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HomeMy WebLinkAbout0027 GEORGE STREET :91 �� � -.4 REGISTRATION AND CERTIFICATION FORM FOR FORECLOSING/FORECLOSED PROPERTY y T Thank you for registering in accordance with Town of Barnstable Code chapter sections 224-3 and 224-4. Please complete one form for each property in forecl (section 224-3)or already foreclosed for which possession has been taken(section 4- N 4). Please file the original with the Building Commissioner and a.copy with the C of of -� the Fire District in which the property is located. 12 If you claim you are exempt from registering under Massachusetts law,please state L O� reason(s)and complete section 1 (property information)and the first paragraph of section 2(foreclosing party,court,etc. and foreclosing party representative,but not other representatives and attorney)so that the Town can review the exemption and update its records: Section 1 —Property Information Property Address: 27 GEORGE ST, HYANNIS, MA 2601 Assessors Map#: Parcel#: 291 088 Land.area and description Building(s)description and contents Occupied: Occupant(s)(if borrowers so state and include name(s)) _ Phone: email: other: Vacant: Date: Anticipated Length of Vacancy: Last occupant(s))(if borrowers so state and include name(s)) Phone: email: other: Has possession been taken If so,please explain and complete and file the maintenance and security plan form.(unless exempt as stated above) Section 2—Foreclosing Party Information Foreclosing Party(full name/title) PennyMac Loan Services Foreclosure Case Court: Docket# t Date filed:11/13/2018 Current Status: Foreclosing Party's representative(s)for property(entry,management,repair, etc.)(name,title,): Christie Anzalone (Bonvissuto) Company(if different from foreclosing party):Safeguard Address:7887 Hub Parkway,Valley View, OH 44125 Phone:80085283061922 email: other: If an exemption is claimed,please do not complete the remainder. Other representative(s)(if foregoing representative is primarily responsible for property and/or foreclosure and is most likely to be able to address town matters concerning the property and/or foreclosure,please so state and do not complete contact information(i.e."none"or"see above")). Name,title,other: Eric Moore Company(if different from foreclosing party):PennyMac Loan Services Address:27720 Jefferson Ave. Ste. 210,Temecula, CA 92590 Phone(s): 877-338-3791 email(s):propertyregistrations@bron other: Name,title,other: Company(if different from foreclosing party): Address: Phone: email: other: Attorney representing foreclosing Ply..............._..............__ Firm name(if different from attorney's name): Address: Phone(s): email(s): other: I acknowledge that the information provided is accurate and correct. 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"jy.e� ',�l I r t a •1F yeti�y' '' �� � ��� -Mon al CA as ffr. so �t MW main arm owl Igo IV rk Vi I. r *.i' -"¢` dry 1�► `� /� Rt+Al' k 1ri7. 3 i^ � •�� , ; ewe�~� '� � �•� b • Y i� T F no, 1� } TOWN OF BARNSTABLE MASSACHUSETTS BARNSTABLE BUSINESS CERTIFICATE OFFICE OF THE TOWN CLERK DATE RENEWED: 367 MAIN STREET HYANNIS MA.02601 DATE 03/22/2017 WED TIME 12:47 RENEWAL BOOK: RENEWAL PAGE: $2000 DATE DISCONTINUED: 03/01/5409 . BUSINESS CHANGE $2000 TOTAL $20.00 V06/2020 DISCONTINUED BOOK: 204 DISCONTINUED PAGE: 17-340 CASH HAVE A FANTASTIC DAY of Chapter Doe Hundred and Ten(110),Section Five(5)of the General Laws,as amended,the undersigned CLERK 1 000074 00000 ;conducted under the title below,located as shown,by the following named person,persons TIREIFICATE;INDICATES THAT THE NAMED PRSON(S)IS(ARE)DOING BUSINESS UNDER A�NAME" ONALzNAME(S)�ITt;DOES`NOTIMRLYTHATTHE'APPLICANT(S)HAS(HAVE)zM�ETAL'LLICENSE, � OPERATION OF TH S B S MESS ATTHE STATED LOCATIONEALTFiyAND CN3EnAFAIIRS GEORGE ST HYANNIS,MA 02601 27 GEORGE ST HYANNIS,MA 02601 THE ABOVE NAMED PERSON(S)PERSONALLY I EARE BEFORE M AND MADE OATH THAT THE FOREGOING STATEMENT IS TRUE. TITLE Identification Presented: DATE: March 22,2017 CONDITIONS: ADMIN OFFICE USE ONLY,NO CLIENTS, NO SIGNS ON SITE,ALL OTHER WORK TO BE OFF-SITE. MUST COMPLY WITH HOME OCCUPATION RULES AND REGUATIONS. FAILURE TO COMPLY MAY RESULT IN FINES. In accordance with the provisions of Chapter 337 of the Acts of 1985 and Chapter 110,Section 5 of the Mass General Laws,Business Certificates shall be in effect for four years from the date of issue and shall be renewed each four years thereafter. A statement under oath must be filed with the city clerk upon discontinuing,retiring or withdrawing from such business or partnership. Copies of such certificates shall be available at the address at which such business is conducted and shall be furnished on request during regular business hours to any person who has purchased goods or services from such business. Violations are subject to a fine of not more than three hundred dollars($300)for each month during which such violation continues. CERTIFICATION CLAUSE I certify under the penalties of perjury that I,.to the best of my knowledge and belief,have filed all state tax returns and paid all state taxes required under law. * ignature�,flndividual or-Corporate Name(Mandatory) By: Corporate Officer(Mandatory if applicable) Z ** or Federal ID Number * This license will not be issued unless this certification clause is signed by the applicant. ** Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or revocation. This Tyquest is made under the authority of Mass. G.L.Cha 62C,S.49A. YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates [cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town(which you must do by M.G.L.-it does not give you permission u must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601. (Town Hall) and get the Business Certificate that is required by law. DATE: Fill 'n pleas `•,,L,;�,:; ;�:.:.g,;,;i.N�;3�zw�, APPLICANT'S YOUR NAME S: _ (� .+,;A0 ,.:` BUSINESS YOUR HOME ADDRESS: iy+ki'.:..�"-.;:i.:7 �!' ,Z496.5f ,.y. '''`� TELEPHONE # Home Telephone Number 2-i s s'� . E I N #: E-MAIL: 1 S- NAME OF CORPORATION. NAME OF-NEW BUSINESS Q ' TYPE OF BUSINESS IS THIS A HOME OCCUPATION? . YES NO ADDRESS OF BUSINESS. 4,4 MAP PARCEL NUMBER [Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of . Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. (corner of Yarmouth ' Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your usiness in this town. 1. BUILDING COM ISSIO ER'S OF CE MUST C `MPLY WITH HOME OCCUPATION This individu I h e n info • e a y p rmit requiremerits that pertain to this type of businesRULES Ah D REGULATION. FAILURE TO COMPLY MAY RESULT IN FINES. Auto ' e Signa ** r COMMENT i d 2. BOARD OF H LTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: . 3. CONSUMER AFFAIRS [LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: Town of Barnstable �tME rqk, Regulatory Services o Richard V. Scali,Director STAK Building Division M'M Paul Roma,Building Commissioner �iOTEn r ° 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: rr Permit#: 2lJ HOME OCCUPATION REGISTRATION Date: Name: Cc—�Lm�t !/� Phone `JC7,Y—Z f--CS`� 2 Address: 1�-/l Al Ybi�AIAOZVillage: Name of Business:Tbk s g cka 1J L/ (V off W X Type of Business: A/1 IA.9 G' !12 -�-heta //,S� Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family.residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve-the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,.glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating.the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: Dili/ 1 n t(l� g( Date: Homeoc.doc Rev.06/20/16 Town of Barnstable THE T Regulatory Services °� do Richard V. Scali,Director TUNN OF ym,STABLE �. Building Division MAS& Paul Roma,Building Commissioner 19 i63q. �0 �1DTEn ° 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us }14.a I Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: 2 HOME OCCUPATION REGISTRATION Date: L Name: CELMOMIX- Phone#: -3 Z Address: -t 6r, 0 k 11- j111 V111!Air AW-0 illage: Name of Business: �Ab,,5 5(X'9 t gy Type of Business: R A.,S0,9. �n Q PIS� Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,.glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for,parking generated by such use shall be met on the same lot containing the Customary Home Occupation, and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with thee above restrictions for my home occupation I am registering. Applicant: d �/ 1n Il1X. PXi Date: Homeoc.doc Rev.06/20/16 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission u'•must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st Fl., 367 Main St., Hyannis, MA 02601. (Town Hall) and get the Business Certificate that is required by law. DATE: 4 Fill "n pleas :L °.'.•�Y��'F' APPLICANT'S �; �,,, YOUR NAME/S: � ''"`' '~ "'% LL)" .Y'' BUSINESS YOUR HOME ADDRESS: +1r4'Ur i'Tic-%i`.'a t,• Li;.;i i,."-.:ii�.`!' 'a TELEPHONE # Home Telephone Number 2 d7i J�i�L L 2J ii �' •:. �+,,.+m:. a+; E I N #: `E-MAIL: ' 1 .j•,..,; NAME OF CORPORATION: C NAME OF-NEW BUSINESS TYPE OF BUSINESS �Si IS THIS A HOME OCCUPATION? . YES NO ADDRESS OF BUSINESS. MAP/PARCEL NUMBER (Assessing) �I When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of ,• Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your usmess in this town. 1. BUILDING CDM ISSIO ER'S OF CE MUST CA�D MPLY WITH HOME OCCUPATION This individu I h e n in#o . e a y p rmit requirements that pertain to this type of businesRULES REGULATIONS. FAILURE TO Auto ' e S+gna ** COMPLY MAY RESUhT IN FINES: �V COMMENT i 0 _ l 2. BOARD OF H LTH S This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: 1 - Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 11/10/2014 Thomas Perry CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 RE: Insulation Permits Dear Mr. Perry This affidavit is to certify that all work completed for 27 George St(#201308118) has been inspected by a third party Certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey NOYSIA10 C id 'ZI Wd G I AU,l Nkt JO NO, *' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ,f Map a Parcel 0$ Application # Os 013 Health Division Date Issued I ' 2 C 3 Conservation Division Application Fee S Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address a:" G @. "E Village 4 40o is $ti ;np� `R �� Owner br Ctr0 Address Telephone 5 02 Permit Request Rid. '-1 9 ee11� *:p '4v- a4i c.. !:6 4e b vvnat� b ox SA1 - NJ, S 1- t- r_ loop, an A akmea+ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 35 Ob Construction Type Lot Size -Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure 6 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Cy ., Basement Finished Areas Basement Unfinished Area( qft.) (sq• ; m, c-j Number of Baths: Full: existing new Half: existing new C; Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Roo Count -� Heat Type and Fuel. ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detac,ed garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size._Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION ` ( (BUILDER OR HOMEOWNER) Name W 111VI k h ,C O r T Telephone Number 50$ 3 9 0 3 4g Address 4`Y IoA nAd rx t License # SQ L�A a�ynp�,-�h o d 9 Home Improvement Contractor# 3 Worker's Compensation # l kg C 33 5 31 0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO aCMo d��'1 SIGNATURE DATE 11 1 FOR OFFICIAL USE ONLY APPLICATION# t DATEISSUED MAP/PARCEL NO. ` ADDRESS VILLAGE OWNER DATE OF INSPECTION: ►JPFO.UNDA•TION>c..-?�z Lt,i,-Vi a _ FRAME JINS,ULATION__ - FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL I °3 FINAL BUILDING DATE CLOSED OUT e L v - ASSOCIATION PLAN NO. - rw [81 Housiin � Assistance kill Corporation Cape Cod HOMEOWNER I RESIDENT WEATHERIZ00N WORK PERMIT&FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM 1F YOU ARE THE APPLICANT HOME OWNER. 1 ��r'1 ie—k her r hereby consent to and agree that weatherization work maybe done by the Weatherization Program of Housing Assistance Corporation (he in after referred-as "Agency'°) on the property located at: The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather-stripping &caulking of windows and doors, Insulation of attics, sidewalls&basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows. In consideration of the weatherization work to be-done at my home I agree to the following: 1. 1 give permission to the"Agencf its agents and employees to travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. . I have read the provisions of this room • t as listed and freely give my consent. Home Owner. (Signature Date: Agent (signature) Date: h 1/ J 014, 1 HAC approved Weatherization Company : ('_.ro 1?, (5 ./ Adam T Incorporated All Cape Energy Alternative Weatherization Building Performance Contracting LLC , Cape Cod Insulation eCa!7��Sav�e Frontier Energy Solutions Lohr Home Improvement Resolution Energy i14--i',!i.:k{ii`•.f:fwS lyi.;g1;t:,>=_...a r_(..:?'>:�.::•>. :'i^•! _ ._..:f'.. .-. �!9.:.�.. Ada The Commonwealth of Massachusetts =� Department of Industrial Accidents �41- Office of Investigations I Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/organization/Individual):, Cape Save Inc. Address: 7D Huntington Ave City/State/Zip: South Yarmouth, MA 02664 Phone #: 508-398-0398 Are you an employer?Check the appropriate box: Type of project(required): 1. ✓❑ I am a employer with k 4. ❑ 1 am a general contractor and 1 6 ❑New construction employees (full and/or part-time).* have hired the sub-contractors 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 employees and have workers' working for me in any capacity. 9. ❑ Building addition [No workers' comp.insurance comp. insurance.+ 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] ,.❑ I am a homeowner doing all work officers have exercised their I LE] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL I2.❑Roof repairs insurance d.re uire c. 152, §1(4),and we have no required.] s employees. [No workers' 13.❑✓ Other Insulation comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. f'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. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Technology Insurance Company Policy#or Self-ins. Lic.#: TWC3353968 Expiration-Date: 04/09/2014 Job Site Address: Go(�S fi City/State/Zip: t�t �1 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 S 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. 1 do hereby certi under the ains and enalties o er' that the in ormation provided above is true and correct. Si nature: Date Phone#: 508-398-0398 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#: .4co CERTIFICATE 4F LIABILITY INSURANCE DATE(Mi1A1DDlY 10/22/201313 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 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 pollcy(ies) 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 endorsements. PRODUCER CONTACT NAME Colleen Crowley Risk Strategies Company PHONE (781)986-4400 FAX. No:(781)963-4420 15 Pacella Park Drive Spite 240 INSURER(S)AFFORDING COVERAGE NAIC# Randolph Phi 02368 INSURERA:Selective Ins. OF America INSURED jNSURERB:Safety Insurance Company 3618 Cape Save, Inc INSURER C:Technology Insurance Company 7 D Huntington Ave INSURERD: INSURER E: South Yarmouth Imo, 02664 INSURERF: COVERAGES CERTIFICATE NUMBER:CL13102268490 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 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER MPMOIDD EFF MM°nm EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY _PREMISES Ea occurrence $ 100,000 A CLAIMS-MADE a OCCUR 1994480 0/16/2013 0/16/2014 MED FRCP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 1 POLICY X PR D X LOC $ AUTOMOBILE LIABILITY BN D SINGLE LIMIT Ea accident 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED 6208200 1/6/2013 1/6/2014 AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OMX HIREDAUTOS X AUTOS ED PerraccidedDAMAGE $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION HIL S1994480, 0/16/2013 0/16/2014 $ C WORKERS COMPENSATION Officers Included for WCSTATU- OTH- AND EMPLOYERS'LIABILITY YIN X I T E ANY PROPRIETORIPARTNER/E)(ECUTIVE Coverage E.L.EACH ACCIDENT $ 500,000 OFFICERlMEMBER EXCLUDED? NIA (Mandatory In NH) 3353968 /9/2013 /9/2014 E.L.DISEASE-EA EMPLOYE $ 50(),0()0 If yes,describe under As OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Weatherization Specialists GL: Blnkt AI, Blnkt PNC, Blnkt WOS, Per Proj Agg, Per Loc Agg / GL Exclusions: Snow & Ice Removal/OCIP/Wrap Ups CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE •'chael Christian/CLC ACORD 25(2010/05) O 1988-2010 ACORD CORPORATION. All rights reserved. INS025(4o1om).o1 The ACORD name and logo are registered marks of ACORD u 9 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supers isor Specialty License: CSSL-102776 WILLIAM J MC C-LUSKEY,. s 37 NAUSET ROAD West Yarmouth NIA 02673 ° �..G.., J1 • ,; ;_��'° expiration Commissioner 06/28/2015 i 91te _ f Office of Consumer Affairs and eusness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 171380 Type: Corporation Expiration: 3/14/2014 TO 222184 CAPE SAVE INC. WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE - SOUTH YARMOUTH, MA 02664 -v Update Address and return card.Mark reason for change. --- - Address n Renewal Employment ❑ Lost Card )PS-CA1 0 50.M-04/04-G101216 -I ✓lee Consumer rr Affairs& a iness Regulation License or registration valid for individui use only �\ Office of Consumer Affairs&Business Regulation g Y �-HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 'tl- Re istration• : 171380 Type: Office of Consumer Affairs and Business Regulation - - 9 Expiration 3/14/2014 Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAp�SAVE INC.:'- WILLIAM MCCLUSKEY \ 7-D HUNTINGTON AVENUE-_ -_ SOUTH YARMOUTH MA02664 Undersecretary Not valid wit o signa '.�„< r,._a.,. sue..: t.r:i,y.r,`sn..,.r --;s.:".;;"'--r=l•^-v..y�� ..+^. ;"`t:{':r -,y �.rry Town..of Barnstable oFtMe ro,,,w Regulatory Services, Thomas F.::Geiler,:nirector + HARNSTABLE. \ MAss. Building,Division Thomas Perry,_CBO,`Bu lding Commissioner 200 Main.Street;-Hyannis;MA 02601 www.town.barnstable.nia.us ' Office: 508-862-4038 Fax: 508-790-6230 EXIT ORDER 1 DATE: f LOCATION: UNDER.THE PROVISIONS OF.780'CMR, THE STATE BUILDING CODE, SECTION 3400.5.1, YOU ARE HEREBY-ORDERED TO IMMEDIATELY, -DISCONTINUE THE USE OF THE:CELLAR/BASEMENT AREA FOR SLEEPING PURPOSES. LOCAL INSPECTOR SSIIGGNATURE.OF RECIPIENT ODEM DE SAIDA DATA: LOCALIDADE: DE ACORDO COM O PROVISORIO 780 CMR, CODIGO DE CONSTRUCAO DO ESTADO,.PARAGRAFO 3400.5.1,.VOCE ESTA ORDENADO•DE DEIXAR DE USAR, IMEDIATAMENTE,.A AREA DO PORAOBASEMENT PARA O PROPOSITO DE DORMIR. INSPETOR LOCAL ASSINATURA DO RECIPIENTS DATE: May 27, 2011 TO: Building File FROM: R Anderson RE: 27 Kitsy, 128 Bishops Terrace, 20 Kent& 27 George St—Hyannis CONDITIONS: Warm and muggy, first sunny afternoon in days 27 Kitsy, Hyannis Property has a sign indicating is under agreement (Margosells.com). Found 2 unreg trucks in driveway off of Bishops Terrace. One Chevy pick up parked on Bishops terrace commercial plate K95-283. House looks neglected. Didn't notice trash on this occasion. 128 Bishops Terrace, Hyannis Property located on the circle end of Bishops Terrace. Large garage—overhead door was open. Building materials were stacked on the side of the drive way. Property looks used and abused. No activity during afternoon 7.27 George Street,H����ni�iis�L Found evidence that several people reside here. Two driveways. Lawn mowers and trailers on left side driveway. Found older male tenant on bike just departing. He advised this is a single family and he is sole tenant. I left my business card and asked him to have owner call me. I said Tuesday would be fine as today is Friday (Memorial Day week-end). 20 Kent Street, Hyannis Found Two Brothers Flooring sign posted on front of lawn. Also noted another sign(exact sign) stored on side of house. Non-English speaking woman answered the door. I left my card. She stated her daughter speaks English and will have her call me- YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1st FL. 367 Main Street, Hyannis, MA 02601 (Town Hall). DATE: p Fill in please: APPLICANT'S YOUR NAME: BUSINESS YOUR HOME ADDRESS: 2,-1, TELEPHONE # Home Telephone Number: F.NEY1�AI_S._.O...r.L.....�,T.......y......._..._.�......r.,...t......._...A.r..n.4i....,.,.H.......l.',,..v..p.n.l..1...V....,.1_.........,r u...,1......4..U.�r..!...CS...,...L.. Ev....1�.v..r....5I.-1.....a....�_r.....L._... .. ....,.....;.....;,i.n._...r.I c.r.rr.r...r..,....,i.. ,.v.,„.....t.....,.,.,......a..,.......r....,;-.;.......,r,,r_...1...a....: ...r.:...,.�..,._.r.,..._r..v... .....:..,_.._.,..:_...u......_.......r.r ..:::............r......�...1,.....r....,... .r..... ......._. t.:...r......_i.;..':.,.r:..,.:_.:,...._U . ..., .... ............ ii........ ..:........... When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM IONER'S OFFICE This indivi al as ee i r of any y permit requirements that pertain to this type of business. Aut orized na ure** COMMENTS: a 2. BOARD OF HEALTH This individual has beep informed ofAbrepermit requirements that pertain to this type of business. thorized Si nature** ` COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AU O This individual hseen inf rimed of, I' a si requirements that pertain to this type of business. COMMENTS: Authorized Signature*"" ft Town of Barnstable Regulatory Services D�THE'Ip� Thomas F.Geiler,Director Building Division anaxsTAsIX, v 1MASS �g Tom Perry,Building Commissioner 200 Main.Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 508-790-6230 ADDrove Fee: �?s Permit#: ,2nne,-3&C'!2 HOME OCCUPATION REGISTRATION Date:10)n�s10 6 Name: 1 I MQ„ 1{-1S �,l�l if Phone#: 5� Address: 2;7,_6 e Village:���_�1 I __ ^ II —r r Name of Business: � _-Q U,Vl`YY� . u QCI.VI i 7 Type of Business:_,FZ cya jo i yo Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such-use occupies no more-than-400-square feet of space. - - - • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by.such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment.. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: /"` -Date: W-'0 3 -0O G Homeoc.doc Rev.5/30/03 Town of Barnstable Regulatory Services c= nF INE T Y c Thomas F.Geiler,Director r ' saxx Building Division M " 9� t639 Tom Perry,Building Commissioner i0rF0 39- A 200 Main Street, Hyannis,MA 02601 ' www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: .- Permit#: g I HOME OCCUPATION REGISTRATION Dater I Name: - .���C'.�'c`n�-� '� Phone#: �50 D 0-�, © 0ZCp Address: a-+ GtC)Q ,-t= 1! Village: t- S Name of Business:--- ---I,!_3sv(-Q ----G_Q -------------------------------- Type of Business: � y V'3 A"L L- Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation, other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. 1,the undersigned,have read and agree with the above restrictions for my home occupation I am registering.J Applicant: Date: L /0`/0 r Homeoc.doc Rev.&97--� TO ALL NEW BUSINESS OWNERS DATE:12,102 Fill in please: 041 RAW, MCMC4 APPLICANT'S � � YOUR NAME: BUSINESS 3� ;��� YOUR HOME ADDRESS: -Q-A TELEPHONE 6 Telephone Number Home o -1`?S 0 7 NAME OF NEW BUSINESS AL O TYPE OF BUSINESS A)N w P,L( IS THIS A HOME OCCUPATION? Y.S NO Have you been given approval from the bui in ivn? YE NO ADDRESS OF BUSINESS cr O � nh MAP/PARCEL NUMBER �� 5-8 When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the.required signatures, listed below,you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall). You MUST go to the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St. - (cor r. f Yarmouth Rd. kinStreet) and you will find the following offices: 1. BUILDING C MI IONE S OFFThis individual h s be infor of an peme s that pertain to this type of business. on Signature** " COMMENTS: 2. BOARD OF HEALTH This individual has been•informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: Business certificates (cost for 4years). .A business certificate ONLY REGISTERS YOUR NAME in the town (which.you must do by M.G.L. Buie ( -it does not give you permission to operate-you must get that through completion of the processes from the various departments involved. **SIGNIFIES APPRO VAL FORA BUSINESS CERT/F/CATEOft Y. 1 Assessor's office(1st Floor): Assessor's map and lot number i� e��l� ' ova o �-�l1 O�THE>O Conservation �� 4 Board of Health(3rd floor): _ >; Dea'sr�Dtc Sewage Permit number IL Engineering Department(3rd floor): ° 39 House number �o rsr Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE I BUILDING INSPECTOR APPLICATION FOR PERMIT TO v' RE ROOF ' TYPE OF CONSTRUCTION _ Sj ngl p_ fames;—racj r1anti al 5-20-93 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 27 George G Proposed Use ^� Zoning District Fire Distn t Name of Owner✓Peppy Davis Address E Draper Ayra Westuiaa/D Ma 02090 Name of Builder i/Jack Maenpaa Address �9 Cant Rrl Maretons MT1 1 Man 648 Name of Architect Address Number of Rooms Foundation I Exterior Roofing - Floors Interior y Heating Plumbing Fireplace Approximate Cost +-"2000.00 Area #/" Diagram of Lot and Building with Dimensions Fee y ' OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re arding th above constructi Name 7 Home Improvement Contractor #104683 Construction Supervisor's License 8246 t DAVIS, PEGGY 35892 RE-ROOF ye ;G No Permit For Single Family Dwelling Location ' 27- George Street 'Hyannis Owner ` Peggy Davis Type of Construction Frame Plot Lot Permit Granted May 21 , 19 93 Date of Inspection 19 = Date Completed 19 Assessor's map'and lot number ...... .L......)..Z?...... .. Swage Permit number ........�` '.. !s� .., .... '��`' a U ?"ET°�� TOWN OF BARNSTABLE BARNSTADLE, i "6 9 ,•� BUILDING IN" PECTOR 4 }. APPLICATION FOR PERMIT TO. ......r�-`�.�S�.O. ... . .................................................... TYPE OF CONSTRUCTION ............:............ ' H... .. ..5A...................19.14 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........!;z ..� ..... ,...... 14.40 .M-1,..1........................................................................ ProposedUse ................. ...... .................................................................................................................................................... ZoningDistrict .........................................................:..............Fire District ................... ....... !.�-5................................ Name of Owner .. � �.P.105.Acldress .....:;.I........... Name of Builder - r' � �`� ...kw'r.� �.�� .......Address ` ..v.l ......... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ................................1..................................Foundation ..........�..............,............................................................ Exierior ..... 1 ............................Roofing ..........`o� �.�.JQ1..1 ........................................ Floorspl.C.�................................................Interior .... ... :'eok.........................:................... Heating ..... . ....................................Plumbin .................................................................................. bco Fireplace ....Approximate Cost ................ Definitive Plan Approved by Planning Board -----------_-------------------19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. D, Name .. ��%�? .......� Freedman, Robert A. , D.D.S. No ...17113 Permit for ......r . ... emodel garage ........ ...... ............ to 1st floor ............................................................................... 27 George Street Location ...........i..... ............................ .............H�'annis.................................... Owner ...............Robert A. Freedman, D.D.S . �► - .................................................. frame Type ofjConstruction _ ........... ..............................................6.......6........ Plot ............... Lot ................................. �• 1. �1 Permitl.Granted 3 7 Ma 1 19 �! +' S R Date of Inspection .. ...... r.......................19 ' ' Date Completed 2k&l ¢ PERMIT -REFUSED ........ .� - 19................................................. ' ............................................................................... .......................................................... .. ... ....................................................... ..............r•.. ... , i Approved ................................................. 19 ............................................................................... ......................................................................... a Assessor's map and lot number ......;.. )J..... ......... . 'A Sewage Permit number ........ j °%T"ET TOWN OF BARNSTABLE t BBSBSTAME, i 16 9 BUILDING INSPECTOR o war APPLICATION FOR PERMIT TO ......re`� U. .l�-- - ate. �".�`' .............. .v. ................................................... TYPEOF CONSTRUCTION ...................................................................................................................................... ..... ��. ..:5..1....................19.4 TO THE INSPECTOR OF BUILDINGS: w The undersigned rh�ereby applies for a permit according to the following information: ................................... Location .........q... ......... -' .� .....� I.1....... .....I �'.r . ? ..... .:.. ..................................... ProposedUse .......:........ ...... .................................................................................................................................................... Zoning District Fire District .................. �dtS ........................�.......... 1 ................................. Name of Owner .C� .,.1�1.:. �' E'CX Lt'�.,b.V�.Address �9 !. :..;.. ........ ...4.... J Name of Builder -�-. ��. Q .. ..: .).� C.{�:........Address ......... 1..� A.......................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation ..................................i......:....:................................ Exterior ....(..A......C..�..(.. ....``��►Y1 Ve ......Roofing ....r.I.CA,�'C`:...............................................................Floors ..........(:: :r.t��.:�.................................................Interior ..���`��.�.I�?d;, t Heating .......S... .................:::.......................................Plumbing .................................................................................. /Ij U 0� Fireplace ..................................................................................Approximate Cost .................................................................... Definitive Plan Approved by Planning Board ________________________________19________. Area ..................................:....... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH G � b , I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Freedman, Robert A. D.D.S. 6 No ...1 3... Permit for ......remodel garage to 1st floor ............................................................................... Location .......27..George Street ....................... ......................RY..annis........................................ Owner .......... obert. A.: Freedman. . . ,... . . ...... .... ` Type of Construction ...............Igarage.............. ................................................................................ Plot ............................ Lot ................................ Permit Granted ............4y...31...............19 74 Date of Inspection ....................................19 Date Completed 19 PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... (� ✓fee�Joow'xanwea�C o�./�amuc�euoeCla �\ OM: TMPFOVE. CONTRACTOR R6gis.ratiorl 10468' INDIVIDUAL rx'viiation 07i15/94 ¢Zllef4o [s^^—Y wildNi3ciluza ;5 Captain 5tuG kGau ADMINISTRATOR 04 Gls�cn Nli_. COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY OF 1010 COMMONWEALTH AVE. MASSACHUSETTS BOSTON,MASS.02215 lit ENCLOSE CHECK OR MONEY ORDER ' A LICENSE EXPIRATION DATE CONSTR. SUPERVISOR FOR REQUIRED FEE, 06/30/1993 MADE PAYABLE TO RESTRICTIONS ° EFFECTIVE DATE LIC NO."" ° NONE o ;,6/30/1 ,��e1 ! Z8z4c5 = ' "COMMISSIONER OF PUBLIC SAFETY" JOHN W MtAENFAA JR (DoI fA ,!`JYASH). 35 CAPTAIN STUDLEY RD MARSTO` S MILLS MA 0264P EASE NOTE FEE INCREASE PHOTO(BLASTING OPR ONLY( FEE: APR J 100.00 E FECTIVE F��F+\\8{��)1 1589 HEIGHT: NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY �.)+F�o + STAMPED OR-SIGNATURE OF THE COMMISSIONER ✓ y�_ " y�0 NOT DETACH LICENSE STUB THIS DOCUMENT MUST BE NATURE LICENSEE « .SIGN:NAME IN,FULC-ABOVE SIGNATURE LINE CARRIED ON THE PERSON 01 THE HOLDER WHEN ENGAG !%��j�:' t�. S• - - OTHERS RIGHT THUMB PRINT ED IN THIS OCCUPATION. h;.'-r C. L'$/f,,, COMMISSIONER " • t 20OM-2-87-81429 '