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HomeMy WebLinkAboutBuilding Permit #1135-16 - 80 BRADFORD STREET 4/28/2016 NORTH BUILDING PERMIT OF�tLeu .b �tio a 4 yf' 1. ••'•A 6 3 - TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION _ A Date Received No#: ?. y / qSS ICHUs��� Date Issued: YZ ae IMPORTANT: Applicant must complete all items on this page LOCATION � ���� k1A not PROPERTY OWNER a,•C( � �yC�\ e-9 Print 100 Year Structure yes no MAP / PARCEL:0-"6 � ZONING DISTRICT: Historic District yes no Machine Shop Village yes. no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building gOne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ❑Well ❑ Floodplain. D Wetlands• ❑.'Watershed�Distnct Y > . Ct Water/Sewe r_ DESCRIPTIO OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: 0 /U1" Contractor Name: oohs` ' c�tL� Phone: F�� "�a� 4,/ Email: T-nnLtW 9 a 10A0o ClWkvA Address' c3 C l c 04 r Supervisor's Construction License: O��i (2� Exp. Date: . Z d Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: 4 Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. n Total Project Cost: $ oAO< FEE: $ 70,00 Check No.: �� Receipt No.: 30-507 NOTE: Persons contracting with u egistered contractors do not have access to the guaranty fund Location No. /�� -/� Date i • - TOWN OF NORTH ANDOVER 1 . Certificate of Occupancy $ Building/Frame Permit Fee $V� Foundation Permit Fee $ Other Permit Fee $ TOTAL $. Check# C G 73 1 30307 ` Building Inspector i' Dimension i 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) it I II 'I ® Notified for pickup Call Email Date Time Contact Name Doe.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. I Roofing, Siding, Interior Rehabilitation Permits 4 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 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 j Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And p p Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products IN OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) i 4- Building Permit Application 4 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) i Copy of Contract 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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:Building Permit Revised 2014 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped flans ❑ i F F SEWERt�.GE DISPOSAL wer ❑ Tanning/Massage/Body Art ❑ Swimming Pools❑ Tobacco Sales ❑ Food Packaging/Sales ❑ I Private(septic tank,etc. ❑ Permanent Dwupster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM I PLANNING & DEVELOPMENT Reviewed On Signature_ i COMMENTS - 7 CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments I � i Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town)Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT ILocated at.1�24 Main Street��y�•e�m• um iey� n steti, n z` ` dire De pa tsignat rNdate . ry a x 71 7 �,T� M M } d.t.t t%ORTIi Town of : _ Andover ' O •'�". `!fir• 0 No. * _ h ver Mass > > o LAKI coc«ic«ew�cw �1• p00ATEO S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ....... �?.�::...... .... ........ ......................................... BUILDING INSPECTOR has permission to erect .......................... buildings on ............ J�:' /_ ',2d� ................................. Foundation Rough/F to be occupied as ............. '. � ;,� .�.5..¢!..:`� ....CJ..... ; ....................................... y Chimne provided that the person accepting this permit shall in every res ect conform tO the terms of the application Final - on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and d Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR � UNLESS CONSTRUCTION TS Rough Service .................. :..... . � ...................... final0�-e BUILDING INSPECTOR 7 4 �4 GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. ✓JiV�? "�%` Smoke Det.Y oma/ Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 22,500.00 m $ - $ 270.00 Plumbing Fee $ 33.75 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 33.75 Total fees collected $ 437.50 80 Bradford Street 1135-2016 on 5/3/2016 Garage Repair NORTFt Town of, 2 �.. : ndover O Yr4 . 1 No. * _ 4". h ver, Mass, COCHICHEWICK U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System - r THIS CERTIFIES THAT ....... ).�C C.t� ` .......................... BUILDING INSPECTOR ..... ..................................................................... has permission to erect g S� Foundation .... buildings �� � ��' Rough tobe occupied as .............ZF...........(.. .......... ..:............. ... .......... ........................................... Chimney provided that the person accepting this permit shall in every respect conform 01 the terms of the application Final 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 VIOLATION of the Zoning or Building Regulations Voids this Permit.. Rough Final PERMIT EXPIRES IN,6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION TS Rough Service .................. ...... .Lr. i� ................ """"""" Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. WA Chimneys Residential & Commercial Roofing All Types Of POINTED-REBUILT-CAPPED Siding CHIMNEYS Expert Masonry Work Mass Toll Free I*Roof Leaks Experts� Licensed & Insured Locally Owned& Operated Sirce 1976 = 1-800-WAIT-4-US ® -� License#034200 (924-8487) IKO Gree warm We work Year Round o- Proposal To: Richard Boettcher Date 4/20/2016 Street: 80 Bradford St. 978-807-6460 N.Andover, MA Garage proposal rboettcher@dddids.com 1. Remove all existing kneewalls and roof structure. Front wall and doors will remain. 2. Frame all new kneewalls to code back to original specs. 3. Frame new support beam and roof structure to code. Beam and roof structure calculated by Jackson Lumber 4. Install 1/2" CDX Fir sheathing to all kneewalls. 5. Install 3/4"Advantech T&G plywood for entire flat roof. New roof will be framed to have low slope away from main house. 6. Install Tyvek housewrap to all kneewalls. 7. Install new vinyl clapboard siding and vinyl corners to match main house as close as possible. 8. Install 1/2 insulation board to entire roof. Fastened with plate and screw system. 9. Install all new white heavy gauge perimeter metal to all eaves. 10. Install new fully glued .060 rubber membrane to entire roof. 11. Removal of all work related debris 12. Building permit included. 13.No electrical work included. 14. Contractor workmanship warranty: 10 years Total cost: 22,500.00 • Payment schedule: $10,000.00 due on project start date Final balance including any extras due upon project completion Thank you!! Acceptance of Proposal—The above prices, specifications and conditions are satisfactory and are herby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Date of Acceptance: Signature: 1 4-7-16 1:57pm 1of1 I Data n: Member Type: Beam Application: Roof Top Lateral Bracing: Continuous Slope: 0.00/ 12 Bottom Lateral Bracing: Continuous #/and Load: Moisture Condition: Dry Building Code: IBC/IRC Load: 50 PLF Deflection Criteria: 0240 live, U180 total 1.000" max. LL ,gad Load: 15 PLF Deck Connection: Nailed Member Weight: 16.6 PLF X Filename: Beam1 Other Loads t Type Trib. Other Dead (Description) Side Begin End Width Start End Start End Category Additional Uniform(PSF) Top a 0.00" 28' 0.00" 12' 6.00" 55 15 Snow �— 1400 ® 1400 2800 ®� Bearings and Reactions Input Min Gravity Gravity Location Type Material Length Required Reaction Uplift 1 a 0.000" Wall SPF Plate(425psi) 5.500" 1.642" 4884# 2 14' 0.000" Wall Steel 3.6W, 3.101" 16280# 3 28' 0.000" Wall SPF Plate(425psi) 5.500" 1.642" 4884# -- Maximum Load Case Reactions used fOrePPIY7ng Point loads(or line loads)to carrying members Snow Dead 1 3765# 1119# 2 12551# 3729# 3 3765# 1119# Design spans 13' 7.375" 13' 7.375" Product: 2,0 RigidLam LVL 1-3/4 x 9-1/2 4 ply PASSES DESIGN CHECKS Connect members with 2 rows of 1/2"diameter bolts at 24.0"oc Design assumes continuous lateral bracing along the top chord. Design assumes continuous lateral bracing along the bottom chord. Allowable Stress Design Actual Allowable Capacity Location Loading Positive Moment 124124 334964 37% 22.85' Total Load D+S Negative Moment 22164.# 33496.# 66% 14' Total Load D+S Shear 73834 14785.# 49% 14.01' Total Load D+S Max.Reaction 162804 203444 80% 14' Total Load D+S TL Deflection 0.3066" 0.9076" 0532 22AT Total Load D+S LL Deflection 0.2364" 0.6807" U691 22.17' Total Load S Control: Max.Reaction DOLs: Live=100% Snow=1150/o Roof=1250/o Wind=160% Design assumes a repetftive member use Increase in bending stress: 4% All product names am trademarks of their espective owners - .. COPydght(C)2013 by Simpson Strong-Tle Company Inc.ALL RIGHTS RESERVED. "Passing Isdefined as when Ne member Ooorjoist,beam orglmet shown on Nis drawing meets applicable design Made forloads,Loading Conditions,and spans listed on this sheet. The design must be reviewed by a Qualified designer or design professional as required for approval.Thlsdeslgn assumes product Installation according to the manufacturer's cifhcations. , A-W NO lo. a - �i coo. N , r n.x l MAW t 4,✓ , .. --• Vie, -- , ..` , > ,�• � ...,�`�,. .� .OW�� ::� a k< � S✓ � @:} rk k At ... NIA �n� u ## § .. esu � � '� �..'_�. •�, �u _ F.. MINE, x. AT , .�x t r - Aw „,5,. ..tet; .x£.§' ..., '� :g E` *< v ,.. <✓.>: - .., ,._�.-. 0, u :';.. f. ... .:, , y a.o--, ,,; �...,., "kn,,;.. fix• .. ,4.:;;,... W. M , z�. n The Commonwealth of Massachusetts Department of Industrial Accidents Ur-, I Congress Street,Suite 100 Boston,MA 02114-2017 www.massgov/dia orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeibly Name (Business/Organization/lndividual): C uV1Q elq 0V Address: �5z, City/State/Zip: /K -c Ik J "1 I� 4fJ Phone#: �' 3 / Are you an empioyer't Check the appropriate box: Type of project(required): Ia employer with _employees(full and/or part-time).* 7. ❑New construction 2.❑1 am a sole proprietor or partnership and have no employees working for me in 8. remodeling any capacity.[No workers'comp.insurance required.] 3.01 am a homeowner doing all work myself.[No workers'comp.insurance required.]t 1 El Demolition 10❑Building addition 4.[]l 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 sok 11.❑Electrical repairs or additions Proprietors with no employees. 12.E]Plumbing repairs or additions 5C]1 am a general contractor and I have hired the sub-contractors listed on the attached shat. ibese subcontractors have employees and have workers'comp.insurance_= 13.E]Roof repairs 6.❑We arc a corporation and its offices have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4)�and we have no employees.[No workers'comp.insurance required.] 'Any applicant that checks box NI must also fill out the section below showing their workers'compensation polity information. t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such_ 'Contractors 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 po/icy and job site information. Insurance Company Name: /•7 K-V1 nm u l-i-r i / r Policy#or Self-ins.Lic.#: /Jui c ' °� a ° �l 2 0/S"Expiration Date:—/ II I asI t� Job Site Address: JS J �l�� lk 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 S 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 DIA for insurance coverage verification. I do hereby certify unk7pl and penalties of perjury that the information provided above is but and correct Signature: Date: Phone#: OffWial use only. Do not write in this area,to be completed by city or town official, City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.Cityrrown 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 en ployee is defined as"...every person in the service of another under-any contract of hire, exiMess 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 tire-occupantof 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 rnnstruct buildings in the commonwealtb 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 Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone numbers)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 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' 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.#617-7274900 ext.7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia i WORKERS COMPENSATION AND EMPLOY RS LIABILITY INSURANCE POLICY INFORMATION PAGE A.I.M. Mutual insulare Company 54 Third Avenue Burlington, M ssachusEtts 01803-0974 (800) 876-2 65 NCCI NO 26158 POLICY NO, AV�1C-400-7009484-201.5A PRIOR NO, gj��400_7009464-2014A ITEM 1. The Insured: All Under One Roof DBA: Mailing address: C/O John Lanzefame 30 Temple Drive FEIN:**-***8251 Methuen,MA 01844 Legal Entity Type: Sole Proprietor Other workplaces not shown above: See Location 2. The policy period is from 11/09/2015 to 11/09/2016 12:01 a.m,standard time at the insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers'Liability Insurance: Part Two of the policy applills to work in each state listed in item 3.A. The limits of liability under Part Two are: Bodily Injury by Accident $ Bodily Injury by Disease $ -- - 100,000 each accident Bodily Injur by Disease $ '""---• --500,000 policy limit each employee C Other States Insurance: Coverage Replaced by Endorse ent WC 20 03 06 B 100,000 D. This Policy Includes these Endorsements and Schedules: EE SCHEDULE 4. The premium for this policy will be determined by our Manuals f Rules,Classifications,Rates and RatingPians. All information required below is subject to verification and cha ge by audit. Classifications '�'- _.__ _.. .. __... Premtu Basis Code Estimat d Perslo0 No, Total Annual Of Estimated — ---- ••- Remuneration Remuneration Annual Premium INTRA 174355 t INTER SEE!.CLASS CODE SCHEDULE ._....,._--�,._ Minimum Premium + - ""----------- _ "—G-O--V-- To[al Estimated Annual Premium , STATE CLASS De osit Premium > VA--54W S# to Assessments/Surcharges $1 .00 x 5 7500% This policy,including all endorsements, is hereby countersigned by `• - Authorized Signature 10/05/2015 Date Service Office: 54 Third Avenue P rry Insurance Agency LLC Burlington MA 01803 5�2 Chickering Rd, Rt 125 N rth Andover,MA 01845 WC 00 00 01 A(7-11) includes copyrighted material of the National council on compensation insurance, used with Its permission. Massachusetts - i.eCpa tl-nent of : J' gliding `:^,`gg Aiaa'.iC;':i License: C8469120 JOHN W LANZAFAME 30 TEMPLE DR METHUEN MA 81844 , CaF'nmissions,r 04/03/2017 • r-mob_ .� .:„ Click on the registration number to view complaint history. You can also view arbitfatiyn and Guaranty Fund history. The list is current as of Wednesday, October 8, 2014, Search Results REGISTRANT RESPONSH E REGASTRATCON ADI SS EXPIRATION STATUS NAME INDIVIDUAL NUME ER DATE ALL UMER OME RGOF LANZAl AA,1E. 137057 166 A MERRIMACK ST 10/02/2016 Current JOHN METHEUN, MA 01844 -- _ _--- --- _ @ 2012 Commonwealth of Massachusetts. Mass.GovG is a registered service mark of the CommonweWth'of Massachusetts. MORTGAGE INSPECTION Appleton Land Surveying, Inc. SURVEYING • ENGINEERING • LAND PLANNING 234 ESSEX STREET LAWRENCE. MASSACHUSETTS 01840 (308)886-424 (508)888-7488 MORTGAGOR oCrtfi'c H t 2- ADDRESS OF�VIPRINCIPAL BUILDING SHED V 0 3(\A V FV D ::5TIZEE-r Nc >r.T 4 ANDovc r NOTE: THIS MORTGAGE MSPECTION was prepared ` apeaficxdly for mortgage purposes and is not to be r6Ged upon as a survey. A.L.S.I accepts no responsity for damages resulting from said reliance by anyone other than the said mortgagee and its N oasigria in connection with its proposed mortgage finonc:ing to said mortgagor. LOT"'/b The information on this mortgage inspection is the exclusive property of A.LS.L Unauthorized use, reproduction or modification of bib material is strictly V " ` prod, and may be subject to legal action unless prior wrbeti conserrt from A.L.S.I. is obtained. CUMFICATION TO: ��F.�tzj7 L A1.JT2�NGE SAVINGS 3�►�E! DD vL�e. F3 This mortgage Inspection was prepared in accordance 7 5-Ty with the Technical Standards for Mortgoge loan In— speed= n— LvD F� DN o aoud Surveyo adopted as and�Civil Engineersthe usetta Association of l �. Zy•ti `� I STATE THAT IN MY PROFESSIONAL OPINION d the prinapcl structure/s and accessory structure/s with the dinermonal setback requirements of the zoning ordinances. and that there are no encroachments of major Improvements either way across property lines - 7i G 3 ' _ except as shown. w 190- syr l7 w 7197 �p 0 9. 0& Nater 2-711 Dwelling is not located within a Flood Hazard Zone ❑ Dwelling is located within Flood Hazard Zone ❑ Information is insufficient to determine Flood Hazard Flood Hazard determined from F.E.MA Flood Insurance rate map. WN Deed Reference: Bk. 3 5 8 Pg. S�o Scale: /! = 36 I �` Cert. No. Date of Inspection: -i " 9 Plan P Reference: PI. No. 8-c X09.�G e Date of Plan: 6 " -y-7 U o- R o,e s7c�3