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HomeMy WebLinkAboutBuilding Permit # 9/20/2016 BUILDING PERMIT AoRrN OF�tLto r614,0 TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION � z Permit No#: 300 N/,7 Date Received ° 'ls �Rnrcn SPR~(5 �SSACµus�4 Date Issued: IMPORTANT: Applicant must complete all itezxs on this page LOCATION o eq4 rf e °�C Print PROPERTY OWNER L i n4 Pard,/5- g+v J °-4 n Print 100 Year Structure yes no MAP 69Y PARCEL: 0 l ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family [I Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg Others: ❑ Demolition LlOther �B nSvl }ro Se ttc� �7 Well [❑Floodpla�rl D]1lletl�nds u ' F ❑ W�tershed,D�tr�ct� �' LI" faterl�ewer '`' DESCRIPTION OF WORK TO BE PERFORMED: t ra Sa f�, l"1 rR -"o '0 Yi Identification- Please Type or Print Clearly OWNER: Name: L ,,AA ?qrdvS, o Phone: Address: I0 rgrb,rr-ef- d'? n if Contractor Name: ]?tirr t I4,&1C Phone: Sok kr,-/'2 Email: Address: eq 0- a`r,e 4' f �s h Supervisor's Construction License: !d Gv t7 Exp. Date: Home Improvement License: Jo Exp. Date. ARCH ITECTIENGIN EER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COSTBASED ON$125.00 PER S.F. Total Project Cost: $ 600-d a FEE: $ Check No.: Receipt No.: 6� NOTE: Persons contracting ith unre istered contractors do not have access to the guaranty fund �®»TaI q Town of ndover O - No. ? - h ver, Mass, o LAK! 1. LOCHICMlWicK V pdRA'rIE S t] BOARD OF HEALTH PERMIT T LD Food/Kitchen ,�( / Septic System THIS CERTIFIES THAT ?40.0 @..r �+ BUILDING INSPECTOR ....... ... ...................................................................................................... has permission to erect frpr4 .eFoundation .......................... buildings on ....�Q.�...... ...,......'.�/.'":�.........�/.1�. r�.f Rough to be occupied as ..........ktot... w .............��..... .......... .. ..... _ ► Chimney provided that the person accepting this permit sha eve res ect conform to the terms of the application p p p g p rY p Fina 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 C®NST TI® Rough Service ... .... ... V�NiS Final BUILPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildin 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. Fatteral ID 1105-0405629 RISE Engineering RI Contractor Registration No 8186 MA Contractor Registration No t20979 RISE divisioll or'I'llielsell Engineering M"Contractor Registration No 620120 ENGINEERING' 60 Shawnuit,CaNtoN,NIA(12021 CONTRACT 339-502-5197MX339JO2-0345 Page r-.—Xzp) PROGRAM 11113 CONTRACT 19 ENTERED INTO BETWEEN RISE C'MA-IW,S U NOUIrCRINO AND T14E CUR TOMER FOR WORK AS DESCRIBED BELOW CUSTOMER wa T PRONE ()ATE CI IMT a WORK ORD514 Linda Pardus-Goodman (978)682-,1909 02/08/2016 427360 00002 SCHVICU SfACEJ C= DIMING STREET r 108 Peachtree Lane 108 Penclarce Latic SERVICE CI I Y,STATE,Z111 UILLING CITY,STAK,Zal North Andover, MA 018 45 N o rth Ata do ve I-, MA 01 14 DESCRIPTION Ill IASI:IMF-Proposal liar this calendar year. SOHO work will be perfibraied in UR'777—M(7, ..7bUej,,,B., ,Bca7or�o .!t,ureic 7 7,, concert with the use ol*speeial tools and diagnostic lems to assure that your home will be]ell with a licaltbrul level orair excliange and Indoor air quality.Materials to be Used to seal your home can include caths,lbarns and other products. Primary meas Ilan sealin),include air,leakage it)anies,basements,auached garages,and other unheated areas(windows are Net gcnerajIy;Rj(Iresse(I.) 'Ibis will ie(joire(8)making loans. A reduction in cubic ire(per minute(01m)of air infiltration will occia,but tire actual number of cram is not g0araineed, At the compIction of the%yeatherization work,and at no additional cost to the homeowner,a rival blower door and/orcovalnistion rarely analysis will be conducted by the sub-conlractor III ensure the satiety o1*1he indoor air quality. AIR SEALING AI DEW (4)wraking hours. $340.00 =)m KTR(i:—Prov ide—labor a]—1d In—m-criali—To ins—tal 1-712"la�—er o I'R-3-8,'No 11,'c'e,—d5be`=ghts-s pu I (sc . (96)s(lame fiect lbr ommom, P) s $196.80 A'I"I'1C:11A"C4'ravialc labor arlt!rriatcrials to insiull as 10"larycr of 4t•-:35 f�larss I C:'ellNlose adaled to(1976)sguau°c icet orogen adtia space. � � �� $2,904.72 7�111( M=1,SS,Provide labor and materials to insulate tile back,of(I)IInic hutch with 2"rigkIThcrjmvx board,Weatherstrip(lie perimeter. $60,00 71 N i ILATION:Provide lahorand materials it)install(1)h1sulated exhaust how with gable wall mounted dapper vent to exhaust existing bathroom fili(s), $118.75 or RII(l araiLrIals it)last, '71 N I I rA I ION Provide it) insulated exhaust hose with soflninounted 11111)1)er Vent to CXIBRIM CNiSfiap, bathroom fian(s,). $'118,75 -71=Ni 17 .)N:Provide laborand materials to install ventilation chuics in(9(I)railer bays to maintain Sir Ilow, IsI80,00 RISE FlIgilwering,will apply all applicable,eligible incentives to this contract. You will only be billed the Net amount, Currently,Im eligible IneaSUIVS,COILIBIbill GHS OfICI-s 751%incentive,not to exceed$2,000 per calendar year,an(]an incentive of 100%for the Air Scaling,measures III)to(he flist$680 and,in additional$340 irsavin p arejuslified by the inalitor. For thc stilety and heallh ofyom home's indoor air qmility,we will be wriducting a blow%er door diagnostic oftlic available air How in vont home both belbre the work is bcgon,and tiller the weallicrization work is complete.We will also conduct a fall assessiment ofthe conibastion sIkty ol'your heating system and water heater.This has a value ol*$()()and is at No cost to you. Total allowable weatheri/ation incentive is$3.110. 590,00 Fadural ID 0 05-0405629 RISE Engineering RI Contractor Registration No 8186 MA Contractor Registration No 120979 RISE tk(tivision or'nimso,nigincering CT Contractor Registration No 620120 HICANEEPING' 60 ShImmut,0toton,NIA(121121 CONTRACT' .339-502-5197 FAX 339-502-6345 Page 2 PROGRAM TRIS CONTRACT IS ENTERED INTO BETWEEN HISS CNIA-1 I ES ENGINEERINO AND THE CUSTOMER roR:WORK AS DESCRIBED 13111.OW CUSTOMER PHONE DATE CLIENT 0 WORK ORDER Linda Pardus-Goodinall (978)682-4909 02/08/2016 1127360 00002 S L H(VICE STREET BILIANO STREET 108 Peachtree Lane 108 Pe"Ichiree Lane SERVICE CIfY,STA1E.Z1P UILLING C0Y,STA1k,ZIP North Andover, MA 01840 Not-Ili Andover, MA 01845 J011 DESCRIPTION Total: $4,689.02 Program Incentive: $3,020.01 Customer Total: $1,669.02 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF "'One Thousand Six Hundred Sixty-Nine& 021100 Dollars $1,669.02 UPO'I INAL,1NrPICo0N ANO APPROVAL.BY RISE ENDINECRING,CUSTOMF'14 AGPLES TO REMIT ANIOUNT DUE III FIJLL,INTEREST OF I',W111 HE CLIARGED MONTHLY ON ANY u GUARAN TEES,BRIMS OF RECISION,SCBEIRILINO,AND CONTRACTOR REGIWIRAYLON. DO NOT SIGN THIS CONTRACT IF T14ERE ARE ANY BLANK SPACES UTHORIV)SIG i"'LURE-RISC.Frqjln.'Wnu zl� NOTE:'0113 CONTRACT MAY VEWIDIORAVON UYUSIF NOT EXECUTED LIO"ON DATE OF ACCEP FANCE, ACCI-.'PTAN('C OF CONTRACT-IFIF.ABOVE PRICES,SPECIr ICA BONS AND CONDITIONS ARE 30 DAYS, SATISFAC TORY TO US AND ARF,HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO 114E WORK AS SPECIFIED.PAYMENT WILL,BE MAULAr OUTI,INV0 ABOVE RISE «'. 60 Shawmut Road,unit 2,Canton,MA 020211339-502-6335 ENGINEERING www.RISEenglnearing.com cl i�riency[n•:n:i:a;. OWNER AUTHORIZATION FORM Linda Pardus-Goodman (Owner's Name) owner of the property located at: 108 Peachtree Lane, N. Andover, MA 01845 (Property Address) (Property Address) hereby authorize (Subcontractor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. This form is only valid with a signed contract. )c wner's nature _-1L3O j Lo Date AC R" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) fi/10/2016 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: It the certificate holder is an ADDITIONAL INSURED,the policy(ies) 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 endorsement(s). PRODUCER CONTACT Linda Bogdanowicz NAMEt insurance Solutions Corporation PHONE (603)382-4600FAlC No:(s03)382-2034 60 Westville Rd - AIL lindab@isc-insurance,com ADDRESS: _ ._ INSURER($)AFFORDING COVERAGE NAIC# Plaistow NN 03865 INSURERA:Western World INSURED ..WJOY41 INSURERS Nautilus insurance Group Polar Bear Insulation Company Inc INSURER C PO Box 958 INSURER D: INSURER E: Andover MA 01810 INSURER F COVERAGES CERTIFICATE NUMBER:t=L1632326134 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 REDUCED BY PAID CLAIMS. _ INSR TYPE OF INSURANCE ADDLE a POLICY NUMBER MWDG(Y FF PPLICY YYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAA CLAIMS-MAGE � PREMISES OCCUR REMI TO RENTED PEa occurrence} $ 100,000 NPP$274967 3/24/2016 3/34/2017 M ED EXP(Any one person S 5,000 PERSONAL&ADV MJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 R POLICY Eo- D LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ _- - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS - NON-OWNED PROPERTY DAMAGE $ HIREDAUTOSAUTOS Per accident X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAB CLAIMS-MADE AGGR GATE $ 1,000,000 DED I I RETENTION AN026107 3/24/2016 3/24/2017 $ WORKERS COMPENSATION PER )TH- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNERJEXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in No E.L.DISEASE-EA EMPLOYE $ 1[yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It mare space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 Osgood St, Ste 2032 ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Keith Maglia/SJR =-- ©1988-2014 ACORD CORPORATION. All rights reserved. ACORIA 2a(2014/01) The ACORD name and logo are registered marks of ACORD !N S025 ren innn 6/10/2016 Preview:Certificates of Insurance DATE(MMIDDlYYYYI A�O CERTIFICATE OF LIABILITY INSURANCEF 08!1012018 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 does not confer rights to the certificate holder In lieu of such ondorsement(s). PRODUCER CONTAcT NAME: Automatic Data Processing Insurance Agency,Inc. AICNNo Ext; _ NC,Not 1 Adp Boulevard ADDRESS: Roseland,NJ 07068 INSURERS)AFFORDING COVERAGE NAIC N INSURERA; NorGUARD Insoranw Company 31470 INSURED INSURER 8: POLAR BEAR INSULATION CO INC INSURER C: PO BOX 958 Andover,MA 01810 INSURER D: INSURER E; INSURER F: COVERAGES CERTIFICATE NUMBER: 503587 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 REDUCED BY PAID CLAIMS. FUMY trf POLICY EXP LTRIRSR TYPE OFINSURANCE INSD YND POUCYNUMBER MNYDDIYYYY M1DDfYYYY LIMITS COMMERCIAL,GENERAL LIABILITY EACH OCCURRENCE 5 CLAWS-LIADE F—]OCCURPREME ISS Ea aeeurre11 S MED EXP(Any one person) $ PERSONAL 8 AW INJURY S GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PRC?JECT 1-1LOOPR00U'CTS•COMNOP AGG S OTHER: $ AUTOMOBILE LIABILITY Ea acddenl $ ANY AUTO BOO#LY INJURY(Per parson) $ ALL OWNED SCHEDIAED BODILY INJURY(Pt accldenl) S AUTOS AUTOS NON-OWNED P,r ucridml $ HIRED AUTOS AUTOS $ UMBRELLA UAR OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE S OED I I RETENTIONS S WORKERS COMPENSATION x I STATUTE I I ER AND EMPLOYERS'LW BILITY ANY PROPRIETOFVPARTNEW'EXECUIIVE YIN E.L.EACH ACCIDENT $ 110001000 A OFFIC£RIM MBER EXCLUDED? [!]NIA N POWWC772258 01101128160110112017 1 080,600 (Mandatory in NHI E.L.DISEASE-EA E"FLOYE $ 11 yes,describe under DESCRIPTION OF OPERATIONS 6dav E.L.DISEASE-POLICY LIMIT $ 1,080,008 DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(ACORD ttlf,Additlonal Remarks Scheduls,may ha allached R rn"aspaw is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood at,f Suite 2035 North Andover,MA 01845 AUTHORIZED REPRESENTATIVE O 1988-2014 ACORD CORPORATION.Ail rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 'l- https:liadpia.adp.comlicertcf/g/Ttinipreview15O3587/900012975 1!1 The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations ' 1 Congress Street,Suite 100 ' Boston,JIM 021142017 www mass gav/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): MfU AM 00A 0 PO BOX 958 Address: ANDOVER.MA 01810 City/State/Zip: _ phone#: FAre you air employer?Check the appropriate box. Type of project(required): � 1.� I am a employer with 4. [] I am a general contractor and I employees(fall and/or part time). * have hired the sub-contractors ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees Tl•.ese sub-contractors have 9. F]Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp.insurance 9. L]Building addition required.] 5. [ We are a corporation and its 10.0 Electrical repairs or additions 1 3.❑ I am a homeowner doing all worir officers have ex_Prcised their 11.❑Plumbing repairs or additions myself. o workers' com right of exemption per MGL Y p c. 152 i4 and we have no i2.❑ Roof repairs t , insurance required.] ' � { )' 13.E] Other i employees. [No workers' comp. insurance required.] *Any applicant that Checks box-1 must also 511 out the section below showing their workers'eonipenasion paliey information. t Homeowners who submit this affidavit indicating they are doing all work and thea hire outside contractors must submit a new affidavit indicating such.. tCcntractors that check this rex must attached n additional sheet show-P-0 the r_Ante of the sub-contractors--nd smote•:hethe:or no:thosw entities!lave empioyees. If the sub-contractors have employees,they must provide their workers'comp.policy number. f a»t an empl ver th_at is prai,ding workers'cr- znsnsr�tion i:�sgrrrrnce for rnv e.�;pinyees. Belon-is Me p0cy and job site information. r Insurance Company Name:. � � �" ��'�� ri$-v ( 4 K Ce. ,, Ca m�4 if - Policy#or Sclf-ins.Lie.#: }?wo G aa_ Expiration Date: O/ A) bo 1> job Site Address: Citilcotate,'Zip: Attach a copy of the workers' compensation policy declaration gage(sh3wing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine lip to$1,500.00 and/or one-year iuriprisonment,as well as civil penalties in the form of STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statem-ent may be forwarded to tare Office of Irri e-stigations c)f the DIA for insurance coverage verification. A do hereby cerci -under the airs and enaltie o- er u -that rile in or nation provided above is true and correct. Si rraEare: rr Data; Phone#: >;F yo)- 7 G 36 Qf racial use only. Do not write in this area,to be completed by city or tower official City or Town: PermitriAcense# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6, Other Contact Person: Phone#: mw P Office of Consumer Affairs and Business Regulation 10 Parr.Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Reqistration: 102726 Type: DBA Expiration: 712/2018 Tr# 419291 POLAR BEAR INSULATION CO. Vincent LeBlanc P.O. BOX 958 ANDOVER, MA 0181(} Update Address and return card.Mark reason for change. SCA 1 0 2OM-05/11 � Address ❑ Renewal ❑ Employment ❑ Lost Card Office of v rF r':�✓r�^ I�aj�t uico�rwt�rr✓fly c��f?lGat,Ptrc�r�le�LY Consumer Affairs&Business Regulation License or registration valid for individual use Only 6P HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 102726 Type: Office of Consumer Affairs and Business Regulation is f Expiration: 7/2/2018 DBA 1.0 Park Plaza-Suite 5270 p Boston,MA 02116 POLAR BEAR INSULATION Co.. Vincent LeBlanc 51 SO.CANAL ST.#5A LAWRENCE,MA 01841 - ---------.---.._.._...-___ Undersecretary I�dat valid without signature 9 mass husett I7epa:tuuu���nt of Pu bh( Safety Board of i :ai din &�egt latnons Bund St andat ,ds C onq ti tiaon suap rubs,-`;J)Q:nand LJc: nseu C+SL-106017 PETER A LEBLANC � 2 EAST PINE STREET Plaistow NH 038&5 G:moram'u' s smneu 0412812018 4