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Building Permit #258 - 183 COTUIT STREET 10/9/2007
BUILDING PERMIT "O oT";�tio TOWN OF NORTH ANDOVER o? APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received AraD rpp`yh �SSACHUS�� Date Issued: Q IMPORTANT:Applicant must complete all items on this page ,a h 11 0CATJON 2 PRDPR'Y�VINERLttCtC MAP l�0 PARCEL . �ONINC D15TRf.CT�H�storac District yesn' • a ' klach�ne Shop Village f TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration-OezK No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other ;Septic" 11Ve11 Floodpla�ri Wetlands 1Natersl�ed Dls#nct W- r/Sewer DESCRIPTION OF WORK TO BE PREFORMED: Identiftion Please Type or Print Clearly) :cc:- a OWNER: Name: u c r l-w (AKI-'�4wt"'e& Phone: Li-7-7-77-6 Address: -"_ [ `'d* i Y ;€' r a �" •tY r;: `�* a _„Yip �' - O�ITRACTOR 71Varti . . �xPhone Addresser. '"- �t't < ..0_t ' .. ;n < jF b r_� � Supervisor"s Construction p ^ e�ebl' �omemprove Exp Date f -7 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ IS OVO FEE: $ �6 Check No.: /� l Receipt No.: 0 2- NOTE: Persons contracting wit unregistered contractors do not have access to the guaranty fund Signature of Agent/Ouune nature of wcontracto z _ BUILDING PERMIToF ''OR T " qti TOWN OF NORTH ANDOVER _ "6'` ° o . APPLICATION FOR PLAN EXAMINATION eti Permit N0: Date Received 799RRm � Ara ' ACHUS�� Date Issued: Q IMPORTANT:Applicant must complete all items on this page , An _ x. PROPERTY DINNER � fi ieu�tK IW �i�t:r� �7 j w F'nn t y p I IAP NO PARCEL ZNING D�Sf fiR1CT Hstonc Daslric# O 01 at Shop V�Ilage yes rio TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration--0 cc K, No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other =septic 1Nellz11 1f Floodplain`= Vlletlands Watersfied District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: I' Identif:cati�nA Please Type or Print Clearly) OWNER: Name: c„ci�u c _ Vli(C�►�l1���4kC�_eo Phone: Address: l (jay t c ' � �. 44Mvele- , VJ 14 CONTRACTOR Name e Phone:. . W Address. It t t S . ervisor'sConstrpction License . S% Ec ®We,: P m _p 77 H©me Improvement L�ceri5e 1 Z T,. P-'-" ExDate 7. ,'?— T ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ ?3 OVOO FEE: $ Check No.: Zqa� Receipt No.: o90�� NOTE: Persons contracting wit unregistered contractors do not have access to the guaranty fund Signature of Agent/Owne nature of contraYcto Location Az L., - Ste' No. 0`J Date f 7 NORTIy TOWN OF NORTH ANDOVER 0 � R 9 } Certificate of Occupancy $ f sACM�S<�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 20bL'S' Building Inspector 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 DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH COMMENTS M 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 Located at 384 Osgood Street FIRE DEPARTMENT Temp Dumps#er Located-at-124,-, ainStreet � Fare D.eparfimen#Mgngate XKx COMMENTS 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 DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH 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 Located at 384 Osgood Street _ f1RE DEl'AR7ML>�1T Temp Dumpster on site yes ro Located-a# 124 Main Street � r fire Department$1gnature%late hr COMME 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 ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 ■ 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.$100-$1000 fine NOTES and DATA— (For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 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 must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 1 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 must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 NORTIy ONM 0 _ over ty, No. dover, Mass.,�� ' y• �' COCMICMEWICK ADRA7ED P' C:) S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System � & BUILDING INSPECTOR THIS CERTIFIES THAT....... ! ..`............ !. l K...4...r-10L.0............................................ Foundation has permission to erect..................... .................. buildings on .12 ...........CaJ�s.�......g�.................. Rough tobe occupied as ................................................................................................................... Chimney provided that the person accepting his permit shall in every respect conform 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 3 6 PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTR AR S Rough Service BUILDING INSP R Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. so-oil 51-011 eP "xx4-QnYb" A =EBB==S=ESSEE Q Q -- - ----------------------------------------------------- - ----- -------- �t PHASE 02 ° Scope of work s r ill 22'-O'• L _ — — — — --' — — — — — - P I 8'-O° I B-6 I I NOTE: Ganterlevered deck, -- o I = I 2x8 PT floor Joiste sistered 82 iJ_J__: o I Q I 8', inside, to existing 2x8 floor '�,"'-`: I foists. Deck construction to be all s J pressure treated, including C14railings, posts, decking and ball6sters, ---------- `� - N ® � < rr vIle O Cn ° O � IV KITCHEN 11'-3" 4'41 `t MASTER SUiTE --------- LiVING ROOt"i ---------- ---------- ---------- -� ---------- 4 T ---------- O ---------- 12'-2" W ---------- _ TW2042 1-5" x 4'-41b" V-O"x 6�_9y� (ts" R.O.Y-i0�b° x 4'-4%" pROPOSED DECK NOTES• 1. PHOTO REPRODUCTION OF THE SEAL AND SIGN- ATURE HEREON IS INDICATIVE OF UNAUTHORIZED REPRODUCTION AND USE OF THIS PLAN. IF THIS PLAN DOES NOT CONTAIN AN ORIGINAL SIGNATURE NOW OR FORMERL Y IN RED TOGETHER WITH AN EMBOSSED SEAL, IT IS RICHARD H. HARRINGTON NOT AN AUTHORIZED PLAN FROM GRE SURVEYING AND CANNOT BE USED FOR ANY PURPOSE WHAT- SOEVER. ANY UNAUTHORIZED USE OR MODIFICATION o 124.57' - OF THIS PLAN MAY CONSTITUTE FRAUD AND WILL RENDER THIS PLAN NULL AND VOID. � ' 2. THIS PLAN IS NOT TO BE USED FOR THE RECON-STRUCTION OF BOUNDARY LINES NOR FOR TITLE INSURANCE PURPOSES. J. THIS PLAN DOES NOT REPRESENT A CONFIRMATION W � �o OF BOUNDARY LINES NOR A DETERMINATION OF TITLE BUT IS SOLELY INTENDED TO DEPICT THE s OFFSET DIMENSIONS OF THE PROPOSED STRUCTURE LOT A do s'9s TO THE LOT LINES AS DEPICTED ON A PLAN 0.57 AC. ���oy RECORDED IN ESSEX NORTH AS PLAN No. 3701. (RECORD AREA) T� 4. THE SUBJECT PROPERTY IS DEPICTED AS LOT 47 ON N. ANDOVER ASSESSOR'S MAP 21%23.0 / 5. OWNER OF RECORD IS DOMINIC J. MANNARINO, 183 / COTUIT STREET, NORTH ANDOVER, MA 20' DRAINACE EASEMENT / b 6 ONE OTFNEl SHOWN OHEAREONO�RE TO THE NEAREST p p NOW OR FORMERLY N HILTON P. CORMEY 7. ZONING DISTRICT IS RESIDENTIAL DISTRICT 4. PROPOSED 12' x 19.33' ADDITION PROPOSED PLOT PLAN of LAND 20.5' 2' OVERHANG SEEME&CM t�eoPos�� LOCATED IN 04 EXIST4'x8 �w�•..,Q 1. DEED IN BOOK 4927 AT PAGE 294. NORTH ANDOVER, MA DECK '� 62.3 (ESSEX COUNTY) F I STORY 2. PLAN No. 3701 I � I WOOD FRAME PREPARED FOR I 74DWELLING J. PLAN No. 597 JA YRON I ? I J. PLAN No. 6178 SCALE. 1"- 30' DA TE,• MAY 29, 2007 I I 15 0 15 30 60 125.0' GR SURVEYING COTUIT STREET 4Raymond Place, Winchester, MA 01890 Telephone 781-721-1944 Rev. 06-25— G No. 911102PP2 GRE No. 911102 The Commonwealth of Massachusetts Department of Industrial Accidents W Office of Investigations 600 Washington Street Boston, MA 02111 °�M SJe,W www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): LLC— Address: t 0 ey& City/State/Zip: JBiLc,FICA J4A( 01362_ Phone#: Ot-23 �IVO Are you an employer? Check the appropriate box: Type of project(required): 1. am a employer with I ( 4. ❑ I am a general contractor and 1 6 ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. i. ❑ Reniadeltiig ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees and have workers' Y p tS'• ,. 9. ❑ Building addition [No workers' comp. insurance comp. insurance.+ required.] 5• ❑ We are a corporation and its 10.0 Electrical repairs or additions officers have exercised their 11. Plumbing repairs or additions 3. I am a homeowner doing all work ❑ g p g right of exemption per MGL myself. [No workers' comp. 12.❑ Roof repairs + c. 152 4 insurance required.) , §1O, and we have no employees. [No workers' 13.❑ Other 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. tContractors 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 workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Ac::oiG'D — Policy#or Self-ins. Lic. #: WG -2-01?_. L4b Y Expiration Date: —0g 1 ,, Job Site Address:1 am=( � City/State/Zip: H. �(L`o�l— 14 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 51,500.00 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. Ido hereby certify ur der the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: 10–LI-0-7 Phone#: St 15–(a k2 R�YC2152 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 S.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employ6rs 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, or 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 of the dwelling house of another who 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 anv 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-contractor(s)name(s), address(es) and phone number(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 may be 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 permit/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 proof drat a valid affidavit is on Erie 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 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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 11-22-06 www.mass.govfdia r ACaRQ. CERTIFICATEOF UABIL17YINSURANCE i4 ° (978) 7-2541 FAX (978)671-4S14 ' "IM CERWICATEMISSUED R8AMATTER OFWORMAIM Neer sack 'ewei i eey im. Aocy, Im. ONLY ANDERSNO.RIGM. UPON TIMECERT=FICATE SSS SOsion ROW, Suite IA HOLDER.TWS CERTIFICA E DOES ROTAMEND,WM OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Billerica, Ii€i 01g21 fUSURERSAFFORDING COVERAGE mm# Ifftim-, 3R LLL x Barleys" le Worcester lns-(f. — 2618.2 F Po Box f21 AIGG s WKYR-1 $ILLERTCA, Rk 41862 c COVERMSE 5 i e % ?"r. e:i� ir'e xar..iouO?-itis'{£itr:raa::OR0fei=e�aiTWrr.i--�?a?TCt =i-- HZ �xev rt�wtieis i W-UMOR rte'Pi�AK THE_i?,iiii5A�AFFORDED EY T4fE K=§ES OESCR2W F REW IS WWECT TO ALL TME TMW,0MLLMMS ANO E17AiDii'MS OF SJCK a--LYU- S.A 2Gk—,x L UTS%WM Moky HAve SM REQ BY PAW W&S_ [Lm TYPEOFB i POf3LYN'.i PFKi.'TEr FIiifYQ .a:r�?t g �s�aot tsaausr CB 7E774 1 12/10/2006 12/10/2W007 {X t teras a,taeLn' i fEMAGE Tf REWO �, I s loo. $ 8 aAw S: } i 4 Ce--'1 AGEAESA?€;,W..fvmtaSPM' PROW-C'S-ODIJPf{-- AGG f S l mm fw # f gouty f f% j i L�( 1 1 # iso.._...} , SA 4-766SS'06/Oa/20%;06/04/21 7 s I ; �-rZ-L�i�v`ici3x:zsse% I s i[-flNH'f�3P..LE LiIvIT .s;jYos Wx i 'x. HR-=>ALMU.Ci ! f� oco&i GARPCELMWUFT # # AA s 1 �?TF1' ITC+ f { � �t£k Yf;ASv E...� i ts ; AABREtAE3mLfTY i rFa'C l�R6'�10E 5 u/ I x -2�K:ti --- i t-- S49 01J35i2007 11 01/25/2009x � S� i � i EL_Dtg1+S£_ERB+Pi_�? S tID_i� { G '. .`:E-?"f.._!^' '.t.'_......___-__-_ I• *•�:c�s�a�as::.oc�arx� �.ssa�i��a .zi� rsass i ATFH-Q TDFIk QA#CELLkTlON 9�i.D fl�P.'^JrTf�1t3:2VEP4LfL�S�CAIVCBsf�;�r�iETi� t BUrFAHSMS TO WJL SUCH NDTX;]-.*AU WOSENO QMJGATM OR 3ABLTf �AiY i@E3LS4illiTlfie if .tiSi�58iT5 f)2 'iiA7".Yr�" FOR CLT.EN PURPOSES ONLY ACORD 75 LZMUM @ACORD CORPORATION I-M ti ov�to>rt�,ruu�rx,C� a- ,,e�laa;cu•�uresF.CJ"i � . �;\ Hoard of Building Reggulation and Standards License or registration valid for individul use olily HOME iMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 147423 Board of Building Regulations and Standards Expiration: 7/7/2009 Tr# 130327 One Ashburton Place Rin1301 Ul ' Type: Ltd Liability Corpor Boston, Ma.02108 JAYRON LLC RONALD HABESHIAN 100 IRON HORSE PARK « N. BILLERICA,MA 01862 Administrator Not val d t signature Cons&uon Supervisor taattgrds Gcevisor Lich ►+se: � Simdm*: 6 s 75630 aEiOn: 970 Ctfo� �� .00 Tri 143¢0 P'QNALD c 545 FARES NST JR DUNSTABLE c��•- _�. 01$27 Cott�missiouer w a Estimate Date Estimate# 9/26/2007 114 �F ADDITION� � �� REMODELING 100 Iron Horse Park N Billerica, MA 01862 Dominic Mannarino 183 Cotuit Street North Andover,Ma 01845 Description Qty Cost Total 4'x8'Pressure Treated Deck. 4x8 Cantilevered Deck off Master Bedroom. 3,000.00 3,000.00 2x8 Pressure Treated Framing. 5/4x6 Pressure Treated Decking. 4x4 Pressure Treated Posts. 2x4 Pressure Treated Railings. 2x2 Pressure Treated Railings. Flashing. Total $3,000.00 Phone# E-mail Web Site 978-663-8400 barb@jayronllc.com www.jayronlic.com