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0033 CIRCUIT AVENUE
ISO Town of BarnstableBuRding 1` Post This Card,So That it•isVisibl:e.From the Street, roved Plans Must be Retained on Job and this Card Must be Kept tl,;.i�iaii• au��.f Ij Posted Until Final Inspection Has Been Made. Permill \\. ._"A Where a Certificate of Occupancy is-Required, such Building shall Not be Occupied until,a Final Inspection has been made. Permit No. B-17-4110 Applicant Name: Abraham Lemotte ' Approvals Date Issued: 12/11/2017 Current Use: Structure Permit.Type:' Building Solar Panel-Residential Expiration Date: 06/11/2018 Foundation: Location: -33 CIRCUIT AVENUE, HYANNIS Map/Lot: 324-10.7 Zoning District: RB Sheathing: Owner on Record: SNIDER;:NEIL'.G & DIANA Contractor Name: ABRAHAM LEMOTTE Framing: 1 Address: 33 CIRCUIT AVENUE Contractor License: CS-109986 2 HYANNIS, MA 02601 Est. Project Cost: . $ 22,760.00 Chimney: Description: . To install a 5.89 kWh DC solar roof mounted photovoltaic system, Permit Fee: $ 166.08 using 18 solar PV panels, as 327 kWh DC each,with integrated Insulation: micro-inverters. Fee Paid: $ 166.08 ) / Date: 12/11/2017 Final: Project Review Req: Ff- Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless thew.or.k authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas 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 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. Service: Minimum of Five Call Inspections Required for All Construction Work:. Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 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 Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health 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. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable- � fill , a „ , .,.: /� - laWain dx#his rd ro y r A r ved PlansdM�st be„Retairtitl _..., ., a Must,tie*Kept • - t,T is,.0 rd So.That, Vis ble Fror>7 the Ste .,. .r.. ,..r ;. M x., . ,�:tiion�Has Bee �Posted Un K� �% . cu herea Ce ica a of O cu anc Is R uiretl, uch B,uiltlmgs all . .O, ,v P Applicant Name: TUPPER CONSTRUCTION'CO, LLC. Permit-No. B-17*1708 Approvals Date Issued: 06/13/2017 Current Use: S ru ure 12 Foundation: q. Permit Type: Building=:Jnsu.l'atiOn-.Residential Expiration Date: /13/2017 Location: 33 CIRCUIT AVENUE,HYANNIS Map/Lot 324 107 k Zoning District: RB Sheathing: Owner on Record: SNIDER,NEIL G&DIANA Contractor Name: Richard S Tupper Framing: 1 _ a : Address: 33 CIRCUIT AVENUE Contractor License CS-069058 2 HYANNIS, MA 02601 Est Project Cost: $3,037.00 Chimney: F Description: weatherization Kermit Fee: $85.00 - Insulation: J Fee Paidti $85.00 Project Review Req: weatherization Final: pK 9161/ Date 6/13/2017 g Plumbing/Gas V r�fL g g.k Rough Plumbing: �e ,,,9_ . —:1"Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six rnonths�fter issuance' Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction document Vfor which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning bylaws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access streetor"road and shall be maintained open for pub*Jinspectidn for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signaturesgby the Building and"Fire Utticials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work., Rou 1.Foundation or Footing g h: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 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:contractin ;with unre ist,red conteactors•do.not,have.accets to:.thi .guaranty fund" (as set'forth.in MGL`c:142A): >' _. „, g,.. . g Fire Department Building plans are to be available`on site Final: All Pe.rmit•Cards are the property of the APPLICANT-ISSUED RECIPIENT y r ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map `�� Parcel o Application # �— ��ba Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee 5 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Stre t Address Village 0n/) gn Owner /V �/ d Address T� /� d Telephone Permit Request f O � V--)l /21m, A!' XA Square feet: 1 st floor: existing proposed 2nd floor: existing proposed. `Total ne Zoning District Flood Plain Groundwater Overlay r - Project Valuation Construction Type = __ Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supprorting doc-umeation. Dwelling Type: Single Family Y"' Two Family ❑ Multi-Family (# units) 03 Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's HJhway: 0 Yes 0 No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) _-T--7 Name �� Telephone Number 0 l Address /7 License# Home Improvement Contractor# Email Worker's Compensation # ALL CO STRUCTIO DE IS RESULTING FRO THIS PROJECT WILL BE TAKEN TO l SIGNATURE DATE 6 . FOR OFFICIAL USE ONLY a APPLICATION# 6 DATE ISSUED MAP/PARCEL NO. E t - ADDRESS VILLAGE OWNER e - DATE OF INSPECTION: FOUNDATION r' s FRAME I INSULATION f FIREPLACE ELECTRICAL: ROUGH FINAL F PLUMBING: ROUGH FINAL s. GAS: ROUGH FINAL FINAL BUILDING 61! f DATE CLOSED OUT ASSOCIATION PLAN NO. w �r 3 mass save PCONT A op tlsougt►tanntlrp,r.Mclt3ncr ��� PERMIT AUTHORIZATION FORM I, NEIL SNIDER• ,owner of the property located at: (Owner's Name,printed) 33 Circuit Ave HYANNIS (Property Street Address) (City) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. X Owner's Signature Z5 f6 Date FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: 114�P Participating Contractor Date [oil 01 s� For Office Use Only Rev.12132011' The Coatjxor Weff&h afManaeAasem t ofllAccPdewtB l Congress&iW,Sla 100 Boston,MA 02114-2019 wwwmaas govldbt Worige"S Compensation Insurance AMdavlt;Bu�detyC r umberr. A a TO BB FI XD Wrrjl TM PnMnTMG AUTHORIZY. Name(Bttseaeea/0i®an ndl Please t Legty . Tupper Cotta ucft Co L,LC Address: SUA HWIns Crowell Rd City/S%tWZip: Wsat Yarm",MA 02673 "i ij _P11011e#: NO-77 Ace you=emAOW Ckeck the W bou t.�tam a omployec wim L o Type of project(required). aaployea(faU and/or Daat-time).•113 r em a Oak p Grp ip=d was a ao enWIGy waMoz him is 7. ❑New ConsttnctiOn 0'"eapachy.I*wG&='eoagt,huts=atgmm l B. ❑Remode li11g 3.o r un a haaeowaer elotag.� tgyaeiE[Ho WWkM',=p.buraw tapfied.]+ p• ❑Dsguft0n 4.[]j am a Soffwviff AM Win be hwq;cam m cowman W0*on my h. s will 10❑0ttilding addition e;mpte tlut eD COaaaetap ai�er have waricas•cemp �ta�a�aoraia axle .ptopEetorr withao amployoca 13.0 Eloctrical tepoin or additions SC li am a OO '�sad then haW she aub�M&Mftn Mined on tbeattachea at t 12.[3Plumbing reaspts or additions adhtvo waakae•C".InRuateae,t 13.QRoof rej*m 6.0 we an;a covandoa and its ommm have a taelaed Sdr d*of esaMdon pamM a. 14.Q ogler Wenthterkmftn iS11 1(4).ad we hallo no"loyeea.(Wo werioar, CU-p.iana+mec ioqulad 'A+h'eppliwat�at checks boa Nl mat ago fill out the soaraa 6atow shoovin�their warYece' +tiomaowaea who aubmh rota ert[davit iod(catiilC they one doing ail wank and than hie ojoida eoatraeloro os awn sgtdavic indica�g ette6, tlm rbeck this be:meat aauhodaa add[tioaat�txttb,same ofttto nub-coafautooa and alsbe whe$aor nvt Hoaeernitrae have �tPloY . If ON oubmconnumhaveomlptoyeea,they,n%Wpmovidefl*w =Elp, ugmvAbor. Ianare"Via er�itM M4>'aor�'oa a aaee _ InfiMfid0 a h my Mp*YM A&W is&a pray"dJob dAr Insurance C r,panyNamc:AEIC Policy#or Self-ins.Lie.p WCC5DM3Q12018A 9013I17 - ExpirationDate: rob.site,4ddteog; 33 (;irruit Ave City/stmop: Hyannis MA 02601 Attach a gaff of the workeW eomptRadon poky+dtte4tratlon page(showing the polky jmutahr and Failure to secvro coverage as expiration dau). e+cquimd under MOL c.152,§25A is a criminal violation puni"We by a fine up to$1,500.00 and/or ease-year imprlsana 04 as well U civil penalties in the lbrm of a STOP WORK ORDFA and a tine of Up to$2M.00 a day ageing the viols=.A copy of this eratement may W farwatdad to the Office of hwa dgation$of the DIA for n►sttrance6 coverage vailication. I hereby efparlti+►y tbat fire In fa p+g+ ei abnt+r is awe nit d eorretce s D 5/8/17 0�9cIa!teas oarl�, DO trot WY&In IMF array is he complatad by or ttv"Offida1 City or Town: PetrmlbLle p Is UIft Authority(Cb&one): 1.Board of Health L BuDdIng Departnwut 3.city/Town Clerk 4.laft"tat inapeetar S..P1umMeig Inspeeter 6.Other Contest Person• P;soaB#: AC O® 166� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 11/28/2016 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 he 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). PRODUCER E:cT Ashley Palva Southeastern Insurance Agency, Inc. PNONE (508)997-6061 FAX isos)99o-z�s1 439 State Rd. ADO a :apaiva@southeasternins.com JUC.Noll: P.O. Box 79398 North Dartmouth MA 02747 INSURER AFFORDING COVERAGE NAIC0 INSURED INSORERAArbella Protection Insurance 41360 _ Tupper Construction Co LLC ER INSUR 8 Boston Insurance Brokerage Inc 546A Higgins Crowell Road 1NSURERC:INSURERD: INSURIM E: West Yarmouth MA 02673 INSURER F: COVERAGES CERTIFICATE NUMBER2016-17 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 - _ LTR TYPE OF INSURANCE vivnPOLICY NU R TL Y EFF -POLICY EXP LIMITS X COMMERCIAL GENERAL LIABIUTN IhMn EACH OCCU $. 11000,000 APP CLAIMS-MADE a RRENCE OCCUR PREM15ES Eaeceurce ee S 100,000 9520045208. 11/1/2026 11/1/2017 MED EXP(Anyone person) S 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEIML AGGREGATE LIMIT APPLIES PER: GENERAL:AGGREGATE $ 2 000,000 X POLICY❑JPERa LOC PRODUCTS-COMP/Op AGG S 2:000,000 OTHER: $ AUTOMOBILE LIABILITY E cadent LE LIMI g, 1,000,000 A ANY AUTO BODILY INJURY(Perparaon) $ AULL TOS OWNED HEDR AUTOSULED 1020009389 12/1/2016 12/1/2017 BODILYINJURY(Peraccident) S B HIRED AUTOS AUTOS PROPERTY DAMAGE Peracatlent $ I Uninsured motortst 81 split limit S 2501000 UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAR CLAIMS-MADE AGGREGATE g �DEI] RFTFNTinjS 4600058368 11/1/2016 11/1/2017 $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY STATUTE ERH ANY PROPRIETOR YIN OFFICER/MEMBEREXCLUDED? a NIA E.L.EACH ACCIDENT' $ 1 000 000 B (Mandatory in NH) WCC5005593012016A 10/3/2016 10/3/2017 E.L.DISEASE-EA EMPLOYE $ 1,000-000 If yes,describe under DESCRIPTION OF OPERATIONS below - - E.L.DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remaft Schedule,may be attached I}Marc Y spats is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Display Purposes Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATNE Ashley Paiva/AMP ©1988-2014 ACORD CORPORATION, All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD INS025 r7nimii i a - 09, Office of Consumer Affairs and Business R 10 Park Plaza-Suite 5170ation Boston,Massachusetts 02116 Home Improvement Conttriactor Registration f, _ - RegisMon: 178434 f b TM: LLC TUPPER CONSTRUCTION CO, LLC. 'r Expus�o"' 4H612018 Tr8 419Z91 RICHARD TUPPER _ 546 A HIGGINS CROWALL RD W. YARMOUTH, MA 02673 Update a Address and return coed Mark reason for c1mge. a, Address Renewal E] gmpbyment [] LostAddress 7 d .y* �//!P tfr�Na[[•trnna�/l r!^..�frtS+�tr7l��3e✓/3 - .. _ _ ..� - �•1 O(Na Of Co,3samer Af$im dt lanwIL,,bdos - License or regllst'ation valid fur hr Nduat on only HOME lion:iI ImuAaff CONTRACTOR before the espiratioa data Itfbnud ratara to: R�tatratlon: 178434 Tjrpe: Office of Com mer ARdn and Balinese Regohrtion Explmdorc- 4/19018 LLC 10 -Suite UPPER CONSTRUCTION CO,U.C. men' t JCHARD TUPPER 46 A HIGGINS CROWELL Ra J.YARMOUTH,NIA 02873 U Not wiEhout algnatuna aanRo PROFMOM trmx snora �R14DRit11NQ�L �INC ~>i aft vo WMSWAM MftdTu BUILDIN>Q PERFORMANCE IN RTAYJ'11,INC `•�:��iv��aRtallito8 Masaaehuaetts DePartment or Public Safety Board of Building Regulations and Standards r wi�1o>>�et(lglm� License:CS46905S �OIOM4 Construction Supervisor. l RICNARD S TUpM ' 5"A NINI NSCROWELt ROAD ° WEBT YARiYMUM MA iftyli am"Sam sba�il�Ge,Ir�e,�,�ortwooliond�y� �,, ,• �j. . = EaOiE;tMrpatlogNWt !d!G!it .{=-a._ Expiration: Commlaaloner 12/3112018 f 06 2017 1131 AM Tupper Construction Co, 15087785010 pageroo0or 4 TUPPER CONSTRUCTION CD.uc 546A Higgins Crowell Rd,WEST YARMOUTH,MA 02673 PHONE: 5M77"111 FAX: 508-77"010 ,1NWW TUPPERCO.COM Date: 1 07 Town of Barnstable Thomas Perry CBO 200 Main Street Hyannis, Ma 02601 i (508) 790-6230 fax Re: Insulation Permits --a Dear Mr. Perry This affidavit is to certify that all work completed for permit application 1-4 Issued on (�/` /� 7 has been inspected by a certified Building Performance Institute (BPI)-inspector. ,All work performed meets or exceeds Federal and State requirements. Sincerely, Address: Richard Tupper License # CS-69058 i I/Assessor's Office(1st floor) Map y' _�j� ;Lot d 7 Permit# 9 Conservation Office(4th floor-) Date Issued d-ef+fe-a 3rd floor" )($.3 9:30/1:00-2:00) -if 3 V// 44 Fee: 76 4� engineering Dept.(3rd,floor) House#YQ 4*:!33 FW,, Planning Dept.(1st floor/School Admin. Bldg.) � '• - - 5� BARNSTABLE. Definitive Pla oved by Planning Board 19 fess TOWN OF.BARNSTABLE' Building PermitApplication Project Stre Village , Owner Address 3.3 Telephone - Permit Request iQA_ S 2=40:1/0 l �t Sb r'� "'Total 1 Story Area(include 1 story'garages&decks) i y o y square feet Total 2 Story Area(total of 1st&2nd stories) square feet _,l-'Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information q ✓ Name Telephone Number1-1' 6�---76 F6 /Q /Address .License# (M 992 S3 Home Improvement Contractor# J ®n g0 oZ Worker s Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE; DA �� 91,�9s BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY , PERMIT NO. 10069 ' S/3,0/9 5'M1 t DATE ISSUED 324 107 MAP/PARCEL NO. ADDRESS 33 Circuit Avenue VILLAGE Hyannis OWNER Jack M. Snider DATE OF INSPECTION: ' FOUNDATION + FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL . FINAL BUILDING DATE CLOSED OUT . /) iJU 00 ASSOCIATION PLAN NO. 11:0�:'9� Zi:fl2 $Sli i 2i i 122 DEFT UW A%,%-I++ aA T CO/t7JYf01ZWFtaLUL O/ MamachU606 , �Q�ilJj�li1.O� 600 Wkajim-Sad .James.J.c,�mpbs+8 fos, irlaesac�rr. 02f f f Commissbnff . worke s' Compensation ttt==ce Affidavit with a principal place of leas alMA t�q"s`m'zta� do hereby certify under the pains and penalties of perjcnr, that. () I am an employer providing worker' ONUMasatiOn coverage for my eatpfoyees this job. , Insurance Company Policy Number O I am a sole proprietor and have no one working for me in any capacity I am a sole proprietor general contractor r ----- wn� (drde one) and hav ( contractors ilsced below who have the foiiov�nng workers' aotapoa policies �7 cw.u''GV InS �pylPOl�lt Contractor lrelic losuraace C�omp�Y nu actor . ylPark Contractor P work t atn a homeowner performing alI the ai<Yself., . 1 tasd��Gnc Est a coy of tilt srtanent tv�il be la sided w she OMM of inv"dCW sa of do OVA for acverW and s mc:•.ed under Sccdon ZSA of MGL ISZ Can lean m the lmaoaidou Signed this oiS100.00� a d�►opiRst n+c IMP=-.�aec as well as dvff awmWes in she toms da SraP WORK 0RO � daY � a �� y s, , t 42-S --- , �/ Building �epat'mtent UcenseedPermittee Liomising Roard . . The Town of Barnstable , . �t Department of Health Safeq and Environmental Se Building Division 367 Main Strom Hyannis MA MWI Ranh C Office: 508-790-6Z27 Euddia{ Farc 508-775-33" For a mce Use only , Permit no. Dan AFFIDAVIT SOME nWROVEMENTCONTRACMRLAW SUPPLEMENT TO PERIVIIT APPLICATION MGL c 142A requires that the"roc I trwliM altaaYions,rmoration,I mod on,ao imp t, Ra► -4 demolitim or coon of an addition to any pm- awacr aoa building wntaining at least ane but not more than four dwelling units or m snrac w1iiCh arc 24 to such residence or building be done by registered cogs,with certainc=qydcM along with Type of Wank: Ert.Cost 07/ dy Address of Work /Oaner.Name: Z, 1 ate of Permit Apph=wn: d I hercbr cmtify that: Registration is not required for the falloa-ing reason(s): Work aoduaod by law JobtinderSIP0 Bnilding not... aocciad Owner pnwingown PC=# Notice is hereby gi%-cn that: OWNERS PULLING THM OWN PERIUQT OR DEALING WITFi� CESS TO APPLICABLE HOME UAMOVEME 4T WORK DO ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: No. Date name gegzsaattoa OR ' i _ a is i ' •`• * �� `S.�P - r J a ; HOME IMPROVEMENT CONTRACTORS REGISTRATIONi oard of Building Regulations and StandardsX � One Ashburton Place - 'Room 1301 Boston Massachusetts.. 02108 ,► � _ { ' ;h l- - E IMPROVEMENT CONTRACTOR __ __ _ istration 100902 Expiration 06/24/96 za e - INDIVIDUALt; t IMPROVEMENT CONTRACTOR Registration 100902 INDIVIDUAL Ronald N . Tocco u z, �a ' Expiration 06/24/96 268 Shore Rd . , Box 3128 Bourne MA 02532 afi* ,Ronald N. Tocco � W 268 Shore Rd., Box 3128 f; 01ti'ne NA 02532 w ADMINISTRATOR ; _ .. _ .._._ _.. ._ ._. _. .__ _ ` � _ _.ri --k ruli44 +u.:ih 3x' �_.. _ -s • ... � .