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Miscellaneous - 200 FRENCH FARM ROAD 4/30/2018
IN Libert MMutual. • y September 24, 2013 Town of North Andover Attn: Building Inspector 120 Main Street North Andover, MA 01845 Liberty Mutual Insurance New England Region Central Property Unit 75 Sylvan Street Danvers, MA 01923 Tel: (800)566-0323 Re: Property Address: 200 French Farm Rd, North Andover, Ma 01845 Policy Number: H3S21869997340 Underwriting Company: LM General Insurance Company Claim Number: 027638206-0001 Date of Loss: 8/7/2013 Attn: Town/City Official Pursuant to M.G.L. c. 139, 5 313, please be aware that a homeowners insurance claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or causes the condition of a building or other structure to render Mass. General Laws, Ch. 143, § 6 applicable. You are required to notify Liberty Mutual by certified mail in accordance with Mass. General Laws Ch. 175, §99, if you intend to initiate proceedings designed to perfect alien pursuant to Mass. General Laws, Ch. 139, § 3A & B, or Mass. General Laws, Ch. 143, § 9, or Mass. General Laws, Ch. 111, § 127B. This letter should not be construed as a waiver or estoppel of any of the terms, conditions or defenses afforded by the policy or applicable law. Please direct your notice to the attention of the undersigned and include a reference to the above captioned property address, policy number, claim number, and date of loss. Sincerely, Liberty Mutual Support Liberty Mutual Insurance New England Region Central Property Unit 1-800-566-0323 Date ..... 3.:..0'S —� f TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ....... J�In .i�r�..... has permission to perform ...�jGyEy��� wiring in the building of .......:;�O.......................... at m cy /%?..... ....................../ ,North Andover, Mass. ....... . b Fee&.-.......-... Lic. No A93? .............. j f ........ `, ELECTRICAL INSPECTOR / Check # 7 f3 86bu t1-13 (.,ornmonwea� o�c�/77i'%aesachude� eLleParfinelzi o�.}ire �ervice� BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. tF6.S4- Occupancy and Fee Checked [Rev. 1/071 (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical CodeC), 5J7 CMR 12.00 (PLEA SE PRINT IN INK ORTYPEA L O 3 TION) Date: Z50 City or Town of: To the Inspe for of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) ZOO FVWI,",1t f (�,A. Owner or Tenant Owner's Address Is this permit in conjunction with a buil ing permit? Yes 1P Purpose of Building S j ►'1 -+Ary► I Telephone No. -r— No ❑ (Check Appropriate Box) Utility Authorization No.— Existing Service Amps / Vo is Overhead ❑ Undgrd ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ICwi7i:c+% 1C� U No. of Recessed Luminaires 'Z No. of Ceil.-Susp. (Paddle) Fans / uc W"I vcu Uy 11 -le im eClOro wares_ No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators K -VA No. of LuminairesSwimming (0 Pool Above ❑ In- ❑ d. nd. o. o Emergency Lighting— Battery Units No. of Receptacle Outlets No. of Oil Burners tj&° FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection an / Initiatin Devices No. of Ranges g � Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pum Total s u__er --m ons ""�' "`""-.._..._.. No. o Self-Containe Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local []Municipal EJ other Connection No. of Dryers No. of Water Heaters KW Heating Appliances I(W No. of o. of Signs Ballasts Security Systems: No. of Devices or E uivalent Data Vlririn No. of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wirin No. of Devices or E uivalent f OTHER: sub � - �UUQ 4 �f �L �iC i ' JJ � .R Attach additional detail y desired, or as required by the Inspector of Wires. Estimated Value of lectrical Work: / (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE C RAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liJvage insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such cis in force, and has exhibited proof of s e to permit issue o e CHECK ONE: INSURANCEOND ❑ OTHER ❑ (Specify:) ("t�f"' ��i,3 I certify, under the pai n1d peva of erjury, t at the information on this application is true and complet �� FIRM NAME: 1 d .�-,tiC LIC. NO.: 33 Licensee: ke," Z717jbA Signature LIC. NO.: (If applicable, enter "ex I' t" in'he�icense numbe n) Bus. Tel. No.- - Address: vG ( Lth CAb Alt. Tel. No.• *Per M.G.L. c. 147, s. 57-61, security rk 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. S It -40141i TOWN OF ANDOVER ELECTRICAL PERMIT FEES (Effective March 12, 2003) NO SE CABLE ON OUTSIDE OF BUILDING Air Conditioners: $40.00 each Alarm Systems Security: (for fire systems see smoke/heat detectors) Residential: $40.00 Commercial: up to 10 Devices $60.00 additional devices over 10- $1.00 each Carnival Equipment: $50.00 each Ceiling Fans: $1.00 each Commercial New Construction or, Alterations: $100.00 per 1,000 Sq. Ft. of Construction Space Commercial Service Change/ Repair: Must have Utility Authorization Number $100 (first 100 amperes or fraction, one meter) a) each additional 100 amperes capacity or fraction. $30.00 b) each additional meter $25.00 Commercial Temporary Service: $100.00 Must have Utility Authorization Number Commercial Repair and/or Maintenance Permit: (Blanket Permit) up to 2 Electricians $150.00 per pair of Electricians over 2 $50.00 Data/Telecommunication: Residential: $1.00 per port Commercial: $30.00 up to 10 devices over 10 - $1.00 each Dishwashers & Disposals: $5.00 Each Dryers: $15.00 Each Emergency Lighting (Battery Units) $ 1.00 each unit Feeders or Sub -feeders: each 100 amp capacity of fraction thereof Residential: $5.00 each Commercial: $15.00 each Gas/Oil Burners: Residential: $20.00 each Commercial $20.00 each OR I - r IN Generators Residential & Commercial: a) including photovoltaic & generating Equip Per KVA $1.00 b) un -interruptible power systems, per KVA $1.00 c) batteries over 100 amp. hours, per cell $1.00 Heat Devices: $1.00 each Heat Pumps: $40.00 each Hydro -Massage Bathtubs/ Hot Tubs: $20.00 each Lighting Fixtures $1.00 each Lighting Outlets: $1.00 each Major Appliances: (not listed) $20 each Motors: (per hp or fractional part thereof) $2.00 Oil /Gas Burners: - Residential $20.00 each Commercial $20.00 each Office Furnishings: per circuit $10 (Relocatable Partitions/Cubicles) Outlets & Fixture: $1.00 each Ovens Built in/Counter Top Units: $10.00 each Panel Change/Circuit Breaker: Residential: $20.00 Commercial: $25.00 Phone Jacks: See data/telecommumcations Ranges $15.00 each Receptacle Outlets: $1.00 each Recessed Fixtures: $1.00 each Reinspection Fee: $25.00 Repair to Service Residential: $20.00 Residential New Construction (Dwelling): $220.00 (with service up to 200 amps) ]Must have Utility Authorization Number for services over 200 amps see below a) for each 100 amps capacity or fraction add $20.00 b) each additional meter $10.00 c) each additional panel/sub panel $25.00 Residential Additions/Alterations: $220.00 maximum Residential Service Change or Underground Service: $40.00 ]Must have Utility Authorization Number a) one meter, up to 100 amp capacity $40.00 b) each additional 100 amp capacity or fraction $20.00 0 LN E" t rA c) each additional meter ..$10.00 Sewer Ejection Pump: $25.00 Signs: $25.00 each ballast Smoke & Heat Detectors & Initiating Devices: Residential: $1.00 each Commercial: $60.00 up to 10 devices over 10 - $1.00 each Space Heaters: area heating $1.00 each Sub -Panel: $25.00 Swimming Pools: Residential: Above Ground: $25.00 Inground: $50.00 Commercial Pool: $100.00 Switches: $1.00 each Temporary Service: Must have Utility Authorization Number Residential $25.00 Commercial $100.00 Transformers: a) capacitors, Per KVA $1.00 b) ducts, conduit & conductors (Associated w/ Padmount Transformers) c) each manhole $10.00 d) each handhold $5.00 e) per KVA $1.00 f) primary feeders, $25.00 each (ove 600 volts, non-utility owned) g vaults and equip. $25.00 each Washers: $15.00 each Waste Disposals: $5.00 each Water Heaters: $30.00 each *For Multi --Family & Large Commercial Pru; ec see Wiring Inspector for pricing: R` Paul Kennedy (978) 623-8306 (Office Hours 8 ani to 1.0 ani") *Inspection Schedule: I ROUGH I FINAL I TRENCH (if applicable ADDITIONAL INSPECTIONS *$25.00 (if applicable) (revised 07/05) Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 0 C) ! J BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/99] 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: March 27, 2009 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 200 French Farm Road Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Residential Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Prol Date .....,�7'�.................Z .9 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that....... ........�....... has permission to perform ....�1eGun..'..1.. ;/..... 5.�/.F`..........r� a' wiring in the building of ............................................................ at .. , .. t�iloEL North Andover, Mass. .......�.../�4.... _ �/ Fee ...` �. S ......... Lic. No.Li..1, . .... ........... ..:.� f ... "f ELECTRICAL INSPECTO� Check # Y -21 8675 x BOND [J OTHER LJ (Specify:) Estimated Value of Electrical Work: -r to UL listed central station; test & table may be waived by the Inspector of Wires fdesiredt, or as required by the Inspector of Wires. formance of electrical work may issue unless coverage or its substantial equivalent. The le to the permit issuing office. (When required by municipal policy.) (Expiration Date) Work to Start: Match 27, 2009 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the informatio,"n app t 6-n�s true and complete. FIRM NAME: OMNI SECURITY TEAM LIC. NO.: 444C/SS695 Licensee: Linda D. Allen Sig ture _ NO.: 81 OD/ (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978 465 5000 Address: 2 Fruit Street Byfield MA 01922 Alt Tel. No.: 978 465 5084 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 FPE"IT FEE: $45.00 Signature Telephone No. No. of 1 Total 16v Transformers KVA Generators KVA El No. of Emergency Lighting Battery Units FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Alerting Devices No. of Self -Contained Detection/Alerting Devices Local ❑ Municipal ❑ Other x Connection Security Systems: No. of Devices or Equi alent 10 Data Wiring: No. of Devices or Equivalent Telecommunications Wiring: No. of Devices or Equivalent fdesiredt, or as required by the Inspector of Wires. formance of electrical work may issue unless coverage or its substantial equivalent. The le to the permit issuing office. (When required by municipal policy.) (Expiration Date) Work to Start: Match 27, 2009 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the informatio,"n app t 6-n�s true and complete. FIRM NAME: OMNI SECURITY TEAM LIC. NO.: 444C/SS695 Licensee: Linda D. Allen Sig ture _ NO.: 81 OD/ (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978 465 5000 Address: 2 Fruit Street Byfield MA 01922 Alt Tel. No.: 978 465 5084 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 FPE"IT FEE: $45.00 Signature Telephone No. C t Date..';!.-. �.." �.�%... o? °� TOWN OF NORTH -ANDOVER • PERM MFOR G NSTALLATION �,SSACHUSE�t This certifies that ........ has permission for gas installation ,-1 in the buildings of .............................. at . p�OO?�1lC,Y. ,f=,�,4�'/!� , �/�, , , , , North Andover, Mass. Fee. ?� 12. Lic. No.112 1130. .......................... GAS INSPECTOR Check # 92-163 • i e � MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FTTTING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date Building Legations C) 1—revlc .� / Permit # 6 0 9 L- Owner's Name Amount S Q New Renovation Replacement D Plans Submitted ❑ G SU B-BASEM EN BASEMENT IST. FLOOR 2N D, FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 5TH. FLOOR 7TH, FLOOR. ;TH. FLOOR (Print or type) ,, /I� (� l' Name /'T'of U ►"� H e lg- si c Address _D� Xtifi rmt+00 Put us:ws ' pnone , �rC �'Li� — CnR"� Name Of -Licensed Plumber'or Gas Fitter ti,4 a r Cnene: Certificate Installing Company CJ Corp.�" ElPartner. E]Firm/Co. INSURANCE COVERAGE I have a current liability Insurance p 'cy or it's substantial equivalent Check� If you have checked es please i nate Yes the type coverage by checking the appropriate boxy Liability insurance policy Other type of indemnity D No[] Bond 0 Owner's Insurance Waiver i am aware that the licensee does nave the insuran Mass. General Laws, and that my signature on this permit apce coverage required by Chapter 142 of the rement plication waives this requcovera Signature of Owner or Owner's Agent Check one: Owner :hereby certify that all of the details and information I have submitted (or entered) in 0 application• e Agent best of my knowledge and that all plumbing work and installations e compliance with all pertinent provisions of the Massachus p ed under Permit Issued for this applicatioand nwill e in curate to the tate G C e and Chapter .142 . enecal Laws. Title City/T1 nk _ APPROVED (OFFICE USE ONLY) j bign re of Licensed Plumber Or Gas Fitter ber Q...p Fitter License umoer � Master r Journeyman U w z a w o u m� x e z � F = Q x w w a c p W F z z e w a a w > u s Z O S L C p V U a W S O W (Print or type) ,, /I� (� l' Name /'T'of U ►"� H e lg- si c Address _D� Xtifi rmt+00 Put us:ws ' pnone , �rC �'Li� — CnR"� Name Of -Licensed Plumber'or Gas Fitter ti,4 a r Cnene: Certificate Installing Company CJ Corp.�" ElPartner. E]Firm/Co. INSURANCE COVERAGE I have a current liability Insurance p 'cy or it's substantial equivalent Check� If you have checked es please i nate Yes the type coverage by checking the appropriate boxy Liability insurance policy Other type of indemnity D No[] Bond 0 Owner's Insurance Waiver i am aware that the licensee does nave the insuran Mass. General Laws, and that my signature on this permit apce coverage required by Chapter 142 of the rement plication waives this requcovera Signature of Owner or Owner's Agent Check one: Owner :hereby certify that all of the details and information I have submitted (or entered) in 0 application• e Agent best of my knowledge and that all plumbing work and installations e compliance with all pertinent provisions of the Massachus p ed under Permit Issued for this applicatioand nwill e in curate to the tate G C e and Chapter .142 . enecal Laws. Title City/T1 nk _ APPROVED (OFFICE USE ONLY) j bign re of Licensed Plumber Or Gas Fitter ber Q...p Fitter License umoer � Master r Journeyman I ne Uommonwealth of 1lfassachusetts Department of Industrizd Accidents Office of firvestigations 600 Washineaton Street BOstOlt, MA 02111 w1VKLv1dla Workers' Compensation Insurance.AfficLavit: $udders/Coutractors/Electricia )h Elf Iafornrration ns/Piumbers 1�3'ne' (Business/Organization/Individual): Address: CIty/Sfatt/ZIp: Phone #: Are you an employer? Check the appropriate box: I•❑ 1 an a employer with 4. ❑ 1 am a o o em io �s roll and/or art -time .* have hired the sub 2.[] P Y (' p • ❑ 1 am a sole proprietor or partner- listed ori the attached sheet ship and have no employees These sub -con workin f factors have g of mem any capacity. [No workers' comp. insurance required.] 3 • ❑ 1 am a homeowner doing all work myself. [No workers' comp. insurance required.] t workers' comp. insurance. �. ❑ We are .a corporation and its officers have exercised.their right of exemption per MGL C. 1525 § 1.. (4) and we have no employees. [No workers' comp ins Type of project (required): .6•. ❑ New construction 7• ❑ Remodeling . 8• ❑ Demolition 9. ❑ Building addition 0:❑ Electrical repairs or additions l I •❑ Plumbing repairs or additions 12=❑ Roof repairs 4ny appfi ant_thar cheeks box # I .must also fill out the section below alio urance requrred.] 13•❑ Other + Homeowners who submit •fbis afftdavir indicating they e o Muir:" = .r.-, ng their workers' compensation policy rrtmrmatron. zConuactors Iha1 cnrc}; this bos.in= ar=hed an additional shirt showing he. hi outside contraciurs must submit a neve the name.Ofthe seb-cont=tors unriavit inaic '*—z..ch. and their... -- -••r• J'... c.a... ., prov!lila wOlf?erS' CZrispes�iaii�It1 ✓ e ---- _....,,. Nu��c.�, irtronnatl0n. information insurance or �' mp sees Below, is the policy and job site Insurance Company Name: Policy # or Self .ins. Lic. #: Expiration Date: Job Site Address: Attach a copy of the workers' compensation policy deciar-afion aQ C1ty/Starr/G�p. .Failure to secure coverage as required under Section 25A of p be (showier; the policy number and expiration trate). fine up to 11,500.00 and/or one-year imprisonment; as well MGL c. 152 can lead to the imposition of criminal penahies of a Of up to .5250.00 a da agaBe inst civil penalties in the form of a STOP WORD O}ZpER and a fine investigations of the DIA for insurance tcoveragedv ovised that n °O� of this statement maybe forwarded to the 'Office of idn YLC PLUM ana penalties of pe'7117 Zhat the information provided above is true and correct official use onto. Dn not write in thus area, to be completed by city or town olein[ City or Town: Permit/License # issuiree Authority (circle one): 1. Board of Health 2. Buiiding Department 3. City/Town perk 4. 6. Other _ Contact Person: Phone 4- information and inst.ruciions .� 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 h the service of another under any contract ofhire, 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 1ea1 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 ap ar'trnents and who resides therein, or the occupant of the dwelling house of another who employs persons to do paint,.-nance, 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 o r local licensing agency shall withhoid 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 acceptabie 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 worll{ 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 compi•etely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), addresses)and phone numbers) along with their c.-rtincate(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. ff an LLC or LLP does have employees, a policy is required. Be advised that this affic$.a.vit may be submitted tothe Department of Industrial Accidents for confirmation of insurance coverage.. Also The sure to sign and date the affidavit. Theaffidavitshouid 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 questionsTdirg the lain or if you are r�, quir-Fi to olein a workers' compensation policy; please call the Department at the nix-rnbe.r:listed below. Self-iinsurcd o-,,�t,aries sfiiould enter their self-insurance license number on the armroBriate line. City or Town Officiais Please be sure that the affidavit is complete and printed le Qs_ fb , The Department has provided a space at the bottom of the affidavit foryou to fill out in the. event the Office of- Investigations has to contact you regarding the applicant: Please be sure to fill in the permitAiconse number which will be used as a reference number. In addition; an applicant that must submit multiple permit/license applications in arty given year, need only submit one affidavit indicatingcurrent policy information (if necessary) and under "Job Site Adeiress" the applicant should write "all locations in a (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 ar licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a licenses 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 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 Departrnent's address, telephone and fax number. . The Commonweadthh of Massachusetts 13cpartment Of lidustrial Accidents. Office of L avestigatioas 600 Washtington Stmt Boston, MA 021 I I Tel. 4 617-727-4900. C= 406 c r 1-977-MASS.AFE Revised 5-26=05 Ear, 4 61 7-727-7749 w1ml.D a=.aovldia a FA Thomas Gal �rin, A1A _ Registered Architect: ........... I........... ........ ..I-,. ..............................�...., ...... 28 Grafton Street, Wakefield, MA 09880' to atvin.arch comcast:net ARCHITECT'S CERTIFICATION OF SUBSTANTIAL COMPLETION April 9, 2009 Project Name: Souza Residence - Addition and Kitchen remodel Project Location: 240 French Farm Road, North Andover, MA 01845 }' Name of Buildings: Souza Residence- Architects esidenceArchitects Project No: 0608 Nature of Project: Addition and Kitchen remodel In accordance with Section 116.2.2 of the Massachusetts 'State Building Code, 784 CMR -7th Edition I, - Thomas Galvin, AIA Registration No. 20285 Being -a Registered.Professional Architect hereby certify that I have provided. construction observation services on behalf of the owner; that 'I was present at the construction site on a regular and periodic basis and that to the best of my knowledge, information, and belief, the work of the project has been executed in conformity with the documents approved for the building permit. v Construction has been satisfactorily completed -in accordance with the construction documents for: -u A list of items to be completed or corrected is listed below- or attached on a separate sheet. Items not listed that are part of theconstruction documents remain the responsibility of the contractor to complete in accordance with the construct'llg2cuments: F. n No.20285 Lvi►Fmll OF r Thomas Galvin, AIA �/Y/o Thomas Galvin, AIA Registered Architect .....................................................................................................................................................................................................-".................................... 28 Grafton e- 0- t, Wakefield, MA 0.. 18.. 80 tomgatvin.arch@comcast.net ARCHITECT'S CERTIFICATION OF SUBSTANTIAL COMPLETION April 9, 2009 Project Name: Souza Residence — Addition and Kitchen remodel Project Location: 200 French Farm Road, North Andover, MA 01845 Name of Buildings: Souza Residence Architects Project No: 0608 Nature of Project: Addition and Kitchen remodel In accordance with Section 116.2.2 of the Massachusetts State Building Code, 780 CMR -6th Edition I, Thomas Galvin, AIA Registration No. 20285 Being a Registered Professional Architect hereby certify that I have provided construction observation services on behalf of the owner, that I was present at the construction site on a regular and periodic basis and that to the best of my knowledge, information, and belief, the work of the project has been executed in conformity with the documents approved for the building permit. ❑ Construction has been satisfactorily completed in accordance with the construction documents for: ❑ A list of items to be completed or corrected is listed below or attached on a separate sheet. Items not listed that are part of the construction documents remain the responsibility of the contractor to complete in accordance with the constructio ents: aAR� NS c0 No.20285 WAKE:�E ~ — Q tiss. �'CID : homas Galvin, AIA TH OF hk���� V/ A Date .,3 -:.Z:3.0') . "0 PT ��oo TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .:... .......... ....... . has permission to perform-:�?'�-`'""' . '': ` !..... �.�.' :�..... . plumbing in the buildings of .� : �.~'�``' .................... . at . ........ '"�'""'....:......... . North Andover, Mass. Fee./ .. Lic. No.//F�'6.. �..ti.� ........... PLUMB1 41 SPECTOR Check #� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVERMASSACHUSETTS rj� ti Building Location ).D 0�� P t>„ of New 0 Renovation Replacement 'Q rrnsrrr Tom-..- Installing Company Name Address �� Date Permit # —77 Amount] Plans Submitted yes No Check one: Certificate Corp. Partaer. Fun/Co. Name of Licensed Plumber. Insurance Coverage: IndicatetIhStype of insurance coverage by checking the appropriate box: Liability insurance policy illOther type of indetnni tY 11 Bond ❑ Insurance Waiver. I, the undersigned, have been made aware that the license three insurance e of this application does not have any one of the above Ygnature 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 willbe in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws, By: rgnature of Lrcensrn iumoer 'Title Type. of Plumbing License Cit3J own 1 / � � i,rcen e vumoer Master Journeyman APPROVED (oFFtcE usE oNL.Y /iia '17�'' aII 1. i ;w , c, The Commonwealth of Massachusetts Department of Industrial Accidents . Office of Investigations 600 Washlr2von Street Briton, MA 0.2111 > wwrv.rr�ass.gov/din VG ant I1 Compensation Insurance.A �Iicant AHdavit: gtinOntractOrs/ElectricianS/Pluders/Cnformation tubers Tl _ 1 flaMt (Business/Organization/individual): Address:_(J (^J City/State/Zip:/ p'V'e Phone #: c1 % 6 -- Are you an employer? Check the appropriate box: : 1. ❑ I am a employer with 4. ❑ f a o Type of project (required): ymployees (full and/or part-time).* 2.1 have hired the sub -co ontractorsr and l 6 New construction am a sole proprietor or partner - ship and have no employees listed l the attached sheet ? ❑ RernodeIina working forme in any opacity. workers b -contractors. have . 8. ❑ Demoliti:n'�' [No workers' comp. insurance 5._ ❑ we are a comp. insurance. corporation and its 9 ❑Building ddition 3. ❑required ] 1 am a homeowner doing all officers have exercised.their O. ❑ Elecpical repairs r additions work myself. [No. workers' comp. insurance right of exemption per MGL c. ISS. c. e 1(4), and we have I ❑ Plumbing repairs or additions required ] t no Io' 'employees. s [No workers 12.❑ Roof repairs comp. insurance required_] Any appiican thMWho checks box # 1 .must also fill our the section below t 13•❑ Other ------------ Homeowners WIIQ Sllbinllr'hIS a1lldavil lnfliCat!!l� L`iei' ICantractors that Check this box'must attached showi,,their workers' com nsation oli arc doilt�;cr;,r;, W,. g P mrormation. +u then hire outside enniraciurs an additional sheet show R roust submit !1 new affidavit rrt_ the ruune of the sub -contractors and their wo ' indi�in� such. "`' °OmP, ooiicy inramtation. l am ar, entplo,)er that is providin; workers' information, co ensation i ° assurance for n" employees. Beiow is the policy and job site Insurance Company Name: Policy # or Self .ins. Lic. #: Expiration Date: Job Site Address: Attach a copy of the workers' . Cit/sta&zip.ponotic deela'afion Page (showing, the policy Dumber and expiration bate). .Failure to secure coverage as required under Section 25A of MGL c. I52 can lead to the imposition of criminal penalties o fine up to 111500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and f a of up to .5250.00 a day against the violator. Be advised that a copy of this statement may be a fine Investigations of the DIA for insurance coverage verification. forwarded to the Office of " 'tie pzuju a,penal 1es oJperjur)' that the informatwin provided above is true and correct ,r__ 1/ i Official use onip. Do not write in this area, to be compietee' h3, city or town off coal Cite or Town: Permit/License Issuing Authority (circle one): I. Board of Iiealt6 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbill. 6. Other blob Inspector Contact Person: Phone # =_411-0 Information E.nd Instructions Massachusetts General Laws chapter 1 S2 requires all empioyers to provide workers' compensation for their employes. Pursuant to this statute, an employee is defined. as ".. every person in'the service of another under any contract of hire, 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 Ina-irit.t-nance, 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 bean employer." MGL chapter 152, §25C(6) also states that "every state a r 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 o►f 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 worilc 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-contractor(s) name(s), address(es) -- .,d phone number(s) along with their certificates) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to catty workers' compensation insurance. If an LLCor 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 affidavitshouid be returned to the city or town that the application for the permit or iicense is being requested., not the Department of Industrial Accidents. Should you have any questions reg�Tding the -lace, or if you are required to obtain a workers' compensation policy, please call the Department at the nti:ariber•listed below. Self-insured ca«„anies should enter their self-insurance license number or, the appropriate line. City or Town Officials Please be sure that the afrrdak is compiete and printed legibly. The Department has provided a space at the bottom of the affidavit foryou to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permitAicense number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in arty given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Addz-ess" 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 licem= 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 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 %o '.;i Department OfLmdustrial Accidynts. Office of LavestigatiEons 600 RWashEington St -=t a Boston; MA G2111 Tel. 4 617-727-4900 zft 406 c r 1-977 MASS AFE Revised 5-26=05 Fax n 617-727-7749 wwlkmass.gov/dia Of .HOQTM , a�°p TOWN OF NORTH`ANDOVER ' PERMIT FOR GAS INSTALLATION s This certifies that.. ! '�' �� .. l�! t .. ' .. )/....... . has permission for gas installation,. �-r:-,-:-t-:- -: t .:^ r�. ......... in the buildings of . > . -........... ........... . at m �.......... ��`^ ...... .. , North Andover, Mass. Fee.. .f� Lic. Nol/c�.. ............ r-� / GAS INSPECTOR Check # ) / �,l 6734 MASSACHUSETTS UNMRM APPLICN7DN FOR PERM U TO DO GAS FITTING (Type or print) NORTH ANDOVER, MASSACHUSETTS date L. Building Locations d 19 0 r l e-rlt, Owner's Name New Renovation D Replacement 11 G !SU B -BASEM ENT BASEMENT ]ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. .FLOOR STH. FLOOR ' Permit # Amount $ Plans Submitted ❑ (Print or type) /J J, Name— i� ew 9 y /,/'j c Address fi✓ t 14 49 L�,w,•e / Name of Licensed Plumber'or Gas Fitter y 0 w � w W c ° a '�' p a w F m Gn F x aa dd O 0 Z a C7 U W O Z W E- z F W C7 F Z O ��, E. a C d O O W ° ir c U J u (Print or type) /J J, Name— i� ew 9 y /,/'j c Address fi✓ t 14 49 L�,w,•e / Name of Licensed Plumber'or Gas Fitter Check one: Certificate Installing Company Corp. Partner. 0 Firm7Co. INSURANCE COVERAGE I have a current liability Insurance, policy or it's substantial equivalent. Check one: If you have checked es please i ate the type coverage by checking the appropriate S 13 NoO Liability in, policy Other type of indemnity D Bond Owner's Insurance Waiver. [.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. Signature of Owner or Owner's Agent Check one: er hereby certify that all of the details and information I have submitted (or entered) ed) in i� gent tion a and accurate best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application willbe in the compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter .142 of the General Laws. By: D Signature of Licens mber r Gas F' r Title Plumber . _ City/Town; ti l&/ Fitter i ense um er Master APPROVED (OFFICE USE ONLY) Journeyman / y W tib N � w Check one: Certificate Installing Company Corp. Partner. 0 Firm7Co. INSURANCE COVERAGE I have a current liability Insurance, policy or it's substantial equivalent. Check one: If you have checked es please i ate the type coverage by checking the appropriate S 13 NoO Liability in, policy Other type of indemnity D Bond Owner's Insurance Waiver. [.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. Signature of Owner or Owner's Agent Check one: er hereby certify that all of the details and information I have submitted (or entered) ed) in i� gent tion a and accurate best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application willbe in the compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter .142 of the General Laws. By: D Signature of Licens mber r Gas F' r Title Plumber . _ City/Town; ti l&/ Fitter i ense um er Master APPROVED (OFFICE USE ONLY) Journeyman / Location �c No. (") Xj Date R WATh TOWN OF NORTH ANDOVER o� ,.,ti + Certificate of Occupancy $ SAC NUS t� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL Check # '3673 Building Inspector 1. I Property Address: 1.2 Assessors Map and Parcel Map Number Number: Parcel Number v / d U ty 1poyt2 ^ 1.3 Zoning Informati : ZoningDistrid os Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SET ACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) Public ❑ Private ❑ 1.5. Flood Zone Information: Zone Outside Flood Zone 0 1.8 Municipal Sewerage Disposal System: ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Name nt) Address for Service 2R-����� Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ 1Licensed Construction Supervisor: 21 SJ License Number Address G y a64&_ g_ M Q 7 / r���� / 7 �7 Expiration Date !/ Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name 103 S--5 5 f��.L �5 / ��' Registration Number Add ess / j / /J 7- 7 -o Expiration Date Signature 41 or Telephone 7 SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildipermit. Signed affidavit Attached Yes ....... No ....... ❑ SECTION 5 Description of Proposed Work check au applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ JAddition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: / I SECTION 6 - F.STIMATRI) CONSTRUCTION COSTS i Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL.USE ONLY 1. Building D D D (a) Building Permit Fee Multiplier 2 Electrical _ 315-0 ©, (b) Estimated Total Cost of Construction O 3 Plumbing e.Z 6 0 O — Building Permit fee (a) X (b) �- 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, `��/ as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. 3— '�' -- 6 a Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIlvIBERS 1 2 ND 3 RD SPAN DINIENSIONS OF SILLS DIMENSIONS OF POSTS DM4ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHININEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE • ROOFING - SIDING - ALUMINUM DOORS - WINDOWS i GUTTERS INSULATOR 11 REPLACEMENT WINDOWS SS PLEASANT STREET NO. ANDOVER. MA. 01045 66.66737 SHOWROOM LOCATED AT it WATER STREET - NORTH ANDOVER NAME �57LLr_n (f 09°f � ��. JOB NAME ADDRESS 0,00 Fj?eNG(j FA W )'1' ADDRESS CITY No �(�t ��ye. �, PHONE # STATE ('"`j Yhss TYPE OF JOB a 3Yu D 11 pie 14L 1 u' gl.,c,l r wo 11�1\:5hetr 1-OCK C.A. W.+D, The Commonwealth of Massachusetts Department of IndustriaUcC;dents Office of Jnvestioations Boston, Mass. 02111 Workers' Compensation Insurance .4,Wdavit dame Ple2se Print dame: Lcc-ticn: Cit•.! Phone I am a homeowner peTcrming all work myself. I am a sole proprietor and have no one working in any capacity 7 I am an Emeloyer providina workers' compensation for my employees werkinc on this job Camcanv name Address CiN: If TSS Phone T g2S--'6Pf--6 7 Insurance Co �- /1' � 1 (17 /� K Pelic•! T Comcanv name: Address Cit,/. Phone T' Insurance Co. Polio Y Failure to secure c cverge as recuirec under Se --:ion 29-\ or MGL 15_ can lead to the imposition cr camirai penalties of a rine up to 51. °c0.00 andlor one years' imorscnrent as 'Neil as c:vii penalties in the f.crm cr a STCF'NCRK ORCER and a fine cf (S100.00) a day against me. I understand that a c y ci .his statement may ce fcrvvarded to the Office cf Investigations cf :he CIA fcr coverage veriricsticn. /do hereby certify under the pains and penalties of perjury that :he infcrmaticn provided accve iS.rUe and correct. Sienature _r_ ate Print name Fhcne ;r O`ic:al use only do not wrrte in this area to be ccmcleted by c: -,y cr town cr^c:af C;ty or Tcxn P=rmdlt ic�nsirc Building Dept 7Ceck if immediate response is required [I Licensing Board ❑ Selectman's OffCe Contact person: Phcre C Health Department Other 71 ✓fze i�oorv�rao�zcuralll o��/Glaaoac�ucaP,C�a 1 OE2ARTNENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Number: Expires: Birthdate; CS 0226.00 051-9,12000 35;x9%1939 Restricted To:- ARTHUR orARTHUR 3 WALSH .�R r7 �jEASAN.T ST • cwwn.v ?i �tr.ci.,. :, • ^a AN00VER, .1A 01845 Cl) m M C/) 0 m CO) 'O aZ CO O ar dd Q �. n� 0 CD o v CL Q C o H 'O CD si O 7 CA d CA c 0 CA d Cl) CD O CD -�v 3 y� CD H O ^lz O1 0 0 I Crr1 cn cn n O V J C: Z 0 N S O -• N O ?CL N to - CO m Cl Co CO) 0 0. n Z _ =10 y --q0 Im .► kwm O T CL =ro aim N CD O m H p N ppm: S CD J2 �` O o ZS.�. p N !7 O � O O 06CD ..� _ Cl) t:3pkl:: N .�%• p1 y Lam• -CV -i, d dcr N _ C 0. H C to O N VJ CO) H CD At/ cu O� a <p I '� �CD0 O O O m-44o:to NZ D � CD w �y •+ .. o c=,r • o XA r� LPwaw O CD 1=p o� O rD d rt ~ p ~ ► °� G °°•r rA w ; x tom" w G a� CA CA A�i G � O G a p' 0 G1 r G? r tD O ^ y ; O O a x r) 0 p x I 0 c cLocation �d / / r Ur h f A, RcI No. 29 Date TOWN OF NORTH ANDOVER ,/#.- 15' `t I 13 ,o4,C2r0/'M 14:41 Water Connection Fee $ TOTAL $ C:2 Building Inspector 225.00 PAID Div. Public Works . n Certificate of Occupancy $ Building/Frame Permit Fee $ s�cHust Foundation Permit Fee $ Other Permit Fee S WOOD $ ° Sewer Connection Fee $ ,/#.- 15' `t I 13 ,o4,C2r0/'M 14:41 Water Connection Fee $ TOTAL $ C:2 Building Inspector 225.00 PAID Div. Public Works M I _ �I N FA 0 'V Vj Z z C :L X O O � - z � -X u w W N_ O L— Z O Q � U Z Q W v Z z tzif 'J¢1 f W ::J W J Z Z Z _ �I N FA 0 'V Vj Z Hearth Works F. S. Inc. 203-A Mann St. N. Reading, MA 01864 / (508) 664-0100 WPaRW"FmPLACE&SEffS e WinterWarm Fireplace Insert T s easily into your heat -losing sting fireplace, and turns it into an efficient heat source. While retaining the allure of an open fireplace, it boasts the convenience and performance of a state-of-the-art wood stove. The WinterWarm Fireplace Insert comes in two sized models to suit many different fire- place applications. Features: • High efficiency - 79% - more heat from less wood. • Large fireviewing area with clean glass. • Easy ash handling. • High heat output - up to 50,000 BTU's. • Flush front on small model; choice of front styles on large model. • Twin fans with rheostat for heat circulation. • Solid, durable cast-iron construction. • Long overnight burn times. • Leg levellers for uneven hearths. • Conveniently located controls. • Thermostatic control for steady, even heat. Options: • Two porcelain enamel color choices: Sand and Midnight, plus Classic Black • Cast-iron surround panels with small model for a neat finished appearance • Outside air adaptors Enamel Colors: N le Front: inimum Fireplace Dimensions: Height: Width: Depth: Flue Collar Size: Large Model WinterWarrn Large Model x.66 0.0�N (110 inn0 191, Specifications Large Small Model Log Length: :Odel 11 18 inches Burn Time: Up to 9 hours 6-8 hours Heating Capacity: 750-1,500 sq. ft. 500-1,000 sq. ft. Maximum Heat Output: 50,000 BTU/hr. 30,000 BTU/hr. Efficiency Rating: 78.3% 79% EPA Emissions Rating: o,2.1 grams/hr. 4.0 grams/hr. Weight: 475 pounds 275 pounds Dimensions: `qj,b le Front: inimum Fireplace Dimensions: Height: Width: Depth: Flue Collar Size: Large Model 41"W x 30"H 26-1/2"W x 21 "H 24" 1,6" 21 " x.66 0.0�N (110 inn0 191, 15" 8 inches oval 6 inches round i( 11 k`innil —_. 26' (660nim)— �_ -- 25"1640min1 41"W x 30"H 26-1/2"W x 21 "H 24" 1,6" 21 " 34" 3y11 26-1/2" 191, 15" 8 inches oval 6 inches round Small Model —_. 26' (660nim)— �_ -- 25"1640min1 I ft /+' �un) '1 I,{" l i'i inn�l 200-2094 C/) m m m m 0 m w v C � CIOCD C7 Cl) Z CO) CD -0 CL r o• CO o _• y CD C-) o p o CD o CL cr cD o CD 0o w C O y• CD a O y CC C � v y O CD Z O O O CD 0 C CD 1,5 L C>:�o m 0 d� S CDy _2 1 n mon" m C) N _ 71 O w hJ Zo 0 Cw n •-• � m m CO) -10 N O Sm o -� = CD m C Cl) O 71 0 0 n O N A .m =r 5"a " D o CL,,..: CDCD N ,om CL -t CD N =N: c� Co. ate• d Q -: a �CD CD IE CD N C - Dom. CD CO �c'): O O =r CD 0 Boz: m 0 N CDCD d d ='O n_3 C, 5 c o O O' y 0 0 c A Z C OTJ x1 0 C: 71 O w hJ Zo 0 Cw O m O x O c CA CA 0 m a w n ,z O G 'n 0 C COO Cf 0 (/) U 71 0 0 n y y 0 0 c A