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0240 PHEASANT HILL CIRCLE
Cal Ybwn Of Barnstable Yti�r egulAt®ry Services y �o� Richard V. Scali, Director STAB _ Building DivisionWJM BABSTABILE MASS. Han n's _s mu niii-+.sr°•n cx:'�"aazt 9Qp 039. �® 'Thomas Perry, CBO 1639-2014 �FnMesA Building CommissionerDg 200 Main Street, Hyannis, MA 02601 www:town.Barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 November 7, 2014 t John Harker 240 Pheasant Hill Circle Cotuit, MA. 02635 RE: 240 Pheasant Hill Circle, Cotuit, Map: 002 Parcel: 002026 Dear Mr. Harker, This letter is to follow up on application number 201305395 to finish the basement at the above referenced address. As you may recall, a permit was issued by this office on or about August 14, 2013 and to date there is no record of any inspections. If the project did not take place you must notify this office so the permit maybe closed out or contact this office with the status and arrange for the required inspections. Thank you for your anticipated cooperation in this matter. Respectfully, Lauzon Local Inspector p e� f rey.lauzongtown.barnstable.ina.us (508) 862-4034 e a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION L TOV, :idSTAj Map Parcel - Application b Health Division � 13 - 'P b Date Issued Conservation Division Application FIV Planning Dept. nv V 3 ;) Permit Fee Date Definitive Plan Approved by Planning Boardj�'0•`- Historic - OKH _ Preservation /Hyannis Project Street Addressffo P6R—di ry c w l Village nottl l ' Owner 0 Address n8qywir �re a 0 U Telephone 4 4 Ut,' St Permit Request �iV►e .Square feet: 1 st floor: existing pproposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation o® Construction Type Lot Size 7r I � Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family >' Two Family ❑ • Multi-Family (# units) Age of Existing Structure ° Historic House: ❑Yes )(No On Old King's Highway: ❑Yes ;.fNo Basement Type: `Full ❑ Crawl 0 Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) �2 Number of Baths: Full: existing 2 new Half: existing new Number of Bedrooms: 2 existing —new Total Room Count (not including baths): existing 5 new J First Floor Room Count s Heat Type and Fuel: &(Gas ❑ Oil ❑ Electric ❑ Other Central Air: V Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:;Kexisting 0 new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Use Proposed Use— Current - -- --_- —__. APPLICANT INFORMATION (BUILDER OR HOMEOWNER) -7 p Name c -1 I Telephone Number P Address i License # akitt 2635t � -Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBTIS RSULTING FJ�jjOM T II PRvlez CT WILL BE TAKEN TO r��t� ✓ n SIGNATURE DATEAdDV.)lgq LOU s FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED I MAP/PARCEL NO. r ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION•_ ' FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING i DATE CLOSED OUT ASSOCIATION PLAN NO. - The Commonwealth of Massachusetts Department of Industrial Accidents ' f; - Office of Investigations y 600 Washington Street Boston,MA 02111 9".mass gov/dia Workers' Compensation Insurance Affidavit: Builders/.Contractors/Electricians/Plumbers A" licant Information Please Print Legibly Name(Business/OrganizafiondndividvaI): fNk�r Address: ®• php_eLs r, City/State/Zip:-. (,t It Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 4. I am a general contractor and I * have hired the sub-contractors 6 ❑New construction employees(full and/or part-time). , 2.❑ I am a sole proprietor or partner- listed an the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g, []Demolition working for me in any capacity. employees and have workers' [No workers'comp. insurance p. # 9.. 0 Building addition romp.insurance.: � required.] 5. We area corporation.and its 10.XElectrical.repairs or additions 3.51 I am a homeowner doing all work officers,have exercised their` ' 11.[Plumbing repairs or additions myself [No workers' comp right of exemption per MGL 12.❑Roof re�airs , insurance required.]t c. 152, §1(4),and we have no ]L employees. [No workers' 13.9'Other comp.insurance required > *Any applicant that checks box#I.must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then him outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-co ntiactors and state whether or not those entities have employees. If the sub—contractors have employees,they must provide their workers'comp.policy number.. I am an employer that is providing workers'compensation insurance for my employees.`Below is the policy and job site information. Insurance Company Name: Policy#,or Self-ins.Lic.#: Expiration Date: Job Site Address: City/state/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A ofMGL c. 152 can lead to the imposition of criminal penalties'of a fine up to$1,50-0.00 and/or one-year imprisonment,-as well as civil penalties in the fohi of a STOP WORK ORDERand a fine of up to$250.00 a day-against the violatot. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for' ce coverage verification I do hereby. e n t ains d penalties of perjury that'the information provided abo is /7e and correct �-Si wee ,'L�` w Date: !'J ;s � -,. Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# .' Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5-Plumbing Inspector ' 6..Other , Contact Person: w. Phone-#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. . Pursuant-to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as 'an individual,partnership,association,corporation.or other legal entity,or any two or more ..' of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity, employing'employees. However the' owner of a dwelling house having not more than three apai-anents and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on.such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be'an employer..- MGL chapter.152; §25C(6)also.states that"every state or local licensing agency shall withhold the issuance or . . renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL,chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checkiag-theboxes that apply to your situation:and,if. necessary,supply sub-contractors)name(s),addresses)and phone number(s)`along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships (LLP)with no-employees other than the' members or partners,are not required to carry workers' compensation insurance. If an LLC or LL:P does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial' , Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of- Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should eatertheir seL-inc,irance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete,and printed legibly. The Department has provided a space at$ie bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact-you regarding the applicant Please be sure to BE in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permitllicense applications in any given year,need only submit one affidavit indicating current. policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city.or. ' town)."A copy of the.-affidavit that has.been officially stamped or marked by the city or town may be provided to the" applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must:be filled out each- year. Where a home owner or citizen is obtaining a-license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions; please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of fnvesfiptions 600 Washington Street Boston,MA 02111 Tel, #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 -vised 4-24-07 www.mass.gov/dia Town of Barnstable ��THE T�ti Regulatory Services } * usuxcrnxrx Thomas F. Geller,Director ' Building Division E'D Tom Perry,Building'Commissioner 200•Main Street,,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:;.508-790-623,0 HOMEOWNER LICENSE EXEMPTION Please Print JOB LOCATION: nu r street village "HOMEOWNER": name b e phone work phone# CURRENT MAILING ADDS: t 1'- 1 ; city/towel w state zip.cod"e The cuurent exemption for"homeowners"was extended to include owner-occupied dwellinzs of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. - DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to'such use and/or farm structures.,A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsrble for all such work performed under the burildin�permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. r }, The Undersigned e caner'.'certifies that he/she understands the Town of Barnstable Building Department e on cedur and requirements and that he/she will comply with said procedures and re uire , Si _re_of_Homeown Approval of Building Official Note: Tiree-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION I The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homeowner.shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a florin currently used by j several towns. You may-care t.ammd and adopt such a form/certificatim.for use in your community. • i Q.forms:homeexempt ; oFIKE Town of Barnstable Regulatory Services t aaxivsxasrs, •. Bass. Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town-b arnstable.m a.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must , Complete and Sign-This Section If Using A-Builder L Owner4toa erty hereby authorize y behalf, M all matters relative to work autho ' by this building permit 5 (Address of Jo Pool fenc s r d alarms are the res onsi ' ' of the applicant. Pools P tY PP are not to be or utilized before fence is in a.11ed and all final inspections are performed and accepted. , Signature of Owner Signature of Applicant Print Name Print Name Date Q:F0RMS:0WNERPERMISSI0NPO0LS 62012 a , y rr 5 » � r _. y ,.rd..x�. 00 ` y 4 i i . ..ems .,., ... -•et"•' Sw= , { : .y. v m 4..,w w. ._..�_,.: �:,,« � .:,. -sue..,_ ♦ � �,"a' :��mare �.�._.,... i t' ff { } Y t ' .. .CLI- A`..r>k-+. wY,- 1 3 j , I .ee.. y to t sit 00 f i r - Y ...�. .. , r�. r« -kr,, .�...: :�>.s _^.a r,._ � Y „¢c �" #, «,• � dr �", •i i. #. r 1 .. •Yf:�e ��i -,�:-.�� i, .v..r r+.i..,�,ir .:..,.�..wue_ ..X. 1-.v2... a l",:.t 1.- �',r�Fr�.. MTt ✓Vj� � -:d:! .r � ,�i:--, ^""M, C ( ff 735, C^. 7a. � _. :, ::.-» w.p::-':..,.,,'.,. ...r. ,.,., a...� ..,...,.._.r ...-,,,-,.--:,,..a v. :_;.:..,_, r.,,z. +,..:, ,;,•..,.. .._ ax:.�.. �,.;;-..c: #. nx,,.ra+,� .:ia,?- k> tau. s,,.-+ .�. v. K, 6; NMI, _ , w g a , .., 172, :. �i,,a i d1 w,, .er wW 1"fF.�,•,..:^`'n.', �.�� - ,M 14 w ,, t. J: Town of Barnstable' Building Department - 200 Main Street BARNgrABLE• Hyannis, MA 02601 9 MASS. 163�. . (508) 862-4038 CFO Mfg A Certificate of Occupancy Application Number: 201100128 CO Number: . 20130009 Parcel ID: 002002026 CO Issue Date: 01129/13 Location: o 240 PHEASANT HILL CIRCLE Zoning Classification: RESIDENCE F DISTRICT 9 ' IN'Proposed Use: SINGLE FAMILY HOME Villager ' i Gen Contractor: DANIEL MARSTERS Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: Building Department Signature Date Signed ,� r • `fit. �IMETn.-� TOWN OF BAKNS iAb�,t _gain Application Ref: 201100128 BARNSTABLE, Issue Date: 01/28/11 Permit MASS, Ar16 39. A�� Applicant: DANIEL,MARSTERS Permit Number: B 20110147 Proposed Use: DEVELOPABLE LAND Expiration Date: 07/28/11 [Location 240 PHEASANT HILL CIRCLE Zoning District RF Permit Type: NEW SINGLE FAMILY HOME Map Parcel 002002026 Permit Fee$ 918.00 Contractor DANIEL,MARSTERS Village App Fee$ 100.00 License Num ONE&2 ONLY62820 Est Construction Cost$ 180,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND NEW CONSTRUCTION OF 1 STORY SINGLE FAMILY HOME THIS CARD MUST BE KEPT POSTED UNTIL FINAL_ WITH 3 BEDROOMS,2 BATH AND 1 CAR ATTATCHED GARAGE INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: COTUIT EQUITABLE HOUSING LLC BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 20 CANDLEWOOD LANE INSPECTION HAS BEEN MADE. DENNISPORT, MA 02639 Application Entered by: RM Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT:TO OCCUPY ANY STREET,ALLY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY. ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLYTERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET ORALLY GRADES AS:WELL AS DEPTH_AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OFTUBLIC WORKS:' THE ISSUANCE OF THIS PERMIT DOES NOT,RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVI SIONRESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY: WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). A ! ir BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECT,ION`APPROVALS 1X0�t (p a 2 F 2 7//zl 10 3 1. Heating Inspection Approvals Engineering Dept yl�J® 117-91/,3 Fire Dept 2 .�';, 1 v.� Board of Health _. ,.+�',' - .`; o C by ,r�•' „f� �;y, - . 'w, ,•a , .. -.ems=,.�.. - `a 1t , TOWN OF BARNSTABLE BUILDING P RMIT APPLICATION 0. t-loqc CCA Map Parcel -Application Health Division Date Issued Conservation Division Application Fee 46 Planning Dept. L n1,tM 09a- Permit Fee Date Definitive Plan Appr ved by Planning BoardAk Historic - OKH —Preservation/Hyannis Project Street Address �1 rr Village l cnt r Owner f 1 RGt (,lYl'4" A 00 AISM6 LLC Address )32, t-A 0U44 R 4_ S bp��- F Telephone 0 0 ii IIvv 10Me- Permit Request Nwj �E?h S-Y�'t�C.1� (�°� 0� �-5�'� �hC ��. -. c wl r UJo k 3 r00 '►S G��Y� Q�d a� Gi��1Q� , r , Square feet: 1st floor: existing 0 proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Z0111 e 60 Groundwater Overlay Project Valuation 0 0 0 Construction Type Lot Size 0aR Grandfathered: ❑Yes ❑'No If yes, attach supporting documentation. Dwelling Type: Single Family , a/ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) 16 y(� SF Number of Baths: Full: existing new 0� Half: existing new Number of Bedrooms: existing3 new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: q.4as ❑Oil ❑ Electric ❑ Other Central Air: tales D No Fireplaces: Existing New _� Existing wood/coal stove: ❑Yes 3 o Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑-new`size_ Attached garage: ❑ existing il new size Shed: ❑ existing ❑ new size _ Other: - T Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ = -- Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use n p' Cry APPLICANT INFORMATION UILDER OR HOMEOWNER) Name rkk) e�� (�rS "f-fS w_ Telephone Number �0�'- `y(5 Address l3 3 PlOAO Kf k d License # C S �a a 1' L6 6 :e e . P/�- o z( V 9 Home Improvement Contractor# Worker's Compensation # b U q `7 -6 FU ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 8 tM �� -SPrV 1 Ge- pro Qicy.cd w4c - resi DATE SIGNATURE �'� ' , 1 FOR OFFICIAL USE ONLY APPLICATION# SATE ISSUED I /PARCEL NO. ADDRESS VILLAGE t OWNER i DATE OF INSPECTION: ,. /dear W��f-L�f SinG 31 !< �nr 0 S(D y 3Lop4FOUNDATION : .� 12 � 4 FRAME3t1�'Af i�r/ R c i��c R n� 6a.T -c INSULATION g IJ1Z 7 ` 1i-1►h►4�c`"`K4 t� Gc n � ;4 FIREPLACE t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL F�GAS: T' ROUGH •Ri a +:=r." FINAL - / I L:f FINAL BUILDING`S � Z3/ '3;? DATE CLOSED OUT ASSOCIATION PLAN NO. . t The Commonwealth ofMassachusetts Department oflndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111` www.mass.gov/diu ' Workers*Compensation Ins'Unnce Affidavits Builders/Contractors/Electric aris/Plumbers A licant Wo rmation .Please Print Le ' I Name (Business(Organization/Individual): d es LL� At3�ress: 3 3 G;S City/State/Zip: Ma-sPhone.#: Are you an employer? Check the appropriate bo ;Type of p ect(required).-. 1. I am a enVloyer with 4 [J 1 m a general contractor and I 6 ' ow construction . * have hired the sub-confractors • employees(furl nor part time). r Remode ' 2:❑ I am a'sole proprietor or partner- listed on the-attached sheet 7• • ship and have no employees These sub-confractors have g; El Demolition employees and hate workers' 'working for me in any capacity. t 9, 0 Builc ing addition [No workers' comp•insurance comp,insurance, 10.[]Electrical repairs or additions ���] S. [] We are a corporation and its 3.[� I am a homeowner doing ill wozk . officers have exercised their 11.❑Plumbing repairs or additions ' myself, [No workers' comp. right of exemption per MGL `UE1 Roof repairs msu ranch.re ed, t c. 152,-§1(4), and we have no ' 4 employees, [No workers' 13.[] Other comp.insurance required.] *Any applicant that checks bax#1 must also fill aut the sm6on below showing their ers work 'compensation pof'soyinfonnadon. f Hnmeowoers,wbdsubnut thin affidavit indicating they am doing all work and then hire outside-contractors mutt submit anew affidavit indicating such. . :Contractors that check thisbox must attached in additional sheet showing thename of the pub-contractors and state whetber ornotthose entities have employees. rf the sub-conctors hav em e ployees,thay=st provide the tra ir workers'comp.polidy number. Iam an employer thattsprovidingworkers'compensatfvninsurancefor my employees. Below isthepolicy andjob site_' tnformatiott. y Insurance CompanyNa`me' Policy#or Self-ins.Lie.#: Expiration D ate: Iola Site Address: City/State zip: Attach a copy of the workers' compensation policy declaration page'(showing tiie policy number and expiration date). Failure,to secure,coverage 95 required under Section25A ofMGL c. 152 canlead to the imposition of ctir nal penalties of a fine up tb $1,500.00 and/or one-year imprisonrnent; as well as civil penalties in the form of a STOP WORK-,ORDER and a fare of up to$250.D0 a day against the violator.•Be advised that a copy of this.statement maybe foravarded to the-Office of' Investigations of the I)IA for insuraA0 covers a verification. I do hereby cent' un er pa' -and ltYes of perjury that the information provided above is true and correct. Si ature: Date; _ Phone# _ - Offtclal use only. Donot write ht this area, to be completed by city or town offiCIA. • eirmit/License#. City or Town' ' - Issuing Authority(cfrd$one): ., ;.` , .. � , , . . .1.Board of Health 2,BuildingDepartment..3,rCity/Town CIerk 4.Electr�ical Inspector 5•Plumbing Inspector 6, Other Contact Person: 'Phone#: Affidavit of Substantial`Financial Interest I, 1G-1 � of 71 �al'P SC4y.+ � 5 Lon oath depose and state as.follows: 1. 1 am an applicant for a building permit for the property located at Map "-Parcel 6 The address of the property is t-to 2. I have % legal or equitable interest in the real property which is the subject of the building permit application which-'is identified in paragraph 1 .above. 3. Within in the last twelve monthsfrom today's,date, which is11o.-In , the following individuals or entities have had a 1% or greater Flegal or equitable interest in the real property which is the subject of the building .permit application which is . identified in paragraph 1 above: w Name y., Address Tnc. , spt' �Iw. 0�G3� 4. Within the last twelve months, from today's date, which is , I have had a 1% or greater'legal or equitable interest-in the following properties which have been the subject of a-building permit application: Map/Parcel Address 5. Within this calendar year,.l have subMitted ® building permit'applications for property in which I have a 1% or greater legal or equitable interest. 6. Within the.last ten days, l have submitted C) building permit applications for property in which I have a 1% or greater legal.or equitable interest. 7. Within this month, I have submitted, C7 ,building permit.applications for.property in which I have a 1% legal or equitable interest. B. Within.this month,-I have received building permits for property in which I have. a. 1% legal or equitable interest. Signed underthe pains and penalties of'perju , t is �` ay of Tr , 200 1J 2001-0050/affin _ 1 Bk 24968 PS272 -9:56780 11-03-2010 a 11 a-17m BARNSTABLETCOUNTYTREGISTRY OFXDEEDS Date: 11-03-2010 a 11:17am Ct 14: 650 Doc': 56780 Fee: $342.00 Cons: $100F000.00 BARNSTABLE COUNTY EXCISE TAX BARNSTABLE. COUNTY REGISTRY OF DEEDS Date.' 11--03-2010 D 11:17am I;h.r.v= r_Eit Dpf;vf 56780 Fee: $270.00 Cons., sloopor)o.cio QUITCLAIM DEED NORTHERN SEALCOATING & PAVING, INC., a Massachusetts Corporation having a usual place of business at 20 Candlewood Lane, Dennisport, MA 02639 C'M CA C3 d In consideration of ONE HUNDRED THOUSAND HUNDRED and 00/100 ($100,000.00) DOLLARS, paid c U ^; Grant to PLEASANTWOOD HOMES, LLC, a Massachusetts Limited Liability Company, having a usual place of business at 10 Pleasantwood Drive. U Forestdale. MA 02644 " I with QUITCLAIM COVENANTS r o LOT 26 as shown on the plan of land entitled "Cotuit Meadows Subdivision 9999 Falmouth Road (Route 28) Cotuit - Barnstable,Massachusetts Prepared For di Cotuit Equitable Housing, LLC, P.O. Box 95, Centerville, MA, 02632 Title Key PIan Baxter Nve Engineering & Surveying Scale I" = 100'dated 4/11/07 Revised n 5/2/07" which said plan is recorded in the Barnstable County Registry of Deeds in Plan Book 617, Pages 69-75). r w Said premises are conveyed together-with the benefit pf and subject to a]I rights, 0 privileges, easements and reservations of record insofar as the same are now in force and applicable. Meaning and intending to convey a portion of the premises conveved to Grantor in Deed dated July 22, 2009, and recorded with the Barnstable County Registry of Deeds in Book 23992. Page 141. 1 Grantor warrants that this is not a sale of all or substantially all of the companies' assets in the Commonwealth of Massachusetts. EXECUTED as a sealed instrument this y! € , day of November, 2010. NORTHERN SEALCOATING & PAVING, INC. By, •ti. Ray and W. Caterino, President COMMONWEALTH OF MASSACHUSETTS Barnstable, ss On this ' : day of November, 2010, before me, the undersigned notary public, personally appeared Raymond W. Caterino, President of Northern Sealcoating & Paving, Inc., and proved to me through satisfactory evidence of identification, which was/were !' '! Z'-- 1 t( -�") [L to be the persons whose names are signed on the preceding or attached document, and acknowledged to me that they signed it voluntarily for its stated purpose. f V l Notary Public My Commission Expires: Dq "' ,y z THIS SPACE LEFT BLANK INTE-.NTIONALLY f 00MA �G•`.r owl, it •yam 1 IAT 28 y'•'^+r 1 WIt8�76i11TiQNi1 • Y� .... tnT 2n Y Y�� �..� .n p� 112T 29 .� 112T a5 ioT z 1 cQ ' r .vA rY ed SAZ.3Q �QtL� Y.A I 1 I Ai 1 T3 YLar fl DT .•p p� m�rt YS.oa A' ! LOT 7d 1 1AZBE WT So1� e♦ LOT fiB IAT M • IAT 94 -C6"1V` 1 • °� LOT ea ]9I_4 inT 8] T 72 �` ` �' i m�ae YoMwrr WlkeTtihlen , .A„s �•j,¢T 71eoldfBunwe0t4 aria I caedi IiL LOT 62 " % '� � ��4PlIT ,aamw..adYNsemnlnp LOT 90 ' • � p LOT 70 •"•® I1 caewrtve. ear u IDT 6.1 C 1 enxmatt Er+caatm��s�vaemn IAT_63 •i AFMRaI•SOIIscllpsbrrgOW t em/nA LOT 47 IDT NQIMF 1 b.1Q1A11C M.{m11AliC f• �1��.�{�,^ jay' I Y M Y ! IM� q � yOU � QI OB:01-11-0 +lli� 4 cPPA arlce ! IMT as A ms®0ox Sd`J ID IDT GRANITE STATE INSURANCE COMPANY 0073061-00 WC 004-47-6888 13102 --------------------------------------------- 013-66-0110-00 • • P NNSY I PLEASANTWOOD HOMES LLC. ` H A R T I S 133 FALMOUTH RD BLDG#1-SUITE D MASHPEE, MA 02649-0000 A Chartis company EXECUTIVE OFFICES: SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE - WC990610 115 Water Street New York, NY 10038 I.D# MA UI#: •.. « . . •• EASTERN INSURANCE GROUP LLC WORKERS COMPENSATION AND EMPLOYERS 51 g STATION AVENUE LIABILITY POLICY INFORMATION PAGE S YARMOUTH, MA 02664-1628 - INSURED IS PREV{OUS=0:_4CY NUMBER LIMITED LIABILITY COMPANY RENEWAL 002 0 46 ' j OTHER WORKPLACES NOT SHOWN ABOVE: SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE - WC990610 ITEM 2 POLICY PERIOD 12:01 A.M.standard time at the insureds mailing address FROM • 01/2 4/1 0 TO 01/2 4/1 1 ITEM 3 A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to the work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident$ 100,000 each accident Bodily Injury by Disease $ . 500,000 policy limit Bodily Injury by Disease $ 100,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: SEE ENDORSEMENT .- WC200306A D. This policy includes these SEE EXTENSION OF ITEM 3.D. OF THE INFORMATION PAGE- WC990612 ITEM 4 The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Estimated Total Rate Per Estimated Classifications Code Number Remuneration S1000F Re- Premium aAnnual ❑3 Year rnuneration a Annual 3 Year SEE EXTENSION OF ITEM 4. OF THE INFORMATION PAGE — WC7754 EXPENSE CONSTANT(EXCEPT WHERE APPLICABLE BY STATE) $159 MA MINIMUM PREMIUM $500 MA TOTAL ESTIMATED PREMIUM $500 If indicated below,interim adjustments of premium shall be made: Semi-Annually Quarterly Monthly DEPOSIT PREMIUM 02/01/10 ASSIGNED RISK 66 Issue Date 39967 (Rev'd 04/08) Issuing Office Authorized Representative WC 00 00 01 12/ 1 CERTIFICATE OF LIABILITY INSURANCE DAn( o �ot THIS CERTIFICATE IS ISSUED AS A PLATTER OF INFORMATION ONLY AND CONFERS-NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER .., CUUTACT Passaro Leverone & Buckley PHONE RAY Insurance Agency Inc (A+e. No. E*t)° iA/C. Ral: E-HAIL P O Box 160 ADDRESS: PRUDUCF.R Dennisport, M 02639 CUSTOMER ADD. _ INWM(S) AFFORDING COVERAGE _ "IC a IUSUREU -Patrick K Orcutt NROe IN A: A.I.M. Mutual Insurance Co �._�._. INSURER O: dba P & S Concrete INSURER C; 37 Ladys �SA�Alipper Lane INSURER D: Mashpee, MA 02649 INSURER E: - _ INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER* T THIS IS TO CERT28Y THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BE® ISSUED TO THE INSURED BMW ABOVE FOR THE POLICY PERIOD INDICATED. BOTHITUSTANDING ANY REQUIREMENT, THEM OR CONDITION OF ANY CORMIACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE I9AY BE ISSUED OR May PERTAIN, THE INSURANCE AFFORDED BY THE POLICIHS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ADD CONDITIONS OF SUCH POLICIES. LIMITS SNOHH MAY HAVE BEEN REDUCED BY PAID CLAIMS. . I.7r TYPE OF INSURANCE POLICY NUMBER POLICY EFF - POLICY ERP LIMITS'Ar IRU/AYJTTTTI - IIdIND/+TTTI GENERAL LIABILITY EACH OCCURRECE $ ❑COMMERCIAL GENERAL LIABILITY - DAMAGE TO PEHM PHEITTISES(Ea.occaueaee) ❑OA.AIIt4 HADe OeccGR - O _ a HER EEP faoY du P-.)El $ PERSONAL 6 ADD INJURY 6 GEN'L AGGREGATE.LIMIT APPLIES ER: GENERAL AGGREGATE $ ONLICY OPRCJECT OLOC PRODUCTS-COMP/op AVG S 6 AUTOMOBILE LIABILITY - CONRINED SINGLE LENIT OA➢Y AUTO (ea ceident) S BODILY,INSURY filer w--) $ GALL OWNED ADIOS OSCHEDULED AUTOS BODILY INJURY(Per a idmt) 6 UNITED AUTOS - PROPERTT DANRGE (Per accldrnl.) S ONOR-OWBED AUTOS - $ O 6 OOIOIRELLA LIAR O OCCUR EMM OCCURRENCE: $ OEIOESS LIAG O CLANG FADE AGGREGATE $ ODEDUCTIBI.E _ $ OPETE PTIOR $ S VORRERS COMPENSATION - uc IDENT EACH srdrP- AND EMPLOYEES LIABILITY © TORT LMNTs EN THE PROPRIETOR./PARTNERS/ A EY,ECVFIVE OFFICERS AREe. 6 1,000,000 lnr_1 excl 6006181012010 E.L. DISEASE -POLICY LffiI $ 1,000,000 10/21/2010 10/21/2011 C.L. DISEASE-CAEKPLOTEE s- 1,000,000 COMI�NIs/DESCRIPTION OF OPENATIm6 OR LaCMIUNS: PATRICK K ORCUTT IS COVERED By THE WORKERS' COMPENSATION POLICY CERTIFICATE HOLDER CANCELLATION PLEASANTWOOD HOMES SHOULD ANY OF THE ABOVE DESCR78B1)POLICIES BE CANCBLLBD BEFORE THE RXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 131 ACCORDANCE WITH THE 133 FALMOUTH ROAD POLICY PROVISIONS. MA.SHPEE, MA '02648 AUTHORIZED REPRESENTATIVE - , 2010-12-1712.42 AIM MUTUAL INSU DTF Fax Machine ID Page 2 AGORD UERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD,YYYY) PRODUCER 05/04/2010 (508)997-6061 FAX (508)990-2731 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Southeastern Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 439 State Rd. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR .0. Box 79398 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Dartmouth, MA 02747 INSURERS AFFORDING COVERAGE INSURED Rons Excavating Inc. — NAIC# INSURERA: Merchants Insurance Group P 0 Box 809 Mashpee, MA 02649 INsuRER B_ INSURER C: INSURER D: --- INSURER E: 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. INSR DD' LTR NSRVGENERAALLIABJUTY INSURANCE POLICY NUMBER POL C�Y EFFECTIVE POLI Y EXPIRATION DATE MM/DD/YYYY DATE MM/DD/YYYY LIMITS CMP9148246 05/01/2010 O5/01/2011 EACHOCCURRENCE $ GENERAL LIABILITY DAM` ET R NTED 1,000,000 MADE PREMISES Ea occurrence $ 100,OOO OCCUR MED EXP(Any one person) $ A luded 9 5,000 PERSONAL&ADV INJURY $ 1,OOO,OOO GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,OOO POLICY JE O LOC PRODUCTS-COMP/OP AGG $ 2,OOO,OO AuroMOBILELwBIUTY 73574400001 08/16/2009 68/16/2010 ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS _ X A SCHEDULED AUTOS BODILY INJURY $(Per person) 1,000,00 0 X HIRED AUTOS X NON-OWNED AUTOS BODILY INJURY $ (Per accident) 1,000,000 PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY 1,000,000 AUTO ONLY-EA ACCIDENT $ ANY AUTO ----- OTHER THAN EAACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE, $ OCCUR CLAIMS MADE -- — AGGREGATE $ DEDUCTIBLE $ RETENTION $ tDISEASE $ WORKER ANDEMPS YERS'LI ATIONILIT WCA9094537 O5/01/2010 . 05/01/2011 $AND EMPLOYERS LIABILITY Y/N X ERANY PROPRIETOR/EXCLUDR/EXECUTIVE�A OFFICER/MEMBER EXCLUDED? ENT $ SOO,OOO (Mandatory In NH) NO EXCLUSIONSIt es,describe under ---- EMPLOYEE $ 500,OOSPECIAL PROVISIONS belowOTHER LICY LIMIT $ 500,OO DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS. dditional insured: Pleasant Wood Homes and Dan Marsters CERTIFICATE HOLDER CANCELLATION 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 Pleasant Wood Homes IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 10 Pleasant Wood Drive REPRESENTATIVES. Forestdal e, MA 02644 AUTHORIZED REPRE ACORD 25 2009/01 Karen Bern 1 FAX: 774.238.4869 ©198/-2009 ACO D CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD RightFax C3-2 12/17/2010 9:37: 12 AM PAGE 2/002 Fax Server ACORD. CERTIFICATE OF LIABILITY INSURANCE 12 imoio THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the policy(fes)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsoment(s). PRODUCER CONTACT NAME: PHONE FAX HORGAN INS AGCY INC (AIC,No,Ext): FAX (A/C,No): 44 BARNSTABLE RD B E-MAIL ADDRESS: PO BOX 250 PRODUCER HYANNIS.MA 02601 CUSTOMER ID 1I: 28XBF INSURER(S)AFFORDING COVERAGE NAIC INSURED INSURER A: AMERICAN Z_URICH INSURANCE COMPANY INSURER B: LABRIE CONSTRUCTION INC INSURER C: INSURER D: PO BOX 2373 INSURER E: MASHPEE,MA 02649 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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.. - - INSR ADDLSUBR POLICY EFF DATE POLICY EXP DATE lTR TYPE OF INSURANCE -MR WVD POLICY NUMBER (MKMYYYY) (MMOD\YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE OCCUR. PREMISES.(Eaoccurrence) MED EXP(Any one person) $ PERSONAL&&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PROJECT LOC PRODUCTS-COMPfOP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKER'S COMPENSATION AND WC STATUTORY LIMITS OTHER ' EMPLOYER'S LIABILITY Y/N UB-0309M544-10 10012010 10/31=11 E.L.EACH ACCIDENT $ 100,000 ANY PROPERITOPJPARTNERIEXECUTIVE Y E.L.DISEASE-EA EMPLOYEE $ 100,000 OFFICERIMEMBER EXCLUDED? (Mandatory is�) .E.L DISEASE-POLICY LIMIT $ 500,000 If yes,describe wider DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/RESTRICTIONS1SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE,ISSUED TO THE CERTIFICATE HOLDER AtTECTING WORKERS COMP COVERAGE CERTIFICATE HOLDER CANCELLATION PLEASANTWOOD HOMES SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE ATTN:DAN MARSTERS WITH THE POLICY PROVISIONS. 10 PLEASANT WOOD DR AUTHORIZED REPRESENTATIVE FORESTDALE,MA 02644 W A Bolinder ACORD 25(2009/09) 1988-2009 ACORD CORPORATION. All rights reserved. 20IG-12-1712:43 TRAVELERS RightFax 0-2 Page 2 r ACORDM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 05/27/2010 PRODUCER 508-398-6033 FAX 508-760-1667 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eastern Insurance Group LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE '719 Station Ave HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ,o Yarmouth MA 02664 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED Donal d Cook INSURERA: Commerce Insurance Company 6 Angel os Way INSURER B: Hartford Mashpee MA 02649 INSURER C: INSURER D: INSURER E: OVERAGES 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 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 DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY BBLTQY 03/10/2010 03/10/2011 EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 CLAIMS MADE �OCCUR MED EXP(Any one person) $ APRF 5,0O0 PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY JECOT_ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS $ SCHEDULED AUTOS BODILY INJURY(Per person) HIRED AUTOS NON-OWNED AUTOS BODILY INJURY $ (Per accident) ✓ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY•EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F1 CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND 08WECTJ2666 05/15/2010 05/15/2011 X I WC STATU- oTH- EMPLOYERS'LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,00 ____,.,,_._ OFFICEF2/MEMBER EXCLUDED? _ _... .... __:If yes,describe under _.E.L..,RI.SEASE---=- — - ,---.. _ 00.._.... SPECIAL PROVISIONS below OTHER E.L.DISEASE-POLICY LIMIT $ 500,00 Donald Cook included or Workers Comp overa e DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS Evidence of Insurance CERTIFICA E HOLDER CANCELLATION 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, Pl easantWOod Homes BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 10 Pl easantWood Drive OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. Forestdal e, MA 02644 AUTHORIZED REPRESENTATIVE C nthia J Jenks ACORD 25(2001/08) @A60D PORATION 1988 ACORD ,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 103/22/2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ahlegel & Schlegel Insurance Brokers Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE L` 4 MAIN STREET HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. West Yarmouth, MA 02673 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A_MIN STREET AMERICA Patrick Cronin _ INSURER B:AIM MUTUAL 376 Lake Shore Drive ---- -._ INSURER C: INSURER D:-----_------- -------- __ ............ . .. . .. -.. an W1Ch, MA 02563 INSURERS 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. LTR INSRD TYPE OF INSURANCE POLICY NUMBER t� POLICY EFFECTIVE POLICY EXPIRATION - i DATE(MWDDlYY) DATE(MM/DD/YY) LIMITS A GENERAL LIABILITY MPR6812N jO6/12/ZOO9 06/12/2010 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY 1 - �I PREMISES(Ea occurence) $100,000 CIAIMS MADE LJ OCCUR f MED EXP(Any one person) $5 000 - - PERSONAL&ADV INJURY $1,000,OOO -- �- GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: I PRODUCTS-COMP/OP AGG s2,000,000 POLICY PRO- JECT LOC AUTOMOBILE LIABILITY +I ---I ANY AUTO _ 7 .. COMBINED SINGLE LIMIT - $ (Ea accident) ALL OWNED AUTOS ---- -- — - SCHEDULED AUTOS BODILY INJURY (Per person) E HIRED AUTOS --- - — ---- I E NON-OWNED AUTOS BODILY INJURY(Per accident) -- -------- � PROPERTY DAMAGE--�---- $------ (Per accident) GARAGE LIABILITY - ! AUTO ONLY•EA ACCIDENT $ ANY AUTO � EA Acc E OTHER THAN _ AUTO ONLY: qGG $ _ EXCEssruMeRELLq LIABILITY j - EACH OCCURRENCE $ occuR L�CLAIMS MADE - AGGREGATE $ DEDUCTIBLE -- $ RETENTION $ _-- $ B WORKERS COMPENSATION AND _ EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE +VqCO2704309 O1/27/2OlO 01/27/2011 E.L.EACH ACCIDENT $100 0O0 OFFICER/MEMBER EXCLUDED? t - .---__.__ ! If yes,describe under YES E.L.DISEASE-EA EMPLOYEE $100,000 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER I - i i I DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS PATRICK CRONIN HAS ELECTED NOT TO BE COVERED ON HIS WORKERS COMPENSATION POLICY CERTIFICATE HOLDER CANCELLATION T MASTERS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION rd'PLEASANT WOOD DR DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 21 DAYS WRITTEN FORESTDALE, MA 02644 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBL R LIABILITY 0 KIND UPON THE INSURER, ITS AGENTS OR REPRESE TIVES. FAX#508-477-5709 - AUTHORIZED SENTATIV ACORD 25(2001/08) ©ACORD CORPORATION 1988 Client#:514675 2ALLCAPEGA ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE lYWY) 06l08/2012010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 973 lyannough Rd., PO Box 1990 ALTER THE COVERAGE AFFORDED BY.THE POLICIES BELOW. Hyannis,.MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED All Cape Garage Door Co.,Inc. INSURER A: Associated Employers Insurance 1 Huntington Ave INSURER 8: South Yarmouth,MA x02664 INSURER C: INSURER D: INSURER E: 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER- POLICY EFFED TIVE POLITYPATE EXPIRATION LIMITS CEtcep_L VA9:L1 TY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMPR_AGE TO RENTEDFM $ CLAIMS MADE OCCUR - MED EXP(Any one person)- $ PERSONAL S ADV INJURY $ GENERAL AGGREGATE $ GEN1 AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO-zCT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO $ (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO - OTHER.THAN EA ACC $ AUTO ONLY: AGG $ EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE - RETENTION $ $ A WORKERS COMPENSATION AND WCC5002586012010 06/01/10 06/01/11 X' °V'• STA f u- •v'i EMPLOYERS'LIABILITY - " ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $10O O00 OFFICERIMEMBER EXCLUDED? NO - E.L.DISEASE-EA EMPLOYEE $1 OO OOO If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Pleasant Wood Homes - DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1_ DAYS WRITTEN BOX 1 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO$0 SHALL Mashpee,MA 02649 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001108)1 of 2 #S70003/M69914 LS1 © ACORD CORPORATION 1988 ACO/20® DATE(MM/DD/YYYY) PRODUCER F_ `.� CERTIFICATE OF LIABILITY INSURANCE 05/30/2010 Aon Risk Services central, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Southfield MI Office AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS 3000 Town Center CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE Suite 3000 COVERAGE AFFORDED BY THE P Southfield POLICIES BELOW. t field MI 48075 USA Ln PHONE- 866 283-7122 . FAX- 847 953-5390 INSURERS AFFORDING COVERAGE NAIC# kD tD INSURED INSURER A: old Republic Ins CO 24147 Builder Services Group, Inc.d/b/a Quality Insulation INSURERB: Indemnity Insurance Co of North America 43575 Building Products A -INSURER ACE American Insurance Company 22667 d A M85C0 COryDOrdtlOn company � 2 Industri a 1 Road INSURER D: Milford MA 01757 USA INSURER F.: b O COVERAGES SIR applies per terms and conditions of the policy, x 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 M PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICAYIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. . INSR ADD' LIMITS SHOWN ARE AS REQUESTED LTR INSRE TYPE OF INSURANCE POLICY NUMBERPOLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MM/DDIYYYV DATE(MM/DD/YYY A ET ERAL LIABILITY MWZY5552510 06/30/2010 06/30/2011 EACH OCCURRENCE $2,000,000 X COMMERCIAL GENERAL LIABILITY - DAMAGE TO RENTED $2,OOO,000 CLAIMS MADE © OCCUR PREMISES(Ea occurrence) M (Any one persona t\ PERSONAL&ADV INJURY $2,000,000 rn GENERAL AGGREGATE $5,000,000 0 GEN'L AGGREGATE LIMIT APPLIES PER: - - ❑X POLICY ❑ PRO- ❑ PRODUCTS-COMP/OPAGG $10,000,000 p JECT LOC O Ln A AUTOMOBILE LIABILITY MWTB1839810 06/30/2010 06/30/2011 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $5,000,000 Z ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) l: X HIRED AUTOS X NON OWNED AUTOS - BODILY INJURY - V (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT ANY AUTO OTHER THAN EA ACC AUTO ONLY: EXCESS/UMBRELLA LIABILITY AGG EACH OCCURRENCE ❑OCCUR ❑ CLAIMS MADE _ AGGREGATE DEDUCTI .._.. .. - _. . .. BLE _., .._ _._. ....._ RETENTION B WLR C 1 X WC STA'FU- OTH- WORKERS COMPENSATION AND Deductible - ADS C EMPLOYERS'LIABILITY Y V LIMITSER ANY PROPRIETOR/PARTNERlEXECUTIVE SCF c46135635 06/30/2010 06/30/2011 E.L.EACH ACCIDENT $1,000,000 OFFICERIMEMBEREXCLUDED? RetrO - AZ,HI,MA,OR,WI C (Mandatory in NH) WLR C46135611 06/30/2010 06/30/2011 E.L.DISEASE-EA EMPLOYEE $1,000,000 If ,describe under SPECIAL PROVISIONS below Deductible Minnesota E.L.DISEASE-POLICY LIMIT $1,000,000 WCUC4613560A 06/30/2010 1 Retention $2,000,000 OTHER self-Insured states - Excess WC Statutory Included DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION Pl edSdntW00d Homes SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 133 Falmouth Rd. DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL Mashpee MA 02649 USA 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE.INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION.All rights reserved= The ACORD name and logo are registered marks of ACORD RightFax 113-2 3/31/2010 8: 14 :28 AM PAGE 2/002 Fax Server v+ ACORD. CERTIFICATE OF INSURANCE PRODUCER DATE(MM1DDiYY) 03-31-10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION LEONARD INS AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 7 WIANNO AVE HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O.BOX 494 OSTERVILLE,MA 02655 COMPANIES AFFORDING COVERAGE 286XR COMPANY A TRAVELERS DIRECT ASSIGNMENT INSURED COMPANY I BRENNAN TIMOTHY DBA BLUE 30ARD B SPECALISTS PLASTERING CO i 117 SOUTH MAIN ST. COMPANYC CENTERVILL&MA 02632 COMPANY D I COVERAGES THISI REQ I TOCERT E ORHAT THECONDITION POLICIES AN Y SURANCECONTRACT TOR BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REOIAREAIENT,TERM OR CONOiTtON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTABOVE MAY BE ISSUED OR MAY PERTATE THE INSURANCE AFFORDED BY CO j THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,POLlqES LDS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM LTR TYPE OF INSURANCE POLICY NUNBER DATT POLICYM GENERAL MIDIXYY) DATE(MNKDD1YY) LIMBS LIABILITY COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE $ CLAIMS MADE OCCUR. PRODUCTS-COMP/OP AGG. $ OWNER'S&&CONTRACTORS PROT. PERSONAL&&ADV.INJURY $ EACH OCCURRENCE $ FIRE DAMAGE(Arty one lire) $ AUTOMOBILE LIABILITY MED.EXPENSE(Anyone person) $ ANY AUTO ALL OWNED AUTOS COMBINED SINGLE LIMIT $ SCHEDULE AUTOS BODILY INJURY(Per Person) t HIRED AUTOS BODILY INJURY(Per Accident) $ NON-OWNED AUTOS PROPERTY DAMAGE $ OARAOE LIABILITY ANYAUTOS AUTO ONLY-EA ACCIDENT $ OTHER.THAN AUTO ONLY: EACH ACCIDENT g EXCESS LIABILITY AGREGATE $ UMBRELLA FORM OTHER THAN UMBRELLA FORM EACH OCCURRENCE $ WORKER'S COMPENSATION AND AGGREGATE $ A EMPOLYER'SLIABILITY US-W94N848A0 03-03-10 - THE PROPRIETOR/ 03-03-11 STATUTORY LIMITS X PARTNERS/EXECUTIVE X INCL EACH ACCIDENT $ 100,000 OFFICERS ARE: EXCL DISEASE-POLICY LIMIT $ 500,000 OTHER DISEASE-EACH EMPLOYEE $ 100.600 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESMRSTRIMONSISPECUIL ITEMS THIS RITLACPS ANY PRIORCURTINCATE ISSUM 770 THE CERTEPICA7E HOLDER AIATCITNG WORKERS COMP COVEMAGp BROMAN nMOTHY ISCOVERf1DBY THE WORKETRS'COMPPIVSATIONPOLECY. CERTIFICATE HOLDER 1 CANCELLATION PI Fe SAN WOOD HOMES LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION - DATE THEREOF,THE LSSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE 10 PLEASANTWOOD DRIVE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAIWRE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIOATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES, FORESTDAI E,MA 02644 AUTHORIZED REPRESENTATIVE ACORD 25-5(3/93) Charles.(Clark 2010-06-1513.19 Ostervllle MA 508 420 5406 Page 1 JUN-16-2010 11:21 k.Urva 1 L I U I I•-A. ,I---•••� •._ A s CERTIFICATE OF LIABILITY INSURANCE F°"'E`"M'°°"rfY' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(3), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder i$an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and condblons of the policy,certain Policies may require an endorsement. A statement on this certificate,does not confer rights to the cenifiaate holder in lieu of such endorsement(s). PRODUCER N ACT LAURA SULLIVAN , CONSTITUTION PROPERTY CASUALTY&LIFE CO PuoNE •508-419.7393 509 FALMOUTH RD SUITE 6 L PRc-0- MASHPEE MA 02649 CUSTOWR 10.1 INSURE 6 AFFORDING COVERAGE NAICO MUI= wsuRERA.-NGM INSURANCE JOSHUA DOUGHERTY NJSURm a:LIBERTY MUTUAL ALL IN THE WOODWORK INSURER c 14 BLACKTHORN PATH FORESTDALE MA 02t344 a+sURER D INSURER E: MISURER F I COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. W oL U9R POLICY POLI CY IMP R LIMITSTYPE OF INSURANCE FOUCY NUMBER A cENERALUADILnY MP0768T 0311612010 03/16/2011 EACH OCCURRENCE # X COMMERCIAL GENERAL LIABILITY r� O o=rry $ CLAIMB-MADE Q OCCUR 1 MED EXP ap Wwn E 10,000 PERSONAL 3 AOV INJURY t 1 OFNERALAGGREGATE t Z 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIQP AGO # _71-POLICY 0 P CT LOG I I ; AUTOMOBILE LU=LnY r COMBINED SINGLE LIMIT s ANY AUTO I BoBO IBODILYIwuRv(Per pia«+) # AILowNSaAUTo'S BWLY INJURY(Paraaiderd) Si SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (PwawdaM) # NON-OWNED AUTOS # UWRN I n Line QCOUR BAiCII Oo V*Jk x t EYGESI UAB GLAIMS-HAPB (� AGGREGATE DEDUCTIBLE 1 E R TEN110N s 9 WoRKE"CWPENRATIDN 04/20/2030 04120/2011 T X oiM• AND EMPLOYEW LIABILITY WC 7157915 ANY FROPRIETORIPARTHARWrRUVW9 E El BACM ACCIDkMT 3 OPFICl"Rmagpt"puiEww N N!A 11000,000 1lhnd=ry In NN) @.L,DISEASE•FA EMPLOYE $ 0 y".Oawbe Uftw r ('' GIL.D18EASe•POUCY LIMIT t 1 1 DESCRIPTION GP&M*AIMI r LOtJ W"B r VMCLES(Atf=h ACOW IOI,AddhkwMl RNiMnu schodul.,a mow epaea k ralobad) JOSHUA DOUGHERTY IS COVERED UNDER THE WORKERS COMPENSATION POLICY. CERTIFICATE HOLDER CANCELLATION Pleasanlwood Homes LLC SHOULD ANY or TNH Aeeve OewwaEe POLICIEe red cnNCELLED sEFORe THE &NPUTAMON pATE THERROI,NOTME MILL HE DRLN11110 IN A"WMANCy VAT"THE Don Masters POLICYPROVISIM, 133 Falmouth Rd#I A en¢ee TA Mashpae MA 02649 ©198&.2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo registered,marks of ACORD TOTAL P.01 Pagel Pnta.n6-181t81 GaudreauftHartgage 5084197393 Massachusetts Workers' Compensation Insurance Plan Acadia Insurance Company Administered by Berkley Risk Administrators Company, LLC PO Box 1100,.Mpls, MN 55440-1100 222 S 9th St, Mpls, MN 55402 Acadia Insurance' Phone(605)945-2144 Fax (866) 215-8118 Toll Free(800)634-4589 NCCI Carrier Code 33301 CERTIFICATE OF INSURANCE 1. The Insured: WCLF Policy Number: WC-20-20-000024-03 Marcos DaSilva Tax ID#: F 02-0861195 dba: Top Quality Painting and Beyond 7 Webquish Lane Policy Period: From: 2/22/2010 Mashpee,MA 02649 To: 2/22/2011 Date of Mailing:5/26/2010 The 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 Policy listed below. This is to certify that the Policy of Insurance described herein has 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 Policy described herein is subject to all the terms, exclusions and conditions of such Policy. 1 1' tme ase ,i a�' 0y, 11, sa. ,..11 r11,11T t'>,4�' ~ 5��., e',!t ik..m'�n'!»A4'' �,1, $�� �"� Coverage- ,..,... t _ Part One State(s) Workers'Compensation Statutory MA Part Two Bodily In/ury byrAoadeat—{n$1,00 000, each accident Bodily In __:.._... _._.__ Employers'Liability ,/ jury by Disease $500,000 policy limit. Bodily Injury by Disease $100,000 each employee. Should any of the above described policies be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. All Entities/Insureds: Certificate Holder's Name and Address: DaSilva -Election Election Pleasantwood Homes Category Status Name 10 Pleasantwood Dr Sole Proprietor Include Marcos DaSilva Forestdale, MA 02644 Date Issued: 5/26/2010 Peters Paul Agency Inc 680 Falmouth RD Mashpee, MA 02649 BA 3140 , k. CERTIFICATE OF LIABILITY °" °°'YY � ILITY INSURANCE PRODUCER (508)428-1943 FAX: (508)420-4474 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION William Palumbo Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4527 Falmouth Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Cotuit MA 02635 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:Travelers Indemnity Company 25658 PRIDE FLOORING INC. INSURER B:Safety Insurance Company 39454 P 0 BOX 1497 INSURER C:Hartford Ins Co 19682 INSURER D: COTUIT MA 02635 INSURER E: 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 OFSUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADD'LTR R� TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE IMMIDDIYYYY) GENERAL LIABILITY _ EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY _ DAMAGE TO RENTED _ PREMISES Ea occurrence $ 300,000 A CLAIMS MADE a OCCUR 6805827N344 6/13/2010 6/13/2011 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO LOC - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ B ALL OWNED AUTOS 6210286 8/1/2010 8/1/2011 BODILY INJURY X SCHEDULED AUTOS (Per person) $ 250,000 X HIRED AUTOS BODILY INJURY $ 500,000 X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) $ 100,000 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ C WORKERS COMPENSATION X WCSTATU- OTH AND EMPLOYERS'LIABILITY YINORY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? - (MandatoryinNH) y 08WEAA1930 6/15/2010 6/15/2011 E.LbISEASE-EAEMPLOYE $ 500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION (5O8)477-1500 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN PleasarltWOOd Homes NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 10 Pleasantwood Dr. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Forestdale, MA 02649 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE J LaRocca, Sr/SROGER " ACORD 25(2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(200901).Ol The ACORD name and logo are registered marks of ACORD ACORa® CERTIFICATE F DATRtMMIDDIYYM %- , O LIABILITY INSURANCE 8/2/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certlflcats holder Is an ADDITIONAL INSURED,the pollcy(Ise)mint be endorsed. If SUBROGATION IS WAIVED,subject to the terns and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certlflcate holder In lieu of such endorsemen e. I PRODUCER CO Suzaane Harrington,NAME gton, CIC Murray & MacDonald Ineuranae services, Inc. PHONE MI, ('S09)540-2400 P (sea)xev-a111 40. 550 MacArthur Blvd. A IL aharrington@mmesi.coon PRoouc! p0034915 Bourne MA 02532 INSURER B AFfORDiNO COVERA09 NAIL @ WeUPAD WSURERA.Travelers Indemnity Co. Of 25666 iNsuRaRe.Liberty Mutual Ins Co IMNNETH F. BRAGA JR & KATHLEEAND AS PER IL T8 INSURER C: P.O. BOX 440 INOURIIR0! INSURER E WEST FALMOVTH MA 02574 INSURER COVERAGES CERTIFICATE NUMBER*Uttar 10-11 REVISION NUMBER: 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 8Y PAID CLAIMS. W R TYPE Of INSURANCE AJ=UULGUURPOLICY EFF POLICY EXp UMITs POUCYNUaBIR GENERAL LIABILITY IMMMONYYYI EACH OCCURRENCE s 1,000 000 X COMMERCIAL GENERAL LIABILITY a 300,000 A CLAIMS-MADE I X I OCCUR i6802593301A /4/2010 /0/2011 MED ExP one n S 5,000 PERSONAL&ADV INJURY s 1,000,OQ GENERALAGCREGATE S 21000,000 GERL AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMPIOP AGG a 2,000,000 7X P POLICY 0 LOC a AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ' a ANY AUTO (Ea eaaident) ALL OWNED AUTOS BODILY INJURY(Per person) S SCHEDULED AUTOS BODILY INJURY(Per @=Merit) a HIRED AUTOS (Pet PERRY DAMAGE S NONAWNEO AUTOS s a i UM8R9W A LIAR OCCUR EACH OCCURRENC! a Exesss LLAe HCLAIMS-MADE AGGREGATE 0 DEDUCTIBLE a RETENT N , B WORIMRB COMPENSATION VNC TATU- DTI+ AND EMPLOYERS'UABIUTY ANY PROPRIETORIPARTNERIEXECUTIYEOFPICEMEM E,L,EACH ACCIDENT a 1OO 000 (MwAnioryIn ER EXCLUDED? u NIA 2315342847010 /1/2010 7l/2011 (rI@IwfNdry 1@ NH) E.L.DISEASE.EA EMPLOYE • 100 � Vim dowitA undr DE RIPTION Of OPERATIONS below E.L.DISEASE•POI LIMB B 5 00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ABeeb ACORD 101,AEdU@rw Remark@ Schedule,R mare specs is ti4Wmd) CERTIFICATE HOLDER CANCELLATION (774)238-4869 SHOULD ANY OF THE ABOVE DE8CRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Pleasant Wood Homes 133 Falmouth Road Maehpee, MA 02 64 9 AUTHORIZED REPRESBNTATNE S Harrington, CIC/Stlate'� ACORD 26(2000109) 01998.2009 ACORD CORPORATION, All rights reserved. INS0261zo m) The ACORD name and logo are registered marks of ACORD 2010-08-0215:39 Cataumet HA 5085635587 Page 1 CERTIFICATE OF LIABILITY INSURANCE 112/0712010 DA�(� TH18 CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW_ 11 CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING (NSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER_ • hOkW It an ADDITIONAL INSURED, the must be e , au to the tsnma and condt8ons of the PWICy, Contain POlkles may PsquIm on sndomement, A ststafmd on thIS certlNcat• dose not Confer fights to the Csttlficate h*Wr In Ilsu of sYCh endomemenl(s►. PRODUCER GLAIR ACENCY, INC. MNMC lay SOUTH t�1IN $T AfC. Ertl soa-g66-9150 p�Ne�508-866-5334 . AODRlSe: CARVER, NA 02330 WaTOItER®!: . f WF04S)AFFORDMCOVeRAOE NALCi 9iRI1RE0 - NORTHWOOD Lh=SCApB,INC. INIIIJIERAFARM FAMILY CASUALTY INSURANCE OCHPAM DER B: 30 JEAIt11E'S ifAY -- INSURER C c PORESTDALE, 401E 02644-1115 v: IN>uftRE: 1HeURER i: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED B LOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED_ N07W IMTAMING ANY REQUIREMENT_ TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WRFI RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN iS SUMC7 TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF NOR MIME NINA WVD PoLLCY NUMBER D,ryYYYI ("Morro" ~LIMfrB agNERAL LUBRnY EACHOCCURRENCE b 1,000,000 A X COYMERCCIALLOENERA.L"tRr 2001X0514 1041'13/201004/13/2011 UMMf r1UVERTE[F _ CtlulsMwE OCCUR uEDEXP(AgemPwu,) i 5,000 I PERSONAL a A!M wjw Y —T s INCLUDED GENERAL ACOWGATE E 2,000,000 4EN1 AGGREGATE LIMIT APPLtEB PER: PRODUCTa-COMPIOP AW a 2,000,00 0 POLICY JECT LOC I AUTOMOBILE LIADJUTY �C�OaNMw W`LE LimIT s AWAUTO 2002CA1471A 07/28/201 07/28/2011L A X ALLowNEOAUTos IsoDllvlruuRv(PatPww) = 500,000 SOORYINJURVtPeraamwo T 1,000,000 SCHEDULED AUTOS PROPERTY DAMAGE 1 100,000 X HIRED AUTO$ (pwwd" X NON.OWNEO AUTOS : UMBRELLA LIAO OCCUR I EACH OCCURRENCE j EXCERR LIAB CLAIMS-MADE - - ADORt oATE f .......-,._W., .. OEDICTIBLE RETENTION is : 1Nwe"COMPEnB Mu - TORY TA% E ER AND EIIpLOYER8'UADUiY IA IAWnPRCoLRnT�ECUTNE rY—'"t MIA 200IW6490 11/10/201 11/18/2011 E.L.EACH ACCIDENT E 500,000 �REXCLUDED? i , —_-- Me"rY(NNII! L'" E.L.DISEASE-eAEMPL*YEP s 500,000 DESCRIPTLON OF OPERATIONS OWw EA.DISEASE-POLICY UMIT 1 500,000 nE9CRID'rON or opwA7 ONa I L.ocAnow I veam"(Aemen AOom lot,Add *"j RwAAcF aeNa a,it men♦pFa a++OuMal OPERATIONS PBRFOMM BY RAtd6D IRSO100 t M MLVnJX HAS SEEN F. WDED FROM THE 11sp IRS' COMPENSATION POLICY CERTIFICATE 14OLDER CANCELLATION PI-EAS UPZROOID SONXB 133 FALMOUTH ROAD, wno 1 STE D SHOULD ANY OF THB A60VE 0MCRM0 POLICIES BE CANCFLLlO BEFORE TM EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SACK PLACE ACCORDANCE WITH THE POLICY PROVISIONS. MASBPER, MA 02649 lNTATN! 774-238-4869 "- - Vv Is86- •ACORO CORPORATION. All Flgma"OMM r ACORD 26(2009109) Tho ACORD t ufm and I o are tegtstered maft Of ACORD 2010-12-0717:28 FARM.FMLY INS Page 2 r "` o1.►~sachu ett: - Depztrt nen( rrt•Pul)ri(: Safety Bikal'lI O Btfil Iin� Rc.!nrlatiurls anl!Sraull,ll-11 Construction Supervisor License -` - -- One-and TWo_Family Dwellings License: Cs 62820 DANIEL E MARSTERS 10 PLEASANTWOOD DR FORESTDALE, MA 02644 . ` Expiration: 6/10/2012 (,nffffi"inier ' 1'r=: 28385 �dpTHE r Town of Barnstable ` Regulatory Services` •, .. BARNSTARLM ` Thomas F. Geiler,Director Building Division F. Tom Perry,Building Commissioner. 200 Main Street,Hyannis,MA 02601 www,town.barnstabl e.ma.us' Office: 508-862-4038 s' ` ` Fax: 508-790-6230 ;Property Owner Must Complete and Sign This Section { If Using ABuilder MQ rs�. , as,`Ov iner-d the',subject property hereby authorize �JG, to act on my behalf, in all matters relative to'work authorized by this building permit application for.*, s Yd Pi.. �c, .. TI �. -- (Address of Job) //04 Sig e of Oviner nate ; Print Name - k If Property Owner,is applying for4pernit.please complete.,the Homeowners License.Exemption,Fonn on the reverse side. - (1•IIRDAf C-(l Ul•IJ 1:DP1:T2 MTf.CCTfTN - - ,,,, 4 Town of Barnstable ofSHe tp� Regulatbry Services �P o aAxrtsrwstE Thomas F.Geiler,Director MAR& Building Division �TED '�a Tom Perry,Building Commissioner 200 Main Street; Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508=790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINMON OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling, attached'or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a for-in acceptable to the Building Official,that he/she shall be responsible for all such work performed under the-building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMOVPNER'S EXEMPTION The Cade states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licertsing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that.they arc assuming the responsibilities of a supervisor(see Appendix Q. Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. in this case,our Board cannot prococd against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To cnstrre'the I the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner ca'tify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by. several towns. You may care t amend.and adopt such a fomv'certifrcation for use in your community. rl•fnrme•t.n,+.�.+.mnt i The Commonwealth of Massachusetts,William Francis Galvin - Public Browse and Search Page 1 of 1 ,. The Commonwealth of Massachusetts S.• " "William Francis Galvin Secretary of the Commonwealth,Corporations Division x One Ashburton Place,17th Floor Boston,MA 02108-1512 Telephone:(617)727-9640 '0 PLEASANTWOOD HOMES,LLC Summary Screen 11u1;,a worn, Request a Certificate The exact name of the Domestic Limited Liability Company'(LLC): PLEASANTWOOD HOMES,LLC• Entity Type: Domestic Limited Liability Company(LLCl Identification Number: 202505905 Old Federal Employer Identification Number(Old FEIN): 000891130 Date of Organization In Massachusetts: 03/17/2005 The location of its principal office:No.and Street: 10 PLEASANTWOOD DR. City or Town: FORESTDALE State:MA Zip:,02644 Country:USA If t and Street: business entity Is organized wholly to do business outside Massachusetts,the location of that office: If t City or Town. State: Zip: Country: The name and address of the Resident Agent Name: DANIEL E.MARSTERS No.and Street: 10 PLEASANTWOOD DR. City or Town: FORESTDALE State:MA Zip: 02644 Country:USA The name and business address of each manager. Title Individual Name Address(no PO Box) First,Middle.Last,Suffix _ Address,City or Town,State,Zip Code MANAGER DANIEL E MARSTERS - 10 PLEASANTWOOD DR. - FORESTDALE,MA 02644 USA- - The name and business address of the person in addition to the manager,who is authorized to execute documents to be filed with the Corporations Division. Title Individual Name Address(no PO Box) First,Middle,Last,Suffix _ Address,City or Town,State,Zip Code SOC SIGNATORY DANIEL E.MARSTERS 10 PLEASANTWOOD DR. FORESTDALE,MA 02644 USA The name and business address of the person(s)authorized to execute,acknowledge,deliver and record any recordable instrument purporting to affect an Interest in real property Title Individual Name Address(no PO Box) First,Middle.Last,Suffix Address,City or Town,State,Zip Code_ REAL PROPERTY - DANIEL E.MARSTERS - 10 PLEASANTWOOD DR. FORESTDALE,MA 02644 USA Consent . Manufacturer _ Confidential Data Does Not Require Annual Report _ Partnership Resident Agent for Profit Merger Allowed _ g Select a type of filing from below to view this business entity filings: ALL FILINGS Annual Report Articles of Entity Conversion ' Certificate of Amendment J Certificate of Cancellation ! View Filings r I New Search Comments. 0 2001-2011 Commonwealth of Massachusetts - All Rights Reserved Help http://corp.sec.state.ma.us/corp/corpsearch/Corp Search Summary.asp?ReadFromDB=True... I/10/2011 , Libeyy`..}t The Ohio Casualty Insurance Company MU1U 9450 Seward Road,Fairfield,Ohio 45014 Bond# 5094239 BOND KNOW ALL MEN BY THESE PRESENTS: That we Pleasantwood Homes,LLC 10 Pleasantwood Drive Forestdale MA 02644 Street Address City State ZIP Code (Full Name[top line]and Address[bottom line]of Principal) (hereinafter called the Principal) as Principal, and , The Ohio Casualty Insurance Company with principal offices at Hamilton, Ohio(hereinafter called the Surety)as Surety,are held and firmly bound unto Town of Barnstable,Building Dept 200 Main Street Hyannis MA 02601 Street Address City State ZIP Code (Full Name[top line]and Address{bottom line]of Obligee) (hereinafter called the Obligee),in the penal sum of Three hundred thirty-two (Dollars)$ 332.00 for the payment of which well and truly to made, we do hereby bind ourselves, our heirs. executors, administrators, successors and assigns,jointly and severally,firmly by these presents. WHEREAS,the Principal has made or is about to make application to the Obligee for a Permit for 240 Pheasant Hill Circle,Cotuit,MA 02635 for a term beginning on January l 1,2011 and ending on* January 11,2012 (*strike out if license or permit is for an indefinite term) NOW,THEREFORE,if the Principal shall indemnify the Obligee against any loss directly arising by reason of failure of said Principal to comply with the laws or ordinances under which said license or permit is granted, or any lawful rules or regulations pertaining thereto, then this obligation shall be void;otherwise to remain in full force and effect. PROVIDED,HOWEVER,AND UPON THE FOLLOWING EXPRESS CONDITIONS: 1. This bond shall be and remain in full force during the term of said license or permit unless canceled in accordance with paragraph 2 below; but if said license or permit was issued for a specific term, and is renewed for one or more specific terms, this bond will be extended to cover such additional term(s) upon the execution by the Surety of a Continuation Certificate, provided such certificate is acceptable to the Obligee. In no event , however, shall the liability of the Surety be cumulative from year to year or from period to period,nor exceed the penal sum written in this first paragraph of this bond. 2. The Surety shall have the right to terminate its liability by notifying the Obligee in writing ten(10)days in advance of its intention to do so. SIGNED,SEALED AND DATED Pleasantwood Homes,LLC By. ZZ 7 Principal The Ohio Casualty Insurance Company' =�' 'y s By. 'Attorney-in-Fact' S-3853 License or Permit Bond (Unnumbered) Principal: Pleasantwood Homes,LLC POWER OF ATTORNEY POA Number: 40-463 THE OHIO CASUALTY INSURANCE COMPANY Obligee: Town of Barnstable,Building Dept WEST AMERICAN INSURANCE COMPANY Bond Number: 5094239 Know All Men by These Presents:THE OHIO CASUALTY INSURANCE COMPANY,an Ohio Corporation,and WEST AMERICAN INSURANCE COMPANY,an Indiana Corporation pursuant to the authority granted by Article III,Section 9 of the Code of Regulations and By-Laws of The Ohio Casualty Insurance Company and West American Insurance Company do hereby nominate,constitute and appoint: Mark McCartin,Robert W.Miller,Kelly C.Bolton or Martha A.Kenney of Hyannis,Massachusetts its true and lawful agent (s) and attorney(s)-in-fact, to make, execute, seal and deliver for and on its behalf as surety, and as its act and deed any and all BONDS, UNDERTAKINGS, and RECOGNIZANCES, not exceeding in any single instance ONE MILLION ($1,000,000.00) DOLLARS, excluding, however, any bonds) or undertaking(s)guaranteeing the payment of notes and interest thereon. And the execution of such bonds or undertakings in pursuance of these presents,shall be as binding upon said Companies,as fully and amply,to all intents and proposes,as if they had been duly executed and acknowledged by the regularly elected officers of the Companies at their administrative offices in Fairfield,Ohio,in their own proper persons. The authority granted hereunder supersedes any previous authority heretofore granted the above named attomey(s)-in-fact. In WITNESS WHEREOF,the undersigned officer of the said The Ohio Casualty Insurance Company and West American Insurance Company has hereunto subscribed his name and affixed the Corporate Seal of each Company this 7th day of January,2008 `SY INSUQ NINSU (z� Y' �cF 4r�, `ctl` IrLYY� SEAL Sam Lawrence Assistant Secretary ° �; a SEAL ;; STATE OF OHIO, COUNTY OF BUTLER On this 7th day of January,2008 before the subscriber,a Notary Public of the State of Ohio,in and for the County of Butler,duly commissioned and qualified,came Sam Lawrence,Assistant Secretary of The Ohio Casualty Insurance Company and West American Insurance Company,to me personally known to be the individual and officer described in,and who executed the preceding instrument,and he acknowledged the execution of the same,and being by me duly sworn deposes and says that he is the officer of the Companies aforesaid,and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies,and the said Corporate Seals and his signature as officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed my Official Seal at the City of Hamilton,State of Ohio,the day and yearQ first above written. `�qIW alnhl/Q, �/R,e `�.io�pJ►t tt,/�� �¢.t,yQ � q�q,�J 3 0 0 0 * * 9 Notary Public in and for County of Butler,State of Ohio My Commission expires August 5,2012 This power of attorney is granted under and by authority of Article III,Section 9 of the Code of Regulations and By-Laws of The Ohio Casualty Insurance Company and West American Insurance Company,extracts from which read: Article III,Section 9. Appointment of Attomeys-in-Fact. The Chairman of the Board,the President,any Vice-President,the Secretary or any Assistant Secretary of the corporation shall be and is hereby vested with full power and authority to appoint attomeys-in-fact for the purpose of signing the name of the corporation as surety to,and to execute,attach the seal of the corporation to,acknowledge and deliver any and all bonds,recognizances,stipulations,undertakings or other instruments of suretyship and policies of insurance to be given in favor of any individual,firm,corporation,partnership,limited liability company or other entity,or the official representative thereof,or to any county or state,or any official board or boards of any county or state,or the United States of America or any agency thereof,or to any other political subdivision thereof This instrument is signed and sealed as authorized by the following resolution adopted by the Boards of Directors of the Companies on October 21,2004: RESOLVED,That the signature of any officer of the Company authorized under Article III,Section 9 of its Code of Regulations and By-laws and the Company seal may be affixed by facsimile to any power of attorney or copy thereof issued on behalf of the Company to make,execute,seal and deliver for and on its behalf as surety any and all bonds,undertakings or other written obligations in the nature thereof;to prescribe their respective duties and the respective limits of their authority;and to revoke any such appointment. Such signatures and seal are hereby adopted by the Company as original signatures and seal and shall,with respect to any bond,undertaking or other written obligations in the nature thereof to which it is attached,be valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATE I,the undersigned Assistant Secretary of The Ohio Casualty Insurance Company,American Fire and Casualty Company and West American Insurance Company,do hereby certify that the foregoing power of attorney,the referenced By-Laws of the Companies and the above resolution of their Boards of Directors are true and correct copies and are in full force and effect on this date. IN WITNESS WHEREOF,I have hereunto set my hand and the seals of the Companies this day of `SY INSU NINSU i���A��'�F• ct n 13. SEAL ;� W; SEAL . Mark E.Schmidt Assistant Secretary ,a REScheck Software Version 4.4.1 Compliance Certificate Energy Code: 2009 IECC Location: Barnstable,Massachusetts Construction Type: Single Family Building Orientation: Bldg.faces 180 deg.from North Conditioned Floor Area: 1640 ft2 Glazing Area Percentage: 10% Heating Degree Days: 6137 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: 240 Phesant Hill Cr. Pleasantwood Homes Cotuit,MA Compliance:3.0%Better Than Code Assembly 'Area or R-Value R-'Value or •.. Perimeter U-Factor Ceiling 1:Flat Ceiling or Scissor Truss 1640 38.0 0.0 49 Wall 1:Wood Frame, 16"o.c. 416 20.0 0.0 20 Orientation:Front Window 1:Vinyl Frame:Double Pane with Low-E 54 0.320 17 SHGC:0.55 Orientation:Front Door 1:Glass 20 0.330 7 SHGC:0.55 Orientation:Front Wall 2:Wood Frame, 16"o.c. 458 20.0 0.0 26 Orientation:Left Side Window 2:Vinyl Frame:Double Pane with Low-E 12 0.320 4 SHGC:0.55 Orientation:Left Side Wall 3:Wood Frame, 16"o.c. 464 20.0 0.0 24 Orientation:Back Window 3:Vinyl Frame:Double Pane with Low-E 28 0.320 9 SHGC:0.55 Orientation:Back Door 2:Glass 32 0.340 11 SHGC:0.55 Orientation:Back Wall 4:Wood Frame,16"o.c. 288 20.0 0.0 15 Orientation:Right Side Window 4:Vinyl Frame:Double Pane with Low-E 12 0.320 4 SHGC:0.55 Orientation:Right Side Door 3:Solid 20 0.330 7 Orientation:Right Side - Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 1640 30.0 0.0 54 Furnace 1:Forced Hot Air 85 AFUE Air Conditioner 1:Electric Central Air 13 SEER 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 20091ECC requirements in REScheck Version 4.4.1 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Project Title: Report date: 01/04/11 Data filename:C:1Documents and SettingslJoyce\My DocumentslREScheck1240 pheasanthill cr..rck Page 1 of 5 REScheck Software Version 4.4.1 Inspection Checklist Ceilings: ❑ Ceiling 1:Flat Ceiling or Scissor Truss,R-38.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame,16"o.c.,R-20.0 cavity insulation Comments: ❑ Wall 2:Wood Frame,16"o.c.,R-20.0 cavity insulation Comments: ❑ Wall 3:Wood Frame,16"o.c.,R-20.0 cavity insulation Comments: ❑ Wall 4:Wood Frame,16"o.c.,R-20.0 cavity insulation Comments: Windows: ❑ Window 1:Vinyl Frame:Double Pane with Low-E,U-factor:0.320 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 2:Vinyl Frame:Double Pane with Low-E,U-factor.0.320 For windows without labeled U-factors,describe features: #Panes_Frame Type Thermal Break? Yes—No Comments: ❑ Window 3:Vinyl Frame:Double Pane with Low-E,U-factor:0.320 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 4:Vinyl Frame:Double Pane with Low-E,U-factor.0.320 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door 1:Glass,U-factor:0.330 Comments: ❑ Door 2:Glass,U-factor:0.340 Comments: ❑ Door 3:Solid,U-factor:0.330 Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-30.0 cavity insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. Heating and Cooling Equipment: e r Project Title: Report date:01/04/11 Data filename;C:\Documents and Settings\Joyceft Documents\REScheck\240 pheasanthill cr..rck Page 3 of 5 ❑ Furnace 1:Forced Hot Air:85 AFUE or higher Make and'Model Number: ❑ Air Conditioner 1:Electric Central Air:13 SEER or higher Make and Model Number: Air Leakage: ❑ Joints(including rim joist junctions),attic access openings,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed with caulk,gasketed,weatherstripped or otherwise sealed with an air barrier material,suitable film or solid material. ❑ Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubs/showers,and in openings between window/door jambs and framing. ❑ Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. ❑ Wood-buming fireplaces have gasketed doors and outdoor combustion air. Air Sealing and Insulation: ❑ Building envelope air tightness and insulation installation complies by either 1)a post rough-in blower door test result of less than 7 ACH at 33.6 psf OR 2)the following items have been satisfied: (a)Air barriers and thermal barrier:Installed on outside of air-permeable insulation and breaks or joints in the air barrier are filled or repaired. (b)Ceiling/attic:Air barrier in any dropped ceiling/soffit is substantially aligned with insulation and any gaps are sealed. (c)Above-grade walls:Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier. (d)Floors:Air barrier is installed at any exposed edge of insulation. (e)Plumbing and wiring:Insulation is placed between outside and pipes.Batt insulation is cut to fit around wiring and plumbing,or sprayed/blown insulation extends behind piping and wiring. (f)l Comers,headers,narrow framing cavities,and rim joists are insulated. (9)Shower/tub on exterior wall:Insulation exists between showers/tubs and exterior'wall. Materials Identification and Installation: ❑ Materials and equipment are installed in accordance with the manufacturer's installation instructions. ❑ Insulation is installed in substantial contact with the surface being insulated and in a manner that achieves the rated R-value. ❑ Materials and equipment are identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. ❑ Insulation R-values,glazing U-factors,and heating equipment efficiency are clearly marked on the building plans or specifications. Duct Insulation: ❑ All ducts not completely inside the building envelope are insulated to at least R-6. Duct Construction and Testing: ❑ Building framing cavities are not used as supply ducts. ❑ All joints and seams of air ducts,air handlers,filter boxes,and building cavities used as return ducts are substantially airtight by means of tapes,mastics,liquid sealants,gasketing or other approved closure systems.Tapes,mastics,and fasteners are rated UL 181A or UL 181 B and are labeled according to the duct construction.Metal duct connections with equipment and/or fittings are mechanically fastened.Crimp joints for round metal ducts have a contact lap of at least 1 1/2 inches and are fastened with a minimum of three equally spaced sheet-metal screws. Exceptions: Joint and seams covered with spray polyurethane foam. Where a partially inaccessible duct connection exists,mechanical fasteners can be equally spaced on the exposed portion of the joint so as to prevent a hinge effect. Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g.(500 Pa). ❑ Duct tightness test has been performed and meets one of the following test criteria (1)Postconstruction leakage to outdoors test:Less than or equal to 131.2 cfm(8 cfm per 100 ft2 of conditioned floor area). (2)Postconstruction total leakage test(including air handler enclosure):Less than or equal to 196.8 cfm(12 cfm per 100 ft2 of conditioned floor area)pressure differential of 0.1 inches w.g. P)Rough-in total leakage test with air handler installed:Less than or equal to 98.4 cfm(6 cfm per 100 ft2 of conditioned floor area) when tested at a pressure differential of 0.1 inches w.g. (4)Rough-in total leakage test without air handler installed:Less than or equal to 65.6 cfm(4 cfm per 100 ft2 of conditioned floor area). Temperature Controls: Project Title: Report date: 01/04/11 Data filename:C:1Documents and SettingslJoycelMy DocumentslREScheck1240 pheasanthill cr..rck Page 4 of 5 At least one programmable thermostat is installed to control the primary heating system and has set-points initialized at 70 degree F for the hedting cycle and 78 degree F for the cooling cycle, Heating and Cooling Equipment Sizing: Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial Building Mechanical and/or Service Water Heating(Sections 503 and 504). Circulating Service Hot Water Systems: Circulating service hot water pipes are insulated to R-2. Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3. Swimming Pools: ij Heated swimming pools have an on/off heater switch. Pool heaters operating on natural gas or LPG have an electronic pilot light. Timer switches on pool heaters and pumps are present. Exceptions: Where public health standards require continuous pump operation. Where pumps operate within solar-and/or waste-heat-recovery systems. Heated swimming pools have a cover on or at the water surface.For pools heated over 90 degrees F(32 degrees C)the cover has a minimum insulation value of R-12. Exceptions: Covers are not required when 60%of the heating energy is from site-recovered energy or solar energy source. Other Requirements: Snow-and ice-melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting off the system when a)the pavement temperature is above 50 degrees F,b)no precipitation is falling,and c)the outdoor temperature is above 40 degrees F(a manual shutoff control is also permitted to satisfy requirement V). Certificate: A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window U-factors;type and efficiency of space-conditioning and water heating equipment.The certificate does not cover or obstruct the visibility of the circuit directory label,service disconnect label or other required labels. NOTES TO FIELD:(Building Department Use Only) Project Title: Report date: 01/04/11 Data filename:C:\Documents and.Settings\Joyce\My Documents\REScheck\240 pheasanthill cr..rck Page 5 of 5 I 2009 IECC Energy Efficiency Certificate Ceiling/Roof 38.00 Wall 20.00 Floor/Foundation 30.00 Ductwork(unconditioned spaces): Window 0.32 0.55 Door 0.34 0.55 "PRIA Forced Hot Air Furnace 85 AFUE Electric Central Air Conditioner 13 SEER Water Heater. Name: Date: R Comments: rs _ 110. MPH EXPOSURE B WIND ZONE F� Checklist , 1.1 SCOPE Wind Speed(3-second gust)......................... ....--110 mph ✓ Wind Exposure Category................................. .................B ✓ 1.2 APPLICABILITY . Number of Stories ...............................................:.............`(Figure 2 ............ g )' —1—st stories ✓ Roof Pitch ................ ........... . ... (Figure 19) .................... 8' 12:12 ✓ Mean Roof Height ...................:......................... - •..-.......�.....(Figure 2) _22 ft, <33' film Building Width,W ...............................................................(Figure 4) ..........46 ft <g . Building Length, L ................................... (Figure 4) ...... '...... .._...... . ft. 0 ✓ .... ... ........ <80' Building Aspect RatioiL/W) ...............................................(Figure.4) •63:0:1 ...... 1.3 FRAMING CONNECTIONS General compliance with framing connections?.................. (Table 2) 2.1 ANCHORAGE TO FOUNDATION Type of Foundation.............................................................. 5) GoUc(LET e ✓ .................. ................................. Foundation Anchorage Proprietary Connectors Uplift....................................................................... (Table 3) U_2 I-plf ✓ ............................:........ Lateral.....................................................................(Table 3) =:L3Z p lf Shear..............:............:.....:.......:.............:......:......: (Table 3) S 352 plf ✓ ............................. 5/8"Anchor Bolts Bolt Spacing................... (Table 4) .me �" . ...... . ....... . ..................... 5/ ✓ Bolt Embedment..................................... .(Figure 5) G Washer Size...........................................................(Figure 5) 3 in. x 3 in. x in.thick ✓ 3.1 FLOORS Floor framing member spans checked?.............................. (/RC or WFCM) �/ 0 Maximum Floor Opening Dimension................: . (Figure 6)................................... g ft: <_ 12' ✓ I . ............. .. Maximum Floor Joist Setbacks M Supporting Loadbearing Walls or Shearwall.................. (Figure 7).......................................83 <d 0 Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall.................(Figure 8)................... . _ Floor Bracing at Endwalls.................................................:.... (Figure 9)................................................... Floor Sheathing Type..........................................................{!RC or WFCM •.GDX T Floor Sheathing Thickness................: ::...- (!RC or WFCM Floor Sheathing Fastening (Table 2) 4.1 WALLS Sd';Gpr-�MON (o �J7yE �IZ`i1�R D Wall Height _ Loadbearing Walls......................................................... (Figure 10) ft. < 10' Non-Loadbearing Walls...............`...................... (Figure 10) I�ft. 20' Wall Stud Spacing................................... ........... (Figure 10) ....j( in. 24"o.c. ✓ ................. ............. Wall Story Offsets..................................... .......... (Figures 7-8) O in. <d 4.2 EXTERIOR WALLS Wood Studs Loadbearing Walls..................................... (Table 5) 2 9 ft. Non-Loadbearing Walls...................... (Table 5) 11 _-AZ.....................2x -_ft. 5_in. ~ 110 MPH EXPOSURE 8 WIND ZONE Bracing Gable End Walls VVSP Attic Floor Length.................................................. 11)--------.-. Gypsum Ceiling Length.................................................(Fig ,e11)---_-----' Doub�Top P�t» ' � ---- 8pUceLenQ�------.-_--.-'_._--.—_-(�guns13)-----_-------- ft. Splice�o�e�n ��� 18dm��o nails) �a�e�� -- ,.~ =^," . n /----'' '---.----.-----''---.Zo Loadboahng Wall Connections � Uplift. connectors) .-----.-.---,-_.(Table 7)...................................... Lateral (no.o/1mu common nails) ................................(Table 7).--...-.---.-----.� ---- mConnections ---- Wpkft. connectors)......................................(Table 8)..................................... / La�ra (noo*16dcomn�onn��)_---._-_-._''�ab�EA._-._-'----_' ---- -� ---' VVmU ' ---- --- ----�- Header Spans . ' ---.---___-'-_-'_-_—''(T�b�9)-'-_-_---. 8.*� i��11' G0pk�eSpans---'''_-.'-------''—.—.��b�B)__-'''—._..-~~-ML i�� 1�� �� -=-- FuU Height Studs (no.of studs).----�'--'—_- ................................................---' -�--' ConnacUonnateaohendofhemdmrnro0 ' -~-- -�-- Uplift. ' (Table .............................................. ` ` ' �3( �z _-,'---, .~.~~.~~'._-''_.---- _--------------__ Lateral �rop�ata�'oonnmotom�-----..----'( ' --- .-----------���-' Wall Sheathing Minimum Building Dimension,VV Sheathing Type......................................................(Table 1O)........... ---...... --.' EdQeNaU Spacing..................................................(Table 1U)....... .--_--.--.- ' Field Nail .......................................---' 1D)------..`_-_. - =-- ShaarConnecUon (no md1GdcomnmonneU�) [ 1O)........(Table .-----.,--_..---.. Mo@Down Cmpacdy .......... _��_ Percent Full-Height Sheathing _L�� Maximum Building Dimension, - Shem0hingType.---...-------------. a11)...................................... Edge NoU8puc�g (Table � --''--------.---_-.. (Fablo11)-.------.---. F��NaU --------------.--. 11)----.----.. ' ' Shear Connaodon�xznd1Gd common naUs ' 11 -'- -^�- ~.~ --..`."=� /---------- -��- Ho�Drwvn '— ' ��vuouy-.-----_.-------..�ab� 11).---.-'---- .Percent Full-Height ' --'-'^=-=~^ rm,np�nmun�eonnQ-.-------_--[7ab� 11)-----_----.--.--.. [�9� CladdingWall . Rated for Wind Speed?......................... _---------'-------'-----'------' ' S.1 ROOFS | Roof framing/nembor spans checked?................................(09CorNFCM)-- - --.--. Roo Overhang I --.----._-.—_-- (F�ure1Q)---- -- ---- .............. / Yi ���orL/3 Truss, I-Joist,cv Rafter Connections atLoadboarngWalls Proprietary.Connector Uplift-......................... .............................................(Table 1O)............�--'_---U Kz Lateral.............................. ........................ --'--(Table 12)............ - L= rp��z -��- Shaar '----- .-�--'_._---___--_----- [7�b� 12) . G Ridge Tension -� ---'---'''—'' , - -----'----''([aU� 13)-----------..]F=Z51pK Gab� RaherQudooker ---' � .----.-.----------.--(F�una��)'------ �� ft.s2'o,i/2 �1�� OudoohmrConnecUonsatNon'LoodbeehngVVa(m ' --- rropnetaryConnectora ' Uplift.-.-----.----------.---.--..- 14).........-.---.--''U 0z I/ L==.wl........................................ -----'.--.. (Tab� 14)---------_''L~ ����x Rmof Type � -^�- °"=�""'y . ---'----.� � . �R�ov � � -----'-'--' ""'C=/-'---'--'-._1~�"��-_' _u�- Roof ShoatMngTh�hnesm h�' .________'_____.__-____.__^___---..��=k��3/8^wop Roof Sheathing~ Fastening __.. �^ �^ � L �� ----- ____________________ _.____ � AMERKCAN WOOD COUNCIL � | � � ' SMOKE DETECTORS EVIE ED --__ —---_-_--- - -- �Wll DA �o -= —_ - FIRE DEPARTMENT DATE __ r RY -- _-- - ======I BOTH SIGNATURES ARE REQUIRED FOR PERMITTING _ _ ASPN.Lr sn • U -� _AWYINUY CIffIFFS•..�.) _ 10� CARBON MONOXIDE ALARMS MUST BE INSTALLED PER GM-X r som MASSACHUSETTS BUILDING CODE 00 - --_ ���� 91T 0.14 OM.DOOR = P l�l IrE w TOMHIEJ RC CI.Y+BDMp 501M0 C'FI SBJ Sd x K-d GNIiRBIIR!TO'/G1NFR EJD'OSURE COLUYN Mm S,ID"FNM DOOR .. - Al FROM DEVAOON O-BASE(iYP.) 'YM10f.Ylf T1RE9NR0 CONC APRON - . FRONT ELEVATION .Asaw�r sNl,.rus /nV' '►dl.1-V 6 PAID .. .. BOXD) DO RIGHT SIDE ELEVATION =c Q Ve.r-o' . ' WNT.NEICE VEW(rnJ d . -M.UN,NUN CURER 6'PATIO 2Ne MSUL CL ax eoxm WN. vm ( (uuwon) ' `w.G SHINCLFS� Y - I61iL GIw4 O.x�••�' REAR ELEVATION SOLE 1/1'.,•�- Br- CONE,PoOOE vEw(TP.) SwNGm - - t. 1 wG SnINGIE$ ® �` LEFT SIDE ELEVATION SCALE:1/4'.V-O' THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) DATA (DEC%) .. ------ -- ID CONC•RUED SON MOM —_—_ 1 -4.O E•u.)BE1Dw r •I i 1 DaoP I I GR.00C FOR ttPf T 1 8-6 g'_6' g•_bn 6- . BN�D I 1 1 _ DROP I I Y-4• r-4• I I t � I a -------� I r I 1-----------------= «UIO aRgl•A ------i r---- .- �y@D, I 1 I , I I I •i Yam. Y-ti• CDWP CrED Ru I I 1 � 1 1 .I L-J. I L_J L J _ L-J I L f/r MIL CONC.Rum 1 Ixsmm4•.l x•co cI= L---------------J I I I I I I - I 1•_3' V-s'(DROP To')-�x'-J' -y '� , 1 a•neat CDNC.SUB ' m I , e•nlNx coNa..u.s `J I i , I i mN'ee Pfg-es NEB co I I o .)--------- --- I b ------------ In•coN Rum T 1 x4•.24"SIT'SONO}UBE n u'-o• 10'-e• . FIOUNDATION P QN 16'-0• I 1 , I 1 I I • I I I I , ( q _ M1 1 A. .R Ct)TR I W µ C.FS wi i anl..eourrc5 -I I Oo.-rt nc.Nt) I a I• - i I' I moo' is 1� rY-0. l4'-d•�'{ ® ® W"H CLOSET M.M. BATH HALF WALL •I IF W/DV GP 3•-d�'-1C Y-0' -0. D•-d• 1. WA L LIEEIRDCI( C i wd 1 I < I �GARAzE'. p•� s' �----J �G F.AT ROOA� - SUB Tti WITH 6adalo Wd'IE ) . CLC= LA.Dw6 .. 4 _ q Y-d" YYYYYaa e 3 e' T Y-d• I•-2- 1 Y--.- NEFD 9'.r G.IE DDDN DEDROO BEDROOM tom l 1 I G..V. Do- $ &COW 42-1 aM - z ____ _ I Sad W.FTEIS PQ DIL 2• 'q . I 3•-d• II'-0' S-d- —'.-0--- .--5'-d- 4•_d•—Jam.•-d• zz-d ID•-d•—� as-d• FIRST Fi OOR PAN SLUE I/a•.I'-O• 1/2'PLYWO00 2at0 RARE2E . 1/2-E>T'.GRI.OE b02 RIDGE - PLYWOOO 12 �1/Y PLYW000 ASP1WLr AOOf SNIRGIE 2XIO RAPIER - °YSpD1 OVER 15 - - RODE FELT ° ,n-EXT.OWE � 12 W. SU O wSPKV r ROOF SMa CIAWSf. RE LA KNEE WALL . ., z.e a�Jr1s srsTEu ovEa,me,aE--_ - 319 . �8 ROOF/FI.r R-M YISLIT - VRFIR-S Ir W/'ROPER :• RRST q.R PUOE M. _ EOWI tal SDUPP . •.. .• ••,,' ••.:-•'•• •.•,'.- 2rB GM RMTERS ' in'EYf.OWE 0� SHEEOiOCK 6 PL e 1 I YWOOD a _LI>v SiRAPP1RG _ SRD 3 W/ ISM B,n¢PAPER a-Ae uDa1L �' TSIDDG AS SPe=EO I ... R snw / -W rho PIYW000 2:10 JOISTS IYa.c _ 1/a-rhG PLYWOOD 1 ARW FR LM __ 2..0 J06I5,C-71 _��- R�(71T.)ETNFEl1 �y ✓r __ - 3G . —a.0 G@DER - t'IIEUE CARD.SUB 1"mm GONG.SUB � CRO .pc. lY.�re.-.'7'�'a°-'C04PACIID SS �3L ON Awn ~L°"COW-,rD W-M SCAM 1/4'.,•-0• CROSS SMON H—B _ SGEE.1/4-.1'-0- r---------------------i i D.UKr GEa mP/ I 1 I Io* Id I I I L P.T.2110 SE AU IJO ND I YW sP _ I I 1 1 y I I 1 � I P.T as - • r----------------- I I 11 11 I -l I D 1 I 1 1 I I 1 11 I I I I L'-----------------1 I 1 1 ,0Y,6• A i 1 I j 1 — — — — — i L--------------------——————— 1 I I --- Nate: DDUaZ Au FLWR.wms UNOEX 00IRW PARi1t,0Ns FIRST FLOOR FR"ING PLAN scue,A•-,'-o• F' 2+,2 PoD.E 1ti AT -oc T I a a 6K CHT a,o aocE i 2n2 R= I TI � S a w IO AT 6' a I I _ I I ROOF FRAMING PLAN 1 A'%Ul Town of Barnstable BARNSTABLE. ` Regulatory Services MARS. p i639 �0 Building Division RFD MA'S s 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection E I�A Location ,--2y0 114EAS#,P-r 14TtL CT-PAPermit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The.following items need correcting: LAWOT" Th &32s�r NCEbs To 9E RkY5ED ✓(�� O A N D f PALS TZ) t)C R'C-TG rZ-N C-D f'NOT 0 PE,�J, Please call: 508-862-4038 for re-inspection. Inspected by Date 1 23 �� I Home Enemy Raters LLC B;('nrrey QgnergyCodeHeIp.com Box 489,E.Sandwich,Ma 02537 888-503-2233 I i I Duct Leakage Test I Address 240 Pheasant Hill Circle Mashpee, MA 02635 Date I January 28, 2013 Contrahtor Quality Mechanical Systems Test Type Post Construction Leakage to Outside4ncludes Air handier/Furnace Conditioned floor area =1680 Sq FT. To comply with Section 403.2.2 Of the 2009 IECC Code in this home the i Maximum duct leakage CFM < 134 CFM (1680/100 x8 = 134) Duct leaks a tested = 28 CFM This Home complies with Section 403.2.2 Of the 2009 IECC Code i TestjMode - Pressurization Test Pressure = - 25.0 Pascals Equi ment - Series B Minneapolis Duct Blaster Duch Leakage as Percentage of Floor area = 1.67% 14 Contact bur officemith any questions, BrucelTorrey, Certified HERS Rater Home �nergy Raters LLC I; I i j a r r Q 83 N 42 E 30 .. =:riback_ttGuirer�enfsw•_---` - 29.7' Lot 26 C, w 9,002tS F. cri CDi O lk � 16.0' O � ( 4 j"1r�/ t W N r i U1� 0 t p 20.0'ca 7.3' 14. �O � Gar. 12.8' �' Exist. Fdn. 12.1' ro EI,=64.9 14.0' � ro i o i 22.0' ro 10.5' 9.0 ! 7 0.0' _ p...— . 22.2' 20.0' 63.42 . L=18•�9' S 83 7 '13 w» R=1 72.42' PHEASANT. HILL CIRCLE STREE-T-ADDRESS.��fF240,PHEASANT_HILL-C/RGL-E—CO-TUl_T ASSESSORS MAP 2 PARCEL 2-26 OWNER: DANIEL MARS7ERS DEED REF.: BK. 24968 PG 272 PLAN REF.:, PL. BK. 617 PG. 73 LOT 26 TOWN OF BARNSTABLE ZONING BY-LAW ZONE : RF I CERTIFY THAT TO THE BEST OF MY PROFESSIONAL SETBACKS : KNOWLEDGE, INFORMATION AND BELIEF THE FOUNDA7ON FRONT = 20, SHOWN HEREON CONFORMS TO THE HORIZONTAL SE7BACKS SIDE = 10' OF THE ZONING BY-LAW FOR THE TOWN OF BARNSTABLE. REAR = 10' -PROPERTY-LINES SHOWN-HEREON' - - �SHOFMASS WERE COMPILED FROM AVAILABLE a�``Y MASS, PLANS OF RECORD AND VERIFIED �° TERRY s� ANN ON THE GROUND. " WARNER N A No.38721 ,act "AS—BOIL T" THE FOUNDATION DEPICTED ON THIS ,/ AL IA S. PLOT PLAN PLAN WAS LOCATED ON THE GROUND IN BY SURVEY ON.APR/L 15, 2011 ani0 EXISTS AS SHOWN AS OF THE DATE l�'I y�� BARNSTABLE, MASS. OF LOCATION. SCALE. 1"-40' APRIL 15, 2011 THIS PLAN IS FOR PLOT PLAN TERRY A. WARNER, P.L.S. PURPOSES ONLY 22 LONG ROAD HARWICH, MA. 02645 (508) 432-8309 7N/S PLAN /S VOID 1F NOT STAMPED AND SIGNED /N RED. 0 20 40 80 PROJECT NO. 10-219AS DWG L_ 07/12/2011 11:19 15089663595 QUALITY INSULATION PAGE 01 •�` �, f �,`.��{� ._�� -taw A�� INSULATION CARD-DO NOT REMOVE BASF Polyurethane Foam Enterprises LLC BASP The Chemical Company 'This form must be filled out and posted to comply with building code and FTC requirements. Meets IRC Section N1101.3.1 requirements. -Please post near electrical panel.""' The following spray polyurethane foam insulation system(s) has been installed. Consult International Building Code,Chap- ter 26-Plastic and International Residential Code(IRC) A318 Foam Plastics for specific requirements. BASF Polyurethane- Foam Enterprises'insulation products conform to Minnesota Insulation Standard program rules 7640.0150. This spray polyurethane foam insulation system has been installed in accordance with manufacturer's processing guidelines to provide a thermal resistance of... area Insulated R-Value Thickness"" floors a R- At inches eilings R- At inches here: Ir St l�� 00lr` ) R- / At 3. inches here: ) R- At inches ver an unheated crawl space) R- At inches ace Perimeter R- At inches t Exterior Walls R- At inches here: ) R- At inches }`Nominal thicknesses are representative of a field,spray-applied foam material. BASF Polyurethane Foam Enterprises Product(s)Installed: Walls: Permeance: perms at "thickness Density: Flame Spread Rating(ASTM E-84): ❑Class 1 (25 or less) ❑Class 2(75 or less) tested at "thickness Other: Permeance: perms at 'thickness Density: Flame Spread Rating(ASTM E-84): ❑Class 1 (25 or less) Q Class 2(75 or less) tested at "thickness Basement Exterior: Permeance: perms at "thickness Density: Flame Spread Rating(ASTM E•94): Not Applicable ----Z ---------------tt------------- ------t---- ----------- ------ Jobsite Location: /7 t�dSQli•`f /T/'G'4 taste Installed: Building Contractor: /'"�'�"u SQ/17�L 4000 V-PS Insulation Contractor: OLI . ! -twS Phone: svoa— !F&4— gs—/U installed By: 66 o "'Caution—No Hot Work-Polyurethane foam is combustible and should be treated as such. No welding or cutting unless foam has been protected from accidental Ignition by open flame.*** INSULATION CARD-DO NOT REMOVE 20*07-1211:15 15089663595 Page 1 07/12/i011 11:19 15089663595 QUALITY INSULATION PAGE 02 INSULATION CARD-DO NOT REMOVE 1 In accordance with the chart below,the spray foam insulation must be installed the minimum thickness for each R-value listed. Closed-Cell Polyurethane(Nominal 2.0 Ib.lcu,ft.density) , Thickness"- Inches %" 1" 1.5" 2" 2.5" 3" 3.5" 4" 4.5" 5 R-Value 3 6 9 12 15 is 21 24 27 30 Thickness"• inches 5.5" 69' 6.5" 7 7.5" 8" 8.5" 9'r 10" 11" R-Value 33 36 39 42 45 , 48 51 54 60 65 "Nominal thicknesses are representative of a field,spray-applied foam material. What You Should Know About R-values These Charl shows the R-value of this insulation.R means resistance to heat flow,The higher the R-value,the greater the insulating power.Compare insulatinm R- values before you buy. There are other factors to consider.The amount of insulation you need depends mainly on the climate you live in.Also,your fuel savings from insulation will depend upon the climate,the type and size of your+rouse,the amount of insulation already in your house,and your fuel use po"ms end family size.It you buy too much insulation,it will cost you more than what you'll save on fuel.To get the marked R-yalue,it is essential that this Insulation be installed properly. BASF Polyrftretime Foam Enterprfees LLC Helping Make 13630 W'atertower Circle Minneappks,MN W47 Buildings Better"'"'' Tel000m:(763)559.3266 Fax.(763)559-0946 www.bast.com/sprety iso 9001:2000 Accredited Facilities--Minaeap01is,MN and Houston,TX 20*07-1211:16 15089663595 Page 2 °FtHE Town of Barnstable ` Regulatory Services BARNSTARLE. ` 9 MASS. 0 i639• �0 Building Division prFD MA'S a 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection 13 �/� Location 1�5j19 eft�-- 5A5V2-t Gc L Permit Number 2-o ! G7® Owner ? ©7t1���' Builder tit n-m 5215:�t S One notice to remain on job site, one notice on file in Building Department. The following items need correcting: P aAdv k,�C- kJ A41Z k4A-TW /Ud 7 �, r �/ tp A- h A- 61 � t k�"z'C�7p IiII �ie_' ct�CE Ctf Ems- 4T tiG . �9L 0111) 6060 G 1ZaiCr),)K— / C1b1577A e Please call: 508-862-40 7for re-ins ectio Inspected by Date / i i g TempParcelEdit Page 1 of 1 m p � y Y, `w „„ ,.a r ... �, ..aa... • -� �'"'Y. Hi'' L Y .� SF _.... �,r Logged In As: Wednesday,January 16 2008 Frank Schlegel New Parcel Application Center Road System Reports Road System The record has been added, New Parcel Detail New Mapparcel: 002 002 026 Street Number: 240 Unit: Dev Lot LOT 26 Road Name: IPHEASANT HILL CIRCLE T/R Sec. Road: �- T/R: Villlage: 07 Cotult mod' Part of M/P: MAP 002 PCL 002 Plan Ref: PLBK 617/69 75 (APP 7 62) Date Added: �� Updated: pdate ®ete AdtlPn®thee t http://issgl2/Intranet/Propdata/TempParcelEdit.aspx?ID=Add 1/16/2008 100 EXISTING CONTOUR _ -- ---"--�, N x 100.46 EXISTING SPOT GRADE C1rc�e d Lot 26 . 55 PROPOSED CONTOUR ; IN LOCUS VEGETATED RAIN GARDEN 58 PROPOSED SPOT GRADE cool o 12" DEEP (125 C.F. STORAGE) S- EXISTING SEWER SERVICE � '� o y 63.23 TOP EL.=56.0 W- EXISTING WATER SERVICE " / X O BOTTOM EL.=55.0 S- a COTUIT ' PROPOSED SEWER SERVICE , / ca oo -W- PROPOSED WATER SERVICE � MEAbOWS 55.60 X 5414 x 54,54 x 55.46 a /tl LEGEND % / V 0 \\\\ ; 59,39 ( I �t� r �O c` Barnstable X 67,1� / // / x ( I /Fj�` a mk5l�0 11 6 oute 2` Mayhpee / I 55,26 / J R 59''99 / STKiNCTCK AND GENERAL NOTES: LOoT TO CUSsCALE MAP I i 833042 EI X 5 61,8 3 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE DESIGN � 96.23' 54 53.49 / ENGINEER./ 0 X 55.75 _ 56 / 1, 2 OFL HOERGENERAL CONSTRUCTIONK AND MATERIALS L CONF OTESOON SOHEET THE CR2QUOF THETS PN �02-01012_ 26 SUBDIVISION CONSTRUCTION PLANS FOR COTUIT MEADOWS, DATED N 9,002� S.F. S tback Regai�er^ents OD x 55 ROOF DRAINAGE 6/25/07. oo ALL ROOF DOWNSPOUTS SHALL BE 3. GRADING, DRAINAGE AND' UTILITY NOTES ON SHEET C-5 OF .THE 62,E�9 / i 56 / " CONNECTED TO A 6 FT. DIA., 6 FT. SUBDIVISION CONSTRUCTION PLANS FOR COTUIT MEADOWS, DATED X 56,52/ DEEP LEACH PIT SURROUNDED 1 FT_OF 3/4" TO 1-1/2" STONE. 6/25/07, SHALL BE APPLICABLE TO THIS PLAN. /cs f X o / 54,84 /, / X 4'. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING �x /10 59.62N I 60 EN�NEER BEFOR THOSE OEWCONSTRUUCTIONEON ACO NTINUESORTED TO THE DESIGN 1 57.97 PROPOSED 1 / 5. ALL ELEVATIONS BASED ON RECORD DATUM. I )12'x26' DECK i / / Lot 25 I X 59.13 i 56.5 58 ) / 62,1 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF Lot 27 �z S 82 / -I'/ / # X 3 HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. o \ 3 rn 6 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. N � 1 a w z 62.52 v 'v o v, � 55.14 ARAGE O m 6 , 8. LOCATION OF EXISTING SEWER STUB IS APPROXIMATE. THE CONTRACTOR / I +' 21 x 5619 SLAB SHALL OBTAIN AS-BUILT LOCATION OF STUB FROM BAYSIDE BUILDERS. PROPOSED � 63.0 12. 6 ,83 1 6 8 \ p •� / 3 BEDR00 / � 9. A MINIMUM 10' SEPARATION BETWEEN SEWER AND WATER. SERVICES SHALL \ C HOUSE 6 BE MAINTAINED. ExistingI \ Qn T.O.F.=64.0/ / i 10. SEWER CLEANOUTS SHALL BE INSTALLED AS REQUIRED BY THE BARNSTABLE \ 55,46 // 0 1 D.P.W. AND SEWER SHALL HAVE A MINIMUM SLOPE OF 2.1% WITH NO LESS Abutting x 61,40 �5 INV.4 63 / / THAN 3' OF COVER OVER THE PIPE. Hse. 248 o d' INV. 60.00 11. SUBJECT SITE LIES WITHIN A STATE REGULATED ZONE II. 6 .19 62•5 PORCH _ _ 58A0 /URB STOP X 62,�5 OF 6 0,2 63 - - 6/ 6 G co`o / 68 ��� MAssq�ti �� OF MASsq�y N �c PR PO TERRY G G BUILDING SETBACKS VEGETATED RAIN GARDEN 6 13 66,49 J 68,95 g ANN g PETER T. FRONT YARD = 20 FT. 12" DEEP (125 C.F. STORAGE) X .02 0 DRI WAY o McENTEE TOP EL.=62.0 61 � E PED . k, WARNER o SIDE & REAR YARD = 10 FT. BOTTOM EL.=61.0 66, 6 o No. 38721 CIVIL 1A' 63.42' STK/NDTCK/FND _119 �o7 No. 35109 WIND CATAGORY 62 IiA=18•79 - S 8337'13" W 64 �^J/ �FG TE�F �J`` o ITEG/STL`�EO �� EXPOSURE .,B,. SMH-17 yq Np S SSI N FLOOD PLAIN CLASSIFICATION 172 SEWER I 67.52 ZONE "C" (NON-HAZARD) RIM(IN)=5 R= 4 CLEANOUT cn 63 65. 1 �� vt k u INV.(IN)=53.95 /SET INV.(OUT)=53.89 Edge of Pavemer�t/b- errs' S__S15 �_S L S ' BENCHMARK ��S22---S- L=292 @ S=4•2% FROM SM( 18 ; MAGNETIC NAIL SET PRO 0 ED SINGLE FAMILY DWELLING EL.=65.15 (RECORD DATUM) 240 PHEASANT HILL CIRCLE, COTUIT, MA 61.05 S H INV SEWER I �1H� R , Prepared for: Daniel Marsters, 10 Pleasantwood Drive, Forestdale, MA 02644 � �ll 2 58 le H'LL CI CLE Engineering by: Surveying by: SCALE DRAWN JOB. NO. PHEAAN T . OWNER OF RECORD Engineering Works, Inc. icMarner Surveying 1"=20' P.T.M. 240-10 DANIEL MARSTERS 12 West Crossfield Road 22 Long Road 0 P0.53 10 PLEASANTWOOD DRIVE Forestdole, MA 02644 Harwich, MA 02645 DATE CHECKED SHEET NO. MAG/SE FORESTDALE, MA 02644 (508) 477-5313 (508) 432-8309 1 1/22/10 P.T.M. 1 Of 1