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HomeMy WebLinkAboutBuilding Permit #311-2017 - 124 Kingston Street 9/22/2016 v I ` L �10RT H. BUILDING PERMIT O`� I ED 6 TOWN OF NORTH ANDOVER o `' APPLICATION FOR PLAN EXAMINATION * _ n� ` — O� t Date Received 2 ZiRpD"TATED Permit No#: �Ppy�S gSSACHUS Date Issued: IMP RTANT: Applicant must complete all items on this page LOCATION - - f 3� 5% NA J Print PROPERTY OWNER Q WAC--P- (,/Zl"x 421.2` 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 - 0 Flo-od IainWWALtands 1Natered District [] Septic �V1Lell p Water/,Sewer - _ _ DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please.T pe or Print Cleary Name: J t'ti -� C�< <-I ��: I Phone: �2- OWNER: ' G Address: mss; t �+ GST& S� /J Contractor Name: j b�� �/-�� 2 "^^G� Phone 9119- 715-- Email: Address _ �:3 U z'"".` L k ' Supervisor's Construction License: Z p� Ex Date: Z J(q i Home Improvement License: / Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDIN�PEERMMIT.$$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 7 -t _�s �.� - - W Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWER�.GE DISPOSAL Public Sewer ❑ Tanning/MassageBody 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 e U FORM PLANNING c& DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed ori 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 _ DP's Town Engineer: Signature: FIRE DEPARxTMENI - - Located 384 Osgood Street at d f !, Temp-Qumpster onsite- % es:.., ��=- Loc r at�1244MMtSt�eet Y fiFiieY®ep,�artmerit�signature/dafe+ ', _ ~' � -�s �-- 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 No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine RITES 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 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 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 m ust be submitted with the building application Doc:Building Permit Revised 2014 Location 1/ No. �- o;7 Date fly f f r t • - TOWN OF NORTH ANDOVER . Certificate of Occupancy $ ` Building/Frame Permit Fee $ `�f Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 1 Building Tn'spector 30935 r , - V NORT11 t sAnc . : ver p - p+ No. �o h ver, Mass, ACAW 16 COCNIC N.WICK �- �,p A�RATEO ►4a`,�'�y S U BOARD OF HEALTH Food/Kitchen PER L D Septic System THIS CERTIFIES THAT �.� ...... .... ..C1,1,�0 „ BUILDING INSPECTOR . �,�. �. has permission to erect .......................... buildings on .... � .. ,... Foundation Rough to be occupied as .....................94A.1P......4...rftmor�...................................................... 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service ................................................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. 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''„ �� �� �� `�, R� ,, ,' • ;r'^ �•t,Jldr t;�f,t;�;r;',Fl`i�f���'t�nlj�til"II'k''tl��rt ,t 't, ,H r� `' n;� "•V '�5'I �t �' rt1 `� � �,� �',�t1 ,St 5�;^�f ..!':;;i"S:�'g� qr.. 4.:, iidl•,.lt�I,;t ; r, 't '}I, .�.S+rt ;1 !rr �� AM JUL UMnElt ONE ROOF RCFhiMnf_-yVS Residential & Commercial RoofingAll Types Of Siding CHIMNEYS POINTED-REBUILT-CAPPED Expert Masonry Work Mass Toll Free I*Roof Leaks Experts * Licensed& Insured 1-800-WAIT-4-US m Locally Owned do Operated Sit-cc J976 'msLicense#034200 (924-8487) IKO GaBB Wozw oz�alan s We Work Year Round • - 3 Eoledwflgzeea 978-975-7531 .70.Jafferson.St.-North And0Ver,..Mk0_1845 30 Temple or., methuen,MA 01844 Proposal To: Village Green West Date 5/21/2016 Street: 200 Kingston St. N.Andover 603-382-6166 68-82, 108-138, 156-170 Roof proposal picaeng@comcast.net IKO Cambridge/Certainteed Landmark 1. Extra caution will be taken to protect all buildings, 11. Counter flash existing chimney lead,wall walkways and landscaping as best as possible. connections and all roof protrusions (pipe boots and Debris will be removed and magnets run daily. vents)with ice and water shield,tie into new shingles Not responsible to move tenants personal items. and sealed with clear Geo-Cel sealant. All installation procedures will follow state code 12. Bath Exhaust vents: Install all new black low and OSHA compliance. Caution tape outline all profile bath exhaust vents on roof line. Counter work areas. flashed with ice and water shield. One for each unit. 2. Remove all shingles and roofing materials as best No interior connection included. Will coordinate with as possible from all four buildings. Association for best locations per unit 3. Inspect and re-nail any loose or lifted plywood. 13.Wall connections: Remove existing siding or Any compromised plywood will be replaced at an aluminum trim as needed. Counter flash at least 18" additional cost. up the wall with ice and water shield. Install new 4. Install heavy gauge 8"white F8 .019 aluminum 5"x7"aluminum step flashing. Re-install siding and drip edge to all eaves and rakes. trim. Install new aluminum siding or trim if 5. Install 6' of IKO Storm Seal or Certainteed Winter compromised. Guard ice and water shield to all eaves and top to 14. Removal of all work related debris. Planks will be bottom in all valleys. All drip edge nails will be placed under dumpsters to prevent any damage to covered with 12"strip of ice and water shield. existing asphalt. Placement and removal of dumpsters (ASTM D6757 certified) will be coordinated with Association to minimize 6. Install IKO Storm Tite or Certainteed Diamond daily interruptions. Deck synthetic underlayment to remaining 15. Contractor Workmanship warranty: 15 years under sheathing up to the ridge. (ASTM D6757 certified) normal wind,rain, ice and snow conditions. 7. Install all new pipe boot flashings. Counter flashed (Please see extended warranty) with ice and water shield. 8. Install IKO or Certainteed starter shingles to all Extended Warranty: (Against material defect) eaves and rakes. *IKO Shield Pro Plus* 9. Install IKO Cambridge or Certainteed Landmark • Full 20 year coverage direct from MFG. Limited Lifetime architectural shingles to all four a Non pro rated buildings. All shingles and roofing materials will • Labor,material,debris removal and workmanship be fastened and installed per MFG specifications. All valleys will be woven. Commercial MFG *Certainteed 3 Star Sure Start Plus* warranty up to 40 years. (Please see extended • Full 20 year coverage direct from MFG. warranty) • Non pro rated 10. Cut and install all new(ASTM certified)nylon • Labor,material and workmanship. Debris removal mesh ridge vents to code to all four buildings and not available with 3 Star coverage capped with IKO or CertainTeed color matched 1%;t% Q*%A,; lnA.•0„ eh;»rtlaa Rnth RytPndpd WarrnntiPC inehidpd in nrnnncnl LL UMIMMIR 40111E R4040F Chimneys Residential & Commercial Roofing All Types Of CHIMNEYS POINTED-REBUILT-CAPPED Expert Masonry Work Siding ,{ Raaf Leaks Ex ertsfl Licensed&Insured Mass Toll Free Locally Owned Operated do Li 5-1976 cense#034200 1-800-WAIT-4-US ® -� (924-8487') IKO Gjaee �� n�/oh�1 `.�..,., We Work Year Mound 0•_ Proposal To: R. J Pica Engineering Date 5/21/2016 (Page 4) Street: Village Green West (Phase 1) 603-382-6166 68-82, 108-138, 156-170 Roof proposal picaeng@comcast.net IKO Cambridge/Certainteed Landmark Total cost and payment schedule Total IKO Cost: $1069000.00 �Y 64a, 0� Total Certainteed Cost: $1 4,000.00 / s'. but>' • Total Gutter Cost: $15,000.00 (Balance due upon fompletion of all four buildings) * Upgraded ice and water shield options (For best defense against water infiltration caused by ice dams) -IKO Premium Goldshield: $3,000.00 additional cost -Certainteed Premium HT : $2,600.00 additional cost Payment schedule: Balance including any additional costs due at the completion of each building. No deposit required. er building Certainteed $28,500.00 per buil g Commercial references: Jackson Lumber • Heavenly Donuts • CSI (Cementary Services Inc) Shaheen, Gurearra and O'Leary Law offices A Plus rated member of the Accredited BBB since 2001 5 year consecutive Super Service Award winner from Angie's list (Top 5% of all New England roofing contractors) Acceptance of Proposal—The above prices, specifications and conditions are satisfactory and are herby accepted. You are authorized to do the work as specified.Payment will a e as outlined above. Date of Acceptance: I l +o'�+ Signatu The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass gov/dia Workers'Compensation Insurance Affidavit:Builders/ContraMors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. ADPlicant]nforulation Please Print Legibly Name(Business/Organization4Wividual): avk< IZ mal% Address: 3b, 1-19k- ✓/5 -c- City/State/Zip: YM L-%0-f� t/1'51 Phone#: `l Ir" P jlJ"`7sr7 r Are you as employer?check tie appropriate box: Type of project(required): i.'!am a employe with___S!_.playocs(full and/or part-time).* 7. New construction 2.[—]]am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any rapacity.[No workers'comp_insurance required.] 3.01 am a home .doing all work myself.(No workers'comp.insurance required.)t 4• E]Demolition 10 Q Building addition 4.01 am a homeowner and will be hiring contractors to conduct all work on my property. 1 will ensure that all contractors either have workers'compensation insurance or are sok I I.E]Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 50 1 am a general contractor and I have bired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp_insurance.1 1ROof repairs 6.D We are a corporation and its officers have exercised their right of exemption per MGL c_ 144.�. Other `►tt�� 152,§1(4),and we have no employees.[No workers'comp_insurance required.) J 'Any applicant that checks box#1 must also fill out the section 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. '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 employers. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 40 t€ M14 tl j Policy#or Self-ins.Lic.#: )qWc- J�E piration Date-,— Job ate:Job Site Address: J kN Lines City/State/Zip: /-1/' Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to 51,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 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. 1 do hereby certify under the,pains and penalties of perjury that the information provided above is true and correct Siggafore: Date: cI /°1 /Z Phone#: g � O kl ial use only. Do not write in this area,to be completed by city or town of ficial City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 9/21 /2016 9 : 07 : 39 AM 8975 p 02/02 .Aco CERTIFICATE OF LIABILITY INSURANCE GATE(MM100IYYYY) 09/211201.6 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(les)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 doesnot confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 02051-:001 CO oNT A C T Branch 2051=1 Perry.lnsurance Agency LLC A7C.NNo.Ext): (978)685-7690 Fi�i No: (978)687-0199 522 Chickering,RdMAIL North Andover,MA 01845 ADDRESS: IN UR5RfS1 AFFORDING ; INSURERA: A.I.M.Mutual insurance Company 33758 INSURED All Under One Roof INSURERS: I C/O John Lanz.afame INSURER D: 30 Temple Drive Methuen, MA 01844 INSURERE: INSURER F 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 REDUC��E��D BY PAID CLAIMS. ILTR TYPE OF INSURANCE atJ SQR-WV� POLICY NUMBER MMID DNYYY IAMlO DNYXYPY LIMITS GENERAL LIABILITY EACH OCCURRENCE f COMMERCIAL GENERAL LIABILITY DAMAGE TORPREMS:. TC Ce f CLAIMS-MADE ❑OCCUR MED EXP(Any one person) ; PERSONAL&ADV INJURY f GENERAL AGGREGATE S �EIIL, AGGREGATE LIMIT APPLIES PER PRODUCTS.-COMPIOP AGG S OLICY R T OC AUTOMOBILE LIABILITY 'OtvIBNED INGLELIMIT S Ea accident _ ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY Per accident S AUTOS AUTOS ( ) HIREDAUTOSNON-OWNED PROPERTY DAMAGEAUTOS $ Reraccicent f UMBRELLAtiA6 �_JOCCUR EACH OCCURRENCE f EXCESS LIAS CLAIMS MADE AGGREGATE Y DED RETENTION S 3 yyORKERS COMPENSATION NlC STATLI- OTH- ANO EMPLOYERS'LIABILITY X TORY LIMITS ER AMY PP2pPRIMp ROARTNEERRIEXECUTIVE Y/N E_L EACH ACCIDENT 3 A OFFICERIMEMBER-EXCLUQED� a NIA AWC-400-7009464-2015A 11/9/2015 11/9/2016 0 Mandatory in NH) El DISEASE-EA EMPLOYEE f Di-non non ffCRIP ONOFOPERAT10NSbelow E.L_DISEASE-POLICY LIMIT 3 1-000,000-0 DESCRIPTION OF OPERATIONS r LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more spats is required) The workers compensation policy does not provide coverage for John Lanzafame I CERTIFICATE HOLDER CANCELLATION Village Green West Condominiums 200 Kingston Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE North Andover,MA 01845 THE EXPIRATION DATE THEREOF; NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PRDVISIONS. AUTHORIZED REPRESENTATIVE ' ©1988-2010 ACORD CORPORATION.All riahts reserved. DATE(MM/DD/YY) CERTIFICATE OF INSURANCE 09/20/2016 PRODUCER AND THE NAMED INSURED THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Transworld Building Trades and Contractors Liability Association,Inc.Inc.,A Risk CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS Retention Purchasing Group qualified under the Risk Retention Act of 1986;Federal Box 469 CERTIFICATE OF INSURANCE DOES NOT AFFIRMATIVELY OR P.O.Box 4 Law NEGATIVELY AMEND,EXTEND,OR ALTER THE COVERAGE AFFORDED Sandy,UT 84091-0469 BY THE INSURANCE POLICIES BELOW. 800-851-8364 INSURERS AFFORDING COVERAGE INSURED INSURER A: NOTICE:Coverage is being provided as part of a Master Group All Under One Roof INSURER B: Policy issued to members of the Transworld Building Trades and Contractors Liability Association,Inc. INSURER C: ,a Risk Retention'Purchasing Group'authorized under the Risk INSURER D: Retention Act of 1986:Federal Law 97-45. 30 Temple Drive Methuen, MA 01844 "LIMITS SHOWN ARE THOSE INPrime Insurance Company COVERAGES EFFECT AS OF POLICY INCEPTION" The policies of insurance listed below have been issued to the insured named above for the policy 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.Aggregate limits shown may have been reduced by paid claims. POLICY EFFECTIVE POLICY EXPIRATION - TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ $1,000,000.00 COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $ N/A Claims Made PRC2656-16090011 09/13/2016 09/13/2017 MED EXP(Any one person $ N/A Exclude Products PERSONAL ADV INJURY $ N/A %e Exclude Completed Operations GENERAL AGGREGATE $ $2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AG $ PRO- M POLICY JECT LOC Per Person $ $300,000.00 AUTO LIABILITY ANNUAL AGGREGATE $ $0.00 ANY AUTO BODILY INJURY ALL OWNED AUTOS (Per Person) $ $0.00 ❑ SCHEDULED AUTOS BODILY INJURY HIRED AUTOS (Per Accident) $ $0.00 JE1 NON-OWNEDAUTOS PROPERTY DAMAGE DRIVE AWAY (Per Accident) $ $0.00 GARAGE LIABILITY/MANUSCRIPT FORM PER PERSON SCHEDULEAUTO - $ $0'00 ❑ G.K.L.L. PER ACCIDENT $ $0.00 ❑ O.T.R.P.D. AGGREGATE $ $0.00 ❑ D.O.C. ❑ CARGO PROPERTY DAMAGE $ $0.00 ❑ ON HOOK ❑ EMPLOYEE DISHONESTY ❑ WRONGFUL REPOSSESSIO EXCESS LIABILITY EACH OCCURRENCE $ $0 OCCUR F-1AGGREGATE MADE GGREGATE $ $0 RETENTION $ $ LIMITATION OF COVERAGE FOR ADDITIONAL INSURED DESCRIPTION OF OPERATION/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISION Coverage is limited to only insured activities or operations on the Participant Member Declaration Certificate or as may be separately endorsed.Contractors-Executive Supervisors,Contracted Services-Using fully insured subcontractors. 661 CERTIFICATE HOLDER 10 1 ADDITIONAL INSURE LJ I LOSS PAYEE Village Green West SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT 200 Kingston St. FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND North Andover, MA 01845 UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Attn:Andrea Georgetti AUTHORIZED REPRESEN5*4h.— Fax Number: 9785326023 Massachusetts -uei.amnen.,or Board of Building ;RcgMiari;nc '131-c. 8:ara"n Cuniti'uitiuli surfej sol* License: CS-069120 JOHN W LANZA,-Am, 30 TEMPLE DR : ► '; s a METHUEN MA I11844' �ainm:SS I JG ir,.r 04/03/2017 I Click on the registration number to view complaint histo , 'fou ran also view arbitration and nd Guaranty Fund history. The list is current as of Wednesday, October 8, 2014, Search Results REGISTRANT RESP+a��HUE REGISTRATION EXPIRATION NAME 13+1Oi}1f DUAL HLISIBER ADDRESSEXPIRATION STATUS ALL UNDER+[ONE ROOF LANZAFAk-JE, 137057 166 A MERRIMACK ST 10/02/201s Crurrent .JOHN METHEUN, MA 01844 _... _ 02012 Commonwealth or Massachusetts. Mass.GOA D is a.registered service mark of the Commonwealth of Massachusetts,. nrnr�nie