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Sheet Metal.Permit 1VIap� Parcel Date: 11/18/2014 W P RE S �)FERM I Tpormit# Estimated Job:Cost: $ 23.000.Q0 MAY 12 2014 Pe-='t.Fee::$ 85.00 Plans Submitted: YES.. N0 Plans Reviewed. s NO TOWN OF BANUM&nse Business License 4 1292 #` Business'Information ` Property Owner./Job.Location Information: Name: Rusty's Inc Name: Amanda Kundel Street: 222 Mid-Tech Drive Street: 46 Bow Lane City/Town West Yarmouth, MA city/Town: Barnstable, MA Telephone. 508-775-1303 Telephone:. 508-360-7364 Photo I.D. required/Copy of Photo I.D. attached: YES NO Staff Initial X1/M-1-unrestri6ted license J-2 I M-1=restricted to'dwellings 3=stories or less and commercial up to 10,000 sq. ft. 2-stories or less Residentiak 1-2 family Multi-family Condo l Townhouses Other Commercial: Office Retail Industrial Educational Fire Dept.Approval, Institutional_ Other Square Footage: under 10,000 sq.,ft. . over.10;000.sq. ft.:., Number of Stories; Sheet metal work to be completed. New Work: Renovation: HVAC Metal Watershed Roofing, Kitchen Exhaust System Metal Chimney(Vents Air Balancing .Provide detailed description.of work to be done: Two (2) Complete Gas-Fired Heating and Cooling Systems Barnstablerr I own of Regulatory a ices ' Thom"F.Geilbr,(Director d��` u ldi g slon. Tom Derry,Buflding.Commissiouer 200 Main Street,Hyannis,MA 02601 www.town.barnstablems.as Office: 508-862-403$ .Fax: 508-790-62io Property Owner Must 'Complete and Sign This Section If Usirw, A Builder I Amanda Kundel as C}cvner of the subject property` hereby authorize WEuSty'S Inc. to act on ray bei . in all smatters relative to work authorized by this building pezxnit 46 Bow Lane Barnstable, MA (Address of job); **Pool fences and alarms are the responsibility of the applicant. cols are not to be fiRed.beforevience,'s:instaUed and fools`are not to be utilized unt l all,final inspections are performed and accepted. Signature of met Signature of Applicant Print Name Print Natne si ry Date WO RM&OWNERPERMSlOrtrooLs DIME Town of Barnstable *Permit I Expires 6 s fr issue date a PERMIT Regulatory Services Fee �STABM 9� S. 16� � Richard V. Scali,Interim Director 7 2013 Building Division Tom Perry,CBO,Building Commissioner TOWN OF BARNSTABLE 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X--Press Imprint Map/parcel Number G j'C 02 Property Addressj j g Cam: ZResidential Value of Work$ ,-),z0V Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address % /9/-,'I S4,/ ✓ w A'6 /61 17A y Contractor's Name 0,,J ZV:k_ Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑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# 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 ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: f Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *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 re red. ty SIGNATURE: / Q:\WPFILES\FORMS\building/pe it forms\EXPRESS.doc Revised 061313 L 11 I I ally' / � L/ s � �� l.s'k/8 SMOKE DET CTORS REVIEWED �I Yf7—�� BAR NSTABLE BUIL ING DEPT. DATE FIRE DEPARTMENT DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITING I ' ey1-z� WON w L_ 6 A.M. , / - inoee Zcv 0,Tr<vz T,,, 1.V-S-ems e,,l 6 I ' �Il � li t 11 �l a 13 s I�' f i flk /3A rl4 «'k -6 x .6 r r } FTHE Tp� Town of Barnstable Regulatory Services 9anxxMw�srEg Thomas F.Geiler,Director 16)q,- Building Division Tom Perry,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 as Owner of the subject property hereby authorize //(�� ���P���•o S to act on my behalf, in all matters relative to work authorized by this building permit &V-.) Z"10 10/l, (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner. _ __._ Signa e f Applicant. litJ�� � S jitJ) /o'/ Print Name Print ame Date QTORMS:OWNERPERNOSIONPOOLS 62012 g�pgIHE Town of Barnstable .- �3 Regulatory Services nnRtasMBLE, MASS. g Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTIO DATE: J� Please Print �,(., JOB LOCATION: L -Yo"?w 5/9d numbb/er,, / s / street village ,•HOMEOWNER": Gi/I/_, j14-�9 .SGc/ i name �r home phone# work phone# CURRENT MAILING ADDRESS: ,00 C' u�_16)) city/town Cnd te zip code The current exemption for"homeowners"was extended to incl -occu ied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not osse,provided that the owner acts as supervisor. DEFINTr EOWNER Person(s)who owns a parcel of land onwhich he/she resides o reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to s /or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowneomeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be res onsuch work per-formed under the buildingpermit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for mpliance ith the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she and stands the Town o-Barnstable Building Department minimum inspection procedur-s and Te ' and that he/she will compl with said procedur and requirements. Signa re ofHomeo Approval of Building Official Note: Three-family dwellings containi g 35,000 cubic feet or larger will be re uired to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "any home caner performing work for which a build' ermit is required shall be exempt from the provisions of this section(Sectio 109.1.1-Licensing of construction Supervisor ;provided that if the homeowner engages a persons)for hire to do such ork,that such Homeowner shall act as supervisor. Many homeowners who use is exemption are unaware thai they are assuming the re onsibilities of a supervisor (see appendix Q,Rules&Regulatio s for Licensing Construction Supervisors,Section 2.15) Th lack of awareness often results in serious problems,panic arly when the homeowner hires unlicensed persons. In this ca ,our Board cannot proceed against the unlicensed pe son as it would with a licensed Supervisor. The homeowner actin as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities requ're,as part of the permit application,that the hobaeommer certify that he/she understands the responsibilities of a Supervis . On the Iast 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. (( C:\Users\decollikV,ppData\Local\Ni osoft\Windows\Temporary Intrmet Files\Content.Outlook\QRE6ZUBN\EX 1RFSS.dcc Revised 053012 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1 Map ; Parcel Application #_-�)®� 3O c + - Health Division Date Issued Conservation Division Application Fee U Planning Dept. Permit Fee �' 3 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 416AUW Z_/va/l Village Owner 40W LAM1 12444 MOS 1 Address,/0 OAO)o Telephone Permit Request /d12 112,16n, /WA/0U 4)5!OJ0S {2/�"/''101�b . .�/rlWAelo 64,�G4/2,ot�M � Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation'A VO Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting ciocuo4ntation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) ® o C Age of Existing Structure _16 U o Historic House: O,Yes ❑ No On Old King.-"9 Highways❑Y63 ❑ No x , va Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other _ Basement Finished Area (sq.ft.) Basement Unf nished Area (sq.ft) a Number of Baths: Full: existing L new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing /Z new First Floor Room Count Heat Type and Fuel: 1AGas ❑ Oil ❑ Electric ❑ Other Central Air: O,Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ nbw 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.;�i/L1.JiS1/'9 .Sl cal rs I Telephone Number V�� 6-7Z,6-7y/L Address �064II_N-G /06 License # �3'f�/L14.S V,6U,� AA 076 -36) Home Improvement Contractor# �� O �GSt�T�GU�tG�EIS�•/V� 7J Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO /'Uliiy O)S'60wted SIGNATURE DATE r FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. Fr ADDRESS 9 ' VILLAGE OWNER DATE OF INSPECTION: FRAME F A, INSULATION,-, t,: FIREPLACE J ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: _ ROUGH- FINAL FINAL BUILDING2 DATE CLOSED OUT ASSOCIATION PLAN NO. i - Town of Barnstable Regulatory Services AM Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 w•r�rr.towu.'v a:�st�ble.ma.u.� Office: 508-962-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION / Please Print DATE: `�"'�`7"�� JOB LOCATION: / b "6a4i ZAXI_� 6Qa±Va7_41 t9 number street village "HOMEOWNW: �t/1WAI7 67)6-7L4-741/Z_ name yy�� home phone# work phone# CURRENT MAILING ADDRESS:---/`/J: 10.131)_x ZQ 6 �loS71A' d&)4 , 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 hue 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 twoo-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 prose Ores and requirginepts and that he/she will comply with said procedures and requirements. S' atune 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. C:\Users\decollildAppData\Local\Mierosoft\windows\Tempormy Internet Files\ContentOutlook\QRE6ZUBNIEXPRESS.doe Revised 053012 Town of Barnstable Regulatory Services MASS Thomas F.Geiler,Director 6; c61, Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-962-4038 Fax: 508-790-6230 Property Owner ust Complete and Sign T 's Section If UsiM A B ' der as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authoriz by this building permit (Ad ess of J ) **Pool fences and ala s are the respon 'bility of the applicant. Pools are not to be filled or u 'zed before fence i 'nstalled and all final inspections are perfo ed and accepted. Signature of Owner Signature of Applic t Print Name Print Name Date QTORMS:OWNERPERMISSIONPOOLS 62012 04--18-2006 1 1 :47 Ctf T e 1798,32 BARNSTABL.E LAND COURT REGISTRY DEED WE, WILLIAM P. SWIFT and HARRIETT J. SWIFT, husband and wife as tenants by the entirety, now of 46 Bow Lane, Barnstable, MA 02630 for consideration of less than $100 grant to WILLIAM F. S IFT. an WENDY S. LaPINE, Trustees of Bow Lane Realty Trust u/a/d 2006, recorded as Document No. 1 , C�31 t0 5 with an address of 101 Deacon Court, Barnstable, MA 02630 with QUITCLAIM COVENANTS, the land, together with the buildings thereon, situated in Barnstable, Barnstable County, Massachusetts, described as follows: LOT A Land Court Plan 15234-A LOT B-2 Land Court Plan 16447-A LOT 2 Land Court Plan 16447-B Subject to and with the benefit of all rights, rights of way, restrictions, reservations or easements of record. In making this conveyance,.the Grantors reserve the estates of homestead created by Declarations of Homestead recorded as Document No. and Document No. ! Property address: 46 Bow Lane, Barnstable, MA 02630 For title, see Certificate of Title No. 13772 at the Barnstable Land Registration Office. WITNESS our hands and seals this 13th day of April, 2006. William P. Swift Harriett J. SAgift � v a 4 -ti- ��7 j,-eoc vY�-t'��. � s� S f Do._: 1 s 229 r 762 . a e;-30-2013 10:r5 • * BARNSTABLE LAND COURT REGISTRY BARNSTABLE TOWN Town of Barnstable Zoning Board of Appeals '� .01- 23 P12 .33 SIX MONTH EXTENSION Appeal 2012-046 - Bow Lane Realty Trust Additional 6 months to execute lot shape factor, contiguous upland, and setback variances Summary: (le5sidenceSFx-2'District d- i onth Extension Petitioner: F. 'ft & Wendy S. Lapine,Trustees of Bow Lane Realty Trust Subject Properties: Lane 1758 Hyannis Road, Barnstable Assessor's Map/Parcel: 99/053 Zoning: Recording Information: Variance 2012-046: Doc. 1,201,926 Deed: Certificate 179802 Land Court Plan: 15234-A (Lot A); 16447-A (Lot B-2); 16447-B (Lot 2) Background On August 22, 2012, the Board granted William Swift and Wendy Lapine, Trustees of the Bow Lane Realty trust variances to re-divide approximately 4.0 acres of land into two residential lots, one of which will contain an existing homestead. Relief was granted from §240-7.E,which requires all lots to have 100% of the minimum lot area as contiguous upland; §240-7.D Lot Shape Factor requirements for one of the proposed lots; and §240-11.E to allow an existing barn to be located 7.4 feet from the proposed lot line, where a 15 foot minimum setback is required. A letter from the attorney for Bow Lane Realty Trust was received on June 28, 2013 requesting a six month extension of Variance No. 2012-046. The request was received within one-year from the date the decision was filed. In accordance with MGL Chapter 40A§10,the request was considered by the Board at a public meeting on July 10, 2013, within 30 days of receipt of the extension request. On July, 10, 2013, the Board acknowledged the extenuating circumstances that prevented exercise of the variances and voted to grant the six month extension. Motion At the July 10, 2013 meeting of the Zoning Board of Appeals, a motion was duly made and seconded to grant a six-month extension of Variance No. 2012-046. The extension shall take effect on August 31, 2013 and shall extend the time limit for exercising the variance to February 28, 2014. The vote to grant the extension was as follows: AYE: Craig G. Larson, Brian Florence, William H. Newton, George Zevitas, David A. Hirsch NAY: None Ordered A six month extension has been granted for Variance No. 2012-046. If this variance is not exercised by February 28, 2014 it shall ex . ems sion shall be recorded at the Barnstable County Registry of Deeds to be in ffec 2 g a' arson, air Date igned I, Ann Quirk, Town Clerk of the Town of Barnstable, hereby certify the filing of this extension in the office of the Town Clerk. r � Signed and sealed this day of 'and penalties of perjury. a4. � o AGnxQq r�Cf2�i �'�k L(Ifk• ---,f;--_------------- �, rs'NS T AM E COUNTY BARNSTABLE REGISTR'>! OF DEEDS '��s•. MASS. A.-jIR Sr Y�=`-TES © 1��9, `�`o�i ?�U :CC)FY,A?T�ST +, A �v� pp pp '�• ` i r `° Autter Eliza Cox Direct Line: (508)790-5431 Fax: (508)771-8079 E-mail: ecox@nutter.com September 5, 2013 #110556-1 Carol Puckett, Clerk Town of Barnstable Zoning Board of Appeals 200 Main Street Hyannis, MA 02601 Re: William F. Swift& Wendy S. Lapine, Trustees of Bow Lane Realty Trust Six Month Extension—Appeal No. 2012-046 Dear Carol: Enclosed for your file please find a copy of the Barnstable Zoning Board of Appeals' six month extension for the above-referenced matter that has been recorded at the Barnstable County Registry District of the Land Court as Document No. 1,229,762. Thank you very much. Very truly yours, Eliza Cox EZC:cam „� Enclosure +' cc: Tom Perry, Town of Barnstable Building Commissioner(w/encl.) Art Traczyk, Principal Planner, Town of Barnstable (w/encl.) — ' Bow Lane Realty Trust (w/encl.) 2249760.1 NUTTER McCLENNEN & FISH LLP • ATTORNEYS AT LAW 1471 Iyannough Road • P.O. Box 1630 • Hyannis, Massachusetts 02601-1630• 508-790-5400• Fax: 508-771-8079 www.nutter.com TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map G` Parcel y9 Permit# �IL2° Id Health Division Date Issued �r Conservation Division Fee_ cX� Tax Collector '- " I I i A 1. t\ %OM A4 n Treasurer l 1 Planning Dept: Date Definitive Plan Approved by Planning Board 1 .Historic-0 reservation/Hyannis Project Street Address Village9�.}��S7i�131 Owner lJ/LZ✓/4/7 /d S'6V,1)P'7 Address _yd YdAJ L4AV'�(A Telephone 6_06.36Z- 36 yy Permit Request -1�60}� �.S%JZ>�' `l � � S'V^d COLO�'1., 'lock ZZ Lo Gr,�i6 • � S J .o � <SJ`�6 Square feet: 1 st floor: existing . proposed 2nd floor: existing proposed Total new Estimated Project Cost �' Zoning District Flood Plain Groundwater Overlay Construction Type 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: V 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 BUILDER INFORMATION Name 69,0W /,VzQ0 "_( g,4LC. Telephone Number cL`D6' ZcS' -M0 Address /rIA_C(4 S61�'t�, /L6/d0 License# Oo 2 6V s ,�j�A/`l. / 4, 0 Home Improvement Contractor# /GOJ/O Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 9"Z7`, 9 0 • FOR OFFICIAL USE ONLY " P&M&NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER,-. " -DATE OF INSPECTIOI\T ;. FOUNDATION r: FRAME ` INSULATIONt ' FIREPLACE ELECTRICAL: ROUGH FINAL '` f PLUMBING: ROUGH FINAL , .0 GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT r ASSOCIATION PLAN NO. , C The Town of Barnstable Department of Health Safety and Environmental Services bro, �►�` Building Division - 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building'Commissioner 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. Type of Work: /�.�j,�0<Il!/X� Estimated Cost S ZGO-- Address of Work: 4?,9/z VS2�13 V Owner's Name: Date of Application: 99 2'y 9 I hereby certify that: Registration is not required for the following mason(s): Work excluded by law blob Under S1,000 Building not owner-occupied E30wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MWROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. 9 Date Contractor Name Registration No. OR Date. 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