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Home My WebLink About121 Camp St #137 Building PermitsP TOWN OF YARMOUTH D APR 2 q 2005 Buildi V AT: Locatio APPLICATION FOR PERMIT TO DO PLUMBING Fee: DPERMIT 6O (OFFICE USE ONLY) M Date r Owner's - Name e Type of Occupancy New novation ❑ Replacement ❑ S b l'tt d YesZNc El Plans u me z Z Y Z H > fA W Y J (A Q V F Z Z Z [L O Cn= ~ W Y. d O U. Q a a O X r fA W N Z Q (A Cn O O LL ( Y� 2 W O M W Q (A � Q-j Y N a.0 OC O H Q 2 Y Z 2 LL Y. W Q F Q Q 2 N_ D Q Cn Q p Q O O Q¢¢ CWC Q O Q F2- Y J rM N O C J 2 H co u. C7 7 0 Q ¢ o0 0 SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Installing Coml Check One: ❑ Corp. _ Address y L� ❑ Pa�ship l Q/Firm/Corn a Business Telephone a of Licensed Plumber uj 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. Check on Owner �j Agent M Signature of owner or Owner's Agent I hereby certify that all of the details and Information I have submitted ggnature of icbhs6d (or entered) in above application are true and accurate to the best of PI ber 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 License Number Chapter 142 of the General Laws. Type: Master 0 Journeyma �p2p5 l��AR U I � _ .s' FILE ti s • s� 6• XR\9�� O EXISTING FOUNDATION \ sz. a 'PON h 6 l EXISTING FOUNDATION 0 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 KNOT A SPECIAL FLOOD HAZARDOAR DATE REGISTEREd KOFESSIONAL LAND SURVEYOR 2 AS -BUILT PLAN OF LOT .137 PREPARED FOR MILL POND VILLAGE IN YARMOUTH, MA SCALE: 1 "=20' - DATE: 3-25-05 .va tx� I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE LOT AS SHOWN, AND THAT ITS LOCATION CONFORMS TO THE MINIMUM SETBACK REQUIREMENTS N /gRwIAL PER T. DATE REGISTERED PROFESSIONAL LAND SURVEYOR GRAPHIC SCALE ( IN FEET ) 1 inch = 20 fL holmes and mcgrath, inc. civil engineers and land surveyors 362 gifford street falmouth, ma. 02540 JOB NO: 201197 DRAWN: LMC DWG. NO.: A2523A CHECKED OF S. MCGRATH �elr Commonwealth of Massachusetts official Use Only _ Department of Fire Services Permit No. C BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked • [Rev.11/99] eaveblank PPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK / \`J All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 f (FLOE P IN INK OR TYPE ALL INFORMATION) Date: 5/5/2005 �' y City o Town of: YARMOUTH. MA To the Inspector of Wires: ^p By this ap licafion the undersigned gives notice of his or her intentionto perform the electrical work described below. �J 6catioii (Street & Number) 121 CAMP ST., UNIT 137 63Owner or Tenant GATEWAY HOMES, INC. Telephone No. 6l Owner's Address Is this permit in conjunction with a building permit? Yes X No ❑ (Check Appropriate Boa) Purpose of Building RESIDENTIAL Utility Authorization No. 1448136 Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service 100 Amps 120/240 Volts Overhead ❑ Undgrd X No. of Meters 1 Number of Feeders and Ampacity 2/100 Location and Nature of Proposed Electrical Work: WIRE HOUSE /'.......Y.a;......r,Ln f !/nwino tnhln .m he waived by the Inspector of Wires. r1 LJ No. of Recessed Fixtures No. of Ceil: addle Sus . P (Paddle) Fans °• of Total Transformers KVA No. of Lighting Outlets 8 No. of Hot Tubs Generators KVA No. of Lighting Fixtures 8 Above n- Swimming Pool md. ❑ rnd. ❑ o. o Emergency Lighting Batte Units No. of Receptacle Outlets 30 No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches 10 No. of Gas Burners o. o electron andInitiating Devices No. of Ranges 1 No. of Air Cond. Tons No. of Alerting Devices Heat Pump Number Tons — No . o el - ontained 6 No. of Waste Disposers P Totals: Detection/Alerting Devices No. of Dishwashers 1 S ace/Area Heating KW P g Local ❑ Co n Connection El Other Connection Dryers 1 No. of D ry Heating Appliances KEN Security Systems: No. of Devices or Equivalent No. o Water 4.5 Heaters 1y ° ° o. o Signs Ballasts Data Wiring: No. of Devices or E uivalent No. H dromassa a Bathtubs y g No. of Motors Total HP o rung: a eco . of Devices No. of Devices or E uivalent OTHER: Auu6'n ci Qmurlw uetu.{ y ucm. cu, v. aw . cy"u — -,, ..... ....,,.-...... J — — __. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE X BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) 10/31/2005 (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: PATTON ELECTRIC, INC. LIC. NO.: A 15542 Licensee: RICIL (If applicable, enter Address: PO BO required by law. Owner/Agent Signature _ PATTON Signature LIC. NO.: Bus. Tel. No.: 508-539-0200 Alt. Tel. No.: 774-353-6878 TRANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally By my signature below, I hereby waive this requirement. I am the (check one)Elowner ❑ owner's a ent. Telephone No. I PERMIT FEE: $125.00 in the license number APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK To the Inspector of Wires: work described below. Location (Street & NvAbi Owner or Tenant OFjY ,, . l this application (OFFICE USE ONLY) UTH IBy - Fee: PERMIT NO. Date: gives notice of his or her Md SAL perform the electrical Owner's Address Is this permit in conju tion with a building permit? I'es Q No (Check Appropriate Box) Purpose of Building o t OAS � Utility Authorization No. Existing Service Amps / Volts Overhead Undgrd ❑ No. of Meters New Service kl-Q Amps Volts Overhead Undgrd 00� No. of Meters_ Number of Feeders and Location and Nature of Proposed electrical wnh,,d by thv Insnortnr nfWires No. of Total Aftnof Recessed Fixtures No. of Ceil: Sus . Paddle Fans Transformers KVA o. of Lighting Outlets No. of Hot Tubs A n- Generators KVA No. of Emergency Lighting No. of Lighting Fixtures ove SwimmingPool rnd. md. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones o. of Detection an No. of Switches No. of Gas Burners Initiatin Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices eat in um er Tons _ _ — — — No. of Self -Contained Detection/Alerting Devices. No. of Waste Disposers Totals: Municipal Local ❑ Other No. of Dishwashers Space/Area Heating KW Connection Secutity Systems: No. of Dryers Heating Appliances KW No. of Devices or Equipvalent No. of Water No. of No. of Signs Ballasts Data Whng: No. of Devices or Equivalent Heaters KW Telecommunications Wiring: No. Hydromassage Bathtubs No. of Motors Total HP No. of Devices or Equivalent A..__L ,. A.r:N,..,..r .infi,a :f .Ia c: ro.l nr ns ronuirod by the Inspector of Wires. 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. CHECK ONE: INSURANCE ge"' OND E] OTHEREJ (Specify:) (Expiration Date) Estimated Value f El cal ork: (When required by municipal policy.) Work to Start: Inspe ions to be r�lueste in acc rdance with MEC Rule 10, and upon completion. I certify, under t e ai s d pe It f p4jury,,that jjh i rm do on this application is true and complete. F NAME: J .e- LIC. NO. L ee: 3 Sign lure .V+ x sM LIC. NO. (If applicable, t em " t th license u ber line Bus. Tel. No.: Address .t�L Alt. Tel. No.: OWNER'S INSURANCE AIVER: I am aware that t e L ense es not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (ch k e) ow er owner's agent. Owner/Agent Signature Telephone No. [Rev. 04/00] - Commonwealth of Massachusetts a i6si Use Only Permit No. OS-- /0� Department of Fire Services 0=4mcy and Fee n O BOARD OF FIRE PREVENTION REGULATIONS 11/ 1 veblank�[%/ �• n; i/ i . APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All workto be perfouned in accocdaace with the M=achutetts Electrical Code (1vffiq 527 CMR MOO (PMSEPMT1YBX0RTYPEAL R&DRW7TONJ Date: d yTJ City or Town of: YARMOUrH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical wont dtsenbed below:_��_; r Location (Street & Number) MIIT POND VII AGE r 121 Camp St Bldg # Owner or Tenant Gatewood Homes/ Jeff Sollows TelephoneNo.508-7789669 Owner's Address 1600 Falmouth Rd.r Suite 25, Centerville, Ma. 0263.2 Is this permit in conjunction with a building permit? Yes X❑ No ❑ (Check Appropriate Box) Purpose ofBuildingsingle family residence Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Woric Firrm e AlaSystem (low voltage control panel) wi h bagj= . batte-ry centrally monitored ' ^---f_�•_.._�.L_lit.....:....mT.ns....n.ry .an.vnN•hv tifY Tn manh+r �%r{�erCi I' No. of Recessed Fixtures No. of Ceti.-Susp. (Paddle) Fans o: 0 Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures ove Swimming Pool Lrmd. •� d. o. o ergency g BatteryUnits No. of Receptacle Outlets No. of Oil Burners FIRE.AT •APIM No. of Zones —17' No. of Switches No. of Gas Burners o. o Detection an 7 InitiatingDevices No. of Ranges No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Totals umber. Tons o. o ontam Detection/AlertingDevices 7 No. of Dishwashers SpacdAreaHeating KW �� AluConnection ®Other No. of Dryers .. Heating Appliances I{�y Security stems: No. of Devices orEquivalent a o ater KW Heaters o. o o• o Signs Ballasts Data Wiring: No. of Devices or uivalent Na Hydromassage Bathtubs No. of Motors Total HP Telecommunications.ofDeVes oruing: No. of Devices or E ivaleat OT�FL• INSURANCE COVERA the licensee provides proof undersigned certifies that GE: Unless waived by the owner, no.permit for the performance of electrical work may issue unless of liability insurance including "Completed operation" coverage or its substantial equivalent The such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) (Expiration to Estimated Value of Electrical Work; $750.00 (When required by municipal policy.) �Work to Start ...2O 5— Inspections to. be requested in accordance with MEC Rule 10, and upon completion. Icertify, under thepains andpenalties ofperjury, that the informaQion on this application is true and compIde FIRM NAME: Baltic Security, Inc LIC. NO.: 117T C Licensee: Jonas R Bielkevicius Signature LIC. NO.: 499D �• (IfaMUcvble, enuer "exempt" in the ifeensemrmbe . Bus. Tel. No.,- 508-833-0996 Address: PO Box ) 609 :SanaVa 02563 Alt. TeL No.: 508508—7�3347 OWNER'S INSURANCE WAIVER .I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement I am the (check one) ❑ owner ❑ owner's agent Owner/Agent PERMIT FEE: $ 40.00. Signature, Telephone No. aF r� TOWN OF YARMOUTH Building Department PERMIT NO (508) 398-2231 ext.261 BUILDING � B-05-1039_ ISSUE DATE ; _ 3/10/2005 _ ; PROPOSED US _ _ _ _ _ _ _ _ PERMIT APPLICANT----capra__________________P JOB WEATHER CARD PERMIT TO ; New Construction ----------' AOC T (LATION) 00121CAMP ST # 137 ZONING DISTRIC R 2 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 44.21.1.CJ37 BUILDING IS TO BE: CONST LOT SIZE 5-B USE GROUP R-4 REMARKS new construction - Affordable Unit: 3 baths, 2 bedrooms, 1 familyroom/diningroom, 1 kitchen, 1 livingroom as per plans dated 03/02/05 and BOA # 3546. AREA (SO FT) EST COST ($ $154,080.00 PERMIT FEE OWNER Villages @ Camp St, LLC ADDRESS 1600 Falmouth Road # 25 ILDING PT BY CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville I MA 102632 Certificate Issue Date �c c-l/ CERTIFICATE of OCCUPANCY1i Departmental Approval for Certificate of Occupancy and Compliance Inspector Date Pprmit fjuemhnr n_-. m-- _ 1 o be filled in by each division indicated hereon upon completion of its final inspection. of ► TOWN OF YARMOUTH Building Department or R BUILDING. (508) 398-2231 ext.261 PERMIT NO � _ 6-05-1039_ � PERMIT ISSUE DATE _ 3/10/2005 - ; PROPOSED USE APPLICANT Frank Capra _ _ - _ _ _' JOB WEATHER CARD PERMIT TO ' New Construction ' AT (LOCATION) 00121CAMP ST # 137 ZONING DISTRIC R 2 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 44.21.1.C137 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE new construction - Affordable Unit: 3 baths, 2 bedrooms, 1 familyroom/diningroom, 1 kitchen, 1 REMARKS livingroom as per plans dated 03/02/05 and BOA # 3546. nn�n tote r 1) EST COST ($ I$154,080.00 PERMIT FEE ($) $0.00 OWNER IVillages @Camp St, LLC BUILDING DEPT BY ADDRESS 1600 Falmouth Road # 25 Centervil�/ MA 02632 INSPECTION RECORD CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 FIELD COPY Date Note Progress - Corrections and Remarks Inspector 3 - j CY / - TOWN OF YARMOUTH Building Department _ Town Hall e Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-418 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST Owner's Name: Villages @ Camp St., LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02632 Owner's Telephone: (508) 778-9669 (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $0.00 Payment Type: Check ChkNo.: 0 Net Owed: $0.00 Application Date: 2/14/2005 Issue Date: Expiration Date Comments: Map/Lot: 44.21.1.C1 new construction - Affordable Unit: ZONING APPROVED -oo- REVIEWED BY: ✓1. WATER DEPARTMENT: DATE: N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: //4. HEALTH DEPARTMENT: ✓ 5. BUILDING DEPARTMENT: DATE: DATE: N/A: N/A: 6. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: Date Printed: 2/16/2005 o� YqR ONE & TWO FAMILY ONLY - BUILDING PERMIT • °' =C APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING p y Town of Yarmouth Building Department ` HAT ^CMEES 1146 Route 28 ° Yarmouth, MA 02664-4492 Tel: (508) 398-2231 x261 • Fax: (508).398-0836 ,. , t y r i� � anning 8pard tn#ormatron Assessorsbepartment,informaUon � ,. 2 � dorsemeotDate, .-�� s u>� c -* � i w Tiecorrlmq Oate � -� �s '� x >f �+ •� � } -� �. 1)epDSl{ieC d Q`; iDatt x Xi iSK. � ",YK i h Plan Nodh 2$'y rY �y •r Cb. �sNi to { "r 3 l jR`#S 1:: � l Net DllE Z $ t = r" �fher' s _u •°; bfArea�stj "'. frontage ft), ? totCwerage' ;� e s Hsu w .-• ti6 I This 5ectioi'i�ou7Jff}ce ral` guifdn Pe" Nu" "er.'Date-]s'suecJ •� 2t' �T x ref „y„ Sy s. � 4�?�4�` ,3 rc'�:€ sF" -e� i � �< r n 1.. ,.i' � "' -mot < 'T �r `�i :.§. �� Gertlflcate ofOccupancyp � - r • �� -� Sr �atuie. 9 , � DatezT as �"� is"�ot�� "re cared q o- SecUon�1 'Site`7nfoniaf"ion: Use Group: R-4 Type: 5-B 1.1 Property Address: 1.2 Zoning Information: - a p 5 -=F,-Q-51 ` - 1:3,7 Zoning District Proposed Use 1.3 Building Setbacks. (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.4 Water Supply (M.G.L.. c. 40. S 54) 5' Flood Zone Infomrat}on : `r oriiments f - F x r � �' ;4i•��tf a z•l ,y fi 'x., i i i.(' p�` .-}.ts�'� 4 � 4 '�5" ie e ht �w' t 31 k A Public Private i J �'J 2 £�• J - ecUon Property Ownerstilpjuthorized Agent; 2.1 Owne of Record: \1; l- O lAs cA 8 �,�,. ,� 5�-:� LLc, l boo R N me pnt 11 Mailing Address C 4,4of e. C Signature Telephone 2.2 uthorize Agent- , no� w,�S�d,, Mailing Name (print) (` a .^ a ss - MAR 1 0 2 50 FaxIM 6 V�l Signature Telephone 4 ZW3 UP' Sec3ion'3.CoiastrucUoiaSer3iices, ByIAJA tit 3.1 Licensed Construction Supervisor: Not A 3h1 License Number ddr 7 Expiration Date h /6 —O Signature Telephone 3 2 Regisf6hid Horne lrr'provemeri .b ntracfor:`" Company Name Not Applicable ❑ License Number Address Expiration Date Signature Telephone /.% 7 9 - 15 - 99 1 of 2 OVER , r ` 5 ct1064 , Workers' Compensation°°tti5u arrice'Aff daui#=(Atl-G.t. c '152 S 2ic (6)" &rkers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes .......... No .......... Section•. -„Description of:P.roposed3 .,or ecksiE appiicable)' New Construction No. of Bedroo s No. of Bathroo s Existing Bldg. ❑ IRepair(s) ❑ Alterations ❑ Addition ❑ Accessory Bldg. ❑ Type A Demolition Other Specify: Brief Description of Pro osed Work: .e, L_.` c Section 6 �:Estitniated` fttruction Costs Item Estimated Cost (Dollars) to be completed by permit applicant Check Below ❑ Conservation -Commission Filing (if applicable) ❑ Old Kngs Highway & Historical Commission approval (if applicable) 1. Building 2. Electrical / 3. Plumbing / Gas 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) , l Z G, 7. Total Square Ft. (new houses & additions) C i1 Section 7a = Owner Authorization Owner's A' ent,o'r'Ca tractorAppbes'for, Tome' Completed When, uilding hermit I, `� �� ` Q as civow of the subject property hereby authorize W oay�eS /a�'`�< C)n-P !tea to act on oLk, e i II atter rel ' e to work authorize y this uilding permit application. Signatur w r Date Sec ion °7b,�, Owner/Authorized Agent Declaration; as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print name 01 K44 Signature o wner ent Date 9-15-99 2of2 T W x TOWN.OF YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT. Job Location: _ Owner of Property: Construction Supei Address: (0 00 Licensed Designee: (If other than Supervisor) Name 2.15 Responsibility of each license holder: License No. A DD63 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 shall willfullyviolate subsections 2.15.1, 2.15.2 or 2.15.3 or any other section of these rules and regulations and any procedures, as amended, shall be subject to revocation or suspension of license by the board. 2.16 All building permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise . those persons engaged in construction, reconstruction, alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and these rules and regulations. In the event that such licensee is no longer supervising said persons, the work shall immediately cease until a successor license holder is substituted on the records of the building department. 2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may be deemed a violation of the permit conditions. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with section 109.1.1 of the state building code. I understand the construction inspection procedures and the specific inspection as called for by the building official. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy 31-� Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAI I am aware that the licensee does not have the insurance coverage required by Chapt of the M r Laws, and that my signature on this permit application waives this requirement. Check one: Sign& ure of Owner or Owner's Agent Owner ❑ Age Signature: Building Official Approval: r ,c.. ✓iu T000svneooaaeall�i o�✓u¢doaritimef�a- r. a BOARD OF BUILDING -REGULATIONS y License= GONSTRU.CTION SUPERVISOR, Nunnbe� 012430 — g Bunt 3 D6E'€E 194a car 00=006' Tr. no: 25926 Restn'�ed`.I1tF'i �' FRANKG CAPR/ ` — 40FCOPPER`LN c ..CENTERVILLE, MA 0263E Commissioner 00 - 35,000 d enclosed space ( (MGL CA 12 S.BOLJ 1 _ 1A-Masonry only - tG -1 & ZFamiy Homes _ Failure: to possess a'curtent.edition of the i Massachusetts State Building. Code I is cause for revocation of this license. i i� DIG SAFE CALL CENTER: (888) 344-7233 i u FAV a-, The Commonwealth of Massachusetts Department of Industrial Accidents e//Ice 0/1"est/Oatlsss 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit citN (PU„� l_k- M q 632 phnne 0 <o�V7 7 M C, 0 I am a homeowner performing all work myself. 0 I am a sole proprietor Zr.4 ha%e no one workina in any capacity C3 I am an employer pro%iding workers' compensation for my employees working on this job. comnanv name' address: city phone It• insurance co. nolicv of C9/1 am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below uho ha%e city: phone 0, . incgrnre co.. policy # company name: Failure to secure coverage as required underSeetion 25A of MGL 152 can lad to the imposition of cri.miaal ptaalnes of a flat up.to 514N.00 and/or one verity' imprisonment as well as cavil penalties in the form of a STOP WORK ORDER and a flat of 5100.00 a day against me. I anderstaod'that a copy of this statement may be forwarded to the Office of Investiga)ions of the DU for Menge verifladoa. I do -hereby certify.upder the pags and Print name _ \_t O`!^ that the information provided above is true and crone l Date X /7 o�^ Phone # 5O� r —j7 ofrocial use only do not write in this area to be completed by city or town official city or town: YARMOUM _ .permitnlcense 0 n8uilding Department ClUccusing Board rl check if immediate response is required 261 OSeleetmen's Offlee C3Health Department contact person: phone 0. _ (508) 398-2231 eat. nOther. TOWN OF YARMOUTH 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 Telephone (508) 398-2231, ExL 261 — Fax (508) 398-2365 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT BUILDING ELECTRICAL GAS PLUMBING SIGNS Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 1 \ cs,3�p `c�E Work Ad esss is to be disposed of at the following location: O C�►'�ln� �� Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Signature of Applican Permit No. l i A Date a`.. ��e 'C�oma�na� o�./l�zacac/aaeftta BOARD OF BUILDING: REGULATIONS } Licenses^ GONSTRUCTIOFISUPERVISOR. Numbej? 012430 �0669f6)2�06: Tr. no 25926 - FRANI6G CAPRf 40°COPPER CENTERVILLE. MA 016321 Commissioner s 00 - 35,000 cf enclosed space --- , (MGL C.112 S.60L) _ 1A • Masonry only i 1G = t & TFamily Homes Failure to possess a -current. edition of the Massachusetts State-Bulding. Code 'I is cause for revocation of this license. Ile I _ t i ,i DIG SAFE CALL CENTER: (888) 344-7233 i CALL US DIRECT AT: Delivery (508) 477-5868 Sales (508) 477-6575 �IlmolL CONTRACTOR DIVISION CONTRACTOR DIVISION Bowdoin Road, Mashpee, MA 02649 Mailing Address: P.O. Box V, Osterville, MA 02655 SOLD TO: i13�Tf� RIVED MILTON, MA 02186 SHIP TO: MILL POND VILLAGE OSPREY BUILDING FRAMING LUMBIER PH#617-698-9383 CALL US DIRECT AT Toll Free (800) 834-3132 FAX (508) 477-4279 ACCT-PRJ: 13297400 INVOICE #: 031009242859 DATE: 10/30/03 TIME: 09:42:29 SALES ID: HAOMI K DELIVERY: 11/28/03 RVJTE: QUOTE 1000-24 PAGE 1 RTE 3 IORTH - TO EXIT 13 - RIGHT OFF EXIT - AT LIGHTS TAKE RIGHT ONTO RTE 123 - FOLLOW TO RTE 3A - TAKE A LEFT ONTO RTE 3A - 30B SITE IS ON RIGHT - LOOK FOR BOTELLO SIGNS' ITEM ()TV U/M DESCRIPTION U-PRC PER NET f19T QUOTE ID: OSPREY BCI EXPIRATION DATE - 11/28/03 PURCHASER: CORMICAN, BRIAN ALL SPL BC FRAMING LUMBER IS BASED ON DIRECT SHIPMENT TO SITE DELIVERY TRUCK MUST HAVE ACCESS TO SITE OR ADDITIONAL CHARGES WILL. APPLY !! **MODULE A.1ST FLR - 10/30/03** SPL 820 EACH EC45012 1-3/011-7/8 1.860 EACH 1525.20 33/20' 5/181 4/16' 2/3' LVL11 106 LNFT 1 3/4"X 11 7/8" LAMINATED BEAM 3.367 LNFT 356.90 4-20',2-10',1-6' SPL 80 EACH VLRIMI2 1-1/16X11-7/8 2.740 EACH E19.20 SOLD 20' LENGTHS ONLY SHGUS410 2 EACH SIMPS DBL FACE MHT HNGR 9 1/2" 23.530 EACH 47.06 15/CTH SIUT11 14 EACH 1 3/4 X it 7/8 FACE MOUNT HANG 2.010 EACH 28.14 **MODULE A.1ST FLR TOTAL. $2176.50** **MODULE B.2ND FLR - 10/30/03** SPL 804 EACH BC45012 1-3/4X11-7/8 1.860 EACH 1495.44 33/20' 9/16' LVL11 98 LNFT 1 3/4"X 11 7/8" LAMINATED BEAM 3.367 LEFT 329.97 4-20'.52-9' SPL 80 EACH VLRIMI2 1-1/16X11-7/8 2.740 EACH 219.20 SHGUS410 2 EACH SIMPS DBL FACE MNT HHGR 9 1/2" 23.530 EACH 47.06 15/CTH SIUT11 7 EACH 1 3/4 X 11 7/8 FACE MOUNT HANG 2.010 EACH 14.07 Fax us your orders 24 hours a day US DIRECT AT: A ffvery (508) 477-5868 CONTRACTOR DJVI S O CONTRACTOR DIVISION Sales (508.) 477-6575 Bowdoin Road, Mashpee, MA 02649 Mailing Address: P.O. Box V, Osterville, MA 02655 CALL US DIRECT AT Toll Free (800) 834-31 32 FAX (508) 477-4279 SOLD TO. LAUNIE GROW, LTD ACCT-PRJ: 13297-M 13 HEATHER DRIVE INVOICE n: 031009242859 MILTON, MA 02186 DATE: 10/30/03 TIME: 09:42:28 SHIP TO: MILL POND VILLAGE SALES ID: hi01I K OSPREY BUILDING DELIVERY: 11/28/03 FRAMING LUMBER ROB: QUOTE PHX- 17-698-9383 1000-24 PAGE 2 RTE 3 NORTH - TO EXIT 13 - RIGHT OFF EXIT - AT LIGHTS TAKE RIGHT ONTO RTE 123 - FOLLOW TO RTE 3A - TAKE A LEFT ONTO RTE 3A - JOB SITE IS ON RIGHT - LOOK FOR IOTELLO SIGNS ITEM OTY U/M DESCRIPTION U-PRC PER NET AMT SMIT411.88 1 EACH 3 9/16"X 11 7/8"70P MOUNT HANG 3.539 EACH 3.53. **MODULE B.2ND FLR TOTAL $2109.27* SUB TOTAL 4285.77 MA 5.000% SALES TAX 214.29 TOTAL 4500.06 Fax us your orders 24 hours a day First Floor 17a V-w 2.� Owyd dN:ib10I1W11:f1 NA P"Dal: 1--.... — FM11 R" Fromin Ba0bdulh-NaMnoll d Mv2 Do um UnpM 1 " 111TICIa11W0P we 2 0 1111P2CI91W1V ter 2 1 11/TlC MSP IOP / 1 111TOCNON" 2P 0 1 13W1111TV6n1RU1M 110 OP we 0 2 12M , 11 7MVER844AM MOD OP IPP / 1 1 NP 111/TV1112MAIM121M or OP 0 R 1'111 AP Vat" 21M►W /2P mrst Floor Madt Qty ManubCluwl Produal o0 IN 2 2aaan MialalYbn NW0110 YIQ1 �iNbll VAan M1b Nast IN 11 a18WMWW"- I MI1 1-V1111•MiY10 tC10 P1N Mani r.n f AI 11 lr•.CI11A 1roc.In Second Floor Framing Plan 1rz-r-• i UM.me 1Mr.1U'.09oe. CIf AM SeDWd Flour rl.mtlpinohsdule•N min.nfed Mark CtY Oestit"on length 1 ff 117A•.00eMN frr 1 1 11/R.CLI1g.r Ifr f i Ifrr.efirv.Rwlwer far e f I311•e111RV.RfAW10 f111.r fr . n re119rv.R5Ae1wto frr 112 a t4 mor"T 4..� WN4PI»•NpMt10� Pr» »•v a•w4+.u� � n•av wlm Ts rvm•v�» vv as 1» YY nN� �•M.FIMI.W. M w..W..•au ° EM m .................................................... rHw+v cmerom Yf1ICl [OOtAtAI aM00.•.9 F.1 8 /BORSE BC CALL® 200T DES(�1 U$. Thursday, October 30, 2003 08:1. �<: . Single 11 7/8 BCI® 450s SP File Name: Tutorial Proto-2 : Floor 1V 14 Job Name: Mill Pond -Osprey Bldg. Description: Address: 1600 Falmouth Rd. Unit 25 Specifier. Rick Lowe City State, Zip: Centerville, Ma Designer. Customer. Launie CCoom�panr Batellwtstw c. Code reports: NER 594, ICBO 5208 BO, 3AX B1, 3-12- 387 Ibs U. 387 Ibs U. 97 bs DL 97 Ibs DL General Data Version: US Imperial Member Type: Joist Number of Spans: 1 Left Cantilever. No Right Cantilever. No Slope: 0/12 OC Spacing: 12" Repetitive: Yes Construction Type: Glued Live Load: 40 psf Dead Load: 10 psf Partition Load: 0 psf Duration: 100 Disclosure The completeness and accuracy of the input must be verified by anyone who would rely on the output as evidence of suitability for a particular application. The output above is based upon building code -accepted design properties and analysis methods. Installation of BOISE engineered wood products must be in accordance with the current installation Guide and the applicable building codes. To obtain an Installation Guide or if you haany questions, please call (800ve )232-0788 before beginning product installation. BC CALCO, BC FRAMER®, BCI®, BC RIM BOARDT°, BC OSB RIM BOARD TM, BOISE GLULAMTm, VERSA -LAM®, VERSA -RIM, VERSA -RIM PLUS®, VERSA-STRANDT", VERSASTUDO, ALLJOISTO and AJST" are trademarks of Boise Cascade Corporation. Total Horizontal -19-04-00 Load Summary ID Description Load Type Ref. Start End Type Value OCS Dur. S Standard Load Unf. Area Left 00-00-00 194)4-00 Live 40 psi 12" 100% Dead 10 psf 12- 90% Controls Summary Control Type Value Y*Affdwatile, Duratia+* . Load Case Span Location Moment 2335 ft4bs 562% 1bb9:t - 2 1 - Internal Neg. Moment 0 ft-Ibs nlas 100% End Reaction 483 lbs 33.3% 100% 2 1 -Left Total Load Defl. L/519 (0.4477 462% 2 1 Live Load Deft. 1_1649 (0.357-) 73.9% 2 1 Max Defl. 0.447- 44.7% 2 1 Span / Depth 19.5 n/a 1 Notes Design meets Code minimum (Lt240) Total load deflection criteria. Design meets User specified (U480) Live load deflection criteria. Design meets arbitrary (1 w) Mardmum load deflection criteria. Minimum bearing length for BO is 3.12'. Minimum bearing length for B1 is 3-M. Entered/Displayed Horizontal Span Lengths) = Clear Span + 12 min. end bearing + 12 intermediate bearing 05t��e� 4601SW i Single 11 7/8" BCI® 450S Sp Job Name: Mill Pond -Osprey Bldg. Address: 1600 Falmouth Rd. Unit25 City, State, Zip: Centerville, Ma. Customer. Launie Code reports: NER 594, ICBO 5208 97lbs DL General Data Version: US Imperial Member Type: Joist Number of Spans: 1 Left Cantilever. No Right Cantilever. No Slope: 0/12 OC Spacing: 12- Repetitive: Yes Construction Type: Glued Live Load: 40 psf Dead Load: 10 psf Partition Load: 0 psf Duration: 100 Disclosure The completeness and accuracy of the input must be verified by anyone who would rely on the output as evidence of suitability for a particular application. The output above is based upon building code -accepted design properties and analysis methods. Installation of BOISE engineered wood Products must be in accordance with the current Installation Guide and the applicable building codes. To obtain an Installation Guide or if you have any questions, please call (800)232-0768 before beginning Product installation. BC CALC®, BC FRAMERS, BCI®, BC RIM BOARDIN, BC OSB RIM BOARDT" BOISE GLULAM7°, VERSA- AM9, VERSA RM, VERSA -RIM PLUSO, VERSASTRANDTM, VERSASTUDO, ALLJOISTS and AJSTm are trademarks of Boise Cascade Corporation. 'age 1 of 1 BC CALC® 2003 DESIGN REPORT - US Thursday, October 30, 2003 08:1 File Name: Tutorial Proto -2: Floor 2U 20 Description: — Spedfier. Rick Lowe Designer. Company. Botello Lumber Co. Inc. Misc: Total Horizontal Load Summary ID Description Load Type S Standard Load Unf. Area Controls Summary Control Type Value Moment 2335 ftabs Neg. Moment 0 ft4bs End Reaction 483 Ibs Total Load Defl. L/519 (0.4477 Live Load Defl. L/649 (0.357-) Max Defl. 0.447- Span / Depth - 19.5 B1, 1-3/4` 387 Ibs LL 97 Ibs DL -19-04-00 Ref. Start Left 00-00-00 End Type 19- "0 Live Value OCS Dur. Dead 40 � 10 Psf 12• 100% 12" 90% % Allowable Duration 562% Load Case Span Location n/a 100% 1000A 2 1- Internal 40.3% 46276 100% 2 1- Left 73.9% 2 2 1 44 7% 2 1 1 n/a - 1 Notes ' Design meets Code minimum (L240) Total load deflection criteria. Design meets User specified (L/480) Live load deflection criteria. Design meets arbitrary (1-) Marimum load deflection criteria. Minimum bearing length for So is 1S/4-. Minimum bearing length for B1 is 1-3/4- Entered/Displayed Horizontal Span Lengths) = Clear Span + 12 min. end bearing + 12 intermediate bearing b1i/F71/2=4 Uti:If CIII-iIy-7II4 JU17111 L,RLAY r-T r H%V- Vl/Ol . ACCe1e CERTIFICATE OF LIABILITY INSURANCE 978-394-2253 DIRECT - THIS CERTIFICATE IS ISSUI 'RODUCER ONLY AND CONFERS NO ATLANTIC INSURANCE GROUP, INC. HOLDER. THIS CERTIFICAI AIP lLC ALTER-THE-COVERAGE-0 DATE (1AMMOW4-... 08/0812004 365 BOSTON POST ROAD PMB 203 INSURERS AFFORDING COVERAGE SUDBURY, MA 01776 ___ "--' •-'- � � • INsuREa A: NATIONAL FIRE BI MARINE •_•_•- I ._— -- --- ... iN5UREo ' 1N..—suaEa. B__�: MA.WORKERS COMP RESEAF2CIi.eRD GATEWOOD HOMES INC. INsuaER c_ _ - -•• --- -- '-' 16M FALOMOUTH ROAD — -- CENTERVILLE MA 02632 - INSURfiRE rFTVFRAGFS _ _ ....-�...nn..a cne TUP PnLTCY PERIOD INDICATED. NOTMI"STANBING— THE POLICIES OF INSURANCE LISTED ANY REQUIREMENT. TERM OR CONDITION BLLOYY RAMC Dccn '�� •- • • •- ----- OF ANY CONTRACT OR OTHER THE POLICIES DESCRIBED kEREIN --- - - - DOCUMENT WITH IS SUBJECT RESPECT TO WHICH TO ALL THE TERMS, THiz, EXCLUSIONS AND CONDITIONS OF SVCH MAY PERTAIN, THE INSURANCE AFFORDED POLICIES. AGGREGATE LIMITS SHOWN BY MAY NAVE BEEN REDUCED BY PAID - ' ' CLAIMS. POLCY EFYfeTIVE _._:. POLICY FAPVUITIDNr —. .. ---- Unit: ' _TTPE OF D19URANCE ►OUCY NUMBER I m OCCURRENCE aQ I GENERAL 4ABILITY 72 LPE 691943 I 4l29/04 4129l05 FFI;EDAMAGE (A01 eae fin : i •- SOOOO_„ A I_X ICCMMERCLAL GENERAL LIABILITY EXP(Anyena eafaW')_��iICuw3MDE XI OCCUR _— . . ___. P_ERSONALS_ADV M_JURY S 1000000 I ....__ '----- I GENERAL AGGREGATE E _20_000OQ --1000000 I _ _.. • - I._. PRODUCTS • COMPIOP AG —_ -._.. _ t•-_ _ .. .... _.. LGENI. AGGREGATE LIMIT AprLIE. PER: -' PRo•. Pa1cr Loc COMBINED SINGLE LIMIT I y I AUTON381.E WENTY I (Ea aCCIOeM) ' ANY AUTO I ' -_ I ALLOWNEDAUTOS i 'IPor 90016Y INJURY peroon) t SCHEDULED AUTOS I ' �--�� HPIEDAUTOS ' i BODILY WJIRY IPm araaen0 t ..___— ..._... NCN•pWNED AUTQS i I ........._i. �' � I 'PROPERTY DAMAGE y .. ...... ._ _._.. (Par acc)dwd) I AUTO ONLY•E_A_ACdOEN- t OARA6-TUABRATY ' EA ACC OTHER THAN t •• --•• ••- ANY Auto I AUTO ONLY. AGS ' S EACH OCCURRENCE t EXCEst LIABILITY ~ IOCCUR I CLAIMS MADE AGGREGATE , .__. 3.. .-.—.. ... i ,DEDUCTIBLE .. _. _-. .. ..__.. .. .._._—.._. RETENTION I - •yTORNERSCOMPENSATIONANO WORKeRSCOMP"SA I POLICY UPDATE NUMBER TB"{U7I ' 8/4/04 8/d/05 TU- ITORY LIMITS_— ,:R. i 515000ir B e LEACHACCIDENT -_�s 500000 E.LDMEMIL-EAEMPLDYS i --.__ lI CL DISEASE . POLICY LIMIT. s .I OTHER � � I I OESCRIPTUAr OF OPERAtIgiS&OGATONWW WZLESff-X=SIONS ADDED BY IKDGR3ENENT A PEC1AL PROVISIONS PROJEC-: MILL POND VILLAGE MLLAGES AT CAMP ST. LLC - DBA) CERTIFICATE HOLDER I X I ADDITIONAL I143UREP• INSURER LETTER: CANCELLATION DESCRIBED POLICES BE CANCELLED BEFORE THE EXPULATION SHOULD ANY OF THEABOVE DATE THEREOF, THE 16SU NG INSURER WILL ENDEAVOR TO MAIL 60 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOL NED TD THE LEFT, BUT FAILURE TC• DO SO SHALL TOWN OF YARMOUTH IMPOSE NO DBUGATION OR TY F ANY KIND UPON THE INSURER, R4 AGENTS OR BUILDING DEPARTMENT REPRESENTA AUTHORD;ED R S HT _ _ ..., nra•Trnu �aaR ACORD 2!i-S (7197) / / - •--- - •�OJP„ CERTIFICATE OF LIABILITY INSURANCE DA8/02/2004 08/02/2004 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 3 Bevilacqua Construction INSURERA: Arbella Protection Insurance PO BOX 628 - INSURER B: Forestdale, MA 02644 INSURER Ci INSURER D: -INSURER E: rnvconr_cc 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 R TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE fMMIDD/YY1 POLICY EXPIRATION DATE (MMIDIVY'nLIMA A GENERAL LABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR X Special Form - 8500018147 07/15/2004 07/15/2005 EACH OCCURRENCE S 1,000.00 DAMAGE TO RENTED $ 50,00( MED EXP (Any one person) $ 5' OQ PERSONAL &ADV INJURY S 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEML AGGREGATE LIMIT APPLIES PER 'o LOC POLICY JECT PRODUCTS - COMP/OP AGG S 2,000,00( A AUTOMOBILE LABILITY ANY AUTO ALL OW NED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 86852400001 02/21/2004 02/21/2005 COMBINED SINGLE LIMB (Ea accident) S BODILY INJURY (Per person) S - 250,000 X X BODILY INJURY (Per accident) $ 500,000 X PROPERTYDAMAGE (Per accident) $ 500,000 GARAGE LIABILITY ANY AUTO " AUTO ONLY -EA ACCIDENT S OTHER THAN. EA ACC AUTO ONLY: : AGG $ $ EXCESSIUMBREILI LIABILITY OCCUR a CLAIMS MADE DEDUCTIBLE .RETENTION S EACH OCCURRENCE S AGGREGATE $ S S $ A WORKERS COMPENSATION AND EMPLOYERS' LABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE - OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 9088680402 04/27/2004 04/27/2005 X 1TwjaCgySTUALTffUTi I OTH. FR EL EACH ACCIDENT S 100,000 E.L DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE- POLICY LIMIT S 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS For any and all operations performed during the policy period. r•reT,r,n wtr ur., nrn n • u..r• , 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, Gatewood Homes Inc. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 1600 Falmouth Rd Ste 2 S OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Centerville, MA 02632 AUTHORIZED REPRESENTATIVE Pauline Desrosiers ACUKU z5 (zoOVUU) ©ACORD CORPORATION 1988 ACORD,a CERTIFICATE OF LIABILITY INSURANCE a3io9i2 0 PRODj10ER (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: rroviaence mutual PO Box 664 INSURERS: OneBeacon West.Hyannisport, MA 02672 INSURER Continental Casualty Co . INSURER D: - _.. _ .. .. INSURER E.'- COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE D MMIDD POLICY EXPIRATION ATE (MMIDDNYI , LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR CPP0053131 01 • . 12/13/2003 . 12/13/2004 EACH OCCURRENCE s 1,000,0( FIRE DAMAGE (Any one fire) - S 50,0( MED EXP (Any one person) f 5 r 0( PERSONAL & ADV INJURY S 1,000,0 GENERAL AGGREGATE S 2,000,OC GENL AGGREGATE LIMB APPLIES PER: POUCY JECT LDC PRODUCTS - COMP/OP AGG S 2 , OOO , OC B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CBXE4812S 02/14/2004 02/14/2005 COMBINED SINGLE LIMIT (Ea accidenq S BODILY INJURY (Per person) $ 250.00 r X BODILY INJURY (Per accident) $ 500,00 PROPERTY DAMAGE (Per accident) s 100,00 GARAGE LIABILITY ANY AUTO .. . ;. _. . AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC AUTO ONLY: AGG $ s EXCESS LIABILITY OCCUR O CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE I $ AGGREGATE S $ • s s C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY GS59UB861X751604 • 03/22/2004 03/22/2005 . I I TORYUMITS ER F-L EACH ACCIDENT S 500,0 EL DISEASE - EA EMPLOYEE s 500,00( EL DISEASE - POLICY LIMIT s 500,00( OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER I I ADDITIONAL INSURED' INSURER LETTER CANCELLATION Catewood Homes Inc 1600 Falmouth Rd Ste 25 Centerville, MA 02601 25S (7/97) 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 AUTHORIZED PI•....4N. 4 4A'IA 9ASSI IRANCFCO A ORD. CERTIFICATE OF LIABILITY INSURANCE ;;,/o °"""' PRCOUCFR Dowling & O' Neil Insurance Agency, Inc. 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. 222 West Main St. PO Box 1990 Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: Travelers Insurance Company Assurance Construction, Inc. A/O Assurance acavation, Inc. 550 Willow Street West Yarmouth, MA 02673 INSURER B: INSURER C: INSURER D: INSURER E. JERA 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. NbK LTR N SR TYPE OF INSURANCE POLICY NUMBER DALICYMMFIFDEE POLICrE Y EXPIRATION � A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 16808387A9841ND04 08/01/04 08/01/05 EACH OCCURRENCE $1000000 RENTED DAMAGE PRrMISESI s300 OOO MED EXP (Any one person) S5 000 CLAIMS MADE Ed OCCUR PERSONAL R ADV INJURY $1 00O 000 GENERAL AGGREGATE s2,000,000 - GEN'L AGGREGATE LIMIT APPLES PER: PRODUCTS -COMPIOPAGG S2000000 POLICY JET Fj LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMB (Ea accident) S BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS _ PROPERTY DAMAGE (Per accident) $ ` GARAGE LIABILITY AUTO ONLY -EA ACCDENT S OTHER THAN EA ACC S ANY AUTO S AUTO ONLY: AGG EXCESSAIMBRELLA LIABILITY EACH OCCURRENCE S AGGREGATE $ OCCUR CLAIMS MADE S S DEDUCTIBLE $ RETENTION $ WC STATU- OTH- WORKERS COMPENSATION AND E.L. EACH ACCIDENT S EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEIVEXECUT VE OFFICERIMEMBER EXCLUOEDI - E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT 1 $ under IF SPECIAL SPECIAL PROVISIONS below 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 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _I n DAYS WRITTEN :E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL M NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED ACORD 25 (2001108) 1 of 2 #35866 Lsi 4 NV VRY V V.\r V. 1. r V n ,j , C06P. CERTIFICATE OF LIAM ITY INSURANCE 0/4/04DDJyY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION $jgLT3pi ( c 11 Tnance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. B>ac 337 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Mmntcm rn_tls, bA 02648 INSURED ..$mricm R1YY1f m Cb. , Inc. 43 R-ji VS TaCL e cpntnn�` e,. MA 02632 COVERAGES INSURERS AFFORDING COVERAGE j INSURERA'. rlh-- PliIV Mlhnl.-FjXe.1M.' Qi. INSURER 8- SMIeM & gBSMIty INSURER C: ' I INSURER D: I 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, ILTH TYPE OF INSURANCE POLICY NUMBER r POLICY EFFECTIVE POLICY EXPIRATION DATE MM/DDJYV I GATE IMMJDOIVV LIMITS GENERAL LIABIUTY i EACH OCCURRENCE j $ j QOO, 000 . M COMMERCIAL GENLFL4L L.IAE.UTY I FIRE DAMAGE (Any one ore) S. 50Ao CLAIMS MADE iXXI OCCUR i I MED EXP (Any am person) i S _. //V�J��//�� -, bill _ I _ PERSONAL 8 ADV INJURY S. 1 R()W, Wo GENERAL AGGREGATE $ 21wo/000 A GF.N'L AGGREGAI iE�„u T APPLIES PER: I GO 0005933 04 i 10-05-M I 10-05 -M FPRODUCTS • C_OMP;_OP AGG 5 2 000, 000 POLICY, :.1lga _OC i CP00005933 05 10-5-04 10-5-05 1, ; AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I • ANY AUTO i (Es accident) $ - • --_- _ ALL OWNED AU'1 OS i BODILY INJURY ' SCHEDULED AU r.OS i i I .. I (Per person) $ HIRED AUTOS ! ! i j I BODILY INJURY $ . NON -OWNED AUTOS (Per ecewenq �PR PCRTY , lDAMAGE 'GARAGE LIABWTV,. .• ,7 ;;� j •�,. (AUTO ONLY• EA ACCIDENT $ .ANY AUTO ! OTHER THAN EA ra.CC - `AUTO . ONLY: AGG S EXCESS LIABILITY I EACH OCCURRENCE _• $ _ OCCUR I j CLAIMS MADE j AGGREGATE ; 5 REI'FNTION $ I S WORKERS COMPENSATION AND j - I WC STATU• OTH-; ! ER _ TORY LIMITSyy__ .� EMPLOYERS' LIABILITY I I EL EACH ACCIDENTI S 100r000 04-01-04 04-01-05 - _ EL DISEASE - EA EMPLOYEE $ _ 100, 000 B I hM 001630 .-_._......I_._...._. I E.L.EDISEASE -POLICY 1polT j $ 5Wr 000 OTHER I i � I DESCRIPTION OF OPERATIONSILOCATIONSJVEHICLMEXCLUSIONS ADDED BY ENOORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION Gatewood Homes SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 1 600 Falmouth Rd. DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN Suite 25 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Centerville MA 02632 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 5 0 8-%% 8- 5 6 0 3 REPRESENTATIVES. AUTHOR#D REPRESEN7ATIV ACORD 25-S (7197) O ACORD CORPORATION 1988 ACORq' CERTIFICATE OF LIABILITY INSURANCE DATE (MM DD YYyY) 11/01/2004 PRO UCER+ (508) 540-2400 FAX CS08)289-4111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Murray &MacDonald Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 406 Jones Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Falmouth, MA 02540 Douglas MacDonald INSURERS AFFORDING COVERAGE NAIC # INSURED Tracy Howerton: wsURERA: Arbella Protection Insurance P0. Box..1551::.,, INSURERB: Liberty Mutual Ins:Corp - Mashpee;--MA 02649 ..... __ INSURER C:. .. _. .... .. _ __... INSURER D:- ,QA�, ,aihn iT" INSURER E THE POLICIES OF INSURANCE LISTEDBELOWHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.: NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH - POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE .POLICY NUMBER POLICY EFFECTIVE DATE MMIDD POLICY EXPIRATION DATE MM/DD LIMITS AFF - GENERALUABIUTY COMMERCIAL GENERAL LIABILITY CLAIMS MADE ❑ OCCUR 8500028756 08/14/2004 08/14/200S EACH OCCURRENCE E 1,000,000 DAMAGE IUTZERTEff— PREMISES Ea o rence $ 100,000 MED EXP (Any one person) $ 5 , OO PERSONAL & ADV INJURY E 1,000,000 7 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JEGTLOC PRODUCTS - COMP/OP AGG $ 2,000,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS _. - COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) E BODILY INJURY (Per accident) $ PROPERTY -DAMAGE (Per.accident). __. $ __.. ... ._. '. ._. .. _._.__ _...__...._...____..._.. GARAGELIABILITY ANYAUTO _ ._.._ .. - .. .AUTO ONLY -EA ACCIDENT $... ._ ._ OTHERTHAN - EAACC .AUTO ONLY.. ._.. _AGG $' .E _.. _.. _ .... _. EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH -OCCURRENCE AGGREGATE $ - E $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTNE OFFICER/MEMBER EXCLUDED? If yes, describe under - SPECIAL PROVISIONS below WC531S317310033 10/05/2004 10/05/2005 TORY LIMBS - ER E.L EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEj $ 100,00 E.L. DISEASE -POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Gatewood Homes, Inc. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Paula 1600 Falmouth Road, Suite 2 S OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Centerville, MA 02632 Dou las MacDonald ACORD 25 (2001103) ACORD.- CERTIFICATE OF LIABILITY INSURANCE DATE IMMUDD(YYYY) PRODUCER S09-398-6033 FAX S08-760-1667 Eastern Insurance Croup LLC 1 Atlantic Ave So Yarmouth MA 02664 09/09/2004 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDEi;L THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER HE COVERAGE AFFORDED BY THE POLICIES BELOW. INBURED Cape Cod Custom F oors 762 Falmouth Road Hyannis MA 02601' INSURERS AFFORDING COVERAGE INSURERA: Arbel la Protection Ins Company . NAIL # INSURERB: Hartford INSURERc :SURER D: C(VFRAnFIR :SURER E: I 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 TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS. EXCLUSIONS AN POLICIES. AGGREGATE LIMITS SHOWN MAY wavO CONDITIONS OF SUCH F RccN ocnl lrCn e.. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POU Y EXPIRATION GENERAL LIABILITY 7500000373 12/13/2003 12/13/2004 LIMITS EACHOCCLRRENCG s I;OaO; X COMMERCIAL GENERAL LIABILITY DAMAGETO RENTED CLAIMS MADE D OCCUR s SO, OO A MED EXP IMIy one pmw,I S S PIERSONALaADVwURY s 1,000,OD GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2 , 000 , 000 X POLICY ETC PRODUCTS -COMPIOPAGG s 2,000 OCO LOC AUTOMOBILE LIABILITY ANYAUTD SINGLE LIMIT ALL OWNED AUTOSSCHEDULED kCO1M8MD AUTOS Y INJURY rso-) S MIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per arclde.rc) S PROPERTY DAMAGE s (Per Aedde.d) GARAGE UAe1LnY ' AUTO ONLY -EA ACCIDENT S ANY AUTO - OTHER THAN EA ACC = AUTO ONLY: AGO S El(CESSNMBRELLALIJBILITY OCCUR CLAIMS MADE EACH OCCURRENCE S AGGREGATE S DEDUCTIBLE - S RETENTION S S Us AFLOYWORKERS COLIABNSATION AND 08WECKL1007 05/25/2004 05/25/2005 EMPLOYERS -LIABILITY X WC 574TU- OTM• B AROFRIETOWAOFFIPLENMEMBERPEXCLUDDED? E E.L. EACH ACCIDENT S 500,000 Ilya desaVeUnde/ SPECIAL PROVISIONS babes EL DISEASE. EAEMPLO S S00,000 OTHER EL DISEASE -POLICY LIMIT S S00,000 DESCRUTON OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BV ENDORSEMENT !SPECIAL PROVISIONS Evidence of Insurance for work performed within the Insured's scope -of normal operations Gatewood Homes 1600 Falmouth Road 92S Centerville, MA OZ632 ACORO25po01/08) FAX: (508)778-5603 SHOULD ANY OF THE ABOVe DESCRIBED POUCIES BE CANCELCED'DFFORETRr--. EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR To MAIL 10 DAY3 WRITTEN NOTICE TO THE CERTIRCATE HOLDER NAMEDfiOTHE-CEp{_. BUT FAILURE To MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR LIABILITY OF AW MNO UPON THE INBURFR. Rs ArCu c n- --.- — _- ®ACORD CORPORATION 1988 'AP CERTIFICATE OF' LIABILITY INSURANCE 8/2/220 4 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION McShea Insurance.Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 749 Main Street, Suite#H ALTER THE COVERAGE AFFORDED BY THE POLICIFS FPFI nW Osterville, Ma. 02655 508-420-9011 INSURED Casperson Overhead Doors Box 517 East Falmouth, MA 02536 508-563-5633 COVERAGES INSURERS AFFORDING COVERAGE INSURERA: Worcester. Insurance Company wsURERB: National Grange Mutual INSURER C: INSURER D: NAIC# THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT -TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MR LTR D-L NSRD TYPEOFINSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD POLICY EXPIRATION DATE(MMIDDrrO LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1 OOO OOO PREMISES Ea.nce S 10-0-O00 X COMMERCIAL GENERAL LIABILITY CLAIMSMADE OCCUR MED EXP(Anyone person) S 1O OOO A CB 2J1973 05/28/04 05/28/05 PERSONAL BADVINJURY S- 11000 000 GENERAL AGGREGATE S 2,000 000 GEN'L AGGREGATE UMIT APPUES PRODUCTS-COMP/OPAGG S 2,000,000 JECPOLICY PRO LOC AUTOMOBILELIABIUTY ANYAUTO COMBINED SINGLE LIMIT (Ea accidwt) $ BOOILYINJURY (Per person) S ALLOWNED AUTOS SCHEDULED AUTOS BODILY INJURY (PeracCdent) S HIRED AUTOS NON-OWNEDAUiOS PROPERTY DAMAGE (Peracdtlent) S - GARAGE LIABILITY AUTOONLY-EAACCIDENT $ OTHERTHEAACC AN $ ANYAUTO $ ' AUTOONLY: AGG EXCESSIUMBRELLA LIABILrr Y OCCUR CLAIMSMADE EACH OCCURRENCE S AGGREGATE $ S DEDUCTIBLE S RETENTION $ $ WORKERS COMPENSATIONAND ANY PROERS'LI BILITYARTNE ANY PROMEMBERIPACLUD /EXEIXlTIVE - CP48352 02/22/04 02/22/05 A U- H- X TORYLIMITS ER EJ_EACH ACCIDENT S 500,060 B tfym, RIMrjbewdXCUAEOT Hyes, tlescdDeunder E.L. DISEASE - EA EMPLOYE S 500,000 E.L. DISEASE -POLICY LIMIT $ 500,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONSADDED BY ENDORSEMENT/SPECLAL PROVISIONS Gatewood Homes, Inc. 1600 Falmouth Rd., Ste. 25 Centerville, MA 02632 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOP 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 LIABILITYOFANY KIND UPON THE INSURER ITS AGENTS OR AUTHORIZED ACORD25(2001108) C ACORD CORPORATION 1988 .4C©_ CERTIFICATE OP ttAWjLi i rMStr :-AT[M., - oP m. �8O17 . •PRODUCER TN13 CERTIFICATE IS ISSUED AS -A MATTER.i}£WFDRMAtaON_ Sullivan, Garri ty & Donnelly ONLY AND COPIFE-IS 140 RIGHTS UPON THE CERTIFICATE 5 0 8 - 7 59 -17 6 7 HOLDER. THIS CEI- TIFICATE DOES NOT AMEND, EXTEND OR 10 Institute Rd PO Box 15010 ALTER THE COVEF AGE AFFORDED BY THE Fw7L1CIMBELOW Worcester MA 01615-0010 — Phone:SDB-754-1767 Fax:S08-754-1885 INSURERS AFFORDIIIGCOVERAGE _ NAIC..#_. INSURED w8UPZ-R A: Hanovfr Insurance Co _ 22292 INSURER B: Arch in,yuran Ce C70D14J n -- Crowell Construction, Inc. INSURERC. _ PO BOX 309 INSURER O: so. Dennis MA 02660 I-nvFoer_rc INSURER E: TI(E POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERM O MOCATED. NOTw(rHsTAudnn;l ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CEF' NFt:ATE MAY BE ISSUED OR 1 ' MAY PERTAI4, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLU:V ON:1 AND CONDITIONS OF S16H POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I" LTR NSR TYPE Of INSURANCE POLICY NUMBER IV DA E MMIOUM' LILY E: PIRA 1 DATE MI VULUYY LIMITS GENERAL LIABILITY EACH OCCURRENCE f SOOOOOO A X COMMERCIAL GENERALLIBIUTY Z=7007141 05/01/04 05/ 11/05 _ PREMIS S EAaITEDxdne•cet f 100000 CLAIMS MADE ®OCCUR MEDEXP(MYCafb".Kni S 5000 PERSONAL i AOW INAIITf 31000000 GENERALAGOIB_CJATS S 20VOVOU-" GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS -C ltkl%AOG X2000000 POLICY hGT LOC - AUTOMOBILE UABILRY - A ANY AUTO ABN7001142 05/Ol/04 OS/ 1/OS COMBINED SINI�J<` lP9r (Eaaadda l) I f ALL OWNED AUTOS X SCHCDULEDAUTOS BODILY INJURY I (PerDMoe) ( 51000000 X - HIRED AUTOS - - NON -OWNED AUTOS eODILYINJURY i (Pn Sedde ) 31000000 X PROPERTY DAINA - (Per r=fdw) 3500000 GARAGE LIABILITY AUTO ONLY. EAAdtCIIR]TT S ANYAUTO OTHER THAN ' 1-'. ACC «. S AUTO ONLY: I A30 f ESSNMBRELLA LIABILITYEACH OCCURRENCE f OCCUR CLAS MADE IM AGGREGATEDEDUCTIBLE R S RETENTION _ WORKERS COMPENSATION AND EMPLOYERS'IIABILITY TORY LIMITS �I I Jim f�• B ANY PROPRIETOWPARTNERIEXECUTNE IRWCIDO100 03 /22/04 03/: 2/05 EA-EACHAcevENT $500000 OFFICERAAEMBER EXCLUDED? E.L DISEASE -Fit EMS�I.(YrE $500000 RyyeeL dHCdbC wd _ E.L. DISEASE • POLICY UMBT f 500000 9PECSAL PROVISIONS below OTHER — - DESCRIPTION Of OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS As per policy forms, Conditions and exclusions. GATIwo0 SHOULD ANY OF THE ABOV i DESCRIBED POLICIES BE CANCELLDO BEFORE DATE THEREOF. THE ISSUIP 1 INSURER WILL ENDEAVOR TO LUA. 10 DAYS WRITTEN Gatewood Homes, Inc. NOTICE TO THE CERTIFICA' 114"LDER NAMED TO THE LEFT, THAT rAILURLTOMQAaZuuj 1600 ralmouth Road Suite 25 IMPOSE NO OBLIGATION Of: LIA 3RJTY OF ANY KING UPON T4,_ BASURER ITS AGENTS OR Centerville ILIA 02632 REPRESENTATIVES. (20011D8) -- 0 ACCIRD 'AtOROm CERTIFICATE OF LIABILITY INSURANCE PRODUCER MARK SYLVIA INSURANCE AGENCY 969 MAIN STREET OSTERVILLE MA 02655 INSURED INSURERS AFFORDING COVERAGE DATE (MMIDONYYY) 08/04/2004 A MATTER OF INFORMATION I'S UPON THE CERTIFICATE .S NOT AMEND, EXTEND OR PETERJ. GOVONI 5` r nrvI rnrvU�f U^OUMLI T IINJUrlt 1NGt DBA P. GOVONI LAND SERVICES INSURERS: 20 OPEN TRAIL RD. INSURER C: SANDWICH, MA 02563 INSURER D: COVERAGES NAIC # THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. WSR DD' POLICYNUMBER POLICYEFFECTNE DATE fMMfDDfYY) POUCYEXPIRATION DATE (MMfDDlYYl LIMITS 'I A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY I 2001L6202 05/31/2004 05/.31/2005 EACHOCCURRENCE E 1,000,000 DAMANfLD PREMISES Ea oce S UED.EXP(Anyonopemon) S 5000 CLAIMS MADE OCCUR _ PERSONAL& ADV INJURY & GENERALAGGREGATE S 2,000,000 GEN'LAGGREGA-1 7TE UMITAPPUES PER: POLICYRO P rt. LOC PRODUCTS, COMPAP AGG S 1 000 000 AUTOMOBILE LIABILITY ANY AUTO COM81NED SINGLE UMIT (Ea a=uent) E ALL OWNED AUTOS SCHEDULEDAUTOS - BOOILYINJURY (Pefpmaan) S HIREDAUTOS ' NOWOWNEDAUTOS BODILY INJURY. (Pvaooitlent) .E. _ PROPERTY DAMAGE (Peraccident) S ..._.._ _... . . .. I� GARAGE LIABILITY. _ ANY AUTO- AUTO ONLY iEA ACCIDENT S OTHERTHAN EAACC S' E z'•'' i AUTO ONLYC I' AGG 1 EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE EACHOCCURRENCE E ` AGGREGATE S E DEDUCTIBLE S RETENTION S E A WORKERS COMPENSATION AND EMPLOYERS'LIABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? M yea. tlestlibe under SPECIAL PROVISIONS below OTHER TO BE ISSUED 07/04/2004 07/04/2005 TOR LIMIT%C O R S EL EACH ACCIDENT s 1,000,000 E.L.DISEASE, EA EMPLOYEE S 1,000,000 E.L. DISEASE>POLICY LIMIT S 1,000 OQO DESCRIPTION OF OPERATIONS /LOCATIONS! VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS - LOGGING AND LUMBERING, TREE PRUNING, STREET CLEANING SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN GATEWOOD HOMES, INC. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 50 SHALL 1600 FALMOUTH ROAD #25 IMPOSE NO OBLIGATION OR LIABILITY oP-ANY"1fM0-tlPON-THHNStfRER •tT--AGENn OR CENTERVILLE, MA 026.32 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD COWODRATION 1' +s TE M M/OD ■r � :...:.......:..v. PRonucER %iai THIS CERTIFICATE IS ISSUED AS A MATTER O03/ 04 F 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. COMPANIES AFFORDING COVERAGE HYANNI S MA 0 2 6 O 1- (508) 775-3366 ( ) - COMPANY . A MERCHANTS INS CO OF MA INSURED COMPANY STEPHEN M CHILDS B 145 CAMMETT ROAD COMPANY C MARSTONS MILLS MA 02648- COMPANY (508) - D GO. VERAG ........... ...........:..:.aa..a...:..,-.... �.. :.. r. :,iix:,:3:i ..as,� ».,..:a%; srz.Y: �...,•...,.:.r....,..:::..,. .w....,.a.,.....,....a r. ... ao.w,x THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PEn.a,.RIOD 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. CO TYPE OF INSURANCE' POLICY NUMBER POLICY EFFECTIVE DATE (MM/DONY) POLICY EILPIRATION DATE (MM/DD/YY) LIMITS A GENERAL LIA8IUTY GENERAL AGGREGATE IS600000 X PRODUCTS - Comp/op AGG I s 6 0 0 0 0 0 COMMERCIAL GENERAL LIABILITY CCP8567749 04/28/04. 04/28/05 CLAIMS MADE a OCCUR PERSONAL & AOV INJURY s3 0 0 0 0 0 EACH OCCURRENCE • s3 0 0 0 0 0 OWNERS & CONTRACTORS PROT FIRE DAMAGE (Any one fire) S MED EXP (Any one Person) $5 0 0 0 AUTOMOBILE LIABILITY ANY AUTO / / / / COMBINED SINGLE UMIT $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULEDAUTOS (Per person) - . HIREDAUTOS - BCOILY INJURY S NON -OWNED AUTOS (Per acciderM PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY -EA ACCIDENT S ANYAUTO / / / / OTHER THAN AUTO ONLY: .; . .............................. EACH ACCIDENT $ AGGREGATE S ' EXCESS LIABILITY EACH OCCURRENCE Is UMBRELLA FORM / / / / AGGREGATE Is. OTHER THAN UMBRELLA FORM S WORKERS COMPENSATION AND WC STD TITTTUS OTH- ............ PLOVERS' LIABILITY EL EACH ACCIDENT $ THE NERSAD(ECPROPRIETORINCL PARTNERS/EJCECUTNE , EL DISEASE - POLICY LIMIT S EL DISEASE -EA EMPLOYEE S OFFICERS ARE. EXCL OTHER DESCRIPTION OF OPERATIONSIIOCATIONS/VEHICLES/SPECIAL 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 20 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE _ A 3 ISSUE DD DATE (bOIM/ /YY) x �r w CER`�IhITCAE OFINS ,F �^ix N3 _. .£`R F ».� l+t.a .AS.f.KY c Win, .43-�`•.i�,e &x✓3. �. N -S 'F� i.,. i .s.�.r..-X+- n kA. Nal. s(".:GZ RT v'i^—�`i . ....t2 .Y9 vn .�-J ic� �iC+. gun±. 08103/2004 .��' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND PRODUCER CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE Harold H WilliaDls IDS AgCy IDC DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 81 Bassett Lane COMPANIES AFFORDING COVERAGE Hyannis, MA 02601 INSURED Stephen M. Childs COMPANYA A.I.M. Mutual Insurance Co 145 Cammett Road Marston Mills, MA 02648 GC?aET2AGESz;., THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE. BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TBE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIO LIMITS I, DATE(MM/DD/YY) DATE(MM/DD/YY) GENERAL LIARDITY GENERAL AGGREGATE S COMMERCIAL GENERAL LIABBITY PRODUCTS-COMP/OP AUG. S S MADF�CCUR .. PERSONAL & ADV. JNJU[Y S OWNER'S & CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE (Any one fre) S ED. EXPENSE (Any one Person) S UTOMOBH.E LLIBDITY COMBINED SINGLE $ LIMIT ANY AUTO BODILY INJURY S ALL OWNED AUTOS SCHEDULED AUTOS - Pam) BODILY INJURY S HIRED AUTOS (Per =id=) ON -OWNED AUTOS PROPERTY DAMAGE S GARAGE LIABILITY CESS LLIBII.TTY EACH OCCURRENCE S AGGREGATE S - BREII.A FORM w':.+b' ?it�g' � 1 TS ,,.„„�a?-t'�, `a").^^..a�*- �' FX 7 77777,.1mT[ 2i'e •Yy {} s HER THAN UMBRELLA FORM WCSIATU- OTH- -r-�t- a i WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY S ' 7015793012003 12/13/2003 12/13/2004 S 500,000 A THE PROPRIETOR/ INCL EL DISEASE -POLL LIMIT EL DISEASE -EA EMPLOYEE S 1OO OOO PARTNERSIMCUTNE OFFICERS ARE: X EX OTHER FSCREMON OF OPERATION$/LOCATIONS/',MMCLES/SPECIAL. TTEMS _" ..,,-+-.•.�...�,_,...,,v.,_ ,,,_..,..,+� CANCE1yLLATTON n-•,. �,. ,..� m ,� i 'z «" � .y-.-'`-w. , r'z- i CERTIFiCATEIiOLDERs s e^ ==_ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 4_ EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO GATEWOOD H011�S INC. MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 1600 FALMOUTH ROAD, SUITE 25 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE CENTERVILLE, MA 02632 ACOM CERTIFICATE OF LIABILITY INSURANCE OATE(MMIDD/YYYY) 8/2/2004 PRODUCER 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 INSURED Casperson Overhead Doors Box 517 East Falmouth, MA 02536 rnv;:RA(OFS INSURERS AFFORDING COVERAGE wsURERA: Worcester. Insurance Company INSURERS: National Grange Mutual INSURER C: INSURER D: 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 MAYHAV E BEEN REDUCED BY PAID CLAIMS. MR LTR ADWL IWRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD POLICYEXPIRATION DATE MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,00 X COMMERCIAL GENERAL LIABILITY PREMISES Eaa rwn S 100 OO CLAIMSMADE DOCCUR MED EXP (Any we pmm) S 10,00 A CB 2J1973 05/28/04 05/28/05 PERsoNAL&AovlNjuRY S 1 000 00, GENERAL AGGREGATE S 2 000,001 GEN'L AGGREGATE LIMIT APPLIES P PRODUCTS-COMP/OPAGG -S 2 , OOO OOI POLICY PECOT LOC AUTOMOBILELIABILITY COMBINED SINGLE LIMIT S ANYAUTO (Ea accident ALL OWNED AUTOS BOOLYINJURY S SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY IWURY S NON-OWNEDAUTOS (Peraccidmt) PROPERTY DAMAGE S (Peraccidmt) GARAGE LIABILITY AUTO ONLY-EAACCIDENT $ ANYAUTO OTHERTHAN EAACC S $ AUTOONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ ' OCCUR CLAIMSMADE S DEDUCTIBLE S RETENTION S S WORKERS COMPENSATIONAND X TORYLMITS ER EMPLOYERS' LIABILITY ANY PROPRIETOR PARTNERIE%ECUPVE CP48352 02/22/04 02/22/05 E.L. EACH ACCIDENT $ 500, 000 B Exa.uDEm Oyes.de E.L. DISEASE- EA EMPLOYE S 5OO O00 albeun Ryes. desafbeunder ' EL OISEASE•POLICYLIMrr S 500 000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I 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 MAIL 10 DAYS WRITTEN 1600 Falmouth Rd., Ste. 25 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Centerville, MA 02632 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES AUTHORIZED REP S T ACORD25 (2001/08) ©ACORD CORPORATION 1988 CERTIFICATE OF LIABILITY INSURANCE RObOCER' (781)431-9800 FAX (781)431-0222 Cochrane & Porter Insurance Agency, Inc. clO Renaissance All i ante Ins. 981 Worcester Street Wellesley, MA 02482 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. INSURERS AFFORDING COVERAGE NAIC # INSURED Cape Cod Ready Mix, Inc. 300 Cranberry Highway Orleans, MA 02635 INSURER A: OneBeacon American•Ins. Co. 20621 INSURERB: Commerce Insurance Company 34754 INSURERC: Zimmerman Specialty Insurance ZSI001 INSURERD: INSURER E ,.nvFRAGES HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PEPJOD INDICATED. NOTWITHSTANDINI ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR Y PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH O LICIES.. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DDT TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE (MMtDDtYY1 POLICY EXPIRATIODATE DATE (MMfDD/YY)N GENERAL LIABILITY CBR817036 01/01/2004 01/01/200S EACH OCCURRENCE S 1,000,001 X COMMERCIAL GENERAL LIABILITY DAMAGE; REPgrumrNTED f 100,001 CLAIMS MADE a OCCUR MED EXP (Any one person) S 5,004 A PERSO--'&-' &ADY INJURY $ i, OOO,OOI GENERALAGGREGATE $ 2,000,001 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG f 2,000,00( POLICYr-j JECT 0LDC AUTOMOBILE LIABILITY ANY AUTO XY9014 01/01/2004 01/01/2005 COMBINED SINGLE LIMIT (Ea accident) S 1,000,00( BODILY INJURY (Per person) S ALL OWNED AUTOS SCHEDULED AUTOS X B HIRED AUTOS NON -OWNED AUTOS X BODILY INJURY (Per accident) $ X PROPERTYDAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY- EA ACCIDENT S OTHER THAN EA.ACC AUTO ONLY: AGG -S ANY AUTO S EXCESSrUMSRELLA LIABILITY BE9744481 01/01/2004 01/01/2005 EACH OCCURRENCE $ 1,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 .0 SIR $ 10,000 - S DEDUCTIBLE S RETENTION S WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY ANY PROPRIE70ILPA.RTNER'EXECJT.VE OFFICERIMEMBER EXCLUDED? E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLD S tl yes, desaitx under SPECu1L PROVISIONS below . E.L. DISEASE- POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ERTIFICA E HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEI LED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Gatewood Homes, Inc. 30 DAYS WRITTEN NOTICE TO THE CERTIFlDATE HOLDERFD TO THE LEFT, 1600 FalmOUth Rd. BUT FAILURE TO MAIL SUCH NOTICE SHALL II PCSE NO OBLIGAOR LIABILITY Sulto 25 OF ANY KIND UPON THE INSURER ITS AGENTS CR NT SES. Centerville, MA 02632 AUTHORIZED REPRESENTATIVE �ACORD 25 (2001108) ORD CORPORATION 1988 CERTIFICATE OF LIABILITY INSURANCE a$;oy04�Y) PRooucER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Fel elberg Company ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 222 Milliken Blvd. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 3220 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fall River, MA 02722 INSURERS AFFORDING COVERAGE INSURED. Cape Cod Ready Mix Inc. INSURER A: Construction Industries Compensation PO -BOX 399 .. .. INSURER B: . INSURER c. Orleans, MA"02653 I INSURER D: COVERAGES 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 TO WHICH THIS CERTIFICATE MAY BE ISSUED Of MAY PERTAIN. THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCI POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE RFFN R;Znl Ir^cn RV DAIn n AMAC INSR LTR TYPE OFINSURANCE POLICY NUMBER POLICY EFFECTIVE DATE M/DD/YY POLICY EXPIRATION DATE WDD LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY _ r—�—� i EACH OCCURRENCE S FIRE DAMAGE (Any one fire) E MED EXP (Any one person) $ CLAIMS MADE OCCUR I ' L—I PERSONAL 3 ADV INJURY § GENERAL AGGREGATE § GEN'L AGGREGATE LIM TrAPPLIES PER:PRO. POLICY PET loc PRODUCTS-COMP/OP AGG E AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE UMfT (Ea accideM) S ALL OWNED AUTOS SCHEDULED AUTOS I BODILY INJURY (Per parson) E HIRED AUTOS NON-0OWNED AUTOS � BODILY INJURY (Per accidenQ S I I PROPERTY DAMAGE (Per accident) i E '—� I — GARAGE LIABILITY AUTO ONLY - EA ACCIDENT Is ANY AUTO OTHER THAN EA ACC S E S EXCESS LIABILITY OCCUR CLAIMS MADE AUTO ONLY: AGG EACH OCCURRENCE AGGREGATE S S DEDUCTIBLE S A I RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC0009254 01/01/04 01/01/05 X WC STAM OTH S E.L. EACH ACCIDENT $500,000 E.L DISEASE - EA EMPLOYEE' S500,000 - EL DISEASE - POLICY LIMIT E500,000 I I OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS rotmnrnTr un� nr.. 1 Gatewood Homes Inc. 1600 Falmouth Road Suite 25 Centerville, MA 02632 SHOULD ANYOFTH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYSWRTTTEN NOTICETOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR ACORn 9tC rwan, • • r w lavv/IVIDUDAI CL3 0 ACORD CORPORATION 1988 Aur03-04 02:42pm From—AIG 973-316-8903 T-2 i B P 002/002 F-481 Dias Ins Agency Inc 535 Brayton Avenue Fall River. MA ()2721 Ella Carpentry Inc 100 West Main Street, St 10 Hyannis. MA 02601 'RTIFIGAT E-0i -03101A -NSUM� R "k, 14 1 ICATE IS AS A MATTER OF INFORMATION ONLY AND ( (DIVERS NO RIGHTS UPON THE CERTIFICATE T" TH 5 C AND O"L HOLDER. OLDER. T� IS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER T 7ALTER THE. ;OVERAGE AFFORDED BY THE POLICIES BEL.GW- 'w'vfrJ4"lr-Q AFFORDING INSURANCE COMPANY A GRANITE STATE INSURANCE COMPANY THIS IS To CERTIFY THAT THE POLICIES OF INSURANCE LISTED :FLOW HAVE k5k:J-N ISSUED TO THE INSURED NAMED Aq0vE F THE POLICY PERIOD INDICATED, NOT WITHSTANDING ANY REQL REMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHEROR DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY B ; ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED THE_.. POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. E '*CLUSIONs AND CONDITIONS OF SUCH pOLICIr MAY HAVE BEEN REDUCED By PAID CLAIMS. =S. LIMITS SHOWN LlAftrrY - eKcL 0 C Group 7/24/2004 7t24/2005 I nnac&4m 00y. POLCY LVATT CERTIFICATE HOLDER CANCELLATION GATEWOOD HOMES 1600 GALMOUTH ROAD. SUITE 25 sHOUL0 ANY OF " ABC JE DESCRMEO pOLICE3 BE CANCOAM UUORE THE CENTERVILLE. MA 02632 DAWYSO�IATR'aTEN DATE THERE )F• T)qE tSSU'NG COMPANY W'LL ENDEAVOR TO MAIL 12 ��CELLAT'O ANY 0" " N ec DA' I`E'lj� WRITTEN T L -�U� I.- c ?..At r I THE-! CERTIFICATE HOLDER NAMED TO THE LEFr. allT FAILURE To MAIL SUCW& DU 0 'TCE M'ALL IMPOSE NO OQUGATMN OR Lj&eLry OF ANY MD UPON THE COL .'ANY. rM AGENTE OR REpRCSrNTATpE& FAUrHOMZjED REPRI SENTATIVE e�2 N IF • VV.i4.V1 1V.YV {(y1 JVOIifVU44`J 6ULMAN ASSOC Cr-;2T1F:jv :E OF LIABILITY !NSURANC` csR aRi GO"D: 3 0 GOIZXXT % ASSOCIATES =SURANCS Y �CER iFIGAF�-IS�ISSUEa4S14Rb4FFE CF FIRA'aTt IAL SBRVICBS nil" ONLY MID COWERS NO RIGHTS UPON THE CF 93} vai lu>1nm� nos HOLDER- THIS CERTIFICATE DOES NOT AMEND 11SYA;:.'IS W. 02601 Phos:ss 508-T75efi0.10 Fe;:5D8-790-0249 ...Si:MS AFFORDING COVERAGE INSURED AM ----- INSURER A. ESSEX n,TSURATeS eo INSwrtaR B: AIK ZEUTUAL =3VRWCZ Co. GOODw3x MWOVATIONS nm rsuRERc: PO BOY 116 SAG_-093 BEACH VI L 02562 INSLIP.-R M INSURER E: CDYERAQFS THE POLICES OF INSURANCE US M DATE jMMyM➢VVVF MAiQ f-. "ITN =IREMEYT. TERN OR CONDITION OF ANY CONTRACT OROTMR_ I IY, 1 nc.v{A:T CT TO WHICH iT Qo INDICATED. NOTWITHSTANOING THIS CERTIFICATE MAY BE NESTED OR MAY BERTA`Y, THE ZZUR-'NCEA£ECa--M EYTt-- ECL.'^,,.E' S L`=IPED tl� ':J '^ �Au I'MCIFS, AGGREGATE LIMITS SHOW N SMY HAVE BEEN REDUCED9Y PAID CLAIMS. Tom. MCLUSIONSANO W' F''p''TWwS OF SUCH LTR TYPE Cf NSUAANCE POLICY NUMISflI DATE fM2MDDIyyI DATE LMURLRY LIMITS COMMERCIAL GENERAL 3C382718 12/12/03 EACHOCCURRENCE 12/12/04 $1000000 IMS MAO& ® �Ua PRE msEs me om ,. j 3 500 00 -- MID OCP tAnV a,.e oaaon) S 5000 PERSDNALaAwINIURY S 1000000 ' REGATE LIMIT APPLIES PER GI7JERAL AGGREGATE i 400'Off0"6 _. Y l 2F� 71LOC PRODUCTS-�INOPAGG S 1000000 LE LUUMLM kALL UTO GLE Law NED AUTOS ULEDAUTOSAUTOSWfAm AUTOS BODILYIN.RNRV S . (PIraC.eO . I IPROPERTY DAMAGE OW#W.d"j S AMYAlITD. AUTOMIF-€AACCIVElfr S I . OTHER -THAN EA ACC S _ tXCeFAWVMBAELdA UA61-Lrry AUTO ONLY: AGG s OCCUR a CLAIMS MADE EACH OCCLRtRE NDE I S AGGREGATE DEDUCTIBLE RET6lTpM i I S WORKERS COMPEN ATEN AM S B ELrLDrExttlAe¢tTr AYY er.De�._ETOsxamr�P.l-.�curlve #ZLWC7016018012004 01/03/04 OFT'A:rWGIIciae-ti E�ED7 TORV Oi/03/05 ELEACHUACQDENT MITS ER s100000 fl yyaeccdeEVlee ulltlar SPINAL PROVISIONS DdOw - E1. OISFASE-FA ESIPL s 1000o6 R—" E.L.asEAsE-PoLICYuMT — $500000 OF9CRIPTIDN GF CPEkAYi3Fi31LOEATiON3/Veti£LESI EitOLUS10iV5 6V EetDORSEiY'chT! WERE PRD'VLik7ria E I GATzwow EOams =cc FAX SOS-778-5602 CSN'TSRV=LLS MA 02632 V.v�VGlAAI1V1� SIXII'M ANY Off TW AA2'-%''E OEnt-R E EO<-n'S EE CA`CEIILED DATE TP.EREOF' TITS 1SEUING INSURER WILL E'.'LVOR TO MAIL 30 DAYS Wg7TE,y NMICA T@ THE QERTMATE Nowlat MAWR TO THIS LEFT+ BUT FALWM TO Dmw-si� WPOSE NO OBLIGATION OR LIABILRV Of ANY WND UPON TIE l &%AE1� ITj AfrENT}' CR I —e —eercYi ell • dD K 11JtK K I bK bFLC; I AL I STS 1 59B 564 7272 P - PI iS') e ro !f co • —'�.Y � � AME �3��L1�B��'"�'��i fl1O0Y^ RIDER RISK SPECIALISTS «!f: dh Y�yF .. v. ,yl`P F OgTCIMMmon _ 07/28/0 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 ALgR..TKF COVERAGE- AFFORDED BY THE.P000IES BELOW, INSURANCE AGENCY, INC. P . O . BOX 115 CATAUMET MA 02534-0115 COMPANIES AFFORDING COVERAGE EO,,,P„L �. A SCOTTSDALE INSURANCE COMPANY INSURED MONUMENT INSULATION, INC. CBMPANY-_ B AMERICAN HOME INSURANCE COMPANY 223 COUNTY ROAD BOURNE, MA 02532 COMPANY ' C COMPANY .• D THIS IS TO CERTIFY THAT THE POL)GES OF WSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANV REOUDTEMENi, TERM OR CDNDRION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 8E LSSUED OR MAY PERTAW, THE INSURANCE AFFDRDED BY THE POLICIES DESCRIBED-HEREIN-M-WE.IEMTb.ALLZHE TERMrx EXCLUSIONS ANO CONDRIONS OF $UCH POLIGFS. LIMBS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE O/INSURANCE POLICY NUMBER POLICY fffEC7NIL. DATE MM/DD/YY) DATE )IMIDDIVY) _^^ —.•. UMR r 2 GENERAL X UABRTJY COMMERCIAL GENERAL LABILITY CLAIMS MADE OCCUR OWNER75BCONTRAC7OR•SPROT CLS1001705 3/30/04 3/30/05 GENERAL AGGREGATE 11 ,_ 0 0 0, 000 65 0 0 , 0 0 0 _ i500, 000 PRODUCTS • COMPIDP AGG PERSONAL& ADV PIJURY _ EACH OCCURRENCE :500, 000 FIRE DAMAGE IAAV ARI Rnl L 5 O, 0 0 0 MED EXP IAnv OM OWWM :5 000 AMOMOBR.E VABRfTY ANY AUTO COMBINED SINGLE UwT fi— ALL OWNED AUTOS SCHEDULED AUTOS e001LY INJURY .� ONSR.i HIRED AUTOS NON-0WNED AUTOS BODILY INJURY IPer •ccgagl i PROPERTY DAMAGE S... - GARAGE WBRJTT AUTO ONLY • fA ACCIDENT ANY AUTO OTHER THAN AUTO ONLY- ."."..`:::'""" EACH ACCIDENT i AGGREGATE I - EXCESS UABUTY _ EACH OCCURRENCE 1 UMBRELLA FORM AGGREGATE OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYBIG' UAMLRYDRY X I WC STrA OTRH•:,::,,_,z:: �:"•_::�^V ^.:,;�_:: EL EACH ACCIDENT 110 0 , 000 g THEPRO7RIETORI X INC,. PARTNERSIEXECUTNE WC 768 29 54 3/5/04"' O5 3/5/CYUMIT _ EL DISEASE POLICY i5$B 099- �_„ L DISEASE. FA EMPLOYEE 1100 000 OFFICERS ARE: EXCL OTHER DESCRIPTION Of OPERATR)NSAOCATIONSIVOUCL$KPEMAL ITEMS �A.E87iF[CIjTE:fiOLD , a.. id14GF iA?1 iAF ....... ....r .:.., .. «......... SHOULD ANY OF THE ABOVE DESCRIBED FOUCIES BE DAYCEU&M BEFORE THE GATEWOOD HOMES 1600 FALMOUTH ROAD #25 EXPMATION DATE THEREOF, THE OWNED COMPANY. WILL..ENOEAVOR TO MAIL 10 OAYE WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. CENTERVILLE, MA 02632 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR UASKM OF ANY KIN) UPON THE COAI ANY, RB AGUOU OR RMMESEYTATIVU. AUTHORIZED A •••Iaa•:1•:, "'IR:A'T`.'''�G,nMa:d>n^x Y.Xe:'fR'eiA:as'> ex'W:,v vnlR:v£v.!i:.':e»:uir::tiiiu :: ICCDRD Z5�S £ti95i .a: ,?�.• '� ,: Y +• ,fA; iEPOiiAT1UNi.988= ADDRESS: / .AL-CULATION FOR PERMIT COS1 4A fr/ 90 elpJ 731 ZsS. g2r WAG • v 9 id . . f ... _ v ,. -., r WAM .,ll . r .. ;Tolle ..Jim M17.,. -.,. , .. r Of TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-418 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST 13r1 1 Owner's Name: Villages @ Camp St., LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02632 ' Owner's Telephone: (508) 778-9669 REVIEWED BY: 1. WATER DEPARTMENT: (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: 2/14/2005 Issue Date: Expiration Date Comments: new construction - Affordable Unit: DATE: FEB 2 2 2005 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT: DATE: N/A: 5. BUILDING DEPARTMENT DATE: N/A: 6. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE flARARECK170. 44.21.1.C1 'EIPT OF COPY: SIGNATURE OF APPLICANT: 'y(C, DATE: /m O Date Printed: 2/16/2005 TOWN OF YARMOUTH WATER DEPARTMENT 99 Buck Island Road West Yarmouth; MA 02673 Telephone: (508) 771-7921 • Fax: (508) 771-7998 Date of Issue : Feb 18, 2005 Letter of Water Availability 1. Single Family Dwelling X 2. Duplex Family Dwelling 3. Condominium Dwelling 4. Commercial / Industrial 5. Other (Specify) Reference; Massachusetts General Laws Chapter 40, Section 54 To Town of Yarmouth Building Inspector Please be advised that the Town of Yarmouth Public water supply is available to service lot/parcel(s) 21.1.137 Street 121 Camp St., #137 as shown on Assessors sheet/map # 44 Issuance of this Letter of Availability is subject to the following provisions/restrictions. (1) The property owner agrees to comply with all Federal, State, and Local Laws, Rules and Regulations as they pertain to the use of the Public water Supply. (2) The Yarmouth Water Department shall have exclusive rights as to the size, number, type and location of all water service lines, fire service lines or appurtenant items connected to the water distribution system. (3) The Yarmouth Water Department reserves the right to require, at the property owners expense, the installation of water mains and appurtenant items to meet water demand requisites within any structure relevant to this Letter of Availability. (4) This Letter of Availability will expire 180 days from the date of issue. I have read and understand the provisions/restrictions of this Letter of Water Availability. Owner (Sign) Reference : Villages ® Camp St., LLC : 1600 Falmouth Rd. #25 : Centerville, MA 02632 of ` TOWN OF YARMOUTH Building Department Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-418 Applicant Name: Applicant Phone: Building Location: Owner's Name: Owner's Addres Owner's Telephone Frank Capra 5087789669 00121 CAMP ST�� Villages @ Camp St., LLC 1600 Falmouth Road # 25 Centerville MA 02632 (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: 2/14/2005 Issue Date: Expiration Date Comments: Map/Lot: 44.21.1.C13'/ new construction - Affordable Unit: REVIEWED BY: 1. WATER DEPARTMENT: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT: DATE: N/A: 5. BUILDING DEPARTMENT: DATE: N/A: 6. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE COMMENTS: RECEIPT OF COPY: SIGNATURE OF APPLICANT: DATE: Date Printed: 2/16/2005 LET A36 �5 V WITH T1zJE-V,.IF WITHIN GRAPHIC SCALE 1 OFT. 20 10 0 20 60 EB IN FEET B I inch = 20 M y PLOT PLAN holmes and mcgrath, inc. OF LOT 137 civil engineers and land surveyors PREPARED FOR T I MCTHY U MILL POND VILLAGE .362 gifford street z SAN Ms 45078 falmouth, ma. 02540 N0.CIVIL IN Aa 9oF is YARMOUTH, MA JOB NO: 201197 DRAWN: LIVIC 'S 0 or, I SCALE: 1"=20' DATE:12-29-041 DWG. NO.: A2523 CHECKED: -roft> 1 F-r,-j M F LG� 9EGfSTERE� ' s„ ® SEWER La BE A SLEEVED IN A •�I?ISANCE WITH TITLE V IF WITHIN GRAPHIC SCALE 60 20 10 0 20 D ( IN FEET ) 1 inch = 20 ft" By PLOT PLAN hoimes and mcgrath, Inc. 'r- S OF LOT 137 ' civil engineers and land surveyors TIMOTHYM +- PREPARED FOR snnTos 1� 362 gifford street � No aFo;e MILL POND VILLAGE falmouth, ma. 02540 ' CIV; 5 F 9 IN n of YARMOUTH, MA JOB NO: 201197 DRAWN: LMC SCALE: 1"=20' DATE: 12-29-041 DWG. NO.: A2523 CHECKED:—#roft> v MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck software version 2.01 Release 2 CITY: Barnstable STATE: Massachusetts HOD: 6137 CONSTRUCTION TYPE: 1 or 2 HEATING SYSTEM TYPE: Other DATE: 4-26-2004 DATE OF PLANS: 04/21/04 TITLE: The osprey PROJECT INFORMATION: Mill Pond village Camp Street Yarmouth, MA. COMPANY INFORMATION: Northside Design Assoc. 141 Main Street Yarmouth Port, MA. 02675 COMPLIANCE: PASSES Required UA = 288 Your Home = 158 Family, Detached (Non -Electric Resistance) I I I Permit # I I I I I checked by/Dated I I Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 740 30.0 30.0 13 WALLS: Wood Frame, 16" O.C. 1700 15.0 15.0 75 GLAZING: Windows or Doors 101 0.340 34 GLAZING: Windows or Doors 40 0.340 14 DOORS 40 0.086 3 FLOORS: over unconditioned Space 740 19.0 19.0 19 ----------------------- I------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310,ad 34.4. Builder/Design e� L� Date h�jai /of LC Massachusetts Energy code MAscheck software version 2.01 Release 2 `• The osprey DATE: 4-26-2004 Bldg.l Dept.l use I I I [ 7 I C] C7 [7 CEILINGS: 1. R-30 + R-30 Comments/Location WALLS: 1. wood Frame, 16" O.C., R-15 + R-15 comments/Location WINDOWS AND GLASS DOORS: 1. u-value: 0.34 For windows without labeled u-values, describal eafeatures: [ 7 No # Panes Frame Type Comments/Location 2. u-value: 0.34 For windows without labeled u-values, describe features: [ ] No # Panes Frame Type Thermal Break? YesComments/Location DOORS: 1. u-value: 0.086 Comments/LOcati FLOORS: 1. over unconditioned comments/Location_ Space, R-19 AIR LEAKAGE: joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. when installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type iC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type Ic rated, in accordance with standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating I I I I C] I and cooling equipment and service water heating equipment must be provided. insulation R-values and.glazing U-values must be clearly marked on the building plans or specifications. DUCT INSULATION: Ducts shall be insulated per Table 74.4.7.1. DUCT CONSTRUCTION: All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in Sections 78004R 1310 and 34.4. SWIMMING POOLS: All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. HVAC PIPING INSULATION: HVAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in.): PIPE SIZES (in.) HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 Low temperature 120-200 0.5 1.0 1.0 1.5 steam condensate any 1.0 1.0 1.5 2.0 COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.7S 1.0 refrigerant below 40 1.0 1.0 1.5 1.5 CIRCULATING HOT WATER SYSTEMS: insulate circulating hot water pipes to the following levels (in.): PIPE SIZES (in.) NON -CIRCULATING I CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F): RUNOUTS 0-1" I 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 I 1.0 1.5 2.0 140-160 0.5 j 0.5 1.0 1.5 100-130 0.5 I 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department use only) -------------------------- Lar,a-r 0Go-3 PRODUCT SPECIFICATIO GMS9/GCS9 SERIES 93% AFUE Multi -Position, Single-Stage/Multi-Speed Gas Furnace Hearing Capacity: 46,000-115,000 BTUH A-�� ETA m ama.,.,.• ® cETA ® � 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 Norton® Mini -Igniter with patented adaptive learning algorithm to maximize igniter life • Aluminized -steel inshot burners • Energy -saving PSC, multi -speed, direct drive blower motor • Quiet, corrosion -resistant induced draft blower assembly • Integrated furnace control with improved ,diagnostics • Low voltage terminal blocks • Multiple flame roll -out switches, blower door safety switch, outlet air -limit switch and pressure switch for proof of combustion air • 40VA transformer for heating and air conditioning control service • Combination redundant gas valve and regulator • Top venting is standard; alternate flue/vent located on right side • Completely assembled, factory run -tested furnace for heating or combination heating/cooling application • All models comply with California NOx Standards • Suitable for direct vent (2-pipe) or non -direct vent. (1-pipe) applications Air Conditioning & Heating 'he GMS91GCS.9 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 00A) • L.P. Gas Low Pressure Kit (LPLP01) • High Altitude Natural Gas/L.E Kits (HANG11, HANG12, HALP10) • High Altitude Pressure Switch Kit (HAPS27) • External Filter Rack (EFR01) • Horizontal Concentric Vent Kit (HCVK) • Vertical Concentric Vent Kit (VCVK) • Internal Filter Retention Kit upflow, (RF000180) • Internal Filter Retention Kit--down£low ' (RF000181) • Thermostats Blower Motors (CHT18-60, CH70TG, CHSATG, H2OTWR) SS377D ww .gomhn=dg.com 6/04 PRODUCT SPECIFICATIONS Nomenclature G M S 8 070 3 A N A Revision Goodman® Brand A: Initial Release M: Upflow/Horizontal D: Dedicated Downflow C: Downflow/Horizontal H: Hi Air Flow S: Single Stage/Multi-speed V: Two Stage/Variable-spee B: 80% 9: 90% M 045:45,000 070: 70,000 090:90,000 115: 115,000 140: 140,000 Nox B: 151 Revision N: Natural Gas C: 2nd Revision X: Low Nox Cabinet Width A: 14" B: 17'r4" C: 21" D: 24'r4" Maximum CFM Co 0.5" ESP 3: 1,200 4: 1,600. 5: 2,000 2 C ` PRODUCT SPECIFICATIONS Performance Ratings 42,800 37,200 GM590453BXA 46,000 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 1 3.0 35.65 GCS90703BXA 69,000 64,400 55,800 93.0 3.0 35-65 GCS90904CXA 92,000 86,000 74,400 93.0 4.0 40-70 GCS91155DXA 115,000 106,500 93,000 93.0 5.0 40 I For altitudes above 2,000', reduce input rating 4% for each 1,000' above sea level. r DOE AFUE based upon Isolated Combustion System (ICS). Specifications BMW, C19f�Yo �'e ze �Y�$A$aY 1 s..� ,+ 2" �. ar��'Lnrzw`�r��aF$1 moo= 2 : ,z L � , klCipcmt mpaciEjr i � kg, G.r� Ouear u ens '1'a.'otec on� �'igh' rx� GMS90453BXA 10" x 7" 113 4 288 576 9.0 15 132 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 790453BXA 10" x 7" 1/3 4 2" 2 288 576 9.0 15. 132 GC590703BXA 10" x 8" 1/3 4 2" 3 282 564 9.0 15 135 GC590904CXA 10"x 10" 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 z 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 use on 115 VAC, 60 Hz; single phase electrical supply. • Gas Service Connection rh".FPT • Important: It is required to size overcurrent protection device and wires properly and snake electrical connections in accordance with the National Eleealcal Cade and/or all existing local codes. PRODUCT SPECIFICATIONS GMS9 Dimensions 61— srHnRG€ I AR I /^\ 83 / 1t'_�GAIRI! "'6 GrE 3/4 {�1S 6B� -+� 1R y21/18 VENT PIPE IAIR I SI C R INTAKE PIPE 7 PVC 2 PVC VA RNATE 21V18NTAKE LOCATION ALTERNATE I .7 NDARD GAS GAS SUPPLY II CdJ IN T AP PPLY HOLEHOLE DRAIN TRAPwSCHA G 41BALTERNATE HIGH VOLTAGE � 1314DISCHARGE LOCATI�NTIFUEELECTRICAL HOLE(E T SIOR LOCATIONLEFIF 1HIEFi SIDEI H VOLTAGE DRAINE51E/ 24 B/18 CTRICAL HOLE HT SIDE 1t2 „ 23 71B 25BIN LINE DRAIN �.P1113149 y8 OLES r TRAP 21114 301/ 103/18 Q LOW VOLTAGE 2 LOW VOLTAGE 14 ELE�C=H� 116 0. 113H I ELECTRICAL HOLE SIDE CUT-0Ur 13A 18 3213/1 7II�1314' SIDE CUT-0UT L J L J KNOCK�� 130 FRONT RIGHT SIDE LEFT SIDE VIEW NEW WEW 171h" 16" 4, gg GMS90453BXA 12'/a" 12%" GM590703BXA GMS90904CXA 21" 191h" 16%" 14%" GMS91155DXA 24'h" 23" 20'/s" 18%" NOTES: 1. Installer must supply one or two PVC pipes: one for combustion air (optional) and one for the flue Cutler (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 909 elbows, one close nipple, straight pipe Right —Straight pipe to reach gas valve Minimum Clearances to Combustible Materials • e s �* ' UNWORN Bo j d+PIN M. 1 r 0„0„ 3" C 0"Horizontal Tn U flow 6" 0" 3" C 0" C = If placed on combustible floor, the floor MUST be wool ONLY. - NOTES: • For servicing or cleaning, a 36" front clearance is recommended. • Unit connections (electrical, flue and drain) may necessitate greater clearances than the minimum clearances listed below. • In all cases, accessibility clearance must take precedence over clearances from the enclosure where accessibility clearances are greater. 4 ' PRODUCT SPECIFICATIONS GCS9 Dimensions LEFT SIDE FRONT RIGHT SIDE VIEW VIEW VIEW 8 9/4 12 R INTAKE PIPE (RETURN AIR) VEM/FLUE PIPE 2' PVC zP 21/16 CONDENSATE r LOW VOLTAGE r , DRAIN TRAP w/3/4'PVC 1 ELECTRICAL HOLE 134 .. LOW VOLTAGE DISCHARGE (RIGHT OR HIGH VOLTAGE ELECTRICAL HOLE�� 40 • IEFT SIDE) HOLEE�H1�E J 6EUE/CTRKAL J L 2 5n8 28 691/8LOCATION HIGHVOLTAGE ELECTRICAL HOLE 2t7H8 ALTERNATE AIRIMAKELOCATION 19TS } DRAIN s 8 11R/JN - TRAPC TRAP 25l&►} ¢ —r7— 18 3/1 RIGHT SIDE LINE LEFT SIDE 1512 DRAIN UN Q Z I 14 77 DRAIN HOLES HOLES 1112 O 81/4 9 W4 73/B-.� ALTERNATE GAS STANDARD GAS 41/8 9 7 78 SUPPLY HOLE SUPPLY HOLE tUN'F::��EBDFLANGES UNFOLD ISd CHARGE 80LFLANGES FOLDED FLANGES pISC1�WIGE AIR y DISCHARGEAIR (7 _ - - 1411A. 16" GCS90453BXA 17W 16" 12%" GCS90703BXA VIA" 16" 12%" 141k" 16" GCS90904CXA 21" 19111" 16%" 18" 191h" GCS91155DXA 2411h" 23" 20%" 2114" 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 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. lane voltage wiring can enter through the right or left side of the furnace. Low voltage wiring can enter through the right or left side of furnace. 3. Conversion kits for high altitude natural gas operation are available. Contact your Goodman distributor or dealer for details. 4. Installer must supply following gas line fittings, according to which entrance is used: Left —Two 909 elbows, one close tipple, straight pipe Right —Straight pipe to reach gas valve Minimum Clearances to Combustible Materials P . pes.afl 1" s :fl°te NC v # :e,P 0" 1" 0' 4" Downflow Horizontal 0" 6" 0" C = Combustible: If placed on combustible floor, the floor MUST be wood ONLY. NC,= Non -Combustible: A combustible floor subbase must be used for installation on combustible flooring NOTES: • For servicing or cleaning, a 36" front clearance is recommended. • Unit connections (electrical, flue and drain) may necessitate greater clearances than the minimum clearances listed below. • In all cases, accessibility clearance must take precedence over clearances from the enclosure where accessibility clearances are greater. 5 PRODUCT SPECIFICATIONS Blower Performance Specifications fi'8a P u '• ntGry 4 , = f- � a l$talmtessU '"ry "= eq& es'W�Yer'�olri ' - 35 45 GEMS 3R15E` 1,202 - - 1,064 ...... 923 36 704 47� i5 7x SEA ,E =815E C -1 - r„ ,194 97� �f 3b6` tt' Z0 P9Y a� ��b7y� 5' r , 35 �0$� Sibs 1tg53 8w I -0ar 793y. a�(i G_590453BXA (LOW) HIGH MED MED-LO LOW 3 0 2 5 " 2.0 1.5 1,352 1,214 997 757 - ------ ------ 44 1,318 1,172 994 753 • -• -••- 44 1,260 1,123 960 734 G_S90703BXA (MED-HI) HIGH MED MED-LO LOW 3.0 2.5 2.0 1.5 1,449 1,192 981 750 36 43 53 --•••- 1,409 1,172 962 730 37 44 54 ------ 1,326 1,141 943 714 39 .45 55 ------ 1,273 1,094 917 692 41 47 56 ..--- G_590904CXA (MED-LO) HIGH MED NED-LO LOW 4.0 3.5 3.0 2.5 1,970 1,713 1,439 1183 ------ 39 46 56 1,874 1,650 1,412 1155L4O 35 40 47 1,757 1,572 1,370 1122 38 42 48 59 1,667 1,510 1,327 1108 40 4412 50 60 31Ta331SP.. 'n 36�8 "dam H ^ 8 g 1I ?1LOW 56- rr MA "frZS• (MED-HI) NIGH MED NED-LO 5.0 4.0 35 3.0 2,134 1,678 1,453 1 259 40 51 58 67 2,103 16431,643 1,4401,426 1 2391 2,029 220 42 52 59 70 1,941 1,577 1,363 1 181 444G591155DXA 54s. 62 ------ 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 blower cooling speed as needed 3. For most jobs, abort 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 slwwn on the rating plate. The shaded area indicates ranges in excess of maximum static pressure allowed when heating. 6. The dashed (---- ) areas indicate a temperature rise not recommended for this model 7. The above chart is for U.S. furnaces installed at 0' - 2,000'. At higher altitudes, a properly de -rated unit will have approximately the same temperature rise at a particular CFM, while ESP at the CFM will be lower , I 6 PRODUCT SPECIFICATIONS Accessories �l� r .�� ,t ,e n �� * �G• �5�B� .6�598i,036'`� 5��O�C�A� �,,1��59�11�8©J,l� LPT-OOA L.P. Conversion Kit ✓ ✓ ✓ ✓ LPLP01 L.P. Gas Low Pressure Kit ✓ ✓ ✓ ✓ HANG11 High Altitude Natural Gas Kit 1 1 1 1 HANG12 High Altitude Natural Gas Kit 2 2 2 2 HALP10 High Altitude L.P. Gas Kit 3 3 3 3 HAPS27 High Altitude Pressure Switch Kit 3 3 3 3 EFRO1 External Filter Rack ✓ ✓ ✓ ✓ DCVK-20 Horizontal/Vertical Concentric Vent Kit (2") ✓ ✓ DCVK-30 Horizontal/Vertical Concentric Vent Kit (3") ✓ ✓ ✓ Available for this model (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: CFBl7, CFB21 and CFB24. Thermostats -_'` -' _ _,��w, ii.+?• d g'�Spt��'.�... ., NTI ps.'' ..,r`X'7:.v",,'.��ra. CHT18-60 Cooling/Heating, Mechanical CH70TG Cooling/Heating, Digital, Non -programmable CHSATG Cooling/Heating, Mechanical H2OTWR Heating Only, Mechanical it [Affordable Unit] MILL POND VILLAGE CONDOMINIUM CAMP STREET, YARMOUTH, MASSACHUSETTS PURCHASE AND SALE AGREEMENT UNIT 137 OSPREY PART A: References: The following terms which are capitalized and marked in quotations in this Part A shall have the meanings set forth below wherever such terms are used in Part B hereof, and this Agreement shall consist of both Parts A and B and all exhibits hereto: A. The "Date of this Agreement" is November , 2004. B. The "SELLER" is: Villages at Camp Street, LLC, a Massachusetts limited liability company, with an address of 1600 Falmouth Road, Suite 25, Centerville, MA 02632, or its successors and assigns. C. The "BUYER' is: Shannon M. Blake of 414 Oakland Avenue, Hyannis, MA 02601 D. Notice. Any and all notices or other communications required or permitted by this Agreement to be served on or given to any party hereto by any other party hereto shall be in writing and shall be deemed duly served and given when personally delivered to the party to whom it is directed, or in lieu of personal service, three (3) days after deposit in the United States Mail, first class and postage prepaid, or one day after deposit with a reputable overnight courier, addressed to the BUYER and SELLER at their respective addresses as listed above. E. The "Unit" to be conveyed hereby is: Unit #114 OSPREY, as such is further shown on the plans attached hereto as Exhibit A, which plans include a unit floor plan (Exhibit A-1) and a Designated Use Easement Area showing the Unit's Maintenance Easement Area and Exclusive Use Easement Area (Exhibit A-2). F. The "Percentage Interest" in the Common Areas referred to in paragraph 2 of this Agreement will be determined upon the completion of the phasing in of the Phase of the Condominium containing said Unit and will be so determined in accordance with the provisions of the Master Deed described herein. See also paragraph 27 of this Agreement. G. The "Purchase Price" referred to in this Agreement is: One Hundred Twenty -Six Thousand and 00/100 Dollars ($126,000.00), which is calculated as follows: $126,000.00 (base price) + $ 0 (options and upgrades further described in paragraph I of this Agreement) PURCHASE PRICE:=$126,000.00 of which: $ 500.00 have been paid as a deposit as of this day, $ have been paid previously, and $ are to be paid at commencement of Unit construction $125,500.00 are to be paid at the time of the delivery of the deed in cash, or by certified, cashiers, treasurer's or bank checks. $126,000.00 TOTAL DUE H. The "Time for Performance" shall be at a.m. on the day of at the place referred to in paragraph 7 of this Agreement. I. Options and Upgrades. The following items will be included in or eliminated from the Unit to be delivered hereunder and the costs or credits thereof are included in the purchase price set forth in paragraph G hereof- J. Commission. A commission fee for professional services specified in this paragraph is due from SELLER to Housing Assistance Corporation,(HAC) but only if, as and when the SELLER receives the full purchase price pursuant to this Agreement and the BUYER accepts and records the SELLER'S deed and not otherwise. Commission Due: 1.835% of Purchase Price -2- GSDOCS-1282281-1 TOWN OF; YAR�OUTH- AUG 2 5 2005 Building t AT Location __ L?.J--._S. Crl New [X Renovation ❑ Plans Submitted Yes ❑ No ik APPLICATION FOR PERMIT TO DO GASFITTING (OFFICE USE ONLY) By----- Fee:-- PERMIT NO._ uate OwnerNama Type of Occupancy—A51�! Replacement ❑ (A in N Wy X z z W. N N by z c m a Q z�$ w W _ to C ¢> W W W z j Z Q S ¢ U 2 W U. J W ryy�j�r� 1 1`v ti Q W> ¢ W z a Q m O O W¢ Qul O y. ¢ x o 0 x u S 3 o c7 g c> ¢> 3 a' o SUB•B MT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PR:NT OR TYPE) � I Check One: Installing Company Name 1 04,TS� AJI-4 r^� Me51a_ ❑ Corp. Address --i_}ems E s ❑/Partnership ,A A! IV IS N1 Firm/Company Business Telephone Name of Licensed Plumber orr INSURANCE COVERAGE: Check One I have a current liability insurance policy or its substantial equivalent. Yes �No ❑ If you have checked yes, please indicate qie type of coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check One: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information 1 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 compltance with all pertinent provisions of the Massachusetts State Plumbing Code and Signature o Licensed Plumber or Gasfitter License Number Tvoe I rreNea•