Loading...
HomeMy WebLinkAbout575 OSGOOD STREET Department of Fire Services Office of the State Fire Marshal b p.O.Box 1025,State Road,Stow,MA 01775 CERTIFICATE OF REGISTRATION North Andover April 30,2020 (City or Town) (Date) NOTE:Complete top and bottom of form and forward both sections and fee to local Licensing Authority(City or Town Clerk). RE RE DO NOT RETURN FORM TO THE DEPARTMENT OF Fthe undersigned hereby certifies that: In accordance with the provisions of Chapter 148,Section 13,of the General Laws, Edgewood Retirement Community,Inc. (TITLE HOLDER): 575 Osgood Street or other (ADDRESS): for the lawful use of the building(s) is the holder of the license granted(Date): 2/28/2000 situated or to be situated at (ADDRESS): 575 Osgood Street structure(s) NORTH ANDOVER,MA 01845 (City or Town) as related to the KEEPING, STORAGE,MANU FACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES ed p OSior o J y 1,1936, NOTE: This certificate of registration must neof signed and Ih eholder of the licensUaidse as <; Otherwise by the owner or occupant �4.R`�,•........ ........2020...... ... `� ignature) Received ��h�1n?06� .�� 1Re4'. O N� 1� to whether occupant or holder) IR���R:....cU.�..`��O.1N�'N0.NL� .. (State �y� oR`�� By .. (Clerk) '�IJ� O (5 I AA,' !.:.:• ...... .. (Official Title) .••.. •••V�'.... ��(¢� (Address) v Department of Fire Services Office of the State Fire Marshall �py o P.O.Box 1025,State Road,Stow,MA 01775 REGISTRATION North Andover, April 309 2020 (City or Town) (Date) This is to certify that Edgewood Retirement Community,Inc. 148, Section 13, of the General Laws,filed with me a certificate of has, in accordance with the provisions of Chapter Inc. registration setting forth that:grantedEDa e)2/28/000 ement Community, d at: is the holder of the license for the lawful use of the building(s)or other structure(s)situated or to be situate ORAGE,MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES- as related to the KEEPING, ST % 4t(Siggnature and cial Title) Clerk of each year. Note:A certificate of registration must be filed on or before CONSPICUOUSLY rPOSTED ON THE PREMISES.) (THIS REGISTRATION MUST EXPIRES APRIL 30,2021 Workers Compensation and Employers Liability Insurance _ POLICY INFORMATION PAGE policy Period l• j� Number From To POIICy� 310 2 8 0- n 6 5 3 5 /2020 06/30/2019 lion Indemnity Compa y (A Stock 06/30 (A Stock Company) 12:01 A.M.Standard Time at the described Iota 650 Elm Street Suite 401 Renewal of Transaction Re Manchester NH 03101-2551 TION Renewal of 310 2806535 RENEWAL DECLARA Agent Named Insured and Address o o o o 16 2 1. MARSH & MCLENNAN AGENCY LLC ITY INC 100 FRONT ST STE 800 EDGEWOOD RETIREMENT COMMUN WORCESTER MA 01608-1435 ATTN: JANE SULLIVAN 575 OSGOOD ST 01845-1975 Telephone: 5pg-852-9400 NORTH ANDOVER MA Unemployment ID# Entity of Insured FEIN#: Risk ID# CORPORATION NCCI Carrier# 043195775 SEE EXT OF INFO 38563 Other Workplac e not shown above: SEE ATTACHED ADDITONAL WORKPLACES SCHEDULE ured's mailing address Standard Time at the 2. The Policy olic Period is from o 6/3 0/2 019 to 0 6/3 0/2 0 2 0 12:�C a.m. to the Workers Compensation Law of the 3. A.Workers Compensation Insurance: Part ONE of the poI Yapplies states listed here:MA of the policy applies to work in each state listed in item 3A.The limits B. Employers Liability Ins Part are: TWO of our liability 1,000,000 Each accident Bodily Injury by Accident $ limit b Disease $ 1,000,000 Policy � to ee Bodily Injury Y 1,o00,000 Each emp Y listed here. Bodily Injury by Disease $ lies to the states, if any, KY MD, ME, MI, HI, IA, ID, IL, IN, KS, LA' UT, VA, VT, C. Other States Insurance: Pao THREE, Cf tDEPoFL applies OR, PA, RI, SC, SD, TN, TX, AK, AL, AR, AZ, CA, NM NY, OK, MN MO, MS, MT, NC, NE, NH, NJ, WI, WV, D. This policy includes these endorsements and schedules: SEE ATTACHED ENDORSEMENT es and Rating Plans. will be determined by our Manuals of Rules, Classifications, 4. The premium for this policy audit. All information required below is subject to verification INFORMATION PAGE SEE EXTENSION 258,721 Total Estimated Annual Premium $ 338 479 Minimum Premium $ Expense Constant $ -18,599 Premium Discount $ 258,721 Deposit Premium $ Assessments and Taxes $ 9,250 day of Au Ze epresentative Countersigns 06�20/2019 Issued Date: Issuing Office:651 Elm Street Suite 401 Manchester NH 031o1-2551 Page 1 of 5 WC oo 00 01 A (Ed. 2-19) INSURED'S PDF COPY The Commonwealth of Massachusetts Department of Industrial Accidents office of Investigations 600 Washington,Street Boston,MA 02111 www,mass gavfdla Workers' Compensation Insurance Affidavit: General Businesses Annlieant InformON Please Print Legibly Business/Organization Name- Address: 7S City/State/Zip; .'��.�% A.,c�,�„r, --./R4�Sphone#, g7R �S3C1U Business Type(required): Are you an employer?Check appropriate box: 5. Retail I�'t' 1 am a employer with _employees(flrll and/ or part-time).* b, ❑Restaurant/Ber/Eating Establishment 2.❑ 1 am a sole proprietor or partnership and have no 7, Office and/or Sales(incl,real estate,auto,etc.) employees working for tne in any capacity. I Von-profit [No workers'comp.insurance required] 9, ❑Entertainment 3,�J We are a corporation and its ef'ficers h../e exercised thetup ht of exemption per c. 152,§1(4),and we have 14,n Manufacturing no oyees.[No workers'comp.insurance required]* I1,[]health Caro 4,❑ Wa non-proftt organization,staffeed by volunteers, 12.[]Other wiemployees.[No workers'com .insurance req.] *A appllcant thid chocks box p 1 most also fill out the section tx low showing their workers' rs'oaomllpensation icy is required and such an **If the corporate officers have exempted themselves.but the eotporation has other employ ees,a organization should clmok box#1. workers'compensation Insurance for my employees, Belorv�to the policy lnforrnatinn, I am an employer that h providt" P insurance Company Namet Insurer's Address' City/State/Zip: • /•• `.•r4e ,(�/� C C7' — Policy#or Self-ins,Lie:# t 2 � Expiration Date: &i 3O .nba0 of the workers compensation policy declaration page(showing the policy number and expir Attach a copy ' ation date). 1:ailure to secure coverage as required under Section-25A of G.152 can lead to the imposition of criminal penalties of e fine up to$1,504A0 and/or one imprisonment,as well as civil penalties in the form of a STOP WORK CIRDER and a f ne of up to$Z5o,00 a day against the violator. Re advised that a copy of this statement may be forwarded to the Office of investi etions of the DIA for insurance coverage verification, under the palms rend penalttes ofperJary that the Information provided above is true and correct. I do hereby eerttJy, i Date- i atur1w ne � Fjs3ulngAuthority Da not write lit this area,to be completed by city or town official, j Town: Permit/License# y(circle one): th 2.Building Department 3.City/Town Clerk 4.Licensing Board 5.Selectmen's Office 6.Othher Phone#: Contact Person: www.msss.goWdia (v° t Department of Fire Services Office of the State Fire Marshal P.O.Box 1025, State Road,Stow,MA 01775 CERTIFICATE OF REGISTRATION North Andover April 30,2019 (City or Town) (Date) NOTE: Complete top and bottom of form and forward both sections and fee to local Licensing Authority(City or Town Clerk). DO NOT RETURN FORM TO THE DEPARTMENT OF FIRE SERVICES. In accordance with the provisions of Chapter 148, Section 13,of the General Laws,the undersigned hereby certifies that: (TITLE HOLDER): Edgewood Retirement Community,Inc. (ADDRESS): 575 Osgood Street is the holder of the license granted(Date): 2/28/2000 for the lawful use of the building(s)or other structure(s) situated or to be situated at (ADDRESS): 575 Osgood Street NORTH ANDOVER, MA 01845 (City or Town) as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. NOTE: This certificate of registration must be signed by the holder of the licens 'f said lic Asearanted prior to July 1,1936, Otherwise by the owner or occupant of the land licensed. . ................ Q Received ....... ..2019......... ........ ... "" � 1 11 (S' nature) cIHeA)`�. CoKNUI�}�`� -L-►s(, By #=9t;;Mt C.. . (State whether ner occupant or holder) .5.......os�oo....S a ..NoR 1�. >v�lov c�, M R (Address) t5 IT Department of Fire Services 40Office of the State Fire Marshall 'ss. 4�D P.O.Box 1025,State Road,Stow,MA 01775 REGISTRATION North Andover, April 30, 2019 (City or Town) (Date) This is to certify that Edgewood Retirement Community, Inc. has, in accordance with the provisions of Chapter 148, Section 13, of the General Laws, filed with me a certificate of registration setting forth that: Edgewood Retirement Community, Inc. is the holder of the license granted(Date)2/28/2000 for the lawful use of the building(s)or other structure(s)situated or to be situated at: as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. l', r ... ... ....... -� ......... (Signature and Official Title) Clerk Note:A certificate of registration must be filed on or before April 301 of each year. (THIS REGISTRATION MUST BE CONSPICUOUSLY POSTED ON THE PREMISES.) EXPIRES APRIL 30,2020 The Commonwealth of•Massachusetts Department of Industrial.Accidents Office of Invest4ations 600 Washington Street Boston,MA 02111 www.mass govldia Workers' Compensation Insurance Affidavit: General Businesses ARplicant Information Please Print Legibly Business/Organization Name: QROCarl/�U✓t /� Address' City/state/Zip Are ye an employer?Check the appropriate box: Business Type(required): 1.L� I am a employer with employees(full and/ 5, ❑R ail or part-time).* 6, ❑ Restaurant!$ar/13ating z.stablishment 2.11 1 am a sole proprietor or partnership and have no 7, Office and/or Sales(inu,real estate,auto,etc,) employees wonting for me in any capacity. -8, Non-profit [No workers'comp.insurance required] 3.0 We are a corporation and its officers have exercised 9. []Entertainment their right of exemption per c.152,§1(4),and we have 10,❑Manufacturing no employees. [No workers'comp.insurance required]" 11.❑Health Care 4,[] We are a non-profit organization,staffed by volunteers, with no employees,[No workers'comp insurance req.] 12.[-Other *Any applicamtthat checks boat p l must also fill out the section below showing their workers`compensation policy informs,i an. **If the corporate offitxrs have exempted themselves,but the corporation has other employees,a workers'compensation po Ioy is required mid such an organization should chock box#1. I am an employer that is provitltn8 workers'compensadon insurance forrl1my employees. Below•is the policy information, , ^ Insurance Company Name: 14�/� / e �n mr► c �" �y Insurer's Address: City/5tate/Zip: S'� Policy#or Self-ins,Lic:# `� ` S3 Expiration Date:_, Attach a copy of the workers'compensation policy declaration page(showing the polcy num er and expiration date).. Failure to secure coverage as required under Section 25A of'MOL 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 STOI'WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwm l.ed to the Office of Investigations of the DIA for Insurance coverage verification. i I do hereby c ,under the pains un ena/a of perjury that the information provided above;s true and correct, Date: /y l turn `7lU �o ne �" S official use only. Do not write in this area,to be conspleted by city or town gfficiat City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CRY/Town Clerk 4.Licensing Board 5,St.ectmen's Office 6.Other Contact Person: Phone#: i www,.;.7goy/d19 i i. NOTICE NOTICE TO TO EMPLOYEES EMPLOYEES ! y M v• The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 1 Congress Street, Suite 100, Boston, Massachusetts 02114-2017 617-727-4900 - http://www.state.ma.us/dia As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30,this will give you notice that I (we)have provided for payment to our injured employees under the above-mentioned chapter by insuring with: MEMIC Indemnity Company NAME OF INSURANCE COMPANY 1750 Elm Street Suite 500 Manchester NH 03104-2920 ADDRESS OF INSURANCE COMPANY 310 2806535 07/01/2018 to 06/30/2019 POLICY NUMBER EFFECTIVE DATES MARSH &MCLENNAN AGENCY LLC 100 FRONT ST STE 800 WORCESTER MA 01608-1435 508-852-9400 NAME OF INSURANCE AGENT ADDRESS PHONE# EDGEWOOD RETIREMENT COMMUNITY INC 575 OSGOOD ST NORTH ANDOVER MA 01845-1975 EMPLOYER ADDRESS EMPLOYER'S WORKERS' COMPENSATION OFFICER (IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER r , . eJi�YG ��e�%I.lyJ.�tYIE'r ���f./�rf ,Illi:✓•Sfi�1 a Department of Fire Services Office of the State Fire Marshal P.0.Box 1025,State Road,Stow,MA 01775 CERTIFICATE OF REGISTRATION North Andover April 30,2018 (City or Town) (Date) NOTE:Complete top and bottom of form and forward both sections and fee to local Licensing Authority(City or Town Clerk). DO NOT RETURN FOAM TO THE DEPARTMENT OF FIRE SERVICES. In accordance with the provisions of Chapter 148,Section 13,of the General Laws,the undersigned hereby certifies that: (TITLE HOLDER): Edgewood Retirement Community,Inc. (ADDRESS): 575 Osgood Street is the holder of the license granted(Date):2/28/2000 for the lawful use of the building(s)or other structure(s)situated or to be situated at (ADDRESS): 575 Osgood Street NORTH ANDOVER,MA 01845 (City or Town) as related to the KEEPING, STORAGE,MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. NOTE: This certificate of registration must be signed by the holder of the lice a if sal license was granted prior to duly 1,1936, Otherwise by the owner or occupant of the land licensed. Received ........2019......... .. C`a M.�r............... ..QQ (Signature) By t � '� °`... !k'�'CN�!'Nl� �.>t' luno .. cl • itl ( ) (State whether�,occupant or holder) .M� � p (Address) ( �• �yI&97d1�9L+rl4:"l.�f.��•e:�/.!.:t�?lY'`ltic7;-°Se�� Department of Fire Services Office of the State Fire Marshall P.0.Box 1025,State Road,stow.MA 0177s REGISTRATION North Andover, April 30;2018 (City or Town) (Data) This is to certify that Edgewood Retirement Community,Inc. has,in accordance with the provisions of Chapter 148,Section 13,of the General Laws,filed with me a certificate of registration setting forth that: Edgewood Retirement Community,Inc. is the holder of the license granted(Date)2/28/2000 for the IawfW use of the building(s)or other structure(s)situated or to be situated at: as related to the KEEPING, STORAGE,MANUFACTURE OR SALE OFF ABLES OR EXPLOSIVES. F , • (signature and Official Title) ••lerk Note:A certificate of registration must be filed on or before April 30"of each year. (THIS REGISTRATION MUST BE CONSPICUOUSLY POSTED ON THE PREMISES.) EXPIRES APRIL 30,2019 r r The Commonwealth of-Massachusetts Department of Industrial Accidents Of flog ofInvesilgadons 600 Washington Street I i Boston,MA 02111 I wlviv.mass govklla Workers'Compensation Insurance AffldOR: general Businesses Applicant Information Pleas Prfint Let=ibly Business/Organization Namd:__ i Address, 7 5 LD S, oc JJ City/Sta dzip. . A--o-J c' Phone le(' Ft;� G'1 Are yo an employer?Cheek ilia appropriate boM Business Type(required): I ,�,f� 1,Fain am a employer wit}►30 I. employees(full and/ 5,.[]Retail 6 p Rastsurent/Ber/Bating Establishment orpert ame).4 2.❑ I am a sole proprietor or partnership and have no 7, []Office andior Salw(Inol.real estate,Auto,etc.) employees working for me,In any capacity. .g. Non-profit (No workers'comp,Insurance required] q. (�Entattalmment 3.❑ We are a corporation and Its officers have ex eralsed their right of exemption per c.152.§1(4),and we have 10,[]Manuf6oturing no employees.[No workers'comp.-Insurance requlred]* 1 I Ej 1`1 ith Care a,n We are a non profit organization,staffed by volunteers, C (►I Other C1 Any ppwcitni hat eheeks bozN i raosstt'euo fdt out comp.eaction lxlmr sholwingtiusrom loyces,e�workws"wan liesisAlion ��fmmaHon. o • F I cmatioapollay is roquiredmid such an . ••irtm oorpo,eteoMoers haraexemptsd thcr solyp,but the corporstio 11 oraenhsetion should oheok box 11. f am an employer drat It providi workers'conrpsrrration/nsur atrec for my unpf pyees. Below is rile policy lnfirmrdlon. {�. 1-ItL r . C'.'i°1s�Gl c{ Insurance Company Name: a ; insurer's Addross::fq —1-21 t/ c !/v'�rl c i c � —/jCl9'C3 —09 70 Cltylstsolzip: sa -In UrnLH—L—FVQ `�06719 2 017A Expiration Date• 1oliay Y or Self mpensation policy declaration page(showing the policy number and expiration date).. Attach a copy of the worlwrs'co Fallura to secure coverage as required under Saetlon 25A of Mt3L c,152 can Ioad to the Imposition of arimtnal penaltfies 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 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Inyustigallana ofthe VIA for Insurance covara o verification. t r lhept slrl# rd pe nitlos q[perjary thail the lrlJbrrnolion provided above is true and correct 3 13D !do hereby ee�1r ,rtlul Phone • EOth. only. Donal writs in this area,to Gs conrplstedlby city or totes q/1'iclaL ns Pormit/License# hority(circle'one): `Health Z.1luilding Department 7.CItYr1'own Clopic 4.Licensing Board 5.Selectmen's Office Phone#: rson: www.mw.`ov/fits � w WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE A.I.M. Mutual Insurance Company 54 Third Avenue, Burlington, Massachusetts 01803-0970 (800)876.2765 NCCI NO 26158 POLICY NO. 7149-2 7A PRIOR NO. I NEW ITEM '1. The Insured: Edgewood Retirement Community,Inc. D13A: Mailing address: 675 Osgood Street FEIN:"-"'5776 North Andover,MA 01845.1935 Legal Entity Type, Corporation Other workplaces not shown above: 2. The policy.period is from 06W2017 to 06/30✓2018 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 applies to work in each state fisted in item 3.A. The limits of liability under Part Two are: Bodily Injury by Accident $ _ _ _1,000,000 each accident Bodily Injury by Disease S 1,000,000 policy limit Bodily Injury by Disease $ 1.000=000 each employee C. Other States Insurance: Coverage Replaced by Endorsement WC 20 03 06 B D. This Policy Includes these Endorsements and Schedules: SEE SCHEDULE 4. The premium for this poll will be determined by our Manuals of Rules,Classifications,Rates and Rating Plans. All informalion required beellow is subject to verification and change by audit. assitications Premium Basis Rates Code Estimated Pet$100 Estimated No. Total Annual of Remunaratian Remuneration Premium INTEA 260564 INTER SEE CLASS CODE SCHEOU E Minimum Premium $558 Total Estimated Annual Premium $190,970 Deposit Premium $20,214 GOV. GOV STATE CLASS State Assessments/Surcharges MA $829 $199,621.00 x 5.6000% $11.173 This policy,including all endorsements,is hereby countersigned by &-,ea 06/22/2017 AWfted to Oslo Service Office: Marsh b McLennan Agency LLC 290 Donald J.Lynch Boulevard 100.Front Street Suite 800 Marlborough MA 01752 Worcester,MA 01600 WC 00 00 01 A(7-11) uedesopyhdmi�l 01 the 14"Onel Council on compenallon lautenee, pen . Hwy ;cc. Department of Fire Services Office of the State Fire Marshal P.O.Box 1025,State Road,Stow,MA 01775 CERTIFICATE OF REGISTRATION North Andover April 30,2017 (City or Town) (Date) NOTE:Complete top and bottom of form and forward both sections and fee to local Licensing Authority(City or Town Clerk). DO NOT RETURN FORM TO THE DEPARTMENT OF FIRE SERVICES. In accordance with the provisions of Chapter 148, Section 13,of the General Laws,the undersigned hereby certifies that: (TITLE HOLDER): Edgewood Retirement Community, Inc. (ADDRESS): 575 Osgood Street is the holder of the license granted(Date): 2/28/2000 for the lawful use of the building(s)or other structure(s)situated or to be situated at (ADDRESS): 575 Osgood Street NORTH ANDOVER, MA 01845 (City or Town) as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. NOTE: This certificate of registration must be signed by the holder of the license t£said li Vnnse was granted prior to July 1,1936, Otherwise by the owner or occupant of the land licensed. Received Am ....f.......2017.... .. . .................. (Signature) (0 By !(Let't°�...� ..tAA'h t. Wl3- Sr't1r!vtJ1t`'�.. (Official Title) (Clerk) (State whether pwner, ccupant or holder) ,J O ycA s f(ZE��...NoVA—�:NA��IO IBIS (Address) �} r Department of Fire Services m; ' Office of the State Fire Marshall P.O.Box 1025,State Road,Stow,MA 01775 REGISTRATION North Andover, April 30,2017 (City or Town) (Date) This is to certify that Edgewood Retirement Community, Inc. has, in accordance with the provisions of Chapter 148, Section 13, of the General Laws, filed with me a certificate of registration setting forth that: Edgewood Retirement Community, Inc. is the holder of the license granted(Date)2/28/2000 for the lawful use of the building(s)or other structure(s)situated or to be situated at: as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. ................................... (Signature and Official Title) Clerk Note:A certificate of registration must be filed on or before April 30'of each year. (THIS REGISTRATION MUST BE CONSPICUOUSLY POSTED ON THE PREMISES.) EXPIRES APRIL 30,2018 i ' I The Commonwealth of Massachusetts Department of Industrial Accidents Office of.Investigations 9 600 Washington Street Boston,MA 02111 www.mass.govldla Workers' Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Legibly i 1?C Business/Organization Name: ? Address: , �.✓� U fV� Phone#, city/state/zip: �� ` Are you an employer?Check the appropriate box: Business Type(required): 1,❑ I am a employer with employees(full and/ 5. Retail or part-time),* 6, Restaurant/Bar/Eating Establishment 2.❑ I am a sole proprietor or partnership and have no 7. Office and/or Sales(inol.real estate,auto,etc,) employees working for me in any capacity. g Non-profit [No workers'comp.insurance required] 3,❑ We are a corporation and its officers have exercised 9. ❑Entertainment their right of exemption per e. 152,§1(4),and we have 10.F1 Manufacturing no employees. [No workers'comp. insurance required]* 11.❑Health Care 4,❑ We are a non-profit organization,staffed by volunteers, with no employees.[No workers' comp.insurance req,] 12.❑ Other *Any applicant that checks box#1 must also f9l out the section below showing their workers'compensation policy information. **If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy Is required and suoh an organization should check box 01. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy lnfornuttion. Insurance Company Name: �Maaki4i�L � Insurer's Address: � 1 r lrW�/►�QII�L City/State/Zip: 1) .An 0IM,3 '49/v149 Policy i/or Self-ins.Lie; Hoc Expiration Date, a ����Z'�17 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 MOL c. 152 can lead to the imposition of criminal penalties of a fine up to r;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. Be advised that it copy of this statement may be forwarded to the Office of lnvestigations of the DIA for insurance coverage verification. I do hereby ee under the pau ruttl penaltles of perjury that Cite 111formation provided above is true and cot-reef. Si a re. � ' ne ©fflcial use only, Do not write In flits area,to be completed by city or town official, City or Town: Permit/License Issuing Authority(circle one): 1,Board of Health 2.Building Department 3.City/Town Clerk4.Licensing Board 5.Selectmen's Mice 6.Other Contact Person: Phone# www.mm.gov/diit WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE Massachusetts Employers Insurance Company 54 Third Avenue, Burlington, Massachusetts 01803-0970 (800) 876-2765 NCCI NO 58713 POLICY NO. MCC-200-2000455-2016A PRIOR NO. I MCC-200-2000455-2015A ITEM 1. The Insured: Edgewood Retirement Community, Inc. DBA: Mailing address: 575 Osgood Street FEIN:'---"5775 North Andover,MA 01845-1935 Legal Entity Type: Corporation Other workplaces not shown above: 2. The policy period is from 06/30/2016 to 06/30/2017 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 applies to work in each state listed in item 3.A. The limits of liability under Part Two are: Bodily Injury by Accident $ 1,000,000 each accident Bodily Injury by Disease $ 1.000,000 policy limit Bodily Injury by Disease $ 1,000,000 each employee C. Other States Insurance: Coverage Replaced by Endorsement WC 20 03 06 B D. This Policy includes these Endorsements and Schedules: SEE SCHEDULE 4. The premium for this policy will be determined by our Manuals of Rules,Classifications,Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Premium Basis Rates Code Estimated Per$100 Estimated No. Total Annual Of Annual Remuneration Remuneration Premium INTEA 260564 INTER SEE CLASS CODE SCHEDU E Minimum Premium $561 Total Estimated Annual Premium $114,023 GOV GOV Deposit Premium $12,252 STATE CLASS MA 8829 State Assessments/Surcharges $147,848.00 x 5.7500% $8,501 This policy,including all endorsements,is hereby countersigned by &Jea 04/14/2016 Authorized Signature Date Service Office: Marsh& McLennan Agency LLC 54 Third Avenue 100 Front Street Suite 800 Burlington MA 01803 Worcester,MA 01608 WC 00 00 01 A(7-11) Includes copyrighted material of the National Councll on Compensation Insurance, used with Its permission. i i ------------- i, Deparlmen[of Fire Services W. Office of the State Fire Marshal P.O.Bo. 1025,S,ate Bead,Stow.MA O1775 CERTIFICATE OF REGISTRATION North Andover April 30,2016 (Ciry or Town) (Uen) NOTE:Complete top and bonom of ibcm and forward both sections and fee 10 local Licensing AuthOtiry(Ciry Or Town Clerk). DO NOT RETURN FORM TO THE DEPARTMENT OF FIRE SERVICES. to accordance with the provisions of Chapter 148,Section 13, of the General Laws,the undersigned hereby cenifies that. (TITLE HOLDER): Edgewood Retirement Commwity,Inc. (ADDRESS): 575 Osgood Street is the holder of the license granted(Date):2/28I2000 for the lawful use of the building($) or other structure($)situated or to be situated at NORTH ESS)' 575 Os good Street ANW(Ciry or Town) as related to the KEEPING, STORAGE,MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSNES. NOTE: This certincite of regotrorion most be signed by the holder of the license 4'f4 id 1w.o aw�ntud pelor to July IJ936, Othnwise by the owner or occupant of tee loud liteneM. g\ " A .2016.._._,. .,......sil_\y1eCr`m".Ue, Received �.ea\� -.TO.-�� rr \\ 1(SI TGPf�a A;...MAIN�C'NAN(L' 40'1'yCW°.0.N..Y.x.si4ltM,Re�..`9f1(`LV.f11.t.1y 11`JC" By ..WtR.....)1.. xue bolder) (Orfitlal Title) (Clerk) (AddreW l.alrurrvrr.aZeo.GLFa ai �lLaad¢CALCt12�.�b s9/ J � Department of Fire Services i � Office of the State Fire Marshall 4' T A P,0.Box 1025,Stara lined,Stow,MA 01775 REGISTRATION North Andover, April 30,2016 (ar.,loroO (D.) This IS to Certify that Edgewood Retirement Community,Inc. has, in accordance with the provisions of Chapter 148,Section 13,of the General Laws,filed with me a certificate of registration setting forth that Edgewood Retirement Community,Inc. is tho holder of the license granted(Date)220000 ) R EXPLOSIVES. for the lawful use of the building(s) O lding(s)or other strocnve(s siNalcd or m be sima[ed at. as related to the KEEPING, STORAGE,MANQFACTI-1RE OR SALE OF (Signamm end Otfie,el Tit FW le C(erk Sou:A cmifima o(mgistndon mun be Glcd on at bcforc April 3Y of moh YOU (THIS REGISTRATION MUST EX CONSPICUOUSLY SLY POSTED ON THE PREMISES.) 30,200 3B/E0 39vd 000M3903 L665ZLBL6 BB �6© SIBZ/bl/b0 TOWN OF NORTH ANDOVER OFFICE OF TOWN CLERK 120 MAIN STREET NORTH ANDOVER, MASSACHUSE'I'TS 01845 d XUN , M Joyce A.Bradshaw ° Town Clerk Telephone(979)688-9501 FAX(978)688-9557 T4(XVb E-mail: ibradshaw@townofiiorthmdover.com 2016 Renewal To All above Ground and Underground Storage Tank License Holders: Enclosed please find your Registration Renewal Form(s) for above ground and/or underground storage tanks. Renewals are due April 30 of each yew. The fee for renewal is $150 per site. Please sign the top portion of the registration form and return it with the appropriate fee, payable to the Town of North Andover, 120 Main Street,North Andover, MA 01845, uic bottom Portion is yours to be displayed alone with Your license. Also included is the requirement to provide an affidavit showing proof of Workma 's Compensation Insurance. Please fill out and return the form to us with your renewal. Your immediate attention in this matter is greatly appreciated. Thank you for your continued cooperation. Please do not hesitate to contact me at the above listed phone number if you have any questions or need additional assistance. Very truly, C� n Joyce Bradshaw Town Clerk Enc. 90/h0 39od QOOP13903 L665LLBL6 00:60 9T0d/PT/r0 TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETT e01845 Telephone(978)688-9501 Joyce A.Bradshaw,CD1MC Gex (978)68&9556 Town Clerk 44 4�Lcxu'1 E-mail lradshaw tnwaofnorlhandover.com TO: All License Holders—Proof of Workers' Compensation 2016 package for 2016 is the attached form which must be Included in the renewal P with your renewal oC the Underground Storage Tank 6 completed and returned Certificate of Registration. requires that all employers commonwealth of Massachusetts must carry a valid workers' Massachusetts General Law Chapter 152 Scction 2 w 11 be verified with the conducting business in the Comm Office of compensation policy at all times. Proof of this custnal Accidents (I)IA), 'msutence carrier directly or the Department of Ind Insurance at goo-323-3249. The Of{ice of the Town Clerk will retain, a copy of the enclosed Workers' Compensation Affidavit. If you have any changes n have any your insurance carrier or questions please contact our office at(978)688-9501. Please return the completed form with your license renewal to Town Clerk's Office, l20 Main Street,North Andover, MA 01845. We appreciate your assistance and cooperation. Sincerely, Town Clerk Jo � oyce A. Bradshaw, �66szcec6 ea:h0 er©z�rolioo QOCM39�3 rDe Cdnrhrorewealth alAf �,h�Pnrprkar Q/fMrrs7r(yAcc4yBa y I tr �Yor on, 11A.B 02111 Iure (,'Da1PeLeetiO ���1JOv/((fQ IrcaatjatormaHoa alnaurance.y�davit: G Bus ness/Or _ Daerel BulweaBes gaaiierion Name: Addteag; �� /S.fOJ,r/ / �l ryq f Plea c Print Le ' 1 o. I City/gpt(,2i ------------- p: ��,✓r- �/ ^��rmplo- 1..ecb t e PProprLtebox: , Phone Oln le er 8 2• 1 am a tied i with 1 Z employeae(Poll end, S.Bu" (regul,ed): Ir Bole propr7ft El Perm or patmership and haveno 6. �p m..,B M owwkar8' m8 Pw me in my capacity. ?, pre erBatfng BerabliehmaM 3.0 IN ve a Comp.lneur. required —J---ol endror Uee(final.reel um ) no Incorpmadnn end 4 a4noe6 have eaercieed '8. L7Non-pm5t m,aura,arc. 0PmmmPlien par a, 152,§1(4),and we he,, 9. Q�tta.=ent I no anplDyoee.(JV0 werkera'comp.Me a r urvro r 70.0 ulhamrin 4. we ere anon-pmfi!o equiredl 8 with no employees.[No wtoorrkam�E'Dom�p u�uwance req j 12.,Other C� C /I e'e't8'RPlielnrtlul Weokeeel/1 melt Wo Nl Out Neatalen bdrethowin theirworkw' � � eeINC eorpeHeoMew axe a br iivLnn axaAgW memedry,bgtfenipnaden hel trJm °01wwekncd wrn. agWnbon ohouldehookbtal . amployeel,ewarkw'welpenotlon Deliey a nqulrtd and eure en �tPr9yNingworkarr'COnfNi9tlonhwmCeforaryemplryc� BakwlJrhapa!!ry/r{fornonoa, 1 "Al�„hl c t� �pY `-rro �ILC l.arnm6fuP.e¢GGii aL �ILQdaaClutO.vMb 1is JJ c" Department of Fire Services Office of the State Fire Marshal P.O.Bos, 1025,Su[a Hood,Slow,MA 01775 CERTIFICATE OF REGISTRATION North Andover April 30,2016 <Ciry or Town) (uno) NOTE:Complese top and bonom of form and forward both sections and fee to local Lwe rsing Aurh my(City or Town Clerk). DO NOT RETURN FORM TO THE DEPARTMENT OF Fine SERVICES. In accordance with the provisions of Chapter 148, Section 13, of the General Laws,the undersigned hereby certifies that', (TITLE HOLDER): Edgewood Retirement Community,Inc. (ADDRESS): 575 Osgood Street is the holder of the license granted(Date): 2/28/2000 for the lawful use of the building(s)or other structure(s)situated or to he situated at (ADDRESS): 575 Osgood Street NORT14 ANDOVER,MA 01845 (City or Town) as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. NOTE: This certificate ufregistretion must be signed by the bolder of the license' aid Iieeme was granted prior to July 1,1936, Otherwise by the own,,or eecupant of the load lieenead. Received �.�.Q..\1 Ar}�1 ...2016.......,. ........ ..,.......,.y'.Oa1 s.+..._.. P(}a e! MgIN'tENA,N o s a, By ...�tR.....A .......... .. . � �o�(Sui. �y.. Rceaw�bcdeo hu.N.l}r Ta c Nfeaial Tile) (Olcrkl (Smm whedo owns,oeuupanl or holder) Oaf l.an>,rrO,uJzaLLli od ✓ILaa4a.(;iuW.e�6 e Department of Fire Services al Office of the State Fire Marshall S a P.0.Box 1025,Some Read,Slow,MA 0171i REGISTRATION North Andover, April 30, 2016 (Cllynr Town) (Eam) This is to certify that Edgewood Retirement Community,Inc. has, in accordance with the provisions of Chapter 148, Section 13,of the General Laws, filed with me a certificate of registration selling forth that: Edgewood Retirement Community,Inc. is No holder f ilie license granted(Date)2129/2000 for the lawful use of the buifding(s)or other stracnme(s)situated or in be situated at as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF MABLESffi OR EXPLOSIVES. (Sguawie and Ocvl Tltle Clerk Fo[e:A enti fiewe of regis:mion mull he[IM on ar neforc Apn110°'of eau Ycu. (THIS REGISTRATION MUST BE CONSPICUOUSLY POSTED ON THE PREMISES.) EXPIRES APRH.30,2017 90/E0 30Vd r100P3903 L66SLL6L6 80:68 9I0Z/CT/D0 TOWN OF NORTH ANDOVER OFFICE OF TOWN CLERK 120 MAIN STREET NORTH ANDOVER, MASSACHUSE't I'S 01845 Ha�rq Joyce A.Bradshaw d,"" � ;e9 Town Clerk . Telephone(978)688-9501 �`i F f FAX(978)688-9557 'Or¢xu0� E-mail: 'bradshaw(2i)townofiiorthandover.com 2016 Renewal To All above Ground and Underground Storage Tank License Holders: Enclosed please find your Registration Renewal Form(s)for above ground and/or underground storage tanks. Renewals are due April 3e of each yew, The fee for renewal is$150 per site. Please sign the top portion of the registration form and return it with the appropriate fee, payable to the Town of North Andover, 120 Main Street,North Andover, MA 01845, The bottom Portion is yours to be displayed alone with Your lieen Also included is the requirement to provide an affidavit showing proof of Workman's Compensation Insurance. Please fill out and return the form to us with your renewal. Your immediate attention in this matter is greatly appreciated. Thank you for your continued cooperation. Please do not hesitate to contact me at the above listed phone number if You have any questions or need additional assistance. Very truly, 2 2� r Joyce Bradshaw Town Clerk Enc. 90/b0 39vd CCCM3203 L66SLLBL6 00:60 9101'/C1/Co TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01945 Joyce A.Bradshaw,C.MMC Town Clerk Tetephone(978)688-9501 Fax (998)688-1556 srx aid �q1 i4 �• 4cxu'-r Email jbredshaw/7o tawnofnorlh d .corn TO: All License Holders—Proof of Workers' Compensation 2016 Included in the renewal package for 2016 is the attached form which must be completed and returned with your renewal of the Underground Storage Tank Certificate of Registration. Massachusetts General Law Chapter 152 Section 25A requires that all employers conducting business in the Commonwealth of Massachusetts must carry a valid workers' compensation policy at all times. Proof Of this coverage will be verified with the insurance carrier directly or the Department of Industrial Accidents (DIA), Office of Insurance at 800-323-3249. The Office of the Town Clerk will retain a copy of the enclosed Workers' Compensation Affidavit. If you have any changes in your insurance carrier or have any questions please contact our office at (978)688.9501. Please return the completed form with your license renewal to Town Cleric's Office, 120 Main Street, North Andover, MA 01845, We appreciate your assistance and cooperation. Sincerely, (•�.;,i Q r' Joyce A. Bradshaw,Town Clerk SG/SO 39dd 400M39B3 L65SLLBL6 BB60 9t0L!Cl/DB The Comtnonwealth ojMassaehrtxtfs Dapnrament Qllnd vof MWAcctdeno OJ}7ce aflnveaaYtgntfornr 600 Waf41M1 n&reel Boston,MA 02111 Workers' Comw'm"ss'Sov/dia A1311licant InformationPetlaa6on Inauraace Affidavit: General Busineaaeg Work Business/Or Plea ePrint Legibiv i ganizatioa Name: Address: City/Statelzip: / �L✓.�- ,�-C/d�j/S — Phone#: 7,�5�-33dc� Any 'an employer?Check IPPropriate Lox: l ll� lamaemployer with F7. �§ ae TYVp(required): or part-ryme),v anployem(full and/ Retell 2.❑ l am a 801e proprietor or pertnerahip and}uve no "'"'Im"B r/Bating Betabliahment runployeee worsting fur me in any capeaity, 9 and/or Salsa(mol.real seta3.❑ Weereac�,eomp.InseR"cerequired] rofs �,aura,mporedon and its afAaerz have exercised the'vri In of mrempiSon pare• 152, §I(4),end wo haveauunent noemploysm.(No want comp, in0o4.❑ We ere a non-p oftoh Ca a with n0 eta to oec, hY volunteore, p Y [N°workera'comp,Laurence req,] 12.abther eAm Npliwa Mal eyaeea bare)man lea 110"the"Aan bdm aMwing heir werkw•meopeoealon Ddlay i,ubrmwa0 �•Ifthe mrsa.a omens hxe examPsed 0eoealvy,but die eo anpalulim should Ned,hoz 41. raeadon M1Y other anployau•e warocre. mpenoaon DWiry anqulnd mdaueh en fan an employerfiaaf ls pro rddtng worAwo, co�mLpaosasoft Anru oricalpr na!' e Lsunnm Compmry Name: ��: it J(Cr tSC'�rj " f°y Bebwta thepabo Nlomenaam' Insumr's Addrraa: -- r / K� dnr• chy/swurc p; ��F� eo S polity#or Self-Ine.Lioag' ��'�'. -„z(''J -�]p0�C' "3- Attach a copy at the wO,kLl, mpematbu paltry declaration xpnntlon Date; ��' ,jL' 6 Page("bary" g the polity number and ) Pasture to eoaure cove each, m required undm Sers]on 25A well MOL a. o can lead to the imposition of criminal penaltim of a ftna up to S1,500.0D anNm'onayen'knpxiaonma!;ea wall as civil peealtlee in the form of u S Of up to 5250.00 a day against the viaktar. Be advised that s co oFNie statement be TOP W'Ol"Y CRDHR ems a Itnc invest Idols of the DIA for insurance coverage verification. n'"y forwmdad to the Office of I do Atnet, rory�y ruu[u 1hapyjne andpnm!llea of�` pvjruy then the lajarmvfoe prevsded Il ft-atrete and correct. Si®eDae_ G L�i one [6. flc/al•urt only. Do not 11417 fills Into,lobe comp/Wedlry coy or lawn ofJlclaL y or Town; ParmitlLicanae# uing Authority(threat one): eard of Health 2.Building Pope entrant 3.Cly/fowo Clark 4.Licensing Board S.Selectmen$Office therntact Parson; Phone#: www.maagov/eta j 90/90 39vd 000M3903 L665LL8L6 00:60 8T0L/bT/V0 s } Department of Fire Services Office of the State Fire Marshal a aas P. 0. Box 11125_State Roud,Smw, MA 01775 CERTIFICATE OF REGISTRATION North Andover April 30, 2015 (CIt,or mhsn) (Date) NOTE: Complete top and bottom of forin and forward both sections and fee to local Licensing Authority((lily or"fmvn C'lerk). DO NO RETURN FORM"1'0 THE DEPART MEN'1'OF FIRE SERVICES. In accordance with the provisions of Chapter 148, Section 13,of the General Laws, the undersigned hereby certifies that: (I I I"LE I IOLDER): Edgewood Retirement Community. Ina (ADDRESS)'. 575 Osgood Street is the holder of the license granted (Date): 2/28/2000 for the lawful use of the budding(s)or other structure(s)situated or to be situated at (ADDRESS): 575 Osgood Street NORTH ANDOVER. MA 01845 (Citp orl own) as related to the KEEPING, ST M ORAGE, ANUFACI'U RE OR SALE OF FLAMMABLES OR EXPLOSIVES. NDI'E This certificatef registration must be signed by the holder of the locipe if said license was granted prior to fuly 1,1936, .\ Otherwise by the owner or occupant of the land licensed. / Received fiEy('.tlou . .7015.... f .� By .. tPseUh'10.1NtG�.}3CE t01a44nvy� Rt�r0.LNN.'Y CeuaMU0 fOltleial'I iticl (Clttk) (scite ed¢nero,oeq uccvpmi(or holder) S`I5 Osy,el ., tee} Ai4wt. t. (Addreu) l,wn�YLaduteccLLlt � ✓l(�ad2trctulo�2 i Department of Fire Services Office of the State Fire Marshall a w� 11. 0. Bos 1025,State Road, Sloss. M:101775 srq y9.. REGISTRATION North Andover, April 30,2015 ((51y at I."') (Date) This is to certify that Rdgewood Retirement Community, Inc. has, in accordance with the provisions of Chapter 148, Section 13,of the General Laws, filed with me a certificate of registration setting forth that: Rdgewood Retirement Community, Inc. is the holder of the license granted(Date)2/28/2000 for the lawful use of the budding(s)or other stmctm'e(s)situated or to be situated at: us related to the KEEPING, STORAGE, MANUFAC"PURE OR SALF. OF FLAMMABLES OR EXPLOSIVES. (sagraturn and otrend role) Clerk Note:A ecmlicate of regisuatiun mLLa be f lcd ou or beiotc A1,nl30"'of cech year. (THIS RECISTRAT(ON MUST BE CONSPICUOUSLV POSTED ON THE PREMISES.) EXPIRES APRIL 30,2016 The Commonwealth of Massachusetts Department of Industrial Accidents Office oflnvestigations 600 Washington Street Boston,MA 02111 wrvw.mass.gov1dia Workers' Compensation Insurance Affidavit: General Businesses Applicant InformationPlease Print Legibly _ Business/Organization Name: (� �J h j Address: City/State/Zip: 1 69,Q Pl g`/S Phone#. c/ Are you an employer?Check the appropriate box: Business Type(required): � 5 Retail i.L✓I 1 am a employer with employees(full and/ C orpart-time).' 6. ❑ Restaurant/BarlEating Establishment 2.❑ 1 am a sole proprietor or partnership and have no 7, ❑ Office and/or Sales(incl.real estate,auto,etc.) employees working for me in any capacity. g Ej 7wbn-prafita (cC tiC- [No warkers'comp.insurance required] 311 We man corporation and its officers have exercised 9. ❑ Entertainment their right of exemption per c. 152, §1(4),and we have 10.❑Manufacturing no employees. [No workers comp. insurance required]* 11 ❑ Health Care 4.❑ We are a non-profit organization,staffed by volunteers, 12❑Other with no employees.[No workers' camp. insurance req.] eAU eppliumtthat checks box al must also fill our tlm mctlonbelee showing their workers compensntion polity information. '•Ifthe.nrpornm 0e,=m have exempted themschex but the cmpmatinn her other employees,a workers compensation policy is required and ulO an i mganimtion should check box kl. I am an employer dta!k providing rvorkers'compensatoa insurance for my employees. Below Is the policy information. Insurance Company Name: VC f fir' z Insurer's Address: -Lt � City/State/Zip: 7 t :r - Policy#or Self-ins.Lio:# WlL Expiration Date Utz 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 ofMOL c. 152 can lead to the imposition ofcrintmal penalties of a fine up to$1,500.DO and/or one-year imprisonment,as well as civil penalties in the form of a STOP W ORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy ofthis statement may be forwarded to the ice of Investigations ofthe DIA for insurance coverage verification. I do hereby cerfi ,under the pains and penalties of perjury that the information provider/above is true and correct SI neture:r- Date: r only. Do not rprlle in nor area, to be completed by city or fmvn ofrcodwn: Permit/License# thority(circle one):f Health 2. Building Department 3.CityfrDwn Clerk 4.Licensing Board 5.Selectmen's Officerson: Phone#: "s .mua.govldie ss-"" ss�, �1LG �rLYdP.2GGh � ✓/tMF1(LL1NI(M1LO,P I/W- �W Y Department of Fire Services �s Office of the State Fire Marshal P-O.lldx 1025, Slum Rold.Side,MA 01975 CERTIFICATE OF REGISTRATION North Andover April 30,2015 Was o1'1'o1n) Wal,9 NOTE: Complere lop and bottom 11 form and fnnvard hoth flue,and I,In lucid Licensing Authmitc(Clip or Town Clerk). DO NOT RETURN FORM TO"1'l1E DEPART NIEN'I OF FIRE SERVICES. In accordance with the provisions of Chapter 148, Section 13,of the General Laws,the undersigned hereby certifies that. 011 LE HOLDER): D.P.W, Garage& Office (ADDRESS): 384 Osgood Street is the holder ofthc license granted (Date): 03/11/1992 for the lawful use of the building(s)or other sit ucturc(s)situated or to be situated at (ADDRESS): 384 Osgood St NOR II I ANDOVER, MA 01845 as related to the KEEPING, STORAGE, MANUFAC IURG OR SALT!01: FLAMMABLES OR EXPLOSIVES, NOTE: This certificate at registration most be signed by the holder of the license if said license was granted prior to July 1,1936, Otherwise by the owner or occupant of the land licensed. ✓��� 2 L . ._... _._.... Received, �._-...._...n_075.._.—" (Si�rauirel . H _ fSto fid uxner. ant or holden � ("fie,141 Iik) fClull (Addnar) Y n Department of Fire Services Office of the State Fire Marshal „r l',o. rst,.. Iozs. Serra hand.Smw, MA 01775 CERTIFICATE OF REGISTRATION North Andover April30,2014 'cnLirrown) [Data NOTE: Cmnplele lop and bouorn of rovn and funcard bosh sections arid 12e to local I_icensine Authorit\ it' or 1 o,rn(Icrk). DO NOT RETE RN FORM l0'1 HE DEPARTMENT OF FIRE.SERVICES. In accordance with the provisions of Chapter 148, Section 13, ofthe General Laws, the undersigned hereby certifies that'. ("I I11C 1I01,DF.R): Edgewood Retirement Community. Inc. (ADDRESS): 575 Osgood Street is the holder of the license granted(Date): 2l28/2000 for the lawful use of the building(s) or other structures) situated or to be situated at (ADDRESS): NOR"I"H ANDOVER, MA 01845 (Cr, or Tmenr as related to the KEEPING, STORAGE, MANUFACTURF OR SALE OF FLAMMABLLS OR EXPLOSIVES. NolE This certificate of tgiorafta lost to,signedl the holder at the loe yif ad I- ranted prior to Juh 1,1936, Otherwise 1n the owner or occupant f the an ld licensed. B Itec T �i�'oR... t pp �eRf2 civod M vY20 4_.. h w, en7tiN[X ����� �� eaee,� Re R.erwcu w (011i'al Tiller 'Clerk) (Siae whether oe_occupant nr holder) 575. 0�3a� btRrei .,N"a ._.fl lan0 M D1B45 (Address) l,omrn.¢tuJ,ecc�i � �Caooac�i.cw,v�l'a s Department of Fire Services Office of the State Fire Marshall sy,y„ ➢^t� I'.O. Rm I U2>. Stec Rood.Stow,MA 0I775 REGISTRATION North Andover, April 30, 2014 tL'ip-ur'I owN 1Par') This is to certify that F.dgesvood Retirement Community, Inc. has, in accordance with the provisions of Chapter 149, Section 13, of the General haws,filed with me a certificate of registration setting forth that: Edgewood Retirement Community, Inc. is the holder of-the license granted(Date)2,28 2000 for the lawful use ofthe bnilding(s)or other structure(s)situated or to be situated at: as related to the KEEPING. S'I"ORAGF., MANUFACTURE' OR SALE OF PLAMMABLES OR EXPLOSIVES. r � 'Si,osone and On'mml Tnlei Clerk Not, A lordtaee dreglsv;tr,o nrrst he rhJ on ur her¢Arid 30'"-1 eadi lean (THIS REGISTRATION MUST BE CONSPICUOUSLY POSTED ON THE PREMISES.) EXPIRES APRIL 30, 2015 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washinglon Street Boston,MA 02111 www.mass.gov/dta Workers' Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Leeibly Business/Organization / m Nae: 1. � �� r2 .0 - Address: J7� 0-S 'IC;d', /Iy1J� City/State/Zip: AL✓", MA- 00� Phone k: C Are yoJ'innemployer?Check the appropriate box: Business Type(required): I am a employer with 3O I employees(full and/ 5. ❑Retail orpart-time).• 6. ❑ RestaurantBar/Eating Establishment I❑ I am a sole proprietor or partnership and have no 7, ❑Offjoe and/or Sales(ind.real estate,auto,etc.) employees working for me in any capacity. g on-profit [No workers' camp.insurance required] 3.❑ We are a corporation and its officers have exercised 9. ❑Entertainment their right of exemption per c. 152, §1(4),and we have 10. ]Manufacturing no employees. [No workers'camp. insurance required]" 11 r�Health Care 4,❑ We are a non-profit organization,staffed by volunteers, fT�, /' with no employees.[No workers' comp.insurance req,] 12, 1,other L •Any eppliceno Net checks box Wl mwl elan nll out the section'odow showing their workers compensation policy informmion. '•If the mraarea officers heve ammpod Themselves,but the wrpmmion has cd m employees,a workers'mmpemaron poliq is required end such an mgenhatlon should check box il. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information. insurance Company Name: T//-Yl.' c' rl Z<,r -hl Insurer's Address: S 13 Lle Chylstatelzip: C .0 Q U _ L G 61I_Ow Policy W or Self-ins.Lic:# Expiration Date: 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 ofMOL c. 152 can lend 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 e fine of up w$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Inveati ations of the CIA for insurance coverage verification. I do hereby cen!fy,under the palrts and ertaIns,ofperjury chat the information provided above Is true and correct. Si Otllre' Phone C OJjcial use only. Do not write in the area, to be completed by city or town official City or Town: PermittLicense p Issuing Authority(circle one): I.Board of Health 2.Building Department 3.Cityffown Clerk 4. Licensing Board 5,Selectmen's Office 6.Other Contact Person: Phone q: xww.msss.govldie -6;f�,M 3 l � Department of Fire Services Office of the State Fire Marshal P. O_Rox 1025.Slate ItoaQ Slow,MA 01 JJi CERTIFICATE OF REGISTRATION North Andover April 30, 2014 (Cup-ur'Imm) IUalo) NOTE:Complete top and bottom of form and foo,a d hutll...dons and fv.lo local I.......ng Authol llp it or I tl,u Clcrkl. DO NOT RETURN FORM TO'1'HE DEPAR VNIEN'I OF FIRE SERVICES. In accordance with the provisions of C hapler 148, Section 13,of the General Lases,the undersigned hereb.s certifies that. (I I I LE HOLDER): 1)P.W. Garage&Office (ADDRESS)- 384 Osgood Street is the holder of the license granted (Date)'. 03/11/1992 for the lawful rue of the budding(s) or other slructure(s) situated or to be situated at (ADDRESS): 384 Osgood St NORTH ANDOVER, MA 01845 ICa - In )l,nl as related to the KERPING, STORAGE, MANUFACTURE;OR SALT? OF FLAMNIABLES OR EXPLOSIVES. NOTE: This certificate of registration must be signed by the holder of the(henna if said license was granted prior to Julr 1,1936, Otherwise bythe owneror occupant oftheland licensed. Lay ..._... IOb®inl fill') (Clcrk) (Mu hUhu mm .cupam, RId.p ...................................................... (Ad dres) '/ ijIG""a'JiJity 3 Department of Fire Services z ' Office of the State Fire Marshal P.O_Box 1025,State Rood,Slow_MA 01775 CERTIFICATE OF REGISTRATION North Andover April 30, 2013 (cny or I.,.) (ome) NOTE:Comm top and bollom of form and forward both ...titans and fire to local Licer..ing Amhorlly(Cay ,I Town Clcrk) DO NO RETURN FORM 10 FFIF DEPARJ MEN I OF FIRE SERVICES. In accordance with the provisions of Chapter 148,Section 13,of General laws,the undersigned hereby certifies that. (TITLE HOLDER)'. Edgewood Retirement Community, Inc. (ADDRESS): 575 Osgood Street is the holder of the license granted (Date): 228/2000 (or the lawful use of the building(s) or other structure(s)situated or to be situated at (ADDRESS): NORTH ANDOVER, MA 01845 ((ny or 1'o,anl as related to the KEEPING, STORAGE MANUFAC I URE OR SALE OF FLAMMARLES OR EXPLOSIVES. Nol E This certificate of registration must be signed I, the holder of the lae a if said license was granted prior to Jul) 1,1936, Otherwise by the owner or occupant of the land licensed. 1.Received v' .. e feR}e— R l0 " « iai 3 C' snorter') y ec°Ce.0....0� Mu,Nieew e d�ewo�\. ottF�� can.Coavtv.v.�lty y .. onus]Tide) .._I(led) -v' (SW¢whelher aum.r occupwn or Homer) b'15...�SSvf.�...StRs`zt...N.:.R^'c�D°tRt MR o lS4s (Addre�a) The Commonwealth of Massachusetts Department of Industrial Accidents Ogee of Investigations 600 Washington Street Boston, MA 02111 rvww.mass.gov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Legibly Business/Organization Name: LDCr )6 Address: City/State/Zip: �) wV4� eYLIM.40 /fichPhone#:_��� J�S� 33UJ Are�yoJ�an employer? Check the appropriate box: Business Type(required)'. I.[j l am a employer with 3,q8 employees(full and/ 5. ❑ Retail or pan-time,/ 6. ❑ Restaurant/Bar/Eating Establishment 2.❑ 1 am a sole proprietor or partnership and have no 7_ ❑ Office and/or Sales(incl real estate,auto,etc.) employees working for me in any capacity. g ❑ Non-profit [No workers' comp insurance required] 3.❑ We are a corporation and its officers have exercised 9. ❑ Entertainment their right of exemption per c. 152, §I(4), and we have 10.❑ Manufacturing no employees. [No workers' comp, insurance required]" I 1 [a-Health Care 4.❑ We are a non-profit organization,staffed by volunteers, �y with no employees. INo workers' comp. insurance req.] 12.E Other /\ 'Any spoleoni that checks box dl must also fill Out the sermon belmv showing their workers'compensation policy Infonnsuar "If the cn,co,ofimcrs have exempted themselves,but the norporetion[..other cmployues,a rvutl wmpereation policy o regn,ed and such an organi as an should check box N I. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy infornurtion. Insurance Company Name: &�Lf]'ll) Zug),-"H��u�ih^�-�_�� N�hNc/ r Insu rer's Address. /0 S . (l p I y� _ - Cay/state/zip: C, oO� Policy P or Self-ins. Lic.h W C 4!)� 1 Expiration Date: 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 S1,500.00 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby c under sire-pgirts I penuhire of perju y that the information provided nbave is rr a and correct. se t Date Phone N' Official use only. Do not write In this area, to be completed by 114 or[own official City or Town: Permit/License 0 Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. Cily/Town Clerk 4. Licensing Board 5. Selectmen's Office 6. Other_ Contact Person: Phone tit: wxr.macseov/Ula WORKERS COMPENSATION AND EMPLOYERS LIABILITY COMMERCIAL INSURANCE INSURANCE POLICY—INFORMATION PAGE Servicing Office. Insurance fo-this coverage part provided by. AMERICAN ZURICH INSURANCE COMPANY 10 li-VS.flS1DG ' H Jo05 1. Policy Numberp( Renewal of Number vil :5031 �2—f,2 Named Insured and Mailing Address Producer and Mailing Address E:: CD RET?RELIElAC ONIPA7 C-'"f 2tH1;3 I irU h,P 57 , ,SG3CD ST'REE 1' 3CU FI -1< 11 UE; F _ 10G NC E I ArIPOt7E1 uH C1SL7 I "A-,) L Producer Code r F—q C J Other workplaces not shown above: FEIN'. 0 1-319 57 7 5 NCCI Company No. "i 7-3 E 5 ❑ New ❑ Renewal ❑ Rewrite of Prior Policy No. This information page, with policy provisions and endorsements, if any, completes this policy. Insured is: corhi-1r -r: 2. Policy Period From L6-3;, ?J 1 to Pr, :13 at 12.01 A. M. Standard Time at insured's mailing address. Insured's Identification number(s) 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the slates listed here: '<n B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3.A. The Limits of Liability under Part Two are: Bodily Injury by Accident: _ �... each accident Bodily Injury by Disease'. __C, COo policy limit Bodily Injury by Disease each employee C. Other States Insurance'. Part Three of the policy applies to the states, if any, listed here: See Endorsement D. This Policy includes these endorsements and schedules: See Schedule of Forms and Endorsements. 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required on the following Classification Schedule is subject to verification and change by audit. See Classification Schedule TOTAL ESTIMATED STANDARD PREMIUM $ t, - . . . PREMIUM DISCOUNT $ oiprennienalich ,a made enis of premi um shall be made: EXPENSE CONSTANT $ PREMIUM FOR ENDORSEMENT $ ❑ Annually ❑ Monthly TAXES AND SURCHARGES $ ❑ semi-Annually ❑ This is a Three Year Fxed Rate Quarterly TOTAL ESTIMATED ANNUAL PREMIUM $ _ .. . ❑ y Policy MINIMUM PREMIUM $ DEPOSIT PREMIUM $ Agent or Producer cuuntersigned by Resident Licensed Agent Date WC 0000 01A U WC D314A(07 94) Page 1 of f �, Of peea`tmeoStatCFsYeMpo �510`I APY t3o ?pe2 V OS the s\a\cR°a ..C.CO ° A0`6' �GI N'� p1Kh° {ovnl �Lyry°t p q o.o '�IIVAc d{ee °A��GF9siD8 ee�(6zstb2l. . . ,� aad{otwyd,t5n4F',�<OF Fdnt�SU dz(`'\"o°eabejeby q- Ol EqP tvtFYaR�Fopn Sew N °ftneG,1oe oq the but�dlo8�sl e NO�F,.cs et cb2vt°(\a8, U^,ry f e�aw1U`° dRe'lement to th e eNoo n 'c dabtbA'ps °ds 281�b�b dpa`°°(da G4»seoaO(Gd� �OR655jOV C.R,�'SP�daAS QIN{A�LF.S ORap apcio<to JaY pse asS at '(F �� nl I O if sa�tice �,`. tO be srtvated FOR °r lea ��iE QRS of Febca ° 0�. 4 de"°I� MP��F� eab7{b°tom rs S1 papGB,a mpstbe S%g' taadlicen st(OGae KEY-Pll�1Gte of reSSV(orr eewwat W G ,h .'.• eC`uPePwe WA 1. ........ °Wn... .. lv t"6 rW 5ebjkeeo ° vlreth� '� {Steter Q 20(2......... ........'.. {Otf;"af' acl r �a4 � Stf�< Department r i t The Commonwealth of Massachusetts Department oflndustridAccidents A=7 600 Street e Boston, tan,M Maassx 02171 Workers' Com ensation Lasoraatt Affidavit-General Businesses .ddtesr �/ r7 �' yYikl -�f I tryk✓c ' / . r i4_ Zip, Ui d S1 b x i 7J" 715 �3uc, ,ror>< t lovli rrwl r �iCOYIk' Ct. qb"L,' I ate a soleRaprieior and love no one Budnm Type: ❑Retail❑RestamanUBa/Eatmg Estabhshmeut /wcaling in nay capacity. ❑Office[]Sala(including Real Estate.Antos etc.) an® I with ' . , rm to tall k time. o Othcr I am an employer providing workers'compeosatim ter my employes—king on this,job. _m AA I am a ssle plop(ietar and have hind the independent contractors listed below who have the fotlowiog workers' compensation polc— bm.+.eeetn. d ivaarhnee ed A.lhv.4reanvrenre r,.FW dun rsad..2 A.(MCL I n ead4 dw lnp ftba Herhele.lPvdtlr H.ar rP b 11,50L.N d/.r .vyrn'I.nprMvmmt r wdr tlrapmLtr 4 tlr brm H.bTOP tw1tY ORDEA.ed.am H51rLM.d.l•pimt ma I mdmM1rd tbr. c.pl.(thY.4toePt mgbv hrwerdd 4 ar omr Hlmnap Wm H1b IAA(w e.rmprnmetM I dP BerebJ unler fAep�utt' awdpmataer^efperjury the the inforrd(Paprorided abort it true odtorred Si�eave �� Ikro ��- -r�� r� slltI Ilk") ph.x .n U]needy d.vt nrlh V.fhb.ry 46e a nsPkrcd bl cal-1 awn dhW eky or bwv: PrrfUb..r.t �ButWf.{Dep.rtmevt �Licemvq Fwrd ❑cheek a�mmedt.te rep.^..h required �9elettmeP'.OtAee �Rnnh Dep.rtmevt contact penan: phone p; 00tber 6�e sip� cI41 eln,�, N JI Q� ti me JDepartment of Fire Services Office of the State Fire Marshal P. o. B,,, lots.Smte Read. So,,_MA ores CERTIFICATE OF REGISTRATION North Andover April 30, 2011 (Clp orIon'n) ID"M NOTE: Compaw top and bosom or torn and forward both seekers and fec to local Lieensrig Authority(City nr loon Clerk)_ DO NOT RETURN FORM TO THE DEPARTMENT OF FIRE SERVICES In accordance with the provisions or Chapter 148, Section 13,ofthe General Laws,the undersigned hereby certifies that: (FFFLE 1101.DLR)'. Edgewood Retirement community. Inc. (ADDRESS): 575 Osgood Street is the holder of the license granted (Date): 2/28/2000 for the lawful use of the budding(s)or other structure(s)situated or to be situated at (ADDRESS): NORTI I ANDOVER, MA 01945 as related to the KEEPING. STORAGE, MANUFACIURF. OR SALE OF FLAMMABLES OR EXPLOSIVE'S. NOI E: 'Phis certificate of r 6istrvtian must be signed by the holder of the 1 eunse sn id It al, s gees led prior to Juh I,1936, Otherwis(e b the owner or occupant of the land licensed. , 'l1A\ Received _ fgl� Ur .J011.._.. ,1119TA* Ey C tea near �dyewce� tte.. tut �yMgN � _ _..... . ........ (offilcl l ldc) (Clerk, ante ebcnei o„�icr o,,npam urholder) or.A...5*gt...r.N,.A4Au kf,. (Address) .. / (p45 The Commonwealth of Massachusetts Via •=: _ Department aflndustrud Accidents .�� 600 Washington Sued - Boston,Mass 02111 Workers' C eematlou 1--M A}6davk-General Busing,,, amm' f u f (�A07/✓lU/7/� 9�� work sit.1 .fim(Fa l nddt ask ❑ f am a mle pmprieno and have no one Busium Type: 0 Retail❑ptstanrauUBs/Fa>mg Pstablishment working in any c4acity.. 05 e❑Salm(including Real Potty Antis ec.) 0 7 am an ® 1 with ® lo foB art lime. Other I am an empin)-providing—kern'mmptnsatim far my tmploYees waling an this jab. Inat�anm eel_77'�'„✓C//I'�'C(✓,Ct7 Aar Y_Y/ L /YL�f Rga M' L�� F 7 am a sole ptopnea and have hired the independent cugtractoro listed below who have the following ' colnpen n-polices mmuxnrn.vr.: .oar...• ekr. . . home,M• inn.rxnmm I . .ddrem: enr h.a• P.ame 4 r..m wrenp m requa+d mdr 9s1Y.2 A aMQ In m.bed Y tbv 14uf ..ttrbdn.l pm.bim N.dr 4.4 JI�SN.N.d/ .mymn'dprMmmtm Mmslyd pmYlx Ytb.Yrm N.bTOP ROAY ORDIa3.N.am Na1N.M.4r.r.imt m. /mM.b.i are. my.feh[r mkme.fvgb 4rw.M.d 4tM Oah..fl..mtlpa.m NtYIMA trrmrvap rmtftmtls t d.ioebr r�nfj wJn hyp;nr mWNo ofperj-y tim t4 infarsNiox proo7ded ebnrrt it to`re/x.d emred Sigvatme I`,41rir-C Dou, ✓�7 _✓.�-%� .fnebl me..y Mmtwrtte 4 thb.ro 4 ho.m Ww by My.,Yx..II1.W .ky or bwc pvm�Nkeme Y ❑ebeek Y I®.dbk r Os.kemv.'r Oak. ontvrt penoo: ph..p; Onmlth Depart W 00th.r J , r y. 4 Depart One of Fne Services Office of the State Fire Marshal R.O.IC% 1025, SWIC RoaA, Slnm, MA 01775 CERTIFICATE OF REGISTRATION North Andover April311, 2010_ (01, ,, to,n) (Dale) NOTE: ( ) plus WE a 1,1 buuo: of loan and fonmrd bosh"ti r n_ v id 1-11 W 11,111 Licensing A'al ly(('itc... ClaA). DO Not RE]URN FORM TO I HE DEPARTMENT'01 FIRE SERVICES In accordance with the provisions ofChapha 148, Section 13.of-the General Laws, the undersigned hereby ccaihes that'. (ri I LE HOLDER): Edgcwood Retirement Community, Inc. (ADDRESS). 575 Osgood Street is the holder of the license granted(Date): 2/28/2000 for the lawful use orthe bu i id ing(s) or other structure(s) situated or to be situated at (ADDRESS): NORTII ANDOVER, MA 01845 (Ca,orTnwn) as related to the KEEPING, S TORAGE, MANUFACI'l1RE OR SALE OF FI AMMADLES OR F.XPI,OSIVES. NOTE: Ihis c tificate of egist'ation must be signed by the holder afro'h se if said I 1-se was granted prior to July I,1936, fltherw se by d w er or occupant ofthe land licensed. '� Rccerv'ed .�;1 .7010. ..... -¢w 'k :"e0( 1Ap�IPlMCNt CS Yfro U�';�. NC. hnldcr) mu o� STJ CS�se:� 5\R¢et AN:�oJCh EyK C45 ... .. (Addre,$) Proof of Coverage Search Page 1 of I Labor • Workforce Develop - 1 , Pip aass.,i Date Last Updated: 3/31/2010 Navigation Links Workers' Compensation Proof of Coverage -Search Results POC Disclaimer Return to Search Page 1 of 1 (( ( ) p New POC Search Employer City EDGEWOOD RETIREMENT COMMUNITY NORTH ANDOVER,MA Report 575 OSGOOD STREET 01845 Workplace Fraud GENESIS HEALTHCARE CORPORATION FALMOU I OF-, RATIONS I ,I NORTH ANDOVER.DBASEDGEWOOD COMMONS MA 140 PRESCOTT STREET 01845 VIES I DEVELOPMENT CORPORATION/t EDGEWOOD HILLSBOROUGH NORTH ANDOVER,MA DebarmilliI LLG 100 ANDOVER BYPASS SUITE 300 01845 List Return to Search o< 4 > )> - ._— Education Links randA.S.9n imitations of Search Results Who Needs WC Insurance, oof of Coverage Application allows the public to search workers' Employer s Guide to WC sation insurance coverage information for policies in the Voluntary Market igned Risk Pool. Do not assume that an employer is operating without Employer's FAGS About We e if your search results do not return policy information.An employer may e a valid workers'compensation policy under a different business name or Injured Workers Guide to WC ve an alternate method of coverage which includes licensing as as self Injured Worker s FAGs About or membership in a self insurance group. Use the following links to view WC of SelRlnsured Employers(Pi and Self-In r G (E /l in husetts. Related Links With limited exceptions,every employer in the Commonwealth with one or more Experience Rating History employee(s) is required by law to have a valid workers'compensation insurance policy at all times.If you are unable to find an employer or suspect an employer is Conoeclicut POC Search wrongfully operating without workers'compensation insurance, please submit a Workens'Compensation Investigation Referral Form or contact the Office of New Hampshire POO Search Investigations at 617-727-4900 x214 or toll free at 1-877-MASSAFE (627-7233). New York POC Search Classification Request Form http://64.73.57.96/Search.aspx 3/31 '2010 Proof of Coverages Search Page I of I Labor and Workforce Develorl ff —Far— Lass.1 Date Last Updated: 3/31/2010 -- - Navigation Links Workers' Compensation Proof of Coverage - Employer Details POC Disdaime, Employer Name: EDGEWOOD RETIREMENT COMMUNITY New POO Search Address: 575 OSGOOD STREET Citycrown: NORTHANDOVER, MA01845 Report Back To Results Pegu 1 011 (< '( ) >) Polley Rum bor Insurer Polley Term AMERICAN Z INSURANCE COMPANY DebarmenWC450318200 AM AN LANE 061302009 06I30/2010SCHAUMBURG,IL60196 List t�f NATIONAL UNION FIRE INS CO OF PITTSBURGH WC4883607 100 CONNELL DRIVE 06/30/2008 06/30/2009 BERKELEV HEIGHTS, NJ 07922 AMERICAN HOME ASSURANCE CO Education Links WC3474448 100 CONNELL DRIVE 06/30/2007 06/30/2008 BERKELEV HEIGHTS,NJ 07922 Who Needs WC Insurahwe Back To Results .,< > )) Employer s Guide to WC Employer s FAQs About WC Limitations of Search Results Injured Workers Guide to WC Injured Workers FAOs About LErequired proof of Coverage Application allows the public to search workers' WC pensation insurance coverage information for policies in the Voluntary Market Assigned Risk pool. Do not assume that an employer is operating without Related Links rage if your search results do not return policy information.An employer may ave a valid workers' compensation policy under a different business name or Experience Rating Hlslory have an alternate method of coverage which includes licensing as as self rer or membership in a self insurance group. Use the following links to view Connecticut PUG Search gs of Self-Insured Employers QeDi and Self-Insurance Groups(Excel)in New Hampshire POC Search achusetts. New Volk Poe Search With limited exceptions,every employer in the Commonwealth with one or more loyee(s) is required by law to have a valid workers'compensation insurance Classification Request Form y at all times.If you are unable to find an employer or suspect an employer is gfully operating without workers'compensation insurance, please submit a ers'Com f'o 1 st' C R f /Fo or contact the Office of stigations at 617-727-4900 x214 or toll free at 1-877-MASSAFE(627-7233). http:/,'64,73,57.96Netails.aspx 3/31/2010 Department of Fire Services Office of the State Fire Marshal R O. lb,, 1025, Smtc Road.Sense. MA 01775 CERTIFICATE OF REGISTRATION North Andover April 30,2009 wftva'Tona) mete) NOTF,: Complete top and hottom of tuna and forward both sections and fee 'ER 1-icemin th g Auority(City o1Town Clerk). DO NOI'FU TURN FORM TO THE DEPART toMENT OF FIRE SERVICES. In accordance with the provisions of Chapter 148, Section 13, of the General Laws,the undersianed hereby certifies tune ('1`11 LE HOLDER): Edgewood Retirement Community, Inc. (ADDRESS): 575 Osgood Street is the holder ofthe license granted (Date): 2/28/2000 forthe lawful use of buildin t,(s)or other structure(s)situated or to be situated at (ADDRESS): NORTH ANDOVER, MA 01845 07,1y nr town) as related to the KEEPING, STORAGE, MANUFACTURE OR SALE Olr FLAMMABLES OR F.XPLOSIVHS. N'OI'F This certific:to of registration must be signed by the look er at the li, a if said license was granted prior to Jul} 1,19JG, Oth rwise b<[he Iwner or ottupant of the land licensed. Reccncd 13y L �V . .)� 0 PI,4ut OPC0.h�rW b am eat rn�) tU rAt .tJ?Weer�. R¢ d$Nel.lt Ce?R?1d N.�I'Y�.._INc. (Stale whethcrawner. erupent or ml�crl sty+... t kPikWO, Ma o1�4s (Adabss) TOWN OF NORTH ANDOVER OFFICE OI' TOWN CLERK 120 MAIN S I RLET NOR It I ANDOVLR, MASSACHUSL 1-1S 01845 o` Nonrn .Ioycc A. BreAshaw �: ,." mp Toen Clerk -� 'telephone(978)6X8-9501 FAX (978) 688-9557 •'Squ^yn..ySEM1tS F:maih 'bradshawntownofnorthundover.com 2009 Renewal — CORRECTED to All Above Grand and Underground Storage Tank License Holders: Enclosed please find your Registration Renewal Forn (s) for above ground and/or underground storage tanks. Renewals are due April 30" of each year. The fee for renewal is $150 per site. Please sign the top portion of the registration form and return it with the appropriate fee, payable to the Town of North Andover, 120 Main Street, North Andover, MA 01845. The bottom portion is vours to be displayed along with your license Also included is the requirement to provide an affidavit showing proof of Workman's Compensation Insurance. Please fill out and return the form to us with your renewal. Your immediate attention in this matter is greatly appreciated. Thank you for your continued cooperation. Please do not hesitate to contact me at the above listed phone number if you have any questions or need additional assistance. Very truly, Joyce Bradshaw Down Clerk Enc. Commonwealth of Massachusetts •. 3 'i. Department of Fire Services Office of the State Fire Marshal P. O. Box 1025,Stale Road, Slow.MA 01775 CERTIFICATE OF REGISTRATION North Andover April 30, 2008. (City or Townl (Unra) Not Cmnplcic lop and hole o1'11ono and Ioraaid both s"nar'and lecto local Licensing Authow, tC'It, or Town(lleik). DO NOT RETURN FORM To THE DEPARTMFN'I OF FIRE SERVICES In accordance with the provisions of Chapter 148, Section 13. otthe General I,aws,the undersigned hereby certifies that: (l7TLE HOLDER): Edgewood Retirement Community, Inc. (ADDRESS): 575 Osgood Street is the holder of(he license granted(Date): 2/28/2000 for the lawful use of the building(s) or other structure(s) situated or to be situated at (ADDRESS): NORTII ANDOVEK, MA 01845 (ChA'ar town) as related to the KEEPING, S"FORAGE, MANUFACTURE OR SALE: OF FLAMMABLES OR EXPLOSIVES. NUIB 1 his certificate of r gistration must be signed by me holder o ithe license aid be nse was granted prior to July 1,1936, Otherwise♦by the o ner or o,equot of the land licensed. Rece�iv5ed ... (?Rs�o. .;J�� ? ..008 ....... s�tQeC�ER OV \ LMI, O QQo.�IDN Si•nolurc) By ...........I.........I.............P... mrrl I Iiticl� (Clerk) (Sunewnemer n_er.owupam or nowo �livI I. . �Qe//IL. j��� S7S OSS.... .... (J, 1VN..oveS2 r.M.FS..Ol55�� ek"4-�crt.C.f£U.D1 �- (Add ) - = The Commonwealth of Massachusetts �Ts{ Department of Industrial Accidents N - IWvds 600 Washington Street Boston,Maas 02111 Worken' Co euntlw Luunuu Afidavk-General Basiueases 7 � /A') ✓Q Y slats ' .U�� `7 / !� /r�� JJC�(� ,o,d, t looti (mnwaro ): J7S �5 �� ✓ 17Lo ❑ lama sole pro¢oewr and have no one oafoma Type: ❑Retail❑Resfawmt/Har/Eatmg RstablishmwA ,working in any rapacity. 0 gf&c❑Sgles(inchtdio8 R�HSl d%Aoki Ec) / I am m®Ploys with�OJ mployen(fun 4 part dine). Other 2 �j GirU/7. (/]M ,�•ems y/( I am Im mplga providing warkas'comPensahm far my employers working m this job. Ydmm ly—e e Lj [am a sole proprietor and have hired the independent camroctom]Ned below who have the following workers' corapeorado Polices: romeenr aeO.l .dar.er: dt" nhga a .ddrer: dtn IBM vce. r.o.r.4.rr.rrenp.rysn• rr wQ.►eYba mdsrbfiw W MMA NMClSTO r WO RI bO ADER.Ya•aNerbim.l P.e.lnr.f.my bSlfN.N.ei�r M.NS]MN•6r Mlrl s I wMsbY tM ..pr.f IhY.bbmMl m•1 M firwrd�Oflb../Imrtlplbr./tl.D1A Me..vvp..dMWw t d.kerebr ISa rrA.pdwa and aH(ea.fpnjmy lhr fat Afsrnraaeapr.vldd.bare is frae anJ re.rrrt Siwe 7 .Mbl me.eir d.vl ndle bthY.rr b be.m WW byciryr N".ltkW airy or bore: p.rmlNk. 0 DIIoWIoa lhp.re ❑rbrk alnmNb4 rnpovr b requkY �����~ OR.ft m.e. roebrt per..e: otb OOIAr De,p.rlmrN (i.v�a s:µ IDvn Phone M, e S-Z -gn sank Check No. 7037 sbveiplgnbankoom Edgewood Retirement Community,Inc. 5,75IM110 575 Osgood St OSI09/008 North Audove,,MA 01845 Wnt PAY Onc:{�wd eb'�r6ty DOl.Cif2S&Gib e£3P75 - TO THE Town of North Andover ORDER OF 9536 .A NORIZED 5 ATURE a'00703711' 1:0110751501: 8640006 5 1 2 3d' Note: Complete top of form and forward both sections and fee to local licensing I authority (City or Town Clerk). Do not make application to department of Public Safery. *� �� irzcuea�C�i c�C/G�alaa�fzuae� y' � �e�irGrneozCc�C�vw Cgrixvccea — �vucar�re - C;ty or Tawn NORTH A�—Care APRIL APPLICATION FOR CERTIFICATE OF REGISTRATION In ace nonce with the provisions of Chapter lag. Sedan II. of the General Laws, the undersigned hereby certlfies ;hat EDGEWOOD RETIREMENT COMMUNITY, INC. 575 OSGOOD STREET, iVORTC ANDOVER, MA s 'he holder of Iicense granted FEERUARY 28, 2000 w� for the lawful use of the dwlding(s) or other strvaurets; r:uated or '.a ae snuaieo ai 575 OSGOOD STREET as raiared ie me KcPING. STORAGF, MANUFACTURE OR SAL OF Ft� ,AMMAMABI?S OR _XPLCSIV17 NORTH ANDOVER Nare: 'his apolicavpn!or ceryfivre of regtstrduon must se signed oy the halo.,of the/icons.:f sate license was granred pnor;o Jury 1, 1936, otherwise dy the owner or occbpant of the lan------------------ d 11� sad.e arvea ,.. SudmiaeC dy -- ---- ,m.,, f The Commonwealth ojMassachusetts Department of Industfid Accidents AV1✓ _ 600 Washington street Boston,Mast 01111 Workers'Compens2flan Insarance Affidavit-General Businessa ohmeaCll§ - '17S 3'C( Y workite loatieo(M addles), C ��LfC- ❑ ram a age proprietor and have an one ' Badaeo ❑Retad❑R�mt/Ba/Eating Pslahlishmeal wort ins in nay capaa `. Oefice❑sales(including Real P.stale,Anna etc)) Q I are an®9;z wit empl=(fall do part time). Other I am m®PbYQ provdmg vrorkas'etanpeasatim for, rmployeea wohmg en this joh. . IM ohoee a- I am a sole poprieta and have hired the independent camuctors listed below who have the following workers' cempeosaties polices m,nmwy never. .ae.ea: /�.5 S.,w`C, CI�Er. ISr.,✓E .S'�uft 5r'� e cvh CC I Man w eomtaay a.nlee: . . .ddres: 1M hone a• . inwenee M P.aon b.aw.weep a regend molar Ss .MANMQ.IRa.dYtlr Im1waY.N.rhalmlp®Mla N.�.�to r1.5N.00 .cyan'heprkaemmtm wan ceW Peseta le ttr f--f.STOPw RR ORDER aed.am.frlaaN.der.pimta 1 imd.nb.d that. ay.f ehY.btmeat mar he f nnrdd b dr oeeae Nlmael(.Wm NA.mA be-.1.1w valaa.a I d.Far�cuti rmlert dpenaMfe ofPnjvrj lhsehs informaftewprseWi.bear is free alaarre¢ ate .(Rent me..y d.wt rrrib 0 thh ara t.be e.mpt hr.ar er bwa.m[bt emy or tow pcmlPikese Y ❑Anadb(Deparemeat [I check ulm n w r.,p,nce t.reywrw Os.kxema'.oth. concoct p.no.: ph..#; 00ta hDepartment [(—dam � (]Other The Commonwealth of Massachusetts Department of Industrial Accidents 600 Washington Street Boston,Mass. 02111 t `~3 Workers, Com ensatfon Insurance Affidavit-General Businesses i �`l7GE Grkt1� Fr rRfmc-r.� �+.>'cwr,� INC- .dd,nss z1111 m O/F�YS n n 97Y�- 7�5 33d site i h Mll ddra k 57S 05(4,01) 1/Jf�F 47Vh, ,?7Y /11+4 0lf5t� ❑ I am a role proprietor and have no one Businesa Type: ❑Retail❑Restaurant/Bar/Eating Establishment working in any capacity. ❑Office❑ Sales(including Real Estate,Autos etc.) I am ao® 1 with eon to full& art time . Other E7iR Ex/ ' r, it I am an employ,providing wmlc,s'ramp®satiw for my employxes wvrlong on Wes job. cooraparry da 5'J-SC)s�a7 Sr' p city- �/rk -,}1 Atl/�>A✓ffl t /Ylf'q phoned: / 7tY �J5�3.3c2, foa nee ece. <2'1IS `-Z' ✓i � Le Y Y Fi I p -- � C ✓ - I am a sole proprietor and have hired the independent contractors listed below who have the following workers' compensation polices: oddrem city- Phone a• Ivwarmc.roc a y ever. addre..• er' phone M• Ivwvvro roc i• � P.Ilure to seem.e..enaer reqatred ender aeetbP 25A.f MGL 152 my lead b the In Borden of modem p fieo of a One V no f1,5WN ao&w en.yrn'avprhsummt r.e.R r,h0 pevalur N the form o!a STOP WORK OImRR.d.am olfloa.M a Ly.pimt ens I um4nn W th.t. ,eq of ehi.Menem m.y fie hrenrdd H the puke ellPvmtlr.tbm olthe D1A for rowaaeserlMtlav I do hereby �underZ,,,, finsnd p®altie ofperjuy tka tke information poided abo m is .�u a1 Gd�ccoLr ect S -fie Date iu, ehm,# ofMial me nab do not write In tha arm to be connuehd by eery or town ofneht darn,tows: wrenUeemea OaundWf neportnen, OLfmmr,hoard ❑,hack if hana dlam rmpome la rNeired OSef«tmed.Ofhe OII.Ith Department ,..tart pen.: phone P; —[]other I— sectSon) t Nate: Compiete tap of farm and forward bath sections and fee to local licensing authority (City or Town Cierk). Do not make appiication to department of Public Salary. a _� �eft2v/mevcCc��ur? Vux�uec✓n — �vuidaox a��r�s ✓�.+eiuenCccn Cltyar Town NORTH ANDOVER DateAPRIL 30,,-Wft0 4 APPLICATION FOR CERTIFICATE OF REGISTRATION In ac_oraance with the provisicns of Ctiapter 148, Section 13, of the Generai Laws, the undersigned heresy certifies ;hat EDGEWOOD RETIREMENT COMMUNITY, INC. 575 OSGOOD STREET, NORTH ANDOVER, MA s the holCer et license granted FEBRUARY 28, 2000_ _-lor the IawNl use of the building(s) or other stmc:urels saca!e^^ oG,.I. de situated at 575 OSGOOD STREET s,..,,.,,— as related to ;he KEEPING. STORAGE MANUFACTURE OR SAL OF F.AMMA81-9S OF SXP'_OSIVES. NORTH 10OVER Note hrs aoplicsvon !or cemfirare of regrstrnon must be srgnad by the holster of the license it said license was g2nred Fncr;o July 1, 1935, otherwise by the owner or occaoarrr of the la 'caned. 3ecarved C O `�Lt. Submitted by - — �� —.UIN vie \�l�l �.-vAll , • ,j � . ,.._ CWA1C-1 �m cc,� M � .� II l I '( i61� d 5 )b' o �\Stnc•� -- ---------- --------------------------------- - Banknorth Massachusetts 53-705412113' Check No. 204180 Edgewood Retirement Community,Inc. 575 Osgood St. 03Y1412008 North Andover,MA 01845 PAY 6. q d se Ve d44RS&00 e£T27S To THE Town of No Andover Licence& Permit ORDER 27 Charles Street of North Andover, MA. 01845 Its 20L. La&t- I: 2L1370 St. 5t: 2 20 5 3 508 3us 'POR'N OF NORTR ANDOVER OFFICL OF TOWN CLERK 120 MAIN STRFE"I' NORTH AVDOVFR, MASSACI ICSETI S 01845 O� MORN , O J rvec A. I3 rnAshme Tn i T I p t9 -9 1 C7trk � FAX (9(97H)68 fdh-9 9557 M1gy�yZ Edgewood Retirement Community, Inc. ` 575 Osgood Street North Andover, MA 01845 March 16.2006 To Whom It May Concern: Enclosed please find your 2006 Registration Renewal Form(s) for above ground and/or underground storage tanks listed at the address(es) on the enclosed form(s). Renewals are due April 30°i of each year. The fee for renewal is S 150 per situ. Please sign the top portion of the registration form and return it with the appropriate fee, payable to the Town of North Andover, 120 Main Street, North Andover, MA 01845. The bottom portion is yours to be displaved along with your license. Your immediate attention in this matter is greatly appreciated. Very truly, Joyce Bradshaw Town Clerk Enc. Note: Complete top at farm and farward bath sections and fee to local licensing authority (City or Town Clerk). 00 not make application to department of Public Sarety. C�cm�m��c�rzcu�jea�t�C c�Uv�culcac�.�eCo`s C./rX'rKCP6 — Z7 .UIL 6�.V'UA'S CID, 2l/Q>L } City or Town NORTH ANDOVER Oate APR1L 30,cX0 APPLICATION.FOR CERTIFICATE OF REGISTRATION In acrdance with the provisions of Chapter 148, Section 13. of the General Laws. the undersigned hereby certifies ;hat EDGEWOOD RETIREMENT COMMUNITY, INC. m 575 OSGOOD STREET, NORTH ANDOVER, MA s the holder of:icense granted FEBRUARY 28, 2000 forme lawfut use of the buildings) or other Soucture(s) stuatec or m.. :c cc sruateO at 575 OSGOOD STREET as miated :o the KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMASTES OR EXPLOSIVES, NORTH ANDOVER cvd ra.., Note: 'his appNcavon for Cervfirare of registration must,be signed by the holder of the/icense it saro license was granted pner x July 1, 1926, otherwise by the owner or o=panr of the and licensed. aecetve m Suamttte0 by ly -- - - --------- -------------------------------- - City or Town NORTH ANDOVER Dare APRIL 30,rXf,(o REGISTRATION -s s 0 oocifv mat EDGEWOOD RETIREMENT COMMUNITY, INC. -a, 6: accrcancs with Ine provisoes of Chapter 148, Seccon 13, of the General Laws, filed with me a certificate of registattcc senlrc Con mat EDGEWOOD RETIREMENT COMMUNITY, INC. is the:holder or the license cranted FEBRUARY 28, 2000 for the lawful use of the builoin s or Other strucmrelsl sruatea or o be situated at 575 OSGOOD STREET, NORTH ANDOVER, MA s eia:ed m Te KEEPING, SORACF, MANUFACTURE OR SAL OF F'AMMASL=S OR EXPLCSIVES. Nofe:A carsficare of regrsrrbon must Oe filed on or 0erare Apnl Jorn feat Td:S RECIST'nA i'CN MUST 88 CONSPIGCUSLy POSED ON THE PREMISES - rem5M;9E1 The Commonwealth of Massachusetts Department of Industrial Accidents AUNSIAIIIIIIIIIIIIIIIffillys 600 Washington Street Boston,Mass. 02111 Worhers, com ensation lnsuranceARdavit-General Businesses FbrEG.IIA�Y� �-y-.eG�nENi C'nmm ,njsT� .dare S7S nS(/ an Si r, AIQ8TJ-/ stowM � 0/SFS'�me#9 /g-7a5 -yt07 work it Jgmfi ffbtladdmml-S-2.L 6SCIQh Sr VIn 019(e5— ❑ I am a sole proprietor and have no one Business Type: ❑Retat7❑RestaumvBw/Eating Establishmmt ,.,working in any capacity. ❑Office❑Sales(including Real Esmt4 Antos etc.) �l I am an® 1 with em 1 M& time. ec M NrT I am m tsnploya providing waters'compeasaUon far my employees working m this job. .eta • S-75 nsca� s ; .s.ed:U�tJ R+T-:ComPc�'HTidfJ SNS�'o. oF : - O.- � 3 8. I am a sale pm{ai mdand have hired the independeat contractors listed below who have the following waters` compensation polices: _ _P net address• io a eo. noliev a cona patty Doan add".: ItY• phone#: .. iaaurspee eti. More toueme rorenear rol k dabder Sretbo 25A of MGL152ass Ind b the tmprhtoociferlminvl pcpdtlnofa Doe op is M,500A0 andlr omyum'b prbpamt so wan etrapemrb to the form of a STOP WRK ORDPRad a Dvs efSIOM a dayapimt and I sodenbd that o - ropy of ehb rbbeeot myb Nraardd btheOmro eflwntgafNm efihe DlA fr csreraae rer111eatMn to.hereby,edify under rhepeina andpeoahivpofperj/ury ebae the Mformssion prwlded above i+true aM ronerL Si�atdae "�ie/1Da.wA�LtPo�o.,@-: Date Priatmme 6YIRJR�EN /Y)6Rk E.S tSr phone# .Mbtumenly domtwrltetothbrrubheeomplt bycityorbtmof is city or tewv: Permtaarere# ❑suodios Degrtmeat cl i c oin2 an" ❑chahahvmedbb rnpotne b requtrd Oselocconwr Omee 011rbh Dr cardmeat centoopenr: phone#; Elother tad syt aiml "'�--- The Commonwealth ofMassachusetls V Departmentof/ndustrialAccidents _ 600 Washington Street a?. ----- Boston,Mass. 02111 �'L� Workers' Com ensa6on Insurance AftldavH-General Businesses r I�iICa(1!I) �CT�/(EP'e.� C.lm n7 cu:eT' INc addre '.Jtcity iJ�)SCrADS /L) stet.- rn7Q as 78' 7J$-A3tZ k site location(full address)' L Ar K ❑ I am a sole proprietor and have no one Business Type: ❑Retail❑RestamanvRar/Eating Establishment working in any capacity. Office❑ Sala(including Real Estate, Antos etc.) I am an an I with 0 can to full& art time. Other Pr, C I am an tanploya providing work/errs' compensation for my employee wmldng on thisjob. 11(a6WpUD RCTK �N,rauwrty l" as ��nS()�GyitD /tl, K dUFI�'� /^1 vh..N: lir 7j"5,-.U'Ii ,,``r1 fnauFavee ea.. IA�ORFSEiLS.`l..'Y# E/✓i der/�fl (��. '( A 1 #.. WC '3. 747 I am a sole proprieor and have hired the indep®d®t contractors listed below who have the following waters' compensation polices e.. address• iw- oho"#r fvauranee ew n flue• addreaa• itr vhove#' insurance co. 1 #. Rathve to.....a.u regained®dn S no.25A of MGL 152•.n lead to the hen ftlaa of erlminal penstties of a floe W W E1,50ada.ad6.r em ynn'Imprb.vmntu neB nelver pemBin In the form ef.STOP WORK ORDBR.vd.live s(Eloe.ay.d.y.pimtm lualmmad tmf• eepy of tbv amtemeot m.r be f.rmrdW to tln 01lfce of Ivrnaptbm efebe DIA Porcercnae rerih.Wit I do hiER577777 - dpenalties ofperlury that the information provfded above L lrve an}.d a rrn Signa 'lam Date wJ CL a;nt Y Ph.# 978^`7a6`93wlp' ' enieml me ody do not write Ia then am to be eomplatM by city err tewa.M,W city er tower: p•rmnNceme a OBa ftaa Deparemevt OLkemiva Boerd ❑cheekai dial.rnpomem requited OSemetm.a'.Omee 011nnh Dep.r .t contact peso.: phow N; OOther tR.:m s.pt sum) I Nate: Complete upper and lower portions of form and ferNard bath sections to local licensing L authority (City or Town Clerk). Do not make application to department of Public Safety. � �rmcmc�nuaa�CL c���G�a�s.�ac�cclel�.� at T�aficvximemte 1. � cea — .uaiam a�:1'v,� �rerrnCi,`irz a c City or-own Oate APPLICATION FOR LICENSE For the lawful use of the herein described building... or other structure..... application is hereby made in accordance with the provisions of Chapter 14a of the General Laws, for a license to use the land on wnich such buldina.... or other strul ware or is, are to be situated,and only to such extent as snown on plat plan which is filed with and mace a part of this application. tI Location of land /yna i �.t t1� w`'s'-� Nearest cross street isna.,e wmv.� r � LL Owner of lardL2C'C_ -"J l i ZTy 6.-1 Address �.rSTer armatures / �( Number of buildings or other structures to which [his application applies Occupancy or use of such buildings ��t=S ( �LN- J H(c"v ly e. W i c �r t1- R 2 e, (i S. Total capacity of tags in gallons: —Aboveground .�/.D c n 2e f t t Cp/' Underground 1 '� Kind of fluid to be stared in tanks:—Aboveground `�� t9 -S Underground LApprov _— Disapprove^ ;Neap o�Gi�Caa.l �5wma vucouO � 2 �IZ0J7 Ill C.�� wvr Sf Cam / jc — ^, � `�irnmcinccecc�lLz c�=/�Ccostctclic�:e�s Date In acwful use a will (aL v��« /'`Y ;ranted to use the land herein cescnhee for the with the use of ti u 1 U ac4 are as descfced cn the plot plan Bled with Iheapplicauc I�1 P ' �` _oration at and Owner of land Number at bull. Occupancy or t ` Total capacity _. ,crcund Kind of fluid to k ncerground Restrictions If THIS LICENS DNSPICUOUSLY POSTED IN A PROTECTED FP (revised Mail \NTED Note: Complete upper and lower portions of farm and forward both sections to local licensing authority (City or TownClerk). Co not make application to department of Public Safety. l l:'r//77/YJ2C�J2L(12CG��� G�L���CY/yJCGC�CGS6CZ.S iY �/Ql)G/I'CM2'YLCG�`/rLX4 J wo`ree5 — _(7" :C dj. ✓�/ ?- ✓"oGM.4 j S, City or Town Cate APPLICATION FOR LICENSE For the lawful use of the herein cescibed building... or other structure._., appiicaticn is hereby made in accordance with the provisions of Chapter lab of the Ceneral Laws, for a license to use me land on which such building.... or other structure..., scare or',c are to be situated, and onty to soon extent as shown on plot plan which is filed with and made a part of this application. Location of land ;Dearest crass street sv�e.vw�o,o Owner of land Address Number of buildings or other structures c which ;his appticatton applies Cccupancy or use of such buildings Total capacity Of tanks in gallons:—Aboveground Underground Kind of fluid to be sided In tanks: —Aboveground Underground Approved = Disapproved Nate: Complete tap of to= and forward both sec8ons and tee to kcal licensing I authcrli (City or Town Clerk). Co not make application to department of Public Safery. 2 Willilillilill Coy cr Town NORTH ANDOVER Date APRIL 30, Wq APPLICATION FOR CERTIFICATE OF REGISTRATION In acroance with the provisions of Chapter 148. Seca., 19 of the General Laws. the undersigned hereby ceroties :hat EDGEWOOD RETIREMENT COMMUNITY, INC. 575 OSGOOD STREET, NORTH ANDOVER, MA s 'he.hdcer of license granted FEBRUARY 28, 2000 for the lawiul use of the buildmg(s) or other simc:urets) s fuses or :c oe snuatea at 575 OSGOOD STREET as Tinted to the KEEPING, STORAGE, MANL'FACTU'RE OR SAL OF FL.AMMABLES OR EXPLCSiVES, NORTH ANDOVER ,Vote: 'hrs acplicavon/or certi(rare of regrs:rarion muss de signed ay;ne holder of me license i/sara license was granted Onor;o Jury I, 1936, ornennse Cy me owner or occupant of me land/Canoed Fecwvec r�. Suarritted by sy..,W. am„ rw _ __ ___ _____ ______ __-- ----_--- _____ ________ .,, g[ry lL !/YYUYIZ(/YL(.'2r�� ��liGL'J ® y jeaivGrrumC��:�vre G e�.ices — �Z`ix�aKcunx¢�;yCde�awc� .1L 4ti �n.� City or Town NORTH ANDOVER Data APRIL 30, vWIA REGISTRATION ''-s a m cecily rho! EDGEWOOD RETIREMENT COMMUNITY, INC. as, r acamance with the provisions of Chanter t48, Session M. of the General Laws, filed with me a certificate of regietraucn sarong �ccn !hat EDGEWOOD RETIREMENT COMMUNITY, INC. is the holder at the license grantec FEERUARY 28, 2000 o for the lawful use of the building(s) or ether structuries; s:luateo cr .c oe s;tuated at 575 OSGOOD STREET, NORTH ANDOVER, MA as reiatec !o T.e KEEPING, STCRACE. MANUFACTURE OR SAL OF R-AM/MMAA/BLES CRREEEXPI_CS;VES. Llsm ocv., Nets:A cernni at req canon must C.51M an a,..tore Apnl 80M ar aeon vent. LiIS RECIS7RA71ON .ML'S SE CONSPICUCL'SL'Y POST=O ON THE PREMISES Note: Complete tap of tans and forward both sections and fee to local licensing I authority (City or Town Clerk). 00 net make application to department of Public Safety. TV � �; �cc�rumrrr�CCuyeczGCli rr�C-'/GGataac�Cc�eCz`� 9 Cltyor Town NORTH ANDOVER Date dPd IL ,30 d�a APPLICATION FOR CERTIFICATE OF REGISTRATION In acopmance with fine provisions of Chapter 146, Section 13, of the General laws. the undersigned hereby certifies that unv Tu nntnntrnR Taxcrn 980 OSGOOD STREET is me voider of license granted 3/25/85 for the lawful use aims builtling(s) or other struc:urels; srtuatee or a. ',c :a snutiac at 980 OSGOOD 'STREET as related to the KEEPING. STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSVES. NORTH ANDOVER MA 01845 urdr� Nate: This application for camfirare or regismranon must be signed by the noider of the licensed said license was granted odor td Jury t, 1936, ofheM1m5e by me owner or or_apant Of the land licensed. rieceivec Supmlaed by O� —_ ___________________________________________. a � �- �amimrnzureaGC� r�UaGa.�aac�coleC�it >®� 3' e�lLY�lI2dT.CG�`!'�.e^. ll E'M^NS25 — GN7�XC�JC6'/¢6¢VO/lYG ✓ .'�X�i"ZYz City or iown NCIBTN ANDOVGo Date/V/Q2L 301 dWa REGISTRATION ^.is s m ceelity that NORTH ANDOVER TEXACO nas, In accamance with the provisions of Chapter tab, Section 13, at the General Laws, filed with me a certificate of registration setting :ben tnat NORTH ANDOVER TEXACO is the balder of the license granted 3/25/85 for the lawful use of the building(s) or other structure(s) situated or :O :a situated ai 9E0 OSF00D STREET, NORTH ANDOVER MA 01845 s�_.,.ro.. as reiareo rc ;he KEEPING. STORAGE, MANUFACTURE OR SALE OF FLAMMAELES OR EXPLOSIVES. £� Q 01r� Note:A ceniRare of ragrstramn musr Oe blae on or before April:GM al..on year. HI5 REGISTRA 71ON MUST 8E C DNS PICJCUSLY POSED CN THE PFEMISES � �a�rnimancc+eaLC� e�C�l/�crrysac�iuseCl`� �j ��e�ianCnxenzCa�scrSVezw,cea - -LLnc�ak�x�nd�Cex¢�o�emz�c ✓x.�r�rn City or Town NORTH ANDOVER Date FEBRUARY 28, 2000 LICENSE In accordance with the provisions of Chapter 148 of the General Laws, a license is hereby granted to use the land herein cescncec lot the lawful use of the building.... or other structure....which is/are or is/are to be situated thereon, and as descibed on the Pict Flan filed with the application for this license. Location of land 575 OSG00D STREET Nearest cross street lavwaNuno✓r Owner of land EDGEW00D RETIREMENT COMMUNITY, INC Address 575 OSGOOD STREET, NORTH ANDOVER, MA 01845 Number of buildings or other structures to which this application applies 2 Occupancy or use of such buildings RESIDENCE APARTMENTS WITH GARAGES CARS BUILDING 2000 — 41 VEHICLES Total capacity of W.Win gallons:—Aboveground BUILDING 3000 — 43 VEHIOBR&rground NONE Kind of fluid to be stored in tanks:—Aboveground GAS Underground NONE Restrictions-It any: CHAPTER 148 THE KEEPING STORAGE AND USE, IN THE TANKS OF MOTOR VEHICLES_ OF INFLAMMABLE FLUIDS AND COMPOUNDS, INCLUDING CRUDE PETROLEUM OR ANY OF ITS PRODUCTS, 0, CAPAGI;p* „ B DG; ennn �..,.,._..... „ram 145�4EO. Nna/;/� n L M THIS LICENS`c OF A PHOTOSTATIC O RTIFIED OOPY TH'r1'flfEOF MBE CONSPICUOUSLY�� POSTED IN A PROTECTED =?-z Uevisen 7rse) PLACE ON THE LAND FOR WHICH IT IS GRANTED Note_ Complete top of torn and forward both sections and fee to local licensing authority (City or Town Clerk). Do not make application to department of Public Safety. �efer✓rGmemte��ure C-J�er��ecen — �vue�ara a��rv.� �rmwnzG,on City or Town NORTH ANDOVER Date APRIL 3011)(Y;6 APPLICATION FOR CERTIFICATE OF REGISTRATION In accordance with the provisions at Chapter 148, Section 13. of the General Laws, the undersigned hereby certifies :hat EDGEWOOD RETIREMENT COMMUNITY, INC. 575 OSGOOD STREET, NORTH ANDOVER, MA a ;he holder of license granted FEBRUARY 28, 2000 —for the lawful use of the building(s) or other sttuc:ure(s) situated or to tie situated at 575 OSGOOD STREET as related to me Kc PINC. STOFAGE, .MANUFACTURE OR SAL=OF FLAMMASLES OR EXPLOSIVES. NORTH ANDOVER Note: This application for cerifidate of registratron must be signed dy the holder of the license it said license was granted prior;o July I, 1936, otherwise by the owner or ocarpanr of the land licensed. Submitted by rW r - tn w m a _ m O w t tit O � m i D s a �I n A Zr Ilk m (D of �rn � A o Y N tR N m' Q I O N di t t CO a�G N, lc-lfi ;acxaseferi�rumarcasea �� � � ��e�CnxanzCa�::/'orn V eztxieti — LLnrler�✓aeond�G.x2c�o�an,/c ✓",�;�xzrro City or Town NORTH ANDOVER Data FEBRUARY 28, 2000 LICENSE In accordance with the provisions of Chapter 148 of the General Laws, a license is hereby granted to use the land herein cescruec for the lawful use of the building....or other structure....which Were or is/are to be situated thereon, and as described an the plat plan filed with theapplication for this license. Location of land 575 OSGOOD STREET Nearest cross street ISwdNum(wl Ownerofland EDGEWOOD RETIREMENT COMMUNITY, INCAddress 575 OSGOOD STREET, NORTH ANDOVER, MA 01845 Number of buildings or other structures to which this application applies 2 Occupancy or use of such buildings RESIDENCE APARTMENTS WITH GARAGES CARS BUILDING 2000 — 41 VEHICLES Total capacity of raWin gallons:—Aboveground BUILDING 3000 — 43 VEHICIZ&rground NONE Kind of fluid to be stared in tanks:—Aboveground GAS Underground NONE Restrictions-llany: CHAPTER 148, THE KEEPING , STORAGE, AND USE, IN THE TANKS OF MOTOR VEHICLES OF INFLAMMABLE FLUIDS AND COMPOUNDS, INCLUDING CRUDE PETROLEUM OR ANY OF ITS PRODUCTS, T CT➢ 1`1417 rARArP TOCATFII Im F 0, rnnn ram.may I r r,Dr 4nnn r.D....m43 . ...._,.. .._ THIS LICENSE R A PHOTOSTATIC 0 PTIFIED COPY THZyRIEOF MUST 1 BE CONSPICUOUSLY POSTED IN A PROTECTED �n 2(revrte4 7pt;5) PLACE ON THE LAND FOR WHICH IT IS GRANTED BOARD OF SELECTMEN MINUTES JANUARY 10,2000 CALL TC /��ct4'7 iC/� order at 8:07 p.m. F ATTEND �� ��(� ditchell, Chairman, William B an, James M. Xenakis, and RobertJ. Halpin, Tc. APPROV � � - - ,John Leer art, to approve the Open Session Minutes of f' rave both the Open Session Ex John Le / in to approve p and the Ex Vote approved 5-0. r TC�aru. COMMIT BLIC COMMENT: Due to the be on Tuesday, January 18, 2000 at 7:30 p.m. z Schneider The Town 1,000 donation from Schneider Electric, w 'chase of rescue airbag system. the total cost o John Leeman made a MOTION, seconded by James Xen: ' - ^^^nt the S 1.000 donation from Schneider Electric and to write a letter thanking them for Chestnut Green Parking Attorney Peter Shaheen discussed the parking situation a r _ to lease some town owned land abutting the property wh for approximately 25 cars. Keith Mitchell recommende( residents,abutters, selectmen and Town Manager to see offered to set up the meeting in his office. and then get t hearing. In the interim,the Chairman recommended the t 7 with the Town Manager. � l /�sf � � -J � %C/L(, r�/�/o LICENSING: ---�„A William Duffy made a MOTION,seconded by James approved 5 -0. Approval to Store Gasoline and Diesel Attorney Cliff Elias represented Gdgewood Re[iremen license to store gasoline in the parking garages locate( when gasoline and diesel are stored and used in Iocatir vehicles. Tire Chief William Dolan recommended ap _ �s Board of Selectmen Minutes January 10,2000 Page 2 William Duffy made a MOTION, seconded by Keith Mitchell, to approve a license for Edgewood Retirement Community to store and use gasoline and diesel in the parking garages under Buildings 2000 and 3000. Vote approved 5—0. James Xenakis made a MOTION,seconded by Keith Mitchell to move out of Licensing. Vote approved 5 —0. OLD BUSINESS Fire Dept./Police Dept.partnerships—Automatic Defibrillator Program The Town Manager informed the Board that the operating arrangement between the Fire and Police Depts. will ensure that all emergency medical personnel operate the same equipment with the same training with the same protocols. He added that the Fire Chief has dedicated Fire Dept. personnel to conduct the training of Police personnel on proper use and maintenance of the equipment. The training,which has been approved by the State Office of Fmergency Services, will take place from January I8"'to January 24", and the defibrillators will be deployed in the Police cruisers no later than January 24"'. Also, a formal letter was sent to IBPO negotiator, Dick Anderson, confirming that he has agreed to the deployment of the equipment on January 24"' Status Report—Greater Lawrence Sanitairy District Permits and Host Community Issues The Town Manager advised the Board that there is a still an ongoing dispute between the Town and the Greater Lawrence Sanitary District over the permitting process to be used for significant capital improvements by both the district and the New England Fertilizer Company. Although the Dept. of Public Safety reversed their earlier opinion and the district must pow apply for a local building permit through the local building commissioner, their attorney filed an opinion with the district urging them to request reconsideration from the Dept. of Public Safety. He added that 98 industrially zoned acres is currently removed from our tax rolls and the Town is losing approximately $275.OK per year in tax revenues. Special Town Meeting—Motions and Recommendations The 1 own Manager told the Board that the Town Moderator has requested that Bond Counsel clarify the language in Article I regarding the site designation of the high school, and that it should specify that the expenditure is cartied out under the jurisdiction of the School Building Committee. NEW BUSINESS: Status of FY2001 Operating Budges The'fown Manager informed the Board that the department requests are being brought down to the target amounts which are necessary to comply with the Board of Selectmen's Budget Policy Statement limiting the amount of new revenue to just over 3%. There will be a presentation to the Board next week. Capital Improvement Plan - FY2001 through FY2005 The Town Manager presented his yearly 5-year Capital Improvement Plan, which is intended to schedule major projects exceeding $25.OK with a life expectancy in excess of five years. He reviewed the goals and strategic direction for the town with the effort this year in vying to provide some direction for how the Town should deal with that portion of the capital plan which is not excluded from Proposition 2 '/,. 'Pine primary goal is to spend between 2 and 4%($934.0K to$1.868M)of the$46.7M in net taxable revenues and limit its net tax supported principal and interest payments to 4 to 6%($1.8M to $2.8,M) of its net taxable revenues. Board of Selectmen Minutes January 10.2000 Page He next reviewed the directly appropriated capital items. These items as well as a $500.OK appropriation to the Stabilization Fund would total spending$1,192AM of net taxahle revenues in the first year of this capital plan. In the fol lowing years, there is an attempt to catch up on deferred maintenance and spend $1.117.OM in net taxable revenues. 'Ihe'town Manager also stated that he has rescheduled the department's capital items by delaying some of the requests to FY2002 and FY2003 in order to even out the cash flow. Raise and appropriated items in FY2001 would bejust over$1.0M, The debt excluded portion includes a $58AM high school,a $12.6M public safety complex (FY2002—2004).a $2.7M out-c( tmtry fire station(FY2002 2003).and a STOM Town Office expansion (FY2002—2004). Eventual consideration of an elementary school on Foster Street. and the roadway water and sewer improvements would bring total P& I payments on all debt to about$12M per year. About $5M of which by FY2005 would be reimbursed under the school building assistance program. He emphasized that the Board needs to decide which of two payment plans they wish to deploy- The Equal Principal Payment plan(principal is divided by 20 years)or the Level Annual Payment Plan(both principal and interest are divided by 20 years). Level Annual Payments means over the life of the loan there is more interest and there is more principal on the books for a longer period of time. Other school debts are on the Level Annual Payment Plan. 'There are some questions about how Fleet calculated the SBAB reimbursement He also reminded the Board that it has 30 days to consider the Capital Budget, and it has the opportunity to consider alter the year 2001 how to best take advantage of an approximate $500.01K reduction of principal and interest. Part of this program to take some of this reduction and program it as scheduled replacement of fixed assets to improve our capability to do capital through the operating budget. Plans for Establishine a Conference Center Enterprise Fund The Town Manager explained that an Enterprise Fund is authorized under state law for those operations which the Town undertakes which are in the nature of being a business and which should be accounted for separate from the governmental accounting system of Town. The Stevens Estate total for FY2000 thus far is$1 19.OK in expenses and $165.OK in revenues. In FYI 999, there was a total of $336.OK in expenditures and $386.OK in revenues. The Department of Revenue feels that we have reached the point where we should establish an Enterprise Fund for the Conference Center at Stevens Estate. ADJOURNMENT: James Xenakis made a MOTION, seconded by John Leeman, to adjourn the meeting at 9:00 p.m.; vote approved 5—0. Carol Ritchie John R. Leeman,Jr., Clerk of the Board Senior Clerk MEMORANDUM To: licensing Commission Town of North Andover Date: January 10, 2000 Re: Edgewood. Retirement Community Inc. petition for License Pursuant to Chapter 148 Edgewood Retirement Community, Inc. (-Edgewood") is a retirement community located al 575 Osgood Street, North Andover, Massachusetts. There are currently 147 independent living rmiLs for the elderly, an extended care health center with 45 beds, and other common areas and facilities. In addition, there is current construction of additional facilities and rebabilitatiun of existing facilities, including 36 additional independent living units, a swimming pool complex, an auditorium, and a rebabililalion of various existing common areas. (The current constriction is identified as phase 11.) Attached to this Memorandum is a site plan of Edgewood, as built. As can be seen on the plan, there are now 5 residential buildings. (The current construction will add I residential building as shown.) There are garages under 2 of existing buildings. The buildings are designated Buildings 2000 and 3000, as shown on the plan. Building 2000 can accommodate a total of 41 motor vehicles, and Building 3000, a total of 43 motor vehicles. The buildings were constructed according to code and are fully sprinkled, as approved by the Eire Chief of the Town of North Andover. At the Lime of the original constriction of the facility beginning in 1995, a Boston law firm was ban&ng a review and implementation of environmental matters. It appears that the requirements of Chapter 148 of the General Laws were not identified at that time. A further review during the current construction of Phase 11 revealed that a license is required, in accordance with the provisions of Chapter 148. Copies of the applicable sections of Chapter 148 are attached. The license is for the `beeping, storage, and use of inflammable {rids and compounds, including crude petrolcum or any of its products, inside a building or garage or other elms ore," if there are more than 3 molar vehicles stored . In this case, the license world be for the gasoline and diesel in the lanlzs of the motor vehicles in both garages. As required by Chapter 148, the Town Clerk arranged for a publication of the petition for the license in the North Andover Citizen on December 29, 1999, which was at least 7 days prior to the hearing. Also as required by Chapter 148 counsel for Edgewood arranged for certified mail notice to those on the required list set out in §13 of Chapter 148, at least 7 days prior to the hearing. If the Licensing Commission grants the request for a license, the (i license should react that it is being granted for fin the language of Chapter \ 148) "die beeping, storage, and use, in the tanks of motor vehicles, of \ inflammable fluids and compounds, including crude petroleum or any of its Vproducts, inside the garages located under Building 2000, with a capacity of 41 motor vehicles and under Building 3000 with a capacity of 43 motor vehicles". Edgewood respectfully requests that the Licensing Commission issue a license pursuant to the provisions of Chapter 148, 31 , 13, and 14. EDGEWOOD RETIREMENT COMMUNITY, INC. By its Attorney: ��A Y Clifford E lias, Esq. 112 Chestnut Street North Andover, Massachusetts 01845 978.686-1092 + C. 148 �� § 3 Fuu_ lh,cvrn note acuuserrs and Storage rank,. nEormation Inspection of Auto Cate Cases and annotation,referred to herein can be fuo- P ` the, researched through the Auto-Citee' computer assisted Related Records. �,, arch serewe Use Auto Cite to check citations for Conn, :cis Upon Violation of Sec parallel refer aces, firm, and late, history, and annotation references. 38A Through 381. reining to Underground l § )l, I rdinidnial _ I,ggrieved"rank Owners. - In dtis chap,t the follow wg wr ods, unless e dilEerent meanwg is works rrgnired by ib cc,text of is cperially prea,bed, shall It,,,, the fol- Iutg I'll:miugs -- � ofFireworks. 11,-ud the bc'irl if lore preweuQ at bli rrgulatiuns estashed not Storage of Fireworks + under setiim i I,...Ic"n c if chaplet aver ty-hvo. ,works. {,p "Building", a iaubinar. n of mny matenal,, whether portable or hibition of Fircworks, Puy hied, having a roof, io lilrm a str to(ruc for the shet[cr of persons, annals or l iopc r} Far the pu.po,e of this defiuirou roof ,hall 1 r Railway Signals Classed ,:,x duel, ant ,u e n and itmil'o covuutg whether or nol [)Lima- and Reyuirentent for Sig uent in natur, h,. word 'building" shall be consrurd where the oniexi all s „ an Ihcntgh followed by the wm,ds "o. part o, pails dm rcoE ed, Limited Kxccpiion fog f to (A mor , the Coumnissioner of public safety of the cum- ' monwcalth_ f,., Ucpw ho r " thc hlpa noun of puhht safety- y Ui dsou the division (if bit ,enou pteo of the depurtn�erm of vi dlammablc Mao,mis Ill, puhhr o'do adol d lit de pnueni the thml exe 'itn ofhcer oL [he Il K - § 50, his d,partm,nt it a Cn t t,at or I , drnrid having uch an ol- hest, otherwise ibo lire '"tuou etoucr, board of lice c nn nussoner or C.igarcttcs Prnhibitcd lit, c,S� et:, of , u ..done, of pubhr ,.lets aad, it, iowu, t hmfng 1 oc depinw eni the chin Eengineer, d aoy, otlunvse -t- the char 'n of the hood oil or le,nnen_ hide Lighted Cigareucs _ Insperi r :m in`pccn '^ pohrc alli,et oC the defier mcmt mf pubhr satel ,kF9 l.oc2l licensing a rtiout eit, to m eluding lhox to, t .' 'hid, arcs; pmrelty. S' '} h ve adople d t to,") onatilt, t tgm n I i n mf gu Senn a h, b ioard si tit Capehlc of Conduce tg ty,. f s Ird nc i S Iu tl e I ar I tf u d in n u t r s ies b rvn S id l d ()too I it plan sl govern o" I pio idcd in stalling and Sc rvinng } t cb+pt a to i1 iIn, ' the n uudl . th ..cnsng board r um usvon it, u 1 :rcz I i u aurh bo ri or oum ,, o is w- nuti, "1 th ltrzed by stun, i ordmana to gr uu licenxs uolder phis ,oMuo ._ Condo ;hiss,. Required; lkt t. I r I re+ d i ,LL if b .ud t -d I .tmLn , the lin uvug s Lmud r ........son o ri,f whctr a _cuch aho ud or at"Lou"ioo -eel 911 Se, ice_ s�,333h: 5A1 14 ,y lt. , ' C +F, A NNOrnI :u t +nc or Ma,ASrllmaN 111 g udloliud by t tulc I ducal < Ili glint hnvscs Order dus 11�� lapel p1 tldul Thal it I l l hF'IFIg lH h erry In n lsad mhtbnults air I Ipaid 11 r S hoard Of duce ulemhlls m'Iy he II ll Ipl v led or c c signaled 10 the hoard of eelectrneu 10 Af I ax (Ile I I n1 lb lIt hm nl Ill iSStIll I g IIR.nSCS fol Eli lgf", l ar nOF un1< dtm �U I. Ieu uLLomohtles or molol s<hl It In Iae< Ih1 board r I aldri I < I nr anuud Constitutes,,III mlhollls Im healinti le'rol rl b1 I II <hapte may be Ili ld I r1r I I a roltuILM r Ihurol i u i d" Ih1 slaty Grt u.hnl. Sin ctur t ulubinatios of malerial rcscmhled u I filed lo(;, II m g", support .,I 1 It Burl I a huildiug h.........OF . k Iliuiuq dl Will, re�I( Ilk f Id pled nn, 1 1,I sig ii I ❑tg1e.od ms I -".]I,, tu(ulri II I6 .Lo word sUI' �I. sh dl br ronw uul Ihuc Ih c nll ilor ', as though followed I I Ihewold pnrt < I put lhercul � ill s' t 111 1 795. S 1 I )tll U.1 1 Pl12, 102' 111 1 0: 230, 1_ Lill � I1 S na>YI 4l2nu ai'2 iA t 1 d I dI {iu I I '1 1 �,cil r I l I I f l. :I qn-tl-nF l l f f1 I I I a I �I IIit, It11'. I liallI), (I'l a• I I s 11 IF, I I I r �i g, r1IIndl 1 1. ....... Ili I I ,, Ill Ili 11I-- Lill h m. ICI ♦ a r �,g 1 71 I I � I I om 1 1 1 1 f L..' I n(r u�qi J.f 527 CAIR nil lr "I" 1 E ..IIII T I I Il loci 11 ii LN liSs sn07p IITII. l u I l l n uol-.nrl rrno h .Ill. of "pill �i e1 n1RI drypo . .'. 411�'I , s an rss III F ill, IF I lill, it Itl ili I I�i II ! 111 .19 "fill V .AP 1 NI If LL I Ill Fill II iIF( 1 1 I Lull 111. r ,II I II Il u 1 i1 h 1,1111F.1i I . vul it s D Narail II ., I1.-a. I( Ni. 1 I V Il. I11 R l l (19 1 CFI 1, ]it'll I ti wd,pia u,a 111 111 II tl a § ,g Free PREVCNrION C. f4fl �fessacuus,.-rs § srPs. 3 pFs elcsigualcd under rca um Ihn 7 r,r. 'he nu shut shall d o repo, m ,h.g a ter 1. �hrt head of the fire depart C'n the result of anti investigation ono fires ,.I t ElSiM I rmr.i oil I n r I -. .+: of a spv,ons ungInn not rd to him b. such head as regwmd I t sev (I -. No. KII-.cenc II t Asso. lion mo. M' ache tIaPG, ilC. N ) G53 I supp 1079- 1 &4ssrtovy- 1910, :128, 5 I:Q;I. 19'LI, 1,18. § 9: 19:i0, 399, § I; 1i)31, SRO, § 4- § 2-5 by Offleer- lia wilbulh neglects of Iefuses to tit imposed upon him b, the pre- § 9. 9fln§es and, R,Ru ations for iexpdosives. 11 a fine of not Icss than t ,enty- 'I Ile board xhnll make ndes and regulations for the keeping, slot Hats age, use, tuanufacttn,. sale, handling, transportation or other dispo- sniou of gunpowder. dynamite, ,In& paruleun, of any of its pnid- ucts, or explosive or inflammable fluid, or compounds, tablets, n2, 32, § 0; GL 1921, 14 R, § 7, IL130, torpedoes or airy explosives of a like naire, or any other cx[I thsI 6rcwo,is in..rackets tit any substance having such properoes that t01 Es it cii o spc utrur,,onsl OI acting undo, the u.fluc nu of any .onugu- ' I tl I " oils sub C nee, or o1 any chemical ()II physical tge IN ignnc or t a .� nl5d b�cu.. .of I t d t d�' inflavu of generate ,, or explosive sapois c r In a nor 1 1Ma 1 0 r u dangerous ,xleut, and may preseTbr Ihr locating vm and tcnals o,t <. talth - D c.. it inl construction of building, ill be used lilt any of the said pu.po,e.s. i • Mzw4 o, 22,NL2d n19. Sudr rules and mgtilaHontl shall regwrc persons kcsI n , stonug, us- iug, selling, mzrndacnlnlig, handling or nanepoitmg dynamile or other high explosives to make reports to OR department In such particulars and in such detail Ihzt the quantity and lorz ill)n drereol ndly, before Lebn,atl' Hi.enth, a will alwa.e be a nranec nl aulhenm recnnI In the department, Cities in relation to fires to the aacloUl- and mwo, may also Tnak, and enforce ordinances and Ill Inws, not nidv the material ponious Ih.tcof inconsssn c W,rh emd rules and regulations. relative to the niby It Mail,,, ill till sec WID. Each ate c r town shall aihnut a cop} of each such , ,dinance or by la. to Ibc board wi,hiu ten clays ain't Ili,, pas- sage die,u f ,Any ill it .i tic ilr b. I r tegulatiug hl.snng opu um,e,. A7. 1911`L 3> C s' 1902 I1L §§ I, °- nr the a handling, tianspori moo r il siorr(,t ol dyuamn. of 350, § 101 ;i 1921. 1 IS § 8; 1030 1 gunpo. din shall not lakt cifeel r old sod,ord n rncc tit by-law „ ap- prved b by die oard <xcept lha a l n nce y such ordina or to law o that ha, not been nppni.al or disapproved ba the board withal lno,tt amapamies. 5"+mperfty v a.r rv, It3ve days alter the receipt then.., shall be da'.m'.1 l u have been:ypt...ed. a¢ll 1 e¢s runs. l9i187 y isuranee lumpanics, t tiers of 1871 C § - IR77, 216 6§4, 5; 1878 l'; vti I882 102 §§ `-801 2, 03, RL 10, .rested to the .vubjen matt, I I 1902. Ill , §§ 97, SN 1I ]o, 100; 1 lo0 370, §$ 1 190.5 •RIi. § 1, 19111. onistan..S ofa fit, any hlfonnaliou 565; to10 588, $§ 1 (;1 1921, 148, § 10; 1921,' 73: 1921, 185, § 2; I030, ,tell mac in his opinion rcyuirc it- 1 399, § I. 1945. 710 3, 1975, 7GL cmnpal s i 'tics c l ptopcm o, t:detar I n tl�a. Hier of the nil' fliost i sk ll l.ak. I by him or fir a person by hin, added the l. , ih-tint fifth Lena s, ni afvr...tour +,51 ;F0 i HrIOG C. 148 1 Cuusrrrs § A®7F § Y� CAST.NOTES ,f r rds d IP ' 1 oh r l zing ,hr annrtuss, nl 1. I IT,,, I f i1 1 YK c 1� � dv qS� o.cll 1V J1978 OI AG, Nn. Ves- g,r i nIRhB opt 1 , od 26- Pl nvto fill 1 I uni u�nv +a1, SO CMR 4 OU- II �g, Appropnabnn for Expert Assistance and txboraioq. see and Classes anf CerstC 1 he Ionlen sionu-nrry expend the amm rl annually appt opmted Ib, the eloplosmc a of t xpco, 111'Co s c, r u I also tI for m t nuung a labor:+fury [o aid iu the cTA01, inu,I of d,c I o , huse, eyilt xfces ,ss'stauuill loycd rules and regulations n Itend udlaminable Ilnlds and compounds_ 1 xpul c types and classes of ct u( undeo do's secuoo shall aid iu ❑tr t llVreeIoVo, of all Izws lint. . and -ner iuslallations. A cu td, rcgndabona which it s the doh of fhc depann,"( ,o administer and installations or mas be -rc vud shall xrfnr,o such wher do ues 'ts fhc t wtmtsstonu of v41n I _ -ha ,tt t ux hour t ' dl be exa ! may prescribe Saod cupert sgulati , I ,hut ooc and the roles Mud oegulations made thereunder. i_ I )14 121, § 1- 1 {I 220, 101( 1OIn 275. 4 k: GL Ip21, Id; 1021, `255, 021, s)8i 1930 3" g I. .F Certificate; Appeals. d hcaring be suspended ur It the cerobtate holder of airy' R ir and Illative to mnstnocnon, ]i`�,. MIlydarflurc of cworks or Firecrackers; License ant ' cquipm,o, Any apphcao, ' ➢ cu• nit Itequsred. it III such cernficALL !`„ No budding sil," be the w uu 1 t onto. nl luewo, o holder - In refusing to issue or iu tom" hot„ackcn1 wLLbow a Ilcen. , lit m ,he to d b to su g ;uthonlp ;old nd v1 ljl ' wldlln tell days, a nl ppeal penr front the aoatshnl_ the dcpartmm,t, who shall Id and to conduct a hearing 4, n .dsion of said board shall be s' 11111 505, 5 ': L;I. 19YI, 14h, C 13; 1930. 'M1O9. C I 4 <J d of M,V,,.LEIs,us Rcn l ,a— IviauoE,, of of 6ruv,r1,,, 527 cMIt'a O'l '.coal Gllenasurvee n.ibcagy Rc&tell'Ll egariced tan kLald Cer4iGcafle:, OI AuL Jo. r 11�.'l IoSoea Woo C plmncr 4k57_ 58. Inrner Technichl" c husiucss of altering, repaiT t shall be ro�uived I" hold a § M License For Storage Aimnofaciure am Sait III iF.f Use e of provided that surh work is Resnoval of LYazardoos Condi2iens "Poll Cessatioer of Il ised LJ- d as oil burner lechne clus for Keeping f.apfosrves, Ltevocakiun of ueasaerc eomses; Appeal by person Ag,reved by Issuance of (License. su'uto toc shall, excepL as provided in section No buildingor Littler 363 jrs j .. v<i .. ]qhy Ah'Vnlntu Law< or Ww.,cuutir,rt,v ij i1$ fourteen, he used for the keeping, storage, manufacture or sale ill any .n of life atncks. an in s led ection tune, unless the local licensing authority shall have grained if license It) Else the land no which such Wilding or odict structure is or is to be situated for the aforemen- tioned uses after a public hearing, nonce of the time find place of which Rearing shall have been given. a the _-p us< if Ike applicant, y� hg the clerk of die ,it i I de I c:Il I lei g r ud i Ip, by puhli", uwi not less Ililit even dall olio, tlretet lit uielispalict publislild in the Issul,hsh language in the city or torn wherein said land is siu- f� ucd, if Ilvte Is Lill, so pminhcd the un tlici,vxc trt the curia in whI h such utt crt.iwn tics utd all , In tic apples tutby t,gill,rcd mid Iyrl 1 . than seem dos poor to loth heanut, LEE Ell oon.ts u1' teal esmn:abutting on said land or dire(fly opposite said land mi tnf ' fl Public or private little( as rhev appear on the most recent local tax list fit the time rite apphraoun for such license is filed, and unless the aplheaunn Ear sorb fillist shall hat udorsed therecu die aernh- e,it, Ill vvl or dis tpl '_vaI of dt, Ill th. fill, depa tmcnl. tin If llcot E h,I11 cc ot he it the Edb I thcr II I let k I and it shall li (he time t Ill n inn thtreul Ill Ill I t 'n", II e file, h, hcuird a ;y u : t, rW t„ In fife and I t b,d therein Intl ,tit lit ideut Art "hill Ihert I t tit, ,fill the land and 7 hall mw I I t t o b fit I is .I 1 n'd ri, I e VEly Tuna( II tit II It, I iud, r. .. .m t e fin tit k 1 AIg, ........ manes( c true _I 'A tI ' EllIh tI I thl"'i It u t in t e ulr,] III t p l fit[, I I'll, hun I 1 ; nd Ihu I i dudes urt In, .c t rted i 1 I-ELIt I , hi- t. 11,Il t hcnut pI olided, ial( } I a E,E,a I l o l t t d : n l I r .d I I r o n l l I ,i l 1 A n h p ) t I Ia't t li'll If hel iond, I sl till 1 ul jrn I u It o td non. t 1� ill lit I tcslli um "Ea h I euribcd EEE It lit E if,( by (he local u.iul; II 10 If .. iutl cu 1iw... d III lircu c l ( 11 1 Ill I I IllIin ilil 11 I lud : I fixed kv 1 � u l .Twit I I �I 11 .. t <wp I .aid Ian I I zi if n I I u pn dt I �� t I till II Id ( run It lit Ili. I III 6 I, 1 ut } I Eli in mmnuliauu II i de Ell I the and sited t t 4 mtcd pro, Iul Iusl, If It l . I od and t1 fit, tt itill"dong tr, inscuod d nit .. I I I Ih, mar.h s hrteut la."E I of shall uI y' Ily I 1 r Al 'I if...I,, if, fill, ilh (he cIc t of (hc (it, oI F ( o 11.lice ll 1111 Ill I Ill. if ifrh I r It, nt ill, Ill nI l In roil t , HE Ili bo:ud I 1 < l t a r s it ill Io I e,L I Cu c III I, Ionit ill, p ' : oil Idtcw )Id I I 'II ul I ... I t 1,d, tit I I[ill,.If( l It Iio . II Ill ugtI h I 1[li I it I I IIi . d h t(111 t )I LU 1II II I i( Ei I l 1 I _ av I � il.� . I I I Ell n I •id.Il i I c i.L II Lz I #.r; , It] A40 ANNIIIIH,O dAtIS Ill MAISM HUSIA IS NOIN:ILCII "I IdIlIL11111 IlN)I,I) 12 II—, )j)jl­ld it IdI.LI)d o, ,If, f LL11 778 JG `,jil 870 ill Ill,dclual of the 1-1111L l'I'l-d Wl,,,,, dil'i th' 'I'llill if , hok... i" Ill, . ("', Could,[ of ml-dicl,d I I f IN, , I (19C,1 153 A—510, 231N1 2,1 llfi.,N I Ill l ll`,Ill� ddIh*I ll IC1 [it( IIINIALIE 'I' dido and app diodd (1968) 392 LIS 296, 11-1,ill( j)( ITI'd I Ill"llilht .1 Id NIOIL ld 21) 1 NAN id 1 1 Oil 8 9 S 2 0 IN 1111 .1 1111 lf(N..I t...ll,I kid it,'."'illd Old,did tilld 11 Of lil idi lit 1 I IN A LIN,di,dl df I1 1 d h.uld I.... It A I It —I-I I I I IN 11'. I I I II t k I, I I I...il If fill uko.......wl...11 .. 10 )1 kod(I . lF, if loill -11 Ill I'll 11 11 1-1 Ill Id OIJI I I AN I ill I I ill 11 1 C�1(1% [lid' H(A I)( L,d] IN� L kh-I I Ildll "I ILLL& LINK Hillil 'If ill Ill(11 1( 1 11F &1 Eddld� 11 Ill I N't I I'lod I l,llo 11"1 I'll l I I L N I i.NL'l 2SIN J111h.."IR VIN111.111 IN.' I olio N-d'ol IN( .......IN, dh,oF, dhlcudh I, ucit,,[M"If,id(1967) V,3 I'Ll"510, I had, -.o lhu f tlt, 1,l,...ill ol 23 f NI,2,1 011 ,an N &.. uid f,p d,onid ,it, k)Not, I,d,.,I 'k, di.,., dind [I, L19681 it ill, ldi 101 IA 2,1 1 ILL, S� d 1 o, N-11,1 fd , ',( 1 201,1 I I I I I I L I I I I 1 1 1 1 L I i I. L'N'' "'I I'L ALI— 'llfil IN I I I I I I I I I I Al I If.I 'I"I t sldd, I Iddl,, (146 0 1 ll 1 ill A)I,d, 1111 'Ibl,Lk," ",I,, A d, `I 'll" 'ILL 170 NI lid (.81, A Ill(IkL( did 1 N I I I L l I I I..A L I NI II I \I. ... "".I, d a .,,I... ... .pi-il I Vold... f I, ill C It ........ A , f....11 I )6i) V); lid,, 10,233:11 ld ;16,o N I it I I L a,I(I If)I N (I I'l Fl I(i (I N IS ift 1 392 L S 290 11 k N-Lti Ilk' I 1 V I( 11H 20 1 1 1 I)d I LOS 88 1 lIdLI R.fildiatuahk IF9ullah ill, tkloft,R v,kI Cl2i'lloGNI Ol any 01 Volatile inflandiriablik, fluid which cools L Pot at a wilipcitune below on( 1,11IIIIII(f 111 18 Fallertheit when Ito ill,, op,fo vt shall, d,hel, In any MOI vchide "Ind, is ik,L building of oche i dtiticl, Ilk i1c,died ill be ki pi it, suel, blolding,o, ,,III... the oolong (A the pi"("fing "'tion; pa'I"'I', Lo tlo� '1(Illoi 11i.111 ollL (o 'llo, lodii(flog it, I'LL f Ill, Iul,[, too,IN ill, huloll"d lod , IN...... Ill 'hi'll loo I o'. 'I'l... ....N :oj.......bde, ILL Ld)j(L ld kcjli, it 1, build g No ILL,[[ thei k-of 1' net used oldo'l f<it IIIII,I'll It"Iti(ditnt Nor lbr holding ll I'I n - of tork, (11,111 odt nit l l ns, o lot g16TIg L of I it on (L I <nll I t it l IN I to 1 11 oi N, thin I I I la I I I I I I I I I r I I Nt illl L L N Ital a din Ion I g and in which I I<11 11 1 1 tll,Nll duce 111(4)[110bil I j . 0000i eoh, I, 1121 1 idt I , 1921, IS 6 1 141,l0 ';Ill) g 1, 11931 'l I I I I I I N N f i LI I I I ll k P N II,I t k I I III I I I I6 1 1 J,I L I I t, SENDER: l also wash to most the rally' a t ing sery cee Car an extra tee)' p e tl a a t.r]Add reaee's Adare e fare a V f eII pies maMtII r.rof _ aim 2. C Rest(eted Del very of p P Ae or J am no I a 6 no derr,areap nlac aocrvc e'.I the J .� 0 related 4 AR Ie 9; Q a.ArT le Aaaras a t : Z Sy-3 41 San—,Tyne Nancy J. Melia ❑Regnmme ldcoofso ad de A 523 Osgood Street DsxPress Mao ❑msumd _ North Andover, MA 01845 ,tea no_RewiptbrMe'heenise nCoo so 7 9nta pl Delmery z .Bete vea 9y'. Pnal Name? SAtltl ass Aooras ronryurequesrd d ( Pld) 0 y e 6.61gnature(Addrcsseg� nl)- PS Form3811 December 1994 ws.,ee?.__1 De.n_sec Reach-herself SENDER: also wish to race a ma muow eComgem moe --der. of sem at, rvlces liar an extra feel'. no F_ y e .aehaam III of farm Is,htw , I Irla t a es 0 Addre seesMothe 6 m t' , t' I.pt sea' z 0 Reerded Deroary �aaaL,nLwa e f aeae, ma o The Fewm Fcrear will he,lI all, ar.mh nee 4eWeree"I meeae da a.Ad-,I Add teseetl im 4 -Artlde rvumbar Q z 5-13 E Mary Charles Trust ~ yoe — ❑ Rj t_ed 2�cenrd � ' of State Street Bank- C STERLING c E R wa,l ❑lus a 225 Franklin Street ❑net,I Re I+ rhmimeeda. ❑GOD or Boston, MA 02110 17 Date at DedVnyam 5.Revised By: (Pcnt Name) / �O.Addresses,'.Atltl e{Onry llrequee, tl d - an �P° le s III 3 6.Sgnaon,(Abdceases ocAgenc) ad P5 Form 3811,December t994 dzses e.a au, Damenm Rewrn Reae�gt SENDER: !also wishereceivet rolmw tpImpleee '.2medaxrnel eervlaaz. eg Sw rvvee(act an extra tee) omple; III Inch...In Ile III et;dubnn.n na;wt wn rv.eed he bevk e ' 1. ❑Addressee's Addre,d o N� le�o r a e emseb'.Ih..ar.e ne p. 0 Resiridetl Delivery IITT 1 R .rn ae wl ant n e ane�e B mar _ _ u 3.Aa—Addlealedt '. 4 At l.N;mbe; s¢3 E re Type Raymond Mesiti I IT,Rat. .acent as ad Gladys P. Mesiti ch ❑Ear ress off 1 ❑Indaree of 526 Osgood Street G R n M pb d . ❑coo • MA 01 845 o t D er North Andover, ( J to 2�2 5.Reoeyetl Dy:(Pdnl Name) 9.AtlJ esaea s Atldress(Only It requested and to W ,ae B paid) ac 6.Slgneture(Atldres et h PS Form 3811,defect 1994 101w.99 B 0I Do....an Realm Reoefgt a SENDER: wrantoreceivetheldlow- ocompllm'ulm.teeaoiz loi leem.asl sem:ea ing servlces(tor an extra lee): dp rteuem.a,at.Ie 0Gd wm hema m m oldII mi e h.m r ..el m,,I.e .. fill wore. .uw, . Cold 10nw T Add,,,,.'s Aaa ss pesit form o Is the ml .air t enon0 z Redhead Dall _p $ oThePll,Recai�laiso,`w exam fhaaa�d'e��aafeae�fomd an,doea ,.eanmem aa,rmeh e a o Aetwereh. 'a p 3.Angola Aaarassea to taa.Archie mtmner — a - _ also war toea , a thes , m oc mplale nomsl anrvmzmrareeloeal senan Ing senores(br en extra lee): o pomvaia!em:d.of ear ao. _ to eca esa o . forso 11 Into In or hol a I h 9 t cold to y e C Aaa seas Address _ y III In 11,1 to the front of 1,noolorcs, f do,, m p O I'Meturted Defvery ru as Is wset..s Ra ae - v olra an _ Tro a Rao' ham m - m > " or or'so Is S In E III d m p Q 1 Art ° z 5f3 /l9 6Fl E� e < � so as Normandy Realty Trust 4d s Type ❑ ❑ �� o Thomas D. Laudani, Trustee �- Ree�wemd Xcalenad f -._ - N "y` _ - - aof 498 Osgood Street E Epp ss Ma'I ❑maurea _ z �1 r a , ip:for lussiands, ocoD N: is R North Andover, MA 01 845 z D t f D-.I e , - - - = - Er hIw ¢ ,j Q0 _ iReceived By: rP,rnr NemeJ I�6.Adtlressee'e as Address(Only/I,equesled entl - � � � � m Is In lee cards c( - i 0 6.5aueWre(Addressee as do Y I- _i 2_ PS Rprm 3811 D mbar lvsa ..asczv Dmeste Return Receipt 5 e° - - -E .r Q SENDER: I also van to receive the callowit ad re - 'omplel slme:IIorch can w... lrig services ffor an extra feet: C c pi d as. m a'. y a ae r r r i.a ca m m v a r aversions,:. Address f _ c o o it v cam n,han o a aslpe rr, Is Farr .. -. m 2 V 9 irmleJ DCI veN �.- U O _ O'hePel, R. ��II aammvnonI as mvacaaa!to ace _ EE YIn � of Q st a bar 9.Ancre Addressed Is 4a Art Ie Numb Q st In WIs O - E z F3 119 � f8 E o � o an Robert T. Scanlon 4b do sanmerype a de Jr- o�oo`a z tnz Q ❑Reyisiered 7Cadllled ¢ N p LL al 0 » Margaret M. Scanlon c lapis aeesed,ayt no pafaldwxdo5z aUVN8ft3tl,ase at n (DEp Mel ❑InsureO ._{ _ i 510 Osgood Street �OR rl v'roluernla ❑COD allorth Andover, MA 01845 7 race of raisers of i may faleaay wnfay Bantu set eon serious sR etlByonatN ) Add shad (O-iy r-q s( o end fee I, od - ByZ itsY Sin�r �:y ° e a SIg t o Ado of l) - v o o m O In 'k i � , ) c p o 'm c. Domestic,Return Receipt Q d E ❑ ¢ Pic Form 381 t December 1994 a ue. D in or se a _ner 13-. o` E or l also ris�lor ve the fallow a Q ° O SENDER: a drys n� soor ana to feel: or ❑ ❑ oq aso amvwa e e m - « �. - C vund s�� 1.E Add Add ess o oarly v d a 2.E Rewr ctetl Dervere �� ° an - AIIIIIrour, In, hipai NIs voi so Thl Re a aI If R ° drvnm na ' era ae va- - �� Ia � 0 an � w L— — oEOE a —�`a Art N5„J3 ' 6`Fz ¢ 6 AR ie naaressea to: z `Y -a ara David W, Rourassa ca e Ti�rb cehr d allIs inso d Elizabeth M. Nadeau DE n rs" of - a ❑no o.pt mane a,fse ECOD = 504 Osgood Street — e o v.Date tI Denver _ North Andover, MA 01845 - - a e.Addressee's Fad (onry I2puearad endz as as i 5T_,s edBy da fN 7 r — r Pardus E w --yy-- - c c � E i 6.59naWre lAtldgge ! _ _ O _ O O O P ❑ O d s �Q o O do PR Farm 3811,December t a = = En a p O - - �a c o w m 0 m R E sE € - muaz w ono se SENDER: rs t themuow m ° Uri se oCovryrnl 3 an and so lirsIneae—l anmor x im of be servmez. �inpbe cesf or an extra leek: pla avenw ayl uo�pataldww5 Oatl Nao 3tl,non s�¢ tl I",o oIII 'rnereve onx r -" t EAtltlre ee's Address au - is alu n,rlmmIomatmnmsme malploreaun menernJsoene-oc�^' ZE lestrieed Deliveryare t m F lumfl G an _ w } cams 1p hall e:'a'etle Gain _ ""or a. _ 'avr to u ¢ 3.Artlsi Addressed ro; yea.nn eN�er,� /l 6 _ ed,ty ool,ilc cp Ill)lltl d We.IUNI a b, biI E6S A n m Ilp�anN api4V Ebb— _. pl ve>.apW alel4tl c a a h Is ti IpP"L�4sdNCP � �. I tl 2 ssa PPV l "PP'I. l y of s4 Lo _ r a uapn s6vm Is ypdr RETURNDDR Impleted an 16erveersesde vInla,IIh anape "I III osier smitic. I 834N3S c Is y Is n om z z o a. ------ --__ o m m o 3 e3 � roseL 9 ...a LLSE dsd )tl epatJ Wnlea 1 swop $o m o 0 On < a d .a 3 � � Q PuaPe]s der/ A1u01 ssarppb PPV .. Nlwrd -fi$Panaoeag - N d 0 �� aleO L, D m y a 3 _ 5L6L0 VW 'Allan88 ° y poo❑ r LI, rI clap❑ o Pycaol❑ L.wIsIA,❑ laagS xass3 ZL9 Patue pI,Ila fide SuONeAJasa o saalsnl S1 1 CR 3 m adn _yd la$ 4 b A r, v bii Efts o NPp uy OV m Passe,ppy aiP ab e a man.iaa pelpusay ❑ z I, c n 4 Safi .a 3 wmr s eo� � 's alnpb a, salppb❑ t e �y. cr - u 0a as 51-1 a. a cLsdc F.a w, m:. a dw bp o _ MIIIa t I'll osle E3CN3SA O m _ Idieoetl.,Me,Inlawop c Pen eq..o kg6 I.,9d a I� p ❑ n 0 dBtl- eesserppVlInflwabi$'9 $ p - tis I8 sr aa/ puapepaenbar yu.Qpf appb aipptl8 (I.ONluud)-RBO epee-S _ fi�en�iso to Ilea e LBLO VW AingS>Innal o —_ — r o aame14nlw iIl Iciasap w�lay m Thank year far using ReWrn Receipt Service. p00❑ ❑ 6 1aa11S is 3 L88 a " pl,csa ❑ r w fd, p 6,� OWF1 0/3 Is year RETURN ADDRE55 completed on the reversesdev palpated p Isi5a,0 r J}1 - m YY' dfiy nia$40 �r t{02gllallaj� a2g011W 3 x � "' 1l S 7- / 3 I . . o N g < a p p N ub' a Ip FPV we On C U < N 1 Im, ] Z f m y < ssaLpPV a�PPbs.aJ fi ers 'tl 6 N 3 � < tI I _(peat c.�p m I) pn as 6u mo ua. pp I� vve. sawepo _ uPlen wa�M osier ya0N3S , m o o R' p nasaawla IllIaLInl bfi6Vegwe d _ w 6i$ t Y ( V _ 3 ..V f P e - dl Ol PLb .p-H B (emeMuud)- pan edaa c 01 �F - `, N a • aJ I a u 968 LO VW 'JDAOPOV 4110N v w.nr., cr. . „d C laallS POOBSO 8£9 v 3 Pa,nawu n dam IeI�IW uanng 'F'- � •� d sI. lalllW d Ayo6atS 3 A n P M1 uV t iP PpV 14V ❑ ❑ S o - _ ur ti IaP L.L NO as so111 ave.,. C ,Lol III cwa1l v o £ Sn- �- ssa,ppb s,aass"PP"❑ L ea °e _ 'e Leal e'1.�.,..,...I',. ZPe n •__ __ e PF POLICE O E P A R T M E N T I m,n ( Ak A h.,,r ,wound g„ra�=c tdnla w l J,ewood :uh imnl Thai ihC P,Jiec Department has no concerns regarding the - ,Im HW I d_e,,,)od Rvlirem,ol Community for above ground storage of gas. snn%I,AIA 11 Rl f I AURI ll BSI rt,A lit �L16>A( I11 hb l'IS IIh Iv In•,, Inlep....,.:I,,,,hlr ii," ❑cc-29-9J O8: 111p, t T9Fl"Ir-ct F FTias 9JS-68b 53132 P - W C-LIFEQRD IA� _E EL - _- - 70 East Street counsellor at Law Methuen, Massachusetts 01844 Telephone: (978) 687-0186, Ext. 2304 TelecOpler: (978) 685-9932 vet Kraunelis, Legal QSStStant FA, TRAM' 'btl _R F�x 'reL1 , C2a -I56 TO: qt � ,11 UA I!- ytc1 �L-��— - N'-imbe- o' pnCu.. including ce�cr Sheet.- __ _ — .— -. 12/29/99 10:15 TX/RX NO.7765 P.001 l lia>. � iri . r�r3�.—yi _r� P . Oel ����_- pg-99 OFd_38A ( I YPYor<t F _ y - I_ Receipt for Receipt for Certified Mail Receipt for Certified Mail Receipt for Certified Mail p �, rn andy FP621ty Trusi V,n reor F. Heif Ich ,repo v F MOPE I_:+i.dani, Tnistec fa 1. Evely, Helt nrh rn tr .I 8 u5good J r 38 Osgood StrePt - l u Stevens Street fv n ido c1 a 'Jt 845 J rile A id i, +i 'JIt. 018, rh A dode,, f11 �1945 _ i _ �g � S P e�a^'mm i SPn v ufl a¢ �'.iOiP F- 198rxa $ �p mor r a- . S y y.� � � M .a �,.. - i •m,n. 3e s 3 Z S33 :19 65'. il5 t FReceipt Receipt for CertifiedJMaiifor Certified Mail Receipt for CertifiedMait Naymondr9,rass.,Cr.rr,T-iJ ,ii A errata 526 Osgood Strec[N,rth Andwcr_ MA 014a5 G1645. Andover, pf,A O1 s --7 � I nj- 5 �� �—I of rov.LI 1 a �....� �— c' I • t Oaf YY o _ i 12/29/99 10: 13 'CX/ItX V0.7765 P.002 9/tt 6f3S 913J P _ 03 Oeo- )9-953 OR: 39H [. l9Ti a,rri L tliati S ♦ j 'yEq 6. - � Le Receipt for Certified Mail Receipt for Certified Mail Receipt for Certified Mail _t P. .. ,f Rr,. .�tkn,� Palrici.9 PA- Clalk .Ir,',nn✓ G. Canal-gar' � , E Esse>. tree: 55C Cscdood Street 574 Osgood Street 91 5 Nn,T'r Aid North Andover, MA 01845 i oto - Z , wai.d snia,u` u Receipt for Certified Mail I Is o�sl,,i saN�e m s..�, m F o< a ,orh Receipt for Certified Mail Receipt for Certified Mail III !a a„P. n _ �.-. c,o,'o . al lJ, 51e-1,1 .� wi n, r . rlo�kwull � r [rs r Pa!rl cr Mary Chsres Tr isT t h ,hard e, Palmer State S reet Bank C Bon 512 06 C) q ,,t Sneer 215 Prar k in Street N�_tli Ai dme M,A Q1 S45o ,u, MA O18 Y `—a Boston, MA 02110 s_ � �/, a am a�.a ro� C LOTRrP 12/29/99 10: 18 TX/Rx N0.7765 11.OU � �re e>rts vJ aJ l' -oa Uac- 19-99 OII= 39A CI F£or-r( Receipt ror Certifieo 'Ma's Rece pt for Cartiied Mel, Rec 1pt to Cart ifled Mail rc 3 QW �� plmT Ptrl East Strc2l _17, � ! - 5 "�' `�• h . t',�:. o 5 a � n� i Receipt for Certified Mall 6ece' pt for Certified Mail Receipt for Gerfdled Mali I T 12/29/99 10: 13 'IX/RX N0.7765 11,004 r �. _.- D E P A q 1 Lf F N T Jo 01/00/00 15 30 TX/RX NO. 7853 P.001 TOWN OF NORTH ANDOVFR 01'FICIi 01- TOWN CLERK CO MAIN S"IRkiFI NORTH ANDOVUR, MASSACI RISI I I S 015a1 e 19iv�e A_ Br:�dshaw/a ,Cl��rk lnphnc (e73)6BS-��Vll FAX 787 F ACSIMILE'IRANSMI"IT M- FORM ADDRESSEE: ✓✓✓�� // NAN� 6�/WI FIRM: STREET: F.kXNUM: FROM: NAME: .IOYCE A. BRADSHAW DEPT.: TOWN CLERK 111) MAIN S'rREEI' NORTH ANDOVER. MA 01845 'TELEPHONE: (978)688-9501 FAX NUMBER:(978)688-9556 TOTAL NUMBER OF PAGES, INCLUDING COVER LETTER: ADDITIONALCOMMENTS: J 1 _S1,ri�U/hyLd - 1111A.�L-4,r..0yv �i TOWN OF .NORTH ANDOVER OFFICE 01 TOWN CLERK 120 NIAIN STIOITT NORTH ANDOVER. ` lASS,501IUSFFI S 0I845 Joyce A. Bradshmc e I clephone(978) 688-95111 F%X (978)688-9��, FACSIMII E IRANSMITT.M FORM DATE: v ADDRESSEE: NAME: FIRM: STREEF: CITY: FROM: NAME:.JOYCE A. BRADSHAW DEPT.: TOWNCLERK 120 ,MAIN S"FREET NORTH ANDOVER. MA 01845 TELEPHONE (978)688-9501 FAX NFMRFR:(978)688-9556 TOTAL NUMBER OF PAGES, INCLC DING COVER LETTER: ADDITIONAL COOLM:MENTS: LLjL�-lZ-txC-LC. +2� EDGEWOOD RETIREMENT COMM] 575 OSGOOD STREET NORTH ANDOVER, MASSACHUSE' PETITION FOR LICENSE PURSUANT 3 To: Licensing Board Town of North Andover 120 Main Street North Andover, Massachusetts 01845 L Edgewood Retirement Community, Inc. ("Edgewood")is a not-for- profit corporation duly organized pursuant to Chapter 180 of the General Laws of the Commonwealth of Massachusetts, with its principal place of business at 575 Osgood Street, North Andover, Massachusetts. 2. Edgewood is the owner and operator of a continuing care retirement community at said location, with buildings for residential and other uses. 3. In two of the buildings which house residential units, there are garages under the buildings. The buildings are designated as Buildings 2000 and 3000. 4. Residents use the garages for the parking of their motor vehicles. The garages currently have 25 cars under Building 2000 and 11 under Building 3000, although the capacity for each garage is greater than presently used. 5. Attached to this petition are copies of the applicable statutes which set forth the requirements of a license for the keeping, storage, and use of inflammable fluids and compounds, including crude petroleum or any of its products, inside a building or garage or other structure, if there are more than three motor vehicles are stored. 6. The applicable statutes are Chapter 148, section 1, 9, 13 and 14. 7. The buildings and garages wherein there are parked the motor vehicles described are fully sprinkled, in accordance with applicable requirements of codes and other requirements set out by the Fire Chief of the Town of North Andover. 8. Edgewood respectfully requests that the Licensing Board issue a license for the storage and keeping of said substances in said buildings and garages. EDGEWOOD RETIREMENT COMMUNITY, INC. BY THEIR ATTORNEY: 1 ' i lifford E. Elias, Esq. 112 Chestnut Street North Andover, Massachusetts 01945 Telephone: 978.686-1092 Facsimile: 978.696-5955 ACHU5ETr5 § ] FIRL I'HEV'rN r[ON C. 148 and Storage Tanks. — - — reformation; Ins eetion o1 Auto Cite'a:Cases and annotations referred to herein can be fur- Related Records. the, researched through the Auto-Croo computer-assisted ¢search service. Usc Auto-Cite to check citations for form, sis Upon Violation of Sec parallel references, prior and later history, and annotation Lreferences. 38B 'I brought 381. rtaining to Underground § �, Definitions. kggrieved Tank Owners. work BI thi-s rhaptcr the follnwmg words, unless a different meaning a nymred by (hc I I niext or I$ sprriall}' presn"Led' shall have the fol- s to 'iug nlcauings. of Fireworks. 'Board the bound Of fire prevention regulations established red Storage of Fireworks. under 1111i011 four(ecN of rhaptcr Iwenty-Iwo. •works hibition of Fireworks; pro 'Building" a n,of Iouon of :nay line 1 a t whether pormble or hscd, havvrg 'I ,of Io linen a at nno urc for the shelter of persons, animalso,plopern'. Fur the loupose of this dcliuioon nlbf'shall r Railway Signals Classed i'(1 au zu nmg uI any suml,o loam q, whether or Hot perma- and Requirtment fur Sig ncnt in Harm, hho word budding'- shall be cons reread where the J CC ntcxt allot ' as though followed by th< words ",)I part or pma a Ihueol." �. ed; Limited Exception fix t Onunissinner Ibc cOmn1111loner Of public safe(} of the com- mONII alth_ "Ucpanwcut". the dcparuuenl of public safer p. y, flammable Materials Ilk DIvISI011 , the division of fire prevention I)[ tho deparunent of public sloe - § 50. ll" f ni the in, rI( partnu ut ILv chief <xennrve ollieel of [hc III, depzrintent ,, a ,it, ( awH or lire b""(t having u¢b an o4 h' r, utherw use (h,fire ronn..i"I net, board of fire t nnnussl )nely or Cigaretes Prohibited; r lilt enyn, nrers, ur f[uonnr vouer of politic safety; and m [,),]I, no( heclog a In, dep,,,Nn ot, the rhicl en girl it airy, otherwise (b, chairman Of the hoaol of sclerl uncu. hicle Lighted Cigarettes " "lusprctur". :w insper(oI or pobre ullicer of lh, department of public alctl Local fieursmg mdtorit6 I I (oa ns, mcluduug those tot Hs which ices; Penally. ::.. Mseadopted o I inanag<nn"( fore Ofgrvernrrn(nt iheheard g Capable d Conducting f ( et C r HI B .a n No I ud of sue a mmmissl Ie I s; IN I-"- ( u b a mg ;oil I Led one (If the pPlns 1 gc 'ernmC u pl Oeirled in I the hCCn61n board or rom- stalling and Servicing Fire h Ipur fn h th cc, fie toCOLORof o 6 w ssum in .Cl, (On 1 11111 ICI 'ueb a ho and or romnu ssum Is au- u Homes, C.ondominiur th> ,e I b st ltu(t or C dHla se to giant licens s Nude, this (s Requited; Use of I I rt ; II C tl I ones J (II board ni Idu men. < I it,, I ,ulsing u� ermcn I Same I oard or(o uIussloll uI in s wherci such a board oI cmnnli[.Yion 11 I ANNo'rnran I:AN'S or M kSSACIIIIS6rr5 § ,[ 1 s aulhorizcd by sLanne or ordinance to grunt Bevis(" under this jehaptcr; provided, that in any town hervmg over went) thousand inhabitants, an unpaid licensing board of due( members tray be appointed or deshgnmed bt (he board of selcrtnhcu to aet as the lirennng a ltholn) in I"unlg licenses fah garages for uotmore dhan II uvo automobiles or uhotot sdfid,, in rase the board of aldermrn or eilp council col L<lilute 'Inli anth"In", alo hearmg required by I This chapter Iuav be If, bc-forc if ronnnatee thcrcof. "Marshal the state lire marshal. Stnstnrc mbmv inn of nI N nal t s ndncd al a fLsed luea- I. n m t i gish supp n I 01 he he I if n a building trlmes'orko tei fining s- ll it in, re du ng stand platform bin Iota sign, II Igpok. mat 1 radio aulcnna or I he I Ae I In wot I SlnleutfY trill be construed, where the romext all,,s , :u Ihongh followed e by dhc rcords "or pan or puts tLcn A I ]1 1 f L , § 1 1910 ill. § L 11.3 . 102. 1915, 4 70, I9 i 30 § I- FU to IN 1953 d d I f h 1 1 - l l e I I it S,won 2 of it,, h c I 6 Aft d as h II � 1 sq tt rvs- N I I g-f.nno d 1 I Ic I 11 II ap- 'glh 1 of ih, Cral I m II fI P t f d -h :1 III i 1 �� s I it Ius' h 1 lf h g b r on d I r = la n,,if man g oh )if,deli egi t I tin" l - - Iho l I I u, "'a how, I F I h I 1 1.......... I ln( s 52: (AIK 2001 1 I I_ s la N 1 I u. P I Ii n C 19) i� A.IMA'st:ans— If II II t 1110 I IItiCS S t I InQlubnng d ig� 1 h -hla h . I Ip"", h..r 1 h Ie r.rhlr me l 1, hae.h a of e l I § s e GI Al It I'od h l l + II _ASt hNit;k.fl ihl 6 : h:uIh 1 FILInH, o I .._u I so I -, RLII, (. 1 . IRhou h fo. do a A' of o 119'%1 a U Is I NI: fL9. tl 11 I6d1. 11 1 I I-. 'I`avk iidi b I t ha I n 1 +u1 10du 1 of xtt 1) 11l ., I k rigl l i l li. hg N" 1oj N I1. A i1. it it 1 110691 ell I - nh i l II i 11 '3oAI W IItNEM 1 . aJ°� MAssnnuusE'ns § 5A g FIRI Pa6AEN'IION C. 148 �TBS designated under section Once, 'fhe marshal shall also report to the K11.1111 imc ... < n ,do dnq head Of the fire department the results Of alit investigation into fires violate Fq of P-111111111 d Doc Pile" of"""moos origin repotted to Into b, such head as rcqu,Ied by sec- ( NW Ibn 1 F e H-lo SO,l. r Lion two. AI u, (I )81 UC Ms) fill F Sapp 1079. t History- ' 1010, 328. § I; (A. 1921, 118, § 9; 193q 399, d I: 1931, 38.3. § 2- 2-5 by officer. oho wilfully orldr(e, or refuses t, in imposed upon him by the Inc- § 9. Rules and Regulations for Explosives. ay a line of not less than twenty- The board shall make rules and regulations for the keeping, stun �Ilars. age, use, manufacture, xalc, handling, transportation or other dispo- sition of gunpowder dynamite, etude pctrolemn or any of iu Prod - 102, 32, §Q GI 1921, 118, §7; 1930, Otis, or explosive or inflammable fluids or compounds, tablets, torptslo" ou our ezploslvcs oC a like nature, or env other explosmcs, (neworks, lrecrackers, or anv substance having such properties that TOTES it Tray spontancuusly, or at under the influence of tnry 1 onugu- i,S - "all ILK P .I " ' ous substance, or of any chemical or phvsical agenev, ignite, or that a wdtol 1-,idi nl dill, dmy ,, If,, inflame or generate inflammable or explosive vapors or gases to a 1 1 I habl,aadll 111,ale m dangerous cxtem, and may prescribe the location, materials and 1 Cmu, llh T Uixn, 12671 N� ., 120 22 NP2d 919 construction of buildings to be used for any of the said purposes al . Suit, rules and regulations shall requite persons keeping, stonng, us- ing, selling, manufacluriug, handling or transporting dynamite or other high explOsrvcn to make reports to the deparunent in such particulars and in such detail that the quantity and location thereof Tally, bcbutu Februarc hliecuth, a will always In a matter of authentic I... ld in the department. Cities in relation to fires to the commis- and towns may also make and cuhn c, ordinances and by-laws, not aody the material portions Hereof inconsistent with said rules and regulations, rrlalive to the subject matter of this sellout t F.ach city or town shall submit a mpv oftrncll .udt ordinance or by-law Io the board within ten days after the pas- sagethereof Any ordlname or by-law regulating blasting operations, R1. 1902, 4 N 1902, § fl 9§ I, 2;1930, or the use, handling, tansportation or storage of dvnanrhe or 95U. y 10 L; 6I 1921,1, 148, 4 ; gunpowder, shall not take effect until uuh ordinance or bs-law is ap- proved by the board, except that any such ordinance or fit [all that has not lean approved or disapproved by the hoard within nines' ampanies, Property Owners, Fire days after the receipt thercol'shall he deemed to have hill'approved. ed Persons. History- isurance companies, to owners of 1871, 6, § 2- 1877 216 §§ 4 5; 1878, 6' PS 1882, 102 §§ 51, 62, 63t f21, erected in the subject naull of:m 1902, 102. §§ 87 rib 94 19 100, 1901, 370, §§ I, 2'. 1905, 290, § 1; 1910, umstances of a fir(- any information 565. 1910, 588 §§ 1,2; GI, 1921, 118, § 10, 1921, 273; 1921,485. § '2, 1930. r,h may in his Opinion require et- 399. § 1. N-15. 710, if 8', 1975, 761 companies, owners of prop(ON or j met of the its of liostOn shall make Editovfal Note- I by him of by a person by him The 1975 amendment added the Iburth and lilth ontm c clau,e In time l00 351 CUCSLITS § l0E § 13 s'nory G. 148 CASE NOTES '1 I d: th l 111 -t n L :J- eoollg tile n e ro nusfnne- f p ry n a K yt l:t ins, hPK 11th, v ,1e Ic 11 -�wd�U ]/19YH OI 1f.. Nu. It". he hal ie vqn, red nor nd 20 :al, 801 GMR 4.00 . ,ppru,. wulu-findAppropriationIn +all111 ,u . J § },]. Appropriation for Expert Assistance and Laboratory. 7 ice and Classes of Certif The euntmissioner n av expend the amount muutally approptialed .� Cor the culplovmcnt of cxpert asststate 1, and dso for mamt'd a labor uury to aid iu the nrfon e7ncnl of the laes re lathe to t xplosivcs :ales and regulatioos as it and itdlamma1& fluids and compounds. Expert assistants employed lvpes and classes of(Old ttilde, tilts section shall aid in ill( ao di>rteulent if 'all laws, rules and ,,,-I installations A leldfl regalauons which a I, ill, duty' I the dcparti tent to adminnster and of installations or may be euin"', and shall putolm suds other duties as the QHnmt6l( laer may ptcscribc Said cxpert :ofrstants shall be esennpt III)... rhzpler thirty-one and tic rules and regulations nnade thereunder. History— [911, 4 1, § 1; 191 220, 1916, 65, 9 1. I918. 'T, g 1; (d 11121, 1 18, § .f Certificate; Appeals. 12, 192), 2,5, 1924 318, 1930, 399 § I. 4 of heanug, b,. suspended or a the cerdficatc holde"A anc and relative to moslntction, 12. Manufacture of Fireworks or Firecrackers; License and N r equipment Am applicant Permit Required n holder n1 such terdficatt No budding shall be used it)' lh< olauulaeplrc of Ilseenrks or m refusing to Issue or In firer sackers without n 1?cnx, (")III III,. Inad bcensing author IIC and a ua}'. within ten n Go days, appeal peult o the nralshal_ the dcpartmcnt, who shall 'it and to nnlducl a hearing History— men of said board shall be 1910 565 4 2. CL 1921, 148. S I 1 1930, 399, si I tl Code. of Massachusetts Regulations— Maun 'ol,c, offrelrotks, 527 (AIR 201 Total Client-S,,c,ice Library' Rvferenees— equired to Hold Certificate; 31 An,Jus 2d, Fsld... s anA I(NO".ives §$ 5i, SS. turner Technician- s business (If all( rcpan- I shall be required to hold a §. 13. License for Storage, Manufacture or Sale of Explosives; provided that such work is Removal of Hazardous Conditions upon Cessation of Use of d as oil burner nrhniduns. Structure for Keeping Explosives; Revocation of Unexercised Li- censes; Appeal by Person Aggrieved by Issuance of License- No building or other structure shall, except as provided in section 363 6i I .;. 948 Arcvo'cr.10 l.aas 1 IAi ass:u.unsl'-rrs § 13 fourteen be used for the keeping. storage, manufacture ur sale of any of the articles named in section lime, aides, the local licensing �. authority shall hate granted a liccnsc to use the land on which surh building or other structure is or is to be situat d for the aforemen- tioned uses', after a public hearing, notice of the tune and place of which hearing shall have been given, et the expense of the applicant, by the clerk of the cite or of da Imtal htensmg a rlu...0. by publicca- ❑rot not less than liven drys prior du)I tc in a uoespaper published jlit English language in the city or tot n wherein said land is situ- ated, it there is any so pabhshed therein, otherwise lit d,. county in Which such uty or town Ices, and also by tic applicant bt registered mail, not Icss than seven dais prior ro ,lit h hcannq, to ail oea.cns of real estate abutting un aid land or ducety opposite said land on am public or private sweet its they appear on the most recent local tax list at the time the applit anon for such htensc is filed, and unless the application hot such lia.nse Shall have endorsed thereon the certih- �� tale of approv il or dtmppt t itl of the head Of the fit, dcpartmen_ Sidi liccnsc h ll I e t crotded Ill the old a of the ent Ol O,n deck, ij and it shall, II m Ih< rim Of tit >,.aul.nr, tucotb ILe hecnsmg u.d. utr be I I a gt n ntuhung Io Ill(' l ...I d utb<d .herciu x uu1 t w uutduu 1 mnu htp thtIr f uming with tilt In, and tf' 1. dI u a be tit utd L m .ek I p t I ricih lac \m lc",' t,Ial n d hers dtt (It alit hut nu fir the A l I g, .I t),c. manaLu t meat sale of ant nl the :alma' named in seclinn nine.,gr:nucd prior li to Ink fans, nin['II'en bundnul and lu tv-siz, ntd lid ng an I ,, ( t t= t ni'Im'd an nIi nc.l 10 tit I ranslttl t hcrcnt la . ed shall !], t nun in Ili u 1 and until I,okt d a, II r inafic pt t- Ic I. :Am II lith I. tnse RI tin I hrrt.....lu hall b abp Y trI u ("u'llnon, and I 'al nn n V, nr, hi pI robed in II Ilcena bt tit( baal It n 16 ant. t {.ich n Inn I tic: ndlli n III n I Im htcnsn be xc I .o utl scant and tt Ihhl 'O It pc .od as on LI fixtd t ifi �5 nth tuth'n it I the •s ip,Int I al land I cn . I in 1 r itltd lit 1 th h ldu 1 tin liau c 1, thr kel I Ira Oa, g, .i mil` Iwc ' t s.1 Of ant Il III nin rim ul iu tl. I One. gt un I I aor In � . fah IIrnI, nuutcen hnnh I and tLi.n .c iu IrdmK tin ll, u'c t t t l( 1 l< n u " l l), h nvsLal t l III I r Ids kill au mall . n I rlot 4ptiI II Ilntth ills t Ith the rhak f tilt lc o. wLur <6 II t Ise ie t 1 I h:I,. he lit o c d, o. a. .. ... n wilt ILe fire conuuisairr ou . or in ( ann1l,91r,r, t.,iih the Loa rd of li- anc aim ne"l . a Cc.tiht:u(' of l( e"Ir:IGun 'emng tort6 the ' nt and art b l the b I h l Of auth h l c la ✓ I d. that zl�i Iihcate of I 6 tr: .ion skdl a rrgtll I f c buddloq Berl a. I ganago for ....tinµ nl out-. .Lau tlnt "hill" wh<a once ,,l t ` uudol .urh fi t n.c l h vd n c It I rcecl ibr .I t 7til L f C 148 71NNOIAIIAl I,A'S or NIAssnt.ut.IIA IS § Y3 S,I,,cuo of Ilahwi (191,1) 326 It 11I 1 L. n blcm ']loge ni Lot 778, 95 N1(2d 870. in'In donlzloflhcpenoh.JollnsonPrud- W horn, aher tic denial of i In,i10 by urt., Inc v (" (lounol of Medtoul bo -1 I :.I toun, -: , Iu 1 II )C ) 3u11M .10 .f3M2d31f,mr fccn g t .-tq ludcl ths lultstit x 1 .nd e11 thound (1969) 39 US 296, [tic 1 nioncl Inouglit l C i I. 20 L h:d 2d 1108 68 S Ct 20Gl_ of(crtnrari on du pit and that one N,. of dal ial of 11 nd.1 ob Cl iib .i10 1 -Ix6oitdh: " i o� Ann in R it drqI Ih 11 9(1 Ili,-iil I -in, if I 1 I d on IFcId I.tt. i 1t ILindI i ", 'it I I'll 11 Ice of 1111 toll I I ding lotI I rewn 1 tl t dot u m d l ite 1 I L I I A I I Plod ., in, cut 1 .r t 111, Ih dol,al, ( in, I .fM (Ifni I(1967) 3 3%1 IF10, In I hat. Im unit A Ik, d of 233 NL2d 310. Ltl i I II tint pp tholld IF, Flood i'l,ind lF., nfint0 h8) 392 11 29it Vl 1. Icl 2d 1108 88 t ......... 11 ,apph Ib S ( I oG1 1 a In Horno olooll_Alb. 11 ..... . t i , Sd ni n .f Su.t I I 11 1 (1960) :111 30A)i. fph<:I h I- v of d. a No.z I )1, 170 Need 18: . 1 Ill Illoc orlicl IniLloott-inlo-J i 'No nolin on it l 1 1 1111 11 1 1 1, ' AI I I t I 1111111.-,l I All ( .i. (It Al-Ilorl adb to I I (191671M3 IlL 10 233N 131r. .� I t I d d apI d I (IAIS) 31 US - t non. lu.-.6tl .9001 .01 Id 2d 110888 S(c2061 1 i Inllannnable Iluids in Motor Vehicins. a Gasolinic or any other volatd( inflammable []fill which emits n h vapor at a temperature below one hundred degrees Pahrcubcit white Iw v teatcd in the open air shall, whore in ally motor vehicle which is if, a building or other structure, be deemed to by kept in Stith building or other svtuuue wulliu We nicauiug of the preceding secuon, pro- �I vidui, that ]List secuou shall not apply to nm building m eNataicc nu .Jule ]list, nineteen hundred :full cloven, in which FIFO more than w,, intoumbiles or motor vehides are kept if such building oil foul thereof is not used -IIhOr li.0 human habitalI'll ur far IIoldnIg gatbcr- �� rigs Of moll Ih1fl hccnlc in r fur gising tullftilinnnmt" inslnituon of cniplo)r till I. uncut than that uuuihou, to to fill prftalc garage out III "istauce mu mid julc lust which is an appufi IF nanoe to a dwclliug and Fit ohlch not more than Ihice automobiles of III'. no,olf cclydes ale kepi. 11 ru lull 4 7, 9 I. CI I021, 118, S 1 , 1921, 181 § L 1930, 399, § 1; 198N. 103_ :;-e F r u,•'and sus - ih d1 blo li,p,o µncivdlc ALAI GI.t I-IS _3 -„ 1 r.= i .•. n2el e.nsee— R (. ] Ih.q t . 1i1. 376 �I FE CLIFFORD E. ELIAS COUNSELLOR AT LAW 70 EAST STREET METHUEN,MASSACHUSETTS 018A4 Telephone(978)687 0151 Telecopier(978)685 9132 December 22, 1999 Town of North Andover Licensing Board 120 Main Street North Andover, MA 01845 Re: Edgewood Retirement Community, Inc. Dear Members of the Board: I enclose a Petition for License Pursuant to G.L. c. 148 in behalf of Edgewood Retirement Community, Inc., which requires such a license for the keeping and storage of gasoline and inflammable materials in buildings and garages. The petition is self-explanatory, but the license is required for Building No. 2000 and Building No. 3000 on the premises at 575 Osgood Street where there are fully-sprinkled garages under said buildings. The Town Clerk is required by statute to advertise at least seven (7) days prior to a public hearing a notice of the time and place of the hearing in a newspaper published in North Andover. The applicant will pay for the publication. If at all possible, we are interested in having the hearing on Monday, January 10, 2000. The applicant is required to send a registered mail notice of the hearing to each abutter and those who own land opposite the Osgood Street property on any public or private street. The license must have on it the certificate of approval of the head of the fire department. I am enclosing the petition in sufficient numbers for distribution to all of the members of the Board. Please call me with any questions. Respectfully yours, Clifford E. Elias CEE vmk Enclosures EDGEWOOD RETIREMENT COMMUNITY, INC. 575 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 PETITION FOR LICENSE PURSUANT TO G L c 148 To: Licensing Board Town of North Andover 120 Main Street North Andover, Massachusetts 01845 1. Edgewood Retirement Community, Inc. ("Edgewood") is a not-for- profit corporation duly organized pursuant to Chapter 180 of the General Laws of the Commonwealth of Massachusetts, with its principal place of business at 575 Osgood Street, North Andover, Massachusetts. 2. Edgewood is the owner and operator of a continuing care retirement community at said location, with buildings for residential and other uses. 3. In two of the buildings which house residential units, there are garages under the buildings. The buildings are designated as Buildings 2000 and 3000. 4. Residents use the garages for the parking of their motor vehicles. The garages currently have 25 cars under Building 2000 and 11 under Building 3000, although the capacity for each garage is greater than presently used. 5. Attached to this petition are copies of the applicable statutes which set forth the requirements of a license for the keeping, storage, and use of inflammable fluids and compounds, including crude petroleum or any of its products, inside a building or garage or other structure, if there are more than three motor vehicles are stored. 6. The applicable statutes are Chapter 148, section I, 9, 13 and 14. 7. The buildings and garages wherein there are parked the motor vehicles described are fully sprinkled, in accordance with applicable requirements of codes and other requirements set out by the Fire Chief of the Town of North Andover. 8. Edgewood respectfully requests that the Licensing Board issue a license for the storage and keeping of said substances in said buildings and garages. EDGEWOOD RETIREMENT COMMUNITY, INC. BY THEIR ATTORNEY: /Clifford E. Elias, Esq. 112 Chestnut Street North Andover, Massachusetts 01845 Telephone: 978.686-1092 Facsimile: 978.686-5955 FIRE PRr,aennON C. 148 4CINSETTS y 1 and Storage Tanks. nformation; Inspection of Auto-Cite®: Cases and annotations referred to herein can be Cur- Rnla[ed Records. ther researched through the Auto-Ci[eG computer-assisted resraroh service Use Auto-Cite to check citations Cor Corm, sis Upon Violation of Sec- parallel references, prior and later history, and annotation references- 3813 Through 381. reaming to Underground § ], Definitions. lggrieved Tank Owners. works. In this chapter the tollowving words, unless a dilfecent meaning a rcquved by the comrxt or is speeiallp prescribed, shall have the fol- lowing urcmungs;— of Fireworks. 15oard", the board of lire pmrcuuon regulations established Ed Storage of Fireworks. under section &vtrtecn of drapt cr twenty-lwo. eworks- .. Inc�thcl ortablc or "Building", a combinauun of .ury Inatulals, ' p hibition of Fireworks; Pro lined, having a roof to loon a stnnune for the shelter of persons, animals or ptoperty. For te h pulposeof thl <Ichnition tool ' shall r Railway Signals Classed 'A include au 1 m Ig ol any sundFit tole log whether or not penna- 7 and Requirement for Sig ncnl in nature TLC word bud<hug" Shall b construed there I ,, I RTItexL allows as though followed by the words "ol part or parts ihetcoi �. ed; Limited Exception for "Couunissioner' the mount,+siouer of publu safety of ILc Com- nuutwralth_ k' "Ucpartnuaii'-. the department of public sality. t. ,flammable Materials Ill,- "Doe,R)n", the dn'isiou of lire prevention of the department of public aahay. _ § 50. Ile , I of du I ,< Iepanu 'ro IhC filet cXC<utnr gHn:f of Lhe III,- dcpartmeol III t rile town r- fire drstnt I Laving auL au of- Lle otbenwis< (Io I is Cununt r mer, bond of fire a nualssioncrz or Cigarettes ProLibited. I for engine r ul mmr uxt mer offublu safety'; and, u, towns not having -I lire departnu- ILe chief engineer, if any, otherwise d,c Chairman of the board of selCCuncn. hide Lighted Cigarettes, "I nspecun11, an inspCClor of polo, oflicer of If,( dcparbnCnt of i public safe[y. Local licensing Iluluerity-1 ur towns, utClud ng du»e towns wLich nes; Penalty. have edopted x town nl21)lgunult limn of goven,me m ill, board g Capable of Conducting f :<ICttunn Billion, th< hood of.ue<t e nnmhvouus; in eit- i < Irtving d prod one 1 it, plans of g ,eminent pt >widcd in stalling and Servicing Fire .S 1 rpter fntlw rhru the t th uncil, In d c hcensnlg board or<om- roll000 III u<b cm w.-I ru w su Ir a bo ud or ronuntsvon rti au- onnes, Condominiwn th< O,I bw Umu r < Idu - nre t< gr, i licenses under this on Heroes, n,Her Required; Use ,,pier, I, the -tuts, d 1 -ud of Idc ncn, t nc� licensing ,ho'cd ent S ire_ I u-d or a uunrcvon m t u <s wshe rCtn h- board m <ommrssion i 341 t8r - C. 148 ANNOTAIELI LAWS or PJAS.59QmsETIS § ] is authorized by stater, or ordinance to grant hcCnSCS under this chaptel, provid,d, that in any town having over Iw,nt� thousand inhabitants, arl unpaid litenemg board of Ellice nhcmbers may be appointed or designated by the board of Sclectnlen to act as the licensing authority in issriug licenses lire garages for not more than two automobiles or rooter vehlds. bl rase the board of aldermen or city anrr,d co,r,Litute such authority, any hearing r,quircd by this (ballet inas be held before it comnhiuec thereof ,Marshal the still( Ine marshal. "Structure", a anubinatiou of materials asseurbled at a fixed loca- tion to give support or shelter, such as a building, framework, retaining wall, writ. reviewing stand, platlbrnt, bin, fence, sign, Il hgpok, re,a for radio ante ma or the like'1'he word ' Immure" t sball be rousoued, when the (anew allows, as though followed [1, the words o pan nt put thereof i PS t y- 1914. 795, if I I )30 sift), § I, 1952. 102, 1145, t70, 1953, 230, C I_ � ( Ed u I Note— �� [hc 1453 amc d V "E'Eal Ill, I fniu f 1. -d II-. g author ill Sut 2 <1 de d g Air F,A, it, 1 II S,,,m 2 No IF n I td FIE11,1 I[EIIIIIIlettldt,d ardI t egll 1 )I ]I,. Ee all p ' I (it, Olvmvcdm I Itt .IdII le I 1 1 hull, be(,I S I I'd b a r e t I Ku IF lis del "'I" I 11 11SI Iisdh, l - II 6 d ktI ( d fMas: 1 setl. R .gulato s 1 l n(I board,- I'l I I d m t I ve hcKulaf Is, .Y7 (:hiK 25001 or : ,I M tTotal C I ri-Se Lib It t nras H W tut. PE,.10 I I § 2r199_ II bl K .ft 111IIIIIII, Ilelatr IS I.SC S § 814(] I - i le 4 d "ye or I E ¢uo I olII p n I ,,If er t, , n r tha he uznN of tSl I I, (it AIR led 899 rt C 1SF NOIl:S I ill 1 Ihal II 1 I(Iltlogt I1,o,FCI ti_ f ce 'it(], < 1 I fool" I 1 r Ill, r S ref. If FEE (I 127) 260 N . _'AS 157 Nr-C J. 11 11 llulAk III Ilk lalit d ' Ln141,P, o"t IlladLeg Okotllles ��k Ilti IFE-01 1 I�`II '"1 I . Ig 11- i 1 fIII Il kita,Iln , 11 1I 1 .Ilsl lild I I u1t N(, 1 II V II. L It It It. ( II'J6I1 IIId. I 3a 71.w _I L 143 NLN- I'. o our 9 ' ding afim tA". I n 1 ,1o1d. enol,who 342 0 ,N4ASSACnnSEY's § 5A § 9 Flee PRIATvrton C. 148 )TES designated under section If "I he marshal shall also report to iha s u :, 'mers,;vr commerce no-a„ the, head of the fire department the results of any investigation imo tires I , ko, poat,eorl red Dc 2 " of suspicious origin reported to him by such head as required by sec- el _Nr. -Ih Hv, Aso. . Mas ia se,u (198 DC Mass) 6,3 1' firm two. Supp1079. History- 1910, 328. § I; (;L 1921, 148, § 9; 1930. 399. § I; 1931, 383, § 2. § 2-5 by Officer. vho wilfully neglects or refuses to III imposed upon him by the pre- § 9. Rules and Regulations for Explosives. >y a fine of not less than twentc- The board shall make rules and regulations for the keeping, Son- llars, age, use, manufacture sale, handling, transportation or other dispel Anonof gunpowder, dynainitc, crude petroleum or any of its prod- ,02, 32, § 6; GL 1921, 148. § 7; 1930. tots, or explosive or inflammable fluids or compounds, tablets, torpedoes or any explosives of a like nature, or any other explosives, fireworks, firecrackers, or any substance having such properties that K)TES it may spmuaneously, or acting under the influence of any rontigu- R I `d, the pr p.:dh.0 oils r substance, o of any cheutical or physical agency, ignite, or it a vilful hoodl of their dui lo, the inflame or generate inflammable or explosive vapors or gases to a t paccobibit,Itoderme-IIII'll dangerous extent, and may prescribe the location, materials and r Coma I,11 a no,.0 (1967) s52 M.s.420,225 uE2d 919, instruction of buildings to be used for any, of the said purposes. Such rules and regulations shall requi ,persons keeping, storing, Its- '. ing, selling, manufacturing, handling or transporting dynamite or other high explosives to make reports to the department in suds particulars and in such detail that the quantity and location ,hereof tally, before February fifteenth, a will always be a matter of authentic record in the department. Cities in relation to fires to the commis and towns may also make and cutoice ordinances and by-laws, not vilify the material oitions thereof inconsistent with said rules and regulations, relative to the subject matter of this section. Karl City or town shall submit a copy of gaol such ordinance or by-law to the board within tell days after the pas- sage thereof. Any ordinance or by-law regulating blasting operations, RI , § D 32 § 8; 21, 1 8, ; L 2: ' or the use, handling, transportation or storage of dynamite or 350 § 101�, GL 1921, 148, § 8' 1]30. gunpowder, shall not take rffert until such ordinance or by-law is ap- proved by the board, except that any such ordinance or by-law that has not been approved or disapproved by the board within ninety ampanies, Property Owners, Fire days after the receipt thercoCshall be deemed to have been approved. ed Persons. History- iswance companies, to owners of 7871 Fi, $ Y, 1877. 216, $§4, 5; 1878, G. P8 1882, 102, 4§ 54, fit, 63. kI. crested in the subject matter of an 1902, 102, §§ 87, 88, 94, 99, 100, 1904. 370. §§ 1, 2'. 1905, 290, § I; 1910, umstances of a fire any inhumation ' 565; 1910, .588, §§ I,2,GL 1921, 148, § 10, 1921, 273; 1921,485, § 2; 1930, hich may in his opinion require at- 1399, § 1; 1945, 710, §3; 1975, 764, companies, owners of pioperty or i mer of the city of Boston shall make Editorial Note- I by him or by a person by him The 1975 amendment added ,he Courth mid fiC�h sentem'cs,rele,ivr mdine f50 351 ';s,:•_ '�c� . tit �. 363� 377 c;uose'rns' § 10E § 13 n-non C. 148 CASE NO IFS he cords dvc. dolPrs in RI ( ,� cu —it nl- orizing the annmrssiomr of Ihdc- f tl 6 I t 1' -t I - 1 l l ^p< t1cs, Pmrni Rg I' IIR3 11 I n& pp —1 1J 7/197S01 AG NI, hm F11.101.1i Is nryow ed 10 0 26 vppa,vc undo-h,d b lrn 1n .uueuom -al, 801 CMR 4,01E § 11. Appropriation for Esprit Assistance and Laboratory. '1'be c...... sionct titer expend the amomu annually appropriated me and Classes of Certif- for the cmplo ment of expert a,lal,nce and also for nlamtalmng a rules and rcgulauous as it laboratory to aid ill the Cn1i,ICemenl of fit(' Iaes "Jam, to exploasos types and dassc, of ce It and iullantmable fluids and compounds. Pxpet t Isastnuts tMploycd undet this ,ccuou shall aid ill Lb, cnlLrcn nent of all laws, rule, and ner installations. A certlfi- rcgulauous wh[,a a is the dun• the dcparu a, til ,(mints...ant of installations ur may be mdou c, and shall petlunn sorb otbcr duties, as the comvusst on" r may' prescribe Said expert ussivtams shall be Cxcntpt Ikom chapter thiniI one and the rules and regulations made thereunder. History- 1914, 121, 5 1, 1915, 220,, 1916, 65, 4 I; 1918, 273, § 4, GL 1921, 148, § f Certificate; Appeals. 12, 1921, 255, 1924, 398, 1930, 399, § I. d hearing, bG suspended or e the certificate holder of any and rclauve to construction, § 12. Manufacture of Fireworks or Firecrackers; License and I equipment Au, appilclut permit Required. G ,r holder w of (h certificate No bmlding 'hall be used for die utanulal lure of hlewurks or in i refusing to issue or ill I 6 fire,al kecs sanhottt a license Gum tht Ioed ht etiviug authorin and a nay, withut tell days, appeal permit front the marshal. the department, who shall rd and to conduct a hearing History- -c,ion of ,aid board shall be 11,10, 565, § 2, GL 1921, 148, § 13, 1930,399. 4 1 Code of Massachusetts Reguhni.111— Mauufacmn- a it,, ,)Ik,, 527l'.MR Llti. Total Client-Scrviee Library" References— .equired to Hold Certificate; 31 Ant Jim 2d. Izplo,<lous and Iixplu,ivo §9 57, 58. turner Technician. e booness of alleting, repair= 1 shall be required to hold a § 13• License for Storage, Manufacture or Sale of Explosives; providtd that surh work is Removal of Hazardous Conditions upon Cessation of Use of d a, oil homer tedmicians_ Structure for Keeping Explosives; Revocation of Cnexeretsed Li- censes; Appeal by Person Aggrieved by Issuance of License. No building or other structure shall, except as provided in .section 363 t C. 148 Awxo'r,rntn i.nsys of A7nssnantsrns § 13 fourteen, be used for the keeping, storage, manufacture or sale of any of the articles named in section nine, unless the local licensing authority shall have granted a license to use the land on which such budding or other structure is or is to be situatud for the aforemen- finned uses, abet a public hearing, notice of the Bute and place of which hearing .shall have been given, at the expcnso of the applicant, s by the Berk of the city or of the local Gceuving audtoriq', by publRa- uon not le" alto, evendat pilot thctet it a new p spaper ublished I us the hagfish language in the a r te o town s [let en said lend Is sitrt- atcd d them is tns so pubhshe 1 timrcan ath"nvtse uI the touuty uI tthtch such it, of ( awn lies and also bs the applicant by registered Mail, not less than even days puor to ouch hcarmg', to at] 'mu"' of real estate abutting ou.said land or directly opposite said land on au}' public o private steel as then appear oil the most rrcent IncaI tas list at the titre the application for such license is Iled, and unless the application for such license shall have endorsed thereou till cettift- f eatc of h approsal of disappt nal Ili die head of the fit, d'partrunu. I Such lccnsc dnall e e(old,d in till' off , of the do In ncn tictk, I'll] It shall, hoot th ❑m" of tht grumug th "of bs the hccnstug= t milt nnv, bed "d t giant m aduug to the land do ,lived therein anti as an int dun I It I hq thereof I raining tr01i the Lind and ry' I dl not be tit t cd to be 111(it'll I pu u d I rnileg" Ant liccnsc I( gr u"ed hereto du. o 'Im ct ns" lot tilt keeping, storage. tuanuGt, un"a sale ol 'im of the arficics nvued III secion owe, gt<urted puor tl, �1 m lily ills(, uni torn hundred and tlino six, including no b't nso 1 P: (unstated an d es It ion, I by the oeushd Is herl'in ptosided. shall c �@ I ntain in loge utdc',and until 1" k'd as horentaftet provided, An' j u"h hit,u se gt unod hctr-tut lu shall I, soIljeel In -ill " >ndfious I IIiction I utty b l I t nibed It tII I ilm it,, h th< local i It t utg auth n it, hieh t is to I"de a e ntdnt t that tilt h uuc be f c' n td to It "'tort and uhht sail p u"d as t at be as,d hs uclt ad 'a I,, 11 c , I, , r ""pant of -f I land III ci,'d as hu ut l r cidcd and the hold I me h t eonse f the k< l uq a aragc ut uud;uhut r -'d" cl asp of d c :ut"I' ntmcd to ' turn nine. granted pilot I, hab' litst, nincmcn luutdred and thin v-six. incluthug no licutec rein rvin(ed :and mntiu"ed to the marshal us herein pio"'I' 1, shall an- ¢ uu all on of btlotc April Ilurti 'th, file s ult the clerk of tilt nu' or f� t II h it. su h I cn:e is to 1 or has I cut t'cteisl'd in Boston S nth the lire ion 'on"r. of m Cambrtdgr, with tine board of b((nsc tomnossioue ts, s tortificnte of r I gauafion sluing Forth die name and -address of tho hold, , of suds Ihanse. provided, that nil ertilicare of n gisuation shall ill' I'llnol'tl Ifx a,I, bull lion used its .t g:uago lot Mo ' tg not atnre than Ihto voldcics, sel cu ona of ondct such a 1"'n'( 'I It, hnerd ma, e I, gtd.uint proscribe (he to i t I C. 148 ANNOrAriF LnNs OF NIASSAatus E17S § 13 Sdm f Ii rlmouc 4'2G nta I f r 6 I1 r allege of Ian. 778,96 NE 2d 870, it, de-al of Ili,1 mit.jo P, d- Vilr. I11 1kc & I ofI -,I" he. I ( t (' mod of Nhdflud aI -I of 1 no r ti -I, Ilo< I (1967)353111 ,510233 NBLI 11r, a fam' g loth on I I r ni sc- d aed xl l I dlid (1968) 4121 US 296, rc It,p Cf r tooligh, --oil fol 20 18d 2d 1108 88 S GI 2001111. rit ofcco orarl on rho ground(b.00fit k1lo. of dei ial of leF ndcr �a o(Ihc mbar ofihr hozM should ha r. ant scaion rras ha had hy oppe:d iil 6....oldi,ilholvIlfer ne, . io1 Ili la tote of 1 : T not, I . 'r 1 con III' dloolf, If III Itlill Ihit Ir s.-1 "'l bt a sod I`rd bs sq ni II u loc-1—ol toe J.Yido 0 r s of d " p ocdloa1 + mo - 1 iuudI n I Lc the cn -I odhgs 'CVIA. lah 1'roduas, lur. Gin Isu , 'i nrbcr -II6 III, (e.ocl CnV12,13 If ud(196 ;tell starsb40. God Imd, sins the limo nl rhr deci4on of (19 Nf2d 31G, art den unrl app di.vud rho board, rocieell hi. olI te, nod be- (19fiA) 392 L9 21G, 20 L h:J 2d 1108,88 e the it ianor could oon fin e 5 O 2(o 1. p I< on rho m, s Albano Adm _ Piennlw All ISL p set I fS th II 11 (I It O) t11 4 o III II I - t l `I If.—I +N 170 AC2J IH fl r 1 ....... elonJI T An pll-tia fill xl 1--t I d 1 f l tl ofN1 If d dY It (116 ) ir:iM 10 231N i310, ua & a l t - �- rl l 1 :oorul d old xIl Inul (1968) 9 1S2916 ci . 1 I )Ingd flh, 201,Fit Yd l 108898C12061. 14. Inflammable Fluids in Motor Vehidcw. 'i Gasoline of any other volatile inflarmnable fluid which emits :t vapor at a temperature below out hundred degrees Fahrenheit whcu II'ii w tested I,, the opcu air shall, when fitanv motor vehicle which is if, a i lui Y building of other s true tore, be deemed to he kept in such building or other rinn('ture within the meaning of the preceding section; pro- ." tided, that (Ilis xcthoF shall not apply to an) hoAding in exisicnoe ,if d` ,July Ilra, Fuietcetl hundred and eleven, in which not of... Ihan Iwo k auto oobiles of motor vehicles :u'e kept, i1 such building or pail thereof is Fill used cithcr On lu III an ha bit aliou nr lot holding gaIIfet �i Jogs of Fiore than twenty p<rsous, of Ihr giving cnlcrtaiumen Le, iff'oo ioo of cmplutmcut ro moor Ihan that number, or to an) private gzrage m t F, eslan-n" ou said July Io,( which is an appune_ ounce In a dwelling mid iu which not more than three nolumohiles or moor vehicles arc kept. I)iYtGY3'- 1911, 177, § I. ill. 021, 1-18. § I , 19 N, -18-1 § 1, 1930, 399, 6 1'. 19:15. 1113. Cross Rcferences— KooIli i I"iis and stoiitI iuflanuit 14, hyoid.. kouac,11,, ALAI G1,r 148 9 ''3 'Total Cticu ESeraivc LillraI Referenozrr— S Ma- lui. Poao,n §2 b171 176 I Note: Completi?I.vp of form and forward bath sections and Wto local licensing authority (City or Town Clerk). Do not make application to department of Public Safety. ke ( VG!'YUJ7LC�YLC�U�j2CLG�lZ G�V��CllJdC7,GiLC!/.i21 3��,J� �efrwrGmem,C c��urro CJ e�xnrccea — �vuiaiarz a��v.� �i�iuvrzCcon City cr Towh NORTH ANDOVER OateAPRIL 30, '�Oocf APPLICATION FOR CERTIFICATE OF REGISTRATION In a=mancs with the provisions of Chapter 14g. Section 13, of the General laws, the undersigned hereby certifies that EDGEWOOD RETIREMENT COMMUNITY, INC. m 575 OSGOOD STREET, NORTH ANDOVER, MA s :ne holder of license granted FE3RUAR'i 2S, 2000 for the lawful use of the budding(s) or other smuc:ureis) sauatec or Ic os situated at 575 OSGOOD STREET as related to the Kc?!NG, STORAGE, .MANUFACTURE OR SAL OF r.AMMAKES OR EXPLOSIVES, NORTH ANDOVER - �r Note: 7 his application !or cervfirare of regrsr2ncn mus be srgned by the folder of the license it said license was granted pncr'a July f, 1936, of erwrse by the owner or oc=paanrrof the I n /;tensed. Feceivec MA'S SuornMed by [� inn lw� Gt u oc� Re���E r � C >nnen� Ty cl SCktc-\�1 a�1 Wv k :w Note: Complete ttirat farm and fcrward bath sections and fc'-e6 local licensing authority (City or Town Clerk). Do not make application to department of Public Safery. IJC�ZP'YGCC�2CL�C� G�'���r2J417,C�CRteG�1 yq �eic+GnzeovCcr° ur? triwuecea — 27vuuuin, c� vK9 �roiwmCcGn City or i own NORTH ANDOVER CataAPRIL 30, APPLICATION FOR CERTIFICATE OF REGISTRATION In acmance with the provisions or Chapter 148, Secton 13, of the General Laws, the unoemgned hereby certifies ;hat EDGEWOOD RETIREMENT COMMUNITY, INC. 575 OSGOOD STREET, NORTH ANDOVER, MA s :he ncicer or license granted FEBRUARY 28, 2000 for the lawful use of the builcing(s) or other stmc:urels; smatec:r a... '.o oe sauatec at 575 OSGOOD STREET as related to ;he K==RING. STORAGE, MANLFACTURE OR SALE OF F_AMMASLS OR EXRLCSIVES. NORTH ANDOVER cvd ,Voter -his application'or cersfirare of regrsrrana'must be signed by the naloer of the licensed sad license was gramec pncr.'o July 1, 1936, otherwise by the owner or occuoanr of all Recervea //[CCCL �� ;all ' SucralnedVA dY c r Notes e:Complete top.,.forth and forward both seotlons and fee mTocal licensing authority (City or Town Clerk). 0o not make application to department of Public Safety. �, _, � �canirrc�tue¢�� G�C/l/�a�aac�CcraeL`L`t 'efi2HGneeozC a� vrr> CJ Niwuecea — �rkauirz a� ura i�iuereCicrz City or Town NORTH ANDOVER CateAPRIL 30, r�a,p1 APPLICATION FOR CERTIFICATE OF REGISTRATION In accomance,with the provisions of Chapter 1<8, Sechon 13, of the General Laws. the undersigned heresy certifies that EDGEWOOD RETIREMENT COMMUNITY, INC. 575 OSGOOD STREET, NORTH ANDOVER, MA is the holder of license granted FEBRUARY 28, 2000Isr:he lawful use of the budding(s) or other struc:urelsj situates or c. is be situated at 575 OSGOOD STREET as related to the KECPINC. STORAGE. MANUFACTURE OR SALE OF Fi.AMMASLES OR SXPLOSNES. NORTH ANDOVER Nate: �is acolication;or cenaficate of registravon mus. Se aq as by the dolCer of the license d said license was granted pnar to Jury 1, 1936, orbervise by the owner or acc�rarrt of Me and c nsed. Peceives P'yAAZ"\ Vk3 Suominedby by �C--VIN VA =1�1CbLWV� TOWN OF NORTH ANDOVER ., 00 33 t O • 9 ". Ioym A. Bradshaw, Town Clerk TOWN BUILDING ';955.ECwU5E1� (508)688-9501 120 Main Strut Fax(508)688-9556 North Andover,MA 01945 J f-�c' N� March 31 , 1997 cdgewood Farm 623 Osgood Street North Andover, MA 01845 Dear Sir: Enclosed please find your 1997 registration renewal form(s) for underground storage tanks. Renewals are due April 30th of each year. The current fee is $100 per site. Please sign the top portion of the registration form and return it with the appropriate fee payable to the Town of North Andover, 120 Main Street, North Andover, MA. The bottom portion is yours to be displayed along with your license. Your immediate attention in this matter is greatly appreciated. Very truly, Joyce A. Bradshaw, Town Clerk enc. JAB/je NOTE: COMPLETE TOP AND BOTTOM OF FORM AND FORWARD BOTH SECTIONS DAND FEE TO LOCAL LICENNG AUTHORITYO NOT RETURN FORM TO DEPARTMENT OF(PUBLIC SAFETY.OR CLERK). The Gjmmunfvrtdtff of csearffnsetts Department of Public Safety—Division of )ire Prevention a J CERTIFICATE OF REGISTRATION ...Iilk16T.H.. ARRTL.aQ...... 19.....9.7 ICitr a. Tewnl ID.lel In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that .....EPG,I?,WOQU„I'.ARMS............................................. Address ...?.L. .. ?SGS7SIA...ST.REET.,..NORTA.ANI10.6'.ER...61A.... IN.-.of -olds ofleen.el MARCH 21 is the holder of the license granted_.................... ................�............................. ...19..SS..for the lawful use of the building(s) or other structure(s) situated or to he situated at...6.2H..QS,G n1a5owinn) ..................... an related to the KEEPING, STORAGE,MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. ................................................... . . cityer Tuwn) Note: Thf. rertifir•to lulY 1. l936no hrr.d.e hynthe o.nv orldoccuPaF of the land Ileeowd. .a.`rained prior Received19........ .............................................................................................. by ...................._.................................................... EDCEW001) .FARMS ............................................ .................................. .. Isms wnanrr ..n... rrr.m ..miae.) wlnd.l TRW .....6 .,Q$c�9A..51'AIE,&Tnd NORTH..ANDA.L:CR.,..MA .... ' 23 ..... Iwaa....l .. The (fummunfuettft4 of lMssadjusefts Department of Public Safety—Division of Ere Prevention REGISTRATION ....NORTH ANDOVER.........................6 PEm xl, 19....9L (city.or Town) IDael Citr This is to certify that.......MqG'YQQp,.gARCIS...................................................has, in accordance with the provisions of Chapter 148, Section 13, of the General Laws, filed with me a certificate of registration set- ting forth that..........ERGDLl,O.OH..EAllMS................. ..................................is the holder of the license granted ..........................19...55. for the lawful use of the building(s) or other structure(s) 624 OSGOOD STREET,..NORTH..ANA.O.Y.GR.,..kA.................__....._._................. situated or to be situated at........2. ........001)...........ET ...... (Shea .na srmwn as related to the KEEPING, STORAGE, MANUFACTURE OR ALE00 FIy�IvIMA4LES OR EXPLOSIVES. ' Sa Le..v.G , Totua CGE'A- .....� ........................................... .................../..........,.. I E*fnrture.•a Olacm Trtiel (Vote: A rertifieate of re{inralion no" be filed on or before April 30th of each year. (THIS REGISTRATION MUST BE CONSPICUOUSLY POSTED ON THE PREMISES.) In"W1 ua/Ga/Yx 14:44 ZY U61 I`K b""n NOTE: COMPLETE TOP AND BOTTOM OF FORM AND FORWARD BOTH SECTIONS DAND FEE TO LOCAL NG AUTHORITYO NOT RETURN FORMCEN CITY TO DEPARTMENT OF(PUBLIC SAFETY.OR CLERK). <C\\ CT4e (f ant 1 ufUrA4 d f 2ISSttrl1 t8et18 '49� Department of Public Safety—Division of )}re Prevention �'Z� CERTIFICATE OF REGISTRATION NORTH ANDOVER — APRIL 30 , 95 ....................................................I......................... 19........ IGIa or Tornl (saws In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that EDGEWOOD FARMS 623 OSGOOD ST. , NO. ANDOVER, MA ................................................. Address .................................................................................... INthe of healer of gran MARCH 21 , 55 is the holder of the license granted......................................................... ................19.... for the lawful use .623 OSGOOD ST. of the building(s) or other structure(s) situated or to be situated at................ .. .................................. m related to the KEEPING,STORAGE, Id„ _MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIF NORTH ANDOVE ...... 1 ,000 GALS . GASOLINE UNDE OUNG cu.—T-1 Note: Thl% certificate of rraistration must be aimed by the holder of she lieenre if said license as.aranrad prior to July 1. 1936.mheraise by the owner or occupant of the land licamed. Received ..................................................19........ ........................................ ..an 1...mre.(.......................................... ism. by ..................................................................I....... .... .... .......... ........................................................................ .. .. (St.,. shah.,arner, :eupmt or Mldol ................................................................................ (OMel.) TMO .............................................................................................. 11e if=m=fuea1f4 of � ttssttcl�ttsefts Department of Public Safety—Division of 13re Prevention REGISTRATION ......... ORTH___ANDOVER,,,-,_APRIL .30 t 1925. (city Or Team) (vs.) FDGEWOOD RMS •,,,,has, in accordance with the This is to certify that .. ... .... . ...... ..FA. .......... provisions of Chapter 148, Section 13, of the General Laws, filed with me a certificate of registration set- ting forth that.....................EDGEWOOD FARMS ._..,,.,,,,_,.,,,.,,,_,._,,.,,.,is the holder of the license granted ...............................................HfATiOH .. :..7YY...�. .... 19.... .. for the lawful use of the building(s) or other structure(s) OSGOOD .ST: t NO; situated or to be situated at..................................................6..23...... .ANDOVER, MA .........................A naT d00 GALS. GASOLINE UNDERGROUND u related w the KEEPING,STORAGE.MANLF.ACTURF. OR •PLOSIVES. .......................................................................................... ISim.mre am 01e—i TWrI Note: A certificate of registration must he filed on or before April 30th of tach year. (THIS REGISTRATION MUST BF. CONSPICUOUSLY POSTED ON THE PREMISES.) TOWN OF NORTH ANDOVER 3t o� Joyce A. Bradshaw, Town Clerk TOWN BUIIDING '�'8s.cwu+t'4 (508)688-9501 120 Main street Fax(508)688-9556 North Andover,MA 01945 March 31, 1997 Edgewood Farm 623 Osgood Street North Andover, MA 01845 Dear Sir: Enclosed;alease find your 1997 registration renewal form(s) for underground storage tanks. Renewals are due April 30th of each year. The current fee is $100 per site. Please sign the top portion of the registration form and return it with the appropriate fee payable to the Town of North Andover, 120 Main Street, North Andover, MA. The bottom portion is yours to be displayed along with your license. Your immediate attention in this matter is greatly appreciated. Very truly, Joyce A. Bradshaw, Town Clerk enc. JABlje NOTE: COMPLETE TOP AND BOTTOM OF FORM AND FORWARD BOTH SECTIONS AND FEE TO LOCAL LICENSING AUTHORITY (CITY OR TOWN CLERK). DO NOT RETURN FORM TO DEPARTMENT OF PUBLIC SAFETY. The CIImmouf loft E IIf 'ffittssadjuseffs w Department of Public Safety—Division of )ire Prevention a otv CERTIFICATE OF REGISTRATION ..=Rlli ANZGVER.......................AERIL.3a._.. 19....9.7 (City or TewnI (D.tel In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that ......EDGEWOOD...VARMS............................................. Address ...hU..9.SGRQA...STREET.,...IORTB.AN➢OV.ER...MA.... I N.—of Mlder of be....I is the holder of the license granted.......................WCE 2k .................................19..55..for the lawful use of the building(a) or other structure(s) situated or to be situated at._5.23..QSA.QO➢..STREET..................... (Street and number) as related to the KEEPING, STORAGE,MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. ...NORT.H..AOAAVER......:.................................................... Icily nr Tcwn, Nwr: Thl% certificme of registration must be.igned by the holder of the license if mid license us.gramed prior to July 1. 1936, otherwise by the owner or occupant of the land licensed. Received ..... ...................0 .........................19........ .............................................................................................. by .............................................I............................ ...E))_GF;WOOD....V ARMS............................................................. ................................................................................ (St.,.wh th., o.n.r, aup.nt or MId-1 l0111.W Tin.l M6........... (eddynsi � �l:I�E �IImmmzhlEttltl� IIf �ttssttcl�usE�s uY Department of Public Safety—Division of )+ire Prevention REGISTRATION ....NORTH. AEIME.h..........................AP.91L J..Q, 19....9.7. (City or Town) IOWI This is to certify that.......EAGLWQQA...VARMS...................................................has, in accordance with the provisions of Chapter 148, Section 13, of the General Laws, filed with me a certificate of registration set- ting forth that..........EBG£W.OQA..EABMS....................................................is the holder of the license granted ,,,,,,,,,,,,,,,,,,,,,,,,F(ARCN„ ..............._.......19...55, for the lawful use of the building(a) or other structure(a) situated or to be situated at......623 OSC000 STREE'......NORTI{„(A]p,OY.ER....kW.......................................... rsi r).... .nd N.mw ..... as related to the KEEPING,STORAGE. MANUFACTURE 0 LE (],Fj rMA)�I,ES OR EXPLOSIVES, b `�.ltd✓,ci:� Town. C'GE.e�C ....U. ...............(stim-to..........nto,.................................... (s{gn.mre.nd oMN.I Tim.) Note: A certificate of regietr.lion must be filed on or before April 301h of c.ch year. (THIS REGISTRATION MUST BE CONSPICUOUSLY POSTED ON THE PREMISES.) ��s NOTE: COMPLETE TOP AND BOTTOM OF FORM AND FORWARD BOTH SECTIONS AND FEE TO LOCAL LICENSING AUTHORITY (CITY Olt TOWN CLERK). DO NOT RETURN FORM TO DEPARTMENT OF PUBLIC SAFETY. The &IIUlmoufUett[fh of ssarhuset% Department of Public Safety—Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION .............o. Andover)......April..Atr....... 19.. ... I6W'. or Tovn) t ) In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that 623 Osgood St. ...................................... Address (e.m,of nad.reni.rs.e) March 21, 1955............................... is the holder of the license granted................................ .......19........for the lawful use of the building(s) or other structure(s) situated or to be situated at.......6210;igood.St......................... (surer .ed ,,.,„s.n as related to the KEEPING, STORAGE,MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. ..............No...AndoyeS'..................................................... 1,000 Gals. Gasoline Underground (City o.To..I Note: This eertifie.te of renar.tion must be sis.:ed by the holder of the Game if said license was wanted prior to July 1, 1936,otherwise by the owner or occupant of the land licensed. Received ..................................................19........ ..............................................................:............................... (sir"u") by .......................................................................... .............................................................................................. Isute wnetn<.oanv. euP.m o. Falaerl ................................................................................ a (O:Faia Title) ..................................................................I——...................... (Addr..n The TOMMI ufuett[fh of fflttssuchusefts Department of Public Safety—Division of FSre Prevention 1010 COMMONWEALTH AVE., BOSTON e REGISTRATION .........No....Andover.............Apr,L1..30............. 19........ (city or Tuw,) low.) This is to certify that Edgexood Farms.........................................................has, in accordance.with the provisions of Chapter 148, Section 13, of the General Laws, filed with me a certificate of registration set- ting ewood Farms ting forth that........dP. ................................................................................Is the holder of the license granted March ..... .21, 1955„..„.,.,...„ 19........ for the lawful use of the building(s) or other structure(s) , .... ......... Osgood St. situatedor to be situated at.................................................................................................................................... (st.eet .na Nur.aer) as related to the KEEPING,STORAGE, MANUFACTURE OR SALE OF FLAM\TABLES OR EXPLOSIVES. 1,000 Gals. Gasoline Underground .......................................................T,00............................. (ciy m m n. .< . oN riJe eLi ) Note: A reetifiri ie of re,im-1 ure mua be filed o or before April 30ih of ...le year. (THIS REGISTRATION MUST BE CONSPICUOUSLY POSTED ON THE PREMISES.) romtws.v(aonwxxs rfE� i' :}, lnf ..'� ❑ 1 Gr rORTi 4, - ih-NC 1C' ' H PIT' WITY f i I•,�-; I , .(,'I' I:Is'il I-, pOI )l TO ' F;PART-MENT OF PL'BI.I(C RAF_', r ci'C�c (r(,))(,ftr�ttfne�f[#Ij of �<cs5�ti(!tl_a��15 Dcoariment of Publie Safety Division of Fire Prevultir,n 1010 CO3MMONWEALTII AVE., BOSTON CF; Hf [ FII; AI' E OF REG1 ! 'TRAT10N i 30 19 . In xcco rdance e'ith the pro%'isions of Ch.rpter 148, Section 13, of the General laws, the uudarsigned !•:ioby certifies that 623 Osgood St, ..._`�diemood_Farl'49 Address ...... . ....._..._... . .. ..._. _. ............ Narch 21� 1`�SJr.......___..............__....... is the holder of the license granted_........___._........_ ..19_ ...for the lawful use of the bi ilding(s) or other structure(s) situated or to be situated at..._..623_ ........ M-1 .Id ,,,.ms..r as releucd w the KEEPING, STORAGE, MANOFAC'PUIiE OR SM,F OF FLAMMARI:ES OR Fal'LOSIVFS. .......___..._........... ......... I ,C-)o ,Is. -oline Underground \t TFi, 1 .; ..r�� SL•Srsip A�. 1, r, r s e n •f . i r' c ��ed: �✓,Y`'`;;1" ,.� _. 19..._._ � '�'� �✓ ; %r/cam s��.'.�.'� ;lilr" . �dl z19 8 i y,,�; NOTE: OOMPLETE TOP AND 'TTOM OF FORM AND FORK"A;' 'GTIf SECTIONS AND FEE TO LOCAI, M'ENSING ACTHORITV 0'1 , Uli 'L l7 AV5 CLH;RK). DO NOT RETURN FORS? 10 DEPARTM1-1-' 1 OF i'TiRIJC SAFETY. (`the (1�nmmm�fuettltl� of xs�uchz��e�ts Department of Public SafeSy Divit=ion of I;re Prevention 1a loEo COMMON\VF.A LTii AVE.. R(v"�TON CERTIFICATE OF REGISTRATION No. Andover, April 30.... 19..._80. . .................................... _......... ...... ....__..... ... . .,a to.mt In accordance with the provisions of Chapter 148, Section 18, of the General Laws, the undersigned hereby certifies that 623 Osgood St. Address .. ....... .__......_.. s.m.or h.dd.r.1 1 March 21 1955 19 ....for the lawful use is the holder of the license granted_._..... .....�._... ... ._.. .. of the building(s) or other atrucW re(s) situated or to be situated at b23."_6g ,tA -.1.... ............ asr,Ilav,dtothel(REPING,STOIi.AGF, )fANI I ACit.U Oil S NLv Of FLAi1M'VRI Es OH ESPLOSIVF.S. AgdoygF............_.. 1,000 Gals. Gasoline Underground Note: T1ds rert,fieme of registration must be signed by the holder of the 1 if suid Perrum .an 1pointed prior to July 1 1916 other be the i7 t'x o f t6 1 t�Gc d �� Receive- 9�4 c: . f�rlTfz� ........XIS ...... ............. ._.... _._. .ro.s.1 Tzia NOTE: COMPLETE TOP H ROTTOM OF FORAM AND FOR' RD BOTH SECTIONS AND FEH TO [,OM L LICENSING AU'1'11ORL'1'P (CI'I'V�W TOWN ('L1?RR). DO NOT RETURN FORM TO DEPARTMENT OF PU RIdC SAFETY. T11C (1l IMMMifun t4 of Mssar4use#s Department of Public Safety--Division of Mre Prevention V ,,,, 1010 COMMONWEALTH AVE., BOSTON f." CERTIFICATE OF REGISTRATION ......_IJo. Andover,......A:Pri1..3!.................... 19.ZA... I.... ne TowN M.W In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that Edgewood Farms ..._................._,.. Address ..__.623_Gsraad..S.t... ............ ......... .. .......... i rv.m is the holder of the license granted.._.1:larp}I_2,� �Q�� ......_. , ......19........for the lawful use of the building(s) or other structure(s) situated or to be situated at..._623..0@good.5.0.......__....._ ........ (Soa ..d . b..) releterl h " KLl l PINC' STORAC'I NC Pe> ANI F VTUIZL ORI ALE OI I I.AIMARLES OR EXPLOSIVES. Ivor h Andoverd .- ........... 1r000 4allons Laroline - I nderara.md �. �.H'n: tiom: 'I lud c 1 11, pie f" e(;rsiration m�s� be.ianed by she holder of the ban:if..id Gc n . e srvmed n w. 1 194'mh by lhe own cap �flh I n 'l d ) Received .._. i 9' n ....... by .. . _..... . ....... ......................................................................_......... ...... iueam ^nb.i ....._.................................._.............._............_..........._........ (n,or .l i?t "il 1';01' I'MT OF FORM AND FORWARD BOTH SEC1'It,..o J. b l U p i,ll' Nv [ NG ALTRORITY (CITY TowN CLERK). �I1EPAR ME-Nl' OF PUBLVI SAFETY. `11C Clummunfuraffil aE nsgucCfuseffs 4 y �' Department of Public Safety- Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION ...__.North.Mdove.r-AP.ra.3.Q............_....... 19..7..... a r'CnonI (Date) in accordance with the provisions of Chapter 118, Section 13, of the General Laws, the undersigned hereby certifies that ..... FarAy ............... ....... Address _...__.. 623 Osgood—Street ._...... . �Nxm: u( noltleo ut Lrrneo: is the holder of the license granted.....hlarch_21,..1955.._._. _.. . ......19........for the lawful use of the building(s) or other structure(s) situated or to be situated at__.623_Qsgood_S.tr.eP.t_................ as r,Iatnl to the KEEPING, �10H t(d AL1'V[ I SC'tt HI OIt i.11.I 0j I I tAIli-ARI.I',S Oil EXPI.OSIvrls. ..,, North Antlyer ........ .. _. ...... . .._... 1;000 Gallons Gasoline - Underground No.- Tin, Geri ifrule of rep Firutiun nmu be signed by the holder of the license if said license was granted prine w Jul, 1, 1936, othe by the opnn f sheIunJ�i d {{ Received lFl LONG — a . _... ._._ . l totsr�a rai: I . ............................................................. No'I'F : cove I r° ri; Tiil` �fzu enrTnar I E Irntnl aNr, 1,01 Arli I i ;r:r 'l�tus, \SU Ih ]A" "N1 11), d Lli17N IN AL IIIOI,I'F) frIiY 0 1 t 10ril`S DO :COT EE EARN I�(WUf "I'U OI'1'ARIMIi NT nl' PI U,l(' _ 'The Tommuutucalth of `.mussarhusetts .a Department of Public Safety Division of Fire Prevention 3 _ a N 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION North Andonier........april,..jo..................._.. 1977.... Kits or Tow„, Iwto In accordance with the provisions of Chapter 145, Section 13, of the General Laws, the undersigned herftgWobfa Vh�at 623 Osgood Street .........._..................................._............................... Address ......................._._... ....................................I................ I e.ow or holder of Ior.-I Ilareh 211 1955 is the holder of the license granted...................................................I........ 19 ffor thhe lawful use 62� U'sgoo'. reef of the building(s) or other structure(s) situated or to be situated at.._..._......................................_........... as related to the KEEPING,STORAGE, MANUFACTURE OR SALE OF FLAAIMABLES OR EXPLOSIVES. ._.,North.AnLl.4per........................................................ 1000 Gallons Gasoline - underground ICI, m Town Note This certi6eaerof re,ko-alon must be eip.ed by the holder of the lice..if.id lice.....Reamed prior o July 1, 1936.otherwise by the owner or oecupant of�heJ. d L'cFn.pd� Receive �..�w. .19........ I - t-ytiY, d ' /G �Y i III-ee lbrwa .T� ._.. ......:.... .. .�l u�. ..._...... .. f. .... .. . . b Tt�u,v 'CLERK tic .., ' ' rlMtS................ .._............................................................................ B .Is whether owner. «eun.m or Mlaen iom.I.1 roue �......... .. .. 5 .`� . ..._4�.Spaa.� .....f. "...4.. 1(("'- NOTE: C-0111IFTE TO 1SD P.O IO111 OF 1 OR11 AND F'( l'ARI) BOTH SECTIONS AND M E TO 111"'Ah LICENSING AU'I 11OKI'I'Y (( rI OR TOWN CLJ I{),1)0 NOT latIl1 fNN PORRtj TO DEPARTMENT OF Pumj( SAFETY, IC E alum1ICDY Walth of flaassarhusettsi {a � Departn-,nt of Public Safety--Division of )ire Prevention I>i 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION North Ilndovur A, 3 ^,ril 0(C,ty ............ ... . . .................. . . . . 1 s..76.. CLLr or Tnwnl IDatel In accordance with the provisions of Chapter 149, Section 13, of the General Laws, the undersigned hereby certifies that 'dgewoo la..n: Address � .o, - ..... . .....J2- O,i.� l.R. ..iLCCh}� . ..I N r nold.r r r.«�.�I .............. is the holder of [he license granted._.. rGh, 21y 1J55,,...,, ,„ ., 19 ....for the lawful use of the building(s) or other structure(s) situated or to be situated at...6... good .Str..et as reef em —1,en ...__..... as r]m,:d to Die KLP.PING, STORAGE. MANI P'ACT(RL OR SAIX OF PLAIIIIABI FS OR EXPLOSIVES, North AndovFr .. ..... __. . .. .. . ....... ........................................ 1000 I:als asolino gut iereround Notr: This rerfifirwe of regintrntion ntmt be signed by the holder of the here,if said lie med prior to Joly 1, 1936, otherwi.e by the o r or p t t bra owner r n Received 19. !!..([�-rrl>a Lef ✓T nd 1'cenred� as JdhiN J. LYUN3; CWC a ' I.i ...J.oU,.S_LLta2.CC............_......_..... . ._,e...I I.) No. ANDOVER MASS. 01845 _...._....... ............ ................................. ........_...._.... I}le4 whelAer meunent ........_............ ����� fOfidnl P1tl.1 "" Duper, ar holAerl ..................................................................... a7hr (dnttttttnntnettlfh of Mal'sttr4usetfs Department of Public Safety—Division of Fire Prevention Ppt ��A 1010 COMMOAWEA1,TI3 AVE.. BOSTON CERTIFICATE OF REGISTRATION North Andover ,",pril 3�r 1975 . ............................................................................ 19........ (llm..l In accordance with the provisions of Chapter 148, Section M. of the General Laws, the undersigned hereby certifies that , ...................Fi.3.pewoo harms.........................._.... Address ...............623 Osgood St. . . . ...................... .. . errs or nem�� �� r.�.,eet .................... is the holder of the license granted........... larch 21, 1955 19..... ..for the lawful use of the building(s) or other structure(s) situated m- to be situated at. 6 Osgood fit, . ..ns.................................... as related to.the KEEPING, STORAGE, MANUFACTURE' OR SALE OF INFLAMMABLES OHR EXPLOSIVES. VL09SVE8. "dort.h Andover 1000 gals gasoline underground, ............................................ .. ......................................... . (City or T-.ot .. Note- This certificate of registration must be signed by the holder of the licciae if said license e mantel /� friar )to loly 11936 there by the ox`ry'er or Damps 1 d erred. Received ..,�-��c )J...l✓`2.rS 19. : ;!� Lj C1�.r7?f��l .....................PSI .< J .. .. . ..... ... . .. ..F. ._`� ` . a) r Idyl_. Al:r�4 ca., it; . . . ................................................................................................ .................._................. ._....................................... r•.m., rvn„no- �..,.r.. o==sneer er m,ia.-.l Iom.Inl snot .................................................................................... (A,d1—s) .............. ---__---------------.____........................._...__...-----_--------------.-----_----__.................. y ) i4e Tommonmetttt4 of Magoar4usetts Department of Public Safety— Division of Fire Prevention 1010 COMMONWEALTH AVE., BOs'POS CERTIFICATE OF REGISTRATION .....North .. . . r..__.,,,April,„j0a, 19]!F 19 tc., Ir to,.-„0 (nu41 In accordance with the provisions of Chapter 14S, Section 13, of the General Laws, the undersigned hereby certifies that .......................B.4lWcod, j5=......_.................... Address ....b.2 _Qs�eaa...StA........................... ........... ... Is— u1 nolI r of liceml) ... ... is the holder of the license granted.............114r.P)l 21a...19SS..................................19........for the lawful use of the building(s) or other structure(s) situated or to be situated at......5,L7... kgop,�„AS,ta......................... "u"'It .ad — ) as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF INFLAMMABLES OR EXPLOSIVES. ................N.ar.%.Andovaz....._............ ............ . Note: This certificate of registration must be signed by the holder of the license if said license was granted prior to July I, 1936,otherwise by the owner or occupant uF1he land lic nsed. Received ........_..�_.`:%,/.-.!,t�.........................19........ Sig aw ( .uk.L!7��...1^..��... �. . � sia r ) ...... by .......................................................................... ................................................................................................ ............................................................I............I...... ts:�n. ..nemer �.aar. orr„rmae or nomeU (ortielq Till.) .................................................................................... (Address) -UT4e Tommnnwralt4 of AHasssrl�useti8 pr Department of Public Safety- Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION `;o. nt.ovor 4ril 3Jr 1973 .......... ................................................................... 19........ I CI:r oe T...:n) INu41 In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that ..................F dreweod Farms Fs ..............I... Andress ............:.,. 3...9. .GRAU...dL......................................... .:..w.....:........ (Name at hold— of li-me) is the holder of the license granted........... 19 ..for the lawful use of the building(s) or other structure(s) situated or to be situated at '4r OsGood 1 ad t _ .. . ...... ....................... as related to.the KEEPING, STORAGE, MANUFACTURE OR GALE OF INFLAMMABLES OR EXPLOSIVES. No. ',ndover ..............................................(C i ce ............................................ Icier or Too—) .. Note: This certificate of registration must be signed by the holder of the lirense if said license was granted Print to July 1, 1936,otherwise by ties owner or occupantyf the land Iicensed. a Rocciced ......... . ., Issn.wvel b ................................................................................................ .................. ............................................................. Ismtr whether owneg onevennt or M1oldey lomelxl TWO .................................................................................... (Addrem) ............................................................................................................................. The (f amutmfuettltlt of fi6ssar4usetts al +I Department of Public Safety---Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION Sl.o,...M.d...._APr.i.1...3Q.,...1.972........... 19........ l ci , ar row.) IOatel In accordance with the provisions of Chapter 118, Section 1'3, of the General Laws, the undersigned hereby certifies that Ed ewood rarms.._...._....... Address .... ... .3...OS.G.Q9.d...St,....................................._.. G... .._......... .. 6 rooms or hind.,of Ifan..) is the holder of the license granted...... - MRR...23.,....1.9,r7.5._......._..................19........for the lawful use of the building(s) or other structure(s) situated or to be situated at.........Fj).1..7.Q.ego.od_.St................ (sn«, .od .w.lar) ,e es relad ,o the KEEPING. STORAGE:, MANUFACTURE OR SALE OF INFLAMMABLES OR EXPLOAVES. ......... ..............1'0. and ... ............................I.......................... m+, rr Tnwm Note: Thir renifn.tr of rr,imtrtunat n us, be.i"ed by the holder of the license if maid license was granted prior to July 1, 1936,otherwise by the owner or orcupant ofthe land licensed. Received l C C.F.13i {��i Yr clzei by ......._........ ......::......................... .........._........ Is�a �: j . ............................................................ ................ ................ ................................................................................. f5relr wh1her ow-1. m nem nr MWeel Io",iml To" .............................................................................................. IAddre I Ae (fummonfuca l of ffittssarhuorits Department of Public Safety—Division of byre Prevention I 1�a 1010 COMMONWEALTH AVE., ROSTON CERTIFICATE OF REGISTRATION ............North...Andovor.....AE2r b.i..?.9.r,... 19..71.. (car — T,wn) m.ui In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that ........... ......... Address ....._G2.3...osgood.s.t................... .................. ... ....... lrv„m,.ar nohic'or i,aa..l March 21 , 1955 is the holder of Lhe license granted.._.......... ... ........................................_...........19........for the lawful use of the budding(s) or other structure(s) situated or to be situated at....__.5.4.Z.0.sg.ond_s.t.___...._... (sera' " nomnerl a, related to the KEEPIN('., STORAGE, MANUFA(TORF, OR SALE OF INFLAMMABLES OR EXPLO'%AVF.S. North Andover,.,, ,. 1000 gals gasoline LCIb o Townl ,Note: I is certain ate of regi oration must be signed by the holder of the license if said license.a s Framed prior to Jule 1, 1936, otherwise by theoccur no Of he land licensed. F Received _.. ._ AR.ck.Z...24 ._ .13J.1 l9 . . d(l?'?:I l i Iry , ri L - ti2.. l r r ( � -�i'�, JOHN J. LYONS by .._..............._...TOWN CiiliRK......... ....... ....... .....................NO.,,A_NDOVER, MASS. 01945 '......................_.........................._....n't.........._...._......._.......... . .......................................... ISule whop— owner u'eova or pahlerl (OMvial TII1i9 .............................................................................................. (AdL'eysl The Tummonfuralt4 of ffiassar4ustfts Department of Public Safety—Division of F7re Prevention 1010 COMMONWEALTH AVE., ROSTON CERTIFICATE OF REGISTRATION NUR i'.. A; J :'.'.: ia�R...3 u..1371�..::.... fCltr oe Townl (On�cl In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that .... ::9.4> > � . ?.g. ............ _. Address ..........._ ................................... I Na of h.W;of pr. ) is the holder of the license granted_.___-`�'I`I' '-'�._I �``J.._.......__...............19........1'or the lawful use 3.; .O O.u.._$.�.............._.of the building(s) or other structure(s) situated or to be situated at........ - (Stnet nnJ numLex) ae relaxed EEPING, STORAGE, MASUFACFURF OR SALE OF INFLAMMABLES OR EXPLOSIVES. .... . ........T Ul... .v ... .. ......... I Cib U.TOW III Nor: This —rdific.ze of rr,kdr. lon ma-1 br.ignrd by rhr holder of zh, licrnee if said lirr.-was gr.nmd prior to July 1, 1936, mherwisr by thr owner or occupant of the land ncraeed. r a. Received ... .... . ......... ._._ =L� G L70WI J by ....................TQW.N...C.;..l.............................. . M. ANDUV L, ..................................................... ._.................. ................... ................................................................................ isiare wro.m.x uwae.. eraaanm ar min.n 1o�real IN110 .............................................................................................. f AJdrml IJIIE �IIYYCIttII1tEUPFT�f� QE �M$SMP�IISP�B x f"I" . Department of Public Safety—Division of Fire Prevention y1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION ._.'. ..._......._......................................I................. 19....... ICIb or Town) (Dn4e) In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that ......:.:.::: o::r.....:. . ..:::......................................... Address .........:.::.._.....: ,._:;.::.:...::::.............................._......... iNu a o[h.1,1 nr I......) is the holder of the license granted.......L:.C:.......J.. _..................I.......................19........for the lawful use of the building (s) or other structure(s) situated or to be situated aC.:...;..... ._. t ..d ou le......................... r suet "na ,,,N,mr A. e rrinlpd m tl eJ(EEV1Nf., STORAGE, MANUFACTURE OR SALE OF INFLAMMABLES OR EXPLOSIVES. .................... .................................................................... Cnr or T.-1 Note: This rer)ifi,me of registro)ion must be sunned by the holder of the license i(said licenx was llr.nted prior to July 1, 1936,otherwise by the owner or orcupu.n of the lend licensed. ' RecReceived .......... ...... .........19.......... . f by .... .............._.......__......................1..'. —.........._ IStete wneuo own-r. aanxm or homert io. SNOX1 7r NHOi .............................................................................................. Inddr.,.) The It ommanfuealth of �HttssarlptsPtts W _ Department of Public Safety—Division of Fire Prevention �+. M 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION c uo ................ l .r. 19... r..: (car or Town) (Date) In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that c" . . ................ Address .:.. I Nnme of M1OIJe.o! Ilvense)is the holder of the license granted.... .............. ........ ........ 19 . ..for the lawful use of the building(s) or other structure(s) situated or to be situated at...;.?:......." 1- '- 18treet end nvmbey v. relat'eX to die' P19G,S'101)'AGE; IfAWUFALTURE OR SALE OF INFLAMMABLES OR EXPLOSIVES. I CSb�r Tnwnl Note: Thk rertifrnte of repistrxtion true, be.hind by the holder of the lirrtox if enid lie w e srtonuod prior to July 1, 1936,otherwi.e by the owner or uraupa" f the Ixnd 1 ented. Received ... i1 .. l�.y.. ._.d!..........19... ..... re.._�f{ mZ,DCi , /: ........ ........................................................................... by .......................................................... .. ......... .r. .........................I.. ..... ....................................................................�. i.a...-'d IS',ete wnemer nwnvr. rcewxnt oe homzel h0. "'491?iiltY i. Ia. ..n.�. J... .............................................................................................. (odd—) �t Department of Public Safety—Division of Fire Prevention 1(110 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION er........... Is...6Z fCllY m Tornl 1Dae1 ��� In accordance with the provisions of Chapter 199, Section 13, of the General Laws, the undersigned her certifie tat ewoo h� 62 os _ ` .� 6 �` farms _3 ..... t. ........... ....... ..........._............_........................_....... Address Irv„s,e yr xamer ar r.ev.el _._..._. is the holder of the license granted.......':.arch .'11, 1955 _..d _....._...._....... ......a ._.....47._19........for the lawful use of the building(s) or other structure(s) situated or to be situated at.._.]�1.7...Qp.Ft71X;._.E4A.......__........ Isu... .aa . related to the KEEPI N(L, STORAGE, MANUFA(9'URF: OR SALE OF INFLAMMARI.F,S OR EXPLOSIVES. forh .�rd ove 100U.. t ........ r.. .. . ... ..... ........ -(a 1s p;�ls olis e un,p:,rr;r Snic: Tbic eertifrme of registration must he signed by the holder of the liven, if said licenser nted prior 1. July 1 1936,M by the o as gra uceup�t of the land licensed. Received ... / G b Isssa,a , .......................... _.............................. .................................... ISule rxeNm ............................... ..._.................. wneq o[e„oant or xnlaerl (OM,lel Tillnl ....................................I...... ................................................... Inaaanl we we ll P (fom ttonfuralf4 of4T65qUrjjusetj6 �I Department of Public Safety—Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON a CERTIFICATE OF REGISTRATION P'o. Kr_dover Aril 30.. . . ....... . ... ........... .. ....... 19..'.6.. ._.. . . ......_..Mac .r r.wm... ... . IM.I In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that ..................... 1�alewood rarms s;;ood St, . . ..... Address ....6`'... O 3 . . ............. is the holder of the license granted........:.13P ch 211 1)5�i . .19........for the lawful use of the building(s) or other structure(s) situated or to be situated at....r21}7 Ost ood St. 1000 gals ('asoline - ( - "" -...-- ns rel:,ted"m the KREPISG, til RVC, MAVLFAOfURF. OR SALE OF InFLAMMARLES OR R%PLOSIVES. 4.E.Y..............I.................... Note: This uectlaeate of registration must he signed by the holder of the license if mid license w prior m July 1, 1936,otherwise by the owner or oreu '"wanted Received ... c z ,-.:.�.. ......... 19 ;'.5.. n t the la nd licensed. .. . ............ by . ...... .......,. "s" ...... ...... .......... (stale wnm.r e ... ..r.eaee .rWn ................ ...... ....................................I..... .................................................... uaa....t The Tammanfura flj of MssMthnsefts Department of Public Safety--Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION North Andover...._,.,April 26.............. 19...6.5J. (I'Y — To n) 1D.41 In accordance with the provisions of Chapter 138, Section 13, of the General Laws, the undersigned hereb r certifies that dg'ewood rarms , Address 623.. sBood .S.Z.. .... . . . .. ........ . . . . ......... .........._... iu r license Maroh 21 1955 i.< the holder of the license granted.... . . . .......... .. f. . ......_...... _.,,,.19........fo the lawful use of the building(s) or other structure(s) situated or to be situated at..57...Osgood �t. . ..................................... 1000 gals gasoline - under g�ound is" OR E , a. mimed w the KF.F.PIVG..S'fURA66, A41Y'AITIIRY: ON SALE OF IfVF1.AMMAIf l.YS II EXPLOSIVES. North Andover, ne T..wnl \me: Tbic renifirme'of reKi. radon n use be.iFned by she holder of she licen.e if xaid hcenx w a gamed prior to Juk 1 1936, mhe by the—ner or ocrupani of do,land fi d _ Received - _ by yi b N ti.' =I _ .... a am .n..m.. ...�.. ,„.an.m o.nmam I DIRripI TiJi+ .............................................................................................. I Addnrvxl The Ctrm anfuralt4 of Mssachnsrt#s Department of Public Safety Division of Fire Prevention 1010 COMMONWEALTH AVE., ROSTON CERTIFICATE OF REGISTRATION ...NCr.th..AndaLer....._...APx.da...9.)_.196A9........ :1s,, er T a fl,atel In accordance with the provisions of Chapter 118, Section 13, of the General Laws, the undersigned hereby certifies that ............Edge.wood. Farms _..._................... Address ........6.23..osgood...St........ .......... ....._... trvan,r.r nnnr�n u is the holder of the license granted...._XRrah...2.1, ,1,95,5._,_„_,,,,,___,_ . .....,.19- __ for the lawful use of the built ing(s) or other structm'e(s) situated or to be situated at....5.47„_,Q14„gp.Q.d St..._,___,_, lSt"" "" """'l relaird m the Kh:F.19iNh. STORAGE, MANL FAITU RE UR SALF, fJF' INFLAMMABLES Ilk EXIILOSIVF.S. ........._u.Nm_th..an.dome.r. µ^.............._.... ....... 1000 gals gasoline - underground Nuie: Tl:is rent Grmr of registration must be signed by the holder of the Ilocnse if said Iicene vas granted prior to July 1, 1936.mher.ia by the owner or occupant of the land llern.wd. Received ........ .._.____... . _19 by ... .......... .............................. ........_....... Mlle Tommanfulealt4 Of Aassar4use#ts Department of Public Safety—Division of Mire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION a..... nu.o.v.c ........ sril..�2..ID......... Is...63. c"o 11 nrn Ifflr or T ) IOvtel In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby, certifies that. _... . .. o_d ` arms ........ Address _ __623._-C�93o.od..-Sb. Is the holder .... fM1 [ � Ilrr oCl I ...._. ._. ...... of the license granted,...._.'-arch 2r t to sit Sp�� 19 for the lawful use of the building(s) or other structure(s) situated or to be situated at t45.,_Jaz AOd .St 1000 -als I1e _ , x�,elnmd In FF.FI ibIf �`' nW?t� 1LES end nXPL h NG, S'111ttA�L Md_vhF'Af TUNE OR SALE OF INFLAMMABLES OR EXPLOSIVES. ........_.._P'er.tlx.,�;n.a.o.ue.r.....ldµss......._................ Hole: on, „,on­od of yells rotl.n need be xmnrd by the holder of dhe lice..,. if—id license ax 1—ted prior to July 1, 1936, otherwl.e by the owner or necupwnt of the land lkens , s Received .. ._.).... ��.....19 by .....................I ..................................... Y.J. ...... ............ sl„I< .n.m.. fOlRrlul Tllle� ........................ (911mmunmrxlt4 of Mus68r4U0rtb Department of Public Safety—Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION No. Andover, May 9, 1962 . ...................I........................... 19........ I�:r - T-1 (Dc4) In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that .....Edgnw.00d. .. ......... ......................... Address in..,. .r ema.r of.r fin.nxi March 1 is the holder of the license granted.............................ZL.a.... 9..r7.. ..................... ...........19........for the lawful use of the building(a) or other structure(a) situated or to be situated at.. ,,0 sgood„St. ........................ 1000 gals gasoline - underground (so-zm act ..muer1 as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF INFLAMMABLES OR EXPLOSIVES. Aaaa.a.................................. (Cur m Town) Note: This certificate of registration must he signed by the holder of the license if said license was granted prior to July 1, 1936,otherwise by theowner or occupant of the land licensed. �-1 Received .............M.@.Y...9 f...1962...... 19........ ....`.'.rti.Prr?:L.fL?.rY!, <l:arl ...... kF .....1. b y ................��:::......:....:.: ........,.:........................ .........................................................'eet.-... ...................................................... .......................AIQ..Aid:.n Title.:aic:............... (ass, nn..e..t n. b.ia<rl f0 Title; � .................................................................................... (Add,..) z4v TommovhCalf4 of ttssttcllixsef#s Department of Public Safety—Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION North Gm,over. April S. 61 .... .............................................................. M11 nr T-wn1 (u.le)...• ••.....• In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that ..................._.....__..,,..... Address .....,623 Osgood St. _.. is the holder ofor structure(s)gan _.. situ1 .ated _.._._-19. ......for the lawful use arch of the building(s) d or to be situated at....62.3...9.lgg0oq, 5t.__, ........... }}3 1000 gels cfi3olineS - under round. is RT and n-,PL I d i d KEEPING,GTl11YACE, MA 'FAf.T11RE OR SALF. OF I6FLAMMARI F.S OR EXPLOSIVES. Plorth anuover. \oie: 'fhi. r.rT�licme of reFiaaiiun mu11 he rigned h, The holder of The nee.--if a-id lice---.a granted prior In Juh 1, 1936, oll—wi- by We o..nrr or oecup-nT of The land_licensed. Received _....... .. 19....... rsrauwn,ti� r � eaw fight �D1tTIliDltiltEt[If D tT88iIC�lISE S Department of Public Safety—Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION ..vac.....::a. .c'.r.1<..-...� z.... ....:C.J`................ LI accordance with the provisions of Chapter 148, hereby Section 13, of the General Laws, the undersigned ,-certifies that .. Address . ll.,d..3 .� A - ( 4 . . .. , . / u ,e I f t f p 1I. of Irteneel ._..... ... . . ... . is the holder of the heense granted !/ .Fi ;. . -j // of the building(s) L.J.ed*' 19 for the, wful use g(s) or other structure(s) situated or to be situated at �. ,J.2 e. r nfed 1O fhe KEEPING,STORAGE,MANUF,IC1'URF. OR SALE OF INFLAMMABLES OR EXPLOSIVES. . ...G: ............................................ l' City ne T,wn) c. N.'.; Thur If t of re" t t of i Reed by the holder of the"creere -.-.(r/✓,/✓ � Prior t J Ir 1 1936 Iherw by .h owner f d li«n.e was retried U P m of Ih � Leonard. Be,eivea - vC u1`,.15� 19.... ' I b J J. `� i . ' '7 Ise . ............. .... ............. . . Y ............ T7 morel a� c i zC.... .............................� _ _. . ... .. ... ....Ism.s.m « m e.a».e.. .�p. o.ndn ae fOlReiel TINeI ��� ���� � ...............55 >z. ..s.�va: _«'..._: c..n ............�r(' T4T Commonfutalth of A"Tar4use#ts Department of Public Safety—Division of Fare Prevention 1010 COMMONWEALTH AVE., BOSTON REGISTRATION ...NoY ..Andover.. .... r ,_.,,_...... 19..5.9. . ....................... own) Ap ;--- 0 This is to certify that......EUGEW OOD FARPIIS (m�r .r r .m anal . . ........has, in accordance with the Provisions of Chapter 148, Section 13, of the General Laws, filed with me a certificate of registration set- ting forth that.............E.PG r 9.0A..kmmK ........................ .. Pdarch 21s 1. _ ............. he the holder of the license granted "'..""-" "'����-��� �-���� 955 .................19......., for the lawful use of the building(s) of other structure(s) situated or to be situated at....6zJ....Osgood. St.... Nonth Ando ver MaBSY (ao-ee] ,.a N.mberl aB re1.1ed to]be KEEPING, STORAGE,MANUFACTURE OR SA '[NFL B OR EXPLOSIVES. 1000 gals gas. Underground .a si�.r ru T 'LYCNS / 1 _, Nmr. A errlificur of reFietruion mu.]be fiW on or befo April 301ti of h r r. 7 c c " (THIS REGISTRATION MUST BE CONSPICUOUSLY POSTED ON THE PREMISES.)��"E'l. mar,=, f Pore P.p.S. IISY_Y_5]-B20Po9 f 'The UI 0mmonfuralfh of S�MC�lISE�B Department of Public Safety—Division Of FSre Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION 1000 gals gas underground North Andover. Aril j0 .......... ...... ...................... .r............. 19... . . In accordance with the provisions of Chapter 148, Section 13,00f the General Laws, the undersigned hereby certifies that . $..... ...................................................- Address ......{rvamr�r mlae,ar r,<.r..r .Ei2.�...QSg`AD.d...SL.......................... . . is the holder of the license granted.......h?arch 21� 1 of the building(s) O e situ..-.. 19........for the lawful use g(s) or other structures situated or to be situated at...6.�J,._0,9g,Qod..ata rd as related to the KEEPING, STORAGE,MANUFACTURE OR SALE OF INFLAMMABLES OR EXPLOSIVES. ..__...... .... An.41od'.0.i:...h?ti.as...................... toiir o,row„I Nair: This —, firm.of registration most be dilsind by the holder of the"rents if mid Renews was framed prior to July 1, 1936,otherwise by the owner or occupant of"he land Restated. Received .....AP.ril_,jp,....i.9.59 ...19 I �.-tl co-. fu(•(t lrtwC... �J9d2L by � __ L tsiaaa I ... j�r'rl Y , ............. r .... n Y, { u r Ist.tr wa.ur.awar. -an.-, ...... ...... mlarrt ................................................... .. ......................................... IAademl P ffT=MaUf rU1f4 tirf nsttr4mrffS y3 Department of Public Safety llivi5lon of Fire Prevention eta 1010 C0A9AT0, WhALTB AVE., BOSTON CERTIFICATE OF REGISTRATION No. kndover, 5, s. A r31 11 8. ...e.........:............2........................ In accordance with the prof isions of Chapter 118, Section 13, of the General Laws, the undersigned h gr 17 certil,es that dgwcod rams. .... 549 Os oed St. Ro. Andover. ..... eAddr ss .._. g rn Hold. Ir i ..... .. .. .... .. iS the holder of the hecnse granted......?"er >1 21,.„ 19 F .. 19 for the lae ful use TDC Lire building(s) or other structure(5) s,tuatld onto 0c Situated ai, 6 % Os cod C.t 1000 gals gasoline (Under ,rotmd .._ .............a......._......_.. l5heet and numl,ca) ne related to Lhe FY:k3YING, ST(IR,1C 1;, 91ANOF-k( rITliL OR `%I.E OF INFLAMIJABLES OR EXI9gSIV1:S. Note: 'Phis certificate of registration must be sigacd IT, the holder a( the )leease If said lieevse n .e Framed prior to Su13 1, 1936, otherwise hF the omwr nr arcupaat of the Lmd.FReneed. P,eeut e,i ... on1 llt..1958 10 � E?7�.L?�i� by I . a .. . IUR@ T. .. ............................. (11 —s, vo,�)_ u1lte Tommiampalfll of— Y Department of Public Safet Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION ...N4r.th...A..p.d.0.ver.•...Riz.SlAld.. .•............ 19...5.5 In accordance with the provisions of Chapter 148, Section 1$ oP the Genera] Laws, the undersigned hereby certifies that 'sat" A.b:a.o.t...S.t a.xe.n.a................... twam. or noiaa oe i�..,,.a.................. Address: ...6_' Os Zoos Street. ... is the holder of the license M. 2 �..." " """.... ............ ....................... . . of the building(s) granted...'........ .:ua:Ck u-r to.................... . . %(s) or other structure(s) 'a"""'. .II .....19.5.Sd Sthe lawful use situated m to be situated at.....r247, .Qsgpo d..S,tr. ,e t�, as related to.the EEEPING, STORAGE, MANUFACTURE OR SALE. OF INFLAN11iAELEB OR EXPLOSIVES. North Ardo verf ,Mai ,a,c hu setts,.♦ . . .. (c', o. Towel 1000 gals — gas — uxider� round Note: This cart fiesta of registration mast he signed by the holder of the lieease if said license was granted prior to dnly 1, 1936, otherwise 6 w the owner or occu I Resell,Resell, ....n ^� ,},.. �. Pane of th nsed e mTl9ce • ` ....t9... `a5 � ( .' -�Jl�li by G/:i.'.� ....... �„k <a wee ..... .... , . ...............T.o.w C]_e.#lF.. s. - (Ortie41 T ) mww. oeninent """•..•.'•""..oe Inldc) S.l6Z...0sg0.Rd..S.C.......NASkh..AX IA.Y.erf Ma s. .................. (Add-.) norm air.z—roxt.)_t.ao-tsrso �+ �°"'ter ,_ � (71 ljP T n wnwrblth of Sl3MrllU6Ptt8 ✓ DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION 1010 COMMONWEALTH AVENUE, BOSTON NO. Andover_- March 5_t fi 55 (City or Town) (D.W /. APPLICATION FOR LICENSE dry , y For the lawful use of the herem described building � - N_, o other etuseth land on which is hereby made msword- stru with the provisions r,Chapter uat of the General such for a license to use the land an which such building.... or other A structure.. is/are or is/are to be situated, and only to such extent as sheen on plot plan which is filed with and made Part of this application. \/ Location of la❑d 547 Osgood Street {' 1•� l� / t Neares arose street Abbot ( tc�Owner of land_ ..) _...Address 623„Osgood Street Number of buildings or other structures to which this application applies..one ` Occupancy or me of such buildings Garage .. ...... Total capacity of stored in gallons Aboveground Underground 1000 Kind of PlacfluidU be stored in tanks Gasoline f This application is for a permit to re- capac our present tvro tanks oP.Sdb gallons, with one new tank of 1000 gal. ' capacity. Appmved—B"q*MW .. . .LL _ .1sS f„Edgewood. Farms, Abbot Stevens) Owner �l ,t cse t re ar APPII n '�y-d+.-.-'�•I.�AfcA�,dhfn. 547_.os.good...Street, N.a.. Andover tAaa...q