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0142 FOX HILL ROAD
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Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address N 9L V" AA ►1 2 Village Q_y% Q_ Owner 7AhC)mc� �d �, Address I�I") Telephone Ll— Permit Request �`„rS i�.�c��co,� ', CkA ()Q1 S/�&A, L CC VCL1`. W QC. \ J {Asnn�j R Cn a ` $b` �I S�Q�A�'.9. ►0 � �O \�6��'1 A J�SC� IQA/�nfZT Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation cA Construction Typed aU, -WC4 C Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family a/ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ 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) Name )OSIN E'�Cp",a Telephone Number 4Ff—rl 9 8-—G)3 Ce I Address,7_ - 21 6 License # C S - 0�7 Ut ,. (S'Z � Home Improvement Contractor# 1-L13 3 Worker's Compensation # Lu C Q 00 q gg00 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO rrrA c k rxA- SIGNATU DATE i • FOR OFFICIAL USE ONLY s APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER i DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL > r GAS: = ROUGH FINAL FINAL BUILDING r' DATE CLOSED OUT ASSOCIATION PLAN NO. aar,rmwmcuealC/o�C�/f/liiaaacluaetla License or registration valid for individul use only Office of Consumer Affairs&Business Regulation g before the expiration date. If found return to: ME IMPROVEMENT CONTRACTOR egistratlon• :174235 Type: Office of Consumer Affairs and Business Regulatio xpiration: 1115/2015. LLC 10 Park Plaza-Suite 5170 Boston,MA 02116 BUILDING PERFORMNCB C` Nlt 'CTING,LLC. ' JOSH EDMOND 8 KINNIKINNICK RD TRURO,MA 02666 " Undersecretary i of valid without signature Massachusetts-Department of Public Safety Board of Building Re ulations and Standards E Construction Supcn-isof I License: CS-078815 . JOSH EMOND = 3 PO BOX 633 Truro MA 026661.4 � - Expiration Commissioner 03/25/2015 r ` PARTtC OMMes f mass save j PERMIT AUTHORIZATION .FORM . .' I, Thomas Edwards . - ,owner,of the property located at: (Owner's Name.printed) 142 Fox Hill Rd Centerville (Property Street Address) (gym) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building mit to perform insulation and/or ' weatherization work on my property.. Owner's Signature i Oate FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: ��c r Participating Contr ,r , Date { For office Use Only Rev. 12132011 ' � The Commonwealth of Massachusens Print Form_ y Department of Industrial Accidents Office of Investigations J b E` I Congress Street;Suite 100 Boston,MA 02114-2017 _ www.mass.- o v1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leoibty NaMe�(Business/Orgamzation(Individual): 1 Address: 03 City/State/Zip: ru yl;� Mpo Lbb Phone#: qj, 0 .� } Are oti an employer?Check the appropriate box: 4. I am a general contracoor and I Type of project(required): 1. I am a employer with l�l� > ❑ g 6. New construction erployees(fi fl and/or part-time).* have hired the sub-contractors 2.❑ I-aih a sole proprietor or partner- listed.on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have • g, Demolition workingfor me many capacity. employees and haveworkers' Y9. [] Building addition - [No"workers'comp.insurance comp.insurance.+ required:] 5. 0 We area corporation and its 10.E 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 f iepairs insurance required.]t" . c. 152,§1(4),and we have no employees.[No workers'" 13. Other �lt.C(1s►r 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. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Mar-Il° Insurance Company Name: ff`I"1C{ yyic_ f Policy#or Self-ins.Lic.#-. W C'V00 ob Expiration Date: C)V Job Site Address: )LA-) -T(Tx �\i\1 Q—A City/State/Zip:C o.A c. o G 2 2- 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 S.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 E!!4a under the pains and enalties 2fferury that the information provided above is true and correct Signature: _.. Q 736 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(curle oate). 1.Board of glealt Building Department 3.Cpty/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector_ " 6.Other 03/31/2014 03:53 9787778415 PAGE 01 DA-FEiCERTIFICATE OF LIABILITY INSURANCE 3/31/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTWCATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EMND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THI3 CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: H the oertlAaate holder Is an ADDITIONAL INSURED,die pol"Ies)must be endorsed. N SUBROGATION 19 WAIVED,subject to the terms and conditions of the policy,certeln policies may require an endomemsni. A swanivent on this cardrlcate does not confer rights to the ceKlBcate holder In lieu of such end*rsamentisIX PRODUCER NAME: COUNTY INSURANCE AGENCY INC PHONE , (978)774-2463 u {M(978)777-8425 123 Sylvan St MP. Danvers, MA 01923 AtwREs :O INfURege►A/lOnDINO COVERAGE_ NAICe INSURER A:Commerce Ins. Co. INSURED Building Performance Contracting, LLC INSURER g:Esnex Ins. Co. INSURER C:Atlantic Charger P.O. Box 633 INSURER D:RB JOnes Truro, Ma 02666 INSURER E I RER F COVERAGES CERTIFICATE NUMBER* REVISION NUMBER. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 9ELOW 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. pl L POLICY W TR TYPE OF INSURANCE POLICY NUMBER M WOQ MWDQIYYYY UM TS e,,,, ,r„to GENERAL LIABILITY EACH OCCURRENCES 1 O0O 000 PR R COMMCROIAL OFNOkAL LIABILITV EMASES IEG occuff me S SO 1 000 CUtlM4-MADE a]OCCUR MEDEW( ens reon) S 1,000 B 3DE9441 11/19/13 11/19/14 PERsoNALaAuvINjuAv s 1,000 000 GENERAL AGGREGATE S 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S 1,000,000 POLICY PRO- LOC W10BIRED-31IRMF LINT S AUTOMOBILE LIABILITY Ea accident 1,000,000 ANYAUTO BODILY INIURY(Per person) S A AAU,UTOS NED X SCCHHODILED BGDDGK 2/2/14 2/2/15 BODILY INJURY(Perecddent) S HIRED AUTOS AUTOS NON-OWNED Par ecddnta = S X UMBRELLA-LIAB OCCUR EACH OCCURRENCE S 2,000,000 D EXCESS LIAO CLAIMS-MADE CUBW3904112 5/1/13 5/1/14 AGGREGATE s 2,000,000 DED RETENTION S f WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY Eft ANY PROPRtETORIPARTNEWEAECUrIVE '^" 11/23/13 11/23/1. E.LEACHACCIDE14T S 500,000 C OFFICER/MEMBER EXCLUDED? Q MIA (wau.Iar inMln WCV00939900 E.L.DISEASE-EA EMPLOYEE S S00,000 N yyeess aeaClb-undw " DESt:RIPI'1ON OF OPERATIONS belay EL DISEASE•POLICY LIMIT S 500,000 , t DESCRIPTION-OF OPERATIONS I LOCATIONS i VEHICLES (AVAch ACORO 101.Additional RemMte SMedWe.II more Apace is rapulred) CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WIT"THE POLICY PROVISIONS_ AUTHORI RE ENTATI 9B&2010 A RD CORPORATION. All rights reserved. ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD y oFtM r Town of Barnstable *Permit# Expires 6 months from issue date . °7 Regulatory Services Fe A snx MAW. _ X-PRESS v� � Thomas F.Geiler,Director Building Division SEP 10 2012 Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us TOWN OF BARNSTABLE Officer 508-862-4038 Fax: 5087790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY / Not Valid without Red X-Press Imprint Map/parcel Number g q / Q-5y Property Address I y 91 t O A 14,11 1 ®Residential Value of Work 1,303 3 ao Minimum fee of$35.00 for work under$6000:00 Owner's Name&Address -.)U&4-0 J o y Gt, I:LO✓1 390 Morn 51 e-L Dr. Cht.sc_p-eaU4--- VIA- U 3 oL! Contractor's Name C(Atl}e lC�f �{� p �e-S . t-�L Telephone Number 5U� Y7 7 8 g 7 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) CS 09c 02?3 F]Workman's Compensation Insurance Check one: ❑. I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# 00 SLt3 7 Q q Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to N �( ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows *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 r fired. SIGNATURE: r' C:\Users\decollik\AppData\Local\Microsoft\Window emporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110. 09/10/2012 11:50 7574833344 KENNEDY PAGE 01 �1 Town of Barnstable . st Regulatory Services 9A1tNSTAZM • MASS. �, Thomas F.Geiler,Director ' ibJD Building Division Tom Perry, Building Commissioner. 200 Main Street, Hyannis,MA 02601` w�vv.town.barnatable.ma.ua Office; 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder 7, ,as Omer of The subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: 1 la H � II Road, Cv�II (Address of Job) ®�G 3� Signa o er Date print Name 1nn� � ddress; `3��9 Y�orn 6if'ivP y QT0RM 5:0WNF-"ERM1S51oN L - V/ieoomrmwruuec�f�a��� �dQOh'� � License or registration valid for individul use only Office of Consumer Affairs&Business Regulation before the expiration date. if found return to: OME IMPROVEMENT CONTRACTOR Type Office of Consumer Affairs and Business Regulation egistration: 143358 10 Park Plaza-Suite 5170 xpiratlon: 71612014 Ltd Liability Corpc: Boston,MA 02116 ®,° CAPEWIDE ENTERPP(it L:L:C; RICHARD CAPEN 4507 R RTE 28 gP Underse cretary Not via lid gnature COTUIT,MA 02635 Unde Y t.,_ t+lass acht.{setYs Department of Publfc Safety Board of tjtsilr3innrestricted-Buildings of any use group which c� t�s�t�uiatit>ns ,,,d Star+x+,acts U (on.truction Super+i+or contain less than 35,000 cubic feet(991M )of License:CS-M273 enclosed space. RiCf,1ARD M.C-APEN X4 t f7'l lJl f %fib' 0263 " 1, Failure to possess a current edition of the Massachusetts Expiration State Buildhtg Code Is cause for revocation of this license. Commissioner 11127/2013 FormUcensingirrformationvisit: www.Mass.Gov/DPS Client#:51439 CAPEENT ACORD. CERTIFICATE OF LIABILITY INSURANCE DATEOMIDDNYYY) 04/16/2012 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 ORALTER 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 poiicy(ies)must be endorsed.If SUBROGATION 1S 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 Linda Taddia Rogers 8r Gray Ins. Kingston Phone 508.746-3311 63 Smiths Lane E•MNL E><t Ne:877-816-2156 Kingston,MA 023644700 ADDRESS: ltaddla@rogersgray.com INSURER 8 AFFORDING COVERAGE NAIC S 508 746-0055 INSURERA:Arbelia Protection Co 17000 INSURED INSURER B i Capewide Enterprises LLC J.P.Macomber B:Sons INSURER c: PO Box 763 INSURER D: Centerville,MA.02632 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 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. �TR TYPE OF INSURANCE ADDL SUB POLICY NUMBER MMNDY EFF r MND EXP LIMITS A GENERAL LIABILITY CPP8500050813 4/30/2012 0413012013 pEAACCHH OCCURRENCE $1 0_00 000 X COMMERCIAL GENERAL LIABILITY PREMISES eoNTErrrDenca E25000O CLAIMS•MAOE ❑X OCCUR MED DP(Any areperson) $S DOO PERSONAL B AOV INJURY $1 000 000 GENERAL AGGREGATE s2 O0O 000 GENT.AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY 7 PRO-CT LOC $ A AUTOMOBILE LIABILITY 58944400004 4/20/2012 04/201201 COMBsWE nt,SINGLE LIMIT 1,000,000 e ANY AUTOBODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) E AUTOS AUTOSNON-O $ IX HIRED AUTOS X" AUTOS PROPERTY ndd n DAMAGE $ A X UMBRELLA LIAR OCCUR 4600050814 4/30/2012 04130/2013 EACH OCCURRENCE $5 000 000 EXCESS IJAB HCLAIMS-MADE AGGREGATE E5 000 000 DEO I X RETENTIONS10000 $ A WORKERS COMPENSATION a 0054370411 4/14/2012 04114/201 WC STATU• OTH- (MandatoryInNH) NO EXCLUSIONS E.L.DISEASE-EA EMPLOYEE AND EMPLOYERS'LU181UTY FR ANY PROPRIETOMPARTNER/EXECUTIVE Y f N E.L.EACH ACCIDENT_ $500,000 OFFICERIMEMBER EXCLUDED'! N/A - a500 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500 O00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,It more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WrrH THE POLICY PROVISIONS. AUTHORIMD REPRESENTATIVE 0 198 -2010 ACORD CORPORATION..AII rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S80369/M80368 CJF Tli°e Conutionivealth of Massadiuselts Departrrtent.of industrial Acc den& Offitre of Investigations 600 Wasldngtou Sheet Boston,MA 02111 p` w viv.ntaxsgosVdid Workers' Compensation Insurance.Affidavit: BtildersI.ContractorsAEIectticians/Plumbers Applicant Information ,,,A Please Print ; Il' ly Name 0hMineW0 gavizatiannadiVidnai)_ �U� ►vi.� f ri 1'i S-0-S L" A,ddr : I S 3 60 m Vnj_rC1 A-L S f-r_e_ - City/Stat�/zp;: /14a,3haf- 111tl 602(o yJ Phome#r 50 t V 7 7- Are you an employer?Beck the appropriate box: Type,of project r ed): L❑ I am a employer with vZ a 4_ ❑ I am a general contractor and I 6. ❑New construction. employees(fall andtor part-time)-* have hired the sub-contractors 2.❑ I arm a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees sob contractors have g, ❑Demolition working for me in any capacity_ employees and have woriie s' 9. ❑Building addition [No walkers'comp.insurance comp_insurance.: 5. ❑ We area corporation and its 10.❑Electrical repairs or additions 3_❑ I am a.horneowuer doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers'comp right of exemption per MGL 12.[2 Roof repairs insurance required`]1 c.152,§1(4X and we have no employees_[No workers' 1.3.❑other comp_insurance required.] 'Any applicand,that checks box#1 mist also fill out the section below showing their wozkeis'compensation policy infhrmsfion. Homeowners who submit this affida nt indicating they are doing all work and then hire outside contractors mast submit a new affidavit indicating such_ (Contractors that check this box mast attached an additional sheet showing the Hates of the sub-contractors and state whether or not those eatitses have employees. If the mbdantractors.have employees,they mim p—ridee th&workers'.comp.policy,munber. lain err t3ttrplo crr thrtt is proviihaxg ttSorket 'corarpettsahtttr irrstrrnnce for ertrptvjedes. $roar is#)ta pa cy attd ob site ittforaittliom .n-r����— Insurance Company Name: ht `` Policy#or Self-iris.Lic.4: V(1) �W-�`7 O N�I ' Expiration Date: 002 Job Site Address: I y Q Fe C o ll kc4 City/Statejzip:C4e,"1Y b'i//e_ MA o d�iu .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 25.A of MGL c. 1.52 can lead to the imposition of c minai penalties of a. fine up to$1,500.00 an&Gr one-yearimprisonment,as well as cii l penalties in the fonu of a S'I OP'a ORK ORDER and a fine of up to$250_00 a Clay against the violator. Be advised.dhat a copy of this statement may be forwarded to the office of Investigations of the DIA for insurance coverage veri tion.. I do hereby cee afg der tk pains and penal es ofperfruy thattIhe iteformahtiatt pem ded abaite is true and corm Si Xnatare. Bate: I b I I L Phone#: U OBIviaL use only. Do not write in this area,to be completed by city or tower afficML City or Town: Permit/Ucense Issuing Authority(circle ane): 1.Board of Health 2.Buitduig Department 3.City/rown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#.- 6