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121 Camp St #118 Building Permits
Official Use Only OL . Commonwealth of Massachusetts Permit No. �'- O�J -5OC1- Department of Fire Services V91 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/991 eave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK CMR 12.00 All work to be performed in accordance with the Massachusetts Electrical Code (IvIEC), 527 PRINT IN INK OR TYPE ALL INFORMATION) Date: �/� /w — (PLEASE To the Ins ector of Tres: yg2�" p vj= City or Town of: - notice of his or her mtenho to pe e electrical work described below. o By this application the undersigned gives ��i/ /�p a Parcel C1,J Location (Street &Number) e Owner or Tenanit Telephone Nor•— 7-2 P--94rvi. 70. Owners Address Oo ,. Yes ❑ No El (Check Appropriate Box)v o Is this permit in conjunction with a building permit? { z Utility Authorization No-:"" purpose of Building Overhead ❑ Undgrd ❑ No. of Meters - �—`Existing Service Amps / Volts � / ❑ Undgrd L� No. of Meters New Service do Amps / Z v Volts Overhead Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work `cC Z z o Completion o the ollowin table ma be waived b the InsLector o rres. �zo � No. of Recessed Fixtures o.o Total No. of Ceil: Susp. (Paddle) Fans Transformers KVA w = No. of Lighting Outlets No. of Hot Tubs Generators KVA mg Z o _ ? No. of Lighting Fixtures Above n- o. o mergency rg Swimming Pool rnd. ❑ rnd. ❑ BatteryUnits Q z ~ L g No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones W ¢ O ,z d ' ¢ No. Switches Z o. o Detection an No. of Gas Burners initiating Devices 11 n rc of g Otal No. of Air Cond. Tons NO• of Alerting Devices — No. of Ranges ¢ eat Pump _ um, er , ons o. oSelf-Contained "-'— Detection/Alertin Devices "_ m No. of Waste Disposers •r0�]s; unicipal Other Local ❑ ❑ No. of Dishwashers Space/Area Heating KW Connection w � o ti ai Security Systems: Heating Appliances KW No. 0f Devices or FAulvalent No. of Dryers 0.0 Data Wiring: o. o ater KW o . Si Ballasts No. of Devices or E uivalent Heaters e ecommunrcatr0ns TI irmg: No. Hydromassage Bathtubs No. of Motors Total HP No. of Devices or E uivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such co�vera is in force, and has exhibited proof o same to the/permit issuing office._ CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) �Z�/L G/ �� puation Date) Estimated Value of Electrical Work: e�� ',, a (When required by municipal policy-) Work to Start: Inspections to be requested in accordance with NEC Rule 10, and upon completion. I certify, under the vains and Penalties of perjury, that the information on this application is true and complete. _ LIC. NO.: FIRM NAME: !t O ✓ LIC. NO.:20 �Ggf- Licensee: o� /Y� Signature 77�� �8'+�8/� (If applicable, ente exemp " in the lrce,�a number line.) Bus' Tel' N0.• / -- j j /, �� �,r: O2sr/i Alt. Tel. Address: /%`/�� ito!✓G��4.�. %L% Q OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑owner ❑ owner's a ent. Owner/Agent Telephone No. PERMIT FEE: $ Signature Commonwealth of Massachusetts Department of Fire Services - vlj� BOARD OF FIRE PREVENTION REGULATIONS Official Use Only permit No. !�_.al- Of occupancy and Fee Cbecked `t�4 111991(leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WO1R/4Cl�� All workto be performed in accordance wide the Mamchuw= Etechied Code (M EC), 527 CMR 12.00 LEASE PRINT 1YRI W OR TYPE ALL INFORMATION) Date: City or Town of: YARMOUrH To the Inspector of Wires': 0C _ e By this application the undersigned gives notice of his or her intention to pezfonn the electrical waric cubed be16w$ 0 ' Location (Street &Number) MILL POND VILLAGE, Camp Street/ 4 OwnerorTenant Gatewood Homes/ Jeff follows Telephone No. 57USZ778966 9 nwner+s Addms 1600 Fa7moutri Rd., Suite 25, Centerville, Ma. 02632 Is this permit in conjunction with a building permit? Yes X❑ No ❑ (Check Appropriate Box) Purpose of Building single family residence Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ Na of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ Na of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Fire Alarm System (low voltage control panel) w; h backs= batteryl'centrally monitored. — •r�hle may be,adrvall$v the Insdeetorol'Wires. Na of Recessed Fixtures No. of Cell.-Susp. (Paddle) Fans No. of Total Transformers KVA Na of Lighting Outlets No. of Hot Tubs Generators HVA No. of Lighting Fixtures Swimming Pool d e . ❑ d, El �cy g Battery units Na of Receptacle Outlets No. of Oa Burners FIRE. ALARMS No. of Zones —1— No. of Switches No. of Gas Burners o. o etRHon sq 7 Initiating Devices No. of Ranges Na of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers �Totalsp um er ons Detection/AlertingnDevices 7 No. of Dishwashers Space/Area Heating KW Ucal AluyConn�ion ®Other No. of Dryers .. Heating Appliances KW Security Devices brEquivalent No. of Water �y Heaters o. o o• o Signs Ballasts Data Wiring: No. of Devices or Eouivalent No. Hydromassage Bathtubs No. of Motors Total HP ecommunrcations Wiring, No. of Devices or E uivalent OTJER: - _ Attach aaaidanat derail p aenrea.. or as regwrw ay "u.naNct:.vr w ......,. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE M. BOND 0 OT1: M O (Sl>ecif3"•) cprrahoa to Estimated Value of Electrical Work $750.00 required by municipal policy.) Work to Start Inspections to be requested 11 accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the inf imadon on this application is true and complefe FIRM NAME: Baltic Security, Inc LIC. NO.: 1499D Licensee: Jonas R Biel '' kevicius Signature �LIC. NO.: 499D (1faRB=ble, enter "exempt" in the license nun0e lme Bus. Tel. No. 508-833-0916 Addrins: PO Box .3:609 :Sandwj_c. J 02563 Alt Tel Na: 508`-7 /�3347 OWNER'S INSURANCE WAIVER .I am aware that the Licensee does not have the liabrhty insurance coverage normally required by law. By my signature below, I hereby waive this requirement I am the (check one) ❑ owner ❑ owner's agent Ownes/Agent PERMIT FEE: $ 40.00 Signature, Telephone No. ?'< I CERTIFY THAT THE FOUNDATION IS\ LOCATED IN FLOOD PLAIN ZONE C AS SHOWN ON FLOOD INSURANCE RATE MAP\ COMMUNITY PANEL NO. 250015 0005D AND THAT FLOOD PLAIN ZONE C IS NOT A \ SPECIAL FLOOD HAZARD AREA. DATE REGIS ED PROFESSIONAL LAND SURVEYOR I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE LOT AS SHOWN, AND THAT ITS LOCATION CONFORMS TO THE MINIMUM SETBACK REQUIREMENTS OF THE 40B SPECIAL PERMIT. DATE REGISTERED PROFESSIONAL LAND SURVEYOR NOTICE Unless and until such time as the original (red) stamp of the responsible Professional Engineer, or Professional Land Surveyor appears on this plan: (A) no person or persons, including any municipal or other public officials, may rely upon the Information contained herein; and (B) this plan remains the property of Holmes & McGrath, Inc. 0, EXISTING FOUNDATION ✓ 0 O N W LOT 119 t�R .S• m o 4. � rn LOT 118 \ . 58.14' S81'47'IO"w GRAPHIC SCALE ( IN FEET ) 1 inch = 20 fL 0 0 0 0 N � 0 .11i". a AS —BUILT PLAN holmes and mcgrath, inc. Of 4}qfT� OF LOT 118 civil engineers and land surveyors ���VA MICHAEL PREPARED FOR 362 gifford street MCpR{ N MILL POND VILLAGE falmouth, ma. 02540IN ,e �s YARMOUTH, MA JOB NO: 201197 DRAWN: LMC SCALE: 1 =20 DATE: 9-09-04 DWG. NO.: A2530A CHECKED OF ,. TOWN OF YARMOUTH Building Department BUILDING (508) 398-2231 ext.261 ►- PERMIT NO B-05-242 = _ _ _ _ ; PERMIT K ISSUE DATE PROPOSED USE APPLICANT .'Frank Capra_ _ _ _ - _ - _ _ _ _ _ _ - _ JOB WEATHER CARD PERMIT TO ; New Construction------------ ; AT (LOCATION) 100121CAMP ST # 118 ZONING DISTRIC R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C118 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE new construction: 2 baths, 3 bedrooms, 1 diningroom, 1 kitchen, 1 livingroom as per plan dated REMARKS 0111OW04. AREA (SO FT) EST COST ($ 1$148,896.UU rtnml 1 rcr- t�p) l�Pow.vw i OWNER lVillages at Camp St., LLC ZagLDING DEPT BY ADDRESS 11600 Falmouth Road, # 25 Centerville I MA 02632 CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 Certificate Issue Date�CERTIFICATE of OCCUPANCY nannrtmPntal Annroval for Certificate of Occupancy and Compliance Inspector BUILDING Date Permit Number Approved By Remarks PLUMBINGIGAS ELECTRICAL y ENGINEERING OTHER ✓\ �� ..,nlnfinn of i}c final 1ngnPc inn. ' 1 U WWI IIICu III Ur V"�t- �1 V-........-__.._1 _. TOWN OF YARMOUTH Building Department BUILDING r�4 (508) 398-2231 ext.261 IF. . - - - -- --- PERMIT NO - - B-05-242 _ - �- _ _ _ _ _ - - - - PERMIT ISSUE DATE ; $/17/2004 _ ; PROPOSED USE _ _ _ _ , - ---------- JOB WEATHER CARD APPLICANT -Frank Capra -------------- ---- _ _ _ - _ _ _ _ _ _ _ - PERMIT TO ;New Construction ; ZON DISTRIC R-25 Bldg. Type: Residential AT (LOCATION) 100121CAMP ST # 118 S ON MAP LOT BLOCK 044 21.1.C718 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 SUBDNI I LOT SIZE new construction: 2 baths, 3 bedrooms, 1 diningroom, 1 kitchen, 1 livingroom as per plan dated REMARKS 08/06/04. r1 r rrr ,C\ CCA�11 nn AREA (SO FT) EST Wti I tzo 1 11, r-- ----- OWNER Ivillages at Camp St., LLC BUILDING DEPT BY ADDRESS 11600 Falmouth Road, # 25 Centerville I MA 02632 CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 INSPECTION RECORD FIELD COPY J O� YAR ONE & TWO FAMILY ONLY - BUILDING PERMIT APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING � Town of Yarmouth Building Department „ATTM„c , a 1146 Route 28 • Yarmouth, MA 02664-4492 Tel: (508) 398-2231 x261 • Fax: (508) 398-0836 Ofgce Use Only T + "_ Planning Board lnforrnation^ "`Assessors Deparimert Information r„ , ,� ♦ Y P�an7ype Y V Lot p Xa f �jO i Permit Not atey 4 F N Key$' r`tC ii - 4 � � Y' k F 1 .�d - s C'-N• l� f 'Permit teee ..<�5 Cty.,`.x S • � , -��� 't"'c �.�, �z{ 3' 7S1>.Y 3e t �Dept�ecd ,Q��P. eeordm Date-� � g ,,, f' tf L Mh { No ey.�t Y s u . s 1'4 ewperty Dimensrons�' �S4 Q` ./ •a' Y'i#}i 'ry h ).W'S F A Y3. i..riyl 4 1 i 1 i e ii f G rt �' �.1. ,r a - t0 rea sl) v «{ p Fror�tag (ft)3 4 =" Lat Caue ages ,. .; .... �.� h"FtiisSeetfon=or.Offioe�UseOnl . r .-_ r ~y.--� ss •� ,� k a-€�- n.��.. ,. �.x ✓ •+ -• `{z, i'r r bt 5..�.ts'.. ;. Bttttfjlrj `Per urtt[i rk kSate Issued fex f � t b 5 t t. s r.. f 4'}xaep'iF b r , ti-3�'yM• ily�e R R"•s.. t -��- :TT iN SV Section>Sltea normat%'n Use Group: R-4 Type: 5-B 1.1 Property Address: 1.2 Zoning Information: a Zoning District Proposed Use L a 1 Q 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.4 Water Supply (M.G.L. c. 40. S 541 1 5 Piobd Zone tiiiomlattor) :' t ' ;F Comments " « w'y93* �.' - tl �` i •} Sty s - S "-^`" ° bt A a i t6 , S ` i�...`�c`� t �.,.F'9�� a ri-[.`: rls"TL*5'4."$ 52 y Public Private Mom, SectlorZ `,Proper)y�wneishiplA"utorizedAgenf 2.1 Owner o Record: 1 /� / " 16On R `—� t.Lc 4 Mailing Address Ce&,, (V{ j,11 jj 02 N me Pntk E Signature V Telephone 2.2 Authorlze4 Agent: Name (print) FP45k Mailing Address a Signature Telephone fF r fl V'r, I g - l Sectiori3fiinstruc ton:ervlces V 3.1 Licensed Construction Supervisor. AUG 1 7 2QQ4 o pplicable ❑ DL se Number ddre // Expiration Date SWhature Telephone 3 2.Register }ierxte » royement,Con ractor Company N me Not Applicable ❑ License Number Address � /�_ ;? (� � l � J� !� Expiration Date Signature 0�rr. Telephone 19- 1 9- 15-99 1. �J 1 of 2 OvER Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial f the issuance of the building permit. Signed Affidavit Attached Yes ... ✓ .. No .......... Section„ t3e'sclYptforioi Proposed Woikchec aGjappGcable}' New Construction Q I No. of Bedrooms No. of Bathrooms Existing Bldg. ❑ I Repair(s) ❑ Alterations ❑ I Addition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: ' ` t V►1 (ln V 1 Item Estimated Cost (Dollars) to be completed by permit applicant 1 Building t k0J o o a 2. Electrical 7-7 o 3. Plumbing / Gas c 5- 4. Mechanical (HVAC) D 5. Fire Protection o (o 6.Total=(1+2+3+4+5) 7. Total Square Ft. (new houses & adc%ons) I Check Below ❑ Conservation -Commission Fling (if applicable) ❑ Old flings Highway& Historical Commission approval (if applicable) asAowner of the subject property hereby authorize ( 0 -e (..A. (- m beh , in all matters elative to work authorized by this building permit ppl-cation. r o Signature of Owner Date to act on as Qwner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print n e ,,"" Signature of Owner/Agent . Date u 9-15-99 2 of 2 k TOWN OF YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: Job Location: _ Owner of Property: V ` Construction Supervisor: Address: I (`' ® O Licensed Designee: (If other than Supervisor) I/ln Street Village -c ,4-Y' Caw p S� .. lL fit" k awl�' Oa I y'3Sob 2�. 3- 9669 Name License No. Phone No. h4P l� , S,,`,%'k 3-� aAk1r✓; l�k to A as G Name 2.15 Responsibility of each license holder: License No. 2.15.1 The license holder shall be fully and completely responsible for all work for which he is supervising. He shall be responsible for seeing that all work is done pursuant to the state building code and the drawings as approved by the building official. 2.15.2 The license holder shall be responsible to supervise the construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of building and structures only pursuant to the state building code and all other applicable laws of the commonwealth, even though he, the license holder, is not the permit holder but only a subcontractor or contractor to the permit holder. 2.15.3 The license holder shall immediately notify the building official in writing of the discovery of any violations which are covered by the building permit. 2.15.4 Any licensee who shall willfullyviolate subsections 2.15.1, 2.15.2 or 2.15.3 or any other section of these rules and regulations and any procedures, as amended, shall be subject to revocation or suspension of license by the board. 2.16 All building permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise those persons engaged in construction, reconstruction, alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and these rules and regulations. In the event that such licensee is no longer supervising said persons, the work shall immediately cease until a successor license holder is substituted on the records of the building department. 2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may be deemed a violation of the permit conditions. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with section 109.1.1 of the state building code. I understand the construction inspection procedures and the specific inspection as called for by the building official. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes FE( No ❑ If you have checked yu, please indicate the type coverage by checking the appropriate box. A liability insurance policy � 7 Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chi 152 94tlae Mass.,#ef eral L;uvs, and that my signature on this permit application waives this requirement. 0 %'mgp! i ■ Signature: Building Official The Commonwealth of Massachusetts Department of Industrial Accidents OIAce eflevestlaffess 600 Washington Street Boston. Mass. 02111 Workers' Compensation Insurance Affidavit ATe-i,.»0 ck H--by-e 4� /fry-- k (xhv7 �A-- cin ( -0-L, Q..%U 0 «k- 14/1 ,� % J� phone I am a homeowner pertormmg all work myself. I am a sole proprietor _r.d have no one workinc in any capacity I am an employer pro% iding workers' compensation for my employees working on this job. company name, address. city phone+t insurance co. poliev tt CR/1 am^a sole proprietor. general contractor. or homeowner (circle onej and have hired the contractors listed below who ha%e ,rta insurance co, policy ff comnanv name: address: ' phone# Pauure to secure coverage as required under Section 25A of MGL 152 eaa lead to the imposition of erimiaal penalties of a Bye ap to S1M.00 and/or one years' imprisonment as well as civil pensidei; is the form of a STOP WORK ORDER and a fine ifS100.00 a day against me. I aaderstsad'that a copy of this statement may be forwarded to the Office of Investigations of the DU for coverage verification. - 1 do herehy tj)} der the pa' is and n is of perjury that the information provided above is ante and corre k Signature X ate Print name \ _` (7L- v�- k AQ fOL Phone K 'official use only do not w rite in this area to be completed by city or town official city or town: YARMOUT$ rmitAicense # Pe MBuilding Department check if immediate response ❑Lleensing Board ❑ ponne is required 2 r. ❑Selectmen's Office ❑Healtb Department contact person: phone#:_ (508) 398-2231 eat. Mother. TOWN OF YARMOUTH 1146 ROUTE 28 SOUTH YARMOLTTH MASSACHUSETTS 02664-4451 Telephone (508) 398-2231, ExL 261 — Fax (508) 398-2365 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT BUILDING ELECTRICAL GAS PLUMBING SIGNS Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 1 `Ca 0 Work Ad4ress is to be disposed of at the following location: ! o(�►'�N� �� Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. le l.0 Signature of <pplicant Date Permit No. -,� ✓ite "I' 4IlJ.'iac%uaea BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 012430 i Birthdate: 06116/1940 Expires: 06116/2004 Tr. no: 25823 Restricted: 00 FRANK G CAPRA ���� 40 COPPER LN rz..A rt CENTERVILLE, MA 02632 Administrator 00 - 35,000 d enclosed space (MGL C.112 S.60L) 1A - Masonry only 1 G -1 3 2 Family Homes Failure to possess a current edition of the Massachusetts Stale Building Code is cause for revocation of this license. DIG SAFE CALL CENTER: (888) 344-7233 A RD,M CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDAYYYI� 07/18/03 DUCER THIS CERTIFICA Dowling & O'Neil Insurance Agency, Inc. 222 West Main St. PO Box 1990 TION ONLY AND CONFIt Ib ERS NO RIGHTS UPON THE CERTIFICAD ASA MATTER OF TE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE . ' ' INSURER A: Hanover Ins. Company NAIL # Hyannis, MA 02601 INSURED Busy Bee, Inc... P.O. Box 50 . INSURER B: Safety Insurance Company . - " East Sandwich, MA 02537 INSURERc: Associated Employers Insurance Compa INSURER D: - " COVERAGES "'SURER E: - THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ' ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR A NSR TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY "CLAIMS MADE O OCCUR POLICY NUMBER OHN643998501 PDA7EYMI VDU/nYYVE 06/14/03 POLICY EXPIRATION 06/14/04 -. LIMBS EACH OCCURRENCE $1 000 000 DAMAGE TO RENTEO n $300 000 MED EXP (Any one pars#) $15 000 X PD Ded:250 . PERSONAL d ADV INJURY $1000000 GEWL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2 000 000 PRODUCTS - COMPAOP AGG s22000,000 POLICY JERO LOC B AUTOMOBILE LIABILITY TO 3175394 01/14/03 • 01/14/04 COMBINED SINGLE LIMIT (Ea accident) s NED AUTOS BODILY INJURY (Pcpersm) $1OO,000 SCHEDULED AUTOS AUTOS - BODILY INJURY. (Peracdd! n!o _ 5300 ,000 NEDAUTOS ... _ _ _ _ _ ... . .. .: VEXCESSIUMBRELLA PROPERTY DAMAGE '(Per accident $100,000 BILITY _ .. .... - - $ . TO AUTO ONLY - EA ACCIDENT OTHER THAN - EA ACC AUTO ONLY: ' AGG s s BRELLA LIABILf(YEACH CLAIMS MADE OCCURRENCE s AGGREGATE Is s DEDUCTIBLE s • RETENTION s C WORKERS COMPENSATION AND EMPLOYERS• LIABILITY WCC5002932012003 06/27/03 06/27/04 WC STATU- OTH- s- ANY PROPRIETORAPARTNERIEXECUTrVE OFFICERAMEMBER EXCLUDED? E.L. EACH ACCIDENT $100,000 E.L. DISEASE - EA EMPLOYE $100 000 If yes, desaibe urider SPECIAL PROVISIONS bel w E.L DISEASE - POLICY LIMIT s5OO,000 OTHER DESCRIPTION OF OPERATIONS A LOCATIONS A VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Operations performed by the named insured subject to policy conditions and exclusions. Gatewood Homes 1600 Falmouth Road Suite 25 Centerville, MA 02632 ACORD 25 (2001/08) 1 of 2 #30822 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 n DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATwP 0 ACORD CORPORATION 198a t'-01 ` ACDM- CERTIFICATE ©i= LIABILITY INSURANCE DJE PRODUCER _ THIS CERTIFICATE IS ISSUED AS D OR A MATTER OF INFO Ecshaa znauranca Agency, Inc. ONLY AND CONFERS NO FLIGHTS UPON THE C 789. Lain Street, Suite#8 ALLTER THE COIS VERAGE AFFORDED BOES OY THEEPOLICIE Oaterville, Ma. 02655 50 B-d 20-9011 INSURERS AFFORDING COVERAGE !P+suneD Casperada Overhead Doors INSURE RA NSLATER &��� � �11:3i�L,_ Sox 517 INSURER Iz East Falmouth, MA 02536 INSURER a. INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINc, ANY REOVIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR F MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CONDITIONS OF SUCH CLAIMS. NT R TYPE OF INSURANCE POLICY NUMBER ATE i.EFFECTIVE POA CY EX►IRA KIN GENERAL LIABILITY LBATG COMMEACLtL GENERAL LWBIUIY EACHOCCURAENCE E ..0...4}$�. CLAIMS MADE OCCUR FIREDAkV'cf( ana pRll 150Q.Di.. MED EXP (AnY aN pwsen) f _. `•.r2s88352 ALa.AOVNAIRY f 05/28/03 05/28/04 rfttA N000 OtN'l AOGHEDAIE LNR AlTiit$ PER ENERAL AGGf GREGATE . POLICY PRO- LOG PRODUCTS • COMP/OP AGO $ Q 00.000.. AUTOMOBILE UASILTY ANVAVIO LIMITt 10EO.MBBINFDSINGLE ALL OWNCO AU70$ $CHEM F0 AUTOS GODLY NA1RY f IPa p�4on) WR[D AUTOS . NON -OWNED AUIO$ GODLY INJURY f (PROaPIZATYanfAMAGE F GARAGE LIABILITY AUTOONLY. EAACcroENT S EA ACC s AUTO ONLY-, EKCEBS-LMGRfTY- AOG f OCCUR CLAIMS MADE EACHOCCURRENCF f ' AOOREGATE s OLOUCTKLE f HfTEurmu f-_ WORKERS COMPENSATION AND EMPLOYERS LIABILITY � TORY UWTS ER - A 02/22/03 02/22/04 ELEACHACCIDENT s500.000, _ EL DISEASE. . EA EMPLOY f �,. OTHER EL Dr5EA5E • POLICY LNR S DESCRIPTION OF OPERATTIONWV9H CLEMCLU$WN$ ADDED BY ENOORSIMENTRIPECIAL PROVIiIONS VAL M3URlA, NBURER LETTER: _ CANCELLATION Gateway $omes 1600 FaUIvuth W40ad-; Sutt=e 257r Czntsrville, NA 02632 778 5603 r ACORO 2S.S (7197) DATE THEREOF, THE ISMING INSURER WILL ENDEAVOR TO MAIL JA_ DAYS WRITTEN NOFIQETp7HE{,ER►gIDATa}IpLpER_W�,, ,,, - �pp�, SO SHALL NPOBE NO OBLIGATION OR LL IMUry OF ANY RIND UPON THE IN ...ww.....�-�..__ BIIRGI, ITS AGENTS OR 0 ACOD CORPORATION 198E i SIJtI 564 725? P.01/©? U._�.r,"»'".y:�.;x;:,�; !!OLDER.�Ti113wmrr`u NO CEFti1FICATE DOES NOT N p OEXTEND , RIDER. RISK SPECIALISTS ALTER THE COVE7AGE AFFORDED 3v Tiat POLICIES Be'L! INSURANCE AGENCY, INC. P • O •BOX 115 COMPANIES AFFORDING 0Ov- GE CATAUMET MA 02534-0115cow AP1Y Daum A US LIABILITY INSUR"CE COMFAiv'Y 223MONMENTCOUNTY INSULATION, INC..� AMERICAN HOME INSURANCE COMPANY 223 COUNTY ROAD BOURNE, MA 02532 OCWANY ,. D •x��'..c„^�..""` Y �..,+...'y..e�die...L y.. �.e �.� r ...y:n ate..,. THIS 1S TO CFJi .,«.,...�-«... -..t .:....h .+...*. .u...:..r.:....... w ..irs t..w ..n:.,C„e: rs-,i ^tax,. 71FY THAT THE POUCIEE UI INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER= INDICATED. NOTWITLRSTANDING ANY REQUIREMENT. TEAM OR CONDITION OF'�"'�"°"^^*•�.,.w,.,..�:.-..�..T CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, T. LIMIT .'RANGE AFFORDED BY THEPOLICIESD gCR gDOCUMENT RESPECT TO WHICH THIS DICLU31pNfi AND CONDITIONS OF SUCH POLICt;<S. LIMBS SHOWN MAY HAVE UEEN REDUCED BY PAID 0W:HCLAM. ACT TO AU. THE TERM3, OR TYPE OF DURANCE POLICY NUMBER S� MOMAAlWWMATE DATE WAWUsu:i X GENERALUABERr OTD/E3t4LAOOREaATE Isl 000,00 CASASHAtX®O=UFI Pm=JeTs.cowP/OPAGG s500 000 A OwNER'2dC1N1IRAcmRsPROT CLI235745 PEFSONALIAZVNAM s500 000 e/23/03 8/23/04 px EACwpmecE sSnn Ann AWE LABILITY ANY-AU17 EICEDB UABILM MOtM IA FCRM D OTHER THAN UMS>7EU.A FC WORKERS COMPENSATION AND E.yTWMNM' IJAMLM 0-1--IWC 782 61 72 GATEWOOD HOMES,INC 1600 FALMOUTH ROAD 025 CENTERVILLE, MA 02632 508 778-5603 COMSW©SWLEUWT s (Per l+i my PROPERTY DAMAGE -.4. �u 9/5/03 19/5/04 1 W SMU D ANY OF INC ROM COMBED MMU BE COMEIM MrMOM M C04PA 4m DATE 7HE3IEGF. THE ISSUING COMPIANy WILL ENDEAVOR TO MAIL ,iy_ DAYS WRITIEH NOTICE TO THE CEAf11FIGTE HOLM NAWWTWTWru FT, BUT FAIWRE;TTf YAR 11. NOTICE SHALL W ND ..c ".:__ ,•;`t _._ 6r-ri.-r..._.� .,_ CeUo4TN7N OR UARWTy TOTAL p.01 CERTIFICATE OF. ITSCE PRODUCER THIS CERTIFICATE IS ISSUED AS A Passaro Leverone & Buckley coNFRRC xo RIGHTS UPON THE c Insurance Agency Inc P 0 Box 160 Dennisport, MA 02639 INSURED Patrick K Orcutt dba P & S Concrete 37 Ladys Slipper Lane Mashpee, MA 02649 DATE (MWDD/YY) THE COMPANIES AFFORDING COVERAGE A A.I.M. Mutual Insurance Cc THIS 1S 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 CONDri ION OF ANY CONTRACTOR OTHER DOCUMENT WITH RBSPECTTO WHI PERIOD CERTIFICATE MAY O ISSUED O MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBIECT TO ALL THB TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LM"TS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIO - DATE(MMMDNY) DATE(MM/DDrM .LIMITS GENERAL LIABILITY MMERCIAL GENERAL LIABILITY ENERALAGGREGATE S IMS MADE��OC PRODUCfS.COMP/OP AGO. S PERSONAL & ADV. INJURY S WNER'S & CONTRACTOR'S PROT. ` EACH OCCURRENCE S FIRE DAMAGE (Airy one Tire) S MED. EXPENSE (AM one Person) S ,UTOMOBIITi LIABILITY � Y AUTO COMBINED SINGLE IT S ALL OWNED AUTOS EDULED AUTOS ODILY INJURY Pe,son) $ IRED AUTOS ' NON-0WNED'AUTOS BODILY INJURY aciden[) S ARAGE LIABILITY PROPERTY DAMAGE S XCESS LIABILITY CH OCCURRENCE S MBRELLA FORM REG THAN UMBRELLA FORM GGATE S WORKER'S COMPENSATION AND WCSTATU- X OTN- EMPLOYERS' LIABILITY A THE PROPRIETOR/ 6006181012003 1021/2003 10212004 S PARTNERS/EXECUTIVE INCL OFFICERS ARE: EL DISEASE —FOCI LIM S PTHEREX I EL DfSEA$E—EA EMPLOYEE S SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIItATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAII. 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT •BUT FAII URE TO MAII SUCH NOTICE SHALL Bv1POSE NO OBLIGATION OR Gatewoods Homes LL4BII;iTy OF ANY 81ND UPON THE COMPANY, rrS AGENT$ OR 1600 Falmouth Road REPRESBNTATIVBS. Centerville, MA 02632 AUTH°Rlzm REPRESENTATIVE -ACQRD3 CERTIFICATEOF L!ABILiTY INSURANCE OATS pMVODIYYM PRODUCER 08l082003 JOAO M OIAS 508 672 2997 THIS CERTIFICATE Is ISSUED AS A MATTER Of E�IfORMATtO? ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATI DIAS INSURANCE HOLDER FHm CE3FTIFKATF DOES- NOT AXEM EXTEMQ OF 535 BRAY -TON AVE A TER THE COVERAGE AFFORDED BY THE POLICIES BELOW FALL RIVER, MA 02721 INSURERS AFFORDING COVERAGE &avREO NR1CC'S: JOEL FERREIRA DEALMEIDA rISURERA: GRANITE STATE INSURANCE COMPANY . WC 494-48-8 DBA EJJA CONS II nUCTION rlmmfi m NAUTILUS'INSUFMCE COMPANY- f NC275806- 50-PICXERING ST. APT 17 INSURER ---- I FALL RIVER, MA 02720 RsuR£Ra SURE COVE'RAGEs W RE THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATE 3. NOTWITHSTANDING AnD:.REOLDREMEN•T. TeITM OR CONDITION OF ANY CC NTRAGT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBEDNLREIN'IS SUBJECT TO ALL Ti/E.TERMS, EXM=cNS.ANO. CONOITtQNg Or SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN RISDUCC-D BY PAID CLAIMS. !N PO EFF[CTIVE rOUCYEARRATION ' P.OU�'NVMEFR L6YIT5 GENERALUABILDY I `rJICN OCCVRRCNCE ERf T,OOO:000 i X COMMCIALotweRAIUAo&L NC27680E III!I 0&2612003 0&2&2004 s oaunRcn al 100,D00 CLAIMS MAUS OCCUR I MEO EXP(AaT pAa parson) T1 S- 5-£60 I _ PERSONAL S AUv aVJuRY I7 1,Op0,000 GENe1PAEA'GGRFGATr �a- _ 2,_000.00Q -P.I.C.GREGATE LNa?APPUES PlR: PRODUCTS. COMP,oOP L:'G ,s 2 000 O0D ➢OI�• .LOG I AUTOMOOU LNNRITY I 'ANY AUTO / Me aCOGW) NGL l' &J.tlT � T F�.J ALLOWNEDAUTOS I C , SCHEBULEDAOt05 - D0•ILY Iw RV jHIREp AUTOS NONAWNED,AUTOS 150 YINJVRY I IrarsacldaR) S II PROPERTYOAMAGE'— . 7EARAG[LlAbnny ` AUTODKnEA�ACCIDeIA' S' _ ANY AUTO I - f OTHERTIIAN EV'� ,- t AUTOONLv: I 17fCE15RpItiReLLA LUl91UTY EAC14OCCURRENCE J (OCCUR LW_JCMS MADE I AGGREGATE IS i RETENTION wORNERa.COYRIOiIAT10NAaID Ci,�rEMPLOYERS UAEItTY W5R_ ttf08/03 i4%08104 ANYPROPRIETORf&cTLUm RIE7fECLTIyE ELEACHACCIDENT O/RCGRaaEYEER OfCLUOEIY/ I S Y,COf'Y,BO� tpa._ditla%* Leo. ri .04CASE.EAENn-Twee a 1 nnn nnn GATEWOOD HOMES 1600 FALMOUTH RD. CENTER VILLE. MA 02632 I 25I200�/081 SNOVLOANY CVTHE ABOVE C"Craa= ,LKMcj 8C CAN=XX7IIEPOIQTIIE VA.WA *D DATE TNCRSOp, THE tiSUINO INSURER WILL ENDCAVOR TO MAIL 10 DAYS WRITTEN NOTICIF"My E'CERrIRCAftMOLDERNAMED70 THE IER, IN=f R=vmnn Yn Z.. M7052 NO OBLIGATION OR UAEtUTY Of ANY RIND UPON T'RE WDURER� ITS AGENTS OR ... ,. i0.11 rAE 5087900249 GOLDMAN ASSOC ".. �O1 ���? C=RTIF!CATE Cs LIABILITY INS RANCE cm M - TAVAN50 11 17 03 QOLD!lALX 6 A88OCIATHS THm C£SUFICATe LS. INSORANCE IS31tEy1A3 A Ri N THE oF.11itcOR - FIr0LF7C1A1, SE:2VIC83 INC. ONLY AND CONFERS NO Rl M'tS UPDN THE 933 FALDOCu1TH VD. HOLDS TM CER-nF" E DOES NOT AMEND. EXTEND OR HYANNIS kA 02601 A=T TH!*�YERAGE AFF BY.TNE POLIAEttSELOfl� .- A1ena:5O8-775-6010 FaX:508-790-0249 � iSL"RERo' i.FFC€!a"1. iiG` RODNEY TAVANO D&k NEC9ANICAL SYSTZM. R?BAWSPARLEE XX 02668 TWEAW POIA7FSOF a T-M L6iF_O am oFAw f"m icr a.R0 NCURF,D N►Ni0 ADCVE FOR THE PC = PERIOD fLOCJ.7L0. ANYREOL.f�M, TRAVAN CFfVFd) 1OFANf CiMRA[:I OFt DTHMOCCUMIEhFTVWMRESPECTTOW"r TM M�YtYRinf'41�-f6URANCt N`I�(�Ep 6fYt$6FIERE�1$Sl�.dY:fYQAti YlE7E7a8,. YEYNY 6g7EDQt PCLMS.A&iOATELWMU4V*WWAYMRWiEMREDX=grF�CtAMs. E$ta+aNl APn QFSL A@fe �AM RZ8172 c7A ArAed % oeait pelt LBC ALLOWNmAlrca sCPGMtltiDAtn= t emcamammumaLLA LudkLay QA96YAOE f -►AaWZ"C0WM iM7--%APO 13 WNRMTO 'LINEL"T R X3►WFOOD Hcws Im PAX 506-778-5603 1`900 FAlk o ROAD- CENTBRVZLLE Mh 02932 #727SA849o3 11/21/03 L 11/21/04 OS/03/03 1 05/03/04 ©„� jiipt4DApt'OP E8 onyw AN.'WiAVV s i 7OFAVORTONAL 10 nAt7 fNyrnn LaoLA°OnTW nAaD iaL -PRODUCER CERTIFICATE OF LIABILITY INSURANCE =DAM(MWDWM•PRODUCER Dowling & O'Neil Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 222 West Main St. PO Box 1990 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis, MA 02601 INSURED INSURERS AFFORDING COVERAGE NAIC # Gutter Pro Enterprises, Inc. INSURERA: Travelers insurance Company P.O. Box.1197 INSURERS: Guard Insurance Group Plymouth, MA 02362 INSURER C: INSURER D: COVERAGES INSURER E THE POLICIES OF INSI IRCMcc I ICTcn o0 ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT NTH RESPECT TO WHICH THIS �ULU TO THE INSURED NAMED ABOVE FOR THE POLICY CERTIFIICATE MAY BE ISSUEDD NOT -WITHSTANDING DING MAY PERTAIN, THE INSURANCE AFFORDED By THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. S. EXCLUSIONS AND CONDITIONS OF SUCH .TR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION A GENERAL LIABILITY DATE MM/OD RR DATE M/D LIMITS 1680459H3118TCT03 11/07/03 11/07/04 EACH OCCUENCE a X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 1 OOO OOO CLAIMS.MADE OX OCCUR MI $300 000 MED EXP GAny one pars«+) $5 000 PERSONAL 3 ADV INJURY S1 000,000 GEN'L AGGREGATE LIMIT APPLIES PER AUTOMOBILE LIABILITY ANY AUTO CO SINGLE LIMIT ALL OWNED AUTOS accident) S SCHEDULED AUTOS BODILY INJURY HIRED AUTOS (Perperson) S NON -OWNED AUTOS BODILY INJURY (Peraccident) $ PROP DAMAGE IARAGE LIABILITY ) S ANY AUTO AUTO ONLY - EA ACCIDENT S OTHERTHAN EAACC $ XCESS/UMBRELLA LIABILITY AUTO ONLY: q(,r, S OCCUR CLAIMS MADE EACH OCCURRENCE S DEDUCTIBLE I I _ I I S B IWORKERS COMPENSATION AND GUWC4406HS EMPLOYERS' LIABILITY 11/07/03 11/07/04 ANY PROPRIETOR/PARTNER(EXECUTrVE OFFICER/MEMBER EXCLUDED? OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECUIL PROVISIONS Operations performed by the named insured subject to policy conditions and exclusions. Gatewood Homes 1600 Falmouth Road, Suite 25 Centerville, MA 02632 ACORD 25 (2001/08) 1 of #32273 000 Q1JVLD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL If)_ 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 AUTHORIZED LS1© ACORD CORPORATION 1988 H_c;vKu�, CERTIFICATE OF LIABILITY INSURANCE I DATE(MMIDDIYY) 07/22/2003 PRODUCER (508) 994-9688 FAX (508) 991-5461 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION RUTKOWSKI & KESTENBAUM ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 414 COUNTY STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NEW BEDFORD, MA 02740 INSURERS AFFORDING COVERAGE INSURED Frank Capra -INSURERA: Providence Mutual. _ PO Box 664 INSURER B: OneBeacon West`Hyannis ort MA 02672 p fiJSURERQ Continental Casualty. Co _:... 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 CLAMS. INSft TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE p POLICY EXPIRATION LIMITS GENERAL LIABILITY CPPOO53131 00 12/13/2002 12/13/2003 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABfiJTY FIRE DAMAGE (Arty one fire) S 50,000 MED EXP (Any one person) $ 5,000 CLAIMS MADE M OCCUR A PERSONAL &ADM INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GWL AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMPIOP AGG $ 2,000,000 POIJCY JJECT LOC AUTOMOBILE LIABILITY CBXE48125 02/14/2003 02/14/2004 COM9INED SINGLE LIMIT S ANY AUTO (Ea accident ALL OWNED AUTOS X BODILY PLURY S B SCHEDULED AUTOS (Per Pe—) 250,000 HIRED AUTOS BODILY INJURY S NON -OWNED AUTOS .... _ - (Per accident 500,000 PROPERTY DAMAGE . .. ... .. $ . M. .. ... .. _'. (Per accideng ... 100,000 GARAGE LIABILITY ._ _ ' _ .._ .AUTO.ONLY-EAACCIDENT. - S ANY AUTO •. ...,.,� ... _ . _. ..- � � OTHER THAN EA ACC S S ' AUTO ONLY: AGG. EXCESS LIABILITY - .. `" .. EACH OCCURRENCE f. OCCUR CLAIMS MADE AGGREGATE S S DEDUCTIBLE - $ RETENTION S S WORKERS COMPENSATION AND GS59UB861X751603 03/22/2003 03/22/2004 199MI ER EMPLOYERS LIABILITY E.L. EACH ACCIDENT $ 500,00 C E.L. DISEASE - EA EMPLOYEE S 500,000 - ---... _. - E.L. DI$FAS�• POLICY L1Mfi r .. 500 -000 OTHER DESCRIPTION OF OPERATIONSA.00ATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECULL PROVISIONS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WALL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Gatewood Homes Inc BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 1600 Falmouth Road Ste 25 Centerville, MA 02632 OF NTHE COMPANY AGEW3A 5gEnrAnVES. AUTHORIZED R R ATNE &rnon 94_C m107% �FlMVVIW VWf wI IIVi\ 1.700 A.CORD_ CERTIFICATE OF LIABILITY INSURANCE OPID A DATE(MM— PRODUCER CROWC50 07 25 03 SuIliban, Garrity & Donnelly THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 508-754-1767 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1'0 Institute Rd - PO Box 15010 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Worcester MA 01615-0010 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Phone: 508-754-1767 Fax: 508-754-1885 INSURED INSURERS AFFORDING COVERAGE NAIL # INSURER A: Hanover Insurance Co 22292 INSURER B: Arch Insurance Ccm an Crowell Construction, Inc. PO Box 309 INSURER C: So. Dennis MA 02660 INSURER D: COVERAGES INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. AND CONDITIONS OF SUCH LTR NSR TYPE OF INSURANCE GENERAL LIABILITY POLICYNUMBER DATE MM/DD DATE MM/DD/YY LIMITS A X COMMERCIAL GENERAL LIABILITY ZHN7007141 EACH OCCURRENCE $1000000 05/01/03 05/01/04 CLAIMS MADE X❑ OCCUR PREMISES Eaocwrence $100000 MED EXP Any one person) $$000 _ PERSONAL d ADV INJURY 11000000 GENERAL AGGREGATE s 2000000 GENL AGGREGATE IIMITAPP.LIES PER: POLICY .�jE0. LOC - PRODUCTS -COMP/OPAGG $2000000 AUTOMOBILE LIABILITY A ANYAUTO .. .., ABN7OO1142 COMBINED SINGLE LIMB S 05/01/03 05/01/04 (Ea accident) ALL OWNED AUTOS X SCHEDULED AUTOS BODILY INJURY (Per person) $1000000 X HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY $lOOOOOO (Per accident) PROPERTY DAMAGE ac$SOOOOO (Peaccident) GARAGE LIABILITY ANY AUTO AUTO ONLY -EA ACCIDENT S OTHER THAN EA ACC S AUTO ONLY. EXCESS/UMBRELLA LIABILITY AGG S OCCUR � CLAIMS MADE EACH OCCURRENCE S AGGREGATE $ DEDUCTIBLE $ RETENTION $ S WORKERS COMPENSATION AND $ B EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNEpAD(ECUTIVE IRWCI00100 TORY LIMITS ER 03/22/03 03/22/04 OFFICERIMFMBER EXCLUDED? E.LEACHACCIDENT. SSOOOOO — Ifyes; describe ender SPECIAL PROVISIONS below E.L DISEASE - EA EMPLOYE S 5 Q O Q OO - OTHER E.L. DISEASE. POLICY LIMIT $500000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPEGAL PROVSIONS Fax #508-778-5603 CERTIFICATE HOLDER CANCELLATION GATEWOO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO Gatewood Homes DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL .10 DAYS WRITTEN 1600 Falmouth Road _ NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Suite' 25 IMPOSE NO OBLIGATION OR UABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Centerville MA 02632 REPRESENTAm q 25 (2001/08) ©ACORD.CORPORATION 198 rs mouth MA 02664 ALTER TH!•rnven,,..�.�______ ape r0a Cus#om Floors INSURERS AFFORDING COVERAGE NAICu 76Z Falmouth Road wsDRCRA Arbella Protection Ins Company Hyannis MA OZ601 Wall III. Hartford W3UREP C! INSURER D.- THE POLICIES OF 1NI'll RAWCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD WDICATEO. NOTWITH$TANDIry ANY REQUIREMENT, TERM NC 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 $(JC}I POLICIES. AGGREGATE L1MfTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. N R D TYPE OF INSLIRJINC6 POLICY NUMBER POLICY E FE THE GENERAL LIABILITY POLICY EXPIRATION 7500000371 12/13/ZOOZ 12//2003 EACHOccul:tl LIMITS X COWAERCIAL GENERAL WBLITv 13S 1�000, 0( CLAIMS MADE D OCCUR - ANAC TO RENTED S so, OC A Ml EXP (Al one III $ PERSONAL A AOV INJURY S CENL AGGREGATEpvLRRBAITAPPLIE9 PER; - GENERALAOGREGA7E S X POLICY MT LOC PRODUCTS-COMP/OPAGO S AUTOMOVRELIASIUTY ANVAUTO LD E LIMIT ALL DINNEDAurae ESCadel S SCHEDULED AUTOS HIUEDAUTOS BODILY InAmy (➢el Dneun) S NON-OWNEDAUTOS BODILY INJURY (Per.codenU f GARAGE UABRny i� DAMAGE ) S ANY AUTO AUTO ONLY. EA ACCIDENT is OTHER THAN EA ACC S EXCESSIUMBRELLA UABILM AUTO ONLY. AGO S OCCUR a CLAWS MADE' EACH OCCURRENCE S AGGREGATE S DEDUCTIBLE S RETENTION s : WORKERS LSATION AND SEMPLOYERS`IABITOSWECKLI007 05/2S/2003 OB S/25/2004 WCSTA7LL ANYETOpJPARTWCVl ( O7H- OFFICCRIMEMBR C XCLUDEdel EL EACH ACCIDENT S SPECIAL PROVISIONS ya� EA- DISEASE • EA EMPLOYE S OTHER EL DISEASE • POLICY LIMIT S or 0 Evidence of Insurance for work performed within the Insured's scope of normal operations �v C C LLATION EHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOI THE ISSUING INSURER WILL ENDEAVOR TO AWL 10 DATS WRITTEN NOTICE TO THE CC"MCATS HOLDER NAMED TO TIM LEI, 1600INFa l outh Homes.. BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR LIABILITY 1600 Falmouth Road i25 Centerville, MA 02632 OF'UIY IONDUroN THE INSURER, ITS AGENTS OR RFARESENTATNE9. _- AUTHORIZED RESEN7A 4CORD 25 (2001/08) FAX: (508) 778-5603 �^ (DACORD CORPORATION 1988 C ER T 2 F S C A TE O F 2 N S UR A NCE Producer: SOUTHEASTERN INS AGCY 641 HYANNISN ST MA 02601 Code------------------- Insured: RJ BEVILACOUA P 0 BOX 628 FORESTDALE MA 02644 Issue date; 7/22/03 noirigchtsicioatthesCertificateaholder. This certificatendoesnnotoamend, extend or after the coverage afforded by the policies below. I"---- -COMPANIES AFFORDING COVERAGE - Sub -code: I Co Ltr A: ARBELLA PROTECTION --------------- -------------------------------- I ------- Co Ltr B_ ARBELLA PROTECTION Lo Ltr Q ------------------------------- Co Ltr D: ARBELLA PROTECTION ----------------------------- - Co Ltr E: COVERAGES This is to certif that policies of insurance listed below have been issued to the insured named above for the indicated, n any requirement, term or condition ar.besissuedg of any contract certificate may be issued or may pertains the insurance afforded by the exclusions, and conditions of such Polic eriod or other document with respect to whico this policies described herein is policies. Limits shown may have been ------------------------------------------------------------------------------------------------------------------------------ subject to all the terms, reduced by paid claims. Co I I Ltrl Type of Insurance Policy ------------ ---__-__----------------- ( Policy lumber effective date ------------------------------------------------------------------------------------- I - Policy I - lexpiration datel All limits A 16ENERAL LIABILITY I 8500018147 I 7/15/03 (� Commercial general liability in thousands I 7/15/04 aggregate: [ d Claims made [ ) Occur I I vner's 8 contractor's Prot I6eneral 2,000 Products-comp/ops aggre9: f[ I I (Personal/advertising inl: I Each occurrence: damage: -----"-"-"----""-----"--- ------------------------------------------------------------------------al B (AUTOMOBILE LIABILITY I 66852400001 2/21/03 I ADZ auto i (Fire f0000 Medical expense: g exp-------------------------- 2/21/04 (Combined I owned autos I Scheduled autos ISingle limit: 250/500 i Bodily IAll Hired autos I injury ((Per person ): I I Non -owned autos I I Garage liability I (Bodily iojarr (Per accident): ---"---j1----------------- I "--"'--"-----I I XCESS LIABILITY I ------- Pro ert1 damage: 00 Other-thanI I I ] umbrella form I I I Each Occarreace Aggregate I ------------------- D I WORKER'S ACOMPENSATION i 9088680403 I 4n7/03 I ------------------------------------------ 4n7/04 I---"---Each-----dent------- IEMPLOYERS' LIABILITY • � I IStatutor ii 100 ch accident •------------------------------ - I I OTHER ------------------------------------------ I 500 sease-policy limit) _ 100. employee)... Msene-each I I ---------------------------------------------------------------- Description of operations/locations/vehicles/restrictions/special items: CERTIFICATE HOLDER 1600WFALMOUTHSRD STE 35 CENTERVILLE MA 02632 4/89 CANCELLATION Should any of the above described policies be cancelled before the expiration date thereof, the issaing company will endeavor to mail 10 days written notice to the certificate holder named to the left, but failure to mail such notice shall impose no obligation or liability -of -any kind upon -the company, its agents or representatives. -------------------------------------- Authorized representative: -_ JOAN M MARTIN JA " UtKTIFIGATE DATE (MM:MD/YYYY) OF LIABILITY INSURANCE . 10/17/03 O'Neil Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE . ain St. PO Box 1990ALTER ::: CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR THECOVERAGE AFFORDED BY THE 02601 pnc POLICIES BELOW. INSURERS AFFORDING COVERAGENAIL Bayside Electrical Contractors, Inc. # INSURERA: Travelers Insurance Company 72 Yarmouth Road INSURER B: Guard Insurance Group Hyannis, MA 02601 INSURER C: INSURER D: COVFRArFc INSURER E: THEPOLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIED HEREIN IS SUBJECT TO ALL THE B POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TERMS, EXC LUSIONS AND CONDITIONS OF SUCH LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE A DATE M/DD POLICY EXPIRATION GENERAL UABILITY 16801484A82ACOF03 1 DATE M/D LIMITS0/05/03 X COMMERCIAL GENERAL LIABILITY111 10/05/04 EACH OCCURRENCE OOO OOO CLAIMS MADE X OCCUR DAMAGE TO RENTED $300 000 MED EXP (Any we person) S5 000 X OCP PERSONAL & ADV INJURY f1 OOOOOO GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE $2000000 POLICY ECOT LOC PRODUCTS-COMP/OP AGO $2 000 000 A AUTOMOBILEUABR.ITY 18102601W5611ND03 10/05/03 ANY AUTO 10/05/04 COMBINED SINGLE LIMIT ALL OWNED AUTOS (EaaccidenU $1,000,OOO X SCHEDULED AUTOS BODILY INJURY HIRED AUTOS (Perperson) S X NON -OWNED AUTOS BODILY INJURY X Drive Other Car (PeraccldmQ s GARAGE LIABILITY PROPERTY DAMAGE S (Per actldenp ANY AUTO AUTO ONLY. EA ACCIDENT S OTHER THAN EAACC S EXCESSIUMBRELLA LIABILITY AUTO ONLY: AGG f OCCUR 11 CLAIMS MADE EACH OCCURRENCE Is B WORKERS COMPENSATIO:AND BAWC436910 08/18/03 WC sTATU.ANY EMPLOYERS•LIABILnY OSH8IO4OFFICER/MEMBER EEXCCLUDlJi1VE E.L EACH ACCIDENT S yes. AL PR a ISIO E.L DISEASE. EA EMPUSPECIAL PROVISION$ belo OTHER DESCRIPTION OF OPERATION -,LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Operations performed by the'named Insured subject to policy conditions and exclusions. - Gatewood Homes 1600 Falmouth Road Suite 25 Centerville, MA 02632 A%,UKU 25 (2001108) 1 of 2 #M31942 ... w r yr THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURES To DO SO SHALL DAYS N E NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 0 ACORD CORPORATION 1988 �m �v •�r OF �TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-079 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST #118 Owner's Name: Villages at Camp St., LLC. Owner's Addres 1600 Falmouth Road, # 25 Centerville MA 02632 ' Owner's Telephone: (508) 778-9669 REVIEWED BY: t"l. WATER DEPARTMENT: V'2. ENGINEERING DEPARTMENT: 3. CONSERVATION: ✓4. HEALTH DEPARTMENT: BUILDING DEPARTMENT: 6. FIRE DEPARTMENT: COMMENTS: (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 702 Net Owed: ($50.00) Application Date: 7/20/2004 Issue Date: Expiration Date Comments: Map/Lot: 044.21.1.C//f new construction: ZONlNu ;�k� i FO®VED DATE: N/A: DATE: N/A: DATE: N/A: DATE: N/A: DATE: N/A: DATE: N/A: PLEASE NOTE RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: Date Printed: 7/30/2004 OF .� TOWN OF YARMOUTH Building Department = Town Hall �e Yarmouth, MA 02664 (508) 398-2231 ext.261 BUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-079 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST #118 Owner's Name: Villages at Camp St., LLC Owner's Addres 1600 Falmouth Road, # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 REVIEWED BY: (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 702 Net Owed: ($50.00) Application Date: 7/20/2004 Issue Date: Expiration Date Comments: new construction: Map/Lot: 044.21.1.0 AUG 0 2 2004 1. WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT: DATE: N/A: 5. BUILDING DEPARTMENT: DATE: N/A: 6. FIRE DEPARTMENT: DATE: N/A: COMMENTS: RECEIPT OF COPY: PLEASE NOTE /3zL„ SIGNATURE OF APPLICANT: DATE: Date Printed: 7/30/2004 TOWN OF YARMOUTH WATER DEPARTMENT 99 Buck Island Road West Yarmouth, MA 02673 Telephone: (508) 771-7921 • Fax: (508) 771-7998 Date of Issue : Aug 4, 2004 Letter of Water Availability 1. Single Family Dwelling x 2. Duplex Family Dwelling 3. Condominium Dwelling 4. Commercial / Industrial 5. Other (Specify) Reference; Massachusetts General Laws Chapter 40, Section 54 To : Town of Yarmouth Building Inspector Please be advised that the Town of Yarmouth Public water supply is available to service lot/parcel(s) 21.1C118 Street 121 Camp St., #118 as shown on Assessors sheet/map # 44 Issuance of this Letter of Availability is subject to the following provisions/restrictions. (1) The property owner agrees to comply with all Federal, State, and Local Laws, Rules and Regulations as they pertain to the use of the Public water Supply. (2) The Yarmouth Water Department shall have exclusive rights as to the size, number, type and location of all water service lines, fire service lines or appurtenant items connected to the water distribution system. (3) The Yarmouth Water Department reserves the right to require, at the property owners expense, the installation of water mains and appurtenant items to meet water demand requisites within any structure relevant to this Letter of Availability. (4) This Letter of Availability will expire 180 days from the date of issue. I have read and understand the provisions/restrictions of this Letter of Water Availability. Owner (Sign) Reference : Villages at Camp St., LLC : 1600 Falmouth Rd. : Centerville, MA 02632 Ya outh Water Department tA of TOWN OF YARMOUTH i` Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-079 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST #118 Owner's Name: Villages at Camp St., LLC Owner's Addres 1600 Falmouth Road, # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 (OFFICE USE ONLY. Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $50.00 Payment Type: Check ChkNo.: 702 Net Owed: ($50.00) Application Date: 7/20/2004 Issue Date: Expiration Date Comments: new construction: 044.21.1.0 /, REVIEWED BY: 1: WATER DEPARTMENT:' 2. ENGINEERING DEPARTMENT: 3. CONSERVATION: 4. HEALTH DEPARTMENT: 5. BUILDING DEPARTMENT: 6. FIRE DEPARTMENT: COMMENTS: DATE: DATE: DATE: DATE: DATE: DATE: PLEASE NOTE N/A: N/A: N/A: N/A: N/A: N/A: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: Date Printed: 7/30/2004 L �6 N21 0 PRN v Q�p�oJS Pam° lil �• )�A R�� I h �R F nh _ v)0.78 �J�) N QLOT 19 0 59082 S.F. is \ 00 J rn r \ \ LOT 117 \ 6,336 S.F. 77 LOT 118 71716 S. F. N •P 58.14' S81'47'10"W MOTE: E1 E C FE I aj E SEWER LATERAL SHALL BE SLEEVED IN ACCORDANCE GRAPHIC SCALE WITH TITLE V IF WITHIN AUG G 2 2004 1OFT. OF WATER MAIN. 20 10 0 20 60� NOTICE 'f D"'1t Unles and until such time as the original (red) stamp of the �esponslble Professional Engineer, or Professional Land Surveyor peons on this plan: IN FEET) _ ,,. _ (A) no person or persons, Including any municipal or other public offfcials, may rely upon the information contained herein; and I Inch = 20 M (8) this plan remains the property of Holmes & McGrath. Inc. PLOT PLAN holmes and mcgrath inc. OF LOT 118 civil engineers and land surveyors zt, PREPARED FOR ,� MILL POND VILLAGE 362 gifford street .,� 3 falmouth, ma. 02540 N.,' IN cr✓ � YARMOUTH, MA\F JOB NO: 201197 DRAWN: LMC SCALE: 1' =20' DATE: 5-1-03 DWG. NO.: A2530 CHECKED:7uc • EFFICIENCY \L • • • • RATING CERTIFIED / Gama C Air Conditioning & Heating �ISTEo ® < sTEa o 92.6% AFUE MULTI -POSITION CONDENSING GASFURNACE GALVrSERIES Uf t� LSETIMEP.. WAPprail'F'���" � oa 5•tiC1E E•mt S�tCY,aR A1�E1t Description / Application • All models design certified by ITS to be in compliance with ANSI 7-21.47 and CAN/CGA 2.3 (Canada) safety standards • Completely assembled, factory run -tested furnace, for heating or combination heating/ cooling application • For utility room, closet, alcove, basement or attic application • Vertical or horizontal venting with 2" PVC for 40k, 60k, and 3" PVC for 80k, 100k and 120k • Capable of multi -position installation — upflow, downflow or horizontal • For direct vent (2 pipe) or non -direct vent 0 pipe) installations Construction • Heavy gauge, reinforced, wrap -around insulated steel cabinet with durable baked enamel finish • Tubular heat exchanger (Primary) • Bottom or side air inlet • Aluminized steel inshot burners • Convenient left or right hand connection for gas, electric service, combustion air and vent • Removable solid bottom block -off Standard Equipment • Energy saving PSC, multi -speed, direct drive blower motors • Quiet operating, sound isolated blower assembly • 40VA transformer for heating and air conditioning control service • Combination redundant gas valve and regulator • Integrated furnace control with diagnostics • Blower door safety switch • Energy saving Hot Surface Ignition system • Multiple flame roll -out switches • Outlet air limit switch • Pressure switch for proof of air • Complies with California NOX Standards • Completely insulated cabinet • Corrosion resistant 294C secondary heat exchanger that extracts energy from the gas and converts it to usable heat • Quiet, corrosion resistant plastic induced blower assembly • Drain kit contains vent screens, drain trap, hoses & clamps Optional Equipment • L. P. Conversion Kit (LPT-01) • Concentric Vent Kit (CVK-00) As an Energy Star Partner, Goodman Mfg. Co., LP., has determined that this product meets the Energy Star guidelines for energy efficiency Information contained herein is subject to change without notice. Made in the USA by: Goodman Manufacturing Company, L.P. SS-312D 2550 North Loop West, Suite 400 - Houston, Texas 77092 GRINT Series 10/01 www.goodmamnfg.com PERFORMANCE RATINGS Model GMNT Natural Gas Input BTUH Natural Gas Output BTUH Propane Gas Input BTUH Propane Gas Output BTUH DOE AFUE Temp. Rise 0403 40,000 37,000 37,000 34,000 92.6 25-5 060-3 60,000 55,000 55,000 51,000 92.6 35-65 080-4 80,000 73,500 73,000 73,000 92.6 35-65 100-4 100,000 92,000 92,000 1 85,000 92.6 40-70 120-5 1zo,000 1 110,000 1 111,000 1 102,000 92.6 40-70 BEFORE PURCHASING THIS APPLIANCE, READ IMPORTANT ENERGY COST AND EFFICIENCY DATA AVAILABLE FROM YOUR RETAILER. SPECIFICATION DATA _ _ .. .. �.. ..... ..__ ___.:__ __—."��s:.... t/_• CDT a Model �1did`MotorW Number W " Blower w Combustion" Air Filter Size In Perm. / Disp. Electrical Ship Weight HP Spd. Dia. Width FLA Max Fuse 040-3 1/3 3 10 6 ET T 290 / 580 52 15 170 060-3 113 3 10 6 2' 290/580 5.215 180 080-4 1/2 3 10 8 3' 385/7707.8 15 205 120-5 12 314 3 1 3 10 1 11 10 10 3 3' 3' 1 3' 3851770 480 / 960 /+"....L 7.8 9.2 15 15 225 1 265 nno u,hirh -Note: vent anu comousuun an UICZIlutulo Agar accompany the furnace. 28" A 58" " 4 5 198 ,. 6" 48 4$„ E3 T ff 8" �� i 4 I COMB. AIR INLET GAS INLET 511. 4 VENT ' 4" LOW VOLTAGE ELEC. 101. Model GMNT A B Combustible Floor Base 04D-3 & 060-3 14' 12 W SBM14 0804 17 % 16' SBM17 100_4 21' 19'/; SBM21 120-5 24 % 23' SBM24 SS-312D 1231. i COMB. AIR INLET i i I I • GAS INLET i r I 1,60. `LOW VOLTAGE ELEC. CLEARANCES FROM COMBUSTIBLE MATERIALS Sides Rear I Front" Vent Top 1' O' 1 3' 0' 1' Approved for line contact in the horizontal position. •36" clearance for serviceability recommended. 2 . CASED (U) COIL APPLICATION OPTIONS Furnace Model Number GMNT040-3 & GMNT060-3 GMNT080-4 GMNT100-4 GMNT120-5 Furnace Width 14' 17 W 21' 24'/z Coil Model Number Coil Width U-18 14' x U-29 14' x U-30 17W x(1) x(2) U-31 14' X U-32 17'/:' X (1) X (2) U-35 14' X U-36 17'W X(1) X(2) U-42 17Y' X(1) X(2) U-47 17 Y-' X U-49 21' X (1) X(2) U-59 21' X(1) X(2) U-60 24 W X(1) X(2) U-61 24 Y: X(1) X(2) U-62 21' x (1) X (2) (1) Using the factory installed bottom cabinet filler plates (2) Discard bottom cabinet filler plates Due to the rating mix/match of various coils with outdoor units it is important to match the furnace air flow for the total system capacity. Refer to furnace, heat pump and/or condensing unit specification sheets. AIRFLOW DATA CFM - NO FILTERS MODEL STATIC .1 .2 .3 .4 .5 .6 .7 .8 GMNT HI 1370 1315 1260 1200 1140 1070 1000 925 040-3 MED 1210 1170 1130 1085 1040 980 920 860 LOW 895 880 870 840 825 780 .725 680 GMNT HI 1360 1300 1250 _ 1190 1135 1065 1000 930 060-3 MED 1200 1170 1130 1080 1035 975 925 880 LOW 910 895 885 855 835 790 750 700 HI 1865 1800 1735 1660 1590 1510 1415 1320 GMNT 080-4 MED 1690 1645 1600 1545 1485 1410 1345 1245 LOW 1450 1400 1390 1360 1325 1270 1200 1125 HI 2010 1945 1875 1800 1 1715 1620 1510 1400 GMNT 100-4 MED 1725 1700 1670 1615 1550 1475 1375 1275 LOW 1430 1390 1350 1315 1285 1245 1160 1070 HI 2360 2325 2300 2170 2125 X95 1945 1850 GMNT 120-5 MED 1815 1750 1710 1660 1600 1545 1480 1415 LOW 1275 1215 1190 1145 1110 1055 985 925 Values indicated by shaded areas represent airflows that are too low for heating temperature rise. SS-312D 3 NOTE: SPECIFICATIONS AND PERFORMANCE DATA LISTED HEREIN ARE SUBJECT TO CHANGE WITHOUT NOTICE Quality Makes the Difference! All of our systems are designed and manufactured with the same high quality standards regardless of size or efficiency. Our designs virtually eliminate the most frequent causes of product failure. They are simple to service and forgiving to operate. We use the highest quality materials and components available because if a part fails then the unit fails. Finally, every unit is run tested before it leaves the factory. Thais why we know... There's No Better Quality. Visit our web site at www.Qoodmamnfg.com for information on: • Goodman products • Warranties • Customer Services • Parts • Contractor Programs and Training • Financing Options SS-312D 4 r - I I MAScheck COMPLIANCE REPORT I I i Massachusetts Energy Code I Permit # MAscheck software version 2.01 Release 2 I I I i I Checked by/Date I CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 4-21-2004 DATE OF PLANS: 04/21/04 TITLE: The Egret PROJECT INFORMATION: Mill Pond Village 1600 Falmouth Road Unit #25 Centerville, MA. 02632 COMPANY INFORMATION: Northside Design ASSOC. 141 Main Street Yarmouth Port, MA. 02675 COMPLIANCE: PASSES Required UA = 216 Your Home = 123 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------ CEILINGS 832 30.0 30.0 14 WALLS: Wood Frame, 16" o.C. 1409 15.0 15.0 62 GLAZING: Windows or Doors 87 0.340 30 GLAZING: Windows or Doors 40 0.340 14 DOORS ------------------------------------------------------------------------------ 40 0.086 3 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design conditions found in the code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date Massachusetts Energy Code MAscheck Software version 2.01 Release 2 The Egret DATE: 4-21-2004 Bldg.1 Dept.1 use I J CEILINGS: C 7 I 1. R-30 + R-30 I Comments/Location I WALLS: [ ] J 1. Wood Frame, 16" O.C., R-15 + R-15 I Comments/Location I WINDOWS AND GLASS DOORS: [ ] I 1. u-value: 0.34 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No i comments/Location C ] I 2. U-value: 0.34 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No I comments/Location I J DOORS: [ ] I 1. U-value: 0.086 I Comments/Location AIR LEAKAGE: [ ] J joints, penetrations, and all other such openings in the building J envelope that are sources of air leakage must be sealed. When i installed in the building envelope, recessed lighting fixtures J shall meet one of the following requirements: I 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. I 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.0 cfm (0.944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. I VAPOR RETARDER: [ ] I Required on the warm -in -winter side of all non -vented framed I ceilings, walls, and floors. I MATERIALS IDENTIFICATION: C ] I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating J and cooling equipment and service water heating equipment must be J provided. Insulation R-values and glazing U-values must be clearly J marked on the building plans or specifications. I I. ] I. 7 I I I. ] I. 7 DUCT INSULATION: Ducts shall be insulated per Table 74.4.7.1. DUCT CONSTRUCTION: All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in Sections 780CMR 1310 and 34.4. SWIMMING POOLS: All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. HVAC PIPING INSULATION: HVAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in.): PIPE SIZES (in.) HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" LOW pressure/temp. 201-250 1.0 1.5 1.5 2.0 Low temperature 120-200 0.5 1.0 1.0 1.5 steam condensate any 1.0 1.0 1.5 2.0 COOLING SYSTEMS: chilled water or 40-55 0.5 0.5 0.75 1.0 refrigerant below 40 1.0 1.0 1.5 1.5 CIRCULATING HOT WATER SYSTEMS: Insulate circulating hot water pipes to the following levels (in.): PIPE SIZES (in.) NON -CIRCULATING I CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F): RUNOUTS 0-1" I 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 I 1.0 1.5 2.0 140-160 0.5 I 0.5 1.0 1.5 100-130 0.5 I 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department use only) 0 / �t�gF�� yro�P� oQ J `��Ol GIx D A0, S \ r ro� �G OJ �•cl � r60 16��� ,`0��6 e ��G� LOT 119 0 Q�oeG5 �, ���5�; 5,082 S.F. N 4P �' LA .�` AFFORDABLE o 6 ry0 \ \ 0 m \ rn 0% \ o�l z �ti o 2Nb 11 \ . o LOT 118 79716 S.F. 1 LOT 117 6,336 S.F. \ 58.14' 77.63 SSI.4710 �`�4 OF MAfJq NOTE., �~ MICB. SEWER LATERAL SHALL BE B. SLEEVED IN ACCORDANCE GRAPHIC SCALE M NTH TITLE V IF WITHIN �. 1OFT. OF WATER MAIN. 20 10 Fs �tsT 0 20 Ai.'0�at L6CiEOTICE Unless and until such time as the original (red) stamp of the responsible Professional Engineer, or Professional Land Surveyor appears on this plan: IN FEET (A) no person or persons. Including any municipal or other public offlclais, may rely upon the Information contained herein; and I inch = 20 ft. (8) this plan remains the property of Holmes & McGrath, Inc. REVISED: 3-8-04 PLOT PLAN holmes and mcgrath, inc. 4 ZH OF +f OF LOT 118 civil engineers and land surveyors �sq PREPARED FOR MILL POND VILLAGE 362 gifford street TIMOTHYM. SANTOS IN falmouth, ma. 02540 d NO.4aG7a CIVIL YARMOUTH, MA JOB N0: 201197 DRAWN: LMC ' � Fsr, , SCALE: 1"=20' DATE: 5-1-03 DWG. NO.: A2530 CHECKED: ' ,Nat /i�S ��� /6 4P ro' 11 \t`00 n LOT 117 6,336 S.F. 77.6S GRAPHIC SCALE t in rr.L1 ) 1 inch = 20 ft. PLOT PLAN OF LOT 118 PREPARED FOR MILL POND VILLAGE IN YARMOUTH, MA SCALE: 1"=20' DATE: 5-1-03 i,. P 5� L� p 1y F `9 t O Ai �- S1 • �0.78' LOT 119 0 5,082 S.F. 1 AFFORDABLE . o CO 'rn \ o 0 O J O LOT 118 79 716 S. F. .� cn MICHAE a. McGRATH 58.14' NOTE: 10" W NOTE: ® SEWER LATERAL SHALL BE SLEEVED IN ACCORDANCE WITH TITLE V IF WITHIN 10FT. OF WATER MAIN. NOTIC Unless and untiProfessional such time as the original (red) stamp of the appears responsible this plan: Engineer, or Professional Land Surveyor aPPeare on this plan: (A) no person or persons, Including any municipal or other public officials, may rely upon the Information contained herein; and (8) this plan remains the property of Holmes do McGrath. Inc. holmes and mcgrath, inc. civil engineers and land surveyors 362 gifford street falmouth, ma. 02540 JOB NO: 201197 DRAWN: LMC DWG. NO.: A2530 CHECKED: �A CF'lFs9� TIMOTHY M. SANTOS No.45078 CIVIL TOWN OF YARMOUTH APPLICATION FOR PERMIT TO DO GASFITTING (OFFICE USE ONLY) By Fee: $ Q PERMIT NO. Building AT: Location 401 New [X Plans Submitted Renovation ❑ Yes ❑ No r' Replacement ❑ Date Owner'g Name(, ,,*s AT �iPirl T Type of Occupancy Al c N to V rn Z c N 1\\VIv4` N F- I m�==M 6 a °m a r g Z o W w �, w a o ►- rn a a hu w H wui Q I = W w z O Q> o o> w W> z J F- W Z M Q m z w O Fw., Z W 5 J O (A 2 Q tr LL Z Q J LL 6 = O a S M .�► G 0 U¢ > C 6. F- O S B-B MT BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR ET (PRINT OR TYPE) '�-� Installing Company Name Address t -► �UG'rS ^ U Al �1 t^ t ITEM G a6z 6 S "- -4Y tia AINI�S M A 0 2 6761 Business Telephone 50 FS — 7 3%— 3 6 9 4 Name of Licensed Plumber ortter AWR Check One: ❑ Corp. ❑Partnership — Er/Firm/Company INSURANCE COVERAGE: Check One _ I have a current liability insurance policy or its substantial equivalent. Yes fl No ❑ By If you have checked yes, please indicate t e type of coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check One: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent 1 hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit issued for this application will be In compliance with all pertinent provisions of the Massachusetts State Plumbing Code and QM0j) jv,!!.�D Signature o Licensed Plumber or Gasfitter 21 5 10 License Number TVDF I ircucc.