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Home My WebLink AboutBuilding Permit #778-12 - 644 SALEM STREET 4/27/2012` BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 7 7eP- —/ 2 Date Received ' O� i.�iE O j 6' •i�� .vz`r:�31Q.iN. A R. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ Addition ❑ One family ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ,1�❑xWSeapttae.icr.r/S^ ewS•',ie'ar"'l+Rl�,w*, ;* ❑ Other `oo.dpin_ la"%°dWFWe,}9srtjWiFe`:F ca n..r:. . OWNER: Name:_ ArlrJracc• (O�O -\ DESCRIPI 1UP, UI- wuKK I u tst FKtrUKivitu: VC V00 - - Identificationease�Type or Print Clearly) S -31-1-(e. W�,% 1:5 -�' ft'-•�.�ti��`�� '� a.�� 'C.+:'�A ♦ .� - � §. e ^'i t'° i s rc+ a.ir � � `�` � (� � � % C®NTRACNTOR Name �* �4 zkrPhone ;�, �;C� . X .S yy sS11'it-a.�4',s,cki� �.�-� � ...a.R •....-._.�* ��lf �'� -.��2 �zt, w� ��:��3,. "t a .1; r -'^x ^•-.e+e. tea. -tee. rra�cm�.a {:"cs15.� r` °na_'"d'..'�`"ri'S,�" � ,. � S pe sor s Construc ion"License. - >� ;.,'77".c. '�`M1..s.'aF•'`' .rtF ..R-' :�1. 4 �'Da. -} �F� YAa`a',i. ! F��» ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT.• $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: $ ' FEE: $ �76 ')a Che k No - �'� 6�� Receipt No.: 5 � . N�F• Pe cons eons adbitrcc c �49zih unmeistered contractors do not have atces lio thAYaY�. 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 DOTE; 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 VOTE: 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) o Copy of Contract ❑ Mass check Energy Compliance Report o Engineering Affidavits for Engineered products IM 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: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 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 COMMENTS DATE REJECTED El DATE APPROVED CONSERVATION Reviewed on Siqnature COMMENTS HEALTH COMMENTS Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comm Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: 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.$10041000 fine NOTES and DATA — (For department use ® Notified for pickup - Date Doe.Building Permit Revised 2008 Location gv/-7 </ -S-� A- -)01 J No. 7 7t3 /2' Date ' TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #12 5 J 25241 �Buil'ding Inspector U) m X m m mm v. y C � m -0O2CD v , o Z CO) CDD O . 'D CL r - C) CL = y ato -0 '0o v CD CD O C7 �d CD CD CD 00 00 a, C CD y CD CLO CO) CO COD S v CO) O 'O Z CD O CD ' O CCD 0 Ic ca 17 O Q dO�•y N n g 4 0=ms ' C'! * O NgO.0 Z O � O1 .mi :w CA NEL T =r maid d y � =r a rrD O CDI 00 AR CD C � y d nn% a CL o b O CD N H T- d O N CL d Q C36 , .rt m m N N ;� O mCDCA o CCDL =om H � oma: o: CD N ` CD Wim: w moCD: mm: CL= n wo �C c o O C� z 0 �J y 0 9 . 0 c 17 O M ;zm n g 'rJ Cn '1y d ° rrD O tz r d nn% a b O O O � H � y z 0 �J y 0 9 . 0 c Baystate Roofers, Inc. P.O. Box 189 North Reading, MA 01864 Tel. 978-664-0668 Fax 978-664-4333 Name / Address 664 Salem Street North Andover, MA 01845 Proposal Date Estimate # 4/2/2012 11016 HIC # 137193 CSSL # 99895 ..Bay State Roofers Inc proposes: Remove approximately 2200 square feet of the existing asphalt shingle roof down to the wood decking. Install new ice and water shield along the 6' roof edge, valleys and around all the roof penetrations. Install new 151b felt paper throughout roof area. Install new white aluminum drip edge along the roof perimeter. A new Lifetime GAF Architectural asphalt shingle will be installed over the prepared substrate. A"new -ridge vent will be' installed"to ensure the proper roof ventilation. All roof penetrations and flashing will be installed according to° manufacturers -recommendation,. specification and details:--, Install new pipe flanges. Bay State Roofers will properly dispose of all roof debris in our 6 ; waste containers. Any wood decking that needs replacement will be an additional $2.50 per square foot. - Lower pitched roofs will be fully covered with ice and water shield. New Shingle Roof Authorized Signat re - � l $7,980.00 Waste containers supplied by Bay State Roofers, Inc. are for sole purpose of roof debris. Under no circumstance is the homeowner to use these containers for personal use. 10 Year Workmanship Warranty on all roofs. (Except Repair Jobs) .CONTRACT ACCEPTANCE The specifications, prices, payment schedule are satisfactory and hereby accepted. Date: BAY STATE ROOFERS, INC. is authorized to perform work as specified. Payment will be made as previously outlined. Signature Giti All bills over 30 days are subject to 1 1/2% finance charge per month (18% r•: annual). Color. - -_ PROVISIONS OF THE AGREEMENT 1. PROJECT PROVISIONS e. Damage to Project Contractor will not be responsible for any a.. Guideline. The Project will be constructed in strict conformance damage caused by the. Owner, or other causes beyond the control of to the plans and specifications which have been examined and the Contractor_ Owner will pay for any restoration work. approved by the Owner. IV_ CONTRACTOR'S RIGHTS AND RESPONSIBILITIES b. Compliance: The Project will be completed in strict compliance with all taws, ordinances, rules and regulations of the applicable government authorities. c. Control: The Agreement plans and specifications ate intended to supplement.each other. In case of confect, the plans volt control the specifications and the Agreement provisions will control both. d. Charge Orders: As directed by the Owner, construction tender, public body or Inspector, any alteration or deviation from the specifications; that involves extra cost (subcontract; tabor, materials) "a be executed only up - m. the parties entering into a written change order. Expense Incurred because of unusual or unanticipated conditions win be paid for by the Owner e. Allowances. to', Vie Agreement prk;e inr;hides allowances; and the cost of perfoirrdng the work is greater or less than this allowance, then the Agreement price will be adjusted accordingly. it. FINANCIAL RIGHTS AND RESPONSIBILITIES a. Labor and Material: Contractor. will provide and pay for ail labor and materials necessary to complete the Project- Contractor is released from this obligation for expenses incurred when the Owner is in arrears in making progress payments. b. Permits: Contractor will obtain and pay for all required building permits and licenses. c. Taxes, Assessments and Charges: Taxes, special assessments of all descriptions, and charges required by public bodies and utilities will be paid for by the Owner. . d. Deposit of Payments: Contractor is required to deposit all payments received prior to completion in an escrow account. to lieu of such a deposit, the Contractor may post a bond or contract of indemnity with the Ownerguaranteeing the return or proper application of such payments to the purposes of the contract_ All advanced funds will be deposited as indicated under Special Provisions. Monies used in escrow become the property of the Contractor when they are applied according to the Agreement payment schedule, when a breach of contract by the Owner occurs; or when the Agreement has been substantially performed. e. Bankruptcy: If either party becomes bankrupt, the other party has the right to cancel this Agreement. Iff. OWNER'S RIGHTS AND RESPONSIBILITIES a. Canceiiation: Ownei las an unroneitionai right to cancai tho Agreement, without penalty or obligation, until midnight of the third business day after the Agreement was signed. Cancellation must be done in writing. Upon cancellation, any property traded in, any payments made under this Agreement, and any negotiated instrument executed will be returned within 10 business days following receipt by the Contractor of cancellation notice. b. Property Lines: Owner shall locate and point out property fines to the Contractor. Contractor may, at his option, require the Owner to provide a licensed land surveyor's map of the property. c. Liens: Failure to pay persons supplying materials or services according to the terms of this Agreement may result in the filing of mechanic's liens on the affected property. Owner has the right to ask the Contractor for lien waivers from all persons supplying these materials or services, In the event any mechanic's lien is filed through no fault of the Owner, then the Contractor agrees to take all steps necessary for the, release and discharge of such Gen. d. Insurance: Owner will maintain property damage insurance at least equal to the Agreement price. a. Delay: Contractor %till be excused for any delay beyond his reasonable control. These delays may include, but are.not limited to Acts of God, falw disputes, inclement weather, acts of public authority, acts of the Owner. or other unforeseen contingencies. b. Right to Stop Work: if any payment under this Agreement is : not made when due. the Contractor may suspend work on the job until such time as ail, payments due have been made. Any failure to make payment is subject to a claim enforced against the property in accordance with the applicable Gen laws. e. Substitution of Materials: Contractor may substitute materials . without notice to the Owner at order to allow work to proceed, provided that the substituted materials are of no fewer quality than those listed in the specifications. d. Salvage: All salvage resulting from woik under this Agreement is to be retained by the Contractor unless other agreements are contained in the written specifications. e. Insurance: Contractor will maintain workers' disability compensation insurance for his employees and comprehensive public liability insurance policies. V. COMPLETION OF PROJECT a. Notice: Owner agrees to sign a Notice of Completion within 5 days after completion of the project. If project passes final inspection and the Owner does not sign the Notice, the Contractor may act as the Owner's agent and sign the Notice. b. Clean-up: Contractor is responsible for removing debris and surplus matena7.trGm. e property. and leaving the propeiiy ii+ a lneaf and orderly condition. VI. CONFLICT PROVISIONS a. Arbitration: Any controversy or claim arising out of this Agreement that cannot be resolved, is subject to arbitration, with an arbitrator of mutual agreement, and all parties (including. Owner, Contractor, Architect and Sub -Contractors) are bound to this arbitration. If any party does . not appear at arbitration proceedings, the arbitrator is empowered to decide the controversy in accordance With whatever evidence is presented by the party(ies) that do participate. b. Attorney Fees. if either party becomes hwolveia In 'it"gation arising out of Agreement, the Court shall award costs/expenses including attorney fees to the party justly entitled to them. c. Limitations. No action related to this Project may be made by either party against the other more than 2 years after the completion of work. ViI. GENERAL PROVISIONS a. Notice: Any notice required or permitted under this Agreement may be given by certified or registered mail at the addresses contained in the Agreement. b. Prohibition of Assignment: Neither party may assign this Agreement or payment due tinder this Agreement without the written consent of the other party. c. Qualification: This document constitutes the entire agreement of the parties. No other agreements exist. This Agreement can be modified only by written agreement signed by both parties. d. Governance: This Agreement shall be construed in accordance with and governed by, he laws of the state in which the Project is located. A� f? CERTIFICATE OF LIABILITY INSURANCE DATE 4i12i12 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 endorsemengs). PRODUCER A & K Fowler Insurance, LLC 200 Park Street North Reading, MA 01864 CONTACT NAME: PHONE FAX • 978 664-0366 I No: (978) 664-2209 E-MAIL ADDRESS: INSURE S AFFORDING COVERAGE NAIC# INSURER A: Western World Insurance Com an 6/15/12 INSURED INSURER B: Merchants Insurance Group Baystate Roofers Inc. INSURERC:ACE American Insurance Co. 240 Park St. INSURER D: North Reading, MA 01864 INSURER E: INSURER F: B COVERAGES CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE ADOL INSR SUBR WVD POUCY NUMBER POLICY EFF MM/DD/Y POLICY EXP MM/DD/YYYY LIMITS A GENERALLIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1XI OOCUR NPP1318117 6/15/11 6/15/12 EACH OCCURRENCE $ 1,000,000 DAMAGE t NTED PREMISESEaE.occurrence) $ 50,000 MED EXP (Any one person) $ 5 000 PERSONAL&ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER POLICY PRO LOC PRODUCTS - DO MP/OPAGG $ 1,000,000 $ B AUTOMOBILE LIABILITY ANYAUTO ALLOWPED X SCHEDULED AUTOS AUTOS NON -OWNED X HIREDAUTOS X AUTOS - MCA7015534 6/15/11 6/15/12 COaB �DiSINGLELIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTYePDAMAGE $ $ UMBRELLA LIAR EXCESS LIAB L OOCUR CLAIMS -MADE - EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? 7N/ (Mandatory In NH) If ESG�yyes describe uS6describnder DRIPTIONOFOPERATIONSbelow A 6S62UB4609PO6212 4/12/12 4/12/13 WCSTATU- orTH- E.L. EACH ACO DENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Isreglired) Insurance verification Baystate Roofers ACORD 25 (2010/05) Phone: %,AIYI,CLLA I IVIV SHOULDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN AOCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE A. Dabrieo U 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Fax: E -Mail: The Commonwealth ofMassachusetts - Department of Industrial Accidents Office oflnvestigations 600 Washington Street .Foston, MA 02111 www.mass gov1dia Workers' Compensation Insurance Affidavit: BuildersfContractorsfElectriciansfPlumbers Name Address: Y`144 - Phone #: � 6 1-t ` 04 Are you employer? Check thpappropriate box: Type of project (required): am a employer with 4. ❑ 1 am a general contractor and I 6. ❑ New construction employees (full and/orpart-time) * have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ? �• ❑Remodeling ship and, have no employees These sub -contractors have 8. ❑ Demolition working for mein any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 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. ❑ Roof repairs insurance required.] i employees. [No workers' .13.❑ Other comp, insurance required.] 'Any applicant that checks box #I must also fill out the section below showing their workers' compensation policy information. I Homeowners who submit this affidavit indicating they tie doing all work and then hire outside contractors must submit anew affidavit indicating such. tContractors 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 thepolicy and job site information. , A A Insurance Company Policy # or S elf -ins. Lic. lob Site Expiration Date: � / 1� Mm Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration dale). Failure to secure coverage as requiredunder Section 25A of MGL o. 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 DI�eft insurance coverage verification. .1 do that the information provided above is 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 #: Informati®u and Instruction's. 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 ofhire, 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 performance ofpublic 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 -contractors) name(s), address(es) andphone 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. I.f 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. Iii addition, an applicant that must submit multiple pennit/license applications in any given year, need only submit one affidavit indicating current policy information (ifnecessary) 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. Anew 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 Massachvsotts Department of Industrlat Accidents pffke ofI�ve tigatio.A 6.00' ashingtola Street Boston, MA, 02111 Tel, # 617-72.7,4900 ort 406 or 1-877,7MMSABB Revised 5-26-05 Fay, # 617;,727-7749 Www-mass,gov/dia I0 A 1 A r` f ✓!ze -Coom�rca�.uup-a,�CLc o�✓�czaaaclzua —Office of Consumer Affairs & Business Regulation f. OME IMPROVEMENT CONTRACTOR Registration,:. 1;37193 Type ` Expiratibi 10/15/2012 Supplement w {) S ? BAY STATE ROiC FtE--- =1 ROBERT O'KEEFEt= t PO BOX 189 i - N. READING, MA 018'6'4 "" Undersecretary —tea N1.assachusetts - Department of Public SafetN Board of Building Re-ulations and Standard Construction Supervisor Specialty License License: CS SL 99895 Restricted to: RF ROBERT OKEEFE 21 FRANCIS STREET NORTH READING, MA 01864 Expiration: 9/29/2013 Commissioner Tr#: 960 i +