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Home My WebLink About121 Camp St #138 Building PermitsG APPLICATION FOR PERMIT TO DO GASFITTING Bye, c New IX Renovation ❑ Replacement ❑ Plans Submitted Yes ❑ No (OFFICE USE ONLY) uate Namer L�i ma ie C�9t� if , S !�' -1r Type of Occupancy_ / N N\ W o�z� 2 z O cc o a .� h J 2 O a W a y a a [t I pU. � S Q W a Q¢~ FW- Y f!f m Z 0 huu0.t1 Z W Q N= '( ` o 3 c� g � >bRru'-o �i csiu�a 0 SUB•BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RO FLOOR EL — — (PRINT OR TYPE) �'� Check One: Installing Company Name -�V�TS ~��g1 tTe 1�_ ❑ Corp. Address ❑❑/Partnership - 44)e �l�l_i�� 1 A D-2- & 0�- -- F FirmJCompany Business Telephone Name of Licensed Plumber of iiiler--. -a 0 1A � - L--iA - INSURANCE COVERAGE: Check One I have a current liability insurance policy or its substantial equivalent. Yes Er'O'No ❑ If you have checked yes, please indicate t e type of coverage by checking the appropriate box. A liability insurance policy Eir 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 I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit issued for this application will be In compliance with all pertinent provisions of the Massachusetts State Plumbing Code and QM01) JO�f�,A Signature o Licensed ~ Plumber or Gasfitter 2tSlSF' License Number TVOF 1IPCNCC- ' C=) r>Lr� cu eUs�z 11° • • Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. (e " (D5-1 171 Occupancy and Fee Checked 165 ` Ob [Rev.11/99] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 SE PRINT ININK OR TYPE ALL INFORMATION) Date: 6/14/2005 City or Town of: YARMOUTH, MA To the Inspector of Wires: tt s application the undersigned gives notice of his or her intention to perform the electrical work described below. ca i ion (Street & Number) 121 CAMP ST., UNIT 138 vn i r or Tenant GATEWAY HOMES, INC. Telephone No. Address Is th permit in conjunction with a building permit? Yes X No ❑ (Check Appropriate Boa) Puff se of Building RESIDENTIAL Utility Authorization No. 1454292 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 Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures (Paddle) Fans No. of Ceil: Susp . le r o Total Transformers KVA No. of Lighting Outlets 8 No. of Hot Tubs Generators KVA No. of Lighting Fixtures 8 Swimming Pool Abodve ❑ I rnd. ❑ BatteryUni sency tg ing No. of Receptacle Outlets 30 No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches 10 No. of Gas Burners o. o Detection and Initiating Devices No. of Ranges 1 TotU- No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals:. _ um.__er � ons____ _ " o. oSelf-Contained Detection/Alertino Devices 6 No. of Dishwashers 1 Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers 1 Heating Appliances KW Systems: Sec No. of Devices or Equivalent No. of Water 5 Heaters 1 KW 4. o. o o. o Signs Ballasts Data Wiring: No. of Devices or Eciurvalent No. Hydromassage Bathtubs No. of Motors Total HP o i valent OTHER Attach additional detail if ed I��{s tjeg,4iZ"t5th # ector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the perf n e o e ectnc wor issue unless the licensee provides proof of liability insurance including "completed operation" verage or its substantial equi alent. The undersigned certifies that such coverage is in force, and has exhibited proof of same CHECK ONE: INSURANCE X BOND ❑ OTHER ❑ (Specify:) 10/31/2005 (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains andpenalties of perjury, that the information on this application is true and complete FIRM NAME: PATTON ELECTRIC, INC. /% 112, LIC. NO.: A 15542 Licensee: RICHARD PATTON Signature /1 /%!e (Ifapplicable, enter "exempt" in the license number line.) Address: PO BOX 1525, MASHPEE, MA 02649 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the list required by law. By my signature below, I hereby waive this requirement. I am the (check Owner/Agent L Signature Telephone No. [ (/ LIC. NO.: Bus. Tel. No.: 508-539-0200 Alt. Tel. No.: 774-353-6878 r insurance coverage normally ) M owner n owner's agent. PERMIT FEE: $125.00 7J� BY • Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. C—M— LF3 Occupancy and Fee Checked ( 0 •Ji 111991 ve blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All wadtto be pedamed in accordance withthe Massachusetts Electrical Code (MEC), 527 CMR 1100 (PLEASEPRINTININKORTYPEALLINFORMATl01D Date: � )zp of eigwr Town of: YARI`�[T111 To the Inspector of Wires:.' tap licai1dn the undersigned gives notice of his or her intention to perform the electrical work desonbed below. tion (S_tr4�& Number) NIILL PONDyniAGE, 121 Carte St Bldg # 1 3 `6s JW16ant Gatewood Homes/ Jeff Sollows TelephoneNo.508-7789669 I Zwner+s ress 1600 Fa]mouth Rd., Suite 25, Centerville, Ma. 0263.2 G u �n unction with a building permit? Yes X No �� P J g P ❑ ❑ (Check Appropriate Box) of Building single 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 Work: Fire Alarm System (low voltage control panel) with ba .ham battery- centrally monitored . . Coconut&on ottht fallawine rablt may bt iwiivdl by the limncrir �I'rv:... No. of Recessed Fixtures No. of Cell-Susp. (Paddle) Fans INO., of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool d a d. g BatteryUnits No. ofRemptade Outlets No. of Oil Burners FIRE ALARMS No. of Zones 7 No. of Switches No. of Gas Burners No. of Detection.an 7 Initiating Devices No. of Ranges No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers t ump Totals: um er. ons JKW No. oSelf-Contained Detection/Alertin Devices 7 No. of Dishwashers Space/Area Heating KW Local ❑ unie,p ®Other Connection .., No. of Dryers Heating Appliances KW eeuntysystems: No. nunevires orEquivalent No. of Water KW Heaters o. o al o Ballasts Si Data Wiring: No. of Devices or uivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunicationswiring-, No. of Devices or uivalent OT1YR• ' A a,en aamaanat aerar[ tjdestred or as required by thelnspeemr cfWira. 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. CHEMONE: INSURANCE ® BOND ❑ OTEM ❑ (Specify:) Estimated value of Mectrical Work $750. 00 ' cpiration Date) (When required by mlmitipal policy) Work to Start Inspections to be requested in accordance with NIEC Rule 10, and upon completion. I ��, under the pairs and penes of perjury, that the information on this appUcation is rice and compida FIRM NAME: Baltic Security, Inc LIC. NO.n 1178C Licensee: Jonas R Bielkevicius Signature -� ^ LIC. NO. 49 D (Ifapphimble, etster "esanpt" in the ftcensenamye .line Bus Tel. No.• 508-833-0996 Addriss: PO Box .1609 Sa idw>_c , 02563 Alt Tel. No. • 508-7 —3 7 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/Agent ❑ owner's agent. Signature. Telephone No. PERWTFEE: $ 40.00 OF, 1• TOWN OF YARMOUTH Building Department BUILDING (508) 398 2231 ext.261 PERMIT PERMIT NO B-05-1040_ ISSUE DATE ; _ 3/10/2005 _ ; PROPOSED USk; - - - - - JOB WEATHER CARD APPLICANT -Frank Capra _ ---------------------- P ERMIT TO ; New Construction ' AT (LOCATION) 100121CAMPST#138 ZONING DISTRIC R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C138 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE new construction: Affordable unit - 2 baths, 3 bedrooms, 1 kitchen, 1 laundryroom, 1 livingroom REMARKS as per plans dated 02/09/05 & BOA # 3546.. CONTRACTOR LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 AREA (SO FT) EST COST ($ 1$117,024.00 PERMIT FEE ($) $0.0U Centerville MA 02632 OWNER lVillages 0 Camp Street, LLC LDING DEPT BY 5087789669 ADDRESS 1600 Falmouth Road # 25 Centerville I MA 102632 Certificate Issue Date (�` ,{, Q� a o �� ''--CERTIFICATEof-OCCUPANCY;_ Departmental Approval for Certificate of Occupancy and Compliance rne"nMnr nato Permit Number Aooroved By Remarks BUILDING ELECTRICAL 1%I ' To be filled in by each division indicated hereon upon completion of its final inspection. TOWN OF YARMOUTH Building Department BUILDING (508) 398-2231 ext.261 -- ►- PERMIT NO B-05-1040 _ � PERMIT aK ISSUE DATE ; _ 3/10/2005 _ ; PROPOSED US _ . _ _ _ _ - - - - - JOB WEATHER CARD APPLICANT Frank Capra _ _ _ _ _ _ _ ----------- PERMIT TO ;New Construction- ; AT (LOCATION) 100121CAMP ST # 138 ZONING DISTRIC R-25 Bldg. Type: Residential SUBDIVISION MAP LOT BLOCK 044.21.1.C138 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE I CONTRACTOR new construction: Affordable unit - 2 baths, 3 bedrooms, 1 kitchen, 1 laundryroom, 1 livingroom REMARKS as per plans dated 02/09/05 & BOA # 3546.. nooe ien FM EST COST ($ $117,024.00 PERMIT FEE OWNER Villages @ Camp Street, LLC ADDRESS 11600 Falmouth Road # 25 Centerville I MA 02632 BUILDING DEPT BY INSPECTION RECORD LICENSE 012430 Capra, Frank 1600 Falmouth Road #25 Centerville MA 02632 5087789669 FIELD COPY Date Note Progress - Corrections and Remarks Inspector - �- '27 r L�— �a c- r oS ►� /iJ��O� m!� TOWN OF YARMOUTH t Building Department Tam Hall YarrtwM, MA 02664. (505) 398-2231 Wd 261 BUDDING PERMIT TRANSMITTAL Temp Permit No.: T-05-391 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST # 138 Owners Name: Villages Q Camp Street, LLC Owners Addres 1600 Falmouth Road # 25 Centerville MA 02632 Owners Telephone: (508) 778-9669 REVIEWED BY: 1. WATER DEPARTMENT: 2. ENGINEERING 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: 1/31/2005 Comments: new construction: DATE: DATE: E WA: WA: 3. CONSERVATION: DATE: WA: 4. HEALTH DEPARTMENT: DATE: WA: 5. BUILDING DEPARTMENT' DATE: WA: 6. FIRE DEPARTMENT: DATE: WA: PLEASE NOTE COMMENTS: 044.21.1.0 RECEIPT OF COPY: SIGNATURE QF APPLICANT: �itcc.� A ca DATE: 3 Q o T Date Printed: 1/31/2005 r TOWN OF YARMOUTHc ? 0 Building Department ~ Town Hall YamMM, MA 026M (508) 3W2231 ext261 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05-391 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST # 138 Owner's Name: Villages @ Camp Street, LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02632 Owners Telephone: (508) 778-9669 REVIEWED BY: ✓1. WATER DEPARTMENT: ✓2. ENGINEERING DEPARTMENT: 3. CONSERVATION: �'5. HEALTH DEPARTMENT: BUILDING DEPARTMENT: 6. FIRE DEPARTMENT: COMMENTS: RECEIPT OF COPY: (OFFICE USE ONLY Recorded By: IC Permit Fee: $0.00 Deposit Rec: $0.00 Payment Type: Check ChkNo.: 0 Net Owed: $0.00 Application Date: 1/312005 Issue Date: Expiration Date Comments: 044.21.1.0 new construction: , - %�G��ar ZONING APPROVED _Q2 DATE: DATE: DATE: DATE: DATE: DATE: PLEASE NOTE SIGNATURE OF APPLICANT: WA: N/A: N/A: N/A: N/A: N/A: DATE: Date Printed: 1/31/2005 OONE & TWO FAMILY ONLY :%BUILDING PERMIT APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING oy y Town of Yarmouth Building Department 1146 Route 28 • Yarmouth, MA 02664-4492 'Al Tel: (508) 398-2231 x261 • Fax: (508).398-0836 ec$oTi ,#_ �o a_t3ri' Use Group: R-4 Type: 5-B 1.1 Property Address: 1.2 Zoning Information: 135- -L-P�Ggc- 3 Zoning District Proposed Use 1.3 Building Setbacks. (ft) Front Yard Side Yards Rear Yard Reauired I Provided Required I Provided Required I Provided 1.4 Water Supply (M.G.L. e.40. S 54) "oodZonO nfQmrar( amrnentsr�#a Public Private ectco. ,��P"A „e ��vv�ers,"P�;��iazrze�iAgerf' 2.1 OWne�o Record. (L L / / , l! bOL u,. N me atprintk r �] > Mailing Address LtCb, (" i/t l k*14 02. w _ 1 t 7i ..:I _O 4-1 �/ i . G'T� ir' '�7 -f Q c%� r Q 2.2 Autho0riz0et( Agent: LL / V" Ylo Name (pri ) f�0.+-� F a �0�""77 Mailing Address o g, — 6 b Sign phone;- I,t� � IS/aCP7S': ,h i alO11� �,b-"},.iOT1St C 3.1 Licensed Construction Supervisor. / ; 2005 u Not Applicable ElDL I License Number O ` O ✓�� ✓I O ddre I� � �[� piration Date d� Signature Telephone IIIII , 'm rn�I -o III -i Company LAdd 9-15-99 Telephone 1 of 2 oplicable ❑ License Number Exoirafion Date OVER /3F v�v.uvtdg-r x, rrv+x'F' aP ;".yua"3#.rcHi1iUElYtI°!7 Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial f the issuance Of the building permit. Signed Affidavit Attached Yes ...-.-.... No .......... I New Construction !3 I No. of Bedrooms I Nn- of Rathrnnmc I Existing Bldg. ❑ Repair(s) ❑ Alterations ❑ Addition ❑ Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: Item Estimated Cost (Dollars) to be completed by permit applicant 1. Building O a 2. Electrical 3. Plumbing / Gas p 7 4. Mechanical (HVAC) p yn 5. Fire Protection o 6. Total = (1 + 2 + 3 + 4 + 5) 7. Total Square Ft. (new houses&additions) I Check Below ❑ Conservation -Commission Fling (if applicable) ❑ Old Kngs Highway& Historical Commission approval (if applicable) hereby authorize fN1-113 a e t .a. ( o m beh , in all matters elative to work authorized by this building permit ppl'c r Signature of Owner ..eel of the subject property to act on 4—O Date as Qwner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. lN I l ( kao.,,,, N — Print aMe / Signature of Owner/Agent 9-15-99 2of2 , Date 104 M uol-v4 TOWN OF YARMOUTH r BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT. Job Location: _ Owner of Property: Construction Super Address: (-0 00 Licensed Designee: (If other than Supervisor) Name 2.15 Responsibility of each license holder: License No. 2.15.1 The license holder shall be fully and completely responsible for all work for which he is'supervising. He shall be responsible for seeing that all work is done pursuant to the state building code and the drawings as approved by the building official. 2.15.2 The license holder shall be responsible to supervise the construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of building and structures only pursuant to the state building code and all other applicable laws of the commonwealth, even though he, the license holder, is not the permit holder but only a subcontractor or contractor to the permit holder. 2.15.3 The license holder shall immediately notify the building official in writing of the discovery of any violations which are covered by the building permit. 2.15.4 Anylicenseewho shallwillfullyviolate subsections 2.15.1, 2.15.2 or 2.15.3 or any other section of these rules and regulations and any procedures, as amended, shall be subject to revocation or suspension of license by the board. 2.16 All building permit applications shall contain the name, signature and license number of the construction supervisor who is to supervise those persons engaged in construction, reconstruction, alteration, repair, removal of demolition as regulated by section 109.1.1 of the code and these rules and regulations. In the event that such licensee is no longer supervising said persons, the work shall immediately cease until a successor license holder is substituted on the records of the building department. 2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may be deemed a.violation of the permit conditions. I have read and understand my responsibilities under the rules and regulations for licensing construction supervisors in accordance with section 109.1.1 of the state building code. I understand the construction inspection procedures and the specific inspection as called for by the building official. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.152 Yes IR( No ❑ If you have checked y.�s, please indicate the type coverage by checking the appropriate box.' A liability insurance policy 31-� Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE W VER: I am aware that the licensee does not have the insurance coverage required by Chaptpr-f52�of the ass.dneral Laws, and that my signature on this permit application waives this requirement. Check one: of Owner or Owner's Agent Owner ❑ Signature: Building Official Approval: ON The Commonwealth of Massachusetts Department of Industrial Accidents 0117ce o/lerestlOstliis 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit I am a homeowner performing all N4rk myself. I. am a sole proprietor znd ha%e no one working in any capacity I am an employer pro% iding workers' compensation for my employees working on this job. company name* address - city: nhone 0- insurance co. _ nnLicv #_ C9/1 am a sole proprietor. general contractor. or homeowner (circle one) and have hired the contractors listed below "ho ha%e city phone M• insurance co ooliev k company name: Failure to secure coverage as required under Section 25A of MGL is2 can lead to the imposition of erimiaal penalties of a fine ap.to S1,5o0Aa and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER ands fine ofSIMM s day against ese. I anderataad'that a copy of this statement may be forwarded to the Ofnee of investigations of the DIA for coverage verifieadoa. l do hereby certif}girder the Print name that the information provided above is true and tareei Date X zZ�/r- 10-4 phone N t rt %70 lr 11��1i atrcial use only do not write in this area to be completed by city or town official city or town: YARMOUT$ _ permiNicense it rlBuilding Department pl.icensing Board check if immediate response is required 261 QSeleetmen's Office C3Heaitb Department contact person: phone p: _ (508) 398�2231 ext. mother BUILDING TOWN OF Y A R M O U T H ELEcrRICAL GAS 1146ROUTE28 SOUTHYARMOUTH MASSACHUSETTS02664-4451 PLUMBING Telephone (508) 398-2231, Ext.261 — Fax (508) 398-2365 SIGNS BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT 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�� GoAA(po Work AAress is to be disposed of at the following location:(�►V1s� Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. D Signature of Applicant Date Permit No. r ✓%Toon�mm�uxa o �iaaaaciu�aefta BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR ' jr Numbe,18Cs 012430 w BIrtF�i 06Li€i%1940 e: E1�r�s�umut T'dOQ6. Tr_ no:2592fi FRANKG CA. 40`COPPERLN CENTERVILLE. MA �'1632� Commissioner a . 00 - 35,000 d enclosed space (MGC CA 12 S.60L) 1A - Masonry only 1G - i. & 7Family Homes Failure to possess a current.edition of the !i Massachusetts State.. Building. Code is cause for revocation of this license. ? i DIG SAFE CALL CENTER: (888) 344-7233 i 0 LAB/b`J/'Lbb4 kTy:lI tjf f_j Is-01(4 ,JUrV`I 1..RLJWLGT rrnac uAi Ul . T T DATE IMMIODLYYj_... CRORe CERTIFICATE OF LIABILITY INSURANCE aalaanoad 978-394 2253 DIRECT THIS CERTIFICATE IS ISSUED AS- A. MATTER OF INFORMATION PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE -- END OR ATLANTIC INSURANCE GROUP, INC. HOLDER. THIS CERTIFEIGAA E DDOOEESS B0 THE END, EEXS ELGW. AIP LLC ALTER. - COVERA6 365 BOSTON POST ROAD PM13203 INSURERS AFFORDING COVERAGE SUDBURY,MA 01776 "' — — --• -- '�- —' "-" • �-- IwsuRER A: NATIONAL FIRE & MARIN __... INSURED___— .-- - E-S CC .. ._.. _ INSURER B: MA WORKEROMP, RESEARCH.BRD ;.--•• __... GATEWOOD HOMES INC. INSURERc: _ _ _ __.._ --_ -.-.•- - -_ --• --- 1600 FALOMOUTH ROAD I INSURER D: _. _.-_ ---• ...._- —__ ...-_-.. CENTERVILLE MA 02632 OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSVRED OF ANY CONTRACT OR OTHE HEREIIN NAMED ABOVE TH SUB FOR THE POLICY RESPECT TO WHICH THIS CERTIFICATE MAY TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS Be LSSUSO OR OF SUCH ANY THE INSURANOR CE AOFFNDITION ORDED BY THE POLICIES DESCRIBED S EIC7 MAY PEA""RAIN POLICIES. AGGREGATE LM117S SHOWN MAY NAVE BEEN REDUCED BY PAID I PoLi FFYEf41VE PCitCY FJ{61RLigNr LmArm S.�__ ^ -TYPE OF INSURANCE � xx ll POLICY NUMBER I t EACH OCCURRENCE - 1 _ —. �QQQ GENERAL LIABILITY 7Z LPE 691943 I ,4129104 4129105 FIRE DAMAGE (AFY ono �"?:• 3_.._50000••: A I_X I C( MMERC Al GENERAL IJAB UTY MADE X OCCUR I MEO EKP IMV eA �»rN A) . 3 n�1,0�,0� 1 I t/W000 CUW4 - PERSONAL A AOV M_ JURY GENERALAGGAEGATE _- E' _20_000M _—t000000 ,_ - tPRODUCT3•WMPAPAG+T -"- - S ._ _ - • -- _„ LGENT. AGGREGATE LIMIT APPLIES PER: I -- I PRO.. LOC I PCLICY _.. T COMBINED SINGLE UNIT y �AVTQMJDILE LIABILITY I (Es etxl0oA1) fIANY AUTO I - I ( IALLOWNED AUTO$ 'BODILY I{For INJURY pononl y SCHEDULED AUTO$ • MINED AUTOS I 1 GOLLY HAIRY (for ...:.en0 ... _..... NCN-0WNED AUTOS .- . PROPERTY DAMAGE . ____._ I y i (Pet ecdMd) 1 I , AUTO 07-EAACCIOEN- •_. __... EA ACC OTHER THAN S __-• f ... —.. __ OARAG:-LIABILITY I� :I ANY AUTO I AUTO ONLY: AGG •.3 iI EACH OCCURRENCE f WBILR'! AGGREGATE s ... ' OCCUR L.__ I CLAWS MADE I (DEDUCTIBLE ..I. .. -_.___ ._-... .. ._.--.... S • F_. RETENTION f TV• WORKERS COMFENSATION AND POLICY UPDATE NUMBER TBI 814/04 8/d/05 I E.L. EACH ACCIDENT B I EMxDYER3'UABIuTY _— I�t•E.L. DISEASE•EA EWIDrE t 500000 I E.L OISEASE • POLICY uMl7 S 5aaB00 PECTAL PROVISIONSDESCRWTOH OF OPERATIONLLOOAE TOWLVENN;Lg 71DLO!IONS ADDED BY ENDORZEMENT1S PROJECT: MILL POND VILLAGE (VILLAGES AT CAMP ST. LLC - DBA) TOWN OF YARMOUTH BUILDING DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 60 DAYS WRITTEN NOTICE TO THE CERTIFICATE HO/Lpp(}y' MED 10 THE LEFT, BUT FAILURE TC• DO 90 SNALL (LOOSE NO ONJGATION OR LYNLM •f ANY KING YPON THE INSURER, ITS AGENTS OR AUTHORIZED 7 elan . �/gp yp�, ryp_y�-,_ y{{y � •1 /�,� ACORD 1. CERTIFICATE.a F LIABIL Ii 9 INSURANCE. /DATEIMfVDDYY) �J 7-1 /1l3 PRODUCER ' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION � A. (,mil lbsLu ame ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. H1Y 337 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1Jcew-!cam s-{iwJ��7�u:tYP.f+�:7 INSURED 9*09 •` I a '• b•SI COVERAGFS INSURERS AFFORDING COVERAGE INSURER A_`"le PI'[" dd-, 3ce- �]- Fir-a_TLs- (b I INSURER B_ SSMIEE i INURER C: ' IINSURER D: ' THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY -PERIOD INDICATED. NOTWITHSTANDINC ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OF MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCF POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR% - �....' _. ___. .. _. ._..._._. i TR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE ! DATE tu1M/DDNV .. _ POLICY EXPIRATION � DATE(MMIDD/YYI LIMITS ... GENERAL LIABILITY i EACH OCCURRENCE S WV jCOMMERCIAL GENERAL LIABIUTY I I :FIFE DAMAGE (Ane %ve) 5 y on ---._-_ .... C�ry/Wy�� 0 i CLAIMS MADE jXlCj OCCUR I1 i i-- ME_D EXP (Any one person) 5 .-Xs� �1 .. I PERSONAL & ADV INJURY 5 i GENERAL AGGREGATE ---5 A 1 - 21 ��. A ; GEN'L AGGREGATE LIMIT APPLIES PER: GO 0005933 04 10-05-M I � r PY ROODUCTS • COMP;OP AGG j S I.._ 2 �0 I POUCY j I JFo- CT _ I 1 1- t.__. _. AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT ANY AUTO (Ea acdtlen[) .— I ALL OWNED AUTOS I BOdfIY INJURY '$ I SCHEDULED AUTOS I i I (Per Person) HIRED AUTOS NON -OWNED AUTOS i I ++ i BODILY INJURY : 5 (Per accident) .. .. .. .._ ._.__.I I PROPERTY DAMAGE (Per acwent) I $ ` GARAGE LIABILITY - j- I AUTO ONLY • EA ACCIDENT ! 5 . ANY AUTO i OTHER THAN - EA ACC j $ —_ _ _ . __ I I AUTO ONLY: AGG i S _ 1 EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE ( _ --r I AGGREGATE 5 i I DEDUCTIBLE I RETENTION $ I I S WORKERS COMPENSATION AND I I EMPLOYERS' LIABILITY I i �-- WC T I T 1 TORS ITS +------- EACH ACCIDENT is 100,000 04-01-04 04-01-05.E.L DISEASE_ EA EMPLOYES_ �001000 B 1 WM OM6 I `E.L I E.L DISEASE. POUCY LIMIT j S 1 OTHER I I I i I DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECU\L PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION GAmood ibrm1 mi:. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOt 1600 Fdlmitl r DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _ DAYS WRRTEF afL1E 25 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALI lb.Fmt.:l T.. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OF "-"�'�`'�-'�I •• REPRESENT ES. �q AUTHOR R RESE AT V9 �: 5W. M.56M L ACORD 25-S (7197) 0 ACORD CORPORATION 198 c'+.a.�urwlYl.Ct,U ACORD� CERTIFICATE OF LIABILITY INSURANCE DATE(MDDm R 08/02/04 DOWling 8r'O' Nei! Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ' . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 222 West Main St. PO Box 1990 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis, MA 02601 INSURED INSURERS AFFORDING COVERAGE NAIC # Assurance Construction, Inc. INSURERA: Nautilus Insurance Company A/O Assurance Excavation, Inc: INSURER 6: 550 Willow Street INSURERC: West Yarmouth, MA 02673 INSURER D: INSURER E: THE POLIOIFR rw Inicl ........... ——__.— _. ABOVE FOR ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TOHWHICH HIS CERTIFICATE MAY BE ISSUED OR THSTANDING 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 NUMBERPOLICY EFFECTIVE POLICY EXPIRATION A GENEPAL LIASILIT'Y NC289301 DATE MM/D DATE MMIDD/YY LIMITS .09/08/03 . 09/08/04 EACH OCCURRENCE $1 ODO 000 X COMMERCIAL GENERAL LIABILITYDDAAMAGE TO RENTED CLAIMS MADE Q OCCUR PR I Ma Q=E1 OO OOO X BI/PD Ded:1,000 MED EXP (Any we Person) $5 000 PERSONAL 8 ADV INJURY s1 _ nnn nnn LIMIT APPLIES PER CT F LDC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND _ EMPLOYERS' LIABILITY ANY PROPP.IETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? "yes. describe under 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 COMBINED SINGLE LIMIT S (Ea ae ,dent) BODILY INJURY (Per person) $ BODILY INJURY (Per axldent) - $ PROPERTY DAAN (Per accident)AUTO ONLY-EOTHER THANAUTO ONLY:EACH OCCURR S SNUULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR AUTHORIZED ACORD 25 (2001/08) 1 01 2 #35194 - —�_ JV © ACORD CORPORATION 1988 l J•ax server e az> x A1:®1:11. }��I 5 $ DATE (M w 3 oa o4DoYn ................... ?.....>.�r .. ..a.� >.»>.a x> ..n»ro...• ...>. xa ,..... .. f s,.a., :• ,.zs.....1 s ,?....:� - - 4 PRODUCER THIS CEHTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY. AND CONFERS NO RIGHTS UPON THE C-EFFFIFiCATE. EMPLOYERS INS GROUP-INC _ HOLDER. THIS CERTIFICATE DOES -NOT AMEND EXTEND OR 261 MAIN ST ALTER THE COVERAGE AFFORDED BY -THE POLICIESI BELOW. STE 5 FITCHBURG MA 01420, COMPANIES AFFORDING COVERAGE COMPANY 76HCK A ROYAL INSURANCE COMPANY OFAMERICA INS UR COMPANY. RESOURCE MANAGEMENT INC .B 2"01 MAIN STREET SUITE 5 FITCHBURG MA 01420 COMPANY C �SS U r'a..i1 � �jCCc+_V cL� or'► COMPANY D COVERAGES.. r - THIS M.TO.CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED.TQ.THE INSURED NAMED ABOVE FOR THE-POLK7C.PERtQCL 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 TYPEOFINSURANCE POLICY NUMBER POLICY EFFECTIVE DATEIMMLDD.YY) POLICY EXPIRATIONLTP DATE(MMWOLYY) LIMITS GENERAL UASIUTY - GENERAL AGGREGATE $ PRODUCTS.COMP/OP AGG. $ COMMERCIAL GENERAL LIABILITY- CLAIMS MADE =OCCUR � m PERSONAL 6 ADV. INJURY i EACH OCCURRENCE S -OWNER'S & CONTRACTORS PROT. FIRE DAMAGE (Any one fire) S MED. EXPENSE (Any one person) S AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALI OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) S HIRED AUTOS NON -OWNED AUTOS BODILYINJURY (Per Accident) i PROPERTY DAMAGE S GARAGE U70UTY - AUTO ONLY. EA ACCIO ENT $ ANY AUTO OTHER T14AN AUTO ONLY: s:::,:, as <:Va:;� EACH ACCIDENT S Pi AGGREGATE i EXCESS LIABILITY EACH OCCURRENCE S UMBRELLA FORM AGGREGATE S OTHER THAN UMBRELLA FORM A WORKERSCOMPENSATIONNAND EMPLOYER'S LIABILITY (UB-967X499-9-03) 11-20-03 11-20-04 STATUTORY LIMITS - , s100„0no EACH ACCIDENT 5 THEPROPRIETOR/ PARTNERSIEXECUTIVE X INCL OFFICERS ARE: EXCL OTHER _ DISEASE- POLICY LMIT S So0 000 DISEASE -EACH EMPLOYEE i 100,000 OESCRIPTION OF OPERATIONS/LOCATION&VEWCLESFRESTRICTIONSSPECJAL S COVERS EMPLYS LEASED TO ASSURANCE-EXCAVA- TORS 55D'VITILLOW ST W YARMOUTH MA 02673 THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. M. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE , GATEWOOD HOMES, INC. ATT:PAULA 1600 FALMOUTH ROAD -SUITES 25 EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDEAWAMED-ro-rn, LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR CENTERVILLE MA 02632 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES: AUTHORIZED REPRESENTATIVE '��R�'�J ,J.^�.•'{�Q�}. � � �R 5. ••�, YL cx.S a.c.� .^�,ry ct x;�n.:.;..hr. f < ... a ..n�� mbC�.Il4i�i5-�.�f•1T�iiii�Shf10O`t ' ACORP CERTIFICATE OF LIABILITY INSURANCE DATE(MMMDNYYY) 08/02/2004 PRODUCER (50&)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. P.O. Box 79398 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. N. Dartmouth, MA 02747 INSURERS AFFORDING COVERAGE NAIC # INSURED R 3 Bevilacqua Construction PO BOX 628 Forestdale, MA 02644 INSURERA: Arbella Protection Insurance INSURER B: JNSURER Ci INSURER D: INSURER E: rnvronr_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 MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD1 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE (MMIDQfYY1 07/15/2004 POLICY EXPIRATIONDATE ' 07/15/2005 UNITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR X Special Form 8500018147 EACH OCCURRENCE $ 1,000,00 i DAMAGE TO RENTED $ 50,00 MED EXP (Any one person) $ 5,00( PERSONAL B ADV INJURY S 11000100 GENERAL AGGREGATE $ 2,000,00( GEWL AGGREGATEPLIRa APPLIES PER POLICY JECT 7 LOC PRODUCTS-COMP/OP AGG S 21000,00 AUTOMOBILE LIABILITY ANY AUTO 86852400001 02/21/2004 02/21/2005 COMBINED SINGLE LIMIT (Ea accident) S ALL OWNED AUTOS A SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per person) $ 250.000 X X BODILY INJURY (Per accident) S 500,00 X PROPERTY DAMAGE (Per accident) S 500, 00 GARAGE GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ANY AUTO' THAN. EA ACC $ AUTO ONLY: AGG $ EXCESSNMBRELLA LIABILITY OCCUR CLAIMS MADE - EACH OCCURRENCE $ AGGREGATE $ S DEDUCTIBLE $ RETENTION S $ WORKERS COMPENSATION AND 9088680402 04/27/2004 04/27/2005 X WC STATU- OTH- EMPLOYERS* LIABILITY E.L. EACH ACCIDENT $ 100.000 A ANY PROPRIETORIPARTNEROEXECUTIVE OFFICERIMEMBER EXCLUDED? H yes, describe under SPECIAL PROVISIONS below E.L.DISEASE - EA EMPLOYE S ZOO OO , E.L. DISEASE -POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS For any and all operations performed during the policy period. Gatewood Homes Inc. 1600 Falmouth Rd Ste 25 Centerville, MA 02632 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WALL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Pauline Desrosiers ACORD 25 (2001108) CORPORATION 1988 ACORD, CERTIFICATE OF LIABILITY INSURANCE. osiu9j2 0 PRODUCER (508) 994-9688 FAX (508) 991-5461 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION RUTKOWSKI & KESLrENBAUM 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 PO Box 664 West.Hyannisport, MA 02672 INSURER A: INSURER B: INSURER Q INSURER D: INSURER E Co 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. ILTRNSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM POLICY EXPIRATION DA MMID , LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL UABILf1Y CLAIMS MADE O OCCUR CPPOO53131 01 12/13/2003 12/13/2004 EACHOCCURRENCE $ 1,000,0( FIRE DAMAGE (Any one fire) S 50,0 MED EXP (Any one person) $ 5,0( PERSONAL & ADV INJURY S 1,000,0( GENERAL AGGREGATE S 2,000,OC GENL AGGREGATE LIMIT APPLIES PER POLICY j� 0LOC PRODUCTS - COMP/OP AGG $ 2,000,010 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-0WNED AUTOS CBXE4812S ' .... _.._ _...._- 02/14/2004 02/14/2005 COMBINED SINGLE LIMIT (Ea accident) S (Perperso)DILY S 250,0 X BODILY INJURY (Per accident) S 500,00 PROPERTYDAMAGE (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 FICLAIMS MADE DEDUCTIBLE RETENTION S EACH OCCURRENCE $ AGGREGATE S S $ $ C WORKERS COMPENSATION AND EMPLOYERS LIABILITY GS59UB86lX751604 03/22/2004 03/22/2005 I TORYLIMITs ER EL EACH ACCIDENT S 500.00 EL DISEASE- EA EMPLOYEE S 500,004 EL DISEASE. Pot S SOO OOI OTHER DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER L I ADDITIONAL INSURED; INSURER LETTER CANCELLATION Gatewood Homes Inc 1600. Falmouth Rd Ste 25 Centerville, MA 02601 FAX: (508)778-5603 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEL I BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO/OBLIGATION OR LIABILITY OF ANY KkRrVPSAi71SCOMPANY. ITS A6ENis O /ROLFYrAl . ACORD. CERTIFICATE OF LIABILITY INSURANCE • PRODUCER 508-398-6033 FAX 508-760-1667 THIS CERTIFICATE IO8/09/2004 S ISSUED AS A MATTER OF INFORMATION Eastern Insurance Group LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1 Atlantic Ave HOLDER. THIS CERTCATE DOES NOT AMEND, EXTEND OR So Yarmouth MA 02664 ALTER THECOVE RAGIFIE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC 0 IruuREe Cape Cod Custom Floors wSURERA: Arbelia Protection Ins Company 702 Falmouth Road INSURER Hartford Hyannis MA OZ601 w'URERC: INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANDIN ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE LSSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONSOFSUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS_ INSR DD' ME OF INSURANCE POLICY NUMBER POLICY EFFECTNE POLI Y EXPIRATION LIMITS M TY 750000037312/13/2003 12/13/2004 EACHOCCLRRENCG s CONMERCIAL CGNGRAL LIABILTry r; OIIO; DAMAGE TO RENTED S SO, DD 01 A GLNMS M,DE O OCCUR MEO EXP (AnY ona pm on) S s GENL AGGREGATE LIMIT APPLIES PEF POLICY n JEGT n LOC AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE UABILTT 7 ANY AUTO EXCEBSNMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETEWON S WORKERS COMPENSATION AND EMPLOYERS• LIABILNY B ANYPROFRIETORIPARTNERO(ECUTIVE OFFICERIMEMBER EXCLUDED? I EXCLVSIONS PERSGNAL S AOV euURY s 1,000,00 GENERAL AGGREGATE S 2, AAA OOO PRODUCTS -COMMI, AGG J _ nnn nnn COMBwEDSINGLELIArr IGa acddalN) S BODLY INJURY (PW Pa ) S NJURY d,,) E TY OAMAGEo) $ AUTO ONLY -EA ACCIDENT S OTHER THAN EA ACC AUTO ONLY: AGO S S EACH OCCURRENCE S AGGREGATE S S S aE.L GCHACGDENT s 500,000 EJ_ DISEASE . EA EMPLOYE S 500 , 000 dence of Insurance for work performed within the Insured's scope -of normal operations Gatewood Homes 1600 Falmouth Road *2S Centerville, MA OZ632 ACORD 25 (2001108) FAX: (508)778-S603 SHOULD ANY OF THE ABOVE DESCRIBED POLIMES BE CANCELCED3EFORETR2 — EXPIRATION DATE TTIEREOF, THE ISSUING INSURER WALL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE NDLDER I%AMElfi9THE-♦:m- BUT FAILURE TO MAUL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY (DACORD CORPORATION 1988 A'CORQ . CERTIFICATE OF LIABILITY INSURANCE 8/2/2200 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 POLICIES BELOW. Osterville, Ma. 02655 508-420-9011 INSURED Casperson Overhead Doors Box 517 East Falmouth, MA 02536 508-563-5633 COVERAGES INSURERS AFFORDING COVERAGE NAIC# INSURERA: Worcester Insurance Company INSURERB: National Grange Mutual INSURER C: INSURER D: INSURER E THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO, THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. wSR LTR D-L IMRD TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE DATE MM/DD POLICY EXPIRATION DATE MM/DD LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMSMADE OCCUR CB 2J1973 05/28/04 - 05/28/05 EACH OCCURRENCE S 1 OOO 000 PREMISES 19=LU ce S 100,00 MED FRCP (Anvanelaon) S 10,00 PERSONAL& ADV INJURY S 1,000,000 GENERAL AGGREGATE i 2,000,000 GEWL AGGREGATE LIMIT APPUM P - POLICY PEO- LOC PRODUCTS-COMP/OP AGG S 2,000,000 AUTOMOBILELIABILRY ANYAUTO ALLOWNEDAUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS - J - COMBINED SINGLE LIMB (Ea accident $ BODILY INJURY (Pffpx at) S BODILY INJURY (Pwacciden[) $ PROPERTY DAMAGE (Pwacadwt) S GARAGE LIABILITY ANYAUTO _ AUTOONLY-EAACCIDENT S OTHERTHAN EAACC AUTOONLY: AGG $ S EXCESSIUMBRELLA LIABILITY OCCUR CLAIMSMADE DEDUCTIBLE RETENTION EACH OCCURRENCE S AGGREGATE S S S B WORKERS COMPENSATIONAND EMPLOYERS'LIAARrNeRreJCEcvrrvE LIABILITY aNY xtoPwrrOR�aux OFFK:ERUEMBER EXCLUDED? Nyes,descdbeundw SPECIAL PROVISIONS below - CP48352 02/22/04 02/22/05 ITATI X TORYLAIITS ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEJ S 500,000 E.L. DISEASE -POLICY LIMIT S 500,000 OTHER DESCRIPTION OF OPERATIONS LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Gatewood Homes, Inc. 1600 Falmouth Rd., Ste. 25 Centerville, MA 02632 ACORD25 (2001/08) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 3E 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 LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR AUTHORIZED C ACORD CORPORATION 1988 i ACORD�, CERTIFICATE OF LIABILITY INSURANCE DATE06/I IYYYy 1106//200; PRODUCER (508) 790-1919 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Sandpiper Ins. Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND," EXTEND OR 12 Enterprise Road ALTER THE'COVERAGE AFFORDED BY THE POLICIES RFI nW Hyannis MA 02601- INSURERS'AFFORDING COVERAGE NAIC # INSURED INSURER AZurich Small Construction CENTURY PAINTING AND DRYWALL,INC CENTURY PAINTI INSURERS PO BOX 2903 au L0 L , o«hp� AINSURER C: , INSURER D: HYANNIS MA 02601-7903 INSURERS CnVFRAl:FS THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO. MTHSTANDING AN` REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTOALL THE TERMS, EXCLUSIONS ANC CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD'L INSRD TYPE OF INSURANCE POUCY NUMBER POLICY EFFECTIVE DATE (MM/DD/1Y) POLICY EXPIRATION DATE (MMIDDIYY) LIMITS GENERAL LIABILITY / / / / EACH OCCURRENCE S 1,000,00 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE ❑OCCUR SCP034309873 12/18/2002 12/18/2003'. DAMAGETORENTED PREMISES aoccurrence S 300,00 MED EXP (Any one person S. 10,00 PERSONAL& ADV INJURY $ 1,000,00 GENERAL AGGREGATE S 2,000,00 GENT AGGREGATE LIMIT APPLIES PER POLICY JJEEC 7 LOC PRODUCTS-COMP/OPAGG S 2,000,00 AUTOMOBILE LIABILITY ANY AUTO / / / / COMBINED SINGLE LIMIT (Ea accident S ALL OWNED AUTOS SCHEDULED AUTOS / / / / BODILY INJLRY (Per person) S HIRED AUTOS NON -OWNED AUTOS / / - / / BODILY INJURY (Per accident S PROPERTY DAMAGE (Per accident S . GARAGELUIBILITY AUTO ONLY -EA ACCIDENT S ANY AUTO I I I I OTHER THAN EA ACC $ AUTO ONLY: AGO S EXCESSfUMBRELLA LIABILITY / / / / EACH OCCURRENCE $ AGGREGATE S OCCUR ❑ CLAIMS MADE S -. DEDUCTIBLE' S RETENTION S WORKERS COMPENSATION AND EMPLOYERS LIABILITY TORY LIMITS ER E.L. EACH ACCIDENT S ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERMIEMBER EXCLUDED? If yes, describe under E.L. DISEASE- EA EMPLOYEE S EL DISEASE- POUCY UMIT S SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS .. - PAINTING 6 DRYWALL CERTIFICATE HOLDER CANCELLATION ( ) - (508) 778-5603 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT GATEWOOD HOMES FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE 1600 FALMOUTH RD SUITE 25 �c11RCR rre er: cure nR RrEo2ee.R.rn.ee ACORD 25 (2001/08) fkINS025 (D1Del.o5 ELECTRONIC LASER kORMS,.JAC. - (800)327-0545 ® JORD CORPORATION 1981 Page 1 of: ORP CERTIFICAT'I= v0P ttAU-jLt T Y-r fZA-T_ PRODUCER THIS CERTIFICATE IS ISSUED AS. Sullivan, Garrity & Donnelly ONLYAND CONFE- IS NO RIGHTS 108Institute HOLDER. THIS TWICATE DOE Institute -. PO 15010 ALTER THECOVEFAGEAFFOROE qO Worceatez MA 01615-0010 — MA 01 10 Phone:5D8-754-1767 Fas:508-754-1885 INSURERS AFFORDII INSURED ' _ INBURERA; Hanovir Insurar ' Crowell COnstzuction, Inc. INSURERS: Arch in,Burance INSURERox MA 02660 INsuRER0: C0VFRAr=Q INSURER E, — DP m A DATETMFvon�YYYYI CAOWC _0 08 09 04 A MATTER IX INFORMATION - UPON THE CERTIFICATE S NOT AMEND, EXTEND OR ABYTHEFFOWCIES_SELAIar —_ . Co NAICIE_. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERF D INDICATED. NOTW ITHSTAIIdIFP;I ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WMCH THIS CEF' nFF:ATE MAY BE ISSUED OR I MAY PERTAIN, THE INSURANCE AFFORDED By THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TEA POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, _ MS. EXCLU:� ONI AND CONDITIONS OF;yJCHI �'- LTR A NSR TYPE OF INSURANCE GENERAL LIABILITY X COMLIERCIALGENERAl1NBILITY CLAIMS MADE QOCGIm POLICY NUMBER ZM77007141 EFF IV DA E MMR)U/YY 05/01/04 LILY E: iIR4I DATE NI WEIIY OS/ 11/05 �_ LIMITS EACH OCCURRENCE f 1000000 _ PREMISS EACF) 11100000 MED EXP(My CA* b"w nl f 5000 PERSONAL {Aryl INAXi/ S 1000000 GENERAL AGORI:dATE S 20VOVW-- GENT AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC PRODUCT'S - ckno p AOG $ 2 0 0 00 00 AUTOMOBILE LIABILITY '- A ANY AUTO ' ABN7001142 05/01/04 OS/ 1/OS COMBINED SIMILE LP9r ("aacddenD I _L_ j ALL OWNED AUTOS BODILY INJURY I (Per DMW) I SSOOOOOO X SCHC•DULEDAUTOS X HIRED AUTOS - X BODILY INJURY I (PM JlWlde t) f lOOOOOO NON•OWNEDAUTOS GARAGELUBJ.ITY ANY AUTO PROPERTY OAW.G'E (Par owdere) ...L- AUTO ONLY. EA.LdCIIK]IT j so0000 S OTHER THAN E., ACO �. S AUTO ONLY: 1 A.30 S EXCESWUMBRELLA LIA81LITY OCCUR CLAIMS MADE EACH OCCURRENCE f _ AGGREGATE _ j f DEDUCTIBLE - S ' RETENTION j - f WORKERS COMPENSATION AND B EMPLOYE.RS' UABIUW ANY PROPRIETORMARTNERIEXECUTIVE IRWCI00100 03/22/04 OFFICERMEMBER EXCLUDED? — I TORY LIMrr3 •I RR• 03/.2/OS E.LEACHACCIDENT- SSOOOOO Irye A, ddedbe under E.L.DISEASE-EA EMPLOYS SPECIAL PROVISIONS below E.L.DISEASE • POLICY U611T OTHER — DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Ae per policy forma, conditions and esc1111810n8. f 500000 $ 500000 CERTIFICATE HOLDER CANCELLATION t GATZWOO SHOULD ANY OF THE ABOIIDESCRIBEDP041CMSBECANCfiLLE!UREFORE GATE THEREOF, THE ISSUIP : INSURER WILL ENDEAVOR TO FJtA 10 DAYS WRITTEN 16 0 0 Falmouth ouliomh B / Inc. NOTK:E TO THE CERTMCA' ° WU 01R NAMED TO THE LSFT, UUT FAILURE2 1600 Falmouth Road Suite 2 S IMPOSE NO OBLIGATION OF: LIA3BJTY OF ANY KIND UPON Ta,S USURER, ITS AGENTS OR Centerville MA 02632 REPA SENTATPJM ACORD 25 (2001108) — O A�QRpm CERTIFICATE OF LIABILITY INSURANCE DATE(MMMDNyrn PRODUCER 508-428-0440 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MARK SYLVIA INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 969 MAIN STREET HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR OSTERVILLE MA 02655 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURED INSURERS- AFFORDING COVERAGE NAIC # PETER J. GOVONI INSURER A: FARM FAMILY CASUALTY INSURANCE DBA P. GOVONI LAND SERVICES INSURERB: 20 OPEN TRAIL RD. INSURER a SANDWICH, MA 02563 INSURER D: I 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 POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ISR DO, CLAIMS. OF SUCH 'TR GENERALLIABIL(TPOLICY NUMBER Y I POLICYEFFECTIVE POLICY EXPIRATION LIMIT$ - I A X COMMERCIAL GENERAL LIABILITY 2001L6202 EACH OCCURRENCE E 05/31/2004 05/31/2005 1,000,000 . CLAIMS MADE 71OCCUR PREMISES Ea occumnCe S MED EXP(Any one person) E 5 000 PERSONALdADVINJURY E __ - UF N'L AGGREGATE LIMIT APPLIES POLICY PRO'r ILOC PER: PRODUCTS, COMPAp AGG + S �'Uvu'vul/ 1 OQO QQQ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMB (Ea aCCIdent) E ALLOWNEDAUTOS SCHEDULEDAUTOS BODILY INJURY (Perpemen) E . HIREDAUTOS - NON)OWNEDAUTOS BODILY INJURY. ' - ---- .PROPERTYDAMAGE GARAGE LIABILITY. (PeraCoiaent) E .._.._.. � ... -. J^� A•NVA�UTO . I AUTO ONLY iEq ACCIDENT -' .. S'"' -:,•, OTHER THAN EAACC E' AUTOONLYt I EXCESSNMBRELLA LIABILITY pGG S OCCUR CLAIMS MADE - EACH OCCURRENCE $ AGGREGATE E DEDUCTIBLE E RETENTION f E WORKERS COMPENSATION AND S A EMPLOYERS' LIABILITY TO BE ISSUED 07/��QQ4 07/��QQS - T CSTATT, X OTRH, ANY PROPRIETOR/PARTNER/EXECUTNE OFFICERRAEMBER EXCLUDED? E.L. EACH ACCIDENT S 1,000,QQQ If Yea. deembe under SPECIAL PROVISIONS below I E.L DISEASE , EA EMPLOYEE S 1,000,000 OTHER EL DISEASE, POLICY LIMIT S 1.000.000 IJUN yr Url AT1ONS I LOCATIONS IVEHICLES I EXCLUSIONS ADDED BY ENDORSEMED 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 SO SHALL 1600 FALMOUTH ROAD #25 IMPOSE NO OBLIGATION OR LIABILITY OF-A7VTYMtr dp THEyNSllRER tTB AgEN73 OR CENTERVILLE, MA 02632 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 25 (2001/08) 'ACORD CO RATION 1 AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED ALTOS ANYAUTO EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS, LIABILITY THE PROPRIETOR( PARTNUME ECUTNE E OFFICERS ARE. EXCL OTHER DESCRIPTION OF OPERATIONS&OCATION ELECTRICAL WIRING Gatewood Homes Inc. 1600 Falmouth Road Ste 25 Centerville MA 02632 ITEMS I /. S MtU tXP GAY one Person) S5 0 COMBINED SINGLE LIMIT S Y IN (Per Lperrsoon) $ BODILY INJURY S accident) PROPERTYDAMAGE $ AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE S EACH OCCURRENCE . ' $ AGGREGATE S S WCRYST TU- MI .....::.,.i: EL EACH ACCIDENT $ EL DISEASE - POLICY UMIT S EL DISEASE - EA EMPLOYEE S 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 UABILITY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESERTAn - r R: ^.,tit -i .s4••T- "CERTIF�C}ATEa C) TT PRODUCER ' ..- HazOld H Williams Ins Agcy Inc C� ="� � 2 '.. .� Y oyx � fr4'M >� � v�{� t + .w.. .e.-kA.n ... 'x s ISSUE DATE (MM/DD/YY) dIl�TS, y E , /03/2004 THLS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE 81 Bassett Lane Hyannis, MA 02601 INSURED Stephen M. Childs COMPANY A A.I.M. Mutual Insurance Co 145 Cammett Road Marstons Mills, MA 02648 COFERAGESz a R r 3 r 'Ty. ry, %t ?u.i.«'f.".'[Rt°w' x, rci.2. .., THIS IS TO CERTIFYVT. THAT THE POLICIES OF INSURANCE LISTED INDICATED, NOTWITHSTANDING ANY REQUIRERffiNT,TERM OR CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN p F s y plrr 3 5Lmd g y Y<i o- L i= v t K BELOW HAVE. BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MM/DD/YY) POLICY EXPIRATIO DATE(MM/DD/YY) LDS . GENERAL LIABILITY GENERAL AGGREGATE S PRODUCT'S-COMP/OP AGG. S COMMERCIAL GENERAL LIABILITY -N=�LAIMSMADF=OCCUR PERSONAL & ADV. INJURY $ EACH OCCURRENCE $ OWNERS& CONTRACTOR'S PROT. DAMAGE (Any one fire) $ -FIRE ED. EXPENSE (Any one person) S UTOMOBILE LIABILITY MBINEDSINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY person) $ HIRED AUTOS NON -OWNED AUTOS - BODILY INJURY (Per=ice) S ARAGE LIABILITY PROPERTY DAMAGE S CESS LL181L1TY EACH OCCURRENCE f AGGREGATE S BRELW FORM R THAN UMBRELLA FORM-- WORKER'S COMPENSATION AND W C S `X R TATU- - .. `�-=�' �""-� ^^^-'^ `• FT EACH ACCIDENT $ i , uuu A EMPLOYERS' LIABBe TY THE PROPRIETOR/ IINCL 7015793012003 12/13l2003 12/13/2004 EL DISEASE —POLICY LIMIT S SOO 000 EL DISEASE —EA EMPLO-EE S lOO OOO PARTNERS/EXECUTIVE OFFICERS ARE: X EX OT1DiR DESCRIPTION OF OPERATIONS/LOCATIONSh'EffiCLES/SPECIAL ITEMS CEILTIFICATE;HOLDER' �k - ._ . " ^ CANCET L'ATION:, W SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE GATEWOOD HOA�S I INC.. XPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO t MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 1600 FALMOUTH ROAD, SUITE 25 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 CENTERVILLE, MA 02632 ACORN.- CERTIFICATE OF LIABILITY INSURANCE DATE(MWDWYYYY) 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 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW_ Osterville, Ma. 02655 508-420-9011 INSURED Casperson Overhead Doors Box 517 East Falmouth, MA 02536 508-563-5633 COVERAGES INSURERS AFFORDING COVERAGE NAIC# INSURERA: Worcester, Insurance Company INSURER B: National Grange Mutual INSURER C: INSURER D: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR Di NERD TYPE F INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD POLICY EXPIRATION DATE MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000 OO PREMISES fEa ocwrence E 100,00 X COMMERCIAL GENERAL LIABILITY CLAIMSMADE O OCCUR MEDEXP(Anyoneperson) S lO 00 A CB 2LT1973 05/28/04 05/28/05 PERSONAL BADVINJURY S. 1 000 001 GENERAL AGGREGATE S 2 OOO,OOI GEN'L AGGREGATE LIMIT APPLIES PER, PRODUCTS. COMP/OPAGG S 2,000,001 POLICY JE C LOC AUTOMOBILELIABIIJTY ANYAUTO COMBINED SINGLE LIMB (Ea accident) S ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per Person) $ BODILYINJURY (Peraccident) S HIRED AUTOS NON-OWNEDAUTOS PROPERTY DAMAGE (Peraccident) S GARAGE LIABILITY AUTO ONLY -EA ACCIDENT S ANYAUTO OTHER TITAN EAACC $ . E AUTOONLY: AGG EXCESS/UMBRELLA LIABILITY OCCUR CLAIMSMADE EACH OCCURRENCE S AGGREGATE S ' S DEDUCTIBLE E RETENTION S S WORKERS COMPENSATIONAND ANY UTYCP48352 ANY PROPRIETOR fNE 02/22/04 02/22/05 X I W A - TORY IMITS ER EL EACH ACCIDENT -- E 500,600 B EXCLLOf-D? FxdAAEDt OFFICERscn'be under Hye5,de5Qlbe Undef ' E.L. DISEASE- EA EMPLO S 500 O00 E.L. DISEASE -POLICY LIMIT S 500,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS HOLDER Gatewood Homes, Inc. 1600 Falmouth Rd., Ste. 25 Centerville, MA 02632 ACORD25(2001/08) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EJIPIRATIO 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 LIABILITY OF ANY KIND UPON THE INSURER, TITS AGENTS OR REPRESENTATIVES AUTHORIZED REP :: T T ©ACORD CORPORATION 1988 ACORN CERTIFICATE OF LIABILITY INSURANCE PRODUCER (781)431-9800 FAX (781)431-0222 Cochrane &Porter, Insurance Agency, Inc. =02120.47 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE c% Renaissance Alliance Ins. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND ggl Worcester Street OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Wellesley, MA 02482 INSURERS AFFORDING COVERAGE NAIC # INSURED Cape Cod Ready Mix, Inc. INSURERA: OneBeacon American. Ins. Co. 20621 300 Cranberry Highway INSURERS: Commerce Insurance Company 34754 Orleans, MA 02635 INSURERC: Zimmerman Specialty Insurance ZSI001 INSURER I% INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINI ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY CBR817036 01/01/2004 0 /01/2005 EACH OCCURRENCE s 1, 00O, OOl X COMMERCIAL GENERAL LIABILITY DAMAGE 70 RENTED CLAIMS MADE O OCCUR MED EXP iAny one person) 5 A PERSONA' L ADV MUURY 5 1, 000 , OOI GENERAL AGGREGATE 5 2 , OOO, OOI IRMR PE GEML AGGREGATE LPRO- OITAPPUES PRODUCTS - COMP/OP AGG S 2,000,00( POLICY JECT LOC AUTOMOBILE LIABILITY XY9014 01/01/2004 01/01/2005 ANYAUTO - (Ea at�dentSINGLE LIMIT 5 1,000,00( ALL OWNED AUTOS SCHEDULED AUTOS BODILY PS (Per persar) X B HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY S (Per accident) X - PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONL'f - EA ACCIDENT 5 ANY AUTO OTHER THAN EAACC 5 AUTO ONLY: AGG 5 EXCESSAOMBRELLA LIABILITY BE9744481 01/01/2004 01/01/2005 EACH OCCURRENCE 5 1, 000, 000 X OCCUR CLPIMS MADE AGGREGATE $ 1, 000 000 C , IR $ 10,000 DEDUCTIBLE - S RETENTION 5 5 WORKERS COMPENSATION AND WC STATU- OTH_ EMPLOYERS' LIABILITY ANY PP.OPRIETOR/PA.RTNEREXECJTIVE EL EACH ACCIDENT Is OFFICEWMEMBER EXCLUDED? If yes, describe under EL DISEASE - EA EmpLOyEd S SPECIAL PROVISIONS below E.L. DISEASE. POLICY LIMIT 5 OTHER DESCRIPTION OF OPERATIONS! LOCATIONS! VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS CERTIFICA E HOLDER CANCELLATION ' SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Gatewood Homes, Inc. 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER N"�Jjp TO THE LEFT, '• 1600 Falmouth Rd. BUT FAILURE Tn MAII g11`u unrra Suite 25 Centerville, MA 02632 25 (2001/08) OF ANY KIND UPON THE INS AUTHORED REPRESENTATIVE CORPORATION 1988 ACD-F L CERTIFICATE OF LIABILITY INSURANCE 0 o210 °^� PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Fe) 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_ INSURER A: Construction Industries Compensation Cape Cod Ready Mix Inc. - PO BOz'399 .. .. INSURER B., ... INSURER C Orleans, MA 02653 INSURER D: I I INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINC ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED Of MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCI POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR LTR I TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE M/DD/YY POLICY EXPIRATION DATE (MMfDDrrYl LIMITS GENERAL LIABILITY k4OM ILR M ERCIAL GENERAL LIAB Y . � 1 CLAIMS MADE OCCUR EACH OCCURRENCE S FIRE DAMAGE (Anyone fire) S MED EXP (Any one person) $ PERSONAL & ADV INJURY S GENERAL AGGREGATE S GENL AGGREGATE LIM ITAPPLIES PER: POLICY PET LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) S IJ I ALL OWNED AUTOS I SCHEDULED AUTOS BODILY INJURY (Per person) S HIRED AUTOS I _ I j � NON -OWNED AUTOS BODILY INJURY (Per accident) S PROPERTY accident) DAMAGE Is i GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ANY AUTO OTHER THAN EA ACC S $ AUTO ONLY: AGG I EXCESS LIABILITY _ OCCUR CLAIMS MADE JAGGREGATE EACH OCCURRENCE Is $ S ��^� I DEDUCTIBLE S I�"'"II A I RETENTION S WORKERS COMPENSATION AND IW00009254 EMPLOYERS' LIABILITY 01/01/04 01/01/05 )( WC STATU- OTH- TORRY LIMITS S E.L. EACH ACCIDENT s500,000 E.LDISEASE-EAEMPLOYEE $500,000 ( EL DISEASE - POLICY LIMIT S500,000 I OTHER , DESCRIPTION OF OPERATIONSILOCATIONSrVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Gatewood Homes Inc. 1600 Falmouth Road Suite 25 Centerville, MA 02632 SHOULD ANYOFTH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH E EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL30_ DAYS WRITTEN NOTICETOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,rrS AGENTS OR ffvD lauwmaaoti CL3 0 ACORD CORPORATION 1988 Aug-03-04 02:42pm F ram -A I G 973-316-8903 T-270 P-002/002 F-401 Dias Ins Agency Inc 535 Brayton Avenue Fall River, MA 02721 Eba Carpentry Inc 100 West Main Street, St 10 Hyannis, MA 02601 'ANSU. THIS CERTl1 ICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND C ONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TI 13 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE. ;OVERAGE AFFORDED By THE POLICIES BELOW - COMPANIES AFFORDING �INSURANCE �COMPANY A GRANITE STATE INSURANCE COMPANY THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED ;ELCW HAVE 13EF-N ISSUED . TO THE INSURED. NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOT WITHSTANDING ANY REQL REMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 13 i ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED THE_ POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. E -CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED 13Y PAID CLAIMS. EmPLOYIERS, uAsury morpiEmpi rNERSlEXECUnVE .FRSARE: 0EXCLO C 7-- 0( a9d AROM to VA Opa Iiws Owy. 7/24/2004 7/2412005 ACCIDENT SE POLICY LIMIT CERTIFICATE HOLDER CELLATION w THE YO GATEWOOD HOMES SHOULD A14 P THE ABC /E DESCRIBED pOICIES BE rANCELLFM 1600 GALMOLITH ROAD. SUITE 25 TION TH E BEFORE THE O(PRAT'ON DATE THERE IF. THE ISSUING comPANY wiLL cNar.AvcR To mkL I) CENTERVILLE. MA 02632 WKITT04 NOTICE T CAYS WKnTM NOTICE 7 . THE CERTIFICATE HOLDER NAMED TO THE LEFT. Wr S To JL MmK. E 'TICE SHALL IMPOSE NO COLIGATION OR LIASx FAILURE To MAIL SUCH K' UPON Jry OF ANY KIND UPON THE COL 'ANY. ITS AGENTS OR REPFWSEWATNE& 7 AUTHORIZED REPRI SENTATIvE o Vr i7�V9 1V. JY {•A.l JVON �V VGYy vULuZAA ASSOC a of J A -. °-FRITI1=1�-ATE ®:: 1 ;III ITT. INSURANCE CSR AB DATEtlaalom'111W GOv:X50 06 23 04 THLS-MRTW4CAS£-IS4S SUED AS,4bM 4TiEWoF imAN Ab4 OW GOMM= & A3SOCIATSS INSURANCE ONLY AND CONFERS NO RIGHTS IPON THE CERTIFICATE FINANCIAL SERVICES INC • HOLDER. THIS CERTIMATE DOES NOT AMEND, EXTEND OR . 03}9ES�ACf'D1TS!_II�t = r- PsXAMIS W.. 02601 Phonss508_775e6010 Fez:508-790-0298 MISURERSAFFFOOR0iNGWIMERAGE INSURED INSURER A. BBSB7f n-TSURANC'E M INSURER 8! Aim 'B SAL MRSURA CZ CO. a06>3W1A R�i[iVATIONS INC PO BOY 116 SAMAsant3 BRACE VIA 02562 INSURER INSURER E THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INUMED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWRHSTANDING ANY I�`UIREMENT, TERM ORCOHWMN OF ANY COW ACT OR OTHER 0=-JENT WrrH RESPECT TO WHICH THIS CERTIFICATE MAY BE I IIXI OR .AY?E9TALV. T:7E L`!SLRLV--A£EOSOM BYTES e==DESCaIEEC tl0ft---4!S P.UC.XCTTO ALL'ThE T&WAS. 04CL. USIONS AIM C0'.ND.•TiOUS OF StPCH POLICIES. AGGREGATE LIMBS EHMN MAY HAVE BEEN REDUCED BY PAID CIMMS LTR TYPE OF NSUAANCE POLICY NUMBER DATE RNLMDD/YYI DATE LDBr3 A GENERAL LULmUTY S ODMMERCIALGEHERAAiwmjw cmus uADE ® o=st 3CH2718 - 12/3.2/03 12/12/04 EACH OCCURRENCE Islooc000 1350000 :NEDocPPAY enapvaon) $5000 PERSONAL d ADV INJURY s1000000 GENERAL AGGREGATE s 2OUD-U O--. GFM AGGREGATE LIMIT APPLIES PM POLICY I J "?T 1 ' LOC PRODUCTS-CCMPIO►AGG S 1000000 AUIOMOBLE LIABIIJTY ANYAUTO ALL OVINGD AUTOS SCHEDULEDAVTOS HIREDAUTOS FiBii-ONiitiE@Al COMB9ED SINGLE LIMB (Ea a=wmlt) i 6"T WVNJUR '( per) S BDORY IILRIRY (Pr adCmD S PROPERTY DAMAGE (Perow-im-0 s �R""R"GELI"� H ANY AUTO. AUTO ONLY -EA ACCIDc?!T S ONst-THAN EA ACC AUTO ONLY: AGG i S ---=�U OCCLiR a CLAIMS MADE ' DEDUCTNLE RETENTION z I OCCURRENCE s rAMM"TE >i s f 9 8 190MMM COMPENSATION AIM LIABILITY � �cUnvP OFFyesK—��'UG� SP£CLAL PRWISBHNS edow #AY.C7016018012004 01/03/04 01/03/05 TORY UMRS ER E.I..EAcHAccmENr slOGOOO E.L. DISEASE- EA EMPL s 100000 E.L DISEASE -POLICY LD:IT s500000 DF.BORIP�DN 8F OFERATK/iJ31lBEA41FiiN3/V�i£LF3! Eit'LLUiiDNBADDc�D BY ci1DOR5EiTeH7l $F`GAL PRfl'vT3i0'eiS GA:'IWe e..O= AJW OE TW f_^YE nW_-2!ff= PMCCE CAkC=ED L:fr�THE=MWI.TJ DATE THEREOF. TH9ISSLIXG INSURER WILL EY9��LVpR TO MAIL a 0 DAYS WR.7TEH GATBWOOD RCM8 3NC - NOTICA T@THrc GERTiFM.ATC HOLDER NMER T4 TH5 LE". BUT FAILURE TO 00640HYL6 FAY 5504-718-5603 WOW NO OBLIGATION ORLLLBILTTYO_FANYMINDUPONTHEW;ImER,rMACEARSQR L.rv•.= 1600 PA�•^WOAD REPRESENTAVVES. _ _ CENTERVILLE 14A 02632 AUTHORIZETROfRESEWATWE t001/0L) VACORDCORPORATOWI MI d/4/U4 Y:JI.I:Jb PM 4154 0 02/03 ACORQ CERTIFICATE OF LIABILITY INSURANCE - GATE (MINDDIYYYY, os/o4/zooa PRODUCER, (508) 540-2400 FAX (508)760-1988 Murray & MacDonald Insurance Services 406 Jones Road Falmouth, MA 02540 Douglas MacDonald .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 # INSURED TRACY HOWERTDN PO BOX 1551 MASHPEE, MA 02649 INSURER A: Hartford Fire. Ins co jjNAIC 1968Z INSURERB Liberty Mutual Ins Corp INSURER INSURER R INSURER E. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHST-AHBING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE IN8UFL4NCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SU&IECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. WSR ADD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE iMMA)Dly" POLICY EXPIRATION LIMRS GENERAL LIABILITY 08SBARR7945 10/02/2003 10/02/2004 EACH ocCLRRENcE s SOO COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR DAMAGE TO RENTED Is 300 .000 APED EXP (Any me peredn) f 10 , A PERSONAL&ADVINIURY $ Soo GENERAL AGGREGATE GENL AGGREGATE L&UT APPLIES PER 17 POLICY P� LOC PROOUCTS-CObP/OPAGG S 1. QQQ AUTOMOBLE LWBIUTY ANY AUTO COMBINED SINGLE LIMIT (Ea mcidG t S ALL OWNED AUTOS SCHEDULED AUTOS BODLLY INAIRY (Per person) f HIRED AUTOS NON-0WNEDAUTOS - BODILY INJURY (Per acctlelnl f PROPERTY DAMAGE (Per accitlenl) f GARAGE LIABILITY AUTO ONLY -EAACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG f EXCESSIIMBRELLA LIABILITY OCCUR C CLAIMS MADE EACH OCCURRENCE $ AGGREGATE Is f DEDUCTIBLE Is RETENTION S Is WORKERS COMPENSATION AND WC131S317310021 10/05/2003 10/05/2004 WC STATU- or EMPLOYERS' LIABILITY Et EACH ACCIDENT Is 100 B ANY PROPRETOR/PARTNERIEXECUTNE OFFICER/MEMBER EXCLUDED? E.L. DISEASE -EA EMPLOYE $ 100 If YM C..c a tler un E.L. DISEASE -POLICY LIMIT S SOO SP ECWL PROVISIGNS eelw+ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS GateAfood Homes Jeffrey Sol lows 16 Falmouth Road Suite 25 Centerville, M4 02632 cAV. /rno♦-sin SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _lO DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF AMY IND UPON THE INSURER RS AGENTS OR REPRESFNTATAIFS_ AUTHORIZED REPRESENTATIVE Claudine Wri hter/ 1515 BACORD CORPORATION 1988 rn.Aa-w-cElEw TJ7•G:> Kl VtK K15K SrtCIRLISTS 1 SOB 564 7272 P-01i02 ACORD..d �CGI. �I i1r x� R L� � aa.J ..,. ...... I, - ."4.1P w.—.«.uarawr•euera.wM.K.iI� ••"••.. " 'n uw F OAn IMMmDIYYL_ is ..nvn • „W::\ �' 07 28/04 ,.. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE' PRODUCER , ` RIDER RISK SPECIALISTS HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER—THE—C VFRDGF.AFFORDED BY THE.POLICIES BELOW. INSURANCE AGENCY, INC. COMPANIES -AFFORDING COVERAGE P . O . BOX 115 EOMPA#,,.—. CATAUMET MA 02534-0115 •... A SCOTTSDALE INSURANCE COMPANY INSURED _-:. MONUMENT INSULATION, INC. a AMERICAN HOME INSURANCE COMPANY 223 COUNTY ROAD COMPANY BOURNE, MA 02532 C _ COMPANY D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FDR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REOUIREMENT, 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 DESCAl86D-HEREDN-IS-SIVE I CT-TO-AII HE_TFRFAS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TN TYPE OF INSURAIICE POLICY NUMBER POLICY EFFECTIVE_.enuoc OATERMMMD/YY) DATEIMMIDDrCO -•• _ GENERAL LIABILITY GENERAL AGGREGATE 61,000,000 X COMMERCIAL GENERAL LABILITY CWMS MADE ❑X OCCUR PRODUCTS • CONPIOP AGO PERSONAL 6 ACV INJURY F5 0 O 0 0 0 _ E500, 00O 2 _ OWNETSBCONTRACTORSPROT CLS1001705 3/30/04 3/30/05 EAcHoccURRENCE 1500, 000 FBIE DAMAGE AAV end Wp $ 5 0 . 0 0 0 MEO EXP LARF OM COMM 15 000 AUTOMOBILE LADWY ANY AUTO COMBINED SINGLE LIMIT IF— .. ALLOWNED AUTOS SCHEDULED AUTOS BODILY INJURY IP1T BmFPM 1 HIRED AUTOS NON -OWNED AUTOS BOD0.Y INJURY IPer maempl F PROPERTY DAMAGE 1... GARAGE LIABILITY AUTO ONLY , Ea ACCIDENT ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT F AGGREGATE d EXCESS LIABILITY _ EACH OCCURRENCE F UMBRELLA FORM AGGREGATE OTHER THAN UMBRELLA FORM WORKERS COMPENSATION COM►ENSATION AND EAIPLOYgR$• LIABILILIABILITYATY ... X W STATU• OTM• DRYFR :••:.-.�:: :`",_G;:.„ ,::•� :: EL EACH ACCIDENT d100, 000 B THE PROPRIETOR/ X INC_ PARTNERSIEX£CUTIVE WC 768 29 54 3/5/64-.. 3/5/05 _ ELDISEASE•FOLICYUMfT Y5�68'—"699— .. . EL DISEASE. EA EMPLOYEE 1100,000 OFFICERS ARE: EXCL OTHER DEACMPTION OF OPEAATIONSAOCATION6NEIGCLES/SPECIAL ITEMS .ERIfFIfJ}E�jOLi3Eti . Y ;rN4GFfJR710N _. ....... . ....... . .. S. ... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BOONE THE GATEWOOD HOMES EXPIRATION DATE THEREOF, THE ISSUING COMPANY. WILL..ENDFAVOR TO MAIL �L 1600 FALMOUTH ROAD #25 10 DAYS WRITTEN. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. CENTERVILLE, MA 02632 BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY RIND UPON THE COMPANY, ITS AG OR REPRESENTATIVES. AUTFIORQm R«<xl,. ATI ::: }.I...f ACDRD.25� fY1S5E YG 0 b.. ", . ti ' ...0 VVVIYVVL4J UULUDLAN ASSOC ff ►_ I:ERTIFICATE OF LIABILITY INSURANCE A SSO MATES INSURANCE THIS CERTIFICATE 13133UED A; `S :CSS SNC. ONLY AND CONFERS NO RIGHT: TH jr). HOLDER. THIS CERTIFICATE DO 02611 AL TERTHECOVERAGEAFFORC 775_6010 Fa3C:S08-790-024o f DEA M� EICAL SYSTxKS 110 HOI dDER LANZ w 9ARNI-7� MA 02668 INSURERS AFFORDING COVERAGE INSURER C ID 02 TA R LB ' NATTER OF INFORMAT►pp /04 'ON THE CERTF CATE dOT AMEND, EXTEND OR BY THE POLICIES BELOW_ Ctr4 TNY RrOURE OF INSURAI :E LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NA►1EDA9pyE FOR THE NOTWITHSTANDING ANY REOUDtEMQE I TERN NCE AF ORDE OF ANY CONTRACT OR OTHER DOG1MENr WITI{ RESPECT R WHICH ICY CERTIH6ITE MAY BEE MAY PERTAp(TH E R#SUPo ITS AFFORDED H THE POLICIES DESCRIBED OR HF12E#Id IS SUBA:CTTD ALL THE TEAMS, POLICIES. AGGRF GATE LIP ITS SNOWN MAY WIVE BEEMTH A'� REDUC818Y PA CLARAS. E>RSIONS AND CONDRLpNS OF SUCH R MSRO Tvse .. ..�.._...__ jG:AW!UAIUU LLUIWL TY M4ERCbLGENERALLUBDJttCLAIM MADE EK) OCCUR, wLs17a 60REGA'E UArtT rM� rE�cr LOC MOLELit BLLOY AUTO OWNEC AUTOS EDU LEI AUTOS DAUTT S -OWNE IAUMS Y UTO ESCESTAAMRM LAUABILT' OCCUR 11 CLAW MADE DEXUCTISL JEIA;PL 0N ANDOPRDEroRIPAJI NERIOlECU}#7278A84903 F.UDEDTLL GATSIQOI #D HOMES INC FAX 501I-778-5603 1600 F"'IM UM ROAD CXWXXW 7LLE MA 02632 73.3 UNITS 11/21/03al/3 EACH NCE : PREMISES LEa amnenca t. 20 PAOOIPTS• COMPIOP AGO S 20 COMMED SINGLE UMff IEm eayeenq s �pINJURY S I BOOBY �L}R s PROPERTY DAMAGE tPwaWde.d) s AUTO ONLY -EA ACCIDENT S-... OTHER TWIN EA ACC S AUTO ONLY: . _ _ S OS/03/04 05/03/05 E-MAACCOEW LWAMS FR s E.L. DISEASE. EA 6 NAIC # 0 0 ria GATEWOANYGFTLE ABOVEOQpy® C.... E.BEFORE THE EXPRATION EREOF, T/E ISSUING DMRERM7LL ENDEAVOR TO MAIL 1:7'-.O THE DAYSgo SHEN CERTIFICATE HOLDER NAMED Tp THE LEFT, BUT FAIWRETO DOSOSHALLOOBUGATION OR UABRITY OFANY IDNO UPON THE ITATIVFs R� EIITTS01t- D PROPERTYADDRESS:-�•xo/�'' :ALCULATION FOR PERMIT COST TYPE OF ROOM ETC NO �yy��• goz. 280.7a ADDITION ALTERATIONS gEo z. ROOM CERTIFICATE OF OCctwAm, �17.0z`l FAMILY ROOM FIREPLACE FOUNDATION ONLY GARAGE NO. OF BAYS GREAT ROOT! OFFICE PORCH CLOS PORCH OPEN SUN ROOM HEAT SUN ROOM UNHE SW Nlil~NG POOL TOWN OF YARMOUTH WATER DEPARTMENT 99 Buck Island Road West Yarmouth, MA 02673 Telephone: (508) 771-7921 • Fax: (508) 771-7998 Letter of Water Availability Date of Issue: February 2, 2005 Single Family Dwelling X 2. Duplex Family Dwelling Condominium Dwelling 4. Commercial / Industrial 5. Other.(Specify) Reference; Massachusetts General Laws Chapter 40, Section 54 To: Town of Yarmouth Building Inspector Please be advised that the Town of Yarmouth public water supply is available to service lot / parcel (s) 21.1C/138; Street: 121 Camp Street, W. Yarmouth As shown of Assessors sheet / map 44. Issuance of this Letter of Availability is subject to the following provisions / restrictions: (1) The property owner agrees to comply with all federal State, and Local Laws, Rules and Regulations as they pertain to the use of the public water supply. (2) The Yarmouth Water Department shall have exclusive rights as to the size, number, type and location of all water service lines, fire service lines or appurtenant items connected to the water distribution system. (3) The Yarmouth Water Department reserves the right to require, at the property owner's expense, the installation of water mains and appurtenant items to meet water demands requisites within any structure relevant to this Letter of Availability. (4) This Letter of Availability will expire 180 days from the date of issue I have read and understand the provisions / restrictions of this Letter of Water Availability. Owner (sign) Y outh er Department Am �� N:\Water Availibility\1 2 1 Camp# 13 8.doc TOWN OF YARMOUTH ` Building Department Town Hap �� • Yam oufh, MA DZU (MG) 391 Zn1 eR281 BBUILDING PERMIT TRANSMITTAL Temp Permit No.: T-05.391 Applicant Name: Frank Capra Applicant Phone: 5087789669 Building Location: 00121 CAMP ST # 138 Owner's Name: Villages is Camp Street, LLC Owner's Addres 1600 Falmouth Road # 25 Centerville MA 02832 Owners Telephone: (508) 778-9669 (OFFICE USE ONLY Recorded By: Ic Permit Fee: $0.00 Deposit Rec: $0.00 Payment Type: Check ChkNo.: 0 Net Owed: $0.00 Application Date: 1/31M005 Issue Date: Expiration Date Comments: new construction: Map/Lot: 044.21.1.0 REVIEWED BY: / J. WATER DEPARTMENT: DATE: WA: 2. ENGINEERING DEPARTMENT: DATE: WA: 3. CONSERVATION: DATE: WA: 4. HEALTH DEPARTMENT: DATE: WA: 5. BUILDING DEPARTMENT. DATE: WA: 6. FIRE DEPARTMENT: DATE: WA: COMMENTS: RECEIPT OF COPY: PLEASE NOTE SIGNATURE OF APPLICANT. DATE: Date Printed: 1/31/2005 I 1Q born)-i- OGO-3 PRODUCT SPECIFICATIONS GMS9/GCS9 SERIES 93 % AFUE Multi -Position, Single-Stage/Multio Gas Furnace l' _odCar Heating Capacity: 46,000-115,000 BR 0I0I010210 Air Conditioning & Heating _ The GMS9/GCS9 single -stage, ink ['j� multi -speed gas furnacesoffer ® f� installation versatility. 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 Cabinet Construction • Heavy -gauge, reinforced, fully insulated steel cabinet with durable baked -enamel finish • Attractive architectural gray paint finish • Fofl-face insulation -lined heat exchanger compartment • Coil and furnace fit flush for easy installation • Convenient left or right connection for gas and electric service • Bottom or side air inlet (GMS9) • Removable, solid -bottom block -off (GMS9) Accessories • L.P. Conversion Kit (LPT OOA) • L.P. Gas Low Pressure Kit (LPLPO1) • High Altitude Natural Gas/L.P. Kits (HANG11, HANG12, HALP10) • High Altitude Pressure Switch Kit (HAPS27) • External Filter Rack (EFR01) • Horizontal Concentric Vent Kit (HCVK) • Vertical Concentric Vent Kit (VCVK) • Internal Filter Retention Kit—upflow, horizontal (RF000180) • Internal Filter Retention Kit— ow (RF000181)0181) • Thermostats Blower Motors (CHT18-60, CH70TG, CHSATG, H2OTWR) SS•377D �.goodmanmfgxom 6/04 PRODUCT SPECIFICATIONS Nomenclature G M S 8 070 3 A N A Goodman® Brand Revision A: Initial Release M: Upflow/Horizontal D: Dedicated Downflow C: Downflow/ Horizontal H: Hi Air Flow 5: Single Stage/Multi-speed V: Two Stage/Variable-spec 8: 80% 9: 90% 045:45,000 070: 70,000 090:90,000 115: 115,000 140: 140.000 NOx B: 1stRevision N: Natural Gas C: 2nd Revision X: Low NOx Ca inet Width A: 14" B: Mi" C: 21 " D: 24i4" Maximum CFM Ca 0.5" ESP 3: 1,200 4: 1,600 5: 2,000 Dr 2 (7- (7 'PRODUCT SPECIFICATIONS Performance Ratings Model „ Natural GasiOut "Anotot�:BT , UW�-- put Hbadfi41C1ApACttjrzTUL. 'Y s6Ran get7VF) ili'NaftiraF� -7 LR'l< GMS90453BXA 46,000 42,800 37,200- 93.0 3.0 35-65 GMS90703BXA 69,000 64,400 55,800 93.0 3.0 35.65 GMS90904CXA 92,000 86,000 74,400 93.0 4.0 35.65 GM591155DXA 115,000 106,500 93,000 93.0 5.0 35-65. GCS90453BXA 46,000 42,800 37,200 U-0 1 3.0 35-65 GCS90703BXA 9 69,000 ; 000 64,400 55,8D0 93.0 3.0 35-65 GCS90904CXA 000 86,000 74,400 n 4.0 40-70 GCS91155DXA 115000 ;, 5.0 40-70 For altitudes above 2,000', reduce input rating 4% for each 1,000' above sea level. DOE AFUE based upon Isolated Combustion System (ICS). Specifications :-Akb:1mumvt Ti-,' 4hipork., z HN Speed Perynainent-IDisposabli Ci {pounds] GMS90453BXA 10- x 7" 1/3 4 2" 2 288 576 9.0 15 132 GMS90703BXA 10- x 8- 113 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 GCS90453BXA 10" x 7- 1/3 1 4 2- 2 288 576 9.0 15 132 GCS90703BXA 10- x 8" 1/31 4 2" 3 282 564 9.0 15 135 GCS90904CXA 10 10- 1/21 4 2" 4 376 7 52 8.9 15 156 GCS91155DXA 11 10- 3/41 4 2" 5 470 1 940 12.2 15 175 I Installer must supply one or two PVC pipes: one for combustion air (optional) and one for the flue outlet (required). Vent pipe must be either 2" or 3" in diameter; depending upon furnace input, number of elbows, length of run and installation (1 or 2 pipes). The optional Combustion Air Pipe is dependent on installation/code requirements and must be 2" or 3" diameter PVC. 2 Minimum Circuit Ampacity = (1.25 x Circulator Blower Amps) + ID Blower amps. 3 Maximum Overcurrent Protection refers to maximum recommended fuse or circuit breaker size. NOTES: • All furnaces are manufactured for use on 115 VAC, 60 Hz, single phase electrical supply. • Gas Service Connection 1/2"FPT • Important: It ' is required to size overcurrent protection device and wires properly and make electrical connections in accordance with the National Electrical Code and/or all existing local codes. PRQDUCT SPECIFICATIONS GMS9 Dimensions il`SCHAR 3/4 ��198R_J�"12 R ALTERNATE l.7 GAS SUPPLY HOLE HIGH VOLTAGE ELECTRICAL HOLE E TRAIN 1 12 GRAIN LINE LINE HOLES r DRAIN 14 TRAP T) 25/8 T LOW VOLTAGE ELECTRICAL HOLE 1! SIDE CUT -Our 1 Ld 11314 J IjL�--- ' BOTTOM KNOCK - LEFT SIDE VIEW 21 FRONT VIEW VENTIFLUE PIPE IS T PVC I MR I ALTERNATE 21 V18 AIR INTAKE LOCATION _STANDARD GAS W LOCATION HIGH VOLTAGE 2 9M8 J14 1 ELECTRICAL HOLE RIGHT SIDE 2yS DRAIN DRAIN LINE _ TRAP HOLES 301/ 1 3/18 Q LOW VOLTAGE 11310 ELECTRICALHOLE 321�1I 13/d SIDECUT-Our L J RIGHT SIDE VIEW C ., �. f GMS90453BXA 171h" 16" 12%" 12%" GMS90703BXA GMS90904CXA 21" 19W, 16%" 4 14%" GMS91155DXA 241h" 1 23" 20%" 18%" NOTES: 1. Installer must supply one or two PVC pipes: one for combustion air (optional) and one for the flue outlet (required). Vent pipe must be either 2" or 3" in diameter, depending upon furnace input, number of elbows, length of run and installation (1 or 2 pipes). The optional Combustion Air Pipe is dependent on installation/code requirements and must be 2" or 3" diameter PVC. 2. Line voltage wiring can enter through the right or left side of the furnace. Low voltage wiring can enter through the right or left side of furnace. 3. Conversion kits for high altitude natural gas operation are available. Contact your Goodman distributor or dealer for details. 4. Installer must supply following gas line fittings, according to which entrance is used: Left —Two 909 elbows, one close nipple, straight pipe Right —Straight pipe to reach gas valve Minimum Clearances to Combustible Materials R 2T3�iOn`��tW�F {"" Jrl�p<' sRear f r ��fi,: rit�Ci 1 9 U flow 0" 0" 3" C 0" 1" Horizontal 6" 0" 3" C 0" 4" C = If placed on combustible floor, the floor MUST be wood ONLY. NOTES: • For servicing or cleaning, a 36" front clearance is recommended. • Unit connections (electrical, flue and drain) may necessitate greater clearances than the minimum clearances listed below. • In all cases, accessibility clearance must take precedence over clearances from the enclosure where accessibility clearances are greater. u C PRODUCT SPECIFICATIONS GCS9 Dimensions LEFT SIDE VIEW FROM VIEW RIGMSIDE MEW 8 3/ Y4 �19518� II 1RI�AKEPIPE� (RETURNAIR) �/ VENT/FLUE. 21/16 r -- , CONDENSATE DRAIN TRAP r 1 Y LOW VOLTAGE J 1 �0 w/ 3/4' PVC ELECTRICAL HOLE LOW VOLTAGE _I ELECTRICAL HOLE DISCHARGE (RIGHT OR NIGH VOLTAGE 40 LEFTSIDE) ELECTRICAL HOLE L J ALTERNATE L VENTIFLUE J HIGH VOLTAGE 2 5/18 28 18 81/8 LOCATION + ELECTRICAL HOLE 211M8 ALTERNATE 19 AS + AIR INTAKE LOCATION DRAIN TRAP 28/8� DRAIN 2SM LEFT SIDE DRAIN LINE 1872 18 3/1 �_ RIGHT SIDE HOLES Q 14 DRAIN LINE HOLES trt 2 B 1/d 11 STANDARD GAS SUPPLY HOLE 4118 9141 8 O 9 3/4 7 ALTERNATE GAS SUPPLY HOLE ''�18 UN' FOLDED FUNGES C D ; DISCNARG UNFOLDED FLANGES AIR FOLDED FLANGES DISr HA�RGE FADED FLANGES AR DISCHARGE AIR v x-i• ..... - � .. .. F. ,•e GCS90453BXA 17h" 16" 12%" 14h" 16" GCS90703BXA 17h" 16" 12%" 141h" 16" GCS90904CXA 21" 19ri" 16%" 18" 191h" GCS91155DXA 24'h" 23" 20%" 2111h 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. 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 Fiont;;? s T` FTo r<t -... ..�.. .... a 5 Y . x , ,Rear_ , �..• .. a' _:eottom y n e _flue 31 y tit.. ;. ,{ Downflow 0"1 0" NC 0" 1" Horizontal 6" 1 0" C 0" 4" 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 % 7onsAC{5 ExternalStattcPressure{InchesWaterLolumn) ,N(odet Heatlnt#4peed Motor' 0 5"' 0.1 *r '. 0 2 0 3 , is 0 4_y r 0 5 w0 b 0,7_` 0 8_- CFM, :RISE ;tFMi .RISE ,CFM- RISE: ,CFM .RISE' CFM= RISE. `:CF.M CF.M 'CFM' XsShtppetl ,, S eed ; P.ESP ., HIGH 3.0 1,352 ---• 1,318 ••-• 1,260 ------ 1,202 --- 128; 7 y 1 T044 r 955. 853: G_S90453BXA MED 2.5 1,214 ------ 1,172 ------ 1,123 ------ 1,064 ---3tij, 938` ;859 ` 741' (LOW) MED-1-0 " 2.0 997 ----- 994 ------ 960 35 923 36 �B �p*'g j4,,� r $t7 741T 611, LOW 1.5 757 44 753 44 734 45 704 47 yfr11•'. r.$7 . '=b20s �24 438; HIGH 3.0 1,449 36 1,409 37 1,326 39 1,273 41 t1)201�, Tt 1 194 t,136 1,018 G_S90703BXA MED 2.5 1,192 43 1,172 44 1,141 . 45 1,094 47 ,1,44b, �t r:973 904._ 793 (MED-HI) MED-1-0 2.0 981 53 962 54 943 55 917 56 888 .q8 §$30 ;764 665:, LOW 1.5 750 --• 730 .----- 714 -•---- 692 --- b5r h I? `b20 ,570 � * 502 >• HIGH 4.0 1,970 ---- 35 38 1,667 40 1# b6 `WI t V431 1,334 1,182' G_S90904CXA MED 3.5 1,713 39 1,650 40 1,572 42 1,510 44& 1313 1 271 1,079- (MED-LO) MED 3.0 1,439 46 11,874 1,412 47 11,757 1,370 48 1,327 50 1,2b.Q; 5` t l66 1,07$ ° 956: LOW 2.5 1.183 56 1,155 57 1.122 59 1.108 60 t 463�b2 K' T011 931= 816 HIGH 1 5.0 2,134 40 2,103 40 42 1,941 44 33! 1,P,'625 G_591155DXA MED 4.0 1,678 51 1,643 52 12,029 1,643 52 1,577 54 62 1;52 1,9 d 1t489 11423 1,253 �;334 1,205 (MED-HI) MED-1-0 3.5 1,453 58 1,440 59 1,426 59 1,363 -- aF314 1.118 1082 -1-015 LOW 3.0 1 259 67 1 239 68 1 220 70 1 181 -- --=159 NOTES: 1. CFM in chart is without fdter(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, about 400 CFM per ton when cooling is desirable. 4. INSTALLATION IS TO BE ADJUSTED TO OBTAIN TEMPERATURE RISE WITHIN THE RANGE SPECIFIED ON THE RATING PLATE. 5. The chart is for information only. For satisfactory operation, external static pressure must not exceed value shown on the rating plate. The shaded area 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 t l (7, 'PRODUCT SPECIFICATIONS Accessories Nlodel<= 4 _ �escriptton T ` , _6'5904538XA ,G°5907Q3BXA G_390904CXA_ G.L591155DXA` LPTOOA L.P. Conversion Kit ✓ ✓ ✓ ✓ LPLPOt 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 EFR01 External Filter Rack ✓ ✓ ✓ ✓ DCVK-20 Horizontal/Vertical Concentric Vent Kit (2") ✓ ✓ DCVK-30 Horizontal/Vertical Concentric Vent Kit (3") ✓ ✓ ✓ Available for this model (1) 7,00l'to 9,000' (2) 9,00l' to 11,000' (3) 7,00l' to 11,000' Note: All installations above 7,000' require a pressure switch change. For installation in Canada, furnaces are certified only to 4,500'. Downflow Floor Base: When the GCS9 model is installed directly on a wood floor, a downflow floor base must be used. Those model numbers are: CFB17, CFB21 and CFB24. Thermostats Destrapton r CHT18.60 Cooling/Heating, Mechanical CH70TG Cooling/Heating, Digital, Non -programmable CHSATG Cooling/Heating, Mechanical H2OTWR Heating Only, Mechanical 7 MAScheck COMPLIANCE REPORT Massachusetts Energy code I MAscheck software version 2.01 Release 2 I I I CITY: Barnstable STATE: Massachusetts HOD: 6137 CONSTRUCTION TYPE: 1 or 2 HEATING SYSTEM TYPE: other DATE: 4-21-2004 DATE OF PLANS: 04/21/04 TITLE: The Plover PROJECT INFORMATION: Mill Pond village 1600 Falmouth Road Unit 25 Centerville, MA. 02632 COMPANY INFORMATION: Northside Design Assoc. 141 Main Street Yarmouth Port, MA. 02675 COMPLIANCE: PASSES Family, Detached (Non -Electric Resistance) Permit # Checked by/Date Required UA = 237 Your Home = 133 Area or Cavity Cont. Glazing/Door, Perimeter R-Value R-value U-Value UA ------------------------------------------------------------------------ CEILINGS 823 30.0 30.0 14 WALLS: wood Frame, 16" O.C. 1588 15.0 15.0 70 GLAZING: windows or Doors 97 0.340 33 GLAZING: windows or Doors 40 0.340 14 DOORS 20 0.086 2 ------------------------------------------------------------------------ COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR 1310 and 34.4. Builder/Designer Date f 1` Massachusett6 Energy code MAScheck Software version 2.01 Release 2 The Plover DATE: 4-21-2004 Bldg Dept Use [] I I I I I I I CEILINGS: 1. R-30 + R-30 Comments/Locati 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, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location 2. U-value: 0.34 For windows without labeled u-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No comments/Location DOORS: 1. U-value: 0.086 Comments/Location AIR LEAKAGE: joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. when installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. 16 O 11 . r �4D'��'� `� e� sue' QO�OJy�eO�p � �'S '`�• III Q 1'P� ��^h 3i. �A• i Iry6 OyF� / rs QQ eop�1p0`DO '13 kl:b see �1y ��\ FF�� `� �>� •,� �\\ Off- ��Qy , �i ��G LOT 137 /\ 2005 NOTE: '^ AEA ``y`•:',' �'� �• �i.,- r B. / �6 �!�\ ® SEWER LATERAL SHALL BE rATH �;� �\ SLEEVED IN ACCORDANCE 4o 2897^ �PHIC SCALE WITH TITLE V IF WITHIN ,�•rs�ipN�ISTN05�1Q, 10FT. OF WATER MAIN. 20 10" 20 60 - .. ( IN FEET) ;nay Vr" 1 inch = 20 ft ,n ' ,' , _ ... - Vd�.1� i PLOT PLAN holmes and mcgrath, inc.,=`,P� OF LOT 138 civil engineers and land surveyors _2 TMI.OTHY M. A PREPARED FOR 362 gifford street a SANTOS a No. a5078 • I[ MILL POND VILLAGE Falmouth, ma. 02540 c!v,L�a IN F�1sTF�' YARMOUTH, MA FSSIpi pEEC JOB N0: 201197 DRAWN: LMC t SCALE: 1 "=20' DATE:12-29-04 DWG. NO.: A2524 CHECKED: -ram OF X W"ACHEESE IN TOWN OF YARMOUTH FS'E�P2320 rin'1 APPLICATION FOR PERMIT TO DO PLUMBING (OFFICE USE ONLY) By ZIW Fee: $ 03 PERMIT NO. io- Cb—a 09 Date By Buildi Owner's 4!nf3,c/z L� afon Al: Locl 3�i /'i/� Name .1 ��inp Type of Occupancy 9rc S Newel Renovation ❑ Replacement ❑ Plans Submitted Yes❑ No❑ ` O IV y U y' Y Z N Z W Y y W 0 O > J y m m Q� F y W O N W 2 N Q y O (r W y y G ~ } Q OQ J z Z U = a a Z FQ- W H Q 3 S V7 to J Q F co Y Z y O tJA Z O tY O LL d Cn J z Z n O u. z Z Z_ Q R p C9 Z a a tY m Z_ z G O W a 0= W Q W 7 M tY Y st V SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) /] Check One: Installing Company Name h,gds(we olg i /*a /yC. 5' Corp. a S"f6 G Address 30y /.v, WOW51df 'a ❑ Partnership 1IJ. of ✓{ a a6dfl ❑ Firm/Company Business Telephone 6 S%S�- y6 o S Name of Licensed Plumber INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent. Check One: Yeses' No ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. A liability insurance policy 200� Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Signature of Owneror Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Check on Owner ❑ Agent ❑ ignature of Licensed Plumber a Y79 License Number Type: Master ❑ Journeyman Zr of APPLICATION FOR PERMIT TO DO GASFI G Yq9 (OFFICE USE ONLY) TOW D r-d YAMT EESE By n- f"�. L SEP 2 2005 Fee: $ PERMIT NO. --Ob — a a 3Z. Date Buildin Owner's AT: Locatio /iv' /'1/!/ Name AMACic Z-4VE1/415 T, / sy• Type of Occupancy Newer Renovation ❑ Replacement ❑ Plans Submitted Yes ❑ No ❑ N Y cc ` rA Cn U O z M y 0 Uj M f/f ccO U S m F M F x 0J Z Q Cn UJ W } Q Z Q cc Q r� 0� M (9 W H 2 W Z Q F- a Q �% LU W \ \`\ W W N J Z Q W S cc W Z° W Z U x ° N 2 = 6 a w> CC w� z a a< W M 0 a 2 7 o}c G 0 J V 2 > G a O 2 LL FW- SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR (PRINT OR TYPE) Installing Company Name Q�f ir-C• Address w. !3,141Us. 11-7,07-0a4&12- Business Telephone �0 f( 6 &S " `<<6 S— Check One: . 2 Corp. -2 Sryo c— ❑ Partnership ❑ Firm/Company Name of Licensed Plumber or Gasfitter INSURANCE COVERAGE: Check One I have a current liability insurance policy or its substantial equivalent. Yes fOr- No ❑ If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy .&K, 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 I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit issued for this application will be In compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. ignature of Licensed Plumber or Gasfitter a y'7ys' License Number TYPE LICENSE: Plumber ❑ Gasfitter ❑ Master ZMurneyman APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 3;c +yg n 1 r- n = TOF YAF WTTA EESE j UL AUG C 4- 2005 lilii�MF4 g (PLEASE PRINT IN INK (1 To the Inspector of Wires: By this application .� work described below. Location (Street & Auf�ber _ n 0 (OFFICE USE ONLY) Fee: $ .4,.�2 wo PERMIT NO. r Uo r f IAT PN) Date: undersigned givesnoticeof his or her in en P. / Cie" lOwner or Tenant ' Owner's Address uciSc:�— Is this permit in conjution with a building permit? Yes C]No i�rpose of BuildinaL\LCX . Utility V� Service Amps / Volts OverheadQ vice (Lm Amps [20 /_ Us Overhead of Feeders and and Nature of Proposed electrical /6, to perform the electrical (Check Appropriate Box) Authorization No. Undgrd C] No. of Meters Undgrd �No. of Meters Cmmnletinn of the fnllnwine table may be waived by the Insnector ofWires of Recessed Fixtures No. of Ceil.-Sus . Paddle Fans No. of Total Transformers KVA o. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above In- Swinuning Pool gmd. gmd. No. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection an Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: um er — — ons — — — — No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Municipal Other Local Connection No. of D ers ry Heating Appliances KW g pp Secutity Systems: No. of Devices or Equipvalent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or u%ent Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may 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 emut issuing office. r CHECK ONE: INSURANCE, B ND O OTHER (Specify:) (Expiration Date) Estimated Value E trical Work: (When required by municipal policy.) Work to Start: I ections to be reque ed ' accordance with MEC Rule 10, and upon completion. I certify, un4theV and pea ' o urn at t e ' fo at n on this application is true and completeNAM�� LIC. NO. L ee: Signature LIC. NO.abexem t" in the license number line.) Bus. Tel. No.: -Address Alt. Tel. No.: - l rq WNER'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 Signature Telephone No. [Rev. 04/00] e- 1 MILL POND VILLAGE CONDOMINIUM CAMP STREET, YARMOUTH, MASSACHUSETTS PURCHASE AND SALE AGREEMENT UNIT 138 PLOVER PART A: References: [Affordable Unit] The following terms which are capitalized and marked in quotations in this Part A shall have the meanings set forth below wherever such terms are used in Part B hereof, and this Agreement shall consist of both Parts A and B and all exhibits hereto: A. The "Date of this Agreement" is 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: Amber Lavelle of 418 Pine Street, South Yarmouth, 02664 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 #138 PLOVER, 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. 1 G. The "Purchase Price" referred to in this Agreement is: One Hundred Nineteen Thousand and 00/100 Dollars ($119,000.00), which is calculated as follows: $119,000.00 (base price) + $ 0 (options and upgrades further described in paragraph I of this Agreement) PURCHASE PRICE: = $119,000.00 of which: $ have been paid as a deposit as of this day, $ have been paid previously, and $ are to be paid at commencement of Unit construction $ are to be paid at the time of the delivery of the deed in cash, or by certified, cashiers, treasurer's or bank checks. $119,000.00 TOTAL DUE H. The "Time for Performance" shall be at a.m. on the day of at the place referred to in paragraph 7 of this Agreement. I. Options and Upgrades. The following items will be included in or eliminated from the Unit to be delivered hereunder and the costs or credits thereof are included in the purchase price set forth in paragraph G hereof. J. Commission. A commission fee for professional services specified in this paragraph is due from SELLER to Housing Assistance Corporation,(HAC) but only if, as and when the SELLER receives the full purchase price pursuant to this Agreement and the BUYER accepts and records the SELLER'S deed and not otherwise. Commission Due: 1.835% of Purchase Price -2- GSDOCS-1282281-1 FILE COPY. f . /y s?, EXISTING ��. s?•M�j FOUNDATION �J ,y'ti v-o U . CO. ARC\ems, LOT 139 �J� 0 EXISTING F tip0 FOUNDATION \ 1rL% �1Cb \ / t S Xs, EXISTING ' FOUNDATION x LOT 137 I CERTIFY THAT THE FOUNDATION IS LOCATED IN FLOOD PLAIN ZONE C AS SHOWN ON FLOOD. INSURANCE RATE MAP COMMUNITY PANEL NO. 250015 0005D AND THAT FLOOD PLAIN ZONE C IS NOT A SPECIAL FLOOD HAZARD AREA. Dill REGISTERED PROFESSIONAL LAND SURVEYOR NOTICE 20 Unless and until such time as the original (red) stamp of the responsible Professional Engineer, or Professional Land Surveyor appears on this plan: (A) no person or persons.- Including any municipal or other public officials. may rely upon the information contained herein; and (8) this plan remains the property of Holmes d: McGrath, Inc. I CERTIFY THAT THE FOUNDATION IS LOCATED ON THE LOT AS SHOWN, AND THAT ITS LOCATION CONFORMS TO THE MINIMUM SETBACK REQUIREMENTS OF THE 40B SPECIAL PERMIT. /l-7 2w'S DATE REGISTERED PRO SSIONAL LAND SURVEYOR GRAPHIC SCALE 10 0 20 60 ( IN FEET ) 1 inch = 20 & AS —BUILT PLAN holmes and mcgrath, inc. aOF ., PdiCBAEL y`yt OF LOT 138 civil engineers and land surveyorso PREPARED FOR 362 gifford street MCGRATH y ; MILL POND VILLAGE falmouth, ma. 02540 9 No.2897a o� �Fs a N YARMOUTH$ MA SCALE: 1 "=20' DATE: 4-26-05 JOB NO: 201i97 DRAWN: LMC DWG. NO.: A2524A CHECKED:,.0* is e P�