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Home My WebLink About0315 VINEYARD ROAD � i � Vs�� . �, �� ' or Assessor's office (1st floor): - tst�/-S-- ��8 SEPTIC D,N COMPL ANCE CF THE t01� Assessor's map and lot number. .... ................. .... INSTALLED Board of Health (3rd floor): 6` ` WITH TITLE 5 .............. Sewage Permit number � .....6 ••••••• ENVIRONMENTAL CODE AND i EAaB9TADLE, Engineering Department (3rd floor): O r� TOWN REGULATIONS ,,o NAB& House number / �0 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 11 . ��?.11.G ..... :,YF�..�1........Qv,�r,��.t. .G. ...I................................................... TYPE OF CONSTRUCTION ...........: ?gz.S... ...:. ........... ....... .(.C� ��............................................... ........................... .........193,6- TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to t4e followivig information: Location ......4...0. ...C)..�.. ..'.................................. ........ ............ ...... �\C ...........Y\.Q�r ........ ................ e �' ProposedUse .....1. ..1!`P. t4.f'.. ..... .A?. . . .. .. ......................................................................................................... Zoning District .......... . ..............................................:.....Fire District ........ . ....... Name of Owner ...Q. .V.I.t�l..... .L! .!^I.1�1.i ,.l`..............Address .......l v . .......................................................... Name of Builder ....\�&..`.\.OV. .`1 .A!`......................Address Name of Architect ....Address .... _q. is Number of Rooms ...••L...........................................................Foundation .� ...... ..:. lX . Ck Exterior .. .... .... .. . A .. ......................Roofing ......... .................................................. Interior ..: Floors . ........................... :............................................... Heating .... .`.... Plumbing ....... Fireplace t........ Approximate Cost ...... . Definitive Plan Approved by Planning Board ________________________________19________ . Area .44.....�.. .. .!�.v........ 3-4 Diagram of Lot and Building with Dimensions Fee ,4J.7t.-- SUBJECT TO APPROVAL OF BOARD OF HEALTH 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. *3 Name` .....lJ .................. Construction Supervisor's License 5.k?......... SCA,54NELL, DAVID No 2Z918... Permit for .... wo Story............ .......Single. ....Fa Family Dwelling..................... ........................ . I Location ........Lot 49, 101OVineyard Road dr 1> Cotuit ►N . Own�r ...... David Scannell ......... Type-of Construction ...Fame ....r................. ................. .............. ............................. ................................ Plot ......................... Lot ................................ ti February 7, 86 Permit Granted .........................................19 Date of Inspection 5�9/71,?A.............19 Date Corn.pie� ecl ...19 an • 4 4C ft M 0 t; 5 cr ri 41 �y 145. Z \ ` 17 IN RICHARD _ 9 A BARTER Z!, � No:240480 FCIsTle h v 7-A447' Tf/.---)CZVA-�4T?oA✓ Lo6.47/CA/ / - SyOLi/� 2- 3-goo �Ec�U/.2E�s-lE.c/TS of T�/� Tow�t/aF � r54��A•r�-C /S_ x/a Zn 40CATE'1>. W17-,S//it/ T//E .CZ-OGiaoG4/.f! 2-3- I SATE. Tf/%S P,[-9Av/S iV:V7 ?ASE0 AAVf �2EG/STE.2EO L�.c/O SU.eY6Siar�� THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I A , m / �(C�"J LI DATA rr ,. ILI TOWN OF BARNSTABL - IT Is ��l (o JOB WEATHER CARD DATE 19 PERMIT NO. APPLICANT ADDRESS IN0.) (STREET) (CONTR'S LICENSE) PERMIT TO NUMBER OF (_) STORY DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ' ' AT (LOCATION) ZONINGDISTRICT (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: ` L AREA OR VOLUME ( ESTIMATED COST $ FEEMIT (C U B I �R-nENF�^E/E,fTI^�) OWNER BUILDING DEPT. ADDRESS BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED - FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT,FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ,ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBFINAL INSPECTION TI TO BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS THISI CARD SO IT IS VISIBLE FROM STREET BUI LOIN PECTION AP V LS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 3 HEATING 'NSPECTING APPROVALS REFRIGERATION INSPECTION APPROVALS Afr7 _ 13ARNSTABLE ; 2TT -H E R .2 V✓c/ ^r" 44 / J WC_RK SnAL_ NCT -IRO c D v`rT'L Te+E.- PERMIT WILL BECOME NULL AND VOID IF _ -'t- co i.'.R SAS WORK IS NOT STARTED WITHIN SIX MONTHS �'' "*" -, '�•� n a . -- RD // ti ERMIT IS ISSUED AS NOTED ABOVE.' 001 e ofTNE>o TOWN OF BARNSTABLE Permit No. ..... BUILDING DEPARTMENT Cash B°g;a TOWN OFFICE BUILDING ��cbur HYANNIS,MASS.02601 Bond ....... . CERTIFICATE OF USE AND OCCUPANCY Issued to DAVID SCAMIELL Address lot #49 101 Vineyard Roast, Cotuit L i 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. August7 19 86 ..... �! .............................. ................. . ............. Building Inspector y. ..ti TOWN OF BARNSTABLE BUILDING DEPARTMENT _ »ISTAU % TOWN OFFICE BUILDING rb 9 HYANNIS, MASS. 02601 �o r►r MEMO TO: Town Clerk FROM: Building Department 4 • DATE: OP An Occupancy Permit has been issued for the building authorized by BuildingPermit $ .......� ......................................................................... . ......_................................................_.. issuedtoo.................................................................................. ...» ..... _. ....... Please release the performance bond. . `' Town of Barnstable Building :P�.o...$'�et� =hH*ai.s��CxC edUn, �.3..:. ...K., � ? Vt Permit o'st �WPS eh Permit No. B-19-2328 Applicant Name: HOBSON, ELIZABETH P TR&LLOYD,ALICE Approvals Date Issued: 07/19/2019 Current Use: Structure Permit Type: Building-Shed-Residential-200 sf and under Expiration Date: 01/19/2020 Foundation: Location: 315 VINEYARD ROAD,COTUIT Map/Lot 015-007 Zoning District: RF Sheathing: Owner on Record: HOBSON,ELIZABETH P TR&LLOYD,ALICE Contrazctor=Name Framing: . 1 k Contractor License` A- 2 Address: 406 E ALAMEDA DRIVE TEMPE,AZ 85282 Est Proiect Cost: $0.00 Chimney : Description: 10x 16 shed �� Permit Flee: $35.00 t Insulation: <� Fee Paid s' $35.00 Project Review Req: 7/19/2019 Final: Plumbing/Gas ro pp vu n Rough Plumbing: 614 Building Official " Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within scgrrr onths after issuance. All work authorized by this permit shall conform to the approved application and thejapproved construction documen for w ch 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. x9 ` s Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the BuUdmg and Fire Officials arepro�ded on this;permit. Minimum of Five Call Inspections Required for All Construction Work:' 'a 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). 6.Insulation Low Voltage Rough:' 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" (asset forth in MGL c.142A). Building plans are to be available on site Fire Department All Permit Cards are the property of the.APPLICANT-ISSUED RECIPIENT Final: Town of Barnstable �rl ( EVE Building Department Services ti Brian Florence,CBO ■AMSTABLE. Building Commissioner #711414 9 Huss. 1/ 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT# FEE: $35.00 SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less no Q &A Ccn Location of shed(address) Village i _ (o IcT31 Property owner's rVe k Telephone number Size of Shed Map/Parcel # E-Mail YlA50Y) 511 e . Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? 6 You must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A, PLOT PLAN � r Q-forms-shedreg REV:08/6/17 O d 6 A`w2 • � in fir.�8 c�k 1 ole, I Ff 00 NO CAZ shed C� AN a^ �f. yf;• sj .•�-'t� a - £ a . LSw7G5'S IE'd ' , ee lwft CAPE COS INSULATION " 7175MYM7i SCA—ESS M TFOAM.7Y7 &Q - mnl YU fFiii WO TLQN C5141N0f 1-800-696-6611 ` 'l'uwn of Barnstable Rtgulatory Services Building Division 200 Main St Hyannis, MA 02601 d late: Dear Building Inspector - !'lease accept this Affidavit as documentation that Cape Cod Insulation, Inc. p4-rlbrmed _ completed the insulation and weatherization work at the property listed below,ICape Cori@ Insulation did this in accordance to the specifications listed on the building pejipit : - application. All work has been inspected by a cer[ified Building Performance listitute (BPI) inspector. All work preformed.meets or exceeds Federal & State Requirements. I'iupert T Qwnr' Property Address Vil 1_l,_ ��z • t�o�sv�, - 3/.s 1/i�cy� i�-,O �p'TZc�,�; iy�/l • lusulation Installed: .Fiberglass 'Cellulose 'R-Value Restricted -Unrestricted Ceilings Slopes Walls emo�i- Spoin,y f-, Att. Sincerely Fle ry L as y Jr, President (' ' e Coda . ulation, Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Vol OF MWEARN TABLE Ntap parcel ANNlicati�n Ob Health Division ?!1!1# AUG —5 AM n. 00 Date Issued N Conservation Division Application Fe Planning Dept. -- �.,x Permit Fee Date Definitive Plan Approved by.Planning Boaidt ` Historic - OKH Preservation/ Hyannis Project Street Address Jls. e z Village Co Z—&Z Owner �/j l'�Gi�1 AAo 'o.SG./ Address Telephone Permit Request �Z2 1IelaJ_; 9� f Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ��De�L, 4Construction Type��d��r Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 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 / e�' r �is/S��' Telephone Number 77,5--/ Z iV— Address ��,?� i �. l j� License Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �� f FOR OFFICIAL USE ONLY APPLICATION# tit DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE.OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL I GAS: ROUGH FINAL ' } FINAL BUILDING DATTE'.CLOSED OUT AS$Q-Q TION PLAN NO. t 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/OrganizadowTndividual): 14 �� - mac, /G, �,% �e •� Address:4- 2�, , City/State/Zi 4hone#: 41 Are you an employer? Check the appropriate box: 1. I am a employer with 4. [] I am a general contractor and I Type of project(required) -� 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 g• (] Demolition working for me in any capacity, employees and have workers' [No workers' comp, insurance comp. insurance.# 9. [] Building addition required:] 5. [] We are a corporation and its 10.0 Electrical repairs or additions 3,❑ I am a homeowner doingall work, officers have exercised their . 11.❑ Plumbing repairs or additions myself. [No workers' comp, right of exemption per MGL 12:❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no 3a.❑ I am a homeowner acting as a employees. [No workers' 13,0 Other1,t'./'�,� igeneral contractor(refer to#4) comp.insurance required] - 'Any applicant that checks box#i must also fill out the section below showing their workers'compensatio3'policy information. It Homeowners who submit this affidavit indicating they are doing all work and then but 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. II am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: %Yf�,i/7jL Policy#or Self-ins. Lic.#: />C,9a/,y S�l�G',l Expiration Date: Job Site Address: �/5� t/> � o /�G✓ �� yl - City/State/Zip'�� el 2- G S� 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 certify un the pains and penalises ofperjury that the information provided above is true and correct SignatmDate: Phone Official use only. Do not write in this area, to be completed by city or town official City or Town: PermitlLicense # Issuing Authority (circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector,5. Plumbing Inspector 6. Other Contact Person: Phone#; I V I FF r I AR CAPECOD-27 KLIGETT �-'" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS N6/1312014 O RIGHTS UPON THE CERTIFICATE HOLDER.HIS 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 Rogers&Gray Insurance Agency, Inc, NAME: Barbara DeLawrence Q4 Rte 134 PHONE _ iouth Dennis, MA 02660 (Arc No Exit;_ a/c No; 877?816 2156 noo less bdelawrence ro ers ra .com INSURERS AFFORDING COVERAGE t — INSURER A;Peerless Insurance COmpany NAIC# NS RED '- - I INsuRERe;COMMERCE INSURANCE COMPANY Cape Cod Insulation Inc INSURER C;Evanston Insurance Co p 18 Reardon Circle INSURERD;ATLANTIC CHARTER INSURANCE South Yarmouth, MA 02664 SURANCE GROUP INSURER E; - - ;OVERAGES INsuRER F; CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDREVISION ABOVE NUMBER:OR THE POLICY PERIOD I�DICIFICA NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH T C R;TI SIGNS MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, E Cj USIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY-HAVE BEEN REDUCED BY PAID CLAIMS. HIS �R TYPE OF INSURANCE POLICY EFF POLICY EXP X COMMERCIAL GENERAL LIABILITY POLICY NUMBER MM/DD/YYYY MMIpD/YY LIMITS 1 CLAIMS-MADE LX-J 3063 A�OCCUR CBP826 EACH OCCURRENCE $ 1,000,000 `- 04/01/2014 04/01/2015 YdFIII�� -- PREMISES(Ea occurrence) _ $_ 100,000 MED EXP(Any one person) $ 5,000 G N'LAGGREGATE LIMIT APPLIES PER: PERSONAL&ADV INJURY $ 1,000,000 POLICY I l JECT LOC GENERAL AGGREGATE $ 2,00.0,000 OTHER PRODUCTS.COMP/OP AGG_ $ 2,000,0Q0 AUTOMOBILE LIABILITY $ . COMBINED SING E LIMIT I ANY AUTO 14MMBCKVMK Ea acciden1L____ $ 11000,000 ALL OWNED X SCHEDULED 04/01/2014 04/01/2015 BODILY INJURY(Per AUTOS parson) $ _ AUTOS $BODILY INJURY(Per accident)HIRED AUTOS X NON-OWNED AUTOS AUTOS PROPERTY DAMAGE '— Per accident $ X UMBRELLA LIAB X OCCUR i $ EXCESS LIAR CLAII\jj AIDEXON,1453514 EACH OCCURRENCE $ 110001000 DED X RETENTION 10,000 04/01/2014 04/t)1/2015 AGGREGATE $ WORKERS COMPENSATION Aggregate $ 1,000,000 AND EMPLOYERS'.LIABILITY - OTH•ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WCA00525904 STAT TE ER OFFICER/MEMBER EXCLUDED? N/A 06/30/2014 06/30/2015(Mandatory in NH) E.L..EACH ACCIDENT $ 1,000,000 D SCRIPTIIPTION OF OPERATIONS below be under E.L.DISEASE-EA EMPLOYEE $ 1,000,00 DESC ? E.L.DISEASE•POLICY LIMIT $ 1,0001000 IRIPTION OF OPERATIONS I LOCATIONS r VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It more space Is required) Sers Compensation Includes Officers or Proprietors. do al Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder, I iTIFICATE HOLDER — CANCFI I ATIr1W *l uN a ' M:assachusetts -Depaftni�a'nt of P�1oft Safety a3loard of Building Regula;ons,and Standards Constntction Supetwisor •� .F. License: CS-100988 1-MNIRY E CASS11ft 8 S11ED.ROW WEST YARMOlM -1 0 ,,.. Expiration. Commissioner 11/11/2015 ` r - - Office of Consumer Affairs and Business Regulation 10 1'axlc P1aza - Suite 5170 i Boston Mas sachLtsetts 02116 I Tome Improvement Cogtra0or Registration ? Registration: 153567 Type: Private Corporation Expiration: '12/15/2014 Tr# 233831 CAPE COD INSULATION INC HENRY CASSIDY f:�: ,....:.:, , •: 18 REARDON CIRCLE ..1 ;..... ..: ----- . _---. ^._. SO. YARMOUTH, MA 02664 qIlx Update Address and return card, Mark rcasun for clrpage, Address Renewal ❑ Elliployment Lost Card - �<<% f(�U lil•IIt C.r/b[UG[[.(l!C *i'(�'((CJJCtC'I'GCGJ(iCt 01ficc of Consumer Affairs& Business Regulation License or registration valid for individul usu only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to, ' opistration: 153.a67 Type; Office of Consumer Affairs and Business Regulation _ xpiration: 1211-5/2014 Private Corporation 10 Parlc Plaza-Suite 5170 - "" Buston,MA 02116 'E c OD INSULATI.QN,,';, dC,. .. 41 VIZy CASSIDY ' lEA DONCIRCLI - YA MOUTi i, MA 02664 —-- — Undersecretary of Val' witho t nat re L _ ,x =` OWNER AUTHORIZATION FORM CIA b (Owner's Name) I ' owner of the property located at {Property Address} Co U i f= III ;6 -5-- (Prope y Address) ' 'Ca hereby authorize +i6r n s U [ahJ (Subcontr tor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Owner's Signature -Date 1