HomeMy WebLinkAboutBuilding Permit #543-2017 - 456 SALEM STREET 11/18/2016L
I
?gyp ii BUILDING PERMIT
Permit No#: -i,! -i]
Date Issued: I t
LOCATION -1
P`R:QF,)RRTY
MA
TOWN OF NORTH ANDOVER
APPLICATION
N 0VE-
APPLICATION FOR PLAN EXAMINATION
Date Received
VORTANT: Applicant must complete all items on this
0
0
E D
no,
ye& I no
TYPE OF IMPROVEMENT
PROPOSED USE
Residen'al
Non- Residential
❑ New Building
L;.ne family
0 Addition
El Two or more family
0 Industrial
0 Alteration
No. of units:
11 Commercial
0 Repair, replacement
El Assessory Bldg
11 Others:
0 Demolition
[I Other
0 Septi DVVelfi
0. FlbGql'p[ 66rid's,
S RIPTIT OF WOKK I U titVtK1-UK1V1r-L).
P - '#1:0 : ";'.01A�l -
i �n)>) Ir
,Jdentification - Please ype or Print Clearly
OWNER: Name: Phone: 97k—
Address: V�
Contractor , -z:2e--- - /�
Marne: 0 7
jRhoneZ �
$L,jp rvisof's: Con -s
,e, J.-huctib hm'L _Exp ... Date,
-ensei
Horne Improvement: -Z'Q - Date,;
License Exp.
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE., BULDING PERT112.00 PEI? $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 tqfhe guaranjyfund
.4 .
Signature _oT tygtpvLq Y L, q -Iu I I= 1J —I,- u I I I Iu-1 I
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
CONSERVATION
COMMENTS
r
SEALTH
COMMENTS
Reviewed On
Signature
Reviewed on Signature
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Commen
Conservation Decision: Comments
Water & Sewer Connection/Signature & Date Driveway Permit
DPW Town Engineer: Signature:
Locate 38 sgood Street
�EPARTME�N Tempi®wmpsterkora�sti= yes.
at' 124 M"`
t
u --—
u �-., ai��S_treet
�partrnen v
t signatture/d`' `�
ENTS
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
NOTES and DATA — (For department use)
❑ Notified for pickup Call Email
Date Time Contact Name
Doc.Building Pennit 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
o Building Permit Application
u Workers Comp Affidavit
o Photo Copy Of H.I.C. And/Or C.S.L. Licenses
a Copy of Contract
o Floor Plan Or Proposed Interior Work
a Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
o Building Permit Application
o Certified Surveyed Plot Plan
o Workers Comp Affidavit
o Photo Copy of H.I.C. And C.S.L. Licenses
o Copy Of Contract
o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Mass check Energy Compliance Report (If Applicable)
u Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
New Construction (Single and Two Family)
o Building Permit. Application
o Certified Proposed Plot Plan
a Photo of H.I.C. And C.S.L. Licenses
o Workers Comp Affidavit
o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Copy of Contract
a Mass check Energy Compliance Report
o Engineering Affidavits for Engineered products
NOTE: 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
No. 9/6 —e% /'
Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
I
Ij(A
Check # f �1 t
31219
E
•
0
Q
W
x
LL
p
m
O
N
\U
O
LCL
EJ
N
CL
(A
W
IZ
z
Z
D
co
"O
O
LL
L
d'
C
E
U
_
ro
I.l
o
a
Ln
Z
zU
m
2
f1
t
j
K
_
co
LL
o
a
H
Z
W
J
W
L
�
K
U
N
_
ra
LL
V
a
H
Q
L
. j
d'
_
ro
LL
z
LLI
2
Q
W
f'
W
LL
i
CO
z
�+
Ln
D
N
Y
O
(n
C-.
w
r-1
ca �
00
O Q
CL
C Q
C �
t =
Cc M
J -0
O d
Z v
d
N
r—
O C
Cc O
V
•
ai Q
S
G O
-=
L
�'
o
a, C
4)
w 0
7cc
O =
O
_
it
y
N
a
N
O O
�r
_
O
LCA
O
��•
O
c
>
y
E o
o
U)
oo
to
=a
CL a)
•�
cc 0 CAS
`o
C"
ti
c c =
o
Q
L
L cc -a•O
_
N 2 m
Qi
C
m
W
LL
uj
O
.y
'a — O O
(D N C
.Q
.� O
w
O
=— . Z.O
LU
C�
0 � = o
0-0 +�+
�-
N
Q
d 9 CO)J
O:�
N
t
=
O
H
. Q. 0 C-)
>
C-.
w
r-1
ca �
00
O Q
CL
C Q
C �
t =
Cc M
J -0
O d
Z v
d
N
r—
CS # 022680
HIC# 103358
Proposal Sub Itted To:
i 46_
Address
We hereby
I Fax #
-n--W.—N nom. -" —N—f— f—
— Page # of pages
978-688-6737
A. J. Walsh & Sons or
159A Waverly Road 1-978-912-2853
North Andover, MA 01845
Job Name
I,/
Job location
J
Date
Architect
Job #
Date of Plans
We propose hereby to furnish material and labor — complete in accordance with the above specifications for the sum of:
6
$+ Dollars
with payments to be made as follows:
Any alteration or deviation from above specificafions involving extra costs will be Respectfully
executed anly'upon written order, and will become an extra charge over and submitted
above the esfimate. AN agreements confingent upon strims, acddents, or delays
beyond our cohtrol. Note — this proposal may be withdrawn by us if not accepted within days.
CCC tBttCP IDf �"al
The above prices, spedfhcations and conditions are sat factoryand are Signath Te l_r�/%!
hereby accepted. You are authorized to do the work as specified.
Payments will be made as outlined above. ; r
Date of Acceptance _ Signature
MASSACHUSETTS HOME IMPROVEMENT CONTRACT
This fortn satisfies -:all basic requirements of the state's Home Improvement Contractor law (MCL chapter 142A), but does not include standard
language to protect homeowners. Seek legal advice if necessary." Atypersorph�ng home tnprovemetus should I i bbfain a copy of "a
Massachutcttsiconsumerguide to home4inprovement" before agreeing to any work on yourreddened. You may obtaina free copy by calling'the '
Office of Consumer Affitirs and Business:Regulation's Consumer Information Hotline at 617-973' 8787 or 148&283475.7. .
Homeowner Information Contractor Information
Pant ame
state
The Contractor agrees to do the following work for the Homeo ner,
la
RequiredPermits - The -following building permits are rcgirired Proposed Start and Completion Schedule - The fbilowiiig schedule will
and will bcsectued:by the contractor as the'homeowuer s agent; be adhered to u'nl s circumstances beyond:the contractor's control arise
(Owners who;secure their own permits will be
excluded: from the Guaranty Fnnd .provisions of tc i coiifractorwill begin contracted work.
MGL chapter 142A.)
Ate when contracted .work will be substandally.complete& .
Total Contract Price and Payment Schedule ,
The Contractor. agrees to perform the'wurk, furnish'the material and labor specified above for the total sum of ��/41 L/ ,� M
Payments will be made according to the following schedule:
$ upon,signing contract (nottb exceed l/3 of the total.contract price. qr the cost;of special order items, whichever is:greater)
$ ------ by
or upon completion of
by / or upon completion of
upon completion of the contract (Law forbids demanding full payment until .contract is completed to both parry's. satisfaction)
Thefollowingwing ntaterial/equipmeatmttst be special $ d for
ordered before the: contracted'woA begins in order S to be paid for _
to meet the.. completion schedule.(**)
NOTES: (h Including all finance charges (••) Law requires that any deposit or down -payment required by the contractor before work begin may
not exceed the greater of (a) one-third of the total contract price or (b) the actual con of any special or custom made material
which must be special ordered in advance to meet the completion schedule
tee„ curd r es of e ohedtotheo e
Subcontractors The contractor agrees to be solely responsible for cdrnpletion of the work deaenbed regardless of the actions of'any tliiid
party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors fol
materials and labor under ihic aereement
Contract Acceptance Upon signin& this document becomes abindin&contract under.law. Unless otherwise noted within this document, the
contract shall not imply that any lien or other security interest as been placed on the residence. Review the following cautions and notices
carefully before signing this contract
• Don't be pressured into sighing the contract Take time to read and fully' understand it ' Ask'question's if something is unclear.
• Make sure the contrae_ n_
- - The hiw requires most home improvement contractors and .
subcontractors to be registered with the Director ofHome Improvement contractor Registration. You may.inquim about.conuactor .
registration by writing to the Director at One Ashburton Place, Room 1301, Boston, MA 02108 or.by _calling 617-727.3200 or .
1-800.223-0933. ,
• Does the contractor have insurance? Check to see that your contractor is properly insurrd
• Know your rights and responsibilities. Read the Important Information on the reverse side of this foiai'aad get a copy of the Consumer
Guide to the Home Improvement Contractor Law:
You amy cancel this agreement if it has been signed step ce otherthan die-coutrectOes normal placeof business, provided you notify die
m
contractor in writing at his/her main office or branch office by ordinary mail posted, by telegrasent or by delivery, not later than midnight of the.
third business day following the signing of this agreement . See the -attached notice of cancellation form for an explanation of.this right
DO NOT SIGN TRIC rONTRArT TV'rTX na A" 111 . t r — I ,._ . ___
o identical copier ofthe• amuse be teed nodi-- — —.1 "AIJI IZ%1 DrAl.'I.D t:1
eooq• fid. One eopyshouid.ao to the hommwair. 7be ocher eopY W be kept by the ooab am
i
w
Homeowner's sane Con 's Signature
�/ /�
DauDate
Contractor Arbitrdtion
The Home Improvement•CotttractorLawprovtdes:homeowners with: thenglivto4nitiate an arbitration action (as an
alteriiattve to court act<on) if.they;have s,dispitte.*ith.e'contractor.. The.samerightis not'automatically afforded to a.
contractor, however •..The contractor would have.Ap resolve any dispute helshe.has.with a homeowner in courtunless' ....
both parties agree to, the optional tliuse provided below:. This clause would.give the contractor the same. right to
arbitration as is afforded to the homeowner.by the Home Improvement Contractor Law. .
The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute
concerning this contract, the contractor may submit the dispute to a private arbitration firm which has:.been. approved by,
the Secretary of the Executive Office of Consumer Affairs and Business Regulation and:the consumer: shall be required
submit to such arbi tion provided InMassachusetts General Laws, cha 2A
Homeo s Signature,,.�. _ ., Contractor's Signature t
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
Homeowner's Rights �...
A homeowner's rights undihhoHome'hnprovemeitt Contractor Law (MGL chapter 142A) and other consumer %.
protection laws (Le. MGL chapter 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 Fund provisions of
the Home Improvement Contractor Law. The•contractor is
responsible -for completing the work as described, in a
timely and;workmanlike.manne.r. 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. An 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 consumer/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 or marked as void, deleted, or not applicable. One original signed copy of the contract with attachments is to
be given to the owner and the other keptby, the contractor. Any modification. to the griginal*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 three day recission period has expired.
Accelerated Payments
A contractor may not demand payments inadvance.of the dates specified on the payment schedule in cases where the
homeowner deems him/herself to be financially insecure. 'However, in instances where a. contractor deems him/herself
to be financially insecure, the contractor may requirethitthe. balance of funds not yet due be placed in'a joint escrow
account as a prerequisite to. continuing the contracted work. Withdrawal of funds 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
ghts,
consumer rior if.you wish to. obtain a.iTee:copy of "A Consumer. Guide to the Home.Improvement Contractor
Law," contact
Cgnsumer Information Hotline
Office of Consumer Affairs and Business Regulation
10 Park Plaza, Room 5170, Boston, MA 02116
(617) 973-8787 or 1-(888) 2833757
If you want to verify the.:registration 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
Bureau of Building Regulations and Standards
One Ashburton Place, Room 1301, Boston, MA 02108
(617)727-3200 ort -800-223-0933
For assistance with informal mediation of ffii putes'or to register formal complaints against a business, call
'Constitzieecomplaint'Section
Office of the Attorney General
(617)727-8400
AND/OR
Better Business Bureau
(508)652-4800
(508)755-2548
(413)734-3114
The Colnlnonwealth of 1V11ssachuselts
Department of Industrial Accidents
r
Office of hnvestigafions
4 k �
600 i'✓flshllleton StrL'et
Boston, 11A 02111
-
Iviviv.mass.govIdia
Workers' Compensation Insurance Affidavit: 13uilders/Contractors/Electricians/Plumbers
Applicant Information
Please Print Legibly
.\able(BLisiness%Oreanizati�on!IndiNidual):
Address: ���f'✓li�e�---
—
City/State/Zip: A16 oq&o
dC f� Phone'':
� 73
Arc an employer-? Check the appropriate
1.
box:
El 1
Type of project (required):
[ am a employer with
am a general contractor and I
employees (full and/or part-time).*
have hired the sub -contractors.
6. ❑New construction
❑ I am a sole proprietor or partner
listed on the attached sheet.
7. ❑ Remodelin
shipand have no employees
}
These sub -contractors have
S. F-1 Demolition
Nrorking for me in any capacity.
employees and have workers'
9. ❑ Building
[\o workers' comp. insurance
comp. insurance.
addition
required.]
5. ❑ We are a corporation and its
101:1 Electrical repairs or additions
3. ❑ I am a homeo���ner doing all wort:
officers have exercised their
1 1.❑ Plumbing repairs or additions
y
myself. [No workers' comp.
right of exemption per MGL
1 �. oo repairs
insurance required.] '
c. 152. § 1 d
� O. and we have no
-
employees. [No workers'
13.❑ Other
comp. insurance required.]
'AnN applicant that checks box =1 must also fill out the section belo\� showing their \corkers compensation policy information.
}-I0me0AA'71erS Vcho submit this affidavit indicating theAare doing all xcork and then hire outside contractor must Submit a ne\c affida\ it indicating such.
Contractors that check this box must attached an additional sheet sho%ying the name of the sub -contractor and state whether or not those entities have
emplo\ees. Ifthe sub -contractors have emplo.ees" the\ must provide their workers comp. polis} number.
I ant rrn emplover that is providitta workers' compensation insurancefor rnI• employees. Below is the polict,nnd joh'site
infol-mation.
Insurance Company Name:
}'olicy ?= or Self -ins. Lic.��(l �� Expiration Date: %A
Job Site Address: {/ Citi/State!Zip:_� �i22t�
Attach a copy of the workers' compensation policy declaration page (shoss ing the policy number and expiration date).
f=ailure to secure coverage as required under Section 25A of \9GL c. 152 can lead to the imposition of criminal penalties of a
Fine up to S 1500.00 and/or one-vear imprisonment. as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to S250.00 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.
/ do herehr certil�_Unrler the pains and penalties of perjtn.y that the infoI'll lotion provkled above is true and correcl
P
Official a.se only. Ido not write in this area, to he cornpletecl ley cihv or town official
Citv 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 #:
A IIA/AI Q&d_A4
rl:tld111111
nn.ienwr_ee rCGTICIrATF M"RAral=ta• RFVISInN N11MRFR!
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
LTRN
CERTIFICATE OF LIABILITY INSURANCE
FDATE (MM/DD/YYYY)
11/17/2016
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 have ADDITIONAL INSURED provisions or 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
Durso & Jankowski Insurance Agency
11 Saunders Street
North Andover, MA 01845
CONTACT
NAME:
PHONE
(A/c, No, Ext): (378) 688-7000 (ac, No):(978) 688-7001
ADDORIESS:
INSURERS AFFORDING COVERAGE NAIC #
EACH OCCURRENCE $
INSURERA:A.I.M. Mutual Ins Company
MED EXP (Any one person) $
INSURED
INSURER B:
INSURER C :
AJ Walsh & Sons
INSURER D:
169A Waverly Street
North Andover, MA 01845
INSURER E
INSURER F :
nn.ienwr_ee rCGTICIrATF M"RAral=ta• RFVISInN N11MRFR!
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
LTRN
TYPE OF INSURANCE
ADDL
SUBR
D
POLICY NUMBER
POLICY EFF
M/ D
POLICY EXP
M D
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE F OCCUR
EACH OCCURRENCE $
PREMISES (Ea occurrence DAMAGE TO RENTED
$
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENT AGGREGATE LIMIT APPLIES PER:
POLICY D PRJECT O F --]LOC
OTHER:
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
$
AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
O
AUTOS ONLY AUUTNOS ONLY
OND
Ea acccidentSINGLE LIMIT $
BODILY INJURY (Per person) $
BODILY INJURY Per accident $
(PROPERTY DAMAGE
Per accident $
UMBRELLA LIAR
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE $
.
AGGREGATE $
DED I I RETENTION $
$
A
AND EMPLOYECOMPENSATION
S' LIABILITYSTATUTE
Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
WFICER/M�MBEREXCLUDED?
andatory m NH)
IF yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
AWC40070146482016A
11/14/2016
11/14/2017
OERH
100,000
E.L. EACH ACCIDENT $
100�QQ0
E.L. DISEASE - EA EMPLOYEE $
500,000
E.L. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Town of North Andover
1600 Osgood Street suite 2035
North Andover, MA 01845
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016103) U 1988-Zo15 AL:UKLJ UUKI-UKA I IUN. Au rlgnrs reserves.
The ACORD name and logo are registered marks of ACORD
Massachusetts Department of Public Safety
Board of Building Regulations and Standards
License: CS -022680
Construction Supervisor
ARTHUR J WALSH JR
159A WAVERLY RD
N ANDOVER MA 01845
zzx
Commissioner
r�t
Expiration:
nainoi-3n,o
« , Office of Consumer Affairs & Business Regulation
�
'�' rn
HOME IMPROVEMENT CONTRACTOR
1 � NI Registration 103358 Type:
1
Expiration:.° 7/7/2018 Private Corporation
r'
A. J. WALSH 8 SONS INC
Arthur Walsh
55 Pleasant St
N Andover, MA 01845
Undersecretary