Loading...
HomeMy WebLinkAboutBuilding Permit #24 - 47 BOXFORD STREET 7/12/2007 BUILDING PERMITO pCRT#f �"t,.eo bgti 0 TOWN OF NORTH ANDOVER 0 - APPLICATION FOR PLAN EXAMINATION 4 Permit NO:� Date Received ' "" �gSSACH�15 Date Issued: �:12,,r` IMPORTANT: Applicant must complete all items on this page LOCATION -7 66X Ft�2D -.37-1 . NIIV2—t Print PROPERTY OWNER ParF-tz: so- i ua Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT P _ D USE esidential Non- Residential New Building ne family Addition Two or more family Industrial Alteration No. of units: / Commercial epair replacement Assessory Bldg Others: '17emolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: St21►� Roo F W,-f/i 06 P sJ�tF -2�a f sh► ?W/e < Identification Please Type or Print Clearly) OWNER: Name: PE7-,E2 Soll1I)0L-A Phone: 97? - 7;2,5-- �FS� Address: 47 136XFOPI-d S1`, A102 4vD641C r CONTRACTOR Name: `Al ,t3Lt/Z ��" Phone: /Q Address: 7- t� , Ef'/c 4 /F-G Supervisor's Construction License: Exp. Date: Home Improvement License: / f Exp. Dater 7-,29 -4 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: $ 017 Check No.: )w� Receipt No.:CQly 3 e -I NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund all §ignature of Agent/Owner - ` Signature of contractor Location qq "nd S= No. t Date 2' NQRT1y TOWN OF NORTH ANDOVER • ; ; Certificate of Occupancy $ Building/Frame Permit Fee $ s�tmus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #S35-3 206 :, 4 Building Inspector 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 i 1 THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT i COMMENTS DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments i Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT Temp Dumpster on site yes no Located at 124 Main,Street Fire Department signature/date COMMENTS 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 i ❑ Notified for pickup - Date I Doc.Building Permit Revised 2007 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 a"building Permit Application 2r"Workers Comp Affidavit �hoto Copy Of H.I.C. And/Or C.S.L. Licenses ,dopy of Contract ❑ FjDnr-PlaP Or Proposed Interior Work ❑ 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/Crossection/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 ❑ 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 NORTH Town of No. 2 Z. o dover, Mass., • ( 2• 0:97 T 0 ! LAKE COCHICMEWICK V 7�S RATED p'P ��� BOARD OF HEALTH Food/Kitchen PERMIT . T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........ 11 ......... ...,.............................. .........................................:............. Foundation has permission to erect........................................ buildings on .....y ........&.Y.. ............................ Rough to be occupied as O Chimney provided that the person acceptI46s permit shall in every spect conform to the terms of the application on file in Final 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 03 J PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR. UNLESS CONSTRU TS Rough ................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. NORTH Town of No. _ z ]](( 0 o , dover, Mass.,1( 2 0 1` 0 = LAKE COCHICHEWICK V 7�S RATED PP BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......... ... ......... ............................... .................................................... �/ Foundation has permission to erect........................................ buildings on.....l ......�[- �C.YA�........>1�.......................... Rough to be occupied as �' .. Chimney provided that the person acceptln this permit shall in every sped conform to the terms of the application on file in Final 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 lO� ! Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR. UNLESS CONSTRU TS Rough .. .. ... . .. .. .. ..... .. .. .. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. Burnet Street No. SEE REVERSE SIDE Smoke Det. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston MA 02111 `moi ^ www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): At4lnh J . Rr,1i2K E koQ 1 Address: a.7 6 USN City/State/Zip: I,c.}e Erri F L 1p M p 6) Phone#: 7J-/ Are you an employer?Check the appropriate box: Type of project(required): 1.ET I am a employer with lz 4. ❑ I am a general contractor and I 6. ❑New construction employee full an r part-time).* have hired the sub-contractors 2.❑ I am a sole pr or or partner- listed on the attached sheet. t 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in an capacity. workers' comp. insurance. Y P tY• 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their 10.❑ Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.[g/Roof repairs insurance required.]t employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks boz#l 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. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ;_2 Lt(Z I C 1-1 f?-n-)1 zL( e/+" :i--r-1 C Policy#or Self-ins. Lic.#: J.32,S C*_ 82, 30 7 Expiration Date: Job Site Address: �/7 ,d 0 X 1`56 02—t7 S7'; /Y6, /9-NfDD✓,E,PCity/State/Zip: Ml--) Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Si nature Date: Phone#1V_fl 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#: 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 of hire, 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 receiver or 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 be 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 applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the perfonnance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)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 Industrial Accidents. 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 Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-7274900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax# 617-727-7749 www.mass.gov/dia TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. DATE ISSUED: X SIGNATURE: Building Commissioner/I for of Buildings Date z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number H©27-/a PfVDQ 1:/2 1.3 Zoning Information: 1.4 Property Dimensions: I Zoning District Proposed Use Lot Areas Fromm e ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water SupplyM.GL.C.40. 54) 1.5. Flood Zone Infomuation: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT storiC District: Yes No M 2.1 Owner of 4tcpwd Y1 W7 KD2r 4 Name(Pri ) Address for Service PFv-2 a 97 aS`- K�? Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O M Signature Tele hone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O License Number / wn Address t� Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v R&I,.PI-1 \l81j1?-k5 PLWFIIY6 ConWa U Company Name 107146 Registration Number a r T, ��'� r- c-� v>�r� o ��� Addre r 7 - Z� - ae h Expiration Date /1 e Tele hone V SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......X No.......0 SECTION 5 Description of Proposed Work check all applicable) New Construction 0 Existing Building K Repair(s) Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: _87-ei Y-3N7� SOF /Jlfh qO !/92 /�t1Lef417TEc,Tit o- shl??ales SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE C !1LY Completed by permit applicant 1. Building �8 (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 a'8' /O(J, Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERP AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorize R19),P1-1 J 19U21 t E RO()Flny to act on MytDha ,in all matters relative to work authorized by this building p nm at pplication. L Si is e of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, R/4/-PH J, 13 U 2 k c as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief 1.f2K t- Pr' e -/9 -0 -2 i ure er/ ent Date Mill Ill 1111 INN NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3RD SPAN DIMENSIONS OF SILLS DMIENSIONS OF POSTS DMIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHEVMY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 07/12/2007 00.54 17812462842 PAGE 01 A `•® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYYI ry 07/12/2007 PRODUCER (781) 245-3954 THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Wakefield Insurance Agency,Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O.Box 557 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 63 Albion St Wakefield MA 01880- INSURERS AFFORDING COVERAGE NAIC9 INSURED INSURER A' Ralph Burke Roofing INSURERB:Sdf@ Indem :Lt 27 Hyron Street INSURER C:ZURICH INSURER O: Wakefield MA 01880— INSURER E; COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTMT14STANDING 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 LBIAITS SHOWN AMY HAVE BEEN REDUCED BY PAID CLAIMS. NSR IISWL POLICY EFF TIV POLICY B%PIRA OM TYPE,OF INSURANCE POLICY NUMBER DATE IN, WE M LIMITS LTR OENERAL LIABMJTY / / / EACH OCCURRENCE s COMMERCIAL GENERAL LIABILITY P MG, O RENTED Q S CLAMS MADE M OCCUR / / / / MED EXP An one w om) S PERSONAL S ADV INJURY S I I I I GENERAL AGGREGATE S GFWL AGGREGATE LIMIT APPLIES PER: PRODUCTS- IOP AGG S PG ICY LOC AUTOMOBILE LIABILITY / / ! I COMBINED SINGLE LMR 3 (Eeoo w") ANY AUTO B ALL OWNED AUTOS 1614563 01/01/2007 01/01/2008 BODILY INJURY 3 250,000 (Pw Person) X SCHEDULEDAUTOS HIRED AUTOS / / / / BODILY INJURY 3 500,000 (Pw—41-M) NON.pYVNEO AUTOS PROPERTY DAMAGE S 100,000 (Pw YorJ0in1) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO I / / / OTHER THAN EA ACC i AUTO ONLY. AGO i EXCESSNMBREI.LA LIABILITY I / / / EACH OCCURRENCE _ OCCUR ID CLAwAS MADE AGGREGATE 3 s DEDUCTIBLE S RETENTION i _ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY E.L.EACH ACCIDENT S 100,000 ANY PROPRIETOA PARTNERIEXECUTWE O OFFICER(MEMBEREXCLUDED? 62MM-132SC82-3-07 03/01/2007 03/01/2009 E.L.DISEABE-EAEMPLOYEE4 500,000 M Yee•tWscrb V^ E.L,DISEASE-POLICY LIMB 3 100,0001 SPECIAL PROVISIONS below OTHER ORSCRIPTION OF OPERATIONSILOCATIONSNE"K:LE61E1(CLUBMHVS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS 47 Boxford at Worth Andover CERTIFICATE HOLDER CANCELLATION SIIOULO ANY OF THE ABOVE OEBCRIBED OOLJGSB BE CANCEILEO ■EFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER W1LL ENDEAVOR TO MAIL 20 DAYS V#MTMN MOTLCE TO THE CERTIFICATE"OLDER NAMIM TO THE LEFT,UNIT Town Of North Andover FAILURE TO 00 60 SMALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE Building Department INSURER ITS AGENTS ORREPRESENTATMIES. AUTHORIZE TIVE ACORD 25(2041/08) EI ACORO CORPORATION 1 SU �*;INS426(o+oe(.os ELECTRONIC LASER FORMS.MC,-(Boo), Pie 101_ i S / • V I.t� M � RALPH J . BURKE �v;,m �A�� A Family Business Since 1941 Roofing — Gutters Rubber Roofing 6 l 7- 6 4`0 - //'/0 DANIEL M.BURKE RALPH J.BURKE,JR. TELEPHONE 781-245-1110 FULLY INSURED-LICENSED 27 BYRON STREET,WAKEFIELD, MA 01880 Estimated price for labor and material to: .0 cry S r t7� Po�G� cava� remove all roof shingles replace rotted/broken roof boards up to 75 square feet re-nail loose boards install aluminum drip edge to 3 feet of ice and water barrier heavyweight felt paper (30 lb. ) 30 year WOODSCAPE Architectural Shingles 0 Q reflash all vent pipes and chimney l{) S GG 0 L Lk8,g'!��& 200f—jA)& 0" ()OR /l�5 LL �° tID6L UL�clTS remove all roofing debris from the yard Total cost /06 All workmanship guaranteed twenty years. Please remove or cover all items in attic, as dust and roof particles may settle on attic floor. T ank ou 4-1e6r10'7- 60772LL� 0*1t(A L) � Xt{LW C0rr -- N North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c11, S150A. The debris will be disposed of in: 6r% WOSTE RT Peol3c)py (Location of Facility) (?Mph 13u21Kr Rod py Tkjqs)-4 TIZUCk Signature of Permit Applicant - 19- 07 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector I ; Boar o ui mgg e u la4(s an tan ar s One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration I Registration: 107146 Type: DBA Expiration: 7/29/2008 RALPH J. BURKE ROOFING Ralph Burke 27 Byron St Wakefield, MA 01880 Update Address and return card. Mark reason for shanks. Address Renewal Employment Lost Caro OPS-CA1 0 50M-05/06-PC8490 .oma ��ie -Vorr�rrea�riule� o�.j�aoaaeluaelta Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration: 107146 One Ashburton Place Rm 1301 Expiration: 7/29/2008 Boston,Ma.02108 Type: DBA RALPH J. BURKE ROOFING 141 i Ralph Burke 2 y �/i✓... ...i . Wakefield.. MA 01880 Deputy Administrator G'` of valid'without4ignature