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HomeMy WebLinkAboutBuilding Permit #1303-2016 - 234 BLUE RIDGE ROAD 6/13/2016 f�� p _1\ BUILDING PER'".:T- o`NO oT"gtio !1 "` el X11 32 y '`• _t'• 6 TOWN OF NORTH ANDOVER O APPLICATION FOR PLAN EXAMINATION h Permit No#: Date Received R �gSSACHus���y Date Issued: IMA ORTANT: Applicant must complete all items on this page LOCATION Z 3L C31 Ut 12.E ctA.�C�.A o-A Print PROPERTY OWNER A 11r-C MAD-r- Gy!a p-n Prim`� 100 Year Structure yes no MAP 2 PARCEL: Ups ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Buildingne family ❑Addition ❑Two or more family ❑ Industrial p teration No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Q Septic ❑Well El Floodplain 0 Wetlands ❑' 'he db District ❑Wate t$ewer DESCRIPTION OF WORK TO BE PERFORMED: at r s-c4i�•. cr WW-- t r\- aA-b e- i CLamm.il-e. V uo il Oyn Identification- Please Type or Print Clearly OWNER: Name: Phn,(_ r-AC.(i c r1 j�!M C h 1M� Phone:421 � r Address: 23`1 Q1vt �, AAc A Contractor Name: Phone: Ot 1'`9 1�`U 3 3 Email: r4 w ,W.i ir-,-w4&,�W Address: p iCh3(� Supervisor's Construction License: ��Z� Z Exp. Date: Home Improvement License: T3 Li I Exp. Date: L b1 1 �P ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$92.00 PER$1000.00 OF THE TOTAL ESTIMATED CBASED ON$925.00 PER S.F. Total Project Cost: $_ 3�hlo ,�'Z FEE: $-4-15> Check No.: ��"t e� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund . ; i Location 1 �� Na v, ` , ,« Date • TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ` f Check# _ f' BuildingInspector �'' Plans Submitted ❑ Plans Waived G 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 a 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 1 Water& Sewer Connection/Sictnature Dafe Driveway Permit DPW Town Engineer: Signature: FIRE 6n-,,site Located 384 Osgood Street DEPARaTMENT �t ml?�tDu� w Te r mpster on site. y nq)'- !o t tejd at124MaintSfreet "�. -. F a De .�A .. partmentslgnature/date f.` t ..y µ f {'' r �• ' cbm a 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 Call Email Date Time Contact Name Doo.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 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) 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 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 aD NORTIy Town 012 „ : ndover 0 . 3 No. LAKE h ver' 'Mass �I Y 0 COCNICNEWICK V� �d ASR-ATEO S U BOARD OF HEALTH Food/Kitchen P� EFXSeptic System 0 THIS CERTIFIES THAT ...................................... .t'n........ ....... . . .......... .. ............................ BUILDING INSPECTOR � has permission to erect . g Foundation ......................... buildings o ... .... ... . ... ...... ... ........ .......... Rough to be occupied as ......�.....................•. .. 0...... .x.�.1 .. a. .. .. ....' ............ Chimney provided that the person accepting this permihll in every respect conform to the terms of thea cation Final on file in this office, and to the provisions of the Codes and By-Laws relating to the sp tin, Alteration and Construction of Buildings in the Town of North Andover. a� PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST 4BUI Rough Seryice .... ...... ....... Final DIN NSPE TOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildins; Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry (Nall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. �f•1h. 1010 4:01t� '�o.8Z�7 1'. �I� ilmeQstlopt fg.w4 . i • - comma . cumw mr • amts aaaro 000eo . =4ftrl*g*W . . SBD I�aoaOr+o tldoalem�►� ee:eoR ItA E ®r°�l�i aaieu(aaps�oatl00li�oo ` ��ala► d�,0�ep�ew �a� ��4�C►meba� ass� if �dsaf�ewgru�� �� �r4�beo�epeoffir@dmooara�tbaq�y�eyp�wse� os. • to�sbi�6 ��� sndb�ao��t,i0od�abM ivW • 'Td* in t • "q'ffieel glglti0 Ott milli I" • � a8 �oota��aor�mi�s �� ��=1��� .mow• �f... ae - - � , 31 Zh 1 RISEso Str&MUW PAA units 1 canton,MA 02021133MU4W5 ENGINEERING' +► ®INNER AUTHORIZATION FORM I, � Iq�i�2 FYI Qrr� �� c,� 1i1 ��.•+no! (Owner's Name) owner of the property Ionated at: ( dress) - •l -1 l?csvLr. fjQ csigjo- (Prnperty Address) hereby authorize ct,ut., 1 Y1 S v 0 tM �\,c (Subcontractor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building Permit and to perform work on my proPerty.This form is only valid with a signed contract. 14 s Signature Date MAY - 5 2016 'The Commonwealth of Massachusens Department of Industrial Accidents Qffice ref`1 n restigations I Congress Street.Suite 100 Boston,N1402114-2tji? xww.mas.-v.gvr1diu NVorkem'Compensation Insurance affidavit: Builders('ontractorsiTlectriciansiPlumbers Applicant Information Please Print Legibly NamerijW\%-f !r 1t1ssA&. tLn- Y,-(— Address. ,-( .Add ess. _00_�i:X 31J4 City st.� .z l�t,on y 9 -TP, IS-Lo- 341a3 Are you an employer'Check the appropriate box: 't't.pr of project i required) .� I wm a a.rnF hvvCr a4itit ". �.{an)a c..C'RC'i"u"i cool`acwt -4 nu.I enlpEr7V� F(fill an tlr kart tirTlc°r.a h a.c hired?h sub 4ti.Vrtt,titch± f ff 6. Q <'t r()rid tT tt ittt?t >- I ain 3 soic F`•ro nctor or parLier- �i4ti.tT ?rl tl.�3t?���,c.�a#lea t. €� �IZ,f;:i}"it,'kttl'T16t° ship and)-,ave n: n p �F'lirss_ ,�F�i.�tt iraCti9rs not �f7elt�c.,t yin. ' 1 IdiV� s work,uwt ,Or DTIC TI;iii! C tI13C itti, e plo ct.' and hat e Wt )rker` P r �BttlTkTldt'?.IIIL�1+l°JFI ti15t;rorker>° %:omp. insurance etIFI3Tf 1:41:'�iitdc.' `.. r,.iium:d.I `. k1 e arc i,:orvor ttlia and its E s 0-0 I-le,imcril r mlirs or adMition v a t Vf cTt l:C Iia.c �.t'rc.irE.2f t}Ia:r I.,[)Y lumbirtg r1:V:tlr� ;r aCtvEitft;: am a ht�tTt tiw T crdaart a.i,:.i. tna wclt (1,F>dd}r#.i.r.' tcatnp. rigrhz -f L ;, i insutanct reclu.redi.a' I5' 1(4 t,and t+c(tacit 00 � .-.0°dwr' repairs } [\ tit.'C9r��e7�a` '_,� t C,Ei3t' t,• ct ttip.#TI.�Jtal?ee ,eq'ulred.T -g rlik:: .,r.,. r a )v;? cmE,.ta4rt= mm `fi{atisI- £s7,0ti:i'i5 that i;n..t'i'.1 h)?.Tt1ti'. .,}. .Xi iS.^.' tEt..1.1:,'S t:,.:Y...t.:a.A;F i i:.^,atiI.! tit }1xr se�,It;k,�ha;i" t:,taf,_+ t:. 1: t'i 5t1 t -x,lrie 't;.Ive.Tt t:. . `c'tr Pmr.i tir,',:,y:g fit.t. 4' PV i=l72tFtti:i. I rem at:empla}er t/sett fc prtrvidint twortrrs'c'rrmtrrrrcutian Jnsururtc°r rir mr rnr�Stc�tcF Below is the jw ic.y andjob site in formation. Fr:�uran � Company Nimw:_A_�r�.fi1 1Y1bt)i` � � {, f'ai11 t clr Scl -13T<, l.t . i +I i/ i 1L �:. �,L_._ .,. l f?31a1�Et141 1EC� �,-3 01'4 jof Site aaa#44� `!`t 11 00- _ Cott state zip.. Nl�,'_ft"vU 1119 OL V1 Attach a copy of the workers'compen"tion.p dics declaration page)showing the polis► nunther and expiration date}. VAlurc o•secure covemge 3s rt quired I ndcr 1i'etion_'_ext o NA ti.c. 15_2 sari iead to(he ttnmisli on 01 cntWnal pezilhicz rt`.7 1f71c p io S1.501100 atk1 or one roar 11t p7i;t tS7`.`rfcnl,.3.}Diol(a4 cT'd f ena.ltitn,M the`tt:brin a1.1 a S1{.Til WORK ORDER and 1 fiat of to S2<0 00 a d;ly aI ainst t!ta:s 1011 tttr. Rc;aitt ised that a copy or ditis sl,st;:vent 111aN be fora`Irded}io the f)itcc of lmestr,,,:anons of the DIA for in•s rancc t.+ i6cr i±c t.,mflii:jhoii. 1 do hereby certify under the panic steed penalties t:fperju)y that the ir(formalion i rorided above is true and correct. Dal Cto L\a I'htinC I Y3 1, "is• 34 3. Official use veiny. IN)not wrile in this areas to be c omplfttd ht•city°OFtown n/ficial City or Town: ___.. _._ Pertnitll_icense# Nsuing Authority+circle ones: 1.board of health 2.Building Mpartment 3.Citiffou n i'ierk 4.Hectricat Ittspector S.Mumtring Inspector 6.Other Contact person: Phone A C <. CERTIFICATE OF LIABILITY INSURANCE 911617015 THIS CERTIFICATE IS ISSUED AS A MATTEL 0=I•FOFMRTIO`+ONLY 4N✓CDhtERS W FUG-rS U:'Ctt--tE CEF+`IFTCATv"O.DER_THIS j CERTIFICATE DOES NOT Af%IPMATRE-Y CA NEGATIVELY AMEhJ t TEND OR W.TER THE CO`IEP,1,GE Af=Cr0Z0 BY T-1E POLICES (} BELOW, THIS CERTIFICATE Of INSURANCE DOES!.OT CONS-ITUT A CONTRACT 8ETi4'EEN''E ISSUING I':SURER(S),AUT40RIZED REPRESENTA TVE OR PRODUCER,AN,')TmE CERTtFICR .HOLDEP IM?ORTANT:If the cert,f-,cate holder is an ADDtTIONAr itSuR:ED,f.;*pokVf,es)mus*be ertdrMed ;f SU@�OvATiON f5 LYACdED,Su5}eCt to:ice teras and ccnd tons of tT=e poticy,ce ta,r pc Ivies rrzv req,ire an enaorserert.A staters.-P-t cn:his Cen f0le doet no:ccnfer nghts to the cen6cam I,ov.mer in lieu Df s+ir7i a lmoc"Se'*1e^..4). C 3yton Martin J Ins Agency Inc 4+A4.` 5e i ky Ass,sed Risk$grvKfS 1619 Nor#hMpten St POax B 989 +c.� S8�)634-4589 ,.c• (66612 15 BI:E Holyoke MA 01041 i`; ss Pc4ct s bw*.ey-Sk.co-- f«rx.3tEP.S,v-sW:M\v Li7vERAvf NVQ? I Rs;t14EA i A�6i i^s..—*4z. 3.925 ar,> Gauthier tnsufation Inc •<.iaFas PO Box 344 lPswkh,MEA 01938 ( tosztq I N5'L{C'ca COVERAGES CERTIFICATE NUMBER. REVISION NUMBER: „S IS TO C R.t Tr.A:T ThE PURMS OF I:.SUFAfNrE LIS ED BELOW rcv_E =M ISSUED'(T-E L,RED NAMED AB v=FOR 11-4E FO-ICY PE OO L'ra1CATE N0T%VtTH$1(AND!NG ABY P=:1JREMENT TERM OR CO,VAIC%Ox 4!'Y CONTRACT OR OT^ER JWuWEF:T MTh RESPECT TO VASICr Tmis CERT1+ICATE MAY BE ISSUS13OR MAY;SSZTALti.Ttt3 U:SVRAtLE A;:FOADED PY T-E POLICES DESCRISED MERE.N 15 5U3JECT TO At-T4E TERMS EX"aLMONS ANO CONO(TiONS OF St t,P01-•C'E5.L GAITS S.'CwN VAY waVE BEEN PED,t^ED SY PA.rO C-Aims. .:p Trac c.s w:.•2us,.t I e.S.R 'V^, POi.iCr*.:WF£•! .t7.+�+Y^.sv' t+ss::;rh.v, t;4tl'S IGEaEatAt WASi{.ii's EAC-OLt::kAE.v COLAMERCOAO VO_-49L tY L• }-- _ zmrla^SES'Ea nrvrRnce: S CUN!S.gA,�E 1 :l'�.t4 L1 �i \°E;•rx:P.Av rt+n i,•+v�. S _ aERSCM�-d4J:Mik1RY = :+E7.FHAt AZCRfrA-E # I �:aEAY ACw'Jr4aA'k L)w'APPLE,xP. sai,yJC^3-cL>w o'-'og i PJL Cv .T-.^, E th S f RJ'OMCSP.f LfAlllli'7' 1 � E3 RYltl.w, a•• 5 {� ANN ALV::, A:�V44C E7'Lc:A_'E6 # 656M.r h:Jr,'v qr�+•. _ rynco.�i iS I.++rwELu.cre ommID -- S I i u L sA.+.oct_utA=w F:CESt r.i.56 :A&WVA,T_� w tC A'E S �E7 i xF't<tfi-KAP; � WDAS�7tY GpIREsr3Ahpi. .A 15 ANQ rmpi4;""%W" '�-*• tO2+Et1'S :'Rt? + 0"Jmlt u1E�JPitt9xALR:hfik:p _ _ V r res.^_esaiee,mu, i _+RFASs{.(iy�r,•zc ]E$C.r'1('«OF['!PF'wTgM.eew E t-MSEASE.x.CY't.W # SOC Oar i 3 NSA.. lYt'W�4*i`i_CC;A:K h- .�^-..lts Art,.r.....•..;'.�ay.:-¢s a+H aVaYx t+.�s:aK[.s'eq.it=i €issAsr.cawwv Eacerxw;rRrw +tsw i:i is+iReAtrwwm. 1 CERTIFICATE?ffltD€ti CA lJ" ION 1 ShD L ANY CSF HE A.XAE O3 SCVdSEC P:Y_ILiES 6_CANCELLE:Wcr-<C Ciearesuit 11 TW_Exr'RATION„ATE-HERE6; BE DELNV� =N Contractor Svcs I ACCG{iCA':E trr :HE Wt crCnaS Oi+S 50 Washington Street Westborough,MA 01581 Ar-ORD 25(2010105} 51✓pC 3139 ACORLY CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) 1 7/7/2015 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 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 Nancy Usher Martin J Clayton Insurance Agency, Inc. PHONE Ex : (413)536-0804 ac No:(413)534-7874 NO- 1649 Northampton Street LMCA" ADDRESS: P. 0. BOX 989 INSURERS AFFORDING COVERAGE NAIC# Holyoke MA 01041-0989 INSURERA:Nationwide Mutual-Harleysville NATIO INSURED INSURERBAllied World Natl Assurance Co Gauthier Insulation INSURERC: 44 ESSEX ROAD INSURERD: INSURER E: IPSWICH MA 01938 INSURER F: COVERAGES CERTIFICATE NUMBER:CL157701379 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE Fx_]OCCUR DAMAGE TO RENTED 50,000 PREMISES Ea occurrence $ X GL43487F 7/6/2015 7/6/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY E PRO F-1 LOC I 2,000,000 JECT PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS leer accident $ $ X UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ 1,000,000 BEXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED 1 1 RETENTION BE020792125-194985 10/18/2014 10/18/2015 $ WORKERS COMPENSATION I PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CSG, NSTAR AND NATIONAL GRID ARE LISTED AS ADDITIONAL INSURED CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MASS SAVE PROGRAM THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CONSERVATION SERVICES GROUP, INC. ACCORDANCE WITH THE POLICY PROVISIONS. 50 WASHINGTON STREET WESTBOROUGH, MA 01581 AUTHORIZED REPRESENTATIVE Daniel Sullivan/MEG ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD MPIM t-d with pdfFactory trial version www.Pdffactory.com Massachusetts• Department of Public Safety Board of Building Regulations and Standards 11"WIN11440"n iuirrr%1%..r%I ft eJtti License:CSSI-102582 KURT'RGAUit�t P.0.801344 1pswkh MA 019-0 Expiration Cwlvrrssirxler 05/25/2017 i Office of Consumer Affairs and Business Regulation AT)"D 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 173410 Type: Individual Expiration: 10/1/2016 Trt1 257812 KURT GAUTHIER KURT GAUTHIER P.O. BOX 344 IPSWICH, MA 01938 Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card SCA 1 Co 2OM-05111 A 'lir Y-r nuiir iriieul/�rI t�e..n��ii.:r// :y Office of Consumer Affairs&Business Regulation License or registration valid for individul use only before the expiration date. if found return to: ItIOME IMPROVEMENT CONTRACTOR I Registration• 173410 Type: Office of Consumer Affairs and Business Regulation !t 1 ? Expiration: 10/1/2016 individual 10 Park Plaza-Suite 5170 Boston,MA 02116 KURT GAUTHIER KURT GAUTHIER JJ 44 ESSEX RD IPSWICH,MA 01938 undersecretary of&4t signature