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Home My WebLink About0168 CEDAR STREET 01 N SMEA No. 53LOR UPC 12543 smead.com Made in USA z f FEm um im"PROma um fA SH OF THE SFI PROGRAM CERIWED SOURONG yWW-gpROGRANLORG - -- Town of Barnstable Building WA 1 Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept SARN MAS& !Posted Until Final Inspection Has Been Made. _ • !Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until,a Final Inspection has been made. I Permit Permit No. B-19-1779 Applicant Name: Scott Horrigan Approvals Date Issued: 05/31/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 11/30/2019 Foundation: Location: 168 CEDAR STREET,WEST BARNSTABLE Map/Lot: 130-007 Zoning District: RF Sheathing: Owner on Record: LEEMAN, ROBERT V JR TR Contractor Name: .Scott Horrigan Framing: 1 Address: 168 CEDAR STREET ' Contractor License: 184079 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $2,500.00 Chimney: i Description: siding j Permit Fee: $35.00 Insulation: Project Review Req: Fee Paid:,` $35.00 — — - Date: 5/31/2019 Final: scrn Plumbing/Gas I 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 Building 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) 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). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: f - Application number.........................0..... � Fee.............................. 3.............................v. e. MASSBuilding Inspectors Initials. .. .....:.a&"4 -f ABLE _ , r\i1�1\� � I�' �� Date Issued.'. ...... . ..!. ................................... Map/Parcel.............:..�.. Q.....a o �J................. TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SID1NG/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: ��✓, f . �6 NUMBER STREET VILLAGE Owner's Name: Igo 6 er/ I-e e/4 a,h Phone Number "77 y 313 625"/ Email Address: Cell Phone Number Project cost$ a5 dd �o Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize SCA-41 1A Offi 0an to make application for a building permit in accordance with 780 CMR Owner Signature: ,„&*1 #M. Date: W I9/ 19 TYPE OF WORK Siding 0 Windows(no header change)# 0 Insulation/Weatherization 0 Doors(no header change)# Commercial Doors require an inspector's review A 13 Roof(not applying more than 1 layer of shingles) //�� U Construction Debris will be going to Nrfl d45 P) YES �rtr S jy, CONTRACTOR'S INFORMATION Contractor's name SGO H-,D(P i§ o Home Improvement Contractors Registration(if applicable)# �Y 67 (attach copy) Construction Supervisor's License# &5 s 0,5'4,aG a (attach copy) Email of Contractor 56e 6or Q- a) 1 • Lv-) Phone number / D 1`o �s,1 ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY.IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER........................4.,,......%............... t..... . *For Tents Only* Date Tent(s) will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X. X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 20 lbs. or>Yes No___, if yes, a gas permit is required. Natural Gas Yes No ,if yes,a gas permit is required. If food is being served at.your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type 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 All permit applications are subject to a building official's approval prior to issuance. ,a 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 r L Please Print Legibly Name(Business/Organization/Individual): J<Oil f�/l• rs� Address: City/State/Zip: AicfS S ILI 6 4160 Phone#: '21 15`3 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2./E?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.❑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. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: q Policy#or Self-ins.Lic.#: L 5 s �"d(v'� Expiration Date: 1 �� Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u,der�the pains and penalties of perjury that the information provided above is true and correct. Signature: �� ""t % Date: Phone#: Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to 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 Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia TO Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR BIndividual _ SCOTT HORRI 06/05/2020 SCOTT HORRIGA 52 WILLIMANTIC�f-� - MARSTONS MILLS,M - 02648-1928 Undersecretary Commonwealth of Massachusetts ®i Division of Professional Licensure J Board of Building Regulations and Standards Const\;ttlrlH�iSp�rviso r CS-059262 �' EA ires: 11/09/2019 1 ti SCOTT J HOR UGAN' 52 WILLIMANI D'RIV > MARSTONS MILIj$MA�O 648 ?> ,.- c10%NN i Commissioner �-/ -- Registration valid for Individual use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation One Ashburton Place-Suite 1301 Boston,MA 02108 Not valid with ut signature fl r ��_ , . � � � � ' e+ . � I ' Town of Barnstable *Permit�D l 30 713 0 Expires 6 mo rom issue Regulatory Services BARNSTABLK v MAss. Richard V.Scali,Interim Director 639. A1� IiM'I Building Division OCT' - 8 2013 Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 TOWN OF BARIVSTABLE www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS,PERMIT APPLICATION - RESIDENTIAL ONLY Map/parcel Number 130 I Not Valid without Red X-Press Imprint d Property .�— Address � /Ark ��, kzez7 Residential Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name -: l :L"� ,�eleph�e Number Home Improvement Contractor License#(if applicable) Email: Z G`t��/� Z.C Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor . ❑ I am the Homeowner have Worker's Compensation Insurance Insurance Company Name -q ,,s1 4,e/e_ Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Requ (check box) [v Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to 4,31 ❑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 equired. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 al'1 0 I " . Ine Cominowntw*h of Massat h=etts Dgxwtnwnt ofln4usb ca Accidentr Ofice of Imestigations 600 Washington Street Boston,MA 02111 www.mass govldia Workers' Compensation Insurance Affidavit:Builders/ContractorsfFlectricianslPlumbers Applicant Information l/ Please Print Legibly Name e 41ea4,e cC% IY_x ` Address: -�.2_5 Ca�aa2 47_ CitylStatrJZip: kj-e_ 8 srA&,1,e " Phone ik J-09 3C�2-efol C Are you an employer?Check the appropriate box: T project am a contractor an �of (required): 1_El I am a employer with 4. ❑ I d I 6- ❑New construction employees(full andlorpart-time).* have hied the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling strip and have no employees These sub-contractors have 8. ❑Demolition w for me in an capacity employees and have workers' o�Cing Y � tY- c insurat�2 4_ ❑Building addition [No workers' comp.insurance 5. a are a corporation and its 10_❑Electrical repairs or additions required-] officers have exercised their 11_ Plumbing repairs or additions 3_❑ I am a homeowner doing all work ❑ g P myself [No workers'oomp. right,of exemption per MGL 12_& RDof repairs insurance required.]f c.152, §1(4) and we have no employees.[No workers' 13.0 Other comp-insurance required-} -Any 2"licant that checks box#I mostalso fill out the section belaw showing di&woxRers'coEVensafiouP0&T info T Homeowners who submit this afadavU indiccstisg they are doing all wat and then hue outside contractors IImsi submit anew affidavit indicating such- tCantracmrs that check this boa uoust attached an additional sheet shoving the name of the svtrca&XbM and state whether ornot thnse entities have employees. If the svlrcontracta m bave employees,they must provide their workers'comp.policy number. I am an employer that is pnnviding workers'compensation insurance for my employees. B*w is the policy anrd job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section.25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as cavil penalties in the form of a STOP WORK ORDER and a fine. of up to$250-0+0 a day against the violator- Be advised that a copy of this statement may be forwarded to the Office of Investigations of die DIA for insurance coverage verification- I do hereby cactilund"erhe do d pe "s of " ry that the information provided above is true and correct. Si tune: Date: Phone#: 0,0cial use only. Do not write in this area,to be completed by city or town official, City or Town: PermitUcense# Issuing Authority,(circle one): 1.Board of Health 2.Binding Department 3.Cigl own Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone it: 6 J- . Information and Instructions _ Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an wWloyee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or'any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees: However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)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 eater their self-insurance license number on the appropriate lime. 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 permitllicense 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 Depailment of Industrial Accidents Office of Tavestigatlans 6U0 Washington Street Boston,MA 02111 Tel. #617-727-4M ext 406 or 1-9 77-MASWE Fax#617-727-7749 Revised 4-24-07 WWW.maMgov/dia F T Town of Barnstable Regulatory Services yBAMSTABLK MMaAS& Thomas F.Geiler,Director 16g9. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038, Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, a� le L�/yl/9� , as Owner of the subject property hereby authorize I el F 6c>rcYe2 ame_-*/P,P to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final � inspections are performed and accepted. ignature of Owner S 2e of Applicant �a�3�,e-r L.e.ems► ev L-e iF Print Name Print Name Date Q:FORM&OWNERPERMSSIONPOOIS 62012 Town of Barnstable Regulatory Services f 1 rrrsrwsM Thomas F.Geiler,Director Building Division QED NAA't� Tom Perry,Building Commissioner ; 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-'790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: village number strut "HOMEOWNER": work hone# name home phone# P 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. 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 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. HOMEOWNERS 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 persons)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. C:\Users\decolldcWppData\L.ocal\Microsoft\Windows\Temporary Internet Files\Content0utlook\QRE6ZUBN\EXPRFSS.doc Revised 053012 NNW Office of Consumer Affairs and Business Regulation 10 Park Plaza -.Suite 5170 --- Boston Mass3c tts 02116 ` = huse Home Improvement.� cntractor Registration Registration: 111950 Type: Corporation 1�{ �o: Expiration: 1/8/2015 Tr# 238418 LEIF BOTTCHER HOME IMP. CONTRACT �I... _ LEIF BOTTCHER P.O. BOX 508 W. BARNSTABLE, MA 02668 Update Address and return card.Mark reason for change. C Q Address Renewal .,Employment o LogeCard.. I o e �pow�n�roaecuea`(.�o/,C/ a.ddac/zeedel Office of Consumer Affairs&Busi6ess Regulation License or registration valid for individul use only. t �� OME IMPROVEMENT CONTRACTOR be;"the expiration date. If found Peturn to: — ;egistration: -111950 Type: Ofuce of Consumer Affairs and Business Regulation xpiration::__1/8/2015-, Corporation 10.Park Plaza-Suite 5170 Be,-.ton,MA 02116 LEIF BOTTCHER HOME'-IMP CONTRACTOR INC. ' LEIF BOTTCHER ei I, 825 CEDAR ST 4� � Q o At6w2ithout W. BARNSTAkE,MA 02668`• Undersecretary signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards • Construction Supervisor License: CS-076085 LEIF E BOTTC14-k 825 CEDAR STREET _ West Barnstable RA 0 � . "'"' Expiration Commissioner 08/30/2015