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HomeMy WebLinkAbout0064 RIDGEWOOD AVE� . � � x f n r;� � �G o ! �� � � rig TOWN OF BARNSTABLE REGISTRATION AND CERTIFICATION FORM FOR FORECLOSING/FORECLOSED PROrUWT11'? a 5 AM 10: 57 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 proJeWrty in foreclosure (section 224-3) or already foreclosed for which possession has becp5 ,gCe'fl (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 I (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: Section I —Property Information Property Address: 64 Ridgewood Ave,HYANNIS,MA 02601 Assessors Map #: 328-222. Parcel #: 328-222 Land area and description Building(s) description and contents Single Family. Sgft. 1.032. Stories 1 Yr blt 1920 .Occupied: Yes Occupant(s)(if borrowers so state and include name(s)) Pamela J Nickerson c/o Ocwen Loan Servicing,LLC Phone: email: other: Vacant: No Date: Anticipated Length of Vacancy: Last occupant(s) )(if borrowers so state and include name(s)) Deutsche Bank National Trust Company,as Trustee for Soundview Home Loan Trust 2005-3, Asset-Backed Certificates,Series 2005-3 c/o Ocwen Loan Servicing,LLC-Judy Credit 8007462936 PropertyRegistration@ocwen.com Phone: email: other: Has possession been taken If so,please explain and complete and file the maintenance and security plan form (unless exempt as stated above) Section 2—Foreclosing Party Information Deutsche Bank National Trust Company, as Trustee for Foreclosing full name/title Soundview Home Loan Trust 2005-3,Asset-Backed Certificates, g Party ( ) Series 2005-3 ./o Ocwen oan Servicing LLC-Judy Credit' Foreclosure Case Court: Docket# SecoP RCS ' F Date filed: 03/21/2018R Current Status: Foreclosing Party's representative(s) for property (entry, management, repair, etc.)(name, title,): Ocwen Loan Servicing, LLC-Judy Credit Company (if different from foreclosing party): Address: 1661 Worthington Road, Suite 100,West Palm Beach, FL 33409 Phone: (800)746-2936 email:PropertyRegistration@ocwen.comother: If an exemption is claimed,please do not complete the remainder. Other representatives) (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 do not complete contact information (i. e."none" or"see above")). "Note: Please mail correspondence to Atlanta office. Darren is local to address property conditions and emergency matters." Name, title, other:. Darren D Wisniewski-Regional Field Service Manager Company (if different from foreclosing party): Altisource Solutions,Inc. Address: 1000 Abernathy Road Northpark Town Center,Building 400 Suite 200 Atlanta,GA 30328 8669526514 VPR@altisource.com/ Darren.Wisniewski@Altisource.com Phone(s): /(407)739-3930 email(s): REOCodeviolations@altisource.coather: Name, title, other: Company (if different from foreclosing party): Address: Phone: email: other: Attorney representing foreclosing party Firm name (if different from attorney's name): Korde and Associates P C Address: Lowell,MA Phone(s): (978)256-1500 email(s): other: 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. Date: Name: Alma Emery Title: Manager 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 i REGISTRATION AND CERTIFICATION FORM FOR FORECLOSING/FORECLOSED PROPERTY , Thank you for registering in accordance with Town of Barnstable Code chapteV 24 sections 224-3 and 224-4. Please complete one form for each property in foreclosure (section 224-3) or 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: Section 1 —Property Information Property Address: 64, Ridgewood Ave, HYANNIS, MA, 02601 Assessors Map #: HYAN M:328 L:222 and 1032 Parcel #: hyanm:3281:222 Land area and description Building(s) description and contents Occupied: Yes Occupant(s)(if borrowers so state and include name(s)) Pamela Nickerson c/o Ocwen Loan Servicing, LLC-Judy Credit 8007462936 PropertyRegistration@ocwen.com Phone: email: other: r Vacant: NO Date: Anticipated Length of Vacancy: Last occupant(s) )(if borrowers so state and include name(s)) Phone: email: other: Has possession been taken If so, please explain and complete and file the maintenance and security plan form(unless exempt as stated above) Section 2—'Foreclosing Party arty Information Deutsche Bank National Trust Company, as Trustee for Soundview Home Loan Trust 2005-3,Asset-Backed Certificates, Series 2005-3 Foreclosing Party (full name/title),c/o ocwen Loan servicing. LLC-Judy credit Foreclosure Case Court: Docket# uW ,r Date filed: 03/27/2017 Current Status: Foreclosing Party's representative(s) for property (entry, management, repair, etc.)(name, title,): Ocwen Loan Servicing, LLC-Judy Credit Company (if different from foreclosing party): Address: 1661 Worthington Road, Suite 100,West Palm Beach, FL 33409 Phone: (800) 746-2936 email:PropertyRegistration@ocwen.comother: 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 do not complete contact information-(i. e. "none" or"see above")). "Note: Please mail correspondence to Atlanta office. Darren is local to address property conditions and emergency matters." Name, title, Other: Darren D Wisniewski-Regional Field Service Manager Company (if different from foreclosing party): Altisource solutions, Inc. Address: 1000 Abernathy Road Northpark Town Center,Building 400 Suite 200 Atlanta,GA 30328 8669526514 VPR@altisource.com/ Darren.Wisniewski@Altisource.com Phone(s): /(407)739-3930 email(s): REOCodeviolations@altisource.co(pther: Name, title, other: Company (if different from foreclosing party): Address: Phone: email: other: Attorney representing foreclosing party Firm name (if different from attorney's name): Korde and Associates P C Address: Lowell,MA Phone(s): (978)256-1500 email(s): other: 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 apter 224 of the Code of the Town of Barnstable. U" (LA� � �n Date: 2 j Name: Alma Emery Title: AsstManager f 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 f -z Town of Barnstable -`rPermit# F Expires 6 months from issue date * * Regulatory Services Fee BMWSTABM MA&1 $ Richard V.Scali,Director 1639. Ar fD MA'S A Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY s 7 Not Valid without Red X-Press Imprint Map/parcel Number Property Address (� 001 n"�� V1 l ❑ Residential Value.of=Work$=�u q6z)�t Minimum fee of$35.00 for work under$6000.00 --Owner's--Name&Address � � Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: J AN 212015 WI, m a sole proprietor m the Homeowner �ARNSTABLE Y❑ I have Worker's Compensation Insurance T®VVW OF Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to k Re-roof(hurricane nailed)(not stripping. Going over / existing layers of roof) Re-side "placement Windows/doors/sliders.U-Value (maximum .35)#of windows #of doors: Smoke/Carb6n Monoxide detectors 4 floor plans marked with red S and inspections required. it Separate Electrical&Fire Permits required. *Where required:. Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors-License is required. ICSIGNATURE QAWPFILESTORMS\building p SS.doc Revised 061313 r�i a The Corgi monnwaLfh of Massachusetts Deparhnent of.Industrial Accidents Office of Investigations Ira''aestigatons " 600 Washington.Street Boston, 02111 wFviv.niass,gov1dia WForkers' Compensation Insurance Affidavit,- Builder stConh-actors/Ele.cttic nsfPhunbers Applicant Information Please Py nt Legibly N isinesvorganizaiion(Iud-rvidua1): 3 7 �3 "'-Ai=e'you an employer;'CheW the appropriate boa: Terre of project(required)_ 1.❑ I am a employer with - . 4. ❑ I am a general contractor and I * have hired the sub-contractors 6_ ❑Neu construction employees(full aud4or part:-#ime). 2.❑ I am a sole MPri etor of-partner- listed on.the attached sheet. 7. ❑Remodeling slip and have no employees• These stub-contrac#ors have g_ ❑Demolition worlring forme in any capacity_ employees and have wodcers' 9_ ❑Building addition [No worlaers'comp.insurance comp.insurance,, ed. . ❑ We.are a corporation and its l0.❑Electrical repairs or additions am a homeowner doing all wror� officers.have exercised their I L❑Plumbing repairs or additions myself [No workers'comp. right of exemptionpe r MGL 12.❑Roof reparrs insurance required.], c. 152, §1(4),and we have no employees-[No workers' 13..❑other comp.insurance required.] *Any apphvmtthat checks box#1'mo also U out the section below showing their workers.'compensation policy information- I Homeowners who submit this affidsvit m&catmg they are doing all wort and then hire outside contractors:nmst submit a new affidavit indicating sack =C'ontractors that chedk this box must attached an additional sheet shorwing the mane of the suit-coutcacrors and state whether or not those entities have employees. If the snb�contranors hie employees,they must provide their workers'comp.policy number. I attn ati employer tliat isproutiditig it,orkers'corgm7tsalion irtsttrnrtce for uuy erriploj?ees. Below is thepolicy artd jab site information Insurance Company Name: Policy 4+1 or Self-ins.Lic.4: Expiration Date: Job Site Address: CitylState zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage:as required under Section 2]A of MGL c. 152.can lead to the imposition of criminal penalties of a. fine up to 51,500.00 anc or one-year imprisonauesst,as well as civil penalties in the foun of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised thatt a copy of this statement may be forwarded to the Office of Investigations of the DLA.for insurance coverage verification. I do hereby,c uyide.rtliepaitisaitd-pe,n,altiesotf Jrerytr ty that the information provided above is trrte and correct a t,,�n Date: Phone- S''✓1 3 Official rise only. Do not uvrite.in this area,to be completed by city or totivi official. City or mim: P'ermitUcense Ensuing Authority(circle one): L Board of Health ?.Building Department 3.Cit}I owrt Clerk 4.Electrical Inspector 5.Plumbing,Inspector 6.Other. Contact Person: Phone#: ' O•� * BARNSrABLE, MASS.i639• Town of Barnstable ♦0 , Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner _ 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us r' Office: 508-862-4038 �. - 5 Fax: 508-790-6230 Y _t Property Owner Must Complete and Sign This Section, If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: tir ' (Address of Job) Signature of Owner Date Print Name - - If Property Owner is applying for-permit, please complete the Homeowners License Exemption Form on the reverse side.' Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 Town of Barnstable Regulatory Services oFTHe toty,� Richard V.Scali,Director Building Division BARNSTABLE, ' Tom Perry,Building Commissioner MASS. 9 1 39• ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 - - Fax: 508 790 6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: number p � �s�traeet- y village ` ..HOMEOWNERS name _ / home phone# work phone# �CURS.ENT.MAII ING"ADDRESS: [- 4� � �,v E C" city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection o d es and requirements and that he/she will comply with said procedures and requirements. Signature of Homeo ner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section.2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:',WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 *. a a Engine6ring Dept. (3rd floor) Map ���J Parcel � Permit#" "✓ � 7 House# Date Issued at) Fee. .�� d?) dg.) i THE►q;- d 19De �`� _ BARNSTABLE. MASS, 1639 N� t TOWN OF BARNSTABLE, lEOMAyp Building Permit Application ; Project Street Address c)CrE7&,J o c)r> Village VA iU A)1`j It-f A . ; Owner S P..1 Address I v1 ���►�L C�i�i ��2 . Telephone d �.� fr, 1;,' Q HA6L 106 r�riC.t "Permit Request C 9--D-bF T FT j (P First Floor square feet Second Floor square feet Construction Type --` ' Estimated Project Cost $ 30 P71� Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑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 ❑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 le-C) 6 l K-'T —f IJ 0 4 IL ' Builder Information Name `T Iy D J4C 4-0 o P' /k-) fx Telephone Number Address 3 -7 6 K- P R- P 9rC-14 4-1) License# 1 1 b 51'E A vo E_L e C9 4'S'�' Home Improvement Contractor# 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 BETAKEN TO SIGNATURE DATE i r 9�1 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) \ d r x' FOR OFFICIAL USE ONLY _ PERMIT NO. -e> FATE ISSUEDy h ,` MAP/PARCEL NO. ► t ADDRESS -` VILLAGE OWNER DATE OF.INSPECTION FOUNDATION' FRAME _ . INSULATION FIREPLACE ELECTRICAL: , ROUGH FINAL a PLUMBING: ROUGH ! FINAL ' GAS: r ROUGH FINAL ' "FINAL BUILDING DATE CLOSED OUT ' ASSOCIATION PLAN NO. 4 _� The Commonwealth of Massachusetts =__�•� Department of Industrial Accidents lad :-::: - Ofrtce of/naestigatioos _ 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: �L e �3 �'� f t/' N D��1'zrcr 1797/1- I jl'V 0,4(-L IL&C)F jP location: 1 a i Ap pisrc—ff city A-J/J L t 6 Alm. phone# ❑ I am a homeowner performing all work myself. ❑ lam a sole i o rietor and have no one workin in any capacity ❑ I am an employer providing workers' compensation for my employees working on this job. comaanv name address. .. city-- phone* 1 � insurance co. policv# I am a ole proprie , general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: '• comoanv name: �' `:" � yt_. 1P,1i 4f x t.t '✓c�y�'�.ey _ , y.:Its e address. -/ Y�!�;/�.� -� f2� . < . ci GP1f�:.;: . ill.. ..:: insurance ca -,. .... company name: ::.::.. ........ address: . ::>;>:: >:<_>:><>:;;::;:;;.::. .. dty: ,.: ;:..: .. .. . : ;•• .:: shone#: . . .insurance co: olicv:#. Failure to secure coverage as requited under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a line of S100.00 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 truce and coned (� Signature g-'�� Date Print name PJ 61'4'r T-r lv9 A G--t— Phone# 41 010 �y� (c:ontact se only do not write in this area to be completed by city or town official wn: permit/Hcense# ❑Building Department ❑Licensing Board if immediate response b requited ❑Seiectrnen's Office ❑Health Department erson: phone#; ❑Other (msed 9/95 P1A) of'ME r� The Town of Barnstable Department of Health Safety and Environmental Services Building Division . 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Cressen 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. Type of Work: OCAA-17 Estimated Cost Address of Work: �f q 6', W 1)17 r�. , j-f qA p NV 5 t44 Owner's Name: 5 A 04 ie 1*/I t Date of Application: 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 [30wner 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 A I hereby apply for a permit as the agent of the ow`�er: Date C tract r ame Registration No. OR Date Owner's Name q:fb ms:Affidav YT ` anal 'HOME IMPROVEMENT CONTRACTOR: i' ���R�TYegistration 116069 _n .; pe} D B A Expiration 05/15/00 ' TYNDAII ROOFINGoil 4 Neat!.,, YNOALL '• �' IAR TPATCHi RD TERVILLE=MA ,'?, • ACORD CERTIFICATE OF LIABILITY INSU'RANC�ID 02 DATE 07/30 /9 OREYTl 07/30/98 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Burlingame Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Robert Burlingame HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 20D Post Office Sq ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Centerville MA 02632 COMPANIES AFFORDING COVERAGE Robert Burlingame COMPANY Phone No. 508-771-0105 Fax No.508-771-1258 A Legion Insurance Company INSURED COMPANY B Tim Morey & Patrick McCrum COMPANY DBA M&M Roofing C 9 Adams Road COMPANY W Yarmouth MA 02673 D COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN.IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ 1 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DDIYY) DATE(MMIDDIYY) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ CLAIMS MADE OCCUR PERSONAL&ADV INJURY $ OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE JAny one fire) $ MED EXP,,(Any orfrVeition) $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRFI.LA FORM e WORKERS COMPENSATION AND TORY LIMITS I ER - EMPLOYERS'LIABILITY EL EACH ACCIDENT $$100,000. THE PROPRIETOR/ INCL WC3 022422 11/13/97 11/13/98 EL DISEASE-POLICY LIMIT $$500r000. PARTNERSIEXECUTNE OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ $100 OOO. OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/SPECIAL ITEMS Carpentry - const of res< 3 stories CERTIFICATE HOLDER CANCELLATION ROBTYNI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Rob Tyndall BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 37 Briar Patch Road Osterville MA 02655 OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Robert Burlingame ACORD 25-S(1195) ©ACORD CORPORATION 1988 ::'•: ::::: DA :.... TE :::::: <::r: ... .. .. .. ...:::: ':: : ...::: :::::::: .. ::: ::::.. ;::;: : ;:: > ..:•: :: ::5::::::rrr;::::i::r::::`;::::::;;;:::::: (M /DD/Y1f) •:?: cell .... :MYI :::::::::::::::::...xx ......... .:: .,.,,,.,.' iIF., f.; :...,,.`, .......:::::::::::::::::::...::.:::.�::::::. :: 06/17/98 PRO::::.:::. DUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Fredericks Insurance Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. 0. Box 427 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, 1046 Main street COMPANIES AFFORDING COVERAGE Osterville MA 02655-0427 COMPANY (508) 428-8999 A UNDERWRITERS AT LLOYDS INSURED COMPANY M & M Roofing B 9 Adams Road COMPANY C West Yarmouth MA 02673- COMPS (508) 771 9079 D II�A . :::':::::: ::2:`::::i::'::::::': :':':` :`::::::::::::: ::: :::::::::::::r':'::::::::::3::: ::::: ::::::i:::::: ::::::%:: :;::::::: :::i::::::::::::::: : :::::::: ::i::::r:::: i:::i:i:::i:: r:i::i:::;:i:: ::: :r:r: i:::;:::;;::::::::i::;... .... ;:;:;::;: THIS IS TO CERTIFY:.::::::.::AT:::::. THAT THE POLICIES OF INSUR ANCELISTED BELOW HAVE BEEN ISSUED TO THE HE 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, EXCLUS!ONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR DATE MM/DD( /YY) DATE(MM/DD/YY) LIMITS 1 GENERAL LIABILITY GENERALAGGREGATE $1000000 CGI,COMMERCIAL GENERAL LIABILITY UNASSIGNED 06/17/98 06/17/99 PRODUCTS-COMP/OPAGG $1000000 CLAIMS MADE 7X OCCUR PERSONAL&ADV INJURY $ OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $1000000 FIRE DAMAGE . y one fire) $ MED EXP,(Any one person) $ AUTOMOBILE LIABILITY ANY AUTO / / / COMBINED SINGLE LIMIT $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per pen►on) HIRED AUTOS eoaly INJURY s NOwoWNEO AUTOS (P«-OkW o PROPERTY DAMAGE t OARAO!LIABILITY AUTO ONLY•EA ACCIDENT i i ANY AUTO / / / / OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM / / / / AGGREGATE $ OTHER THAN UMBRELLA FORM $ WC STATU- OTH- WORKERS COMPENSATION AND TORY UMITS ER ' EMPLOYERS'LIABILITY EL EACH ACCIDENT $ THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $ PARTNERS/EXECUTNE OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS ROOFING CONTRACTOR .............:I . : :::: :: ::::XXX:: i ::::::::::: ;: :i::;i':: :;; i:i::i::: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Tyndall Roofing 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Robert Tyndall, D B A BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 37 Briar Patch Road OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. Osterville MA 02655 AUTHORIZED REPRESENTATIV