HomeMy WebLinkAboutBuilding Permit #980-15 - 90 OLD FARM ROAD 5/11/2015TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO- Date Received
Date Issued -
IMPORTANT: Applicant must complete all items on this age
LOCATION V -0 -0 -4 -
Print
PROPERTY OWNER
Print / 100 Year Old Structure yes no
MAP NO: PARCEL: C�&?'ZONING DISTRICT: Historic District ye no
Machine Shop Villaqe yei,- no
TYPE OF IMPROVEMENT
PROPOSED USE
Ak5-exjpu1r Phone:07Y–sf/�
Residential
Non- Residential
El New Building
, One family
El Addition
El Two or more family
El Industrial
El Alteration
No. of units:
El Commercial
(,�epair, replacement
0 Assessory Bldg
11 Others:
11 Demolition
El Other
11 Septic 0 Well
El Floodplain El Wetlands
El Watershed District
El Water/Sewer
DESCRIPTION OF WORK TO BF, PERFOLZMED:
N,:n A!en2� -e--
'OF
Identification Please Type or Print Clearly)
OWNER: Name- O'sh -Srwce—v Phone:
Address: �(D 01-2) lc4em _n
I
CONTRACTOR Name:�,SbrqwkO
Ak5-exjpu1r Phone:07Y–sf/�
–11FI-11'r
Address: 1025–
6-7—
Supervisor's Construction License: /0 (100�3 / Exp. Date: QT– c2-'71— A
Home Improvement License: IZI -
Date: 03' c:P/— 14 -
AR HITECT/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 ith . s re ntractors do not have access e g un
ft e gu
_to
Signature of Agen Owner ignatu're of contracto
V
Plans Submitted Plans Waived C rtified Plot Plan 0 Stamped Plans
— I . 4 t- : j jr j
Plans Submitted 11 Plans Waived 11 Certified Plot Plan D Stamped Plans 11
TYPE OF SEWERAGE DISPOSAL
Public Sewer
Tanning[Massage/Body Art
Swimming Pools
Well
Tobacco Sales
Food Packaging/Sales D
Private (septic tank, etc.
Permanent Dumpster on Site F1
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATEAPPROVED
PLANNING & DEVELOPMENT F1 F1
COMMENTS
CONSERVATION
COMMENTS
HEALTH
COMMENTS
Reviewed on Signature
Reviewed on -Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
'Pie -ming Board Decisio n:
V
Conservation Decision:
Comments
Comments
Water & Sewer Con nection/sig nature & Date Driveway Permit
DPW Tow;! Engineer: Signature:
FIRE tEPA*RTMENT - Temp Dumpster on site ye -s
Located at 124 Main Street
Fire Departmey'itsignatuee/date
COMMENTS
LOcatea ots4 usg000 zjtreet
no
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 21 A �F and G min.$100-$l 000 fine
Nu i t5 ana UA I A — wor deDartment use
Ll Notified for pickup - Date
Doc.Building, Permit Revised 20 10
&F(74:P 7
Building Department
The fol�owing is a list of the required forms to be filled out for the appropriate permit to be obtained.
Roofivg, Siding, Interior Rehabilitation Permits
u Building Permit Application
u Workers Comp Affidavit
o Photo Copy Of H. 1. C. And/Or C. S. L. Licenses
o Copy of Contract
o Floor Plan Or Proposed Interior Work
o Engineering Affidavits for Engineered products
NOTE: 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
Li Copy Of Contract
Lj Floor/Crossection/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
NOTE: 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
L3 Photo of H.I.C. And C.S.L. Licenses
o Workers Comp Affidavit
u Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
L3 Copy of Contract
• Mass check Energy Compliance Report
• Engineering Affidavits for Engineered products
MOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
In all cas,�s if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
that the app�-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be submAted with the building application
Doc: Doc.Bui"Jing Permit Revised 2012
Location qe
No. 9,66 — / Date
Check # IT -5
TOWN OF NORTH ANDOVER
Certificate of Occupancy $-
Building/Frame Permit Fee $ --�Z"
Foundation Permit Fee $
Other Permit Fee $
TOTAL
V
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LY,
MOYNIHAN-NORTH READING LUMBER, INC.
"QUALITY BACKED BYA DESIRE TO PLEASE" -
164 Chestnut Street FEIN:04-2261995
North Reading, MA 01861 &A Contractor Reg No.:
978-864-3310 / 781-944-8500 W W Exp. Date: — /_/_
Salesperson(s):
HOMEOWNER INFORMATION
-Teosli 7XI- 6 19-3 - C;�
Name Daytime Phone
Street Address (Not P.(?, Box) Evening Phone
AA�71 Amd6kkA ojo"-
City[Town State Zip Code Mailing Address (if different from Street Address)
WORK TO BE PERFORME& AND MATERIALS TOBE USED,
Moynihan -North Reading Lumbee, Inc. agrees to perform the work set forth in Exhibit A for Homeowner -and to
use such materials in connection therewith as set forth also in Exhibit A, attached hereto and made a part
hereof.
The following schedule shall be adhered to unless circumstances arise beyond Moynihan -North Reading
Lumber, Inc.'s control: Work scheduled to begin: Expected date of. comp�etion:
May be based upon arrival of special order material
TOTAL CONTRACT PRICE AND PAYMENT SCHEDULE
Moynihan- North Reading Lumber, Inc. agr@gs to perform t ork, and furnish the material and labor set forth in
Exhibit A for the Total Contract Price of: $ -3q-&�L. 2:2 (which amount includes all finance charges).
PaymenWhall be made by Homeowner g to the following payment schedule:
$ �5_31 142 initial deposit upon signing this'Contract (the initial deposit shall not exceed the greater of
one-third (1/3) of the Total Contract Price as set forth above; OR the Total Cost of Special/Custom
Orders as set forth below)..,
$ 153 Z i �O " 7 by_L_�__or upon completion of delivery of materials
$ 6Z�� by -L -L --or upon completion of install
$ upon completion of the Contract
In order to meet the completion schedule set forth above, the following materials/equipment must be special
ordered before the Contract work begins, for a Total Cost of Special/Custom Orders of $
$ to be paid for huilding permit
$ 1.10 to be paid for MJPUAi1e_r9., 7- _70�1.
,s -4;w. to,-be-Daid4or XX-::bQC-_T f?-42,T"r-'AJ>
IGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES
�Ah 5-- Moynihan -North Reading Lumber, Inc. 'Of_11AA1__
I I Date Contractor Date
U U.) IV P, 1.� –I- tA By: Dale Fuller
Homeowner's Name (Printed) Installed Sales Coordinator
You may cancel this Contract if it has been signed by a party thereto at a place other than an address of
Contractor, which may be its main office or branch thereof, provided you notify Contractor in writing at
its main office or branch by ordinary mail posted, by telegram sent or by delivery, no later than midnight
of the third business day following the signing of this Contract. See attached notice of cancellation for
an explanation of this right.
See reverse side for additional Homeowner Terms and Conditions
1057 -NR 1/11 White - Office Yellow - Sales/Service Pink - Customer Page 1 of 5
HOMEOWNER TERMS AND CONDITIONS
The following terms and conditions are an integral part of this Contract between
Moynihan -North Reading Lumber, Inc. ("Contractor") and Homeowner.
1 All payments are due upon presentation of billing, and a late charge of one and one-half percent (11/2%) per month will be applied to past due
charges. Homeowner shall pay Contractor court costs, attorneys' and paralegals' fees, and any other expenses incurred in the collection of
past due accounts.
2. If Homeowner is borrowing money from a construction lender to perform the work, Homeowner represents that the construction loan fund is
sufficient to pay Contractor and any other contractors performing work on Homeowner's property. Homeowner irrevocably authorizes
Contractor to communicate directly with the construction lender regarding payments and loan balances, and authorizes the construction lender
to make payments directly to Contractor.
3. Homeowner shall be in default if it breaches any provision of this Contract; if any warranty or statement to Contractor in connection with this
Contract or Contractor's extension of credit to Homeowner is false or misleading when made; if any statement to a lending institution in
connection with financing for this Contract is false or misleading when made; or if Homeowner becomes insolvent, makes and assignment for
the benefit of its creditors, or files or has filed a petition for bankruptcy.
4. If the Total Contract Price includes allowances, and the cost of performing the work covered by an allowance is either greater or less than the
allowance, then the Total Contract Price shall be increased or decreased accordingly without the need for a signed Change Order. Unless
otherwise requested by Homeowner, Contractor shall use its judgment in accomplishing work covered by an allowance.
5. If Contractor agrees to do any installation work, Homeowner will procure at its expense and before the commencement of work hereunder "all
risk" insurance with construction, theft, vandalism, and mischief endorsements attached, the insurance to be in a sum at least equal to the
Total Contract Price. The insurance will name Contractor and any subcontractors as additional insured. If the project is destroyed or
damaged by accident, disaster or calamity such as firp, flood or storms, Homeowner shall pay for work done by Contractor in rebuilding of
restoring che project as extra work.
6. If Homeowner defaults under any of its obligations under this Contract, Contractor may:
Stop work until any payments are received or defaults are otherwise cured.
Terminate work upon seven (7) days written notice and recover as damages, at its option, either the reasonable value of
the work performed through termination, or the balance of the Total Contract Price plus any other damages including
reasonable attorneys' and paralegals' fees Contractor suffers as a result of the default.
7. Contractor shall be excused for delay in completion of the Contract caused by contingencies out of its control, including acts or delays of
Homeowner or other contractors, acts of God, labor trouble, acts of public agencies or inspectors or public utilities, extra work, breaches of this
Contract by Homeowner, problems obtaining materials from suppliers, or other contingencies unforeseen by Contractor. Under no
circumstances will Contractor be liable for monetary damages caused by delays as set forth above.
8. If Contractor encounters unforeseen conditions that were not reasonably anticipated by Contractor, Contractor shall call the conditions to the
attention of Homeowner and the Total Contract Price and schedule will be adjusted by the extra work necessitated thereby. No installation,
plumbing, electrical, flooring, decorating or other construction work is to be provided unless specifically set forth herein. In the event
Contractor is to perform the installation, it is understood that the price agreed upon herein does not include possible expenses incurred in
addressing hidden or unknown contingencies found at the jobsite. In the event such contingencies arise and Contractor is required to furnish
labor or materials or otherwise perform work not provided for or contemplated by Contractor, the actual cost of such additional unexpected
work plus fifteen percent (15%) thereof will be paid by Homeowner. Contingencies include but are not limited to: inability to reuse existing
water, vent and water pipes, air shafts, ducts, grilles, louvers and registers; the relocation of concealed pipes, riser, wiring or conduits, the
presence of which cannot be determined until the work has started; or imperfections, rotting or decay in the structure or parts thereof
necessitating replacement.
9. Homeowner shall be responsible for the coordination of any work performed by itself or other contractors, and shall be responsible to have the
work site ready for contractor to proceed. If installation is involved, with its work through the completion date. Any work performed by
Homeowner or other contractors shall not hinder Contractor's schedule. Contractor does not warrant any work performed by Homeowner or
other contractors not working for Contractor as its subcontractor.
10. Homeowner understands that some products described in this Contract may be specially designed and custom built, and as such Contractor
will take immediate steps upon execution of this Contract to design, order and construct those items as set forth herein. Except as provided
on page one of this Contract, inis Contract is not subject to cancellatiol I by Homeowner.
it. The delivery date, when given, shall be deemed approximate and performance is subject to delays caused by strikes, fires, weather
conditions, acts of God or other reasons not under the control of Contractor, as well as the availability of the product at the time of delivery.
Once the delivery date is determined, Homeowner agrees to accept delivery of the product(s) within one (1) week.
12. The risk of loss, damage or destruction, shall be upon Homeowner upon the delivery and receipt of the product. If Homeowner is not ready to
accept the product, the delivery payment will by made as agreed upon and an extra storage fee of Fifty Dollars ($50) per week will be
charged.
13. Title to the items sold pursuant to this Contract shall not pass to Homeowner until the full price as set forth in this Contract is paid to
Contractor.
14. Contractor agrees that it will perform this Contract in conformity with customary industry practices. Homeowner agrees that any claim for
adjustment shall not be reason or cause for failure to make payment of the purchase price in full.
15. This Contract sets forth the entire understanding of the parties. Any and all prior contracts, agreements, warranties or representations made
by either party are superseded by this Contract. NOTWITHSTANDING PARAGRAPH 4 NO CHANGES SHALL BE MADE TO THE WORK
DESCRIBED OR TO THE CONTRACT PRICE UNLESS AND UNTIL HOMEOWNER AND CONTRACTOR SIGN A WRITTEN CHANGE
1057 -NR 1/11 White - Off ice Yellow - Sales/Service Pink - Customer Page 2 of 5
The Commonwealth oj'.Hassuchusetts
Department of IntlivOrialAccitlents
0 'ice o
,�; J'Investiqations
600 Washington Street
Boston, YVIA 02111
WIVIV. HU111118. 0101,1(fia
Workers' Conipensation Insuranc.- Afffidavit:
Applicant Information Please Print Leuiblv
Name (Business/Or,-,anization&dividual)'. Shawn Arsenault & Eric Arsenault
d/b/a Arsenault Brothers Construction
Address: 105 Hamilton Street, Ist Floor
Clt,//State/Z'11X Leominster. MA OL453 Phone 4- 978-514-4848
Nre you an employer? Check the appropriate box:
4. [-1 fain a general contractor and I
[X_1 I am a employer witli 3 t�
employees (fWl and/or part-time.).
2. El I am a sole proprietor or partner-
ship and have no empjoyees
working for me in an�v capaci . ty.
[No workers' comp. insurance
required.]
3.0 1 am a homeowner doing all work
myself. [No workers' comp,
insurance required.] Ti
have hired the sub -contractors
listed on the attached sheet.
These sub -contractors have
employees and have workers^
comp. insurance.i
5. F-1 We are a corporation and its
officers have exercised their
right of exemption per MGL
c. 152, § 1(4), and we have no
employees. [No workers'
cornp. insurance required.]
Type of project (required):
6. New construction
7. Remodeling
S. El Pernolition
9. F� 9w1ding addition
10. El Electrical repairs or additions
11. 0 Plumbing repairs or addidons
12.F� Roof repairs
13.7 Other
*!�,nv applicant that checks box --'I must also Fill out ihe section below showing their workers' compensation policy Inforinaiion.
Homeowners who submit this affidavit indicating thev are doing ail work and then lure outside contractors must submit a new affidavit indicating such.
-Contractors that check this box Must attached an -additional sheet showing the name ofthe sub -contractors and state -whether or not those zmfities iiave
2nioiovees. Ifilic �ub_,ontrIC'MS haVC' ��IIIDII)Vet�S� OIC', MUSI theii conit). Dolic,, ounibe-.
1 aman enzDlo.i.,er ihat is jirmi(lint; iI1SUrUI1Ccj I 01-71yemplo-Vecs, Bellow "S till! p0iic", Ina . 1 . oi . ) te
illy-ormation.
Insurance Company Name
Travelers
Policy 4 or Self -ins. Lic. #:IHUB6B90875713 Expiration Date: 04/02/16
Job Site Address:
City/State/zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required wider Section 25A of MGL c. 152 can lead to the imposition of criniinal penalties of 1,1
fine up to $1,500.00 and/or one -\Teff imprisonment, as well as civil penalties in the form of a STOP WORX ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be fonvarded to the Office of
Investigations of die DIA for insurance coverage verification.
I do herebi; certify ander thepains andpenafties ofpeijury that the information provided aboi,e is true and correct.
Signiature:g-,_t� Date: 67.P- — /—f-
978-514-4848
Official use only. Do not write in. this area, to be completed by city or to)vn official.
Citv or Town: Permit[License 4
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Elecuical Inspector S. Plumbing Inspector
6. Other
Contact Pei -son: Phone -4:
ARSEN-2 OP ID: NI3
1411c"R"'
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDIDN"10
1 0410212016
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(ios) 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 ondorsement(s).
PRODUCER
Anderson, Bagley & Mayo
Insurance Agency, Inc.
44 Main Street, P. 0. Box 360
Leominster, MA 01453
CONTACT
NAME:
PHONE FAX
(A/C, No, Ext): (AIC' No):
E-MAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
Richard M. Bagley
INSURER A: Charter Oak Fire Ins Company 26615
INSURED Shawn Arsenault &
Eric Arsenault
Arsenault Brothers Constructio
INSURER 13: Travelers Indemnity of America 25666
INSURER C: Travelers
INSURER D:
105 Hamilton St Ist FL
Leominster, MA 01463
INSURER E:
INSURER F:
16805583M546ACJ14
COVERAGES CERTIFICATE NUMBER: RFVI-RlnN NI]MRFP-
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 CONDIT40NS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDLSUBR
POLICYNUMBER
POLICY EFF
(MMIDO/YYYY)
POLICY EXP
(MWDDNYYY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE i$ 1,000,00(
B
7X COMMERCIAL GENERAL LIABILITY
16805583M546ACJ14
08101/2014
08101/2015
PREMISES (Ea occurr) f 300,00(
ence) $
CLAIMS -MADE FXI OCCUR
MED EXP (Any one person) $ 5,00(
PERSONAL & ADV INJURY $ 1,000,00(
GENERAL AGGREGATE $ 2'UUU'00(
�GE R ATE LIMIT APPLIES PER:
PRODUCTS - COMP/CP AGG $ 2,000,000
POLICY JECT
F—] PRO- LOC
$
AUTOMOBILE LIABILITY
COM BINED SINGLE LIMIT
500,000
(Ea acc4dent) S
A
ANY AUTO
BA -8672A678 -14 -SEL
08/26/2014
0812612016 person) S
ALL OWNED SCHE ULED
AUTOS FX AUTOS
BODILY INJURY (Per accident) $
NON -OWNED
HIRED AUTOS AUTOS
PROPERTY DAMAGE
(PER ACCIDENT)
UMBRELLA LIAB
HCLAIMS-MADEJ
OCCUR
EACH OCCURRENCE $
H
EXCESS LIAB
AGGREGATE $
1 1
DED I I RETENTION$
$
WORKERS COMPENSATION
--- 770TH
X 11yC STATU.
DRY LIMITS I I ER
AND EMPLOYERS! LIABILITY YIN
E.L. EACH ACCIDENT $ 100,000
C
ANY PROPRIETOR/PARTNER/EXECUTIVE
IHUB6B90875715
04/0212015
0410212016
OFFICERIMEMBER EXCLUDED? r7
NIA
E.L. DISEASE - EA EMPLOYEd $ 100,000
(Mandatory in NH)
if , d scribe under
DIeSCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT 1 $ 500,000
DESCRIPTION OF OPERA71ONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
Fax 978-664-0872
Moynihan Lumber Co.
164 Chestnut Street
North Reading, MA 01864
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
Richard M. Bagley
@ 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
LUMBER
BEVERLY
NORTH READING
PLAISTOW
82 River Street
164 Chestnut Street
12 Old Road
P.O� Box 1160
P.O. Box 509
P.O. Box 128
Ncdh Reading, MA 01864-0128
Plaistow, NH 03865
Beverly, MA 01915
(978) 927-0032
(978) 664-3310 - (781) 944-8500
(603) 382-1636
FAX: (978) 927-8201
FAX: (978) 664-0872
FAX: (603) 382-1935
Subcontractor Workers' Compensation Waiver
--Shawn Arsenault_, hereby acknowledge that 1, as an
independent contractor., have been asked by Moynihan Lumber
Company to provide it with a certificate of Worker's Compensation
Insurance coverage- for myself. Based on the exemption provided by
the Worker's Compensation Insurance coverage for myself because I
am a sole proprietor without employees. Therefore, I hold Moynihan
Lumber Company and it's related organizations and the Arcadia -
Insurance and or Self Insured Lumber Business Association, Inc.
totally harmless for any injuries or cost of injuries incurred by myself
because I have voluntarily chosen to exclude myself from coverage
by engaging the exemption provided under the Worker's
Compensation Laws.
I have taken this option of my own free will.
4C gnaturo,
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Witness
Date:
"QUALITY I BACKED BY A DESIRE TO PLEASE"
Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5 170
15 o ston, Ivias s acn.us e -as 0 2- 1 16
Home Improvement Contractor Registration
Registration: 136860
Type: Private Corporation
Expiration: 9/6/2016 Tr# 255814
MOYNIHAN NORTH READING LUM'BEfR.-."I,N
DALE FULLER
PO BOX 128
N. READING, MA 01864
Update Address aDd return card. Mark reason for chan.ffe.
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CSFA-106031
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SHAWN ARSENN!JLT
105 HAMILTON STREET
Leominster MA (A453
08/24/2016