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Home My WebLink About121 Camp St #127 Building Permits,JAJL BU1WtNO' O� I TOWN OF YARMOUTH UN 17 4;1-7 APPLICATION FOR PERMIT TO DO PLUMBING (OFFICE USE ONLY) By — Fee: PERMIT NO. rl U�o - O Date wilding Owner's T �"I Name Location Renovation ❑ Yes El No El �P13RDFLOOR W Y J NIn 0z w c U) X ccUlW O � W Q Cn 0Z USNCn 0 J (PRINT OR TYPE) Installing Comnj Address Business Telephone Type of Occupancy Replacement ❑ z Y F W W Z S C7 N Y ¢ a U. Q a ;a�+ X W 0 z_ o o. (A Z rt a o OJ LL 3 J N H Q �d a W U. Y W Y a O y z Z W F- O U S 0 H N O Cr cc G Q = m 0 C4 7 7 Check One: It �41 ❑ Corp. —D ❑ P s ip Firm/Company Name of Licensed Plumbe INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes No ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. Bond ❑ A liability insurance policy ❑ Other type of indemnity ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. C Signature of Owner or Owner's Agent 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 Chapter 142 of the General Laws. Type: Master El JourneymanO' Commonwealth of Massachusetts Official Use only _ Department of Fire Services [[Rev. rmit No. ` BOARD OF FIRE PREVENTION REGULATIONS cupancy and Fee Checked _ee��_ 11/991 eaveblank QN APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK oAll work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 o N EASE PRINT IN INK OR TYPEALL INFORMATION) Date: 07/21/2005 To the Inspector of Wires: City or Town of: YARMOUTH, AMBf P this application the undersigned gives notice of his or her intention to perform the electrical work described below. cation (Street & Number) 121 CAMP ST., UNIT 127 G m ner or Tenant GATEWOOD HOMES, INC. Telephone No. 508 778 9669 wner's Address 1600 Falmouth Road #25 Centerville MA 02632 Is this permit in conjunction with a building permit? Yes X No ❑ (Check Appropriate Boa) Purpose of Building RESIDENTIAL Utility Authorization No. 1462679 Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service 100 Amps 120/240 Volts Overhead ❑ Undgrd X No. of Meters 1 Number of Feeders and Ampacity 2/100 Location and Nature of Proposed Electrical Work: WIRE HOUSE Com lesion o the ollowin table m be waived b the Ins actor o Wires. o. o No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans Transformers KVA Generators �'`� No. of Lighting Outlets 8 No. of Hot Tubs o. a Emergency Lighting A ova • No. of Lighting Fixtures 8 Swimming Pool md. ❑ rnd, ❑ Batte r Units No. of Receptacle Outlets 30 No. of OR Burners FIRE ALARMS No. of Zones No. of Switches 10 JNo. of Gas Burners Initiating Devices To No. of Alerting Devices No. of Ranges 1 No. of Air Cond. Tons eat ump .__umber ons No. oSelf-Contained 6 No. of Waste Disposers Totals: " Detection/Alertin Devices Municipa ❑ Other No. of Dishwashers 1 Space/Area Heating KW Local ❑ Connection Heating Appliances KW Security Systems: `� Hg pp No. of Dryers 1 No. of Devices or E uivalent o. o ater o. o 0.0 Data Wiring: 1 KW 4.5 Ballasts No. of Devices or E uivalent Heaters Si ns Te ecommumcations wiring: ti 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. IN 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. 10/31/2005 CHECK ONE: INSURANCE X BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete FIRM NAME: PATTON ELECTRIC, INC. � � LIC. NO.: A 15542 Licensee: RICHARD PATTON Signature LIC. NO.: —�— (If applicable, enter 'exempt" in the license number line.) Alt. Tel. No.• 774-'t 53-6878 Bus. Tel. No.: 508-539_n200 Address: PO BOX 1525 MASHPEE MA 02649 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 Telephone No. PERMIT FEE: $125.00 Signature APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK To the Inspector of Wires: (OFFICE USE ONLY) ._ WN`OF YARMO TH By III Fee: j AUG G 4 Z0� :uI d PERMIT NO. � / J E AYL,L-jh}JR�GItI AON) Date: this application the undersigned gives notice of his or her work described below. A Location (Street &� Nu her t' Owner or Tenant _ Owner's Address Is this permit in conjun 'on With building permit? Yes QNo Purpose of Building Ll Utility Existing Service Amps / Volts Overhead❑ New Service Amps �% / '6�' .Io s Overhead[ �J Number of Feeders and Ampacity w� Location and Nature of Proposed electrical Work: (Check Appropriate Box) Authorization No. perform the electrical Undgrd C3 No. of Meters Undgrd-e)'�' No. of Meters_ KVA V `-No. oI Ul nun vuua Above C3 in- ... v...,..6 .. �.b.._ Batte Units No. of Li htin Fixtures Swirnmin Pool rnd. md. No. of Zones No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS o. o etecuon an No. of Switches No. of Gas Burners Initiatin Devices Total No. of Alerting Devices No. of Ranges No. of Air Cond. Tons No. of Self -Contained Heat pump um er ons _ _ Detection/Alerting Devices No. of Waste Disposers Tota]s: Municipal Other Local Connection S ace/Area Heating KW p No. of Dishwashers Sec tit Systems: valent Heating Appliances KW No. of Devices or ui No. of Dryers No. of No. of Data Wing' No. of Devices or Equivalent No. of Water KW Heaters signs Ballasts Telecommunications Wiring: No. Hydromassage Bathtubs No. of Motors Total HP No. of Devices or mvalent Attach additional detail if desired, or as requirea oy me ulayrLsu. -r ��\ INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued unless the licensee provides %proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in mit force, and has exhibited proof of same to a pe BONDing office. OTHER (Specify:) CHECK ONE: INS NCE (Expiration Date) a 1 (When required by municipal policy.) Estimated Val f 1 ctri Work: nd complete \� Work to Start: O In c ions to be requeste in cc da ce with MEC Rule 10, and upon completion. �I.certify, unde th `p s and p al of p hCis at teinf on v application is true LIC. No. NAME: %tu. LIC. NO. L N Signature e ice a umber lin Bus. Tel. No.: ` (If applica r "e t" / t it. Tel. No.: '— Address WNER'S IN CE WAIVER: I am aware that the icens a oes not have the liability insurance coverage normally required by law. By my signature elow, I hereby waive this requirement. I am the (chec one) ow er ❑ owner's agent. Owner/Agent Telephone No. Signature [Rev. 04/001 -ev off�7a1 Use - Commonwealth of Massachusetts �//y .� Permit No. Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS�ivncyandFee4 1 ve blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK, All viwktr be pezfo=ed is aeoordance with the MLuarhusats E ectrial Code (MEC), 527 CIvIIt (PLEASEPRI7VTINIIVKORT7PEALLENFOR&fA770A9 Date: City or Town of YARrOclrx To the Inspector of Wires:. ry -19 he By this application the undersigned gives notice of his or r intention to perform the electrical work desked below. o Location (Street & Number) MILL POND V'II.LAGE, 121 Carnp St Bldg # Owner or Tenant Gatewood Homes/ Jeff Sollows Telephone No.5U8-71$J 9 Owner's Address 1600 Falmoutti 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 / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ IIndgrd ❑ No. of Meters Number of Feeders and Ampachy Location and Nature of Proposed Electrical Work Fire Alarm System (low voltage control panel) with haClct_m battery ' . ntral ly mnnitorecL No. of Recessed Fixtures No. of Cell-Susp. (Paddle) Fans ° ° Dial Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Futures Swimmin Pool o —e g o. o ergency g d. d. Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARM No. of Zones —1— No. of Switches No. of Gas Burners o. Of UPlnitiDevices 7 t No ofitanges No. ofAir Cond. tal Tons No. of Alerting Devices No. of Waste Disposers Totalsp umber. Tons o. o ontam Detection/Alertin Devices 7 No. of Dishwashers SpacelArea Heating KW Local �«p Connection ® Other No. of Dryers .. Heating Appliances KW ecunty ystems: No. Devices ore o. o Water Heaters' o. Sr Ballasts of ivalent Data Wiring. s No. of Devices or uivalent Na Hydromassage Bathtubs No, of Motors Total HP eco un=c :boas wing No. of Devices ore ivalent OTHER: INSURANCE COVERAGE: Unless waived the owner, n°. permit o�magnioe ofele sr cal woo may issue unless the licensee provides proof of liability� pemrit for the peri'ormaace of electrical work may issue unless insurance including "completed operation" coverage or its substantiall equivalent. ent. The undersigned certifime es that such coverage is in force, and has exhibited proof of sato the permit issuing offi cRECK ONE: IN uRANCE ® Boi ID p OTMM p (Specify) Estimated Value of Electrical Work $750.00 �'�0II to (When required by municipal Policy) Work to Start Inspections tobe requested in accordance with LMC Rule 10, and upon completion. Ica*, andet thepains and penalties of perjury, that the information on this application it true and complete FIRM NAME: Baltic Security, Inc LIC. NO.: 1178C Licensee: Jonas R Bielkeviclus Signature _ LIC. NO. 499D Addrkss-bl. enter "exempt"in elieensenwnb 02563 Bus. Tel. No.- 508-833-0996 Addrfss:� PO Box .1609 Sandwic ,lea. Alt. TeL No. 508-7 —33 7 OWNER S INSIIRANCE WAIVER aware that the Lrcensee does not have the liability insurance coverage normally required -bylaw. By my signature below, I hereby waive this requirement I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature. Telephone No. PERMIT FEE. $ 40.00 DRIVEWAY 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 REGISTERED PROFKSIONAL 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 contelned herein: and (B) this plan remains the property of Holmes dt McGrath. Inc. FILE COPY L=37.08' ' • LOT 126 LOT 127 '(mom" N c 1B.5 cD ro EXIS •a IO 0o FOUNE cr EXISTING rn s FOUNDATION 0 Im CP M N 25.0' J 01 1� Na 2142E 226•��O v 20 1 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 PR FE SIONAL LAND SURVEYOR GRAPHIC SCALE 1 inch = 20 & AS —BUILT PLAN holmes and mcgrath, Inc. OF LOT 127 civil engineers and land surveyors ��EA�1H of y�y PREPARED FOR 362 gifford street MICHAEL Cyr MILL POND VILLAGE a IN falmouth, ma. 02540 MLGRATH H YARMOUTH, MA "o.2 JOB N0: 201197 DRAWN: LMC SCALE: 1"=20' DATE: 6-6-05 DWG. NO.: A2514A CHECKEDZAOA. t IA' o AT (LOCATION) TOWN OF YARMOUTH Building Department (508) 398-223 1,,ext.261 PERMIT NO B-05-1033_ ISSUE DATE 3/10/2005 _ ; PROPOSED USE ----------- ----------- BUILDING PERMIT APPLICANT _F'a"kcap_ra_ : _ _ _ _ - _ _----- ---- JOB WEATHER CARD PERMIT TO New Construction-' CAMP ST # 127 DISTRIC R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C127 BUILDING IS TO BE: CONST LOT SIZE 5-B I USE GROUP new construction: 2 baths, 3 bedrooms, 1 greatroom, 1 kitchen as per plans dated 02/09/05 and REMARKS BOA # 3546. �nr.i I is I COST ($ [$141,600.00 PERMIT FEE ($) $516.00 OWNER lVillages 0 Camp Street, LLC UILDING DEPT B ADDRESS 11600 Falmouth Road # 25 CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville I MA 102632 Certificate Issue Date 30 do s e CERTIFICATE of OCCUPANCY De _ artmental A .__ p Approval for Certificate of Occupancy and Compliance Inspector Date Permit Number Aooroved By Ramnrlra BUILDING PLUMBING/GAS ELECTRICAL ENGINEE To be filled in by each division indicated hereon upon completion of its final inspection. `i TOWN OF YARMOUTH Building Department BUILDING _ _ _ _ _ _ _ _ _ _ , (508) 398%- , ext.261 (yq�6�' PERMIT NO B-05-1033:- • -- _ ---pERMIT ISSUE DATE 3/10/2005 _ ; PROPOSED USE APPLICANT Frank Capra --------------------- JOB WEATHER CARD PERMIT TO New Construction ' AT (LOCATION) 100121CAMPST#127 I ZONING DISTRIC R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C127 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE new construction: 2 baths, 3 bedrooms, 1 greatroom, 1 kitchen as per plans dated 02/09/05 and REMARKS BOA # 3546. AREA (SO FT) EST COST ($ $141,600.00 PERMIT FEE ($) $516.00 OWNER lVillages @ Camp Street, LLC BUILDING DEPT BY ADDRESS 11600 Falmouth Road # 25 Centerville I MA 102632 INSPECTION RECORD CONTRACTOR LICENSE Ot2430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 FIELD COPY ..Note Progress ! I 50 �i7_�/lam i u 0 ONE & TWO FAII -.y ONLY - BUILDING PERMIT SIP CAPPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING 0 Town o ' f Yarmouth Building Department K-T C.ECS 1146 Route 28 - Yarmouth, MA 026614492 Tel: (508) 398-2231 x261 - Fax: (508) 398-0836 n Assessors De�a i'24 A-4 Irs iD, ten'4 h", -i Q4r 'w '6w s -Al ;* hl'Z 7FR."Mi�- I �M.11 J-!VtA; amg Use Type: 5-B 1.1 Property Address: 1.2 Zoning Information: Zoning District Proposed Use 1.3 Building Sc Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.4 Water Supply (M.G.L. c. 40. S 54) iz Public Private 2.1 Owner of Record: Q,, LLc Aou Nte I Pintk I Mailing Address Q4,4#urvrU Ak�)n- A) i 2 - :7 9 - 1 & ;z Signature V \-Ili V I Telephone- 2.2 uthorizeq Agent: A I 00 Name( (\0 Mailing -Address -7 7 Sig ature Fax II �1 -/ w w. vik 3.1 Licensed Construction Supervisor: UL n< Not Ica DL License er fQJk'.AC, a nta Addre ;9� r Expiration Date Sign&6re .4# IS A:!()jrP 'A er, Company Name 3A 7005 Not Applicable ❑ Address License Number Bv- Signature Telephone ----------- N- Expiration Date jov (le,ml 1 of 2 OVER eciiFitai1f01rSPCS�OfperlS3 i4L}e}t7Clj3nCe1�fCfi3}ll(iG".7ra2 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 .......... S,ep)ttfa� ��'3esenpfiz�t-ofx�'ropt�;sed�o(•)�`I*cC�iecka�;�pp�ieai7g� New Construction No. of Bedrooms No. of Bathrooms Existing Bldg. ❑ Repair(s) ❑ Alterations ❑ Addition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: j t/� W` f Vl� i ''�` "'EsTrtataii ;Coristnc`"tioz�is Check Below Item Estimated Cost (Dollars) to be ❑ Conservation -Commission Fling (if applicable) ❑ Old Kings Highway8 Historical completed by permit applicant 1. Building O o 2. Electrical Zo 3. Plumbing /!as =7 V A y� 4. Mechanical (HVAC) Commission approval �o 5. Fire Protection If applicable) 6.Total=(1+2+3+4+5) 7. Total Square Ft. (crew houses & adrLlions) O . sSestmnaWneA`tf� �t'[o� C3wnrSA pnisu—ntraptrrAP itsfoz r�,t�e"Compfeted'1�her Bdingt?errnit,w :: as vner of the subject property Y''^'e S co, �� to act on hereby authorize J m beh , in all matters elative to work authorized by this building permit ppl'cation..r r Signature of Owner ' Date Zeta�.�BT,,lfp�D�EC"C3r3ti0lg �EC2it1rl�r7E7�"' f, SNS'1BS/AClt ai .. `st R (/U Agent t Gt--t^� v , as Qwner/Authorized 1, t 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. Ina.f Owner/Agent Date N 9-15-99 2 of 2 •p;a4 'ARbO 'r O F y k PLEASE PRINT. Job Location: _ TOWN OF YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM Owner of Property: Construction Supervisor: Address: ('0 00 Licensed Designee: (If other than Supervisor) Name Name )0 `'K " -, /U 2.15 Responsibility of each license holder: Village S�I . LL c oaly3� License No. License No. Phone 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 Anylicensee 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 (� No ❑ If you have checked }L, please indicate the type coverage by checking the appropriate box.' A liability insurance policy 0 Other type of indemnity IDBond ❑ OWNER'S INSURANCE WAIVER: 1 9w9vilre that the licensee does not have the insurance coverage required by Chapter f the Mass eneral d that my signature on this permit application waives this requirement. Check one: Sian a Own r wnersAaent Owner ❑ Agent 9 63 Signature: Building Official Approval: The Commonwealth of Massachusetts Department of Industrial Accidents office of ftestfpotfoss 600 Washington Street Boston, Mass. 02111 Workers' Compensation insurance Affidavit O I am a homeowner performing all work myself. I.am a sole proprietor _r.d ha%a no one working in any capacity I am .an employer pro,. iding workers' compensation for my employees working on this job. company name: address: city: phone N• insurance co. nolicv N (/I am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below ttho ha%e cit-v: phone N: . insurance co.. policy 0 company name: Failure to secure coverage as required under Section 25A of MGL 152 as lad to the imposition of criminal peaaides of a Ilse up. to S1,500.00 sadfor one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine ofS100.00 a day ataimt me. 1 vaderstand'thst a copy of this statement may be forwarded to the Oft Pf—q Investigations of the D1A for coverage verification. k I TOWN OF YARMOUTH 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664 4 51 Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT BUILDING ELECTRICAL GAS PLUMBING SIGNS Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 1 \C&JvXA p Work Adc6ss �n l is to be disposed of at the following location: ! nw►��S`` C� �` Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Signature of Applicant Permit No. i ✓ ti Date t �j' ✓'hB �L(1COU� O�J/Ulh16G�QC� BOARD OF BUILDINGREGULATIONS License: GONSTRU.CTION SUPERVISOR. Numbei» 012430 .. Birtfidate II6 i 494 ExpF�s�dquiisM06 Tr. no: 2592.6: Restncted FRANK CAP.FF = ;' 417,60PPER'LNr� ` CENTERVILLE, MA OY163� Commissioner ' 00 - 35,000 d enclosed space -) (MGL C,112 S.6ap 1A • Masonry only F 1G F 1- & ZFamiy Homes Failure to possess a cumentedition of the Massachusetts State Building. Code is cause for revocation of this license. i '-- DIG SAFE CALL CENTER: (888) 344-7233 L '� bFi/tly/'Ltlt74 by:t/ tl/!-3l7-7//4 0U [N L,MC mT L L f AQC,A CERTIFICATE OF LIABILITY INSURANCE 978.394-2253 DIRECT THIS CERTIFICATE NFEIS ISSUE' IODUCER ONLY AND CORS NO i ATLANTIC INSURANCE GROUP, INC. ..en tulc rr.RTIFICATE AIP.LLC 385 BOSTON POST ROAD PMB 203 SUDBURY, MA 01776 uaeo GATEWOOD HOMES INC. IWO FALOMOUTH ROAD CENTERVILLE MA 02632 r tRTL V1/ Vl j� DATE (MWDODOQ.... ' 08/0812004 ASA MASTER OF 1. FORMATtON GHTS UPON 7HE CERTfFlC7i7E �.. unT AUCAIn FYTEND OR INSURERS AFFORDING COVERAGE -- - I INSURER A NATIONAL FIRES MARINE _. __ . --•• I...�. --- '-- -- -- —_. �._ ._.... INsuREA B: MA WORKERS COMP. RESEARCH BRD ;. INSURER G_ _ __.._ .— -..._. -..-_ _—• _ __. I Ns�RC0. E� OVERAGES ;UED TO THE INSURED ANY RE vESOENTSTERMCORICOND CONDITIONBELOW OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH PTHIS OCERTIFIC CERTIFICATE MAY BE ISSUED OR MAY OERTARE THE INSURANCE AFFORDED OFBY` 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 CLAS. IM Efl'ECTnvE ►oLICV EAviaATpNr� � UnYe ,f�_ TYPE OF INSURANCE I _--• ►OLICYNUM9ER I efmomaml 1i`Q EACN OCCURRENCE f j DENERAL LIABILITY F 43 I 4/29/04 4/29/05 FULE oAMaGE (AnY oAo &e: - t - — • 3000Q„ /{IXICC MMERCIAL GEHEAALLWBILTTY MEOEXP(Mry'_oAa_P_aw"I, 3—•_.1�� CuDA3 MADE I X_ I OCCUR I -_ II' PERSONALSADV INJURY f 1000000 IF-GE—NERAL AGGREGATE 1 E' __2O_000O-- I yRppUCTS • COMPIOP A&i I f y _ 1000000 �GENI AGGREGATE UNiT APPLrE3 PER: `—_. —_ . -.•.. 11 ... .� r PARO-. —I or. ry I I f ;LOG WTOM:)ml LIABILITY I ANY AUYO AL_OWNED AUTOS SCHEOULEDAUTOS -! HRIED AUTOS -- NCN-OWNED AUTOS .- OARAG-2 LIABEJTY .-1 ANY AUTO .I OCCUR I CLAIMS MADE DEDUCTIBLE B I WORKeR3 COMPEN TY�N ANO I POLICY UPDATE NUMBER TB B/4/04 EMPLOi OTHER _ I IESCRIPTION OF OPERATIONVLODATVNEAIENIOLELEXCLUEIONS ADDED BY ENDORSEMENTI3PECUU. ►RC PROJEC' : MILL POND VILLAGE (VILLAGES AT CAMP ST. LLC - DBA) TOWN OF YARMOUTH BUILDING DEPARTMENT ,MaBBIINNEo SINGLEOMIT I f ._ .__.. BODILY INJURY r t BODILY INJURY LPu araAaM PROPERTY DAMAGE (PM acddenq If If AUTO ONLY•EAACCIOEN- ___• OTHER THAN AUTO ONLY. AGG • S EACH OCCURRE NCB_ AGOREGATE t ,_,_• ... t .--• S _ 614105 `— X= - IELEACH ACCIDENT _ 3 rE.l DISEASE: EA ENPIDYEq t _ SHOULD ANY OF THEABOVE DESCRIBED POLICES DE CANCELLEO BEFORE 711E EXPIRATION DATE THEREOF, THE 1861BNG NSUAER WILL ENDEAVOR TO NAIL 60 DAYS WRITTEN NOTICE TO THE CZRTwx:ATE NOL ED TO THE LEFT, OUT FAILURE TC• DO 30 SHALL IMPOSE NO OBLIGATION OR D.ITY F ANY KING UPON THE INSURER. n3 AGENTS OR D CORPORATION 1998 ACOMa CERTIFICATE OF LIABILITY INSURANCE. DATE(MM/DDIYY) 05-n-04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION BlEwd A. (flail Irxm=m ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P O 3i7 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURED INSURERS AFFORDING COVERAGE . INSURER .A: � fir- a--711erY1}��'�� Fire Im. Cb- INSURER B_' ( ^ '-3 & qEg 1ty . _ _ -. _ __ INSURER C: INSURER D: ' f 1 INSURER E: COVFRLrRFS _ THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY* PERIOD INDICATED. NOTW)THSTANDINC ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OF MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OFSUCF POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. '. _ ___... _ _. ._. __._. _, .. .. _. . .__. . ...... INSR i )POLICY EFFECTIVETPOLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER DATE M"00/YY I DATE fMM/DD/YYL LIMITS GENERAL LIABILITYEACH OCCURRENCE $ 1 a( ow COMMERCIAL GENERAL LIABILITY FIFE DAMAGE (Any one Fire) S_ 5 CLAIMS MADE ixK1 l OCCUR , - I i r I 1 MED EXP (Any one person) $ 1 PERSONAL S ADV INJURY 1 $ 1 000,000 GENERAL AGGREGATE 13._2F 00(�. A I GEN'L AGGREGATE LIMIT APPLIES PER: GO 0005933 04 lO—QS—m r--' ... 10-05}-04 PRODUCTS - COMPIOP AG_G 15_ 2, QQQ( 000 I POLICY j I PFO- i .' LOC AUTOMOBILE LIABILITY i I I I COMBINED SINGLE LIMIT ANY AUTO i + (Ea accident) • ALL OWNED AUTOS SCHEDULED AUTOS I - BODILY INJURY i I (Per Person) `$ HIRED AUTOS I I i I BODILY INJURY I j NON -OWNED AUTOS i I (Per accident) I 1 PROPERTY DAMAGE I$ I - (Per accident) I GARAGE LIABILITY _ I I AUTO ONLY_ EA ACCIDENT I $ 1 ANY AUTO I r EA ACC 13 I OTHER THAN I I I 1 AUTO ONLY: AGG $ EXCESS LIABILITY '' EACH OCCURRENCE • $ OCCUR L J CLAIMS MADE I - r AGGREGATE IS DEDUCTIBLE I $ I RETENTION WORKERS COMPENSATION AND 1 STATUTH-I II 'O i EMPLOYERTUASIUTY I TWC ORY LIMITSS-ER. , I �""' �'------'_' $ 0 04-01-04 04-01-05GELEACHACC.- ... I.. LEL. DISEASE_. EA EMPLOYE$100(0m B ` I Hm 0m6m I I EJ_ DISEASE - POLICY LIMIT i $ 500,000 OTHER i DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER i ADDITIONAL INSURED; INSURER LETTER: CANCELLATION GAeknod�( SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATOOI 1600 TMl_th R DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _ DAYS WRITTEI Sli25 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALT Umbmy lle, ' M IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS Of •• REPRESENT ES. AUTHORIZ R RESE A V,E FAX: 506.M.5603 C ACORD 25-S (7197) © ACORD CORPORATION 198 ACORD- CERTIFICATE i OF LIABILITY INSURANCE ECO =DATE.(M=D/MYYRI j Dowling & O'Neil Insurance - -' Agency, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON Inc. THE CERTIFICATE HOLDEP- THIS CERTIFICATE DOES AMEND 222 West Main St. PO Box 1990 ALTER THE COVERAGE AFFORDED BOY THE POLICIES BE OW, Hyannis, MA 02601 INSURED INSURERS AFFORDING COVERAGE NAIC # Assurance Construction, Inc. INSURERA: Nautilus Insurance Company A/0 Assurance Excavation, Inc: INSURER B: 550 Willow Street INSURER C: West Yarmouth, MA 02673 INSURER D. CnVconr_vc _ INSURERE: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PEP.100 INDICATED. NOTWITHSTANDING . ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 70 WHICH THIS CERTIFICATE MAYBE ISSUED A MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OFOR SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -TR NSR TYPE OF INSURANCE POLICY NUMBER' POLICY EFFECTIVE POLICY EXPIRATION A GENERAL LIABILITY DATE MMIDD DATE MMIDO LIMITS N�C289301. .09/08103 09/08/04 EACH OCCURRENCE X COMMERCIAL GENERAL LIABILITY $1 (100 000 DAMAGE TO RENTED CLAIMS MADE � OCCUR PR 1 $100 000 X BI/PDDe_d:1,000 MEDEXP(Any one pem 1 $5000 PERSONAL &ADV INJURY E1 OOO OOO GEN'LAGGREGATE UMrrAP1�PUEES PER GENERALAGGREGATE S2 OOO O00 POLICY JEC- I 1 LOC PRODUCTS -COMP/OP AGG S2_000_DOD AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT ALL OWNED AUTOS accident) $ SCHEDULED AUTOS .BODILY INJURY HIRED AUTOS (PerperSMI $ NON -OWNED AUTOS BODILY INJURY (Per nciderd) S - PROPERTYDAMAGE IARAGE LIABILITY (Pe eccidm) S ANY AUTO AUTO ONLY -EA ACCIDENT S OTHER THAN EA ACC i KCESSIUMBRELLA LIABILITY AUTO ONLY: ' AGG S 7 OCCUR CLAIMS MADE EACH OCCURRENCE $ DEDUCTIBLE WORKERS COMPENSATION AND EMPLOYERS' UABiLIT1' ANY PROPP,IETORIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES, ET(CLUSION5 ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Operations performed by the named insured subject to policy conditions and exclusions. Gatewood Homes, Inc. Attn : Paula 1600 Falmouth Road, Suite 25 Centerville, MA 02632 ACORD 25 (2001108) 1 of 2 #35194 rnxanttsq i E S S S _ S VIC STATU- OTH_ M E.L. EACH ACCIDENT y E.L. DISEASE -EA EMPLOYE S E.L. DISEASE - POLICY LIMIT $ 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 JV `�0 ACORD CORPORATION 1988 max server Ats"61.l►. °CER.i1M PROOUCEA EMPLOYERS INS GROUP-INC 281 MAIN ST STE 5 FITCHBURG MA 01420 vn�.n A RO' INSUR _ - COMPANY RESOURCE MANAGEM"Eh I INC B 281 MAIN STREET SUITE 5 FITCHBURG MA 01420 COMPANY r1 NY C rIS5Ura-.iAce_ �j��Vcs_ ar DGDA iLIIIAItU, NOIWfrHSTANDING ANY R. ERTIFICATE MAY BE ISSUED OR MAY ZCLUSIONS AND CONDITIONS OF SUCH TYPE OF INSURANCE GENERAL LIABILITY ERCIU- GENERAL LIABILITY 4517S WMS MADEOCCUR 8 CONTRACTORS PROT. MOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ANY AUTO EXCESS LIABILITY UMBRELLA FORM OTHER TFWM UMBRELLA FORM A WORKER'S COMPENSATION AND EMPLOYERS LIABILITY THE PROPRIETOR! X INCL PARTNERS'EXECUfIVE OFFICERS ARE: EXCL JILNF, TERM OR CONDITION OF ANY CONTRACT OR OTHEI N, THE INSURANCE AFFORDED BY THE POLICIES DESCRIE ES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM: POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRAM DATE(MMIDMYY) DATE(MMJ)DAYY) (UB-967X499-9-03) I 11-20-03 1 11-20-04 - WITH RESPECT TO WHIM IS SUBJECT TO ALL THE uMTrs GENERALA GGREGATE I PflODUCTS-COMPIOP Off. 13 PERSONAL & ADV. INJURY S EACHOCCURRENCE $ FIRE DAMAGE (Any one fire) S MED. EXPENSE (Any one Person) S COMBINED SINGLE S UMTT BODILY INJURY (Per Person) $ BODILY INJURY (Per Accident) S PROPERTY DAMAGE S AUTO ONLY - EA ACCIDENT s OTHER THAN AUTO ONLY: EACH A= NT AGGREGATE s:: S EACH OCCURRENCE S AGGREGATE S ACCIDENT S 1 C iE—POLICYLMIT Is 50 iE—EACH EMPLOYEE S 10 COVERS EMPLYS LEASED TO ASSURANCE —EXCAVA- TORS 5S0('WILLOW ST W YARMOUTH MA 02673 =Sor�� - THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. EFFFtGA�E:}fQL{3FJ .+ .4' •n{.y, ,..4na.�.n ., .ntw„ fira..�i?`5'+ LUTHOFU-ED NY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THEGATEWOOD HOMES, INC. DATE THEREOF• THE ISSUINGCOMPANY WILL ENDEAVOR TO MAIL ATT:PAULA S WRITTEN NOTICE TO THE CERTIFICATE HOLDERW=MD TD•TC'1600 FALMOUTH ROAD —SUITE$ 25 FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR CENTERVILLE MA 02632 F ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATTYES REPRESENTATIVE A)CORD CERTIFICATE OF LIABILITY INSURANCE . I' oR/n2/2n 4 PRODUCER (508)997-6061 FAX (508)991-3283 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Southeastern Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 662 State Rd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 79398 N. Dartmouth, MA 02747 INSURERS AFFORDING COVERAGE NAIC # INSURED R J Bevilacqua Construction INSURER A: Arbella Protection Insurance PO Box 628 INSURER B: Forestdale, MA 02644 INSURER C: INSURER 0: INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTW ITHSTANDINI ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' - TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE fMM1DD/YY) POLICY EXPIRATION DATE IMMIDONY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FRI OCCUR X recial Form 8500018147 07/15/2004 07/15/2005 EACH OCCURRENCE - $ 1,000,00 DAMAGE TO RENTED $ 50,000 MED EXP (Any one person) $ 5 , 00 PERSONAL B ADV INJURY S 1,000,00 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: POLICY EPRO- LOC PRODUCTS - COMPIOP AGG S 2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 86852400001 - 02/21/2004 - 02/21/2005 COMBINED SINGLE LIMIT (Ea accident) s BODILY INJURY (Peon) S 250,000 X X BODILY INJURY (Per accident) - S 500,000 X PROPERTY DAMAGE (Per accident) $ S00,000 GARAGE LIABILITY ANY AUTO _ AUTO ONLY - EA ACCIDENT $ OTHER THAN. EA ACC AUTO ONLY: AGG $ $ EXCESSNMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION S EACH OCCURRENCE $ AGGREGATE $ S S S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERID(ECUTIvE OFFICER/MEMBER EXCLUDED? If yes. describe under SPECIAL PROVISIONS below 9088680402 04/27/2004 04/27/ZO05 X I WCSTATU- OTH- S 100,000 E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ 100,000 E-L DISEASE - POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS or any and all operations performed during the policy period. CFRTIFICATF HOI TIFR - CANCELLATION -------------------- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MALL 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 Rd Ste 25 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Centerville, MA 02632 Pauline Desrosiers ACORD 25 (2001/08) ©ACORD CORPORATION 1988 ACORDn CERTIFICATE OF LIABILITY INSURANCE oAio9i2 0 ' 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 414 COUNTY STREET HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NEW BEDFORD, MA 02740 INSURERS AFFORDING COVERAGE INSURED Frank Capra INSURER A: Providence Mutual PO Box 664 INSURER8: OneBeacon West.Hyannisport, MA 02672 INSURERC.' 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 LUWTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. INS: TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE fMMIDDfYYI POLICY EXPIRATION DATEMM , LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR CPPOO53131 01 12/13/2003 . 12/13/2004 EACH OCCURRENCE $ 1,000,0( X FIRE DAMAGE (Any one fire) S 50,0 MED EXP (Any one person) S 5 , Q( PERSONAL & ADV INJURY S 1, OOO , O( GENERAL AGGREGATE S 2 , 000 , 0C GENL AGGREGATE LIMIT APPLIES PER JECaT LOC PRODUCTS - COMP/OP AGG $ 2 , OOO , OC AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BXE48125 02/14/2004 - ... 02/14/2005 COMBINED SINGLE LIMIT (Ea accident) S JPOLICY BODILY INJURY (Per Person) S 250,00 BODILY INJURY (Per accident) . $ 500,00 PROPERTY DAMAGE (Per accident) AUTO ONLY. EA ACCIDENT S 100.00 S GARAGE LIABILITY ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR O CLAIMS MADE DEDUCTIBLE RETENTION S _ - EACH OCCURRENCE S AGGREGATE $ s • S S C WORKERS COMPENSATION AND EMPLOYERS' LIABILITYER OTHER [S59UB861X7516O4 03/22/2004 03/22/2005 TORYLIMIT- OTH. EL EACH ACCIDENT S 500.00 EL DISEASE - EA EMPLOYEES 500,004 EL DISEASE -POLICY UMrT S 50-0 QQ( DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESlEXCLUSIONS ADDED BY ENDORSEMENTISPECULL PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED- INSURP LETTER: CANCELLATION _. Gatewood Homes Inc 1600 Falmouth Rd Ste 25 Centerville, MA 02601 25S(7/87) FAX; (508)778-5603 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KJNM'OI381T" 6CnMPAW Me A..,ane� ��..,�.�...... A I DATE (MMIDOMYYY) ACORD. CERTIFICATE 4F LIABILITY INSURANCE 09/09/2004 PRODUCER f 08-398; 6033 FAX 509-760-1667 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eastern ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE tern Insurance Group LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1 Atlantic Ave ALTER T COVERAGE AFFORDED BY THE POLICIES BELOW. FSo Yarmouth MA 02664 INSURERS AFFORDING COVERAGE NAIL INSUAED Cape Cod Custom Floors _ - INSURERA: Arbella Protection Ins Company 762 Falmouth Road INSURERS: Hartford Hyannis MA 02601- INSURERc INSURER D: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTTHSTANOIN 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 CONDITIONSOFSUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS- INSR DD`L ME OF INSURANCE POLICY NUMBER POLICY EFFECTIVE 12/13/2003 POLE Y EXPIMTION LIMITS A GENERAL LIABILITY J( COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fx 1 OCCUR 7500000373 12/13/2004 EACHOCCLRRENCE s I,0r10; DAMAGE TO RENTED S 50,00 MEO EXF (Arty one person) L S-000 PERsoNAL A FOY "JURY s 1, 000 , 00 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPA7P AGG S 2 , OOO OOO GENL AGGREGATE LIMIT APPLIES PER: X POLICY PRO. LOC JEGT AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDVLEDAUTOS HWEDAUTOS NON -OWNED AUTOS COMBINED SINGIE LIMIT S BODILY INJURY (Pa pasty) S BODILY INJURY (Pa aCoagm) S PROPERTY DAMAGE (Per eerida ) S GARAGE UASILTTY ANY AUTO _ AUTO ONLY -EA ACCIDENT S OTNER THAN EA ACC AUTO ONLY: A043 S S EXCEESAIMBRELLA LIASIUTY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION S - EACH OCCURRENCE AGGREGATE f S s °�" S B WORKERS COM►ENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOWPARTNEWEXECUTNE OFFICVWEMBER EXCLUDED? _ N yyaesp da PROVISIONS bales Wbe UA&H SPECIAL 08WECKL1007 05/ZS/2004 OS/25/2005 x WCST4TU' E.L. EACH ACCIDENT S 500,000 E_LDISEASE .EAEMPLO S S00,000 E.L. DISEASE •POLICY LIMIT S S001000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Evidence of Insurance for work performed within the Insured's scope -of normal operations Gatewood Homes 1600 Falmouth Road $25 Centerville, MA 02632 ACORD25(20oi/08) FAX: (508)778-5603 INCELLAl1UN SNOULD ANY OF THE ASOW DWCRIBED POLICIES BE CANCELLED-BER)RETRLP EXPIRATION DATE THEREOF, THE 163UWG INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE To THE CERTFlCATE HOLDER NAmn"& PMrtER— BUT PALURE To MAR, SUCN NOTICE SNALL IMPOSE NO OBLIGATION OR LIABILITY OF AMY KIND UPON THE INSURER. ITS AGENTS OR REFRESENTATviB---- CACORD CORPORATION 1988 DATE(MM/DO/Y" AC ,M CERTIFICATE OF LIABILITY INSURANCE 8/2/2004 PRODUCER j THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION McShea Insurance.Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 749 M inStreet Suite#H ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. a , Osterville, Ma. 02655 508-420-9011 VSURED Casperson Overhead Doors Box 517 East Falmouth, MA 02536 1508-563-5633 CnVFRAGFS INSURERS AFFORDING COVERAGE NAIC# INSURERA: Worcester Insurance Company INSURERS: National Grange Mutual INSURER C: INSURER D: INSURER E THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TQTHE INSURED NAMED ABOVE FOR THE POLICY PERIOU INUIUAI EU. NUI WI I M IANUINu ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. wsR LTR D'L NERD TYPE OF RAN ' POLICY NUMBER POOALI �EEFFFEECTIVE PpAT' _n5 D ON LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMSMADE OX OCCUR CB 2J1973 05/28/04 05/28/05 EACH OCCURRENCE S 1 OOO OOO PREMISES Ea oocorence S 100,000 MEDEXP(Anvoneperson) S 10,000 PERSONALBADVINJURY $ 1,000,000 GENERAL AGGREGATE s 2 OOO OOO PRODUCTS-COMP/OP-AGG E 2,000 000 GEN'L AGGREGATE LIMIT APPLIES P • POLICY F1 jECOT- LOC AUTOMOBILE LIABILITY ANYAUTO ALLOWNEDAUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS . " " _ COMBINED SINGLE LIMIT (Ea accident) $ BODILYINJURY (Per person) $ BODILYINJURY (Peracadent) $ PROPERTY DAMAGE (Peracadent) $ GARAGE LIABILITY ANYAUTO AUTO ONLY -EA ACCIDENT E OTHERTHAN EAACC AUTOONLY: AGG S S IXCESSNMBRELLA LIABILITY OCCUR CLAIMSMADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE S E B wORKERscomPENSATIONAND EMPLOYERS' LIABILITY ANY PROPRIETORRARTNER/EXECUTNE OFFICER/MEWER EXCLUDED? Hyes, desWDeunder SPECIAL PROVISIONS below CP48352 02/22/04 02/22/05 X W A H- TORYLIMITS ER EL EACH ACCIDENT $ 500,000 E.L. DISEASE • EA EMPLOYE $ 500,000 EL DISEASE• POLICY LIMIT S 500,000 OTHER - .. DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Gatewood Homes, Inc. 1600 Falmouth Rd., Ste. 25 Centerville, MA 02632 ACORD25(2001/08) GANGELLAIION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOt DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITYOFANY KIND UPON THE INSURER ITS AGENTS OR C ACORD CORPORATION 1988 �,>, CERTIFICATE OF LIABILITY INSURANCE PRODUCER (508) 790-1919 THIS CERTIFICATE IS ISSUE[ DATE (MMIODIYYYT 11/06/200? ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Sandpiper Ins. Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 12 Enterprise Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. H annis MA 02601- INSURERS AFFORDING COVERAGE NAIC # INSURED - INSURERA:ZL1rich Small Construction CENTURY PAINTING AND DRYWALL,INC CENTURY PAINTI INSURER 8: PO BOX 2903 it G1 INSURER C: INSURER D: HYANNIS MA 02601-7903 INSURER rnvvaer_cc THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING AN' 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 ANC CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADUL INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDIYY) POLICY EXPIRATION DATE (MMIDDIYY) LIMITS GENERAL LIABILITY / / / / EACH OCCURRENCE $ 1,000,0C ED PPRREEMMISES ( a o�cc r nce) S 300,00 X COMMERCIAL GENERAL LIAV TTY - MED EYP (kny one on s. 10,00 CLAIMS MADE ❑OCCUR SCP034309873 12/18/2002 12/18/2003' PERSONAL 3 ADV INJURY S 1,000,00 GENERAL AGGREGATE S 2,000,00 GENL AGGREGATE LIMITAPPLIES PER PRODUCTS-COMP/OP AGG S 2,000,00 POLICY JJ'EC LOC AUTOMOBILE LIABILITY / / / / COMBINED SINGLE LIMIT (Ea accident) S ANY AUTO BODILY INJLRY (Per person) S ALL OMED AUTOS - / / / / SCHEDULED AUTOS BODILY INJURY (Par acddentl S HIRED AUTOS / / / / NON -OWNED AUTOS ' PROPERTY DAMAGE _ (Per accider* S - AUTO ONLY -EA ACCIDENTANY OTHER THAN EA ACC f 0GARAGELIABILITY AUTO $ AUTO ONLY: AGG EXCESSfUMBRELLA LIABILITY / / / / EACH OCCURRENCE S AGGREGATE S OCCUR CLAIMS MADE S S DEDUCTIBLES / / / / S RETENTION S WORKERS COMPENSATION AND / / / / TORY LIMITSER EL EACH P,C7DEN7 - $ EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNSWEXECUTTVE OFRCER/MEMBER EXCLUDED? / / - / / EL DISEASE- EA EIAPLOYEd S E.L.DISEASE-POLICY LIMITS If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS PAINTING r DRYWALL CERTIFICATE HOLDER CANCELLATION ( ) - (508) 778-5603 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE _ EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT GATEWOOD HOMES FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE 1600 FALMOUTH RD SUITE 25 URER,ITS AGENTS OR ATIVES. ACORD 25 (2001/08) w INS025 (01oe).05 MA 02632- ELECTRONIC LASERVRMSjAC. - (800)327-0545 © AR ORD CORPORATION 1931 l Page I of: aco CERTIFlC i era i ti �f`tntstIZA [Gr ,. PRODUCER Sullivan, Garrity & Donnelly THIS cERTIFICATE Is ISSUED AS 5 0 8 - 7 59 -17 6 7 ONLY AND CONFE IS NO RIGHTS 10 Institute Rd -. PO $Ox 15010 HOLDER. THIS CEI• TI)'ICATE DOE ALTER THECOVEFAGEAFFOROE Worcester KA 01615-o010 — tN3URER5AFFORD111GCOVERAGE Phone:508-754-1767 Fax:SOB-754-18B5 INSURED ' _ WeURE-R A; Hanov Lr Insurer INSURERS: Arch Cnaurance Crowell Construction, Inc. PO Box INSURERC; wsuRER D: _ NA 02660 I`nvaner_rc INSURER E: __ Co OR NAIC1!... THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY P£RF D INDICATED. NOTwITHSTAIjdiwj ANY REOUIRK"N""'IM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WFTH RESPECT TO WHICH THIS CET' (IFY_ATE MAY BE ISSUED OR I MAY PERTAG THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, TERMS' E%CLlY.� ON; AND CONDITIONS S}'J�I J LTR NSR TYPE OF w$VRANCE POLICY NUMBER I Y F TIV DA E MMIOIVYY ICY E: PIRA I DATE NI vD[UY '�'- LIMITS A GENERAL X UABMY COMMERCIALGFNFRALUl9IUTY tLAIM$MADE ®OCCUR ZEN7007141 OS/O1/04 05/ 11/OSI $ 1000000 _ $100000 cMlx+.%nl j 5000 MCARRENCE AO� IN_Ani1 f1000000 RI°6ATBS GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JEC7 COC OINf)101%AOG f 2000000 AUTOMOBILE UADILITY I A ANY AUTO ABN7001142 05/01/04 05/ 1; OS COMBINED SINAI.E LINE (Ea occIdwdI I y- f AUTOS BODILY INJURY I (Pm imri A) SlOOOOOD ULEDAUTOS AUTOSWNED BODILY INJURY IfZOOO000 (Per a¢weralIIPROPERTYDABN.GEj$00000 tGAJUABILNED AUTOS ITY TO UTOONLY-EA.A&IIXWT S OTHER THAN E^ ACS AUTO ONLY: I --- A-10 S . S EXCESS/UIHBRELLA LIABUJTY OCCUR CLAIMS MADE EACH OCCURRENCE S _ AGGREGATE S —�- f DEDUCTIBLE S jP,OPRIGr.OPJPARrNER1EXECUTWE RETENTION- j f KERS COMPENSATION AND 'FR OYERS' LIABILITY RZRWCIDO100 CR/NEMDER EXCLUDED? TORY LIMITS +( 03/22/04 03/:•2/OS FLEACHAcerE:NT $500000 'dededbe wd�Y E.L OL4EASE-E.A EMPL(r/c IAL PROVISIONS Below OTHER E.L. DISEASE - POLICY UNUT — DESCRIPTION OF OPERATIONS / IOCATION9 f VEHICLES I EXCLUSIONS ADDED By ENDORSEMENT I SPECIAL PROVISIONS —�-- As per policy forma, Conditions and exclusions. f500000 S 500000 CERTIFICATE HOLDER— -- Gatewood Homes/ Inc. 1600 Falmouth Road Suite 25 Centerville KA 02632 (ZUDTIUB) GATZWOO SHOULD ANY OF THE AROt iof.CRIBFO POLICIES Be CANM:L LED BEFOR -TW&- PWA!M OATE THEREOF, THE ISSUIH f tkaURER WILL ENDEAVOR TO I.NJL 10 DAYS WRITTEN NOTICE TO THE CEATIFICA' T W LDEA FUMED TO THE LQFT. INUT FAILURESOna Sc aHAt I IMPOSE NO OBLIGATION OF: LIA DILITY OF ANY KIND UPON W,z INSURER ITS AGENTS OR V '` '-A'CORD- CERTIFICATE OF LIABILITY INSURANCE °08/04/200"44 PRODUCER 508-428-0440 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MARK SYLVIA INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 969 MAIN STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. OSTERVILLE MA 02655 INSURED PETER J. GOVONI DBA P. GOVONI LAND SERVICES 20 OPEN TRAIL RD. SANDWICH, MA 02563 CnVFRAGFS INSURERS AFFORDING COVERAGE INSURERA: FARM FAMILY CASUALTY INSURER B: rm NAIC # 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. SR WLTRTYPE DD' OF INSURANCE POLICY NUMBER POLICYEFFECTIVE POUCY EXPIRATION LIMITS GENERALLIASILTTY EACH OCCURRENCE S 1,000,000 DAMAGtTQKtNltU PREMISES Eaoccurence S A X�COjMMERCIAL GENERAL LIABILITY 2001L6202 05/31/2004 O5/31f2005 MEDEXP(Anyonepenon) S 5,000 I L I CLA.IMSMADE 71 OCCUR PERSONAL& ADV INJURY S T GENERALAGGREGATE S 2,000,000 GEN'LAGGREGATE UMITAPPLIES PER: PRODUCTS>COMPIOPAGG S 1,000,000 JECT POLICY PRO, LOC ' AUTOMOBILE UABIUTY - COMBINED SINGLE LIMIT S (Ea aociaent) ANY AUTO BODILY INJURY S ALLOWNEOAUTOS (Per person) SCHEDULEDAUTOS BODILYINJURY. -s�_- •• - HIRED AUTOS ' NON,OWNEDAUTOS (Peractldent) . PROPERTY DAMAGE ....^ _.... . S (Per accident) GARAGE LIABILITY. AUTO ONLY IEA ACCIDENT 5•.. EAACC S" - .. ANYAUTO •.. .. .• - .. ..OTHERTHAN S 51 .. - AUTOONLY: -' AGG I EXCESSIUMBRELLALIABILrry - EACH OCCURRENCE S AGGREGATE S OCCUR CLAIMS MADE S S DEDUCTIBLE S RETENTION S WORKERS COMPENSATION AND - ' TWCSTMTT, X OTW A EMPLOYERS'UABILITY TO BE ISSUED 07/04/2004 07/04/2005 E.LEACH ACCIDENT IS 1,000,000 ANY PROPRIETORIPARTNER/EXECl1TIVE OFFICER/MEMBER EXCLUDED? - E.L DISEASE, EA EMPLOYEE S 1,000,000 E.L. DISEASE.POLICY LIMIT S 1,000,000 Des desmbounder SPECIAL PROVISIONS below - OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS . LOGGING AND LUMBERING, TREE PRUNING, STREET CLEANING " SHOULD ANY OF THE ABOVE DESCRIBED POLICIES Be CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAR: 30 DAYS WRITTEN GATEWOOD HOMES, INC. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL 1600 FALMOUTH ROAD #25 IMPOSE NO OBLIGATION OR LIABILITY OF7LTTY'KN&VPON-THE-/NSURER-ff"GEN•TS OR CENTERVILLE, MA 02632 REPRESI I AUTHORED REPRESENTATIVE AUTHORIZED I A 1 " AUUKU L, (LUUI/US) j .................. ......... . . ................ ::: CORD i]uA � 5 DATE MM/DD/YY) PRO8 03 04 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HAROLD H WILLIAMS INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 81 BASSETT LANE ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, COMPANIES AFFORDING COVERAGE HYANN I S MA 0 2 6 O 1- COMPANY . (508) 775-3366 ( ) A MERCHANTS INS CO OF MA INSURED COMPANY - STEPHEN M CHILDS B 145 CAMMETT ROAD COMPANY . C MARSTONS MILLS MA 02648- COMPANY (508) 1 - D ................ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TION CO OA TYPE OF INSURANCE POLICY NUMBER PDAATE (MMID DE LI ATE (MMMIDO/YY) LIMITS A GENERAL uAsluTy GENERAL AGGREGATIE' $6 O O O O O X COMMERCIAL GENERALLIABIUTY CCP8567749 04/28/04. 04/28/05 PRODUCTS - COMP/OP AGG $600000 CLAIMS MADE a OCCUR PERSONAL a ADV INJURY S 3 0 0 0 0 0 OWNERS & CONTRACTORS PROT EACH OCCURRENCE . r.,; n n n n n - FIRE DAMAGE (Any one fire) S MED EXP (Any one person) $ 5 0 0 0 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OMED AUTOS / / / / COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) - $ BODILY INJURY (Per aecideno $ PROPERTY DAMAGE $ GARAGE LIABILITY ANYAUTO _ • / / _ / / AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY EACH ACCIDENT S AGGREGATE S EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM / / / / EACH OCCURRENCE $ AGGREGATE $ S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOFV INCL PARTNERSANECUTNE OFFICERS ARE g EXCL WC STATU- OTH• RY MIT EL EACH ACCIDENT S EL DISEASE - POLICY LIMIT $ EL DISEASE - EA EMPLOYEE S oTHEa DESCRIPTION OF OPERATLONSILOCATIONSIVEHICLES/SPECUU. ITEMS ELECTRICAL WIRING Gatewood Homes Inc. 1600 Falmouth Road Ste 25 Centerville MA 02632 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 2 0 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. NORIZED REPRESENTATIVE _ _/A 4Y !S Nk;2 3 t ?'Z:S xr v S'iJ d `2='q.YY � S -y h t 'Y, '+•Ys `i +.:�,� DATE,DD,YY, sGER�}IFICATE OF INS CEF x5� rISSIT g THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND PRODUCER CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE Harold H Williams Ins Agcy Inc DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 81 Bassett Lane COMPANIES AFFORDING COVERAGE Hyannis, MA 02601 INSURED Stephen M. Childs cARNY A.I.M. Mutual Insurance Co A 145 Cammett Road Marstons Mills, MA' 02648 CQVERWGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE. BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NarwrrHs'TANDING ANY REQUIREMENT, TERM OR CONDTTION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH. THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. co POLICY EFFECTIVE POLICY EXPIRATIOD . LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS GENERALIJABUXrY GENERAL AGGREGATE S COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGO. S =CLAIMS MAD PERSONAL & ADV. PQU[Y S EACH OCCURRENCE S OWNER'S & CONTRACTOR'S PROT. FIRE DAMAGE (Any o fie) S ED. EXPENSE (Airy one Person) S AUTOMOBILE LIAEU TY COMBINED SINGLE $ ANY AUTO LIMIT BODILY INJURY S ALL OWNED AUTOS SCHEDULED AUTOS P+ ) BODILY INJURY S FIRED AUTOS NON -OWNED AUTOS r =idm) ARAGE LIABILITY PROPERTY DAMAGE S EXCESS LIABILITY EACH OCCURRENCE S AGGREGATE S . RELLA FORM z HER THAN UMBRELLA FOAM WORKER'S COMPENSATION AND X WC STATU- OTH- EMPLOYERS'LIABB�TY RL EACH ACCIDENTs UUv ' A 7015793012003 12l13/2003 12/13/2004 THE PROPRIETOIU INCL EL DISEASE—POUCT LIMIT S 500.000 PARTNERSIEXECUI'IVE S 1OO OOO OFFICERS ARE: X EX EL DISEASE —EA EMPLOYEE OTHER DESCRIPTION OF OPERATIONS/LOCATION&",=CLES/SMCIAL ITEMS t SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ' EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO GATEWOOD HOMES, INC. ':: MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 1600 FALMOUTH ROAD, SUITE 25 >': LIABILITY OF ANY ]KIND UPON THE COMPANY, ITS AGENTS OR Y REPRESENTATIVES. AUTHORIZED REPRESENTATIVE CENTERVILLE, MA 02632 y .arY ACORQ CERTIFICATE OF LIABILITY INSURANCE 8/2/200 PRODUCER t THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION McShea Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON .THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 749 Main Street, Suite#H ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Osterville, Ma. 01655 508-420-9011 INSURERS AFFORDING COVERAGE NAIC# INSURED Casperson Overhead Doors INSURERA: Worcester_ Insurance Company INSURERS: National Grange Mutual BOX 517 INSURER C: East Falmouth, MA 02536 INSURER D: 508-563-5633 INSURER E r:nVPPAr.F-q 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR D•L IMRD I TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD POLICYEXPIRATION DATE MMIDD UMTTS GENERAL LIABILITY EACH OCCURRENCE $ 1,000, OO X COMMERCIAL GENERAL LIABILITY PREMISES fEaocauence S 10-0- f OO CLAIMSMADE 7 OCCUR MEDEXP(Any weperson) $ 10,00 A CB 2J1973 05/28/04 05/28/05 PERsoNALaADviNJuRY s 1 000 00, GENERAL AGGREGATE S 2 OOO, OOI GENT AGGREGATE LIMIT APPLIES P PRODUCTS-COMP/OPAGG s 2,000 001 PROJECTLOC 17 POLICY F . Al1TOMOBILEUABIUTY LIMIT COMBINANYAUTO $ (Fa acadmt�INGLE ALL OWNED AUTOS BODLYIN S - SCHEDULED AUTOS (Per person)) HIRED AUTOS BODILcldmt) Y NON -OWNED NONWNED AUTOS (Peracadent) PROPERTY DAMAGE, S (Peractldent) GARAGE LIABILITY AUTO ONLY-EAACCIDENT S ANYAUTO OTHERTHAN EAACC S - S AUTOONLY: AGO, EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE s OCCUR CLAIMSMADE AGGREGATE S- s DEDUCTIBLE s RETENTION $ S WORKERS COMPENSATIONAND X EMPLOYERS LIASIL(TY Thy IMrrs ER E.L. EACH ACCIDENT $ 500,000 ANY PROMEMBER CP48352 02/22/04 02/22/05 B OFFICER/MEMBER EX0.UDED? EXCLUDED? E.L. DISEASE - EA EMPLO S- 500,000 Dyyees5 des EL DISEASE -POLICY LIMIT S 5OO OOO PR SILO SPECULL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONSADOED BY ENDORSEMENT/ SPECIAL PROVISIONS Gatewood Homes, Inc. 1600 Falmouth Rd., Ste. 25 Centerville, MA 02632 ACORD25 (2001/08) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPj:SFITa ILI CACORD CORPORATION 1988 A02HRU CERTIFICATE OF LIABILITY INSURANCE DOAr, 4i PRODOCER (7g0)431-9800 FAX 781 431-0222 /02/2004 ( ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Cochrane & Porter Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE c/o Renaissance Alliance Ins . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 981 Worcester Street Wellesley, MA 02482 wsuRED Cape Cod Ready Mix, Inc. 300 Cranberry Highway Orleans, MA 02635 INSURERS AFFORDING COVERAGE NAIC 4 INSURERA: OneBeacon American. Ins. Co. 20621 INSURERS: Commerce Insurance Company 34754 INSURERC: Zimmerman Specialty Insurance ZSI001 INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINt 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 D TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION 01/01/2005 - LIMBS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR CERS17036 01/01/2004 EACH OCCURRENCE S 1,000,001 DAMAGE 7D RENTED $ 100,00 MED EXP ulny one person) $ 5,001 PERSONA LADVLNJURY s i,000,001 GENERALAGGREGATE $ 2,000,00( GENT. AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC PRODUCTS - COMP/OP AGG S 2,000,00( B AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS XY9014 01/01/2004 01/01/2005 COMBINED SINGLE LIMIT (Ea accident) S 1,000,00( BODILY INJURY (Per person) $ X X BODILY INJURY (Per accident) S X PROPERTY DAMAGE (Per accident) s GARAGE LIABILITY ANY AUTO - AUTO ONLY- EA ACCIDENT S OTHER THAN EAACC AUTO ONLY: AGG S S C EXCESSIUMBRELLALIABILRY X OCCUR CLAIMS MADE DEDUCTIBLE RETENTION S BE9744481 01/01/2004 01/01/200S EACHOCCURRENCE Is 1,000,000 AGGREGATE s 1,000,000 IR s 10,000 S $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPA.RTNERIEXEC-ITIVE OFFICER/MEMBER EXCLUDED? If yes. describe under SPECIAL PROVISIONS below WC ST.ATU- OTH- E.L EACHACCIDENT S EL DISEASE- EA EMPLOYE S E.L DISEASE -POLICY LIMB S orHFJ: DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Gatewood Homes, Inc. 1600 Falmouth Rd. Suite 2S Centerville, MA 02632 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTFCATE HOLDER FFVE:S. D TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL mwi.SE NO OBUGAOR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS CR REPRESENT AUTHORIZED REPRESENTATIVE .. J 25 (2001/08) ORD CORPORATION 1988 �. .ACORDn CERTIFICATE OF LIABILITY INSURANCE DATE(MWDWY) PRODUCERR 08/02/04 The Fel et (berg Company IS SUED AS A I ryUPONROF 222 Milliken Blvd. ONLYAND CONFERSCATE NO RIGHTS THE CERTIFICATE THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 3220 THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fall River, MA 02722 INSURERS AFFORDING COVERAGE INSURED Cape Cod Ready Mix Inc, INSURER A Construction Industries Compensation PO Box 399 - .. .. NSURER B: [INSURER Orleans, MA 02653 c 1 INSURER D: _ COVERAGES INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN( ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH MAY RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OF PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCI POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY INSR PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER POLICYE�POLICY EXPIRATION DATE GENERAL LIABILITY DATECTIVE M/D LIMBS I (COMMERCIAL GENERAL LIAB ILITY EACH OCCURRENCE $ MADE ❑ I CLAIMS OCCUR FIRE DAMAGE (Any one fire) § ' MED EXP (Any one Person) S PERSONAL 6 ADV INJURY § GENL AGGREGATE LIM ITAPPLIES PER: GENERAL AGGREGATE $ POLICY JPE 6 LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY ANY AUTO COMBBIINNE�D SINGLE LIMB S (Ea ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY § (Perperson) HIRED AUTOS NON -OWNED AUTOS - BODILY INJURY I (Per accident) S GARAGE LIABILITY PROPERTY DAMAGE j S rn (Peraccide) is ANY AUTO AUTO ONLY -EA ACCIDENT I OTHER THAN EA ACC S EXCESS LIABILITY AUTO ONLY: AGG § OCCUR r CLAIMS MADE EACH OCCURRENCE § . DEDUCTIBLE RETENTION § A I WORKERS COMPENSATION AND WC0009254 D1/01/04 U1/01/05 X WC STATU- Ol EMPLOYERS' UABIUTY EL EACH ACCIDENT OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Gatewood Homes Inc. 1600 Falmouth Road Suite 25 Centerville, MA 02632 SHOULD ANYOFTHE ABOVE D ESCRISED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYSWRnTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO TH E LEFT, BUTFAILURE TO DO SO SHALL IMPOSE NO OB LIGATION OR LIABILITY OF ANY KIND UPON THE INSURERJTS AGENTS OR ACORD 25-S (7/97)1 of 2 #S61300/M55627 CL3 0 ACORD CORPORATION 1988 Aug-03-04 02:42pm From -A I G 673-316-8903 T-271) P 0021002 F-491 C C�RT" PRODUCER ICATE I THIS CE 11 i 8 ISSUED AS A MATTER OF INFORMATION ONLY AND C ONFERS NO RIGHTS UPON THE CERTIFICATE Dias Ins Agency Inc HOLDER 5 0 LT T HOLDER. TI- IS CERTIFICATE DOES NOT AMEND, EXTEND OR 535 Brayton Avenue ALTER THE. ;OVERAGE AFFORDED PRODUCER River, MA 02721 By THE POLICIES BEL-GW- INSURED COMP y %l%JIwrANJt5 AFFORDING lhl�U�RANCE COMPANYA GRANITE STATE INSURANCE COMPANY Eta Carpentry Inc 100 West Main Street, St lo Hyannis. MA 02601 t: x; CERTIFY THAT THE POLICIES OF INSURANCE. ..... . THIS IS TO CER :�R-- THE POLICY PERIOD INDICATE LISTED 'cLuvv HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR D. NOT WITHSTANDING ANY REQL REMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 13 ; ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. E -CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS MAY HAVE BEEN REDUCED By PAID CLAIMS. SHOWN EMPLOYEW LL48Lrry PROrfumpj VA Op= gm $ OWy. CERTIFICATE HOLDER GATEWOOD HOMES 1600 GALMOUTH ROAD. SUITE 25 CENTERVILLE. MA 02632 7/24/2004 7/24/2005 m MY LMTS CMENT POLICY Lmr $1.00o.00l S 1.0oo-0ch CANCELLATION s'O ANY OF " AM /E DEXROW PCXXES or: CANCELLED BEFORE THE OPPA'"O" GATE THEM IF. THE ISSUING COMPANY WU ENDEAVOR To PAIL,. DAYS WRITTEN NOTICE 7 -THE CERTFICATE HOLDER NAMED TO TI.,E LEFT. BUT F ALURE TO MAIL SUCH K 'TICE SfL IMPOSE NO OBLIGATION OR LIABLITYOF ANY Mo UPON THE COIL 'ANY. MS AGENT; OR fMppCS&NTATIvM AUTHORIZED REPRI SENTATIVE ••�•��. ..+ i.....� er, .+ ovoJauvaey UiULU.71AJN ASSOC �O1 CERTIFICATE OF r&IXir IrI i 0 INSURANCE f.SR AB DATFf�Dl9YMj'.. aR R ��D%50 06 23 04 #Hi3CERTiFlCAF$ I I A� Icei ic: GOLDffiL8T & ASSOCIATES S?7SIIEANC$ LUA#T€_�Of Iuew�J�ait..�u FINANCIAL SERVICES INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFIGATE HOLDER. THIS CERTIFICATE DOES NOTAMEND,.EXTEND OR 4! Tflli Ti11 t:'SV£tt4Gz sa �w��_�BFFlEP9�.lS)S9F6�L�? bYA;.i32S w"T. OZBOl PhoaaL508a77Sefi0.l0 Pa::50fl_790e0349 l iwsu?eo 1`.'BUI=3 AFFORDING COVERAGE INSURER A: ESszj-L IN3ffi2ANell e6 INSURERS: AIR MZ=AL ni-SURANcz CO. PO BUOZ�I�0VATIONS INC INSURER C: ¢_per'-- R-1 93ACE MA 02562 IN-.).DERD: THE POLICES OF INSURANCE LISTED BELOW HAVFBFEN ISSUED TO THE INSURED NAMEDASOV£ FOR THE ANY(�L'LRE`dQJT. TERM OR CONDITION OFANY CONTRACT OR OTHER CO„^fy,�.'(JT gVR71 YPEWOD WDIGITED. )407W{TMSTANOING LAY PERTABJ. T4E INB .e:r,e..m RESPEST TO WHICH THIS CERTFICATE MAY Be tSSED OR By eOLK= DES-8^ =HE.e tS^..S/&MCT TO ALL ThE,E>".A- MCLUSIONS AM COR..7.TIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAVMS. LTTZ TYPE OF PJSURANCE POLICYNUNISER DATE fMdVDWYYI DATE OENER" I.I.Am ry LYKr5 A Y CN.LJERm-1 GENERAL LIABILITY �� OCCURRENCE I s 3C252718 12/12/03 12/12/04 PR£MIBFS(EAJca.ane.) s CLAIMS MAx ®OCCUR Mm ESP (A-T en. aoaon) s PERSONAL B ADV KAJRY s LOC ANTOMOBLE LIABILITY ANYAUTO ALL OWNED AUTOS SCH£DULEDAUTOS HIREDAUTOS F aWh4kEd Ams CARAGI LLAo:ULTY 7 ANYAUTO. OCCUR u CLAIMS MADE DEDUCTIBLE REIENTICN S WORKERS CONrEYNZATION AM H EIRIL S'1,LASS,ITY �AlIY,'ROP^. •EIDRQ/L!T!'5.•;3r(,yjIVE DFFxsw-,��EscLUDbo? #ANC7016018012004 I 01/03/041 01/03/05 AGO COMBINED SINGLE LIMIT S RMAYINJURY BODLY"Llum (Prarz�sO = PROPERTY DAMAGE (PIY aw.d- IN1 S AUTD CL&Y • FA ACCOENT S OTHER -TWIN EA ACC AUTOONLr. S eGG s EACH OCCURRENCE I s 1 7 000 c HOLDER C A NC€LLA' .Cm GA"T% o SHOULD D ANY C£T'l'•• MCI= eOL.,^@. S BE CA=ELLED B` TrT)E Zxmu .O' DATE Tr.-" - THE ISSUING NsuRER WLL L-ADFAVOR TO Nan. 3 0 DAYS WG•TTEy GATXN0033 HOFS$S 3= kQhGi Ta THI CERTMATE H*WM NAMWR TO TM UWrl NUT FALUFM To go BDSHALy. FAY W -?T S- 5603 WO;S UP OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURE "D ITE A4�(T@ DR 2600 PA+."DT3 '..DAD REPRESpJTATNES C82�L-X MA 02632 - R REsartArn� H di4iU4 Y:3U:35 PM 4154 (2 02/03 ACW4 . CERTIFICATE OF LIABILITY INSURANCE DATE OMMDDIyyyY) PRODUCER (508)540-2400 FAX 508 M0-1988 08/04/2004 THIS CERTIFICATE IS ISSUED AS A MATTER OF Murray & MacDonald Insurance Services INFORMATION ONLY AND CONFERS NORIGHTS UPON THE CERTIFICATE- 406 Jones Road HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND Falmouth, MA 02540 OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ERS AFFORDING COVERAGE Douglas MacDonald INSURED TRACY HON/ERTDN NAIC # PO Box 1S51 INSURER Hartford Fire Ins co 1%8f' INSURER Liberty Mutual Ins Corp MASHPFF, MA 32649 C :OUR D: 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 MAV BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN RI IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POL.ICIES.AGGREGATE UIWTS SHOWN MAY HAVE BEEN REDUCED PAID CLAIMS. NSR DD TYPE OF INSURANCE POLICY NUMBER - POLICY EFFECTIVE POLICY EXPRATON GENERAL LLA81D}y - LIMITS O856AIQt7945 10/02/2003 10/02/2004 EACH OCCURRENCE s COMMERCIAL GENERAL LIABILITY 500- 00C DAMAGE TO RENTED CLAIMS MADE OCCUR $ 3C10OOC A MED EXP ) (AAr are Pena+ s 10 .00C PERSONAL a ADY nuURY s 500 000 GENTAGGREGATE LIWTAPPLIE3 PER GENERAL AGGREGATE S --- --- 1, POLICY PFO. PRODUCTS. COMP/OPAGG S 1 000 000 JE.T LOC AUTOMOBLELUkOlu Y ANY AUTO COMBINED SINGLE LIMIT S (Es wdds) ALL OWNED AUTOS SCHEDULED AUTOS BOOLYINA Y S (Per pee ) HIRED AUTO$ NON-0WNEDAUTOS BODILY INJURY S - (Per mdde ) _ PROPERTY DAMAGE $ (Per muienB GARAGE LIABILITY ANY AUTO AUTO ONLY -EA ACCIDENT $ _ OTHER THAN EA ACC S AUTO ONLY: AGO. S EXDESSaMBRELU LIABILITY EACH OCCURRENCE $ OCCUR C CWM3 MADE AGGREGATE S DEDUCTIBLE S RETENTION S - $ WORKERS COMPENSATIONANO itiIC131S3WC STATLL 17310021 10/05/2003 10/O5/2004 S ENIPLOYERS•DABLRY OT B ANY PROPRETORPARTNERIEXECUTNE OFFICEEL EACH ACCIDENT S 100 W MEMBER EXCLUDED? . EPAntler SP SPECIAL PROVISIONS DaWE.L.E.DISEASE -EA EMPLOYE S 100 OTHER E.L. DISEASE -POLICY LIMIT $ 500. DESCRIPTION OF OPERATIONS I Gatewood Homes Jeffrey Sollows 16 Falmouth Road Suite 2S Centerville, NCI 02632 ACORD 25 (2061I68) FAX: I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _SO _ DAYS WROTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF AMY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE tt" Claudine Wrighter/CONY (/(.4s ✓✓ 1515 CACORD CORPORATION 1988 TR.A.1 r,•-+-crnX+ En cD K 1 utK K 15K tiHtU I RL I STS 1 SOB 564 7272 P. 01 /02 ACORD E i 7�fiTE 1i� E'JAR# C A�j DA; Ie y,- PRODUCER THIS C07/28/04 ERTIFICATE IS ISSUED AS A MATTER OF INFORMATION - ONLY AND CONFERS NO RIGHTS UPON THE CERTIFMxTf- RIDER RISK SPECIALISTS HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR e1TM_THECOVPRA�AFEORDED BY THE.POLICIES BELOW. INSURANCE AGENCY, INC. COMPANIES AFFORDING COVERAGE P.O.BOX 115 . CATAUMET MA 02534-0115 Ei4COTTSDALE INSURANCE COMPANY INSUREn __:.... . MONUMENT INSULATION, INC. CeMMPAaIA N B AMERICAN HOME INSURANCE COMPANY 223 COUNTY ROAD COMPANY • BOURNE, MA 02532 C COMPANY D vni Tmg HIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE <FOR THE POLICY PERIOD .�' INDICATED, NOTWRH$TANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICES DESGRIBED-HEREIN-.IS-SUgIFCS,TII.A�I ?klTFpI� <p EXCLUSIONS AND CONDITIONS OF SUCH POLICES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OP WEFFECTIVE-_^'— -.•. LTR INSURANCE POLICY NUMBER POLICY .RDUC.Y DATE IMWDD/YY) DATE IMMIDDTYYI �- OU"IMAL UAMUTY X COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE M1 ,_OOO, DOO CLAIMS MADE X❑OCCUR PIro0UCT0_CONIPIpP wGG i5O0 000 2 OWNEWSBCONTRACTOI'SPRDT CLS1001705 PERSONALS.ACVINJURY MSOO, D00 3/30/04 3/30/05 EAc --- --- V— ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS MIRED AUTOS NO"WNEO AUTOS AOE LIABILITY ANY AUTO I ESS LIABILITY UMBRELLA FORM OTHER THAN UMMRELLA CORM EEA9 COMPENSATION AND OYERS LIABILITYPRomlErow qWr. WC 768 29 54 PARTNERSIEXICUTryE 3/5/0,4--- 13/5/05 WC ur.n.<.c IwAY MM NN MID EM [An, o" PMrsom COMBINED .91NGLE LIMIT MJ :5 4--- BODILY I JURY IPW BNMBN BODILY INJURY IF. A owt M PROPERTY DAMAGE i.. AUTO ONLY . EA ACCIDENT OTHER THAN AUTO ONLY• EACH ACCIDENT _ M -' AGGREGATE M EACH OCCURRENCE 1 F E B M I EL EACH ACCIDENT 1100, 000 EL OISEASE • PDucr LINBT F5 O!} @$@- ELDISDISEASE•EAEMPLOYEE 133.00.000 GATEWOOD HOMES SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE OSSUNO COMPANY..INU..ENDEAVOR TO MAIL 1600 FALMOUTH ROAD #25 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, CENTERVILLE, MA 02632 BUT FAILURE TO MALL SUCH MOTICE SHALL IMPOSE NO OBLIGATION OR UABIUTT OF ANY RIND UPON THE PnrAwNY 1� ..•.-...E. ------ _-___- 6UL VMAIN ASSOC .►. w .FW L! I:ERTIFICATE OF LIABILITY INSURANCE CSR i+s �_. ASSd 7ATE5 ISi3BRANC$ SERV ;CES INC. TAVAN50 08 02 04 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON tTH K ).. A. 026 )1 THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE ••775-6010 FAN:508-790-0249 f POLICIES BELOW. INSURERS AFFORDING COVERAGE ODNEY TAVANO i► 11MI.HAjj CAL NAIC # INSURER A: COmwRCE INSUR"CH CO w3URERI ZURICH— lU7—AA AMERICAA =S CO SYS�S 10 801.DBR LANE INSURER c BARN1•TASL3 2 02668 Dr.URER D: POL THE RmuPE E3IT. TJRA)rE L18T'EOBELOW HAVEB�I�ED R NWAI�-OABOVE FOR THE POLICY PEA100 INDICATED- NOTWITHSTANDING ANY PERTAIN, HE TERM NCCONDfnON OF ANY COOR MAY PERTAIN, AG TH E WSUR! IT E AFFORDED BY THE POLICIES DESCRIBED DOCUMHEREMENT WITH RESPECT TO T THE CN THIS CERTIFICATE MAY BE ISSUED OR POLICES. AGGRE GATE l8 ITS SHOWN MAY HAVE BEEN REDUCED BY PAID CL,NNg TERMS, ELUSIONS AND CONDITIONS OF SUCH A'pmD'Li- GENERU. W1916 Ty A % CCMMERC6 LGENERALLIABIITY iPL8172 OLAIAA MADE ® R GER1 AGGREGA M LIMIT APPLIES PER �� rREc°r LOC AUT002BLE LU BILITY AN/AUTO AU.OWNEC AUTOS SC 4EDULEI AUTOS MFM3AUTr S ` NCNCWNE 'AUTOS �S GARAG=_Lueary ANYAUTD EXCESIAAImREI LALUUTILITY OCCUR CLANS MADE DE WCTIBL RErENTIDN S wOR cm cc mpmu TON ANO s EMPLOYERS' JABXRI ANYrOPJPAR OT*727BA94903NDmicUrrvEFFHBERE.UDDT 11/21/031 11/21/04 LNTS �OCCURRBdE s1000000 PREMISES ecbr ce S 50000 MW EXP IAAI/ om pemoD S5000- PERSONALILADVgUURY 31000000 GENERALACGREGATE s 2000000 PROOU;TS•COIAPIOPAGG S2000000 fEa eeyeIABINatSIN'�R S BODILY wURY Warpa3w) S teOvrDILo ) s P( DAMAGE : ) AUTO ONLY. EA ACCME �... OTHER THAN EA ACC s AUTD ONLY: AGG S_.. EACH OCCLRRCN('e 05/03/04I 05/03/OS r EL LNR S fFc3jNTZW`Il,LZ CANCELLATION GATEWOO SHOULD ANY OF,THE ABOVE DESCRIBED POLICES BE CANCELLED SEFORETNE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVORTOAWL lU" - DAYS WIBTTDITEWOI /D HOMES INCNUTCETO TIE CERTIFTCA7E A[OLDER NAAIEp TOTHELEFTBUTFAX URETD YS 50 W % 50::-778-5603 BrosENo III:TIONONUABILITYOF,�,MW�THE ��00 ZZINOUTH ROAD REFRESENTATIVM MA 02632 �EDE RTYkkPDRESS,w A-cutAT10N FOR PERMCt Ct zlrw /Y/l 6110 TOWN OF YARMOUTH WATER DEPARTMENT 99 Buck Island Road West Yarmouth, MA 02673 Telephone: (508) 771-7921 • Fax: (508) 771-7998 Letter of Water Availability Date of Issue: February 2, 2005 1. Single Family Dwelling X 2. Duplex Family Dwelling 3. Condominium Dwelling 4. Commercial / Industrial 5. Other (Specify) Reference; Massachusetts General Laws Chapter 40, Section 54 To: Town of Yarmouth Building Inspector Please be advised that the Town of Yarmouth public water supply is available to service lot / parcel (s) 21.1 C/127; Street: 121 Camp Street, W. Yarmouth As shown of 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 owner's expense, the installation of water mains and appurtenant items to meet water demands 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) Yarmo Water Department Aw toN:\Water Availibility\121Camp#127.doe OF TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 rD BUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-388 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST # 127 Owner's Name: Villages @ Camp Street, LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 REVIEWED BY: 11. WATER DEPARTMENT: 2. ENGINEERING DEPARTMENT: 3. CONSERVATION: 4. HEALTH DEPARTMENT: 5. BUILDING DEPARTMENT: 6. FIRE DEPARTMENT: COMMENTS: RECEIPT OF COPY: (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: 1/31/2005 Issue Date: Expiration Date PLEASE NOTE SIGNATURE OF APPLICANT: Comments: Map/Lot: 044.21.1.0 new construction: DATE: N/A: DATE: N/A: DATE: N/A: DATE: N/A: DATE: N/A: DATE: N/A: IW DATE: Date Printed: 1/31/2005 I y1N ► I '1,,�1` ,1, ` • 4 149-,Zdl- �11' LOT 3 W , �30 LOT 4� CA If L--51.60 244 WpjER pp E 'OpOSEDR \ACE S 'OPOSED RAL SEWER N 2 0 9 46 54.83, L=37.08' 36.90 f 3.5 is. ,32' PROPOSED I HOUSE ppopoSED p I, 1 j J (SANDPIPER) HOUSE (EGRET) 0) C% "t Irn -Xj.O 31 .0 FF 16.0 GW FF 31.0 24. GW 16 A LOT 27 LOT 128 55-OU. Ail-i26- --tAj6-�21 —42! E i4-90, - ` * 00USE POSED pp'(EGRE') - :51.0 FF A G* B \'OT A 26 L 2005 ui OF ')',f 4 V V o WCHAEL'r SEWER LATERAL SHALL BE SLEEVED IN ACCORDANCE GRAPHIC SCALE WITH TITLE V IF WITHIN Is 1OFT. OF WATER MAIN. 20 10 0 20 I1 '17 ' L- ',�,jl 11 .,- %. jj the !jj_ - IN FEET 1 inch = 20 ft PLOT PLAN holmes and mcgrath, inc OF LOT 127 civil engineers and land surveyors Iv. PREPARED FOR 362 gifford street TPVOTif V SANTC,� MILL POND VILLAGE No. 450-18 ✓j ft IN falmouth, ma. 02540 YARMOUTH, MA JOB NO: 201197 DRAWN: LMC I AL SCALE: 1"=20' DATE: 12-29-041 DWG. NO.: A2514 CHECKED: mut 4 OSED „ _ PROP LATERAL � , SEWER L.127.01 W PROPOSSERVICE��_ 00 t i t, L,53.07 ATER N82 O'46"E 54.83"� !! ! L_37.08' 17.92' 36.90W 1. ti11CA � 32 rn rn j •I ` 1 11 O,, PROPOSED 9' :r /18.5 O HOUSE 13.5 N 1 ` 1 (EGRET) O i 31. 32' PROPOSED rn d FF _ 16 HOUSE O G`i'i 1= PROPOSED N I. 4'' ' ° 2 rn 1 (SANDPIPER) -Im, 6v r,; !! FF=31.0 2g (E RET) GW = 16.4 , LA FF=31.0 I !i `1 24. I 3 GW=16 j +1 �3" 5 1, v 11 -' w LOT 127 p55CTI :00 y `� "- LOT 128 5'. 226•1?'� Zp05 , NOTE: IBy <<r0" o` SEWER LATERAL SHALL BE PJiCFLaEL �:t SLEEVED IN ACCORDANCE GRAPHIC SCALE WITH TITLE V IF WITHIN rr' N 10FT OF WATER MAIN. y N .28978 20 10 0 20 °fersy�° J'n SJF. :.- tll .-. , chP , ;u•rf lr rjl t nG ct ;... i r ( IN FEET) ; 1 inch = 20 fin q s, PLOT PLAN holmes and mcgrath, inc. ��°�" • '',c\� OF LOT 127 TOAOTHY M. " \ civil engineers and land surveyors a sANros � PREPARED FOR No. 15Gi9 MILL POND VILLAGE 362 gifford street c, ,L IN falmouth, ma. 02540 YARMOUTH, MA JOB NO: 201197 DRAWN: LMC n g SCALE: 1 =20 DATE:12-29-04 DWG. NO.: A2514 CHECKED: mut �� Z-ax MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAscheck Software version 2.01 Release 2 CITY: Barnstable STATE: Massachusetts HOD: 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 Sandpiper 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 = 223 Your Home = 138 I I I I I Permit # I I I I Checked by/Date I I I Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 845 30.0 30.0 14 WALLS: Wood Frame, 16" O.C. 1415 15.0 15.0 62 GLAZING: windows or Doors 93 0.340 GLAZING: Windows or Doors 80 0.340 27::: 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 74.4. Builder/Designer. Data r L Massachusetts Energy Code MAScheck software version 2.01 Release 2 The sandpiper DATE: 4-21-2004 Bldg.1 Dept.1 use i I I CEILINGS: [ ] I 1. R-30 + R-30 Comments/Location WALLS: [ ] I 1. Wood Frame, 16" O.C., R-15 + R-15 Comments/Location WINDOWS AND GLASS DOORS: [ ] I 1. U-value: 0.34 i or windows without labeled u-values, describe features: Panes Frame Type Thermal Break? [ ] Yes [ ] No I omments/Location [ ] i 2. -value: 0.34 I or windows without labeled u-values, describe features: Panes Frame Type Thermal Break? [ ] Yes [ ] No i omments/Location DOOR : [ ] I I. -value: 0.086 I omments/Location AIR EAKAGE: C ] I joi ts, penetrations, and all other such openings in the building I env lope 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 inside of the recessed fixture and ceiling cavity and sealed or j 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 conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. VAPOR RETARDER: [ ] I Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. I MATERIALS IDENTIFICATION: [ ] I Ma erials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be I provided. Insulation R-values and glazing U-values must be clearly I marked on the building plans or specifications. I I I I I I I I. ] l 0. DUCT INSULATION: Ducts shall be insulated per Table J4.4.7.1. 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 J4.4. 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)------------------------- (L—m a+- OGo— 3 PRODUCT GMS9/GCS9 Mufti -Position, Single-Stage/Multi- Furnace Hearing Capacity: 46,000-115,000 BTUH The GMS9/GCS9 single -stage, multi -speed gas furnaces offer �� ETA ETA m installation versatility. Standard Features • Corrosion -resistant, aluminized -steel tubular heat exchanger and stainless -steel recuperative coil for maximum efficiency • Designed for multi -position installadon—GMS9: upflow, horizontal right or left; GCS9: downflow, horizontal right or left • Energy -saving, reliable Hot Surface Ignition system, featuring a.Norton® Mini -Igniter with patented adaptive learning algorithm to maximize igniter life • Aluminized -steel inshot burners • Energy -saving PSC, multi -speed, direct drive blower motor • Quiet, corrosion -resistant induced draft blower assembly • Integrated furnace control with improved •diagnostics • Low voltage terminal blocks • Multiple flame roll -out switches, blower door safety switch, outlet air -limit switch and pressure switch for proof of combustion air • 40VA transformer for heating and air conditioning control service • Combination redundant gas valve and regulator • Top venting is standard; alternate flue/vent located on right side • Completely assembled, factory run -tested furnace for heating or combination heating/cooling application • All models comply with California NOx Standards • Suitable for direct vent (2-pipe) or non -direct vent . (I-pipe)applications Cabinet Construction • Heavy -gauge, reinforced, fully insulated steel cabinet with durable baked -enamel finish • Attractive architectural gray paint finish • Foil -face insulation -lined heat exchanger compartment • Coil and furnace fit flush for easy installation • Convenient left or right connection for gas and electric service • Bottom or side air inlet (GMS9) • Removable, solid -bottom block -off (GMS9) Accessories • L.P. Conversion Kit (LPT OOA) • L.P. Gas Low Pressure Kit (LPLP01) • High Altitude Natural Gas/L.E Kits (HANG11, 'HANG12, HALP10) • High Altitude Pressure Switch Kit (HAPS27) • External Filter Rack (EFR01) • Horizontal Concentric Vent Kit (HCVK) • Vertical Concentric Vent Kit (VCVK) • Internal Filter Retention Kit—upflow, horizontal (RF000180) • Internal Filter Retention `""�J r Kit—downflow � (RF000181) / • Thermostats Blower Motors (CHT18-60, CH70TG, CHSATG, H20TWR) SS-377D www.goodmanmfg.com 6/04 PRQDUCT SPECIFICATIONS Nomenclature G M S 1070 3 FAI EN A Revision Goodman®Brand A: Initial Release B Ia Revision M: Upflow/Horizontal D: Dedicated Downflow C: Downflow/Horizontal H: Hi Air Flow S: Single Stage/Multi-speed V: Two Stage/Variable-spee AFUE 8: 80% 9: 90% LNOx N: Natural Gas C: 2"d Revision X: Low NOx Cabinet Width A: 14" B: VIA" C• 21" D: 24h" Maximum CFM @ 0.5" ESP 3: 1,200 4: 1,600 5: 2,000 045:45,000 070:70,000 090: 90,000 115: 115,000 140:140,000 aW 2 C - C V PRODUCT SPECIFICATIONS Performance Ratings n Or 11WMrr" 1. a �- � n W." gg gsi�� errip uf§od rg GMS90453BXA 46,000 42,800 37,200- 93.0 3.0 35-65 GMS90703BXA 69,000 64,400 55,800 93.0 3.0 35.65 GMS90904CXA 92,000 86,000 142,800 74,400 93.0 4.0 35-65 GMS91155DXA 115,000 106,500 93,000 93.0 5.0 35-65. GCS90453BXA 46,000 37,200 93.0 3.0 1 35.65 GCS90703BXA 69,000 1 64,400 55,800 93.0 3.0 35-65 GCS90904CXA 92,000 1 86,000 74,400 93.0 4:0 40 - 70 GCS91155DXA 115,000 1 106,500 93,000 93.0 5.0 1 40-70 I For altitudes above 2,000', reduce input rating 4% for each 1,000' above sea level. 2 DOE AFUE based upon Isolated Combustion System (ICS). Specifications VUP� MURIVS- norir, A!M! Up asapip, %xio V GMS90453BXA 10. -x 7" 1/3 1 4 2- 2 288 576 9.0 15 132 GMS90703BXA 10" x 8" 1/3 1 4 2- 3 282 564 9.0 15 135 GMS90904CXA 10" x 10" 1/21 4 2" 1 4 376 752 8.9 15 158 GMS91155DXA 11" x 10" 1 3/41 4 2" 1 5 470 940 12.2 15 175 GCS90453BXA 10" x 7" 1/3 4 2 288 7 6 9.0 15 132 GCS907036XA 10" x 8" 1/3 4 3 282 564 9.0 15 135 GC590904CXA 10" x 10" 1/2 4 2. 4 3L6 752 8.9 GCS91155DXA 11 " x 10"3/4 4 2- 5 A7n CiAn 12.2 15 175 I Installer must supply one or two PVC pipes: one for combustion air (optional) and one for the flue outlet (required). Vent pipe must be either 2" or 3" in diameter, depending upon furnace input, number of elbows, length of run and installation (I or 2 pipes). The optional Combustion Air Pipe is dependent on installation/code requirements and must be 2" or 3" diameter PVC. 2 Minimum Circuit Ampacity = (1.25 x Circulator Blower Amps) + ID Blower amps. 3 maximum Overcurrent Protection refers to maximum recommended fuse or circuit breaker size. NOTES: • An firmaces are manufactured for use on 115 VAC, 60 Hz, single phase electrical supply. • Gas Service Connection V2" FFT • important: It is required to size overcurrent protection device and wires properly and make electrical connections in accordance with the National Electrical CDde and/or all existing local codes. I CRODUCT SPECIFICATIONS GMS9 Dimensions 314 618 R INTAKE PIPE Y' PVC ALTERNATE SST 318* GASSUPPI.Y HOLE HIGH VOLTAGE 1 }14 ELECTRICAL HOLE LEFT SIDE 1N C RAIN LINE HOLES 1112 DRAIN TRAP 27 /4 Q LOW VOLTAGE ELECTRICAL HOLE 19 18 14 1 SIDE CUT-OUT 17 34 L J ��-23 W16- SOTTOL/ KNOCK -OUT - LEFT SIDE VIEW FRONT VIEW VENTIFLUE PIPE ISCHAR 7 PVC _ —� L AIR I ALTERNATE 211/16 .l FAIR INTAKE LOCATK 4 HIGH VOLTAGE 6 1 ELECTRICALHOLE 2 RIGHT SIDE DRAIN DRAIN LINE TRAP HOLES 3n6 G. 321 i i 3,4 SIDE CUT-OUT L RIGHT SIDE VIEW Mt" 17%» GM$904536XA 16" � 12'/e" 12s/e GMS90703BXA GMS90904CXA 21" 1914" 16%20% 14%" GMS91155DXA 241h" 23" 20'/s" 18s/e" NOTES: 1. Installer must supply one or two PVC pipes: one for combustion air (optional) and one for the flue outlet (required). Vent pipe must be either 2" or 3" in diameter, depending upon furnace input, number of elbows, length of run and installation (1 or 2 pipes). The optional Combustion Air Pipe is dependent on installation/code requirements and must be 2" or 3" diameter PVC. 2. Line voltage wiring can enter through the right or left side of the furnace. Low voltage wiring can enter through the right or left side of furnace. 3. Conversion kiss for high altitude natural gas operation are available. Contact your Goodman distributor or dealer for details. 4; Installer must supply following gas line fittings; according to which entrance is used: Left —Two 909 elbows, one close nipple, straight pipe Right —Straight pipe to reach gas valve Minimum Clearances to Combustible Materials AY _ ry iw 0" 0" CIFl1;I .r 3" 3^ iGBO.'AyG FuC a r �. O U flow Horizontal 0" 6" C C 0^ 0" 1» 4" C = If placed on combustible (loot, the floor MUST be wood ONLY. NOTES: • For servicing or Cleaning, a 36" front clearance is recommended. • Unit connections (electrical, flue and drain) may necessitate greater clearances than the minimum clearances listed below. • In all cases, accessibility clearance must take precedence over clearances from the enclosure where accessibility clearances are greater. 4 PRODUCT SPECIFICATIONS GCS9 Dimensions RIGHT SIDE LEFT SIDE VIEEWW VIEW VIEW 8Y &I �1958—� 314 +R (RETURN AIR) 3N VENTIFLUE PIPE 7PVC —� 2. VC 21ns CONDENSATE r r , DRAIN . TRAP + LOw VOLTAGE ELECTRICAL HOLE LOW VOLTAGE 1 314 .. DISCHARGE (RIGHT OR HIGH VOLTAGE �CTpCAL"OLE ELECTRICAL HOIF�� 48 LEFT SIDE) ALTERNATE L J L - J 2 SIB 28 8 8i18 VENT/FLUE LOCATION HIGHVOLTAGE 21U18 - ALTERNATE- AIR INTAKE LOCATION ELECTRICAL HOLE 10718 t 25l8 � _ TAP 25lSal �4RIGHT S DINE LEFT SIDE DRAIN LIN 1512 tN' DRAIN HOLES HOLES �/ 11 12 O 2 8114 7 318� ALTERNATE GAS SUPPLY HOLE STANDARD GAS J 91 18 4 V8 SUPPLY HOLE - I'�+s UNFOLDED FLANGES L � _I UNFOUDI ED FLANGES I dSCH ROE AIR FOLDED FLANGES d^1 " FOLDED RANGES 1 as !i DISCHARGEAIR 12'/s" 14+ft" 16" GCS90453BXA 1Th" 16" GC5907036XA 1Th" 16" 12s/s" 14+h" 16" GCS90904CXA 21" 19+h" 16%" 18" 19+h" GC591155DXA 24+h" 23" 20'/s" NOTES: must be either 1. Installer must supply one or two PVC pipes: one for combustion air (optional) and one for the flue outlet (required). Vent pipe 2" or 3" in diameter, depending upon furnace input number of elbows, length of run and installation (I or 2 pipes). The optional Combustion Air Pipe is dependent on installation/code requirements and must be 2" or 3" diameter PVC. 2. Line voltage wiring can enter through the right or left side of the furnace. Low voltage wiring can enter through the right or left side of furnace. 3. Conversion kits for high altitude natural gas operation are available Contact your Goodman distributor or dealer for details. 4. Installer must supply following gas line fittings, according to which entrance is used: Left Two 909 elbows, one dose nipple, straight pipe Right —Straight pipe to reach gas valve Minimum Clearances to Combustible Materials xr a ear 0" eons= mil 1" BntSo „� . NC C 0" 0" 1" 4" Downflow 0" Horizontal 6" C = Combustible: If placed on combustible floor, the floor MUST be wood ONLY. NC,= Non -Combustible: A combustible floor subbase must be used for installation on combustible flooring' NOTES: • For servicing or cleaning, a 36" front clearance is recommended. • Unit connections (electrical, flue and drain) may necessitate greater clearances than the minimum clearances listed below. • In all cases, accessibility clearance must take precedence over clearances from the enclosure where accessibility clearances are greater. 5 P.RGO ACT SPECIFICATIONS Blower Performance Specifications o V � P e a der�tai E 1,318 ------ 1,172 ---- 994 ------ tzltic)'rass3 1,260 - 1,123 960 fnr s 1hiate 1,202� ` G_5904536XA HIGH MED 3.0 2.5 " 1,352 1,214 ----- (LOW) MED-LO 2.0 997 44 753 44 734 45 704 47* Br: LOW HIGH 1.5 3.0 757 1,449 36 1,409 37 44 1,326 39 1,141 1,273 41 1,094 47 U 3A y 04 79' G_590703BXA MED 2.5 1,192 43 1,172 54 .45 943 55 917 56 itll�I9 (MED-HI) NED-LO 2.0 981 53 962 730 ----- 714 _..--- 692$. 562 1 83483=. LOW HIGH 1.5 4.0 750 1,970 ------ ------ 1,874 35 1,757 38 1,667 40 44 �� 33 G_590904CXA MED 3.5 3.0 1,713 1,439 39 46 1,650. 40 1,412 47 1,572 42 1,370 48 1,510 1,327 50 6b " 18} 9 6' (MED-LO) MED-LO LOW 2.5 1 183 56 1 155 57 1 122 59 1.10 60 1,941 44 ?�y03itT" a- 8 fit =1625 IIGH 5.0 2,134 40 51 2,103 40 , 1,643 52 2,029 42 1,643 52 1,577 54 8 G S91155DXA MED 4.0 1,678 59 6211$4! U20- (MED-HI) NEODO 3.0 1 259 67 t 68 1,220 70 1 18t - A NOTES: 1. CFM in chart is without filter(s). Filters do not slip with this furnace, but must be provided by the installer. if the furnace requires two returns, this chart assumes both filters are installed. 2 All furnaces slip as high speed cooling. Installer must adjust blower cooling speed as needed 3. For most jobs, about 400 CFM per ton when cooling is desirable. 4. INSTALLATION :S TO BE ADJUSTED TO OBTAIN TEMPERATURE RISE WITHIN THE RANGE SPECIFIED ON THE RATING PLATE, late. The 5. The chart is for information only. For satisfactory operation external static pressure must not exceed value shown on the rating p shaded area indicates ranges in excess of maximum static pressure allowed when heating. 6. The dashed ( ---- ) areas indicate a temperature rise not recommended for this model. 7. The above chart is for U.S. furnaces installed at 0' - 2,000'. At higher altitudes, a properly de -rated unit will have approximately the same temperature rise at a particular CFM, while ESP at the CFM will be lower (71 P�QDUCT SPECIFICATIONS Accessories OR W MOV4,40 LPT-OOA - L.P. Conversion Kit LPLPOI L.P. Gas Low Pressure Kit KA14G 11 High Attitude Natural Gas Kit HANG12 High Attitude Natural Gas Kit 2 2 2 2 HALP10 I High Attitude LP. Gas Kit 3 3 3 3 HAPS27 High Attitude Pressure Switch Kit 3 3 3 3 EFROI External Fitter Rack V DCVK-20 Horizontal/Vertical Concentric Vent Kit (2")— DCVK-30 Horizontal/Vertical Concentric Vent Kit (3") V Available for this model (1) 7,00l'to 9,000' (2) 9,001'to 11,000' (3) 7,00l'to 11,000' Note; All installations above 7,000'require a pressure switch change. For installation in Canada, furnaces are certified only to 4,500'. Downflow Floor Base: When the GCS9 model is installed directly on a wood floor, a downflow floor base must be used. Those model numbers are: CFB17, CFB21 and CFB24. Thermostats ;WWW � 'o N, . . . . . . . Cooling/Heating, Mechanical CHT1 B-60 CH70TG Cooling/Heating, Digital, Non -programmable CHSATG Cooling/Heating, Mechanical H20TWR Heating Only, Mechanical • � TOWN OF YARMOUTH Building Department Town Hall r Yarmouth, MA 02664 (508) 398-2231 ext.261 BUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-388 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST # 127 Owner's Name: Villages @ Camp Street, 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: $0.00 Payment Type: Check ChkNo.: 0 Net Owed: $0.00 Application Date: 1131/200_ Issue Date: Expiration Date Comments: new construction: DATE: N/A: 1. WATER DEPARTMENT: 2. ENGINEERING DEPARTMENT: DATE: NIA: DATE: N/A: 3. CONSERVATION: DATE: Z /� N/A: 4. HEALTH DEPARTMENT: 5. BUILDING DEPARTMENT/ DATE: N/A: DATE: NIA: 6. FIRE DEPARTMENT: PLEASE NOTE COMMENTS: U44.Z1.1 . V RECEIPT OF COPY: SIGNATURE OF APPLICANT: (5iuL_ DATE: 0 o S Date Printed: 1/31/2005 .. ►-� TOWN OF YARMOUTH ? Building Department Town Hall rrntt. Yarmouth, MA 02664 e.e. (5w) 398-2231 ext.261 BUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-388 Applicant Name: Applicant Phone: Building Location: Owner's Name: Owner's Addres Frank Capra 5087789669 00121 CAMP ST # 127 Villages @ Camp Street, LLC 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: $0.00 Payment Type: Check ChkNo.: 0 Net Owed: $0.00 Application Date: 1/31/20 55 Issue Date: Expiration Date Comments: map/Lot: U'+'+.c I . new construction: ZONING APPROVED -?I- REVIEWED BY: DATE: N/A: t/1. WATER DEPARTMENT: ✓2. ENGINEERING DEPARTMENT: DATE: N/A: � DATE: N/A: 3. CONSERVATION: � HEALTH DEPARTMENT: DATE: � N/A: DATE: N/A: S. BUILDING DEPARTMENT: DATE: N/A: 6. FIRE DEPARTMENT: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: Date Printed: 1/31/2005 APPLICATION FOR PERMIT TO DO GASFITTING (--• • --- -- _-w(OFFfCE USE ONLY) --- • ---------- TOWWOF YARMOUT S� �� 2005 � Fee: $----- _ �� ------ 05 . i �C— PERMIT NO..--. Buildln 6� _ Owner'S Al. Location_ .� Z.�S.�.�rn_L_--_. Name�� Type of Occupancy_�i?ttl.L — --- New LY Renovation U Replacement ❑ Plans Submitted Yes '6_J No fk f � to to lu W in cc In II� Z Q W '� C C Q f Y y m Z CV U. 00 µ lJf O N V. IXz O (a � u, a� O c7 J IX> b Q. O SUB•BSMT. BASEMENT iST FLOOR 2ND FLOOR 3RD FLOOR ,PRINT OR TYPE) Check One: Installing Company Name -VG•T' S[f^J_r'? IT��_ Corp. Address--i.�--_G_�r9 _..—s T-_.--.--- --- CI Partnership A�_...__...... i�_..�%pt,1.—_--- - ?"J Firm/Company_... Business Telephone F__ a. 7 _3_�� 7 Name of Licensed Plumber or�Et INSURANCE COVERAGE-: Check One I have a current rabdity insurance policy Jr rts substantial equivalent. Yes a No Ic It you nave checked yes, please indiaare t e type of coverage by checking the appropn8re box. A Ilan city insurance policy Other type of indemnity F1 Bond C3 OWNER'S INSURANCE WAIVER: I am aware that :he licensee does not have the insurance coverage required by ChaptH1 +42 of the Mass. Genera; Laws. and that my signature on this permit application waives this requirement Signature of Owner or Owner's Agent 1 hereby certify that all of the details and information I have submitted Tor 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 l� Signature o licensed Plumber or Gasfrtter Z 1 .S 1 5' License Number rvor 1 rrcracc.