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HomeMy WebLinkAboutBuilding Permit #316-16 - 165 CARLTON LANE 9/11/2016 NORTH BUILDING PERMIT o��tLE° ,h.bq"o TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION * ,T �o °y .p COC—ev.K• Permit No#: Date Received �gssgArev US Date Issued: 14PORTANT:Applicant must complete all items on this page LOCATION /&S Print PROPERTY OWNER rint 100 Year Structure yes o MAP/PARCEL: ZONING DISTRICT: Historic District yes o Machine Shop Village yes o ;d 3 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family El Addition ❑Two or more family El Industrial ❑Alteration No. of units: [i Commercial ❑ Repair, replacement ❑Assessory Bldg 2-Others: ❑ Demolition ❑ Other ❑ Flootl Iain ®Wetlantls OWate""t�s`YecTD�stnct,§`; D Septic ❑Well r p b t ; ±Y1Nater Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: 1) 6 u NA- �' N ;kR I Q Phone: Address: 1 (03 G AAC fb w �0 V I S C— Contractor Name: Phone: !724- Email: 77vEmail q(,4- E fv u- c • Co,� Address: a •r4JJ'- DcvG 0% � Lfrr h w o II Supervisor's Construction License: C IZS6. 106,017 Exp. Date:_ J- AA Ao,4B Home Improvement Licenser V LinI:)v f%. Exp. Date: 1 f od•/ aa�� ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.-$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST SED 0�25.00 PER S.F. Total Project Cost: $ �J7,1(- • 8 FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the gua n fund - - - - Y mom, . -. _ . -._, -: ,. .. .. , . .r . ,- . ._ _ .:. _. ,..- . _.. -. . .: . .. . _ . ..;. :_ .. .. . . . . .a . _ .. .. .. _ :. ..r. _ _: _. ,. ,__ _ .-:. -w t -�, .. - : ~ 1 y.a.. _ .. .. — 1, f�� I i . Location/ l .2L A7 /4 - :.��-.--'�%:.-......!..—......."-I.:�1I..'w..'-..-:�...--...*l—!-...";II.�..'I..�-I.'-.I�..—-.�I--.....-.�...�...�-..-.:..,-3�...-.-.-—�...,-:::.)-'..,-II.-..:%.--..:.�F-,.;I.I...:...��..-.I...- ..I.-I:'.:I.r.-�--.I-':..I.:...�..--�I-l..:.:,�--.�..�..'-.--....�4.I,�I;-�..:­...�.'.I."..�:j-.%..T'-:-....'.,'....":L.-I':,�.1I1�1....:-,...I,-�I_�:..-::.�-.I:,..I,:....;:—...:.�I'::1:�1.I:-:'-;r..-,.:.::...."zC;:.:...l.;u..r.:�,.'�:..�,,'.:-...:.�.I-I.:..1-:%,�,--:I:.�,: ,'..II�.�I m...,.�'....-':-.:�..-.�.�...-4.'.'...-.�.....,-.,,"P'..1.-�".-'.-..-.-.C,'.�'.;.1 I....�:-�j"�-,'7�--..�-..4..'-. .!!;I,I.*:.'.:aI�...:,!'.I.:a�,K..I.�.:;.,:.I`..�.::�:�.;.:I"..,...'';�..,:..�,'�:.,'���I-.7.�-..-:.:,.2-,.I.:.:.:.-..�....-��,-�.. - No.� _ Date /:� �. . : _: . . . ,: - ' TOWN OF NORTH ANDOVER a $QED I6g6 . .. . ' . :i' . . -- _. .. Certificate.of Occupancy $_,,, Building/Frame Permit Fee $ --_ . $ T,:: _.. .- . t` Foundation Permit Fee Other Permit Fee $ ° TOTAL ti Check#. "� r.-_._ L Y . { Bw ding Inspector .:. .,. .__ . , i } 4 . . . . L..e. -,-a,. _ _ _ t . .. .: - -:. g M - - — `: . Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well 0 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 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 38_4 Osgood Street F�DEPAR,fTrOENTI Tei p}®umpster=on site �yes:�,s no, itLocated at 124 Main S�'reet �' � -�'' ,`` �1fi f�}��� � .µ' _'3 :r/`r-:r:.,fr,.." t +re+`4+.1 "'} ��' `i rX ?f� s M..•. , ;1 Fire Departrtmensigniature/tlate�; ., y ' .; � yrs--r' �77+»�.I:• "--. —• t:. �:� .._,.�-�....«. � tk �,.#'4.r1.,ti ^r" � ,-xt � 1 f ; � S *r -s i � .. t Y'. r -f j. 5 : '', eY rS • �C -4 �4`i'17i COMMENTS �, r =�,,� r , '..` ,. • ,, 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.$10o-$1000 fine NOTES and DATA-- (For department use) U Notified for pickup Call Email Date Time Contact Name i_ Doc.Building Permit 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 4. 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) 4. Building Permit Application 4- Certified Proposed Plot Plan 4, 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 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 ffi 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- ng application Doc:Building Permit Revised 2014 t_ NORTH F � - Town Of T EAndover h ver, Mass, COC NIC Nl WICN �� °R,TE0 ►PP,�'(y s U BOARD OF HEALTH Food/Kitchen PER I T L D Septic System 0 THIS CERTIFIES THAT ... ..... .h!!►.�! ......... ... .. !..p�1.Z 4...Q............................... BUILDING INSPECTOR ........... ..... .... has permission to erec .................... buildings on ....... ........� � ....law.....M Foundation I ........................... Rough to be occupied as ......... .... 1�.�.h/. ...... ..... .......... .. .� .�!��. Chimney provided that the person accepting this permit shall in every respect conform to the term 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 IOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 THS ELECTRICAL INSPECTOR UNLESS CONSTRUCT N A Rough Service ............................ ..... .1 Final BUILDING INSPECTOR 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. Burner Street No. Smoke Det. 6j—01 U ! Federal iD#054)405629 RISE Engineering RI Contractor Registration No 818G MA Contractor Registration No 120979 A division ofThietsch Engineering -=TCout>actor-ItegMration No.620120 60 Shawmut,Canton,NIA 02021 /+�/�1T1�RACT N I RAC I 339-502-5197 FAX 339-502-6345 Page - .._,4— PROGRAM ENGINEERING THIScoxrRA %S=MEOINTOBETWEEN RISE CMA-HES ENGINEERING ANOTRE CUSTOMER FOR WORK AS DESCRIBED. CUSTOMER PHONE DATE CVENTO WORKORDER DonnaDeprizio (41%)685-4436 0512912015 41569? 00002 SERVICE STREET -�1]NG STREET 165 Carleton Lane 165 Carleton Lane �' t SERVICE CITY,STATE.LP 01WNG CITY.STATE.ZIP North Andover,MA 01845 North Andover,MA 01845 ` t U11 --=j t1 i JOB DESCRIPTION r AIR SEALING:Provide labor and materials to seal areas of your home against wasteful,excess air leakage. This vork will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful air quality.Materials to be used to seal your home can include caulks,foams and other products. Primary areas for scafical:age to attics,basements,attached garages and other unheated areas(windows are not generally addressed.) This will require(8)workinghours. A reduction in cubic feet per minute(efm)of air infiltration will occur,but the actual number of cfm is not guaranteed. At the completion of the weatherization work,and at no additional cost to the homeowner,a final blower door a �Y analysis will be conducted by the sub-contractor to ensure the safety of the indoor air quality. $680.00 AIR SEALING ADDER: (4)working hours. $340.00 DAMMING:Provide labor and materials to install a 12"layer of?0%unfaced fiberglass baits to(244)square fast purposes. 1 O;t V C- X05 95M.20 ATTIC FLAT:Provide labor and materials to install a 9"layer of R-32 Class I Cellulose added to(1076)square feet of open attic space. -- $1,538.68 ATTIC ACCESS:Provide labor and materials to install(1) easily moved,insulating cover for the attic access folding stair. A smalF dot surface of plywood will be created around the opening within the attic. This will allow the cover's integral weather-stripping to restrict air lcafcage_ 5237.65 VENTILATION:Provide labor and materials to install(1)insulated exhaust hose with soffit mounted flapper rent to exhaust existing bathroom fan(s). Y bty $118.75 VENTILATION:Provide labor and materials to install ventilation chutes in(105)rafter bays to maintain air flow. / $210.00 RISE Engineering will apply all applicable,eligible incentives to this contract. You will only be billed the Net amount. Currently,for eligible measures,Columbia Gas offers 75%incentive,not to exceed 52,000 per calendar year,and an incentive of 100%for the Air Sealing measures up to the first$680 and an additional 5340 ifsavings arejustified by the auditor. For the safety and health of your home's indoor air quality,we will be conducting a blower door diagnostic of the available aliffiVOcryour home both before the work is begun,and after the weatherization wort:is complete.We will also conduct a full assessment of tTie combustion safety of your heating system and water heater.This has a value of$90 and is at no cost to you. Total allowable weatherization incentive is$3,110. $90.00 ✓ Federal ID S 05-0406629 RISE Engineering RI Contractor Registration No 8186 NAA Contractor Registration No 120979 A division of Thielsch Engineering :-_CT ContrarterFegistration N*620120 '•L 60 Shawmut,Canton,iVlA 02021 __ ,ra��rg�t►� 339-502-5197 FAX 339-502-6345 it tai I� -MOGRAM Page ENGINEERING CMA g� EENNCIN0e�i1HO�OMMEERF�ORWORK DESCRIBED'3Tr! CUSTOMER PHONE DATE CLIENT 0 WORK ORDER Donna Deprizio {978)685-4936 SL5f29f2015 415697 00442 SERVICE STREET BILLING STREET 165 Carleton Lane 165 Carleton Lane t ??--••) I� SERVICE CITY.STATE.ZIP BILLING CITY.STATE-ZIP 11U North Andover,MA 01845 North Andover,MA 01841 11.1 , 1 JOB DESCRIPTION cu .28 --pragtive: $3,013.96 �iustomer >!: $651.32 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIOTt9ISGIRTHS—SUM OF ***Six Hundred Fifty-One&321100 Doilars $654.32 UPON FINAL INSP ON AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL INTEREST OF 1%WLLL-BE CHARGED MORTFR DN ANV�� UNPAID BALA A R 30 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES.RIGHTS OF RECISION,SCHEDULING,A40 CONTRACTOR REGISTRATION. DO NOT SIGN T"IS CONTRACT IF WERE ARE BLANK SPAt&S AUTHOR¢EDSIGNA RE-RIS inecring CUSTOMER ACCEPTANCE NOTE THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE ACCEPTANCE OF CONTRACT.THE ABOVE PI FS,SPECIFICAT1OUSAND4ONQMOmS ARE, 30Y5SATISFACTORY TO US AND ARE 8 • VE AUTHORO'fO W 00 THE WORK 0A . AS SPECIFIED. The Conzinon iveattiz of f lWassadi aseits � Office ofivestivatfons 600 €Aashingto 1 Street Bosion,111_ 021 i 1 Workers' Compensation Insurance Affidavit: B-aiIdersIContractors/k—leet>r-icians/Plambers A ppiicahit Inforrnatio-vt New Print Leaibiv Name(Busintss.'Organization.'Individual): i�� '�r MA 5'd Ida g° `i�11, Cit}JState/7_ip: a '6lI t Phone Are You an emplaBca?Check the agpropi-42te box: Type of project(r egnst ed): . I am a general contractor and I I.91 am a employer♦t ith 4 �_� � 6_ F1--\-e,,construction employees(full and/or part tune).* have hired the sub-contractor 2_�( I am a sole proprietor or partner- listed on the aitached sheet. 7. ❑Remodeling- ship emodeIingship and have no employees These sub-contractors have S. []Demolition working for me in any capacity_ employees and hal=e x ori ems- [ o.corkers comp.insurance comp.insurance g ❑Building addition required-) s.D We are a corporation and its 10.[]Electrical repairs or additions 3-D I am a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself[\o workers comp. r�gggr{of exemption per MGL insurance required-]= c-152§1(4)_and we have no 1-2 �- Roof repairs employees.[Noztorkers' comp.insurance required.] *rtm applicant that dtecis hos=i most also hili out the section in'low shmvike their workers eompens--ation policy information. floc=%hers who submit this alfida%it indicating they aredoing all tvwk-and then hire outside contractor must submit anew affidavit indicadri_a such_ contractor that check this box must attached an additional sheet showing the name of the sub-commctors and state ub-ther or not those entities have employees. Iliiresult-contractorshaceemployees.they must Provide their warl;cm comp.golicrnumber. I apsr carr ea rplal�er tlid�* �F©vizlirrh ivvs ers'ranlpertsrrtiotr arrSrerrrfrCe fvf I rl'a rplvJ�ees: Bedoly is fire poligr and job site inforifiation. Insurance Companii'Name: l i ,,q C—ai u Q�-A, Polic.,-or Self-ins.Lic.r: k o we- ',00 S7_ £x-piration Date: t Job Site Address CihdState/Zip_ _ Attach a copy of the workers'compensanoe puixtz-, �L�.a<ation page(shotgving the policy'number and expiration date). Failure to secure coveraEe as required tinder Section 25A of.LIGE c_152 can lead to the imposition of criminal penalties of a nne up to S1500-00 00.00 and/or one-tear imprisonment as well as civil penalties in the forma of a STop WORK ORDER and a fine Of UP to S?a0-00 a dad,against the violator. Be advised that a copy of this statement may be fonyarded to the Office of Investigations oftlhe DIA for insurance coverage verification. I do kerehr cell'rrlrder fhe pains and/peaaftFes ofpe#[BT/lira the ittforrrrution provided above is trite and correct. Siathature: J4- t67 ECs Date: Phone Offrridrl Ilse areli: �t7 rrut trrite in dais area,to be canrgleied br citt°yr fUtrrt vciaL City or Torn: Feh-t�it/Lisertse Issuing Authority(circle one): 1. Board of Health 2 BttiWng Dep.irtment 3-CitS•ffown Clore -I.Electrical Inspector a.plumbing Inspector fir.Other Contact Person: Phoney- OP!D:sa CEM ATE OF LIABILTY INWRANCE aims TELE;ATE 16 ISISM AS A WATER OF OMMKIM ONLY ANO COWERS NO SES UPON THE CERTMA7E ROLOEFL TM CERTIR=M DOES NOT AFFMAZRMELY OR NEGATMELY AMM, EXTEND OR ALTER 211E COVERAGE AFFORM 8Y 211E PMMM BES THE:tERtNICME OF MRANCE,DOPE MT COTS A GONTRACf SEEM THE ISSUNG DSSVREP44 AUTHOP ED 1102 F H1I IMEORPRSANDTILECERTM ATEMOLDER. 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AW 5 1,OBp, LM s onammu mmr IcammWMELMw S tEasoditM 13 AAfl'AUiO tT1lB4f�TS OiM4l�t6 BODLYMARY owPomm) S ALLOtlIB�A1lrOS 6p�LvguuRltt�* s X autos PERiVVAUMs MOM= 6MAMMEM X aosaaurx�atst� S s >ms g EPM CLOMENM s Isamu A83l?�1Dt6 s RMSMON s s cammummum v� "'� tu- AM EMP OV9mtummr v� F-L iACG�tf S Hde� A F.L -6ABdP S OSO Tt01$6et�i ELDiSF11SE•POIJGYaw 5 �TF?dOLDFA CA{tC.ELLA2�At T1'i�2 S3�Ot1t.DlifiN�'lit5lt50VEO pm,iC�4BEl .L�s�+OAe ME EXPSfA'= "'mppugYpgOy�y dftE WU.L BE liH3Vmm iN 185 Fameb Ave {rats,R1 m"a ®1 AC03iDcppppRA'1't�!!1L All dgtt� . ACORDM ) TftACORD nme=d 9"o.+e mwftcFACORD A�® CERTIFICATE OF LIABILITY INSURANCE °A04/2812015° "I' 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(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 Automatic Data Processing Insurance Agency,Inc. ac°NN Exti: AI No): 1 Adp Boulevard ADD, : Roseland,NJ 07068 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: NorGUARD Insurance Company 31470 INSURED INSURER B POLAR BEAR INSULATION CO INC INSURER C: PO BOX 958 Andover,MA 01810 INSURER D: INSURER E: ENSURER F: COVERAGES CERTIFICATE NUMBER: 338194 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. CY EXP LTR TYPE OF INSURANCE p POLICY NUMBER MM/D F MMN LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE 1-1 OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY E1JE T M LOC PRODUCTS-COMP/OP AGG $ FIOTHER: $ AUTOMOBILE LIABILITY COMBINE INGLE LI $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PRORTY DAMAGE $ AUTOS Par acriPERITY, $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIARCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION �( PD R TH- AND EMPLOYERS! Y 1 N LIABILITY STATUTE I ER _ A ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.FACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A N POWC660990 01/0112015 01/01/2016 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE9$ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E_L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 107,Additional Remarks Schedule,may be attached R more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CONSERVATION SERVICE GROUP5 ACCORDANCE WITH THE POLICY PROVISIONS. 50 WASHINGTON STREET Westborough,MA 01581 AUTHORIZED REPRESENTATIVE A©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD {II /�Il usiness'RwJe`-.(�/w�ion Affairs and Office of Consumer Aff 10 Park - guile 5170 Boston,Massachusetts ORegistration Home Improvement Contractor Registration: 102726 Type: DBA Tr4 252249 - Expiration: 71212016 POLAR BEAR INSULATION CO- _ Vincent LeBlanc p.O. BOX 958 ANDOVER, MA 01810 - rd.Mark reason for change. Update Address and retur►►-' Employment [] Lost Card I Address E]Renewal J OPS-CA, Ar 50Nb04/04-Cs101216 Massachusetts-,Department of Public Safety Board of Building Regulations and Standards Con-itructiun Supervisor Specialtc License:CSSLAM17 PETER A LEBLAKC 2 EAST PINE STREET _ Plaistow NH 03865 ' Expiration 0412812018 commissioner