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HomeMy WebLinkAbout0125 FIVE CORNERS ROAD Cern eS f i, A V YV U Vl 1341 lla LAUXG *rermity Cl 0o 4 n 0•* Expires 6 nioxths from issue date BAMM"M Regulatory Services Fee XAM cb a6? Thomas F.Geller;Director Building Division Torn Perry, Building Commissioner 200 Main Street,.Hyannis,MA 02601 Office: 508-862-4038 A � • 5 Fax. 508-790-6230 7,4VVN QF B NL EXPRESS PERWrtAPP IICANIOX-Pressler nIDENTIAL ONLY IV jT,�&L& YalidP 4ap/parcel Number A- ,roperty Address 6VI (0//Y 7 Jt Residential Value of Work / Minimum fee of•$25.00 for work under$6000.00 3wner's Name&Address Nit tyl i8i'o III YA Contractor's Name Telephone Number %t Home Improvement Contractor License#(if applicable) �� EJV Construction Supervisor's License#(if applicable) �Workrnan's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name W orkman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) . ... [�Re-side • �� 1 ���: ��y� 1. Replacement Windows. U-Value (maximum.44) '"Where required: issuance of this permit does not exempt compliance with other town depart:ieat regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Imlb"M prov t Contractors License is required. Signature A. Q:Forms:expmtrg Reviu063004 CAPIZZI HOME IMPROVEMENT INC . SPECIFICATIONS AND ESTIMATES PAGE 6 OF 6 STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I, OWN THE PROPERTY LOCATED AT IN MASSACHUSETTS. i 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: OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: Plo APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 NEWTOWN RD. , COTUIT, MA 02635 APPLICANT'S TELEPHONE: 5081428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: ACCEPTED BY DATE THIS PAGE IS PART OF AND IN CONFORMANCE WITH PROPOSAL # J . Board TO l u lg Regula on s and Standards One AshbuT on Place - Room 1301 Boston. Mas achusetts 02108 Home Improvement; ogtractor Registration - Registration: 100740 Type: Private Corporation Expiration: 6/23/2006 CAPIZZI HOME IMPROVEMENT, INC. ::` Thomas Capizzi, jr. 1645 Newton Rd. Cotuit, MA 02635 Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card ✓/e'C�anvrno�uueallf o�./�aaaac�ruc�,lta '" Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before.the expiration date. If found return to: Board of Building Regulations and Standards Registration:. 1 D0740 One Ashburton Place Rm 1301 Expiration: 6/23/2006 Boston,Ma.02108 Type: Private Corporation' , CAPIZZI HOME IMPROVEMENT,1 %omas Capizzi,jr. 1645 Newton Rd. _� ,,� Cotuit,MA 02635 Administrator Not valid without "r _ - ,: > ✓,ze -panUmwnurea// o�✓�aaaaclucae�ta _ BOARD OF BUILDING REGULATIONS _ License: CONSTRUCTION SUPERVISOR Number'•:=CS 057032 Expires 09/2 - 05 Tr.no: 7171.0 Restricted .00 .? THOMAS X CAPIZZI JR 1645 NEWTOWN RD,,,,°„"s` ( .•�, COTUIT, MA 02635 Administrator D Sfan u, 1(n ✓�'�l 0 265� FF ofTeero♦ TOWN OF BARNSTABLE Permit No. ..29456 BUILDING DEPARTMENT q4v TOWN OFFICE BUILDING Cash 7 .n.�.Q HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to, A. J. Lane Compeny,, Inc. Address Lot #1, 125 Five Corners toad Centerville, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. Building Inspector II I� N' G BUILD11" TOWN 06 BARNSTABLE,_MASSACHUSETTS PERMIT JOB WEATHER CARD �p DATE 19 PERMIT NO. /X APPLICANT _ ADDRESS f (N0.) (STREET) (CONTR'S LICENSE) PERMIT TO (_) STORY NUMBER OF (TYPE OF IMPROVEMENT) N0. (PROPOSED USE) DWELLING UNITS AT (LOCATION) 1. ZZj . /!fie Cp/-,tee/ S 6d ZONING (ND•) (STREET) DISTRICT Cei�o� BETWEEN AND � (CROSS STREET) (CROSS STREET) - SUBDIVISION LOT BLOCK SIIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION i TO TYPE e USE GROUP BASEMENT WALLS OR FOUNDATION - (TYPE) REMARKS: AREA 6R VOLUME ESTIMATED COST $ PERMIT 1 (CUBIC/SOUAR,.EE FEET) FEE I OWNER v �� ADDRESS BUILDING DEPT, BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OF ® PROVPERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP ED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WE,L.L AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINEC FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. FROM THE CONDITIONS i r MINIMUM OF THREE C.ff4L INSPECTIONS REQUIRED P1 �RAPPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE ALL CONSTRUCTION WORK: CARD KEPT PASTED UNTIL FINAL INSPECT I ION HAS BEEN PERMITS ARE REQUIRED FOR 1. FOUNDATIONS OR'FOOTINGS. ELECTRICAL, PLUMBING AND MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIREO,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBFINAL I S(RE DY INSPECTION LATHE I FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDIN NSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 717� 3 HEA G 'NSP EC TI. G PP OVALS REFRIGERATION INSPECTION APPROVALS V C T ri E R 2 !RO=EEL UNT:L THE PERMIT W!LL BECOME NULL,AND VOID IF CONSTRUCTION iNS@ECTi0N5 iN01CATED ON THIS CARD �� "`- 'A�-vUS- I WORK IS NOT STARTED WITHIN MONTHS OF DATE THE ram., l CAN 9E ARRANGED FOR By TELEPHONE PERMIT Ic Iccllcn •c un rr.. no .+oar � oJJ 0►�2-.� rQ I 0 � ��• J � N � m A44 o`O orG'oa` V � lil ov 1 O Lo-r 1 o 17 a 290.00' L; z Lar - JOB # 85-492 CF_RTIFIED PLOT PLAN PREPARED FOR.- LOCATION. LOT-1 FIVE CORNERS RD BARN SCALE. 1 " =60 ' DATE: 05/0VB6 REFERENCE: PB 410 PG 10 A . J . LANE CONSTRUCTION I HEREBY CERTIFY THAT -THE;BUILDING - - - SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON �A�tN Of Af��,^ ARNE cya down cape engineering C. OJHIA . z s CIVIL ENGINEERS LAND SURVEYORS �40� S ROUTE 6A YARMOUTH MA DATE REG. SURVEYOR •, ri 777"`��� A essor'?office (1st floor): .. ." ' { o�TNETO� Assessor's map q,nd lot number- C... ...� ..��p�l,[s� cy a Board of Health Ord floor): �� ��' ©r- EPTIC S Sewage Permit number .:............................... ................. .... INSTALLED i UST BafiHA9eTa LE SYSTEM fill Engineering Department' (3rd floor): —,�5: ~. N COMPLIAI ''�o t639. LLE® House number ................................... ...I.............' .... o�aYa`e WITH TITLE 5 APPLICATIONS PROCESSED 8:30.9:30 A:M. and 1:00-2:00~P.M. only ENVIRONMENTAL CODE AN" TOWN E ULPTIONS TOWN OF `- -RARNSTA L BUILDING INSPECTOR a APPLICATION FOR PERMIT TO ............... 42..... i.QI.I ................... TYPE OF CONSTRUCTION ................S1. ................................................ �lJ_.__....19f r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies applies for a permit according to the following information: Location ......!..1. .- r..l S.� .n -r.�..... .., .... .fr.U/..(.............L�}T ..�................ �.n.. �-,... cerrrn.4.l. . e, �1 ............................... Proposed Use .� . �...... � .. . !�. !. . �,�.......................................................... ZoningDistrict .......... .�.J... .........................................Fire District ........ ..Q......................................................... Name of Owner y"J... '.....� ..�...1�Q.... ?.........Address �. ../ .Ul ......rf^QW?./.� ......................Address Name of Builder ..... ...' ....... ..... ........................................................................ Name of Architect V .. aaaaj-:� ....Tn. .........Address .l.!,?..�.. Number of Rooms ......:�......... a�.—.L..�CJ.C ?h......................Foundation ....L(?Kti.C: ._..........: Exterior .... r)l.d �. ..�.L 1' CIAO'1�.....................Roofing ....... .5 .................................................. Floors "..........................Interior ..,� P ,p��-iaS. ;................... Heating (. /. ..(/..................:.......................:....:............Plumbing ..........��..�........................................................... �....... . I_ '.................................Approximate Cost"` O Q 0 . Lks.....1.6 Fireplace ..........CSC/�:�.......................... .... .. �.. ..........� Definitive Plan Approved by Planning Board ------!_ZV_a------------19? Area .. .. ............................... / Diagram of Lot and Building with Dimensions Fee ✓ /` ©O SUBJECT TO APPROVAL OF BOARD OF,HEALTH '® '25�'e39011 SON. 2C I?N r 4)6V-94e 4 r,� ,cam , 116,4 `( VJ'T N4 r.. �n OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS ` I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above . construction. Name ... . .............................. Construction Supervisor's License IJ........... . A. J. LANE COMPANY, INC. 29456 1' Story b 4. .... Permit for ... 2 ........... ................................. Sin�le Family Dwelling ................ Location .... ......1..2..5....F.iv e..Corners...RoF.d. Centerville ............................. Owner .....A.- J. Lane Company, -Inc. ...............................Company, 4 L Typen F of Construction ,.Frame -ARe.................. .................... ............6.............................................. ................. Plot .............. Lot................................ June 4" 86 Permit Granted ........................................19 t Date of inspection 7 ....... Date. Completed ...... ........ <� 74 M ur til 17 L 0 F Assessor's office (1st floor): Assessor's map and lot number All .....!C pF�'� L ��a o 1 �oF THE to y ..................h............ Board of Health (3rd floor): Sewage Permit number ........................................................ Z BA"STABLE. i Engineering Department (3rd floor): *jaJ �Q 900 ,"639. 0� House number ........................................................................ o YpY a' APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO `.....�"r i� . .'�......�....©..`�.................... TYPE OF CONSTRUCTION ';,`I%L... <[./.).)11c� ................ ............................................. ...................... ............................ ... .......19....� .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to .the following information: 6'Pol-e r" V L�- rL cr;*1. Location ...........................................................f....—.-......................... .............. Proposed Use ..SIr�C)� ... ` �.}.�... .�:1..... 5/C.le.r7f p . . .... Zoning District -' ....Fire District �t� ................................................... r. -►'1 �- n0 t7 C f� I'�(1)'C �.Sfi. (�kin i1I Jf c r' Name of Owner �. �.l C.......D. ). .......Address ... ................................ ..... �` I Y� .............. ! .... t� � � )� Nameof Builder ..................:............�....................................Address ....................................................................../............ Name of Architect !,.)crrie-'' 4o �?cw("a ��--........Address 1"c'�i"r`) t i r')Cr4c' l fJ r 1 U .1 t C.�..3r .!. . ..... Number of Rooms " � (.. ..C i ........................2........:.......:......................Foundation ........:..................................................................... AExlerior ....� ?.!...11� . ....iLf...... fiC'( r ...Roofing ......... Floors Pn r-Gf C�.-°c=,C b 1...lrt_1.`2t4-t- jJ ii.C. '�J .�aC �C.! j���i.S..�..f:.l ..................... .....................................................................................Interior ...................................... ` ? I Heatingn............................::.................:...........:.....Plumbing .........:.....! �..............................................p.................... Fireplace ........... ...�`- -......................................I....................Approximate Cost .... :�/............. ......4.................N•.c............. Definitive Plan Approved by Planning Board ------'--:-- r ---19------ . , Area Diagram of Lot and .Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH ;��0"W aq ' somp '/PP P r 97V sV.. A III OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations'of the Town of Barnstable regarding the above construction. Name ....................... ... ....... .................................. Construction Supervisor's License ..................................... n 'C C i) A. U. LANE -COMPANY, INC. A=1* 68-92 0 _2.9.4. .... Permit for ... ...Star . ................ ...........Single Family., in ................... Location .... ... ... F..v�. .._ Corners .. Road............ Centerville.................................... Owner ....A.....J......Lane CoTpj!pAy,...I]Aq., Type of,Construction ....FK4aq........................... ................................................................................ Plot ............................ Lot ................................ Permit Granted .....June._4......................1986 Date of Inspection. ....................................19 Date Completed ......................................19 PV TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �' '` Permit# '?7 S(o t h0al •Division Date Issuedeo (wsewation Division �- - •�V �� • �/v�../�� Fee Tax Collector Treasurer om P p"hig Dept. Date Definitive Plan Approved by Planning Board Hist -OKH Preservation/Hyannis Project Street Address �5_ Fi-Vt (26 12AJs Village Ci5AI 73 Qt/f LL--E Owner - RA/AL0,4AJ Address a�a- �2.L3C�lLtVJ� (P Telephone no) 466 r,r Permit Request 311k[ 0d15 —3 CY alm 6 tw f Qr 5Ee :! 11�H7- 5T7"�riRd Square feet: 1 st floor:existing proposed 2nd floor: existing proposed Total new Estimated Project Cost 560 Zoning District Flood Plain Groundwater Overlay . Construction Type • (AI) F�Z_ Lot Size Grandfathered: ❑Yes w o If yes, attach supporting documentation. Dwelling Type: Single Family 2r Two Family '❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ,046 On Old King's Highway: ❑Yes O*15t 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 0 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: s . Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes O10 If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name 0 AP1 ZZ-1 S�: D pkd11C#1 lephone Number °�o�tl—�}5/4!f Address to e(tl mdk, f��� License# 7,2 1�G C6-1.L U°-6,36 Home Improvement Contractor# l 2d Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE - FOR OFFICIAL USE ONLY PERMIT N,O. �� DATE ISSUED MAP/PARCEL NO. 1 s a , .t, a .- = w{.. �:, '. ` _, � • •' --- � «`- ADDRESS i VIL'I)AGE , r OWNER, DATE OF INSPECT FOUNDATION r, FRAME I s «"� i ? f . .. •• ` • INSULATION t 1 « FIREPLACE ELECTRICAL: ROUGH FINAL r ' PLUMBING: ROUGH FINAL y° ' GAS: ROUGH FINAL' FINAL BUILDING DATE CLOSED OUT YY ASSOCIATIONTLAN NO. s ° r The Town of Barnstable 9 MAS& De artment of Health Safety and Environmental Services.- Ea59. ►`� P Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with. certain exceptions,along with other requirements. ` d- s t. Cost` Type of Work:_� 1p 1PP Q� 3 S I/. / Address of Work: �y-I�� CyP. �� �e�ui l�P 'o� Owner's Name T/�17Ta� 7?�i�/� rn l /�I16�JM/JdJ l) Date of Permit Application: �1 Q� I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under 51,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING , WITH IMPROVEMENT WORK DORNOTTERED HAVE CONTRACTORS FOR APPLICABLE HOME ACCESS TO THE ARBITRATION PROGZAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permif as the agent of the owner: Date Contractor Name Registration No. etlP /Z OR Date Owner's Name ---_ The Commonwealth of Massachusetts ''-.....•._ - : Department of Industrial Accidents , � — Olflcr olloYestleatloos ` - 600 Washington Street - - � Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name: location: city phone# '70 - / l0 7a ❑ I am a homeowner performing all work myself. ❑ I am a sol et or and have no one woridn in act . I am an employer providing workers' compensati n for my employees working on this 'ob.. In hone: - - ...-. :. :< lnsnrancet;o:::: :: :. C �� ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers'compensation polices: ....... ............... .::............... ..:.. comoanv name.. .....:....:.... ::::.:::.:::. ..:::.:...:::........ :::::>:::>:;:::'::::<::i;;::;:.:;:::>:::.::i:::i:•:.:::::::i:::i'.`:::2' i:::ti::i::i::i :i iii.is...ii...I: :.i.....•...ii::?.<<:.... .........................,.)........... address.. :. .... ,... .. ...........:. .............................................................. ::.......................:.x.:::::::::.::..........:.. ........ ........................, :v:::::::.�:::::::.�:.�:::::.�.�::::::::::.: � ::::::::::::v::::::::.:.::�::.:::::::::.�::::::::::::.:::::::iii}.�::::.�::::.::.�::::::::::::.�::. 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'iiiY:v::i:::•�::::?::::.±::v:.yiii'.::.i:•iiii:?•i:{ni:??4i:?{4:?4:??ryiiii}iiiiiii::n:::�::v:::::...i......4ii}iii%::.??::::?::>::::iii>i::n�:::: :t�ttrQnaQv:'Qanrei ::'`... ::'.:,_...: ::."'."iii.,...,...; ... .:........ ... .......... ............. ....... w:I. .•.Tn::::v::v: i•..::':::.::::: ::......iii is ... ...... .�.; v:::.v::::•:::....::: :::::.:..::.� Skn G:wilww:ilMw'•:i:::i atkttress. :: :j�:;:y:......iii: ::city: ........ ....... . ............................... .. <:::iii.i::....::;.i:.i:?:� •:•::>.:i::si::>::iii:::iiii:':: .......... :. ...... :.:,:.•:.::•::.. ...:.... .•::::::::::.:::.::.:::::::::::::...:.:.::>:.i:.:<.ii:{•ii:??.i•:.:... :.;'.:.;i;•:.:::::::::.:::;.i:;::.;i:.:o-;::::::::::::.i'.;•.i:{{{?{{•:;:;•;;::{::::.>:???:.ii. .....iii:.i:.i:.i:.i:.i:.;ii:::i:;::iiii::;;:•;i:.•i;::>:<:»: iii:{{•;i:•i:?.....; i::•i:•:;:{•:•i:;•i:.::i:;•i:.i;i:•::.; ::<•i:?.;:.isi:>;ii:;•:;;;i:•;i:•;iiii:.>:.iiiii:•i:•;:.i:•;::::. lL717raQCE.Cn..... ._.................................. .............. _..................._........... ........................ ;::i : >:.:::::'.;ii:,.iiiii:.:.iii;i:,.;:...:-:.w>?a.:.:.;.•;>iii;::;.iii:i':.:>s::.�: Fafimx to secure coverage as requited under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,M00 and/or am years'imptiwtnent as weR as.civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigation of the DIA for coverage verincadon. I do hereby cce�� er�tify under theparrn and penalties of perjury that the information provided above is true.and correctSignature C�t/L� 4/ Cc Date o1/[' Print name �2le ot7al C,C Phone# 9 5 1 l7 official use only, do not write in this area to be completed by city or town offidai city or town: perm ifficene# rlBnflding Department OLicensing Board ❑checicif immediate response is required ❑SekvtzneWs Once ❑Health Department contact person phone#; _ ❑Other (rmW 9195 PIA) s 3 Af . � �• - � ' . ��5 rive, le AF e. fSi�NG r• , ice!SIN �,•{ - •i••- •- � _ j . -�=-_-•— • .f t t• In accordance with the provisions of MGL c 40, S 54, a condition of Building Pe.-.nit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as derined by MOL c I11, S 150AThe debris wM be disposed of W.- . (Lo©aoa of ciliry) SiSnature of Pc.-=tt Appiimnt Date r s /ze �aorvrrzanurealC� o��•'lr!a<uac�uaeCZ� OEPARTiUENT: ,71 PUB_I r A,• TV, CONSTRUCTION SUPERVISOR FINS ? CS 001a5d '02,'7.a!')0t) GTIle& as Restri�t2d t'=HOME IMPROVEMENT CONTRACTOR . /THONA' .-GRPI=`` �'Registration --100740L' L6"5 NEWTO!JfI RO PRIVATE CORPORATIONS g COT,UIT. NA ?2635 Expiration `06/23/00 ` ' CAPIZZI HOME IMPROVEMENT,,INC is-CapizzL, Sr 1645 Newton Rd ADMINISTRATOR ui Cott MA 02635 w ; _ �/z Coo�nvnzanzueaC�- o` .uac zu:;etld OEPARTMENT OF PUBLIC SAFETY .` l CONSTRUCTION SUPERVISOR LICENSE Number: Expires: — Restricted To,.:. 96 THONAS".X- C'RPIZZI JR 280 PERCIVAL OR -I W BARNSTABLE, NA 02668 �-•=cam-- �� w ✓�e �omvzna�z�ueaCC� o`��G`ir��ac�u�eClt' / OEPARTNENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Number Expires: Restricted T6 - 00 _ FREOERICK.V. 'RASCH IIi 1069 BOURNE RO PLYNOUTH, NA M60 o� Thank you for choosing VELUX° Roof Windows and FILE COPW Merci d'avoir choisi les fenetres de toit et puits de lurntere co \ ' Skylights. if at any time you have a question or concern VELUX'. Pout tous renseignements concern ant les produits `,' regarding.VELUX products, please call us troll-free using VELUX, veuillez communiquer aver nous, en tout temps, av the number below. numero sans Frais suivant. 6, USA and Canada Austnolia New Zealand Plats-Unis et Canada Australie Houve�Zklandia o' 1-800-WVELUX i 800 231 960 0800 4 VELUX 1-800-88-VELUX ti 800 251 964 0800 4 Y9 UX a on]l o National Fenestration National Fenestrati Rating Council „ 0 ' W Rating Council MID WARN=6 CV VELUX-AMERICA INC. VELUX-AMERICA INC, 1O Manirfochxer stipulotes drat these ratings were determined Le labricont stipule roc cer cotes ont€6 determines con rmement in accordan,oe with o icable NFRC mcedures. aux rocedvre,a licables de to NFRC. �� Description Energy Rating Factors � �,�� DRatings s Product n Cotes d'eEPi°°°rbe hte�tigoebodwrW Nw du roduit �' Model FS (75) Coefficient U 0 37 {3,37 Modele FS (75) °o Z '. Lgactor 0.3 7 0.37 Deriei en code mi6�Io n— ' C Di.%.Ined In Aarado,o w*lfOC too Tempered, low-E too de NFRC Trempe,foible 11 Argon Gosfilled coefficient d'a��rt r emissivok inject -�J Solar Heat Gain Coefficient Low E -0.04 nement so' hire 0,30 0,30 d argon w D w Teed Amon.*4 HW 200 0.30 0.30 0.378 Gap n m�4 erg b ^'° Foible emissivit- F— 20o a NFRC 0,04 Focteur de transmission de Vide-0,378 Visible tight Transmittanoe 0.47 0.47 al 1umibre visible 0,47 0,47 adensloed i,Ao=6m wRh NFIC NO d.301 wi"'an O"Form-M a1ei°b 10O m 300 er 30'du FRC j NFRC ratings are determined for a fixed set or enwronnten►al conditions and may Lee 6yahsatioss du WW'wo,�hablies Pour des k-gion des per climonnan s 46— Ces doe nor be oppropnate far deRsrmining seosono(en y Performance.For more informo- n6m ne son►pet"Ire pas opproprrees poor f'dvaluaron des performances energy ues lion ooMacr NYVWDA, t 4W f.Touhy Avenue,Suite 470,Dos Plaines,A 600f 8; sai.sannidres.Pour plus de renseigoemenh,►euillez oonkKAw NWWDA, 7400 f.7ouhy ~ Tel: cofttf84/ 299-5200;Fez (8d7J 299-1286. Avenue,Serire 470,Des Plaines,rt 60018;TeJ.t847J 299-5200,•Fax_ (847)299-1286- V Meets or exceeds C.E.C.Air Irtfillratbn Requirements Satisfait ou e=bde les exigences du C.F.C.quart aux rarmes die I'infilimlion de I'air. .� o a Meets the requirements of AS4283 Skylights Salisfnit 1es exigences du AS4285 et puns de lurniijre. ry w , CD cz = t vLSAII69L a oar _, , vvVvvvJJJ -