HomeMy WebLinkAboutBLD-19-2302 : 7 , `4
RECEIV L..
ONE & TWO FAMILY ONLY-BUILDING PERMIT
• Town of Yarmouth Building Department --, 4, ?PI i
1146 Route 28, South Yarmouth,MA 02664 4492
508-398-2231 ext. 1261 Fax 508-398-0836 te� M
Massachusetts State Building Code,780 CMR ::-
Building Permit Application To Construct, Repair, Renovate Or Demolish
a One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number—/9- 0-7p7,02. Date Appli •
I r. SQ4 rs ` . .. . ., . .. 10,-‘s-af
Building Official(Print Name) Signature. _ Date -
• SECTION 1:Sll'E INFORMATION • 8
1.1 Property Address: 1.2 Assessor17
&Parcel Numbers
a3 03;ts �-r e 1 /3
1.1a Is this an accepted street?yes 1/ no Map Number Parcel Number I
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
if-
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public Private❑ • Zone: _ Outside Flood Zone? ---I• Check if yes❑ Municipal❑ On site disposal system fib
tAI I c41 yk1 ck.l SECTION 2: PROPERTY OWNERSII)P1
2.1 Owner'of ecor.. 1 '�tt\A r eprk AO o 1&
t [)v\
Name(Print) ` � - n City,State,ZIP 1
P-3 U9.t�r7.s.WQRt Q6-11r ac.ANCX�y t\4.IP-o-, i .um-
No.and Street Telephone Email Adclss
SECTION 3..DESCRIPTION OF PROPOSED WORK2(check all that apply) '
Tx
New ConstructionAl Existing Building❑ Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition ilifi n
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:, i' F C Ft m �
rn
a
Brief Description of Proposed Work : Pow c_SIA-... lt{ k\Lx $ _ • . -n - ,�
NOV Fri
02 2010 , m 0
=t a
V7
. . . . . ]tii L
SECTION:4::EST .ATED CONSTRUCTION COSTS. NG DFP.'.RT. 'rte a
Estimated Costs:
Item (Libor and Mat rials) OffictalTJse Only y -i
I.Building $�0 � 0... 1-Building Permit Fee;$' t 0 Indicate how fee is determined: m xi
2.Electrical g / Ai Standard City/Town Application Vee° _ ,; :c; •n-I m
0,OUa • 0 v O.Total Project Costa(Its 6)xmultiplter Y O 0
3.Plumbing $ 2, Other Fees: $.:3 . Z C
4.Mechanical List: m
(HVAC) $ ..... . .:.: .. . ... 73
. . v
5.Mechanical (Fire
Suppression) $ Total All Fees'>$
Check No. • Check Amount: Cash.Amouht:y '
6.Total Project Cost: $ al vcx, •Gu 0 paid m'Full . . 4 Outstanding Balance Duei VS
•'' SECTIONS:.CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
• +, I CS7 4 40S5199 %/a3/aolf •
•
• Vfi.hf 0•Ne (• License Number Expiraaoh Date
Name of CtHolder
List CSL Type(see below)
Mtgne, t
No.and Street Type Description
I-(yah h;5 I"/�e A 0,)-40 U Unrestricted(Buildings up to 35,000 cu.ft.)
City/1'
11.,) Restricted l&2 Family Dwelling
own,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding •
SF Solid Fuel Burning Appliances
.SC's' 3?'37(3 O .oCat peift u..1.ca. I Insulation
Telephone Email ad'dress'es D Demolition
5.2 Registered HomeysW (A
Improvement Contractor(MC) /C8 1)A
( •
�d'
otitis HIC Registration Number p non Date
BIC Company Name or HEC Registrant Name
3 St Me a.•. Dlocctrpc..tt ;).Coos%
bra,and Stree E a s
({ ...5 MA 02601 31)84-11•x1-14
C' !Town, State,ZIP Telephone
SECTION 6:WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this affidavit will result in the denial of the Issuanccee of the building permit.
Signed Affidavit Attached? Yes No ❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
' • OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT ..
I,as Owner of the subject property,hereby authorize s A pQ (h'
to act on my behalf;in all matters relative to work authorized by this building permit application.
•
r
Print Owner's Name(Electronic S{�ature) Date
• • SECTION 7b: OWNERt.OR AU'IIiORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
C% q [ I Ic
Print Owner's or Authorized A_ is Name(Electronic Signature) Date
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(MC)Program),will not have access to the arbitration
progam or guaranty find under M.G.L. c. ICA.Other important information on the HIC Progam can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.aov/dns
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
The Commonwealth of Massachusetts
/ ��a
' otrt. / Department of lndustrialAccidents
Y ' H"M►I_ 1 Congress Street, Suite 100
• • to= f_ Boston, MA 02114-2017
. •Q.�mo- � www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Name (Business/Organization/Individual):pC,.,ti j .A c:57)....4
Address: 3E( ,Mie&Gt, RA .
City/State/Zip: 'I�r/-/-ar,r,i-j )4 A.porn k Phone#: S'C>e -731 -.31- J 9
Are you an employer? heck the appropriate box:
Type of project(required):
1.0 I am a employer with employees(full and/or part-time).*
7. New construction
2. am a sole proprietor or partnership and have no employees working for me in
any capacity.[No workers'comp.insurance required.] 8. ❑Remodeling •
3.0 I am a homeowner doing all work myself.[No workers'comp. insurance required.]t 9. ❑Demolition
4.0 I am a homeowner and will be hiring contractors to conduct all work on property. I will 10 [i]Buildtng addition
ensure that all contractors either have workers'compensation insurance or are sol
p 11.0 Electrical repairs or additions
proprietors with no employees.
5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet 12.0 Plumbing repairs or additions.
These sub-contractors have employees and have workers'comp.insurance.t 13.0 Roof repairs
6.0 We are a corporation and its officers have exercised their right of exemption per MOL c. 14.❑Other
152,§1(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'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must atached 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 $3(Cfj 'E $ I� ,�„5c,s,,� Ca••••
Policy#or Self-ins.Lic. :tIJCC SOt1s01 ciao x.10 I /1 Expiration Date: //2//9
alJob Site Address: l w e�•QNtv6PI-Pk•rL City/State/Zip: iWeftovi&pu f.AA
Attach a copy of the workers' compensation policy declaration page(showing the policy umber 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$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
1 do hereby certis under the pains and penalties of perjury that the information provided above is true and correct
Signature: Sr
Date: —e— /&
Phone,",: COs—"?a 7 - 33 / 51.
Official use only. Do not write in this area, to be completed by city or town official
City or Town: Permit/License# •
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone::
'91"YA .y TOWN OF YARMOUTH
.-an•y€ C BUILDING DEPARTMENT
1146 Route 28,South Yarmouth,MA 02664
• 3 508-398-2231 ext. 1261 Fax 508-398-0836
•
BUILDING DEPARTMENT
DEMOLITION DEBRIS DISPOSAL AFFIDAVIT
Pursuant to M.G.L. Chapter 40,Section 54 and 780 CMR, Chapter 1, Section 1113,
[hereby certify that the debris resulting from the proposed work/demolition to be
conducted ata w t JssA9t ()Sr.
Work Address
Is to be disposed of at the following location: `&�,.l.$¶
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 111, Section 150A.
Signature of Application Date
Permit No.
. c
• �t=Y^ TOWN OF YARMOUTH
• !+ °� HEALTH DEPARTMENT
' PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant: p
Building Site Location: 9 3 `�
t' `r"'?Sw-e-pf.. 1 c
Proposed Improvement: S(_J'e.et-. PbtcS•
Applicant: (JG fr- 1 . 0 Il/-eJ-t (, (r / , Tel. No.:CO G 77' 3 4 - 3-' /
Address: 3S A4 e c V� I�1 Cinh�S ✓"l4 &ea6O Date Filed: �''S ze
•'/f you would likee-mailnotification ofsign off pleaseleprovide e-mail address: Di OC4;-pe'- t- (� Gb fh I. Co—.
Owner Name: <) Jy. Cw( � Ctyn
Owner Address: `a 3 t ne(Su e pd— Pc' +K Owner Tel. No.:CUC,j—'iSV_2'0 S
RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements
For Septage Disposal and other Public Health Activities.
Please submit three (3) copies of plans, to include:
(1.) Site Plan showing existing buildings, water line location,
and septic system location;
(2.) Floor plan labeling ALL rooms within building
(all existing and proposed)—
Note:Floor plans not required for decks,sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWED By cLai a DATE: (1,--75.79
PLEASE NOTE
COMMENTS/CONDITIONS:
f y TOWN OF YARMOUTH $7, �/
• t
s WATER DEPARTMENTt d99 Buck Island Road
. West Yarmouth, MA 02673
Telephone: (508) 771-7921 • Fax: (508) 771-7998
• BUILDING PERMIT APPLICATION
DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET
Bldg. Site Location a 3t4J%ncfS(rwc/yr •pAtF(N 0 / '•
Proposed Improvement��yySCtec. I cV'Cc. )1,1 ivo-,
Applicant: `1 /v.2c t(
Address .3r5, _.. ___ Tel. #: .5�?-moi 3? -37 PDate Filed: /Cc-M.- /61
•
37/ 9
RESIDENTIAL AND / OR COMMERCIAL BUILDING
Water Department: • Determines Compliance of Water Availability and or Existing Location
Engineering Department: Determines Compliance for Parking and Drainage
Conservation Commission: Determines Compliance to Wetlands Acts; i.e. If Lot(s) Border any Type of .
Wetlands, Streams, Ponds, Rivers, Ocean, Bogs, Bays, Marshland, Etc...
Health Department: Determines Compliance to State and Town Regulations, i.e., Requirements
for Septage Disposal and other Public Health Activities
Fire Department: • Determines Compliance to State and Town Requirements for Personal,
Safety, Property Protection;, i.e. Smoke Detectors, Sprinkler Systems, Etc...
/ ignature of applicant Date
PLEASE NOTE:
•
COMMENTS:
•
. eetl /r//t-/(
Reviewed by: Water Division Date
e
so:►d}n,
•
. 3= % TOWN OF YARMOUTH
02664-4451
r� �� Telephone(508)398-2231 1146 ROUTE 28, YARMOUTH,
1292-Faxl RECEIVED 1
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMIT-EE AUG 2 2 2018
APPLICATION FOR OLD KING'S HIGHWAY
CERTIFICATE OF APPROPRIATENESS
Application is hereby made for issuance of a Certificate of Appropriateness under Section 6 of CI
amended,for proposed work as described below&on plans,drawings,photographs, &other supplen
application. PLEASE SUBMIT 4 coples OF SPEC SHEET(S),ELEVATIONS,PHOTOS,&SUPPL
Check All Categories That Apply: Indicate type of Building: Commercial i
1)Exterior Building Construction: _New Building Addition _Alterations
_Shed _Solar Panels _Other:
2) Exterior Painting: Siding _Shutters _Doors _Trim _Other. -- --- -
3)Signs/Billboards: _New Sign _Change to Existing Sign
4)Miscellaneous Structures: _Fence Wall Flagpole _Pool _Other.
Please type or print legibly:
Address of proposed work:-Z S GU/NDS(, PATH Map/Lot# 1 49 II
Owner(s): ICt(OAQb (0. (tJ(6CN.yyang.( Phone#: SOS -450-908
All applications must bebsubmitted by owner of accompanied
'by_letter from owner approving submittal of application.
Mailing address: 25 W t JbSw&vr T ATN {/�Icr CrAToi21 Year built: I.9 Z O
Email: V W I LCl-I y-1SKt e AOL.con Preferred notification method: Phone `/Email
Agent/contractor: 3-1ThI PINS l+Q0C ,ig
Phone#: LZ'7I I4 .
G
Mailing Address: VT E e C/efZ/T r)7/4y 6)-1 , CC?,1-1.
Email: 4.53IZ8o reare t) MASU9�1 Preferred notification method: Phone mail
Description of Proposed Work: 07a4,,
&)A iid osl, SZ42-0-ta el RECEIVED
I`r to.cth 19 IbSEP 112018
TOWN CLERK c / f c
Signed(Owner or agent): SOUTH YARMOUDldeMAO lli(r 6
> Owner/contractor/agent is aware that a permit Is required from the Building Department(Check other departments,also.)
D If application is approved,approval is subject to a 10-day appeal period required by the Act.
➢ This certificate Is good for one year from approval date or upon date of expiration of Building Permit,whichever date shall be later.
> All new construction will be subject to inspection by OKH.OKH-approved plans MUST be available on-site for framing&final inspections.
For Committee use only: Approved I/Approved with r Modifications _Denied
Rcvd Date: gr.a9--11 g Reason for Denial: A 1�u•.
Amount �ri `+1
CasaCas
t: S3, I ��/
Revd b �(,� Signed: /✓ _ ;lA�,r S ' I 1 •;
Y
45 Days: 16-4-1 S(
6 •°.
I _'4 • • KINGS HIGHWAY
Date Signed: 9/igzo r N+l/. 7e
03/2018 1 APPLICATION#: /P-/rid93
MODIFICATIONS TO
CERTIFICATE,,11OFAPPROPRIATENESS
Date: C51 I I o lQ0 (Y)
C/A Number: &QS Address: 2g L.91
1. llki'( Divi) I J Lw V& f Q4(A3- D
2. 1115Na fl t /i', ��'7X t C-TO to
RECEIVED
3. SEP 11 2018 APP-R-OVED
SEP 10 2018
4 TOWN CLERK
SOUTH YARMOUTH, MA YARMOUTH
OLD KING'S HIGHWAY
I agree to the above conditions and changes to the Certificatertof� Appropriateness:
Signature , (CC --(�r S '
Signature�i � J '� .1, Signature tc�c-
. . .
of YAR$� r- -
o Town of Yarmouth
y
"I Conservation Commission ion
"` :x
Building Permit Sign-off Application
TO BE FILLED OUT BY APPLICANT:
Building Site
LLocation: c3 w; .Jswopi UD
c 4-
Map# , /1 Lot(s) # 13
Property Owner: ((47 W; Ec5P ci
Applicant: PQ✓v ail,-1ei‘ I 'I G1�4
Applicant Address: 3 S I ✓V c c4'\ 6 Q( 14/' Cunnrs . 00)60 I
Telephone: 5-09 '7 31 '3"' 19 `/Date Filed /0 -/l"/8
Proposed Project Description:
.odd; , .. 01 Cu.ea..{ i-. pops. -
Plans: S 14 e. Pia., ay Q 3 (444 auto l A\-'
TO BE FILLED OUT BY CONSERVATION ADMINISTRATOR:
Do You Have A Valid Permit From The Conservation Commission For The Proposed
Project? be A N26 2,
Comments from Conservation Ciss:on:
Approved onditionally Approved Rejected
All work related debris shall be taken offsite or disposed in a legal upland location
At the end of each day, the area shall be c debris shall be in the Resource Area
Refer to: SE83- or (DOA permit `7
Conservation Commission Sign-offSignature:Sr
Date: 1
o Ju't a �' ""
•
•
' DANILON-01 CLEDDUKE
.ACORO CERTIFICATE OF LIABILITY INSURANCE DATE
09/28/2028/20 8
• �� 18 _
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(les)must have ADDITIONAL INSURED provisions or 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(leu of such endorsement(s).
PRODUCER CONT CT
Rogers 8.Gray Insurance Agency,Inc. PHONE FAX
434 Rte 134 ANC,No,Est): (NC,Mo1:(877)816-2156
South Dennis,MA 02660 Iran.mail@rogers9ray.com
INSURER/SI AFFORDING COVERAGE RAC I_
INSURER A:Associated Employers Insurance Company 11104
INSURED INSURER 8:
Daniel L.O'Neill DBA Daniel L.O'Neill Carpentry INSURER C:
351 Megan Road INSURER D:
Hyannis,MA 02601 ---
INSURER E:
INSURER F
COVERAGES CERTIFICATE NUMBER: 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS.
(NSR TYPE OF INSURANCE ADOLSUER POLICY NUMBE0. POLICY EFF POLICY EXP LIMITS
LTR MED NND IMWDEWTYYI IMWDENY YYI
COMMERCIAL GENERAL UABILITY EACH OCCURRENCE $
CLAMS-MADE OCCUR DAMAGE TO RENTED
PREMISESS(EaoCCURIEt df
MED EXP(Anyperson) I$
PERSONAL ADV INJURY Is
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
I
POLI IJECT LOC PRODUCTS•COMP/OP AGG $
OTHER $
•
AUTOMOBILE UABILITY COMBINEDecc�anu SINGLE LIMITS
ANY AUTOBODILY INJURY(Per penal) �S
OWNED SCHEDULED
AUTOSp� ONLY AUTOS
SSWNLY BODILY INJURYYAPgr accident)$
AUTOS ONLY AUTOS OEp Wer (DAMAGE
$ _
f
UMBRELLA UAB _ OCCUR EACH OCCURRENCE
EXCESS UAB CLAMS-MADE AGGREGATE Ls
DED RETENTIONS $
A WORKERS COMPENSATION PER OTH-
AND EMPLOYERS'LIABILITYYIN STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE WCC50050162012018A 07/12/2018 0711212019 1,000,000
pFICER/MEMBER EXCLUDED? I N I N/A E.L EACH ACCIDENT S
Mandatory in NH) E.L DISEASE-EA EMPLOYEE§ 1,000,000
DESCdTbOeOFdOPERATIONS below E.L DISEASE POLICY LIMIT $ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more epees Is required)
OS
CERTIFICATE HOLDER CANCELLATION
• SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
For informationalu purposes only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
P rpo y ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ACORD 25(2016103) ®1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
-
„ ®i Commonwealth of Massachusetts
- ( Division of Professional Licensure
irnirrormvriew�(/n/C�lr.:.:nr�rUr(h
Board of Building Regulations and Standards
Office of Consumer Anairsa Business Regulator
HOMEIMPROVEMENT CONTRACTOR COnstructioSU TOsf.1 & 2 Famil
Y
TYPE:Individual
•
• I> .5 Registration Expiration CSFA-105994 Expires: 10/2312019
i ,a 166722 asna/2ols i', a ._
1} ,....,,,,,„y
DANIEL O'NEILL' ti DANIEL O'NEILL 1.71. '` :. -
I DB/A DAN L O'NEILL CARPENTRY 351 MEGAN ROAD , . X t * .
f HYANNIS MA 02601 . • �
f I(/i,. li1:A' e 8.
DANIEL O'NEILL R-�^`�`—;
351 MNRD i
HYANNIS,MA 02601 - Undersecretarl
Commissioner
C N.
1 Construction Supervisor 1 a 2Fitnily
Registration valid for individual use only '
before the expiration date. If found return to:Office of Consumer Affairs and Business Regulation •
v
10 Park Plaza•Suite 5170
Boston,MA 02116
ie
6/ `/- Failure to possess a current edition of the Massachusetts
1. Not valid without signature State Building Code is cause for revocation of this license.
For information about this license
Call(617)7274200 or visit www.mass.gov/dpi