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26 VALIANT WAY - BUILDING INSPECTION The Commonwealth of Massachusetts Board of Building Regulations and Standards CITY OF Massachusetts State Building Code, 780 CMR SALEM � Revised Alur 20/1 Building Permit Application To Construct, Repair, Renovate Or Demolish a �� One-or Two-Familt, Dwelling This Section For Official Use Only Building Permit Number: Date Applied: Cho S3 i� Building Oflicial(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property A1t{Irfs n�\ 1.2 Assessors Map& Parcel Numbers 1.la Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(fl) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard 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? Municipal ❑ On site disposal system ❑ Check ifyes❑ SECTION2: PROPERTY OWNERSHIP' 2.1 Owner'of Recprd:- , A Name(Print) �7 City.State,LIP { tot No. and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK (check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) r Alteration(s) ❑ 1 Addition ❑ Demolition ❑ 1 Accessory Bldg.❑ Number of Units Other ❑ ecify: Brief Description of Proposed Work': c SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) I. Building $ I. Building Permit Fee: $ 1nElicate how fee is determined: ❑ Standard City/Town Application Fee '. Electrical $ ❑Total Project Cost(Item 6)x multiplier x 3. Plumbing S 2. Other Fees: $ 4. Mechanical (I-IVAC) S List: 5. Mechanical (Fire $ Total All Fees:$ Suppression) Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ 0 paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor Lice} �nsse�CSL) Littnsc un Expi tioi Dale Name of C SL. I lolder t.rl�1-� �' l �,t / List CSL Fype(see below)_ GrG J`�(f' uV No d StFect I Type Description D U Unrestricted(Buildin s u' to 35,000 cu. 11. 02 R Restricted IX217annil Dwelling CitylPown.State,'_IP M Masonry RC Roofing Covering WS Window and Siding p' 2� SF Solid Fuel Burning Appliances 1 Insulation Telephone L'maiI address U Demolition 5.2 Registered H"'l tprove tent Con •ictor(HIC) , HIC Registration Number Is uati n ale HIC tm r m or IIC I olmnt 't e�-'-- No. and Street Email address City/Town, State,ZIP Telc hone 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 Issuance f the building permit. Signed Affidavit Attached? Yes ......... No........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTO APPLIES FOR BUILDING PERMIT 1, as Owner of the subject property,hereby authorize n C to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Nance(Electronic Signature) Dat el SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION By entering my name below, 1 hereby attest and a pains and penalties of perjury that all of the information contained in application is true and accura to th b of m nowledge and understanding. Print Owner's or i uthorized Agent's Name( �.Iecuon.,S Ana ure) pale NOTES: I. 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(HIC) Program),will not have access to the arbitration program or guaranty fund under M.G.L. c. 14 Other important information on the HIC Program can be found at m;v�s, ov_oca Information on the Construction Supervisor License can be found at wtt tv.ma agu_�IL 2. \V ten substantial work is planned,provide the information below: Total Fluor 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" May 1511 07:35a Kowslozik 9789352838 p.1 HOME IMPROVEMENT CONTRACT PLEASE READ THIS „ ; Sold,Furnished and Installed by: Branch Name: Boston Date: 5- Ll-CF(J LE THD At-Home Services,Inc. d/b/a The home Depot At-f lome Services 345A Greenwood Street,Unit.2,Worcester,MA 01607 Branch Number:31 Toll Free(800)657-5182; Fax(508)756-8923 Federal ID#7 5-2 69 84 60:ME Lie#C 02439;RI Cont.Lic#16427 r� /�y Cf Lic#056552^_:MA Home I�mpp..wcmem Conift.ctor Reg.#126593 Installation Address: -&—&d- C c_ L4 Avt.4- Z5:. .__J1rS1ti v/ 0 City State Zip Pu chaser(s): Work Phone: Home phone: Cell Phone: [ IS1 � o1a 70 7& I [ (If different from Installation Address) City Ip`,-/,, State Zip E-Ipsd Address(to receive project communications'and Home Depot updates); t "�I S)aal&LA 30 . to I DO NOT wish to receive any marketing emails from The Home Depot Protect Information: Un icrsiencd("Customer'),the owners of the property located ut the above installation address,agrees to buy. and THD ALHomc Services, inc.("I'he Home Depot')agrees to furnish,deliver and arrange for the installation('Installation")of all materials described on the: below and on the referenced Spec Sheet(s), all of which are incorporated into this Contract by this reference,along with any applicable State Supplement and Payment Summary attached hereto and any Changc Orders(collectively, "Contract'). Job#: Products: Sec Sheets)#: Project Amount ( ❑.Sl ) 0Roofing dlOs Yindaws ❑Insulation I $ n '/'�•'r'/fll oC 2 51 y QGunen/Cover. g Doo s ❑ _-_ Q 0/ ✓� —}-oaeenn> osi.tiag o Wiadew, o t�u,h�,ar, I s L0Guacrx 1 Carvtrm CEntry Deers ❑_ ___ __ p r Rawlins QSidin^_0 NWindews Insulation S E ��—,��.�<iutfcrs/Cos (] r..verEntry Dean, a IJRonfing QSiding �Windto s ❑insulation j06u1ters l Covers CIE."Doun (� S hiilumum��.D.puvtad't:amfraci.inaaurtl due nprm csaartiam ad FlusatnUact I Total Contract Amount Marne WrcM1asyrsrm)'madepavt more that oo�third ufthe(:unlractAmuunt. .JJ✓ Customer agrees that, inmiediately upon completion of!he work for each Produce, Cus inner will execute a Completion Certificate (ono for each Product as defined by an individual Spec Shect) and pay any balance due. As applicable, each Cusiommr under this Contract agrees to be jointly and severally obligated and liable hereunder. The Homc Depot reserves the right to issue a Change Order or terminate this Contract or any individual Product(s)included herein,at ins discretion,if Home Depot or its authorized serviceprovider determines that itcamtot perfoma itspbligations due to a structural problem with file hetue,coviromn rival hariu'ds such as mold,asbestos or lead paint,other safety concerns,feicing criers or because wm'k required to complete thcjub was not included in the Contract. Payment Summary: The Payment Summary tf �SO 2 0.5_ , included as part of this Contract, sets forth the total Contract arnount and pawnents required for die deposits and final payments by Product(as appiicalii NOTICE TO CUSTOMER You are entitled to a completely filled-in copy of the Contract at the time you sign. Do not sign a Completion Certificate(note: there is one Completion Certificate for each listed Product as defined by individual Spec Sheets)before work on that Product is complete. In the event of teroduation of this Contract,Customer agrees to pay The Home Depot the costs of materials,labor,expenses and services provided by The Home Depot.or Authorized Service Provider through the date of termination), plus any other amounts set forth in this Agreement or allowed under applicable law. THE HOME DEPOT MAY WITHHOLD Ah1OUNTS OWED TO THE: HOME DEPOT' FROM THE DEPOSIT PAYMENT' OR OTHER PAYMENTS MADE, WITHOUT LIMITING THE HOME DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. Acceptance and Authorization: Customer agrccs and understands that this Agreement is the entire agr"inont between Customer and The Home Depot with regard to the Products and Installation services and supersedes all prior discussions and agreements.either oral or written, relating to said Products and Installation. This Agreement cannot be assigned or amended except by a writing signed by Customer and The Home Depot.Customer acknowledges and agrees that Customer has rend,understands,voluntarily accepts the terms orand has received a copy of this Agreement. �C � �w��^QJ! f lMay1/ x Custo s Sigmature Dates Salts Cons ul/t�rrt's [gnat c,273 �J D�iaft�c X -tI'Y�t o.xrat /� one. �E Telephone7�� Customer's Sa a c Sales Cons u taut License No. CANCELLATION: CUSTOMER MAY CANCEL THIS t�nlmrcaht<) AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING THIS AGREEMENT. THE STATE SUPPLEMENT ATTACHED HERETO CONTAINS A FORM TO USE IF ONE 1S SPECIFICALLY PRESCRIBED BY LAW IN CUSTOMER'S STATE. NOTICE:ADDITIONAL.TERMS AND CONDITIONS ARE STALED ON THE REVERSE SIDE AND ARE PART OF THIS CONTRACT 7-7-10 GSC WNW—aranch File Yeltaw-costumer l"ani , ` ?i1is r�1icfl 41I11ta'fl is IMc1 f_3=5+l9tss Y4ebultiOtx t f„: J' If k PrL l ;ttjt4 5170 02U6 ; '� 131� 11ie�)11Si( h'' Il Cgnt4riwtt?a 44F cai3ex1:I147 3?ritlhr! 1.'r`!PE'sQ j. FcaSn 'Pow ion #malts -. 17 'BC--A(�ki RD, 1`Ai-T L4'h9 P, NIYA 0'1S02 t:fnSatc,41lrEres<att�t rcl not ere+f 'd+r k real-rn irAr k�ar{�r AclsiY�s i{ s »all i ' '1 n:pl„r nssn Larr.t c trd . ,i •{fsl'+1. 'YX:MWkfl fiC .�*{ ..Q(J{'-A 11FRrf,te� . - 1 tsc5aa4 "t'tyMtrrscinca�'alstt fr to t+ ctL�';tnl>tues+�I� r ' . four f,.+rl4 em"3Fa1R'ki fA lf.6 V1gfi Kss 1< nM.1., i.n Lxtluci'E}v tr mrn ctrkar, if t�nstll rekucata: - _ - t .ex}' hif}P11k tfl.t,ht�VEMENT CUN;R&..1^I� i1{tt�t{fCh'I4'zll,a^1111=tfirr,guJ kkr?Slt+e�+fLeja47ttt'e�Rn + vdr P 46 Pur6 f'tnol 4tnta s.l�7il 5 �a� £EG`6" 'Ia3Pil4n €lA'21it3 Twe: i'TiNa".f*S,'pr(tat;d - k .;c7 ri ria '�r A 5CI �z rll rxix j�r? - N.rB a:d[dwiRlrutlt�-1"!.�rrtk7t'c w,0ktay - - _ - Dcn tr ttncnt of Public !�sttty 9�! f;l�u d of Buthlurl R. ul tdlPu. nul�t:tti�i a d� ' �_. c_.,ut., n coa ,Is r �cectanyL,ters - License: CS SL.99699 Restricted to: WS.. ROSERT POCZOBUI 17 BEACH,ROAD APT. 45 LYNN, MA01902 `ExbirMidn: Z''6l2(1t2 t nnmisri,.nvi'. 7r#-, 99699 `; CITY OF S.XLEN19 �LkSS.�CHCSETTS BLIMLNG DEPAIMEENT 120 WASHLNGTON STREsT,3'0 FLOOR ` TEL (978) 745-9595 FAX(978) 740-9846 KIMBERLEY DRISCOLL ,MAYOR THO.NA9 ST.Min g DIRECTOR OF PCBLIC PROPERTY/BCUMMG COMMISSIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR section l 1 l.5 Debris, and the provisions of MGL c 40, S 54; Building Permit Al is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 111, S 150A. The debris will be transported by: L ti CucV name of hauler) The debris will be disposed of in : (name of facility) (address of facility) sVxna re o per it applicant [C Icbrwlf J•x The Commonwealth of Massachusetts 3lepartment oflndus>a^ial.4eeidents Office of Investigations 600 Washington Street Boston,MA 02111 wnnv.mass.gov/dia ers Workers' Compensation Trgarance Affidavit: Bu3l dens/Vona actors/El pl�se PrintLe bl A.pplicant iiiformy-tdon —^ Name(Business/Oro nmat on/lndividual): 1 Address: City/State/Zip: r • 1 hone.#: Are y an employer? Check the appropriate bar. Type of project(required): i I am a employer with 4. ❑ I am a general contractor and I 6 ❑New ctim mction have hired the sub-contractors employees(full and/or part-time).` listed on the attached sheet 7• ❑ Remodeling 2.❑ 1 am a sOleproprietnr orpartner- These sub-contractors have g'• ❑Demolition ship and have no employees employees and have workers' addition working for me in.any capacity. 9. ❑BuIlding No workers' camp.; *a ce comp.insurance.. 5. ❑ We are a corporation and its 10.❑Electrical repairs or addrt ons required.] officers have exercised their 11.❑Plumbing repairs or additions 3.❑ I am a homeowner doing all work right t of exemption per MGL . Myself [No workers' Comp. gh p p 12.❑Roof epaus insurance,required.]I - c. 152, §1(4), and we have no 13 therPI)111 employees. [No workers' comp,insurance required] °Any applicant that ebaks box#1 must abo fill out the section below showing their worlmr§'aornpensation policy information. t gomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tCo b=ton that check this box must attached m additional sheet showing the name of the spolicy b-contracton and state whether ornot those entities have crnployers. If the subaontracMts have earpleycu,they must prmide their workers'co olic number. I am an employer that is providing workers'compensation insurance for my employees.. Below is the policy and job site information. Insurance Company Name: pp ++ , Policy#or Self-ins.Lic.#: 1"31 1111 ,,` - Expiration Date: .. Job Site 4ddr - �� 11A� � h /�1�) Cihr/State/7ip:_4-31_��• — A-t ch a copy of the workers' compensatio¢policy dec�Page(showing ing the policy number and expiration date). Paine ro sec+L*e coverage zs required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year impr sonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investi lions of the D r insurance eovera a verification. I do hereby certi un a he ns d p aloes of perjury that the information provided ab ve a rue and correct Date: — ' Si afire: - Phone#: Official use only. Do not write in this area, to be completed by city or town offrciaL Permitucense# City or Town: Issuing Authority(circle one): ector L Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Ins p 6. Other . Phone#: Contact Person: ' TEA CERTIFICATE OF LIABILITY INSURANCE G D2/21/201IMMIDDIY1Tri) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject l0 the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 1-404-995-3000 CONTACT PRODUCER NAME: Marsh USA, Inc. PHONE FAX E--MAIL homedapc0.certraquest@marsh.core gDORE55: -- ---------- Two Alliance Center, 3560 Lenox Road, Suite 2400 INSURERI$ AFFORDING COVERAGE _ NaIC9_ Atlanta, GA 30326SteadEast Ins 26387 Fax (212) 948-0902 INSURER a: ---- INSURED INSURER 8: Zvrich American Ins- Co_ - 16535_—_ The Home Depot, Inc. rINSURER C: New Hampshire Ins Co 23841 Home Depot U.S.A., Inc. 2455 Paces Ferry Road NW - D: Illinois Matt. Ins Co —_ _ _ 2_3817 Buildin^ C-20 E: NATIONAL UNION FIRE INS.CO OF PITTB _ 19445 _ Atlanta, GA 30379 Illinois Union Ins Co 27960 • F: COVERAGES CERTIFICATE NUMBER: 19834682 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.'-NCI-,91THSTANDING 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.__—____ __ __ �INSR -----AOOL SMDR--------------_- .-- POLICYEFF POLICY EXP LIMITS LTN� -TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIODIYYY A GENERAL LIABILITY - GL04887714-01 D3/01/1 03/01/12 EACH OCCURRENCE $ 9,000,000_ X OISMAG ORENT 1_000,OOfI_ COMMERCIAL GENERAL LIABILITY PREMISES[Ea oa rrence { CLAIMS-MADE,u OCCUR MEO EXP(M one person) S E%CLVD£D X LIMITS OF POLICY XS - PERSONAL BAOV INJURY S 9,000,000 X OF SIR: $IM PER OCC' GENERAL AGGREGATE E 9.000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG f 9.000,000 - —_ X PRO- S POLICY LOC BAP. 293886J-08 03 O1 1 J 01,12 COMBINED SINGLE LIMIT 11000,000 B AUTOMOBILE LIABILITY X ANY AUTO _ BODILY INJURY(Per person) f ALL OWNED SCHEDULED _ BODILY INJURY(PeraccMent) S AUTOS AUTOS OWNED PROPERTY DAMAGE Per cidenl f HIRED AUTOS AUTOS X SIR AUTO P Y - - - - S UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LAB CLAIMS-MADE - _ AGGREGATE S OED RETENTIONS WC STATU- OTH- C WORKERS COMPENSATION WC061967352 (AOS) U3/O1/1 OS/0"12 X r LIMITS AND EMPLOYERS'LIABILITY YIN WC061967354 (FL) 03/01/1 03/001/12 EL.EACHACCIDENT E 1,000,000 D ANY PROPRIETORIPARTNERIEXECUTIVE❑ NIA '-'— OIFICERIMEMBEnE%CtUDED7 N WC0 919 673 53 (CA) 03/01/1 03/01/12 E.L.DISEASE.EAEMPLOYq S 11 000,000 E (Mandatory in NIL) — Ifyes,desalheunder E.L.DISEASE-POLICY LIMIT S 1,000,0Do- 0 ESCRIPTION OF OPERATIONS below C Workers Compensation 7CO61967355(KY;MO,NY,WZ, Dl/Ol/1 03/OL/11 F TX Employers XS Indemnity - TNSC46244151 (TX) 03/01/1 03/01/12 Occurrence/SIR 30M/1M . E Workers Compensation WC1192378 (QSI) 03/01/1 03/01/12 SIR 1pl DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORO 101,Addilional Remarks Schedule,if more space is required( RE: EVIDENCE OF COVERAGE CERTIFICATE HOLDER CANCELLATION . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE HOME DEPOT, INC. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN HOME DEPOT V.S.A., INC. ACCORDANCE WITH THE POLICY PROVISIONS. 2455 PACES FERRY ROAD NW AUTHORIZED REPRESENTATIVE BUILDING C-20 USA ATLAMA, CA 30339 ©1989.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORO i F:­ k,n • U-raccf Sc�arNe LairCCe�',ezrt • . . r•�-emu crrr�:.,�:bd..n,4:�t,r •• f`0. . 32 1.• PDDCi1JPlAL PERF..UNMAHCE RATINGS > • EVALISALION&WLpAENTMIA M PaOs6WE M ..,, ri'C. .tans�4 w:r,<al,rs>aic.iaasr�eo�>o Wc�lranun�+n + Cepetonr aila+e.., "•I<s'Gl n 8dmked ks rAaaQ ssl d nFoimml aYtlCuu vd f P�'m.lfTG A+.,l•rc4rc�'mnrd rl aanedail Mt?Rr ONp'ode P ! ': sd&isrdyansrR 7+1s&birgd=9'R"fA�X n�recat _ �__ • . ••EsL �m 4A W''��aindat do lil R�Tl1'�b�'d°i` pnbLmtr bbkX% Omro d Pul�t': " p6dmin+.ker r�al>.Daf aartdArtd'!dm patio oa'7+�M1�h�' •r antkWrl IfPLm��f�Va�7al=f7ro7r+�+P+�7�oacend.naff.Pnu�oPa4,•c•!a?.>.Aa�i .; - :t4;� ,tbU Jd YtrlatiCma�tb PR'►m ds tsY Redthrw6ca9.:':•-, .• :•:. - + ' '"Un LC q+alltLia for ,(MERCY 9LA-4 eaglenlUn llnctnicn, NoctR - _ .• So+t^•+^- .,.k '. Cant.al,•fo+tK Gnt.a L, ShCABl STAR 14 +n1dtC 1,LLflea•pa.a la(al •• .. ra�LAn(.fI 't1u0RQY_7LLA: lla cti. - r • Hocta Canteal. Iai Centcal, l+e..' , ' '•" " ' INO: (la La 0C/CLaaa S/]1'/s—Rl];, • �'>� •.. ' Luta6 9Caca 7C r G7' •• .Ill(a:.Hat+ac,o -OC/YLd.10 2.311 3WK( RIS .: . I1p . ( 43 . .. rsMa�a ppoz,ao: lL.4 CA 45 '•' �U713. .'. N! Yof Lain c . . . Cnp�F,�Ifapos6wEHQ4T�uNn�i+L4ta�ea+•klrvr:.u�stai?r. .: . . • Wad(um ihNam P�Pow nuria modj6 SWhmmrowra0'3rmd(ism.sidemjm mftrt • =-:- K=P,m�•�.;.,�xr� �✓Lfa°°a�"eats UfBee of Consumer Affairs&Business Regulation OMEIMPROVEMENTCONTRACTOR 1 _ VRegistration 136893 TYPO . .EzplTalion--813i2(112 - ' `:StiPplement! Thee Home OeWL.p?FlameSeYv ces . _ RICHARD FALLOKIE 2690 CUMBERLAND PARKWAY S - - !LTf.-.849, ne anz�o , _a..e.cretary