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HomeMy WebLinkAboutBuilding Permit #122-12 - 8 WOOD AVENUE 8/10/2011 BUILDING PERMIT yORTF/ Ot,.�° ,b�++ TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO:/0101-'f 2 Date Received is `°q,..o.►°' c`� i �SSACHUSE� Date Issued: 0 IMPORTANT Applicant must complete all items on this page LOCATION. PR1r1F OPERTY ONER ? �6-A P. :MAS'`NO PAI C0=L ZO 1�Nt-'DISTR'I'CT H�stonc D�sfir ct yes o - Macline•Shop Village yes o. r TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building x One family Addition Two or more family Industrial Alteration No. of units: Commercial }� Repair, replacement Assessory Bldg Others: Demolition Other $epbc _ Weil Floodplain Wetlands UUatershed DistIct -� A ,Water/Sewer .r DESCRIPTION OF WORK T E PREFORMED: 1,A VIZ 44-71 Id ti kation Please Type or Print Clearly) OWNER: Name: Phone: r Address: i, Am if "A QONTRACTaR Narne- �� � .,ho ( h Address .01 � fl Su pervisor's'Consfruction Lacense Exp Date 777 Hnme,lmm provent Ltceise ,E�cp _Date. . ARCHITECT/ENGINEER 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: $ �;D ) 0 FEE: $ `:57®-= Check No.: ! WI Receipt No.: Cq- y NOTE: Persons contracting with unregistered contractors do not have access t e uar ty fuhd Signattare of Agentl0+ rner � „` r Signature of contracto T a� Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/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 COMMENTS DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH 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 Located at 384 Osgood Street FIRE DEPART�VIEIVT '-Temp�D.urnpster on stte yes no Located-41°24.Mai n Street h Fire Departrnen#sj atureldate;.. COMMENTS 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 ❑ 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 o 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 ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy 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. Thea applicant must then et this recorded Pp g at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 I � Revised 2.2007 i I Location No. O Date MOATN TOWN OF NORTH ANDOVER F � Certificate of Occupancy $ Building/Frame Permit Fee $ c0 Foundation Permit Fee $ Other Permit Fee $ (� `TOTAL $ Check # 244Gb Building Inspector The commonwealth of Massachusetis N�. Department of Industrial Accidents ¢ wf. Office of Investigations �. I Congress Street, Suite 100 , .;Boston, MA 02114-2017 www.rnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/lndividual): Address: 00 elv°L 'Cl�i l.( ti,• City/5t to/Zip: C��t ' 1 Phone#: (�Ur' C� Are u an employer?Check the appropriate box: Type of project(required): 1. I am a em to er with ��r 4. [].1 am a general contractor and I p y * have hired the sub-contractors 6. ❑Now construction employees(full and/or part-time). 2.❑ I am a sole proprietor or partfier- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, .❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers.' comp. insurance comp.insurance.: required.] 5. Q We are a corporation and its 10.Q Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.Q Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.[]Rif repairs insurance required.]t c. 152, §1(4),and we have no L��1/ tQ1JJDa(�-,_ employees. [No workers' 13. Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out.the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicatiag they are domg all work and then hire outside contractors must submit a mew affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-coatraetors and state whethef or not those entities have employees. If the sub-contractors have employees,they must provide their•workers'camp.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: Policy#or Self-ins.Lica M �0 I Cl�0 11-34-13 19 Expiration Date: [ � ,� City/State/Zi .Tob Site Address: t�� P' ~� Attach a copy of the workers'compensation 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 qday against the violator. Be advised that a copy of this statement may be for-warded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify unler the Ains d penalties of er'ury that the information provided above is true nd correct Si nature. Q. _... _. _ Date . _.._ ...... Phone#• `�'�� _f�'7��(,��� Official use only. Do not write in this area, to be completed by city or town offtciaL City or Toren: Permit/License# Issuing Authority (circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector NORTH ® of : Andover 0 C,, 0 , dover, Mass., �S • 11�f i COCMICMEWICK I� 7�S0"SATED U BOARD OF HEALTH OEM PE� , a MIT , T D Food/Kitchen Septic System BUILDING INSPECTOR 1_ `.. to 0 THIS CERTIFIES THAT....... ...1/1�/t/ ............................. /!!�h.�w��........................................................................ Foundation haspermission to erect..................................... ......... 3..........building ............................................................... Rough to be occupied as.......... ....�� . ................ ........ .. ..b!!!�!�.�� f� �........ . Chimney w provided that the person cep g this permit sha 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 3 , PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIST' Rough N............................................................................................ Service ..................... BUILDING INSPECTOR 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 Det. GATE(MMIDOIYYY'f� A�021� CERTIFICATE OF LIABILITY INSURANCE 02/21/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CER>IRCATL- HOLDEp_7 IS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE PO 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 (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 1-404-995-3000 CONTACT .•,wer.� NAME: ....... Marsh USA, Inc. �""' PHONE - FAX 4AIC,No)_--.._._...=''.:_..... ._........ _ E-MAIL homedepot.certrequest@marsh.Com ADDRESS_ _ _---- --- -•••- "-"` Two Alliance Center, 3560 Lenox Road, Suite 2400 INSURERS AFFOROINO COVERAGE NALCO Atlanta, GA 30326 —(.1---_--.-.— --_.----.-. _••-_._..__.... -----_— Fax (212) 948-0902 -- INSURER A: Steadfast Ins Cc 26387 INSURED — INSURER B: Zurich American Ins Co 16535 The Home Depot, Inc. INSURER C: New Hampshire Ins Co_ 23841_ Home Depot V.S.A., Inc. 23817 2455 Paces Ferry Road Wq INSURER o: Illinois Nat' Ina Co_-- E Building C 20 INSURER E: NATIONAL UNION FIRE INS CO OF PI19445 Atlanta, GA 30339 ------'—' -' _ .._9 INSURER r: Illinois Union Ins Co 27960 COVERAGES CERTIFICATE NUMBER: 19834682 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 TADUL SUER - POLICY EFF POLICY EXP ~-- LIMITS LTR TYPE OF INSURANCE - I POLICY NUMBER .MIDDIYYYV .MIoOIYYY A GENERAL LIABILITY GL04887714-01 03/O1/1' 03/01/12 EACH OCCURRENCE $ 9.000,000 - S ,., " DAMAGE TO NTD 1 000,000 COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence).,_ __._____--...._._ CLAIMS-MADE OCCUR MED EXP Any one person) E EXCLTJDED -_- X LIMITS OF POLICY XS - PERSONAL 6 AOV INJURY E 91000,000 X OF SIR: $1M PER^OCC GENE-RALAGGREGATE g 9,000,000 - PRODUCTS-COMPIOPAGG E 9,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER � _ X POLICY PRO- LOC BAP 2938863-08 3 O1 .L Ol 12 COMBINED SINGLE LIMIT 1,000,000 B AUTOMOBILE LIABILITY I F actidenl X ANY AUTO BODILY INJURY(Per person)_ ALL OWNED SCHEDULED BODILY INJURY(Par accident) S AUTOS AUTOS PROPERTY DAMAGE No er nt S _ HIRED AUTOS AUTOS X SIR AUTO P Y S UMBRELLA LIAROCCUR EACH OCCURRENCE_ H EXCESSLIAB CLAIMS-MAGE AGGREGATE-_� S __-__-„_.- S DED RETENTIONS WC STATU• 0TH• C WORKERS COMPENSATION WC061967352 (AOS) 03/01/1 03/01/12 X _____-_•_• AND EMPLOYERS'LIABILITY YIN D3/Ol/12 D ANY PROPRIETORIPARTNER/IiXECUTIYE WC061967354 (FL) 03/01/1 E.L.EACH ACCIDENT s 100000000_- '. OFFICERIMEMBER EXCLUDE 07 a NIA E (Mandatory in NH) WC061967353 (CA) 03/01/1 03/01/12 EL.OISEASE•EAEMPLO__ S 1,000,000_ If es,describe under E.I.OISEASE•POLICY LIMIT E 1,000,000 DESCRIPTION OF OPERATIONS below C Workers Compensation WC06196735S(KY,MO,N7 03/01/1 03/01/12 .Occurrence/SIR 30M/1M F TX Employers XS Indemnity THSC46244151 (TX) 03/01/1 03/01/12 E Workers Compensation WC1192378 (QSI) 03/01/1 1. 03/01/12 SIR 1M DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks schedule.if more space is required) RE: EVIDENCE OF COVERAGE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE HOME DEPOT, INC. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN HOME DEPOT U.S.A., INC. ACCORDANCE WITH THE POLICY PROVISIONS. 2455 PACES FERRY ROAD NW AUTHORIZED REPRESENTATIVE BUILDING C•20 �- ATLANTA, GA 30339 .,, USA ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD jfiero-hd 19834682 I - t + �l<ts+,tchusetts-Department of Public�afet+ Buard of Build ill- Regutatiolis and St.lit]itrds ` + Construction Supervisor Specialty License License: CS SL 100696 Restricted to: WS ALAN PAINTEN 11 16TH AVENUE HAVERHILL, MA 01830 �a.ash Expiration: 8/212012 ( mflklissioarr Tr-: 100696 t tilassachust tt -Department of Public Barn Board of Bu'rldin!, Re-ulations and Stund:u•il; + Construction Supervisor Specialty License License: CS SL 100696 Restricted to: WS ALAN PAINTEN . 11 16TH AVENUE - HAVERHILL, MA 01830 Expiration: 8/2172012 t'niuui��iuncr Tr:: 100696 i ;�:J"r.r---.•' ~,.' ._ .. � ---'lam ••__ •• , . ,• - ,y�y t.��r rr ���, til�y�-,.•Y:Yuw�•— -�--'-- � � --• •�f' ' ��aa• 1� • 1 Y• .{ V l•'7� J^711. . • . £,.1,: ScarHP� •t ��c '� 2-9 !0,•..32. . . - .. -A.D[)MoNALPERF..uRWNCE RATINGS • • , �tA1,(ytG10N SIJpLE7�cp{r1�AlA G!!µE40A�?nn • .... 0.1 k$2 ' .• . .. . 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' f nambobat 61U6(SD,L`tw mmcuta oa�m�ido:r�Ic tY'��14t�Q� 4 Orrice orC6rtsumer Arrairs&Business Regulation ORAE IMPROVEMENT CONTRACTOR TYPO RegistraLon 125893 Edpp�ement�_ :' :Expicabo�8f3l2Q92_,. - The 1� [>� L',RE kiamS�re+car i;ICHARO FrACIONE a ARKWAY 5 2690 CUNiBERLANO:P �� � ! � rt,. �: °�''�•�,r�yra;��'L`'L�',�`�2'�'�'!�,•'�� �.f'� �'�•`��.-��'f��.::%'����' t'so'-�1.��i'�•fi'i.� Office icc cif Gowsua er 111 airs a.rlti ISUS.ness Regulation ark Plaza - Suite, _ Boton -1, 'sachuseus 02116 ,iotr r zTYpr 4, t x ft Contractor Registratioat- _ Registration 168740 :ype: Priva v Corporation 41, F-x0ratio 'ti2l�J'2;1 3 TO 209.198 t CUSTOM PROJECTS INC. SVIATLANA BETTIS 76-NOR-TON AVE _: ....... ._....... __._.. m MANGRES T EIS, NH 0310 tSfttfa:te 4r{dt't5ti and c*,tut tt carr#.Mnric reason fqr chung�`. < cldres� Renc`� t I Employment � � Dost 4':t�ri1 c ,n �.YNii�a,clrf �i�:yx�r{/frre�l' Liceux i or regi+trationThr<1 Fti'r 40184(hit mse oniv (}rirC t)1 .i1t7ttt77C1,c4,r(A,CR cX,113RIRCR ftC;;ifldtlJ» - aROME IMPROVEMENT COWRACTC7R frCf<trt if5c 7��7ir altitn d itr. it fttiuitf r�tttr,r[r�; r Tof esrf. osumer A.-Virskunffusines Rtwutntiunn u , 1U 1'.)t-k Plaza-.Suite 51 0 � �, � ��t Csipr'rt,ory, .-'tl�Gi20'13 t�rivae Co pc1r2 tan Snctno,NW!,02116 VIAT LANLA BE--Tr T I` 711 iN!ORT OM A1. ►r<Pl }iiC<t NHt 030t'1»dcrcccret tri Not val it.ri(fitrtrEst 'ri:iCrtre I P. k•�ul:.i".0 -,:111'�4a^:f•..•! err 5 S L 99823 ?::>r tit• c;z... RF•VVS OZMiTRY HRYTSUK 13A VUHITTIER DR 4. SEABROOK, NH 03874RAM 626/2012 2011-07-21 20:01 8931-EXPOTR/PRO DESK 6036927701 >> Home Depot AHS P 1/7 t':f,FARIw REAL►THIS .St'anoh Nie: 1)oston DeEtta Date. d I-Wdiahc4 CM Inlled by: �•J THO A(-lam 3etvicr:s,•Inc. d&R The Hnnty Depgt alt-ffome Scrvlotg 345A Ciregttwoad gftM fMt 2,W(wcWr,bdA ti:607 lf►ttacL Number-32 31911 fv.M NOW 657.5182.Rao:(508)75ti8823 Fr kvat(Et#75-2$98416 MP iii:#C()x439;)tl4bat.UW427 � CT Tis#tnCD50522 MA Ita x Imptmxuu�c Ccmttstw Pcg.4 I?bR43 IttstRHaiiuts Atbdtaevs� •�Gtr 4 e?�f, City State �� rmer{sk Zv _...—,.,7__.: c*kP6att2s BuotcPlsatte Cd)Pbs�_ Addrm Mdiffemt ficnmltts(dltation Addrim) _—....._— . &mad Address((jo re4dvc ect r4l DO N0T xzah W"= ie atuins etul lfuate )' the ally iSlarketltt8 emsi)s hum ,he ffttttg: piNldt 1 , - iintletslggcd("��ihC oaytierb trf t13b ltst%i+tD'I 8!tha Ahotte tsttt8B2tihn and TY At.;lumc Stxvlcca,Inc_t'�7te Ffttpte lleppt•,18t�t�s to fittms cksiitar an4 addrrxs,age�7` aiI D)atttct");ialb dt�erittntl an the beinw and on tise�Gry>god S 8e tnr the install�tia¢t("ir�tftlltBloty" tleferratec,alg".th ContraAtty nFPlicable 8itppleptertt Attu Psi a'ltattts).sD of +ch are axe intra miR Ccmttaet i>x(leis onytta@ut$eueittlaty stf�CF:Ud h and sny C7e�tge l7ntrsa{cuttcctivrty, 3ote•k:tf�et ,e PradGms, t ���vofirrg�SidiNa��Wiu�taws'�1naulaian'• ••�1—.-• 3 k: _—r—........�!►m0�utt...,,-.. ���,s�s�ts CT�t��� ia��' ...�.�, 3�..,T.� � ��•/� � %t�i1 1'iTttoi�ren�s;ai��`1�riada�c�Fnwtaaog �'�ll�toft3n+tsndAmn�doet>�Oa�Yhttian�t7daoongr�, � +t tmmem�tt ntak�ec,misaaamxmt TOW CwtttxtctAsmuA C'astotaet zAmcs that,immetti6bdy trptm cantpl lkM of the work tkrr t�ac h (oft fin each ftraduc[as de fxtxed by an ittdividat3t, i stucr Cttt3tUmea ai7U ekctet$u Cnnt{zle_dun Lett catc Contract ghiszt)and pay any lexluncc due. As agp8cnnble,rtrh(itgummy va&-r WA pThe Eiomr.l7eptjl texenes th--4&W iMe a Change()ti1Cr or tetminsfe this C`Mract an"tgv;rR icittua:F'itxtW.t(s)irEcluded b rein. rlisam with"'Lotetf eavirM Of ifs aatlt6rrrsd satvit�c proylder dM u y t9tst it catsnet per,i nlilil alioits dub ir+a suucvufsJ titfem vritfi flit stnemal hazards such ere mold selr or brut w9vk eequurtl u>rnttepktc the jab'A=not itaC,Wed in thz Conrrart paier.other as fety camccans.priciag MM tK bcettitgt: $aya�n � T1�f'sStneat Sunair1ry#•��j�'t"7L� �,�..� Contract ht'naant atki paY77tEgiti ILX.]aiteit for die S- --,i;wludod a8 port of this G9+dtau,RCES Itttlh f1iC ttfi&1 tis tmd fjml paymoo is be Ptrxi�y,(yq.Vptieaht::), You sry yntisted Lou tV(MCLTo CVS-Mq UR tbeft is taee.campkikM(3t aftt�P.cR Y 9 t`+ttllCkct at flte!illi(Stw sib I1tY not Sign s Cotnitltiion f'¢ R (wale: is exinive&_ f`rWkW as deftnrd by)ndidduat Spee sham)IcefmM W*A an abet Pr"ttaet '0 the svcM of�at thio C a*b'a&CD-stmt -W"to pay The Have n"t the cWs of,nMetin ahar,.esl,ytisys Rrtd Wr"M ptoyMed 4 Thy 110-Me t ur Atrthotiaed 5etatce PrdYsder thtentUb the date of (C Y W"bilts"t forth m(hitt Agrft wat or owfd nader applremble taw. 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ELAS t`hNCh1, TIM CDhWibMti,icrascNo. `(`lsl. 1YtlAl: C[iS"f`Eh'�lRR -- t -&GPJWIMLNT WTMOUF PENALTY OR 4DRLIGATJON » BY la LIVERING Wltr" NN NOT'lM TO nM 11'UMF ' DMh 0'f .BY MIDNICAff ON Tim IMRD gjjSTlNlz<5S FW"`` DAY AbtlSit SIC.NfNG TW AGttE&%WT. -rte t (WATT -iU?F`l.LrAlMT ATTA(WD Hf7�7� CO'Y1hf?�fS A TottSE` W L31VR 'V3t(;IfrMt;!UAL''Y rR'ICS'C ffE&D By LAW FN (USiT)MM'&STATL. I i�¢Dt'tt;�:ADLaTrrxAtnL'iEic Aivt►r-'r>HfYf77t1TtgARESTAL'tD?ONyagEEVEM7 Or"AfBDAUt'S8Tox•xftfStX1Nf7eAC:1' 8i�1-tD L`s(: 15Rr2o"-tttar�t f*� YeR"tAr-.�rgtpm�y