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HomeMy WebLinkAboutBLDG-20-005699 , __ III:=TM - UNIFORM APPLICATION FOR A Parr TO PGRFORM OAS TRIM WORK 1 r). atY r neve; ° Lk IA DATE 51`i1 JOB8ITEADDRESS • .��S A' G ADDRESS TYPE oa "�r2`' rllx 1 nun ANCYTYPE COMMERCIAL 0 EDUCATIONAL 0 RESIDENTIAL EL MAYAN NE*0 RENOVA • :❑ REPLACEMENT:21, PLANS SUBMITTED: YES CI NO 14 :re-IL:- ROOM-, I s e 7 0 10 11 1E 1a BOOMER � F•Ii _ Ili .?= 111111111111111111111111.1 L1_''r�.'F III In III ORLLE IMF INS .-.`F,f: IMF r 0- . "-iiINIMIMENEN . � 1 � -. : 11111101111111111.1 s".' 4 HEATER IMF EYE t1NRH1?A II�� 1i��� cc 5 I MI MI I - T 4 OE I have a euwatlialkunemenee policy . Its l ub�ff.I aqutwMi„t moats the I You ctapc�laq,PL,lAtE MATE �TYPE OP COVERAGE of tNru„c�,.,� YEp-®,� 000VERAGE BY CIS ME APPROPRIATE BOX BELOW LUERRY , ' • POLIOrk OTHER TYPE INDEMNITY 0 �D OWNERS�tANC�MUNiEl:1 an the Ilotz� ❑ iliromokumb tl WI,and the myM . , on Ns p appkidien the l this n ti mmo required by Chapter 1�of the SIGNATURE OFOWNERCHECK ONE LILY: OWNER ❑ AGENT 0 anti mid ppetev y sm1, i •+ ti , . •.- miNarkawlb eta Plu ogee me ••'". 14E des Gomm Lawn. ' MONoNbi ti l bs i't' ' 4 v to .t'r, d in PLUMBESRAIFTfTER"ME Francois;1-aravieini MP❑ MN p ,p ,� Llc�tsE�r is�i I ' : - TUBE ❑ ❑ une a CORPORATION -Lo i02-> . ansANYN =' + -, = Plumbs & Heath. OS • cxrY Orieene Loss PO Box 2585 STATE MA ZIP 02653 TEL CW1-255-4556 PAX 7T4-316-____4249 caL 4-216-9484 EMAIL Jde©TheCapeCOdPluRlbet'lllleom 64_2 7/go 1 _ _ _ _