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121 Camp St #123 Building Permits
OF r TOWN OF YARMOUTH Building Department BUILDING N� (508) 398-2231 ext.261 PERMIT NO 6-04-1401_--------- PR - 'V' PERMIT ISSUE DATE _ 6/14/2004 _ ; APPLICANT rFrankbapra JOB WEATHER CARD ------------------ - PERMIT TO ; New Construction ; IAT (LOCATION) 00121CAMP ST # 123 ZONING DISTRIC R-25 Bldg. Type: Residential I SUBDIVISION MAP LOT BLOCK 1044.21A.C123 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R•4 LOT SIZE CONTRACTOR new construction: 2 baths, 3 bedrooms, 1 kitchen, 1 diningroom, 1 livingroom as per plans dated LICENSE 012430 REMARKS 04/26/04 and BOA # 3546. Capra, Frank 1600 Falmouth Road #25 AREA (SO FT) EST COST ($ $146,400.00 PERMIT FEE ($) $0.00 Centerville MA 02632 OWNER Ivillages at Camp St., LLC WILDING DEPT BY 5087789669 ADDRESS 1600 Falmouth Road # 25 Centerville I MA 102632 �l - Certificate Issue Date 9 CERTIFICATE of OCCUPANCY i Departmental Approval for Certificate of Occupancy and Compliance Inspector Date Permit Number Ap ved y Re arks BUILDING PLUMBINGIGAS 36 LV ELECTRICAL S a,< ENGINEERING OTHER t✓ PPS i o oe nnea in oy eacn arvision maicatea nereon upon compieuon of its final inspection. of r TOWN OF YARMOUTH Building Department BUILDING (508) 31 ext.261 PERMIT NO _-------1_ PERMIT ISSUE DATE ; - 6/14/2004 _ ; PROP SE - - - - - _ _ _ JOB WEATHER CARD APPLICANT ,Frank Capra _ _ _ _ _ _ - _ _ _ _ _ - . _ - _ - - - - - - - - - - PERMIT TO ; New Construction ; AT (LOCATION) 00121CAMP ST # 123 ZONING DISTRIC R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C123 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE CONTRACTOR new construction: 2 baths, 3 bedrooms, 1 kitchen, 1 diningroom, 1 livingroom as per plans dated [�Franra. ICENSE 012430 REMARKS 04/26t04 and BOA # 3546. Frank 1600 Falmouth Road #25 AREA (SO FT) EST COST ($ $146,400.00 PERMIT FEE ($) $0.00 Centerville MA 02632 OWNER Iviiiages at Camp St., LLC BUILDING DEPT BY 5087789669 ADDRESS 11600 Falmouth Road # 25 Centerville MA 02632 INSPECTION RECORD FIELD COPY A TOWN OF YARMOUTH : /Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT APPLICATION RECEIPT Temp Permit No.: T-04-437 Applicant Name: Frank Capra Location: 00121 CAMP ST # 123 Owner's Name: Villages at Camp St., LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02632 Owner's Telephone: (508) 778-5603 (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $0.00 Payment Type: Check ChkNo.: 0 Net Owed: $0.00 Application Date: 3/8/2004 Issue Date: Expiration Date Comments: C/Z 3 new construction: This is NOT a building permit. Application subject to plan review. Contact Building Department for permit status. Official Building Permit will be issued upon plan review completion, approval, and complete payment of Net Owed on Permit Fee. Date Printed: 3/15/2004 A1: OF ,- ` nwrrwcnEES 1J` ONE & TWO FAMILY ONLY - BUILDING PERMIT APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING Town of Yarmouth Building Department 1146 Route 28 • Yarmouth, MA 02664-4492iozjhL Tel. (508) 398-2231 x261 • Fax: (508) 398-0836 - - j l7 Office se Only Planning Board .Information':; Assessors Department Information Permit NO 1��'f �� Date Plan Type t Map for Map` tot EYX ndorsement Date a`� r Per It Fee / �Im = ;Old --stew y Recording Date " 1 4 Property Dimensions Deposit Plan Nod NetDUe: ether "�� LotArea{sf) Frohtage(ft), ibtCoverage i x This Section #or Office`Use OnI :` 7 ' ildin`':P it`Nu rv` r Date Issued.-`- . i, X Certrfl te`of Occupancy > Signature aw 177 uilding Of icial ;� Date 14 �s" �'° is not•�`, required Section, t = Site'lnformat"ion Use Group: R-4 Type: 5-B 1.1 Property Address: 1.2 Zoning Information: a `11 5n4 - I° �� Des, ` L-4 1�-3 Iv �� Zoning District Proposed Use 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.4 Water Supply (M.G.L. c. 40. S 54) 1 5 Flood Zone Information , C%omments . Public Private ,r;Zone. BFE=��` :Section 2 -: Property Ownership/Authorized Agent 2.1 Owner of Record: ,, �1� / LLG Aov N mePint� Mailing Address CAt4ALC V� Signature I V Telephone 2.2 ze uthoriAgent: n off- ►��s l ooName (print) (,aw- 0. MailingAodress 6 Signature Telephone Se6ti66''3 -`Construction Services 3A Licensed ConstructionsSupervisor: Not Applicable ❑ COLO Qti� I'• DL o ✓ lUl� o By t f ✓I 3a' License Number Address O Expiration Date Signature Telephone 82 Registered Home Irtprovement'Contractoc, Company Name Not Applicable ❑ Address License Number Expiration Date Signature Telephone /d 3 I— 9-15-99 1 of 2 OVER /d 3 I— 9-15-99 1 of 2 OVER Section°4:-�WoTicers''Compensation Insurance Rffda�it'(M.G t C:.;1,52 S 25C (6) 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 .......... Sectiotl_5,,, Description of. Proposed Work,{clieckaq`apprcatile}, New Construction ff 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: tV%, { It, tL W� (ln �� tJ Ut :Section f = Estimated bnstruct on'.Costs Item Estimated Cost (Dollars) to be completed by permit applicant Check Below ❑ Conservation -Commission Fling (if applicable) ❑ Old Kings Highway & Historical Commission approval (if applicable) 1. Building 2. Electrical 3. Plumbing / Gas ` 7 7 4. Mechanical (HVAC) `7 X 5. Fire Protection '7 q -7 6. Total = (1 + 2 + 3 + 4 + 5) p 7S o 7. Total Square Ft. (new houses & additions) Section 7E0 OwnerWAuthonzation OwneAenYorConirac'torA'Itesfor r's To be Completed; Buildtn Pe it u e�i hereby authorize ` O -e ,a'`�owner of the subject property 6 t' to act on m beh , )n all matters elative to work authorized by this building permit Application. Signature of Owner Date Section- = Owner/Authoriz�edd Agent Declaration r7b as sw vW— V V t I lGr tM 1 �C�'CJQner/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. F Print nm'e ` VIJ��'Lt7 Signature of Owner/Agent 0-3 Date W 9-15-99 2 of 2 I k of "'9R TOWN OF YARMOUTH ...u,�y BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: - r (� / y, Job Location: I lil.. ST -/ GIJ q o" Owner of Property: Construction Super Address: 00 Licensed Designee: (If other than Supervisor) Name 2.15 Responsibility of each license holder: License No. ; (�k o A co 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 willfully violate 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 U( No ❑ If you have checked yes, 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 Chapter 152 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner I] Agent ❑ Signature: Building Official Approval: The Commonwealth of Massachusetts Department of Industrial Accidents OM CO011nestlpidess 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit cm I( t u k_. W/ 7 phone q 6-76 —2 7 I am a homeowner performing all work myself. I am a sole proprietor =rd halve no one working in any capacity 0 lam an employer pro%iding workers' compensation for my employees working on this job. comnanv name, address: city: phone Ih insurance co, policy k [?"'I am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below «ho hase city: ohone tl• insurance co. policy 0 comoany_name: Failure to secure coverage as required under Section 25A of MGL lit can lead to the imposition of erimitutl penalties of a else up to S1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a floe ofS100.00 a day against me. I andersmad'that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. t do hereby certify under the sins and naldes of perjury that the information provided above is true and correct k Signature��Date X Z Print named fit^ � i� official use only do not write in this area to be completed by city ortown affleial city or town: YnxnaUT$ _ permitAicense 0 MBuilding Departmeat oUcensiog Board ❑ check if immediate response is required 261 OSelectmen's Office 13Healtb Department contact person: phone M: _ (508) 398-2231 eat. Mother. I TOWN OF YARMOUTH 1146ROUTE28 SOUTHYARMOUTH MASSACHUSETTS0266411451 Telephone (508) 398-2231, Fact. 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 ` S+. Work AdAress is to be disposed of at the following location: 1Q►'� dT� _ 10d l� Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Permit No. Date r ' f BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 012430 Birthdate: 06/16/1940 Expires: 06/16(2004 Tr. no: 25823 Restricted: 00 FRANK G CAPRA 40 COPPER LN„r CENTERVILLE, MA 02632 Administrator 00 - 35.000 d enclosed space (MGL C.112 S.60L) to - Masonry only 1 G -1 & 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DIG SAFE CALL CENTER: (888) 344-7233 i It -IL ATE OF LIABILITY INSURANCE DATE(MMIDD/YY) 07/22/2003 PRODUCER (508) 994-9688 FAX (508) 991-5461 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION RUTKO%ISKI1 & 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 JNSURERA: Providence Mutual PO Box 664 INSURERB: OneBeacon West`Hyannisport, MA 02672 INSURER0. Continental Casualty.Co._:... INSURERD.-__ .. - . .. _ _.._... ._...... 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. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE jMM1DOfYY) POLICY EXPIRATION DATE (MMIDD[YYI LIMITS GENERALUABILITY CPP0053131 00 12/13/2002 12/13/2003 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE D OCCUR FIRE DAMAGE (Any one fire) S 50,000 MED EXP (Any one person) $ 5,00 A PERSONALS ADV INJURY $ - 11000,00 GENERAL AGGREGATE $ 2,000,000 GEHL AGGREGATE LIMIT APPLIES PER: POLICY JPECT LOC PRODUCTS. COMPIOP AGG $ 2,000,000 AUTOMOBILE LIABILITY ANY AUTO CBXE48125 02/14/2003 02/14/2004 COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS B SCHEDULED AUTOS (Per BODILY P INJURY person) S 250,000 X BODILY INJURY (Per accident) S 500 .000 HIRED AUTOS NON -OWNED AUTOS. .. - . �.... .. -. .. . _ .. _..... PROPERTY DAMAGE . ... (Per accident) _.... $ 100 .000 GARAGE LIABILITY - - _ .._ .AUTOONLY-.EA ACGDENT. S 'ANY AUTO _ . _.. ... •. OTHER THAN EA ACC S - _ AUTO ONLY: AGG $ EXCESS LIABILITY - OCCUR CLAIMS MADE .. EACH OCCURRENCE S. AGGREGATE $ S DEDUCTIBLE S RETENTION $ S WORKERS COMPENSATION AND EMPLOYERS LIABILITY 559UB861X751603 03/22/2003 03/22/2004 TORYLIMILt-TS ER EL EACH ACCIDENT S 500,0 C E.L. DISEASE - EA EMPLOY $ 500,000 E.L. DI$EAS. POLICITLIM(f >: 500 000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS nrvrronwry u�, err. _ _ _. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 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 AGE S R SgREnfNTA711VES. AUTHORIZED R R TATVE _ ACORD 25S 1714471 �t/I�V Vf�Y VVRfwf IIVIY rasa Loot I INUA I t of LIABILITY INSURANCE DATE(MMf°DNM) PRODUCTR a Dowling & O9 Neil Insurance THIS CERTIFICATE IS IS10/17/03 SUED AS A MATTER OF INFORMATION Agency,'Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 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 # Bayside Electrical Contractors, Inc. INSURERA: Travelers Insurance Company INSURERS: Guard Insurance Group 372 Yarmouth Road Hyannis, MA 02601 INSURER C: INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITHRESPECTTO 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. .TR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE w7ii LIMITS A GENERAL LIABILITY 16801484A82ACOF03 10/05/03 CURRENCE sX COMMERCIALGENERAL LIABILITY 1 000E 00TO RENTED $300 000 CLAIMS MADE O OCCUR MED EXP (Any one person) X OC.•P - PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE - PRODUCTS-COMP/OP AGG POLICY JECOT LOC A AUTOMOBILE LIABILITY ANY AUTO 18102601 W5611ND03 10/05/03 10/05/04 COMBINED SINGLE LIMIT (Ea accident) ALL OWNED AUTOS X SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per Person) X X BODILY INJURY (Peraccident) NON -OWNED AUTOS Drive Other Car X PROPERTY DAMAGE (Par accident) ' GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ANY AUTO THER THAN EA ACC UTO ONLY: EXCESS/UMBRELLA LIABILITY AGG ACH OCCURRENCE OCCUR CLAIMS MADE GGREGATE DEDUCTIBLE RETENTION S JA B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ' BAWC436910 08/18/03 08/18/04 WC STATU• OTH. ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED?Des. L EACH ACCIDENT describe under SPECIAL PROVISIONS below L DISEASE - EA EMPLOYE L DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Operations performed by the named Insured subject to policy conditions and exclusions. - Gatewood Homes 1600 Falmouth Road Suite 25 Centerville, MA 02632 ACORD 25 (2001/08) 1 of 2 #M31942 $1,000,000 S S S LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10_ DAYS WRITTEN E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL ;E NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED ACORD CORPORATION 1988 �J-------------- Producer: u�:x'.�' = F 2 CATS OF 2 NSURANCE SOUTHEASTERN INS AGCY 641 MAIN ST HYANNIS MA 02601 Code: ------------------------- Insured: RJ BEVILACOUA P 0 BOX 62B FORESTDALE MA 02544 Sub -code; Issue date: 7/22/03 This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policies below. ----------------------------------------------------------------------- ---------- COMPANIES AFFORDING COVERAGEY- I Co Ltr A: ARBELLA PROTECTION _ Co Ltr B; ARBELLA PROTECTION Co Ltr C: -------- Co Ltr D_ ARBELLA PROTECTION I Cc Ltr E: COVERAGES This is to certify that policies of insurance listed below indicated notwithstanding any requirement, term or condition have been issued of any contract to the insured named above for the policy period or other document to certificate may be issued or may ertaint the insurance afforded by the exclusions, and conditions of suc� policies. Limits shown have been with respect which this policies described herein is subject to all the terms, -------------------------------------------------------------------------------------------------- may reduced by paid claims. Cc I I I Policy Ltrl Type of Insurance I Policynumber leffective date -- -------------------- ------- ------------------------------------------------------------------------------ --------------------------------- I Policy I ex iration datel All limits in thousands p A I ENERAL LIABILITY I Commercial general liability s y 8500018147 I I 7/15/03 7/15/04 I 8eneral a re ate: 2,000 IProducts-comp//o [ Claims made (J Occur Ler's 8 contractor's I I I s a- Personal/advertising (Each Prot occurrence: 11000 (Fire damage: 100 --------------- -------- --------------------------------------------------------------- Medical 5 LIABILITY An 1 86852400001 I 2/21/03 ---- 1 2/21/04 -expense_ ------------------------ (Combined IAUTOMOBILE rr auto All owned autos I I Single limit: 250/500 (Bodily inju Scheduled autos Hired autos I I y IjPer person: Non -owned autos Garage liability I I II I bodily injury (Per accident}; -------- - -- ---------------------------------------------I------------------------------ Property damage: 500 II 1XJESS LIABILITY I -------------------------------- Each I ----------------------------------------------------------------------------------------------------I----------------------------- Other than umbrella form i I I I Occurrence Aggregate D i WORKER'S COMPENSATION I 9088600403 I 4/27/03 I 4/27/04 (Statutory I----------------------------- EMPLOYERS' LIABILITY I f00 (Each accident) 500 Disease -policy limit) .-.. -_. - --------------- ----- ----- --- - -------------------I ------------ ------------------------------------------------- 1sease-each emp-loyee.)..---------- IOTHER i i Description of operations/locations/vehicles/restrictions/special items: CERTIFICATE HOLDER CANCELLATION Should any of the above described policies be cancelled before the GATENOOD HOMES expiration date thereof, the issuing compact rill endeavor to HOO FALMOUTH RD STE 35 mail 10 days vritten notice to the certificate holder named to the CENTERVILLE MA 02632 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: --------------------------------------------------------I----- JOAN M MARTIN_- JA 4189 drM�K UtK FIFICATE OF. LIABILITY INSURANCE FRODucem 508-398-6033 _ FAX SOS-760-1667 THIS CERTIFICATE IS -ISSUED AS A Allied LAmericaxn Insurance Agency LLC ONLYANO CONFERS No RIGHTS U ` 1 Atlantic Ave ALTER THE COVERAGEATE DOE D SO Yarmouth MA 02664 Fu «a Lu5Tom doors 762 Falmouth Road Hyannis MA 02601 INSURERS AFFORDING COVERAGE INSuRERA: Arbella Protection I INSURERS: Hartford INSURER C: INSURER D: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJEI POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. —R GENERAL LIABILITY -XI COMMERCIAL GENERAL LIABILITY CLAIMS MADE rX OCCUR A CENL AGGAEGATE Uf�mITAPPLIE9 PER: X� POLICY n JEGT LOC AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS NIREDAUTOS NON -OWNED AUTOS We LIABILITY ANY AUTO EXCESSIUMBRELLA UA131UTY OCCUR CLAIMS MADE DEOUCnaLE RETENTION S WORKERS COMPENSATION AND EMPLOYERS` LIABILITY B ANY OFFICEWMEMBER EXCLUDED?�UT1VC SATE (MMA)ONYYY) I7/21/2003 OF INFORMATION OR NAIC III 'E. FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN 'ECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH ICY EXPIRATION LIMITS /13/2003 EACHOCCURRENCE e 1 OOO,OI DAMAGE TO RENTED I SO, OI MED EXP(A.Y ene paMM) S S,OI PERSONAL AADV INJURY E 1, 000, 01 GENERAL AGGREGATE I 2 OOO,O( PRODUCTS-COMPIOP AGG S 7 nnn n/ COMBINED SINGLE LIMIT S Ica aeuaeml BODILY INJURY f (P., PSMW) BODILY INJURY f (Per.Todeny PROPERTY DAMAGE S IPer abenl) AUTO ONLY - EA ACCIDENT f OTNER THAN EA ACC AUTO ONLY; ADOEACH FS, OCCURRENCE E.L EACH ACCIDENT S 100,000 EL DISEASE • GA EMPLOYE Ion _ nnn E.L Evidence of Insurance -for work performed within the Insured's scope of normal operations CERTIQCATE HQLDgR C C ELLATION SHOULD ANY OF THE ABOVE DjarrSAGENTS ,cg3 Be CANCELLED BEFORE THE EXPIRATION DATE THEREOF, TURER WILL ENDEAVOR TO MAIL 1� DAYS WRITTEN NOTICEIFICATE HOLDER NAMED TO THE LEFT, Gatewood Homes.. BUT FAILURE TO MAIL SUCH NOMPOSE NO OBLIGATION OR LIABILITY 1600 Falmouth Road k2 $ OF ANY KIND UPON THE INSUREOR REPRESENTATIVE$. Centerville, MA 02632 AUTHORIZED RESENTATIV 4CORD26(2001108) FAX: (508)778-5603 ©ACORD CORPORATION 19118 ACORD_ CERTIFICATE OF LIABILITY INSURANCE OP ID A DATE IMM/DD/YYYY) CROWC50 1 07 25 03 PRDDUCBR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Sullp-van, I Garrity & Donnelly ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE t08'-754-1767 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 10 Institute Rd - PO Box 15010 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Worcester MA 01615-0010 Phone: 508-754-1767 Fax: 508-754-1885 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: Hanover Insurance Cc 22292 INSURER B: Arch Insurance Company Crowell Construction, Inc. INSURER C: PO Box 309 INSURER D: So. Dennis MA 02660 INSURER E feTa1Tly:7-T1q=L1 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. lNbK LTR RUIJ � :NSR TYPE OF INSURANCE POLICYNUMBER POLICY EFFECTIVE DATE MMIDDIYY POLICY EXPIRATION DATE MM/DD/Yl' LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X OCCUR ZHN7007141 05/01/03 05/01/04 - EACH OCCURRENCE $1000000 PREMISES Ea occurence $100000 MED EXP (Any one Person) $5000 PERSONAL 3 ADV INJURY $ 1000000 ' GENERAL AGGREGATE s2000000 GEN'L AGGREGATE LIMIT APPLIES PEFt POLICY • ' jER7 LOC PRODUCTS-COMP/OP AGO s2000000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ARN7001142 05/01/03 05/01/04 COMBINED SINGLE LIMIT (Ea accident) f BODILY person) (Per person) $SOOOOOO X X BODILYINJURY (Per accident) $1000000 X PROPERTY DAMAGE (Per axidenl) s 500000 GARAGE LIABILITY ANY AUTO AUTO ONLY -EA ACCIDENT $ OTHER THAN EAACC AUTO ONLY: AGG $ S EXCESSIUMBRELLA LIABILITY OCCUR F-ICLAIMS MADE DEDUCTIBLE RETENTION S - EACH OCCURRENCE S AGGREGATE $ S $ S B — WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTrVE OFFICER/MEMBER EXCLUDED? ay es; descrbe under SPECIAL PROVISIONS bebw IRWCI00100 03/22/03 03/22/04 - - TORY LIMBS ER E.LEACHACCIDENT $ 500000 E.L. DISEASE - EA EMPLOYE $ 5 0 0 0 0 0 — E.L. DISEASE? POLICY LIMIT 5 500000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS Fax #508-778-5603 V CR I Il' I V N I G f1 V LUGR liN1Yl.G�LJ\ I I V I\ GATEWOO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL .1 O DAYS WRITTEN Gatewood Homes NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 1600 Falmouth Road IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Suite 25 Centerville MA 02632 REPRESENTATIVES. ACORD 25 (20011081 A- CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYy PRODUDER • 11/14/U3 Doyvlin3q 8 d' Neil Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Agency, Inc. ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE 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 Gutter Pro Enterprises, Inc. P.O. Box 1197 Plymouth, MA 02362 INSURERS AFFORDING COVERAGE INsuRERA: travelers Insurance Co INSURER B: Guard Insurnnrn rI D: c NAIC # THE POLICIES )IFE 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. _.R NSR TYPE OF INSURANCE A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS. MADE O OCCUR LIMIT OMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 1680459H3118TCT03 GARAGE LIABILITY ANY AUTO EXCESSNMBRELLA LIABILITYtGUWC440685 OCCUR CLAIMSDEDUCTIBLERETENTION SB WORKERS COMPENSATION AND EMPLOYERS' LIABILITYANY PROPRIETOR/PARTNER/EXECUTIV OFFICERIMEMBER EXCLUDED? H yes, tlescn' under SPECIAL PROVISIONS below OTHER 11/07/03 11/07/04 EACH 11/07/03 11/ 77/04 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECL4L pRONSIONS 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 Z #32273 MED (Ea aeddeentswGLE LIMIT i BODILY INJURY (Perperson) S BODILY INJURY (Per accident) 1 $ PROPERTY DAMAGE (Per acc 1 E OTHER THAN EA ACC AUTO ONLY: S SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL MOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL DAYS N MPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR tFPRFeevr•�-- AUTHORIZED 0 ACORD CORPORATION 1988 i1i 1� i 0.i 10. 11 rAA OU47900249 GOLDMAN ASSOC ACOPD CERTIFICATE OF LIABBLIT- Y WSU ANCE --T< Gos A SOCTAns INsnprlcs reps c�aru-scar r� u; ftlzba7CIAL 3ERVZCEs INC. ONLY AND CONFERS NO 933 FALMOU273 RD. HOLDER- THISCERTIFIC, HYANNIS MA 02601 'T THECQYERAGE) Phone: 509-775-6020 2aa: 505-790-0249 : t8st OR�akt3 CO a's_. RODNEY TAVANO MUMM& ZLIZIC3 DBA DMC 1jLNICAL SYS-Xq iastAaozc A?BARNSTABLE Rol 0266H ZM6—.mM. rrr- 7W-PaJSBOF LmTEO MaMWttAV£BEEN 'M=TO TFR.MURED NALRD ADOM FOR TM PC= PEAK ANY WOUSMMUH. TERYOR COND YM OF ANY CONTRACT OR ODESt OOQBOFNrV6TN OWSPECT7D WVttTN6l Ril MAT PERTAftTME M5UfWC6ARFROEO BfTT$FCtJC= DESCRoMHVtFal19 tMAWrTOALL TTEMaa9 F3Q.iJ�p POLXES. AGGOTEOATE LWM S"OWNUAVI VE GEM REDOCMBC PAtOC7A16. A 0 � I H1.8172 LAf`. EGATL LowrAP'PLiFS PER poLCyn FEO- CT I I LDC ALLOWNWAlTOS -GT14MtxxDAUROS MWDAUTOO NDN4whW ALFTGs -- dAPAGELmoLRY . ANY AUrO. OCCT,R g 1OtEr:d�RLtT`»SSAi7 T ".^.Y JCLA&O WADE 279AS4903A VmPLcvwWLL%wJ► GAVEWOOD Nows nm FAX 508-778-5603 1600 FA112X g gpAp CENTSRVnJX MX 02632 11121/03 I 11/91/04 OS/03/03 1 05/03/04 OFMJCH QJIE WE .e -13 m -n a i ZO1 ate... S 2000 s GATZWoor. .. SHOULD ANY-m TTEASO%S OOLLCtF6 n4TE7H6R[i�F,TNHtiitTwo MUPMR MWAVORTONAIL 10 rATSWRRTtilt -. MOLICEIO.TNE 7E.HpLCEhJ .M TlELFFT.tilr FALLMtETOOOSOLWI Oro"WOHlSAT10 0RFU L Y Mr'2WtVMTMMgL�R HSAaMM Olt --� AMRTM CERTIFICATE OF LIABLLtTY INSURANCE DATEr-mDofTYY,) PROOUCIR 08108!^003 + JOA4M DIAS- 51.18 672 2997 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO? ONLY AND CONFERS 'THE OIAS INSURANCE NO RIGHTS UPON CERTIFICATE HOLDER. THIS- EERFfFiEJFT6 Da ES NOI END- EXiEHQ 535 @RAYTON AVE QF ALTER THE COVERAGE AFFORDED BY THE POLICIES BELQVY FALL RIVER. MA 02721 INSURED -- INSURERS AFFORDING COVERAGE �KA]Jr JOEL FERREIRA DEALMEIDA RISuaERA: GRANITE STATE INSURANCE COMPkNY i ANC�.•494-48-8 DBA EJJA CONSTRUCTION PISUREN a: NAUTILUSIIVSCJRANC€ COMPAW-- NEZ75806 50"PICKERING ST. APT 17 FAIL RNER, !a+A 02720 aISURERC: wSuRERo --- COV@RAGES e+SURER E: THE POLICIES OF INSURANCE LISTED BELOW NAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATE 7. NOTWITHSTANDING AITY..REQULREMEN'T. TERM OR CONDITION OP MY CCNTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES 0ESCRIB€D7IEREk*I& SUBJECT TO ALL THC-TERMS, EXCLUSIONS.ANO. CQNOITIQNS POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID SR w. CLAIMS. OF SUCH P.OII!-]'RUMMER EFFECTIVE FOUCYEVIRATION ' GENERAL UA51UTY ' LIMITS X i NC27S80E CACHCCURRCNCECGNMFRCKLOtWFRALVAaILn S f.wT000 S2612003 06l262004 � CLAIMSMAD6 OCCUR P IauQCoo I{MEDE.[P Ais,FJ�Q t Pv on. Pwsm) i —�-- _ PERSONAL&AUVINJuM' Iy 1,Dp0 D0� tt6N'L AGGREGATE LIMIT APPLIES PER: GENERRC+YGGREGATE• f• T,000,000. - POLPCT PRO, .LOG I PRODUCTS. COMPgP A'.1- 2 000 000 AUTOMOBILE UAM JUTY I ANY AUTO PALLOWNEDAUTOS comll(60 lm I.CL6 LIMIT S I I �__.•��• I SCHfBULEDAVTOS i I WIRED ALTOS GODR.YIWU=Y fl D'er W�sOli) _� fl NON10"EQAUTOS YIWTY VRY v aaadantl = HE4— I —'-' PROPERDAMAGE GARAGE AUTOLIABILITY ANY AUTO I A0r0VNLYYIEXACCtOLj � OTHER THAN F?;�C•= I1� AUTO ONLY: , EXCESSnIMaREtLA LIAaILRY I OCCUR L CWMS MADE I EACNOCCURRENCa �S .-- AOGREGATa I S �I oEDucnaLE i 1 RETENTION S WGAIWRXID i PENU4Skr48-8S�EAPLOYSR3 rtN An"ROPRIETOR( =-- Op' RV LIMiSiU t8103•' UTyE OPICGRMEMSER OCCLUDED? II EL EACHgCCR7fA1T Il iv9S. 6e.:I�lw�.-� I GL OaCCiSG.Ei fium •wree � I. nnn nnn GATEWOOD HOMES 1600 FALMOUTH RD. CENTER VILLE. MA 02632 25 SHOULDANY OFTHEABOVi RPEGNWM PaLwj"ae CANCa. BEPOReTNe 17MIRA"" DATE THEREOF. THE ISSUING INSURER WILL t"CAVOR TO MAL 10 DAYS WRITTEN NOTICiTO•THC CERfaI4TTNOGDEitNAMIDTO THE LEFZ, I=PAILURE.IO nn Zn m. DAPOSE NO OBLIGATION OR LIA8ILTTY OF ANY KIND UPON THE WaURER, T9 AGENTS OR CERTIFICATE OF I SURANCE. riiS�UETE(MM/I)D,YY) 0/2003 PRODUQER ` `'Pasar0 Leverone & Buckley THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE Insurance Avency Inc POLICIES BELOW. P 0 Box 160 COMPANIES AFFORDING COVERAGE Dennisport, MA 02639 INSURED Patrick K Orcutt 6a P & S Concrete COMPANY A A.I.M. Mutual Insurance Co . 37 Ladys Slipper Lane Mashpee, MA 02649 COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECrTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, TEE 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 CI.ABvis. co LTYPE OF INSURANCE POLICY NVMIIER POLICY EM- CTIVE DATE(MM/DD/YY) POLICY DATE( LIMITSGENERAL LIABILITY IRSONAL NERAL AGGREGATE S ODUCTS-COMP/OP AGG. S OMMERCIAL GENERAL LIABILITY & ADV. INJURY S IMS MADE EACH OCCURRENCE S OWNER'S & CONTRACTOR'S PROT. FIRE DAMAGE (Any " fin:) S ' MED. EXPENSE (Any one person) S AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT S BODILY INJURY person) S ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-0WNED`AUTOS BODILY INJURY Per=idwt) S GARAGE LIABILITY - PROPERTY DAMAGE S EXCESS LtABnxry EACH OCCURRENCE S MBRELLA FORM AGGREGATE S THFR THAN UMBRELLA FORM WORKER'S COMPENSATION AND ORYWCSTATU- LIMIT X OTH- EMPLOYERS' UABILn'Y t A 6001111012003 10212003 10212004 EL DISEASE —POLICY LIMIT $ 1,000,0w THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE —EA EMPLOYEE S 1000 000 (OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIVEBICLES/SPECIAL ITEMS CERTIFICATE HOLDER CANCELLAMON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR Gatewoods Homes LIABILITY OF ANY KIND UPON THIS COMPANY, ITS AGENTS OR 1600 Falmouth Road REPRESENTATIVES. A(�•Ho�y� REPRESENTATIVECenterville, - MA 02632 t1W 554 =f P. 01 /01 • ; AI"ORZ%i., �iw7 i�"' � z}" " ,i H,�` Y Y' D4 _. _,.._. ..........< .uM.�. ..w .. _ 6.�a .... ,F.'_ .. wz. M.ta.• flies O3 Pf°11UClR • THIS CERTIFICATE IS ISSUED A$ A k7ATTFA OF iNFORRAATIOH AAND FERPFIC4TERS NOE N THE- EDEfi RIDER. RISK SPECIALISTS P THIS S CY OGOES NOT AMEND, EXTEND OA ALTER THE CCVE17a'GE dFF6pDED 6Y i(ie P81ICI'e8 6EL0{nW. INSURANCE AGENCY, INC. COMPANIES AFFORDING COVERAGE P . O . ROX 115 COMPANY A US LIABILITY INSURANCE COMPANY CATAUMET MA 02534-0115 W SURED MONUMENT INSULATION, INC. COMPAMERICAN HOME INSURANCE COMPANY 223 COUNTY ROAD BOURNE, PM -A 02532 COMPANY C COMPANY D THIS IS TO CERTIFY THAT THE POLICIES OF WSURANCE LISTED BELOW NAVE BEc6 ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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 PERTAM THE INSURANCE AFFORDED BY THE POLICES DESCRIBED'N.EAEW IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. c TYPE Of DIDUAANCE POUCYNUNBEA FCLCY=WCTIVE POU16 E%fl`nAT10H LTA RITE jNNAfO/TYl DATE dOVODlY17 LIMITS 08NERAL LIABILITY GET+eRALAooAEOATLS (c1 000 000 RI �1ClAC✓ALflENERAL OC=.Y PROOLCT9• COMPAP AGG3500 000 aO"&CONc®occLm PER30NALAADYawm $500 000HOWNF1YsscoNTlucroRgPROT CLI235?45 8/23/03 8/23/04 EACH OCCURRENCE s500,000 — I FwecaMAaelAAya»s.I 550o000000 AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE UL4T s ALL OWNED AUID9 SClgEOIJLED AUTbS (P pww") i MRED ALITOS NON-OWNTOALUOS BOORYfJJURY �oar,J i PROPERTY DAMAGE IS , CALRACt LIA91LllY ' ANYAUTCY .. AUTO ONLY. EAA W3 .... ..—.-- .. L2CEDB wBRM iwaT,�RETytT[. i uMeAFttt FCRM �aa+.�• s AOORECLATS s OTHER THAN UMBRELLA FORM s WOAKEBBCOi1PFJBAT ANZANO v A EyPIDY9C' UP.BiUTYPa 0. EACH Ac=NY 8100 000 �> B eP,w�,E X D �C 782 51 72 9/5/03 CFFt=M AAE 9/5JOd_ FlDISEASE - POLICY UMrt s500 000 OTHER ioLSF>sE.EAEMPLOYF—'.inn mnn , ENDULD ANY OF THE ABCVB DE>SCLDBED POLICIES BE CANCELLED i$ORE THE GATEWOOD HOMES, INC EXPIRATION DATE THEREOF, THE ISMN6 COMPANY WILL ENDEAVOR TO IWL 1600 FALMOUTH ROAD #25 IL DAYS wBITTEN NOTICE TO THE CERTIFICATE HOLDER NANIECTCTwI=Fr' CENTERVILLE , MA 02632 BUT FALllHB;TO rAs NOTrca SHALL nsP 508 778-5603 paE ND aBuoATroN on uABIm .:::.__ ::: s._ ..� 41, TOTAL P.01 t r.LJl CBR i IFICA i B ©F LIABILITY INSURANCE DATE()lpJOYYY) PRODUCER I a - THIS CERTIFICATE IS ISSUED AS A MATTER OF INPORYATION EE.'ShCo. IaSutaaCB AgfFriCy, IriC. ONLY AND CONFERS NO RI HOLDER. THIS CERTIFICATE DOES NOTOAMEND, EXTEND OR 749 main Street, Suite#A ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Osterville, Na. 02655 50$--520=2p1.1 INSURERS AFFORDING COVERAGE INSURED Casperaoa Overhead Doors INsuRERA u+rIena �rB INSURER D Box 517 INSURER V.East Falmouth, MA 02536 INsvaERo IYSURER E: a.�..Cw...�.. _ THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING - ANY REOVIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY SE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. EXCLUSIONS AND CONDITIONS OF SUCH NCR FOXY YE P0- CYEX� ATb4 T TYPE OF W4URANCF POLICY NUMBER 0 TE LIMITS eeHEflAL LIABILITY COMMERCIAL GENERAL LMBIUIY EACH OCCURRENCE - S .().,L.46S-� 5500. Q., . CLAMS MADE .- OCCUR FIRE DAMAGF. I"meKrol L.I J►] MED EXP (Anypn.Ors�l is Ate" — ::?3C83S2 05/28/03 05/28/04 PtRSONALa.ADvPwRV E 9 _ OENI AGGREUAI E LIMIT AM-LItS PER GENERAL AGGREGATE fl POLICY L) PRODUCTS -COMP/DPAGO f 000,004 ,pERO, AUTOMOBILE LIABiLRT ANY AU10 COMBINED SINGLE LIMIT fEa .eriaw) f ALL OWNED AUT03 - SCHEOUI FO AUTOS BODILY INJURY IPst pq s ) f WRCD AUTOS NON-OWNw AUTOS BODILY INJURY _ ro...eaa«II) PROPERTY OAMAGE (Pa w1c4m) f GARAGE LIABILITY AUTO ONLY -E►ACCIDENT S EA ACC f EkCESSLhum-mr- AUTO T. A00 f OCCUR CLAIMS MADE EACHOCCIIRRENCF S AOOREGATE S. OLOUCTIOLC H€TENTwN_ WORKERS COMPENSATION AND EMPLOYERS LIABILITY 1FC'P4S332- TORY LIMITS ER 02/22103_ 02/22/04 A E.LEACHACCMENT f5#0.000. E.L�p5EASE-. EA EMPLOY mneR E.L. DISEASE • POLICY LIMIT f DEZCRtPTION OF OP:RATtON�1LOCATION�YEIBCLEfi2XLYVSfON$ ADDED BY ENDORSEMENT/gPECUL PROVftION3 CERTIFICATE HOLDER AODMONAL INSUREn: INSURER LETTER. �.....�...�..,.. Gateway Roman 1600 Fal=ut' -toad-, Suite 2SIC Carterville, X% 02632 778 5603 DATE THEREOF- THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10_ DAYS WRITTEN NOTIQETOil1E-cERi/R0AT6}IOLDE QDO 90 SHALL IMPOSE NO OBLIGATION OR UA91UTy OF ANY KIND UPON THE INSURER, IT$ AGENTS OR ACORD 2S.S (7197)- O ACORD CORPORATION THBB DATE (MM/OD/YYI Y) A RD. CERTIFICATE OF LIABILITY INSURANCE DICER+ 07/18/03 • THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling & 10' Neil Ilhsurance - ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE AgenBy, 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 :::4ERS AFFORD*4CNAIC #INSUREDBusy Bee, Inc... A: HanoverP.O. Box 50 S: Safety InEast Sandwich, MA 02537 c: Associatce Compa D: E: COVERAGES A ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TOVE FOR HWHICH I HIS CECY IRTIIF CAI E U MAY BE ISSUED EDS OR DING 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. i NSR TYPE OF INSURANCE POLICY NUMBER POLICY TIVE POLICY EXPIRATION . DATE MM/DD/YY LIMITS GENERAL LIABILITY — " "- - X COMMERCIAL GENERAL LIABILITY 'CLAIMS MADE O OCCUR X PD Ded:250 06/14/03 106/14/04 . & ADV LIMB APPLIES PER: �.v.1 nwR 11, iL UUU UUU CY JERCaT PRO DucTs-COMP/OPAGG s2 000 000 ILE LIABILITY UTO 3175394 01/14/03 01/14/04 COMBINED SINGLE LIMIT(Ea accident) WNED AUTOSDULED �POrDIcWURYs1OO,000 rGEGREGAGREGATE AUTOS AUTOSWNED BODILY INJURY.S3OO (Per accident) ,000 AUTOS .. . PROPERTY DAMAGE $100,000'(Peraccident) ABILITYAUTO S UTO ONLY• EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: $ EXCESSNMBRELLq LIABILITY AGG $ S OCCUR CLAIMS MADE EACH OCCURRENCE AGGREGATE $ ' S -DEDUCTIBLE $ ' RETENTION S' C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WCC5002932012003 06/27/03 06/27/04 wcsTATu- oTH. I S- ANY PROPRIETOR/PARTNER/EXECUTWE OFFICER/MEMBER EXCLUDED? E.L EACH ACCIDENT $100,000 E.L. DISEASE - EA EMPLOYE $100000 H yes. describe under SPECIAL PROVISIONS below E.LDISEASE-POLICY LIMB SSOO,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Operations performed by the named insured subject to policy conditions and exclusions. i CERTIFICATE HOLDER CANCELLATION _ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION GateWOOd Homes DAE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1600 Falmouth Road Suite 25 �0_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Centerville, MA 02632 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001/0 1) 1 of 2 #30822 - �— KJS O ACORD CORPORATION 1988 e AFF���S�O_NI.X PROPERTYADDRESS: ALCULATION FOR PERMIT COST" ! TYPE OF ROOM ETC 6�7 L33. IS ADDITION ?� ALTERATIONS 3 3• LATH BED ROOM CERTIFICATE OF OCCUPANCY COMPUTER ROOM r3 DECK OPEN DECK WITH ROOF DEMOLITION DEN. b 4 _ .. DINING ROOK! I FIREPLACE FOUNDATION ONLY GARAGE NO. OF. BAYS GREAT RO M KITCHEN ' LAUNDRY ROOM LIVING ROOM MUD ' ROOM OFFICE PORCH CLOSED PORCH OPEN REROOFING SHED STORAGE AREA SUN ROOM HEATED SUN ROOM UNHEATEE SWIMMING POOL ABO SWIMMING POOL. INGF NO z ,) , _ _ n. •I� � a e.w r-.. ♦-J w. .-. ..Rti..)'iar.: w lr`-.�n� c O y tee- Building Site Location: Proposed Improvement: Address• i 6 ` - y3 TOWN OF YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET / a3 &Q l Map No• _Lot No. o)/• /. L'/C& 7 / Lgg 3 Date 3 Gb3�The Building Department will be responsible for assisting the app scant y dispatching your plans and or application to the following applicable departments. 'SIDENTIAL AND/OR COMMERCIAL BUILDING WATER DEPARTMENT: Determines Compliance of Water Availability and or existing location. ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage. CONSERVATION COMMISSION: Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. REVIEWED BY: / !/1. WATER DEPARTMENT: DATE: N/A:, ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE. N/A. V41. HEALTH INDUS7 RIAL AND/OR COMMERCIAL PERMITS S. WIRING INSPECTOR: DATE' N/A: 6. PLUMBING INSPECTOR- DATE. N/A. 7. FIRE DEPARTMENT: DATE: N/A: COMMENTS: RECEIPT OF COPY: PLEASE NOTE SIGNATURE OF APPLICANT: DATE: White copy - Buddmg Dept - Prot 0opy - Wala Dept - Yellow Copy - Health Dept - Pick Copy - EnOwaing DepL - Goldenrod - Fire DeWCM9MVR an TOWN OF YARMOUTH WATER DEPARTMENT 99 Buck Island Road West Yarmouth, MA 02673 Telephone: (508) 771-7921 • Fax: (508) 771-7998 Date of Issue : Mar 18, 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) 21.1C123 Street 121 CAMP ST #123 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 STREET : FRANK CAPRA 1600 FALMOUTH RD #25 CENTERVILLE, MA 02632 J. U �� �-/3 TOWN OF YARMOUTH BUILDING DEPARTMENT BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET �3 Building Site Location: % �'� � �" Map No: !�/ Lot << Proposed Improvement: tom/ 'iS)'.d a �P�ni /'�1a�k >v ?.l A r7 G SGG 3 Annlicant: Address: Date Filed: The Building Department will be responsible for assisting the appIi'c�� ant'�y dispatching your plans and or application to the following applicable departments. aESIDENTIAL AND/OR COMMERCIAL BUILDING WATER DEPARTMENT: Determines Compliance of Water Availability and or existing location. ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage. CONSERVATION COMMISSION: Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc. -------------------------------------------------------•--------------------------------------------------------------------------------- REVIEWED BY: �. WATER DEPARTMENT: _ DATE 3 N/A ✓2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A' ✓4. HEALTH DEPARTMENT: DATE: N/A: INDUSTRIAL AND/OR COMMERCIAL PERMITS 5. WIRING INSPECTOR: DATE: N/A: 6. PLUMBING INSPECTOR: DATE: N/A: 7. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: White CDPY - Buddmg DePL - Pick 00py - Water DepL - Yellow Copy - Health Dept. - Fink COPY -En&eming Dept - Goldenrod - Fire DepuC0NffvRt*8 r r NOTE: ® SEWER LATERAL SHALL BE SLEEVE RDANCE WITH TI 1=7 lIOFT. y� If fj M1 JU '7A GRAPHIC SCALE ay O'R?004 OTICE 20 10 0 20 60Fr-re6nslble ess-and-until-su a original (red stamp of the Professional; Engineer, or ai Lan Surveyor on'this plan:— a- I no person -or -persons, Including any municpal or otherficials, may rely upon the information contained herein; and IN FEET) this 'plan [femalnl �e property of Holmes do McGrath, Inc. 1 inch = 20 fL c., PLOT PLAN IY,. ,., -�• I ,�.k,►tA,�,;, holmes and-mc_ OF LOT 123 grcath, i c. a�. 9 civil engineers and land surveyors PREPARED FOR 362 gifford street MILL POND VILLAGE a ` falmouth ma. 02540 N YARMOUTH, MA JOB NO: 201197 DRAWN: LMC SCALE: 1"=20' DATE: 1-22-03 DWG. NO.: A2509 CHECKED: 71ifb �" . } • � � tD i22 s rm � T m r 0 io C tJ_ \ LL• J f � Z3 O Q >o WU O 0 J 0] L o C, I O O 47� a Ln p (Pl-p e?-) A I 1 I I! 26 F/ 14, I PROPOSED WATER SERVICE 0 1 "E� N81.3�•• 69.66 LOT 123 3,787 f S.F. 15� W ,33' 041. pRoposED HOUSE rn CD rn (MALLARD) 31' w 5.3AFFORDABLE N8 5 W 75, 7n %R' o� o3 LOT 122 ` 4,862 t S.F. I N OO NOTE: ® SEWER LA ALL BE SLE IN IF k INCE M PR a TPI GRAPHIC SCALE ICE 20 10 0 20 60 Unless and ah time as the original (red) stamp of the responsible Profess anal Engineer, or Professional Land Surveyor appears an this plan: (A) no person or persons. Including any municipal or other- ' public officials, may rely upon the Information contained herein; and IN FEET (8) this plan remains the property of Holmes & McGrath, Inc. 1 inch = 20 ft. PLOT PLAN holmes and mcgrath, inc. D,.AAAAAA OF LOT 123 civil engineers and land surveyors a^j" OF �'4S' PREPARED FOR - 362 gifford street TIMorHYki 0 MILL POND VILLAGE Falmouth, ma. 02540 SANrce 0 No. 4„ OId —' IN '�ti b C!V1 y r, � � rr YARMOUTH, MA JOB NO: 201197 DRAWN: LMC �w° 9, /aa' SCALE: 1"=20' DATE: 1-22-03 DWG. NO.: A2509 CHECKED: 7iitb i rq Vr _ 30. r Ln i22 I i ' u APR 2 3 2004 PROPOSED in BUILDING DEPT. O w (PLO 33 0 �. 16 GW Y p O 2 '� rn 14' � io O w w N rTl o m rrl -a S PROPOSED I WATER SERVICE o 1-3590 ..E� �N v my m � 69.66 LOT 123 rri v o 3,787 f S.F. 15. r in 33' (n .p. O .p �► O N \ PROPOSED ro HOUSE ,. �- N Q O Cn (MALLARD) tl Lin = N 33.0 aG G=15 rn — to to Cn \ w I 5.3AFFORDABLE � Z z� i� •�• ti o CON80 Sg' 7 ,W o w Co 75 76 %/ fn W LO W �a W ?6. .2 I Q; Co M w O Z o o ad LOT 122 I ,�, �:� N 4,862 f S.F.0 Co a NOTE: ® SEWER LATERAL SHALL BE SLEEVED IN ACCORDANCE p WITH TITLE V IF WITHIN 1OFT. OF WATER MAIN. GRAPHIC SCALE. 20 10 0 20 60 OTICE Unless and unto such time as the original (red) stamp of the responsible Professional Engineer• or Professional Land Surveyor - ( IN FEET appears on this plan: or persons. public (offi officials. person elY upon then Information on contany ained d hereal or in. 1 inch = 20 ft. (8) this plan remains the property of Holmes do McGrath, Inc. FLVI I f'LHIV �Ivllt es and mcgrath, inc. �P'SN OF nfgss OF LOT 123 q PREPARED FOR gineers and land surveyors � c�a TI 362 gifford street SAaM NTOS MILL POND VILLAGE falmouth, ma. 02540 G N e CIVIL N IN crvlL QISTEP�� YARMOUTH, MA JOB NO: 201197 DRAWN: LMC FS fGN Itt SCALE: 1 "=20' DATE: 1-22-03 DWG. NO.: A2509 CHECKED: -vc �R MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.01 Release 2 CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 HEATING SYSTEM TYPE: DATE: 4-16-2004 or 2 Family, Detached Other (Non -Electric Resistance) DATE OF PLANS: 04/16/04 PROJECT INFORMATION:. Mill Pond Village 1600 Falmouth Road Unit 25 Centerville, MA. COMPANY INFORMATION: Northside Design Assoc. 141 Main Street Yarmouth Port, MA. 02675 COMPLIANCE: PASSES Required UA = 245 Your Home = 140 0/" HOUSE MODEL: MALLARD I I I I Permit # I I I I Checked by/Date I I Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA --------------------------------------------I---------------------------------- CEILINGS 865 30.0 30.0 15 WALLS: Wood Frame, 160 O.C. 1631 15.0 15.0 72 GLAZING: Windows or Doors 109. 70.340 37 GLAZING: Windows or Doors 0.340 14 DOQRS--' 20 0.086 2 r�----- -------------------------------------- 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 Dat APR 2 � 7004 a r A f Massachusetfs Energy Code MAScheck Software Version 2.01 Release 2 DATE: 4-16-2004 Bldg Dept Use CEILINGS: 1. R-30 + R-30 Comments/Loca WALLS: 1. Wood Frame, 160 O.C., R-15 + R-15 Comments/Location WINDOWS AND GLASS DOORS: 1. U-value: 0.34 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location 2. U-value: 0.34 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: 1. U-value: 0.086 Comments/Location AIR LEAKAGE: Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. r EFFlGIENCY RATNG / 1 CERTFlED ■ Air Conditioning & Heating s.Eo ® < <ISTEo 92.6% AFUE MULTI -POSITION CONDENSING GAS FURNACE GMNT SERIES -0;* S»slcEwmis•.c,uwNVER Description / Application • All models design certified by ITS to be in compliance with ANSI Z21.47 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 (1 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., L.P., 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 GMNT Series 10/01 www.goodmarunfg.com PERFORMANCE RATINGS Model Number GMNT Natural Gas Input BTUH Natural Gas Output BTUH Propane Gas Input BTUH Propane Gas Output BTUH DOE AFUE Temp. Rise 040-3 40,000 37,000 37,000 34,000 926 25-55 05M 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 1004 100,000 92,000 92,000 85,000 92.6 40-70 120-5 120,000 110,000 111,000 102,000 926 40-70 BEFORE PURCHASING THIS APPLIANCE, READ IMPORTANT ENERGY COST AND EFFICIENCY DATA AVAILABLE FROM YOUR RETAILER. SPECIFICATION DATA 44G14 fall !sc. nen•"vw Mnnn^+;^n 1/0 CDT Model Number Motor Blower Vent` Dia. Combustion* Air Filter Size In Perm. / Disp. Electrical Ship Weight HP Spd. Dia. Width FLA Max Fuse 040-3 1/3 3 10 1 6 2' 2' 290 / 580 5.2 15 170 060.3 1/3 3 10 6 2' 2' 290 / 580 5.2 15 180 0804 112 3 10 8 3' 3' 385 / 770 7.8 15 205 1004 1/2 3 10 10 1 3' 3' 385 / 770 7.8 15 225 120-5 3/4 3 1 11 10 11 T 3' 480 / 960 9.2 15 265 -Note: vent ana comousnon air warnercrs may vary ucNanull iy UNvll VGI 1t 1=1 l!JLI 1. Vl1c ft Wllll II[JU YbOVL501 Yru,v, 1 accompany the furnace. 28' A 55" 3.. 195., 6,. 71, 4 3 471. 4$ I 3 r 4., 4.. COMB. AIR INLET GAS INLET 54 of 27., LOW VOLTAGE 4' ELEC. 10�" 4 Model GMNT A B Combustible Floor Base 0403 & 060-3 14' 121/2 SBM14 080-4 171/2 16' SBM17 100-4 21' 19 V SBM21 120-5 241% 23' SBM24 SS-312D 123- COMB. AIR INLET i GAS INLET i i r i 20$" LOW VOLTAGE CLEARANCES FROM COMBUSTIBLE MATERIALS Sides Rear Front* Vent To 1' 1 0' 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'�i 21• 24 v= Coil Model Number Coil Width U-18 14• x U-29 14• x U-30 17Y2' x(1) X(2) U-31 14' x U-32 17Y2' X(1) X(2) U-35 14' X U-36 17Y2" x (1) X (2) U-42 17Y2' X(1) X(2) U-47 17'/i x U-49 21' X(1) X(2) U-59 21' X(1) X(2) U-60 24'/2 X(1) X(2) U-61 24'/: 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 HI 1370 1315 1260 1200 1140 1070 1000 925 GMNT 040-3 MED 1210 1170 1130 1085 1040 980 920 860 LOW 895 880 870 840 825 780 725 680 HI 1360 1300 1250 1190 1135 1065 1000 930 GMNT 060-3 MED 1200 1170 1 1130 1080 1035 1 975 925 880 LOW 910 895 885 855 835 790 750 700 HI 1865 1800 1735j19360 1590 1510 1415 1320 GMNT 080-4 MED 1690 1645 16001485 1410 1345 1245 LOW 1450 1400 13901325 1270 1200 1125 HI 2010 1945 18751715 1620 1510 1400 GMNT 100-4 MED 1725 1700 1670 1615 1 1550 1475 1375 1275 LOW 1430 1390 1350 1315 1285 1245 1160 1070 GMNT 120-5 HI 2360 2325 2300 2170 2125 M45 1945 1850 MED 1815 1750 1710 1660 1600 1545 1480 1415 LQW 1275 t7121571 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. That's why we know... There's No Better Quality. Visit our web site at www.eoodmamnfg.com for information on: • Goodman products • Warranties • Customer Services • Parts • Contractor Programs and Training • Financing Options SS-312D 4 0 0 : - Commonwealth of Massachusetts Official Use only A,[ Permit No. �E-- OS— Department of Fire Services . Occupancy and Fee Checked, l.l�? BOARD OF FIRE PREVENTION REGULATIONS . 11f99j veblame l F l l ~ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WOR `o All woricto be performed in accordance with the Massachusetu Electrical Code (MEC), 527 CMR 12.0� ] I / S t P C 7 2004 (PLEASEPRINlIY=ORTYPEALERYFORMATIOA9 Date: City or Town o£ YARMOUPH To the Inspector of Wires, Y By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) MILL POND VILLAGE, Camp Street lC7 i 17,3 Owner or Tenant Gatewood Homes/ Jeff Sollows Telephone No. 50 8-778966 9 OwaeesAddress 1600 Fallmutti Rd., Suite 25, Centerville, Ma. 0263.2 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 1 Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Amp acity Location and Nature of Proposed Electrical Work Fire Alarm System (low voltage control panel) wi h ba kiM battery. centrally monitored . Camaletioif ofthe followine table may be iaaived-hv the Inmeetor ofii imt No. of Recessed Fixtures No. of Cell.-Susp. (Paddle) Fans of Totai Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool d e ❑ d. ❑ Battery Uniits g No. of Receptacle Outlets No. of Oil Burners FARE.. A? ARMU No. of Zones —1— No. of Switches No. of Gas Burners o. o etectioa.aa 7 Initiatin Devices No. of Ranges No. of Air Cond. Tons al No. of Alerting Devices No. of Waste Disposers HeatDam Totals: um er. ' core o. a ontame Detection/Alertin Devices 7 No. of Dishwashers Space/Area Heating KWum Local 0 Co neetion ®Other No. of Dryers .. Heating Appliances KW ecurrty ystems: No. of Devices orEquivalent o. of Water KW Heaters o o. a Signs Ballasts signs Data Wiring: No. of Devices or Equivalent No. H drumassa a Bathtubs y g No. of Motors Total HP Telecommunications Wiring, No. of Devices or Equivalent OT=k. Attach additional detail ifdesire4 or as required by the Inspector oflYirm 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 forge, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE M. BOND D OTBER ❑ (Specify ) (Expiration tr Estimated Value of Electrical Work $750.00 (When required by municipal policy.) Work to Start: Inspections to. be requested in accordance with NEC Rule 10, and upon completion. I certify, under thepains and penalties ofperjury, thatthe information on this application is true and complete FIRM NAME: Baltic Security, Inc LIC. NO.: 1178C Licensee: Jonas R Bielkevicius Signature �� �" LIC.NO: 499D (Ifappftcvble, enter "exempt" in the Iieenaenmttbelya02563 Bus. Tel. No.- 508-833-0996 Addr6ss: PO 'Box 1609 SandwicV, . Alt, Tel. No.: 508-7 —3347 OWNER'S INSURANCE WAIVER .I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement I am the (check one) ❑ owner ❑ owner's agent Owner/Agent PERMIT FEE. $ 40.00. Signature. Telephone No. lO�r OF yg9�oi TOWN OF YARMOUTH _ x ""CHEESE 1phuN O AVI7 /23 APPLICATION FOR PERMIT TO DO PLUMBING By Fee: $ PERMIT NO. (OFFICE USE ONLY) Building ./ Ownei �/ AT: Location Name New Plans Submitted Date Type of Occupancy /No enovation ❑ Replacement ElYes❑ z ? N ZO Y H > fN W Y J N Q V F Z 7 O y UJI a X N Z Cn Win F W tr 2 y O Z Z Z U R !r N W F in Z t] a M 0¢ a cc 0 IJ. w= Z LLI M 3 3 o Z i 3 Y VJ p 0: F J a x C G a= Q. u w LuRW o J m W O G J N O cc a 7G a� MY M 0 SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RDFLOOR (PRINT OR TYPE) Installing Company Name Address Business Telephone Name of Licensed Check One: ❑ Corp. ❑ Part-o INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. C41c One: FYes 1�J ? f'So_ ❑ L: .11 If you have checked YES, please indicate the type of coverage by cking the appropriate box. lSG A liability insurance policy Other type of indemnity ❑ SEP j34d 4 r OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance voerage required, by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. I a �'"r_'r t u"--. Check on Opgr ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted;§gn4gre of (or entered) in above application are true and accurate to the best of Plumber 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 i ense Nurr Chapter 142 of the General Laws. Type: Master❑ Journeyman 0 TOWN OF YARMOUTH APPLICATION FOR PERMIT TO DO GASFITTING (OFFICE USE ONLY) Fee: $ L307- it PERMIT NO. (S-65- ea Date Building Owner'g // AT Location % Z ���1 #� �J % NameAdK��T Type of Occupancy 7 [jVj 1 / lT New ELK Renovation ❑ Replacement ❑ f Plans Submitted Yes ❑ No �k 11 U) N N Y V Z M 2 H U) 0 0 m I.- N 0 z J U) ¢ W a r z z o 1— Il! m N r w w o o a w Q G7 � co C3 V W = N W t7 a 0 C W 0 z ►- a Z W J F a Z X W W �- N O m � z U. o FW- z W J o I.N. W s ¢ i o a= LL D 3 e ¢> c °o N o ca7 coy rW- SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Installing Company Name -�UGTS U Al/,i ►^'� tTE-D Address I L� G 14A16 S �r• f4�e�a Niy is r►'t A p 2 6 6 1 Business Telephone SD F-7 3 7- 3 6 S q Name of Licensed Plumber order 2�:O IAN INSURANCE COVERAGE: Check One: ❑ Corp. ❑._/Partnership — L Firm/Company Check One 1 have a current liability insurance policy or its substantial equivalent. Yes Er'�No ❑ If you have checked yes, please indicate t e type of coverage by checking the appropriate box. A liability insurance policy itr Other type of indemnity ❑ FE6 dZ- t 1 Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Check One: Owner ❑ Agent ❑ Signature o Licensed Plumber or Gasfitter 2t S' 10� License Number TVOG 1 lrr-FJCG- MILL POND VILLAGE CONDOMINIUM CAMP STREET, YARMOUTH, MASSACHUSETTS PURCHASE AND SALE AGREEMENT UNIT 123 MALLARD PART A: References: [Affordable Unit] The following terms which are capitalized and marked in quotations in this Part A shall have the meanings set forth below wherever such terms are used in Part B hereof, and this Agreement shall consist of both Parts A and B and all exhibits hereto: A. The "Date of this Agreement" is , 2005. B. The "SELLER" is: Villages at Camp Street, LLC, a Massachusetts limited liability company, with an address of 1600 Falmouth Road, Suite 25, Centerville, MA 02632, or its successors and assigns. C. The "BUYER" is: Lynda L. Gannon of 773 Depot Street, Harwich, MA 02645 D. Notice. Any and all notices or other communications required or permitted by this Agreement to be served on or given to any party hereto by any other party hereto shall be in writing and shall be deemed duly served and given when personally delivered to the party to whom it is directed, or in lieu of personal service, three (3) days after deposit in the United States Mail, first class and postage prepaid, or one day after deposit with a reputable overnight courier, addressed to the BUYER and SELLER at their respective addresses as listed above. E. The "Unit" to be conveyed hereby is: Unit #123 MALLARD, as such is further shown on the plans attached hereto as Exhibit A, which plans include a unit floor plan (Exhibit A-1) and a Designated Use Easement Area showing the Unit's Maintenance Easement Area and Exclusive Use Easement Area (Exhibit A-2). F. The "Percentage Interest" in the Common Areas referred to in paragraph 2 of this Agreement will be determined upon the completion of the phasing in of the Phase of the Condominium containing said Unit and will be so determined in accordance with the provisions of the Master Deed described herein. See also paragraph 27 of this Agreement. j :0 G. The "Purchase Price" referred to in this Agreement is: One Hundred Twenty -Eight Thousand and 00/100 Dollars ($128,000.00), which is calculated as follows: $128,000.00 (base price) + $ 0 (options and upgrades further described in paragraph I of this Agreement) PURCHASE PRICE: = $128,000.00 of which: $ 1.00 have been paid as a deposit as of this day, $ 0 have been paid previously, and $ 0 are to be paid at commencement of Unit construction $127,999.00 are to be paid at the time of the delivery of the deed in cash, or by certified, cashiers, treasurer's or bank checks. $128,000.00 TOTAL DUE H. The "Time for Performance" shall be at 11 a.m. on the 31 st day of January, 2005, at the place referred to in paragraph 7 of this Agreement. I. Options and Upgrades. The following items will be included in or eliminated from the Unit to be delivered hereunder and the costs or credits thereof are included in the purchase price set forth in paragraph G hereof- J. Commission. A commission fee for professional services specified in this paragraph is due from SELLER to Housing Assistance Corporation,(HAC) but only if, as and when the SELLER receives the full purchase price pursuant to this Agreement and the BUYER accepts and records the SELLER'S deed and not otherwise. Commission Due: 1.835% of Purchase Price $2,349.00 GSDOCS-1282281-1 .2- I °10 l I I I I I I Cc 3.7� V7� I LOT 124 Imo' N81035 0,�.E—I-i' N 69.66 J o 15.4'� 33.0' N J 4 � CO I I r N EXISTING 0) O1 FOUNDATION o N l� rn 00 26.0' 2 21.3' —30.3'' — ^' LOT 123 4.7 I� _N 1 W 75.76' LOT 122 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 ARE . 7� ATE REGISTERED PROFESSIONAL LAND SURVEYOR GRAPHIC SCALE 20 ( IN FEET ) 1 inch = 20 ft AS -BUILT PLAN OF LOT 123 PREPARED FOR MILL POND VILLAGE IN 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. ATE REGISTERED P OFESSIONAL LAND SURVEYOR NOTICE 60 Unless and until such time as the original (red) stamp of the J responsible Professional Engineer, or Professional Land Surveyor 7 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 do McGrath, Inc. holmes and mcgrath, inc. civil engineers and land surveyors 362 gifford street falmouth, ma. 02540 YARMOUTH, MA JOB NO: 201197 DRAWN: LMC SCALE: 1 =20 DATE: 7-05-04I DWG. NO.: A2509A CHECKED No. n