HomeMy WebLinkAbout0298 BISHOPS TERRACE aye �;s�o� �.
----
_�___ — -
Town of Barnstable *Perml #'
� Expires 6 ont am' aft
y rr Regulatory Services
�� Thomas F.Geiler,Director
P�C1S�P Building Divasi®n
s�k Tom Perry,_CBO, Building Commissioner
200 Main Street,Hyannis,MA 026fl1:
wavw.towribarnsfiable.ma:us,,
Office: 508-862-4038 Fax:508-790-6230
EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY
-Vaud x f o Red Press Imprint
Map/parcel Number 1.
Pro rtyAddress 8 s ^�5 � ►y' Gin►? ( OoZ601
Residential Vahie off Work y� Mint M=fee of$25 00 for work under$6000.00
Owner's Name&'Address h r
Contractor's Name 19-a5er Can ruc�,'n,�, L C C Telephone Number
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable) " 8
[7 Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
I am the Homeowner
I have Worker's Compensation Insurance
Insurance Company Name unior, ('i fe 4r1SU` -6 AC-e CD.
Workman's Comp.Policy# 1N C-6O!9
Copy of Insurance Compliance CertiiMcate must accompany each permit.
Permit Request(check box)
A-roof(stripping old shingles) All construction debris will be taken to (S�Qnd W I eh
❑Re-roof(not stripping. Going over existing layers of roof) .
M/Re-side
#of doors
❑ Replacement Windows/doora/sliders.U-Value (maximum,44)#of windows
*Where required; Issuance of this permit does not exempt compliance with other town department regulations,i.e,.Historic,Conservation,etc.
Property Owner must sign Propertycvtier]Letter of I'ermissioa.:
A copy of the Home Improvement ComtracfoxS.License&Construction.Supervisors License is
requir
SIGNATURE: a3 i'
QAWPMESTORIAMbuildiag permit formAMPRESS.doC
Revised 090809
x
;5
The Cemm&nwealth ofMassachresdJs
P'�birent oflndrestrial.4cdde
Opsee ofinventa&ns
600 was"gwn mtreet
Boston,MA 0.2111
'Workers'Compensation Insuce ran A �gov�d�r
f
Ii Inform Buildes/Contimctorar/Electnicisais/p
lumbers f
Name(Business/or P t L
°allnaividuat): base.Y
Address: ---�
Ci Istaw : i
ri1.�4b3 Phone#: sad- v28 9a '
Arc you sa emptoyw Cheek the apprnpibate boc
I. I am a employer with 15 4 ❑I am a general Viand I Type ofpro�(ram):
employe"(fall azsd/or parttmre)s have hired the�s 6. C1 New construction
2.0
.[]I ant a sole proprietor or partner. IWW on,the attached sheet, 7 ,
ship sad have no employees These a b-coftactors have ❑R�wdelnrg
working for me in aq capacity emplayeea and have workers' 8 Demolition
Dk wmi m,comp.iaauance camp t , 9. ❑BWIding addition
I 3.0 we are a corpor�on and its 10.0 Blec:{[w
3.❑1 am a homeowner doing Q waak afficas have erxercised thear is oron
_...
m3'g�[No woQicers'camp. Ii&of exemption p M(IL•+- `'11.E Phrrnbing repairs or additions
d j t c 15Z§1(41 sari we lsave ao` '.1g'❑Roof mpaim
employes �N®a!or aa', 13.j]Othm
'CRY eppltcaat that Chodw box#I�abo fU oat the SM*4 below f Tf mwwnem who submit this 8WIh*Idoingvwjand tbgit,war<c •co oie policy mio merlon
1CMftc6ors that eheokft boot nowwwwa widma shwto0wheto�e� e subs a mw affl&vg smh.
employees lPthe ��oY�y,�a9m�tpoovidetkdt watkaS' ,. �•statewh�oraoitboseeapEies>a�O
Y omnber:
. . I am avr saaploper�k pmy workers'co�e bt �ece o�
da{form�on. Belmr is tditepopty mrdfob stte
fas mm Company Name: 47'0>7Q
4.7.
Folacy#or Self-ins.Iic.#:_- fN L' t�Q4���
F.xpiaatianDat : O Z$ o2p/�
.Job Site Addmss• �q
i
City �
Attach a copy a$ffie woelaea 'soi� n ? n r a l °, p 2(7p
oIlcydec�tatfion �--�' I
Fagure to wage cov puge(slro�g the epicy xa er sled espirafi�.datej.requned trader Section 25A of MOL c 152 can lead to the imposition of r moral peaaltics ofa (
fine up to$1,500.00 andlos oatey imps we as CM pearames in the form of a STOP WORK ORDERens and a fire 1
of up to$?.SQ.t><!a day sga;mt ate violator, Be advised that a of this aoemem
Iuvw igatfims of the DIA#tot inmmm veai$eadm� may be fmwmW to the Office of {
1 do hemby ofper,fray dw*2 }
Worrxanottpmw!dedaboysts&Am andconied
7 2 7 /Z i
_... . OffidQd use'ondy. Do rust xnke in w6%to be co
Wleutdby c&y ormwn o#kid
City or rows: {
PerEnit/Lfeense# i
issuing Authority(drde one):
I•• afiHeah'h 2,Bagdfibg Department 3.-City)Iown Cleric 44 Fdec&kW Inspector S.Phrmb'raeg Inspector j
Contsd Person: P #: I
FMSCON-01 MOSU
0
�.i CERTIFICATE OF LIABILITY INSURANCE °"912`612011"Y'
PRODUCER (508)676.03M THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Viveiros Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER THIS CER71KCATE.DOES NOT AMEND EXTEND OR
375 Airport Road , ' ALTER THE COVERAGE AFFORDED BY THE,POLICIES BELOW.
Fall River,I1 02720
M
--'INSURES AFFORDING COVERAGE NAIC#
INSURED Fraser Construction LLC jNSURERA:.fttiori i Union Fire Insurance Company
P.O.Box 1846 .., .,
y... -INSURER B::_. _j ;
`........,
Cotuit,MA 02635- `INSLNiER C s'
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO'T i iNSURED,NAMED'.OVE FOR THE POLICY PERIOD INDICATED.NOTVWTHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR-OTHER.DOCIIMENT WITH:RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRISEDHEREIN I$.SllBJECT'TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCEP<BY,PAIq.CLAIMSTYPE GE INSURAhICE _.. '.
POLICY NUMBER;-..M-.. StA _ LIMITS
'GENERAL LIASKM 7• EACH OCCURRENCE $
COMMERCIAL GENERAL UA&UTY PREMISES(Ea c= rice $
j •fif P ' 4 n� '" N t Ly
CL/uMS MAcsE;;O 'MED EXP Om ow pe S
CsfLi ors PERSONAL,&ADVINJURY» 8
"+..RE
GEN'LAf30REGATELIMITyAPPLIESPER: PRODUCTS-COAAP)OPAGO s
POLICY 7M El,=
AUTOMOBILE LIMUTY CO SINGLE LIMIT
ANY AUTO
ALL OWNED AUTOS .» BODILY INJURY.
SCHEDULEOAUTOS (Perpe—) $
HIREDAUTOS - BODILY INJURY
NON-OW NED AUTOS $
PROPERTY DAMAGE $
ammmuAmLnY AUTO ONLY-EA ACCIDENT S
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY' AGG $-
EXCESS I UMBRELLA LWBIYTY EACH O_CC UPMNCE $
OCCUR CLAIMS MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ S
11YORE�RS COMPENSATION « X WC STATU OTH-
ER
AND EMPLOYE LIABILITY YIN
A ANY PROPRIEmRtPpRrNEIvDmcUTTVE C008930601. 9126=11 912612012 EL EACH ACCIDENT $
OFFICERIMEMBER EXCUJDED9 - $00,
��g,( Y In NK) E.L DISEASE:-EA EMPLOY" $
SPEGA P&S,10 d3 beloM, E.L.DISEASE-POLICY LIMIT S- , W0'
00(
OTHER
DESCIRIPIION OF OPERA7WN S I LOCATIONS I VEHICLES I D(CLUNONS ADDED BY ENDORSEMENT I SPECIAL PROV ONS
CERTIFICATE HOLDER CANCELLATION
j\ SHOULDANYOFTHEABOVE DESCRIBED POUCxES BE CANCEUM BEFORETHE EMRATION
_,,Fraser Construction,LLC DATE THEREOF, RASIIRER V41UAAI MVCR TO MAL W DAYS wlarrEN
r �OX;1�5 - •. p°; t ` NQTI `b THE a:GERitF1EA'f'E•FCOf�ER, TOlHE•LEFT,&J-T'6 '�i;;. URE ZD`DO rfl'SHALL
.�COtuft.,,' FA`OZ63S {�I O�RE_Igb3 ij�i l t OR-UA�LI1'Y CIP ANY gQ=UPON THE INSURER CTS AGENTS OR
. `'r' rREi!rlIE9ENTATIVES: t.;'s.
" ci;urtttotvzm RE9PRESTEN'TATD(E'
P rI-t {�1988-2000�ACORD CORPORATION. AII� Tex
ACORD 2b(2009/0'I) " � � ,•I - rights rved.
The ACORD rome and logo'are Inarics,oE•ACORD
V \r' h
F V I
Office of Consumer Affairs and Ifusiness Regulation
10 Park Plaza - Suite 5170
Boston, Massachlsetts 02116
Home Improvement Contrtor.Registration
___w_...,........."__ Registration: 1125313
r7 Type: DBA.
Expiration: 3/23/2013 Tro 209024
FRASER CONSTRUCTION CO.
DEAN FRASER
P.O. BOX 1845
COTUIT, MA 02635
;Updatg l d rgts„{.1ud retur v*!-d.Mark reason for change.
[J Adairess ndq s1 ,0 Employment E ost Card
DPS-CA1 CS 50M-04/04-�101216
�mnrm ea o � LlcenW r registfatldri� Ied fbr'individul use only
0ftice o onaumer -Ira ness egu a on
HOMffiww� E IMPROVEMENT CONTRACTOR before;lire ex�iratton date If found return to:
Registration: t 12536 Type:
Office of rs Consumer Affai add Business Regulation
Expiration: 3123013 DBA 10 ParkuPlaaa.�:SurteSl7�pw
Boslon,MA DZ116
TFR CONSTRUCTION do. /7
DEAN FRASER
104TWINN VIEW 4NE
E FALMOUTH,MA&36 Undersecretary ot"va t rt r ut si re
✓ fCY ✓ ,.h YI 'Yuh Ail
......
v
-
/
Massaefidsetts-*l)ep;wtment of Publie_Saftety
Board of-Building Regulations and Standards
G StPucf�tsrt Supervisor License
on
-License: Gs 97668
im—
. ' A 104 TV�/lllIfIE
EAST SAL' tt lfit i"w A&536
f t t fit.
Expiration. 6171=13
�h �' * *. :lv Eonunissiorior Tr#: 96692 -
i
F(A k
Fraser Const ti ruc on LL
CEOP.O. Box 1845, Cotuit, A. 02635 WEVE)M
Email: fraser_construction@verizon.net 712 ��Z
www.fraserroofing.com
Phone 1-508-428-2292 &FAX 1-508-428-0123
DATE: July 21, 2012 PHONE: $08-775-4866
NAME: Violet Bourque
MAIL ADDRESS: PO Box 766 West Barnstable MA 02668
JOB ADDRESS: 298 Bishop's Terr.Hyannis MA 02601
RE: Sidewall Estimate
Replace rear sidewall'shingles and."-,i side,cheek-
APProximately 650 a ft ..� _
PRICE- $3,500 00""r ' Initial
Replace steps rear of house andjiemove old;�-'Remove handicap ramp
and build new steps with rails --A11;woos to be pressure treated.
-�
Labor & Material-
,*
PRICE- $725 00, 'K i Initial
PAYMENTS ARE DUE IMMEDIATELY AFTER JOB COMPLETION.
Payment Schedule to be worked out prior to job.
Payments accepted are:
CASH- CHECK-MASTERCARD- VISA -AMERICAN EXPRESS
* Any payments not immediately paid upon job completion will be charged 0.005%
for everyday after the given 5 day grace period upon day of job completion.
' r 3
r .y
Y„�,. Fait rTJ
4
Any deviation or alteration from,above•specification will be executed upon
written orders and will become ar-extra charge fiver and above the estimate. All
agreements contingent upon strikes, accidents ...delays are beyond our
control. Owner should carry fire, tornado and other necessary insurance upon
the above work. We,if riot aecepfed within thirty..days`may withdraw this
proposal. ,, f ,.
FRASEWCONSTRUCTION, LLC: Carries Workman's Compensation and
Public.Liability Insurance on the above work, certificate available upon
request. -
DATE OF ACCEPTANCE: 49- aL.
4.
Homeowner Fraser Cons r tion, LLC
4 '
- r.mnr
.v
- f
r
oFIKE r, Town of Barnstable *Permit# ��ti
�^ Expires 6 months from issue date
BARNSTABLE, = Regulatory Services Fee
y MASS•
qj 1639. Thomas F.Geiler,Director
MA'tA Building Division
Tom Perry, Building Commissioner X-PRESS pERMI�'�200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 JUL 0 5 2006
Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL OF BARNSTABLE
Not Valid without Red X-Press Imprint �1
Map/parcel Number o�s
Property Address 2 I O
Residential Value of Work (� Minimum fee of$25.00 for work under$6000.00
Dwner's Name&Address
2,912) I o G3 Ci P`.> -T—Q-2—
contractor's Name e� ��Z J NOM S)`-(p Telephone Number.E:Qb 42.0 —IS?
Some Improvement Contractor License#(if applicable) 100-140
:onstruction Supervisor's License#(if applicable) n 51 b `6 Z
]Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
I have Worker's Compensation Insurance
asurance Company Name
Vorkman's Comp. Policy#
,opy of Insurance Compliance Certificate must be on file.
ermit Request(check box)
❑ Re-roof(stripping old shingles) All construction debris will be taken to
❑Re-roof(riot stripping. Going over existing layers of roof)
❑ Re-side
Replacement Windows. U-Value .�Z (maximum•44) '2)o' kh-e-c4 .D
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
Home Improvement Contractors License is required.
gnature
Fonns:expmtrg
-vise063004
L
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Page 7 of 7
CAPIZZI HOME IMPROVEMENT INC.
SPECIFICATIONS AND ESTIMATES
STATE OF MASSACHUSETTS
LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT
OWN THE PROPERTY LOCATED AT
INA$Q MASSACHUSETTS.
I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR
A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING
CODE.
I GIVE MY PERMISSION TO LESSEE
TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS
STATE BUILDING CODE.
SIGNATURE OF OWNER(S):
OWNER'S ADDRESS:
OWNER'S TELEPHONE:
LESSEE'S SIGNATURE:
LESSEE'S ADDRESS:
LESSEE'S TELEPHONE:
APLLICANT'S SIGNATURE:
APPLICANT'S ADDRESS: 1645 kown Rd., Cotuit, MA 02635
APPLICANT'S TELEPHONE: 508-428-9518
RESPONSIBLE OFFICER:
RESPONSIBLE OFFICER ADDRESS:
RESPONSIBLE OFFICER TELEPHONE:
r
e
I
P IZ
Home
Improvement
Inc.
I, Thomas Capizzi Jr., owner of Capizzi Home Improvement, hereby authorize Lisa
Haworth, to sign on my behalf for permit applications filed through the town.
Signed:
� -
Thomas apizzi,fr. Date:
Haworth Date:
1645 Newtown Road Cotuit, MA 02635 (508) 428-9518 (800) 262-5060 FAX (508) 428-1547
fLate: 6/13/2006 'time: 8:40 AM TO: W 9,1,5084281547 R&G Ins. A90y. Page: UU1
Client#:47298 CAPIHOM
ACORD,. CERTIFICATE OF LIABILITY INSURANCE 06113106 DfYYYY)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
"Rogers&Gray Ins.Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
434 Route 134 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.0. Box 1601
South Dennis,MA 02660-1601 INSURERS AFFORDING COVERAGE NAIC#
INSURED Capizzi Home Improvement,Inc. INSURER A: National Grange Mutual Ins.Co.`
INSURERB: GUARD Insurance Group
Capizzi Enterprises,Inc.
' INSURER G:
1645 Newtown Road .INSURER D: - -
Cotuit,MA 02635
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT SO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL_THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY EFFECTIVE POLICY EXPIRATION .
LTR INSRE TYPE OF INSURANCE POLICY NUMBER DATE MMIDD DATE MMIDO LIMITS
A GENERAL LIABILITY MP010707 06/08/66 06/08/07 EACH OCCURRENCE $1 OOO OOO
X COMMERCIAL GENERAL LIABILITY - DAMAGE TO RENTED PREMISES(Ea occurrence) $5OO OOO
CLAIMS MADE a OCCUR MED EXP(Any one person) $1 O 000
PERSONAL&ADV INJURY $1 000 000
GENERAL AGGREGATE s2,000,000
GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2 OOO 000
I POLICY JPERCOT- LOC
A AUTOMOBILE LIABILITY M1010707 06/08/06 06108107 COMBINED SINGLE LIMIT $5OO 000
ANY AUTO (Ea accident) ,
ALL OWNED AUTOS
BODILY INJURY $
X SCHEDULEDAUTOS (Per person)
X HIREOAUTOS
BODILY INJURY $
X NON-OWNED AUTOS (Per accident)
X Drive Other Car
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $EAUTO ONLY: 1 .
AGG $
A EXCESSIUMBRELLALIABWTY CU010707 06/08/06 06/08/07 EACH OCCURRENCE s5,000,000
X I OCCUR CLAIMS MADE AGGREGATE $5 000 000
DEDUCTIBLE $
X RETENTION $10000 - $
LIMITS
B WORKERS COMPENSATION AND CAWC702365 12/25/05 12/25/06 x WC IS
TATU- OTH-
RY
EMPLOYERS'LIABILITY
ANY PROPRIETORIPARTNER/EXECUTIVE- E.L.EACH ACCIDENT $500,000
OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000
If yes,describe under -
SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT T$500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS -
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL I n DAYS WRITTEN
NOTICE TOTHE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR -
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25(2001108)1 of 2 #M22681 MEE 0 ACORD CORPORATION 1988
'``- :•; ,� -JS
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1 i
:'�'���xr��c>rti' C'Uzz�7>e��.s��.ic�x� �x�s��r:a��z:c',��'iid���>i#. �3�lilt3ea��;/C;�r��z-;�rir�r-as1�i;�c:c.�.x-iciaxasJl'lx�z�•�1.►c�z-,; ..
173JC; {1:3�si��css/U�•�a7iixaii.ol��3jc�ivSdua)): • • �2pltiZl H0.1T1E ImprOb'2i?1e31'� 1�1G I
3 6`RNB\,krtn do Rrnd
id es_ CoMit, MA 02635
Tel.A2&951r
1113 OD C A.
Uxz ato coaployer7 Chad,,jbc•ap}aroP��aJ.e i3or:
Type of project(required):
am a ems ploya imb 9- El l am a,general coniraclarand 1 .
err�p3oyeeS M71 and lorpaii-7 me).* a��c hb-ed be sa.U-cont3-acO S 6.' 0 Ne;w nonsstmc6on
I aaaa'a solej�ioprieio -Otpartner- lisied on sae atiadbe-d sleet 1., EJ
Remodelia,g
shy'and lra tre ho•emplo3'ees Tbdse SDb-coniradors lna?,. S. Derxioliiiozl
W0' g zor nae io any capacity. Workers' coMp.irsunke.
7q vorkeat'cow_ r��+an �_ 9. Q Bnjldieg addidoj'
n We are a corpoa-ation aad it
I ewired j officers have ex_ercisa hear 10-D llle;cirical repaiis or addition:,-
nTn a lat3meo�x�laer doing all wor,, ai t o eae pion per A�C�L I-E Ph,--bing repairs cox ad
dii?ons
I:Pysclf [l` o uor ers'comp__' c. � ,§1{9),and we have.no l�_� l�ofrepaszs
insa�x-an ?eg ed el3�plo3rees_ [No x�Torke�s'
comp_insnzancereiirliced
rn_+icsn=YbaYc3�eck s box f.1 anLu1 also RG oat�e section belop,,-bo g jae rozlti zs'ro ensaiioxi 3�o3scy om #iou'
eaOLS s ?so �i a£uds c7t mdac ng Y+ey�re rloiog' r ox3immd Tnen hire paEdceonitazlozs missL submit s vm afdavii i6ck s iug saeb. 1
io sY chec3;ibis vo0x mus7 ailsclied as addi�ionsl slay isbo ding II�ez��e o�flze sub-mid-ctors and cozy.policy-hafbrmBxion.•' .
?Z EJ'TIPLD-}>F?-VIZExiSp71TPZ�go-3i�07"�z.,Bl"S�Ct�3T1�3C7'Isl(7`J.OrT.Z3'zSXtt;4�'XCL'�Ol-!A]>G'X7J�7�p�2P�',S S�PL�07i'�S�`YE�301TJ+C��Yl'3�•�`O�7 sl'.3E .
nmpa.ye: i�ard 1
GAM C WC-7 0a
Expiration Dale:
.. -.y --�-•-,= ..��:�:� �. Ozt�rlStaielZip:
a a c-ppy o e' oxkexs'.cox pe�asatio>�a policy dec�ar a�io>a e slau !.
p� �( e policy nw3x1)er watt expix�oxx dai.e)_
to secure+co1 e as required l der Sermon 25 A.of MGL c- 152 can lead ID il3.e imposition.of crimja ,-p aloes.01 a :.o -50-00 d y a.,,o r one reaz impzzsonme��,as reli as cii pe�tiesiu ire forrn-of a STOP TVOIK.ORDER and a fme
3 $2�U_t 0 a clay b�ainsl ihe violator- Bead sed a� a cop),of.illis sbte3amt may lie i`orwardt-a to tile Office of
,,ations of fat DIA for i�st�ce co�rerage�Terz� �.
rcli3� �x ��xrrxi'et e irzs,+r�z d,p�rul es n� e , 3' izr tlx e 4"fol radenpz.gvwe X a iiave is rr ag mu4 care �. •..,
rre: •
J Q� Date:
=
[Z13 asE +(1X7��? Do,wt Tw &in, +w Gq to�C bJ>ch�'pl^tOHrX=offiCttXL -
or To-vsu-
iog Atxdioxity (circle O)ae): �'erroaitl�acett�e#
paid of Realti, z,l3nildxng 3Repat f�oa�tzi 3_ Yl of� Ckexk 4_lglectrzc:A b3,spedox- 5_Nximbin.g b3spector
-----------------------
�tlaer
tackPexsoxa_ �—_ -_______. _.-_..-__. -...- ..-- __......____ _ _ -•- - . . ...__ ..
Board of Building Regulations. and Standards
One Ashburton Place - Room 1301 ,
Boston, Massachusetts 02108
Home Improvement,Contractor Registration
Registration: 100740
Type: Private Corporation
Expiration: 6/23/2 008
CAPIZZI HOME IMPROVEMENT,.INC ',
Thomas Capizzi, jr.
1645 Newton Rd. — - —
Cotuit, MA 02635
Update Address and return card.Mark reason for change.
oPS-CA1 0 5OM-04/05-PC8698 � Address E] Renewal 0 Employment ,� Lost Card
✓XI VOJY7//77.p021lJC2GLIL o�✓/�/,C�iJd utOe�d
> = Board of Building Regulations and Standards License or registration valid for individul use only
a i HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to
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Registration: 100740 Board of Building Regulations and Standards
Expiratjon `•6/23/2008 One Ashburton Place Rm 1301
Type Private Corporation Boston,Ma.02108
CAPIZZI HOME IMPROVEMENT, INC. ..
Thomas Capizzi jr,,
1645 Newton Rd � � --�`
Cotuit, MA 02635 Deputy Administrator Not valid without signatm e�V
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License: �CONSTRUCTiON S - 1
Number,:yCS• 057032 d
Birthr3ste=i39/251-7$63
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7645 NEWTOWN R13.,
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