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HomeMy WebLinkAboutBuilding Permit #323-2017 - 110 Kingston Street 9/26/2016 (� �\ BUILDING PERMIT of posrN " TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION A Permit No#: T ( I Date Received „TED c5 �SSACHUS�C Date Issued: 1� IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER G° Print 100 Year Structure yes no MAP X3 PARCEL: G O (0 ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Resi ntial Non- Residential ❑ New Building n6ne family ❑Addition ❑Two or more family ❑ Industrial 0 6,k6ration No. of units- ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other o Septic ❑WON ❑ Floodplain '1Netla.nd5 0 1Naterst ed District 0 Water/Sewer DESCRIPIKOUDF W TO BE PERFORMED: Iden 'fication- Please Type or Print Clearly OWNER: Name: Phone: `— Address: Contractor Name: lam Phone: Email: Address: Supervisor's Construction License: Exp. Date: 3;-- Home Improvement License: I CDf�o�Sf Exp. Date: ~. ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ L7 FEE: $� -- Check No.: Receipt No.: 3`79 tI NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund 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 Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature T COMMENTS 0 HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Wafter & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIREDEPA, R�TMEIVT.-,Temp 17umpsfier on site :yes, :• `"T•` �' ` =' r • - _. ..1n�t .....a..r.._ ..sem_._._ :�. Located at41241MaintSfiet 5�� � � Fire Departm`ent•s gnature/date r. •k,,., t__ t,r' `` :£ ;; _ 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, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes Ido 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 Pernnit 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 rF 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) 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 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 2012 I ECC 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 Doe:Building Permit Revised 2014 NORTIy Town of t _ 6 ndover O AiALTPIKS ver, Mass, q • p/ b COCNIc"t 7� Ar PPa,��y S u BOARD OF HEALTH PERMIT .T LD Food/Kitchen Septic System THIS CERTIFIES THAT BUILDING INSPECTOR . has permission to erect .......................... buildings on .....��0....����5 .....�..... ........... Foundation Rough tobe occupied as .............................T.......W..`ovba.W..s............................................... 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 MONTHS ELECTRICAL INSPECTOR. UNLESS CONSTRUCT N START Rough Service ....... .. ...t....... .. ............ 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. arl"5A Cummings,Park . C3295 Old Oak Street 166025 Woburn, MA 01801 Pembroke, MA02359 Federal ID# (781) 932-4805 (781) 826-.6281 27-14816 65 "Simply the Best for Less" www.WindowWorldofBoston.com L Customer: es le v Fusco Phone (h) 917'-lo��'lv�'�3 Install Address: I 10 (1 l' :5 4oY) s/,. Phone (w) City: A&A Andover State: MA Zip 00d'YY E-mail WINDOW WORLD CLASS OPTIONS 1000 Series Single-hung All-Weld $189 SolarZone Elite $99L5 a 2000 Series DH Mech/Welded Sash $195 Triple Glazed TG2* $175 4000 Series DH All-Weld - $205 (*Series 6000 Only) 6000 Series DH All-Weld $240 WINDOW OPTIONS 2 Lite Slider $334 ✓ Glass Breakage Warranty $15 INCLUDED 3 Lite Slider (U3,113,113) (1/4,1/4114) $525 ✓ 1/2 Screens $9 INCLUDED Picture/Fixed Lite $334 t/ Foam Insulation on Jambs and Head $11 INCLUDED Awning $260 �/ Double Strength Glass $15 INCLUDED Casement $290 ✓ Double Locks (> 26") $5 INCLUDED 2 Lite Casement $575 Full Screens $22 3 Lite Casement (1Is,11a, Is) (114,112,1/4) $860 Colonial Grids (Contoured/Flat) $45 Basement Hopper $334 Prairie Grids $51 Bay Window-Soffit Mount/INS Seat $2660 Diamond Grids $69 Simulated Divided Lite $$69 Bow Window-Soffit Mount/INS Seat$2785 Tempered DH Sash (BSO).(TSO) $65 Garden Window $1880 Obscure Glass (BSO) (TSO) $35 Specialty Window $ Oriel Style(40/60 or 60/40) $30 Beige/Almond $40 Foam Enhanced Frame $35 Wood Grain Interior(series 4000/6000 only)$100 PRE 1978 BUILT HOMES(Federal Lead lContainment Law) (Light O Dark bak/Cherry/ Fox wood 8 Lead Safe Practices Required $25 ,?00Maple) MY HOME WAS BUILT IN THE YEAR Ini ftlal r Brown Exterior(Arch.Bronze 1American Terra)$100 CAJ Designer Colo r Exterior $155 MISCELLANEOUSr 9 6 S Custom Exterior Aluminum Cladding Window Color (� 1j� / `�� � e El Textured$75 eSmooth G-8 $75 $-&00 Facing Calor WA+_-� Inside Outside Metal Window Removal $50 q 00 NON CUSTOM DOORS New Construction Vinyl Removal $175 Vinyl Rolling Patio Door 511t.or 6ft. $995 Specialty Window Exterior Trim $ Vinyl Rolling Patio Door 8ft. $1095 4 Mull to Form Multi Unit $30 60 Add to base price for Custom Rolling Patio Door $1150 _ Install Interior/Exterior.Stops $50 Vd® French Rail Sliding Patio Door 5ft.or 6ft. $1295 Install Interior Casing Starts At $95 French Rail Sliding Patio Door 81t. $1395 Insulate Weight Boxes $20 French Rail Sliding Patio Door 9ft. $1495 Roof for Bay/Bow Windows $500 Custom Exterior Cladding $150 Existing New Const. Ext. Retro Fit $150 SolarZone Elite or ETC Glass $175 Removal of Existing Bay/Bow $250 Grids Patio Door $128 Repair Sill,Jamb or replace sill nosing $50 Woodgrain Interiors $295 Full Sub-Sill (Single) replacement $150 Exterior Designer Colors $395 Mullion Removal $30 Interior Casing 21 3112 $175 Herior et Options $ Bay/Bow Conversion Ext. Retro Fit $350 $ (New Siding Will Not Match) Building Permit $150 Door Color / ®. ROLI D-UP FCRINDOWW"LD CARS Inside Outside L.i St.Jade Cbddren's Researchf1os )tat! $ ���- Customer declines exterior wrap and understands painting and/or repair may be required Initial C;i.mMmPr rianlinPG nrid.q on winrlovim/rinnrq It JIX_iLW�lER:Customer is responsible for the following in connection with this contract:Painting,Staining,Alarm System discon"ndKrecorinect Building Permit fees in excess of$25.00,Homeowner and or Condo Association Approval,Historic District Approval.City of Boston parking&sidewalk Permit fees in connection with installation. NO EXTRA WORK IF NOT IN WRITING! Customer agrees to the terms of payment as follows: Extra Labor&Materials $ y�-,Vo 00 Site Set Up, Disposal &Delivery Fee $ $195.00 Total Amount $ fid Custom Order Deposit 50% $ Ck# Balance Paid to Installer upon Completion $ Amount Financed $ 1137° 00 Window World of Boston anticipates starting this work on -8�1 KS and being substantially completed in i-�days.Security Interest Yes No Any deposit required In advance of the start of the work SHALL NOT exceed 331/3%of the total contract price or the actual cost of any material or equipment of a special order or custom made nature,which,must be ordered in advance of the start of the work to assure that the project will proceed on schedule.No final payment shall be demanded until the contract is completed to the satisfaction of both parties.: All home improvement contractors and subcontractors shall be registered and that any inquires about a contract or subcontractor relating to a registration should be directed to:Office of Consumer Affairs and Business Regulation,Ten Park Plaza,Suite 5170 Boston,MA 02116.Phone:(617)973-8700 No work shall begin prior to the signing of the contract and transmittal to the owner of a copy of such contract. Window World of Boston under provision of Chapter 142A of the general laws is required to apply for and obtain all construction-related permits.Window World of Boston shall not be deemed responsible for delays in the work described in this agreement caused by regulatory,permit granting agencies,authorities or individuals. Notice:If the PURCHASER(S)obtains his own construction related permits for the work described under this agreement or deals with unregistered contractors, the PURCHASER(S)is hereby advised that in the event of a dispute,judgement and nonpayment,the PURCHASER(S)will not he entitled to make a claim or collection from the guaranty fund established by chapter 142A,M.G.L. You the buyer may cancel this.transaction at any time prior to midnight of the third business day after the date of this transaction. Notice of cancellation must be in writing postmarked no later than midnight of the following third business day. THIS.IS A if T M ORDERNOT EOR RESALE! This Window World°Franchise is independently owned and operated by Window World of Boston,LLC.under license from Window World,Inc. - _ I CIM/16— Owner:Do not0i 6 if there are any blank spaces. I Date Sal an:Do not sign if there are any blank sp es. Date Owner:Do not sign if there are any blank spaces. Date soston w-15 White Copy-Original Yellow Copy-File Pink Copy-Customer Hayes Printing 868-667-1116 WtNDO 2 OP!D:HI CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDNYW) 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 Senn Dunn-GSO NAME: C.Timothy Ward,CPCU,CIC 3625 N.Elm St. PHONE Greensboro,NC 27455 A/c No,at).336 272-7161AX No).336-346-1397 C.Timothy Ward,CPCU,CIC Z&'Ess:tward@senndunn.com INSURERS AFFORDING COVERAGE NAIC q INSURED INSURER A:Citizens Ins CO of America 31534 Window World of Boston,LLC INSURE a:Allmerica Financial Benefit 118 Shaver Street North Wilkesboro,NC 28659 INSURERC-Hartford Fire Insurance Co. 19682 INSURER D- INSURER E: COVERAGESINSURER F 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 AFFORD ED BY THE POLDESCRIBED EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCEDICIES BY PAID CLAIMS. HEREIN IS SUBJECT TO ALL THE TERMS, INSR I 1ADDL SUER LTR TYPE OF INSURANCE 1 S D POLICY NUMBER POLICY EFF POLICY EXP A I X COMMERCIAL GENERAL LIABILITY MMIDDITYYY)2MaR= LIMITS CLAIMS-MADE � EACH OCCURRENCE S 1,000,00 OCCUR 066790252707 04101!2016 04/01/2017 AGE TO R TED Business Owners PREMISES Ea occurrence S 500,00 MED EXP(Any one person) S 5,00 PERSONAL&ADV INJURY S 1,000,00 GE sN'L AGGREGATE LIMIT APPLIES PER POLICY❑ECT ❑LOC GENERAL AGGREGATE S 2,000,00( OTHER: PRODUCTS-COMP/OPAGG S 2,000,000 AUTOMOBILE LIABILITY S COMBINED SINGLE LIMIT BS AUTO AW68757615 person Eaacddent S 1,000,00 ALLOWNED SCHEDULED 06/16/2016 06(1612017 BODILY INJURY(Per ) 5 AUTOS AUTOS NON-OWNED BODILY INJURY(Per accident) S HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident S X UMBRELLA UAB X S OCCUR A EXCESS LIAB CLAIMS-MADE 086790252707 EACH OCCURRENCE S 1,000,00 04/01/2016 04/01/2017 AGGREGATE S DED I RETENTIONS WORKERS COMPENSATION S AND EMPLOYERS'LIABILITY YIN X STARTUTE H_ C ANYPROPRIMBER/PARTNER/EXECUTNE ii 22WECLJ2635 (1/27/2016 01/27/2017 (Mandatory in H) LUDED? ❑ NIA E.L.EACH ACCIDENT S 500,00 (Mandatory in NH) _ Ifyes.describe under EL DISEASE-EA EMPLOYEE S 50D,00 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT S 500,0fl -r DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remark Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood St.Ste 2043 North Andover,MA 01845 AUTHORIZED REPRESENTATIVE ACORD 252014101 ©1988-2014 ACORD CORPORATION. All rights reserved. ( ) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts _ 0 Department of Iptdustrial-A.CCidents 1 Congress Street,Suite 100 F Boston,MA-02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/I'lumbers. TO BE FILED WITH THE PERMIT TZRG AUTHORTT Y• Please Print Le 'bl A j)dcant information Name(Business/Organizationadividual): Address: 16 City/State/Zip: v Phone#: .} Are you a ployer?Check the appropriate box: Type of project(xequired)' eto ees full and/or part ❑ time).* 7. N6W'donstruction 1• am a employer with_mP y 2.F-1I am a sole proprietor or partnership and have no employees working forme in $. Remodeling any capacity.[No workers'comp.insurance required] 9. ❑Demolition 3.Fj i am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10E]Building addition contractors to conduct all work on my property. I will 4.Fj I am a homeowner and will be hiring 11.[]Electrical repairs or additions ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees. IZ.Q Pj=-m ing repairs or additions S.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13•,n Rbbf airs These sub-contractors have employees and have workers'comp.insurance.t 14� ther 6.0 We are a corporatiori and its,officers have exercised their right of exemption per MGL c. 152,§1(4),and we Have no empldyees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. submit•this affiare doing all work and of the sub-contractors and state whether then hire outside contractors must submit a new affidavit indicating such. Homeowners who davit indicating they Contractors that check this box must'attached an additional sheet showing the name or not(hose entities have employees. If 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 job site information. Insurance Company Name- Policy#or Self-ins.Lic.#: ExpirationDate: City/State/fip: _r Job Site Address: Attach a copy of the workers' compensa ion policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requir fine up to$1,500.00 ed under MGL c.152,§25A is a criminal violation punishable by a 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 certify and r ze in and enalties of perjury that tlae information provided abave is true and correct. Date: Si ature: Phone#: ow official use only. Do not write in tlsis area,to be completed by city or town official. Permit/License City or Town: # Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Phone#• Contact Person: 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 receivbfor trustee d 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 iequi-red." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance 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=contractors)uame(s),address(es)and phone number(s)along with their certificates)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 IndustrialAccidenis. 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 thai 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 Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial.Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 wwwmass.gov/dia Mass achusatts Department of Public Safety Board of Building Regulations and Standards License: CS-072772 Const-.ctian S�oerr�so< JEFF C STEELE - 24 SHERWOOD AVE DANVERS MA 01923 ,2 -A ,. A` Expiration: Commissioner 04!07/2018 _�.:. n,r..,,,<f•..,:le :::i _.GCv.;.;c'icrrr.;r;r Office of Consumer Affairs&Business Regulation — HOME IMPROVEMENT CONTRACTOR _ b Registration: 166025. Type: s Expiration- 4(12/2018 LLC _ . WINDOW WORLD OF BOSTON,LLC. JEFF STEELE 24 CUMMINGS PARK SUITE.15-A .tea. .:. WOBURN,MA 01801 Undersecretary License or registration valid for individual use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation LO Park Plaza-Suite 5170 Boston,MA 02116 ,Aot valid without signature Location I/o K.o qt�l a ly - 5—r o No. 0'17 Date t � y • - TOWN OF NORTH ANDOVER'- . Certificate of Occupancy $ Building/Frame Permit Fee $ �1 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# /�g c" t-Building lnspector T