Loading...
HomeMy WebLinkAboutBuilding Permit #599 - 117 MILK STREET 3/11/2013 TOWN OF NORTH ANDOVER I� APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received Date Issued: I ORTANT:Applicant must complete all items on this page LOCATION E7 7 [Y\o �T I Print PROPERTY OWNER f g,G('barge S 1 eg 0_1 Print MAP NOPARCEL ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial :Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition _ ❑ Other �iSeptic0�WellIFloodplam� OlWetlands} ® Watershed}District 0 Water/Sewers DESCRIPTION OF WORK TO BE PERFORMED: rec'aaF (Identification Please Type or Print Clearly) OWNER: Name: &� �m S$�g cl Phone: ` 9 c?72-7 Address: CONTRACTOR Name: GC (- ,A� c I myxcl Phone: q-7��-/C6o Address: 'A,7 /04 '� ✓` 6 Supervisor's Construction License: �'j 84/F0 Exp. Date: /p-02 Home Improvement License: /1-7 e7o , Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 63 0. DO FEE: $ I C ) 4 Check No.: -NReceipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund - Signaturejof Agent/,Own2f___ Signatureioficontractort e� Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed.Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan.Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording roust be submitted with the building application Doc: Doc.Building Permit Revised 2008mi Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature � COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA— For department use ® Notified for pickup - Date —~ Doc:.Building Permit Revised 2008mi 7NORT" - ve" 'o No. _ _ ��K. h ver, Mass, �� • I A— ACOCHIC„eWIcw �1 S U BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System c n BUILDING INSPECTOR THIS CERTIFIES THAT ...............&j-7-6_1:kr.......6-a. .: ..2 ._............................................,........ Foundation has permission to erect .......................... buildings on ......... '..:.. : .1. ......51............................ Rough tobe occupied as ...............S. ...."r..... .d ...... ................................................. Chimney provided that the person accepting this permit shall in every respe t conform to the terms of the application Final on file 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final b PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI ST TS Rough Service ... ... ................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildink 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. SEE REVERSE SIDE 1NOR . w: : ve- Ae No. _ h ver, Mass, I �. A- cocNIc«ewocK '" 79 AERATED �P���S S u BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System bra, cBUILDING INSPECTOR THIS CERTIFIES THAT ................ •. .......5..?a. .,? ...................................................... r � Foundation has permission to erect .......................... buildings on ......... . ...... !:4.1. ....� ..1............................ Rough tobe occupied as ...............�. ...."r...... .a ...... .................................................. Chimney provided that the person accepting this permit shall in every respe t conform to the terms of the application Final on file 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 b PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI ST TS Rough Service ................. .. .. ... ................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. SEE REVERSE SIDE GEORGOULIS ROOFING & CONSTRUCTION, INC. 96 Arlington Ave. Dracut,MA 01826 At Greene-Estimator 1-978453-4242 Office 1-978-888-1700 Cell eor oulis141 ,aol.com CONTRACT Barbara Siegel 02/22/13 117 Milk St. N. Andover,MA 1-978-886-2979 bsiegelphd@hotmail.eom Job Location: 117 Milk St.N.Andover,MA Scope of Work: Remove all layers of roofing down to wood deck on entire house,additions,and garage roofs,protecting_ the grounds and house body with heavy duty tarps as stripping is being done. Install 6'GAF Weatherwatch ice/water shield underlayment across all eaves,in all valleys,full coverage on back breezeway roofs,3'up rakes at all roof to wall locations,and around chimney. Install GAF Shinglemate felt paper underlayment on remaining exposed roof deck. Install 8".025 gauge heavy duty white aluminum drip edge on entire roof perimeters. Install GAF Timberline HD Lifetime Architectural shingles with Timbertex caps on roof. Install new Coravent V-400 ridge vent on main ridges. Install new stack pipe boots on existing plumbing pipes. Install new bath box vent replacing existing vent. Install new lead flashing around existing chimney. Georgoulis Roofing will pull the required building permit,and the cost is included. Thoroughly clean grounds,and remove all job related debris from property on a daily basis and at jobs completion. $2.50 Per Lineal Foot Extra Cost to replace any damaged plank board decking(if needed). Entire job includes GAF Systems Plus Warranty. First 50 yrs.Is non-prorated,full labor and material Coverage from GAF,against any material defect cause. WE PROPOSE hereby to furnish material and labor complete in accordance with above specifications, for the sum of. Eight Thousand Six Hundred Thirty Dollars $8,630.00 PAYMENT TO 3E MADE AS FOLLOWS: $3,630.00 PAID IN ADVANCE FOR MATERIAL COST.$5,000.00 PAID IN FULL WHEN JOB IS COMPLETELY FINISHED ACCORDING TO THE ABOVE LISTED PROPOSAL. All material is guaranteed to be as specified.All work to be completed in a substantial workman like manner according to specifications submitted per standard.practices.Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our control, caner to carry fire,tornado and other ur necessary insurance.Our workers are fully covered by workers compensation' an Georgoulis Authorized Signature This proposal may be withdrawn by us if not acceptedithin 30 .lays. Acceptance of Proposal-The above prices,specifications are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. i Signature � rature )ate�f 2cceptuc 3 g The following is part of this contract: Contractor Registration All home improvement contractors must be registered with the Commonwealth of Massachusetts. Contractor Registration#117870 and Construction Supervisor License#058498. Inquires about registration should be made to: Director, Home Improvement Contractor Registration, One Ashburton Place,Room 1301,Boston,MA 02108(617)727-8598.Better Business Bureau, Inc. Georgoulis Construction, Inc. member ID# 35522. Contact the Better Business Bureau (508)652-4888 or at memberservices@.bosbbb.org. General All outside work areas will be left rake clean. Roofing may result in dust or debris falling into the attic. This contract does not include clean up or protection of the contents in the attic. In the event a satellite dish should have to be removed to complete project, Georgoulis Construction, Inc. will not be responsible for repositioning after re-installation, should it be necessary. Payments The maximum down payment or advanced deposit allowed by Massachusetts law is limited to whichever is larger: (A)One third of the total contract or(B)the entire cost of any special order materials. Final payment is not required until the date of completion of the project. Payment must be made within seven days from completion date. All Credit Card Sales over$1,000.00 are Subject to a 2.0% Convenience Fee. Work Schedule The owner agrees the scheduling date is approximate. The contractor agrees to show good faith in meeting deadlines but are not responsible for delays caused by weather. Suppliers, subcontractors, building officials. asbestos abatement,hidden damages or conditions, accidents, acts of God or anything beyond our control. Change Orders The owner is aware that the work may contain hidden damage, defects, or conditions such as decay, insect damage, or substandard construction practices,that may require additional work not included in this contract. In this case, Georgoulis Construction, Inc. will contact the owner and agree on an additional charge to the original contract rice. In the event the owner n gp o can of be contacted, and it is crucial that work continue to protect the residence from the elements, (rain, snow, ect.)photographs will be taken to document the necessity of the additional work. The owner understands that any additional work will delay the completion of the project. Warranty The contractor, Georgoulis Construction, Inc. agrees to correct any work that fails to conform with the contract or workmanship that is defective with in TEN(10)years from the substantial completion date of the project at NO CHARGE to the homeowner. The homeowner agrees to notify Georgoulis Construction, Inc. specifying the nature of any workmanship defect,immediately. No warranty is provided o ded f r o ordinary wear and tear, fading, abuse,neglect or casualty, or minor cracking/shrinking of concrete or caulking. No warranty is provided for materials not directly supplied by Georgoulis Construction, Inc. or for used,re-installed materials, (including skylights not installed by Georgoulis Construction Inc)or work done by others. This warranty excluded consequential and incidental damages. Contract Acceptance Upon acceptance of the authorized parties at Georgoulis Construction, Inc. this contract and all work described herein will constitute the entire agreement between Georgoulis Construction, Inc. and the Homeowner. The,Commonwealth ofMassachusefts Department oflndustria(Aecidents �UvOffice of Investigations € ; ` 1 •' 600 Washington Street Boston,MEI 02111 www.mass:gov/dia Y, e Workers' Compensation Insurance Affidavit:Builders/Contractors +lectricians/Plumbers Applicant Information . Please Prinf Legibly Name(Business/Organization/individuaO: Q*C6�Jll t�n1`' tic-, Address: v Gty/State/Zip: F G t �.�� meq, Ci/e�6 Phone#: `l"7b�� Are you an employer?Check the appropriate box: Type of project(required): 1.,�] I am a employer with_ 4. ❑ I am a general contractor and I employees(fiilt and/or part-time), have hired the sub-contractors 6• ❑New construction 2.❑ I atrx a sole proprietor or partner- listed on the attached sheet,t 7• E]Remodeling ship and have no employees These sub-contractors have 8• []Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right ofexemption per MGL - 11.0 Plumbing repairs or additions inyself.[No workers'comp, 0. 1,52,§1(4),and we have no 12.[�Roof repairs insurance required]i employees.[No workers' comp.insurance required.] 13.❑Other *Any applicant that checks box#I must also,fill out the section below showing their workers'compensation policy information. fi Homeowners who submit this affidavit indicating they are doing all work and thea hire outside contractors must submit anew affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their Workers'comp.policy information. lam an employer that is providing workers'compensation insurancefor my employees: Belo w is the policy and job site information. Insurance Company Name: py7- j✓1,s Policy#or Self-ins.Lie.#:_ (A,)(- 00 "Ir]7 ol Y Expiration Date: 9`!S'13 Job Site Address: l!-) (YI i �, ��� City/State/Zip-A, P Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as 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 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 of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. X do hereby certify un r the pains and penalties of erjury that the information provided above is true and coi rect.• Simature: Date: a' Phone#: 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#: Information and Instruef ions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an em•ployee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written.,, An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives g , of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments an dwell' P d who resides therein,or the occupant of the inghouse,of another who employs persons to do maintenance constru p coon or re air work on such dwelling o _ pho r on the use grounds or building appurtenant thereto shall not because of such employment p yment be deemed to bean employer." - MGL chapter 152,§25C(6)also states that"every state or local Iicensin g agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' ens t' com p a ton affidavit completely,b checking necessary,supply sub-contractor(s)naine(s),address es and hoy the boxes that apply to your situation and,if ( ) phone number(s)P along with their certificate(s)' () g rtificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit vi may e su bbmittedto the Department Accidents for confirm t' p rfinenfi of Industrial a ion of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the pen-nit or license is being requested,not the Department of Industrial Accidents. Should you have any,questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Departinent has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the perm t/license number which will be used as a reference number. In addition,an applicant j that must submit multiple-permit/license applications in-any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proofthat a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOTrequired to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number; The CQM.QRwealth of Massachusetts Department of Industrial Accidents Office of Tnvestiptions 640'(? Washington Street Becton,MA 02111 Tel.#617-7274900 ext 406 or 1-87 MASSAFE Revised 5-26-05 Fax#617-727;7749 WWW mass.g0VIdia A ACC>Rv CERTIFICATE OF LIABILITY INSURANCE DAMo/o 01 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 CERTIFIQAIE HOLDER IMPORTANT: If the certificate holier is an ADDITIONAL INSURED, the poficy(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 Phone: (978)263.3500 Fax:(978)263-1438 �^cr Gallant Insurance Agency,Inc. GALLANT INSURANCE AGENCY,INC. PHONE FAX(A/C,No (978)263-1438 Ext: 978 2633500 No q(C 199 GREAT ROAD I P 0 BOX 975 E-MAL ACTON MA 01720 PRODUCER CUSTOMER ID: 36702 usronl INSURER(S)AFFORDING COVERAGE NAIC9 INSURED INSURER GEORGOULIS CONSTRUCTION INC. :Seneca Specia Ins Co C/O SCOTT GEORGOULIS INSURER :Chartis Insurance Company 96 ARLINGTON AVENUE INSURER DRACUT MA 01826 INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 31434 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, ---------------- MITS SHOWN MAY HAVE IRFFN RFI ED By PA n Q AIU-q !NSR TYPE OFINSURANCE ADDL SUER POUCYEFF POUCYEXP LTR INSR WVD POLICYNUMBER LIMITS A GENERAL uABUTY BAG4001034 03/05/12 03/05/13 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGETO RENTED PREMISES Ee omsence $ 100,000 CLAIMS-MADE ( 1L I OCCUR MED.EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 1:1POLICY PRO LOC $ AUTOMOBILE UA131UTY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY(Per person) $ SCHEDULED AUTOS BODILY INJURY(Per accident) $ PROPERTY DAMAGE HIRED AUTOS (Per accident) $ NON-OWNED AUTOS $ $ UMBRELLA WhB OCCUR EACH OCCURRENCE $ EXCESS UAB HCLAIMS-MADE AGGREGATE DEDUCTIBLE RETENTION $ $ B WORXERS COMPENUMON W0009774283 09/25/12 09125113 WroRVTian °n' $ AND EMPLOYERS' LIABILRY YIN ANY PROPRLETORIPARTNER/EXECUTPJEEL EACH ACCIDENT $ 100,000 OFFlCE JMEM®Et EXCLUDED4 NIA (Morwftry in NN) E.L.DISEASE-EA EMPLOYEE $ 100,000 0 yes,desame wider DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 T— DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remadw Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN North Andover,MA ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRFSENTATTVE Attention: Fax 978458-9997 Ray Gallant ACORD 25(2009109) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD J tQz Office of Cons er Affairs and B.isines&R.egWation r Id Park Raza.-Suite,5170' Boston,Massachusetts 021.16 Homy-finpTc vevent Ca m Deg- Registration. 11.787G TV=: NvateGa maton Expw&mr 111t212Q '.4 Tr# 234343 GEORGODUS CONSTRUCTION, INC- STT GEORULf: 31�a �Tetam om,CKLA i�.i'en dIC [lrCil8i1 '. SCA 1 4 2aM-tS111 Ej Addrew F Remwal ❑ EPloymn;t Q Lostcsa - �ia:•achusctt•-Department of puhlir r ' Board of Buiidin-, Reutilation> and "'tand<lyds k 1 Construction Supervisor _icense License: C& S-GC)TT- GMRG-MUS ,%ARUNGTON AVE DFS,MAO&2 n Expiration: li?=fZ4i2{Ill Location No. Date i ' TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Ff e $ DLl °7Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# � y 26198 Building Inspector