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Miscellaneous - 115 MAIN STREET 4/30/2018 (3)
Cl 7r D i Location )1--) H(,,, 6A - 06, o"I� No. Su 14—Zv 13 Date /a 7 Air • • TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee 5 �� $3� '— TOTAL $ Check#oA" 26036 �b uilding Inspector i a pORTFj o��t61D 16, '1p TOWN OF NORTH ANDOVER t° SIGN PERMIT p0"AT1E M�SSACFILIS�� DATE: December 17_._2012 PERMIT: S014-2013 THIS CERTIFIES THAT Chama Grill has permission to erect. on 115 Ma in Street — 4 35"x17" self adhesive si ns Chama Grill for windows and eov'e 9 i hchours of o eration provide that the person accepting this Permit shallevery r a conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. egulations, Section #6, Voids this Violation of the Zoning of Sign RPermit. INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED I4D __Z4uildingsr of B Amount Paid:$30.00 Check 227 Receipt 26036 S> GN PERMIT APP]LWATION 11600 Osgood Street Buildling 20, SmAte 2-36 TOWN OI' NORTE1 AMOVER Date: In Name of applicant'who Is purchasing the sign j_ j Tom- j Sflte OwnerM l,L `` I L-i `S� ° I Phone#of applicant who is purchasing the ilgn 92� "'�d (gyp " Site Address ��� m ri ll� T N©V�h 1�L,pPt- Name of sign com an C 1 � compan JI h 1 . �G Phone#q�k'o?0_k_d0/a - Size of Proposed Sign `-� x " ti l ?'' I l s�o Parcel Illumination: t Not illuminated b)Roofglow attached: a)Against the wall � Internally illuminated c)Ground i. c)Eby illuminated d)Other_W tit Materials: 5e If u c1 he si l-e. )*0 k emtd l�t tc ill nLj, Proposed Colors: Background Lettering rf\&In I I.c, byx s i omnnp _p4JU Border Cost of Sian A,!)1p 01 exp Regumired Aftrachmennts: Eote: No permanent/temporary sign shall be erected,or enlarged until an Photographs of building✓ application on the appropriate form furnished by the Sign Office has been filed Colonsample Material with the Sign Officer containing such information including photographs,plans Color and scale drawings,as he may require,and a permit for such erection,alteration, Site or Plot Plan(Required for,all free-standing signs) or enlargement has been issued by him. Such permit shall be issued only of the Drawings of proposed sign✓ Sign Officer determines that the sign complies or will comply with all Other,specify applicable provisions.of the By-Law. Will sign overhang any public road or walkway Yes( ) No 4 If Yes,Name ofAgency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE]FYLED: Receipt# Check# A/I Revised 10.31.2006Borm sign Permit Application SIGNATURE OF APPLICANT APPROVED B Q 4 GU�52 1 o Foe Chama Grill Logo: „ r -35"x 17" -Vinyl applied letters/logo. I -Colors:bright orange and metallic brass. AN EDEN snow ram �L.�i�� ./lir ����� ,";:µ{ �- � �, "`"""' f■�.�1■�. �t - tea. - -a1,■�■.11w�+�.■�israi�r rsr rt , LI z 7671 �7 CIE] F�Fl� F DEI _ ren HAMAry i Chama Grill Logo, M' -35"x17^ „. -Vinyl applied letters/logo. " ,y e -Colors,bright orange ! and metallic brass. 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'�:'••e•Y"5'S%; 'k _ ����. � - - - '. �+�;r”, �•,�sis' �•;".',�,:,�_ ..�� Ya�y.:ek �`�. .s.,K >':lq'- �`x"�<#*^, •��,�.,.,.;�..� f '� '"x y,`se,�:r'{t. Y" �. 't'rYt� :�' ,•Z,,{�e ...s` =?. >r.•g�tldt t �_ t�.sc2-"y,...,d+ .'ee ;"'.a 't, '�? ;�,i - .r '% y; �Ff.�.N, .��ic'�S','�t ,� .� :^✓`s` �a.' ��. ��. ��•y�,.f;"i•'-'t�• �r��z.r�.StR1�'it";^ •s. :s''it zy.: w'.a,;."` '� ,.+o.a"� vx4 3 a 3'�' ';�Y:,, a ^ .�Ij}, ;•¢�� y� �."yE� �3-�jf W. iF�.d ti P^d' x) ��.l�k 'Yac"�' }.: .`,i -�rr H '�f ( � "'Y �A*' a+`R t'•ab: ,t� i f+.,f ✓ 't {' t �Y9 E z 2 ;yt"�Y� +1`W K F f�� ,f'.. �,.� �'it�� ¢ „„ j fin,y� wy �•r S ,� t � s. •� s1 xel-v�#."•�..�x,T..+ x ^'r x'•��r.g,'j Crry,. .�k� eS��� r : 5;Z.'t•;�f ,r' "t :,�` t ,•�+ � '> s. 1. 1 r ,. 11 iy CHAMA Grill I-T ri Chama Grill Logo: -3.5"x 7.5" -Vinyl applied letters/logo. WO, U R WO - -Colors:bright orange ND 3: 00". 9: and metallic brass. Charna Hours, 16"x8.75" MI -All hours cut in white vinyl. -A `T The Commonwealth of Massachusetts i City\Town of North Andover Certificate of Inspection . In accordance with 780 CMR, Chapter 1 (The Sixth Edition of the Massachusetts State Building Code) and Chapter 304 of the Acts of 2004 (an Act to further enhance fire and life safety),this certificate of inspection is issued to the premise or structure or part thereof as herein identified. Identify Name of Establishment Certificate No. Issued to 125-2012 Chama Grill Certificate Located at 125 Main Street,North Andover, MA 01845 Expiration May 2013 Use Group Restaurant Allowable Classification(s) 116 Dining Occupant Load 26 Bar Area 142 This certificate of inspection is hereby issued by the undersigned to certify that the premise,structure or portion thereof as herein specified has been inspected for general fire and life safety features. This certificate shall allow for the temporary use as herein described and in conformance with any and all conditions as identified below. It.shall be framed behind clear glass and\or laminated and posted in a conspicuous place within the space as directed by the undersigned. Failure to post the certificate,failure to comply with conditions or,tampering with the contents of the certificate is strictly prohibited. Conditiuris of Temporary Use Name of Municipal Name of Municipal Date of May 2012 Fire Chief AndrMelnikas Building Commissioner Gerald Brown Inspection Signature of Municipal Signature of Municipal Date of Fire Chief Building Commissioner Issuance May 2012 NORTH ANDOVER,MASSACHUSETTS PLUMBING FINAL AFFIDAVIT Permit No. To the Inspectional Services Department: Re: Chama Ward I certify that engineers under my supervision have observed the work associated with Permit No. 3 K.)—.2,/- ,dated K--// , locus 125 Main Street,North Andover MA 01845 and that to the best of my knowledge, information and belief the work has been done in conformance with the plumbing plans, approved by the Inspectional Services Department and with the provisions of the Massachusetts State Building Code and other pertinent laws and ordinances. Engineer's Name: Peter J. Reilly,PE ®FMq� ((1frP ERJ. Engineer's Registration Number: 47826 ��y Company Name: AKF Group,LLC Yl/nl Address: 41 Farnsworth Street, 3rd Floor,Boston, MA 02210 Date: May 23, 2012 Then personally appeared the above-named Peter J. Reilly, PE and made oath that the above statement by him is true. Before me, LLU EY Notary Public .--,XGs10N 0PJ0 25, y M Commission expires: August 25, 2017 NORTH ANDOVER, MASSACHUSETTS FIRE PROTECTION FINAL AFFIDAVIT Permit No. To the Inspectional Services Department: Re: Chama Ward I certify that engineers under my supervision have observed the work associated with Permit No. 3-Z-9— .z7(, ,dated /-r._ 2 Y—r( , locus 125 Main Street, North Andover MA 01845, and that to the best of my knowledge, information and belief the work has been done in conformance with the fire protection plans, approved by the Inspectional Services Department and with the provisions of the Massachusetts State Building Code and other pertinent laws and ordinances. Engineer's Name: Peter J. Reilly, PEEN OFl�,�� PE`PfER d. Nr p REOLLY Engineer's Registration Number: 47826 C RRE PROTECTION 9 No.47 Company Name: AKF Group,LLC V'i'fY Address: 41 Farnsworth Street, 3rd Floor,Boston, MA 02210 Date: May 23,2012 Then personally appeared the above-named Peter J. Reilly PE and made oath that the above statement by him is true. Before me, _ f A \\\\\11i11111i1i1/!!/!!/ / A A No,.. � •••• �S'). . Notary Public . ,•o\J. ,25,zpElp9•� yi _ My Commission expires: _ August 25, 2017 �s �'�':'TAFlYPV��•OQ �,� H1 NORTH ANDOVER, MASSACHUSETTS ELECTRICAL FINAL AFFIDAVIT Permit No. To the Inspectional Services Department: Re: Chama Ward I certify that engineers under my supervision have observed the work associated with Permit No. 3 9J_ dated / K 1/ , locus 125 Main Street, North Andover MA 01845 that to the best of my knowledge, information and belief the work has been done in conformance with the electrical plans approved by the Inspectional Services Department and with the provisions of the Massachusetts State Building Code and other pertinent laws and ordinances. This affidavit is valid based on items identified in AKF's final punch-list being addressed and installed as required. Engineer's Name: Daniel A. Hurley, PE H OF DANIEL y Engineer's Registration Number: 41825 EL HUJRLE F 4 25 v' Company Name: AKF Group,LLC ss�ON I FIR G��F Address: 41 Farnsworth Street, 3rd Floor, Boston, MA 02210 Date: May 23, 2012 Then personally appeared the above-named _ Daniel A. Hurley, PE and made oath that the above statement by him is true. Before me, ``ppuqunHprgir,, . ����o����NEY g�S;•.,,y � `•�� M6s2�J5c 2 FA���y�y Notary Public Cj My Commission expires: ' August 25,2017 I,rr f?!i�i ii411�t�``i NORTH ANDOVER, MASSACHUSETTS HVAC FINAL AFFIDAVIT Permit No. 3 .2. To the Inspectional Services Department: Re: Chama Ward I certify that engineers under my supervision have observed the work associated with Permit No. dated /o_„9�—// , locus 125 Main Street,North Andover MA 01845 and that to the best of my knowledge, information and belief the work has been done in conformance with the HVAC plans approved by the Inspectional Services Department and with the provisions of the Massachusetts State Building Code and other pertinent laws and ordinances. This affidavit is valid based on items identified in AKF's final punch-list being addressed and installed as required. Engineer's Name: David P. Roberts, PE ��� OF Engineer's Registration Number: 36830 30 ; �AL Company Name: AKF Group,LLC Address: 41 Farnsworth Street, 3rd Floor, Boston, MA 02210 Date: May 23,2012 Then personally appeared the above-named David P. Roberts PE and made oath that the above statement by him is true. Before me, v4EY 9/ SCION +• �i,� 25,20A�C P Notary Public e . My Commission expires: '}•S, Off•'�]AFyp�}e1•.0 ANC X S `l� August 25, 2017 99cambridge architecture + interiors 319 A Sfreef Su to 56 Bosfon,MA 02210 i 617 426.6800 ;99combr3ege.com FINAL CONSTRUCTION CONTROL AFFADAVIT Project Name: Choma Restaurant Project Location: 115 Main Street, North Andover, MA 01845 Project Description: Restaurant Permit Number and Date: #382-2012 1 Oct. 28, 2011 As a Massachusetts State Licensed architect, I certify that I, or an authorized representative, have performed the necessary professional services and was present on the construction site at intervals appropriate to the stage of construction to become familiar with the progress and quality of work and determine that the work was performed in a,manner consistent with the construction documents. To the best of my knowledge, the construction complies with the provisions of Article 107.6.2.1 Eighth Edition of the Mass State Building Code and other pertinent laws and ordinances applicable to this project. A May 23, 2012 Signature Date Sally A. Gibson Printed Name 20275 Mass State Registration No. Registration Seal: A. GtB�, 0 No.20275 CAMBRIDGE 'gyp MA �liN OF M��SP LINEA 5, inc. 195 STATE STREET BOSTON,MA 02109 &gInecture Engineering 617.723.8808 Interior Design FAx 617.723.8898 FacilityAssessments STRUCTURAL FINAL AFFIDAVIT To the Inspector of Buildings,Town of North Andover: I certify that I,or my authorized representative,have inspected the work associated with Permit No. 382=2012, dated October 28,2011,for the renovations at the Chama Grille, 125 North Main Street, North Andover,Massachusetts,and that to the best of my knowledge,information,and belief the work has been completed in conformance with the permit and structural plans approved by the Building Department and with applicable provisions of the Massachusetts State Building Code and other pertinent laws and ordinances which I have identified. Robert S. Cotta 33894 Structural Engineer Mass. Reg.No. r Linea 5,inc. Company COTTA STMMIVtai. 195 State Street Boston MA 02109 Address (617) 723-8808 Phone Then personally appeared the above named Robert S. Cotta and made oath that the above statement by him is true. Befor me, ``,,,i{1`IIF/i1clNllf/f it Not Pub ,My Commission expires: L U Y AC NUst� FARSC Projects\)25 Main St-NAndovcr\11143-0t_Struct Final Aff€davit.doc Date./I....a I. .............. NORTH AL TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSAc US� This certifies that ..... v ..�—A"5 .... has permission to perform ... . . 1 (1! 1 ............W.1.! ...I ...... wiring in the building of... }' .4x11. ....... ...................... ... �'......./?1Gtl11...... ... .North Andover,Mass. �ee � Lic.No. ...177 ................. .......... ......... . . ... . . ............ ELECTRIC S E R Check N 10465 Date. .h70 /* ".Z. . ... . . WOR7h pF „ao ,e 11% ` TOWN OF NORTH ANDOVER 1 9 • PERMIT FOR GAS INSTALLATION 7SSACMUSEt This certifies that . . !.1 G' . . . .,�t�91/S. . . . . . . . . . . . . . . �fC �/�I SL f/FYI has permission for gas installation . . . . . . . . . . in the buildings of . . . . . .; .G�a. . 7Cvl� . . . . . . . . at . . . . . . . . ., North itdover, Mass. ` Fee� 6. . Lic. No..'�°. . . . . f. . . . . GAS INSPECTOR V Check# CO,y'(9 8069 9 2 9 9 Z12 fez t (Date. . . . . . J. . . . . . TOWN bF"NORTH ANDOVER PERMIT FOR PLUMBING SSACMUS� This certifies that . //�!�. . 1.!a . . . . . . . . . . . . . . . . . . . . 3. . . . . . has permission to perform . .�mmP .... . e� plumbing in the buildings of .'-y`91Z-570 . . . . ?.'.� .!!`ff . , . , at. . .q�?S. . �1�. . . . . . . .S7—. . . . . . ,. No&t Andove , Mass. Fee. 1. '� 3�Lic. No. / / . . PLUMBING INSPECTOR Check # 7�. J k b t 02S 00 _ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK I W- 4-P, CITY, N A N o G v•jr MA DATE I ?--1 '-12— J PERMIT# JOBSITE ADDRESS I Z5 I OWNERS NAMSrNvI—AO P OWNER ADDRESS T.EI-17 79 ?74- 777& IFAX I TYPE OR OCCUPANCYTYPE COMMERCIAL�i EDUCATIONAL ( RESIDENTIAL PRINT CLEARLY NEW:�-I RENOVATION:I ( REPLACEMENT:( ( PLANS SUBMITTED: YES.J,-f NOI I FIXTURES-1 FLOOR- BSM 1 2 3 4 5 6 7 a 9 10 11 12 13 14 BATHTUB j CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM ! DEDICATED GASIOIUSAND SYSTEM DEDICATED GREASE SYSTEM { 4 DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM I — DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR INTERIOR KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL ! } SERVICE/MOP SINK 2. 1 ►. I TOILET URINAL - WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER I I I.0,Aj J Sauk --I — c z f _ I S tV INSURANCE COVERAGE: I have a ctfrrent Iia- bility insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES NO ( I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY BOND( I OWNER'S INSURANCE.WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER AGENT I SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the permit issued for this application will be in compliance m otih all Pertinent provision of the Massachusetts State Plumbirxl Code and Chapter 142 of time General Laws. PLUMBER'S NAME[R010 I4144kw-s 'LICENSE#1316] SIGNATURE MPI I jPY I CORPORATION) j#' (PARTNERSHIP{ I# ILLG( r COMPANY NAME( rJ� n>s I�Iupzlj ADDRESS CITY I O�JIr� I STATEA� o a 1 a / ( i ' IZIP I �( l TEL( G 7 a� �UoK ! FAX I CELL 161)2Mfr eO�MAIL Jr! MA41V.WS QluMfl�'0 bA Gnnol .co-1 � I f I J I ROUGH PLUMBING INSPECTION NOTES EELOw FOR OFFICE UE ONLSG, FINAL 1NSPEC'II ION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑. ❑ _ Z /L FEE: $ PERMIT# ? e, PLAN F�VIEW NOTES I wy t S S 4 k t f � 'fli CpijlitiDl lt!elrtllt 0f1wass(rchuseia f �� D�_��rx�Inrerrfo�lttrfir$f�firl'�ice�(lerits d,f�fc�'oftrertesfigRliorrs { X110�i�irslrbtgtorr"SYr•�et , BONIorr,MA 02111 E , - - �plPiV,►trpsssoi/fitl '�'4torft6ts'°Coltyit;tist>ittau')f't9�t.���nCi���4t`ticlsE�f�:Bit6tt�otslG"ottftYttrfo%s�let`trtctsit�sl�'�utei�elis { .�ttI »lttlltfotilttt�i6it; _ =PTe[isl'riulle0C►i1r /LUfrl•655:. l nt� ��''"( rCl� cS 1 .... . . 4 t t t ifef i i;. 1/�lA (7, � l'liolig i'ft �e a��'�':Cy ca k ' Ar��btr(tueitti�totixrFCltecitttret�pirioprit[(eGox: �bf 1 � � � � � l:0 Etlntttegtpibgerteltit .. ./.. ri.ED am o general coidrnctor ntitl l ' G, []t`feit Coiistriiclion �uittlo}:ecs(flitnu(tJorpo[ti'iwc};� irate"Ettrccltl[esnlrcoritrnetors .OIautt<sofe-proprictororpar(,per- fste(lonttienitttdfettslett.t 7. 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Pai'suantto.tbisstatuteraneuAp?gypP.i itefiitedas.`:.,iri�ei persottfitillsserviceo€au.otitcttinders�n,y'conCractoflfire,. lbtcp*ss orkiplied,oral or 157ittell.- ' �kdrt�Jot•ei-irtle#i>2e$as"au,inilividltal,paitttership;,asieelatcon;cpXp�ttilibnQto.Ihoi=le��teittiCyrolrapyf� ,Ot•aiiore ri€itteforagoingenagecTn>a(oinFetderprise,anitiuClitdingthe Iega1 hprascntatii�3 s.o1`a deceased empttij�et;ortTte receirecortiitsteeo€atrutdii�id�ial,ItarGtershik„as ociatioti:or.otlteriegaTenfity;,ct�5ldy�ingemplit}iees fiotvezerthe otvngr ofa�tvelliitglioiise havtig 1atEtnbte than tiiree:apailtitents:aad�ivlto resides tliereiu;or tits occupant oftlue cltve[liltglionseoftunothernthoemployspetsoustodoanaiiutenance-,constructionorrepairitorkonsuchdtttiliiigil irs- .Prou:014ronndsor builciiag.app urienautthereto,Ahaliroot,bacause•ofsach.einploynientbe deeme(l'toIfe-6 empla}ger;” 11.�,GL•c'l��ptcrl32;• • SC6,also'slatestltat'`•'eveptRstti[cut;ItOcallice»Sllugrigeticy�s11rt1CtivItliTtolTthe�stiaitceor t'PnetEal-414 NQ1608e bJ•Iiertnitto operate n busiuessot to coulsFr(ict Utiildiugs in fire connttoiitxealtli fol at�t• nJiplieant�i�L.(►Itas iiot protiueecl nccepfitbleevfdettce ofcompliattce ltifit.Fliefn'suiriiuce fiottet•{tge regttiee8'� Atlditionalt};AGI:i�fi(tpterlS 2SC(?)sEates"�ieither]he�conutton►vt aitluuorady�obs poliam.subdivision�41ali OW Winnto any contract for(Ito perforltlatrce ofpubliciverkuntil acceplabTeevicleliceofcompliaucei�titiitheinsurance regilii-ements o*rlws eltapterhave,boon preseaitedto trio co)ihacting authority:" 1?leaseftllouE tityitiar�:ors'-calll�eltsa[iou��fiilxiitttitn-I�tat t -.- = � I p ' ',Y,A3.bhecl.tt)gt�teiioxesih�tappl}�t4�#'otirsituaFtolttuid,if • �uccesSiilj;supglysUb-contractor{s}itauue(s),address(es)'andpltonenulhb�r(s}along�vithilteucect'ifieate�s�pP insiirattct•.•LintitedLiabilify Companies(LLQ or- m[tedLiabilitYVffflneiships(LIP)W111110 eutplpye sotliertliaii:t'ae Iitefiibersorpar.triers,are not required to care}ttvorkers'cotppensationinsurance. ifflmMCorLLPdoes have, :employees,apolicy is required. B.dtudvised fltaf flustifficlavitntay besnbntitted to the•Depadment o£Industrial - Accideiitsforcottfimtatiottofi;tsnrancecoverage. A'[sobesurefosign altddritetilt Affidavit; Theaftidavitshotuttl be returteirto tile.city or town that tltc application for the permit or license is being requested,trot the-Deparintent of InduslriFl Accidents. Should yon]tutu auy'quesliQ11s regardittgdlte lain dr ifybit are required to obfabi n workers' tuttipelt ttioll policy,please call file' 1141illitinelit tit thomumber-ligled b-.fojv. 'SON 114urcil compaiiies!010utd enter their Self=insutunee license numberoiitlteeppropriateline. City,of ToIsn Officials 'leasebv:tuiethattheaffiilavitiscouitileft;aucipriutetl-legibly, 7liebepattuitentltaspt'O.YideilaspRep,ttltebott0ttt j ,oftlie,aftidavit foryoittd f 11 outin thoevenf the office of I ivestigations]IRS to coittnc[yourtg,-rdhigihe applicant. Pieasebesur@tofill inthepennit/licettseintmberivltichtviil.bettsedasa.refcreucetiiunbzt; Inadclition,aaitppliciut Mat imistsubthitatulEiplePorai ticensea licatiotisinanty y y g PP giveii ear,lteecl'oni sutbmitoneaf�davitindicatin current ; polis}'Infotntation(ifnecessary).and Vider"Job SiCeArfdress"tile applicant'shotdclwhe`!at[localionsIn or 1 ! l4iiit}.'�A copy ofQte atlidevitthat Las been officially stamped or in arkdd fey file city or toWil.utay be-provided to Elie alipiicantasproofthatavalld afftdavitis ori filoforfuture-perutits or licenses.A tietv.tiftidavit must be filled out each ve<ir.Zj7iete a itonte atvner or citizen is dbtaiiftug n license oiperntlt not related to anybitsf im oreommerciat ti�althtie F i a dotr.license or.jiermitto barn leaves etc)said person is Nor rcguirecl to complete this affidatizt j 't'1te![S,Ellie-ofItitieteptionsSroutdli(;efotltiifikfrottinadvaIce fory±ouueopperi{tiotitiicts>ldtticly�ott:ltat�caitycitiestions, jitase do not licsirate to give tis h cell: i Tim Dpparftqnt'&address,telepltane.ancl fax jiff, er. s Tile Common-mortlL r3 '1�s c�ltrsetts - i .De2iartmeltt ofii dus[cial Accidents Office of-111yesJ)"gWolts 600AVashingtoli Sheet B- 0stoll,AM 0211:1 Tc1..#617-727-000 e91406 of 1-877 IVIASSApP t I e hcd 5-26-05 Ff�fi V 6174727 X749 i Grease Trap Sizing Project Chama Restaurant Location Andover, MA Three Pot Sink 1 Compartment Volume 20" x 20" x 12" =4800 cu in 3 Compartment Volume 4800 cu in x 3 = 14400 cu in Volume in Gallons 1 gal = 231 cu in 14400 cu in/231 cu in = 62.34 gal Actual Drainage load 75%of total volume 62.34 gal x 0.75 = 46.75 gal Drainage flow rate (1 min) 46.75 gal/ 1 min =46.75 gal/min Use JRS Products 800-YO3-50 Dishwasher and Floor Drains Pre-Rinse Sink 1 Compartment Volume 20" x 20" x 8" = 3200 cu in Volume in Gallons 1 gal = 231 cu in 3200 cu in/231 cu in = 13.85 gal Actual Drainage Load 75%of total volume 13.85 gal x 0.75 = 10.39 gal Drainage flow rate (1 min) 10.39 gal/ 1 min = 10.39 gal/min Dishwasher maximum drainage 38 gal/min flow rate Dishwasher+ pre-rinse sink 48.39 gal/min combined flow rate Floor Drains 50,gal/min Worst case scenario = Floor Drains @ 50 gal/min Use Watts/ Dormont WD-50 Date. ZZ�Z ...... .. NORTH o? TOWN OF NORTH ANDOVER • "PERMIT FOR'GAS INSTALLATION • • a . 9 �,SSAC MUSE�l This certifies that . . . . . . . . . . . %i4. has permission for gas install tion . o/ylfrlPr G�ja. . ,/�Z , in the buildings of ., fin. 4U . :4q /r 4!S . . . . . . . . . at . .�2 . . 'j?. -ST./ . . . . . .,/North A ver,;Mass. Fee. � s�Lic. No�. / . . . l/!.�` . .. . . . ,� . . !'? . GAS INSPECTOR Check# r� 8040 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING 1111'ORK i CITY Npvv-C/t _ 4 MA DATE2– -- �—jPERMIT# _ JOBSITE ADDRESS � .. ��Z S' < i� � �W ]OW--N–E•R''-S NAME ��A:N��:A.0 y I��-'►'i.��. �jS_[ OWNER ADDRESS _]TEL TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL [--j PRINT RESIDENTIAL CLEARLY NEW:( �' RENOVATION:El REPLACEMENT: PLANS SUBMITTED: YES[:I NO[_ APPLIANCES-1 FLOORS BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER - - �= -- ----- ._. :. - -- ---- -- --- - - --— — - -- --- BOOSTER CONVERSION BURNER COOK STOVE - DIRECT VENT HEATER DRYER i FIREPLACE FRYOLATOR - FURNACE - GENERATOR i GRILLE ------ INFRARED INFRARED HEATER _ _ LABORATORY COCKS MAKEUP AIR UNIT -t OVEN POOL HEATER = .. . .... .... ROOM/SPACE HEATER ROOF TOP UNIT - TEST - - UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER I_ INSURANCE COVERAGE I have a current liabili insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES , O { L� I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY J;-,� OTHER TYPE INDEMNITY [--I BOND 1 OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER (.-J AGENT [, SIGNATURE OF OWNER OR AGENT 1 hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME LICENSE#� _ SIGNATURE MP I { MGF( "= JP JGF PGI( -� CORPORATION ,# PARTNERSHIP[._�r# LLC COMPANY NAME: `Aas CITY ��<).�C16 til ` _.... ._ . STATE �Q ZIP . a/2 -JT FAX I_,_—_._... — -ICELL4Gl7aSf-6CC & 'EMAIL{1'!''I I ��5 ' ml►��:�i da._G M Cp,�( � _.. ..w ���_ I I ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ T FEE: $ PERMIT# /J21 � %t PLAN REVIEW NOTES 4/00. _ I - a The Commonwealth qMw"*ren ens Deptrrinrern,�o,�"Lrrftnsltial'A'�arctl Oprca�irjtnt�slfgrnlftatrs 600 Waslthtgtom S+Yred Boston;MA 02, Ht r�ivtt.�mnss�go,►firfi�c Ap �fi�otrlt�s�Cb,nl�t�stiteb���i,scrt:>r��cc Ai¢fitiT�vite I3ti,'h�� brttrrrt�ous�i�iec@��t:i�slP�t��.be Ihtfot nrttfion, PleasoP int,Legii&, €IW. , trsittrsa!Otgxtm'7atmt�lirdi9idhat$ ����.L� // �/JN / /�! Ai a nrt enrpk"erg Meek the appropriate box: Typdt of pr(dect(requf;<vd): 1 ani n.emptbyer%,.itfi 4. [F I am.a.gt iierttl cartractor Wrap I. cwfobees(11oltntifforputtniaer have iuredfire s&coitractors 2. 1 am,to sore proprietoror-liarttrcr= Iisted oil,ffmattacltedl sweet_ � l crnodli�fiiyg sMp.and We:no empt%,cos Time snfr-ronttaetors bate & DemoMn it waiting Ebrum immhy Cup-mil . workere comp:iusuniryedn i f B'udfiirgiidttfit'iom wol'it'ew c°otnp:ilISUlBtiCt; S: ❑duo Rre it.cortrocatibir acrd its I requimQ, offccers1rave.enreL-ed thein i. Cm,[ El�cfri ti i zrics o>add oris 3. Tom m homeowiterdobig all work t ght of'ccetription per MOL !. )t l.6'edtimviug Fairs or adfdilions tsgnff.(No.%rorkers'comp. C.liS2n�l(dj;autttcefrava tro iFiZO Roof eelrahs nisttimrce rrgpimd jI' empfoyces(KO Workm" 13. 00m comp.Insurance regpiredf 1 '�tnyappiica�tCrttaeeti;nf±s6os�tu►usi'cfsafi0ourtiiestctionb'domsibuingttkiiwalb s,mnipensationpotiayi4bnnation. W"OUntisviiosubnnIthisaffi teitiadimUq,IhtVsitdoingall��ockandtheahittoutsiQtcotuiactetsmustsubatdaacual�Cd►r�&t&catingwcL_ itkmcixtrics;tautefr;�i:.tir'xltarmusta.i;wIcdan idiiia ttsls.CsBai►inutFrmaw ofivwrkars'Camp-turuwIifonnatioir t l rwta a eurptk fiver tkofts proriding wars erst compenswiemhisrrrance for igvevypto�ws. Belml,tr 111elr0110mtdjvb stle lararuiattary.. InstitaitceConipauyMaw f t'/ Poncy ff or sw-iris Lie..B C P 1-27 6 >apir ttinn Date; 7 f Job Syne ttftess:_.. /n I N Atfack a ea'I,g,of flte worl.ej a coritlrensfdion policy decratofibu p:tU(showfitg;the.lwuey,nmhber uudl expftatfotr da(0Y.z. Ii�ailtiisc ttirsetairer;:ovccagd asreguirediuncfer'Seetioti,??S�i oliPvfO>�:c.G52:cnn fog the;Gttiinsbibn�ofcraii�mlipcnal��a t'ttie tip Co S l.,SaO:t!'O ancUui one-year impnsomnettfn as i el[as chit penafties ira;ftie:form of'a:SI OP_M'ORK ORD 1 tzv rind a rnm afUpto$2'Stht)t3BAWa aa-titist0mviofntor: Beadwised:tllatacop;.ofthisstatenrent:ntaybforwardedtto,tfiaofficeof' ttrt+esligafionsofthe DFA,for iiisurnncecmTmge:veriftteafion: s I ala twccl =c n th urns ;p�erz fc+s od'perjtrr, dJrat Nre t►tjarravxt!% pr rrrGla�tallntie is nam rrrrrl erarrer . C`�tts0 cyrtIP Nn nut ttlrtte us MIs area,to be conrtrleted hyd:I&ortomrr crf}tefe. € City.orT(nvm. PeiintfVU.cense 9 Issuing Auffiorif,(circleon;ey, 1.lloIntt of Heaffli 2.iiuifilhig Departmtn( 3.CifytE b tc Cieeld. .Q.Clceft�l¢a�hispect 5:riatattb£itg limpector �aClicr i Contact f''eisotr P'Itwieftr i i •e E formatio andns udions Mumeflilseftl3xileralUivschapter.152 mgith=aH eMAyem ioe,pmyide; V Produces systm �� s d of R egis`t xon of... 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L}-(1,A,F) _ 142 134,0D0 BTU/HR(NG)f €� i32,0(!0(LP)DlrectVent De1Ray €ER42DF(is,!}3/7/2012 31712Di3G1-0312-297 3Fireplacetleat� I tl,F) _ ie 42 i37,OWffTUJHR(FlG)7 `6h8oS g�1#dt8ay Fa51 ti :32,�Direct vent i 337rJ22W2 -33777Q1333G�3&8EM7r 9 � ` ? l f f $ `42 t �37,000 BTU/HR(NG).t � € ':35,0DO(LP)Direct Vent "ivfbnti�ol2pli0iy 319fL5T 38r'2D123:712013 Gt-0312-297 ----- -ESP- s(N,L}A. 1 - — �; €F#reptace Heater 142 '34,000BTU/HR.Direct ��Defty °HR42DFN-(t, i a l317/2012 3/712(13`G4-0312-297 1 Event Gas Fireplace Heal3Corp. 'F) i 134,000 BTU/HR direct I4torsti�o De(Ray HW42DFN-(l,i3r7 20#2 E3/712iFt3 iG1 0322 297 'Vent Gas Fireplace ;Cans. 4 E42 4 h 132,000 8TU/HR Direct `ls maip Deity �L42DF{N,Q- r !Vera Gas Fireplace :Corp.A, r3f7f24t2 3f7f2A1.3 EGZ 0312-297 n 134,1 81U,'HRDirect MOO igoDelRay �L42DF-ST(N. 3Ri2432 31712013 G1-0312-297 'Vent Gas Fireplace HealerICorp. !){E,F) ! t ;S3 F E j I55.090 BTU/MR Nmt%§D Defty HXPV(N,Q- 1 } ! _3f722012 3171243 1 0312 2 (NG)150,000BTU/HRR* ;Garp. F ' Poorer'Vented Dec 3'G i. '# h#tp:l lcens�.reg.state ma usiplxbLicfpl c pm :bk- 4/3=012 RE:gwase trap ftc I o(4 Fi=n: Mike Den mrsky 4U1 .coM> To:sierras<swnas@aol.corry Subject: RE:grease UV Date:Tue,May 1,2012 9:21 am Try this—this is rightoff the Mass Gov we)site.... The Official Website of the Office of Consumer AfTairs and Business Regulation(OC:ABR) Mass.Gov Division of Professional Licensure Mass.Gov Home State Agencies A-Z Topics OCABR Home For Consumers For Businesses For Licensees For Government Online Services Check a License Locate a Licensed Professional Online Address Change Contact the Agency More... Home>Division of Professional Licensure>Board of Registration of Plumbers and Gas Fitters Approved Plumbing Products Online System By the Division of Professional Licensure Table.ONLINE PLUMBING PRODUCTS SYSTEM: SEARCH RESULTS Search Criteria: Type:Plumbing http://maii.aot.com/36032-1I1/acct-6/Cn-ust p6.>I84c.. x VV2012 RE: grease trap Page 2 of 4 Manufacturer:Canplas Industries LTD Product: Model:3950A Description: New Search There are.11 record(s)in our database felting your search criteria.Please note that if your product is not displayed in the search results,you can refine your search criteria. Displaying page 11 of T1 search results pages Requested products per page: u Product,Description,Approval APS Manufacturer Model Approved Expires Condition Code 3950AS Endura Trade Name: 50 GPM Grease Interceptor Canplas Industries P3-0610- Approved for use with the Endura LTD Endura 6/7/2006 6/2/2013 515 Trade Model: Spigot PVC Flow Control Device 3950AS First Page 1 Previous Page I Next Page Last Page C ©2007-2011 Commonwealth of Massachusetts 0 Site Policies 0 Contact Us Thank you, Mike Demersky,CFSP Project Development&Design—Sales Manager Cell—617.504.6517 Office—617.965.1100 Fax—91I71.911F588 66 Winchester Street Newton Highlands, MA 02461 www.bostonshowcase.com -----Original Message----- From:sienas@aol.com[mailto:sienas@aol.com) Sent:Tuesday,May 01,2012 9:18 AM To:Mike Demersky Subject:RE:grease trap Hi Mike,the link you send me can not be open,please advice. Thanks http://mail.aol.com/36032-11 l/aol-6/en-us/mail/PrintMessage.aspx 5/2/2012 Common-wealth of Massachusetts Official Use Only Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leaveblank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEA SE PRINT IN INK OR TYPE ALL NFORAL4 TIOA9 Date: 11 - 21 — 13 City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perfotm the electrical work described below. Location(Street&Number) L 2 M ok 11-` - Owner or Tenant it-1-vWt4 Jti A- 6e-e t*,6 l Telephone No. 61 Z Owner's Address sok"-CF- Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps "o / ZarVolts Overhead � Undgrd❑ No.of Meters -5 New Service Amps Volts OverheadEl Undgrd❑ No.of Meters Number of Feeders and.Ampacity Location and Nature of Proposed Electrical Work: K L I R_(5 kC S Z-A-ae of F_c6 5 Completion of the following table maybe waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceff.-Scusp.(Piiddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 'In of Emergency Lighting grna. 11 9 Battery Units No.of Receptacle Outlets No.of Oil Biffne-r6l: FIRE ALARMS No.oMnes No.of Switches No.of Gas Bummers No..of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal El Other Connection No.of Dryers Heating Appliances IOW Security Systems:* - No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: . Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: it- 21- I/ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE PJ-50- ND El OTHER n (Specify:) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: 0 q-r-Y_A9T bFI-ECZ&=TCAc Ca"7-RACrO15 LIC.NO.:J4 17 S 21 Licensee: 15;VtI-e- Signature C.NO.: 2&Z 92 Signat g::� =�t�Ll( Bu . i I��-;2-2��b-2 45 ffapplicable,enter"exempt"in the license number line) Bu . -No.:--61 Address: Alt.Tel-No.. _t -72cll"34 92- --Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) F1 owner El owner's agent. Owner/Agent PERM-TTFEE.-S The Commonwealth ofMassachusetts Department of Industrial Accidents -1' Office of Investigations ta�tY 600 Washington Street Boston MA 02111 � { ' www.hwss gov/dia Workers' Compensation Insiurance Affidavit: Builders/Contractors/Eieotricians/Plumbers Applicant Information Please Print Le�biv Name (Business/Organization/Individual):_O Q'C`[S c,` iS�(2-r- 1 JC4 Address: �S City/State/Zip: tx�F g 2$ Phone#: . G( z- Z c(-- 4S Z Are you an employer?Cheek.the appropriate box: ' I•©'1"am.a employer with 't' — 4, ❑ I am a general contractor and FF[JIDemolition. required): employees(full and/or part-time). have hired the sub-contractorsructiott 2.(] I am.a.sole proprietor.or partner_ listed on the attached sheet.I g ship and.have no employees These suh-contractors have working for mein any capacity, workers' comp.insurance. [No workers'comp.insurance 5. 9• Building addition p ❑ We are a corporation and its required.] officers have exercised#heir 10❑-Electrical repairs or additions 3.E3 I din a homeowner doing ali work right of exemption per MGL ILEI Plumbing repairs or additions F myself.[No-workers,comp, c. 1.52, C 1(4),'and we have no 12.❑Roof repairs insurance-required.]t employees. [No workers' comp. insurance required.] 13❑mer 'Any applicant that checks bob#I must also fill out the section below showing their workers'bompensation policy information, t Homeowners who submit this affidavit indicating they 2se doing all work and then hire outside conuac}ops must submit a new'affidavit indicating such. - $Contractors that chests this box mustnttnched an Pdditional shyer showing r_he pane of the sub-contractor and their tvarkars'camp.policy in ra,;,adon. lawn an aMployer that esPr,?v1d1ag:wD kers'co sapensad oa insurance j`or Wy.employees; Below is tlaepolicy arrdjob site inforynation. Insurance Company Name: ' 7`Rf°r SEC Policy#or Self-ins.Lie,#: Expiration Date: M - It Job Site Address: 1 2S - ivt l'�-c •�' City/State/Zip: t\[ A m Pa-t c!;K 14/,4 c Attach a copy of the workers'.'compensation policy declaration page(showing the policy number and expiration date). S 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct: Sienature Date l{ 2 f [ E Phone#: to[ Z ^ 2 01^ Z. official use or3ly. Do notwFMe hi tats area, to I;e co,,,p'et�d by tuy or town official City or Town; Permit/License# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/f o`vn Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Locationzio /PGt/ �Y No. D//1 Date !/.F /�- 1 MORTq TOWN OF NORTH ANDOVER 0:,�•c .1+ ` �: • o AL9 �e Certificate of Occupancy $ S,CMUs<�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee.��iv $ TOTAL $ `k Check # k 24964 Building Inspector ,NOR'TFj 1. pE�t :so '��• i 0 ��� TOWN OF NORTH A'N D O V E Vit. �p�AT[n *ok . SIGN PERMIT CHU i DATE: January 17, 2012 PERMIT: S01.0-20111 THIS CEIMMIES THAT SAN-LAU R.T. First and Main Marketplace. 1 has permission to erect. Wall sign 268" CHAMA Grill on 109-123 Main Street, ,,North Andlover, MA provide that the person accepting this Permit shall in every respect conform to,-the terms of tfre applicatioq on file in this office, and to the provil'sions of the d Codes and By-Laws relating to,the Sign aegulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section #6, Voids-this Permit. 4 INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED Inspector of Buildings Amount Paid: $36.00 Check#2997 a SIGN PERMIT APPLICATION 1600 Osgood Street Building 20, Suite 2-36 TOWN OF NORTH ANDOVER Site Owner A/Zl ��A/ • � Applicant ��w�Y G.'9 /V Tel Site Address /,/l yM�!121 ,7- Size of Proposed Sign _Map Parcel Illumination: a)Not illuminated How attached: a)Against the wall !-"'* b) Internally illuminated b) Roof QExternally illuminated c)Ground d) Other Materials: `SI ��' / p /''ry Proposed Colors: Background % Lettering Border Cost of Si Required Attachments: V Note: No permanent/temporary sign shall be erected, or enl ed until an Photographs of building application on the appropriate form furnished by the Sign Office as een filed Material sample with the Sign Officer containing such information including photographs,plans Color sample and scale drawings, as he may require,and a permit for such erection, alteration, Site or Plot Plan(Required for all free-standing signs) or enlargement has been issued by him. Such permit shall be issued only of the Drawings of proposed sign Sign Officer determines that the sign complies or will comply with all Other, specify applicable provisions of the By-Law. Will sign overhang any public road or walkway Yes ( ) No If Yes,Name of Agency who will provide liability insurance: i AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: Receipt# Check# Revised 10.31.2006Fonn Sign Permit Application SIGNATURE OF APPLICANT APPROVED BY c�r� MM . MSM Rpm 5. C AMA R dow"hAMET M■WOMM Company: Chama Grill 24 Spencer Street Stoneham, Ma Address: This Drawing is the Property of Gamit Signs (781)438-5280 FAX (781)438-8823 and can not be reproduced without the Date: 1/09/12 Permission of Gamit Signs. 268" 38" 29" CHAMA 7JL . 0 22.5" H 20" C■AM■T ME"MM [Address: pany: Chama Grill 24 Spencer Street Stoneham, Ma This Drawing is the Property of Gamit Signs (787)438-5280 FAX (787)438-8823 and can not be reproduced without the 1/09/12 Permission of Gamit Signs.