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Building Permit #280 - 240 CHARLES STREET 10/20/2003
TOWN OF NORTH ANDOVER DMD' ING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A�¢ONE gOR TWO FAMILY DWELLING BUTT DING PER1y1IT NUiVIBER:�� BATE ISSZIEEI�. � ��� Building Commissioner/ins for of Buildin mate Z a I.1 PrM_. Address: 1.2 Assessors Map and Parcel Number: 02B dor 1 1 \01a 1,,,,i„ 'sMap Number Parcel Number 1.3 Zoning Information(: 1A Property Dimensions: v Zoning District Proposed Use Lot Areas Frontage(11 � 1.6 BURDING SETBACKS(ft) r ' Front Yard Side Yard I Rear Yard O Required ProvideReqliired Provided R red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal On Site Disposal System ❑ //2..1 Owner of Record lYr1P_0AW")1Ce_ �;T r}i ��StY',�?' ;ooCltcfteS S�_ Name(Print) Address for Service_ 75 Signature Telephone 2.2 Authorized Agent Name Print Address for Service: - l� Signature Telephone INS v j�at 3.1 Licensed Con ction Supervisor Not Applicable ❑ Address License Number 1 S r-�.i` s r'� ►�t#t,�.!{-�,��-�u� Licensed Construction Supervisor: �,',Z to! �2 j DTiration Date Signature Telephone 1 JJJ 3.2 Registered Home Improvement Contractor Not Applicable ❑ ComparryName Registration Number i i I � Address Expiration Date I Signature Telephone I I Location o2 Cl C A JZ S SIA No. caZ O Date ��_G 3 NORTH TOWN OF NORTH ANDOVER I t n Certificate of Occupancyi S,cNustt Building/Frame Permit Fee $ + 6 D Foundation Permit Fee $ Other Permit Fee $ TOTAL $ !_ i Check # ,A- (C- Building Inspector :��'plCO1�I 4 �!4!$ ��l�fl��1�. $;RF�( �'��-� ►� Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildin rmit. Si ned affidavit Attached yea No. ..❑ sir�eo�r s >�� c�rastii� xes vet To 5.1 Registered Architect: l � ►'''1� �T`e SSc�'�" �' 1�1� k e� T��, Name:: rn b( r ! i Address Signature Telephone $Z f(sier�t tf4 3sia <7777,7,77- 71 cc,r-1re S�t' ;�/J C �ee Area of Responsibility Name: nt i �• �Y►t )^t Registration Number Address: Expiration Date Signature Total Not applicable ❑ Name: Registration Number Address Signature Telephone Expiration Date Area of Responsibility Name r Registration Number Address Telephone Expiration Date ignature Area of Responsibility Name Address Registration Number Signaturc Telephone Expiration Date Not Applicable ❑ Company Name Responsible in Charge of C nstruction 'C i10IPT IP3St#3 (mei{;all appleablel New Construction Existing Building 0 Repair(s) 0 Alterations(s) 0 Addition ❑ Accessory Bldg. Demolition 0 Other 0 Specify Brief Description of Proposed Work: co 1z,/r(-, USE GROUP `Check as applicable) CONSTRUCTION TYPE AAssembly 0 A-] ❑ A-2 ❑ A-3 0 1A 0 A4 ❑ A-5 ❑ IB 0 B Business ❑ 2A 0 C Educational ❑ 2B 0 F Factory ❑ F-I ❑ F-2 ❑ 2C 0 H High Hazard 0 3A 0 IInstitutional D I-1 ❑ I-2 0 I-3 0 3B 0 M Mercantile' ❑ 4 0 R residential 0 R-1 0 R-2 ❑ R-3 0 5A 0 S Storage 0 S-1 0 S-2 0 5B 0 U Utility 0 Specify: M Mixed Use 0 Specify: S Special Use pY Specify: SeW a-re. V'n t eT VCuJ COMPLETE THIS SECTION IF EXISTING BUILDING UNMRGOING RPqOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floors 6 Total Areas 3I- Total Height ft 7 .. Independent Structural En nn Structural Peer Review Required Yes 0 No SECTION 10a Owner Authorization- TO BE COMPLETED WHEN ------ OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property Hereby authorize ©LI) Co T n C to act on My behalf,in all matters relative two work authorized 16y this building permit application Signature of Owner Bate -71 Agent as Owner/Authorized Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pain//s and penalties of perjury c k e, a� LiPrnintName ure of Owner/Agent Date Item Estimated Cost(Dollars)to be uROT Completed by permit applicant 1. Building (a) Building Pemut Fee 2 Electrical 1 a Multi lier (b) Estimated Total Cost of 3 Plumbing Construction from(6) Building Permit fee (a)x(b) f leg =+ .Mechanical(HVAC) Lc 5 Fire Protection 6 Total (1+2+3+4+5) Check Number EMIL t!u r � G `l IYNI"� -Id 1 ;7f NO.OF STORIESF_ i SIZES FBA'SEZW:NT O=SLAB ZE LOO1- 2ND 3RD AN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS '31 SIZE OF FOOTING �; Y.7 ( X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE arH �'rsgcuu8et CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 2 80 (10120/2003) Date: January 27, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 240 Charles Street MAY BE OCCUPIED/USE AS Sewer SMph B� uil ft&Meter Vault IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CO AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO: It Great Lawrence Sanitation Dist/The Dow Co.Inc. 240 Charles Street North Andover MA 01845 wilding Inspector - N,orcrM Town of 4 over No. O L A o dover, Mass., Oen ig Ce 3 -COCK.ICM WICK V ADRAYE D BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT Cirfd ��i ! .. �1., �1!?�g `!S1' c�'�'..'Tf'a*„jv.-.C�v�l!!�,n� ,X...t,�,C.,.,-. Foundation has permission to erect..Ft.S '�rl:$ •r ' ...... buildings on .A.4.o...dH�N�pLCt`5 YMOMT' Rough tObeoccupied aS.... !++4: «..,44'14e���.t, ' .., !S. !N ....11!1IG...1�/!4t.. ..................................... Chimn;// provided that the person accepting this permit shall in every respecttonform to the terms of the application on file in Fi 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 INPECTOR . VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTSE ECTRI/C,)AL INSPECTOR :.... .................................... BUILDING INSPECTOR Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Finalh No Lathing or Dry Wall To Be Done 4r— FIRE DEPARTMENT Until Inspected and-.Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. 1+�6{.1 As 0 Cit V4(7 • 4 eO'Ve-fZ6T FORM U LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits frc Boards and Departments having jurisdiction have been obtained. This does not retie, the applicant and/or landowner from compliance with any applicable or requirements *****************************APPLICANT FILLS OUT THIS SECTION APPLICANT ► e_ 100 �O� Tre, . PHONEa- YZ "Iy)Y LOCATION: Assessor's Map Number 02& [ PARCEL SUBDIVISION LCLL,�rse_et 6cy LOT(S) STREET L 0 -Q%JVXAFI&� Ur ST.NUMBER. a 40 ********-�`***'k VFFICIAL USE ONLY ** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED st COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPRbVED DATE REJEGT ED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE-REJECTED COMMENTS , 'UBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT /� J04 v` RE DEPARTMENT � � l /q/er� CEIVED BY BUILDING INSPECTOR DATE 7v o 3 ✓ised 9W jm JUN-U-213H Ib:Dl MM-Aliionia, lnc. I ' n 4 1975 Research Pkwy. Suite 305 Colorado Springs,CQ 80920 77A] .- To: DOW CO INC Fax From: Lucent Date: June 27, 2003 Fax: 978.681.1284 Phone: MIKE DOW Pages: 7 PO#: Z10033664 Phone: 888-300-0770 option2, option 2 +++This facsimile is for the sole use of the intended recipicnt(s) and may contain information that is privileged, confidential, and/or privileged action lin relianeenupon� this info rmtttiontbyapersons or dissemination or other Use Of, or taking of any entities other than the intended recipicni is prohibited. If you received this in error, please contact the sender and destroy any copies of this document.+++ JUN_V_- UU3 Ib:bl rKUM-Alllente, Inc +Iflb[ftltifCb 1-b46 N UU[iUUb r-cad Page I of'G Puhhase Order 0 Lucent Technologies Gell Labs Innovatlons PO Number: ZY10033664 PO Date: 06/27/2003 Send llurehasing Correspondence to: Vendor: CO INC Alliente,Inc.-EZBuY DOW DOW COAC PLAZA Anent for Lucent Technologies Inc. N4ERSuite 305 15414AVERIITLL ST STE B ME.THUIrN MA 01844 1975 Research Parkway Colorado Springs Contact PersoD:MIKE DOW ngs CO 80920 Send Invoice to: Ship to: Lucent Technologies Inc. Norman Denault 40-A4 P.O. Box 105446 1600 OSGOOD ST Atlanta GA 30348 NORTH ANDOVER MA 01845-1043 Questions regarding Delivery date: 06/25/2003 Purchasing: Alliente/E7,Buy-US Company: Lucent Technologies Inc- Telephone: 719-278-6707 Fax: 719-278-6725 • Freight Collect-FOB ORIGIN F.O.B.O.B./Delivery Terms. $ I3/L Instructions: Bill Frei-hi Charges To: Lucent Technoloaics Inc. C/O Ryder Transportation Management(PO#ZY10033664) PO Box 134003 Ann Arbor,MI 48113 Shipping Instructions: se Order Numbers,nl other identification as directed by Ryder/Lucent must be on 1.Lucent's Sales Order Numbers,Purcha Air Bill or Bill of Lading. 2.Proper NMFC Classification of goods should be used when describing the shipment on the Bill of Lading. 3. All sensitive equipment must be labeled with the"Do Not Break Down'T Do Not Stack on Top of This Pallet" placards. Routing-US Domestics: Ground Shipments: 1 ib to 150 lbs UPS-800-742-5877-Account#A43W59 Air Shipments: 1 ib to 2 lbs Airborne-800-247-2676-Account#202542700 For other shipments,contact Ryder Shipment Planning&Execution-877-593-9775 or LAL-LUCENTCRYDER.COM(i.e., all LTL,TL,Heavyweight Air,Specialized,Air Ride,ctc) Tax Status:Taxable -Own use or consumption TAX CERT.NI3R.: Pay Terms: Net by 45 days from Invoice This order is for furnishing the equipment on the forced main as pan of LUccnt's agreement with the Greater Lawrence Sanitaty District(GLS D).This line is used to pump our sewage over to GLSD for treatment.C ontact Name:MIKE DOW Contact Fax: 978-681-1284 Item Material Order Qty' UOM Prtce per unit Net value Descriptio Sulu-Zl-Zou3 lb:bl FROM-Alllente, Inc. +17192786725 T-548 P.003/006 F-883 Pagc 2 of 2 Piukhase Order Lucent Technologies Dell t.,ibs lnnovdLlOns PO Number: ZY10033664 PO Date: 06/27/2003 1 91,100 Mon V $ 1.00 USD 91,100.00 Furnish and install a sampling bldg,ref rigerawd sampler,now meter,by-pass with valves,tlow meter vault, and electrical from the nearest point available,with a four foot manh ole,regrade and seed area Total Value USD $ 91,100.00 NOTE TO VENDOR: You have agreed to provide to Lucent Technologies with the accurate country of origin for the matcrial(s)contained on this purchase order. *If you have provided a Certificate of Origin prior to this date and the country of origin of the material(s)to be shipped to fill this purchase order do not differ from that Certificate then you need to do nothing more. x, If the country of origin of the material(s)to be shipped to fill this purchase order is(are)different from the country of origin stated on the previously provided Certificate of Origin then you must CLEARLY indicate the accurate country of origin on your confirmation of this P.O.,and on all subscgaent documents related to it. * tificate of Origin then you must CLEARLY indicate the accurate country of origin on 1f you have not yet provided a Cer your confirmation of this P.O.,and on all subsequent documents related to it. Authorized Lucent Signature P.O. Acknowledgement required Scheduled ship date Item Qty To be signed by Authorized Supplier Representative Date: We accept your purchase order subject to the teens and coltditions referenced thereon. Supplier please mote, If unable to furnish materials as or when specified in this order,please note. Oct 14 03 03: 25p Power House Manager 978-960-6525 p. 1 AMENDMENT TO AGREEMENT This Amendment dated as of May 29, 2003 (the "Amendment") to the Agreement entered into as of the 5 c day of November 2001, by and between THE GREATER LAWRENCE SANITARY DISTRICT ("GLSD"), a body politic of the Commonwealth of Massachusetts and LUCENT TECHNOLOGIES INC. ("Lucent"), a Delaware corporation, qualified to do business in the Commonwealth of Massachusetts and having an office and place of business at 1600 Osgood Street, North Andover, Massachusetts, (the "Agreement") is entered into by and between GLSD and Lucent. 1. The parties agree to amend the Agreement by deleting ARTICLE 1 (B), in the form reflected in the Agreement and replace with the following: ARTICLE 1 (B) of the Agreement as amended shall read as follows: °(B) Whether Lucent Follows (1) or(2) above, Lucent agrees to modify, at its expense, the existing connection to provide, or include in any new connection to the GLSD Wastewater Facility, the following items: (a) A new flow measuring and sampling station near the point of modified or new connection to the GLSD Wastewater Facility, and (b) to pay to GLSD the sum of$15,000, which GLSD shall apply to GLSD's costs in connection with GLSD's ultimate installation of piping and other appurtenances necessary to direct Lucent's wastewater to the GLSD Wastewater Facility at a point upstream of the Screening Building. 2. The parties agree to Amend the Agreement by deleting ARTICLE I (D) in its entirety and replacing it with the following: ARTICLE I (D) of the agreement as amended shall read as follows: "(D) Upon completion of the construction and installation of the items recited in ARTICLE I (B) (a), and the payment called for by ARTICLE I (B) (b), Lucent's installation and construction obligations under this Agreement shall be satisfied and discharged in full. 3. Except as amended herein, the provisions of the Agreement shall remain unchanged and in full force and effect. 4. GLSD and Lucent represent and warrant to each other that they have full right, power and authority to enter into this Amendment without the consent Oct 14 03 03: 25p Power House Manager 978-980-6525 p. 2 or approval of any other entity or person and each party makes these representations knowing that the other party will rely thereon. 5. The signatories on behalf of GLSD and Lucent represent and warrant that each has the full right, power and authority to act for and on behalf of GLSD and Lucent in entering into this Amendment. Rebecca L. Ewy Sr. Real Estate Manager Northeast & Canada Lucent Technologies Inc. Richard S. Hogan Executive Director Greater Lawrence Sanitary District 2 Oct 14 03 03: 25p Power House Manager sbu-b5;�5 p. 1 AMENDMENT TO AGREEMENT This Amendment dated as of May 29, 2003 (the "Amendment") to the Agreement entered into as of the 51h day of November 2001, by and between THE GREATER LAWRENCE SANITARY DISTRICT ("GLSD"), a body politic of the Commonwealth of Massachusetts and LUCENT TECHNOLOGIES INC. ("Lucent"), a Delaware corporation, qualified to do business in the Commonwealth of Massachusetts and having an office and place of business at 1600 Osgood Street, North Andover, Massachusetts, (the "Agreement") is entered into by and between GLSD and Lucent. 1. The parties agree to amend the Agreement by deleting ARTICLE 1 (6), in the form reflected in the Agreement and replace with the following: ARTICLE 1 (B) of the Agreement as amended shall read as follows: "(B) Whether Lucent Follows (1) or(2) above, Lucent agrees to modify, at its expense, the existing connection to provide, or include in any new connection to the GLSD Wastewater Facility, the following items: (a)A new flow measuring and sampling station near the point of modified or new connection to the GLSD Wastewater Facility, and (b) to pay to GLSD the sum of$15,000, which GLSD shall apply to GLSD's costs in connection with GLSD's ultimate installation of piping and other appurtenances necessary to direct Lucent's wastewater to the GLSD Wastewater Facility at a point upstream of the Screening Building. 2. The parties agree to Amend the Agreement by deleting ARTICLE I (D) in its entirety and replacing it with the following: ARTICLE I (D) of the agreement as amended shall read as follows: "(D) Upon completion of the construction and installation of the items recited in ARTICLE I (B) (a), and the payment called for by ARTICLE I (B) (b), Lucent's installation and construction obligations under this Agreement shall be satisfied and discharged in full. 3. Except as amended herein, the provisions of the Agreement shall remain unchanged and in full force and effect. 4. GLSD and Lucent represent and warrant to each other that they have full right, power and authority to enter into this Amendment without the consent Uct 14 UJ UJ: 25p Power House Manager 978-960-6525 p. 2 or approval of any other entity or person and each party makes these representations knowing that the other party will rely thereon. 5. The signatories on behalf of GLSD and Lucent.represent and warrant that each has the full right, power and authority to act for and on behalf of GLSD and Lucent in entering into this Amendment. Rebecca L. Ewy Sr. Real Estate Manager Northeast & Canada Lucent Technologies Inc. Richard S. Hogan Executive Director Greater Lawrence Sanitary District 2 8 7 6 5 4 3 2 1 EXTERIOR COLOR: #1540 PURE WHITE LOAD CENTER: 125 A.ML. 120/240 VAC, 1P H INTERIOR COLOR: #1540 PURE WHITE NEMA 1 -SIEMENS EOIIML1125A5 H INSULATION: 1"(R-7) LIGHT: 100 WATT INCAN.-M 14915K54 DOOR HDR: SCHLAGE SS CLASSROOM STYLE FAN: 565 CFM-G 2C819 SS STRAP HINGES SHUTTER: 10'X 10'-G 50210 SS DOOR STOP CHAIN HEATER: 1500 WATT-O 52KM ACCESSORIES: NONE OUTLET: CFI-L-RON G G 100 WATT VAPOR-TIGHT INCANDESCENT LIGHT 1'-3' 6' L * r-1I I 1 16, ---- 42" W X 48' ® :Eli H EQUIPMENT 7, MOUNTING PANEL 0 5'-6' I I I E E e" —L 3'�'l 16' I -- 6' LEFT ELEVATION FRONT ELEVATION RIGHT ELEVATION REAR ELEVATION D D GF] OUTLET 585 CFM EXHAUST FAN 1500 WATT HEATER----- WITH FRP HOOD C C I I i INTERNAL MOUNTING FLANGE 10' X 30" INTAKE SHUTTER WITH I125 A, NEMA 1 MAIN LUG INSECT SCREEN CIRCUIT BREAKER PANEL B g LIGHT/FAN SWITCH PLAN VIEW . TRACHM ONE-PIECE FRP BUILDING, W X 6'-0" D X 7•-6•' H WITH STANDARD ACCESSORIES PACKAGE A FIBERGLASS PRODUCTS NO.REV OPB-72-72-90-49 0 A 1) ANCHOR BOLTS BY OTHERS THE DOW COMPANY - LUCENT TECHNOLOGIES PROJECT NORTH ANDOVER, MA DAZE 8/14/03 8 7 6 5 4 3 2 1 8 7 6 5 4 3 2 1 EXTERIOR COLOR: /1540 PURE WHITE LOAD CENTER: 125 A,ML,120/240 VAC,1P H INTERIOR COLOR: #1540 PURE WHOE NEMA 1 —SIEMENS EOSML1125AS INSULATION: 1-(R-7) LLCM: 100 WATT INCAN.—M 14915K54 H DOOR HOR: SCHLAGE SS CLASSROOM SNLP FAN: 585 CFM—G 2CB19 SS STRAP HINGES SHUTTER: 10"X 10-—G 5C210 55 DOOR STOP CMN HEALER: 1500 WATT—G 5ZK58 ACCESSORIES: NONE OUTLET: GO—LEVrrRON G G 100 WATT VAPOR—TIGHT INCANDESCENT LIGHT 6' F -- I 42' W X 48' ® L�I i H EQUIPMENT 7' MOUNTING C) T a PANEL 6'-10' 5'-6' r 1 E to tt r—� 4' L------------J i � E _L 6'— --� f 6' LEFT ELEVATION FRONT ELEVATION RIGHT ELEVATION REAR ELEVATION D D GFI OUTLET 8' 585 CFM EXHAUST FAN 1500 WATT HEATER WITH FRP HOOD C INTERNAL MOUNTING FLANGE 10' X 10' INTAKE SHUTTER WITH125 A, NEMA 1 MAIN LUG INSECT SCREEN CIRCUIT BREAKER PANEL 3 LIGHT/FAN SWITCH B PLAN VIEW TRACHM 07 E 6PI HC WITHPSBANDARD ACCESSORIES6PACKADGEX DWG. REV 1) FIBERGLASS PRODUCTS NO. OPB-72-72-90-49 ANCHOR BOLTS BY OTHERS 0 A PROJECT THE DOW COMPANY — LUCENT TECHNOLOGIES DATE 8/14/03— NORTH ANDOVER, MA 8 7 6 5 4 3 2 � 8 7 6 5 4 3 2 1 EXTERIOR COLOR 11540 PURE WHITE LOAD CENTER: 125 A ME,120/240 VAC,1P H INTERIOR COLOR: ,1540 PURE WHITE NEMA 1 -SIEMENS EDOML1125AS H INSULATION: 1-(R-7) LIGHT: 100 WATT INCAN.-M 14915X54 DOOR HDR: SCHLAGE SS CLASSROOM SIYIE FAN: 585 CFM-C 2CS19 S3 STRAP HINGES SHUTTER: 10'X 10--G 5C210 SS DOOR STOP CMN HEATER: 1500 WATT-G 52K89 [A. .IES: NONE OUTLET: GFl-LEVRRON ri G 100 WATT VAPOR-TIGHT INCANDESCENT LIGHT 6 iI I 'I I 1 42' W X 48' ® ��I i H EQUIPMENT 7' MOUNTING OTPANEL 6'-10' 5'-6' I 1 I ®j E E' _-T ' 3. Y-3' 3 �- f '- 6' -� 6, LEFT ELEVATION FRONT ELEVATION RIGHT ELEVATION REAR ELEVATION D n125 LET 585 CFM EXHAUST FAN 1500 WATT HEATERWITH FRP HOOD C INTERNAL MOUNTING FLANGE 10' X 10' INTAKE SHUTTER WITH A, NEMA 1 MAIN LUG INSECT SCREENCIRCUIT BREAKER PANEL LIGHT/FAN SWITCH B PLAN VIEW TRACUM 07 E6PIH WITHP ECE FRPSTANDARD ACCESS RIESBUILDING, 6'-0" W X6PAOCK GEX DWG. REV 1) FIBERGLASS PRODUCTS NO. 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L `-------- E' L6x air SEF.C1YdE RC&R IC3f'l:1-LUSSi 1.fY9CY lbObs JNda t67t~U. il PLfUi V1E W ---j I r n f.eerDct mrrRrwe to LEFfT,vE tP416lE sacs r 1 ta:a%6. j5.Acomo PE FoFmnm/Ram Ri cVD.CS 6 JW TD BE SAM NIK,'9fM 91682 T.PDF.PCS7t1 CDPP.&==ratm!♦nl CFPD66E Do,4.0cu f- 6 H.w 4PPL.ED Be cwodm 06141 By OM2 1 A UCM TD C 9PPM J+EDM n MUS Cr:>m Pfv.Y:AYi]t SQ 0.91®.IX8 Bi GETJ6G tfl[Ct Ao]oE9S J PU1L'1tlH6, 1JD i $- mws cqt N 1WT a PPCitlu'J1 sww mJud _————————�.I —————- pan LorPn�ma,J.rra.o Len wr ten mcru.� —————— OMg 1BLl:,s1 CLIP.oar A:iFs75 Fiv-05mm T19J y 8Mr.t i PPLDLQ anau Pal M 1PsfDm Dara ea.ora.'m mmff a wo imP w D� I I I I I 1 I owars,.,�;o ---------- 7d' ------- ------- J 1 I i —{ Rf nor omww sc eranr xaxcR,w SEE F1 EVATM Ff FVAnON YIEW s<.1 lnvm o� e � ,e1e1 w�Ir1. LkYt vb+� aPw..n. J J J 3 i JUN-27-2003 15:51 FROM-Alliente, Inc. +17192786725 T-548 P.001/006 F-ae3 1975 Research Pkwy. Suite 305 Colorado Springs.CO 80920 FM t,;c r o [77 To: DOW CO INC From: Lucent Fax: 978.681.1284 Date: June 27, 2003 Phone: MIKE DOW Pages: 7 PO#: Z10033664 Phone: 888-300-0770 option2, option 2 +++This facsimile is for the sole use of the intended recipiertt(s) and may contain information that is privileged, confidential, and/or privileged material. Any unauthorized review, retransm1ssion, or dissemination or other use of, or taking of any action in reliance upon, this inforTnat�on by persons he entities other than the intended recipient is prohibited. if you received this in error, please contact the sender and destroy any copies of this document.+++ JUN-27-2003 15;51 FROM-Allienta, Inc. +17192786725 T-548 P.002/006 F-883 VI Page I of''2 'Purchase Order Lucent Technologies 0, W1 Labs lnno ei lons PO Number: ZY10033664 PO Date; 06/27/2003 Vendor: Send Purchasing Correspondence to: DOW CO INC Alliente,Inc.-EZBuy MERRIMAC PLAZA Anent for Lucent Technologies Inc. 154 HAVERIIILL ST STE B Suite 305 gETHUEN MA 01844 1975 Research Parkway Contact Person:MIKE DOW Colorado Sprinas CO 80920 Ship to: Send Invoice to: Norman Denault 40-A4 Lucent Technologies Inc. 1600 OSGOOD ST P.O. Box 105446 NORTH ANDOVER MA 01845-1043 Atlanta GA 30348 Questions regarding Delivery date: 06/25/2003 Purchasing: Alliente/EZBuy-US Company: Lucent Technologies Inc. Telephone:719-27 8-6707 Fax: 719-278-6725 F-O.B,/Delivery Terms: Freight Collect-FOB ORIGIN WL,instructions: Bill Freight Charges To: Lucent Technolo;ics Inc. C/O Ryder Transportation Management(PQ#ZY10033664) PO Box 134003 Ann Arbor,MI 48113 Shipping Instructions: 1.Lucent's Sales Order Numbers,Purchase Order Numbers,or other identification as dircetzd by Ryder/Lucent must be on Air Bill or Bill of Ladina. 2.Proper NMFC Classification of goods should be used when describing the shipment on the Bill of Lading. 3, All sensitive equipment must be labeled with the"Do Not Break Down'T Do Not Stack on Top of This Pallet"placards. I Routing-US Domestics: Ground Shipments: 1 lb to 150 lbs UPS-800-742-5877-Account#A43W59 Air Shipments: 1 lb to 2 lbs Airborne-800-247-2676-Account4 202542700 lanning&Execution-877-593-9775 or LAI_LUCENT@RYDER,COM(i.e., For other shipments,contact Ryder Shipment P all LTL,TL,Heavyweight Air,Specialized,Air Ride,ctc.) Tax Status:Taxable -Own use or consumption TAX CERT.NBR.: Pay Terms: Net by 45 days frotn Invoice This order is for furnishing the equipment on the forced main as part of I.Uccnt's agreement with the Greater Lawrence Sanitary District(GLS D).This line is used to pump our sewage over to GLSD for treatment.C ontact Name:MIKE DOW Contact Fax: 978-681-1284 Item Material Order Qty. UOM Price per unit Net value Descri tion JUN-27-2003 15:5 2 FROM-Alhante, Inc. +17192786725 T-548 P.003/006 F-883 0 Pagc 2 of 2 a Putrchase Order Lucent Technologies Bell Lib,Innovatlons PO Number: ZY10033664 PO pate: 06/27/2003 1 91,100 Mon V $ 1.00 USD 91,100.00 Furnish and install a sampling bldg,ref rigeratcd sampler,flow meter,by-pass with valves,flow meter vault, and electrical from the nearest point available,with a four foot manh Ole,regrade and seed area Total Value USD $ 91,100.00 NOTE TO VENDOR: You have agreed to provide to Lucent Technologies with the accurate county of origin for the materials)contained on this purchase order. *If you have provided a Certificate of Ori,gin prior to this date and the country of origin of the material(s)to be shipped to fill this purchase order do not differ from that Certificate then you need to do nothing more. * If the country of origin of the matcrial(s)to be shipped to fill this purchase order is(are)different from the country of origin stated on the previously provided Certificate of Origin then you must CLEARLY indicate the accurate country of origin on your confirmation of this P.O.,and on all subsequent documents related to it. " if you have not yet provided a Certificate of Origin then you must CLEARLY indicate the accurate country of origin on your confirmation of this P.O.,and on all subsequent documents related to it. Authorized Lucent Signature P.O.Acknowledgement required Irern Qry Scheduled ship dare To be signed by Authorized Supplier Representative Date, We accepr your purchase order subject to the terms and conditions referenced thereon. Supplier please note: If unable ro furnish materials as or when specified in this order,please note. JUN-27-2303 15:51 FROM-Alliente, Inc. +17192TB6725 T-548 P.001/006 F-883 P w 1975 Research Pkwy. Suite 305 Colorado Springs,CO 80920 FM Alliente._ I l To: DOW CO INC From: Lucent Fax: 978.881.1284 Date: June 27, 2003 Phone. MIKE DOW Pages: 7 Po#: Z10033664 Phone: 888-300-0770 option2, option 2 +++This facsimile is for the sole use of the intended recipicnt(s) and may contain information that is privileged, confidential, and/or privileged material. Any unauthorized review, retransmission, dissemination or other use of, or tailing of any action in reliance upon, this information by persons or entities other than the intended recipient is prohibited. If you received this in error, please contact the sender and destroy any copies of this document.+++ JUN-27-2003 15:51 FROM-Alliente, Inc. +17192786725 T-548 P.002/006 F-883 Page I of'l _Purchase Order Lucent Technologies ' Bell Labs lnnwatlons PO Number: ZY10033664 PO Date: 06/27/2003 Vendor: Send Purchasing Correspondence to: DOW CO INC Alliente, Inc.-EZBuy MERRIMAC PLAZA Anent for Lucent Technologies Inc, 154 HAVERIIILL ST STE B Suiie 305 MF_THUEN MA 01844 1975 Research Parkway Contact Person:MIKE DOW Colorado Springs CO 80920 Shin7Denault Send Invoice to: NormA4 Lucent Technologies Inc. 1600P.O. Box 105446 NORMA 01845-1043 Atlanta GA 30348 Questions regarding Delivery date: 06/25/2003 Purchasing: Atli ente/EZBuy-US Company: Lucent Technologies Inc. Telephone:719-273-6707 Fax: 719-278-6725 F.O.B./Delivery Terms: Freight Collect-FOB ORIGIN B/L instructions: Bill Freight Charges To: Lucent Technologies Inc. C/O Ryder Transportation Management(PO#ZY10033664) PO Box 134003 Ann Arbor,MI 48113 Shipping Instructions: 1.LUcent's Sales Order Numbers,Purchase Order Numbers,or other identification as directed by Ryder/Lucent must be on Air Bill or Bill of Ladino. 2.Proper NMFC Classification of goods should be used when describing the shipment on the Bill of Lading. 3. All sensitive equipment must be labeled with the"Oo Not Break Down"/"Do Not Stack on Top of This Pallet"placards. Routing-US Domestics: Ground Shipments: 1 lb to 150 lbs UPS 800-742-5877-5877A43W59 Air Shipments: 1 lb to 2 lbs Airbome-800-247-2676-Account#202542700 For other shipments,contact Ryder Shipment Planning&Execution- 877-593-9775 or LAI—LUCENT @RYDER,COM (i.e., all LTL,TL,Heavyweight Air,Specialized,Air Ride,ctc,) Tax Status:Taxable -Own use or consumption TAX CERT.NBR.: Pay Terms: Net by 45 days from Invoice This order is for furnishing the equipment on the forced main as part of LUccant's ap eement with the Greater Lawrence Sanitary District(GLS D).This line is used to pump our sewage over to GLSD for treatment.C ontact Name:MIKE DOW Contact Fax: 978-681-1284 Item Material Order Qty. UOM Price per unit Net value Descri tion JUN-27-;003 15:52 FROM-Alliente, Inc. +17192786725 T-548 P.003/006 F-883 Page 2 of 2 ]?&chase Order f~ucent Technologies Bell LabsInnovatiOns PO Number: ZY"10033664 PO Date: 06/27/2003 1 91,100 Mon V $ 1.00 TJSD 91,100.00 Furnish and install a sampling bldg,ref rigeratcd sampler,flow meter,by-pass with valves,flow meter vault, and electrical from the nearest point available,with a four foot manh ole,regrade and seed area Total Value USD $ 91,100.00 NOTE TO VENDOR: You have agreed to provide to Lucent Technologies with the accurate country of origin for the material(s)contained on this purchase order. 41 If you have provided a Certificate of Origin prior to this date and the country of origin of the material(s)to be shipped to fill this purchase order do not differ from that Certificate then you need to do nothing more. * If the country of origin of the matcrial(s)to be shipped to fill this purchase order is(are)different from the country of origin stated on the previously provided Certificate of Origin then you must CLEARLY indicate the accurate country of is P.O.,and on all subsequent documents related to it. origin on your confirmation of th K if you have not yet provided a Certificate of Origin then you must C1,EARLY indicate the accurate country of origin on your confirmation of this P.O.,and on all subsequent documents related to it. Authorized Lucent Signature P.O. Acknowledgement required Scheduled ship date Item Qty To be signed by Authorized Supplier Representative Date: We accept your purchase order subject to the terms and conditions referenced thereon. Supplier please note,- If unable ro furnish materials as or when specified in this order,please note. Z w k The Commonwealth of Massachusetts Department of Industrial Accidents � d Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affrdavf Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity ® I am an employer providing workers'compensation for my employees working on this job. Comaarty name: .-The Dow Company, Inc. Address 154 Haverhill Street City: . . Methuen, MA 10844 Phone* (978)682-1414 Insurance.Co. Travelers Incurance Co. Policy# 7PJUB-902X310-9-03 Company name: Address Cffrr Pho a#: Insurance Go. Policy.# Failure to secure cows age as required:under Section 25A or MGL 152 can lead tathe M positiar cfcriminal penalties cr. fine up:to$1,500.00 andfor one years'imprisonmentag_NielLas-ch d.penaINesio-lheSormjofa-STOP Mo-d($IW-00)-2JdW--gaiost me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby cerW under the painsan of that the' - ! provided above a bre andoorrect Signature Date 1 14. � /t3 Print name MICHAEL S. .DOW Pine.# X978)682-1414 Official use only do not write in this area to be completed by city or tam officiar City or Town __ _ Renn>7JLicensin4. D BuiloSng Dept []check Yhr mediate response is required ❑ L ken3irry Board ❑ Selectman's Office contact person: Phone#: ❑ Health Department Other OCT 2 0 2003 BUILDING DEPT I _ _ tAORT1y Town ofE over 0 No. C OC LA o dover, Mass., 0a11P IS E HIC HE WICK � ADRATED S H BOARD OF HEALTH Food/Kitchen PERM IT T D Septic System . BUILDING INSPECTOR THIS CERTIFIES THAT i R 1 ...�►A �!?C y� �4' ...... .� ... 7..: �1!!��1N. ...=!yam"... .... Foundation has permission to erect.. .�. � ...... buildings ................... Rough —y„ Chimney to be occupied as.... ..... �t,,...Srhk►(.i', .!�C�...�rwv5.?a�!?Q-. ....�U1�,11.'7C... ..�1c.Q .................................... provided that the person accepting this permit shall in every respecttonform 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 Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough .. �,r.................................... 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 •S. L..�c.... os�3q� Street No. SEE REVERSE SIDE Smoke Det. BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 003909 Birthdate: 09/1411.925 Expires:09/14/2003 Tr.no: 4974 Restricted: 00 MARY H DOW 227 N LOWELL ST METHUEN, MA 01844 Administrator f� 6/1s Z��- 3.z0° 6F 0Enc°. GAslil�P �s 6XPl.2cs 0 _ i i �,h ✓fie-Faonnna�n,�oea,/l�i ay/'�/�1ac�urGellii BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 003909 Birthdate: 09/14/1925 Expires:09/14/2003 Tr.no: 4974 Restricted: 00 MARY H DOW 227 N LOWELL ST METHUEN, MA 01844 Administrator Oct 14 03 03: 2�5p rower house ricirldrCI law 66 (77 2�l AMENDMENT TO AGREEMENT This Amendment dated as of May 29, 2003 (the Amendment ) to the Agreement entered into as of the 5`h day of November 2001, by and between THE GREATER t-AWRENCE SANITARY DISTRICT ("GLSD"), a body politic of the Commonwealth of Massachusetts and LUCENT TECHNOLOGIES INC. ("Lucent"), a Delaware corporation, qualified to do business in the Commonwealth of Massachusetts and having an office and place of business at 1600 Osgood Street, North Andover, Massachusetts, (the "Agreement') is entered into by and between GLSD and Lucent. 1. The parties agree to amend the Agreement by deleting ARTICLE 1 (B), in the form reflected in the Agreement and replace with the following: ARTICLE 1 (B) of the Agreement as amended shall read as follows: "(B) Whether Lucent Follows (1) or (2) above, Lucent agrees to modify, at its expense, the existing connection to provide, or include in any new connection to the GLSD Wastewater Facility, the following items: (a) A new flow measuring and sampling station near the point of modified or new connection to the GLSD Wastewater Facility, and (b) to pay to GLSD the sum of$15,000, which GLSD shall apply to GLSD's costs in connection with GLSD's ultimate installation of piping and other appurtenances necessary to direct Lucent's wastewater to the GLSD Wastewater Facility at a point upstream of the Screening Building. 2. The parties agree to Amend the Agreement by deleting ARTICLE I (D) in its entirety and replacing it with the following: ARTICLE I (D) of the agreement as amended shall read as follows: "(D) Upon completion of the construction and installation of the items recited in ARTICLE I (B) (a), and the payment called for by ARTICLE I (B) (b), Lucent's installation and construction obligations under this Agreement shall be satisfied and discharged in full. 3. Except as amended herein, the provisions of the Agreement shall remain unchanged and in full force and effect. 4. GLSD and Lucent represent and warrant to each other that they have full right, power and authority to enter into this Amendment without the consent Uct 14 UJ UJ: .--Sp rower House Manager Jib-Feu-ticcc N• C- or approval of any other entity or person and each party makes these representations knowing that the other party will rely thereon. 5. The signatories on behalf of GLSD and Lucent.represent and warrant that each has the full right, power and authority to act for and on behalf of GLSD and Lucent in entering into this Amendment. Rebecca L. Ewy Sr. Real Estate Manager Northeast & Canada Lucent Technologies Inc. Richard S. Hogan Executive Director Greater Lawrence Sanitary District 2 Town of. over N®. C, LA WiCQ darer, Mass. QCIM t3 M A°RAYED S E BOARD OF HEALTH PERMIT T Food/Kitchen Septic System • THIS CERTIFIES THAT: BUILDING INSPECTOR 1�..�:M�1"1�?cgl'� �, ..'[��..�...�,�,,,,�.,�� 'CNS , . &xf—"k Foundation has permission to erect.. �.?, ' t ...... buildings on . ... . Rough ........................ to be occupied as.... ..,..$rtf .na -...t4.' !1► -. ....N�lA1C...✓.�4�.. '...................................... Chimney provided that the person accepting this permit shall in every respect1tonform to the terms of the application on file in F''' this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of L Buildings in the Town of North Andover. PLUMBING IN PECTOR . VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Fina' UNLESS CONSTRUCTION STARTS E ECTRICAL INSPECTOR BUILDING INSPECTOR Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Rou Display in a Conspicuous Place on the Premises — Do Not Remove Rou No Lathing or Dry Wall To Be Done Final FIRE DEPARTMENT Until Inspected and�sApproved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. � 6 i . SEE DETAIL .2, ON'SHEET C-12 T NEW SAMPLE . BUILDING y NEW FLOW NEW 10" D.I. METERING - 111.75' 2 1/2" ELECT. CONDUIT 45 BEND WITH STRUCTURE RESTRAINED JOINTS (TYP.) OKL C. TEIR�r ectc — Ew N 11435'"W 1 KANPH-A,6 { / INV. EL. 66.5 ROOF DRAIN . 73.0' (t l — 1 ,o !p"x I D"MCC 14. ov INT EXIST. 81 vi P �� 7-A PP IN & -$LffEvd^ �ti e osl c $LOCK i i I I � I 1 al _ I I4O - I I I I FORCE MAIN 76 lz I bh I II LA I I I I I n CONC. PLATFOR LAND STAIRS I ` EXI I •A� / \ -y I I \ WG \ O ONC. PAD CI I FILLING STAT I ' \ \ ION i \ 7 7 . AWG PAD OWG \ SCREENINGS E f J BUILDING FLUME T EXISTING PANEL PAD' CONC. LHS NOTE 1 NEW NEW 10" D.I.: TRANSFORMER TEMPORARY CONC. BOX NOTE 2 DISCH. PIPE WITH CONC. COVER SCALC SEE I) TAIL .2r ON'SHEET C-12 r NEW SAMPLE . BUILDING y NEW FLOW _ 2 1/2" ELECT. CONDUI NEW 10" D.I. METERING 111.75' T 145 BEND WITH STRUCTURE JESTRAINED OINTS (TYP,) / i T rivST it e.tc -` 4 +�E17k1 N 1f'435 W- INV. EL. 66.5' KA N D tfol,6 1 10, U i. P ff i ROOF DRAT i gh / = EXIST. 8' V P TkPPIN & ILEA Alv 1 $C.ocic I I I I 121 to - NN I frn -- I v a • I i I I � 110 10 FORCE M I I I I f AIN I 76 -ri 71D 1 i � kn a I `-4 ' 1Ni � ICONC. PLATFOR 1 IAND STAIRS I ` EXI 1 I C) j i I 1 Z WG Zo I 1 I CONC. PAD I �\ \ FILLING STATION i7 7 CONC PAD OWG OWG \ SCREENINGS E BUILDING 1 i ---------- FLUME L_ J EXISTING PANEL PAD ' CONC. LHS NOTE 1 NEW NEW 10" D.I.. TRANSFORMER TEMPORARY CONC. BOX NOTE 2 DISCH. PIPE WITH CONC. COVER P� SEE OtTAIL;2.. ON SHEET C-12 T NEW SAMPLE . ' 1 BUILDING _ ti NEW FLOW — — NEW 10" D.I. ° METERING 111.75 2 1/2" ELECT. CONDUIT 145' BEND WITH STRUCTURE -- RESTRAINED JOINTS (TYPJ ' r1~lt�vsr � 1 ectc ti / ,h9 E't�c( N 1143 5�'SW- JULErrm-i e / // `��' INV. EL. 66.5' KA ROOF DRAIN 0h 73,0' x !D"M�N, �-p",jT . . t±l I � �0 � �� EXIST. J/vl P �h TAPP IW .4 j i i $Loc.lc I I Izl f I 1110 10" D.I. I 11 + FORCE MAIN � v I 76 I v h I 1 1 _ I 1 F � c I I II ` �, • m 1 { I I 11 D ICONC. PLATFORI N 1EX1.� LAND STAIRS I \ 1 C3 j ef- ti 1 \ WG CONC. PAD FILLING STATION i \ C CONC. OWG . PAD \ OWG E SCREENINGS BUILDING -r r FLUME •� 4'X4' CONC. EXISTING PANEL PAD NEW 10" D.L LHS NOTE i NEW TEMPORARY CONC. BOX TRANSFORMER DISCH. PIPE WITH CONC. NOTE 2 COVER PLAN . 6.eo' /150 2043.04 _N /0'53'40'W � F'�S/04.11 EN6 -__ opt- _i B.E�•'Q � - [:I[Q.tnf Permanent Eaaemrn>` ' w� lR Area 40.502 f 3y,f/. E 700.SOO �"�-w '• '•.LBwrenca rt4umcpe/ g 75r.., Irs.:o Arrpo,t U Owner Untnown I2 P2 0 ^ Temporary EasemenA h FLOTATION NOr('S. l wh ^ Area 64.7501lq_fl. ti TH/CLfNING 9U/LD/�G y,t�T j•;, .o e L For com le/e information on eetemen/s taE-n N� w `fly � _N la a V PROCESS � lee Easemenim Orawin9sonF/ea!l,�a I r � h MA/NrCNANeE Tae/er Lawrence 50nrtary tI25• 75' 1�/�Q E 74000p o BU/LO/ti!G -f.99 Essex Sf, (awrence,Mdss. �Q'urve Dafa: .owner 4Q,7own rOo.oO-' r" r o TN/CKENEO PQ/MARY 54UOGE QI Rs 62.00 a ss6o"sv o (- , 48.49'50 7 Far fence defar%J Jee ?hee` G_GB. N ( i PC/MPrNG J rA7/O / T-- 28. 14 ' t0o.00_ `, Iwo / L a 57.84' O --Al 10'53'40'w � 99.00 5tase«SB. 594.77 O , ' Curve Da/a: __ O 3.For,goad I J, K L,Al.M. kJ de/ai/ed ans EA SEMEN��E TA/L . 4400 oo.oo' psb`5 grafi/es See Shec _dr 90'00'00 R OAD `A' L"9 b W ca/e:/_loo' T.ae.00 a s90.0o' Tianai on ;o P e W ^o- -�1 0 /03.33 �h� ADM/NiSTQAr/ON ROAD n 'H'. BUrLDCnG 41h �. O - - -- -- � •3 Z C I 4 � \ \ y 40.00- 0.00 u� v v rN/c KEN/NG \\�. PAR GQ• 7p0 wO J IV 9.3E E ,= TANKS U fG \` - \ �E 599.B63.¢9 �+� 000 N 626.737,/2 E E 699.565.59 5 699 I �t i _ ;,--_I ' i,'. __ 465•Z-3 _g0p ` ,- Co/umn Q Lme /576.2/ CC � � ___ 17 -' j� �a I O YI � - cess C Meru N r0 9'40tY 0 v •a - d - 4i AC71VArED 34UO(5 Q \ -T NEL �1 h PUMPING .5rAT/ON O 6 _ \\ \ \\ J'ACCE33 BU/LD/NG Q \\ 1! /V� o ¢CuryeO 'J \� 3 i9 MA/N EL ECTg1�C'AL aVQutt 3' II < Dr574/BLmON dU/ INe StJ0 _ d�� N 615,77!,97 tI P ad 'C' -T. OZ00 7 * 0 �� Sa. -r . !2J Q E69275108 _: ROAD - `�' S0.PYrto' Bid240.00 aso3 OAD A /ON NN7 WATEQ `B1ING J7A7/O/Y e iD1•Jfe/4r6Y. 9t b _ ACCEJS BUILD/NG 3' 'a s 'II 1 © ,? \\y0 15 to L 5 263.50 - S. .. 9 i TUNNEL h 86.00 00 ROAD " 00% r 0, .Z i N 6Z4.63/,93 a//Oro e.",701 ti U .Y N / 4 7'UNNeL TUNNEL QOI N./ I / O �y?_; the P/ant E6994290/ E 699-pp0 czono'M i, TANKS sj -- ti'621/;5.6/ 7✓/0'53'40°w y ^ I Q l --I- , 00I 3 -N. 3 �• E 698.95/-37 -- Q m� C/Iain LrnE fence I n/°•2 n'�I -SCQCEN/NG5 g a//aro and the E�ani I n h' 0 j I Al.. 2 - N•. 4 N> 3 + No. 1 4 I J I TUNNEL 9 s6- /627, I "69G9,599.SB 0i ?4' II � /3L7 ' � � PQlMAPY JLUUGC�G?lT � Sfa.f'1/r59.64 PUMP/NG i747/0A/ CHLOQ/NE CONTACT Ro / e TANKS I cr cc End fRoad'C' T- ° � \ s4r, 'P0,16.9P I ROAD 1 iy0 " 4/3.50 /66)5 R 00- - !99.50 - C90.O0-I /'JO,DO Z97-ZS I � � EDlMCNTAT/ON \\ 58./S '' TANKS I � OEGOrvOAQY i N624.0/9.5G' �\ \ 3' 3'.oma. I I + SCO/MCNT4T/ON TANKS b I ' No7b: E 69B 951.66, \ C3 I I A// radius corner) arc 95.G7 ff,exceP/ ea nolee; Q I /2' i2oS S � Al 9?6,/54-66 GREATER LAWRENCE SANITARY DISTRICT `= �� \ _ II ' ` o• HALF-SIZE DRAWING WATER POLLUTION ABATEMENT FACILITIE 4 _ CONTRACT 'NO. I av�by: Dab Nam= _ �----�i� i -- B03TON d �%'A/NE lA/LROAD _- rural ,,N a •� ,,,,,,,,,,, PLOT PLAN I ird � I �ermanenf Psscmen/ get de/ail AOs sheet, B.M.B, C I/00' D�sianed by: Temporyry Eascmen/ A.y Ma/cb.1972 SNEE7 NO. - Drawn by+ - „ CAMP nRF.SCR7R 6 McKEE n_7 _. _, il' 6.I0 - N 616.//!.!3-/ �l - - _ •-oFfcwnuat� - 9 Mo 190 O �. 2049.00 r N 10'53'40'w £ 70Q 583.60 'a At - R•1971w " \ f.n.o7H ;[.Id�.eo --Permenent£-,semen/ iA Arra a0.son 39.f/. E 70Q SOO Al - E .Lewrcnce tiJunicp I/ 0 7S,'... 'Ia •o AL-pal II� NOTES. �2 P2 0 � _Temporary Eeaemen� h f LOiGT/O A! pwnerUnEnown al 1, Area c 64. dCWLO750 Y J _P. THICKENING I�G / for t e f comp/e%.�Farma.tan on eeJ_.ne.71s :of-.o ^ W ton Z PRoc£ss f aea Easemeh's Oraw%�75-on f,'/ea%rye rGree%� Lawrence San%iar v^;'s. �:ee MA/Nr£NAN[E 598 Etsex 31- LawrenceyMa:J N t I2b �s' rrI Q y0o 000 nem d5(//4 D/NG �[ur ve Dml'a D.wner Unbnown r --- ' R.6?.(.V :NiCKENED PQ/MARY DLUDGE a� d=4B•49'50' 7 For f nce de/al%7 gee lheer` G_4B, o ss40'a PUMPING BTA,/ON 0 / T. 28. 14 n 1 ^ IV/4 12 L:P0000_ '. L. S?.84' A; -�-__ oz e^�' O 0 --N 70'S3�40'w -Carve OR/0: 93.00 L 5te.�es9.d4 694.77 9.Far,Dodd z�.J, K L,M. ill do/ailed p;'an3 _le v"e O - --� G/ y e prof%le-, Sec Shects [3./1,!4/5,291 3/. EASEMENT DETAIL _ 90.00'00" mo.oQ' ROAD/ 'A' p. � r C "39000' soa.lon F�' ADM/N/STRAT/OA[ 3ca e: lDo ! T<44.00 b -� p /03.33 �9 5=69./2 ROAD n .H. Ti I I BWLD/�/G h 38 -- GRA V1 7 Y THICKEN/NG �� \\\\�`� W. / .V625./B9-3Z E )O0 4 ey 40.00 0.00 \\\ W/Y o r ml \�\\\\`\ PAR W' 000 _ TANKS t \\�\�� /- ki . N 606,75 7,f,? I U EG E699.863.¢9 r E 699.565 59 \ 60 5 5.P3 J E 69 --,rp0 46 Q / aeesa f Me1n. erttG 9rii 1n3s_N1CL'12.42J7 - '\ \ - - 1� O M - \ \ ` \\\': \�\ _ �-TUNNEL 0i ACT/VA TED 1LUDG Q Q 'q j \ \ \` \ An PUMPING STAT/ON� O 1 $ r _t,\\ \\��\\\� \\ \\ II -V:AItlT` f ���_� \, 30.aQA6 MAiN E�ECT81; e1 e vG�-u ACCE03 8U/GOrNG Q \" \ ¢/ "Curve[ w 4 e' 3' I -oruNN SLD/d ra/bL/r/ON h R R 47.00 - d on I N 675.774,77 /n/. Rad 'C' z,5b•xo � �� \ .r o p - 11 � \ \ I L0 9 �' «`i T �` 0 0'I1 E69275/OB , ROAD \\ y `S1a 9.3I.a6 �- �0.Fn p`t/!q 51tlq. 1+ I 0 1 D� /f'Ge1e ~ ?4a.00 8503 pR POA D --� /t' aC. -�' \\ o ti ^„ '°F P4/MAAY 3G UDGf d O I - _ T-- o\ R�PUM6/NG N3 ON ter _ PLANT WATER , 82. -m ct --;� iQ _ �' ' U,NP/NA754..14, 9t G)TAT/ONE dCCEOJ BU/LD/lA^i i 15 L3 /6 H\ 5 \?63.50 - \ _ _ I � �� s 9'/ O TUNNEL ti 85.00 S N..l 0 I N..2 I' `ROAD n •, K d II 63/.99 = Vy / 4 r UNI eL TUNNEL A_RAT/O J a I./ a '�4.Oo; the P/anf E 699,429.o/ E 699,0p0 ROAD'M" \ Ksl 'I TANKS 699.300 15 ZZ Z4 7 'b'622 1/.7.6[ .- r 7J/0'53'00"W 698.95L 87 - Chain Lint' fence Q I a I a ml i hl y I DG/lLy7NG � ��• a/ldroundiheflan/ i !B/' 627.9?9,24. 699,599.58 ?4I ' `fu1 3O, /s,y 3 3 I PQ/MAPY?JLUUGC!G ?lT \ Raad64' B' 36TA7/oN gm e/9 PUMPINO O R CNLO?/NE CONTACTII 1 O / '--+� ' 40 O •k TANKS ?0 I h I Ie 1 a o to - - �nd t Road C' �`•. 6 50 510. ?0,/6.92 `.. II I ROAD I / /46.00 6615 R* 65.00 [99.50 90.00 I 150.00 I 297.25 3 6.TS` I " 4/3 50 / \ j l M II I M P2/MA 2Y SED/MENTATrON 7ANK3 - -�. A/6?O -- I I a£COn1DARY .0/9 5; 3CO[MCNTAT/Or4 TANKS ' Vo?e: E69B.95%.661 A// rediva corner) are 95.0 f1,except e-,nolbd. oS. B O /So CC GREATER LAWRENCE SANITARY DISTRICT o SO f B.4ax 90. HALF-SIZE DRAWING WATER POLLUTION ABATEMENT FACILIT{E CONTRACT NO. I PL ,-dbys 'Daft Hans. - `� T1� i -- BOSTON 4 N'.A/NE _ QAlLr�OAD. �aI ft a'k•d. baro-, OT PLAN I Da �brmanent CeJcmen/ 5 d / y f/,a sheet p.f;y,,,d M B.M.B, SHEET No Arl"porary Pasrmen>` �z� -!_ _ �a b, Maroh.l972 F •4 Y I� •vn nv iCCF.R A .MeKEE. .�..7 V 6t6.//6./3 / b M V.. . 2043-od N 10'53'40'W �ofGrSiEa'•'•4"4 - E 70Q 583.60 _75.•``I 510'33'4 'E- R.197 Gne.67 "SC oO:. \ - --Pennanenl Edeemen>' t.'ef.e0 Area A0,SOt_'6y.f/. 7p0_sop � - '•.Lawrence,Ulunicpe/ owner Uninown IZ PZ o :Tempora.y Ea.lemons /VOTE$, FLOTATION qL+ ° Area�64.7502Jq-P. ti 7H/CKENIN6-8L/[LDIAG • tI Flo ja b e /. For comp/�`e IrFo�ma.tian on eeJe.re.ofs �aEen ti� ., hM�n Lf w PROCESS f zee Easements Onvwir�s on,5%,d%'le r �..MA[NTCti[A.I/CE �Jrea/er Ldw/once Sanildry v:irc1J�:P CU/LD/ti/G S98 EsS/, sex L a wrence, V,?j,s. N� � ties' TS' �ril�. E 7p0p0p � - v - `s Owner C(ninown ¢Carve Oale: �00.00" •` ' o r- THiCKENEO PR/MArPY zLCIDGE �� R.62.00 /0 S3SD'w o I PU.lwlolNG D7AT/ON Q / / T-28, 14'SOS FOr f nce delai/s JCe Jheef G_dB, N � 93.00 5>nJa.SB -594.77 O m 3.For.Poad Z J, K L,M. 11 defai/edP.br.3 Cur re Dala: $ O EQ 3EMENT DETA/L X44.00' h - �19 d profi/as See sheds c3_/s,ro IS,29i �- _ 90.00'00" Q 390.00 ROAD, •A' b T p /09.33 %ry�0 ADM/N/STOAT/ON 1.69./2 _ROAD n H. BUILDING h O _ -- O - 35 ti ,G R.4V/TY 40.00 0.00 .r .a rN/CKEN/NG \\�\\. PAR GQ'. _ N625.189-3E E'7pp O W© J i9 \ 00 N 6P6.737r/P _ TANKS 6E 9 863.49 a k+ E 699.565.59 \ i S F N 'z __ ,1- -'y _ \ 1 i.'_ __ 465.z3 I j Q C z 4 f 6,99 Sp0 \� _ Co/umn ® Lrne 15.V.2/ 60 _ ___ 1 __� OCEJ7 C .oto f+'�e?LC_.S'/i _N.12S1_QQ-w - �. ACT/VATEO SLUDGE Q I P •a \� \� �\ \ \ \\ TUNNEL \ \\ PUMPING zTAT/ON O 6 ACCEC6 BU/LO/NG Q i Imo;_.;-� \ \\ 30.Q0.36 MA/N EL EC'QI.CAL tis ^ Q.Ey r,0 tit¢CarveD w �, �J' J' Iq\ ��� ! \�`f�\ gra" D167.7/Bu7/ON ;au/ ING �• 5 Q t '00'• - \ is a TUNNEL I�•� I T. 07.00 I o N 6Z5,77J.J7 \� d/nr P ad 'C' 7 m L] D� E 697 7StOB __ ROAD �\ 1 5'a. 9x3/.46 �^ S0.Nr 1�r e el q. o 4 1.47 - O -� '' / J J t�D'l If'Ge1e 270.00 P603 BROAD O �' a Rza' PP/MA AY 5: DOGE( O I"- t' �C' t / PUMP/NG O; 2� 0 _ _ I. 7 � y- c� 3 A /ON N RL A N7 WATER $ .d -r- J i P'r n �/,V,P/N'G 67A 710N E !a.7s1e 14.8r. 02 o �' a \ o m "0 1 ^s.a/ , a --Y' o ti •� I I 5� 0 A:CE65 6U/LO/W^ \ '10' �� \ �O o y -1 4I 11 5 263.50 - n 3 3'% 7UNN`t ti :N•./ � II TO A.RAT/ON I_ - Cha!2LinE Cnce V67a 63/,93 ^ O I I----- ` V r 9l/Around - _.._ h �•/ I I �� U 4 TUNNGL TUNNEL of V..[ I p ' 4 00 the P/ant E 699,429.0/ E A 69g of I u l. / ,aQ 0p0 ROAD'M" m� it 7ANk5 i N•, 2 v/a*53'40'W - - I \ s ' ; o. £ 69$95/.37 .-..._. 111 O Na 3 pl ffjain Linb fence Q I --- of ° nr..2 SCQC£NINGQ 3 al/around/het9anl 8/, Z N(3 hrI y ( J EL N.,14 f (Fufy e) �I --- SIn __ a 698,599,58 O, 24a jlI t \ I Fl ' 3 s•N. 3/.7 ' gjnf/Baa•d4? PUMPING O rA7/0,V CYLOQ/NE CONrAC7 f/ �i i m O TANKS 20 and ,,Poaa,c Sla. ZO r/6.92 OA^^ �� m Z � 65.00 99.50 /9000 /30,00 97. 3/6.75\\ r.� .8„ 48.50 166./5 Rs50 b elmARY 6EDIMEN7'.471ON I O /8. Sa./S 7*ANK6 �' �' zPCOrVOARY b N624O/95� 3• 3 a II ; SCD/MEll TAT/ON TANKS � jl E69895.:66. n I ^ Vole: ` All redius corners are 83.0 r!,except ea noted, /2'Gale 1 205. 6 NA'26./54.66 _ GREATERLAWRENCE SANITARY `DISTRICT �4 SO c B 4ai 90. HALF-SIZE DRAWING WATER POLLUTION ABATEMENT FACILITIE Q CONTRACT NO. 1 N. � __ B05TON d ; M4/NE P4/LQOAD nut PLOT PLAN Deb CAW& �,.;,�,,, I . Cas ,__ 1 Rtrmanenl Eesrmenl 5ee delai!A,i;ahret. SHEET NO. 0..;9d 1,y; B.M.B, �- Tem arar Easemenl� �� Match /.97? ^ P Y D.b .4,Y. Des.- I\ nnrccFe to McKEE ___..v ,V 616.1/D,13 / y9$�-T'°Ps°� rV.♦ __ 2043.04 N lo,S3'40'w C 708583.60 - g`ssra. R.197, _Z.'18.67 5 \ .'G.a.o7' �N �' .- •-P[rmdnent£d0e/nM1 iv G.ias.do 8 1, Area 00,502_'sq_zz 700 SOL 'm :o E-' Lawrence Mc,,n,cpe/ O u- '0 /0a'_ .1 v 0 734"I I o Aupo:f O Owner Uninown 2 P^ o _Tempora y Easement h NOTES, FLOTATION h TH/CCENING Ou/LDI�G /'For cam/�:e%.iforma.tion�neeJs.a,e.ofs faEen Ared c 64.750'�q_f1. e }r+�n rnlO 1.'N t0 �h « NM*1 Li ti � , PRoeB3s E gee Easement Orgwinc�t onf•'iee'r,�e N h MA1NrCNANCE �irsaler Law�enct $anrfdry r E 7p S9B Et 1Ias »' tex Ss Law, ce ,Naas I �o O /,Iy CU/L D/.VG v ppp ^ ¢Curve Da/e: 100.00N�CXENE0 PU PR/MARY OLDGE 4' a�48.49'SO ?. for f nce dela,,% oee Jheef G_4B. /0 5360'w J I PUMA,NG 9TA T/ON / T- 28. 14 . 0.00_ '. Z. 52.84' f0 oa O Q� . N !O'S3'40'w 93.00 5tn7B•se87 590.77 9.For po/, I, J, K, L,M. !�! dcfa,'/ed p:ar,� - Cvrre Dafa: e'Orafi/e1 5ee Jh elr C3./9,/41Sr29i 3/. EA?EMEN? ETAlL X44.00 �6`' h 'd-c90'00'00' q 390.00' oeo onf ROAD, 'Ar / G� 'v ca/e:1 r 100 ! T 44.00 b----q- � �I a 403 33 %h�a ADMINISTRATION L.69./P .ROAD „ H. ` BUILDING O O - _ 3a / 4t _�aA yr r r 2 / 4 uF \�\ +/ - TN/CX£N/NG 40.00 0.00 ,u �I U-7`4 \ \\. Pa,Q 4v _ i ,v 625.189"32 E TOpOpp o IV 626,737A2 - , i E 699"863.49 1 E 699"565 59 \ ? ^ p L 699 SOp \ - Column Q Line 15.76•?I Bar S O G 0- A . __ f Oeess�Me,,nanenGL_.'9rii uaj_N._/[L'3d:3Q1K n p � •- �\� � _ _ \ 7 - --- p AcilvAr�IA11011 Q ° 'a - •!s \\ �\\�\�\\\ \ �\ �' PUMPINO i 6 ��.., �,\. \� H ACCE5Q I r j_ \\ 90.4439e 'er I1+ Q MANN ELECT4/CAL 50 a ¢Curve D8! o o a 3 V TUNNEL i I o\\ o, �� \�`f 4./d. D/'JT.7/8L/T/ON dVl ING h V a w R. �'�'O � Vo � v o Y ,, � \ A.VO 00 $; - - ( �j Q �:. 7 + 0411 + \~ i, `Sra. 9>3/.46 9L so-rylt F1 F l, Q 81 /J n E69275LOB o, .- QOAD � / 3 {d PP/MAQY 5G UDG£ i �O Z00.00 BSO9 ROAD (YQ/TPUMDING Oj A !ON N m PLANT 'NATER -\ T- 1' .r O U•MP/NG 5TA710N E /?I•Sfe.10.81. 9t d n ti_ C � o'� q "m Vf ,,I ,�S+d,, m n �O ^a "' 2•y� ACCBDS Bu1LD/AG 15 S Q 41 5 � 1 r I Ie \ h `267.90 5 0 .. 1 3/ TCINN£L ti p \ 86.00 .1Je.1 O I N..2 ' \ ^ n iK 0 / �� z �o - aro";"- ice nrSze 63/.93 N A-RAT/OI I. E699,429"O/ TUNNEL IN 6.9,9 I p TANKS w �� E6gg5pp i Ne, Z _ _ _ _ I __ 232 7.?4 __ :7 _ � -' -�---- I I \ o 3 ` IZ 698.95/.97 Is �. O I '1. Q :SCREENINGS g C�j ain[int fen Ce Q ____ /J."2 ' 699,,599.58 . I ' ' O m3lLFI 3„, to/LING 4a//gro and/he IB A/. Z IV'3 TUNNEL I 627 44'1B241 I1 1 75' .>• • !i �gef/Raa'd4a IPRIMARY OO U I PVmPlvG 2 0747/0,v Cv[o TANKA&1, S a 5 a. ------- - • , �tRoadZ" 1.•. - ROAD � 413-50 zo./6.9e /46.00 165'oD 199.50 130.00 I 180,00 I Z9z 25 \ ZIII f --- .1-- 1 PRIMARY SED/MCNTATION - \ S 3 b I '" TANKS 11 _ _ --- H I ` h Be--- ' 3' a` l r �CO/MGNTAT10+� TANKS Nam: E69B 95/.66 A// radius corners arc 35.0 lf,ex^epi e5 noted. IV 0t8./s4:66 GREATER_ LAWRENCE SANITARY. DISTRICT o.� � HALF-SIZE DRAWING WATER POLLUTION ABATEMENT FACIUTIE 4 _ _ CONTRACT NO. 1 49037-0N d /NA/NE _ •?AILQOAD - --T a'k'd PLOT PLAN I kd �brmanlnf teatmenl 5ee delad lhfi ah"i. Ds18s,d by. B.M.B, SHEET NO. c poo, Temporary Caarmenl _� -� own sv Marh.1972 I AILrc r.vn rin cc's ;A McKEE-, n_7 ' e TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING T�113 motion for Official Use Onl A-1 BUILDING PERNUT NUMBER: DATE ISSUED. SIGNATURE: Building Commissioner/Inspeclor of Buildings Date I I Property Address: 1.2 Assessors Map and Parcel Number: )(J Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zonin Distrid Pr osed Use Lot Areast Frorrta e ft 1.6 BUILDING SETBACKS(ft) Front Yard Side Yard Rear Yard Required Provide R aired Provided Regaired Provided 1.7 Water Supply M.G.L.C.40. 34) 1.5. Flood Zee Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ ZOIIe Outside Flood Zane 0 Municipal On Site Disposal System 0 >'-. 3..0 rN+...,.��� R., r,3:3•. x .,Ret ,,.: -#_;t7i�' '�'*e-�. 2.1 Owner of Record Name(Print) Address for Service Signature Telephone 2.2 Authorized Agent Name Print Address for Service: Signature Telephone J.I Licensed Construction Supervisor Not Applicable ❑ Address `` License Number I?a7 / o- Z.- oo��o9 Licensed Construction Supervisor: \ J — Expiration Date Signa Telephone t 3.2 Register Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone 6. "'. I Agent as Owner/Authorized Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury i Print Name Signature of Owner/Agent Date 411 Item Estimated Cost(Dollars)to be Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction from(6) 3 Plumbing Building Permit fee (a)Y(b) 4 Mechanical(HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) Check Number s "Imp"� �� ...v. 1,, •d H, ...1 s ,�-�"r`�71 r �i�:.tr,�`L P'ir 'Nilo t .9:� 4- ��. ; 1 � �� NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS ] 2ND 3RD SPAN L OF SILLS OF POSTS OF GIRDERS UNDATION THICKNESS NG X CHWNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE "C. Y i' -T L Us ;e,. y 1 Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yea-------0 No.......0 S� TfOPT:S; PIdfD SSIUl�FA1E lEtGt ANII! bJR�I€ YtiL{R�'� 5 lff1�1AM t i1JIS 5B 5.1 Registered Architect: Name: Address Signature Telephone $.�It�tstered�rafe�s�ena� �ee�f�' ; 3 t Area of Responsibility Name: i Registration Number I Address Expiration Date Signature Total I Not applicable ❑ i Name: Registration Number Address I Signature Telephone Expiration Date I Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Not Applicable ❑ Company Name: Responsible in Charge of Construction t+� � sl(I;7 ►1�i?F'lP)�4�P061 �'�,{ck afl appl�cabie� New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition 0 i Accessory Bldg. ❑ Demolition 0 Other ❑ Specify Brief Description of Proposed Work: I USE GROUP Check as applicable) CONSTRUCTION-TYPE---- A ONSTRUCTIONTYPEA Assembly ❑ A-1 0 A-2 0 A-3 ❑ IA 0 A4 ❑ A-5 ❑ IB 0 B Business ❑ 2A 0 C Educational 0 2B ❑ F Factory 0 F-1 ❑ F-2 ❑ 2C 0 H High Hazard 0 3A 0 IInstitutional ❑ I-1 0 I-2 0 I-3 0 3B 0 M Mercantile ❑ 4 0 R residential 0 R-1 ❑ R-2 0 R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use 0 Specify: S Special Use 0 Specify: COMPLETE TRIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area s Total Hei t ft Y 1 independent Structural Engineering Structural Peer Review Required Yes ❑ No ❑ SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property Hereby authorize to ad on My behalf,m all matters relative two work authorized by this building permit application Signature of Owner Date