HomeMy WebLinkAboutBuilding Permit # 11/19/2015 OOR
BUILDING PERMIT
TOWN ONORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
m
°pnreo hP� 4 x4.(5
��SACHUy�4 `�
Date Issued:
IMPORTANT: A licant must com Tete all items on this a e
TYPE OF IMPROVEMENT PROPOSED USE
Re 'dential Non- Residential
❑ New Building One family
❑ Addition ❑ Two or more family ❑ Industrial
❑ Iteration No. of units: ❑ Commercial
Repair, replacement ❑Assessory Bldg Others:
11Demolition [I Other
REPLACEMENT OF 14 WINDOWS-NO STRUCTURAL CHANGES
Identification Please Type or Print Clearly)
OWNER: Name: CAROL ZAMPROGNA Phone:978-880-1211
Address: 46 RUSSETT LANE NORTH ANDOVER, MA 01845
ARCHITECT/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.
23,372.00 �.
Total Project Cost: $ FEE: $
Receipt No.: "
Check No.: b p
do not have access to the uaranty fund
red contractors g
NOTE: Persons contracting wit
unre 'ste
F ®RTS
own uf Andover
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c
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T � ..� y
C, h ver, ass, v!
cocMic641WICK �1
AERATE O PPP
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BOARD OF HEALTH
tjERM T T L nor
Food/Kitchen
Septic System
THIS CERTIFIES THAT BUILDING INSPECTOR
................... . ..... A....... ...... .. .. L
.......................
. .. ..... .. .
has permission to erect . ... buildings on . !, .............. Foundation
` Rough
to be occupied as .... ... ....��... .. ... .. �.6.W.*............................................ Chimney
provided that the person acce tithis 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
IT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTI S Rough
Service
................ ....... ... ...................................... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required t® 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.
A Home Improvemt Contractor�
Renewal Ar);4, , License#1170810(Expi es 12/23/2015)
hyAndersen. Renewal by Andersen Corporation Federal Tax ID*11-19184131
Wlx OOW REPLACEMENT -.-k
30 Forbes Rd, Northborough,MA 01532
(508)351-2200 Fax(508)-986.7072
CUSTOMER WINDOW AND DOOR REMODELING AGREEMENT
Buyer(s)Name Date:
CAROL ZAMPROGNA - TRAVIS HOLLAND OCTOBER 28, 20115
Buyer(s)Street Address City State Zip Code
46 RUSSETT LANE NORTH ANDOVER MA 1 011845
Email Address Home Telephone Number Work/Cell Telephone Number
TRAV 1 SOTRAV ISHOLLAND.COM 97s-a86-1211 978-486-40148
Buyer(s)hereby jointly and severally agrees to purchase the goods and/or services of Renewal by Andersen Corporation("Contractor"),in accordance with
the terms and conditions described on the front and the reverse of this agreement and on the attached specification sheet(s)(collectively,this"Agreement").
Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement.
Est,Start Date Method of Payment
Total Job Amount $ 23,372 aunt Financed S23,372
Deposit Received(33%)$ 0.00 Depusit at S�grnq S 11,686.00 Check/Cash
10-12weeks
Balance Start of Job(33%)u 0.00 Check b
Balance on Substantial At substaratW Est.Install Time Credit Card
Completion of Job(33%) 0.00 Conneta hon S 11,686.00
2-3 days If credit card is selected,please
No final paymeN sinal be demanded until ag parties are satusCed see Credit Card Payment form
Buyer(s)agrees and understands that this Agreement constitutes the entire understanding between the parties,and that there are no verbal understandings
changing or modifying any of the terms of this Agreement. No alteration to or deviation from this Agreement will be valid without the signed,written consent
:of both Buyer(s)and Contractor. Buyer(s)hereby acknowledges that Buyer(s)1)has read this Agreement,understands the terms of this Agreement,and has
received a completed,signed and dated copy of this Agreement,Including the two attached Notices of Cancellation,on the date first written above and 2)was
orally informed of Buyer's right to cancel this Agreement. 00 NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES.
Renewal by Andersen Corporation Buyer(s) Buyer(s)
Signature of Consultant -4Si ature Signature
x WILL SALEM CAROL ZAMPROGNA TRAVIS HOLLAND
Printed Name of Consultant Printed Name Printed Narne
YOU,THE BUYER(S),MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.
SEE THE ATTACHED NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT. '...
---------------------------------------------------------------------------
NOTICE OF CANCELLATION NOTICE OF CANCELLATION
Date of Transaction BrDJPNfpS You may cancel this I slate of Tranaacttaa W12311."r You may cancel this
transaction,without any penalty or obligation,widain three business days from the I transaction,without any Penalty or obligation,within three business days tram the
above date.If you cancel,any property traded in,any payments made by you under above date.It you cancel,any property traded in,any payments made by yon under
the Contract of Sale.,and any negotiable instrument executed by you will be I the Contract of Sale,and any negotiable Instrument executed by you wi8 be
returned within lb days following receipt by the Contractor("SeUer")of your I returned within 10 days following receipt by the Contractor("Seller`") of your
Cancellation notice,and any security Interest arlsing nut of dee transaction will be 1 cancellation moil",and any security Interest arising out of the transaction will he
'...Canceled. If you cancel,you most make available to the Seller at your residence,In I canceled, If you cancel,you must make available to the Seller at your residence,in
substantially as good condition as when received,any goods delivered to you under I substantially"good condition as when received,any goods delivered to you under
this Contract or Sale;or you may,if you wish,comply,with the instructions of the 1 this Contract or Sale;or you may,if you wish,comply with the lostructions of the
"Seller regarding the return shipment of the goods at the Seller's expense and risk. I Seller regarding the return shipment of the goods at dee Seller's expense and risk.
If you do make the goods available to the Seller and the Seller does not pick them up I If you do stake the goods available to the Seller and the Seller does not pick thein up
within 20 days of the date of your Notice of Cancellation,you may retain or dispose I within 20 days of the date of your Notice ar CanceHation,you may retain or dispose '
or the goods without any further obligation. if you rail to make the goods available I of the goods without any further obligation. If you fail to make the goods available
to the Seller,or H you ague to return the goods to the Seller and fail to do so,then I to the Saber,or If you agree to return the goods to the seller and fail to do so,Wen
you remain liable for performance of all obligations under the Contract. To cancel � you remain liable ror performance of all obligations under the Contract.To cancel
this transaction,mall or deBver a signed and dated copy of this cancellation notice I this transaction,mail or deliver a signed and dated copy of this cancellation notice '.......
'...,or any other written notice,or send a telegrams to Coutractort Renewal by Andersen,I or any other written notice,or send a telegram to Contractor, Renewal by Andersen, ''.........
30 Forbes Rd. Northborough,MA01532. I 30 Forbes ltd.Northborough,MA 01532.
1 HEREBY CANCEL THIS TRANSACTION. I 1 HEREBY CANCEL THIS TRANSACTION.
1
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Renewal Renewal bV Andersen Corporation MA Home Improvement Contractor
byAndersen.CrAlm 30 Forbes rd Northborough,MA 01532 Liconse#170810 (Expires 12123/2015)
WINDOW REPtACCIVIENT (508)351.2200 Fax:(508)-986-7072 Federal ID#41-1918413
Window Specification Sheet
Datc ofAgi-ccilit,10
CAROL ZAMPROGNA TRAVIS HOLLAND WED, OCT 28, 2015
flit,buyer's)listed alm\v ju-rI-hyJtIiIIlI}
lit ill'rverally agree ill purvilase lilt-gluldsalld/ol,sett/ict-s listed below,in accortlanct,%%ith lilt,plices and terills,(Icst-lilwd
�
oll flu-Spt-cificatioll Sheet acrd thefitull and(ha reverse of tilt-act-ollipiliqilig CCSTONI WINDOW AM)DOOR REN10I)FILING AGRI-A'All"Xi"4)1*\S,Ili(11
the Specification Sheet is part.
WINDOW&DOOR DETAILS
Apit Apo, Apt. ExtoriorAntoor Col I lardwa'a Hwdwiyo Lov&41 Grato Ge'do Close
Room 41,
" wot ul. Window/Door St 1e Detail caws Extllat ColorStyle Screens Smansuri Grilles Sash 1/3 Sash 2 Lifts Options
Lluin 100 :t5 .55 90 Do uare equal full frame Ext.Wrap VVH/WH White Standard FTS Low-E4 Carl 4/2 4/2 No BoL
Linn II)l .-)(1 105 PW full frame —it--W—rap—WH/WH ..... ..... None Low-r4 N.- .. ...=_ No 'temper
Living 102 35 55 90 08 square equal full frame Ext.Wrap WHIWH White Standard FTS LowrEl Can 4t2 4/2 No 3ot.Tempi
.................
on
Dining 103 :10 500
0 D8 q rail equal Insert sloped sill L-Trim NHiWHI White Standard, FTS I Low E4 can 3/2 3/2 No No
pinin 101 :it) '-)1) CDinsert 80 DB sq rail equal Insert slop!�sill L-Trim NH/WH White Standard FTS L.w,C4 can 3/2 3/2 No No
2Lnf�n ILI 31) 50 80 DB s rail a ual insert sloped sill L-TrIm NHIWH White Standard FTS Low,114 GGG 3/2 3/2 No No
Kitchen 106 It) 40 80
—T--Tri—M NH1WH—W1—R—. —Standard—FTS —LowE4 None No No
Bath 1 107 30 50 80 GW full frame lafo L-Trim NHIWH.. White Standard FTS Low E4 None No No
80
Laundry _IL_�L OW full frame lafo L-Trim NHWH White Standard FTS Low"E,l Norio No Na
Family 109 30 ,)1) 80 DB sq rail equal Insert sloped sill L-Trim NFVWH White IStandard FTS I Low,E4 I one 322 312 No No
Family I to :to 0 L-Trim NH/WH White IStandard FTS I Low.E4 I Gua 3/2 3/2 No No
Family I I IT30 50 80 DS square equal full frame Ext.Wrap NKlWH White Standard FTS Low,E41 Gso 4/2 4/2 No No
Fn!y_ 112 1 30 1)0 80 US square equal full frame Wra NH1WH White Standard FTS Low�E,1 GBG 4/2 4/2 No No
Err" 113 T 217 24 48 PW full frame Ext.MWrapH/WH ----- ----- FTS
Low,E4 No- — No No
. ......................
Total 14 BAY,HOW&BUILD OUT DETAILS
AWox
Style Dotal h Approx. Nu nbof name Window Center Sr I-mvil Roof I fardw Fit
Count style nauliefs 1 heJoh, Golfoq Soffit Color
widt End
Room crin Ii Ano LZ9 Interior Ext/Int Color ashos tiashos Smarlsun
SPECIAM WINDOW DETAILS
Specialty
� ull,,72 i
rua I Approx. IowE/ Specialty DAY/HOW ADDITIONAL WORK NOTES
Room Count Style Insert U.I. SnoirtSun G6110S Grillo Style Ext/Int Cotor
11--'01 th"1--,
ADDITIONAL WORK DETAILS'
No Contractor will wrap exterior casings with coil stock color of
Owner is aware that Contractor does not do any painting/staining or removallinstallation of alarm system or window treatments/hardware.It is the responsibility of
the homeowner to have the alarm system and window treatments/hardware removed prior to installation. We make no guarantee as to whether alarms or window
treatments/hardware will fit after replacement. Customer is also aware in some cases there will be glass loss. If there is,the amount will be dependent on the type
of existing windows,type of Installation and window style.We make no guarantee as to the amount of glass loss.Customer is aware and understands any and all
unseen rot is not included in this contract.Should any rot be found there will bean additional charge for time and materials unless so stated in this contract.
yes Contractor will Insulate,caulk and seal windows with 3-point system to prevent water and air infiltration.Removal and disposal of all job related debris,
windows,doors,storm windows and vacuum nightly included. Upon completion of the job and payment In full,a limited warranty shall be Issued.
t yes Building Permil—Contractor will secure any and all necessary permits. The fee for the permit(s)is included In the total contract price,
yea All discounts have been applied to this agreement.
6 V :No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment/finance form(s).
11 dund<ow."I IA'and Ilvo-,it lilt-lmi Ii",14.11(ii,slxvifi,alion Sit, lilt Itic(:1 ISTONI WINDOW AND 1)0()k KI'A101 IF LIN(;A(;1(1�I�MI'AT olloilull,(Ill. 1116'.
I lilt 1111131111ttg IK I%1 CIA I if Wl"ll 6-,anti llle I—It vit—v•I I ml um I.-I'landing,dlalll�illg or Olodi I`%in14 alp,'r the 1,-[111,. ltol)It'll
illi)'%,ay ill.1-smich dolig-mv ill wiling:rid,igil'-d I,%[..Ili the liltyt-v')1111d Cowravlmlllqvl,',1 lic.,by Thal lill)vl")has rvall Ilti,sil't111r,tioll sli'vi.
Renewal by Andersen Corporation 1111tv(s)
Signature of Consultant gnature Signature
WILL SALEM L ZAMPROGNA TRAVIS HOLLAND
Print Name of Consultant Print Name Print Name
I
Renewal
!� 1.X%'. byAndersene
WINDOW, REPLACEMENT enMdetaenCompaoy
N 4%* ..r-tlltl �'
.V.'*. , Wood/Vinyl Composite IF
. ~sDual Argon Low E4 StnartSun
,ti..�.,. ,.,.. Double Hung
100-00473518-010
-ENERGY PERFORMANCE RATINGS
U-Factor(U,S)/I-P Solar Heat Gain Coefficient
0 : 29 0m19_
r
1
ADDITIONAL PERFORMANCE RATINGS
Visible Transmittance
0 . 42
Manufacturer stip; that these ratings conlormto applicable NFRC procedures for determining whole product
performance.NFRC 'Zar*determined lora feted sat olenvrortmentslcemditions and a epacir. product Sae.
NFRC does not recommend any product and does not wevant the suitahiay of any product for any spscNi.use.
Consult manufacturer's iterature brother product performance Information. -
www.nitc.olp
This product menta Green •/
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TasYAW1Uf3020fANdM'AF.IA/CSA101FlSrA{IOM Msruh.u.st ms lJmea kaDls staMsrds.
Naets or exceeds M.E.C.,C.E.C,R I.E.QC,Air lnftatation requirements VV%4A H&Vmirk Cenj icatimn progra,
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ENERGY PERRATINGS
ll-Factor Solar.Heat Gain Coefficlent
0 29 1 .65 0..28.
U•SA-P MWC/SI
ADDITIONAL PERFORMANCE RATINGS
Visible Transmittance
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Product Type: Picture
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ENERGY PERRORMANCE RATINGS j
U-Pactor Solar Heat Gain Coeffioiient
0.27 1 1 53 ./ ® 22
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ADDITIONAL PERFORMANCE RATINGS
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ENERGY PERFORMANCE RATINGS
U-Factor Solar Had Gain Coefficient
0:29 : 1.65 0.21
U.S.A-P atr1r151
ADDITIONAL PERFORMANCE RATINGS
Vlsible.Trans mfttance
0.49 _
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600 Washington Street
Bo tton,ll 02111
wwwinaftgorldia
Workers' Compensation ineuirmace Affidavit.,Ruilders/Coutracto iectntcia"IMI lumbers
"88
&t1j&Lbjj
Name(Business/Organizadon/Individual): RENEWAL.BY ANDERSEN
Address: 30 FORBES ROAD
City/State/Zip: NORTHBORO,MA 01532 Phone A': 508-3512200
Are ou an employer?Check the appropriate bon: Type of project
1. lain a ctnployer with 30__ 4. I am a sawral oontrertor and 1 b. New wnstructicn
employees(full and/or pail time).* have lured the aunt-contractors
2.D I am a sole proprietor or partner- listed on the attached sheet.t 7.itilemodeling
ship and hove no employees "These sub-contractors have 8. }Demolition
working for we in any capacity. workers'comp,insurance. 9. Building addition
[Ilio workers'comp.insurance 5. ® We are a corporation and its 10.0 Pleeirk-al repairs or additions
requftW.) officers have exercised their
3.® I am a homeou-ner doing all work right oftotemption pex-MM 11.x.1 Plumbing repairs or asiditions
myself,[No workers'comp. c. 152;4,1(4),and we have no 12._C]Roof repairs
insursoce required.]t employees.(No workers'
comp.insurance required.] i3, Other _
*Any applcoaat dw alecks box#I must also fill out the section bduw sbowins their workers"compensation policy intbrmadon,
t Homeowners wito submit this affidavit indir"g d k6y,aro doing all work and thele hire outside ocauwAm mtwt suhtntt a 116 a8'idWit ittdjj+Wng such,
+0onuzctom diet chc,lc this box must alta heti an additional sheet. towing the paw of the sub-coalraotoro and+.hoer workers"owip,policy in&Amation.
lam an earloysr that is provkMV workers'con"sadon Morance,for o V enWaysm Below 8s t e poNcy arsdM site
information.
Insurance Company Name; OLD REPUBLIC INS. GO.
Policv#or Self4ns.Lie.9: MWS 3(154.37pQ__________._ Expiration Due:_10,-01-y16
NORTH ANDOVER, MA 01845
Job SiteAddress: 46 RUSSETT LANE City/St"(Zil►;_ w„
Attach a copy of the workers'compensation polky declaration page(showing the poficy number and expiration dated
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or o+DB-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and d fine
of up to$250.04 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,
I do h by ro seeder dw pains rind penaNes o,f perjasry that the iqforwadon provided above is true and cn
jmt
Phone- 508-351-2200
official use only. Do not write in this area,to be complesed by clp-.or town of elat
City or Town: PermitlLicense#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Cleric 4.Electrical Inspector S.Plumbing Inspector
6.Other
Contact Person: Phone 0:�,
ANDECOR-01 YADAVYO
CERTIFICATEF LIABILITY INSU NCE FDATIN1fYYY)
101a11Dv2o1s
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 terns and conditions of the policy,certain policies may require an endorsement. A statement on this csrtificate does not confer rights to the
certificate holder In Ileu of such endorsement(s).
PRODUCER NAME cT Willis Certificate Center
Wilcdo 2 of Minnesota Inc. LAIC,Ktumb 877 945-7378 Fax No: 88B)457-2378
c/o 28 Century elvc) B�MAiI .( )
P.O.Box 305191 :CertlI illls.com
Nashville,TN 37230-5191
INSURERIBI AFFORDING COVERAGE N=6
INBURERA:OId Republic Insurance Company 24147
INSURED
INSURER e
Renewal by Andersen LLC INSURER C:
30 Forbes Road INSURER D.
Northborough,MA 01532 INSURER E: _
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 SUBJECTTO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
ILTR TYPE OF INSURANCE POLICY NUMBER (IMM) MAAlD LIMITS
A X COMMERCIAL.GENERAL LIABILITY EACH OCCURRENCE ; 1,000,000
cLABnsMADE I—XIoccuR MWZY 305440 10/01/2015 10/01/2016 PRISES Eaoccurrerwe s 500,
MED EXP one person) ; 10,0
PERSONAL b ADV INJURY ; 1,000,00
GENLAGGREGATELIM[TAPPLIESPER: GENERAL AGGREGATE $ 4,000,00
X POLICY PRO-
JECT FILOC
PRODUCTS-COMPIOP AGG ; 4,000,00
OTHER $
AUTOMOBILE LIABILITY �MBINED 8WW $ 51000,00
A X ANY AUTO MWTB 30543a 10/01/2015 10/01/2016 BODILY INJURY(per peraon) ;
ALL OWNEDSCHEDULED
AUTOS AUTOS BODILY INJURY(Per sooident) $
HIREOAl1TOS NON-OWNED
AUTOS Per aerlderN $
i
UMBRELLALIAR OCCUR EACH OCCURRENCE ;
EXCESS LIAR CLAMS-MADE AGGREGATE $
DED RETENTION S $
WORKERS COMPENSATION
AND EMPLOYERS LIABILITY YiN X STATUTE R
A ANY OFFICERIMEMB REXRCLUDEEDD? NI NIA X30543700 10101/2015 1010112016 EL EACH ACCIDENT S 1,000,0
(Mandatory In NH) E.L.DISEASE-FA EWLO ; 1,000„000
U yes,describe under
DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LMR ; 1,000,
DESCRIP'nON OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 107,AdMonal Romana SchsdWe,maybe aHachsd N mora 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
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPREsmATIVE
Erridence of Insurance r �
)1988.2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD
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Massachusetts-Department of Public Safety
Board of Building Regulations and Standards
Construction Supervisor
License:CS-090'25
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JAIL L MOBIN, �.
86 GARDIlM S� T
LYNN MA 0190
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Expiration
Commissioner 10108!2018
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