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HomeMy WebLinkAboutBuilding Permit #048-2016 - 3 Fernview Avenue U-7 7/10/2015 BUILDING PERMIT Of NORTH TOWN OF NORTH ANDOVERo� APPLICATION FOR PLAN EXAMINATION Permit No#: // (/ Date Received A°RwreD �gSSACHUs�� Date Issued: rs IMPORTANT:Applicant must complete all items on this page LOCATION yzi4 Yj4",� Print PROPERTY OWNER `,= '�1 PX/19- P,)IZT Z Print 100 Year Structure yes no MAP +01 PARCEL: Z ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 2-4ne family ❑Addition ❑Two or more family ❑ Industrial ❑Alt tion No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition El Other _ -W -- ---- _- - - Septic ❑ ell ❑ Flood Iain El-Wetlands ❑ Watershed District DIESCRIPTION O WORK TO BE PERFORM )o9 T Identification- Please Type or Print Clearly f� _ OWNER: Name: l�i�� � �. Phone!Z � �2-2f2- ? Address: 52w!?P T Contractor Name��f �d" �Phone: �� `1-� � -- Email: Address: _ Supervisor's Construction License: 66�' 1�96 P,946 Exp. Date: 2 T)) ^ 'g Home Improvement License: �CJ Egg"/� Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ a,75�"LDS FEE: $ ,Uv Check No.: I' � � Receipt No.: Z9 a NOTE: Persons contracting with unregistered contractors do not have ass to the gu d 0nafure of — — r Location Date to . - TOWN OF NORTH ANDOVER • Certificate of Occupancy $ ^ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 1 f. �J r �� uilding Inspector R ` :i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swunming 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 CONSERVATION Reviewed on Signature i 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 Wafter& Sewer Connection/signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street «FIFZEDEPAR�TMENT -,TempDumpster, pn�site; t:Locate�at`,124�Main,Stceet• � �� ,,..-" I �� � ` `�`""'"' "" �"""" ' ' re�Departnen��s`ignaturee%elate `' ,��,_ I COMMENTS. f i 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 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 4. 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 ' r -1 NORTH F . w: .. . : : .. . : ve- 0 h_ n ver, J%�j o Mass> COCNIG Hl WICK y1' p�RATED S V BOARD OF HEALTH Food/Kitchen PERM T LD Septic System R.�L THIS CERTIFIES THAT �. BUILDING INSPECTOR . Foundation has permission to erect .......................... building on .... �. r ...V1 e.J P..'t-A. .. ......... ��O �� Rough to be occupied as .... ....W Vj..............................��. ��� ...... Chimney provided that the person accepting this permit shall in every respect conform to the terms 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTH ELECTRICAL INSPECTOR UNLESS CONSTRUC S S Rough Service ........... ..... ..... ..... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. i k . 1 HOME IMPROVEMENT CONTRACT PLEASE READ THISV�l (( 4fed SoId1Fc►rtl lielY dRns by: Branch Name:Boston North&South Date:k/q/L5 THD At-Home Services,Inc. d/b/a The Home Depot At-Home Services Branch Number: 31 and 33 908 Boston Turnpike,Unit 1,Shrewsbury,MA 01545 Toll Free 877-903-3768 Federal ID#75-269$460;ME Lie#C 02439;RI Cont.Lie# 16427 e qCT Lie#HI.0565522;MA Home Improvement Contractor Reg.#126893 Installation Address: ` py a' '" • --R A 6 " - City State Zip Purchaser(s): Work Phone: Home Phone: Cell Phone: Ll Home Address: (If different from Installation Address) City State Zip E-mail Address(to receive project communications and Home Depot updates): ❑I DO NOT wish to receive any marketing emails from The Home Depot Project Information: Undersigned("Customer"),the owners of the property located at the above installation address,agrees to bury.. and THD At-Home Services, Inc. ("The Home Depot")agrees to furnish, deliver and arrange for the installation (`Installation")of all materials described on the below and on the referenced Spec Sheet(s), all of which are incorporated into this Contract by this reference,along with any applicable State Supplement and Payment Summary attached hereto and any Change Orders(collectively, "Contract"): Job#: (toternat Rerermce) Products: Sec Sheet(s)#: Project Amount -CIRoofingSiding Windows H Insulation ❑Gutters/Covers ❑Entry Doors ❑ Roofing USiding LJ Windows insulation $ ❑Gutters/Covers ❑Entry Doors ❑ Roofing ElSiding El Windows Insulation $ ❑Gutters/Covers ❑Entry Doors❑ Roofing ❑Siding Windows Insulation $ ❑Gutters/Covers ❑Entry Doors ❑ Minimum25%Deposit of Contract Amount due uponexecution of this contract. Total Contract Amount 2s- Maine Purchasers may not deposit more than one-third of the Contract Amount. J Customer agrees that, immediately upon completion of the work for each Product, Customer will execute a Completion Certificate (one for each Product as defined by an individual Spec Shect) and pay any balance due. As applicable, each Customer under this Contract agrees to be jointly and severally obligated and liable hereunder. The Home Depot reserves the right to issue a Change Order or terminate this Contract or any individual Product(s)included herein,at its discretion,if The Home Depot or its authorized service provider determines that it cannot perform its obligations due to a structural problem with the home, environmental hazards such as mold, asbestos or lead paint, other safety concerns, pricing errors or because work required to complete the job was not included in the Contract. Payment Summary: The Payment Summary #10-1 S! included as part of this Contract, sets forth the total Contract amount and payments required for the deposits and final payments by Product(as applicable). NOTICE TO CUSTOMER You are entitled to a completely filled-in copy of the Contract at the time you sign. Do not sign a Completion Certificate(note: there is one Completion Certificate for each listed Product as defined by individual Spec Sheets)before work on that Product is complete. In the event of termination of this Contract, Customer agrees to pay The Home Depot the costs of materials,labor, expenses and services provided by The Home Depot or. Authorized Service Provider through the date of termination, plus any other amounts set forth in this Agreement or allowed under applicable law. THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO THE HOME DEPOT FROM THE DEPOSIT PAYMENT OR OTHER PAYMENTS MADE, WITHOUT LIMITING THE HOME DEPOT'S OTHER REMF,DIES FOR RECOVERY OF SUCH AMOUNTS. Acceptance and Authorization: Customer agrees and understands that this Agreement is the entire agreement between Customer and The Home Depot with regard to the Products and Installation services and supersedes all prior discussions and agreements,either oral or written,relating to said Products and Installation. This Agreement cannot be assigned or amended except by a writing signed by Customer and The Home Depot. Customer acknowledges and agrees that Customer has read, understands, oluritarily accepts the terms of and has received a copy of this Agreement. �4ccepted by: ,r� Submitted by: Work area will be contained Pre-Renovation Form Date ZO 1.5 NAT-19276 This form is used to document compliance with the requirements of the Federal Lead-Based Paint Renovation,Repair,and Painting Program after April 2040. Customer Address Job Number(s) ?. 12, h minimized _r+� OCCUPANT CONFIRMATION Dust will be 8 i t i n f m ized Pamphlet Receipt 4 � i have received a copy of the lead hazard Information pamphlet informing me of the potential risk of the lead hazard exposure from renovation activity to be # ,, M performed in my dwelling unit. I received this pamphlet before work began. Home Year Built Enter the year my home was built. If my Home Year Built is Pre-1978,my home requires lead paint testing to determine whether Lead-Safe Work Practices are necessary per EPA or State regulations. ® work area will be cleaned up If my Home Year Built is 1978 or after,Lead-Safe Work Practices are not required. thoroughly Printedlqame of Owner-occupant i'nature of Owner-occupant . x Signature of PePA Certifytg tead rrjlet Delivery SEE STATE SPECIFIC FORMS ON REVERSE SIDE Work area will be contained _ Pre Renovation Form Date0 ^` . _ � �.. This form is used to document compliance with the requirements of the Federal Lead-Based Paint Renovation,Repair,and Painting Program after April 2010. 3} Customer Address Job Number(s) Dust m _ J OCCUPANT CONFIRMATION ® Dust Will be minimized Pamphlet Receipt I have received a copy of the lead hazard Information pamphlet informing me of t the potential .risk of the lead hazard exposure from renovation activ4, tobe performed in my dwelling unit. I received this pamphlet before work began. Home Year B uift Enter the year my home was built. If my Home Year Built is Pre-1978,my home requires lead paint testing to determine >_ whether Lead-Safe Work Practices are necessary per EPA or State regulations. ® Work area will be cleaned up If my Home Year Built is 1978 or after,Lead-Safe Work Practices are not required, thoroughly m, PrfntedWame of owner-occupant zL=' y ! . �Y' i nature of C3wnersoccupart t f Sign@tiara of P16 Qerfifyi ead.. 'm .1st Delivery r,n it/t SEE STATE SPECIFIC FORMS ON REVERSE SIDE a /• r. ' � z' r ene�4Y>Cat:nrt;an—tncan.g ( LIMcd ..t • Remove label. an_t Lural in;peclioh; SAVE for fviur� reference Wealher Shield • C?Di 050-A-172 HpFic }1,odel 81DB Double Hung Dp=ralinq Alum clad Thermal@ms 314 loch Glazing •022 LoW— c Argon "rill Grille in Alr SPace ENERGY PERFORMAUDE RATIN nl SDI:N U—ft-ler D, 1 • 0.30 I � .�0 � .iuGs . ADDlT10KAL P�ERFORMARC EtR`A • Yltlblt 1r�+3r�l:t^. D brtt t° •yP11c.nU NFO:pr°ctdwct C"I'tunt rtpul+Ct htl Qca nln�s too L NFI.0 ,,,It to dtttr+�tj tobtrt.••c-o++^''Q'd lsrd0tnq .1,Jc pnLccl+ni+1 Pcrynnm. tt nd.,d e:•c•r-NFIY c1111 tt>s. tzl°t t°t4rnn++tW c�-'MAI h tnl r�tJ P r°d°t1 w •r+7 I ctbnnw+°t lnbrm+tun. I �^T pt�titi v+L'lact nit rcTtnt he uttutlgY° • L�c+ll mc,ul+atni•c tUnun Ut ettu Frodvcl Alp Dutra mt nlc Al ldr In1tIUaIlon P• c tri L�.C.`• uu+rKr'p1 fUlt.!—T� kt,I, or tttef t N.`_G. C._.C.. 1XS1u 1meLt° . (DP) (PS�1 M-LCYS tib 1t,nsat+uq_It ` M_LCJ1111t:. U.t Y..tt s.�.n.J r.Ar.•....1.•111Y F—• r ' ' 1101SCG211!YSiD . c-� iL-7L;_1- 1 . .. --.. The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Pluhnbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Avylicant Information Please Print Le 'bl Name(Business/Organization/Individual): Address: City/State/ZipPhone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $, ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10E]Building addition 4.❑I am a homeowner 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 11.❑Electrical repairs or additions p netors with no employees. 12.❑Plumbing repairs or additions 5. I am a general contractor and I have hued the sub-contractors listed on the attached sheet. 13.❑ Of repairs These sub-contractors have employees and have workers'comp.insurance? 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other , , �� 152,§1(4),and we have no employees.(No workers'comp.insurance required.] ��Ooq— *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 insurancefor my employees. Below is the policy and t` ' -ite information. / /Y 5 �. Insurance Company Name: �7 Policy#or Self-ins.Lic.#: WG 5 G6 Expiration Date: � 1 ^11� . Job Site Address: �A � City/State/Zip: . Attach a copy of the workers'compensation policy declaration page(showing the policy number-"d expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$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$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. ! I do hereby certi and nq1ygLqfperjury that the information provided above is true and correct i Si a Date: Phone#: 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 5.Plumbing Inspector 6.Other Contact Person: Phone#: 1 1 i . l ® DATE(MMIODIYYYY) A�o CERTIFICATE OF LIABILITY INSURANCE 02/25/2015 THIS CERTIFICATE IS ISSUED AS A MATTEROF 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 pol(cy(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 endomement(s). CNT ACT PRODUCER NAME: MARSH USA,INC. PHONE FA% TWO ALLIANCE CENTERA1C No): 3%0 LENOX ROAD,SUITE 2400 -Mail Eldl a REss: ATLANTA,GA 30326 tNSURER(SI AFFORDING COVERAGE. NAIC t 100491•HaRCD�W•1516 INSURER A Steadfast Insurance Company 126387 INSURED INSURERS:Zurich Arreriew Insurance Co 16535 THE HOME DEPOT,INC. HOME DEPOT U.S.A.,INC. INSURER C:New Hampshire Ins Co 13841 2455 PACES FERRY ROAD,NW INSURER D:Illinois National Insurance Company 23817 BUILDING C-20 ATLANTA,GA 30339 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-003155301.06 REVISION NUMBER:0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT'WITHST'ANDING 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. rA ADDL SU R POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE I POLICY NUMBER MMIDDII^rYY MMtDDNYYY GENERAL LIABILITY GLO4887714-05 0310112015 03!0112016 EACH OCCURRENCE I$ 9'000'000 AMA E TO RENTED 1,000,000 JCOMMERCIALGENERAL LIABILITY P s gccurrenoe) I S CLAIMS-MADE M OCCUR LIMITS OF POLICY XS MED EXP(Any one person f S EXCLUDED OF SIR:$1M PER OCC PERSONAL 6 ADV INJURY IS 9,000,000 GENERAL AGGREGATE i$ 9,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG I S 9,000,000 X POLICY (PRO- LOC S B AUTOMOBILE LIABILITY IBAP 2938863-12 0310112015 03/0112016 COMBINED SINGL LIMIT 1000 Opp a accident) X ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED SELF INSURED AUTO PHY DMG BODILY INJURY(Per accident) S AUTOS AUTOS PP0®EReOAMAGENON-OWNED $ HIRED AUTOS AUTOS accident) Is UMBRELLA LIAB OCCUR EACH OCCURRENCE I I EXCESS LIAR i CLAIMS-MADE AGGREGATE S OED RETENTION S C WORKERS COMPENSATION WC017731493 (AOS) 03101/2015 0310112016 X Wl ST - OTH- AND EMPLOYERS'LIABILITY YIN WC017731495AK,KY,NH,NJ,VT 0310112015 0310112016 1,0004000 ANY PROPRIETORIPARTNERIEXECUTIVE ( ) E.L.EACH ACCIDENT S D ,OFFICER/MEMBER EXCLUDED? � NIA WC017731494 FL 0310112J15 0310112016 1.000,000 (Mandatory in NH) ( ) E.L DISEASE•EA EMPLOYE S Ues,describe under Conitnued on Additional Page 11000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) a CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 16W OSGOOD ST. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVER,MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. • y. AUTHORIZED REPRESENTATIVE of Marsh USA Inc I Masashi Mukherjee �tau,aow% ..tc a.ar;�cc ©1988-2010 ACORD CORPORATION, All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD S V � e '4 dy /�' '.Su.• � ., tri. r• � �f,� .l �f , � _,2 y Y 4 x �n � t •- c�.}< �� �^tY *-., +�i�s�r t�r k „ b�'�'A / c.Aa •. ,. n. ° ^ � Y's i J 'I 5" 5, -� � av�, f � a�� +k ' "i p., .»v k H ^1,-{£F s1�i-•A_ y ,�rH 4 / t a M ass�chuseAts u ` t#n nt' cif u a i+ (�-� r,.{.# 7c' Buil q(1�Ty3 - yy�� Y; ry�r �7y y���±-r-{� r�.�"{+1��/ ,}r/_.�_{W�.f, r- r, tl Q! 'iJ_4�411.,[ si t"S �R.1 %�i�7.+�7 i.w7�.�Gt� '_ �b'�!'1.3�-yJ'�.A' Co11%t1-14etiia"11 ,SluperCIN S��'z'I�{�� x rk >rt' ��." nse: CSSL-10fi006 Vq � z G BENJAMIN PARKER 43 GRE ENOUGH-'Rg � kid '{, W ,� -V Plaistow NH 03865 l a, S ry t 02/11126"' }N x K Ai �4 y♦ h'ermttServices / 4U1 •L40'ZOOO p.2 �� U fL2 �i�?''✓?�"L�Y�2�11P�.,1�.�� �����f/�•Gti.:J�lL}�;iG�.i . ' Office of Consumer Affairs and Business Regulation �Y 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor•Registration R:egistruWn: 126893 Type: Supplement Card THD AT HOME SERVICES, INC. Expiration: 8/3!2016 RICHARD TROIA ` ----------- 2690 CUMBERLAND PARKWAY SUITE 3Q0 . --- ATLANTA, GA 30339 _— _.....___ ..........___ Update Address and return card.Mark reason for change. scat `: !Il _ Address 1— Renewal ample}vncc„ ;,;rst Lut u y Otlict of Cunsurner AM-irs&Busiotss Regulation License or registration valid for individul use only 5 gOME IMPROVEMENT CONTRACTOR before the expiration date. 1f found return to: Office of Consumer Affairs and Business Regulation ; .s Registration_ .126993 Type: 10 Park Plaza-Suite517D Expiration—8312016 Supplement Cana Boston,MA 02116 THD AT HOME SERVICES,INC. THE HOME:DEPOT AT HOVE SERVICES RICHARD TROIA " 2690 CUMBERLAND PARKWAY S �— /Not GA 30339 Undersecretary valid wi out signature f i i i