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121 Camp St #135 Building Permits
'9s OF 49 TOWN OF YARMOUTHj ; _ s MA EESE �anm O U/ V l � �% � i�,•' � i l APPLICATION FOR PERMIT TO DO PLUMBING (OFFICE USE ONLY) By Fee: $ ` �U 4P� V l0` �� PERMIT e � _� D �w Building � j Q .I AT: Location / Date Q 0► • VE 11.4 f- Type of Occupancy I New ❑ Renovation ❑ Replacement ❑ Plans Submitted Yes ❑ No ❑ Z Z Y F W W W N co J FLLI= co } = U = Q F N Z LL Z C7 Z U) Z _ a 0 OJ Z w r/1 W 0 W =� ~ a W y fA X Q 2 tl) Q a Q 3 X P W W y W a. = J a Z cc a. Q OLL = O O Q 0 Q N 2 O= = H a Q S y T Q Q Q a Q 0: OC O: Q O Q H Y J m Cl)Cl)O in J= F ) LL CZ 7 G Q cc In O SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Installing Company Name Check One: ❑ Corp. Address 5 / ❑Part ip (! FF- i �rry o m p Business Telephone —5 Nge of Licensed Plumber INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yes ❑ No ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. License;7Number Type: Master 0 Journeyman, MAR 0 20075, 0 55 D, LOT 135 EXISTING FOUNDATION 10 R=1 05.00 I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE LOT AS SHOWN, AND THAT ITS LOCATION CONFORMS TO THE MINIMUM SETBACK REQUIREMENTS OF r THE 40B SPECIAL PERMIT. A4xA ':p DATE REGISTERED PROFESSIONAL LAND SURVEYOR .,LE COPY EXISTING FOUNDATION 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. "a4;t DATE REGISTERED ROFESSIONAL LAND SURVEYOR GRAPHIC SCALE 81 F ( IN FEET ) 1 inch = 20 fL AS —BUILT PLAN holmes and mcgrath, inc. `H of OF LOT 135 civil engineers and land surveyors a`°�MICHAELSgCy PREPARED FOR 362 gifford street EL MILL POND VILLAGE a McGRAATFi IN falmouth, ma. 02540 Na 28M s YARMOUTH, MA JOB NO: 201197 DRAWN: LMC s SCALE: 1 "=20' DATE: 3-25-05 DWG. NO.: A2521 A CHECKEQ;G✓AW hi f \S4)�26"F 9s. . ti . (�pGSFFo V 19, titi �'r1 ri V � ,N LOT 134 'PROPOSED WATER SERVI S• g0, R=105.00 -`--SEE SL i LOT 135 ' oSE0 PRNOVSQERI lSPN�e, 29 � „J PROP aS�P�ERP� it e /N 1xq A ` 1 , NOTE:Y 2a978 r � . EEN. E R=145.00 ® SEWER LATER. SLEEVED IN'A[1EE GRAPHIC SCALE WITH TITLE V IF'�VIHrN _�� 1 OFT. OF WATER ]MAIN, �l 20 10 0 20 60. I U i it T hA i11J p 11 rr1� r. F1I1 ) L_�UCI. `I ILL ( IN FEET) dJ r - „ 1 inch = 20 it 3y swum, ' PLOT PLAN holmes and mcgrath inc. OF LOT 135 PREPARED FOR civil engineers and land surveyors ? nricTNvra -_ MILL POND VILLAGE 362 9 ifford street NCIVIL4 73 C J IN falmouthma02540 , . PoF 9 Fss/0N" YARMOUTH, MA JOB NO: 201197 DRAWN: LMC . SCALE: 1 "=20' DATE: 12-29-041 DWG. NO.: A2521 CHECKED: -711 I L MAR 0 2005 A BY. N 716 County street, Taunton MA 02780 I . I- =nqins=eing-corp- 0014SULTING Ef-Kilt-JEERS Tel. (508) 822-6934 Pax. (509) 880-7811.1- FieldQensttv Test Report - Sand Cone Method (ASTM Q1556), Client: Gate -wood Homes - Job No. 10980.010 1600 Falmouth Road, Suite 25 Date: 3/29/05 Centerville, MA 02632 Report No:: I, Project: Mill Pond Village, West Yarmouth Test No. Location of Field Density Test F05083A North Cast Corner of Building Area, of 135 FD5083B South West Corner of Building Area, Lot 135 Tabula -Field Dei?sfttETestResults -- Date: Test No Pr6dor I.D. - Req. %- Obtained— Meets Moisture Dry Wt Max Dry Optimum z Cquipt-T Compaction Specs. Content P.C.F. M. PCF Moisture 312512005 FD5083A PR5093A '95 IM yer, 37 120.7 119.8 10.2 3125/2005 FD5083B PR5083A 95 100 Yes Is 13U.2 119.8 102 Remarks M.White Waller P. Galuska Laboratory Technician Laboratory Supervisor toE t ts engi 1 _ CONSULTING ENGrrJEERS 716�Caasyt�aa; Taut-anIMIA02780 Tel. (308) 83] 6P34 Fss. (Sod 880.Z811 Report of Aggregate Wet Sieve Analysis (ASTM C136) Client: Gatwood Homes Job No. 10980.010 1800 Falmouth Road. Suits 25:..... pate. 0328N5 Centerville. MA 02632 Report No.' MA5083A -------------_________=____--_--__--_ WProject: Mill Pond Village, West Yarmouth Material: Medium and tine clean sand. Location: Onsite Stock Pile Specifications: Holmes and McGrath specifications for dean send. Sampled By: M. Rebello Date Sampled: 3/24/2005 Tested BY: M. Rebello Date Tested: 3/25/2005 ANALYSIS RESULTS Ieve Size: Weiaht Retained % Retained %Passing (Grams) _ -- I Inch. 51:26 3:8_ . 96-2 3/41nch 32.59 2.4 93.8 1/2Inch 30.07 2.2- 91.6 No.4 82.16 6.0 85.6 No.10 77.30 5.7 79.9 No. 40 637.36 48.8 33.2. No.100 378.50 27.8 5.4 No.200 41.96 3.1 2.3 Pan 31.60 2.3 Remarks: Sample Wt.(p) = 1362.80 Specification Gradation Limits Min. - Max. - ------- --------- Walter P. Galuska ... M. Rel ello Laboratory Sup. _isor LaboratoryTechnidan CAPE COD CUSTOM _FLOORS 762 FALMOUTH RD HYANNIS, MA 02601 PHONE 508-778-1965 FAX 50$-7.7$--55.75 EMAIL: CCCP@CAPE.COM FACSIMILE TRANSMITTAL SHEET TO; FROM: Jeff 5-.111-ows , JEtlf COMPANY: DATE: G2tmvood I4onw 3/29/05 FAY NUMBER: -TOTAL NO. OF PAGES INCLUDING COVER: Svo 770-5603 I PHONE NUMBER: SENDER'S REFERENCE NUMBER: 508-772 ^669 RE. YOUR REFERENCE NUMBER: Mal Pond village #124 Joy Childs Upstairs carpeting Jeff, Per you FAx today we inspected the upstairs carpet today. We found no defect in the carpet this carpet shows high and low loops in the each raw. We aid trim some of the edges. Tninggs shouki be. -di set now. if you have any questions please call! me. Jennifer (CLICK HERE AND TYPE RETURN ADDRESS) Sold 9LSS 8LL 80Q S8007dWoisnoaoo3do3 Wd b£:60 S0-6Z-NUW HP Fax Series 900 Plain Paper Fax/Copier Pate T = T Mar 29 3:13pm Sent Result: OK - black and white fax Identification 5087718286 Fax History Report for jeffrey sollows (508)778-5603 Mar 29 2005 3:15pm Duration Pages Result 2:04 5 OK �� tibbetts'.�rlgin��''ir}g.c�cp. C:v^N SiJLTINC �`JCINccog 71Z CouaTy Sw'` ix stnr, bi4..027.$U. Tel. (508) 2 .65L 4 FS: (508} &$0-7811 c-Nfail _ cwritectibbetnengineerilg.cem ri~ rRNI fAN'R DAii REPORT `& CONSTRr1 _IION PRO SCUT: Mill Pond Village W. Yarmouth, MA CLIENT: Gatewood Homes CONTRACTOR: Client EOUIPMENT WORKING: None MEN WORKING: Rick Howe of Gatewood Homes WORK PERFORMED: PATE: 3/24/2005 JOB NO.: 10980.010 FIELD TIMEITRAVEL TIME: 5.25 hours in accordance with a request from the client: I arrived at the referenced Job site -at 12:00 Am to perform soil compaction tests: Upon_ my arrival. 1. met .with Rick Howe of Gatewood Homes who informed me that he needed compaction testing on lof13S• h noted that the test areas were previously compacted wither vibratory plate and were covered with a tarp to protect it' from the snow. I performed a total of two ebmpactron tests. -The final results could not be determine to the field. I took a sample of the soil from a pile next to the foundation for a proctor test and sieve analysis to be performed back at the lab. Once testing was finished i packed up my equipment and left the job site. Matt Rebella La!r_.Techric'ran VbblEtts erdmeft COPP• CONSULTING CIVIL ENGINEERS 6 LAND SURVEYORS 30OACu6hn Avenue 718 c"swd New FSeD1llrl. MA C2745 Tawnon, MA D27e0 Ism on-37DO (SOO) W-5934 m�snnvafN>DMsa+pinlrnrp.cpm FbNve!@WIMMengln!lnrg Dien w.1w.L'L�'..LR.W `ry^MLl1h!3.Lw!1 TO / Idg0 rC10_,40_Vm Rvud ',;a:i?rLzr DATE ATTENTION 7 V J RE: v. d WE ARE SENDING YOU PO Attached ❑ Under separate cover via the following items: O Shop drawings 0 Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter Cl Change order t7�S COPIES DATE NO. DESCRIPTION si OV w Rai ta rrw'Zest P85083 THESE ARE TRANSMITTED as checked below: ❑ For approval d For your use 2 As requested GI For review and comment ❑ FOR BIDS DUE REMARKS TYPE OF DELIVERY: ❑ UPS ❑ CERTIFIED MAIL ❑ EXPRESS MAIL ❑ HAND CARRIED ❑ Approved as submitted ❑ Approved as noted ❑ Returned for corrections ❑ Resubmit copies for approval C1 Submit copies for distribution ❑ Return corrected prints ❑ PRINTS RETURNED AFTER LOAN TO US O FEDERAL EXPRESS ❑ PRIORITY MAIL ❑ FIRST CLASS MAIL ❑ PICKED UP BY CLIENT COPY TO SIGNED: „f It onorasurcs we not as noted, kindly notify us at arcs. HP Fax Series 900 Plain Paper Fax/Copier Last Fax Date Time T= Identification Mar 29 5:00pm Received 508 778 5575 Result: OK - black and white fax Fax History Report for. jeffrey sollows (508)778-5603 Mar 29 2005 5:01ptn Duration Pages $esult 0:39 1 OK TIBBETTS ENGINEERING CORP. Laboratory Density Relationship of Compacted Soil Using ASTM 0 1557-91: Procedure C Date: 12/19/02 121 mmmmmmmmmmmm M.ii.i•i•■i•i•i•ENE MEN WOMEN in-111111111 ON MMMMMw1w; ■��i�'•f•iI/moo® 11111M■■MAINVaIM■IM MEMENEWAMME' =====aR-jwM.a■ --T121 120 0, J 119 5 V �O -117 L116 —x— Maximum Dry Density 119.8 PCF —xw optimum Moisture Content = 10.2% 115 1 2 3 4 5 6 7 .8 c 10 11 12 13 14 15 16 17 18 19 Percent Moisture Content JobNo: 10980.010 Gatew ad Homes Project: Mill Pond Villagz �03/25/05} Report No: PR5083A (Sand) TIBPETTS ENGINEERING CORP. Graph of Sieve Analysis Results Usina ASTM G-136 100 90 50 70 60 50 40 30 20 10 0 Grain Size in Millirnelers Job No, 10980.010 Date: 3/28/05 Mill Pand Vjllagp, W. Yarmouth Report No,. MA5083A 10 100 TOWN OF YARMOUTH Building Department BUILDING (508) 398-2231 ext.261 PERMIT NO 6-05-1037 _ - - - - - - - PERMIT ISSUE DATE ; _ 3/10/2005 _ ; PROPOSED U E ; ; -------------- JOB WEATHER CARD APPLICANT Frank Capra -- -------------------------- ------------ OPMAIT Trl Nww Construction AT (LOCATION) 100121CAMPST#135 ZONING DISTRIC R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C135 BUILDING IS TO BE: CONST TYPE 5 B USE GROUP R-4 LOT SIZE new construction: 2 baths, 3 bedrooms, 1 greatroom, 1 kitchen as per plans 2/09/05 and BOA # REMARKS 3546 - Subject to Compaction and Proctor tests. AREA (SO FT) EST COST ($ 1$141,600.00 PERMIT FEE ($) I$516.00 OWNER IVillages @ Camp Street, LLC ILDING DEPT BY ADDRESS 1600 Falmouth Road 025 B 'jN '4!2 CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 Certificate Issue Date � y'� t /�� a/ ova ',CERTIFICATE�of-OCCUPANCY :- _ _ Departmental Approval for Certificate of Occupancy and Compliance n_._ n -.- 14 Ll...wl.wr Anne %#arl QV Qamarkc LU MEMO J'arox, VON 4 go PA To be filled in by each division indicated hereon upon completion of its final Inspection. I f l OF r TOWN OF YARMOUTH Building Department BUILDING IL (508) 398-2231 ext.261 '- PERMIT NO 6-05_1037---------- PERMIT •� ISSUE DATE ; _ 3/10/2005 - ; PROPOSED USE ' APPLICANT Frrank ankCapra Jr.----------- ------- --------JOB WEATHER CARD ------------------------------- PERMIT TO ' New Construction ' AT (LOCATION) 100121CAMP ST #135 ZONING DISTRIC R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C135 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE new construction: 2 baths, 3 bedrooms, 1 greatroom, 1 kitchen as per plans 2109/05 and BOA # REMARKS 3546 - Subject to Compaction and Proctor tests. AREA (SO FT) EST COST ($ $141,600.00 PERMIT FEE ($) $516.00 OWNER Villages @ Camp Street, LLC B ILDING PT BY ADDRESS 1600 Falmouth Road # 25 Centerville I MA 102632 INS�E"CTION RECORD CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 ector FIELD COPY Date Note Progress - Corrections and Remarks Insp k .0 ONE & TWO FAMJILY QNLY - BUILDING PERMIT A ki o APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING 0 y Town o ' f Yarmouth Building Department MATTACKEES* 1146 Route 28 - Yarmouth, MA 02664-4492 Tel: (508) 398-2231 x261 - Fax: (508) 398-0836 �W yti l. �0 e gel _ 1ww " MM NI= q- 0, Use Group: R-4 ype: , ". , �rl 1.1 Property Address: 1.2 Zoning Information: D, OF-4-5-1 0-5c- � Zoning District Proposed Use 1.3 Building SE --�Ks (it) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.4 Water Supply (M.G.L. c. 40. S 54) Public Private 2-1 wne ko ecor LLC, RtAo-A& a iU 8— N me Qprint� Mailing Address Ce,&,4kjr- Vt Ike ;1 MAI 11IM" 7667 - Signature V Telephone 2.2 uthori Agent: A I 01��LM'4-5 A 0--c:E9 Name (print) C-;Pf rA Mailing Abdr6ss, -J � Lj LE L7f-' --? -7 ' ' 1 6 f EA 3 I- Lb rL y 1 Signature Telephone 17 011 u:) o 3.1 ' Licensed Construction Supervisor.. --JNRotkp�pfica; License Number (t wvq 0 Address 77,F- Expiration Date 01, -16 -b gignatke Telephone Pk5.0- P, Company Name 1� A Not Applicable ❑ License Number Address ub Lig Expiration Date Signature Tele 9-15-99 1 of 2 OVER ectTiin 4 , "Jo L2} Workers 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 ........... sec#tad aescnptt©trflpcseciN.o"rICec sGeatYe' New Construction No. of Bedrooms No. of Bathrooms EAsting Bldg. ❑ Repa)r(s) ❑ Alterations ❑ Addition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: tssts Estimated Cost (Dollars) to be completed by permit applicant Sirc,iorr�st+inated Cortsi"rictlor Item Check Below ❑ Conservation -Commission Fling (if applicable) Old IGngs Highway& Historical Commission approval (if applicable) 1. Building toO a 2. Electrical 3. Plumbing / Gas .� 4. Mechanical (HVAC) 5. Fire Protection 3-0 6. Total = (1 + 2 + 3 + 4 + 5) o o 7. Total Square Ft. grew houses & additions) 1�p Secitc�ex�`Ovvner�\tltf#orrzatt Owiiir`sA tit rxC�ntractc>iAp ^tesftt� »Tff�be;�aFn�let"ed`Wher.�= uiidtng ettrtd� , 1, C.i hereby authorize C1 J4jo' i1Vt-e S 1:i4—k a�owner of the subject property ` f r'^ to act on m beh , in all matters elative to work authorized by this building permit Application. Signature of Owner "(Date SeCtt`P(�?ba �__ tNnertA�ittorrze�Ag�nt Decfaiattori„ 1, V V ► ` it eL , 1 D `CJ , as Qwner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Ee A g Print nar Sighatur of Owner/Agent .Date u 9 - 15 - 99 2 of 2 i t T7- �� a�lfiamar/euaelk BOARD OF BUILDING. REGULATIONS License. CONSTRUCTION SUPERVISOR NumberaJ 012430 B'trttirfate Q66I;940 ExptresrMM2006- Tr. no: 25926 ' Restneted Ate, ;, } FRANKG CAPR/C \ 49COPPER LN:- CENTERVILLE, MA 02632 Commissioner �{ 00 - 35,000 cf enclosed space ' - I (MGL CA 12 S.60L) - „ _ to - Masonry only - i 1G=1&ZFamily Homes Failure to possess a -current. edition of the i Massachusetts State Building Code is cause for revocation of thin license. y r DIG SAFE CALL CENTER: (888) 344-7233 ;i i It, TOWN.OF YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: Job Location: _ Owner of Property: Construction Supervisor: Address: ("o O C) Licensed Designee: (If other than Supervisor) Name 2.15 Responsibility of each license holder: 'v�tqt License No. I& 04 oa63 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 Anylicenseewho shallwillfullyviolate 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 IR( No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond OWNER'S INSURANCE WAIVER: 1 am aware that the licensee does not have the insurance coverage required by Chapter 1 f the Mass. General Laws, and that my signature on this permit application waives this requirement. /��/l.ti�• Check one: Signature df Owner or Owner ge)4 Owner ❑ Agent Signature: Building Official Approval: The Commonwealth of Massachusetts Department of Industrial Accidents 0/fleg o/Isvest/Osvess 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit tits 4'0 � J J— nhone moo$ 2 7 I am a homeowner pertormmg all work myself. [.am a sole proprietor =r..a. has a no one working in am• capacity I am an employer pro%iding workers' compensation for my employees working on this job. company name: address: - city: shone e insurance co. policy 0 CR/l am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractnrs listed heinw uhn have I�t.T, TIT insurance Co.. policy H comnanv name,. rauure to secure coverage as required underSeetion 25A of MGL 152 can lad to the impotdtlon of eriadw penattlt s of a One op.to S1.500.00 and/or one vein' Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a flue of S100.00 a day against me. 1 naderstsad'that a Copy of this statement maybe forwarded to th Office of Investigs dons of the DIA for coverage verifiadoa. l do hereby cerlo. under r paint a allies of perjury that the information provided above is trite and co eya k Signature X au Print name otTicial use only do not Trite in this area to be completed by city or town oMcial city or town: YARMOIIT$ _ permit/license p (38uildieg Department check if OUcensiug Board immediate response is required 261 0SClectmen's Omce C3Healtb Department contact person: phone K; _ (508) 398-2231 eat. rlOther. TOWN OF YARMOUTH 1146ROUTE28 SOUTHYARMOUTH MASSACHUSETTS0266411451 Telephone (508) 398-2231, ExL 261 — Fax (508) 398-2365 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT BUILDING ELECTRICAL GAS PLUMBING SIGNS Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting from �the proposed work/demolition to be conducted at 1 \ 3+ WorkAdAress is to be disposed of at the following location: 7-FD-L:- n it( a t` 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. Date tlti/F,`J/•Ltlb4 tlJ:l/ tl/!-}/7-7/tY .JunIY t,rtuwlcr ACC► -D„, CERTIFICATE OF LIABILITY INSURANCE 978-394 2253 DIRECT TNIS CERTIFICATE IS I5SU1 ooucER ONLY AND CONFERS NO ATLANTIC INSURANCE GROUP, INC. HOLDER. THIS CERTIFICAI AIP.LLC ALTER-THE-COVERA6E-AF rr-„Tc uA/ uA . DATE (M9I500M... O8/O8/2004 385 BOSTON POST ROAD PM8 203 INSURERS AFFORDING COVERAGE SUDBURY, MA 01776 _ .. ..— _,.. _ ... . Nsuaea A NATIONAL FIRE 6 MARIN _ sunEo ...— . _...__.. GATEWOOD HOMES INC. I INSURER B: MA WORKERS-9OMP RESEARCH,_BRD 16M FALOMOUTH ROAD INsuaEa c_ ---- •— - ._._.. ---- —• ---- CENTERVILLE MA 02632 �INsuaER D: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITRSTANBIN6- TO WHICH THIS CERTIFICATE MAY BE LS&UEO OR ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH MAY PERTAIN, POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.•--- ...—.__-_--..�. -- POLIDATCY Ei�fCT1VE ►OLICY E]IPiRi710lIr' LIM{TS _. 3.�__ .---fmow=l -DAY rcN II TYPE OF INSURANCE POLICY MEMBER I I (EACH OCCURRENCE f tAQ_�QQ.Q DENKIML LIABILITY /�X I C_CMMERCIAL GENERAL LW8IUTY 72 LPE 891943 4/29/04 - 4129105 _ f ARE DAMAGE tmyvof� : _ _ 5000Q — 10000 •• CLAW$MADE I X.IOCCUR I NED EXP(AnY on_a Pot 1. f -- - i - - PERSONAL A ADV INJURY f 1000000 - GENERALAGGREGATE b200000Q- L—RO- MPP-... '.... .__..1000000LGEN1 AGGREGATE LIMIT APPES PER: --OUCTS-O- -A•G- - r PCLICY PRO-. ( ; LOG A_V_TOM3811.E •r1 LIABILITY 1 I COMBINED SINGLE OMIT (EA RmMoMI y r ' I ANY AUTO i i I._... ... ._ .�•_- _• .__.. r I ACLOWNEDAUTOS BODILY INJURY y ' sCHEDULEDAUTOS -•---- --" •F� HNEDAUTOS I I I I NCN.OWNEDAUTOS I _^II PROPERTY DAMAGE I I AUTO ONLY EA ACCIDEN- If OARAG-T LIABILITY _ E(`ACC.�f-- _ 1 ANY AUTO i i I OTHER THAN AUTO ONLY: qGG . —_., ••_ ' y EXCESS LIABILITY _ I EACH OCCURRENCE ._. f—.. ..•--. . __ ` ]OCCUR 1 CLAIMS MADE AGGREGATE f —I I � OEDUCiIBIE f AETENTp! f WORKERS COMPENSATIONAMO pOLICYUPDATENUMBERTB r B/4/04 8/4/0$ ITDarLrQTS--= E17• B EMPLOYEas- LIABILITY I I E.L EACH ACCIDENT f SOQQOG- E.LDISEASE- E.AENPLOrE S—_-500000 i 1 I f EL.DISEASE • POUCY LINT f .I OTHER I DESCRIPTION OF OPERATIONSR-OCATONSIVEN(CLESMXC JJSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS PROJECT: MILL POND VILLAGE (VILLAGES AT CAMP ST. LLC - DBA) TOWN OF YARMOUTH BUILDING DEPARTMENT (Tf97) SHOULD AMY OP MEABOVE DESCRRTED POIJCES BE CANCELLED BEFORE TILE EXPIRATION DATE MEREOP, ME KKUNG NSVREII WILL ENDEAVOR TO MAIL 60 DAYS IYRNTEN NOTICE TO ME CERTIFICATE NOL MED TO THE LEPT, OVY FAILURE TO DO $O SMALL RKPOSE NO 08MA71ON Oa fury F ANY KIND OPON THE NSVRER. ITS AGENTS OR REPRESENTA AOTHORNRD R f M� VE /. / J•4x Server IMIA PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOI EMPLOYERS INS GROUP-INC ONLY. HOLDER. NO CONFERS NO RIGHTS UPON THE£ER 281 MAIN ST ALTER THE COVERAGE AFFORDED BYT ETPOL�ICNE§ BELL STE 5 FITCHBURG MA 01420COMPANIES AFFORDING COVERAGE IN TRESOURCE A RI COMPANY MANAGEMENT INC B 81 MAIN STREET SUIIE 5ITCHBURG MA 01420 COMPANY C �SSUray►C° :CMLVcL oYl LroMP""' D _____ ,,,,,-„ aMLUM HAYL tttLN ISSUED.TCLTHE INSURED NAMED ABOVE FOR.THEPQ""S7( INDICATED NMAY B ISSUED ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO I MAY BE ISSUED OR MAY PERTAIN, THE WH6 EXCLUSIONS INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE ONS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER L POLICY EFFECTIVE POLICY EXPIRATION DATE(MARDMYY) DATE(IRM.DU%YY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL U421UTY GENERAL AGGREGATE $ CLAIMS MADE OCCUR PRODUCTS-COMP/OP AGG. $ OWNER'S 8 CONTRACTORS PROT. PERSONAL A ADV. INJURY SEACH OCCURRENCE S FIRE DAMAGE (Any one fire) S AUTOMOBILE LIABILITY MED. EXPENSE (Any one Person) S ANY AUTO COMBINED SINGLE S ALLOWNEDAUTOS LIMB SCHEDULED AUTOS BODILY INJURY (Pr Person) S HIRED AUTOS ' NON-OWNEDAUTOS _ BODILY INJURY (Pr Accident) . S PROPERTY DAMAGE S GARAGE LIABILITY ANY AUTO ' AUTO ONLY - EA ACCIDENT S ' - OTHER THAN AUTO ONLY: EACH ACCIDENT 5..... EXCESS UABILTTY AGGREGATE S UMBRELLA FORM EACH OCCURRENCE S OTHER THAN UMBRELLA FORM AGGREGATE S A WORKERS COMPENSATION AND EMPLOYERS LIABILITY (UB-967X499-9-03) 11-20-03 11-20-04 - STATUTORY LIMITS THE E PARTNERSIEXSCUTIVE INCL R EACHACGDENT OFFICERS ARE-- ElCI DISEASE —POLICY LIMIT SS 51(( S 000 COVERS EMPLYS LEASED TO A"UpjANcE_E,_XCAFFFc I TORS 55D'WILLOW ST W YARMOUTH MA 02673 rn- s J r2d THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. EFFICAiiQLDEf( a. ::< <a DANCE! EhTFC�Af SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE GATEWOOD HOMES, INC. EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ATT : PAULA 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOEDEARAMED'TST"r 1600 FALMOUTH ROAD —SUITE# 25 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR CENTERVILLE MA 02632 LIABDJTYOFANYIOND UPON THE COMPANY, ITS AGENTSOR REPRESENTATIVES; ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDONYYY) 08/OZ/2004 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 662 State Rd. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 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 D: INSURER E: nnvro wrrc. 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - INSR OD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE fMM/Dnffn POLICY EXPIRATION DATE IMM/DDfM 07/15/2005 LIMITS .GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE � OCCUR 8500018147 07/15/2004 EACH OCCURRENCE S 1,000,00( DAMAGE TO RENTED $ 50,00 MED EXP (Any one person) S 5 , OO A X Special Form PERSONAL a ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2 000 OOO GENL AGGREGATE LIMIT APPLIES PER POLICY JE° LOC PRODUCTS - COMP/OP AGG , , $ 2 , OOO OO r AUTOMOBILE LIABILITY ANY AUTO 86852400001 02/21/2004 02/21/2005 COMBINED SINGLE LIMIT (Ea accidem) $ A ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED BODILY INJURY (Per person) $ 250, 000 X X BODILY INJURY (Per accident) S 500.000 X PROPERTY DAMAGE (Per accident $ 500, 00 GARAGE GARAGE LIABILITY AUTO ONLY -EA ACCIDENT $ ANY AUTO THAN. EA ACC AUTO ONLY: AGO $ S EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE S .RETENTION S - $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY 9088680402 04/27/2004 04/27/2005 X wcsrATu- E.L EACH ACCIDENT A ANY PROPRIETOR/PARTNffmcECUTNE Oyes. de (MEMBER EXCLUDED? rc yes descries PROVISIONS SPECIAL PROVISIONS Uelow S lOO , OO E.L. DISEASE - EA EMPLOYE S 100,000 El DISEASE - POLICY LIMIT S S00,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS For any and all operations performed during the policy period. Gatewood Homes Inc. 1600 Falmouth Rd Ste 25 Centerville, MA 02632 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Pauline Des osiers ACORD 25 (2001108) CORPORATION 1998 ACORD,� CERTIFICATE OF LIABILITY INSURANCE. osio9j2o j I PRODUCER (508)994-9688 _ FAX (508)991-5461 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION RUTKOWSKI & KESTENBAUM ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 414 COUNTY STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NEW BEDFORD, MA 02740 INSURERS AFFORDING COVERAGE INSURER A: ProVTOence mutual PO Box 664 INSURERB: OneBeacon West.Hyannisport, MA 02672 INSURERC: Continental Casualty Co INSURER D: INSURER E.. _. .... . THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM POLICY EXPIRATION DATE(MMIDDfYn , LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX OCCUR CPPOO53131 01 12/13/2003 12/13/2004 _ _ EACH OCCURRENCE S 1, 000, 0( FIRE DAMAGE (Any one fire) $ 50,0 MED EXP (Any one person) $ 5,0( PERSONAL & ADV INJURY S 1,000,0 GENERAL AGGREGATE S 2,000,0 GENL AGGREGATE LIMIT APPLIES PER O. f7POLICYELECT LOC PRODUCTS. COMPIOP AGG S 2,000.0c B AUTOMOBILE UABIUTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CBXE48125 .... 02/14/2004 02/14/2005 COMBINED SINGLE LIMIT (Ea accldeni) S (P-P = RY S 250.00 X BODILY INJURY (Per accidenQ $ 500,00 PROPERTYDAMAGE (Per acmderM S 100,00 GARAGE LIABILITY ANY AUTO - . .. .. ' AUTO ONLY • EA ACCIDENT S OTHER THAN EA ACC AUTO ONLY: AGG S S EXCESS LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION S EACH OCCURRENCE S AGGREGATE S s • S $ C WORKERS COMPENSATION AND EMPLOYERS LIABILITY S59UB861X751604 03/22/2004 03/22/2005 . ORVUMrIS 0T EL EACH ACCIDENT S 500,004 EL DISEASE. EA EMPLOYEE S 500,004 E.L. DISEASE _ POLICY LIMIT S 50O OOl OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES!EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURP LETTER: CANCELLATION Gatewood Homes Inc 1600 Falmouth Rd Ste 25 Centerville, MA 02601 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 KINC'DRDISTTII&COMPANY. ITS AOL+IITS O "0 Rft4 Al Q ACORDt CERTIFICATE OF LIABILITY INSURANCE DATE M/7nnA) QRODUCER 508-398-6033 FAX 509-760-1667 'Eastern ox/n THIS CERTIFICATE IS ISSUED AS A MATTER OF 1NFORaIATION INFORMATION Insurance Group LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1 Atlantic Ave ER. TE DOES NOT AMEND EXTEND Yarmouth MA 02664 ALTER E COERAGE AFFORDED BY THE POLCES LW. INSURERS AFFORDING COVERAGE NAIC # INsuRSD Cape Cod Custom tors 762 Falmouth Road INsuRERA: Arbel7a Protection Ins Company. INSURERS: Hartford Hyannis NA 02601- INSURERc INSURER D: E: oyfmINSURER GES 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 RESPECT TD 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 POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ILTR OD' CLAIMS. CONDITIONS OF SUCH TYPE OF INSURANCE POLICY NUMBER II EFFECTIVE POLI Y EXPIRATION GENERAL LIABR1Ty 7500000373 X COMMERCIAL GENERAL. LIABILITY 12 13 2003 12 13 2004 EACH OCCURRENCE LIMITS / / / / r; oaa; art S CLAMS MADE IOCCUR JAILIED DAMAGE TO REMED $ A EXP (Any mA pMon) S ' PERSONALS ADV INJURY i 1 OOO OOI GENt AGGREGATE LIMIT 4PPLIES PER: - GENERAL AGGREGATE S 2 OOO , OOI X POLICY PI TCTc LOC PRODUCT!-COMPIOPAGG S 2,000 OOr AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE LIMB S - (Sa atti0enl) ALL OWNED AUTOS . SCHEDULED AUTOS BODILY INJURY HIRED AUTOS NON -OWNED AUTOS BODILY INJURY S (Pb a�0anO PRO iCEt� DAMAGE s U GARAGE LBILITY ANY AUTO AV TO ONLY-FAACCIDENT S OTHER THAN EA ACC I EI(CESSNMBRELLA LIABILITY AUTO ONLY: AGO S OCCUR CLAIMS MADE EACH OCCURRENCE I AGGREGATE S DEDUCTIBLE S WORNERSCOMPENlATION AND 08WECXL1007 0$ 25 2004 OS 25 2005 X ts, WORVX ERE' UABILnY // WC STATU- OTOFFINY CM �RPEX UJDEE0 ECUTIVE E.L. EACH ACCIDENT SPECIALLPROVISIIOONA III I � I I �OISEASE-EA EMPLOYE S /SPECIAL ence of Insurance for work performed within the Insured's scope -of normal operations InCATE HOLnFR C N E ON sNouLD ANY or THE ABove ocacRleeD rouclg BE uHCELCED-aErvRETRB-- EXPIRATION DATE THEREOF, TIIE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 OAT! WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAM�NC.tEFY_ GateWOOd Homes BUT FAILURE TO MAIL bUCN NOTICE SMALL IMPOSE NO OBLIGATION OR LIABILITY 1600 Falmouth Road C2S OFA XmD UPON THE INSURER ITS AGENTS OR REPRESENTArncJ>_..... Centerville, PIA 02632 AUTH DREPRE9EJ!1:11ArnE III ACOR025(2001/08) FAX: (508)778-S603 ®ACORD CORPORATION 1988 i ACOR.a- CERTIFICATE OF LIABILITY INSURANCE s/°` `M""2/2004o04' PRODU 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 -.-� _.._ __..__.__ ._______ __ __ _ I Osterville, Ma.02655 508-420-9011 4SURED Casperson Overhead Doors Box 517 East Falmouth, MA 02536 508-563-5633 C_OVFRAn9q 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 TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT -TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR WDXL LTR NsnD TYP OF INSURANCE POLICY NUMBER POLICY EFFECTNE DATE MMA) POUICYEXPIRATION DATE MM/DD LIMBS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILJiY CLAIMS MADE � OCCUR CB 2J1973 05/28/04 05/28/05 EACH OCCURRENCE E 1,000,000 X PREMISES Fa oeoumn E 1OO 000 MED EXP(Anf one person) S 10 000 PERsoNAL&ADVINJuRY s 1 000,000 GENERAL AGGREGATE E 2 GOO 000 GEN'L AGGREGATE LIMIT APPLIES P POLICY PRO- LOC PRODUCTS -COMP/OP-AGG E 2 OOO , OOo AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS _ COMBINED SINGLE LIMB (Ea acadwt) S BODILY INJURY (Per person) S B eracci wt) (Peracddent) S PROPERTY DAMAGE (Peractldent) S GARAGE LIABILITY LY-EAACCIDENT EANYAUTOAN EAACC AGG ELY: SEXCESSIUMBRELLA LIABILITY CLAIMSMADE CURRENCE EOCCUR TE EEDEDUCTIBLESRETENTIONSWORKERS INS00,000 COMPENSATIONANDEMPLOYERS' LIABILITY PROPFIEM"AR7MR/EXECUTNE OFFICERMEMBER EXCLUDED? Ifpyes,desaibeundu PROVISIONS below OTHER CP48352 02/22/04 02/22/05 LIMITS ERANY ACCIDENT, E Soo 000B SE -EA EMPLOYE S 5O0 ADOSPECIAL SE -POLICY LIMB S 500 0OO DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES/ EXCLUSIONS ADDED 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 EXPIRATIot DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILRY.OF ANY KIND UPON THE INSURER, ITS AGENTS OR OACORD CORPORATION 1988 PRODUCER• • Sullivan, Garrity & Donnelly =ALTERTpr IS ISSUED AS, 508-754 -1767 - IS NO RIGHTS 10 Institute Rd --PO Box 15010 TIF ICATE DOE Worcester KA 01615-003.0 AG,EAFFOROE Phone.SDB-754-1767 Fax:508-754-lass INSURED INSURERS AFFORDII IG COVERAGE C,5 INSURER B: Crowell Construction, Inc. INSURERC. PO Box MA 02660 INSURER 01 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY P£Rf D INDICATED. NOTW ITNSTAIN ANY REOUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WRN RESPECT TO WHICH THIS CEF' RFF:AT6 MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED By THE POLICIES DESCRIBED HEREIN IS SVBJECT TO ALL THE TERMS. EXCLU:' Oft, AND CONDITIONS OF S•J POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LTR ftUNSR TYPE OF WSURANCE POLICY NUMBER I Y IV LILY E: ARA GFJJE77AL UABAJTY DA E MMIOOA^/ DATE M! I�[UY A X COMMERCIALGSNERALUABILITY ZEN7007141 EACH OCCURREN OS/Dl/04 OS/ 11,/OS PREMIS s EAPrt CWMS MADE ®OCCUR MED fi%P (AnT cwq PERSONAL A A71 GENT AGGREGATE LIMIT APPLIES PER: POLICY MT OLOC AUTDMOBILE LIABILITY A ANY AUTO ABN7001142 ALL OWNED AUTOS X SCHEDULED AUTOS X HIRED ALTOS X NON -OWNED AUTOS GARAGE LIADW7Y ANY AUTO ES3WBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION S WORKERS COMPENSATION AND B EMPLOYERS' LIABILITY ANY PROPRJ97,0WARTNERIEXECUTNE IRWCIOOSOO OFFICEROAFMBER EXCLUDED? As per policy forms, conditions and exclusions. 05/01/04 1 05/ 1; 05 EXTEND OR NArc.x-.. 22292 11000 75000 $ 1000 S 20uv 32000 s BODILY INJURY I s 10p0000 IPgr PMW) BODILY INIURY i IPNfmaene) I 210a0000 1_ PROPERTY DAW-rl $500000 (Pqr owdeM) �- AUTO ONLY- EA.LLNCIIR]NT S OTHER THAN ! G, ACC S AUTO ONLY: I --A10 S EACH OCCURRFIICE S S S i 03/22/04 03/:2/0S EL EACH ACCDENr _ s500000 E.L DISEASE -SAE Ltres S 500000 E.L DISEASE• POLICY UNBT S 5000p0 GLHTIFICATE HOLDER CANCELLATION GATIWOO SHOULD ANY OF THE ABOO i DESCRIBED POLICIES BE CANCEL LED BEFORE GateWOOd Homes, inc. GATE THEREOF. THE LLLUIV S INSURER WILL ENDEAVOR TO I.N.I. 10 DAYS WRITTEN 3.600 Falmouth Road NOTICE TO THE CERTIFTCA• 3 KLDER KAMEO TO THE LEFT. IMJr FAILURET. Suite 2 S IMPOSE NO OBLIGATION OF! LIL3R.TY OF ANY KWO UPON Tay? INSURER. ITS AGENTS OR Centerville MA 02632 RSPRESENTATMI. ACORD 25 (2001/08) O A r ORD. CERTIFICATE OF LIABILITY INSURANCE MARK SYLVIA INSURANCE AGENCY 969 MAIN STREET OSTERVILLE MA 02655 INSURED PETER J. GOVONI DBA P. GOVONI LAND SERVICES 20 OPEN TRAIL RD. SANDWICH, MA 02563 AND CI R. THIS INSURERS AFFORDING COVERAGE INSURERA: FARM FAMILY CASUALTY DATE(MMIDDIYYYY) 08/04/2004 INFORMATION CERTIFICATE ), EXTEND OR 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 RY PAID rl AIRAC INS TR DD' F POLICYNUMBER POLICY EFFECTVE POLICY EXPIRATION LIMITS GENERAL LIABILITY A X COMMERCIAL GENERALLIABILITY 2001L6202 05/31/2004 EACH OCCURRENCE S 1,000000 05/31/2005 PREMNnce S CLAIMS MADE OCCUR MEDmon) S 5000PERSURY S GENETE S 2,000,000GENT.AGGREGATE LIMIT APPLIES PER: PROJEC, PRODP AGG S 1,000,000 POLICY LOC AUTOMOBILE LIABILITY ANYAUTO - COMBINED SINGLE LIMIT (Ea accident) f ALL OWNED AUTOS SCHEDULED AUTOS . DILY IN penmS HIREDAUTOS ' [(PwaccidenEt) S NON,OWNED AUTOS ILYIN . PROPERTYOAMAGE j GALIABILITY.AUTO - (Peraocident) $ ..�._ _... . . ONLY TEA ACCIDENT'_ ANYAUTO S' Ell OTHERTHAN EAACC I FXCESSIUMBRELLA LIABILITY - AUTOONLY: AGG S .:i.. ' EACHOCCURRENCE S " OCCUR CLAIMS MADE $ I AGGREGATE $ DEDUCTIBLE S RETENTION f S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC STATU, OTH, X TO BE ISSUED 07/042004 07/04/2005 T M R ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT S 1,000,000 11 yea, describe under E.L. DISEASE > EA EMPLOYEE S 1 000 000 SPECIAL PROVISIONS below I OTHER EL DISEASE >POLICY LIMR S 1,000000 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS LOGGING AND LUMBERING, TREE PRUNING, STREET CLEANING CERTIFICATEHOLDFR-___-- GATEWOOD HOMES, INC. 1600 FALMOUTH ROAD #25 CENTERVILLE, MA 02632 ACORD 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 CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY-KV40 ypON-7NE-'N5t}REf"T'"GEN7S OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE - e r .is_ M DA ,. DATE (MM/DD .:,:..i>iii:<:.:>:;:.:.:i,..:.:::.:.i... > :.>:i ;;.: 0 8 0 3 04 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HAROLD H WILLIAMS INSURANCE AGENCY ONLY AND CONFERS NO 'RIGHTS UPON THE CERTIFICATE 81 BASSETT LANE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, HYANNIS MA 02601— COMPANIES AFFORDING COVERAGE COMPANY (508) 775=3366 ( ) - A MERCHANTS. INSURED INS CO OF MA STEPHEN M CHILDS COMPANY 145 CAMMETT ROAD COMPANY C MARSTONS MILLS MA 02648- COMPANY (508) - D . ......::.,::n.::.v.w.......:::........... ;CC7.:<::i;;>:.i;:.:t::;:.;ti<;:.ii:.i>::.....:.:.,:::.::...::.:t:.:....v:::::::::::t;t.>;ii:t;t n .::...nJnM. M..J.v.a.... :.. v. ........................:.. .......... n.....::::..............:::..:::n::::: n:..v:::...: v:::.:.v.... .. ..v. n... ...... :.i.:..... n ......n:.::vnt>.::....iii:iii:Ciii:Y.-Y':::: x.:nvY.Oii::J: iiv::::.iynii't i.,:.:!.i �.:......::isii:tt:J.:;::yiii•••:is::nv::::._:Ji::::::::::::::nvi: i'^. wW.., ....:+.v..vuaJnn.waaJn: n::xnv..w.A.n.n.:rii.:.;.J,.'lnii:.;;.ii:n..vi:•i'-i':n}:n:.i•••.i'.v.::":�::nii::!'iiit:::::::.i:.:,::;.i:niiii: iiiiv::i::..i:>..ii>ii?i'.:Jiiiv.v. i:.iiii: it iiiii/.5:::: '� 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. INSURANCE POLICY NUMBERDATE POUCY EFFECTIVE - POUCY EXPIRATION ILTR (MM/DDNY) DATE (MM/DD/YY) LIMITS GETY XLL.GENERALLIABILITY GENERALAGGREGATE 5600000 CCP8567749 04/28/04 04/28/05 PRODUCTS-COMP/OPAG' g s600000 MADE❑OCCUR PUISONAL $ ADV INJURY a3 0 0 0 0ONTRACTORS PROT FIRE DAMAGE (Anyone fire) S AUTOMOBILE LIABILITY MED EXP (Any One person) $5 0 0 0 ANYAUTO / / / / COMBINED SINGLE LIMIT S ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per a—ldenq S PROPERTY DAMAGE S GARAGYAUTUTY ANY AUTO AUTO ONLY -EA ACCIDENT OTHER THAN AUTO ONLY: S - EACH ACCIDENT $ AGGREGATE S EXCESS LIABILITY UMBREtlA FORM OTHER THAN UMBRELLA FORM EACH OCCURRENCE AGGREGATE g - WORKERS COMPENSATION AND EMPLOYERS' LIABILITY THE PROPPoETORI PAR TNERi//ExEcu NE INCL OFFICERS ARE-,. EXCL OTHER - - WC STATU. OT}{..S ... T RY MI R: EL EACH ACCIDENT S EL DISEASE - POLICY UMIT S EL DISEASE -EA EMPLOYEE S 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_ 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 `ISSUE DATE �„Do,YY, PRODUCER Harold H Williams Ins Agcy Inc 81 Bassett Lane THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis, MA 02601 COMPANIES AFFORDING COVERAGE INSURED Stephen M. Childs 145 Cammett Road COMPANY A A.I.M. Mutual Insurance Co Marston Mills, MA 02648 COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVEBEENISSUED 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, TBE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. 12vIITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MM/DD/YY) POLICYEXPIRATIO DATE(MM/DD/YY) LIMITS GENERAL LIABILITY jENERAL AGGREGATE S PRODUCTS-COMP/OP A G. S COMMERCIAL GENERAL LIABILITY S MADE[�JCCU = PERSONAL & ADV. INJURY f EACH OCCURRENCE f OWNER'S @ CONTRACTOR'S PROT. FIRE DAMAGE (My a fie) $ ED. EXPENSE (Airy om person) S - AUTOMOBILELIABIITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY Per Person) f HIRED AUTOS ON-OWNEDAUTOS BODILY INJURY Perweidnn) f GARAGE LIABILITY PROPERTY DAMAGE f LESS LIABILITY EACH OCCURRENCE S RELLA FORM AGGREGATE f HER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS'LIABILTY X WC SIATU- OTH- M _ y f A THE PROPRIETOR/ INCL PARTNE:R.S/E(EC V I'I VE OFFlCERS ARE: g EXIT 7015713112003 12/13/2003 12/13/2004 EL DISEASE —POLICY LIMIT S SOO OOO EL DISEASE —EA EMPLOfEE f 1 OO 000 OTHER DESCRIPTION OF OPERATIONS20CATIONS/NIMCLE&WECIAL ITEMS CtSNCEI;LATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE GATEWOOD HOMES, INC. 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 1600 FALMOUTH ROAD, SUITE 25 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. CENTERVILLE, MA 02632 ?' AUTHORIZED REPRESENTATIVE DATE(MWE)D/YYYY) ACDRa CERTIFICATE OF LIABILITY INSURANCE 1 8/2/2004 • PROD(9CER 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 Osterville, Ma. 01655 508-420-9011 4SURED Casperson Overhead Doors Box 517 East Falmouth, MA 02536 508-563-5633 nnvPPAnPR 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 TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR D'L NSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD POLICY EXPIRATION GATE MM/DD LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMSMADE O OCCUR CB 2LT1973 05/28/04 05/28/05 EACH OCCURRENCE E 1 , OOO OO PREMISES fEa o=rence E ZOO OO MEDEXP(Anyoneperson) E 10,00 PERSONAL &ADV INJURY S 1 000 001 GENERAL AGGREGATE E 2 , 000 , 001 GEWL AGGREGATE LIMIT APPLIES PER POUCY PE o- LOC PRODUCTS -COMP/OPAGG E 2,000,00( AUTOMOBILELIABIUTY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS - COMBINED SINGLE LIMIT (Ea accident) E BODLY INJURY (Per person) E BODILYINJURY (Peraoddent) E PROPERTY DAMAGE (Peraccideni) E GARAGE LIABILITY ANYAUTO AUTO ONLY. EA ACCIDENT E OTHERTHAN EAACC AUTOONLY: AGG E E EXCESSIUMBRELLA LIABILITY OCCUR CLAIMSMADE DEDUCTIBLE RETENTION E EACH OCCURRENCE E AGGREGATE E E E E B WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNEWEXECUTIVE OFFK IRUMEMBER EXCUJDED? I desWbewder SIAL PROVISIONS below SPEC CP48352 ' 02/22/04 02/22/05 X I TORYLIMITS I I ER E.L. EACH ACCIDENT E 500,000 E.L. DISEASE - EA EMPLOYEj E 500,000 E L DISEASE -POLICY LIMIT E 500OOO OTHER DESCRIPTION OF OPERATIONS / LOCATIONS/VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO Gatewood Homes, Inc. DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL10 DAYS WRITTEN 1600 Falmouth Rd., Ste. 25 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO 00 SO SHALL Centerville, MA 02632 IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES AUTHORIZED REP S T ACORD25 (2001I08) V © ACORD CORPORATION 1988 a coRo CERTIFICATE OF LIABILITY INSURANCE pRODUQER (781)431-9800 FAX (781)431-0222 =081;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 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 981 Worcester Street Wellesley, MA 02482 INSURERS AFFORDING COVERAGE NAIC # p15URED INSURERA: OneBeacon American,Ins. Co. 20621 Cape Cod Ready Mix, Inc. INSURERB: Commerce Insurance Company 34754 300 Cranberry Highway INSURERC: Zimmerman Specialty Insurance ZSI001 Orleans, MA 02635 INSURERD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PERIOD POLICY INDICATED. NOTWITHSTANDINI 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 AGGREGATE POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. SUCH INSR DO' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTNE POLICY EXPIRATION LIMITS GENERAL LIABILITY CBR817036 01/01/2004 01/01/2005 EACH OCCURRENCE E 1,000,001 X COMMERCIAL GENERAL LIABILITY DAMAGE 7.0 RENTED S 100,001 CLAIMS MADE f OCCUR MED EXP (Any one person) f 5,001 A PERSONA: L ADV INJURY $ 1, 000, 00( GENERALAGGREGATE S 2 , OOO, OOI GENT AGGREGATED Ort APPLIES PER• PRODUCTS-COMP/OP AGG S 2,000, 00( POLICY JECT LOC AUTOMOBILE LIABILITY XY9014 01/01/2004 01/01/2005 ANYA1JT0 COMBINED SINGLE LIMIT (Fa accident) E ALL OWNED AUTOS 1,000,00( X SCHEDULEDAUTOS - (Per person)tory BODILrsY f B X HIREDAUTOS - X NON -OWNED INJURYWNED AUTOS (Per accida-d) $ PROPERTY DAMAGE. S (Per accident) GARAGE LIABILITY AUTO ONL'f - EA ACCIDENT E ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG S IXCESSIUMBRELLA LABILITY BE9744481 01/01/2004 01/01/2005 EACH OCCURRENCE S 1,000, 000 X OCCUR CLAIMS MADE C AGGREGATE S 11000,000 DEDUCTIBLE IR S 10,000 s RETENTION S ' E WORKERS COMPENSATIONAND WC STATU- OTH- - EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNEWE)(ECJT!VE E.L. EACH ACCIDENT S OFFICER(MEMBER EXCLUDED? H yes, describe under E.L. DISEASE - FA EMPLOYE S SPECIAL PROVISIONS below OTHER E.L. DISEASE -POLICY LIMIT E DESCRIPTION OF OPERATIONS / LOCATIQJS /VEHICLES (EXCLUSIONS ADDED BY ENDORSEMENT I SPECUIL PROVISIONS CERTIFICATE HOLDER CANCE LA ION ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Gatewood Homes, Inc. 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER 1) TO THE LEFT, THE 1600 Falmouth Rd. BUT FAILURE TO MAIL SUCH NOTICE SHALL INIPCSE Mn OBLIGA OR Suite 2 5 OF ANY KIND UPON THE INSURER ITS AGENTS CR ESENT Centerville, MA 02632 AUTHORRED REPRESENTATIVE ernon iS /inn-imo1 ,�&RD CORPORATION 1988 QCQBDr CERTIFICATE OF LIABILITY INSURANCE 08/02/04 DATE(M��n PRODUCER � THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Fel et (berg Company ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 222 Milliken Blvd. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O B 3220 - . . ox Fall River, MA 02722 INSURED Cape Cod Ready Mix Inc. PO Box 399 Orleans, MA 02653 INSURERS AFFORDING COVERAGE INSURER A. Construction Industries Compensation INSURER B: INSURER C INSURER D: INSURER E: ' THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OF MAY 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 RFFN RFnI Ir.Fn RV PAM rN Auee �7p TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MID POLICY EXPIRATION DATE (MM/Onfryi LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIAB ILITY i � 'i CLAIMS MADE OCCUR I EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) E 61ED EXP (Anyone person) S PERSONAL & ADV INJURY S I1Lj GENERAL AGGREGATE S GENL AGGREGATE LIM rrAPPUES PER: POLICY jE 6 LOC PRODUCTS-COMP/OP AGG S AUTOMOBILE LIABILITY - ANY AUTO P COMBINED SINGLE UM (Ea acatlent) R S IJ ALL OWNED AUTOS I I SCHEDULED AUTOS rrr'lll BODILY INJURY (Per person) $ HIRED AUTOS I NON -OWNED AUTOS BODILY INJURY (Per accident) S PROPERTY DAMAGE (Peraccident) i S —J — ( I GARAGE LIABILITY .. .. AUTO ONLY - EA ACCIDENT S ANY AUTO OTHER THAN EA ACC S S AUTO ONLY: AGG I EXCESS LIABILITY F—ICLAIMS MADE EACH OCCURRENCE S AGGREGATE $=$500,000. ROCCUR DEDUCTIBLE II—"-lI RETENTION - SA WORKERS COMPENSATION AND WCOOO9254 01/01/04 01/O1/05 X WCSTATU- O1H-EMPLOYERS'LIABILm' MEL EACH ACCIDENT E.L CISEASE - EA EMPLOYEE' s500,000 EL DISEASE - POLICY LIAR s500,000 i I I OTHER , DESCRIPTION OF OPERATIONS/LOCATIONSJVEHECLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Gatewood Homes Inc. 1600 Falmouth Road Suite 25 Centerville, MA 02632 SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYSWRITTEN NOTICE TO TH E CERTIFICATE HOLD ER NAM ED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY IOND UPON THE INSURERJTS AGENTS OR " ACORn gr—c nroT. _t .. • • -• - w tawnrwUUcy CL3 0 ACORD CORPORATION 1988 Client#: 18434 i'7_F' iI1:7_1:Lei:W01 A ORP- CERTIFICATE OF LIABILITY INSURANCE °'"""' 10 PRCIDUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling 8r O'Neil Insurance Agency, Inc. 222 West Main St. PO Box 1990 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC # INSURED Assurance Construction, Inc. A/O Assurance Excavation, Inc. 550 Willow Street West Yarmouth, MA 02673 INSURER A. Travelers Insurance Company INSURER B: INSURERC. INSURER D: INSURER E THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Matt LTR NSR TYPE OF INSURANCE POUCYNUMBER D TE(MICY IDDTHE PDATE(MOLIC)(PI pTION LIMITS A GENERAL LIABILITY 16808387A9841ND04 08/01/04 08/01/05 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES (Ea� $300 DUO CLAIMS MADE Fil OCCUR MED EXP (Any one Person) $$ 000 PERSONAL It ADV INJURY $1 000 000 GENERAL AGGREGATE 52 000 000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS -COMPIOP AGO E2000000 POLICY PE 0. LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per Person) $ ALL OWNED AUTOS SCHEDULED AUTOS - BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) S GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $ OTHER THAN EA ACC S ANY AUTO $ AUTO ONLY: AGG EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE S S RRDEDUCTIBLE $ ETENTION S WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? - H yea, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Operations performed by the named Insured subject to policy conditions and exclusions. Gatewood Homes, Inc. Attn: Paula 1600 Falmouth Road, Suite 25 Centerville, MA 02632 AI:UKU ZD (ZUUI/UIS) 1 of 2 #35866 ) ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 1EREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR LS1 0 ACORD CORPORATION 1988 ,AC.QR0. CERTIFICATE OF LIABILITY INSURANCE 0/4/04 1 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION d � G✓11� ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ., rco rwc f^rn/cRAGF AFFDRDED BY THE POLICIES BELOW. P.O. BDx 337 NHTstcm mills, m 02648 INSURED AYIaacan Rxnlitim m• Inc. 43 RArrley's Iane Oaabe vine,. M!1 02632 INSURERS AFFORDING COVERAGE j INSURER A: T'i- �'ML#3nl. .Fixe Ins. Cb+ _INSURER S: S-:i"em PrIxer I-s & CC s . lty - INSURER C: - j INSURER D:. INSURER E: cunccc ` Ti- IE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PULIGY Vt:hluLJ Irvuwnr cv. ,..+, ..,,, .. •••-••• •-^ ANY REOUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR NIAY 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. _._., ,_- ! POLICY EFFECTIVE POLICY EXPIRATION LIMITS Vok TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY I DATE IMM/DD/YY .TH I I EACH OCCURRENCE 1 5 1,000,000 GENERAL LIABILITY FIRE DAMAGE (Any one life) S 50' WO CONINIkiRCIAL iiENL`.RAL L.IABIUTY CLAIMS MADE OCCUR OCCUR MED EXP (Any one Person) S 5wo , ' ' ) PERSONAL & ADV INJURY- __ . S. 2, 000, 000 j (GE NERAL AGGREGATE A GYN'L AUGHEGAI'E LIPAI T APPLIES PER: ( CFO 0005933 04 10-05-03 i 10-05-N I PRODUCTS _COMP_OP AGG i S 2, 000, OW P"O CP00005013 05 10-5-04 I10-5-05 POLICY ,If CT LOC I I I COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY ! ! i (Ea accident) ANY AUTO _ _S ALL. OWNED AD 105 I ! BODILY INJURY - $ (Per Person) SCHEDULED AU'T.OS - I IIk11HL0 �_ _-_ ..... .... ...... ._._.. AUTOS I I BODILY INJURY y (Paf acci0enf) . NON-OWNLO AUTOS i ' PROPERTY DAMAGE $ r (Per a=dan) I� Y-E_—C_C_ I E AUTO ONL'AACCIDENT D T .._.. .. GARAGE LIABILITY, ACCI $ ANY AUTO i I i ' OTHER THAN - -.. I.--• - I AUTO ONLY: AGG S - I EACH OCCURRENCE $ EXCESS LIABILITY AGGREGATE $_., OCCUR I CLAIMS MADE 1 i j , UEDUCMILE I ' - ! --- -- fiEIFNTIUN $ I WC STATU• OTH-; l-ORY LIRIITS WORKERS COMPENSATION AND - I __ E.L EACH ACCIDENT_ I $ 100, ow EMPLOYERS' LIABILITY 04-01-04 04-01-05 _ E.LDISEASE ; EA_E_NIPLOYE' $ - 100T000 B I WM OM 6 I I E.I DISEASE • POLICY LIMIT j$ 5Wr OW OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESfEXCLUSIONS ADDED BY ENOORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER i ADDITIONAL INSURED; INSURER Gatewood Homes 1600 Falmouth Rd. Suite 25 Centerville MA 02632 508-778-5603 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _ 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. _ O ACORD CORPORATION 1988 25-S (7I97) ACORDCERTIFICATE OF LIABILITY INSURANCE DATE (MM Dp/yyyy� 11/01/zoo4 PRQD ER �`508) 540-2400 FAX (508)289-4111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Murray•& MacDonald Insurance Services 406 ]ones Road Falmouth, MA 02540 Douglas MacDonald PO Box 1551:::.. Mashpee;"-MA 02649 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW INSURERS AFFORDING COVERAGE NAIC # INSURER A: Arbella Protection Insurance INSURER8: Liberty Mutual Ins -Corp INSURER C: .. .. ..- ... _ __.... -. NSURER D: .... NSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSRTYPE OF INSURANCEPOLICY POLICY NUMBER 79mow EXPI DATE MM/DD LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE ❑OCCUR 85000287S6 08/14/2004 08/14/2005 EACHOCCURRENCE E 1,000,000 PREMISES EKLNI LU a 1DD, DDU MED EXP (Any one person) a 5 r OD PERSONAL 8 ADV INJURY a 1,000,00( GENERAL AGGREGATE a 2,000,00( ' - - GEN'L AGGREGATE LIMIT APPLIES PER POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG E 2,000,00( AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE LIMIT (Ea accident) E ALL OWNED AUTOS BODILY INJURY (Per person) a SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per accident) E NON-0WNED AUTOS - - - - PROPERTY DAMAGE (Peraccident)... - E. .._ .. ... . GARAGELIABILITY _. ._..-. _. ANYAUTO __._. _.. _.. _.. -.:.: _ _. __.- -AUTO ONLY - EA ACCIDENT a . - -- -.- _ OTHER THAN EA ACC E - - ,._ :.• - . ., - - - AUTO ONLY:. __.._. .. .AGG E_.... EXCESSNMBRELLA LIABILITY OCCUR a CLAIMS MADE - EACH OCCURRENCE - E '-- - AGGREGATE a - -- DEDUCTIBLE RETENTION E aa Is EMPLOYWORKERSCOMPBILrTYONAND WCS31S317310033 10/OS/2004 10/05/2005 EMPLOYERS' LIABILITY TCRY LI-IMIIU UIH- T7 S1 IER B ANY PROPRIETORIPARTNER/EXECUTWE OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT a 100 00 R yes, describe under SPECIAL PROVISIONS belay OTHER E.L. DISEASE - EA EMPLOYEE E E.L. DISEASE - POLICY LIMB E 100,000 - SOLI. 00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE WnI nco Gatewood Homes, Inc. Paula 1600 Falmouth Road, Suite 25 Centerville, MA 02632 A(`nDn 9c InAn4 me% SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. --- .. --' ©ACORD CORPORATION 1988 Aug-03-04 02:42pm From -A I G I 873-316-6903 T-2j0 P-002/002 F-481 l. P1 ---- -11 - - 1 C E. . -..- - -•* - , . -" e % A. INSUFA147 kta 37 PRODUCER r - :17:: A ICTE 1-� A;r S ISSUED AS A MATTER OF Dias Ins Agency Inc INFORMATION ONLY AND ONFERS NO RIGHTS UPON THE CERTIFICATE 535 Brayton Avenue HOLDER. TI- IS CERTIFICATE DOES NOT AMEND. EXTEND OR Fall River, MA 02721 ALTER THE. ;OVERAGE AFFORDED By THE POLICIES BEL-G)W- %-%JfflrAmJ&:U AFFORDING INSR�ANCE TN—S—U—RE—DT— COMPANY GRANITE STATE INSURANCE COMPANY Eba Carpentry Inc 100 West Main Street, St 1() Hyannis, MA 02601 t 7-0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED ;tzl-uw HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOT WITHSTANDING ANY REOL REMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY a ; ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED THE... POLICIES DESCRIBED HEREIN IS SUEQECT TO ALL THE TERMS. E -CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. C�QykKs- Lmn-rry PROPRIETOW rN 1EXECU77ve CMSARE: 0 e(CL D 3 EXC0 C 0( OVR dOwy. 7/24/2004. 7/24/2005 ACCIDENT SE POLICY LIMIT CERTIFICATE HOLDER ANCELLATION GATEWOOD HOMES SHOULD ANY OF THE ABC JE DESCRIBED POLICIES BE CANCELLED 1600 GALMOUTH ROAD, SUITE 25 BEFORE THE CEL T'O SHOULD = P T" L 0 N E AB' OFV�AYION DATE TfiMU )F. THE ISSUING COMPANY WILL r .IMF _AVOR To M CENTERVILLE. MA 02632 0C AILIG DAYS WMTrEN NoTrCEr 'THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT To M SUCH F 'TCE SMALL IMPOSE NO OBLIGATION tIAB OF FALLRE To MAlL SUCH ?" 0 UPC OR alTy ANY KIND UPON THE COL 'ANY, ITS AGENTS OR REPRrSEWATmES. KIND 14 H AUTHORIZED REPRI SENTATNE 5t . vVIi7♦V7 1V.YV 1'ILl JUO/`JVV69.`1 VULJ%yly� ASSOC r s a����r� CERTIFICRATE O � LIABILITY lN83 :R�/��J'� RL '--_ +a... .,a ��� s,iie viii �Iv GOLDMM & ASSOCIATES MNSURA CZ YHtSt'E FINANCIAL SSJ2VICE3 INC. lCAZE-ISJSS�l6S�ASE1 ONLY AND CONFERS NQ RIcHTS Upol 93} paijgl_ yam_ HOLDER THIS CERTIFICATE �jawla w 02601 ALUP-THECjYER_AG— .DOES NO ?hOmal!508e775e6010 Fv=:508_790-0249 MYRED I..-BL:-€R-5 AFFORVING COVERAGE WSURERA: ESSEX IN34RANC8 Co 7 Goovw= U-bovATIOHS vm i FO BOX 116 83ECz2" ?33 aZACE M-A 02562 MUMC: INSURER Lt THE POLICREOUIES OF WSURANCE LISTED BEJ.OW NAVE BEEAI LSSUED TO THE INSUfLED NAMED ABOVE FOR THE AMAYNY F�OL'L'LAENT, TERL I OR CONDITION OF ANY CONTRACT ORCT: fER POLICY PERIOD WIXCATFD.410TW{TMS7ANDING POU PER7AIL THE .T� m.«rn M EY7�- E^..L1ClES -C .•CBIB`D � WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED DR POLICIES. AGGREGATE LIYRS StpW N MAY HAVE BixJN MCLAN S sL'B..'-L'T TO ALL TSTE TEIp;S, W=lZr40 AM COND..TIOUS.OF SUCH REDUCED BY PAID CLAIMS. LTR TYPE OF LVSLRLANCE GENERAL LIAMUTY POLICYNUMBER DATE (M.FDo/m DATE[ Lamm A Y COMMERCIAL GENERT LIABn.rry 3CM2718 EACH OCCURRENCE s CLAIMS MADE Most 12/12/03 12/12/04 PRn.LSEs(Es ocsvan�) s MED EJIP (Any PERSONALd AM INJURY s GENt AGGREGATE LnM APPUES PER GENERAL AGGREGATE s POLICY I JEET I I LOC PROO�"TS-CCMPiOp Acc I c ANYAuTo ALL OWNED AUTOS SCHEDULEDAUTOS HI:1E0 AUTOS FiSii-f3wf�9 Alirti$ + RGA AGF L.'-'1LJTY ANYAUTO Q;qA u C4AIM3 MADE DEDUCTIBLE RETENTIDN s B EkPLOYEW LABILITY ALE7 AYYPROPLE—E-A m �eCUTryi RIceR EXCLUDe'"DT GATENOOD fiOms mrC FAx sob-�fi:t-5so3 1600 ar, ..•� „ �?�??IZLB 1dA 02632 #ANC7016018012004 1 01/03/041 01/03/05 SINGLE LIMTT IS ( WILY &n�i RY S BOOI.Y WJURY (P.T a=d..y is PROPERTY PBr �amAGE s AUTO OWL Y-FA ACC,:,ENi S OTHER.THAN EA ACC s AUTO ONLYI EGG S EACH OCCURRFI(CE Is s s s �Di W� DATE (N.Y[fID'y7q� NAa.# 00 >=OI-.."'-S BE CAkCELLEO LEEORE TY.B -� ..ATM DATE THEREOF.T!E? 155LlNG I'.5lL4ER .%,U ENDEAVOR TO %LL 2 Q D . 4Y-..l1TBN POT"TQ 7Hfi 6ERT1FMxATE N9kLtER NAMfO TO TH5 LEFTS BUT FAILUIIE T090-SOEHALL NdPOSE NO OALt<AMN OR LIAWyTY OF ANY )qND Y" THE *4YREIq REPRESENTATIuee K I UtK K 1 bK 51-'tC I RL I STS 1 508 564 7272 P.01,-02 ._. ,• F•�+.>`.Aa..s,.ra.'sa.R7'�. 8 >� vR; LfI!S'1DiL,! i I...1 E.aJ1J, PRODUCER THIS CERTIFIC. ONLY AND C RIDER RISK SPECIALISTS HOLDER. THIS INSURANCE AGENCY, INC. THE_ C P.O-BOX 115 .,,,,K DATi IMMttIpIYYI... d� 07/28/04 AS A MATTER OF INFORMATION RIGHTS UPON THE CERTIFICATE DOES NOT AMEND. EXTEND OR ORDER BY THE Pot Inks DFt Mu CATAUMET MA 02534-0115 A SCOTTSDALE INSURANCE COMPANY EONiPAENY- MONUMENT INSULATION, INC. E.. _ B AMERICAN HOME INSURANCE COMPANY 223 COUNTY ROAD •- _ BOURNE, MA 02532 COMPANY COMPANY D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THEINSUREDNAMED ABOVE FOR THE POLICY PERIOD—— CERTIFIED, NMAY BE ISSUED O ANY REQUIREMENT. INS 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 DESCAIBED_k1EREBII-T VAT"1EESPEC gLL_'WH H THIS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CD TYPE OF INSURANCE _._. LTR POLICY MUMMA POUCT EFFECTIVE .BOLLCY DATE IMM/DD/M DATE IMM/DO/YYI LIM 13 GENERAL LIABILITY X COMMERCIALGENERALLIABILITY GENERALAGGREGATE t1,.000, OOO CLAIMS MAOG XI OCCUR PRO_D___ _; COMPIOP AGG 1500,000_ 2 _ Y OWMFRS&CONTRACTORSPROT CIIS1OO1705 PERSONAL&ADVMJURY t5OO; O00 3/30/04 3/30/05 rFEnoaLRIRENCE :500.000 ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARA g LIABILITY 7 ANY AUTO EXCESS LIABILITY VMSRE LLA FORM OTHER THAN UMBRELLA FE WORKERS COMPENSATION AND EMPLOYERS UABEUTY B THE PADPRIETOR/ PAIRNERSIEXECUTNE OP mcL I WC 768 29 54 EXCL COMBINED SINGLE LIMIT F..- BOCILY BUURY IPr a wq t BODILY INJURY IPv cide"I s PROPERTY DAMAGE AUTO ONLY . EA ACCIDENT OTHER THAN AUTO ONLY: 'w: w: EACH ACGDENY s AGGREGATE t EACH OCCURRENCE s AGGREGATE t X WC STATIC- R . EL EACH ACCIDENT 3/5/014-" 3/5/OS EL DISEASE-rDucr LIMIT tr7$I t t t GATEWOOD HOMES ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE TNEREOF, THE ISSUING COMPANY. WILL -ENDEAVOR TO MAIL 1600 FALMOUTH ROAD #25 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT. CENTERVILLE, MA 02632 BUT FAILURE TO MAIL SUCH'NOTtCE SMALL IMPOSE MO OBLIGATION OR UABIUTY OF AMY RIND UPON TNT rnMPAOv TOWN OF YAIAMOUT11 Building Department Town Hall Yam outh, MA 02664 (506) 39e-2231 eA2611 BUILDING PERMIT Temp Permit No.: Applicant Name: Applicant Phone: Building Location: — - Owners Name: Owners Addres TRANSMITTAL T-05-389 Frank Capra 5087789669 00121 CAMPST#135" -_ Villages Q Camp Street, LLC 1600 Falmouth Road # 25 Centerville MA 02632 Owners 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: 1/31/2005 Issue Date: Expiration Date comments: new constniction: U44.c1 A; ZONING APPROVED REVIEWED BY: ✓1. WATER DEPARTMENT: DATE: ✓2. ENGINEERING DEPARTMENT: DATE: 3. CONSERVATION: DATE: X'�1 HEALTH DEPARTMENT: DATE: 5. BUILDING DEPARTMENT: DATE: 6. FIRE DEPARTMENT: DATE: PLEASE NOTE COMMENTS: Wk. WA: N/A: N/A: WA: WA: RECEIPT OF COPY: SIGNATURE OF APPLICANT: �� A A4 DATE: 3 6 bJ Date Printed: 1/31/2005 TOWN OF YARMOUTH Building Department Town Han Yamwulh, MA 02654 (508) 398-2231 e)d261 BUILDING PERMIT Temp Permit No.: Applicant Name: Applicant Phone: Building Location: Owners Name: Owners Addres TRANSMITTAL T-05-389 Frank Capra 5087789W9 00121 CAMP ST-#1351 jr Villages @ Camp Street, LLC 1600 Falmouth Road # 25 Centerville MA 02632 Owners Telephone: (508) 778-9W9 (OFFICE USE ONLY Recorded By: IC Permit Fee: $0.00 Deposft Rec: s0.00 Payment Type: Check ChkNo.: 0 Net Owed: $0.00 Application Date: 1/31/2005 Issue Date: Expiration Date Comments: Map/Lot: 044.21.1.0 new construction: REVIEWED BY: 1. WATER DEPARTMENT: 2. ENGINEERING DEPARTMENT: 3. CONSERVATION: 4. HEALTH DEPARTMENT: 5. BUILDING DEPARTMENT 6. FIRE DEPARTMENT: COMMENTS: Z DATE: WA: DATE: WA: DATE: WA: f / DATE:. Z /� pS N/A: DATE: WA: DATE: WA: PLEASE NOTE RECEIPT OF COPY. SIGNATURE OF APPLICANT:��7 1�-�d �I Lx�c.cvJ DATE: 6 0 J Date Printed: 1/31/2005 TOWN OF yARmOuTH BUILDING DEPARTMENT PLAN REVIEW & BUILDING PERMIT APPLICATION REVIEW NOTES ADDRESS: Map / Lot: le Date of Initial Review: Other: Approval Date: Inspector: NOTES: Zoning Denial (if applicable): Section 104.3.2, para. jChange, Extension or Alteration (pre-existing, nonconforming) The proposed Other requires a Special Perrint from the Zoning Board of Appeals.. BuildingCode Denial (if applicable) Rev. 11-01 0 ADdREss: /a/ :ALcu1ATION FOR PERJMiT COST "a+v ,=C a /S-D� - gSt� 297sn � AD lor+ as Y rvunuAllo" ONLY GARAGE NO.OF BAYS 0 n 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) 21.1C/135; 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. AM �� N:\Water Availibility\121Camp#135.doc r TOWN OF YARMOUTH Building Department Town Hd ` Yarmouth, MA OM4. (5W) 3WMI eAM1 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-389 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST #135 Owners Name: Villages Q Camp Street, LLC Owners Addres 1600 Falmouth Road # 25 Centerville MA 02832 Owners 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: 1/312005 Comments: Map/Lot: 044.21A.0 new construction: REVIEWED BY: 1: WATER DEPARTMENT: DATE: p WA: 2. ENGINEERING DEPARTMENT: DATE: WA: 3. CONSERVATION: 4. HEALTH DEPARTMENT: 5. BUILDING DEPARTMENT: 6. FIRE DEPARTMENT: COMMENTS: RECEIPT OF COPY. PLEASE NOTE SIGNATURE OF APPLICANT: DATE: WA: DATE: N/A: DATE: WA: DATE: WA: DATE: Date Printed: 1/312005 I U—mO-r OGO-3 In GMS9/GCS9 93%AFUE Multi -Position, Single-Stage/Multi-Speed Gas Furnace Heating Capacity: 46,000-115,000 BTt ink �C,IV® Standard Features • Corrosion -resistant, aluminized -steel tubular heat exchanger and stainless -steel recuperative coil for maximum efficiency • Designed for multi -position installation—GMS9: upflow, horizontal right or left; GCS9: downflow, horizontal right or left • Energy -saving, reliable Hot Surface Ignition system, featuring a.Nortoe 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 Conditioning Heating The GMS9/GCS9 single -stage, multi -speed gas furnaces offer installation versatility. Cabinet Construction • Heavy -gauge, reinforced, fully insulated steel cabinet with durable baked -enamel finish • Attractive architectural gray paint finish • Foil -face insulation -lined heat exchanger compartment • Coil and furnace fit flush for easy installation • Convenient left or right connection for gas and electric service • Bottom or side air inlet (GMS9) • Removable, solid -bottom block -off (GMS9) Accessories • L.P. Conversion Kit (LPT OOA) • L.P. Gas Low Pressure Kit (LPLPOI) • High Altitude Natural Gas/L.P Kits (HANG11, HANG12, HALP10) • High Altitude Pressure Switch Kit (HAPS27) • External Filter Rack (EFROI) • Horizontal Concentric Vent Kit (HCVK) • Vertical Concentric Vent Kit (VCVK) • Internal Filter Retention Kit—upflow, horizontal (RF000180) • Internal Filter Retentio40� Kit—Iownflow (RF000181) • Thermostats Blower Motors (CHT18-60, CH70TG, CHSATG, H2OTWR) SS•377D w .goodmanmfgxom 6/04 0 M PRODUCT SPECIFICATIONS Nomenclature G M T E 070 3 A N A Goodman® Brand Revision A: Initial Release Air Flow Direction NOx B: 1n Revision M: Upflow/Horizontal N: Natural Gas C: 2nd Revision D: Dedicated Downflow X: Low NDx C: Downflow/Horizontal Cabinet Width H: Hi Air Flow „ S: Single Stage/Multi-speed V: Two Stage/Variable-spee AFUE 8: 80% 9: 90% .k 045:45,DD0 070: 70,000 090:90,000 115: 115,000 140: 140,000 A: 14 B: 17W' C: 21 " D: 241h" Maximum CFM @ 0.5" ESP 3: 1,200 4: 1,600 5: 2,000 "� 2 C. PRODUCT SPECIFICATIONS Performance Ratings Ru N. t17! MMM rw - . I - 'r, 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 74,400 93.0 4.0 35-65 GMS91155DXA 115,000 106,500 93,000 93.0 5.0 35-65. GCS90453BXA 46,000 42,800 37,200 93.0 3.0 35.65 GCS90703BXA 69,000 64,400 55,800 93.0 - 3.0 35-65 GCS90904CXA 92,0D0 86,000 74,400 93.0 4.0 40-70 GCS91155DXA 115,000 106,500 93,000 93.0 5.0 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 -1 V NOUN RM� I - M I - % e'E2 Burnes. IM 0, -e - I 4'' U 1 - 0 GMS90453BXA 10" x 7" 1/3 4 2- 2 288 576 9.0 is 132 GMS90703BXA 10" x 8" 1/3 4 2- 3 282 564 9.0 15 135 GMS90904CXA 10" x 10" 1/2 4 2. 4 376 752 8.9 15 158 GMS91155DXA 11" x 10" 3/4 4 2. 5 470 940 12.2 15 175 GC590453BXA 10" x 7" 1/3 4 2- 2 288 576 9.0 15 132 GCS90703BXA 10" x 8" 1/3 4 2- 3 282 564 9.0 15 135 GCS90904CXA 10" x 10" A 1/2 4 2- 4 376 752 8.9 15 156 GCS91155DXA 11" x 10" 3/4 4 2- 5 470 940 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 (1 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: • All furnaces are manufactured for we on 115 VAC, 60 Hz, single phase electrical supply. • Gas Service Connection V2".FPT • Important: It is required to size overcurrent protection device and wires properly and make electrical connections in accordance with the National Electrical Code and/or all existing local codes. PRODUCT SPECIFICATIONS GMS9 Dimensions 314 .�1 �19 5/S ALTERNATE GAS SUPPLY HOLE LEFT IN IDE DRAIN LINE HOLES 1112r z3 �1I r DRAIN TRAP Q LOW VOLTAGE 14 ELECTRICAL HOLE SIDE CUTOUT 1 34 L J 0 BOTTOM KNOCKOUT LEFT SIDE NEW 2 PVC 134 "S121 3/1 (DISCHARGEAIR) �311 ,E 21116 VENTURE PIPE I A I MR I O ALTERNATE 211A6 ..� AIR INTAKE LOCATION Q- CONDENSATE STANDARD GAS DRAIN TRAP SUPPLY HOLE W/ 314' PVC 11VDZRMN ALTERNATE TDISCHARGE VENDFIUE IB LEFT(RIGSIDE) LOCATION iN LEFT SIDE( HIGH VOLTAGE / 2 WISELECTRICAL HOLE Il27118 T 1B 2RIGHT SIDE DRAIN LINE HOLES 1B 3N8 Q LOW VOLTAGE •' 2 8 11111 13l/ ELECTRICAL HOLE 18 5!S 3213H I I I I �1 31 SIDE C if-0Uf 1 11 L J BOTTOM KNOCKOUT FRONT RIGHT SIDE VIEW VIEW M.. n' - x , , `' «--' . '_`'13.,r.x ..� � _ .. w: � s:: "' s.. '�a""x 'tea. .$ A A�d � GMS90453BXA GMS90703BXA 17%" 16" 123/s" 12%" GMS90904CXA 21" 191h" 1 16%" 14%" - GMS91155DXA 241h" 23" 20%11 18%" 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 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 90° elbows, one, close nipple, straight pipe Right ---Straight pipe to reach gas valve Minimum Clearances to Combustible Materials 4 at 1s r' 8ot�tb[1? �_ ;,Ca _ a: „0 fJu - . x, i �Vri'' W, U flow 0" 0" 3" C 0"^1 1" Horizontal 6" 0" 3" C 0"1 4" C = If placed on combustible floor 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 GC89 Dimensions LEFT SIDE VIEW FROM VIEW RIGHT SIDE VIEW 8 314 [—�19 5/11-1 i12 RI=PIPE 12 3/� VEMZ'PVC AIR) .(RETURN 307H8 r -1 CONDENSATE DRAIN TRAP r .� 1 LOW VOLTAGE ,,,I 1�- wl3W PVC ELECTRICALHOLE LOW VOLTAGE "I ELECTRICAL HOLE DISCHARGE (RIGHT OR HIGH VOLTAGE rF LEFT SIDE) CAL HOLE L. ALTERNATE VENDFLUE —� HIGH VOLTAGE SM6 28 6 61A1 LOCATION V5M ELECTRICAL HOLE ERNATE LOCATION DRAMSINTAKE (L 2 "—I 181am t. LEFT SIDE DRAW LIN� 15112 TT T q11t16 �� RIGHT SIDE HOLES /�/ 1112 Q 2731% I DRAIN LINE HOLES SGNDARD LE J11/B SUPPLY HOLE s16 O81N ALTERNATE GAS HOLE UNFOLDED FLANGES I{ -------------I tSUPPLY - tIISCHAR(3E 0 FOLDEDFLANGES FLANGES ' UNFOLDED G,ES I NR . DISCH�E FOLDED FLANGES AR DISCHARGE AIR sF GCS90453BXA 171h" 16" 12%" 141h" 16" GCS90703BXA 171h" 16" 12%" 1411" 16" GCS90904CXA 21" 191h" 16%" 18" 19A" GC591155DXA 241h" 23" 20B/6" 211ft" 23" 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 diamete; depending upon furnace input, number of elbows, length of run and installation (1 or 2 pipes). The optional Combustion Air Pipe is dependent on installadon/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 901 elbows, one close nipple, straight pipe Right —Straight pipe to reach gas valve Minimum Clearances to Combustible Materials mat ; ..�. • -Fdes _p-�l!.S q a""r^,-_. `a...t«� �' a;rs+`.E$..°mom a:», >s ._ �v - Downflow 0" 0" 1" NC 0" 1" Horizontal 6" 1 0" 1" C 0" 4" C = Combustible: If placed on combustible floo; the floor MUST be wood ONLY. NC,= Non -Combustible: A combustible floor subbase must be used for installation on combustible flooring NOTES: • For servicing or cleaning, a 36" front clearance is recommended. • Unit connections (electrical, flue and drain) may necessitate greater clearances than the mmunum clearances listed below. • In all cases, accessibility clearance must take precedence over clearances from the enclosure where accessibility clearances are greater. 5 PRODUCT SPECIFICATIONS Blower Performance Specifications 1•(' Pe. ��. a w> tISEr ,a R15� 1 1? Fi$E+'rCFfVl4 RISE rGl,%�1 z?11,5E �CFM, .� WWA`` HIGH 3.0 1,352 ------ 1,318 -•---- 1,260 ------ 1,202 ------,�44 f53 G_S90453BXA MED 2.5 1,214 ------ 1,1n ------ 1,123 ••---- 1,064 --•--• 938 FIN (LOW) MED-LO `" 2.0 997 --•--- 994 ------ 960 35 923 36 - 1 "ri�I LOW 1.5 757 44 753 44 734 45 704 47i;k024` . y3B" HIGH 3.0 1,449 36 1,409 37 1,326 39 1,273 41F94 risaBG 11' G_S90703BXA MED 2.5 1,192 43 1,172 44 1,141 .45 1,094 47 (MED-HI) MED-LO 2.0 981 53 962 54 943 55 917 56 LOW 1.5 750 --•--- 730 •----- 714 ------ 692 ------ Al a �02 HIGH 4.0 1,970 ------ 1,874 35 1,757 38 1,667 40 P44. �19-434 G_S90904CXA MED 3.5 1,713 39 1,650_ 40 1,572 42 1,510 44 (MED-LO) MED-LO 3.0 1,439 46 1,412 47 1,370 48 1,327 50 Uri "1,t{i7 W LOW 2.5 1,183 56 1,155, 57 1 122 59 1,108 60 1 9 1 513 is G_S91155DXA iIGH MED 5.0 4.0 2,134 1,678 40 51 2,103 1,643 40 , 52 2,029 1,643 42 52 1,941 1,577 44 54 {8 89 R, y�j�s 3y1gv 3 W 4G (MED-HI) MED-DLO 3.5 1,453 58 1,440 59 1,426 59 1,363 62 LOW 3.0 1 259 1 67 11,239. 68 1 220 70 1,181 a .'H2,. T 1 NOTES: 1. CFM in chart is without filter(s). Filters do not ship 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 ship as high speed cooling. Installer must adjust blowercooling 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. 5. The chart is for information only. For satisfactory operation, external static pressure must not exceed value shown on the rating plate. The shaded area indicases 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 PRODUCT SPECIFICATIONS Accessories LPT-OOA LP. Conversion Kit _m ✓ LPLPOt LP. Gas Low Pressure Kit ✓ ✓ ✓ ✓ HANG11 High Attitude Natural Gas Kit 1 1 1 1 HANG12 High Altitude Natural Gas Kit 2 2 2 2 HAlP10 High Altitude LP. Gas Kit 3 3 3 3 HAPS27 High Altitude Pressure Switch Kit 3 3 3 3 EFROt External Fitter Rack ✓ ✓ ✓ ✓ DCVK-20 Horizontal/Vertical Concentric Vent Kit (2") ✓ ✓ DCVK-30 I Horizontal/Vertical Concentric Vent Kit (3") ✓ ✓ Avana[ae ror Ems moaei (1) 7,001'to 9,000' (2) 9,001' to 11,000' (3) 7,001'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 CHT18-60 Cooling/Heating, Mechanical CH70TG Cooling/Heating, Digital, Non -programmable CHSATG Cooling/Heating, Mechanical H20TWR Heating Only, Mechanical I • Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No./,Agll Z Occupancy and Fee Checked = 41 �U 1 V991(leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All wodcto be performed in accordance with the Massachusetts Electrical Code (MEq 527 C S M 12.00 (PL&UEPRINTLVENWORTYPEALLWFVBA"77020 Date: <:;ALAOS r Town of: YAIMUTH To the Inspector of Wires: . ffil; on the undersigned gives notice of his or her intention to perform the electrical work described below. &Number) I�,L POND vrr•r �c E 121 C� St Eldg # 13 �- 0 0`�T c t Gatewood Homes/ Jeff Sollows TdephoneNo. 5U8-7789669 Owner'sAddres 1600 Falmouth Rd., Suite 25, Centerville, Ma. 02632 action with a building permit? single family residence Existing Service Amps / Volts New Service Amps / Volts Yes ] No ❑ (Check Appropriate Box) Utility Authorization No. Overhead ❑ Undgrd ❑ No. of Meters Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Woric Fire Alarm System (low voltage control Panel) with hacict�'battenr, centrally monitored. ComaleDo of the following table may be ivaived by the Inroeewr of liYiret No. of Recessed Fixtures No. of Cer1 Susp. (Paddle) Faces No.' of otal Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators IKVA Na. of Lighting Fixtures Swimming Pool d e d. Batte Unn s�cy g No. of Receptacle Outlets No: of OR Burners ME.ALARMS No. of Zones -1- No. of Switches No. of Gas Burners o. o stingy Dan 7 Initiatin Devices No. of Ranges No. of Air Cond. Tons al No. of Alerting Devices No. of Waste Disposers ma—t p Totals: • um er. Tons o. o Self -Contained Detection/AlertingDevices 7 No: of Dishwashers Space/Area Heating KW Local ❑ umcrp ® Other Connection .., No. of Dryers .. Heating Appliances KW Security Systems: No. of Devices orE ivalent o. of Water KW Heaters o. o o. o Si s Ballasts Data Wiring; No. of Devices or trivalent No Hydromassage Bathtubs No. of Motors Total HP comma raub. No. of Devices or uivaleut OTSEI2: ' ' INSURANCE COVERAGE: Unless waived the owner, no Amen aaamonta ac cat gaestre4. or" regmredby thelnspeeroro-Wirer. by , permit for the performance of electrical work may issue unless the licensee provides proof of liability immrance including "completed operation" coverage or its substantial equivalent The undersigued certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CBEM ONE: INSURANCE ® BOND ❑ OTFIER p (specify:) Expiration tr Estimated Value of Electrical Work $ 750.00 (When required by municipal policy) Work to Start Inspections to be requested in accordance with NMC Rule 10 and upon completion. Ica*, under thepains and penalties ofperjury, thatAe information on this application is true and complete FIRM NAME: Baltic Security, Inch NO. 1178C Licensee: Jonas R Bielkevicius Slgnature LIC. NO.• 499D ffapphcable,enter'c=npt"inthelfcauentatt{te. Bus. Tel. No.. 508-833-0996 Addrbss:__ EO 'Box .y 609 Saridw a 02563 Alt. TeL No.: 508-7 --3347 OWNR'SEINSURANCE WAIVER Jam 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 Signaturie Telephone No. PERMIT FEE: $ 40.00 C APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 TOWN (PLEASE PRINT IN INK OR TYPE (OFFICE USE ONLY) Rwlt By JI,C.- 9 200 Ni Fee: $ 7��rrd `'L� f fyLi JUN 5 PERMIT NO. OJ To the Inspector of Wires: By this application the undersignedgives notice of his or her intention to perform the electrical work described below. Location (Street & Number) lal e4n7,0 /9�la16yT� Owner or Tenant % � llo�2 /`yr a Telephone No. Owner's Address lfi0 5� rbzcr-fi /1/I�GL��,,��C`Pirz�P,PC/%��i� Is this permit in conjunction with a building permit? 93 Yes ❑No (Check Appropriate Box t C Purpose of Building�..ruUtility Authorization No. '11�xisting Serviced Amps ej'7 / Volts Overhead No. o ete New Service 16V Amps 1 �4' Z44 Volts Overrhead❑ Undgrd D:� No. of Meters / Number of Feeders and Ampacity a Location and Nature of Proposed electrical Cam letion of the following table may be waived b the Inspector oWires . of Recessed Fixtures No. of Ceil.-Sus .Paddle Fans No. of Total Transformers KVA o. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above In SwimmingPool md. rnd. ❑ No. of Emergency Lrghtmg Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection an Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: um er — — Tons — — — _ No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Municipal Local 13 Connection Other No. of Dryers Heating Appliances KW See tity Systems: No. of Devices or Equipvalent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or uivalent Arracn aaaatonat aeraa g aestrea, or as requtrea uy urc rrwycuur uj rrura. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. G / CHECK ONE: INSURANCE [� BOND OTHER (Specify:) �Uie (C ez) /I b (Expiration Date) Estimated Value of Electrical Work: G UU (When required by municipal policy.) Work to Start: Inspec tons to be requested in accordance with MEC Rule 10, and upon completion. I certify, under thtpains and penaltie of perj that the information on this application is true and completes F NAME J ��/���Z C % Lr� LIC. NO. Lleisee: S4 m G Signature LIC. NO. (If applicable, enter "exempt" in th icense umber line.) Bus. Tel. No.: Address- �`z�� G &A %W '%� ee Alt. Tel. No.: 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 v Signature Telephone No. [Rev. 04/00] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 (OFFICE USE ONLY) v r � J�.-.F■y.i i v Fee: $ W,,6. Vy I JL AUG III PERMIT NO. �� ' D (PLEASE PRINT IN INS To the Inspector of Wires: By this work des Location Owner o. Owner's Date: gives notice of his or her Is this permit in conj tion with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building��Utility Authorization No. Existing Service Amps / Volts New Service k00 Number of Feeders and Location and Nature of Proposed electrical perform the electrical Overhead Undgrd El No. of Meters Overhead[] Undgrd4�3— No. of Meters_ Cmmnlefinn nfthe fnllnwina fnhly may he waived by the /n.tnertnrrnfWzm.v of Recessed Fixtures No. of Ceil.-Sus . Paddle Fans No. of— Total Transformers KVA 14To. of Lighting Outlets No. of Hot Tubs Generators KVA' No. of Lighting Fixtures Above n- SwimmingPool rnd. ❑ d. Nao of Emergency Lighting Btte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection an Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Purn Totals: um er — — Tons — — — — No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Municipal Local ID Connection Other No. of Dryers ry Heating Appliances KW g pp Security Systems: No. of y eveces or Equipvalent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or uivalent ,vrraen aaamonat aeran ii aestrea, or as requirea ay tue rnspectur q/ res. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same tote permit issuing office. CHECK ONE: INSURANCE BOND [3 OTHEREJ (Specify:) (Expiration Dale) Estimated Val f ctrical Work: (When required by municipal policy.) Work to Start: Inspe ions to be requestedin ccordance 'th MEC Rule 10, and upon completion. I certify, unde th a and en t s o ury, that nfo n on this pplication is true and complete FjkNAME• LIC. NO. l L ee: Signature LIC. NO. (If applicab e t e lic number i e.) Bus. Tel. No.: Address; .f.k Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that tbt Lic;nsj does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (che k one) o ner ❑ owner's agent. Owner/Agent Signature Telephone No. [Rev. 04/00] TOWN OF Y Building AT. Location New EX Plans Submitted Renovation ❑ Yes❑ Nock APPLICATION FOR PERMIT TO DO GASFITTING (OFFICE USE ONLY) Fee: PERMIT NO. Type of Occupancy l Replacement ❑ W �I U1 Y N Q (� J rq W Or ? F_- _ � - v Q O m W C M O O D O Z F Uj F W W = W W Q 0 ¢ W Q W O H W J Z U Z= U! j 0 Q> Q: C t- f., 0 _ N W Z Q Z W =� F;. Q o� F.. W H {y >- N m Z LL O z W J O y= ..1 1011105 rL S O 0= LLL 7 O CS J C> 2> C Q. I- O SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Check One: Installing Company Name-►�UG" U Al1,1 P" tTE17 El Corp. Address t O G 4As E S- ❑ Partnership ?A /1//V 1Sr^ MA 0 2& 0 � LrJ Firm/Company Business Telephone J Q �_ 3 r 3_6 Name of Licensed Plumber or tier a n lAN .1..J- L -A n1 (27- INSURANCE COVERAGE: Check One I have a current liability insurance policy or its substantial equivalent. Yes �No ❑ If you have checked yes, please indicate t e type of coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: 1 am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check One: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent S?D 1 hereby certify that all of the details and information I have submitted Signature Kedice�nse (or entered) in above application are true and accurate to the best of Plumber or Gasfitter my knowledge and that all plumbing work and installations performed Z 1 S 1 under Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and License Number ... ..� ... .. TVDF 1 IP9:MCF-