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HomeMy WebLinkAboutBuilding Permit #247-2016 - 52 Kingston Street 8/27/2015 _ L BUILDING PERMIT o� (%-ED TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * ,� .��1-Z y Permit No#• ��� Date Received k �9GHU5���� Date Issued: v�7 - IMPORTTANT_: Applicant must complete all items on this page LOCATION PROPERTY OWNER Drokl Pr-r D Print 100 Year Structure yes no MAP OP-3 PARCEL: ZONING DISTRICT: Historic District yes no ��� Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ane family ❑Add' ion ❑ Two or more family ❑ Industrial ❑A ration No. of units: ❑ Commercial VfZepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other r 0 Septic ❑1Ne11-� lantls 0 VVatershetli®stnctt u �Wate�lSewer ' ' ESC TION OF WORK TO PERFORM M[-!�7AIZA�l 1 C �u 9PL if dentificatio - P ase T e or rint Clearly OWNER: Name: ©� IPhone: Address: k,11VS6Ty710 E 6Wez i/fi-- Contractor Name: Phone: �l � Email: Address: 3 ® / Supervisor's Construction License: L-00�" � Exp. Date: Home Improvement License: /� Exp. Date: �(o x ARCHITECT/ENGINEER Phone: a I I Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COS�(T�BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ •� Check No.: Receipt No.: -12—r12V3 NOTE: Persons contracting with unregistered contractors do not have access to the2w d 1 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ ; -i TYPE OF SEWERAGE DISPOSAL r I 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 m U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature I COMMENTS HEALTH Reviewed on Siqnature COMMENTS r i I f Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes e Planning Board Decision: Comments t 'Conservation Decision: Comments Wafter& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIREDEP/ R� MT ENTTempDumpster ori�site z,yes, i ; 'Ah-; In' iiLo ated at 1y24Mai�St eet� Fi i0Rment gnatu��e/da#e,�,��� r.: fa w 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: lies 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 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 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) I� 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 4. Photo of H.I.C. And C.S.L. Licenses Workers Comp Affidavit 4. Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) 4. 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 i NORTH To' 'wn of ; 2 t E �� Andover O No. h ver, Mass 01. 2A to O coc Mlc Hlwlc. ��• RATED J► .(5 U BOARD OF HEALTH Food/Kitchen PERMIT LD Septic System THIS CERTIFIES THAT . 64 ,,,,,,,, ,,,,,,,,,,,,,,,,,,,,,,,,,, BUILDING INSPECTOR e .} Foundation has permission to erect .......................... buildings on ... . .................... . ............................................ Rough to be occupied as ......10...... .....��l.......... .................................... 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 MONNS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI A 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. 11C.111H:111fip1tt11'PMLN'I'1a1N1'ItAC"I' 1'I11:u1�1:Ill.A,tkw 11f's Ilroncit Nome:Ilothrn North A SnlIll, dole:7,4 �rJ� Sold,I'utnixhrd lull(tr,Nlllyd fly; `1'1[11 Atl(nnu'tint vh�cs,Inc, Ilronvit Nnnihrt`:,11 nod;1;1 (1/11/11 The I lot Ile Ik piI AI I Is Servict,s 4)I►N IIlmolI TO,gdkv.I[nit 1,SInvivshmy.111A 1115.15 ,1,41111!1ev N1'1 11111.1%h$ I'1'drud 1111!7 v.h4ts,lhn:Kit!Lie It(•0,',-1 to;Ill Plod.1101 1111~'1 CI'I.It'll III('JIVAi 11:ill Ilome Implovlvnonl Omiolctur Rcl!,It 1*!%W)l Insftlilitllutt Addl')vs; ._._��• KIYic�S�Or�- rj�-" �q�•M.,/� n /'�1� 4p/��s Stille I'urrhuvt,rtsl: Work 1'llolle: linmi•11h.iur:_ �� t�ill_I'haro_: -3°rvI IYnabI _ _._ lioniv.Address: (Ifdifiel`e111 111111111 lu1,1t111nthm i\ddhlss) Sl:dc Zi 1) P-111111)Address Ill n tl•ivi•1114+ir4•i conn,nniculitals 114111 llonte Depot updales): ID I DO NOT hill ut 14.4.4.X4 ;illy 1111akt,tioh vomils I'lonl Tht,I[()lite l tilul J Pru oc1 lol'ornnnIluu: 1 talr1s11 dei►1"'1`uslonn .tilt,owns 1 s of 1114.propolly Ittvalell 111 the tdl4wt,iudallatiun it Prem,agrees to buy, Ind'I'l11)Al'iI1Hlit P+enilrs fin .I"'6`he Ilonp•114.11411")al ries In fiumsh,deliver and :nu'ull,c lire the inslnll:tion i"Instalhttluti')of all In,dcn de di-scrt vin/111 Ill I'vIt'v and on ill µ`li-Iclic1d spec Shcct(s).all of which "('unlr11rnclite incurpormc•d int)(his Contract tract b�this 4.h 4.c or:ll"V•oui!leith any aP111ic1ildc~Elle Snpplemenl and Payment SuOtmary 1111110,01 herehr and Wily Clumpe Orders(collemycly. .1()1111: IbdwnldNnlnrn,rl � �n _ I'rr s; SpeeShtvlls)it: Pro ed AnhoOnt nknoluq 115111/1111. - inJ nv (]In:itlalion C�rJ'7 p (,f V C13�I I.JCinn44�/t 4nerti(�I:nl4yllan:. ®_ _ 1�1 I -I l� 2�+ / / n li4q \111/1/11 ] 11hu4havti n hnuimion ('-^-�1 I�^� ,_•Il tinrly I Covet" �.,,I1?lily hen's I_J,��-"- l�Itnnlio• nSi(liu�r�1 1b'{n lit1�c �J(:mtcl+l i•nc,•ra IMF l4ntry ihnns� -�-• •11R4iolinl� ntiiJiol•, n Windmv% rI h4ul:ainil i�(.:ullr4s/1"'uvivs 1�[I?mry I)nn4s (J. �._ t)linhnum 2S'b 114.114w11 41/'('ontnlet rtnnund 1/111.11111111 vslvrolhm 4d'Ibls erunrini. -38 q1 AIn611.1'urehas4•1s11nty11.4Ill-IN Kit Hn\'t1I11141111••VIII'IIor1lit-CIIIlmoAImau4t. El'otullltrat'IAm4111n1 (()1111 11114.eneltc!'rexluhtI 11111dclincd byll'$" I"Illwlnli Slice ill the %voile for c4 h IlI'xlucl.Customer will execute a Completion Cenilieide I . - ► y y 1 alanec duc. As applicable,Well Custnitler and this 1 t CeIntrllct ngrccs to Ile J1lintly and severally abligmed an([liableherelnlder, I'he I Ionic 1)01101 reserves tile 111;111 w tscui 1 tat int a Ordc:r or terminate this Contract or any individual Prmluci(s)included herein,a Its discrclicti,if lite.Flume 1)cpnl or ifs authorized wrvice prnvider determines than it cannot perlilrnl its obligations due to a stnlclural pruhicnt will,rte home,environmental halards such:13 111old.asbrslos tm lead pain[,other safety c•onecrus.pricing etTOrs or because work required Irl complete the job was nal included in the Contract. 191yrtwnt Summary: 'lite Ilaynlcnl Snnun:uy Il_��(�L�777 inchldcll 's part (Willis Contract, sets 11114.111 the 1411,11 Contract amount and paymeuls required liar IIIc deposits and 11111:11 payments by Proluci(as appiic:lhle). NOl'I(F.'I'O CIISl,ONIF.R You arc entitled to a conrydetell`ftlled•111 copy of file Contract at rile lime you sign- 001101 sign A Completion Certificate(1144, there is one('0ngrlt,lion Certificate for Inch lislcd I'r1 Is complete. r(lutl as del It ll by Individual SP c Sheets)before work()it that Product In the evcnl nr termination of Ihls Contract,Customer ago es 10 0"''lite 11nmc Dep01 the clrsls of materials,labor,exinnses and services provided by'file florae Depot or Authorized Service Provider through Ibe:date or termination,plus any other amounts set Ibrlh In Ihis Ay reeuarnt or allowed under applicable Iaw. THE'IIOME DEPOT MAY Wil'111101,D AMOIIN'I:ti OWED 'I'O 11111E HOME, DEPOT FROM 1111'. DEPOSIT PAYMENT OR 0'611•:11 PAYNIFNTS NIADE. IVl'1`IIOU'f LIMITING THE'HOME DEPOT'S O'1'11EIR Ill NIE..DIEN FOR RECOVh.RY 01;SUCH AMO1jN7;ti. Arcentance and Authorization: clistlnnt,r agrees and understands that this Agrccnu:nt is the entire agreement between Cusl(mler and The 1lonte Depol with regard 10 the 1'r4xlac•ts and Install cion servico and superset"'alb prior dtsrussums and agr-mcnls.either oral ur wrillen,relating lit said Pr4xlmis and 111millalion.'Iles Agreement c:u1n111 lie assigned or amended except by a wriling signal 1 by C11stonhcr r atl and*file I Ionic Depot.Cuslonhceknoedge s and agrees than Customer has read,understands,voluntarily accepts the Iemis of and has received it copy of this Agrecntcul. Acce NZ Snbm11 1►y: r x Cls l ne'. Signature 1)atc Saks LOusuha s Signalurc U: e X Telephone Net. Cumomer's Signature Date Sales COns"IMill Licemse No. CANCELLATION: CUSTOMER MAY CANCEL THIS brsBPI lialbla) AGREEIMENT IVITHOUT PF,NAI;I`V OR OHLIGATION BY DEJAVERING Wltl'1'TEN NOTICE TO TIIE IIOMIs DEPOT BY MIDNIGHT ON nui '1.111111) BUSINESS DAY AFTER SIGNING TINS AGRETMENT. 1'111? STATE SUPPLEWNT ATTACHED III'RKFO CONTAINS A FORM TO USE IF ONE 1S SPECIFICALLY PRESCRIBED BY LAW IN CUSTOMER'S STAT L NOTICE;ADDITIONAL TERMS ANI)CONDITIONS ARh S•TA I'F.0 ON TIIF Rl:%FRSI-,Sll)E AND ARE PART OFTIIIS CONTRAer 02-09.16 White-BranchFllo Yellow-Customor .. � z �• rt� enet9Ytar.nrcan—tncan.gc.ca . ;�S Q.tJltled • � emove label.aftcr Ctnat insp ecticn;SAVE lar tulure reference Weather Shield CPQ6 050-A-172 Q crating NFRC Model B108'Qouble Nang P- Alum clad Thermal Frame .... 314 loch Glazing t' +r:f NrrcT n rtgrig c?e,;la ZO—E .022 Low— Argon Fill Grille in Alr Space ANCE RAS c>hIGS ENERGY PERFORM Sol>:Hi 0.30 1 .70 N Sn-P Itf,rri1 L. PERFORMANCE RAT ADDITIORAILNGS cejjdt:o • Yl:iblc 1�jttttllnoa Q . 0.40 l:rm to+PPne.4U I0 PC Pmcsdufee b!- uletct hit flea n fJ1nT=n.HFRC hinge en dajcttntneyobr �d i Yrsule:uut Ttp rsdrsi Ar-s-RFRC dou Wtmicing.Ade podt8 tn't ICP Predsej lot�nJ TPeelle usa. tird ml el rorlrs+m•nW t:on&lsn/tnd IV%( a+t'{ Ce.nbmuet�n. •nr Ptodtiti end'dset nil rcn+tt he wttabrvy n ctbntwt :ansullmmul,:vnirFtrnun jai eCtwiww°n1Ire.o atsutremenls 1,.1t UdlllraUon P tcocdtollBUu'►tu w�I10)LS.I-77 ' - Meeh or ezceedr N.:. C„ C.E.C.,nrtd i.E.C.C. (D P) (PSLI j,-tcrunv uu�ou:r_ci join S2ta�o-ot ` .. � N-L:IS t1tf:TZFCI p.e Y.a.Sa�abtA Ad.rn..t.to 011th . 6tiQl5CG21111{SiD - . The Commonwealth of1V1assachusetts Department of IndustrialAccidents I Congress Street,Suite 100 Boston,MA 02114-2017 UT. - ewww.mass gov/dia orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Le 'blv Name(Business/Organization/Individual): � ��- Address: City/State/Zip: Phone#:_ Are you an employer?Check the appropriate box: Type of project(required): I.Q I am a employer with employees(full and/or part-time).* 7. Q 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.] 3.Q[am a homeowner dein-Vail work myself.[No workers'comp.insurance required.]t 9. ❑Demolition ❑ 4.Q I 2m a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions pnetors with no employees. 12.❑Plumbing repairs or additions 5.91 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.VfThese sub-contractors have employees and have workers'comp.insurancet 6.Q we are a corporation and its officers have exercised their right of exemption per MGL c. 14. r .. 152,§1(4),and we have no employees.(No workers'comp.insurance required.] 11 'Any applicant that checks box r 1 must also fill out the section below showing their workers'compensation policy information. y 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 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 isproviding workers'compensaigon insurance for my employees. Belowis ttheepololicy and job site information.Insurance A/ Insurance Company Name: / Policy#or Self-ins.Lie.#: W6- 04101 5W_ Expiration Date: Job Site Address: k1jCity/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). 0{ 7- 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 cern and Hallie erjury that the information provided above is true and correct Si a 7 Date: Phone#: official use only. Do not write in this area,to be completed by city or town ofciab City or Town: PermitlUcense# 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 M ! 7 ® DATE(MMIDDIYYYYi A�D CERTIFICATE OF LIABILITY INSURANCE 025015 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 CONTACT MARSH USA,INC. NAME. — FAx —" TWO ALLIANCE CENTER 1AIC.NL1Eo.EIU• 1 AIC Nol: 3560 LENOX ROAD,SUITE 2400 ADDRESS: ATLANTA,GA 30326 INSURERS AFFORDING COVERAGE NAIL Is 10049_2-HaneD-GAW-15.16 INSURER A,Steadfast Insurance Company k2638-7 INSURED THE HOME DEPOT,INC. INSURER S:&tchAfft,6 nlnsuranceCo 116535 HOME DEPOT U.S.A.,INC. INSURER C!New Hampshire ins Co 123841 2455 PACES FERRY ROAD,NW INSURER 0:OPOS National Insurance Company 123817 BUILDING C-20 - I ATLANTA,GA 30339 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATt-003155301.00 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. 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. ILTR, TYPE OF INSURANCE IINSRIWVD POLICY NUMBER MMIDDCY mYY I MMOD E"P LIMITS A GENERAL LIABILITY (GL04887714-05 03±0112015 103,02016 EACH OCCURRENCE S 9,0w. 0 X DAMAGE TO RENTED I 1,000,000 CO?7MERCIALGENERAL LIABILITY PRJML*f;,$Lftacwrfencel I s )� X� LIMITS OF POLICY XS EXCLUDED CLAiMS-).RADE OCCUR MED EXP(Any ane person) {S i 1 OF SIR:SIM PER GCC PERSONAL&ADV INJURY S 9.060' III- I 4 GENERAL AGGREGATE Is 9,00Q000 hGEN,'L AGGRE�G'A'T�E LIMIT APPLIES PER: PRODUCTS COMPIOP AGG S 9,1!00.000 POLICY I k JFCTPRO" F LOC $ B AUTOMOBILE LIABILITY f BAP 2938863.12 !0310112015 03101/2016 COMBINED SINGLE LIMIT 1,000,0w SEa accident X ANY AU10 BODILY INJURY(Per person) $ 1 ) (S ALLOWNED Pi SCHEDULED P� ! Y N RY Pe accident 5 INS OAUIO HYDMG BODIa i JuAUTOS AUTOS NON-Ot SELF URE i ( f 1NON•OWNED PROPERTYDAMAGEI HIRED AUTOSAUTOS i l Peracadent 1I S UMBRELLA LIAB OCCUR 1 EACH OCCURRENCE It s L —I— EXCESS LIAB CLAIMi AGGREGATE. 1 S DEO RETENTIONS 1} C WORKERS COMPENSATION IWCOi7731493(AOS) 030iF2015 0310112016 X I WrSTATU-AND EMPLOYERS'LIABILITY 3Y_WA1FS i C Y(N �WC017731495(AK,KY,NH,NJ,VT) 03t01l201503.ro11201fi 1.000000 ANYPROPRiETOWPARTNERIEXECUTIVE E.L.EACH ACCIDENT 5 D OFFICERIMEMBER EXCLUDED? a NIA WC017731494{FL) 0381112315 03!0112016 1,0w,ow (Mandatory in NH) E.L,DISEASE•EA EMPLOYE 5 yyes,describe under I 5,000,060 If DESCRIPTION OF OPERATIONS belowConitnued on Add' Page E.L.DISEASE-POLICY LIMIT S I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 161,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED'BEFORE 16000SGOODST. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVER.MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee ,Mauaa�% � s►.ani e I ©1988.2010 ACORD CORPORATION, All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD / 1-19rma SefVICBS ~/ 4U1 240•Z000 P•� ���� �fL2 �C�i?''���`ZQ�Z'irf�-G'r„f���2 fl�✓ lz;C%:J£,rL�2G:%�G'�.�' . Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement-Contractor'Registration Registration: 126893 Type: Supplement Card Expiration: 8r312016 THD AT HOME SERVICES, INC_ RICHARD TROIA --- 2690 CUMBERLAND PARKWAY SUITE 300 . . -- ATLANTA,-GA 30339 -.....__.. ........----- update Address and return card.Mark reason for chnngc. zo>h ni - Address J Renewal mploy c:_i. Sea i Ofticc of Cunsu acr pt[airs&Basioess Regulation License or registration valid for indiridul use onlp �{On1E IIhPROV=i41ENT CONTRACTOR before the expiration date If found return to: r^ tai q Office of Consumer Af7airs and Business Regulation - RC3;Stmti0n: 126593 Type: 13 i ar;t 1?Saza-SuiteSI7G Expiration.:-Sl312016 . Supp:ement Cana Gorton,MA 02116 THD AT HOME SERVICES.INC. THE HOME DEPOT AT PiOMZ-SERVICES RICHARD "fRD1A 2690 CUMBERLAND PARKWAY S L Y� Ac11At GLA 30339 Undersccretury Notyalidwi outsignature I f - I i ! \�ehUeerS - Ds . , BoQrd of Pam$entofPUbhc SafetyB m+Rg Ro7ma§o and Standards Q m 5 m 66 n &l� p,n an!Spiddw_ L2ees CSSt-09 # y _B,RoVI&70 AORIOa AVE. Manchester } q,3! \ \ _ - . . \opn4k R 0626/2018 Location i No. 0 V7"21) Date f i • - TOWN OF NORTH ANDOVER LED Certificate of Occupancy $ Building/Frame Permit Fee $_6L.—do ' Foundation Permit Fee $ F r � ^ Other Permit Fee $ rA .� TOTAL $ r i Check#� ° ding Ins•ector