HomeMy WebLinkAboutBuilding Permit #298-16 - 146 MIDDLESEX STREET 9/8/2015 w Z 2 s—
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BUILDING PERMIT oFt�yeo -6 ��o
TOWN OF NORTH ANDOVER 32 ht• ``'+;s6
APPLICATION FOR PLAN EXAMINATION
Permit No#:� Date Received '� AERATED TPy4`�
�SSgCHUS�'t
Date Issued:
11 v IMPORTANT: Applicant must complete all items on this page
LOCATION n(ad e S,e-/ Jq
y /I Print
PROPERTY OWNER ��, /> P C'In n 5f
Print 100 Year Structure yes no
MAP 'b� PARCEL:-DO'5 ZONING DISTRICT: Historic District yes no•
Machine Shop Village yes nq
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑ Addition P f'wo or more family ❑ Industrial
❑ Alteration No. of units: `t ❑ Commercial
GAepair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Septic []Well ❑ Floodplain ❑Wetlands ❑ Watershed'District
El Water/Sewer
DESCRIPTION OF W R ,TO B PERFORMED:
i
Identification- Please Type or Print Clearly
OWNER: Name: Phone:
Address:
Contractor Name: �I {' �d't:�� Phone:
fG • /)3
tc^ +b v
Email: '
� SfrT-f, r4 ,�1�-�--
Address: S� A) Q 1 �n 5 t G���. fly)!�, 6 j 7r 9!/
Supervisor's Construction LicenseLS /G Exp. Date:
Home Improvement License: ( f Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT.$12.00 PER$10nn nn nc Uja WTA•-ESTIMATED COSTBASE ON$$125.00 A
Total Project Cost: $ fv — �o EE: $ 6�'1
Check No.: /y,?� Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have cces tothe guaranty fund
Sianature of Agent/Owner Sia--nature o �1
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
PLANNING & DEVELOPMENT Reviewed On Signature_
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
CON MENTS
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
FIREfDEPARTMENT TemptDumpsteronxsitet tyes�_._ _o _. v �t
_ _. ._. __ rGn
I 11i D- 124MainrStreet r
FireiD_epartment�sgndture/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 lies No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
NOTES and DATA— (For department use)
❑ Notified for pickup Call Email
Date Time Contact Name
Doc.Building Pennit Revised 2014
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
OTE: 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/Cross Section/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
OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
New Construction (Single and Two Family)
,,6 Building Permit Application
,4 Certified Proposed Plot Plan
4. Photo of H.I.C. And C.S.L. Licenses
4 Workers Comp Affidavit
Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
Copy of Contract
2012 IECC Energy code
Engineering Affidavits for Engineered products
OTE: 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
must be submitted with the building application
Doc:Building Permit Revised 2014
Location
/ r
No. (® Date
A�5
e = TOWN OF NORTH ANDOVER'
SLED I .
•
Certificate of Occupancy $�
Building/Frame Permit Fee $
Foundation Permit Fee $
s-. Other Permit Fee $
TOTAL $
Check#
-� Bwii ing Inspector
NORTH
Town of n d ove* r-
No. czqs .
� .
* � _
I
h , ver, Mass, 61 �5
0LAX@ ,�.
COC NIC CHE N!WICK
U BOARD OF HEALTH
Food/Kitchen
. PERMIT T D Septic System
THIS CERTIFIES THAT ...........&..6....�er,,AlnA!!iA................. :ksfy..
.................. ....................
BUILDING INSPECTOR
Foundation
has permission to erect buildings on �� . ... •_ .......................... ... .. . ............ . . ...................
1 g
to be occupied as .�.� L.V.I�.N.�... I...&.traix... Rqf6c& 3 &M6 Rough Chimney
provided that the person accepting this'permit shall in A4 respect 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
PERMIT EXPIRES tINTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUART Rough
Service
........................... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Display in a Conspicuous Place on the Premises — Do Nof Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
s
Smoke Det.
0 � Zal
� NvR �H
own of t E ndover
O ,• .�r �„
No. ,t - .�
� e n
Z
o h , ver, Mass,
coc NJc NtwK. �1.
A�RATEO Cl
s u
BOARD OF HEALTH
Food/Kitchen
PER T T D Septic System
THIS CERTIFIES THAT ....... .#I............ .�! �. ... . .................................... BUILDING INSPECTOR
has permission to erect ...... buildings on 1440...... ! Foundation
.... .... ...................
�................ Rough
to be occupied as ............ .....I�.......V1... ........ �. ... .. .... ..................................... Chimney
provided that the persona tin this erm all in eve res ect confo to the terms of the application
pro p p g p every p pp 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
PERMIT EXPIRES IN SK
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTS 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.
I�
f
Pag of 2 iII
I
1►�1..��,.0
(C(o)>n155rtlr Z11(Crr«o>>n
AWlerthaelnr ffai), 011844
(6,(0,�--b� )
JULY 19, 2015
BOB SECHRIST
146 MIDDLESEX ST 01845
NORTH ANDOVER,MA
JOB:VINYL SIDING
PLANS DATED: ESTIMATE
(1) INSTALL 3/8" FANFOLI) INSULATION D DOORS ONLY.FACIA
2 INSTALL WHITE COIL STOCK ONALL HS ST MA E DOES NOT INCLUDE
AND RAKE BOARDS ARE ADDITIONAL.
ANY ROT REMOVAL OR REPAIR. CERTAINTEED DOUBLE 7"
(3) INSTALL 13 SQ OF CEDAR IMPRESSIONS BY „VINYL SIDING ON
CTION SHINGLES ON THE FRONT OF THE HOUSE,AND
STRAIGHT EDGE PERI E LIGHT
RTAINTEED WOLVERINE AMERICAN EBOTH PANEL COLORS ARE
A NING WALLS UP TO THE' SOFFIT.
ALL RE, NEL TO MATCH AS WELL.
MAPLE AND THE CORNERS/J-CSN SOFFIT BRACKETS AND
NEL AROUND TH
(4) INSTALL J-CHANE DECORATIVE
INSTALL VINYL SIDING UP TO THE DECRATIVE BRACTS AT THE SOFFIT.
(5)INSTALL STALL SHUTTERS ON ALL WINDOWS.
(6) REMOVAL OF ALL DEBRIS CREATED FROM THE ABOVE TASK. r
LABOR AND MATERIAL TOTAL= $36,925.00 -$38,925.00
THESE PROJECTS
SHOULD TAKE APPROXIMATELY 4 - N WEEK
GN AND CTHANGES
START DATE (YET TO BE DETERMINED) DEPENDING CONTINUES
IF
THIS PROCESS.I ENCOURAGE HOMED OWNERS TO MSE
MADE THROUGH OUT TIME AS THE PROJECT
ANY SUGGESTIONS OR CHANGES AT ANY
FULLY LICENSED AND INSURED MA. LIC#CS 104466 HIC LIC#167074
Page 2 of 2
ANY CHANGES ARE MADE A CHANGE ORDER SLIP WILL NEED TO BE SIGNED
AFTER A PRICE HAS BEEN AGREED UPON. DISPOSSAL OF DEBRIS IS NOT
INCLUDED IN THIS ESTIMATE,UNLESS OTHERWISE STATED OR AGREED UPON.
UPON EXCEPTANCE OF THIS PROPOSAL PLEASE SIGN THIS COPY AND
RETURN: EITHER IN PERSON, OR MAIL TO M.S.O CONSTRUCTION @ 56
NEWPORT ST. METHUEN, MASS 01844.
IF YOU HAVE ANY QUESTIONS YOU CAN CALL ME ANY TIME THAT IS
CONVIENENT TO YOUR SCHEDULE.THIS ESTIMATE IS VALID FOR 30 DAYS
FROM ABOVE DATE,THERE AFTER A NEW MATERIAL QUOTE WILL BE
NEEDED. UPON ACCEPTENCE OF THIS PROPOSAL A 1/3 WILL BE DUE AT
SIGNING, A THIRD WILL BE DUE 1/2 THROUGH THE PROJECT AND THE
REMAINING BALANCE IS DUE UPON COMPLETION. ANY AND ALL EXTRAS WILL
BE DUE ONCE A PRICE HAS BEEN AGREED UPON.ANY INVOICE THAT IS NOT
PAID WITH IN THIRTY DAYS FROM THE DATE RECIEVED IS SUBJECT TO A 5%
LATE FEE PER MONTH OF THE OUTSTANDING BALANCE.THANK YOU FOR
CHOOSING M.S.O CONSTRUCTION,AND I HOPE I CAN SERVE ALL OF YOUR
REMODELING NEEDS IN THE FUTURE.
7, �✓ l
�a- a n'i
MICHAEL O'NEIL
M.S.O CONSTRUCTION
n c� 6
()00"
P,,') r,),�
FULLY LICENSED AND INSURED MA. LIC#CS 104466 HIC LIC#167074
Sep. 08.2015 01: 39 PM Advantage Insurance Agenc 978 794 4833 PAGE. 1/ ]
CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY)
F09/08/2015
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 IN URED, the policy(►es) must be endorsed. If SUBROGATION , su ect to
the terms and conditions of the pol(cy, certain policies may require an endorsement. A statement on this Certificate does not confer rights to the
certificate holder In lieu of such endoreement(s).
PRODUCER NAME: PAUL DEVIN
ADVANTAGE INSURANCE AGENCY INC. PNONE 97t3-681-1055 978-794533
Arc No En: AICLNo
184 PLEASANT VALLEY STREET
ADDRESS:
METHUEN MA 01844 INSURER(S)AFFORDING COVERAGE V' NAIC p
INSURERA:ARBELLA PROTECTION INS. CCN[PANY
INSURED
INSURER B: ._•-••---.
idSO CONSTRUCTION
INSURER C:
MICHAEL ONEIL DSA INSURER D:
56 NEWPORT STREET INSURE R_E: _
METHUEN MA 01844 INSURER F: ._
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE NSUREb 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 I$ SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE INSR wVb POLICY NUMBER (MM/DD/YYW MMIboIYYYY) LIMITS
A GENERALLIABILITY 8500047872 07/21/201507/21/2016 EACHOCCURRENOE S 1,000,000
COMMERCIAL OENERAL LIA6IUTY -PREMISES(Ea oocurmica) 9 100,000 ,^
CLAIMS-MADEELI OCCUR MED EXP(Any one person) $ 5,00()
PERSONAL&ADV INJURY $ 1,000,000
_ QENERAL AOOREGATE $ 2,000,000
GEN'L AOOREOATE LIMIT APPLIES PER: PRODUCTS-COMP/OP ACG S 2,OOO,000
'-+• POLICY PRP
JEG7 LOC $
AUTOMOBILE LIABILITY cum 'NUL'
(Ea accident $
ANY AUTO BODILY INJURY(Per perm) $
-- - ALL OWNED SCHEDULED BODILY INJURY Per eccldenl $_
_ AUT09 AUTOS Y ( )
NON-OWNED $
HIRED AUTOS AUTOS Per ecclQenl _
UMBRELLA LIAB OCCUR EACHOCCURRENCE $
EXCE66LIAR CLAIMS-MADE AGGREGATE $
OED RETENTION $ $
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY YIN TORY LIMITS I
AN PROPRIETORIPARTNER/EXECUTIVE
OFF ICERIMFMRFR EXCLUDED? NIA E.L.EACH ACCIDENT $
(Monoatory In NH) E.L.DISEASE-PA EMPLOYEE $
U yea,describe under -•—"-" --------
DESCRIPTION OF OPERATIONS bolow E.L.DISEASE•POLICY LIMIT $
DEBCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 1131,Addldowd Remark&Bchadula,n Amore epaoe Ie requlmd)
CERTIFICATE HOLDER CANCELLATION
TOWN OS NORTH ANDOVER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
BUILDING DEPT. THE EXPIRATION DATE THEREOF, NOTICE: WILL BE DELIVERED IN
1600 OSGOOD STREET BLD-20 SUITE 2035 ACCORDANCE WITH THE POLICY PROVISIONS,
NORIA ANDOVER MA 01845 �N�A�S1!/�)�
AUTHORIZED REPRE^�
C
1988.2010 ACORn MOWTI . All rights reserved.
ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD
The Commonwealth OfMass�chusetts
_ . Department of Ind-ustrialAceldents
P d 1 Congress Street,Suite 100
µ Boston,MA 02114-2017
www.anassgov/dia
�y. Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERAWTING AUTHORTTY.
Aplilicant Information Please Print Le0b
Name(Business/Organization&dividual):
.Address: ( kt,...�Prt7 S f
City/State/Zip: . 4 Phone#: - 73 dl
Axe you an employer?Checkthe appropriate box: Type of project(required):
1.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction
2.Lr 1`am a sole proprietor or partnership and have no employees working for me in &. [4-ffemo delirig
any capacity.[No workers'comp.insurance required_]
9. El Demolition
IF]I am a homeowner doing all work myself[No workers'comp.insurance required.]t
10 E]Building addition
4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions
proprietors with no employees. ftFJ Plumbing repairs or additions
5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.0 Roof repairs
• These sub-contractors have employees and have workers'comp.insurance.:
6,F1 We are a corporation and its ofTcers have exercised their right of exemption per MGL G. 14.Q Other
152,§1(4),and we have no employees.[No workers'comp.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 is providing work6w compensation insurance for my employees.'Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins,Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers'compensation•polley declaration page(showing the policy number and expiration(late).
Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify rude/r t/iepains andpenalties ofperjury:haat the information provided alcove ' true and correct.
Signafore: G Date: a' j
Phone# Ci 7 i�aL✓7
Official use only. Do not write in this area,to he 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. Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee 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,of any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives 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 and who resides therein,or the occupant ofthe
dwelling house of anotherwho employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing 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 of public 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'compensation affidavit completely,by checking the-boxes that apply to your situation and,if
necessary,supply sub=contractoi(s)name(s),address(es)and-phonenumber(s)along with their certificate(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 maybe submitted to the Department of Industrial
Accidents for confirmation 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 permit 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 Department 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 perirut/license number which will be used as a reference number. In addition,an applicant
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 burn leaves etc)said person is NOT required to complete this affidavit.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street, Suite 100
Boston,MA 02114-2017
Tel.# 617-727-4.900 ext. 7406 or 1-877-MASSAFE
Fax#617-727-7749
Revised 02-23-15 www.mass.gov/dia
Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Cotactor,Registration
Registration: 183128
TYpe: Individual
Expiration: 8/28/2017 Tr# 270040
� rM
MICHAEL O'NEIL
MICHAEL O'NEIL
56 NEWPORT ST !�
METHUEN, MA 01844
Update Address and return card.Mark reason for change.
El Address El Renewal Employment Lost Card
SCA 1 Co 20M-05/11 ������ >
(9/a"Wpo�mi110"U.0ea��
License or registration valid for individul use only-
office of Consumer Affairs&Business Regulation before the expiration date. If found return to:
HOME IMPROVEMENT CONTRACTOR office of Consumer Affairs and Business Regulation
Registration:' 183128 TYpe' 10 Park Plaza-Suite 5170
j Expiration:-Zk/ /2017 Individual Boston,MA 02116
MICHAEL O'NEIL
MICHAEL O'NEIL
56 NEWPORT ST
METHUEN,MA 01844 - Undersecretary Not valid without signature
I _.
i
_ Massachusetts -Department 6f-Public-Safety ,
Board of Building Regulations and Standards
Construction Supervisor
License: CS-104466
11:ris
MICHAEL S ONE�Y.
56 NEWPORT SIMEIE V
METH JEN MA 01844
� S �
Expiration,
Commissioner 09123/2010j.