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HomeMy WebLinkAbout0138 STRAIGHTWAY -5 5,2 3 3 Town of Barnstable *Permit# Expires 6 mont m issue date Regulatory Services Fee * IMMSrnsne, 163� ,0� Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner �U' 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY jalid out Red X-Press Imprint Map/parcel Number L(C 1 Property.Address �/�. i ,Residential Value of Work o 0 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address v �� .✓fit 6 _ . Contractor's Name Aa aoed 2e-/ Telephone Number 7 2 cl 9'0 J ;a Home Improvement Contractor License#(if applicable) 7Z D a l F Construction Supervisor's License#(if applicable) QW/o`rkman's Compensation Insurance Check one: X PRES"' PERMIT ❑ I am a sole proprietor ❑ Lam the Homeowner MAY 2 12013 I have Worker's Compensation Insurance C--7­1 Insurance Company Name 0 e-1 e r5 TOWN OF rs A RR�STABLE Workman's Comp. Policy# co K O q q3q P 5 q —B— A c;=' Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) [74''Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken tomo,.vt be r ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. 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 t7Hol Improvement Contractors License&Construction Supervisors License is re d. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 053012 The Commonwealth of assay-buselts Department ofIndusirial Accidents Office of Inv7estigations 600 Washington Street - - Boston,.MA 02111 wnwwr.mass.gov ldia Workers' Compensation Insurance Affidavit: Builders/ContractorsJElecti-icians/Plumbers Applicant Information 0 Please Punt Legibly Name{BusinessKhganizationadividaai): of Al t I f Address.- Z3 0 )e City/State/Zip: ✓ l oa(a?d Phone#. '7 7�/ Y 77 Sd 7 X Are you an employer?Check the appropriate box: . Type of project(required):. IAZ I am a employer with 4- ❑ I arm,a general contractor and I employees(felt and/or part-time).* ltavebired the sub-contractors 6 ❑New construction 1❑ I am a sole proprietor orparfnex- listed on the attached sheet 7- [—]Remodeling ship.and have no employees These sub-contractors have 8- ❑Demolition working forme in any capacity- employees and have workers' [No workers' comp-insurance comp-irmnmxr I �. ❑Building.addition 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 NIGL 12.❑Roof repairs insurance required.]f c. 152, §1(4),and we have no employees.[No workers' 13.❑Other- 4 ew roo a Irl compAnsurance required.] •Any apphcamt that checks box#1 must also fill out the section below showing their workers'compensation policy information. 1 Homeowners who submit this afhdsvit mi catimg they are doing all mod and then hire outside contractors mns#subma[a new afdnat indicaamg such- lCanimctors that check this boon must attached an additional sheet showing the mame of the sub-conixtors and state whether or not those entities have employees. Ifthe sub-mutmaorsbave employees,they m must provide their workers'comp.policy number. I urn an employer that is protfixling workers congwnsadon insurance for my ampiqymm Below is thepoliey and job site information f� Insurance Company Namie: l/A✓G ip f, T Policy ft or.Self-ins-Lie. ::�( f'D $ 1 7?3 Expiration Date: '/— Job Site Address: ! ?18 S �a►9 r�r Citvistawzip: 1 t Attach a copy of the workers'compensation policy declaration page(showing the policy uu(nber and expiration 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 mere coverage verificcation- I do hereby cerh*fy a the s a d pena es of pedury that the info.rinalian protrided above is true and correct Si Date: Phone Y k 7 f 0 F Official use only. Do not write in this area,to be completed by city.or torwl officiat City or Tom m: Permit/License Issuing Authority(circle one): 1..Board of Health 2.Building Department 3.C tyiTown Clerk 4.Electrical Inspector 5..Plumrbirrg Inspector 6.Other Contact Person: Phone#: 6 y OF tHE 1p� * BARN BLE, ► 'T� b 9 ,�� Town of Barnstable i0reo rna�" Regulatory Services Thomas F. Geiler, Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis, MA 0260.1 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby auth e S.SZV. l to act on my behalf, in all matters relative to work authorized by this building permit application for: ram'5i -0- (Ad ress offob) S#Jture of Own r t Print N me If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on.the reverse side. QAWPFILES\FORMS\building permit forms\EXPRESS.doc Revised 070110 Fy °FTMET Town of Barnstable Regulatory Services BARNSTABLE, " Thomas F. Geiler, Director, 9 MASS. �AIFo39. ,,A Building Division Tom Perry,Building Commissioner 206 Main Street, Hyannis, MA 02601 www.town.barnstable.m.a.us Office:. 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: - JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURREN`"MAILING ADDRESS: 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, -ides and regulations. The und-rsigned "homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and.requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official s 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 perfom•iing 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 070110 AC---Maas- 21. 2013 2: 56PM No. 7651—P. 1 fts- CERTIFICATE OF LIABILITY INSURANCE 3/21(/20 3 WPDNYYY) THIS CERNTICATE IS ISSUED AS A MATTER OF INFORMATION CERTIFICATE DR.ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE O OES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE EPOL CI ES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(Ien)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 CON MCSHEA INSURANCE AGENCy INC NAME: Chevonne A. Pratt 1550 Falmouth Rd Ste #2 PNpN@ Arr N (506)420-9011, w No,(50$)420-.9010 Centerville, MA 02632 ADDREss:chevonne@mosheainsuranee.com INSURER(S)AFFORDING COVENAGE NAlC�' INSURED IN8URER A:Travelers In9 C . Tyler. , Sanford P.O. BOX 216 INSURER a West Hyannisport , MA 02672 INSURER 0: INSURER INSURER E COVERAGES INSURER F CERTIFICATE NUMBER: REVISION NUMBER; THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURBD 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. INUR ADDL VJW LTR TYPE OF INSURANCE INSR WV POLICY NUMBER GENERAL, LIABILITY MMrDDM'YY MwD0 LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 000 0Qj) �IXI PREMISES Ea occurrence s 300,000 CLAIMS-MADE �X OCCUR MED EXP(Any one araon) $ 55 000 A #680-OB051763 11/14/1111./14/12 PrRSONAL&AOV INJURY $ 1,000,000 11/14/12 11/14/13' GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-ECT LOC PRODUCTS-COMPIOP AGG $ 2,000,000 AUTOMOBILE LIABILITY 5 L ANYAUTO \ Ea accident ALL OWNED SCHEDULED BODILY INJURY(Per parson) $ AUTOS AUTOS BODILY INJURY(Par accide it) g HIRED AUTOS NON-0OWNED AUTOS Per acEddent 'E � UMBRELLA upB $ =060CUREXCESS LIAB EACH OCCURRENCE $ AGGREGATE $ ot;0 RETENTION$ WORKERS COMPENSATION $ AND EMPLOYERS LIABILITY wcSTA - OTH- ANY PROPfdeTGR/PARTNERIEXECUnVE IrrN GICUB4934P58-1 11/22/2011 11/22/2012 RYLIMI ER pi GFFIC,EWMEMBER EXCLUDED7 ! I NIA E.L.EACH ACCIDENT S 100,000 (Mandatory In NH) Lam! 11/22/2012 11/22/20IJ Ilyaa,dascrib0unn, E.L.DISEASE-EA EMPLOYE $ 500,000 DESCRIPTION OF OPERATIONS below H,L,DISEASE-POLICY LIMIT $ 100,000 )ESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Auach ACORD 101,Addidonai Rsmafks Schedule,if more&Paco is repuhad) f , 3ERTIFICATE HOLDER CANCELLATION Town of Barnstable Building Dept. SH ANY OFT E DE CRIBED POLICIES BE CANCELLED BEFORE E EXPIRATION TE TH EOF, WILL BE DELIVERED IN ACCORDANCE W THE PO ICY P tSIONS. AUTHORIZED R ES ATIVH (fir 1988-2010 ACORD CORPORATION, All rights raserveo. 1CORD25(2010/05) The ACORD name and log �registeredarks ofACORD }fit Massachusetts -Department of Public Safety Unrestricted -Buildings of any use group which �! Board of Building Regulations and Standards contain less than 35;000 cubic feet (991M )of Construction Supervisor t enclosed space. License: CS-060982 " SANFORD R TYL�R *R PO BOX 80 W HYANNISPORT s; 2G 23 I Failure to possess a current edition of the Massachusetts Expiration I State Building Code is cause for revocation of this license. Commissioner 10/12/2014 For DPS Licensing information visit: www.Mass.Gov/DPS h 92. Office of Consumer Affairs&Business Regulation - VHOME IMPROVEMENT CONTRACTOR Registration: w_j 0218 Type: Expiration: 9/93/-2013 Individual SAFORD TYLER SANFORD TYLER 67 CRANBERRY LN i + W. HYANNISPORT,MAQ2672.:' Undersecretary __.. t kk Ole-S V /6�) homes vcvne4PI eeLr( 5 Y- YS& as9 DURABLE POWER OF ATTORNEY I, Phillip R. Vinton; of 138 Straightway; Hyannis, County of Barnstable and Commonwealth of Massachusetts,. hereby appoint my daughter, Rene Mendes, my agent to do the following things for me and on my behalf: 1) Purpose of this Power of Attorney. I intend this to be a general power of attorney. I shall specify certain acts that my agent is authorized to do., in my behalf, but this is not intended to limit the generality of this power.. I intend that my agent shall have the power to exercise or perform any act, power, duty, right, or obligation whatsoever that I now have,or may hereafter acquire the legal right, power, or capacity to exercise or perform, in connection with, arising from, or relating to any person, item, transaction, thing, business, property, real or personal;tangible or intangible, or matter whatsoever, 2) To Collect Enforce, and Manage Assets and Claims. To request; ask, demand, sue for, recover, collect, receive, and hold and possess all such sums of money, debts, dues, commercial paper, checks, drafts, accounts, deposits, legacies, bequests, devises, notes,:interest, and retirement benefits, insurance benefits and proceeds,securities, any and all documents of title, claims, personal and real property; intangible, and tangible property and property rights, and demands Whatsoever,*liquidated-or unliquidated,. as now are, or shall hereafter become, owned by, or due, owing, payable or belonging to, me or in which I have or may hereafter :- acquire an interest, to have, use, and take all lawful means and e#table and,legal remedies; procedures, and writs in my name for the collection and recovery thereof, and to adjust, sell, compromise, and agree for,recovery thereof, and to adjust, sell, compromise, and agree for them, and to make, execute, and deliver for me, on my behalf, and in my name, all endorsements, acquittances, releases, receipts, or other sufficient discharges for them; 3) To Deal With Personal Property. To lease, purchase, sell, exchange,, and acquire, and to agree, bargain, and contract for the lease,purchase,.sale,.exchange, and acquisition of, and to accept,take, receive, and. possess any. personal property whatsoever, tangible or intangible, or interest therein, on such terms and conditions, and under such covenants,:as my agent shall deem proper; 4) To Deal With Real Estate. To maintain, repair, improve,.manage,.insure, rent, lease, sell; convey, subject to liens, mortgage; subject to deeds of trust, and hypothecate, and in.any way or manner deal with all or any part of any real or personal property whatsoever, tangible or intangible, or any interest therein, that I now own or may hereafter acquire, for me, on my behalf, and in my name and under such terms and conditions, and under such covenants, as my agent shall deem.proper. To sell and convey any and all land owned by me; 5) .To Establish Fund, and Amend Trusts. To establish trusts on my behalf, on terms which my agent shall believe to be my wishes for my estate,,to amend any trust established by me, and to transfer money, securities, and other property to any trust which I have established or which my agent has established on my behalf;. 6) To Execute Disclaimers. To execute disclaimers on my behalf under Section 2518 of the Internal Revenue Code or any other federal or state statute permitting disclaimers; 7) To Deal With Brokerage Accounts. With respect to my brokerage accounts, to effect purchases and sales (including short sales), to subscribe for and to trade in stocks, bonds, options, rights, and warrants or other securities, domestic or foreign, whetherr dollar or non-dollar denominated; or limited partnership interests or investments and trust units, whether or not in negotiable form, issued or unissued, foreign exchange, commodities, and contracts relating to such (including commodity futures) on margin or. otherwise for ,. my account and risk;.to deliver to my broker securities for my account and to instruct . my broker to deliver securities from my accounts to my agent or to others, and in such name and form, as my agent may direct; to instruct my broker to make payment of moneys. from. my accounts with my broker, and to receive and direct payment therefrom payable to my agent or others; to sell, assign, endorse and transfer any stocks, bonds, options, rights and warrants or other securities of any nature, at any time standing in my name and to execute any documents necessary to effectuate the foregoing to receive statements of transactions made for my account(s); to approve and confirm such accounts, to receive any and. all notices, calls for margin, or other demands with reference to my accounts(s); and to make any and all agreements with 2 - my broker with reference thereto for me and in my behalf. The power granted herein shall apply to brokerage accounts with the following brokers: and any other brokers with whom I may have accounts from time to time. I authorize my agent to execute on my behalf any powers of attorney in whatever form that may be required by any stockbroker with whom I have deposited any securities; 8) To Deal With Securities. To buy, sell, trade in, hypothecate, and otherwise manage any securities, domestic or foreign, whether dollar. or non-dollar denominated, including, but not limited to, stocks, bonds, and options, which I may own, and to sell all or part of such securities and purchase other securities; 9) To Make Contracts and Give Releases: To make, receive, sign, endorse, execute, acknowledge, deliver, and possess such applications, contracts, agreements, options, covenants, security agreements, bills of sale, leases, mortgages, assignments, fire and casualty insurance policies, bills of lading, warehouse.receipts, documents of title, bills, bonds, debentures, checks, drafts, bills of exchange, letters of credit, notes, stock certificates, proxies, warrants, commercial paper, receipts, proofs of loss, evidences of debts, releases, and satisfaction_ of mortgages, liens, judgments, security agreements and other debts .and obligations and such other instruments in writing of whatever kind and nature as may be necessary or proper in the exercise of the rights and powers herein granted; 10) Bank Accounts. To deal with any bank accounts or certificates of deposit which I may own, to withdraw .funds from such accounts, to pledge such.accounts, and generally to exercise control over such accounts, and to establish new accounts; 11) Life Insurance Policies. To deal with life insurance policies and. annuity contracts, to change the beneficiaries to assign the policies, to surrender and.borrow against the policies and 3 _ to exercise all of the incidents of ownership in any life insurance policies or annuity contracts I own; 12) Medical.Care: To make decisions as to acceptance or rejection of medical treatment, to engage and dismiss physicians and other health care personnel, to choose where I shall receive medical treatment and to arrange for my admission to and discharge from .,hospitals and other places of treatment, and to do anything in connection with my health care which I could do personally. If I shall have executed a valid Health Care Proxy this provision shall be inapplicable; 13) Tax Matters. To represent me in all tax matters;-to prepare, sign, and file federal, state, and local income,.gift and other tax returns of all kinds.; including joint returns, claims for refunds, requests for extensions of time, petitions.to the Tax Court or other courts regarding tax matters, and any and all other tax-related documents, including, but not limited to, consents and agreements under Section 2032A of the Internal Revenue Code or any successor section thereto and consents to split gifts, closing agreements and Form 2848, and any other power of attorney required by the Internal Revenue Service, any state or any local taxing authority with respect to any tax year between the years 2000 and 2020; to pay.taxes due, collect and make such disposition of refunds as my agent shall deem appropriate, post bonds, receive confidential information and contest. deficiencies determined by the Internal Revenue Service or any state,. or any local taxing authority; to exercise any elections I may-have under- federal, state or local tax law; and generally to represent me in all tax.matters and . proceedings of all kinds and for all periods between the years 2000 and 2020 before all officers of the Internal Revenue Service and state and local tax authorities; to engage, compensate and discharge attorneys, accountants and other tax and financial advisers and consultants to represent and/or assist. mein connection with any and all tax matters involving.or in any way related to me or any property in which I have or may have any interest or responsibility; 14) Safe Deposit Boxes: To enter any safe deposit box which I may have leased; to add property to the i box or take property from the box, and to surrender possession of the box and terminate the lease; 4 15) Mail Boxes and Mail: To enter any.-mailbox leased by me; to instruct that mail be forwarded to another address selected by my agent and to surrender any leased mailbox; 16) Power to Do All Necessary Things. I grant to my agent full power and authority to do, take, and perform all and every act and thing whatsoever requisite, prior, or necessary to be done, in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as I might or could do if personally present, with full power of substitution or.revocation, hereby ratifying and confirming all that my agent shall lawfully do or cause to be done by virtue of this power of attorney and the right and powers herein granted; 17) Powers Not Intended To Be Limited. This instrument is to be construed and interpreted as a general power. of attorney. The enumeration of specific items, rights, acts, or. powers herein is not intended to, nor does it, limit or restrict, and is not to be construed or interpreted as limiting or restricting, the general powers herein granted to my agent; 18) Choice of Conservator or Guardian. If at any time protective proceedings for my person or estate are initiated, I nominate my agent to serve as guardian of my person or conservator of my estate, and I request that sureties on any bond of a guardian or conservator shall be waived. 19) Power to Remain In Effect: This power of attorney is intended to remain in full effect notwithstanding any subsequent disability or incapacity on my part; 20) Expiration. This.power of attorney shall not expire or become stale upon the passage of time but is intended to continue in force until -revoked by me or by a conservator, guardian of my estate, or other fiduciary appointed by a court of my.domicile. 21) Counterparts and Copies Valid. I execute this power of attorney in a number of counterparts, each to be valid as an original. A photocopy of this power of attorney shall be deemed to be as valid as an original; 5 22) Other Powers of Attorney Revoked. I hereby revoke all other powers of attorney I have executed earlier, except such as have to do with signature powers over savings or checking accounts; 23) .Appointment of Successor Agent. If my daughter, Rene Mendes, shall be unable or unwilling to serve as my agent under this instrument, then I appoint my daughter, Christine Chambre, to serve as such agent.. Inability of my agent to act shall be evidenced by a certificate disclosing my agent's death or by a certificate of a licensed physician to the effect that my agent is unable, for reason of physical or mental disability, to act. Unwillingness to act shall be evidenced by a statement in writing, signed by the agent and acknowledged before a notary public,and attached to this document; 24) Protection for Third Pg!y Accepting Power of Attorney._ Any person, firm, or corporation shall be entirely protected in relying upon this power of attorney or any action taken by my agent pursuant to this power of attorney, and I, or my estate in the event of my death, shall hold harmless any such person, firm, or corporation so relying upon this power of attorney or any action taken by my agent pursuant to this power of attorney; 25) Designation as Personal Representative Under HIPAA. I grant my agent the following powers, status; and privilege in order to enable my agent to obtain all protected information with respect to my health under HIPAA (The Health Insurance Portability and Accountability Act of 1996.) I intend that my agent shall be able to obtain all of my health information, since I anticipate that my named agent shall be obliged to make decisions related to my health care, including, but not limited to the payment of expenses for my care. I declare that I consider all of my health care information to be relevant to such activity on the part of my agent. I direct.that my agent-shall.have such:authority to act on my behalf in making decisions related to health care as shall entitle him or her to receive protected health information under HIPAA in the status of my personal representative as that`term is used under HIPAA. In addition to, and not in limitation of; the foregoing designation of personal representative, I intend this provision of this durable power of attorney to be valid authorization for my agent to receive all of the health information that my agent in his or her sole discretion shall deem relevant. My agent shall not be obliged to state a purpose for the request of such health information, and my agent's request.alone shall be presumed to be based upon a.valid reason. 6 . I intend that any provider of health care services, including, by way of illustration and not of limitation, any physician, surgeon, dentist, nurse, physical therapist, chiropractor, psychologist, hospital,.nursing home, or assisted living facility, shall be entitled to accede to the request by my agent for protected health care information. The authority granted under this Article shall expire in five years from the date I sign this durable power of attorney. The reference to "agent". in this Article shall apply to the named agent and any alternate or successor agent. I understand that I may revoke the grants made in this Article at.any time by revoking this durable power of attorney. I intend that the grants under this Article are not a precondition for any treatment, payment, or enrollment under any program or protocol of health care or payment therefore. I understand.that health care information under..this Article may, once released to my personal representative or person to whom this authorization runs, be later released by such personal representative or person to whom this.authorization runs. 26) Fiduciary Standard. In carrying out his or her.duties under this power of attorney, my agent shall act as a fiduciary and shall exercise the powers granted hereunder as my agent shall believe to be for the best interests of me, my estate, and the beneficiaries of my estate. 27) To Make Gifts. To make gifts of my, assets to such persons and institutions as shall appear to my agent to be consistent with my prior pattern of giving, or as shall be appropriate-to reduce or eliminate Federal or State estate or inheritance taxes .on my estate, or as shall be appropriate to reduce the exposure of my estate to nursing home expenses. Such gifts shall be made in a manner..which is consistent with, and does not significantly change, my estate plan to the extent possible. Such gifts'shall include, by way of illustration, direct payment of college or school tuition, annual exclusion _ gifts, and transfers by way of family limited partnerships, limited liability companies, or other vehicles. This power shall not authorize my agent to make gifts to himself or herself. If such power is granted, it will be provided in Article 28; 28) To Make Gifts to Himself or Herself. I specifically authorize my agent to make gifts to himself or herself, directly or. indirectly, in accordance.with the provisions set forth in the preceding Article; (To be signed only if this power is granted.) 29) State Law To Govern. This power of attorney is to be construed according to the laws of the Commonwealth of Massachusetts'. WITNESS my hand this 19th day of J. 2010. Phillip.R. Vint, COMMONWEALTH OF MASSACHUSETTS Barnstable, ss. January 19, 2010. Then personally appeared the above-named Phillip R. Vinton, personally known to me, and acknowledged that he signed the foregoing instrument voluntarily, for its stated purposes,before me ussell E. Haddleton Notary Public My commission expires. December 24, 2010 RUSSELL E.HgppLE7pN . c .2010 8