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HomeMy WebLinkAboutBuilding Permit #551 - 21 HIGH STREET 4/20/2009 BUILDING PERMIT "°oT" qti TOWN OF NORTH ANDOVER 02 APPLICATION FOR PLAN EXAMINATION 4 * Permit NO: Date Received �' `^Too" " p�gwTeO �SSACHus�� Date Issued: -0/0 9 IMPORTANT:Applicant must complete all items on this page LOCATION �k\4-K 1JU _ rint PROPERTY OWNER_ , Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village CiDno TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial eration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: (2 IdentifiSation lease Type or Print Clearly) OWNER: Name:__DI A v i v -STN i W Q 6,rL CrH Phone: 82 /3 1 Address: V!9 La o �' 17 (AI0 a-ki vt 1sL 1 i d ZI x CONTRACTOR 'Name: '`4 µ0�,V r Phone: Address: t' IrUp ;t Ct g1 Y Supervisor's Construction License: Exp, Date: 05 Home`Improvement License: 10 8' �l U Exp. Date: O q . ARCHITECT/ENGINEER VkA L-,'✓9 3-(16-rJ Phone: 6/-7-e,�`� .aCs- Address:S u r--6 ft-t)0 1,oqLo C) V- �r9- Reg. No. bd � 0 u �-3 FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $_ O ck FEE: $ k �0 k x Check No.: 1 Z Receipt No.: -91 �76/ NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund �.� §ignature of Agent/Owner _ ignature of contractor �t,� 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 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 a 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 FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: 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 2008 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 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 Application Revised 2.2008 'J . Location No. Date MOR7M TOWN OF NORTH ANDOVER � w f a y • ; , Certificate of Occupancy $ Building/Frame Permit Fee $ 3 s�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # .314 t 21961 Building Inspector Location No. / Date NORTH TOWN OF NORTH ANDOVER � 9 QG Certificate of Occupancy $ ' �'�s'••°•;<�' Building/Frame Permit Fee $ ncMus Foundation Permit Fee $ Other Permit Fee $ o+- TOTAL $ Check # 0 y�p96 22 � � 5 , Building Inspe or MUDtTN O •4 Y N CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Permit# 551 0/22/09) Date: July 1. 2009 THIS CERTIFIES THAT THE BUILDING LOCATED ON 21 High Street— Ste 210 MAY BE OCCUPIED AS Commercial Fit Up—GAB- Robins Ins ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Robins Insurance 21 High Street North Andover Ma 01845 Building Inspector NORTH T And O" 0 f over A In �/' /� No. LAKE dower, Mass.. A COCHICHE"":."' 0RATED 5 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System N4. BUILDING INSPECTOR THISCERTIFIES THAT.................................................. ........................................................................ Foundation 4 has permission to erect........................................ buildings ......i.................... ................... ... Rough Chimney to be occupied as.... .......S....... ...........;:. 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION TARTS jco19`E .......... Service .............OC�..�a-"c-1A .�BXA i�i�TOR _inalL 9�. d4p 4 �et Occupancy Permit Required to Occupy Building -A f(A I 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. NORTI-� 0 0Andover . No. -__ 6-- o dover, Mass.- LAKE , �. COCMICMEWICK y 7d ORATED 5 77S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT (2� �'�' � ''/s ' ..................................................1.....�... � .:........................................................................ Foundation buildings on , .�... �. f� sv�'�f� � c ; has permission to erect............................: ... Rough �J . to be occupied as.............. �." "' '. ..�!�.0�7(..: :. SU/l%/�/� ... 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 PERMIT EXPIRES IN 6 MONTHS ` ELECTRICAL 111SPECTOR UNLESS CONSTRUCTION STARTS o Ne_ � ; Service ............. ..... . .... ...... ......................................... inal -d BUIL ING INSPECTOR Occupancy Permit Required to Occupy Building PEc 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: K'�� _��x+ '"� .�*k� ��e"' .�y���"'1<tz3"`fie. .r, �� ,n g e � .��. :�t. z �' r.,; •.. _ 3ankp# erica: 5-13/110 { — *GentralN.Ug Office _ X10 040996 y.. c . Sea SO "a 4 DATE CHECK AMOUHIM NT . �tN �: G _ = — Y. ,.. — -- ;E VW pEgg NOV 71 11804099611' in 0 L 1000 L.381: 94 2 LO 20609Un w -ORTH ooAndover , Twn f No. 0 dower, Mass.,_-�/"-`/�� 0 LAKS IF COCHICHEWIC O�?ATED % BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR AT.... "t''! /; BUILDING ........................................................................ THIS CERTIFIES THAT ............................................ Foundation rte has permission to erect........................................ buildings on.,;, .................... ............................. ... Rough to be occupied as..............(��,4 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 TARTS 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. s 4' M ' BUILDERS Standard Form of Agreement between Owner and RCG Builders LLC where the basis of payment is the Cost of the work Plus a Fee without a Guaranteed Maximum Price Date: A��rIX' Oy 20D Owner: iC Nat'thAndovF Illlll�s LLC Cfo IC3 L .0 , 'f7 Iv�la© �tre-erz, �►lulte �bQ , vttel"vrll�, Ma 04 a ! Contractor: SCG � i[�arrL jd SYlnt+ r`Ytl(8� IIIA D214t ' S 1 Architect. 1 b 1 ;3t C}e r rt T fv�il � tot, Pulte 0 Som�lrtriPOO y'M 't Project Name: CAS �blr�s �r+nartp�lt�e, 2"t FC�h Su ety Notes Al. .. ... The Owner and Contractor agree to the terms stated by this contract. This contract supersedes any prior agreements, representations,or negotiations, oral or written. No liquidated damages shall apply to this agreement. This contract consists of the following documents: 1. Obligations of the Parties 2. Contract Sum 3. Project Schedule 4. Signatures Exhibits Exhibit A: Estimated Cost of Work Exhibit B: Project Schedule Exhibit C: Drawings i Page 1 of 7 ti BUILDERS 1. Obligations of the Parties Obligations of the Contractor: The Contractor accepts the relationship of trust and ronfidPnre PstahlishPrl by this AgrPemPnt and covenants with the Owner to cooperate with the Architect and exercise the Contractor's skill and judgment in furthering the interests of the Owner;to furnish efficient business administration and supervision; to furnish at all times an adequate supply of workers and materials; and to perform the Work in an expeditious and economical manner consistent with the Owner's interests and in compliance with all applicable governmental codes and regulations. The Contractor shall keep full and detailed accounts and exercise such controls as may be necessary for proper financial management under this Contract. The Contractor shall keep full and detailed records of all books, records, permits, licenses, correspondence, receipts, instructions, data, and drawings associated with the Project including all Subcontractor contracts, invoices, vouchers, insurances, lien waivers, and other correspondence. The Owner and Owner's Accountants shall have access to review, audit, and copy all Contractor documentation. The Contractor shall retain these documents for a period of three years after final payment. The Contractor shall maintain insurance at the rullowing levels with the Owner listed as a co- insured: Type of Insurance Limit of Liabili Colmrytert �C�ltletal L►�bitit1 t}DOOQ010 Upon request, and at the cost of the Owner, the Contractor shall obtain a performance bond up to the total Cost of Work. Such costs shall be added to the Construction Volume. The Contractor understands that the Project will be financed by a construction lender and, then, by a permanent lender. The Owner may assign any of its rights under this Contract to the construction lender and the Contractor hereby consents to any such transfer provided no such assignment shall relieve the Owner of any of its obligations under this Contract, unless agreed to in writing by the Contractor. The Contractor shall execute any certificates, lien waivers, releases, receipts, and other documents as may be reasonably required by the construction lender or permanent lender including a subordination of its mechanic's lien rights to the construction lender's and permanent lender's mortgage or deed of trust, The construction lender for the Project will be: , ..... ... .. .. ............. ...,.. : .... ........f...it... .. .. � Obligations of the Owner: The Owner agrees to furnish or approve, in a timely manner, information required by the Cuntrautur died to make payments to the Contractor in accordance~with the requirements of oris Agreement. Dispute Resolution: Claims, disputes or other matters in question between the parties to this Agreement shall be resolved by mediation or by arbitration. Prior to arbitration, the parties shall endeavor to reach settlement by mediation. Page 2 of 7 I t x �w 2. Contract Sum Cost of Work: The Contractor shall provide a detailed estimated Cost of Work to the Owner(see Exhibit A). The sum of these costs, including the fee is as shown below: .1'3r4`f,� _..... Change Orders: The Contractor does not guarantee the Contract Sum in any form. In the event of changes to the Contract Sum, the Contractor will present written changes to the owner for costs that exceed the Contract Sum in the form of a Chanqe Order. The Contractor will review all Subcontractor Chanqe Orders before submittal to the Owner and Architect and make a recommendation for payment or non-payment. The Contractor's Fee will be calculated including any approved Change Orders. The Owner, Architect and Contractor will negotiate disputed Change Orders in good faith. Contractor's Fee: 15%of total construction volume up to$1 million, and 10%of construction volume over$1 million. This includes pre-construction and project management services, and field personnel and associated management overhead. The fee is based on actual costs incurred, with final true up, and is booked monthly in arrears. Specifically, 1. The cost of pre-construction and construction management services provided by RCG personnel is booked monthly in arrears based on the hours reported by each employee. 2. Hours are billed at the standard hourly billing rate established from time-to-time for each employee. The hourly billing rates effective 1/1/2007 are shown below. 3. The cost of pre-construction and construction management services provided by independent contractors is booked when invoiced and carried within the fee. 4. RCG Builders personnel functioning as tradesmen outside their management duties will be charged according to their hourly billing rate. 5. If a project is terminated or suspended by the Owner prior to completion, RCG Builders LLC is compensated for the actual cost of services provided prior to receipt of notice of termination or suspension from the Owner. 6. Total Construction Volume includes all construction trades, general requirements, insurance, bonds and miscellaneous costs deemed necessary to perform the construction of the project, but excludes permits and tees. Permits and Fees snail be paid directly by the Owner. 7. Construction management labor, standard tools and equipment, and labor-related overhead arc covered"within the fee". Specialty tools or equipment, trade labor supplied by Builders personnel and approved transportation and meals costs shall be charged directly to the Owner without a fee. Employee Rate David Steinber h $125/hr Mike Bernier $125/hr Kieran Whelan $125/hr Jason Downing $50/hr Subcontractors: Page 3 of 7 - i - IY M1 BUILDERS' Tho Contractor plans to hire Subcontractors to perform the majority of construction associated with this project. The Contractor shall provide the Owner and Architect information on all of the bids received by Subcontractors and the names of the Subcontractors selected. Owner shall have the right to reject a proposed Subcontractor; however, in the event that this leads to a higher Cost of Work, the Owner shall pay for the difference. The Contractor reserves the right to reject any Subcontractor, even if it is the lowest bid, and to dismiss Subcontractors from the job that have been previously approved by the Owner. Payments: The Owner shall make progress payments on the Contract Sum according to the Requisition process described below. The Contractor shall, at the conclusion of each calendar month on the project, present to the Owner an application for payment(Requisition)for costs incurred during that month. The Requisition shall include all invoices, vouchers, partial releases of liens, expense reports, and any other evidence to support the validity of the Requisition amount. The Contractor may requisition for completed, but unpaid work based on an expectation of payment upon receipt of funds. The Owner, the Architect, or their representatives shall be afforded five (5) business days to review such application and question the Contractor about its contents. In the event there are no disputes, the Owner shall pay the Contractor within 10 business days of receipt of the Requisition. Payment by the Owner does not represent that the Owner or Architect have made a detailed examination of the documentation, inspection of the work, or verification of the accounting. At the completion of the project, the Owner shall make a final payment to the Contractor based on a final Cost of Work with a truing up of fees. If further corrections to work are required that are not covered under warranties with Subcontractors, or that are not the outcome of negligence or poor workmanship by the Contractor, the Owner shall pay the Contractor for any work associated with performing the corrections based on the hourly rate agreed to in this contract. Retainage: The Owner shall not hold back any fees to the Contractor to ensure completion of the work. The Contractor will be expected to hold back fees from Subcontractors to ensure their performance based on the terms below: 'I0%of lilt Costs unless otherwise a rav d.b„ ;:H ?w1 F Termination of Contract: The Owner shall reserve the right to terminate or suspend the Contract at its sole discretion. Within 15 days of termination or suspension, the Contractor shall present an accounting of all its costs incurred for reimbursement by the Owner. If the Owner elects to proceed with the project without the Contractor, the Owner shall have the right to assume the Subcontracts and agreements related to the Project. Working Capital- RCG Builders shall not bear the costs of Working Capital for the project. If the Owner would like the Contractor to gain beneficial pricing on its behalf by paying subcontractors ahead of the Requisition schedule, the Owner shall either(1) put on deposit with the Contractor a sufficient amount of Working Capital for the Contractor to pay these Subcontractors, or(2) make immediate payment upon request from the Contractor outside of the normal Requisition process. Provision of Working Capital shall entitle the provider to all discounts and savings associated with that capital. Page 4 of 7 - 0 f Y. e e BI , E A 3' 3. Project Schedule Date of Commencement: The Contract Time shall be measured from the date of commencement. The date of commencement of the Work shall be the date of this Agreement, unless a different date is stated below or provision is made for the date to be fixed in a notice to proceed issued by the Owner. Contract Time: The Contractor shall provide to the Owner a Project Schedule (see Exhibit B). This Schedule is based on assumptions reached prior to the signing of this contract, which assumptions the Contractor shall attempt to clarify in the Schedule. However, the Schedule always assumes the Owner and the Architect respond promptly to requests for infomiation and do not request any significant changes to the construction program. In the event that the Owner or Architect find any discrepancies with the Schedule or its Assumptions, they will promptly notify the Contractor, who shall make adjustments to the Rnhedule as nPcessnry. According to the attached Schedule, the Contractor shall achieve Substantial Completion of the entire Work as follows: Date of'� t [tt Nal:..om The Contractor does not guarantee the date of completion. However, the Contractor snail not ue entitled to additional fees based on delays in the project unless those delays can be shown to incur extra costs for the Contractor and were caused by the actions or requests of the Owner or Architect. The Contractor shall present an updated Project Schedule to the Owner and Architect on a weekly basis for their review, - Page-5 of 7 _ I I �r BUILDERS 4. Signatures The Owner's representative is: Matt Pic�r��d I�,l��tager �Ca fVlitl,1��E!ixdt���r IUlitts LLC; § 14.4 The Contractor's representative is: 4rlllft �@{i1�1ll�r .0f01' RGG�Cii[ff�t�,�•� 1�'IValab Strut',quite t0.0 A$ �43 Some�nll.���tf1(.....,......,,.. I This agreement is entered into as of the day and year first written above and is executed in at least three original copies, one for the Owner, one for the Contractor, and one for the Architect. OWVer Contractor Signature Sig iLure z Printed Name and Title Printed Name and Titt Page 6 of 7 BUILDERS Exhl bits Exhibit A: Estimated Cost of Work Page 7 of 7 GAB Robins Construction Estimate Division Description Budget Division 1 General Requirements&General Conditions $ 500.00 Prep work by RCG Division 2 Site\Alnrk/namn $ - Division 3 Concrete $ Division 4 Masonry $ Division 5 Metals $ - Divieion 6 Wood and Ploatics $ 2,000.00 Framo&Board by RCG Buildore Division 7 Thermal/Moisture Protection $ 1 - Division 8 Doors and Windows $ 1,350.00 3 glass doors by Al Juzukonis Division 9 Finishes $ 3,500.00 Painting by STR Division 10 Construction Specialties $ Division 11 Equipment $ Division 12 Furnishings $ 500.00 Countertop Division 13 Special Construction Systems $ - Division 14 Conveying Systems $ - Division 15 Mechanical $ 1,500.00 Ductwork&Plumbing Division 16 Electrical $ 2,200.00 Wiring by Young Electric Division 17 Misc.Construction Trades $ - Division 18 C;M contractors(;en Liab Ins $ Ub.bU I.zu% Division 19 CM Fee $ 1,753.29 15% Division 21 Permits&Fees $ 168.00 1.20% TOTALS $ 13,609.89 I I NOTICE NOTICE TO TO EMPLOYEES (EMPLOYEES i of Massachusetts The Commonwealth DEPARTMENT OF INDUSTRIAL. ACCIDENTS 600 Wash Stlree4 Boston,Massuchuse{ts 02111 61.7-727-4900 As required by Massachusetts General Law,Chapter 152, Sections 21, 22& 34,this will give you notice that I(we)have provided for payment to our In employees under the above mentioned chapter by insuring with: ASSOCIATED EMPLOYERS INSURANCE COMPANY NAME OF INSURANCE COMPANY 54 THIRD AVENUE,P.O.BOK 4070,BURUNGTON'MA 01803.0970 ADDRESS OF INSURANCE COMPANY woo RV=101200S 05110/2008 - 05/10/2009 POLICY NUMBER EFFECTIVE DATES 24 Federal Street 4th Floor Boston Insurance Brokerage Inc Boston,MA 02110 61 656-7000 NAME OF INSURANCE AGENT ADDRESS PHONE RCG Builders LLC 17 Ivaloo Street Suite 100 Somerville, MA 02143 EMPLOYER ADDRESS 03/10/2008 EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE WZ CAL TREATMENTS The above named hover Is required in cases of pajonat J*Aes mrift out of and is the coarse of employment to furnish adequate and reasonable Mal ail medlcad services in accordance with the provisions of the Workers Compensatiou AeL A copy of the First Report of L0ary must be given to the i*f ed employes. The employi*may select his or her own physician. The reasonable cost of the services provided by the treating pbysician w81 be paid by tle.insurer,if am treatment is necessary and reasonably cormected to the work related bdury. In cases requiring hospital attention,employees are hereby notified that the Insurer ho arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY NAME OF HOSPITAL ADDRESS TO BE FROSTED BY EMPLOYER I `Board of Building liegntahons and Standar Construction Supervisor License License: CS 66334 Birthdate: WMI956 ExPkufM: 91,12009 Tr# 3960 4 Restriction. 00 KIERAN T WHELRN 31 RICHMOND ST WEYMOUTH,MA 0218$ Commissioner 1 i - : .� OFFICE OP BUILDING INSPECTOR TOWN OF NORTH ANDOVER � ► - '� CONSTRUCTION CONTROL PROJECT NUMBER: PROJECT TITLE- GAB Robins.Insurance . . 21 High Street,North Andover MA PROJECT LOCATION, g NAME OF:BUILDING* 21 High Street NATURE OF PROJECT: Tenant Fit Out :IN ACCORDANCE WITH ARTICLE 116 OF 1HE MASSACHUSETTS STATE BUILDING CODE, I, :Jai Singh Khalsa , . REGISTRATION NO. 6042 : 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 STRUCTURAL 0 MECHANICAL FIRE:PROTECTION.0 ELECTRICAL .:OTHER(SPECIFY) ... ... . . .. B FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE,SUCH PLANS, _.. COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION.CFTHE. MASSACHUSETTS STATES ILDING.COUE,:ALLACCEPTABLEENGINEERING:PRATICES. . ANLL APPLICABLE LS AND ORDINANCES FOR.THE PROPOSED t�SEAhtC7 OCCUPANCY.. _. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY:PROFESSIONAL SERVICES AND.B r*PRESENT ON THE..CONSTRUCTtO.N SITE UN A REGULAR AND PERIfJQIC BASIS T4.LtETERMihIE THAT. THE WORK I$PROCEEEDING.IN ACCORDANCE WITH:THE DOCUMENTS APPROVED FOR_THE BUILDING PERMIT AND,SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 11€x.0 1.. : Review,for conformance to the design concept,-shop clraWngs, samples and other submittals which are submitted by the contractor In accordance vAth the requirements of the construction. documents... 2. Review and approval of the quality control procedures for all code-required controlled.materials. 3. Be present et lir#ervals:appropriate to the stage of construction to become;generally familiar vdifh8the 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 1.16.2.2 . 1 SHALL SUBMIT WEEKLY. A PROGRESS.REP �N k�9 ��'�► TOGETHER.WITH PERTINENT.:COMMENTS TO THE NORTH.ANDOVER BUILDING 1 R o:6042 v CAMBRIDGE N UPON COMPLETION OF THE.WORK,I SHALL SUBMIT A:FINAL REPORT AS TO T �y� MA SATISFACTORY COMPLETION AND.READINESS OF.THE PROJECT FOR OCCUP F o a P �rH OF tv9ASS .SIG T !Jolt V SVBSCR ED D WOI� To BEFORE ME THIS 2� �tR t'OI~ OTA.. UBLIC E. iMY COMMISSION EXPIRES�et �isGomonwafh of osochuseto . . cion Expires M?'Comm. 4ctoh >Es 27,20 1 .. -- --