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Home My WebLink AboutBuilding Permit # 12/21/2015 BUILDING PERMIT ®RYa q ®`R.tLED TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION v - Permit N® : Date Received cwus�c ' Date Issued: I RTANT: Applicant must complete all items on this page ;f L y/,L /<s r� Ip✓r"�;f..rlraY�•`%'lr�a�r� �'ri fi f r ��✓s { r f r r 5,'�r / r� ?y- rr ru.✓ yrs, -/ I✓ i/1�/,� r n ✓. r �. t r T r ra��,z,�� r� �r�� fj r s ®°k•"/r r r, r°� ./r n r l �t r'' �1 f srrt` n �L�d C��ATI®N' � '�� %;��% � ��,��f �►�£�r�"� � ��x � ,�� k,�y,,;,r �r �� rr��r {;�r6a- - ! n 2Yr'Gm? r :� r -.�:7nsr ✓ l� . �� ,i'. ~r r:r �•.� e•.-,".r.'7 tf_ a r �;,. xF..... n ,n a r �,�-•� I r� :'< � :��'` k.P,nnt&�,",rd�`,"•"' ;P: � r ,+ t r` ,rxr�rc-,;+ � r�;�/r` r-5f�c`�' ��..sr`,1 J.'ue'Jr�Y�:d'��"s r�,,�'rr arf,,,�wsr' 't"'d'' lr_,.,�,��n,�. .;. -.; �'r: ,�.�� '• -, '�% `.�� /';:,,,�.u+ ,�r;,�� ,,� S � xa f��, � �r"��''�i �6"{ '�, ,r`��.�: Ir'�� :n� rx,��.:x1,.�-✓Y��r �'S'�:x`c"- �'"Y'�sz"' <x r.�r;,� ar tier.. '��r' �'sr" �v�rrri ��k�xr-'"3' ��_ ��..=�`�. ' ..�uUxz• �.!..�,�; �".r�"un:?�.-�,�ir,'`�Y.,t'=k En �. ' s,r,fr c r Pnntr 100rYear Strucfure tr ls .yres r rR ` .�,0250, TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg Others: ❑ Demolition ❑ Other ❑ Septic ❑"Well{ ❑ Floodplain ❑Wetlands ❑ WatershedtDistnct ❑UVater/Sewer 4 ¢ F` DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Tvpe or Print Cleary OWNER: Name: i'�`r` e WL�0 Phone: �� 0� l � Address: 115-- r c�S� �� : ContractName l r Cep c Phone or 'fErn`ail � { Address ��N� ,� r��'�r�,,r�, �sh� t ��"" �� rte•?' r r ��, ��t�� r r ySupervisor's�Construcfion License !�� r ear � r Exp Date �s�HomelmproverrieritLicense � � _ _ _ _ - y_- E `x p Date ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$9000.00 OF THE TOTAL ESTIMATEDCOSTBASED ON$925.00 PER S.F. Total Project Cost: $ 3 1, ucg.- ® U FEE: $ H �� Check No.: Receipt No.: MOTE: .Persons cora reacting with unregistered contractors do not have access to the gu ar an fund Sgnature_of Agent/Owner gnat_ure afconfiractor. ! .rin 9V t4CIRTH \An.doveri own ot : _ 0 7;;SM. C, LAKE h .� very Mass, ®� J COC KICKEWICK ATE. ►4�,��(5 S U . BOARD OF HEALTH RM PE IT T L Food/Kitchen Septic System THIS CERTIFIES THAT ............................................... BUILDING INSPECTOR Foundation has permission to erect .......................... buildings on .......... . ............................... ® Rough tobe occupied as ...... .. .... ........... .. ........:'.' ........° .... ............................................................ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final At PERMIT EXPIRES IN 6 ® TS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIZ" Rough — 'Service ................................................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy BuRough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. r Federal 10008-0405829 RISE Engineering RI Contractor Registration No 8188 MA Contractor Replstration No 120979 A division of Thfelsch Englneering CT Contractor Registration No 620120 60 shawmat,Canton,MAA 02021 CONTRACT 339-502.5197 FAX 339-502-6345 Page 1 PROGRAM � � a rniro smear RnRa CMA-MS p oMOANOTaa eUBrOMERFORWORKA8 CUSTOMER PHONE OATH cagNIV VQUWz7MMr-- Patrick BatemanR10 (978)208-1582 09!27!2015 413289 00007 15 Bradstreet Road Fa od 15 Bradstreet Road N CL- North Andover,MA 018i0l W North Andover,MA 01845 Wrle. JOB DESCRIPTION AIR SEALING:Provide labor o yome against wastefid,excess air leakage. This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams and other products. Primary areas for sealing include air leakage to attics,basements,attached garages and other unheated areas(windows are not generally addressed.) This will require(8)working hours. A reduction in cubic feet per minute(cf n)of air infiltration will occur,but the actual number of of n is not guaranteed. At the completion of the weatherization work,and at no additional cost to the homeowner,a final blower door and/or combustion safety analysis will be conducted by the sub-contractor to ensure the safety of the indoor air quality. $680.00 AIR SEALING ADDER (2)working hours. $170.00 ATTIC FLAT:Provide labor and materials to install a 6"layer of R-21 Class 1 Cellulose added to(864)square feet of floored attic space. $1,537.92 ATT1C FLAT:Provide labor and materials to install a 10"layer of R-35 Class 1 Cellulose added to(196)square feet of open attic space. $288.12 SLOPES:Provide labor and materials to install a 10"layer of R-35 Class 1 Cellulose added to(128)square feet of slope area.Wherever possible,baffles will be installed to the entire length of each bay to maintain ventilation space. $249.60 ATTIC ACCESS:Provide labor and materials to insulate the back of the attic door with 2"rigid Thermax board and seal the doots edge with weatherstripping to restrict air leakage. $73.91 VENTILATION:Provide labor and materials to install(5)8"diameter roof vent(s)to increase ventilation in attic areas. The vent can be supplied in(circle color)black,brown,gmy or mill finish $427.50 VENTILATION:Provide labor and materials to install ventilation chutes in(64)rafter bays to maintain air flow. $128.00 RISE Engineering will apply all applicable,eligible incentives to this contract. You will only be billed the Net amou"L Currently,for eligible measures,Columbia Gas offers 751/o incentive,not to exceed$2,000 per calendar year,and an incentive of 100%for the Air Sealing measures up to the fust$680 and an additional$340 if savings are justified by the auditor. For the safety and health of your home's indoor air quality,we will be conducting a blower door diagnostic of the available air flow in your home both before the work is begun,and after the weatherization work is complete.We will also conduct a full assessment of the combustion safety of your heating system and water heater.This has a value of$90 and is at no cost to you. Total allowable weatherization incentive is$3,110. $90.00 r Federal ID#05-MOS29 RISE Engineering RI Contractor Registration No 8186 MA Contractor Registration No 120979 A division of ThleiseL Engineering CT Contractor Registratlon No 620120 60 Shawmat,Canton,MA 02021 CONTRACT 1 N�t 339-502-5197 FAX 339-502-6345 Page 2 PROGRAM TR18 coNTRncr to INro sETWeBN RISE CMA-HES o,°cweeneF-ow CUSTOM18L FORWORK AS Patrick Bateman (978)208-1582 09/27/2015 413289 00007 15 Bradstreet Road 15 Bradstreet Road SERVICE-CITY.STATE,N]s SUMO CITY.Mmar North Andover,MA 01845 North Andover,MA 01845 JOB DESCRIPTION Total: $3,645.08 Program Incentive: $2,840.00 Customer Total: $705.08 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Seven Hundred Five&051100 Dollars $706.06 UAID�AN0D�� AOTO MUT FdFFULL INTEREST 4ACO� O� BANCE 30DAY& RlEFOR IMPORTNT NA ONOURAN®. aHBOREC8J8GDA , DCONACMREMMTICK DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES MkhadT�27.201S) OL2Ti�iUf /� Signature: pelrick bale=n(Sep 28.2015) Email: bateman.pj@gmaii.com NOTE:TNIS CONTRACT MAY BE WITHDRAWN BY ealF NOT H)MCUIED WHIN _..._......_..-•-- sAACWWiousArm�iliE�rapc�Pr Yo FIA eA�urRAORIZEDMWO�OooT�L��w�ORK 30 oars ASSPWRW.PAYMWW IMK4WASOUTLOMAWR OWNER AUTHORIZATION FORM Patrick Bateman I, (Owner's Name) owner of the property located at 15 Bradstreet Road, North Andover, MA 01845 (Property Address) 15 Bradstreet Road, North Andover, MA 01845 (Property Address) hereby authorize (Subcontractor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. Q `ops) man(Sep 28.2018) Owner's Signature 9/28/2015 Date Tize Calillllonivealtlt of Hassadiusetts Departimertt of Industrial Accidents Of`ce Of hivestigation.5 ,e '00 r'[tslriltgton Street Boston, 1111A 02.111 }`� '_ •� ivlvlU.11tltSS.yOV�[�l[t 4 i•_ Workers' Compensation Insurance Affidavit: Builders/Contractor-s/Electrici.insf?lumbers Applicarit Information p1w-3ce i rirat I.t:aibl�- Name (Business Organization/Individual): o f�zr A, ec r ir,�Y&z'iato ey Address: P1 , Czi,-!State/Zip: -It�eQ®�t�,� 4 �yPj� Phone Q Are you an employer?Check the appropriate box: Type of project(required): am a employer with4- ❑ I am a_eeneral contractor and I employees(fitiI andior part-time).* have hired the sub-contractors b- ❑New construction 2_❑ I am a sole proprietor or partner- listed on the attached sheet_ 7. ❑ Remodeling ship and have no employees ern These sub-contractors have s_ p ❑ Demolition working for me in any capacity- employees and have Nworker57 [No.workers comp.insurance comp.insurance.= 9 ❑ Building addition required.] ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3_❑ 1 am a homeo«-ner doing all work officers have exercised their 11.17 Plumbing repairs or additions myself.[\o workers= comp- right of exemption per MGL 12_❑ Roof repairs c. 132.§1(4).and we have no insurance required.]' e13.�l Other h5_-J kl � - taipiov-ees. [\o workers- comp_insurance required.] °:Ln}•applicant that checks box;:!l mnsl also fill Out trte section helots shotcinc their workers-Compensation policy-information. 1 lorneotetters.rho sabntit this airidavit indicating they are doing all stork and then hire outside contractors must submit a nen-affidavit indicating strep >Contractors that cJnck this box nuut attached an additional sheet showine the name of the sub-contractors and state%rheilteror not tltuse entities have enTlo-vea. If tile sub-contractors have eniploYees_theg niust protide their Ntorkers'comp_policy number. 111111 an enlplor•er tbal is provkding ivorkers'coltrpetlrrrtiaa iiisctratice for nlr empkIvees Beloit,is i to police'ttiltl job site information. Insurance Company Lame: ` 1 1 tai q policy=or Self-ins.Lic. : RRi, 0 Vie— '��C� � Expiration Date_ P Job Site Address: / S^ 11 6-0,4 y l 0&s'.e- CiLN-lState!Zi P= A /9 o_ Bve d' Attach a cope of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of NIGL c. 133 can lead to the imposition of criminal penalties of a fine up to S 1.500.00 and,'or one-year imprisonment,as Well as ch°il penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator_ Be advised that a copy of this statement may be forwarded to the Office of Investigations of die DIA for insurance coverage verification. 1 do berebr eert#y untler the pains and penalties of perjta_r•tenet Me i1tfO171taM711 Protillerl above is true lutd correct 9 Signature: 1 � -� Date' Phone Dfflcial use Oull: Do)Apt "Fite ill this orett,lO be collipleted Gr city or talent of-eial. Cit}'or Town: Permit/License m Issuing Authority(circle one): I_ Board of Health ?- Building Department 3_City/Tou-n Clerk 4. Electrical Inspector i. PIutnbing Inspector G. Other Contact Person: Phone�: I i i p 1111E WAIDD:YYYY) CER- FICA T E OF LIAG IL I INSURANCE lznsrzol4 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOTAFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETTNEEN THE ISSUING INSURER(S),AUTHORIZED 1 REPRESENTATIVE OR PRODUCER,ANDTHE CERTIFICATE HOLDER. IMPORTANT:Ifihe certificate holder is an ADDITIONAL INSURED,the policy(tes)must be endorsed.If SUBROGATION 15 WAIVED.Subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu ofsuchendorsement(s). PRODUCER LON IAL 1 NMIE: Automatic Data Processing Insurance Agency.Inc- (A.C.Na Ex0r Int nbx 1 1 Adp Boulevard A�RESS: 1 Roseland,NJ 07068 NSURER(S)AFFOROBiGCOVERAGE w5URER A: NorGUARD Insurance Company 31470 ENSURED POLAR BEAR INSULATION CO INC ENsuRER B: DBA:Polar Bear Insulation CO Inc ENSURER C: PO BOX 958 ENSURER D: Andover,MA 01810 ENSURER E LN5URER F: COVERAGES CERTIFICATE NUMBER: 291629 REVISION NUNIBER: THIS 15 TO CERTIFY TFIAT THE POLICIES OF INSURANCE LISTED BELOK HAVE BEEN 155 UED TO THE INS UREDNA\SED ABOVE FOR THE POLICY PERtOD I140ICAT'eED_NOTWITHSTANDING ANY'it EQUIREA;ENT.TERIM OR CONDITION 0r ANY CONTRACT OR OTHER DOCU\SENT KITH RESPECT TO WHICH THIS i CERTIFICATE\.AY BE ISSUED OR%SAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJ ECTTO ALL THE.TERMS, I EXCLUSIONS AND C014DMO.,45 OF SUCH POLICIES.LUMITS SHOWN'MAY HAVE BEEN REDUCED BY PAID CLAMS. I UP LTR TYPE OF INS URANCE 0151)tm POLICY NUMBER (MALODrYYYY) C-L D�Yy") LLitITS COAIAIERCILLGENEnALLIASt1ny EACHOCCURRENCE 5 CL,W.IS-t.IADE [--I OCCUR PR£r.1iSE5 rtspctwwM0 S DIED ESP binv--• p,,.w S PERSONAL B ADa R:1 UItY GEAt AGGREGATE LILIIT V'1'UE5 PER- GENERALACCREGATE i'OLICV❑iECT F--]LOC PRODUCTS_CO(.IP.OP AG6 S i O i E$(t L AIBRtEUN' V.II S AUIORz)BLLELIAe11rrY IEa atUdEUU i NV AUTO BODILY INJUIt1'11",WISCO S ; ,LLL 0, ,ED SCHEDULED ECDILT IK/DRY(Ptr_uidercr S AUTOS AUTOS HIRED'UT05 t:Oh-0"'FL) t{'er atOdrrtl i AUTOS S I f UAHRELLALIAM EACH OCCURRENCE CCUR O EXCESS LlAtI CV\V.t5�U1DE AGGREGATE S DED RETENTION S _ tt'ORtiERS COsl1'Ets'"ON ST,ITUTE ERfi MO EMPLOYER S'LLIBILTTy YIN EL EACH ACUDEt.T i 1,ODO,000 A O F CEIOt!c�Iti4Eit EXCL DED- imE �!r+A N POIVC650990 01,91(2015 01012016 1,000,000 01.1dstory•in Mr) EL.DISEASE-EA EAII'LOYEE S Il yea.destnlY under EL_DIS E,LE-POUCI'URIIT S 1,000,OOD C SCItIPTIONOF 01'EIO\TIONS Ltiu.•: OEscRIPt10.V OF OPERATIONS?LOCATIONS?VEHICLES(ACORD IDL Ad&tl.J Remalu Sdredute.may Fxatuched amorea Wce Columbia Gas massachusetts 1 ) CERTIFICATE HOLDER I ANCELLA701Q SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO14 DATE THEREOF, NOTICE WILL BE DELIVERED IN ' Theilsch Engineering,Inc. ACCORDANCE WiTHTHE POLICY PROVISIONS_ 195 Frances Ave Cranston,RI 02910 AUTHORIZEDREPRE5ENTAT(VE ; s �All reserved. j ACORD 25(2014,01) The ACORD name and logo are registered marks of ACORD OP 1®:SS �� _ DAZE(PdMlDD/YYY'n CERTIFICATE ®F LIABILITY INSURANCE 03I1�iD15 'THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THUS CERTIFICATE DOES NOT AFFIRMATNELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BV THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT DETYWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an AUDITIONAL INSURED,the p 1 ((es)must be endorsed. If SUWO IS WAIVED,subject to the terms and conditions of the policy,caMin policies may require an endorsement A statement on this cs.,r'tiflcate does not confer eights to the eertiticate holder in lieu of such endorsement(s). CONTAcs PRODUCER NAME: Durso((e Jankowski ins Agcy LLC PHONE SAX Nu 195 Massachusetts Avenue Arc No EsI North Andover,MA 09895 AosDRESS' Durso tie Jankowski ins.Agcy. CUOD AER IO S!P®��'1 INSURERS)AFFORDING COVERAGE NAIL 8 INsuRED Polar Hear Insulation Co.➢nc. INSURER A:Penn America 32859 P®Box 958 INSURER 13:safety Insurance Co. 33618 Andover,MA 01810 INsuRER c: INSURER D: INSURER E INSURER F. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER* THIS IS TO CERTIFY THAT THE POLICIES bF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ASOvE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOVn MAY HAVE BEEN REDUCED BY PAID CLAIMS. rdur'M INSSR TYPEOFINSURANCE PouavNUMBER 96PWDDCYEFF FOU MMWVV P L6STeS LTRGENERALLI BILM' EACH OCCURRENCE $ 1,0001800 A COMMERCIAL GENERAL LIABILITY PAC7052023 03/2412015 03/24/201en 6 AREMISEs Ea accurtce S 50'000 CLAIMS-MADE 1g OCCUR MED EXP(Anyone PerSOM S 5,000 PERSONAL SADVINJURY S 1,000,000 GENERALAGGREGATE S 2,000,000 GENLAGGREGATE UM(TAPPLIES PER: PRODUCTS-COMPIOPAGG S 1,000,000 POLICY PRC LOC $ AUTOMOBR.ELIABILnY COMBINED SINGLE WIT S '1,(}00,000 2100925 01/04/2015 01/04/2016 (EaeWdenl) t$ ANYAUTO BODILYINJURY(par Person) $ ALLOWNEDAUTOS BODILY INJURY(per aaidenl) $ 1� SCHEDULED AUTOS PROPERTY DAMAGE S �C HIRED AUTOS (PERACCIDENT) NON-OWNEDAUTOS 5 5 UMBRELA[IAB ZI OCCUR EACH OCCURRENCE 5 1,000,000 EXCESS LIAB CLAIMS4,IADE PAC590&W5 03/24/2015 03/24/2016 AGGREGATE S A DEDUCTIBLE $ RETENTION S _ S 4VOA{:ERSCOPAPENSATION TORVUA11 EH ANDEMPLOVERS'LIABILTN ANY PROPRIEfORIPARTNERIEXECUTIVEY�N E.LEACHACCIDENT S OFFICER(MEMBEREXCLUDED? ❑ MIA (Mandatory In NH) E.L DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OFOPERATIONS WWI EL DISEASE-POUCY UMIT S DESCRI PTIONOFOPERAT(ONSILOCAM014S/VEHICLES(AUnchACORDIOI.Additiorm]Remwil,sSchedula,Ifmom opacoiarequlmd) Insulation Work-Mineral;Additional insured for general liability Int hh i red eats to World performed on their behalf by the above insured is N elsch En sneering CERTIFICATE HOLDER CANCELLATION THIELS2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3b31L'IS6111=n iri2erin THE EXPIFIRWILL T(ON DATE THEREOF, NOTICE LL BE DELIVERED IN g ACCORDANCE WITH THE POLICY PROVISIONS. Columbia Gas 195 Francis Ave AUTHORIZED REPRESENTATIVE Cranston,RI 02910 41611L (0 1988-2009 AC®R®c®RP®t$ATION. Ali rights reserved. ACORD 25(2009/09) The AC®RD nape and logo are registered m2111 s of AGORD and u5]11esS Regulation Office of Consumer pffalrs Suite 5170 10 Park Plaza- Boston,Massachusetts 07-"' Registanon Plome improvement Contractor Regislta8on- 102726 Type. DBA TO 2=49 Explrat+on, 712/2016 POLAR BEAR.4NSULAT'ON Co. VincentLeBlanc = P.Q. BOX 958 1�,�® _ mark reason for change. ANpOVER, MA 0 update Address and return card- p Lost card p ddress U Renewal _ OPS-CAY €3r SfiM04tt1A-G1012t6 t 4aas. s zds rdarcl- 'Ise:GvSSL=406017 PETER A LEBLANC 2 EAST PM STREET Plaistow NFL 03865 0412812048