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12 MASS AVE
5..c►.SI e/ ?�'� !'l%J1�J2�/lilG�/f/'7--� c f�/l-°' /�/,G��I!/ 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, 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). 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): Global Montello Group Corp. (ADDRESS c/o ECS Eclipse 705-A Lakeview Plaza Blvd.Worthington,OH 43085 is the holder of the license granted(Date): for the lawful use of the building(s)or other Amended 8/22/2020 to increase the storage of gasoline in their underground tanks from 24,000 gallons to 32,000 gallons and also added diesel fuel. structure(s) situated or to be situated at(ADDRESS): 12 Mass. Avenue 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 if said license was granted prior to July 1,1936, Otherwi a by the owner or occupant of the land licensed. Receiv 020......... Si nature) By . Avthvl�.z � - .. -?!�e.�...... Offic I i ) (Clerk) (State whether owner,occupant or holder) (Address) a ���a`��c+i SlClttG Department of Fire Services Office of the State Fire Marshall P.O.Box 1025,State Road,Stow,MA 01775 REGISTRATION North Andover, April 30, 2020 (City or Town) (Date) This is to certify that Global Montello Group Corp. 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: Global Montello Group Corp. is the holder of the license granted(Date) for the lawful use of the building(s)or other structure(s)situated or to be situated at: 12 Mass.Avenue as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. (Signature an icial 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 30,2021 E The Commonwealth of Massachusetts Department of IndushialAccidents Office of Investigations Lafayette City Center 2 Avenue de Lafayette, Boston,MA 02111-1750 ` www.massgov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Anulicant Information Please Print Legibly Name (Business/Organization/Individual): &d 6&6 LP Address: ga) Crn,._Lla , City/State/Zip: Phone#: d - Are you an employer?Check the appropriate bog: Type of project(required): 1. I am a employer with M1 4• ❑ I am a general contractor and I employees full and/or * have hired the sub-contractors 6. ❑New construction ( part-time). 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' o workers' com comp. insurance.t 9. ❑Building addition [N p. insurance p• required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑Other comp. insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. law an employer that is providing workers'compensation insurance for my employee& Below is the policy and job site information. Insurance Company Name: -0"- CA nUC�e ��___T__1 Policy#or Self-ins.Lic.#: .,U� �4 Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 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. I do hereby ce fy under t e pains and penahies of perjury that the information provided TT is true and correct Signature: o Date: Phone#: !��' J�?5'•' ©�,Z, Ofeki use only. Do not write in this area,to be completed by city or town o0ciaf j City or Town: Permit/License# Issuing Authority(check one): 1❑Board of Health 20 Building Department 3❑City/Town Clerk 4.0 Electrical Inspector 5alumbing Inspector 6.❑Other Contact Person: Phone#: WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY, Libel'Ly Mutual. INFORMATION PAGE INSURANCE 175 Berkeley Street Boston,MA 02im Issued byLiberty Insurance Corporation(a stock company) 21814 Policy Number WA7-69D-460066-019 Issuing Office Lewiston, ME Renewal Of WAS-69D-460066-018 Issue Date 10/31/2019 Account Number 9-460066 Sub Account 0000 1. Insured and Mailing Address FEIN 74-3140887 Global Partners, LP 800 South Street, Suite 500 NJ TIN 743140887000 WALTHAM MA 02453 Risk ID 911385333 Status Limited Partnership Other workplaces not shown above:See Item 4. Premium-Extension of Information Page 2. Policy Period: The policy period is from 10/01/2019 to 10/01/2020 12:01 A.M. standard time at the Insured's mailing address. 3. Coverage A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: CT FL GA IN IA ME MD MA MT NH NJ NY NC OR PA RI TX VT VA B. Employers Liability Insurance:Part Two of the policy applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 1,000,000 each accident Bodily Injury by Disease $ 1,000,000 policy limit I Bodily Injury by Disease $ 1.000,000 each employee ` C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: All States except those listed in Item 3.A and the States of: ND OH WA WY D. This policy includes these endorsements and schedules:See Item 3.Coverage D-Extension of Information Page 4. Premium: 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 Code Premium Basis Total Rate per$100 Estimated Annual Number Estimated Annual Rerowneration of Remuneration Premium See Extension of Information Page Minimum Premium $1,753 (PA) Total Estimated Annual Premium $ 1,074,457 Premium will be billed Annual Deposit Premium $ 1,074,457 Deposit Tax/Surcharge/Assessment $ 40,229 Producer 0002 000499 Countersigned by Authorized Rep. (FL) LOCKTON COMPANIES LLC(DALLAS SERIES) 2100 ROSS AVE STE 1400 DALLAS TX 752016706 WC 00 00 01 A 01987 National Council on Compensation Insurance.Inc. WIC 00 00 01 B (CA) �.+ mrnl nm All Rights Reserved Page 1 of 1 7 t�G 45 Z Department of Fire Services 9J6 `°b 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): Global Montello Group Corp. W-1 (ADDRESS c/o E-eS Eclipse 705-A Lakeview Plaza Blvd.Worthington,OH 43085 is the holder of the license granted(Date): for the lawful use of the building(s)or other Amended 8/22/2019 to increase the storage of gasoline in their underground tanks from 24,000 gallons to 32,000 gallons and also added diesel fuel. structure(s) situated or to be situated at(ADDRESS): 12 Mass. Avenue 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 if said license was granted prior to July 1,1936, Otherwise rby--the owner or occupant of the land licensed. Rec ' e �..1d....2019..... ... . . ..................................... �....... ^ ��,, Signature) By ......U%0(l .. I1C'.�........ (Official Title) ( I k) (State whether owner,dccupant or holder) 70 e-,A Laevl=11oza'Vrd,l t� .. ' pq.43x (Address) or Department of Fire Services Office of the State Fire Marshall abssV ,Q�a P.O.Box 1025,State Road,Stow,MA 01775 REGISTRATION North Andover, April 30, 2019 (City or Town) (Date) This is to certify that Global Montello Group Corp. 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: Global Montello Group Corp. is the holder of the license granted(Date) for the lawful use of the building(s)or other structure(s)situated or to be situated at: 12 Mass. Avenue 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 30,2020 The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:General Businesses. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Business/Organization Name:Global Partners LP and its subsidiaries and affiliates Address:800 South St City/State/Zip:Waltham, MA 02454 Phone#:781-398-4032 Are you an employer?Check the appropriate box: Business Type(required): 1.❑✓ I am a employer with 3965 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(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,§1(4),and we have 10.0 Manufacturing no employees. [No workers' comp.insurance required]* 11.❑ Health Care 4.❑ We are a non-profit organization,staffed by volunteers, Convenience Store/Gas Station with no employees.[No workers'comp. insurance req.] 12.E Other *Any applicant that checks box#I must also fill 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 such an organization should check box#1. 1 am an employer that is providing workers'compensation insurance for my employees. Below is file policy information. Insurance Company Name:Liberty Mutual Insurance Company Insurer's Address: 175 Berkeley St City/State/Zip: Boston, MA 02116 Policy#or Self-ins.Lic.#WA5-69D460066-018 Expiration Date: 10-1-19 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 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. I do hereby cSMIJ nder t e pains and penalties of perjury that the information provided above is true and correct. i r Da e• Phone# 115� J71S" �� Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Licensing Board S.Selectmen's Office 6.Other Contact Person: Phone#• www,mass.gov/dia WORKERS COMPENSATION AND EMPLOYERS LIABILITY Liberty Mutual. INSURANCE POLICY INSURANCE INFORMATION PAGE 175 Berkeley street Boston,MA 02116 Issued by LM Insurance Corporation (a stock company) 27243 Policy Number WA5-69D-460066-018 Issuing Office Lewiston, ME Renewal Of WA7-69D-460066-017 Issue Date 10/18/2018 Account Number 9-460066 Sub Account 0000 1. Insured and Mailing Address FEIN 74-3140887 Global Partners, LP NJ TIN 141924242000 800 South Street, Suite 500 Risk ID 911385333 PO Box 9161 WALTHAM MA 02453 Status Limited Partnership Other workplaces not shown above:See Item 4. Premium- Extension of Information Page 2. Policy Period: The policy period is from 10/01/2018 to 10/01/2019 12:01 A.M. standard time at the Insured's mailing address. 3. Coverage A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: CT FL GA IN IA ME MD MA MT NH NJ NY NC OR PA RI TX VT VA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: 1,000,000 each accident Bodily Injury by Accident $ Bodily Injury by Disease $ 1,000,000 policy limit Bodily Injury by Disease $ 1,000,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: All States except those listed in Item&A and the States of: ND OH WA WY D. This policy includes these endorsements and schedules: See Item 3. Coverage D- Extension of Information Page 4. Premium: 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 Code Premium Basis Total Rate per$100 Estimated Annual Number Estimated Annual Remuneration of Remuneration Premium See Extension of Information Page Minimum Premium $1,603 (PA) Total Estimated Annual Premium $ 1,019,175 Premium will be billed Annual Deposit Premium $ 1,019,175 Deposit Tax/Surcharge/Assessment $ 39,077 Producer 0002 000499 Countersigned by Authorized Rep. (FL) LOCKTON COMPANIES LLC(DALLAS SERIES) 725 S FIGUEROA STREET 35TH FLOOR LOS ANGELES CA 90017 WC 00 00 01 A 01987 National Council on Compensation Insurance,Inc. WC 00 00 01 B (CA) Ed.07/01/2011 All Rights Reserved Page 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 30,2018 (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 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): Global Montello Group Corp. (ADDRESS c/o ECS Eclipse i 705-A Lakeview Plaza Blvd.Worthington,OH 43085 is the holder of the license granted(Date): for the lawful use of the building(s)or other Amended 8/22/2018 to increase the storage of gasoline in their underground tanks from 24,000 gallons to 32,000 gallons and also added diesel fuel. structure(s) situated or to be situated at(ADDRESS): 12 Mass. Avenue 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 if said license was granted prior to July 1,1936, Otherwise by the owner or occupant of the land licensed. Recei l... .2018......... . .......... .... ............................ (Signature) By . .. Ac AQn,ze�l (Offs i itl (Clerk) (State whether owner,occupant or holder) 70SA.t44, kep,,.Plaza .Wgtfh'(r� Alau.30�S (Address) wi ja Department of Fire Services Office of the State Fire Marshall b�sV �4o P.O.Box 1025,State Road,Stow,MA 01775 REGISTRATION North Andover, April 30, 2018 This is to certify that Global Montello Group Corp. (City or Town) (Date) 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: Global Montello Group Corp. is the holder of the license granted(Date) for the lawful use of the building(s)or other structure(s)situated or to be situated at: 12 Mass. Avenue as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF.FbA,,MMABLES 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 30,2019 4 /'X�y G !y� 3 Department of Fire Services J` , 6b Office of the State Fire Marshal P.O.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 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): Global Montello Group Corp. (ADDRESS): c/o ESC Eclipse 705-A Lakeview Plaza Blvd Worthington,OH 43085 is the holder of the license granted(Date): for the lawful use of the building(s) or other structure(s) situated or to be situated at (ADDRESS): 350 Winthrop Avenue 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 if said license was granted prior to July 1,1936, Otherwise by the owner or occupant of the land licensed. Receiv 4L.12018...... , �................. ..I. ....V.--�......................... Signature) By ......... ....(Official Tie (Clerk) (State whether owner,occupant or holder) (Address) IDepartment of Fire Services Office of the State Fire Marshall asM ��or P.O.Box 1025, State Road,Stow,MA 01775 REGISTRATION North Andover, April 30, 2018 (City or Town) (Date) This is to certify that Global Montello Group Corp. 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: Global Montello Group Corp. is the holder of the license granted(Date) for the lawful use of the building(s)or other structure(s)situated or to be situated at: 350 Winthrop Avenue as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF F MABLES OR EXPLOSIVES. (Signature and Official Title) erk Note:A certificate of registration must be filed on or before April 30'h of each year. (THIS REGISTRATION MUST BE CONSPICUOUSLY POSTED ON THE PREMISES.) EXPIRES APRIL 30,2019 The Commonwealth of Massachusetts = Department oflndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 0211 d-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:General Businesses. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeibly Business/Organization Name: QdhOl DQAVVJ�, 1—P MJ-JS SQ�n C&S? A hate-c, Address: City/State/Zip: V)a&w Phone#: Are you an employer?Check the appropriate box: Business Type(required): l.X I am a employer with_3= employees(full and/ 5.. EKRetail or part-time).* 6. Restaurant/Bar/EatingEstablishment E 2.❑ I 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, [No workers'comp.insurance required] 8.i ❑Non-profit 3.❑ We are a corporation and its officers have exercised 0❑Entertainment i their right of exemption per c. 152,§1(4),and we have 1Q.❑Manufacturing no employees.[No workers'camp.insurance required]*I11.❑Health Care 4.❑ We are a non-profit organization,staffed by volunteers, with no employees.[No workers'comp,insurance req.] 12.0 Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. **If the corporate officers have exempted themselves,but the corporation has other emplDyees,a workers'compensation policy is required and such an organization should check box C. I am an employer that is pro id.ng � workers'compensation insurance form employees. Below is the policy information. Insurance Company Name: Insurer's Address: j 15&1 Ll .si- City/State/Zip: T,S6 l F van n up Policy#or Self-ins.Lic.# M-('C �Q-0� - 4 0&'*01!7 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. 1$2 can lead to the imposition of criminal penalties of a MUM 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 may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby rtify,un r the pains and penalties of perjury that the fitformatiorr provided above is true and correct. i r • Date: P n #: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone#: www.mass,gov/dia WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY '04bertyMutug. INFORMATION PAGE INSURANCE 975 Berkeley Street Boston,MA 02116 Issued by Liberty Insurance Corporation (a stock company) 21814 Policy Number WA7-69D-460066-017 Issuing Office Lewiston,ME Renewal Of WA7-69D-460066-016 Issue Date 1 0/1 812 01 7 Account Number 9-460066 Sub Account 0000 1. Insured and Mailing Address FEIN 74-3140887 Global Partners, LP 800 South Street,Suite 500 NJ TIN 141924242000 PO Box 9161 Risk ID 911385333 WALTHAM MA 02453 Status Limited Partnership Other workplaces not shown above:See Item 4. Premium-Extension of Information Page 2. Policy Period: The policy period is from 10/01/2017 to 10/01/2018 12:01 AM, standard time at the Insured's mailing address. 3. Coverage A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: CT FL GA IN IA ME MD MA MT NH NJ NY NC OR PA RI TX VT VA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item &A The limits of our 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: Part Three of the policy applies to the states, if any, listed here: All States except those listed in Item&A and the States of. ND OH WA WY D. This policy includes these endorsements and schedules: See Item 3.Coverage D-Extension of Information Page 4. Premium: 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 Code Premium Basis Total Rate per$100 Estimated Annual _ Number Estimated Annual Remuneration of Remuneration Premium See Extension of Information Page Minimum Premium i (PA) Total Estimated Annual Premium $ Premium will be billed Annual Deposit Premium $ Deposit Tax/Surcharge/Assessment $ Producer 0002 000499 Countersigned by Authorized Rep. (FL) LOCKTON COMPANIES LLC(DALLAS SERIES) 2100 ROSS AVE STE 1400 DALLAS TX 752016706 WC 00 00 01 A 01987 National Council on Compensation Insurance,Inc. WC 00 00 01 8 (CA) Ed.07/01/2011 All Rights Reserved Page 1 of 1 TOWN OF NORTH ANDOVER OFFICE OF TOWN CLERK 120 MAIN STREET NORTH ANDOVER, MASSACHUSETTS 01845 OE NORTH 1 Joyce A.Bradshaw 3? o� Town Clerk 1 p Telephone(978)688-9501 * FAX(978)688-9557 ITS US t�9 E-mail: jbradshawaa,townofnorthandover.com 2018 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 301h 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 yours to be disnlayed 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 Town Clerk Enc. TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER, MASSACHUSETTS 01845 Joyce A.Bradshaw,CMMC Telephone(978)688-9501 Town Clerk Fax (978)688-9556 f NORTM 1 � 9 SS^CRUSE E-mail lbradshawna townofnorthandover.com TO: All License Holders—Proof of Workers' Compensation 2018 Included in the renewal package for 2018 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 Clerk's Office, 120 Main Street, North Andover, MA 01845. We appreciate your assistance and cooperation. Sincerely, f' Joyce A. Bradshaw, Town Clerk �sF sG 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): Global Montello Group Corp. (ADDRESS c/o ECS Eclipse 705-A Lakeview Plaza Blvd.Worthington,OH 43085 is the holder of the license granted(Date): for the lawful use of the building(s) or other Amended 8/22/2017 to increase the storage of gasoline in their underground tanks from 24,000 gallons to 32,000 gallons and also added diesel fuel. structure(s)situated or to be situated at(ADDRESS): 12 Mass. Avenue 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 if said license was granted prior to July 1,1936, Otherwise by the owner or occupant of the land licensed. Received 2017......... ..... �"1 ..... ........................... Signature) By ....................................... !?h!rp► . iQ145Erl�tE . G?Q Wt1t�L.............. (Official Title) (Clerk) (State whether owner,occupant or holder) (Address) Department of Fire Services w. 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 Global Montello Group Corp. 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: Global Montello Group Corp. is the holder of the license granted(Date) for the lawful use of the building(s)or other structure(s)situated or to be situated at: 12 Mass. Avenue 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 1� 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): Global Montello Group Corp. (ADDRESS): c/o ESC Eclipse 705-A Lakeview Plaza Blvd Worthington,OH 43085 is the holder of the license granted(Date): for the lawful use of the building(s) or other structure(s)situated or to be situated at (ADDRESS): 350 Winthrop Avenue 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 if said license was granted prior to July 1,1936, Otherwise by the owner or occupant of the land licensed. Received ...........................2017......... . . gat e art....................................... .. ...tVK? ? .............. (Official Title) (Clerk) (State whether owner,occupant or holder) 45:A ta►l�aJ pb2�.BIB. .�:�h�r��0►���o�s ., (Address) Department of Fire Services #Xe Office of the State Fire Marshall mod'` r� P.O.Box 1025,State Road,Stow,MA 01775 REGISTRATION North Andover, April 30, 2017 (City or Town) (Date) This is to certify that Global Montello Group Corp. 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: Global Montello Group Corp. is the holder of the license granted(Date) for the lawful use of the building(s)or other structure(s)situated or to be situated at: 350 Winthrop Avenue as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. �ignature 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 The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:General Businesses. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Business/Organization Name: j Ci LIL t ill t LP Address: �Co _ t City/State/Zip: Wtt z Phone #: ' Are you an employer?Check the appropriate box: Business Type(required): 1.Er I am a employer with 57(0 employees(full and/ 5. ❑Retail I or part-time).* 6. ❑Restaurant/Bar/Eating Establishment 2.❑ I 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. [No workers'comp.insurance required] 8. Non-profit 3.❑ We are a corporation and its officers have exercised 9. ❑Entertainment their right of exemption per c. 152,§1(4),and we have 10.0 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'?ct(c taikLi,' *Any applicant that checks box#1 must also fill 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 such an organization should check box#l. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information. Insurance Company Name: L&,d, kvu"—� Insurer's Address: ' City/State/Zip: � f 1 Policy#or Self-ins.Lie.# (-) fF`i Expiration Date: I o b Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of 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. I do hereby ce; y,under Ire pains and penalties of perjury that the information provided above is true and correct. Signature: "L Date: ! Phone#: r _t 9_ 'rW Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Cleric 4.Licensing Board 5.Selectmen's Office b.Other Contact Person: Phone#: www.mass.gov/dia WORKERS COMPENSATION AND EMPLOYERS LIABILITY �kgbertyMutual. INSURANCE POLICY INSURANCE INFORMATION PAGE 175 Borkat.y Street eo.ton,MA 02118 Issued by Liberty Insurance Corporation (a stock company) 21814 Polley Number WA7-69D-460066-016 Issuing Office Lewiston,ME Renewal Of WA7-69D-460066-015 Issue Date 10/18/2016 Account Number 9-460066 Sub Account 0000 1. Insured and Malting Address FEIN 74-3140887 Global Partners,LP NJ TIN 141924242000 800 South Street,Suite 600 Risk ID 911385333 PO Box 9161 WALTHAM MA 02453 Status Limited Partnership Other workplaces not shown above:See Item 4.Premium-Extension of Information Page 2. Policy Period: The policy period Is from 10/01/2016 to 10101/2017 12:01 A.M. standard time at the Insured's mailing address. 3. Coverage A. Workers Compensation Insurance:Part One of the policy applies to the Workers Compensation Law of the states listed here: CT FL GA IN IA ME MD MA MT NH NJ NY NC OR PA RI TX � VT VA B. Employers Liability Insurance: Part Two of the policy applies to work In each state listed in Item 3.A. The limits of our liability under Part Two are: 1,000,000 each accident Bodily Injury by Accident $ Bodily Injury by Disease $ 1,000,000 policy limit Bodily Injury by Disease $ 1,000,000 each employee C. Other States Insurance:Part Three of the policy applies to the states,9 any,listed here: Ali States except those listed in Item&A and the States of. ND OH WA WY D. This policy Includes these endorsements and schedules: See Item 3.Coverage D-Extension of Information Page 4. Premium: The premium for this policy will be determined by our Manuals of Rules,Classifications,Rates and Rating Plans. Ail information required below is subject to verification and change by audit. Classifications Code Premium Basis Total Rate per$100 Estimated Annual Numb r EstimatedAnnual Remuneration of Remun Premium Soo Extension of information Page _ Minimum Premium $1,806 (PA) Total Estimated Annual Premium $ Premium will be billed Annual Deposit Premium $ DepositTax/Surcharge/Assessment $ Producer 0002 000499 Countersigned by Authorized Rep. (FL) LOCKTON COMPANIES LLC(DALLAS SERIES) 2100 ROSS AVE STE 1400 DALLAS TX 752016706 Producer MASTERS 6828 Irving,TX WC 00 00 01 A ©1987 National All Council on Reserved lion Insurance,Inc. WC 0o 00 01 Page1(MCA) Ed.07/01/2011 i - w An kTCe lip e The petroleum industry leader for compliance and fuel management. G April 7, 2017 North Andover Town Clerk 120 Main Street North Andover, MA 01845 RE: FPS Certificate of Registration Renewals -Global Montello Group Corp. 350 Winthrop Avenue 12 Massachusetts Avenue To Whom It May Concern, ATC Eclipse is an environmental and compliance consulting firm retained by Global Montello Group Corp.to assist with their storage tank compliance program. In this role, I am writing to renew FP5 Certificate of Registration for the above-referenced facilities. Please find enclosed the documentation needed to perform the renewals,as follows: 1. 2 Certificate of Registration Renewal Applications 2. Worker's Comp Form 3. Remittance in the amount of$300.00 - Check#074983 Our client requests that the new permits and future renewals be sent to my office at the address below for processing and distributing to the sites. Global Montello Group Corp. C/o ATC Eclipse 705-A Lakeview Plaza Blvd. Worthington, OH 43085 Thank you for your assistance. If you have any questions or need any further information, please feel free to contact me at 614-433-0170. Sincerely, ATC Eclipse ONNS-�j Wendy Morgan Compliance Analyst Enclosures 705-A Lakeview Plaza Blvd. Worthington, OH 43085 O: 614-433-0170 F: 614-433-0217 /ATCGroupServices.com W z a Department of Fire Services 4 Office of the State Fire Marshal P.O-Dox 1025,Su1c Road.Stew, MA 01775 CERTIFICATE OF REGISTRATION North Andover April 30, 2016 Kite o(rowo) (Unm) NOTE:(bmplew lop and bottom of form and forward boll sections and flee to local Licensing Aulhorit) ICih or I(,+n t'erk) 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 HOLIJER): Global Montello Group Corp. !ADDRESS do L'.CS Eclipse 70S-A Lakcvlcu Phan 11hd.wonhmgnm.(111 J3081 is the holder of the license granted (Date): for the lawful use of the buiti ing(s) or other Amended 8/22/2016 to increase the storage of gasoline in their underground tanks from 24,000 gallons to 32,000 gallons and also added diesel fuel. structure(s) situated or to be situated at(ADDRESS): 12 Mass. Avenue NORTH ANDOVER, MA (H845 '(,,or lbvm) as related to the KEEPING. SIORAGF.. MANUFACTURE OR SALE01: FLAMMADLES OR EXPLOSIVES. NOI'r.: This crumattofregistration mustbesigned by the holder of the license ifsild license was granted priormJuk 1,1936. �-yO�t�herrwise be the owner or occupant all land licensed. R cel edAInT.D I!>_x� _20 Al VIx( w p`.��a14}, kcLanil2 . ....... onmlal rid,) Clcrkl (State whelhcr qavncr_nu,,anr or I to,,, tnddr�) l.oeruruzruJ,eaGG/a � �aadac�ivac.CCa W <. Department of Fire Services s Office of the State Fire Marshall L T dyseN � v� P.O. Btu 1025. State Road Stew.MA 01795 REGISTRATION North Andover, April30, 2016 Chart own) (1)a11l This is to certify that Global Montello Group Corp. has'_in accordance with the provisions of Chapter 148, Section 13, ofthe General Laws. filed with me a certificate of registration setting forth that: Global Montello Group Corp. is the holder of liceme granted(Date) for the lawful use of the building(s)or other structure(s)situated or to be situated at I) Most. Avenue as related to the KEEPING, STORAGE. MANU17AC I RF: OR SALE OF F' 1vIMe1,13LFS OR EXPLOSIVES. ." l LQ:.\ s,ta,trc and Official Tit 9 ) Clerk Vol, A nail at ill"lot ton must he filed on ar le,kre April 3ni of each y,ar. (THIS REGISTRATION MUST DE CONSPICUOUSLY POSTED ON THE PREMISES.) EXPIRES APRIL 30,2017 ir The Commonwealth ofMassachuselts Department of Industrial Accidents' a 1 Congress Street,Suite 100 Boston, MI 02114-2017 tvlvtnnmks.gon dia Workers'Compensation Insurance Affidavit:General Businesses. TO BE FILED WITH This PERMITTING MITI IORI'I'V. Annlicant Information Please Print Legibly Business/Organization Name_Global Partners LP its affiliates and subsidiaries Address:800 South Street City/State/Zip:Waltham, MA 02454 Phone N:781-398-4032 Are yearn employer?Check the appropriate box: Business*1'ype(required): LQ I am a employer with 3000 cmployces(lull and/ 5. ❑✓ Retail or part-lima).* 6. ❑ResrauraNBar/l;aling Establishment 2.0 I um a sole pmprictor or partnership and have no ❑Office ct 7. and/or Sales load.real estate,rate,etc.) employees working for me in any capacity. (No workers'comp. insurance required S. ❑Non-profit 3.0 We are a cot oration and its of ficors have exercised 9. ❑ Farertainment their right of exemption per c. 152,§1(4),and we have 10.❑ Manufacturing no employees.[No workers'comp. insurance required)* .❑ I Icallh('are4.❑ We are a non-profit organization,staffed by valunteeis, with no employees. I No war less comp.insmvnce req 12.❑Other °Ary appliart that dicks has III a alt also fill nor he scene,bolo,eheacag[I at, oocc,, emnpensatloa pal,matn aa.,r ^If tile curyowleofnwohave cereaed thentselvee,hattheeonmmtiuo has effraemPlayees,n,rorkms'e penaaaeo carte,e,L,,t andsuch or orga...ation Alton)check We Ill. I am an einpioyer ibat is providing workers'cmnpensatian/asurnrrce Jor nT employees. Below is the policy infuratadon. Insurance Company Name:Llberly Mutual Insurance Company Insurer's Address: 175 Berkeley Street City/State/Zip: Boston,MA 02116 - — policy It or Self-ins.Li,.fl WA7-69D-460066-15 Expiration Date:10-1-16 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration(lale). Pailu t,to secure coverage as required under Section 25A ol'MGL c. 152 can lead to the imposition ofcriminal penalties ofa fine up to S 1,500.00 matter one-year unprisommenl,as well as civil penalties in the farm offs STOP WORK ORDER and a line of to$250.00 it day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of thn UTA for inwrance coverage nxihcation. I herzbv car under Ow pains au petmhies of perjury that Ore information provided above is true anrd correct. li mature: ��— I _ Date J%l Phone d' �C7 _' Offfciai use oniv. Do not write in Ibis area,to be completed by city or low"official. City or ],run: Perm lt/Liceuse 4 Issuing Authority parade one): 1.Board ofllealth 2. Building Department 3. Cityffown Clerk 4. Licensing Board fSelectmen's 6.Other Contact Person: Phone It: !j rvwry r acs govtdal f E 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY Lib I N SL Mutual.NANCE INFORMATION PAGE 175 Berkeley SUM Boabn,MA 02118 Issued by Liberty Insurance Corporation (a stock company) 21814 Policy Number WA7-69D-460066-015 Issuing Office Lewiston, ME Renewal Of WA7-69D-460066-014 Issue Date 10/15/2015 Account Number 9-460066 Sub Account 0000 1. Insured and Mailing Address FEIN 74-3140887 Global Partners, LP NJ TIN 141924242000 800 South Street,Suite 500 PO Box 9161 Risk ID 911385333 WALTHAM MA 02453 Status Limited Partnership Other workplaces not shown above: See Item 4. Premium-Extension of Information Page 2. Policy Period: The policy period is from 10/01/2015 to 10/01/2016 12,01 A.M. standard time at the Insured's mailing address. 3. Coverage A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here CT FI. CA IA ME MD MA MT NH NJ NY NC OR PA RI TX VT VA B. Employers Liability Insurance. Part Two of the policy applies to work in each state listed in Item 3.A. The limits of our 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: Part I hree of the policy applies to the states, if any, listed here: All States except those listed in Item 3.A and the States of: NO OH WA WY D. This policy includes these endorsements and schedules: See Item 3. Coverage D-Extension of Information Page 4. Premium: 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 Code Premium Basis Total Rate per$100 Estimated Annual _ Number Estimated Annual Remuneration of Remuneration _ Premium See Extension of Information Page Minimum Premium $1,771 (PA) Total Estimated Annual Premium $ 1.041,289 Premium will be billed Annual Deposit Premium $ 1,047,289 Deposit Tax/Surcharge/Assessment $ 106,089 I Producer 0002 000499 Countersigned by Authorized Rep. (FL) COMPANIES LLC (DALLAS SERIES) 2100 ROSS AVE STE 1400 DALLAS T DALLAS TX 752016706 Producer MASTERS 8828 Irving,TX i WC 0000 01 A 01987 National Council on Compensation Insurance,Inc. WC 00 00 01 B (CA) Ed.07/01/2011 All Rights Reserved Page 1 of 1 �� � �pztDtL4J o� aGh4.oeCtd 111 s i >a Department of Fire Services „. Office of the State Fire Marshal P.O. Has 1025 Stale(toad,Stu,. ,NIA 01775 CERTIFICATE OF REGISTRATION North Andover April 30, 2011 Icily or Tow°I IDete, N O'FE:DOmplem lop and bottom of form and Turn artl bosh xeclions and fm to local Licensing Authority(City ar lbx'n Clerk). DO NOT RETURN FORM TO TIII:DEPAR7 NEN'f OF FIRM:SERVICES, In accordance with the provisions of Chapter 148. Seetioa 13,Of the General I.aws, the undersigned hereby certifies that: (I iT1-L IIOLDISO Global Montello Group Corp_ (ADDRJ_SS co Gtko,tl Vecdcr-Root CMS 73ao R. 1-l1111111 Me,MS f76.(irccmbom,NC 27420 is the holder of the license granted(Date): Amended 8/22 � for the lawful use of the building(s) or other /_U a, increase the storage of gasoline in [heir underground tanks from 24,000 gallons to 32,000 gallons and also add diesel fuel. strucmrc(s)situated or to be situated at(ADDRESS): 12 Mass. Avenue NOR"fll ANDOVER, MA 01845 (city or ro,„,1 as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR LXPLOSIVLS. S o I:: This certificate of regis[rat ion most be signed by the holder of the license d,vod license xas Olhen•ise by the owner or ot,emot of the land licenxd. granted prior to July 1,1936. Rwuecd ! l 011..,_.... {! < C By � <�Ch Irh mn21 - AI. ........................... IS'tak whether ns,,,, oaupaal or holder) ............................ 2`1ti- �_.eL�fc ✓✓ adQ.ae%124 w,r;LLQ v Department of Fire Services Office of the State Fire Marshall n n P.(1. Bon 1025, Slate Rlad, Shns, MA 01775 REGISTRATION North Andover, Apri130, 2011 T his is to cel'llf' that Global Montello Group Corp, aaa�rrm„o (Doer las, in accordance with the provisions of Chapter 148, Section 13, of the General Laws, filed with are a certificate of egtstr anon setting forth that: Global Montello Group Corp. s the holder oithe license granted(Dale) br the lawful It, It building(s)or other structures)situated or to be situated at: 12 Mass. Avenue s related to the KEEPING. STORAGE, MANUFACTURE OR SALF OI' FLAMMABI.ES ( I,OSIVGS. 0 r V m 4 molt t t.�slmtim moat he f I.d on a hellre Apt it30"' t { lti°'4 pfbcial nU Clerk (THIS R GIS]RATION MUST BE CONSPICUOUSLY POST LD ON THE PREMISES.) EXPIRES APRIL 30, 2012 -1 re �amtiilz rrure2 � r�^f� {� � ra.mc�u;elG GIS Coordinates i/ L1Cellse Massachusetts General Law,Chaptci 148 §13 IH 0:2009J �� � El Now License id-An7ended Licensc After notice end hearing, and in accordance with Chapter 148 of the Mass_General Lew,, a license is hereby granted to use the land herein described for the purposes described. Locution 'It Land r - ���1� /l��ll�t<tl4 Owner of Land. -- Address of Lend — �-1./s,Lt__1L�1�1/11LtL��1! ��_l� _ Flammable and Combustible Li( Dids Flammable Cases and Solids lT C,npl r rA :/n do to' yr'IP v lh �dIII/ (der vdrr d ffil. I .../ lls, l / I el J//ccros'.gr rdp"'c"1 „ (Alf"k orldv .... d 1/1ruksa l rrminur.are m pnyre'ijncc�aa'ur r.l PRODUCT NA AIE CLASS MAXIMUM UNI'r5 QDAN7'ITY (.ON7' TI gal,Ibs, LIST,' AST,ST, TIC, tnmereet �AII I _`�.z1�/:"r--• z,riL� dums jr� ---- it -- L��L l, r r//"ass/ f - .. � !v9 emu antlp (In bsllens)It LP-gas to be"'I"' "''ic"111"Llryl ruminers':__ List sizes and capacities of all aboveground containers used for storage h9 It a I, lily(In gellonoofIPq,t'In be stored In todergrourd...... net, I III sties Iud capadte, of all undo ound coniamcrs usad for storage 7hml IlgpmI IL quantity If all LP-pay to besml..If Firew( rks r('onpde'rr tIlia.v,rec,,f,,Ih, :um'eg�ol�rcunrhr9 q�:IYIIn LIIII FIInoGp(tilt poll../')cfCl19A I.]C_ • Mi'l....Iu dm011lll(:n polnrcls)of Clays JAO.. b1uuilnanl:urmiall fin poarz r)cf(III,, LIL olal ayprclate ymuviry ofall clns_vcs nl'firewnrks to be slurcA. TITS LICE (III A C'LRTIFJFn Ci IF HI RL'OF MUST I3L CONSPICIOUSLY POSTED ON THE LAND FOR NVUUCH PI'IS(MAN]ED, EYRI Old'US �(bmplerc rhia.veolonl;'the s/arnyo ojcpr/osi vae) hI .:muni rm;u u(in poiaul�)ol'Cluss 1.I N umher of mnguziucv used fonsmrugc � n mn ammmi (in......... 0l Cless 12. --- Nninberofnmgm.iner ue'ed for,elnmec Ni nrun pn ouv (in pound) IChvsl l: N --_ unibcr of n�aga.ii es uvcd Inr sn -;yr. t`1 ir,I. :muuni(iu pu n Asl o.('Insa 1.4: —_ - Numhe;of mugmivea r1of I... xge: 41 miwn un of v (in pmumf) HCI':S LS: - - Nun l ,r of niug;vincs rased for_vmmgo M ......m umaunl(/r pnmrAU II U;s> Lb: — — Nwnber of mug;vincv uvcd for smruge: I,icensine Autlmrih U This keens' is granted upon the condition that the licensed activily will comply with all applicable laws, coda odes and regulations, including but not limited to Massachusetts General Law, Chapter 145, and the Nb1SgCJlLSCIlS Fire Code(527 CMR) as amended, 'I'hC license holder may not store materials in an amount eseceding pie capacities herein specified unless and until any amended license has been granted. ADDITIONAL RESTRICTIONS: THIS LICENSE OR A CERIWwD COPA"THEREOF NIIIS'I III'1 CONSPICIOHSI,Y POS I ED ON THE LAND FOR WHICH IT IS(;RANTED. In'C If— 6`53n0vt Pugu_ I _ TOIL(800)225-1927 Direct(781)402-8883 (781)094-7799 '� ��Iliance � i �+ Alliance Rncrgy LLC DAN BERRY 404 Wyman Street,Suite 425 G—trvo wlMainrenance5u erv¢m { 9� l+.i Waltham,MA 02451 dberry"allianoeenargy-com i i I i Fitzgibbons, Karen To: dber Subject: rYv ceenergy com 12 Massss Avenue Good Morning Dan, At their meeting of August 22, 2011 the Board of Selectmen voted favorable on Alliance Energy, LLC's application requesting an increase in the storage of gasoline in the underground tanks from 24,000 to 32,000 gallons and to also add diesel fuel at the location of 12 Massachusetts Avenue. The Town Clerk's Office is working on processing the paperwork and will contact you when completed. Due to summer vacations it likely won't be until the middle of next week. Thank you for your patience and all of your assistance in this matter. I will keep you posted. Karen 998-68&9501 t TOWN OF NORTH ANDOVER OFFICE or TOWN CLERK 120 MAIN STRF,I r NOli I I I ANDOVFR. MASSACIII;SF;"I I 01945 (eA. Hradshaw, CMMC Clerk Telephone(978)688-9i01 I'AX (978)688-9557 MEMORANDUM 1 O: Tracy Watson, Chairman BOS Members of the Board of Selectman James Purcell, Interim 'Down Manager FROM: Karen A. Fitzgibbons, Asst. 'town Clerk4'iv DATE: August 16. 2011 SUBJEC' I': Gasoline Storage— 12 Mass. Avenue .Attached please find a letter from Alliance Energy, LLC, written on behalf of Global Companies, I.I.C. regarding the gas station Global owns located at 12 Massachusetts Avenue, North Andover, MA, Alliance Energy is requesting to increase the storage of gasoline in the underground tanks from 24.000 gallons to 32,000 gallons and to also add diesel fuel. The Fire Department has been working with the applicant on this project and 1.t. McCarthy recommends favorable action. At their meeting in July, the Conservation Commission issued an Order ot('onditions and stormwater management improvements have been made. The legal notice was published in the North Andover Citizen on August 5, 2011 and all abutters were duly notified and proofof mailings are in the oil-ice file. If you have any questions or concerns, please do not hesitate to contact me. ,&&ll_iance Alliance Energy LLC A Global Partners LP Management Company March 30, 2011 F( Mn Clerk's office 120 Main Street North Andover 01845 Attn: Karen Fitzgibbons VIA I IRST CLASS MAIL RL: Underground Storage -anL Rc lacemcnt and I't Pension: L Massachusetts Avenu North AndoNcr, Massachusetts Dear N1s. Fitzgibbons: I and writing on behalf of Global Companies LLC, as their managing agent, regarding the gas station Global owns at 12 Massachusetts Avenue, North Andover, MA. The underground storage larks at that location are reaching their"end of life", prompting us to replace them in the near finale. It would be very beneficial to us ifduring the replacement process we were able to expand the capacity of the underground storage tanks from 24,000 gallons to 32,000 gallons by replacing the current tanks will slightly larger lanks. W'c are aware that this station is located near a river and we have accordingly hired MHF Dcaign who has a water source engineer organizing our plan and overseeing the proposed tank replaccment. Additionally, we have been in contact with Lieutenant McCarthy of the North Andover I he Department and we are currently working with the fire deportment regarding the proposed work. Please feel free to contact Dan I3er y, our cnvirunmental/maintenance manager, al (781) 4W-88N, if you have any questions. l eon Ryee"ards, I)ante Dcli>o Associate (]elicial Counsel P. ,-ei14eH � , o /�°r�cP W ri/onela�emenp uE s Il and^p�hg�hP-pl 4^none. / TOWN Of NOR]IJIANUOV6R pB W/ m o B e ed l�2 /h n,'Tp Ihpl 01 P1( L OI npn BPM sia� 'oh in°hp TOWN CLERK G/ n a app� I N Me tPmd sB pp �p_tl /oF Byr _ngntlBq�IhP 10 ,%1AIN S I RIFI 4�tl e�4°ol tiv sic pe ° %a4 iNORI II ANI)OVi R, M ASS1('HLISL I IS (1 18�6 ll. '�s,�a. hprro 2/0 p�'/9CyPg2lhPp PicP �dtpd d9 pl Op 10 B N � I 32tl tll p �h ryp io /BBBb l�/9d Ape * ,fix ann :cep ^d 1 1 a a h �oo am. CMMC s o %q q'Pnd� _Iro�ea telephone(9781 G88-9S01 h,zSs�B Norm k N L 1`%X (978) 688-9s97 gp657P4ertep ' 'ss'ncw Public Hearing Notice Board of Selectmen Town of North Andover Noticc is hereby Lived that the Licensing Commission, Town of North Andover, will hold a public hearing on August 22, ,I 1 at 7 30 pm rn the Board of Selectmen's Meeting Room, 120R Main Street, North Andover, he In the application recemed from All'ance Energy, LLC, on behalf of Global Companies, LLC regarding the gas station Global owns located at 12 Massadiusetts Avenue, North Andover, MA. The applicant is proposing to increase the storage of gasoline in their endergruund tanks from 24,000 gallons to 32,000 gallons and to also add diesel fuel. The tanks are stored underground ana ocated at 12 Massachusetts Avenue, North Andover, MA. "I OWN OF NOR III .4ND0VP;R OFIICG OI TOWN CLERK I°0 MAIN slRI I I NnR III ANlt()l lit, N1:NStigClit 14 1 IS 018-If e 1AI4racidnis ( 'AMC Tclepl on ONIGk N 9i01 IJ Public Hearing Notire Board of Selectmen town of NurNr Andover c < b1 Pg,,, that tko Licensing Colmnission, Town of North Andover, will hold a public hearing on August 27 1 it ,u pm n-he Board of Selectmen's Meeting Room, 120R Main Street, North Andover, MA on the application 1 elvoa tl rrn All ance Lnergy, LLC, on behalf of Global Companies, LLC regarding the has station Global owns located al B sa,h IhISPtf Avenue, North Andover, I The applicant is proposing to increase the storage of gasoline In their n;cn ul Irnl s 'rom 24,000 gallons to 32,000 gallons and to also add diesel fuel The tanks are stared underground n rated 3t 12 b9n55achusetts P.venrte, North Andover, MA_ n NDSl12 MAS3A1.NOTICE AVErl s k o RualcHyeake, yd t Soera W Suecemenre tl IN of NorM Antlover d Notice hereby given that the d Licensing Commbsron Town of North 11 Adovr,wYl hold a public heading on Boardeof$&admen6 Mee" Roompery I, e n 12oR Male Street,North Merrier MA be the a plication eceived from pAlliance �nergy, LLC on behall of Global CoaGgP des, LLC regarding the e 9e stet It dear pbe Jostledue al 112i l- Andorec MA.The applbaM Is pro 1.9 reic vdaa geroun t storage froomza 000 g illors to 32,000 gallons and to also ad Glee d fuel, The tanks are stored derground end IOCeletl a, 12 Massrchu(etle Avenue, North Anapver,MA. NotAD ndrov<A be I Adorer Clllzen 8f3/fi - N,mrc,mAOW l er—e 'p Iv I 1 cnuorva(wn r 1 IDinr9 eEO U/eEM T_ ,ram un a my n .gym n M,i on i, $ubpct Gr MAP PA9CfL Nerne Atltlress 2 3 Global Companies,LLC Alliance Energy,LLC 36 East Industrial Road Branford CT 06405 Abutters Pro erties Map Parcel Name Address 1 Patob Realty Tmet 9 1 Massachusetts Avenue North Andover,MA 'Islas Spruce Wood Realty 30 Massachusetts Avenue ssachusetts Avenue North Antlover,MA 01845 ` James McMurray 25 Ma 2 1 it ROsage Realty North Andover,MA 01845 2 11 Keith Harley 2'Massachusafm Avenue North Andover,MA 'Islas P_ Joyce Sullivan- COmmonwealtnwealtM1 Avenue North Andover,MA 01845 11 Cmmonweelth Avenue North Antlover,MA 01845 Ie Ryan Tankersley - 15 Coommonwealth avenue 1- Rachelle CaWrano North Andover,MA 01845 In Scott Salivate Commonwealth Avenue Nohh Andover,MA 01845 Y Rosage Realty. 23 Convnontreelth Avenue North Antlover,MA 01845 40 Shaheen Guerra&O'Lear ,LLC 100 Salem Street North Antlover,MA 01845 Y 17 Massachuseils Avenue North Andover,MA 01845 This certifies that the names a aar,� 712201 appearing on the records of the Assessors Office as of Certified by:_ Date ��' 2r Fitzgibbons, Karen From: Hughes, Jennifer Sent: Friday, August 05, 2011 10.13 AM To: Fitzgibbons, Karen Subject: RE. Alliance Energy, 12 Mass Avenue Is this the Mobile Station?The Conservation Commission issued them an Order of Conditions last month for replacement of underground fuel storage tanks and gasoline dispensers. Stornewater management improvements were also made. Let me know if you need more information. Jennifer A. Hughes Conservation Administrator Town of North Andover 1600 Osgood Street, Bldg 20, Suite 2-36 North Andover, MA 01845 phone 978.688.9530 Pox 978.688.9542 From: Fitzgibbons, Karen Sent: Thursday, August 04, 2011 11:38 AM To: McCarthy, Fred; Hughes, Jennifer Subject: Alliance Energy, 12 Mass Avenue Good Morning Fred and Jennifer, Alliance Energy, 12 Mass Avenue, is scheduled for the August 22, 2011 BOS/Licensing Comm meeting. I am looking for any recommendations your departments can provide. If you could have them to me no later than Monday,August 15th I would appreciate it. Thank you in advance for your assistance. Karen hIt¢/Iwww hm 1 Fitzgibbons, Karen From: McCarthy, Fred Sent:To: Thursday, March 31, 2011 4.26 PM Fitzgibbons, Karen Cc: Melnikas, Andrew Subject: RE: Alliance Energy LED Re 12 Mass Ave Karen I had a meeting with Dan Berry of alliance Energy regarding the replacement of all underground fuel tanks, piping and other related equipment. The Proposed tank field would not increase substantially in square footage. The proposal calls for replacing 3 tanks with 2 larger tanks in the same field. I will review the plan with Chief Melnikas and write a letter of recommendation to Alliance Energy. They are aware of having to notify conservation and the probability of having to file. I will send a copy of this email to Jennifer and work with her throughout this process. At this point I would say the fire department would be favorable toward this upgrade. Is this what you are looking for at this time, let me know. Regards. Fred M From: Fitzgibbons, Karen Sent: Thursday, March 31, 2011 11:34 AM To: McCarthy, Fred; Hughes, Jennifer Ca Bradshaw, Joyce Subject: Alliance Energy, LLC Good Morning Fred &Jennifer, Just received this letter re the above named business. Before the Clerk's Office proceeds with the request, wejust wanted to verify that Alliance Energy has indeed contacted your departments. If so, could you please give us a brief status. Thank you very much, Karen Mto//www sac stale m_a. uI//Qre/ore ft hi — 1 Fitzgibbons, Karen To: McCarthy, Fred, Hughes, Jennifer Subject: Alliance Energy, 12 Mass Avenue Attachments: noreply@townofnorthandover com 20110804 114432 Good Morning Fred and Jennifer, Alliance Energy, 12 Mass Avenue, is scheduled for the August 22, 2011 BOS/Licensing Comm meeting. I am looking for any recommendations your departments can provide. If you could have them to me no later than Monday,August 15th I would appreciate it. Thank you in advance for your assistance. Karen 1 Fitzgibbons, Karen To: McCarthy, Fred; Hughes, Jennifer Subject: Alliance Energy, 12 Mass Avenue Attachments: noreply@townofnorthandover com_20110804 114432 Good Morning Fred and Jennifer, Alliance Energy, 12 Mass Avenue, is scheduled for the August 22, 2011 BOS/Licensing Comm meeting. 1 am looking for any recommendations your departments can provide. If you could have them to me no later than Monday, August 15th I would appreciate it. Thank you in advance for your assistance. Karen t Fitzgibbons, Karen To: legals@wicked loca I.com Subject: Legal Notice Please post the following Legal Notice in the North Andover Citizen on August 6, 2011, Also, please confirm to me that You have received this e-mail. Thank you very much! Karen Cr 978-688-960f Public Hearing Notice Board of Selectmen Town of North Andover Notice is hereby given that the Licensing Commission,Town of North Andover, will hold a public hearing on August 22, 2011 at 7:30 pm in the Board of Selectmen's Meeting Room, 120R Main Street, North Andover, MA on the application received from Alliance Energy, LLC,on behalf of Global Companies, LLC regarding the gas station Global owns located at 12 Massachusetts Avenue, North Andover, MA. The applicant is proposing to increase the storage of gasoline in their underground tanks from 24,000 gallons to 32,000 gallons and to also add diesel fuel. The tanks are stored underground and located at 12 Massachusetts Avenue, North Andover, MA. 1 ��o o TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER. MASSACHUSE.EFS 01815 .h,"A. Bradshaw, CVIMC' Tcicphone(978) 688-9501 Town Cl,k P'ax (978)688-9557 F.-mail ibrodslun.Iiaow'�of� tl 1 FACSIMILE TRANSMITTAL FORM DATE: d ADDRESSEE: NAME: FIRM: S FRE ET: CITY: FAX NUM: FROM: NAME: _dF)}E=F A—B4F;tlyil}AW DEPT.:,w,,/- TOWN CLERK 120 MAIN STREET NORTI1 ANDON ER, MA 01845 TELEPHONY:: (978) 688-9501 FAX :NUMBER: (978) 688.9557 TUT A , NUMBER OF PAGES, INCLUDING COVER LET I'ER: 11Z ADDITIONAL COMMENTS: Ia; Fitzgibbons, Karen To: Hoyen, Carol Subject: RE. Legal Notice Carol, Thank you for painting that out - I must have been looking at the wrong day! Also, it dawned on me I forgot to say who to bill (can you tell I'm having a great day???) anyway,this is the name of who Should be billed: BIII to: Alliance [ nergy, LLC c/o Dan Berry 404 Wyman Street, Suite 425 Waltham, MA 02451 Phone: 18 L 402-8883 From: Hoyen, Carol LMaiito.choyen@Aickedlocal.core] Sent: Thursday, July 28, 2011 3:22 PM To: Fitzgibbons, Karen Subject: RE: Legal Notice Rec'd for 8I5/11 (It is a Friday publication not Saturday). From: Fitzgibbons, Karen [mailto:kfitzaib( townofnor[handover.com Sent: Thursday, July 28, 2011 2:53 PM To: Legals Subject: Legal Notice Please post the following Legal Notice in the North Andover Citizen on August 6, 2011. Also, please confirm to me that you have received this e-mail. Thank you very much! Karen r�r ,/tp..�tY�i�'ierd .C.�idanL � + 978-688-96O1 Public Hearing Notice Board of Selectmen Town of North Andover Notice is hereby given that the Licensing Commission,Town of North Andover, will hold a public hearing on August 22, 2011 at 7:30 pm in the Board of Selectmen's Meeting Room, 120R Main Street, North Andover, MA on the application received from Alliance Energy, LLC,on behalf of Global Companies, LLC regarding the gas station Global owns located at 12 Massachusetts Avenue, North Andover, MA. The applicant is proposing to increase the storage of gasoline in their underground tanks from 24,000 gallons to 32,000 gallons and to also add diesel fuel. The tanks are stored underground and located at 12 Massachusetts Avenue, North Andover, MA. 1 Fitzgibbons Karen To: dberry@allianceenergy.com Subject: Legal Notice Hi Dan, Below is a copy of the legal notice I plan to send to the local newspaper. Please review it and let me know if you approve the wording. I am out tomorrow and Monday, will return Tuesday 7/26/20,1. You are on the August 22, 2011 agenda so we have plenty of time to advertise. 97,Y 6d8-96O/ TOWN OF NORTH ANDOVER —LICENSING COMMISSIONERS PUBLIC HEARING NOTICE Notice is hereby given that the Licensing Commission, Town of North Andover, will hold a public hearing on August 22, 2011 at 7:30 pm in the Board of Selectmen's Meeting Room, 120R Main Street, North Andover, on the application received from Alliance Energy, LLC, on behalf of Global Companies, LLC regarding the gas station Global owns at 12 Massachusetts Avenue, North Andover, MA. The applicant is proposing to increase the storage of gasoline in their underground tanks from 24,000 gallons to 32,000 gallons and to also add diesel fuel. The tanks are stored underground and located at 12 Massachusetts Avenue. i Fitzgibbons, Karen From: dberry@allianceenergy.com Sent: Monday, July 25, 2011 12,38 FM To: Fitzgibbons, Karen Subject: Re: Legal Notice Hi Karen this looks fine Tkx Dan Dan Berry Construction / Maintenance Supervisor Alliance Energy LLC 404 Wyman Street Suite 425 Waltham, Mo. 02451 From: "Fitzgibbons, Karen" <kfitz¢i b(dtownofnorthando er com> To: "dberry0allianceene " <dberry(@allianceenergy.co > Date: 07/21/2011 01:59 PM Subject: Legal Notice Hi Dan, Below is a copy of the legal notice I plan to send to the local newspaper. Please review it and let me know if you approve the wording. I am out tomorrow and Monday, will return Tuesday 7/26/2011. You are on the August 22, 2011 agenda so we have plenty of time to advertise. Karen Fitzgibbons Assistant Town Clerk 978-688-9501 TOWN OF NORTH ANDOVER BOARD OF SELECTMEN PUBLIC HEARING NOTICE Notice is hereby given that the Licensing Commission, Town of North Andover, will hold a public hearing on August 22, 2011 at 7:30 pm in the Board of Selectmen's Meeting Room, 12013 Main Street, North Andover, on the application received from Alliance Energy, LLC, on behalf of Global. Companies, LLC regarding the gas station Global owns at 12 Massachusetts Avenue, I Fitzgibbons, Karen From: Bradshaw, Joyce Sent: Tuesday, July 12, 2011 4.00 PM To: Fitzgibbons, Karen Subject: FW: Mobil 12 Mass. Ave We can put this on the August 22, 2011 agenda. -----original Message----- From: dberrvLa llianceenerey com [mailto,dberry0allianceene coml Sent: Tuesday, July 12, 2011 3:44 PM To: Bradshaw, Joyce Subject: Mobil 12 Mass. Ave Hi Joyce We propose to increase our underground storage at this site, the existing storage is 24,000 gallons and we would like to increase it to 32,000 gallons and add Diesel fuel. I did go over this with Lt. McCarthy and we have been to Conservation, DEP File # 242-1521 If you need any other info please do not hesitate to contact me Tkx Dan Dan Berry Construction / Maintenance Supervisor Alliance Energy LLC 404 Wyman Street Suite 425 Wlatham, Ma. 02451 direct 781-402-8883 cell 207-252-6039 This transmittal may be privileged or confidential. If it is not clear that you are the intended recipient, you are hereby notified that you have received this transmittal in error. Any review, dissemination, distribution or copying of this transmittal is strictly prohibited. If you suspect that you have received this communication in error, please notify us immediately by email at itemail(@allianceenergy.co and immediately delete this message and all its attachments. Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: httrl:.%/www.sec state.ma.us/pre/p reidx htm. Please consider the environment before printing this email. 1 e TOWN OF NORTH ANDOVER DAELEL LBNC, Town NT TOWN f, NIASSN0 ELECTION DETMTMENR NUHfR AyROreR. M1fass. O1P45 Dear Friend: It is required by law that you be notified of the Following hearing as being one of the said abutters adjoining said property involved: xb MlN ! 4n Notke to hattlt!".i}iYm thet tiro a Rf: SalvCtmm. !> � w ReviamhalrwRl,' tsst it z30 oa fhb .ypltaltYols of MohR 1)R 58Q E1alw St:&Baton Mue.01128 to Inc, or gasoline dhm 20,000 pRoar to?A,OOR p➢om 9'hb b to ;he:noted undeWonod.,ttnd •floated at 12-Mam. Aga. North Andom. 161to W.Graham -R,Loub DIFroedo $..lom i1 I F '31ppM 2'N�: 1 L11 If you have no objection to this license being ranted, it will not be necessary for you to attend the hearing. Please call upon this office at anytime we can be of any assistance to you. -}}} -- incErr y rs, v/yQ'E- Daniel Long Town Clerk Fitzgibbons, Karen To: McCarthy, Fred, Hughes, Jennifer Cc: Bradshaw, Joyce Subject: Alliance Energy, LLC Attachments: noreply@townofnorthandover com 20110331 113602 Good Morning Fred &Jennifer, Just received this letter re the above named business. Before the Clerk's Office proceeds with the request, we just wanted to verify that Alliance Energy has indeed contacted your departments. If so, could you please give us a brief status. Thank you very much, Karen t o � m 7 Y IL N m m wreg. s N Pamge i N o cmr.,Fro o I;xaP P�rmex ere o IEao� v Pe me®� n Ir v o n ure ryF w U;&Postal Service T. 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Fitzgibbons, Karen From: Gaffney, Heidi Sent: Monday, April 04, 2011 3:32 PM To: Fitzgibbons, Karen Subject: RE. Alliance Energy, LLC Hi Karen, 1 confirmed with Jennifer that to our knowledge we have not received anything from them. So the next possible meeting they could be in on would be April 27th if they submit by April 15th. I will be sure to keep you in the loop regarding any new info or submissions we get from them. Thank you, -Heidi From: Fitzgibbons, Karen Sent: Monday, April 04, 2011 2:45 PM To: Gaffney, Heidi Subject: RE: Alliance Energy, LLC Thank you, Heidi. If you could keep me in the loop on this I will then be able to inform the BOS/Licensing Comm at their meeting of 4/25/2011. Thanks again, Karen -----Original Message----- From: Gaffney, Heidi Sent: Monday, April 04, 2011 2:41 PM To: Fitzgibbons, Karen Subject: RE: Alliance Energy, LLC Hi Karen, I'm relatively certain that this is the Mobil Station, someone had come into the conservation office last week or so and inquired about what would be required. We looked up the plans and this is located within Riverfront Resource Area and I believe it is also in buffer zone to wetlands, the were informed that they need to file with Conservation. I will confirm, but I do not believe we have received a filing from them as of yet. After I confirm that they have not submitted anything to us I will e-mail you. If they have not then the next meeting is April 27th with a submittal deadline of April 15th. Thank you, -Heidi From: Fitzgibbons, Karen Sent: Monday, April 04, 2011 11:57 AM To: Gaffney, Heidi Cc: Bradshaw, Joyce Subject: Alliance Energy, LLC Good Morning Heidi, l The above named company has applied to the Town Clerk's Office to replace and/or expand underground storage tanks at 12 Mass Avenue. I need to schedule a public hearing before the BOS/Licensing Commission for this project. The next available meeting date is April 25th. Does the applicant have a date to appear before the Conservation Comm yet, or is that not necessary? Please advise as I will need to include a Conservation update in my memo to the BOS/Licensing Commission. Thanks for your help, Karen Karen Fitzgibbons Assistant Town Clerk 978-688-9501 Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. 2 Fitzgibbons Karen From: Hughes, Jennifer Sent: Thursday, March 31, 2011 1 55 PM To: Fitzgibbons, Karen, McCarthy. Fred Cc: Bradshaw, Joyce Subject: RE'. Alliance Energy, LLC I have been contacted and will be working with them to get the project permitted. Jennifer A. Hughes Conservation Administrator Town of North Andover 1600 Osgood Street, Bldg 20,Suite 2-36 North Andover, MA 01845 Phone 978.688.9530 Pox 978 688 9542 ,m r , In,1,a , .... ..n. From: Fitzgibbons, Karen Sent: Thursday, March 31, 2011 11:34 AM To: McCarthy, Fred; Hughes, Jennifer Cc: Bradshaw, Joyce Subject: Alliance Energy, LLC Good Morning Fred &Jennifer, Just received this letter re the above named business. Before the Clerk's Office proceeds with the request, we just wanted to verify that Alliance Energy has indeed contacted your departments. If so, could you please give us a brief status. Thank you very much, Karen httD/Iwww secsata ma us/orelnre whim 1 eclipse rosn rAxa,"ew rva�a.+n wmn.�o�n oa n:nus to<�ans,m September 1,2014 North Andover Town Clerk 1'0 Plain Street North Andovcr, MA 01845 RE: Change of owner contact information Global Montello Group Corp.and Alliance Energy LLC To Whom It May Conccm: Eclipse i Division of ECS. Inc. is an environntenml and compliance consulting firm that has been retained by Alliance 8nergy H C and Global Mtlntcll0 Group Corp. to assist with the permitting management component of their storage tank compliance program. Our client has requested that effective Sentembe�l 2014 invoices, permits,registrations.etc. related to their storage tank systems and compliance be sent to then attention at our on-tee address,as follows: Attn: Global Montello Group Corp: C/o ECS Eclipse 705-A Lakeview plaza Blvd Worthington,OH 43085 In the role of compliance consultant, I am writing to request that your agency update the contact information for Inc facilities listed below,to the contact information identified above,so that any future invoices, permits,registrations,etc.ate sent by your agency to us,for processing on behalf of ourclient. Facilitvstreet.rddrecs,City/Stale - 12 Massachusetts Avenuc,North Andover,MA 01845 � �50 Wm[hrop A+enuc,North Andovcr MA0I845 Thank you for your assistance with this matter. In the event that this letter alone will not sunicc as adequate d00nmc[aathal for your agency to make these changes. please notify me by email(rltk micrczakLdecseelip com)or contact a member of our Eclipse staff at 614-333-0170 so that we can provide you with anything needed to make this change. Si ru crelv, f_cIipse,a Division of ICS, Ina Megan Ku-nuerezak Manager of Compliancy Services e � ..snH�vssau h],AWNY HIM;1n A;AOI 6£ :n NV L 183S III OZ j1dt, s,us 1, ,n1 03AI?33, The c,oaeum Indust,Y 1a6d2T for compliance and fuel management Cep3N3_),/)?(: A(I_ I&JjO)? 7`I ` I " s .". +,,.. CJ' lie l,rJmzlreane9,eccGCl2 a� �/(.ao4.aciieedz�Ca " Department of Fire Services x, ,Qs Office of the State Fire Marshal P O. Roc 1025,State Rnnd_Stott'.MA 01775 CERTIFICATE OF REGISTRATION North Andover April30, 2014 tCipnn'own) fUatc) NOTE: Complem lop and bottom of Corm and funvard both seducrs and fee to local Liccns'mg Authow, (City or I awn('Icrkl. DO NOT RE'I URN FORM '1'O'1'HE DEPART:MEN I OF FIRE SERVICES. In accordance with the provisions of Chapter 148,Section 13.of (lie General Laws,the undersigned hereby certifies that (11111,((OLDER): Global Monello Group Corp. (ADDRL2SS c/o Gilbarco Vecdcr-Root CMS 73,00 As Inendip Ase,MS F7G.Greensboro_NC 27-120 is the holder of the license granted (Date): for the lawful use of the buildings) or other Amended 8/22/2014 to increase the storage of gasoline in their underground tanks from 24,000 gallons to 32,000 gallons and also add diesel fuel. structure(s) situated or to be situated at(ADDRESS): 12 Mass. Avenue NOR"I I I ANDOVER, MA 01845 (Cipur9�wnl as related to the KEEPING, S"FORAGE, MANUFACTURE OR SAIT: OF FLAMMABLES OR EXPLOSIVES. � owner . .. Oth�oise by the owne or o No I t This certificate of registration most be signed by the holder of the license i1'said license was (wise Priorm July hl')3h, r or occupant of the land licensed. 12 cc, d '. 2014 __._ -.. _..... By L R � 1 r.,f.:-.c(-�� .... Owrler5s .�{t�10rizFc� ��„+.. � c/o Gilbarco Veetler Root . (oln a1Idc) (Clerk) Alto. CMS-PerrnntinO nnld.n 7300 N✓Friendly Ave, MS F-76 ............................... Greensboro, NC 27420-2087 trc„I The Commonwealth of Massachusetts Department of IndustrialAecidents Office of Investigations I Congress Street, Suite0 700 Boston, MA 02174-2077 wwiama.cs.gov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant information Please Print Legibly Business/Organization Name:Global Partners, LP Address:800 South Street, PO Box 9161 City/State/Zip:Waltham, MA 02453 Phone# (781)674-7780 Are you an employer?Check the appropriate box: Business Type(required): LN I am a employer with >1,100 employees (full and/ 5. Retail orport-time).* 6. ❑ RestaoranUBar/Eating Establishment 2.❑ 1 she a sole proprietor or partnership and have no 7 ❑ Office and/or Sales(me],real estate, auto,etc,) employees working for me at any capacity. [No workers' comp, insurance required] 8. ❑ Non-profit 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]" I1 ❑Icare Care 4.❑ We are a non-profit organization, staffed by volunteers, with no employees. [No workers' comp.insurance req_] 1 121:1 Other *,ka, apphovethatchcclsbox Rtmast also filleat the section below shmrdng their workcis rvur aeon policy Informauun. "If the ranarate of itri have ecempmd theinxelcez butthe wmaretion bu other anployus,a xodas'compensation pollq is rwpuired and such an iIDmn should check box:I. 1 am an employer that is prov iding workers'co n sensation insurance for my employees. Below is the policy infornwtion. ]assurance Company Name:Liberty Insurance Corporation Insurer's Address'717 N Harwood, Suite 2500 City/State/Zip: Dallas, TX 75201 policy 9 or Sefirms. Lie.,4 WA7-69D-460066-13 Expiration Date: 1 0101/2 014 Attach a copy of the Workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the Corm of a STOP WORK ORDER and a fine of tip to$250-00 a day against the violator. Be advised that a copy ufthis statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify,under Or ains an4penalties of perjury that the information provided above is true and correct Siganore:_ __- __— Date. y / Ili I L4 Phone".(800) 253-8054 Official use only. Do not write in this area,to be completed by cio,or town official. City or Town: __ Permit/License 9 Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Licensing_ Board 5. Selectmen's Office 6.Other Contact Person: Phone n: vv,w.rhat,godd,s �_rtt r Orl r<, E- Lblo--T, u sun ace [ .CI1 t,_ f I case r-e; e µa ozlrs I slued by I.i boi I i Gurance Conic i a5o n (a sto d<Go i nP eny) 21314 Policy nfumber V1jA7-(39D-060066-013 Issuing Office Lwisfop, ME ReneweCOf WA7-G9D 460066 012 Issue Date 11/07/2o13 Aewurd Number 9 400066 Sub Account 0000 t Insured and Walling Address PEN 74,3140887 Clabal Paiiners, LP NJ TIN 141924242000 800 Noun Street PT) 13D-9161 RiskiD 911385333 WACfHAM MAD2453 Status Limited Parmersh_p Otherworlreaces Put shown above:See Item 4. Premium-Extension of Ihformamm Page. 2. Policy Period; The policy period Is from 10/01/2013 to 10/01/2014 12:01 A.fJ. stan8ani foie at the Insured', mailing address. 3. Coverage /a. Wickens Compensation Imc,ance_Part One of the policy apples to the Vlod<ers Compensation Law oftne states listed here: CT FL Pv16 MA NIT Nri NJ NY OR PA RI TX VT VA B_ Enployers Liability Insurance: Part if oithe pa➢cy applies to wort( in each sate listed in Item 3.A. The limits of our Ilabliity under Part I wo era: 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 Stites Insurance PariThree of the policy applies to the states, If any,➢sted hels: All Stites except those listed In Item 3A and the States of: ND ON VVA V✓Y D_ This policy includes these endorsements and schedules: See Item 3,Coverage 13-Extension of infonna?Ion Pegg 4. Premium: fhe to Enjoin for this Policy will be determined by our Manuals of Rules, C'.assificatlons, Rates and Rating roans. All n om ation rom led below is subjectto veriflcaroon and change by audit. Classifications Code Premium Basis Total Rare per$100 Estimated Animal _ PluniBe_r__. Esti atrr� ed Annual Remuneration of Remuneraton_ _ Premium See Extension of Information Page. .Minimum Prmium $1,818 (PA) Total Estimated Annual Premium $ 597,163 Prnmiwn will be billed Annual Deposit Pi Cumuli, ? 591,163 Deposit Tax'SurcharoelAssessment $ 26p96 Producer Cl 000499 Countersigned by Authorized Rep. (FL) LOCKTON COMPANIES I I WALLAS SERIES) 717 N 1iARWOOD STE 2500 DAI-1_.AS TX 75201 Producer (MASTERS B628 Irving, TX i'lic i6 30 O1 `< 01961 IA'a a al Co_rel on Cure .�.yoa l r c -,m_,Inc. oc m d0 0, 3 r J) oi 0"0112011 P.II RI_,its Rcsni,cd lige I of 1 u 'f Oz-m� � Department of Fire Services Office of the State Fire Marshal P_O. box 1025. slate Goad.Su,, MA 111775 CERTIFICATE OF REGISTRATION North Andover April 30, 2013 (Cr, ,,T.,n) tDmq NOTE: Complete top atel bosom ot'mrm end 1'oneard boos sections and fee to local Licciuing Amhority(City or'I ('lerkl. DO NOT RETURN FORM TO THE DEPARTMENT OF FIRE SERVICES. In accordance with the provisions of Chapter 148,Section 13,otthe General Laws,the undersigned hereby certifies that: (TITLE HOLDER): Global Montello Group Corp. (ADDRESS c/o G1lbaico Veeder-Root CMS 7300 W.Friendly Ave,MS 176,Greensboro,NC 27420 is the holder of the license granted (Date): for the lawful use of the building(s)or other Amended 8/22/2013 to increase the storage of gasoline in their underground tanks from 24,000 gallons to 32,000 gallons and also add diesel fuel. Structure(s) Situated or to be situated at(ADDRESS): 12 Mass. Avenue NORTII ANDOVER, MA 01845 (01ry of-I moo as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. NOTF 1 his certifeate of registration must he signed by the holder of the license if al} I tense was gra find prior to July 1,1936, /Otherwise by the owner or occupant of the land licensed. I 1{ //, Iteccived .✓lrli .2013. ... CZ" om �^"`.�I..... (s 1 } .. TolAGEN ieial l inlr� elCie,y nGILBARCOVEED,ERDROdT� 730%W,.FMENDLY'AVE:..... TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER, MASSACHUSETTS 01845 Joyce A. Bradshaw,CMMC Telephone(978)688-9501 Town Clerk Fax (978)688-9556 %1 �o 3 E-mail II d I wrdlowoofnorthandoveecom TO: All License Holders— Proof of Workers' Compensation 2013 Included in the renewal package for 2013 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 (D1A), Office of Insurance at 800-323-3249. The Office of the Town Clerk will retain a copy of the enclosed Workers' I 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 Clerk's Office, 120 Main Street, North Andover, MA 01845. We appreciate your assistance and cooperation. Sincerely, yK A. Bradshaw, Town Clerk The Commonwealth of NTasvachusetts Print Form _J Department of Industrial Accidents ',� �={' Office of Investigations =� I Congress Street, Suile 100 F; r Boston, MA 02I14-2017 wow.mnss.gol/dia Workers' Compensation Insurance Affidavit: Ceneral Businesses Applicant Information Please Print l.e¢ibi Business/Organization Name: Global Montello Group Corp,Global Companies, LLC,Global GP LLC Address: 800 South Street; PO Box 9161 City/State%Lip:_Waltham MA 02454 Phone#: 781-674-7780 Are you an employer? Check the appropriate box: Business Type(required): I.❑% t am a employer ve th >1,100 employees (full and/ 5. J❑ Retail or part-time)_* 6. ❑ Restaurant/Bar/Hating Establishment 2_❑ t am a sole proprietor or partnership and have no 7, ❑ Office and/or Sales(met. real estate,auto, etc.) employees Working forme in any capacity. [No workers' comp. insurance required] $ Non-profit 3_❑ We are a corporation and its officers have exercised 9. ❑ Entertainment their right of exemption per c. 152,$1(4), and we have I0 ❑ Manufacturing no employe. [No workers' comp. insurance required]' 4.❑ We are a non-profit organization, staffed bnsurance y volunteers, 11.❑ Other Care with no employees. tNo workers' comp. i req.] 12.❑ Other 'My applicant Nat cheek,hox MI n can also fill out ne won hclow shuwine their workers'compensation poliv, iofermate,n. "if the corporate officers have exempted rhemuhes,hte hasoNerunployees,a.k odas comp....e s,policy is required attd such an organiwtion should check box NI_ 1 ant an employer tirnt is prm,irling workers'compensation insurancefor mr emplaVees. Below is the policy information. Insurance Company Name: Liberty Insurance Corporation Insurer's Address: 717 N. HARWOOD, LB#27 CIIY/State/Z DALLAS TX 75201 Policy 4 or Solf-ins. Lic. N WA7-69D-460066-012 Expiration Date: 10/1/2013 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 tine 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 m $250.00 a day against the violator. Be advised that a copy of this statement may,be forwarded to the Office of Investigations of the DIA for insurance coverage verification. =herelv der[hepait andpenp(ti�Gq ofperjurp dmt the infarmation provided above is true and enmeetr Ll' % �J5-�1Z L __ Date: 2/26/2013 —_r _ __ Phone f: 800-253-8054 Official use onlr. Do not write in this area, to be completed by city or lawn officiaL City or Town: Permit/License# issuing Authority (circle one): 1.Board of Health 2. Building Department 3. CiN/Town Clerk 4. Licensing Board 5. Selectmen's Office 6. Other Contact Person: Phone#: uvxvvv, aysgoetdn ACORD- CERTIFICATE OF LIABILITY INSURANCE _ DATE MM,DDAYYY 101/9013 2./26/3013 THIS 6ERTIFIC OE IS ISSUEDNOT AFFIRMATIVELY AS A MATTER OF INFORMATION ONLY EAD.XTEND CENTERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOi AFFIRMATIVELY OR NEGATIVELY AMEND,E A COST ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE C INSURANCE DOES NOT CONSTITUTE A CONTRACT HBIWFEN THE ISSUING INSURERI51,AUTHORQFD REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If 0e ceNGcale holder is an ADDITIONAL INSURED,Me Pnlicy Yd re—C be enJorse IT it SUBROGATION IS WAIVED,sMCjed no Me terms and conaidons of Me Policy,certain P daneS may ra are an endorsement A statement on Nis c officale does not center rights to Me enir.M MUUM m I.M.ofsxcb eM.—M.M0 Postram R LOCKTON COMPANIES LLCM DALLAS CA me 717 N.HARWOOD, -EG7 wc.N. MA GAX uc,xo: DALLAS TX75201 E MAIL 214 969 6700 INE TERST AFFORDING OE ......A A. Libert�llswvTCD CTIT mariol 42404� cx INSURED F Glonal Monlello Gmupp PP MULD,Be. Idbal Companl6s,LLO,AIIce IR inayy IIC 13J3083 GiDeal GP I LC re"PlR C. MAC In Street POWx9161 a enI WGI1dam MA 02454 ___ __ _ _ I'."a r COVERAGES( I_URAAT KITS FI INSURANCE I ST 1220936 HAVE REVISION NUMBER: XXXXXXX THIS I$TO CERTIFY THAT THE POLICIES OF INSUMNCE 16TED BELOW O 01 BEEN O5l1 FA TO HE INSURED NAMED ABOVE FOR THE POI ICY PERIOD INDICATED NOTWITHSTANDING GALE BE ISSUED O ABC RFOUIR IN THE OR CONDITION OF ANY CONI PACT OR OTHER DOCVMENT WITH RESPECT TO WHICH THIS EXCLUSIONS AND BE ISSUED OR MAY PERTAIN,THE INSURANCE N MAY HAVE BY THE POLICIES DESCRIBED HEREIN IS SUP FED T TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN 2FVVCEO BY 1'FN CLAIMS. IUSi CULL ER su POLICY CLUISIN LIICyo.am� OLICY Loo IJMli6 are TYPE OF L ABILITY N6URANCE ELECT VRNtNCE XXXXXXX LRCIAL GENERAL LAST ITV NOI'N'PIICABLE DAMAGE TO RENTED XXXXXXX AD DOMcuIMsr.AnE❑"Ful �I XXXXXXX PERCONAL No v INJURY $XXXXXXX CFNFRAI ArcRTCATE a XXXXXXX I FUDTL 6-wMPIOFAcv s XXXXXKX F 1ICYrU MT. ILm AHTOMOateuABluTr - s XXXXXXX -- No I kPITAK SRI F RALLY mOiv XX X XXXX L;O RYC �ImA1 s _ ii`ao° "a vrvsjEO s XXXXXXX O EOOILY INJURY Der amlmot HIREOAUTOE ALIG°swNc° Ponsli ROPERTY DAMAGE sXXXXXXX BREwA YCCC, FACT ACCURREDGE s XXXXXXX aNDFUSILIAS OIAM ITAO DI)i RENAL AGGREGATE sXk'X1XXX LED 1E1E1TION1 S A iNOE aocv°Ba's`"liewiv N wNLvo-+6oU50-oe lollem^_ Ion;zol3 X Toav'ixJnC oT" IF OOUAUO "xwNnr�°ml his - I.000.000 - lallrr 1,111 N, t D00.000 serelPTlory of OPERATIONS LOCATIONS I VEHICLES HARMI ACORD 101,Aaaldaotl Rena ke Scneawe,if mort sPza Is req Ireel CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF r HF ABOVE DESCRIBED PO ORE THE EXPIRATION TEwtOF NO ICE M RE DFUVxFD IN ACCORDANCE H POLICY PROA90NS. 12209363 AUFFHOUPPER FEPRESENTATIVF GFORGO Verde'Root 7300 W-Friendly AYE. Greensboro NC 27420 ACORD 25(2010I05) 01988-2010 ACORD CORPORATION.All rights reserved The ADDED name and logo are registered marks of ACORD TOWN OF NORTH ANDOVER OFFICE OF TOWN CLERK 120 MAIN STREET NORTH ANDOVFR, MASSACHUSIFI I S 01845 JE HOPiry, u ,l .. A. Undsha++' 00 leFAX ( 78)68 -955701 Turn Clerk PAX (978)688-9557 51CPJSEt F;mail: ibrtdshowntownofnorthandoveeeom R F�FI�F 2013 Renewal APRI 7 � D To All above Ground and Underground Storage Tank License I folders: By GVR Enclosed please find your Registration Renewal Form(s) for above ground and/or underground storage tanks. Renewals are due April 30ih of each year. The lee 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 disnlaved alone with your license. r 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 Town Clerk Enc. L Y' yDepartment of Fire Services Office of the State Fire Marshal P.O. Ito, 1025, Sure Road,St.,MA 01775 CERTIFICATE OF REGISTRATION North Andover April 30, 2012 (Ca>„nmrn) (Dale) NOTE: Complctc lop and bottom offixm and Ibnrard both...ron,ard Rcto local Licensing Aulhono (01% orlbwn Clcrk). DO NOT RETURN FORM' o I HE DEPARTMENT OF FIRE SERVICES. In accordance with the provisions of Chapter 148, Section 13, of the General Laws,the undersigned hereby certifies that ( 111 LF I IOLDER)'. Global Montello Group Corp_ (ADDRESS c'o Gilbarco Vecder-R001 CMS 7300 W. friendly Ave_M5176,Grecnsbom,NC 2742o is the holder of the license granted (Date): for the lawful use of the building(s)or other Amended 8/22/2012 to increase the storage of gasoline in their underground tanks from 24.000 gallons to 32,000 gallons and also add diesel fuel. structure(s)situated or to be situated at (ADDRESS): 12 Mass. Avenue NORTH ANDOV ER, MA 01845 as related to the KEEPING, S"FORAGE, MANUI-ACTFIRE OR SALF. OF FLAMMAHLES OR EXPLOSIVES. Not k This certificate of registration must be signed br the holder of the license if said heense e#67u ly I,1 Otherwise by the owner or occupant of the land licensed. Received 1�*"f 2I 1 11 .. 2012_. ... _ 13y Ir �� s. .. ....... 0WNERf65MAMHORIZED AGENT imo mnlTalo (CI,k( Is ILSARCOV�EDER-ROOT d6'W,`rffltW&*AVE ..............PO.BOIL 2208.7....... . . . rRWWld9',R0RO NC 27420 a seeEli u eam,ne s. .Iwo — .dare,.- M - ahooeA:or . . IONr10Cl CA- P.Wro b oe[r.sarora,r rr pdtd mar Seer a."A NMCL IS2 e.4ad b tho ImpxftYv ofermiml peoalt N.pr vp f.M_%LN oN/r osyrra,ireprhonroot r ad todr9pe rlatlr/.rm.�.bTOP INDRC ORDER u1.M.N21M.N.iq.plmt ma Imdea+ratltMo coy ofdalo.htmt.uybo tarty BprfosrNar llGfrwmapr.dlirtYa 7 L hweby certi dD1+edRo a/ jrry that Lie infervatioR praaldd abate is true anti roneet Dal print.2 t Vs�) ph. « elBefol me Wy d.notat,ne,to into area to he mailevd by city or town amid toy or Departwent m Elfacemf Booty ❑cheek it hareashouto rnpovoe 6 rNutred ❑seksunuit note.�Drhh fleryrrmeot contact penoo: Phom N; (]Ottrr n�.e.e a.re most the Co ntnonwealth ofMnssachuseas Print Form Der urintent of Industrial Accidents -f- Office of Investigations 1 Congress Street, Suile 10O `,rn.'•'i E' :ri Boston, AIA 02114-2017 www.rauss.gov/din Workers' Compensation Insurance Affidavit Ceneral Businesses Applicant Information Please Print Le ibly Business/Organization Name: GLOBAL Go LLC Address: 800 SOUTH STREET; P O BOX 9161 City/stale/Zip: WALTHAM, MA 02454 PhOnc #: 781-674-7780 Areyou an employer? Check the appropriate box: Business'I ype(required): 1.❑� 1 am a employer with >1,100 emplovccs (Ildl and/ >- E Retail orpart-lime).' 6. ❑ RC51anCant/Bar/Eating I'stablishment 2.❑ 1 am a sole proprietor or partnership and have no 7. ❑ Office and/or Sales find, real estate,auto, etc.) employees working for mein any capacity_ j Noworkers comp. insurnnccreyuired] 8. ❑ Non-profit 1 El We are a cnmoration and its officers have exercised 9. ❑ Pntertainment their right of exemption per c. IS2, §R4), and we have 10_❑ Manulacturing no employees. [No work... comp. insurance required]* I I_❑ I Ieolth Care 4.❑ We are a non-profit organization.slatted by volunteers, with no employees. [No workers' comp. insurance req.1 121:1 Other .4ny appl'c: tl thm chwk.b di nusI ako fill o,rthc cwl'o t M.l rho.e,n th '. . ... n ap t un poli, i,,fernmin ^IIWec< p tcorfccnhoot ex,i,,a,d that. le,hit the...... ha,,the is —. k nlatru ... c✓s uqu' dmd,rd,at rnrmiirninn 4s,Jd check hox Pl_ I am me emplaeer that is providing worriers'compensation insurance jar ntp etrtploeees: Below is the poticI,information. Insurance Company Name: Granite State Insurance Company Insurer's Address: 175 Water Street CihdStalc/7,ip: New York, NY 10038 Policy h or Self ins. Lic. N WC 007-20-8856 Expiration Date. 10/01/12 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration (late). Failure to secure coverage as required under Section 25A of MCI,c. 152 can lead to the imposition of criminal penalties of fine up to $1500.00 and/or one-year imprisonment, as well as civil pcnaltiere is the form of a S COP 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 certy.i under the ns nail�ofper' se information provided ohure is true nor/correct. i Sienature,-- _ _� — Date:_4/18/2012 phnnc d: 800-253-8054 Official axe onl1� Do not write in this area,to he completed he city or town official City or Town: Permit/Licenseh _ Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Licensing_ Board 5. Selectmen's Office 6.Other Contact Person: Phone N: moo./R, GRANITE STATE INSURANCE COMPANY 0088122-00 WC 007-20-8856 -___---- -----_- _. "-------- ---- 13102 05 4-04-1011-60 GLOBAL GP LLCr IN7ANCISCO. 0 H A R T 15 P00 BOXT9161 WALTHAM, MA 02454-0000 A Chartis company EXECUTIVE OFFICES: 175 Water Street SEE EXTENSION OF ITEM 1. OF THE INFORMATIO New York, NY 1003E oz 11 COMPANIES LLCWORMERS COMPENSATION AND EMRCADERO CTRLIABILITY POLJCY INFORMATION PA CA 94111-0000 INSURFUI IS PRFVIOOS F011CY NOMNFR CORPORATION RENEWAL 007208856 OTHER WORKPLACES NOT SHOWN ABOVE: SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE - WC990610 PLUIL—EAKIIm., R " eP1n6J1"' 10101n1 10101/12 q. Workers'Compenuti0n Insurance: Part One of tM1¢ policyNapplles to the Workers Compensation Law, of the states listed here: CT MA ME NH NJ NY PA RI TX VA VT B. Employers LiaEilily Insurance: Patl Two of lM1e policy applies to the work in eacM1 Slate listed In item 3.A. The limits of our liability under Part Two are: Bouily Injury by Accident $ 1 000 000 each accident Soddy Injury by Disease E 1 ,000,000 policy Omit Botlily Injury by Disease s 1 000 000 each employee G OtM1er Slates Insurance: Part TM1ree of the policy applies to the states, if any, listed here'. AK AL AR AZ CA CO DC DE FL GA HI IA ID IL IN KS KY LA MD MI MN NO MS MT NC NE NM NV OK OR SC SO TN UT WI WV D. Tnls porcv Indmes mesa endorannTems and scneawer. SEE EXTENSION OF ITEM 3.D. OF THE INFORMATION PAGE - WC99DS12 USAIa The premium for this policy will be determined by our Manuals of RUlUP, Classifications. Rates and Rating Plans. All information Termini below is subject to verification and change by audit. Renium Ikas HconM O essGralions CbJe Nembcr Tohi IUR Ll llnn H ner"PI- Hanlum ❑X Annual❑]Yea 21 Anneal ❑9 Yee SEE EXTENSION OF ITEM E. OF THE INFORMATION PAGE- IAI TAXES/ASSESSMENTS/SURCHARGES $73,569 EXPENSE ANT ISSIT VOTERS APPtICAaLF By STATI $338 MA MINIMUM PREMIUM $1 060 PA TOTAL TEo ANNUAL $461 791 11 mmpTee rAo,numm aai-almenls IT premium snail oo L.S. ❑ FA- Annually ❑ a..=Ianv ❑ Monlnly DEPOSIT PREMIUM $461 ,791 10126/11 BOSTON 04 (--t sr r •m I"LPR 0NUN -P.LP,a PCOmaamanve OF W fA FIE 399E]IfmVO DMaRI `� GILBARCO Glbarco Inc `� VEEDER-ROOT CMS W stFne alyq e.7s P. O. Box 22087 G reensbom, NC 27420 United Stales Phone: 800-253-8054 Fax 336-547-3384 November 26, 2007 w gilbarc000m w veeder.com NORTH ANDOVER TOWN CLERK 120 MAIN ST NORTH ANDOVER, MA 01845 RE: Mobil R/S # 11639 12 MASSACHUSETTS AVE; NORTH ANDOVER To Whom It May Concern: Gilbarco Veeder-Root's Compliance Management Department manages compliance activities at ExxonMobil Oil Corporation owned service stations. As Exxon Mobil Oil Corporation's authorized Compliance Service Provider, Gilbarco Veeder-Root is responsible for renewing and maintaining registrations, licenses and/or certificates associated with the operation of the underground storage tank systems and for coordinating and tracking the resolution of compliance issues. The Certificate of Registration for the above referenced service station expires April 30, 2008. To ensure the station remains in compliance with your agency and payment for renewal is returned in a timely manner, please update your records to mail the Certificate of Registration renewal to the address below: Gilbarco Veeder-Root CMS 7300 W. Friendly Ave., MS F-76 Greensboro, NC 27420 If you have any questions, please do not hesitate to contact me. Sincerely, Joey`Weisman Joseph Weisman Gilbarco Veeder-Root Compliance Analyst 336.315.2889 Regulatory Administration, UST Compliance Services, USTMAN© SIR f E�.Ah(11 ,+oo oa ••' ncuus°` TOWN OF NORTH ANDOVER OFFICE OF THE TOWN CLERK 120 MAIN STREET NORTH ANDOVER, MASSACHUSETTS 01845 April 25,2006 Joyce A.Bradshaw,CMMC Telephone(978)688-9501 Town Clerk Fax (978)688-9556 E-mail iradshaw(aitownofnorthandover.com TO: All License Holders—Proof of Workers' Compensation The enclosed form must be completed in order to complete the renewal of your Underground Storage Tank License, The Office of the Town Clerk's acts as agent for the Board of Selectmen in their capacity as Licensing Commissioners. In that capacity, we are requesting that you fill out the enclosed foam from the Commonwealth of Massachusetts, Department of Industrial Accidents. 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 to The Town of North Andover, 120 Main Street, North Andover, MA 01845. We appreciate your assistance and cooperation. Sincerely, J a. �, oyce A. Bradshaw, Town Clerk A -� The Commonwealth ofMassaehusetts Department of industrial Accidents AftVM 600 Washington Street .t� Boston,Mass. 02111 -eAtyT* workers' com easstion Insurance Affidavit-General Businesses MOW Uit D IWb 1)bA �Vm S M6b1� addttas: 12 AA W AW, `.7fid �Et 9 �} A�n600'-( state- MR � j}S hom 21 j 9 work sir°lomti ful addram ❑ I ma'a mle proprietor and have no one Bvsivess Type: Office❑Reslammludin F wal Establishment . working in MY capacity. kxk herEl Salts(including Real Estate,Autos etc.) I am an® 1 with 10 cm to full & an time). IJ Other I am an employer providing workers' compensation for my employees working on this job. rom av a UC`. : '.1S WbiI •ddrcu: - Z t Y�tl RS1 X(/ 1 - J}11c Uel' h' N: el 165,irGt1 IaaYr9aR<0. . ll}S�V ✓l —1J 1. �{� I am a mle prupnemr and have:hired the indepeud®t c moractma listed below who have the following workers' compensation Polices: rom ev ei N ivvarevm ro• rom vaviv addreaa: hove M: B Ia9YfnaCC ee. F•Wre to anon my to r'9°tr'd�Or�''cn°°25A of MGL153c•°kadrotb lmWaBMv°(erlmlmlpemBb ef°tl°e vpbf/3aa.N°dM1r em Yr rclva Oeminr Wtb•form ofo3l'OP wOAK ORDBR edelim ofSlN.Ne4Y a,•Imt9r lmdendd tbt• copy• hY an Y Y hrmrddroW[OBke oflmntl,atbm of the DlA far sovenea vermnlMY I de eery cede Ihepains andpenaftiet ofperjury that the information provided,bore is hue and correct Si trim otrk4l uae oety do not orik no thu ern to he on ploo d by city or town•mein city or fawn: perdulk.# ❑Bondi°,Departovet �t.icemie,Bocrd ❑c ee ❑selectmenh Omea h k if Immediate rnpome b required ❑Hnith Depertosnt ph..s; ❑Other event penm: (vaeea seq.zoop ADVANTAGE INSURANCE 1 970 794 499E OS/06/96 06:32pm P. 002 f I11� J FROM FAX NO. Ma, 12 2986 09:14W P1 AgO,k?D,. CERTIFICATE OF LIABILITY INSURANCE oa os/xoos PROD.ICER I976) 670-2122 THIS CERTIFICATE 19 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS- NO RIGHTS L/PON THE C TIFICATE NCSSARA Ynsuranca AMenry Inc MOLDER. TRIM CERTIFICATE GOES NOT AMEND, EXTEND OR 574 BOston Roatl ALTER THE COVERAGE AFFORDED RV THE POLICIES BELOW suite 12 0i 11Rica MA 01821- .. INSURERS AFFORDING COVERAGE �NATO 0 —. _—._. —_ IXaURED -- —_— vn star Insurance_ Samuel J. AmeeO, Sc. dhA Sm'S Mobil 12 MmSSHCiwbetts Avenue NSLRFRC EI-Atffivez tM 111t45- 'TURTT,E THE RAGES _ ➢LE PULILIES Of EACIINSURANCEL18TE0 BELOW HAVE SEEN ISSUED TO tllf INSURED NANEO ABOVE FOR ME POLICY PERIOD INOIGTE O.NOPMTHSTRNDINDR9V PEp11qF TTGRM OR ONDITpIpANY CONiRRCT OR4TN[RRIRMLM4Ifil1 RE51I MNILHTtSCEATIfICAIE}MVHE 155OED OR NAV I'fPT41rv. � THE IMSURINLI, AFFORDED BY THE POLICI6S.DESCRIBED NEREIN IS RETRACT TO 4LL THE TER45. FYGWSIOKS RNO CONOVFGNS Of LIICN JOUCIiS AGGREGATE 14Mn55HOWS PAY HAVE BEEN REDUCED By PAID CLAWS. N6R 1 Pl M1Ll'FRF�i1VE M)LICYQTt1TD11 LTR 0 TYPE M OP 9IHI/nKE MMITNVNB N ER TATEV4 DATFIYIR m. LIM 16 42NVUL LIABILITY / / / / EACR TTXU nR EKc s — 1 EOMMERC-TTJFNERALL.MIII•v PPHRI:ts F.ttn„mn talus MRUE E RSUKIF E AOV INN4r E 4.I:—Ac4AEw*t !_„ NL RGGREGATI 11µINI APPLE S PER PRODUCTS-CURPOPAGG POLIDVF—i 7M LOC IAU,mMDWE LTAIILTTY J / / / LO ..TINGLE LIMD Y WTO IN LTIXETI Am, / / / / ItlW M1Y mJURr IV.r Ynnl i ' SENvhAFD Mp05 (�� MREOAUIBS NOxLvnIEO.WIUS x II PnDPEmvw4EacE cAA.GE.wIUTv .um ITAEY °Imo nX Ea uc < xv .uL E L n""U' A LEAU CLTY rwG<ImncxcE t OCCUR DUWS HR➢E AOGREflF4RTf. f �„ ITEDUITAILI 91 TLxTIOry cRACOOKI"IT AXD / / / / X �FJSY:inIFR "A'nwomlfTgwARTNERIF}ECUnyE el Encnn[cIx[xI s 500,ODC ? OERCFaMEMPfR EACmc v+ '02,1604 OB/01/2005 08/01/2006 nL mSusE [A emcLortEt 500,000 RIG h.YRY UGw L.L DISEAS[�POtILV LIMIT s 500,000 [InL RRDV0gN51tlw EEanPARN9F9AFwAFIRRRAamwa�M+eNs+weLsaYemelMLwnmrcaALrADxeaXa ROT:kde's fnRenAakaen coMaeRDo LneluARr .,A.we ef-RUDaegAl Lon eMorvaRent. Ae¢9 B19054 CERTWICIRTEHOLDER CANCELIATION____ _ ( - (501) 45D-6963 9nUIKU ART OE TR AROuf OFSCAIBED PUERES R6 DAII FO fiiDRi TEE WIPATION OTTE TOMIDIF. THE 1999IHG INSIB ER TILL 4ADPVOR I N4rt 1D OAK WRIiTEX NOTICETD EYE CEMInCAiE EDITOR utu[U EO TIE LEFT.801 -Snm.TMbbil oil TO{EU—T, vn ARLmF Tnmasruv�rmt«OnR1+L�.TTeRVAis^R^Yw"^'°"°^^°^*'F c/p ANCS m sRREP,n4.-TIETSORR[PTYSEaT.11 9O 19ms 2D20 AImIDAeeouDleYRumE Cones AR T2033- ACORD.2A(2001/OB) -vACORO CORPORATION ISA6 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. _ � �oa�rrunw�rccueaLC�i a�C'/G�aoaac�ivaeCCt IS �efw�G.rzartt o� dre r.�yyv�wecPn — �exv.bar, OT , V UXB ✓-WYUP//SCLGK F City or Town NORTH ANDOVER Date _ APPLICATION FOR CERTIFICATE OF REGISTRATION n accsaance with the provisions of Chapter 148. Section 13, of the General Laws, the undersigned heredy candies !mat EXXONMOBIL OIL CORPORATION - 12 MASS. AVENUE c Te o:der of license granted forthe lawful use of the building(s)or other stmcuretsl SncateC v '.c oe s,r_atec at 12 KASS. AVENUE as males to me KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. NORTH ANDOVER, MA 01845 Nora: This application for cmoflcate of regri nepon must be signed by the holder of the license if said license was granted prior to Jury 1, 1936, peril by the owner or ocwpanr of the land licensed. =eceivea Submitted by _ _-- -------------------------------------- - - - _ � rca7�ma7ccuea,`C� �c�/G/a��ecc� Clty or Town NORTH ANDOVER Date REGISTRATION --.z s '.c cecdv that EXXONMOBIL OIL CORPORATION u..umw ae n aocrcance with me provisions of Chapter 148. Section 13• of the General laws, filed with me a Carl of registration semnc nai EXXONMOBIt OIL CORPORATION Is the holder of the license gramec for the lawful use of the building(s) or other trial Sacaiec cr e.0 c _e s,watec at 12 MASS. AVENUE,-NORTH ANDOVER, MA 01845 sv.xwovnoe s 'e,a:ec .c me KEE?ING. STORAGE, MANUFACTURE OR SALE OF F_AMMABL25 OR EXPLOSIVES. ,m.--cam.,nw omhrare or regarraucn must ae tied an or aelcm ton,Torn ar aan rear. Tr'.IS REGIS'=ATICN MUST?E CONSPIQICl PCSTEL ON ^dE P9Ef,IISES Note: Complete top of form and forward both sections and fee to local licensing jauthority(City or Town Clerk). Do not make application to department of Public Safety. �G'%YYUI72lJOZC(U�2�� O�i C%(�LCLJQCLC�U/J2/jJCJZ)'✓ -`� �L �eC�L2Xr/rRe'IEl6��lq.8 Cl{x%cGPb — �N/WG6'ro 6��!/f6 ✓'/M/b2Ccc2 Clty or Town NORTH ANDOVER pate_ APPLICATION FOR CERTIFICATE OF REGISTRATION n accamance with me provisions of Chapter 14, Section 13, of the General Laws, the undersigned hall cerates that EXXONMOBIL OIL CORPORATION rv.m.aroo..eur... 12 MASS. AVENUE s '.re holder of license granted for the lawful use of the buildings)or other struc:uretsl seuaiec Cr .c cc suuatea at 12 rKASS. AVENUE as :e:atec to me KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. NORTH ANDOVER, MA 01845 Note: This application for caeRmfe or registration must be signed by the holder or file license if said license was granted poor to July 1, 1926, ofhawrse by the owner or occupant or me land licensed. =eceivee Submitled by +ww. --- _ _______________________________________ __ _ � �c'a7�marccueccltLc ���d� cty ®a a 2efL�p� 4Xa Vexvicea — �G��'JCa�ra�z�am.�c ✓ryne y CI(y or Town NORTH ANDOVER Date REGISTRATION s c :c_?Mi that EXXONMOBIL OIL CORPORATION as r acccrcance with the provisions of Chapter 148, Se tIon 13, of the General Laws, tiled with me a certificate of registration senmg c" a[ EXXONMOBIL OIL ORPORATION is the holder of the license graaec for the lawful use at the budding(s)or other SWo'urelsl situated cr ou. c :e swatec at 12 MASS. AVENUE, NORTH ANDOVER, MA 01845 S.and nun. as -e.atec to he KEEPING. STORACE, MANUFACTURE OR SALE OF FIAMMASLES OR EXPLOSIVES. Ncfe:.4 comfimra ur rsgrsrraocn must oe,9ie:r cn or derore.lom_01n cr dam Near TrilS RE_IS'PATICN MUST?E CONSPICJCL'SLY PCSTE^ CN "PE Pq EMISES 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 Pudtic Safety. � �a�mmea�rocu�jeaLC�C a�C'/l/�crrtiaczc�zuae�/Cr�Z%i P Jefw/fLirtend 6��2re VU/rtaccea — �vuWaart 6��'mre ✓-roivarzCcan City or Town NORTH ANDOVER Cate APPLICATION FOR CERTIFICATE OF REGISTRATION n acaorcance,with the provisions of Chapter tab. Section 13, of the General Laws, the undersigned hereby certifies ;hat EXXONMOBIL OIL CORPORATION 12 MASS. AVENUE s 'tie noder of license granted for the lawful use of the building(s)or other snuc:urelsl vuaiee or c ce sm_atec at 12 MASS. AVENUE zs Tatec to the KEEPING, STORAGE,MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. NORTH ANDOVER, MA 01845 ,Vote: This application for carv0care of registration must be signed by me holder of the license if said license was granted prior to July 1, 1936, otnerwisa by the owner or occupant of the land licensed. =ecemec Submitted by oery rm .m.0 - -- - -------------------------------------- - - - - I �a�;�morccaea���i c���aaczcLuraeCG3 ®a � �efadxGmartLp�C-1'vrre �ex+xeea — G�x�xwirnrL:lCoaa�a�ar✓c ✓rxvr�nrz yr City or Town NORTH ANDOVER Date _. REGISTRATION ' s I c :?,.IN that EXXONMOBIL OIL CORPORATION ems n accrcance with the provisions of Chapter tab, Section 13, of the General laws, filed with me a ceraf(dale of registration seninc scr. :^.ai EXXONMOBIL OIL CORPORATION is the holder of the license grarnec for the lawful use of the builoing(s)or other struc:urelsi suuaiec or o.r. c ;e Sl"also at 12 MASS. AVENUE, NORTH ANDOVER, MA 01845 is eaac .c -tie SEE?ING. STORAGE. MANUFACTURE CS SALE OF FLAMMABL2S OF EXPLOSIVES. No,..a Csm/1cs re or IeglsPaWn must eb,tii0]cn of 3e1 AD,,Mn or aan vedl TnIS PEGISTpATICN MUST EE CONSPICJCIISLY P^STEI ON PE ?9E411Sc'S Note: Complete top of form and forward both sections and fee to local licensing j authority (City or Town Clerk). Do not make application to department of Public Safety. _ � �007?/I9L09'0002�� 0���CL�G�GliJ2CC'.Y lil �e�na?'rin.enC o��'t�e Va/urrtucro — o� ure �;v�winCcon P City or Town NORTH A14DOVER Date APPLICATION FOR CERTIFICATE OF REGISTRATION acccmance with me provisions of Chapter 14, Section 13, of the General Laws, the undersigned hereby comfies that EXXONNOBIL OIL CORPORATION 12 MASS. AVENUE s ne rower of license granted for the lawful use of the buiiding(s)or other struc:urel sl situated or �c tie srcalea at 12 MASS AVENUE as Toted to the KEEPING, STORAGE,MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. NORTH ANDOVER, MA 01845 tiro o.m Note: This application for certificate of registration must be signed by me holder of the license if said license was granted prior to Jury 1, 1936, otherwise by the owner or occupant of the land licensed. ^.ecewee Submiaeo by --- - ---- ---------------------------------- -- - _ ®, �e�wanCa�Gl�vxe C`�e� ce — OlG dex3 ou �dCa�a�s C�Ja ✓ J 9 City or Town NORTH ANDOVER Dale _. REGISTRATION — .s s c cemry that EXXONMOBIL OIL CORPORATIONN�. as n accceance with the provisions of Chapter 148, Section 13. of the General laws, flied with me a certificate of registration semrc EXXONMOBIL OIL CORPORATION is the Insider of the license grantec for the lawful use of the butding(s) or other slruc:urets) wmatec cr ou. c :e sjmaiec at 12 MASS. AVENUE, NORTH ANDOVER, MA 01845 SYsx wnunex .: 'ra,ec c '.he KE-PING, STORAGE, MANUFACTURE CR SAL° OF FILAMMABLES OR EXPLOSIVES. ,a�.�•.via cw.,nr. Note'.+ca®fiore or'sperroucn must:a,9ier cn cr swore Aom Joln or aao fear THIS PE=I57PA7ICN M(,ST EE CONSPIc,,)CUSLY POSTED ON ^r= P9EMISEE Note: Complete top of form and forward both sections and fee to local licensing authority (City or Town Clerk). Do not make application to department of Public Safety. - � Cy �omvnzanurea�G�i a�-'C/G�ataczclzuaeG'l3 JPfIO/Fr/It69[f 6�V'UXB vIN2(Geb — % NX446'2 6C�V'UiB ✓-M%UP/ILCcGtt City or Town NORTH ANDOVER Cate APPLICATION FOR CERTIFICATE OF REGISTRATION acomance with the provisions of Chapter 148. Section 13, of the General Laws, the undersigned hereby certifies mat EXXONMOBIL OIL CORPORATION 12 MASS. AVENUE s he nocer of license granted for the lawful use of the building(s)or other siructure(si situated c: ,c oe s%aieo at 12 MASS. AVENUE 3 related to the KEEPING, STORAGE,MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES, NORTH ANDOVER, MA 01845 Note: This application for card6care ohegfstraaon must be signed by the holder of the license if said license was granted pnor to July 1, 1936, otherwise by rho owner or occupant of the land licensed. =eceive� n Submitted by *w'w _ -- --------------------------------------- __ _ . _ � � �c'a7�7n,Varcurea,��111/z c�=� ila�acCz�cLcuaeCtJ, a ye�iaieanCo�C�1�'vve Ver�ieces — GCndexro`md:lCorna�a C�/om.E ✓, vvzrrz a y _ City or Town NORTH ANDOVER Date REGISTRATION s S 'c ce"N that EXXONMOBIL OIL CORPORATION zs n acccroance with the provisions of Chapter 1 a8, Section 13, of the General Laws, filed with me a certificate of registration semnc xn. .eat EXXONMOBIL OIL CORPORATION is the holder of the license grameC for the lawful use of the builoingls) or other structures) s,iOatec or Our c .es:waecat 12 MASS. AVENUE, NORTH ANDOVER, MA 01845 su.«w.�o.. 'eztec Ic '.he KEEPING, 570RAGE. MANUFACTURE CF SALE OF FLAMMABLcS OR EXPLC5iVES. vcW'A csmbote of:erystraocn must:e.5ia1 on or Jeldre Aom]pin of lac, veac TriIS RE31S7?A7I0N MUSS EE CCNSPICUCUSLY PCSTED CN TdE P4EMISES Note: Complete top of form and forward both sections and fee to local licensing authority (City or Town Clerk). Do not make application to department of Public Safety. �oonima�rccuea`C�z V`'o�-'C/G�a�aac — �lzuae/JJCJC Vw ✓-'KNW/Itic6)t City or Town NORTH ANDOVER pate APPLICATION FOR CERTIFICATE OF REGISTRATION accomanee with me provisions of Chapter 148. Section 13. of the General laws, the undersigned hereby cenilies mat EXXONMOBIL OIL CORPORATION 12 MASS. AVENUE s 'ne naieer of license granted for the lawful use of the building(s)or other atuRure(s) sauaiee a c ce sl%aiec at 12 MASS AVENUE su...ne.u�. as re;aea c the KEEPING. STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXP!OSIVES. NORTH ANDOVER, MA 01845 caa ra Note: This application for osNllmre of registration muse be signed by the holder of me license it said license was granted prior to July 1, 1936, otnerwi5e by the owner or occupant of me land licensed. e<erveo Submitted by .;.,.,. v.,..,�,.,,.... . _ —_ - - _----_----C—�-------------------------- - - _ . � rc'a7�yrw�rwreall/z c�-� i`a�aacLu�oeGt`y Shy; City or Town NORTH ANDOVER Date REGISTRATION —s s 'c cemiv root EXXONMOBIL OIL CORPORATION <, n acccrcance with the provisions of Chapter 148. Section 13, of the General Laws, tiled with me a certificate of regisrraljon senmc _-Mai EXXONMOBIL OIL CORPORATION is the holder el the license gramec lot the lawful use of the buildings) or other struc:ure(s) simafec s OW, c :e s;wa.ec at 12 MASS. AVENUE, NORTH ANDOVER, MA 01845 sv.w ram.naw s 'e.a:ac ic ^,e Kc`-PING. STORAGE, MANUFACTURE OF SAL° OF FI a.MMASLs OF EXpLOSIVES. Nae:A c'mhcara ur n.9sus Don.nust:e,tiiP]^,n or Jerore Aom rpm ar aac9 va& THIS RE-IS7"Ai ICN MUS BE CCNSP!CJCUSLY PCSTE^_ CN THE PREMISE'S Note: Complete top of form and forward both sections and fee to local licensing j authority (City or Town Clerk). 0o not make application to department of Public Safety. �aminw�rzcuecz`CLc o�C-'/l/�a�aczc�uae/jt�C �CfwirGnxe.tt O��URB C-_�{'N�Utl.26 — �N/(0G64E 4��Vx6 ✓-/NUbnCw n, City or Town NORTH ANDOVER Date APPLICATION FOR CERTIFICATE OF REGISTRATION n accmcance with the provisions of Chapter 148. Section 13, of the General Laws, the undersigned hereby certifies ;hat EXXONMOBIL OIL CORPORATION - wm.aroru�... 12 MASS. AVENUE _ v.e voider of license granted for the lawful use of the building(s)or other stmaure(s) Sdcatee Or c ce srcared at 12 MA55. AVENUE as T,atea ;o the KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. NORTH ANDOVER, MA 01845 o > o.. Nore: This application for citrd8care or regrstradon must be signed by the holder of the license it said license was granted prior to July 1, 1936, otherwise by the owner or occupant or the land licensed. cecervea Submitted by or.+a.rw —_- - _--- ---------------------------------- __ _ . _, � ?7`eiQ/X�iYlEbrtlp`�t/Xe 6Jex�xpas —'2C�r�rp.N,dS'r�e�� J��, y City or Town NORTH A"OVFR Date REGISTRATION _.,.s s :c cenav inai EXXONMOBIL OIL CORPORATION ac__rcance with the provisions of Chapter 148, Secton 13, of the General laws. tiled with me a certificate of registrallon sen:nc aai EXXONMOBIL OIL ORPORATION is the holder of Me license grarnea for the lawful use of the building(s) or other strvaurli snuarec cr ou. c :e siwaiec at 22 MASS. AVENUE, NORTH ANDOVER, MA 01845 Sur.nunar .c e z:ac ;c '.he KEEPING, SSORAC"c, MANUFACTURE OF SALE OF FLAMMABLES OR EXPLOSIVES. ,m.n„•—cam.'I ,Vote.l carsfiore or regrsrraocn must oe.tier sn or aerate Acm 30m cr aaca rear. Tr'IS PE3IS7'A71CN MUSS SE CONSPIrJCUSLY POSTED CN T.'E ?REMIISES 3 Department of Fire Services x Office of the State Fire Marshal 11. 0 Bo, 1025_State(toad.Slow. MA 01775 CERTIFICATE OF REGISTRATION North Andover April 30, 2015 ((ht'o' la.rn) pain NOTE: ONOT RET URNtom"' TO TIIEbDN:PARTMF.Rf OF FIRE:SERVICF.S�sing Authoritc(Cltc orl'own Clcrk) FORM In accordance with the provisions of Chapter 148, Section 13,of the General Laws,the undersigned hereby ettrl fcs that'. I I I Lf-.HOLDER)'. Global Montello Group Corp. (AI)DRESS c'u ECS Eclipse 705-A Lakevior Ploza nlvd Wonhodan.OH 13095 the holder : Por the (awful use of the building(s) or other Amended 8/2 2/the license granted (Date)212 0 1 5 to increase the storage of gasoline in her underground tanks from 24,000 gallons to 32,000 gallons and also added diesel fuel. strucnlrc(s) situated or to be situated at(ADDRESS) I'NOR l ANDOVER, MdA 01 uc 845 I l o:I,,,Town) as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMA[314S OR EXPLOSIVES. Noi r.: This certificate of registration most be signed by the holder of the license if said lirense was granted prior lo.lt l} I,1936, Otherwise by the owner or occupant of the land licensed. pZ �. .�.� �.. ')01.__._.. Received�, � t cvxaeA':... (yt I 1 tl p'nt.rholdu) / (Ott a1 fail) lChrk) The Communlvealth ofMassuchusefls I)cpartment ofbtdustrial Accidents 6 Office by Inivesligations reet 600 {3'ashfngtnn Street B,seon,MA 02111 tvrwv.mass.gm✓di(I Workers' Compensation Insurance Affidavit: General Susinesscs Please Print Legibly A tlicaut lntonnatlon �,,I,,,, �A" /�� i3usincss,tOrgadrdion Nawc:�luuti 1"1ontectio&WO S.VIcp Addruss:-goo <,bow swc& SOksw- C tTy/Slat /zip Wa ln'1� M$ o,)A��3 Ru me Typc(regmred): 1tey ,jipliv,, C her k the approprmte ko, 9 R tail I a emplo c am wi0t � employ cs(full rind/ I bill tlm e).s f ❑ Re>taur rib Rat l thng l.stnohshrnent 2.❑ iam asole proprietor or pattnurs'hip and havo ro ❑ Office Inc ' -SalesQncl-realestate auto, etcI employees working for me in rlp capu:'ity. ti ❑ NonyaroGt [No workers' comp. insurance required] - d.❑ 1Vc ar...otporadan end its otHce¢hove cxereiseJ 9. P,ntcdmnment their right of oXentption per c. 152, $1(11),an d meh,,e 10.❑Manutactunug no employees. No workers' comp.insurance rnqulredl" I1.❑ health Czro n..❑ We are a jam profit oi ganization.staffed by vohmlem's, Uutet - - t with nu emplo ens. [Now rl cis romp instrnse rcy � - _- -- - Atxpp�hatcb 4 box Al niz.,I t III _mdo bl I II oI > t ICI aoyon rootr csloved ,p1Jd I' : tie die q .�iw iizCne nph yt „; w rN ea p `"o iP l , r�pu T_I nJs ml �" arqun Oovibchcok b-e'1 -- -_ ve rnployer amiss prorafin"""g"""'''�poeher s'myrnpeu�rnllon ins¢r mere fo(r}�trzy e���njyyyl���n���i���es. 6elnry ec the policy infurnmtfnrz. Insunn ,Cotnpl iyNamc: ''��� ��+,{((�ISLIrS��hS� I uru sAddrosr.__t cIry,State'Zip .yy� lp lT/ VSLQL�. _I np� bcn Datc: — Iohcyl/r:Sulf--ins Im u. Atteeh a cop}of the wm'kers' cant pensation pehey dr.elaratinn peg,(vhowbig the pt liry mailer and expiratiml dato). i 211LIFe to,vucure coverage as requited under Section 2?A ofMOI 151 can 11,111,,th inwosiflai of dmmxipe'r Ili ;of a I'meupto$1,50000 md'orolo-V+erimprisonmcat as well as c,v1pendties In tha farm faSPOI WORK ORDLR ilb]ICme It f up to$250,00 a day against the v5oletor. Re ads iced that a cope of tcl�statemej,rjepr he forwarded w the Office of lm h annns ofthe DIA fariusul mce covu'ng,vr`p nl u- — I d I r hV ce under gee p at and Hall,, e fP 'Pay Ilia/t mf�nuahmr l......t deArzhnve s fz rind cnrr¢I. Dtt I, I. OIl'(! [eeeuriot} Ot not�eriten lire,vv<q I[ 7 uurrp]rtrd lit +ry erlorvn rjf end -- lm m},Authority (0,t lu u,) 1.0 mLLardof11 ,lth 2 Rnld... oel u0 cat i City s u(ktl 1 J i ustnglt ml SSdectm enAOffue ( Uthrr _ Ilion, 4: wl . WORKERS COMPENSATION A DPOLICY LOYERS LIABILITY Liberty Mutual. INSURANCE INFORMATION PAGE ns Berkeley serer Arm,MA 02116 Issued by Liberty Insurance Corporation (a stock company) 21814 Policy Number WA7-690-460066-014 Issuing Office Lewiston, ML Renewal Of WA7 69D-460066-013 Issue Date 1012012014 Account Number 9-460066 Sub Account 0000 1- Insured and Mailing Address ILIN 74-3140887 Global Partners, LP NJ TIN 141924242000 800 South Street Risk ID 911385333 PO Box 9161 WALTHAM MA 02453 Status Grnited Partnership Other workplaces not shown above'.See Item 4.Premium-Extension of Information Page 2, Policy Period The policy period is from 10/O1/2014 to 10/0112015 12:01 A.M. standard imam at the Insured'a mailing address- 3. Coverage A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensaion Law of the states listed here: CT FL GA ME MA MT NH NJ NY OR PA RI TX VT VA B. Employers Liability Insurance: Part Two of the policy applies to work In each state listed in Item 3 A. The limits of our liability under Part Two are: 1,000,000 each accident Bodily Injury by Accident $ Bodily Injury by Disease $ 1,000,000 policy limit Bodily Injury by Disease $ 1,000,000 each employee C Other States Insurance:Pant Three of the policy applies to the stales, if any, listed here: All States except those listed In Item 3A and the States of: NO OR WA WY D. This policy includes these endorsements and schedules: See Item 3. Coverage D-Extension of Information Page 4. Premium: 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. Classiticatons Code Premium Basis Total Rare per$100 Estimated Annual _ Number Estimated Annual Remuneration of Remuneration - . Premium_ ---- See Extension of information Page -- 688,867 Minimum Premium $1,835 (PA) Total Estimated Annual Premium $ 688,867 Premium will be billed Annual Deposit Premium $ 31,084 Deposit lax/Surcharge/Assessment $ Producer 0002 000499 Countersigned by Authorized Rep. (FL) LOCKTON COMPANIES LLC(DALLAS SFHIES) 2100 ROSS AVE STE 1400 ��- DALLAS TX 75201 Producer MASTLRS 8828 Irving,TX i WC 00 00 01 A Kd 1987 National coma9l on Compensation Insurance,lea WC 00 00 at B (CAJNJ) '-d.0110112011 All Rights Ruservcd Pays i of I eclipse 705n L-11"Peia BIM ooMhr ion,OH 43085 L6fai 433 Oqa unry n�."pay.i rig April 17, 2015 North Andover Town Clerk 120 Main Street North Andover, MA 01845 RE: FP5 Certificate of Registration Renewals—Global Montello Group Corp. 350 Winthrop Avenue 12 Massachusetts Avenue To Whom It May Concern, Eclipse, a Division of ECS Inc. is an environmental and compliance consulting firm retained by Global Montello Group Corp. to assist with their storage tank compliance program. In this role, I am writing to renew FPS Certificate of Registration for the above-referenced facilities. Please find enclosed the documentation needed to perform the renewals, as follows: 1. 2 Certificate of Registration Renewal Applications 2, Worker's Comp Form 3. Remittance in the amount of$300.00— Check#606744 Our client requests that the new permits and future renewals be sent to my office at the address below for processing and distributing to the sites. Global Montello Group Corp. C/o ECS Eclipse 705-A Lakeview Plaza Blvd. Worthington, OH 43085 Thank you for your assistance. If you have any questions or need any further information, please feel free to contact me at 614-433-0170. Sincerely, Eclipse, a Division of ECS, Inc. Sarah Beaumont Compliance Analyst Enclosures The pPT olennl nduetry Leader for compliance and fuel management. Department of Fire Services z Office of the State Fire Marshal s✓n Yl` p.p, Ihs I025. Slate(toed_Smw. MA 01775 CERTIFICATE OF REGISTRATION North Andover April 30, 2011 (any or town) (Dale) NOTE:Complete top and bottom of form and foncurd both sections and fee to local I.iceraing Authority((M e,Down 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: (HTLE BOLDER)'. Global Montalto Group Corp. (ADDRFSS c,o Gilbarco Veeder-Root CMS 7300 N.Floral) Ace.,kP,176,U,,,oabun,,NC 27420 is the holder of the license granted(Date): for the bwful use of the building(s) or other Amended 8/22/2011 to increase the storage of gasoline in their underground tanks from 24,000 gallons to 32,000 gallons and also add diesel fuel. structures)situated or to be situated at(ADDRESS): 12 Mass. Avenue NORTH ANDOVER. MA 01845 (CIR, nr l own) as related to the KEEPING, STORAGE:, MANUCACI'URE OR SALE OF FLAMMABLES OR EXPLOSIVES. NOJ E: This certificate of registration must be signed by the holder of the license if said license was granted prior to July 1,1936, Ottherl,ise by the owner or occupant of the land licensed. Received (Swan.") � htnl'r del fCIcM1) (StI I thr smr " ,t nr hoWu) ...................................................... (Address) s • , �DFDtr�F� � a�t�d�eed, p� << � s Department of Fire Services ®Jar Office of the State Fire Marshall �I�VTSf//J P O Rae 1025, State Road Stem, MA 01775 REGISTRATION North Andover, April 30, 2011 (Cn}o1 -o) )Date) This is to certify that Global MontcllO Group Corp. has, in accordance with the provisions of Chapter 149, Section 13, of the General Laws, filed with one a cerliflcate of registration setting forth that: Global Mo ldellO Group Corp. is the holder of the license granted(Date) for the lawful use of the building(s)or other structmc(s)situated or to be situated at: 12 Mass. Avenue as related to rho KEEPING. STORAGE, MANUFACTURE OR SALE OF FLAMMABLES XPLOSIVES. -E urc'end OnlCwl l iac) Clerk Note:A co,of,,aa of......a0mt mot be ld) d oa or befom Apol 10"M each year (THIS REGISTRATION MUST RE CONSPICUOUSLY POSTED ON THE PREMISES.) EXPIRES APRIL 30,2012 ` i•`✓�r `�t+nearurnraeas!CL a���' "aJJtu'�u+aPL/J GIS Coordinates L,rt. License s,Nr --��' Massachusetts Gencial Law, C.hapteT 148 § 13 FP¢ � Llrmw Nunihcr (Hev.052o09) ❑ New License 3Amended License After notice and hearing, and in accordance with Chapter 148 of the Mess. General Laws, a license is hereby granted to use the land herein described for the purposes describedLocaton of . P 47 Ownetr of Land d /r5, ��1 �L(� J /� n,�ini1 _ _ — mn ,sir �� Address of Land Ownetl [ ![ _�/d/{r//.'`1�LLC[ �•—�r !�' 4��/� �� �LL—r���� ��—� _ s Flammable and Combustible Liquids Flammable Gases and Solids Co,aplere this secumr/,, the slornge rf fl ,u,nn III c m,d"'nhe'ihle hquid,,,solids, mrd 11,11,. All mnke d canminecc we coal...k,ed/ail fur step j,"",of(icru.duy and prnoiuG,g. (Allah udahtimml pagee t/neceesa..) PRODUCT NAME CLASS MAXIMUM UNITS CONTAINER QUANTITY gal.,lbs. LIST,AN 1,IBC, f �t cubic feet drunis � ..� [��l�J/Z L///7 j�/��rJ^ � _ l JP n// LKIZIL LP-i (C, plot,(ho e�,lo,i st,It"aloof LP-ger pw¢ Maximum(jemftity(in gallons)ofl.P-gas to be allied in aboveground natunce, _ List sizes and capacities of all aboveground containers used for sturagc Maximum quantity(In Gallons)of LP-gas to be sn,rcd in and etground cnntainen. List Was and capacities of all under isnind containers used for storage __ -- Toll aggregnte gaanGry of all LP-giu it le scored.— Fireworks (Complem ih6,ec non lr the vorgye o/Pt no al/oc) Max im um mnount(in pouedv)ef Clas.11.3G. — Maximum amount(iu pounds)of Clew I AG. Mallmmll amuuat(in pounr/s)of('lass 1.4: _ Taal aggregate(jauntily of all clneser of fireworks to be swrcd.. THIS LICENSE OR A CERTIFIED COPY THEREOF MUST BE CONSPICIOUSLY POSTED ON'I HE LAND DiIR WHICH IT IS GRANEUID. Exi losives (Cornplelc ILis ss¢lion for the.vo"ge o/cayl... Maxinwm xmou,a(rn polo..10 ofCh" 1.1 _ Number of r,ap,lnes used for slot ge. Maxhnumamount(u,yow.Js)of Class 1.2. _ . _ Number of magazinct used for storage — Maximum amount(in ponodv)of Clans 1.3: Number of magnzlnes mod for Maxllnum amoum(,,, , u rle)oI(9av, IA: Numbs,III nugaxines used l a a),,gc: Moxinnlm fllOOWIt fin PouuAsJ oCCless 1.5: Number ofn nap",)"used forsmragc- Muxlmum amotmt(in pmrndv)of Class I,b: Nu tuber of magazines used 12,r snit I _ I AcerI Authority Use: This license is granted upon the condition that the licensed activity will comply with all applicable laws, codes, rules and regulations, including but not limited to, Massachusetts General Law, Chapter 148, and the Massachusetts Fire Code(527 CMR) as amended. The license holder may not store materials in an amount exceeding the capacities herein specified unless and until any amended hearse has been granted. ADDITIONAL RESTRICTIONS: L'6�-1 C24 /Iy f r ,j rt Y/ tlJ�/J+'// r. �Z<�/� rlii //i/'s i�'.a/C,''/i�-6 o2 SiPo. �e JA c........A, M1a v THIS LICENSE OR A CDO IFiED COPY THEREOF MUST BE CONSPICIOUSI.Y POSTED ON I HE LAND FOIL WHICH IT IS GRAN"1'1:1). I P-2(It,, 052000, Page� loll'.MOO)225-1927 Direct (M)402-8883 ----- Pax.(751)674-7799 I lance Allinnec 8nergy �,�49t„30,an/Y BAN BERRY _ j 404\Nyman Street,SWt,425 C4nslmclionlMainlenance Supervisor Waltham,MA 02451 dberry0lallianceenergycom 1 1, G C -J (c, G ccl� Z��v +� li t� 1. The Commonwealth of Massachusetts Print For. Department of Industrial Accidents Office of Investigations k 1 Congress Street,Suite 100 Boston, MA 02114-2017 - /. www.mass.gov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant Information nn //,, Please Print Le¢ibly Business/Organization Narne:_V1� 77D��In s S Co e 79 ��tQ n Le �Jf e/it:j Address: 70y W L I-M all S�✓Ce-+ Yd-S -1 _ City/State/Zip: WQ � 4 h1� Phone#: qg1 - � T� — �� �0 Are you an employer?Check the appropriate box: Business Type(required): Lyy I am a employer with_7/r /00 employees(full and/ 5. Retail or part-time).* 6. ❑ Restamnt/Bar/F.aling Establishment 2.❑ I am a sole proprietor or partnership and have no 7. ❑ Offico and/or Sales line]_real estate,auto,etc.) employees working for me in any capacity. g ❑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 10.0Mumfirchning no employees. [No workers'comp.insurance required]' I1.❑ Health Care 4.❑ We are anon-profit organization,staffed by volunteers, with no employees. [No workers' comp. insurance req.] I2.❑ Other 1My applicant that checks as di must also till oar the section below showing their workers'compensation policy inromration. eenthe ,asaxte officers have exempted themmlees,but the o.,racaonl has other employees,a verses'compensation policy is required wd such an organization should check box 91. I am an employer that is providing' work s'compe/nsation insurance for my emplo ees. Below is the policy information. Insurance Company Name:_ N OMB ' ) lbw �-n iU✓GA w.. brl _ Insurer's Address:_ (O� �]of City/State/Zip: __ N o') 7 GY pit YV Y- Policy k or Self ins.Lic.R_ W G )�T=�'b — L(� Expiration Date: 0 (] oil, Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required trader Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations ofthe DlA,,fiar insurance coverage verification. too hereby c ;under thepains and penalties of perjury that the information provided bov is f and correct. Si nature' 4- Date: /f Phone 4: — Official use onr. o not write in this area,to he completed by city or town official City or Town: PermitfLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4. Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone#: wanv.massgov/din / LBARCO Gilbarco Inc I/, 'k V GI CMS Department, MIS F-76 VEEDER-ROOT 73oo West Friendly Ave, e. P. O. Box 22087 Greensboro, NC 27420 March 22,2011 United States Phone: 800-253-8054 Fax 336-547-3384 NORTH ANDOVER TOWN CLERK w .gilbarco.com 120 MAIN S f www.veeder.corn NORTII ANDOVER, MA 0 1945 RE: Global Station N 2432 12 MASSACHUSETTS AVE NORTH AN DON FR, MA 01845 To Whom It May Concern: As a Global Montello Group Corporation and Global Companies, LLC(Global) authorized Compliance Service Provider, Gilbarco Veeder-Root is responsible for renewing and maintaining permits and licenses, and for coordinating and tracking the resolution of compliance issues. Global purchased the above-referenced station from ExxonMobil Oil Corporation in September 2010. At the time of purchase, Global submitted to your municipality an application to amend the facility license for storage of flammables and combustibles at the above-referenced gasoline service station (FP-2A form). To date we have not been issued an amended license. -this letter is to request either an updated License reflecting the transfer of ownership for the above referenced gas station or written confirmation that one will not be issued. According to the "Guidelines for Municipal Officials on the Issuance of Licenses Granted under Massachusetts General Law, Chapter 148 § 13": "A license is granted by a local licensing authority and then is recorded in the office of the city of town clerk...Massachusetts General Law Chapter 148. Section 13 establishes the procedure under which local licensing authorities may grant licenses for the storage of flammable combustible and explosives on the land. City and town clerks are required to maintain records of licenses that have been granted." I have included a copy of-the License in the old owner's name for your reference. If the local licensing authority does not issue an updated License for a change of ownership, please sign below. Signature: _ I it1e: Nysg - _m' ltte , - a-r me q tr I nm,d dl: ein men crs name l'h`har will act J glon with the cro m L,o se m enxt re full compl once w th Maseachureas G I h m uCh,ty, 148 y 113. Sincerely, 9oseph'Weisman Joseph Weisman Owner's Authorized Agent (336) 315-2889 Rog 11 2009 1 : 27PM NO RNDOVER CLERK 976GOOS557) P• 1Q rm.oa.1®.snrvls 9I6.S— 102 Z-2Z) V l I' �/ •? _�(63q�1z � ,. I�p C�i�ttmtp�•� of �ttse�+c�f� `t �� � w DEPARTMENT OF AFETY—DIVISION OF IVISI FIRE PREVENTION 1010 COa1 9 Earth Andeuver &ulruat goo 81 (Olt or Tore) c>»m APPLICATION FOR LICENSE F. the lawtal vas of the herein deeerbed buildim{,.. m other etracture...., Cppll"tiOn is herehy made la meord- mee with the proehom/of Chapter 148 of the General Lows,for a Beene¢to we the land m which such bulging.... or other .. 1-r..e to be eibanted, earl only to such atmt m shnam m plot plan which Is filed with end msde a JAI '.1 6 Department of Fire Services Office of the State Fire Marshal P. O. f3us 11125.Srelc hoed_Slurs; A9A 01775 CERTIFICATE OF REGISTRATION North Andover April 30,2011 NOTE: (' n plot top and b uom of Iona t DO NOT RN;TI:RM1FORM TO end Irt eard both s u'c n:end fcc to l CL i cnsin= ID 1p] ' TTlt DEPARIT1f N'f OF FIRE S I S. In accordance with NRtI the provisions of Chapter IVB, Secliun 13, of the General Laws, the underlie 6 amhunp'(Cin-nr lava Clerk). (TITLE)!OLDER): Fg;eOMobil(),ICorporation ned hereby ecrtilles' Ihat: (ADDRESS); c/o Gilbarco Veeder-Root CMS 730011 F ,o,k'Arc., M5 f9(.,Gnevhom- is the holder of the license granted(Uate FC'Jd20 hot): slracture(s)situated or to be situated at (ADDRESS): 12 Masts. Ate NORTIi ANDOV)'.R. N1 lslnue Ul se oPthc buildings) or other (( 11 � l'orml 0 4 as related to the KLEPINQ STORAGE„ MANUFACTURE OR SALE OP 1:1.AMN4Af3LLS OR EXPLOSIVES. NOTE: This certificate of registration must be signed by the lmlder of the,icense if said license suns rented riot tn.lel O[herwue by the on net or oreupnnt of the Innd licensed. g P ) I, 1936, Received �f I IIrI I (CI k) perm or huWcrl Tatsl capat"y ,,. ....... ;'... CV'(2 �,i..y1.�✓`L �yzJ mod of aWd to bestored is ta}dt6 ............................ .........._ (Address) ... Ratrktloaf—I[ any: .•......( fw.rvr. of sunder eW.+igl T C E !e A PHOT a�AcTIQ.9m CGTINI€D 1 H N r ERE RT [ CON 1 ObELV wwn w vM� P,Tvrr PI er1/ O TMv ANb OR WgIaN A GUIDE FOR MUNICIPAL OFFICIALS ON LICENSING THE STORAGE OF FLAMMABLES, COMBUSTIBLE and EXPLOSIVES - Licenses, Registrations and Permits The purpose of this document is to provide guidance to fire departments, local licensing authorities, and municipal clerks on licenses, registrations and permits for the storage of flammable, combustible, or explosive materials in accordance with Massachusetts General Law (MGL) Chapter 148 and the Board of Fire Prevention Regulations, Code of Massachusetts Regulation (CMR), 527 CMR 2.00, 527 CMR 6.00, 527 CMR 9.00, 527 CMR 13,00, 527 CMR 14.00. • A license is the permission by competent authority to do an act which, without such permission, would be--un7a—wTul, a trespass, or a tort. A storage license is applied for and granted by the local licensing authority. The license is granted to the land and not to an individual. Only one license may be issued to a parcel of land. This license may be amended to reflect changes in quantity, conditions or restrictions. The license may be revoked or suspended for cause by the issuing authority. Information pertaining to the license and the license shall be maintained by the city or town clerk. • A registration is the acknowledgement by competent authority of the act of recording a formal or official record. s orage registration is filed annually with the local city or town clerk. The registration serves solely to notify the community of the present license holders name and address. Only one registration may be granted for each license. Records of registration shall be maintained by the city or town clerk. • A permit is a written authority or warrant, issued by a person in authority, empowering a person to do someact not forbidden by law but not allowable without such grant of authority. The law allows certain small quantities of flammable and combustibles to be kept or stored on the land without a license, but with a permit granted by the head of the fire department. 527 CMR 14 requires a permit in addition to the license. The following are definitions related to the terms"flammable or combustible". Combustible liquid Any liquid having a flash paint at or above 100-F shall be known as a Class II or Class III Liquid. Combustible liquids shall be divided into the following classifications: Class II: Liquids having flash points at or above 100' and below 140°F. Class IIIA: Liquids having a flash point at or above 140'F and below 200T Class IIIB: Liquids having a flash point at or above 200°F. Flammable Liquids. Any liquid having a flash point below 100' F and having a vapor pressure not exceeding 40 psia at loo,F. Flammable liquids shall be known as Class I liquids and shall be divided into the following classifications. Class IA. Liquids having flash points below 73'F and having a boiling point below 100T. Class IB. Liquids having flash points below 73°F and having a boiling point at or above 100'F. Class IC: Liquids having flash points at or above 73'F and below 100°F. The authority for the keeping and storage of flammables, combustibles, and explosives, is section 13, of Chapter 148, M.G.L. This General Law is rather lengthy; this document references only the relevant sections. In order to apply for a new license or to change the conditions or restrictions of an existing license, the applicant must apply for approval or disapproval from the head of the local fire department. Whether the local fire official approves or disapproves the application, the next step is a public hearing on the application. Not less than seven days prior to a the all public lbutterrs and owners of reallsed in sttateamust be newspaper otipublished ed lby registered ed English maill not less than[the seven days priorts ptonthe hearing at which the licensing authority acts on the license application. A licensing authority may prescribe conditions or restrictions to a license. Any such license granted hereunder shall be subject to such conditions and restrictions as may be prescribed in the license by the local licensing authority, which may include a condition that the license be exercised to such extent and within such period as may be fixed by such authority. ' A certificate of registration must be filed annually on or before April thirtieth by the ownerloccupant of the land who holds (exercises) the license. This informs the licensing authority that the license is still being exercised, and the name of the person or entity exercising the license. The Board of Fire Prevention Regulations has been granted the authority to exempt certain quantities of the articles (flammables, combustibles, and explosives), articulated in section 9 of Chapter 148, from licensing, and registration.' These exemptions may be found in the relevant sections of 527 CMR governing the articles to be stored. Every license granted, and every certificate of registration filed under Section 13, is deemed to be granted or filed upon condition that if the land described in the license ceases to be used for the aforementioned uses, the holder of the license shall within three weeks after such cessation eliminate, in accordance with rules and regulations of the board, all hazardous conditions incident to cessation. Massachusetts Code of Regulations 527 CMR 9.00, Tanks and Containers, uses the definitions "abandoned' and "out of service',to further categorize storage containers subject to cessation of use. As defined: "Abandoned, in the case of underground storage tanks, shall mean out of service for a continuous period in excess of six months where a license from the licensing authority is required under the provisions of M.G.L. c.148, s. 13, and for a period in excess of 24 months in the case of any other underground storage facility or an aboveground tank of 10,000 gallons capacity or less; and in the case of aboveground storage of any fluid other than water, where a permit Is required from the Marshal under provisions of M.G.L. c. 148, s. 37, it shall mean out of service for a continuous period in excess of 60 months and it has been deemed to be unsafe and a threat to the public safety by the head of the fire department and by the Department of Fire Services." "Out o/service, not in use in that no filling or withdrawal is occurring." ' Once the tank is abandoned or out of service it must be removed. (With the exception of certain double wall underground storage tanks) If it is determined that a fire or explosion hazard exists or is likely to exist as the result of the continued exercise of a license, the local fire chief may issue a cease and desist order. The fire chief shall order reasonable measures to protect the safety of the public from the hazards of a fire or explosion. Any measures so ordered are at the expense of the license holder. "When a fire or explosion hazard exists or is liable to exist due to the exercise of such license, the marshal or head of the fire department, shall issue an order to the licensee to cease and desist in the exercise of such license and said marshal or said head of the fire department shall direct that reasonable measures to insure safety to the public be undertaken at the expense of the holder of such license. The first paragraph of section 13, Chapter 148, speaks of certain articles named in section 9 of Chapter 148, that are subject to regulation. Section 9, names the articles subject to regulation by license or permit. "The board shall make rules and regulations for the keeping, storing, use, manufacture, sale, handling, transportation or other disposition of gunpowder, dynamite, crude petroleum or any of its products, 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 it may spontaneously, or acting under the Influence of any contiguous substance, or of any chemical or physical agency, Ignite, or inflame or generate inflammable or explosive vapors or gases to a dangerous extent, and may prescribe the location, materials and construction of buildings to be used for any of the said purposes. Such rules and regulations shall require persons keeping, storing, using, selling, manufacturing, handling or transporting dynamite or other high explosives to make reports to the department in such particulars and in such detail that the quantity and location thereof will always be a matter of authentic record in the department... ,8 The first paragraph of section 9 of Chapter 148, states that the Board of Fire Prevention Regulations shall make rules and regulations for the keeping, storing, use, manufacture, sale, handling, transportation or other disposition of the articles name. The Board has made these Rules and Regulations with the Code of Massachusetts Regulations (CMR) 527 CMR 2.00 (Fireworks), 527 CMR 4.00 (Oil Burning Equipment) 527 CMR 6.00 (LP-gas), 527 CMR 9.00, (Tanks and Containers), 527 CMR 13.00 (Explosives) and 527 CMR 14.00, (Flammable Fluids, Solids, or Gases). These regulations allow the storage of certain quantities of materials to stored without a license, but subject to permit issued by the head blithe fire department. Hegulatlon b2/ CMR 14.03 section (Z), requires a permit tar the storage or any flammable fluid, solid or gas. This permit is to be obtained from the head of the fire department, as provided by M.G.L. c.148, s.10A and 23, The head of the fire department may restrict the quantities to be stored under the permit. What this means is that a permit in addition to a license a permit is required from the head of the fire department for the storage of flammable and combustible fluids. The head of the fire department may reduce the quantity of product allowed by permit but may not increase the quantity beyond that allowed by the regulation. Exceptions to the permit process are granted to certain persons for the storage and use of and use of limited quantities of flammables, combustible. These exemptions may be found in the relevant sections of 527 CMR governing the articles to be stored. Important Points • A license for the storage of flammable or combustible fluids in quantities in excess of those allowed by regulation is granted by the local licensing authority after approval or disapproval by the head of the fire department and after a public hearing. A permit is granted by the head of the fire department. • A license is not owned by an individual as a personal privilege. A license once exercised is a giant which runs with the land. The permanent record of a license is to be recorded and maintained by the city or town clerk. • A permit from the head of the fire department is required in addition to a license for the storage of materials regulated under 527 CMR 14.00 (Flammable or Combustible Liquids, Flammable Solids or Flammable Gases. • A certificate of registration is annually filed by the holder or occupant of licensed land to inform the city or town clerk to record (register)the license as still active and being exercised. • A city or town may develop its own form for the actual license and registration. The form of the license and registration must contain, as a minimum, that information contained in Department of Fire Services Fire Prevention Forms, FP-2, License and FP-5, Registration respectively. • A license, when exercised, is a grant running with the land. A parcel of land may only have one license for the storage of flammable or combustible fluids. • If the conditions, capacities or restrictions authorized by a license are changed, an amended license must be obtained. A new application must be submitted to the local licensing authority, the head of the local fire department must approve or disapprove, and a public hearing must be held. If granted, the amended license supersedes and replaces the old license, and will show the aggregate total capacities allowed under the grant. The terms and conditions of the new license now prevail. The license must be plainly posted on the premises. • A certificate of registration is the vehicle used by the license holder or occupant of licensed land to notify the city or town town clerk annually, before April thirtieth, that a license is in use and currently being exercised. If a registration is not applied for and issued, after three weeks, it may be viewed as cessation and cause for review of the license. A registration must be plainly posted on the premises. 527 CMR 14.02 2 Massachusetts General Law,Chapter 148 § 13,Paragraph 3 'Massachusetts General Law,Chapter 148§ 13,Sentence 2 °Massachusetts General Law,Chapter 148 § 13,Paragraph 3 '527 CMR 9.02 527 CMR 9.02 'Massachusetts General Law,Chapter 148 § 13,Paragraph 6 °Massachusetts General Law,Chapter 148 §9 y Department of Fire Services Office of the State Fire Marshal P. O. Iloz IOti.Sta¢hoed.Stow.MA 01775 1 4S2JCERTIF[CATE OF REGISTRATION North Andover April 30,2010. (cn nrm.,al D'a" NOTE: Complele I'll bovom of Cunn and horwnrd both on sectis and fecto Iocal I,icensine A Whorill (('.'(I or Town('Icrk)- DO NOT RF:I'L'RN FORM'1'O'I HE DEPARThIENT OF FIRE SERVIC ES. In accordance with the provisions ofChapler 148,Section 13, ofthc General Laws,the undersigned hereby certi lleschat. (TITLE IIOLDER): EsxonMobil Oil Corporation (ADDRESS): clo GilbarcoVeeder-Root7CM5......hnro.v( 2741_6 iS the holder of the license granted(Date): for the lawful use of the building(g) or other strucLLne(s) situated or to be situated NOR I Avenue II ANDOVER. MA (1I845 asb or r„r„o as related to the KEEPING, STORAGE. MANUFACTU RE OR SALEOI' FLAMMABLES OR EXPLOSIVES. NOI f: This rerti Ocalo of registration must be signed by the holler of the lies...if said license was granted prior to.July 1,1936, Otherwise by the owner or occupant fthe land liecnsed. _2010. i(pQLBARCOVEEDER-ROOT R�eived THpKIZEg g300 W FRIENDLY AVE. l.�k.:.... S.AV. .se';' d ... . 87...... —�on�e�nl rder tcluk� ����Y � EENSBORO, NC 27420 ...................4AA1 L STOR#F76.. Addasss The Commonwealth ojMassaehusetts Department of Industrial Accidents AMtrNAmuMb~ 600 Washington Street Boston,Mass 02111 Workers' Co eafatlon laaarana Affidavit-Genera)Businma .ddee 12 Mass Ave North Andover, MA OIR45 st.tr ohm.# '--`doll lbdl.ddte F - - ❑ I m a]olepmpriUar and have m me Be dnm Type: ❑Rend O RestMUVBaN/P�tmg Pslahhshmmt working in any capacity. Olfim❑Sales(iueluding Rmk Estate•Autos etc.) ®I am m employe with ro moploycas(fill &Part time). Other ✓ I M m employe providing wsskas'M thltlob. ._ eeeet, .a city- oboes Y• Ej I am s sole po cux and have hired the iudepmdmt wtttrxtars listed below who have the following worker' c P,21116(11 polices, .duress- _.. .�_- ., t :'seal �t3A fiain a P4ekli } P4a 5 ddnr: 12 Mass Ave North -Andover ohov#i 978 689 2719 Imm�nee ea i-0An3 a' Flrl� N[lz.zIWAvf W.cic-rJ.)p 1,011"t Oily 00a'.0.31537 Iko �f1I P.Wn b erreeneup r+.9eYtl mdr 8ra.o 2SA NMQ.lf2 m d Y ld Ivgrebe Neetub.l pe.mr Na IW�Y f1,SaLM a.Yhr .m tyr•t�tb.eralr a.ardrl[mYw btbr N.6rOP ROi1C OitDt�Id.an.Nf1MM.4r yYmtr lmdmb.i act. ny ortee.bereat sped br.rrdd b dr OIIb+Nlv.sapWr NtY pAfr e.er.prrllblYa I d.berebp cw*mdn tk pi.aadpm.fti..Jpwje y raa dt.infsrral.e pr..1/d.bare b tme.ed tmred sib Prfirt S' � -t�) >T' aim �n ds . PLom# `37y 4: aZi9 fft Mial me.dy bnetwreebdtY.tea bbe esmpiNM bf err sr bwe.BkYl trord puvWfe.rR �B.IWer D.pr[meat OLte.rbr B..N ❑+err abmedt.b rrpeor b,eym.a Oeelrtmeo't oelr Onreh Bep.rtmeot .ntaet pan..: ❑Other m "Ise Com:nmaweal.is a� dcssed::rse�; leprrlrre:.l ay`7r.3:!r:rlsll.ec{Ztues Office O/IIW8S71g8ttL!!5 606 YS-'rrsSir Floor f1D.LCPsipp" e!DlCSI 02111 ' No kere �cnoe r'a^.Irtbt on e •11 n•'i:-i eye;a`L,rs!ers=es e,nel7;vrz 4r?7 lion__. Ple•.. rR\ I, !^v _�.--_..—. 14 Lk ❑ : meealc propriaror and 4sce no one Luslncas7YPo� ❑Ae4lIQ RvsomranV5=:lFiatir.g'vstsb;isl¢non:^ wvr'ang in oy cepaw:y, E,Off c❑Sales fivctutlin Fezl sh:e {o etcJ ❑!nrz.on e-sltloyu•wd4', t_xx;7loY'ece(fult FcpLsxp) ❑OIrJ„_, �� �'1lcC.>Z vtpby•xF;o.ld.nywotkevi ceerxsa ton Faenayeryvl ycews:m,c th'sjeb. AF_�,c c.} or. 6rsseS,hs SeY �.a�r\py !eve Ci i c cam,_315�"l S6a pm;. 51 i And h yo - =(!!u mdepL Lrt<AL{ra I0i6 ostI d FO nefu coc.pt=I aR policca! n�ranrc.a oolk�N - note Ce. fcuF - Art 1 xJdrllanRi 6FiP`.re "t. .•. - r o d 6 tlG sx rMCL a l a I vJl f � ntl, n Ill p P 60rn dr� Ce rc'11 antq¢wcl P;nl:u,nl Inn G.:STpf AJFF'O.D£FvWe(4pr5fop.pped � v.m. I ' un.pd Ll e ropy oflM1itnmmmnt ruuy uc rannrJOJ 6o 0x Vtn¢oflmaOL'd{vn:of cha DlA(ar:ovon,+,e �n'6e;Rbn. I2 1 . eLy anrfyv+ Irtayn ad �oLfrt fl J Jrdutlhe GJ>,n n'iatt rvxin 7uveerAo ea. � aC �aIL ny Ic rp I �r arw Uh _e.GbY e'tl we o,t.;.l 1^ -tOF'n: __ ___ i m.smcn ___, nLLrv;lalnf,�gaovrmonL i ['cLccAl 1' ¢rtica. I _nv...v (] I r i0f0 �ier�� Commonwealth of Massachusetts Department of Fire Services 'x Office of the State Fire Marshal h s P.O-Box 1025, State Road.Srorc,MA 111975 CERTIFICATE OF REGISTRATION North Andover April 30,2008. (Gp,or o%%n) (Dale) NOTE: Complete lop and bolos, of form and forward both scclions and fee to local Licensing Aulhoriy (City or'foo'n Clerk). DO NOT RETURN FORM TO HIE DEPARP TENT OF FIRE SERVICES. In accordance with the provisions ofChapter 148, Section 13, of the General laws, the undersigned hereby cerlilies that: (TITLE HOLDER): Exxon Mobil Oil Corporation (ADDRESS): c/o Gibacco Vecder-Roof DUU V% Fdaadly Avc.MS 196,Grecnshnru,NC2)4_'n is the holder of the license granted(Date): for the lawful use of the building(s)or other structure(s) situated or to be situated at (ADDRESS): 12 Mass. Avenue NORTH ANDOVER, MA 01845 (co, nr loon) as related to the KEEPING, STORAGE. MANUFACTURF OR SALE OF FLAMMABLE.S OR EXPLOSIVES. NOTE: This certificate of registration must be signed by the holder of the license if said license was granted prior to July 1,1936, otherwise by the owner or are upant nfine land licensed. Received Al. L J�tJw ......—...' �LBARCO VEEDER-ROO T 'be RAtlO 00 W FRIENDLY AVE. By n ✓ OWNEt pty87........ (Ontcial Tillq (Clttk) (titatc ni,ethcromncq Ub R ENSB RO, NC 27420 MAILSTI A F7&..... (Address) JFM r= -- ?hc Comneo7aweal:{: of N saccl:rse7s l f�d�-- �,/n Depar;me:.l of lr.�t_.. lnlAc•idents t I QBFCe eIJAYestlyzilaRS ci r-j"�-yv 6co iV�hlrtaton Street Roor Rcsfuq afass- 02117 `-- Wark:re' Cmoae:u'rtiw:InS.:fance Afiica,i:-C3c�era'. I?ac;eessas .e onf;c nt!n Po-�^.a}icn: i. PIn•d: d'R'4'T'.�;1.,, __--.--. la (11 ssachu5etfskvP -- Nic r [I I+mnaolc yropriuor au3 Lsuc no one Business TYPa I,]Ree11r R's:a:venrH..distics 5st.busNrom_. wo:Mng in ory eapn.it;. ❑Odfec[]Sala(wc.odm P sl Es.a:e,A tes eta) ❑lam.an emolay „�emp O➢eee(full 4�a t.na). ❑Oli o;t nttar, cr.rPt 5 P,avilin6 oc _ lhsebp ... ....-i, e .-.. Q��uo3 �zsve�,i Sr-Ca {�t ,xcy r C14 CCSv31�"'�—li Cam . ❑ I am a so.ep >nm or and Eavc Lc d[n iriepe Jeru ontnaors , tzd b:ow whoh vz t,4,,toL`ow ny com,p4mmion policcc: r�mE Addreai: � -- _[6V• sul'anre fa. CO��)_M Amch a...... F 1 rVIS111 a 6rreov5z rYI L Qr AOn U.. . a>Illo:, tt r ea,..n o nb Fl$0¢AO Lnd/a: vrarYlmp II.en,rnraiwo,—in:prne)i Off me rennela5--OPWh,,I), ER n .fnl ar POJDOa u.y c; r_mu lun2urstmld flute oepv of<},ir SUament n'.ey be(orx�rJLd eL,to Off",er In+eiFptl:n:ar:�e Di.\for om�eeepe.Lrifim<lon. Id / (yc i hL/p�aix•a J�.rlvhl:a nfye/ 1'tb�i lhr L,fo pu""eu aL rt enOc r. Iz LmLimi I,,a/.Y l �,..n "l+b[Ubnn e[ eLf eey E'towrOro, toj3 I, li'L'Ih ILI —_^f 'Id nt,Uepv'n,enl ❑cecck l('numedlem reuCmmlt r-A A,LJ OIn v O,en 0`f,c2 �I GILBAJRCO VENDOR No A0014025 CHECKNO. 0000857725 �.. VEEDER-ROOT DISCOUNT PAYMEN150.00T ooc DOCUMENTNO. AMOUNT p0 150.00 DOC DATE 150 .00 SM129165 1/29/08 IN STS00005081 11639 452860 F 150.00 .00 150.00 PAY CUR ENC TOTAL USD 1 V� VEPIFV THEAUINEMT ITV OFTNLSMVLTFTONE EGUPRYOOCIIMEM_ CNECKBM%GI�UNt�_.,,MEACHiINO�E6COLDPGRA *QOM TOT _T�.�O�.M� Ob00857725'. ¢ohs BeRR'Of ARlell`i+3, 01 I'' Dale 4129/08 GoMrolled Disbursement i ® 7300 W F(ienHN7Avenue g ,XdAme(-,NA NET AMOUNT - VOID"OVER 90,DAYS � - Greensboro.NG 27410 Northbrook,Ninrns * E ***'S150.00 �e SRC �I 4 PAY NONE HUNDRED FIFTY DOLLARS AND 00 CENTS ..... TO THE TOWN OF NORTH ANDOVER r a onEP 1-- s wlTxouT uaLs xaTUPEs. ORDER TOWN BUILDING OF 120 MAIN STREET NORTH ANDOVER MA 01845 Ir00008 5 7 7 2 51r r:07i9232841: 01289115 i o ' Note: Complete top of form and forward bath sections and fee to local licensing authority (City or Town Clerk). Do not make application to department of Public Safety. � �ao�nvmc�ru.-e�z`C�i o�C/�/lalaczc�zuaeCZ1 P�LQ/M�rlte9trb V'UMP. C/NN✓.GP6n. d�V'U ✓ '�3'U%�I[�C4612 City orTown NORTH AND_ OV�R APPLICATION FOR CERTIFICA`fE OF REGISTRATION n accamance with the provisions of Chapter 148, Septlbb 13, of the General Laws, the undersigned hereby certifies That EXXONMOBIL OIL ORPORATI ON wm.aZvur..,. 12 MASS. AVENUE ww..� s one ^.Icer 01 license granted for the lawful use of the building(s)or other siruaurel s) stuaiec '0 0e snua�ea at _. 12 MASS. AVEN E a5 rciatec!0 The KEEPING, STORAGE,MANUFACTURE OR SALE OFFL FLAMMA9LE5 OR EXPLOSIVES. NORTH ANDOVER, MA 01845 �o Nore: This application'or c6ntNoate pl registration must be signed by the hol r or a/Lnsad. e was granted prior to July 1, 1936, otherwise by the owner or occup nt of m a =ecerve0 Submihed by —__ ____________________ .uv.,, Note: Complete top of form and forward both sections and lee to local licensing authority(City or Town Clerk). Do not make application to department of Public Safety. ' /] //� �OmUhZOrILLlJ2CLGLi2 r7�C.:%(✓GCZ;J6CLGiLUQ2�,1 Ep JefiairLmeorC a��2xe G�vxvcc� — �vutieon o��ure �wsva�re�Cw�n � ��� ����� Sd 86 C City or Town NORTH ANDOVER DateTfl/Y I I___N1CU� APPLICATION FOR CERTIFICATE OF REGISTRATION n acccmance with the provisions of Chapter 14a, Section 73, of the General haws, the undersigned hereby vanities 'hat EXXONMOBIL OIL CORPORATION wn.w wo.on.w 12 MASS. AVENUE rw.., s 'ee noteer of license granted for the lawful use of the building(s)or other struCuretsl sitLaled or . oe sn_.ieo at 12 MASS. AVENUE as Ruled to the KEEPING, STORAGE. MANUFACTURE OR SALE OF FLAMMABLS OR EXPLOSIVES. NORTH ANDOVER, MA 01845 owd o Note: This application for canlAcafe of registration must be signed by the h0f r o a ' ns if said license was granted prior to Jury I, 1936, otherwise by me owner or ocup nr of th n l' need. Fecerveo Submitted by r v'{I7an ir,� p �300 [./ F�•adf N� sISP �G G..r. sb a ti' omr.,rw s .my _ __ _ _____________ 274 2Z IVIQG�rr/YI2�6j�Z1(J2Q�GGl2 G�CJ/!/ �j /2llQy�,L ��menCo��f�'vrre C�/ervtces — �Lir�xyrouncoy:JCara�a�am�C ✓w>�rrz City or Town NORTH Affri Datei I j �') U0 REGISTRATION --I s :o cemN [her EXXONMOBIL OIL CORPORATION as n ac_omance with the provisions of Chapter 748, Section 13, of the General Laws, filed with me a certificate of regrstrauon 5anir5 rorr. Inai EXXONMOBI OI ORPORATION is the holder of the license grantee pie for the lawful use of the building(s)or other suucturelsl nmatec or c :e sa,a,e,at 12 MASS. AVENUE,- NORTH ANDOVER, MA 01845 .c e,a;ae o ne KEEPING. S7CRAC'e. MANUFACTURE OF SALE OF FLAMMABLES OF EXPLOSIVES. %�rnyyM.. 1 �I nn �'✓ ern«rw Nae:.4 nnrbo fe or•epsrrawn mwt oe.filar on or oerors aom.Orn or aaca I.W. TclS RE_IS7^ATICN MUSS eE CONSPICJJCUSLY PCSTt!D ON r'E PgEbIISe3 ► ISL�h•; Note: Complete top of farm and forward both sections and tee to local licensing ^' application to department of Public Safety aumorrty (City or Town Clerk). Do net make app P • �arrur7wmcuea�C/z a�C/G�a:raac�uaeClm �"AN 2 0 7oo(z �^ Clry or Town NORTH ANDOVER Dare to�II -�X.'„�Pb APPLICATION FOR CERTIFICATE OF REGISTRATION accorcance with me provisions of Chapter 19, Section IS, of the General Laws, the unaersigned hereby cenifles ;hat EXXONMOBIL OIL CORPORATI. ON nun a.w.•>�r..,• 12 MASS. AVENUE s he nelaer 01 license granted for the lawful use of the building(s)or other structuretsl secaiec cr W. .c oe s,ua,ec ae 12 MASS AVENUE as reiatea to me KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. NORTH ANDOVER, MA 01845 cnd Note: This apteloadon for comflo tte or mgiseation must be signed oy me hot er of me license if said license was granredpnaraa July 1, 7936, otherwise by the owner or oev a of me land licensed. CMtfdn'S aWiln'a tftl c�4 =ecervea f 4t \ Submihe by -. -- - if` GILBARCO l�;• % t. VFEDER-ROOT _ w•- 12596 West Bayaud Ave Suite 100 Lakewood, CO 80228 - -- - ----------- ------- TOWN OF NORTH ANDOVEI2 __. UIIICG OF TOWN CLERK N7R 2 0 ?Cpt RO MAIN SIR FF-I NORII I A,N UOAV I:R, MASSA('HI.SGI-iS M 845 Oairy Ol"C A, Hlil[91i1A1 3� �Op rl( (lorb' Tcicphonc(97v)688 9501 .�YL FAX (97s)684 9i57 �qs' ExxonMobil Oil Corporation c/o Veeder-Root CMS 12596 W. Rayaud Ae. Suite#100 Lakewood, CO 8022X 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 of each year. The ice for renewal is S 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 along with your license Your immediate attention in this matter is greatly appreciated. Very Iruly, �� cr. ` - Joyce Bradshaw Town Clerk Enc. VERIFY THE AUTXENTICITY OF THIS MULT140NE SECURITY 00CUMENT CHECN BACNGROUNOAREA CHANGES COLORGMBUALLY FROM iOP TO BOTNM GILB p - Bank af`America '0--"�s -Check# 00,077so95s.' VEELXWROOT -7300 W Friendly Avenue Controlled Disbursement Date , , 3120/06 Greensbord NC 27410, Bank ofAmece N.A. NOMIrook,Illinois NET AMOUNT VOID OVER 90 DAYS "'**.'*"5450.00. - 8 PAY N FOUR HUNDRED FIFTY DOLLARS AND 00 CENTS ......•... RAF7r TO THE TOWN OF NORTH ANDOVER ORDER TOWN BUILDING T A GYER s.sss.so OF 120 MAIN STREET mTNour uA�s MTUREs NORTH ANDOVER MA 01845 "D0007909S9n- 1:0719 2 3 284r: 876SLrIl0126911• �43S'. 1 _. t `� TOWN OF NORTH ANDOVER OFFICE OF TOWN CLERK 20 MAIN STRUT NORM ANDOVER. MAS&ICIRISETTS 01845 Joyce A. Bradshaw o� xon,H Prn,n Clerk o� ��,••>� �yo - Tdephona(978)683--950I FAX 078)688-9557 Gilbarco Veeder-Roof ,��,,,•`� Compliance Management Team 12265 West Bayaud Ave., Suite 300 Lakewood, CO 80228 March 16, 2006 To Whom It May Concem. Enclosed please find your 2006 Registration Renewal Form s underground storage tanks listed at the address(es) on the enclosed form April 30 of each � ) for above ground and/or m year. (s). Renewals are due The fee for renewal is $150 per site. Please sign the top portion of the registration form and return it with the a bottom onion is ours o be Main Street, North Andover, M ppropriate fee, dis la ed alon witb A 01845. The our license. Your immediate attention in this matter is greatly appreciated. Very truly, Joyce Bradshaw Enc, Town Clerk i Note: Complete top of form and forward both sections and fee to local licensing authority(City or Town Clerk). 00 not make application to department of Public Satery. _ � � ��JJ''J7(� �0�77/YI2LL0�IZCU2CLGG/2 O�/���-///�CL;IdIZpC/LCL6�/�1 -• `� JB�I�t 1�irrLe'1[16�1�•UFB C-Jeavccrn — % y�yyaryK. 6L�r/..6 ✓'MALbKCWK City or Town NORTH ANDOVER Date Ari3i0o,azp APPLICATION FOR CERTIFICATE OF REGISTRATION r. accorcance with the provishme of Chapter 148, Section 13, of the General Laws, One undersigned hereby certifies that EXXONMOBIL OIL ORPORATI N ..o.vmo.vr u. 12 MASS. AVENUE s ne nmder of license grante0 for the lawful use of the buiftling(s)or other struCure(s) SltLE ec a a oe mated at 12 MASS. AVENUE e..„e,w,,,� as related To me KEEPING, STORAGE,MANUFACTURE OR SALE OF FLAMMABLES OR EXP!OSIVES. NORTH ANDOVER, MA 01845 Note: This application for cmtiHcare of registraoon mum be signed oy the holder of the/icense if said license was granted prior to Jury 1, 1936, ame,swse by the owner or dd-. pam of the land/,tensed. eceivea Submitted by iv +vise.. _-- - -------- .ov.., � � �cdy�moouuecalC/i c�-� ii/,�clu�aeCti -------- - ?' efaa�GnrereC°�C-iAvxe E`�n.,.ues - '�LirdexayrwurndC-.Jto-.was 6%am� ✓rxovrmKa i _. City or Town NORTH ANDOVER Date AoAi6 )or (0- REGISTRATION —.s s ;c cenity mat EXXONMOBIL OIL CORPORATION a.. -. ac-crcance with the provisions of Chapter 148, Section 13, at the General Laws, filed with me a CemBcate of regis ion setnrg "-h *hat FIXONMOBIL QJL CORPO RATION is the holder of the license grat c :e sn•.:aiec at 12 !(ASS. AVENUE,- NORTH ANDOVER, for me lawlul use of the buildings)or other struaurets) snuatec or MA 01845 ee.em,,.eew -= e.=:ec).c he KEE?ING. STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OF EXPLOSIVES. Ncl.A brfbpra 0"0915rmWn Must oe.11"on or J.,are Aont]01n at aam ryy.i'IS PEZISPATICN .MUST BE CONSPICLCUSLY POSTED CN d5 PRE411$c5 - enaw 'SS, Note: Complete top of form and forward both sections and fee to local licensing 2 authority (City or Town Clark). Do not make application to department of Public Safety. �ammzGarzcuC�ea�C�C a�C/G`alaacliu�seL`Ci _%aJ;n..JIlie9LC 6`V'U.'8 CVYFUCGCb — LUCM.drt 6� VYB ✓-H'W/rl�i.Gn 0517 City orTown NORTH ANDOVER Oate -'r11L'Cy aQ.�j APPLICATION FOR CERTIFICATE OF REGISTRATION n accorcance with the provisions of Chapter lag. Section Q. of the General Laws, the undersigned hereby certifies EXXONMOBIL OIL CORPORATI N 12 MASS. AVENUE s ne rcae,cl license granted for the lawful use of the buildings)or other structweOt snuatec v .c ce sauateo at 12 AV Nam , as ,,atec!o the KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. NORTH ANDOVER, MA 01845 yore: This application for cereflwte of mlilsmdtion must be signed by fh older of rho license if said license was granted prior Ica July 1. 1936 otherwise by the owns or ant of the land licensed. sub red � GILBARCO n �p VEEMER—ROOT ('omca I lance Management Team ma 01U�b ptwl nF 11165 West Bav'md Ave., Suite 300 f ` ` � 4 t"✓ — — La6ewood_C0 %0228 om..J-. 3L1E1IFYTHE AUTHENTICITY OF THIS MULTI-TONE SECUHITY Rvu �� GILBARCO - T - Check# GGQ076,G949 VE ROOT BartR of America s � ��. COntrollei 1TSBursement 48Ye 4107)05 EOER 7300 W.Friendly Avenue Bank of Paredes,NA "\ Greensboro NC 27410 Nonhhrookaninci. NET AMOUNT VOID OVEfl:90 DN.tS PAY N THREE HUNDRED DOLLARS AND 00 CENTS """":' TO THE TOWN OF NORTH ANDOVER NOTYAIID OVER S25,000.00 ORDER TOWN BUILDING WITHOUT DUAL LSIGNATURES —//`�'' OF O IN STREET NORTH NORTH ANDOVER MA 01845 '✓�O."t ;Ar'k�iL�rC"xld--�d'I�5 11.000076094911' IM769232841: E176SLrr1012891r The Commonwealth ofMassaehusetts �.- — Department of7ndustrialAccidents AUMNIs 600 Washington Street Boston,Mass. 02111 - '� Workers' Com ensatlon lnaurance Atffdavk-General Businesses nmrre: address: d state: work 'td—ti MatWredo I am a sale proprietor and have no one Business Type: ❑Retail❑Restamant/Bar/Fating Establishment working in my capacity. Office B sales(including Real Fstsfc4 Antos eta.) ❑ 1 am m em l with lit em 1 fail & art time . 10ther 1 am m rmployu provedmg workers'comp®satim for my employees working m thisjob. exanD 5-fim, addreoa- 1 /{ rj Hff oL S'NS m N• `j7/f—.� £s4 -- 271J i am a sole proprietor and have h-red the independent comrac[ lined below who have the following workers' compeosaboa polices: atl Kss• ova N• e - Ile N ' aurevK ea eddrcas: h N I lDlDr.nK e0.' Pa Wn to vecmt arenK r n'<I'd'"d mdm Sm1bn 25A of M('L 152 eK bad ro tb Imgvebv oferlmiool ptsltin of v Dve W m 5130a.N vvdhr one ymn'Imprbavmeot r wen r ema penDW ro the form of.SDOP WORK ORDPdi vd.11va of5100.0a v d.y.s.lmt ma f mdenmvd thvt v cepy.(thb vmbmeve moyMfrw.rdN to the Oiilce of lvrrtlavebm of the DiA ror.orenaererNcvebn Idoherebyerfrfy nsa°dpenvltiejofperjuryth&the TnformwiOmprovidedaboveishuevndc°rra<Y Si�a,ae DMv Print name �ia>rzkc/ r /7m�g> r.. Pk®e# 4z 6-GfrG- 27ly oflicml m.ody do not wrtro In thb srev to ten completed by city or totcv otikW <tty or row•a- Pna t,uc.me d 011 ading Departamvt E]Uc. eDoard ❑ehe.klf inaodmm rnpome b required 011.1 h uctc OR e ankh Depvremmt coneac<penov. Dh...M �Oeher faysasatamt Note: Complete top of form and forward both sections and fee to local licensing atahoritY (City or Town Clerk). Do not make application to department of Puhl'c Safety. _ � �QiYi7//2?.OiJ7CUeCLGC!Z O�C///C2'JQlX.C/2C166C�.1 ` `7 Clly or Town NORTH ANDOVER Date APPLICATION FOR CERTIFICATE OF REGISTRATION accordance with the provisions of Chapter 1Ag, Section 13. of the General Laws, the undersigned hereby ceeUieS That EXXONMORIL OIL CORPORATION wm.aim.swiw 12 MASS. AVENUE s 'he ocher of license granted for the lawful use of the building(,) or other siNcturet,) Sjtualee w :a ae vruateo at 12 IM5 AVE as T'aac to The KEEPING, STORAGE,MANUFACTURE OR SALE OF FLAMMABLES OR IXPLOSIVES. NORTH ANDOVER, MA 01845 Note: This application for cmdryca re o/r 9duTabon mug be signed by the holder or the iicenae it sard license was granted prior to July I, 1936' otherwise by the owner or occupant or the land licansed. Fecervea Submitted by — ——— omm rw '�----- m. -------------- _ (, �ay`vrrwazcuea.`l�i �� �y ---- -- - - - Cllydr Town NORTH AN 0VRR Dale ctg,--,Y05 REGISTRATION S s c lenity that EXXONMOEIL OIL CORPORATION ao. r. ac:orcance wi con naT th the provisions of Chdpler 148. Seaton 13. of the Ge era Laws, filed with me a cemficate of regis:allon serms � EXXONM I IL RPORATION is the holder of the license gran:ec ty„ for the lawful use at the buileing(s) ar other structuretsl suuarec or :e sr.atec at 12 MASS. AVENUE, NORTH ANDOVER, MA 01845 := e:a:rc !c re KEEPING, STCFACE, MANUFACTURE OR SALE OF FLAMMABLES OF; EXPLOSIVES, Q - Ncre:,J pA7I la It rUS—2 C CON 0e,'a"an ar Jerore Aon':Orn m aac9 way a/ai. r,N I i-:IS RECI57FA ION MUSS PE CONSPICUCUSLY PCSTE^ON ,JF o9EkIIS22S .rsac 'SS. Nate: Complete top of farm and forward both sections and fee to local licensing authority (City or Town Clerk). Do not make application to department of Public Safety. _ d a � �Jf �o�rrrmw rficuecz��� o�C—/G�a�czc�cu�ett�t y J' CfkLXGIlt9YCC 6�V'r/MC C-9N/wUlGe6 — �vfYGLd2 / C5.7 �YHIM/RCcC�c aV�7 V City or Town NORTH ANDOVER .3d Q7� APPLICATION FOR CERTIFICATE OF REGISTRATION aq[Ycance win the provisions of Chapter Ili Secticn 13, of the General Laws the undersigned heredy cenities net EXXONMOBIL OIL CORPORATION 12 MASS. AVENUE -,ice,cf license granted for the lawful use of the buildings)or other structurelsl sih_a(ee cr c oe st_atea at 12 MASS. AVENUE as T,a;ec '.a the KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES, NORTH ANDOVER, MA 01845 'u r� 'yore: inls application for comficate of registration must be signed by the holder of the license if said license was granted poor to July 1, 1936. otherwise by the owner or occupant of the and licensed. =rer.ec Submitted by or rm. -----_----�--_-- /-----_- - -- 6 Iv ? L'�G i71/I7�2�C/�JZClJ2CLG/L(l�2/ G/�U/� ��j {7�[lA2GJ/�.l / »d Y =IP�LQ�/RP/1CC b��pYC IJ i'�^N.Ced — CLnCLP/KZIr6U/rCd'JCJ O/lLK �;�.2W✓m City or Town NORTH ANDOVER Date fiGRie 30„�Gb REGISTRATION s s 'c e^M:nat EXXONMOBIL OIL CORPORATION __ n eccrcance with fhe provisions of Chapter 148, Sechon 13, at the General Laws, filed with me a certificate of regs:raucr semn; — EXXONMOBIL OIL CORPORATION is the holder of the license game- w4 for the lawful use of the building(s) or other si=urets) ea..atec ar c :e sm_ztea at 12 MASS. AVENUE, NORTH ANDOVER, MA 01845 ._ r.a'.1: ,_ ne<cPING. STORAGE. MANUFACTURE OF SAL OF F1.AMMASLES OF E/X/ L P(OrSIIVES. Q U XY141&4�v— a .�.w, —ate« rn� ,yore:.+�mrtcare s-eq!s.ravcn musf�n vcvv cn or aerate.+om SOrn cr aac� re Tr:IS RE=JS'ATION VLSI ES CCNSPICUCUSLY FCSTED ON 71c PREbtISES Note: Complete top of town and forward both sections and fee t 1 authority (City or Town Clerk). Co not make a licatipn to de a ee t PP o local licensing P nt of public Satery_ Jv �- cr9 �GYhjyJ2C�JZCL:«�CLLC/Z G��(/`Cc✓ y�/ /' CiiceoeC"a2v,� xrxcea _ ' "CL'J2�.l�inCccn vutGctiry a �� CltVOrSewn NORTH AIR Cate 30 CKU APPLICATION FOR CERTiFiCATE OF REGISTRATION m ar_oreance with the pmvisicns et Chaoter 'ag, Sean. " el the General Laws, the uneem ned hers.y canifies MOBIL OIL CORPORATION 9 net MA AV'DK L[ . he neleer of license granrec ler the awml use of the buddi ln er :o oa srtuataa at 12 MASS. AVf:NL'L 9t ,sl other s;mrurei s. s:h:atec or as 'eiatec!o 'he KEE?!NC. STORAGE. NANUFAC"JFE OR SAL CF z' o Mar- NORTH ANDOVL.R, MA AMMAEL cS OR EXF�_OSiy ES. Nore: ihrs =vd— aC'icanen Is cI'Ily e of regrsrratien must ce s:gnec Ov the hot granted pncr y jury 1, 1936, ornenvrse�y n der of the license if e owner or �panrf o sago/icense was �eCerveC "C me lano/icense¢ �c�mm�rLcc�al��i o 4vv .% , YK'e/I'LrrG �Lkc ✓aY/CCE: — �`yr�.iK , GIN cr'awn ypp*u n rh Clare 4 L/�do x/ REGISTRATION Iss :o=en1NMat MOBIL OIL CORPORATION �. r. dcCe'Canee with 4he oro....... ol-h3prer 14, Secson t;:, MOBIL OIL CORPORATI09 or !he Gen ^a9Y _nr •nal eras -aws. filed with me a :-mficate cr eersr.3na- samoC js the hCider of;he 'icense cm,ec �•,• torihe law,, dse c ce v;caec at , of;he buiding(s Cr ether12 >7ASS. AVtNUE, NORTH ANDOVLR, v;ua;ec er eseiatec :e ae KEERING. STORAGE MANUFACTURE OF SAL JF F-AMMARL_S n OR EXPLCSIVES, GC— J�kitt �kJ NOW A [errtfi[are of ra9rsrranon muss oe me^a +^o L,�•, ,,y, RE3lS'PATICN MUS-BE CCNSP nor celore Apol3orn or aeca vex -'' �'JOUSL'/ ?CSSED CN l'nE PFE411SES Note: Complete top of form and forward bath sections and fee to 10=1 licensing authority (City or Town Clerk). Do not make application to d p rhnent of Public Safety. i >, �crnirrcc�cr�cz�� c�—C/�/�aa:rczc�ic�eL�y � efz2xlmey�C o ,=%i,.o i-/a.�uicey — '�i�uea..drz a� v ✓�veian City or Town NORTH A=DOVER Date APRI�(998 APPLICATION FOR CERTIFICATE OF REGISTRATION In accordance with the provisions of Chapter 148, Section 13, of the Seneral Laws. the undersigned hereby cerdliies that MOBIL OIL CORPORATION P.O. BOX 142667, AUSTIN, TX 78714-2667 is the holder of license granted to be situated at 12 MASS. AVENUE w for"be lawful use of the building(s)or other structures)situated or . as related to the KEEPING, STORAGE, MANUFACTURE OR SAL OF FLAMMABLES OR EXPL OSiVES. NORTH ANDOVER Hare: i his application for certificate at registration must be signed by the hoioer or the license if said license was granted prior to July 1, I g36, amerwrse by the owner or occupant a/the land licensed. Received y„ Suomitted by by v. anv,-w P.O. BOX 142667, AUSTIN, TX 78714-2667 ---------------------------------------------- City or Town NORTH ANDOVEOOR Dale APRIL 30, 1998 REGISTRATION -his is to certify that MOBIL OIL CORPORATION has, in accord ance with the provisions of Chapter 14g, Section 13, of the Seneral Laws. filed with me a certificate of registration setting lorth that MOBIL OIL CORPORATION is the holder of the license granted aro for the lawful use of the builaing(s) or other struc[ure(s) Situated or to be situated at 12 MASS. AVENUE, NORTH ANDOVER, MA su..r.,,o T---- as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF FI_AMMABLLEE/S O'REXPLCSI7VES. it L{ . XIS/i'I/N/' Not&:A canibote o/tegrstraeon must be filet on or bebre Apnl 3pm o/eacn year THIS PEGIST'nATICN ,NUS'9E CONSPICUOUSLY PCSTED ON THE?REMISES -:irevisea]A61 Nett: Complete top of farm authority (C and farward bath ay or Town C:erk). seCions and tee to logl licensing Oa net make application to de a P rtment of public Safety. 19 F_"o 0-"L/JYG772!/JZLL�aILGL�G G`.�--iGLGIJJfLC�LLGle�.: City Or-awn NORTH ANDOVER APPLICATION FOR CERTIFICATE OF REGISTRATION 9 In aCoardance with the provisions at Chacter t«, Sedoon 1C cf;he G OIT eneral Laws. the urdersignec hereoy csm/ies ;hat P.O. BOX 142667, AUSTIN TX 78714-2667 is ;he holder of license granted �•�� c•,• lOr the law/ul to be situates at 12 MASS. AVENUE use at the Jo"Oingio) or other struc;urel sJ otuatec a as related to the KEEPING, STORAGE. MANUFACTJFE OF SALE OF LAMMA fiLEs CF EXP!OSIVES. NORTH ANDOVER Note: ad" auplicatlen for cenf6care a/rZxaa11nn TUst be st granted pnar;o Jury 1, 1936 n, ornervae dv the owner or ode oam vI fhe lens 6censedd license was Received by �• SUomrtted by ——- -———————— 1 -------------- �` C�YUYhC ZLGPCGLCi —————————-- Lp - akJ�c�ilii..eLZy =7y �G u xr nG 0 City ar-own NORTH ANDOVER Oate APRIL 30, 1999 REGISTRATION his is to certity that MOBIL OIL CORPORATION m 'n accomance with the pravisicns at Chacter 1.tg, Secacn 1C, at;he Gzne21 Laws Files with ne a ceriticate ct rem In that MOBIL OIL CORPORATION _lsrtion seams is the holder of the license-rented I. for the lawrul use of th :e satiated 12 MASS. AVENUE- e swlaing(sl or Other s'v-uOr,,,sI sauatea ar al relates to ;he:KCPINC. S-OFAGE, MANL'FYCSCFE"F SALE OF FLY,MMA_cL_-_S CF c<FLCSIVES. vote. 4.;owner,ar."cewcn.met Os ale:cn cr care T'r,1S ?.Enla-^A-:CN MUS-3"'O c cn:C,:;r. :r aaorear Ism7,nb) - - N,.P�C'CCSL, -cs- . - __ rnl -r Pc'c411S E= RM AND NOTE �014DPFEEETOTOP LOCAAND BOTTOM LICENSING AUTHORITY FORWARD OR TOWN CLERK) �B DO NOT RETURN FORM TO DEPARTMENT OF PUBLIC SAFETY. `,\ e �iDItUttD1t�UP2i�th of �ttSsuchustttS 389 Department of Public Safety—Division of nre Prevention 1010 COMMONWEALTH AVE.. BOSTON t' CERTIFICATE OF REGISTRATION Now, rardo� z3 ,gq?-. . Gv .r L.•I is of Chapter 148, Section 13. of the General Laws, the unde In accordance with the provisio rsigned hereby certifies that Mobll._Oi 1„Corp.:............ Address 322.a...Ga11oa�s..Raad....Eair. an.,.... . ......._ .. .i ra...n...Yl III... for the,lawfptuse ranted....._ ._....._..................... . s _.._.. � IZ Vl'lss.�. I, the holder of the license g of the building(s) or other structure(a) situated or to be situated u.......:. Say ted lY a EPING.STORAGE,MANUF.ACTI RE OR SALE OF FLA.MMABLES OR EXPLOSIVES. ... .9.C..............._ m:v.,T..a.... ....................... . Thi. nniRnv of -9." .ivw Pw M.ia+w by the hpWer of Ih< IievYw If rYYi i`+•u Pvv�J ldr 1. 193b.rYp.ir ►> the vv or oc.Yyvi V— y � ...... Received `^^.................................................. \ „J�,J 3225...Gal•}ow.S...Boad.,__Ropry..�w318............................... TOW➢... L.q.T.K..................._... ..................... ..........ioi,ni ruYi ��� Fairfax ,Virginia 220 ..... _...................... 331 zhe e=MM*a dth of IffiaSSUOUSAts ` Department Of Public Safety—Division Of 1}re Prevention M 1010 COMMONWEALTH AVE., BOSTON €l REGISTRATION Mobil Oi' Corp ...___ . . ...... _.... has. in accordance with. the Thu is to cert:fY that............ et- ........._.Is the holder of the license granted ws filed w Ith me a certificate of registra :on a provlsiona of Chapter 148, Section 13, 01 the General La ting forth that .. Mobil Oil Corp,..,_.... . . _. . Ig .... for the lawful use of the building(s) or other structure fa) _. L m4.S` _._...... ..... . ...... ........... situated or to be situated it .�_ ). wn„ u related to the BEEPING,STORAGE. MANCFACTL RE OR SALE OF FLAMMABLFS O..EXP,.,oOSIVF�lerk_ rya.: A nYlho,e YI nPYn:iaY nYY k hW M Y before Aynl S&L.f ...h>nr. (THIS REGISTRATION UST BE CONSPICUOUSLY POSTED ON THE PREMISES M .1 Mobil Corporation s?u GAL LOWS ROAD FAIHLAX VIRGi NIA1411 111, July 3 , 1991 Town Clerk, Please find enclosed the check for the appropriate amount for the renewal of the Certificate (s) of Registration for the Mobil Service Station(s) in your Town. Sincerely, /�-�S- A. Smith - - S}o• and t'< Deparonent of Fire Services a n = , Office of the Sthal ate R Fir O, .NIA )1 75 CERTIFICATE OF REGISTRATION ��63 °1�1�9165_ Ys26-/o0 North Andover April 30, 2009, NOTE: ('ompl t I<p end h HI n ,I'funn and li tG I Torn) tU Icl n0 Not RETURN FORM TO TII4 nvuN b°tlt ecU bns anA Ice ID local 1 -tensing Authuril DEPARTM 4;N7 OF FIRM:SERb ICNS YIOtyc 1 °`Ii Cicrk). In accordance with the provisions of Chapter 148.Seelion 13. of the General haws, the undersigned hereby ce"hies(TITLEHOLDER) fixxonMobll Oil Ccrporntion that (ADDRESS): do GllbarcO Veedcr-Root CMS 7300W I -,,RdlpA,, CMS 176.Grcenshoro,N127421,i; !he holder arthe license granted(Date) I� sw Note: Complete AG Of form and forward both sec:Eons and tes local licensing (city or Town Clerk). Do net make applib tion to department of Public Safety. authority ( ty "- . gelhm mean6a� urw CJ ta�x*.✓a — vuw✓A'ro a� ure �,v/ iwL6IZ o NORTH ANDOVER Dale 'Mv, CIN°r Town APPLICATION FOR CERTIFICATE OF REGISTRATION n ncsdance calm me provisions of Chapter 1a , Section 13, of the General laws, the undersigned hereoy certifies !hat EXXONMOBIL OIL CORPORATION d�,r 12 MASS. AVENUE forme lawful use of the building(s) or other slmc:urelsl slcalec a ^.a ^4iCe;ai 'icense�Yanled c de ;nua[ec a1 l2 MASS. AVEN E sv...� w, as reia:ec jo me KEEPING, STORAGE MANUFACTURE OR SALE OF FLAMMAKES OR EXPLOSIVES. NORTH ANDOVER, MA 01845µw o* cense if wore: This application for to Julyr1,°f936.1stration must be otherwise d tnesigned by the holder of°caner or a pa of the lend licens dd license was granted poor ra July 1, y ,t Submitted by ecemed ,..... 170 it Y)��.�kl:eJ �4t'L� Tarn 1.9kt1/IAl o.r..�'a. — _ - — - ,✓ The Commonwealth of Massachusetts Department of Industrial Accidents � 1� �c,nrroaanr, 600 Washington Street Boston, Mass. 02111 n Workers' Compensation Insurance Affidavit-General Businesses address: atv -____- - _._ slate: no: work Bile location Ifull eddmast ❑ I am a sole proprietor and have no one Business Type: ❑Retail❑Restauranl/Bar/Eating Emablishmern working in any capacity. ❑Office Sales(including Real Estate,Autos the Q I am an cuployer with Oa- em to gees(fzll & art rime) ❑Odter s OO//v//O//%O//%O/90///s0////%///O////7l%%//%/// t ela/6ArOilf//' ///%/Od//Od/d%%////OO l l lamas employer providing workers' wmpmsatioafnrw�ploye orking-onlhisjob. omv.vv name: -sy-r-, > rf oA3rt nddress: !h N//iSs. /IV c'ty �G /IN tk�d/Li /n Cl %1 -y Phonea- 27/ hum...ee co. S T?/L /N 1 co . Ijvv a V,c o ,L t/ Al lam a sole proprietor and have hired the independent contractors listed below who have the following workers' wmpeasation polices: compaoY name: nddress: city: h a• fnsnr.nce co. lig a common,name: eddre city' h q. insurance co. 11e p %A.f to nr% r.,,.r//l/// Fullwe to enure coverage u required under Section 25A of M16 112 ran lead to the Inmwinvn of olminel perultin of a fine up to Sl soeoa vnA/or v<year:Imprbotunent u coca n grit peoahlee W the form o(a STOP WORK OBUEB and•fine of xlna.aa a dq agalmt me. 1 aodentand that a copy of thf.eWemeat nuy he forwvrded to the Ofnce of Invertigatlom of the DU for eaverage vennn non. took...b,certify under the pains and penaltier fperjary that the information provided above is true and correct Siguntore P:vn mvue_SstM t.r'T� S /d Hr. s<tiv p'r 1'h.e q_'jyY ofMvl ive only do not write In the area to be completed by enyor town official ety or tawot "."prom"N m ,_�Bullding Dopvtm.:nt �IAcoving Rovr ❑check If Imedutr reapome b required d ❑Seleetmen'e Oak,❑nedth Department ct person:____ pLoue.p; ❑Other a.am sot wrl , flpr 23 04 11 : 10e p. 2 ACORD CERTIFICATE OF LIABILITY INSURANCF Od DATE°M/D23/2DI00 I d PRODUCER (97E) 67D-2122 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION NESSARA Inatrance Agency Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 574 Boston Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 12 Billerca FA. 0282'_- IN50RMS AFFORDING COVERAGE NAICp .UDU= INSURER.e Stax Insurance LS Snteopvi... dba SaD'a Mobil IxsORERB 12 Maaeachucetta Avonce ITFI G: .CLEEF D: Nort', Andover MA 01945- N.UPEPE COVERAOES THE POI OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NUAD ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING AN' REOU RENEW,TEW DR CONDITION OF ANY OONTRAr.T OR OTHER DOCUMENT WITH RESPECT-0 WHICH THIS CERTIFICATE WY BE ISSUED 03 MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICI-S DESCRIBED HEREIN IS SUBJECT TO AL- THE TEPMS, EXCLUSIONS PNO CONDITIONS OF SUCH POLICIES. AGGREGATE LOTS SHOWN^AY HAVE BEEN REDUCED BY PAID C-AIMS. MSR G .L P0.me EFFECT Cuev LTA 1 TYRE 0G INSURANCE YOLILY NUtlBER DATE MY/DO,YYI DATFINIiI LMITS GEHIGX nluTr / / / / EA�L(NA CLLURPENce a C MMEACI4 GENERP.L.Vb�UT' PREMI ES EYO%w. 3 CL1.S MADE El OCCUR / / / / MEDEXFI Imp—) S PFRSONALOMVINILRV 3 GENE AGGRE AIE 3 GENLAGOREGATFUTTITAPPDESPER IFI.C.- OMP: PAOG S POLICv F LOC AUTDN0Ln1A UAaury U.UF Omole unn a �IE..ow.Iu ,WY AUTO , ALO.NCAJTOS / / / / EDO LY MILEY S SCNEOCLEOPLTOS ;IFf oHI,,) HIPE°Al. / / / / II 1.11RY II ON.OKNED AOTOS ;PM.�.ICs.O ! PRDPERTY 0.4MAGE IFR..—II S GAUGE UAEwTY li MRO ONLY-EAACCIDENT s A-All. .1.DELY AGO B EIICESSIU48RELIA UUABILITY EACH OCCUR N T-T OGOUN L GLgNSMADE AGGREGTE 3 DEOUL'IBLE 1ETEFTQ. E jL PPGPLIETOWPFAT XEP R%E CUTIVE / / / I I EWO LIABILITY E.L EACH y PCI'tl OENT HCO216B4 OS/D1/200d ELTNYCMNUG ... SATO4AND R S 500,00 ORI ' OISEA$E-EAEYPL Ti SGOr ODI It,u lwiw oral CXL MCN510NS Oe4:w EL OSEAW. POLICY LIMIT 13 500,00 OTIWI CES,MPTION OF OP UT0NS oX11IOXSNENICUnXXMJCICNE ADDED BY ENOdiSfNFNiSpECIPL PROVIVCKS So. LOC6tiCD'. 'D ✓U.YChuB41te A,—, Hoith Mdovt, !A CERTIFICATE HOLDER CANCELLATION SHOULD ANY OP THE ABLE Of3c4mfD PCLICIES aE CANCELLED BEFORE 'ME TOYRL of Nosth Andover EAPIAAMOX DATE THEPEOE THE ISSUED INI HILL ENOFAVOP To .1 30 _ DAYS WRTME NOTICE TO THE CIURPACRE HOLDER xA.E'TO ME ISER fUT PATOGi0DO SO SHPLL ...NOO°LIDA➢.OH LIPPUTY CP IN,RIM DFOH TE NS4F..ITS A4 XTS L A REMESENTATIVE3. AUTHOAIEED ABPREEENTA L NcrtH Andover MA 01845- a-.mil ACORD 25(2001103) D ACORD CORPORATION 19 0 INW24 fFaems 1L%-IEO11IASER1a105.TIC ( opn.wu P.wl� 'OPr 23 04 11 : 18e r IMPORTANT If the Mill ete holtler is an ADDITIONAL INSU;E0, the nohcy(Ies) m1st be endorsed. A statement on ITs - i5pte does not confer rlgnts to the Cacif,aLe holder in lieu of sud.endoreement(e). If SU3ROGATION IS WAIVED, sgbjeot to No terms an s d condillon of the policy, eadain p4cie, may requne an endorsement. A statement or this ceniBnte does not confer rights Io the el,11 ete holder m lieu of such endorsarnent(s, DISCLAIMER The Cenlf�te of Insurance on the rover,e side of this form does not constitute a ccntract between the issuing insurer(s), authorized represerhative or producer, and the cerlifoale holder, nor does It affirmatively or negatively amend, extend or alter the m,,erage afforded by the policies listed thereon. AA.ORD 2e(2001108) y„-INS025 tormt� Pro.:az Note: Comp" e top of fans and forward both sections aru"ee 10 local licensing authority (City'`own Clerk). Do not make application to dement of Public Safety. . �pruuea�C�i o�C�l/�alaac�zuaeCZy 11UM L �efca�xG.nent o`�1�r'i7e �'p APR 0 7 2003 Clty or Town NORTH ANDOVER DateA�Yk APPLICATION FOR CERTIFICATE OF REGISTRATION e accoreance with me provisions of Chapter 148. Section 13, of the General Laws, the undersigned hereby certifies tnai EXXONMOBIL OIL ORPORA IQN .uw.,. 12 MASS. AVENUE nrn s Ime eo.cer of license granted for the lawful use of the building(s)or other stmcturelsl sdcaled a at 12 MASS VENUE as re,a:ec if, the KEEPING. STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. NORTH ANDOVER, MA 01845 Note: This application for eerdBmte of negismaen mug oe signed by the holder at the license if said license was granted prior to July 1, 1936, arhenvise by the owner or occupant of fit I/nd licans Submitted by 1 Fe ervea ro.Lteo'e eQTHORIZEDAQE}'fT C,%IS 12265 5 W st liar d Avc i. ,c _ u ✓1 / �1^7 of�u.r Sunc3n0, Inke000d,(.O h0.28 4 ;I h1 Ulfbl'xi V Nate: Caplet�rop of farm and forward bath sectlons and fee to local licensing m authority (City or Town Clerk). Do not make application to department of Public Safety. �ma r✓rccc�z�l�i aG C G�aJ3ac�uLZ z, p y ' ���G.meoxC GG'�-_l l.�✓ C-J 'U✓vUCGPb — �Wr�h' b�`=' !/M3 ✓ /r�/1JG/2LLGJL 0 CitynrTown NORTH ANDOVER Cate c4il A, ' rl APPLICATION FOR CERTIFICATE OF REGISTRATION Jr. accordance with me provisions of Chapter 1a Sec:icn 19. cf :he General Laws. the undersigned hereoy candies ;Mat MOBIL 011 CORPORATION AVIi50I'; _ is the Moleer of license granted aalar the Jamul use of the building(s) or other nmc:urets) s tuatec or :cbesituatedatl2 MASS. AVENUE as related to :he K===?ING. STOFAC'c, MANUFACTUFE OF SALE OF F.iMMABLES OF EXFLCSIVE5. NORTH ANDOVER, MA Note: This apolication for cemtirate of regrs;Tdlior,muse e signed ey the holder of.-Me licensed said license was Lh granted promo Jory 1, 1921 gtrtenarae oy fhe owner or scmpanr or the land licensee. eCeNed Sucmittec 0v 11Y't I• oy ��LC.•�. G1 ���tl/ P. Q. BOX 142667 AUSTIN'i 78714-2667 - -- ----- - -------- -- ------------- -- Nate: Complete t f form and famard bath sections and fe, local licensing authority (City or Tow lerk). Do not make application to department of Public Safety. cmyrrrrrecc�a L ��G��a.kSac ORTh O' ERK" to' OVER �, �, '�`eirvxC.,ze7eC�'i'��'.re .:7��r Kce^, — �r urxar�ire ai'.�"r•�w. ��. .J�tectT A 9 AlCity or?own NORTH ANDOVER Date BULY 17, A APPLICATION FOR CERTIFICATE OF REGISTRATION In acao reance with me provisions of Chaster :18, Section 12. of the General 'aws, the uncensigned Mersey carries !hat EXXONMOBIL OIL CORPORATION 12 MASS. AVENUE -is :he holder of license granted for:he lawful use of the buiicing(s) or other simc:ure(s) situated cr u.r. to be situated at 12 MASS. AVENUE as related to the KEEPING, STCRACE, MANUFACTURE OR SALE OF=LAMMAELES OR EX?LCSIVES. NORTH ANDOVER, MA 01845 wwr� Note: i his application for certificate or r ege:rduan must he srgnec by#,he holder of;he!icense i1 said license rss granted pner a July 1, 1936r oMenvrse dv;he owner or occusanr of;he land licensed Received Submitted by .l±"LL4 o� by Owners. .utr.r�rzrk; nCun, ------------ anr✓n n----------- ' L12. 'K--`�1�1.1---------- ��" �b��ll(�J� (;, C;rimmc�nu�a��rc c��G"�z:aac�rtileC`Z1 a�a a' �efiaix�mePirtC�.:%'bx¢ Gie�N.ceG— Lon¢ri,���¢ 'd uvr2ae — ain/c � w.2v�zm J l sry7 Coy ar-awn NORTH ANDOVER Tare i11i.Y 17, 7001 REGISTRATION This is;o coolly that EXXONMOBIL OIL CORPORATION has. 'n accorcance with the provisions of Chaster 142. Section 11, of the General laws. files with. me a certificate at recisomian aett:ng larch that EXXONMOBIL Oil. CORPORATION -a the holder of:he license craned for the lawful use of:Me buddrigsi or other stmcturelsl aauawc ar is be situated at 12 MASS.WAVENUE,- NORTH ANDOVER, MA 01845 as -elates to ;he KKEE?'NG. STCRACE. MANUFACT'JFE CR SALE CP F_>,NMAELES CF E:<FLCSIVES. ,.,,,.,....o c.-, m:iC:le or e- - -an cramre?cn:Corh a ran rear 7HIS -EGIS'A70N Mit S-?E CCNSF'Q.'CUSL- PCS-__ _.N r1E ?9EMIEES vises 7'°61 ur lx 14 Note: Corr 'ite top of farm and forward both sections - fee to Icoati licensing !h authority (Cit}` Town Clerk). Do not make application to . artment of Public Safety. ? y �P�L2Mf//L%I2C 6�J'l/KC ✓UFUUFb — �(/U(4G6'2 6G'`J'� ✓�.'v/UP/JLCCC2 City or Town NORTH ANDOVER Dare�[i'/C APPLICATION FOR CERTIFICATE OF REGISTRATION n accareance with the provisions of Chapter 148, Section 13, of the Genemi Laws, the uneentigned hereby cenifies :rai �7 QEXX�ONMOBIL OIL CORPORATION ('�0 1,fF1'c� - PC, ', (-N1 j lJt'1cw6I ��l #� xJ� lal=PJ U� i�022 ? s the nmcer of license granted o . for the lawlul use of the building(s) or other stmc:urei s: st-niee or c tie s.waec at 12 MASS. AVENUE as �atec to Te KEEPING, STORAGE, .MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. NORTH ANDOVER, MA 01845 Vote: This application for certificate of registration must be signed by the boider of rite license it said license aas granted pnor ro July 1. 1936, otherwise by the owner or occupanr of the land licensed. �j'�� =ecervec Submitted by 41 L�r �6i;�L( +m.w. c V 'R t Pu r �ZZUr7 W -- -_--__a---___— ._— Nate: Camplera a of form and farward both set tcns and'1!( to iecal licensing aumority (City or Town C:erk). 0e not make applid,loco to de artm� P ent of Public Safety. I I� eneenCaG° ✓xe <=/�wuecel — f7'utxri2 _pr�'ur< �r�nseveircn City orTown NORTH ANDOVER �Care APPLICATION FOR CERTIFICATE OF ance REGISTRATION In a=rd with the previsions or Chapter IA8. Secden 13, of the GeneralLaws,Laws, the undersigned hereby certifies that MOBIL OIL CORPORATION MASS.-12 AVENGE is the holder of:icense ranted _., Ior the lawful use of the buddingls) or other structure,) situated or tebesituatedat12 MASS. AVENUE as related to the KEE'PING. STORAGE, MANUFACTURE OR SA ^ L OF Fi_gMMA81-E3 OR 2�(RLCSIVES. NORTH ANDOVER, MA wd re.. Note: fis acplicaticn for,eNficare of regis6al7cn must be signed by the holder or;he license 0 said license was granted poor a..fc July I, 193Q orhenvise di,the owner or odc;;oanr or(he land licensed. Feceived � � — Sucmttted dv by d`. O-BOX 142667 AUSTIN, 7-9-76714- 01-389 Note: Complete I of form and forward both sections and ` to local licensing l $100.00 i authority (City or TAY.n Clerk). Do not make application to depanflent of Public Safety. � � � �c7lairrecaccaea�� o�C/�/�i1�ac�u�etGi City or Town NORTH ANDOVER Date APRIL 30, 1998 APPLICATION FOR CERTIFICATE OF REGISTRATION In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that MOBIL OIL CORPORATION Y.O. BOX 142667, ADSTTN, TX 78714-2667 .any is the holder of license granted u., for the lawful use of the buildings) or other strut urep) situated or to be situated at 12 MASS. AVEN0II as related to the KEEPING, STORAGE. MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. NORTH ANDOVER Note: This application for certificate of registration must be signed by the holder of the license if said license•,vas granted pnor m July 1, 7936, otherwise by the owner or cccul oaanntt of the land licensed. Received �7 .?� / 1�9� . Submitted by '✓ 7d�arct' �/1/((O Owner's Authorized Agent P.O. BOX 142667, AHSTTN, TX�78714-2667 oexw n. SS# 01-389 NOTE: COMPLETE TOP AND BOTTOM OF FORM AND FOR- -'kRD BOTH SECTIONS <,100.00 AND FEE TO AL LICENSING AUTHORITY (CIT R TOWN CLERK). DO NOT RETUfM FORM TO DEPARTMENT OF PUBLIC SAFETY. Commonf rexlth ofIN ttssttcllnsefts VDepartment of Public Safety—Division of )ire Prevention CERTIFICATE OF REGISTRATION ....NOR'1:11 ANDOVER..................APRIL 30.v. ...........-.... ....... ICill ar T-1 Ina¢1 In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that MOBIi, OTi. CORPORATi ON... Address ... ..... . ................................... IHe of LOWer al rm th granted... is the Holder of the license rnted............_._.........................................................19........for the lawful use of the building(s) or other structure(s) situated or to be situated at.....1.?-MASS..AUCNEL......................... letreo uW nu-W11 As related to the KEEPING,STORAGE.MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. .N OiiTki-AN P O VE R......................................................I...... I ar.IT...I Note: This creiifieete of resi+tretion must he silmed by the holder of the license if mid license wee`rented prior to July 1, 1936, mher.im by the owner or ocuspety of the And lieemed. Received .........................19........ ._hJ9')ad. , ........................ .......... ..... ... 1? '.......................................... Is+mrm.n by .......................................................................... MOBIL OIL._t:MRPQRdT.1.Q.;................................................ ................................................................................ ISuu.ehrther .—I. aup.a .r h..", (CoN6.3 TltkI P„Q;., BQS, 14[667,__AL;STIN I„TFXd,$,,,78714„- @h7,,.. uaa...a ¢ (iLIITttmvnftt¢MIt4 of &emr1juodts kvDepartment cl public Safety—Division of ire Prevention tt5vvv� REGISTRATION North Andover April 30, 96 ...................................... .............. 19........ Ieitr oe Toxnl IDatel This is to certify that.....Mobil 9i1 , ,_,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,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. Mohil Oil Corporation,,.,,_._,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,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...1,2_Mas,S.flF.huSl:S.Cs..6venue............................................................................... as related tD the KEEPING, STORAGE. MANUFACTURE O1/JR SALE �1OF IFIL(A��MMIIC�A((/RLES��O``REXPLOSIVES. Ic�ynemr<ma OMeltl Tulel Note: A eertifiorn of real+trniion must be filed uD or before April 301h of each year. (THIS REGISTRATION MUST RE CONSPICUOUSLY POSTED ON THE PREMISES.) �was FEE: $7.50 S/S N01-389 NOTE: COMPLETE TOP AND BOTTOM OF FORM AND 1^ORWARD BOTH SECTIONS AND FEE ' LOCAL LICENSING AUTHORITY TY OR TOWN CLERK). DO NOT BE N FORM TO DEPARTMENT OF-F5LIC SAFETY. x4F (f mz=VnfUrU1ffi of '4ffrzs5ar4usft5 F Department of Public Safety—Division of lire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION _NORTH ANIIOV H:R Se tember 26 19..95 .................................P lOw or ro..) lueel In accordance with the provisions of Chapter 148, Section 13, of the General Laws. the undersigned hereby certifies that _...,..h1obil Oil. CorA,o rat Address 3225 Gallows Road t„[airf�x L. . ................ ............................ ............................... . . .. I N.mr.( .WJ.r al Ilwnrl is the holder of the license g:anted..... ..............19........for tho 1.=ful use of the building(s) or other structure(s) situated or to be situated at.12 h?.asac huats.Avenue latr..t.r aetiltwt as related to the KEEPING,STORAGE.MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. NORTH ANDO`✓P:R ............................................... ....................................... IciU.'r Town Note: rhie«ni6rav of ri........muu be.land b,the holder of the lieenee if rid Ii..e tr.Ryornd prior to July 1, 1936.otherwi.e by the owner or occupant f thr land h wd. Received SE PTEMBER 28 ...... . � 7 19.5. i.. Y..........: �...... �Z... ..l.0 �... aima. by ...... ................... _ ....Nobil Oil Corporat.i. tl - Own1r....._....................... OWN CLERK Iauv.Imeer ..new. mare or pawn ................................................................................ 10111ma Titles 3225 6a 11ows Road, Parifax V_A ...2..0.3.__7.. ,,,,,,,, .....................................1.... .. . ... A'r1N: EARTH GrouroAV�t \nTE : rn\IPI,FTE TOP ...4, EOTTnit O(' PnRll :\Ki) FOR\, wpj, 7:0TH SE(T.ION*S AND I is '1'(/ 1.(11'A�. LICE. S 1' IG I\" �\C' UI; I'II t 115':V (lirlCr;� Ull S0E'1'URN F'OIIM 'f(1 UI':,I;':\R'I'\I IiN'1' OF 1'Ltltl,;t- N 114E � iai &urfEusrtts Department of Public Safety—Division of Fire Prevention 00 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION a, ... In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that •....7:lpb.il..L1i1�...Gao.r..p....�.........,......._......................... Address 3225 Gallows.... ........... , R$ad, Fairf x V -.z.?.23 Z....7 . ...... ... . . is the holder of the license granted.Z.4�"r.z /<, � 3 -'�„"•'"' ` ..G..... 19........for the lawful use Z ... ..... .......of the building(s) or other structure(s) situated or to be situated at.!_Z! �„_ _��;.�.d r_.rt�t..,.•.,_ as related to the KEEPING,STORAGE,MANUFACTURE OR S ta......r •�•�ALE OF ............. FLAMMARLFS OR EXPLOSIVES. .................................. Thr.r b.ni Ysto Thi.r«ti6cmT of rt9i«n.irn mom br.f9nrd by.he holder of.hr Been«if.rid lion«�m 9nmed ncior ro J.IT 1, 1936.mhe jN by.hr an„eri ur nern Wnr of rh Vb liernsd, Received ..„•............. _ . ......_, :...___....._.._..e-n-t._...... by ................Dl�1T�Tv ......... ..... .. ... ....... 'n.....ni Re re .......... h<214CT..................... � P sentative TOWN CLERK Mobil O.il Corporation .._......»....._........ .................._..._................... North �d �jErC... iau«�onb...«.,..ten..«' . _............... .A GIS45 3225 Gallows Rd. , Fairfax, VA 22037 .............I............._........._.. NOTE: COMPLETE TOP r:.D BOTTOM OF FORM AND FOR" ' RD BOTH SECTIONS AND FEE TO LOCAL LICENSING AUTHORITY (CITv ODR TOWN CLERK). DO NOT RETURN FORM TO DEPARTMENT OF PUBLIC SAFETY. 4g TujILu j6talth of filassnchnsetts 3S-1 Department of Public Safety—Division of nre Prevention -�° 1010 COMMONWEALTH AVE., BOSTON R CERTIFICATE OF REGISTRATION a,.. In accordance with the provisions of Chapter 148, Section 13. of the General LAws, the undenigned hereby certifies that Mobi I_ Oi.l... orP,............ Address ....322.S...Ga1loas..Raad,...Eairfas,....VA._ is the holder of the license granted__.__._.._ ........_........................, ®........for thc,lawful use of the building(s) or other structure(s) situated or to be situ c:�s 1. ..........................vim. u r ted m.{he}:EEPING. STORAGE,MANLTACTI RE OR SALE OF FLA.1111.ABLFS OR EXPLOSIVES. j�i ,., 14�...!:k..•.�.a u.........:............................... .... Icm.,r..a fVwe: Thu aenianu of n(�wmwn .ow k u1Pd ar rAr hpldrr or rb< 11re..e I!rN l:.s...an.W M�u 1•Ir 1, 1936. MAr.i.e ar rar e. or xr.w•1 ee-d,r 4.d Ivev.d p/ "v ... 19.Y:1- Cl by .... ]22S GclJ.lows Roac�,,__Roory,�w318, .... . T oµ:n G1.E.rx.................. s..,. .ru........ mp.. ..wrn IO�IJ Tltlrl Fairfax I,,,V,irg in is ,22037 lur.�i NOTE: COMPLETE TOP 4•'D BOTTOM OF FORM A\D RWA qD' ROTA s _ AND FEE TO LW,—, LICENSING AUTHORITY (CITY '2 TOWN .CLERK)_ DO NOT RETCRN ORM TO DEPARTMENT OF PCB 'FtWSAFETY. the 42umtt10116ex4 of. Aicsseo*seits Department of Public Safety—Division of F9re Prevention 1010 COMMONWEALTH AVE., BOSTON Ni- sc ,ter SRq CERTIFICATE OF REGISTRATION e NORTR ANDO➢ER - 91 s........................................_...... 19..__.. ICiY•e Two 10•YI In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that ,,,,,,,MOBIL OIL CORPORATI,9R........................... Address ,.3225 GALLOWS ROAD FAIRFAX VA 22037 n.w er iw,yr.r iw...a ...-....._-- is the holder of the license granted._�' � .t zs > ` / of the building /�uated r to be situated t... TMA 19........for tks lawful use (a) or other structure arcuated or to be situated at.._12 MASS Ave as ....... related to hr i sled to the KEEPING,STORAGE,MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. ........................ Mai.,TM.« Ifi .i.of Iesian,ee�.w h.Nand 1,eh.heldw of eM lieaw/1f aW N•ai..�Ve.W IMw i.July 1, 1936-ohs.. hr the o.eer or aee.p A f t1� Received .....::...... ..�-G.:.. .................._19` .... � . . ............. by .......:: ............................................................. OWNER REPRESENTATIVE .................................................. . ................................................................................ Y•r,e«YW.I 19asin Tuur 3225 GALLOWS RD FAIRPAX VA 22037 ' 7. s 0 IN � - � (�tl�e BImilmmtinettlfl� ,af �Cttssttchuseits Department of Public Safety—Division of Mre Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION ............Ilarkh.Andover...............A.P.&IL.......... 19.2D In accordance with the provisions of Chapter 148, Section 13,of the General Laws, the undersigned hereby certifies•�hhaat t,tG&IL OiL COPRORe't'1'I.OF Address 10 NE Business Center Drive Andover MA . ..............1......................... .... .... . . .............. ............... ...._...._ .... is the holder of the license granted...).Q/..?/Ez. �L. .5L.7. ..9L.9Lu,l.......................t19........for the lawful use of the building(s) or other structure(s) situated or to be situated at...12..CiasSdGhuseLi;S..AYe I t"w .e.rn as related to the KEEPING,STORAGE,MANUFACTURE OR SALE OF FLAMMAELES OR EXPLOSIVES. ..........lilar.Lh..AstLov.................................................... iuu»r..a N.Ie, ThL e s tlaeete o!»ttbtntlen then belittled by the holderV- 2 Id Ikenv.0 pvted ..pA.,to let, 1. 1936.elher.iw hr the Diner .. nd Ileen..& Received ............. ...19........ ........................................_................. I)ANIEL LONG 'llifTY/LSSR _.......... . .......... .............._.............................. ..................................1'NI.MIIfF..�rMt .......... 'tsun.ewe:...:.::.».r..t..A.tt..t Nt> .mxmm .............................................................................................. IAMm.I AND FEE TO LOCAL LICENSINGrAUTHORITY F(CITY RD BOTHOWN SEC i"[) DO NOT RETURN FORM TO DEPARTMENT OF�Pt"**LIC SAFETY.CLERK) `• C $ 389/0111 Depaitment of Public Safety—Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION ...Ncu.2h..AnARret..................FebruarY._).6..... 19 B9... In accordance with the Provision$ of Chapterlaw r...l '1eiel Aereb7 certiitu that 1�• Section 13, of the General Laws, the undersigned Noexr;._ozr,..S9..M. P4:11.04........................... Address ..9.L.marLtval$..Av.w=&,..sco _._.. IMth M license Mgrantis the nebam...tlA............ of the holder of the Ilcenw granted.....tA/..1.l.62.:...6/.25./..7.}.:...9/.9/81...................19........for the lawful use building(&) or other structures) situated or to be situated st.12.Massachusetts Avenue ...._ . ...._................................... r rQ Wd to the KEEPING,STORAGElLES il .�r.r MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. ,,,, ,,,„,,,,,,,,,,,,,,,,,,,,,,,,North Andover . . . ..................................... rclw«n..� Marl 1%6~Ifi r N n4e.rir err 4 eleeee b I N If rY 16re..e wr pier r 1Nr 1, 1936•nbr.lr b tee Wi 9N...d. Received ..._._........................................ I9........ ...._.i :i,,,......... by _ ._..I2L1L _ ?.'L Xp ...................... . CL -.1 we�y werVr ............._.........._.....__.................................... IFS: } n. 'iosewl r o ,5 ...... . Montvale Avenue, Stanches, MA 021ac ................................��ir..�......................................... 389 NOTE: COMPLETE TOP ANy-BOTT011 OF FORM AND FORWA'.-Wj BOTH SECTIONS AND FEE TO LOCAI, LICENSING AUTHORITY (CITY OR TOWN CLERK). DO NOT RETURN FORM TO DEPARTMENT OF PUBLIC SAFETY. z4e Gunnatc&taf t4 of Massachusetts Depa1•tment of Public Safety—Division of Mre Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION R....................M d r..c,h..1.,... HIM... ICay or Townl IIMxI In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that ......,NABZL oIL CORPORATION........................... Address ..9.]...MonCVale..Svenue,...Stoneham»..Na............ . . ....... . . .... I N.me of FOIJer of license'is the holder of the license granted....10/11. ;,,6,(,25L.7.1:..5/.4,[,t}1..................19........for the lawful use of the building(s) or other structure(s) situated or to be situated at....12...MdSS.AChl1SR.xkS..AY.F.RIIf:...... f straet see ""here, as related to the KEEPING,STORAGE,MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. .......................................................................................... ICib or Townl oNote: This certiaeate of reaialretion must be sinned by the holder of the license it said lirense wee,avnted FQ d IE priorM lath,1, 1936,olhe.wiw br the owner or pent of the used. f Ir 4 Ur, a1n Received ..................................................19._..... .............. .. . N3ACf t.: ;: H1y0N ene'"^I by ............._.0k't.'�.;.:I..f ..................................... ya ...................... .................................................................. R .^nt ' ............................... Islatr wnenrr..e.r, «euw9t.r mte.rl 91 Montvale Avenue, Stoneham, MA 02180 .............................................................................................. uddmxl NOTE: COMPLETE TOP PD BOTTOM OF FOR11 AND FOE %RD BOTH SECTIONS AND FEE TO LICENSING AUTHORITY (CIT�+"OH TOWN CLERK), DO NOT RETURN FUI;M TO DEPARTMENT OF PUBLIC SAFETY. The (fam ttauffirAfh d Affztrjjusjeftq 0/-3xy ti Department of Public Safety—Division of Mre Prevention Qv� 1010 COMMONWEALTH AVE., BOSTON :+ a CERTIFICATE OF REGISTRATION .............. 19.a...7 In accordance with the provisions of Chapter t4S, Section 13,mar or T-1 hereby certifies that of the General Laws, the undersigned ,,.,,__MOBIL OIL rvsn,r CORPORATION..... ......... ........... Address ...9.1.Montvale..Avenuz,...5toneham....MA............ � or is the holder of the license granted._.19/.1/.62.-.6/.25/.73-9/9./.81......................19........for the lawful use of the building(s) or other structure(s) situated or to be situated at.....12..Mas.S.achusatts..Avenue...... isuan +na ...Gn as related to the KEEPING, STORAGE: NI.ANLFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. i Ci,y o:Tavn: Mom: ThG cerfificme of regiatrnion moat be aip,ed by the holder of the license if uid license wr panted prior to July 1, 1936.otherwise by the owner or oreupant of the land licensed. Received G p"> ii�7 --7 Lt/..... : ,:a cLElut s m: ......................................... __.�stye=t............................... hAr,_.._, Macs. 01845 ....................................... ..............cH. ................ isr.,e .error. ..........................._.......... IOMeial TIUeI 91 Montv , Stoneham, MA 2 . ..............a....l.eAvenue 0........................ .. ..................................180....... inea.r„i NOTH: COMPLETh: TOPnaan 1101"10�,,f or For:,; :1Nn For ti;D 7;OTf[ SECTIONS AND FEE TO LO(';AL LICI;-SING AG10E'11FTY WIT1 OL' 'TOWN CLERK). DO NOT R ETURN FORS[ TO DEPARTMLNT OF PUEmc SAFETY. (�Ijr (fardMim(uralf4 of 4ffaf.5ztrjjUSrff6 0 � a Department of Public Safety—Division of Mre Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION .. ......... ......... ....... North Andover April 119 86 In accordance with the provisions of Chapter 148, Section 1 hereby certifies that 3. of the General Laws, the undersigned MOBIL oIL CORPORATION , Address ....9.L..Mpn.tY.dJe..dV.enue.,...SYoneham....MP............. ........................ ................................ .. IN the of cone gran 10 1 62 6/25/73 9( 8 is the holder of the license ranted........(..(.....i..... gaga. .......i..... 9(....�...................19........for the lawful use of the building(s) or other structure(a) situated or to be situated rSo—' .ad —1a,t as related to the KEEPING STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES. ............................ ....................... IC."oe a Note. This certificate of registration must he signed by the hoIde of the license if uid license was panted prior to July 1, 1936.otherwise b the ovn J'r I f the].ad lice Received ..........................91 9L.. ..19{...W -- L-�gnt,C e N ..... ........................ ..................................................... sim.wrn ' Q,T... owner rpQ ..... .... ... .................. .............:..:.. Isw..nrtn<r .................................... (OMeial Tillel 91..Mo. ntvale Avenue, Stoneham, MA 02180 . .. ................................ ....... ......................................... Inatl.ea.l NOTE: COMPLETE TOP AN 30TTO:,I OF FORM AND FOR'IVA BOTH SECTION'S AND FEE TO LOCAPPOLICENSING ACTIIORITY (CITY OS TOIVN CLERK). DO NOT RETURN FORM TO DEPARTMENT OF PUBLIC SAFETY. Cie (1inmi:cflzi{nzIt.T ff# ts��e4setYs Department of Public Safety—Division of nre Prevention 1010 COhiS10NlVE?.LTH AVE., BOSTON \w CERTIFICATE OF REGISTRATION NIOC1bT or AeNvDe1OVER . ........... ....................... RT............................... 19..85.. (0.re1 In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that 611 North Avenue, Wakefield, 11A 01880 ..................k1Ql}Zb...O.>.h..CA)3?.QBF+T ON................ Address orth................................................._............. IN—of hma<r-f —.--' is the holder of the license granted....}RL.I.(.62:...6L25/73,, 9/9/81...................19........for the lawful use 12 Massachusetts.Avenue of the budding(s) or other structure(s) situated or to be situate at.........._s`r�....a�.,,m�a m related to the KEEPING,STORAGE,MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVE.:. NORTH ANDOVER .............................................. . ......................................... ate f rrgist _ 11o1a: Tl.i. anifinre of reaisvmion most be aipned by the holdo of'he licen„e if d•id liana w red prior to July 1, 1935,of erw i—br the owner or xcup•!q'o'f rye,land B red. Received ........f:........... _ ...................19........ ... .5.. .............................. by ...........................................................5.............. OWNER c. .......................:................................................ Is:.:c wnrmr.aw,.rr, rip ................................................................................ (o1fi—I Title, 611 North Avenue, Wakefield, MA 01880 .............................................................................................. (Adds . NOTE: COJSPLETE TOP A- BOTTO:.1 OF FORM AND FORW 101 3'Y9 AN SECTIONS D FEE TO LOCNW LICENSING AUTHORITY (CITY c- TOWN CLERK). DO NOT RETURN FORYi TO DEPAP.TMENT OF PPBLIC SAFETY Q I1 (911rar m"m1#h of c xss�t ixsef�s � 1 �a Department of Public Safety—Division of Fire Prevention \` :Y 1010 COAIMONWEALTII AVE., BOSTON CERTIFICATE OF REGISTRATION NORTH ANDOV ER , In accordance with the provisions of Chapter 143, Section 13, of the General Laws, the undersigned hereby cerE�fi that MOIL OIL CORPORATION - ........................................................ ... Address INrme of xolAe.o!!Itenae� ................................................. is the holder of the license granted....�.0/1/62� 6/25./73; .9/,9/61 . ................19........for the lawful use of the building(s) or other structure(s) situated or to be situatedted ak._I2_Ma ssachuset is Avenue . . . . ..... ....................... Aso—"d .,�meer� . as relamd to the KEEPING, STOR9CE. (tiIAN L'E.ICTCRE OR SALE OP FLAMMABLES OR EXPLOSIVES. North Andover . . . . .......................................................... r Clt o.Towc Rme: Thi, renifirae of ree�nrnlnn mnn be.irned br the holder of the lieenx if aid liana wee Rr.med pine m )ui. 1, 1931, mherwi.e b. 'he--o r afupnnr of she 1„nJ I' Received ..._.A/"'r,".................... .............19! S c Y ................. 1......... tom. by ..................DANIEL LONG. T6WNCLERI{............................. Owner 120 Main Street ....................................... ...................................................... ............... ............rdimidp. ...._ ................ Isu�e whemer ewn... --pant o.Iwlderl Iv`orth And�@erl Mbge;"01845 .............................................................................................. (ALdervl 3 \DING AUTHORITY (CITY Oft VN CLERK). NOTE: COMPLETE TOP AND 'TO.S 0^ bORM AND FORWARD aOTH SECTION AND FEE TO LOCAL - t TY. DO NOT 11E1'URN FORM TO llL;PAP.9"'.I F.NT OF PL RLIC 5 U ire Con,rlrr��ttl#4� of C�tttsstt��r>ass#s ' Division of Fire Prevention Department of Public Safety t AVE., BOSTON 1010 CO'�fAfONWEP_..':H CBTETIFICATF OF REGISTRATION NORTH ANL)MER.„_..................................... 19..83.. IGV or TawN a Chapter 148, Section 13, of the General Laws, the undersigned In ccordance with the provisions of hereby certifies that Address tiff XNATN RYEMXE. M�KEFlELN, Md3S. 9tX Mobil..O1l .Curpor.aticoi .. - ..m.nl hma..on 10/1/h2$ h(2�(731„9(9/81 ,_....19 for the lawfuluse 12 Mass,nchuset is„Avenue,.,,.... is the holder of the license granted'...-........ �st.Ra ,an nnmx.a of the building(sl or other structure(s) situated or to be situated at... _.. as related to the KEEPING, STORAGE 9IAlEFACTLRE OR SALE OF FLA11'vfABhES OR EXPLOSIVES. North Andover ' .................. .. .. ................ .. ..... ... ....................... . ur the holder of the licenx if acid liwnee xee Rrent 1 ��e ( reRic tr'tyi oin m.1a9y..8be3 a ilm a...o..w..n..¢.....o.r...e..T.c..u.p..e..n..t..o..f...h..._ysI nnd mc Thi+ nemto ay otherwi.ebrth ior . .................. Received ...... � cx.t c. c.. kt ..................... — Owner ......................................... .... i. i . .._ ..... .. n'�. . ,�w a i UhA AYVC- t�l,( 1. ............ . ... Rorlh i '� �tlM�,1'�Wget ....................... �nm...a BM-389 H SECTIONS NOTE: COMPLETE TOP AND IL W"TO,,1 Clr11'i!II�R[NT FO�y OR11�'VTN CLERK). �� 17 �0 DO NOT RETURN ]'oRM TO DEPARTMENT OF PUBLIC SAFETY. r, C�Yee l�nmm lfn:tt4tlt of Cffiassar4usetts Department of Public safety--Division of Fire Prevention y ioio COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION ARd ............ is&2.... mitt ur Tornl In accordance with the provisions of Chapter 148, Section 11, of the General Laws, the undersigned hereby certifies that .......... Address -' corporation 1g for the lawfuluse io. T/ez; 6/zs/73 91.91a1 I, the holder of the license granted.-.. . � Isv«t .•e E�mn�e of the building(a) or other structure(s) situated or to be situated at ]1 N1aSs Ave as relto the KEEPING, STORM7,MAN'UF'ACTI BI'OR SAI V CH' PTA➢ibIABLE5 OR EXPLOSIVES. Ngtvndover .... .... ... .. . .._ o.T id IiCEnx nYY 6rY led pU�ui Thie Ificd mo•t b Red by th h Id of th 1 t n pNri; t t u (thl dlcenxd. too ey no MY 1 1936 tL.r by the awr � n 19. 82. ....... wz3 21 N G/%^ /l 1. . ............................_....... I.[I]F;GT ..N.... ..• ....... ..••_ IS�nlc n n � « p t or noleerl y ................. ('011 NOTE: AND YEE , TOP y) RO'f'la)M OF, FOR11 ASD FORRyw¢D BOTH SEOTIONS AND FEE TO T,Uf ,C i, LI('I?NyING d1'711ON iTV WITY OR 1'OW?\ CLERK). DO NOT KET( RN E01;11 TO Uh:I'1R"IMEN'F OF' P L131,IC SAFETY, r lJ £ �IIY[IIt[Lt1T(ltEMl Df ssa£husPtts Is Department of Public Safety—Division of FSre Prevention d 1010 COMMONWEALTH AVE., ROSTON CERTIFICATE OF REGISTRATION North Andover Apr1f ............... .......In accordance with the provisions of .............. _... ._ . . 19..... ?,1 .......ipiei. . Chapter 1,18, Section 13, of the General Laws, the undersigned hereby certifies that ._.._. Address . . L - is the holder of the license granted Of the building(,) fxL7..5/13' - 19 for the lawful uae or other structure(s) situated or to be situated at.... ?...N.!`?as: Ave. as related to No, KE EPIX(, 57oR.1( N1,1AI I cr(CRL OR SAl,E OF FI AMYfA61.ES OR EXPLOSIVES. North Andover .. r(uxy^r�,,. . ... H i Th c rr o PV t i b p„ d by the h Id f the lieenw if e.id L} i6 J rwj by ih orn. _,.pant •6ngtM rof the End Lcen d Received a R Mobil oil corpora c. s.... .. Poratlon b m O :...' - F. D. K.mo All MGR . .. ...... ...... . 0 _..__ownc..r .. a..o.m o.nem.a ... ............ L 4;..,. ...._...... ... . u., a is the holder of th hi ens- y,,, i ..i 10/l/62;6/25/73 Of the building(s) i th a s'hi t .r tiie I,vful use ` - 12 Massa Ave. ._..._..__.North-.Andov c n m: 'fL�. � P fdh r rJ Received r' ` MOBIL B�L 0 _O�L 0 PORATION i - . ......by ....... ... - A&C MGR. ... Owner 611 North Ave. , Wakefield, Ma. 01880 r l ' Sr NOTE: CO]1P].F;'1'E 'POP f ) ROT'I'OM OF 1'0RA1 AND PORV IT) BOTH SECTIONS DO \11T , TOURN�711M ENII AU'111°RT OP PUMA(' CLERK). z4r @Tummort l rAll of A?Missacl usdts �E Department of Public Safety—Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON d CERTIFICATE OF REGIS 'FRATION North Andover April 197g ............ . l Cib nr Tuwnl In accordance with the provisions of Chapter 149, Section 13, of the General Laws, the undersigned hereby gertifies,that ,fit l..p N.IYIP�I[..WACfF1El1,.l1hSS, 81894 — _.......LV.LObill Oil C.gfppfatlAtf......_........_.._. .... Address 1 pPi �N„meote.".-.f —rut 10/1/62 & 6/25/73 79 for the lawful use is the holder of the license granted.__. uat _... 12_tlass. Ave;,.,, ........... of the building(s) or other structure(s) situated or to be situated at R� e �� � as relates]to the KEEPING,STORAGV: 9IAN[FA("L "p. OI1 S.NI.I:OF FL,ANiNDART.ES OR EXPLOSIVES. Npr[h..Andover ,'r,,3 r ' ......................... mus ed he !Vote: Th pr"`-"� �1935,n�her'wbe�bymthebowlo r nolT$dw��.ruGGnQqnm��of she fund Gae'nsed- ~•� �ed P an d lr l , 1"5 U_..1 RP I N Received ...... 3_....,..._.19....."' BY: Manton AYORAT S's'o . .. `3 .i14 ' I District Administrative b ................._..._... Owner & o, wh,Lh,, n... " .,d ..... ...._....._.. om ivd 611 North Ave Wakefield, Ma. 07.880 CH Srt'n' - ,v - 1 ,� i CLl?lth 01 V ll [CY OJ 5gF1PV.•L p} 11 AN] ilT f0'J, c A�[LIO� 11D1 ] �6LZC o }itr;lr tO711r }� Dly1x7v9EN1 v �� �Q S :-oTrl' lrr cLx ��}� Orit1LCOS�c���"� A Fire prevention �afetY- Division Of aYtMellt efo pubOMMONw EALIc T}l AVE., gOSTeN Delp tION l978 "`� _... {i A R.� l t, A' . O d the nndecsiSne A l F' the General I aws of t rT1R Si etion lS. ri 11;.1e`l Chap " j IY[ + for the lawtui use the loop tons of p1s.i�s q . wit Addres ..Ml In ieeordanth t 6/25/73.. 12 . ass Ave .. cert}hes that iv a (lit gSPL(�1165 rn ,�,:, r r 10�1.tea be situated at hereby rated..-. tea or to a the license bra srtua . (11 t} AA1Al Al I1.> or other structure lsl Ol.r AI h. id }e the holder of n.d nreno< Re the buildin¢(sl of Ik.YI1�C tit0. ...... An6"..er .. e dh the hot iF a�mlan� a 9 ..,Na,r tih.. it rat re�1.¢u �herwl.r br ii d t •n ne r r er ihru IV36, r Q �1. B JDa iT Thar .. BY dark to A n M ray er 19........ W E geceivea .� " . . ' .....' .. by .._..._ _._ ._.. ................ }OCII li) qvp 70R\ti�)j�l( )l1N CLYd: 1'u'li It ff l(.[IV 1 SANLTY. ('031pl,r TP:fOlhC��l°iT•\( Ito�I)G'AR'D11" IItBLIC' ���[[„„ ��yy��LL f1 �I.,tgQ}�u N t)PG) IVOTERL"CU T 6 �lYLZMuaLU"E.""A� UG s ent of Public Safety—Division of Fire Prevention i I Depa1 t111 jolt) COMMONWEALTH AVER BOSTON is REGISTRATION .' yam I' E p 1' April ( 19..". ►cA< �. I F• a�I ... NORTH AND04ER.... ............. . . . . .. ._ loi+ ^= Ws,the undersigned u,visions of Chapter 149, Section 13, of the General La 01880 In accordance with the F 611 North..Avenue,r,.Wakef ieldx„Ma. ,,,,...us certifies that ......... Address 6.. 6�25/73 . ....19.... for the lawful use hereby --' """" Mobil Oil. Q4rPorati4u n.,,.. ..... .(.... 12 ?kris., Ave .. m„, roll Inn t,d...__......" Isv<n O..a,.muedp¢t cG situated or to be situated at... iSIaCldiLiffi�2a ex'1ai Is the holder of ch orl other sg'Lructm'e(s) S ERapllytgpW5( R di ffi of the building(') 1 I (]It i to ING,JTOILt(;E,\1A! nNlls . . . 4000 6a1• tank (or a Lotal of nudes ga s I lal 1 .0 the L.1 LP .. - 1 tank fue (urdove. .r gASbY�N 11 North I . i�w n bz oipned br the bolder.f rbe Gmnx if e.;d liceneei.$._ t' .ndlmnxd ' .. ._.._ 1�q<�a� ee��;;P` � 150n gal tank ,.1< i I ( rer. .i ' Werw;.r b. r Iffle „'UI . . . ... .. i Tho c ru l b 1 1931 f ) p ... .. . . a a BY:.1L.C.<�'��� � (t.�."Adm nistrat>.ve & Contr 9__.... .........._•a;C'C W. E. Clark Received -. .. ... ..... ....... .. A ... . ... .. ..... . by , v MSS,OiB15 IS ae t A�rr owner aeupmt or aolderl .vim ..... ...21.. 611 North Avenues wakefield� Md, 01660 ........ APOPP OR08Ni7?^600 gal motor' 0 I 300 gals anti�reeeeW80 ga3s suEDAtpG�p I' lllllllllll 60 gals brake Fluid � relsp 04e Tilutmo=ra t4 of Mansar4usetts Department of Public Safety—Division of Fire Prevention 1010 COALATONWEALTH AA'E., BOSTON CERTIFICATE OF REGISTRATION ,..,.,.,,.North Andover.._.._ ,..March 17 197�_. 19........ 1::.:7 T...o) (Dme) In accordance with the provisions of Chapter I IS, Section 13, of the General Laws, the undersigned hereby certifies that Habit oi.l Corp...,,,.,,. ,.. . Addross 611 North Alve, Wakefield, .......................... . ...................... ............ . . ............. . . . ............ irv.mr of nc!mr of l....... Octob2 1 1l9b. __............ ... . ..... . . ..... . is the holder of the license granted..................12 1!assacius�tts xve• 19........for the lawful use ... ......... . .... ................. of the building(a) or other structure(s) situated or to be situated at.12 ];Iassachusetts,,Ave,r,.., ,,,, I s'o-ma eod n.mbep as related to the KEEPING, STORAGE, ]MANUFACTURE OR BALE. OF INFLANIMABLES OR EXPLOSIVES. "north Andover. Bass. ......................... (cuy or Town) Note; This certificate of registration must 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. Received ....................................................19'._.... ................................................................................................ b se .mrm ..........•....... ................................................................................................ ...• .•••..._......... ..... Itimn� wF.o\her maerrq weunm[ or(Onteial Tttla) Folded ........................................................ ............................ Ae Clommm6cal#ll of AIttssu'husms Department of Public Safety—Division of Fire Prevention 1F F \ 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION ......North..Andover......................Apr..i.l............1. 1 s.75... In accordance with the provisions of Chapter 148, Section 13,uof the General Laws, the undersi hereby certifies that tined -' -Mob#}..pi.l...(�.oic t1 .a ., Address 611 North Ave. , Wakefield, Ma. 01880 r...a ... . _ . .. is the holder of the license granted . . ` ' of the building(s) or other structure(s) situ to "QC.CQ er 1, ... . 19.62...for the lawful use ated or to be situated at..._..),2..Md5.Sd.C}J.USet.tS..AY.e..._..... ea relined m ,he KEEPING, STORAGE, MANUFACTURE OR SALE OF INFLAMMABLES OR EXPLOSIVES. — North Andover.. .............. . ronr.r,ro. .................._............... Nn,e: Thi., renif rage of eegieVath" muss be vgned by the holder of gybe license rlcenx n ,pooled 'or � J Ir 1 I936 otherwise by th if aid l e Received .. 19., rht7gfL"UYL CUIEYUftH�I UIV l nR.d. b r ................. Owner .... is�a,..nrm......................I.. 6.11. North Ave. , Wakefield, Me. 01880 .......... .................. ...... pRrN TOWN OF NORTH ANDOVER OE e,tp k ?� TOWN.= ?. sf , 0 s D,>_NmL LONG, Town Clerk Noa'ex Asnovr;v. A[-ass. 1843 •yN559CMC5E14 ELECTION DEPARTMENT Dear Friend: It is required by law that you be notified of the following hearing as being one of the said abutters adjoining said property involved: Legal Notice TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF SELECTMEN e Notice is hereby given that the Board of Selectmen, Town of North Andover will hold a public hearing on September 8, 1981 at 7.30 P.M. on the application of Mobil Oil Corp. 580 Chelsea St. B. Boston Mass.02128 to increase the storage of gasoline from 20,000 gallons to 24,000 gallons. This is to be stored underground and located at 12 Mass. Ave. North Andover. John W.Graham R.Louis DiFruscio Ralph R.Joyce Thomas J.McEvoy Chutes A.Salisbury Sound of Selectmen Publish North Andover Citizen:August 27,1981 L17 If you have no objection to this license being ranted, it will not be necessary for you to attend the hearing. Please call upon this office at anytime we can be of any assistance to You- inner ➢aniel Long Town Clerk eo,.re-x. xa-ms-xwsss _ i � i �, ,r�e (�nnaitunmrttltfl of 91�tta3ttxl isrfts ' DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION 1010 COMMONWEALTH AVENUE. BOSTON Korth f ndover august 2 g (Care, Tarn) (pate) — 1 APPLICATION FOR LICENSE For the hurful use of the herein described building. . or other =mature_., application is hereby made in accord- ance with the protisions of Chapter 14F of the Cenand 1,", lia'n then,' to nse the land on which such building._. or other structurl_. . is/are or is/;Ire to be efluatni, :Ind onh' Ia such oN'telo ns shown on plot plan which is filed with and made a part of this application. Location of land 12 lliass, nvC Nes rent crass street _ ls�r.ri s s�norrl Chelsea . _.. Owner of ]and... Inobll (lit Corp.- _..Addlass58G G St E- BUstGn Ma 02128 Nurat of buildings or other structures to rhkh ti I application applies One - - Occupancy or use of such buildings Gasoline service station Total capacity of tanks in allons — -"l%X19t a 20e 000 'gal g AbaYgasorlineas. exists _.. Underground Add. .4WC,00 _gal Kind of fluid to be stored in tanks _..._ TQtal, 24,000 gal APprobed—Deapptnv 02 ed � (sic t Mobil Oil Corp 5 ire at . . _.. _. j n I 580 Chelsea at.• 4AUS ton LIa.02128 (H (Add ,an) o[ Fire Dept 2Paat ' cUhr 0ammuttmrttl* of 9Dlttsmttr4amrtts DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION F IO10 COMMONWEALTH AVENUE. BOSTON v I�g. —� � North Andover August l981 'p�,s. LICENSE (cur n,m.. ) In aeeoedace with the provision= of Chapter 148 of the (:enerld Lacs, a license is hereby granted to use the land herein described for the lawful use of the buildhn,_.. or other structure which is/ace or is/are to be situated thereon, and as described on the plot plan filed with the application for thls license. Location of land 12 Mass , Ave Nearest cross street (Sheet m N,.rebe,) _.._ 0uner of find _..._Mobil Oil Corp -- __ %dd, < 580. Chelsea St.... E. Briton Ma.. 02128 Somber of bnildings or other structures to IrI,ieh this hcmtsc applies One _ Occupancy or use of such huddings Gasoline. Service 5t6t.i On .. .exist 20,.000 gals , Total capacity of tank. rn gall'a":—. Gli is „-Underground add 4, 000_..gals 3G ud of fluid to be stare n aso ne d in t ks 16meg rad li eXis Total 24.000 gala Restrmtlore—If any. ---/��'1✓7/�/p/`./'.�ft� bG�� - _...... _. (soorat a t It 'ire+.-.a THIS LICENSE OR A PHOTOSTATIC OR CERTIFIFD COPY THEREOF MUST BE CONSPICUOUSLY POSTED IN A PROTECTED PLACE ON THE LAND FOR WHICH IT IS (:ReuTrn I.—el-2, trees..... . � �1.Le e �i[ st._ �� �✓ 7.3 ' � _ (�! IMP �A11lrilAltlUP�I��1hV�IIf�`' xrl�usPtte '�; a�� f',�l MENSMAN DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION 1010 COMMONWEALTH AVENUE. BOSTON VY North Andover 6/11 1973_ (city or Town) WSW APPLICATION FOR LICENSE For the lawful use of the herein d....ibed building , or other steecture , application is hereby made in accord- ance with the provisions of Chapter 148 of the General Lace, fill o heense to use the land on which such building_.. or other structure. . is/era or is/are to be actuated, and only to such extent as shown on plot plan which is filed with and made a part of this application. Location of land 12, Massachusetts Avenue Nearest cross street Tnterstate 495. .... ... ........... s e a ��me.'> 611 North,,,Avenue, Wakefield Masp.. Owner of land Mobil_( ��.� Corporation _._ Address Number of buildings or other structures to ahmh this application applies. 1 (one) .._.. ...., ' Occupancy or use of each baildmgs __ $e Station FV ca -- Total capacity of tanks in gallons Abevegro(md 00 gals. motor oil Underground 4j100„gallon tank, Kind of fluid to be stored in tanks (aA<bLU, 300 gals. anti-freeze in addition to gg0 gals. auto $tans fhiid exi(�tin 16,000 gallon 60 gals. leilel � Cor atyon _ c - 0 gals. fuel oil R _ 3" 1993 by__s Attorney (s,en.e.m et Avnh...U $00 gaad�"Waste 041 345 Main Street, Haverhill Masa (ue.d of Fire Derr.) (Aaaeeeq �hr (�omotottwrttltll n�-�tssxCl�tsPtts ,i %� , , DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION 1010 COMMONWEALTH AVENUE, BOSTON No. Andover. Sept. 10 19 62 (City oe Taw.) (Date) APPLICATION FOR LICENSE For the lawful use of the herein deserihed building.. or other structure_., application is hereby made in accord- ance with the provisions of (-hapter Its of the General Lars, for a li, Ica to use the,land on which such building_.. or other structure is/are or isLm to be ,situated, :rid only to such leetent as shown on plot plan which is filed with and made a part of this application. Location of land 12Massachu3 et is Ave. Venrest cross street_Perry Street s' ' a 5 m . North Andover. Owner of Iand JOhn_I G"ari°P11 El St N _._._ Address _._.. _.__. .._.__... Number of buildings or other strictures to which Ihh application applies.. One Occupancy or use of such la ildiege Service Station Total capacity of tanks in gallons ) oveglound Underground 16,000 gals .gasoline . Bind of fluid to be stored in tanks.. 560 fuel oily 560 Waste oil. (Underground) .Approied—Hr6ppreved _'. ' , jt... �....19 .._.. tY�!1/u(4.. � l:.XJ./V�•.JL•IC, .._.._..... (e,pnature +`f App eao0 1 (Heed o[ Frt¢ llerl) (Ae .) CK4P Towwouwralt4 of fiawwar4uwrttw DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION it 1010 COMMONWEALTH AVENUE. BOSTON Oo toter 1. No. Andover gept 10. 1962 (cty or Town) (.ate) LICENSE 1. accordance with the provisions of Clmpter I IS of the General Unws, a license is hereby granted to use the land herein described for the lawful u,e of the building.... or other structure. .. which is/are or is/are to be situated thereon, and as d....ibed it the plot plan filed )vlth the application for this license. Location of kind 12 Massachuaetts Ave._. Henrest cross eterst Perry Street. 0wn Ian J. er of d Sohn. .S (VW 'ha lddrese rt 45 Elm St. Nortkl..AAi over.,...Mass. . ly Noods,r of buildings or other aiuctures to which this license applies One __.... Oecnprr" or use of such buddings _....Service Station Total capacity of trks in gnllorp:—Aboveground __ _. __Underground161600 Oats gasoline xndornnidwbeseorulmtanks 510 . fuel oily,., 510 waste oil. (Underground) , lcertrbtions—If .ni _...._. ___ . __...._ _.._... .___.. _._. __._..... - (SF 1 to linen si., uthoilty) T_H IS LICENSE OR A PHOTOSTATIG_OR CERTI FIFO COPY THEREOF MUST BE CONSPICUOUSLY POSTED IN A PROTECTED PLACE ON THE LAND FOR WNION IT IS GRANTED NOTE: CO-MPLETE TOP ANIrr10TTOM OIa FORM AND FORWA, BOTII SECTIONS AND FEE TO LOCAL LICENSING AU'1'IIOI;I TY (CITY OR TOWN CLERh). DO NOT RETURN FORMr TO 11E RT\1ENT OF PUBLIC SAFETY. Pt TOIMMOnflI M4 Of ffinSadjustfifi i Departlr,,nt of Public Safety—Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION 6lorth B:ndovf,r ur__........._Pr)mi1„3�",,,.._......... 19.76, I" u. Tawn) IDelel C' ITt accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that 6P th `a;7ue y : - 'ie ' ....... n ... I. .... . ....... Address . . .. .._.. .. .... .. P1 obil C'tl or-mra uo " is the holder of the license granted.... �%iF.Uat_�.'��.ue����`�bs...".................19........for the lawful use of the building(s) or other structures) situated or to be situated at......R.4Ab.0..��.�...�:�f?wrca;. (so-re, wd na.nal) as related tD the KEEPING, STORi Gl,, M ANIFACTI-RF OR SAID! OF FLAMIIABLES OR EXPLOSIVES. 2j,2,n0 als pas .. .. c. 7rw W ) fir oil No"; "1 brs reran mr of re&stranun must b . Rased by the holder 67�� h ��en iiai aCbcenw was wanted prior to July 1, 1936,utherwoe by the owner or occupant of the lend nceneed. Receive ... .. . . 19........ ........................................... ... .. . PORN J tYONS; f:M..G".... r�.)�r<,. . .. ......................................... by ..........No....l o14.:N�.. CLERK..............._............ NO. ANGOVEe, MASS. OIB45 Isut: wean. nw.<r, a«uoam o. nam<r) ................................................................................ IOMrinl TtlIN .............................................................................................. uea.<n i r (tllte (fOntI"0Uf Irajt4 of 4%ssac4usrtts 5 Department of Public Safety—Division of Fire Prevention a 1010 COMMONWEALTH AVE., B09TON REGISTRATION Slorth nd,vE r April 30.. 19.....76. .................................................................. ........ . . (Ca, or Taw.) IDalel This is to certify that N o6! 1 Ui1 Corl.+oration ...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..... ,,i].Ll..:: .),_ .,7SN.Ozidb3,4A........_.._............ .......is the holder of the license granted ,._......._. ......._i.ur oust lbr ....19 65for the lawful use of the building(s) or other structure(s) situated or to be situated at I';01� (1'1-ar I a rr:.net L:n ) ....... tsn<rt and Nomn<r) as telatM to thr.KEEPING, STORAGE,MANI.FACTIRIC OR SALE 0P FLAMMABLES OR EXPLOSIVES. 2 r2^O Fals i-.,,sol: . r. .... ......... .. . .. ...... ......... "On gals fuel n 1 �e'a�aa.< . . onaiealdy})(N J IYONS, GM,C, 500 L` eSe w,e. r me of regmtrtl Don —,be filed on or before April 301h of carh y (THIS REGISTRATION MUST RE CONSPICUOUSLY POSTED ON THE PREM , , I CLERK Mobil Oil Corporation 611 NORTH AVENUE WAKEFIELD,MASSACHUSETTS 018W ,Tune 18, 1973 Office of the Town Clerk Mr. Sack Erle, Administrative Assistant 120 Main Street North Andover, Massachusetts Re: BO-389 12 Mass. Ave., No. Andover, Mass. Underground and Above Ground Storage Dear Mr. Erle: This letter will serve to confirm our telephone conversation this date relative to the subject. The storage license should properly read to include: Underground: Gasoline - 1-4000 gallons tank (in addition to an existing 4-4000 gallons tank) or a total of 20,000 gallons 1-500 gallons tank, fuel oil 1-500 gallons tank, waste oil Above Ground: 00� gallons motor oil 300 gallons anti-freeze 80 gallons automatic transmission fluid 60 gallons brake fluid Thank you for your interest in this matter, I hope that this correspondence will serve to help you in this matter. Very truly yours, T. F.Z lle TFZ:kk Underorou_nd - 23, 000 gallons of gasoline -1 - 10, 000 gallon tarok- 1 - 8, 000 gallon tank - 1 - 5, 000 gallon-tazl< 500 gallons waste oil 500 gallons fuel oil - to be used to heat the building (Aboue Grouacl 600 gallons motor oil ' 300 gallons anti-iiree c , 80 gallons no2rtacgfluid ' _ 60 gallons brake fluid O� North 9nd ���:::/// over I I / .. TOW Nry1A55AGHU5ETT5 OloLF1-- 73 May ' FH�M T A=aessors - - To:� rlerk J. twons, for John pratinn the an: ratto io 01�000 addh{n�to thF "netlf e'1F,000 li eX e n nermiss °n " d tank in ah,,tters: addit� in unr.;rgrovn are t. , ed. A;,dover the follo��ne 17 n.ami-Eton gallons, N n Lavjd B. ?: Loona S1. Hollins' 9ve. `3arron, 1 N�ass• n n Jr. e,. Florence 6. ylth ,'we. ..,ill.iain F. � �oounonWe n N)l pe.livan> ll ^ p ' JOfOe A. � classachnset0s - n"drew A• n t1oM'°tray' 9 etts We* J manes R. ac rlaudette Plassachus v. tM1arte �" • V'Irzi, 79 "di ng 9 t•, „harles 1F in 0 a. Lorraine ',1hiLe` ;fohert J . Tnc. for 1973 "'CO, is assessed Ato ll mh9s grope rtY .._venue, - 1� [na9sachusetts aloe (rnututunmeatO of fitassar4usetts Department of Public Safety Division of Fire Prevention 1010 C0111MONWEALTH AVE., BOSTON ..a CERTIFICATE OF REGISTRATION N9RT.H..MQQ ER............ApUtl......................... 19.......76 {ally ox T—) (Deis) In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned bereby certifies that .....MIQBII...QIL LCRRQRATION............................... Address ..4.�1..N.QR:CH..AIIR.,.....WAKkFlE1.A....NA......A.l.FiflO (N. oL holder of Hoe^xl is the holder of the license granted.........1041/62.:.....6/25/73...................'If Massachusetts Ave ul use of the building(a) or other structure(a) situated or to be situate a ..............�si.�...cna^ued»rt as related ta.the KEEPING, STORAGE, MANUFACTURE OR SALE OF INFLAMMABLES OR EXPLOSIVES. L0r. h..Npdaver........................................................... (City oe Town) Note: This certificate of registration must he signed by the holder of the license if said license was granted ,prior to daly 1,1936, otherwise by the%M, pr prspp f pd lice . I°IUB1L lJlt. Y lUN nse Received ..� _„ �� 19........ ... BY.:.. . CJ, .. / ....................... ' ^ � W. E. Clark (s,a^•<^'°' A/C Manager ...... .. .................. by ............ .: ............ ............................. Owner ...... .......................... ...................................................... b (stet: whem.� �w^c., om-,e�o.^t or hmarrt """""""""""""""'....'.iortiti.l.xill.)........................ 611 North Ave. , Wakefield, Ma. 01880 .................................................................................... (Add—) ....u.. . ...e.............eu.u,.......u,....uu....uu.........u• U14P Tnutu onmralth of Massar4usetts Department of Public Safety—Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION ...NORTH..ANDO V E R............Ap r..i.l....................... 19..7.b.. (ct;^r x^r,nl wam) In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that .......MQQIL...QIL_L.O.RRORAT.ION............................. Address .ball..NORTH..AV.L_.,..IoAKEF.I-LLD....EA....Q1880.. 'N'me ^L holder of limn.) is the holder of the license granted.................{.1U9 ............................19........for the lawful use of the building(s) or other structure(s) situated or to be situated at......RQUN..10................................... (street and nerrbee) as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF INFLAMMABLES OR EXPLOSIVES. .......N.O.RTH..ARQQVU........................................................ (cite., 'r^wn) Note: This certificate of registration must 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 lean licensed. Received ....... .. vLTION ...... .......................19........ .......8 ... . .. ... . ,��.�. ........................... VJ.y lark (Sir atn•et� ABC Manager by ................_ .. .. . .................................... Owner t .............. .......................... ................................................................................ (Srnte whether, owner, oreu0ent or hoder) (ORlrlel Title) .....,fill.. IAdde... drecel -NOTij: COl'(I 1 L '1'E TOP AN,.,BO TOAl OF 1 oRM AND 7 ORWA./ 7 OTH SE(. NONS 4AU HIE TO LOl'.A I. IdC I;KSINU :1CTIIUItTT� (('1'hP OR 1 ()WS CLERK). DO NOT RETURN FORM TO Ul?PART61EMf OF PC h1,IC SAFETY. TPe (fommozxfoealt4 of cffirzssar4uset#s Departn nt of Public Safety—Division of hire Prevention �n5 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION .. 11_lIl 6ndavar...........!.!;11: �:. �0.. ...... 19....76 In accordance xith the provisions of Chapter WN, Section 13, of the General Laws, the undersigned hereby certifies that (a cil ,hl ornor. _n„_....._.___...... Address __..Gl� --o U:...:. .__..- rry .nr nme„ v ',o y It �( �.. , 19 for the lawful use is the holder of the license granted., - "" of the building(s) or other structure(s) situated or to be situated at .. .. .�. ' 'aG r' 4, ?➢i:AUC. (so-, ..a as r,latcd oth, KIEPIN( S'loii Wt1 . N ANLtACR10 ORSAIA,OI ILAVMABLE50REXPLOSIVES. o .„ ..... O 1 )00 nls : aso'inr d' t Ior h r, do � r r .. (, c 1P0nn ^ 1'i m�P,or oil 60 Lass rak f] No,- Th eni h,utr of reg t mus, Le si", d by th h3iat�.6fw,@ II�.Nel TJrT.�d'P,C n..ru 6. ted S J ' pri r ,o July 1. 1936, .1herw,..by the owner o. oro.p.ra of the land Leenxd. 50 i a'... Received .... C. ...19 ......................................... .. .... Y ISiynaurel by .................._:441AW J..CLERK. . ..................... ..�.... ................................ 1. ':.:1 ;a;50VCR. MASS. 01845 s.,.Wno.,e.. .......... ... s.a..., 14P tQowwonwratt4 of Massxr4usrtts Department of Public Safety—Division of Fire Prevention quvl� 4010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION . ....AIN..oX$iv.............June...z.J............. 19.72.. (C::' or T".) tnctel In accordance with the provisions of Chapter 148, Sectigu 13,,,pf thg GBneral Laws, the undersigned hereby certifies that 111 orttz .,venue. ................tlob il._�Ji1... QF.P..or3'il: !?.... Address .......�l..j.e fi el .A..!'i�::....!...QiL t1().................. IN.— o[ M1o1J " l"—" is the holder of m'the license granted........T::�F ..2},,,,.1; ;'}.....................................19........for the ]awful use of the building(s) or other structure(a) situated or to be situated at.....12..t asaagk{u..s e,t ts„,iv,o....,rd over. (S,-I, .m e.,ebee) as related to the KEEPING, STORAGE, h1ANUFAQPOR,, OR S INFLAMh1ARLES OR EXPLOSIVES. ..................North .'lndover, addit' n. ell - 0" :*,upon tank of p;5soline. ............ ........................................................... c 1sfuel Dil -. :G - als 'N.;41. (cur oc rowel 7 Note: This certificate of registration moot be signed by the hot lic seif said license was greeted Ppor to Iuly 1,1936, otherwise by the owner o f t e d lifepsed. Received .......,.t... . .... ............19< �'... .. ....µ�. . ..{.a.,.�e.�l ✓✓ /// by ............... . ... .. .. . ... . C/G 7KC' ............. ✓✓ (9m[er M1elhn owneq oecvp,,t oe haltlec) ................................... (orcl<1.1 xa1.( il.!-'� 1. v..nc- ...........Y.k:=.a /f............:......................... (Addce..) .. ._.................................................. L The Tammonfuralt4 of f' ae'sarhuse##s ��\ Department of Public Safety— Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON qr may.. CERTIFICATE OF REGISTRATION ...North Andover.......................April...._........ (Q11 nr'f^w^) (pit,) In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that - - _Mobil.-Oil. Corporation - .............. Address ..611 North.-Aae_,..Jiake£.iel.d,..h1a.................. I N•mr o[ �•W v of granted 10 1 6G is the holder of the license granted.............................._._.L..L...............................19........for the lawful use of the building(s) or other structure(s) situated or to be situated nt__12..Mass achusiett5..AY8......_._.. Is'—, end —o's") as related to the KEEPING. STORAGE, MANUFACTURE OR SALE OF INFLAMMABLES OR EXPLOSIVES. ............RortM..Andover._.......__................................ �av Nate: '1'Lis rertifirm,of registration most be signed by the holder of,he license if said]fees.w .peened prior to July 1, 1936,othereke by the owner or orcupant f the. land licensed. MOBIIL OIL -f,ORR�aRATION I' Received ....... . ........................_...19........ .1�.:. .. ..._L�;k,._ 5.-i.1... .... ................................ . ' E. Clar �s�g^•a^r•` ffice Mgr. by ............................................_......................._... Owner ............................................................................................. fOMei•1 Th:v: ...6.1.1...NorV4 Ave..,...Wakefiol-d.,..Ma,_.0.1880.... ....... . uddrsssl Thr E1T1tImufUeaffil Df jfflassar4usefts ' I Department of Public Safety—Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON F�F CERTIFICATE OF REGISTRATION liorth .,mover.....................ly ......... 19...73.. ....... ........ . . . . ICIty nr T-11 (Orte) In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that .. .hk,1.7.1P.s..Petgo�e.Am_Col((ganX............_....... Address ..P..._Q....1.ox..4833,..AAlanta.,..i eargia....3CX2 (N.—.( nod.,of l:ce W ^cto er 1, 1962 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.12, I•.:. ss.,_. rye,..._...,_......._.,_,,,__. (su-t —d -ix,) related to the KEEPINC,STORAGE, MANUFACTURE OR SALE OF INFLAMMABLES OR EXPLOSIVES. North iindover, Mass. 018L,7 ........ . .. ............................. (cityo.'1 w 1 Note: This crtifirae of vegmrxtlon tone, be signed by the holder of the i, if xxid licenv w n pxnted pri r to Jnly 1, 1936,ath—me by the oxner,orr ocenpant of the hind li,eo d. Received ........ . .: 19..... 2.t. z.:I:r.n.�. _N. by ........................ r? . . > ...... ........ ...... Uwnex... .... .... ;Bute wpetber awneq oecrOnnl m bolas.. mfam Teml P.J. Box g833, .,tlanta, Georgia 3C302 ................__..................................................I....................... �naa.rs.� oa , . )WN OF NORTH ANDC~fR e.O fiyllG.,l6. s. IBBB �j JORN.i. I,Toxs, Town Clerk i qS'• •gt` ELECTION DEenimHxuT TOWN BIIILDING • r• JUSTICE OF THE PEACE NOETH ANTOVER, MAPS. 01845 Liar 25, 197j Dear Friend: It is re,u ired by law that you he notified of the following hearing as being on(,. of the said abutters ad,joiriln:' said property inv,lved: T0,7 OF -;O-Ti II:.LOVIJ,- ,Y 27, 1975 Notice is hereNt g_ver. that the L'oa rd of Selectmen, Town. of ::orth ln.dover w111 hole a public hearing on t.oriday evening, June 11, 1W7 at 7:50 P,;% , in the Selectmen' s Office , Town LaTilding on the ap,;lication of ilobil Oil Corporation, 610 North Avenue, ';lakefield, 1,lass. , for a license to store underground 4000 gallons of gasoline in addition to the existing 16,000 gallons, at 12 16assachusetts Avenue , ;forth iird over, :Mass. Joseph A. Guthrie, Chairman. John I'. Kirk John F. Coady. L Oe:Y.11 OF SLLLCTLU1 . If you have no objection to this license being granted, it will not be necessary for you to attend the hearin(?. Please c911 tenon this office at an7time that I can be of assistance to you. Yours very truly. JOIti J. LY01,S. TOWN OF NORTH ANDOVER 7onN J. I.YUNS, Town Clerk t. L'LEC'IION UEYA RI'NPNT TOWN HIIQ.DINO Nuwre""vas. Nose. e1146 A JUSTICE OF THE PEACE May 25, 1973 Nagle Tribune Publishing Co. North Art over, Mass. Dear Sir: Flould you kindly publish the following as a Legal Notice in the North Andover News Column on Wed::esday 'day Su, and aga7.r. on Monday June 4, 1973• j TOWN OF NORTH ANDOVER. 31 Date : Notice is hereby given that the Board of Selectmen, Town of North ^ndover will hold a public hearing on Monday Evening June 11, 1973 at 7:30 P.M. , in the Selectmen' s Office , Town Building on the application of Mobil Oil Corporation, 610 North Aveuua, Wakefield, Mass., for a license to store under- ground 4000 gallons of gasuli.ne in addition to the existing 16,000 gallons, at 12 Massaehusetts Avenue, North Ard aver, j Mass. itI Joseph A. Guthrie, Chairman. John P. Kirk t ATTEST: John F. Coady. JOHN J. LYONS. Board of Selectmen. Town Clork . ' i i Kindly bill the suave to: Robert J. White, Esouire. 345 Main Street. Haverhill, Mass. 0,1830. A copy of pricaed notice would be appreciated by this office . i '. ery truly yours, i ')HI+ J. LYUNS. i - KA -E�LITZ COHEN AND WHITE � c co Acc ea"eurz HAVERHILL. MASSACHUSETTS 0I830 May 15, 1973 Board of Selectmen 14 Main Street North Andover, Mass. Gentlemen: Enclosed please find Application for License on the premises situate at 12 Massachusetts Avenue. If there is any charge for this, please advise and we will remit by return nail. Please advise of the time and place of hearing on this permit. Very truly Boars, Robert J. White RJW:pf Enc. P.S. Also enclosed you will find Plan in duplicate. x The (fontutonfuralf4 of ffl ttssnr4ttsjetttl Department of Public Safety—Division of FSre Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE. OF RF, GISTRATION .NarU' Andover............... 'eb__29,..... ... L C ......... 19..72. hereby certifies that I accordance with the provisions of hapter 148, Section 13, of the General Laws, the undersigned Phillips Com Petroleum . . ........Paz!Y.......... . �N the�f nomrr,,r rr.,,,mAddress .,.Q._.G.&33.,,.Atlanta.,...Qaor.Pia.$0302...._.. rouse is the holder g(a)hor other structure s situated or toebe �� Of the building r t0.- situat����.......1 ..........19..22..for the lawful use 1 ) situated at..a2..1!I3ss....A.V_...... ..__......_.......... es •ele,ed io the KEEPING. STORAGE, MANUFACTURE OR SALE OF INFLAMMABI[ES OR EXPLOSIVES. !North And hlxss. 01545 No,,: This cerlilmaa,of 11m.riuma mura l b [ d by Ih holder of,h 1 f d ee was 6••med P t J ly 1 I936 ,Le• by the ow . B¢Celv¢d 1 ,h 6oid 1 aeneed. d. 6FfJ t ''S Js ✓ . r�� by Phill Pet N0 Ps ... leum Come any Cri%L-J7 .......Iomrmi Tui.o ts,.m wnrurr ownrr aam.m or ,...P..O. ..41333, Atlanta, Georpia 30302 . .................................... .. .........................................Inaa..,,I PHILLIPS PRTROLr7.N COMPANY ATIANTA, GEORGIA SWJECT: 1,50-20 Massachusetts Gasoline Storage Permit /l 7z. City C k City ai North Andover- =.018L•5 Dear Sir: Attached is an application for renewal of a Gasoline Storage Permit for our service station # IRRSL at the following location: Mass. Ave & Shaw2hgQU Please find attached a check in the amount of .5� 9 C�i, / J F Xj to cover this renewal fee. Return the completed registration to my attention. Thank ,you for your cooperation. Sincerely, A.J. Bangs AJB/os Encl. war (` 4e (Iommo IUralt4 of flAttssar[lusrtfs ml Department of Public Safety—Division of Mre Prevention r+s 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION 07111 ,. rod„i to...l In accordance nith the provisions of Chapter 148 Section 13, of th General Law e s, the undersigned hgr pgrtifiea p _ Address le In d. f ' �� Gouer 1, bZ is the holder of the license granted.___ ._.__. y _. .. 19 ....fo7 the lawful se of the building(s) or other structure(s) situated or to be situated -- (se...' .na nammo O e. r nm ,ao Ebyy KEEPING, STORAGE, MANUFACTURE OR SALE OF INFLAMMABLES OR EXPLOSIVES. Nme: Thi.,erlif u rote of rcairtralion musr be sip.,ed by she holder o i( id rase'was gamed pri r m July 1, 1936,olherw,.e by the owner _ f e� _ ice Received - s by . ... st..... . n- mow,,... w ,t n�ia..) . .. ioxv -a am.i _ �eaa M1'X,1 s (` 4e ffomuconf realt4 of f f assar4usetts Department of Public Safety—Division of Fire Prevention 1010 COMMONWEALT11 AVE., BOSTON CERTIFICATE OF REGISTRATION North Any over, mass. 4`.-arch 13 1970 tc T .,o tmm) In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that RiILLIPS P_MOLSUh1 COMPIllVY__... __. Address 340_�tlaxn StFeet.,..1``ddAs9A...�aw.JegS.EY._. fN,,,at f,oWer of 1—all is the holder of the license gt '._ _....... . .... 19. for the lawful use of the building(s) or other structures) situated or to be situated at 12 Nassachusett@ avenue.,,..,.. (surcl end a.-..1) as related to the KEEP]NC, SIORACR, M.%NLEACfORF OR SALE OF IN f'LAMMARLES OR EXPLOSIVES. North Andover,,Yassachus Atts............._... errs r No,- I lo, t fi i of re,kurlow. n. tic i,ned by the holder of the Leenre,f said 1 joeroe yes granted prior J � July 1 1036, nJ lu the u qu,to of the food I ed. Received .. ../ � . � � 1975 PFIIiIPd �i2HUID 1PT.NY , Sot A Ar� q h Berl "' tortrai T'nr Torrn Clark 31t0 i:aun btre t Mad on Ne-7 Jer . v . .......... .. .._ .. a... .. ...__ .. ............. „,.., ��E �ammnnfnett(f1� of xssttcE�setts Department of Public Safety—D{vision of Fire Prevention 1010 COMMONIVEALTII AVE. BOSTON CERTIFICATE OF REGISTRATION In accordance with the provisions of Chapter 148, Sect. 13, of the General Laws the undersigned hereby tct> ...Tawm 191.�... Y certifies that ma�.r Pnif le to n on - Address is the holder of the license ranted t of the building(s)s) or otherS - e situate d e�LLr. I'^n�•s.. structures situated or to b 19 for the lawful use at clmed to flo,Kh FP1Rg, tiFORA4E, MAdUFALTl1RE OR SALE OF INFI AMMgREES OR EXPLOSIygS�Ue is.« a ye,r` ......... a........ City m'Townl - " rvote: Th;, een;fea«of registration moo be-isord by the bolder of the Rcense if w;d Kcenx was prior ro lol 1 wise by the owner or ore up..,..,. upant of the land liren..ed. Reamed by ....... ... -J.'il ,]�_.R I, i� r ..................... -. Inaaa.,nl n C�I�e (f0zamaninrtt(t4 of 4&ssarc usetts Department of Public Safety—Division of FSre Prevention 1o10 COMMONWEALTH AVE., BOSTON a CERTIFICATE OF REGISTRATION North Andover, Mass.............APr;l,.,19` 1967.... m,. o. To ) lout In accordance with the provisions Of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that 886. Waehineton, St..,a..�.e..dh�L.m,.-ass'--... _Petrolev.... . awparxv............ .. ..... Address ,x„m.,,r n�lae��n,�.�•o October..h..................... ...19..4.2-for the lawful use is the holder of the license granted....._... _ sr ee, ^na ^^mm.t of the building(s) or other structure(s) situated or to be situated at..12-Ma9�acbJ,l@B.tt,g....YeI1RZ......... us related to the KEEPING.STORAGE, M%NGFMTURF. OR SALE; OF INFLAMMARLF.S OR EXPLOSIVES. North..Andover,,..1`?o,"gch=PttS................... City m"n ' Ic¢nM WBB(.ant¢d d by the.holdee of the Remse if raid 1' Note: This rertificute of 1, 1,1936, must be.eby uWner or^crupant of the End licensed. poor to Julr 1 1936,oche. by J ^ ............. . , 19. . Phi,,4Ps PeStro3 Qo rti3 _ Received ...886 Washin: ..... by ... .._ on�l Town Clerk .... ..................io�,.�ni ro � Street Dedhala Alassachuset s ........� The (rams DI bralth Of cssutf Setts �I Department of Public Safety Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION North ,mover. FI pril 17. 67 . ............................................................................ 19........ ICitr ur Twnl IO.tel In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifie that .„ dokul S. L'ahi 11 ._ ...... Address St. .. .. ................ ......................................................... ethe nt censer granted iCtober 1 1962 is the holder of the license granted....._`_........._..........t........................ ....... .. ... 19 .tor the lawful use of the building(s) 12 Blass' "ve. or other structure(s) situated or to be situated at......................._................................... f8tmt and nom4rl n.related to the KEEPING, STORAGE:, MANUFACTURE OR SALE OF INFLAMMABLES OR EXPLOSIVES. ..........___.., :,gr,th.. [�nd o,y,ei)__...._.__....I........__..... 16,000 gals gus, 560 Eals :;I,Sto oil 560 gals fuel oil. Nno-: Tl.i. rertifirntr of re6iarmion moat be xianed by~the holder of the lfue if xoid lieenx wee ported prior m July 1, 1936,other.l.e by the owner or ureopem of the. land lieenxd. Received ..............................._................19........ .............................................................................................. Isla„nmal by .._......................_.................._.........._......._..... .............................................................................................. ..._.............. ........................I....... IGtue whether owner wcuuent or h,lderl ............................ (OlRlinl Tllle: .............................................................................................. (add--) l r TOMMUT nraffil Of �Massarhusetts { Department of Public Safety—Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON REGISTRATION ......1E or, ... ...�nu ov,e r.�..._.`.`Pr'.=.l...li.e.... 19...67 Cite or Tow..l Inntel This is to certify that.........Johp...S,, Bahl ll...._„ has, in accordance with the pro%isions of Chapter 118, Section 13, of the General Laws, filed with me a certificate of registration set- ting forth that..... J, Cahill is the holder of the license granted __ Cc_t,ober 1,,,, 1262. .19 .. . for the lawful use of the buildings) or other structure(s) situated or to be situated at......12.J.1.a3.. ve........_......................_._................._....................................... xr tr rind to the KEEPING,STORAGE, MANY FACTURE OR SALE OF INF'LAMMARLES OR EXPLOSIVES. 16,000 gals gas. 5bc I;Als .. ce oil 560 ^als ffir.el oil ltr,derFroura. I �.e,re xnl orteal reel N'nte: A crrtif rote of rcltistrnlion roue be filed...at before April 30th of e.eh year. (THIS REGISTRATION MUST RE CONSPICUOUSLY POSTED ON THE PREMISES.) vow, ry s,-Fes-reee, F , The (IIommOnfMalth of 49as5tteljusetts 1 Department of Public Safety—Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE 0R REGISTRATION Jo,�th Andov. r N'ase March 1z, )g 69 fit acem'es that with the provlsimis of Chapter LIH, Section 1:3, of the General Laws, the undersigned hereby certifies that '.......PN..jJ.hIYS..P,dTRCUUk;..GG11Y.AlI"............... Addresa j4� Fain Street Nadis nn New Jerse 'o"'or M1OWrc of limnsel .:.. •_...•• .. ...•............L._. ....__. 1......_......._.....Y.... is the holder of the license granted...., of the building .. - -- ..._19 for the lawful asp g(a) or other structures) situated or to be situated It l7 }_.assachusetts Avenue t J . wed gF;EI'INf„ SrONA4F. MANUFA(Tl1RF: OR SALE OF INFLAMMABLrs„ES OR F CPLOSIVFS m h.a M.assa.ehuss A a............ ...... c>;t. nav�er. 'fib o,Tnwnl Non: Thk (enif rate of rcg3tratiov mue1 be signed by th, holder of the lwv .n if 2 )P )to July b,?936, mhr. h, tL<aw xW I la granted ✓ w cupuvt f th land In 1 Received J01N .] . .LY�ONS . IsZ` '- u b TOWN CLERK P"Y'LTd'APS _F 'Qjd'Ukip.Nppq _ .__..... NO ANC lei .....3A4 ddFl StP.BCt 1 .1d?,6 Jersey.._.._.. t alex.) r � C fllummmd ball l of 4Httssarhusefls UjW n ,} - Department of Public Safety--Division of Fire Prevention 1010 COMMONWEALTH AVM:., BOSTON CERTIFICATE OF REGISTRATION ....... .. .. ...... . . 19 '... ' �� � IGb or Tm'n) 1Oatr1 In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned herebly.ce�L♦hc,S th�S ^^J -. ,u „I t .,r,� .s. . _. ,_ ...... ... Address ...... .. ...... ..... ........... ........................................................ In enl t is the holder of the licensLobaee granted .. --?.__L -,;...,,, ..................19 .for the lawful use of the building(s) or other structure(s) situated or to be situated at__,..:: ' -- ' Iso- nuat aaa „ame.rl n. related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF INFLAMMABLES OR EXPLOSIVES. ............ .Note: T6i. renif tale of registrvtiun n uet be eilfned by the holder of the licenu if said licenx w e Rranted prior to July 1, 1936.otherwise by the owner or ocenpant of the lend lirenard. Receive;SOH ........._.19.k..:.. Is,a�a,ar., by ...._.......T.Q.V [ GI E.,,l.i.......... ............_..... _._ . hIOY ANDOVER, MASS 01845 Isu�e..nrm.r a.a.r, o<raoam a.namea O)Mvl„I r�o�.l .............................................................................................. I AtlJrvssl Zlle Gmmunfnettllll of 4aassar4usslls � i � I Department of Public Safety—Division of Fire Prevention �yy 1010 COMMONWEALTH AVE., BOSTON REGISTRATION d:. -.. ..M_, ... 1 L ..................... 19... 2..' ........................ Ic", or T... (o.10 This is to certify A.;. d ........__............_..._..................has, in accordance with the provisions of Chapter 14S, Section 13, of the General Laws, filed with me a certificate of registration set ting forth that i':.-. . I L i',: t ,.- ..... ...__.......is the holder of the license granted or, the lawful use of the building(s) or other structure(s) situated or to be situated at ._. . ...... ..... ......... ............ .._........... Iso- t J�N erq a. related to the KEEPING,STORAGE, MANUFACTURE OR SALE OF.INFLWM4AHLES'OR EXPLOSIVES. .........._.._......_ .......... ..............................__............. ... (a', n nA Ofidel TWe) Note; A --boos of .e,iono,o., roust be filed on or bdNMe 4a�ii 60t1i T h (THIS REGISTRATION MUST BE CONSPICUOUSLY POSTED ON THE PREMISES.) 111.o.,a-samm The lILII1ttmmfurA4 of 4nMSSMrhusetts Department of Public Safety—Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON Y CERTIFICATE OF REGISTRATION P: 9..... n.d.auICity or..Townlxi1...54..19.s6...... 1s........ IDatd In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that John J. Cahill................................... Address ............ `..lm....'.t.........iio. udo ver I Npme of polakr of Ilcenml is the holder of the license granted...... L�tgtte.11...rI......1.Ok ......................19._.....for the lawful use of the budding(s) or other structure(s) situated or to be situated at.l7 ... v.P._..._........................ (Sower and raram ) as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF INFLAMMABLES OR EXPLOSIVES. Forth Andover 16, 000 [;als Etas-andgrnd. 560 Gals lo,r',Ta-^I waste oil 56 gals frel oil. Note: Thi, wy,ifrme of registration must be signed by the holder of the hcenne if raid license was sTatnM pri r m July 1, 1936,otherwise by the own er or lan repent of the land berated. Received -- ..-1...�r..., _ _ ISiRnataeel J'J�I Pn 1 ..... ....................I ........ ................................................ State wx.mer -or. aea+m o hold*,)tortemi Tnlrl .............................................................................................. (Add—) Cale @Tnmmazrfnrajt4 of Massar4usrIts " —Division of Fire Prevention Department of Public Safety �y lot() COMMONWEALT11 AVE., BOSTON 'rs r V11 CERTIFICA,rE OF REGISTRATION ....North .Andover..........ARF.11..24....... 19..b.5. I City or Tnw of IOevd In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that h, ilp, And.b4.er. -- . . Cah.. ... Address .�t5.....� St. John J� i.11 �N11m,Ifna n ...i QQtober_,la9.62 . .........19 for the lawful use is the holder of the license granted.... 12 L2ass !'•ve. . .. . .. - of the building(s) or other structure(s) situated or to be situated at Io- and n my AMMAHLES OR S. . relaiedm We KF.fll'IMi,STORAGE,M1NCFAl"1'UR i6,000 gals Lgas—txndgrnd 560 'V rf. E waste oil orth yndover -_ 560 Waste oil c T if aid 1 or R r m<d Note: T I i l ,vie f ¢ 'in tL gn dbrO . hld .ofn I . . offer w Job 1, 1936,,1 ,.e by the enp f the [and I� �d Received _... iva�a,nni `C i Yin .... ... by ...... .._ Cr, rd G T r r�mia i i s n u r a w . !/ 14C 19ommolthtraffil of �Hassarhu etts r� Department of Public Safety—Division of Fire Prevention 1010 COMMONWEALTH AVE., ROSTON CERTIFICATE OF REGISTRA 'CIOIN ......No.«..And.ove r...._....Apri1...9.«...1.96.419_...... felt, ,, Towvl (paml In accordance kith the provisions of Chapter 1J8, Section 13, of the General Laws, the undersigned hereby certifies that ....._.S.ohn._5.....Cabill.. .... .._ .address ..__..A&_Elm..S.t....NA....Pncb.ver. ..._.._.... is the holder of the license granted_..0.0-tOber...1_i_1962._..... ......._....____J )_ .._.for ue lawful use of the building(s) or other structure(s) situated or to be situated at__-.12..Masa-A.ve.«._.____.___.. 16r0 , a 560 11.Ie1 oil 560 waste oils'""` """ n—Iso '!'4 �I6ftU AGE, MA]'UFA(TURF OR SALE OF 19FLAMMAUEA OR EXPLOSIVES. ....._......._N anth...Andover...................._................... ]um: On. re (ifir" of regi.frn(ion moo, he eigned by the holder of fhe Ilrrn.e If-id lirenw r "grnmeJ pr/or 1« J«I, I, 1936,ofhir-i.e br the o ner nr nrenp-I of d.e I—] lire/.w'd. ./ Received .�.. .-t._.. T ._......_....19E'f.... .✓ �i(':�_ _ >' CST�.G15/�✓� .. by . . ..........._ _ .. ............. ..............._ . ......_ ........................... /] VJ ItE (ggmmanfUEalt4 of tssarfjusrtts Department of Public Safety—Division of Mre Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION 1...1.................... 19.63.. ICib m Town1 (D.) In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that .....................................d.Q.hn...d......Q"111....... Address ....v5..&:1m...S.t..y...NomttL.atla.g,overy...1&,.S s. (N.—.1 Collor of r.... 1 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......12...MFS.SS...r...A.V.R.s'................ (snre1 em o.mc<n amed to the KEEPING, STORAGE, MANUFACTURE OR SALE OF INFLAMMABLES OR EXPLOSIVES. as re,,.,,.North_.�ndoyer................................. 16,000 Gals Gasoline - 560 Fuel Oil, tmtvo Tow,) 560 'Neste Oil. Notr: This t f am of g vmion sonar he,i"ed by the holder of the I if said 1 een.e was premed p r to 1 ly 1 1936,otherwise by the owner or orrupt t of the land Urenised. Received19........ .......... ..:..::..............................'............................................. y ............. . . ' -_. a,wn<m.r owr «rua.n o. nem<n ................. fOMalel T41e1 .............................................................................................. teaar-s �C�e @Tmnmolcfuettltlt of ffittssarhusetta Department of Public Safety—Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION North fnndover. ,October 2. 19_62,. IC tv or i..w. Iva�l In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that , dakn.d....Cab11.1..........._........_......._._....... Address .....4.5..Nlsa.s.t.e._Nortb..Ando.vfx.._I asa.. w""`"f'"1a"uf October 1, 1962 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..12....Ma.SS...AA.9e............................ 16,0011 ({als ine . 60-£ule oil. 560 Niaste oil- Ism«t am aamm' relate North d to e KFF.asolPING, SI'�RAGE,MANUFA/TUR OR SALE OF INFLAMMABLES OR EXPLOSIVES. �`+ndover . .......................................................................................... I Ci,y or Town I Noe: TI t fi to of g_t t t be sisoed by the holder of the lirenx if said berate.as sramed p to 1 ly 1 1946 ,otherwiar by the owner or oxupam of the Received .. ... -i - .....19'..,,.. .... L -i.a, '?,...... .. ..�?` '.-Z � by s . w , is< n n t mia<r) �� Inam<ad' / � � �� 1 < < ti�� 1 "� / ` F `.: x f - i Z -� �, _� � � l:, ;r /� , �, � . ,° � _ :� ��` �l �� �� ,� ��, l � � ' z� ` V'�A " . � iii . � " " i � , �. .. _[ � '�,- _'_ , i � � �` � � � i � . - � . . L - ,,% �,\7 ' !, �. , , � _ . � �� r�� a �<<< � � �- � _ �-- � � { \a��L �u .�i , ��1� � � . . ,, /. y 7— � r � _ (. \; ,� ., � � LEGAL NOTICES TOWN OG NORTN 1NDOVER d f'M.mj!. �az °'Nfritie�0 a IlereM1v p n Ip°r Illq BwRde' ��wlll�holemap pub�l r1n pmlrin9p on Maneov 1Poiow °i m.r In IM1< Sele<Imen s Oglce. n BV11 n0e n Ih oppllt %rt i J. C°IIIIIr 5 Elm srom'pmerrvro�oe oia000 amionv.,p�eo m omlon5 p w le ou Vne SEO ollom 1 v oll of 1] MeffacM1Usells enue. N°rItlM1e Antl°vep Mov. W ILLIgM A. GINNERANr Chohmon RAYMOND 9ROADHEAD EREO P. OgKES ET—Snpl.e11�mu clmen TOWN OF METNVEN Of hg� 3`a b R Y 4N OF NORTH ANDOVER fie.......,,, lit 11136 yyk r'� JOHN J. Moss. Town Ctork �.MI, Deaaamt 'IYIWN "I'llj)IN : Nam Aow$... a.... September 9, D+ar Priends it is regitred by lse that you to n•r'.tflel fol.lowlrq hearing as being or.e or the +a: n' ;nlning said property Snvolvs9l %VN k .t(:ltTB A)rJi.':it'lt jep tola'�e^ lo., 196Z ' q :rios to hereby liven trxt the Board cf Se;sotl�0.1,, Tan of 4^rth andovor sill ta'' a put`.ic hearing a., 16rnj 03, ecoaing Ootober 1, 196; at ?i;0 P,k In the :Selea*,ms•� ,, C•l:cep Town Building no cue apFlloation of ;assJ+..`.L .'. h:■ Street, North Andclsrp for a Iisen r so ra •tcs :nls• - grw=d 16,00C gallons cf easollne , 560 cf Waste cf ! an, 74C gallons of fuel dnCJvor. Maas, oil at 12 Muuohll setts lever.,,:*. MILLIekt A. F?tt\�gAN, CfiGL'.MAv KAYM.) ID 6hGAMEAD IT41) P. OAA&S, Board of Seleotalerl. you Lave no obsot ion r , this aiconse being ?ranted, Will not be nocosssry for you to attend tau tearing. u'.'Ase call a or. this ol'f" r, P e at an%tdao T car. be -if any . ..'. vtan.ce to you, '. '.ery truly voure, TOWUF NORTH ANDOVER, MASSA TT91; ornc[ or BOARD OF SELECTMEN ..g01M A. FINNERAN. CMAIRMAM • I{Y y • i F RFD P. OAKES. CL[R[ •Wy(• RAYMi)ND BROADHEAD T[L[AMONE MU Z I $eptaier 16, 1962. I To all Torn Offieialst The Board of Belectmw OOrEiall, invites You to partielpau In the "por God and Oo®trf" parade I, h marokiag rich tb� in a gsorp rapreeemtlmg the toao of MrOh Asdever. Me svast will. take place 8mdgr September 23. 1962. An rt at 12t30 y tbon wi a�oeSBnoAgr to igepterber 23 d, at thcipate we asked to e I a.Bhpp parking area to Borth Andover. Ifhs PIDUP rill than proceed together to the parade location In Lr rence. Wehope all or trip of 7oa will take part 10 this seat motamorth7 eomemoration. I i Sinosnly 7e9 'er Bout at Sa "tmw _ Ylllia�. linnerwr WArtmml Ouli+w. , �VCj TOWN OF NORTH ANDOVER Ibbb WCNU9�w .IUISN J. hrury n, Town Clerk TOWN BUILDING ..•• fts A1' � o'emn Urcen[mxwmr NOx ANDOVER, VANS. September 19, 1962 Dear Friend: It is required by law that you be notified of the following hearing as being one of the said abuttors adjoining said property involved: TOWN OF NORTH ANDOVER September 19, 1962 Notice is hereby given that the Board of Selectmen, Town of North Andover will hold a public hearing on Monday evening October 1, 1962 at 7:30 P.M. , in the Selectmen' s Office, Town Building on the application of John J. Cahill 45 him Street, North Andover, for a license to store under- ground 16,000 gallons of gasoline, 560 of waste oil and 560 gallons of fuel oil at 12 Massachusetts Avenue, North Andover, Mass. WILLIAM A. FINNERAN, CHAIRKAN RAY14OND BROADHEAD EKED P. OAKLS. Board of Selectmen. If you have no objection to this license being granted, it will not be necessary for you to attend the hearing. Please call upon this office at anytime I can be of any assistance to you. Very truly yours, JOHN J. LYONS. .30 04r Tommonwrafth of- ttmarllumns DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION 1010 COMMONWEALTH AVENUE, BOSTON No. Andover Nov. 151961 (car ar Town) (n.W APPLICATION FOR LICENSE For the lawful use of the herein described building... or other structure_.., application is hereby made in accord- ance with the provisions of Cuv,ter 14,9 of the General Lams, far s lireree to use the land on which such building.... or other structure._. is/are or is/are to be situated, and only to such extent as shown on plot plan which is filed with and made a part of this application. Location of land�Massachusetts Avenue Nearest cross street 400,.,West of „Perry Street Oo'ncr of land p y Address Tidewa��+" bir.C'om an _.. 660 Madison„Ave., N,Y„ N,Y.,... - Number of buildings or other structures to which this application applies_. One Occupancy or use of such buildings Service Station Total capacity of tanks in gallons:—Aboveground - Underground 1-4000gal.2-3000gal. Bind of fluid to be stored in tanks 10,000gaI.gasoline,510 fuel oi1,510 waste Oil ,2-510ga1 TIDE/kT OIL COMPANY y. Approved . ....' �..,_.._ t _......19 1 �R.�..._ 1-..............w ... .......__._. / 660 Madison A IS , N.Y., N.Y. (stem al atre Went) (snare,+) e .-_--__.____________________________________________________________. T4P Tonnnonwralt4 of Massar4usPtts DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION 1010 COMMONWEALTH AVENUE. BOSTON No Andover Nov. 15, 1961 felt,o.Town) ID+lel LICENSE In accordance with the provisions of Chapter 148 of the General Laws, a license is hereby granted to use the land herein described for the lawful ass of the building on other structurr,.... which is/arc or is/are to be situated thereon, and as described on the plat plan filed with the applleatuan for this license. Location of land Massachusetts Avenue Nearest arose street 400_West of Perry Street Is' " ""d 660 Madison .Y., N.Y,. Owner of land .T1deWater ��� COm�8ny _.4ddre,� Ave,,a Number of buildings or other structures to which this license applies ____ One p g Service Station Occupancy or Lae of such buildm s $E - - - Tet I tapa=ity of tanks in g llueu —Aboveground _.. Underground 1-4000gal,2 3000gal. l.,nd of Onid to be stored uu tank,l0,000gal.gasollne,510 .Fuel Q1.1,-510 waste oil 2-510ga1. R"trictions—If anw __.._. __. _....._. _._... ._......._ _....... ._._. (st¢nnIs" nt uorn,;n¢ ,ntanav) THIS LICENSE OR A PHOTOSTATIC OR CERTIFIFQ COPY THEREOF MUST SE CONSPICUOUSLY POSTED IN A PROTECTED PLACE ON THE LAND FOR WHICH IT IS GRANTED n.. e.ez u.e-ss-assays ' — �hr (�mlNitaNlurttltll ni�ttssNrllusrtts DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION 1010 COMMONWEALTH AVENUE, BOSTON No. Andover _ NOV.. 5)9 61 (city or T.".1 (Due) APPLICATION FOR LICENSE For the kmrful use of the herein ih,"" d bolding or other ,slmrlere..., application is hereby roudl in .caetd- nnec n'ith the...... ions of('bemer 148 of Ibe Ceaeral Lave, for a bener to n=e the land on trhirh arch building_ or ether etruclure i./ore or is/ate Lu br sihwlrtl, anJ only to such cdent as lln"n on plot phn which is filet with sad made e part of this application. Location of land 7' MassaOhUsetts AVenUe ',,hest tress street 400 West of Per Street oemer of landTidewatbrifOft"Company Ilhes 660 Madison Ave., N.Yry N,Y, Number of builhngs rr oiber t ntdmee to whoh Ihn a tp11mation appl es. . One Oeoupunry of use of such hnildtngs Service 8b}ation - Told repacit, of tanks in gallons —,4bmvground Underground 1-4000ga1.2-3000ga1. Kind of fluid to be stored in tanks 10,000ga1.gasoline,510._fuel 0110510 waste oil -2-510ga1 T21}EYfI� OIL CONPANY .4pprot ed Illla.pfrneed J _..19 < r of ernr.m) 660 Madison A ., M.Y., N.Y. ......_... l _. (.car..., ��'���'���—�u�u���u��uu,u4.uuu�uuy�.uuu uuvr.aYuuuYa�auYUYYi4.44YY YYYt44Yi�--y._� T14r @Iml ma"Wraltil n# 141Nssttr4usrtts DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION 1070 COMMONWEALTH AVENUE, BOSTON NO. Andover Nov. 1_5, 1961 't (c;taras»•aj (pas) LICENSE In nceotdanes with the provisions of Chapter 148 of the G....el Tams, n license is hrrehy grunted to use the land LeceSn descdbed for the Inn'Ad use of the building oe other struch(re. . whch fslave insists to be situated thereon, and as described on the plot plan filed with the applientinn for this license. Location of hand NassaOhtlsette Avenue Nearest eras. asset 400 West Of Perry Street Onner of hind TidewateaYltf "Oftany .iddress 660 Madison Ave., N.Y. , N Y P wnPet F buildings on other structures ta8f Much this kmenxe a plies One _ . . .._. K P 0ccn inc or use of such buildings rvioe Station Total capacity of tanks in gallons:—Aboveground _. _...Underground 1-4000ga1.2-3000ga1. Kind of Polid to be stored in t:wks l0,000gal.gas011ne,510 fuel oi1.,510 waste oib 2-510gal, Its++trictimts—If it,: __._... _._.._ _.._... . (ligve(un of Gceneiu6 avth o.itrj THIS LICENSE OR A PHOTOSTATIC OR CERTIFIED COPY THEREOF MUST BE CONSPICUOUSLY POSTED IN A PROTECTED PLACE ON THE LAND FOR WHICH IT IS GRANTED (90mmaniaralt4 of 'Massnrhusr##s "� I ! I Department of Public Safety--Division of Fire Prevention loin COMMONWEALTH AVE, BOSTON CERTIFICATE OF REGISTRATION .:'o• nd' ove_.. .. .m. -. _... . 1rsa — Tow.m ..... muel In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned herebYnfipJ that Sz ll ......._.... Address ' �ner .............. Jo ^ . .the a uran � 1. ........far the lawful use is the holder of the license granted..__-_J:117A�'JStY--}e- 1-95J - -'-" """"' of the budding(s) or other structure(s) situated or to be situated 33 ((�� ]]�YY11ftft uunn aa rr�� 13 f OCC n el:ned m`the KFF.YIN6, 9TUnr�,l;MA A URE OR SALE OF INFLAMMABLES OR EXPLOSIVES. North tn�lo�.Ler........_......_.......... .. Taws _.._... tl'llY a No,r: "fbin een i bane of reR i ntrmlun nw.I be ni so ed by the holder of the lirenne if nail licenw w e granted r m July 1, 1936,mherwue by the owner r occupant of gybe land lueoned. prior a � l . .19......_ 1�.4`!G.L4 L t.:: ..1.... Received -:rri1...7. �.. .6.9-..-. ��rer _ �s by ............................... .. . ...._.... � owner. oeeul ent oe bolaerl w�el�e ur�mm T�a,o ..................................................... T4C (9IItllt m1iIra1t4 D f Assar4usrtts Department of Public Safety—Division of Hre Prevention 1010 COMMONWEALTH AVE., BOSTON s CERTIFICATE OF REGISTRATION ..No...Andover T:7aY......11k.r................. 1 . .... 'c" nr Town) (Dos) In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifies that ...............Sohn. .J.....Q.a..hi,ll.................... ........ Address ........4.5... lm..;i.t..................................................... IN—of hold-or Ilan-) is the holder of the license granted..........,January 5A 1Q,5j.. 19 . .for the lawful use of the building(s) or other structure(s) situated or to be situated at Cor Perry & Islaes AVI! as 10,000$ gals gas - underground Isnrn and nurl related to the KEEPING, STOR. E,MANUFA(TURF OR SALE OF INFLAMMABLES OR EXPLOSIVES. ....................N.or.th..And auw..................................... a.,nr Tnw„) Note: This rerlif rate of re,haatwn must be sifned by the holder of the liretne if said hcenx was[:ramN prior t July 1 1936otherwise by the owner or oreupan f tFri d liana Received . ........ . . .... . .H zn -ate by . . 'TnWN._C ... ...... „ .. ........................ .....N.Q...AN Lr�,'F.F...:P ,5.,. Isulo wnem.r awn.,, anaaam or hoia.n (Ofi-Lel Tltlel ................................................................................I............. I Addo—I The TQXttranufuralth of +16s2iarhuSrff'S 1�ry Department of Public Safety—Division of Fire Prevention iQ 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION ............... .. ....... 19....:... ICib n Y-1 (Dv41 In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby,, rtifies that-- ...._..�l..o-"t �. Address � ) / L. o.. . t, (( (( le. .... (6.. lQG`F. . ..... !N eo( h 11 (f m¢I ^�. � � 1v the holder of the license granted C1 LS'.t� .1...` / 19 f of the build n occ the la ul use ,y x g(s) or �tper at situated or to be situated at G.CI i�0 I�y 'feZ c,�PdT t L. Ae tc2 b�l1 ;suet lndo o,, h,led Iti be KLFPI NC. STORAGE, M4N Ii F.A(TU HE ()It SALE OF IN LAMMABLES OR EX PI.OSI VES. ................................. .. N(ol I hi, oiI i, lu 4 c alit t 1 .qoll,d by fill, hold f d I enpe Rrxnted n ...r J I 1 1936 d by d or �Jllenx Peceiv � k / 1r//I 1� e l 19bl ( � i -7 1. C ..... .. wM1ahern,� nnl a.A IJ p uad.ra TOWN OF NORTH ANDOVER f', 1833 "4CXU ` ORN J. LYONS. Town Clerk T W-N BUILDING .f Y:LNRI'ION DP.PA KI'M NN'[ No( . A3IIO VNIi. NANB. November 290 1961 Dear Friends It is required by law that you be notified of the following hearing as being one of the said abuttors adjoining said property involved: TOWN OF NOLTH ANDOVER December 1, 1961 Notice is hereby given that the Board of Selectmen, Town of North Andover will hold a public hearing on Monday Evening, December 11, 1961 at 7:30 P.M., in the Selectmen' s Office, Town Building on the application of the Tidewater Oil Company, 660 Madison Ave ., N.Y. N.Y., for a license to store underground 10,000 gallons gasoline, 510 gallons fuel oil and 510 gallons of waste oil at 12 Massachusetts Avenue, North Andover, Mass. William A. Finneran, Chairman Ralph E. Finck Philip Sutcliffe 13OAHD OF SLL1.CTlvEN If you have no objection to this license being granted, it will not be necessary for you to attend the hearing. Please call upon this office at anytime I can be of any assistance to you. Very truly yours, JOHN J. LYONS. November 29, 1961 Fear Friend: It is required by law that you be notified of the followin,: hearing:, as bean,> one of the said abuttors adjoining said property involved: TOWN OF IJOr.TH i..*JDOVLR December 1, 1961 Notice is hereby given that the board of Selectmen, Town of North Andover will hold a public hearing on Monday Lvening, December 11, 1961 at 7:30 P,'4. , in the Selectmen' s Office, Town Building on tho application of the Tidewater Oil Company 660 Madison Ave., N.Y. N.Y. , for a license to store underground 10,000 gallons gasoline, 510 gallons fuel all and 510 gallons of waste oil at 12 Massachusetts Avenue, North Andover, Mass, William A. Finneran, Chairman Ralph L. Finok Philip Sutcliffe B01.itD Ob' SEUCTMEN If you have no objection to this license being granted, it will not be necessary for you to attend the hearing. Please call upon this office at anytime I can be of any assistance to you. Very truly yours, JOAN J. LY0115. TIDEWATER OIL COMPANY 824 BOYLSTON STREET , P. O. BOX 68 CHESTNUT HILL 67, MASSACHUSETTS .ER. November 27, 1961 Town of North Andover Town Building North Andover, Massachusetts Attention: Mr. John J. Lyons Town Clerk Dear Sir: Relative to your request of November 21, we attach and forward herewith three prints of the plot plan of the proposed service station on Massachusetts Avenue adjacent to the Shawsheen River, which you requested in connection with our application previously filed with your office. Cordially yours, TIDEWATER OIL COMPANY S. C. King, N. El District COnstrue�t ia--Engineer SCY/B Attach. Th ��ffrr e �lJ,ammoIIf lralth of 0achusf#s Department of Public Safety—Division of Mre Prevention 1010 COMMONWEALTH AVE., BOSTON 10,000 gas - undergrPlE1qk-TIFICATE OF REGISTRATION N o.__.And over.'.....April.....27.,............... ICiu—Torn) loth) In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certft� hat. CAHILL ................................................................................. Address ...45 is.1m St. No. Arm oyerl .................................... . . ..................... fNnmr o1 nolaP,of licenarl is the holder of the license granted...........IsT.U.ry..5.R...1.95.'3...........................19........for the lawful use of the building(s) or other structure(s) situated or to he situated at..Cor.__Perrp..Fc,.tvlas9,_Aye.F, (Sore, and narls,0 as re].led to the KEEPING, STORAGE, MANUFAfTURE Oft SALE OF INFLAMMABLES OR EXPLOSIVES. .................. or th_. ....................................... (m ..r—) Note: This rerti l:rarn of rcR�ahm:on moat be e:Rned by the dd of th ice ee:f uid lirenw was tPwmed prior to July 1, 1936,otherwise by the a t of t n land lieeneed Received ........ k. .X ll.27.,...1955. 19........ ear..... ... .. .Id!.. ..n.. ......... . ....._.................. ... JO'HN J. LYONS 'sia la") by ..................... .................... s . ... .... . . ....... .......... ........................ NO L�NUOV ER, MAS _ Is W h.r. .. . worm. ..o.,.a, mra...,.)o.Mi..ar..q ................................................................................ lOMcirl Titlel .............................................................................................. (tddrcv) The (f untmonfuett[t4 of �ffttswr(pzsE#s Department of Public Safety—Division of Fire Prevention 1010 COMMONWEALTH AVE., BOSTON CERTIFICATE OF REGISTRATION ...N.OA..And.A..Y.Br,....M2.3s.r......Ami?§..t..l i9...`7.$ ATAI Town) (Date) In accordance with the provisions of Chapter 148, Section 13, of the General Laws, the undersigned hereby certifie tha�tt ...................JOfTti.. 1?.t...CAHILL...................._... Address E 8t ........N A. . . . . ...4�5.........dun........, ..R.:.....nd.q.Ye.F.f.............. I Nnme of Aolaer of license) is the holder of the license granted.......January,,,5.............. 19.511or the lawful use of the building(a) or other structure(a) situated or to be situated at..Co>c. P BD,y .St. k Mass Ave. (street a.a nomMr) .s re lated to the KEEPING, STORAGE, MANUFACTURE OR SALE OF INFLAMMABLES OR EXPLOSIVES. _.._..-- .No.r.tla. Andoge r.,..,Mass. ......................... 'C."ar Town I Note: I t f .te of reautr.tion must be siFned by the holder of the liernse if mid arouse was Brant elf prior to July 1, 1936,otherwise by the o 'ups t f theland 1 esso d.p J:. , `/J Received .Au ,1�t .a. .. . . 19 58 .... L:iY'>�L.�S l.... . by ..... ..... .. . Isixamrel . ... .... IOF I:' . . 45 Elm St. No. Andover, Mass. K .................................. .........................-h............................. ........p.. ......................... ................ .......... (state wM1eWer onner. aeanmt or AoMerl •.. N(koANOplenER, MASS. OWNER .............................................................................................. (Aaa.ea orn,r..r1".tia Prraeasvao i, o-- � " 1 /�V'vCvin� ry. J�f�q l�3 II4e Tanm n wrltU4 n#.El�ss�rllixs r DEPARTMENT OF PUBLIC SAFETY-DIVISION OF FIRE PREVENTION 1010 COMMONWEALTH AVENUE, BOSTON �2 (pity or Tox'o) (Dote) APPLICATION FOR LICENSE For the lawful use of the herein described building._- ur other structure.. , application is hereby made in accord- ance with the provisions of Chapter 148 of the General Laws,for a license to use the land on which such building.. . or other structure_.. is/am or Were to be situated, and only to such extent as shoal on plot plan which is Sled with and mud,a part of this application. Location of land _:`r. e . +d i`� I:Nenreat cross street } . Owner of b"ps 6 A xgbe land• n ,._,....:.: i 1 , :1" Number of buildings or other stvmtnres to which this application applies Occupancy or use of such buildings r t lid c ...� t o Total capacity of tanks in gallons. Aboveground ..... Underground 0. n Kind of fluid to be stored in tanks....... ... . . .. Approved '" .. Sj..._... ..........._.1953 ...... . ::.C......... ...._�_.� :_....'._.. (signature d Applicant) j '—._ (Need o�Firo De�O _ (Address)