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HomeMy WebLinkAbout0027 PINE GROVE AVENUE . Town of BarnstableBuilding ... ....... ... C Hnxssresi t ;Post ThisCatil So That it is Visible From the Street-Approved P-Ians Must be Retained on Job antl this Card Must'!be Kept Posted Until Final Inspection Has Been Made ; 9 1� Permit - ,Where aCertificate of Occupancy is Required;such Building shall Not be Occupied until a Final Inspection has been made Permit No. B-20-121 Applicant Name: pedro mezzon Approvals Date Issued: 01/17/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 07/17/2020 Foundation: Location: 27 PINE GROVE AVENUE,HYANNIS Map/Lot: 290-032 Zoning District: RB Sheathing: Owner on Record: MEZZON, PEDRO Contractor Name:. Framing: 1 Address: 27 PINE GROVE AVENUE -Contractor License;' 2 HYANNIS, MA 02601 Est Project Cost: $5,000.00 Chimney: Description: Replace house siding(new siding) &Windows Permit Fee: $35.00 Insulation: Fee Paid: $35.00 Project Review Req: No documents attached front desk 'Da te: 1/17/2020 Final: Gt7J�V� Plumbing/Gas,, v 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. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public:inspection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by,the Buildine.and Fire Officials are provided on this:permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Town of Barnstable - ,)o — I a wilding Department Services Brian Florence,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 MM� www.ummbarustable maus Office: 508-862-403 8 Fax 508-790-6230 HOMEOWNER LICENSE EXEMPTION _ Ple=Print DATE: JOB LOCATION: 2�- I N (� &\j number suet ��v01 -� "HOMEOWNER": Q fQ 7 A- -ZZQ mime hams phant# Wok ph= CURRENT MA11MG ADDRESS: 2 I ti C G (Lo JE Ut A C)1(d L c4�. atate The current exemption for"homeowners"was extended to include gwgg--died dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,prpvided that the owner acts as supe�n g's r. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall slot 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 pert rued under the hdft RlM% (Section 109.1.1) f, 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 hatshe understands the Town of Barnstable Building Department minimum inspection pro eats and that helshe will comply with said procedures and requirements. f . I Approval of Building Official f. Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Buuilding,Code Section 127.0 Construction Control /t gOMEOWNER'S ERElVIP1ION 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.L1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. , To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that helshe understands the responsibilities of a Supervisor. On the last page this issue is a form currently used by several towns. You may care to amend and adopt.such a form/certification for use M' your community. Q:\wPFII.EmRMSIbuilft permit fmns\EXPRFSS.doc 08/16/17 � > Town of Barnstable Building Department Services Brian Florence,CBO Bulfding Commissioner 200 Main Street,Hyannis;MA 02601 www.town.barnstable mz us Office: 50&862-403 8 Fax: 508-790-623.0 �pleoperty Owner MustCoa and Sign This Sec�xion - If s' A Builder f a I ,as Owner of the subject property hereby authorize to act on ray bebA in all matters relative to work authorized bg`/this buildiapermit application for. (Address of Job) **Pool fences and ak are the responsibility of the a licant. Pools are not to be filled utilized before fence is installed d all final inspections are p ormed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORMS.OWMUERMISSIONPOOLS Rev-09/16117 AQN The Commonwealth of Massachusetts Department of IndtLnWd Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Bugders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: T' - P f E ( -N c k U f g City/State/Zip: l IJ S Phone#: Are you an employer?tfieck the appropriate boa: Type of project(required): 1.❑ I am a employer with- 4. I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have S. ❑Demolition working for me in any aP c aci tY• employees and have workers' _ 9. ❑Building addition [No workers' comp.insurance comp.insurance• 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 11. Plumb' airs or additions 3. I am a homeowner doing all work ❑ repairs myself(No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance i 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 eontractms must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: >` Job Site Address: P t c C o U� E City/State/Zip: �/ _ � C l p Q I 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 er pains and penalties ofperjury that the information provided above is true and correct Date: `� �ZU Phone#: [6. jjkkd use only. Do not write in this area,to be completed by city or town ooMaL ity or Town: Permit/License# Is Authority(circle one): Board of Health 2.Building Department 3.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector Other ontact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to constrict 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(LLQ 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 nummber listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Ofticials 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 burn 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 Offce of Investigations 600 Washuigton Street Boston,MA 02111 - Tel.#617-727-4900 ext 406 or 1-877-MASSAFB Revised 4-24-07 Fax#617-727-7749 www;maw.gov/dia —z7 --�� OFIKE r Town.of Barnstable# Expires 6 mo s f m issue e Regulatory Services Fee • snxtasTnsc.E. 16j � Richard V.Scali,Director Building Division . Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Map/parcel Number �e) 6��Not Valid without Red X--Press Imprint Property Address &Residential Value of Work$ '500 o. Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ��� R &W�t,/ LL )6 Rio _ Contractor's Name / Telephone Number s& 7 �d Home Improvement Contractor License#(if applicable) 1 7791 / Email: Cl k-CKke4 t /'l'1 a . • GG � Construction Supervisor's License#(if applicable) CS — V 3 9 A-Fftbb - T Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ii 'y (, Q 2 ;4 ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name _).e4 C,1j ler1 C/� 14 S • TftOF BARNSTABLE Workman's Comp.Policy# 6-LZ u g )V 36 V 3(© Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) r Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to Lk) rZy' ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ 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 ire . SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc ' Revised 061313 1 Hie Consmunwea li of Vassachuselts Deb hnen a ffidust ial Accidents - Office of fin shkations 600 Washington Street Bostor4 MA 02LU wmv.inass.garfdur Yorkers' Compensation Insarance Affidavit:Seders/ContractursMectricians{P1vmbers A:pPlicant Infarmation Ftease Print, b11Y Na={Busi ors Vorganimfiona,':',is-a[): A,ddre—ss- 16 ki ' _Are Iron an employer?_ erlcthe appropriate box: _- -_-.--- ---- --._ 1_�I am a employer with 4_ ❑ I am a f contractor and I 6_ ❑New cetas.truchoa employees(fall and/or part#ime)* havefired.thesub-contracfom. listed on the attached sheet y- ❑I�t�todeling 2_❑ I am a sole proprietor or partner- ship h h and have no employees snonutractorsave 8- ❑Demolition W ftlr�in an c ci r_ employees and have workers' or�ng y � � �_ ❑Building addition [Now'orkers' comp_ins uranre Comp_MSUMM 5_.❑ We are a corporation and its 10_[] 'Electrical repairs cr additions required-]] exercised their 3_❑ I am a hameou�ner doing all work officers have 1I_.Q Plumbing repairs or additions myself[No workers'comp_ right of exemption per MGL I1.0 Roof repairs. tn�t;required-]t e_154§1(4} and wehnt-,no employees-[No Workers' 13_0 other comp-insurance required.j " YLppbcant drat checks boat#1hoist also fill out the sectioabelDwshmdngtheir�*orkers'coa ensafioapuiicyi 1Iomeuwners who submit this affidsvff irxTir +.g they ace rising sII wad[and thtsr hug amside cantractas inns#stabatiL a weir al davit mrhr��sack Coainctoa that deck this Gas must sttadhed as additional sheet shotsiag the n=le of the sdb-�m3 siat a whether Ur not those emiDes Lwe .anployees- irthe sob-cont maurs have employees,they must pruvwe their work-en'camp.policy number_ I am arz employer iliat isprmidi g it orlse_rs'conWanarrtian ircuzmuc-e for nzy e-n em Below is fate paTicy anal job site irrf`orrrrafian_ Insurance CompanyName: s erl LUVi li or Self i Lim CjZ� �) Ot ® �j Expiration Date: C f� Soh Site Address: a:7 Cit dstafie ziP=&41A 01 ki 1 Attach a cups'of the wGrkers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MILL c, 152 can lead to the imposition oferirninai penalties of a fine up to$I,5Ot}_00 andlor one-yearinTrisortment,as well as civil penalties in the form of a STOP WORK ORDER-and a fine ofup to$250_00 a.day against the violator_ Be advised that a copy of this statement may be forwarded to the Office of Im-'eut gations of t17e D incaxxnCe coverage verification- Ida here c to pains and aWes ofpertury Aatthe irrformatian pratddedt a ,e is. /and orrect S,i lure: , Bate: � Phone 9: —�O� J �) Ojfcial use ont. Da not unite in this area,to be comple-ted by di�v or town officinL City or Town: I'm-ndtMicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: 6 Information and. Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"_..every person in the service of another under any contract of hire, express or implied, oral or written_" An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,-or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." i MGL chapter 152, §25C(6)also states thzt"every state or Iocal 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 ally 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-contractors)name(s),address(es)and phone number(s)along with their ceitificatc-(s)of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employ e'�es 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 11ie 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. Sell 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 pemitllicense applications in any given year,need only submit one arffidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations iaz (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 Depar raent's address,telephone and fax number: \ The Gomm.onwmalth of Massachusetts Department ckf 7ndusfrial Acteid�nts , Office of kvestigatio-as 600 Wachiioaa Street Rastous MA 02111 Tel.A 617-727-4900 W 406 of 1-a MASSAFF Revised 4-24-07 Fax 4 617-7`7-7-749 VIWW-Masls-gavldia P� ti * anxxsresr.E, 9$ ' ,�� Town of Barnstable ArFn Mai a Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, Fl-�✓`u;f Q � �"� , as Owner of the subject property hereby authorize �� S �Q VV`�-�[� to act on my behalf, in all matters relative to work authorized by this building permit application for: d7 �� 61-vv( h�� , (Address of job) O er Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:\WHILESTORMS\building permit forms\E)PRESS.doc Revised 061313 Town of Barnstable Regulatory Services 1 N, t°ty,` Richard V.Scali,Director r Building Division * snarrST"L.E, Tom Perry,Building Commissioner Mass. r� 1 );9. 200 Main Street, Hyannis,MA 02601 PrED I'�i a 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. DEFINFFION 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) ti , The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. - r 1, t � jN 1 1. , + 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. l 1 HOMEOWNER'S EXEMPTION The Code states that: "Any horrteowner,perfor fining work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities, many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 Ac R a CERTIFICATE OF LIABILITY INSURANCE 04-09-2014 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),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). CONTACT PRODUCER NAME. HURRAY&MACDONALD INS PHONE Far. A1C No,Exl': 550 MACARTHUR BLVD E-MAIL BOURNE,MA 02532ADD INSURERS)AFFORDING COVERAGE NAiC 9 INSURERA:AMERICAN ZURICH INSURANCE COMPANY INSURED INSURER 0: BAYRIDGE REALTY LLC INSURERC: 16 KINGS WAY INSURER HYANNIS.MA 02601 INSURER.E: INSURER F COVERAGES CERTIFICATE NUMBER: 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. INSR ADDL SUB POLICY EFF POLICY EXP LIMRS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER IMMMDIYYYY) MMIDOIYYYY - GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED S PREMISES IEa occurrence CLAIMS-MADE I OCCUR, MED EXP(Any one person) J PERSONAL&ADV INJURY S GENERAL AGGREGATE S �I-E,N'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP,'OP AGG S POLICY PRO- JECT OMB INED SINGLE LIMIT AUTOMOBILE LIABILITY a a rid.nl i ANY AUTO BODILY INJURY(Per person) S B SCHEDULEDALL OWNED BODILY INJURY(Per ac�deM) AUTOS AUTOS HIkED AUTOSNON-0INtJEDOPE RdentRAGE S AUTOS S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTION S S WORKERSCOMPENSATION X We LIMITS ER R E AND EMPLOYERS'LIABILITY TORv LIMIT Y"!N ANY PRO PRIETORMARTNEZ'EXECUTIVE E L.EACH ACCIDENT $100,000 OFFICER4JEMBER EXCLUDED? IY NIA 6ZZUB 02-20-2014 02-20-2015 (Mardatory in NH) 2EO36436 E.L.DISEASE-EA EMPLOYEE $100.000 It yac.d^'CntQ under E.L.DISEASE•POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS belrrri - DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTI CE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD • � �?/�e �^"orrtrirc.ntnect�l�c! .'ll z.!:'a��.c;t.-!l.; Massachusetts - Department of Public Safety l Office of Consumer Affairs&Business Regulation Board of Building Regulations and Standards OME IMPROVEMENT CONTRACTOR """'"c t""n " egistration: �77g19 - _ Type: License: CS-093445 — 'Expiration: 2/3412016 LLC .a DENNIS KERKA)b BAYRIDG.E REALTY LLG + 16 Kings Road i - Hyannis MA 02661 I \ DENNIS KERKADO 16 KINGS WAY -' HYANNIS,MA 02601 Undersecretary Expiration Commissioner 02/26/2016 Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991m3)of License or registration valid for individul use only enclosed space. before the expiration date. If found return to: i Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. j I For DPS Licensing information visit: www.Mass.Gov/DPS j ! Not vali wt out signature Engelsen, Jennifer From: Callahan, JoAnna Sent: Tuesday, June 17, 2014 9:40 AM To: Engelsen, Jennifer Subject: 27 Pine Grove Ave 290 032 Please be advised the outstanding Tax Title taxes for 2005 through 2012 on Parcel 290 032 located at 27 Pine Grove Ave have been satisfied in full. This payment is in process of being posted to Munis. If you have any questions please contact me. Thanks JoAnna Callahan Assistant Treasurer Town of Barnstable PH 508 862 4656 Fax 508 862 4779 joanna.callahan@town.barnstable.ma.us 1