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HomeMy WebLinkAbout0016 SCHOOL STREET TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �� Application # ; Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address /w/ SC 1 D?) Village OwnerG��vl/tJ s /��Go�< 5` Address /?y , C '7��7 �4fy/t D�63�✓ Telephone Permit Request � /�//° - es SAiNS%lell� Square feet: 1 st floor: existing/ proposed 2nd floor: existing proposed Totdli new tv- Zoning District Flood Plain Groundwater Overlay �.,, .try ^ Project Valuation �� Construction Type 12- Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting A-umPriation: I Dwelling Type: Single Family �f Two Family ❑ Multi-Family (# units) Age of Existing Structure 7YYIZ5 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sgft) A11A Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new O Half: existing Z> new b Number of Bedrooms: existing anew Total Room Count (not including baths): existing new D First Floor Room Count Heat�Type and Fuel: ❑ Gas )id Oil ❑ Electric ❑ Other Central Air: 0 Yes ❑ No Fireplaces: Existing 62 New O Existing wood/coal stove: ❑Yes JW No 4 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 IkYes ❑ No If yes, site plan review# y "!�l e s Current Use ITT/G&-6' ( A,� Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) v %------ �:D / ? �U' Name, J --- —`ioq ,lephone Number "� f� /� ee 99 Address`�`PO 4bO' ,- 61 � C icense #--�J "' �C� �p� N MIST y 9k Sew Home Improvement Contractor# !� Email ,VA) doanuumbu4'(AlWorker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FR M T IS PROJECT WILL BETAKEN TO 41ir> Dry T127e C2)U � . I SIGNATURES `-DATE=-y—q 6 FOR.OFFICIAL USE ONLY z APPLICATION# DATE ISSUED` MAP/PARCEL NO. ADDRESS VILLAGE . OWNER DATE OF INSPECTION: FOUNDATION � FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DAME CLOSED OUT ASS®.OIATION PLAN NO. 4 J ��e 'van;°rxirrtssi�i a��assat�rr�e�: ° Deparlrtrent ofludust a Accidents - Office of r st�grfians ... . ' 600 ffiashangtbm meet Boston,MA112111 wmv arztass:gar,1dira Workers' Compensatiaxtlnsmrant davit:Budders/ContractorsMechicians(Plvmbers Applicant Infarmatian. /Please Print Lq�ibly Name(IhesslOnizationrFndividnst)_ Do la W PO &OA 6101.10 cka+-ko-M" 4 ►� A- ctYi5tat&a�p:_Q a 6s-oPhone 9- �08 -_AF e you an employer?Check the appropriate box: T ec° 4. NaveMredthe a � - (+mod} - - ---- - 1.❑ I am a employer with f 6- ❑New lion employees(full and/or pmt-fine)* sub-contract: �_❑ I am a sore proprietor or partner- listed on the attached sheet'; l- ❑Remodeling ship and have no employees These sees contractors have g- ❑Demolition. w for me.in an c ci �, employ.ees and have workers> offing Y � � _ 9_ [:]'Building addition oworkers.ctS _hisuranre Comp.insurance-, reTi,_ed-] 5_❑ We are a corporation and its 10.0 Electrical repairs or additions 3.E11 am a homeawner doing all work officers have exercised their 11_❑Plumbing repairs or additions myself[No workers'comp- right.of exemption per MCL 12.❑Roof repairs c.15Z§1(4),andwehnena ins x-ance required_]F 13_❑Other employes [No ' Comp.Insurance required:] it "mayapP'=thatchecksbox-#1taust also MI out the sectionbelow showing&&wu&ea�m=pemdonpolic rse yiufnmmti Homeowners Rho submit this afhdavd nxUrstmg dhey are Honig aII nude and dLea hire outside coot moors rat s�anew affidavit i frlr�c ME tcantracmrs that cheek this box must sttadied an additional sheet shave--mg the name a£the :md state whether ornot these entities have, .Iftlie stdr contracta�s Ike emplvs,ffi Est provide their workers'comp.policy number-_ Z lam arz empZoper that is prmidfsrg tt�orke-rs'coniimmmn'mn inrrtrarice for my e.mpivy^ Ha1q*v is the j2LQ c}and joh sits Pro4 in s ro Insurance Gompauy Name' e "I e t`V 1 1 Polliicyy or Set€ins Ii� 7 ' Il. a y o5 r y Expiration Date: Job Site Address: / 5 C oq Cifyr"5tate!Zig: YQ .0 54- Attach a copy of the workers'compensation policy declaration page(showing the policy number and eicpi=ation date). Failure to secure coverage as regaireduuder Section 25A of MGL c. 152 can Lead to the imposition of criminal penalties of a tine up to$1,500.0a and/or one-yearimprisonment,as well as civil penalties in the fowl of a STOP WORK ORDER-and a fine, ofup to$250.00 a day against the violator_ Be advised that a copy of this statement maybe forwarded to the Office of Irizestigations of the DIA fior'm�tFar,re coverage-veri$cation- I da her c ettify ItJf1�Er t}E8 Fi3 ati a lu tlhEattfle informagan prodded abate iss h7w and correct Signatare: Date: ` Phone;w: - o -- �c� - 50© OUicial use on[y. Da not ivrite in this area,to bs campT ted by c.,ityv at town official City or Town: PerrmtUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3_Cityll`own Clerk 4.Electrical Inspector S.Plumbing rg 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. 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 Iegal 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 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;or Pi 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 cei i�ficate-(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 shoal-d 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 arorkers' 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 is 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 addl tion,an applicant that must submit multiple permitflicense 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 m (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 INTOT 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 Comman -e�alth of Massaehusatis Department of Ind al Accident Q4ffice Of Iawstiptfaas 600 Wasbin as Stet nstomz 02111 Tel.A 617-727-4900-w 406 or 1-977 7 AS E Revised 4-24-07 Fax# 61 727-7-149 ViWW Eaa:sS. -g,Uvddia Client#:137130 DONOVANBUI '' ACORM, CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 810612014 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(les)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). PRODUCER CO TAC NAME: John Powers HUB International New England HU Ne Exl:508 945 0446 FAX 508-945 9136 265 Orleans Road Arc Not: EMAIL North Chatham,MA 02650 ADDRESS: 508 945.0446 INSURER(S)AFFORDING COVERAGE NAIC H INSURER A:Arbella Protection InS CO. INSURED Donovan Building Inc. INSURER B:Arbella Insurance Group P.O. Box 612, - INSURER C: North Chatham,MA 02650 INSURERD: 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 TYPE OF INSURANCE ADDL SUER POLICY EFF LTR POLICY EXP LT INSR VJVD POLICY NUMBER MMIDDIYYYY MMIDDIYYY LIMITS A GENERAL LIABILITY 8500040518 710112014' 07/01I201 t EACH OCCURRENCE pgMq EE 77 $11000 000 X COMMERCIAL GENERAL LIABILITY PREM CES ER oNcu rerv:.e $100 000 CLAIMS-MADE ®OCCUR - MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER:7X POLICYPRODUCTS-COMP/OP AGG $2,000,000 PRO - JFCT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO -ALL OWNED SCHEDULED BODILY INJURY(Per person) $ AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED HIREDAUTOS AUTOS PROPERTY DAMAGE $ Per accident I� UMBRELLA LIAR OCCUR EACH OCCURRENCE 3 EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ B WORKERS COMPENSATION - $ AND EMPLOYERS'LIABILITY 9115240514 5/0912014 05/09/201 X "Ic v AT ITS oTH- ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? ® N I A E.L.EACH ACCIDENT $500 000 (Mandalo In NH) If yos,describe under E L.DISEASE-EA EMPLOYEE $500 000 DESCRIPTION OF OPERATIONS belay E.L.DISEASE-POLICY LIMIT $500 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more$Paco Is roqulrod) CERTIFICATE HOLDER CANCELLATION Town of Chatham SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 261 GIeo Dept.rg@ Ryder Road ACCORDANCE WITH THE POLICY PROVISIONS, ` 61 Ge Chatham,MA 02633 AUTHORIZED REPRESENTATIVE ©1988.2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1192073/M1155826 T0002 RECEIVED 09/10/2014 08:55AM Fronn:Suzette Moniz FaxID: Page 2 of 2 Date:9/10/2014 09:00 AM Page:2 of 2 ROBEELD-01 MOSU A�ORO" CERTIFICATE OF LIABILITY INSURANCE 1 DATE 9/10/IDDIY2014 110/ 4 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 (508)676-0309 NAME: Diane Carvalho Vivelros Insurance Agency,Inc. PHONE 375 Airport Road (A/C,No. o EA I: 508-673-6993 1 WC,No: Fall River,MA 02720 AooREss:dcarvalho viveirosinsuranCe.Corn INSURER($)AFFORDING COVERAGE NAIC# INSURERA:Utica Mutual Insurance Company 25976 INSURED Robert Eldredge INSURERS: 11 Treasure Lane INSURERC: South Yarmouth,MA 02664 IINSURERD: INSURERS: 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. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM1DDNYYY MMIDDIYEYXYPY LIMITS GENERAL LIABILITY EACH OCCURRENCE IS COMMERCIAL GENERAL LIABILITY PREMISES IEa occurrence IS CLAIMS-MADE F—IOCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GERL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ JECT ECT LOC POUCY IS AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO - BODILY INJURY(Per person) $ ALLOWNED SCHEDULED - BODILY INJURY(Per accident) $ AUTOS AUTOS HNON-OWNED PRO DAMAGE $ HIRED AUTOS AUTOS (PERACCIDENT) $ UMBRELLA LIAB OCCUR - EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED RETENTION $ - $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY UMITS ER A ANY PROPRIETORIPARTNER/EXECUTIVE 4465058 9/28/2013 9/28/2014 E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBEREXCLUDED? NIA (Mandatory In NH) - E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POUCY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CER71FICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Wide Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Main St ` ACCORDANCE WITH THE POLICY PROVISIONS. Chatham,MA- AUTHORIZED REPRESENTATIVE j ©1988-2010 ACORD CORPORATION. All rights reserved. ' ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD " r * IARNSTABLK • _ �$ 1639. ,0� Town of Barnstable 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, fi�,Y66�V\ , as`Owner of the subject property hereby authorize �� QVAAJ S/�kr __LAC to act on my behalf, in all matters relative to work authorized by this building permit application for: �� �1 � , (Address of Job) J Signature of Owner ate Print Name" If Property Owner'is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPFILES\FORMS\building permit fonns\EXPRESS.doc Revised 061313 , Town of Barnstable Regulatory Services ` P�°Fig T°ty,L Richard V.Scali,Director Building Division * snxNscasrE = Tom Perry,Building Commissioner Kkss. 9� 163;9. 200 Main Street, Hyannis,MA 02601 pTFO��y a www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print F 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. 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. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed 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 forns\EXPRESS.doc Revised 061313 1 OILNI Ii - BUILDING �%..ucssor's nuinbcr USVS Quad � assachusetu Historical Commission Vl 2 7/2 33 " 70 '` 80 Bovlston Street • Boston,.Massachusetts 012116'. Tom`." Barnstable place.(nerghborhood'orvillage) Hvanni G 'leasant `St. /School -St. Area ..L - ;►ddress 16 School Street` iistoriC 1Tame McCarthy House ses• Present office building. _ ---== Residence _ . . :Original ate of Construction: c 1.940 Asse:ssor's Records source tyie/Form Cabe - chitect(Builder` unknown Ytenor Matenal 1 f Sketch MYl '` a+o�ndaiion Pooured concrete Drams a.map of the area inddzcating propertre .7wz b n it. Number each properry for wbicb individual Wall/Tnm .Clapboard inventory forms have been compkted Label streets hoof Asphalt hingle inducting zoure numbers, fany- Attach a separate sheet if spare &not suffirient here. lndkaie Nortb; Outbuildings/Secondary Structures Hone a. r Major.Alterations,(With,dares) G re a t y .. Beer enlarged: • D0 Condinon Good Moved ® no ves ` Dare. :._-- Acreage` •22 Roy Richardson, Charles Lockhart:Setung B'usinessresiden Recorded by' Tracy Lauer Organization Barnstable Historical Comm. Date (monrh/di by/year)2/6/92, 8/4/93 - Office of Consumer Affairs and 8usiness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 173513 Type: Corporation �,fXW Expiration: 10/11/2014 Tr# 232503 DONOVAN BUILDING CORPORATION PETER DONOVAN P.O. BOX 612 '� �Y' N. CHATHAM, MA 02650 Update Address and return card.Mark reason for change. Address Cj Renewal Employment Lost Card DPS-CA1 Co 50M-04/04-G1001o216 �r��p Office 0 0nsOmerW°�res f Bir�ines huon License or registration valid for.individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: .473513 TYPe: Office of Consumer Affairs and Business Regulation Expiration: 1_Q11a,2014 Corporation 10 Park 1 Plaza-Suite 5170 Boston,MA 02116 D4 VAN BUILDING -WEg PETER DONOVANy 239 COMMERCE PARK yap S.CHATHAM, MA 02'659 4 % a r ass Undersecretary Not valid without signature 1 Massachusetts -Department of Public Safety .Board of Building Regulations and Standards Construction Supenlisor License: CS-086659 PETER B DONOV AN . - PO BOX 612 NO CHATHAM 16IA 0265jr Expiration Commissioner 08/07/2015 i