HomeMy WebLinkAboutBuilding Permit #663-2016 - 23 IPSWICH STREET 11/30/2015selw va /� �`�- BU.ILDING PERMIT
TOWN OF NORTH ANDOVER
' APPLICATION FOR PLAN EXAMINATION
Permit No#: "1 Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION 3 ��Swr�cJ1 S%
Print
PROPERTY OWNER A, -C"14 Akt'rr,"14)'B14
Print 100 Year Structure
MAP PARCEL: �� ZONING DISTRICT: Historic District
Machine Shop Village
yes no
y s no
ve r no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ One family
❑ Addition
El Two or more family
❑Industrial
❑ Alteration
No. of units:
El Commercial
❑ Repair, replacement
❑ Assessory Bldg
Others:
4-v\5 V /iTr' B N
❑ Demolition
❑ Other
_
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1hVel�
� ootl ,�IainWet�la
❑ p.LOW _
W to shetl ®`istct
DESGKIF I IUN UI- VVUI' M I v or- rr_FxrvRinw.
{o; ,(` S-ra 1►`vt I Ig7.7-Pc s N5g te,;,-pC) !d 3o A- 4 9
Identification - Please Type or Print Clearly
OWNER: Name: �� cl..alr J 14tf-I'VIA ro Phone: �eflb- �o
Address: �,3 �F�w j e L, 5T- n. A,(^ef ov e
Contractor Name: `firtY t' tc f% 1 a1^t Phone: 5>,F -q62
Email:
Address: a- ec�57- 'r -e T 1 ai510 �✓ _
Supervisor's Construction License: i Exp.. Date:
Home Improvement License: 10 d
ARCHITECT/ENGINEER
Date: 2 % Id o Ik
Phone:
Address: Reg. No.
FEE SCHEDULE. BULDING PERMIT; $92.00 PER $1000.00 OF THE TOTAL ESTIMATED COSTBASED SED ON $925.00 PER S.F.
Total Project Cost: $ 3Y od- '0 ° FEE: $ A
Check No.:�/ Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access ko the guaranty fund
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
TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
Building Permit Application
46 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)
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
46 2012 IECC Energy code
Engineering Affidavits for Engineered products
TOTE: 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
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑
Well ❑
Private (septic tank, etc. ❑
Tanning/Massage/Body Art ❑ Swim iug Pools ❑ ;'
Tobacco Sales ❑ Food Packaging/Sales' ❑
Permanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF m U FORM
PLANNING & DEVELOPMENT
COMMENTS
Reviewed On Signature.
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
6
Conservation Decision: Comments
Water & Sewer Connedion/Signature � Date Driveway Permit
DPW Town Engineer: Signature:
I. L
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 ease)
LI Notified for pickup Call Email
Date Time Contact Name
Doc.Building Permit Revised 2014
Location2
No. Cob -3 Date
Check
29743
TOWN OF NORTH ANDOVER
Certificate of Occupancy
Building/Frame Permit Fee $
Foundation Permit Fee
Other Permit Fee
TOTAL $
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RISE Engineering MCcultactorRogist 211a
a cobacmrno
A dividon of Thteisch Engineering CT Contractor Reg�ratlon No
- - 60 Shawmat Unit #2, Canton. MA 02021 CONTRACT
= _ - FAX 339-502-6315
R I S E PROGRAM PW '
CMA -HES was
ENGINEERING
euaiote3t N PHUME oats etmvre
woaxora 3
Richard Harringtono ter (978)686-2880 08/102015 421273
00003
13131v= arat11132HIJeavao arrW
23 Ipswich Street U j 23 ipsMch StreetEn
(2
L�
auvaaCR.anne.aP anaower .8TAMEP
North Andover, MA 0184 North Andover, MA 01845W)
OCT
JOB WSCREMON
VASE ONE - Proposal for this calc u ar year.
$0.00
BARRIER: We have dboovered what appears to be a mold I mildew4ike sahstancc in your home. This is being broaOt to your
attention to identify it as a pre4odsting condition to the insolation and air searing wotk planned for you home. Your sipretue is
your acknowledgemem of [hese conditions and agmcment to pmceed.DARK SPOTS ON ROOFNDECK
50.00
AIR SEALING: Provide labor and materials to scat areas of your home against wasWK excess air lcatmge. This wok will be
performed in concert with the use of special tools and diagnostic tests to assure that you home will be left with a.health6t level of
air mheoge and indoor air gtality. Materials to be used to seal your home can hwk* catdtrs, foams and oMp products. Primary
nem for ding include air leakage to attim basements, afteltedgmM and other unheated areas (wpadom me not gmendly
addressed.) '[itis will mquim (8) working hours. Anduction in cubic feet per minute (e6n) of* infiltration will occur, but the actual
cumber of chn is not guaranteed.
At the completion of the weatherhation work and at no additional cost to the homeowner, a final blower door and/or combustion
safely analysis will be conducted by the sub -contractor to ensme the safety of the indoor air quality.
5680.00
AIR SEAl1NG ADDER. (4) working hoes.
$340.00
DAMMING: Provide labor and materials to install a tr layer of R 38 unlaced fibaglms bans to (40) square feet for damming
Pte•
582.00
ATTIC FLAT: Provide labor and materials to install an 8" layer of lt 28 Class 1 Cellulose added to (I 150) square feet ofopen attic
SPUL
$1,57550
ATTIC ACCESS: Provide labor and materials to hatall (1) easily moved, insulating cover for the attic acc m folding stair. As"
flat odboe of plywood will be created around the opening within the atria This will allow the cover's integral weather-stripping to
testrietaIr leakage.
$237.65
ATTIC ACCESS: Provide labor and materials to mate (1) temporary access to on attic area The opening will be closed with
materials similar to those existing. FudA sanding and painting is not included.
$85.00
VENTILATION: Provide labor and materials to install ventilation dcdm in (38) raft bays to maintain air flow.
576.00
VENTQ.ATION: Provide labor and materials to install (10) 4" X 16" rectangular alum6wm soffit vents to Immense ventilation in
attic areas. Spedry color: White or Gray.
5250.00
RISE Engineering will apply all applicable, eligible incentives to this contract. You will only be billed the Net anoint. Currently,
far eligible measures, Colombia Gas offers 75% incentive, not to eaooed $2,000 per caleadwyear and an incentive of 10056 for the
Air Sealing measures up to the fust 5680 and an additional $340 if savings are justified by the auditor.
W
Gia
Federal ID #
RISE Engineering RI Contractor Registration No
MA Contractor Registration No
A division of Thielsch Engineering CT Contractor Registration No
60 Shawmut Unit #Z, Canton, MA 02021 CONTRACT
339-502-6335 FAX 339-502-6345
Page 2
R I S E PROGRAM
RISE
THIS CONTRACT IS ENTERED INTO BETWEEN
CMA -HES ENGINEERING AND THE CUSTOMER FOR WORK AS
ENGINEERING DESCRIBED BELOW
CUSTOMER PHONE DATE CLIENT0 WORK ORDER
Richard Harrington (978)686-2880 08/10/2015 421273 00003
SERVICE STREET BRAMC STREET
23 Ipswich Street 23 Ipswich Street
SERVICE CITY. STATE, ZIP Y DILIING CITY,STA-M ZIP
North Andover, MA 01845 North Andover, MA 01845
JOB DESCWTION
For the safety and health of your home's indoor air quality, we will be conducting a blower door diagnostic of the available air flow in
your home both before the work is begun, and after the weatherization work is complete. We will also conduct a full assessment or
the combustion safety of your heating system and water heater. This has a value of $90 and is at no cost to you. Total allowable
wcathcrization incentive is $3,110.
$90.00
Total: $3,416.15
Program Incentive: $2,839.61
Customer Total: $576.54
WE AGREE HEREBY TO FURNISH SERVICES - COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS. FOR THE SUM OF
"'Five Hundred Seventy -Six & 541100 Dollars $576.54
UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING. CUSTOMER AGREES TO REMIT AMOUNT DUE IN FlIIL. TOF TY, WRl BE CHARGED MONTHLY ON ANY
UNPAID BALANCE AFTER 30 DAYS. SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES. RIGHTS OF RE. N, S EDUUNO, AND OONTHACTOR R TRATION.
DO NOT SIGN THIS CONTRACT IF THEREARE ANY BLANK SP
RObeA GWen (Oct e015)
-_
AUTHORIZED SIGNATURE -RISE Engb a tg GUST01 ACCEPT CE
NOTE: THIS CONTRACT MAY DE WITHDRAWN BY US IF NOT DMCUTEO WITHIN DATE OF ACCEPTANCE •••---
ACCEPTANCE OF CONTRACT -THE ABOVEPRICES, SPECIFICATIONS AND CONDITIONS ARE
30nSFACTTO USANO MEACCEPTED-YOUME AMORM 7000 THE WORM
WILL BEHEREBY
DAYS. ASFA. E
6 / ;� ;�.,>
OWNER AUTHORIZATION FORM
Richard Harrington
(Owner's Name)
owner of the property located at
23 Ipswich Street, North Andover, MA 01845
(Property Address)
23 Ipswich Street, North Andover, MA 01845
(Property Address)
hereby authorize
(Subcontractor)
an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building
permit and to perform work on my property.
�, . ! rZIA112
Owners • - v
Date
SIR 0 Z 100
s
x,, a
CERWICATE OF LIAGILITY INSURANCE
OU,FE(IMI2o14n
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, ANDTHE CERTIFICATE HOLDER.
IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. IfSUBROGATION S WANED, 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(sl
PRODUCER
AL
NM1E:
in crow E:tt Int nbk
Automatic Data Processing Insurance Agency, Inc.
1 Adp Boulevard
Roseland, NJ 07068
ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIL s
CMDONYYY)
INSURER A: NorGUARD Insurance Company 31470
INSURED POLAR BEAR INS ULATION CO INC
INSURER 6:
INSURER C.-
:PO
DBA: Polar Bear Insulation CO Inc
POBOX 956
Andover, MA 01810
INSURER D:
INSURER E:
INSURER F:
t_VVtKH4t.5 CERTIFICATE NUMBER: LJlbM REVISION IU"MRFR-
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BEL OL•S HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
114DICATED- NOTLVrn4sTANDiNG 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 SUBJ ECTTO ALL THE TERMS,
EXCLUSIONS AND CONDTimONS OF SUCH POL)CIES_ LIMITS SHORN %:AY HAVE BEEN REDUCED BY PAID CLAIMS_
LTR
TYPE OF INSURANCE
MSD
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EACH OCCURRENCE 5
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PERSO2Aw INIUIty S
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AUt'OMBB.E
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0110112015
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i STATUTE WANDENPLOYERS'
ELEACH ACCIDENT S 1,000,OOD
El. DISEASE -EA EMPLOYEE S 1000000
E1. DISE+LE-POLICY UtJIT 5 11000'000
OESCRIPIlm OF OPERAMONS tLOG17tONS IVENCLES (ACORD 10L Addrmnal Renw6 Schedute. MN be attached i(rnmespace is regvirndl
Columbia Gas massachusetts
t.cmnrn,.rLtc nLJLutH ramrF1 i a-nnhi
AU 1780'YV14 AL.UKU t.VK PURATIUN. HU ngnts Tesetveu.
ACORD 2S (2014,01) The ACORD name and logo are registered marls of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Theilsch Engineering, Inc.
ACCORDANCE WfTH THE POLICY PROVISIONS.
19S Frances Ave
Cranston, RI 02910
ALI M0&IZEDREPRESENTATiVE
lit -.-
AU 1780'YV14 AL.UKU t.VK PURATIUN. HU ngnts Tesetveu.
ACORD 2S (2014,01) The ACORD name and logo are registered marls of ACORD
®p ID: SS
CERTIFICATE OF LIABILITY Q INSURANCE
ILTR
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RiGHTS UPON THE CERTIFICATE HOLiDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVEi.Y OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITM 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(les) must he endorsed. If SUBROGA'!i 101U IS WAIVED, su(ojeC: to
ft terms and conditions of the policy, cerlain policies may require an endorsement. A Statement on #his cesfiliCate does not confer rights to the
Certificate holder in lieu of such endorsement(s).
PRODUCER
Durso & danlwvlrsld Ins Agcy I.l_C
198 Massachusetts Avenue
North Andover, MA 0184.5
Durso &:.lanaowsid ins. Agcy.
Durso
CONTACT
NAME
IrmONE
Arc E01-- FAX f:°
saaess:
ADDRESS -
PRODUCER
CUSTOMER ID&POLAR-1
INSURER(S) AFFORDING COVERAGE NAIL S
Cranston, 13102910
INSURED Polar Bear Insulation Co. InC.
Andover, 801810
JPAURERA:Penn America 32859
INSURER B : Sslety Insurance Co. 33518
INSDRERC:
INSURER D :
COMMERCIAL GENERALLIABIUTY
INSURER E
INSURER F:
032412015
^^11M®^r--0MC1F-AT= NIIRNRr;b9 kiiAr six2 i XiiumipGiv-
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE OU 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.
ILTR
TYPEarMSURANCE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
POLICYNUMBER
atm EFF
POLICY Em
LIMTS
GENERALUABILFV
AUTHORIZED REPAESEN:ATLUE
Cranston, 13102910
AA9419-
EACH OCCURRENCE 5 1,000,000
PREMISES Ea°�"S 50,fl0
A
COMMERCIAL GENERALLIABIUTY
AC7052023
032412015
03124P�011i
MED EXP (Any one Pe1Sen) S 5,fl0fl
CLAIMS -MADE ® OCCUR
PERSONAL BADVINJURY S 11000,000
GENERALAGGREGATE S 2,000,00
GEITLAGGREGATE LIMIT APPLIES PER_
PRODUCTS-COMPIOPAGG S 1,000,000
S
POLICY PRO LOC
AWOiAOBILELIABILIV
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01/04/2016
COMBINED SINGLE LIMIT S 1,000,00
(Eaawdent)
BODILY INJURY (par person) S
ALLOWNEDAUTOS
BODILY INJURY (per acddeft� S
3C.
SCHEDULED AUTOS
HIREDAuros
PROPERTY DAMAGE
(PER ACCIDENT) S
S
X
NON-OVVidEDAUTOS
S
UTABRELIA UAB
If
OCCUR
EACH OCCURRENCE $ 1,000,00
AGGREGATE S _
A
EXCESS Lian
CLA1MS.MA0F
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03/2412095
03l24PL{)96
DEDUCTIBLE
$
$
RETENTION S
WORIERSCOPAPENSATION
ANDE:fPLOVERW LIAMLITV
ANY PROPRIETORIPARTNERiEXECIJTIVE YIN
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(Mandatary In NH)
►TTA
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If yes, describe ger,
OFOPERAT[ONS halon
-rr-
DESCRiPnONOFOPERATfONS/LOCATIONS/VBUCLES(AUaehACOBD101,AddiSwmlRemnrlmSchedule, Ifmore GPM isMqulred)
insulation Work - Mineral; Additional Ensu d for general liability, wreth
Eft Redin s towork performed on their behail by the above insured is 3hlelsch
/-eaTlc r,-ATc r,int ncE2 r-A1ur_l:1 I n-ranR1
Tlri1EI.S2
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
N DATE TEOF, NOTICWILL BE DELVER® IN
O=
Thleisch Engineering
ACCORDANCE THE POLLICV ROVIS ONS•
Columbia Gas
195 Francis Ave
AUTHORIZED REPAESEN:ATLUE
Cranston, 13102910
AA9419-
to itfdw duuv§4%ewnU;.wKrwrw11avae.
ACOR D 25 (2009109) TheACORD name and logo are registered marks 01 ACOIRD
Ttie Co111111onit°e(lltll of Mas5achuseits
Deptirtnrent of Inchistrial Accidents
- -� Office of lnvesti- atiolU
;t 600 Tf%ashilaon Street
Bosion, AIA 02111
'v)v1v-inass.9 olr�L�lLt
Workers' Compensation Insurance Affidavit: Builders/i contractors/Electrician§/Plumbers
\mite (Business=Organizationtindiyidual): 1V-
Address: ko'0
Phone A: P 7
Are you an employer? Check the appropriate box:
1 _ �L�►i am a employer with '7 4- ❑ 1 am a general contractor and I
employees (full andlor part-time). have hired the sub -contractors
2_ ElI am a sole proprietor or partner- listed on the attached sheet_
ship and have no employees These sub -contractors have
working for me in any capac%-. employees and have corkers-
[No workers= comp. insurance comp. insurance.=
required.] 5. ❑ Vire are a corporation and its
3. ❑ 1 am a homeo-t-r--rler doing all Avork officers have exercised their
myself_ [No workers: comp. right of exemption per MGL
insurance required.] ` C. 152 S 1(4). and xt°e have no
employees. [\o workers-
camp. insurance reciuired.l
Type of project (required):
6- ❑ New construction
7. ❑ Remodeling
S. ❑ Demolition
9- ❑ Building addition
10.❑ Electrical repairs or additions
I i.l'] Plumbing repairs or additions-
12-El
dditions12.❑ Roof repairs
`any applicant that dtecks box = t const also fill out the section below showing.their worker; compemintion polio- infornatinn.
I for eou-ners who submit this affidavit indicatine die.- are doir._ ail.cork-- and then hire outside contractor must submit a nett affidavit indicating suds
=Contractor that dint: ibis box nmst attached an additional sheet showing the name of the sub -contractor and state tt-itether or not those entities huVe
eniplorce5. Irate sub -contractors have employees_ they must provide their scorers' Tromp police number.
1 Mir an employer char is provicrng workers' compensation insurance for iz r enrpiol:ees Below is the policy crud job sire
I11f01'11ta11011_
Insurance Company Name:
Policy = or Self -ins. Lic. �:: 3N p Vie— & S7— Expiration Date:
Job Sitc Address: �3,psj,V 1`C� 1� Citi Stat ,; aLr t -p ,,.Pym
�j9d
Attach a copy of the workers' compensation polio declaration page (sho,%c•ing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of -IGL c_ 152 can lead to the imposition of criminal penalties of a
fine up to S 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 5250-00 a day against the violator_ Be advised that a copy of this statement mai• be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I da hereby cert * tinder rLe pains and pe�rahies afperi'm tl
F,-,lat the information prorkled abovecol
is trite d correct
7
Official Ilse only. Do not write in this area, to be colliplert,bra rift rlr tvtell offeinf
City or Town.: Permit/License
Issuing Authority (circle one):
I_ Board of Health 2_ Building Department 3. Citt/To%vn Clerk-: 4. Electrical Inspector s. PIumbing Inspector
6. Other
Contact Person: phone ':
'
RegulefOn
Office of Coromer Aff1m 8011 Suite 5170
jo Park Plaza_ 02116
ett
BosBoston,Mosachuss
Improvement CoReestr24011
NomeRegodow-
TVPw-
E*,Mtor
102726
DM Tt# 25:249
7=06
of,&GA1 a 5QM44M41MMM5
Mas . sachusetts -Department of pubSlic Sa�letY
and +andards
Board Ott 13uiiding Regulations
construction -Supen'isor Specialty
License: CSSLA0017
pj&TRR A, LRBIATC
2 VAST PRM STRERT
p1ghtow NK 0386
FXpiration
04128MIO
Commissioner