—GMS9:" upflow, horizontal right or left; GCS9: downflow. horizontal right or left • Energy -saving, reliable Hot Surface Ignition system, featuring a Norton! Mini-Igniter.with patented adaptive learning algorithm to maximize igniter life • Aluminized- steelinshot burners • Energy -saving PSG, inulu-speed, direct if ivi blower motor • Quiet. corrosion -resistant induced'dtaft blower assembly • Integrated furnace control —with —improved...... diagnostics • Low voltage terminal blocks • Multiple flame roll -out switches, blower door safety switch, outlet air -limit switch and pressure switch for proof of combustion air • 40VA transformer for heating and air conditioning control service - • Combination redundant gas valve and regulator • Top venting -is standard; alternate-fluepvene located -... on right side Completely. assembled, factocit-run-tested fttmace.for. . heating or combination heating/cooling application • All models comply with California NOx Standards • Suitable for direct vent (2•pipe) or non -direct vent (]-Pipe) applications alrfiandltiontngr-& 1ieatMg-\ The GMS9/GCS9 single -stage, multi-stree&gus furnaces offer — installation .versatility. . Cabinet Eartstractiocr • Heavy -gauge, reinforced, fully insulated steel cabinet with durable baked -enamel finish - • Attractive architectural gray paint finish • Foil -face insulation -lined heat exchanger compartment • Coil and furnace fit flush for easy installation • Convenient left or right connection for gas and electric service • Bottom or side air inlet (GMS9) • Removable, solid -bottom block=off (GM59)` Accessories • L.P. Conversion Kit (LPT-OOA) LP -Ow -Low Prcasure-Kit (LPLP01) • High Altitude Natural Gas/L.P. Kim (HANG11. HANG12, HALPIO) .. . • High Altitude Pressure Switch Kit (HAPS27) • ExtemadFilterRack4EFR01). . • Horizontal Concentric Vent Kit (HCVK) • Vertical Concentric Vent -Kit (VCVK) ... • Internal Filter Retention Kit—upflow, horizontal (RF000180)..... • Internal Filter Retention Kit—downflow (RF300181) • Thermostats Brower Motors (CHTI8.60. CH70TG. CHSATG. H20TWR) SS-377[) vw•rovdmanmfgum —_ 6/04• EEQDU!;T SPECIFICATIONS Nomenclature -'al'FAI F m S a 1,070 Goodman® Brand T Revision A: -Initial BelAir Flow Direction NOX 8: f,t Revfsion M: Upf lowtHonzontal. N* Natural Gas C: Z"d Revision . D: Dedicated Downf low X: Low NOx C'. Downftow/Horizontal Ma inetWidth- It HJAir Flow A: 4 Description 11: 17A" [5-:-Siwinqle StAge/Multi-speed C:Ir. I V: T a TStage/Variable wo -Weed P; 2414" 4-,1.600 5: 2.000 f KBTIJH 070; 70,000 090: 90,000 1115:415,D00— M9W— - - 140.140,000 Bpi �Ij PRODUCT SPECIFICATIONS GCS9 Dimensions tvr SIX V*W F e. e101R 31DE VIEW w ►e tRE'ru,w AlR) y auw CDRDE4G.TE DRaw TRA► w w•►vc aftmAms e ►DDrrt 1) lerT 7roE1 n FOLDED rtAROE6 atSCHaRDENR f r lour votrAOF 1 ..EIECTUC.t 11DtE /—ELEcrRicq state a T9 Dow � r►A►a � A10R7 n 1N T ,�J .�..cca saa 'i AtTERN ,;G" �atr►tT Kota_. V GCS90453OXA• 17%" 16" 12%0 141/ GC590703BXA 17Si" 16"..... 16. GC590904CXA Zt" 19A" 16%" 18" 16. GC591155D7 241A" 23"._. 19W urvp,: e- 1. Installer must supply one or two PVC pipes: one for combustWstaia(nptionaH.and-ew fort1woue outlet (required), Vent pipe must be either 2" or 3" in diameter, depending upon furnace input; numberofelbays, length of ruts ancrinstallation (I or 2 pipes). The optional Combwrion Air Pipe is dependent on insrallation/code requirements and must be 2" or 3" diametet PVC• 2. Lino colggc wiring can enter thawgh tilt r ght orlektfdeafzhe furcate Ctsw volts&* ,piling cam enter through the righror left side of furnace. 3. Cbnpersitm kin for high altitude natural gas operation are available. Contact ypur Goodman distributor or dealer for derails. 4. /nscallez must supply following fins line fittings, according to which entrance. is used: Left—I'wo 900 elbow', one close nipple; straight pipe Right--Sitaight pipe to rexh gas valve Minimum Clearances to Combustible Materials C . Combustible: Ifplaced ran CUMNAStibit floor, the 06"MU$T be wood ONLY. NC = Non•Combustible: A combustible floor subbase must be used for installation on combustible flooring NOTES: • fur nrpkmg or cleaning, a 36" front clearance is recomencssded. • Vnit connections (electrical. flue and drain) may necessitate &rester eleasneuthao.t)sem{aimumeka..met listed below• • In all cases, accessibility clearance Tnuat take precedence avow clearances from the cndosure when accessibility clearances an gteattn 5 I PRODUCT SPECIFICATIONS Blower Performance Specifications ,o ..,})•, I I >la ?� �;.y t,352 -••--• `' a HIGH 3.0 t,318 1,260 .• 1,202 G_S9045313XA MED 2.5 1214 1,t72 1,123 1,064 (LOW) MED-LO 2.0 997 ----•- 994 ----•- 960 35 923 36 • Low.. ..t:5.. ..757...4+•...753- 44-- 73a .. 45.. -70t- 1,271 . 4r , 41 HIGH 3.0 1,449 36 1,409 37 1,326 39 G_5907038XA " MED Z.5 "2.0 1,192 43 1,172 44 1,141 45 1,094 , 47 (MED-HI) MED'-LO 981 53 962 •54 943 55 917 56 i`" LOW 1.5 1 750 --••-- 730 --•--- 7m .... 692 ...... )a 'j HIGLi.. ...4.0.. 1.,970 ...... i.874...-35- 1,757 ..3&- 1667 .40-- G_590904CXA MED 3.5 1,713 39 1,650 40 7,572 42 1,510 44 •e. 4 , 1f;;f.'. �f... (1AED-1-0) MED•LO 3.0 - t,439 46 1,412 47 1,370 48 1,327 50 LOW 2.5 1 T8] - 56 " 9"tS5' --57-- 1 172 '59- 1 10g , ' 60 i"s ;:: >ti 44G591155DXA HIGH 5.0 2,134 40 2,103 40 2,019 42 ,941 MED 4.0 1§7E ..51_ 1,643 - 52. IA43 .52.[11 577(MED•HI) MED•LO 3.5 1,453 58 1,440 59 1,426 59 1,363 62. LOW ..3.0... 1259 -67. .1739 _68-.. 220 70..1 1al NOTES: 1. CFM in chart is withuut fdter(s). FUtcm do nM +)ip.wuh this furnace but nun[ lx;.pruv[dcd..by. t)u.itu[A11IM.if the-f\una eieyuires two re s. this chart assunlas hn[h filters iw,: installed. 2. All h.trsaces ship as high speed cooling, 1m1AIcr must adjust blower ern>IivII speed m needed. 3. For must jobs. alusor 400 (TM per tun when et„I is desirable. - 4. INSTALLATION IS TO BE AI)JUSTED TO OBTAIN TEMPERATLIV,, RISE WITHIN ME RANUE SPECIFIED ON THE RATING PLATE. 5. The chart is fur Infixmatkm only. For sacisfacrorf uperatkm, external stutie pressure mvst non exceed value shown on the .;Ring plate. The shaded area indicates mazes it, excess of maximum static prc-ixtue :diLmed when heating. 1. Thu dashed ( ---- ) areas indieare a ttntpe. tr s,I ner recommended f "**rm,dei.-. 7. The above c%trt is fen U.S. fumnecs insc11led at 0' • 2.000'. At higher altitudes. a pregerly de -rated unit will have appraelanataly the same temperature rise at n p, .titular CFM,. while ESP at the CFM willbe kiwea... . `J,. ,PRODUCT SPECIFICATIONS Accessories LPT-o0A L.P. Conversion Kit I ,i LPLP01 L.P. Gas Low Pressure Kit ♦ ,r 1 HANG77 High Altitude Natural Gas Kit I I HANGIZ High Altitude Natural Gas Kit 2 2 2 2 HALPIO High Altitude L.P. Gas Kit 3 . .. ..._-. 3... , . 1. HAPS27 High Altitude Pressure Switch Kit 3 3 3 3 ..EEIMI.. External Flleer.Rack...... _... _. i....... ..... ....._ �..... - .,�._. DCVK-ZO Horizontal/vertical Concentric Vent Kit (Z") DCVK-30 Horizontal/verticalfoncentricVerrtxtt(}")- ....... 1.... �. . - r v Aarnc nx tnn nxiae, (I) 7,ocil-tii 9, (z) 9,00i' to 1100' (3) 7,001' to I I,000' Note: Ail ittstallations above 7,000'regvire a pressure switch chanp- Fix instaaact(" in CanaJa, Pomaces are certified only to 4,500'. Downflow Floor 8aae: When the 0CS9 model is instalicd directly on a wuod fluor, a dnwntln* Rout but must be tutd..Thove re x-Ael stu:oheta ary CFRI7, CF821 and UF824. Thermostats CHTIS-60 Cooling/Heating, Mechanical CH70TG Cooting/Heating, Digital, Non -programmable CHSATG J CoolM4/+ie3tin4T Mechanical .. HZOTWR Heating Only, Mechanical J 7 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: 5-3-2004 DATE OF PLANS: 05/03/04 TITLE: The Swan 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 = 229 Your Home = 125 Permit # checked by/Date Area or Cavity Cont. Glazing/Door Perimeter R-value R-value U-value UA ----------------------------------------------------------------------------- CEILINGS 1112 30.0 30.0 19 WALLS: wood Frame, 16" O.C. 1048 15.0 15.0 46 GLAZING: windows or Doors 86 0.340 29 DOORS 40 0.086 3 FLOORS: over Unconditioned Space 1112 .19.0 19.0 28 -------------------------------------------------'---------------------------- 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 apd%J4 Builder/Designer ������ Date '-13 /DT_ or '. y v Massachusetts Energy Code MAscheek Software version 2.01 Release 2 The Swan DATE: 5-3-2004. Bldg.I Dept.l use I 1 CEILINGS: [ ] I 1. R-30 + R-30 Comments/Location WALLS: [ ] I 1. Wood Frame, 16" O.C., R-15 + R-15 comments/Location WINDOWS AND GLASS DOORS: [ ] I 1. U-value: 0.34 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] NO Comments/Location DOORS: [ ] I 1. u-value: 0.086 Comments/Location FLOORS: [ ] I 1. over unconditioned Space, R-19 Comments/Location AIR LEAKAGE: [ ] I joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. when installed in the building envelope, recessed lighting fixtures i shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type iC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: [ ] I Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. 1 MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. r %, r DUCT INSULATION: ['] I 'Ducts shall be insulated per Table 74.4.7.E DUCT CONSTRUCTION: [ ] I All accessible joints, seams, and connections of supply and return I ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. TEMPERATURE CONTROLS: [ ] I Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] I Rated output capacity of the heating/cooling system is I not greater than 125% of the design load as specified I in Sections 780CMR 1310 and 74.4. I SWIMMING POOLS: C ] I All heated swimming pools must have an on/off heater switch and I require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I HVAC PIPING INSULATION: [ ] I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in.): PIPE SIZES (in.) I 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 i Steam condensate any 1.0 1.0 1.5 2.0 COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0 1.5 1.5 CIRCULATING HOT WATER SYSTEMS: [ ] I Insulate circulating hot water pipes to the following levels (in.): I PIPE SIZES (in.) I NON -CIRCULATING I CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F): RUNOUTS 0-1" I 0-1.25" 1.5-2.0" 2.0+" I 170-180 0.5 I 1.0 1.5 2.0 I 140-160 0.5 I 0.5 1.0 1.5 I 100-130 0.5 I 0.5 0.5 1.0 I ----NOTES TO FIELD (Building Department Use Only)------------------------- SEE SLEEVING NOTE BELOW GRAPHIC SCALE ( IN FEET ) I inch = 20 ft NOTE: ® SEWER LATERAL SHALL BE SLEEVED IN ACCORDANCE WITH TITLE V IF WITHIN 10FT. OF WATER MAIN. 170TIC_F, Unix^__ and iMil 1!•zh ti,no as th? orlgincl (red) stool? of '> re-p^nsi`;I Pr;feasic•nal Er.�naer, or Professional land Surveyor oppno..; on this pion: no person or parsons, in Auding any municipal of nthcr puLii: official.-, may rely uo,:n the icformation cont�in=.d h-- 1e6; (B) thil p' ,n remcins tha property of F7olmea ?: faro --lit„ �- PLOT PLAN holmes and mcgrath, inc. �''as� f''` •r�, OF LOT 107 civil engineers and land surveyors i TI OTHY M. R b PREPARED FOR 9 SANTOS 362 MILL POND VILLAGE gifford street o No.45075 IN falmouth, ma. 02540 v 9 clvl� a �� w�FF Ft''/STEP�r t�F. YARMOUTH, MA JOB NO: 201197 DRAWN: LMC / s fou; SCALE: 1 "=20' DATE: 3-23-051 DWG. NO.: A2541 CHECKED: `-ro s `1 9 Ic Commonwealth of Massachusetts Official Use only INDepartment of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 111991 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performcd in accordancc with the Massachusc is Electrical Co do (1N.EC), 527 Cb:R 12.00 (PLEA SE PRINT IN INK OR TYPE A LL INFORMA TION) Date: 1/17/2006 City or Town of. YARMOUTH. MA To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 121 CAMP ST., UNIT 107 Owner or Tenant GATEWOOD HOMES Owner's Address 1600 LMOUTH RD UNIT 25 CENTERVII LE MA 02632 Telephone No. Is this permit in conjunction with a building permit? Yes X No c - J Pu}'pose of Building SINGLE FAMILY DWELLING (Check Appropriate Boa) �o Existing Service Amps ! Utility Authorization No. 1499044 P Volts Overhead ❑ Und gt'd ❑ No. of Meters New Service 100 Amps 120/240 Volts Overhead '—' � umber of Feeders and Ampacity Undgrd X No. of Meters 1 Locaation and Nature of Pro osed Electrical Work: WIRE HOUSE, INSTALL SERVICE u a � 1 P ate-- ad i!V /1 r Attach additional detail ifdesirert or as required by the Inspector of Wires. 1 INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. .CHECK ONE: INSURANCE X BOND ❑ OTHER ❑ (Specify:) 10/31/2006 �D Estimated Value of Electrical Work: (Expiration Date) (When required by municipal policy.) p\ Work to Start: Inspections to be requested in accordance with NEC Rule 10, and upon completion. lv I certify, under the pains and penalties ofperjury, that the information on this application is true and complete FIRM NAME: PATTON ELECTRIC INC LIC. NO. A15542 `�i "Licensee: RICHARD pATTON Signature (lfapplicable, enter "exempt"in the license number line.) IC. NO.: Address: PATTON ELECTRIC INC. PO BOX 1525 MASHPEE MA 02 required by law. By my signature below, I hereby waive thi649 Bus. Tel. No5DS 539 02n0 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally s requirement. I am the (check one ❑ owner Owner/Agent ❑ owner's agent. Signature Telephone No. PEJROUTT.F'EE. $a125.00 0 No. of Recessed Fixtures �v"I geuun o u;e� No. of Ceil: Susp. (Paddle) Fans table n; be waived b d e h:s ectur ° ° Total No. of Lighting Outlets No. of Hot Tubs Transformers KVA' Generators KVA °• of Li hting Fixtures ..un; n Above In- S:v:m.....6_Col ❑ ❑ o. o me enc ig tmg tg Y No, of Receptacle Outlets rnd. rnd. No. of Oil Burners Batte Units FIRE ALARMS JNo. of Zones No. of Switches No. of as Burners o. o Detection and No. of Ranges No. of Air Cond. Total Initiating Devices Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons TKW _N otal eonamed No. of Dishwashers Space/Area Heating KW Detection/Alert Devices Local ❑ Municipal Connection ❑ Other No. of Dryers o. Water Heating Appliances KW Security Systems: No. Devices of Heaters K Noo . No. o of or Equivalent Data Wiring: No. Hydromassage Bathtubs Si ns Ballasts No. of Motors Total HP No. of Devices or Equivalent Telecommunications Wiring: I17•ut•n. No. if Devices or Equivalent - 0 1 9. Iq OF Y4 oar 9�'0 YATT,_CHEESE x ta, M o APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEQ, 527 CMR 12.00 0 2 1 200 (PLEASE PRINT IN INK OR TPEALL_INFOR4 To the Inspector of Wires: By this application the work described below. Location (Street k N) mber�C3,-� Owner or Tenant Owner's Address!= ►Mbs (OFFICE USE ONLY) ey Fee: $ PERMIT Date: &k- 2mgs)6 gives notice of his or her intention to perform the electrical Is this permit in conjun tion with a building permit? P-VesONo Purpose of Building >/Q�J� Utility Existing Service Amps / Volts Overhead❑ New Service _tom Amps ' Q-P / Volts OverheadD Number of Feeders and Location and Nature of Proposed electrical (Check Appropriate Box) Authorization No. Undgrd Q No. of Meters Undgrd No. of Meters 1 No. of Recessed Fixtures �••�.•� No. of Ceil: Sus .Paddle Fans •r•r ouowur iame may vewaivea oy ineinspector o wires No. o Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above n- Swimmin Pool rnd. md. ❑ No. of Emergency Lighting Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. o et an Initiatingg Dc Devices No. of Ranges g Tota No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers eat Pum TotalI Num er Tons _ _ No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local C] Municipal Other Connection No. of Dryers No. of Water Heaters KW Heating Appliances KW No. of No. of Signs Ballasts Security Systems: No. of Devices or E ui valent Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications wiring: No. of Devices or E uivalent nuu• I uuuuwrrue "clu!l rf uesirea, or as requirea oy Inc inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE �BONDC] OTHER (Specify:) Estimated Value of Electrical Work to Start_3 !� I certify, unde the ms and �RM NAME. censee: If 1' bl (Expmahon Date) (When required by municipal policy.) to be requested in ccordance with MEC Rule 10, and upon completion. r, th t tD fo ion on this application is true and complete �J i LIC. NO. I Signature LIC. NO. ( app tca e,� �exe me tt e e numb line.) 11Bus. Tel. No.: Address Ik%, Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that a Lice see 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 No. [Rev. 04/00] WPS - Permit Page 1 of 1 CJ NSTAR WPS - Permit Work Order Information Utility Auth/WO #: 01499044 Date: 01/172006 Company LINDA BISHOP ,jj Rep: Report By: YAR 121 CAMP ST UNITIp7 VILLAGES AT CAMP ST Status: PLAN Ser' Ice: NEW Type: RES Nature of Work: NEW 100AMP U/G TO HANDHOLE ON PROP LINE... TRANSF#P100A .... RES DEV...MILL POND ... CROSS ST BUCK ISLAND RD.... RES DEV W/O# 1171520 AND 1171519 ..... 1200 SQ FT .... ELECT RANGE,DRYER.... NO A/C ... GAS HT/HW...NO JACUZZI OR HOT TUB Service Information: There is no Service Information. Permit Information Permit M E06-667 Meters: 1 Reseal (YIN): Y Date: 04/112006 Inspector. W10060 Description: E' S arch - _ D'� etail' 7Coniacts NSTAR Home 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.com/apps/wps/wpspermit.cfm?Page=Permit&Unique={ts_'2006-0... 4/11/2006 TOWN 0 JDEPT; APPLICATION FOR PERMIT TO 00 GASFITTING (OFFICE USE ONLY) By�-- JUL 0 Fee: Sr�PERMIT NO.. � %Q�JBUILDIN—_ - ----- -h-10 - - Date Bu ltiing -��^^� Owner 0 AT. Location Na Name- }--0--F .`7- .........._� ... _...._.. Type of Occupancy- i5?t1"Aiiie__--- New IV Renovation `j' Replacement D Flans submitted Yes E.'. No f' lky � 'Uj y � y Ix r W I 1► 1 'G �5 % 4--o Ci i W a ¢ y J y �2' w Q 2 ��N I¢ �j W Gt O i V= W > rL W 2 `_ Q fay 9 1O. O z, a J W g _• •� ¢ x o t7 r v 3 a ca 5 u rz �" i5 r o SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR , 4M 3RD FLOOR {PRINT CR TYPE) r Check One- instaliiny Company Name D1LJC— "._i } .1 �!t i��,1�.. Ej Corp. Address .._.l_8�...._G.r4t`.. .`-�__.. _...-----.-.._._._._. LE-1 Partnership --._....-_------•----_.._._.._.____._ Business Telephone�'� -� `� 1 - Name of Licensed Plumber or•,r .___..._.'_ N -_. __ L?_!v___..------_.--•---_--...__.._._.. _. _.. INSURANCE COVERAGE: Check One I have a current Ioabitity :nsuran•:e policy pr i!s sunstamal equivPlent. Yes Cl No '_J It you have checked yes. please !rytl-cata t to type of coverage by check'ng the appropriate box. A liab+iity ,nsurance pol:cy Giber t;pe W indemnity Q Bond OWNER'S INSURANCE WAIVER ! am aware tt,nt the !:cenee does not have the insurance coverage required by Chapter tat 0' the Maas General Laws. and that my s•gnature on this permit application waives this requiremer:t. Cneck One: Owner Agent ;r.�) S:gnatu:h of Owner or Owner's Agen+ 1 I hereby certify that all of the details and Information 1 have spbmitted Signature o U ensod (or entered) In above application are true and accurate to the best of Plumber or Gasimar my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with alt --- -'- -'' "-"-"-""— pertinent provisions of the Massachusetts State Plumbing Code and Ucense Number