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HomeMy WebLinkAboutBLD-19-002608 . ~p4'Y91;- a se Only, .! ,/ '�'Ag ! 0 � f/126,9166; ••,O ' .1 H; AmountP. , I v. Permit expires 180 days from . #issue date I EXPRESS BUILDING PERMIT APPLICATIOWt E C E I V E D TOWN OF YARMOUTH Yarmouth Building Department ICI 30 2018 1146 Route 28 r. ip est South Yarmouth, MA 02664 B IL:N DEPART .. e of 9Y ck.-/ /(5508) 398-2231 Ext. 1261 A CONSTRUCTION ADDRESS: 73 4 a- /LW./ g ' S ec1- Y � Olo-rr o uof"& ASSESSOR'S INFORMATION: • Map: <7, Parcel: s/ OWNER t%1_ RD lib/' NAME�, ,"P"RESENT ADDRESS n TEL I# �COONNTRACTOR N /a C a WomeT{/I GADDdRESTS 1 f On J&J k Jarnco j Residential 0 Commercial p. `y'� Est Cost of Construction S lO Ia a col Home Improvement Contractor Lic.# -M 0 Y 3 Construction Supervisor Lic.# /o� 0 9L/ Workman's Compensation Insurance: (check one) 0 I am the homeowner 0 I am thesoleproprietorplCOI have Worker's Compensation Insurance /M 2 Insurance Company Name: Andt. l7 tUL/E'Y Worker's Comp.Policy# Q40123 WORK TO BE PERFORMED Tent _ Duration (Fire Retardant Certificate attached?) Wood Stove Siding: #of Squares -7 Replacement windows:# Replacement doors: # Roofing: #of Squares /xq T ( $ )Remove existing* (max.2 layers) Insulation Old Kings Highway/Historic Dist. ( )Replacing like for__likk/een `/ ,'(Pool fencing *The debris will be disposed of at / ,/WS / 1/`C/!'l/ s Location of Facility I declare under penalties of perjury that the statements herein contained are true and correct to the best of my knowledge and belief I understand that any false answer(s) will be just cause kr denial or revocation of my license or p secutio under M.G.L.Ch.268,Section 1. D Applicant's Signature: Date: /o/30/!p Owners Signature(or attachment) • �uter r `^-0—- Date: Approved By: G 1/2Date: /5—3O -Y5 Buil ' (or designee) ADDRESS: Zoning District Historical District: ❑ Yes 0 No Flood Plain Zone: 0 Yes 0 No Water Resource Protection District: Within 100 ft.of Wetlands: - ❑ Yes 0 No 0 Yes 0 No r � The Commonwealth ofMassadtusetts Department oflndustrialAccidents wrIff. 1 Congress Street, Suite 100 Boston, MA 02114-2017 • V.6.) r,,, 4 www.mass.gov/dia \Yorkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): COcl i4 ) c .. jy tale Address: oC ;- / e/// /4O u C. lC/k�d r City/State/Zip: W Ya -pi of Phone #: 502469'0%2 Are yo an employer?Check the appropriate box: Type of project(required): I. I am a employer with 10 employees(full and/or part-time). 7. 0 New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling • any capacity.[No workers'comp.instance required.] 3.0 I am a homeowner doing all workmyself t 9. ❑Demolition [No workers'comp. insurance required.] 4.❑I am a homeowner and will be hiring contractors to conduct all work on property. I will 10 ❑ Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑ Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.0 I am a general contactor and I have hired the sub-contractors listed on the attached sheet These sub-contractors have employees and have workers'comp.insurance? 13, f repairs 6.❑We are a corporation and its officers have exercised their richt of exemption per MGL e. 14. Other VO 152,11(4),and we have no employees.[No workers'comp.insurance required] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensaton policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating suck IContactors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employe-.s. If the sub-contactors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information.C61 C Insurance Company Name: /1144 Policy#or Self-ins.Lic.#: 11/4O/22 3 Expiration Date: � 06/d s1/4.9s1/4.9lob Site Address: /3 9 old/ It sci.`e n City/State/Zip: g. [Gw e tc Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certtfy under the pains andpe lties of perju hal the information provided above is tr�uee cot ect. Si nature: toy Date: /0.9 d /'t Phone#: 5-017690/02- 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#: r ' • Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contact of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the,grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MOL chapter 152,§25C(6) also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152; §25C(7)states "Neither the commonwealth nor any of its political subdivisions shall enter into any contact for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contacting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractors)name(s),address(es) and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to cavy workers' compensation insurance. If an LLC or T.T.P does have employees, a policy is required. Be advised-that this affidavit may be submitted to the Department of Industrial Accident for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accident. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit The Department's address,telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 r Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 02-23-15 www.mass.gov/dia art CAE P oD CAPE COD HOME IMPROVEMENT.'TN1 27 MILL POND ROAD, WEST YARMOUTH MA 02673 (617) 710.10014;(508)469.0102 CAPECODINC@GMAIL.COM, WWW.ROOFCAPECOD.COM, WWW.FACEBOOK.COM/CAPECODHOME PROPOSAL 10. 17.2018 TO JOHN ROBBINS LOCATION: 134 OLD MAIN ST, SOUTH YARMOUTH • WE HEREBY SUBMIT SPECIFICATIONS AND ESTIMATES FOR MAIN COMPOSITION RUBBER ROOF. • REMOVAL OF ALL EXISTING ROOFING AND FLASHING MEMBRANES TO THE PLYWOOD DECK SURFACE. • REPLACEMENT OF ANY DAMAGED OR DETERIORATED PLYWOOD DECKING AT AN ADDITIONAL COST OF'$40 PER FOUR FOOT BY EIGHT FOOT SHEET OF PLYWOOD NEEDED.DECKING WILL BE REPLACED IN WHOLE SHEETS ONLY IN ACCORDANCE WITH RECOMMENDATIONS BY BOTH THE NATIONAL ROOFING CONTRACTORS ASSOCIATION(N RCA)AND THE AMERICAN PLYWOOD ASSOCIATION(APA).NEW DECKING SHALL BE APA RATED FOR STRUCTURAL USE.DECK FASTENING WILL MEET OR EXCEED LOCAL BUILDING CODE REQUIREMENTS. • INSTALLATION OF INSULATION BOARD 4'XB'PANELS,USING SCREWS AND INSULATION PLATES TO SECURE THE PANELS(MINIMUM 10 PLATES FOR EACH PANEL). • THOROUGHLY SWEEP OR VACUUM THE ROOF AND THEN POSITION THE RUBBER SHEETS SO SEAMS OVERLAP BY 4"AND OUTER SHEETS OVERHANG THE ROOF EDGE BY AT LEAST 3" • INSTALLATION OF THE EPDM RUBBER MEMBRANE USING LATEX BONDING ADHESIVE,SEAMING TAPE,PRIMER • FLASHING AND FINISHING USING DRIP EDGE,TERMINATION BAR,PUSH BROOM,ROLLER,RUBBER CAULK • ALL GROUNDS TO BE CLEANED UP ON A DAILY BASIS.ALL BUSHES,SHRUBS,AND FLOWERS TO BE PROTECTED.HOMEOWNER IS ASKED TO SUPPLY ELECTRICAL POWER IF NEEDED. • REPLACE ANY DAMAGE FASCIA AT A COST OF$50 FOR THE FIRST 10 LINEAR FEET AND AN ADDITIONAL COST OF$3.50 PER LINEAL FOOT THEREAFTER.NEW FASCIA SHALL BE PAINTED TO MATCH THE EXISTING. • CAPE COD HOME IMPROVEMENT TM GUARANTEES THAT ALL COMPONENTS INSTALLED PROPERLY %� PLEASE FEEL FREE TO CALL CAPE COD HOME IMPROVEMENT T" WITH ANY QUESTIONS OR CONCERNS . PLEASE INITIAL THIS PAGE • " °'�ion CAPE COD HOME IMPROVEMENT TM 27 MILL POND ROAD, WEST YARMOUTH MA 02673 (617) 710.1001, (508) 469-0102 CAPECODINC@GMAIL.COM, WWW.ROOFCAPECOD.COM, WWW.FACEBOOK.COM/CAPECODHOME EPDM RUBBER MEMBRANE LABOR AND MATERIALS: $5,600.00 ASPHALT ROOFING LABOR AND MATERIALS: $2,970.00 MASONRY • LABOR AND MATERIALS: $1 ,860.00 DUMPSTER: $450.00 GRAND TOTAL: $ 10,880.00 *WE WILL MATCH OR OUTBID ANY LEGITIMATE COMPETITOR PAYMENT TERMS: 3O%AT DEPOSIT; 30%AT STARTING; 40%UPON COMPLETION. JOB IS ESTIMATED TO COMMENCE APPROXIMATELY 1 TO 4 WEEKS AFTER DEPOSIT RECEIVED WORK IS SCHEDULED TO BE SUBSTANTIALLY COMPLETED IN APPROXIMATELY 1 TO 2 WEEKS. ANY WORK ABOVE AND BEYOND THE SPECIFICATIONS WILL BE PERFORMED AT 56.00$PER MAN HOUR PLUS MATERIALS OR PRICED ON REQUEST.ALL ADDITIONAL WORK, INCLUDING TRAVEL TIME AND LUMBERYARD RUNS. MOVING ALL PERSONAL OBJECTS,FURNITURE,ETC.FROM WORK AREA.WILL BE SUBJECT TO EXTRA CHARGE. IN THE EVENT OF ROT REPAIRS.ROOF REPAIRS OR ANY RELATED WORK REQUIRING IMMEDIATE ATTENTION.WE WILL PROCEED WITHOUT CUSTOMER APPROVAL. CAPE COD HOME IMPROVEMENT TM WILL PROVIDE CLEANUP ON A CONTINUING BASIS AND ALL DEBRIS WILL BE REMOVED FROM SITE(PROFESSIONAL CLEANING DOESN'T INCLUDE).ALL PRODUCTS INSTALLED BY CAPE COD HOME IMPROVEMENTTM WILL BE TO MANUFACTURER SPECIFICATIONS.ALL WORK WILL BE PERFORMED BY INSURED PROFESSIONALS. ALL MATERIAL IS GUARANTEED TO BE AS SPECIFIED,AND THE ABOVE WORK TO BE PERFORMED IN ACCORDANCE WITH THE DRAWINGS AND/OR SPECIFICATIONS SUBMITTED FOR ABOVE WORK AND COMPLETED IN A SUBSTANTIAL WORKMANLIKE MANNER. CAPE COD HOME IMPROVEMENT TM GUARANTEES THAT ALL COMPONENTS INSTALLED PROPERLY P PLEASE FEEL FREE TO CALL CAPE COD HOME IMPROVEMENT rat WITH ANY QUESTIONS OR CONCERNS PLEASE INITIAL THIS PAGE /VS Aralnon CAPE COD HOME IMPROVEMENT TM 27 MILL POND ROAD, WEST YARMOUTH MA 02673 (617) 710.1001, (508) 469-0102 CAPECODINC@GMAIL.COM, WWW.ROOFCAPECOD.COM, WWW.FACEBOOK.COM/CAPECODHOME OWNER TO MOVE ALL PERSONAL OBJECTS. FURNITURE, ETC. FROM WORK AREA. ALL ITEMS AGAINST WALLS SHOULD BE CONSIDERED FOR REMOVAL DURING ANY EXTERIOR SIDING JOBS.ADDITIONS.ETC.TO GUARD AGAINST DAMAGE.IN THE CASE OF ANY ROOFING AND RIDGE VENTING,DUST AND DEBRIS SHOULD BE EXPECTED AND ANY ITEMS IN THE ATTIC SHOULD BE REMOVED.CAPE COD HOME IMPROVEMENT"IS NOT RESPONSIBLE FOR ANY DAMAGES IF SAID ITEMS REMAIN IN PLACE. CAPE COD HOME IMPROVEMENT"IS NOT RESPONSIBLE FOR ANY DAMAGES THAT MAY OCCUR DURING CONSTRUCTION TO LANDSCAPING OR ANY FINISH GROUND WORK.PLANTINGS,ASPHALT OR STONE DRIVEWAY,ETC.FLOWERS AND SHRUBS AGAINST HOUSE MAY NEED TO BE REPAIRED OR REPLACED BY HOMEOWNER. ANY ALTERATION OR DEVIATION FROM ABOVE SPECIFICATIONS INVOLVING EXTRA COSTS WILL BE EXECUTED ONLY UPON WRITTEN ORDERS,AND WILL BECOME AN EXTRA CHARGE OVER AND ABOVE THE ESTIMATE.ALL AGREEMENTS CONTINGENT UPON STRIKES.ACCIDENTS OR DELAYS BEYOND OUR CONTROL OWNER TO CARRY FIRE,TORNADO AND OTHER NECESSARY INSURANCE UPON ABOVE WORK.WORKMEN'S COMPENSATION AND PUBLIC LIABILITY INSURANCE ON ABOVE WORK TO BE PLACED ON THE RESIDENCE AS A CONSEQUENCE OF THE CONTRACT.OWNER WHO SECURE THEIR OWN CONSTRUCTION- RELATED PERMITS OR DEAL WITH UNREGISTERED CONTRACTORS WILL BE EXCLUDED FROM ACCESS TO THE GUARANTY FUND. COSTS OFF COLLECTION,INCLUDING ATTORNEYS FEES WILL BE YtECOVERABLE,IN THE EVENT OF NON-PAYMENT. WE LOOK FORWARD TO WORKING WITH YOU: PLEASE CALL IF YOU HAVE ANY QUESTIONS. SINCERELY CAPE COD HOME IMPROVEMENT"' THIS CONTRACT NOT VALID UNLESS SIGNED BY ANATOLI'TONY-SIVITSIC ACCEPTED BY awoG rk.OnR- SIGN Y. DATE \O-gr\2 ACCEPTED BY iv # -"-1714S! ' 511 r\ i E ;`)� (o CAPE COD HOME IMPROVEMENT TM GUARANTEES THAT ALL COMPONENTS INSTALLED PROPERLY PLEASE FEEL FREE TO CALL CAPE COD HOME IMPROVEMENT" WITH ANY QUESTIONS OR CONCERNS PLEASE INITIAL THIS PAG a. Commonwealth of Massachusetts t • . '. �, c Division of Professional Licensure Board of Building Regulations and Standards Construction-;Sl1p`erisor Specialty CSS L -1x6440 �} - Empires : 05/ 14/2020 . 0 der ANATOLI SIVITSKI 'I 27 MILL POND-RD . ;; :' es'. • WEST YARMOtl -1 MA -02673 '�`.. , ( t.) 41 , Commissioner Cole als----- ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE IM5rzo ef) 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 policy(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 endorsement(s). PRODUCER CONTACT NAME Linda Sullivan DOWLING & O'NEIL INSURANCE AGENCY PHONE (AKr O o; I PAX (508 775.1620 INC.Not EMAIL Isons.com ADDRESSullivandi � 973 IYANNOUGH RD INSURERS)AFFORDING COVERAGE ` MAPCO _ HYANNIS MA 02601 INSURER A: AMGUARD INSURANCE CO 42390 INSURED INSURER a: • _ CAPE COD HOME IMPROVEMENT INC INSURER C: INSURER p: 27 MILL POND ROAD INSURER E: . - ! WEST YARMOUTH MA 02673 INSURERF: I COVERAGES CERTIFICATE NUMBER: 281511 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM CR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .. .. _. .._ -. ... ADDLSUBR _._ POLICY EFF.__POLICY EXP --__.. _...__-.___..._ ._ ........ _ _._.__. ILTRR, TYPE OF INSURANCE •IN50 wv0 POLICY NUMBER IMMIDDIYYYY) (MMIDDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY ! . EACH OCCURRENCE S ,.. _.-._._ ', 'DAMAGE TO RENTED . •CL AIMMADE OCCUR PREMISES:Ea occurrence.) 1S- ._.__ MED EXP(Any one person) S N/A PERSONALS ADV INJURY 5 GEN'L AGGREGATE LIMIT APPLIES PER I GENERAL AGGREGATE $ •L_._..:,POLICY: JEa _ _ LOC I PRODUCTS.COMP/OP AGG S ;OTHER $ _.. 'AUTOMOBILE LIABILITY j COMBINED SINGLELIMIT $ • ANY AUTO ' BODILY INJURY(Per person) $ •._. , ALL OWNED . • SCHEDULED NrA BODILY INJURY(Per accdent) 5 !_ HRED AUTOS L_ 1 AUOMMED • PROPERTY DAMAGE 5 _J AUTOS Aber accident) ..._.___.____._.._.._. S UMBRELLA LIAB 1_ OCCUR EACH OCCURRENCE ' $ EXCESS LIAB i CLAIMS-MADE N/A AGGREGATE 5 DED ' ' RETENTIONS S WORKERS COMPENSATION XPERH STATUTE ER _ ANA OFFICERMEMEER EXCLUDED+ECUTIVE NIA NIA N/A' R2WC940123 06%03/2016 06/03/2019-EL EACH ACCIDENT _ s 7.000.000 in NH) E L DISEASE.EA EMPLOYEE 5 1.000,000 If yes describe under DESCRIPTION OF OPERATIONS below E L DISEASE•POLICY LIMIT 1 1,D00,000 N/A i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule.may be attached if mon space is required) Workers'Compensation benefits will be paid to Massachusetts employees only. Pursuant to Endorsement WC 20 03 06 B,no authorization Is given to pay claims for benefits to employees in states other than Massachusetts If the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage car be monibred daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.goviwd/workers-compensationhnvestigahons/ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Anatoli Sivitski ACCORDANCE WITH THE POLICY PROVISIONS. • 222 Buck Island Road 6-8 AUTHORIZED REPRESENTATIVE West Yarmouth MA 02673 ` l " Daniel M.CroWty,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACO RD name and logo are registered marks of ACORD C-51171€6-70/nrnaJ7weah Sadttlr1PrZ Office of Consumer Affairs and Business Regulation One Ashburton Place- Suite 1301 Boston, Massachusetts 02108 • Home Improvement Contractor Registration • F _ Type: Corporation CAPE COD HOME IMPROVEMENT,INCRegipiration: 168043 C. 27 MILL FOND RD Expiration: 12/08!2018 WEST YARMOUTH,MA 02673 r Update Address and Return Card. tef Trento Peinea/Z4 C.fletuarktint� ♦ • Oft co of Consumer Afters&Business Regulation hOMEIMPROVEMENTCONTRACTOR Registration valid for Individual use only • TYPE:Caccration before the expiration date. If found return to: Rgaistratlon •• Fxniration Office of Consumer Affairs and Business Regulation '60043 -: 12;06!2010 - 10 Park Plaza-Suit • •.::WEE COD I IO%C IMPfOVEMENT,INC. Boston,MA • C ;jt` ti -r Yash 1 r:I,IVA 02073 undersecretary Not valid without signature