HomeMy WebLinkAboutMiscellaneous - 1820 TURNPIKE STREET 4/30/2018 (7)�
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,Location
No. Date
TOWN OF NORTH ANDOVER
�e Certificate of Occupancy $
',ssA�Nustt�' Building/Frame Permit Fee $
Foundation -Permit Fee $
Other Permit F $ CJ. ev
f��C �✓` 1 TOTAL $
Check # —6-
r, (� ?1 %- C,,
2 3 J�} U U Buil ing Inspector
-984`7
Date../ . �z'.>.
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ......4. .e ....... ........................................
has permission to perform Aq�EL4:zzCae .... " /09
wiring in the building of ... &'. fiff ..... e ............................................
at.f.&:P ..... r ..
.................... North Andover, Mass.
Fee:�f-K Lic. No. 6D39. �. ............. !x.......
ELECTRICAL INSPECTOR
Check #
1W
ti
k.
' Commonwealth of Massachusetts Official Use Only
lugDepartment of Fire Services Permit No. % g f %
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev. 1/071 leave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (1vlEC), 527 CMR 12.00
(PLEASE PRINTININK OR TYPEALL INFO TION) Date: IQ—aa— /
City or Town of:To the Inspector of Wires:
By this application the undersi ed gives no ' eof his or her intention to perform the electrical work described below.
Location (Street & Number) rlQ7 *'-� N N7 --A) b (o
Owner or Tenant�/V1
Owner's Address
- - • ■ivies
Is this permit in conjunction with a building permit? Yes W— No ❑ BLDG PERMIT #
Purpose of Building 1MyV\p CK -A 0,C._ Utility Authorization No.16 l 1. 8 �,.<7!q
Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters
New Service aao- Amps Qp--/6RQKVolts Overhead ❑ Undgrd ❑ No. of Meters
// Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: G. -
No. of Recessed Luminaires
[No.
o. of Luminaire Outlets
o. of Luminaires
of Receptacle Outlets
No. of Switches
No. of Ranges
No. of Waste Disposers
No. of Dishwashers
No. of Dryers
Heaters KW
Completion of the followin
No. of Ceil: Susp. (Paddle) Fans
No. of Hot Tubs
Swimming Pool Above❑ In- ❑
grnd. grnd
No. of Oil Burners
No. of Gas Burners
of Air Cond.
otals:
;e/Area Heating KW
ting Appliances KW
Ballasts
i table may be waived by the
iranstormers KVA
Generators KVA
ALARMS INo. of Zones
0 IINo. of Alerting Devices
tion/Alerting Devices
❑Municipal
nnnartann ❑ Other
No. of Dei
_a Wiring:
nu. of mevices or -Equivalent
No. hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring:
r No. of Devices or E uivalent
OTHER: --
Attach tional detai i desired or as required by the Inspector of Wires.
Estimated Value of Electrical Work: Q (550 (When required by municipal policy.)
Work to Start: Ipl l b Inspec ions to be requested in accordance with MEC Rule 10, and upon completion.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) <2,ed, �S S
X cert, under the p, ains and nadties of perjury, that the information on th ' _ lication is true and complete.
FIRM N Le,� c� C C LIC. NO.:
Licensee: Signature LIC. NO.: -j Y�
(If applicable,g ter "e mpt" in the license number line.)
Address: qD � y`q� (�� �e� Bus. Tel. No.:(?� 1� b
*Per M.G.L. c.147, s. 57-61, security work requires Department of PPublic Safety S Licen Alt. LIC. NO.. a
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: $
ELECTRICAL PERMIT NO. INSPECTION REPORT:
ELECTRICAL INSPECTOR - DOUG SMALL
1. ROUGH INSPECTION:
Passed — Failed — [ ] Re -inspection required ($50.00)
Inspectors' comments:
(Inspectors' Signature - no initials) Date
2. FINAL INSPECTION:
Passed — A Failed — [ ] Re inspection required ($50.00) ( ]
Inspectors' comments.
(Inspectors' Signature - no initials) Date
3. UNDER GROUND INSPECTION:
Passed — [ ] Failed —I ] Re -inspection required ($50.00) - [ ]
Inspectors' comments:
L (Inspectors' Signature - no initials
4. INSPECTION — SERVICE:
DATE CALLED NATIONAL GRID:
Passed — Failed — [ ]
Inspectors' comments:
(Inspectors' Signature - no initials)
5. INSPECTION - OTHER:
Passed — [ ] Failed — [ ]
Inspectors' comments:
(Inspectors' Si nature - n ' . 1
NAME: -
inspection required (550.00)
Date
Date
g o ' n a a)
Date
DOOR TAGS ARE TO BE FILLED OUT AND LEFT ON SITE IF THE AREA TO BE INSPECTED IS NOT
ACCESSIBLE AND A RE -INSPECTION OF $50.00 IS TCBE CHARGED.
The Commonwealth of Massachusetts
Department of Industrial.Accu%nts
Office of Investigations
600 Washington Street
` Boston, MA 02111
www.mas..gov1dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electriciansfplurabers
Micant Information Please Print Lelribl,
Name
Address: 9e
15
City/State/Zip: � j d�� �Pho.n #: i00 ` t __U Q �G 7(f)
Are you an employer? Check the appropriate box:
1 am a employer with 1'
4. ❑ I am a general contractor and I
_
employees (full and/or part-time).'
have hired the sub -contractors
2. E]I am a sole proprietor or partner-
listed on the attached sheet.
ship and have no employees
These sub -contractors have
working for me in any capacity.
workers' comp. insurance.
[No workers' comp. insurance
5. ❑ We are a corporation and its
required.]
officers have exercised their
3. ❑ I am a homeowner doing all work
right of exemption per MGL
myself. [No workers' comp.
c. 152, § 1(4), and we have no
insurance required.]
employees. [No workers'
comp. insurance required.]
Type of project (required):
6..�' ew construction.
7. ❑ Remodeling .
8. ❑ Demolition
9. ❑ Building addition
1011 Electrical repairs or additions
11.❑ Plumbing repairs or additions
12.❑ Roofrepairs
13. ❑ Other
*Any applicant that checks box 41 must also fill out the section below showing their workers' compensation policy information.
T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
lContractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp, policy information.
lam an employer that is providing workers' compensation insurance for my employees Below is the policy and job site
information. r
Insurance Company Name: rC' '�rte,9E' c 5
Policy # or Self -ins. Lic. Expiration Date:
Job Site Address: �o� —r7eS � Ca k P c5T City/State/Zip: LIQ Y rA
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine .
of up to $250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby e f tify under tli�-ftfidpenaldes ofperjury that the information provided above is true and correct.
Phone #:
Official use only. Do not write in this area, to be completed by city or town official
City or Town:
Permit/License #
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person:
Phone
CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH[ ANDOVER
Building Permit Number.. 441-2011_ Date: March 17, 2011
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 1820 _ Turnpike Street, unit # 106, North Andover
MA 01845
Spectrum - Adult Day Care
MAY BE OCCUPIED AS adult day, care IN ACCORDANCE WITH THE PROVISIONS
OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS
AS MAY APPLY.
Certificate Issued to:
Fee: 100.00 previously paid
Receipt, 23734
Stonewall Plaza
1820 Turnpike Street
North Andover, MA 01845
Building Inspector
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APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION
Building Permit #
ADDRESS&OCATION OF PROPERTY:--/ k2.J t S`14 Uh,•�
Map Parcel Lot Number
DATE REQUESTED FILED/READY FOR INSPECTION_.
CLOSING DATE ON PROPERTY: -3
FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED
ALL WORK AND SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-
INSPECTION FEE OF TWENTY DOLLARS $20.00) WILL BE CHARGED IF THE STRUCTURE
DOES NOT MEET ALL APPLICABLE CODES.
PGS t Issued.10: Wo� �}-A r f S
Address
1 yZ0 j S;�- vnl� -*106
ROUTINGc^-`
CONSERVATION
PLANNING
DPW, WATER METER
SEWERIWATER CONNECTION
NOTE
DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO
SUBMITTAL OF THE OCCUPANCYANSPECTION REQUEST t
DPW
Signature
Fife: Application for OC form revised Jan 2007
M.E.A. Engineering Associates Inc.
Consulting Mechanical Engineers
20 F;Iwn Strue;t, Waltham. MA 02453 761 /894-6730 FAX 781/647-3542
CONSTRUCTION CONTROL AFFIDAVIT
CLOSING REPORT
PROJECT TITLE: Tenant Fit Up Spectmm Senior day carc
PROJECT LOCATION: 1820 Turnpike Street North Andover MA
NAME OF BUILDING: Stone Wall Plaza North Andover MA
In accordance with Section 116.0 of the Massachusetts State Building Code. 780 CMR, 7`h Edition, I,
Alfred E. Mueeini, Registration No. 23339, certify that I am a Massachusetts Registered Professional
Engineer. I have prepared or directly supervised the preparation of all design plans, computations and
specifications concerning:
ENTIRE PROJECT PLUMBING ✓ _
MECHANICAL ✓ ELECTRICAL ✓
OTHER (SPECIFY) FIRE ALARM ✓ FIRE PROTECTION✓
for the above named project and to the best of my knowledge, such plans, computations and specifications
meet the applicable provisions of the Massachusetts State Building Code, 7h Edition, all acceptable
engineering practices and all laws and ordinances for the proposed used and occupancy.
I or my authorized agent, have performed the necessary professional services in accordance with my
Contract with my client, and was on the construction site on a regular and periodic basis to determine that
the work has proceeded in accordance with the documents approved for the building permit and have been
responsible for the following as specified in Section 116.0.
Review of the shop drawings, samples and other submittals of the contractor as required by the
construction contract documents as submitted for building permits, and approval for conformance to
the design concept.
2. Review and approval of the quality control procedures for all code required controlled materials.
3. Special engineering components requiring controlled material for construction specified in the
acceptable engineering practice standards listed in appendix .B of the Massachusetts State Building
Code.
THIS AFFIDAVIT SERVES AS A FINAL REPORT THAT TO
AND BELIEF THE ABOVE PROJECT IS SATISFACTO
WITH THI: SUBMITTED PERMIT DOC'! NTS, AND I
OCCUPANCY. M JI
to before me
day
No. 236W
OF OUR OBSERVATION
IS IN ACCORDANCE
*INTENDED USE AND
20�
N tary Public Irli R y A. COLLINS
Notary Public
COMMONWEALIM Of MASSACHUSETTS
aty.eowwgpw, 11*101 F*tKv" m 1014
LEVI-?WONG
DESIGN ASSOCIATES INC
Final Affidavit
Architectural
To the North Andover, MA CODE ENFORCEMENT DEPARTMENT, BUILDING DIVISION;
I certify that I, or my authorized representative, have performed periodic inspections on the construction
work associated with the Northeast Health Systems — spectrum Adult Day Center Tenant Fit Up
project, located at 1845 Turnpike street North Andover MA, and to the best of my knowledge,
information and belief, the project was constructed in general conformance with the permit and
architectural plans and specifications approved by the North Andover MA Building Department.
Therefore, the construction is in compliance 780 CMR 7th Edition: The Massachusetts State Building
Code, Section 116.21 (Registered Architectural Services).
The statements contained herein are an expression of the undersigned professional opinion; are made
to the best of the undersigned knowledge, information and belief; are based on the undersigned
performance of service under the scope of work and agreement; and are in accordance with acceptable
standards of professional practice. As such, they constitute neither a guarantee nor warranty,
expressed or implied.
I hereby certify that I am a duly licensed and registered architect in the Commonwealth of
Massachusetts.
kl)
DARcF'�'� N Ee��TF��
No. 20028
TEWKSBURY
oy Plass �Jy
4H OF 0PSyP
(Seal)
(Signed)
Ruth Neeman, AIA
(Architect)
#20028
(MA Registration)
March 16 2011
(Date)
Final Inspection Date: March 16 2011.
Ruth Neeman, AIA has personally appeared before me, a Notary Public, and being
duly sworn, attests to the above statement.
Subscribed and sworn to before me this day of &AR,0)4 2011 .
o EDWIN R WHOXM-ORE
Notary Public
COMMONWEALTH OF MAS&4CjPJ6 $
MY Commission feg
�a Uary 91 2015
(Notary Public)
My Commission Expires Iz-hs--
1/1
45 Walden Street, Concord, MA 017421 tel 978.3711945 fax 978.311.006g
Gerald A. Brown
Inspector of Buildings
TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
400 Osgood Street
North Andover, Massachusetts 01845
Telephone (978) 688-9545
Fax (978)688-9542
AFFIDAVIT FOR FINAL COST OF CONSTRUCTION
in accordance with the provisions o the Massachusetts State Building Code, Article 1, Section 110.4
and 114.2, the total estimated cost of the construction including all related construction costs* of the
building located at 1 S ;9_0 ?-v r n �r 1't e �-�-- rJ n , f l of amounts to
$ 5(9-9, C90
j- o c4 2 (`ate ,being the person referred to as the owner
identified below, do solemnly swear that the statements made herein are strictly true and correct and
made in good faith.
*Related construction costs included all work done with or concurrently with the work contemplated
by the Building Permit including demolition, plumbing, heating, electrical, air conditioning, painting,
carpentry, landscaping, site improvement, etc. Furnishings and portable equipment are not part of the
total construction costs.
Signature of Owner
COMMONWEALTH OF MASSACHUSETTS
M, c u PC � e S.S. [/ � 0 -c -e' 1 / -7 20 / /
Then personally appeared the able named and
Made an oath that the above statement is true.
•
�M.'AspO Before,
w a=
--1oi-ary
OFFICIAL USE:
Final Cost:
Original Estimate cost of general work:
Cost Difference:
Additional Fee Required:
TO AMEND FEE UNDER PERMIT NO.:
Inspectional services Department 2005
I -':'.I inalcostallidav iltiorm
ma
Solo code en%orcemenl makes the lo)cn.eNl�,r
l3e/ore htr.i ing, renting, leusi)V check :'ening
Itrt:\I"I)OI \I'IT. \I'SOY-0541 (' )Nl,I R\, \I'U)N6x5-,)i30 III.\1.111oxx-Q, 10 I1I.,\NNIN(;a:;8.1 -:5
PUBLIC HEALTH DEPARTMENT
Community Development Division
November 24, 2010
Darcey Adams, L.I.C.S.W.
Northeast Senior Health
600 Cummings Center; Suite 2752
Beverly, MA 01915
Re: Spectrum Adult Day Care, 1820 Turnpike St
Dear Ms. Adams,
The Health Department has received the email request from Bud Holden, on behalf of the
application for Spectrum Adult Day Care, requesting to be placed on the December 16, 2010
agenda of the Board of Health meeting. At that meeting, you may present evidence in support of
the variance request regarding the use of a 2 -bay sink as opposed to a 3 -bay sink FC 4-301.12
(D) (1). This meeting will take place at 7:00 PM, in the second floor selectmen's room of the
Town Hall, located at 120 Main Street.
In regards to the other deficiency items noted in the plan review, we will review your
corrections/explanations upon resubmission. It is recommended that all other.items be cleared up
prior to the Board of Health meeting, so that we can be sure that all issues needing to be dealt
with are clear before the Board.
Please also note that it is my understanding that the Community Development Director, Curt
Bellavance, along with the Building Inspector, Brian Leathe, has issued your building
owner/construction contractor a building permit for the site and he is proceeding at his own peril.
The concern for you, as the applicant, is that the Health Department is not aware of what plan
was submitted to the Building Department to gain this permit. It is more than likely a plan that
does not incorporate the changes to the kitchen area that you will be making in the next several
weeks.
You may not be aware that this action may have put your company at increased financial risk.
Though your contractor may begin construction, moving ahead without an approved kitchen plan
Page 1 of 2
North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
Spectrum Day Care Hearing
is ill-advised. The best general practice is to only approve the final version of a plan. In this case
the permit issuance circumvented the standard Community Development "Form U' process,
which Community Development designed to keep applicants safe from unnecessary corrective
costs.
In light of this, it is highly recommended that you consult with your builder to restrict his
construction from the internal area of the kitchen. This matter is extremely important, as this
establishment will not be permitted to operate until it is in full compliance with 105 CMR
590.000, as it is being constructed without the approval of the Board of Health.
Thank you for your cooperation in this important matter of public health. We look forward to
working with you as we continue through the building process and throughout the coming years
as you strive to bring your services to the citizens of North Andover and we strive to ensure the
service of safe food to your clients.
Sincerely,
us Sawyer, H�/RS
-� Public Health Director
Cc: Mark Rees, Town Manager
Curt Bellavance, Community Development Dir.
Gerald Brown, Inspector of Buildings
Board of Health Chairman and Members
Michael J. Moore, R.S., Rapid Response Team Project Coordinator
MDPHBEH Food Protection Program
Page 2 of 2
North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
PRINTED BY: Pamela DelleChiaie -PLEASE LEAVE IN PRINT-OUT TRAY.... THANK YOU
DelleChiaie, Pamela
From: Sawyer, Susan
Sent: Wednesday, November 24, 2010 9:38 AM
To: Grant, Michele; DelleChiaie, Pamela
Subject: FW: Request to appear at Board of Health Meeting
From: Edward Holden fmaiIto: EHOLDENCab nhs-healthlink oral
Sent: Tuesday, November 23, 2010 3:15 PM
To: DelleChiaie, Pamela; Sawyer, Susan
Cc: Ruth Neeman; Darcey Adams; Edward Holden; James Dunne
Subject: Request to appear at Board of Health Meeting
Dear Ms. Sawyer
Referencing your letter dated November 23, 2010, to Darcy Adams in regards to the Spectrum Adult Health Center at
1820 Turnpike St., I would like to request a variance on your note regarding the use of a 2 -bay sink as opposed to a 3 -
bay sink. 4-301.12 (D)(1).
As you are aware, we have provided you with an opinion from our engineer at R.W.Sullivan. That coupled with the need
to create a home -type environment, which is a critical piece of our therapy in the program, is why we feel that a wavier
should be granted. That being said, I would greatly appreciate you allowing us to be placed on the agenda to meet with
your Board of Health on December 16, 2010 to present our request for variance. If this request is granted, I will be
attending with Darcy Adams our Program Director, Ruth Neeman our Architect and a representative from R.W.Sullivan
our Engineer.
If there is any material I can supply ahead of time, please let me know.
Respectfully,
Bud Holden
System Facilities Director for Northeast Health System
This message and its contents are confidential and are intended for the use of the addressee only, and may contain information that is
privileged, confidential and exempt from disclosure under applicable law. If you are not the intended recipient, this serves as notice
that any unauthorized distribution, duplication, printing, or any other use is strictly prohibited. If you feel you have received this
email in error, please delete the message and notify the sender so that we may prevent future occurrences.
Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For
more information please refer to: http://www.sec.state.ma.us/ore/preidx.htm.
Please consider the environment before printing this email.
I OF I
DelleChiaie, Pamela
PUBLIC HEALTH DEPARTMENT
Community Development Division
November 23, 2010
Darcey Adams L.I.C.S.W.
Northeast Senior Health
600 Cummings Ctr.
Suite 2752
Beverly, MA 01915
Re: Plan Review - Spectrum Adult Day Care, 1820 Turnpike St,
Dear Ms. Adams,
The Health Department received your completed application submitted for the new food
establislmient to be known as "Spectrum Adult Day Care" on November 10, 2010. Acting under
the authority of MGL Ch. 111, s. 127A, the office of the Board of Health reviewed these plans to
determine whether or not the proposed remodeling complies with the 1999 FDA Food Code as
revised by Chapter 10 of the State Sanitary Code, 105 CMR 590.000, Mini»ram Sanitation
Standcrrds for Rood E.strrblishments.
This office is unable to grant its approval of these plans because the proposed
construction does not comply with the above cited code. Please refer to the items listed below
for those specific items which are not in compliance. The professional document submitted by
R.W. Sullivan Engineering has been reviewed as well. We concur with the premise that a two -
bay sink is allowed if approved, the need for a grease trap is determined by the Plumbing
Inspector and the slop sink placement in the janitor closet is appropriate.
Please review the items below and revise as needed and resubmit to the Health
Department. Once received, a second review will be conducted and response will be sent to you
in hopes to move forward as soon as possible. If the choice is to request a variance in any
specific item please note that the next regularly scheduled meeting will be held on December 18,
2010. To be on the agenda, a request must be received at the Health Department by December
North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, Page I of 4
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
Spectrum Day Care Plan Review Nov. 23, 2010
Stn The Board of Health will be provided copies of your submission and you may address the
need for the variance.
Please be aware that this until an approval letter is generated in this matter, the building
permit application can not be signed by this office. Also note that once approval is received, the
establishment will not be permitted to operate until it is in full compliance with 105 CMR
590.000. Under section 105 CMR 590.15(B) of the Food Code, you are entitled to a hearing in
this matter. Written request for such a hearing must be received by this office within ten days of
receipt of this letter.
Thank you for your continued cooperation. We look forward to working with you on this
project and in the future.
an Sawye , REHS/Rs//- �
clic Health Director
Cc: Curt Bellavance, Community Dev. Dir.
Gerald Brown, Inspector of Buildings
Dr Thomas Trowbridge, BOH Chairman
Michael J. Moore, R.S., Rapid Response Team Project Coordinator
MDPH/BEH Food Protection Program
305 South St., Jamaica Plain, MA 02130
phone: 617-983-6754 fax: 617-983-6770
Encl. 3- page Sample Finish Schedule- excerpt from FDA plan review guide
Items of Deficieng noted in plan review
Code ref.
Corrective Action
Plan does not address the issue of the fine flowing of
2-103.11(B)
Please address Health
clients into the kitchen area during food service.
concerns regarding the
There is also no description of how the food in the
allowance of
refrigerators and cabinets is protected from
"unnecessary persons" in
unauthorized persons in the "participatory" style
the area during food
kitchen. Code states Persons unnecessary to the food
service. Also, please
preparation, storage or warewashing areas
address the allowance of
establishment operation are not allowed in the food
free access of clients to
areas except for brief tours etc.
all cabinets, utensils,
refrigeration and cooking
equipment etc.
Page 6 #4 description does notfilly follow state food
590.003 (D)
The Highly susceptible
code recommendations "Any staff member showing
(3) (a)
populations require
signs of illness will not be allowed to serve food to
exclusions in certain
program members". Please review policy for sick
cases. Please submit a
Page 2 of 4
North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
Spectrum Da Care Pl R ' N 2
workers.
y an
evrew UV, 3, 20I0
sick policy noting this.
Page 7 #5 a multi surface cleaner cannot be used on food
FC4-501.114
Identify type of sanitizer
contact surfaces. The food code allows for bleach,
and change test strips to
quaternary ammonia or iodine to be used. Also a test kit
"yes"
for the chosen sanitizes must be on site at all times.
Page 7 description of cleaning and sanitizer is incomplete.
"food
Please elaborate on process
-service grade sanitizer" This statement does not
describe a procedure
Page 7 #8 minimizing length of time PHF's are in the
No action needed
danger zone
Answer should describe process ie. that hot foods will
-anive-and-be tested.-I€temp-is-notabove ...140-eitherthe.... ..... ...... ....
.......... .... ..... .............. .......... ..............
_._....... .................. ..... ........ ........................ .................................... ........... .
food will be reheated to 165 degrees or served
inunediately. If cold foods arrive not less than 41 degrees,
they will be served immediately or cooled immediately.
Page 8 #12 measures taken listed do not indicate level of
FC 3-801. 1 F
The Highly susceptible
care for high risk populations. ie. no re -service of
populations require
unopened packages such as butter, ketchup, creamers etc.
compliance with this
section. Please review
and revise answer
Page 10 finish schedule not specific as requested on form.
FC chapter
Please direct questions with
Ie, all splash zones are not washable durable surfaces.
6
Health Dept and revise as
Ceilings over food service areas are not washable tiles.
needed
Coving not stated as curved base, usually vinyl.
Please see attached "finish
The ware washing area is the area around the 3 bay sink. It
schedule" noting
acceptable finishes per
is not N/A
FDA guidelines.
Please revise
Page 13 requests the plumbing boxes be initialed, Often
Please have plumber initial
the plumber can complete this for the applicant if you are
as requested to ensure
not sure. This is a confirmation only,
com liance to code
Page 15 #29 no grease trap. The plumbing code may or
Plumbing
Investigate and confirm that
may not require one with the three -bay sink. Please
code
inspector does not require a
confirm with plumbing inspector
grease trap
MSDS sheets are not submitted with application. If all
Please submit copies for our
chemicals are not chosen to date, please submit when able
files
Pae 18 — NO checked on test strips
FC 4-302.14
Please change to yes
Equipment
No three bay silk. Only 2 -bay shown. We concur with
4-301.12
Please revise as a three -bay
Sullivan Eng. That the MA Code allows for 2 bay if
(D)(1)
or submit a request in
allowed. This allowance can be approved by variance by
writing to address the BOI-I
the Board of Health, if when presented, the Board deems it
at a scheduled mtg.
appropriate for this application.
Dish machinespec sheet says either hot water with booster I
Please specify machine type
North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, Page 3 of 4
North Andover, MA 01845 Phone: 978,688,9540 Fax: 978.688.8476
or chemical.
Location of handsink may not be accessible by all parties
in the kitchen. Possible safety issue. Located very close to
stove.
Microwave installation instructions submitted. No unit
specifications found in packet.
If a vent is provided, no vent information
No specification sheets for sinks.
Care Plan Review Nov. 23, 2010
5 203.11
Please
check with
building
Please
check with
de
Provide safety and
adequate hand wash
facility
Please submit spec sheets
for NSF U1, rated
-equipment
Please inform Health
with details
................................................................................................................ .
NA incl s sinks in the
category of equipment
Please submit specification
sheets
North Andover Health Department, 1600 Osgood Street, Building 20, Smite 2-36, Page 4 of 4
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
Uompliance & t1itorcement > rood Establislinient Plan Review Ouide - Section III, Part 10 Page 1 of 3
M U.S. Food and Drug Administration
Home> Food> Food Safety> Retail Food Protection
Food
Food Establishment Plan Review Guide - Section III, Part 10
Food and Drug Administration and Conference for Food Protection
SECTION III
FOOD ESTABLISHMENT GUIDE FOR DESIGN, INSTALLATION, AND CONSTRUCTION
RECOMMENDATIONS
PART io - FINISH SCHEDULE
The following chart and footnotes provide acceptable finishes for floors, walls and ceilings, by area:
KITCHEN
COOKING
FOOD PREP
BAR
FOOD STORAGE
OTHER STORAGE
TOILET ROOM
DRESSING DOOMS
FLOOR WALL
Quarry tile, poured Stainless steel; aluminum; Ceramic
seamless, sealed concrete tile
Same as above plus
Same as above plus approved wall
commercial grade vinyl
panels (FRP) Fiberglass Reinforced
composition tile.
Polyester Panel; epoxy painted
composition tile or sheets block with epoxy paint or glazed
drywall; filled block with epoxy paint
surface
or glazed surface
Same as above
Same as above for areas behind
concrete; commercial
sinks
Same as above plus
Approved wall panels (FRP)
sealed concrete,
Fiberglass Reinforced Polyester
commercial grade vinyl
Panel; epoxy painted drywall; filled
composition tile or sheets block with epoxy paint or glazed
surface
Same as above
Painted sheetrock
Quarry tile; poured sealed Approved wall panels (FRP)
concrete; commercial
Fiberglass Reinforced Polyester
grade vinyl composition
Panel; epoxy painted drywall; filled
file or sheets
block with epoxy paint or glazed
surface
Same as above
Painted sheetrock
GARBAGE & El3 FUSE Quarry tile; poured
AREAS (Interior) seamless, sealed
concrete; commercial
grade vinyl composition
tile or sheets
MOP SERVICE AREA Quarry tile; poured
seamless sealed concrete
Approved wall panels (FRP)
Fiberglass Reinforced Polyester
Panel; epoxy painted drywall; filled
block with epoxy paint or glazed
surface
Same as above
CEILING
Plastic coated or metal
clad fiberboard; Dry-wa
epoxy, Glazed surface;
Plastic laminate
Same as above
Meets building codes
Acoustic tile; painted
sheetrock
Same as above
Plastic coated or metal
clad fiberboard; drywall
with epoxy; glazed
surface; plastic laminate
Same as above plus
Painted sheetrock
Plastic coated or metal
clad fiberboard; drywall
with epoxy; glazed
surface; plastic laminate
Same as above
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.-viilpiituice a rinorcenient,- rooa Lstaonsnment clan Keview (juicie -section in, Part 10 Page 2 of 3
WAREWASHING Same as above plus Stainless steel; aluminum; approved Same as above
AREA commercial grade vinyl wall panels (FRP) Fiberglass
composition tile Reinforced Polyester Panel; epoxy
painted drywall; filled block with
epoxy paint or glazed surface
WA�.LI<-IN Quarry tile; stainless Aluminum; stainless steel; enamel Aluminum; stainless
REFRIGERATORS & steel; poured sealed coated steel (or other corrosion steel; enamel coated
FREEZERS concrete; poured resistant material) steel (or other corrosion
synthetic resistant material)
Notes:
LOORS
.......................... ..
i, All floor coverirt.gsin._food..prepara9r�,._frage,....u.tens.i.l-washing...ar..eas,...walk-.in...refrtgeratlon..units, ...............................
dressing rooms, locker rooms, toilet rooms and vestibules must be smooth, non-absorbent, easily
cleanable and durable. Anti -slip floor covering may be used in high traffic areas only.
2. Any alternate materials not listed in the above chart must be submitted for evaluation.
3. There must be coving at base junctures that is compatible to both wall and floor coverings;
recommended to provide at least 1/4 inch radius and 4" in height. See figure 410-1.
4. Properly installed, trapped floor drains shall be provided In floors that are waterflushed for cleaning or
that receive discharges of water or other fluid waste from equipment or in areas where pressure spray
methods for cleaning equipment are used. Floors should be sloped to the drain at least 1/8" per foot.
5. Grouting should be non-absorbent and Impregnated with epoxy, silicone or polyurethane.
6. All walk-in refrigeration units both with prefabricated floors and without, should be Installed in
accordance with the manufacturer's Installation requirements.
WALLS
1. The walls, including non -supporting partitions, wall coverings and ceilings of walk-in refrigerating units,
food preparation areas, equipment washing and utensil washing areas, toilet rooms and vestibules shall
be smooth, non-absorbent, and capable of withstanding repeated washing. Light colors are
recommended for walls and ceilings. Studs, joists and rafters shall not be exposed In walk -€n
refrigeration units, food preparation areas, equipment washing and utensil washing areas, toilet rooms
and vestibules. Where permitted to be exposed, studs, joists and rafters must be finished -to provide an
easily cleanable surface.
2. All alternate materials not listed In the above chart must be submitted for evaluation.
3. Glazed surfaces should be glazed block, or brick or ceramic tile. Grouting must be non-absorbent and
Impregnated with epoxy, silicone, polyurethane or an equivalent compound. Concrete block, if used,
must be rendered non -porous and smooth by the application of an approved block filler followed by the
application of an epoxy -type covering or equivalent. All mortar joints shall be only slightly tooled and
suitably finished to render them easily cleanable.
4. Plastic laminated panels may find applications but are not recommended. Joint finishes should be
compatible with the wall structure. Voids should be eliminated at joints.
CEILINGS
Finishes shall be light-colored, smooth, non-absorbent and easily cleanable. Acoustical material free of
porous cloth or sponge may be used, provided ventilation is adequate to minimize soiling.
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