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Building Permit #711-14 - 350 WINTHROP AVENUE 4/15/2014
TOWN OF NORTH ANDOVER (H4'�' APPLICATION FOR PLAN EXAMINATION Date Receive7171 Permit NO: ed Date Issued: - I PORTANT: A licant must complete all items on this page s - LOCATION._ .} - Print, PROPERTY OWNER _ _ - _ Print - 1:Q0 Year Old Structure yes f-nMAP NO:PARCEL4WL ZONING DISTRICT - Histonc,Districf yes,o ._ ._- Machine Shop Village yeso TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial Alteration No. of units: )<Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑-Septic r WeIL 11 Floodplain, ❑.Wetlands . 0 Watershed District. L ❑ Water/Sewer _ •' DESCRIPTION OF WORK TO BE PEKFOKMEu: %., <.. 7f' •ate. �'..4 T+ 7 - Identification Identification Please Type or Print Clearly) '1-4-rod:/6Phone: Cyiv� Seo - 7S,u OWNER: Name: i � FiUU 1 CJ'. n m _ � , � w.�.. _.%. .. / Phone(.7o/j_?.3! Gip _ CONTRACTOR ,Name: � - - _ _ � Address: 4/SS'v� r �.....►� -- �7 vG -- _ R n Supervisor s -Construction �Exp. Date: - - Home Improvement'_Lk erase ARCHITECT/ENGINEER !l,•sa„r LLC Phone4!2�?G) Address: /4lo � �, WAA Reg. No. nfw FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ c ` -A FEE: $_v? 4E A-> . cam__ Check No.:e2 M-7 Receipt NOTE: Persons contracting with unregistered contractors do not have access to the guar my fund Plans Submitted LJ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Plans -Submitted ❑ Plans Ul7aived❑ Certified Plot Plan ❑ Stamped Plans F1 ;ThP1 :OF;SI;WFRAGE:DISPDSAL ' _ -- Public Sewer ❑ Tanning/Massage/Body Art El Swimming Pools ❑ Well ❑ Tobacco.Sales 0 ToodPackaging/Sales ❑ Pxivate se tic tank etrf P t -`. =Permaiient DWnpster on Site ❑ -THE. FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM _:-__-DATE REJECTED: DATE APPROVED PLANNING & DEVELOPMENT ❑ COMMENTS lO __ 11n�;✓� �Oa✓� d'edi�,� �`� �A ; v� :CONSERVATION Reviewed on Signature COMMENTS HEALTH v COMMENTS Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments !later & Sewer Connection/S_ignature Date Driveway Permit DPW Tow;r Fngineer: Signature: Located 384 Osgood Street FIRE DEPARTIVlIT t TeM.p Dumpster on siteyes no Located at.124,Mair� Street .ie� , - .,, - : , • , De tJ: t _. Fire partme►1t signature/date�.y a .4. Y X� •-,t; , :,- COMMENTS - ..�. ---Dimension. Numi)er of Stories: I otal square Leet 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- .Chapter466. Section 21A: -F and G min.$100-$1000:fiine NU 1 h5 ana UA I A — (vor ae artment use e ® Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department :,.-The foI63wing-is4list of -the required forms to be filled outfor.:the appr-opriate.permit to= be obtained. Roofir,g, Siding, Interior Rehabilitation Permits o' Building Permit Application ❑ Workers Comp Affidavit o Photo Copy Of H.I.C. And/O•r C.S.L Licenses o Copy of Contract o 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 o Building Permit Application L3 Certified Surveyed Plot Plan o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If gApplicable) Engl�eerin__Affidav_lts 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 o Certified Proposed Plot Plan L3 Photo of H.I.C. And C.S.L. Licenses o 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 o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all casts .if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apv,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:tted with the building application Doc: Doc.Buiiding Permit Revised 2012 Location No. Date c - TOWN OF NORTH ANDOVER 5n X46 e Certificate of Occupancy $ Building/Frame Permit Fee $cY Q d �-- C�- Foundation Permit Fee $ Other Permit Fee $ TOTAL $ d,% 2 Check # 15 U1 27449 Building Inspector o=�° a __ coir =~ �. CDD N (S lr-DL nn 0 rt O' 0 _ M O 'p N• '� cn r0► CD' TI h ::g s 0) N WCDy O --I CD CD 2 G. 's D O C7 to � U) -10L O rt N CD .� .� O0N `j z CD o0,c D CD Q O a cn O CD CD �CD ai FL D O O 0 0J C . CD 4 CD CD7 r I0D N o °� s: D CD m- 0 0 n: o O �o7N C7 0 VI V) v T � T VI x T Zo TI n x T C N � S p((D D) C y C D3j C pOj CD C -0 O (D 3 Oq (D ;zZ CL �, OA r rn ''� O. (D =� Cl) � CL r -O ct Ci) — O_ nO rn \ • O M� Z (w•± v M �d N (D� o z �m cn cr K Z %< K C (D O O (D c� s rrD CL N �• O0 T1 d//P��//�� co cD I m C v C 3 O W Z CDD O v O 70 c < n C OW 0. o=�° a __ coir =~ �. CDD N (S lr-DL nn 0 rt O' 0 _ M O 'p N• '� cn r0► CD' TI h ::g s 0) N WCDy O --I CD CD 2 G. 's D O C7 to � U) -10L O rt N CD .� .� O0N `j z CD o0,c D CD Q O a cn O CD CD �CD ai FL D O O 0 0J C . CD 4 CD CD7 r I0D N o °� s: D CD m- 0 0 n: o O �o7N C7 0 VI V) m T x T VI x T Zo TI n x T N T S p((D D) C y C D3j C pOj C C -0 O (D 3 Oq 04 04 3 OA 3 ''� O. (D O_ [1 \ K "*. K rr �m s rrD T1 m C C 3 O W C OW 7D n Z N M ci 0 m z z m z m m O m m m D 0 0 2 0 O ti '.. O bs Enter construction cost for fee cal - North Andover Fee Cakulation Construction Cost $ 2345106.00 m $ - $ 2,809.27 Plumbing Fee $ 351.16 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 351.16 Total fees collected $ 3,611.59 350 Winthrop Avenue 711-14 on 4/15/2014 Tenant Fit Up = AT&T Store r A ► r CONSTRUCTIONti- ..N/EBUILDRELATIONSHIPS� Letter of Transmittal Transmittal #: 1 Date: 4/2/2014 Subject: Permit Package Urgency: Normal Sent Via: Next -day service To: Brendan Sharkey AmeriZone, LLC 600 Mt Carmel Ave Hamden, CT 06518 Ph: (203)248-8545 Fax: (203)248-6908 WE ARE SENDING YOU r Attached 17 Shop drawings r Prints 17 Copy of letter 1-' Change order Job: 14-00-039 AT&T - North Andover MA From: Schuettler, Erin (Herman/Stewart Constr.) Fax # (301)429-1240 Phone: (301)731-5555 17 Plans r Samples r Specifications r Other Document Type Copies Date No. Description Attachment 1 Approved as noted r Submit_ copies for distribution r Copy of Michael Dennis's MA Contractor's License Attachment 1 r For review and comment MA Workers Comp Affidavit Attachment 1 FOR BIDS DUE r Certificate of Insurance Attachment 1 Construction Cost Attachment 1 Dumpster Service Letter Attachment 1 Permit Fee Check Attachment 2 Interior Lighting Compliance Certificate Drawing 3 Signed/Sealed Architectural Drawings Drawing 3 Signed/Sealed MEP Drawings THESE ARE TRANSMITTED as checked below: r For approval r Approved as submitted r Resubmit _ copies for approval r For your use r Approved as noted r Submit_ copies for distribution r As requested r Returned for corrections 1- Return corrected prints r For review and comment r Other r FOR BIDS DUE r PRINTS RETURNED AFTER LOAN TO US Remarks: Copy To: File If enclosures are not as noted, kindly notify us at once. 4550 Forbes Boulevard, Suite 200 Lanham, MD 20706 Ph : (301)731-5555 Page 1 of 2 'f Transmittal M 1 If enclosures are not as noted, kindly notify us at once. WE BUILD RELATIONSHIPS Letter of Transmittal Job: 14-00-039 AT&T - North Andover MA Signature: Erin Schuettler 4550 Forbes Boulevard, Suite 200 Lanham, MD 20706 Ph : (301)731-5555 Page 2 of 2 Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS -062906 MICHAEL F DEN$IS --- 4550 _-4550 FORBES Bl" LANHAM MD 25706 W Expiration Commissioner 08/16/2015 The Commonwealth of Massachusetts Department of Industrial Accidents 19Office of Investigations ' 1 1 Congress Street, Suite 100 Boston, MA 02114-2017 ;= www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/Individual): Herman/Stewart Construction & Development, Inc. Address: 4550 Forbes Blvd. Suite 200 tate/Zip: Lanham/MD/20706 Phone #: 301-731-5555 Are you an employer? Check the appropriate box: [. ❑ I am a employer with 4. ❑M I am a general contractor and I employees (full and/or part-time).* 2. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.$ 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' insurance Type of project (required): 6. ❑ New construction 7. ❑■ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. EJ Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12. ❑ Roof repairs 13. ❑ Other *Any applicant that checks box 41 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. $Contractors 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: Valley Forge Insurance Co. Policy # or Self -ins. Lic. #: WC4032515512 Job Site Address: 350 Winthrop Ave Expiration Date: 6/12/2014 City/State/Zip: North 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 and penalties of per jury that the information provided above is true and correct. Phone #: 130).— 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 #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 7-2013 www.mass.gov/dia C I ient#: 213903 2HERMSTE ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES, DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 6/17/2013 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Willis of Maryland, Inc.PHONE 301 530 5050 FAX 301-897-8506 AIC, No, Ext : AIC, No 12505 Park Potomac Avenue #300 E-MAIL Potomac, MD 20854 ADDRESS: EACH OCCURRENCE $ 301 530-5050 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Valley Forge Insurance Co. 20508 INSURED INSURER B Herman/Stewart Construction DAMAGE TO RENTED PREMISES Ea occurrence $ and Development Inc INSURER C CLAIMS -MADE 1-1 OCCUR 4550 Forbes Boulevard, Suite 200 INSURER D: Lanham, MD 20706 INSURER E: MED EXP (Any one person) $ PERSONAL & ADV INJURY $ INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES, DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSIR TR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ CLAIMS -MADE 1-1 OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE $ Per accident UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION Y I N AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? [N N I A WC4032515512 6/12/2013 06/12/201 X WC STATU- OTH- I I E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $500,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Insurance verification only L:ANL:tLLA I IUN The Commonwealth of SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Massachusetts Dept. of ACCORDANCE WITH THE POLICY PROVISIONS. Industrial Accidents 1 Congress Street, Suite 100 AUTHORIZED REPRESENTATIVE Boston, MA 02114-2017�� ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S756438/M754264 2KVAN Client#: 213903 2HERMSTE ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) TYPE OF INSURANCE 3/24/2014 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Willis of Maryland, Inc.PHONE 301 530-5050 FAX 301-897-8506 AIC, No, Ext : AIC, No 12505 Park Potomac Avenue #300 E-MAIL Potomac, MD 20854 ADDRESS: PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 INSURER(S) AFFORDING COVERAGE NAIC # 301 530-5050 INSURERA: National Fire Insurance 20478 INSURED INSURER B: Continental Casualty Co. 20443 Herman/Stewart Construction Valle Forge Insurance Co. 20508 INSURER C : y g and Development Inc INSURER D: American Casualty Co of Reading 20427 4550 Forbes Boulevard, Suite 200 06/12/201 Lanham, MD 20706 INSURER E: BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx_] OCCUR C4032515509 6/12/2013 06/12/201 EACH OCCURRENCE $1 000,000 DAMAGE TO RENTED PREMISES Ea occurrence $1,000,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC JECT PRODUCTS - COMP/OP AGG $2,000,000 $ D AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS X AUTOS C4032515543 6/12/2013 06/12/201 CEa acOMBINEDcidentSINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ B X UMBRELLA LIAB EXCESS LIAB HCLAIMS-MADE OCCUR L5085133741 6/12/2013 06/12/2014 EACH OCCURRENCE $10000000 AGGREGATE $10,000,000 DED X RETENTION $10000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N OFFICER/MEMBER EXCLUDED? NI (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC4032515512 6/12/2013 06/12/201 X WC STATU- OTH- Y E.L. EACH ACCIDENT 5500,000 E.L. DISEASE - EA EMPLOYEE 5500,000 E.L. DISEASE - POLICY LIMIT 5500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Projec t- AT&T located at 350 Winthronp Avenue in North Andover, MA When required by written contract and subject to the terms and conditions of the policy: 1. Town of North Andover is included as an additional insured with respect to general liability. CERTIFICATE HOLDER CANCELLATION Town of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 120 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE A/C �} ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S804068/M754262 2ELOG HtRMAN/STEWART 1 WE BUILD RELATIONSHIPS N AT&T 350 Winthrop Avenue North Andover MA 01845 Total Cost of Construction TOTAL CONSTRUCTION COSTS $403,892 Electrical/Fire Alarm/ $111,583 HVAC $25,547 Plumbing $1606 Fire Protection $165050 TOTAL CONSTRUCTION COST LESS MEP $2341106 4550 Forbes Boulevard, Suite 200 Lanham, MD 20706 Phone: 301/731-5555 Fax: 301/429-1240 HERMAN/STEWART CONSTRUCTION WE BUILD RELATIONSHIPS H AT&T 350 Winthrop Avenue North Andover MA 01845 Dumpster Service We will be using Waste Management for our dumpster services. Waste Management 207 Marston St Lawrence, MA 01841 USA Phone: 800-443-5515 4550 Forbes Boulevard, Suite 200 Lanham, MD 20706 Phone: 301/731-5555 Fax: 301/429-1240 2009 IECC COMcheck Software Version 3.9.3 Interior Lighting Compliance Certificate RECEIVED Section 1: Project Information Project Type: Alteration Project Title : AT&T Store of the Future @ North Andover Construction Site: Owner/Agent:. 350 Winthrop Ave. AT&T North Andover, MA 01845 Section 2: Interior Lighting and Power Calculation APR 0 2 20% HERMAN/STEWART Construction & Development Designer/Contractor: Darrell Case AEdifica Case Engineering 796 Merus Court St. Louis, MO 63139 A B C D Area Category Floor Area Allowed Allowed Wafts (ft2) Wafts / ft2 (B x C) sales area (Retail) 1963 1.5 2945 Allowance: Vehicles, sporting goods, small electronics. highlighting / Fix. ID: 400(a) 0.6 240(b) LT1 1 5 60 managers office (Office) 79 1 79 inventory (Retail) 211 1.5 317 work/break room (Retail) 194 1.5 291 men's restroom (Retail) 53 1.5 80 women's restroom (Retail) 51 1.5 77 hallway (Retail) 200 1.5 300 960 Supplemental Allowed Watts(c) = 720 Total Allowed Watts = 5047 (a) Area claimed may exceed total floor area when Retail Merchandise Highlighting allowance(s) are specified. LED 4: LS2: LED MR 3.2W: (b) Allowance is (B x C) or the actual wattage of the fixtures given in Section 2, whichever is less. 16 3.6 (c) Supplemental watts must be associated with retail merchandise highlighting fixtures. managers office ( Office 79 sq.ft.) Section 3: Interior Lighting Fixture Schedule A Fixture ID: Description / Lamp / Wattage Per Lamp / Ballast B Lamps/ Fixture C # of Fixtures D Fixture Watt. E (C X D) sales area ( Retail 1963 sq.ft.) _ Compact Fluorescent 1: DP1: Quad 4 -pin 42W: Electronic: 1 2 42 84 Compact Fluorescent 2: DP2: Quad 4 -pin 18W: Electronic: 1 8 13 104 Linear Fluorescent 2: FD1/E: 48" T8 30W (Super T8): Electronic: 1 5 60 300 LED 1: LA1: LED PAR 18W: 1 4 18 72 LED 1 copy 1: LA2/la2a: LED PAR 18W: 1 5 18 90 Track lighting 1 copy 1: LT1: CK5: Wattage based on circuit breaker capacity (8 amps x 0 0: 960 960 120 volts) Track lighting 1 copy 2: LT1: CK7: Wattage based on circuit breaker capacity (8 amps x 0 0 960 960 120 volts) LED 4: LS2: LED MR 3.2W: 1 16 3.6 57.6 managers office ( Office 79 sq.ft.) Linear Fluorescent 4: J: 48" T8 32W (Super T8): Electronic: 3 1 93 93 inventory ( Retail 211 sq.ft.) Linear Fluorescent 8: M/ME: 48" T8 32W (Super T8): Electronic: 2 4 . 64 256 work/break room.( Retail 194 sq.ft.) Project Title: AT&T Store of the Future @ North Andover Report date: 03/31/14 Data filename: N:\2014\Callison\AT&T\clnm-01-14 - North Andover Mall, North Andover, MA\documents\2014-03-19 2009 IECC.cck Page 1 of 3 Linear Fluorescent 4 copy 1: J: 48" T8 32W .(Super T8): Electronic: 3 2 93 186 men's restroom ( Retail 53 sq.ft.) Linear Fluorescent 4 copy 2: J: 48" T8 32W (Super T8): Electronic: 2 1 93 93 women's restroom ( Retail 51 sq.ft.) Linear Fluorescent 4 copy 3: J: 48" T8 32W (Super T8): Electronic: 2 1 93 93 hallway ( Retail 200 sq.ft.) Linear Fluorescent 4 copy 2: J: 48" T8 32W (Super T8): Electronic: 3 4 93 372 Total Proposed Watts = 3721 Section 4: Requirements Checklist Interior Lighting PASSES Lighting Wattage: ® 1 Total proposed watts must be less than or equal to total allowed watts. Allowed Watts .Proposed Watts Complies 5047 3721 Passes Controls, Switching, and Wiring: ❑ 2. Daylight zones under skylights more than 15 feet from the perimeter have lighting controls separate from daylight zones adjacent to vertical fenestration. ❑ 3. Daylight zones have individual lighting controls independent from that of the general area lighting. Exceptions: ❑ Contiguous daylight zones spanning no more than two orientations are allowed to be controlled by a single controlling device. ❑ Daylight spaces enclosed by walls or ceiling height partitions and containing two or fewer light fixtures are not required to have a . separate switch for general area lighting. ® 4. Independent controls for each space (switch/occupancy sensor). Exceptions: ❑ Areas designated as security or emergency areas that must be continuously illuminated. ® Lighting in stairways or corridors that are elements of the means of egress. ❑ 5. Master switch at entry to hotel/motel guest room. ❑ 6. Individual dwelling units separately metered. ❑ 7. Medical task lighting or art/history display lighting claimed to be exempt from compliance has a control device independent of the control of the nonexempt lighting. ® 8. Each space required to have a manual control also allows for reducing the connected lighting load by at least 50 percent by either controlling all luminaires, dual switching of alternate rows of luminaires, alternate luminaires, or alternate lamps, switching the middle lamp luminaires independently of other lamps, or switching each luminaire or each lamp. Exceptions: ❑ Only one luminaire in space. M An occupant -sensing device controls the area. lj The area is a corridor, storeroom, restroom, public lobby or sleeping unit. ❑ Areas that use less than 0.6 Watts/sq.ft. ❑ 9. Automatic lighting shutoff control in buildings larger than 5,000 sq.ft. Exceptions: ❑ Sleeping units, patient care areas; and spaces where automatic shutoff would endanger safety or security. 10. Photocell/astronomical time switch on exterior lights. Exceptions: ❑ Lighting intended for 24 hour use. ® 11.Tandem wired one -lamp and three -lamp ballasted luminaires (No single -lamp ballasts). Exceptions: ❑ Electronic high -frequency ballasts; Luminaires on emergency circuits or with no available pair. Section 5: Compliance Statement Project Title: AT&T Store of the Future @ North Andover Report date: 03/31/14 Data filename: N:\2014\Callison\AT&T\clnm-01-14 - North Andover Mall, North Andover, MA\documents\2014-03-19 2009 IECC.cck Page 2 of 3 Compliance Statement: The proposed lighting alteration project represented in this document is consistent with the building plans, specifications and other calculations submitted with this permit application. The proposed lighting alteration project has been designed to meet the 2009 IECC, Chapter 8, requirements in COMcheck Version 3.9.3 and to comply with the mandatory requirements in the Requirements Checklist. y 1Z R �t Q )�'� Name.- Title Si R. CASE Dalfe MECHANICAL °• 0872 ®�o O TEa SS/ONAL EN��� Project Title: AT&T Store of the Future @ North Andover Report date: 03/31/14 Data filename: N:\2014\Callison\AT&T\clnm-01-14 - North Andover Mall, North Andover, MA\documents\2014-03-19 2009 IECC.cck Page 3 of 3 2009 IECC CO.Mcheck Software Version 3.9.3 Interior Lighting Compliance Certificate FRECEIVED Section 1: Project Information Project Type: Alteration Project Title : AT&T Store of the Future @ North Andover Construction Site: Owner/Agent:. 350 Winthrop Ave. AT&T North Andover, MA 01845 Section 2: Interior Lighting and Power Calculation APR 0 2 20% HERMAN/STEWART Construction & Development Designer/Contractor: Darrell Case AEdifica Case Engineering 796 Merus Court St. Louis, MO 63139 A B C D Area Category Floor Area Allowed Allowed Watts 1 (ft2) Watts / ft2 (B x C) sales area (Retail) 1963 1.5 2945 Allowance: Vehicles, sporting goods, small electronics highlighting / Fix. ID: 400(a) 0.6 240(b) LT1 1 5 managers office (Office) 79 1 79. inventory (Retail) 211 1.5 317 work/break room (Retail) 194 1.5 291 men's restroom (Retail) 53 1.5 80 women's restroom (Retail) 51 1.5 77 hallway (Retail) 200 1.5 300 Supplemental Allowed Watts(c) = 720 Total Allowed Watts = 5047 (a) Area claimed may exceed total floor area when Retail Merchandise Highlighting allowance(s) are specified. 960 (b) Allowance is (B x C) or the actual wattage of the fixtures given in Section 2, whichever is less. (c) Supplemental watts must be associated with retail merchandise highlighting fixtures. Section 3: Interior Lighting Fixture Schedule 1 16 A B C D E Fixture ID : Description I Lamp / Wattage Per Lamp / Ballast Lamps/ # of Fixture (C X D) W Fixture Fixtures Watt. sales area (.Retail 1963 sq.ft.) Compact Fluorescent 1: DP1:.Quad 4 -pin 42W: Electronic: 1 2 1 42 84 Compact Fluorescent 2: DP2: Quad 4 -pin 18W: Electronic: 1 8 13 104 Linear Fluorescent 2: FD1 /E: 48" T8 30W (Super T8): Electronic: 1 5 60 300 LED 1: LA1: LED PAR 18W: 1 4 18 72 LED 1 copy 1: LA2/la2a: LED PAR 18W: 1 5 18 90 Track lighting 1 copy 1: LT1: CK5: Wattage based on circuit breaker capacity (8 amps x 0 0 960 960 120 volts) Track lighting 1 copy 2: LT1: CK7: Wattage based on circuit breaker capacity (8 amps x 0 0 960 960 120 volts) LED 4: LS2: LED MR 3.2W: 1 16 3.6 57.6 managers office ( Office 79 sq.ft.) W Linear Fluorescent 4: J: 48" T8 32W (Super T8): Electronic: 3 1 93 93 inventory( Retail 211 sq.ft.) Linear Fluorescent 8: M/ME: 48" T8 32W (Super T8): Electronic: 2 4 64 25.6 work/break room ( Retail 194 sq.ft.) Project Title: AT&T Store of the Future @ North Andover Report date: 03/31/14 Data filename: N:\2014\Callison\AT&T\clnm-01-14 - North Andover Mall, North Andover, MA\documents\2014-03-19 2009 IECC.cck Page 1 of 3 Linear Fluorescent 4 copy 1: J: 48 T8 32W (Super T8): Electronic: 3 2 93 186 men's restroom ( Retail 53 sq.ft.) Linear Fluorescent 4 copy 2: J: 48" T8 3.2W (Super T8): Electronic: 2 1 93 93 women's restroom ( Retail 51 sq.ft.) Linear Fluorescent 4 copy 3: J: 48" T8 32W (Super T8): Electronic: 2 1 93 93 hallway ( Retail 200 sq.ft.) Linear Fluorescent 4 copy 2: J: 48" T8 32W (Super T8): Electronic: 3 4 93 372 Total Proposed Watts = 3721 Section 4: Requirements Checklist Interior Lighti Ing PASSES V Lighting Wattage: ® 1. Total proposed watts must be less than or equal to total allowed watts. Allowed Watts Proposed Watts Complies 5047 3721 Passes Controls, Switching, and Wiring: ❑ 2. Daylight zones under skylights more than 15 feet from the perimeter have lighting controls separate from daylight zones adjacent to vertical fenestration. ❑ 3. Daylight zones have individual lighting controls independent from that of the general area lighting. Exceptions: ❑ Contiguous daylight zones spanning no more than two orientations are allowed to be controlled by a single controlling device. ❑ Daylight spaces enclosed by walls or ceiling height partitions and containing two or fewer light fixtures are not required to have a separate switch for general area lighting.. . ® 4. Independent controls for each space (switch/occupancy sensor): Exceptions: ❑ Areas designated as security or emergency areas that must be continuously illuminated. ® Lighting in stairways or corridors that are elements of the means of egress. ❑ 5. Master switch at entry to hotel/motel guest room. ❑ 6. Individual dwelling units separately metered. ❑ 7. Medical task lighting or art/history display lighting claimed to be exempt from compliance has a control device independent of the control of the nonexempt lighting. ® B. Each space :required to have a manual control also allows for reducing the connected lighting load by at least 50 percent by either controlling all luminaires, dual switching of alternate rows of luminaires, alternate luminaires, or alternate lamps, switching the middle lamp luminaires independently of other lamps, or switching each luminaire or each lamp. Exceptions: ❑ Only one luminaire in space. ® An occupant -sensing device controls the area. ❑ The area is a corridor, storeroom, restroom, public lobby or sleeping unit. ❑ Areas that use less than 0.6 Watts/sq.ft. ❑ 9. Automatic lighting shutoff control in buildings larger than 5,000 sq.ft. Exceptions: ❑ Sleeping units, patient care areas; and spaces where automatic shutoff would endanger safety or security. 10. Photocell/astronomical time switch on exterior lights. Exceptions: ❑ Lighting intended for 24 hour use. ® 11.Tandem wired one -lamp and three -lamp ballasted luminaires (No single -lamp ballasts). Exceptions: ❑ Electronic high -frequency ballasts; Luminaires on emergency circuits or with no available pair. Section 5: Compliance Statement Project Title: AT&T Store of the Future @ North Andover Report date: 03/31/14 Data filename: N:\2014\Callison\AT&T\clnm-01-14 - North Andover Mall, North Andover, MA\documents\2014-03-19 2009 IECC.cck Page 2 of 3 Compliance Statement: The proposed lighting alteration project represented in this document is consistent with the building plans, specifications and other calculations submitted with this permit application. The proposed lighting alteration project has been designed to meet the 2009 IECC, Chapter 8, requirements in COMcheck Version 3.9.3 and to comply w' t andatory requirements in the Requirements Checklist. � o����,tN Of ygss*�G /- q )e- % �/ / �� — �s� as DARRELL �A. 3 A Name - Title Signature " MECHCASE a Da e ANICAL N 40872 AL Project Title: AT&T Store of the Future @ North Andover Report date: 03/31/14 Data filename: N:\2014\Callison\AT&T\clnm-01-14 - North Andover Mall, North Andover, MA\documents\2014-03-19 2009 IECC.cck Page 3 of 3 r Permit NO: ' J " I Date Issued: LOCATION k)d� i PROPERTY OWNE BUILDING PERMIT TOWN OF NORTH ANDOVER i APPLICATION FOR PLAN EXAMINATION K*1 Date Received IMPORTANT: ADDlicant must complete all items on this rnnt MAP NO: 671 PARCEL � ZONING DISTRICT: Historic District Machine ShOD Vill yes no yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition - ❑ Other ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer OWNER: Name Address: t `SIL att Identification Please Type or Print Clearly) LJAZNLNN� 1 t flit J Phone: S ©� CONTRACTOR Name: //V e l -t 14 i LLCAQ4 Phone: &O3- _32l- g'T i� Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER CO�LV JV4Nst�, P" ok OWN Phone: Address: 71I /V l� tdl ;� RI) 'VU -4410W 7" Reg. No. FEE SCHEDULE: BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. [V �/e2v - Total Project Cost: $ �,s"C�®� FEE: $ �0g/�Z)CD Check No.: /3`2�&: Receipt No.: c2?"]! k NOTE: Persons contracting with unregistered contractors do not have access to !4e ty fund Signature of Agent/Owner Signature of contractor r ;J ti� Plans Submitted ❑ ,1 Plans Waived 0 Certified Plot Plan ❑ Stamped Plans ❑ TYPE'OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swumning 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 PLANNING & DEVELOPMENT Reviewed On COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS Signature_ Reviewed on Signature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Com Conservation Decision: Comments Water & Sewer Connection/signature & Date Driveway Permit DPW Town Engineer: Signature: LOcatea 664 usgooa Street PIKE DEPARTMENT - Temp Dumpster onfsite yes no. Located- at 124 Main Street Fire Department sig_ nature/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 Call Email Date Time Contact Name Doe.Building Pen -nit Revised 2014 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 L. Licenses Copy of Contract i � a 5 ❑ Floor Plan Or Proposed Interior 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 ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Cross Section/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 a Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Building Permit Revised 2014 I -1v I/ . 4 T �r 5A� Location �-J 5 () �" � i'z�0,e . No. JP —/� Date e • TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ }� Foundation Permit Fee $ �Fo �Other Permit Fee $ �,k � ter• s� ���''TOTAL $ Check # 15-5k ' 28 126 Building 1A + ector mot 4 i + +" rr 3,SS+CHUSEt�9 CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 351-15 on 10/10/2014 Date: November 17, 2014 THIS CERTIFIES THAT THE BUILDING LOCATED ON. 350 Winthrop Avenue MAY BE OCCUPIED AS an A T & T store_IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Delta & Delta Realty Trust 350 Winthrop Avenue North Andover, MA 01845 ds- &,- --,' Building Inspector Fee: PrePaid $100.00 Receipt: 28126 Check: 1598 l=� < 00 s -q O :3 2 N = < (D N cn D cv n O 0 1 O ' CD 0 m O 0 CL C 3 z c ��.0 (n O vi 2 cN m O O C m N =. CD mO • cu 2 n.su@= i D = C n -i CL co rt ' o -.0 CO) W =r CD CD 2L 0 =� O < .d cQ N. 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'p<N�pTN �1 +° 0 1 '* 41 SsACHOUSi CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 351-15 on 10/10/2014 Date: November 17, 2014 THIS CERTIFIES THAT THE BUILDING LOCATED ON. 350 Winthrop Avenue MAY BE OCCUPIED AS an A T & T store_IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Delta & Delta Realty Trust 350 Winthrop Avenue North Andover, MA 01845 Building Inspector Fee: PrePaid $100.00 Receipt: 28126 Cheek: 1598 i v M. C � N n 10 O CD !••h O mo CD CLO (Q. y -a O 0 CD CL Cr CD O CD 0° IM CD v CD CO CD I v O U) CD o o CD 3 CD c� s in - 0 O n r. -I �1 z m cn cn O U) Z CJ cn Cl)�� �1 � z G) Z cn: ol 0 A m X -v z d7 Z V• O D O Z -h 5 CD N O co O C. (O <D to rt O O N 2. N o = c = <, C N Cl) cC'0. ,CD0CD 0 m 0 CL 0 m o. =-0 N O N N FD -T 0 0 .ACL ° m -" C 0) cn W�� N 0 -i CD CD 2 G cD > to Q. c� rt su CD pow CD 0 C O O cn NP+ "h N o 0, a C rt D CD N 7 n <Q N CDN (D� � .�`. 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Robert Nicetta, Building Commissioner TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 01845 Telephone (978) 688-95454 Fax (978)688-9542 CONTROL CONSTRUCTION - SECTION 116.0 M.S.B.C. CERTIFICATE OF ENGINEERING/ARCHITECTURE BULDING INSPECTOR TOWN OF NORTH ANDOVER 400 OSGOOD STREET NORTH ANDOVER MA 01845 I, David B. Parmiter, PE ,HEREBY CERTIFY THAT THE BUILDING CONSTRUCTED AT 350 Winthrop Ave. North Andover, MA 01845 DOES CONFORM IN ALL RESPECTS TO THE MASSACHUSETTS STATE BUILDING CODE AND APPLICABLE FEDERAL REGULATIONS FOR THE FOLLOWING: AUTHORIZED SIGNATURE: DATE: 11-12-14 REGISTRATION: 50384 DAVM' R. G NOTE: ENGINEER WET STAMP MUST BE AFFIXED TO THIS FORM f0ECHA. , CAL No. 503H /ST AL SSS/SIAL Control Construction Form revised 11.15.2004 BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 a� 0ORT01 TOWN OF NORTH ANDOVER �°o� OFFICE OF BUILDING DEPARTMENT o 400 Osgood Street 4 t North Andover, Massachusetts 01845 +p ` h e4'+nn� .�t D. Robert Nicetta, Building Commissioner Telephone (978) 688-95454 Fax (978)688-9542 CONTROL CONSTRUCTION —SECTION 116.0 M.S.B.C. CERTIFICATE OF ENGINEERING/ARCHITECTURE BULDING INSPECTOR TOWN OF NORTH ANDOVER 400 OSGOOD STREET NORTH ANDOVER MA 01845 I, James A. Bile 11 a, 11, PE ,HEREBY CERTIFY THAT THE BUILDING CONSTRUCTED AT 350 Winthrop Ave. North Andover, MA 01845 DOES CONFORM IN ALL RESPECTS TO THE MASSACHUSETTS STATE BUILDING CODE AND APPLICABLE FEDERAL REGULATIONS FOR THE FOLLOWING: AUTHORIZED SIGNATURE: REGISTRATION: 50658 DATE: 11-12-14 NOTE: ENGINEER "WET STAMP" MUST BE AFFIXED TO THIS FORM Control Construction Form rcviscd 11. 15.2004 ya� of 44"ASs��y F JAMES A. G BILELLA 11 ELECTRICAL Ch No. 50658 �OFG'ISTEQ'�o�`��'� BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Final Construction Control Document To be submitted at completion of construction by a Registered Design Professional for work per the 81h edition of the Massachusetts State Building Code, 780 CMR, Section 107.6.4 Project Title: AT&T Store Date:11-13-2014 PermitNo.4r 3 5I—IS Property Address: 350 Winthrop Ave, North Andover Mall, North Andover, MA 01845 Project: Check (x) one or both as applicable: New construction X Existing Construction Project description: AT&T Store, Des 1 -white space,Tenant fit -out retail space. I, Cortland Morgan, MA Registration Number: #9580 Expiration date: 8/31/15, am.a registered design professional, and hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning': Entire Project X Architectural Structural Fire Protection Electrical Other: Mechanical for the above named project. I certify that 1, or my designee, have performed the necessary professional services and was present at the construction site on a regular and periodic basis to determine that the work proceeded in accordance with the requirements of 780 CMR and the design documents prepared by me and approved as part of the building permit and that I or my designee: 1. Have reviewed, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. . ®ke A ® . Enter in the space to the right a "wet" or electronic signature and seal: Phone number: 817-635-5696 Email: tricia@cmaia.net Building Official Use Only Building Official Name: Permit No.: Date: rA�, 9 5 )0 t Note 1. Indicate with an `x' project design plans, computations and specifications that you prepared or directly supervised. If `other' is chosen, provide a description. Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost fi5,,t0.0,0l.0.0 m $ - $ 780.00 Plumbing Fee $ 97.50 Gas Fee 100 comm. 3 1100:00 Electrical Fee $ 97.50 Total fees collected $ 1,075.00 350 Winthrop Street 351-15 on 10/10/2014 At&T Tenant Fit Up m U) CD 0 Z C Cr 2 rt CL �. D co O O `o C Q C c CD. O CD CL O so = CO CD U) CD rF O 7 LWJ �G n F 0 U) CD CD MIN CD _a U• CD I O O rTF N a z m 0 z cn 0 D N --i � // Vn C z 0 70 m X T0 V''N + z Z cn 1 O D O z O rmpL CD N O R v' cc O 1 W CD cc 0 Q N cn :•r o0 -0°z N '* z O (8,)) 7o m m m z U) CD N a`D,CrDLo 0 m v. v o -5-CI)�. Zo O OCG S O t/1 rOy CD TI O O C ID0N m T 5' O 7 Sm CD cD CD = a a) m v O D to CL N Im O O T 2 m 2 O n : � r+• C7 D O pow CD = ; O < m CD :+�. O Z ar ,,L rt =_ D `D y Q v n = 0 O cv CDCf) �• - 7 G1 � O lD Loft CD rCD� a� 'a � 0 CO) 0 O O '= p 's CQ • O C W CD CD U) CDCD .� C 0 � 5-0 > O CD -0 S31 � 5- A O CL N 3 ON rD N '* z O W C O rDD 7o m m m z T �' xT O 000 3 G7 n O j N O Zo O OCG S m r- m A r N m M T S. cu 7.7 O UCO 3 C N M T 5' O 7 O 000 3 O 7 O_ 0 � W C ° Z C Z N m O (D 0 3 O Q n s (D :3 Im O O T 2 m 2 O y 0 Page 1 of 1 Aco a CERTIFICATE OF LIABILITY INSURANCEDATe0= ;ii; 0523/2014 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. IMPORTANT: H the certtllcate holder Is an ADDITIONAL INSURED, the polloy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsemen s . PRODUCER I=r Kathy Camahan SlaWwido Insuranoa, LLC PNONE (603) 673-4500 FAx (866) 571-8331 206 South St 1226 — KAIhvI@nhcUltawidm mm Milford NH 03055 1143LR EA A: EMC Ccrrgany INSURED poing . NCCI HUGH KILLORAN wsumMc a A.I.M. MUTUAL DBA HPK 00: 8 WOOD HAWK WAY LITCHFIELD NH 03052-2445 IAF; (•_AVFnanvq rI=9MCI9%ATrc wnrece. e�.ne..,.........,..,_ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUTAEMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L TYRE OF 06URANCeJIM I= POLICY NUMBER A ReseMrAn / tm LOOM Kath GENERAL LIABILITY EACH OCCURRENCE 3 1000000 D 1" 5 . oauvee 3 100000 OO)1MERCIALGENERALLIAEIUrY CLAAr^..h1A0E ®OCCUR MEDEXP(Mya --I 3 5000 A N 4025810 01/08,2014 OI AM 015 PERSONAL a ADV DwaY 3 1000000 GENERALAGGREGATE 3 2000000 GENL AGGREGATE LVOT APPLIES PER. POLICY PM LOC PRODUCTS -COSAROP AGG 3 2000000 3 AUTOMOBILE LIABILITYLMT iF i ea SOOILY INIURY IPS, p.cenl 3 Nr AUTO ALLONMED SCHEDULED AUTOS AUTOS BODILY 1111URY IPvI ...dM} 3 HatED JWTOS �0 OS PROPERTY DAMAGE 3 3 ULTBReIU L A OCCUR EACH OCCURRENCE S EttCEe9 LIAB CLAMS -MADE AGGREGATE 3 ED R M 3 8 LYORHERSCOMPENSATION Atm WIPLOTERS' LIABILITY T i N ANY PROPRETORPARTNEREILECUTIVE OFFICER. ENMAellCLUDCD7 (111w,da" In " IL • dvsadruMvr O CPoPTtON 01"OPERATIONS6vlov H:A 6KUB51339110312 05/1&2014 05+182015 X1 WCSTATU-OTH- EL. EACH ACCIOBVT 3 1000000 E L DISEASE - EA EUPLOYEE 3 1000000 EL DISEASE -POLICY LOM 3 1000000 C MA WORKER'S COMPENSATION AWC40070300092013A 102912013 10292014 81 accident 100000 each accident 81 disease 500000 policy favid DESCRIPTION OF OPERATIONS) LOCATIONS, VE19CLES (Athch ACORD TOL. Addhiuol Amar6 Sdrdah. B m qp is rcgo4edt JDR Fixtures tris. is added as additional Inwed. email: TracyD@jdrfixttces oom ..wr.ai w Tw.wwl YJ 1V60-ZU10 AVIJHU WXYUHA 11UN. AB nghtS rerierVed. The ACORD Tame and logo are registered narks of ACORD https://acord.agencymatrix.com/APPortal.axd?rt=c&dk=0016F888JOAVOQ5I96FW97H9... 6/25/2014 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE JDR FIXTURES INC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: TRACY ACCORDANCE WITH THE POLICY PROVISIONS. 264 SHOEMAKER D A ReseMrAn / POTTS TOWN NH 19464 Kath ..wr.ai w Tw.wwl YJ 1V60-ZU10 AVIJHU WXYUHA 11UN. AB nghtS rerierVed. The ACORD Tame and logo are registered narks of ACORD https://acord.agencymatrix.com/APPortal.axd?rt=c&dk=0016F888JOAVOQ5I96FW97H9... 6/25/2014 The Commonweaft of.t7 assachuseft - . Office ofhvesfigafions 00 Wasfikgtow Skeet Roston, MA 02111 www.mass go-pldla - 'QVQrkex ' pompe aii ninsurance Afidadt:1�ui�c�ereslCo��ac�ox�/E+Xe��re�czansl�'��v�iex,� Auplicanflbfomaton PXasePxznJbXv Name, (Bus1nosW0rganizaiion&dWdua1): YUG(4 - L L J \A 1/ , C y/ ',aioIZ: A. t H Pham :_ Are you an. employer? Cb eels the appx opxzate lO o�: 1. [] I am a employer with. ' �, 4. El l am. a general contractor and l - employeeg (dill andlaxpalt tune) T have Dkedihe sub-con-tracioxs 1:1sted on fho attached sheet 2. ❑ I am a style proprietor or parin.ex ship auTliaveno.employees These mh-contractoxshavo worldng foxm.e in any capacity, workers' comp. insurance, 5. ❑ we axe a corporation and its [No workers' eomp. piwaace xe�xed.1 officers have exercised. their s.E1 am a homeowx er doing all work right ofexemption perlt/SG . myseL Voworka& comp. insurancexetluixed.� c.152, §1(4), andwehaveno employees. (No workors, comp. lagaaace repaired.] Type of project (reluixed): 6.1ew cbnsix�zction f 7. �Bemorleliug 8. [( Demolition 9. Building addition. 101] Electricalxepab ox auditions 11,.[( )?J mbingxep*s or additions 12.PWofxepaixs 13.� Other • Any applicant that checks bol musEalsoilancfheseefion bel6wshowingtheixwbrkers' compensation.policy ntbzmaffon. 'Hov,Tha submit this affidaviiindicafingfhey tie do ing allwork andfhen biro outside contractors must submit a new affitdavif indicatizig sucl tConfracfors�ibai c icGlrt us boxmnstaifached apt additional she eishowingthenama ofthe suh-contractors and �fh*workers' comp. polioyinfozmauon, Iar cwt ern,V10yeNtraatisprovidingl ork'ePs?coynperasatroninsr��ancefo any royees..�erofpastrieyolieyavdjobsite information. . lnsumnce Company Name% tALL�' i � i � 1 t� C (S) policy # or Selz"-vss. Vic. #: 4' �C��) �9 �� I � Expiraizon Da%: 'Z rob Sitee✓� i (� U S Cl /State%Zi j�6%Vc��i>r .A�ddxess� �� j �� rr�'p'--� iiaieh a copy of l tewoxl exs' eompensaiion polxeg aeclaxatzon page (s1tpw1ng,f*Ae polzcy n=hex and eUkaiioa crate). ailzir, to secure coverage as xequixedunder Section 25A ofMGT, 0.152 can. lead to tate imposition of criminalpenalties of a Fate up to$1,500•ti0and/orone�yeax npriso nenExaswell .ascivzlpenaltiwinditefoamofaSTOPViOI ORDERandaane ofup to $250.0o a dayagabBtthe violator: Be advised that: a copy ofthis statazentmaybe foxwardedto the Moo flf hvesdgations ofthe DTA- for inswafttce, coverage verif cation. x & hereby eerz ry 'ore le_&ins an ipenfff ies o, perjury tricot flae inforrizaiion provided above is true and eo rea,, Of, ficial use only, Do not WN in trail ON, torte corVIeted by city or town offifelff : City or Town: Eezmpl cense d'ssWngAthority (circle one): 1. Board. of ffealth 2. Buffd1upepartmee3. Cetyl- oym Clerk 4. Electrical( Inspector 5. Elumbirtgfuspector d. Other Information an Ins%uctions MassacMsefLs General Laws chapter 152 requires all employers to provide workers' compensation for Eck employees, l'ursuaait to this statute, an ern,ployee is daf hod as ",..every person, hi the SexVice of another under any contract of fire; ' express oximplied, oral orwdiLen °' .An. ewfoyeiis defined as "an individual, partnership, association, corporation or otherlegal entity, ax anytwo oxxnoxe Of thekxego3ngengaged in a joint enterprise, andinoludingthe legalxepxesentatives ofa'deceasedemplVaT .ox the receiver orrfrizstee of an. i dMdual, partership, association or oth.exkgal entity, employing employcog'. 1S ovm the ownerofadwe7linglzousehavi%gnatnnorethartihreeaparimenisandwlnaxeszdas'�herezn,oreheoccupanto�'i7ie dwolling house of another who employs ,persons to do maintenance, confMotion ox repair work on such dweffing house ax onthegrounds oxbuilding appuzcenanttherefo shalinot because ofsuch empZoymentbe deemedta be an employer:" MUL chapter 7.52, §25C(6) also states that "every sfate or local lkensiug agency Dail withhold the issuance or renewal of a license or permit to operate a busiuess or to constctzet buildings fa the commonwealth for any applicant wSno has )tot pro duced•acceptable evidence of compliance with the insurance coverage required." Additionally, MOL chapter 752, §25C(7) stafes,Weitherthe eommonwealthnor any of its political subdivisions shall entex into any contractfor tine performance ofpublic workuntR acceptable evidence of compliance with the insurance regairemenfs Of this chaptexhavebeenpresenfedtathacufxacfingauthoi%r2. Applicants Please 0 out the workers' compensaiiou affidavit completely, by checldng the boxes that apply to your sifuagou and, i; necessary, supplysub-confracfor(s)name(s), addresses) andhonenumbex(s) alongwiththeir ceriitzcafe(s) of insuxauce, LhniLedLiabifiVCompanies (LLC) orUiNdLiabilityPartnerships (LLT')vrithno employees otherthatrthe Members orpartn.ers, axenotrequiradto canyworkers' compensatkufisuxance, lfanLLC orYW? doeshave employees, apolicy urequired. Be advisedthatthis afdavitmaybesubmitiedto theDeparbmonf of Tndusfrial Accidents for confirmation of insurance caverago. Also be sure to sign, and date the affidavzi The afzrdavit should be, refumadta the city or town that the applicai Qn fox thepermit or license is being requested, xtot fhe Department of fndustr al Acoidents. Shouldyou have any questions regarding the law or if you are xequked to obtain a oxkexs' Comp ensatioizpolicy, please call the Department atthe number listed below. Self insured companies should enter 1�heir 190J - insurance license number on the appropriate line. _ ' ' City or Town MIA l'IeasebesIIxef$attheai�davitiscomplefeandpxinfedlegibly. TbeDepartmenElras�pxovidedaspaceattbeboiLorr� ofthe aMdavitfotyoutoM o-utinthe eventfhe Office offavestigationshasto contactyouregardingth ap&aut. Pleasebe-sarefanllintlnepemzxt/Jzcensenumbexwl�iclzwillbeused asaxeaencenumber. fn.adaon,anappVcaat dratrirust submitmulfiple permit/license applications hE any givenyear,need only submit one afidavitindicafing current PORGY iMfoxmation (ifnecessary) and under "YA ,Site Address" the applicant shouldwxite "afllocations in . •(city or tawzr)".A: copy oi`'tlie aftidavit thathas been o�ciaifysfa�rtped oxmaxked byfihe city oxtowuznay fiepxovided to the applicant asprgofthatavalidafrtdavitssonirleioxiSrtoxepermitsOrRcenses. finev,�a�xdavitxnustbe lledouteach year. Where a.horm owner or citizenis obtaining alicense oxpexmitnotrelafed to anybusiness ox commercial venture (i.e. a dog Reema orpermitto burn leaves etc.) saidperson is N'OTxegUhedto complete this affidavit, The Office of l'nvesiigavons would like to thank you in advance for your cooperation and should you have aay questions, please do ztothesitafe to give us a Gaff. Thu Depatttnent's address, telephone and fa�numbext Tha lQx4xbNORIOt o�Sa r,7�vP 1?epax teU.t Qf1UdU*ia1 'acc do t Mee OfIRVaRgattm 60asg(onee Roaton , Q2111 Tel# 617ri7-217-.4.,0Q W406 ax 1-87.7 M Ro-vised5 26-o5 FOX 617"7271749 ww mangov.M— a Delta & Delta Realty Trust 875 East Street, Tewksbury, Massachusetts 01876 Telephone (978) 851-5000 September 22, 2014 Town of North Andover Building Department 1600 Osgood Street North Andover, MA 01845 RE: AT&T 350 Winthrop Avenue To whom it may concern, Please accept this letter as Landlord's authorization to allow HPK Enterprises to perform work on behalf of Wireless Experience of New England, Inc., d/b/a Wireless Experience and The Wireless Experience at the above referenced location. Should you have any questions, please call me at 978.851.0200. Sincerely, '"l Steven Cucinatti Delta & Delta Realty Trust Landlord Representative t%ORTH 4 O �S�ao ".'I'6 r �., 6 a� �SSACHusrtc D. Robert Nicetta, Building Commissioner TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 01845 Telephone (978) 688-95454 Fax (978)688-9542 CONTROL CONSTRUCTION — SECTION 116.0 M.S.B.C. CERTIFICATE OF ENGINEERING/ARCHITECTURE BULDING INSPECTOR TOWN OF NORTH ANDOVER 400 OSGOOD STREET NORTH ANDOVER MA 01845 1, James A. Bilella, 11,1E HEREBY CERTIFY THAT THE BUILDING CONSTRUCTED AT 350 Winthrop Ave. North Andover, MA 01845 DOES CONFORM IN ALL RESPECTS TO THE MASSACHUSETTS STATE BUILDING CODE AND APPLICABLE FEDERAL REGULATIONS FOR THE FOLLOWING: AUTHORIZED SIGNATURE: DATE: 07-28-14 REGISTRATION: 50658 "t"1-&64 V UP a'�i° s9n c JAWIM A. NOTE: ENGINEER "WET STAMP" MUST BE AFFIXED TO THIS FORM 15 3 BILELLA 11 I ELECTRICAL No. 50858 Control Construction Form revised l 1.15.2004 NA1-e�5'f' BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 ttORTH 04yt�so 4,0 #a`r a0 °�tTlo erg t� 9SSRCHU D. Robert Nicetta, Building Commissioner TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 01845 Telephone (978) 688-95454 Fax (978)688-9542 CONTROL CONSTRUCTION — SECTION 116.0 M.S.B.C. CERTIFICATE OF ENGINEERING/ARCHITECTURE BULDING INSPECTOR TOWN OF NORTH ANDOVER 400 OSGOOD STREET NORTH ANDOVER MA 01845 I, David B. Parmiter, PE .HEREBY CERTIFY THAT THE BUILDING CONSTRUCTED AT 350 Winthrop Ave. North Andover, MA 01845 DOES CONFORM IN ALL RESPECTS TO THE MASSACHUSETTS STATE BUILDING CODE AND APPLICABLE FEDERAL REGULATIONS FOR THE FOLLOWING: AUTHORIZED SIGNATURE: DATE: 07-28-14 REGISTRATION: 50384 OF ,QT`S A DAVID 9. � PARK&ER NOTE: ENGINEER "WET STAMP" MUST BE AFFIXED TO THIS FORM v MECKI N,CAL No. 5E4 Abp 9FGIST(cp`�'O 4 `,�,�� Control Construction Form revised l 1.15.2004 'hpONALL BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 638-9540 PLANNING 638-9535 D. Robert Nicetta, Building Commissioner TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 01845 Telephone (978) 688-95454 Fax (978)688-9542 CONTROL CONSTRUCTION - SECTION 116.0 M.S.B.C. CERTIFICATE OF ENGINEERING/ARCHITECTURE BULDING INSPECTOR TOWN OF NORTH ANDOVER 400 OSGOOD STREET NORTH ANDOVER MA 01845 1, Cortland Morgan HEREBY CERTIFY THAT THE BUILDING CONSTRUCTED AT 350 Winthrop AvenUe DOES CONFORM IN ALL RESPECTS TO THE MASSACHUSETTS STATE BUILDING CODE AND APPLICABLE FEDERAL REGULATIONS FOR THE FOLLOWING: AUTHORIZED SIGNATURE: REGISTRATION: 9580 NOTE: ENGINEER "WET STAMP" MUST BE AFFIXED TO THIS FORM Control Construction Form revised 11.15.2004 BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 RICHARD M. COLE AND ASSOCIATES Architects 15 SOUTH 3rd STREET PHILADELPHIA, PENNSYLVANIA 19106 (215) 922-6930 FAX (215) 922-4549 LETTER OF TRANSMITTAL DATE: 10 September 2014 PROJECT NAME: AT&T NO. North Andover Mall CS 350 Winthrop Avenue TO: 1451A Route 37 West North Andover, MA. 01845 Toms River, NJ. 08755 Floor Plan T. 609-713-2800 PROJECT NUMBER: 14165 Attn: Brian Wainwright Fixture Plan WE ARE SENDING YOU X Attached Under separate cover via FedEx the following items: _Prints _Reproducibles _Reductions X Originals _Samples _Photographs COPIES 3 signed/ DATE 09-09-14 NO. DESCRIPTION CS Cover Sheet sealed A-1.1 Floor Plan A-1.2 Fixture Plan A-1.3 Finish Plan A-2.1 Reflected Ceiling Plan A-3.1 Interior Elevations A-6.1 Abbreviations, Finish Legend & Schedule A-6.2 Door& Hardware Schedules A-6.3 Details A-7.1 Architectural Specification M-1.1 Mechanical Cover Sheet M-1.2 Mechanical Specifications H-1.1 HVAC Plan H-2.1 HVAC Details & Schedules E-1.1 Electrical Cover Sheet E-1.2 Electrical Specifications E-1.3 Electrical Specifications E-2.1 Power Plan E-2.2 Lighting Plan E-3.1 Panel Schedules FP -1.1 Fire Protection Plan FP -1.2 Fire Protection Specifications 1 signed/ 09-09-14 Control Construction Form - Architectural sealed 1 signed/ 07-28-14 Control Construction Form - Mechanical sealed 1 signed/ 07-28-14 Control Construction Form - Electrical sealed THESE ARE TRANSMITTED as checked below: REMARKS: Brian, enclosed are signed/sealed permit drawings for the above referenced project. COPY TO: i SIGNED: --- /John J. McHugh z Massachusetts - DepArtment of PublicP.Safety Board of Building Regulations and Standards Construction Supen isor License: CS -068501 `�L ^ .• /��� �. dei " k HUGH P KILLORT 'i- '•, 8 WOODHAWK WAY� LITCHFIELD NII 0 Expiration commissioner 06/28/2016