HomeMy WebLinkAboutBuilding Permit # 12/8/2016 q,ORTH
BUILDING PERMIT oF��4Eo
TOWN OF NORTH ANDOVER 00
APPLICATION FOR PLAN EXAMINATION
SFA
Permit Nod`: Date Received 7q p�RzD t4a�t�3
ssacwu5�
Date Issued: r
I PORTANT: Applicant must complete all items on this page
LOCATION 37I CiYb�r+�
Print
PROPERTY OWNER
Print 100 Year Structure yes no
MAP b��PARCEL: L ZONING DISTRICT: Historic District y s no
Machine Shop Village y no
TYPE OF IMPROVEMENT PROPOSED USE
Reside al Non- Residential
❑ New Building ne family
p ASion ❑Two or more family ❑ Industrial
teration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg thers:
❑ Demolition ❑ Other
C�Se tic Q Well ❑ F[oodpla�n ❑ et AMY"" ❑ 1lVatershed District
n < r
' cx ✓.�.::veav�,,,,..u,`��-,�,``"�,r, " f;<.�y �r r^
DESCRIPTION OF WORK TO BE PERFORMED:
f ce� IGS lor - 9'
.9� S
Identification- Please Type or Print Clearly
OWNER: Name:_ ��� Phone:
Address:
Contractor Name: c �! Phone: "7�S -2qzf R1
Email:
Address: ITr
'3' q77 Ex Date: �l�2 .7
Supervisor's Construction License: 7 p
Home ]mprovement License:
ARCH ITECTIENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST 8 ED ON$125.00 PER S.F.
Total Project Cost: $ a [ FEE: $ � .�-
Check No.: Receipt No.:
NOTE: Persons contracting WA unregistered contractors do not have access t the guaranty fund
..............................
FORTH
town of � at,
®veer
No.
h ver, Mass, � � g
COC Ic"aCK
A 7-E 0 P'1F
U BOARD OF HEALTH
Food/Kitchen
PERMI D Septic System
THIS CERTIFIES THAT ....... .... ... ............ ......... ... ..... .. . ...... BUILDING INSPECTOR..............
at Foundation
has permission to ere t .......................... buildings on . . ... .. ..............!!A.... tj A
to be occupied as ..... ...... Rough
... ... t...................... . ........... Chimney
provided that the person accepting this permit shall in every respect conform to the terms 0 he application Final
on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection Altera ' n 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 IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONST TI® Rough
Service
...jk_x Final
BUILDING INSPECT(A
GASINSPECTOR
Occupancy Permit Required to Occupy Buildin 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. Burner
Street No.
Smoke Det.
ntis farm"Sff, Dai CO fi °Mt
language to PMtedttoME0wAe refiseak fffiesta[E'siiamclmpnavDmentContract
MasilchttsettsConsumerGtEldcbHaEnB�adfncaff�ecessUwr nypemnplanntagh�n� 142A).�tdoesltotmdudesbndnsr]
OfSceoFCaDsumer andBc nasg provetnrnE beftttungztein�toany�vorLan �lovmrtenlsshould fiaubtainacopy of"A
+gnTatians Couswner InfomEatiaa$oHina nt617•A7�31-S787 nrOU May
of 57 aam copy
opM g the
�'o>tieo�er.�f'or�tz3iioQUin
Mame COTIftctorWor maiiora
eA G; CamPuyNMae
Strect Address(do nat esenp
10 _71TfiCOBOx nddrtas)
Ma.6/er, Cnntrectont5al
n� '°"° ,
CitylCou l j ff
s 1c Code BasiD �j AYMUe
atsAd@rzss(must'
DaytimeFhopne �� $g"
D�d ���v�tagPhona '�� Cityll'av,n
'f� SLIM ZIP Code
Isdniling Address{ltdiffarent fmrrE abovz}
$win Pham Pc�rtfal 1
Srga war ipar8,3.Ntanhx
r.�s islra ems=-ssrla� �r�'°���"��+n4•N�bn- �,� w
_�� Sriwnt�ru �UJZG�
The E;antrnc4o:A,ns'es to da fire FalfDv�incaLa>,quLs�s,�,�
fD,sribeindetailEb-atiarktaaamplctads dr{°rl�for the Holawpnst:
P ns thrrypybmul,and pad'ofnatcriaistohe
6/m +-- , C- Axl, adDdiNo �t.gcetsiF
Reg UIred p
-T"nafolIDwing haildiasP�nits aro
and�villbcsecrtredbythecontmejorasthe homeotsamrra� �OpO'�Sttugnud�
(t vg7pt 5 WT70 secure their arta a gent: beadhemd to mtl °�effan SrSag sTtrte-TbefoffarringMha&dorwM
esc9uded offi ralaitsw he esscirctnnstmnxsboymtdtheeantEactorscantralnriss
MCL ch2pier142A,uuranty npd Provi lues of
3 'when euaFm°tarSedff bDSin cantrncted Ei'oth
Tatulaon ---�w�ala vheDcontractedwDrkrvi716ssuhstantiOlfYaomplcled.
trnctf'rice ndI'ayEuui: I!5edufe
Th ConnaDtorD to ptaFara,tha tyark,Ftuaish drr:utateri
Aayst3cntstvitfnacardi al&,a labor
be made
baveforihefatalsumttfr. ��,
ogto thOfalloVAngsahedale: (°)
uoon sighing coat—t(flat to eked f/3 aftho total contract
Uric--or
Uric--Z, orderitams,
b3'--•1�oruPan whieh�isgreatcr)
completion of �
�/�fJ`��'—by -f I orupau completion of
t= .�
Upon colnplcliunofthoConhac,, {Lawfarbidsdewandio C �P' G7-v
TncfallawFngraaEsinl/ g_ IPayment lmh cantractis mpletcdtohD>b
ord:rr,Elbafer*1hocall a,mpmentmDstBaspecjel Parvs&t&Factiow
to meet the fed�vd br"�ins in ardor �" --t0 d f r
sDm1`141)n scbedala,(4>)
hretadingaltA - be ' Car
not exceed
trrealareage'(")Lnvrreyvir�ttmsanydepceitDrdexrr•
whictlrnu,tt,", {lan iMaftltareteJwnh;=atNicear tu]+mrntrcq°itt�ibytbacanlrctarbeFarauUtf.b
oralanieredinadvancntomectthewmple@onse�edala [ualeasloFarsycPxia! ui m 4nsmay
xE Partarcastomrrradcmatezint
Iisnra;,s q�n..nt -Ls:r c res 7r�'-�
snGr-antt'aC#ara"�iEe Canlfaetara ntvh^n Yrdrd IhCmntiar ar? i.-1`•
party/srd�eonErnctoru" gtcestobesolal rd5p ,n�fYen rlti 7nanfshenn nhrmr thaattnrledtnthernntr7
bfEredbYthecoahn Y a�•bleferaompletionnftLDwad;descn7redn
atetia�sn dlah rrmderthisltaftcntrecnatrsctorFtuiheraudte�gEthearaeonsafuvYtl>irrI
COrtMCt Ace- Eo besafety rzxpansiibloibrall paymanis to W1 EubcoutmCrors for
enntrtctsitallnotimcl•th�n� toiherEL nentGecomMabindingcennernnderlatr TInlDssatharvdsenatedtvitSintFrisdoDltmant,[hc
earefidfyhcFnresi P} UMILIfen otberse tyiw"Wtbasbeeaplaca<Iantlrc
SuingtbisconGact. resid°uaa Rcvj�rf]tei'agoyyrng�ytionsanduatiDDa
° Don't be pt�:urcd tnta EI
° YfafcesuEt±thcconhsel r�sthewnq�Tht;etimetor�dnndFuli
sub an[raclomlo6ere 'ste ralidHomeTir� vament Yunde:staadit Aslegnes4ansiFsDmethin is j
registrat{onb t gg radtsitlt(heDir7ctaroFHome nttacrarR s 'a 8 unclear.
Y vtiQa totb,I)freator ImproventeatContrzDtar tt lacvregtzlresmbstbomcimprovcrnentaantrDctDEsand
b Does thecantracrarha4a nt[OpadcPlara Raam5l7i3 Basio wstralion'Youm yiatTuireabaDtcon[rnattr
eaaC°Fvofa`i�r4ofafin st tcO Ask the,contran[arforhisi7, n' (12I1GarG}r�fl�gG}773�pTurS862B3-3757.
Q I€11 a atu sumd da°ument "umato oamPany inForutDfiou sn
3
Guido tothcSfosncnc,",rtdrz, nnsiGdities Retdttte thatyoacannan&mtrnveraga,araskto
Tmpraveur
ant
CoafisctorLai pa tfnfora;a on an theravcEsasldeoftirisformaadget ncnpyofrlteCausEtn� cr
YoumnycancDl6'Efsa eemMe-- sb
contraDtarintvritingattrisllE°rmainasrgnedataplaceathatbaBEheacalrctaPsn
third business day follotvin a�caor bmciE trtiice nuAal P1atb aFGusin
9thesigniagoPthisa
91 Div
7hai1Qar®$el3c�roI4nicfr1aru: � camk451+otrsolfcsaa¢tmytrm"cmlE�e'da POI suact�stanf�byttelegrma
lcutnrbydaveyI,nnaavtiidaetdcryt
mrata%pTagah1CTMiBonofthottui�snriamgtahiEdtyu.
tigbhe
IRE, ARM,
taftle
ANINKSPACEMY!
77ea12'crwx. d6eLav
® .ac
Ilamuw3;as 5it:nnttrrc
Daze
L Coatraaraes sipatura
1
The C'onwrioniveaffli o�`'MassacktiseMs'
Office of bivesfigadoyis
f
WWakens' Compensailon Insurance Ai" da-viit: TRuil hers/Contr acto>rsf ElectF-ic ians/PI-tuber s
ApOicaut infoi:•majon Please Print Libl T
Naille (Business/Organization/individual), SrS�VrC F.¢L 'tL ?_:cfl ,ct?i, . LI. '
Address: ~f rc '\V, 111970
Cita,/State/Zip: Phone#: 7 - 7/� - �
'era yau-9iemployer? Check the appropriatle ox: Type of project(required):
I.Ell arn a employer with .... 4• [[ 1 am a general contractor and 1
employees (full and/or part-time).'`
have hired the sub-contractors ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. [-1 Demolition
working for the in any capacity. employees and have workers
[No workers' comp. insurance comp. insurance.! � E]Building addition
required.] S. ❑ ale are a corporation and its 10.[] Electrical repairs or additions
3.❑ I am a homeowner doing all work- officers have exercised their I LE] plumbing repairs or additions
]myself. [No workerscomp, right of exemption per MGL 12 � Roof repairs
insurance required.] c. 152, §1(4),and we have no
employees. [No workers' la
comp. insurance required.]
'.Atty applicant tlsat checks box 1 must also fill out the section below showing their workers'compensation policy information.
`i-lonteowners who submit this affidavit indicating they are doing all wort-and then hire outside contractors must submit a new affidavit indicating such.
Contractors that check this box crust attached an additional sheet showing the name or the sub-contractors and state tiviiedier or not those entities have
amp loyeeS. If the sub-contractors have employees,they must provide dieir workers=comp-polis},number.
I aln all employer that is providing workers,compens¢fion Irisanarlce far my employees Below is the policy acrd job site
111fo1'll adolr.
Insurance Company Name:
policy T or Self-ins.Lica: �'j 2 7 0 /Z j' Expiration Date: _'f
Job Site Address: 3 / Cit}�IStatel�ip: xx/Ke/",�
Attach t= copy of the workers, compensation policy deelar'a#ion page(shoving the policy number and expiration date).
Failure to secure coverage as required under Section 25A of NIGL c. 152 can lead to the imposition of criminal penalties 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 fine
of up to$250.00 a day against the violator. Be advised That a copy ofthis statement may be forwarded to t11e Office of
Investi;atibris ofthe DIA for insurance coverage verification.
I do hereby c`r't!hp harder thepains/aced peilatties ofpeiji"/fart tate infor enation provided above is true and correct.
Sienatttre:
e,.. Date: /2
Phone 4.
Official use only. Do not write in this areato he Coll
1pleted by city or toivlt offrcial,
Cita{or Town: Permi'd-License N
Issuing Authority (circle fine):
s. Board of�lea3th 2. Building Dapar imam 3. Cit,//To-wn Cle>h 4.Electrical Inspector 5.Plumbing inspector
{. Other
Contact Pe-son:
Phone
•.va v v E L,.• G.ii GV1V 2.011 . 4.'l HL'I lle% 'L. G/ vVG I.'GLA. at"ix VUx
rTHISCERTIFICATE OF LIABILITY INSURANCE DATE{MM1DDnYYY1
TIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
ICATE DOES NOTAFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
ERTIFICATE OF INSURANCE DO, S NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING 1NSURER(S),AUTHORIZED REPRESENTATIVE
O UCER H CERTlF C T OLDER.
TANT:If the certificate holder is N n ADDITIONAL INSURED,the policylies)must be endorsed. 11 SUBROGATION 15 WAIVED,subject to
the terms and conditions of the policy,c��1l I'lairt policies may require and endorsement. A statement on this certificate does not confer rights to
the Certificate holder in lieu of such end Irsement s .
PRODUCER CONTACT
NAME:
EASTERN INS GROUP LLC PHONE FAX
233 W CENTRAL STREET (AIC,No,Ext): (AIC,No):
E-MAIL
NATICK,MA 01760
ADDRESS.,
72MLW i INSURER(S)AFFORDING COVERAGE NAIC#
INSURED INSURER A: AMERICAN ZURICH INSURANCE COMPANY
ATLANTIC WEATHERIZATION Ll !C INSURER B:
I NSURE»R C;
f
9
61 REAR JEFFERSON AVE INSURER O:j INSURERE:
SALEM,MA 01470
INSURER F:
COVERAGES CERTIFICATE NumsE9R; REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE RISURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANYICONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE
AFPOROED BY THE POLICIES DESCRIBED HEREIN(S SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONOITKINS OF SUCH POLICIES. UNITS SHOWN MAY HAVE BEEN REDUCED BY
PAID CLAIMS,
INSR ADD SUB POLICY EFF DATE PrILrCY EXP DATE
LTR TYPE OF INSURANCE L R POLICY NUMBER IN"DDIYYYYE (M8'6DDIYYYYI LIMITS
GENERAL LIABILITY ACH OCCURRENCE $
rG17NL
MMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $
CLAIMS MADE OCCUR. REMISES(Ea occurrence)
MED EXP(Anyone person) $
ERSONAL 8 ADV INJURY $
GREGATE LIMIT APPLIES PER:€ ENERAL AGGREGATE $
ICY 0 PROJECT LOP RODUCTS-COMPIOP AGO $
AUTOMOBILE LIABILITY COMBINED SINGLE $
ANY AUTO LIMIT(Ea acradent)
ALL OWNED AUTOS BODILY INJURY $
SCHEDULE AUTOS (Per person)
HIRED AUTOS BODILY INJURY $
NON-OWNED AUTOS
{per accident)
E PROPERTY DAMAGE $
(Per accident)
I
UMBRELLALIA13 F OCCUR I EACH OCCURRENCE
EXCESS LIAR CLAIMS,MAQE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
WORKER'S COMPENSATION AND X we sTATttroRY OTHER
EMPLOYER'S LIABILITY YIN UB-bB27(121-15 03/2012096 03!2(!2017 LIMITS
ANY PROPERITORIPARTNER/EXECUTWE
'I Orr10ERINIEMBER EXCLUDED? a NIA E.L EACH ACCIDENT $ 500,000
(Mangetoryln NHJ E.L.DISEASE-EA EMPLOYEE $ 500,000
If yes,descr€be under 3
DESCRIPTION OF OPERATIONS below i E.L DISEASE-POLICY LIMIT $ 500,0O0
DESCRIPTION OF OPERATIOI151LOCATIONSIVE:HICLUS1RESTRICTIONSISPECIAL ITEMS
THIS RHPLACEiS ANY PRIOR CERTIFTCATri ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE.
3
k
CERTIFICATE HOLDER CANCELLATION
TOWN OF NORTH ANDOVER j SHOULDANYOFTHEABOVEDESCRIBED POLICIE$8ECANCELLED
1600 05GOOD ST BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL HE DELIVERED
IN ACCORDANCE WITH THE POLICY PROVISIONS,
AUTHORIZED REPR, TA. VE U;:••` :•w..
N.ANDOVER,MA 01845 : "'
4,
ACORD 28(2010106) The ACORD name Bnd logo are registered marks of ACORD 19B$-'2010 ACORV CORPORATION. All rights reserved.
I
i.
I.
i
AC"R® CERTIFICATE OF LIABILITY INSURANCE DATE(MNBQQIYYYY)
9/9/2016
THIS CERTIFICATE IS ISSUED AS A MPTTER 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 INSURERjS), 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: Construction
Eastern Insurance Group I,T,CI PHONE
(SOO)333-7234 FAc o:
233 West Central St i E-MAIL
RD Rarss:
INSURERS AFFORDING COVERAGE NAIC H
Natick MA 01760
INSURED INSURER Arbella Protection Ins. Co. 41360
INSURER B.Nautilus Insurance Co
Atlantic W@@tiler]Z�t1071 INSURER C:
61 Rear Jefferson Avenue INSURER ID
6 INSURER E:
Salem MA 01970 INSURERF:
COVERAGES CERTIFICATE NUMBERiAaster 2016 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 RECIOIREMENT, 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.
IN" B POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE POLICY NUMBER MMIDQ MMl00 LIMIT'S
GENERAL LIABILITY FACHOCCURRENCE S 1,000,000
X COMMERCIAL GENERAL LIABILITY PR E A RENTS $ 50,OOa
i E Ea oc rrence
A CLAIMS-MADE R OCCUR 8500042816 /20/2016 /20/2617 MED EXP Any one person) $ 5,000
X CONTRACTUAL LIABILITY PERSONAL&ADV INJURY 5 1,000,000
_X_j CG0001 10/01 FORM GENERAL AGGREGATE $ 2,000,000
GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIpPAGG $ 2,000,000
POLICY X JFCT PRO. LOC { $
AUTOMOBILE LIABILITY j come
O flr8aidenDlS1NGLE LIMIT 11000,000
ANY AUTO
AALL OWNED SCHEDULED { BODILY INJURY{Per person} S
AUTOS X AUTOS 1020015871 /20/2016 /20/2017 BODILY INJURY(Peraecfdenl) S
x HIRED AUTOS X AUTOS
PROPERTYDAMAG>
Peraccidenl $
I PIP-Basic $
X UMBRELLA LIAB XOCCUR EACH OCCURRENCE S 1,000,000
A EXCESS LIAR CLAIMS-MADE
AGGREGATE $ 1,000,000
DEP RETENTIONS 10,00 600058654 /20/2016 /20/2017 $
WORKERS COMPENSATION WC STATU- OTH-
ER
EMPLOYERS'LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE YIN
OFFfCERIMEMBER EXCLUDED? N l E.L.EACH ACCIDENT 5
(Mandatary in
I#yes,describeaunder E.L.DISEASE-EA EMPLOYE $
nd
DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT S
]3
POLLUTION i PL200378614 0/1/2015 0/1/2016 EA POLLUTION CONDITION $1,000,000
GENERAL AGGREGATE
$1,dao,aoo
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space Is required)
i
i
i
I
e
CERTIFICATE HOLDER CANCELLATION
h SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
i THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
TOWN OF NOR'T'H ANDOVER ACCORDANCE WITH THE POLICY PROVISIONS.
1600 OSGOOD STREET
NORTH ANDOVER, MA 01645 AUTHORIZED REPRESENTATIVE
i
Tohn Koegel/SME
ACORD 25(201 0105) I O 1988-2010 ACORD CORPORATION. All rights reserved.
4
(NS025 onina.m al Tho Atlf)pn nftma an,i Inn^nrn ranictnrnrt marlrc of llr:rlPn
Massachusetts Department of Public Safety Construction supervisor
Board of Building Regulations and :standards Restricted to:
License: CS-087977 Unrestricted-Buildings of any use group which contain
less than 35,000 cubic feet(991 cubic meters)of
aaa. &,d°¢ � iaaat«�Supervisor enclosed space.
ERIC Ott PALM
3 HILTON ST
SALEM MA 01970 "
.. I
Failure to possess a'cufrentedition of the Massar-huseft
i
Expiration: State Building Code Is cause for revocation of this ficenSe.
Commissioner 041231201$
CIpS Licensing information visit:11WIfOkt,MASS.ta01f/Ctp
y 4
' '/ r. naa„rnr�€urrrll�r�{,.tri�azrr,/rratl,+; License or registration valid for indiv"sdul use only
_.Ofiicc of Consumer Affairs lu Business Regulation before the expiration date. If found return to:
t E@W"== ME IMPROVEMENT CONTRACTOR office of Consumer K"ffairs and Business Regulation
egistration: 142089 Type: 10 Park Plaza-Suite 5170
. a; )radon: 311212018- Ltd Liatiffily Co or Boston MA 02116
ATLANTIC VVEATHEAlkAtION.L.L.C.
ERIC PALM `� r
61RJEFFERSONAVE2'7a'
Not valid without signature
SALEM,MA 01970 Undersecretary
k
Y
I
V
i