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HomeMy WebLinkAbout0521 OLD POST ROAD v Town of Barnstable Building ewtt.arnes e Post This Card So That it is Visible From the Street-'Approved Plans Must be Retained on Job and this Card Must be Kept t .•,�$ Posted Until Final Inspection Has Been Made. Permit Where a Certificate of Occupancy is Required,such Building,shall'Not be Occupied until a Final Inspection has been made. Permit No. B-20-1565 Applicant Name: Henry Cassidy Approvals Date Issued: 06/22/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 12/22/2020 Foundation: Location: 521 OLD POST ROAD(CT&MM),COTUIT Map/Lot: 054-021 Zoning District: RF Sheathing: Owner on Record: MORRISSEY,ROBERT&OREILLEY, NOEL LE Contractor Name: HENRY E CASSIDY Framing: 1 Address: 669 CARROLL ST,APT#2 Contractor License: CS=100988 2 BROOKLYN, NY 11215 Est. Project Cost: $6,200.00 Chimney: Description: Insulation/Weatherization Permit Fee: $85.00 Insulation: Project Review Req: Fee Paid: $85.00 Date: 6/22/2020 Final Plumbing/Gas Rough Plumbing: h= \Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. ' Rough Gas: All construction,alterations and changes of use of any building.and structures shall be in compliance with the local zoning by-laws and codes. 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 Final Gas: 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. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 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 Final: 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 contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). tea— Building plans are to be available on site Fire Department Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 0�^^Q0 3v Ce CP Town of Barnstable *Permit# W v Expires 6 months front issue date Regulatory Servkes Fee Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner / 200 Main Street,Hyannis,MA 02601 Q www.town,bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 "EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without RedX--Press Imprint Map/parcel Number Property Address , (. . per�fi r r)-) A- (5a 3 6 Nesidential Value of Work G S Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Xa" � Contractor's Name F- G_a-L-C, Telephone Number-50 S'-cI Home Improvement Contractor License#(if applicable) 1 P S 3�P Construction Supervisor's License#(if applicable) C (o 9 [ Vorkman's Compensation Insurance X�pr' �It�'� Chec1�one. - ❑ I am a sole proprietor J U N - 9 Z001$ ❑ I am the Homeowner Z,I have Worker's Compensation Insurance TN of BARNSTAIIL Insurance Company Name Workman's Comp.Policy# 7 5 0 L 35 c5 U 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 ��Zt ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town, gulatlons,i.e.Historic,Conservation,eta Ai *.**Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: Q:Forms:expmtrg Revise061306 1 The Commonwealth of Massachusetts. Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): �f}��r� �o fL)' r (U- fi 0 Ay Address: -Po City/State/Zip: C° 6L �Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.0I am a employer with _! 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors - 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in an capacity. employees and have workers' Y p tY• 9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions m self. o workers' com right of exemption per MGL Y � p. c. 152, , and we have no 12.,�Roof repairs insurance required.] t §1(4) employees. [No workers' 13.❑ Other 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. Insurance Company Name: P_-7�—Py K Policy#or Self-ins.Lic. L. vS S,50 Expiration Date: ' v�2 ' Q Job Site Address: Y City/State/Zip: m14 (� )563 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$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 certi er the airs and [ties ofperjury that the information provided above is true and correct Signature: Date: Phone#: Jc— _ I GK. Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: - ::>f>:::<z:>�:�:�>^'s::::,; :>::�::::>;:::�:::«r<;.:err::�:.;}•.:.::::::::::::::........ ...........:.�::.�:.::�::.�.�.,:.�:::._:::{_:•::...nt.�:.�:.�.�r.-:::::::.}:�... r.,..:�:..-- -n� -8�.. :.�::-.....::}::.�..:...;:.�.:.. ,...........:::::::......:::::-..,..:. ( NIA D1 .............,,........:::;;;•r>:;a:t:R;;:Yiir::::::`:::`:'::::;'•}:.:;::r'::::;:'•.••::::{::_�:........{.....-•----:.:::r::::}:.::?;.:v:•.�::.:::.r•.r:.i}•::.::;r}..i;<..::::.r:.}::: ., AID . ....,.... :..,ri:;•i::,•.r�•h::{.,:.};;;::.;.:.i:.f,:,A:.}xr::•:•:t:,::;t{•:.}:;{.�':.}:•>}:-rr:;•r?>;:?•}i::::.r:::, r'� PRonucEA To-I1S CERTIFICATE OS ISSUED A5 A-�HA7"r•f::;:r.{}� 10-15-07 WISE & QUINN IN5 AGCY OfiNLV AN9D CON4FERS N!O RICaFITS UPONTFIE ICERTI�ICATE +449 PLEASANT 5T HOLDER, T�IIS CERTIFICATE DOES N10T ANBENID EXPEiVD OR ALTER THE COVERL40E AFFORDED®V TIE POLICIE�BELOW. ELO MA 02301 COMPANIES AFFORDIN r.COVERAGE 24WCB COMPANY INSURED A HARTFORD UNDERWRITERS INSURANCE COMPANY COMPANY FRASER CONSTRUCTION LLC B PO BOX 1845 COTUIT MA 02635 COMPANY C COMPANY {�.'.: +��.,:;�{`:::?n,.l�:;:�?}�}.{. �'•y,�:x.'f;r rr':}r;,•n 3;}�;n{..r::r+;9i::;c.::•,"...::u-:.r::,-- :,,.:...:.-r:,:.n�:n.;,•„n... r::•-.t 4f7,tic?.:.,r}::v"�...:., •{.r`:�..hk. .:.. ..;t};�..;`:•;;;:r.•••;•::;i.'•rix•..•.�•: ............::vrf%/j ::::rn:}.:v.irl::tirik{' h:::: ••rl: }r.} •.-•r} •:n{.:::r.:J:i}::r:•x?x:::•.:•}: i':.: AK{:...fin}}::rr4\+:i 3 r:.nW/.::t•{:• ::i•.n.,ht•. ....{.rn ry:i•..}:r:;:'.:n}}•:'..9 v:•:iv.;v::. .rv.3rn. .•f�f::?.n..tt}:i,>.r}::.-r::rn-:, r .?in ..x:n4•.v.C•-. ?vvY'.?:.,v..ri:}.}:v'4 THIS IS TO i . ?^:firs:•.:iaisUirirGt:,;,i:-?• `�';::<��t:::i;,r {?..,•..:•'• i.;;^>,:ct.,�•::,...+....<:.> :...r:.:t..:}...n??;i;:s.. .. CERTIFY THAT THE .....:.. ... POLIO ......u.n+n.:•r:v.+.�:::}•:•.r•:#:�•-rr--:t.ii'.'-i ;'f{:3 '\•r::;:'.:r;.:.`.:r.:}•? ?•r:`::i':•:':•`.:•,::r::}:::.:.:;.:.}•:;::f�:;;:':::::..::i:;:•;��:::::, IES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDnABOV...`.. f} ' "''" INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY O ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, IXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. C TYPE OF INSURANCE ILTORI POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE(MMLDDIVY) DATE(Bffi1DDJY1) LIMITS GENERAL LIABILITY . COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE $ ?X.'' ^' CLAIMS MADE 0 OCCUR. PRODUCTS-COMP/OP AOG• $ OWNER'S&CONTRACTOR'S PROT. PERSONAL SIAOV.INJURY $ EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ AUTOMOBILE LIABILITY MED.EXPENSE(Any one person) $ ANY AUTO COMBINED SINGLE ALL OWNED AUTOS LIMIT $ SCHEDULED AUTOS BODILY INJURY HIRED AUTOS (Per Person) $ NON-OWNED AUTOS BODILY INJURY (Per Acoldent) $ GARAGE LIABILITY PROPERTY DAMAGE $ ANY AUTO AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ EXCESS LIABILITY AGGREGATE $ UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ A WORKER'S COMPENSATION ARID EMPLOYER'S LIABILITY (6S60UB—085OL35-5-07 I 09-26-07 09-26-08 STATUTORY LIMITS THE PROPRIETOR/ : �''•s:�f:t'�:?::.�::?:;?: PARTNERS/EXECUT VE INCL EACH ACCIDENT $ OFFICERS ARE: X EXCL DISEASE—POLICY LIMIT g j OTHER DISEASE—EACH EMPLOYEE $ 500 000 � I i DESCRIPTION OF OPERATIOWS/LOCATIONS/VEH'CLES/RESTRICTIONS/SPECIAL ITEMS ------------------ I i I THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER A .....::.�::::.:};:.}}»:;:ss:::i:.:.:}:>:�}:.r:is�i:-:;.}:._.�.�:::::.ir•:::::::::::::::n.::::.;::::::.:�::::.�:::::::::.}:.�::n.:.�::::::::::.}�:::.:.�.�:-::::.�:.:_.;::.�....:-:-.::::.:.�::....-......... FFECTING ..........::::::n.:::::::;}i:.;:.::;:•ii}}:.}:.::>t:<:;:?;�:.:::<:}`:?.:;•i�!° �•9n • � •. . WORKERS COMP COVERAGE I' . .............::::..:r:,:•:_:;.:;.::;.r:;•r>:;:•:•:.:::;;:>::>.;::.:;::::;c:2i}r:;.::':>;sr::><•r;>:::z:s<:::<:•:;•rr<::>:<:::;}i•:?•:;;•;r>:iii:.i}r:{;�:.}:: :.:,i>:• SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE.CANCELLED BEFORE THE EXPNRA IION DATE THEREOF, THE ISSUING 1845 R I 5 E 5 LLC 10 DAYS WRITTEN COMPANY WILL ENDEAVOR TO MAIL ERASER NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE PO BOX 1845 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR C OTU I T MA 02635 LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTA I .:t�:::.;.::-:�::;•};.;.};.;,..r..+r•r:.�.}r:->:.>�.::.:>::.}�.}::.�.>::::.:�:::::.>�.>:.:?.;r:.;i:?:.}::.r:.:.iiiiiis}�::::.::::._.�:::.................. I— ................:.�.: :.:��:.>:.:.:;t:.t.i:?.i:<�:.i:.::..:.i:<;.}:.r:::<.i:.:.>ii:.i�:.:;.:;;;,.:.>:.ii::.:.:.:.:;.r;:.:.i>i:::::.i:;:�:.}:�::;;.r:.}�::.isi:;.:.:;;.::�:.::.iii}•}:.}:.i:.r�::.�:::.�:.............. a �®ardd o�_a- ding Stand 1;Zea. ed ��arw j.� i an -Boston A�&Ssac 1301 Home 02log 1-1 °apt®�AP91strati, FRASEp, C®i'��T Regiat-ation: 472536 � DEAN ®®® �E� �LJCTI®!�► Co. fie: SBA iration: 3/23I2009 Tee# 727820 ®Tur�-e MA®26as 13P8-Oq7IL d5 60AR pS/p9_f,C849� TgPdlate Agidx a e�andi retmm UPI ® ®fl�u�t --- - ❑ Renewal a an go.Cyr MEN g C®hf ®ant ❑ Lmt Card 9) �Oi t68n: MR L&Mwe or re gbtr&thMa 7 D9 before o]i��t[�a�$�Dtmd Use o.Uly the e: dB,a�t T-P 127920 ®��lala �g at, n �� > t®: USER CONSTRUCTION jd1 Ja®omy ®�� � 1301 DEAD{ FRASen 004, 4558 RT 28 � COTUIT,MA 02835 10T®t�gd(�a...t - I �, - AIL <�Ux Fraser Construction, LLC CONSTRUCTION Home ImprovementLlcense #112536 ROOFING & SIDING P.O. Box 1845, Cotuit MA. 02635 S Email: fraser construction@verizon.net 508-4Z8-ZZ9Z w ww.fraserroof M.com FAX 1-50$-42$-0123 RE-ROOFING PROPOSAL DATE: May 69 2008 NAME: Kyle Goldman PHONE: 408-395-7602 MAIL ADDRESS: 15276 Karl Ave. Aponte Sereno, CA 95030 JOB ADDRESS: 521 Old Post Rd. Cotuit, MA 02365 5 g_Y,�_T 3 70S EMAIL: kylegl@eardAink.net FRASER CONSTRUCTION hereby proposes to perform the follo services in a neat and professional like manner and in accordance with the manufacturer's specifications and local building code. -Remove and Haul away all of the old roofing material -Re-nail all plywood sheathing as needed. Supply and Install - CERTAINTEED LANDMARK /WOODSCAPE AR 30: 30-Year Warranty, 5 year Sure Start.Protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi- Layered, Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 10 Year Warranty against ALGAE Containment. 5 year 70 mph wind- resistance warranty or 5 year 80 mph wind-resistance warranty available with six nails is common bond area, for an additional cost. See actual warranty for specific details and limitations. P ' Color: f 4// � PRICE- i$6,695 house Initial PRICE- $2,010 garage Initial r Supply and Install - CERTAINTEED LANDMARK /WOODSCAPE PREMIUM: Lifetime Warranty, 10 year sure start protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, Laminated Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 10-year Warranty against ALGAE Containment. 10 year 90 mph wind-resistance warranty or 10 year 110 mph wind -resistance warranty available with six nails in common bond area, for an additional cost. See actual warranty for specific details and limitations. Color: PRICE- $7,895 house Initial PRICE- $2,370 garage Initial ZPossible Extra-After the shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation is not up against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood'sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$4.00 per panel including Materials & Labor. There are 6 Panels per sheet of plywood. Possible Extra-Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$55.00 per hour, plus materials, plus 15%overhead mark-up on total extras. FRASER CONSTRUCTION Warranties the labor for 12 years FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for,10 years. CERTAINTEED Warranties the shingles and labor 100%through the Sure Start Warranty duration. CERTA NTEED Warranties the shingles to be ALGAE resistant for the duration of the that was purchased. Warren depending on the shinglep Start g Sure S Warranty � Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: -------------- Home'dyiner Fraser Const c on, LC Assessor's office(1st Fbor): L � � r,, Assessor's map and lot numb / e4 u.E�'��I� ���� (l MUST�� C�THE 10 d �..'� � 9" OMPLi �' C �'�°� . Conservation(4th Floor) Board of Health(3rd flo 9 �K--O- ' 8�°L�5UBLZ Sewage Permit number ' � @l6 ®il ENTAL CODE AN f;o AU � rua Engineering Department(3rd floor): , "• s ® �" GULATIONS House number Definitive Plan Approved by Planning Board 19' APPLICATIONS PROCESSED 8:30-9:30 A.M:and 1:00-2-00 P.M.only i TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION yFOR'PERMIT TO GQ r , • TYPE OF CONSTRUCTION ' 0 0 19 I J TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the followi information: Locations L L 1 Proposed Use 1 l���� 4 Zoning District jar Fire District 2/ n 1 �a3 c�jqg ®�l Name of Owner 1 Address Name of Builder J Hn A M6 '9"- A Address Name of Architect Address Number of Rooms Foundation \(_K Exterior (tit )��� S 6A/G- Roofing Do '-,� Floors i_ts I r`)O Interior5 � Heating �— r.(l Plumbing Fireplace _ Approximate Cost � Area o Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable r arcing the above construction. Name Construction Siipervisor's License �� �'ALVOKli �-ANNE - i f No 34 9-5 Permit For REMODEL INTERIOR , - & Reroof/Single Family Dwelling - i. Location 521 Old Post Rodd Owner -Anne Alvord ` Type of Construction Frame j Plot Lot r Permit Granted `A„g„G t 'In 19 94 t i ; Date of Inspection: ! ` Frame * 19 _ } Insulation ! 19 - Fireplace 19 19 Date Completed ' 7 ' r >< TH TS - DEl':",1�:INNT O F �DUSTRIAl.ACCIDENTS V701U 1E—S COJMP1 _' -`— 1 )'� i'�'Sli1:-LACE AFFIDAVIT 1.1-1 co As (hCCnsee/perminec)with a principal place of busin ss/residcncc at: ,�e (City/Brno/Zip) do hereby ccrtif)•, under the pains and penalcies`of perjury, that: [ J I am an cmplovcr providing the following workcrs' compensation coverage for my employees working on this job. Insurance Company Policy Numbcr am 2 sole proprietor and have no one working for me. ( j ) am 2 sole proprietor, gene:v eontr2aor or homeowner (circle one) and havc hired the eontraaors listed blow who havc the following workcrs' eompcnsazion insu—,ana politics: Namc of Contrzaor insurance Company/Policy Numbcr N2mc of Contr2ctor lnsumncc Company/Policy Numbcr Namc of Contraor Insurance Company/Policy Numbcr 1 �m a nomco�ner performing all the �or1: myself NOTE-- Please be ,?:;-.131e homcowrers—ho eruploy persons to co rnainten=cc construction or repair work on : c' nsi ins of no: roor< th:. LnCc uniu in k�iCh the homeowner also resiccs or on the grounds appurtenant tbcrcto arc not gcncr.Jll• considered to be c-G?cycr: tz c r the G'or':crs' Cornpcns:tion Ac, (GL C. 152,:cc.. 1(5)). application by a borDcowncr for a license or peri-;i(r..:y eviccacc t^c ICEJ s"rus cf a-z cr✓plovcr unccr the Vorkcrs'Cornpecs:tion AeL I underst:nc that : copy of t'r•.is staterncnr wiU be forw::dcc to the Depa:trnent of Indusui:l Aeddenu'Olriee of Insuraner for eovcraze .•crifsc:uon Lnc th:: f:i!urc rc sccurc C.0,C tic :.s rceairec ur,ccr Sccrion 35A of MGL 152 e:n Iead to the imposition of_wminJ penalties cor.sis�nc cf: f,nc C. c S1�Q4.0C.(/or i-pr"z_lonmcr.t cf c- tc ccc)c:. :nd c per.Jocs L7 Lhc form of: Stop Work Orccr and : fmc of S l GG.GC'; c; :g :-I,: f C. Signed this < I�. U v QaY of LieenSce/Permlrtec Liansor/Pcrmrrtor r COMMONW EALTH DEPARTMENT FaJlurAtq OF OF PUBLIC SAFETY �aurient MASSACHUSETTS ONE ASHBORTO.K PLACE I6tassAah,tsrt:„; BOSTON,Ih: CodO/a cease fcr ate Bull nt 9 ©© 02108 �. o9tAJ8//�nss: ferocetlon ATE 1-S ENSr EXPIRATION C �;. OR RESTRICTIONS _ RESTR CT ONS g- tJhl£ EFFECTIVE Dg CAUTION TE LIC-NO. FOR PROTECTION AGAINST 474 THEFT, PUT RIG ME3 o PRINT IN APPROPRIATE THUMB SS ; T�I J r � P. -I G Rs F BOX ROPRIATE �'2_ -4 i_g ?r;1 3y'31 z•a� E:;HOtt— p ON LICENSE. PHOTO BLASTING Opq ONLh LASTING OPERATORS FEE: MUST INCLUDE HEIGHT: NOT VALID UNTIL SIGNED BV --- LICENSEE AND OrFICIALLy STAMPED.OR- DOB: SIGNATURE OF THE COMMISSIONER ' YS : I i J�l� n .,.-.— THIS DOCUMENT M l c 6 UST BE CARRIEDONTHEPERSONOF OTHERS-RIGHT TH THE HOLDER WHEN EN ATURE OF L NSE SIGN NAME IN F UMBPRII,R GAGEDIN THISOCCUPAT#EN. P1 {1lL-` SIGNATURE LINE - TONER _ ..... .. ✓/re i�ix�xveruie¢��,��aaaar�mw,!!a nuME :MFROVEMPU-Cu,'ITRA 7u6 k key"iS�raLiGfi 1042SE s if ;_xciration 07/13/94 T,cFas R. Morse Ruoce:ia'; 5� Toomas R. Morse : 4 Lakesl e Drive ADMINISTRATOR Sa.nEwic l M„ o2w: i. 1