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HomeMy WebLinkAbout0094 PINE AVENUE ___ �.�.�.- s _ _3 Message Page 1 of 1 Anderson, Robin From: Swiniarski, Ellen Sent: Thursday, March 28, 2013 2:37 PM To: Anderson, Robin Subject: FW: Citizen's Resource Line Referral Robin, Mrs. Doherty just called back this afternoon regarding her inquiry below. She is wondering if you have any information for her? I provided her with your direct number so she can contact you'. Ellen ECCen N.Swiniarski T&wn of Barnsta6Ce Site Ptan/Regulatory Review Coordinator BuiCding Division Tel: 5o8-862-4679 Fax:5o8-79o-6230 -----Original Message----- From: Swiniarski, Ellen Sent: Monday, March 25, 2013 9:45 AM To: Anderson, Robin Subject: Citizen's Resource Line Referral Robin, Laura Doherty of 19 Harvard Street, called CRL to report that a large permanent freestanding sign "THRIFT STORE" was installed at St. Francis Xavier Church, 341 South Street, over the weekend. She was concerned because the church is located in a residential district. A quick check did not find evidence of a sign permit or historic review, although the use may be exempt. I informed Mrs. Doherty I was referring her inquiry to you regarding what is allowed. Her number is 508-778-6739. Ellen ECCen JW.Swiniarski Town of Barnsta6Ce Site Ptan/Regulatory Review Coordinator BuiCding Division TeC' 5o8-862-4679 Fax:5o8-Igo-623o n Q-S),d-h ST i 3/28/2013 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION... Map o Parcel �' � Application, �r7 7S Health Division ' Date issued Conservation Division :Application Fee Planning Dept, ;Permit Fee, VV: Date Definitive.Plan Approved by Planning Board Historic - OKH _ Preservation /Hyannis Project Street Address 'J l IV 1 AV Village ��h �t�/A Owner 70 ,� A 7 Tr�r� U oc Address f �043�ix 2213 � qm C Telephone / 0`S Permit Request JrJ \6Nr*_46Z,: wt.T� A i;o 41 VIN6 Square feet: 1 st floor: existing pvpose floor: existind2_0 propose otal new /2 3 7 Zoning District: ood Plain Groundwater Overlay *Project Valuati` Constructio p 01?b c Lot Size `7 thered: ❑Yes ❑ No If y ch supporting documentation. 4 Dwelling Type: Single F@Aily :. amily ❑ Multi-Family (# ur ) Age of Existing Structure �i Historic House: /ry\ rn Old g' g ay: ❑Yes ,0'No Type:Basement T e: ull I ❑Walkout ❑ Oth Basement Fini ed Are ft Base m nfinished Are (s .ft) `— Number of ths: Ful A gam_ new Half: existing new f Number of Be s: existing new Total Room C n including baths): existing new First Floor Room Count Heat Type and Fuel: .s'Gas ❑ Oil ❑ Electric ❑ Other Central Air: .P Yes ❑ No Fireplaces: Existing—]_New _� Existing wood/coal stove: ❑Yes Wr1go Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new_;size_ Attached garage: ❑existing gnew size d Shed: ❑ existing ❑ new size _ Other: Zoning,Board of Appeals Authorization ❑ Appeal # Recorded ❑ ' W Commercial ❑Yes J"No If yes, site plan review# �n Current Use _ f E2 Proposed Use �1— 1co � ,r co APPLICANT INFORMATION f fX (BUILDER OR HOMEOWNER) 1&0 7SY g�� Name �' SG,o` Z&--Oyrr Telephone Number 6l5 955/ 7 ©r Address 1 o 8 0,c 2 0 P-6 Cdl License# Home Improvement Contractor# Worker's Compensation # ALL CONSTRU7 DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO_ � SIGNATURE DATE -5/A5 FOR OFFICIAL USE ONLY r APPLICAT)iON# :t 4 DATE ISSUED MAP PARCEL NO. .i ADDRESS VILLAGE: OWNER r► j DATE OF INSPECTION: , FOUNDATION `; FRAME W s INSULATION 4 FIREPLACE ELECTRICAL: ROUGH FINAL r s PLUMBING: ROUGH - FINAL ` GAS: ROUGH FINAL IV If 5 FINAL BUILDING ti DATE CLOSED OU7T ASSOCIATION PION NO. A Cn -f- � j t Town of Barnstable Regulatory Services Thomas F. Geiler, Director, e� `ran My; Building Division Thomas Perry, CBO,Building Coranissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fes;,: 508-790-6230 PLAN REVIEW Owner::�-i 2-67 H 0 V i C Map/Parcel: Project Address9LV frqC- 14:VC # milder: ® ff ER The following items were noted on reviewing: DVS ft 4q s�Cc s �� flrSo9 c-� ��'► i-a�ST s crlf� cr aw ��?ar c'rr�Pl �7- .s "-E7- b I S �.fr!' C� "� � Dz��ctjes-C k>�4LL . N���S � r► G-IN�F�/M� A *8 D 0S( Z-E p � 3O iS`7� P6--A f o I I� sc)PP� REspr a ���o L J#ARElzoaf=rG� Reviewed by: ILJ Date: 0 f —b Q:Forms:Plrn'w • F � �+ I I �CO3f rowti ` 'own of Barnstable Regulatory Services ILIRNSTAULE, - Thomas F. Geiler,Director Sy MASS, � ' Building Division Tom Perry, Building Commissioner MO Main Sheet, Hyannis, MA 02601 NYMY.town.barnstabIC.ma.us Office: SOS-862-4038 lax: 508-790-6230' PLEASE FORWARD THE ATT'AC;U:ED PAGE(S) TO: TO: ATTN: - -7-; 'Z-66`f6 V /C FRO ML : �i40 L DATE: PAGE(s): � (TNCLUDTNG COVER SHEET). i PROPERr - -29.76 / / 9 26' � LOCUS 55 Sot �29.6 6 9.91 27.89 9.98 N .�^O // 1 .30 PARKING PROP. ,5A �o- / 29.81 AREA GARAGE/ ADDITION 1.17 // .. x 27.87 / x3o.9s f" 0.94 29.32 TOP OF STONE #94 PINE AVE. BOUND EL = 33.0 x 27.65 EXIST. DWELL " TOP FNDN. = 32.2' 16' P.PI E �$ x 27.94: 27.22 rt _ DECK LOT AREA .56 x 27.87 9,788t SF 7 pip/ .44 ?8 x 27.62 a 6.75 /�' \ x 28.61 2 LO S \ SOCK iJ -10 S 7.13 30. 8 30.9 2 1,96 9 GRN 1 .5 x 30.69 - 30.71 off 508-362-4541 fax 508 362-9880 OFMgSS,9 down cape en gin eerin g,- in c. DANIEL cyw o A. CIVIL ENGINEERS . oJALA No.40980 LAND SURVEYORS �gNQess% av C 939 Main Street — YARMOUTHPORT, MASS. rjl$I' ') DATE DANIEL A. OJALA, P. os7 i 10—2-, -1 cf r of Im Town of Barnstable *Permit# Regulatory ServicesExp gee 6monthsjrissuedat r SAMSTABLF, MAC' $ Richard V.Scali, Director 16;9. ArEp�p Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY �,�j �yot Valid without Red X-Press Imprint Map/parcel Number ``��j, —V 9 Property Address lim,� [residential Value of Work$ 0 o 0- Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name C i- &gao n L-LC , Telephone Number Home Improvement Contractor License#(if applicable) 1?�u.� L Email: L' q&j *I-N,LtC,Aljj Construction Supervisor's License#(if applicable) PIV�0—r"n's Compensation Insurance Check one: ❑ I am a sole proprietor Iam the Homeowner have Worker's Compensation Insurance OCT 14 2014 Insurance Company Name A T1nNT,C C tt k 'gel MAIN N OF B A R N CU I_E Workman's Comp.Policy# V d 10,&j®Q 9 Copy of Insurance Compliance Certificate must accompany each permit. Permit Reques check box) LYRe-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to p Unnio q�r2� ❑t-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ER'Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is re red. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 G1 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 n Please Print Legibly Name(Business/Organization/Individual): ��f (, 6A)9An►^-� Address:_ �ifL)9NT ��y City/State/Zip: 04 ft)v iiS AJ9- 0.)601 Phone Are you an employer?Check the appropriate box:1.2 1 am employer a em to er with -� � 4. Type of project(requi I am a general contractor and I _red): - 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 g. ❑Demolition working for me in any capacity. employees and have workers' - 9. ❑Building addition [No workers'comp.insurance comp.insurance.: required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp: right of exemption per MGL 12.Dloof 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: �� C C A42rU2 i Policy#or Self-ins.Lic.#: to pp rj 9 r,-D1 Expiration Date: p _ Job Site Address: {7)h4 T City/State/Zip: /91vN+�,dY11� V.)16) 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 qndpenafties of perjury that the information provided above its true and correct. Si mature Date: D Phone Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit1License# -Y mm Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the.service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the dwelling house having not more than three apartments and who resides therein,or the occupant of the owner of a dw g g p P dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www.mass.govfdia i Town of Barnstable A Regulatory Services Richard Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 A Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I. - 6. /i/I,r.bad I; z,0JAZL ,as Owner of the subject property hereby authorize 6 44zy C. Ce,A A., to act on my behalf, in all mattets relative to work authorized by this building permit application for: �y D)fui 5r 9w3,-A%x(, MP (Address of Job) Signature of Owner Date �tt jj Print Name If Property Owner is applying for permit,please complete.the Homeowners License Exemption Form on the reverse side. Q:\WPFILES\FORMS\building permit forms\smokecarbondetectors.doc, Revised 050412 Town of Barnstable Regulatory Services - ptrt Richard V.Scali, Director Building Division RAx►vSTMM Tom Perry,Building Commissioner Mass. se3�. 200 Main Street, Hyannis,MA 02601 AEG MIS�' www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINrrION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building_permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply`with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed j persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require, as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. I From:d)nderwdlin Dee fax: 6171488-6601 To: 7758E refax. Fax: 1508T766685 1 E 1 8144:18 3/3/2014 THIS CERTIFICATE IS ISSUED AS A NATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS cERT)RCATE DOER NOT AFFIRMATIVELY OR MMTIVELY ANWND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.TIES CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(Sh AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT,. If Dw co0cate hWder A an ADDITIONAL INSURED,the policy must be erxkmsed. I SUBROGATION IS WAIVED,sU*d to the terms and condnons of the policy,certain policies moV require an endorsemef, A st9 m it on Uft c NWIMO does not confer ooft to the cue holder In Neu of such endomw PRODUCER CONTACT NAME Horgan Insurance Agency,Inc. ac°I act): (508)775-5830 NE Fa No. 1O Box 250 EMAIL xyamt;B,MA 02601 ADDRESS PROTNIE'.FR INSURERS AFFORDING COVERAGE NAIC hT INSURED INSURER a Atlantic Charter Inau rartce Company VDAC 44326 Graham,LLC INSURER RR INSURER C 66 Bra lit W INSURER o: HyaQnus, 0260 1 INSURER E: INSURER F.,COVERAGES: CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THATTFE POLICIES OF INSURANCE UST®BELOW HAVE BEEN ISSUED TO THE INSURSID NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDMON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECrTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED 13Y THE POLICIES DESCRIBED HEREIN IS SU ILJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. WEIR TYPE OF e8=141 DE ADOL SWR POLICY NUMBER POLCY EMCTM POLICY MMRA7M Lam LTR RieR WVD DATEPOADDIYn DATBOWDINM Qn Thn wtd) GENBIAL UASIM EACH OCCURRENCE S COWERCIALGENERALLAHILITY DOMAGE IO RENTM ISES S CLAIMS MADE ❑ OCCUR ❑ ��WH�PN E .PEFSONAL&ADVIKURY f GENERALAGGRECATE f GEN'LAGGREiQ4TELImITAPPUESPat PRDOIlCT3-COtd?KPAOCi S POLICY ❑PROJECT El PRODUCTS AUTON IALELIABLIn COMiEpNEDSINGLE UMT f ANY AUTO F-AocM" AILOAINEDAUTOS ❑❑ BODILY INURY f I�P�J SCHEDULEDAUTOS BMLYIN1URY f HIRED AUTaS P A-16" PROPERTY DWAGE f NON-0WNOEDAUTOS JUMMELLA, LIABILITY ❑ OCCUR EACH OCCURRENCEf EXCESS LAB❑ CLAIMS MADE AWREQATE S I)EmcnBLE f ❑Elf RETEN7ION S NORKERS A �uA AND WCV01059001 01/29/2014 01/292015 R OTHER STATUTORY ANYPROPPoETOWPARTNPZeECVTNE YIN OMITS InOFRCEftWMSM&zuDw? � NA Policy Coverve State:MA rACHAC0�tr f 100,000 Fyn.de a UrdwSPECAALPROMSIONSOelow DSEA%-PCUCYUMrr S 500,000 OSEASE-FAa412MPLOYEE S 100,000 oTHSh ❑❑ DE3WOMON OF OPERATIO NdAAW Orly UMM(Ame11ACORp INN,AONRIoml R8=0 Stll/lAn4 aemnepueIs re*&eq Re.Job-388 Main Street, Hyannis,MA offid N, d: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Town of Barnstable EXPIRATION DATE THEREOF,THE ISSUING COMPANY VWLL ENDEAVOR TO MAIL 2W 1%I Strftt 12 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT_ Hymmis,MA 02601 BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVE& tlthroR¢®RsENrATNE ACORp 45 0009131 . Page t of 1 CMTMCATE HOLI)EIt COPY 0198a-M ACORD CORPORATION.All daft reaervea AC®L! CERTIFICATE OF LIABILITY INSURANCE DATE(YIIIDDIYyYYI3A5/2014 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), AUTHORMED 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 WANED,subject to the terns 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 endorseme s. PRODUCER =NE. Maureen Roderick Horgan Insurance Agency PHONE (508)775-SO30 FAX (508)775-6686 44 Barnstable Rd. EMAIL-AMREss.msureenr@horganinsurance.cam P.O. Bog 250 INSU AFFORDING COVERAGE NAIC D Hyannis MA 02601 INSURERA Western World Insurance company IwsuLLED INSURER B.-Safe s.-Safetv Insurance Co. Graham LLC INSURER C: Gary Graham INSURER o 66 Brant Way INSURER E: H anni s MA 02 601 INSURER F: COVERAGES CERTIFICATE NUMBER:GL 13 - 14 w/Snit Removal 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. DIm ISK TYPE OF INSURANCE YBER PO LIMITS EFF POLICY E)IP GENERAL LJABIL rTY POLLY cuRRENCE $ 1,000,000 EACH Oc X COMMERCIAL GENERAL LIABILITY $ 100,000 A CLAIMS-MADE FZ OCCUR NPP8184557 2/12/2013 2/12/2014 MED EXP one $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPMPAGG $ 1,000,00 X POLICY JFCT PRO- LOC $ AUTOMOBILE LIABILITY MBINEDSIN LELMIT B ANYAUTO BODILY INJURY(per Pemm) s 100,000 'OWNED SCHEDULED /4/2014 /4/2015 300 000 AUTOS X AUTOS 221997 BODILY $ HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAG $ 200,000 $ UMBRELLA LLABHCLAMS­.ADE OCCUR EACH OCCURRENCE $ EXCESS LIAB AGGREGATE $ DED I I RETEmnoN WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABIL rrY Y I N ANY PROPRIETORIPARTNERIEXECUTNE L.EACH ACCIDENT $ . OFRCERIMEMBER EXCLUDED? N I A (Mandatgy In NH) EL DISEASE-EA EMPLOYEE $ if desaibe wrier DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,N more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main St- Hyannis, MA 02601 AUTHORIZEDPJ30MEWAYM ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights recerved. INS025(2o1oo5).01 The ACORD name and logo are registered marks of ACORD Massachusetts -Depa.rtment of Public Safety ...Board of Buildin g Regulations and Standards Construction Supervisor Licenser CS-042246 I BAHAlyt GARY C G 66 Brant Way Hyannis MA 02601 Expiration Commissioner 03/20/2016 i ` w �ie�a��ur�xayuaea�a��aQacrc�uQeG/d.E Office,of.Consumer Affairs&Business Regulation` ME IMPROVEMENT CONTRACTOR! VE, gistraton w174282- Typ,gatlon _11723/j2015" LCE xQRAHAMV,'ILC. a GARY GRAHAM! t694,FALMOUTH tD �113 ;CENTE�RVILLE, MAti02632 'Ugdersecretary I 1 s e � i POWER OF ATTORNEY Know all men by these presents that the Roman Catholic Bishop of Fall River,A Corporation Sole, duly incorporated under the laws of the Commonwealth of Massachusetts(Chap. 390, Sect. 4 Acts of 1904), for it and its successors, has made, constituted and appointed, and by virtue hereof does make, constitute and appoint Reverend Michael J. Fitzpatrick, of Saint Francis Xavier Parish,Hyannis,Massachusetts, in the County of Barnstable and said Commonwealth, its true sufficient and lawful attorney for it, and its name and to its use,to deposit and withdraw all funds in the name of"Saint Francis Xavier Parish"whether time deposits or checking accounts. The account or accounts are designated only as follows: ROMAN CATHOLIC BISHOP OF FALL RIVER, CORPORATION SOLE, SAINT FRANCIS XAVIER PARISH, HYANNIS, MASSACHUSETTS Any previous trusteeships for,or power of attorney of such account or accounts are hereby rescinded. The only authorized signature to be included on the above cited accounts is to be that of Reverend Michael J. Fitzpatrick. In witness whereof the said Roman Catholic Bishop of Fall River,A Corporation Sole,hereunto sets its hand and corporation seal by George W. Coleman,the present Roman Catholic Bishop of Fall River on this twenty-fifth day of June in the year of Our Lord Two Thousand Fourteen. ROMAN CATHOLIC BISHOP OF FALL RIVER A Corporation Sole By: �4d�v The Presen oman Catholic Bishop of Fall River COMMONWEALTH OF MASSACHUSETTS County of Bristol June 25,2014 Before me,the undersigned, a Notary Public within and for the County of Bristol and State of Massachusetts, personally appeared the above-named George W. Coleman,the present Roman Catholic Bishop of Fall River,who acknowledged the foregoing instrument to be the free act and deed of the Roman Catholic Bishop of Fall River,A Corporation Sole. Notary PIT is My Commission Expires: LORRAINE J.LECOUR NOTARY PUBLIC COMWMiVEALTH OF MABSACtg1SEM My Comm.Expk"Maz.14 2020 Mass. Corporations, external master page Page 1 of 2 ♦xa� X 'f William Francis Galvin Secretary of the Commonwealth of Massachusetts F w� b V 3 b Corporations Division Business Entity Summary ID Number: 000871586 Request certificate I New search Summary for: ROMAN CATHOLIC BISHOP OF FALL RIVER The exact name of the Religious (Chapter 180): ROMAN CATHOLIC BISHOP OF FALL RIVER Merged with BLESSED SACRAMENT CHURCH OF FALL RIVER on 07-01-2004 Merged with SAINT ANN'S ROMAN CATHOLIC CHURCH OF FALL RIVER on 12-01-2009 Entity type: Religious (Chapter 180) Identification Number: 000871586 Old ID Number: Date of Organization in Massachusetts: 06-01-1904 Last date certain: Current Fiscal Month/Day: 12/31 The location of the Principal Office in Massachusetts: Address: 450 HIGHLAND AVE. City or town, State, Zip code, FALL RIVER, MA 02720 USA Country: The name and address of the Resident Agent: Name: Address: City or town, State, Zip code, Country: The Officers and Directors of the Corporation: Title Individual Name Address Term expires PRESIDENT UNKNOWN UNKNOWN SAME SAME, MA 02720 USA NONE TREASURER UNKNOWN UNKNOWN SAME SAME, MA 02720 USA NONE CLERK UNKNOWN UNKNOWN SAME SAME, MA 02720 USA NONE DIRECTOR UNKNOWN UNKNOWN SAME SAME, MA 02720 USA NONE DIRECTOR GEORGE W. COLEMAN SAME SAME, MA 00000 USA 394 HIGHLAND AVE. FALL RIVER, MA 02720 USA http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=000871586... 10/14/2014 Mass. Corporations, external master page Page 2 of 2 ❑ ❑Confidential ❑Merger ❑ Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS Annual Report Application For Revival El Articles of Amendment Articles of Consolidation - Foreign and Domestic v [View filings Comments or notes associated with this business entity: n V New search http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=000871586... 10/14/2014 K r [ ] [R308 245 . v� ] LOC10094 PINE - CTY107 TDS] 400 HY KEY] 222226 ----MAILING ADDRESS------- PCA] 1011 PCS] 00 YR] 00 PARENT] 0 DALY, JOHN S MAP] AREA1 61AC JV] 416044 MTG] 0000 240 LONGVIEW DRIVE SP1] SP21 SP31 UT11 UT21 . 22 SQ FT] 1829 CENTERVILLE MA 02632 AYB11938 EYB11975 OBS] CONST] 0000 LAND 21300 IMP 56000 OTHER 900 ----LEGAL DESCRIPTION---- TRUE MKT 78200 REA CLASSIFIED ##LAND 1 21, 300 ASD LND 21300 ASD IMP 56000 ASD OTH 900 #BLDG(S) -CARD-1 1 56, 000 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #OTHER FEATURE 1 900 TAX EXEMPT #PL 100 PINE AVE RESIDENT'L 78200 78200 78200 #DL LOT UNNUM OPEN SPACE #RR 1257 0085 0392 0118 COMMERCIAL #SR CROSS STREET INDUSTRIAL EXEMPTIONS SALE] 00/00 PRICE] ORB] 3058/133 AFD] LAST ACTIVITY] 01/11/96 PCR] Y R308 245 . A P P R A I S A L D A T A KEY 222226 DALY, JOHN S LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RB 21, 300 900 56, 000 1 A-COST 78, 200 B-MKT 66, 300 BY 00/ BY ML 5/88 C-INCOME PCA=1011 PCS=00 SIZE= 1829 JUST-VAL 78, 200 LEV=400 CONST-C 0 ----COMPARISON TO CONTROL AREA 61AC -- TREND EXCEEDS STANDARD NEIGHBORHOOD 61AC HYANNIS PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 213001 LAND-MEAN +Oo 782001 74880 IMPROVED-MEAN -250 2501 ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 1000] LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP]ADJS/SB/FEAT STR] STRUCTURE ARR]AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] R308 245 . P E R M I T [PMT] ACTION [R] CARD [000] KEY 222226 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR oCMP NEW/DEMO COMMENT f ( -4 RESIDENTIAL .PROPERTY MAP NO. LOT NO. ',,,,/ FIRE DISTRICT STREET El.-HCJ .P�..ne � Hyannis SUMMARY 308 245 H -73 LAND J BLDGS. N I f a, OWNER TOTAL G .. - - LAND 7� O L ` RECORD OF TRANSFER DATE SK PG I.R.S. REMARKS:Unnumb. 7X BLDGS. Mumh ,,,i,enore:.-E� ,.� -..,--,,-rt.-,.— r-.,--,,-.��.-,.-nw-. ._ 6/12/35". _.512w, 406 ..- g � TOTAL LAND •229844886~4. Wallis 9- OI BLDGS. ° TOTAL LAND Buckler"- 8:.. ....: _2 _ : 1826 M = - 1 = 15,000 consideration BLDGS. TOTAL LAND Daly, John S. 2-15-80 3058 133 1 $29,010. BLDGS. TOTAL /e & �7T /V/t//.S .� D LAND BLDGS. O1 TOTAL LAND BLDGS. TOTAL LAND INTERIOR INSPECTED: 1 C 1 C) BLDGS. •- f ,1 ,' � TOTAL DATE: � � - ` .��. �.' }i, `� LAND A REAGE O ATIONS BLDGS. LAND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL HOUSE LOT y77t Z Al,C-J,q J '�SoZ O SU U LAND CLEARED FRONT BLDGS. REAR TOTAL WOODS&SPROUT FRONT LAND REAR BLDGS. WASTE FRONT TOTAL REAR LAND BLDGS. TOTAL LAND �+ BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT FT:PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND SWAMPY NO RD. BLDGS. Cont.Wells ✓ Fin.Bsmt.Area Bath Room �j Base i S J Q SLOG.COST orP Conc.Blk.•Wall$ Bsmt.Rec.Room P V St.Shower Bath Bsmt. PORCH. DATE Cone.Slab Bsmt.Garage St. Shower Ext. Walls �`�� ��• Brick Wells Attic Fl.&Stairs Toilet Room PORCH. PRICE. Roof RENT c� Stone Walls Fin.Attic Two Fixt. Bath Floors 17 Piers INTERIOR FINIS I Lavatory Extra 3 Bsmt"' 1' 2 3 Sink SA 1/21/4 Plaster Water Clo. Extra Attic ��SO EXTERIOR WALLS Knotty Pine Water Only Double Siding Plywood No Plumbing Bsmt.Fin. 2� �8a b ff Single Siding Plasterboard Int.Fin. 17 OOd,,Shingles ✓ TILING �a0 Cone.Blk. G_V LP Bath Fl. Heat Face Brk.On Int.Layout Bath Fl.&Wains. Auto Ht.Unit Veneer Int.Cond. 1 V Bath Fl.&Walls Fireplace Com.Brk.On HEATING Toilet Rm. Fl. ,p Plumbing Solid Com.Brk. Hot Air Toilet Rm.Fl.&Wains. ' Tiling Steam Toilet Rm.Fl,&Wa Blanket Ins. I Hot Water p St.Shower Roof ins. IV I Air Cond. Tub Area Total Floor Furn.. ROOFING COMPUTATIONS ' Asph.Shingle Pipeless Furn. 8 8 oZ S.F. Wood Shingle No Heat S. F. Asbs.Shingle Oil Burner N1/ /')U S. F. 17. 20 Slate Coal Stoker S.F. Tile Gas S. F. OUTBUILDINGS ROOF TYPE Electric Gable 1/ Flat S. F. 1 2 3 4 5 6 7 8191101 1 213 4 516 7 8 9 10 MEASUREI Hip Mansard FIREPLACES S.F. Pier Found. Floor a Gambrel Fireplace Stack Wall Found. 0.H.Door LISTED FLOI0Rq Fireplace Ilk Sgle.Sdg. Roll Roofing ,_ — Cone. LIGHTING Dble.Sdg. Shingle Root L (Aj Earth No Elect. Shingle Walls Plumbing DATE Pine Cement Blk. Electric Hardwood ROOMS P Asph.Tile RICED e Bsmt. 1st TOTAL �,��/(p 3 Brick Int.Finish r _ Single 2nd 3rd FACTOR - REPLACEMENT OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. DWLG.j 1#1V tqf Fit' S/ 1 a0/63 3 .� /5�/ / y/ad t 2 — 3 4 fs". ' 6 7 9 10 TOTAL :..:........:.:: 11".i.-IBUILDING SERVICES B ILD .x. ::.::.....................::...........:.........:.............:.............................. .... ::::::.:::::.::::::.::::.::::::.:::::.::::..::::::::::::::::::.::.:::.::::.:.::.: .:.::: ....:::..:....:.::.:::.... . .:PINE S .... . .................:.:. ]HYANN ::: .:.:... ........................... .......................... ....... ....... .. I ................................... 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