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HomeMy WebLinkAboutBuilding Permit #315 - 60 WILLOW STREET 10/19/2009 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received �� 9 Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION , 110 uy 'Iii"e c P'nt PROPERTY OWNER ,OdW eyl r cuss t` y , a t�f a P. MAP NO:qF PARCEL: ZONING aHistoric District yes rto Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USES" Residential ( Nori=Residential New Building One family — -- Addition Two or more family < Industrial--. ,::� Alte on No. of units: Commercial -epa- rr eplacement Assessory Bldg Others: I Demolition Other Septic Well r Floodplain Wetlands Watershed District Water/SewerTi^r¢,^ V,r DESCRIPTIgN F WORK TO BE PERFORMED: New 720 5f eoiler'e�e at/ o;� r©ce>s uS GZ 200 5f 0-017e-eede �Oel 2 r et 11fo�tyl M e W Sl el-f,e-oj c 41-r' Y, a4405dtZ&r,.tci alc'"'rq we L' / :rq vvdlewcl Identification P1' Type or Pr�'pt Clearly) OWNER: Name: oyy C/�r�r,�a/ ( .rN e ray j<�/� �/���s� Phone: `l7SY 15,E Address: 0 � I�(�W S�%'tee f ' J CONTRACTOR Name: tM C ' -:`I�hone: ` °/ 49:55' 47 Y !fir Address: ) OOW er 141 ,11 a r Supervisor's Construction License: C1J Oq 9 0 2- Exp. Date f , 2Z 09 Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: 508'- 5-14 1695- Address: 95 /04/`h ;,¢o,.,`GNI�T Reg. No. 75-?e- 04, <<► r,tcY�iyrTf FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ .233, 6�27 —��-4--0 ,. Check No.: / -7-79-' -772'/ Receipt No.: 4-c,,� NOTE: Persons contracting,w it unregistered contractors do not have access to the guaranty fund Signature of Age'nt/OwnerSignature of contractor , 44 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public S � Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE.REJECTED DATE APPROVED r ,.J- PLANNING & DEVELOPMENT COMMENTS -� 1 CONSERVATION Reviewed on Signature COMMENTS EEC 4L LLLk,/�c� OQ HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124'Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: l Total square feet of floor area, based on Exterior dimensions. r�, Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc:.Building Permit Revised 2008 J _ Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (if Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Doc.Building Permit Revised 2008 Location l� //X)Cc, No. �/S� Date Z!0 r y NaRTM TOWN OF NORTH ANDOVER F w a Certificate of Occupancy $ �►�s',.•„Eta' Building/Frame Permit Fee $ -2° s�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 12 � F 22- EJ /17 /Building Inspector Z CHARLIE SPICER -1 Pre-Construction Project Manager � x U � TEL : 978-461-0330 ext. 14 s FAX: 978-461-0480 WEB: www.jmcoull.com E M L: cspicer@jmcoull.com .�� �/ �wM I �,1 � � 97�- � 90 - 6 �3 a -�_ I (Fallon Community Health Plan) -- - #-ggl First Seniority Freedom (Harvard Pilgrim Health Care) # g _ ` Senior Whole Health # 1 Tufts Health Plan Medicare Preferred (Tufts Health Plan) #S [Medicare Card Number I # l I give permission to bill my insurance compan� L (Signature of person to receive vaccine or that person' L X ` � I For Clinic/Office Use: Vaccine namee� Injection site: Date VIS given: , JVaccine manufacturer: Vacciry Name and title of vaccine administrator: Clinic/office address: Influenza Forms—MAHP/Masspro Plan Reimbursement Program 2008 l ' / v PO Number PO Date 4501707007 10/08/2009 Contract Page 1/ 1 Transport Mode Currency Ref.Doc.No. VAT Number USD Vendor Address Payment Terms JM COULL INC 45 Days Net 20 POWDER MILL ROAD MAYNARD PAA 01754 Storage Location Vendor Number 40011398 Terms of Delivery Not Applicable ZNA Invoicing Address Delivery Instructions: Rohm and Haas Company North Andover,MA PO Box#1310 Rohm h Haas Electronic Materials LLC Philadelphia PA-19105-1310 60 Willow Street USA NORTH ANDOVER MA 01845 PO Number PO Number Storage Location 4501707007 4501707007 MST Number: CST Number: PAN Number: ECC Number: ii4. 0a .......- Validity Start 10/08/2009 Validity End 12/31/2009 PLEASE SEND ORDER CONFIRM TIONS,PRICIN AND/OR DELIVERY CHANGES TO: JESSICA COVIEO, MAIL FUSROHP®DOW.COM;fax 989-4 6.7361. PLEASE REFERENCE THE PURCHASE ORDER N1 IMBER ON ALL PACP ING SLIPS AND CORRESPONDENCE- INVOICES ORRESPONDEN E.INVOICES MUST HAVE PURCHASE ORDER NUME ER TO FACILITATEPAYMENT; NVOICE LINE ITEMS MUST MATCH PO LINE ITEMS. THIS PURCHASE ORDER IS GOV RNED BY THE RMS AND CONDIT NS LOCATED ATTHE WEB ADDRESS IMMEDIATELY TO + FOLLOW WHICH ARE HEREBY REFERENCED AN D MADE PART OF TH S ORDER ht1pJ/w%vw.rohmhaas.comiassets,attachments/sul ipIIers,FieIdLabor—GC.pdf 1 12/18/2009 1.00 AU 233,627.00 233,627.00 Construction for Nitrogen Tank 00:00:00 USD/1 AU USD/I AU s !? tiDii elX . ;'� f r ittr `;i "n .. ' M-7 Total net value excluding U x USD 233,627.00 Refer all Cluestions/Inquirtes To: Purchasing Contact Name: Jessica Covieo Purchasing Contact Phone Number: 989-636-5409 Purchasing Contact FAX: 989496.7361 Purchasing Contact E-mail: (Signature) IFDI Industrial Facilities Design, Inc. CONSTRUCTION CONTROL AFFIDAVIT(ARCHITECTURAL) (PRIOR TO START OF CONSTRUCTION) PROJECT LOCATION: 60 Willow Street,North Andover,MA PROJECT DESCRIPTION: Rohm&Haas—Nitrogen Installation In accordance with Section 116.0 of the Massachusetts State Building Code,Seventh Edition,being a registered ARCHITECT,I hereby certify that I have prepared or directly supervised the preparation of the plans and specifications for the above named project and that,to the best of my knowledge,such plans and specifications meet the applicable provisions of the Massachusetts Sate Building Code,all acceptable architectural practices and all applicable laws pertaining to the proposed project. I further certify that I shall perform the necessary professional services and be present on the construction site on a periodic basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following as specified in section 116.2.2: 1. Review of shop drawings,samples and other submittals of the contactor as required by the construction contract documents as submitted for building permit,for conformance to the design concept. 2. Review of the quality control procedures for all code required controlled materials. 3. Where appropriate,review of critical building components requiring controlled materials or construction when specified in the accepted practice standards listed in Appendix B of the Massachusetts State Building Code, Sixth Edition. Pursuant to section 116.2.3,I shall submit periodically progress reports together with pertinent comments to the building inspector. Upon completion of the work,I shall submit a report as to the satisfactory completion and readiness of the project for occupancy. a rR ;ignature a No. 6QI � NATI CK, MASS. ° Robert C.Troccolo,A.I.A. �nf or Name 6011 SEAL Architect/Engineer Mass.Reg.# 85 Main Street Phone: 508-544-1695 Hopkinton MA 01748 Fax: 508-544-1694 IFDI Industrial Facilities Design, Inc. CONSTRUCTION CONTROL AFFIDAVIT(Structural Work Only) (PRIOR TO START OF CONSTRUCTION) PROJECT LOCATION: 60 Willow Street,North Andover,MA PROJECT DESCRIPTION: Rohm&Haas—Nitrogen Installation In accordance with Section 116.0 of the Massachusetts State Building Code,Seventh Edition,I,being a registered STRUCTURAL ENGINEER,hereby certify that I have prepared or directly supervised the preparation of the plans and specifications for the above named project and that,to the best of my knowledge,such plans and specifications meet the applicable provisions of the Massachusetts Sate Building Code,all acceptable engineering practices and all applicable laws pertaining to the proposed project. I further certify that I shall perform the necessary professional services and be present on the construction site on a periodic basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following as specified in section 116.2.2: 1. Review of shop drawings,samples and other submittals of the contactor as required by the construction contract documents as submitted for building permit,for conformance to the design concept. 2. Review of the quality control procedures for all code required controlled materials. 3. Where appropriate,review of critical building components requiring controlled materials or construction when specified in the accepted practice standards listed in Appendix B of the Massachusetts State Building Code,Sixth Edition. Pursuant to section 116.2.3,I shall submit periodically progress reports together with pertinent comments to the building inspector. Upon completion of the work,I shall submit a report as to the satisfactory completion and readiness of the project for occupancy. �ZH OF 'AAs Aignatture JAMES M.WOLAHANNo. 31610 H _ STRUCTURAL 9FGISTEE� �``� Name ONAL EN. 7�(/7 /o SEAL Architect/Engineer Mass.Reg.# 85 Main Street Phone:508-544-1695 Hopkinton MA 01748 Fax: 508-544-1694 B I - :Z.- BUILDING ENGINEERING RESOURCES, INC. Construction Control Affidavit (Prior to Start of Construction) DATE: September 14,2009 PROJECT LOCATION: 60 Willow Street-North Andover,Massachusetts NATURE OF PROJECT: Rohm&Haas- Nitrogen Installation In accordance with Section 116.0 of the Massachusetts State Building Code, I,Marc R. Plante,PE,Massachusetts Registration No.#38119 being a Registered Professional-Axcliite-e4/Lngineer hereby certify that I have prepared or directly supervised the preparation of all Design Plans,Computations and Specifications concerning: ENTIRE PROJECT __- ARCHITECTURAL STRUCTURAL----- MECHANICAL FIRE PROTECTION ELECTRICAL XX OTHER For the above named project and that,to the best of my knowledge,such Plans,Computations and Specifications meet the applicable provisions of the Massachusetts State Building Code,all acceptable Engineering practices and all applicable Laws and Ordinances for the proposed use and occupancy. I,further certify that.I shall perform the necessary Professional Services and be present on the Construction Site on a regular and periodic basis to determine that the work is proceeding in accordance with the Documents approved for the Building Permit and shall be responsible for the following as Specified in Section 116.2.2: 1. Review of shop drawings,samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit,and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code required controlled materials. 3. Special architectural or engineering professional inspection if critical construction components requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix A. Pursuant to Section 116.2.2.3,I shall submit periodically,a Progress Report.together with pertinent comments to the Building Inspector. Upon completion of the work,I shall submit a Final Report as to the satisfactory completion and readiness of the project for occupancy. tNbF��B R. PLA I �i Signature"/Seal E NO.38119 Subscribed and sworn to before me thi , 1 ay of September,2009. 181 _____ My Commission Expires: April 6,2012 ary ubl c , 28 Main Street,Building 3A North Easton,Massachusetts 02356 T 508.230.0260 1 F 508.230.0265 BER@BER-engineering.com -. 3 R BUILDING ENGINEERING RESOURCES, INC. Construction Control Affidavit (Prior to Start of Construction) DATE: September 14,2009 PROJECT LOCATION: 60 Willow Street-North Andover,Massachusetts NATURE OF PROJECT: Rohm&Haas-Nitrogen Installation In accordance Nvith Section 116.0 of the Massachusetts State Building Code, I,Steven A.Kazan,PE,LEED AP,Massachusetts Registration No.#34989 being a Registered Professional °l+itee-/Lngineer hereby certify that.I have prepared or directly supervised the preparation of all Design Plans,Computations and Specifications concerning: ENTIRE PROJECT--___ ARCHITECTURAL STRUCTURAL_____ MECHANICAL FIRE PROTECTION ELECTRICAL OTHER PLUMBING XX For the above named project and that,to the best of my knowledge,such Plans,Computations and Specifications meet the applicable provisions of the Massachusetts State Building Code,all acceptable Engineering practices and all applicable Laws and Ordinances for the proposed use and occupancy. 1,further certify that I shall perform the necessary Professional Services and be present on the Construction Site on a regular and periodic basis to determine that the work is proceeding in accordance with the Documents approved for the Building Permit and shall be responsible for the following as Specified in Section 116.2.2: 1. Review of shop drawings,samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit,and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code required controlled materials. 3. Special architectural or engineering professional inspection if critical construction components requiring controlled materials or construction specified in die accepted engineering practice standards listed in Appendix A. Pursuant to Section 116.2.2.3,1 shall submit periodically,a Progress Report together v<ith pertinent comments to the Building hnspector. Upon completion of the work,I shall submit a Final Report as to the satisfactory completion and readiness of the project for occupancy. SHOF414S . o STEVEN A. N l AN ------------- y -- --- — ----- u iUECHAtdICAL Signnalure/Seal No.34989 Subscribed and sworn to before me this 1 day of September,2009. �oFFSQS/IST ___ ___ My Commission Expires: April 6,2012 otay ubl c 28 Main Street,Building 3A North Easton,Massachusetts 02356 1 T 508.230.0260 F 508.230.0265 BER@BER-engineering.com __ 31 R BUILDING ENGINEERING RESOURCES, INC. Construction Control Affidavit (Prior to Start of Construction) DATE: September 14,2009 PROJECT LOCATION: 60 Willow Street-North Andover,Massachusetts NATURE OF PROJECT: Rohm&Haas-Nitrogen Installation In accordance with Section 116.0 of the Massachusetts State Building Code, I,Steven A.Karan, PE,LEED AP,Massachusetts Registration No.#34989 being a Registered Professional-ArskiweWEngineer hereby certify that I have prepared or directly supervised the preparation of all Design Plans,Computations and Specifications concerning: ENTIRE PRC1ECT ___ ARCHITECTURAL STRUCTURAL_____ MECHANICAL FIRE PROTECTION XX ELECTRICAL OTHER For the above nailed project and that,to the best of my knowledge,such Plans,Computations and Specifications meet the applicable provisions of the Massachusetts State Building Code,all acceptable Engineering practices and all applicable Laws and Ordinances for the proposed use and occupancy. I,further certify that I shall perform the necessary Professional Services and be present on the Construction Site on a regular and periodic basis to determine that the work is proceeding in accordance with the Documents approved for the Building Pennit and sliall be responsible for the following as Specified in Section 116.2.2: L Review of shop drawings,samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit,and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code required controlled materials. 3. Special architectural or engineering professional inspection if critical construction components requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix A. Pursuant to Section 116.2.2.3,I shall submit periodically,a Progress Report together with pertinent comments to the Building Inspector. Upon completion of the work,I shall submit a Final Report as to the satisfactory completion and readiness of the project for o icy. ZH OF Mgss9c STEVEN A. �G N � KAFiAN m, MECHANICAL n _ No.34)8"' ----------- -- -- -------- Signature/Seal O� /STEP�\��`�� ss/ONAL ENG Subscribed and sworn to before me tills, 14th ay of September,2009. ____ My Commission Expires: April 6,2012 0 any bl 28 Main Street,Building 3A North Easton,Massachusetts 02356 T 508.230.0260 1 F 508.230.0265 BER@BER-engineering.com BUILDING ENGINEERING RESOURCES, INC. Dow Advanced Materials Nitrogen Storage 60 Willow Street North Andover, MA FIRE PROTECTION CONSTRUCTION DOCUMENTS 1. a. Basis (Methodology) of Design: Section 1 —Building Description: a) The existing building consists of B-Use Group Office, Laboratory Research and Testing Lab, F-1 Factory Moderate Hazard, and Hazardous H-2 perimeter and inside areas as allowed for in an "Unlimited Area"building as defined by CMR 780. b) The total square footage of the building is 53,830 square feet, of which 53,830 square feet is occupied by the subject tenant. c) .The main building height above grade is approximately 20 feet to the ridge, 32 feet to the top of the Maintenance Mezzanine. d) The building has a total of(1) one story above grade. e) There are no floors below grade. f) There is 53,830 square feet on the first floor. g) The occupancy types are: B, F-1, and H-2. h) The type of construction is 2C,Non Combustible,Unprotected with Automatic Fire Suppression System. i) LN2 fill station to be used to store flammable process gases in cylinders. Area to be exterior and covered by a canopy. (List of process gases to be provided by Rohm& Haas.). j) The building will not include any high pile storage. k) Emergency response vehicles and personnel can access the building directly from 3 sides on paved parking areas. 28 Main Street,Building 3A North Easton,Massachusetts 02356 T 508.230.0260 F 508.230.0265 BERBER-engineering.com F Dow Advanced Materials—North Andover,MA Nitrogen Storage g g September 14 2009 Fire Protection Narrative-Page 2 Section 2—Applicable Laws, Regulations and Standard: The following regulatory codes and standards are applicable to this project: a) 780 CMR(2005) Section 903.11 b) NFPA 13 (2007) Installation of Sprinkler System c) NFPA 72 (2007)National Fire Alarm Code d) NFPA 101 (2006) Life Safety Code e) 521 CMR—Architectural Access Board Section 3 —Design Responsibility for Fire Protection Systems: a) The professional engineer(PE) fully designs (complete layout) and specifies the fire protection system or systems to be installed, reviews and approves the Installing Contractor's shop drawings. The PE is considered the engineer of record and certifies system installation for code compliance at completion. Section 4—Fire Protection Systems to be Installed: a) Water supply and hydrants: 1. Two fire hydrants will be located within 50 feet of the building. 2. Water supply information. Static Pressure: psi Residual Pressure: psi Flow: gpm Pitot: psi Location: b) Automatic sprinkler systems and components: The existing wet sprinkler system is fed from an existing main, located in the street. The existing 8" sprinkler main is brought into the building in the mechanical room. The system contains an existing 6" double check valve assembly and 6" alarm valve. All areas which are Ordinary Hazard will have a sprinkler spacing of a maximum of 130 square feet. The Extra Hazard Labs will have a sprinkler spacing of a maximum of 100 square feet. The existing sprinkler system is currently gridded with 4"mains and 2"cross branches. The LN2 fill station area will be protected by an anti-freeze sprinkler system. The existing 4" storz fire department connection is located near the fire service entrance. 28 Main Street,Building 3A North Easton,Massachusetts 02356 T 508.230.0260 F 508.230.0265 1 BERCwBER-en ing eering.con P:\07150\07150.07\Correspondence\Narrative(Fire Protection)Sept 14 2009.doc Dow Advanced Materials—North Andover,MA Nitrogen Storage September 14,2009 Fire Protection Narrative-Page 3 c) Standpipe systems and components: The building does not have any standpipes. d) Fire alarm systems and components: The building is presently equipped with an existing addressable fire alarm system. The existing fire alarm control panel is located at the rear main entrance and an LCD remote annunciator is located at the front main entry lobby. Building occupant notification of a fire alarm is accomplished via new and existing audio/visual (horn/light) appliances. These appliances will sound automatically based on an alarm condition initiated by smoke/heat detectors, manual pull stations, sprinkler flow or lab hood ansul system discharge. Detection devices include smoke/heat detectors,manual pull stations, and duct mounted smoke detectors. In addition, addressable monitor modules provide fire alarm system monitoring of the buildings sprinkler flow and tamper valves and lab hood fire suppression systems (ansul systems). Upon the initiation of any manual or automatic alarm device, the North Andover Fire Department will be notified via the existing municipal connection. When a fire starts,the fusible links at the sprinkler heads are melted, allowing water to flow from the system. A flow or pressure switch triggers an alarm within the building. The fire alarm panel will notify the fire department. e) Automatic fire extinguishing systems: This project will not include any new fire extinguishing systems. f) Manual suppression systems: Manual fire extinguishers are provided throughout the facility in accordance with NFPA 10. g) Smoke control/management systems: The space does not require a smoke control or exhausts stem. p q Y h) Kitchen cooking equipment and exhaust systems: The space does not possess any kitchen cooking equipment and therefore an exhaust system is not required. 28 Main Street,Building 3A North Easton,Massachusetts 02356 T 508.230.0260 F 508.230.0265 1 BEKajBER-engineerin .con P:\07150\07150.07\Correspondence\Narrative(Fire Protection)Sept 14 2009.doc Dow Advanced Materials—North Andover,MA Nitrogen Storage September 14,2009 Fire Protection Narrative-Page 4 i) Emergency power equipment: An existing diesel fueled 80 kW standby generator has been installed to provide standby power only to the new Clean Room exhaust system. Emergency lighting is provided by new and existing self-contained emergency battery units with low voltage lamps, L.E.D. exit signs with integral battery back-up and by certain light fixtures equipped with integral emergency ballasts. All emergency lighting equipment is designed to provide emergency lighting for 90 minutes. j) Hazardous material monitoring equipment: The space does not require hazardous material monitoring equipment. k) Seismic consideration: All installations shall comply with 780 CMR Chapter 16. The fire protection system that is to be installed for this project is a modification to an existing system to incorporate the new Laboratory layouts and spaces. This layout is required by 780 CMR to provide 100%protection. Section 5 —Features used in the Design Methodology: a) Building occupant notification of a fire alarm is accomplished via new and existing audio/visual (horn/light) appliances. These appliances will sound automatically based on an alarm condition initiated by existing and new smoke/heat detectors, manual pull stations or sprinkler flow. b) All responding emergency personnel will be directed to the existing main fire alarm control panel or the remote annunciator at either the front or rear entrance. This panel will advise emergency personnel of the location of the fire and the device that initiated the alarm condition. c) All construction work will be performed in a manner that is safe and in compliance with applicable codes. The existing fire alarm and sprinkler systems will remain operational throughout construction. In the event the Contractor is required to temporarily disable the system(s), a minimum of(72)hours notice must be given to the North Andover Fire Department. 28 Main Street,Building 3A North Easton,Massachusetts 02356 T 508.230.0260 F 508.230.0265 1 Bffi@DBER-engineering.co P:\07150\07150.07\Correspondence\Narrative(Fire Protection)Sept 14 2009.doc Dow Advanced Materials—North Andover,MA Nitrogen Storage September 14,2009 Fire Protection Narrative-Page 5 d) All future testing shall be conducted in accordance with NFPA 72 and NFPA 13. This will include quarterly testing of 25% of fire alarm components. Any device/appliance found to be faulty and re-tested. All testing will be coordinated with the North Andover Fire Department prior to initiation of testing. Section 6—Special Consideration and Description: At this time, the designer does not require a waiver or variance. The fire protection design is in accordance with 780 CMR 1. b. Sequence of Operation Section 1: The fire alarm system shall operate automatically to sound all interior building evacuation alarms and flash all alarm strobes upon activation from pull stations, detectors, or sprinkler water flow devices. Upon initiation of any manual or automatic alarm device, the Fire Department shall be notified via the building existing municipal connection. When a fire starts, the fusible links at the sprinkler heads are melted, allowing water to flow from the system. A flow or pressure switch triggers an alarm within the building. The existing fire alarm panel and municipal connection will notify the fire department. An alarm condition will notify the North Andover Fire Department via the existing municipal connection. A tamper(supervisory) condition will notify the local fire department via the existing municipal connection but horn/lights appliances within the building will not be activated. 1. c. Testing Criteria Section 1 —Testing Criteria Personnel: a) The Construction Manager in association with the Electrical and Fire Protection Contractor will coordinate the actual test dates. This date will be based upon completion of installation of all components. b) Upon completion of a successful pre-test, the Contractor shall notify the Professional in Charge that all systems are ready for a final test. The Contractor will provide the professional with documentation that all equipment was 100%tested and that the system is ready for a final acceptance test. As part of the pre-test,the Contractor shall ensure that the graphic annunciator has been updated to reflect all changes performed under this contract. 28 Main Street,Building 3A North Easton,Massachusetts 02356 T 508.230.0260 F 508.230.0265 BER(OBER-engineerin o P:\07150\07150.07\Correspondence\Narrative(Fire Protection)Sept 14 2009.doc Dow Advanced Materials—North Andover,MA Nitrogen Storage September 14,2009 Fire Protection Narrative-Page 6 c) Upon receipt of the aforementioned confirmation letter,the Professional in Charge will direct the Construction Manager to proceed with notifying all interested parties (Contractor,Distributors, and Code Officials)that all Life Safety systems have passed a pre-test and are ready for a final test. The Construction Manager will then proceed to coordinate a mutually agreeable time for all parties to witness the final test. d) The following paperwork needs to be submitted to the North Andover Fire Department prior to Final Testing. 1) Affidavits by Designer. Letter certifying system has been installed according to Plans and Specifications and has been witnessed that it is 100%operational and ready for Final Testing. 2) Affidavits by the Electrical Contractor. Letter certifying system is complete. 3) The Fire Alarm Manufacturer. Certification of complete system. 4) Copy of the Manufacturer's Program Notes. 5) Copy of the stamped Drawings (As-builts if available). Section 2—Equipment and Tools: a) All equipment required to perform a 100%test of the fire protection and detection systems will be furnished by the Contractor. This equipment shall be available at the time of the test. A listing of the equipment that is to be supplied will be forwarded to all "Final Test participants"prior to the test occurring so as to allow for comments. Typical equipment supplied would include the following: Manufacturer's instructions Specifiers' special instructions Approved Narrative Report, sequence of operation section Sound meters Smoke detector aerosol tester Flow measuring devices Gauges Voltage meters Magnets Communication radios Fire department equipment Special tools Notification announcements 28 Main Street,Building 3A North Easton,Massachusetts 02356 T 508.230.0260 F 508.230.0265 1 BEECePBER-engineeiing.com P:\07150\07150.07\Correspondence\Narrative(Fire Protection)Sept 14 2009.doc Y Dow Advanced Materials—North Andover,MA Nitrogen Storage September 14,2009 Fire Protection Narrative-Page 7 Section 3 —Approval Requirements: a) Upon viewing a successful test of all fire protection and fire detection equipment,the code official(s) shall "sign off' on the Building Department Inspection Card. This act will confirm the code official has witnessed the test and accepts the building as satisfactorily complete. b) In the event a piece of equipment fails during the final test, the affected Contractor will make a reasonable effort to replace the defective equipment immediately so the test may continue. In the event this action is not possible, the Contractor shall procure the piece of equipment as soon as possible. The Contractor will be responsible for re- scheduling the test with all attendees. c) Upon successful completion of all tests,the Contractors and Distributors will provide documentation attesting to the fact that they have performed, witnessed and successfully completed a test of all Life Safety systems. The Professional in Charge will provide construction affidavits which acknowledge tests have been witnessed in addition to periodic site visits and that recommendation is made to the Local Official that a Certificate of Occupancy be provided. d) In accordance with 780 CMR Chapter 903.4, all documentation listed in paragraphs 1, 2 and 3 shall be furnished to the building official and the head of the fire department. e) At the initiation of the construction phase of the project, the General Contractor will provide all parties with a list of personnel who will respond to an emergency situation at the project. This list will include addresses and cell phone numbers. 28 Main Street,Building 3A North Easton,Massachusetts 02356 T 508.230.0260 1 F 508.230.0265 BER ruBER-engineerint.com P:\07150\07150.07\Correspondence\Narrative(Fire Protection)Sept 14 2009.doc ACORDM CERTIFICATE OF LIABILITY INSURANCE 10/2i?s' PRODUCER (978)392-4S67 FAX (978)392-9696 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION E.J. Wells Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Regency Park HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR g y ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 238 Littleton Road Westford, MA 01886 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Travelers Indemnity Co. I.M. Coul l, Inc. INSURER B: Travelers Property Casualty Co 20 Powder Mill Road INSURER C: Travelers Casualty & Surety Maynard, MA 01754 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS I TR NRRGENERAL LIABILITY DT-CO-463D5003-IND-08 09/01/2008 09/01/2009 EACH OCCURRENCE $ 1,000,0001 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,00 CLAIMS MADE a OCCUR MED EXP(Any one person) $ 5 r 00 A PERSONAL&ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2,000,00( GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00( POLICY X PRO LOC JECT AUTOMOBILE LIABILITY DT 0-810-463D5015-COF-08 09/01/2008 09/01/2009 COMBINED SINGLE LIMIT $ X ANY AUTO (Ea accident) 1,000,000 ALL OWNED AUTOS BODILY INJURY $ B SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY DT M-CUP-463D5040-IND-08 09/01/2008 09/01/2009 EACH OCCURRENCE $ 10,000,00 X OCCUR ❑CLAIMS MADE AGGREGATE $ 10,000,00 B $ DEDUCTIBLE $ hX RETENTION $ 10,000 $ WORKERS COMPENSATION AND 1.113-5635L515-08 09/01/2008 09/01/2009 X WCSTATU- I OTH- EMPLOYERS'LIABILITY LIMITS ER E.L.EACH ACCIDENT $ 1,000,00( C ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $ 1,000,00( If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,()0( OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. *SAMPLE AUTHORIZED REPRESENTATIVE Paul Coffey/NAM ACORD 25(2001/08) ©ACORD CORPORATION 1988 BOARD OF BUILDING REGU6AabNs ` came CONSTRUCTON SUP&MOR Number: CS 093026093026%f w @rth Gm 12/220975 - Em;m« 12A212009 #. nz Byy shk± m so,ACL K v GEL « >& nwKswESTATE RD WNWENDON, MG O 75 Gmmkmar » The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): J /-I ( JU Address: PrM►fly ` 2_0 �'��� City/State/Zip: al P1 CL r V� 01-7— Phone#: Are you an employer?Check the appropriate bgl: Type of project(required): 1.❑ I am a employer with 4. LV I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 1 7 Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.R Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.DrPlumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.] t employees. [No workers' 13.❑ 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. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. / f 1 / Insurance Company Name: J 1�giV e-`e f 6t S k 5,t ire Policy#or Self-ins. Lic.#: u �� 5� / " o l Expiration Date: Job Site Address:_. t,o W)-&w St;"e e'/ City/State/Zip: /Y� � A,,ct-,y 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. A I do hereby ceriiW u der the ains andZpenalties of perjury that the information provided above is true and correct Si ature: Q p ,C� Date: Phone#: 1c If'T 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 bum 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 600 Washington Street Boston,MA 02111. Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 5-26-05 www.mass.govfdia � r10 R Tly � ovvn oT _ t Ando v 0 4L L dKE over, Mass., � l' COCHICHEWICK 1• Of?ATED PPP��y S BOARD OF HEALTH PERMIT T Food/Kitchen Septic System THIS CERTIFIES THAT ) BUILDING INSPECTOR ............ ...................................A ............................................... Foundation has permission to erect.............. build' gs on ...6.o /.. ..h,J Rough..... .............................. to be occupied as............ ., .r... f� i /...Y..l.........Q .-644 .. .1.4 .......,a..te : /lr/1;t1 Chimney this provided that the person accepting this permit sh 11 in every resp conform to the terms of thb application on file in s office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final i j Buildings in the Town of North Andover. • VIOLATION of the Zoning or Building Regulations Voids this Permit. PLUMBING INSPECTOR Rough I PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION qARTS ELECTRICAL INSPECTOR Rough ........................ ... ,...................... Service BUILDING INSPECTOR 1 Final OCCLtPC ncy Permit Required t0 Occupy Building GAS INSPECTOR I I Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. SEE REVERSE SIDE Smoke Det.