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HomeMy WebLinkAboutBuilding Permit #120-16 - 458 JOHNSON STREET 7/28/2015 BUILDING PERMIT or°e TOWN OF NORTH ANDOVER ►- ,� APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: �SSATEO t �1 RIMPORTANTT: Applicant licant✓m�ust complete all items on this page LOCATION_ 4:1a n tv JO c76W : IrIrp_ PROPERTY OWNER__. Print MAP NO: PARCEL: ZONING DISTRICT Historic District yes'} no Machine Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential Fi New Building -] One family Addition ❑Two or more family iLi Industrial F Alteration No. of units: _l Commercial X Repair, replacement 7 Assessory Bldg 0 Others: C Demolition 7 Other 0 Septic ❑.Well . ..,Floodplain . P3,Wetlands_ :D. Watershed.District. r. 1 Water/Sewer V Identification Please Type or Print Clearly) Q 7 OWNER: Name: Phone: Address: CONTRACTOR Name: Phone: ?¢3l G2 4400 Address: 5� Al-L pC I 'IC- +TWO r� . .�A:� t,� Supervisor's Construction License Exp. Date:' - 082453 :31281�!�y Home Improvement.License: Exp. Date: # ;� 14.1448 122 CP r ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATEQ C�OPLBASED ON$125.00 PER S.F.y Total Project Cost: $ gc)20 FEE: $ I �- Check No.: Receipt No.: NOTE: Persons contracts with gistered cont tors do not have ace t t e Yua anty fund Signature of Agent/Owner ature of contractor '"'�� BUILDING PERMIT o`N�oT 6q�'o TOWN OF NORTH ANDOVER �� yam '16 o A APPLICATION FOR PLAN EXAMINATION * ey w Permit No#: Date Received �gssgcHus���5 Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone: Email: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: 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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund - - t Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swinnning 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 m U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS 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 Water'& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street .FIRE�DEPARATMENT Tempi©umpster gnfiste Locatetllat 124N,.int%t Obt w,_ Fire,D:eparLtment,signature/dote, COMMENTS 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 Pennit 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 4 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 ;rw Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks :rt Building Permit Application Certified Surveyed Plot Plan :ra 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 Location No./Q0 Date / A • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ � e Building/Frame Permit Fee $ '�� Foundation Permit Fee $ Other Permit Fee $�� TOTAL $ J Check# Building Inspector r- , NORTH - W* '. . A- ,. -c ve: O No. — a - � 1 oh ver, Mass, coc«1c«.WK« '►. �•9 °R�rEo �Pa��S S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT .......... ., r... „ ............1.0 . . . .... ............................... BUILDING INSPECTOR Foundation has permission to erect . buildings on .. .. . ..... '`�.�. ..................:...... . ........ .... ... e� Q Rough to be occupied as(1.. .. ...Vo.�41�W.......f:....(..7. ........ .' �.Ll V ........................... Chimney provided that the person ccepting this permit shall in eve res ect conform to the tof thea application every pp 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 10 PERMIT EXPIRES IN 6 MOTHS ELECTRICAL INSPECTOR UNLESS CONSTRU N ARTS Rough Service ........ .. ................................ ............................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. Giovannucci Brothers, Inc. CUSTOM CARPENTRY &REMODELING SERVICES 59 Atlantic Avenue Marblehead,MA 01945 P: 781-639-4400 --- P: 781-639-4401 Massachusetts Construction Supervisor License#082453 Home Improvement Contractor License#141448 P PROSAL O PROPOSAL SUBMITTED TO: DATE PROPOSAL Matt Carpenter 7/27/2015 repairs ADDRESS HOME PHONE 458 Johnston street CITY,STATE&ZIP WORKPHONE North Andover,MA 01845 WORK TO BE PERFORMED AT.- MOBILE PHONE ARCHITECTIDESIGNER DATE OF PLANS PHONE ADDRESS FAX Giovannucci Brothers, Inc. CUSTOM CARPENTRY &REMODELING SERVICES PROJECT START DATE: to be discussed PROJECT DESCRIPTION Ceiling repairs Strip and remove selective ceiling strapping and install new joists in existing ceiling to pass framing inspection of all joists at a minimum of 16" on center. Install new joist hangers as needed on all joists if possible. Install strapping as needed for new blue board installation. Insulate around all exterior surfaces with fiberglass insulation. Install fire stopping foam on all wires and penetrations. Install new blue board on living room, dining room ceiling and kitchen ceiling Skim coat all new blue board walls and ceilings blend into existing plaster as needed. Laundry room walls not to be plastered. Wainscoting installed by others. Giovannucci Brothers, Inc. CUSTOM CARPENTRY 8c REMODELING SERVICES LABOR&MATERIALS NEEDED TOTAL DEMOLITION all demolition done by matt TRASH REMOVAL all to be removed by matt EXCAVATION&CONCRETE WORK none FRAMING Repair ceiling framing 21600.00 INSULATION insulate around all exterior surfaces and fire foam all penetrations 420.00 BLUE BOARD &PLASTER Blue board all ceilings exposed and some walls as discussed. 2,800.00 Plaster all ceilings and blend into existing plaster. Plaster walls as discussed 3,200.00 FLOORING none TILE INSTALLATION none WINDOW&DOOR INSTALLATION SIDING&EXTERIOR TRIM ROOFING&GUTTERS none PLUMBING&HEATING ALLOWANCE none ELECTRICAL ALLOWANCE PAINTING ALLOWANCE none BUILDING PERMIT FEE to be assessed by building department 0.00 TOTAL LABOR&MATERIALS 9,020.00 Giovannucci Brothers, Inc. CUSTOM CARPENTRY & REMODELING SERVICES 4T PROPOSF,TO FURNI.SHMATERIALAND LABOR,COMPLETE ITT ACCORDANCE WITHABOVF,SPECIFICATIONS FOR THE SUM OP: Nine thousand twenty dollars $9,020.00 PAYMENT IS TO BEMADE AS FOLLOWS: Amount Due Total 500.00 deposit with signed proposal 500.00 2,000.00 start date 2,500.00 2,000.00 completion framing 43500.00 33000.00 completion blue board 75500.00 1,520.00 upon completion of project 95020.00 9,020.00 9,020.00 Please Make all Checks Payable to Brian GimTannucci FINANCE,CHARGF.AFTER 30 DAYS ON UNPAID BALANCE 11/2%,PER MONTH OR 18%ANNUAL PERCEWTAGE RATE. AL1,MATERIAL,IS GUARANTEED TO BE AS SPECIFIED. ALL WORK TO BF,COMPLETED IN A WORKMANLIKE MANNER ACCORDING TO STANDARD PRACTICES AND TO STATE BUILDING CODES, ANY ALTERATION OR DEVIATION FROM ABOVE SPECIFICATIONS INVOLVDIG EXTRA COSTS WILL BE FXCUTED ONLY UPON WRITTEN ORDERS,AND WILL BECOME AND EXTRA COVER CHARGE OVER AND ABOT7E THE F,STIMA77,'. ALI,AGREEMENTS CONTINGENT UPON ACCIDENTS OR DELAYS BEYOND OUR CONTROL. OWNER TO CARRY FIRE,AND ANr OTHER NECESSARYPROPERTYINSURANCE. BRIAN GIOVANNUCCI ar ilUCA GIOVANNUCCI DATE ACCEPTANCE OF PROPOSAL THE ABOVE PRICES,SPECIFICATIONS AND C,'ONDITIONS ARE SATLSFACTORY AND ARE HFREBY'ACCFPTED. GIOVANNUCCI BROTHERS,INC ISAUTHORIZEDTODOTHE WORKASSPECIFIED. PAYMENTK'ILLBEMADEASOUTLINED ABOVE SIGNATURE DATE SIGI64TURE DATE THIS PROPOSAI,AdA T BP'WLTHDRAfVLY IF NO7'ACCEPTED WITHIN 30 DAYS. The Commonwealth of Massa.chusetts . Department of IndustrialAccidents I Congress Street,Suite 100 Boston,MA 02. 14--2017 - www mass.gov/dia yV• Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERAUTTING AUTHORITY. Applicant Information / L Please Print Legibly Name(Business/Organization/Individual): 1 600.Ar1 UC_--7db Address: 5-1 ��°���Z -- City/State/Zip: M��➢��` � Phone#: Are yoy-an employer?Check th./ee�appropriate box: Type of project(required): 1.M I am.a employer with . IL J employees(full and/or part-time).* 7. ❑rNe.-construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $, odeliAg any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3..Q I am a homeowner doing all work myself[No workers'comp.insurance required.]t 10 Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. ❑ 13.0 Roof repairs These sub-contractors have employees and have workers'comp.insurance.$ 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.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors 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,%ey must provide their workers'comp.policy number. Y am an employer that is p/'oviding workers'compensation insurance for•my employees.'Below is the policy and job site information. � � Insurance Company Name: L� `- Policy#or Self-ins.Lic.#: S 1 ((Q—05�_Expiration Date: Job Site Address: �/ �J City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and 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. Ido hereby certify un .tlie pains and penalties of perjury that the information provided above is true and correct. Sijznature: L Date: �Gr 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#: �c�R 0 CERTIFICATE OF LIABILITY INSURANCE DATE(MM,DplYYYY) 07/28/2015 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Blackstone Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 3144 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Worcester, MA 01613 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Guard InSUf2nCe GIOVannucci Brothers Inc. INSURER e: 59 Atlantic Avenue INSURER C Marblehead, MA 01945 INSURER D INSURER E. COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INSRo TYPE OF INSURANCE POLICY NUMBER DATE PIRAOW MIDp/Y ATE M /DDI Y) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 717 COMMERCIAL GENERAL LIABILITY PRE AGESTO EaEccoencer $ 50,000 A [] CLAIMSMADE 0 OCCUR GIBP505716 02/20/2015 2/20/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPIOPAGG $ 2,000,000 POLICY F-JPROJECTF� LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EAACCIDENT $ ANYAUTO OTHER THAN EAACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MAGE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? IF yes,describe under E.L DISEASE-EA EMPLOYEE It SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER CERTIFICATE HOLDER CANCELLATION Town of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 1600 Osgood Street DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 15 DAYS WRITTEN Building 20, Suite 2035 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL North Andover, MA 01845 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHOR $EPRESENTATIVF.----- ACORD 25(2001108) Q ACp D CORPORATION 1988 A�® CERTIFICATE OF LIABILITY INSURANCE FDATE O1rc5 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 CONT CT PETER BEATRIC INS AGENCY NAME: 286 HUMPHREY ST PHONE FAx SWAMPSCOTT, MAO 1907 A/c "° EMAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURERA: Liberty Mutual Fire Insurance 23035 INSURED INSURER B: GIOVANNUCCI BROTHERS CONSTRUCTION INC 59 ATLANTIC AVE INSURER C MARBLEHEAD MA 01945 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 25740935 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 TYPE OF INSURANCE ADDL S BR POLICY EFF POLICY EXP LTR POLICY NUMBER MM1DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTE CLAIMS MADE OCCUR ( PREMISES Ea occurrence $ i MED EXP(Any one person) is PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO I BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS I Per accident $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADEI AGGREGATE $ DEQ I I RETENTION$ $ A !WORKERS COMPENSATION WC2-31 S-361316-045 4/3/2015 10/3/2015 �/ STATUTE ERH !AND EMPLOYERS'LIABILITY Y/" ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100000 ,OFFICER/MEMBEREXCLUDED? ❑N N/A (Mandatoryin NH) E.L.DISEASE-EA EMPLOYE $ 100000 If yes,!DESCRIPTION OF ribe under below E.L.DISEASE-POLICY LIMIT $ 500000 I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,AddMonal Remarks Schedule,may be attached if more space Is required) WORKERS COMPENSATION INSURANCE COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF MA This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 OSGOODTRE S ET, BUILDING 20, SUITE 2035 ACCORDANCE WITH THE POLICY PROVISIONS. NORTH ANDOVER MA 01845 AUTHORIZED REPRESENTATIVE tyj Liberty Mutual Fire Insurance ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 25740935 1 1-361316 1 15-15 WC I Kartik Wali 17/28%2015 10:27:07 AM (EDT) I Page 1 of 1 - � �c�n�rat�eaurrerrll�n�<',�lr,urrc/r%telt Office of Consumer Affairs&Business Regulation License or registration valid for individul use only kWME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: gistration: 14144$ Type: Office of Consumer Affairs and Business Regulation plration. 4/2212016. Partnership 10 Park Plaza-Suite 5170 Boston,MA 02116 G10VANNUCCIBROTHERS BRIAN GIOVANNUCCI 59 ATLANTIC AVENUE. MARBLEHEAD,MA 01945 Undersecretary r of�Yalid without signature • u 9 Massachusetts -DePartmen of Public Safeb Restricted-One-and two-family dwellings or any Board of Building Regulations and Standard's accessory building thereto,irrespective of size. License: C SF A-082453 BRIAN R.GIOVA�UCCi-. "';, 59 ATLANTIC AVE Marblehead MA x1945 i Failure to possess a current edition of the Massachusetts �1" ..tr�,t�,� „ ,,,,•� State Building Code is cause forrevocation ofthis license. Commissioner =::pica*=ar 03/28/201fi For DPS licensing information visit: www.Mass.Gov/DPS