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Home My WebLink AboutBuilding Permit #526 - 10 LACY STREET 2/1/2007 F NORTH ANDOVER �APPLICAWIOFOR PLAN EXAMINATION o� '`O oTN ° Permit NO: .2 Date Received—A C;�?-d MAI— Date Issued: n• — '' O �'�sIc�s IMPORTANT:Applicant must complete all items on this page LOCATION Z42 L*_ Prin PROPERTY OWNER / ldr�/e— Print � MAP NO.: ,0 PARCEL: OD ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ❑One family ❑ Addition ❑Two or more'family ❑ Industrial ❑ Alteration No.of units: ❑ Repair, replacement ❑Assessory Bldg ❑Commercial ❑ Demolition ❑ Moving relocation ❑Other ❑ Others: ❑ Foundationonl DECRIP O OF WORK TO BE PREFORMED I Identification Please Type or Print Clearly) OWNER: Name:///l/"V�w � Phone: Address:4LZ-AFY- ,1 12- 22�-/?te U- 4/60r— dw/� D19,11 I / CONTRACTOR Name:c fah' 1� 4yn Phone— , !W(� Address: Supervisor's Construction License: p eff) A6&e?- 1-7 Exp. Date: A17,,IeM Home Improvement License: 2 y`Z®J Exp. Date: J 47 ARCHITECT/ENGINEER ,ef /� 1A06 Name: Phone: �� 473 d Address: l 4,441'0ate' Reg. No. ?-el957 FEE SCHEDULE.-BULDINGPfRMIT.•,512.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON x125.00 PER S.F. Total Project Cost :$ FEE:$__Lk66 Check No.: Receipt No.: Page I of 4 i TYPE OF SEWERAGE DISPOSALe,'-� ❑ Tanning/Massage/Body Art . ❑ Swimming-fools El Public Sewer Tobacco Sales ❑ Food Packa in $ales ❑ Well ❑ g ;. Permanent Dumpster on Site ❑ Private(septic tank,etc. Electric N1,e OT location to project NOTE: Persons contract; with u gistered contractors do not have access to the aranty nd r Signature of Agent/Owner v Signature of contracto Plans Submitted Plans 'ved ❑ Certified Plot Plan ,�. Stam eJ/Plans THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS E REJECTED DATE APPROVED CONSERVATION2� ��'CI COMMENT Pet AJ5 AT ^a2 ' DATE REJECT11D DAT PROVED HEALTH ElJ � a COMMENT 4 rAA R E , B&\� FIRi9 DEPARTMENT - Temp Dumpster on site yes no I Fire Department signature/date COMMENTS Zoning Board of Appeals: Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature&Date Driveway Permit i �I Buil din Setback ( Front Yard Side Yard Rear Yard Re uired Provided Required Provides Required Provided Dimension Number of Stories:_Total square feet of floor area, based on Exterior dimensions. Total land area, sq. I: 1 p 5f r NOTES and DATA— For department use 1 t I Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPA RTMENT:BPFORMOS Created 1MC.Jan.2006 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 a,/Building Permit Application Workers Comp Affidavit /Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract P/ Floor Plan Or Proposed Interior Work Addition Or Decks erBuilding Permit Application e Surveyed Plot Plan V orkers Comp Affidavit V Photo Co of H.I.C. And C.S.L. Licenses PY i ❑ jsPY Of Contract c�Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And H aulic Calculations (If Applicable) q/Mass check Energy Compliance Report (If Applicable) , New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ; ❑ Mass check Energy Compliance Report I 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 I Doc:INSPECTIONAL SERVICES DEPARTMENT:81'FORM03 I I i Page 4 of 4 Location / No. Date i s �oRTh TOWN OF NORTH ANDOVER 9 + Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ �C�C S cMust 9 Foundation Permit Fee $ + Other Permit Fee $ TOTAL $ Check #/5-4 19964 Bwldine�spector v%ORTH own of 4 over No. sa - - A dower, Mass., COCMICMEWICK y�. Ids RATED 5 1 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT /_ , I BUILDING INSPECTOR (N.��. ......... ..... ..,/.. .............................................................................. Foundation has permission to erect............... V. � GfG�. ....•• Rough p ......................... buildings on....� ...... .... ......�'.� ................ ................ e�rnr..�1.o..L......A M1e!..../91n1/.. i.4.-A.7...................... ..Sir ....P/.4 W.. ................ to be occupied as Chimney provided that the person accepting this permit shall in every respect conform to the ms of the applic n on file in Final 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 1606 PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTI S Rough .. ... .............. ....... .. .................................. Service BUILD CTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE smoke net. NEw EN GLAND IENGINEEPOG SERVICES, INC. 01600 Osgood Street Building 20 Suite 2-64 North Andover, MA 01845 Tel: (978) 686-1768 • Fax: (978) 327-6138 Benjamin C. Osgood, Jr., P.E. President July 27, 2006 Allison McKay,Administrator North Andover Conservation Commission j 1600 Osgood Street North Andover, MA 01845 Re: 10 Lacey Street North Andover, MA ODear Allison: Please accept this letter as notification that I have inspected the proposed addition site at 10 Lacey Street and have determined that there are no vegetated wetlands or other resource areas within 100 feet of the proposed construction. The actual distance between the proposed addition and the edge of a Bordering Vegetated wetland which is along the banks of a pond is in excess of 250 feet. If you have any questions please do not hesitate to contact this office. Sincerely, Benjamin C. Osgood,Jr., P.E. President O I �7 � I Permit Number O . REScheck Compliance Certificate Checked By/Date Massachusetts Energy Code REScheckSoflware Version 3.5 Release le Data filename:C:\Documents and Settings\wildwoods\My Documents\William Pogor Building\Clients\10 Lacy Additionone.rck CITY:North Andover STATE:Massachusetts HDD:6322 CONSTRUCTION TYPE: 1 or 2 Family,Detached HEATING SYSTEM TYPE:Other(Non-Electric Resistance) DATE:01/22/07 COMPLIANCE:Passes Maximum UA= 1571 Your Home UA= 1495 4.8%Better Than Code(UA) Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA OCeiling 1:Flat Ceiling or Scissor Truss 1250 30.0 1.4 43 Wall 1:Wood Frame, 16"o.c. 450 19.0 1.4 23 Window 1:Vinyl Frame:Double Pane with Low-E 12 0.350 4 Window 1 copy 1:Vinyl Frame:Double Pane with Low-E 12 0.350 4 Window 1 copy 2:Vinyl Frame:Double Pane with Low-E 12 0.350 4 Window I copy 3:Vinyl Frame:Double Pane with Low-E 12 0.350 4 Wall 2:Wood Frame, 16"o.c. 252 30.0 1.4 11 Door l: Solid 20 0.350 7 Wall 3:Wood Frame, 16"o.c. 360 30.0 1.4 15 Window 5:Wood Frame:Double Pane with Low-E 9 0.350 3 Window 5 copy 1: Wood Frame:Double Pane with Low-E 9 0.350 3 Window 7:Vinyl Frame:Double Pane with Low-E 12 0.350 4 Window 7 copy 1:Vinyl Frame:Double Pane with Low-E 12 0.350 4 Basement Wall 1: Solid Concrete or Masonry500 19.0 1.4 4 0 Wall height:6.0' Depth below grade:4.0' Insulation depth:4.0' Basement Wall 2: Solid Concrete or Masonry 280 19.0 1.4 22 Wall height:6.0' Depth below grade:4.0' Insulation depth:4.0' Basement Wall 3: Solid Concrete or Masonry 400 19.0 1.4 29 Wall height:6.0' Depth below grade:4.0' OInsulation depth:4.0' Window 9:Vinyl Frame:Double Pane with Low-E 8 0.350 3 Window 9 copy 1:Vinyl Frame:Double Pane with Low-E 8 0.350 3 Door 3: Solid 20 0.350 7 Floor 1: Slab-On-Grade:Unheated 1250 0.4 1223 r Insulation depth:3.0' Floor 2:All-Wood Joist/Truss:Over Unconditioned Space 1250 30.0 1.4 39 Boiler 1:Other(Except Gas-Fired Steam),97 AFUE Air Conditioner,1:Electric Central Air, 15 SEER 0 COMPLIANCE STATEMENT. The proposed building design described here is consistent with the building plans,specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in RES checkVersion 3.5 Release Ie (formerly MECchecl and to comply with the mandatory requirements listed in the RES checkInspection Checklist. The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Standard Design Conditions found in tbe Code. The HVA eq ipment selected to heat or cool the building shall be no greater than 125%of the design load as specifi d in Secti 780C 310 and J4.4. Builder/Designer Date4j !/ 0 O � .. V l7.P L09J1,97L697fI1P",/«�•J•�.,�•••,•J,•/ _./.,« .,..,.�... t # BOARD'.OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 083917 Birthdate::06/2$/1957 _ Expires: Ofi/28/6b8 Tr.no 28106 Restricted: WILLIAM H POGOR _ 101ACY ST NO ANDOVER, MA 01845, t� • Gomeitssione—__t1 1 <: :, :77- 7 a t � j X``Y s�try er �L y-R b ✓f2E VZCY/LQ T - P fBoerd.of,$uild�ng Regnlations and S:indards g HOME IMRROUEMENT CONTRACTOR ,ltd YRegisttation .139707 „Expiration 8/5/2007 �; Type individual c3k5a. ORl�.a s ✓! xa leu?yt� i I WILLIAM POGOR ;iYC 79 J HNSON ST f NORTH'ANDOVER MA01845 Admirii fetor ., „ _ Adnulntscrar" O , I 01/23/2007 12:53.PAX 603 898 8269 FOY INSURANCE SALEM 11001 ACORDa CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 01/23/2007 PRODUCER (603)898-63ZO FAX (603)898-8269 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION IFoy insurance Group - Salem ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 130 Main St - Suite 103 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTENO OR Salem, NH 03079 ALTER THE COVERAGE AFFOROEO BY THE POLICIES BELOW '"irri Truhn INSURERS AFFORDING COVERAGE NAIC 0 I BRED Kevin Z69-in INSURERA: National Grange Mutual 14788 DBA: Godin's Carpentry & Remodeling INSURERS! Liberty Mutual 62 Pleasant Street INSURER Q Salem, NH 03079 INSURER D! INSURER E: COVERAGES 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 OTMER 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.AGGREGATE LIMBS:iHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, IIm NSR 00' TYPE OF INSURANCE POLICY NUMBER POLIL1r POLICY EXPIRATION LIMITS GENERAL LIABILITY MP089434 11/29/2006 11/29/2007 EACH OCCURRENCE s 500,0001 IC", MERCIAL GENERAL LIABILITY OE TORENTED S00,OO PAgNIMP-4(Fe CLAMS MADE M OCCUR MED EXP(Any one peroon) 5 10,OO01 APERSONAL A ADV INJURY S 50000 GENERAL AGGREGATE S 1,000 00 GENL AGGREGATE LIMIT APPLIES PER PRODUCTS•COMPIOP AGG $ 1,000 00 POLICY IRIJECT f7 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT & ANY AUTO (Eo aaddent) ALL OWNED AUTOS BODILY INJURY i SCHEDULED AUTOS (Per Pmw) HIRED AUTOS BODILY INJURY s NON-OWNED AUTOS (Per aotddent) PROPERTY DAMAGE S (Por aocldant) GARAGE LUIBIUTY AUTO ONLY-EA ACCIDENT ANY AUTO EA ACC $ OTHER THAN Q� AUYOONLY' AGG S BXCESSIUMBREL.IA UABILITr EACH OCCURRENCE S OCCUR F CLAIMS MADE AGGREGATE � s DEDUCTIBLE ' RETENTION S WORKERS COMPENSATION AND WC531S36OS37015 11/29/2006 11/29/2007 X wCSTATu. OTH• EMPLOYERS'LIABILITY EEL 6 ANY D YIP CER/MEETOR EXC TN ECLITIVE EL ACCIOENT $ 100,000 K ao,dem be under E.L.DISEASE•EA EMPLOYEE t 100,000 SPECIAL PROVISIONS below EL DISEASE-POLICY LIMIT S 500.000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS , CERTIFICATE HOLDER CABLCELLATIQN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TOT"CERTIFICATE HOLDER NAMED TO THE LEFT, William Pogor BUT FAILURE TO MAIL SUCH NOT4CE SMALL IMPOSE No OBLIGATION OR LIABILITY 10 Lacey Street OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVE& N. Andover, MA RIZED•RE NTATI CCORD 25(2001/08) FAX: C978)685-2425 Q►ACORD CORPORATION 1988 The Commonwealth of Massachusetts '] ' Department of Industrial Accidents l w Office of Investigations O W° 600 Washington Street eW= Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Q e Address: _0& City/State/Zip: Phone#: �� _q74 �7cS j Are you an employer?Check the appropriate box- Type of project(required): 1.❑ I am a employer with 4. Varn a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. KBuilding addition [No workers' comp, insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.F-1Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL insurancec. 152 12.❑Roof rep airs insurance required.] t , §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. O t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:��ww/Tr L A;L-f�Z_� Policy#or Self-ins. Lic.#: [�� Expiration Date:Z—/,5 '-409 Joh Site Address: L q City/State/Zip: Attach a copy of the workers' dompensation policy declaration page(showing 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 up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a da against the violator. Be advised that Y g a copy of this statement maybe forwarded to the Office of Investigations of the DIA for ' urance coverage verification. Ido hereby c tify under th p ins and penalties of perjury that the information provided above is true and correct. Si nature: Date: _ Phone 4979 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# O 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#: Information and Instructions ^ Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, O express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants i Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' O compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 4 Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE O Revised 11-22-06 Fax#617-727-7749 www.mass.gov/dia rax. Jan 19 2007 11:26am P002/002 AMM CERTIFICATE OF LIABILITYINSURDA7E(�°"�D mTy) PrsaLx ANCE 1/1.9/2007 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Cixcle Business Insuralnce Agency Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2147 Newbury St. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Danvers, MA 01923 ALTER THE COVERAGE AFFORDED BY THE POLICIES SELOW. 77-7030 'Upm INSURERS AFFORDING COVERAGE William Pogor General Contr&ct.inq INSURERA. ESSEX INSURIkNCE CO Services, LLC INSURERS. Gr=it* State In suraneo Co. 10 Lacy3 t INSURER a Travelers Insurance Co. North Andover, Mh 01845 INSUMR D: 978-685-2425 Ml$URER E NERAGES THE POLICIES OF INSURANCE USM BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY RE4UIRL HENT.TERM OP,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,Q(CLUSIONS ANO CONDMONS POLICIES.AGGREGATE LIMfTSStiom MAYHAVE BEEN REDUCED BY PAID CLAIMS. OF SUCH INBR LTR "MmOF POLICYNUAIBER ICYEXPIRATION DATE GENERAL LIABILITY gm LIMITS TACH OCCURRENCE S 1 000 OQQ X COMIAW40 ALGENE AL UABILTTY PREMISES occvrfyloe S 50,QQQ GIAIMSMaDE FX- OCCUR MEDEXP(Mynnop-SM) S excluded I p' 3CS2317 8-19-06 8-19-07 PERSONALBAOVINJURY Is l 000,000 I GENGENERAL AGGREGATE S 2 QQO,000 I 1 AGGREGATE LIMIT APPLIES PER' POLICY Loc PRODUCTS-COMPIOPAGG s 1,000,000 I -AUTOMOBILELw51UTY J ANYAUTD COMBINEDSIN%ELIM(r s I ALLOWNED AUTOS X SCHEDULED AUTOS =ILYYI„NI)RY S 250,000. a R HOWDAUTOs BA17900686 02/23/06 02/23/07 BODILYINJUfa;Y 1C NON•own�aaLTros (Pe,acrdaal s 500,000 c( DAMAGE s 100,000 GARAGE LIABILITY 1 ANYAUTO AUTDONLY-EAACQDENT Z I EAACC i AUTO�ONTL j EXCESS IBRELLA LIABILITY EACH OCCURRENCEAGG s j 11 OCCUR Q ClA1MSMADE j AGGREGATE S DEDUCTIBLE S RE-(ENTKk1 E S WORKE i 3COMPENSAT10NlUVD 0APLOY X TORYUMff3 E EMPLOYHZS'UAeq►TY 8734899 B ARiN 01-13-07 01-13-08 e.L.FAAiacC1DENT IS 100,0 0 xy�B aeaartee„neer E.L.DIWEASE-EA EMPLOYE S 100,000 SPECIAL PROVISIONS blow OTHM EL DISEASE-POLICY LIMIT S 500,000 I I L)W-R1P'nON OF OPERATIONSILOCATIONs/vEHKxrs/EXCLUSIONS ADOEO BY ENDORSEMENT/SPECIAL PROVLSIONS I I 1 CERTIFICATE H104DER CANCELLATION TOWNSHOULD ANY OF THE ABOVE DESCRIBED,POLICIES BE CANCELLED BEFORE THE EXPIRATx1 1600 OF NORTH STREAMOET DATE TNERE;OF,n4E I$$UING INSURER WILL ENDEAVOR TO MAIL10 DAYS WRITTEN 1600 OSGOOD $TRE)~'j' NOTICE TOTI4E CERTIFICATE HOLDER NAMED TO THE t.WT.OUT FAILURE TO DO So SHALL NORTH AMOVER MA 01845 IMPOSE NO OBLIGATJON OR LIABILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR REPRESENTATTv6S. AUTHORRE0 R"RESENTATIYE ACORD25(2001=) 0 ® ORD CORPORATION 1948 CER 7MED PLOT PLAN a PREPARED FOR.- m BILL POGOR AT ` 10 LACY STREETEAS'IkY NORTH ANDOVER, MA. NORTH ESSEX REGISTRY OF DEEDS: SK. 9740 PO 44 ASSESSOR'S MAP: 1050, L 0 T 73 ZONING.- R-1 � > � SCALE'.•1"--100' DA 7E.- MAY 02, 2006 N 267.98' 1 LOT 2EB ` 8.00 ACRES t! At' cp aX °`•L6•' S'•. 260`e 270.+00' it je s .38.89' �tN OF 44 PREPARED 8Y I s JOHN ABAGIS & ASSOCIA TES, PROFES90MAL LAND,SURVEYORS NO. LAW 9 BARTLETT STREET, ND. 252, ANDOVER. MA. (978)-688-4899 'cul LAW ✓08 NO. 5353 LL O O 1 CERTIFIED PLOT PLAN a PREPARED FOR.• BILL POGOR N` ATunury 10 LACY STREET �o.~ EAS''U. NORTV ANDOVER, MA. � �� NORTH ESSEX REGISTRY OF DEEDS.• SK. 9740 PG. 44 ASSESSOR'S MAP: 1050, LOT 73 ZONING. R-1 '>, SCALE•1"--100' DA 7F• MAY 02, 2006 ° -VA N 26;.98' LOT 2 ` 6.00 ACRES 270.00' tot�9 i '136.'•i' X38.89' �ZK OF 44s Com ' PREPARED BY N0.. 335775 JOHN ABAGIS & ASSOCI Ma PROFLr ONAL LAND .SURWYORS 3 9 BAR7LETT SIREET, N0. 252, ANDOVER, MA. (978)-888-4899 "`""0 JOB NO. 5353 0 0 0 Date.... 2- -7 .......................... TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING SSACHU Thiscertifies that ............................................................................................. `fit has permission to perform ..... .......................................... ................ wiring in the building of......../ .............1gl(.......................................... 4,we at...../42' .................y..............................................**** ,,North Andover,Mass. Fee...` �f... Lic.No..&;��..............i�. ........................ EcrRICAL INSPECTOR �F 1? Check # 105 7881