Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Miscellaneous - 129 MAIN STREET 4/30/2018 (5)
W' MICHAEL J.Qtft(g 7� � gp/96 0�7 Dunkin'Donuts r 883 Turnpike St • `F North Andover MA 01843 - 1LIW6 `- /000 o /0 M AI-X -7(wtm�( �S CQ-) ��c,Q 41 Cl �� 40n MEN NORTH ANDOVER DONUT, INC. ANDOVER BANK 53-7047 11245 2113 d/b/a DUNKIN'DONUTS 129 MAIN STREET NORTH ANDOVER, MA 01845 10/12/2000 PAYTHE Town Of North Andover "*45.00 ORDER OF $ Forty-Five and 00/1DOLLARS Town Of North Andover P.O. Box 124 NORTH ANDOVER DONUT,INC. North Andover, MA 01845 AUTHO ED SIGNATURE MEMO VARIANCE-SIGN II'OL12451I' 1: 2LL3704771: 220SS44330 I X DO NOT WRITE,STAMP OR SIGN BELOW THIS LINE NP RESERVED FOR FINANCIAL INSTITUTION USE' MP I If I I I I l I i I I I I ` I I I I AiP hP rr .,H Ire Ple SCOW, mac. ... � .o arc:•� rJ..l y q � �,�r:_ t W ,;E C JRF. RIGHT Ft 9turf; GFr n'{.hi a'. f _- L ".:PP�o _ Y Srr,fll tyt .. Y VV',.�f Absence of feature;may indicate a forgary *FEDERAL RESERVE BOARD OF GOVERNORS REG.CC `f -Now 'IWO mooL 40 �r•Ti � � 4 t'...vy<''J �� ' t °k . : �:..,,,,i. *� s .� oy �� '�, • �.. f . � • � 1 1 1 �; 4- 14 b r. TOWN OF NORTH ANDOVER Cd SIGN PERMIT APPLICATION Site Owner &C.6de/ QU14� Applicant U //y/� `oZ /'� //(,' QST r Site Address 9 Size of Proposed Sign 6 ank �e ,(rjig How attached: a) Against the wall_ Illumination: a) Not illuminated bS Roof ( ) b) Internally illuminated ( ) c) Ground O c) Externally illuminated (� d) Other ( ) Proposed Colors: Background IrEl Ale& Materials: Lettering A/&L- ' Border A"��A may" Note: No permanent/temporary ora sign shall bp' erected or enlarged until Required Attachments: p p 'T. g ,� 9 ' Photographs of building an application on the appropriate form furnished,by the Sign Officer has Material sample been filed with the Sign Officer containing such information including Color sample photographs, plans and scale drawings, as he may require, and a permit for such erection, alteration, or enlargement has been issued by him. Site or Plot Plan (Required for all free-standing signs) Such permit shall be issued only if the Sign Officer determines that the Drawings of proposed sign sign complies or will comply with all applicable" provisions of the By-Law. Other, specify Will sign overhang any public road or walkway Yes O No (K) If Yes, Name of Agency who will provide.liability insurance: res r LeLy4(l, AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILE=D: SIGNATURE OF APPLICANT revised:jm- BAA C.CM43G Y ASC,i;, StGti DO-JTS SIGN MANUFACTURER SIZE X 8'-4 1/2 • AREA 35.94 SQUARE FEET f 1 c,, � GENECK OR AR F':XTUR' ( r� t �AC�e l - (4 OTAL) 13� 77 oo _ rt % FR ONT ELEVT oN SCALE: 1/4" -- 1'-0" s ru D o VD� Mi+N ST ss o t � .d dt�d1;T►S - �. j I ---go .-�-'�---• ss�� "A ,mem.' a.. a� � fo�r� .ems i vs . s oirr' o.au ����' 4y l✓ laei�rrRu'dw�ii.avw� r.��'i�rw`i sa.w'�,�.s n g "i �?',�i:�fAa ,,.."'M r:�w. •.,< i -. ,,,,ire's,• � •`"9'htT,'�TV�v ��+i._��,,,,, ....- .Y n w .. M i �t�P- ,�'!• - a .. � F i � - .. ty �S.I 4, � t - t' 4 •i ! � 11 I1. 7: 7 _ '•. —r!. f i� —rr,t:. .� iV � �:�•t + j {.r- i•i-•�- A- t ! ..t. l — L7 or,noaaxwe=-NO N0 tx ' d r N3HM Alit HIVA {IION(loaz�ns �Nid aafl 3YtNNt <?Mf10 �pY& -uNsn vii L ►s �ILi •spa . swa � Nt� :,H�a '� £� ,. 7�1N1A W£ tZ85:;ir1/1 '9$Z #SNId `3(118 ;,$ 013 u 3114: '13Nno&X3V8 lJINiA W£: LLSZ'#,L A '0612 #SWd:A8838dSVs ;.S1t NQ0. ` IAN1AW£ 0$LZ #1.A •3S9t11. SYtci '39NV.2i0 .;;NlXNi1�3;; S310N 80`10 u•G E;wry ( ' s ` , s , < � h f. �' � .^i..4.a.rr Y►�•p � •t�f{yet,•_•'• .;�^��.,.•,<� •vu +. .i •�-. Co •'C t, ✓ ,x -�...5 �� •tF ,� � �2} by C... _ ?'� +• .t�?t`�l w�.� '3 � ��>Zv 4� C l i .,,J*.:� •c r ;.tq �'+As. 1:. tai. � .�r .. j�.a St C'`I•<r '+i'r 4',t' L ' ti F� +'..14ti 1 J?r S :••. _���J All immIt J...�.. � _ ;��'.. '•'.,.:ar,...:y_,+..,a... .��.. t y, •r r •i r` �t7.Ri0�l` i.r w-.y s .�.rJ• s*. 4. r.r.3 a '-+ 4 2+}ri -Ak?�" .<_ '•ro ..r^lf�' ..:5••,.L ..B '+j-`b�-+ � -Y'±t iy.. ,�.>rti-yf�:'h«r�..J`��* ,�;•�;t.�.r�,�.:.t:��f•'itr:io'r�em�:Fh•L! t..ta�- ♦.;'.+, '+k ,i:' +�,•�f..+� � S•, -iZ Z +- r <J? �`•afi'✓•.1'+. tit:, 's.'o.•:a,w.. _ �..� :�',. .s �. � ...,X ^� .,. l�sy�,kv�``•Ye•J•h.�'= t +;..}x-'.y7.kbi" at .•xl. 1 t .F.r. .<., �:t.�ui,s '"�'2F fr;?✓�S ,,'fy`.', �_.s'G4 • j,, r• - '' -J. v ,yrs d'i+.,as.-1b. t 1!cy,'4 <,s. yr >"+ .4 �S. Vii•,:<. -. i't•,„ `'""° •w����} •..'� "' 'Ya'+..r:' ^:?. rn ,`` x• ,:•tiT a ^� ~ .5• .Z-y:.K,.:.x,'- I.YrS i`L-y:= •w✓"y•"L j o4.h..• ^;r. ! !_N •:;,Jr'• •+yn f Y,1•: -.� t..� i. r.J i! •3., f•.sSS�' �. .tc ,/,. .;'f,iy`-• �, �% ,fir: ��� .tr[,1•."c.4S;i�i+r^I .r:,- S s.} ..C~<.9, ♦ ...�;• :s. aa..•:{..�,. _ •� "r:4. � .r.r:•i''' t.��_ ��`f,.� )J.-:.'�,,�J�''. `'y'.i' '! :F.. >.Y.. ,�rr'K�':Lam. ;..���,+.�j•x..0 JLf:n•w,;:t,•; ,{ _ ✓ ,},: .i'•tir•�,,,,`•�.9 ;e;..%�'"':+'"t.�' ..r• .yt�r',:=;',tri:- n. 'tet, .��..�. .L>.^,'''< t.�t.;3�, %'+,; :..' k�'y ;1++"3:'i T:. �-+.. ,•_a''•n ,� .. ?•:,,1a}.. » .:t v;,•-M.!.5�. .D.•.i-`✓.��.:C' Z' ,.;e'r �- .!1,•.•!'w: t :i.', •.:?t.� .�,,+i'�.• ,r; �5, '�_.�,, f t. i S .�. r ;.ti .:}'% ,:i•:'.t_ `i•" -.r.•t.: �. :d}, :-i t-i<i,. .::'i.'• v�., ,t..., •t• y+ S ..::+.i• � .<J;:� 1 w'�F: �e•�;�,i': .�-• K \ -:r:.A :`�fl� ',w.d.Et.3"•.` '•J .1 u:.ti�• � ,^i^� �J4'f r ic' � `��r, LAA: !T•• � a'• �+tr.f�t�';r'~;{.�••b 'A4`�.-+• ) .`rl ti ..,_ �t -..r�, r i.::' .:..��,Jy� 1+�„�.w► � '21i • - v .i. �y� N •� ” �'ty'•� .,LyA•�z'4Fi R"✓,-���'����' z"�. t l:y+ �,.• Z;tii�,'.. i4i0J sc•., ...w... ! s���,a�f G7',j .:l' 't✓.•� r '{rs �'. �y.y +<^t �i� s �� .r SFI.^�•t`�►'•i,«S '�+ �++MW�. .� !•!M� ^'+.�'C"^,` f�•� •J��I�h�.M� <���r •r {r:',�,,�L '}. R^ + �1,+I�i`y'�..G•�"�1�r;4 y�l� '� <:J.ai,�1•J' .rt'' '�. �:Pta rti •-• �,.. f. 3 r5f• 1�/.iw��•.`M.f�'•'��»7�{.AS'�`r4'C'G'li' J>�~. �.v Yii �••r � f. Kr .1•: '� L � .r„ � rh�J! -,1-i', ;i�' L�.•,,.A .A',�;.-� 1 tu. 9�p �'. �,.. ♦ �..1`a. C �}�•> e • < t :• v.'i;,�;•:., yyrt5:l r,s".'�.y'x•�, :� �Y�jy' .y�v !•+�Ii:J:r•sli .'i�i: t *� v+. •• 5►t •Jl�lerT►.M` ,yif 1 �• K ':.ij.:. Y 7k J ati�'r• �. %'1M.. w < /' +di�.,�+tt:.?`�i's�t �,,.: r ♦ J4• �.. 'J4: J } tf,,,,,.., i. 7• '�J. rl ^1,� Y • J }i.. •y 1 ,�+�i�w"1►.'IL,. ..• i a:t}.r r .r*K " iV� ✓�. K�i7 'r,:�•ti '.• : titin t �' �K�� y�YAi� ASA i;�,�'✓lt•:.'L:'� r+ �•yt •'"" ''u�•q r � • y'�� - p��l .�^. �f�'.�����;i�:4•rrt.' `Y„• �M'���' «`f'r;frT• .•j� .. � `�.'_r`, ��R��*•r,r��•.l'•'Fr�J�',,tI�,J`Y'�+'� r i �riq`,e'1..��sy�'.. QTR• ♦" J+. r . •! 3-+;C '•'`t'•'L'•� 'v j '•;'y , ,r�.'r C?i✓f,^• t rs� �'�`� •',Yr:��;"i.�.y'Q1�l�.°��ti,r j^I�J.j�Lf .� ; .v 1 ���• �� � r ,a•q.v s. L r f z r. .� {'jyi l t .• w s l.-' < > r�7 t t .r S � , •i .. .t f t t• M NORTH RECEI% bM%jpTH ANDOVER OF N� f� 9Gtt`Eo 6•e Op PMII FOR GAS INSTALLATION a � a <h No.Andover Coil 'ts,9SSq C,Hu5E4 eCtor This certifies that Aa . .? .`. .. �. .. ! . . . . . . . . . . has permission for gas installation . . . . . , . in the buildings of . . . . . at .1 , . f . . . . . . . . , North Andover, Mass. Fee/.!r�'"�"". Lic. No.c/... ..i . . . . . . . . . . . . . . . . . . . . . . . . . . . `/,- T' I,S 7.)V GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File .. f MASSACHUSETTS,UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING t (Print or Type) NORTH ANDOVER Mass. Date,�'=- �7—9� kuilding Location � Permit # 1� Owners Name • �' New Renovation EJ Replacement or Plans Submitted FIXTURES W N N 0 V xCC lr Cf N Q N ¢ .O N SF V to F' -9x rn x o m a cc a o a i.- w ¢ W d w w O a ¢ q t- > to cc W z V y to w 4 cc F.- in I- X to „1 a x tr: ¢ a a w to t7 F. z F- z H. W to d ? t<. F- .t z 4 W G cc f' }- N 0 2 O z a O r i x d ,,t > C W :3z 6 ¢ 4 .Q O O to cc O W IF- 0 O u. G1 c7 .s V cz, > ci n. t- O SUR—esNIT. BASEMENT IST FLOOR 2MD FLOOR 3110 FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TK FLOOR 8TH FLOOR (Print or Type) Check one: Certificate Installing Company Name �L�.s► s,�,�� Corp. Address �yj l� ,,1� T- Partner. [3�-rFi rm/Co. Business Telephone: Name of Licensed Plumber or Gas Fitter Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy YT-0—ther type of indemnity 0 Bond Ej 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 coverages. Signature of owner/agent of property Owner F-] Agent rT i hereby certify that all of the details and information 1 have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under Permit iuucd for this application wW-be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 14I of the Genual Laws. By TYPE LICENSE: Plumber Title Gas fitter- Si ature of icensed City/Town: Master Plumber or Gasfitter Journeyman APPROVED (OFFICE USE ONLY) License Number Location /C;�q /�7", /0 "" ,�}} No. Date Pl P) NORTH TOWN OF NORTH ANDOVER 3: • OL � s s i # Certificate of Occupancy $ T-2 S Building /Frame/Frame Permit Fee $ <� � s�cNuse Foundation Permit Fee $ Other Permit Fee $ �_ TOTAL $ a S Check # Building Inspector ` TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. DATE ISSUED: p _ D V X SIGNATURE: Building Commissioner/I for of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: f} w rJ�ovr2 Map Number Parcel Number C A , M� 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING 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: 1.8 Sewerage Disposal System: n Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record 1�lr Name(Print) Address for Service: 1 i Signature Telephone �J 2.2 Owner of Record: Name Print Address for Service: O Z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ N o CS 06 ZgO-7 icensed Construction Supervisor: O License Number O n> f34-,PG. — ui�� Jq 11 Address Z /Zy /oZ � 7 (, — DO Expiration Da e Signatur Telephone r Y < 3.2 Registered f4me Improvement Contractor Not Applicable ❑ Company Name M Registration Number r Address r Z Expiration Date A Signature Telephone Y) i 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 au a ticable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work- SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by Ennit applicant - I. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN r OW ERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 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 OWNER/AUTHORIZED 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 Print Name Signature of Owner/A ent Date 11.11...'------ MEMO NO. OF STORIES SIZE c BASEMENT OR SLAB SIZE OF FLOOR TIMBERS IST 2ND 3RD 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 Department of Industrial Accidents Office of Investigations Boston, Mass. 02191 Workers'Compensation Insurance Affidavit Please Print Name: Location: City Phone am a homeowner performing all work myself. Ol am a sole proprietor and have no one working in any capacity QI am an employer providing workers'compensation for my employees working on this job- Company name: 0 Ll S 13 v LDE 2-S /nJ C, Address 167 AuI>y30� City' /A�Ak—r.r-%-Fj _r2 lam✓)Q()(Z4L2 Phone# -7 / ' 7 y6 /g/OCA Insurance Co. F-;44 Policy.# li(/C 7e1322-- -D. Company name. Address City: Phone Insurance Co Policv# 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'impris6nment 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 under the pains and penalties of rjury that the information provided above is true and correct Signature Date I/ U(> 14 Print name �l�9TTk GE�ZRc� Phone# t Zy9 foo Official use only do not write in this area to be completed by city or town official' E Building Dept OCheck if immediate response is required Building Dept p Licensing Board Q Selectman's Office Contact person: Phone A- Health Department 0 Other FORM WORKMAN'S COMPENSATION 19 9 7 ED IT I ON AIA DOCUMENT A107-1997 .s Abbreviated Standard Form of Agreement Between Owner and Contractor for Construction Projects of Limited Scope where the basis of payment is a STIPULATED SUM This document includes abbreviated General AGREEMENT made as of the eighteenth day of July Conditions and should in the year Two Thousand not be used with other (In words,indicate day,month and year) general conditions. BETWEEN the Owner: North Andover Donut Inc. This document has impor- (Name,address and other information) 853 Turnpike Street tant legal consequences. North Andover, MA 01845 Consultation with an attorney is encouraged with respect to its completion or modification. and the Contractor: Prism Builders, Inc. This document has been (Name,address and other information) 107 Audubon Road approved and endorsed by Building 1 — Suite 19 The Associated General Wakefield, MA 01880 Contractors of America. the Project is: Renovations to Dunkin Donuts (Name and location) 129 Main Street North Andover, MA 01845 the Architect is: New England Design (Name,address and other information) P. 0. Box 311 West Barnstable, MA 02668 © 1997 AIAO AIA DOCUMENT A107-1997 The Owner and Contractor agree as follows. ABBREVIATED OWNER- CONTRACTOR AGREEMENT The American Institute of Architects 1735 New York Avenue, N.W. Copyright 1936, 1951, 1958, 1961, 1963, 1966, 1974, 1978, 1987,© 1997 by The American Institute of Architects. Washington, D.C. 20006-5292 Reproduction of the material herein or substantial quotation of its provisions without written permission of the AIA violates the copyright laws of the United States and will subject the violator to legal prosecution. WARNING:Unlicensed photocopying violates U.S.copyright laws and will subject the violator to Inoal nrn<orution. Town of North AndoverNORTH oF�t�eD ;6�tio Building Department 0 27 Charles Street V North Andover, Massachusetts 01845 4 D� (978) 688-9545 Fax(978) 688-9542 QDR TED �SSgcHus�� DEBRIS DISPOSAL FORM In accordance with the pro isions of MGL c 40 s 54, and a condition of Building permit# the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, sl 50a. The debris will be disposed of in/at: Dependable Waste Disposal-Peabody, MA Facility location Sigilature of Applicant 7-28-00 Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 062407 Birthdate: 02/24/1951 l r' Expires: 02/24/2002 Tr.no: 17414 / Restricted To: 00 ANTHONY A SCANZILLO. 80 HAVERHILL STS- / READING, MA 01867 Administrator Location__ No. �% Date NORTN TOWN OF NORTH ANDOVER • s + ; , Certificate of Occupancy $ ��s'•^ E<�' Building/Frame Permit Fee $ AGMUS Foundation Permit Fee $ Other Permit Fee (- ,7 $ TOTAL Check # 1. J Building Inspector Locatio - No. �✓� Date NORTH TOWN OF NORTH ANDOVER O? • • OR . ; , Certificate of Occupancy $ cHusEt� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee GI,7: $ TOTAL $ Check # 'Poo 47 14158, Building InS or CUMMULVWCA.L.tn Ur TOWN OF NORTHANDOVER 27 CHARLES ST APPL ICA TION-FOR CER TIFICATE 0FINSPECT1,ON V� Date () Fee Required(Amount) -9 l () No Fee Required Accordance with the provisions of the Massachusetts State Building code, Section 108,15, 1 hereby apply foi Certificate of Insyct-Fon for-the-below-named premises-located at the following address: Street and {{�� Number D C3 N K,n) vJ O ru UT-5 Name of Premises /- �— - - Purpose for which Premises is Used ( n 424=e--e < cQ eo n V W -S aTt Licenses (s) or Permr-t�s) Required for the P-remises byV.ther Ao-ver-mnena Agencies: License or Perm if A enc RV) Ll 1920119. �+GG / tl Certificate to be issued to Address J a' l 9 � Telephon Owner of Record of Building 1 Address I v © 17 46 D Name of Present Holder of Certificate er W Name ofA gfncy, if any SIGMA URE F PERSON O OM CERTIFICATE TITLE IS ISSUED OR HN A-UTHOIRIZED AGENT DI TE INSTRUCT 0NS: 1) Make check payable to• Town of North Andover 2) Return this application with your check to: Buildby Deft. 27 Charles Street, North Andover MA 41845 PLEASE NOTE: Application form with accompanying _LEE must be submitted for each building or structure or part thereof to be cert 3) Application and fee must-be received before the zer-tfcate will-be-issued. 4) The building officials shall be notified within ten (10) days of any chane in the above information. CERTIFICATE# EAPIRATIONDATE: FORM SBCC-3-74 REWSED 2199 jmc TOWN OF NORTH ANDOVER INSPECTOR'S NAME OFFICE OF THE INSPECTOR OF BUILDINGS MICHAEL MCGUIRE INSPECT40NIIEPORT FORM CLASSIFICATION PASSES INSPECTION yes 0 no 0 DATED OWNER - BUILDING NAME OFA-NO. STREET LOCATION TYPE OF OCCUPANGY Day -CarrCenter -0 -Aud.-0 -Cafe B -GYM fl Apt. 0 j School 0 Common Victualer's 0 Liquor Place of Assembly 0 Other OCCUPANCY NUMBER itdtjocj2 es -.cjupaFxq�Pr�lOOr - -use-reverse side IST1N-1 S EXIST SIGN yes 0 no 0 LIGHTED EXIT SIGNS -operable -0 Yes -0 EMERGENCY LIGHTING SYSTE M operable dry cell 0 wet cell 0 SPRINKLER SYSTEM operable 0 gage pressure yes no 0 SMOKE DETECTOR operable 0 yes 0 no FIRE ALARM SYSTEM expiraffen-date -Yes -0 -no E ANSUL SYSTEM yes 0 no 0 FIRE ALARM SYSTEM operable 0 municipal 0 yes 0 no 0 ELECTRIC EQUIPMENT PROPERLY PROTECTED yes 0 no 0 EGRESSES LAWFULLY{DESIGNATE unobstructed 0 -yes -D -no 0 STAIRS PROPERLY RAILED yes 0 no 0- HALLS AND STAIRWAYS LIGHTED yes 0 no 0 RADIATOR GUARDS yes 0 no COMPLIES HANDICAPPED PERSONS LAWS -yes -no 0 FIRE RESISTANT CURTAINS OR DRAPERIES HOW HEATED NO. FIREPLACES yes 0 no BOILER ROOM CONDITION VENTILATION UTILITY ROOM - CLOSETS j NUMBER OF GRADE FLOOR MEANS OF EGRESS DOORWAYS NUMBER OF SEPARATE STAIRWAYS ACCESSIBLE PER STORY SHOPS FOR INSPECTOR USE ONLY Revised vss SMC CERTIFICATE OF U E & OCCUPANCY Town of No h Andover Building Permit Number _ Date 19 1C,9� ~ a� THIS CERTIF S THAT THE BUILDING LOCATED ON �'Q MAY BE OCCUPIED AS dN v v7�s 164) kPi IN ACCORDANCE WITH THE PROVISIONS OF THE MASSAC USETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APP Y. CERTIFICATE ISSUE TO L�/e, Aden-el �aa,(/v ADD tESS S',5�3 v 1IVV +:4CMUSBuilding Inspector DVNKIN' DONUTS DATE EMPLOYMENT APPLICATION NAME SOC.SEC. NO. TEL NO. ADDRESS CITY S STATE (ZIP CODE) HIGH SCHOOL COLLEGE CITY&STATE CITY&STATE LAST YEAR COMPLETED LAST YEAR COMPLETED EMPLOYMENT RECORD(LIST MOST RECENT EMPLOYMENT FIRST) You may include any verified work performed on a voluntary basis. NAME AND ADDRESS OF COMPANY DATE TYPE SALARY NAME OF REASON FOR TO-FROM WORK SUPERVISOR LEAVING AVAILABILITY-STATE ALL HOURS YOU WILL BE ABLE TO WORK IN CHART BELOW MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY CHECK ONE FROM o FULL TIME TO o PART 71ME NPOWMT:WORK=PAPOIS OR A CE nFIrATE OF ASE MAY eE REQUOM eEFORB NIAe1Q In answering the following questions,you may omit any information or answer"no record"with regard to any conviction for which there is a sealed record on file.You should also omit first convictions for drunkenness,simple assault,speeding,minor traffic violations,affray or disturbance of the peace. 1. Have you ever been convicted of a felony? Yes 1-1 No❑ If yes,give details and date. 2. Have you been convicted of a misdemeanor in the last five years? Yes No El If yes,give details and date_ Are you a U.S.citizen or otherwise legally able to work in the U.S.? Yes NoEl Proof of employability wig be required of all applicants hired. The facts set forth in my application for employment are true and complete.1 understand that if I am employed,false statements on this application shall be considered sufficient cause for dismissal. I agree that all individuals supplying information about me,for reference purposes,are released from liability. If a job opportunity is offered, 1 shall comply with all Dunldn'Donuts uniform requirements. I understand that job responsibilities often include counter work,product preparation and cleaning duties. Unless box below is checked,this is an independently owned and operated FRANCHISE of the DUNKIN'DONUTS SYSTEM. Company Operated Shop SIGNATURE OF APPLICANT Selection of employees will be on the basis of occupational qualification,education and character without regard to age,sex,race,creed,color,national origin or hartdcap. Applicants for employment in Massachusetts note:It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment An employer who violates Ctrs law shag be subject to criminal penalties and civil liability. DUNIGIT DONUTS IS AN EQUAL OPPORTUNITY EMPLOYER PER1115AIIS 5 NORTH', ® o x over M V No. � * - Z- LA o '� lover, ®. COCMICHEWICK 7�A0aATED o'Pa\,`rC�J `s BOARD OF HEA VU PERMIT T Food/ttitcheV;J� /o`iP .� Septic System /�'' THIS CERTIFIE THAT BUILDING INSPECTOR oundation moa. I,t 10 �� . ha: permission m wet...ja,I. � .. buildings on.. �►q l�1.a 0"'` ' .... ...... ............ ... ..................................... .....,........ Rough/400'-", . .. ...... . .. ..... .. . to be occupied a:........ N 1 �E C r`�ea n1 0 ro ch►coney o...... ........., .................................................. .......... ....... 1� 1�.......... .�........... ......... provided VM the on ase this shag in res t conform to the terms of thea liicadon on file in F;,,� �yJ /p a this office, and to the rovisionss�of the C and B -laws to the Ins ion, Ageratian and Construction of /° `� Bugdin s in the Town of North Andover. V g PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. �� PERMIT EXPIRES IN 6 MONTHS ELECTRI INSP , UNLESS CONSTRUCTION ST TS BUILDllVG INSPECTOR �� Of Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough C. Display in a Conspicuous Place on the Premises -- Do Not Remove No Lathing or Dry Wail To Be Done FIREDEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. i SEE REVERSE SIDE Smoke Det. DUNKIN" DONUTS DATE EMPLOYMENT APPLICATION NAME SOC.SEC.NO. TEL NO. ADDRESS CITY&STATE RiP cooe:f HIGH SCHOOL COLLEGE CITY&STATE CITY&STATE LAST YEAR COMPLETED LAST YEAR COMPLETED EMPLOYMENT RECORD(LST MOST RECENT EMPLOYMENT FIRST) You may include any verified worts performed on a voluntary basis. NAME AND ADDRESS OF COMPANY DATE TYPE SALARY NAME OF REASON FOR TO-FROM WORK SUPERVISOR LEAVING AVAILABILITY-STATE ALL HOURS YOU WILL BE ABLE TO WORK IN CHART BELOW MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY CHECK ONE FROM o FULL TDA TO o PART TIME RWORTAMT:WORIONG PAPERS OR A CERTFICATE OF AGE MAY K REQUIRED AFORE NI ING1. In answering the following questions,you may omit any information or answer"no record"with regard to any conviction for which there is a sealed record on file.You should also omit first convictions for drunkenness,simple assault,speeding,minor traffic violations,affray or disturbance of the peace. 1. Have you ever been convicted of a felony? Yes EI No F] If yes,give details and date. 2. Have you been convicted of a misdemeanor in the last five years? Yes [] No El If yes,give details and date. Are you a U.S.citizen or otherwise legally able to work in the U-S.? Yes U No El Proof of employability will be required of all applicants hued The facts set forth in my application for employment are true and complete.1 understand that if I am employed,false statements on this application shall be considered sufficient cause for dismissal. I agree that all individuals supplying information about me,for reference purposes,are released from liability. If a job opportunity is offered, shall comply with all Dunkin'Donuts uniform requirements_ I understand That job responsibilities often include counter work,product preparation and cleaning duties. Unless box below is checked,this is an independently owned and operated FRANCHISE of the DUNKIN'DONUTS SYSTEM. Company Operated Shop SIGNATURE OF APPLICANT Selection of employees will be on the basis of occupational qualification,education and character without regard to age,sex,race,creed,color,national origin or handicap. v Applicants for employment in Massachusetts note.It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment An employer who violates this law shag be subject to criminal penalties and civil liability. •c OUN GIT DONUTS IS AN EQUAL OPPORiUM7Y EMPLOYER PER/115IR15195 DUNKIN' DONUTS 853 Turnpike Street Suite 144 North Andover, MA 01845 Phone: 978-681-9667 Fax: 978-738-8834 October 18,2000 Mr.James Lyons Town of North Andover Commission on Disability Issues 120 Main Street North Andover, MA 01845 Dear Jim: Thank you for meeting with me today to discuss accessibility issues at our 129 Main Street location. As we discussed, the following changes will be made: MEN'S ROOM: 1. Replace tilt mirrors with vertical mirrors 40"above finished floor. 2. Lower soap dispenser to 40"above finished floor. 3. Install one coat hook 42"from finished floor. 4. Relocate flush-activator to right side of toilet. LADIES ROOM: 1. Replace tilt mirrors with vertical mirrors 40"above finished floor. 2. Lower soap dispenser to 40"above finished floor. 3. Install one coat hook 42"from finished floor. ENTRANCE DOOR: Create new additional A.D.A.-compliant entrance using one of the three (3) agreed-upon accessible solutions: 1. New door with automatic opener and re-grading to proper slope(1"A 2"). 2. Construct concrete ramp with proper slope, 5'x 5' landing, manual door, and rails on both sides of ramp and around landing. 3. Install pre-fabricated ramp with proper slope, 5'x 5'landing, manual door,and rails on both sides of ramp and around landing. Per our agreement, bathrooms would be made compliant immediately (prior to opening of business). Entrance doors will be completed within 60 days(December 18,2000). Ancerely, r4vl�,�l (5,-,_- Michael J.Quinn Franchisee o , I 1 S rr-s4'T'l A3o,. V'A co L _ s- - gY•i,)Ti IS C9 Levs 1-7LAMA z o ' V ADA wwt Derr 'G,'A1L 1y LLcu�Ti 1 l�� rz rMvan k ccr o C6 � f 0 fl U O T 'O N Cy C- TJ tU i Oct 18 00 04: 22p DUNKIN DONUTS NORTH AND 978 7388834 p. 1 853 Turnpike St„ Suite#144 North Andover, MA 01845 DUNKIN' DONUTS PHONE: 978-681-9667 FAX: 978-738-8834 Fax To: From MIKE QUINN Fax- `S er y/ ULA zrc-sCO ff" Pages: a, (Incl/udes Cover Sheet) Phony. Dotal �Q A�le O Re: U11L1*1fit1 0OX-16173 CC: ❑Urgent ❑ For Review. ❑Please Comment E3 Please Reply p Please Recycle e Comments; B sz - . Oct 18 00 04: 23p DUNKIN DONUTS NORTH REVD 976 7388834 p- 2 DUNKIN DONUTS Sui Turnpike Street Suite 144 North Andover, MA 01845 Phone: 9TB-681-9667 Fax: 978-738-8834 October 18,2000 Mr.James Lyons Town of North Andover Commission on Disability Issues 120 Main Street North Andover,MA 01845 Dear Jim: Thank you for meeting with me today to discuss accessibility issues at our 129 Main Street location. As we discussed, the following changes will be made: MEN'S ROOM: 1. Replace tilt mirrors with vertical mirrors 40'above finished floor. 2. Lower soap dispenser to 40"above finished floor. 3. Install one coat hook 42"from finished floor. 4. Relocate flush-activator to right side of toilet LADIES ROOM: 1. Replace tilt mirrors with vertical mirrors 40"above finished floor. 2. Lower soap dispenser to 40'above finished floor. 3. Install one coat hook 42"from finished floor. ENTRANCE DOOR: Create new additional A.D.A.-compiient entrance using one of the three (3) agreed-upon accessible solutions: 1. New door with automatic opener and n3-grading to proper slope(1"-12"). c� 2. Construct concrete ramp with proper slope,5'x 5'landing,manual door,and rails on both sides of ' ;) ramp and around landing. TD0 3. Install pre-fabricated ramp with proper slope,5'x 5'landing,manual door,and rails on both sides of ramp and around landing. Per our agreement, bathrooms would be made compliant immediately (prior to opening of business). Entrance doors will be completed within 60 days(December 18,2000). cerely, Michael J.Quinn AJ Citi Q Franchisee - J � / �wtwr!s .::.. •wr,�s:wisawrrA ar�s�eaMs... It7ME:1MYfip' <lM..!kiMN I�NpE.,., 1{:3.I.MtNM1 the northeast independent living program, inc. DATE: 2d 6-0 TO: B0 FROM: _ NUMBER OF PAGES (including fax cover sheet): NOTES: �Q) S - - ( rn cj D n Or m i Q,- Qom - � —�za8 u PLEASE DELIVER IMMEDIATELY! Full community participation 20 Ballard Road, Lawrence, Massachusetts 01843 through education, training (978) 687-4288 (Voice/TTY) Fax: (978) 689-4488 and advocacy by and for Amesbury Office:24 Morrill Place,Amesbury, MA 01913 978 388-0677 Voice/Fax/TTY OJi1i°�""" people with disabilities. � ) � ) 1 Merrimack Valley / ct 18 00 04: 22p DUNKIN DONUTS NORTH AND S78 7388834 p. 1 853 Turnpike St., Suite#144 North Andover, MA 01845 DUNKIN7 DONUTS PHONE- 978-881-9667 FAX: 978-738-8834 Fax To: T/w'-ej From: MIKE QUINN l:ax:/43" zrc- Pages: (Includes Cover Sheet) Phony. Date: �__ Agr le O Re: U!'✓lc/t� (JCS!"/ 1.7 CC.- 0 C:l7 Urgent E-3 For Review 13 Please Comment O Please Reply ❑Please Recycle *Comments: L' 6 Y41-4-�Ljl� 11L y 1 Oct 18 00 04: 23p DUNKIN DONUTS NORTH AND 978 7388834 p. 2 DUNKIN' DONUTS Sui Turnpike Street Suite 144 North Andover, MA 01845 Phone: 978-681-9667 Fax: 978-738-8834 October 18,2000 Mr.James Lyons Town of North Andover Commission on Disability Issues 120 Main Street North Andover,MA 01845 Dear Jim: Thank you for meeting with me today to discuss accessibility issues at our 129 Main Street location. As we discussed, the following changes will be made: MEN'S_ROOM: 1. Replace tilt mirrors with vertical mirrors 40"above finished floor. 2. Lower soap dispenser to 40"above finished floor. 3. Install one coat hook 42"from finished floor. 4. Relocate flush-activator to right side of toilet. LADIES ROOM: 1. Replace tilt mirrors with vertical mirrors 40"above finished floor. 2. Lower soap dispenser to 40'above finished floor. 3. Install one coat hook 42"from finished floor. ENTRANCE DOOR: Create new additional A.D.A.-compiiant entrance using one of the three (3) agreed-upon accessible solutions: 1. New door with automatic opener and re-grading to proper slope(1"-12 ). 4' 2. Construct concrete ramp with proper slope,5'x 5'landing, manual door,and rails on both sides of �D 0 1J ramp and around landing. 3. Install pre-fabricated ramp with proper slope,5'x 5'landing,manual door,and rails on both sides of ramp and around landing. Per our agreement, bathrooms would be made compliant immediately (prior to opening of business) Entrance doors will be completed within 60 days(December 18,2000). cerely, .std ' Michael J.Quinn Franchisee r ` 1 J O4 Town of NORTH ANDOVER COMMISSION on DISABILITY ISSUES 120 Main Street • North Andover, Massachusetts 01845 the northeast 0. independent IR program, inc. 20 Ballard Road, Lawrence, Massachusetts 01843 1 �. 5 J Date.. ��.....U No . ....... . ............ NORTH °`,«`° :•�"° TOWN OF NORTH ANDOVER - ' PERMIT FOR WIRING ,SSACMUS� 1 This certifies that has permission to perform ........... wiring in the building of,.........!�.:r. ........ . ......:..................................... ,North Andover,Mass. Fee7Zr-.......... Lic.No 4./C /-.Z- .......... —:���.... �•..�r................... �ELECTRICAL INSPECTOR Check # �` — WHITE: Applicant CANARY: Building Dept. PINK:Treasurer OfficialUseOnly Permit No. �Lfb !1i G�(if���'�GW`i1g.�/ Ts f��'�G1g.�s1g�%fr•v`.���.� � 6'-tl as Sa�euy Occupancy&Fee Checked,f BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Date Gg�� ay,a c-oo To the Ins for of Wires: Town of North Andover The undersigned applies for a permit to perform theCelleectn I work described below. Location(Street&Number �C�n9Q i r�! Jf' Ale., O4 Owner or Tenant� ^� �` O Owner's Address Is this permit in conjunction with a building permit Yes No ❑ (Check Appropriate Box) Purpose of Building o� ` �+� ` Utility Authorization No. Existing Service cJbf) Amps /d Voits Overhead ❑ Undgmd 3- '- No.of Meters. New Service Amps voits Overhead ❑ Undgrnd ❑ No.of Meters Number of Feeders and Ampacity 6 &W;re Location and Nature of Proposed Electrical Work ecLf�itie c.tzx;r E T tu�J i�c 2 c Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA Above ❑ In ❑ No.of Lighting Fixtures Swimming Pool grnd ❑ grnd ❑ Generators KVA No.of Emergency Lighting No.of Receptacles Outlets No.of Oil Burners -Battery Units 7S_1Y�vl Si S No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone hex; ,- Total ^^ No.of Detection andc�S f No.of Ranges No of Air Con 3 1 Nrw � Tons oho Initiating Devices Heat Total Total No.of Di osal No. Pumps Tons KW No.of Sounding Devices No./of Self Contained i No.of Dishwashers Space/Area Heating KW Detection/Sounding Devices ❑ Municipal ❑ Other No.of Dryers Heating Devices KW Local Connection j No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases I Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER 2e�OCc (,c i G�g,C��tI 7C�rrl4n.�n /�Wa �` (�•��I� (.J�f �"�c�d- t IT�ttL INSURANCE COVERAGE. Pursuant'fo t e requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy incluci mpleted Operations Coverage or its substantial equivalenYES NO = ,have-submitted,valid proof of same to the Offs YES NO = If you have checked YES please indicate the type o'coverage by checking the appropriate box INSURAN - BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Ele Tical Work$�g C702� Work to Start S Inspection Date Resquested-icri I I c-<:,W Rough Final Signed under Pen I_ties of perjury: FIRM NAME ..,i E ffA3:x C_ cl S LA'r`A C,ri4o t,Xi� `A4 4 G1631 LIC.NO.4113IG2, L ensee��g �A��Z3ac __ Signature ^mac Q c // LIC.NO.�3606OF /� /- Bus-Tel No. Co �—/T? y642 Address0P4(. -fa, &1(�,A M A '0!&;t Arc Tel.No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) �L c� Telephone No. PERMITTEE $ (Signature of Owner or Agent) N° 2 5 u 0 Date.................................. �aOR7M <<``°:•�"� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING •D�Ai�D��,V� ��SSAcm � i This certifies that .. has permission to perform ..........� " .................................. ,,....... . .. Ni r wiring in the building of at.............,.... ..........'...... ............�................./..........................North Andover,Mass. Fee Lic.NoH.e i?- ?- / � . �• .................... .............................................................. / ELECTRICAL INSPECTOR Check # WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Official Use Only Permit No. Cz—pz) De�ant�:art S Occupancy&Fee Checked N � BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 MR 12:00 (Please Print in ink or type all information) Date /, (Please dO Town of North Andover To the 1 Spector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number �G1 1 t tc�tt�} �-�-• 1� I v+�(�` S oy�� — Owner or Tenant c y� +t•N �jr Owner's Address_S�woo Is this permit in conjunction with a building permit Yes Cp/ No ❑ (Check Appropriate Box) Purpose of Building QC sz-r,iCe n"Al, UCO&! Utility Authorization No. OL (off Existing Service O Amps /dv a© Voits Overhead f.0�_ Undgrnd ❑ No.of Meters �(c New Service Amps 4O o�17 Voits Overhead fes— Undgrnd ❑ No.of Meters Number of Feeders and Ampacity 4i , , cj22V c pm Location and Nature of Proposed"Electric, Work A,��� �^� £reMov oT o/CJG.,in r h.•�G /;/� ' �✓r Total No.of Lighting Outlets No.of Hot fuse of Transformers KVA Q Above ❑ In ❑ No.of Lighting Fixtures 8 Swimming Pool grnd ❑ grnd ❑ 7TGenerators KVA No.of Emergency Lighting No.of Rece tacles Outlets No.of Oil Burners Battery Units No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No.of'Ran es No of Air Cond Tons Initiating Devices Heat Total Total No. Di osal No. Pumps .Tons KW No.of Sounding Devices No./of Self Contained No.of Dishwashers S ace/Area HeatingKW Detection/Sounding Devices ❑ Municipal ❑ Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wirin No.Hydro Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy includin Completed Operations Coverage or its substantial equivalent ES NO = have ed valid proof of same to the Office= NO = If you have checked YES please indicate the type o coverage by checking the appropriate box. I URANCE BOND = OTHER = (Please Specify) pD (Expiration Date) Estimated Value of Ele trical Work$ Soco t Work to Start / Inspection Date Resquested Rough Final Signed underta Penalties of perjury : FIRM NAME AA&y , ,uC �'S �ati,i tirG oLvrni/rl/t pt0t LIC.NO.�} //3�a �� Lit �i .. Signature pn� LIC.NO. Address o��GO veld � �c� M�O(ed( Bus.Tel No. lel"1571-7 � Alt Tel.No. —Y f i—,P6e79 OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMITTEE $ (Signature of Owner or Agent) Location No. 7 y Date O�°� -C�0 NORTH TOWN OF NORTH ANDOVER f �,r 3? � • �L ' Certificate of Occupancy $ #;7 b''•o'�t�� C Building/Frame Permit Fee $ sswusE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ � Check # / d / 4 j�Building Inspector a IJWN OF NORTH ANDOVER BUH DING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING Section for Official Use OaI BUILDING PERMIT NUMBER- � DATE ISSUED: z SIGNATURE: 0 BuildingCommission or of Buildings Date 1.1 Property Address: L2 Assessors Map and Parcel Number: 129 Main Street • Existing Dunkin' Donuts Store Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: v Zoning District Proposed Use Lot Area Frontage ft 1.6 BUIILDING SETBACKS(ft) rn Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided �[ Existing ___ Existing Existingw 1.7 Water Supply M.G.L.C.40.§54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal On Site Disposal System ❑ 1 2. Owner of ecord l\�7 ) o Name(Print) n Address for Service: Signature Telephone 2.2 Authorized Agent Robert Waxman 107 Audubon Road, Building #1, Wakefield MA D N e nn Address for Service: z (781) 246-1900 Si ture Telephone /m ,- ..,� .i.. .... gay..._ ♦ r1 x 3.1 Licensed Construction Supervisor Not Applicable ❑ 80 Haverhill Street CS 062407 Address License Number 11� X1 Lice Co c' n Supervisor: 2/24/2002 781-246-1900 Expiration Date Sign Telephone 3.2 Registered Home Improvement Contractor Not Applicable 9 v Company Name,. Registration Number Address r Expiration Date Z Signature Telephone �+ SECTIUN 4 [fl SA1fI0NX1XG.1„C x 25it�'( —\ ` Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will sulNn the denial o.'(& issuance of the building permit. Signed affidavit Attached Yea.......Ik No.......❑ SECT ON s-PB©F t�lv�ek IfES�I�i 1'+13 C NS C7 x�N��RYI<CES �O ��D -GS ANb SMUG 5��::3�3 COI+ISTBUCTiaN C+(3ITRUL PSt7AX1 C3 Cl�1R STA ll+l<4ii 'THAED 35,E G7 O +TC> 1SE111 Si'At'l 5.1 Registered Architect: New England Design Name: P.O. Box 311 — West Barnstable, MA Address (508) 362-9724 Signature Telephone ,5:2 Regst��+e�'Prafess��al� l �a� _ Area of Responsibility Name: Registration Number Address: Expiration Date Signature Total Not applicable ❑ Name: Registration Number Address Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number ANA—111,10-0, Telephone Expiration Date Ir�l'4F1 Prism Builders Inc. Company Name: Not Applicable ❑ Anthony Scanzillo Responsible in Charge of Construction C J 94 '.` �"T� , �r��'�►�!�ON;��'I�'Rt�# C� . { Ic ail Rj�?'IIe�SIt:� New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) k7 Addition ❑ Accessory Bldg. ❑ Demolition 0 Other 0 Specify Brief Description of Proposed Work: Interior renovation including: carpentry, painting. electrical, floor tile & plumbing us ow ITT, N USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 0 IA 0 A-4 0 A-5 0 113 ❑ B Business 2A 0 C Educational ❑ 2B 0 F Factory ❑ F-1 ❑ F-2 0 2C ❑ H High Hazard 0 3A ❑ IInstitutional ❑ I-1 ❑ 1-2 ❑ I-3 0 3B M Mercantile 0 4 ❑ R residential ❑ R-1 ❑ R-2 ❑ R-3 0 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use 0 Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels 2 Floor Area per Floors 2,040 Total Areas 4,080 Total Height ft 16' Independent Structural Engineering Structural Peer Review Required Yes ❑ No I SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT OI, ,as Owner of the subject property Hereby authorize Prism Builders Inc. to act on My behalf, in all matters relative two work authorized by this building permit application _ Wy� V/i U -710 of o Signature of Owner Date 1, Prism Builders Inc. asOwner/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 Robert Waxman Print Nam W%,,,,, 7-28-00 Signature oV Owner/Agent Date Item Estimated Cost(Dollars)to be Completed by permit applicant 1. Building (a) Building Permit Fee $118,000. Multiplier 2 Electrical (b) Estimated Total Cost of $ 18.000. Construction from(6) 3 Plumbing $ 17,000. Building Permit fee (a)x(b) 4 Mechanical(HVAC) $ 18,000. 5 Fire Protection N/A 6 Total (1+2+3+4+5) $171,000. Check Number t ?a 1�int51 2 9f 3 S is`as -A' 5t P ttF s d F �a 7 ''ttS to �-a v A t r, ry sM' yrr� fr r A �tx q"L :.Xc s �; iv t 5 ;y r; NO.OF STORIES 1 SIZE BASEMENT OR SLAB Basement /r SIZE OF FLOOR TIMBERS INI Existing 2 ° 3RD SPAN Existing DEMENSIONS OF SILLS Existing DEMENSIONS OF POSTS Existing DIMENSIONS OF GIRDERS Existing HEIGHT OF FOUNDATION Existing THICKNESS Existing SIZE OF FOOTING X Existing MATERIAL OF CHIlANEY N/A IS BUILDING ON SOLID OR FILLED LAND Existing IS BUILDING CONNECTED TO NATURAL GAS LINE Existing :. ,. 'i x} ..cin 0",> a •+ --" trt' t yadaa # .,t, r :{ w"; ,•+5'. 'is s 'S,'ii 0 NORTH TO" . Of , Andover � -alon T �O t-_- L A O dover, Mass., ACOCMICMEWICK V % DRATED PPat�S S ` BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIE THAT./on�.� Al� � .. •� r Dwokow NN14 , B�KMh01. ............ ........................................ c •••••••••••••• ••••••••••••• Foundation has permission to at...IN f PIP*- buildings on S+ ' g ... I.a ......M.A.1.0............................ .............. Rough to be occupied as 7)O N t u� C"a rn S �O A el r; ,�'1 Chimney • V e�e . . . . . .. . . . provided that the person accepting this permit shall 1n every respect conform do terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws elating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. ft) 03 0 1 ' PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR Rough C Service BUILDING INSPECTOR Final r Occupancy Permit Required t0 Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner p Street No. SEE REVERSE SIDE smoke Det. c Memorandum To: Sandra Starr,Health Director CC: Building Dept. ' From: Susan Ford Date: 08/16/00 Re: Main Street Dunk'in Donuts review Sandy, I have reviewed the plan for the renovation of the Main Street Dunk'in Donuts and have telephoned the owner,Mike Quinn. The outstanding question is? Question 2) Where are the dip-wells and their associated plumbing? There is nothing showed on the plan. He will most likely address the dip-well issue today,but if not,I wanted you to know my position on a building permit sign off. Once addressed, I have no other outstanding concerns and am recommending Health Department approval of the plan. f G2 7' r/ 2_ . r'_.. L "'ti.,. ���..n_._.. �• �''_`�j_ C.. i? Lf.c....N� i-'1 �>� .._�_ �`?.. \� 1 r � S 1 ✓lce V�am�naarw�ea�i a�/��aaaac�auaella BOARD OF BUILDING REGULATIONS ;License: CONSTRUCTION SUPERVISOR Number: CS 062407 Birthdate: 02124/1951 l ` Expires:02/24/2002 Tr.no: 17414 / Restricted To: 00 ANTHONY A SCANZILLO � 80 HAVERHILL ST zz,-eC 7--- READING, MA 01867 Administrator y • Town of North AndoverNORTFI 0F�t,�o 6! O Building Department o Z. 27 Charles Street North Andover Massachusetts 01845 h (978) 688-9545 Fax (978) 688-9542 SSAGHUS� DEBRIS DISPOSAL FORM In accordance with the pro isions of MGL c 40 s 54, and a condition of Building permit# —the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in/at: Dependable Waste Disposal-Peabody, MA Facility location Sigr6ture of Applicant 7-28-00 Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. t , The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: Location: City Phone am a homeowner performing all work myself. �I am a sole proprietor and have no one working in any capacity 0 I am an employer providing workers' compensation for my employees working on this job. Company name' Prism Builders Inc. Address 107 Audubon Road, Building Ill, Suite #19 City. Wakefield MA 01880 Phone#: 781-246-1900 Insurance Co. Great American Policy# WC814322-05 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 and h p and penalties of perjury that the information provided above is true and correct Signature I Date 7-28-00 9 Print name Ro ert Waxman Phone# 781-246-1900 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 ❑ Licensing Board ❑ Selectman's Office Contact person: _ Phone#: ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION r , 19 9 7 ED IT I ON e AIA DOCUMENT A107-1997 Abbreviated Standard Form of Agreement Between Owner and Contractor for Construction Projects of Limited Scope where the basis of payment is a STIPULATED SUM This document includes abbreviated General AGREEMENT made as of the eighteenth day of JulY Conditions and should in the year Two Thousand not be used with other (In words,indicate day,month and year) general conditions. BETWEEN the Owner: North Andover Donut Inc. This document has impor- (Name,address and other information) 853 Turnpike Street tant legal consequences. North Andover, MA 01845 Consultation with an attorney is encouraged with respect to its completion or modification. and the Contractor: Prism Builders, Inc. This document has been (Name,address and other information) 107 Audubon Road approved and endorsed by Building 1 — Suite 19 The Associated General Wakefield, MA 01880 Contractors of America. the Project is: Renovations to Dunkin Donuts (Name and location) 129 Main Street North Andover, MA 01845 the Architect is: New England Design _ (Name,address and other information) P. 0. Box 311 West Barnstable, MA 02668 ,� P/,a p1997 A I A 0 AIA DOCUMENT A107-1997 The Owner and Contractor agree as follows. ABBREVIATED OWNER- CONTRACTOR AGREEMENT The American Institute of Architects 1735 New York Avenue, N.W. Copyright 1936, 1951, 1958, 1961, 1963, 1966, 1974, 1978, 1987,© 1997 by The American Institute of Architects. Washington,D.C.20006-5292 Reproduction of the material herein or substantial quotation of its provisions without written permission of the AIA violates the copyright laws of the United States and will subject the violator to legal prosecution. WARNING:Unlicensed photocopying violates U.S.copyright laws and will subject the violator to legal prosecution. ' T v ARTICLE I THE WORK OF THIS CONTRACT The Contractor shall fully execute the Work described in the Contract Documents,except to the extent specifically indicated in the Contract Documents to be the responsibility of others. ARTICLE 2 DATE OF COMMENCEMENT AND SUBSTANTIAL COMPLETION 2.1 The date of commencement of the Work shall be the date of this Agreement unless a different date is stated below or provision is made for the date to be fixed in a notice to proceed issued by the Owner. (Insert the date of commencement, if it differs from the date of this Agreement or,if applicable,state that the date will be fixed in a notice to proceed.) Within five (5) days of receipt of Building Permit 2.2 The Contract Time shall be measured from the date of commencement. 2.3 The Contractor shall achieve Substantial Completion of the entire Work not later than thirty=five days from the date of commencement,or as follows: (Insert number of calendar days.Alternatively,a calendar date may be used when coordinated with the date of commencement. Unless stated elsewhere in the Contract Documents, insert any requirements for earlier Substantial Completion of certain portions of the Work.) subject to adjustments of this Contract Time as provided in the Contract Documents. (Insert provisions,if any,for liquidated damages relating to failure to complete on time or for bonus payments for early completion of the Work.) IIIA 0 0 o. .o ARTICLE 3 CONTRACT SUM r--� OD 3.1 The Owner shall a the Contractor the Contract Sum in current funds for the AIA A I A pay AIA DOCUMENT A107-1997 Contractor's performance of the Contract. The Contract Sum shall be ABBREVIATED OWNER- ONE HUNDRED SEVENTY—ONE THOUSAND ------ Dollars(s 171,600.00 ) CONTRACTOR AGREEMENT subject to additions and deletions as provided in the Contract Documents. The American Institute See Exhibit "A" of Architects 1735 New York Avenue, N.W. Washington, D.C.20006-5292 WARNING:Unlicensed photocopying violates U.S.copyright laws and will subject the violator to legal prosecution. ' r 3.2 The Contract Sum is based upon the following alternates,if any,which are described in the Contract Documents and are hereby accepted by the Owner: (State the numbers or other identification of accepted alternates.If decisions on other alternates are to be made by the Owner subsequent to the execution of this Agreement,attach a schedule of such other alternates showing the amount for each and the date when that amount expires.) 3.3 Unit prices,if any,are as follows: ARTICLE 4 PAYMENTS 4.1 PROGRESS PAYMENTS 4.1.1 Based upon Applications for Payment submitted to the Architect by the Contractor and Certificates for Payment issued by the Architect, the Owner shall make progress payments on account of the Contract Sum to the Contractor as provided below and elsewhere in the Contract Documents. The period covered by each Application for Payment shall be one calendar month ending on the last day of the month,or as follows: 4.1.2 Provided that an Application for Payment is received by the Architect not later than the �•-� twenty—fifth day of a month,the Owner shall make payment to the oo Contractor not later than the eighteenth day of the f ollowingnonth. 0 19 97 A I A@ If an Application for Payment is received by the Architect after the date fixed above,payment shall AIA DOCUMENT A107-1997 be made by the Owner not later than days after the ABBREVIATED OWNER- Architect receives the Application for Payment. CONTRACTOR AGREEMENT The American Institute of Architects 1735 New York Avenue, N.W. Washington,D.C.20006-5292 WARNING:Unlicensed photocopying violates U.S.copyright laws and will subject the violator to legal prosecution. 4.1.3 Payments due and unpaid under the Contract shall bear interest from the date payment is due at the rate stated below,or in the absence thereof,at the legal rate prevailing from time to time at the place where the Project is located. (Insert rate of interest agreed upon,if any.) (Usury laws and requirements under the Federal Truth in Lending Act,similar state and local consumer credit laws and other regulations at the Owners and Contractors principal places of business, the location of the Project and elsewhere may affect the validity of this provision. Legal advice should be obtained with respect to deletions or modifications,and also regarding requirements such as written disclosures or waivers.) 4.2 FINAL PAYMENT 4.2.1 Final payment,constituting the entire unpaid balance of the Contract Sum,shall be made by the Owner to the Contractor when: .1 the Contractor has fully performed the Contract except for the Contractor's responsibility to correct Work as provided in Paragraph 17.2, and to satisfy other requirements,if any,which extend beyond final payment;and .2 a final Certificate for Payment has been issued by the Architect. 4.2.2 The Owner's final payment to the Contractor shall be made no later than 3o days after the issuance of the Architect's final Certificate for Payment,or as follows: ARTICLE 5 ENUMERATION OF CONTRACT DOCUMENTS 5.1 The Contract Documents are listed in Article 6 and,except for Modifications issued after execution of this Agreement,are enumerated as follows: 5.1.1 The Agreement is this executed 1997 edition of the Abbreviated Standard Form of Agreement Between Owner and Contractor,AIA Document A107-1997. 5.1.2 The Supplementary and other Conditions of the Contract are those contained in the Project Manual dated and are as follows: Document Title Pages I yl 0 oo: .o� p1997 AIA® AIA DOCUMENT A107-1997 ABBREVIATED OWNER- CONTRACTOR AGREEMENT The American Institute of Architects 1735 New York Avenue, N.W. Washington, D.C.20006-5292 WARNING:Unlicensed ohotocoovinQ violates U.S.coovriehi laws and will subject the violator to legal prosecution. 5.1.3 The Specifications are those contained in the Project Manual dated as in Subparagraph 5.1.2,and are as follows: (Either list the Specifications here or refer to an exhibit attached to this Agreement.) Section Title Pages 5.1.4 The Drawings are as follows,and are dated unless a different date is shown below: (Either list the Drawings here or refer to an exhibit attached to this Agreement.) Number Title Pages See Exhibit "B" 5.1.5 The Addenda,if any,are as follows: Number Date Pages Portions of Addenda relating to bidding requirements are not part of the Contract Documents unless the bidding requirements are also enumerated in this Article 5. 5.1.6 Other documents,if any,forming part of the Contract Documents are as follows: (List any additional docianents which are intended to form part of the Contract Documents.) 0 0 O Q 1997 AIA® AIA DOCUMENT A107-1997 ABBREVIATED OWNER- CONTRACTOR AGREEMENT The American Institute of Architects 1735 New York Avenue,N.W. Washington,D.C.20006-5292 WARNING:Unlicensed photocopying violates U.S.copyright laws and will subject the violator to legal prosecution. 9 'ARTICLE 20 OTHER CONDITIONS OR PROVISIONS This Agreement entered into as of the day-and vear first written above. NORTH ANDOVER DONUT INC. PRISM BUILDERS, INC. O W N E R(Signature) C 0 N T R A C T 0 R(Signature) (Printed name and title) (Printed name and title) CAU' '-'' 1`011 should sign an original.-1L-1 document or a licensed reproduction.Originals contain the.-1LA logo printed in red;licensed reproductions are those produced in accordance with the Instructions to this document. © 1997 AIAOO AIA DOCUMENT A107-1997 ABBREVIATED OWNER- CONTRACTOR AGREEME;:- The American Institute of Architects 1735 New York Avenue, N.W. Washington, D.C.20006-529: WARNING:Unlicensed photocopying violates U.S.copyright laws and will subject the violator to legal prosecution. RETROFIT BID FORM Prism Builders, Inc. J EXHIBIT "A" BUILDING IQTY 1UNIT (UNIT COST COST DIVISION 2-SITEWORK II 15,000 02050 Building Demolition I JEA I I 11,800 02051 Trenching/Sawcutting/Removal/Infill I IEA I 3,200 02200 Earthwork for Building Addition I EA I N/A I DIVISION 3-CONCRETE I I N/A 03300 Footings & Foundation EA 03300 Concrete Slab I IEA 33000 Concrete Sidewalk I EA I DIVISION 4-MASONRY I I I N/A 04200 Masonry I IEA 04220 Exterior Insulated Finish System I ISF I I DIVISION 5-METALS II I N/A 05100 Steel Beams & Columns I IEA 05500 Steel Ladder I EA I I I DIVISION 6-WOOD I I I I 18,600 06100 Carpentry-Rough I IEA I 15,500 06150 Parapet Framing (awning) I ILF I N/A 06200 Carpentry-Finish IEA I 3,100 I I j I DIVISION 7-MOISTURE PROTECTION j I I I 2,200 07210 Insulation (batt) I ISF I N/A 07400 Atas Aluminum Fascia System I ILF I N/A 07510 Built-Up Roof(with rigid insulation) I SF I 2,200 07520 Roll Roofing I ISF I N/A 07260 Gutter& Downspouts I IEA I I N/A I I DIVISION 8-DOORS & WINDOWS I 1 i I 8,300 08110 Doors-Metal with Hardware IEA I I 3,000 08210 Doors-Wood with Hardware l IEA I N/A 08213 Eliason Door I IEA I I 1,000 08410 Aluminum Storefront I IEA I 4,300 08411 Drive-thru Window I IEA I N/A I I I I I I I I I I I I I I I I I I i I I I I I i I I I I I I I I l I I I I I I I I I I RETROFIT BID FORM Prism Builders, Inc. DIVISION 9-FINISHES I 41,100 09250 Gypsum Wall Board and Durock I SF 12,500 09330 Ceramic Tile ISF 18,700 09330 Tile Base ILF I 700 09330 Quarry Tile ISF I N/A 09510 Acoustical Ceiling (Sales) ISF 1,600 09520 Acoustical Ceiling (Kitchen) I ISF I 1,400 09660 Floor Covering-VAT I (SF N/A 09661 Resilient Base ILF N/A 09900 Painting I IEA I 3,200 09950 Fiberglass Wall Covering I ISF 1,600 09952 Vinyl Wall Covering j jSF j j 1,400 I I DIVISION 10-SPECIALTIES I I I I 800 10671 Shelving I IE4 I N/A 10820 Toilet Accessories I I EA I i 800 I DIVISION 15-MECHANICAL i j 37,300 15100 Plumbing I EA I I 17,600 15200 HVAC j IEA I 19,700 15300 Make-Up Air I IE4 I I N/A 15400 Hood w/Ansul System I IEA N/A � I f DIVISION 16-ELECTRICAL I I 18,000 16100 Electrical IEA ( I 18,000 16200 Electrical Service Upgrade I jEA I I N/A GENERAL CONDITIONS Dumpster I I I 14,700 IEA ( I 3,100 Temporary Services I IEA j I 600 Supervision IWK I 5,500 Final Cleaning ! iEA I I 1,000 Insurance I IEA I j 3,500 Misc Costs j I f 1,000 SUB TOTAL- BUILDING I I I I 156,000 OVERHEAD & PROFIT- BUILDING I I I I 15,600 TOTAL- BUILDING j I I I 171,600 I I I I I I I I j I I I ( I I I ! I I I f i j I I 1 I I i i I I ! I RETROFIT BID FORM Prism Builders, Inc. STORE INFORMATION Store Location:N.Andover, NIA 6/23/00 CONTRACTOR INFORMATION Name: Prism Builders Inc Address: 107 Audubon Road Building 1 Suite 19 Wakefield MA 01880 Contact Person: Bob Waxman Phone: 781-246-1900 Fax: 781-246-0901 BID INFORMATION Site Cost: I � � I Building Cost: N/A 171,600 Total Bid Cost: 171,600 COMPLETION TIME IN 42 CONSECUTIVE DAYS The undersigned proposes to furnish all labor, material and equipment required for the construction of an Allied Domecq Retailing USA Brand building, and all site work at the above subject location in accordance with the bid documents. The contractor certifies that he has inspected the site and carefully reviewed all bid documents. Bid documents include Dunkin Donuts National Accounts Book and all addendums. Qualifications: � � I 1.Bid proposal is valid for 30 days. 2.Removal of asbestos is not included. 3.Providing signage is not included. EXHIBIT"B" Document Title Date Tl Title Sheet 6/1/00 Al Floor Plan, Schedules and Details 6/1/00 A2 Details,Schedules 6/1/00 A3 Reflected Ceiling Plan 6/1/00 A4 Floor Tile Plan,Legend 6/1/00 A5 Exterior Elevations 6/1/00 EQ1 Equipment Plan,Equipment Schedules 6/1/00 E1 Electrical Lighting Plan 6/1/00 E2 Electrical Power Plan,Electrical Panel Boards 6/1/00 P1 Plumbing Plans,Schedule 6/1/00 M1 Mechanical Plan,Legend 6/1/00 ' ACORD CERTIFICATE OF LIABILITY INSURANCgSR JU DATE(MM/DD/YY) RISM-1 07/14/00 PRODUCER , ` THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE John McLaughlin Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 828 Lynn Fells Parkway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Melrose MA 02176 COMPANIES AFFORDING COVERAGE John E. McLaughlin Jr. COMPANY Phone No. 781-665-2775 Fax No.781-665-0295 A Great American Ins. Co. INSURED COMPANY Prism Builders, Inc. B CGU Insurance Attn: Tony Scanzillo COMPANY 107 Audubon Road, Bldg 1 C Suite 19 COMPANY Wakefield MA 01880 D COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MM/DD/YY) DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE I S 2 000 000 A X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OPAGG I S 2 000 000 CLAIMS MADE 7X PERSONAL&ADV INJURY 1$1,000,000 OWNER'S&CONTRACTOR'SPROT PAC 8143210 01/05/00 01/05/01 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE(Any one fire) $ 100,000 MED EXP(Any one person) $ 5,000 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $1,000,000 ALL OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS CBXB17590 01/05/00 01/05/01 (Per person) B X HIRED AUTOS BODILY INJURY $ B X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT I$ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT S AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE I $5,000,000 A X UMBRELLA FORM AGGREGATE S 5 000 000 OTHER THAN UMBRELLA FORM 1180429 01/05/00 01/05/01 I$ WORKERS COMPENSATION AND I TORY WCSTATU- IOER-I EMPLOYERS'LIABILITY p' THE PROPRIETOR/ EL EACH ACCIDENT 1 $500,000 PARTNERS/EXECUTIVE X INCL WC814322-05 01/05/00 01/05/01 EL DISEASE-POLICY LIMIT 1 $500,000 OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE I S 500 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION DUNKI—1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Dunkin Donuts 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Michael Quinn BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 129 Main Street N. Andover MA 01845 OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZE EPRE NTA ACORD 25-5(1/95) ' ACORD CORPORATION 1988 Location - + No. Date NORTp TOWI IN ORTH ANDOVER Certificate of Occupy, $44, Build' g/FramOermit Ri r$ 'ss�cMusEt� Founctati PerAPF)ee $u Other Permtt•M& $ Sewer Connecti Kpq_e $ r Water Connection Fee $ TOTAL $ iY -� AV Building Inspector Div. Public Works PER111f rib. Z ` ' APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. A✓PAGE 1 —r AAAP K40. LOT NO. 12 RECORD OF OWNERSHIP --DATE BOOK 'PAGE ZONE I SUB DIV. LOT NO. �— i N' ✓LOCATION �„�' �^ I PURPOSE OF BUILDING �>�ST'O �dr 'AKrT .T -r,, 447t WNER'S NAME 'y r NO. OF STORIES SIZE � F Dt ?EQPt Rc�al.4+II �`a�'sfi , f --OWNER'S ADDRESS li7 O 1B.0 x /4,,qO A,��./'IMA O�^I BASEMENT OR SLAB - -- -� ARCHITECT'S NAME Cl j.) rt �C f7 SIZE OF FLOOR TIMBERS IST 2ND 3RD /BUILDER'S NAME t ApV--, '7 oockGp, SPAN -- DISTANCE TO NEAREST BUILDING`..7 �`'�-,y! 1� G� DIMENSIONS OF SILLS DISTANCE FROM STREET �l " 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 BUILDING ALTERATION SG�YF i 'dn/,��� IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE 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 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES ,00ST. BLDG. COST Ste,bD O PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED�AND"APPROVED BY BUILDING INSPECTOR ATE FILED BOARD OF HEALTH SIGNATURE OF OWNER OR AUTHORIZED AGENT r F E E Z6�0 ' PLANNING BOARD PERMIT GRANTED h-fJ' ¢ 19 OWNER TEL 46i(617) 72I-IG/S tONTRACTOR TEL #(W37q -73s'$ ,/CONTRACTOR LIC # a 34`,p,i BOARD OF SELECTMEN 79 'n BUILDING INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS, WITH PORCHES, GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION —I B INTERIOR FINISH CONCRETE B 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDWD PIERu PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT AKEA FULL FIN. B'M'TAREA _ FIN. ATTIC AREA _ N_O B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 22 f 3 DROP SIDING CONCRETE I_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDW D _ ASBESTOS SIDING COMMON VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIORI� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLEHIP BATH (3 FIX.) _ GAMBREL MANSARD TOILET RM. (2 FIX.) _ FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGE$ KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR HlTILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE _ FORCED HOT AIR FURN. TIMBER BMS. &COLS. _ STEAM STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UN-IT HEATERS - r - I.• _ •. 7 NO. OF ROOMS GAS _ IL NtjO B' T 2nd _ ELECTRIC 1st r--I 3rd I NO HEATING - :. 1 j NORM TF OSI n O 6 ®Ver 0 . 0% �.,;VEWAY ENTRY PERWI =Kn� er Mass., 19�! C HI HE WICK PERMI D A �V oR QP SS BOARD OF HEALTH • T R .N.�e THIS CERTIFIES THAT........... '.�... .. .. .1.`... ... .. .�. t............ ^.� BUILDING INSPECTOR has permission to sweet ..l� EM ...... buildings on ....1.�rl.... s►. ... .....�..r....... Rough T • to be occupied as...,tad- Z�P0... :L'.�nrk-!'w`.�'�o rpm vropte o. Chimney .... ..... ............ ........... Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Rough UNLESS CONS ST R Service Final .... ...... ... .. .. ................................ BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Require to Occupy Building Rough Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by Smoke Det. Building Inspector r FORM U TOWN OF NORTH ANDOVER r LOT RELEASE FORM SUBDIVISION ASSESSORS MAP ' SUBDIVISION LOT(S) PERMANENT ADDRESS (ASSIGNED BY D.P.W. STREET /� 1 APPLICANT G /�L)A 1,(/C�� ��J� c Z-1q PHONF,,!�03, SS�-I S �-7 DATE OF APPLICATION 1 TOWN USE BELOW THIS LINE PNIN BO 7 DA'L'E APPROVED j 0 PL ER DATE REJECTED CONSERVATION COMMISSION DATE APPROVED CONSERVATION ADMIN. DATE REJECTED BOARD OF HEALTH DA'Z'E APPROVED HEAL H T DATE REJECTED DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT SEWER/WATER CONNECTIONS FIRE DEPT. I LJ RECEIVED BY BUILDING INSPECTION II . � DATE ! r, �; L N This form shall be signed by the agents of the Planning and Heal, _ the Conservation Commission prior to the issuance of any building permits for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement .or Bylaw. e - - i - I - Fire Alarm - _ Table -- Table 12"x 12 Commercial Flor Tiles (selection by own i i Main Dining Area UU (Front Counter Cash Register 6le Table Table' ff Freezer 4L I IWO - -- �Pf.►►i Ij Walk-in Cooler IV- rl c 0 o CL I Refrigerator (below table) h Footl Preparation Table II, Refrigerator be able) t ' c 1 14)t a $" C Steam Table t l Floor Tile f yp• r-- rcia Z,, 1 Exhau4t_4tentilation Hood above I >I• j � �'" fid' Rice Maker t i , Wok (Wo7k (Wok � vok 1 1 wok 1 I i I. - - Freezer a, f Walk-in Cooler HVAC Unit FD _ , },� n I I aI Refrigerator (below table)4� Foo 1Preparation Table 0 �; RefrigE Handicap Bathroom _ _ ? - f . I I O I J Laches Steam Table - -- t 77 AIv� { I i Exhaust Ventilation Hood above - -- - - - ¢ - I Rice!!Maker . 0 .Wok (Fo)k S Wok (Wok > Handicap Bathroom � Broil+ LL U_ ti --- ens - �. '__ , � -• .� f - i J- Pork Oven- relocated circuit breaker panel brease Trap l¢o a-ALJ-ew� Collector Sink Provide sheet metal panels on all walls within the hood area (as al: I) Exhaust Ventilation Hood with bilt-in automatic fire suppression system (as -2) Contractor to field verify hood dimensions per exact equipment layout per c Proposed Floor Plan Dimensions and layout of all new equipment shown is based upon manufacturers recommendations A 250 gallon grease trap shall be connected to existing waste line to intercept grease. Install grease trap in basement as approved by North Andover Board of Health_ AN contractors to verify with owner all utility connections as required for equipment hook-up. w . � GQRB GRAB 8A�t5_ s ; 2it, _ W J . o' F3��'aF Roots �T+k�2 oor� . iiLT" - Mt Q A � , 0009- ; 1 to, - l36 � 1 p� Ait fou) "'A " t4rJ�t C SPP�� !�. A, #,A#.• L.AYDUT . F� NP•uS�FR. Exc-(Aos ESS EX 14r1��+ � I Gsi i aG �oo� cost F o R M.►o �LZA -r i �G I - SX%ST lot, : '5 EE, .5 44 CST - �GatJFeRV.tS.i;O NEPA 16J. _ i t { t 25 -� �. F R R i F ' E E v►o is (� v A.LA- R k!TGF{EiJ u1PM�1J►. 4AY 0�.rl cli4o1A . \OoK 7�ETMA-F4rk . AN.J a 0 ;E2 , i X T V3 CA 1 2RS P.0 l OF ; � G. �c's� t SsAczn Waurs 4 Ayre, A. . . . . . . . . l .WA.LL CEtLcr� Ga CF�RE Col>C No,'t�ATEp� T T (4 LL- Ex PosF.D G,-i/guM soR.PAC.Eg --ro ' U �-J-�J E ./-�tJ �.PP�.�c.�4T►o�J O F. W/�5 �/� 81..x. �� 'aU�41.t.�t CEa�.����► D �i4-e NT. o. i,M o' ,r-IC-ArTI�NS S C, # 5 i4Fr . - - - . Excv5'rrr..)(„ p 7X6 Wo K u T- 0 . '0 . ANDaJt-R. N ASS r Rep ' K TG rif 63 r gEE 5 t-F1`S"rS 'Fait PE C'A%"S opEaoe.1G MA%O UIwiOG /4 A 1 - WAU FaD� +o+ss - t�x+sZ'+sJly wA��S IIS SPEC I F I CAT 1 ON Ql` N!'PA c:/o 96 WALL TYPE- I I(X)11' WAIJ, 'I'yl'C: Iloods will be conaLructed Lo N.F. P. A . code #96. Bodies Of 1 ©ca . stainless steel type 301 . All external seamy will be continuously welded and ground smouLlt so that hood will be moisture Proof- Box type construcL- ipn, Hood will be constructed with full length filter frame consisting of the same materials as the body . Filter frame will fit standard size filters. Removable pitched grease troughs under bottom of filter frame included to catch grease flow from filters . Easily removable grE:ase cup provided under troughs , floods included full compliment. of Aluminum Filters which are U. L. listed and N. P. P.A , approved . floods to be provided with wolded brackets on top of hood for moiniting . I1(X)I) SIZE IS 20 -24 " !lI;IL;ifl' AND 'tlIl:: WtI)'I'!f IS 18" . %VAI-1. TYPIE. WITH lIWE-01' /flit: Wall type wAt•h Make-up air 's hood Front to have integral fresh air wake up air plenum constructed of samo material as hood. Plenum Lo be fitted with manually operaLecl adjustable snake up air registers . Chamber to be 6" wi(je. 11001) HAVE 'l SIZE'S WII)1' I8" Ult 5.1" WALL 7'YPC o.t ain out NU � NOTE: Oz, 18 ga. stainless steel � �•'' ' '!''• 'jf % for the entire hood. CONSTRUCTION: Continuely weld fpr all seams. CLEANING; BALL TYPE MAKE-UP AIR No grease could be stock — —� inside the hood. Use hot a.ia out removable grease catcher for easy clean purpose. 1y�� FILTER: � Z,% A acs Aluminum Filters (MEA H �< %::' aefuan r 1 RE EXTINGUISHER SYS 1' v1: JA ' ' Must install by local license �.K r d company. � ,� ` s; .,• Bi A_ = Grease Catcher W 13; [fo.lder f•;� Filter I), Filter Holder �O 3SUd Xaa S3I83S OOT-3S ROOF AND WALL MOUNTED TOP DISCHARGE EXHAUSTERS ..,OR COMMERCIAL KITCHEN VD,, ATING This cenlrlfutal 14P OISCIIAPGE root exhauster Is Id#AI for exhatlitlrlt air liar"tommercia)Mitch. arts, thircoa[ broilers, and dish washers. It [ills foul confaminsled air, gases, fumes, and odors high above the tool and d;%rcraes Urem Into pati- _g +.mar Ing alt curtents, [aNAtjST ram Kitchen range hoods greater than 12 feet In length require more than one exhaust fan. 1......�iCiai✓11I((.1L�.L• � I'ins 1 1 •"� ....�..��ci,�ir+a��.;'Jr.:. -�;,r.�. ,.., •,. butt butt 1 �` � ictu7.-7= ^ � .'.__..-....... erICNtN aaoo (Sido Vi(.-w) IttlCw[N m000 \; I 1 \ • g11Uf[II TNArr Twrty[ r[[T -----•---{ (Front. view) Q \ 1� INSTALLATION FOR WALL MOUNTING MOTOR COMPARTMENT FORCED VENTILATION DETAIL � ' _ Remo+o Mt •++olnr nn�,r ( _.'— � H i M ,. ........� y._ _� Gos•el tens ron mantel ` '►, �► Jr ,s Durr t - i..' ;; f .. _ ar.,tit• .._. fe••rw ewe 5:r.r ' 11 M,ryr 1 ar HMre 41LBCRU Belt Drive t��13: 4'ti� ,xh �lounted Vertical Discharge Po%:,e gar . muster .w i I Nw Size 216 & _. 0 --A BMW,•�[ 4 Y �.i �.f c •.til--.`size 216 &219 1, Motor Done 5.Centrifugal Fan 9.Anti vibration 2.Discharge Apron Wheel with Mounts J. Spur) Inlet Venturi Intake Fan 10.Drainage Area 4, Main Brace 6.Motor 11.Conduit Guide FasteningAssembly 7- Motor Support Plat@ 12:Weather Baffte a.Cooling Tube with 13.Fan Shaft d, SIzes 225 to 251 a weather Cowl ge .--.._-._ 14.V-80&Pulleys This centrifugal top discharge roof exhauster is ideal for + i exhausting air from commercial kitchens,charcoal broilers ' K N and dishwashers.It lifts foul,contaminated air,gases,lumen and odors high above the roof and disperses them into passing air currents. Units 216 through 231 can also be wall mounted. Standard Features-- o Top discharge, upblast. 0 Continuous forced motor cooling. f•."'" "— 0 Complies with NFPA, Bulletin 96. • V-Belt drive, variable pitch. ''. -'-Sizes 225 to 251 0 Backwardly inclined centrifugal wheels. I. Motor Oonri a 5. Intake Fan e Non-overloading balanced wheels. 2. UF)13or t,, i.uwt;r 6.Main Brace 9.���� e Heavy duty greasable bearings, Nrin.lt�,uuf Fastening Aasernbiy 10•Ant•Vibratkan 3. Spun Inl(A Vtrnturi 7.Ball Bearing Motor mounts A Weatherproof construction. 4. Centn&rycrl Fan A.Motor Support Pteto 11.Wealfl@r t3eftis ® Corrosion resistant spun aluminum, wFasl 12.Cor"Oulde c Motor shield. Fa;leniny Assembly 13.Drahuge At" B U/L Listed for grease removal (YZHW). 14•v @eft 3 Pw hays a AMCA licit mod. Tax•Fan shaft b t3earirlptt Dit"ensTonal Data '�"`a— ��a�8ffl F ie(ciiifiBf 6wo dditiflds that the Acorn units « shOWH h6fi#A f6 ll§#f b68 ip Bear the AMCA Seal,The raNnr3s MODEL L M 8 CURB tiP MR shot A iib W1901 OM labia nli3do In aCcordanco with AMCA 0 Y IlLaus) ..� Staffii&W W Ofid W i0ly with th6 requirements of the AOCRU216 37 28 2814 2Q 24 28 114 AW.' er4r'tiijed Plagng Program. A8CRU2I. 37 28 2814 2Q 24 28 118 A06m.AG�CAtJ Ata dela are listed with Underwriter's A8CRU225 _ a4 31 3314 25 Labpratt5rlr;t8, for maximum operating temperature of 3Uti° ASCRU231 54 3314 3614 26 2 33 22 UL and can bo used for installation in aCcordanct; wilh NFPA ABCR�U237 64 32 4 350 96 SiandArd, 39 4414 38 40 44 450 AeCRif251 78 54 58 926 -- .. -. ......-. .—•---,.,.—_.. ..... . Air tJirnen?.iun;in Inches, 48 59 SQ tside}11atFeeE, NY New York 101713 Tnlf�t'f1 ARS vided by an appropriate number of thermal detectors the National Fire Protection Association Standard'No. 17A mounted in series on a single stainless steel wire input line "Wet Chemical Extinguisher Systems" and Nti.''.'96 "Stan- to Stan to the control head. Manual actuation shall be provided by dard for the Installation of Equipment for the`Removal of turning a handle on the primary control head and/or by an Smoke and Grease Laden Vapors from Commercial Cook- :H. optional remote pull station with a dedicated stainless steel ing Equipment", and comply with all,local,'and/or state ,•; „ - input lint to the control head. The system shall be U.L. codes and standards. „ } <*=a' Listed and F.M. Approved and installed in accordance with �x z4w,tx. iyvf • UI_ Listed • F.M. Approved • Complies with N.F.P.A. Standards No. 17A &96. • Approval by the Hoard of Standards and Appeals of New York City ,, r • Meets the requirements of the Building Officials and Code Administrators �f u,N G ° f—Duct { Plenum To Remote Pull 1 �—Station(Optional) Remote Manual r rol Control ipw,Nc� .,Co�ToG .. asShutOff Filters -Valveional) To Fusible Epiis Link Detect ,t,�y,�,,.,,,,"' ` .. Range ice'/ ���j Wet Chemical xiti't,t' �► ' Cylinder i �, j��j Gnddl e . i Fryer ill h,lrp ,t , /Upper Broiler Char BroilerAl 1. CYLINDER CONTROL HEAD—Integral design requires no separate release 5. REMOTE MANUAL PULL STAT ION—Simple operating mst'ructlons with a r pressure cylinder—separate wire cable activation lines for automatic fus- double action release avoids careless system discharge—a:100`'wire'cable ible link and optional remote pull station provide an added measure of run with 20 corner pulleys maximum allows mounting flexibility`.`='a deli- �. safety—an easiiy accessible manual release mechanism which provides an cated wire cable input line to the cylinder control head,provides;a,true option to the automatic fusible link and depending on local codes can be back-up in the event thermal link lines are fouled A;> ;'` - Vit' .^' `:• used in place of a remote manual puil station—unique fool proof technique placement 6. FUSIBLE LINK KITS—Accommodatesbothseriesandterminal lacement •�.r� - for achieving necessary input wire cable tension. to minimize inventory and simplify ordering—all necessary,components 2. PIPING— Unbalanced piping network simplifies application design and included for efficient assembly and installation a 350'Ef6sible link installation—no separate piping to connect system pressure cylinders to standard—15fusible links on a 100'wire cable run with'20'eorner`pulleys extinguishing agent container. Schedule 40 stainless,chrome-plated and maximum provides substantial hazard coverage. i' black pipe can be used. 7. AUTOMATIC GAS VALVE SHUT-OFF—Complies with requirements per- + 3. CYLINDERS.-DOT-4B-175 Rated—contain Py ro-Chem" Potassium Car- taining to the shut-off of fuel as described in N.F.P.A.Sta'ncldd'No.tl.7A— bonate Solution stored at 175 p.s.i. —pressure gauge for visual main- After regular maintenance/service check car,be reset'at'control"head for tenance checks. 1.65,2.75 and 5.50 gallon sizes provide 6, 10 and 20 convenience of serviceman—a 50'wire cable run.with',15`coine'puIleys flow point coverage respectively, offerin a broad range of application maximum provides mounting flexibility. `t'11111. , r x:' P gg g PP 2 t t t+ ,: coverage. 8. CORNER PULLEYS AND ACCESSORIES—Designed to ensurerreliable sys 4. NOZZLES—Extinguishing agent discharge patterns have been established tem function as tested by U.L.Laboratories. 4,a�an ;• ' to relax placement tolerances. + f{ s: .'f 7r6:�� q ��Nry�>•� ��' v�� r '' '�,��)`• ��te' �, s �'' �+.-rr ,t,s 4...'''• "i3 4«'�,4.1 - !..'.-'drd+..✓a;:-s.:: T.w �`5 rl. �t, �� F x ,S" Engineer and Architect Specifications 4, 4r k SAME AS PCL-165 Cylinder and Valve Assemblies with SCH-ML Control Head F SAME AS PCL-165 _ %�• 1 TO FUSIBLE LINKS— = -- Ml' R^'—;li'f• j `'f 100'—20 CORNER PULLEYS— TO REMOTE PULL STATION— �. Jt 17 ?d•+ ', } �'e 15 FUSIBLE LINKS MAXIMUM 100'—20 CORNER PULLEYS — - t tc-1 ;' 1 � r,•'y;, MAXIMUM 7' 'I ' OPTIONAL MINIATURE SWITCH ! : WIRING CONNECTION INPUT/OUTPUT 4014 �/i P J TO GAS VALVE SHUTOFF— 50'—15 CORNER PULLEYS I 1 MAXIMUM --- 34Te' e 25" L PCL-165 PCL-275 �— _ PCL-550 - 1 ot — � The Pyro Chein'Il restaurant cooking area fire extinguishing out the discharge nozzles. The wet chemical?discharge ;. system is a Pre-engineered solution to appliance and venti- pattern is maintained for a duration of'time.,to'in ' re extin- . r lating hood and duct grease fires designed to maximize guishment and inhibit reignition. hazard protection reliability and installation efficiency. Expanded capability is available to provideremote manual i 'S Automatic or manual system activation releases a throttled activation, gas equipment shutdown and•electrical equip- r dischar e of potassium carbonate solution in the form of 4 ment shutdown..This optional equipment,Will enhance the fine droplets which is sprayed on the protected area in a basic system functions and be applicable when";designing pattern U.L. Listed to extinguish the fire and prevent re- +'•� ignition alter the discharge is complete. custom configurations to suit a particular c'u 6"Amer'.s need and/or comply with local codes. m esi''d/4 i'('JI tett'.4 rS 7l'CZ ZCpt10Yl5k„`. The Pyro Chem restaurant cooking arca wet chemical fire ` f extinguishing system has been designed for protecting The fire extinguishing system should be the stored pressure kitchen hood, plenum, exhaust duct, grease filters and wet chemical pre-engineered fixed nozzle itypc;#manufac cooking appliances such as fryers, griddles, range tops, tured by Pyro Chem, Inc. A carbon dioxide.;1`cartridgc 't upright broilers and charbroilers from highly flammable designed in compliance with military specification."MiL- Tease fires. The versatile state-of-the-art wet chemical C-601 G” shall be used to discharge the wet chemical extin- distribution technique combined with dual, independentguishing agent. The cartridge shall be an integrzlypart of the 7 activation capability — automatic fusible link or manual control head assembly. The wet chemical storage cylinder release — provides efficient reliable protection the moment shall be D.O.T. rated for stored pressure of 175 P:SJ. and a a fire is detected. Once initiated, the pressurized wet chem- pressure gauge shall be provided on the cylindervalve for ical extinguishing agent cylinder expels a potassium carbon- visual inspection. The system shall be capable of,ai#tomatic ate solution through a pre-engineered piping network and and manual actuation. Automatic actuation shhall.;be. pro- ( , Pyro Chemnr 4M A Subsidiary of Baker Industries, Inc. 301 Division Street9�0 , k Boonton, New Jersey 07005 • • r 0 " 1 1 1 1 �� r , I� � � c 3 Pyro Chem"s Innovative r Dry Chemical System r Pyro Chem,an acknowledged pioneer for fire extinguishing equipment performance, three decades in extinguishing technology and resulted in a superior, cost effective system. the#1 manufacturer of dry chemical extin- Reliably the rapid,turbulent discharge of dry RK guishing agents in the world, introduced the chemical knocks flames down and snuffs flow diverter concept.Pyro Chem's unique flow them out.Reignition is impeded by a saponifi- ^' diverter distribution technique simplifies dry cation process—the process by which the dry chemical piping chemical reacts with the hot grease and forms F networks...render _ a soapy layer—which seals off the extin- ing obsolete tradi- guished fuel from oxygen while the substance tional "balanced" cools. piping networks. It Pyro Chem has taken the proven restaurant minimizes installa- cooking area fire extinguishing agent and tion time and elimi- through innovative equipment design made nates unsightly and the best dry chemical fire extinguishing sys- nuisance piping ° tem available . . . another first! runs.Applying en a 3 gineering concepts, developed over years of optimizing NNr zw; N ra. x u A. Tandem Wet and Dry Agent Cylinders M with Single Control Head Pneumatic Actuation B. Incremental Cylinder Sizes i C. Multiple Cylinder Pneumatic Actuator with Control Head D. Single Cylinder with Control Head I E. Fusible Link Bracket,Chrome Nozzles, Flow Diverter and Remote Manual Pull O Station F. Control Head k` Pyro Chem's Revolutionary Dual Agent System The tandem system which maximizes the critical fire extinguishment margin of safety. Specifying Considerations: chemical are employed to direct the chemical in a very effi- In the context of the National Fire Protection Association cient and effective discharge pattern.The "throw"of chemi- Standard No. 17,a restaurant cooking area is categorically a cal and accompanying turbulence are excellent for total two hazard application requiring a combination of two dif- flooding applications. . .a popular choice by Fire Protection ferent fire extinguishment techniques . . . total flooding and Engineers for industrial hazards. Consequently, dry chemi- local overhead protection.The duct/plenum is an enclosed cal is the superior fire extinguishment agent for ventilation space and is considered a total flooding application. The system fires. f appliances,since they are not enclosed, require local over- Wet Chemical's Excellent Appliance Protection: head protection. Pyro Chem's wet chemical system best utilizes the merits An important extinguishing characteristic of grease fires of the agent in local overhead applications. The wet chemi- is Auto Ignition.Cooking grease at room temperature is not cal system has a significantly different method than dry a problem. Its vapors, unlike gasoline for instance, are not chemical for extinguishing grease fires.The discharge is easily ignited. However,when heated to Auto Ignition tem- much slower.At a reduced pressure of 175 p.s.i.,the liquid perature—a temperature at which it ignites—extinguishing discharge is throttled through equipment designed to spray the fire and removing the heat source may not prevent reig fine droplets in a protected area. The slow 45 second dis- nition.Reignition can occur until the liquid is cooled below charge lacks the"throw"and turbulence associated with dry its Auto Ignition temperature. chemical . . . however,the wet chemical adds a unique fea- Dry Chemical's Superior Duct/Plenum Protection: ture which makes its use on appliances an excellent choice Pyro Chem's dry chemical system extinguishes fires in a . . . the heat of vaporization. This cooling effect in combina- characteristically,traditional method.A high pressure(350 tion with the excellent saponification characteristics make it p.s.i.) discharge of chemical "knocks"the fire down and a the best choice because cooking grease/oil is intentionally chemical reaction keeps it out.This rapid discharge occurs heated for cooking purposes, and the apparent danger of in 6-8 seconds. Nozzles designed to take advantage of both overheating it to auto-ignition temperature exists. the high pressure and physical characteristics of the dry Technical Conclusion— Dual Agent System: While Pyro Chem's wet and dry chemical systems have been U.L. PYRO CHEM'S DUAL AGENT SYSTEM OPERATION Listed and F.M.Approved as stand- alone systems and achieved j superior ratings,the nominal test criteria is not intended to evaluate each agent's inherent fire fighting characteristics and as noted above, each agent clearly has a signature h -• of performance/function. Con- sequently, maximizing the fire ex- tinguishment margin of safety can only be achieved by properly (� utilizing the agent most effective • •. ��'� 0 on the appliances and in the ven- Opt tilating system.A wet chemical sys- tem protecting the appliances and a dry chemical system protecting o the duct and plenum . . .A dual agent tandem system U.L.Listed to simultaneously discharge auto ' matically when a fire is mechani- cally detected or manually when a decision is reached to extinguish 1.Heat Sensing detectors located over appliances and in duct/plenum areas monitor temperature.2.When a hostile fire occurs and the temperature rating of a a small growing fire before it is detector is exceeded,the thermostat fractures and triggers a mechanical activation of the control head...releasing the agents in the pressurized cylinders. 3.Simultaneously wet chemical flows through piping dedicated to appliance protection and dry chemical flows through piping dedicated to the duct/plenum area. severe enough to automatically 4.Pre-engineered piping networks,effectively and efficiently distribute extinguishing agents to nozzles.5.Nozzles with customized discharge patterns direct the trigger the system. agent accurately to insure rapid fire suppression.6.A remote manual pull station provides a dedicated,independent means to activate the system. f Pyro Chem Offers You the Most Versatility, . . Now you can choose the wet, dry or dual agent system that exactly meets your needs. A commercial cooking area, designed for ❑ Automatic detection and manual discharge utility, inherently is an assortment of unique, controls provide 24 hour protection with potentially flammable areas. Heating appli- fail safe manual back-up. ances such as ranges and griddles,fryers with ❑ Traditional fire extinguishing"red"cylin- volatile cooking oil and grease,charbroilers ders that are easily and quickly recognized without temperature monitoring controls and in emergency situations. a ventilating system that deposits grease from exhausted vapor throughout the hood,filters ❑ Streamlined design and component and ducts must be separately considered for options compliment modern kitchen proper protection. In combination,designing decor. the fire extinguishing system becomes more ❑ Underwriters Laboratories tested and complex.The placement,mix and number of listed. cooking appliances all must be considered as E] Factory Mutual Insurance Approved. well as hood size and construction. Once the hazard survey is complete,the ❑ Conformance to National Fire Protection choice of fire extinguishing agent must be Association Standards NFPA-17,17A and 96. decided. Fire extinguishing characteristics, ❑ Conformance to all local and regional application advantages, and cost factors are building codes. important considerations to be reviewed be- fore a decision can be reached by you. Pyro Chem's select,trained distributors provide convenient single source reliability.With access to wet,dry and dual agent fire extin guishing systems,they can recommend the best system for your needs. Every Pyro Chem system features: ❑ Flexible placement of nozzles,pipes ,. and cylinders that suit your kitchen lay- out and minimize interference with work flow. ❑ Expandable systems that fit your budget today but accommodate your growth tomorrow. ❑ Steel shelled,Depart- ment epart ment of Transportation ! ? rated cylinders that are pre-filled and pressur- izedat the factory where l quality inspections in- I� ''j sure conformance to standards. cfyr Chem's State-of-the-Art Wet Chemical System By 1985,several fire equipment manufacturing companies subject 300 standard was changing to more specifically had submitted wet chemical cooking area fire extinguishing address wet chemical fire extinguishing characteristics.A systems to Underwriters Laboratories for evaluation and list- revised subject 300 was distributed in July, 1985. ing. During the process of testing various equipment,the On December 30, 1985,the National Fire Protection ! Association adopted NFPA-17A,a comprehensive"Standard t r on Wet Chemical Extinguishing Systems". In early 1986, Pyro Chem introduced a wet chemical system that would establish it as a development leader in the field. Pyro Chem's new system met or exceeded the more rigorous U.L. testing specification and complied with NFPA_17A. Subsequent development added more flexibility } j to the system and refined testing established new wet chem- 1 f ical extinguishment thresholds . . . unmatched today! — The unique nature of Pyro Chem's wet chemical extin- guishing agent eliminates many piping limitations • T associated with competitive dry chemical systems and added a significant fire fighting advantage . . . the heat of vaporiza Otion.The wet chemical agent is released in a throttled fine I spray so as not to cause a dangerous splash in hot greases or thermal shock damage to cook- ing appliances. The spray is a cooling agent which in the pro cess of flashing to steam absorbs heat—the heat of vaporization —from fire hot surfaces result- ing in significant temperature drop,usually below auto-igni- tion levels while the fire is extinguished. Once the fire is out,the wet agent chemically reacts with grease and saponi- fies prohibiting reignition ©xj while it continues to cool. r Another benefit of using wet chemical agent could be less clean-up time as compared to t a dry chemical system. Pyro Chem's wet chemical cooking area fire extinguishing �.z system represents State-of-the- Art TO RELEASE PULL PIN txFn 'tNp�LSHWG SYSTEM Art engineering with depend- TURN HANDLE able Pyro Chem fire extinguish- ing know-how...mastering the K dynamics of fire extinguishment. � � 1 Flexible Design . , ,Superior Protection Within Your Budget Pyro Chem's dual agent cooking area fire extinguishing reliable, competitively designed systems.After all,the Pyro system should be considered first and foremost. Should the Chem dual agent system is a combination of two outstanding size of the hazard or cost factors dictate a single agent sys- single agent systems. tem, Pyro Chem can provide either . . . both high quality, Pyro Chem . . .A Fire Protection Commitment A major innovator in the fire extinguishing industry for Pyro Chem's international distributor network adds over 30 years,Pyro Chem is the No. 1 manufacturer of dry responsive,professional representation at the local level. chemical fire extinguishing agents in the world.Pyro Chem's Carefully selected and trained,they can review your restau- extinguishment expertise is an important part of the pro- rant kitchen plans, survey the hazard, and provide design, tective services group of the Borg Warner Corporation . . . installation,service and maintenance to insure compliance dedicated to personal and property protection. with local codes and proper system function. Pyro Chem . . Adding Equilibrium to Cooking-Area Protection Today, Pyro Chem's satisfied customers provide a valu- adopted by kitchen equipment manufacturers including able testimonial.Small delis to five star restaurants,specialty hood and duct fabricators,Pyro Chem invites you to explore establishments to fast food chains are protected by Pyro the options available with Pyro Chem dry,Pyro Chem wet, Chem systems. and Pyro Chem dual agent cooking area fire extinguishing Confidently specified by Architects and Engineers, and systems. Authorized Distributor BAKER Pyro Chem, Inc. A Subsidiary of Baker Industries,Inc. A Borg-Warner Company 301 Division Street 1� NOusT"IES Boonton, New Jersey 07005 77 t � FIRTIFICATE OF, USE �t OCCUPANCY tip'': a+1� -4 a.�}' .z•. + r � Town `of North Andover .r • Building Permit Number 023 Date APRIL 2, 1991 THIS CERTIFIES THAT THE BUILDING LOCATED ON 129 MAIN STREET (rear)- "CHINA WOK" ! MAY BE OCCUPIED AS interior alterations for restaurant IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO 129 Main S t . Realty 1'r u s t P.O. Box 8180 ` ADDRESS Natick MA 017.60 sACMUs�� s Building Inspector i c it y li 'at 1 • Y .7 a r 4 1.1 t r + ,'`1!',,tom. ,•. `. ., 44 s 3 'a1$0ERMATE ; TAO R AL Town of ndover No o 23 0 ; = � :• .y- �:� IVEVIAY ENTRY PERMIT - E�n� er, Mass., 1971 ApR P��� SS BOARD OPERMI Wn I F HEALTH THIS CERTIFIES THAT..........1.z!9...h/.� .� .. .t.`... .�`r �rs ... .. �!�: ! ........... • �+� BUILDING INSPE TOR has permission to @Peet .. ` —% ...... buildings on ....r2m. i.... :�► ...Sa.E. Roug • Chimney to be occupied as....Tf4"rd ,l.PA...A�r�� �'®� fir. !� ..... ............ .. ............. Final Oe- 34-0/� provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough L Buildings in the Town of North Andover. final � VIOLATION of the Zoning or Building Regulations Voids this Permit. L PERMIT EXPIRES IN 6 MONTHS ELE TRICALINSPECTOR Rough UNLESS CONS ST R Service Final .... ... ... .. .. ............. ...... ...... i (- BUILDING INSPECTOR GAS 1 SPECTOR Occupancy Permit Require to Occupy Building _`Rou /�3 Display in a Conspicuous Place on the Frernises FIRE CE-Pi. ®o Not Rem-ovo Rem- vBurner No I at it toBe Dcvne Urti fio��ect��` :�� ���=������ .�y F:_ w .e.t Uke Det. Usttildingg !rs0ect67 -___ APR 2 ' 91 13: 39 IFATERBASE PAGE . 'G 1 INTERBASE An A AshtonTate Company Interbase Software Corporation 209 Burlington Road, Bedford, MA 01730 Telephone: (617) 275-3222 FAX: (617) 271-0221 FAX Cover Sheet To: CHRIS HUNTRESS Company: Town Hall of North Andover FAX number: 508-686-2168 Phone number: From: Jane Di Perri Date: April 2, 1991 Number of pages, including this cover sheet: 2 Comments: Chris: Attached is the letter you requested in order for the China Wok to be opened for business tomorrow - April 3, 1991. Location: 129 Main Street, North Andover, MA Ji ' APR 2 ' 91 13: 39 I NTEF'I;ASE PHGE . 0 c 9 April 2, 1991 REF: 129 MAIN STREET, NORTH ANDOVER, MA Dear Chris; This letter is to confirm that the landscaping will be completed within thirty days from the date of this letter. Please call me to confirm your receipt of this. I also need aknowl.ed.gement from you that the "China Wok" will not be delayed any longer from. opening� Sincerely, Jane Di Perri Own6r 129 Main Street North Andover, MA Work # 617-275-3222 I It o Date..... No NORT#q °I��``°;•�"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING Ii�SJ^CHuSEt This certifies that \` i1 F (f L .................... �........ ................................................. has permission to perform p(u C ... ....................... .................................... wiring in the building of.... `� )Dv�,- 15 ..................................................................... at !a . .q D1 sr .....A ,North Udover,Mass. Fee... .: ..... Lic.No.�l ..........A. . . t ..................... ` /� ELECTRICAL INSPECTOR 1 �f G Lf( 3 P, WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Office Use Only g V) uE�e LIImmunutl:ui ofItt> 5�ruet#s Permit No. Occupancy Occt & Fee Checked f�E�t1I1"t'II[EITt Df Public �FIfEt�1 P � 3/90 (leave blank) BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date ,i± 99 City or Town of -�- 1 �� d: To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) �C�-/ f��� �p 0+ Owner or Tenant a1► I Owner's Address — Is ddress Is this permit in conjunction with a building permit: Yes ❑ No L`1 (Check Appropriate Box) Purpose of Building Utility Authorization No. Exi,ssting Service Amps _J Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps _/ Volts Overhead ❑ Undgrnd ❑ No. of Meters N*Irnber of Feeders and Ampacity ,nn Location and Nature of Proposed Electrical Work ��L 1"7 !7 1'�� ifs M �� No. of Transformers Total No. of Lighting Outlets No. of Hot Tubs KVq No. of Lighting Fixtures I Swimming Pool Above In- grnd. ❑ grnd. ElGenerators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners I Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Air Cond. Total No. of Detection and No. of Ranges tons Initiating Devices N�o. of Dis osals No of Heat Total Total P Pumps Tons KW No. of Sounding Devices No. of Self Contained N.o. of Dishwashers I Space/Area Heating KW Detection/Sounding Devices NKW o. of Dryers I Heating Devices KLccai = Municipal U Connection L i No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws , 1 have a current Liability insurance Policy including Ccmplet perations Coverage or its substantial equivalent. YES O ❑ I have submitted valid proof of same to the Office. YES NO ❑ If you have checked YES, please indicate the type of coverage by checking the aprop a box. INSURANCE BOND ❑ OTH R ❑ (Please Specify) -5— (Expiration Date) Estimated Value of Electrical Work$ Work to Start Inspection Date Requested: Rough Final Signed under"51e Penalties of perjury: FIRM NAME ./ s LIC. NO. ✓ Licensee PA V L -I- it F pj h � V �P,J Signature LIC. NO. y �±- Bus. Tel. No. 7 Address I E )`5 rn�' U �`' V7 Alt. Tel. No. s; OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner. nC nt (Please check one) Telephone No. PERMIT FEE $ Date. . . . N2 TOWN OF NORTH ANDOVER _ s PERMIT FOR PLUMBING • R CMUS��i t I. '.L This certifies that . . . . ..� . . . . . . .!f. . . . . . . . . . . . . . 1 ha.s permission to perform . .'. .' :`-»`� '. .a. �-� . . . . . . . . . . . plumbing in the buildings at . . . . . . . . . . ., North Andover, Mass. Fee-�r4 . . .Lic. No A i,_ .l . . . . . ... /4. .. . . . . . . . . . . C. PLUING INSPECTOR Check # ��� M WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERM DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS 11 Date Building Location Owners Name Permit# is �(o �d Type of Occupancy ��n /V i`lV [ �v il/Cn s New Renovation Replacement Plans Submitted Yes No FIXTURES x Cn IPd a a x zpro W x F W 3 o z x 3 � a o w w w d �d Fd � x d E- z �d d O Ud Fx- O 3 x a as A a a 3 x H 00 w U a 3 x as o Sri» PAWMM MRJOCR ZSD>LOCIR 3MEli" 4M>B 5M It" 6MFUM 7M>t(= HDM (Print or type) , Check one: Certificate Installing Company Name Corp. Address Partner. C Business Telephone 6 �� ® Firm/Co. Name of Licensed Plumber: 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 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 and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachu s State lu g Code and Chapter 142 ofthe General Laws. By: NigRature or Licenseapwnper- Type of Plumbing License Title City/Town Icense Flumoer Master Journeyman ❑ APPROVED(OFFICE USE ONLY �_—� J J Date. .. ...i J. ... ......... HORIM TOWN OF NORTH ANDOVER 0 � `p PERMIT FOR GAS INSTALLATION SACHUSES This certifies that . . . . . . . . . . . . . . . . . . . . .`. . . . . . . . . . . . . . . . . . . has permission for gas installation . . . %. . . . . . . . . . . . . . . . . . . . . . . . in the buildings of . . . . . . . . . . : . . . . . . . . . . ... . . !. . . . . . . . . . . . . . . . at . . .. ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . North Andover, Mass. Fee. . . . . . . . . Lic. No.i!. . . . . . . . . . . . . . . . :�:. ! . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer ijqff 1 > MASSACHUSETTS UINTORM APPLICATON FOR PERMIT TO DO GAS G Type or print) Dat NORTH ANIQOVER, MASSACHUSETTS i Building Locations Q `tel �?- n �� Permit# I Amount S Owner's NameLA- AJ (� ��A,L. - AJ 1e AjL,A•S f New❑ Renovation Replacement ❑ Plans Submitted ❑ ' n ' m ~ C u = — InIn LW i z c r z _Z C z {EE GC n �- � •� C � r sir 'C 1 z =e %r n ^ z W > w z < c C = C m SUB -BASENI ENT BASE .v1 ENT !t 1ST. FLOG R 2N D . FLOG R 3 R D . F L O O R 4"r it FLOGR ST If FLOOR 6TH . FLOOR { 7T If FLOOR I -ST I1 FI, O O R (Print or type) /-� Check one: Certificate Installing Company Name l �(t�1 1� ❑ Corp. { f Address ❑ Panner. Business Telephone Firm/Co. 1 Name of Licensed Plumber or Gas Fitter 1 INSURANCE COVERAGE Chec one- I I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ Ifyou have checked yes,please indicate the type coverage by checking the appropriate box. Liability insurance policy�' Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver. I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the 1 ivlass.General Laws,and that my signature on this permit application waives this requirement. Check one: ❑ Signature of Owner or Owner's Agent Owner ❑ Agent f 1 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 and installations performed under Permit Issued For this application will be in compliance with all pertinent provisions of the Massachusetts to Gus Code hapten 142 of the General Laws. Bv: Signature of Licensed P umber Or Gas Fitter Title Plumber } City/Town ❑ Gas Fitter License Numoer AZMaster APPROVED(oFr!ci-USE ONLY) ❑ lournevman * T-) 2517 Date. . . . ... . Of NORTk TOWN OF NORTH ANDOVER 3r 5• . O PERMIT FOR GAS INSTALLATION � 9 �9SSA USES I I i j This certifies that . . has permission for gas install ti in . - '--; . . 1i in the buildings of ./01 u c h.... . . . . . . . . . . . . . . . . . . . . . . at .�-?. . .�?!f?!!?. . .f . . . . . . . ., North Andover, Mass. Fee'2!�?.-: . . Lic. No. .> ?.. . . 04/29/97 14:49 20a pp PdAS INSPECTOR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer GOLD:File ti ao MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTIKG (Print or Type) t NORTH ANDOVER Mass. Date y hF- i 't tuiiding Location /;P, //fr Permit '- Owners Name �G�P� a, New Renovation II Replacement Pans Submitted II -�' ply . ►occ m G m u� vi H _ 7 Ni. tat Q!' --< �. C W W Y C7 - ._ _ • - -Q - F+ -W W Q ? tt_ - d O U O 03 — .. BASrzMEMT I IST FLOOR + TI—LD FLa0R j aRn FLOOR I I 4TH FLOOR {I .{__ ..1 .._L ._.f� 5TH FLOOR 6TH FLOOR I I I I I I f f f I ( I 4I I I I I I I I I I f I 7TK FLOOR STH FLOOR f f - ( { f I ( f . . :.f... :I I.,--I ... (Print or Type) Check one: Certificate Installing Company Name v Q Corp. Address - Partner. Firm/Co. Business Telephone: Name of Licensed :Plumber .or..Cas Fitter �Lanti Ir-surancc- Coverage: Indicate .ne :ype o: i^suran.ce coverage by checking the appropriate. box:, •, _ Liability insurance policy. �Ct ser tvpe of indemnity 0 ,Bond -' Insurance Waiver: I, the undersicne4, have been made aware that -the licensee of this application-does not have any one o; the above three insurance _coverages,_-._ Signature of owner/agent of proper -y Owner (� -Agent - - - I he:eby ccrtiry that all of the dcuilt and information I have submitted (or entered)in above&PVReation are tree and accurate to the best of my $:tovitcdge and that ail plumbing work and LrucAdstions 7=iarsa.c: undue'!-_rrnit !==td fo: this appuatEna will be Ia coaapliutw Witk all,;aun=t provisions of t.4o 3iarsae4uaetts Slate Cas Gade srsd C`saptcr It'_ci the Ccaezi Lara. - 3v TYP= LICENS F—, ?lu.Ttber Title I Gasiitter Signa re of License_ C' tr/Tcwrt- I P1t:IIt Master b or Gasfitter Journeyman 10 APPROVED (OFFICE USE ONLY] License N der Date.���.9. 7 . : .— 3315 i TOWN OF NORTH ANDOVER s PERMIT FOR PLUMBING k • � " f SSACHUSE� This certifies that . . .CJ-? . . . ,��S.u. �!� .� . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . cr.t.r:4v� . . . . . . . . . . . . . . . . . . . . at. . . �. . . ��/.h . r . . . . . . . . . . . . , North Andover, Mass. Fee. .�-0 . . . .Lic. No.. . PLUMBING INSPECTOR 04/29/97 14:49 20.00 PRID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer �� .. ••••...• 1.4 u���f'vt�M Mt'i'L/l�ril/tJ/r f V11 f Ct1M11 /u uV f'Lu�tiwu•u .�� (Print a Type) NORTH ANDOVER, , Mass. Date Building �n Permit #- 3 3 /s� Locatlon . /r°�9 f' ,9,1�-a Owner's Name rm l cH e-h4 Q L& New O Renovation O Replacement Plans Submitted: Yes O No ❑ at w = w = 19 � w -' sue• u° s j w M Z ■ F w ON06 IL ox 1 a► o < < s at el � � r < w C � < � A ■ � ./ s 0 � a .r a. sus–�sMT. SAGUNn"T j 1ST FLOOR IND FLOOR $NO FLOOR 41H FLOOR sTH FLOOR ITIS FLOOR. tTHFLOOR aTH FLOOR — Check one: Certlticste Installing Company Name—C2,4 PL'/V1 la nye ❑Corp. Address nom./ AA,e-- D Partnership �717P�'`j w O Firm/Co. Business Telephone /'g 7 7 Name of licensed Plumber INSURANCE COVERAGE: ec e I have a current IlablIty Insurance policy or Its substantial equivalent. Yes No O It you have checked y . please Indicate the type coverage by checking the appropriate box A Ilabllly Insurance policy ❑ Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: 1 am aware that the licensee does not have the Insurance coverage required by Chapter 112 d the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: SIgnsfins of Oovnw a owner's Aqent Owner O Agent ❑ t hereby tartly that all of the details and informatlon 1 have submitted fon entered)in above application are true and accurate to the best of my Irwwfedpe and that&N plumbing work and Installations performed under the permit Issued for this ap tion wil be In compflance with all pertinent provi&Ions of the Msuschusetts State Plumbing Code and Chapter 1sZ of al By Title g" of Uceniod Pkimber CttylTawn License Numt> pf Af'f'f1t'1VEt](OFFICE USE ONLY) Journeyman of gybing Lkense: Master 19/ Journeyman ❑