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Home My WebLink AboutBuilding Permit #696 - 135 RALEIGH TAVERN LANE 2/27/2007 ttORTly BUILDING PERMIT 0 -J"LEo ,s�ti y."'. '.-.+p 6 O TOWN OF NORTH ANDOVER c o APPLICATION FOR PLAN EXAMINATION '' z �_ T � 6 Permit NO: Date Received ` �.9 AORw4co I.PP` (5 Date Issued: SsgcHus�� IMPORTANT:Applicant must complete all items on this page ' ✓» .`"'' - "^`� .,- - �7 / K� `'v K.S . h �FRO�9"A y ' � ,��;a�:. , _ 'n2 e' '�� Pr�rit ✓�� Ste'' " �f"" �, / -- � oW'a �A N� � Y IICLr :ZONING DIST51C HK� HISTOfIC�� RI07 � � I I TYPE OF IMPROVEMENT PROPOSED USE f Residential Non- Residential ❑ New Building ne family PlAddition ❑ Two or more family ❑ Industrial h ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: [i Demolition ❑ Other Icdpla�nyOW cls y t�V1/a�ersI�S)tt� a DE IPTION OF ANORK T BE PREFORMED: s i O be clrooe)-r ® y el- (Doln Identification Please Type or Print Clearly) ce-1 i 7 —S�` — (0 h I OWNER: Name: t" 1 1-4trA P Phone: � Address: a l if,Zn `J A ti 74 AL Suer�I&D s ��3ClStClCIb1°tl_I $a a�X3 ate rl ' Ha 6 f ARCHITECT/ENGINEER OjA S h60 42 Phone: M Address: IQUa(J i 0kP' (CY Q�/,5SReg. No. I FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. h Total Project Cost: $ a 7` 0 ,0 FEE: $ ��/ �-- I Check No.: Receipt No.: �Ul NOTE: Persons contracti with unregistered contractors do not have access to the guaranty fund 4 Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED I _ PLANNING & DEVELOPMENT ❑ ❑ i COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS_� DATE REJECTED �DAATE APPROVED _ HEALTH ❑ �' �O L`1 . , C� COMMENTS 74 - U� TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art . ElSwiimning Pools Elr p Well Q ❑ ❑ Tobacco Sales Food Packaging/Sales ❑ II Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ ! Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Drivewav Permit Located at 384 Osgood Street FIR F�E�PA 2TII� NT Tenap— utrlpster on sitees �' nom s g� ria* P 0", - " Located a14 Main St eet y . Filre Ddp`a me t s�gnatu elc a � � ,F . - a �z i `y,_ 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 2 1 A—F and G min.$100-$1000 fine NOTES and DATA— For department use / _-2 11/7 711 , �Vis. �-_' - - r - ❑ Notified for pickup - Date ................................._.......................-................................................................................................................................................................................................ ....................................................................................................-.........................................................._.............-...................... Doc.Building Permit Revised 20 it i I ;F Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. f��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 Addition Or Decks :. Building Permit Application Plot Plan OLJWorkers Comp Affidavit \$� photo Copy of H.I.C. And C.S.L. Licenses Ce Ou Copy Of Contract >----'Ploor/Crossection/Elevation .Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) _ U Mass check Energy Compliance Report (If Applicable) Li Engineering Affidavits for Engineered products New Construction (Single and Two Family) ❑ Building Permit Application 4 ❑ Certified Proposed Plot Plan I ❑ 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 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 must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 F Location � No. Date r f NORTH '1 TOWN OF NORTH ANDOVER Certificate of Occupancy $ 5 Building/Frame Permit Fee $ � —y°'� �AGMUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ' Check 4p-53 20153 Building Inspector NORTH ONM Of No. to ?0 t/A Ogg o dover, Mass. C , • C �. COC NIC KEwICKV �d ARRA T E O O'k S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT .r.....s. 9 ...... .................... ..... ................................................... Foundation has permission to erect........ ..............................�Yldings on....� .....�... .. .. ..�. �'�/� �/�'• Rough t0 be occupied as.., .. ....... �.... .i%.mf...... ...A!00 ... ........... ................................. ...... Chimney provided that the person accepting this permit shall in every spect coorm to the terms of the application on file in Final 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 t3( 3 PERMIT EXPIRES IN 6 MONTATiS Final ELECTRICAL INSPECTOR UNLESS CONSTR S TS Rough .... ......................................................... . ... ......... .. ...... Service BUILDING INSPEC R Final Occupancy Permit Required to Ocmpy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. REScheck Software Version 4.0.1 Compliance Certificate Project Title: Julin Residence Report Date:03/19/07 Data filename: F:\DSA Files\Dwg_file\Julin Residence-North And over\Jul i n-ResC heck.rck Energy Code: Massachusetts Energy Code Location: North Andover,Massachusetts Construction Type: 1 or 2 Family, Detached Heating Type: Other(Non-Electric Resistance) Glazing Area Percentage: 12% Heating Degree Days: 6322 Construction Site: Owner/Agent: Designer/Contractor: 135 Raleigh Tavern Lane Debra and Erik Julin Doug Shoop,AIA North Andover,MA 01845 135 Raleigh Tavern Lane DSA Architects North Andover,MA 01845 One Shipyard Way,Suite G-01 Medford,MA 02155 781.391.1939 doug@dsaarchitects.com Ceiling 1:Cathedral Ceiling(no attic): 461 30.0 0.0 16 Wall 1:Wood Frame,16"o.c.: 547 21.0 0.0 27 Window 1:Wood Frame:Double Pane with Low-E: 67 0.360 24 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the Massachusetts Energy Code requirements in REScheck Version 4.0.1 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Standard Design Conditions found in the Code.The HVAC equipment selected tohea r cool the uilding shall be no greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. �— Name-Title l�rj/�i1� /.s'1'))(JbkA-C, dI5q7ftF -JAR— MCA0 S/ Signature Date Julin Residence Page 1 of 4 REScheck Software Version 4.0.1 Inspection Checklist Date: 03/19/07 Ceilings: ❑ Ceiling 1:Cathedral Ceiling(no attic), R-30.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame, 16"o.c., R-21.0 cavity insulation Comments: Windows: ❑ Window 1:Wood Frame:Double Pane with Low-E,U-factor:0.360 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Air Leakage. ❑ Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed. ❑ When installed in the building envelope,recessed lighting fixtures#meet one of the following requirements: 1• Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2• Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cfm(0.944 Us)air movement from the the conditioned space to the ceiling cavity.The lighting fixture has been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. Vapor Retarder: ❑ Installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: ❑ Materials and equipment are identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. ❑ Insulation R-values and glazing U-factors are clearly marked on the building plans or specifications. ❑ Insulation is installed according to manufacturer's instructions,in substantial contact with the surface being insulated,and in a manner that achieves the rated R-value without compressing the insulation. Duct Insulation: ❑ Ducts are insulated per Table J4.4.7.1. Duct Construction: ❑ All accessible joints,seams,and connections of supply and return ductwork located outside conditioned space,including stud bays or joist cavities/spaces used to transport air,are sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions.Mesh tape may be omitted where gaps are less than 1/8 inch.Duct tape is not permitted. ❑ The HVAC system provides a means for balancing air and water systems. Temperature Controls: ❑ Thermostats exist for each separate HVAC system.A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor is provided. Heating and Cooling Equipment Sizing: ❑ Rated output capacity of the heating/cooling system is not greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. Julin Residence Page 2 of 4 Circulating Hot Water Systems: Circulating hot water pipes are insulated to the levels in Table 1. Swimming Pools: ❑ All heated swimming pools have an on/off heater switch and a cover unless over 20%of the heating energy is from non-depletable sources.Pool pumps have a time clock. Heating and Cooling Piping Insulation: ❑ HVAC piping conveying fluids above 120 degrees F or chilled fluids below 55 degrees F are insulated to the levels in Table 2. Julin Residence Page 3 of 4 F Table 1:Minimum Insulation Thickness for Circulating Hot Water Pipes Insulation Thickness in Inches by Pipe Sizes Non-Circulating Runouts Circulating Mains and Runouts Heated Water Up to 1" Up to 1.25" 1.5"to 2.0" Over 2" Temperature(°F) 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2:Minimum Insulation Thickness for HVAC Pipes Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range ff) 2"Runouts 1"and Less 1.25"to 2.0" 2.5 to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant and 40-55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD:(Building Department Use Only) Julin Residence Page 4 of 4 Mar 19 07 08: 09a The Bliss Company 15086360705 p. l t The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 wwmmass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization;lndividual): CCLVI .5L i SS C:Wot_ -T 'l e-�jl iS'S Address:__ ! 5 S i ES OO H wy1�1 L ct_rr-z City/State/Zip: Wt/zstpc r 4-: Phone#: 10 L-7 791 310 (--) Are you an employer?Check the appropriate box: Type of project(required): 1.JR I am a employer with 2 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6 E] New construction 1❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' [No workers'comp. insurance comp. insurance.* 9. Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their l 1.❑ Plumbing repairs or additions myself. o workers' comp, right of exemption per MGL 12.E] Roof repairs insurance required.]s c. 152,§1(4),and we have no 13.❑Other employees. [No workers' camp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. +contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have employees.they must provide their workers'comp.policy number, I am an employer that u providing workers'compensation insurance for my employees. Below is the policy and job site information. c Insurance Company Name: G f'aVl1 L i e- 3+a±-P_ Ins , CO Policy#or Self--ins.Lic.#: 6,0. '713 f 0(00 1 10 6 100 / Expiration Date: LZ-00 7 Job Site Address:. l 3�5 7 Ct_(eLq k TQ. lf-eJ.,-VZ UC11-e-- City/State/Zip: N6 rtk Aaxdffvi?i, -t 641A 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. I do hereby cercunder topains and�p n tiesofperjury that the information provided abov is true nd correct Signature: '7ae: 4 Phone#: 3 l �✓ — 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): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#• Mar 19 07 08: 09a The Bliss Company 15086360705 p.2 ACORD.- CERTIFICATE OF LIABILITY INSURANCE 0ATE 03/19/2007 PRODUCER Bridge Insurance Assoc THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O.Box 600378 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR NelA4onville MA 02460 AILTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (617)965-1777 _.---_-_-- --_-• -,--- _ INSURERS AFFORDING COVERAGE-- -- — NAIC# INSURED 1 1` N�Norfolk&Dedham Dean Bliss INSURER&.Granite State Ins.CO -- - ---- ' I 35 Sisson Farm Lane __..----_-_... Westport MA 02790- (- � INSURER E COVERAGES 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 CONTRACTOR OTHER'JOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Y KU R POLICY EFREGTIVE POLICY EXPIRATION AMTS A GENERALLITY bia713PO50721-001 OT2112006 07%2112007 EACHQCf,L1HRENEE,_,___._. S 1,000,000 X_�..COW&R.I.GENERrIABILRY DAMAGE TO RENTED 50,000 1 CLaMSMADe X OCCUR I 1FaOCCIxoncal. _ b_ --_.–_ 5.000 I —1-.— ED£SP.IAny Oneper5gn�-- —.. PERSONALADv INJURY L 1.000,000 GENERAL AGGREGATE 5 2,000,000 li ENL AGGREGATE LIMIT AP&j4 PER: PROQt&T$_I;j)W/OPA(F _ 1.000,000 l! POLICY PRO. L Or AUTOMOBILE LIABILITY ANY AUTO tEa�eCCrEmSINGLE LIMIT 9 i ALL OWNED AUTOS I BODILY INJURY ,.._ SCHEDULED AUTOS I f(�P__) 5 HIRED AUTOS NON-OWNED AUTOS BODILY INJURY S t (PCr eeddeM) PROPERTY DAMAGE S (Per Accident) GARAGFLIASILJTY AUTON Y- .ACCI6ENT-- .$-------- ANY AUTO OTHER THAN EA ACC. $ AUTO ONLY. AGG EXCESSIUMBRELLALIABILITY _EACHOCCURRENCE--.-- S .-_----.--_ OCCUR E–CLAIMS MADE AGGREGATE 5 1 DEDUCTIBLE e WORKM COMPENSATION AND bia713P060105-001 1210l2O0h 12.101/2007 XWcsTATu- 0,4"1- EMPLOYERS'LIABILITY ---JORY ANY PROPRIETOR(PARTNERrEXECUTIVE I .�.l.E9Ftl AF5lP_E[iL 100.000 OFFICEPJMEMBER EXCLUDED? EI pI $_EA.EMPLOYEE $ 500,000 It .Cesenbe under E.L.DISEASE-POL10Y LIMIT 100,000 OTHER + I � ' r I DESCRIPTION OF OPERATIONS(LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY P,NDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION AI 000318 SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO$0 SHALL Town of North Andover IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR REPIRIESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08) 0 ACORD CORPORATION 1988 Proposal From: Dean C.Bliss dba The Bliss Company(Contractor) 35 Sisson Farm Lane West ort,MA 02790 Phone 617-791-3100 Ma Lic.CS-093173 To: Mr Erik and Mrs Debra Julin Owners 135 Raleigh Tavern Lane North Andover,MA 01845 Phone: 781)826-8053 Date:March 15,2007 re:Proposal for Construction of Second Story Master bedroom Team Hrs Rate Amount Items supplied by Contractor Attend all inspections 1 4 125.00 $ 500.00 Demolition Remove all debris as a result of demolition and construction 1 1 5900.00 $ 5,900.00 Dum sters 1 2 800.00 $ 1,600.00 Dust and water protection 1 1 2500.00 $ 2,500.00 Wood frame labor&project supervision Supply all labor and materials required to complete the following:Rough Framing and 'ob supervision,as per plans and specifications dated March 5,2007. 1 1 35000.00 $ 35,000.00 Insulation and Venting Supply all labor and materials required to complete the following:Vent and insulate new room as per plans and specifications dated March 5 2007. 1 1 3500.00 $ 3,500.00 Roofing new areas on 1000 square feet Supply all labor and materials required to complete the following:Install 25 year 3 tab roofing to match existing,as per plans and specifications dated March 5,2007. 1 1 4000.00 $ 4,000.00 Gutters/Downspouts Supply all labor and materials required to complete the following:install matching gutters and down spouts,as per plans and specifications dated March 5,2007. 1 1 1800.00 $ 1,800.00 Red Cedar Siding-Approx 600 square feet Supply all labor and materials required to complete the following:Install Red Cedar siding,as per plans and specifications dated March 5 2007. 1 1 6500.00 $ 6,500.00 Exterior Trim Supply all labor and materials required to:Purchase and install primed pine trim boards on soffits,fascias,rakes and corners to match,as per plans and specifications dated March 5 2007. 1 1 $4,000.00 $ 4,000.00 Exterior windows 9 Supply all labor and materials required to complete the following:Installation of nine (9)new construction windows in proposed master bedroom,with Azek casing and sills on exterior to match existing as per plans and specifications dated March 5,2007. 1 1 $3,600.00 $ 3,600.00 Interior doors 2 Supply all labor required to install(2)closet doors and(1)Solid core storage door,as r plans andspecifications dated March 5 2007. 1 1 1000.00 $ 1,000.00 Blueboard and Plaster Supply all labor required to complete the following:Install Blue board with skim coat plaster in existing den new ceiling on first floor,new master bedroom and closets. Supply and install sheetrock with taped seams over existing sitting area window and fust floor laundry room walls as per plans and specifications dated March 5,2007. 1 1 5000.00 $ 5,000.00 Exterior prime/paint new areas Supply all labor and materials required to complete the following:Paint 2 coats,new red cedar shingles as per plans andspecifications dated March 5 2007. 1 1 3500.00 $ 3,500.00 Scaffolding Rent,deliver,erect,remove and return all scaffolding required to supply safe exterior work surfaces to construct new room 1 1 2800.00.$ 2,800.00 Electrical-rough and finish Supply all labor and materials(materials does not include any fixtures,bulbs or dimmers)required to complete the following:Rough and finish electrical,as per plans andspecifications dated March 5 2007. 1 1 4000.00 $ 4,000.00 Plumbing rough and finish Supply all labor and materials required to complete the following:Relocate exisitng laundry drain,vent with PVC,Copper piping for water and black pipe for gas, as per plans and specifications dated March 5 2007. 11 1 3500.00 $ 3,500.00 Heat 2nd floor Supply all labor and materials required to complete the following:Tap into exisitng heating zone,add 24 feet of baseboard, as per plans and specifications dated March 5, 2007. 1 1 2500.00 $ 2,500.00 Contractors Sub Total Labor and materials $ 91,200.00 Contractors Profit $ 9,120.00 Contractors overhead $ 9,120.00 Total Project $ 109,440.00 BOARD OF BUILDING REGULATIONS �- License: CONSTRUCTION SUPERVISOR nod:• s�_-: Number: QS 093173 Birthdate: 08/14/1951 Expires:08/14/2009 Tr.no: 93173 Restricted: 00 DEAN C BLISS 35 SISSON FARM LANE WESTPORT, MA 02790 Commissioner I (�a1,✓cam✓7r�,;e�a�.,1— �; Board of Building Regulations and Standards License or registration valid for individul use only W)p IMPR6YEMENT CONTRACTOR ' before the expiration date. If found return to: Board of Building Regulations and Standards Registration 148764 ' . One Ashburton Place Rm 1301 Expiration: 10/21/2007 §f Boston,Ma.02108 Type: DBA THE BLISS COMPANY DEAN BLISS yEy' 35 SSIO.N FARM LANE , �„- ! t•• __�M WESTPORT,MA 02790 Administrator Not valid without signature I