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HomeMy WebLinkAboutBuilding Permit # 8/16/2016 NORTH BUILDING PERMIT f.D TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: d� Date Received Date Issued: Z—ORTANT: Applicant must complete all items on this page LOCATION e-1-e57;0c/ 17-- Print iPrint PROPERTY OWNER C Pnnt. 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District ye no Machine Shop Village y no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family El Addition Ll Two or more family 11 Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg Pi Others: ❑ Demolition �d��``��� ' ❑ Other QNO "� DESCRIPTION OF WORK TO BE PERFORMED: 77-'-C r. 5AiiE®&I TO ~`[ JrV\ IQTrDV Identification- Please Type or Print Clearly OWNER: Name: 1g Phone: E3,60 -o&oo Address: e-L-r 5 p 7- Contractor Contractor Name: tTY ` - fl^c Phone-. EmaiG' Address: 2.- &,51i 15r �P`STo �✓ Supervisor's Construction License: /0601.) Exp. Date: l bmz If_ HomeP Im rovement License: /® 71 ( Exp. Date: ?Z? 2/,T- ARCH ITECTIENGI NEER /,T-ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL.ESTIMATED COST j 3ASED ON$125.00 PER S.F. Total Project Cost: $ 3 3 Co. ® ® FEE: $ t� Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund thoRT11 '4 Town, of � .. s .:..... 6Andover . 0 = s+► No. Iql. d � � Z n T O LA/{E h ver, Mass, C0CKICKEWICK y1. S U BOARD OF HEALTH Food/Kitchen LD Septic System THIS CERTIFIES THAT [TI BUILDING INSPECTOR -ow.............. ..... .................. ..... +...... ....... ... .................. R et4 ... Foundation has permission to erect .......................... buil ingAs on ..--��RR���,.... ... ,..... . ..... Rough p S ,. ......• . . ....... ..�,,� �lt�, .. .r Chimney to be occupied a y provided that the person accepting th permit shall in every respect conform to the terms of the application Final on fife in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES 16 MONTHS ELECTRICAL INSPECTOR. LESS CONS TI® S Rough Service BUILDING IN CTO Final GAS INSPECTOR Occupancy Permit required to Occupy Buildinz Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. surer Street No. Smoke Det. Foderod to#05-0406620 RISE Engineering Rl Contractor RoUlstration No 0186 U4,Contractor RogistratiGn No 120979 R IS A division of'lblelsch Engineering ECo 44A 00 ENGINEERING' T-1� CONTRACT 401 FA 401-123-1234 ELI, PROGRAM Page I 1115 CONTRACT IS ME RED INIDBEIWEEN RISE CMA-HFS ENGINCERINCIAND VIE OUSIONIERFOR WORK AS ORBORIDED UELOW cualmen PHONE DAIS CUENTO WORKORDER Charles Gangi (978)36(),0600 06/28/2016 436947 00002 -Y SERVICE SYREET DUA10 SIREET e tit 53 Chestnut Street 53 Chestnut Street I Di SERVICE CITY.DTNIE.ZIP 81111140 CITY,GIAIE,ZIP v N I n 0 r, North Andover,MA 01845 otih Andover,MA �1$45, , JOB DESCRIMON BARIU E,R:A Blomor Door TDst mill not be conducted at your home,duo to the presen se of asbestos. WOO I IA ZA R 1)BARRIER:We have idvit ificol that Ihere are uncovered electrical junction boxes present in your home.T hese need to be covered prior to the start of your homes mcat licrizat ion mourk,and are the responsibility of the hoincowier. $0.00 I IAZA R D BARRIER:We have identified that there ate recessed lights present in your home,unless the recessed lights are certified as IC-rated(Insuhnion Contact Rated)%w will create a 3"clearance space around the fixture by using fiberglass blanket insuiat ion as a damming material,no insulation will be installed across the top and closed eav it ics which contain reemed lights NviII not be insulated $0.00 BARIZI Bit:The following contract is not valid unless accorn panied by the P re-Wcot her izat ion Barrier Incentive form,signed by your licensed electrician Work Will not proceed with this work until we receive a copy of the form. $0.00 At R'A,'A 1,1 NG:Provide labor and materials to seal areas of your home against waefal,excess air leakage, This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healt h fill level of air exchange and indoor air quality Materials to be used to sea]your home can include caulks,foams and other products. Primary areas for sealing include air leakage to attics,basernon(s,attached garages and other unheated areas(windows are not generally addressed,I This Will require(8)vNorking hours.A reduction in cubic feet per minute(cfm)of air infiltration Will occur,but the achuil nUinber of efin is not guaranteed, At the completion of the wwatherizrnion work,and at no additional cost to the homeowner,a final bIo%wr dour and/or combustion .safety analysis will be conducted by the subrconttactor to ensure the safely of the indoor-,air quality, $680.00 ATTIC FLAT:Provide labor and materials to install a 6'layer of R-21 Class I Cellulose added to(352)square feet of floored attic space, $626.56 DAMMIN(1 Provide labor and materials to install a 12"layer of R-38 unfaced fiberglass batts to(112)square feet for(kinniling purposes. $229.60 ATTIC FLAT:Provide labor and materials to install a 12"layer of R-42 Class I Cellulose added to(396)square feet of open attic Space. $633.60 SLOPUS:Provide labor and materials to install It 6"layer of R-21 Class I Cellulose added to(88)square feet of slope area.Wherever possible baffles will be installed to the entire length of each bay to maintain ventilation spacc,K]Hrip FLOOR. $163,68 ATTIC ACCESS:Provide labor and materials to insulate the back of(l)attic batch with 2"rigid'r h crinax board,Weatherstrip the perimeter $60.00 mob\ /01`aft� /0-, Federal ID 0 0440829 RISE Engineering RI Contractor"Istration No$186 VAContrector Ropietratlon No 120879 A division of'lbietsth Engineering RISEiCompany Address,City,MA 00000ENG 401-123.1234 FAX401-123-1234 CONTRACT RACT page 2 PROGRAM CMA-NES risoosIMWM DrISrEDWOMAMMxen'" "vrcnn'e0iS osteseae CVah1 m PKM DAM CLMW/ WORK omit Chanes Gangi (978W0.0600 06/28!2016 436847 00002 590105 Susses muowo ova" 53 Chestnut Street 53 Chestnut Street 6ERV1Ca aw."v4 nP aP.rCur,mia,RIP North Andover,MA 01845 North Andover,MA 01845 JOB DESCRIP'T'ION ATTIC AOCESSProvide labor and materials tomake(1) access opening from one attic area to another by cutting a passage through sheathing This areas All be left open as it is between two common unhealed non firewalled attic areas. $31.31 VENTILATION:Provide tabor and materials to install(1)12'X 18'aluminum gable end attic vent.RIDGE VENT EXISTS,NOT CUT THROUGH. $247.OD VENTILATION:Provide labor and materials to install(2)80 diameter roof vent(,)to increase ventilation in attic areas. The vent can be supplied in(circle colnr ask brown,gray or mill finish-RIDGE VENT EXIST$NOT CELT THROUGH. $171.00 VENTILATION:Provide tabor and materials to Install(1)insulated exhaust hose to existing bathroom fen(s). $50.00 VENTILATION;Provide labor and materials to Install ventilatlort chutes in(44)rafter bays to maintain&flows $88.00 VENTILATION;Provide labor and materials to install(6)4"X 16'rectangular aluminum soffit vents to increase ventilation in attic areas.Specify color:White or Cray. S150.00 BASEMENT CEILINl3:Provide labor and materials to install(82)linear feet of R 19 unf ed fiberglass insulation to the perimeter of the bamment ceiling at the house sill. $143.50 INCENTIVE:RISE Eagineeringwdll apply all applicable,eligible incentives to this contract. You will only be billed the Net amount. Currently,for eligible measurea,Columbia Gaa offers an incentiveof 75%not to exceed$2,000 per calendar year,and an incentive of 100%for the Air Sealing measures up to the first$680 and an additional$340 if savings are justified by the auditor. FOR A LIMITED TIME:Columbia Gas will also offer an additional S 100 incentive towards the weatherization hark outlined in this proposal.This special Summer Incentive is available to homeowners who have had their Columbia Gas home energy audit before July 31,2016. A signed proposal for weatherization needs to be submitted by August 8,2016 and work must be completed by September 30,2016. For the safety and health of your homes indoor air quality,we will be conducting a blower door diagnostic of the available air flow in your home both before the work is begun,and after the vseatherizatfon work is complete.We will sire conduct a full assessment of the combust ion safety of your heating system and avatar heater.T his has a value of$90 and is at no cost to you The maximum allowable fneent Iva for 411 measures,including air sealing,is$3,210 $90.00 V I !1 i Federal 10 A 054MD$020 RISE Engineering RI Cantraetor Ra islydon No WO MAContractor Re0isMon No 120874 S A division of Ibletseb Hagtneering ENGEMEE�lG Company Addregs,City,MA 00000 O��wRA�� 401.123.1234 IFAX401-123-1234 rV Page 3 PROGRAM CtVIA•H�S ��Rm" 181 VUSINUR WON DAM Como WMGFM" Charles Gangi (97M),MU600 06/28/2016 436847 00002 SERV=ATdMT U)"D ovkm 53 Chestnut Street 53 Chestnut Street $Ekvm ra",GA7.aP sum OW.aa$aP North Andover,MA 01845 North Andover,MA 01845 JOU DESGRWnON Total: $3,364.26 Program Incentive: $2,770.00 Customer Total: $684,.26 WGA8MH9RIWT0PURNWBERVUB-OWPUFMOIA0000ARCHWIT11ABCV116110 CATMILFCRTheWMCF *"Five Hundred Ninety-Four&261100 Dollars $684.26 late eA4AkCEa mnAAPY8888aSY=2 Caaln4U9 �AROQA6AHaWARAN11ae.ROMOPWRE�pMao1��lQ��9RYGNAMY O NOT S THIS CONTRACT IF THERE ARE ANY BUNT ES "EEO Sl6NAMS SO EMVAWKG►e once r jj Kam;ra)ortinAcrlq►vssw� aruea�KorexaouaowianK oATeaOPAaegPvaea G ACC � ARK IACCEPYOUARAU7CK®ak1aa118VO DAM Rc30 AB9OAAAq aELHH2gifE t RISE60 Shawmut Road, Unit 21 Canton,MA 020211339-602-6335 ENGINEERING www.RISEenginearing.com OWNER AUTHORIZATION FORM I, v-/e (5Q� , (Owner's Name) owner of the property located at: (Property Address) (Property Address) hereby authorize b 10't- Bec� w5 - . (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property.This form is only valid with a signed contract. t �— Owner's Signature Date 'i i i The Commonwealth ofM'assachusetts Department of 1fidustria(Accidents Office Of-ruvestigations, 600 Washington Street Boston,MA 02111 '+ www.ma_v.gov1dia workers, Compensation Insur4 ceAffidavit: Buflde�rs/Contractors/BIectrie-ians/Plumbers A Reant Information please Print Le 'bI Name(.Business/Oxgaaization/rndividual): .A.ddress: PO BOX 958 MA M10 Cxt�r/State/Zip: Phone#: I1 , Sfto�S�l�Sr` [EDI n employer?Check the appropriate box: Type of project(required}: a employer with.�_ 4. ❑ I am a general contractor and Z loyees(full andlox parj time).* have hired the sub-contractors S• ❑New consti ction a sole proprietor or partner listed on the attached sh%et.3 7. ❑Remodeling and.have no employees These sub-contractors have 8. ❑Demolition ing for mein.any capacity. worlcers'Comp.insurance. g, Building addition workers,comp.insurance 5. ❑ We ate,a corporation and its red.J Officers have exercised.their 10•❑Electrical repairs or additions a homeowner doing all work night of exemption per MGL 11.❑Plumbingg repairs or additionslf. jNo workers'comp. c.152,§1(4),andwehaveno 12.E]Roofrepairs nce required.]i employees.[No workers' comp,insurancerecluired.J ME]Other :Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indiqatingthey are doing all work andthen hire outside contractors must submit anew affidavit indicating such. tContractors that check this box must attached an additional sheet shewingtho name of the sub-contractors and their workers'cornp.policy information. I'M an employer that isptavdding workers'compensation insurance far my errtployees: Below Is thepalicy anrZJ~ab site information, Isurance,Company Name: P Policy#or Self-ins.Lia. ' —,-- Bxpiratloal)ate: ) Or bt7! rob Site Address:_ (`1•n.v STSy 477— City/State/Zip r- Attach a copy of the workers,c ' ensation policy declaration.page($howing the policy.number and expiration date). Failure to secure coverage as requited under Section 25A of MGI,c.152 can lead to the imposition of criminal penallies of 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 foie of up to$250.00 a day against the violator. Be advised'hat a copy Of this statement may be forwarded to the Office of T- vestigations of the DIA for insurance coverage verifleatiou. t Ido hereby ce 'y nrler lite pains nndpennlfies ofperjury that rile infor"arrtion providerd above is true and carred. Si ature: Date ��/Co 'Irene#: FFFI0;ifjffJ7IcIaInly. Do not Pyritein this area,tolie eompletecdby city or town official.: Permit/License# ority(circle one): 1.Board of Health 2.Building Department 3.Cityffgwn Clerk 4.Electrical inspector 5.Plumbing Yspector 6.Other Contact Person: Phone#: 7 ® DATE(MWDD)YYYY) A`C<>o CERTIFICATE OF LIABILITY INSURANCE 6/10/2016 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 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 Linda Bogdanowicz insurance Solutions Corporation PHONE (603)382-4600NQ:(603)392-2034 E-MAIL ].indab@isc-insuranae.com 60 Westville Rd ADDRESS: _ INSURER{S)AFFORDING COVERAGE NAIL# Plaistow NH 03865 INSURER A NOLStOrn Worid INSURED INSURER B NaUtilAS insurance group . Polar Bear Insulation Company Inc INSURER C: w PO Box 958 INSURER D: _ INSURER E: Andover MA 01810 INSURER F: COVERAGES CERTIFICATE NUMBER-.CL1632326134 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. INSR ADDL 5 POLICY EFF POLICY EXP LIMITS LT TYPE OF INSURANCE POLICY NUMBER MMID YYyl ("WoYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 9� DAMAGE TO RENTED $ 100,000 rn A CLAIMS-MADE L OCCURPREM15ESf€aoccurrenca NPP8274967 3/24/2026 3/24/2017 MED EXp(Any one anon) $ 5,000 P€RSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- �LOC PRODUCTS-COMPIOP AGG $ 2,000,000 X JECT $ OTHER: COMBINED AUTOMOBILE LIABILITY Ea acccIdentSINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY€NJURY(Peracckienl) $ AUTOS ��OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident "o $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAR CLAIMS-MADE AGGREGATE $ 1,000,000 7ua026107 3/24/2016 3/24/2017 DED RETENT€ON $ WORKERS COMPENSATION STARTUTE �TRH- AND EMPLOYERS'LIABILITY YI ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ _„ N/A OFFICERIMEM13EREXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ It yes,describe under E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below L L DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Addillonal Remarks Schedule,may be attached It more apace to required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 Osgood St, Ste 2032 ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Keith Maglia/SJAL`� O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD IN5025r�Mant� 611012016 Preview:Certificates of Insurance DATE ISMA&WYYYY) A �L7 CERTIFICATE OF LIABILITY INSURANCE W1012916 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 INSURERtS),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED.the policy(les)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 thls certificate does not confer rights to the certificate holder In Lieu of such endorsement(s). PRODUCER NAME: PHONE Automatic Data Processing Insurance Agency,Inc. tAJC.No.Est: IA C.Nok 1 Adp Boulevard ADDRESS: Roseland,NJ 07068 WSURER(S)AfFORDING COVERAGE NAIL It INSURERA: HorGUARDInsuranwCompany 31470 INSURED INSURER B: f POLAR BEAR INSULATION CO INC INSURER C: PO BOX 958 E Andover,MA 01810 INSURER O: INSURER E: FNSURERF: E COVERAGES CERTIFICATE NUMBER: 503587 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%':HiCH 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. LTR TYPE OF INSURANCE INSD Iyyp POUCYNUMaER MWDOFYYYY MFDDIYYYY LUMtTS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 CLAILIS-FAADE OCCUR PREF.IISES[Eu occurmnce) S LIED EXP(Any ma pa,sonl S PERSONAL S ADV INJURY S [ENL AUGREGATE LIMIr AF•I''LiE$1'ER: GENERAL AGGREGAI E 5 PRO. LOC 0 2 PRODUCTS-CCFPt'hGGE S OTHER: CorAUTOMOBILE UAUNUTY SINGLE :,I S IEa.1"IN s,l) ANYAUTO BCDILY INJURY IPa penOnl S ALLCYrh`ED SCHEDULED BCOILY INJURY(Prs—d-t) S AUTOS AUroS NCN�OINNCU iP�xcidcrll ..U S HIREf1AUTOS AUTOS S UMBRELLA Like OCCUR FACF+.OCCURRENCE 3 EXCESS LIAR CLAILIS-FdAOE AGGREGATE S DELI I I RETENTIONS S WORKERS COMPENSATION X H AND EMPLOYERS'LIASILITYY 1 N STATUTE ER 1,000,000 A o€c�RIL i8ERFXC1UOED1�uFlVE NIA N POWC772258 91!01!2016 0110112017 EL.EncHAccIDENT 5 (Mandatory In NHl EL,OkSEASE-EA EMPLOYEE S 1.000.999 Iry do e t e aad« 1,000,000 OESCRIPT(ON OF OPERATIONS E.L.DISEASE•POLICY LIMIT S DESCRIPTION OF OPERATIONS 1 LOCATIONS VEHICLES(ACORO 101,Additional Remarks Schodule,may he amched if mora spaca is required) CERTIFICATE HOLDER CANCELLATION u SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood St.!suite 2035 North Andover,MA 01845 AUTHORIZED REPRFSE14TATIVE 1S. _ j A©1988.2014 ACORD CORPORATION.Atl rights reserved. ACORD 25{2014101} The ACORD name and logo are registered marks of ACORD I' Itttps:lfadpia.adp.cornlicertefl#lninlprevieYv1503587)900012975 1!i � "^� ,!'�'ffi' �"11�-'.��'���`Ai�1��"'d✓�fl-tv"t°�'✓ �''F'� �J � f;�'/1��,f' '1✓d:�,/.�f�✓,�,,✓,� R- y?` Office of Condoner Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 102726 Type: DBA Expiration: 7/2/2018 Tr# 419291 POLAR BEAR INSULATION CO. _.-- Vincent LeBlanc P.O. BOX 958 _.. . _......__ ANDOVER, MA 01810 Update Address and return card.Marls reason for change. Address f-] Renewal Employment Lost Card SCA 1 0 2W05/11 / /J off^° License or registration valid for individual use only .��.`� Office of Consumer Affairs&Business Regulation g VHOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 102726 Type: Office of Consumer Affairs and Business Regulation Expiration: 7/2/2018 DBA10 Park Plaza-Suite 51"70 '�'\ Boston,MA 02116 POLAR BEAR INSULATION CO. Vincent LeBlanc 51 SO.CANAL ST.#5A LAWRENCE,MA 01841 Undersecretary Not valid without signature 1 M assaac h usetts [)epaurtir uetit of a bt~ c Safety-- Board of Baia dl ng Regdaafions and Standards Conr11.1wairan supero isor siredalt) G.-:cclns : ChSL-106017 w % rig PETER A LE BLANC 2 EAST PINE STREET Plaistow NH 03865 i=x4a6uafion r nmm�r aakirn*r 04/28/2018 a