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0138 ELLIOTT ROAD
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HYANNIS,MASS.02601 Bond r - .: -:-.•::..... ~ CERTIFICATE OF USE AND OCCUPANCY Issued to Prestige Properties Address Lot #1, 138 Elliott Roan? Centerville" MA USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. October 17 .. .... 19...9 .......... ` � Building Inspector �. , ..� °•� TOWN OF BARNSTABLE BUILDING DEPARTMENT _ --'� = aARi� 'riva TOWN OFFICE BUILDING ~! t639' HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building/ Department DATE: An Occupancy Permit has been issued for the building authorized by BuildingPermit $ .. » l .». .....».......................................................................... .............................»»»».......»»». issuedto ! _ 1! // '` �f�1P��»..........................................».............................. »...».._» ...»..»........ Please release the performance bond. Assessor's office(1st Floor): Assessor's map and lot number oi THE ro`o Conservation —16 9 ,6,7_ ,�3 TIC SYSTEM MUST BE � • Board of Health(3rd floo): INSTALLS® 'N COMPLIANCEw Sewage Permit number WIT�I TITLES t VA Sewage ; N a Engineering Department(3rd floor): ENVIRONMENTAL COIDE AND ' �o 6�V House-number 313 '� •T(a N REGULATIONS DefinitimeAm Approved by Planning Board tg APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only �6 . TOWN ' OF BARNSTABLE � 0D BUILDING INSPECTOR APPLICATION FOR PERMIT TO C f!n S E r ue-E r7e-4f S:n 'F TYPE OF CONSTRUCTION _ bu o o d a P 19 93 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora r i accor g to the following information: cow j 1 - C'e-vfc•Zvtc4 Location E Proposed Use �we!! Zoning District '� " 2C z Fire District C- O - t* Name of Owner '> `'" Address P. D, i30,x s 74 PeK tc.V. 1c Name of Builder �reeKhr'e,- °H Address_n Name of Architect "— Address Number of Rooms Foundation oOiYe Cox ere f-e ---- �__ Exterior C f a0 b o-d.-d 5 /W `9!-es Roofing 04 5 4-a 16 Floors C ��f / v � Interior r0c, X Heating N A b� h a s Z �ONe'S Plumbing Z Y2 1,,2 f 4-s Fireplace r Approximate Cost ��a' sacra ' q a� ssa�y Area y-� Diagram of Lot and Building with Dimensions LL Fee 7 �75V i Se e- a fE OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re rding the rvonstruction. Name Construction Su isor's License 60 3 9 7 i GAR - No Pemmit For Two Story Single Family Dwelling Lot #1 , 138 Elliott Road Location a Centerville ' Greenbrier Homes Owner . Type of Construction Frame i Plot Lot Permit Granted April 21 , 19- 94 Date of Inspection ?� y 19 �at let 19 ` ` IT ., r� : r_.. ,, I I r I ( �; i t I c_ a :', ..'-" , 1', w _W. _ - ", �.' 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PETER �r c St1L11VAN y i t i i f .,1t;, , ,•.� � t1 ,.. '. ,�� 5's� Ml + + � t i , , — —� -r •t — rJ . i , I } :303.; Engineering Dept. (3rd floor) Map 2. Parcel ^ e Permit# 7c;�,7 House# ! Date Issued j`vl—f iA Board of Health(3rd,floor)(8:15 -9:30/1:00-4:30 ;��ee � Conservation Office'(4th floor)(8:30- 9:30/1:00-2:00) Planning Dept. (1st floor/School Admin. Bldg.) IHE Definitive Plan Approved by Planning Board 19 SEPTIC SYSTEM M WSMLED IN COM. 'TOWN OF BARN � HNTATIT�coy' a q Building Permit ApplicatiolJOWR,RE0ULA4TIONS Project Street Address_��?J f5l� L l d jZ 01< Village /LLL Owner /P S Address l j e4'e" az �CAO Telephone Permit Request w. . 2 y 'X 26 First Floor square feet Second Floor square feet Construction Type G��bt�f&AJ*4 4' Estimated Project Cost $ 2 000, Zoning District Flood Plain Water Protection Lot Size Z Grandfathered ❑Yes ❑No Dwelling Type: Single Family , Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes �l No On Old King's Highway ❑Yes No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half. Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas p Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name ,cam/<L G 1A2 FYI L.Z e Telephone Number -�T Address �i� C/�OGKE12 �T; License# C, Ehr�n a,cL e Home Improvement Contractor# Worker's Compensation# 00Z3129 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Z-A dk BUILDING PERMIT DENIE FOR THE F LLOWING REASON(S) FOR OFFICIAL USE ONLY ` PERMIT NO. - DATE ISSUED MAP/PARCEL NO. •.' .. ., 13 yr. ,_ ADDRESS r r. VILLAGE' OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION . FIREPLACE VJ ELECTRICAL: ROUGH- F'" FINAL ' - r PLUMBING: TROUGH ;" •FINAL GAS: Xi o fe. FINAL - ,. r• - ;. FINAL BUILDING 4� ✓ f r+ J-'j �Y DATE CLOSED OUTj, t ASSOCIATION PLAN NO. 1 `' .� jw �(� �y^^ C� � � � ivy _ _ :�, - . �; �/ � 1yy �� ti i,,NHI i , �d•« � � r, I -1 I t+, c : k � r VF S° I I ; �Y I ,I U II ) , i 6Y I I I a 'o. is �1------- -+. ' I � ,. •. 1$ I I p f I I I I I I II i II l 11114144 i Ill !Ili!IIBf III I � I I I I 0 ,�� •aga � I' � i �. ',•,I I III E- g IN �. • i I -tad p I �. � ' � ff}111�11'I` I q T <I { I I i I e '�. � •,III l_ +� ' t . ; The Town of Barnstable • ux�vernar,�, • Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,.demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. 7 Type of Work: Estimated Cost 4Z ��• Address of Work: / J 8 o Q Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law _ C]Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: oy0 Date Contractor Name Registration No. OR Date Owner's Name q:fbnns:Affidav I The Commonwealth of Massachusetts =- Department of Industrial Accidents 600 Washington Street - c�? Boston,Mass. 02111 -' Workers' Compensation Insurance davit i �����C����������� ����������������������������������1�1�,������ name: z/,U-J,4 A'.4'I J c•N 4 L Z-r. ,. . location: l 3 8� f-:�gd 42z� /I e�� I city phone# ❑ I am a homeowner performing all work myself. . ❑ I am a sole rietor and have no one workia in ca achy %%%/%%%%%/%%/% %%%%%%%/%%%%%%%%%%%%%/%/% %///%%%/%/%%%%%%%/G%/G%%%%%%%%/G��%%%///%%%%/G�%///%/%%�///%/%/////�� ff /////�i, am an employer providing workers' compensation for.my employees working on this job. >:.:.::::.:: <:::' >;: :>::>':;:>:>:::: >::>':>':>:::>:::::>::::::..::>::;:::...;.X...: ........ m an ram ;:.::.;:.;'.;:.;::.;:.:;.:;:.>:.::. :.>:::.»>::?;::::::?::. '�- 22':;f `' .; ` `. i> `'':'E'': ''';::-y�> ``'`> '''Y:i`i<'::%:::::< :::Y::r:`::': ::f`% ": : %: isi i 2 v'<`::::::::::t'` ..... :......:.... . . O. cites s ?:.:::::::::.:..::. ..X...:::::::.::.::::..:. atfsdtrancexG.`::::.X.:. :'>::;::;;:;::.;;>:.?:,::::::::'':: go #' ': :...... i ❑ I am a sole proprietor general contractor, r homeowner(circle one)and have hired the contractors listed below who have thefollowing workers'..compensation polices::::.::::..:::::.:::,::::.::.:.:::::,::::.:,:::::::::::.:::::::,.:::.::::,::::::::::::::.:.::::::::::::::.:.:::::::::::::::.:::::.:::::.:::::.:.,::•:..:::::.::. comoanv4sme.: ;»>»>>:;:::>`i:: :::.t_.F:,.:: a f<... . ;:.: :< ::�x.. >..:.JY: > ..� 1. .: XXI.- .............. ...............................................................................................,.. :.::::.:::::::.::.:::.::::::.::.::::::.:..::.::::::............:::::::::.::::.::::::.:.:::::::::::::::.::::.::::::::.:::.::.:..:::::::.:::::::.:::.: ::::.:::::..::.:.::..::::..:..::::.;:.:.......:::;.;:.:;:.:.;i;::.;:;;;;.;:::::::.::.;:.?:;.?:. ??:.:;:.::•::.:::::..:<.?:.?:;.?:,<.::.:::.::.:...........:..:.:...:.......:.::::............................................................................ 111; ...............................................................................................................................................................?.?:.?:................... ;::?:;:»;::': »:.'..::«:,..,-.::::»::<>::»:<::<::>:: :::>::>::::;:<::>:::::;;.:>:::>:>: <<::<:;:::»::::?'><'>:':. :?::;-....phllat ._. .....- ..... ......—.. . :?:. .. ... .. .. ........................ .................................. ............... ..:i:WTY SAJ J:4 ii:iiii v?? >::ij:%:ij?ii'?ijiii:<:iii::�3ii::iii:...i'ri:i:i:?iCi:2:::i?Y:i j+j i'i%:fi':>%:•iil''i:;:ji}iii:^i?y:};+{}{:+isj;Y?i:;:;:;i::;i:;:isiTi::isii:ii?'?:?:'r :;:;;:;�:': ;..I- ::}iii:4::;{:jit::iii':vi: }.:;4;ii?:::•i;;;??;:J::is i????:!i:�??ii:•: v:::::.�:.:�:::.�:::::•.�:.�:::......... ................v. .........:...........:•::::::::•::::::::::::::::v:::::v.:::::::. :•:::::•:::.:::::?:::::::.:::.ii??}???:•;::•?:•?;:?:.ii?}?:•i:•i}i •.•.••.•.•..•••••••••••..•..••........•.tG;?i:•??::Jiiiiiii::.:.n:. +vtJh. kYrv., ...............:::....:.....................................................................:..... . ......:::::::•?::::::•:::.:.:.::::.:................................ hsiurance:ca...... . :............................:...:.::.::.::..::..:.::,:::::,::::,. ::..,.:.:.,:::::::::.:.:.:::.:::::.: o #.::::::.:::::::,.:,::::::.:::.::::.:::,:..:.,:::::::::,:..:::::::::•:.::. ..............:.............,......... :;:>::t:>::s: : :;;•:.:::::•:::::::.::::::::::::::.,.:.:::::•.:::....................... .........................................I....X........ 1. 1. >ti zz< ...............:........`Ii..........:...:::..:::...:......:..::::....:.:.:............::::::..:.......:.:.::::.....,.:..:.:::.:............:..;.....:......................:::.::::.::::.::::.::..:..............:......................................,.::. as .name:::::. :::........... ..',. .;.,.,. ..................................................................................;;-;-;.................................................................................................................................................. :..............:::::::::::::::.::::::::::.:::::::::::::::::::::::::.i:.:;.;:.;..::::::::::.::::::::::::.:::::.::::::::::::;::..:::::::::::.:::::::::::::.:::::::::::;:..::::.:.::::::::.:::::::::::::.::..::::.:::::.:::::::::.:::::::::::. il: :....:.:::::..::::::::::::.::::::::::::::::::.:::::.:::::::::.:..-:::::::::::::::::.:::::::.:::::::::::::::.::.. :........................ ::::::Ew<� i:<> . address =A> » >' >:: > ti ... :t:» :'4' ............. ........ ::::•::::.::::::::. ::^v:.. .........:.....�:::. jj::k:.':ti:tiv::::i: K " :' ::- a3ti. .:.�•... .:::w:.............................................. ..... ;+:h:.— :::Y iT::::is4:>iC<:iiiiiii:ii::!?G.'v<'`•T1 ii}iw:::::::: ..............:..:......:.::::..::..::::.............:... ... ............... 11" •5:•i;::!Jy;:.;•.:.:::i::{...;.:::.•.::.i..�.yni'::•::::.}::::i.::;:?.};•i;i.::::::.y:::::::::::::4v?;;•.Y;::::v':v'.i:iv?Y:y::.}w::+•;Y:•;-.f:.}. w::.�:::::::: •:i??Y.•:•?,.b:•.:??:v:.isYv;.n}:Y:isJi:!:viii:4:;;v:::•::;:;h>;:::?;:•::;;?i':4:Ji:w.J::.�::??:J::.:.i.:w:::.-:5::?iii: ..;;:::;: •�:i;;s::>.:i;iy::iy;}:;:;iiiif:ii?i:iiij$:ii i::isiC:?:;f;is;i;';>:;:;; :;'::ayj':'':;?:;:::::: :: Failure to secure coverage as required order Section 25A of MGL 152 can lead to die imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby certify under the pains and penalties of perjury that the information provided above is trw.and coned If Signature Date /z �� 4 g - Print name Phone# official use only do not write in this area to be completed by city or town official . city or town: permit/iicense# ❑Building Department ❑Licensing Board ❑checkitimmediate response is required ❑Selectmen's Office . 0Ilealth Department contact person• phone#; _ ❑Other Onised 9193 PUq Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for .- e=piovees. As quoted from.the "law", an employee is defined as every person in the service of another under any watt- of hire, express or implied, oral or written. , An employer is defined as an individual, partnership, association,corporation or other legal,entity, or any two or=ore of joint enterprise. arid,including the'legal representatives of a deceased employer, or the rece:s'e= ct:,.foregoing engaged in a j rP r*ustee of am individual , partnership, association or other legal entity, employing employees. However the owner of s dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of ...�.e�—.6—AV",ninqM r.Prennc in rin maintenance , construction or repair work on such dwelling house or an the grounds 0: building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chap ter 152 section 25 also states that every state ooca r local licensing agency shall withhold the issuance or renew _ ;. of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who ha not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the ccmmonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work unta acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contra g authority. ' Applicants compensation affidavit completely, by checking the box that applies to yoursttnation and Please fill in the workers' comp bers along with a certificate of insurance as all affidavits may be �V supplying company names, address and phone num submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and $ � date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is �Nlu z being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you: are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Pl=e be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of im►estigations has to contact you regarding the applica= Please be sire to fill is the permitAicense number which will be used as a reference number. The affidavits may be reurncd io the Department by mail or FAX unless other atraagemeats have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please :a not hesitate to give us a call. 11 7 The Dept moat's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Oiice of imtest10alloas 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 eat 406, 409 or 375 ,., �' � ✓fie i�o�n�nzoozurea� a�•�aysac�iudettt M' DEPARTHENT OF PUBLIC SAFETY CONSTRUCff0t,,SUPERVISOR LICENSE Nucber Expires: f �Estricted� .; ;` 00 V ' ' I ILL IAW'. SCNULZE PO 803,188x s Y; a rrA4/CENTERVILLE, NA 02632 IMPF11f I� A�TDR • ;Rsistrat�0 ����49.: I _IAMB ER- ENTERV ll51 63 � ~PERMIT TOWN OF BARNSTABLE, MASSACHUSETTS "'BUILDING DATE 19 PERMIT NO. ..Y." 3, pi I APPLICANT ADDRESS 'IND.) (STREET) ` ,ICONTR'S LICENSE) yq t 1 1._,; - �i"-.. , ? �,. .,_ i.j lra.q-. -,NUMBER OF PERMIT TO - (_) STORY -" OWELLING UNITS'.:" (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) � AT (LOCATION) - " DISTRICT_ jel BETWEEN Q• /r/J�lJ" G•.(��!' AND (CROSS STREET) - (CROSS STREET) SUBDIVISION -LOT 'BLOCK- S:ZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY �! FT. INN EIGHT AND SHALL.CONFORM'IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR.FOUNDATION *ret; REMARKS: Ix AREA OR -,�'.. .;. -+,': PERMIT VOLUME ESTIMATED COST $ "' ,FEE (CUBIC/SQUARE FEET) OWNER _- ,„ � .-t. • BUILDING DEPT. ADDRESS BY I THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART T}iEREOF.�EITHER"TEMPORARILY OR PERMANENTLY, ENCROACHMENTS- ON PUBLIC"PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINEv FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS.PERMIT DOES NOT RELEASE THE APPLICANT FROM THE COND)TIOS iS OF ANY APPLICABLE SU BDIV ISION.RESTRI CT IONS. MINIMUM OF THREE CALL -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTILFINALINSPECTION HAS BEEN 'ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTLFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING S•HALL NOT BE OCCUPIED UNTIL _ - MEMBERSIREAOY TO LATH). FINAL INSPECTION HAS BEEN MADE. - - 3. FINAL INSPECTION BEFORE - - - OCCUPANCY. POST THIS CARD SO IT .IS VISIBLE FRrgw%M STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION 4PPI30VALS 1Y I V. --- 2 z vis/x��l 2 HEATING INSPECTION APPROVALS ENGI ERING�JEP T ENT J - BO I�TH OTHER LPLANREVIEWPROVAL(©Irz WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT "W!LL BECOME NULL AND VOID.3."F CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION I PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. f .L A �L, EG NOTIC Date Article Section of the Zoning Ordinance EREAS, violations of Article—may Section of the Building Code have been found on Article Section of the Code se premises,IT IS HEREBY ORDERED in accordance with the above Code that all persons cease,desist from,and STOP WO,RK at once pertaining to construction, alterations or repairs on the a premises known as //0�` / # l3 e ozz/'o 7T '/6 - I persons acting contrary to this order or removing or mutilating thi ice are liable to arrest unless such tion is authorized by the Department. :.r G CODE OFFICIAL 1 ;,{ 1 f ^ t , I Foy it J , , t t } i 4 I, i t , ✓� 9' k ti {. ' V'ILUAM No 19334 •) AV G D C.d T/O/C � :�;�/o�.�/v yE,�EO.v Cow-1.�.�YS ,. ._ �.. .k .� _. _.. _ •_ . ,4 SETB,4 Cl-, 'EQliieEi'�1E.c/TS o,C- 7"h/E Tow�c/oF" �.L>q/C/ �2EE�2EtiC'E IUOF aCA W17_s,V//V TyE .�LoaDPLA/y, �LA�cJ. r-4;r? E'T.S.��f/a,VIYI ShL�ULD M0 B� j J''E'el�/�,CL ,4G.a.L/C, 7"lj� C�!v;v" a ® ® r ® ISSUE DATE(MMIDDlYY) 19/94 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE McAlpine Insurance Agency DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE One Center Place POLICIES BELOW. 1550 Route 28 COMPANIES AFFORDING COVERAGE Centerville, Ma. 02632 COMPANY A LETTER The Travelers Insurance Company COMPANY INSUREDLETTER B COMPANY C Greenbrier Homes , Inc. LETTER P.O. Box 510 COMPANY Centerville,Ma. 02632 LETTER D COMPANY E LETTER , THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. CO POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY BODILY INJURY OCC. S COMPREHENSIVE FORM BODILY INJURY AGG. 5 PREMISES/OPERATIONS (PROPERTY DAMAGE OCC. (S ! UNDERGROUND PROPERTY DAMAGE AGG. Is j I EXPLOSION&COLLAPSE HAZARD I nPRODUCTS/COMPLETED OPER. I&PD COMBINED OCC FS ! i i c0`TRACTUAL 1'D CO,�BitJEC AGG. ! ------------- I I i':DEPER^ F:T CONTRACTORS PERSONAL INJURY AGG. 5 1 j ! BROAD FORK'PROPERTY DAE6AGF I I -SONAL INJURY ' AUTOMOBILE LIABILITY BODILY INJURY ! 'ANY AUTO I (Per oersoo) j S ALL OWNED AUTOS(Priv.Pass. I I I I "----- a -------t----- I BODILY IPJJUE S Other Than H;RE'JAUTOS PRO(EI?TY NON-O'A'NED AUTOS I I GARAGE LIABILITY i FODIi-Y :r:JU{tY E ! — FORS.' I j AGGREGATE -- ---'s ---- ! �r j07 ri.ER 1 r%":Ut:BRELLA F Ofit.' •�� i i I � i+ -'E UTOF:Y Llhii i'E j ---_i _�.� ! L:'ORK.ER'S COMPENSATION --- I ' '-" . { 04/08/94 04/08/95; -�-AND 560K8345 j-Y-- !-5 0--0J,-0-00 .A "' 6Y EPS'Ll1;rt 1 T .100 OOO -�- , ' I fi�}t_r'.i ti;af"r")Pt:Ff r!.e,_S.1 GGAt;I:d:: R'u.! �SlSPECi AE tTEtdS �.,1{ 1t i Carpentry r � -Nbr yj -'>I S i .y.'pia..,�.�:-�"�,.?L..,t':-�..rs 'x' w::'�t.�. ......:.�",`...... F,.....«.£v`z,, r_g:aa,�.'�� ..'a't.+s..•-k.�r:;w,: �»t- ..,...,.. ..a ......^Z...,, ..`-k.._ k }........,..La.�f�.t.�.�z a.,�.4'rG.�;!Y.a��.t:::x'f.-.."3.._ ..•,r...s....a.."a..,,., :. .. : I � 4 I TOWn of. Barnet able Fxr>I�/ TE Tt�ER(UF. 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