HomeMy WebLinkAboutBuilding Permit #528-2017 - 262 SOUTH BRADFORD STREET 11/16/2016PIAjos !gcRNNED
BUILDING PERMIT S'MUETRI FRA 'rbt?6-s
TOWN OF NORTH ANDOVER kc
APPLICATION FOR PLAN EXAMINATION
Permit No##: ,5-?,?- 1-017
Date Received )-0 I k
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
P-6ne family
❑ Addition
❑ Two or more family
❑ Industrial
"Iteration
No. of units:
❑ Commercial
repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
El Septic -0, 1Ne11
❑ Floodplain 0 Wetlands
Watershed District
®'Nater/Sewe"r, _.�.
-
� •
DESCRIPTION OF WORK TO BE PERFORMED:
r10 ,--TWVy,.►-I ,&,irlo -.
r r '�✓w- v. G�� NP1,114Nrlw ` ♦)l'k:1i !i-wei F421 -05000r" a
T �
6Z \ ti
r -) V\ W �N ar \ �Q 1 �i
Iden ' cation - Please Type or Print Cleary _
OWNER: Name: ' oy\, Phone:101`1_C, 03`75
Address: Z(.r.,Z S
Contractor Name: -c
�e3 Phone:.
Address: -0 .0. B04- Z-3 n- `� �.� ��c /YYq- Cx1&
Superviso_r's,Construction License"; (7?; ?� �� _ Exp. Date
Home Irnprovewment License: %9Exp,.
ARCHITECT/ENGINEER � t,�„A,, ��� �h Phone: --�-. —)- 2-77'; -ZZZ5
Address: 1-4 1 �A � � , 5 ; v � /V►�� Reg. No.
FEE SCHEDULE: BULDING PERMIT: $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F.
i 1 /
.Total Project Cost: $ !� n� `� FEE: $ y 0' '0
Check No.: irt, 7�- Y Receipt No.; 3 f 96 1
NOTE: Persons contracting with unregiste d contractors do not have. access to the guaranty fund
064
--4.S`ignature_of_Agent/Owner `ignature ofconttactor'
r_.._ _.
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. ❑
Pennanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT Reviewed On IO 9 �� Si nature
�
COMMENTS
IffNl-
CONSERVATION
> COMMENTS
HEALTH
COMMENTS
N
Reviewed on
Loo `
natur(
inn
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
G
r
Clanning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature & Date Driveway Permit
DPW Town Engineer: Signature:
FIRE DEPARTMENT' - Temp Dumpster on site yes
Located at 124 Main Street
Fire Department signatureldate
COMMENTS
no
Street
dimension
Number of Stories: 2- . 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
MGL Chapter 166 Section 21A —F and G min.sloo-sl000 fine
No
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.
r
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/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
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
o 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
40TE: 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 t
Doe: Building Permit Revised 2014
Location A, � r�,- 5 0, i-�
No. G ay -:2 7 Date //- /b- PW �
Check # 67 2' Li
TOWN OF NORTH ANDOVER
Certificate of Occupancy
Building/Frame Permit Fee
Foundation Permit Fee
Other Permit Fee
TOTAL
�,/ Building Inspector
Enter construction cost for fee cal -
North Andover Fee Calculation
Construction Cost
$ 145,000.00
m
$ -
$
1,740.00
Plumbing Fee
$
217.50
Gas Fee 100 comm.
$
100.00
Electrical Fee
$
217.50
Total fees collected
$
2,275.00
262 South Bradford Street
528-2017 on 11/16/2016
demo lower level
Plans Submitted 19
Plans Waived El
0
Certified Plot Plan ❑ Stamped Plans ❑
TYPE bF SEWERAGE DISPOSAL
Public SewerTanuing/MassageBody
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 I � Signature
V
n _
COMMENTS
CONSERVATION
Reviewed on
ature
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
r
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/signature &Date Driveway Permit
DPW Town Engineer: Signature:
FIRE DEPARTMENT - Temp Dumpster on site
Located at 124 Main Street
Fire Department signature/date
COMMENTS
yes
L54 US900C1 Street
no
v
C �
0
O
CD O I
CL o�
O
CL
co to
O
<o
v�
Q =
cr
CD O
W
Q O N•
to I
� v
0
o
O
O
NO
O
M-
m
TX
V
55
cn
Z
O
v/
C
o = "a O
O p F V:
rt rt��
O
� -h 0 rr
C
s
r-
CD
CD
-a
�°
DC7
C
— C
T
y
O CD
O
M
C
Z
LA
n
0
�
(�
S
=
<
.Z1
C
�
T
C
a
E
.-�
o O n
S
7
O
G
O
r
2
CL
.e
b
CD
CD
O
O NCD
O O O
n
ccCL
,o
3D`D
c
CD-�
-i o O
0`-`mto►
m
�y�p
o03
o �,
a
O
CD N
n =
Q
O
:�
Q oto
O
O Q
N
N
CD
CD N
.�O
CD.
<
S
O lD
CL
N
CD
O
rN
0)'a
CD
N rt r
So
�
O
1
2
Mn
0
m
T
Fn
N
2
�V
i
c
46
0
O
own
0
J
y
0
N
p
0
m
o
K
L
m
z
O
O p F V:
rt rt��
Aa
CD
C =r(A(Di
C
s
G7
_N
Z
cn
Z
CD
C.)
DC7
C
m
m
�
D
r
f7
00
T
y
O CD
O
M
C
Z
LA
n
0
�
(�
S
=
<
.Z1
C
�
T
C
a
E
ci
rt
N
'O
n
3
:4p
O
G
O
r
2
CL
.e
b
2
O
own
0
J
y
0
N
p
0
m
o
K
L
m
z
O
W
C
3
(D
�D
c
3m
'Zi
T.Z7
fll
C
s
G7
_N
Z
cn
T
N
VI
m0
<
m
DC7
C
m
m
�
D
r
f7
00
T
y
W
0
C
cm
M
C
Z
LA
n
0
T
N
(�
S
=
<
.Z1
C
�
T
C
a
E
W
C
O
N
'O
n
3
T
O
m
O
G
O
r
2
H
c
Fontes Construction
P.O. Box 237
Reading, Ma 01867
Contract to Build
To
John Gagnon
262 S. Bradford St
North Andover, MA 01845
Structural
CSL# 0332324
H I C# 148144
Date 10- 26-16
Dig 3 new footings, 2 exterior and 1 interior 2 -ft x 2 -ft x 18 -inches to accept new
steel post for garage. Install 2 new steel I -Beams as specified by Engineer, install
beams on 4 -inch x 4 -inch steel post anchored to new footing pads, Post will be
bolted to steal 4 point connection, Install blocking to connect existing 4 -inch x 10 -
inch wood beams, hang with Simpson Hanger with rating of #20 or 30 to plan.
Remove adjustable support post in front of bedroom window and install new
steel 4 x 4 posts. End of steel beam in garage will be installed in a new concrete
pocket.
Exterior Finish of beam to be designed by others.
Floor Cutting
Cut concrete trench for plumbers, contractor will remove concrete as marked,
plumber to excavate as needed to code, Contractor will backfill and cap with 4
inches of concrete and rebar.
Exterior Framing
Remove existing garage door frame opening to accept new single door, Remove
existing window next to door, close wall off reframe wall to accept new garage
door.
Exterior Stone Work
Remove existing stone as needed to remove wall for garage and new window,
Reinstall stone not to exceed $1,200.00
Interior Framing
Build new walls to plan, all walls to be 2 x 4 construction with pressure treated sill
on concrete, garage dividing wall will be 2 x 4 framing, build new 4 inch concrete
curb under wall to divide garage and living space to code. Reframe interior walls
to plan, reframe walk in closet door area to accept larger door.
Window
Remove window in bedroom and repair water damaged wall, reinstall window.
Insulation
Install fiberglass R 15 Insulation on all exterior walls, with 3 mill vapor barrier.
Blue board and Plaster
Install 1 %2 inch foam board on ceiling in garage, Install 5/8 inch fire code on all
walls and ceiling in garage, with the exception of concrete foundation walls in
garage, all other walls and ceiling as needed will have %2 inch Blue board with skim
coat plaster.
Tile Floor
Install new tile on floor in new bathroom. Cost of the not to exceed $6.75 per
square foot, with no installation of perimeter boarders.
Hardwood Floor
Install hardwood floor in all areas except bathroom and garage. Not to exceed
$6.75 per square foot.
Interior Doors and Trim
Supply and install 1 Fire door with Hardware in separation wall in Garage, Install 4
Structure core hinged doors, 1 double hinged door and 2 sliding doors for
Mechanical room, bathroom and laundry room, all doors to have Anderson
Mcquade Poplar trim not to exceed $2.00 per In ft. Install Anderson Mcquade
Poplar baseboard as needed on all interior walls not to exceed $2.75 In ft. Supply
new hardware for all doors, Doors and hardware not to exceed $3,100.00
Exterior doors.
Remove and replace front and rear door units and frames, supplied by customer.
Stairs
Widen upper level stairs; Install new Rails and Balusters to code.
Garage Door
Install new Garage door not to exceed $3,000.00
Laundry Room
Re -pipe laundry to accept new layout, Remove cabinets in old laundry room and
reinstall in new laundry room. Install new Granite counter top with sink and
faucet not to exceed $1,350.00
Vent Dryer to Exterior
Master Bath
Install shower with 1 Granite bench seat with glass doors, Install new cabinets
with 2 each recess medicine cabinets and double sink with granite counter tops.
Tile floor and walls of shower. Install new Vent Fan.
s
Items of Budget
Shower base acrylic $700.00
Shower valves 2 ea. $2,000.00
Under mount vanity's 2 ea. $500.00
Faucets 2 Ea. $1,000.00
Granite counters top $1,000.00
Recess medicine cabinets 2 ea. $1,400.00
Cabinets $6,500.00
Shower glass doors $4,100.00
Misc. hardware $350.00
Toilet by Plumber
Install new Baseboard heat in all rooms,
Install new electrical to code in affected areas,
Install owner bought light fixtures.
Total Materials and Labor $145,000.00
John Gagnon
Tha,hk you
I Fontes Tel 781-308-1184
Paul Fontes 1 /26/16
The Commonwealth of Massachusetts
Department of IndustrialAccidents
1 Congress Street, Suite 100
Boston, MA 02114-2017
www massgov/dia
Compensationbsurance Affidavit: BinUders/Contractors/Electricians/-lumbers.
TO BE MED WITH THE PERMUTING .A.UTHO*Y.
Name (Business/Oigai&ation/Individual):
Address:
Phone
City/State/Zip: ti
#: 1
Axe you an employer? Checicthe appropriate box:
1.[S�I am a employer with employees (full an(i/or part time).*
Z.❑ I am a sole proprietor or Partnership and have no employees working for me in
any capacity. [No workers' comp. insurance required.]
3. I am a homeowner doing all work myself [No workers' comp. insurance required.] t
4.❑I am ahomeowner 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
proprietors with no emgldye6s.
5. ❑I am a general contractor, and I have hired the sub -contractors listed on the attached sheet.
These sub -contractors have employees and have workers' comp, insurance #
6. Q We are a corporation and its, officers have exercised their right of'exemptio .per MGL c.
152 1(4) and Wa have no employees. [No workers' comp. insurance require(LI
V
Type of project (required):
7. ❑ Neva'consiruciaon
8. [R-femodeliiig
9. ❑ Demolition
10 [] Building addition
11.❑ Electrical repairs or additions
12�[] Plumbing repairs or additions
13.0 Roof repairs
14.r] Other
*Any applicant that checks boat #1 Aust a s stindl g 9 ar ao l ng all o and then hire outside contractors moust submit new affidavit indicating such.
t Homeowners who submit•this a. avi
Confractors that check this box must aihaclied an additional sheet showing the name of the sub-contractorsrk - and state whether or not (hose entities have
employees. If the sub -contractors have employees, they must Provide their workers' comp. policy number.
compensation insurance for my employees. Below is the policy and job site
X am an employer tliat is providingworkers'
information.
Insurance Company Name - - - - -
L11� -03 6 ExpirationDate, `-� -� —��
Policy # or Self -ins. Lic. #: ► r � 11C - �1(�
Job Site Address: 2i 2Z-� � 5'
- City/State/Zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy nary rand expiration date).
Failure to secure coverage as required as naltiesMGL c. 2inthe form ofraaSSTOP WORK ORDER al violation Iand fine f p to $250.00 a
and/or one-year imprisonment, as well p
day against the violator. A copy' of this statement may be forwarded to the Office of Investigations of the D7A for insurance
coverage verification.
I do Itereby certi under tlzepai andpenalties ofperjury that the information provided above s true and correct
Official use only. Do notwrite in this area, to be completed by city or town official.
Permit/License
City or Town- #
issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Phone
Contact Person•
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 o£hivre,
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
receivbfor 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 b6 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
applicaxxtwho has not produced -acceptable evidence of compliance with the insurance coverage Aquiired."
Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Pleasb fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if
necessary, supply sub=contractors) name(s), address(es) and phone number(s) along with their certificates) 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
JndustrialAccidents. 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 that 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. # 617-727-4900 ext. 7406 or 1-877-MASSAFE
Fax # 617-727-7749
Revised 02-23-15 www.mass.gov/dia
ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDrYYYY)
11/8/16
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. THS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLIER.
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 endorsemen s .
PRODUCER
Exchange Insurance Agency
330 Rutherford Ave Suite B
Charlestown, MA 02129
NANET:CT Dou las Cameron
PHONEFAX 6
617 523-7360 N . ( 17) 523-6313
L
ADDRESS: doug.cameron@exchangeins.com
BKS56404745
2/17/16
INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A: Liberty Mutual Insurance
DAMAGE TO RENTED $ 300,000
MED EXP (Ary one person) $ 15,000
INSURED
INSURER B :
Fontes Contracting
INSURERC:
P 0 Box 237
INSURERD:
505 Main St (rear)
Reading, MA 01867
INSURER E:
INSURER F:
allislyl40_1ci y4:491J[N:\9:40till J 1:14: :7�•�(~ir.T,�[1TTr
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
LTR
TYPE OF INSURANCE
AWL
WEIR
POLICY NUMBER
POLICY EFF
MIDDN
POLICY EXP
MMIDD/YYYY
LIMITS
A
GENERAL LIABILITY
X CCMMERCIALGENERAL LIABILITY
CLAIMS- MADE a OCCUR
BKS56404745
2/17/16
2/17/17
EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED $ 300,000
MED EXP (Ary one person) $ 15,000
P'ERSONALBADVINJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'LAGGREGATE LIMITAPPLIES PER
POLICY PRO- LOC
ECT F
PRODUCTS-OOMP/OP AGG $ 2,000,000
$
AUTOMOBILE LIABILITY
ANYAUTO
ALLOWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIREDAUTOS _ AUTOS
CONS
a accident $
BODILY INJURY (Per poison) $
BODILY INJURY (Per accident) $
PROaPEE DAMAGE $
UMBRELLA UAB
EXCESSLIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE $
AGGREGATE $
DED RETENTION
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETORIPARTNERiEXECUTiVEN/A
OFFICERI EMBER EXCLUDED?
(Mandatory in NH) 7Y
Ii yyeess describe under
DESCRIPTIONCFOPERATIONSbelow
WC5-318-376415-036
4/14/16
4/14/17
X wCSTATU- OTH-
E.L. EACH ACCIDENT 1,000,000
E.L. DISEASE -EA EMPLOYEE $ 1,000,000
E.L. DIS EASE - POLICY LIMIT 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Rerrerks Schedule, If more space is regri red)
VCn I Ir ivm I C IIULIJCn %.AIM L.CLLA I IUIY
Town of North Andover
Building Inspector
120 Main Street
North Andover, MA 01845
SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
19RR-2010 ACARrn rnRPORATION_ All rinht¢ racorvarl
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
Phone: Fax: E -Mail: phutchins@northandoverma.gov
, - ^---/ ---
--
Office -
HOME IMPROVEMENT CONTRACTOR
Ty'pe: Individual
Expiration
!M4831 44 11/06/2018
Paul Fontes
D/B/A Fontes ConStruc6onjl
�7
r"='"""="
/
26 No"w"ods C
�
Woburn, MA 01 80i Undersecretary
| ^
Massachusetts Department of Public Safety
Board of Building Regulations and Standards
License: CS -033234
Construction Supervisor
PAUL FONTES ;
PO BOX 237
READING MA 01867
Expiration:
Commissioner
12/09/2017
89OU 8908
Cl)7 f§0
N
I L-lez
LO
N
cu0 _
0
0
o
N
M�
W
.0 -ILL
bo
N O 00
� Cl)
`L CA N
d
o
J W 00
C?n
t
r
N
N
E
r
�w
N
CV 1D
r
W
ti
N N
M
I I
I I
0o I
I I
co co
10
I I
I
N
bo
I
4�
N
4
co
wmg
O
Q
(9 rn >
ch .0
C
J
C -4
Q
NZ
850 U 9909
f 0L
„Z/6 -,
—„ Z/6 6 6-, Z
f� N C
,� D
O O Q
U O
C CL _
�C
a1 N
3 C '
c
CV �
r C1
� N
N E N
a) Co
m �
N
V
Of
m
II
3
AM Z -,U U <\
o
N_
x +
d'
C N
xm
W m
M
O
m a
o0
a) I'll N
04
. L
0
ao
o a n Q
z�
REF. FLCE
N O
..0 1 -,9L -.t? - ;;tE, /L
"![A
N CV CV
W cm
N
890£ c—,
— — — — — — O
UL
O I I 3
�° I I z
3
z I I
I I
N I I
x Wo I I
Nr d I I
Mn x I I cv
x a) �,.., N I I m
wm —�
a�
IY 3
cu
ca z
U) I I
3 I I
z I
I I
IL — — — — — —
N
O
O
LL
3
a�
z