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Miscellaneous - 1600 OSGOOD STREET 4/30/2018 (32)
lDs 4 t6CtD �ci S4 . 0 1 13,4-4w cp-eO TOWN OF NORTH ANDOVER Final Design Affidavit Project Number: 0903027 (Architect's Job Number) Project Title: DSA Detection Tenant Space Project Location: 1600 Osgood Street 2nd floor bldg 20 South Name of Building: Blg 20-2 South Nature of Project: Fit-up of tenant space. In accordance with Section 116.0 Registered Architectural and Professional Engineering Services-Construction Control of the Massachusetts State Building Code, I, Gregory P. Smith Registration No. 8688 being a Registered Prefessional E^g'^^_-/Architect, HEREBY CERTIFY that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Architectural XXXX Structural Mechanical Fire Protection Electrical Other(specify) FOR THE ABOVE-NAMED PROJECT, AND THAT SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE 780 CMR MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I HAVE PERFORMED THE NECESSARY PROFESSIONAL SERVICES AND EITHER MY REPRESENTATIVE OR I HAVE BEEN PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK HAS PROCEEDED IN ACCORDANCE WITH THE DOCUMENTS SUBMITTED FOR THE BUILDING PERMIT, AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2 1. Review for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the state of construction to become generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. I AM SUBMITTING THIS FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. � y Sign re and Stamp(no fa mi ) Qb�'� P. MOM ANDMNo.8M try oat SUBSCRIBED AND SWORN TO BEFORE ME THIS oT-�yd DAY OF .�/%/ 2009 c%!ukz* 411-- MY COMMISSION EXPIRES /o?� NOTARY PUBLIC DSA Deteawn Plumbing Inspector Town of North Andover 1600 Osgood St., Suite 2-36 North Andover, Massachusetts 01845 March 30, 2009 To whom it may concern: This note is in regard to a sink that will be installed in a tenant space of building 20 at 1600 Osgood Street,North Andover for DSA Detection (immediately south of New England Engineering Services and across from HBSS). This sink is for the purpose of washing and rinsing items including food or other non-toxic materials. No chemicals of any kind or other hazardous materials will be disposed of in the sunk, including cleaning liquids and cleaning waste water. If you have any questions or concerns, please don't hesitate to contact me directly. Sincerely, Stephen S. Milt Vice President Operations DSA Detection LLC 978-975-3200 x l 3 l �" 00 y 1600 Osgood Street.Suite 2-43 1 North Andover,Massachusetts 01845 Telephone 978.975.3200 1 Facsimile 978.975.3201 TOWN OF NORTH ANDOVER Construction Control Affidavit Project Number: #0903027 Project Title: DSA Detection Tenant Fit-Up Project Location: 1600 Osgood St, Building 20, Second Floor Name of Building: Building 20 Nature of Project: Tenant Fit-Up Plan for DSA Detection In accordance with Section 116.0 Registered Architectural and Professional Engineering Services-Construction Control of the Massachusetts State Building Code, I, Gregory P. Smith Registration No. 8688 being a Registered Professional Engineer/Architect, HEREBY CERTIFY that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Architectural XXXX Structural Mechanical Fire Protection Electrical Other(specify) FOR THE ABOVE-NAMED PROJECT AND THAT SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE 780 CMR MASSACHUSETTS STATE BUILDING CODE. ALL ACCEPTABLE ENGINEERING PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the state of construction to become, generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. UNDER SECTION 116.4, I SHALL PERIODICALLY SUBMIT A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS, TO THE ANDOVER BUILDING INSPECTOR UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COM), !� D READINESS OF THE PROJECT FOR OCCUPANCY. �01 . OAq�k�T Signature and Stamp (no facsimile) roes o NORTH ANON, � SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF 2009 MY COMMISSION EXPIRES NOTARY PUBLIC I i f I f Construction Supervisor Licenses of ' ' License: CS 48040 � Birthdate: 10/29/1955 t- ' R ration 10/29/2009 Tr# 5601 x Res m 'on. 00 TADEUSZ DOW(,IEERT I E 175 BRADY AVE SALEM,NH 03079 r Commissioner x 10/28/2008 13:35 FAX 19786833147 M.P,ROBERTS INSURANCE 4001 8�,., CERTIFICATE OF LIABILITY INSURANCE °ATEIMMIDDMYYI 10/26/08 MOOUCER THIS CMRCATE IS ISSUED AS A MATTER OF.INWRMATiON M.P. Roberts Insurance Agency ONLY AND COWERS NO RIGHTS UPON THE CERTIFICATE 1060 Osgood Street HOLO TMS CERTIFICATE DOES NOT AMEND. EXTEND OR 4 ALTER THE COVa?AGE AFFORDED BY THE POLICIES SOW. North Andover, M& 01845 iNSUREFtS AFFORDING COVERAGE NAIC 0 HISUREO LNSURERA R OVidenCe NuttEal DOWGIERT CONSTRUCTION CO. , INC INSURER B:Guard Insurance 616 ESSEX STREET INSURERC: LAMENCE, MR 01841 INSURER DI INSURER Q COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE®BEN 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 8E ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.E)OCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PMD CLAIMS. POUCYNUIISBEA POLICYE ENPIRATIONU11 TYPEOFINSMAIML— LIMITS CANEMLIABILITY FACHOOCURRENCE S 1.000.000 DAMAGE O RENTED X CONMERCLALGENERALLIlI841TY s 100.000 CLAIMSMADE OCCUR MEDEXP( amps s .5,000 A CPPOO64437 10/26/08 10/26/09 PERSONALaADVNJURY s 000 000 GDXRALAQGRG;IATE s 2.000.000 GL IAGGREGATELMITAPDUESPER PRMUCTSmCOaPOPA00 s 2,000,000 PRICY �O• Loc AUTOMOBILE LIABILITY COMBINED SNGAUMR ANYAUTO IfSlsould") S ALL OVYNED AUTOS BOOILY N JURY (RIF P—) S 9CHEpULEDAt1TOS HUREOAUTOS BODILY NJURY NON4"EDAUTOS (Paraci�rt) S PROPERTY"AGE S iFbrecWlryN) GARAGELIABRITY AUTOON.V-EAACCDENT S ANYAUTO OTLER THAN EAACC S AUTOOWY: AGO S EXCESSKINBRELLALIABILLTY EILpiOCCURRENCE_... S OCCUR CLAMS MAGE A001183ATE S S DEDUCTIBLE s RETENTION i S MVC STA GTN• WORKERS COMFENSAIWN AND H EMPLATERTLIABIUTY DOWC911544 10/26/08 10/26/09 ELIACHACCIDENT a 1-0-0-0-000 ANYPROPRIETOR(PARYNEROEXECOFFicERIM EXCLLUOED7 DYNE r.L OISBAiE•EAEMPLO/EE S 1,000,000 ;;WmftzwbnbN ELOIIIEABE-POUCYLMIT S 1,000,000 OTHER DECRNITICIN OF OPER01IONS I LoCamoms ivmcm imCLUSLONSADDED 9YENDORSEMENTi3PEClALPROVISHM F-603-458-1090 I CERTIFICATEHOLCIER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCHES ISE CANCELLED Gfff LE THE t7MATION TOWN OF NORTH ANDOVER DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MN` 10 DANS WRITTEN 1600 OSGOOD STREET NOTICE TD THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 60$HALL NORTH ANODVER, MA 01845 IMPOSE NO OBLIGATION OR LIABRJTV OF ANY KIND UPON THE INSURER ITS AGENTS OR REkEEENYAYIVES. iAUTHORIZED REPRESENTATNE O ACORD ACORD 25(2001108 CORRORATION 1986 e i i NORTH Tovm of No. qq� O LAKE o '� dower, Mass., 3 410 COCMICME WICK ORATED BOARD OF HEALTH Food/Kitchen PER M IT T.. D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT Foundation has permission to erect........................................ buildings on160dz �.....�oo . . ..sr........... .Z. ............L..... Rough • to be occupied as.... QQ.Q.... .. . r........la i .Q.OTOO...................... Chimney . .............................................................. provided that the person accepti this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONS UC STAR Rough ........ .......... .................................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR gh Display in a Conspicuous Place on the Premises — Do Not Remove F nal, No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Bumex Street No. SEE REVERSE SIDE Smoke Det. TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING � a ;This Section for Official Use Oral ' y r:; s BUILDING PERNUT NUMBER: DATE ISSUED: �,- V arm SIGNATURE: Buildin Commissioner or of Buildings Date 1.1 Property Address: rr 1.2 Assessors Map and Parcel Number: ,—� Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: v Zonin District Proposed Use Lot Area Fronts ft 1.6 BUILDING SETBACKS(ft) m Front Yard Side Yard Rear Yazd Required Provide Required— Provided R red Provided 1.7 Water Supply NW.L.C.40.1§54) 1.5. Flood Zone h6nuation: 1.8 Sewerage Disposal System: Public ❑ private ❑ Zone Outside Flood Zone ❑ Municipal On Site Disposal System ❑ t z ici: es—No 2.1 Owner of Record ®� pew 12 0 CD e9 0 O Name(Punt) �ddress for Signature Telephone 2.2 Authorized Agent Name Print �� Address for Service: z Signature Telephone M AXI M. 3.1 Licensed Construction Supervisor Not Applicable ❑ r Address License Number O r 2 f � n Licensed Construction Supervisor: le q �� ErDid r- Signa�� Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Com Name 1Y Registration Number M r Address Expiration Date ^z Li Signature Telephone gra �t 17,CIV� .. �3 3 y Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in Che denial of the issuance of the building permit. Signed affidavit Attached Yea.......❑ No.......❑ ' 5ECICfON S t4� Q1 A ,bll CC 1 W4N,S I.M.�A SM ONST8I3rQN CO�OI� ' x "fib 7 >� yrr �014+Y��iD ,b> NTID � j h a 41 , 5.1 Registered Architect: 2 Name: Address Signature Telephone 7 r +L� Area of Responsibility Name: Registration Number Address: Expiration Date Signature Total Not applicable ❑ Name: r. 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 1 Signature Telephone Expiration Date r � _r �� '�- Not Applicable ❑ mpany Name: = z Responsible in Charge of/Construction ' I New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: 41- Lt- a C-C LC_ )9f2 F2 °i E Y v\. .I M USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ IA ❑ A4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A 0 C Educational ❑ 213 0 F Factory ❑ F-I ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ IInstitutional ❑ 1-1 ❑ 1-2 ❑ 1-3 0 3B ❑ M Mercantile 0 4 0 ❑ R residential ❑ R-1 0 R-2 ❑ R-3 0 5A S Storage ❑ S-1 ❑ S-2 0 5B ❑ U Utility ❑ Specify: M Mixed Use 0 Specify: S Special Use 0 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: INA,s BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area s Total Height ft y�, Independent Structural Engineenng Structural Peer Review Raluired Yes ❑ No ❑ SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, vt' as Owner of the subject property Hereby authorize_ / o I to act on My behalf,in all matt relatives&6 work authorized by this boding permit application Signature of Owner Date i L-- _ c_s- `� as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury Print Name Signature of Owner/Agent Date Item Estimated Cost(Dollars)to be Completed b t a licant -5 WOO,�� V�k x P P Y PP _. aka , ..8ty,c 1. Building (a) .Building Permit Fee Multiplier 2 Electrical - (b) Estimated Total Cost of Construction from(6) 3 Plumbing Building Permit fee (a)x(,) n 4 Mechanical(HVAC) 5 Fire Protection 1y;11d fn ' i� 2,5 Aed4L� ��, .� < 6 Total (1+2+3+4+5) }1Check Number O }� 1 �,J Si„Boi'1:r £•! .�""i*Y(£ .,f H.',k`tu E q4, $s T °�` tU, yc'. #. Pn'`..Z SJ'h� N�y> )., i,L 2"4'd'n Ila.?4: t4''. R", n,� :. t j.F,?a -\ -;f: i. �; �.. i .t�rfyrs•�r .. tir r",xfi .+ tfi,Y.-;. r...t3=W S�E.�:.,+sfi, .sla. .s><.,;r%�si ,r✓�i a` � Cl�,. '� ��.. 3�4,r�'r i.- z r ..:.,v. `1., �, .+yq 1.8'r:.'s§'s7 Swie:. ,,;, 1._AT.. < 1 t'w@�'t; �r 3,.. 4 c'+'s i+x•1.h�f .s y:}pw ,�.w sx14�a. y.,� °n,,.d �. ?C & r x, s �+ e yid su y�x rt �,�y..,.:.,.> '� NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1ST2 ND 3RD SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Ys,4 w;� 7 g ,"acc t��'Tx NORTH Town of Andover z - E dover, Mass.,—/Ap- 0 COC LA MI C MEWICK Y�. DRATED IPa� �C7 ` BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System � BUILDING INSPECTOR THIS CERTIFIES THAT................... 1? Foundation has permission to erect... ......... ...................... buildings o J .�D........{.X..!. . ........... ................. Rough to be occupied as.... Chimney . . ....;�?t .............................................................. provided that the person accepting this permit shall in eve aspect coto the terms of the application on file in Final this office, and to the provisions of the Codes and By-La rela ' tospection, Alteration and Construction of Buildings in the Town of North Andover.,a5'q oe0#7 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ARTELECTRICAL INSPECTOR Rough Service B L G TOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. TOWN OF NORTH ANDOVER Construction Control Affidavit Project Number: 0506065— DSA Detection Project Title: DSA Detection Services. Project Location: Bldg 20, 2nd floor south wing at 1600 Osgood Street, N. Andover, MA Name of Building: 1600 Osgood St. Building #20 Nature of Project: Tenant Fit-up in existing building. In accordance with Section 116.0 Registered Architectural and Professional Engineering Services-Construction Control of the Massachusetts State Building Code, I, Gregory P Smith, Registration No. 8688 being a Registered PFefessienal Engine^yArchitect, HEREBY CERTIFY that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Architectural _XXX Structural Mechanical Fire Protection Electrical Other (specify) FOR THE ABOVE-NAMED PROJECT AND THAT SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE 780 CMR MASSACHUSETTS STATE BUILDING CODE. ALL ACCEPTABLE ENGINEERING PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the state of construction to become, generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. UNDER SECTION 116.4, I SHALL PERIODICALLY SUBMIT A PROGRESS REPORT, TOGETHER WITH PERTINENT COMMENTS, TO THE BUILDING INSPECTOR UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. Signature and Stamp no facsimile) EDA RY P No.8688 ti C) NORTH ANDOVER, O MA. c� ` �J 9�tR OF MPSS�G SUBSCRIBED A SW N RE ME THIS DAY OF 200 C NOTARY PU MY COMMISSION EXPIRES DOWGIERT CONSTRUCTION CO. INC. 616 ESSEX STREET LAWRENCE, MA 01840 978 685-0306 fax 978 685-1290 CONTRACT Customer Name 1600 Osgood St. LLC Ozzy Property mgmt Date 11/8/2005 Address 1600 Osgood St Job Loc City North andover State ma ZIP Job Name DSA Detection Phone Qty Description Unit Price TOTAL Supply necessary material and labor including necessary permits and build out approximately 3,063 sq ft. as per preliminary plan by GSD on 9/26/05. Price includes building of walls as per lay out, installation of electrical service, necessary meters, including two electrical panels. Install parabolic lighting and electrical outlets as per Ozzy standard. Modify duct work and registers as per new lay out. Install oak doors in metal frames, Install windows as per plan. Install 2x4 suspended ceiling as per Ozzy standard. Adjust sprinkler heads as per new lay out. Install emergency lighting and horn strobes per new lay out. Paint new walls and woodwork, colors to be picked by others. Install carpet and cove base Ozzy allowance$12 per sq yard installed. I TOTAL CONTRACT PRICE $87,816.00 SubTotal $0.00 Price does not include arcitectural or engineering Shipping & Handling costs, data, telephone wiring, equipment or furniture installation TOTAL $87,816.00 Office Use Only i Nov 08 05 09: 30a 6038900192 P. 1 FROM :ROBERTS INsuRANCE FAX NO. :9786833147 Nov. 08 2005 10:44AM P1i1 ACERTIFICATE OF LIABILITY INSURANCE 1 B 05 /RDDUCEII TM CERTIFICATE 19 1SSLMD AS A MATTER OF DWORMATION N.V. PRBERTS INS. AdE m SNC. ONLY AND CONFM NO FMGHTS UPON THE CEItTIFTCATE 1060 OSCs00D STREET M THE THIS AAFFFFORDDEED BY T!MM, EXTEND OOW. HORTR AND=R, NA 01845 979-693-eQ73 INSURERS AFFOROINQ CCWERAGE NNCN NBU14ED DOMGIERT COP8Ti=TI@T OONBAM INC. NBUREA k ESSE7ClusuRmcs COMPANY- MSURIER P. 175 BRADY AVL MBURER c: SALSH, 98 03079 INSURER 0. MLMO INSVR1ai.i f gOplp _ "SURER t COVERAGES TME POLICES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO TME INSURED NAMED ABOVE FOR TME POLICY PERIOD INDICATED.NOTWfii(STANDING ANY REQUIREMENT.TERM OR COHOITWN OF ANY CONTRACT OR OTHERYY DOCUMENT RH RESPECT TO WMICM TMIS C:R Wf ATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SMECT TO ALL THE TETRAS.EXCLUSIM AND CONOrt[OHS OF SUCH POLICES AGGREGATE L MIT_SS_MWNMAY t(AVE BEE_O_ N REDUCEDBY PATO CLARm. O -_ PoucymmmR - FOVIOMEWMEMO oR LIMITS GONER&LIABLITY ZACH OCCURRENCE s 1,000,000' �' NNMERCUIL QENERAL lIABiUTY IREYISES�aOar�, _,_! OOQ N CLA SMADC• ®OCCUR MED ExP(Anyarrpenanl s - ED A 3CP3616 10/26/05 10/26/06 PERwm4ADvKAW s 1,_OQQ.,,000 _ W"AL Ar4RE-GATE s 2,000,000 GGNL AGGlarATE LMT APPLES rM PRODUCTS-COMPr'OP AGO S 1-000,000 POLICY MPno- Loc AUTOWBUL AsurrY mCUELWry ANYAUTO ( x A) s ALLOWNWAUT08 BODILYANJURY SCHEDULEAAVTOS (Pvpsm" : HIRED AUTOS NOt14MIUEDAUT08 "LAlI�� i —^— PROPERTY VARtACE i (ParrooJaNl GARAGELM81UtY AUtOONLY-EAACCIDENT • OTHER Tom AUTOONLY. AGO i EXCE6ffiNXMGLL(ALlLU101UTY EACtlOCCURRENCE 3 OCCUR ` CI.AMMAOE AGGREGAIE i DEDUCTIBLE i RETIRMON 1 i WOR><ERSCDYPEN4ATIONANO TOR A E EIPLOYM LUMM TN DOWSOO548 10/26/05 10/26/06 LLEACHACcwEw s _ 500 000 Nn.RomETOAIPAan„E _ D eJaC UDW EL DISEASE-EA TBFL i 500 OOO =swoeto 500 000 tio1oi E.l.d9EA65.POLwv tnurr s OTHER DE.WAFTIONOPOPERATIONSftocmomstveia EgIEXCLUSIONSADDEUVYENOORSEM RTtSPCCIALPRONSRTN9 JMKI Z CERTIFICATE HOLDER CANCELLATION OSYRY PROPERTt89, LLC. GKOULD ANY OF THE ADM-DESCMKD POULEs BE GA"CELkW YCFORE TM E7rIRATRTN e DuNum PARK DAZE THEREOF,THE tMIWG 94UMM PALL ENDEAVOR TO w x 10 DAYS YATITTCN ANDOVER NA 01810 NOrlm TO THE CERfOXATE;HOLM NAKED TD Tm uWr.an Muuk io vD SO stwia DAME NO OKMTION OR LWRLRY OF ANY XM UPON TIE MmuRER IY's AGENTS OR ATAIE TAT ACOR025(20011118) DACORD CORPORATIONISBB rUKm U - LU 1 KGLGAQC rvRm i INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTION APPLICANT PHONE LOCATION: Assessors Map Number PARCEL SUBDIVISION LOT (S) STREET 'UST. NUMBER OFFICIAL USE ON!- RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT All Pc�m 7ECEIVED BY BUILDING INSPECTOR DATE ROWWW 9197 JM kviDqwrtmewof1MdUMfdAcchfextj Offift oflnvesde s 600 W@Ajgjon Street Boston,MA 01111 www.mossaov/dIff Workers'Compensation Insurance Affidavit: Binders/ContractorsMectricianWplum ben Aaalicant Information Name sincerer Pleall-PrintLe blv (Bre OrgadZatio�nlladividttan: c c Address- l-D rr City/State/Zip: 1, ----_ Phone#: Are y7amumn employer?Check the.appropriate box: 1. eu*Pbyar with 4. 0 I am a Smetal cont actor and I Type of projft'(regdred). aPbyeei(fill and/or part-time).* have hired die sub-comma �or 6. []New nction 2.0 I am a sole proprietor or partner- listed on the attached shut t 7. ❑ Remodeling ship and have no cnsployces These sub-eontrackm have working for me in any capacity. workers'comp ina+uance. 8- ❑Demolition [No workers'tom.insurance 5. El We are a corporation and ils 9. []ming addition require&] oftw have exercised ibeir 1e•❑Elecwcal Rpm or additions 3.0 I a n a homeowner doing all work right of exemption per MGL 11-11 MUM[No workers'comp. c- 152,11(4),and we have no POit� or additions required.]t employees [No workers' 12.(�Roof repairs _ c%V-imwance required.] 13•❑Other tAnHomw wen who mbma Sus 95&"= cs an cbecb box#1 MM doo sat the sego 6do�r rhawb Oak worloets+oomph PobcYUMMMM tContnreto"that check ibis boa mut M an�and tt+ea L'R naiads cofactors nno snbn*a aew�s�K dwwiq MMMMMMMMMMlbs acme ofa m f 8" I s m an employer that 6 pr�oview Brim,a °0pe"am* t Y Formation teform4tlo�e, m�msnnuft"Jer my AVV&VM Below fi Awp kv andjOb sbie Insurance Company Name: Policy#or Self-ins.Lic.#: 1 ExpiationData: ? Job Site Address: Attach s copy of the workers'cum city/State/Zip: =-t pen oa po8ey deciarat On page(showing the _ Fa>'lure losec um coverageas r p�7'°umber and e:plranon date). under Section 25A of MGL e. 152 can lead to fie� fine up m$1,500.00 and/or one-year ss well as civil o�on of til penalties of a of up m S25o.00 a day against The violator. Be advised fiat a penalties in the form of a STOP WORK ORDER and a fine Investigations of the DIA for insurance coverage vgditcttion, of this staterneat , ftwarded m the Office of I to herby eeerrounder the paw andpew ofpedkry At the lnfwmgdm Si choir is&M andc� Phu #: C9 Q,Q4e/el use o� Do not tvrltt lit dirt uta,to be eo mPtesad by do or tomer o,�ed City or Town: Issui Authority PamWLce°>te ng rity(tdrde one): I- Board of Health 2.Building DOPartment 3.Ctty/Town Clerk 4.Electrical I 6.Other nspecter S.Plumbing Inspector Contact Penn: Phone ft . ;�sie-Pa�sv»zrnzu�ea�� a�✓�aar,�uaelld BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number::CS 048040 I Birthdate: 10/29t1955 4 EXpires: 10!2912007 Tr.no: 8053.0 'Restricted: 00 TADEUSZ DOWGIEERT c, 175 BRADYAVE OT 03079 /J f SALEM, Commissioner ()fiicial mF!se Unly Comonwealth of Massachusetts G Y� � <-----__- Permit No. '- Department of Fire Services Z Occupancy and Fee Checked J BOARD OF FIRE PREVENTION REGULATIONS t[Rev. 205] (leave bl;,nk) APPLICATION FOR PERMIT TO PERFORM�ELECTRICALt�WORK Mi work to be performed in accordance with the%lassachusctts F.Iecu Date: (PLEASE PRINT IN INK OR TYPE,-LL L�'FU ;1'LITIO,�) To.1he Inspector of Mres: City or Town of: �% By this application the undersigned gives notice of his or her intent fn to perforin the el cuical vrk described umber) d o :7 Location(Street& Numb ) Telephone No.' f % Owner or Tenant ' 6 L Owner's Address r' � (Check Appropriate Box) Is this permit in conjune i n with a buil ing p rmit. es t � Purpose of Building rd Existing Service Amps ___Volts Overhead ❑ Und g ❑ No.of Meters Volts Overhead❑ Undgrd ❑ No.of,Meters/ •- Neww a Ze Amps Vl �J I �— �G1 > S w C- Number of Feeders and Ampacity e c Location and Nature of Proposed Electrical Work: r table nury he waived by the!ns pec•trrr•n/'I I'i Y ('um lelinn o Ihe,loNoicrn'Q Total No.of KVA Transformers No.of Recessed Luminaires (J No.of Ceil.-Susp.(Paddle)Fans KVA No.of Hot Tubs Generators No.of Luminaire Outlets Aboven- 0.0 mIergency ig ing No.of Luminaires Swimming Pool rnd. ❑ rnd. ❑ Batter Units No.of Oil Burners FIRE ALARMS No.of Zones No.of Receptacle Outlets.- No.of Detection and CQ No.of Gas Burners Initiatin Devices , No.of Switches Total No.of Air Cond. Tons No.of Alerting Devices No.of Ranges No.of Self-Contained Heat Pump Ngmher Tons I Detection/Alertin Devices No.of Waste Disposers Totals: Municipal Other Space/Area Heating KW Local❑ Connection — No.of Dishwashers Security Syste ms: HeatingAppliances K No. Devices*o r E uivan No.of Dryers No,o Data Wiring: KWr NO'°f Ballasts No.of Devices or E uivalent No.of Water Signs Heaters Telecommunications Wiring: No. Hydromassage Bathtubs No.oof Devices or E uivalent f Motors Total HP No, OTHER: I MICIr ruhlitiorrul detail iy rlesired, or ns regnirrd!n the In.pcilnr n/ II'P (When required b municipal policy.) q Y Estimated Value of Electrical Work: h ti9EC Rule I Q,and upon completion. requested in accordance with Inspections to be � work may issue ante Work to Start: of electrical Y INSURANCE CO V ;RAGE: Unless waived by the owner, no permit for the performance • s substantial equivalent. `fl►c the licensee provides proof of liability insurance including-completed operation covtta�c or rt undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing ollice. ❑ 110ND El ❑ (Specify:) CIIECK ONE: INSURANCE • rnirrs raid ennities u7" . ' rury,that Nie in/itrnurtiurr rip Nris n/rplieatiurr is true and rurnplete. �r ndei Nrc PLIC. NO•: ��Sar1 certr I r FIRM N,\,NIE: /�( /� ` ' LIC. N0.: 7 l� � �i.. � Signature�C,W t'� Licensee: L� c '� _ Bus.Tel. No.: 1/I'al;plicuhle,uNet ''wr-+n tl"nt Ihr.'lic'cnse another line.) / kit.Tel. No.:__—i i Address: le enter the license number here: forif applicable,, °Security System Contractor Ltcen,e required ware e is work, pprage tile liability OW'NER'S INSURANCE W,%IVER: 1 am awarwaivettl s ile Licensee requirement. rlramrthe(check one)tt❑`townerC°❑ owners ag(. required by law. By my signature below, t hereby I �'ERrd11T FEE: Owner/Agent Telephone No. 3 - 3 - oma h� K Date..-2. .:��y.. 1 MORT1{ °e�"`°:•�"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING U This certifies that MILL-- �T/?c ..................... . ' - . ................................................. has permission to perform ............. .... ........................................... wiring in the building of X — DS4 Q...... ..................................7z�ay........... � C.. �9"cr�?� S% at................................................................................ North Andover,Mass. Fee.�2�°........ Lic.No... .�'. ...................... .. ELECTRICAL INSPECTOR Check # 8663 Commonwealth of Massachusetts Official,Use Only Department of Fire Services Permit No. IS GS BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: S — I 1— 6 6F City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) � S' od� S' � caner Tenant�G Uer� �Z djta � / 5 t:5 TeIephone No. v 1 h 1 Owner's Address IMO Q � � 1,414 3 O Zl" PGG Is this permit in conjunction with a Pbuilding permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. '1 Existing Service Amps / Volts Overhead ❑ Und rd g ❑ No.of Meters New Service Amps / Volts Overhead❑ Und rd g ❑ No.of Meters Number of Feeders and.Ampacity Location and Nature of Proposed Electrical Work: vs t r,,f 20, 2u� Rdm Svvf4 bSif i 1000 S44. Co— leh'on of thefiollowing table maybe waived ky the Ins ector o Wires. No.of Recessed Luminaires No,of Ceil.-Susp.(Paddle)Fans N .of Total Troansformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Poo. Above ElIn- ❑ o.o mergency ig g grnd. rnd. Batte Units —, No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zone.- No.of Switches No.of Gas Burners No.-of Detection and InitiatingDevices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No,of Waste Disposers Heat Pump Number_"Tons_ KW No.of Self-Contained Totals: """ Detection/Alertin 9r,Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other f No.of Dryers Heating Appliances KW Security Systems: No.of waterNo.of No.of Devices or Equivalent Heaters KW No.of Data Wiring: Si s Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring.. No.of Devices or E uivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Ins ec ions to be P requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liabili insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cov rage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Spec I certify �'') under the aims and penalties of perjur, that the information on this application is true and complete. FIRM NAME:.. t � Ft is eo. iic. S, LIC.NO.: s�3 Licensee: 1Q,(,/�@Jj� Signature �/�' (If applicable, e�' .empt' in th license n m er line.) z LIC.NO. >o sf7 Address: k�( ver, Bus.Tel.No.:/403'7E.�54T2 2 *Per M.G.L c. 147,s. 57-6 ,security work requires Department of Public Safety"S"License: Alt.L cl.No OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ r Date 7/3/*d TOWN OF NORTH ANDOVER mom p PERMIT FOR-PLUMBING ,SSACMUSE� This certifies that .�- ., i ,!7�.f f �``. . . f1� �� . . . . . . . . . has permission to perform . . . . \. . plumbing in the buildings of . at . P.G.9. . . G:�S.`.`. . � . . . . zo-2 . . . . . . . . . . . .. North Andover, Mass. Fee. . . . `'c'�!�" 7 t PLUMBING INSPECTOR Check 11 8030 I w MASSACHUSETTS UNIFORNI APPLICATION FOR PERMIT TO DO PLUMBING " (Type or print} NORTH ANDOVER,MASSACHUSETTS Building Location Owners Nae C�cSt� Date (�� 2 `� d i Permit# Type of OCCUTIaxicy 0 ount New rl Renovation Replacement '4 Plans Submitted yes No ❑ FarTUR.ES � N � O F-• q U H4411�' q � M 1+1COUIR • 3V2 Knm 4IHIIl.XR SIH ELOCR 61[Fi II1XIt 91H I I i I I I (Print or type) I � I Installing Company Name ��r I,S-�o✓�� r Check one: Certificate Address ❑ Corp' Partner. ausmess elephone Name of Licensed Plumber: - n Fum/Co. Insurance Coveraee: Indicate the type or msuFance coverage by checkur � Liability insurance policy E3Other type Indeof g the appropriate box: qty, Bond ❑ =thm ,Insurance Waiver. I, the undersigned,have been made aware tht. at the licensee of this application does not have any one of th trrancee above e ❑ Owner Agent E]I hereby certify that all of the details and information I have submitted (o best of my,knowledge and that all plumbing work i entered) above application are true and accurate to and installations compliance with all pertinent provisions of the Massachusetts State pl the performed under Permit Issued for this application will be in =�XR (o77'usE bmg de and Chapter 142 of the General Laws, igna�ure of tcensaa moer Type.of Plumbing cense rcense 4umoe Master NLY Journeyman e� ne Lo►nmonwealth of Massachusetts <, Department of lnduMt1ia1 A cidentc OfTace o u ;�� %; f Investigations 600 Wash Ing,'on Street Boston,` n, MA 02111 � rr WWYt'.J72Q,gS.e 01��d1a Workers' Compensation Insurance A i",,,It, guilders/Contractors/Eiectric' An Iicant Information >ians/Pjam bers Please Print Leaib}v Name (Business/OrganizationMdividual): Address: 1✓'/6 G���l�/,✓ fi 5 i City/State/Zip: ll��/ / /�C Phone re you an employer?Check the appropriat�e b FA am a employer with 4. Ll i am ao. Type of project(required): general contractor and Iemployees(full and/or part-lime).* have hired the sub-contractors ❑ New construction.❑ I am a sole proprietor or partner- listed p o� the attached sheet $ 7• 0 Remodeling. ship and have no employees These strb-contractors have working for me in any capacity. workers' p. insurance. g ❑ Demolition [No workers' comp. insurance 5..❑ we are a eorporationon and its 9• ❑ Building addition required] officers have exercised.their L13.E] ectrical repairs or additions 3.❑ I am a homeowner doingall work right rk n ht of ex' myself. [No workers' coin c i5� emptton per MGL mbing repairs of additions p , 1(4),and we have no insurance required.] t employees, [No workers' of repairs comp. insurance required] er `Any appficant_that checks box#1.must also fill out the section below showing their aorkels coMPC nsation oft ?t'lUnteoWllelS WhC SUbmli.fiLS aiildavil Ifldicatin�they ars duill�aE;c�+t:r;; Policy information. YContnlrtots that Check this box must amici Eden hire outside coni;u tors rnLL4i su'mnii a new atnd , at= an additional sheet showing the mune of the sub co a it irdicaung such. I am an enrnlover that i� Dov actors and their workers'comp.policy infotmation. f p ufirzg workers compensation iuzsuranee for , in urination ►rg employees. Below is the pnficy,and job site Insurance Company Name: �(� � �5�� C© Policy#or Self-.ins. Lid.#: Expiration Date: Job Site Address: �lo pD c���,� S/ Attach a copy of the workers' compensation,policy declaration o City/State/Zip:� /9 Failure to secure coverage as required tinder Section 25A of pabe(showing the policy number and expiration date). fine up to$1,500.00 and/or one-year imprisonment,as well as civil penaltic. 152 es in tthh forthme imposition of criof a STOP WOR in penalties of a of up to.5250.00 a day against the.violator. Be advised that a copy of this statement may be forwarded.to the ORDER ofd a fine Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and Pn.,lt:�o er u -------------- -------------- rP that the infornza n provided above es rrue and correct Si--nature: Phone#: / b ���- ��© G Date: p .5;> Ufj"ecial use only. Do not write in this area, to be completeQ bJ cit),or town o lciaL City or Town: Issuing Authority(circle one): Permit/License# 1. Board of health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Piumbi Q 6. Other nb Inspector Contact Person: Phone DSA Detection Plumbing Inspector Town of North Andover 1600 Osgood St., Suite 2-36 North Andover, Massachusetts 01845 March 30, 2009 To whom it may concern: This note is in regard to a sink that will be installed in a tenant space of building 20 at 1600 Osgood Street,North Andover for DSA Detection(immediately south of New England Engineering Services and across from HBSS). This sink is for the purpose of washing and rinsing items including food or other non-toxic materials. No chemicals of any kind or other hazardous materials will be disposed of in the sunk, including cleaning liquids and cleaning waste water. If you have any questions or concerns,please don't hesitate to contact me directly. Sincerely, Stephen S. Milt Vice President Operations DSA Detection LLC 978-975-3200 x131 1600 Osgood Street,Suite 2-43 1 North Andover, Massachusetts 01845 Telephone 978.975.3200 1 Facsimile 978.975.3201 Location No. Date NORTIy TOWN OF NORTH ANDOVER AL VITO 4 ♦ i Certificate of Occupancy $ �- �'� CMUs Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ / s Check # 6-..3z;�5 19233 Building Inspe%or :� � � �i r_ -----��_--- `\\� -- __ �� Or,MOI1TN,y N r i f�9G y^i �ACN 5 4, CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 645 4/12/06) Date: MU 262006 THIS CERTIFIES THAT THE BUILDING LOCATED ON 1600 Osgood Street MAY BE OCCUPIED AS Commercial Tenant Fit U for CMI IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: ozzy Properties 1600 Osgood Street Andover 0 45 Building Inspector A NORTH Town of q r rte- dover, Mass., it GOC HICHEWICK V ��ADRATED PPS\ �� S ti BOARD OF HEALTH PERMIT . T D Food/Kitchen Septic System THIS CERTIFIES THAT...1.6.00 BUILDING INSPECTOR Foundation has permission to erect........................................ buildings on .......�!�►�..........101. ..6.4... .. .-P ................... Rough to be occupied as..... u o.or.............Cm t.. ,� provided that the person accepting this permit shall in every respect conform to the terms-of the application on file in #Final' this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING iNsPE&rOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI TA:V0 TS �� jr.� .! ' ?t!. <,- )/°tea, 011gl¢1 ................. ... ... ... .. .... Service DING INSPECTOR .,r Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and. Approved by the Building Inspector. Burner 1 �— Street No. a ✓ 1 Det.D e k mo SEE REVERSE SIDE Smoke � •' r TOWN OF NORTH ANDOVER Final Design Affidavit Project Number: 0412108 Project Title: CMI Technology - Tenant Fit-up Project Location 1600 Osgood Street, Building 20 2"d Floor South Wing Name of Building: Osgood Landing Nature of Project: Tenant Fit-up of Office Space In accordance with Section 116.0 Registered Architectural and Professional Engineering Services-Construction Control of the Massachusetts State Building Code, I, Gregory P. Smith Registration No. 8688 being a Registered /Architect, HEREBY CERTIFY that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Architectural )000( Structural Mechanical Fire Protection Electrical Other (specify) FOR THE ABOVE-NAMED PROJECT, AND THAT SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE 780 CMR MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I HAVE PERFORMED THE NECESSARY PROFESSIONAL SERVICES AND EITHER MY REPRESENTATIVE OR I HAVE BEEN PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK HAS PROCEEDED IN ACCORDANCE WITH THE DOCUMENTS SUBMITTED FOR THE BUILDING PERMIT, AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2 1. Review for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the state of construction to become generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. Issues: -The proposed bathrooms in this area are almost completed, however, other bathrooms are located in adjacent areas including accessible toilets that con be used until the proposed toilet rooms are completed. I AM SUBMITTING THIS FINAL REPORT AS TO ORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. ey�� RY P. Signature and Stamp (no facsimile) N0.8688 o NORTH ANDOVER, �o MA' 711 OF Mi SUBSCRIBED NDS O FORE ME THIS DAY OF 2006 MY COMMISSION EXPIRES xakal r NOTARY PU C ONORTH 7y F - D sSACM�� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 645 4/12/06) Date: May 26, 2006 THIS CERTIFIES THAT THE BUILDING LOCATED ON 1600 Osgood Street MAY BE OCCUPIED AS Commercial Tenant Fit U for CMI IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: ozzyoperties 1600 osgood street Ft t Andover 0 45 Building Inspector NORTH Town of O _ - //j 214 -== A dover, Mass., COC HIC HE WICK ADRATED F?a` �C7 `S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...1...00........ :.. 0.0........ ... ...C.............................................................. Foundation has permission to erect. g 6. g .................................. buildings on .......1 �..........i0.��..1�.®.... .. .................... Rough to be occupied as.....0✓.1..ld....O..dr.............� ..�.................................................................................... ✓v' i provided that the person accepting this permit shall m every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING iNspEcIrOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI ;:W84mNGINSPECTOR TS ou , �- 4,! ���. A Service Fifial ' Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Location A/061 " �/ No. __ Date O / 7 NORTh TOWN OF NORTH ANDOVER l � s Certificate of Occupancy $ s,�'° E<� Building/Frame Permit Fee $ 4CMU5 Foundation Permit Fee $ R Other Permit Fee $ TOTAL $ Check # 18723 Building Inspector t ��� .�'7✓ ir If TOWN OF NORTH ANDOVER BUILDING DEPARTMENT i APPLICATION TO CONSTRUCT 5&LA RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING A Ago* BUILDING PERMIT NUMBER: DATE ISSUED: d C / M �5 SIGNATURE: Buildi Commissi;;r/12s xMr of Buildings Date 2 6 SECTION 1-SITEAFORMATION 1.1 Property ess: 1.2 Assessors Map and Paroe(Number: 1�0o Os�or� �f Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zonin District Proposed Use Lot Area Fronts e ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.GL.C.40. 54) 1.5. Flood Zone Inf°mution: 1.8 Sewerage Disposal System: Public ❑ Private 0 Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes_ No_ M 2.1 Owner of Record Pim ae r kle s , .Th C_ A00 05!m01 ,5 4 Name Mint) Address for Servi \Liv �T'r1�1 c-Q-0 &L \L�_ 978 - C`�S•��co ignatu Telephone 2.2 Owner of Record: Name Print Address for Service: z Signature Tele hone M SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ V,�,- ((_ ?ICrgiz Px ldm(da it lni OII�P e Licensed Construction Supervisor: License Number 0 Add/r/e�J`/,'Q Expiration Date xSignature one 3.2 Registe Home mprovem tractor Not Applicable ❑ Company Name Registration Number Address -- r MCNIN+ Expiration Date A Signature Telephone 4�/ t SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work(check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: X02. x v -f;a t fro/"/,e r i' CJ 7L /(CDU DSS oocQ S- ire-ef /�lor�h Adagg, SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed b ermit applicant I. Building (a) Building Permit Fee �.3, a O Multiplier 2 Electrical (b) Estimated Total Cost of 0Ua© ©O Construction 3 Plumbing Building Permit fee(a)Y(b) 4 Mechanical HVAC 5 Fire Protection t� 6 Total 1+2+3+4+5 3 S 3 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN . OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as`e v=/Authorized Agent of subject property ereby authorize to act on My b e s relative to work authorized by this building permit application. S iatur of weer Date SECTION WNER/AUTHORIZED AGENT DECLARATION 1 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 1 Print Name Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3 SPAN DIMENSIONS OF SILLS DM ENSIONS 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 Attention: Building Inspectors Office Town of North Andover, Ma. Northern Essex Community College, Corporate and Community Education Center has permission to place a trailer on site in the West Lot of 1600 Osgood Street. Northern Essex Community College is leasing this lot location for the college's Truck Driver Training Program. O Sig at Date V Ozzy Properties, Inc. Dundee Park Andover, MA 01810 Phone: 978.475.4569 Fax: 978.475.4638 Email: info@ozzyproperties.com I 1 I a NORTHERN ESSEX COM M U N I T Y COLLEGE as Haverhill • Lawrence' WORKFORCE DEVELOPMENT&COMMUNITY EDUCATION BETTE BROWN j Facility Manager Corporate and Community Education Center Telephone 978.659-1211 Fax 978.659-1256 bbrown@necc.mass.edu 1600 OSGOOD STREET,NORTH ANDOVER,MASSACHUSETTS 01845 i Ili roti �1� iI SOUTHWEST LOT 14 65 / I•ii k:C SOUTH LOT SPIN El il 1 � r • v C NORTH �9 Town of 4Andover -No. :; 2.. 70 i=- dover, Mass., D I� LA COCMICMEWICK AERATED C3 S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT. ql�.. �.. .. .. 14PW ,,,5................... ...�C... ................... Foundation has permission to are W ....... buildings on ./ aQ:... .. �� ............................ Rough to be occupied as ... .................................................. Chimney 11�� � Ch' e provided that the rson aci�eptinhi�ermit s1hwall iMO. a cofif�fnt terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 ONTHS UNLESS CONSTRU �TS ELECTRICAL INSPECTOR Rough ............... Service ING Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. DEA41it711t WOFPEIBUICsAFElY tPenrdtNo.iSQARDOFFI►RBPREVFVIXXV�Sl7a g,a-Mancy a Fees Checked APPUCA71ONFOR PERNITTTO PERFORM ELECTRICAL WORK ALL woRa(To BE PERFORMED IN ACCORDANCE Wf[H THE MASSACHUSSTS ELECMXAL CODE,527 CMR 12:00 (PLEASE PRIIVT IN M OR TYPE ALL INFORMATION) Da I Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) i wo n-raco c lC'C ' Owner or Tenant i t,,6V 0-S Sueef Li-C22- hit'a 4w N F Owner's Address Is this permit in conjunction with a building permit: Yes No (Check Appropriate Boa) Purpose of Building C ON'Te C o f'+'t e Kt'r-W A f S Utility Authorization No. Existing Service Amps nits Ov'erfiead`^ Underground No.of Meters New Service Amps Volts Overhead Underground No.of Meters Number of Feeders and Ampacity '" F Location and Nature of Proposed Electrical Work ` 1 .c �O !oe- A-\.0\ Ion epi z v'Cl't c>tZ No.of Lighting Outlets No.of Hot Tabs No.OtTromb mars Total KVA Na of L'andq RMINes Swinuning Pool' Above in Below Oatmttots KVA Na of Receptacle Outlet, I / No.of Oil Burner No.of Emergency Llandna Battery thdta � r/,- No,of Switch Outlets No.of On Burrrms No.of Ranges No.of Air Cond. Total FIRE ALARMS No.Of Zama Tau Na Of Disposals Na of Has TOW Total Na ofDerecdon and re�octifia `L ponva No.of Dishwaahen Space Mea Heating Toes KW lulN o daring } of Sounding a �1i i r v% u CC Na of Self CcntabmdDeNcti ;J t��rc�yfitvai Na of Dryer Heating Device KW Local ��ic" LX v� O- Cotmecdan No.of Water Heaten KW Na of Na of sixas Baillsk No.Hydro Manage Tuba Na Of Moron Total HP Ur HER• - iteuarnaeCb�aa�Pir®stbdlera�iaznabdmmdl Laws Ihwaans tlit&yJ a zeRrkir AftCm arb&*A'dWgWm 09 YES Np Q ItimahrtifledveidpoofafsamelDbOMM YM I)wharediedoedY!?S,pkandc*dr of type corwVby IrsrRAN� eon®❑ o� 13 �� ( 13~ 06 g 22 t%5 (' I / 181°dValreafHec�lV►krlr S WO&OSM 1lepeclirnD*Re4:�d Rot>gIL PN l C k fW 1� P�Cfp0►M i LL ELec1 a(-c 'T'u cS moria l e 24111-(5 9800 J650 3 �9�1 Bud=TdNa Ad& ./ l Ait IdNa OWI�RsIIVS'IJRANCEWA1VIIt;IantawaeQtetLheLimBelheirannoeeutea�tzlesi�l8iegiivalatasmc}iedbyMeeaad><BdlsGa>ErelLaws arddzlmysgr*zcrlffipmriappic�imvNtiaf nOurin (Please check one) Owner LJ Agent / G Telephone No. PEJWT FEES L '� �=-- L - 3 - 0 Date... . .. ... rJ. ... �aORTI{ °f'"`°;••'"� TOWN OF NORTH ANDOVER = p PERMIT FOR WIRING �SSACHUS This certifies that ..............1.:.`....�'L.S.......!P-.LEG.r.............................. has permission to perform V` s —���L��� ............................................... ............................ wiring in the building of.. G©..............11. 2 2}' ®/D ........... ............. at.,�tPP.4.. 5 �? ............................... .North Andover,Mass. Fee.. . .. Lic.No... ....... ............................ ............... . ........................... ........ ELECTRICAL INSPECTOR Check # 6751 Commonwealth of Massachusetts Department of Fire Services Ckcuranc% ind Fee C heckcd BOARD OF FIRE PREVENTION REGULATIONS APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK �1 -111 1 0 I'LL Lti'E Pw%r/.N 1,\K OR TYPE.I L L /.\FOR.1 1,1 Tl().\', Date: C i h- I)r T I)%v n I)f: 6zyj 0 L-)� rojik' Ily is .1ppl Icallon the 1111del-S Ud" e ot hi�"ol.11cl. I. I", Q ;Ives IlotIc 1el l"A"ll die Location(Street & Num her , . S DU Owner Or Tenant Telephone \o. ONvner'sAddress Is this permit in conjunction with a building permit? YesF1 No (Check;appropriate Box) Purpose of Buildiog 911,CLerpi.ex km . Ltility Authorization No. Existing Service aLj Amps * olts Overlilvad UndgrdF L20 No. of Meters New Service 6-6— %mPs � 0ZVolts Overhead E] Undgrd ❑ No. of Meters Number of Fecders and Ampacity Location and Nature of Propo5ed.-Electrical Aork: OF C-Mi 1010tj It No.Of Recessed Luminaires No.Of Ceil.-Susp.(Paddle)FansN-0--5 TTodal 'Transformers KNA No.of Luminaire Outlets No.of Hot'Tubs Generators KVA iNo.of 1-liminaires Swimming Pool aboveIn- O-o mergency Lighting .'rnd. -----,3attt:ryUni(s No.of Receptacle outlets No.of Oil Burners FIRE ALAR-NIS I . [No.'of Zones No. of Switches No.of Gas Burners :10-of Detection and Initiating Devices No.of Ranges No.of A ,lir Cond. .rollsI No.of Alerting Devices No. of Waste Disposers Heat Pump Number rolls KW No-ofSelf-Contained DetectioniAlerting Devices No. of Dishwashers SpaceiArea "eating Kw 'Viollicipal Local Connection � Other No. of Drvers "eating Appliances KW Appliances Secur by S Steins' "V Security ". No. Of Water No. of N .'Of 6evices or Eguivalent Heaters KW No.of Data I ns Ballasts N')"a - E a�ia r a Data Wiring: ,signs Ballasts = E No.of Devices or Equivalent r(�t"l tip No. Hydromassage Hathtnbs- NO. of Motors rot,11 tip I decommunications �41iriog: OTHER: Devices or Equk alent tinl;aQd V,Juc ol FIcctI-jc�jI %Vi�i-k: ...... .. to',t:lj-t: In rccokati to be I*C(11.k;�tCd in .pith \IEC Rule'I(). dild LIP011 INSL R.1VCE COQER k(.E. I h; (he ukElwr. III) hermit tcr ilic 1tCI'IGI'11hIIlLC 11c'.. Ink':11.0 ilv� alivI( IIIc IjIll. -I hrr A-L. f�4!c Idmss: :`Aller