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Building Permit #635 - 80 CHICKERING ROAD 4/2/2007
BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 63 ) Date Received Date Issued: - 2,—O , * - i T i y i TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial P,1:epair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other O Septic ❑.1Nefl a �F#cid °air FR ° Wetla ds '` " ❑Watershed District ter/Sewe DESCRIPTION OF WORK TO BE PREFORMED: go -pp kr- a-NS'ILA Il XV9 O.Mj 2304•zJ d J A& LJJAft fPIS-<°o'H--i 174 OWNER: Narne:_ Address: O CONTRACT OW Nai Identification Please Type or Print Clearly) )Cf FiEL /ne inA,nis Ph ARCHITECT/ENGINEER Phone: r Address: Reg. No. FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ 71S-1 2 0/FEE: $ C'/ 6-2— Check ^Check No.:�0 /tIl Receipt No.: 000;-Pol- NOTE: Persons contracting with unregistered contractors do not have access to the guara and Signature of Aglenttowner Signature of c�ntr i�ctor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT ❑ COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS 4 ❑0 x DATE REJECTED DATE REJECTED DATE REJECTED DATE APPROVED DATE APPROVED DATE APPROVED Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes *A Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit Located at 384 Osgood Street Dimension Number of Stories: Total land area, sq. ft.: Total square feet of floor area, based on Exterior dimensions. ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes DANGER ZONE LITERATURE: Yes MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine M No NOTES and DATA — For department use ❑ Notified for pickup - Date ................................................................................................................................................................................................................................................................................................................................. Doc.Building Permit Revised 2007 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: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 ✓,4e eollli%%aiNuea��,2 0�✓l�(.�Ad NIQP ti Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR } Registr108383 Xp4ratiot>1,18!2008 f, KEEN CONSTRUClQ13© Kenneth Keen 21 Hewitt Ave,..�GZ Q...` No. Andover, MA 01845 Deputy Administrator ! j i BOARD OF BUILDIN rRE`C�UL�i4+TiM ;� s'' icerasa CONSTRUCTION SUPERVISOR NAinber —S 058245 1rthdate 03124/_1943 A� xp p31�i(i8 .Tr. no 13436 e aM est ictedr '0�3 l NAtOV 0I5`,r'r� i ' - �Cbmlp3iss nne� � . f r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' d 600 Washington Street Boston, MA 02111 r www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly / Name (Business/Organization/Individual): ,1. eeri Address:—Z 1 u -i i V- A V' 6- City/State/Zip: g. R w d,0 i/ t rz /� Phone.#: 9% 8 6g/ - S Z o 1. Are you an employer? Check the appropriate box: 1. I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for me in any capacity. employees and have workers' [No workers' comp, insurance comp. insurance.# required.] 5. ❑ We are a corporation and its 3. ❑ I am a homeowner doing all work officers have exercised their myself. [No workers' comp. right of exemption per MGL insurance required.] t c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required):. 6. ❑ New construction 7. remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12. ❑ Roof repairs 13.❑ Other •Any applicant that checks box #1 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. tContractors 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:-- 6 2 A u 1 /y +6- .S � A f � _� $ , C, ' c Policy # or Self -ins. Lic. #: LU C g g S,45'0 S 3 Expiration Date: l ^ Q 9 6 Job Site Address: City/State/Zip: 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 painondpenalties ofperjury that the information provided above is true and correct. 7-4 Phone #: !2� 7 -�, - G g', — , —z n 1 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 -contractors) 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 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 Revised 11-22-06 Fax # 617-727-7749 wevw.mass.gov/dia �IY Qi v w a U y U w" a a°' w" a w w°' G w a w a O cn GJ A uml z CL DE 0 w a T AV E Z D I y h E O CD ca I cc M CA 0 a C40 0 cc cc C403 0 W 0 LLI U) 19 W ce W N A RD CERTIFICATE OF LIABILITY INSURANCE 03/22/2007' PRODUCER (781)942-2225 FAX (781)942-2226 Gilbert Insurance Agency, Inc. 137 Main Street Reading, MA 01867-3922 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Kenneth B. Keen DBA: Keen Construction Company 21 Hewitt Ave. North Andover, MA 01845 INSURERA: NORFOLK & DEDHAM INSURANCE 23965 INSURERB: Granite State Ins. Co. 0077 INSURER C: INSURER D: INSURER E: [K�PI�'L[N7.9 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN 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 AjR_ ADDT AM TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MMIDDfYYI 03/13/2008 LIMITS EACH OCCURRENCE $ 1,000,000 21 HEWITT AVENUE OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE M OCCUR ND -P-010078/000 03/13/2007 DAMAGE TO RENTED $ 100,000 MED EXP (Any one person) $ S,000 A PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ (Ea accident) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per person) HIRED AUTOS NON -OWNED AUTOS BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY OCCUR FICLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC8855053 01/09/2007 01/09/200$ 1 WCSTAru- OTH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 100,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under E.L. DISEASE - EA EMPLOYEd $ 100,000 E.L. DISEASE - POLICY LIMIT I $ 500,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CFRTIFICATF Hn1 nFR rAKI1'G1 I ATInn1 ACORD 25 (2001108) FAX: (978)682-3231 ©ACORD CORPORATION 1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, KEEN CONSTRUCTION CO BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 21 HEWITT AVENUE OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. NORTH ANDOVER, MA 01845 AUTHORIZED REPRESENTATIVE DOREEN M DONOHUE ACORD 25 (2001108) FAX: (978)682-3231 ©ACORD CORPORATION 1988 KEEN CONSTRUCTION CO. 21 HEWITT AVE. NORTH ANDOVER, MA 01845 (978)691-5201 Harrison's Roast Beef 80 Chickering Rd. North Andover, MA 01845 (978) 687-9158 Contract # 1.657; Appendix A Date:3/29/07 Install bead board: • Supply & install MDF bead board in both dining rooms, entry area, & two islands over existing v - groove pine • Supply & install trim as necessary • Remove & replace existing tables as necessary Total Price:$7589.60 (seventy five hundred eighty nine and 60/100 dollars) Price does not include cost of permits, painting, or new tables. Payment schedule: $2500.00 due upon signing contract $2000.00 due when one dining room is complete $2000.00 due when second dining room is complete $1089.60 due when contracted work is complete f f` Customer KeaTV. Kee6 Date KEEN CONSTRUCTION CO. n 21 HEWITT AVENUE NORTH ANDOVER. MA 01845 Tel: (978) 691-5201 Fax: (978) 682-3231 Submitted To: FICAi r► jOt� 5 �za5 C i� tG�Ff it�� �C► NocU � Ian rn:tC, MP cl 'I5 H-57 F, QC1 0 Posh% L All home improvement contractors and subcontractors engaged in home improvement contracting, unless specifically exempt from registration by Provisions of Chapter 142A of the general laws, must be registered with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the Director, Home Improvement Contract Registration, One Ashburton Place, Room 1301, Boston, MA 02108 (617) 727-8598. Owners who secure their own construction related permits or deal with unregistered contractors will be excluded from the Guaranty Fund Provision of MGI_ c. 142A. PHONEDATE REGISTRATION NO. 9 % -? - 9115'Z 3 - 2 y - c MA. H.I.C. 108383 > C/S = Customer Supplied S + I = Supply + Install We hereby submit specifications and estimates for work to be performed and materials to be used: Construction related permits: FID NO 04-325-8052 WORK SCHEDULE Contractor will not begin the work or order the materials before the third day following the signing of this Agreement, unless specified here in writing. Contractor will begin the work on or about (date). Barring delay caused by circumstances beyond Contractor's control, the work will be completed by (date). The Owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall not be considered as violations of this Agreement. WARRANTY The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of following completion and shall comply with the requirements of this Agreement. In the event any defect in workmanship or materials, or damage caused by the Contractor, his subcontractors, employees or agents, is discovered within one year after completion of any job, including cleanup, the Contractor shall, at his own expense, forthwith remedy, repair, correct, replace, or rause to be remedied, repaired, or replaced, such damage or such defect in materials or workmanship.The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. We Propose hereby to furnish material and labor - complete in accordance with above specifications, for the sum of: jC t� �l `� t � � �' ��� t �� �i � 1� � �� N � 11 C r, dollars ($ '75 < 9, ) Payment to be made hs follows: r % ($ ) upon signing Contract; % ($ upon on 'a" of % ($ upon of l� L shall be made forthwith upon completion of work under this contract. KENNETH B. KEEN Name of contractor / Designated Registrant 21 HEWITT AVE. _ Sheol Address N. ANDOVER, ill11A 01845 Gry / State (978) 691-5201 (978) 682-3231 Phone Fax Notice: No agreement for home improvement contracting work shall require a _ / Name n! sa r ,.' _ down payment (advance deposit) of more than one-third of the total contract price ,�n'Pn ,l --- ti or the total amount of all deposits or payments which the contractor must make, in advance, to order and/or otherwise obtain delivery of special order materials and AuthorvEd Shrm.e equipment, whichever amount is neater. � Note: This Proposal maybe withdrawn by us A not accepted within . days. 110 0q 40RTA, 0 # S C04US "— � 2 '2- C Date. .��/ -. . . /'. . . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING. This certifies that ... ................. 4— has permission to perform .... ..................... L plumbing in the buildings of ... ........................... at. � � � !�' �' ') ................. rNorth Andover, Mass. Fee Lic. No.. ). !.i. (, )- ... .. .......... PLUIVI�ING INSPECTOR Check # 3)1 - 5388 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS BuildingLocation : Date a ,� 6 l C Owners Name /SOa / 0A -S 'rrL Permit # Amount ,2 Type of Occupancy New Renovation Replacement 010� Plans Submitted Yes ❑ No ❑ FIXTURES (Print or type) Check one: Certificate Installing Company Name ❑ Corp. Address & to JL) E Partner. usmess Telephone �i Firm/Co. Name of Licensed Plumber: ? un 5° s U v c Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Bond ❑ . Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner 11 Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work arTi-nNtallations perform under Permit Issued for this application will be in compliance with all pertinent provisions of the Mal sa setts State Plumb' Cod and Chapter 142 of the General Laws. By ig ure Or i ense um er Type of Plumbing License Title U City/Town is nse um er Master Journeyman APPROVED (OFFICE USE ONLY Location No. r,2� Date /j -/4(-az , TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 18671 Inspectv TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCTREP RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING .:: _ BUII,DING PERMIT NUMBER n-- DATE ISSUED: l ._ 77 7-7 SIGNATURE - Building Commissioner/I r of Bui!4±2 Date SECTION 1- SITE INFORMATION I Property Address: 40 C 171/ e � /C 1.2 Assessors Map and Parcel Number: �Z Map Number Parcel Number 1.3 Zoning Information: Zonis Distrid Progmed Use 1.4 Property Dimensions: Lot Area Fronts ft 1.6 BURRING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public ❑ Private 0 Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSH[P/AUTHORIZED AGENT Historic District: Yes No 2.1 Owner of Record L L— A 7q / 1G/t714r.c/S �O ,v X Name (Print) Address for Service: // Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Sipa re Telephone SE ON 3 - CONSTRUCTION SERVICES 3.1icensed Construction Supervisor: • Licensed Construction Supervisor. Address Signature Telephone Not Applicable ❑ License Number Expiration Date 3.2 R 'stered Hgme Improvement Contractor Company Name ,S—Z/A / T / ��®� C� Not Applicable ❑ 3 Registration Number `� ✓ 7 Address �y i`%r IR"tu, Expiration 11 ft Telephone M ' fe SECTION 4 - WORKERS COMPENSATION (M:G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ JAddition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: o �= �' �z �/� /2� s z1 f^X j��� PA ' re— SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item 1. Building Estimated Cost (Dollar) to be Completed b permit applicant (?FF�CIAL (a) Building Permit Fee Multiplier USE�ONLY3 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (e) X (b) A6 —6 4 Mechanical (HVAC) 5 Fire Protection 6 Total 1+2+3+4+5 o J Check Number SECTION 7a OWNER AUTHORIZATION TO BE tOMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUII.DING PERMIT I, , as Owner/Authorized Agent of subject property' Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application.; Signature of Owner Date SECTION 7b OWNERJAUTHORIZED AGENT DECLARATION ✓- I> ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief /7— Print-Name Print Nam Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 12 0 N, O z R�, A �� -0 O w > .z v cn wWU � C p w O c� v X U C w � a p u: r rj. a a U w p w c� � C w � " �, p rx C w w w w c w rA z41 cn -Nd O cn c o o O y O CJ V : 'a 1p CL C O W ;Z O O � C,* i" Ea �o ,.. a o a y EE LD a v O O r. -V O O Z Q O y p c I C c' C O •� � p Z ._ ca O O 'F m m 3.0 O O p i cc o a CL Ca c ev Qca -� •v C z � V CO) c C C C c CLCO3 uj 0 W N oc W W oc W N :oma m c E CL*-. y R z y cm ;3 y... y C O C � Mo y O O y EM Ml m m �Qzm+COC� CO V Z C Co HSH- Niz o � CD co ruj -0 C NOCL • P dt C Z LU N C •� O� a v O O r. -V O O Z Q O y p c I C c' C O •� � p Z ._ ca O O 'F m m 3.0 O O p i cc o a CL Ca c ev Qca -� •v C z � V CO) c C C C c CLCO3 uj 0 W N oc W W oc W N ��e Caa»c�nanure� a�,. %tauac�u.�ea Board of Building Regulations and Standards ^c HOME IMPROVEMENT CONTRACTOR rd� Registration: 133221 Expiration: 5/23/2007 Type: DBA KEOHAN ROOFING MICHAEL KEOHAN 54 ELM ST. N.ANDOVER, MA 01845 Administrator INSURER:. ThE TRAVELERS INDEMNITY COMPANY INSURED: KEOHAN, MICHAEL DBA KEOHAN ROOFING 54 ELM STREET NORTH ANDOVER MA 01845 Insured Is AN INDIVIDUAL WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLIC TYPE AR INFORMATION PAGE WC 00 00 01 ( POLICY NUMBER: (6KU8-7223A41-A-05 ) RENEWAL OF (6KUS-7223A41—A-04) NCCI CO CODE: 11347 PRODUCER: T F WARD INS AGCY INC 403 FRANKLIN ST MELROSE MA 02176 Other work places and identification numbers are shown In the schedule(s) attached. 2. The policy period is from 02-26-05 to 02-26-06 12:01 A.M. at the Insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of the state(s) listed here: - MA B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work In each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident: $ 100000 Each Accident Bodily Injury by Disease: $ 500000 Policy Limit Bodily Injury by Disease: $ 100000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, If any, listed here: SEE ENDORSEMENT WC 20 03 06 D. This policy includes these endorsements and schedules: SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All required Information is subject to verification and change by audit to be made ANNUALLY . DATE OF ISSUE: 02-27-05 - UK OFFICE: ORLANDO INDUS AFF 161 PRODUCER: T F WARD INS AGCY INC 28FSX ST ASSIGN: MA The Commonwealth of Massachusetts I Department of Industrial Accidents Office of Investigations ' 600 Washington Street ;II Boston, MA 02111 �c www.mass.g ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name (Business/Organization/Individual): Address:a City/State/Zip: Al' f Ae!/V g ,.��F Phone #: Are you an employer? Check the appropriate box: I . ❑ 1 am a employer with 4. ❑ 1 am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors ?. ❑ I am a sole proprietor or partner- listed on the attached sheet. 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 These sub -contractors 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' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 1 l .❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks box # I must also till 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. Insurance Company Name: Policy # or Self -ins. Lic. #:_ Job Site Address: Expiration Date: City/State/Zip: 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 tine 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 lite pains and penalties of perjury that the information provided above is true and correct. Signature: Date: #: 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 perfonnance 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 tilled 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 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance�'ith the provision of MGL c 40 S 54, a condition of Building Permit at: his that the debris resulting from this work shall be disposed of in a properK licensed solid waste disposal facility as defined by MGL 11, S 150 A.. Also, note Permits are required under Fire Prevention laws Chapter 148 Section I OA. The debris will be disposed of in: e // tq Oko 5 Fire Department Sign off: Dumpster Permit (Location of Facility) 1 Signature of Permit Applicant °F5ate � /V 6, ,? 1//-4/0 s f- /Z C),A/ TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING ^:+'-4 ;'`.-i✓- 'f„j' 'L >y a. `{ 9`, ,. k s Section for Oficial Use Onl BUILDING PERMIT NUMBER:(i� / DATE ISSUED: C SIGNATURE: Buildin COMMISSione or of Buildings Date 'iEC'l 1.1 Property Address: 1.2 Assessors Map and Parcel Number: �l(� 31 Map Number Parcel Number ( `l 1 C (tf- r 1 N 1.3 Zoning Information: Zonin District Proposed Use 1.4 Property Dimensions: Lot Area Frontage ft 1.6 BUILDING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Provide R ed Provided ReqWmd Provided 1.7 Water Supply M.G.L.C.40. § 54) Public ❑ Private ❑ 1.5. Flood Zone Information: Zone Outside Flood Zone 0 1.8 Sewerage Disposal System: Municipal On Site Disposal System ❑ ` %'� e �t'liu•gj +� 4 s e *- ,,(i 516 2.1 Owner of Record /—X�57' NdA/2�� s ��,-r0 UC A (L k-e fz 10�. Name (P Address for Service : PG*-&A)6, e 751 Signature Telephone 2.2 AuthorYed XgTnt Name Print Address for Service: Signature Telephone MWKM 3.1 Licensed Construction Supe r � w� �o� Not Applicable ❑ l-Ser7s��i Address -7S c0ckIllridt-1 Ale License Number JQ Q —2- Licen struction Supervisor P.. (�/, L % 7 i 0 Expiration Date Signature Telephone 3.2 Regi Home ImprovemekLj1ontractor Not Applicable ❑ Company Name,. , f , '7 S 1 )2 Cl% Registration Number Expiration Date Address j Q SignaM Telephone v M 0 M D z 0 z M 90 0 n r v r r z G) SECTION 4+� Workers Compensation Insurance affidavit must be completed and submitted with this application. issuance of the building permit. Failure to provide this affidavit will result in the denial of the Signed affidavit Attached Yea ....... 11 No ....... ❑ SECTION 5 - PROF$SMONAZ DO htvD ftTR1UCTION ARV1C E 1T1 01M t S U "i S SURMC TO CONSRIICTI4N Cf3iTR�(3L P+�"TC1 1k 16 CONT+ 1� GF, OF ENC`LlS)b D SPAS 5.1 Registered Architect: Name: Address Signature Telephone .3.2 itegfgtexed Pr�,f�asiei�F�s�;` � Area of Responsibility Registration Number Expiration Date Name: Address: Signature Total Not applicable ❑ Registration Number Expiration Date Name: Address Signature Telephone Area of Responsibility Registration Number Expiration Date Name Address Signature Telephone Area of Responsibility Registration Number Expiration Date Name Address Signature Telephone �yry Company Name: Not Applicable ❑ Responsible in Charge of Construction New Construction ❑ Existing Building 0 Repair(s) 0 Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition 0 Other ❑ Specify Brief Description of Proposed Work: 2:6L f&AYd A 0 Ah& d& pe&o, IA 1 B 0 ❑ B Business 0 Structural Engineering Structural Peer Review Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property Hereby authorize !� 1/L! to act on My behalf, in all matters relative two work authori6k author'by this building permit application 7130111 Signature of Owner Date USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A4 0 A-2 A-5 0 A-3 ❑ 0 IA 1 B 0 ❑ B Business 0 2A 2B 2C ❑ ❑ ❑ C Educational 0 F Factory 0 F-1 0 F-2 0 H High Hazard ❑ 3A 3B 0 0 IInstitutional ❑ I-1 ❑ 1-2 0 I-3 0 M Mercantile ❑ 4 ❑ R residential ❑ R-1 0 R-2 ❑ R-3 ❑ 5A 5B 0 ❑ S Storage 0 S-1 ❑ S-2 ❑ U Utility M Mixed Use S Special Use 0 0 0 Specify: Specify: Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND OR CHANGE IN USE Existing Use Group: Existing Hazard Index 780 CMR 34: Proposed Use Group: Proposed Hazard Index 780 CMR 34: Structural Engineering Structural Peer Review Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property Hereby authorize !� 1/L! to act on My behalf, in all matters relative two work authori6k author'by this building permit application 7130111 Signature of Owner Date I, as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury nt Name Signature of Owner/Agent ate Item Estimated Cost (Dollars) to be t } Completed by permit applicant ` 1. Building4F,5,M 0 V (a) Building Permit Fee D Multiplier 2 Electrical (b) Estimated Total Cost of Construction from (6) 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical (HVAC)+- wak d ��µI 5 Fire Protection /00 6 Total (1+2+3+4+5) Check Number iii r✓:J5 is x3 ii.. t �.f �lJ f'4 Pr t t yt tel... ZS1t �` "6 PY ifU' !u U 3' j`" yF" 3/4 27r3 Y. f t G�': )1g xLiX yk ti..i d td.`,rW1\?%z'F71 •e iii, Y 7d' 3� y t t S. 3C tf} fW�'y'td'}�1t'!A1'`al _I ,R ? ,t{72 1 f 3^x 'tf� NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS l sr 2ND 3PD SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Location C�10-vvrll-, -I>ql No. / Date ?-30 - 0 AORTh TOWN OF NORTH ANDOVER 01 Certificate of Occupancy $ Building/Frame Perrnit Fee $ Foundation Permit Fee $ Wo OU, Other Permit Fee s TOTAL $ Check # (P SCIL Building Irnspector North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed of in: (Location of Facility) Si nature o Vermit Applicant 2 - Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector PROPOSAL SUBMITTED TO: NAME ADDRESS PHONE NO 9 7�) / WORK TO BE PERFORMED AT: We hereby propose to furnish the materials and perform the labor necessary for the completion of.-.. 19. ODA . ' f _414 92 ,. OGv All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications bmitted for abLework , nd completed in su stantial work nlik manner forth su of r a� with payments to be made as follows: Respectfully submitted A'.4; Any alteration or deviation from above specifications involving extra costs will be executed only upon written order, and will become an extra charge Per over and above the estimate. All agreements contingent upon strikes, ac- cidents, or de"lays beyond our control. Note - This proposal may be withdrawn by us if not accepted within days. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above. Signature Date qA?L"2..� Signature _ D8118-- y{�[ �titi r'I .do— MADE IN USA j A\'e, F .% y AL �ti��s�trs� The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit I am a homeowner performing all work myself. 0 I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for m emplo ees workin n this job. Comnany name: © tW l Company name: Address City Phone #: Insurance Co. Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of.a fine up to $1,500.00 and/or one years' imprisonment.as welt_as_civil..penalties in-thel=.d-aSTOP.W. _ORK ORDERmd_afire af._($1D0M)-aA y.againstme. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone.# Official use only do not write in this area to be completed by city or town official' City or Town Permit/Ucensina El Building Dept ❑Check if immediate response is required p Licensing Board p Selectman's Office Contact person: Phone #• Health Department Other 0/2 �amnta�uaealdc, o�,/tiaaaac%uge�ld. BOAMOF BUILDING REGULATIO143 License:..P ONS.TRUCTION SUPERVISOR . Numbei-O _,._ 07:53.$4 p- 902 Tr. no: 75384 I i 1To: 00 RONAi_D P GAGOQN j 75 COCHREiNE Cl i METHUENMA 01844i Administrator k �I0 Z 4 O I w WE x A a Oa c o w a Cf)a a cn o U A a w w U w" 0 � W ca �' w —cdW w a � W u w w cn _cd w a O U a w F -4 A w G CQ z° cn Q o cn w O O F=4 O z T .1.1 0 0 v TIT P4 4.4 •r.a m y CDMa .E L Q O CD Q cc :-W CO2 0 Q V CO) O V cc - cc CLCOD E L 0 v 0 CL CO) c 0D C? c C 0 . 0 :5 co m m LU 0 U) U) ccw LU crw LLJ U) c o m c o � :w: O C Mo U _ O O L ® CD i:mCF oo w V :*C ftp : •.. m ' y0+ c • dEc O O Q tx- V O! m c mi �mm a y CA ; s cm m v c y cO° 2 .� . _ r O: y m Z OE m O 0:� �� c � CLC.)m m ® ` y m = O L +- •a Cm c O C �p y ft ® O :0 y O m i C1•�Z O O0 O cmc •O = m :m:3 N WM ~ W S y aSI0 mi C ;:5 -CZ O -M C m t r LU CLC .0 cm Z CLg C.3 4D ve '� O � V2 m m i y •� O � = 4. CLO. T .1.1 0 0 v TIT P4 4.4 •r.a m y CDMa .E L Q O CD Q cc :-W CO2 0 Q V CO) O V cc - cc CLCOD E L 0 v 0 CL CO) c 0D C? c C 0 . 0 :5 co m m LU 0 U) U) ccw LU crw LLJ U) 6 Location CS0 Nct Ci Date TOWN OF NORTH ANDOVER 0 Certificate of Occupancy $ Building/Frame Permit Fee $ C Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ 16 TOTAL $ Building Inspector fo/06�9 16:08 3P- 00 PAID Div. Public Works J I�I W F W W U h H J W U 7 Z O O O U U ., w z w z " CN q v1 N H Y O A l A Q H lk W o ti z z W z a .K ❑ e ,�. j �' O K � � � a a A ❑ W o o z F F z 0 F F O o 0 0 U U 0� U c w a U U U u z z z z ❑ ❑❑ Q FU^, < o o �o o U o O U O U O v .11 w w w wn a z o o U U z o H O n W tr y C/) v S ❑ ❑ ❑ ❑ m q N c to � v1 v1 r , M^i N 4 Z o� v� t�i� q ❑ � �n I� O z 0 � � z U 0 O ° J /� p W cX )1?e U ❑ 'o z w O O F a p R v w °< o M 7- O W a' En a p H G ❑ n < z w O Z < < U W Z ° W < � v v ucn W < pzp p i i a 14 J I�I W F W W U h H J W U 7 Z O O O U U ., J North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with t e provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a p#erly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed of in: OV &,,&I,v, D1,Ma4k SeteUCC1C-1 (Location of Facility) Signature of Permit Applicant i Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector ht I ./= �./ l/�%%i/%%Ni7%.��iGWL1I�019 V � '�; ,�ut W OEM t �-•..•sd:, �r� As�fL� 1Fa.-. i�N �3.LLgr�'s-•rn�w. — .. r -'S '�-^ ct.; Pte jai'. a -� '`'" .• r '�,(r.:�•,. „x.., ...a.� �� - Nus' :fzpires: Birthdate: L V�Ifv 05/12/2060 85/02/1933 R00 4 R .. _INTO i. R08ENTNi TT _ w ai �Y' r 1 20 AE6EAN OR UNIT 1 A— METHUEN, MA 01844 m a{ Sol a vski I ./= �./ l/�%%i/%%Ni7%.��iGWL1I�019 V W OEM t DEPARTMENT OF PUBLIC SAFETY CONSTRUCJUK SUPERVISOR LICENSE - Nus' :fzpires: Birthdate: L V�Ifv 05/12/2060 85/02/1933 R00 4 smy !�_ r R08ENTNi TT WNW �r�wr� �i.�r�✓ . �Y' r 1 20 AE6EAN OR UNIT 1 A— METHUEN, MA 01844 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02191 Workers' Compensation Insurance Affidavit Please Print Name: Location: City 71 am a homeowner performing all work myself. rMV_ I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name: Address City: Phone #• Insurance Co. Policy # Company name: Address City: Phone #• Insurance Co. Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify unde s an an of perjury that the information provided above is true and correct Signature Date Print name ®rO� Phone # 450411R(y �tl Official use only do not write in this area to be completed'by city or town official' Building Dept ❑Check if immediate response is required Building Dept Lincensing Board p Selectman's Office Contact person: Phone #. Health Department F-1 Other s of Z co O CD 0 bI Z v y CDy O CD L o a CD v � �(U ►-ir Q V CL CO2 O V COD C O U V O cc .0 CL CO2 0 L 0 co CL CO) c O OM C mm 0 U) U) CC W W VJ 0 a 0 o � C w w W x O z w =o o z ac z o� T .oC w ° w s o O w p w U w G w� C2 C/) 94 w co' cin cn of Z co O CD 0 bI Z v y CDy O CD L o a CD v � �(U ►-ir Q V CL CO2 O V COD C O U V O cc .0 CL CO2 0 L 0 co CL CO) c O OM C mm 0 U) U) CC W W VJ o � C i.+ ; O = C N V V 'd'C3 CLc :mcc =o of Z co O CD 0 bI Z v y CDy O CD L o a CD v � �(U ►-ir Q V CL CO2 O V COD C O U V O cc .0 CL CO2 0 L 0 co CL CO) c O OM C mm 0 U) U) CC W W VJ Location Y() d k, e(C� 6(6 0 No,, Date TOWN OF NORTH ANDOVER 0 Certificate of Occupancy $ 'MF1 Pow Building/Frame Permit Fee $ CHU Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL 4L 7,�), 9 $ Buirding Inspector a, Div. Public Works I PE&JiI'�'� APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. 1 /^ LOT NO. (� I ZONE E, `Y SUB DIV. LOOT NO.� 2 RECORD OF OWNERSHIP DATE �- BOOK iPAGE - LOCATION it /�/_ CJ f•7 S 1 PURPOSE OF BUILDING// L �T OWNER'S NAME .I� Jt n. G�s p R.!'� NO. OF STORIES , SIZE �,fY n OWNER'S ADDRESS �/1 ,l. �,_i G•V BASEMENT OR SLAB ARCHITECT'S NAME GQ�.' ✓I../U SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME A�!`, ���/ /v SPAN DISTANCE TO NEAREST B✓/UIILDING -- DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES — SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION /C 2 Q� IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE Z4 IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS RLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED // SIGNATURE OF OWNER FEE DC7. PERMIT GRANTED -34 19 4H31 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST EST. BLDG. COST PER SCr FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY OWNER TEL. # I 37 CONTR. TEL. # CONTR. LIC. # lfl -IL m I � �i -4 `�' � . � ` � ,. -- _� i � � � � "a' � �' r. � 111 i; ,� I �' �� ,s-. �� ,�' STieXS .� �� - � ��y -y -� �� 7 rte,,-�' �� _ ,������ �� ��� ��°-`� �� ���o.� y�s�F� OCEAN (! 3'INC. CHEMICALS (012) 234-1236 440 MAGAZINE AVENUE POST OFFICE BOX 1667 SAVANNAH, GA. 31402 CABLE: OCEANCHEM, SAV. COMPARATIVE ANALYSIS OF WHERE AND WHY TO USE OCEAN 776/777/778 OR OCEAN 431/432A/433 Relative to our two clear, fire retardant varnish systems, we offer the following advice: Our Ocean 431/432A/433 system is vulnerable to attacks from water, condensation, or cleaning. When exposed to these conditions, it has a tendency to become milky or cloudy. Ocean 433 Overcoat will minimize or eliminate this condition under normal circum- stances. We recommend that this system be applied only on wall paneling or surfaces which will not receive a great deal of the above adverse conditions. Where a clear, fire retardant varnish system is required, for applications such as wooden doors, door jambs, cabinets, moldings, wainscoating, furn- iture and other areas that must withstand heavy traffic and/or an appreciable amount of washing and scrubbing, then our Ocean 776/777/778 two -component, polyurethane system MUST be used. Both of the above systems have been tested in accordance with ASTM E-84, NFPA Standard 255, and the U/L "Tunnel Test" 723. Please note that Ocean 778 Satin or Gloss Overcoats are entirely optional and are to be used to change the sheen of 777 plus provide maximum durability and cleansability. These two overcoats must NOT be used in lieu of 776 and two coats of 777. The same basic premise holds true where 433 Satin or Semi - Gloss Overcoat is to be applied over two coats of 432A Flat Varnish. Frankly, you will find that the 776/777/778, varnish system would be much more adaptable to the general wear and tear and cleaning conditions prevalent in applications such as, restaurants,.hospitals, schools, and day care centers. ATTENTION: PLEASE NOTE THAT 432A FLAT FIRE RETARDANT VARNISH IS A CLASS "A" CLEAR, ONE -COMPONENT COATING FOR INTERIOR USE ONLY. THE 777A VARNLSH SYSTEM IS NOW ALSO CLASS "A", 9/82 FIRE SAFETY PROTECTIVE COATINGS - MASTICS - CLADDINGS Milieu Business Carpet May 30, 1984 Warrens Floor Covering 204 Broadway Lawrence, MA 01840 RE: ARGYLE/ACTIONBAC Dear Sirs: This letter will act as certification that Wellco Carpet Corporation has submitted for flammability test our carpet style ARGYLE/ACTIONBAC. This test was conducted in accordance with requirements set forth in ASTM -E-648 testing specifications, and this style has successfully passed the test. The results are as follows: CRITICAL RADIANT FLUX: .31 This style was also tested in accordance with ASTM -E-662 testing procedure for the N.B.S. Smoke Chamber. The results are as follows: N.B.S. SMOKE CHAMBER #: 371 Should you require additional information, please do not hesitate to contact me. Sincerely, WELLCO BUSINESS CARPET 4rances Harmon Administrator of Contract Services FH: ec/sa CC: Mr. John Williamson DIVISION OF WELLCO CARPET CORPORATION POST OFFICE BOX 281, CALHOUN, GA 30701-9987 SALES OFFICE SPACE 13-141 THE MERCHANDISE MART CHICAGO, IL 60654 OCEAN CHEMICALS 9EDINC. 440 MAGAZINE AVENUE P.O. BOX 1887 SAVANNAH, GA. 31408 /A1A*fY)WR8 PRODUCT INFORMATIOR OCEAN NO. 777 INTUMESCENT SEMI -GLOSS FIRE RETARDANT VARNISH * CLASS A SYSTEM * CLASS B SYSTEM Ocean Fire Retardant Varnish System No. 777 is a Clear Catalytic Polyurethane Varnish. It is formulated to combine intumescence and fire retardancy with exception hardness, abrasion resistance, flexibility, rich appearance and good application qualities. When attacked by flame, Ocean No. 777 Fire Retardant Varnish expands and forms a thick, cellular, char matrix (intumescence) over the substrate which reduces heat penetration, retards flame spread, blocks release of potential fuel, and minimizes smoke development and release of toxic gases. * Application properties are identical to a conventional catalytic varnish. * The system offers three esthetically attractive finishes: • .....Semi -gloss (fire retardant varnish itself) .Satin or Matte (overcoat) .....High gloss (overcoat) * Both overcoats contain ultra -violet light absorbers which aid in limiting film degradation from exposure to sunlight. * Periodic washing for maintenance purposes will neither cause water spotting nor leach intumescent ingredients from the film. cean No. 777 System is recommended for INTERIOR application on any combustible or non- combustible substrate where a clear finish is desired - doors, paneling, kitchen cab- inets, storage cupboards and shelving, window trim, furniture, et cetera. Ocean No. 777, Class "A" is designed to be used where a coating meeting Federal Spec- ification TT -C-1833 is required. This system consists of three functional components: (1) a sealer, (2) an intumescent varnish, and (3) an optional decorative/protective overcoat. These components are as follows: 1. A clear, single component fire retardant sealer, Ocean No. 776, specially 1 '7 4 formulated for use with Ocean No. 777. Coverage is 400 to 650 sq.ft. per et) U.S. Gallon; per coat. One or two coats may be require epen in i fie' p o s i f y of`iie surface . Information provided herein is based on tests believed to be reliable. Our products are sold on condition that the user will evaluate them to determine their suitability for his purpose. Ocean Chemicals, Inc. makes no guarantee or warranty since they hove no control over application conditions OCEAN CHEMICALS INC. 440 Magazine Avenue P. O. Box 1667 Savannah, Georgia 31402 34.1236 Page 2 61 2. Ocean No. 777 is an intumescent catalytic polyurethane fire retardant varnish (� which dries to a hard, semi -gloss finish. Coverage is 250 to 270 s .ft. ....er w..—..,L � U.S. Gallon, per coat Net coverage is 135 `s ,,:2 Xpa,S,,, . A * J A Class A flame spread requires 2 coats at 270 sq.ft. per gallon, per coat. * A Class B flame spread requires 1 coat at 250 sq.ft. per gallon. 3. Ocean No. 778 Satin Overcoat is a two -component polyurethane, it may be used on all interior surfaces where a satin (matte) finish is desired. Coverage is 500 to 600 sq.ft. per U.S. Gallon. One coat is required. Ocean No. 778 Gloss Overcoat is a two -component polyurethane, it MUST be used where there will be exposure to free standing water, such as on bar or table tops. Coverage rate is approximately 600 sq.ft. per U.S. Gallon. Two coats are suggested for best protection. The Ocean No. 777 System, tested in accordance with ASTM E -84-81a (NFPA 255), has been assigned the following Fire Hazard Classification: Surface Douqlas Fir Flame Spread 25 Fuel Contributed 10 Smoke Developed 230 No. of Preliminary Coats (776) 1 No. of 777 Coats 2 Rate Per Coat (Sq.Ft. Per Gal.) 270 A copy of the test report is available upon request. APPLICATION INSTRUCTIONS: OCEAN NO. 776 SEALER GENERAL DESCRIPTION: Douqlas Fir 45 25 215 •1 1 250 Ocean No. 776 is a clear, hard, specially formulated sealer developed for use as a surface preparation for Ocean No. 777 Intumescent Fire Retardant Varnish. It is a one -component ready -to -use coating. Partially used containers may be retained as long as the cans are resealed after use and kept airtight. NEW SURFACES: Staining or filling must be done prior to sealing. Staining should be done with a non-bleeding type of stain. Apply a full-bodied coat of Ocean No. 776 with a natural bristle brush or spray. Allow overnight dry at a temperature not below 550F before recoating with Ocean No. 777. Porous woods, such as oak and teak, may require a second coat of Ocean No. 776. If the grain is lifted by sealing, light sanding is necessary before recoating. Use Ocean No. 776 T special reducer for cleaning equip- ment. Do not thin the sealer for brush application, but up to 20% per gallon of Ocean No. 776 Thinner may be added for spray application. Proper sealing will give a uniform angular sheen. Look for it! CAUTIOfN: Other types of sealers may not be compatible with Ocean No. 777. • 0 PREVIOUSLY FINISHED SURFACES: Page 3 Previously finished surfaces must be sanded or chemically roughened to remove all gloss, loose, or poorly bonded material. Wash with Ocean No. 776 Thinner to re- move any residual grease, wax, oil, or other foreign matter that may interfere with adhesion and allow to dry thoroughly. Seal as with new surfaces. To determine adhesion and compatibility, test patch a small area. If lifting develops, it will be necessary to completely remove the previous finish before proceeding as with new surfaces. OCEAN NO. 777 INTUMESCENT SEMI -GLOSS VARNISH Mix thoroughly equal parts (by volume) of Ocean No. 777 Component A and Ocean Nlo. 777 Component B. Allow to stand for 30 minutes, then strain and apply over the dry Ocean 776 Sealer (pot life will be 12-24 hours, depending on temperature). Apply two coats of Ocean No. 777 by brush or spray at a coverage rate of 270 sq.ft. per U.S. Gallon, per coat. (Two coats at the recommended coverage rate are required to achieve a Class A rating. Allow 18-24 hours drying time at temperature above 60OF before recoating. Sand lightly between coats. Equipment used in application should be cleaned thoroughly with Ocean Special Solvent No. 777/778 T. OCEAN NO. 778 SATIN OR OCEAN NO. 778 GLOSS OVERCOAT For a satin finish, mix thoroughly equal portions (by volume) of Ocean No. 778-S Component A and Ocean No. 778-S Component B. Allow to stand for 15 minutes minimurn, then strain and apply. (Pot life will be 12-24 hours, depending on temperature). For a gloss finish, mix thoroughly equal portions (by volume) of Ocean No. 778-G Component A and Ocean No. 778-G Component B. Allow to stand for 15 minutes minimurn, then strain and apply. (Pot life will be 12-24 hours, depending on temperature. For interior applications only, apply Ocean 778 Satin or Gloss Overcoat by brush or spray at a coverage rate of 500 to 600 sq.ft. per U.S. Gallon. Spray application will always give the best appearance, especially when applying 773 Satin Overcoat. Dry overnight at temperatures above 60OF before recoating. Sand lightly between coats. Equipment used in application should be cleaned thoroughly with Ocean Special Solvent No. 777/778 T. SYSTEM WET FILM THICKNESS SCHEDULE Ocean No. 776 - Approximately 3 mils Ocean No. 777 - Class A - each coat - 6 mils (� Class B - 6 to 7 mils If varnish is thinned, the wet film thickness must be increased proportionally Ocean No. 778 S/G - Approximately 3 mils Page 4 SYSTEM DRY FILM THICKNESS SCHEDULE Ocean No. 776 - .25 mils but inspect for angular sheen and recoat if necessary Ocean No. 777 - Class A - 5 to 6 mils required Class B - 3 to 3.5 mils required Ocean No. 778 S/G - .75 to 1 mil NOTES: (1) Ocean No. 778-G is required for interior applications where standing water may be anticipated as on a counter top or table top. (2) No reducer, other than Ocean Special Solvent No. 777/778 T may be used for reducing Nos. 777, 778-S, or 773-G. (3) Ocean Nos. 777 and 778 should not be stored for periods longer than six months prior to use. Opened, mixed cans should be used as soon as possible. Any re- maining material must be discarded. (4) Under no circumstances should Nos. Ocean 777, 778 Satin or 778 Gloss be inter -mixed. Components A and B are not interchangeable. Each Component A must be mixed with the appropriate Component B. (5) Packaging: A standard 1 gallon kit has Component A in a half -full, 1 gallon can, to which must be added Component B, which is packed in a full 1/2 gallon oblong can. A standard 5 gallon kit - Available only in 10 gallon increments - has Component A.in,two half-full,5-gallon pails to which must be added equal amounts of Component B-, which is packed in a full 5 -gallon pail. WARNING ADEQUATE VENTILATION MUST BE PROVIDED DURING AND IMMEDIATELY AFTER APPLICATION. AVOID BREATHING VAPORS OR SPRAY MIST. MASKS SUITABLE FOR ORGANIC VAPORS ARE RECOMMENDED WHEN VENTILATION IS QUESTIONABLE. OCI 12/83 • OCEAN CHEMICALS INC. 440 Magazine Avenue P. 0. Box 1667 Savannah, Georgia 31402 234-1236 Ocean Chemicals' products have an Underwriters' Labora- tories rating, or meet federal or military specifications. Ocean Chemicals' coatings include paints, varnishes, and mastirrs— over twenty-five different prod- ucts in all. Published by: National Paint 3 Coatings Association 1500 Rhode Island Avenue, NW Washington, DC 20005 R 21OCEAN CHEMICALS INC. 440 MAGAZINE AVENUE P.O. BOX 1667 SAVANNAH, GA. 31402 9121234.1236 Sel112ting Intumescent architectural paint is a special type of interior coating characterized by an ability to effectively retard the progress of a building fire. In case of fire, materials coated with intumescent paint are less likely to ignite and less smoke will be generated. By reducing the spread of flames along a painted surface, intumescent paints provide an extra margin of safety to occupants by giving them minutes longer to escape before smoke fills the building: Oz NW ei W Z F= � WW~Q =mZ Experts have studied what happenswhen a building catches fire and the fire is not controlled. They have found that there are three stages in a building fire: flamespread, flashover, and total combustion. Using intumescent paint on a building can minimize property damage and save lives. When properly applied, this type of paint can retard flamespread, and postpone or prevent flash- over. FLAMESPREAD, the first stage, takes the form of a rapid succession of flames that pass over walls, ceilings, floors or sup- porting timber. The travel rate of flamespread can be as high as 20 feet per second depending upon the combustibility of the materials in the building. As the air becomes more intensely heated, toxic gases are released and the oxygen supply depleted. This results in a large amount of radiant heat. Wood, wallboard, surface coatings and other combustible materials ahead of the spreading flames become heated and draw the flames over a constantly wider area. As flamespread prog- resses, the heated surfaces release great volumes of com- bustible gases into the air. When this mixture of gases and air reaches a critical proportion it ignites. The result is flashover. FLASHOVER is identified by a thunderous popping noise that blows glass from windows and sends flames flashing out of every opening. It signals the transition from localized burning to the envelopment of the build- ing. The aftermath is usually a steady burning that ends in total destruction. At this point the rate of the fire's progression depends upon the amount of draft. TOTAL COMBUSTION of the building materials is the final stage of the fire. Again, the rate of the destruction depends upon the amount of air reaching the burning area and the combusti- bility of the substrate. With exposure to heat and open flames, a surface coated with intumescent paint will swell into a layer of protective and insulative foam hundreds of times the thickness of the orig- inal paint film. If heat persists, the foam will expand rapidly to delay contact between the material underneath and the flames. The insulating foam impedes flamespread and holds down smoke and the evolution of radiant heat, thus, delaying the ignition of walls, ceilings and supporting timber. The foam also keeps the surface underneath from heating up rapidly. This reduces the evolution of gases, which retards the advance toward the flashover stage. The fire -retarding foam does more than increase escape time; it also minimizes property - damage. If the fire hasn't been too extensive or burned too long, the substrate may still be sound. In many instances the dry, charred foam can be scraped off, and the walls, woodwork or timber can be repainted. A number of large scale burning tests have found the protective action of an intumes- cent coating to be a major factor in keeping a fire within bounds until it could be extinguished. However, while intumescent paints can provide an extra mar- gin of safety, it must be recog- nized that surfaces coated with intumescent paints can burn under severe fire conditions. Selecting a fire retardant paint is quite simple. Many intumes- cent paint can labels list the product's flamespread rating as tested and rated by an indepen- dent testing laboratory, such as Underwriters Laboratories, Incorporated, the coverage required to achieve that rating, smoke evolution ratings, and the types of surfaces used for test- ing. They may also provide data from burning tests and make recommendations for or against specific uses of intumescent paints. When estimating how much of the product you will need you should consider the number of coats you plan to apply, coverage (sq. ft./gallon), and the film thickness required for a given flamespread rating. Remember, 4 I 1 ;4 M 0 MV. I"IfF I'M 11 00 ITT" I 1 ;4 M 0 MV. I"IfF I'M 11 00 440 MAGAZINE AVENUE P.O. BOX 1667 SAVANNAH, GA. 31402 The Company Ocean Chemicals, Inc., located in Savannah, Georgia, manufactures and markets a proprietary line of special coatings in the fire retardant and thermal protection fields. All products have either an Underwriters' Labora- tories rating, meet certain military or federal specifications, or have been developed to meet customers' special needs. The Company was founded in 1958 when fire retardant coatings with a fire reactive composition were an oddity. Ocean Chemicals, through years of extensive research and development, has a complete line of fire retardant (intumescent) coatings which are high in quality, durability, and ease of application, and are the equal of the finest quality conventional coatings in compatibility with environmental guidelines. The Company maintains a technical marketing office in Washington, D.C., and a research and development laboratory co -located with the manufacturing facility in Savannah, Georgia. Homer OCEAN Fire Retardant Coatings Work When a surface coated by Ocean fire retardant coatings is exposed to heat and flame, as in a real fire con- figuration, the coating puffs up (intumesces) and forms a thick, insulating matrix which prevents the pene- tration of heat to the suface underneath and confines surface spread of flame along the coated surface. Its reaction seals out the oxygen required for combustion, so that only the most intense exposure to heat can char the under -surface. This matrix or crust which is formed is known as intumescence and is composed of tiny air cells which build up to a thickness of approximately 200 to 300 times the original coating thickness. Underneath this intumescent matrix, the surface may become discolored but remains structurally sound. aV;_ Why Use OCEAN Fire Retardant Coatings? According to the National Fire Protection Association, there is a major fire every 25 seconds of the day and night for a total of 1,270,000 fires per year. In this last year there were 76 school fires and 43 hospital fires every day. Again in 1975, in addition to the tremendous property damage of $4,400,000,000, over 11,800 people lost their lives due to fire and smoke inhalation, and preliminary figures for 1975 indicate over 150,000 people were seriously injured. There have been many fires in which the building has not suffered extreme property damage but in which there has been a heavy loss of lives due to composition of the combustible materials in and on so-called non- combustible surfaces. Many lives are lost due, not so much to the fire itself, as to the high heat build-up and density and toxicity of the smoke created. The use of a fire retardant coating on any substrate reduces the flame spread of that surface and, more importantly, eliminates the phenomena of "flashover" and controls the emission of toxic smoke and heat which would quickly produce an environment in which many cannot live for more than a few breaths. It is been Ocean Chemicals' policy that in order to be universally accepted as a leader in the production of fire retardant coatings and systems, approved fire treatment must meet the following criteria — they must: (a) Provide protection required (b) Retain their fire retardant qualities (c) Be economical (d) Be safe to handle, non-polluting, and of low toxicity. The nucleus of the product line comprises some twenty-five highly specialized coatings, some of which have been in use for 15 years or more. OCI 5-77