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Home My WebLink About0084 BASSETT LANE /�xs5e77- L ZLA-O- w i N v 1 I i I I t ACORD,. CERTIFICATE OF LIABILITY INSURANCE 9/14%98 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Edward A. Grazul Ins. Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE PO Box 337 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Marstons Mills, Ma 02648 INSURERS AFFORDING COVERAGE INSURED INSURER A: e Maryland CommercialIns. Group Gregory Straticoglu INSURERS: Arbeila Protection Ins. Company DBA Atlantic Contractors INSURERC: 21 Fir Lane INSURER D: Osterv'lle, Ma 02655 INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRDATE(MMIDDNY) DATE DATIONLTR LIMITS GENERAL LIABILITY EACH OCCURRENCE $ ,0 OO COMMERCIAL GENERAL LIABILITY '* FIRE DAMAGE(Any one fire) $Excluded CLAIMS MADE CALM OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $500,OOO GENERAL AGGREGATE $1,000,000 A GENT AGGREGATE LIMIT APPLIES PER: SCP 31819627 08/01/98 08/01/99 PRODUCTS-COMP/OP AGG $1,OOO,OOO POLICY JE LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ N/A ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $1OO OOO HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $300 000 B 06844400000 08/01/98 08/01/99 (ROPERTY DAMAGE Per accident) $100 000 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND STA TU- S LIMITS E OTRH- EMPLOYERS'LIABILITY TORMIT E.L.EACH ACCIDENT $ E.L.DISEASE-EA EMPLOYEE $ E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Bon-Repose Bedding & Gladstone Furniture DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN 106 Bassett Lane NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis, MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRES TATIVES. AUTH dREP ESENTAT E ACORD 25-S(7/97) ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMe'rs � The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s); authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25-S(7/97) Engineering Dept. (3rd floor) Map 3® cj Parcel Permit# House# Date Issued Fee,' do elie,it THE Tp;- 4, 1� BARNSTABLE. (F �r•�� t679. �� f ' 1�W *2ion Building Permit App o'e rlee't Address Village 1-4 Y,&-rV w 1 4�4�1 Owner r jQ0,Q 6!J Cl0`t o- g Address : !�_(7 Ti t4.,J-Le, by 4..,tz, Telephone i Permit Request - 1 ; First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size A Grandfathered ❑Yes ❑No f Dwelling Type: Single Family ❑ Two Family ❑' Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway' ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) . Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) I o x pL 6 Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use jo- � Proposed Use Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO y t ��f(>M� f4�• SIGNATURE DATE BUILDING PERMIT DENIED FOR HE FOLL WING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED - MAP/PARCEL NO. • .. .. _ � tea$. ADDRESS '� .VILLAGE OWNER ; DATE OF INSPECTION:' FOUNDATION w FRAME INSULATION FIREPLACE ELECTRICAL:, ROUGH FINAL, _ PLUMBING: ROUGH FINAL, GAS: ROUGH ' FINAL M , FINAL BUILDING _ DATE CLOSED OUT F t . ASSOCIATION PLAN NO. • . The Commonwealth of Massachusetts = t -:iF Department of Industrial Accidents , lad , <'___ Office oflosesaff0ons 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit i,�� c�� 'ems name: VA -�r" -Re))11) 12"0 (Z 0-- location: !� (7 y k W tT city �I � G,� phone# Sy 6 �{� I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working in any capacity %%// %//%//%%%%%/%/%///%%//%%///////////%/////%///%%//%/D%//%/%/%%%%%/%%%//%//%%///%%%%///%/%//%/%//%%////%////%%%%%�%%%%///%/%/%/%%%////%% ❑ I am an employer providing workers' compensation for my employees working on this job. comany name l )o YV GCe- address LO � city 1 `-� yYt/►ti� .}�LI Gl, phone#• so insurance co. +rcz U�. r-J. R01iCV# ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: ........ ... company name: address: rid, phone#: olicv# insurance ///////// company name: .... ......., address: city phone#: insurance co olicv# Failure to secure coverage as required under Section 25A of 11GL 152 can lead to the imposition of criminal penalties of a One up to s1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a One of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do here y. ertify under the pains d penalties of perjury that the information provided above is true1 and correct Signature Date I q l4 Cl Print name V l Phone# C..ntict do not write in this area to be completed by city or town official permitllicense ft ❑Building Department ❑Licensing Board ediate mpotue i!required ❑Selectmen's Office ❑Health Department phone#; ❑Other (m%sed 9/95 P1A) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their ", an employee is defined as every person in the service of another under anv contrac employees. As quoted from the"law of hire, express or implied, oral or written. y , or other al entity, or y two or more of An employer is defined as an individual; partnership;association, corporation of a deceased employer, or the receiver . the foregoing engaged in anoint enterprise, and including the legal representatives trustee of an individual, partnership, association or other legal entity, employing employees.i 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 o: building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renew of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who ha not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract'for the performance of public work until acceptable evidence of compliance with the insurance requirements of this,chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. tthn umbeg fisted below, w"or if You are required to obtain a workers' compensation policy,p ase call the Department a City or Towns omplete and printed legibly. The Department has provided a space at the bottom of the Please be sure that the affidavit is c affidavit for you to fill out in the event the number which wilffice of l Investigations used as a referee a number to contact u rplicThe affidavits may b Please ret��t" be sure to fill in the permit/license the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investlgadons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 Z � � � � h V � � � � � � DEMOLITION PERMIT NOTE: OKH District approval required prior to issuance of permit for propertylocated in the Historic District (north of the Mid Cape Highway) In Hyannis - Check to see if it's included in the Hyannis Historic Waterfront District, if so, it needs approval from the Historic District. Sign-Off from Historic Preservation(this is required no matter where house is located) Specify on permit where demolition debris is to be disposed of. Certification that the following utilities are shut off.- Gas Electric Water If on town sewer- sign off from Engineering that sewer has been capped If septic system -no certification required Worker's Comp form must be submitted if more than one person will be involved in the work. Fee - (Minimum) NOTE REGARDING DUMPSTERS: (527-CMR-34) TELL APPLICANT THAT A DUMPSTER OF 6 YARDS CAPACITY OR LARGER REQUIRES A PERMIT FROM THE APPROPRIATE FIRE DEPT. q-forms-PERMITS I Rev 6/2/98 AUG-31-1998 13:44 COL GAS MARKETING P.01 god 127 COLONS 117 8 A A C O M ' A M Y 3owh Yanww^MA 0260 30�,1S4-A85! ' Aaw 50"9d-2SM August 31, 1999 Harvey Gladstone c/o Bon Repose Hyannis,MA 02601 fax 508-775-1128 re: 84 Bassat Lane Hyannis,MA account number: 52-09-1046 To Whom It May Concern: This letter is to confirm that the natural gas service to the above referenced property has been cut and capped at the gate box merco. This work was completed by us on August 28, 1998. If you have any questions,I can be contacted at the number listed above, extension 7503. Sincerely, Bonnie Figueroa r� Dism'bution Department Original Signed 08/31/1998 TOTAL P.01 8-26-1998 3. 18PM FROM HYANNIS FIRE DEPT. S08 778 6448 P. 3 Comment Page for Incident No. ! A980825 Address 184 1BASSETTLANE Date of Report ' 8/25/98 Commanding Officer F Knowlton I WAS IN THE STATION ON STAND-BY WITH FF STORIE AND LT.KENNEY.WE RECEIVED A CALL,FROM THE 7-11 PAY PHONE ON NORTH STREET,FROM A PARTY REPORTING A GARAGE FIRE IN THE REAR OF THE 7.11 STORE.WE THEN RECEIVED NUMEROUS OTHER CALLS REPORTING THE SAME..I RESPONDED ON 82B WITH LT.KENNEY AND FF STORIE DRIVING.A FULL FIRST ALARM ASSIGNMENT WAS STRUCK.AS WE PULLED OUT ONTO HIGH SCHOOL ROAD EXTENSION, WE COULD SEE BLACK SMOKE IN THE AREA OF THE 7-11 STORE.WE STOPPED AT THE CORNER OF NORTH STREET AND BASSETT LANE AND LAID A 4 INCH SUPPLY LINE.828 ARRIVED ON SIDE 1 OF 84 BASSETT LANE AND I REPORTED A FULLY INVOLVED GARAGE IN THE REAR OF 84 BASSETT LANE.802 ARRIVED ON LOCATION AND ASSUMED COMMAND, LT.KENNEY STRETCHED A 2112 INCH HAND LINE TO SIDE 4 OF THE STRUCTURE AND BEGAN EXTINGUISHING THE BULK OF THE FIRE,I COMPLETED A 3W EXTERIOR SEARCH OF THE BUILDING AND DETERMINED THE FIRE TO BE CONTAINED TO THE GARAGE.THERE WERE NO PERSONS AROUND THE BUILDING.I STRETCHED ONE 1 3(4 INCH HAND LINE TO SIDE 2 OF THE GARAGE AND EXTINGUISHED THE FIRE ON SIDES 2 AND 3.LT.KENNEY CONTINUED TO APPLY LARGE VOLUMES OF WATER INTO THE GARAGE AND SUCCESSFULLY EXTINGUISHED 95%OF THE FIRE.THE 1 3/4 INCH HAND LINE WAS THEN REPOSITIONED TO SIDE 4 AND COMPLETED THE EXTINGUISHMENT.OTHER RESPONDING APPARATUS INCLUDED 829, 822,AND 827.AS THESE UNITS ARRIVED,THEY ASSISTED IN OVERHAUL OPERATIONS.COMPLETE EXTINGUISHMENT WAS OBTAINED AT 1924 HOURS.DUE THE STRUCTURAL DAMAGE TO THE BUILDING,SUPPORT MEMBERS WERE CUT WITH A SAW AND THE MAJORITY OF THE BUILDING COLLAPSED DOWN.COMPANIES MADE UP AND SECURED THE SCENE AND COMMAND WAS TERMINATED AT 1951 HOURS.ALL UNITS WERE IN QUARTERS AT 1952 HOURS, THIS BUILDING WAS INVOLVED IN A FIRE ON 08/22/97 AND THE REPORT IS IN THE FILES UNDER*000827. THIS FIRE IS SUSPICIOUS IN NATURE AND THE BARNSTABLE POLICE ARE INTERVIEWING A SUSPECT AS THIS REPORT IS BEING WRITTEN.BARNSTABLE POLICE SGT.THOMAS TWOMEY WAS ON SCENE AND IS HANDLING THE INVESTIGATION/INTERVIEWING OF THE SUSPECT. SGT.TWOMEY AND MYSELF DID INTERVIEW ONE WITNESS AT THE SCENE. THE WITNESS WAS KIMBERLY REESE- SHE LIVES AT 926 HIGH SCHOOL ROAD, PHONE # 778-2598. SHE STATED SHE WAS IN THE BURGER KING PARKING LOT AND SAW TWO"STREET PEOPLE"WALKING AWAY FROM THE SCENE AND DROP MATCHES ON THE GROUND.SGT.TWOMEY AND MYSELF COULD NOT FIND ANY MATCHES ON THE GROUND NEAR WHERE SHE HAD REPORTED THEM DROPPED,WE ALSO FOUND IT DIFFICULTTO BEUEVE SHE COULD SEE THROUGH THE TREES TO THE GARAGE FROM THE DRIVE-THRU AT BURGER KING.SGT_TWOMEY WILL CONTACT HER IF NEED BE FOR FUTURE REFERENCE. BARNSTABLE POLICE OFFICER SCOTT THOMPSON TOOK PHOTOGRAPHS OF THE FIRE BUILDING. NO OTHER INFORMATION WAS AVAILABLE AT THE TIME I WAS COMPLETING THIS REPORT. RICHARD A. KNOWLTON, 8/25/98 - 2114 HOURS. 8-2E-1998 3: 17PM FROM HYANNIS FIRE DEPT. 508 778 E448 P. 2 Massachusetts Fire Incident Report Hyannis Fire Department FDID Incident No. Exposure #, Date of Da of week Time Of Arrival Time In Incident y Call Time Service Ot922 A880825 0 of 0 8/25198 Tuesday �j 18;50 1 2� 19:51 ........._..._......-.....,..,..... 1 (f d r05§ ��•p Census tract,. 8 4 Bassett Lane Hyannis 4 0 Type of Situation Found _ Type of Action Taken Mutual Aid 11 Structure Fire_ 1 1 1 Extinguishment Fixed Property Use Ignition Factor "residential Parking Garage."j 8; „1,.,.. 21 Suspicious, No Civil Disturbance 2 1. Occupant Name _� Occupant Tele hon® k,. ....,, None Owner - _ � rAddrias Owner Tele hone HarveyGladstone I sOThistle Drive Centerville, 508-428-2708 ................... r Method Of Alarm Shift No Of Alarms # of Personnel Responded l L N.azar.d.o.us ,1 Telephone i...1. C 1 1 7 Materials Engines Tankers Aerial Other Vehicles Present 0.02 0o.0 0-61 O-0-11 No Fire Service Other Injuries Injuries 0 0 0 Fatalities I o 0 0 Injuries _0 0 0 Fatalities Q 0 0: Rescues .202 Mob�ls Pr_ cam, Ws $tofsn Insuras�oecrrrpany "mobile Property. Tyt i M Moblle Property Makd , ''Years Mo-d$l Color. License Number VIN. Complex Area Of Origin ...... Warehouse, Storage 7JCEE1 747 Garage, Carport, Vehicle 47 . A E9t!-nii;aite� Equipment involved In Ignition Form Of Heal Of Ignition SOS$.'` i Undetermined 00 (T 00 Undetermined 4 If Equipment Was Involved In Ignition Material Ignited Year Make Model.. Equipment Serial Number. i Structural J �-�___J Of Fire Origin Number Of Stories 8 ._ Method Pre onf Extinguishment nect t.� Level W/ex ® � G rade Level 0 _One1[ i Construction Type Detector Performance Sprinkler Performance I a Unprotected $ No Detectors F a 8 No Extent Of Damage Flame l 6 Confined To �6 l Smoke(9 No Damage Of This j=e� Material Generating Most Smoke Type Of Material Generating Most Smoke Structural Member,framing 1..Z.. a paper We 6 9 6.9 Avenue Of Smoke Travel Weather Conditions Commanding Officer 18 No Significant Avenue 0 8:... . Lt Knowlton ..,. ..-_.� l _ 8-2E-1998 3: 19PM FROM HYANNIS FIRE DEPT. 508 778 Gd48 P. d TOWN OF BARNSTABLE BUILDING PKWI'T PARCEL ID 309 235 GEORASE ID 22527 ADDRESS 84 BASSETT LAME PHONE HYANNIS ZIP - LOT BLOCK LOT SIZE DHA DEVELOPMENT DISTRICT HY PERMIT 32156 DRSCRIPTION DEMO DAMAGED GARAGE PERMIT TYPE BDMO TITLE DWOLITION PERMIT CONTRACTORS: PROPMM OWNER ARCHITECTS: �epartmetit of Health, Safety and Environmental Services TOTALD FEES: $25.00 BONCONSTRUCTION COSTS $•0® $_oo S� 649 ALL OTHER B= DIKOLITION I PRIVATE P Q ; MAW M� $ SIO B DATE ISSUED 07/15/1998 EXPIRATION DATE �_�