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Home My WebLink AboutBuilding Permit #585-2017 - 458 JOHNSON STREET 12/2/2016 V NO R TF► 1411 � L/V/ BUILDING PERMIT o� C�LED ,6�tiO TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ~ T T h Permit No#: Date Received AT"E"D''KQ 4 �5 gssgc Husr`� Date Issued: i-L IMPORTANT:Applicant must complete all items on this page LOCATIONy � �0 h kl0 t/! Print PROPERTY OWNER eocr Pe,l !s r' r pdn# 7 DD:Year Structure yes a MAP . PARCEL: 00 C_g ZONING DiSTRJCT- Historic Disfrict 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 K Others: ❑ Demolition ❑ Other - _- ❑ Septic El W611, 0.Floodplain [I Wetlands, Watershed District n Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: M ar.,cR « rPrrk rr r Phone: Address: r-P 3e Alife h 5 i Contractor Name: poi aR gpAR 1NSutATtoN Phone: 4 e Email: PO BOX 958 Address: ANDOVER,MA 01810 Supervisor's Construction License: l oG o Home Improvement License; /e1-�}b 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: $ 0-00-B n FEE: $ 3() Check No.: 7FY Receipt No.: 3 fatn NOTE: Persons contracting with nregistered contractors do not have access o t guaranty fund Si w nature of A ent/Oner Si nature of contractor --g-- --g--r -- _ __g -- - 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. ❑ 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 COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Roard 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: Lo Gat_ed 384 Osgood Street FIRE DE_P_A_ RTMENT - Tempi®umpster bnr site yes. _ _ _.�_ no —___ �. s Located at 124Main,Street Fire Department signature/date 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-$1000 fine NOTES and DATA— (For department use) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Pp Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 Location 4/S$ JON No. cr 7 Date /J '} 'd 0/ � • - TOWN OF NORTH ANDOVER % Certificate of Occupancy $ Building/Frame Permit Fee $ '�^ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# E q �f Building Inspector • 1 J til r 1 V NORTH • � - . w. .. . . _ A.- .-. .c . . ve- ,*0 . . - . No. - ,� o h ver, Mass, / ;L rZ 0/ 6 coc@41c„ewlcw 1• S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT .P440.4 jC.......1 10Ilk M 111V �� . & .. � ^ BUILDING INSPECTOR .,. has permission to erect buildings on A zo S.0 sro Foundation MLL ,l o V'�P4#*4P� �� Rough tobe occupied as ....... ..............................�............................. ........................... .. �....... 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO STA 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. • L� Lie Federal II) ' RISE Engineering 10 Conlracttor R"istration No SE A division otlfielseb Engineering CCT R t o ENGINEERING 60 Shawmat Unit A Canton.61A (401)784.37111) FAX(401)784-3710 CONTRACT Page 1 PROGRAM IMS MAW$RM CMA-NES @i00n�AIItDArmTMa rOMFORWOR1rAS OBSCRIBEDratt,aw CUSTOM � -- u DAYS CLOff s V4M ORDER Monica Carpenter o (781)710-9063 0120!2016 428113 00003 BFRVICE OTR54r ® - -BULAN0 STRaEr--• — --. — — _—.—. .—..—___ _ 458 Johnson Street a 458 Johnson Street SERV=CRY.STATE.DP .. — _ - SUM CITY.STATE.DP — North Andover,MA 01845 North Andover,MA 01845 B DESCRIPTION PHASE TWO-Proposal for next yrm's w tlteriystion project.Prices and program incentives not guaranteed. $0.00 ATTIC ACCESS:Provide labor and materials to insulate the back of the attic door with 2•rigid Thermar board and seal the doors edge with weatherstripping to restrict air leakage. 573.91 STAIRWELL:Provide labor and materials to install Class 1 Cellulose insulation to the sheatocl;or plaster ceiling and/or walls ora stairwell which are common to heated space,through a surface drill and plug method. The holes are plunged with styrofoam plugs, and spadded to a tough finish. Any sanding and painting required are the customers responsibility. $175.00 WALLS:Provide labor and materials to install blown in Class 1 Cellulose to(30)square feet of exterior walls through an interior surfax drift and plug method. Plugs will be spackled and lett with a rough finish.Finish sanding and touch-up priming*ntitg will be the customers responsibility. Homeowner has received a copy of the EPA's Renovate Right Lt ad-Safe information guide explaining the potential risk:of the lead hazard exposure 6om the weathaiztion work to be performed.Your signature is your adLnrowedgement of receipt and agteentem to pr000ed. 560.00 WALLS:Furnish and install blown in am I Cellulose to(465)square feet of shitngle and/or clapboard exterior walls.The bun of the upper course of your wood siding is rat to drift holes into the well sheathing behind.The holes are then plugged and the wood siding it reinstalled using stainless steel finish nails.Touch-up painting„if needed,will he the customers responsibility. Invoicing will occur upon completion of iotatfation.Homeowner has received a copy of the EPA's Renovate Right Lead-Safe information guide explaining the potential risk of the lead lmzard cxposme from the weathnization wok to be performed.Your signature is your acknowedgeme►t of receipt and ag eonea to proaxd. 5860.25 RISE En&eahng will apply all applicable,eligible incentives to this contract. You will only be billed the Net m=mL Cmnattly, for eligible measures,Columbia Cas offers 75%ineemive,not to exceed$2,000 per calendar year,and an incentive of 1001A for the Air Sealing measures up to the first$680 and an additional$340 if savings are justified by the auditor. For the safety and health of your hoa s indoor arc 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 weatherizadon work is complete.We will also conduct a ftdl assessment of the combustion safety ofyour hosting system and water hewer This has a value of 590 and is at no cost to you. Total allowable motion incentive is 53,110. 590.00 E =CC E0 ;� JUN 2 4 2016 t Federairo# • RISE Engineering R!Contractor ReffiWadon No Contmeter RegistraN MSE A division of Intielseb Engineering CT MA Conftclar Reofttfon Ido ENGINEERING 60 Sbawmut Unit#2,Canton,HA (401)794-3700 FAX(401)784-3710 CONTMCT Page 2 PROGRAM TMOUNFOUkerelt 011MMOMWMN CMA-HES EMORtESM MU)"M CUSTOM MR ASIUSE CESCV480DOELOW CUSIOM "NONE DATE CUMS VM=Ord" Monica Carpenter (781)710-9063 01/2012016 428113 00003 Saw=il"—RiiF --,BL—UU-*S,..—RM,—v — --,— — — — — — — — — 458 Johnson Street 459 Johnson Street BILLM C"V.S1A1 ZIP North Andover,MA 01845 North Andover,MA 01845 JOB DESCRIPTION Total: $1,259.16 Program Incentive: . $966.87 Customer Total: $292.29 wt:AGRMHMUWMFUMMSMRM-COMPLM UOA=IWMCEVMASM SPECW=TtOULFORM suet OF ***Two Hundred Ninety Two&291100 Dollars $292.29 UPCftFWftUdP8CT%W ANGAPPROVALOYSM eMONEEMM CUSTOURAORM T0RWffAUCUW0UEW FULL NUFMTOF I%ML SEC6UUWWUQXMV=MV QUARAWSMINOMOF REdSHN7,=MWA=D "0C=MW=ftE=M=ft 00 NOT SIGN THIS CONTRACT F THERE ARE ANY BLANK SPACES Nathan Weiss C AunWR=SHWMM-MW ft,"T" "MTMCWT"=1"YfzWMuUu6UV P—TEXECUM DATE OFCOMICT IMMM DAYS. TCUSAWAMMBMVACCE"ELYWAMAUTNORMTODOWMVXM AS PAVAUWVXLL6E==A5CU1TLU=AS= TE T USAIM PA�1"l G//6/k I RISE60 Shawmut Road,Unit 2Canton,MA 02021 339-502.6335 ENGINEERING www.RISEengineering.com OWNER AUTHORIZATION FORM �J I, r 1(� �fnf ��f• (OvGner's Name) owner of the property located at: (Property Address) ' (Property Address) ' hereby authorize—�()/A (' t a f n Silk (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. Y Owner's ' nature x Date The Commonwealth ofMassachusettsNEW --_ Deparhneut ofl'ndr<strialAccidea& Office ofInves4ailo. I Congress Street;Suite 100 Boston,M4 02114-2017 www-mass-gov/dia Workers' Compensation Insurance Affidavit.,B�ders/Ctonractors/Electricians/Plnmbers A licant Information 'bl - J Name(Business/orgawntion/individual): -Please Print I Andress: PO BOX 956 ANIM11M MA Q181Q City/State/Zip: Phone#: �! Are you an employer?Check,the pea r priate box: _ — -- I• I am a employer with 4. C] I am a general contractor and I Tie of project(rcurred): 2.❑ employees(fWl and/or Part-time).* have hired the sub-contractors b. ❑New ceastruction I am a sole proprietor or partner- fisted on the attached sheet, j 7 0 Remodeling ship and have no employees These sub-contmctor have working for me in any capaci y-. employees and have workers' $• ❑Demolition [No workers'comp.insurance comp,insurance.t 9- ❑building addition required.] 5. ❑ Wre are a ccrperadon and its i0L13. LI Electrical repai's or additions I am a homeowner doing all work Officers have exercised their Plumbing repai.-s or additions myself.(No workers'comp. right of exemption per MGL insurance required.]t c. 152,§i(4),and we have no ❑Roof repairemployees.[No workers' [i Other I comp.insurance required.] *AnY aPplicant that checks box aI must a►so m Out the section below shoring their workers'compensation policy iufom oa Homeowners who submit this affidavit indicating they are doing aLt work and then hire outside contractors must submit a new affidavit indi tContractors that check.this tlm�,�attached m addt*oP4 shut she,' a the esrne�;th. ung such. empioyees. If the sub-contractors have employe y P strb-co�aears and;zste.itedi or nG gig; hm P oYees,the must provide their workers'comp.policy number. entifies i o empl^ver that is provhftg iporkene I eo'" enSGt[9n-"suraftee`or illy e„ to ea. Belo.: is t/a oils-• information. � � Y -- `• P s findk*sig Insurance Company Name: s- Polic;;#or Scl ins.Lic.#: ?pt„JC 7, Expiration Date. of et _? lob Sitc Address: _._._.`CSS 7 o f.n 5 a vt •S i City/StataiziP:-1-7-,OA t r' s tush a COPY of the workers'compensation policy declaratio:e a (Showing Failure to secure coverage as re p g'( g the PORGY number and expiration date). gaited under Section ZSA of MGL c. 152 can lead to the imposition of criminal penalties of a fine up ie$t,5Q0.Q0 and/or one-year imprisonment,as well as civr�penalties in the form ofd STOP WORK ORDER and a fine Of up to S25Q.GQ a day against the violaror. Be advised that a copy of this statement may e Lnvestigasions of the DIA for insurance cove.raa-verification. be forwarded to the U�ifice of do hereby cern Undv the airs and enaltiav of rr ury'ilial lite or nation provided above is true and correct. Sig ature: '��'"�""�"'— Date. W30 Phone#: q%F ye)- 7&36 t'l�ci7PerSDn: not write in this area to be completed by city or town official City oPermit/License# Issuincle one): L Boa .Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Oth Conta Phone#: r4 O RV® CERTIFICATE OF LIABILITY INSURANCE FDATE(''"�"YYY) 6/10/2016 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 endorsemen s. PRODUCER CONTACT Linda Bogdanowicz Insurance Solutions Corporation PHONE (603)382-4600 Fnx No:(603)382-2034 60 Westville Rd ADDRESS -insurance.com INSURER AFFORDING COVERAGE NAIC 4 Plaistow NB 03865 INSURER A.Mostern World INSURED INSURER B Nautilus Insurance Group Polar Bear Insulation Company Inc INSURERC: PO Box 958 INSURER D INSURER E Andover MA 01810 INSURER F: COVERAGES CERTIFICATE NUMBER�L1632326134 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 DDL TYPE OF INSURANCE B POLICY EFF POLICY EXP POLICY NUMBER M YY UNWM X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE ❑X OCCUR DAMAGMISEE E TO RENTED 100,000 PRESES ER,=Erence $ MPP8274967 3/24/2016 3/24/2017 MED EXP Anyoneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 g POLICY❑JE 2x000,000 LOC PRODUCTS-COMP/OPAGG S OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Peraccide $ $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAR CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTIONS AN026107 3/24/2016 3/24/2017 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNERIEXECUTIVE $ OFFICER/MEMBER EXCLUDED? � N/A E.L.EACH ACCIDENT (Mandatory In NH) E.L.DISEASE-EA EMPLOY $ If yes,describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached H more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 Osgood St, Ste 2032 ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Keith Maglia/SJA `- T - — @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INSD25 ommnn 6/1012016 — ——- Preview:Certificates of Insurance .4�oRv® CERTIFICATE OF LIABILITY INSURANCE DATE(MM(DD"-" THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS 0611012016 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES N COVERAGE AFFORDED BY THE REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER UTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED nz IMPORTANT: c the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION iS 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(s). PRODUCER Automatic Data Processing Insurance Agency,Inc. NAME: PHONE 1 Adp Boulevard AM'No-E'(= lac No Roseland,NJ 07068 ADDRESS: INSURERIS)AFFORDING COVERAGE NwGUARD Insurance company NAIL B =IMSSURED INSURER A: 31470 ON CO INC INSURER B: INSURERC: INSURER D: INSURER E: COVERAGES CERTIFICATE NUMB11 ER: 503587 INSURER F: THIS A E CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREDE-11—IOABOVEFOR THE POLICY PERIOD INDICATED.NOTWfTHN N5 STANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACTOR 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. LTR TYPE OF INSURANCE m ( WVD pOUCYNUMBER COMMERCIAL GENERAL UABILRY MMIDDIYY M0DIYYYY) LIMITS GiVLIS-MADE 0 OCCUR EACH OCCURRENCE S PREIAISES(Ea 0=unence) S MED FRCP IAny one perwnl S GENL AGGREGATE LIMIT APPLIES PER. PERSONAL 8 ACV INJURY S POLICY JECT LOC GENERAL AGGREGATE S OTK.J2: PP.ODUCrs-COMPiOP ACG S BILEUA S ANYAUTO (Ea dCL+denn S- L O: Office of Consumer Affairs and Business Regulation 10 Park Plaza.-Suite 5170 Boston,Massachusetts 02116 Home Improvement C-dptractor Registration Registration: 102726 Type: DBA Expiration: 71=018 Tr;r 419291 POLAR BEAR INSULATION CO. - Vincent LeBlanc P.O. BOX 958 ANDOVER, MA 01810 - Update Address and return card.Mark reason for change. $CA c 4 eons-osnt ❑Address [I Renewal F1 Employment Q Lost Card plc`�nttrmunrrerilff o�C'%fjiiztn�ncc/f; Orrice or ConsumerAfff s&Business Regulation License or registration valid for individual use only _ HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 102728 Type: Office of Consumer Affairs and Bushmss Regalatwn Expiration: -71k018 DBA 18 Park Plaza-Suite 5170 Boston,MA 02116 POLAR BEAR INSULATION CO. Vincent LeBlanc 51 SO.CANAL ST.MA LAWRENCE,MA 01841 Underseeretary Not valid without signature s.. Massachusetts -Department of Public Safety Board of Building Regulations and Standards 01ngtraction Super;islir Spteiall _:cense: +CSSL=106017 PETER A LEBLANC 2 BAST PINE STREET ; Plaistow NH 03865 i? Expiration Commissioner 04128/20/8 r