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HomeMy WebLinkAboutBuilding Permit #161-2016 - 84 INNIS STREET 8/5/2015 AORTF� Oftt,e° e6�ti AAi\) L' BUILDING PERMIT TOWN OF NORTH ANDOVER •' APPLICATION FOR PLAN EXAMINATION Permit NO: I `c I ��tp Date Received Date Issued: L7 �9SSACHus���y IMPORTANT: Applicant must complete all items on this page r LOCATION p { OSIER ri r > KIM 'Vi eH IIIA .NO: I rz�N G )1T I ' tttoc Dlct N jt0`! 'fto P 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 I Septic 11 11 ❑ Floa e � �` Ian, S� { D C7'V1/ ter/Sew t F s _Id cuu inSulali(. `r r)a . c cx su Z42:; lnhPQ ,t-Sf-riPS Identification Please Type or Print Clearly) OWNER: Name: _ JOEL lAk)S Phone: (0/-7- 233-876?4 Address: 2 1�PraftJY s . -43R Sk11 MA az12R CRAC �F �T9 � : Y Su isrviso s ru lyse x its_ �rvef� rtitL►c �' � bat65t 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. J Total Project Cost: $ �IQ33 . 3,;t- FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with un egrstered contractors do not have access to the guaranty fund -ft re of J�66n Ow er ._ "Signature of ccs ttr ct .. ... .._ _ G NORTH BUILDING PERMIT oF�t�eo �bq4, TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: ` Date Received 7RA�R.t7ED�'Pp`'�y gSSACHl1`'�t Date Issued: _ IMPORTANT: Applicant must complete all items on this page LOCATION _ Print PROPERTY OWNER Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District 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 ❑ Others: ❑ Demolition_ ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone: Email: Address: Supervisor's Construction License: Exp. Date: 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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Plans Submitted Plans Waived ❑ Certified Plot Plan Q 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 a CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board 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: Located 384 Osgood Street ',FIREDEPRAT AME.NT Temppumpster onsite, yes� � Locatedjat 12e4�Main�St�eet> --"" w' - F rei'Department4s gnature/d' a 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, roast 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 Permit Application 4. 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 4 Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract .46 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 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) 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 Location 94 4 1,2�4— No. I (�" Z.U �' Date . - TOWN OF NORTH ANDOVER � cIED Ick' • Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ ; TOTAL $ Check# F r.-7 Building Inspector NORTH Town of , .. .. EAndover O ...a.4, 0% No. 1 _ * _ Z y h ver, Mass, oAS� 5 COC NICNtWICN y1. % x,95 RATED 5 U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ....... ....4�b�..��... BUILDING INSPECTOR .... ........................... ...................... Foundation Xt�nT4Nhas permission to erect ................:..:....... buildings on .. ..... ....... .............. ............... Rough to be occupied as .....�.�t�. * .. .. . . ...... .,..fA1M11!. � . .'� ..... Chimney provided that the person accepting this permit hall 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, AI ration and Construction of Buildings in the Town of North Andover. Pio PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service ........... .... ... . ... .......... .................................. Fina BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Reguired 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. ®® ®®'ABT American Building Technologies Energy Savings Is Our Specialty 263 Western Avenue-Lynn-MA 01904 Phone-781-598-7125/Fax-781-479-0727 www.americanbuildingtechnologies.com Authorization Letter I,Jose Santos,HIC 163106 and CS-101378 holder hereby give my authorization to Andre Aguiar to act on my behalf regarding the Building Permit Application 84 Innis St, North Andover, MA01845 e ntos /4/15 B .�, l Id h 17} X521573 Contract for Products/Service Work This Agreement is made by and among John Casey 84 Innis St North Andover, MA 01845 American Building Technologies(ABT) 2 Neptune Rd, Suite 439 Boston, MA 02128 I. DESCRIPTION OF WORK TO BE PERFORMED 1-Venting 2- Door sweeps&weather strip 3-Wall Insulation Total: $4,032.32 Customer Signature: Customer Name: _chon a�w Date: 1J Contractor Signature: nt..n(. . Contractor Name: joi ZfJ Date: 'S �S f Job Number 5250 DATE 7124/2015 Client John Casey address 84 Innis St. city Itown N.Andover,Ma. contractor -_A S-T 1.WEATHERSTRIPPINGICAULKING QUANTITY TOTAL AUDITOR NOTES Door Kits Q-Lon or Equiv. 3 153.00 Fr.ext/rear ext./base.ext. Door Sweeps(Regular) 2 35.28 Fr.ext./base.ext. Door Sweeps(Automatic) 1 26.00 rear ext. Reglaze Windows/In.inch 0.00 Window.Weathstr Schlegal per side 0.00 Recessed light cover per SWS.Not a tenmat cover 0.00 attic sealing 2 part foam 0.00 attic sealing 1 part foam 2 140.00 seal all top plates,plumbing,elect.and all chases basement and living space air sealing 1 part 1 70.00 seal under sinks,plumbin ,elect,and any chases. SUBTOTALS 424.28 2A.INFILTRATION/INSULATION AUDITOR NOTES Domestic pipe Hot Water Tank 1st 6' 0.00 Sill Two Part Foam w/Fiberglass Batt 0.00 1"T-max only foam boardPerimeter per IECC&SWS sq.fL 0.00 2"T-max only foam boardPerimeter per IECC&SWS sq.ft. 0.00 Drape DOOR R-5 or T-max only 0.00 Tape Joints(Aluma Grip only)per hr. 0.00 Duct Ins w/Tape sq.ft.R-5 conditioned space 0.00 Duct Ins w/Tape sq.ft.R-8 unconditioned crawVgarage/attic 0.00 Hydronic pipe insulation to 1"R-5 0.00 Hydronic pipe ins.1.25"-2"R-5 0.00 Steampipe Ins.1.25"-2"iron pipe R-5 0.00 Steampipe Ins.2.5"-3"iron pipe R-5 0.00 Air Conditioner Meeting Rail 0.00 Air Conditioner Cover 0.00 Air Conditioner Cover Special Order 0.00 SUBTOTALS 0.00 28.INSULATION __ AUDITOR NOTES Open Unrestricted R 49 0.00 _ Open Unrestricted R 38 0.00 -i Open Unrestricted R 30 0.00 Open Unrestricted R 20 0.00 Open Unrestricted R 10 0.00 Restrict FUSloped R 38 0.00 Restrict FUSloped R 30 0.00 Restricted FUSloped R 20 0.00 Restrict FUSloped R 10 0.00 R-19 FGB open rafters/walls/kneewalls 0.00 R-11 FGB open rafters/walls/kneewalls 0.00 Attic Stairs(stairwell&common wall) 0.00 Cover Pull Down Stairs Thermadome up to R49 per SWS 0.00 Site built pull down stairs 2"foam box 0.00 f AUDITOR NOTES Attic/Kneewal Floor Transition.Dense pack cellulose 0.00 W.S.Hatch Q-Lon or equal 0.00 W.S.&bat Hatch,dam around etc.complete to attic 1 67.00 Kneewall R-12 cell behind Per.Memb 0.00 Open Rafter R-20 Cell./w poly 0.00 Open Rafter R-30 Cell./w poly 0.00 Basement Overhead R-19 fiberglass 0.00 Basement Overhead R-30 fiberglass 0.00 Crawlpace Overhead<4'high R19 0.00 Crawlpace Overhead<4'high R30 0.00 Garage Ceiling cavity filled w/cellulose 0.00 Wood,Shake,Clapboard,Shingles Vinyl 1216 2432.00 Asbestos(single nail)/Asphalt 0.00 Asbestos(doub.Nail)I Aluminum 0.00 Brick/Stucco 2 hole 0.00 Vinyl over Asbestos 0.00 Multi-layered 3 or more layers 0.00 Drill rough plaster or finish wood plug 176 359.04 Drill finish plaster 0.00 Test Drill Walls(all 4) 0.00 SUBTOTALS 2858.04 2.INSULATION TOTAL 2A.+2B. 2858.04 3.STORM WINDOWS I DEADLITES AUDITOR NOTES _ Plexiglass up to 88 u.i. 0.00 Additional per UI over 88" 0.00 Dead light 0.00 SUBTOTALS 0.00 S.OTHER MATERIAL AUDITOR NOTES Ridge vent In ft. 0.00 _ Gable Vent rectangular 0.00 Varipitch Vent 0.00 Roof Vent 135(1 sq ft NFV)Large 2 212.00 on back side Roof Vent 865(A sq ft NFV)Small 0.00 Soffit Vent Rectangular 6 180.00 6x16 vents 2 in fr.Left side&4 out back Turbine Vents All 0.00 Stack Vent 0.00 Acuvent proper(Must be this product)available @ h 10 46.00 Permable House Wrap 0.00 6 mil poly on ground 0.00 Energy Star R-4 Rigid Vinyl Rept 94-101 U.I. 0.00 SUBTOTALS 438.00 6J7.E.C.MATERIAULABOR 3720.32 f ` Page 3 8a. HEALTH&SAFETY AUDITOR NOTES_ CO detector 0.00 Vent Bath/Kitchen Fan 2 200.00 bath fan and exhaust fan vent out roof Dryer vent w/exhaust duct Heartland 0.00 Dryer Transition Duct only 0.00 Bath fan 50 CFM(replace exsisitng)fan only 0.00 Bath fan 50 CFM(new install)with timer 0.00 Bath fan Smart timer 0.00 Blower Door Test Pre Post 1 45.00 r SUBTOTALS 245.00 8b.REPAIR MATERIAULABOR AUDITOR NOTES _ Basement outside door solild core inc all hardware 0.00 _ Basement outside door w/jambs inc all hardware 0.00 Basement outside door site built per SWS inc all hardware 0.00 Door Repl pre hung 32-36"Steel**w i Lite 0.00 Door Repl interior solid core 28-32" 0.00 Door Repl pre hung 32-36"wood**w/Lite 0.00 Window Replacement w/SIR less than 1 0.00 Basement Window Repl.Awning/Hopper 0.00 Basement Window Repl.With a frame 0.00 Lockset(door)Schlage or equal 0.00 Repair/Refit Door 0.00 Replace Side Stop 0.00 Replace Casing 0.00 Glass Replacement to 64 u.i. 0.00 Glass Replacement per W.over 64 0.00 Thermo pane Glass replacement 0.00 Sash Sidelock/Top Replacement 0.00 Threshold(Wood) 0.00 Threshold(Aluminum) 0.00 Slide Bolts/pull handle 0.00 Cut/finish attic-kneewall access 0.00 Cut/close attic-kneewall access 0.00 Labor Rate Hours 1 67.00 repair around hatch Labor Rate Hours 0.00 Labor Rate Hours 0.00 K&T inspection 0.00 K&T repairs 0.00 Permits/Fees(Wap only) 0.00 SUBTOTALS 67.00 TOTAL REPAIR+HEALTH&SAFETY 312.00 ___._L 3/_1X? /J GRAND TOTAL WORK ORDER# (A) 5250 4032.32 Any alterations or deviations from the above specifications involving extra costs must be cleared in writing before installation. The Work Order must be complete within 15 working days from acceptance date below: CONTRACTOR/COMPANY: 0 ACCEPTANCE:Company/Contractor AUTHORIZED SIGNATURE: Date AGENCY APPROVALS: CTI Authorized Signature: Date GLCAC Authorized Signature: Date The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly Name(Business/Organizationfindividaal):American Building Technologies — Jose Santos Address: 2 Neptune RD #439 City/State/Zip:Boston MA 02128 Phone#: 617 233 8704 Are you an employer?Check the appropriate box: Type of project(required): 1.[3 I am a employer with 5 4. ❑ 1 am a general contractor and 1 6. ❑New construction employees(full and/or part-time)." have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.t 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in 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 re ' insurance required.]t employees.(No workers' comp.insurance required.) 13.[ Other insulation "Any applicant that checks box#1 must also fill out the station 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. 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 the policy and job site information. Insurance Company Name: Hartford Policy#or Self-ins..Lic.#: 6BO2483-5-13 Expiration Date: 5/2 9/17 YY Job Site Address: 0 11 1315 R. City/State/Zip:WORW ( MA o i$�j 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 u er pains and penalties of perjury that the information provided above is true and correct Signature: Date: Phone#: 61723 8 7 Official use only. Do not write in this area,to he 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#: Aco CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) L.•"� 5/29/2015 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 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 Mary 0 Demala AME:Ambrose Insurance Agency, Inc. PHONE FAX 70 Munroe Street, Suite D EDpAIE s:mdeznala@prescottandson,com INSURERS AFFORDING COVERAGE NAIC# Lynn MA 01901 INSURERAAtlantic Casualty Insurance Co. INSURED INSURERB:Torus Specialty Insurance CO. American Building Technologies, Inc. INSURERc:Hartford Insurance Co. 263 Western Ave. INSURER D: INSURER E: lLynn MA 01904 INSURER F: COVERAGES CERTIFICATE NUMBER:CL14103019581 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. 1�TR TYPE OF INSURANCE SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITYA AGE TO RENTED PREMISES Ea occurrence $ 100,000 A CLAIMS-MADE OCCUR 035-011660 0/17/2014 0/17/2015 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO- JECT RO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ }( ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE Pacci $ AUTOS er dent X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 TORY I IMITS ER DED RETENTION 8331OH141AL 10/17/2014 0/17/2015 $ (` WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN — OFFICERIMEMBER EXCLUDED?ANY ECUTIVE[Y NIA E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) 6BO2483-5-1 6/29/2015 6/29/2016 E.L.DISEASE-EA EMPLOYE $ 1 000 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Insulation Contractor Community Teamwork, Inc, NGrid Corporate Services, LLC, dba Boston Gas Co., dba Colonial Gas Co. , dba Essex Gas Co., Action Inc., NStar, and ABCD, Inc. as additional insured general liability, excess liability, auto liability CERTIFICATE HOLDER CANCELLATION (978)681-4980 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN GLCAC ACCORDANCE WITH THE POLICY PROVISIONS. Weatherization Assistance Program 305 Essex St. AUTHORIZED REPRESENTATIVE Lawrence, MA 01840 J S Scholnick/SJG �'�-��-� ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 rgninnst ni Th.Af nion..—a-t 1n gra ranie4aror!-11—of Arnon rt+�pr•�vi7+P M'ttNFY9[i7`!t'Fi r 6Y'a�;A'Ct/P':I.S�J --•�. --.-- -•` Office*f(**w.strAffaQxRtmula6ac lticdmSC�pIP'ftghtraWnra5dfor i9di%idolazeemly ONEIMPRDVEWNIT CONTRACTOR bc%rtthe expiration dads ff foutd return t4, o0r, atiow 163100 Type_ Mike Oft:omwmcrAffaireand Rosin+,xcs:"k6ou pirA000: WIM17 LLC 10 Park Plan-Suitt 5170 xBGSUm.MA 021x6 AMMCAN LiUtl.QIN TN:iJt1h1f7LOG1U d464: ALVES-GANTOS •. e NrPTUNE RD.5UTTL 431! BOSTON,MAI 021215 tJnrlaseprrts -� -- - -� � irat valid wrd6dut SigOatOR' MasSachusc .Depansxnt of P.ublrc S2f,"y 8O39c1 6f&oihfang Reg'uckbons mrd Sts+Wards s•Qn.tructi. Sup,r+,or Ucense:M1,01an jp�oss A SAN axrN Jf A. �rr9t(y _ Cdrmussunner 11127MOIS