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Home My WebLink AboutBuilding Permit #164 - 595 CHICKERING ROAD 8/30/2007 OOK1p BUILDING PERMIT TOWN OF NORTH ANDOVER F i APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received jSACHt1`, 11 2 Date Issued: -� ` D IMPORTANT Applicant must complete all items on this page ` �' � 'A� µ LO� 1l AT ' ? �� 1 € t l s x x �PROPEFtT� Q11I � � g ;• MAP JO P,4RIE Z3tNC ll "1�� '" I �st�r�fiirot �' y ; m � �ac) nStaplfl � Vires rrra TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family El Addition El Two or more family 11 Industrial Alteration No. of urAs. "ommercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other CSe tE11�ell ��llan �etlands �l Wlh lal � tr� DESCRIPT, ON OF WORK TO BE PREFORMED: '4 ST/.► A T�u�/ -F YtNto V (.J (S h�2 v /t OleSK t`�� dentifica on Please Type or Print Clearly) 7� &36OWNER: Name: �(�O/� 2 i AV&/4 Phone: � ' `y Address 3G J uA/ h 4 olo �'�r�c , I*A . O/15 y m a Str1tSOPSrQ� llf� tlt11�C5� j`1tX1De a` Iornp I�npraare�e # ARCHITECT/ENGINEER OMAN Phone: 1,✓ l l4M /YW r Address: �No /n�/N 3 rA `A Req. No. �T s'3 FEE SCHEDULE:BULDING PERMIT,:$$12.000 PER$1000.00 OF THE TOTAL ESTIMATED COST ASED ON$125.00 PER S.F. Total Project Cost: $1 `7 / s�� FEE: $ Check No.: ,�2 D D 7 Receipt No.: 2o!N NOTE: Persons contracting wi unre istered contractors do not have access to the uaranty and , Sagnattare of A ertO�rner - nater xofi contracorw Location No. A-V Date 40RT1y TOWN OF NORTH ANDOVER 3? � • 0 AL 41 + i Certificate of Occupancy $ t sACNUs t Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ w ! . TOTAL $ �` Check It' ` 205 " Building Inspector Location No. ' �/ Date NORT" TOWN OF NORTH ANDOVER 9 + s + ; , Certificate of Occupancy $ ,ssAGMUSEt'�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ /00 C'"',6 TOTAL $ /03 Check # 2 0 y U 2 s§uilding Inspector Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer Tom' /Massage/Body Art Swimming Pools ❑ 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT [,�-" 1 COMMENTS d G DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE AP ROVED HEALTHEl COMMENTS Zoning Board of ApIt; peals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/S9nature & Date Driveway Permit Located at 384 Osgood Street FIREEP.Ai�iTMIT Term Dum` Aster nkf g eyes z d1C3 p :Locat d,.1,af14j4 Mtn Streef Firepair�ea date- - r� xr ° r w �aMMENTS 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.$100-$1000 fine NOTES and DATA— For department use P ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 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 ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application 91VIdc 12,, ❑ Certified Surveyed Plot Plan, Workers Comp Affidavi ❑* Photo Copy of H.I.0 And C.S.L. Licenses `75Copy Of Contract ❑ Floor/Crossection/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 NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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 ❑ Engineering Affidavits for Engineered products NOTE: 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 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 ♦ r CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 164(8/30/07) Date: January 17, 2008 THIS CERTIFIES THAT THE BUILDING LOCATED ON 595 Chickering Road MAY BE OCCUPIED AS Tanning Salon (Sun Bay) Ilv ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: The Santo Mangano Trust 595 Chickering Rd North Andover Ma 01845 Building Inspector h 1 NORTH o of yAndover 0 . _ rn or, dover, Mass., CAKE st, COCHICHEWICK �DRATED U BOARD OF HEALTH IT T D Food/Kitchen Septic SystemPERM 0 ... .. ,. �� 41'+0 s i 1, B DING INSPE OR THIS CERTIFIES THAT .....�Vn .4h.9..1� ,, ! hA/. ............................. .. Foundation has permission to erect. ..... buildings on ..... is... ..C. .0:40.1� � ................... Rough tobe occupied as. f4A.04A.iWi..... . ...1.............................................................................................. provided that the person acceptintpermit shall in every respect conform to the terms of the application on file in incl 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. PLUMB&G INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough C9 ' PERMIT EXPIRES IC6N3THS ELECTRICAL INSPECTOR �J 1 ti LES�7 C®NS�V C �S Rough Service ........ ................. ..................... Occupancy Permit Required t0 Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry (Nall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner fA-- Street No. � SEE REVERSE SIDE Smoke Det. . Date NORT:,tia TOWN OF NORTH ANDOVER f ioPERMIT F OR PLUMBING s � s ,SSACMUSE� This certifies that . .�� .�?�. h'. . . . . . . . . . . . . . . . . . . has permission to perform . . . . _ . . plumbing in the buildings of r. . . . . . . . . . . . . . North Andover, Mass. Fee.5�. Lic. No. .{�.'�.-. . . . . . LUMBING INSPE(?TOR Check ff C/ 7618 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Q 1 Date Building Location Owners Name Permit# Amount <71 Type of Occupancy l oJ��er�/c��+L j1�NNry� >T44�-J New rl Renovation Replacement Plans Submitted Yes No FIXTURES z H � . W � v a A A [m � oa BA�INI' �l�.locR P zl�n gnat M R—OCR 4MKOCIR 7MFLOM six FMM (Print or type) C �G✓ y. p� Check one: Certificate Installing Company Name7'Y', ,}� ❑ Corp. Address �l� 7(ulS ( �y�l. �3� Partner. ]Business elephone ffFirm/Co,. Name of Licensed Plumber: Insurance Coverage: Indicate the t*of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State PI Code d Chapter 142 of the General Laws. By: �gnaure o u Type of Pl mg icense Title —,�I',2.4 City/Town icense um er Master ❑ Journeyman APPROVED(OFFICE USE ONLY Date. l. .•. ,AOR Try 3r�°`' •°�� TOWN OF NORTH ANDOVER O a - PERMIT FOR GAS INSTALLATION _ y + �9SSACMUSE�A This certifies that . . . . . . �, . has permission for gas installation . . . Rr-4. i�:. .' .. . . . . . . . . . in the buildings of . .- Ae e>.t:.�. . . 5. lam. . . . . . . . . . . . . . . . . . . . at . . . c?!. . l. . . . .. . . . . . . ., North Andover, Mass. Fee.Fc! . Lic. No.. GAS INSPECTOR l' Check# 4/V 7 G 6235 MASSACHUSETTS UNIFORM APPUCATON FOR PERNIIT TO DO GAS FTrn NG (Type or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations ��S �—`�l��.� lY�` Permit# G 3 Amount S Q5,-",30 r'�.'L ��e(,v.✓ Owner's Name �.-r—�—� Tj New Renovation Replacement Plans Submitted IJ E4 w v�' C p CC z ' Z z E• CC m F W p a I p z v, n; z = v, �- a C a > w CS F z F Q x W w w F' w F O a z d w Q C v� Z O z w O x � x oa °x a N o SU B-BASEM ENT ° > o BASEM ENT 1ST. FLOOR 2ND . FLOGR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type) Name ` / PZ u Check one: Certificate Installing Company C ! L ,�/ �,� _ < Corp. n Address 711 �tll �Sl�� 1 6j9—GS Partner. Business Telephone (p �,2, ,�1 117 Firm/Co. Name of Licensed Plumber'or Gas Fitter Al (-J �(! to INSURANCE COVERAGE Check on . I have a current liability Insurance,pol'cy or it's substantial equivalent. Yes No If you have checked es,please in 'cate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity D Bond 13 Owner's Insurance Waiver: I,am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent 0 hereby certify that all of the details and information 1 have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas an r 142 of the General Laws. By: Signature of Licensed Plumb Or Gas Fitter Title 1:3 Plumber a�4 f City/Town. Gas Fitter License Number M er _ APPROVED(OFFICE USE ONLY) oumeyman Construction Su '� pervisor Licens License: CS Birthday 2/4/1965699 E �iratt�n o� eo1Zoos �sTr �aoo ! h►ction JAMES KATER f r' 91 BRADFORD qVF /tr/ BRADFORD, MA 0 .-! Commissioner GENERAL CONTRACT This Contract is made on V'I a � � between Party One,of40_,� C ! Coil/ , City of State of and %( Qyl/(�� Party Two, of City of State of For valuable consideration,the parties agree to the following: Party One agrees to: j� /� ��•/ _ �L r� ,[, s /y ��jl/�p=/� Iva Ian 14^61,;) 61"117 OVAIII—I Party Two agrees to: Any additional terms: __/ No modification of this Contract will be effective unless it is in writing and is signed by both parties. This Contract binds and benefits both parties and any successors and assigns. Time is of the essence of this Contract. This document,including any attachments,is the entire agreement between the parties. This Contract is governed by the laws of the State of Dated: 011.51Q Signatureo One Si gnatu of Party Two Name of Party Otte Nam Party Two tjORTH TOWN OF NORTH ANDOVER ,ats `n o�°oma OFFICE OF BUILDING DEPARTMENT 400 Osgood Street North Andover,Massachusetts 01845 �Ssacwu�� D.Robert Nicetta, Telephone(978)688-95454 Building Commissioner Fax (978)688-9542 CONTROL CONSTRUCTION- SECTION 116.0 M.S.B.C. CERTIFICATE OF ENGINEERING/ARCHITECTURE BULDING INSPECTOR TOWN OF NORTH ANDOVER 400 OSGOOD STREET NORTH ANDOVER MA 01845 I —T-1-10 ev%ot 9 r 5C 0-f fi HEREBY CERTIFY THAT `i"EN�tNTSP�}� THE B+4L-�CONSTRUCTED AT '51G C ti 1 C Ke r t rnq Ra(• r ,tz St1Nt3f�NQuE �ikl�N DOES CONFORM IN ALL RESPECTS TO THE MASSACHUSETTS STATE BUILDING CODE AND APPLICABLE FEDERAL REGULATIONS FOR THE FOLLOWING: AUTHORIZED SIGNATURE: �/1�4 e Ryff— DATE: 7 REGISTRATION: NOTE: ENGINEER"WET STAMP"MUST BE AFFIXED TO THIS FORM ' �Ry9a�.�g'J�6! � �y P'V 38.GJ W. tz MASS. Control Construction Form revised 11.15.2004 BOARD OF APPEALS 688-9541 CONSERVATION 685-9530 HEALTH 688-9540 PLANNING 688-953; PF6j Town of No. 0 r _ 17 * dover, Mass., Q LAKE It. COCHICHEWICK V Ids RATED PPS 7 V BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System � BUILDING INSPECTOR THIS CERTIFIES THAT 3.06.6.0.11..o.4 �kh .. .......) �� S 1. ' .................. ..... ........................................ Foundation has permission to erect..................................... buildings on ...5j.............C.60� .......ow. ..!!................... Rough to be occupied as /r1.h .. ..... . S ..�. Chimney . . . . . .. . .... . . . . .. . . . . . .. . .. . . . . provided that the person accepting t permit shall in every respect conform to the terms of the application 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 Final 3PERMIT EXPIRES IV6NTHS ELECTRICAL INSPECTOR UNLESS CONSTRU TS Rough ................... .... .. Service BUILD OR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry (Nall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. S tINBANQUE 595 CHICKERING RD. NORTH ANDOVER, MA 01845 BUILDING COSTS CARPENTRY 8,375.00 ELECTRICAL& LIGHTING 31,260.00 PLUMBING 2,300 FLOORING 35775 HVAC 16,550 PAINTING 111500 ALS 690 TOTAL Q ss Date.....p ::.�'. -. '.7... - 3?°.;� .:"�o� TOWN OF NORTH ANDOVER ic W. p PERMIT FOR WIRING ,. SACHU i I I This certifies that ................................................. � ... G. ...�'..e. ............ has pennission to perform .....r...' til✓ wiring in the building of.. ./a..................�,..... ...........................,......... at `� �lc / .....�� ... North Andover,Mass. Fee..99AP Lic.No..........7! .3.4.... .IX .. .a. . ... ELECTRICAL INSPECTOR Check# 336, 7 31 1 Commonwealth of Massachusetts Official Use Only •_ Department of Fire Services Permit No._� � BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked [Rev. 1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: '�-5- Q City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Owner or Tenant �VC� n �� c 1 an Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building~)�n,,,\,\c„- Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service FON4 Amps / olts Overhead❑ Undgrd No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: e r-"� L wry\ Completion of the ollomtable may be waived b the Ins ector of Wires. + No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of LuminairesSwimming Pool Above ❑ in ❑ .o mergency ig g rnd, d. Battery Units No.of Receptacle Outlets 11 } No.of Oil Burners FIRE ALARMS N�ofZ�o�nes No.of Switches � No.of Gas Burners No.of Detection and Initiatin Devices No.of Ranges No.of Air Cond, i To a IS No.of Alerting Devices No.of Waste Disposers Heat PSP Number Tons No.of Self-Contained Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of WaterNo.of Noof No.of Devices or Equivalent Heaters KW Signs Ballasts . Data it Devices or Equivalent ” No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: q-5-d ON Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Er BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: r� \eC��SCC LIC.NO.: ly (� Licensee: Signature LIC.NO.: (If applicable, enter" empt"in the license number line.) v Address: X95 C4 4in ►�!� rya ��\ 71�cJ Bus.Tel.No.:%-iff- Sia-SFI-I-1 Alt.Tel.No.: 10\0% *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ eyt-;--k- "' ,-.3 t pot, INTERNET INSURANCE Fax:97B6870149 Aug 29 2007 15:47 P. 02 ACORD CERTIFICATE OF LIABILITY Y INSURANCE DATE(MMIDDh•YTY) PRODUCER 0$129/2007 Internet Insurance Agency THIS CERTIFICATE IS 188UE0 As A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 522 Chickering Road HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR North Andover, MA 01845 ALTER THE COVERAGE AFFORDED oY THE POLICIES BELOW. INSURED INSURERS AFFORDING COVERAGE MAIC M JAMES M. KATER INSURER A; AIM INSURANCE COMPANY DBA JAM BUILDERS INSURER B: NORFOLK AND DEDHAM 371 HOWE STREET INSURER C; METHUEN,MA 01844 INSURER D: COVER INSURER E; 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 TERMSSIM ,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LTROISRD TYPE OF INSURANCE POLICY NUMBER IRVm� IMM B GENERAL LIABILITY R0622157AI uMITs ✓ COMMERCIAL GENERAL LIABILITY 05/222007 0522/2008 EACH OCCURRENCE y 1,000,000.00 EICLAIMS MADE g] OCCUR PRE 6NTry '50,000.00 MEDEXP(Arryone penton) $6,000.00 PERSONAL&ADV INJURY 6 1.0m,000.00 GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGOREGATE E 200,000.00 POLICY PROJECT LOC 1 PRODUCTS•COMP/OP AGG S 2.000,000.00 AUTOMOBILE LIABILITY ANY AUTO G a fmEDt¢tNc,LE LIMIT S ALL OWNED AUTOS (Etlen 1 SCHEDULED AUTOS $001,LY INJURY S HIREDAUTOS NON-OWNED AUTOS BODILY INJURY 4 (Per eeudorn) P OPER7Y DAMAGE II IPer PER,GARAGE uAea1TY ANY AUTO AUTO ONLY•EA ACCIDENT S gpg THAN EA ACC b AUTO ONLY; AGO S EXCESWUMBRELLA LIABILITY OCCUR CLAIM$MADE EACH OCCURRENCE S AOORECATE ; DEDUCTIBLE 6 RETENTION i E A Wo RKERS COMPEN KATION AND 3 FJIePLovtEgT,LU1BIurY AWC 7013345012004 09/28/2008 09/281.2007 ✓ TRY TAT LIMITS ER' ANY PROPRIETORMARTNER/EXECUTIVE OFFICEWMEMBER EXCLUDED? E.L.EACH ACCIDENT 6 1100,01W.00 Itye a deevibe umoor 111 DISEASE.EA EMPLOYEE $100,000.00 8PEGIIAL PROVIBIONS below OTHER E.L.DISEASE•POLICY LIMITI C 600,000.00 ADDITIONAL INSURED;SUNBANQUE TANNING 595 CHICKERING ROAD NORTH ANDOVER, MA 01845 CERTIFICATE HOLDER CANCELLATION SUNBANQUE TANNING 4OPJZED THE BOVEDSSCRIBEDP ES BE CANCELLED BEFORE THE EXPIRATION 595 CHICKERING ROAD ,TN $SUING INSURER ENDEAVORTOMAIL 030 DAYSWRITTEN NORTH ANDOVER, MA 01845 TIFK:ATE HOLDER AM90 TO THE LEFT,BUT FAILURE TO DO BO SMALL ATION OR LIARI OF ANY KIND UPON THE INSURER,ITS AGENTS OR 6S.RESENT ACORO 26(20OVDS) 0 ACORD CORPORATION 1966 l�tY Y {l Y V, k ,ki KK J �.Pu,"t Y!� x"+'3•. f .n" h 4y 'MY :t", <Y 1 7.. f l Y �,�A - h Y M- P\ 3 A J !,5 s F A✓`k �t1 1 2, '.4 h Z V ■ 3 A ! 2 I I �Y u ` \ '-' ,..r.:.., ...,r, r., i, ,.. ,.,.:'. ..-,, S , r 4+o-✓t 5 Z ICK A TTIIT formi • r s 4 , � a ., w x , Y t-: , r-. ^ , „ TTT O O ' - w. ` _ .. �- '' .,, .. .�, , ,. ;:.a 'k•-•.': 1.", �a ..- ... _.._. ,---. .. .._. .-. ., ,: .. .:.-" ,-...:. �=.-Jw Ji r eri. ,., '✓r.: ,e.y, '�k,v. r;( .`'� •iYvx, ':fi,«? ..1: , ,. ::'. ,... .-.: � ,..,,. a �- ,3 >,.- ,tea r -•GE4,..: i. >: ,x s. ;x.£ :fa r. F*1 ., .... r ..•., -.. • � � - � — - ! •._• •• _. o. _ ',.' • s. 8 l I I/ C - ` X15' 1 Y �� f�-� F• b u +Y r r: . .0 . ,.....,:. -_.-. .,.-. .. .. ..,. w rc. .... -... .._. .. ..:.... ... ... ,:.;. ,. :-, rn .... Y. lid' It. i , ti t. `x i r , v i q: y , , TIII ,.. ..,.. s_.... a, x'*, fit,-n+r, S '`�_ ,a� . _ "J r a � a . „ > k x. t t g Reface Pre='Existin :Non Conn ` Si n ( ,�:,g g - Existing . .r r k I e _ f "... _ .. .. a .. ... ..< ". ,. ._ ..:.. :. , .. ,. ,. r X.. ,, ,•(p�� ,r a -.. 4, -._.�p� -.. .... ..- - -,:.: ,.. _ .. i• t. {�, ,„ ,rt"i.,! I• r ,: ,a e , _ ,.r i.,4A ,.., nu.: 1 �4 i1'r'. External Ground r. a , , 1^ i Lighting Added - t „ e $ � r