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HomeMy WebLinkAboutBuilding Permit #523-16 - 536 FOREST STREET 10/28/2015Permit NO: Date Issued: �d ✓ i s- �� BUILDING PERMIT ' TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received Ae all items on this �.k tICT._ f. istone Distrief. .. TYPE OF IMPROVEMENT CONTRACTOR "Name: PROPOSED USE Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Alteration No. of units: tpair, replacement ❑ Assessory Bldg ❑ Demolition ❑ Other 0 Septic ❑ UVeI{ 77777777777❑ Floodplain f' 1lVetlands Water /Sewer k: f aj a -, Non- Residential ❑ Industrial ❑ Commercial ❑ Others: R��atersnea uistrtct 3 xA Identification Please Type or Print Clearly) OWNER: Name: .`�L��SC� I'l4646U,eAJeatCPhone' G%%,? Address: ra 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: $ D FEE: $ Check No.: fit- ` Receipt No.: Kb NOTE: Persons contracting ith n tere d cont r tors do not have access t uaranty fund Si nature of A ent/Own - _ g 9 _ ignature of contractor P, } at CONTRACTOR "Name: 97 (s ZRhone E� Address: Supervisor's Conttructi6n icenSer%Exp Date' x 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: $ D FEE: $ Check No.: fit- ` Receipt No.: Kb NOTE: Persons contracting ith n tere d cont r tors do not have access t uaranty fund Si nature of A ent/Own - _ g 9 _ ignature of contractor P, } at BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION p-�tteo i64'NO 02 Print 100 Year Stfuctuhe yes no MAP"-- PARCEL: _ __..e r _ ZQNING'DISTRICT: __,Histor;c pistrict yes. moi Mar•'h.na �fnn\lillarie ��ac. Jnr; 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 Q-teptic"'.10-OWN,ell ❑ ,Floodpla ;n Wetlands �' 1NatershedD strict A.�'1Na'e DESCRIPTION OF WORK TO BE PERFORMED: r, C.- Identification - Please Type or Print Clearly OWNER: Name: Phone: Address: 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 �gnature of Age�It�'O.wr' . ,. �____ , ,,,_., Signature off contractor_ Location r / No. 3 " 2v/ Date ! 6) -Le f � TOWN OF NORTH ANDOVER 4 Certificate of Occupancy $ Building/Frame Permit Fee $g Foundation Permit Fee $ Other Permit Fee $ Plans Submitted i❑ 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. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS Reviewed On Signature Reviewed on Signature Reviewed on Signature Zoning Board of 'Appeals: Variance, Petition No: Planning Board Decision: a t Comments Conservation Decision: Comments Zoning Decision/receipt submitted yes Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 38 !F;IRE D��P,AR�TME-NTS- �T�em;p ®umpste���:on�site� �vesa. � ,. �Osgood �Street ._ 4 an, r t ' - _ . �fid. Dimension Number of Stories: Total land area, sq. ft.: Total square feet of floor area, based on Exterior dimensions. 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 Nu i is ana UA I A — (For department use ❑ Notified for pickup Call Email I I Date Time Contact Name Doe.Building Permit Revised 2014 f L 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 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) ❑ 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 40TE: 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 Cl) �D Z o CL r Q CQ. �O 00 cD � � C c =r -•I CD O AWA CA O (1)n O a 230 0 CD CO)CD U) O O CD O CD n Es c� Z. O m X cn Z 0 < 0 :3 p _ O Vj='�CD -0 O CD D m Q CD 0 O n CL c.) o 3 =� z FD Ln =r o o m 0, O N su CD N W 'O . ID CD o n 2 `D • N D V � O 0 --1 CL U'o0 , 5' rt W (D . Q --I co v`,• , �0cn CD 0+ O Oz p Cr rt O <D y CL N = 0 �. C Q CL _ N N �N • < 3_ CDCL - CD �i tN p sA. •� Z O C G .x CD p : CD J Da CD CL 3 O o fD � z W j T m M D m z �o d : D v+ n O m ��0 N < m m 70 to m d o - C ao m •i �so0 R rD OCL a) p C r G M n 0 (Do 'a < N m Q. n r3o W D z O m D x NO Service Information Susan Letourneau 536 Forest St North Andover MA 01845-3216 Contact: Susan Laturno Phone: (978) 687-0442 Alt Contact: E -Mail: smlet536@gmail.com Fax: Alt Phone (978) 807-7323 Job Name ❑ Call Ahead ❑ Confirmed Letourneau, Susan - 2255 Job Type PO # Sweepnman, Inc. 108 Main Street Building H North Reading MA 01864 Phone: (978) 664-6642 Fax: (978) 664-1298 sweep n manO-yahoo. com www.sweei)nman.com Work Order Billing Information $250.00 Susan Letourneau 536 Forest St North Andover MA 01845-3216 $250.00 Marketing Campaign Yankee Sales Rep TermsType $0.00 Class DB Due on receipt MMENDATION Route F__BrianH Scheduled Start End 10/24/2015 08:00 AM 02:00 PM Item Quantity Rate Amount LINER:FIREPLACE LINER - Installation of approx 6" x 25' hybrid stainless 1 $2,290.0000 $2,290.00 Liner for customers fireplace insert. This includes all components necessary top and bottom. Permit - Permit Fee MISC. SERVICES - MISC. SERVICE pick up insert, delivery, set up, and installation System Info Chimney Cap Job Notes and Instructions Customer to purchase jotul wood burning fireplace insert Home Heating System $250.0000 $250.00 $250.0000 $250.00 Job Subtotal: $2,790.00 $0.00 Account Balance: $0.00 Total Due: $2,790.00 Chimney Info This report is the result of visual inspection done at the time of cleaning. It is intended as a I have read this form and understand the convenience to our customer, not as a certification of fire worthiness or safety. Since apparent condition of my fireplace, appliance, conditions of use and hidden construction defects are beyond our control, no warrantee is chimney, and / or vent system. Furthermore I made for the safety or function of any appliance, and / or system, and not is to be implied. understand the limitations of this report as given. f., The Commonwealth of Massachusetts nonnrtment of Industrial Accidents Are you an employer? Check the appr 1. [I am a employer with employees (full and/or part-time).* 2. ❑ l am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ 1 am a homeowner doing all work myself_ [No workers' comp. insurance required.] " Phone lie—box: 4. 1 am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.+ 5. [] We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. 0 New construction 7. [] Remodeling g. [] Demolition 9. [] Building addition lo.❑ Electrical repairs or additions I i.[] Plumbing repairs or additions 12.[] Roof repairs 13.Other fi �F GX�Lg_,1Q *Any applicant that checks box #1 must also fill out the section below showing their workers compensation policy information. `tel I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contactors must submit a new a ffidavit 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. 1f the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees Below is the policy and joh site information. Insurance Company Name: ► L �[ 1'���t GC�� �t �/� �ta1�'—�–�1� o yr Policy # or Self ins. Lie. #: /1)l'..�i J J?1S '� /37n -61 tl Expiration Date: /,;z J73Lr� Job Site Address: �� City/State/Zip: - A - . Attach a copy of the workers' compensation policy cieciaranon page tsnowing we pulicy na,ubci- and oxpirai:on dates). 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 forth of a STOP WORK ORDER and a finc 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 herebv certify under the ai nd penalties of perjury that the information provided above if true and correct. 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 #: ACC>Ra CERTIFICATE OF LIABILITY INS THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR AL1 BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must b the terms and conditions of the policy, certain policies may require an endorsement. A sta certificate holder in lieu of such endorsement(s). PRODUCER dI D -JOHNSON INSURANCE AGENCY, INC DALE JOHNSON - AGENT 7 GROVE STREET, SUITE 201 TOPSFIELD, MA 01983-1862 CONTACT NAME: DALE E. PHONE 978 I ,E- IIE�,DALE J( IN INSURER A:MESA INSURED INSURER B : CERT SWEEPNMAN INC. INSURER C:LIBER_ 27 LOWELL ROAD INSURER D: NORTH READING, MA 01864 INSURER E: INSURER F: COVERAGES CERTIFICATE 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 I LTR TYPE OF INSURANCE ADDL S BR POLICY NUMBER POLICY EFF MM/DD/YY POLICY EXP MM/DD/Y LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR MP0004018000569 11/18/201411/18/2015 EACHOCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 50,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY ElJE C LOC GENERAL AGGREGATE $ 2,000,000 GEN'L X N PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident $ ( ) NON-OWNEDPROPERTY HIRED AUTOS AUTOS DAMAGE Per accident $ $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE AGGREGATE $ DED I I RETENTION$ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICERIMEMBER EXCLUDED? (Mandatory in NH) II es, describe under DESCRIPTION OF OPERATIONS below N / A INFORMATION TO FOLLOW UNDER SEPARATE COVER DIRECT FROM CARRIER PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT i $ B CONTRACTORS PROFESSIONAL LIABILITY ANDSP00221 POLLUTION LIABILITY 11/18/2014 11/18/2015 $100,000 EACH CLAIM -PROFESSIONAL LIABILITY $10,000 EACH CLAIM - POLLUTION LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may 1. attached if more space is required) CHIMNEY CLEANING/INSPECTION, MASONRY, APPLIANCE DISTRIBUTOR SUSAN LETOURNEAU 536 FOREST STREET NORTH ANDOVER, MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I Dale S. " v 1966-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and 1000 are reoistered marks of ACORD :>i.'il.,. �. ;:0: AM PST K-1VIT-8) FROM: 100,005 -TO: 10,1888,1 517 CERTIFICATE OF LIABILITY INSURANCE DA'IL-(MMIODrYYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TEPV-S, 10123/2015 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 T14E 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 D -JOHNSON INSURANCE AGENCY INC C'f 7 GI�ROVE-STREET STE #201 NAME: NAME: PHONE FAX - tnr. ny,nn,_._ _._._.____..___.-._.....__ _{AlC _Nuj,--__-__ l OPSFIELD, MA 01983 --•- CLAIMS-F:1ADF U OCCUR E•MAIL -....__.__._._..._..___.._.. ADDRESS: INSURERS AFFORDING COVERAGE -� NAIC n T INSURER A: LM Insurance Corporation :336(10 INSUREI3 SWEEPNMAN INC —"' INSURLRB: � _ 27 LOWE=LL RD _ INSURER C: -- NORTI--1 READING MA 01864 PRFMISF. Fn rrcurrrn*crit 5 INSURLRD: b u INSURER E : �- _—• _........_............... .._.__.___---.._.......---..........._ --___ -- INSURER F ... ............ TI IIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TI IE POLICY PERIOD INDICATED. NO-RNITHSTANDING ANY REOUIREMENT, 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 TEPV-S, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS Sl TOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY EFF POLICY EXP POLICY NUMBER MmmolyYW MM1UD/YYYY LIMIIS COMMERCIAL_ GENERAL LIAr31LrTY --------- --•- CLAIMS-F:1ADF U OCCUR EACHOCCURRENCF _ D%r1C(AC`i='1`�*t:f=NTfD .-""'._._ S _._. _ PRFMISF. Fn rrcurrrn*crit 5 MFD FXP (Any one, porso) b u -- .........--_-................... ___- ..............— PERSONAL. 8 ADV INJURY _.._.. GEN'[- ACCREGATE LIMIT APP LIES PER. - PCI-ICl' n PRO f� GEIJF..RAL AGGREGATE- PRODUCTS COMP/GPAGG ---- _ . 8 _ JFCT ' J LOC OTlOTHER_ _ - - --_._...........__... � AU"I OMOHILL LIA13IL11Y COMBINED SIIJU -F I.INVIT �- - IF.n nrridrm AIJY AUTO BODILY INJURY (Per pP.Trm7 J. ALI. OWNFq I SCHEDULED BODILY INJURY (Per accirfcrt) S AUTOS i AUTOS ---- HIRED AUTOS ! AUTO S N014 -OWNED AUTO PROPERTY OAMAGE� �'___. Per � 4tlrht1l I— •__—.. -- - - ._. - .._............... _... "-- UMBRULLA UAD ---- OCCUR FACI'I CCCIIRRE WCE $ EXCESS UAB CI.AIMSAIADF- AGGREGATE S 111711RF.TF.tJTIOIJC A WORIMASCOMPENSA1IOrJ WC!;-31S-3II8i39-t)14 12/18/2014 12/18/2015 PFR OTI�I� E AND EfdPLOYLRS'LIA811-nY YIN 2L1 -§1A TUTF FR ANv PRC3PRIFiTORn'AR11Jri!tIFXLCU1NlF. OPb U:121i/h41iL5HF..R F.XC+.Il1)I.I:)7 FN N I A E.L. FACIi ACCIDENT jppQOQ ry tN NH) II[I yar" do +;rel=er E,!_. DISEASE; • EA EMPLOYEE —.-.-.._----___...._.__._............__.__......_-.._..-._....__.... 5 100(700 t.0 !PT! 14 Df:SCR!rT:OiJOFOPF.RATIONSbelew F1 DISFASF POLICY LIMIT $ 50(7(100 UESCRIP-PION OI' OPERA PIONS I l_OCAI'IONS! VEFIICLES (ACORU 101, Addilienut Lemarks Schectul e, may Ue atlueBed i! nwra sPacu is rryuiru d} Workers compensation insurance COVeI-aqe appliFls oily to the workers Compensation laws of thdstaie of MA. This corllficate cancels and Supersedes all previously issued cerlificatHs, Only as they relate to workers compensation coverage. r1 RTIFir AT'F unl rico _ C L L -H SUSAN LETOURNEAU SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 536 FOREST ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN N ANDOVER MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I LM h)surance CorporaiiDn U "�) ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD X70.'. "l ;:i; :Ffi139 ..1••19 :<r yoyvnh.fi,aci. LL�LxhrxCymucuaLo.n: 10/731,'015 6:33:40 A!•1 (Pbl) Pagc- I of I 1 Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor SpecialtA- License: CSSL-100886 DAVID A BANCROFT r 27 LOWELL RD.-; North Reading N[i 01St5:4 Expiration Commissioner 03/0912016 Commonwealth of Massachusetts Department of Public Safety Oil Burner Technician CcrtiticatE License: BU -026558 I IN DAVID A BANCROFT rN 27LOWELL RD - North Reading KA 018G4t - r Commissioner Expiration: 03/09/2016 Office of Consumer Affairs & Business Regulation' C F,t ME IMPROVEMENT CONTRACTOR ����:.._ ._. •fie ==Registration: 160389 ! Type: : ;,0•_y: -,Expiration: 7/16/2016 Private Corporation. SWEEPNMAN, INC. DAVID BANCROFT 27 LOWELL RD. NO. READING, MA 01864 Undersecretary License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, MA 02116 Not valid without signature