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7 PATTON RD - BUILDING INSPECTION rhe Commonwealth of assaehtrssots r u , . _ dar I F 5 1 Board of building Re u s arrd, tandard VC` CITY OF LO W Massachusetts State O g u1&e, 780 CMR 1 Revised SSALErr12011 Building Permit Application To Const t�43er�at�e OP Demolish a y One-or 71vo-F% *MTewelling r This Section ForOfficial Use On it ,, - i 91sthis mit Number. Date p lieds )cial(Print Name) , Signature - ate r(( SECT70N f SITE INFORiIMATION Lit A res 1.2 Assessors Slop&Parcel Numbers accepted strew.yes no &tap Number Pamel Number X41 a.t151r:1 YY ,yiif)i,S f;i 1.3 Zoning Information: L4 PropertyDime on�:r t ar,rrsfl�? l,) Zoning Distrito Proposed Use Lot Area(sq h) Frontage 1.5 Building Setbacks(R) Front Yard _ . . Side Yards Rear Yard - Requirid Provided Required Provided_ Requim:d'. Provided 1.6 Water Suppiy:(M.G.L c.Ja,§5d) 1.7 Flood Zone Information' ss Sewage Disposal System:' Zoae: Outside Flood Zone? Public❑ Private O . . — Municipal Q On site disposal system O Cheddf. ex0 ..- SECTION;: ?ROPERTEYOWNERSIfiPf.', 2,1 OV3prt of Re rd: �+ t C. a0S.. 10h .Ju 1Ityan y, lei" tYy7" Nome(Print City;state,'ZIP 7 to J�v� 12d No.and Street - Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORW(check all that apply)` Now Constniction O Existing Building❑ Owner-Occupied Q itepairs(s) ❑ I Alteration(s) 17 Addition O Demolition ❑ Accessory Bldg.0 . Number of Units_ Other Q Specify: Brief Description of Proposed lVork3: SECTION 4:ESTIrNIATED CONSTRUCTION COSTS Item - Estimated Costs: - - Official Use Only Labor and Materials 1,Building Sf 1. Building Permit Fee:S Indicate how fee is determined: 2.Electrical 5 Q Standard Cityfrown Application Fee. O Total Project Cost'(Item 6)x multiplier x 3. Plumbing s P Qther Fees: $ r 4. Mechanical (11V, C) s List. - 5.Mechanical (Fire $ Suppression) 'total All Fees:S Check No.f W_7 Check Amount: Cash Amount: 6."Dotal Project Cost: S mo -- - ❑Paid in Full ❑Outstanding Balance Due: fat t tJ S f4 SI= i 2.I I'� r SECTION 5: CONSTRUCTION SERVICES 5.1 ConstructionSupervisorLicense(CSL) '_7977 Z3 t License Number Expiration Date Name of CSL Holder Eric W. Palm List CSL Type(sen below)�_ 3 Hilton Street Tye. .. . . . Description No.and Street - Salem MA 01970 - -" - . U Unrestricted(BuildingsIt to 33,000 cu. ft.) R Restricted 1&2 Family Dwelling Cityfrown,State,ZIP M Masonry RC Rooting Covering WS Window and Siding (��� / ([4 d SF Solid Fuel Burning Appliances ( ✓i I ✓1 l 1 Insulation Telephone Email address D I Demolition 5.2 Registered Home Improvement Contractor(HIC) /Inoo Atlantic Weatherization,LLC HIC Registration Number Expiration Date HIC Company% 0JdfN&*44~ No.and Street Salem MA M70 - Email address Ci frown State ZIP Telephone SECTION 6:WORKERS,COMPENSATION INSURANCE AFFIDAVIT 44. .C.F.IS;-§25C(6)y.. Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Isiu Ince the building permit. Signed Affidavit Attached? Yes.......... No...........❑ SECTION 7a.OWNER AUTHORIZATION TO HE COMPLETED.WHEN' OWNER'S AGENT OR 4bONTRA&6*4PP[.IE3 FOR BUILDING.PERMIT' I,as Owner of the subject property,hereby authorize—L, t i W /h'r^ t9 act onmybehalf,in all matters relative to work authorized by this building permit application. (� Print O% 's N&nc(Electro tic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,l hereby attest under the pains and penalties of pedury that all of the information contained in this application is true and aacccuu�rate to the best of my knowledge and understanding. Print Owner's or Authorized Agent's nic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or art owner who hires an unregistered contractor (not registered in the Home improvement Contractor(HIC)Program);will no have access to the arbitration program or guaranty fund under M.O.L.c. Ig2A.0their important informan no on-theIIICTrogrnm can be-foimd-aY — -- www mass eovlorn Information on the Construction Supervisor License can be found at www.nuss.eov/dM 2. When substantial work is planned,provide the information below: 'focal floor area(sq. R.) s (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths type of heating system Number of decks/porches Type of cooling system Enclosed Open J. 'Total Project Square Foolage"may be substituted for"Total Project Cost" i — - iviassachusetts Home Ir; BLotveaaent Samnle�amlxact This farm stQLlffesanlresic requimmmm of8maete'kHnmelmp[wam®tCaonar LsW(MGLvbsP a 14W!hmdnesaotmdadeetaadard longmgem Prosrgthommwnets.Sedthgmadv)mif'nsessary.AaYpasoo p)aomutgh®aim{aowem®tssheuL[6ntohtainacopyof"A 1KasvdtaseaSConsonafinidcmHome tmlaovemmP befm'ettgtmingto aaywrork�yomstsiriram.Yaa may,obbim afimcopgbyra8mgdm 0&mafCmmmmAifausaadRnsinassR tion'sConstm�InfarmntionHmlioeat617A73S7g7 or 1-888-2833757 ar�aarwabsue HOmeewneC.InfOrTnniinll COnttYlt�arinfermHtiOn Name cmulwy arae / �_� �u�1�V�+ Atlantic Weadteriza viz Llii, Stmt Address(do r�o amr connsems""Pe"AcI aMW Avenue CityfC ga¢o:.,. 2ipCde=`.•� eufmmAddtess(mm' Dapmephode £%ming Pnme Ciwfrawe State Z��pCode 97 fr- Ky- 81�r Mailigg Addms(adiffbna from above) W�Phoac Fdevt EgydarcIDwSB Nmibc temcsp meararmc=9�aaa� �' 'ne Cummctoroamm to do the€allnwingwm§for Meftomemvner. SDessiht in imil dxwah rocomptetai,sPrriFYi4athetYM.laaad,mdgmleof tmremtsmaeaced. ...tK.riamt a..n iFae�wJ Required Permits-ThefoQawmg buildiogPvmitsae required PropoWStadaod CumpletloaStbedde-Tbcfd ow®gscbc&dewM mrd wiG bosmmed hydra wntraanrastbehomeowner'sagmi: beadhasib,udessdrtmmamxsha}rondthe mntrattm'scosaolarw (Owners who secure their ecru permils will be excluded from the Guaranty Fund provisions ofZ /Z./ nata%mm nontluca,will begin mnnnemd MGLebapterl42A.) t2/ / Z Data w€tm conuactctwodcmTl 6e;bstanaaRysmtpkled Tomr ContmctPrimaed Payment Schdme ThaConfragor ggemmP me wmk.tarnish thammainiaarllaborspssi8ed ahavnfurdremTs)srm of. 1 diJV • M Payments will be made according ro tbefoIIotvmgsehedobn S,l�t/.'/_-upon signing musasi(mt toexcced 113 aftbotnW culam2prim g thecMofgal ocdsitems.wtssdtevarisgmaW) S by—I—/- 1 "Puncoa4monof J sj U—)VJ '^by L'_r�i l upon completion of l - fi'7'✓' CC/}9'1 L74 6- S/W- upon completion of thoannvatx. (fawflrbidsdemmdmgfullmtooblmnaaa ismmp lh4edtobothl pmty's tis6etion) the follow ngmatuia/7egidpmemmmt6espziat Sin be df. ordered befamdm cmbwei wars begun in..ia m mcetthe emgddmsnhedme('% 5._��m "d _ _,__,___ NOTES:(0)Jncluding all Sum cmulla(°II)lawmwumdataay drpra{tardaw,fyaymmtrnetdredbydxmn>rammbefmwwh bVmmay not ox¢d megreaerof(a}oact5int oFA7cmfat mvbamfoiceat @)umaaualerotaFmy spxxivt WrtiPmeotmcuuommadematntiat whidsmmtbegxeial aderediodvmmreromsethecompleamsnhdvle wa -I a Il Y err ea Sahmotracmts-lTtamnkay the mutofin. The amoaUltlaforcomp7eHan besolely ORPcsaftheall ofmpthud partyl5ubeannnmorvaliadbY the covhastor. The mntmmrfmWaragrees(o&mlmY responsTdefarall paymmtam a8 wboonhaMrsfor materials andl bn CnnetnctAmaptanm-Uponsigning,th(s dommembecamesatrmdlog mnaadanderiaw.Unitaothvwim aotalwitbm falu',sdommmLthe mntmet shall not imply that my Gen ormbermcmity imeredlo sbemplave lm themsidmca Rasiewdtefa8uwmgmuaoaaavdaaaces carefitaYbetnre sismgthis mnnam. �f v Dari be pfesUMd anSigning theeomomL Take time mrmdavd tally undev andiL Askguesa=ifs%methiogism`tray. o 'rWaim sue dremn>mctarhasa valid Homo fmnns%®mtCmaaceorR . The hmtagaimmasthameimpmve matrsaorsand uibcaaunmot5 to be segiand with the Lt waroMume lmpmvanmt Coateantor Regisoman.You may mquieabcoYcovmmsur regiumaan bywriangto the Di ww st la Peok FhmRoom 5170,Rasion,MA 02116 or by calling 617473-9787 m 886-283-3757. Doestha mnaadm t¢veinsnanm?AskdtaConaadorfarhis issuance mmpmyiufa m aon so d atyou can mnf ml mimegq orask to see a mpy afa`}rrmfaFvmsaam^document Know yomrigbtsond tasponsdidlitim Read the hnponmm bdmmaaoo on the reverse side ofthisfmm and get acepyo€fhc Commoner. Guide In thaHame unpmvemrnt CovasdarLaw. You may mnml thisaiplemn brit basbeen sigtedmaplemodterthm thecanandm'smumod placeefbaskow,provided youlm de, connimtorin writing atlddhermain oScets Immcb officeby onlimly matt ponel,by tdegma seuterby dulivey,am imalb'm midnight of the lord business day following dtesignmgofddsa enL See Ore attaWednoacoafamce)laaonfmm tonneLwaaon expisovi DO NOT SIGN THIS CONTRACT IF TE M2E ARE AM BLANK SFACESr.9t. Twu'ufmtlNmrve+alaeaamatl,,ml}}(m//l/ttt�aegrkfatao4v3^et OaemFY:twSlEamileia9yiwv.'Cbem3vebwtdbet�QT mmwnc Homm.ma SignalAc ConaantoYS signature J Date Dena Contractor-Arbitration The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action(as an alternative to court action)I if they have a dispute with a contractor. The same right is not automatically afforded to a contractor,however. The contractor would have to resolve any dispute he/she has with a homeowner in court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded ro the homeowner by the Home Improvement Contractor Law. t The contractor and the hotiteow¢er hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract,�!!e� ca¢tr�cto�rstay ( the dispute to a private arbitration Earn which has been approved by the Secretary of the Execiti le Once of o&�Tsqmer Affairs and Business Regulation and the consumer shall be required to submit to such arbitot I- •a�p4oit11t� ✓LWI$ssachusetts General Laws,cha er 1,2A. w �, HomeaVees Signal= I Contractor's Signature NOTICE:The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. Homeowner's Rights A homeowners rights under the Home Improvement Contractor Law(MGL chapter 142A)and other consumer protection laws(i.e.MGLIchapter 93A)may not be waived in any way,even by agreement However,homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from all Guaranty Fond provisions of the Home Improvement Contractor Law. The contractor is responsible for completing the work as described,in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular purpose. A' enumeration of other matters on which the homeowner and contractor lawfully agree may be added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions about your consi imer/homeowner rights,contact the Consumer Information Hotline(listed below). Execution of Contract The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached Parties are also advised not to sign the document until all blank sections have been filled in ormarked as void deleted,or not applicable. One original signed copy of the contract with attachments is to be given to the owner and khe other kept by the contractor. Any modification to the original contract must be in writing and agreed to by both parties.Contracted work may not begin until both parties have received a fully executed copy of the contract,and the throe qday rescission period has expired,' Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the y homeowner deems him/heiself to be financially insecure. However,in instances where a contractor deems him/berself to be financially insecure,the contractor may require that the balance of funds not yet due be placed in a joint escrow `account as a prerequisite to continuing the contracted work Withdrawal of finds from said account would require the signatures of both parties. Additional Information If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights,or if youwish to obtain a free copy of"A Massachusetts Consumer Guide to Home Improvement" contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation - 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the OCABR website at hftm//www.mass.eov/ocabr/ if you want to verify the Igistration of a contractor or if you have questions or need additional information specifically about the contractor registration component of the Home Improvement Contractor Law,contact Director of Home Improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the HIC website at httD://uww.mass aov/ocabr/ Go online to view the statys of a Home Improvement Contractor's Registration: httpt ://db.state.ma.us/homermnrovement/licenseelistaso I For assistance with informal mediation of disputes or to register formal complaints against a business,call: • onsutrler plaint Section '.ffi _ omey General 617-727-8400 AND/OR Better Business Bureau 508652-4800.508-755-2548 or 413-734-3114 V.iou 11-1Ir1Y2010 i 7 I h ��Eig B..fi�Bfls2i'Jeltit's F3jrll'GsSLtCI?Z?5E£`t5 it ,{ rer�a cFr en£aj cazse'riCe1.GCC+rteFifs congress sSe'Pe:3ir Yel t`e loc. 2,V-00 "'1021-74-42017 et=urice:s'tC��peltsat=o,-rsnslraace:iia;davit:Stt;3tyer;/�on�eactcrs/EIe^_3eicianslpfu�t�e.s. ' TO BE FILED o r a€I THE PE-VETT ENG.*_UIVORiT Y. Aoplicatltaafo=-ration PleasePrirtf r _tibiv iVflme(BusinesJOr�.anizakionitadividuai): Aecce>.iv ,e�&NAt?�'r?.,°U,si-i I_,i :51 ve-amp Address: :,_�--- - ,i nal. -?v City/State/G`ip: I Phone F": + '7 Grtj {a t r 4 Are you all employer?Chinch,the'appropriate bov �•. Type 6I project(saG�f ): t. * I am a employor with .:�,� employees(full and/or part time).'= 7, 74.hlevv CpnSitllGtipn ?.C]1 an a sole proprietor or pattnership and have no employees working for in anyca act o. CRemodeling p ty_[l.o.n'arkers'comp.insurance ,required] i.Ell)am c homeewner doing al l evrlr myspif,[?tra anrker`comp.insurance required.]t 9_ l—i yi Demolition d.�j F am a homernhmer and ui17 fie1hiring conuactors to conduct all work on my properry, I will )6 C Building addition ensure,that all contractorsenher havcrcorker`compensation insumnee erare sole 11.0 Electrical repairs or additions proprictos with no employcesI - ❑ . 12� Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed an die aaachad sheet ' i nese sub-contraciorshave cmpiovees and have workers comp.iteamne-r 13.❑t-2pof,repair5 r E,+ (lie arc a corpomtioa and its o�cem..have exercised their right of exemption perh•IGLc I-lain Other lstd-£11F,-.j t52, i(4),and nchavenoemployees.(NO warkers"tomo.insurance retiuired.j i •zAny allphcant that checks has=1 most'olso fill out the section below shomine their workers'compensation policy information. T Homeonmers who submi(this effidavit indicating they are doing all ivork and then hire outside contractors most submit a new affidavit indicaiin_a such. =Contractors that check this box must attached an additinnai sheetsimwine the time of the sub-contractors and sate whether or not those entities have employees. If the sub-contractors have employces,they must provide their warkers comp,policy number. a?)i 2f:eiita+OJ�Pr:1tA1`iF f1iOLldlFt�hJOP%ieTS'COiili7PiISAilOr7 7I7SLiaiZCelOi 71?I'PI17P10{�ePS. e/OiN/S P11P1701iC)'Aii:1,JOb S%iP ii jOi191APfoli. ` Insurance Company Name: ! s'JEr'1,'^ `1 Policy=or Self-ins. Lic_k_ Expiration Date,-3/,2,6 job Site Address- - 7 J /r�� City/Stamizip '3�4 � l ✓1 �/ r r / d 6 t 9Ca h.e_ At`acz r_copy of,the aarl.e-s'compensation= policy declaration nays(sitoryizg the policy�_:r5sr and e=ptra:-:on en---) Failure to secure coverage as required udder ivIGL c. 153, s25A is a criminal violation punishable by a fine up to S1,500-00 and/or one-year imprisonment;as well as civil penalties in the form of a STOP WORK ORDER and a line of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. f CIO harean Certl-� -zdeC Fltery- Its e,: F Fier of-Oer m,that flre i tjonnatioiz provided allove is arae Cold cor,ee )I SiS77aNre' �� i�^"»��•^-'-`'-{✓ Date: '. PllpnC'T: ' 7"j f !'S..l 4"f L � 4 Offielci nese mtle. Do;zOl hvrite lit this over,to be completed by crag or town ofJ1cial f=v or Town. � Permit/License= - .. ?:ssu= g=+-uT€tin-2ty(circie oi_e): ` s. C2fj/' ._Mer:j'iCal inSDe:EfF g.�lLF1'?ia i3GeCE0>462rGof'Pai' 2.33idGS�Q 'tme=? J.Da OV _ :.oritpeci Yet'Sim: � Ph one r:: t l A1�'V CERTWICATE OF �BQ��UTY INSURANCE OATE{6i01-5YSS� 3rsrZD_� 1 HIS CEP,TIFICA TE IS ISSUED ASA M-17ER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTtFICA TE Mur-DER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AiN}E ID, EXTEtBD OR ALTER THE COVERAGE AFFORDED BY THE POLICIES SELO!)0, THIS CEPTIFICATE10F INSUP.ANCE DOES NOT CON;;!}'i'UTE A CONTRACT SE-1VMEN THE ISSUING INSURER($), AUTHORIZED REPRESS NATIVE OR PRODUCER,AND THE CERTIFICA T 9_HOLDER. 11WPORTANT: If the cer`uficate'holder is an ADDITIONAL INSURED,the policy(les) rause he or endsed. 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 cerificate holder in ifeu,of such endorsement(s). PRODUCER. CONTAC COn Stl' Ot on PIAP.SE Easterm insurauee Gz4ap LS,C NONoE_t, (200}333-7234 aC.Hal: 233 'Wast Cant lel .St Eh Alt AODP.ESa^• I INSURERSAFFORDNNGOOVERAGE NAiCB iVati as NmL_ 01760 IRs4RERA-a�be11a P=Ot90t Z10n las. Co. ?1360 Msuaeo 1 INSURER BOTa22'i-7.S.UB Sasu-"aaoe CO 3tlant-10 GTeasherizaiion INSURERC: t 61 Rear cT2f�.arson Ave.ue SURER Q: ' INSURERE: Salem ai 01970 INSURER F: I COVERAGES I OERTIFICAT'F&VUNIBERj)%STtta 2015 REVISION muffiaM THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY FERIOD INDICATED. NOTUt17THSTANDINC- ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WWTH 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 COPIDITIONS OF SUCH POLICIES,UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ,INS TYPE OPINSURAiRCE (a GR LSU POLICYPIUTABER PM�� IP O OU EXP UtVir GE@ERALUAelOTY 1,000,000 EACHCCURRENCE S CO:diPLERCIALGaFEAALUAQILnY� DMAc Ea c^ ,aa,=�_s 50,000 CLAIh§5?v7ADE OCCUR`: 5500042816 /20/2015 /20/2016O,(Am/aaapl ) Is 5,004 Li AL&ADVINJURY {S 1,000,000 LAGGREGATE S 2,000,000 'L AGGREGATE LVrr APPPLIES PER: CTS-COMPIOP AGG S 2,000,000 ( (LOC SAUTGUOSILE DABIU t; - EO BINGLE LI`A� S 7 ODD 000 ANY AUTO RUURY(Pupe ') IsAU OS SCHEDULEQ 020015871 /2D/2015 /20/2016 WJURY(Perxaeda�t) 5 �- AUTOS I�AUTOS A NON-o4vN'cD TYDA6IALE i SHIREp AUTOS I AUTOS d=) i PiP Bas t __ UMBP.ELLA UAB �I 1 OCCUR 1 EACH OCCURRENCE S 7-000,0001 . t((ENCESS UAB I I CLAINIS-0VI ce I}iy AGGREGAie is 1,000,000 I DED IHETENn0NS 600058654 /20/2015 /20/2036 F S i 4VORttERS COhSPENSRTIDN IT STA, e - Ai4DELiFLOYERS'LIABILIRX YIN 'NYP::GPRIETORIPERTNc_Rlr..c^CUiKc� NIA EL EACH ACCIDENT S QP=iCEFJP:EP.IEEP.EXCLUDEQt cL DISEASE-EA cMPLO S {h:endataty in NH) If,,es.dear;be 4ntle; O SCRtPTtQN OF OPERATIOHe beter. ! I� EL DISEASE POLICY UMfr S LPL200378613 0/1/2014 0/1/2015 GENERALACCREGATE $1,000,000 i EA POLLUTION CONDTnON $1,000,000 CRIPTION QF OPERATIONSI LOCATIOP)SIV.-MCLES(Attazh AGORD•107,AdtliGom!P.ematits s'ehadW&iPRwTrspace is ragairedJ , i '.I(FIC A,t e IdOLDea2 CA19CaLt;?7}ON SHOULD AN Y OF THE ABOVE DESCRIBED POLICIES BE CA14CELLED BEFORc- THE EXPIRATION DATE THEREOF, NOTICE VOLL BE OE.PJERED )N CTfry O,. SDT.T•n_ ACCORDANCE WITH THE POLICYPROVISIONS. 93 Tl$ft2nTt' 0?T STREET yv7 01970 AUTHOR15EDREPRESE'NTATIVE Rohs! ltoegeljai-M .D 26(20'10105} i ©18B$-2O?4AvOF�.O CORPORR'xtON. Ai!siBeT4s resemad. 5 tJtitfi141m ` ,1-,eAf`.fl,-+vl vensanr.,if.•,ean>-a-an:c-ernr7^s=rale,a4 Lt["P1Rk't IAVMassachusetts -Department of Public Safety '�='' Board of Building Regulations and Standardsem�<n,onruen�(/+0�"6,✓�fa.uad+rue(G a Construction Supervisor tee of Consumer Affairs&Business Regulation i - - - MEIMPROVEMENT CONTRACTOR License: CS-087977 Typo. agistmtion: 142089 ERIC W PALM - xpiration: 3192/2016 Ltd Liability Coryoc 3HII.TONST r r ATLANTIC WEATHERIZATIONL.L.C. Salem 114A 01970= T s, ERIC PALM Expiration 61R JEFFERSON AVE J, - Commissioner 0412312016 SALEM,MA 01970 Undersecretary Unrestricted-Buildings of any use group which Y~ Contain less than 35,000 Cubic feet(991m)of License or registration valid for indfvidut use only 1 ,v before the expiration date. If found return to: enclosed Space. ? Office of Consumer Affairs and Business Regulation , 10 Park Plaza-Suite 5170 ,_1 Boston,MA 0211166' ; Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. -- Not valid without signature -- For DPS Licensing information visit. w .Mass.Gov/DP5 - ,