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HomeMy WebLinkAboutBuilding Permit #739-16 - 28 MORNINGSIDE LANE 12/17/20157Iv i � � 1 B u I ` BUILDING PERMIT (�¢� `fU lel TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: Date Issued: IMPORTANT: Date Received must complete all items on this LOCATION (- "`= , !: � , i Se- 1C,`x c Print _ PROPERTY OWNER - Tv P rVK 100 Year Structure MAP PARCEL: u 7 ZONING DISTRICT: Historic District Machine Shop Village yes yesnno yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family El Addition [I Two or more family 11 Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other El Septic ❑ 1Nell Floodplain Wetlands ❑ Watersheds District El Water/Sewer re Arno v,e-o OWNER: Name: Address: DESCRIPTION OF NVL)MM I u Or- rtrcruruvir-u: roc I ; s Aec .ation - Please Type or Print Clearly 4 \t Phone: Contractor Name: U61 11 o te,\\ Phone: Address: 73 Supervisor's Construction License: J(3 _Exp. Date: /D // 3/® 7 Home Improvement License: ) y Yy � 7 Exp. Date: ARCHITECT/ENGINES 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: $ 6 , q J t FEE: $ Check No.: 20 Receipt No.: 3 NOTE: Persol' contracting with unregistered contractors do not have access to the g aranty fund Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Swfinming Pools 0 i Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM //!� PLANNING & DEVELOPMENT Reviewed On Z'1?' IS Signature_ —? COMMENTS KEA,)�nss CONSERVATION COMMENTS HEALTH COMMENTS Reviewed on re Reviewed on Siqnature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Com Conservation Decision: Comments Water & Sewer Connection/Signature ®ate Driveway Permit ]DPW Town Engineer: Signature: Located 384 Osgood Street FIRELDEPAR�T - MENT �TempDumpster,on;site:�.,yes 1�w ,. wt# �x .noi ,LocatedjaC41241Main#Street ' ` x' , �� �� '� .;,� Y�� _° "`�'�`� � �'°- •� 'Fir e�Depaft- COMMENTS,' tmCOMMENTS:' 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 21A—F and G min.$1oo-$100o fine NOTES and DATA — (For department use) ® Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 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 Building Permit Application Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses 4, Copy of Contract Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: 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 Copy Of Contract Floor/Cross Section/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 TOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) 46 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 2012 IECC Energy code Engineering Affidavits for Engineered products TOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit 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 Doe: Building Permit Revised 2014 Location No. - Date d J� Check #6 L 1J :. 0 3 4. TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ 4 Other Permit Fee $ TOTAL $ Building Inspector <_ o - o O -,, < a U) r `D• CD CD O N• O rt-� Z o =r N. O O V! CD' C O_o -1- C `C CDW n CD cn O N =• CD mo • CD �• 0 Q 0)y n co N � O s �D oo rt CD c� z �, A c =. CD ;t Za poCQ mr.L� co ' CQ• o 3 a n =� O m o n Q- < v cD co c y — v, Q O CDS o �m � CD (n � c Cn a 2 �, C7 �' W 'CD CD -� z CD U) SSU m cD o O �rt ou W 3 � c CD z �-,X Q� CDcm o cn S• = b --I cn CO CDc v �:® y�O � 00 v, CD Z CD �Dr 0 vi O � G> y cD 7 Z CD -Oa N o M CD ° 0. 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DECK DESIGN REPORT Evangelista Overview Number of Levels: 1 Footer Depth: 48" Joists Total Square Feet: 340 Live Load: 62 Beams 2 X 10 Dead Load: 10 Component Size Wood Type Joists 2 X 0 Treated Beams 2 X 10 Treated Posts 4 X 4 Treated Decking 5/4 x 6 DlYosite Railing Craftsman Lattice FooterDe th 48" 1 Live Load 62 psf Dead Load 110 psf Note: It is your responsibilty to verify complience with all Local Building Code requirements. This is not a finished building plan. Load Calculations and construction practices are based on the International Residential Code (2012). Limited States Design construction practice values are not provided. www.uspconnectors.com All rights reserved copyright ©2015 DIY Technologies Page 8 USP Po Deck 1C.: BEAM LABEL A B Beam Layout Level 1 BEAM LENGTH POST COUNT 19' 10 1/4" 4 19'10 1/4" 4 www.uspconnectors.com All rights reserved copyright ©2015 DIY Technologies Page 10 DECD DESIGIN REPORT POST SPACING 6' 3" 6'31' Evangelista USP Po Deck Designer"' Permit Page: Level 1 DECK DESIGN REPORT Evangelista LOAD AND SUPPORT: Your deck will support a 62 pounds per square foot (PSF) live load. Posts have 48" below ground support. DECK AND POST HEIGHT: You selected a height of 42" from the top of the decking to the ground level. The top of the deck support posts will therefore be 33" above ground level. Joists: Set joists on top of beams, 16'; center to center. Stress Anaysis- Level 1 Joist Deflection 321 Joist Bending 90 Joist Shear 119 Joist Compression 119 Beam Deflection 558 Beam Bending 97 Beam Shear 72 Post Stability 131 Note: It is your responsibilty to verify complience with all Local Building Code requirements. This is not a finished building plan. Load Calculations and construction practices are based on the International Residential Code (2009). Limited States Design construction practice values are not provided. www.uspconnectors.com All rights reserved copyright ©2015 DIY Technologies Page 9 , t- 3 � 1 i k . rt e j , s I ' a1 F E i 1 y TI , {{ ( jj t4 i 3 , c7 v A �y v _ 1�._q—...— I I v t Ej Ck I I n — c _ ---T-�--- |--� --`- r--�- '--'/---r----|- TT ir JL f , a.-_.. -_^.t.__'""""'"_.—c._...'.__3,..__,.p.,_.._,._..�-•----*-`--�#"'p""""` L e i fie/ ! ', S 4 ,moi p� ' 'fit ��•,,..___E--�__,..s.—...i �, ,,.—_, � _.__ f ?-----}�--- , "� F ���� t� A � � _ ' f 17 fi --}--•y-s-+--_,-__-�__—�- � ! .� ° � 1 t ! ;fit i {Q `� i E E � if i 1 i t E ( e E � lit f( '�._._...r,.......• t„f'f.e°��1 1 �I�. # f .�, -+.`e� ! � + 1R?1 f � i ! -7 7—i + ! f 4 � i � ' A •G` _-.-'�-- __ _. �"—�`--•--_Y[n'Z...��y.,,-�—• ` —+--tet--- . j l , E ' f , North Andover MIMAP November 30, 2015 125 MEADOWVIEW RD 103:0=005:1l.'`�'': •-� ;:::::=-u1,tr. li .:_••';-.:_:"41; ,..-..;"•:::_:"t. 12' 104.A-0054 : ,a_lu ':a-::.. ...... u1t.. ....-.0050 11, 135 MEADOWVIEW RD _� 103' 0-0049 '.._ �►tilu::.:...'::: 103.0-0048 0 .• - _.. ..._.. _ ::�..,lllt. �_=" �� •.::_:::. • •....._ flu •.::_•:.:•••'�a6c N T. • t Ira_ .._.. I, 104.A-0055 ::. ..:._. `11...._ ---- A& :.. .�4LC. .. .... .,/„ :�... .V.lt( �._=:.1.. 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S 103:0_0045 ""'.>!." -''' 104.A-0057 103.0-0103 104.A-0060 20 MORNINGSIDE LN 104.A-0058 104.0-0003 25 MORNINGSIDE LN [3 MVPC Bo E3 Municipal Boundary Horizontal Datum: MA Stateplane Coordinate System, Datum NAD83, — Rail Line Interstates — I — SR NORTH ? _ 0+++� +s 00 3t Meters Data Sources: The data for this map was produced by Merrimack Valley Planning Commission (MVPC) using data provided by the Town of North Andover. Additional data provided by the Executive Office of Environmental Affairs/MassGIS. The information depicted on this map is for - Roads t Easements Y. F -- ' " to Y - ♦ planning purposes only. It may not be adequate for legal boundary definition or regulatory interpretation. THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY ❑ Parcels — Trails - • s ,^ i► o� OF THESE DATA. THE TOWN OF NORTH ANDOVER DOES NOT V Hydrographic Features _ �+ i ,j� '� ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION '-- Streams ,SSACMUSpS Wetlands C Exempt Lands .�.r _ 82 ft „,�, North Andover MIMAP November 30, 2015 125 MEADOWVIE.W�RD ` _ _ 104.A-0054 - ' � :•� ••"`-.'- ..143.:0-0050:...-:::•:.' � - ...-•�:�', ....... _ 103:0-004.9 103.0-0048 s. :•.::' _ .. ..'.'..:. - "...:•.:'-: _ 104.A-0055 ....... ... I- I . .=047 103 0 0 6 .•::: - • . .. ....'•_ . • __ -. �_ .. _ _ _ _ _ /22� ORNINGSIDE L'N ) 1�n , -_ 104.A-0056 24-M.O.RNINGSIDE,LN:-.-- . •-.-: -:- •.: .�.. -: ..� .• .:. _:.:- � : 103:0-0046 I :' - - , ' -. • _ - j AN - - - 33 MORNINGSIDE L 103:0=004b- 104.A-0057 103.0-0103 � 104.A-0060 20�MORNINGSIDE.LN 104.A-0058 104.0-0003 t 25 MORNINGSIDE L El MVPC Bo Wetlands Zoning Busine s 1 DisMct �, Municipal Boundary C Exempt Lands p Busine 12 District Horizontal Datum: MA Stateplane Coordinate System, Datum NAD83, — Rail Line 0 Busine s 3 District Meters Data Sources: The data for this map was produced by Merrimack Interstates ■ Busine s 4 District @Genera Business District HORTN q� Valley Planning Commission (MVPC) using data provided by the Town of North Andover. Additional data by the Executive Office of — — SR p Planne Commercial Dev Of t'tic ��• O ? O provided Environmental Affairs/MassGIS. The information depicted on this map is Roads 47, Easements !] ComDevelopment Dist 13 Corrido Development Dist O Comido Development Dist Ind ustri 11 District �. _ L O --• ' "` 1� 10 4t for planning purposes only. It may not be adequate for legal boundary definition or regulatory interpretation. THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY ❑ Parcels C Industri 12 District * y w * OF THESE DATA, THE TOWN OF NORTH ANDOVER DOES NOT Zoning Overlay 0 Adult Entertainment 13 Industri 13 District R Industri S District * o l { •moo °`-""-..'� ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF Q Downtown Overlay District Historic District it Residence 1 District Reside 2 District �7,' ��r�o • ,� S` THIS INFORMATION 0 Water Protection ce C Reside ce 3 District SACNUS� Hydrographic Features 1" = 82 ft de ce 4 District de ce 5 District .de -- Streams ce 6 District ge esidential District 3c) , 30, `50 The Commonwealth of Massa.chusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-.2017 www mass.gov/dia sy Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Le -41 -1 ­ Name (Business/Organization/individual): ©1-4,01t S �Tc c� l,_t> o n s LLC - Address: City/State/Zip: Are you an employer? Check the appropriate box: a phone _Mef I. M I an, a employer with A, . employees (full and/or part-time).* 2. D I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] IF] I am a homeowner doing all work myself. [No workers' comp. insurance required.] t 4.n I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5Q I am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors Bade employees and have workers' comp. insurance.I 6. ❑ We are a corporation and its ofiigers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no. employees. [No workers' comp. insurance required.] Type of project (required): 7. EINew construction 8. E] Remodeling 9. ❑ Demolition 10 ❑ Building addition 11.❑ Electrical repairs or additions 12. [] Plumbing repairs or additions 13. Fq Roof repairs 14. ❑ Other *Any applicant that checks box 41 must also fill out the section below showing their workers' compensation policy information i 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 fiave employees, they must provide their works' comp. policy number. lam an employer that is providing workers' compensation insurance for my employees. • Below is the policy and jolt site information. Insurance Company Name:. Policy # or Self -ins. Lic. #:. Expiration Date: 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 under MGL c. 152, §25A is a criminal violation punishable by 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 day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DLA for insurance coverage verification. X do hereby certify under tlaepains andpenalties ofpe; 'u;y that the information provided above is true and correct. nate• /1130 J/ c Phone #: Q 1 -39 ) •-S'214 Of use only. Do not write in this area, to be completed by city o; fawn official. City or Town: Permit/License # 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 l'iire, 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 rrequired." 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 Please fill -out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractox(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 may be submitted to the Department of Industrial Accidents foi• 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' 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 burn leaves etc.) said person is NOT required to complete this affidavit. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-NUSSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia 11/30/2015 03:37 FAX 9787940313 -err) THIS CERTIFIC AT E CERTIFICATE 1;)01:: BELOW. THI:s CI::I REPRESENTA'T'IVE IMPORTANT: Ti r E! the terns and coo a Ii certificate holds r 11 I h PRODUCER Durso B Jankowalld II I. li 11 Saunders Streat North Andover, NIA 01 1 INSURED Wardell I I 190 Hav ) Medium 1. DURSO&JANKOWSKI INS AGCY Z001/001 WORDHOM-02 JONEILL CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOIYYYYI 1113012015 IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES ,TIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED IR PRODUCER, AND THE CERTIFICATE HOLDER. certificate holder Is an ADDITIONAL INSURED, the Policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to tions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the au of such endolsernent(s). Urance Agency 46 CONTACT NAME: PHONE 97e 688-7000 (978)688-7001 AIC No all. ( ) AIC No ; A ADDRBBB: INSURER(3) AFFORDING COVERAGE NAIC 0 INSURER A! MSA Group 14788 lome Solutions LLC till St., Suite 173 iRA 01844 INSURER B INSURER C! INSURER D. INSURER E: INSURER F; COVERAGES _ CERTIFICATE NUMBER: REVISION NUMBER: THIS IS 70 CE14,TIF I • THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. N0TW 11 WTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 07HER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 19 ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AMI;) CNSR :1 LTR TYFV OF 11. A 7X�OMMEREZC4 CLAINIIII•M/ E 1 GEN'L AGGREGr TE 1 II 1 K POLICY E] F � I _ J2, AUTOMOBILE LIAMIL I i _ ANY AUTO ALL OWNE AUTOS HIRED AU1 OS UMBRELu, IJAI EXCESS LOS DED [,RE' E 1 KERS COMP ENS C EMPLOYER 11 W II DROPRIETORIPAI f I '1ER/MEMBEFI EX ; I DESCRIPTION OF OP6FIAT1 /1 IDITIONS OF SUCH '3URANCE POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ADDLSUKK INSD WVDPOLICY NUMBER —punt7lw— MMIDD/YYTY POLICY EXP (MM/DD/YYYT) LIMITS ERAL LIAeILITY P�IQCCUR MPT9992P 10/18/2015 1011012018E EACH OCCURRENCE $ 1,000,000 e oeeurrenem) ® 600,00 MED EXP (any one person) $ 5,00 _ PERSONAL 6 ADV INJURY 6 1,000,000 T APPLIES PER: r ❑LOC GENERAL AGGREGATE 3 2,000,000 PRODUCTS •COMP/OP AOG $ 200,000 $ — SCHEDULED AUTOS NON -OWNED AUTOS MBIN D SIN L LTM 6 Ee accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) S R PERTYDAMA E P■ .� d■ r $ OCCUR CLAIMS�nADE EACH OCCURRENCE $ AGGREGATE S iT1ON 9 ON .1TY YIN (ERIE ECUI❑� MONS below N f A STATUTE ER E.L. EACH ACCIDENT 6 E,L, DISEASE • EA EMPLOYEE 6 EL. DISEASE - POLICY LIMIT S 3 / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be al ached M more space Is required) Towrl of I berth Andover 1201111a1r 24reet North At n hover, MA 01846 ACORD 26 (2014'01 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. REPRESENTATIVE REPRESENTATIV ®1988-2014 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD 1=ocZ t�llc�R't'G.Q.C� PUVZPoSCG "'5ANWK OSE 0)1L -X (bASEa UPOo l PubUa RECOW:15AMP r=VrDe9CE ar► `rK s�.rN t-•�DQPess.. Z&yo2KtiwenstLAO �©mica A&JPC>yET7_ 12. iy G1kLt_`i Cko`K' INIG�R''�C-AGO . k4A �-. �. �o CLT C o,►.,l o � .: LOT 2 S fig,©r2. 1�. A. Ir. ..... 10-j- PATE OWNER(S) R �" K t I,•I CERTIFICATE REGISTRY: ESSex Boor `ClA I CERTIFY that the' Lot shown hereon DEED: BK. P. 'Z J D that the W L LL Gx shown i • PLAN: (4'c, �o���e�✓( ZoniC RT. OF TITLE: ng�Y= NOTE of -the�r,(1� • of 1�.1© A.h�©OVA, r�Tu The -Premises do I _ not lie ,within. ,`''. a designated �; �'� �� Of els i r 7oa Hazardand ' : Zone. ObMtA,�kgr_CILUEr ROBERT. G. GOODWIN, .R.L.S. - �ZSdcal�)8-Mo w Gillett �n GOGGWJlid �� �, 82-CENTR.IL "I'TREET / Goodwin I ` ll75iti0 ANDOVER 11 As N��� S ,N UKE �•�: L 1�� ;fid.