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Building Permit #441-11 - 1820 TURNPIKE STREET 11/23/2010
TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit Date Received /`/�f//0 fl- Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION S ' O /Y 3 O Iy C'nZ J t e S Print PROPERTY OWNER h iJa I Z c^ �- L Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ew Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: U-Coo"mmercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ®..Septrc Well FD Floodplain Wetland"s _ Water"slied�Distnct . - DESCRIPTION OF WORK TO BE PERFORMED: o C' a,3- e-v► t o Identification Please Type or Print Clearly) OWNER: Name: C% C'o {o 2c�d. I �ri�a Phone: Address: `39-5 Y- M u l e,' �'�, M a l o( 1 e7�P-7 , M✓q o 19 y Uh r � CONTRACTOR Name: '7 f�7.V�C r'�d Ed t ra, Phone: 27S-777- 8a,97 Address:- 7t" I•l. c).I✓I S 7LUri ,� $ ���J�fo� , /� ev 9 Y 9 Supervisor's Construction License: 5 1 7 9 3 5 Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER R- ,� �e e YY)O � Phone: 7S-"3-71 " 11�l Address: r7 (il/`u. �y� e�S+ C��C��r� , �/� 0/7y2Reg. No. 6>0 Q- FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. { Total Project Cost: $ f� 67/ � �0• �o FEE: $ 2 O l� �� CSO Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have a ess to the uar fund Signaturekof Agent/Qwner :, Signature,ofcontraeto Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ I THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ///w3 40 COMMENTS k;K21116j CONSERVATION Reviewed on I Si nature oeiCOMMENTS / 9q� �� �M . 12,x-4, (1) Va , nature HEALTH Reviewed on Si g COMMENTS wed a) �Mtg ADT J - Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town'Enghleer: Signature:' Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS I I Dimension Number of Stories:_Total square feet of floor area, based on Exterior dimensions.IY,4/I Total land area, sq. ft.: esu Y 7 ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No 4 DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA— For department use Ooll Cox o/i I i I Notified for pickup - Date Doc:.Building Permit Revised 2008 r II Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses } ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work I ❑ Engineering Affidavits for Engineered products r NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks k ❑ Building Permit Application ' ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire q g Department prior to issuance of Bldg Permit New Construction (Single and Two Family) i Y) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire prior Department p p r to Issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doe: Doc.Building Permit Revised 2008mi Location -f�f�D I42MA s� No. Date f TOWN OF NORTH ANDOVER o�.... ,•rya 1of �o Certificate of Occupancy $ U too Building/Frame Permit Fee $ MU Foundation Permit Fee $ y Other Permit Fee $ TOTAL $ ( s Check # 23764 Building Inspector ORT#q 1 T0VM of And 0 LAK O dover, Nlass., , COCHICHEWICK �d AQRATED P' �� `S tJ BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System Q�- I �ABUILDING INSPECTOR THIS CERTIFIES THAT...- r (/�.�:. ...P.1220 .................N.Q 2 !!!.�'S N�.l�....1.,� Foundation has permission to erect.................:...................... buildings on ..1. v.....17 AJ ..........P1.. ... .... ..... ............. Rough to be occupied as.. v..1. .Q. ..... .).. ........10/40......... �o,l�.......k,44W�... ... G !G Chimney ........... ...'►. provided that the person accepting this permit shall in every respect conform to the terms of the applicatiod on file in Final 1 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 I VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final ap S^ PERMIT EXPIRES IN ONTHS d � UNLESS CONSTRU ELECTRICAL INSPECTOR O S TS Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Ocmpy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. 3 M.E.A. Engineering Associates Inc. Consulting Mechanical Engineers 20 Felton Street, Waltham, MA 02453 781/894-6730 FAX 781/647-3542 Document Ref. No.: Stonewall NorthAndoverMA office.doc November 16, 2010 Fire Prevention Office City of North Andover Fire Prevention Department 124 Main Street North Andover, MA 01845 Attention: Fire prevention officer. Reference: Fire Alarm and Sprinkler Narrative Ilse Floor Tenant Fit Up for Spectrum Senior day care center Stonewall Plaza 1820 Turnpike St. North Andover MA Dear Fire Prevention Officer: (1.a) BASIS(METHODOLOGY) OF DESIGN Section 1—Building Description a) Building "Use" group: 1-4 b) Total footage of building: 38,430 c) Building height: d) Number of floors above grade:) 3 e) Number of floors below grade: 1 f) 1St floor tenant square area: 4,700 g) Access type of occupancies within the building: i-4 h) Type(s) of construction:2C Unprotected with and automatic sprinkler system i) Hazardous material usage and storage: none j) High storage of commodities within the building: none 1 M.E.A. Engineering Associates Inc. `� Consulting Mechanical Engineers 20 Felton Street, Waltham, MA 02453 781/894-6730 FAX 781/647-3542 CONSTRUCTION CONTROL AFFIDAVIT START OF PROJECT PROJECT TITLE: Tenant Fit Up Spectrum Senior da care PROJECT LOCATION: 1820 Turnpike Street North Andover MA NAME OF BUILDING: Stone Wall Plaza North Andover MA In accordance with Section 116 of the Massachusetts Building Code,I,Alfred E.Muccini,Registration No. 23539,hereby certify that I am a Registered Professional Engineer. I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: ENTIRE PROJECT ARCHITECTURAL STRUCTURAL ✓ FIRE PROTECTION I/ ELECTRICAL ✓ MECHANICAL ✓ OTHER(SPECIFY) PLUMBING I/ FIRE ALARM for the above named project, and that, to the best of my knowledge, such plans, computations, and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptabld engineering practices and all applicable laws and ordinances for the proposed use and occupancy. I shall perform the necessary professional services and be present on the construction site in accordance with my contract with the owner to determine that the work is proceeding in accordance with the documents approved for the building permit,and I shall be responsible for the following: 1. Review of shop drawings, samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Special engineering professional inspection if critical construction components requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix B. 4. Periodic progress report with comments to the Building Inspector. UPON CO .i FTION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATIP t4IPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. ti LF E. 111JUCCI to.23538 a Signature Subscribed rn t re me this day of�/�`1�� Y1��`p� 20 /0 LAURA K CANNON /6 / Notary Public co11411woN 7H of sion Expires My Cwaftssion Eg*n JUNAVY 18,2015 i � . BUILDING PERMIT ° "°oT" �+ti TOWN OF NORTH ANDOVER F? °� \ APPLICATION FOR PLAN EXAMINATION Permit NO: �`" Date Received 0' `"'�•`•�• '� / �SSACHU Date Issued: IMPORTAiiNT Applicant must complete all items on this age a 'P >7l_ ' �p ::un, ✓aa+J..§t< '� '..r� } �,�r+ p T�1+N�� �r d4� „ tt :"'b �J s' ,�y k TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ew Building One family Addition Two or more family Industrial Alteration No. of units: i�ommercial Repair, replacement Assessory Bldg Others: Demolition Other �* '`���� `-r'a{1 1• �. 1 1d� i. S.ti ]Y� UI+�J � rr`` + #;��r(��(pp771y�y�,,��a�+�, y.``l!w��''��y `��µµ t" y. DESCRIPTION OF WORK TO BE PREFORMED: o a7 a h ISS o ,-► =-N-'y c'Gi vi C e cti-, c e Identification Please Type or not Clearly) OWNER: Name: C-. E;25 � A e rot , Phone: 617— ,f-7.7 `-19( 3 Address: Z5; ct i rl t -�0r1 om I/ (JnI t`4t7-. S�c� w ./y'y/y/�r�,__ ,,r��t� ,��rrjj:-fi�nn t --ic ��'; �/ .,�_*V f� ,4,�'� y�� �4�A #. +� J• T i+�;.� ,' �,��,��� a h .. � e��r�a ✓ :telaoerre: „� ;r _. , `Dat e�� ARCHITECT/ENGINEER V,gmoL5"o S4r,l _k,��',/q�,0SIA hone:_ V/ X9.22 Address: Z TAM\ d MIn 122, M 01701 Reg. No. C9 �?i FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ONNIV Y. , -7-) 2 b� Total Project Cost: $ 9- e (9 0 0,00 FEE: $ Check No.: �� 2 Receipt No.: Y �� NOTE: Persons contracting with unr 'stered contractors do not have acc ss to the guar ty fund 5igture of Agr� lOw er: re oontracto f + -• Plans Submitted Plans Waived Certified Plot Plan Stamped Plans A TYPE OF SEWERAGE DISPOSAL Public Sewer ✓ Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street m��, �r� F!%4► �� � ����p�i`el �^, ���� �n�n {.' G A� �.a �'����b.laN- �u.�x��� aS.rNn�h `'�{r .3{ twa F�,�`1i*n `S P M us h { Fy-t1 kF "h ✓ k 11�1 'I� C f 'L..r ,/y� . ME � Al Location No. �—� I Date t �� E �pRTh TOWN OF NORTH ANDOVER O'4 .•0 :•1�0 Certificate of Occupancy $ / b - ;� roe Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ - TOTAL $ Check # 23628 Buil g Inspector S. Bud Holden Director,Off Site Campus Fan iries I , Northeast Hospitals 298 Washington Street,Gloucester,Massachusetts 01930 i Ph: 978-283-4000 es:242 �l celk 978-375-2928 I A 978-491-6584 eholden@nhs-healthlink.org I a CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number^ 366-2011 Date: April 6, 2011 THIS CERTIFIES THAT THE BUILDING LOCATED ON 1820 unit #207, Turnpike Street, North Andover, MA 01845 Robert J. Swajian & Associates, Insurance office MAY BE OCCUPIED AS :insurance.office IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to. Stonewidl Plaza,ITC 1820.1830 Turnpike Street ` North Andover,MA 01845 Bui ding Inspector Fee: 100.00 Previously Paid Receipt: 23628 NORTH TO" of No. 0. In LAKE -0 dover, Mass.,l • 2' � y COCMICMEWICK �S RATED BOARD OF HEALTH Food/Kitchen .PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT � n.( . � .�ir /�..: Q ............ ........ Foundation has permission to erect.... ..... buildings on .1.I-=..TV V0140.0.. ......Sr............... Rough ' 4 to be occupied as............. .� .��!!!1r. .....fes.. ...,/ .........' .... �!`� ... �.ah....� .! Mt.. 1 imney provided that the person ccepting this permit shall in every espect conform to the ten�Rs of the application on file inina this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of 6 Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Fin - .d PERMIT EXPIRES IN 6 MO S / ELECTRICAL INSPECT R UNLESS CONSTRUC O ST T oug Service ................... :........................................BUILDING INSPECTOR � y. Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove ire ©� /��� ��___ No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner, Street No. SEE REVERSE SIDE Smoke Det. 3- 36— i GP ASSOCIATES. Inc Consulting Engineers Mr. Gerald Brown Inspector of Buildings 1600, Osgood street No.Andover, Ma Reg: 1820, Turnpike Street, Unit- 207 11-16-2010 Metal Stud work-100%complete. Wall Insulation complete. Electrical Rough work started. Work conforms to the Code& is acceptable. O Ra Satyaprasard,P. " Al X, YqPasrRyu9G RASAD cn M -:p NO.28o96 �~ 9r S, TER `1\,0NAL EN I 29 Cresthaven Drive Burlin on Ma 01803 T 1 1- - gt e . 78 572 2768 E mail: run4am@comcast.net In GP ASSOCIATES. c Consulting Engineers ineers Mr. Gerald Brown Inspector of Buildings 1600, Osgood street No.Andover,Ma Reg: 1820, Turnpike Street,Unit-207 12-07-2010 Metal Stud work,-100%complete. Wall Insulation complete. Electrical Rough work complete. Rough Plumbing--Complete Woorms to the Mass Building Code & is acceptable. /=74ar4asa ,P. �F 4 41AMASASTRY G SATYAPRASAD rn ti No 28096 O /S T O" ss/ON&ENG i I ii I 29, Cresthaven Drive,Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net GP ASSOCIATES. Inc Consulting Engineers Mr. Gerald Brown. 2-10-2011 Inspector of Buildings No. Andover, MA Reg :1820, Turnpike Street, Suite 207 PROGRESS ; Drywall-100% Complete 14VAC-90% Complete Electrical-90 %Complete Plumbing 90 % Complete All work is satisfactory &is acceptable. am S a rasad �F ��s� t3' p RAMASASTRY �yG > SATYAPRASAD m y ND.280% FFss�ONAL I 29, Cresthaven Drive,Burlington,Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net GP ASSOCIATES. Inc Consulting Engineers Mr. Gerald Brown. Dt; Mar.31,2011 Inspector of Biildings 1600, Osgood Street. No. Andover,Ma 01845 Reg : 1820, Turnpike Street.No.Andover,Suite207 Final Report. The fit up work is complete.The completed work meets the requirements of the Massachusetts Building code. The Elevator&Fire alaram systems have been inspected & accepted by responsible authorities. The completed work includes all the Plumbing and HVAC work. If you have any questions,Pl. contact our office. Sincerely. D Satyaprasad H of M �9 RAMASASTRY �y SATY4PRASAD cn No.28096 - F O Q'S TE�k �Ss��NAL 29, Cresthaven Drive,Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net NORTiy T0VM of r O ti.:w Z. 411 No. 3�,G - Zo --- }�, �, dower, Mass*,l�' Y O t- LAKE COCHICHEIVIC11 DRA rE D "?�\��� BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System Q BUILDING INSPECTOR THIS CERTIFIES THAT i,,7�nC4 .� ........pta.jm..:. .. Q ............... .. ............ .... ................................... Foundation has permission to erect........................................ buildings on if-z ..Tv&.M10j.4,00....:S ............... Rough • r to be occu ied as............. . �I!!!1!..[........ ........ ... .� ...S �!`� ... �.ah.... Chimney provided that the arson cce g this permit shall in every Tespect conform to the to s of the application on file in Final P P this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations"Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MO S ELECTRICAL INSPECTOR UNLESS CONSTRUC O ST T Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Dimension Number of Stories:_Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: �y ELECTRICAL. Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department , The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application o Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan a Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All. dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2008 r AC.OAD -- CERTIFICATE OF LIABILITY INSURANCE OP ID CA °ATE(MM/°DIYYYY) C;PXCO-1 06/14110 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dadgar Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 400 Neat Cummings Park HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Suite 6725 ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW, Woburn MA 01801 Phone:781-933-2626 FaX:781-932-6341 INSURERS AFFORDING COVERAGE NAIC9 INSURED — �— INSURER A: polyol* INtual Ina co In salon 14206 INSURER B: QFFaM Contracting ng INSURER C: Middleton MainKA at, Unit 15B INSURER O: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMENT,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.AGGREGATE LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. LTR INSRIO TYPE:OF INSURANCE POLICY NUMBER DATE I DATE rYY VLIWTS OENERALLIABILITY EACH OCCURRENCE S1000000 A X COMMERCIAL GENERAL LIABILITY CPP7017804 01/01/10 01/01/11 PREMISE$(Ee000urcn2p i 100001) --J CL AIMS MADE rX'7 OCCUR MED EXP(Any one oMon) S5000 ` PERSONAL&ADV INJURY $ 1000000 GENERAL AGGREGATE $2000000 GEMLAGGREGATE LIIMIITAPPLIES PER: PRODUCTS-COMP/OPAGG 52000000 POLICY JppECT El LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 A _ ANY AUTO CA9012129 01/01/10 01/01/11 (Ea accident) l– ALL OWNED AUTOS BODe,Y INJURY f X SCHEDULED AUTOS (Per pySon) X HIRED AUTOS BODILY INJURY f X NON-OWNEO AUTOS (Per accident) --- PROPERTY DAMAGE E (Pal acudent) GARAGE LIABILITY AUTO ONLY-EAACCIOENT S ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG S EXCESSIUMBRELLALIABILITY EACH OCCURRENCE S 1000000 A OCCUR CLAIMSMADE CU0006054185 01/01/10 01/01/11 AGGREGATE S1000000 f OEDVCT18LF. f . X 'RETENTION $10000 S WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS'UABIUTY ANY PROPRIETOR/PARTNERAXECUTrvE E.L.EACH ACCIDENT S OCFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ IK yeS.AL PROVISIONS E.L.DISEASE•POLICY LIMIT 5 SPECIAL PROVISIONS belov+ OTHER A Property Section CPP7017004 01/01/09 01/01/10 Contents 10404 A Equipment Floate CPP7017004 01/01/09 01/01/10 Deductibl 500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS COPTRACTOR FAX 781-944-2609 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION r DATE THEREOF,THE ISSUING WWRER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Xx=xXXXXxxxxxxxxxxxxxxxxxxxx NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 50 SMALL x)=xxxxxxxxx3= X IMPOW NO 09UOATION OR LIABILITY OF ANY KIND UPON TME INSURER,ITS AGE14TS OR XxlumxxxxxXxxxxxxxxxxxxxxxxxxx REPRESENTATIVES. A RED RE ATIVE ACORO 2S(2001/08) 0 ACORD CORPORATION 1908 M.E.A. Engineering Associates Inc . Consulting Mechanical Engineers 7 20 Felton Street, Waltham, MA 02453 781/894-6730 FAX 7B1/647-3542 CONSTRUCTION CONTROL AFFIDAVIT START OF PROJECT PROJECT TITLE: 2nd floor Tenant Fit Uv office PROJECT LOCATION: 1820 Turnpike Street North Andover MA NAME OF BUILDING: Stone Wall Plaza North Andover MA In accordance with Section 116 of the Massachusetts Building Code,I,Alfred E.Muccini,Registration No. 23539, hereby certify that I am a Registered Professional Engineer. I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: ENTIRE PROJECT ARCHITECTURAL STRUCTURAL MECHANICAL ✓ FIRE PROTECTION ✓ ELECTRICAL ✓ OTHER(SPECIFY) PLUMBING ✓ FIRE ALARM ✓ . for the above named project, and that, to the best of my knowledge, such plans, computations, and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws and ordinances for the proposed use and occupancy- I shall perforin the necessary professional services and be present on the construction site in accordance with my contract with the owner to determine that the work is proceeding in accordance with the documents approved for the building permit, and I shall be responsible for the-following: 1. Review of shop drawings, samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit and approvah for conformance to the design concept. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Special engineering professional inspection if critical construction components requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix B. 4. Periodic progress report with comments to the Building Inspector. UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. ign f4 t. Subscribed an "'to>before- e Phis day of �( 20�� LAURA U.CANNON 6 Notary Public ommis ion E-pires My Gomn�s�ian'E�irrs ' 18,2015 ' M. E.A. Engineering Associates Inc . Consulting Mechanical Engineers 20 Felton Street, Waltham, MA 02453 781/894-6730 FAX 781/647-3542 Document Ref. No.: Stonewall NorthAndoverMA office.doc October 20, 2010 Fire Prevention Office City of North Andover Fire Prevention Department 124 Main Street North Andover, MA 01845 Attention: Fire prevention officer. Reference: Fire Alarm and Sprinkler N 2nd Narrative 2 Floor Tenant Fit Up for office at Stonewall Plaza 1820 Turnpike St. North Andover MA Dear Fire Prevention Officer: 0.a) BASIS (METHODOLOGV9 OF DESIGN Section 1—Building Description a) Building "Use" group: B b) Total footage of building: 38,430 c) Building height: - d) Number of floors above grade:) 3 e) , Number of floors below grade: 1 f) 2nd floor tenant square area: 6,007 g) Access type of occupancies within the building: B h) Type(s) of construction:2C Unprotected with and automatic sprinkler system i) Hazardous material usage and storage: none j) High storage of commodities within the building: none 1 I i I I k) Site access arrangement for emergency vehicles is through: Front access Type Section 2—Applicable Laws, Regulations and Standards The following is a list of reference standards that shall be used in system design, operation and maintenance. a) M.B.0 780 CMR 6th edition.). b) N.F.P.A. 13 (2007 Edition) c) 527 CMR 12.0, the Mass Electric Code 2005, N.F.P.A. 70 with Mass. Amendments. d) N.F.P.A. 72 2002 Edition e) ADA strobe meeting code reference 780 CMR N.F.P.A. 72-2002, and 521 CMR. The Massachusetts Architectural Access Code. f) Authority Having Jurisdiction — City of North Andover Section 3—Design Responsibility for Fire Protection Systems MEA Engineering associates; Inc. is responsible for 2nd level only. The Fire alarm contractor shall submit complete information regarding the fire alarm notifications devices shop drawing to the engineer for approval. The Sprinkler Contractor shall submit and shop drawings and proposed sprinkler equipment to the engineer for approval. The contractor will submit all approved shop drawings and product information to the North Andover Fire Department for approval. Section 4—Fire Protection Systems to be installed The proposed new work is summarized as follows: A. Sprinklers 1. New sprinkler heads shall be utilized in all locations. (Quick response type. sprinkler heads to be installed with an ordinary temperature rating.) Stonewall North Andover office.doc 2. New seismic support for new sprinkler piping. 3. Sprinklers shall connect to existing zone flow station currently serving space. The existing sprinkler grid shall be reused and modified for new floor plan. 4. Existing sprinkler service is provided with a backflow preventer. 5. Existing system serving adjacent floor shall be kept live. B. Fire Alarm System 1. The proposed second floor tenant fit up shall tie the proposed power booster supply to existing landlord building main fire alarm control panel. 2. Smoke detectors located in electrical, telephone equipment room. and similar rooms and are provided throughout as required per code. Audible alarms in common areas shall be sized to insure maximum sound levels throughout the tenant space. 3. The existing Fire alarm system shall be activated thru new manual pull stations, and common area smoke detectors. 4. The new Notifications fire alarm devices shall meet N.F.P.A. 72, 2002 ADA and local Fire Department requirements. 5. Manual pull station shall be located at exits, ADA strobes shall be in the public common areas and horn/strobes shall be in accordance with N.F.P.A. 72 2002. 6. Rooftop unit over 2000 CFM shall be equipment with duct smoke detector _ linked to fire alarm system 7. Common areas shall contain system smoke detectors wire to F.A.C.P Section 5—Features used in the Design Methodology A. Basis Of Design New portions of the sprinkler piping have been designed using the pipe schedule method for Light Hazard occupancies. I Stonewall North Andover office.doc I B. Sequence Of Operation Upon actuation of a sprinkler head (designed to release at 155°F) water shall start to discharge from the sprinkler head and water flow switch shall signal a water flow condition to the fire alarm panel. C. Testing Criteria Sprinkler System The new piping and heads shall be tested in accordance with all applicable codes. At a minimum this shall include notifying the. Building Inspector and Engineer of Record of the time and date testing will be performed, completion of the contractor's material and test certificate (N.F.P.A. 13, Figures 8-1a and 8-1 b). The system shall be hydrostatically tested in accordance with N.F.P.A. 13 Section 8-2.2.1 "hydrostatically tested at 200 PSI and shall maintain that pressure without loss for two (2) hours." (1.b) SEQUENCE OF OPERATION Section 1 1. The operation of a manual station or activation of any automatic alarm initiating device (system smoke, system heat detector) shall initiate a system- wide response as follows: a. Initiate the transmission of the alarm to master box and central station. b. Sound a code 3 temporal evacuation signal over all audio circuits and shall be in sync. c. Flash all visual signals throughout the building. Visual notification shall be synchronous in accordance with NFPA 72 guidelines. Synchronization shall be system-wide, and shall be subject to the N.F.P.A. 72 2002 edition adopted as Massachusetts code. The failure of one visual NAC shall not cause a failure of other NACs serving the same evacuation zone. 2. The operation of any activation of other device designated to initiate a system Supervisory condition'shall cause the following to occur: a. Duct smoke detectors shall be installed in accordance with manufacturer spec's NFPA72 and NFPA90 they shall be resettable at the fire alarm control or other location approved by the local fire department. Remote duct smoke indicators shut down latching supervisory signals for all remote duct smoke indicators shall report to a central supervising station. The station shall notify the building owner. Stonewall North Andover office.doc (1.c) TESTING CRITERIA Section 1— Testing Criteria A. The fire alarm system shall be completely tested in accordance with N.F.P.A.-72 by the Contractor when the tenant renovation is complete in the presence of the Owner. Upon completion of a successful test, the Contractor shall so certify in writing to the Owner and General Contractor. Section 2— Equipment and Tools A. The complete fire alarm system shall be installed in accordance with manufacturer's recommendations. All necessary equipment needed for a complete installation shall be available at the site. Section 3—Approval Requirements A. Upon completion of fire alarm and fire protection system installation, the Contractor shall obtain written approval from the Owner stating that systems satisfy all operational code compliance requirements. B. Owner shall provide to the City of North Andover Fire Department, the name and address of the Fire Alarm Contractor responsible for relocation of existing equipment and installation of new equipment. If you have any questions or comments, kindly contact our office. Sincerely yours, a� M.E.A. ENGINEERING ASSOCIATESWING: .; , S ` 61 �w3 Al d E. Muccini E. President � `- t . '. �'•� Stonewall North Andover office.doc , OFFICE OF BUILDING INSPECTOR ° TOWN OF NORTH ANDOVER '•�� ': CONSTRUCTION CONTROL PROJECT NUMBER: n �� PROJECT TITLE: R o e C't `S w i tx ,I j��r oc ✓t C T7h s ✓rot#1 C PROJECT LOCATION: ��(� �u rhlJ✓► 4 7 NAME OF BUILDING: f d1 OLVI-cr\, NATURE OF PROJECT: I P_✓1 c� '�" �� — y rIN ACCORDANCE WIT ARTIC 7 116_ THE MASSACHUSETTS STATE BUILDING CODE, 1, 1 y REGISTRATION NO.Z BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT 0 ARCHITECTURAL 0 STRUCTURAL 0 MECHANICAL 0 FIRE PROTECTION 0 ELECTRICAL 0 OTHER(SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATICES. . AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction . documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become, generally familiar with6the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. �jSUANT TO SECTION 116.2 .2 Lha T WEEKLY , A PROGRESS REPORT a��AQP•E(K OkIER WITH PERTINENT GO 1 S Y NORTH ANDOVER BUILDING INSPECTOR. ,��. g�/r.Q�,11.EXp•. �., �lo S AMASSASTR N J •it,�. PLETION OF THE 1IUU ,�TYAPRW T A FINAL REPORT AS TO THE = CORY COMPLETION`..' READ TH� P, JE T FR OC/C�UPANCY. Nf t ; AT�FFSSONAt .•��� ��•''. P SIGNATURE TARp ti0 • 1� ORN T EFO THIS,r DAY OF aM Q/ Z66 P .• y MY COMMISSION EXPIRES !l at /? i Gr,M {� ConLractill�. e, C' Ufa 325 North Main Street Unit 15-B Middleton, MA 01949 [rice: 978-777-8007 Pax: 978-777-5004 G m Ger► , C�,� f I � ) -}--e Y).*pi / goo 1v- f-'o V)h 4- IV 41,d o v C f- �r d UN) QINtj r 0 . 4ss-, zLL , Flit o )q c7- goo, :ce,e - -r�j Total A� 3/13/�® CERTIFICATE OF LIABILITY INSURANCE DA/13/DDIYY2008 8 PRODUCER .(978) 696-0007 FAX: (978)345-6811 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Employers Insurance Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 281 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 7B Fitchburg MA 01420 ' INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA Savers Property & Casualty .......... Resource Management, Inc. INSURER 8: Alternate Employer: GFM General Contracting INSURER Corp. , 281 Main Street, Suite S INSURER Fitchburg MA 01420 INSURER e. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE 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,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L ATIO...... ..... .. I TYPE OF I ' POLICY NUMBER POLICY EFFECTIVE ,POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY � DAMAGE TO RENTED PREMISES(Ea occurrence) $ CLAIMS MADE OCCUR I MED EXP(Any one person) $ • - - - PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER:. PRODUCTS-COMP/OP AGG $ POLICY PRO- i..-- - LOC I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS ' SCHEDULED AUTOSBODILY INJURY $ 1 (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) I PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ i ANY AUTO ' OTHER THAN _EA ACC' $ T..... _.. .. . . AUTO ONLY: AGG I $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ A WORKERS COMPENSATION WC STAT U- OTH- Y/N AND EMPLOYERS'LIABILITY ' X TORY.LIMITS:. ER ANY PROPRIETOR/EXCLUDRIEXECUTIVE E.L.EACH ACCIDENT $ 1 000,000 '. OFFICER/MEMBER EXCLUDED a ,-, .._ .._ , (Mandatory dory beund WC0002526 1/1/2010 1/1/2011 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under __.__...__..... .... .. _.... SPECIAL PROVISIONS below OTHER E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Covers the employees of the named insured leased to: GFM GENERAL CONTRACTING CORPORATION 325 NORTH MAIN STREET - UNIT 15 B MIDDLETON, MA 01949 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION for record only DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Judy Prescott/KATHYM ACORD (2009!01) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025 tz00eoi) The ACORD name and logo are registered marks of ACORD Manaachusett. - Department of Public Safetl, Board of Building Re,-,ulations and Standard. Construction Supervisor License License: CS 17935 Restricted to: 00 FRANCESCO FODERA 2 FRANKLIN ST READING, MA 01867 WL Expiration: 7/29/2011 c ,uai..i nw Trtt: 19552 NAM rV483054 EV ooa '7201.3 07-2 CLASS REST MGT SEX t eft g D ^ t� W7 M FGDERA MGSr U k FRANCESCO 2 FRANKLIN ST READING.MA " 01867.1117 GrM Contracting ev C' 325 North Mein Street Unit 15-B Middleton, MA 01949 Office: 978-777-8007 Fax: 978-777-5004 S+oo ew, Va z V, /,.2 �2 c,? � , L) . A , p Total �� �' 617 wy " BUILDING PERMIT rp` �,T" TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 4L s Permit NO:4tki Date Received "4`���` •.�''� Date Issued: IMPORTANT Applicant must complete all items on this page 1CA {A W {Rt �` +i.•� r�, }���)",¢/+�c1 �Yyr} "..f i �a M4 A h. 1 1 �4 rt. ' - i 4015M -T t � �, yy 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 Ft ��aS.•t.c DESCRIPTION OF WO K TO BE PREFORMED. V 2 21/ Yl� -ec e- 4JA 36rs• -ell Identification Please Type or Print Clearly) OWNER: Name: G c-o tc-k (G, n a Phone: 617- J77- `1 163 Address: '� 2 I�- ma SA, Aiddhc4oi In 6 CD/9 vh 41 F ��'` !'A.14�s e•4 �V {�H:,��5...."E.��{�4..^�'> ��.�� i' +� � i�74iW,l:ffie. .f 4� "'ii i �� �� ,6. ��` `�gR �y( �."�p ;��a._yr�°71•i' �� ^* � `�_ S '-'EW .rotlt ARCHITECT/ENGINEER'R a n4e,S ck s+r ci,20, hone: X08 --3 6/—2 2�2 2 Address: Doi ng fi„�)1 ckp, /I)/q o/7o/Reg. No. 2,'09 6 FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ jw'�70(949- 00 FEE: $ �( Check No.: �a60 Receipt No.: NOTE: Persons contracting with unre 'stered contractors do not have access to the jzharantyfund Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer P"" Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE.ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT Ild COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street :e ? 'tft- ©� � Sk t JM:"Po,1 f r+ w t "4x r' M �w 5 ��ti/Qtt�I��tG�K�'YL� a� �7#+WT { { Y at �4 c ilk f J'M r' 4 31l',{ .W,h .a�K • p.�'2`: A. 't:�" w ry4•.M ise au � a�>. Fh_.�+a '� ;� � .�k',i'p y �,r� ;yF.l ° r.'Mei Y�5{,cry i vgr�e.h t+� '� *�l n 1;.'q^'° ��` �, ire e, a �rfil gra rye a e r ....._.—,.nw— � ..�t Ukrr �.IOt 1 Location © 2.o No. IL Date 1 l R "O"'q TOWN OF NORTH ANDOVER - �o Certificate of Occupancy $ _ � •w�i1� 4 Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # v 2362- 9 Building Inspector NOR7M o a 01 .� CHO CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER 3 2011 Building Permit Number 369-2011 Date: January , THIS CERTIFIES THAT OCATED ON 1 820 Turnpike Street Suite #210 & #211 THE BUILDING L Bridal by Meredith MAY BE OCCUPIED AS tenant fit-u p, 2"d floor bridal sho IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Stonewall Plaza,LLC i 1820 Turnpike Street 'u North Andover,MA 01845 Building Inspector Fee: $100.00 Receipt: 23629 previous paid NORTH - TO" � over O No xv- -- -0 dover, Mass-,uZ O LAKE . 1%, COCMICMEWICK �t 7�ADRATED S ` BOARD OF HEALTH Food/Kitchen Septic System .PERMI lZ.11. BUILDING INSPECTOR THIS CERTIFIES THAT. � `. i ••••••. f "" '� """.'.......... Foundation �� R has permission to erect..... J ' �A�• hi,, ey to be occupied.as �. .� ' "" ile • • 6 �gs, Ax,Provided that the person accepting this permit shall in eve respect conform to the terms of the application on file m i" this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of PLUMBING /INSPECTOR Buildings in the Town of North Andover. o h `21 Y1 a lrrlT VIOLATION of the Zoning or Building Regulations-Yo ids this Permit. n / PERMIT EXPIRES IN 6 MONTHS ELECTRICAL IN CTOR UNLESS CONSTRUC S TSS Rou © . �a Service .... ....... ........................................BUILDING INSPECTOR ina Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough 3 6J�... Display in a Conspicuous Place on the- Premises — Do Not Remove On No Lathing or Dry Wall To Be Done FIR EPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. smoke Det. ` - SEE REVERSE SIDE GP ASSOCIATES. Inc Consulting Engineers Mr. Gerald Brown. Dt ;December 30,2010 Inspector of Biildings 1600, Osgood Street. No. Andover,Ma 01845 Reg : 1820, Turnpike Street.No.Andover,Suite210 Final Report. The fit up work is complete.The completed work meets the requirements of the Massachusetts Building code. Work completed includes Drywall,Painting,Ceiling, and Electrical. All the work is as per drawings issued. If you have any questions,Pl. contact our office. Sincerely. H 0,F Satyaprasad s�r�As Ry 9y A�'�AAST SAp i A �0 0.28095 ti �/S T E���Q SSMC \C1�' NAL ENS 29, Cresthaven Drive,Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net I GP ASSOCIATES. Inc Consulting Engineers Mr. Gerald Brown. Dt ;December 30,2010 Inspector of Biildings 1600, Osgood Street. No. Andover,Ma 01845 Reg : 1820, Turnpike Street.No.Andover,Suite211 Final Report. The fit up work is complete.The completed work meets the requirements of the Massachusetts Building code. Work completed includes Drywall, Painting,Ceiling, Electrical &plumbing. All the work is as per drawings issued. If you have any questions, Pl. contact our office. Sincerely. J Satyaprasad STRY G ;;AP,AASA J, gA;YAPRASAD � : ., ivo.28096 Q C/' FSSlow-EAG a 29, Cresthaven Drive,Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net 1 M.E.A. Engineering Associates Inc . Consulting Mechanical Engineers '*�"V_ J 20 Felton Street, Waltham, MA 02453 781/894-6730 FAX 781/647-3542 CONSTRUCTION CONTROL AFFIDAVIT START OF PROJECT PROJECT TITLE: 2nd floor Tenant Fit Up office PROJECT LOCATION: 1820 Turnpike Street North Andover MA NAME OF BUILDING: Stone Wall Plaza North Andover MA In accordance with Section 116 of the Massachusetts Building Code,I,Alfred E. Muccini, Registration No. 23539, hereby certify that I am a Registered Professional Engineer. I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: ENTIRE PROJECT ARCHITECTURAL STRUCTURAL MECHANICAL ✓ FIRE PROTECTION ✓ ELECTRICAL ✓ OTHER(SPECIFY) PLUMBING ✓ FIRE ALARM ✓ for the above named project, and that, to the best of my knowledge, such plans, computations, and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws and ordinances for the proposed use and occupancy- I shall perforin the necessary professional services and be present on the construction site in accordance with my contract with the owner to determine that the work is proceeding in accordance with the documents approved for the building permit,and I shall be responsible for the-following: 1. Review of shop drawings, samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit and approval for conformance to the design concept: 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Special engineering professional inspection if critical construction components requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix B. 4. Periodic progress report with comments to the Building Inspector. UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPL>ETION AND READINESS OF THE PROJECT FOR OCCUPANCY. AO dz 0, i r4dg-f %l' r 1ifed k. �. ... . day of 20/0 Subscribed an '.tp>before me=this uuxu M.CANNON Notary Public �� ommis ion E pires My CAmeiasiantow " 16;�/5- M.E.A. Engineering Associates Inc . Consulting Mechanical Engineers 7 20 Felton Street, Waltham, MA 02453 781/894-6730 FAX 781/647-3542 Document Ref. No.: Stonewall NorthAndoverMA office.doc October 20, 2010 Fire Prevention Office City of North Andover Fire Prevention Department 124 Main Street North Andover, MA 01845 Attention: Fire prevention officer. Reference: Fire Alarm and Sprinkler Narrative 2"d Floor Tenant Fit Up for office at Stonewall Plaza 1820 Turnpike St. North Andover MA Dear Fire Prevention Officer: (1.a) BASIS(METHODOLOGr OF DESIGN Section 1—Building Description a) Building "Use" group: B b) Total footage of building: 38,430 c) Building height: d) Number of floors above grade:) 3 e) , Number of floors below grade: 1 f) 2"d floor tenant square area: 6,007 g) Access type of occupancies within the building: B h Type(s) of construction:2C Unprotected with and automatic sprinkler system i) Hazardous material usage and storage: none j) High storage of commodities within the building: none i k) Site access arrangement for emergency vehicles is through: Front access Type Section 2—Applicable Laws, Regulations and Standards The following is a list of reference standards that shall be used in system design, operation and maintenance. a) M.B.0 780 CMR 6" edition.). b) N.F.P.A. 13 (2007 Edition) c) 527 CMR 12.0, the Mass Electric Code 2005, N.F.P.A. 70 with Mass. Amendments. d) N.F.P.A. 72 2002 Edition e) ADA strobe meeting code reference 780 CMR N.F.P.A. 72-2002, and 521 CMR. The Massachusetts Architectural Access Code. f) Authority Having Jurisdiction — City of North Andover Section 3 Design Responsibility for Fire Protection Systems MEA Engineering associates; Inc. is responsible for 2nd level only. The Fire alarm contractor shall submit complete information regarding the fire alarm notifications devices shop drawing to the engineer for approval. The Sprinkler Contractor shall submit and shop drawings and proposed sprinkler equipment to the engineer for approval. The contractor will submit all approved shop drawings and product information to the North Andover Fire Department for approval. Section 4—Fire Protection Systems to be installed The proposed new work is summarized as follows: A. Sprinklers 1. New sprinkler heads shall be utilized in all locations. (Quick response type sprinkler heads to be installed with an ordinary temperature rating.) Stonewall North Andover office.doc 2. New seismic support for new sprinkler piping. 3. Sprinklers shall connect to existing zone flow station currently serving space. The existing sprinkler grid shall be reused and modified for new floor plan. 4. Existing sprinkler service is provided with a backflow preventer. 5. Existing system serving adjacent floor shall be kept live. B. Fire Alarm System 1. The proposed second floor tenant fit up shall tie the proposed power booster supply to existing landlord building main fire alarm control panel. 2. Smoke detectors located in electrical, telephone equipment room and similar rooms and are provided throughout as required per code. Audible alarms in common areas shall be sized to insure maximum sound levels throughout the tenant space. 3. The existing Fire alarm system shall be activated thru new manual pull stations, and common area smoke detectors. 4. The new Notifications fire alarm devices shall meet N.F.P.A. 72, 2002 ADA and local Fire Department requirements. 5. Manual pull station shall be located at exits, ADA strobes shall be in the public common areas and horn/strobes shall be in accordance with N.F.P.A. 72 2002. 6. Rooftop unit over 2000 CFM shall be equipment with duct smoke detector linked to fire alarm system 7. Common areas shall contain system smoke detectors wire to F.A.C.P Section 5—Features used in the Design Methodology A. Basis Of Design New portions of the sprinkler piping have been designed using the pipe schedule method for Light Hazard occupancies. I Stonewall North Andover office.doc B. Sequence Of Operation Upon actuation of a sprinkler head (designed to release at 155°F) wafer shall start to discharge from the sprinkler head and water flow switch shall signal a water flow condition to the fire alarm panel. C. Testing Criteria Sprinkler System The new piping and heads shall be tested in accordance with all applicable codes. At a minimum this shall include notifying the. Building Inspector and Engineer of Record of the time and date testing will be performed, completion of the contractor's material and test certificate (N.F.P.A. 13, Figures 8-1 a and 8-1b). The system shall be hydrostatically tested in accordance with N.F.P.A. 13 Section 8-2.2.1 "hydrostatically tested at 200 PSI and shall maintain that pressure without loss for two (2) hours." 1.b SEQUENCE OF OPERATION Section 1 1. The operation of a manual station or activation of any automatic alarm initiating device (system smoke, system heat detector) shall initiate a system- wide response as follows: a. Initiate the transmission of the alarm to master box and central station. b. Sound a code 3 temporal evacuation signal over all audio circuits and shall be in sync. c. Flash all visual signals throughout the building. Visual notification shall be synchronous in accordance with NFPA 72 guidelines. Synchronization shall be system-wide, and shall be subject to the N.F.P.A. 72 20D2 edition adopted as Massachusetts code. The failure of one visual NAC shall not cause a failure of other NACs serving the same evacuation zone. 2. The operation of any activation of other device designated to initiate a system Supervisory condition'shall cause the following to occur: a. Duct smoke detectors shall be installed in accordance with manufacturer spec's NFPA72 and NFPA90 they shall be resettable at the fire alarm control or other location approved by the local fire department. Remote duct smoke indicators shut down latching supervisory signals for all remote duct smoke indicators shall report to a central supervising station. The station shall notify the building owner. Stonewall North Andover office.doc (1.c) TESTING CRITERIA Section 1— Testing Criteria A. The fire alarm system shall be completely tested in accordance with N.F.P.A.-72 by the Contractor when the tenant renovation is complete in the presence of the Owner. Upon completion of a successful test, the Contractor shall so certify in writing to the Owner and General Contractor. Section 2— Equipment and Tools A. The complete fire alarm system shall be installed in accordance with manufacturers recommendations. All necessary equipment needed for a complete installation shall be available at the site. Section 3—Approval Requirements A. Upon completion of fire alarm and fire protection system installation, the Contractor shall obtain written approval from the Owner stating that systems satisfy all operational code compliance requirements. B. Owner shall provide to the City of North Andover Fire Department, the name and address of the Fire Alarm Contractor responsible for relocation of existing equipment and installation of new equipment. If you have any questions or comments, kindly contact our office. Sincerely yours, ,nn,n ti tom' �•�,;•'.:__.___.;_\US . M.E.A. ENGINEERING ASSOCIATES' AI d E. Muccini, E. tVf President ,...,; Stonewall North Andover office.doc i I Dimension Number of Stories:��" _Total square feet of floor area, based on Exterior dimensions. �Q Total land area, sq. ft.: V j ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date 1 Doc.Building Permit Revised 2010 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit , ❑ Photo Copy of H.I.C. And C.S.L. Licenses n ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance ors special permit was required the Town Clerks p p q office must Stam the decision from the Board of Appeal s P that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application I Doc:Building Permit Revised 2008 a � a i i d;°^ OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL PROJECT NUMBER: PROJECT TITLE: M e t e d ►+L) 13 o c s--e // 13 r f da S Z, L4114—I PROJECT LOCATION: © �v r? � �( -2 S '�"� - a /o d2 1 1 NAME OF BUILDING: S'-D h Q LA/a- I I �l 0. Z qZ- NATURE OF PROJECT: Te-in a v1 r y IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, REGISTRATION NO. Z S o X16 BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT ARCHITECTURAL 0 STRUCTURAL 0 MECHANICAL 0 FIRE PROTECTION 0 ELECTRICAL 0 OTHER (SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT 1 SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become, generally familiar with6the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with ruction documents. OF .."0"j%RSUANT TO SECTION 116.2 .2. I EKLY , A PROGRESS REPORT HER WITH PERTINENT COME Tp ORTH ANDOVER BUILDING INSPECTOR. +QQ�L d• �� A'1JRSASFfiY : •..•M'Rr p•.���'y� SATYAPRASAD JF7 7<2.��MPLETION OF THE WORK, I S gSU A FINAL REPORT AS TO THE A TORY COMPLETIONA ID IN ! HE PR EC FO OCCUPANCY. ' ;: FSSIONA ' V' •• 4(nio C4. IGNATURE .I,�T••• • i •• D S N-T`O B ORE ME THIS )AY OF� J2DrD A RY UB MY COMMISSION EXPIRES �� Z2 /3 GFM Co n Lractr, • ��e� � Cil 325 North Main Street Unit 15-B Middleton, MA 01949 Office: 978-777-8007 rax: 978-777-5004 S 4o e LvC', I (p/-4 z Ck L. L /0/2 -Z)/O GF 3 b-e �-� , 2 o -� l�. 1�� - L ��`� v( -FCv-`) M E 6 Total � � NORTH 0 0 _ over No- 34f ; 7-- dover, Mass.,4 � � • ?� C OCHICHEWICK 0RATED Cl 7 v ` BOARD OF HEALTH Food/Kitchen .PERMIT T D Septic System to #. BUILDING INSPECTOR THIS CERTIFIES THAT..S��. .04.��i ...9......el�.� OZ.to. zlt Foundation has permission to erect.........................................4 Paild' gs�n .....� ..TV.4w p1. ....c�............ Rough to be occupied asT ' imn y provided that the person accepting this permit shall in eve respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC S- TS Rough ... ....... ....................................... ..... .... ........ Service .. .... ............ ..... ..... ....... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Ac.®Rc- CERTIFICATE OF LIABILITY INSURANCE OP ID CH DATE(MMIDDIYYYYI QvxCO-1 06/14 10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dadgar Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 400 deet Cummings Park HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Suite 6725 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Woburn MA 01801 Phone:781-933-2626 Faxs781-932-6341 INSURERS AFFORDING COVERAGE NAIC# INSVREO — INSURER A` polyol* Autual Ina cc in Balon 14206 INSURER B: GFM Contracting INSURER C: 3JS Nocon KA 01944 Main St Unit 158 INSURER O: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN L4SUEO TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMENT,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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR*SRI TYPE OF INSURANCE POLICY NUMBER RATION DATE 0 OATS IYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1000000 A X COMMERCIAL GENERALLIABIUTv CPP7017604 01/01/10 01/01/11 PREMISES(Ee oWurence) $ 100000 -.J CL AIMS MAGE r___7 OCCUR MED EXP(Any one person) $ 50 00 ` PERSONAL&ADV INJURY E 1000000 GENERAL AGGREGATE s2000000 GEWL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000000 POLICr PERQ LOC AUTOMOBILE LIASIUrY1 COMBINED SINGLE LIMIT $ 1000000 A _ ANY AUTO CA9012129 01/01/10 01/01/11 (EOaccloenq l- ALL OWNED AUTOS BODILY INJURY S X SCHEDULED AUTOS (Per poson) X HIRED AUTOS BODILY INJURY f X NON-OWNED AUTOS (Per sco dent) -- PROPERTY DAMAGE S (Per aoddent) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EA ACC S _R AUTO ONLY: AGG S EXCESSIUMBRELLALIABtLTPY EACH OCCURRENCE S 1000000 A OCCUR CLAIMS MADE 000006054185 01/01/10 01/01/11 AGGREGATE 31000000 ` S I OEDVCTIBLE $ X--111.RETENTION $10000 S WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OCFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE S M yes. lescriI Vntler 9PECLAL PROVISIONS below E.L.DISEASE•POLICY LIMIT $ OTHER A Property Section CPP7017004 01/01/09 01/01/10 Contents 10404 A E i ent Floate CPP7017004 01/01/09 01/01/10 1 Deductibl S00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS COPTRACTOR FAX 781-944-2609 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN XxxxxxxxxxxxxaxxxxxxxxxxxxxxXX NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 50 SHALL Xx1xXXxxxxxxxXxxxx7.1=Xxxxx=x IMPOSE NO 09uGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR XxXXXXXxxxxxxxxxxxxxxxxxxxxxxx REPRESENTATIVES. A RED RE ATIVE ACORD 2S(2001108) 0 ACORD CORPORA11ON 1988 I CERTIFICATE OF LIABILITY INSURANCE F DA/13/DDIVY 3/13/2008 8 PRODUCER (978) 696-0007 FAX: (978)345-6811 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Employers Insurance Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 281 Main Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Suite 7B Fitchburg MA 01420 INSURERS AFFORDING COVERAGE NAIC# _ .. ..........- (.. INSURED INSURER A:Savers Property & Casualty Resource Management, Inc. INSURER B: Alternate Employer: GFM General Contracting INSURERC Corp. , 281 Main Street, Suite 5 INSURER D: Fitchburg MA 01420 INSURER E' COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADD'L TYPE OF IN�URANCFPOLICY NUMBER..__._ ._-.. ---_. ...1...---....._..... ..... ... _ - .. LTR 'SPOLICY EFFECTIVE POLICY EXPIRATION: LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED... PREMISES(Ea occurrence), $ CLAIMS MADE OCCUR I MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG PRO• L.__- -- -- $ POLICY' LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO $ (Ea accident) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $(Per person) HIRED AUTOS NON-OWNED AUTOS BODILY INJURY(Per(Per accident) PROPERTY DAMAGE $ ' (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN .EA ACC $ AUTO ONLY: AGG 1$ EXCESS/UMBRELLA LIABILITY ; EACH OCCURRENCE $ (--; I_.. .. . ... OCCUR I CLAIMS MADE AGGREGATE .$ $ DEDUCTIBLE - $ - RETENTION $ A WORKERS COMPENSATION WC STATU- .OTH AND EMPLOYERS'LIABILITY Y 1 N '-TORY.LIMITS:-X.. ER , ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED E.L.EACH ACCIDENT - E.L.DISEASE-EA EMPLOYEE $ _1'.9.00,000 (Mandatory in NH) WC0002526 1/1/2010 If yes,describe under : 1/1/2011 $ 1,000,000 SPECIAL PROVISIONS below : OTHER E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Covers the employees of the named insured leased to: GFM GENERAL CONTRACTING CORPORATION 325 NORTH MAIN STREET - UNIT 15 B MIDDLETON, MA 01949 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 0E CANCELLED BEFORE THE EXPIRATION for record only DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 1 Judy Prescott/KATHYM ACORD 25(2009!01) ©1988-2009 ACORD CORPORATION. All rights;reserved. INS025(200901) The ACORD name and logo are registered marks of ACORD tiiasachusrtt.- Drpa(-tmcnt 411' Puhlic SafetN Board of Building Regulation% and Standard. Construction Supervisor License License: CS 17935 Restricted to: 00 FRANCESCO FODERA 2 FRANKLIN ST READING, MA 01867 ML Expiration: 7/29/2011 Tru: 19552 Dfl S57483054 r 07920T3 07-24;'!, CUSS REST MGT SEX 0/�^ 907 M \ : FCDERA Ma55 a FRANCESCO 2 FRANKLIN ST ::.;" ,�;• READING.MA 01867.1117 i GF M Contraclil,g. 0 325 North Main Street Unit 15-B Middleton, MA 01949 Ot1'ice: 978-777-8007 Tax: 978-777-5004 i i e U),-jC I- �/A z L 0 -z -Z ho G-F U YJ , -} �L1 O � 4��I) G.-S' c' Q`elt h S ck 0�)-'e'A (Y lo,vi M E 43 -F Totals , � � ���, - Scl��o � �F�t� � i i www.eiz.org/MANN y 800 272 3900 alzi�eftmer s association } it November 8,2010 Mr.Gerald Brown Massachusetts/ Building Inspector ector New Hampshire Chapter City Hall 311 Arsenal Street North Andover,MA Watertown,Massachusetts 02472 Dear Mr.Brown, 617 868 6718 p I am writing to support Northeast Senior Health's plan for an Adult Day Health Program specializing in dementia care 617 868 6720 f in North Andover. REGIONAL OFFICES: As Vice President of Clinical Services for the Alzheimer's Association Massachusetts and New Hampshire Chapter and as a clinical gerontologist specializing in Alzheimer's disease for more than thirty years,I have seen first hand the Southeastern Mass multiple benefits of adult day health programs for Alzheimer's patients,their family caregivers and the health care Cape Cod&the Islands system. Current research on this topic indicates that adult day programs are treatment centers. With structured Cape South Plaza activities-programming well designed programs can prevent many of the symptoms associated with Alzheimer's disease and,they may even,slow the rate of decline,allowing patients to remain in the community longer. 473 South Street West Unit 13 The algorithm for this treatment effect involves several key elements:staff training;prosthetic design of the Raynham,MA 02767 environment;cognitive training;exercise;diet;purposeful engagement and socialization. Many adult day health 508 880 0055 p programs in Massachusetts,Northeast Senior Health most notably among them,follow a treatment strategy that I and 508 880 0056 f others have developed called"Habilitation Therapy". This approach focuses on bringing about and maintaining positive emotions in patients over the course of the day. Ceptral mass The activities program is the motor that drives this treatment approach. The activities should be adult-like,failure free, 128 Providence Street familiar,convey a sense of purpose and provide ongoing practice with the person's remaining capacities. Worcester,Massachusetts 01604 Design features should include a home-like environment,space to wander,color cueing that promotes independence, 508 799 2386 p enhanced lighting and other features that cause positive emotions. A participatory kitchen plays a key role in the 508 799 2653 f therapeutic objectives for many adult day health patients. First of all,the kitchen is an iconic symbol of home,it is where people gather naturally,it conveys a sense of safety and in this sense it contributes to the positive emotions of clients. In another way,the kitchen gives homemakers a familiar arena where they can use"hard wired"cognitive skills Western Mass that relate to their role nurturers which gives them a sense of purposefulness. Keep in mind,the participatory kitchen is 264 Cottage Street not where food is prepared for consumption and not be thought of in that sense. The kitchen in this sense is a stage set Springfield,Massachusetts where adult day clients can continue to play a role,and that is part of our therapeutic aim. 01104 413 7871113 p I strongly urge that the kitchen be considered one of the many therapeutic tools that are essential in our work with 413 7871109 f dementia patients. Indeed,in my many years doing this work,I have helped to design dozens of adult day programs with therapeutic kitchens. I would encourage you to look at similar programs in assisted living and adult day programs in the Merrimack Valley area to see how these kitchens are used. New Hampshire One Bedford Farms Drive I would be happy to talk with you further on this matter. Suite 105 Bedford,New Hampshire Sincerely, 03110 603 606 6590 p Paul Raia,Ph.D. 603 6066803 i Vice President,Clinical Services Alzheimer's Association,Massachusetts/New Hampshire Chapter 311 Arsenal Street Watertown,Massachusetts 02472 617 868-6718 the compassion to care,the leadership to conquer ,Fti.• L ALL OiFtSCA014AL SIGNAL[ANO PAVMNIF MAR040S S:4ALL E VOCREAY0 6Y 13 FEET M!E7if v C SWMIA TO T!#C LATEST MFT04 OF WE MANUAL OF UWOAM SOETITIAL 2DNC AS PZI1 TA!>4L>. TRAFAC CONTROL DNCE"Ns A+aavtr Z-%4 Or-c-5-0-1 6. A:GWE FOLC ?:,ynTT r...e 1. P40VV SPACE Sljt* .SCALL SE ACCOPPLI&I'M VAT"reit ACtclrau WALMY 6?i Ra REFucavc TRAMC PANT. �PI 3 T• A � ig r%Dy6 P-P.R�ate , 1 EA a 75%OF AA'S L.OT AREA C-M730 SF) IKEA-76.?20 SF Far Regbtry use Only �a ONE HUND I51 mo itE=aSn1tS CSY a rtms�a W PLAN CCWOq%CLN OF MASSSSACANXMAS W TS 7,as Or Dx �t •�1C� 1S R£� cod' °� yya+' ` R.S' i f'�,y\. TEVNCSE Ek 200 SF 16 SP/s000 ST..24 SPANS t'&*W MAT THE PROMFY LFe�CS ARE sF+f i"S M10.10 EJSSTA6S �G 0�5 E 511,tdE. R_M low Ss•5 SP/1000 7 -7 SPALLS 0044SW.AM TFAr LINES Of SMEM AN9 WAYS SNOW AAL MW DF s-SP/I000 SF r xd SPACES Poax OR PAEV.r7E"an OR zi IS ALRFADr ESTAgLIP£D Aho go jw_w LAKS � �•� ylA�Jr� ><.Io � �� `\ T1 EmPLOYM(TOTAL) -.s SPAM iA?ALLRQOIY Or rJ MW.OML.RJNP OR FAP NZW WAYS ARE SW.W MIMED FARRYKt _II•SPACESY PROPOM PARKM :.119 SPACES P�- ` � VA a � �� D ON HC OW"RML7AWSN7fY1D!N AMLO ITS M,H,,.�i 'O * L r_ O. h e• r AANs Y jv Mme° �, L�r�S t T1s .�1 0 ° • IROf MWS A4 ►' ft t'A• D J4 1M 10117 0 e11Ti0�Ei►FY 17TtEarwF'a•iAwete�oEo O,e yi„'t• � p >i o � JAr 5T1 avDt77 el'SMRAZ R I t i t r > MfII 0117f ALL APP11CAaALE /� a.�.. o OtPIII tiWTS ta / F LIN t� ��'`, r ��c�T rei•�,l Fa� s how EMST. 25' PROPOSED BUILDING / / I�'` .• i '� (23 SPACES NBASEMENT GARAGE)/ I� �s I IA ACL • ....K N � m► e K aIMACC N IIT• 1 ! • / a 1y_ -• 1 ' � .,.3' y / � / SEC AIfAEi•Aw,�, / a. ALL PROPOSED EOOM SHALL Off Foa LAtT OF CLIARA+� -j otawD m VERTICAL GRA04TE CUPS Al.�' — rk. a. / 95' x I� >o a as AP 1060 1 4-7 ' I Y-- c / y I�� t e 5 e e, e / �/�Ldf• -LF I J/ / Og � ryj %PCPO'SCD SIT :DNC.PA)LtNG LOT f-/ I] SAA f' • [i' u I / i �LQ� , f, ' I PROPOSED I ��' I yi ,sArr� o I s" I // ./ o EASEMENT PRCP W. CRAM, I"M00 6 LOT ITrPJ / u r+ I � A.i.s• 1 DRyv'S�tWt vALNJA'Cf'TGill �\� _J � / �� /' r ,6 EVA.S t• « S�. I rxDacstn oxRoaAL PROPOSED.•".CN(7'.yi. J'hlph /' - ' _ u -�,- �pppl• /'�` Y I 1 K`•�-._^•^ate „.�_ ��' t f3.1D• T•y.3Td(rAi:xtt RLI.Mol o'w^ ! d''•f r N5517129"r1:83 95' I I RH Y lLWT Or Wm SIM AOT[?.&,"T3 TURNPIKE 'vZAL';° STREET Th151s I dap hat of f". Torn CYC oppad h C utdotrer PtonNng Board tAft O+ �� ____ •-JJ Dot• '•7� . Tear CS• NESITI—MOORE'S”FA" . 100.; iNDQVER..BY-PASS _ QWG HE f845 TURNPIKE.ST. N: ANDOVER, MA. 01845 N ANUOVFit .� BUILDING PERMIT "O pT"qti j 'Z a�;�. •6 pp TOWN OF NORTH ANDOVER - Z. APPLICATION FOR PLAN EXAMINATION /' 1► s « Permit NO: vJ 1- b Date Received °'4`""•`•"•.'� rap Date Issued: d ss^cH"5�� IMPORTANT:Applicant must complete all items on this page LE. p G� '4 Y ' � � 1. ,Yf p"��� j.Ew 1�'t l ^�� 1 1 � T1�••+M� �i�Y Y} 4 }. A WN3 r � TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ew Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Wela _ DESCRIPTION ;. ... OF WORK TO BE PREFORM ED: 0" 1 0 C 'P d Identification Please Type or riot Clearly) OWNER: Name: Ci ca o c1 &, e7o ) Phone: 617-e77- 9963 Address: /Vow n f-)—. �d )e �an ©/9 Y 9 v 4 50�g 01 q I � rpyi. F ..@ .1 P l ✓ 14^Iry ; �� Y ''^��''�i�' 3i17�i �'�:y� �� {�.�'� }.; � ♦ 'die '� �"� .• ''�xF. �� r`� � by .' ,p , �.., ��,��,3y4� .may' �+..°.�y .��u., t* � ii��7 ,' +J�I'�A+ .'lif �7G .: •19�s - -> ARCHITECT/ENGINEERS Phone: - 6/- -gqz 9, ~ Address: ��✓�q �� �=r a Iti►in hti�, /7),40/70/Reg. No. C9 2 6 FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �, 6>0 0,00 FEE: $_��� (j Check No.: / S Receipt No.: 3 �, NOTE: Persons contracting with unregi d contractors do not have access to the ara fund Bi nature oI A Wenl/Owne'£ k natureo#coritrac# -_g __. g . .. 9 v +r M Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSALL Public Sewer J Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED 1 PLANNING & DEVELOPMENT / /C COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street *•t ti�l�' ��y.''�! Pd4 .e` 4 ;h K',y y ,. :, d�Q iwYu,�ati�} fw�;+g xd,{�.,a '�+a yE .vm,`.. Location F ;r No. 36 7- 2 0// Date i f MORTh TOWN OF NORTH ANDOVER S F Oj° + Certificate of Occupancy $ /040 j p Y Building/Frame Permit Fee $ 6 6 �CMUS a Foundation Permit Fee $ Other Permit Fee $ b TOTAL $ r�"` M Check # ? 23651 building Inspector NORT►y Town of 0 No.34o 7- a oil - .. v 1. ,1 _ ITM _ty LAKE 0 dover, Mass., COCHICHEWICK 7�ADRATED pP"1; Cy S V BOARD OF HEALTH Food/Kitchen .PERMIT T D Septic System �J A�.. / �7 BUILDING INSPECTOR THIS CERTIFIES THAT.........., ...bM 6 (ems / f� /` (� ..................................................................:......................... Foundation has permission to erect_........................... ^...... buildings on ..I. . a - ....3..`1`a ej Rough to be occupied as.......... !orf. .............. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations'.Voids this Permit. Rough _. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough .............................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. M. E.A. Engineering Associates Inc. 13 Consulting Mechanical Engineers 20 Felton Street, Waltham, MA 02453 781/894-6730 FAX 781/647-3542 CONSTRUCTION CONTROL AFFIDAVIT START OF PROJECT PROJECT TITLE: 2°a floor Tenant Fit Up office PROJECT LOCATION: 1820 Turnpike Street North Andover MA NAME OF BUILDING: Stone Wall Plaza North Andover MA In accordance with Section 116 of the Massachusetts Building Code,1,Alfred E.Muccini,Registration No. 23539, hereby certify that I am a Registered Professional Engineer. I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: ENTIRE PROJECT ARCHITECTURAL STRUCTURAL MECHANICAL ✓ FIRE PROTECTION ✓ ELECTRICAL ✓ OTHER(SPECIFY) PLUMBING ✓ FIRE ALARM ✓ for the above named project, and that, to the best of my knowledge, such plans, computations, and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws and ordinances for the proposed use and occupancy. I shall perform the necessary professional services and be present on the construction site in accordance with my contract with the owner to determine that the work is proceeding in accordance with the documents approved for the building permit,and I shall be responsible for the following: 1. Review of shop drawings, samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code-required controlled materials. , 3. Special engineering professional inspection if critical construction components requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix B. 4. Periodic progress report with comments to the Building Inspector. UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COIV BILETION AND READINESS OF THE PROJECT FOR OCCUPANCY. ign .,;. �� day of 20/ Subscribed an to before me this LMM M.c 6 S Notary Public ommis ion E-pires My flornr�ion E�pirs M.E.A. Engineering Associates Inc. V-�twol Consulting Mechanical Engineers 20 Felton Street, Waltham, MA 02453 781/894-6730 FAX 781/647-3542 Document Ref. No.: Stonewall NorthAndoverMA office.doc October 20, 2010 Fire Prevention Office City of North Andover Fire Prevention Department 124 Main Street North Andover, MA 01845 Attention: Fire prevention officer. Reference: Fire Alarm and Sprinkler Narrative 2nd Floor Tenant Fit Up for office at Stonewall Plaza 1820 Turnpike St. North Andover MA Dear Fire Prevention Officer: (1.a) BASIS (METHODOLOGY) OF DESIGN Section 1—Building Description a) Building "Use" group: B b) Total footage of building: 38,430 c) Building height: d) Number of floors above grade:) 3 e) , Number of floors below grade: 1 f) 2nd floor tenant square area: 6,007 g) Access type of occupancies within the building: B h) Type(s) of construction:2C Unprotected with and automatic sprinkler system i) Hazardous material usage and storage: none j) High storage of commodities within the building: none 1 k) Site access arrangement for emergency vehicles is through: Front access Type Section 2—Applicable Laws, Regulations and Standards The following is a list of reference standards that shall be used in system design, operation and maintenance. a) M.B.0 780 CMR 6th edition.). b) N.F.P.A. 13 (2007 Edition) c) 527 CMR 12.0, the Mass Electric Code 2005, N.F.P.A. 70 with Mass. Amendments. d) N.F.P.A. 72 2002 Edition e) ADA strobe meeting code reference 780 CMR N.F.P.A. 72-2002, and 521 CMR. The Massachusetts Architectural Access Code. f) Authority Having Jurisdiction — City of North Andover Section 3—Design Responsibility for Fire Protection Systems MEA Engineering associates; Inc. is responsible for 2nd level only. The Fire alarm contractor shall submit complete information regarding the fire alarm notifications devices shop drawing to the engineer for approval. The Sprinkler Contractor shall submit and shop drawings and proposed sprinkler equipment to the engineer for approval. The contractor will submit all approved shop drawings and product information to the North Andover Fire Department for approval. Section 4—Fire Protection Systems to be installed The proposed new work is summarized as follows: A. Sprinklers 1. New sprinkler heads shall be utilized in all locations. (Quick response type sprinkler heads to be installed with an ordinary temperature rating.) Stonewall North Andover office.doc 2. New seismic support for new sprinkler piping. 3. Sprinklers shall connect to existing zone flow station currently serving space. The existing sprinkler grid shall be reused and modified for new floor plan. 4. Existing sprinkler service is provided with a backflow preventer. 5. Existing system serving adjacent floor shall be kept live. B. Fire Alarm System 1. The proposed second floor tenant fit up shall tie the proposed power booster supply to existing landlord building main fire alarm control panel. 2. Smoke detectors located in electrical, telephone equipment room and similar rooms and are provided throughout as required per code. Audible alarms in common areas shall be sized to insure maximum sound levels throughout the tenant space. 3. The existing Fire alarm system shall be activated thru new manual pull stations, and common area smoke detectors. 4. The new Notifications fire alarm devices shall meet N.F.P.A. 72, 2002 ADA and local Fire Department requirements. 5. Manual pull station shall be located at exits, ADA strobes shall be in the public common areas and horn/strobes shall be in accordance with N.F.P.A. 72 2002. 6. Rooftop unit over 2000 CFM shall be equipment with duct smoke detector linked to fire alarm system 7. Common areas shall contain system smoke detectors wire to F.A.C.P Section 5—Features used in the Design Methodology A. Basis Of Design New portions of the sprinkler piping have been designed using the pipe schedule method for Light Hazard occupancies. Stonewall North Andover office.doc B. Sequence Of Operation Upon actuation of a sprinkler head (designed to release at 155°F) water shall start to discharge from the sprinkler head and water flow switch shall signal a water flow condition to the fire alarm panel. C. Testing Criteria Sprinkler System The new piping and heads shall be tested in accordance with all applicable codes. At a minimum this shall include notifying the Building Inspector and Engineer of Record of the time and date testing will be performed, completion of the contractor's material and test certificate (N.F.P.A. 13, Figures 8-1a and 8-1 b). The system shall be hydrostatically tested in accordance with N.F.P.A. 13 Section 8-2.2.1 "hydrostatically tested at 200 PSI and shall maintain that pressure without loss for two (2) hours." (1.b) SEQUENCE OF OPERATION Section 1 1. The operation of a manual station or activation of any automatic alarm initiating device (system smoke, system heat detector) shall initiate a system- wide response as follows: a. Initiate the transmission of the alarm to master box and central station. b. Sound a code 3 temporal evacuation signal over all audio circuits and shall be in sync. c. Flash all visual signals throughout the building. Visual notification shall be synchronous in accordance with NFPA 72 guidelines. Synchronization shall be system-wide, and shall be subject to the N.F.P.A. 72 2002 edition adopted as Massachusetts code. The failure of one visual NAC shall not cause a failure of other NACs serving the same evacuation zone. 2. The operation of any activation of other device designated to initiate a system Supervisory condition shall cause the following to occur: a. Duct smoke detectors shall be installed in accordance with manufacturer spec's NFPA72 and NFPA90 they shall be resettable at the fire alarm control or other location approved by the local fire department. Remote duct smoke indicators shut down latching supervisory signals for all remote duct smoke indicators shall report to a central supervising station. The station shall notify the building owner. Stonewall North Andover office.doc (1.c) TESTING CRITERIA Section 1— Testing Criteria A. The fire alarm system shall be completely tested in accordance with N.F.P.A.-72 by the Contractor when the tenant renovation is complete in the presence of the Owner. Upon completion of a successful test, the Contractor shall so certify in writing to the Owner and General Contractor. Section 2—Equipment and Tools A. The complete fire alarm system shall be installed in accordance with manufacturer's recommendations. All necessary equipment needed for a complete installation shall be available at the site. Section 3—Approval Requirements A. Upon completion of fire alarm and fire protection system installation, the Contractor shall obtain written approval from the Owner stating that systems satisfy all operational code compliance requirements. B. Owner shall provide to the City of North Andover Fire Department, the name and address of the Fire Alarm Contractor responsible for relocation of existing equipment and installation of new equipment. If you have any questions or comments, kindly contact our office. Sincerely yours, M.E.A. ENGINEERING ASSOCIATES,,,1NC; � tp, nrA #AldMuccini, E. �, President `'�► ,�� �;; Stonewall North Andover office.doc OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER '•' � CONSTRUCTION CONTROL PROJECT NUMBER: PROJECT TITLE: f to�6c l O-! UL f.__jt'e_(-/I to n e-Z e &j-o C. ),ck cf d��t C Q PROJECT LOCATION: I 92,0 y ('✓I h e- -/- l) YI NAME OF BUILDING: S L2 nL- J NATURE OF PROJECT: 11��1 vi - ✓(� IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, I,_\,A & ' T . �; ' 1 S REGISTRATION NO. 2.,R O Ci(-,, BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT l ARCHITECTURAL 0 STRUCTURAL 0 MECHANICAL 0 FIRE PROTECTION 0 ELECTRICAL 0 OTHER(SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become, generally familiar with6the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS,TyOJFHE,,NORTH ANDOVER BUILDING INSPECTOR. p1 H OF JN COMPLETION OF THE WORK, I SHA U NA EPORT AS TO THE �QQE C' ACTORY COMPLETION AND RE4G3R OJ CT FOICU AN OP.70 IGNATURE _ U CR�ED © BEFOR i s _DAY OF ZQ f U AL EI '•yNor Tq/�y UBLI MY COMMISSION EXPIRES // 2 2 �'� i GrA M Contracui, C� ,o 325 North Main Street Unit 15-B Middleton, MA 01949 Office: 978-777-8007 Fax: 978-777-5004 D S on Ca I �� �L. L �i Z lnr 1 G. D O I C" Pcx-4-c'1 Cl o,, T tc ri o A Z gs-s-cD yYl�� tJ r► , 0,_ /CA 1-7 J- dlb e 2 bio 000 ,00 Total i OCµ0i e'M'y Ili y. O �'rSACHUSEi CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 367-2011 Date: January 3, 2011 THIS CERTIFIES THAT THE BUILDING LOCATED ON 1820 - 1830 Turnpike Street, Patricia S. Fernandez & Associates Law Office i AY BE OCCUPIED AS tenant fit-up, 2°d Mfloor law office IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Stonewall Plaza,LLC 1820 Turnpike Street North Andover,MA 01845 I Building Inspector Fee: $100.00 Receipt: 23631 previous paid- r NORTH - ofower 0 No.-3 6o'7 aor/ i. dover, Mass.,LA E COCHICHEWICK 7�S RATED U BOARD OF HEALTH Food/Kitchen .PERMIT T D Septic System / BUILDING INSPECTOR THIS CERTIFIES THAT.......... ............................................................. Foundation has permission to erect.........:. r...... buildings on ..A.Pez . 3...� ...... ..�/� � �:...........��?`l.`t ough � ............. ..... to be occupied as ! !?-! � /.. f. .......... 1�" 'G. ..:.. ''�!!�. ?�clG � ...r, ' 5 ? .. 1.�� ii' `Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 INSPECT VIOLATION of the Zoning or Building Regulations-Voids this Permit. ou /Z/ry PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION STARTS EL cTRICAL PECTO Rou /'-'- //- I Ltt .................. ......... . .. ............................................................. Service BUILDING INSPECTOR ina Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove in No Lathing or Dry Wall To BeDone FIRE DEPARTMENT' Until Inspected and Approved by the Building Inspector. urner / Street No Smoke Det. SEE REVERSE SIDE f y_�� GP ASSOCIATES. Inc Consulting Engineers Mr. Gerald Brown. Dt ;December 30,2010 Inspector of Biildings 1600, Osgood Street. No. Andover,Ma 01845 j I Reg : 1820, Turnpike Street.No.Andover,Suite201 Final Report. The fit up work is complete.The completed work meets the requirements of the I Massachusetts Building code. Work completed includes Drywall,Painting,Ceiling, • Electrical &plumbing. All the work is as per drawings issued. If you have any questions, Pl. contact our office. Sincerely. A Ram kSatyvapprahsa ka 'A'"'&'SASTRY TYAPRASAD Cn No.28096 O Cn "S1 M tiN i 29, Cresthaven Drive,Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net Yf` . Dimension Number of Stories:_Total square feet of floor area, based on Exterior dimensions.3F 3� Total land area, sq. ft.: F -y� ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine I I NOTES and DATA— For department use I I ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 I ra r, Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products dumpster NOTE: All Aster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2008 x -- YYYI r ACORD pPlSCO-1 0 6 1910- CERTIFICATE ®F LIABILITY INSURANCE OP In °ATE(MMIDD/- 10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dadgar Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 400 Test Cu mingo Park HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Suite 6725 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Woburn NIA 01801 Phone: 781-933-2626 FaXs781-932-6341 INSURERS AFFORDING COVERAGE NAIClt INSURED r� INSURER A: Noiyoko n4tuni rno cc in eaim 14206 INSURER B: QFM Contracting INSURER C: Ai5 North Main 8t Unit 158 INSURER D: ddleton KA 01944 INsuaERE: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMENT,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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. "RgWLTR RKOO TYPE OF INSURANCE POLICY MlAASER DATE D GATE /YY) VLNIIR9 GENERALLIABILRYEACH OCCURRENCE S 10_00000 A X COMMERCIAL GENERAL LIABILITY CPP7017804 01/01/10 01/01/11 PREMISES(Eeoccur i 100001) --J Ct AIMS MADE FX]OCCUR MED EXP(Any one Pena+) $ 5000 ` PERSONAL&ADV INJURY $ 1000000 GENERAL AGGREGATE s2000000 GEN'LAGGREGATE LIMITAPPLIES PER! PRODUCTS-COMP/Op AGG s2000000 POLICY JPER� LOC AUTOMOBILE LIABlUrYCOMIBINEDSINGLE LIMIT $ 1000000 A _ ANY AUTO CA9012129 01/01/10 O1/O1/11 (Fa accident) l ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per oypon) : X HIRED AUTOS BODILY INJURY X NON-OW NEO AUTOS (Per ecocent) f ��. PROPERTY DAMAGE & (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG S EXCESSIVMBRELLALIABILITY EACH OCCURRENCE S 1000000 A XOCCUR 17 CLAtMSMADE 000006054185 01/01/10 01/01/11 AGGREGATE $ 1000000 S _ DEDUCTIBLE S R i RETENTION $10000 S WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT S ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE,-EA EMPLOYEE S N ye9,describe Willet SI'ECtAL PROVISIONS below E.L.DISEASE-POLICY LIMIT b OTHER A Property Section CPP7017004 01/01/09 01/01/10 Contents 10404 A Equipment Floate CPP7017004 1 01/01/09 01/01/10 Deductibl 500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CONTRACTOR FAX 781-944-2609 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE OESCRIBEO POLICIES BE CANCELLED BEFORE YHE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 oms WRITTEN xxxxxxxxxxxxxxxxxxxxxxxxxxxxXX NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 50 SMALL XXXXxxxxxxxxx7=xxxZx1=xxxxxx IMPOSE NO 001-10ATION OR LIABILITY OF ANY RIND UPON TME INSURER,ITS AGENTS OR XxxxxxxxxxxxxxXXxxxxxxxxxXxxxR REPRESENTATIVES. A RED RE ATIVE ACORO 25(2001108) 0 ACORD CORPORAIlON 1988 * i 17 ,aco CERTIFICATE OF LIABILITY INSURANCE -DATE/13/2008) �� 3/13/2 PRODUCER (978) 696-0007 FAX: (978)345-6811 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Employers Insurance Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 281 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 7B Fitchburg MA 01420 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA:Savers Property & Casualty Resource Management, Inc. INSURER B: Alternate Employer: GFM General Contracting INSURER Corp. , 281 Main Street, Suite 5 INSURER D: Fitchburg MA 01420 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTAN DING 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADD'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION. LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED i PREMISES(Ea occurrence) CLAIMS MADE OCCUR ; MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY' PRO-jEC LOC AUTOMOBILE LIABILITY ECOMBINED BINEt DSINGLELIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO ! OTHER THAN EA ACC $ ........._.. .I._.... .... .... . . AUTO ONLY: AGG I$ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE $ DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION WC STATU- OTH AND EMPLOYERS'LIABILITY Y/N TORY LIMITS:-X...ER ANY PROPRIETOR/PARTNER/EXECUTIVE L OFFICER/MEMBER EXCLUDED --E.L.EACH ACCIDENT-- :.$ 1,000,000 (Mandatory in NH) WC0002526 1/1/2010 1/1/2011 E.L.DISEASE-EA EMPLOYEE $ 1r 000r000 ._ . . ................ . If yes,describe under _ � SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 a OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Covers the employees of the named insured leased to: GFM GENERAL CONTRACTING CORPORATION 325 NORTH MAIN STREET - UNIT 15 B MIDDLETON, MA 01949 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION for record only DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE _ .. Judy Prescott/KATHYM ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(200901) The ACORD name and logo are registered marks of ACORD I ti(assachusetts- Department 44 PUI)lic Safe" Bourd of Building,; Regulations:ind St.indards Construction Supervisor License License: CS 17935 Restricted to: 00 FRANCESCO FODERA 2 FRANKLIN ST READING, MA 01867 Expiration: 7/29/2011 ( nuroi..i ecT Tr#: 19552 tnsof W483054 G10' pOB, ry� '07: .2013 07-2 I r CLASSREST MGT SEX �' re 0 W)7 M F4DERA M1ASSd� we f FRANCESC4 "Fr 2 FRANKLIN S7 READING.MA 01867.1117 J GFA M Contract . 325 North Main Street Unit 15-B Middleton, MA 01949 Office: 978-777-8007 Fax: 978-777-5004 S 4-o,i e tv a I 1 `0 A 1,/� o rm �, C-174 , ill --e � f - u r c i o, n o.Yl G Q f:: YY► F�} Cn� /err Pl���, S 2 J / `T-C9 T/�L- ccT 90 ,00 _ r .1 Total LEVI - WONG DESIGN ASSOCIATES INC Design Affidavit Architectural To the North Andover, MA CODE ENFORCEMENT DEPARTMENT, BUILDING DIVISION; In accordance with Section 116.21 of the Massachusetts State Building Code, I Ruth Neeman AIA being a Professional Architect, certify that that the plans for the areas within the designated limits of work for the Northeast Health Systems— spectrum Adult Day Center Tenant Fit UD project, located at 1845 Turnpike street North Andover MA, have been reviewed by me and to the best of my knowledge, such plans conform to the provisions of said Code, all acceptable engineering practices and all applicable laws and ordinance. will comply with the requirements of Section 116.22 (Construction Control) for the structural portions of the building if applicable and submit reports to the Building Inspector for inclusion in his reports as required by Section 116.23 of the Code. The statements contained herein are an expression of the undersigned professional opinion; are made to the best of the undersigned knowledge, information and belief; are based on the undersigned performance of service under the scope of work and agreement; and are in accordance with acceptable standards of professional practice. As such, they constitute neither a guarantee nor warranty, expressed or implied. hereby certify that I am a duly licensed and registered archite Commonwealth of Massachusetts. D AERP? NEF�q F�,� (Signed) 2 Ruth Neeman AIA No. 20028 (Architect) 4 TEWKSBURY �o Mass G,rJ 20028 � [TMOF M'qZ `SP (MA Registration) o 'w ' I &, ,2U1 e? (Seal) (Date) Subscribed and sworn to before me this JLAk day of 2010 . LIBBY DANA (N ublic) t"My Public My Commission Expires tr♦0° OaoWr 14 1/1 45 Walden Street,concord,MA 01742 1 tel 978.371.1945 fax 978.371.0069 GFM Contrac(11,g, C Of. •b 325 North Main Street Unit 15-B Middleton, MA 01949 Office: 978-777-8007 Fax: 978-777-5004 November 22, 2010 Stonewall Plaza, LLC 1820 Turnpike Street N. Andover, MA GFM General Contracting Corp. will build tenant Fit-Up for Northeast Senior Health at 1820 Turnpike St in North Andover, MA Unit #106 as per plans dated November 16,'2010. Plans # GO.01, A1.11, A1.21, A4.11, E-1, E-2, E-3, E-4, FA-1, FA-2, M-1, M-2, P-1, P-2, P-3, SP-1 and Site Plan # A of 1 1) Inside Metal Partitions $25,000.00 2) Sheet Rock and Joint Compound 19,500.00 3) Floor Tiles and Rugs 9,500.00 4) Drop Ceilings 10,200.00 5) Electrical and Fixtures 22,500.00 6) Plumbing, Kitchen Fixtures and Bathroom 24,700.00 7) HVAC 23,000.00 8) Fire Protection 3,000.00 9) Painting 6,000.00 10) Doors 12,000.00 11) Kitchen Cabinets, Vanities and Appliances 6,500.00 12) Bathroom Vanity Tops and Misc. 6,000.00 Total Contract $167,900.00 Signatures of Agreement Stonewall Plaza, LLC GFM General Contracting Corp. C � ���. k) Site access arrangement for emergency vehicles is through: Front access Type Section 2—Applicable Laws, Regulations and Standards The following is a list of reference standards that shall be used in system design, operation and maintenance. a) M.B.0 780 CMR 7th edition.). b) N.F.P.A. 13 (2007 Edition) c) 527 CMR 12.0, the Mass Electric Code 2008, N.F.P.A. 70 with Mass. Amendments. d) N.F.P.A. 72 2007 Edition e) ADA strobe meeting code reference 780 CMR N.F.P.A. 72-2007, and 521 CMR. The Massachusetts Architectural Access Code. f) Authority Having Jurisdiction —City of North Andover Section 3—Design Responsibility for Fire Protection Systems MEA Engineering associates; Inc. is responsible for 1st level only. The Fire alarm contractor shall submit complete information regarding the fire alarm notifications devices shop drawing to the engineer for approval. The Sprinkler Contractor shall submit and shop drawings and proposed sprinkler equipment to the engineer for approval. The contractor will submit all approved shop drawings and product information to the North Andover Fire Department for approval. Section 4—Fire Protection Systems to be installed The proposed new work is summarized as follows: A. Sprinklers 1. New sprinkler heads shall be utilized in all locations. (Quick response type sprinkler heads to be installed with an ordinary temperature rating.) Stonewall North Andover office.doc 2. New seismic support for new sprinkler piping. 3. Sprinklers shall connect to existing zone flow station currently serving space. The existing sprinkler grid shall be reused and modified for new floor plan. 4. Existing sprinkler service is provided with a backflow preventer. 5. Existing system serving adjacent floor shall be kept live. B. Fire Alarm System 1. The proposed first floor tenant fit up shall tie the new proposed fire alarm remote annunciator to existing landlord building main fire alarm control panel. 2. Smoke detectors located in electrical, telephone equipment room and similar rooms and are provided throughout as required per code. Audible alarms in common areas shall be sized to insure maximum sound levels throughout the tenant space. 3. The existing Fire alarm system shall be activated thru new manual pull stations, and common area smoke detectors. 4. The new Notifications fire alarm devices shall meet N.F.P.A. 72, 2002 ADA and local Fire Department requirements. 5. Manual pull station shall be located at exits, ADA strobes shall be in the public common areas and horn/strobes shall be in accordance with N.F.P.A. 72 2007. 6. Rooftop unit 2000 CFM shall be equipment with duct smoke detector linked to fire alarm system 7. Common areas shall contain system smoke detectors wire to F.A.C.P 8. Carbon Monoxide shall be local and not connected to main fire alarm control panel Section 5—Features used in the Design Methodology A. Basis Of Design Stonewall North Andover office.doc New portions of the sprinkler piping have been designed using the pipe schedule method for Light Hazard occupancies. B. Sequence Of Operation Upon actuation of a sprinkler head (designed to release at 155°F) water shall start to discharge from the sprinkler head and water flow switch shall signal a water flow condition to the fire alarm panel. C. Testing Criteria Sprinkler System The new piping and heads shall be tested in accordance with all applicable codes. At a minimum this shall include notifying the Building Inspector and Engineer of Record of the time and date testing will be performed, completion of the contractor's material and test certificate (N.F.P.A. 13, Figures 8-1a and 8-1b). The system shall be hydrostatically tested in accordance with N.F.P.A. 13 Section 8-2.2.1 "hydrostatically tested at 200 PSI and shall maintain that pressure without loss for two (2) hours." (1.b) SEQUENCE OF OPERATION Section 1 1. The operation of a manual station or activation of any automatic alarm initiating device (system smoke, system heat detector) shall initiate.a system- wide response as follows: a. Initiate the transmission of the alarm to master box and central station. b. Sound a code 3 temporal evacuation signal over all audio circuits and shall be in sync. c. Flash all visual signals throughout the building. Visual notification shall be synchronous in accordance with NFPA 72 guidelines. Synchronization shall be system-wide, and shall be subject to the N.F.P.A. 72 2007 edition adopted as Massachusetts code. The failure of one visual NAC shall not cause a failure of other NACs serving the same evacuation zone. 2. The operation of any activation of other device designated to initiate a system Supervisory condition shall cause the following to occur: a. Duct smoke detectors shall be installed in accordance with manufacturer spec's NFPA72 and NFPA90 they shall be resettable at the fire alarm control or other location approved by the local fire department. Remote duct Stonewall North Andover office.doc smoke indicators shut down latching supervisory signals for all remote duct smoke indicators shall report to a central supervising station. The station shall notify the building owner. (1.c) TESTING CRITERIA Section 1— Testing Criteria A. The fire alarm system shall be completely tested in accordance with N.F.P.A.-72 by the Contractor when the tenant renovation is complete in the presence of the Owner. Upon completion of a successful test, the Contractor shall so certify in writing to the Owner and General Contractor. Section 2— Equipment and Tools A. The complete fire alarm system shall be installed in accordance with manufacturer's recommendations. All necessary equipment needed for a complete installation shall be available at the site. Section 3—Approval Requirements A. Upon completion of fire alarm and fire protection system installation, the Contractor shall obtain written approval from the Owner stating that systems satisfy all operational code compliance requirements. B. Owner shall provide to the City of North Andover Fire Department, the name and address of the Fire Alarm Contractor responsible for relocation of existing equipment and installation of new equipment. If you have any questions or comments, kindly contact our office. Sincerely yours, M.E.A. ENGINEERING ASSOC C. %A OF t% AtFMD RJOCINI y Alfred E. Muccini, P.E. -. No.23539 President °i(JIVALE�``. Stonewall North Andover office.doc ACORD p88C0_CERTIFICATE OF LIABILITY INSURANCE OP ID DATE(MMIDD1 06/14110 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dadgar insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 400 West Cumminga Park MOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Suite 6725 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Woburn MA 01801 Ph*ne:781-933-2626 PaXs781-932-6341 INSURERS AFFORDING COVERAGE NAICS INSURED INSURER A: Holyoke Natwl me ee in gale& 10206 INSURER e' GPM Contract' INSURER C: 3f5,t eton MM,Iad"St� Unit 158 INSURER O: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW WAVE BEEN LSSUEO TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUtREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY Be ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED eY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR R TY060F INSURANCE POLICY MRIMOElt DATE D GATE /YY .lMIT9 OENENMAL LIABILITY EACH OCCURRENCE 3 1000000 A X COMMERCIAL GENERALLIA8ILITY CPF7017604 01/01/10 01/01/11 PREMISES(Eeoocurenm) $ 100000 _ J CL AIMS MAOE �X]OCCUR MED EXP(Any one Person) $ 5000 PERSONAL&ADV INJURY 31000000 _ — I GENERAL AGGREGATE $2000000 GEN•LAGGREGATE ppLRIIMpIITAPPLIES PER! PRODUCTS.COMP/OPAGG 32000000 POLICY JECT ,LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 A _ ANY AUTO ICA9012129 01/01/10 01/01/12 (Eaacvaent) ALL OWNED AUTOS I BOOILY INJURY x SCHEDULED AUTOS 4I (Per Deleon) f X HIRED AUTOS BODILY INJURY 4�� NON-OWNED AUTOS (Per M6Cldent) f PROPERTY DAMAGE (Per accdenl) AGE LIABILITY AUTO ONLY-(?A ACCIDENT S ANY AUTO EA ACC S OTHER THAN AUTO ONLY: ACG S ES&UMBRELLA--LIIA81LrYY EACH OCCURRENCE 31000000 OCCUR ( JCLAIMSMAOE CVOOOGOS4185 01/01/10 O1/O1/11 AGGREGATE $ 1000000 f DEDVCTIBLE 3 %---j RETENTION $10000 S WORKER6 COMPENSATION ANO TORY LIMITS ER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT S ANY PROPRIETOR/PARTNMEXECUTIVE OFFICER/MEMBER EXCLUOEW E.L.DISEASE•EA EMPLOYEE $ N Yes.AL PR a unosPROVISIONS E.L.DISEASE•POLICY LIMB 3 SPECIAL PROVISpNS beta. OTHER A Property Section CPP7017604 01/01/09 01/01/10 Contents 10404 A Squizoent Ploate ICPP7017004 01/01/09 01/01/10 Deductibl S00 OESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDEO BY ENDORSEMENT I SPECIAL PROVISIONS CONTRACTOR FAX 781-944-2609 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.TWE ISBUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Xxxx =xxxxxxxxxxxxxxxxxxxxxx NOTICE TO THE CERTWICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 00 SMALL xxxxxxx IMPOSE NO OALIGAT1pN OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR XXXXXx7[7gCxxxxxxxxxxxxxxxxxxxxx REPRESENTATIVES. RED RE ATIVE ACORO 25(2001100) IID ACORD CORPORATION 1988 CERTIFICATE OF LIABILITY INSURANCEDATE(MMIODIYYYY) 3/13/2008 PRODUCER (978) 696-0007 FAX: (978) 345-6811 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Employers Insurance Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 281 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Suite 7B Fitchburg MA 01420 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER Savers Property b Casualty Resource Management, Inc. INSURER B Alternate Employer: GFM General Contracting INSURER Corp. , 281 Main Street, Suite 5 INSURER Fitchburg MA 01420 INSURER COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTAN DING 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AOD'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION )ATE IMMIDD1YYYY1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Ea occurrence) $ CLAIMS MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCT$-COMP/OP AGG $ POLICY PRO- LOC - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOSBODILY INJURY $ . (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESS I UMBRELLA LIABILITY r— EACH OCCURRENCE $ OCCUR _ CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ $ RETENTION $ $ A WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN .TORY LIMITS: X ER ANY PROPRIETOR/EXCLUDED� �j RIEXECUTNE EL EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED' (Mandatory in NH) WC0002526 1/1/2010 1/1/2011 EL DISEASE $ 1 000,000 If yes descnbe under . . .. -, , SPECIAL PROVISIONS..I.. E L DISEASE-POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Covers the employees of the named insured leased to: GFM GENERAL CONTRACTING CORPORATION 325 NORTH MAIN STREET - UNIT 15 B MIDDLETON, MA 01949 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION for record only DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 GAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ..L:dy Pre scot t/KA:NYM ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025zooeo, c ) The ACORD name and logo are registered marks of ACORD tit:+..:+chusrtt• Department 401 Public '%afct� Board of Building_ Re-_ulation% and 1%tandard.% Construction Supervisor License License CS 17935 Restricted to: 00 FRANCESCO FODERA 2 FRANKLIN ST READING, MA 01867 ML Expiration: 7/29/2011 Trtt. 19552 ;awl. :;;w<,r•-.: .,. 557483054 _ cxr Dob •07-2-4-201.3 07- CLASS Rcs1 %G1 $ix � Fs-07 M ODERA r ,5c ��If tM Mo55���w2 FRANCE00 " FRANKLIN S .' READING.W 01867.1117 "Q macnv d' . NORTHEAST SENIOR HEALTH Page 1 of 2 Policies & Procedures: Flooding, or Loss of Heat, Effective: 11/15/01 Air Conditioning, Power,Water or Sewer Spectrum Adult Day Health Flooding or Loss of Heat,Air Conditioning,Power,Water or Sewer APPLICABILITY: All clients. POLICY: To provide a safe, sanitary environment for clients and staff according to Board of Health and State Regulations in the event of flooding, loss of � g power,heat,air conditioning,water or sewer. PROCEDURE: If any of the above emergency situations occur,the following steps should be taken: 1. Call or page building maintenance immediately to ascertain the nature of the problem and the expected length of the outage or disruption. 2. Notify Director of Community Programs. 3. If resolution of problem is expected to take longer than 30 minutes,page or call the Director of Community Programs, for advice on relocating the clients temporarily in another location. 4. If clients have to be temporarily relocated,two staff must stay with each group as they are moved. All emergency documentation,treatment,medication, and personal items must be relocated with the clients. The cell phone and call lists must also be taken. 5. Staff should try to minimize client confusion and disorientation by redirecting them with activities,etc. 6. If water,power or sewer interruption cannot be re-established within a reasonable period of time, and this is a building-wide problem with no safe location for the clients to be transferred into,the program may be closed for the day. Staff should call family and caregivers to pick up their loved ones as soon as possible from either Spectrum or the temporary location. 7. Billing for this day will depend on the number of hours spent at the program(Medicaid requires a minimum of 6 hours for reimbursement to be paid). OUTCOME: Clients will be cared for in a safe and sanitary environment. C:\Users\G.C.FODERA\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.IE5\8BB4G9SK\Flooding Heat Loss Etc..doc Fnrmat Rpvical• 2/21/(14 ('nntvrt Ravicail• 1N72/(1(. ♦ I NORTHEAST SENIOR HEALTH Page 1 of 2 Policies & Procedures: Fire Safety Effective: 08/27/08 Spectrum Adult Day Health North Andover Fire Safety POLICY: In the event of a fire in the North Andover Day Program, staff are responsible for evacuating clients to a safe location and contacting the Fire Department PROCEDURE: Fire and Safety Prevention: 1. Staff will review policy and procedure during orientation and at least quarterly at staff meetings. 2. All staff will demonstrate knowledge of the location and use of the following: I a. Fire alarm boxes b. Fire extinguishers c. Heat and smoke detectors d. Program evaluation diagrams, i.e. Client Emergency g g Y Information or Kardex file 3. Monthly fire drills will be conducted with the staff and an evaluation form will be completed and assess the staff's knowledge with fire safety procedures. 4. Electrical Equipment e. Do not overload outlets by using multiple plug adapters. f. Do not pull wires to get a plug out of the wall socket. g. Keep wheelchairs away from any electrical cords. h. Keep unused wall sockets closed off with childproof plugs. Evacuation: When the fire is within the building: 1. If the automated fire alarm system has not yet activated on its own, staff will pull the fire alarm switch to activate it. 2. All staff will assist in calmly grouping the clients and putting on outdoor clothing. Ambulatory clients will be led in pairs out of the Center. Wheelchair clients will be wheeled to the exit by staff, who I will remain with the clients until they are evacuated by Police/Fire Department. When practical, Clients will be evacuated to the back fenced in patio area for safety. If this is not possible due to the location of the fire, the location of exit will be at the far end of the Format Revised: 3/31/03 Content Revised: 08/23/10 NORTHEAST SENIOR HEALTH Page 2 of 2 Policies & Procedures: Fire Safety Effective: 08/27/08 parking lot area. 3. Site Coordinator/Nurses will bring Kardex, cell phone, first aid kit, and medications, and assign one staff member to check the bathrooms and kitchen for clients. Shut down doors after everyone has exited. 4. Extinguish the fire if possible by using a fire extinguisher—if wastebasket or small fire. Fire Extinguishers: • Type A: Combustibles (paper and wood)—Use water,powder or halon extinguisher. Type B: Flammable liquids (gasoline, Kerosene YP ids q (g ) Use e carbon dioxide or halon extinguisher. • Type C: Electrical (computer, television)—Use carbon dioxide, owder or halon extinguisher. p � 5. All clients, staff,volunteers and family will be evacuated in a timely manner to Beverly Hospital At Danvers, 480 Maple Street,Danvers 978-774-4400 and wait for clearance. When a fire is outside of the building: 1. Remain in the Center continuing normal course of activities. Clients and staff will NOT be evacuated unless told to do so by Administration of the North Andover Police or Fire Department. Evacuation will be to the parking lot and then directly home if caregivers are in place to receive clients. Post-Incident Evaluation: 1. Executive Director will conduct evaluation using Disaster Post Evaluation Document. This should then be forwarded to the Director of Community Programs. OUTCOME: Danger to clients and staff will be minimized through knowledge and execution of correct procedure. Format Revised: 3/31/03 Content Revised:08/23/10 NORTHEAST SENIOR HEALTH Page 1 of 1 Policies & Procedures: Disaster Plan Effective: 08/27/08 Spectrum Adult Day Health Disaster Plan POLICY: To ensure basic life/safety of Day Programs participants during declared community disasters. PROCEDURE: 1. The Director of Community Programs will notify staff of the Spectrum Adult Day Program in the event of a community disaster. Some examples of this are fire,weather,power failure, etc. 2. Program managers,their designee(s) and staff will implement the snow chain.This list of clients will be known as"Day Programs Snow Chain." It will be updated regularly as program participants are admitted/discharged or have changes occur. 3. Program managers and staff will contact each participant of the Snow Chain to access their personal safety and needs to maintain and promote basic welfare during the disaster period. Staff will coordinate with other departments (i.e.,NHS dietary department, NSPRN,NortheastLink, Transportation, ASAP's etc.) and outside community agencies as deemed necessary to ensure the basic safety for each participant identified as"at-risk". 4. Documentation of telephone contact and result of call(s)will be maintained by program managers. 5. In the event a day program participant cannot be reached or thought to be at risk,and where conventional options/interventions cannot ensure their basic safety, staff will notify the Director of Community Programs for further review and attention. 6. Program managers will do post disaster follow-up within three (3)working days using disaster evaluation tool. OUTCOME: Danger to clients and staff will be minimized through knowledge and execution of correct procedure. C:\Users\G.C.FODERA\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.IE5\8BB4G9SK\Disaster Plan.doc �..,.,,�rno.,;�o,�• znmz 1,n *n +Ao..-4.nQn'YmQ NORTHEAST SENIOR HEALTH Page 1 of 1 Policies & Procedures: Weather Emergency Plan Effective: 08/27/08 Spectrum Center Adult Day Program Weather Emergency Plan POLICY: To ensure basic life/safety of Day Programs participants during severe weather events such as hurricanes and snow storms. PROCEDURE: 1. The Director of Community Programs will notify staff of the Spectrum Adult Day Program in the event of a weather emergency. Some examples of this are hurricanes,blizzards etc. 2. Executive Director,their designee(s) and staff will implement the snow chain. This list of clients will be known as "Day Programs Snow Chain." It will be updated regularly as program participants are admitted/discharged or have changes occur. 3. Executive Director and staff will contact each participant of the Snow Chain to access their personal safety and needs to maintain and promote basic welfare during the disaster period. Staff will coordinate with other departments(i.e.,NHS dietary department, NSPRN,NortheastLink, Transportation,ASAP's etc.)and outside community agencies as deemed necessary to ensure the basic safety for each participant identified as"at-risk". 4. Documentation of telephone contact and result of call(s)will be maintained by Executive Director. 5. In the event a day program participant cannot be reached or thought to be at risk, and where conventional options/interventions cannot ensure their basic safety, staff will notify the Director of Community Programs for further review and attention. 6. Executive Director will do post event follow-up within three(3) working days using disaster evaluation tool. OUTCOME: Danger to clients and staff will be minimized through knowledge and execution of correct procedure. C:\Users\G.C.FODERA\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.IE5\8BB4G9SK\Weather Emergency Plan.doc Format Revised: 3/31/03 Content Revised:08/27/08 NORTHEAST SENIOR HEALTH Page 1 of 2 Policies&Procedures: Evacuation Plan Effective: 08/27/08 Spectrum Adult Day Health North Andover Evacuation Plan APPLICABILITY: All clients enrolled in Spectrum Center Adult Health Program at North Andover and all staff,volunteers and family present at the time of Emergency. POLICY: All clients, staff,volunteers and family will be evacuated in a timely manner to Beverly Hospital At Danvers, 480 Maple Street,Danvers 978-774-4400. PROCEDURE: person in charge of program at the time of the emergency,will determine the need to evacuate and will inform staff in a calm manner. The Director of Community Programs must also be informed by calling 978-921-1697,x 226,or cell phone 978-697-6996. Building security must be contacted immediately for assistance. The following actions will then be taken: 1. A quick head count will be taken of clients, checking bathrooms and activity space for stragglers. 2. Clients(with their outerwear)will be escorted to transportation by staff members,volunteers and family members. Transportation will consist of the Spectrum Van as well as staff member's vehicles. Once there, another head count should be taken and the clients made comfortable. 3. The Program charge person should take any supplies required to provide interim care to the clients. Supplies will include the emergency file/Kardex with client information,appropriate medications and treatment supplies,personal care supplies, blood pressure equipment and activity items. The cell phone must also be taken. 4. During the stay in the temporary facility,head counts will be taken frequently and at least every fifteen minutes to minimize clients wandering from the room. 5. When the reason for the emergency has been determined, and a correction plan is in place,clients will either be returned to the Spectrum at Andover site,or families will be called to pick up their family member. C:\Users\G.C.FODERA\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content_IE5\8BB4G9SK\Evacuation Plan Andover.doc Format Revised: 3/31/03 Content Revised:08/27/08 NORTHEAST SENIOR HEALTH Page 2 of 2 Policies & Procedures: Evacuation Plan Effective: 08/27/08 6. If a family is not able to pick up their family member, staff will remain at the temporary location with the client until the family can come to take the client home. 7. All supplies should be returned to the program,and the Director of Community Programs must be notified at the conclusion of the evacuation. OUTCOME: Clients, staff and volunteers will be located in a safe,temporary location,until the outcome of the emergency can be determined. C:\Users\G.C.FODERA\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.IE5\8BB4G9SK\Evacuation Plan Andover.doc Format Revised: 3/31/03 Content Revised:08/27/08 Northeast Senior Health Page 1 of 1 Policies & Procedures: Client Wandering Effective: Spectrum Center Adult Day Program Client Wandering APPLICABILITY: All clients. POLICY: 1. Clients will be evaluated upon admission, and then at frequent intervals during their stay in the program to determine wandering risk. This evaluation will include discussion with the family or caregiver. The wandering risk will be documented in the client chart,and all staff made aware of this prior to admission or at a Care Meeting. 2. The program exit doors will be alarmed at all times. PURPOSE: To keep clients safe in a secure alarmed environment. PROCEDURE: When the client has been identified as being at risk for wandering, staff will plan strategies to redirect client either on a 1:1 basis or with more than one staff member. Activities will be considered as a diversionary tactic,particularly regular walks in the building. The staff member accompanying the client should have a cell phone with them at all times in order to communicate with the program. Medication management changes may also be discussed with the family, if all other options have been explored and the client appears to be"sun- downing". Staff on the floor will monitor all clients frequently during the day, doing a visual"head count"that includes the potential wanderer, In an emergency situation where the client cannot be redirected for substantial periods of times, a staff person will be designated to physically remain at or close to the exit door to prevent the client leaving the program. If a client successfully leaves the program without a staff person in attendance, staff will notify security at the North Andover Police Department for assistance if client is not immediately found in the parking lot. Subsequently, an Agency incident report must be filled out and the Director of Community Programs notified as soon as possible. OUTCOME: The clients will remain safe in a secure,alarmed environment without potential injury to themselves or others. C:\Users\G.C.FODERA\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.IE5\8BB4G9SK\Client Wandering NA.doc Format Revised: 3/31/03 Content Revised: 10/16/10