28 NORTHEND AVE - BUILDING INSPECTION 4 .v
The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY OF
Massachusetts State Building Code, 780 CMR SALEM
Revised Mar 2011
Building Permit Application To Construct, Repair, Renovate Or Demolish a
One-or Two-Family Dwelling-
This Section For Official Use Only
Budding Permit Number: Date A ,plie
Building Official(Prin N e Si _ atur
SECTION 1:: SITE INFORMATION
1.1 Pro a Ad d 1.2 Assessors Ma. & Parcel Numbers
—0 , �ren c� 41C_ 1 .4
6=.'�.S 3-
1.1 a Is this an accepted street?yes_ no Map Number Parcel Number
1.3 Zoning Information: (1 1.4 Property Dimensions:
Zoning District Proposed Use I Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1. r Owne 'of cord:
i ��� ��s ,l.an It s bk9 4
Name(Print) City,State,ZIP
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORKZ(check all that apply)
New Construction❑ Existing Building Owner-Occupied Repairs(sY6 Alterations) ❑ I Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units_ I Other Specify: G a�
Brief Description of Proposed Work2: e w
r t
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: I
Official.Use Only
(Labor and Materials
1.Building $ 3• a 3d,a o 1. Building Permit Fee:$ Indicate how fee is determined:
❑ Standard City/Town Application Fee
2.Electrical $
❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) .Total All Fees: $
Check No. Check Amount: Cash Amount:
6. Total Project Cost: $ �3a, ao 0paid in Full ❑Outstanding Balance Due:
r .
♦j
SECTION 5:"CONSTRUCTION SERVICES °
5.1 Construction Supervisor License(CSL)
—T' u
,�/J�
S c oo \ Y�e gyp, License Number Expiration Date
Name of CS3 Holder
List CSL Type(see below) L)
No.and Street �.- Type Description
1 A ' A-"'e 1 tM� ,n I � a , U Unrestricted2 Family
(Buildings u el 35,000 cu.fr.
�J 1-�"' ` R Restricted 1&2 Fami] Dwelling
Cityrrown,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
✓b 8"35A- I IInsulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
Pe �c, l h� I�nc�e�ccn I sa810 i�a�-�3
V�v HIC Registration Number Expiration Date
HIC Com y Name r C Registrant Name
Ion op `
N �\IJS � l7cybi l /�) s3� Email address
City/Town,State,ZIP Telephone
SECTION 6: WORKERS' COMPENSATION INSURANCE-AFFIDAVIT(M.G.L. c. 152.§ 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this affidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes ......... No........... ❑
SECTION7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT r
I,as Owner of the subject property,hereby authorize n n �e :2-
to act on my behalf,in all matters relative to work authonzed by th t building permit application.
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this a licatio is true and accurate to the best of my knowledge and understanding.
S /0'1 113
Print Owner' uthorized Agent's Name(Electronic Signature) Date
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L. c. 142A.Other important information on the HIC Program can be found at
www.mass. ovg /oca Information on the Construction Supervisor License can be found at www.mass.gov/d�a
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (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
3. "Total Project Square Footage"may be substituted for"Total Project Cost" '��7a w
CITY OF S.U.&M, UNSSACHUSETTS
Btitt, NG DEPARTMENT
130 WASHINGTON STREET,3' FLOOR
TEL. (978) 745-9595
FAX(978) 740-9846
KIMBERLEY DRISCOLL
MAYOR THOMAS ST.PIFRRS
DIRECTOR OF PUBLIC PROPERTY/BUILDING CO\WMIONER
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5
Debris,and the provisions of MGL c 40,S 54;
Building Permit# is issued with the condition that the debris resulting from
this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c
111, S 150A.
The debris will be transported by:
Y�J�cwc l lrjnAC�e.rkr.r
(nahie of hauler)
The debris will be disposed of in :
(narhe of facility)
(address of facility)
� re of permit applicant
2
date
dcbrioffAm
WINDOW REPLACE ENT PM4MMMconlram
To whom it may concern:
Enclosed is a permit application package for a project we have been contracted to do in your
town. Thank you in advance for receiving this package by mail. As we work in every town in
the state, it greatly helps us in our process.
We have also enclosed a self addressed and postage paid envelope and would request that
when the permit application has been processed, that you would mail it back to us.
Enclosed for you review in this package is:
o Permit Application
o Home Improvement Contractor License
o Construction Supervisor License
o Proof of hlsurance
o Proof of Energy Efficiency Rating
o Signed Contract from Customer
o Permit Fee(if accepted at time of applying)
if you have any questions regarding this application please call me at: 508-351-2200 X55285
Regards
Kelley Donahue
Permit Coordinator
104 Otis soma
NW&bomuSk MA,01532
MOM(508)351-2200
Fs:(651)-351-4807
websiw
Renewal
al ,- MA Home Improvement Contractor
RC 1.rY(A License#170810(Expires 12/23/2013)
byAnlC�erSerl. y Renewal by Andersen Corporation Federal Tax ID#41-1918413
WINDOW REPLACEMENT an MdeatnCgmpanY
104 Otis St.,Northborough,MA 01532
(508)351-2200•Fax:(651)351-4810
CUSTOM WINDOW AND DOOR REMODELING AGREEMENT
Bur,r(si Nome Date of Agreement
A
Buyerlsl street Address,City state,and zip Code
E.Nail Address Homa Tele hone Nam r Work Telephone Number
a 3294 7 -79xf 06. 3
Buyers) here ;jointly and severally ag es tf5 pchase the products 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.
�1 Estimated Starting Date: Method of Payment:
Total Job Amount: 77 32 Amount Financed 3 deck ❑Cash
Deposit Received(33%(: 6) 4) OYso/MC ❑Discover^j
Balance at Start of Job(33%(:_�_,_-z..1� 0 e anted GAME%
Estimated Completion Date: IF credit cord is selected,please
Balance on substantial / see Credit Card Payment Form.
Completion of Job(33%(: �(J
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) I) 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.DO NOT SIGN THIS CONTRACT IF
THERE ARE ANY BLANK SPACES.
Renewal by rseo Co radon DBuyer(s)
Buyer(.)
By:
Signature of Product Manager Signature Signature
riot Name of Product Manager Print Name Print Name
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. -
_ _ _._ _ _ _ _ _ _ _ _ _ r _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
NOTICE OF CANCELLATION X, NOTICE OF CANCELLATION
Date of Transaction t/27—r 7 You may cancel Date of Transaction ZI-2 7—r You may cartcel
this transaction,without any penalty or obligation,within this transaction,without any penshy or obligation,within
three business days from the above date.If you cattcel,any three business days from the above date.ifyou cancel,any
Property traded in,any payments made by you under the property traded in,any payments made by you under the
Contract of Sale,and any negotiable instrument executed Contract of Sale,and any negotiable instrument executed
by you will be returned within 10 days following receipt I by you will be returned within 10 days following receipt
by the Contractor ("Seller") of your cancellation notice„ by the Contractor ("Seller") of your cancellation notice,
and any security interest arising out of the transaction will and any security interest arising out of the transaction will
be canceled.If you cancel,you must make available to the be ronceled.If you cancel,you must make available to the
Seller at your residence,in substantially as good condition Seller at your residence,in substantially as good condition
as when received, any goods delivered to you under as when received,any goods delivered to you under this
this Contract or Sale; or you may, if you wish, comply ! Contract or Sale;or you may,if you wish,comply with the
with the instructions of the Seller regarding the return instructions of the Seller regarding the return shipment of
shipment of the goods at the Seller's expense and risk. I the goods at the Seller's expense and risk.If you do make
If you do make the goods available to the Seller and the I the goods available to the Seller and the Seller does not
Seller does not pick them up within 20 days of the date pick them up within 20 days of the date of your Notice
of your Notice of Cancellation,you may retain or dispose of Cancellation,you may retain or dispose of the goods
of the goods without any(artier obligation.If you fail to without any further obligation. N you fail to make the
make the goods available to the Seller, or if you agree goods available to the Seller,cur if you agree ro return the
ro return the goods to the Seller and fail ro do so, then goods ro the Seller and fail ro do so,then you remain liable
you remain liable for performance of all obligations under for performance of all obligations under the Contract.
the Contract. To cancel this transaction, mail or deliver a I To cancel this transaction, marl or deliver a signed and
signed and dated copy of this cancellation notice-or any dated copy of this cancellation notice or any other written
other written notice, or send a telegram to Contractor. notice,or send a telegram to Contractor.
Renewal by Andersen Corporation, 104 Otis Renewal by Andersen Corporation, 104 Otis Street,
Street, Norehbo gh MA 01532, BY NOT LATER THAN NorhborokI h,MA 01532,BY NOT LATERTHAN MIDNIGHT
MIDNIGHT OF (Date) OF y—� =-7? .(Date)
I HEREBY CANCEL THTRANS�ACTION. 1 HEREBY CANCEL THIS TRANSACTION.
Bvyei c5ignomre Print Nome Dine Buyei s5ignaNre Print Nome Dote
RbA Copy- White Buyer Copy-Yellow Buyer Copy-Pink gBBP200`aRBAPh.MANR
L
Renewal 'newal by Andersen COrporatit^ MA Home Improvement Contractor
by
f�,,,({ ��� 104 Otis St.,Northborough,MA 01532 License#1708 10(Expires 12/23/2013)
"yA der' en' (508)351-2200•Fax:(65 q 351-4810 Federal Tax ID#41-1918413
,,,law aEPLACEMENT mMdersen Company
WINDOW SPECIFICATION SHEET
Buyer(s)Name Date of Agreement
he Buyers)listed a6 ve erebyjointly and severally agree to purchase the goods and/or services listed below,in accordance with the prices and terms
described on the Specification Sheet and the front and the reverse of the accompanying CUSTOM WINDOW AND DOOR REMODELING AGREEMENT,
of which this Specification Sheet is a part.
W WDOW DEEA11 S
1. Contractor will Install a total of windows in Owner's home,using the following individual quantities:
Double Hung Tnq±Equal sash_Cottage sash(I/3 top,2/3 bottom)_Oriel sash(2/3 top.I/3 bottom)_Flat sill awam io cas of
_Square Check Rim}?{Curve Check Rail
Casement(CS)_Hinge right_Hinge left(as viewed from exterior)
Double Casement(CD)
2lite Gliding Window(GW)
Casement/Picture/Casement(CH_L 1:1 or 1:2:1
Glider/Picture/Glider(GPW)_1:1:1 or 1:2:1
Picture Window Bay or Bow
Awning Window _#Lights Soffit/Roof Shingle/Copper
Specialty Window Patio Doors(sec Separale dmr spre sheep Seat m be Primed/Oak/Pine
El I I ❑0❑
2. a Qty of Windows to be Custom Fit Replacement:
3. A Qty of Windows to be Custom Fit Full frame(INCLUDES NEW INTERIOR S,EXTERIOR CASINGS)
Exterior casings:_Pine_Maintenance-free material_Factory applied 908 Fibrex brickmold
4.Glazing to be:_HE low-E-4 sa Tempered Wither If other,please specify: SM R/f—
S.Exterior color to be: KWMte Sand_Canvas_Terratone_Cocoa Bean_Dark Bronze_Forest Green_Black
G.Interior color to be: XWhite_Canvas_Pine_Maple_Oak_Same as Exterior Note:Wood interiors need to finished by Owner.
7.Hardware:Y White Stone_Canvas_Estate Hardware: Style:
8. 410 Install Lifts with Double Hung Windows
9. Screens:windows to have:'Half or_Full screens Screens to be: Fiberglass_Aluminum TmScene
GRI=DETAILS
10. U Windows have grilles:_Grl71e eetwecn Glass(GBG)_Removable Interior Wood UNTW)_Full Divided Light(FOCI
( )Owner approved(initials) Draw grille patterns below *Use additional sheet if needed
Qty Qty Qty Qty Qty: Qty Qty-
ADDITIONAL WORK DE@UIS
11. O Qty of_Sills_Sill noses to be replaced by Contractor
12. niJ Contractor will remove metal frames of windows.
13. Wl install new_paint-ready or_stain-ready_Interior_Exterior casings¢r_Pine_Maintenance-free material
/1 O Contrac r will talc new_paint-ready or_stain-ready_Interior_Exterior crops in_Pine_Maintenance-free material
J14.5. )In wrier is aware,contractor Aoea not do any painting is removal/installation of alarm system/hardware. It is the
L� ((( responsibility of the homeowner to have the alarm sys/em/hardware removed prior to installation.
16. Contractor will wrap exterior casings with coil stock of color.
Note:Wrapping maybe required with storm window removal;removal of storm windows will leave screw holes in casing.
17.Contractor will insulate,caulk and seal windows with 3-Point system to prevent water and air infdtmtion. Removal and disposal of alljob related debris,win-
dows,storm windows and vacuum nightly included. Upon completion of thejob and payment in fWl,a limited warranty shall be issued.
IS.Wits❑No will secure any and all necessary permits The fee for the permits)is not
included in the Contract Price and a separate check is required at the tone of sale for this fee. Cx# $
19.�yJ�s'qv'es❑No All discounts have been applied to this agreement price.
20.Addttional job details: , /— GACf r1T 3 akAj Ar4
2l.49-Yes❑No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment/finance form(s).
It is agreed and understood by and between the parties that this Specification Sheet,along with the CUSTOM WINDOW AND DOOR REMODELING
AGREEMENT,constitutes the entire understanding between the parties,and there are no verbal understandings changing or modifying any of the
terms.This Specification Sheet may not be changed or its terms modified or varied in any way unless such changes are in writing and signed by both
the Buyer(s)and Contractor.Buyer(s)hereby acknowledge that Buyer(s)has read this Specification Sheet.
Renewa y riders Corporation Buyer(ss)n� Buyer(s)
Signature of Product Manager Signature Signature
Print Name of Product Manager Print Name Print Name
T&e Cottmm s of VaswAMOM
rturt ojLtdt<elrlol�
08ke ojlnvia*o*&r
600 WaskkW oo Sbteef•
BOMtr,AM 02111
is ww.yfMLSOv%4o
Workers'Compentatfon Ele Nwace Affavft: RuMeMAContreetora/Electalctana/pl6mbera
at. fisant dnforsaadan_ t Fleas t
lain (B )'�P.f\
Address: 104
CiWstate✓ : IJ �, 53d Phone M 5b
Are you mm emipioyw7 Cheek the appropriate boar
1." I am a employer with #. Q Y am a geoaal cantracxor and I °f Protect(required):
maPloyeea(hill and/or part t®e).s have hued the 6. ❑New suction
2.❑ I am a soh:'prgnie0or or partner- listed on the attached sheet. 7• (�
ship and have no employees These sob-contracYms have 8 ❑Demolition wwldng for me m any capacity. employees and have wa*an;'
[No workers•camp.bMUM ce COMP•hmua=t 9• ❑Buril ft addition
7ued) S. Q We are a oarparauori and its 10.E Electrical rePw ca
3. 1 am a homeowner doing all work Offices have Crorcised their
myself [No wgd=l Comp. right of exemption per MGL Phmhy npafrs O1 additions
iaawmoce required.]t a 152,¢1(4),e�we have no �'�ROof s
employees.[No wodoera• 13.Q Other,
w
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_ibab ed)
f #
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m daft
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diaamployaea_ tt'me. aao6sam.hsvq!mWuras.ther.mmtwogHeamtr womambo mb4m, , I =d1blowbahweraat5wagoyymaaro
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Idon as onyrlo�tl6edtrpP.awntaa•ooAa .
byornmtiara . �03' IPelew tr etre�erlday��t4te
Insurance Company Name: 6 —r^
P b��
Policy#or Self-ma.Lac. r,V C- GLi 5?n
Job Site Adding,In/3 Uh rf e, , I
Attach a ropy of the workers eom -�� "^ ✓�'L-�^ U l Q� d
Failure to secure coverage as ' d n der dttdlsr ion PIES(showing the polh:y number and eVirsdou date)v
required andw Section 25A ofMGL C. 152 can lead to the fine UP to$1,500.00 m"r ona-yar hNprisoomeut,as well as Civil °f�Peres ofa
of up to f25b.00 a day Whist the viohitm Be advised that a Peres ieine fog o e STOP WORK ORDER and a fine
Investigatroos of the DIA for insurance coverage v�cagm. of thin atdbemeatmay 6e hmvded to the Office of
I do kereby eff" abePebrr assdPthulat►ea olPeoury ON&a�o>ee�lenProvidedabvse 11,+1w�gdOs„tia
. S•la� 1 � 3 .
0~esse only. Do not wr&in abir area, 19 be emrktedby eity,or fovea oomw
CUy or Town: PeraaWlaoense#
Lanhhg Authority(circle one):
L Board of Health 2.Building;Department 3.City/rowe Clerk e.Electrical 6:Othar • hwPed0r S.Plumbing Laspecier
ZI=Person:
Phone#:
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CERTIFICATE OF LIABILITY INSURANCE °"" 5/2012
0,/2S/3012
THIS CERTIFICATE IS MUED AS A MATTER OF S ruO AIWN ONLY AND CONFERS No jSGNgR UPON THE CERTMATE HOLDER.TM
CERTIFICATE DOES NOT AFFIRNATMY OR NEGATIVELY AMEND, EXTEND Olt ALTER THE COVERABE MFOap® BY THE POLX=
BELOW THE CERTIFICATE INSURANCE TT:HOLDER. A CONTRACT BErWEW
THE ISSUING NNSU W"L "MORM
REPRESENTATIVE OR PROD
mpoRTANT: N the earlMealI 101111W In an ADDITI DISURED,Ihs PdtsYMs)In bo mrdaray. N S Bw bans mul Dondldons of as Policy,oseWn pogdes may requlm an NNbrasnwnL A stdmem on lift UBROGwTIOH E WANED,aRNhJad tr
osrtlaeds holder In�u crumb s wrHseda doss not nrd/r rights to thr
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CM 1-622-333-3323onelle zargrave or Erie Johsen
Co�panlel !•Race . 63.2-333-3323,th Street
Bolts 700
it= spolle, l0e 55{02
INSURED MAIC/
general »S' Anderson corporation aNRRSRRDNA: OLO EEPOELIC z•s CO 2{i{7
ammma: "TIONAL 0AXOK FIRE"=a CO Or PiSTB 19{{5
10{ Otis street
/wRwere:
Eorthborough, E1 01532 /OURap:
HaRNdma.
F•
COVERAGES CERTIFICATE NUMBER: 29229426 REVISION NUMBER
TH19 IS TO CERTIFY THAT THE POLICIES OF INSURANCE LASTED BELOW NAVE BF�N ISSUED TO TFIE WSU,.MDICATm, NOTWRHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTTER NAMED ABOVE FOR THE POLICY PERIOD
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE MSURANCE OF
BY THE POLICIES D OTTER O EW WITH RESPECT TO WMDII THIS
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY NAVE BEEN REDUCED BY PAS)CLABAS, HEREIN SUBJECT TO ALL THE TERMS.
NIR TmorSOURAmor IMF .or
FouerrsNe:ENL
A aBIriULL LOWNUIr ER2Y 59028 10/01/2 10/01/13 Tama
z a,eaa�RaN.oENeuuurawn Ewwoccad:BN� { 1,aoo,000
0tAeaa•YAOE z❑OCCUR , $ 500,000
%Hmm or aw { 10,000
PERSONAL aADVNAIRY { 2,000,000
aBN1AGQREQA7ENasrN�PL�PER: �ALwGaE0n7E 9 {,000,000
z pOlcv PRo- Inc EgODR/G'rE-00LPMPAOG { 3,0001000
A !ummomms LMMLRV ERls 21700 10 01 1 10 01 13 oo LIMIT 6
E ANYAWO $3.000,000
ARLOWNEDAUIOS e001LYIM10m grpaunq $
tCHEDULDAUTOS aOOArKMVOM.cditM {
z HUMAUTOS PRO"mmONSBE
z NONOWN®AUICS Pivallm q {
6
8 z Lmsr1Ell z I" OCCUR 23273355 30/O1/1 20/01/19
rJOCgaLUa EAMOOUrUMMM $25,000,000
DEOUC70LE AOOPEOATE i 25,000,000
zCOLPB 26,000 3
A Arp �Y MNC 1179{B 00 rrCgrA {
ANY r/M 10/01/1 10/O3/13 Z
p�l7o�yyOFFC E1z1.UOED7 O N/A r1EAL7RACCDBtr q 1.000,000
dw
Ra PIIONOFOPERAT10N8lrnw ELOWASE-EAErp { 1,000.000
ELOWASE.POLU.y LOR $2.000,000
oFaPeu N Wme nowm101.AMft W Reaafo rseAapaq
Eridencs of insurance.
CERTIFICATE HOLDER CANCELLATION
Xvidenee of iaourance SHOULD ANY Or THE ABOVE DESCRIBED POLICIES BE CANCELLER
BEFORE
THE 1EXPIRATION DATE THEREOF, moTicEACCORDANCE WITH THE POLICY PROYISIDIN.. WILL BE DELIVBiEp
AUTHDRIES) 1EtR9NrA7RR
axial
4 free of Consumer Affairs&Business Regulation
i
ME IMPROVEMENT CONTRACTOR
egistration: 17F0810.:; TYP9:
ExpirafloI:'A.ZZM013- Supplement i t
RENEWAL BY ANDERSON CORPORATION
e ti
JOSEPH REZZA
104 OTIS STREET
NORTHBOROUGH,MA 01532 - !
Undersecretary f
i
{
Massachusetts -Department of Public Safety
�✓ Board of Building Regulations and Standards
Construction Supenisor
License: CS-065272
JOSEPHPREZZer
168 KELLEY BLVD I s
N ATTLEBORO Y" 0
s
w Expiration
Commissioner 04/25/2014
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