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0360 MAIN STREET (COTUIT)
� l'Y)w� C�`re�' �0 � � � � a �� � �' -2®- 3 17q i � � � Application number...N......................................... ED E, Fee ....... ..:��........................................................ NAM�.ASLe. Building Inspectors Initials....................................... DateIssued................................................................. Map/Parcel....... Z2 ...... .�.�.......................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 36O ham 3Q- C© Dt NUMBER STREET VILLAGE Owner's Name: 626R -t- Aa.t./ f'l en g2se- Phone Number 5d g 7 3 7 9616 Email Address: edaerlee a f a vn Cell Phone Number Project cost$^/,Q©00 ' o v Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize kl c4a e l 4u,o p-wle e to make applicatio=fouil permit ' accordance with 780 CMR Owner Signature: Date: /B12- o c. TYPE OF WORK ® Siding 0 Windows (no header change)#__L_ED 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—42- an,-r!:�/,yd/e CONTRACTOR'S INFORMATION Contractor's name "Home Improvement Contractors Registration(if applicable)# / :5 3 e/4%) (attach copy) Construction Supervisor's.License# Ott`/ 45: (attach copy) Email of Contractor Gt e cz u p,�oGt 6 f oh-► Phone number �OS� ALL PROPERTIES THAT HAVE STRUCT ES 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 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-4:34pm. 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 APPLICANT'S SIGNATURE Signature Date & fill permit applications are subject to a building official's approval prior to issuance. �i�7rreaitf��¢ ��f/�/���ix� 'ull•� �,. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:,Individual Registri;tiori, Expiration y ry fi53440 12/10/2020 MICHAELAUPPFRC -i D/6/A MICHAEL:ACiPPERLEFlRENOVATIONS i MICHAEL J.AUPPE�IL -- 169 SANDAIJVVO DfDFf r C: i COTUIT,MA 02636 UnderseCrotafy Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construct o .S4T /60p 1 &2 Family CSFA-049205 E� ires 07/14/2022 MICHAEL J l��PPERLE 4 i " 169 SANDALWOOD'jDR y t t COTUIT MA 02635 Vol 4 i Commissioner j '. 'A # The Commonwealth oj'Massachusetts Department of Industrial Accidents = Office of Investigations 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information p Please Print Legibly Name(Business/Organization/Individual): Address: DIrl City/State/Zip: ;"� ;� Phone#: 3 B Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. Demolition workingfor me in an capacity. employees and have workers' Y P h'• $ 9. Building addition [No workers' comp.insurance comp.insurance. required.] 5. „We are a corporation and its 10. Electrical repairs or additions 3. 1 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 l.v 1AW6t..0 , /�e l4c�drr comp,insurance required.] P *Any applicant that checks box 41[trust 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 most 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. q �AA Insurance Company Name: Policy#or Self-ins.Lic.#: WCL 566 501169 90?,-0A Expiration Date: Job Site Address: 360 Lee-, �7Z -�� � t. n - "-amity/State/Zip: �r11_11 6 p? IM 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. do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: D a 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#: 4 ` T ' CERTIFICATE OF LIABILITY INSURANCE DATa`MM�DDrY 0 �`.. 10 12 0 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 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 policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terra 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 endorsemen s. PROMJM 1=7 Sharon Covina McShea Insurance Agency,Inc PNON=O. 608 20-90111 Fax . 508 20-9010 1645 Falmouth Road,Rt 28 BLDG D rsMalL Sharon mesheainsurence.com Centerville,MA 02632 INSU s AFFORDINGROM&O NAIO9 INIMMA, National Grange MUtual Ins Co. 29239 INSURED Michael Aupperlee I ERB: NATIONAL ORANGE MUTUAL DBA:Michael Aupperlee Renovations mmme. AIM Mutual- 169 Sandalwood Dr IISIRERD Cotult,MA 02635-2315 IN E: INSURER F: COVERAGES CERTIFICATE NUMBER-. OCOM 97 77165 REVISION NUMBER: 22 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. INSR TYPE OF INSURANCE POLICY] AMMR POUCYS" POLICY E7IP LIMITS A X COMMERCIAL GENERAL UAMUTY MPJ26304 07JOS12020 02109M O21 EACH OCCURRENCE _ $ 300,000 CLAIMS-MADE ❑OCCUR PREMISES'Fa amiffencel $ 500 000 MED EXP ens S 10,000 PERSONAL&AM INJURY $ 30,000 GM AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 600 POLICY❑Jar ❑LOC PRODUCTS-COMPIOPAGO $ 800.000 s THER: B AUTOMCBILEUANUTY M1T4893T 09/3012020 091301202! COMaINEDSIN i r $ ANY AUTO BODILY INJURY(Per Person) $ AUTOSDAY X D BODILY INJURY(Per aeddeno $ 500,000 HIRED EO PROPERTY DAMAGE S AUTOS ONLY I ALJ AUTOS ONLY $ u"RELLA UAa OCCUR EACH OCCURRENCE $ Excess Like CLAIMS-MADE AGGREGATE $ DED I RETENTMS OTW $ C WORKERS COMPENSATION WCC6005011097.2020A 08M94020 06M912021 I • MD9VL0YWUAMLnY YiN E.L.EACH ACCIDENT $ 500,000 aNVPRO NIA O EMBER°cctuDED? EJ„DISEASE-EA EMPLOYE $ 500 000 (lmdatory In ON) R desa9bB� El.DISEASE- LIMIT S 500.000 DtieICRIPnON OF OPERATR>a18 rLOCAnO f VEHICL E8(AGGRO jai.Addlq"Raanuko Sahedule,maybe aWhW R more epees Is raqulrad) CERTIFICATE"OLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE VVILL BE DELIVERED IN 'TOWN OF BARNSTABLE ACCORDANCE WITH THE POLICY PROVISIONS. BUILDING DEPARTMENT AUTIIORIZEO ATNE SSC ®1gas-2015 ACORO CORPORATION. All rights reserved. ACORD 26(MOM The ACORD name and logo are registered marks of ACORD Pdnted by SSC on October 06,2020 at 11:05AM Town of Barnstable ld B 'n Post This.Card So That it is,Visible from the Street--A pprovedPfans Must be Retained on Job and this Card Must:be Kept �NSPAIBL� Z Posted Until Final Inspection Has Been Made . r Permit udR Where a Cei ificate;of Occupancy is Required;such Buildmg shall Not°be Occupied until a Final Inspection„has been made , . Permit No. B-20-139 Applicant Name: Henry Cassidy Approvals Date Issued: 01/15/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 07/15/2020 Foundation: Location: 360 MAIN STREET(COTUIT),COTUIT Map/Lot: 022 012 Zoning District: RF Sheathing: Owner on Record`. MENESES,CARA D& PAUL A.G. Contractor NameAPE COD INSULATION,INC Framing: 1 Address: 147 SANTUIT-NEWTOWN ROAD Contractor," License: 153.56.7. 2 COTUIT, MA 02635 m' ,: . Est. Project Cost: $7,600.00 Chimney: � y: Description: Insulation/Weatherization Permit Fee: $88.76 Insulation: Project Review Req: ' Fee Paid:+ S 88.76 i_ Date: 1/15/2020 Final: Plumbing/Gas Rough Plumbing: \Building Official "-^ Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the`approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open forr'public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not.be issued until all applicable signatures by the Building dndFiA6 Officials are provided on this:permit. Minimum of Five Call Inspections Required for All Construction Work: _F Service: 1.Foundation or Footing `* Rough: 2.Sheathing Inspectionw - - 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. 'Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site �� Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Application number �tq SEP-112019 Fee.................................. .......................................... rlUH -Aoffi t 6ANS] BLE Building Inspectors Initials...... 4 ............... 6 Date Issued..... ........1..�......1.7......................... Map/Parcel.........0-1)........b.......................... TON" OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 360 . IW,4,V cop/uf. NUMBER STREET VILLAGE Owner's Name: &A/eSM Phone Number Email Address: Cell Phone Number Project cost$ vG 600 Check one Residential V 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 E:1 Siding 0 Windows (no header change)# 0 Insulation/Weatherization ED Doors(no header change)# Commercial Doors require an inspector's review Roof(not applyifig more than I layer of shingles) Construction Debris will be going to chi I bjS�VzSQ1 CONTRACTOR'S INFORMATION Contractor's name cq cod i& e: wry h ovedew4 Home Improvement Contractors Registration(if applicable)# Y69 OVS (attach copy) Construction Supervisor's License# 4060yo (attach copy) Email of Contractor c*cod role. ma d - coo, Phone number 502 169 0 ALL PROPERTIES THAT HAVE STRUCTURES&ER 75 YEARS OLDOR IF 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 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 APPLICANT'S SIGNATURE Signature Date 0 9 OS All permit applications 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 ae l.�lll Name (Business/Organization/Individual): C �&Ne �m�QOt�—M P.all'� Address: I011d 7V4 City/State/Zip: Y.79MOu4 YA aMV Phone#: 5�� Are you an employer?Check the appropriate bog: Type of project(required): I. I am a employer with 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. Demolition workingfor me in an capacity. employees and have workers' Y p tY• 9. Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. We are a corporation and its 10. Electrical repairs or additions 3. 1 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.Lic.#: AP41,41 We- Expiration Date: Ue, O�/110-i�v Job Site Address: 260 NC4;Al City/State/Zip: �o➢1ui'y le 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 under the pains and penalties ofperjury that the information provided above is true and correct Signature Date: 0�z Phone#: Official use only. Do not write in this area,to be completed by city or town ojjtcial 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 ��'; �.�"'C�/,�Gd�l�`r°�/,r�:.!G'�1`�C��Li ��'',f�°.i(,/gas;%�f�.r�i%`�i�<!���•�%'��,r., Office of'Consumer Affairs and Business Regulation 1000 Washington Street Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration- Type: Corporation �g Registration: 168043 CAPE COD HOME IMPROVEMENT; INC Expiration: 12/06/2020 27 MILL POND RD WEST YARMOUTH, MA 02673 " a f Update Address.and.Retum Card. ✓r �ivi»rrr"rrr r�r�;:�r�'� /'�1�ri:JrCrYySr"/� Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corporation before the expiration date. If found return to: Register ion Expiration Office of Consumer Affairs and Business Regulation 166043 12106/2020. 1000 Washington Street-Suite 710 CAPE COD:HOME IMPROVEMENT,INC. Boston,MA 02118' ANATOLI,SIVITSKI CGS 27 MILL POND RD 1 _ WEST YARMOUTH,MA 62673 NoiNai+d Without signature Undersecretary, e DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCEF06/04/2019 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 BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING fNSURER(S), AUTHORIZED REPRESENTATIVE 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 NAMEACT Linda.:Sullivan _ - DOWLING &O'NEIL INSURANCE AGENCY P"�"y� ;_(508)775-1620 FAX c.No,: E-MAIL.. ADDRE-s: Isuilivan@doins.com _ 973 IYANNOUGH RD IN SURER(S)AFFORDINGCOVERAGE NAIC#. HYANNIS MA 02601 _ INSURER A: AMGUARD INSURANCE CO 42390 INSURED INSURER B`. CAPE COD HOME IMPROVEMENT INC INSURERC: .INSURER D: ' 27 MILL POND.ROAD INSURER E: WEST YARMOUTH MA 02673 wsuRER F: COVERAGES CERTIFICATE NUMBER: 410126 REVISION NUMBER: 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. ILTR�.NSIR TYPE OFINSURANCE -, IIADDL SUER pQUCY NUMBER' PM DDOUCfYYM Y EFF MM POLICY EXR LIMITS I j COMMERCIALGENERALLIABILITY I EACH OCCURRENCE Is _ 111 DAMAGE TO RENTED CLAIMS-MADE L OCCUR PREMISES LEE.occurrence) $ i MED EXP(Anyoneperson) $' } N/A. PERSONAL&ADV INJURY $_._ GEN'L AGGREGATE LIMIT APPLIES PER: y GENERAL AGGREGATE $ . I tr PRO JECT POLICY 1 - LOC. II PRODUCTS.COMP/OP AGG $, I _ AUTOMOBILE LIABILITY i COMED'INGLELIMIT $ E.accBIN dent I I ANY AUTO ? BODILY.INJURY(Per person) S: + I ALL OWNED SCHEDULED I, ! N/A BODILY INJURY(Per accident) $ i a AUTOS AUTOS ( I PROPERTY DAMAGE {{ $ i NON-OWNED ! _ P r accident j HIRED AUTOS. ( L $ UMBRELLALIAB. HcLAtMS-MADE- OCCUR .I .. . 1 EACHOCCURRENCE.. $ -EXCESS LIAB' _ f , � "NIA; � !AGGREGATE $ I UED 1 1:RETENTION$ !- ($ WORKERS COMPENSATION - 1/� STATUTE -ERH AND EMPLOYERS'LIABILITY Y I N iANYPROPRIETOR/PARTNERIEXECUTIVE. I - - E.L.EACH ACCIDENT. $ 1,000,000- A f OFFICER/MEMBEREXCLUDED? N/A N/A• NIA R2WCO23262 06/031201.9 06/03/2020 " (Mandatory in NH) f (E.L.DISEASE=EA EMPLOYEE $ 1,000,000 I If yyes;describe under j j - tDESCRIPTION-OF OPERATIONS below - L_.-.- E.L.DISEASE-POLICYLIMIT $ 1;000,000': i N/A DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)- Workers'Compensation benefits will be paid to Massachusetts employees Only.Pursuant to Endorsement WO 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured'hires,or has hired those employees outside of Massachusetts. 9 This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date-on the above policy precedes the, issue date of this certificate of insurance). "The status of this.coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.m6ss.gov/lWd/w6rkers-compensation/investigations/. CERTIFICATE.HOLDER CANCELLATION SHOULD XPIRATIION H ABOVE POLICIES DATE T EREOF, -NOTIICE WILL CBE CDELIVERED FORE: THEN;. t Anat011 SIVItSkI ACCORDANCE WITH THE POLICY PROVISIONS: 222 Buck Island Road'6-8 AUTHORIZED REPRESENTATIVE y West Yarmouth MA 02673 ""'{f t i Daniel M Crowley,COCO,Vice President—Residual Market-WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. t...'o,mmon, wealth of K, -s's- "'C' . 1,vulsel"t Division of Profess[onal L � w Deed n In . Con -structi pcpecja . ty CSSL-106� . 015/'14/2020 , ANATOLI S VITSK1 x. . 27 MILL POND--.RD SST YARMOUTH MA 02673 g CAPE COD Home Improvement GAPE COD HOME IMPROVEMENT TM 27.MILLPON'IJ ROAD, WEST YARMOUTH MA 02673. (1017)710-` 00 , cso$) a69.O t o2 CAPECUDING@GMAIL COM WWW;ROOFCAPEGOD.COM, WWW.FACEBOOK.COM/CAPECOQF OyIE' PROPOSAL eCol = etitterwoo 0727.2019 S To ConF,r r (�3) SKyl+ ant Sc 2e CARA MENESES VY1 + .' LOCATION. 360MAlN ST, CUTUIT' , a ate 9�q q.� 12 WEHEREBY.SUBMIT SPECIFICATIONS'AND:ESTIMATES:E'OR: MAIN.COMPOSITION SHINGLE ROOF: . :. 4. REMOVAL OE ALUEXISTING"ROOFING AND FLA'SHING.MEMBRANES TO.THE'PLYWOOD DECK.SURFACE o REPLACEMENT OF ANY DAMAGED OR:`.DETERIORATED PLYWOOD:DECKING:AT AN.ADDITIONAL COST.DECKING WILL BE H REPLACED'IN WOLE SH£ETS Y:ONL IN.ACCORDANCE Wi71i RECOMMENDATIONS 8Y BOTH THE NATIONAL FI ROONG: CONTRACTORS ASSOCIATION(NRCAYAND THE,AMERICAN.PLYWOOD.ASSOCIATION(40A).NEW.DECKING;SHALL-BE APA RATED FOR STRUCTURAL USE;.DECK FASTENING WILL MEET OR EXCEED LOCAL BUILDING CODE REQUIREMENTS. .REPLACEMENT OF FOLLOWING FLASHING MATERIALS:STEP FLASHINGSG.pik FLANGES,PERIMETER,:DRIPEDGE MATERIAL. ... AND ALL SKYLIGHT FLASHING:MATERIAL.ALL MATERIALS TO MEET OR EXCEED MANUFACTURER'S REOUIREMENTS • ONE ROW OF ICE AND WATER:PROTECTION MEMBRANE:SHALL 13E INSTALLED IN_ALL VALLEYS AND AROUND THE CHIMNEY. ONE ROW OF ICE AND WATERRROTECTION MEMBRANE SHALL BE INSTALLED ALONG ALL EAVES AN6 SHALL'EXTEND:PAST . THE INTERIOR WALL LINE AiMINIMUM OF 1$INCHES TO.PROVIDE;PROTECTION:AGAINST DAMAGE FROM ICE DAMS:. INSTALLATION OF ONE LAYER OF ROOFING UNDERLAYMENTON:DECK SURFACE"NOT.COVERED WITH.ICE AND WATER: PROTECTION:MATERIAL'.. INSTALLATION OF NEW ARCHITECTURAL STYLE ALGAERESISTANT CERTAINTEED SHINGL£5 SHINGLES WILL BE INSTALL£D: IN STRICT ACCORDANCE WITH THE MANUFACTURER'S.SPECIFICATIONSAND SHALL BE FASTENED USING r�IX NAILS PER SHINGLE.: . COLOR OF,ROOF.PENETRAITIONS AND:FLASHINGS TO BE CHOSEN BY OWNER IN OF A;SHINGLE-0VIER RIDGE VENT.VENT IN THIS AREA IS:CONTIN000S AND_W.lLL PROVIDE_ MAXIMUM INTAKE VENTILATION FOR THE FULL ATTIC ENTILATIONSYSTEM;i. . REPLACE ANY DAMAGE FASCIA-BOARDS OR RAKE.BOARDS AT AN'ADDITIONAL COST • ALL GROUNDS TO BE CLEANED UP ON A DAILYBASIS.ALL BUSHES SHRU85 ANDfLOWEIR TO BE PROTECTED HOMEOWNER IS.ASKED TOiSUPPLY'ELECTRICAL POWER IF NEEDED CAPE COD HOME IMPROVEMENTTM.GUARANTEES THAT ALL COMPONENTSINSTALLEQ"PROPERLY PLEASE FEEL.FREE:TO CALL;CAPECOD NOME:IMPROVEMENTr' WITH"ANY QUESTIONS OR CONCERNS.: PLEASE INITIAL THIS PAGE YAI'H OU1� Ilnn�Iru rrovsrurol COD H ME .iM`PRauEMENT`T 2/ M 1.LL, ON :ROADr YY(.'::S�' T/,R'MOUTH MA 0, 673 (6 7) 1 0•;100 4;.(508) as9-o i 0►2 CAPECO INC I'GMAII�40m, W*WW FZOOF Arr:Q(�EOM,. WWW.rACEf�0MCOM/ At'1aC0I)HOf�{F > rrr�r,rrrrrr rrrrrrrr—lr ---------- rr y—rrrr-irrr�ir ifi�rrrr��r���Nrrrr�Lr�r.��rrrr��rr�� - ` C)1 :1!1(N 1: CERTAINTEED LANDMARK SHINGLES i1,9T11R�,S0 YEA�B NON�PROR/1TEO,TF2ANS�ERABI.E WARRANTY ANra MATCR 3 750 00 �UMPSr9g $850 04 TOTAL: 24,600.00 CIRTAINTEED LANDMARK SHINGLES` STANDARD•S©YEARS PRORATED TRANSFERABLE WARRANTY(I,O YEARS NON-P,RORATED'PER10D) L AI§0 a AND MATERIALS :$229950 00 ��MeS FRr .$85000 TOTAL: . $23800.00 "wgWILL MATCH OR OUT130 hNY LEGITIMATE COMPETITOR." CAI L+ �(� jQt:11 [�(5. IS PROUD TO FRI SENT YOU WITII SUPERIOR I O YEAR WORKMANSHIP_;AND SERVICE WARRANTY. y'ItIn,WARI�ANTY I i IN;Afjl)ITIUN:fiO.1)UT RUNS CONCURRE.NTI.Y WITFI:ANY MANUFACTUI2CRS VVAf;RANTIES.1T COVERS AlL SERVICE. CAM S RGl Al`R_D TO WkRRANTY;RCPLACGMCNT AND./OR INSTALL 14 N 155UES FOR THC:FIRST:TEN YEARS:AFTCR PRODUCT IN6TALLAT10N,. L PAYMENT TERMS: �O�t{Arf}I rQ�1T;. 3(Yfr.AT:;TALI':: AOh;UPON C M rj,F;T 1.6 N.. IC111 l PSTIMATfD TO�GO: I C APPRQYIMATELY.2 TO B WEEKS AFTER DCPOStT RECEIVED: WC1CiK1W GfIPDULCD:T.Ot1C�iUfiSTANTIALLYCOMt'LETCDaNAPPROXIMATELYITOZ:'WEEKS. ANY WORK AIIOVC ANt]:QCI'ONnmir SPCCII'ICATIONS WILL JC PERFORMED AT 56 OO$:PER MAN-`HOUR PLUS MATERIALS QR'.PRICED ON n,r,.Q [!,P.::A(( AI1[)I110NA4 WORK'INCLUpING fRAVI LTIMC AND LUNIBEOARD RUNS;MOVING:gLL PERSONAL OBJECTS;, DUI'tN1t41121.,.1',7C.f1,f?M1VC?I:KAt3EA,.WIIA::fIfSUfiJECTTOt:XTRACIIARGC.INTHEEVENTOFROT:REPAIRS,_ROOFREPAIRSORANY REIJ Tt ,):%v w RI[}iJi)?INO IMrit DIATC AI TfNTION,WE WILLPROCCEI)WITI OUT CUSTOMER APPROVAL 'CAM COl]FIOME IMPROVEMENT M GUARANTEES THAT ALL COMPONENTS INSTALLED PROPERLY' PLIJISIC FEEL FREE.TO CALL CAPE COD HOMe IMPROVEMENT^" WITH ANY QUESTIONS OR CONCERNS" PLEASS INITIAL.THIS.PAG90 ~ tr iir����wrari�� -r-r------ ------ -----r-r ------ ��...rs..� CAPE COL)HOMQ IMPROVEMENT?M WILL PROVIDE CLEANUP ON A:CONTINUING.BASIS`AND ALL DEBRIS WILL BE:REMOVED FROM SITE' (PROFESSIONAL CLEAN ING.DOE5N'T INCLUDE).ALL PRODUCTS INSTALLED BY CAPE COD HOME IMPROVEt4LENT-WILL BE TO. MANUF.ACTURER.SP.ECIFICATIONS:.ALLWDRK WILLBE PERFORMEq.9Y INSURED PROFESSIONALS. AI L MATERIAL IS GUARANTEEDTO BE AS SPECIFIEp:AND Tf�E ABOVE WORK TO:BE PERFORMED IN ACCORDANCE.WISH THE'. DRAWINGS AND%OR SPECIFICATIONS$UBMITTED FOR ABOVE WORK AND COMPL tE ED IN-A:SUBSTANTIAL WORKMANLJKE MANNER: OWNER:TO.MOVE ALL.P.ERSONAI,OBJECTS FURNITURE.,ETC]FRONI.WORK AREA ALL ITEMS AGAINST WALLS SHOULD BE: CONSIDERED FOR REMOVAL DURING ANY:EXTERIOR`SiDINGJOBS AbomONS(ETC.TO GUARD. DAMAGE.IN THE CA It OF AN f ROOFING AND:RIDGE VENTING,DUST AND DEBRIS SHOULD BE EXPECTED AND'A &EMS IN THE ATTIC SHOULD.BEREMOVED.GAPE: COD'.HOME-�MPROYEhIt3fT IS NOT RESPONS113LE FOR ANY.DAMAGES IF SAID ITEMS REMAIN IN PLACE. . CAPE COD HOME IMPROVEMENT TM IS NOT RESPONSIBLE FOR ANY DA:MAGES.THAT MAY OCCURI URING CONSTRUCTION TO LANTISCAPING:OR ANY FINISH GROUNDWORK;.PLANTINGS.ASPHALT'OR STONE DRIVEWAY,ETGFFLOWERS AND SHRUBS AGAINST:. HOUSE`MAY NEED TO BEREPAIRED OR:REPLACED BY k6MEOWNER:. ,. ANY ALTERATION OR DEVIATION FROM ABOVE SPECIFICATIONS INVOLVING EXTRA COSTS WILL'13E EXECUTED ONLY U06N'1NRRTEN. ORDERS.AND WILL BECOME AN`EXTRA CHARGE OVER AND'ABOVE THE ESTIMATE.ALL AGREEMENTS CONTINGENT UPON SL RIKES; ACCIDENTS OR,DEL AYS.BEYONO OUR CONTROL:OWNER TO.CARRY FIRE.TORNADO AND OTHER:NECESSARY INSON ABOVE WORK:WORKMEN'S COMPENSATION AND PUBLIC CIABILI7Y INSURANCE ON ABOVE WORK TO BE::PLACED ON THE RESIDENCE icW-F ZiFTHE CONTRACT.OWNER:WHO SECURE THEIR OWN CONSTRUCTION RELATED PERMITS OR DEAN ifIniNG CAPE COD Home Im rovettteat �■i.® CAPE COD HOME. IMPROVEMENT TM 27 MILLPOND ROAD, WEST YARMOUTH MA 02673 (617)`71.0.1001, (508)460-0102. CAPECODINC@GMAIL:COM, WWW ROOFCAPEGOD.COM, WV W.FACEBOOK.00M/CAPECODHOME PROPOSAL 08.07.2018 TO CARA MEN ESES LOCATION. 360 MAIN ST, L OTUIT WE HEREBY(StJBMlT SPECIFICATIONS AND ESTIMATES FOR . GUTTERS;REPLACEMEIV'i . REMOVAL OF ALL:EXISTING GUTTERS TO:`THE FASCIA SURFACE'... REPLACEMENTALL;OF FASC 1.IA-BOARDS;RAKE-BOARDS SOFFITS:TRIM FASTENING WILL MEET.:OR EXCEED LOCAL RUILDING:CODER EQUIREMENTS; LL MATERIALS TO MEETOR EXCEED MANUFACTURER'S REQUIREMENTS, , !' INSTALLATION OF:NW A ELUMINUMy.GUT.TER5 GUTTERS:WILL BE;INSTALLED IN'STRI 'T ACCORDANCE W(TH THE MANUFACTURER'$SPECIFICATIONS • ALL GROUNDS TO`-BE CLEANED.UPON A DAILY BASIS.ALL.BUSHES,.SHRUBS,AND FLOWERS TO BE. PROTECTED.HOMEOWNER IS ASKED TO::SUPPLY.`ELECTRICALPOWER IF NEEDED TRIM i ALL RAKES,.FASCIA-BOARDS AND, SOFF.ITS WITH AZEK AND CORTEX ✓� J COS heY bo ltri . �y� e r 1 mo�)�j LABOR-AND MATERIALS 7 1,300.00 GUTTERSoi OPTION 1 ; 5 K: STYLE G`61171ERS AND 2XS0'- DOWNSPOUTS...IN WHITE WITH.11.1.,SECTION C'N TH.E BACK UPGRADED TO " GU`ITER AND 3X4" DS'TO HANDLE THE AMOUNT OF WATER.ITS 6ETTIW3 LABOR AND MATERIALS: $3,700.00 CAPE COD Home lmprovcment CAPE COD HOME LMPRovEMENT T 27 MfLL POND ROAD,.WEST YARMot" MA 42673 c617) 7 (508)46. 02 CAPECODINC@GMAIL.COM; WWW'.ROOFCAPECOD.00M WWW.FACEBOOK COM/CAPECOD. . GUTTERS. OPMN2 ALL.6" K=STYLE..GUTTERS..AND 3.X,4" DOWN5POUTS. I_AF30R AND MATERIAL..S: 5 300.00 GUTTERS. OPTIONS 6":HALF:ROUND GUTTERSAND 3 ROUND SMOQTH DOWN-SPOUTS LABOR ANQ MATERIALS: 8 000.00 .X PAYMENTTER.MS . 30Vo AT DEPOSIT; 30%AT START 40%UPON COMPLETION: JOB IS ESTIMATED;TO COMMENBSiAN71AOLLY COMPLETED IN�APPFtOXITMATELYOI TO Z WEEKS: ` WORK IS SCHEDULED T0:.8E.SU MAK ANY WORK ABQVEAND BEYOND THE SPECIFICATIONS WILL K ENGLUDIN. TRAVE..— ANDHOUR P RU)MBERYARD�S MATERIALS'ORPRICED ON`REOUEST ALLADDITIONAL RUNS,MOVING A WOR LL PERSONAL OBJECTS. OF REPAIRS OR ANY EIJfTED WORK R QU R NG MEDIATE CHARGE.IN THE tvENT,OF:ROT REPAIRS,.RO ATTENTION;WE WILL PROCEED WITHOUT CUSTOMER APPROVAL CAPE(iOD HOME IMPR01tEMEN MEW-,WILL:PROVIDE CLEANUP ON A CONTINUING 8ASt5 AND ALL DEBRIS VNILL BE REMOVED FRINCLUDE) ALL PkbwcTSIN!��I*L l3y! OM SITE(PROFESSIONAL CLEANING DOESN FACTURER SPECIFICATIONS.ApL WORK W LL BE EREOpRMED. GOD HOME IMPROVEMENTS IN WI LL BE TO:MAN BY;INSURED PROFESSDIN IONALS ALL MATERIAL IS:GUARANTEED TO'BE AS SPE SPECtFICAT ONS SUBMITTED FOR ABOVE WORK AND COMPLETED ACCORDANCE WITH THE DRAWINGS AND/OR ItQA SUBSTANTIAL WORK1ytANUKE:MANNER #: .OWNE R TO MOVE ALL RERSONALOBJECTS,FURNITURE;ETC.FROM WORK AREA::ALL ITEMS AGAINST WALLS RI SFOUI�BE CONSIDERED'FOR REMOVAL DURING:ANYD REXTEON�DUST AND DEERS SHOUJ p BTO EARD AGAINST DAMAGE.:IN THE CASE.OF ANY ROOFING TAILLED PROPERLY CAPE COD: mmo RAN. HOME IMPROVEMENT COD HOM IMPROVEMENT*WITH ANY Q ESTIONS OR CONCERNS PLEw►sEIw�FREE Yo cAu;caPE. . PLEASE;INITIAL THIS PAGE Home COD Tm : . C APE GUD HOME 1MPRovEMEN-r 27 MIL `POND'ROAD,WEsrYA MOLFrH, MA 026:73 _ (617)710-!001 (508j 463-4102 CAPECODINc@GMAILcoM; wwwRooFCAPECaD.coM. vvVvW FACEB�•K COM/CAPBCODI-TOME _ —_.. _. OT EXPECTED AND ANY ITEMS IN:THE ATTIC SHOULD BE REMOVED C RESFONSIBL E FOR ANY DAMAGES IF SAID ITEMS REMAIN IN;PLACE: CAPE COD'F10NI>;.IMPROVEMEIYI ,IS NOT:RESPONSIBL E FOR Aft:DAMAGES THAT MAY OCCUR DURING GONSTRU.GTtON TO:LPLAN ANDSCAPING>OR ANY FINISH GROUND.WORPA E OR REPLACED BY FIQMEQWNERAY: ETC::;FLOWERS AND SHRUBS AGAINST.HOUSE MAY NEED TO B IVA ANY ALTERATION OR DEVIATION FROM ABOVE SPJ GIFICIXA CHARGE OVEREA D ABO E$T1IE ESTIMATE ALL.D ONLY UPON WRITTEN ORDERS,AND WILL 6EGOME:AN AGREEMENTS CONTINGENTUPON STRIKES;ACCIDENTS OR!DELAYS;:BEYOND OUR CONTROL OWNER TO. CAf2f2Y FIRE;:TORNADO AND.f3THER NECESSARY INSURANCE UPON.ABOVE WORK.WORKMEN S COMPENSATION AND In LIABILITY INSURANGE,ON ABOVE WORK TO BE::PLACED ON THE RESIDENCE AS A GONSEQUENGE OFTME CONTRACT::OWNER WHO SEGURE'THEIR OWN CONSTRUCTION REIATED'PERMITS OR, DFJ1L WITH.UNREGISTERED CONTRACTORS:WILL WILLS: FROM.; GCESS TQ THE GUARANTY FUND: COSTS OE'F'GOLLECTIOf�t,INCLUDING ATTORNEYS:FEES WILL 8E RECOVERABLE. THE EVENT OF NON 1. PAYMENT, F WE:LOOK FORWA.RD TO WORKING WITH YOU`:PLEASE CALL IF YOU>,HAVE ANY CQtJEST10NS. SINCERELY CAPE:CQD HOME IMPROYI~MIrNTTM THIS CONTRACT NOT VAL":ID UNLESS SIGNED BY ANATOU'"TONY"SM5K1: w Y II ACCEPTED B ,r SIG DATE "-ACCEPTED BY , 51G DATE .' y'. I TREFOLLOWING IS/ARE THE BEST IMAGES, FROM POOR QUALITY ORIGINALS) Im / �c(3 L � I DATA I Bk 32277 P-a135 - ",429135 w . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . 09—.06-2019 9212 -- 30P TH".OMMO— . . . SAL S — . . . . . . . . . NFE B" MASS40U: ETTS . DECLAAWON O]EdROMEST&W . . . . . . . . man NOW HwmumWweddwWMra&ftm= BM1911 D. Boom . , — memo . . . .. 1900M 1. We,Paul A.G. Meneses and Cara D.Menses,husband and wife,hereby declare homestead pursuant to M.G. L. C-1885 §3 and stale�AFe own thehffe des6ribjWbw and.ocW&or intend to occupy the home as our . . . . . . . . . . . . . . . .principal residence . . . . . . . . His . . . . 11M. . . . . an. . . . . . INS 2. Check all that apply: 11010 M1111M. . . . . . BEENE. . . . . MUMIN. .. . . . . . El I/we,Paul A.G.Me and Cara Fjj&neses,am jWffly(62 yea4la' bage or older). . . . . . . . . . . . . . . . . . 0 I/we,Paul A.G. Meneffand Cara D.Teneses am/aMisabled(hav@9 physical or mental impairment that meets the disability reguir'Meonts,Po'r;" oemlentaP e'cumn', V Y%U.S.0 1282c(a)(3)(A) and 42 �Inco e Me U.S.C. 1382c(a)(3)(CjPffle of the*fd owing must befflaWhed4 1)Almolriginal or certified copy of a disability award letter issued to Mthe ers by the United States Social Se uri Administration,or 2)a letter signed by 'on a physician register e boardWegistration IR'R-edicinec e ut�in that each person meets the disability requirementsTlited in 42 URF. 1282c and 42-U. .�. 1382c(a)(3)(C). B110101MM, , . . . . . . . . . . . . . . . . . . . . am married.to. . . who is not a co- . . . . .owner of the home but1who.occupies or intends.to occupy the home as his/her principal residence. . . . . . . . I . 'MR0 Uffl'%ome1nfMtiGn . . . . . . . . . . . . . . . . . T 3.Address:360 Main Street MA 026 . . . . . . . . . . . . . . . .. . . . . . . . . . 4. Select ONE of the followhom HOW . . . Inns . MHOM . . . . . . . Deed is recorded in Barnstable Regis try of Dee.ds,in Book W/Und Page . . . . . . . . . NPUR . . . . . . ling . . . . . . non 4 El Certificate of Title Ln M11 registeMe in the Landftgistration.Office in Book . . . . . . .and Page. . mmoullums uminomnan wilsomilmll, MIRRIDINIM. . . . . . . . . . . . . . . . . . . . 11 Inheritance from 8"MM RNEMM MR-MR N Rck number in County 0 For manufactured homes,license number 5. I/We,whose names are signed on this document acknowledge that I/we sign it voluntarily for its stated purpose. To be signed by Applicant(s)in front of Notary Public. Signed under pains and penalties of pejury this 6th day of September,2019 aul.A.G. Menses Cara D.Menses 7aul A.G. Meneses Declaration of Homestead for Homes Owned by Natural Persons Page I of 2 A Bk 32277 Pg136 #42905 T q (\�{ �pg C COMMONWEALTH H OF MASSACI��Jf. ETTS BARNSTABLE, SS. . . . . . . . . . ®111 ®1Z . . . IBM MR On this 6th day jfi r, Wjjgbj@y mjhdjAjR&igWddyMjpub1ic, personally appeared Paul A.G. Meneses and Cara D ses, pro me thro gttisfactor)h j ence of identification, which were ,to be the person who signed the preceding or attached document in my presence, and who swore or ed to m �the conten the doc e truthfiil and accurate to the best of " (his)(her)knowledge and be �® . . ' -I pill,. DOU CABIPAC�® f Pudic Natary lic: �� . . . . . . . COMMONWEALTROF MASSACi;USE;TS MY comrrr MWI Erp.ires MY Ct21�'tt1ission ex��r s E) r 07.. 2022 . Rio ®�®. . �. . . : . . lain . . . . . R. . . . . . . R . . . . . . . . . . . . . Return To: moil sill®® : 10®®101®® . ® M®PM ® R ® M. . . . . . .. . Paul A.G.Menses and Cara D.Menses 360 Main Streef . . .. . . . .. . . . . . . . . . . . Cotait,MA 02635 mIM ®® NE11119. MM 91 Root mm . . . . `1 . log . . . of `. . . . . H . . . 1. WE MEN . . . NIER . . . . . "him . . . 19FA E1 ME . . .. . . . BARNSTABLE REGISTRY OF DEEDS Johfi F. Wide, Register ' Declaration of Homestead for Homes Owned by Natural Persons Page 2 of 3 TOWN OF BARNSTABLE Permit No. „31263 BUILDING DEPARTMENT Cash TOWN OFFICE BUILDING 7 OYL 67V HYANNIS.MASS.02601 Bond ................ A D D I T I O N CERTIFICATE OF USE AND OCCUPANCY Issued to ELLIOTT MARK BOBOLA Address 360 Main Street, Catuit USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN �+ REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. Q December 8 19..93 ... .. .... .. .. ... ...... ...... ............... ........... .. .. ................. Building n Inspector . .. �-. - , •+ ..e, . ..W,„ .�S'1-fn .is c�.�` _+�n,s..f•!Rr.,.L.r3.` °y... . ...�R't"'� r` .`Wry. .n 'r....a r -r.t .._ +, - „R ,.t TOWN OF BARNSTABLE 31263 Permit No. ......:......... BUILDING DEPARTMENT ................ l "'0". TOWN OFFICE BUILDING Cash HYANNIS,MASS.02601 Bond ................ ADDITION CERTIFICATE OF USE AND OCCUPANCY Issued to ELLIOTT MARK BOBOLA Address 360 Main Street, CAtult J USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT#WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL . SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. Dece her S m, 9 4 Building Inspector r File No.: 33159 Client. Smith & Connoily, P.C. Deed Book: 4182 Page: 144 Owner, Robert & Marcia M. Jordan Plan Book: 194 Page: 113 Lot(s): 7 Applicant. Robert & Marcia M. Jordan Plan No.: of Lot(s): Census Tract No: None Available Assessor's Plan: Lot(s): MORTGAGE INSPEIN I0N PLOT PLAN B A R N S T A B L E Cotuit Fire District`" Concrete,Bound 243.65 I Shed Lot 7 40,550 S.F. ± o C; pwei 11 04 9 Lot 6 N °• 36 , • S4.x coo ' 125.00 Concrete Bound C 0 T�U I T Scale: _ S A N T U I T R 0 A D Date, 8��5087. I CERTIFY TO SMITH $ CONNOLLY, P.C. , BANK OF CAPE COD AND ITS TITLE INSURANCE COMPANY, THAT THERE ARE NO VISIBLE EASEMENTS OR ENCROACHMENTS EXCEPT AS SHOWN AND THAT THIS PLAP! WAS PREPARED UNDER MY IMMEDIATE SUPERVI— SION, ; THE LOCATION OF THE DWELLING AS SHOWN HEREON IS IN COMPLIANCE WITH THE LOCAL APPLICABLE ZONING BY—LAWS IN EFFECT WHEN . CONSTRUCTED WITH RESPECT TO HORIZONTAL DIMENSIONAL REQUIREMENTS.` THE DWELLING SHOWN HEREON DOES NOT DES LAURIE,RS&ASS0Q TKjNC. FALL WITHIN}A._SPEC T A.�.— __FLOOD 1"AZARD r ._. 1256 Park Street,Suite 202,Stoughton,MA02072 iZONE"AS SHOWN ON A MAP OF COMMUNITY 1-800-553-6&%/(617)559-8028 NUMBER 250001C DATED 8/19/85 BY Ti-iE F .E ,M.A. aF (08S, s6 �ISSC�tAP�i:s''rF • Odra. 3!13@fS,q sa GENERAL NOTES:(I)The declarations made above are on the basis of my knowledge,information,and belief as the result of a mortgage plot plan tape survey inspection made to the normal standard of care of registered land surveyors practicing In Massachusetts.(2)Declarations are made to the above named client only as of this date.(3)This plan was not made for recording purposes,for use in preparing deed,descriptions or for constructions.(4)Verifications of property line dimensions, building offsets,fences,or lot configuration may be accomplished only by an accurate Instrument survey. t , Assess�or's offioe Ost floor): 1,1L �� ,,- THE ' Assessor's map and lot number ,.. ..... ..... ... .<. . . % `*'s t�' 6 gV)leal- �� yoF rot♦ Board of Health (3rd floor): t- � M COMFLIA s • ,- �.L ............................... >, _,� Sewage Permit number ... ... .......... WITH TITLE 5 Z BAUSTAM. Engineering Departm nt (3rd f oor): �� g�� r a •J -/ ,�y w V �aJh�Jy�U�i®6�i�, 60®3�� �1�,,.� !OO tb}q e0� House number .. ®.../:«1..d!r� ......C119Y ,I..T . 7(700 • i°�t a� y, a:... APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only F TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .IrG, r�.'.....2.. .4C!...'.4? P✓ -"6..)... .'. r.K. �i....ryAv.e,xcv4J TYPE OF CONSTRUCTION ...........::::.................................................. .. ............................. r cc .....G.. �......... 190.7 TO. THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: r � Location .� � .....5.A...........iA..�Lco....y.` ............................................................................................................. Proposed Use ..!l.. 3.rt�.. ��?.�............. Zoning District • �.........................................................Fire District �, p..t"Gi.!... .................................................... 2,�7 Name of Owner lL� f' .�..�'. I (. ---�-� p �^ l .�'Z<�./.4.. ... r....�lOfalRlddress ,3G.o..... rh...S1�'. g.�' Name of Builder !"4.!...�✓t�'.0.. ./..............................Address .). ` qf A4 f Name of Architect ..1�.!^. �..../�Q.k:.�9.�Pt'E..? /..................Address �..11!.f'1.. !.. .1 G4!�i1�/�.. ................ Number of Rooms .... •..........................................................Foundation .. 0�?.�iY.C....[... ...�.`. ..AV9 `. .................. Exterior .rj{��ld.......1 !.h .�Q,.............................................Roofing .�'�,r��'IG1. ........................................................ Floors ..O4L.0........................................................................Interior ..y............................................................. Heatingof.r....L..AZ.................................................Plumbing ................... .............................................................. Fireplace .../...........................................................................Approximate Cost ../..l..�y�. ......................... Definitive Plan Approved by Planning Board ________________________________19________ . Area ....1.22pz........................ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 243.65' pshed ;: XAI 9a rr2 :Lot 7 40,550 S.F. ± 1 • S _ DIM tort' p)• N a• 36cc tiP 1 125.00' concrete Bound OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name z.. ....r`�.(. .. ........................... Construction Supervisor's License �.° a JORDAN it ROBERT & MARCI 71 31263 Build Garage/Bareezeway No ........................ P6rmit for .................................... Single Family Dwelling ......................................................................... 360 Main Street Location ................................................................ ' Cotuit ............................................................................... Owner ......Robert....&....,-.4ar.c.ia. ...M.......J.or.aah . .. .... .. .... .. .... .. Type of Construction ...F.ra.m.e............................ .... .. .. .. ................................................................................. Plot ............................ Lot ................................. 7 Peimit Granted ..... 6x.... ...19 8 19 .Date of Inspection ........... Date,Completed ............ . .....19 1�4 6 r' .� Wells Fargo Home Mortgage �G u' a� MAC F2303-04J p�, "�,� `� x One Home Campus 0 . Des Moines,IA 50328 Ph:877-617-5274 October 14,2015 Town of Barnstable Attn:Robert McKechnie Building Department 200 Main Street Hyannis,MA 026oi Completed Property Registration for: [" 36o MAIN ST COTUIT,MA o2635-3122 L TAX ID: 022-012 Dear Sir/Madam: Please see the attached property registration form and use the below contacts to expedite any future requests. Code Violations: CodeViolations@WellsFargo.com Property Registrations: Registrations@WellsFargo.com General.Property Preservation: Property.Preservation@WellsFargo.com j Call Toll Free: 1-877-617-5274 For questions regarding purchasing a Wells Fargo property please contact 1-877-617-5274• Sincerely, Brian Jackson '__3 Wells Fargo Home Mortgage MAC F2303-04J a t One Home Campus t Des Moines,IA 50328 r brian.a.jackson@wellsfargo.com n � Ln UJ v v ' 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 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: N/A Section 1 —Property Information Property Address:360 MAIN ST COTUIT MA 02635-3122 Assessors Map#: MAP: 22 BLOCK: 12 Parcel#: 022-012 Land area and description Single family dwelling Building(s)description and contents Single family dwelling has 4 bedrooms, 2.5 baths Occupied: Y Occupant(s)(if borrowers so state and include name(s)) ANDREW J BOBOLA Phone: email: other: r Vacant: N Date: 10/14/15 Anticipated Length of Vacancy: ' F Last occupant(s) )(if borrowers so state and include name(s)) Phone: email: other: Has.possession been taken No If so, please explain and complete and file the maintenance and security plan form (unless exempt as stated above) Section 2—Foreclosing Party Inform ation Foreclosing Party (full name/title) Wells Fargo Bank, N.A. Foreclosure Case Court: Docket# h Date filed: 03/15/2013 Current Status: Notice of Foreclosure Filed Foreclosing Party's representative(s)for property (entry, management, repair, etc.)(name, title,): Company (if different from foreclosing party): Wells Fargo Bank, N.A. Address: One Home Campus, MAC F2303-04J, Des Moines, IA 50328 Phone: (877)-617-5274 email: codeviolations@WellsFargo.com 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 (i. e. "none"or"see above"A ' Name, title, other: None Company (if different from foreclosing party): Address: Phone(s): email(s): other: Name, title, other: Company (if different from foreclosing party): Address: Phone: email: other: Attorney representing foreclosing party Harmon Law Offices PC Firm name (if different from attorney's name): Harmon Law Offices PC Address: Phone(s): 617-558-8400 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. Digitally signed by Brian Jackson Brian Jackson'':Date:zoie.,o.�aos:as:es-oeoo Date: 10/14/15 Name:Brian Jackson Title: Research/Remediation Associate 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 a 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 and file the applicable sections of the registration form for foreclosing/foreclosed property N/A Town of Barnstable 367 Main Street, Hvannis, MA 02601 (1) Registration date: If not registered, please complete the registration form and state date of filing or anticipated filing 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.21K 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,N.A. F2303-04J, 1 HOME CAMPUS, DES MOINES lA 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. MAC F2303-04J, ONE HOME CAMPUS DES MOINES, IA 50328 (7) If the Fire Chief of the Fire District in which the property is located has approved 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,ONE 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,ONE 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 NA(Property occupied) (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 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. BrianJackson Digitally signed Brian Jackson I 1 Date:2015.10.14 09:47:34-05'00' Date; 10/14/15 Name: Brian Jackson Title: Research/Remediation Associate 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 i 0 „ -*V 0 s WELLS FARGO HOME MORTGAGE 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 ConvUtilitvPmt@wellsfargo.com HOA or Condominium Dues or Fees HOAPmtReguestFH@wellsfargo.com Tax Related Requests: TaxGatekeeper@wellsfargo.com REO property inquiries PASAPinguiries@wellsfsargo.com Insurance Claims HazardClaims@wellsfargo.com General Property Preservation Property.Preservation@wellsfargo.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 Home Mortgage 1 Home Campus MAC# F2303-04J Des Moines, IA 50328 r 21174 ® DATE(MM/DD/YYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE 3/25/2015 `4�. 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 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 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 Wells Faro Certificate Service Center NAME: 9 Wells Fargo Insurance Services USA,Inc. PHONE 404-923-3719 FAX No: 1-877-362-9069 C No Ext 3475 Piedmont Rd E-MAIL ADDRESS: wfis.certificaterequest@wellsfargo.com Suite 800 INSURERS AFFORDING COVERAGE - NAIC N Atlanta,GA 30305 INSURERA: 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 INSURER F: 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 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. IN SR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDDIIYYYY MM DCY EFF Y EXP IYYYY LIMITS LTRlNc;n MID A X COMMERCIAL GENERAL LIABILITY MWZY304056 04/01/2015 04/01/2020 EACH OCCURRENCE $ 10.000.000 DAMAGE TO RENTED CLAIMS-MADE 1_5�1 OCCUR PREMISES Ea occurrence $ 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 PRO LOC PRODUCTS-COMP/OPAGG $ 10,000,000 JECT OTHER: AUTOMOBILE LIABILITY (Ea accidentINED) SINGLE LIMIT $ BODILY INJURY(Per person) $ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE NON-OWNED Per accident) $ HIRED AUTOS AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ $ DED I I RETENTION$ _ - A WORKERS COMPENSATION MWC 302638 04/01/2015 04/01/2020 X STATUTE EERH AND EMPLOYERS'LIABILITY Y I N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED' F N/A' - 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below - DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) j 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 POLICY 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) TOWN r1.9 74 P` REGISTRATION AND CERTIFICATION FORM FOR FORECLOSING/FOREQUOV0 p fzOI'ERTY Thank you for registering in accordance with Town of Barnstable Code chapter 224 sections 224-3 and 224-4. Please complete one foo ec popty, i foreclosure (section 224-3) or already foreclosed for which poD-.djsr0n'lids 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: —Property Information Section1 op rty o Property Address:360 MAIN ST COTUIT MA 02635 Assessors Map#: Parcel #: 022-012 Land area and description SINGLE FAMILY Building(s) description and contents Occupied: Y Occupant(s)(if borrowers so state and include name(s)) ANDREW J BOBOLA: BORROWER Phone: email: other: Vacant: N Date: Anticipated Length of Vacancy: Last occupant(s) )(if borrowers so state and include name(s)) Phone: email: other: Has possession been taken NO If so,please explain and complete and file the maintenance and security plan Torm(unless exempt as stated above) Section 2—Foreclosing Party Information Foreclosing Party (full name/title) WELLS FARGO HOME MORTGAGE Foreclosure Case Court: Docket# i Date filed: 2/22/2013 Current Status: NOTICE OF FORECLOSURE FILED Foreclosing Party's representative(s) for property (entry,management,repair, etc.)(name,title,): WELLS FARGO HOME MORTGAGE Company (if different from foreclosing party): . Address: ONE HOME CAMPUS, DES MOINES, IA, 50328 X9400-022 Phone: 8776175274 email: codeviolations@wellsfargo.com 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 de:not complete. contact information(i. e. "none" or"see above)). Name;title,other:" NONE Company(if different from.foreclosing party): Address:. .. . Phone(s): email(s): other: Name,title, other: . Company (if different from foreclosing party); Address: Phone: email: other:. Attorney representing foreclosing party HARMON LAW OFFICES PC Firm name (if different from attorney's name): HARMON LAW OFFICES.'PC Address: Phone(s): (6 1)55�-8400 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. jonathan.mosier@wellsf.°igitallysignedby <\jonalhan.mosier@wellsfargo.com c ON.cn=jonathan.mosier@wellsfargo. Date. 09/23/2014 a rg o.co m Data.2014.09.23 12:42:47-05'00' Name: Title: 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 and file,the applicable sections of the registration form for foreclosing/foreclosed property (1) Registration date: If not registered,please complete the registration form and state date of filing or anticipated filing 9/23/2014 (2) If commercial property, describe space utilization floor plans required by the Fire Chief and filing date (actual or anticipated) (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.21K and the date(s)and method(s)for removal as approved by the Fire Chief (4)Method(s) and date(s) all windows and door openings secured (or will be secured) The building is secured; all doors and windows are locked. If left secured, name, address, and contact information of security personnel providing twenty-four-hour on-site security personnel on the property WELLS FARGO HOME MORTGAGE + 360 MAIN`ST`COTUIT MA 02635 (5) Location(s) and date(s) "No Trespassing" signs posted or to be posted on the property N/A OCCUPIED (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 HOME MORTGAGE 101 Federal St Boston, MA 02110 8776175274 cod eviolations(cD-wellsfam (7) If the Fire Chief of the Fire District in which the property:is located has approved turning off the water or electricity,please state: Date of approval ; Date(s) electricity turned off on if applicable ; Date(s) water turned off on if applicable (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 HOME MORTGAGE 101 Federal St Boston,MA 02110 8776175274 codeviolations@wellsfargo.com (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 HOME MORTGAGE 101 Federal St Boston,MA 02110 8776175274 codeviolations@wellsfargo.com (10)Date(s) certificate of liability insurance on,the property filed with the Building Commissioner (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 09/23/2014 (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 or to identify the provisions with which the property does not comply and establish a program to bring the property into full compliance (13)Date(s) when the'property was sold, or is anticipated to be sold,to the foreclosing party. If neither,please explain N/A:NOT LISTED FOR SALE . 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. jonathan.mosier@wellsfargo Digitally signed by jona6lan.mosier@) Ilsfargo.mm �DN:rnyonalnan.mosier@wellsfergo.mm - Com Date:2014.09.23 12:40:57-osoo' Date: 09/23/2014 Name: JONATHAN MOSIER Title: RESEARCH AND REMEDIATIONm 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 TRAVELERS BOND AM (License or Permit - Definite Term) - Bond No. 106149535 KNOW ALL MEN BY THESE PRESENTS: THAT WE, Wells Fargo Bank NA as ' Principal, and Travelers Casualty and Surety Company of America acorporation duly incorporated under the laws of the State of Connecticut and authorized to do.6usiness.in the state of Connecticut as Surety, are held and firmly bound unto Town of Barnstable as Obligee, in the.penal sum of Ten Thousand sonars and 00J00 { $10,000.00 ) Dollars, for the payment of which we hereby bind ourselves, our heirs, executors and administrators, jointly and severally, firmly by-these presents. WHEREAS, the Principal has obtained or-is about to obtain a license or permit for LOAN#106-1205320317.360 MAIN ST COTUIT MA 02635 NOW, THEREFORE, THE CONDITIONS OF THIS OBLIGATION ARE SUCH, that if the Principal shall faithfully comply with all applicable laws, statutes, ordinances, rules or regulations, pertaining to the license or permit issued, then.this obligation shall be null and void; otherwise-to remain in full force and effect. This bond is for a definite term beginning 9/23/2014 and ending 9/23/2015 and may be continued at the option of the.Surety by Continuation Certificate. PROVIDED, that regardless of the number of years•this bond is in force, the Surety shall not be Liable hereunder for a larger amount, in the aggregate, than the penal sum listed above. PROVIDED FURTHER, that the Surety may terminate its liability hereunder as'to future acts of the Principal at any time by giving;thirty.(30) days written notice of such termination to the Obligee. SIGNED, SEALED AND DATED this 9/23/2014 Wells Fargo Bank,NA By: , Principal Tra rs C ual and u t Com an of America • o 1 By: au a ayl r Attorney-in-Fact t S 2151 B 6/10 , WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER p q e ® Aim POWER OF ATTORNEY TRAVELERS I.RA Y E L E P�S J Farmington Casualty Company St.Paul'Mercuiy Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company Attorney-In Fact No. 225809 Certificate No. 005268702 KNOW ALL MEN BY THESE PRESENTS:That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United_States Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut,that Fidelity and Guaranty Insurance Company is a . corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc.,is a corporation duly organized under the laws of the State of Wisconsin(herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint Scott Davis,Tina Kennedy,Dawn T.Kirkland, Steven L. Swords,Carol Philyaw,Cheryl Boozer,Annette Wisong, Janice W.Brickner,Joseph W.Hamilton,III,Joseph R.Williams,Cindy A.Thibodaux,Tracy Wallace,Julia Taylor, and Michelle Kelley of the City of Atlanta State of Georgia ,their true and lawful Attorneys)-in-Fact, each in their separate capacity if more than one is named above;.to sign,execute,seal and acknowledge any and all bonds,recognizances,conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of. contracts and executing or guaranteeing bonds.and undertakings required or permitted in any,ndons or-proceedings allowed by law. y 13th IN WITNIRS WHXREOF,the Comp havecaused this instrument?to be signed and their corporate seals to be hereto affixed,this 1 ovem er �U day of Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insura�nce-Gompany;: Travelers Casualty and Surety Company Fidelity and Guaranty Insurance-Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company r,{(y,plpS U,��T` • J�F\0. � O\*N.I NSG9 \ JPY{'•Ng41, • 9JP,TY OR P0flAlf�m NANtfoAo SEA D1 , ] taitrtnN0.� a 4Q�q S,y O 1.9Jr1 G E i CCNN. n8 N 1896 , 0 . n� tiN �'! 1� - � �Mwnn1� 1S•Aa� lg........1-� ei � ,,a1 a +� '�/ANIo` - State of Connecticut By: City of Hartford ss: Robert L.Raney,renior Vice President .. 13th November 2012 On this the day of before me personally appeared Robert L.Raney,who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.tPaul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America;and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do,executed the foregoing. instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. 1 In Witness Whereof,I hereunto set my hand and official seal. 1 My Commission expires the 30th day of June,2016. �/Bu� % Mane C.Tetreault,Notary Public 58440-8-12 Printed in U.S.A. . WARNING:THIS POWER 0F ATTORNEY IS INVALID WITHOUT THE RED BORDER 'Town of Barnstable ern t: Regulatory Services Dat e:. 4 °F1HE l°� Thomas F.Geiler,Director Building Division Fee:' BARNSTABLE, Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Alsn �A www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: ��/- - 1 �4 , Phone: a 15 y ' Install at: 3 d 1'7 a, �4 Village: e -�u> Map/Parcel: b `z O I Z Date: S-A oI P Stove A. New/ sed B. Type: Radiant/ Circulating C. Manufacturer: t r rti.e n� C s a"�9 Lab. No. D. Model No.: I 0 c,• G �k Chimney A. New/Existing. (If existing,please note date of last cleaning) t' f Q B. Flue Size mob ' C. Are other appliances attached to Flue? D.• Pre-fab Type and Manufacturer J, E. Masonry: ine nlined Hearth •A. Materials: ; B. Sub Floor Construction: U B Installer Name: Address: Phone: 7-7 t-79-7 9 Location of Installation: a,ti S . Co u 1 H.I.0 Registration# Construction Supervisor# 197 OR check_Homeowner Installing, no lice se required APPLICANTS SIGNATURE APPROVED BY: no Zee Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection,photograph.ed, and approved by the Building Inspector Q:forms:stove Rev103107 May 13 08 11:59a E. Mark Bobola 508-428-0958 p.3 . House 360 Main wood Burning stoves 360 Main street COtUit, MA Elliot Mark Bobola Manufacturer: Vermont Castings , Type: Radiant Heat stove: Radiant with rear heat shield Smoke Pipe: Inside Chimney & connected into o en damper with un-faced fiberglass insulation forced in-around the pipe and a non-combustible seal, .Floor : Chimney hearth with brick and mortar frith , set back from the brick back wall Manufacturer : Bay Vista Type : Radiant Heat stove : Radiant with rear heat shield Smoke Pipe: class A oura System plus Air insulated Pipe System Floor : Asbestos Millboard with sheet steel Page 1 PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 06/03/08 TIME: 15:52 -----------------TOTALS---- --- ------ PERMIT $ PAID 25.00 AMT TENDERED: 25.00 -CHANGE: 25.00 APPLICATION NUMBER: 200802974 PAYMENT METH: CHECK PAYMENT REF: 3549 PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 06/03/08 TIME: 15:54 -----------------TOTALS------------------ PERMIT $ PAID 25.00 AMT TENDERED: 25.00 AMT APPLIED: 25.00 CHANGE: .00 APPLICATION NUMBER: 200802975 PAYMENT METH: CHECK PAYMENT REFS: 3549 k - Town of BarnstablePermit: Regulatory ServicesDate: `t F1ME T Thomas F.Geiler,Director °* Building Division ee. 0 ♦ Y BARNSTABL.E, � Tom Perry, Building Commissioner y MASS. g qj 039. 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT { Owner: It."� l Phone: y Z�' 'd 59 a. a n Install at: 3 d /7 e,,i r SA Village u, ZMap/Parcel: ;'� �� Ol Date: a =Y, t Stove A. New/ose B. Type: Radiant/ irculatiri U. C. Manufacturer: w Lab. No. wco D. Model No.: can rn Chimney A. New/ Existing. (If existing,please note date of last cleaning) B. Flue Size a C. Are other appliances attached to Flue? a D. Pre-fab Type and Manufacturer E. Masonry: Lined/Unlined Hearth A. Materials: lcs� 1l o&.f4l B. Sub Floor Construction: ' Installer > s' . Name: Address: Phone: •7 7> l F- -7 9 Location of Installation: 3 6o Yl�, H.I.0 Registration# Construction Supervisor#` < V 12`7 °.,:OR check_Homeowner Installing, no li ense required :APPLICANTS SIGNATURE ,APPROVED BY: 'Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector A Q:forms:stove ti Rev 103167