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HomeMy WebLinkAbout0060 GROVE STREET l I . I Application num r..4�......... . tMEC� �.�' Fee ........................ ��.. ........... ................... Building Inspectors Initials.......... .. ...................... Date Issued....... ... d Ma Parcels .... .... ............................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project:6© CroV42-- e nrs R STREET VILLAGE Owner's Name: �GprILTr /��-h Phone Number �� - 3 6o..—l`- -7/ Email Address: Cell Phone Number Project cost$ 2S Check on Residenti Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK Siding Windows(no header change)# Insulation/Weatherization oors(no header change)#~2. Commercial Doors require an inspector's review U Roof(not applying more than I layer of shingles) Construction Debris will be going to �`1`l�- sJL.� � CONTRACTOR'S INFORMATION Contractor's name ��/� �P.�! ��R-t1-7 Home Improvement Contractors Registration'(if applicable)# 2 y 7 b (attach copy) Construction Supervisor's License# (,� '- ll���� (attach copy) Email of Contractor)OPl VLDVGGh&.tt Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR/F THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT. YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION.NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent Fuel source being used LP tank 20 lbs. or> Yes No ,if yes, a gas permit is required. Natural Gas Yes No ,if yes,a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3.30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. , Signature Date YJ�ICANT'S SIGNATURE Signature Date ' All permit plic ' ns are subject to a b ding official's approval prior to issuance. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): t F—kw -L-,0 U Address: 9-0Y ( �1 P1 City/State/Zip-/1fr1-r,S A*A l r Phone#: Are you an employer?Check the appropriate b : Type of project(required):. 1.Ly I am a employer with � 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the,sub-contractors , 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor me in an capacity. employees and have workers'. Y P tY• t � 9. Building addition [No workers'comp. insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their ' 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.F]Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. ///1 Insurance Company Name: �' VtQK lh � Policy#or Self-ins.Lie.#:' G - t7 Expiration Date: `Z `�,?,0/9 9 Job Site Address: 0 or-0 V City/State0p: ,4/d Attach a copy of the workers' compensation policy declaration page(showing the policy numWer and expi tion date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurayfcoverage verification. I do hereby certify un the pa' and penalties of perjury that the information provided above is true and correct. S i ature: Date: < Phone#: vv �`� �7 CY Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract 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 more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency"shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be 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 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. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please 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 Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which will be used as'a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address;telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington.Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 wwwr.mass.gov/dia Home Improvement Bel Islands Home Improvement 204 Cinderella Terrace Name i Address Marston Mills,Ma,02648 cape cod HOMES,Lac Scott Manley -Belislandsroofingandsiding.com 60 Grove sheet 508-280-1794 / x�A1s,ma 508-364-6909 0 U ew Tents Project Description Qty Rate Total. Extra charge to upgrade shingles to Lark Pro is$850 POSSIBLE EXTRA- Any rotted plywood,trim boards,lead flashing or other carpentry needing replacement will be done and charged for as an extra at rate of$60.00 per hour,plus 15%marls up materials Bel LSlands Home Impmvem Mt Guarantees the labor for Lifetime of roof and against Blow-offs for 15 Years. Bel islands Home Improvement:Carries Worksman's Compensation and Public Liability Insurance on the above work, certificate available upon request New Siding installation(LAbor/matenals)-whole house #00.00 8,41F0:OD 1.Strip old vinel siding Y 2.Supply and install proper undealaymeat(Typar Paper) 3-Supply and install new White Cedar shingles New Azek trim installation(Laborh aterials) 4,000.00 4,000.06 1.Supply and hrstall new Azek rakeboards(2 members)-front and back gables 2.Supply and install new Azek coraerbomds(All five corms) 3.Supply and install new Azek Freezeboards (Front and back of the house) New Harvey or Anderson 200 series windows installation(8 f Z 700.00 5,600.00 windows)-laborhnaterials 1.Remove old windows 2.Supply and install new Windows with proper vieor flashing 3.Supply and install new Exterior Azek trim and interior colonial trim New back exterior door installation(labor/materials) 1 8 40000 Permit 400.00 0.00 400,00 600.00 600.00 Total $24,750.00 Y 7 `� Page 2 Date, Estimate# L ISLANDS Home Improvement 9/3/2019 1033 Bel Islands Home Improvement 204 Cinderella Terrace Name Aaaress Marstons Mills, Ma,02648 cape cod HOMES,LLC Scott Manley Belislandscoofingandsiding.com 60 Grove street 508-280-1794 Hyannis,ma. 508-364-6909 Terms Project Description Qty Rabe Total Bel Islands Home Improvement-ROOFING PROPOSAL- 4,9W.W' 4,900.00 ,laborlmaterials( architect shingles)-whole roof L;c BEL Islands Home Improvement hereby propose to perform the fiollowing services in a neat professional mariner in accordance with manuficturers specifications and local building code Strip existing roof shingles(1 layer of shingles) and nmmvc all debris.Any more layers of roofing needed to be stripped-it will be additional charge. and install• New Shingles:Certainteed Architectural Landmark shingles with lifetime warranty,10 years Algae Resistant,110 MPH Wind Warranty,240 Lbs weight/square-(Every shingle will be nailed by the code with 6 nails-storm nailing system) install: Vol 8"Aluminum Drip Edge install: Certainteed ice and water shield to eves,valleys,rakes,and skylights and low pitch areas (18"on rakes and skylights and 3 ft on eves and valleys to prevent ice dams) install Certainteed Swift Start-with self-adhering asphalt starter course on all eves and rake edges install Aluminum&Neoprene Soil Pipe Flashing Install: Synthetic undelayment paper(Rhino) install Precut Hip&Ridge shingles and new ridge vent Total Page 1 oRlce Of ConsumarAff@ IFS :B;_Byslne HOME IMRRGVEMEyY.C-_, 9I atlon TY QNRTRACFOR AND REhYAR � 07%00 � D/B/A BEL ISLAIr,)]�8_ IMRiOVEMENT ' AND,EI YARMAL��/ H� 204 GINDERELLA MARSTONS MILLS,IIdA 02948 Underseerefa ry . Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Constr ij"(visor Aires:0610112021 CS-111305 ANDRE YARMALOVI 204 CINDEREL--LSO TE MARSTONS MILLS MA''0'�648 Commissioner t/'�' Registration validfor individual:use only Ri tiefars the oxpitation:0dte,, }o4rfd return to: Office of CPnsumer Aff@ d Bysinsss Regyl T 10.00 Washington-Stye• ite 770 Boston,MA 02118 No 1 fMout si ure Construction Supervisor unrestricted-Buildings of any use group which-contain. - Iles than 35,000 cubic feet(881 cubic meters)of enclosed space. Failure to possess a.current edition ofthe Massachusetts State Building Code is cause for,rsvocation of this license. For information aboutthis license Call(617)727-3200 or visit WWW.Ma.ss.gov/dpl 1 _ � U a Wells Fargo Home Mortgage 1 Home Campus MAC: F2303-04J Des Moines,IA 50328-000i Ph:877-6i7-5274 07/10/19 Town of Barnstable Attn: Robert McKechnie 6�i7 occ- Building Department 200 Main Street I ra Hyannis,MA 02601 f Regarding Property Registration at: ca w 6o GROVE-STREET HYANNIS,MA oP 309-075 • a 5 Dear Sir/Madam: M rr+ The property above was sold to a third parry as of 04/19/19;therefore, Wells Fargo no longer has interest in the property and is no longer the responsible party. Please update your registration records. Thank you for your'assistance in this matter. Sincerely, Andrea Steffen Research/Remediation Associate ' Wells Fargo Home Mortgage Brittani.d.coleman@wellsfargo.com - Wells Fargo Bank,N.A. MAC F2303-04J One Home Campus Des Moines,IA 50328 Ph:877-617-5274 . i June 9,2o16 Town of Barnstable Attn: Robert McKechnie -1 Building Department 200 Main Street Hyannis,MA 02601 1 Completed Property.Registraiion for: bo GROVE STREET HYANI�IIS,MA o26012912 " " 0 TAX ID: 309'�075 � �' ... .•.._m�� � _ .. a. �_ : _.. .. . .... . . �._ . Dear Sir/Madam: Please see the attached property registration form for the above property and use the,> below contacts to expedite any future requests. Xj " Thank you for your assistance in this matter. Code Violations: CodeViolations@WellsFargo.com Property Registrations: Registrations@WellsFargo.com a. General Property Preservation: Property.Preservation@WellsFargo.com Call Toll Free: 1-877-617-5274 For questions regarding purchasing a Wells Fargo property please contact 1-877-617-5274• �Sincerelyy. . ...........�,"�. .�...� �<. ..�:...s Angela Pryor Research/Remediation Associate WPllc Farm Rank N A AngelkLPryor.@wellsfargo cornF r One Home Campus,F2303-04J Des Moines,IA 50328 t•-s _ t: --n �: cn _ w Mi. Town of Barnstable, 367 Main Street, Hyannis, MA 02601 REGISTRATION AND CERTIFICATION FORM FOR FORECLOSING/FORECLOSED PROPERTY Thank you for registering in accordance with Town of Barnstable Code chapter 224 sections 224-3 and 224-4. Please complete one form for each proptrty in foreclosure (section 224=3) of already foreclosed for which possession has'been taken (section 224- 4). Please file the original with the Building Commissioner and a copy with the Chief of the Fire District in which the property is located. If you claim you are exempt from registering under Massachusetts law, please state the reason(s)and complete section 1 (property information) and the first paragraph of section 2 (foreclosing party, court, etc. and foreclosing party representative,but not other representatives and attorney) so that the Town can review the exemption and update its records: N/A Section 1 —Propelly Information Property Address: 60 GROVE STREET HYANNIS MA 02601-2912 Assessors Map#: n/a Parcel#: 309-075 Land area and description 5,663 sgft (or 0.13 acres) Building(s) description and contents single family home of 804 sgft Occupied: yes Occupant(s)(if borrowers so state and include name(s)) James Climo c/o Wells Fargo Bank,•N.A. Phone: 877-617-5274 email: codeviolations@wellsfargo.com other: fax: 866-512-0757 Vacant: no Date: 6/9/16 _Anticipated Length of Vacancy: n/a Last occupant(s))(if borrowers so state and include name(s)) n/a Phone: 877-617-5274 email: codeviolations@wellsfargo.com other: fax: 866-512=0757 Has possession been taken no If so,please explain and complete and file the maintenance and security plan form(unless exempt as stated above) see attached vacant building plan Section 2—Foreclosing Party Information Foreclosing Party (full name/title) n/a Foreclosure Case Court: n/a Docket# n/a x :.w �' Date filed: n/a Current Status: n/a Foreclosing Party's representative(s) for property (entry, management,repair., etc..)(name,title,): n/a Company(if different from, foreclosing a Wells Fargo,Bank, N.A. Address: 1 Home Campus, MAC F2303-04J, Des Moines, IA 50328 Phone: (877)-617-5274 email: codeviolations@WellsFargo.com other: fax: 866-512-0757 If an exemption is claimed,please do not complete the remainder. Other representative(s) (if foregoing representative is primarily responsible for property and/or foreclosure and is most likely to be able to address town matters concerning the property and./or foreclosure,please so state and(Io not complete contact information(i. e. "none"or"see above")). Name, title, other: see above Company(if different from foreclosing parry): n/a Address: n/a Phone(s): n/a email(s): n/a other: n/a Name, title, other: n/a Company (if different from foreclosing party): n/a Address: n/a Phone: n/a t email: n/a other: n/a Attorney representing foreclosing party Orlans Moran PLLC Firm name (if different from attorney's name): n/a Address: P.O. Box 540540 Waltham , MA 02452 Phone(s), 781;790.7800 email(s): info@orlansrnoran.com o,her,,.n/a I acknowledge that the information provided is accurate and correct. I also understand that any inaccurate information will result in non-compliance with section 224-3 of chapter 224 of the Code of the Town of Barnstable. Angela Pryor,Research/Remediation';Digitally signed by Angela Pryor,Research/ Associate,Wells Far o Bank,N.A.I:..Remediation Associate,Wells Fargo Bank,N.A. 6/9/1 6 g i D8te:2016.06.0915:14:08-0800' Date: Name:Angela Pryor Title: Research/Remediation Associate Z I hereby certify that the above-named foreclosing party is in compliance with the provisions of section 224-3 of chapter 224 of-the Code of the Town of Barnstable. Date: Building Commissioner,Town of Barnstable MAINTENANCE AND SECURITY PLAN FORM FOR FORECLOSING/FORECLOSED PROPERTY Town of Barnstable General Ordinances, Code section 224-4,requires a mortgagee taking possession of a property before or during foreclosure, or after foreclosure if the mortgagee becomes the owner,to bring the property into compliance with the , maintenance and security standards contained in Code subsection 224-4(B)within thirty (30) days of a notice from the Building Commissioner. Please either complete and file this form or another containing the same information with the Building Commissioner within thirty(30) days of the notice. If a mortgagee claims an exemption from the provisions of Code sections 224-3 and 224- 4,please explain, leave the remainder blank, sign at the end and file this form or letter of explanation and also complete wnd.file the applicable sections of the registration form for foreclosing/foreclosed property NSA Town of Barnstable, 367 Main Street, Hvannis, MA 02601 (1) Registration date: 6i9i16 If not registered, please complete the registration form and state date of filing or anticipated fling N/A (2)If commercial property, describe space utilization floor plans required by the Fire Chief and filing date(actual or anticipated)N/A (if in possession or ownership must be certified as accurate twice annually in January and July). (3)Describe any hazardous materials on the property as that term is defined in MGL c. 2 1 K and the date(s)and method(s)for removal as approved by the Fire Chief UNKNOWN (4)Method(s)and date(s) all windows and door openings secured(or will be secured) UNKNOWN If left secured, name, address, and contact information of security personnel providing twenty-four-hour on-site security personnel on the property wELLs FARGO BANK,NA., F2303-04J; VHONIE CAMPUS, DES MOINES IA 50328, 877-617-5274 " (5) Location(s) and date(s) "No Trespassing" signs posted or to be posted on the property UNKNOWN (6)Name(s), address(es) and contact information of person(s)responsible for maintaining: structures, lawns and shrubs in sound condition free from excessive growth and the property generally in accordance with the Barnstable Zoning Ordinances the definition of"maintenance" in this Ordinance; any other provision of this Ordinance; and for disposing of trash, debris and pools of stagnant water as provided in Chapter 54 of the Town of Barnstable General Ordinances WELLS FARGO BANK,N,A. X9400-034, ONE HOME CAMPUS, DES MOINES, IA 503.28 1� { $R 55 :•t.....i '` t.+�v'ukc '-8_>vm...�,>,1 a�i{ tC...:c�' �i:.:,: 7 If the Fire Chief of the Fire District in which the roe is located has approved ( ) property rtY pp turning off the water or electricity,please state: Date of approval UNKNOWN Date(s) electricity turned off UNKNOWN on if applicable UNKNOWN Date(s)water turned off UNKNOWN on if applicable UNKNOWN (8)Name(s), address(es) and contact information pf person(s) responsible for maintaining all existing fences around swimming pools and spas or installing fences as required by Chapter 210 of the Town of Barnstable General Ordinances WELLS FARGO BANK,N,A.,,F2303-04J,1 HOME CAMPUS,DES MOINES IA 50328 (9)Name, address, telephone number and email address of person who can be contacted in case of emergency if different from the person named above or in the registration under section 224-3(A) (name and contact number to be posted on the front of the property if required by the`Fire Chief or Building Commissioner WELLS FARGO BANK,N,A.,F2303-04J 1 HOME CAMPUS,DES MOINES IA 50328,877-617-5274 (10)Date(s) certificate of liability insurance on the property filed with the Building Commissioner SEE ATTACHED EVIDENCE OF INSURANCE (11)Date(s)cash or surety bond of at least$10,000.00 filed with Building Commissioner to remunerate the Town for any expenses incurred in inspecting, securing and making the premises comply and continue to comply, a portion of which shall be retained by the Town as an administrative fee N/A (12) Date(s) scheduled for inspections with the Building Commissioner and Health Director,who may at his or her discretion include the Fire Chief, in order to confirm that the land and structures.comply with the provisions of this Ordinance UNKNOWN or to identify the provisions with which the property does not comply and establish a program to bring the property into full compliance UNKNOWN (13)Date(s) when the property was sold, or is anticipated to be sold, to the foreclosing party. If neither,please explain UNKNOWN - ., ..r, ,. to _ .. .. « . - — .. .• I acknowledge that the information provided is accurate and correct. I also understand that any inaccurate information will result in non-compliance with section 224-3 of chapter 224 of the Code of the Town of Barnstable. Angela Pryor,Research/Remediatlon:Digitally signed ay Angela Pryor,Research/ --Remediation Associate,Wells Fargo Bank,N.A. Associate,Wells Fargo Bank,N.A. ', Date:zots.os.oa t5:15:57-os'oo' Date: 6/9/16 Name: Anqela Pryor t .Title: Research/Remedation Associate i i I hereby certify that the above-named foreclosing party is in compliance with the provisions of section 224-4 of chapter 224 of the Code of the Town of Barnstable. Date: Building Commissioner, Town of Barnstable r 21174 ' ® DATE(MMIDDIYYYY A�00REY CERTIFICATE OF LIABILITY INSURANCE 3/25/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES j BELOW. THIS CERTIFICATE OF INSURANCE DOES.NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED I RtORESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement, A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Wells Fargo Certificate Service Center Wells Fargo Insurance Services USA,Inc. PHONE 404-923-37?9 F^X 1-877-362-9069 AIC o in: AIC No 3475 Piedmont Rd E-MAIL wfis.certificatere Jest awellsfar o.com ADDRESS: RI C 9 Suite 800 INSURERIS)AFFORDING COVERAGE NAIC# Atlanta,GA 30305 INSURER A: Old Republic Insurance Company 24147 INSURED - INSURER B: Wells Fargo Home Mortgage INSURER C a division of Wells Fargo Bank,N.A. INSURER D: 90 South 7th Street, 14th Floor INSURER E: Minneapolis,MN 55402 INSURERF: COVERAGES CERTIFICATE NUMBER: 8901677 REVISION NUMBER: See below 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 OP..CONDITION OF ANY.CONTRACT OR OTHER DOCUMENT %AITH.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. ILTR TYPE OF INSURANCE ADD)_SUBR POLICY NUMBER MM/DDY� MMILDDIIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 10,000,000 A MWZY 304056 04/01/2.015' 04I01/2020 — _ CLAIMS-MADE a PREMISESS OCCUR I DAMAGE (Ea RENTEDoccurrence $ 10,000,000 MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 10.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000 X POLICY❑JECT PRO �'LOC PRODUCTS-COMP/OP AGG $ 10,000,000 _ OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident; _ ANY AUTO BODILY INJURY(Per person) $ AL AUTOLL OW S AUTOS NED SCHEDULED )_BODILY INJURY(Per accident) $ . PROPERTY DAMAGE HIRED AUTOS AUTOS NON-OWNED Per accident)_ $ $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION MWC302638 04/01/2015 04/01/2020 X STER ATUTE OERH AND EMPLOYERS'LIABILITY YIN 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑N NIA ------ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yyes,describe under - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Proof of Insurance CERTIFICATE HOLDER CANCELLATION Wells Fargo Home Mortgage, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN a division of Wells Fargo Bank,N.A. ACCORDANCE WITH THE,P()LICY PROVISIONS. 90 South 7th Street,14th Floor Minneapolis,MN 55402 AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD ©'1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) 4 Barnstable, MA Vacant Building Plan Current status of the Building: The building is secured; all doors and windows are locked, if the property utilities are on when we find the property abandoned,we will transfer the utilities into our name and leave active. If we find the property to not have any utilities we winterize the property according to investor/insurer guidelines. Plan of action for exterior building maintenance: We inspect and maintain our properties. We work to keep the property secure and free of any health hazards and/or debris. Wells Fargo also schedules our grass cuts twice a month. What improvements are planned? If the property is in need of repair to avoid a code violation,we will review and take any appropriate action. If there are insurable damages, we will file an insurance claim and review for repairs. What is the scheduled date of re-occupancy? Approximately 90 days after the foreclosure sale is confirmed. Building to be sold or rented? The building is-to be�sold: - Certificate of Occupancy: The buyer will be responsible for re-certification and occupancy inspection with the city. Is property to be demolished? There are no current plans for demolishing the property. The city will be notified if there is a change of action. r e WELLS FARGO BANK, N.A. CONTACT INFORMATION For questions or concerns regarding a property registration issue please contact the Property Registration Department. Property Registration Department Registrations@wellsfargo.com For other inquiries please route applicable requests to: Building and Code Compliance Department CodeViolations@wellsfargo.com Utility Bills` ConvUtilityPmt@wellsfargo.com HOA or Condominium Dues or Fees HOAPmtRequestFH@wellsfargo.com Tax Related Requests: TaxGatekeeper@wellsfargo.com REO property inquiries PASAPinguiries(c@wellsfsargo.com Insurance Claims HazardClaims@wellsfargo.com General Property Preservation Property.Preservation@welIsfargo.com For questions regarding purchasing a Wells Fargo property please contact 1-877-617- 5274. You may also contact our dedicated property preservation call center at 1-877-617-5274 Monday—Friday from 8:00 AM —9:00 PM EST. Please note all legal documents should be sent to our legal.mailing address below: Wells Fargo Bank, N.A. 1 Home Campus MAC# F2303-04J { Des Moines, IA 50328 Engineering Dept. (3rd floor) Map fie' `` Parcel 0,7V Permit# 00' 3 i House Date Issued /a 19 (3rd floor)(8:15 -9:30/1:00-4:30) Fee th floor)(8:30- 9:30/1:00-2:00) t floor/School Admin:Bldg.) tMe rq by Planning Board } 19 . • BARN5IABLE TOWN OF BARNSTABLE Building Pennit Application Project Street dress Village ` Owner Address Telephone Permit Request i r M First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family p� Two Family ❑ Multi-Family(##uu .its) Age of Existing Structu Historic House ❑Yes f9' ii�O On Old King's Highway ❑Yes Basement Type: ull ❑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 a2� New 22 Total Room Count(not including baths): Existing tiL New First Floor Room Count Heat Type and Fuel: ❑Gas it ❑Electric ❑Other Central Air ❑Yes ��o Fireplaces: Existing New Existing wood/coal stove ❑Yes io Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) J-Ko�ne ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial Yes No If es site plan review# ❑ ❑ yes, Current Use Proposed Use udder Information Name Telephone Number �� — 3 o-3 Addr sS 0 J V-� icense# 5LVHome Improvement Contractor# /o? J/ Worker's Compensation# 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��- 96 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) ~ FOR OFFICIAL USE ONLY PERMIT NO. F i DATE ISSL�,JED MAP/PARCEL NO.:,� ADDRESS VILLAGE i T OWNER ' t i DATE OF INSPECTION: FOUNDATION - FRAME INSULATION i FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ; DATE CLOSED OUT ASSOCIATION PLAN NO. THE A The Town of Barnstable MAM • enarrsr;�, . Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 5087790-6227. Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only 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. Type of Work: Est.Cost f.11 07JZ fO Address of Work: Owner's Name 004, Date of Permit Application: X2 —r9 —9r% I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby ppiy f r a permit as the agent o r• Date Contractor Name Registration No. OR Date Owner's Name t The Commonwealth of Massachusetts Department of Industrial Accidents Office of/flVeMal/otts 600 11 Qshmgton Street Boston,Alas. 02111 Workers' Compensation Insurance Affidavit It n tnf rn t name: y— /4�? �-�-PA - �alo `7" cit phone# c� I a homeowner performing all work myself. am a sole proprietor and have no one working En any capacity t ., ivp�'g' sai�ec.,n..r..x's.,y�wa.s+"`RaT¢v�f:58F�y„wi°ra�r;::.,M..!•'•+. -uMnxg.., •,...a� `re"g.".'.'"'f'"'w,.._,.�.•..,,4r _ ... `?Y.;:a..j:..��}.ra�xr:,+wv><aw.«n:w�.L-._:'La..� :,, .«.. ".....,: ra:LW... i"' x�YS'�a _�:o_�. - .:_;�liL;..d, •.,, k,C +.� .� 1 am an employer providing workers' compensation for my employees working on this job. cnmpam•name: address: city: phone#• insurance co police# _ �•e0`,±='. i.:�..`�. I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name- address: city: 12hone#• - insurance co policy# .. _ .«.. ._... .:t'Fi'....... N^v*. r-.r 'T C�".n�.^.f .r+T^-imt [�1rw�r nwa . 7a:,n. 4'F.�?:�'•""•^-^..� .�.._._.ya.........:r_,.....r..:a.�r...__�._.:�sra• -^ a.r... - -.�a..Ii,►r:.au. 3�5:4k• ='751 ''�--`�_F!�"•:_,_. �'$.u�'.zsdsr.c.as�����i.^�.rrud�r .a.ta:x:uir company name: address: phone#• insurance co to icy# Attach add:donal sheet if necessary it ."dw-'ry ..va:�n,,, _". ,Air, may Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a line up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. I understand that a cope of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. Ziereht• ert 1 turd le pains penalties perjurt•that the information provided above is true and correct, q ture Date a — _ Print name Pho ?Tofficial use only do not write in this area to be completed by city or town official '' city or town: permit/license# tnlluilding Department E)Licensing hoard. 0 check if immediate response is required QSelectmen's Office pllcalth Department ' contact person: phone#; nOther '2Y_�s'Y�� .�.T+.'�q�,,'.•!.!'9.3• ..,.. ..�q.la,R .i.NM'T�"4n' f�f^.. .,•"^.�ST^i`R9a?"P;.�.'.. arev,sed xos PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide Nvorkers' compensation for their employees. As quoted from the "law", an enrploree is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An empl(�ver is defined as an individual, partnership, association. corporation or other legal entity, or any two or more of the foreaoing enga��ed in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelli �(, house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the -rounds or building appurtenant thereto shall not because of such employment be deemed to be an emplover. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or rencival of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. ,. Applicants Please fill in the workers' compensation affidavit completely, by checking,the box that applies to your situation and supplying company names, address and phone numbers as all affidavits may be 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 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. .- ;y,......s Im+;t.J'•.:...-a`- -.•-...:'.+.s�,. :;.as-. •r^•..•+•.*-.rnno,.9t+=r- s,ov+.�sr-.•t. '.r'..: fir: *.,1..,.:..E«,,, ." •S.'.K't'..'• ✓...,,: .... City or Towns Please 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 Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. Tile affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. t••+rar. ..• ,-wr,- ...Pwz$"r'^w •.o.n- -cs+Wr. ++►•�nr.4+f+t;•-nay=e+.w�+mw ,r•��, -^^ nnw�wsnr-a7 xor�s.rar:. m .n++Nr�w.wr�.••muw• The Department's address, telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 ^tea. �.y.-� "e" *'^ws�'Srd...d..�.,.,.,:... �.:-,.�...�' �;� -St�Sil�ai2iW-BHSv.: ar-r '.".'�'F'243�_,'A� ;oc:tn'ww._..�.._��..r_n+rz�..�c•'.svw,_-a. I HOM IMPROY�gENT CONTACTORS REGISTRATION i Boar of Bul pGing Regulations and Standards ! ' One Ashburton Place - Room 1301 Boston , Massachusetts 02108 HOME IMPROVEMENT CONTRACTOR Registration 123111 Expiration 12/10/98 - - - ---------------- -' Type = DBA ! T2. t HOME IMPROVEMENrCONTRACTOR Registration 123111 CAPE COD REMODELING AND DESIGN ! Type - OBA DAVID A . CARROLL ! Expiration 12/10/98 31 PIERRE VERNIER DR/PO BOX 342 FORES7•DALE MA 02644 j CAPE COD REMODELING AND DESIG DAVID A. CARROLL 3 PIERRE VERNIER DR/PO BOX 3 t ORESTDALE MA 02644 ADMINISTRATOR COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY OF ONE ASHBORTON PLACE MASSACHUSETTS BOSTON,MA 02108 LICENSE CAUTION CONSTR. EXPIRATION DATE SUPERVISOR FOR PROTECTION AGAINST 0:3/r)R/1 9 9 7 EFFECTIVE DATE LIC-NO. THEFT, PUT RIGHT THUMB RESTRICTIONS - PRINT IN APPROPRIATE (? I��1 ./19�J 3 ?fi'S BOX ON LICENSE. �& 2 FAMILY HOME . DAVIDCARROLL R a E 40 ESSEX DR ` BLASTING OPERATORS SS 027--SU-4Q70 MASHPEE MA 02649 z MUST INCLUDE PHOTO. PHOTO(BLASTING OPR ONLYI FEE: ryry �^yn ' U.L#l.! NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY ' HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER 1f"" DOB: I 03/08/106. ��/' F THIS DOCUMENT MUST BE l.�(� .G E OF LICE E 1 SIGN NAME IN FULL ABOVE SIGNATURE LINE CARRIED ON THE PERSON OF 1-9-19 THE HOLDER WHEN EN- C` MISSIONER ., OTHERS-RIGHT THUMB PRINT GAGED IN THISOCCUPATION. ,_