Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
121 Camp St #133 Building Permits
C'l r� TOWN OF Yi Building AT: Location New[X Plans Submitted jpmgmm NOV 2 12005 APPLICATION FOR PERMIT TO 00 GASFrMNG (OFFICE USE ONLY) By--_------iTET Fee: Sr— _ — _-- PERMIT T Na Name _ 4 Qlw SZ—' Type of Occupancy2!Fo1�G_ Renovation ❑ Replacement ❑ Yes ❑ No Fk (PRINT' OR TYPE) �� Installing Company Name -✓.UCJs-- Uukna 1T�_ Address Business Tele hone 50E-732"���L��—_... p Name of Licensed Plumber orr Check One: ❑ Corp. -„-^ 0 Partnership P Firm/Company------•---. -_ INSURANCE COVERAGE: Check One I have a current habdity insurance policy or its substantial equivalent. Yes $'No ❑ If you have checked yes, please indicate a type of coverage by chocking the appropriate box. A liability insurance policy 12 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 requiremeni. Signature of Owner or Owner's Agent 1 hereby certify that all of the details and Information I have sulftnft ed (or entered) in above application are true and accurste 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 Check One: Owner ❑ Agent ❑ Signature Licensed Plumber or Gashtter 2 J S ► �s ' License Number Tvoa 1 rrcrrcc• '--L=1.53' /°9; SCHOOL BUS KIOSK 3 OpOs S2OyF 8, s Fp A A 1.� �0 3 SFy'FR 4q 4• ,FRq< 'GRAPHIC SCALE ( IN FEET ) 1 inch = 20 M ^ ?/ ' to °' F pS SFO 4� i / > cRFTF G �Y� Sep / 3? : hr'V � 'AROA jet u PI LOT 134 ZH OF eA •ya., d. NOTE: ® SEWER LATERAL SHALL BE SLEEVED IN ACCORDANCE WITH TITLE V IF WITHIN 10FT. OF WATER MAIN. 140TICE lhiless and until such time as the original (red) stamp of the responsible Profesuinnal Engineer, or Professioncl Land Surveyor nppeors on this plan: (A) no person or persons, including any munioipel or o'.hcr putrofflcials, may rely upon tha Information cuntaieed here'.n: and (8) this plan remains the property of Holmes &. M:Crath, I"r,. PLOT PLAN holmes and mcgrath, inc. OF LOT 133 civil engineers and land. surveyors PREPARED FOR 362 gifford street ' MILL POND VILLAGE falmouth, ma. 02540 ^�_ , %a IN YARMOUTH, MA- JOB NO: 201197 DRAWN: LMC SCALE: 1"=20' DATE: 1-5-05 DWG. NO.: A2519 CHECKED: N" TOWN OF YARMOUTH Building Deoartment BUILDING (508) 398-2231 At.261 ------------ PERMIT NO B-05-1556_ ISSUE DATE ; _ 6/30/2005 _ ; PROPOSED USE APPLICANT _Frank Capra - _ - - - - - - - - - - AT (LOCATION) 100121CAMPSTUnit 133 ZbNW diSTRICTC SUBDIVISION MAP LOT BLOCK 044.21.1.C133 BUILDING IS TO BE: 'CONST LOT SIZE _ -- PERMIT JOB WEATHER CARD PERMIT TO ' New Construction _; Bldg. Type: Residential new construction: 2 baths, 3 bedrooms, 1 diningroom, 1 kitchen, 1 Iivingroom as per plans dated REMARKS 06/09/05. Subject to compaction & proctor tests. AREA (SO FT) EST COST ($ 1$148,896.00 NtHM1 I t-= tZ�) J3Oa s.vv i OWNER Villages 0 Camp St, LLC ILDING DEPT BY ADDRESS 11600 Falmouth Road # 25 Centerville TWAT02632 USE CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 MA 02632 Certificate Issue Date A4 y o'o >+ CERTIFICATE of OCCUPANCY Departmental Approval for Certificate of Occupancy and Compliance neas onrmlt Nnmhor Annrnved By Remarks :111- UM`- O M PLUMBING/GAS�#»m ENGINEERING _1 F nyI i I To be filled in by each division indicated hereon upon completion of its final inspection. I TOWN OF YARMOUTH Building Department BUILDING (508) 398 2231,axt.261 -- 5-155 ; PERMIT ►- PERMIT NO �_B-05-1556_� _______. ISSUE DATE ; _ 6/30/2005 _ ; PROPOSED US ------ ----------------- --®, JOB WEATHER CARD APPLICANT �FrankCapra _ _ _ _ _ _P� -------------------- ------------ PERMIT TO ; New Construction ; AT (LOCATION) 00121CAMP ST Unit 133 ZONING DISTRICT= Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C733 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE new construction: 2 baths, 3 bedrooms, 1 diningroom, 1 kitchen, 1 livingroom as per plans dated REMARKS 06/09/05. Subject to compaction & proctor tests. 4REA (SO FT) EST COST ($ $148,896.00 PERMIT FEE OWNER Villages G Camp St., LLC ADDRESS 11600 Falmouth Road # 25 Centerville MA 02632 BUILDING DEPT BY INSPECTION RECORD CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 FIELD COPY Inspector o' r MEMO SEP p To: Jim Brandolini, Building Commissioner 7 2005 :.. sy ©UILDi.: o-r From: Richie Anctil, Engineering Division �_" , Subject: Dwelling 134, Mill Pond Estates, VN Date: September 7, 2005 During July, a drainage pipe which runs between dwelling 134 and 133 was damaged while excavating for foundation work for dwelling 134 (see attached photos and locus). Although the contractor has promised cooperation regarding the repair of this pipeline, the trench was filled in without the necessary repair. In an effort to insure that the entire line is re -excavated and repaired under this department's inspection, we request at this time that an occupancy permit not be granted for dwelling 134 until the repairs are complete and accepted by both this department and the site owner's engineer, Holmes and McGrath, Inc. Please see me should you have any questions or comments. XC: Rick deMello, Town Engineer Raul Lizardi-Rivera, Holmes and McGrath, Inc. Crowell Construction — t-NUF'US;F D 8" D.I. �.. WATER MAIN I ASSEMRly ) SEE NOTE2 PRO WATER GATES I PROPOSED — > AN PROPOSED SEWER MHOLE HYDRANT Ir I 16 PROPOSED SEWER LINE (TYPICAL OF 13) (TYPICAL) D z > z 1 I O ,j Z 14� 4 3 �1 El z �'� 2 13 ./ ;\ z '`\, '�I ti R:? 124 m I m ° £ 8 z N. 'r� TIE PROPOSED W � m 3 _ _ \, \, 125 ❑ I INTO EXISTING W, 127 "' I ���. �• 2 �i. 128 12 / 9 129 i ��! • jhlj z i 123I s a , 139 `5 R' A ��� •��•�::GDV( fit' ���� "� - Z I r� 122 1 SBUSOL� `l 62 N KIOSK` 121 // lV 3 /i i 4 s 134``� / 63 135\\ , `v 120 PROPOSE 134 \+ V PROPOSE s 112� 119 PROPOSE 113 4 \\� \ . PROPOSE 0 s 114 5 �' \ \ 118 / ++ 1 11 \, t 4 R ��•O w / r�,:' , +I� �y'lyi OPROPOSE 117 iEl FLOW DIF (� ^i PROPOSEI 109 v PROPOSEI 82 _ Ei3 PROPOSED B" PROPOSE[ s_ GATE VALVE LOCATION J 108 PWATERROPOSED N D.I.(TYPICAL) N EW 12" X 8PROPOSE( a r frvcireiN REDUCER fbbetts E e i EC�jlrlEEPqt1Cj COP JE CONSULTING CMIL ENGINEEtRS a LRNb SURVEYORS :�Fl�� NrQw11i�C p( RTTQ�.�.�C7 ]iL AN ER � �v��SG D: 9nros Imo:109SO.010 CLTE14T: Gateavood Homes C4 ii18KTOlt: Homes mad McCh-A MLD TIME: j Ir 1� ZDAK G: 1 M> niaWIVator TRAMM TD 6.5 Hours 1 Yibcstory Plate Compactor MEIY WORMY .- Rick H, of Gatewood Homes WQRK,QRMED: In accordance with a request from the client, I arrived at the rdhvnced job site at apx. 8:OOAM for scheduled compaction besting. Upon my arrival I met with ]tick of Gasewood Horn informed me that compaction testing would be needed at the base of the footings on lots ] ]33 134. He informed me that he would get an excavator and dig two test pits on lots 133 and on the outside of the building at footing depth. Rick requested that two compaction tests at footing base be performed on each lot. A total of six compaction tests were taken today. All tests taken did meet, or.awced, 95% compaction. See attacbed report for detailed information on test locations and results. After testing was completed I informed Rick of all test results, packet up my equipment and left the job site. F. F Miades Lab Technieiaa 716 Count> Wiest Tac:nton, MA 02780 Tel. (3Cb) 822-6834 Fax (F08) E80-: 811 E-Mal: Ar�tibbettssnginesrirg.ra�r i bbetts Engimering Corp. CONSULTING ENGINEERS • s ' .; - Tel. Dan az3.694 r 0. OTT) 990-7311 716 C aroeg 3tres% Tasixteos MA 02780 Cllwd: Gatewood Homes Job No. 10960.010 16M Falmouth Road, Suite 25 Data 977105 Centerville, MA 02632 Report No.: 2 1 Project. Mils Pond Village, Walt Yarmouth Testnnarinn e! Field DeRSd1/ Test FD5250A Ld#133 - NoM Center- em of Foodtlp -Sandy Grua► FD52WB Lot#133 - South Center - Base of Footkg - Sandy Gravel F05250C Lot* JU- Nodh Center - Beae of Feoaing - &w* C-Aw i FD5250D Lot #134 - SMM Center - Baee of Foo" - t98* tlraval FD5250F .d #112 - Ead Cetlter - Beee of Footing -Sandy (Tstuai FD525DF - Lot #112 - West CMW - Saes of F0011V - Sandy Gr vd J Tahutabon Fled Den V 10tatOM I Date: Test No. Proctor I.D. Re% % Muk"d trleate IloisLts all Max Dry aPf n CQfML *a Cotfernt P.C.F. 1Aft. PCF Moiehxa 9/70OZ F05250A PR425& 95 90.8 Yes 4.7 123.9 125.4 82 i 91712005 F052508 PR42S E 95 96.3 Yet 3.9 120.7 125.4 62 91712008 r05= PR4252E 95 96.1 Yes 4.1 120.6 1264 82 9f�MM F05250D PR4252E 95 957 Yea 42 1200 125.4 82 82 917M FQ5250E PR42M 95 99.8 1,8 Yea 4.9 121.8 125A ' 6 2 9f7M FD525OF PR4252E 95 RemafRs met me me" MwMUM corrodeb" Of M. feat rested for Oversize PsPsdkiss In a000rrianoe.wtth ASTM D-4716. Labommy edmwen Walter P. GOUMM t aharstto y Supavow �► t' O d � J88 LINE & I WU FAMILY UNLY - 13UILUINCa PLKMI 1 APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING Town of Yarmouth Building Department 1146 Route 28 - Yarmouth, MA 02664-4492 Tel: (508) 398-2231 x261 - Fax: (508)::398-0836 PermttVoW armingdpowdv_tuformatlon ,�� 3�^ { `Nssesso y QPa iimeyr�rt l fomratio[ 7 `u s?� , ; #.LF."�ti tt a� sly h yes,a, Yr r� X�{ .3eSHx ei Ya` i�ry riS' Y tJ �y.l � t, +f � 3`kL "''4 ?i, fm ..55tt J'H ��e Y{' KTF y{.jtyny %r��IN"=fi �'l`�.%^d k`k �yr� �x�•i' E3 yiY� '�y�i�[^=°�� s^ ' is a�w3Xm� ss3%M� Permltfee�%S ¢t% s HRv x x A3 � l�� `C1M`-�.Y• rsar-^'�. ' �p(�f7Sl�`),it3G-��' W '`3 .�., ` 1']"%"' _ �., aPlan 0]' c. �� Y# �...4 „f, ,+fir s�-fr�r "x�.kt. µ� qs try d,R a i .:.t�`t'.g`!.fi �'a e �_. � �.: T R � a).'µ'�4"� �. y -� `n ✓r Yhs P'� 5. h� > :! VE40 13�P�� sue. ,.� . inK✓-�i rX,Iv. F.ts S .Ay .+ ✓' ah all gyQMs!ptiy ..£ vlvftgS i�.+s`+�y a. �''h+!"i""`>'��rr, .• x,.Cs �.t £ y.y `.e'er#1{'; .zrn's�'z r3+,�At Effi,y„ - S.i.L'?+,^gY�'t-vT a �E�i Sec_ifo(ite>rrrtatio' Use Group: R-4 T pe: 5-B 1.1 Property Address: 1.2 Zoning Information: 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) d v �F1ood,Zone fraiomatiori�]� aaK `xwinmenis�s� +Hrs Public PrivateZofi� ' =Sectton�� .:,ra a C1w e slu ��vtFtanz�tlA"'e 2.1 \I Owne of l Record: / t G R 'g l lt01Rs ^- N me (printk Mailing Address CA4t r vt — N t 11 cb,r.,, 126 Signature Telephone 2.2 uthorize Agent: l �t4 G�, - nod, �s 00 Name (print) a Mailing Address _ Sa, 7 S-QGG o g- 6 Sign u elephone Fay S0C.10 3.1 Licensed Construction Supervisor. P61ickfeEl eY JUN 2 4 200 /) („ ( a' iqth �{ icenseg rr ber O %0 0 ✓l ✓� CJ Expiration Date ddre —7 V 6 —C ) Signature Telephone 3:�,.Ftecltstgre�lorp>�fltr}irouerrjentlCsotttragta►��:; Company Name y J ZQ�� J NotApplicabl Address G` l- License Number Expiration Date �.��� Signature Telephone OVER I— :6e,M/. 9-15-99 1 of 2 mac. uf, �r �r�rorfcers tsrC7pnsaUotktdavi:tl>fa i' 152 S'2afi Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial f the issuance of the building permit. Signed Affidavit Attached Yes .......... No .......... eCtitli���""ii@S'GC(pt{6i��j��P1'QFosed"��tk�cCieck�l# �appi#ca61e� New Construction No. of Bedrooms No. of Bathrooms Existing Bldg. ❑ Repair(s) ❑ Alterations ❑ Addition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: r ` t f V'% k� V1 Q '�'ECttp�Ji6�*�.srtt(rf3t$[i.0?1Strl7.C�f0�I�CC1St5'. _ Item Estimated Cost (Dollars) to be Check Below completed by permit applicant ❑ Conservation -Commission Filing 1: Building. 2. Electrical • (if applicable) 3. Plumbing / Gas ❑ Old Kings Highway& Historical Commission approval (if applicable) 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) 0610 7. Total Square Ft. (new houses & addNorts)` Sec#iat7a ©vmer�Atlilo#ioio �33Yvn�K�� �eCompie#ed Vtifhe entf¢r.�oniractarAp fes�orwBuitdfn" e.X— a�owner of the subject property hereby authorize -e r to act on m beh , in all matters elative to work authorized by this building permit Application. r -14103 Signature of Owner Date Secito�I7bi��3ihmef'1�t�t[aar,�?ed=�igent�D.ec�taration bV t as Qwner/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. Print name Signature O e gent Date u r 9-15.99 2 of 2 x oc y 1 <J w IN . yr YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: / Job Location: �- I G41 Num. ber. Street �� Y Village Owner of Property: V [L G Construction Supervisor: Loa f/'Name ,,��%� ,� r License No. /Phone No. Address: /- 5� 00 l k4lo `' "� ! , �v�i�= a i� (fin / `i£�[ rJ. U. IM Q 1 Licensed Designee: (If other than Supervisor) Name 2.15 Responsibility of each license holder: License No. 2.15.1 The license holder shall be fully and completely responsible for all work for which he is supervising. He shall be responsible for seeing that all work is done pursuant to the state building code and the drawings as approved by the building official. 2.15.2 The license holder shall be responsible to supervise the construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of building and structures only pursuant to the state building code and all other applicable laws of the commonwealth, even though he, the license holder, is not the permit holder but only a subcontractor or contractor to the permit holder. 2.15.3 The license holder shall immediately notify the building official in writing of the discovery of any violations which are covered by the building permit 2.15.4 Any licensee who shall willfullyviolate subsections 2.15.1, 2.1-5.2 or 2.15.3 or 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 M, please indicate the type coverage by checking the appropriate box. A liability insurance policy Er Other type of indemnity ❑ Bond OWNER'S_INSURANC WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapt of t ss. Geperal Lawis, and that my signature on this permit application waives this requirement. Check one: SigrAture of Owner or Owner's Agent Owner ent (� Signature: Building Official Approval: G _im"\ The Commonwealth of Massachusetts Department of Industrial Accidents times ollsvesgIsttsss 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurnnep srr,t..,lr ( t.� v t! � k_k— rvc-M o�10'') 7 rk my I am a homeowner performing all woself. O 1 am a sole proprietor ani haN a no one working in any capacity I am.an employerpro% iding workers' compensation for my employees working on this job. company name• address• city: phone u insurnnce co, noliry k C9 I am a sole proprietor. _eneral contractor. or homeowner (circle one) and have hired the ennrrartnrc lierprl hpinu• uhn 1,n, ntv Rhone tl insurance eo.. policy tt company name• rauure to secure coverage as required undtr Section 2SA of MGL 152 can lead to the insppittion of ttintlaal peaaides of a fine up. to S1,500.00 and/or_ one yesirs' imprisonment as well as aril penaltiei in the form of a STOP WORK ORDER and a (lie 4SI00 00 a day *against me. I andetstand'that a copy of this statement may be forwarded to the Once of Investigations of the DIA for.eoverage verification. f do -hereby terrify I Ider he �I�s and penaldis of perjury that the information provided above is trite and omci k Signature U v — %1b f pate X ' !z OU Q Print name ��t1�t1 k lAh CA,Phone N _So of iici2l use only do not %rite in this area to be completed by city or towaolfieial city or town: YARMODT$ _ permit/license q n8uilding Department cheek if immediate response is required OLicensing Board261 C3seleetmen's Office �Ifealtb Department contact person: pho�c cat _ C508j 398�2231 eat. mother. ... 1 11. i.,, TOWN OF YARMOUTH 1146ROUTE28 SOUTHYARMOUTH MASSACHUSETrS026644451 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 l�js� (�5+. Work Ad$r ew is to be disposed of at the following location: ►'\1n5 `C 64 Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Signature of Applicant Date Permit No. 'f. 00 - 35j000-d endOSedspace (MGL C.TT2rS:8OL) - <' 4A -Masonry ort}y ?- 4G_=k&7FamkHomes Failure:toposses imirieditionofthe Imssacli0settsSfateeBuiidinq..Code: - I is-cai+safw;2vocationofthis -license. Y DIG SAFE.CALL.CENTER: j888) 344-7233 133 ���se1 MPD3328 MPD3530 MPD4035 33' fireplace w/opt. flush face 3S' fireplace w/brusbed stainless 40' fireplace w/polished brass- louver and door trim trim arch door kit Beauty, efficiency, convenience and reliability. Just some of what you'll find in our Lennox Merit® Plus Series direct -vent gas fireplaces. Our combo DV configuration, with both top and rear outlets, allows for top or rear venting (except_ our 33" units which have either a top or rear outlet). Standard features include a deluxe pan burner that produces big yellow flames and glowing embers, brickaded interiors and Hi/Lo flame opera - tion. And, these models are even easier to warm to when you select one of our optional remote controls, or polished brass or brushed stainless trim options. MPD4540 MPD4035 Standard Features • Louvered face design • Charred split oak gas log set • Deluxe pan burner for big yellow flames and glowing embers • Charcoal black exterior powder coat finish • Realistic brickaded interior panels • Combo top/rear direct -vent outlets (except 3328 models, which have either a top or rear outlet) • Hi/Lo flame operation Pre -wired for wall switch Options • Choice of standing pilot (works in a fower failure) or pilotless electronic intermittent) ignition • Decorative polished brass or brushed stainless accessories (arch door kit, door trim, louvers, hood) • Wireless remote controls • Blower kits (including a temperature control version) • Screen panel kit (heat guard) • Radiant panel kits (for a clean face look) All Merit Plus Series direct -vent gas firepplaces utilize either a Secure Vent (rigid) or Secure Flex flexible 4.5" umer/7.5" outer coaxial venting system, and include a 20-year limited warranty. Note: Due to Lennox' ongoing commitment to quality, all specifications, ratings and dimensions are subject to change without notice. Local conditions, such as elevation, wind vent configu- ration and choice of fuel will affect the overall appearance of the fire. Warnock Hersey Q20006711) Wn ock Hersey SAELAF CC �- r us MPD3530 MPD3328 The first two model number digits indicate frame width, the last two digits indicate glass width. All are A.EU.E: rated high efficiency vented gas fireplace heaters, certified under ANSI Z21.88 and CSA 2.33-M99. DIMENSIONS (Rear vent modd shown) 3328 MODELS 9h s model comes as a top or rear vent only) Front Face 35,40 & 45 MODELS D H T-12' 4.11r Top (These models come with a top and rear vent) Right Side wo Front Face Top Right Side FIREPLACE & FRAMING DIMENSIONS 3328 33% 303/s 17 271/t 333's 195/8 21�'z 103/4 331/4 33t/4 13 3530 351/s 32% 19 291/z 351/s 211A6 24%s 12%6 351/4 351/4 16 4035 401/8 371/s 24 341°t 401A 2611A6 29h 143SA6 .401/4 401/4 16 4540 401A 373's 24 39% 451/8 261A6 34h 17%6 45/4 40Y4 16 3328T NG 17,500 45 64 62 3328T LP 17,500 49 66 64 3328R NG 17,500 53 63 61 3328R LP 17,500 55 66 64 3530 NG 20,000 53 64 62 3530 LP 20,000 55 62 60 4035 . NG 27,000 59 69 67 4035 LP 27,000 60 69 67 4540 NG 29,000 59 69 67 4540 LP 29,000 59 69 67 "Intermittent ignition systems Look for the ErwrGulde TYPICAL ROOM APPLICATIONS VKR CAL 05105/2005 14!09 .a'fPRODUCER D. CEI 5US-398-6033 tern Insurance Cr Atlantic Ave Yarmouth MA 0266,1 762 Falmouth Hyannis MA 0 50B9 760-1667 EASTERN-INS..YARMOUTH PAGE 01 DATE (Mwo¢mYY) TIFICATE OF LIABILITY INSURANCE OS-/OS/2005 FAX 509-760-1667 TTHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION up LLC ONLY AND CONFERS NO RIGHTS -UPON THE CERTIFICATE' HOLDER. THIS GERTIFI_CATE DOES.NOTAMEND .EXI QR INSURERS -AFFORDING -COVERAGE INSURFJAA: Ae el a. Protection Ins Company +NSVKR-B Hartford INSURER a WBURER D'-.... WSURER.E: ' COVERAGE NAMED ABOVE FOR THE POLICY PERIOD INDICATED: THE POLICIES OF-INSURANCe LISTED BELOW HAVE BEEN ISSUED TO THE INSURED RNOrTWITHSnARNDIN DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY - ANY REQUIREMENT. TERM O CONDITION OF ANY CONTRACTOR OTHER HEREIN tSSUWECTTO-ALL TRETERMS EVULISIONS RND-CONoI7ION8 OF SUC1' MAY PERTAIN, THE INSURA AFFORDED BY THE POLICIESDESCRIBED MAY HAVE'BEERREDUCED-BY PAID CLAIMS,, POLICIES. AGGREGATE LIMA SHOWN POLICY EKPIRATION_ LIMITS tNSR DD TYRE OF JNSURLLIABLYTY ►OLI6Y NUMBER- . - . . _. .... 7S0000017312113/20OS -EACH OCCURRENCE . S. 1 000 00. GENERAL LIABILITY. DAMAGE TO RENTED S 50,00 )( COMMERCIALGENE 7�UW�/13/2004 MED EXP (AnY p»_DwYOP) S_ - 'S,0OPERSOUL}ADY CLAIMS MADE INJURY S 1,000 0AGENERAL AGGREGATE- i 2. 000 00GENL PROOUCYS - COMPIOP AGG S 2 DOD, OO AGGREGATELBMR ... X POLICY JEC _ LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT IEe ea+dent) s„ ANY AUTO ALL OWNEGAUTOS BODILY INJURY $CNEDULEO AUTOS -. HIREDAVTOS .. ... BODILY INJURY (FW foldeni) A NON.OWNED AUTOS ... - AAMAGE S " -EAACCOENT. E7AUtTCONLY! t - GARAGE LABILITY .. ... T:�lANY AUTO - - NE4ACC �� � AGO 11 1_ f ... EACH OCCURRENCE IxCCSSAIMBR¢LU WS JTV 460002928E 12/13/2004- 12/13,/2005- .AGGREGATE . ' :. 1,000 00 X OCCUR QC Aims MADE f- A f - . DEDUCTtME ' X wcsuTu - ; OTH f.. . X RE;E+TION' f IO, OO ... 08WECKL1007 .. ... OS/25/2004- W2S/ZOQS - E-L, EACHJICCI]ENi-.. i.... 500,000 WORKERS COMPENSATIONA -- EMPLOYERTLIABIUTY -OS/2S/200S- -0S/2S/ZM- B OFFIGEHMEMSEREXCLUDED? CUTtvE E.L:DISEASE-EAEMPLOYE S" SOQ 00 S... Ryes, d"wbe under SPECIAL PROVISIONS b6IW E.L-DISEASE-PDUCY-UMR OTHER ... - DESCRIPTKINOF OPERATJONAILDC, TIONSI VFAICLESIFXCLUSIONS ADDED BY EMOORSEMENTJ SPECIAL PROVISIONS wi dance -of Insurance Catewood NomeS 1600 Falmouth A 1 025 Centerville, M-02632- ACORD 25 (2001f08) FAX: .(508)778-S603-- SHOULD AMY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXNRATION➢ATE JHEREOf-, THEISSUINIG ROMER-WML ENDHIYOR TO MAL- ' ZD- DAYS WRITTEN NOTICE TO THE CERTIfICATE HOLDER NAMED TO THE LEFT. BUY. FAILURE TO MAIL SUCHNOTICESHALL IMPOSE NOODLIGATIONO&UA51UTY - OFANY IONOUPOWTHEITMSURER. ITTAGETITSGKDEPRESENTWTH ET" AUTNORILE6hE,giESENT tTVE /\- (� �__ �-. OACORD CORPORATION 1955 n w ccno A atrct%e% �t A ORD- CERTIFICATE OF LIABILITY INSURANCE io0410 MID°�""' PR UCER Dowling 8 O'Neil Insurance Agency, Inc. 222 West Main St. PO Box 1990 Hyannis, MA 02601 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED I. Assurance Construction, Inc. A/O Assurance Excavation, Inc. 550 Willow Street West Yarmouth, MA 02673 INSURER A. Travelers Insurance Company INSURER B: INSURERC: INSURER D: INSURERS CUvLKAtits 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 NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE D POLICY EXPIRATION DATEIMMIDOIYYI 08/01/05 LIMITS EACH OCCURRENCE $1000000 A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY MADE O OCCUR 16808387A9841ND04 08/01/04 - DAMAGE TO RENTED ISES (E.CLAIMS E3OO OOO MED EXP (Any ale person) $5 000 PERSONAL 6 ADV INJURY E1 DUO 000 GENERAL AGGREGATE s2,000,000 PRODUCTS-COMP/OP AGG $2000000 GENL AGGREGATE LIMIT APPLIES PER POLICY PRO- JECT LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS - COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per Penton) E BODILY INJURY (Per accident) E PROPERTY DAMAGE (Per accident) E a GARAGE LIABILITY ANYAUTO AUTO ONLY -EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGO S E IXCESSIUMBRELLA LIABILITY OCCUR r� CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERSCOMPENSATIONAND EMPLOYERS LIABILITY ANY PROPRIETORIPARTNERIEXECUTNE OFFICERIMEMBER EXCLUDED? Kyes, de=be under SPECIAL PROVISIONS below EACH OCCURRENCE S AGGREGATE $ $ S WC STATLL OTH- E E.L. EACH ACCIDENT $ E.L.DISEASE • EA EMPLOYEE $ E.L. DISEASE. POLICY LIMIT E OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Operations performed by the named insured subject to policy conditions and exclusions. Gatewood Homes, Inc. Attn: Paula 1600 Falmouth Road, Suite 25 Centerville, MA 02632 ACORD 25 (2001108) 1 of 2 #35866 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 REPRESENTATIVES. AUTHORIZED �REEPP±RES ATIVE ....nn..e wr,nu •eas • . .ti1=�/1.1% ;'CERTI FI CATS OF ,INSURANCE DATE (N MOLnYY) 01-19-05 ::. s::.. ......:......:....:..: :...:.... .:...:... ..:....... THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE DOWLING & 0 NEIL INS AGC 222 WEST MAIN STREET HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE PO BOX 1990 HYANNIS MA 02601 COMPANY 22LGR A ST. PAUL FIRE AND MARINE INSURANCE COMPANY INSURED HP BUISNESS SERVICES INC A5surance 6A,-Irud; COMPANY B COMPANY 118 WATERHOUSE RD SUITE E ll nn� BOURNE MA 02532 - 4,keLy�C1'44-e. (.L.'t'LI�La_ C.. 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. CO L TYPE OF INSURANCE POLICY NUMBER POLICY DATE EFFECTIVE (MLL(DD1YY) POLICY EXPIRATION DATE (M=MYY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ PRODUCTS-COMP/OPAGG. S COMMERCIAL GENERAL LIABILITY PERSONAL & ADV. INJURY $ CLAIMS MADE = OCCUR EACH OCCURRENCE g OWNER'S & CONTRACTOR'S PROT. FIRE DAMAGE (Any one fire) § MED. EXPENSE (Any one person) S AUTOMOBILE LIABILITY COMBINED SINGLE § ANY AUTO LIMIT BODILY INJURY (Per Person) § ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per Accident) $ HIRED AUTOS NON -OWNED AUTOS _ PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: .................................... ANY AUTO EACH ACCIDENT $ AGGREGATE S EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM OTHER THAN UMBRELLA FORM A WORIffITS COMPENSATION AND EMPLOYER'S LIABILITY (LIB-4042637-2-04) 12 -24-04 12-24-OS STATUTORY LIMITS ... EACH ACCIDENT $ 100 000 DISEASE —POLICY LIMIT $ 500 000 THE PROPRIETOR/ X INCL PARTNEFPLECUTIVE OFFICERS ARE: EXCL DISEASE —EACH EMPLOYEE $ 100,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONOEHICLES/RESTRICTIONS/SPECULL ITEMS COVERAGE RESTRICTED TO LEASED EMPLOYEES OF ASSURANCE EXCAVATION INC THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION .:......:..........:..::..:.....................:.. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE GATEWOOD. HOMES ---------------------- - - ATTN: PAULA EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 1600 FALMOUTH RD LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UNIT 25 LIABILITY OF ANY NAND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. CENTERVILLE MA 02632 AUTHORIZED REPRESENTATIVE .....:, ACORB35 5 (3f93j f1R . .......... ON tss < Dates 5/5/2005 Time: 3sO2 PM To: 0 15007785603 - - Pape: 002-003 /rA-DrVMrM71rAnV .AG - . CERTI�ICATE OF LIABILITY INSURANCE (w/D 'YY"Y' PRODUCER The FeRelbeM Company 222 Milliken Blvd. P.G. Box 3220 Fall River, MA 02722 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE-CEFMFICATE HOLDER: THIS C€RTI€ICATE DOES NOT AMEND; EXTEND OR-- ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Cape Cod Ready Mix Inc. PC BOX aft ' Orleans, MA 02653 INSURER A: Acadia Insurance Companies INSURER B: Construction Industries Compensation INSURER G INSURERD: INSURER e. COVERAGES _8 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTAN1NG- ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTIACTOR`OTHER DOCUMEN7WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUI>SOR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN RIEDUCEDBY PAID CLAIMS. Trw TYPE OF INSURANCE POLICY NUMBER POLICYEFFErnVE Poi-ICYEXPIRATION UNITS A - GENERAL LIABILITY X COMMERCIALGENERALUABILITV CLAIMS MADE OCCUR CPA0132488t0- _ • . - ot/0't/�r, - - OljOf/OB. . . _ _ EACH OCCURRENCE E100(000 DAMAGETOPENTED PREMISFS 8100 000 MED EXP (Any we pe n) S$ 000 PERSONAL S ADV INJURY 61,000,000 GENERALAGGREGATE S2 008000 GEN-AGGREGATE LIMIT APPLIES PER: POLICY M JFCr (� LOC PRODUCTS-COMP/OP AGG S2 NO 000 - A - AUTOMOBILBUABILITT ANY AUTO ALLCWNEDAUTOS SCHEDULED AUTOS HIREDAUTOS NON-OWNEDAUTOS MAA013246510 01/01/05 .. .. 011011w. OOMBINEDSLNGLEUMIT lEa acctlertj S1,DOO,000-' BODILY INJURY Pe Pa ; S. X BONLYINJURY - �a aaltleNl S X is 'PSOPERTYDAMAGE Per ao;%roml GARAGE UABRITY .ANYAUTO - _ _ - AUTO ONLY• EA ACCIDENT S OTHER THAN EA ACC AUTO ONLY: AGO S S A . B - EXCESSAUMBRELLAUAMUTY _ X OCCUR Ei CLAIMS MADE RXDEIXUCTISLE RETENTION so WORKERS COMPENSATION AND EMPLOTEW L %ML FT- _ ANY PROPRIETOFVPARTNERUEXECUTNE OFFICERIMEMBER EXCLUDED? Itymdesatbe Yntler SPECIAL PROVISIONS below CUA0132470.10 - WCOOM55 01/O1.ID5 _ p1/01/05 01/01)06 01/01/06 EACH OCCURRENCE $1 000000 AGGREGATE $ S S X. W-91I IT. DTH• S EA.. EACH ACCIDENT S5 000' E.L. DISEASE - EA EMPLOYEE $500000 E.L. DISEASE POLICY OMIT 5500000- . . OTHER DESCRIPTION OF OPERATIONS ULOCATIONS [VEHICLES r0=119oNS ADDED -BfEt TIENrt SPECMt PROVISIONS" Gatewood Homes Inc. 1600 Falmouth Road Suite 25 Cetdarvl[W,, MA 02632 LD ANY OF THE ABOVE DESCRIBED POUCIES SE CANCELLED BEFORE THE EXPIRATION THEREOF; THEISSUINOtP)MNE VVRLLENDEAVORTO MAIL �3Q�- DAYSWRITrI:N % TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL M NOOBUGATtON OR LI0181LNTY OF ANY IOND UPONTHE INSURER, ITS AGENTS OR ACORD25(2001/08) 1 of #S68M/M66526 AH10-AOOHLIUUMFUHA11WnIITIu 05/06/2005 09:38 5084204474 EDWARD A GRAZUL ACORD., - CERTIFICATE OF LIABIUTY. INSURANCE. PRODUCER THIS CERTIFICATE IS ISSUE[ ONLY AND -CONFERS NO I PAGE 02 FA,ard A. (Irawl.Inmxcv Ce Agerc}!, Its. HOLDER. THIS CERTIFICATE'DOES 140T -AMEND; EXTErNB-OW- P.C1Xx 331 • ALTER THE .COVERAGE -AFFORDED :BY THE POUCIES BELOW_ Mmstrm Mills, MA C2648 TNiBURERSAFFORDINGCOVEERAGE; NAIC S B,GUREo I WGUREFRA;._ r ]�Sj-C29181ty.IT14.., St tLlTfj�S,,., UJSURER 9-.. . /�/�.��1 ,C,,� . 145 Cmmtt Pbad INSURER[.. yyy� Marstcm K1I3,. M4 i�L8 -'' ' IN_S41RL'I+Dc - ... W46URFa e �.vr cn.T�rc� THE POLIEIES OF;INSURANCE LISTEOBELOW NAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM.OR fONOITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO' WWCH THIS CE WIFICATLL _MAY BE 151911ED.9R.. MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES OESCRtOMHEREIN IS SU9.IECT TO ALL THE TERMS. EXCLUSIONS'AND CONDITIONS OF SUCH POLICIES AGGREGATEUMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POUCY NUMBER ►OLICYEFFEOTIVE POI. ICY EXPIRATION - NMO'S GENERALLIABILRY .... .. .... I E0.CH OCCURRENCE S _ T>STLFRTFR...19-1- COMMERCIALGENERAL LInBAJTY I �1 ' PRFMISE9IEIlV4GVSD.FB) . 1 I -CLAIMS MADE :pgoccuR 1 MEDE%R IAq.mMMllonl�v'u{./�_ I! Il `" PERSONAL&ADVMURY(�TT���pTO�QT���Q� %J�T ��QJ(�j A OEN'LACGREOATELIMITAFT'LIESPlR: � WIA.OJ916 ' -4/28�: .. 4/ 2VG6 - GE+E!iAI.AGGRtnA'f%t �cy€yctt PRODUCM'•Cmww AO-,- S-�=—=- 7 POLICYPRQ. Lam.' .. . AUTOMOBILE LIABILITY ... .. COMBINED SINOI.EUMIT I'. IEP MXIdirVl .. ANY AUTO .�_ .. ALL OWNED AUTOS BODILY INAIRY S SCHEDULED AUTOS �(PV DG" HIRED AUTOS BODILY XJUURY NON-OWNEOAUTOS !Pr><eleeRB .. - (Pw )oALBAOF S GARAOELIABLITY 'AIlTD ONLY•EA ItCGDENT _ i' ANY AUTO OTHERTHAN EAACC S _ AUTOQNLYi Ado I S EXCESSNMBRELLA UABP.ITV EACHOCCURPGHCE Is , CCCUW ... CLAIMS WADE' - AGGREGATE A OEDU TI;ff _ RETENTION S - t WORXERECOMPENSATONAND - ARY�tX`%� -ER- EMPLOYERS•LIABIUTY E.L. EACHaCCIDEM I ANY PROPRN?ONPARTNERiEXECUTIYE _- OFFICEPIMEMBEP 4XCLUOED? E.L. DISEAST EA EMPI,OYGE i 11 yyeeee wacrtbo BN SPECVK PROVISIONSVNar< G.I. DISEASE •POLICY LMIT i OTHER DESCRIPTION OF OPERATIONS ILOCATIONS t VEHICLESIEYCWSIONS ADDED BY ENDORSEMENTISPECIAL PROVISORS' ['� Qte��i�Al H=e51�T1m' ... C/Q 13p7' }� tbu GNOULO ANY OF THE ABOVEDESCWDBE'OLICIESS BE CANCELLED DEFORE.THE 2XPISATIOR OATE THEREOF: THE D1NR ER L ENONAVOR TO MAIL DAYS WRITTEN NOTKB TaTNE CrRVHCATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO OO SO SHALL ... Rte .29- ... Gmtmville, MA C2632 EAX: ...5 -MB-M-5 WPOSE A10-08LIGAZON-09 LABILITY. OF. ANY .IOND UPON THE INSORM rtYAGENTS-OR-- REM9FZEQ . REPRESENTATIVE AUTRO EPRESENTATWE AL:VIiLAj>(ZUVT/Uw, . Q wn. w CERTIFICATE OF INSURANCE SSUE 05/06ATE(MM/DD/YY) 7 005 PRODUCER Harold H Williams Ins Agcy Inc 81 Bassett Lane Hyannis, MA 02601 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY A.I.M. Mutual Insurance Co LETTER A INSURED Stephen M Childs 145 Cammett Road Marstons Mills, MA 02648 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 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/YY) POLICY EXPMATIO DATE(MM/DD/YY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY LAIMS MADE[�CCUR OWNER'S& CONTRACTOR'S PROT. - GENERAL AGGREGATE t ' PRODUCTS-COMP/OPAGG. $ PERSONAL&ADV. INJURY $ EACH OCCURRENCE S FIRE DAMAGE (Any one Brc) $ - MED. EXPENSE (Any ore person) S AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY COMBINED SINGLE LIMIT S BODILY INJURY (Per pe n) S BODILY INJURY Per atzitknU S PROPERTY DAMAGE t AHEPROPRIETOR/ (EXCESS LIABILITY 1 MBRELLA FORM THEIR THAN UMBRELLA FORM M'ORKER'S COMPENSATION AND MPLOYERS•LIABILITY INCL ARTNERS/EXECUTIVE FFICERS ARE: X EXCL 7015793012004 12/13/2004 12/13/2005 EACHOCCURRENCE S AGGREGATE t A U u H IMITS ACH ACCIDENT S 100,000 ISEASE—POLICY LIMIT r t 500000 ISEASE—EACFI EMPLOYEE S 100,000 OTHER DPSCRIPriON OF 01'1-,RAT'IONS/LOCATIONS/VEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION - Gatewood HorneS _ Bell Tower Mall Rte 8 Centerville, MA 02632 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 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 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE DATE (MM)DNY) AWED-. CERTIFICATE OF LIABILITY INSURANCE 10/28/2004 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRGrxICT� Serial # A1530 ONLY AND CONFERS NO RIGHTS UPON. THE CERTIFICATE CERTIFICATE DOES NOT AMEND, EXTEND OR ROBERT P. BIXBY, CPCU P.O. BOX 830 -651 PUTNAM PIKE HOLDER. THIS ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. GREENVILLE, RI 02828 INSURERS AFFORDING COVERAGE NAIL# ws pxR K. NAIL FIRE INSURANCE CO. OF HARTFORD INSURED INSURER B: VALLEY FORGE INSURANCE CO. HOLMES AND MCGRATH, INC. CONTINENTAL CASUALTY CO. 362 GIFFORD STREET INSURER c: FALMOUTH, MA 92540 wsuRET: o: INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAR) CLAMS. - . POLK:Y EPFECTNE EXPIRATION LIMBS Wool TYPE INSURANCE CNUMBER EACH OCCURRENCE $ 1,000 000 GENERAL LIABILITY AMAG TO ENTED $ TIRE 2SO,000 9 _ J( COMMERCIAL GENERAL LIABILITY- 1074082434 10/06/04 10/06/05 MED EXP one f 10 000 A CIJdMS MADE 0 DCGIR - PERSONAL 5 ADV INJURY f 1,000,000 GENERAL AGGREGATE S 2,000,000 PRODUCTS-COMPIOPAGO E 2 000 000 GENL AGGREGATE UMIT APPLIES PER: PRO- POLICYF-I LOC COMBINED SINGLE LIMIT (Ea acddenq f . AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) f SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per accident) f NON -OWNED AUTOSW.PERTY . GE E GARAGE LIABILITY AUTO ONLY ACCIDENT S MER THAN EA ACC f S ANY AUTO AUTO ONLY:. AGG EXCESSNMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE f AGGREGATE E $ E DEDUCTIBLE _ f RETENTION S WORKER'S COMPENSATION AND EMPLOYERS! LIABILITY 2057445273 09/01/04 09/01/05 X WC STATU- TH• EL EACH ACCIDENT f 1 OOO OOO ELDISEASE-EA EMPLOYEE E 1,000,000 B ANY PROP RIETORIPARTNERIE)TCURYE EL DISEASE. POLICYUMIT $1000000 1,000,000 $AGGREGATER CLAIM/ OFFlCERIMEMBEREXCLUDED? M yes escribe nder d SPECIAL PRO SIONS below OTHER PROFESSIONAL LIABILITY AEA 00 43133 38 07/13/04 07/13/OS C DESCRIPTION OF OPMATION-�vLOCATIONSNEHKXES)EXCLUSIONS ADDED BY ENDORSEMENTMIECIAL PROVISIONS AGGREGATE LIMITS ARE PER THE TERMS AND CONDITIONS OF THE POLICIES_ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES Be CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN GATEWOOD HOMES, INC. _ NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL 1600 FALMOUTH RD., STE. 25 IMPOSE No O&1GATION OR UABLaY OF ANY KIND UPON THE INSURER ITS AGENTS OR CENTERVILLE, MA 02632 REPREsEWATIVES. AUT I� AcoRD CORPORATION 1988 ACORD 25 (2001/08) C:WFWROWCERTPROS.FPS DATE IMNIDDIYYYY) AC CERTIFICAT.E.OF LIABILITY INSURANCE 514/05 .. I MS CERiI RCATE IS ISSIED AS A M ATTER OF INFIORM ATION PRODUCER ONLYArID COMERSD1O18GfiTS UPONTMECERfFlCA United InsLT;anes Ageney4 Inc. HMML-TMIS£E2TIRCATEDOE"OF AMEM E%TEWOR- 19%. Main Street ALTBRTHECOVEiiAGEAFT•URDMBYTHEPOLICIMMOW. P'.O. Box 1013 Buzzards RaZ, MA 02532 INSURERS AFFORDING COVERAGE NAICit INSURER A. Zurich NA INBURED Patton zloctric, Inc. NEURERB!Libor Mutual Tns. Co. 128 Scituate Road - INSURER C. _ Maahpee, mA 02649 NSURERD: NSURER E: COVERAGES BELOW _ BEEN tSSUW NSURED NAMED ABOVE FOR THEPOUCY CER7IFICATEAMY �E ISSUED OR DING TETHER O THE, FDOCUMENT CONTRACT OR WITHRESPECTTO WHIC"_THiB POLICIES. DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 61DCLUSIONS AND CONDITIONS OF SUCH ANY ROLICIREMENT. URA OR CONDITION OF ANY MAY- PERTAINJHE INTERMSURANCE AFFORDED BY THE SHOWN MAY HAVE BEEN REDUCED BY PAID POLICIES. AGGREGATE LIMITS 40UOYISASL OM - LIMKI-- D' - - P)LICYNUMBER _ EACH OCCURRENCE s _1.000,00.D— OL-7NERAL:LABIIJTI SCP42415399 T/30/04 7/30�Of FREMISEs • .. S 30a "0- tDMiaERcIALOENERULIAeem MEDEIIPI ene s 10T000 CLAMS MADE ®OCCUR . . PERSONALAADVWJURY f 1.,-000r-Ann GEMERALAOGREGATE s 2,000,000 7RDDUC rS • CDMPW A= s GENT. AGOR MATS UMR APPLES PER: PRO• ]( POUCY JECY COMBINED SNOLE UMR f . AUTOMOBILELLAEILITY lF�eetlAMIB ANY AUTO BODLLVNAiRr f " ALL OVWWAUTOS ... 7Per P_"rs SC+IEDLBEQAUTOS.... - (PT:m�MRr NIREDAUTOS - NON-OYMEOAUTOS. PROPERTYDAMAOE f IPr eccwwh AUTOONLY-EA ACCIDENT S GARAGEUABLLITY .... OTHER TRAM EAACC S ANYAUTO AUTOIQ AGO s EACH OCCURRENCE f CICESSNMBRELLALUIBRJTY AGGREGATE s OCCUR CtAIMSMADE S DEDUCTIBLE RETENTION f WGmC WS COMPENfATRDN AND .. 12 1D 8 EMLOYERS'LUIMUTY WC23i3-353O4A414.... ,� l-Da ..12/.lalCs EAsac+iAccwEHT-... ANY PROPR IEToRIPMTNERIE%ECUTNE £l.OIGEAIE. EA EMPLOY 0FFICERlMEMBER E%CLU DEOT ELDISFAEE- POULYUM SPEOAL PROVISION SOebw X . 01MER D86C4RrpMNOPoMRATAMSILACA7DN5/VEMC3SSI CL NB ADDEDEVENMOR8EME8TISPFCM4PROVISlONS Electrical Gateway Homes, Inc. i500 Fa7,aouth Rd., unit 25 fax 5o8-778-5603 Coatprvii.l.e, Ma 02632 r1j SHOULD ANY OF THE ABOVE DESCRIBED POUCESBE CANCELLED BEPORETHZ ZVOIAT10N PATETMEREOF.TMENuINGWSURER WILL ENDEAVORTOMNL _Qr DAnwRITUX NOTLCETO THE CERTB•CATE MOLDER HAMM TO THE LEFT. BUT FALLURETDD08a9NAM IMPOSENOOSUCUITIDM 0 R IIABILIiYOVMYKMBUPDNT"E1N?UBPJI.RSAMFHT80R REPRSSENTATIVE& ` AC`ORD .R CERTIFICATE OF m LIABILITY INSURANCE DATE (MMIDDIYY)_.. 9 1s/o4 x PRODUCER _ Chatfield, Whitman & Young g 549 Washington Street 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 P.O. Box 850963 COMPANY _A Harleysville Worcester'Ins Co Braintree, MA 02185-096 'INSURED - p Lawrence Robinson Masonry COMPANY - B 5 Fresh Hole Road Hyannis, MA 02601 COMPANY C COMPANY D COVERAGES THIS IS TO CERTIFY THAT THE POLICIESOF 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 EFFECTNE DATE (MMIDDIYY) POLICY EXPIRATION DATE (MM/DDIYY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR OWNER'S& CONTRACTOR'S PROT CB 7E 32 32 9/07/04 9/07/05 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 PERSONAL & ADV INJURY $ 1,000,000 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) S 100,000 MED EXP (Any one person) $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMB $ , ANY AUTO ALL OWNED AUTOS BODILY INJURY (Perperson) $ SCHEDULED AUTOS HIREDAUTOS 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 $ UMBRELLAFORM - OTH_ TORY L MRS ER $ ' OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EL EACH ACCIDENT $ EMPLOYERS' LIABILITY EL DISEASE - POLICY LIMIT $ THE PROPRIETOR/ INCL PARTNERS/EXECUTIOE OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE E OTHER DESCRIPTION OF OPERAMONSILOCATIONSIVEHICLESISPECIAL ITEMS - CERTIFICATE HOLDER -''° " " CANCELLATION" SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Gatewood Homes EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 1600 Falmouth Road 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Suite 25 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILI Centerville, MA 02632 OF ANY KIND UPON THE COMPANY E SENTA S. AUTHORIZED REPRESENTATIVE Robert E. Chatfield 3,rOAC TION°1988' �m �. "ORD CORPORA ACORD. CERTIFICATE OF LIABILITY INSURANCE. Ro 009-27 2004 PRODVCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PAYCHEX AGENCY INC. 210706 P: (877)287-1312 F: (877)287-1315 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE 308 FARMINGTON AVE FARMINGTON CT 06032 WSURED - INSURERA:TWln City Fire Ins Co INSURER B: INSURER C: LAWRENCE ROBINSON MASONRY INC INSURER D: 5 FRESH HOLE ROAD INSURERE: HYANNIS MA 02601 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. WSR TR TYPE OF INSURANCE PoLlCY NUMBER POLICY EFFECTIVE MM D Y POLICY EXPMAT/ON DATE MM D 1 � GENERAL LIABRJTY COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR . EACH OCCURRENCE e FIRE DAMAGE (Any one fire) II MED EXP (Any one person) 11 PERSONAL& ADV INJURY 8 GENERAL AGGREGATE $ GEN'L AGGREGATE UMIT APPLIES PER: POLICY PRO- LOC PRODUCTS - COMPIOP AGG 8 AUTOMOBRELIAB2RY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS - NON -OWNED AUTOS -.' -- - _ -'BODILY -, COMBINED SINGLE OMIT (Ea accident) - BODILY INJURY' (Per person) ! - - - INJURY (Par accident) ',. _ PROPERTY DAMAGE Per accident) $ GARAGELLABBLTY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ EXCESS LL4B1Lf Y OCCUR E]CLAIMS MADE DEDUCTIBLE RETENTION II EACH OCCURRENCE e AGGREGATE a a 8 A WORKERSCOMPENSATIONAND EMPLOYERS'LIABRITY 76 WEG NQ5620 09/06/04 09/06/05 ATUTORY - OTH- X WC STLI ER E.LEACH ACCIDENT *100 000 E.L. DISEASE - EA EMPLOYEE $100, 000 E.L DISEASE -POLICY LIMIT $500000 07NER DESCRM77ON OF OPERA 71OA=OCA770NSNEMCYE&fXCLUSIONS ADDED 8YEN0ORSEMEM/SPECIAL PROVISIONS Those usual to the Insured's Operations. CERTIFICATE HOLDER I I ADDITIONAL INSURED hVStWRLET7ERr CANCELLATION 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 00 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 ALffffaFWDREPRESENTA Ise ACORD 25-S (7/97) ACORD CORPORATION 1988 12/02/04 13:36 FAX 5087900249. GOLDMAN ASSOC Q 02 .JAgom CERTIFICATE OF LIAWLIT f-miSttttAl E TAVVArNSO 1 12 02 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MAI I ER OF INFORMATION GOLDMAN & ASSOCIATBS INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE gINANC3AL S$3tVICE3 INC. HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 933 FAL>!SOUTH RD• ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 31YANNIS MA 02601 Phonr1568-775-6010 Faxs508-790-0249 INSURERS AFFORDING COVERAGE NAlC13 U�D RERA MARYLAND CASUALTY COMPANY RER B:RODNIff EINSURERC: TAVANO DBA MECHANICAL SYSTEMS110 E(OLDER LANE W BASNSTABLE MA 02668 RER D: INsi1RERE COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN MWED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY RGDUIRGLiNT, TSRM OR CONDITION OF ANY CONTRACT OR OTNGR DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INS;INANCE AFFORDED BY THE POLICIE$ DESCRIMI) HEREIN I$ SVBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_ AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAn CLAIMS - LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMID _ DA E MMID _ LIMIT; EACH OCCURRENCE ._ S 1000000 A GENERAL LUaE1TY g CoMMEIICIALGENE7ALLIABUTY CLrJMSMADE ❑ � 000372088 11/21/04 11/21/05 FREMISEs(Esomaean) 100 s 30() MmI"(Arymepom ) I s 10000 PERSONAL t ADV RAW S1000000 GENERAL AGGREGATE S 2000000 PRODUCTS -COMPAP AGO S 2000000 GEITL AGGRL.CATE LIMIT APPLIES PER: POLICY ! PE�CT LOC .. AUTOMOBRL: LIABILITY COMBINED SINGLE LIMIT s ANY AUTO ALL OWHED AUTOS BODILY INJURY (Per PMW) s SC EDULEDAUTOS HIRED AUTOS _ BODILY "JURY (Per aecmmo S NON-0N'NED AUTOS PROPERTY DAMAGE (Mramdenq s AUTO ONLY -EAACCIDENT S— - flARAflE LIAI)1LTIY ANY AUTO onMERTHAN IU ACC AUTO ONLY: AGO S S EACH OCCURRENCE S EXCESSRI BRELLALLASILR7 OCCUR CLANS MADE AGGREGATEs s - -- S DEDUCTIBLE S .� ,-jIMOR1�Rs CpeJAENSATION AND EIIPLBYERS' Wg( fly _ TORY LIMBS ER E.L EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE S ANY PROPRIETORWARTNEWEXECUTIVE OFFICERIMEMSER UICLUDED? W40* SPECIAL PROVISJ0,13 aebr Ma El DISEASE - POLICY LIMIT S OTNEA DESCRIATIOXri OPSRATY:fIS/l!RA7�0.7IVEX.'CLES/E."L ��r�tMl9tlt71CalY- - P AMf•CI I ATH1N E OII' HONRs INL- " FA8 508-778-5603 1600 FALMOUTH ROAD SUITE 25 . CMMIRVnME MA 02632 25 SHOULD ANY OFTHE ABOVE DE3CF "POLICIES BE CMNCO.LEDBEFORETHEETIPIRATIOI DATE THEREOF. THE ISSUNG INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN F NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION ORLLWJ f OF ANY I0NO UPON THE INSURER ITS AGENTS OR RlgyT 1.D GA naI Lr VIU O/7/4VVO 1Vi J.7 YAUE VVY/VVY PG.A ocryur S DATEiMMsODIYYi 05-06-05 PRODUCER GOLDMAN a ASSOC INS.FIN 933 FALMOUTH RD RTE 28, THIS CERTIFICATE IS ISSLIED AS A MATTER OF INFORMATtON_- MY -AND- T) CONFERS- NO - RW41TS UPON • THE- CERR)CATE- .HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR AL7rER-THECOV€RAGEAEFORDFAELXTHEQOLEgiRF:10W ...- HYANNIS MA 026012319 COMPANIES AFFORDING COVERAGE COMPANY 28HPP __] '.A-AMERICAR2VRICH' rNSURANCE'COMPANT INSURED COMPANY - TAVANO, RODNEY DBA g.... MECHANICAL SYSTEMS 201 CAPES TRAIL COMPANY AEsr'BaRNsrABLE MA 02668 C-. COMPANY D. CQVE{T;AGES G ?s a y r '' t .u•:„.— r THIS IT TO' CERTIFY THAT THE POLICIES OF INSURANCE LISTED BE _Low HAVE BEEN ISSUED TO THE INSURED NAMED ABOVETORTHE-POLICY-PERIOD-' INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ' CERTIFICATE -MAY BE ISSUER OR -MAY PERTAIN, TH JNSURANCE.AFFORDED_ BY_THE_ POLICIES RESCRJBED HEREIN 13 SUBJECT TO -ALL -THE TERMS EXCNISK NS ANO CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - - 70 - TIIPEOF INSURANCE _ POLICY POLICY EFFECTIVE DAiETMMtDDFY'f)'--.DAM POLICY EXPIRATION jIAlIMYYi-'- _ .UNITS GENERAL UABIUTY - GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PRODUCTS-COMP/OP AGG. S .... PERSONAL & ADV. INJURY S EACH OCCURRENCE" ' . - . S OWNE RS A CONTRACTORS PROT. FIRE DAMAGE (Any oie fire) $ MEO. EXPENSE(Anr o e person) S - AUTOMOBILE LIABILITY - _ � - - - _ ATFAUTO - - COMBINED SINGLE UMfi-... . $_ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS- - - (Rer Persln). $. HIRED AUTOS - BODILY INJURY (Per Ac¢danl) _ . . $ N6N-OWNEDAUTOS_. - - PROPERTY DAMAGE S GAMGE}IABILTTY .. ... AUTO ONLY - EA ACCIO ENT S. . ANY AUTO. - - OTHER THAN AUTO ONLY: EACH ACCIDENT $ - .. AOGREGATE $ EXCESS UABILTTY - - - - EACH OCCURRENCE $ UMBRELLA FORM _ AGGREGATE $ OTHER THAN UMBRELLA FORM - A WORKERS COMPENSATION AND EMPLOYERS -LIABILITY - (UB-7278A84-9-05) - _ 05-03-05 05-03-06 - STATUTORY LIMITS EACHACCIOENT S 10D 000 THEP-ROPRIETORI. .. PARTNERSlEXECUTIVE INCL OFFICERS ARE- � X EXCL - OlHER_" . _ - DISEASE-POLICYLMTT S 500 000 DSEASE-EAEFFEMPLOISE - - - 1Q0, OAO DESCRIPTION OF OPERATIONS/LOrATIONSlVEKCLESrRE$TRICIION57SPECUL ITEMS - - THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. RTIFIOATE QkDER CANGEEEe6TtON _ }.. . ay..v.wv r ev..an .> w v..>i..n :..: >.,v::.>c xro. ,�>....>. ,.e> .w:r., _ >. ...x •v av-v...... ..¢>h. ea�K ,+»nen rvrsv.v ,'�,q>n...: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE } - . EXPIRATION DATE THEREOF, THE ISSUING - COMPANY WILL ENDEAVOR TO MAIL GATEWOOD HOMES INC 1600 FALMOUTH RD SUITE 25 '10 -DAYS' " WRrtTEN N0TTCETo1HECERRFlCICTE-motrERNAMEDTo TMC -LEFT,_BUT. FALLURE_TQ MAIL SUCH_NDTICE..SHALL IMPOSE NO. 0-BLLGATLON OR CENTERVILLE MA 02632 LIABILITY OF ANY KIND UPON TH(E{COMPANY, ITS AGENTS OR REPRESENTItnym AUTHORIZED REPRESENTATIVE �`JI,E TOWN OF YARMOUTH Building Department _ Town Hall e Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-615 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Unit 133 Owner's Name: Villages @ Camp St., 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.: 943. Net Owed: ($50.00) Application Date: 5/12/2005 Issue Date: Expiration Date Comments: Map/Lot: 044.21.1.0 new construction: [2[E@T0WIE10 HEALTH DE REVIEWED BY: 1. WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT: ZL CV DATE: 6, i3 Dye 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: 5/24/2005 r TOWN OF YARMOUTH WATER DEPARTMENT 99 Buck Island Road West Yarmouth, MA 02673 Telephone: (508) 771-7921 • Fax: (508) 771-7998 Date of Issue : May 31, 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., #133 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 the provisions/restrictions of this Letter of Water Availability. Owner (Sign) Reference : Villages @ Camp St., LLC : 1600 Falmouth Rd., #25 : Centerville, MA 02632 Yarmouth Water Department ut1TOWN OF YARMOUTH Building Department.Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-615 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Unit 133 Owner's Name: Villages 0 Camp St., LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02632 i Owner's Telephone: (508) 778-9669 (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 943 Net Owed: ($50.00) Application Date: 5/12/2005 Issue Date: Expiration Date Comments: Map/Lot: 044.21.1.0 new construction: REVIEWED BY: . 1. IIVATER DEPARTMENT. `"---- 2. ENGINEERING DEPARTMENT: 3. CONSERVATION: 4. HEALTH DEPARTMENT: 5. BUILDING DEPARTMENT: 6. FIRE DEPARTMENT: PLEASE NOTE COMMENTS: DATE: DATE: DATE' DATE: DATE: DATE: N/A: N/A: N/A: N/A: N/A: N/A: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: Date Printed: 5/24/2005 MAscheck.COMPLIANCE REPORT Massachusetts Energy Code MAscheck software Version 2.01 Release 2 CITY: Yarmouth STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 4-21-2004 DATE OF PLANS: 04/21/04 TITLE: The Egret PROJECT INFORMATION: Mill Pond village 121 Camp Street — 00 /x 3 � Yarmouth, MA 02673 COMPANY INFORMATION: Northside Design Assoc. 141 Main Street Yarmouth Port, MA. 02675 COMPLIANCE: PASSES Required UA = 216 Your Home = 123'- I I I I I Permit # I I I I I Checked by/Date I I Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ----------------------------------------------- CEILINGS 832 30.0 30.0 14 62 WALLS: wood Frame, 16" D.C. 1409 15.0 15.0 0.340 30 GLAZING: windows or Doors 87 40 0.340 14 GLAZING: windows or Doors 40 0.086 3 DOORS ----------------------------------------------------------------------------- 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 Massachusetts Energy code MAscheck software version 2.01 Release 2 The Egret DATE: 4-21-2004 Bldg.l Dept.l use I I I C7 I C 7 II C] C7 CEILINGS: 1. R-30 + R-30 Comments/Locati WALLS: 1. wood Frame, 16" Comments/Locati O.C., R-15 + R-15 WINDOWS AND GLASS DOORS: 1. U-value: 0.34 For windows without labeled u-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] NO Comments/Locatio 2. u-value: 0.34 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? C J Yes [ ] No Comments/Locatio DOORS: 1. u-value: 0.086 Comments/Locati AIR LEAKAGE: joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. when installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type Ic rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type Ic rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors.. MATERIALS IDENTIFICATION: Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. insulation R-values and glazing u-values must be clearly marked on the building plans or specifications. I, DUCT INSULATION: [ ] I Ducts shall be insulated per Table 74.4.7.1. I 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. I 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 34.4. I I SWIMMING POOLS: [ ] 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. 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.) 1 I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" 1.0 1.1.5 2. Low pressure/temp. 201-250 Low temperature 120-200 0.5 1.00 1.0 1.55 I steam condensate any 1.0 1.0 1.5 2.0 COOLING SYSTEMS: Chilled water or below40...51. -5540 05 05 05 0 I refrigerant CIRCULATING HOT WATER SYSTEMS: [ ] I Insulate circulating hot water pipes to the following levels (in.): i PIPE SIZES (in.) NON -CIRCULATING I CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F): RUNOOUSS 0-1" i 0-1.0 " 1.1.5.0„ 2.0+" I 170-180 I 0.5 1.0 1.5 0.5 I 140-160 0.5 1.5 1.0 I 100-130 0.5 I ----NOTES TO FIELD (Building Department Use Only)--------------------- C-' M rJ-1- OGO-3 11 GMS 9/GCS 9 SERIES 93% AFUE Multi -Position, Single-Stage/Multi-Speed Gas Furnace Heating Capacity: 46,000-115,000 BTUH UWE_f PARTS UMiTED r WA RRF NTY: �� Y r.uq n Gama InkPAAW amm Standard Features • Corrosion -resistant, aluminized -steel tubular heat exchanger and stainless -steel recuperative coil 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 -steel inshot burners • Energy -saving PSC, multi -speed, direct drive blower motor • Quiet, corrosion -resistant induced draft 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 flue/vent located on right side • Completely assembled, factory 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 (I -pipe) applications Air Conditioning & Heating The GMS9/GCS9 single -stage, multi -speed gas furnaces offer installation versatility. Cabinet Construction • 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 (GMS9) Accessories • L.P. Conversion Kit (LPTOOA) • L.P. Gas Low Pressure Kit (LPLPOI) • High Altitude Natural Gas/L.P. Kits (HANG11, HANG12, HALP10) • High Altitude Pressure Switch Kit (HAPS27) • External Filter Rack (EFR01) • Horizontal Concentric Vent Kit (HCVK) • Vertical Concentric Vent Kit (VCVK) • Intemal Filter Retention Kit—upflow, (RF000180) • Intemal Filter Retentio Kit—downflow (RF000181) • Thermostats Blower Motors (CHT18-60, CH70TG, CHSATG, H20TWR) SS•377D w-goodmanmfgxom 6/04 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No.E-0110 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 111991 Leave blank , r —APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK �All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 "' (PI EA SE PRINT IN INK OR TYPE A LL INFORMA TION) Date: 08/26/2005 0 "' City or Town of: YARMOUTH,, MA To the Inspector of Wires: cByl this application the undersigned gives notice of his or her intention to perform the electrical work described below. CL LoIcation (Street & Number) 121 CAMP ST., UNIT 133 LLJ �Oi ner or Tenant GATEWOOD HOMES, INC. Telephone No. 508 778 9669 _ cbOwner's Address 1600 Falmouth Road #25 Centerville MA 02632 ^his permit in conjunction with a building permit? Yes X No ❑ (Check Appropriate Boa) Purpose of Building RESIDENTIAL Utility Authorization No. 1469881 Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service 100 Amps 120/240 Volts Overhead ❑ Undgrd X No. of Meters l 03 Number of Feeders and Ampacity 2/100 1, Location and Nature of Proposed Electrical Work: WIRE HOUSE Completion of the following table may be waived by the Inspector of Wires J No. of Recessed Fixtures No. of Cl Susp. (Paddle) Fans ° ° Total Transformers KVA No. of Lighting E ts 8 No. of Hot Tubs Generators KVA Above - o. o me en l , No. of Lighting res 8Swimming Pool and ❑ md. ❑ Batte Umrtgs ig ing . No. of Receptacle Outlets 30 No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches 10 No. of Gas Burners Au. of Detection and Initiatine Devices No. of Ranges 1 No. of Air Cond. Toonsl No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons KW o. o el - ontained Totals: """"' 6 --�� Detection/Alertin Devices lC�jl No. of Dishwashers 1 Space/Area Heating KW kcal umcipal ❑Connection ❑Other No. of Dryers I Heating Appliances KW Security Systems: o. o Water No. o No of Devices or E uivalent Heaters l' 4.5 No. o Data Wiring: Signs Ballasts No. of Devices or Equivalent V No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications W1 . �4 OTHER: No of Devices or E uivalent Attach additional detail if desireLt or as required by the Inspector of Wires. Ol INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless Q� the licensee provides proof of liability insurance including "completed operation' coverage or its substantial equivalent. The t 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/ce/2005 Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) - Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. L- j I certify, under the pains and penalties of perjury, that the inforntation on this application is true and complete; FIRM NAME: PATTON ELECTRIC, INC. LIC. NO.: A 15542 Licensee: RIC LARD PATTON Signature LIC. NO.: • (If applicable, enter "exempt" in the license number line.) Address: PO BOX 1525 MASHPEE MA 02649 Bus. Tel. No.L508-5310200 OWNER'S INSURANCE WAIVER; 'am aware that the Licensee does not have the liability insurance coverage normally Owner/Agent required law. By my signature below, I hereby waive this requirement. I a i the (check one) Elowner ❑ owner's a ent. Signature Telephone No. PERMIT FEE.• $125.00 • • Commonwealth of Massachusetts Department of Fire Services OF FIRE PREVENTION REGU A71ONS Official Use Only Permit No. b Ocatpancy and Fee Checked q 0 • 111991(leave blank Q�. APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK wmkto be perfo=ed in accordance with the Masu busen E lariat Code (MEC), 527 C R 12.00 2E, RINTWINKORTTPEALLINFORMATI010 Date: �� Z-)) o S City or Town of: YARMOtTl7i To the Inspector of Wires:. pplication the undersigned gives notice of his or her mention to perform. the electrical work described below. Location (Street & Number) MILL POND VILLAGE, 121 CmT St Bldg # 133 Owner or Tenant Gatewood Homes/ Jeff Sollows Telephone No.508-7789669 Owner's Address 1600 Falimuth Rd., Suite 25, Centerville, Ma. 02632 Is this permit in conjunction with a building permit3 Yes El No ❑ (Check Appropriate Box) Purpose of Building single family residence Utility Authorisation No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ Na of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ Na of Meters Number of Feeders and Ampacity Location and Nature of Proposed EIectrical Work Fire Alarm System (low voltage control panel) with back_ilp•batterv, centrally monitored. Camnlehmt ofdw faflawint, mble may he i«i;vdi AV the rk"Pp ,.. Na of Recessed Fixtures No. of CeM-Susp. (Paddle) Fans ° Total Transformers Tormers KVA Na of Lighting Outlets No. of Hot Tubs Generators XVA No. of Lighting Fixtures Swimming Pool Ermd Above. d UEency g Batte Units Na of Receptacle Outlets No. of 02 Burners FIRE. ALA WMM No. of Zones —1— Na of Switches Na of Gas Burners' o. of Detection.and7 Initiatin Devices Na of Ranges Tal Na of Air Cond. Tuns No. of Alerting Devices No. of Waste Disposers t p Totals: [Number ons I o. o Detection/Alerting Devices 7 No. of Dishwashers SpacelArea. Heating FW Local 0 unicsp ® Other Connection .., No. of Dryers .. Heating Appliances ' KVir •o. ecunty ystems: No. of Devices brEquivalent No. of Water F'W Heaters o o. 01 Si Ballets Data Wiring: No. of Devices or uivaleut No. Hydromassage Bathtubs No. of Motors Total HP eco . ofDevahans rrrag: No. of Devices or ivalent OTBFIL: • A=C" aaarU== aarmr (faettrat. or at requrrad by tpeLupator ofWira. INSURANCE COVERAGE: Unless waived by the owner, no permit for the perform== 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 to the permit issuing office. )C11EOC ores: INSURANCE M BOND 0 OTEM 0 (Specify > cpuation Estimated value of Mearicall Work $750.00 (When required by ummicipai policy.) Work to Start Inspections to be requested in accordance with IviEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the inforn a ion on this application is rice and complete FIRM NAME: Baltic Security, Inc LIC. NO • 1178C Licensee: Jonas R Bielkevicius Signature 5:Z LIC. NO.• 499D (Ifappliarbk,caer exempt "in the Geensearart(ie.Wre 02563 Bu&Tel. No.• 508-833-0996 Address:__ p 'Box .1609 Sandw c , Alt. Tel No.; 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 am the (check one) 0 owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 40.00. 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 OF YA MOUTH By Fee: $ c P-A--T--I-O-N-,) PERMIT NO. (PLEASE PRINT IN INK ORiEAALLJNF6 Date: C To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to work described below. / t r,1 Location (Street & q Owner or Tenant Owner's Address Is this permit in conjuj Purpose of Building_ with a building permit? Q Yes (Check Appr Existing Service_ Amps •/ Volts New Service (00 Number of Feeders and Location and Nature of Proposed electrical Work: Utility Authorization a rform the electrical No. Box) L 46 Q W ( 60-74-0C No. of Meters Undgrd 9--� No. of Meters AnNo. of Recessed Fixtures �.•..,. No. of Ceil.-Susp.(Paddle)Transformers v ,nc mwwu, mutt rem vc wwvea ale Inspector o Wired o, o ota KVA 0 of Lighting Outlets No. of Hot Tubs Generators KVA No. of Li htin Fixtures Aboven- Swimmin Pool md. Q md. ❑ o. o mergency ig ung Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners an o. o URInitiating Deian ic No. of Ranges No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat mp Number Totals: Tons — — No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ MuniConnectiocipaln Q Other No. of Dryers Heating Appliances KW SecurtyoS Nof Dmcse:s. or Equipvalent No. of Water Heaters KW No. of No. of Signs Ballasts Data wirm No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications of Devices o Wiuiva No. of Devices or Equivalent miacn aaarnonat aerart if aesirea, or as requirea 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 a permit issuing office. CHECK ONE: INSURANCE BONDO OTHERQ (Specify: Estimated Value of ` Work to Start: t C I certify, unde�the MUM NA11?F• � LiFee: (If applicable, p "ex�lic se nu Address• 1 OWNER'S INSURANCE WAIVER: I am aware that below, I hereby waive this requirement. I am the (ct Owner/Agent Signature (Expiration Date) (When required by municipal policy) Meucsted in cordance with MEC Rule 10, and upon completion. orm on on this application is true and complete. LIC. NO. _Signature LIC. NO. ,er li .) Bus. Tel. No.: Alt. Tel: No.: SCES License does not have the liability insurance coverage normally requited by law. By my signature one) o er ❑ owner's agent. (] Telephone No. Page 1 of 1 Cipro, Linda From: Raiskio, Peter Sent: Monday, March 13, 2006 5:14 PM To: Cipro, Linda Subject: RE: final for occupancy inspections @ 121 Camp St - Units 9, 10 & 133 Linda The crew went over to do this inspection. Units 9 & 10 did not pas, no power to the detectors. Unit 133 passed. Peter -----Original Message ----- From: Cipro, Linda Sent: Monday, March 13, 2006 10:08 AM To: Kelleher, Robert; Raiskio, Peter; Sherman, C Randall Subject: final for occupancy inspections @ 121 Camp St - Units 9, 10 & 133 The Building Department is scheduled to conduct a final for occupancy inspection @ 121 Camp Street Units 9, 10 & 133 today 3/13/06 in the afternoon and would like for you to attend. Thanks - Linda Linda Cipro Building Department Administrative Assistmit 3/14/2006 SCHOOL KIOSK „o • � S 3 , s9�• Ss' l . 40, EXISTING 46• 9S•' LOT 133 1W7, 40 "t � APgY FOUNDATION O ?. p. N 2 EXISTING /tyro// e95, FOUNDATION 79 p• I CERTIFY THAT THE FOUNDATION IS LOCATED IN FLOOD PLAIN ZONE C AS SHOWN ON FLOOD.INSURANCE RATE MAP COMMUNITY PANEL NO. 250015 0005D AND THAT FLOOD PLAIN ZONE C IS NOT A SPECIAL FLOOD HAZARD A ,�� v/�A�TE REGISTERED iSROFErSIONAL 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 (8) this plan remains the property of Holmes & McGrath. Inc. LOT 134hi/j v H E E D \36• / h� AUG. U 1 2005 BUILDING DEPT. 11 I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE LOT AS SHOWN, AND THAT ITS LOCATION CONFORMS TO THE MINIMUM SETBACK REQUIREMENTS OF THE8 S�C14 PERMIT. / DATE REGISTERED PROF SSIONAL LAND SURVEYOR GRAPHIC SCALE ( IN FEET ) 1 inch = 20 ft .• AS —BUILT PLAN holmes and mcgrath, inc. `Z" OF /Fq OF LOT 133 PREPARED FOR .civil engineers and land surveyors �� o� MICHAEL �y MILL POND VILLAGE 362 gifford street s McGRATH ti IN falmouth, ma. 02540 9 ' No.28M e . YARMOUTH, MA JOB NO: 201197 DRAWN: LMC E SCALE: 1 "=20' DATE: 7-29-05 DWG. NO.: A2519A CHECKE CGS Temp Permit No.: Applicant Name: Applicant Phone: Building Location: TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BUILDING PERMIT TRANSMITTAL T-05-615 Frank Capra 5087789669 00121 CAMP ST Unit 133 Owner's Name: Villages @ Camp St., LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 ' REVIEWED BY: ✓1. WATER DEPARTMENT: 2. ENGINEERING DEPARTMENT: 3. CONSERVATION: �jHEALTH DEPARTMENT: 5. BUILDING DEPARTMENT: . 6. FIRE DEPARTMENT: RECEIPT OF COPY: (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 943 Net Owed: ($50.00) Application Date: 5/12/2005 Issue Date: Expiration Date PLEASE NOTE Comments: Map/Lot: 044.21.1.0 new construction: ZONING APPROVED S -1a�,C6- DATE: N/A: DATE: N/A: DATE: N/A: DATE: N/A: DATE: N/A: DATE: N/A: SIGNATURE OF APPLICANT: �,J, '�(J DATE: 7, ' OS Date Printed: 5/24/2005 Page 1 of 1 Brandolini, Jim From: Brandolini, Jim Sent: Friday, March 24, 2006 1:06 PM To: Anctil, Richie Subject: 121 Camp St Unit 133 &143 Richie: You had requested in Sept. 05 that I withhold Certificates of Occupancy for units 133 & 134 because of pipe damage. The contractor is now requesting the release of unit 133. Please advise me of the status relative to this matter. Thanks Jim 3/24/2006 iviui rona v usage: uramage easement in between dwelling 134 & 133. While digging foundation for dwelling 134, 12 inch drain pipe was hooked by excavator. Border of easement is shown on plan as 3 feet off of the foundation. Pipe runs from manhole just off vement to leach basin beyond dwellin . i{ a r Y'zqy M J Close up of pipe just beyond the rear of dwelling 134. Pipe is out of alignment both horizontally and vertically. OF rq APPLICATION FOR PERMIT TO DO PLUMBING TOWN OF YARMOUTH (OFFICE USE ONLY) �CNEEE,2 SE j�(7 ^ BY 11p aU '1`(7L'� 1 Fee: $GF%03 A4araa 2 DZOO$ PERMIT NO. — pwq Date 20 v.z_ f Building ��,yA �/% Owner's AT: Location CC����pl �Name Type of Occupancy--r New � R ation El Replacement El Plans RuhmittPrl Yes No ❑ z Z 0 Cl) N Q X Q C) Al Z O Z Z 0. 7 0 Z Z Lu �.'. W I Fes- U 2 N Q M LL Z 11 Q� X V p� Z W 2 O m 2 W rA Q W O } p Q FW- 3 y J Z_ N G Q H N Q e Y 4X a W n Y u. W o Q. °O LL a > D N Q 0 z a X a 0 a Y J m Cl) O 0 J = H y LL 0 0 0 0 X m 0 SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Installing Company Check One: ❑ Corp. Address �5 K ❑ Partnershop w 12 it Comp Business Telephone l-5 Name of Licensed Plumber Ol/L�5 INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes 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 voerage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. L Signature of Owner or Owner's Agent I hereby certify that all of the details and information 1 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. 2.5/ g-7 License Number l Type: Master❑ I Journeymam