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Home My WebLink About0100 HIGHLAND DRIVE loo 4 yP. r a • , , c 4. a • f y c. �x 4 t e J. - :y .. f S] - v , a u t„x � L t � - ; z _ 'c < : - ,. .. � , �. _. n � .. _ .. „ .. .. .. ., i .. ., .. .. _ '.. -� - -. � .. L. - r .. .. .. � �. .' � _. _. _ . � - .. w .. a �- ,� c ,. :. .. e _ - '{ �.. �• .� � i F =a` L' � .� .. � � � e .. .. ` E �.. ,.. t 'c r � � <' �, +'iy � - r .. ,. .,. . ;.. ., � . �1 _ - j � � - ... .. _ _. ,.. .. ,. �. � .' - ';' a u. C .. e � � : - . _. ��. G r . , _ t , , . . : . .. . r , _ - .- .. ..; .. - � � ,. a.. - .. a .. � ;, _ �` � . a LDS Application number-Z 3 ..............................................• .... � O Fee ......... {} g g Inspectors Building ctors Initials... °Ra P ........... ............. bAhNbIAb . Date Issued..... „l` �1.`I. ..................................... �c� Map/Parcel...... ....:..........::...........................::.......... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: M t 1� NUMBER STREET VILLAGE Owner's Name: - 1n W i C. Phone Number Email Address: v Wily. J .C J~Cell Phone Number Project cost$ oto 0- Check one Residential f 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 ❑ Doors(no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to SCSI 1 (d t CONTRACTOR'S INFORMATION �� ) �., - - i r Contractor's name Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# (atta6 copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT. YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION.NUMBER............................................x............. *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 t Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number 'J 0$ 1 �1 — q o'75 Cell or Work number S.O 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-9f Barnstable. ) Signature Date -7A / APPLICANT'S SIGNATURE Signature Date All permit application are subject to a building 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): ('LQJ!� U-)_1I ' Address: 0 O City/State/Zip: J dUl t✓ Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ 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 working for in an capacity. employees and have workers' g Y P h'• t 9. ❑Building addition [No workers' comp.insurance comp. insurance. equiredA 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. 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. $Contractors 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. Insurance Company Name: Policy#or Self-ins.Lie,#: Expiration Date: Job Site Address: City/State/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 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 insurance coverage verification. I do hereby certify u er-he pap and penalties of perjury that the information provided above is true and correct Sip-nature: Date: 5 Phone# 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-contractor(s)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 permit/license 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 J 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 www.maw.gov/dia Property DeReeistration ATTN: RE: 100 HIGHLAND DR,Town of Barnstable, MA 02632 To Whom It May Concern: The above referenced property was previously registered with your municipality by BRON Inc on behalf`' of M&T Bank. M&T Bank and its respective investors and property management team have no affiliation or. responsibility for this property as it is no longer under their service as of 06/06/2019 due to The property has been Liquidated as of date 05/20/2019 due to 3rd Party Proceeds Received. If additional information is needed.to ensure that this property is removed from your registry, please let us know. Otherwise we are now considering this property DeRegistered and compliant. Thankyou,., ., ,, c: Compliance Team ��*��, +..-+ ....:.7 877-338-3791 NJ 110 r 1 9�fq�17 Bron Inc 877-338-3791 27720 Jefferson Ave Ste. 230 --- V q Temecula, Ca 92590 �U,ipca7 l . . �pL� Ivy y 41951 Remington Ave Suite##1.50 Temecula,CA 92590 propertyregistrations@ broninc.eom Contact:(877)338-3,791 , For any issues or concerns regarding the re gistration in this packet, please contact Br®n Inc. at: ro erg re, istratiar� bronincxom p p - Y _� I (877) 33&3791 I m Thank you, Compliance Team Bron Inc. If returning this registration,for ony reason, please include reason of return. "Please inspect FedEx envelope for registration check** ANY CHECKS NOT PROCESSED BEFORE IZO DAYS WIU BE VOIDED i After 220 days Tease 60l1 Bran Inc at the phone number above. 1 REGISTRATION AND CERTIFICATION FORM FOR FORE,CLOSLNG/FORECLOSED PROPERTY Thank you for registering in accordance with Town of Barnstable Code chapter 224 sections 224-3 and 2244, Please complete one forte for Each property in foreclosure (section 224-3)or already foreclosed for which possession has been taken(section 2,24 4). Please ale the original with the Building Cornmass?on-T and a copy with tlZe 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 (pr,.erty information)and the first paragraph of section 2 (foreclosing party, court, etc, anti foreclosing party representative,but not other representatives and,attorney) so that the Town.care review the exemption and update its mcords: Section I Iforr_won Property. Address "Lowr,�•of-arnat,�able,MA 02632 - Assessors Ma #: Parcel#. Aso 136.M 2962p8 sz Land area and description Building(s)description and contents Occupied: Occupant(s)(if borrowers so state and include name(s)j _ Phone., ither: , Vacant: No Date: Antipi paW Length of Vacancy. Last occupant(s))(if borrowers so state and include name(s)), Phone �--T, _„� 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 Foreclosing Party(full name/title) Foreclosure Case Court: ,.wok: 6659 Pags_90(l Docket# , ]sate filed: 11/17/2016 AM Current Status: -u41�. D ;--.._ Foreclosing Party's representative(s) for property(entry,rztaz agement, r pair, etc.)(name,title,), Ryan Sabo .... ._ .. ern..��_.......»-,....+....�„-_`m.,- ... ...,.i ..,..�.s+_9.....�o.-�v;s...m.,ve.�.-..-.- ... .... Company(if different from foreclosing patty): Safo uard Pro ertles h� V Address: 7887 Safeguard ,ir eVallev Mew, ryan.spbq safeguordproperties.com Phone: 800-852-8306 email: other: 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 G. e. "none"or"see above")). Flame,title, other Grace Wesson _ . Company Y Of different from foreclosi party)•.-� Address 41951 Reminaton Ave Suite 150 Temecula. CA 92590 879-339 3794 propel Eure�alstratigns bcort nc eortl Phones) . Name.title, other; Company(if different from foreclosing paAy)< Address: Phone: email: other: Attorney representing foreclosing party Firm name (if different from attorney's name); -- Address: Phone(s) . other I acknowledge that the information provided is accurate ai?.d correct. I also understand that any inaccurate information will result in non7com, ance with section 224-3 of chaptor 22-. of the Code of the Town of Bar stable. Date Name: Grace Wesson Title: Vp of OpeTat on I hereby certify that e aboweenamed foreelosin party is in compliance, with the provisions of seetion 224-3 of chapter."of the Code of the Town.of Barnstable. Building Commissioner, Town of Barnstable