Loading...
HomeMy WebLinkAboutBuilding Permit #291-15 - 315 TURNPIKE STREET 9/23/2014 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: L—cr Date Received Date Issued: Z344, IMANT:Applicant must complete all items on this page LOCATIONy s T YV/Dt�- 5frod Print PROPERTY OWNER M_ P.,1_ Vf ✓V Gly v I lea. .r Print 1 o0 Year Old st"rudure yes no MAP NO: PARCEL: ZONING DISTRICT _ Historic District yes no Machine Shop Village__ yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition El Two or more family El Industrial El Alteration No. of units: El Commercial ❑ Repair, replacement ❑Assessory Bldg "thers: 7- ��1-s ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED:I C� V-) D !� bar t� 9� zhy r&e will el-s- GT a,-Za Z� 910eol ld—"4 101*7 �9"-Crl Xeo-�—Ne Identification Please Type or Print Clearly) ri;'naee Ca/�rG� Phone: OWNER: Name: /l Address: 3�S T� 1VX CONTRACTOR Name: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: . Exp. Date: Q A R / C{-E l. Phone. Address:!/��OI�I ��'• •/�`7 D�D eg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �i8�� — FEE: $ WSJ Check No.. Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Own Signature of contractor -1 1 A r-'---_i rv-4- r)l-- F—I Q+. rvimnrl pl7ne F1 Plans Submitted ❑ PlansWaived-❑ Certified Plot Plan ❑ Stamped Plans ❑ .-TY-PE OF_.SEWERAGEDiSP:OSAL Public Sewer ❑ TanningWassage/BodyArt ❑. . ,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 �y t 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 Tovv;-, Engineer: Signature: �t Located 384 Osgood Street FIREDEPART�E"NT -Temp Dempster on site yes no Located-at 124 Mair,Street Fire'Departmerit 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 DANCER ZONE LITERATURE: Yes No MGL-Chapter-166.Section 21A-F and G min.$100-$1000 fine NOTES and DATA— (For department use El Notified for pickup - Date F Doc.Building Permit Revised 2010 Building Department The foli�swing is4list of the requi-red.forms to be filled out for the appropriate.permit to'be obtained. Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application ❑ Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application ❑ Certified Surveyed Plot Plan o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses Li CopY Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) o 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) o Building Permit Application Li Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit o 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 cans if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apo,-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm..ted with the building application Doc: Doc.Bui?ding Permit Revised 2012 Location No. S Date . - TOWN OF NORTH ANDOVER ' • Certificate of Occupancy $ Building/Frame Permit Fee $ - Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# v 101._./ � Building Inspector NORTH Town of t EAndover No. T - CO, h ver, Mass, c0c.0c«twic" �1 A0R.{TED S U BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System THIS CERTIFIES THAT ....... �Yl � ........C06.14.0.4p.0 .................. BUILDING INSPECTOR has permission to erect .......................... buildings on . I. .........}.{JP.h►. .. ...... . �...�....... Foundation Rough tobe occupied as ..... .. .............r. .. ...................................................................................... chimney provided that the person ac epting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR J#11 UNLESS CONSTRUCT S TS Rough Service ............. .......................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. Smoke Det. Main Street Layout Homecomeing 2014 • arking Lot H (Sakowich Campus • Tent 1 2000 n t: Tent 5 Tent 4 Tent 3 Tent 2 20x20 20x20 20x30 2000 r Carnival Area Ne 4 if: y "3o •i •1 - The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations W W I Congress Street, Suite 100 t Boston,MA 02114-2017 y�1 www.mass gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/OrganizatiorAndividual): Christian Delivery & Chair Service, Inc. Address: 18 Clinton Drive City/State/Zip: Hollis, NH 03049 Phone#: 603-883-5326 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 30 4. [] I am a general contractor and I employees (full and/or part-time).` have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. E]Demolition workingfor me in an capacity. employees and have workers' y p �'• $ 9. E] Building addition [No workers' comp. insurance comp. insurance. required.] 5. We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no Tents employees. [No workers' 1 AM Other comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: NH Motor Transport Association Policy#or Self-ins. Lic. #: P000749NHMTA2014 Expiration Date: 01-01-15 Job Site Address: 315 Turnpike Street City/State/Zip: N. Andover, MA 01845 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains nd penal ' of perjury that the information provided above is true and correct. Signature: Date: 09-23-14 Phone#: 60 -883-5326 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: P1%fffiWM NEW HAMPSHIRE MOTOR TRANSPORT ASSOCIATION P.O.Box 3898 Concord,NH 03302-3898 (603)224-7337 CERTIFICATE OF INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S)AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. This is to certify that: Christian Delivery&Chair Service Inc. DBA Christian Party Rental 18 Clinton Drive Hollis, NH 03049 Is,at the issue date of this certificate,insured by the Company,under the policy(ies)listed below. The insurance afforded by the listed policy(ies)is subject to all their terms,exclusions and conditions and is not altered by any requirement,term or condition or other document with respect to which this certificate may be issued. COVERAGE AFFORDED UNDER WC LAW OF THE FOLLOWING STATE: NH TYPE OF POLICY EXP DATE POLICY NUMBER LIMIT OF LIABILITY Continuous' Extended Policy Term Workers'Compensation 09/01/2014-01/01/2015 P000749NHMTA2014 Bodily Injury By Accident $1,000,000 Employers Liability Bodily Injury by Disease Policy Limit $1,000,000 Bodily Injury by Disease Each Person $1,000,000 ADDITIONAL COMMENTS: 'If the certificate expiration date is continuous or extended term,you will be noted if coverage is terminated or reduced before the certificate expiration date. NOTICE OF CANCELLATION: (Not applicable unless a number of days is entered below.) Before the stated expiration date,the company will not cancel or reduce the insurance afforded under the above policies until at least 30 days. Notice of such cancellation has been mailed to: NH MOTOR TRANSPORT ASSOCIATION SELF-INSURANCE GROUP TRUST Christian Delivery&Chair Service Inc. dba Christian Party Rental 18 Clinton Street Hollis, NH 03049 Authorized Representative Concord, NH 603-224-7337 08/28/2014 Office Phone Number Date Issued c1�cP�PrJ��PPclrJ�rJ�rJ�cJ7rPc PrJ��PrJ�r��fi M ® 7A �PrJ�rJ�rJ�eJ��Pr��Pr�rJ�rJ�r�J�cPrJ�rJ�rJ� r 5Coortffleate of Tlcglstapce S S ' ISSUED BY Date of Shipment 5 5 REGISTRATION a 3/3/2008 5 SNUMBER :L INDUSTRIES INC.® 5 CSJ ~ EVANSVILLE, INDIANA 47725 Tent Identification 5 5 5 F140.1 �~ MANUFACTURERS OF THE FINISHED 04590588 C] TENT PRODUCTS DESCRIBED HEREIN S 5 This is to certify that the materials described have been flame-retardant treated S 5 (or are inherently noninflammable) and were supplied to: 5 5 269800 - 5 CHRISTIAN ER DBA CHRISTIAN PARTY ENTAL 5 18 CLINTON DR C5 5 HOLLIS NH 269800 �eC 5 5 5 5 5 5 5 5 Certification is hereby made that: S c5� The articles described on this Certificate have been treated with a flame-retardant approved S 5 chemical and that the application of said chemical was done in conformance with California 5 5 Fire Marshal Code. All fabric has been tested and passes NFPA 701-99, CPAI 84, ULC 109 5 �j Serial# 5 5 8151210(1) 5 5 Description of item certified: 5 CENTURY END 60WX20 HOLE SNYDER 5 WHITE VINYL WITHOUT WEB GUYS 5 Flame Retardant Process Used Will Not Be Removed B 5 Y 5 Washing And Is Effective For The Life Of The a Fabric S 5 5 5 SNYDER MFG NEW Pill LADELPHIA.OIi Signed: S Name of Applicator of Flame Resistant Finish ANCHOR INDUSTRIES INC. 5 .IRE 01't �E rQj 3rr r.PLJ-PL M IMPORTANT DOCUMENT Certificate of Acme Wsistance ISSUED BY Date of Shipment 2/24/2014 Registration Number CHOW F-140.01 CNINOUSTRIES INC. Sales Order# SO-601120 EVANSVILLE, INDIANA 47725 MANUFACTURERS OF THE FINISHED TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described are inherently flame retardant and were supplied to: 269800 CHRISTIAN DELIVERY CHAIR SERVICE INC DBA CHRISTIAN PARTY RENTAL 18 CLINTON DR HOLLIS NH 03049 USA GASTER N Z yy�i� MPS�4 � RET p4 Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code. All fabric has been tested and passes NFPA 701, ULC 109. Serial# 8151030 1) Description of item certified: CENTURY MIDDLE 60WX20 SNYDER WHITE VINYL WITHOUT WEB GUYS Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric SNYDER MANUFACTURING INC. PHILADELPHIA PA a Name of Applicator of Flame Resistant Finish Signed: ANCHOR INDUSTRIES INC NI IMPORTANT D O C U M E N T������������LP o 5 Certunicat�e of Fla l�esl� ce -9 5 ISSUED BYji(r S 5 REGISTRATION (tT4 Date of Shipment C5NUMBER 11 D��I�I� 3/3/2008 5 5 5 r� a5�i EVANSVILLE, INDIANA 47725 Tent Identification 5 MANUFACTURERS OF THE FINISHED 04590588 5 5 F140.1 E TENT PRODUCTS DESCRIBED HEREIN 5 5 This is to certify that the materials described have been flame-retardant treated S 5 (or are inherently noninflammable) and were supplied to: 5 5 5 269800 5 CHRISTIAN DELIVERY& CHAIR SER 5 5 1CLINTON DRD8 BA CHRISTIAN PARTY RENTAL 5 5 5 HOLLIS NH 30496576 5 5 5 5 5 5 5 5 5 5 Certification is hereby made that: 5 5 The articles described on this Certificate have been treated with a flame-retardant approved 5 5 chemical and that the application of said chemical was done in conformance with California 5 5 Fire Marshal Code. All fabric has been tested and passes NFPA 701-99, CPAI 84, ULC 109. 5 SSerial # 5 55 5 8151110(4) 5 Description of item certified: 5 5 CENTURY MIDDLE 60WX30 SNYDER WHITE VINYL WITHOUT WEB GUYS 5 Flame Retardant Process Used Will Not Be Removed By 5 5 5 Washing And Is Effective For The Life Of The Fabric 5 5 SNYDER MFG NEW PHILADELPHIA,OH Signed: rj Name of Applicator of Flame Resistant Finish ANCHOR INDUSTRIES INC. S rJ��PrJ�rJ�rJ�r J��PrJ�rJ�rJ��Pr��PrJ�rJ�rJ��PrJ�cPrJ�rJ�rJ�r�rJ�rJ�r�rJ�r��J`]rJ�r1rJ��PcP[J��J�rJ�rlrJ�rJflJ�r�rJ�c!rJ�rJ�r J-r frJ��PPcJ�rJ�cPr P�P�PrJ�rJ�rJ�rJ�rJ�rJ�rJflJ�rJ��P�P�Pr��PPPrJ�rJ� Fal 5 � ISSUED BY 5 5Date of Shipment 5 REGISTRATION 5 a S NUMBER :� 3/3/2008 5 INDUSTRIES INC. 5 Tent Identification EVANSVILLE, INDIANA 47725 S S F140.1 yr MANUFACTURERS OF THE FINISHED 04590588 5 5 TENT PRODUCTS DESCRIBED HEREIN 5 5 This is to certify that the materials described have been flame-retardant treated 5 5 (or are Inherently noninflammable) and were supplied to: 5 5 269800 5 S CHRISTIAN DELIVERY & CHAIR SER 5 DBA CHRISTIAN PARTY RENTAL S18 CLINTON DR 5 5 HOLLIS NH 269800 5 5 5 5 5 5 5 5 5 5 Certification is hereby made that: 5 5 The articles described on this Certificate have been treated with a flame-retardant approved 5 5 chemical and that the application of said chemical was done in conformance with California 5 5 Fire Marshal Code. All fabric has been tested and passes NFPA 701-99, CPAI 84, ULC 109. 5 5 Serial # 5 5 5 5 8151310(1) 5 Description of item certified: S 5 CENTURY END 60WX20 LOOP SNYDE-R 5 WHITE VINYL WITHOUT WEB GUYS 5 Flame Retardant Process Used Will Not Be Removed By 5 5 Washing And Is Effective For The Life Of The a Fabric 5 5 SNYDER MFG NEW PI-IILADELPI-IIA.OH Signed: 5 5 Name of Applicator of Flame Resistant Finish ANCHOR INDUSTRIES INC. 5 L3Pr LPLnr�J-r�rJ�eJ-�J'tl��l-r�rJ�.f�P�J'r�tJ-cJ'cl�PrJ�rJ��P�PeJ-rPc.f�.frJ�tJ-t.�rl�PrJ�tJ'�J-c.Pr�r��.frJ��PtI-r��.f7rJ6��r�tnr�cl�cJ7�J-r��J'eJ�tJ7r�rJ��Pr�r.PrJ�rJ��.Pr��.frJ�z.l�t.n�Pc.fL3 Page: 3 C ��SRI, ertif itate of jflame Rem',5tance Date Manufactured AZTEC TENTS Invoice Number: 0202537-IN r 2665 COLUMBIA ST Customer P.O.: 1/8/2014 TORRANCE,CA 905036 (800)228-3687 Customer Number: CHR030 This is to certify that the materials described below have been flame..retardant vendor Trade ame Bruin Ma Gras F- v treated(or are inherently flame retardant). v� Bruin Mesh F-222.04 California Camb, Lam-Tex 12,14,16,18oz F419.01 Coated Fabrics Clear Vinyl 16ga/20ga F-570.02 Christian Party Rentals DAF Clear Vinyl 16ga/20ga F-593.01 - d q; DAF DAF F-593.02 18 Clinton Drive Exclusively Expo 7oec Fe�" ro0taint 502 F-444.01 Hollis, NH 03049 v `� Ferrari Precgntraln[702 F-444.08 s � Phillips Textiles Phil-Tex Liner 7-500.01 ` PVC Tech, Deco Cloth/Velon F-504.01 Snyder Weathempan F-140.01 \`pv Tri Vantage Firesist Sunbrella F-368.05 Certification is hereby made that the articles described below hereof are made TriVantage Patio 500 F-121.02 from a flame-retardant fabric or material registered and approved by the Tri Vantage Big Top IF-121.10 Tri Vantage Vanguard Weblon F-069.01 California State Fire Marshal for such use.The fabric has been tested and Td Vantage Weblon/Coastllne F-069.01 ? passes NFPA 701 Large Scale.See chart to right for trade name of Verseldag Duraskln 81673,81515 F-530.01 y I flame-resistant fabric or material used and additionally referenced on the label of the fabric panel. ' THE FLAME RETARDANT PROCESS USED WILL NOT BE REMOVED BY WASHING David Bradley General Manager- Manufacturing °\ Name of Applicator or Production Superintendent Title of Applicator or Production Superintendent ITEM CODE ITEM DESCRIPTION UNIT ORDERED PRODUCED Z22130CM2002 30x20 Mid Jumbotrac Top EACH 2 2 UW Blockout White-w/2Ratchet Tensioners Z22140CE4002 40x40 2pc Jumbotrac Top EACH 1 1 UW Blockout White-w/8Ratchet Tensioners Z22140CM2002 40x20 Mid Jumbotrac Top EACH 2 2 UW Blockout White-w/2Ratchet Tensioners Z22520FC2002 #20x20 1 pc Festival Top EACH 2 2 UW w/Ratchet Tensioners& Flag Blockout White #with Double Valance Z22520FC4002 #20x40 1 pc Festival Top EACH 2 2 UW w/Ratchet Tensioners& Flag Blockout White #with Double Valance Z211203002 #20x30 1 pc Top Only UW EACH 2 2 Blockout White #with Double Valanace /ZFRT Daylight Freight Prepay&Add �v � � �e�titicte of � � �� trce Date Manufactured AZTEC TENTS Invoice Number: 0202537-IN \; 2665 COLUMBIA ST Customer P.O.: ,� 1/8/2014 TORRANCE,CA 90503 �- I (800)228-3687 Customer Number: CHR030 This is to certify that the materials described below have been flame retardant vendor Tracle Name CA Gen.9 * ruin Ma I ras F- y - treated(or are inherently flame retardant). \\ Bruin flesh F-222.04 3 California Comb. tam-Tex 12,14,16,18oz F-419.01 .\ x Coated Fabrics Clear Vinyl 16ga/209a F770.02 Christian Party Rentals a DAF Clear Vinyl 16ga/20ga F-593.01 DAF DAF F-593.02 18 Clinton Drive ' a Exclusively Expo PolySateen Liner F-434.01 \\ Hollis NH 03049 Ferran Precontraint 502 F-444.01 r £;`R - Ferrari Precuntralnt 702 F-444.08 �- \: PhIIIIDS Textiles Phil-Tex Liner F-500.01 PVC Tech. Deco Cloth/Velon F-504.01 \ Snyder Weatherspan F-140.01 `- ti ? Td Vantage Firesist Sunbrella F-368.05 Certification is hereby made that the articles described below hereof are made Tri Vantage Patio 500 F-121.02 from a flame-retardant fabric or material registered and approved by the Tri Vantage Big Top F-121-10 '"; California State Fire Marshal for such use.The fabric has been tested and Tri H Vantage Vanguard Weblon Tri F-069.01 Vantage Weblon/Coastline F-069.01 \ passes NFPA 701 Large Scale.See chart to right for trade name ofVerseid IDuraskin 61673,83515 F-530.01 flame-resistant fabric or material used and additionally referenced on the label of the fabric panel. \. � THE FLAME RETARDANT PROCESS USED WILL NOT BE REMOVED BY WASHING David Bradley General Manager- Manufacturing � \i Name of Applicator or Production Superintendent Title of Applicator or Production Superintendent �, ITEM CODE ITEM DESCRIPTION UNIT ORDERED PRODUCED Z22130CM2002 30x20 Mid Jumbotrac Top EACH 2 2 UW Blockout White-w/2Ratchet Tensioners Z22140CE4002 40x40 2pc Jumbotrac Top EACH 1 1 UW Blockout White-w/8Ratchet Tensioners Z22140CM2002 40x20 Mid Jumbotrac Top EACH 2 2 UW Blockout White-w/2Ratchet Tensioners Z22520FC2002 #20x20 1 pc Festival Top EACH 2 2 UW w/Ratchet Tensioners& Flag Blockout White #with Double Valance Z22520FC4002 #20x401 pc Festival Top EACH 2 2 UW w/Ratchet Tensioners& Flag Blockout White #with Double Valance Z211203002 #20x30 1 pc Top Only UW EACH 2 2 Blockout White #with Double Valanace /ZFRT Daylight Freight Prepay&Add \ r r 114�111 Page: 3 1211" ertatrate of jrlame Rem'qtanre Date Manufactured AZTEC TENTS Invoice Number: 0202537-IN 2665 COLUMBIA ST Customer P.O.: llx1/8/2014 TORRANCE,CA 90503 Customer Number: CHR030 (800)228-3687 This is to certify that the materials described below have been flame.rqqBruin Mardi ea or rs e ame t Gras —FTlrr2 �\c treated(or are inherently flame retardant)' Bruin Mesh F-222.04 California Comb. Lam-Tex 12,14,16,18oz F-419.01 Coated Fabrics Clear Vinyl 16ga/20ga F-570.02 VA: Christian Party Rentals DAF Clear Viny116ga/20ga F-593.01 DAP DAF F-593.02 18 Clinton Drive Exclusively Expo PolySa[een Liner F-434.01 \ Hollis FerrariPrecontraint502 F-444.01 Hollis, \ � ,.NH 03049 FerrariFerrad Precontralnt 702 F-444.08 � _._.. 71111Ps Textiles Phil-Tex Uner F-500.01 PJC Tech. Deco Cloth/Velon F-504.01 \, \ �a Snyder Weatherspan F-140.01 Tri Vantage Firesist Sunbrella F-368.05 Certification is hereby made that the articles described below hereof are made Tri Vantage k. Patio 500 F-121.02 from a flame-retardant fabric or material registered and approved by the TO Vantage Big Top F-121.10 Tri Vantage Vanguard Weblon F-069.01 California State Fire Marshal for such use.The fabric has been tested and Td Vantage Weblon/Coastline 1-069.01 ~ passes NFPA 701 Large Scale.See chart to right for trade name of Verseldag Duraskin 81673,81515 F-530.01 flame-resistant fabric or material used and additionally referenced on the label of the fabric panel. THE FLAME RETARDANT PROCESS USED WILL NOT BE REMOVED BY WASHING \ David Bradley General Manager- Manufacturing Name of Applicator or Production Superintendent Title of Applicator or Production Superintendent ITEM CODE ITEM DESCRIPTION UNIT ORDERED PRODUCED Z22130CM2002 30x20 Mid Jumbotrac Top EACH 2 2 UW Blockout White-w/2Ratchet Tensioners Z22140CE4002 40x40 2pc Jumbotrac Top EACH 1 1 UW Blockout White-w/8Ratchet Tensioners Z22140CM2002 40x20 Mid Jumbotrac Top EACH 2 2 UW Blockout White-w/2Ratchet Tensioners Z22520FC2002 #20x20 1 pc Festival Top EACH 2 2 UW w/Ratchet Tensioners& Flag Blockout White #with Double Valance Z22520FC4002 #20x40 1 pc Festival Top EACH 2 2 UW w/Ratchet Tensioners& Flag Blockout White #with Double Valance Z211203002 #20x30 1 pc Top Only UW EACH 2 2 Blockout White #with Double Valanace /ZFRT Daylight Freight Prepay&Add r �� x30 t r r r Page: 3 Certificate of JUMP ; po6tattce 4 a Date Manufactured AZTEC TENTS Invoice Number: 0202537-IN 2665 COLUMBIA ST Customer P.O.: 1/8/2014 TORRANCE,CA 90503 Customer Number: CHR030 (800)228-3687 This is to certify that the materials described below have been flame.�etardant e^or ra a ameCA Gert.a treated(or are inherently flame retardant). BrMesh F- ruuln fd5 222.04 \\ California Comb. Lam-Tex 12,14,36,38oz F-419.01 /'� j4 t Coated Fabdcs Clear Vinyl 16ga/20ga F-570.02 S Christian Party Rentals DAF Clear Vinyl 16ga/20ga F59301 Party ��\ �V DAF DAF F-593.02 18 Clinton Drive a Exclusively Expo PolySateen Liner F-434.01 Hollis NH 03049 $ Fe-,iPrecon[aint502 F-444.01 t w..-�.. Feman precontraint 702 F-444.08 '� �......_...............' PhI11Ip5 Textiles Phil-Tex Liner F-500.01 }p; Q P/C Tech. Deco Cloth/Velon F-504.01 4" Snyder Weatherspan F-140.01 \ Td Vantage Flresist Sunbrella F-368.05 l Certification is hereby made that the articles described below hereof are made Tn vantage Patio 500 F-121.02 U from a flame-retardant fabric or material registered and approved by the Tri VantageBIg Top F.121.10 Tri vantage vanguard Weblon F-069.01 \ California State Fire Marshal for such use.The fabric has been tested and Td Vent g lWelolon/Coastline I F-069.01 passes NFPA 701 Large Scale.See chart to right for trade name of Verseldaq Duraskln 81673,B1535 F-530.01 flame-resistant fabric or material used and additionally referenced on the label of 61 the fabric panel. v THE FLAME RETARDANT PROCESS USED WILL NOT BE REMOVED BY WASHING David Bradley General Manager- Manufacturing Name of Applicator or Production Superintendent Title of Applicator or Production Superintendent ITEM CODE ITEM DESCRIPTION UNIT ORDERED PRODUCED Z22130CM2002 30x20 Mid Jumbotrac Top EACH 2 2 UW Blockout White-w/213atchet Tensioners Z22140CE4002 40x40 2pc Jumbotrac Top EACH 1 1 UW Blockout White-w/8Ratchet Tensioners Z22140CM2002 40x20 Mid Jumbotrac Top EACH 2 2 UW Blockout White-w/2Ratchet Tensioners Z22520FC2002 #20x20 1 pc Festival Top EACH 2 2 UW w/Ratchet Tensioners& Flag Blockout White #with Double Valance Z22520FC4002 #20x40 1 pc Festival Top EACH 2 2 UW w/Ratchet Tensioners& Flag Blockout White #with Double Valance Z211203002 #2000 1 pc Top Only UW EACH 2 2 Blockout White #with Double Valanace /ZFRT Daylight Freight Prepay&Add s R, o,ffiv r r r Page: 3 ` Certittrate of jrtame allre Date Manufactured AZTEC TENTS Invoice Number: 0202537-IN 2665 COLUMBIA ST Customer P.O.: 1/8/2014 TORRANCE,CA90503 � (800)228-3687 Customer Number: CHR030 ,tipv This is to certify that the materials described below have been flametptardant vendor Trade Rame 12 cert. \ ruin Ma ras F- treated (or are inherently flame retardant). \ a ��r. .s s Bruin Mesh F-222.04 California Comb. tam-Tex 12,14,16,18oz F-419.01 a r >: Coated Fabrics Clear Vinyl S6ga/20ga F-570.02 \ y;' Christian Party Rentals b;1 DAF Clear Vinyl 16ga/20ga F-593.01 DAF DAF F-593.02 18 Clinton Drive Exclusively Expo PolySateen Uner F434.01 Ferran Precontraint 502 F-444.01 Hollis, NH 03049 _a V . , Ferran Precontraint 702 F-444.08 S z' Phillips Textiles Phil-Tex Uner 7-500.01 PVC Tech. Deco Cloth/Velon F-504.01 �a Snyder Weatherspan F-140.01 Tri Vantage Firesist Sunbrella F-368.05 Certification is hereby made that the articles described below hereof are made Tnvantage page 5DD F-121,02 from a flame-retardant fabric or material registered and approved by the Tn Vantage PBigat Top F-121.10 California State Fire Marshal for such use.The fabric has been tested and TO Vantage Vanguard Weblon F-069.01 Td Vantage We^Ion/Coastline F-069.01 passes NFPA 701 Large Scale.See chart to right for trade name of Vemeldag Duraskin 81673,81515 F-530.01 , flame-resistant fabric or material used and additionally referenced on the label of the fabric panel. THE FLAME RETARDANT PROCESS USED WILL NOT BE REMOVED BY WASHING David Bradley General Manager- Manufacturing ��� Name of Applicator or Production Superintendent Title of Applicator or Production Superintendent ,�� ITEM CODE ITEM DESCRIPTION UNIT ORDERED PRODUCED Z22130CM2002 30x20 Mid Jumbotrac Top EACH 2 2 UW Blockout White-w/2Ratchet Tensioners Z22140CE4002 40x40 2pc Jumbotrac Top EACH 1 1 UW Blockout White-w/8Ratchet Tensioners Z22140CM2002 40x20 Mid Jumbotrac Top EACH 2 2 UW Blockout White-w/213atchet Tensioners Z22520FC2002 #20x20 1 pc Festival Top EACH 2 2 UW w/Ratchet Tensioners& Flag Blockout White #with Double Valance Z22520FC4002 #20x401 pc Festival Top EACH 2 2 UW w/Ratchet Tensioners& Flag Blockout White #with Double Valance Z211203002 #20x301 pc Top Only UW EACH 2 2 Blockout White #with Double Valanace /ZFRT Daylight Freight Prepay&Add 2 o X2© a:• ��.... •Rj\ 3.F: 3'v,moi slt3t �.- '1 � a = ft. ?.. `_i"a F ? rt as Z, .c4,- .'.�-.,. '. rZ. .• :!'1:±k tic.?r..:1'•h'A.�Q•!il:J•h�ti. ` !a;r- � .. • . "�r� .HY9.,�+y,.� ,�.1e rt�r �rt`� :. ,a :..�:•;a7, •�• ' , •.a a..y+p. ., '.:>.•.'ca.. `� ti, ,.,,y. ..N�.t ..v. .a �Y•n.» h4, 1, (1 � F.1, ...k. ,G;n, .ir. ;F, ria, r. /,., .C.. t• /..: 1. F.. f.... h.n F... n. 1 sl.� rn. A.d.`•ka'•b1�`6%: 'Ski P.•.• J�, A.''*,.•n a�n rnsC�rn„ eVr» ••,u;9xiia�m ;,t�irs xe n,'�nxx .A••n`ifi7vf:;, 1) .: ,• n r;C.;7y•• .tt�+�'t+!1�• ..1 .».�` •,•,�».t ,r,7 .. 4. n. ..,n .J» n1 n .13 » .,n .a»..,• .• s �f��.L-x�y�.ufi..mn_ i • y 4 _ 44 i�'Jh�nt .����_ _ tV_li�gnTl;'.!4:14i_J.7im._..w�_r���n:w`�_.7�i -✓,�� �4�k� w�slww8�1 ui'owwwuxuu�urwm.uw w 1S"w'{'�'u'1"A.=dE"8dtlr'4�V:/"d41tA1, -J�rJ�l�r}uiSkEmu6.l iiilN;l�rU^- �,aw�wut�uSwl.,16w1�1twu�- $� �Ce�t ttt��cte �t lame Rew"qtanre �p^, ',a 4 ^' = REGISTERED Date treated or TE .; AZTEC NTS r APPLICATION manufactured a CONCERN NO. 2665 COLUMBIA ST TORRANCE,CA 90503 ?t! CAL COMB F-419.01 (800)228-3687 03/2009 This is to certify that the materials described below hereof have been flame retardant treated(or are inherently nonflammable). r; FOR CHRISTIAN PARTY RENTAL 18 CLINTON DRIVE HOLLIS, NH 03049 rr. aE t REt Certification is hereby made that: rr(check an u 'or b ) (a) The articles described below this certificate have been treated with a flame retardant chemical approved and registered by the State Fire Marshal and that the applicationof said chemical was done in confor- mance with the laws of the State of California and the Rules and Regulations of the State Fire Marshal. a;r•- .., Name of chemical used ............................................Chem.Reg.No......................... F' Meathod of application .. >y.:•, (b) The articles described below hereof are made from a flame-resistant fabric or material registered and approved be the State Fire Marshal for such use;Fabric has been tested and passes NFPA701-96. = , Y Trade name of flame-resistant fabric or material used..Lamf-wFablk . Reg. No. ......MMA1...... I h. J WILL NOT - h: The Flame Retardant Process Used .... Be Removed by Washing (will or will not) t David Bradley Chuck Miller- PresidentF Name of _" + Applinlor or Production Superintendent Title f R�I M,!T... ...... �b'w��;4"fl�4f�+�"�R `f,l�t��l fly!», 4 ru4; a» '�'i�N?fila;: at»= "a �R�"3��F�!�' ��y' •,f�K�l'�rx.m r�*'r .n'�1.. ..s r,. G.. r..r n... r. ..n' :s k.. hr y.. 0 t ut ,'s' ..: •;r.,. ...} (.; ...;A�.;..r ,; ;...; ,..i r .v • rt.;r^':tij't•;., ,r .,..;} �`. 's h.. :v 3A..tY:. •:Y.A.n.�Y.",s' '.n A.�8= �f• yA�,iv!�n♦.�l A.4 tY•� EYE` 0- CUSTOMER .'1'Y)✓3�1�-.Sin 5 Gln r �Y�+ .i§r-�titb 3 CJI. t ��/ •n•d��':'d'c:. �:t��'el, "•q?.:' �@�ks.�..e1 �4 �r.�' •L-s &� ��� �'i .'..��-. d te( � .S ��'��-����' 4���f � CUSTOMER ORDER NO. R173827 ITEMS MANUFACTURED: 4-3040 2pc.Jumbo Trac Top UW 1-30x10 JumboTrac Middle Top UW 3-30x20 JumboTrac Middle Top UW 1-40x40 2pc.Jumbo Trac Top UW 3-40x20 JumboTrac Middle Top UW 2-20x401 pc.Festival Top UW 2-20x301pc. Qwik Style Top UW 2- 15x151 pc. Qwik Style Top UW 2-20x20 Series 15001 pc. Top UW 2-20x30 Series 15001pc. Top UW 2-20x40 Series 15001 pc. Top UW i