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Miscellaneous - 1820 TURNPIKE STREET 4/30/2018 (3)
Q INIMLAMMA aQ, Suite 2-36 Fax 978-688-9542 North Andover, MA. 018415 . Street: 1820-1830 Turnpike St Map/Lot:. 106D/ 46 and 47 Applicant: Stonewall Plaza,LLC Request: Ground Sign Date: September 11, 2008 Please be advised that after review of your Application and Plans that your Application is DENIED for the following Zoning Bylaw reasons: Zoning District: GB Remedyfor the above is checked below. Item # Special Permits Planning Board Item # Item Notes Setback Variance Item Notes A Lot Area Common Driveway Special Permit F Frontage Variance for Sign 1 Lot area Insufficient Independent Elderly Housing Special Permit 1 Frontage Insufficient Earth Removal Special Permit ZBA 2 Lot Area Preexisting x 2 Frontage Complies x 3 1 Lot Area Complies 3 Preexisting frontage 4 Insufficient Information 4 Insufficient Information B Use 5 No access over Frontage 1 Allowed G Contiguous Building Area 2 Not Allowed 11 Insufficient Area 3 1 Use Preexisting 2 Complies x 4 Special Permit Required x 3 Preexisting CBA 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply x 1 Height Exceeds Maximum 2 Front Insufficient 2 Complies x 3 1 Left Side Insufficient 3 Preexisting Height 4 Right Side Insufficient 4 Insufficient Information 5 Rear Insufficient i Building Coverage 6 Preexisting setbacks 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies x D Watershed 3 Coverage Preexisting 1 Not in Watershed x 4 Insufficient Information 2 In Watershed j Sign 3 Lot prior to 10/24/94 1 Sign not allowed x 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking 1 In District review required 1 1 More Parking Required 2 Not in district x 2 P rking Complies x 3 Insufficient Information Remedyfor the above is checked below. Item # Special Permits Planning Board Item # Variance Site Plan Review Special Permit Setback Variance Access other than Frontage Special Permit Parking Variance Frontage Exception. Lot Special Permit Lot Area Variance Common Driveway Special Permit Height Variance Congregate Housing Special Permit Variance for Sign Continuing Care Retirement Special Permit Special Permits Zoning Board Independent Elderly Housing Special Permit Special Permit Non -Conforming Use ZBA Large Estate Condo Special Permit Earth Removal Special Permit ZBA Planned Development District Special Permit Special Permit Use not Listed but Similar Planned Residential Special Permit Special Permit fortNU Unit R-6 Density Special Permit Special Permit Pre-existing, Non - Conforming Watershed Special Permit x Special Permit Sign The above review and attached explanation of such is based on the plans and information submitted. No definitive review and'or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for DENIAL. Any inaccuracies, misleading information, or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department. The attached document titled "Plan Review Narrative" shall be attached hereto and incorporated herein by reference. The building department will retain all plans and documentation for the above file. You must file ew building permit application form and begin the permitting process. Buildi g Department Official Signature Application Received A'ppflca-tio6 Denied Denial Sent: If Faxed Phone Number/Date: Plan Review Narrative The following narrative is provided to further explain the reasons for denial for the building permit for the property indicated on the reverse side: TENANT SOON 8' -4 - TENANT SDON � 0 TENAN IT SM TENANT SOON `v Go TENAN�S N TENANT SOON 0 TENANT SOON PV 1-8'= TENANTENANTMGN TENANT SDON TENANT SOON \ 1 M 2'- 0" 178 5j Ft 2'-0" Owner: Project: Contractor. SIGN ELEVATION STONEWALL PLAZA, LLC. STONEWALL PLAZA G.F.M. 325 NORTH MAIN STREET GENERAL CONTRACTING Project number Project Number UNIT 15 B MIDDLETON, MA 01949 1820 -1830 TURNPIKE ST. NORTH ANDOVER, MA 325 NORTH MAIN STREET Date Issue Date A7 9 UNIT 15 B Drawn by Author MIDDLETON, MA 01949 Checked by Checker Scale 3/8" = 1'-0" 9/8/2009 7:40:40 AM 7708 Date ..!'.`.: TOWN OF NORTH ANDOVER F��4 PERMIT FOR GAS INSTALLATION This certifies that .. ! `6sY.��=r�.. . !r........... . t� has permission for gas installation in the buildings of .... 4�-Fj.. . at .. / d ...f!2�"�'C'' �a'� orth dovM. S. Fee./f. a. . Lic. No... GAINS ECTOR Check #/ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING Mass. Date . L a ' Location � x 7�i /���e,� _/ P4rm1t Location cL� � Owner's , CSW �'t1/J*4axg` Name f G New Renovation ❑ Replacement ❑ Plans Submitted: Yes& No ❑ Check one: Certificate Installing Company .Name Address #SAy)C-- ❑ Partnership (� • ❑ Firm/Co.. Business Telephone Name d licensed Plumber or Gas FMer INSURANCE COVERAGE: Check one 1 have a cement liability Insurance policy or its substantial equivalent. Yes ❑ No ❑ K you have checked Yes,, please Indicate the type coverage by checking the appropriate box A Ihbilty Insurance policy Other type d Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance. coverage required by Chapter 142 of the Mass. General Laws. and that my sigmtUre en this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signatin of Owner of Owner s ftent 1 hereby certify that all of the detalls and Information 1 have submitted (of entered) In above applkation are true and sowrats to the oeu vi my knoMedpe and that all pphimbing work and Installations performed under the permit 1 for this tion be In am., lance with aft an pertlnant povtsions of tM Massachusetts State Gas Code d Chapter 112 oI tlw gy Two of Llcenso: mbar PNumbeer- ee um w or s rater Tette Gasfflter / aster L �2 CftyfTawn Journeyman .nrrrwjCn rncrire r iec nM 1n , MENEM �����������������������■1111■ ■1111■���������������������� G�T�������■1111111111■���������� Check one: Certificate Installing Company .Name Address #SAy)C-- ❑ Partnership (� • ❑ Firm/Co.. Business Telephone Name d licensed Plumber or Gas FMer INSURANCE COVERAGE: Check one 1 have a cement liability Insurance policy or its substantial equivalent. Yes ❑ No ❑ K you have checked Yes,, please Indicate the type coverage by checking the appropriate box A Ihbilty Insurance policy Other type d Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance. coverage required by Chapter 142 of the Mass. General Laws. and that my sigmtUre en this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signatin of Owner of Owner s ftent 1 hereby certify that all of the detalls and Information 1 have submitted (of entered) In above applkation are true and sowrats to the oeu vi my knoMedpe and that all pphimbing work and Installations performed under the permit 1 for this tion be In am., lance with aft an pertlnant povtsions of tM Massachusetts State Gas Code d Chapter 112 oI tlw gy Two of Llcenso: mbar PNumbeer- ee um w or s rater Tette Gasfflter / aster L �2 CftyfTawn Journeyman .nrrrwjCn rncrire r iec nM 1n , riot 4W triri f 11'. 04 y 18bb89641 TOWN '37OF HUDSON PAGE 81 The Commonwealth of Massachusetts -Department ofIndustrial Accidents 091ce ofInYtstdgatwns 600 Washington Street Bost a6 MA 022 www.massgov/d'ia ` Worken' C4mpeiasation Insurance Affidavit: Buldelrs/Contractors/Electridans/Plumbers A�litcant omlination please PtintEeAly Nance City/Statemp:_ �• - ,1��}' db�one Type of project (required): . 6. ❑ New constauction 7. Remodeling 9. ❑ Building tion • , 10.❑ Electrical repgiis or additions Plumbing r+epaus cr additions ME] Roof repairs 13.❑ Ocher ' Aay applicant that cbeela box #1 rAase aIN fill out the section baibw tGrowiog tfteir workers' omnpemetioai policy iafoemadon. t Haoseow as wlm subs k ibis affidavit fad eff ft shay sae doing all wank od dmn biro to uide coalraators mustaddia submit a new ffidavit indicsiinsuch. g ane<acters that"Mi this box nun attad►ed an tioaai sheat skioarigg tin amne of'tEto sora and •theirwoiiaers tC'• policy irdormatioa ,i On av atrplvyer that is providing workers' compensation insumcefor my employeet Below is thepobtey and job site ;:sforn�dan. . insurance Compal+ Name...,_ Policy # or Self -ins. Lie. #: �' ti Expuatiott Rate: Job Site Address•_i�L� �i /�Q� City/state/Zip:AD'/7xeS Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required wader Section 25A of MGI, e.152 can lead to the imposition of criminal penalties of a fine up td 51,500.00 audlor one-year imprisonment as well as ci o penalties in the form of a STOP WORK ORDER amd'a fine of up to 5250.00 a day -against the,violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations Otte DIA frit .coye1W vip fica on. Ida hereby c d the paitrs mid pen ojperj fleet the Fnforatatdon provided above ft true and correct S. e Date• Phone• f .. _3 - 7� oit'd use orgy. Do not write hi this ana, to be completed by cI& or town ojj`rclaL City or Town: Permit/t itense # Issuing Authority (circle one): 1. Board ofIlealth 2. Building Department 3. Clty/Towu Clerk. 4. Electrical Inspector S. Plumbing Inspector 6. Other Contact person: Phone Are you an employer? Check the appropriate box: . 1. ❑ I am a employer with �r 4. ❑ I am a geawal.coutractor and I ' employees (frill and/or 06-Itime) * have hired the sub -cont mctors 2. (] I am a sole proprietor or partner listed on the attached sheet # , soap and have no employees :These subcontractors pave worlds$ for mein any capacity.workers' [No workers' comp. imm'Once. ' 5. [] cgmp..insuramee Rhe are a corporstion,,and its requiredj' 3. ❑ I am a homeowner• doing all work officers have exercised their : rlght of exemption per MGL •, . mySel>W No Mlo kers' comp, c.152, §1(4), and we brave sty insurance roqui-ed.) t employees. (No workers' comb- insurance reouired.l Type of project (required): . 6. ❑ New constauction 7. Remodeling 9. ❑ Building tion • , 10.❑ Electrical repgiis or additions Plumbing r+epaus cr additions ME] Roof repairs 13.❑ Ocher ' Aay applicant that cbeela box #1 rAase aIN fill out the section baibw tGrowiog tfteir workers' omnpemetioai policy iafoemadon. t Haoseow as wlm subs k ibis affidavit fad eff ft shay sae doing all wank od dmn biro to uide coalraators mustaddia submit a new ffidavit indicsiinsuch. g ane<acters that"Mi this box nun attad►ed an tioaai sheat skioarigg tin amne of'tEto sora and •theirwoiiaers tC'• policy irdormatioa ,i On av atrplvyer that is providing workers' compensation insumcefor my employeet Below is thepobtey and job site ;:sforn�dan. . insurance Compal+ Name...,_ Policy # or Self -ins. Lie. #: �' ti Expuatiott Rate: Job Site Address•_i�L� �i /�Q� City/state/Zip:AD'/7xeS Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required wader Section 25A of MGI, e.152 can lead to the imposition of criminal penalties of a fine up td 51,500.00 audlor one-year imprisonment as well as ci o penalties in the form of a STOP WORK ORDER amd'a fine of up to 5250.00 a day -against the,violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations Otte DIA frit .coye1W vip fica on. Ida hereby c d the paitrs mid pen ojperj fleet the Fnforatatdon provided above ft true and correct S. e Date• Phone• f .. _3 - 7� oit'd use orgy. Do not write hi this ana, to be completed by cI& or town ojj`rclaL City or Town: Permit/t itense # Issuing Authority (circle one): 1. Board ofIlealth 2. Building Department 3. Clty/Towu Clerk. 4. Electrical Inspector S. Plumbing Inspector 6. Other Contact person: Phone �..,1"�.1„..'�'�1�.n�'fr•�M'�.«3�p7h�V«,.•�;.•,•'c�{tIN^2�� ---------------- �rw.roa3:f�bL[Y.:Ji�l,^�e:�.,V•: `�':.1^1:�lShkiWcCC.» IN PLUMBIRS AND GASFITTERS LlCSNSED. AS A MWAR• PLUMBER JOSEPH P MCNAMEE 23 BAYSWATER STREET EAST BOSTON MA 02128-12I6 €` mm ;��7 kwda..=;t"):.s�c?iricYri�ti4h:•:iiii-;N.. ti. ' r CbMMONWEALTH OF MASSACHUSETTS LICENSED AS A JOURNEYMAN:PLU' ISSUES THIS LICENSE TO t - EDWARD J MAZERSKI JR .39..CONWELL AVENUE - L`L. S0MERV:IE MA 021'4471201 24088 05/01/12 76066 f` Fold, Then Deikfi Along All P&f6iFtlons F866462 If this ns t Oq ! Division of a is lost or destroy, s , 5th Floor, Qosto f essional yens notify sour f If your n, Mq 02114.ure, 23 C Board at the: Of Corr ca na or address sho ause Way St., Renewal me or addr wn is changed1 s tic Applicatio ess to ins , notify as amended. �t subls aect tol tbo he refer to Yo per mallinguo nenseLard Personl or ed to any Other Personal pn- iOvIsl ns of the cGand Mustener number. t 1 I posted as l Laws reqied by tawKeep th s license not o goy ed _,.. Fold, 7:h-e— n Oetyoh Along - All Perorations C COMMONWEALTH OF MASSACHUSETTS AFFIDAVIT OF PETER MURPHY RE: Division of Professional Licensure ("DPL") Docket Number: EL -11-075 I, Peter Murphy, hereby depose and say upon personal knowledge as follows: 1. I am the Inspector of Wires for the Town of North Andover, Massachusetts. 2. On December 3, 2010, in my capacity as the Inspector of Wires for the Town of North Andover, Massachusetts, while performing an electrical inspection at the request of Stephan Decker (Massachusetts Electrical License Number License E 19737) at Stonewall Place located at 1820 Turnpike Street/Route 114 in North Andover, Massachusetts, I witnessed Stephan Decker performing electrical work without the supervision of a Licensed Electrician in the Commonwealth of Massachusetts. 3. At that time (December 3, 2010) Mr. Decker stated that his boss/employer, Licensee Hart is aware of the fact that he does not have an electrician's license. SIGNED UNDER THE PAINS AND PENALTIES OF PERJURY THIS 7 DAY OF December 2010. Peter Murphy Inspector of Wires, Town of Nort dover f.• Peter 0Frorn: Paris, Richard G (DPL) [Richard. G. Paris@state. ma. us] Sent: Friday, December 17, 2010 9:24 AM To: Murphy, Peter Subject: Decker Good Morning, Could you please mail a copy of the Affidavit that you signed. Division of Professional Licensure Office of investigations 1000 Washington Street Suite 710 Boston, MA 02118 — 6100 Attn: Richard Paris 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/pre/preidx.htm. Please consider the environment before printing this email. 101 Date.. . 89�G j 3 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... u,(u-). ..... . .................... has permission to perform .....��.4 plumbing in the buildings of ... Od at. &,40- ..f .L10\ P �. ?.. 0 .. Uf" i . iU;}lVorch Ando, Mass. Fee .91 .... Lic. No..(�-(O.�. ..... � _ PLUMBING INSPEC OR Check y MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town: 116 d7fV C/O'v R SMA. Date: �-1 — G! Permit# UV-(T� oa Building Location: J a.© r„_p,/; r -)Owners Name: T®•a-e �&/ sG/ [,� Type of Occupancy: Commercial ['�]r Educational ❑ Industrial Institutional ❑ ❑ Residential ❑ New: U Alteration: ❑ Renovation• ❑ Replacement: ❑ Plans Submitted Yes ❑ No ❑ FIXTURES DEDICATED r w F_ Z z SYSTEMS N Y Z of U D O 0 Z n h W v)Q Z w Ln h Z H a 2 Ln Z Q�Q N vZai W w 0 O Q C a Z D: Y = 3 O C ?�. _ F- W Z LL N W -� a Z U a LL = = = W- 2 OZS -� Q 3 O W 3 LU Q Q~ H H OLn > > a m m D L6 S Y g g O O Oa oOc y� Z Z H 3 F- FLU S 3 3 0 O r a �' G V1 W 1a- a 3 SUB BSMT. BASEMENT 1ST FLOOR a- ND R 2FLOO 3RD FLOOR 4T" FLOOR 5T" FLOOR 6T" FLOOR 7T" FLOOR 8T" FLOOR Installing CompaName: � (/ f L_ -f>� `'1 � �✓' �- Check One Only Certificate # Address: 4- .I Y�/n►,,y 'llgo\'•4, ' s5 / I City/Town: !^.O w C � 1 State: ► 'I El Corporation _ El Partnership Business Tel: q77- 4Q 15 5 C) Fax: ❑ Firm/Company Name of Licensed Plumber: �J 0 INSURANCE COVERAGE: I have a current liabilitv insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes [t -No ❑ If you have checked Yes, please indicate the .type of coverage by checking the appropriate box below. A liability insurance policy 2-1�' 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Agent Owner El Agent ElSignature of Owner or Owner's I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Type of License: Title City/Town. APPROVE ❑ Plumber RI("llaster ❑Journeyman Signat/e of Licensed Plumber Licensee Number: � -7 Date VIA2 # . . S9719 9 This certifies that ..... ur-00 .... f' ... ,i}.. ......... 1 }�+.L. has permission to perform /k,iL1. ; �(�� ,,e. jYY .............. plumbing in the buildings of Norah Andover, Mass. at ..... Fee�.t'j,�y� . Lic. No..�5 {d . ......... 1C,4�.C.�. . P UMBING INSPECTOR Check TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING �SSACMUS� F This certifies that ..... ur-00 .... f' ... ,i}.. ......... 1 }�+.L. has permission to perform /k,iL1. ; �(�� ,,e. jYY .............. plumbing in the buildings of Norah Andover, Mass. at ..... Fee�.t'j,�y� . Lic. No..�5 {d . ......... 1C,4�.C.�. . P UMBING INSPECTOR Check MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town:Alor-f"y A, JA, e iMA. Date:_ Permit# Building Location:_ / a jy T �! `e Uf-d l © 3 Owners Name: S/p t Iles L(- Typeof Occupancy: Commercial Educational ❑ Industrial ❑ Institutional ❑ Residential ❑ New: ❑ Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ❑ FIXTURES DEDICATED H z SYSTEMS Z z > Y O Z V) 'n O Z a it z Y Q u F w o O a W W z rn W z (n z a o LL aa z s z Ln LU z Ln u a W a U. _ W u F S C. O U z Q LL a Y a Z W W K W m m o omoawcw a s V1 to -1 Y O X f> > 0 = Q a LL s 3 g 3 3 3 o Q F- -SU.BSMT. Q 3 BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4T" FLOOR 5T" FLOOR 6T" FLOOR 7T" FLOOR 13TH FLOOR Installing Company Name: V E C C) 7 C A �y'^ ACA / Check One Only Certificate # Q(,�a �� ®-eSrporation Address: —L�1c M� City/Town: c� c State: El Partnership Business Tel:- I J� y CO S-6gy Fax: ❑Firm/Company _ Name of Licensed Plumber: �,i w of C_ INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes Er—No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy 0'' 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Si nature of Owner or Owner's A ent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application Pertinent provision of the Massachusetts will be in compliance with all State Plumbing Code and Chapter 142 of the General Laws. 7 6 6 4, Date ... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ....T.U. r"Cfj ..... /i i has permission for gas installation ..� r/?�fi' ..5.. W.6,4-+. AtA in the buildings of ..,54-d Y\g.1, ct......�.�.(.i .-- ............ at ...�. �%... ! l h.P.�. .. �" North Andover. Mass. Fee../. .... Lic. No. �a.�:% ,�� ! 1. A . GASINSPECTOR Check # rwrl 1000 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING CityITown:NOrlk ,�old�,PrMA. Date: �I—/(—�� Permit# • &C�. c� %,1`r�-(r(V Building Location: /Yd� ti CUcti -e �o� Owners Name: Type of Occupancy: Commercial 921" Educational ❑ Industrial ❑ Institutional ❑ Residential ❑ New: ❑ Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ❑ rwrl 1000 INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes P- No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy Z2--- 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner El Agent E] By checking this box❑ I1 hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and - - --- - -•�Qy� a••a a.a. all N— IM111y worn dnu mstanauons perrormea under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Type of License: ❑ Plumber Title ❑ Gas Fitter [a'Ifllaster Signa of License Plumber/Gas Fitter City/Town ❑Journeyman License Number: �Cg APPROVED OFFICE USE ONLY El LP Installer N Uj •` ~ Z Q N N W Q = C6 m = 0 LU W L) y H 0 = ix W Z H Z � W W j W IX O� M v0—i w > W to v W w U) m C7 0 a WZ a O Q D Lu W w X _ > W W z C7 J LJ F- H O z T J to U' LL F = W H W W z 0 o = o LL 0 Q i= Q m W O O Z 0 W F- ~>>> > z 1-- _ O a0 ac SUB BSMT. BASEMENT 1 FLOOR ! / 2 FLOOR 3 KU FLOOR 4 FLOOR 5 FLOOR 6 TH FLOOR 7 FLOOR -i 'FLOOR Installing Company Name: -C 0 P/ f `,f Check One Only Certificate # Address: 01-� 104"— (-L(// �City/Town: 6 State: El Corporation El Partnership Business Tel: 44Sa .SU s v Fax: ❑ Firm/Company Name of Licensed Plumber/Gas Fitter: i L D INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes P- No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy Z2--- 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner El Agent E] By checking this box❑ I1 hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and - - --- - -•�Qy� a••a a.a. all N— IM111y worn dnu mstanauons perrormea under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Type of License: ❑ Plumber Title ❑ Gas Fitter [a'Ifllaster Signa of License Plumber/Gas Fitter City/Town ❑Journeyman License Number: �Cg APPROVED OFFICE USE ONLY El LP Installer .;LL1 � rJ Date.. /�.... . 6y ATOWN OF NORTH ANDOVER 9 �-� � ; PERMIT FOR GAS INSTALLATION This certifies that ... l.L.,(.-<,o .... AW has permission for gas installation�%�ft?,� in the;, buildings of .. 5Ty,.A,0..Lk (t ....0 ................ r z at.1.?h: b,�North Andover,, Fee. �? ... Lic. No.. ��. ..7. .....,�` !�' .Ikf .... t GASINSPECTOR Check # asp CIVY OCO Cn W W MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING Cit /Town r A-1 o� (( Permit# Y % O — O rMA. Date r I V �v C.Jw� 1 � i3 3 Building Location: f�J'n.�. �'Q Owners Name: (7-4,-, /U- C ^ Type of Occupancy: Commercial [ Educational ❑ Industrial ❑ Institutional ❑ Residential ❑ New: ❑ Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ❑ CIVY OCO Cn W W Y rn aH 0 = m= O J V W U) ~ 0 w� 0 z 9 V5 W M W z 9 O m 0 L W M o 0 o r H W N U W W Z Q = N a. O W 0 u� X = Li W W Z Cn J l— l— 0 Z J 0 u_ F = W F W W D o o LL 0 z z g 0 a of >>> o SUB BSMT. BASEMENT -i 'FLOOR 2 FLOOR 3 RuFLOOR 4 1 HFLOOR rTHFLOOR 6 FLOOR 7 THFOOK= -i'FLOOR � Installing Company Name: ' LI -c d u P /i �v� -- Check One Only Certificate # Corporation Address: Aq 11 a rs w ( City/Town: 0 c— �� State: ❑ Partnership Business Tel: 1' 2 hfs'd - 50 'Yb Fax: ❑ Firm/Company Name of Licensed Plumber/Gas Fitter: INSURANCE COVERAGE: I have a current liabifily insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes [-'No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy Me� 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner El Agent El By checking this box ❑; I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and.., accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this applicatiowill berin compliance with all Pertinent provision of the Massachusetts State Plumhina cnrla and f[hnnfnr Id9 -f fhe r_ .. I ...— Type of License: By ❑ Plumber Title ❑ Gas Fitter SignatureA Licensed Plumber/Gas Fitter EN -aster Cityrrown ❑Journeyman License Number: - 7 APPROVED OFFICE USE ONLY ❑ LP Installer 8716 Date../ TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... has permission to perform .. ��. �'` "` .. ' ..`�.:.f . 2-9. plumbing in the buildings of ... :f ............ at ...,/,?1. .0. . f. x.h. - ... ':�........ North Andover, Mass. Fee .3 �'.Q Q. - . Lic. No. .... . PIM- BING INSPECTOR Check # —G'X04Y� t) -a-- % CO I /'I Ko (- I n I 1 `) 1 1 tay i lore r -- - J : \ v 02 1 —.— l L- l MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING 4City/Town: , MA. Date•A,14 Permit# BuildingLocation: % yZ 6 Fel �um�� � Owners Name: Type of Occupancy: Commercial YpEducational ❑ Industrial ❑ Institutional ❑ Residential ❑ New:0--Mteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ❑ tay i lore INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes ❑ No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner E] Agent E] I hereby certify that all of the details and information 1 have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the nermit issuPd fnr this nnnii—C— ,.1111 tie a.. , ...:: ...:— _:: reranent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Title City/Town APPROVED (OFFICE USE ONLYI Type of License: ❑ Plumber ❑ Master ourneyman Signature of Licensed Plumber License Number: 2 0 6 � 6 DEDICATED Z SYSTEMS W � Z H Z Y LULU Z a' Z Y (A Q VI LA Q W C7 0 C C In Z C d Z W Q 3 m LA it oac Z L f W y R Z Q&n H Y 2 0 0 N of Z a x Q Q Ln W F- W Q 0 O i- Q Ln C Q W O W Z W J Z C OC LL _ O W LU U ~Q d O > > Ln Z Z x W LU V! C Q 4A O a m m o o x H x g g° N O y Q 3 Q 3 Q 3 o a VI Q 3 SUB BSMT. BASEMENT 1sT FLOOR 7%D FLOOR Ll6. 3RD FLOOR 4T" FLOOR 5T" FLOOR 6T" FLOOR 7T" FLOOR 8T" FLOOR /} : Check One Only Certificate # Installing Company Name: t2Lt!AA/1 N O- (Itj\UCQ81-�t,�, nn Qo Address: g D lt-r'& C -I `{/City/Town: ' � C State: El Corporation ❑ Partnership Business Tel: 0 "j� 7 I -3 6 7 Fax: 2-Flrm/Company Name of Licensed Plumber: aar d INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes ❑ No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner E] Agent E] I hereby certify that all of the details and information 1 have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the nermit issuPd fnr this nnnii—C— ,.1111 tie a.. , ...:: ...:— _:: reranent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Title City/Town APPROVED (OFFICE USE ONLYI Type of License: ❑ Plumber ❑ Master ourneyman Signature of Licensed Plumber License Number: 2 0 6 � 6 m e�lmm dWV1S 3SN30I1 $ o Q N o �• W+ m m �i C� min"• 3 ` 0 a U d a aD n 3=°� M Z r m C4 m ) O t E� N ` E C x IEIaeO aeon eyOaelANfV e06a60ue1 u8Re0 mlle?II a/0',e1PPlV a — C: co t" t0 u2a�LL �� r SNI 531V1�0551f N71530 0 �� i u a a z= y wU)8 mzo DN0AA+IAI Q° U) m E m 4 o U r m T co a c m E m 4 o g + � a LL m K w , LO Q f7 N OA 6d O p O � C c o y v ti 1 Q Q m do u Q ci 0 )PON lawalul cm E �c E v •i v c .UL OL -199 c n c s ' „b/£ 6-34 .o-,zL ZO .b/£ 9-,£ A .9-,6 m LM ao LM l y—+ "OLI lM o v � S F- X 61 � 0 O N X m X U d o m 0� 4 3 x v a d IA I 0 I V `� i O rC9 c i .9 .b/LBd O mN m m dl0a cum\i •� i M mem t 10 r L 3 u in i C, 0 Owner: Project: 3D VIEW OF SIGN STONEWALL PLAZA, LLC. STONEWALL PLAZA 325 NORTH MAIN STREET 1820 - 1830 TURNPIKE ST. Project number SW G. SIGN UNIT 15 B MIDDLETON, MA 01949 NORTH ANDOVER, MA Date 9/15/2009 A732 Drawn by MR Drawn by Scale 9/15/2009 9:28:57 PM th , J r Owner: Project: 3D VIEW OF SIGN STONEWALL PLAZA, LLC. STONEWALL PLAZA 325 NORTH MAIN STREET 1820 - 1830 TURNPIKE ST. Project number SW G. SIGN UNIT 15 B MIDDLETON, MA 01949 NORTH ANDOVER, MA Date 9/15/2009 A732 Drawn by MR Drawn by Scale 9/15/2009 9:28:57 PM Apr 27 11 03:39p Austin Spinella 9784992187 p.l CHESTNUT REALTY DEVELOPMENT, LLC 231 SUTTON STREET, SUITE 1B NORTH ANDOVER, MA 01845 978-687-6200 phone 978-687-3212 fax April 27, 2011 John Simons, Chairperson North Andover Planning Board 1600 Osgood Street North Andover, MA 01845 Attn: Judith Tymon, Town Planner Dear Mr. Simons: Please consider this letter as a request to the North Andover Planning Board to release a site opening bond for the Autumn Chase subdivision located at Molly Town Road and Summer Street. This bond was posted in accordance with the Planning Board decision. believe that the bond requirements have been fulfilled and respectfully request its release. Please contact me if you have any questions about this matter. Thank you. Sincerely, Chestnut Realty Develo ent, LLC 19 Louis P. Minicucci, Jr.� Manager LPM/kp C;\Minco Fifes\lpmfiles\Chestnut Realty Dev\bond release Itr.doc 7 4 t Date. ........ TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION .4 This certifies that ... %..................... has permission for gas installation r. ....... in the buildings of t, at —/-t— e,,. ............... North Andover, Mass. Fee. d Lic. No.. /k --� ...... G; INSPECTOR Check # 19 '7 7 6 .1 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING. (Print or Tvue► _ Mass. Date /l _23--20 Permit # Building Location lf,0Z joi&e-t,_0d Owners Name g���,�!/ I ' Type of Occupanry, New Renovation ❑ Replacement ❑ Plans Submitted: Ye$ No ❑ Installing Company iL;f/IAf� Business T Name of Ucensed Plumber or. Gas Fitter ti Check one: Corporation ❑.. Partnership ❑ Firm/Co. Certificate INSURANCE COVERAGE: I have acu entyability. Insurance ce policy.or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes If you have checkedrtes, please. -Indicate the type Coverage by checking the appropriate box. A liability insurance policy 0 Other type of indemnity DBond ❑ OWNER'S INSURANCE WAIVER: I am aware thafthe, licensee does not havethe Insurance coverage required by Chapter 142 of the Mass. General Laws. and that my signature on this permit application waives this requirement. Check one: Owner❑ Agent ❑ Signature of Owner or Owner's Agent 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 the permit' d for this application VA. in compliance with all pertinent provisions of the Massachusetts State Gas Code and -Chapter 142 of the Ge Laws, Nu ,C�. BY T license: Plumber Sign re o tensed lumber or atter rhe fitter Mer se- Rumber _ (] fylrown - R5',eyman APPROrVED ( i NL Cz Installing Company iL;f/IAf� Business T Name of Ucensed Plumber or. Gas Fitter ti Check one: Corporation ❑.. Partnership ❑ Firm/Co. Certificate INSURANCE COVERAGE: I have acu entyability. Insurance ce policy.or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes If you have checkedrtes, please. -Indicate the type Coverage by checking the appropriate box. A liability insurance policy 0 Other type of indemnity DBond ❑ OWNER'S INSURANCE WAIVER: I am aware thafthe, licensee does not havethe Insurance coverage required by Chapter 142 of the Mass. General Laws. and that my signature on this permit application waives this requirement. Check one: Owner❑ Agent ❑ Signature of Owner or Owner's Agent 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 the permit' d for this application VA. in compliance with all pertinent provisions of the Massachusetts State Gas Code and -Chapter 142 of the Ge Laws, Nu ,C�. BY T license: Plumber Sign re o tensed lumber or atter rhe fitter Mer se- Rumber _ (] fylrown - R5',eyman APPROrVED ( i NL z 0 W cr O IL, z 0 z I I 7. P 40 0. tL Lu 92 IL I-oc U. A 43 c Am d. Q mc NJ z 0 z I I 7 4 Date / . ? .3 j %U...... . �q'O TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION a o .ty i This certifies that /jvr.c' G.... lc.� /:... ........ . has permission for gas installation .. Fc. h. - /-! .e- . c ........... in the buildings of .< (.. 7_ �a at . 62U ..-.—tG. `: o .' � .............. , North Andover, Mass. .� Fee: Lic. No. ... . GAS INSPECTOR Check # /1527 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO ISO GASFITTING SL (l'rhnt or Type' Mass. Date F " 20 Permit # Building Location f:` �=—! "��Eti Owner's Name Az Type of Occupancy New Renovation Q Replacement D Plans Submitted: Yesp No l c Check one: Certificate Address,/ r 3 } "'Corporation Partnership W Gi pn Name of Ucensed Plumber or. Gas Fitter S x rc 7! o 0 wuspa. � 4 4 ee rO r- � 0 o � rA � W 7 ,( Uj .: Q � pit ~ W 4'^ _ Wt ix w A > v.. is 'J' ('. put �[ Itt ?' lit x- '� Q.' +K o �} 1rt Yp.: d a iLl >r" M A SUB• -BSMT. BASEMENT 1 ST FLOOR i ! 2ND FLOOR 3RD FLOOR 4TH FLOOR STK FLOOR 6TH FLOOR TTKFLOOR STH FLOOR Installing Company Name « / ` ;6 �¢' ` Check one: Certificate Address,/ r 3 } "'Corporation Partnership Business Telephone �C` " < Gi Firm/Co. Name of Ucensed Plumber or. Gas Fitter INSURANCE COVERAGE: I have a cutrent Iia`&lity Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 13" No C1 If you have. checked yes. please: Indicate the type coverage by checking the appropriate box A liability Insurance policy 0 Other type of indemnity (3 Bond 0 OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owneriel .Agent � Signature of Owner or Owner's (gent I hereby certify that all of the details and information I have submitted for entered) in above application are -true and accurate to the gest of my knowledge and that all plumbing work and installations performed Lander the permit issued for this application will Uq in cornpliance with all pertinent provisions of the Massachusetts State.Gas Code and Chapter 142 of the Gen¢rdl taws. By T of License: T7 Plumber Spgrpatprre at ceased Plumber or teas Fitter Title Gasfitter .tea master Gc ase Number _ �r City/Town -- Journeyman APPRC7VED i N 0 dl 16 N6 a. CA. c 16 Y. O 0 m ca uj &6 W be 4) 0 dl UTS of Massachusetts, Inc. Page 4 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Report Date 09/11/2008 Report No. 9 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Attachment f• Of Mea mhusetts Inc. "The C Mf rllCOM Testing people" Page # DAILY REPORT OF CONCRETE POUR /ROJECTME: XK-Ac' i�/ I// PROJECT NO.: DATE: _ C' S A]R TEMP.: TOTAL YARDS: _ �� LOCATION OF POUR: Load & Truck # Slump Inches Batching In Batching Out Time In Minutes Yards Concrete Temp. % of Air Ticket # No. of Cylinders rid 76 C2 du 1/) / & 46 A INSPECTOR: %� , ll�►,(i�LL•-� REMARKS�� 5 Richardson Lane_ Stnneham- Maesaeh11ce++0 A94RA 179241 d40_y7ee r.,., 170 -Al w02o_&'n4c 87og This certifies that .. has permission to perform Date. 41VI A TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING Ul2 <.�.....� ................. plumbing in the buildings of c at...�.2. �..`.4 .n.wr./ �! (�., North Andover, Mass. Fee �� L .� .. Lic. No..J.6. 2. .. ....... �? .. ....... DUMBING INSPEC(04- Check # . Z )"� CIYTI IDCQ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town: Al. % AgLJOL. —SMA. Date: Permit# Building Location: �d o tn,c r P Td Owners Name: W ,.9 �� / A Type of Occupancy: Commercial Yp2— Educational ❑ Industrial ❑ Institutional ❑ Residential ❑ New: ❑ Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ❑ CIYTI IDCQ INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes [Flo ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner [:] Agent E] I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the nermit iR%nPd fnr fhk annnrarinn will he i., ......,..r.,..,.. —:.� ..11 Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Type of License: Title ❑ Plumber Signat 6r, of Licensed Plumber City/Town easter APPROVED OFFICE USE ONLY ❑Journeyman License Number: ___ DEDICATED z SYSTEMS in LU W Y z 0 s Z cc W Z Z } FQ- Y J Ln a N LU W o Q Cc W 3 N 2 N QCA to W Z ~ W Z N W ca in C Q _Z a ~ Q 2 LUI-- Q Q 0 W Q Y Q H I- ?j O 2 OC p Q W C+ ?� t] 2 Z Q W Z in W 3 W {3 W Q Y Z U 2 W a W � z W W J 3 in W I H W u a m CL 1- in m a o O v > °2 Y 5 g O O 0 Z Z �n H 3 3 F- 2 D 3 o O Vf W Q in Q W � a C) ID W 3 SUB BSMT. BASEMENT 1ST FLOOR (a 2"D FLOOR 3RD FLOOR 4T" FLOOR 5T" FLOOR 6T" FLOOR 7T" FLOOR 8T" FLOOR (� v✓ Cf_. N Check One Only Certificate # Installing Company Name: y f. `,,,._,, .-- Address: cz y Mgrs S I City/Town: h 0 U -C Stater [� Corporation ❑ Partnership Business Tel: 9-2F 4ffa S-090 Fax: ❑ Firm/Company Name of Licensed Plumber: dim Vd L v INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes [Flo ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner [:] Agent E] I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the nermit iR%nPd fnr fhk annnrarinn will he i., ......,..r.,..,.. —:.� ..11 Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Type of License: Title ❑ Plumber Signat 6r, of Licensed Plumber City/Town easter APPROVED OFFICE USE ONLY ❑Journeyman License Number: ___ 5 U NU, Date .p//, TOWN OF NORTH ANDOVER 10 PERMIT FOR GAS INSTALLATION amt This certifies that ...................... has permission for gas installation ......... in the buildings of . Vel � A� " ............ ........... at ,A,jy North Andover, Mass, Fee./06., . . Lic. No.. ... ... ........ INSPECTOR" Check # CIYTI IOCe W WLU LU MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town: 141,r-Z�, 4 Ota PQA. Date: /tl V7 IX - -/off-/0 Permit# Building Location: I-L,1A Owners Name: 6/0—c-4// / jit2✓l [ U) M ~Q U) 2 O0 Type of Occupancy: Commercial [9' Educational ❑ Industrial ❑ Institutional ❑ Residential ❑ FN- New: ❑ Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ❑ CIYTI IOCe W WLU LU co le V7 IX U) M ~Q U) 2 O0 Co U O W V U) FN- = O= W O Z IX J Z 0 W w S W w p Q m w N W W U w g m 0 W Z _ o w D O w X o= u. W W5. Z (4 J H 1— O Z J a LL = W W W IX V O a QU' — 0__ O a >>> O t=i Fw- SUB BSMT. BASEMENT 1 FLOOR 3 12 FLOOR -S'FLOOR 4 FLOOR -5 'FLOOR 6 TH FLOOR 7 1H FLOOR 81HFLOOR „Q� 1 ` Check One Only Certificate # Installing Company Name: /VV -C-0 (/ %'� ❑ / Corporation Address:,2y /'/G�rS�a l �-r�City/Town: Ali 1,— C I r State: � ❑ Partnership Business Tel: pJ % /ts-c1 5-0 g U Fax: ❑Firm/Company Name of Licensed Plumber/Gas Fitter: h f . c J INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes L9 -No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy P�1- 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner El Agent El By checking this box ❑, 1 —hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and ', ��uvmncuyc 011U LIIdL du piurnomg worK ano mstauanons perrormed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Type of License: ❑ Plumber Title El Gas Fitter Signatur ic6nsed Plumber/Gas Fitter M -Mister City/Town ❑Journeyman License Number: �G %� APPROVED (OFFICE USE ONLY) ❑ LP Installer VIVuewaaN ylnd .A8 ._..:_..v....._......._.._._....,._._......__.._..._.......:..._.._...._ ....�..:...._..._....._ .....__.w:..... :s;uawyoeud ......w..._.......M._....._....._............_.....�...�.,........_...w.w..,..._.�..........�...........�.M........._w..�..._...,.....�.,..................,.,....._..,... alnpayos jo peayy alnpayos pulya8 n alnpayos up ® eoueumpoo elnpa43S :Bulpuad suol;aV jo senssl WOWBBVPOOH _..... ..,,� _ .....,.. ..._ ..W .. . _ ...... W .. _.. ......_... . leou10913 / 9L ONAH/56 uolIoaIo]d a]l3 / 9L �. ....w.. 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T 7 V Date. ,%?�. U ....... or �` TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATIO h SACHUSEtt ; This certifies that ............................. has permission for gas installation ... I/...� ` .: `,l'.� ...... in the buildings of .�� r v..`G.:......................... at ..�.1 �...4l�. �,/.'.'.!::....r�.... North Andover, Mass. Fee..2.0 .. Lic. No.?-. � � ... .... � -t-� .... . AS INSPECTOR Check # S 3 r- nv*ri loco � MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town: -✓ , MA. Date: % 2, - 3 / Permit# a Building Location: D �u rytl � � 2 Owners Name: 6 EM Type of Occupancy: Commercial B—Educational ❑ Industrial ❑ Institutional ❑ Residential ❑ w New: Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ❑ nv*ri loco � N w V W zal� z F zw~ to Ca Y L) I -- W zo7!►r- m= O WV O Cn o=wW Z H O z Z J iY W _� Z W 0 O W IX ?- C > W V m 0 ~ a a 0 W X -V Z W W W 0~ W y Lu O = W ~ a _ > W e Z Of W Z J~ >- N Q F- Q O Z oo W --I (7 O z li 0 Fy- �' W > H Z W W x ,rSOwrt Nvn U o � C9 _ _ O Oa i > > > O ty SUB BSMT. BASEMENT 15T FLOOR 2"u FLOOR 3 FLOOR 4 1 H FLOOR 5 FLOOR 6 FLOOR 7 FLOOR 8 FLOOR :d — — — ---------------- L - - - Check One Only Certificate # Installing Name: CR.,t..MlVv� C!U/1 Company 9 PJ ^ n OC .� ty Address: Ci /Town:�� State: �la( [I Corporation ❑ Partnership Business Tel: % L/ %% 3 6 7 Fax: �. &-FiFm/Company Name of Licensed Plumber/Gas Fitter: d t" INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes ❑ No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner F-1 Agent F-1 By checking this box ❑; I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and 0-10M LV LIM VCAL V1 Illy r%IIVWIHuyP. ana mai au piumumg worK ana installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Type of License: By ❑ Plumber Ak� Title ❑ Gas Fitter Signature of Licensed Plumber/Gas Fitter ❑ Master City/Town ❑Journeyman License Number: 2-0 APPROVED OFFICE USE ONLY ❑ LP Installer Q Date.4.... TOWN OF NORTH ANDOVER PERMIT FOR WIRING ov" This certifies that . ................ has permission to perform .... .............. ................................................... wiring in the building of ........................................................................ ...... North Andover, Mass. Fee f?�A� ...... L i c. N o. '411t ................. . ....... ... . ... / EL CTRICALINSPECTOR Check # S i6 °-� Commonwealth of Massachusetts - official Use Only Department of Fire Services Permit No. [ 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 CK R 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: <; 9 O 9 City or Town of: NORTH ANDOVER To the Inspector o Wires: By this application the undersigned gives notice of his or her intention to perform the electrical wor described below. Location (Street & Number) Ag -010 '82Q Owner or Tenant G /— Owner's AddresO 2 S N. /LJ,p �,y Er l�.ui 7 l5 Is this permit in conjunction with a building permit? Yes ❑ Purpose of Building dFe IE -4- cs Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Telephone No. %??T7YO67 No ❑ (Check Appropriate Box) Utility Authorization No. F .5-2-79 a P Overhead ❑ Undgrd ❑ No. of Meters Overhead ❑ Undgrd ❑ No. of Meters Location and Nature of Proposed Electrical Work: / - -- - —.., y ut;ureu, or as required by the Inspector of Wires. bstimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains andpenalties o p ) / p f perjury, that the information on this application is true and complete FIRM NAME: l� LIC. NO.: Licensee: �,,`�5�-- �� S� Qr Signature �- (If applicable, enter "exempt " in the license number line.) �-� LIC. NO.: Address: 6 �a G r s eA st �C C� Bus. Tel. No.: 7f3Gf�SG3U/ Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Alt Lc. . No 92 88p 9,y4',0,0 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 El owner's anent. Owner/Agent Signature Telephone No. PERMIT FEE. $a. C�3S ��-4 �,- 7 7z� b c0k' Z- z 2—ca�- bs 0 3a n J GP ASSOCIATES. Inc Consulting Engineerrs Mr. Gerald Brown. Dt ; Sept 16,2010 Inspector of Biildings 1600, Osgood Street. No. Andover,Ma 01845 Reg: 1820, Turnpike Street ,3rd floor Final Report. The fit up work is complete.The completed work meets the requirements of the Massachusetts Building code. The Elevator & Fire alaram systems have been inspected & accepted by responsible authorities. The completed work includes the Lobby area also. If you have any questions, Pl. contact our office. Skicerely. Satyaprasad �``P��N OF Mgss�@ v= RAMASASTRY G SATYAPRASAD rn No. 28096 O ?? �� GIST p� FSStONAL�� 29, Cresthaven Drive,Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net GP ASSOCIATES. Inc Consulting Engineerrs Mr. Gerald Brown Inspector of Buildings 1600, Osgood Street No. Andover, Ma 7-22-10 Reg: 1820, Turnpike Street, 3rd floor Metal Studs,90 % complete. Work conforms to drawings. ---- 7 Nammoaprasad,P.E ,' A, a INN OF �gssgcy O RAMASASTRY G SATYAPRASAD m -i v ND. 28096 cn 9 O � �/sTE�' � A F �� ��FSSI0 AL��'\� 29, Cresthaven Drive,Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net GP ASSOCIATES. Inc Consulting Engineerrs Mr. Gerald Brown Inspector of Buildings 1600, Osgood street No.Andover, Ma Reg: 1820, Turnpike Street, P floor Metal Stud work -100% complete. Dry wall started. Electrical work -75% complete. Work conforms to the Code & is acceptable. W.,aprfsa7d�,I.E of Mg N;ssgcy � :�F SATYAPRASAD G� —a No.28096 Q "' A 9F�i / ST EPS �a` ��FFSS100- �G\� 8-05-10 29, Cresthaven Drive,Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net GP ASSOCIATES. Inc Consulting Engineerrs Mr. Gerald Brown. Inspector of Buildings No. Andover, MA Reg :1820, Turnpike Street, 3rd Floor PROGRESS; Drywall -100% Complete HVAC -90 % Complete Electrical -90 % Complete Plumbing 90 % Complete All wor is satisfactory & is acceptable. j. atyaprasad Hof ` S9 }/^.N RAMASAS7RY �y %Q SATYAPRASAD vGi v m 9 No. 28096 IS T A�o�Fs ANAL 8-19-10 29, Cresthaven Drive,Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net 13 GP ASSOCIATES. Inc Consulting Engineerrs Mr. Gerald Brown Inspector of Buildings 1600,Osgood Street No. Andover, Ma Reg: 1820, Turnpike Street. 3`d Floor Painting –100 % Complete Carpet -95 % Complete Work is ,satisfactory & is acceptable. d�.E � < �P��H OF a p o` RAMASASTRY yG SATYAPRASAD v' v No. 28096 1QFG�O oA ,gFFSS/ONAI.EN�'\� 8-31-10 29, Cresthaven Drive,Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net Date. .y. 'r U No°T:1�c TOWN O/F NORTH ANDOVER o40 PER/MIT FOR PLUMBING w This certifies that has permission to perform . .. --�.4. plumbing in the buildings of ............ 2 ....... . at.. �. �y.� .G.. �0.:� •..�............. . North Andover, Mass. )� (� Fee./4r7...Lic. No ..... Q �.. ........ �... ..�.✓`�'`' LUMBING INSPECTOR Check „ 8393 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO ]DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building New Ef Renovation ❑ Replacement ❑ Date O tl !— 50 Permit # " Amount J' Plans Submitted Yes ❑ No ❑ - "- - (Print -or type) 1 Check one: Certificate Installing Company Name - J J ❑ Corp. Address v`" ❑ Partner. Business Telephone 7 j7 _ �� �% j 13 ❑' Firm/Co. Name of.Licensed Plumber: I(Gt_t" M U I \ Insurance Coverage: Indicate the 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 ofthe above threeinsurance Signature Owner ❑ Agent ❑ Er I hereby certify that all of the details and information I have submitted (or enfered) in above application are.true and accurate to the best of myknowledge 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 State Plumbing Code and Chapter 142 of the General Laws. By: Signature ot JlGensedPlumber Type ofPlumbing License Title 2-0 6 G to City/Town jicense Numoer Master ❑ Journeyman u APPROVED (OFFICE USE ONLY -mom • j a .J ON mom imom ■ :., ::� ::.WOMMO............ ■ 3 ,.' �....�...........�..W... ,.. o.r�.n.. . 0 0 no.. mom No MMIONN ON =mom ON 0001000 . - ,. • ON No m............IN... UIP00NOON mom ON... mom No 0 ON ONN.......No 010010010No .. NNNO10000 No NOWWWW (Print -or type) 1 Check one: Certificate Installing Company Name - J J ❑ Corp. Address v`" ❑ Partner. Business Telephone 7 j7 _ �� �% j 13 ❑' Firm/Co. Name of.Licensed Plumber: I(Gt_t" M U I \ Insurance Coverage: Indicate the 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 ofthe above threeinsurance Signature Owner ❑ Agent ❑ Er I hereby certify that all of the details and information I have submitted (or enfered) in above application are.true and accurate to the best of myknowledge 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 State Plumbing Code and Chapter 142 of the General Laws. By: Signature ot JlGensedPlumber Type ofPlumbing License Title 2-0 6 G to City/Town jicense Numoer Master ❑ Journeyman u APPROVED (OFFICE USE ONLY -1 The Commorzweralth ofMassachusetts Department. o f rndusfrialAccidants Ofjlce ofbivestigaiions 600 Washington Street Boston, 3L4 O2II1 www.,masSgov/dia Workers' Conipen.sation Insurance Affidavit: guflders/Con�ractors/Lieciricians/Plumbers A icant •Tnfnrm"on Name(Bainess/organization/Individual): Address: ' • G City/State/Zip: Phone #: -Are you an employer? Check the appropriate box: 1 • ❑ I am a empIoyer with 4. ❑ I am a g�.neral contractor 2.E3employees (full and/or part-time).* -1 and I have hired the sub -contractors am a sole proprietor or partner_ -listed on the attached sheet t ship and have no employees These sul>_contractors have working for me in any capacity. [No workers' comp, insurance workers' comp, insurance. J. ❑ We are a corporation and its 3. ❑retluired.] am a homeowner doing officers hake exercised their _I all work myself. [No workers' right of ex �ptiou per MGL comp. c. 152, §1 (4), and we have no in required.] t employees. [No workers' { F comp. iust�randrequired-] L:.0 Ee^_L+M+ � Flo�eowners who suhmit'$iis affidavit • di^ h G:w��• P.•^..Q::2^..= r-':^.�.^ 9'or �6' com---mi. i. Type of project (required): 6. R Wew construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Bmldmg addition 10.0 Electrical repairs or additions •11.❑ Plumbing repairs or additions 17.❑ Roof repairs 13.❑ Other III ..at]ng t_Cy are dc..zg ail wmk an Y••••.•• r•:�:::� .:.a"II2—.c:�:i:J:�. +Contractors that ch=, ' � ter nano. a accred an additional sheet showing th e then hire outside eou**zctors det ,ut wit a new amdavit h3ci sting such. r _ a rime of the sub -connectors and theirworkert' enT.. isProv rng workers' compensation information„ insurance for my employees Beloitl is the policy and job site Insurance Company Name: +11aeoJ—e Policy # or Self-ias. Lic. #: Expiration. Date: Job Site Address: Crty/State/Zip-------- Failure to secure coverage as required . Attach a copy- of the workers' compensatiorz policy decIarai%on.page (slra�ving;.hepohey number•and expiration date•. under Section 25A of MGL c. 152 can lead to the imposition of c ) nne up to $1,500.00 and/or one-year imprisonment; as well as civil penalties in the form of a STOP WORK ORDER rad a fine nnunaI penalties of a Of up to $250:00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office a Investigations of the DIA for insurance coverage verification 7 ,r- z - r uir uaaer me pains nd iz'es ofPerlurJ'th zrthe informarion provided above is true and correct .(/QZ 3ture: n / I Official use only. Do not write'in this area, to be completed hi, city or town officio( City or Town: yssniiza Authority (circle one): L Board of Health 2. Buiiding Department 6. Other Contact Person: P`ermit/License 3. City/Town CIerk 4. EIectricaI inspector Phone'#: S. PIumbing- Inspector Information an- d Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every pe✓zson in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnefship,•association, corporation or other'legal entity, or any two or more of the foregoiag engaged in a joint enterprise, and including t1ie Iegal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association otim other legal entity, employing employees. However the owner of a dwelling house having not more than -three apartmL encs and who resides therdin, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurbenantthereto shall not because of such. employment be. deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing'agency shall withhold•the issuance or renewal of a license or permit to operate a' business or to c=onstruct buildings in the commonwealth for any applicant who has not produced acceptable evidence of crvvnpliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the.ped€orrmance of public work irn:-it R acceptable evidence of compliance with the insuraace requirements of this chapter have been presented to the contracting authority." Applicants Please fill -out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-coniractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability partnerships (LIP) with.no employees other than the members or partners,. are not required to carry workers' comp enation insurance-. If an LLC or LLP does have employees, a policy is required Be. advised that this affidavit may be submitted to the Department of Industrial Accidents for con-firmaiion of irozanre coverage. .Also be rnure to sign and date the affidavit. The affidavit should i a s —c that, a . _ r s e t� i Zile returned to the City o. town that the aPplicauum:Ra the p •rzioit- i license is being requestmd natt the T'epari—m -"tt of Industrial Accidents. Should you have any questions regardiL.,ga the law or if you are rehired to obtain a worlcrss compensationpolicy, please call the Department at the aumbesr listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. , e City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to ccntact you regarding the applicant Please be sure to fill in the permit/license number which will be -used as a reference number. In addition; an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under `.`Job Site Address" the applicant should write `tall locations in % (city or town.)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled .out each . year. Where a home owner or citizen is obtaining a license or permit not related to any business, or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would lie to thank you in advance f6r your cooperation and should you have any questions, please do not hesitate to give us a calL The Departrnent'.s address, telephone and,famnumber._.. Revised 5-26-05 ' - The Comimonwealth_ of Massachusetts. Department ofFndustrial Accidents •Ofrace of lnuesAgmfions 600 WgshinaiQn street' Boston, MA 02111 Tel ##' 617-727-4900 ext 440.6 or 1-8 7 7-1VLA.S.S:AAE Fv. 96-17-7277-7749 7 3 5 7.j Date. ..1 �A�....... MORTM pf .o ,°,ti0 of '` TOWN OF NORTH ANDOVER :- PERMIT FOR GAS INSTALLATION � �SSACHUSE, 1 This certifies that ..... /. w( U ................ • ... , . , , . , . . has permission for gas installation :: .......... in the buildings of ... 54,,k4 u ............. at G ........ 1 . , Norrth� Andover,, Mass. Fee.. Lic. No.. ! 2 7c.`... � — .t ....... . . ..... GAS INSPECTOR Check # 1 ) ? MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING _ (Print or Twe` p� Mass. Date Permit # Building Location Owner's Name Type of Occupancy New *I Renovation F1Replacement ❑ Plans Submitted: Yesx, No ❑ GI Installing Company Namef S - Check one: Certificate Address /�� Corporation p . Partnership Business Telephone' J CD Firm/Co. Name of Licensed Piumber or. Gas Fitter �✓ �/5� //���— -- INSURANCE COVERAGE: ! have a curt liabiltty insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No 17-1If you have ec ed yes, please indicate the type coverage by checking the appropriate box. A liability 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 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information 1 have submitted (or entered) in knowledge and that all plumbing work and installations performed under the permit pertinent provisions of the Massachusetts State.Gas Code and Chapter 142 of the By T of License: P1�rmber S, Title sfitter Master en City/Town Journeyman APPROVED ( I NL application are trueoand accurate to the best of my for this applicabonl be in compliance with all e of oucented mumoeror uas ritte J Number ` 971/v MEMNON MEN SEEM am SEEN M- ON MEN E ONES MOINIMMIRM ANN on MIS M MENEM MEMO SEEN ME MESIMEMEMMEMOMMOM Installing Company Namef S - Check one: Certificate Address /�� Corporation p . Partnership Business Telephone' J CD Firm/Co. Name of Licensed Piumber or. Gas Fitter �✓ �/5� //���— -- INSURANCE COVERAGE: ! have a curt liabiltty insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No 17-1If you have ec ed yes, please indicate the type coverage by checking the appropriate box. A liability 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 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information 1 have submitted (or entered) in knowledge and that all plumbing work and installations performed under the permit pertinent provisions of the Massachusetts State.Gas Code and Chapter 142 of the By T of License: P1�rmber S, Title sfitter Master en City/Town Journeyman APPROVED ( I NL application are trueoand accurate to the best of my for this applicabonl be in compliance with all e of oucented mumoeror uas ritte J Number ` 971/v ' d Z• f - r U. N' } J O S O O O W O W, V � L6 16 O ju O Z d C O O � d S G• O J r W t m V J a 6 W U W V H W Y N q • 0 V-4 —e &Lou r 1cy1 7 f Cobb Jb41 TOWN OF HUDSON PAGE 91 (/ 17 The Cemmnweafth of Massachusetts Depariment of Industrial Accidents O, f ke ofInvestigations 600 Washington Street Boston, MA 02111 www. massgovldfa Workers' Competasation Insurance ,Affidavit: Buildelrs/Contractors/FIectriciam/Plumbers A -pip cant Molrmation Please Print Legibly Name (Business/Organitation/Iadividusl). Address: Le, Ave City/State/4p:_ _ AJha!,,),4 d phone, it 7f Are you an employer? Check the appropriate box: Type of project (required): . 1. ❑ I am a employer with' 4. ❑ 1 am a general.coutractar and 1 6, Q New constxW., ' . employees (full andlor parr~,time).'" • 2: ❑ I am a sole proprietor or Partner - have hired the sub -contractors listed on the attached sheen t 7.Remodeling " ship and haveho empl6gees .'!hese sub -contractors k ave 9. • Demglitior�; . working forme ut any capacity. [No workers' comp. workers' comp. inu=re. 5. W.q are acorporation and its 9. Q BuWis>gtadon • ::; -insurance required -1 officers Dave exercised their „ . , i 0 ❑ Electriedl i epaiis or additions 3. ❑ I am a homeowner doing all work ; right of exemption per MGL , . 1 I Plumbigg rep4irs or additions myself [No Workers' comp, c.152, §1(4), and we have no _... • 32. El Roof repairs insurance roquired.j t employees. (No workers' 13.❑Other comp. insurance required.] *Any appiloW mat cheep box #i rtast also fit! out the section beibw 9howioa their worlml cotetptmsetiod policy infomadon. t itomeow co who submit this affidavit indic sft they we doing all work and then bin outside conhoton must submit a new affidavit Indicating such. rCmtractom that check this box must attadW an addidonsi sheet showing the pane ofthc sab-Conkaetots and tlseirwod=l comp, policy iniorasadoa. .f am art employer that Irspmvift workers' eompensallon insuraaedfor my employes Below k the policy and job site Insurance Company Name: Policy # or Self -ins. Lic. #: PP A -A)N4 Q o � Expiration Date: Job Site Address:_ City/State/Zip: yi9 Attach a copy of the workers' compensation policy declaration page (showing the policy ntuuiper and expiratiot6date). Failure to secure coverage as required under Section 25A of MOL e.152 can lead to the imposition of Criminal penalties of a fine up t6$1,500.00 and/or one-year imprbonmw� as well as civil penalties in the form of a STOP WORK ORDER aud•a ftae of up to $250.00 a day'sa in the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations,Kthe DIA for fimm i m.coverage verification. .1 do hereby1cr y 11111�( thff paWpd pena[tki of perjtvy that the tnforrxation provided above is true and correct Official use only. Da not write hi this area, to be completed by chy of town otj`iclaL City or Town. Permit/lideese # Issuing Authority (circle one): 1. Board of Utalth 2. Building Department 3. City/Town Clerk - 6. Other lerk•6.Other Contact 3r-16 4. Electrical Inspector S. Plumbing Inspector Phone i„Tr?Ly%-0tV'aSA`.FRM•'�,r �re:s�7f��y�a,'<�+♦*t�4 .` , ,ynr�{�q..s ----------------- '[L3s�rr,2nr,:6i.�1•.#',tib++Y.•:t��twe:te,•tr..!�:::�r.•'Cx'%n.�:-cr_:!a•s'.�tin�2�s: 1N PLUMBERS AND GASFITTERS LICENSED. AS A M4S79R, PLUMBER JOSEPH P MCNAMEE 23 BAYSWATER STREET EAST BOSTON MA 02128-1216 �� �±.P.Pyp'j� // /L� -47, " 3 �. -0iG Date .���!/. ........ of �` TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION �9SSACNUSEt 7 ` This certifies that... has pernhission for, gas installation in the buildings of .. . ..... ........................... . at.......... , North Andover, Mass. Fee, ...... tic. No. 2 D ��C.. ... y��^..... . GAS INSPECTOR Check-# / 3 i 7 730 ,.r MASSACHUSETTS UM ORM APPLICATQN FOR PERMIT TO DO GAS FITTING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations 2- © �e.�-►'4�ae I�e/1 Owner's Name New Renovation ❑ Replacement ❑ Date 0! /1110 Permit #. 3 10 //-- Amount $ �� f 11A. Plans Submitted El (Print or type) _ C❑heck one: Certificate Installing CompanyName_2CUHam ckm Corp. Address A) ®' C A ❑ Partner. Business Telephone 1� p_I�` u`„, iCo Name of Licensed Plumber or Gas Fitter pi 11ylntrl nn �,0 E INSURANCE COVERAGE Check one: I have a current liability u-tsurance policy or it's substantial equivalent. Yes E] No ❑ If you 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 ofthe Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent _.—„-y ,.,,.—y — al. V �, —11b culLL uiiunuauun r nave suom mea dor enterea) 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 State Gas Code and Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ❑ Plumber Z 691� 4 6 ❑ Gas Fitter License Number "❑ Master ra,k=eyman � w wO 0. OZ 0 0 0 z 0 W� ' w w � w-4. H a UU) o a nn o SUB-BASEM ENT BASEMENT 1ST. FLOOR 2ND. FLOOR 2 3RD. FLOOR 4TH. F L 0 O R 5TH. FLOOR 6TH. F L 0 O R 7T H. F L O O R -- &.T •H . F L O O R (Print or type) _ C❑heck one: Certificate Installing CompanyName_2CUHam ckm Corp. Address A) ®' C A ❑ Partner. Business Telephone 1� p_I�` u`„, iCo Name of Licensed Plumber or Gas Fitter pi 11ylntrl nn �,0 E INSURANCE COVERAGE Check one: I have a current liability u-tsurance policy or it's substantial equivalent. Yes E] No ❑ If you 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 ofthe Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent _.—„-y ,.,,.—y — al. V �, —11b culLL uiiunuauun r nave suom mea dor enterea) 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 State Gas Code and Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ❑ Plumber Z 691� 4 6 ❑ Gas Fitter License Number "❑ Master ra,k=eyman The Commonwealth of Massachusetts Department o fIndustrial Accidents Office of Investigations ..600 Washington Street I IF Boston, AIIA 02111 www.mass govldia Workers' Compensation Insurance Affidavit Builders/Contracfors/ElecfricianslPlumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: B vyz t p u (( a Jr,rto r _Q City/State/Zip: t oo C Phone #: N Are you an employer? Check the appropriate box: 1. ❑ I am a employerwith 4. ❑ I am a general contractor and I employees (full and/orpart-time).* 2 0I am a sole have hired the sub -contractors listed proprietor or partner- on the attached sheet I ship and have no employees These sub -contractors have working for me in any capacity. [No workers' comp. insurance workers' comp. insurance. 5. ❑ We are a corporation and its required.] 3. ❑ I am a homeowner doing all work officers have exercised their right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees_ [No workers' c9mp, insurance required.] fir-`l?,�-3167 Type of project (required): 6. ew construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12.❑ Roof repairs 13. [1 Other UU. �e se_uo eeros suo.�b T^eir :�•o* s' comps :tion Colicy �io.�ai on T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp, policy information. lam an employer that is providing workers' compensation insurance for my employees Below is the policy and job site information. , , Insurance Company Name: tYQ.,c.{ &,P4_p -' Policy # or Self -ins. Lic. #: Expiration Date: Sob Site Address: It 2 0 City/State/Zip: jjft y- (� Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby certify under the pai and penalties of perjury that the information provided above is true and correct Signature: Date -- Phone #: F ficial use only. Do not write in this area, to be completed by city or town offrciaL City or Town: Issuing Authority (circle one): PermitUcense # 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. PIumbing Inspector 6. Other Contact Person: Phone #. Information ant d Instructions, Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person -in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or. other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three aparhnents and who resides therein, or -the occupant of the dwelling house of,another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter.152; §25C(6) also states that "every state or local licensing*agency shall withhold the issuance'or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter -hay - t been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), addresses) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) w#.no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be stye to sign and date the affidavit. The affidavit should be ret-arned to the v t or owrn that the licauon- for the 'Cense ' be' m e e s t t D =t r of s permit or L :s :ng qu s . a, no the epar of Indmstrial Accidents. Should yo': have any questions regarding the lx%— or if you are required to .obtain a worKers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the pennittlicense number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only'submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business. or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. . The Office of Investigations would like io_thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number. The Commonwealth of Massachusetts Department ofFndusfrial Accidents Of -lice of lnvest bations 6.00 Washington Street Boston, MA 02111 Tel. # 617-727-4900.ext406 or 1-877 MAS.SAFE Revised 5 -26 -OS Fax # 617-727-7749 www.mass.-govfdia Date..�. 2.; !. °...... . TOWN OF F NORTH ANDOVER PERMIT FOR GAS INSTALLATION Io This certifies that has permission for, gas installation ... C6. r tc.p . .... .......... in the buildings of . 7 .............. at North Andover, Mass. v GCS AINSPECTOR/- Fee. . Lic. No.. � , r, -�-�� ....... Check-# 7317 i,k MASSACHUSETTS UMPORM APPLICATON FOR PERMIT TO DO GAS FITTING (Type or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations / X 2 U mMJD I iii2Q --\A ! 514azAvie-u Permit # 3% 7 L��20 he SGyv) ,/ -y( Amount $ ,__��t.ce-Q /[�ICtvtlZf�tirt��•�lOwner's Name New Fr Fr Renovation Replacement Plans Submitted (Print or type) VV Check one: Certificate Installing Company Name RA I rt M % ✓1 vi ❑ Corp. Address Partner. C���U u►1. .SSS Ol Y. usmess Te ep one _Y % '7 Elfmn%Co Name of Licensed Plumber or Gas Fitter I M VElfmn/co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes®�_ Nou If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 0 Bond 0 Owner's Insurance Waiver: I am aware that the.licensee does not have the Insurance coverage required by Chapter 142 ofthe Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner [:] Agent 0 -- —Y ��lUI.Y Way au vi we ucLau5 anu mrormaiion i nave suMutteo (or entered) iii 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 Massachuset otate Lias Code�nd Chaptgr 14Aof the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) t Signature of Licensed Plumber Or Gas Fitter 0 Plumber 2 67 4 6� MGas Fitter License Number 0 Master �urneyman W U O m H CS 0 G H 0 Z z z C W rh H OF F Con U 0W� qOW FUW v� rza O >O on W oO O zo OG Uz °a o SUB -BASEM ENT BASEMENT IST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLO O R 7TH. FLOOR Lid &.T -H, YLO O R (Print or type) VV Check one: Certificate Installing Company Name RA I rt M % ✓1 vi ❑ Corp. Address Partner. C���U u►1. .SSS Ol Y. usmess Te ep one _Y % '7 Elfmn%Co Name of Licensed Plumber or Gas Fitter I M VElfmn/co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes®�_ Nou If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 0 Bond 0 Owner's Insurance Waiver: I am aware that the.licensee does not have the Insurance coverage required by Chapter 142 ofthe Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner [:] Agent 0 -- —Y ��lUI.Y Way au vi we ucLau5 anu mrormaiion i nave suMutteo (or entered) iii 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 Massachuset otate Lias Code�nd Chaptgr 14Aof the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) t Signature of Licensed Plumber Or Gas Fitter 0 Plumber 2 67 4 6� MGas Fitter License Number 0 Master �urneyman The Commonwealth of Massachusetts Department o f Industrial Accidents Office of Investigations 600 Washington Street Boston, .MA 02111 www rnassgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly r' Name (Business/Organization/Individuoal): OI:.LJYL!✓t'l(�.n^ ��c •• - . Address: �1 em rir/1 ' •"(o ,,,.,moo it o City/State/Zip: a,4,1�C2,Jqo cB 3 Kone , #: 5 2F%Q/`3 1 (9, 7 Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* 2-.01 have hired the sub -contractors am a sole proprietor or partner- listed on the attached sheet. I ship and have no employees These sub -contractors have working for me in any capacity. [No workers' comp. insurance workers' comp. insurance. 5. ❑ We are a corporation and its required.] 3. ❑ I am a homeowner doing all work officers have exercised their right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees_ [No workers' . A -.. __-1' _ - .. c9mp, msurance required.] Type of project (required): 6. [_1 New construction 7. [] Remodeling 8. ❑ Demolition 9. [] Building addition 10. [] Electrical repairs or additions 1 L ❑ Plumbing repairs or additions 12.0 Roof repairs 13. ❑ Other --�✓-rr•••••.••� � •.c::.::.� �r�z r. a must GtSo 11i UL`C tae £CCnU^ be i0w wlnb their :?'C:Ke:S' _,omocnsalioa policy' iE.f'o: .lion. t homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a neer affidavit indicating such. #Contactors that check this box must attached an additional sheet sfiowing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my emp information. loyees Below, is the policy and job site Insurance Company Name: Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signafore: Date: Phone #: r0ffzcia[use only. Do not write in this area, to be completed by city or town officiat City or Town: Issuing Authority (circle one): Permit/License # 1. Board of Health 2. Building Depattment 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Information and Instructions , Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every perrson in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or. other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartmLents and who resides therein, or.the occupant of the dwelling house of. another who employs persons to .do maintemance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter .152,, §25C(6) also states that "every state or local licensing•agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of coxnpliance with the insurance coverage required." Additionally, MGL chapter 152,.§25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter•hay,e been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) and phone numbers) along with their certificate(s) of t insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with.no employees -other than the members or partners,. are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or tcm am that the app hica an- for the per=*t'or license is being reauested, not the D--partment of Industrial Accidents. Should you have any *questions regarding the law or if you are required to .obtain a workers' compensation policy, please call the Department at the numbe=r listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a- space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be -used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future perinits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business. or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. . The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number. .The Commonwealth of Massachusetts Department of ndustrial Accidents Office, of Inv�estibatiGns 600 Washington Street Boston, MA. 02111 Tel. # 617-727-4900.ext406 or 1-877-MAS.SAFE Revised 5-26-05 Fax # 617-727-7749 wvrv,.mass._govfdia 7357 Date. J.. /. `.'% MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) AV15 e,9 cJ , Mass. Date ( 20 Permit # 2L 7 Building Location © r�,z.,V f i jcG Owner's Name �p7✓L %; /C �'/�Z Telephone 6 1 7 — �T) 4 61,6 3 Type of Occupancy New lel Renovation Replacement Plans Submitted: Yes 11 NoEl Installing Company Name EnergyUSA Propane, Inc. Check one: Certificate Address 100 Myles Standish Blvd., Suite 101 X❑ Corporation 132 C Taunton, MA 02780 M Partnership Business Telephone (800) 822-1300 X8055 Mike Smith Cell (508) 922-7891 M Firm/Co. Name of Licensed Plumber or Gasfitter William Kent Corson (800) 822-1300 X8051 Cell (508) 294-6660 INSURANCE COVERAGE: EnergyUSA Propane, Inc. has a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch. 142. Yes X❑ No M If you have checked Yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy X❑ Other type of indemnity F1 Bond M OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner Agent Signature of Owner or Owner's 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Code and Chapter 142 of the General Laws. Type of License: By Plumber ��/�� Title XD Gasfitter Signature of Licensed Plumber or Gasfitter City/Town X❑ Master APPROVED (OFFICE USE ONLY) Journeyman License Number .3707 m •• - Moro Installing Company Name EnergyUSA Propane, Inc. Check one: Certificate Address 100 Myles Standish Blvd., Suite 101 X❑ Corporation 132 C Taunton, MA 02780 M Partnership Business Telephone (800) 822-1300 X8055 Mike Smith Cell (508) 922-7891 M Firm/Co. Name of Licensed Plumber or Gasfitter William Kent Corson (800) 822-1300 X8051 Cell (508) 294-6660 INSURANCE COVERAGE: EnergyUSA Propane, Inc. has a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch. 142. Yes X❑ No M If you have checked Yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy X❑ Other type of indemnity F1 Bond M OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner Agent Signature of Owner or Owner's 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Code and Chapter 142 of the General Laws. Type of License: By Plumber ��/�� Title XD Gasfitter Signature of Licensed Plumber or Gasfitter City/Town X❑ Master APPROVED (OFFICE USE ONLY) Journeyman License Number .3707 J z O w D w U LL LL O w O LL O J w m z!, O LU Q. cn z LU O O w a LU w LL LU 2 U F— w Y O z O z D J_ m LL O LU a H 0 LU Q' z O z U_ J O H U w a N z ,�-. Date. .....�.. .. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that has permission to perform �. A� ................... plumbing in the,, -buildings of �1... `...................... . North Andover, Mass. Fee ......... Lic. No.. ... � P� ins .............. ING INSPECTOR Check # MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location IF L 0 of Date ,S' Q Permit#--,Y1,1-7- Amount /y2 Amount Y3 New 0-- Renovation ri Replacement 0 Plans Submitted Yes ❑ No ❑ 01 Kly K NJ t ":NTA II nnnMnsnnn nnn�n�nn 0nnnMnMn®nn�nnsnnnnnn�nWnn ,,' ®nnMMnnnnn■■nnannn ■ M 11F7110171"MOMMMMMMMM--M-. .-W-7101-67MMMMMMMMMM �-�--� MM , 1 11:' -----------.5-...�.--.�-.� 11:' ---M-.MMMM-mmmm M�-� .----.-------M......MM.-.E MMMMMMMME (Print or type) Check one: Certificate Installing Company Name ,/ ❑ Corp. Address ' l Partner. ustness Telephone irm/Co. Name of Licensed Plumber: RC 1j'WL I LA'A < H < c -k Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity 13 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 IOwner ❑ 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'Plumbin ode andhapte 2 of the General Laws. By: igna ure 37 Licensea ru-M5ur Type of Plumbing License Title ,Z & 6 6 City/Town icense .um er Master ❑ Journeyman n APPROVED (OFFICE USE ONLYL-�- Ile j1 4 ! cz The COmmonWe4*k ofMassachusetts Department o- f Industrial Accidents Office of Investigations 600 Nrashington Street Boston, MA 02111 www nurssgovldia . Workers' Compensation Insitrance Affidavit: Builders/Co Dlicant Information ntractors/Eieotricians/Piambers Name (Business/orgenirationAndividual): Address: CitytState/Zip: e� Phone Are you an employer4 Check -the appropriate box: 1. ❑ I am a employer aired. with —0 4. ❑ I am a general contractor and I employees (full an part-time).* �i am .a sole proprietor or have hared the sub-contractors2• listed partner- ship and have no employees on the attached sheet. � These sulk -contractors have working for me .in any capacity. [No workers.' comp. insurance workers' comp. insurance. 5. ❑ We are a corporation and its required.] 3. ❑ I am, a homeowner doing all work officers have exercised their right of exemption per MGL myself. [No•workers' comp, r 152, § 1(4)? 'and we have no insurance required.] t employees. [No workers' comp insurance Type of project (required): - 6. ETKew construction 7. ❑ Remodeling S. ❑ Demolition 9. ❑ Building addition 10. Electrical repairs or additions 11 .17 Plumbing repairs or additions 12.7 Roof repairs I3.7.Qther `Any epp[icant that ehedcs boa'fl 1 must also fill out the section below showing their workers' oompensa tori policy information. Homeowners who submit this a'ffi'davit indicating they are !icing all worts and then ham outside conttaetots must'submit a new affidavit indi such. =Contractors that check this box musrattaehed an additioaal sheetshow' asg the name of the sub-cotrttactors and their workers' con . ti , cater . 1 an, an estployer first is t'» , r Po..�, irfotmation. p Viarw :workers compensation insrcrame for np eatployees Below is the o ' information. P &7 and job site . Insurance Company Name: Policy # or Self -ins. Lie. #: Expiration Date: Job Site Address: City/statezip. 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 tts civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cergry under the pains and penalties ofperjury Mat the information provided above is ince air rowed Ll:---- tcial use only. Do not write in this area, to be cnmpleted by city or town official City or Town Permit/License # Issuing Authority (circle one): I. Board of Health 2. Building Department 3. City/Towu Clerk 4. Electri 6. Other cal inspector S. Plumbing Inspector Contact Person: ` Phone----------------- #: sv Information a. nd Instructions Massachusetts General Laws chapter 152 requires all emp loyes to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, assodiation, corporation or other legal entity, or any two or more of the'foregoing engaged in a joint enterprise, and includir*g the legal representatives of a deceased employer, or the receiver ortrustee of an individual, partnership, associatioin or other legal mrtity, employing employees. 'However the owner -of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance, or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence -DC compliance with the insurance coverage required." Additionally, MOL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter im any contract for the performance of public work until acceptable evidence of compliance with the insurance requiremetts of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation• affidavit complertely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), addmss(es). mind phone number(s) along with their certificates) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' eornpensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the .application for the permit or license is being requested, nofthe Department of Industrial Accidents. Should you have any .questions regarding the law or if you are required to obtain a workers' compensation policy, please cap the Department at the nurmber. listed below. Seif +++_gured m7 panic chnuld P..,for fhf;r self insumnce-Iicense number on the'appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating -current policyinformation (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy ofthe affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid afridaA is on file for fit= permits or licenses. A new affidavit must be filled out each year. Whers a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidaviL The Office of lnvestigeations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give as a call. The Department's address, telephone and fax number- The umber The Commonwealth of Massachusetts Department of i-ndustrial Accidents Office of Investigations 600 Washington Sheet Boston, IIIA 02111 TeL 9 617-727-4900 Ext 406 or 1-977-MASSAFE Fax # 617-727-7744 Revised 5-26-05 www.mass.gov/dia Date .... X. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ... ........... has permission for gas installation r) in the buildings of at � /I. may. �......... North Andover, Mass. Fee..J Lic. No....? I ......... GAS INSPECTOR Check # L( s> MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING � rr (Print or Type) y . A< -ass. Date 20 Permit # (> V11. Building .� Building Location (Nc� ip I Owner's Name /—C �7rvv� Cans/ Telephone 1� 0— S-7 -7 – % cj (Q 3 Type of Occupancy Cam VY) New El Renovation ❑ Replacement E] Plans Submitted: Yes 11 NoEl G Installing Company Name EnergyUSA Propane, Inc. Check one: Certificate Address 100 Myles Standish Blvd., Suite 101 X❑ Corporation 132 C Taunton, MA 02780 ❑ Partnership Business Telephone (800) 822-1300 X8055 Mike Smith Cell (508) 922-7891 El Firm/Co. Name of Licensed Plumber or Gasfitter William Kent Corson (800) 822-1300 X8051 Cell (508) 294-6660 INSURANCE COVERAGE: EnergyUSA Propane, Inc. has a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch. 142. Yes D No If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy X❑ 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner Agent Signature of Owner or Owner's 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Code and Chapter 142 of the General Laws. Type of License: By ElPlumber Title X❑Gasfitter City/Town X❑ Master APPROVED (OFFICE USE ONLY) Miourneyman Signature of Licensed Plumber or Gasfitter License Number 3707 �IMEMMMEMMMMM■NNEN MEN MEMEMEN 101 ••' -mo••-■EMM■EM NEON MEMMEEMMEME■MEN rMuWaMEMEMEM NONE MEME ME NNE NONE MIN • • - mmmmmmmmmmmmmmmmommmmmmmmm ff ••-MEMOMEMEMEMENEMMENEMMENMEN M-OW01MEMEMEM Installing Company Name EnergyUSA Propane, Inc. Check one: Certificate Address 100 Myles Standish Blvd., Suite 101 X❑ Corporation 132 C Taunton, MA 02780 ❑ Partnership Business Telephone (800) 822-1300 X8055 Mike Smith Cell (508) 922-7891 El Firm/Co. Name of Licensed Plumber or Gasfitter William Kent Corson (800) 822-1300 X8051 Cell (508) 294-6660 INSURANCE COVERAGE: EnergyUSA Propane, Inc. has a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch. 142. Yes D No If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy X❑ 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner Agent Signature of Owner or Owner's 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Code and Chapter 142 of the General Laws. Type of License: By ElPlumber Title X❑Gasfitter City/Town X❑ Master APPROVED (OFFICE USE ONLY) Miourneyman Signature of Licensed Plumber or Gasfitter License Number 3707 } J z O w w U LL LL O w O U. O J w m z O F- U w CL z_ (1). w t9 O w a C0 w U H w Y Cl) z O H U w a U) z Q z LL w w LL 0 z 1- LL U Q O 0 O F- F- w CL w O U. O z z O F - Q U J a CL Q O z 3 J m U. O w CL } 06 w Q z w w r LL U) t9 O w w m D J a 0 N w u Date./.`! �-')Iq "pRT►TOWN OF NORTH NDOVER of �4, PERMIT f -OR" PLUMBING 0, 1u 5 2 This certifies that .................. ... ... ...... has permission to perform . ` .. ..-.'.. .................. plumbing in th. ildings of-:•. ... ".:� ......`.". . "f at . .. ..` ' . .. ` .. ,North Andover, Mass. Fee......... Lic. No.` ..... `":«/`�..... . a/ PLUMBING INSPECTOR Check ff 0, 1u 5 2 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS r)i� Date Z -3 0 Building Location z O ,1.. q Owners Name t /� �) Permit # /�S"2 Amount _ j Co Type of Occupancy r ,�,� r— New Renovation Replacement Plans Submitted Yes No (Print or type) Installing Company Name Address Check one: Certificate ❑ Corp. El Partner. Business Telephone 1 •7 '3 i L t -7L/ J '3 [3"FfmVCo. 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 ignature 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 Massachusetts State Plum ing Code and Chester 142 of theneral Laws. erg �� By: Signature Of icensea riumoer Type of Plumbing License Title 6 Citwn Z e, icense 6/ er y/Toum Master ❑ Journeyman APPROVED (OFFICE (OFFICE USE ONLY • ..�.���..5--�.-....-M 0 N .------------.-.-----m� �--�-.-.��-MMM-.-. (Print or type) Installing Company Name Address Check one: Certificate ❑ Corp. El Partner. Business Telephone 1 •7 '3 i L t -7L/ J '3 [3"FfmVCo. 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 ignature 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 Massachusetts State Plum ing Code and Chester 142 of theneral Laws. erg �� By: Signature Of icensea riumoer Type of Plumbing License Title 6 Citwn Z e, icense 6/ er y/Toum Master ❑ Journeyman APPROVED (OFFICE (OFFICE USE ONLY The Commonwealth of Massachusetts Department of Industria! Accidents Offoe of Investigations 600 Nrmhinvton Street Boston, MA 02111 www.nxass gov/dia . Workers' Compensation Insurance Affidavit: Enilders/Contractors/Electricians/pinmbers A iicant Information . Please Print Leeibly Name (Business/organirafion/Individual): Address: City/State/zip: Phone------------------ #: . FAe you an employer? Cheek.the appropriate box: I am a employer with 4. ❑ I am a general contractor and I Type of project (required):employees (fun and/or part-time).* have fired the sub-cotttracors6. ❑ Naw construction . I am a.so}e proprietor. or partner. listed on the attached sheet = 7• ❑ Remodeling ship and have no employees Tbese sub -contractors have 8. ❑ Demo}ttion working for me in any capacity, workers' comp, insurance. [No workers. tom insurance 5. 9• Building addition ' P ❑ .We are a corporation and its required.) officers have exercised their 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing all work right of exemption per MOL 11.❑ Plumbing repairs or additions myself. [No -workers' comp. c, t52, § 1(4), and we have no insurance requ d-].tI2.❑ Roofreairs em IoYees. [Ya workers' p'I3.❑ Other • comp. insurance require&] Any applicant that checks bolt# a must also fail out section below showing their workers' aotnpensation policy information. t Homeowners who submit this affidavit indicating they aredoing all work and then hire outside connectors m='submit a new affidavit indicating each ' #Cotrnactors that aherk this box must attaehed an additional sheet showing the name of the sub-cotttnutois and their workers' tom.,. it i . .. r po• J irifoRn8170R. 1 err rrr: employer fhra is ptoVidrMr:workers' compensadan insurance or to ees Below is the o irfarrnatiort f �' a mP Y p lccy and job site . Insurance Company Name: ' Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address: City/Statezip. 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 5250.00 a day against the violator. Be advised that a copy of this sttement may be forwarded to the Office of ' Investigations of the DIA for insurance coverage verification. 1 do hereby cerci under the p and penaities o Si f p vif erjury that thein ornurtion m ' ded above is true and rorrect tore: C Date: 2 � Phone #: ficial use nnfy. Do not write in this area, to be cnmplered by city or town ofcid City or Town:Permit/License # Issuing Authority (circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phone #: Information a nd Instructions Massachusetts General Laws chapter 152 requires all emp 3 overs to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, nsOciatlon, corporation or other legal entity, or any two or more of the'formgoing engaged in a joint enterprise, and including the lepi reprnsentdjv'es of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. 'however the owner -of a dwelling house having not more than three apa rimers and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work m such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of license or permit to operate a business or *o construct buildings in the commonwealth for any applicant who has not produced acceptable evidence.of compliance with the insurance coverage required" Additionally, MOL chapter 152, §25C(7) states `Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation. affidavit complentely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es). artd phone nuvnber(s) along with their certificates) of insusance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' co=npensation insurance. lfan LLC or -LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also 'be sure to sign and -date the affidavit. The affidavit should be returned to the city or town that theapplication for.the permit or license is being requested, not'the Department of Industrial Accidents. Should you have any .questions regarding the law or if you are required to obtain a workers' compensation policy, please.call the Department at the nrumberiisted below. Self-insured cornpanies ckrs A err self -insurance -license number on die' appropriate. line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department hes provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/iicense number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given your, need only submit one affidavit indicating -current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of�the affidavit that has been _officially stamped or marked by the city or town may be provided to the applicant as proof that valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license ar permitto bum leaves etc.) said person is NOT required to complete this affidavit The Office of Investigations would lice to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give as a call. The Department's address, telephone and fax number. The Commonwealth of Massachusetts Department of 1:3ndmstrial Accidents Office of Lavestigatf ons 600 Washington Street Boston, MA 02111 TeL # 617-727-4900 ext 406 or 1-977-MASSAFE Revised 5-26-05 Fax # 617-727-774$ www.mass.gov/iiia Location G �- 4F /14 No. �.�� � � � �`�/l.� Date N�RTh TOWN OF NORTH ANDOVER 41 D :0: ; Certificate Occupancy $ ; of ?ssncMusE< Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee _ $ TOTAL $ Check # 16 / ?' Building Ins`p'ector W N f - r. 4 O � � o H � N o O � N O 06 H O d U � f - r. 4 U ol v Or r IM � O � U •� � O U `--N O "G w J m ol v r IM � O � U •� � O U O "G w m © p v Q a O z a� a cmca U '^ rnlu. a p 6 oo�Im.��. z�. It U O OZ zm����a O U � O ol r IM � O � U •� � O U O "G w m © p v Q a O z a� a cmca U '^ rnlu. a p 6 oo�Im.��. z�. It U O OZ zm����a U � � A, ol m 9n m ao 9 QI Nv J Q r IM � O � U •� � O U O "G w m O z a� a cmca U '^ rnlu. a oo�Im.��. z�. It U O OZ zm����a m 9n m ao 9 QI Nv J Q a w U w m O z a a 3 OZ U � � A, w •� F o C. � t✓ U � 0 W W O Z W 0� 3: W W_ W > F- (n 3 m cz C H U W rn W Iq N U) 00 Qo aaLo 010o Q .- -� -Oti Q=Z0 , W� a� ZZ �� 0 L aU)Q W Y J CLQ� J z> Q �o oQ w °° TZ ^T1 C � o �O T U O W H U W rn W Iq N U) 00 Qo aaLo 010o Q .- -� -Oti Q=Z0 , W� a� ZZ �� 0 L Wd £t :90:O 1 600Z/6 L/M ..0-3 =A/c aleaS JaNa040 Aq palloa40 6 L Ld 600Z/5L/6 ale(] NJIS '0 MS jagwnu loafold NOIIVA313 NJIS VW `d3n0(]NV HI?ION 1S 3>iIdNHni 0£8L - OZ8L VZV ld IIVM3NOIS :laafOJd 6'+610 VW `NO131(](]I1N 8 5L 11Nf1 133HIS NIVW HiHON 5Z£ 011 'VZVId 11VM3NOIS :jq.uMO it 11015 9Al- t�t1 'J'S Z£L 1V NIVW38111M NOIS 30 3ZIS x3/10 ',kdV/1 kVW 30VNJIS 1NVN31 (WOUN301) -NOIS (]301S OMI A'S Z£ L = -k- L L X J?-, L L 3ZIS IIVH3AO NOIS 0 -.z ----- -----8 L 0 .Z LAOIS INVN31 DOTS JLNV X31 (LOIS INVN31 NUS I.NVN3.1 , PO TIS II�VNHI .s TIS�InI` NRl IT I- �r�f� � RMU 00�,.� - 000[ A 71 R m Ad 617 171:5 60OZ/6l/Ol aleaS Aq PaMoaU0 bW Aq uMe1Q ZCLV 60OZ/9l/6 ale(] NJIS '0 MS aagwnu laa(oJd NOIS AO M31A 4£ I i dW 'b3A00NV H1bON '1S 3NIdNbf11 0£8l - om VZV-1d 7VM3NOiS :laa(01d 617610 dW 'NO131OORN p 8 S6 i1Nn 1398iS NIVN H1bON 5Z£ 011 '`dZVf d IIVM3NOIS ------ _...---tauMO , a 1 I` I i i N 99: L L:g 600Z/6L/0L aleoS Aq PaMo6y0 2�W Aq uMeja ZELd 600Z/5L/6 a)ea dW '2i3AOONb HiNON 61r6L0 dW 'N013laaIW NOIS '0 MS jaquanu 109(ad '1S 3>fIdNdni 0£8L - OZSL 8 5L llNn — 1338iS NIdW HiHON 5ZE VZYld IIVM3NOIS 011'bZbld llt/M3N015 NOIS 30 M31A CI£ :Pafold :uaunnp ., Date . 9. P-� TOWNZF�NORTH ANDOVER PERMIT FOR PLUMBING . . . . . . . . . . . ""This certifies that . has permission to plumbing in the buildings of atNorth Andover, Mass. ................. Fee//.b .... Lic. Nd.'. PI.6�41f]NG INSPECTOR Check# 17 17 79'C' MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Location 0(JlV-rur-4t.- ST of Name S7Ohe jj(% ll l Date9 t Permit # �+ pancy 6 Y3'1 Y'1 / r i y' Amount New Renovation rj ReplacementPl ' ❑ ans Submitted Yes No ❑ Ti TVTTTT� r... Installing Company Name S� 6 W P l� 4 CffZ�� Certificate S Address _ l7 v c �e �- -- ❑ Partner. usiness elephone Firm/Co. Name of Licensed Plumber: -'S co ; ll+ Insurance Coverage: Indicate the a of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity El Bond ,Insurance Waiver. I, the undersigned, have been made aware that the licens three insurance ee of this application does not have any one of the above '+ Signature, Owner ❑ I hereby certify that all of the details and information I have submitted (or best of my knowledge and that all plumbing work and insta ons��erfo compliance with all pertinent provisions of the Massachu�ftc .4rni,�.. VED (OFFICE USE ONLY Type, Plumbing License I�e um Brum er Master Agent ❑ in above application are true and accurate to the -Pe Peed for this application will be in er 142 of the General Laws. i Journeyman ❑ ARCHITECT'S OWNER 000 FIELD REPORT ARCHITECT 000 PROJECT: Stonewall Plaza FIELD REPORT NO: FR 42309 1820-1830 Turnpike St., North Andover, MA CONTRACT: ARCHITECT'S PROJECT NO: DATE: 4/23/09 TIME: 2:30 WEATHER: Seasonable TEMP RANGE: 45 EST. % OF COMPLETION 67 %comp CONFORMANCE WITH SCHEDULE (+, -) on schedule WORK IN PROGRESS PRESENT AT SITE Owner, General Contractor, GFM, Crew, Window Contractor, Act Glass, workers Masons laying bricks at covered walk located in front of building. Window contractor installing window frames, caulking and other prep work for glazing. OBSERVATIONS Shell is 85% complete. Job is progressing on schedule. 11 L`1v1a 1V Y1.'ll11` I INFORMATION OR ACTION REQUIRED H 1 1 Hl.n1V-t r 19 1 a REPORT BY: M. Richard, Architect page 1 of _1_ pages ARCHITECT'S OWNER ❑❑❑ FIELD REPORT ARCHITECT ❑❑❑ PROJECT: Stonewall Plaza FIELD REPORT NO: FR 31909 1820-1830 Turnpike St., North Andover, MA CONTRACT: ARCHITECT'S PROJECT NO: DATE: 3/19/09 TIME: 8:00 WEATHER: Seasonable TEMP RANGE: EST. % OF COMPLETION 67 %comp WORK IN PROGRESS CONFORMANCE WITH SCHEDULE (+, -) on schedule PRESENT AT SITE Owner, General Contractor Window Contractor, Act Glass- Tim Preparing for work start-up due to winter conditions. Meeting with window Contractor to review scope of work and start up dates. Contract awarded and materials ordered by sub. OBSERVATIONS Shell is 80% complete. Job is progressing on schedule. ITEMS TO VERIFY INFORMATION OR ACTION REQUIRED ATTACHMENTS REPORT BY: M. Richard, Architect page _1_ of _1_ pages ARCHITECT'S OWNER ❑❑❑ FIELD REPORT ARCHITECT ❑❑❑ PROJECT: Stonewall Plaza FIELD REPORT NO: FR 1211.08 1.820-1830 Turnpike St., North Andover, MA CONTRACT: ARCHITECT'S PROJECT NO: DATE: 12/11/09 TIME: 11:00 WEATHER: Seasonable TEMP RANGE: EST. % OF COMPLETION 65 %comp CONFORMANCE WITH SCHEDULE (+, -) on schedule WORK IN PROGRESS PRESENT AT SITE Owner, General Contractor, GFM, Crew, Frank Metal Stud Sheathing Workers, Masons Worker finishing up 3`d floor exterior framing gable wall & exterior dense glass. Workers installing azek trim boards. Masons working on front pilasters columns. Workers on exterior mechanical 3`d floor screens. OBSERVATIONS Shell is 80% complete. Job is progressing on schedule. ITEMS TO VERIFY INFORMATION OR ACTION REQUIRED ATTACHMENTS REPORT BY: M. Richard, Architect A. page _1_ of _1_ pages ARCHITECT'S OWNER ❑❑❑ FIELD REPORT ARCHITECT ❑❑❑ PROJECT: Stonewall Plaza FIELD REPORT NO: FR 111008 1820-1830 Turnpike St., North Andover, MA CONTRACT: ARCHITECT'S PROJECT NO: DATE: 11/10/09 TIME: 9:00 WEATHER: Seasonable TEMP RANGE: EST. % OF COMPLETION 60 %comp CONFORMANCE WITH SCHEDULE (+, -) on schedule WORK IN PROGRESS PRESENT AT SITE Owner, General Contractor, GFM, Crew, Frank Metal Stud Sheathing Workers, Masons Worker finishing up 3rd floor roof framing. Exterior wall dense glass sheathing installed on 50 % of building, in progress. Masons installing brick veneer at stair exterior and other locations. OBSERVATIONS Shell is 70% complete. Job is progressing on schedule. ITEMS TO VERIFY INFORMATION OR ACTION REQUIRED ATTACHMENTS REPORT BY: M. Richard, Architect i LATER mmi page _1_ of _1_ pages Matthew A. Richard, Architect 69 Chestnut Street Leominster, NIA 01453 (978)537-7188 (978) 467-6633 (cell phone) May 2, 2009 Inspector of Buildings, Town of North Andover Mr. Gerald Brown 1600 Osgood Street North Andover, MA 01845 Project: Stonewall Plaza 1820-1830 Turnpike St. North Andover, MA 01845 Contractor: GFM General Contracting Corp. 325 N. Main Street Unit 15-B Middleton, MA 01949 978-777-8007 978-777-5004 (fax) This letter is to confirm that I will be the architect of record on tenant fit -ups, architectural development of the existing shell from this date forward. I have been working for GFM as an employee since August 11, 2008 during which I have made numerous job -site visits with the owner, general contractor, sub -contractors and material suppliers. Professional Engineers supervised the construction of the structural, roof framing and other engineering disciplines required. In accordance with Chapter 1 section 116.0 of the Massachusetts State building code. I will be overseeing this project. If you should have any questions, please do not hesitate to contact me at 978-777-8007. ri�J vL Matthew A. Richard, ArchitecdtY-:e_V Architecture, Interior Design, Planners, Historic Preservation, Handicapped Accessibility Design Matthew A. Richard, Architect Iz---Z1_/0 -/� � M R DEVAL L. PATRICK GOVERNOR TIMOTHY P. MURRAY Commonwealth of Massachusetts LIEUTENANT GOVERNOR Division of Professional Licensure Gregory Bialecki Office of Investigation �i SECRETARY OF HOUSING AND ECONOMIC DEVELOPMENT 1000 Washington Street, Suite 710 Boston, Massachusetts 02118 - 6100 December 9, 2010 Mr. Peter Murphy Inspector of Wires Town of North Andover 1600 Osgood Street North Andover, Massachusetts 01845 RE: Docket No. EL -11-075 Board of Electricians (Complainant) vs. Stephan Decker (Unlicensed) Allegations: Performing Electrical Work for Hire with a Revoked License Property Location: 1820 Turnpike Street/Route 114, North Andover, Massachusetts Dear Mr, Murphy: BARBARA ANTHONY UNDERSECRETARY, OFFICE OF CONSUMER AFFAIRS & BUSINESS REGULATION GEORGE K. WEBER DIRECTOR, DIVISION OF PROFESSIONAL LICENSURE The Division of Professional Licensure ("DPL"), Office of Investigations ("OI"), is in the process of investigating allegations that Stephen Decker was performing an electrical installation at Stonewall Place located at 1820 Turnpike Street/Route 114, North Andover, Massachusetts. while being unlicensed as an electrician in the Commonwealth of Massachusetts. Background Information Regarding The Non Licensure of Mr. Decker: On or about May 14, 2008, the Massachusetts State Examiners of Electricians (the Board) revoked by administrative action the Massachusetts Journeyman electrician's license of Nr. Stepan Decker. It has come to the attention of the Office of Investigations that you witnessed Mr. Decker performing an electrical installation at the above captioned location without being under the direct supervision of a licensed electrician in the Commonwealth of Massachusetts. Enclosed is an Affidavit for you to review and sign. Please return the Affidavit to the Office of Investigations, in the self addressed envelope at your earliest possible convenience to my attention at: Richard G. Paris Compliance Officer Office of Investigations Division of Professional Licensure 1000 Washington Street, Suite 710 Boston, MA 02118 - 6100 TELEPHONE: 617-727-7406 FAX: 617-727-1944 TTY/TDD: 617.727.2099 http://www.mass.gov/dpi If you have any questions I can be reached at 617-727-6090. Thank you in advance for your assistance in this matter. Respectfully, 2� Richard G. Paris Compliance Officer Division of Professional Licensure Office of Investigation 1000 Washington Street, Suite 710 Boston, MA 02118 - 6100 Fax: 617-727-1944 Page 2 DEVAL L. PATRICK GOVERNOR TIMOTHY P. MURRAY LIEUTENANT GOVERNOR Commonwealth of Massachusetts Division of Professional Licensure Gregory Bialecki Office of Investigation SECRETARY OF HOUSING AND ECONOMIC DEVELOPMENT 1000 Washington Street, Suite 710 Boston, Massachusetts 02118 - 6100 December 16, 2010 Mr. Peter Murphy Inspector of Wires Town of North Andover 1600 Osgood Street North Andover, Massachusetts 01845 RE: Docket No. EL -11-075 Board of Electricians (Complainant) vs. Stephan Decker (Unlicensed) Allegations: Performing Electrical Work for Hire with a Revoked License Property Location: 1820 Turnpike Street/Route 114, North Andover, Massachusetts Dear Mr. Murphy: BARBARA ANTHONY UNDERSECRETARY, OFFICE OF CONSUMER AFFAIRS & BUSINESS REGULATION GEORGE K. WEBER DIRECTOR, DIVISION OF PROFESSIONAL LICENSURE The Division of Professional Licensure ("DPL"), Office of Investigations ("OF), is in the process of investigating allegations that Stephen Decker was performing an electrical installation at Stonewall Place located at 1820 Turnpike Street/Route 114, North Andover, Massachusetts. while being unlicensed as an electrician in the Commonwealth of Massachusetts. Background Information Regarding The Non Licensure of Mr. Decker: On or about May 14, 2008, the Massachusetts State Examiners of Electricians (the Board) revoked by administrative action the Massachusetts Journeyman electrician's license of Mr. Stepan Decker. It has come to the attention of the Office of Investigations that you witnessed Mr. Decker performing an electrical installation at the above captioned location without being under the direct supervision of a licensed electrician in the Commonwealth of Massachusetts. Enclosed is an Affidavit for you to review and sign. Please return the Affidavit to the Office of Investigations, in the self addressed envelope at your earliest possible convenience to my attention at: Richard G. Paris Compliance Officer Office of Investigations Division of Professional Licensure 1000 Washington Street, Suite 710 Boston, MA 02118 - 6100 TELEPHONE: 617-727-7406 FAX: 617-727-1944 TTY/TDD: 617.727.2099 http://www.mass.gov/dpl If you have any questions I can be reached at 617-727-6090. Thank you in advance for your assistance in this matter. Respectfully, Richard G. Paris Compliance Officer Division of Professional Licensure Office of Investigation 1000 Washington Street, Suite 710 Boston, MA 02118 - 6100 Fax: 617-727-1944 Page 2 I - rf COMMONWEALTH OF MASSACHUSETTS AFFIDAVIT OF PETER MURPHY RE: Division of Professional Licensure ("DPL") Docket Number: EL -11-075 I, Peter Murphy, hereby depose and say upon personal knowledge as follows: 1. I am the Inspector of Wires for the Town of North Andover, Massachusetts. 2. On December 3, 2010, in my capacity as the Inspector of Wires for the Town of North Andover, Massachusetts, while performing an electrical inspection at the request of Stephan Decker (Massachusetts Electrical License Number License E 19737) at Stonewall Place located at 1820 Turnpike Street/Route 114 in North Andover, Massachusetts, I witnessed Stephan Decker performing electrical work without the supervision of a Licensed Electrician in the Commonwealth of Massachusetts. 3. At that time (December 3, 2010) Mr. Decker stated that his boss/employer, Licensee Hart is aware of the fact that he does not have an electrician's license. SIGNED UNDER THE PAINS AND PENALTIES OF PERJURY THIS 1 ' I� DAY OF December 2010. Peter Murphy Inspector of Wires, Town of Nort ndover +' P. 1 J ( Communication Result Report ( Dec,17. 2010 8:26AM) 2) Date/Time: Dec,17. 2010 8:25AM File Page No. Mode Destination Pg (s) Result Not Sent ---------------------------------------------------------------------------------------------------- 1583 Memory TX 16177271944 P. 1 OK ---------------------------------------------------------------------------------------------------- Reasonfor error E. 1) Hang up or line fail E.2) Busy E.3) No answer E.4) No fats im'i 1 e connection E.5) Exceeded max. E—mail size COMMONWEALTH OF MASSACHUSETTS AEEWAVIT OF PETER M[7 PHy RE: Division ofProfcssionalLicensuroP'DPL')Docket Numbeh;PL-1 1-075 I, Peter Murphy, hereby depose and Say upon personal knowledge as follows: L Iran the Inspector of Wires for the Town of Narth Andover, Massachusetts. 2. On December 3, 2010, in my capacity as the Inspector of Wires for the Town ofNarth Andover, Massachusetts, while petfmming an electrical inspection at the request of Stephan Decker (Massaclmsetts Electrical License Number License E 19737) at Stonewall Place located at 1820 Turnpike StreeNRoute 114 in North Andover, Massachusetts, I witnessed Stephan Decker performing electrical work without the supervision of a licensed Electrician in the Comrmnwealth of Massselmetts. 3. At that time (December 3, 2010) Mr. Decker stated that his boWamploM licensee Hatt Is aware oflhc fact that he does not have an electrician's license. SIGNED UNDER THE PAINS AND PENALTIES OF PERJURY THIS 1'L DAY OF Dceember 2010. Peter Mutphy Inspector of Wins, Town of Non ver Murphy, Peter From: Murphy, Peter Sent: Thursday, December 16, 2010 8:10 AM To: 'ckbinc@ckbinc.net' Subject: 1820 Turnpike st Mr. Hart, I have received your letter, RE: 1820 turnpike street, my records indicate permits # 8816, 9768, 9773 have been finalized for CKB INC. The permits that are in the process of take- over are permit # 9769, 9770, 9771, 9772 and one for service work - additional meter bank positions due to be applied for shortly. Please supply me with a new letter reflecting above information. Thank You, North Andover Electrical inspector Peter Murphy 12/28/10 TUE 13:17 FAX 97606UOUZO �•�� �' r '...> r CKB INC P.O. Box 2062 Salem, NH 03079 Phone: (603) 894-5820 (978) 6850301 Fax: (978) 689-8628 email: ckbinc@ckinc_net 17th December 2010 Town of North Andover Building Department 1600 Osgood Streer North Andover, MA 0184.5 atcn: Electrical Inspector Peter Murphy re: 1820 Turnpike Streer In response to your email of December 16rh were writing chis letter to inform you that we have left the job at the above referenced job site. We informed the property owncr;i, Giuseppe & Sons, last week chat we arc no longer going to be working chert, and he is arranging to employ another contractor to finish the job off. We are vacating, the standing electrical permits, numbers 9769, 9770, 9771, 9772 as well, as the one for the service work. If you have any other questions please dont hesitate to Gall. Sinccrely, _..- Ernest R. Hart M-Iss Electrical License #. 14361A CKB INC P.O. Box 2062 Salem, NH 03079 Phone: (603) 894-5820 (978)685-0301 Fax: (978) 689-8628 email: ckbinc(@ckbinc.net 10th December 2010 Town of North Andover Building Department 1600 Osgood Street North Andover, MA 01845 attn: Electrical Inspector Peter Murphy re: 1820 Turnpike Street We are writing this letter to inform you that we are leaving the job at the above referenced job site. We have informed the property owners, Giuseppe & Sons, that we are no longer going to be working there, and he is arranging to employ another contractor to finish the job off. We are vacating the standing electrical permit (permit #8816, issue date 6/10/09), a copy of which is attached to this letter. If you have any other questions please dorA hesitate to call. Sincerely, Ernest R. Hart Mass Electrical License #: 14361A )"...--.J� ? - I YW;�'J� R PermitsElec Permit # 1Clos(l Date I Owner i Lirpncp 8816 CL 6/10/2009 TURNPIKE ST 1820 14361A 9768 CL 11/15/2010 TURNPIKE ST 1820 14361A 9769 11/15/2010 TURNPIKE ST 1820 14361A 9770 11/15/2010 TURNPIKE ST 1820 14361A 9771 1 11/15/2010 TURNPIKE ST 1820 14361A 9772 11/15/2010 TURNPIKE ST 1820 14361A 9773 ICL 11/15/2010 TURNPIKE ST 1820 14361A Page 1 11/23/2010 P 1 Communication Result Report ( Nov•23. 2010 12:08PM) 2) Date/Time: Nov,23, 2010 12:04PM File Page No. Mode Destination Pg (S) Result Not Sent ---------------------------------------------------------------------------------------------------- 1429 Memory TX 16177271944 P, 8 OK ---------------------------------------------------------------------------------------------------- Reasonfor error E. 1) Hang up or line fail E.2) Busv E.3) No answer E.4) No facsimile connection E.5) Exceeded max. E—mail size Division of Professional Licenwre: License Such page 1 of 1 ILu ou6delwehxla ame oMRe RraRxuRd.AIMIm s EuxRlsss RandaRo� foC<avl Division of Professional Licensure McEtGee Mesc6arHme blttnb---- 641eemne 9Mm6 Homos VMSIM 01 Pry imd U—SUM, - Check AProfessional License lREAPI[y—r onmau xmesAfHrs 1; 9Y UIeIFY�mIa•PmM1�610n Rimm Svane ONLCN6agnV[CFS HEW SEARCH Qed[01it®e ApfrySif61<t __....._.—.._......._....._...._._._...______________.__._._.__......__......,._.__._�. LIELNiING BOARD TYPE C1aliReAad"ChcM IC./ LI[ED6Et'6 eUYE EIxYNTArE xr 1 EIaNTMe bma=1M1im ae[Itl0¢n �� [Id1E5T RN<Rf BmIFORp. µ1 [xreM I ncbsdm I{{{ �j97y� (LwS[srayAg[ CmIlstl V.Agmq pll<. aalticien 3pBA. NH Olrnit aBl•aBENCES a a6iA7ap INfV VA60 eb eha,CoenggrnrneerI, U10 Ne.6:l aHnre�slorlL Ummnexsep , TROSGp, Mo¢rtAal3•RDIGa1A:Rt:)d,xlZ OixtlaleleeHepe S. NI<'M�lia6lse Sealnfi06 Enfnff.. tpF ¢eR nmexary Help Oo UDereg Se More_. 9t0nTf vrvreeplylAae¢amuva9e Ste Pnfidp C—.1w SI.M" f8� Tvaw P&-+`_ s, owF/cam- gly'�8d�9u-irs ��/��� Division of Professional Licensure: License Search The Official Website of the Office of Consumer Affairs & Business Regulation (OCABR) Division of Professional Licensure Mass.Gov Home State Agencies State Online Services Home > Division of Professional Licensure > Check A Professional License By the Division of Professional Licensure NEW SEARCH LICENSING BOARD TYPE LIC. # LICENSEE'S NAME CITY/STATE STATUS Electricians i Journeyman Electrician 15422 ERNEST R HART BOXFORD MA Current Electricians Master Electrician 14361 ERNEST R HART SALEM, NH Current The page above has been generated by the Division of Professional Licensure web server on Tuesday, November 23, 2010 at 11:46:36 AM. © 2007 Commonwealth of Massachusetts Rc tc, 19 2-c-,) 7�tr`i-, F kPt�7 -s 14�-Mr--A Page 1 of 1 Mass.Gov SEARCH Office of Consumer Affairs %-A Search ONLINE SERVICES Check a License Locate a Licensed Professional Online Address Change Contact the Agency More... REFERENCES & RELATEDINFO Disclaimer Regarding Website License Searches Enforcement Process Glossary Help on License Search More... Site Policies Contact Us Site Map http://license.reg.state.ma.us/public/pubILicsn.asp?board code=EL&type_Class= A&lice... 11/23/2010 s Commonwealth ealth of Massachusetts Department of Fire Services - BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. Occupancy and Fee Checked tev. 1/07) (1ravP k1, 1A — APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC) 527 C R 12.00 (PLEASE PRINTININK OR TYPE ALL INFORMATION) Date: 40,9 City City or Town of: .th NORTH ANDOVER To e Inspector o Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number). /56 a2 0 w]p Jam, rT Sly--- 2'� "' f fJ�' Owner or Tenant G /C/I.iJ Telephone No. 9% 7%7'007 Owner's Address.�•2-� /V• /L/'AI,v �j,'" L%v,�- , Is this permit in conjunction with a building permit? Yes ❑ No LJ (Check Appropriate Box) Purpose of Building �f'�/C e � �, G.. Utility Authorization No. Existing Service Amps / Volts Overead ❑ Und rd-- ----- hg ❑ No, of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and.Ampacity Date . �4....za... d.?..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that . %' ........ ....................... has permission to perform ............................................... f wiring in the building of ....:-�I ....:. ..................................................... 12 n....... ...............*............ ...........:-.......... North Andover, Mass. Fee...% na5...�. Lic. No. /r�-............. L ;..,r. . EL CTRICAL INSPECTOR Check ti �,pe table may be waived by the Inspector of Wires. No. of Total Transformers KVA Generators KVA o. o mergency zg .Bg ette Units - FIRE PAIS Na. of Zones No. of Detection and Initiatin Devices No. of Alerting Devices No, of Self -Contained Detection/Alerting Devices Local ❑ Mumcipal Connection ❑ Other Security Systems: No. of Devices or E uivalent Data Wiring: No. of Devices or E uivalent Telecommunications Wiring: No. of Devices or Eouivalent desired, or as required by the Inspector of Wires. 1 �L(. _ �� cipal policy.) INS CE COVERAGE: Unless waived by the o - EC Rule 10, and upon completion. the licens permit for the performance of electrical work may issue unless so ce mcluding "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:) I certify, under the pains and penalties o er u that the information on this application is true and complete - FIRM lete. fP .1 +1', PP P FIRM NAME: LIC. NO.: Licensee: 45,ZA1&,r------ i gnatuz e (If applicable, enter "exemypt " in the license number li Address: �a L s s ems, SAS n/G C *Per M.G.L C. 147, S. 57-61, security wo requires Department of public OWNER'S INSURANCE WAIVER: I am required by law. By my signature below, I hereby waive this requirement. Owner/Agent Signature Telephone No. _f LIC. NO.: Bus. Tel. No.: �' Alt. Tel. No.: 92 88®� .- iaf "S" License: Lic. No. not have the liability insurance coverage normally I am the (check one) ❑ owner ❑ owner's agent. PERMIT FEE. &;,?. n�S ^> C.?OI'VlYYloruvea tl1 6 c'�IQ,S.SLICI'EllSGtt,S' GD epar•tment. (11 ire <SerUrce,s BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. 7 b O / r� _i --- Occupancy and Fee Checked [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with thMassachusetts ElectricalCode (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: f��� City or Town of: x^i�r-;. ;, .t�?c��r.;� �',: To the tns ector of Wires: By this application the undersigned gives notic of his or her intention to perform the electrical al work described below. Location (Street & Number) Owner or Tenant Telephone No. Owners Address z` ,/��� �, � aC %% Is this permit in conjunction with a building permit? Yes 0� No ❑ Purpose of Building Utility Autho 9768 Date ...... °o- TOWN OF NORTH ANDOVER 9 „ PERMIT FOR WIRING This certifies that has permission to perform ............ `,. 7. ` .............................................. wiring in the building of ......�� !' ,%zip.... !�e�....................................... at ....1 ?fP.......T. 4-, C - ,, S% North Andover, Mass. Fee.. �.Zg.. !077e=_' r : Lic. No..'�l3 %... 4, I¢ .................... . . n 116(- � ELECTRICAL INSPECTOR Check tf (Check Appropriate Box) tion No. N No. of Meters ❑ No. of Meters )Ie may be waived by the Inspector of Wires. isformers - KVA erators KVA pry Units ALARMS No. of Zones Initiating Devices l of Alerting Devices /Alerting Devices Municipa Connection ❑ Other of Devices or Equivalent Wiring: i. of Devices or Equivalent ommunications Wiring: �. of Devices or Equivalent Attach additional detailif desired, or as required by the Inspector of Wires. Estimated Value of Electrical Wor Gt'/Gfj_.(When required by municipal po!icy.) Work to Start: Inspections to be requestd in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for thqgerformance of electrical work may issue unless the licensee provides proof of liability insurance including "compled operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, aohhas exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Ef BOND ❑ OTHER I certify, under the pains and penalties of perjury, that th e information on this application is true and complete. FIRM NAME: (:KR Dior.+�,,, I�. p Licensee: Ernest R. Hart v LIC. NO.: Signature-! c —�` - ��'� LIC. NO.: 1 4 3 6 1 A (If applicable, enter "exempt" in the I' a num e.) Address: P.O. Box 206 alem NH 0307 Bus. Tel. No.: _(978) 685-0301 *Per M.G.L. c. 147, s. 57-61, se q1y worlil2qWffes.epartment of Public Safety "S" License: Alt.cel. No..- (978) 809-2600 OWNER'S INSURANCE WAIVER: I am aware that the Licenseedoes not havethe liability insurance coverage normally required by law. By my signature below, I herEby waive this requirement. I am the (check one[- owner El owner's agent. Owner/Agent Sinnature — __- _ Telephone No. I PERMIT FFP• t k, =rnl= (,01T11'r10nu)eaLt`r o ! e fassac4usett•5 'Department ol ire (Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. 77 Occupancy and Fee Checked ev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with thMassachusetts ElectricalCode (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 6 ,� City or Town of:`�.-:.- To the I nsp ctor of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street &Number) 0-,«;-I Owner or Tenant'W �`, /�' /'.•i' l....,,Yf d`� Telephone No 47-1..>r,..:. Owners Address �,:7 ' �•�/:icy, j t Is this permit in conjunction with a bung permit? Yes building ® No ❑ (Check Appropriate Box) Purpose of Building 3 . i 16 6 v, Utility Authorization No. Existing Service---- :-- ,&LO Amps 14,,-, /� Volts Overhead ❑ Und rd g No. of Meters New Service Amps / Volts OverheadUnd rd ❑ g ❑ No. of Meters Number of Feeders and Ampacity 7ble may be waived b the InsRector of Wires. J Date ......�..�....... � . o t Tota nsformers - KVA t NORTH, ' nerators KVA TOWN OF NORTH ANDOVER o mergency ig mg PERMIT FOR WIRING tteryUnits E ALARMS No. of Zones ot Detection an SACH S Initiating2 Devices �' , �ss�cMusE� of Alerting Devices This certifies that ...............i!...........................................CC �f1 c��`°r`. o Se -Contained __ff�.... Rection/Alertin Devices has permission to perform ........ .`...7....�f......... �K.`.la'�.......al Muni cipa ❑ �J ' ""' Connection Other wiring in the building of . �.....1, Q/�. - urity Systems:* ... ................................................ .................................... If :1No. of Devices or Equivalent Z D UCL �/ h 5 �— rth Andover Mass. la Wiring - at .......I:....................................................................... , 7No. of Dvices or Equivalent Fee....! ZS"""� . Lic. No. 3(�. �/ c munications Wiring: " NSPEcrORo of Devices or E«uivalent Check # ( Z�S' ;1 i or as required by the Inspector of Wires. •- > _, yy�l ., .. ule 10, and upon completion. the icenset vides _... n- n s sive y t e owner, no per or th(performance of electrical work may issue unless the licenseeui�s ratic-e-iracl " et] operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, a;hhas exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Ef BOND ❑ OTHER I certify, under the pains and penalties of perjury, that th e information on this application is true and com lete. FIRM NAME: CKB Electric Inc. p LIC. NO.: Licensee: Ernest R. Hart _ Signature_ c=� �� LIC. NO.: 1 4 3 6 1 A (If applicable, enter "exempt" in the license number line.) Address: P.O. Box 2062 Salem NH 03079 Bus. Tel. No.: (9781685-0301 *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Alt. LIC. Nl. No (978) 809-2600 0. OWNER'S INSURANCE WAIVER: I am aware that the Licenseedoes not havethe liability insurance coverage normally required by law. By my signature below, I herdby waive this requirement. I am the (check one[] owner ❑owner's agent. Owner/Agent _ Signature __ Telephone No. I PFRMIT GGc. e Y C,01TInIonwea to Or e:1 aQ-Yacflusetts 61)erartmierd of `,',ire (-Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No._ - Occupancy and Fee Checked [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with thMassachusetts Electrical Code EC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: t City or Town of: :.fr '%; ,>S,7',.�.�; To the I n pecto of Wires: �'.% r� By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Owner or Tenant Owner's Address _ ¢" Telephone No.rf�'; �„�....` -- -•> ' x� �'! ; ! ✓7 /� Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) - Purpose of Building �1;z�:: �� Utility Authorization No. Existing Service ------ Amps / . Volts Overhead ❑ Und rd F-19 Q No. of Meters ”" ' No. of Meters I 9.7 `l � _ Date ........... .......1. S-- -• f AORT,l Of ".0 �'-�•"° TOWN OF NORTH ANDOVERiansformers � ble may be waived b the Ins ector of Wires. Tota - KVA PERMIT FOR WIRING ' mors KVA o mergency ig ing Units . o .�"; �,SSACMUatter E ALARMS No. of Zones This certifies that.................. •..........%/r�.�:................ and InitiatingDtlon Devices has permission to perform .....t� !., .... i/ /L ,. f j of Alerting Devices ... 1)b wiring in the building of ,Qtection/Alertin o Se -Containe Devices ....... at.... �� Z n r ► S,- cal Municipa onnec tion ❑Other ..7f .,...tkL ......••••••.......... ;7rth Andover, Mass. Fee... Z `- 7 3��/;� curity Systems:* No. of Devices or Equivalent Lic. No ..... ........................ eta Wiring: ELE RICALINSPECTOR Check No. of Devices or Equivalent #� J ecommunications Wiring: No. of Devices or E uivalent Estimated Value of Electri al Work: fid, or as required by the Inspector of Wires. F%� (When required by municipal policy.) Work to Start: (� Inspections to be requestd in accordance with MEC Rule 10, and upon completion. INSURANCE COV RAG Unless waived by the owner, no permit for thqDerformance of electrical work may issue unless the licensee provides proof of liability insurance including "compled operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, Ahas exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Ef BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: CKB Electric Inc. LIC. NO.: Licensee: Ernest R. Hart Signatur c� -"`� (If applicable, enter "exempt" in the license number line.) LIC. NO.: 1 4 3 6 1 A Address: P.O. Box 2062 Salem NH 03079 Bus. Tel. No.: X978) 685-0301 *Per M.G.L. c. 147,s. 57-61, security work requires Department of Public Safety "S" License: AI L c. No. o (978) 809-2600 r OWNER'S INSURANCE WAIVER: I am aware that the Licenseedoes not havethe 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 Sinnature - _. TelPnhnnn N- DCnnnrr rrr t 1 -; l_.�llr'm' onivea(M 0 j r."%—Y cfrusef! 61)epur•tment. o. `,,ire (Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. 411 Occupancy and Fee Checked_ lev.1/07) (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with thMassachusetts ElectricalCode (MEC 527 CMR)2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: (� G City or Town of: Z -4a(. > r., f - To the I nspec or of i res: C 'V`.✓ 1 L'� G Y By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) ! Owner or Tenant ' Owner's Address Telephone No.,9. � <• � t:./� fir' Is this permit in conjunction with a building permit? Yes Purpose of Building��- :.;, ® No ❑ (Check Appropriate Box) - -� �� �`•- � Utility Authorization No. Existing Service /Fief) Amps '"/ �' ";Volts Overhead ❑ Und rd g No. of Meters New Service 4f71j Amps / Volts Overhead _t -._ ❑ Undgrd ❑ No. of Meters 9769 Date ......�.......................... le may be waived by the Ins ec o Tota nsformers ^KVA TOWN OF NORTH ANDOVER erators KVA PERMIT FOR WIRING gencYTigfiTing o mer UnitsR ' E ALARMS No. of Zones �SSAcMusE� o Detection an G� InitiatingDevices This certifies that ................................... of Alerting Devices has permission to perform ...............! �//� o Se ntai ................................�fv!.. Co ne lection/AlertingDevices wiring in the buildingof .......! /°� �dr1......................................... al ❑ Connection ......�............. El Other u em * rity Syst s: at """"'��' z0 „ % !� 2'? fLt orth Andover, Mass. " o. of Devices or Equivalent F ................ Lic. No.3�a.%!...........<a Wiring: \10. of Devices or Equivalent ELE • RICALINSPECTOR �' % -firin: Check # 12 -go Vo. of Devices or Equivalgent of Wires. l �C required by the Inspector of Wires. , or as re ,, ,_:. � _:. •, licy.) yf F.1 Inspecti ns to be requestd in accordance with MEC Rule 10, and upon completion. issue INSURANCE COVE AGE. Unless waived by the owner, no permit for th(performance of electrical work may ise unless the licensee provides proof of liability insurance including "compled operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, Ahas exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [ff BOND ❑ OTHER I certify, under the pains and penalties of perjury, that th e information on this application is true and com FIRM NAME: CKB Electric Inc, plete. Licensee: Ernest R. Hart LIC. NO.: (If applicable, enter "exempt" in the license number line.) Signature c — LIC. NO.: Address: P.O. Box 2062 Salem NH 03079 _ 1 8 3 6 1 A *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety S' License: Bus. Tel. No.: - (978 685-03019-260 Lic. 1140. OWNER'S INSURANCE WAIVER: Alt. Tel. No.: (978) 809-2600 I am aware that the Licenseedoes not havethe liability insurance coverage normally required by law. By my signature below, I herEby waive this requirement. I am the (check onef ]owner Owner/Agent ❑ owner's agent. SinnaturP Telebhone_No_ PPRnntT C1:1- , I ��oinmonivea tl of 31 assachselts Department o f ire (Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. Occupancy and Fee Checked (Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with thMassachusetts Electrical Code (ME ), 527 CY 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: a City or Town of. ��' rr'�� n`r . ' ;, To By this application the undersigned gives noti e of his or her intention t perform heelectrical ts work described below. Location (Street & Number) 2 a Owner or Tenant_ Owner's Address Is this permit in conjunction with a building permit? Yes Purpose of Building s- �C. d- Fxistina Service 10(w Amps 97/1 elephone No.'., No ❑ (Check Appropriate Box) Utility Authorization No. Volts Overhead n Date ......1... 7. —'� �.......... TOWN OF NORTH ANDOVER A PERMIT FOR WIRING This certifies that ......................... CZ.:6-c %....... K ... ......... has permission to perform .......�' ..1. n /� .......................... .. wiring in the building of ........�`�...'.. �� at.... © 7 .c........5................................................... ( �. .............................................. , North Andover, Mass. Fee ...... zs.. .... Lic. No. �. . 6 �.! ........ � .. . ELECTRICAL INSPECTOR Check 11 I Uridq rd No. of Meters ❑ No. of Meters _ le ma be waived by the InsRector of Win o Tota nsformers - KVA nerators KVA <. o mergency Ig ing ter Units E ALARMS No. of Zones o Detection an Initiatin Devices Of Alerting Devices . o Se -Containe tection/Alertin Devices dal ❑ Municipa Connection ❑ Other uritySystems:* No. of Devices or E uivalent to Wiring: No. of Devices or Equivalent (.' ecommunications Wiring: No. of Devices or E uivalent Attach additional detailif desired, or as required by the Inspector of Wires. Estimated Value of ectric I Work: 00Zj '' _(When required by municipal policy.) Work to Start: j f ' 17j Inspections to be requestel in accordance with MEC Rule 10, and upon completion. INSURANCE COVE AGE: Unless waived by the owner, no permit for th(performance of electrical work may issue unless the licensee provides proof of liability insurance including "compled operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, adihas exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Ef BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that th e information on this application is true and complete. FIRM NAME: CKB Electric Inc. LIC. NO.: Licensee: Ernest R R. Hart Signature �_ (If applicable, enter "exempt" in the license number line.) LIC. NO.: 1 4 3 6 1 A Address: P.O. Box 2062 Salem NH 03079 Bus. Tel. No.: _(978) 685-0301 *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: AlL c. No.o.: (978) 809-2600 OWNER'S INSURANCE WAIVER: I am aware that the Licenseedoes not havethe liability insurance coverage normally required by law. By my signature below, I herdby waive this requirement. I am the (check one❑ owner ❑ owner's agent. Owner/Agent Sinnature Telephone No. I PFRMIT GGG• t s. I (,Mmonivealtf o/ '.was.scickuselts "Department ol 'ire (Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. % 7 0 Occupancy and Fee Checked— [Rev. 1/071 hecked[Rev.1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with thV18sachusetts Electrical Code ( C), 527 R 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: l l ('s i0 City or Town of: ° ac.>. ;� , �, c ,�.� To the'l nSo (tor Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) i'Z/ 3�`. Owner or Tenant � � /)� �',,.� � � Owner's Address';`!;' Telephone No.Z Is this permit in conjunction with a building permit? Yes ®' No ❑ (Check Appropriate Box) Purpose of Building %,.� 4, Utility Authorization No. Existing Service Z "`l Amps Volts Overhead ❑ Und rd g )E] No. of Meters New Service ; Amps / Volts Overhead ❑ Undrd r� g ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Pr oposed Electrical Wnrle• ble ma be waived by the InsRector of Wires. — ` � � � o. o Tota 9770. Date.....�.........�. �............. I ansformers - KVA nerators KV/{ NORTq o TOWN OF NORTH ANDOVER tte Unitsency ig mg p PERMIT FOR WIRING EALARMS No. of Zones • i ' o Detection an s Initiatin Devices sAcHus of Alerting Devices ..........lr,%." ......................... o Se-Containe cl This certifies that ... lection/Alertin Devices cip a n T has permission to perform ..... `.........U.J...............(�.w�r..••••••••®` al ❑ Muni C9 Connection ❑ Other urity Systems * wiring in the building of ....... ......... .... o. of Devices or E uivalent t� ..' !,. "a Wiring: at ... 2 p.... �.`4.. ! ........ S?........... North Andover, Mass. ices or Equivalent ommDunications Wiring Fee ...1 ................. Lie. No..�..` 3.6 �./'-�.......... o. of Devices or Equivalent EL CTRICALINSPBcrOR Check # (— u�®r asrequired by the Inspector of Wires. 1AV,U / ��%'��`� licy.) ale 10, and upon completion. ,�r�'t;-rriiif rorfli�er ormance of electrical work may issue unless —�e licensee provides proof of liability insurance including "compled operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, ahhas exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Ef BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that th e information on this application is true and complete. FIRM'NAME: CKB Electric Inc. Licensee: Ernest R. Hart Signature LIC. NO.; '� �� - (If applicable, enter "exempt" in the license number line.) LIC. NO.: 14 3 6 1 A Address: P.O. Box 2062 Salem NH 03079 Bus. Tel. No.: _(978) 685-0301 *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" Lice Alt. Tel. No.: (978) 809-2600 Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licenseedoes not havethe liability insurance coverage normally required by law. By my signature below, I herd:)y waive this requirement. I am the (check one[] owner ❑ owner's agent. Owner/Agent SinnaturP _ TelephoneNo. PERMIT FIT. t 7 a* --1t s Commonwealth ofMassachusetts lugDepartment of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. 07,s2`g Occupancy and Fee Checked [Rev. 1/071 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL All work to be performed in accordance with the Massachusetts Electrical Code (MEC) 527 CMR 12 00 WORK (PLEASEPR&TININKOR TYPEALL INFO TION) Date: j �, — 1(3 City or Town of: W' To the Inspector of Wires: By this application the undersi ed givesqno'eof his or her intention to perform the electrical work described below. Location (Street & Number) j 56' ,�o %-t— U t --j \t -*a6 t Owner or Tenant r--zty� ('0 �jp Telephone Noq 77%dC' % Owner's Address Z C •1'111 A i s -. z r— AA. ,I„1(__ ,-�._ _ . _ . _ Is this permit in conjunction with a building permit? Yes Purpose of Building ..C31-- g:�s f . 0 - No ❑ BLDG PERMIT # Utility Authorization No. Existing Service �vVAmps �, / Volts Overhead ❑ Nvw,4QPrvinn d f7A A— i C%jr,/zr_,i_ — . r—I 9828 Date... ...... j l'...... /D TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ................................... e ' `el �.�......._ ....QGQ. "�'��' fa... i j Uyi % �o/I '. has permission to perform ........................... �.�`.'%'<a.4 ................. wiring in the building of... �?".....(et.............................................. at . 12D Tv2k �/k ST ........................ . North Andover, Mass. Fee ..5......—.... Lic. No. t 1. UP.9.......... r.�. ..... ELEc RicAL INSPEcroA Check # 3 Undgrd R' No. of Meters Undgrd ❑ No. of Meters 1 I t -j 1Ilowing table may be waived by the Inspector of Wires_ 101 lransiormers KVA, Generators KVA ALARMS No. of Zones IINo. of Alerting Devices II Detection/Alerting Devices Local ❑ Municipal Connection ❑ Other Security Systems: * No. of Devices or Equivalent Data Wiring: No. of Devices or Equivalent Telecommunications Wiring: No. of Devices or Eauivalent - -• = _ :... w �iil if desired, or as required by the Inspector of Wires. �Bstunated.-W�eof Ele tr caT Work: (When required by municipal policy.) Work to Start: I;N rt) 1 C) Inspections to be requested in accordance with NEC 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:) a cerd, sender th pains and n tags OfPerjury, that the information o 'application is true and complef� FIRM N � � � �,S LIC. NO.: l ' Q Licensee: Signature �r57 (Ifapplicable enter `exe hi the lic nse number ine.) LIC. NO.: n4 Address: �, , ( Bus. Tel. No.:,to I Lj4D Sy To *Per M.G.L. c.147, s. 57 61, security work requires Dep ent of Public Safety "S" Licen Alt. LIC. oO.: 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.'FPERMIT FEE: $ dig tt � Commonwealth of Massachusetts Official Use Only MMM -Department ®f Fire Services Permit No. 'q `� qX BOARD OF FIRE PREVENTION REGULATIONSOccupancy 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 (1v1EC), 527 CMR 12.00 (PLEASE PRINT EV INK OR TYPE ALL INFO TION) Date: la _Q0 City or Town of: To the Inspector of Wires: By this application the undersi ed givesWn6tefhis or herention intto perform the electrical wor d ribe below. Location (Street & Number)_�, t � c �e � �"cL� yk .. Owner or Tenant Owner's Address a -I Wl Is this permit in conjunction with a building permit? Yes Rj' No ❑BLDG PERMIT # - - -i-.- -.-.7 No. m- 6rf Purpose of Building rnlYN TAeC�-k Co Utility Authorization No. Existing Service Amps Q0 /� olts Overhead ❑ Undgrd`�— New Service Amps U8 / Volts Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity 12, U AT"-- „fPrnnnQf,_jJR1FL.c%.frie91 Work: a',I A e, Date .....�. Z...-.. 2-2-- /G' /`_ : j''• °off TOWN OF NORTH ANDOVER _ PERMIT FOR WIRING This certifies that ................... has permission to perform ......Se -feat e. /. ....... .... wiring in the building of ..................6?sv5 T ............................. at .....(....h... U/ik Pik s; Fee ..� 2,`�„� Lie. No..8�7M/('..................... � orth Andover, Mass. ........; No. of Meters_ No. of Meters table may be waived by the Tn.enortnr of wis ELE ICAL INSPECTOR �/ Check # tail if desired, or. as required by the Inspector of Wires. municipal policy.) with MEC Rule 10, and upon completion. _: 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: INSURANCEBOND ❑ OTHER ❑ (Specify:) I cert, under t e pains an alties of perjury, that the information on a plication is true and complete, FIRM NAME: LIC. NO.. Licensee: Signature LIC. NO.: (If applicab nter " empt" in th�Iicense nu ber line.)Address: '®Bus. Tel. No.: veeAlt. Tel. No.:*Per M.G.L. c.147, s. 57-61, secrk requires partment of Public Safety "S" Licen LIC. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. 13y my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMITTEE: ,$ No. of� .... Total . - Transformers KVA, Generators KVA LE]o. o mergency Ig Ing Batteryits FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Alerting Devices W No. ofSelf-Contained Detection/Alertin Devices Local ❑ Municipal ❑Other Connection Security Systems:* No. of Devices or E uivalent Data Wiring: No. of Devices or E uivalent Telecommunications Wiring: No. of Devices or Equivalent ELE ICAL INSPECTOR �/ Check # tail if desired, or. as required by the Inspector of Wires. municipal policy.) with MEC Rule 10, and upon completion. _: 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: INSURANCEBOND ❑ OTHER ❑ (Specify:) I cert, under t e pains an alties of perjury, that the information on a plication is true and complete, FIRM NAME: LIC. NO.. Licensee: Signature LIC. NO.: (If applicab nter " empt" in th�Iicense nu ber line.)Address: '®Bus. Tel. No.: veeAlt. Tel. No.:*Per M.G.L. c.147, s. 57-61, secrk requires partment of Public Safety "S" Licen LIC. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. 13y my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMITTEE: ,$ Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 197-7 v BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/071 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 .ININK OR TYPEALL INFO TION) Date: t City or Town o£ 2' To the Inspector of Wires.' By this application the undersi ed gives not' e of his or her intention to perform the electrical work described below. Location (Street & Number) j e6 lotO Owner or Tenant r :p. Telephone NaPI`j' Owner's Address ��� h/113, t ti -�,«, It g ?A i� lP_ �'s��.I v� A Is this permit in conjunction Purpose of Building building permit? Existing Service? 006 Amps Volts 198`L7 X 504.71-1 Overhead . - ❑ BLDG PERMIT # Utility Authorization No. Overhead ❑ Undgrd ❑ No. of Meters Date..... .�......�D TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .............................................. U�/c 1 xt T 7A� E �d£1c ..... ati i has permission to perform OAS 77 wiring in the building of ...(,T /..........4:.d21;c............................................. at ............................. . North Andover, Mass. Fee .. �'T�. o ... Lic. No . b 31 T2 E EMICAL INSPECTOR Check # � �� Undgrd ❑ No. of Meters N -ti i^s Ci Mowing table may be waived by the Inrnectnr of W;,,v --`— `-- riiz�crczzaiiziiari�rl tart if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 14AZI 0 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE C RAGE: 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 cove ge is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE JM BOND ❑ OTHER ❑ (Specify:) I cert, under the ainsandpep494es ofperjury, that the information on this application is true and complete: FIRM NAME: � ,C s V''s LIC. NO.: l �Cj 'S (•� Licensee:Q�p�QI S �� Signature LIC. NO.: (If applicable, ter "e p�nthe icense umber l' e.) �� h` Address: � C� A r--, K C3 -0 Bus. Tel. No.- LigQ !S(:,7Z) *Per M.G.L. c.147, s. 57-61; security work requires Dep ent of Public Safety "S" Licen ,Alt. LIC. Nd 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: $ No. of Total. J Transformers KVA, I Generators KVA o. o mergency ig ting B-atteKy Units FIRE ALARMS No. of Zones No. of Detection and initiating Devices No. of Alerting Devices V.......... No. of Self -Contained Detection/Alertin Devices Local ❑ Municipal ❑ Other Connection Security Systems:* No. of Devices or Equivalent Data Wiring: No. of Devices or E uivalent Telecommunications Wiring: No. of Devices or Equivalent --`— `-- riiz�crczzaiiziiari�rl tart if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 14AZI 0 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE C RAGE: 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 cove ge is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE JM BOND ❑ OTHER ❑ (Specify:) I cert, under the ainsandpep494es ofperjury, that the information on this application is true and complete: FIRM NAME: � ,C s V''s LIC. NO.: l �Cj 'S (•� Licensee:Q�p�QI S �� Signature LIC. NO.: (If applicable, ter "e p�nthe icense umber l' e.) �� h` Address: � C� A r--, K C3 -0 Bus. Tel. No.- LigQ !S(:,7Z) *Per M.G.L. c.147, s. 57-61; security work requires Dep ent of Public Safety "S" Licen ,Alt. LIC. Nd 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: $ 9829 ('700mmonwealth or Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. 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 (MEC), 527 CMR 12.00 (PLEASEPRINTININKORTYPEALLINFO TION) Dater_ ® f City or Town s To the Inspector of Wires: By this application the underersi ed gives not' e of his or her intention to perform the electrical work described below. Location (Street �& Number) s Owner or Tenant & Owner's Address 1r� Is this permit in conjunction with a building permit? Yes Purpose of Building ,c� j —� G�,p A Telephone Noql& 7 771;3`7 No ❑ BLDG PERMIT # Utility Authorization No. Egistmg Service%C._h Amps / r Volts Overhead ❑ New Service 100 Amps 1 / 2gVolts Number of Feeders and Ampacity Overhead ❑ Date...12- ...../.v.-/ ig TOWN OF NORTH ANDOVER PERMIT FOR WIRING l This certifies that ............��.... LIA"V� has permission to perform ......? TV*,`1bNw % 77 f.........A........P,.......................................1..... wiring in the building of ..... cy'"�'/................................................................ at . ............ T �!t!P e `-� , North Andover, Mass. Fee .......� , o o.... Lic. No.............. /'I ........., .... ........... D 3q, E�xcr�uc� INs � Undgrd [' No. of Meters Undgrd ❑ No. of Meters t vmg table may be waived by the Inspector of Wires. No. of P +f I V1 Transformers K VA, Generators KVA ALARMS INo. of Zones of Alerting Devices No. of Devices or :a Wiring: No. of Devices or 'communications No. of Devices or ❑ Other Check # d-� it zfdesired, or as required by the Inspector o Wires. I unicipal policy.) f h MEC Rule 10, and upon completion. '� by e 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 � OND ❑ OTHER Sec' I cert, under the pains and Ities o.fPerJrY'u, that the information on th' Itcation is true and complete: FIRM NAME: �9•C < �� Licensee: LIC. NO,: S_� C �� Signature LIC. NO.: � r►.� (If applicable enter "exempt" in the license number line.) Address: 0 Bus. Tel. No.:1'nf I ? Alt. Tel. No.: *Per M.G.L. c.147, s. 57-61, security work requ es Department of Public Safety "S" Li cen LIC. o.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. 13y my signature below, I hereby waive this requirement. I' Owner/Agent amthe (check one) [] owner El owner's agent. Signature Telephone No. PERMIT FEE: $ Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked [Rev. 1107] (leave hlankl 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 PRINTW INK OR TYPE ALL INFO TION) Date: a �) p r City or Town o£ To the Inspector of Wires: By this application the undersi ed gives no ' e of his or her intention to perform the electrical work described below. . Location (Street c& Number)_ Owner or Tenant vu1 <-�p Telephone No-qj& j7 J •bc>' Owner's Address _yy�� f �-�' �� 2 Is this permit in conjunction with a building permit? Yes V Purpose of Building t!:3> No Lj BLDG PERMIT # Utility Authorization No. Existing Service Amps,Volts OverheadE] Undgrd ❑ New Service 100 Amps l 01-Z / ❑ Undgrd ❑ Volts Overhead 9526 Date .... I.. Z ./ n - /z) ................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ................. U, f / ...... � ....................... has permission to perform .....T��L'-2// �'� d� �--4�'' `T '0 ... 7 Z. ................. wiring in the building of... d op.......................:Sj......................... North Andover, Mass. Fee.. .....d.......... Lic. No. e ,Y 2 ELECTH Check # 13ICALINSPECT13&4_3 Wi CI No. of Meters No. of Meters _ A -e be waived by the Inspector of Wires. Generators KVA ALARMS INo. of Zones Initiating Devices of Alerting Devices Local ❑ Atuntcipal Connection ❑ Other No. of Devices or `a Wiring: . No. of Devices or "communications No, of Devices or tail if desired, or as required by the Inspector of Wires. municipal policy.) Work to Starti i Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE-NiTBOND ❑ OTHER ❑ (Specify:) I cert, under th ains and p ties ofperjury, that the information on this application is true and completes ]FIRM N C C � S Licensee: L Signature LIC. NO.: / O� (If applicable, enter "exe t" in the license number li e.) LIC. NO.: Address: �fety� Bus. Tel. No.: (nom L40 S�� b *Per M.G.L. c. 147,s. 57-61security work requires Depent of Public S" Licen Alt. Tel.LIC. N 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: $ -tA /S';o - /axv 'Ice e a t East Elevation Signs: Total Area: 33' x 99' = 2,970 sf 10% Allowed: = 29i7 sf 1 st Level: (12) x 1.5' = 1'8 sf (4) x 1 = 4 sf 2nd Level: (12) x 2' = 24 sf Total = 46 sf m 0 U � ct � O ct North Elevation Si ns• U� Total Area: 25'x146' = 3,650 SF 10% Allowed = 365 SF z 1st Level: kn M (9) x 2.5' = 23 SF 0 0 z o Q 0 CD � o a civ � � z U A i c .r H � G W � ` O � W o ` a r� U � i O z� West Elevation Signs: 4. a Total Area: 24' x 55' = 1,320 sf a 10% Allowed: = 132 sf 1 st Level: (12) x 1.5' = 18 sf W F 2nd Level: (12) x 21 24 sf �C C Total = 42 sf W �. Ot H A a b 3 � - Aluminum Gutter (tYP•) Note: Roof height to average finished grade is 42.28 feet, or 181.50 feet South Elevation Si ns: Total Area: 24' x 146'= 3,504 sf 10% Allowed: = 350 sf 1 st Level: 12' x 1.5'x (8) = 144 sf (9) x 1.5' = 14 sf 158 sf 2nd Level: 12'x2'x(8)= 172 sf Total = 330 sf o O � 0 V � � o Q o b a o w N � c z v' M o 0 o z � o Q o o a o w N � � z Q (� U a ?levation Sites: O m M U y CA r a O ami o rn �y 0 C.) 3 U W E; � cu cd 132 sf �M U NrA V ?levation Sites: area: 24'x 55'= 1,320 sf .11owed: = 132 sf vel: 4? 1.5' = 18 sf � ;vel: t'r1 21 24 sf ♦, 00 �, W = 42 sf00 a� r U 3 Q a b Q O i ,� Page I of I Project Locationnspector Name: Inspection Date 1820 Turnpike Street N Andover MA A Comerford 09/11/2008 roleName: I ime: Yveatner on ions: Stonewall Plaza 2:00 pm clear / 78° F Remarks SCOPE OF INSPECTION: This inspection is provided in accordance with Section 116.2.2 of the Massachusetts State Building Code to determine if the work is in general accordance with the designs and with standard practice. While reasonable care shall be exercised in performing these inspections, responsibility for conformance with the plans and specifications, compliance with safety regulations, means and methods of construction, and all activities and associated with control of the work shall lie with the Contractor. GENERAL OBSERVATIONS & FINDINGS: ■ Concrete placement in process at ground floor slab. ■ UTS on site for conc. slump and cylinder Testing. ■ Verified 5000 psi light weight concrete as specified. ■ General conformance checks of wire mesh steel reinforcing bars appeared as specified. RECOMMENDATIONS: 0 OF MqS 0 U O- C. COMERFO -' CIVIL r' NO. 417 ob��.c�ssQ/S T F- OVAL EN Page I of I Project / Location Inspector Name: Inspection Date 1820 Turnpike Street N Andover MA D. Comerford 09/23/2008 Project Name: I ime: Weatner on i ions: Stonewall Plaza 2:00 pm clear / 65° F Remarks SCOPE OF INSPECTION: This inspection is provided in accordance with Section 116.2.2 of the Massachusetts State Building Code to determine if the work is in general accordance with the designs and with standard practice. While reasonable care shall be exercised in performing these inspections, responsibility for conformance with the plans and specifications, compliance with safety regulations, means and methods of construction, and all activities and associated with control of the work shall lie with the Contractor. GENERAL OBSERVATIONS & FINDINGS: ■ Light gauge metal roof framing in process. — Bering walls 90% complete w/ roof rafter wok beginning ■ Noted header in bearing wall at center dormer on east side is spliced at 1/4 point. — Must be corrected. ■ Verified 16 Gage 50 ksi material for roof joists on site for conformance with 12005200-54 specified. ■ Intermediate blocking and bearing stiffeners required at bearing locations. ■ Masonry work at south stair tower nearing completion. Verified steel reinforcement and grouting procedures. RECOMMENDATIONS: Identified need to correct splice in header at east dormer w F. Fodera.- Issue to be corrected. OF M s VA COM RD y CI L No. 41725 A90 9,G�ST6P�o `<Q FESS/ONAL Pae 1 of 1 Project / Location Inspector Name: Inspection Date 1820 Turnpike Street N Andover MA A Comerford 10/07/2008 role ame: I ime: weatner on ions: Stonewall Plaza 3:00 pm clear / 60° F Remarks SCOPE OF INSPECTION: This inspection is provided in accordance with Section 116.2.2 of the Massachusetts State Building Code to determine if the work is in general accordance with the designs and with standard practice. While reasonable care shall be exercised in performing these inspections, responsibility for conformance with the plans and specifications, compliance with safety regulations, means and methods of construction, and all activities and associated with control of the work shall lie with the Contractor. GENERAL OBSERVATIONS & FINDINGS: ■ Light gauge metal roof framing in process continues. ■ Rafters for main roof section 90% complete. — Top Section (Flat Section) of mansard completed. ■ Center bearing partition for roof support has been installed ■ Spot check of material gage and depth used with specified found no exceptions. ■ Dormer framing at beginning stages. (Smaller dormers at north end) Work at large center dormers east & west has not begun. ■ Intermediate blocking and bearing stiffeners required at bearing locations. RECOMMENDATIONS: tH of 4140 G. COME RD -' CIVI in 9 No. 41726 'PVF FCIST01 s�/oruaL �N�\� Page I of I Project / Location Inspector Name: -7 Inspection Date 1820 Turnpike Street N Andover MA A Comerford 10/21/2008 roleName: I ime: weatner on ions: Stonewall Plaza 3:30 pm clear / 60° F Remarks SCOPE OF INSPECTION: This inspection is provided in accordance with Section 116.2.2 of the Massachusetts State Building Code to determine if the work is in general accordance with the designs and with standard practice. While reasonable care shall be exercised in performing these inspections, responsibility for conformance with the plans and specifications, compliance with safety regulations, means and methods of construction, and all activities and associated with control of the work shall lie with the Contractor. GENERAL OBSERVATIONS & FINDINGS: ■ Light gauge metal roof framing in process continues. Main dormer work in process. ■ Perimeter wall framing and approved sheathing work in process at first level. ■ Membrane flashing in place at brick veneer. ■ Verified fire retardant treated lumber for blocking at window openings RECOMMENDATIONS: V DFMAssq tai D- v C RD CI m .o ,¢ X10.417260 90.c• /STEP FSSIONAL Pae 1 of 1 Project /Location Inspector Name: Inspection Date 1820 Turnpike Street N Andover MA A Comerford [11/05/2008 roleName: I ime: Weather Conditions: Stonewall Plaza 9:30 am clear / 55° F Remarks SCOPE OF INSPECTION: This inspection is provided in accordance with Section 116.2.2 of the Massachusetts State Building Code to determine if the work is in general accordance with the designs and with standard practice. While reasonable care shall be exercised in performing these inspections, responsibility for conformance with the plans and specifications, compliance with safety regulations, means and methods of construction, and all activities and associated with control of the work shall lie with the Contractor. GENERAL OBSERVATIONS & FINDINGS: ■ Light gauge metal roof framing in nearing completion. ■ Identified location at top of perimeter bearing wall supporting roof framing which require bearing stiffeners and intermediate blocking for roof joists. ■ No roof sheathing in place at time of site visit. ■ Perimeter wall framing continues at ground floor. RECOMMENDATIONS: %1H Of !1).'G. COMER D CIVIL c' No. 41726 0 �a/STEPS SS�ONAL ENG December 21, 2007 GFM General Contracting Corp. Attn: Gino Fodera 325 North Main St., Unit 15B Middleton, MA 01949 Re: Stonewall Plaza,Turnpike Street N. Andover, MA - UTS - 11647 Dear Mr. Fodera, Thank you for this opportunity to work with you on this project. The following page is a report distribution list and billing address for the above referenced project, as provided to us. Please review this, making any corrections or additions as necessary. Please be aware that all of our reports are available as PDF files via email. This will ensure that all required parties receive reports from the start of this project. JnOUI(7 yC7U have any que51`iC3't iS, l.):t:dsc d€3 not he.~,,Ie_ ..o to contact t1hi:; o:: ice. Sincerely, UTS,of Massachusetts, Inc. Shirley Eat Secretary 5 Richardson Lane, Stoneham, Massachusetts 02180 -(781) 438-7755 Fax (781) 438-6216 Website: http://www.utsofmass.com - Email address: generaloffice@utsofmass.com ` - r..�i •... Re: Stonewall Plaza,Turnpike Street N. Andover, MA - UTS - 11647 Billing Address: GFM General Contracting Corp. Attn: Gino Fodera 325 North Main St., Unit 15B Middieto i, ivlA ii 1 S''r+Z'Y Report Distribution List: Name GFM General Contracting Corp. Phone No. 978-777-8007 Address Attn: Gino Fodera Fax No. 325 North Main St., Unit 15B Cell Phone No, Middleton, MA 01949 Email Address Reports Sent Via MAIL Name N. Andover Building Dept. Address Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Email Address Reports Sent Via MAIL Phone No. 978-688-9545 Fax No. Cell Phone No, 2 5 Richardson Lane, Stoneham, Massachusetts 02180 - (781) 438-7755 Fax (781) 438-6216 Website: http://www.utsofmass.com - Email address: generaloffice@utsofmass.com ` Of Massachusetts 'The Construction Testing People' Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Report Date 12/12/2007 Report No. 2 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benvento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 3000# 3/4" No. Of Sets: 2 CUBIC YARDS: 82 SFT 1 1 OrATInN• Footina. column 1 i ne H -,T At 1-1 g Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type G897 4 x 8 12.56 Good 12/12/2007 12/19/2007 7 25,000 1,990 3 G898 4 x 8 12.56 Good 12/12/2007 12/26/2007 14 37,000 2,950 2 G899 4 x 8 12.56 Good 12/12/2007 01/09/2008 28 G900 4 x 8 12.56 Good 12/12/2007 01/09/2008 28 G901 4 x 8 12.56 Good 12/12/2007 01/09/2008 28 SET 21OrATIr1N- Footina. column line r -F at 1 7S -i an Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type G892 1 4 x 8 12.56 Good 12/12/2007 12/19/2007 7 24,000 1,910 2 G893 4 x 8 12.56 Good 12/12/2007 12/26/2007 14 36,500 2,910 1 G894 4 x 8 12.56 Good 12/12/2007 01/09/2008 28 G895 4 x 8 12.56 Good 12/12/2007 01/09/2008 28 G896 4 x 8 12.56 Good 12/12/2007 01/09/2008 28 GENERAL REMARKS: Slump (in.) 4 3/4 Air Temp. (F.) 43 Conc Temp (F) 75 Truck No. 307 Ticket No. 6038 Time 12:45 Unit Wt Ibslcu ft Air Content (% Slump (in.) 4 1/2 Air Temp. (F.) 43 Conc Temp (F) 72 Truck No. 401 Ticket No. 6044 Time 2:05 Unit Wt lbs/cu ft Air Content (% Inspector Name Premium Time Hours Travel Time S. Phelan No Max Day 1 Hr (s) REVIEWED BY: Robert S . Granada FRACTURE TYPES r (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar rJak— AA Of Massachusetts he ■,i�� The Construction Testing Peoplem -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Concrete Field Report Report Date 12/21/2007 Report No. 2 Job Number 11647 N. Andover Building Dept. Project stonewall P1aza,Turnpike st,N.Andover Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Contractor GFM WEATHER: .TIME: CONTACT: SUMMARY: Transported 1 set of cylinders cast on 12/20/07 to the lab for testing. GENERAL REMARKS: Inspector Premium Travel Name Time Hours Time B. Chan No REVIEWED BY: William P. Crabtree / �Q Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 12/12/2007 Report No. 2 N. Andover Building Dept. Job Number 11647 Attn: Gerald A. Brown Project Stonewall plaza,Turnpike St,N.Andover 1600 Osgood Street N. Andover, MA 01845 Contractor GFM Concrete Co. Benvento .Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera Of Massachusetts 'The Construction Testing People' Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 12/12/2007 Report No. 2 N. Andover Building Dept. Job Number 11647 Attn: Gerald A. Brown Project Stonewall P1aza,Turnpike St,N.Andover 1600 Osgood Street N. Andover, MA 01845 Contractor GFM Concrete Co. Benvento FIELD SUMMARY REPORT Total Pour: Footing, column line A -J at 1-7 Method of Placement: ❑ Pump ❑X Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: © Vibrator ❑ Other Other: Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑X Field ❑ Other Placement Protection: © Thermal Blankets ❑ Heat ❑ None ❑ Other Slump Specification (in.) 4-6 Number of slumps out of specification reported to If rejected Approved by Remarks: LITS of Massachusetts, Inc. Page 4 5 Richardson Lane, Stoneham, MA 02180 781438-7755 (Voice) 781-438-6216 (Fax) N. Andover Building Dept. Report Date 12/12/2007 Attn: Gerald A. Brown Report No. 2 1600 Osgood Street Job Number 11647 N. Andover, MA 01845 Project Stonewall Plaza,Turnpike St,N.Andover Attachment Q AILY K'—N CF =r- r7 UF I- A7 7� 12414M-7 -iEMP.: 7AL YAF�DS: L t -;,-% .LK J-252901 n 7,:-� inc Za-,C I Ir"C; i i;rr e- cr, 111io. Cr 1 'A s n C. J A,r t 1 Cyh' it italm I, 2.po= 1 1apf=Q.- -1 L7 3F; Age. Of Massachusetts 'The Construction Testing People' -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 12/12/2007 Report No. 2 N. Andover Building Dept. Job Number 11647 Attn: Gerald A. Brown Project Stonewall P1aza,Turnpike St,N.Andover 1600 Osgood Street N. Andover, MA 01845 Contractor GFM Concrete Co. Benvento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 3000# 3/4" 1 No. Of Sets: 2 CUBIC YARDS: 82 SET 1 LOCATION- Footing, column line H -J at 1-1.6 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type G897 4 x 8 12.56 Good 12/12/2007 12/19/2007 7 25,000 1,990 3 G898 4 x 8 12.56 Good 12/12/2007 12/26/2007 14 G899 4 x 8 12.56 Good 12/12/2007 01/09/2008 28 G900 4 x 8 12.56 Good 12/12/2007 01/09/2008 28 G901 4 x 8 12.56 Good 12/12/2007 01/09/2008 28 SET 2 LOCATION: Footinq, column line C -F at 1 .7s-1 .4n Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type G892 4 x 8 12.56 Good 12/12/2007 12/19/2007 7 24,000 1,910 2 G893 4 x 8 12.56 Good 12/12/2007 12/26/2007 14 G894 4 x 8 12.56 Good 12/12/2007 01/09/2008 28 G895 4 x 8 12.56 Good 12/12/2007 1 01/09/2008 28 G896 4 x 8 12.56 Good 12/12/2007 01/09/2008 28 GENERAL REMARKS: Slump (in.) 4 3/4 Air Temp. (F.) 43 Conc Temp (F) 75 Truck No. 307 Ticket No. 6038 Time 12:45 Unit Wt lbs/cu ft Air Content (% Slump (in.) 4 1/2 Air Temp. (F.) 43 Conc Temp (F) 72 Truck No. 401 Ticket No. 6044 Time 2:05 Unit Wt lbs/cu ft Air Content (% Inspector Premium Travel Name Time I Hours Time S. Phelan No Max Day 1 Hr (s) REVIEWED BY: Robert S. Granada FRACTURE TYPES i �i (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 12/12/2007 Report No. 2 N. Andover Building Dept. Job Number 11647 Attn: Gerald A. Brown Project Stonewall P1aza,Turnpike St,N.Andover 1600 Osgood Street N. Andover, MA 01845 Contractor GFM Concrete Co. Benvento Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera Of Massachusetts!1t tai*�wThe Construction Testing Peoplem 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Page 3 Report Date 12/12/2007 Report No. 2 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete CO. Benvento FIELD SUMMARY REPORT Total Pour: Footing, column line A -J at 1-7 Method of Placement: ❑ Pump ❑X Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ® Vibrator ❑ Other Other: Cylinder Fabrication Location: © Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑X Field ❑ Other Placement Protection: ® Thermal Blankets ❑ Heat ❑ None ❑ Other Slump Specification (in.) 4-6 Number of slumps out of specification reported to If rejected Approved by Remarks: UTS of Massachusetts, Inc. Page 4 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) N. Andover Building Dept. Report Date 12/12/2007 Attn: Gerald A. Brown Report No. 2 1600 Osgood Street Job Number 11647 N. Andover, MA 01845 Project Stonewall Plaza,Turnpike St,N.Andover Attachment I - C 5-C C-NCF--: z�CU79 E 7 N" yvj E - Zz—": Inc- arc - 11110, Or CT rc. i r s 1 12^nc. 1 A, 1 '1 Cyhrck-r: a67 I c2i;Z10= -1 9-11-7 -AX 111!2aS ariff) � � e ■,ice iOf Massachusetts mThe Construction Testing 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Concrete Field Report N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 -Page 1 Report Date 12/14/2007 Report No. 1 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM WEATHER: .TIME: CONTACT: SUMMARY: Transported 2 sets of cylinders cast on 12/12/07 to the lab for testing. GENERAL REMARKS: Inspector Name Premium Time Hours Travel Time Rich Fogg No REVIEWED BY: William P. Crabtree 09C_1 Cs' Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. CC: GFM General Contracting Corp. Attn: Gino Fodera lld,;: Of Massachusetts � «� a ■.�. � The Construction Testing _ oplem cam. 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Reinforcing Steel Report N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 CONTACT: Gino Fodera .TIME OF INSPECTION: 9:30 AM Report Date 12/20/2007 Page 1 Report No. 1 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM TIME OF CONCRETE PLACEMENT: 9:35 AM SPECIFICATION: ASTM A615 Grade 40 Grade 60 X Grade 75 ASTM A616 Grade 50 Grade 60 ASTM A617 Grade 40 Grade 60 CONTRACT DRAWINGS:S1.02 REVISION NUMBER: DATED: 10/5/07 SHOP DRAWING(S): PROJECT SPECIFICATIONS: 03300 OTHER: DRAWINGS STAMPED: YES NO X AREA REVIEWED: Wall, column line J at 3-7, H -J at 0-1.25 ATTRIBUTES: REVIEWED Yes No _ Coverage (Top x Bottom x and/or Inside Face x Outside Face x ) X Clearance X Cleanliness (heavy rust, scale, mud, dirt, oil, etc. not permitted) X Bar Supports X Bar Spacing X Bar Quantity X Placement and tying X OX The details in the above described area(s) were complete at the time of this inspection. R The results of this inspection were discussed with the aforementioned contact persons prior to departure from the project site. GENERAL REMARKS: Inspector Premium Travel Name Time Hours Time S. Phelan No Of Massachusetts The Construction Testing People' Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Reinforcing Steel Report Report Date 12/20/2007 Report No. 1 Job Number 11647 N. Andover Building Dept. Attn: Gerald A. Brown project Stonewall P1aza,Turnpike St,N.Andover 1600 Osgood Street N. Andover, MA 01845 Contractor GFM REVIEWED BY: William P. Crabtree Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. Cc: GFM General Contracting Corp. Attn: Gino Fodera Of MassachusettswThe Construction Testing Peoplem -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street Report Date 12/20/2007 Report No. 1 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover N. Andover, MA 01845 Contractor GFM Concrete Co. Benvento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/4" 1 No. Of Sets: 1 CUBIC YARDS: 25 SET 1 LOCATION- Wall, column line J at 3-7 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type H816 4 x 8 12.56 Good 12/20/2007 12/27/2007 7 35,000 2,790 3 H817 4 x 8 12.56 Good 12/20/2007 01/03/2008 14 H818 4 x 8 12.56 Good 12/20/2007 01/17/2008 28 H819 4 x 8 12.56 Good 12/20/2007 01/17/2008 28 H820 4 x 8 12.56 Good 12/20/2007 01/17/2008 28 GENERAL REMARKS: Slump (in.) 4 1/2 Air Temp. (F.) 35 Conc Temp (F) 64 Truck No. 306 Ticket No. 6104 Time 9:35 Unit Wt lbs/cu ft Air Content M Inspector Name Premium Time Hours Travel Time S. Phelan No Min Day 1 Hr (s) REVIEWED BY: Robert S. Granada FRACTURE TYPES � II (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Our reports are available in PDF form via email. Please email us at reportsOutsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera Of MassachusettsmThe Construction Testing + Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Report Date 12/20/2007 Report No. 1 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benvento FIELD SUMMARY REPORT 'Total Pour: wall, column line J at 3-7, H -J at 0-1.25 Method of Placement: ❑ Pump ® Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ® Vibrator ❑ Other Other: Cylinder Fabrication Location: © Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑X Field ❑ Other Placement Protection: ❑ Thermal Blankets ❑ Heat ® None ❑ Other Slump Specification (in.) 5 Number of slumps out of specification reported to If rejected Approved by Remarks: UTS of Massachusetts, Inc. Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) N. Andover Building Dept. Report Date 12/20/2007 Attn: Gerald A. Brown Report No. 1 1600 Osgood Street .lob Number 11647 N. Andover, MA 01845 Project Stonewall Plaza,Turnpike St,N.Andover Attachment ii Ly �l C. �4 LTi l.:F `.t-., � ' I�r`A.�iE : S,ry.,_�l a�►z,A r r4G.:� � .>>l_ .9� AIR TEMP.: MP.: � .�" i <: 1 Ar_ YARC';.'S'_ �1S tint _-a : c iUi rr - -�!(IC ; .^c'C,Tir � i rr -^. S C ? - v mut v , Mir,utss f ie�c. j *,r i;i to i ii i� s �� - i-�' i �• � �,1+� �4 rel ! 1 ! I�•5 i I i �—i 1 ! ! o ! I 1 ' I ; 1 i I _ 7 ii Ly �l C. �4 LTi l.:F `.t-., � ' I�r`A.�iE : S,ry.,_�l a�►z,A r r4G.:� � .>>l_ .9� AIR TEMP.: MP.: � .�" i <: 1 Ar_ YARC';.'S'_ �1S tint _-a : c iUi rr - -�!(IC ; .^c'C,Tir � i rr -^. S C ? - v mut v , Mir,utss f ie�c. j *,r i;i to i ii i� s �� - i-�' i �• � �,1+� �4 rel ! 1 ! I�•5 i I i �—i 1 ! ! o ! I 1 ' I ; 1 i I i t 4 ! I � i t L . 11 •�Of MassachusettswThe Construction Testing Peoplew 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 -Page 1 Report Date 09/11/2008 Report No. 9 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 .ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/8" * I No. Of Sets: 4 CUBIC YARDS: 155 SFT 1 I nrAT1(1N- S.O.D.. Column line 1 at H. 1st floor Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type C902 4 x 8 12.56 Good 09/11/2008 09/18/2008 7 37,500 2,990 4 C903 4 x 8 12.56 Good 09/11/2008 09/25/2008 14 50,000 3,980 2 C904 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 67,000 5,330 2 C905 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 69,000 5,490 1 C906 1 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 65,000 5,180 2 SFT 2 MrATInN- S.O.D., column line 3 at J. 1st floor Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type C917 4 x 8 12.56 Good 09/11/2008 09/18/2008 7 35,000 2,790 3 C918 4 x 8 12.56 Good 09/11/2008 09/25/2008 14 46,000 3,660 2 C919 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 55,000 4,380 4 C920 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 57,000 4,540 3 C921 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 59,000 4,700 2 SFT 31(H_ATMN• S.O.D.. column line 5 at F. 1st flnnr Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type C912 4 x 8 12.56 Good 09/11/2008 09/18/2008 7 38,000 3,030 1 C913 4 x 8 12.56 Good 09/11/2008 09/25/2008 14 48,000 3,820 4 C914 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 58,000 4,620 1 C915 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 60,000 4,780 3 C916 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 1 .61,000 1 4,860 2 SET 4 LOCATION: S.O.D., column line 4 at G, 1st floor Slump (in.) 7 Air Temp. (F.) 62 Conc Temp (F) 73 Truck No. 309 Ticket No. 15024 Time 6 :15 Unit Wt lbs/cu ft Air Content M 121.0 Slump (in.) 7 Air Temp. (F.) 69 Conc Temp (F) 74 Truck No. 307 Ticket No. 10619 Time 7:20 Unit Wt lbs/cu ft Air Content M) Slump (in.) 7 Air Temp. (F.) 68 Conc Temp (F) 75 Truck No. 305 Ticket No. 10622 Time 8:00 Unit Wt lbs/cu ft Air Content M Of MassachusettsmThe Construction Testing Peoplem Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Report Date 09/11/2008 Report No. 9 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type C907 4 x 8 12.56 Good 09/11/2008 09/18/2008 7 36,000 2,870 2 C908 4 x 8 12.56 Good 09/11/2008 09/25/2008 14 49,000 3,900 2 C909 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 62,000 4,940 1 C910 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 60,000 4,780 4 C911 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 63,000 5,020 2 GENERAL REMARKS: * Lightweight _Slump (in.) 7 Air Temp. (F.) 64 Conc Temp (F) 73 Truck No. 304 Ticket No. 10626 Time 10:00 Unit Wt lbs/cu ft Air Content (%) Inspector Name Premium Time Hours Travel Time D. Montello No Max Day 1 Hr (s) REVIEWED BY: Robert S. Granada FRACTURE TYPES N II (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Our reports are available in PDF form via email. Please email us at reports®utsofmass.com for more information. CC: GFM General Contracting Corp. Gino Fodera Of Massachusetts 'The Construction Testing People' Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Report Date 09/11/2008 Report No. 9 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT Total Pour: S.O.D. , column line 1-7 at A -J Method of Placement: ® Pump ❑ Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ❑ Vibrator ® Other Other: motor screed Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑ Trailer ® Field ❑ Other Placement Protection: ❑ Thermal Blankets ❑ Heat ® None ❑ Other Slump Specification (in.) 4-7 Number of slumps out of specification reported to If rejected Approved by Remarks: Of Massachusetts 'The Construction Testing People' -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 09/04/2008 Gerald A. Brown Report No. 8 N. Andover Building Dept. Job Number 11647 1600 Osgood Street Project l Stonewall --PYdza,Turnpike St,N.Andover- N. Andover, MA 01845 - -- - - - - - Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 .ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/811 * I No. Of Sets: 4 CUBIC YARDS: 154 SET 1 LOCATION: S.O.D., column line J at 1, level 2 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type B300 4 x 8 12.56 Good 09/04/2008 09/11/2008 7 36,000 2,870 1 B301 4 x 8 12.56 Good 09/04/2008 09/18/2008 14 49,000 3,900 2 B302 4 x 8 12.56 Good 1 09/04/2008 10/02/2008 28 60,000 1 4,780 3 B303 4 x 8 12.56 Good 09/04/2008 10/02/2008. 28 58,000 4,620 2 B304 4 x 8 12.56 Good 09/04/2008 10/02/2008, 28-161,600 68,000 4,860 F 4 SET 21_OrATION• S.O.D., column line F at 4. level 2 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type B310 4 x 8 12.56 Good 09/04/2008 09/11/2008 7 51,000 4,060 3 B311 4 x 8 12.56 Good 09/04/2008 09/18/2008 14 53,000 4,220 1 B312 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 65,000 5,180 2 B313 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 67,000 5,330 2 B314 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 1 68,000 5,410 1 SFT 31OCATInN S.O.D., column line E at 7. level 2 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type B305 4 x 8 12.56 Good 09/04/2008 09/11/2008 7 38,000 3,030 2 B306 4 x 8 12..$6.. Good 09/04/2008 09/18/2008 14 51,000 4,060 1 2 B307 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 63,000 5,020 1 B308 4.x 8 _ 12.56 -----Goode 09/04/2008 10/02/2008 28 64;006 5,100 2 B309 4 x .6 - -12:56 —'Goo '09104/2008 10/02/2008 28 - 61;•600 I 4;660 4 _ SET 4 LOCATION: S.O.D., column line A at 6, level 2 Slump (in.) 7 1/2/6 Air Temp. (F.) 63 Conc Temp (F) 72 Truck No. 304 Ticket No. 10432 Time 6.:35 Unit Wt lbs/cu ft - - Air Content (%) Slump (in.) 8/6 1/2 Air Temp. (F.) 65 Conc Temp (F) 71 Truck No. 307 Ticket No. 10435 Time 7:30 Unit Wt lbs/cu ft - - Air Content M Slump (in.) 5 Air Temp. (F.) 74 Conc Temp (F) 72 Truck No. 205 Ticket No., - - 10441- Time- .. �: 8:35 - Unit W' t=lbs/cu ft - - Air Content M) Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Report Date 09/04/2008 Report No. 8 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type B295 4 x 8 12.56 Good 09/04/2008 09/11/2008 7 35,000 2,790 4 B296 4 x 8 12.56 Good 09/04/2008 09/18/2008 14 45,000 3,580 1 B297 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 57,000 4,540 1 B298 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 56,000 4,460 3 B299 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 53,000 4,220 2 GENERAL REMARKS: * Lightweight Slump (in.) 6 1/2 Air Temp. (F.) 77 Cone Temp (F) 73 Truck No. 207 Ticket No. 10448 Time 10 : 15 Unit Wt Ibs/cu ft Air Content (%) Inspector Name Premium Time Hours Travel Time D. Campolini �, .,...<. ., .. No Max bay., .. ..., 1 Hr (s) ... REVIEWED BY: Robert S. Granada FRACTURE TYPES (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. CC: GFM General Contracting Corp. Gino Fodera Of Massachusetts 'The Construction Testing People' Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Report Date 09/04/2008 Report No. 8 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT -Total Pour: S -0-D., column line A -J at 1-7, level 2 Method of Placement: ❑X Pump ❑ Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ❑ Vibrator ❑ Other Other: Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑X Field ❑ Other Placement Protection: ❑ Thermal Blankets E] Heat 0 one " Other Slump Specification (in.) 5-6 Number of slumps out of specification reported to If rejected Approved by Remarks: Slumps approved by Gino Fedora. Set #1 & #2: two slumps at truck discharge/end of hose. UTS of Massachusetts, Inc. Page 4 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Report Date 09/04/2008 Report No. s Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Attachment Of Massachusetts W. «The Construction Testing people" DAILY REPORT OF CONCRETE POUR Page # PROJECT NAME: ,�T"cN ,,, ALL k 4-1ji, PROJECT NO.: DATE:—q - 4 .- D S AIR TEMP.:43--TOTAL YARDS:_ / { LOCATION OF POUR:_ S o A -.T [� f— r) ► _ Load & Truck # Slump Inches Batching In Batching Out Time In Minutes Yards Concrete Temp. % of Air Ticket # No. of Cylinders � d 6 '3S ;%0 is 3o G:ao �.�fs 90 o� 35 ,,,3 p/ �:L�D g-00 A303 5� x:15 D� Q=O� 7_as V30 $: 6-6�' %D y y v Lcs 4 40 •�` �� 3 y '13 a o `7 ', 5 l�. i s V �r -TOR: C,I M r,,Lj-t41 REMARKS: dson Lane, Stoneham, Massachusetts 02180 (781) 438-7755 Fax (781) 438-6216 Of Massachusetts 'The Construction Testing People' -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 08/28/2008 Report No. 7 Gerald A. Brown N. Andover Building Dept. Job Number 11647 1600 Osgood Street Project Stonewall P1aza,Turnpike St,N.Andover N. Andover, MA 01845 Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 .ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/811 No. Of Sets: 4 CUBIC YARDS: 160 SET 1 LOCATION- S.O.D., 3rd floor, northeast corner Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type A393 4 x 8 12.56 Good 08/28/2008 09/04/2008 7 39,000 3,110 3 A394 4 x 8 12.56 Good 08/28/2008 09/11/2008 14 50,000 3,980 2 A395 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 67,000 5,330 2 A396 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 65,000 5,180 2 A397 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 70,000 5,570 4 SET 2 LOCATION- S.O.D., 3rd floor, southeast corner Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type A211 4 x 8 12.56 Good 08/28/2008 09/04/2008 7 40,000 3,180 3 A212 4 x 8 12.56 Good 08/28/2008 09/11/2008 14 50,000 3,980 3 A213 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 63,000 5,020 1 A214 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 64,000 5,100 4 A215 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 66,000 5,250 2 SFT 31nCATMW S.O.D.. 3rd floor. southeast corner Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type A216 4 x 8 12.56 Good 08/28/2008 09/04/2008 7 41,000 3,260 2 A217 4.x 8 12.56' Good`, 08/28/2008 09/11/2008 -14 51,000 4,060 2 A218 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 68,000 5,410 2 A219 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 67,000 5,330 1 A220 4 x 8 12.56 Good08/28/.2008 09/25/2008 28 65,000 5,180 2 71 SET 4 LOCATION: S.O.D., 3rd floor, northwest corner Slump (in.) 6 Air Temp. (F.) 70 Conc Temp (F) 76 Truck No. 304 Ticket No. 10775 Time 6:45 Unit Wt lbs/cu ft Air Content M) Slump (in.) 6 1/2 Air Temp. (F.) 70 Conc Temp (F) 77 Truck No. 207 Ticket No. 10280 Time 7:30 Unit Wt lbs/cu ft Air Content M Slump (in.) 6 3/4 Air Temp. (F.) 70 Conc Temp (F) 79 Truck No. 309 Ticket No. 10287 Time 8: 15 Unit Wt lbs/cu ft Air Content (%) > w .. .. .'AM!%fM1R!�l.'�I%afk"3. T.. +n Y [--w.. .. . ♦ - -+ iAAf/R.,..a.1' �+.. i •.tl .1Fu sLSY.i.�a+twaw`.✓Is:.sa�. .. ". .�. • �. i .6 t. �. .�rw . ^i. 'T 9iL'+raq^W^ ieoi fiM�OAMrFYIt '+moi.. v'F+ 1 w � .wr..s.naw< M�� z .+A �. �n.r�i ... « ' ♦ �. .-.. � . .��.,... �. > w .. .. .'AM!%fM1R!�l.'�I%afk"3. T.. +n Y [--w.. .. . ♦ - -+ iAAf/R.,..a.1' �+.. i •.tl .1Fu sLSY.i.�a+twaw`.✓Is:.sa�. .. ". .�. • �. i .6 t. �. .�rw . ^i. 'T 9iL'+raq^W^ ieoi fiM�OAMrFYIt '+moi.. v'F+ 1 w � .wr..s.naw< M�� z .+A �. �n.r�i ... « ' ♦ �. .-.. � . Of Massachusetts 'The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date Gerald A. Brown Report No. N. Andover Building Dept. Job Number 1600 Osgood Street Project N. Andover, MA 01845 Page 2 08/28/2008 7 11647 Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type A221 4 x 8 12.56 Good 08/28/2008 09/04/2008 7 38,000 3,030 4 A222 4 x 8 12.56 Good 08/28/2008 1 09/11/2008 14 47,000 3,740 3 A223 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 62,000 4,940 3 A224 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 63,000 5,020 2 A225 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 60,000 4,780 4 Slump (in.) 6 1/2 Air Temp. (F.) 75 Conc Temp (F) 80 Truck No. 309 Ticket No. 10299 Time 11: 00 Unit Wt lbs/cu ft Air Content (%) GENERAL REMARKS: *, Lightweight _ ;:'.,.,v'• Inspector Name Premium Time - - Hours Travel Time Jim Connolly: , : • ,:.., No Max -bay ......:..... . . .... 1 Hr (s) ., .. .: REVIEWED BY: Robert S. Granada FRACTURE TYPES 1 (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Gino Fodera Of Massachusetts -The Construction Testing People' Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Report Date 08/28/2008 Report No. 7 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT -Total Pour: S.O.D. , 3rd floor Method of Placement: ® Pump ❑ Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ❑ Vibrator ❑ Other Other: Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box [-].Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑X Field Other Placement Protection: []Thermal Blankets ❑ Heat ® None ❑ Other Slump Specification (in.) 5 = 6 Number of slumps out of specification reported to If rejected Approved by Remarks: Slumps and cylinders performed at truck discharge chute -1" slump loss at end of hose. UTS of Massachusetts, Inc. 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Attachment Page 4 Report Date 08/28/2008 Report No. 7 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Of "=mhusem Inc. MArm Construction 1r "f1tv Peo* 5 DAILY REPORT OF CONCRETE POUR Paae #_ PROJECT NAME.- 1g37z PROJECT NO.: DATE: AIR TEMP.: 90-5 :TOTAL YARDS:_ 160 LOCATION OF POUR: 'SOO 311A .01— I Load & Slump Batching Batching I Truck # Inches In Out c y) 6 _1 Time In M Minutes - Yards I Concrete I % of Tirc--kk-,-e--tt--:#�-t---TK-N-lI f Temp. ;Air Cvi*inders I t 96 0'v? 0() 73 9/ C1115 6 6,5-o NO Y60 Z-/0 I `1;Oo UO 60. 2v W CSS 110 C) i014 0 11 65 I A, 0 C) bO 10/1 2- o r-� 1 1!�125 1q, �0 l ot/ i _5- 1CX 3o?) !9' ->D CA L 6,57- 1160 Z,41.NSPECTOR:_i ial (aul 140 ILI REMARKS: I L Ichardson Lane. Stoneham. Massachusetts a2iaa Mli A2A.7741; Far (7241 A'AQ_r,*4a �Of Massachusetts 'The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Page 1 Report Date 09/11/2008 Report No. 9 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 .ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 _ CLASS CONCRETE: 4000# 3/8" No. Of Sets: 4 .CUBIC YARDS: 155 SET 1 LOCATION: S.O.D., column line 1 at H, 1st floor Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type C902 4 x 8 12.56 Good 09/11/2008 09/18/2008 7 37,500 2,990 4 C903 4 x 8 12.56 Good 09/11/2008 09/25/2008 14 50,000 3,980 2 •C904 4 x 8 12.56 Good 09/11/2008 10/09/2008. 28 C965 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 " C906 4 x •8. 12.56 Good 09/11/2008 10/09/2008 28 ti. Air Content (%) 121.0 SET 2LOCATION: S.O.D., column line 3 at J, 1st floor Lab No. Slump (in.) 7 Air Temp. (F.) 62 Conc Temp (F) 73 Date Cast Truck No. 309 Ticket No. 15024 - Time 6 : 15 - Unit Wt lbs/cu ft ti. Air Content (%) 121.0 SET 2LOCATION: S.O.D., column line 3 at J, 1st floor Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type C917 4 x 8 12.56 Good 09/11/2008 09/18/2008 7 35,000 2,790 3 C918 4 x 8 12.56 Good 09/11/2008 09/25/2008 14 46,000 3,660 2 C919 1 4 x 8 1 12.56 Good 09/11/2008 10/09/2008 28 C920 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 C921 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 SET 3 LOCATION- S.O.D., column line 5 at F, 1st floor Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type C912 4 x 8 12.56 Good 09/11/2008 09/18/2008 7 38,000 3,030 1 C913 1 4 x 8 12.56 Good 09/11/2008 09/25/2008 14 48,000 3,820 4 C914 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 C915 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 C916 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 SET 4 LOCATION: S.O.D., column line 4 at G, 1st floor Slump (in.) Slump (in.) 7 Air Temp. (F.) Air Temp. (F.) 69 Conc Temp (F) Conc Temp (F) 74 Truck No. 307 305 Ticket No. 10619 10622 Time 7:20 8: 00 Unit Wt lbs/cu ft Ait t (°/ ) C Slump (in.) 7 Air Temp. (F.) 68 Conc Temp (F) 75 Truck No. 305 Ticket No. 10622 Time 8: 00 Unit Wt lbs/cu ft Air Content (%) Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Report Date 09/11/2008 Report No. 9 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit. Load (psi.) ' Fracture Type C907 4 x 8 12.56 Good 09/11/2008 09/18/2008 7 36,000 2,870 2 C908 4 x 8 12.56 Good 09/11/2008 09/25/2008 14 49,000 3,900 2 C909 4 x 8 12.56 Good 09/11/2008 10/09/2008 1 28 C910 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 C911 4 x 8 12.56 Good 09/11/2008 10/09/2008 281 1 Slump (in.) 7 Air Temp. (F.) 64 Conc Temp (F) 73 Truck No. 304 Ticket No. 10626 Time 10:00 Unit Wt lbs/cu ft Air Content (%) c GENERAL REMARM * Lightweight Inspector Name PremiumTravel Time Hours Time D. No Day 1 Hr (s) REVIEWED BY: Robert S. Granada ; ti :..•, FRACTURE TYPES (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Gino Fodera " Of Massachusetts 'The Construction Testing People' Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Report Date 09/11/2008 Report No. 9 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT Total Pour: S.O.D. , column line 1-7 at A -J Method of Placement:®Pump ❑ Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ❑ Vibrator ® Other Other: motor screed Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑ Thermal BlanketHay/Straw El Trailer: X Field ❑ Other _ ,.. A ,... .,.. ._❑ ,4 ....., ® . Placement Protection: .[]Thermal Blankets ❑ Heat ® None ❑ Other Slump Specification (in.) 4-7 Number of slumps out of specification reported to If rejected Approved by Remarks: UTS of Massachusetts, Inc. Page 4 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Report Date 09/11/2008 Report No. 9 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Attachment .• Of Massachusetts Inc. "The Construction 'resting peop�" Page # DAILY REPORT OF CONCRETE POUR /ROJECTME:IrlrPROJECT NO.: DATE: �� ' �� S AIR TEMP.: �� TOTAL YARDS:__. ZrT LOCATION OF POUR: _ %- I Jv Load & Truck # Slump Inches Batching In Batching Out Time In Minutes Yards Concrete Temp. % of Air Ticket # No. of Cylinders a rK 6� HA f' ?f b I C -71 /G (G 7s'- T INSPECTOR:= j� _ � ��� '� REMARK&; �/ 5 Richardson Lane. Stoneham_ Mn- A9�StA l7Sta1 d4Q_77CG �,,,, ��s*� w�o_cn�� A R C H I T E C T S AM9 71 30 September 2008 Mr. Gerald Brown, Inspector of Buildings North Andover Town Offices 120 Main Street North Andover, MA 01845 Sir, I have reviewed the new tenant renovation work to create a driving school classroom and associated spaces at the AAA at 49 Orchard Hill Road (first floor) in North Andover and find that the work was performed in a manner consistent with the construction documents, and consistent with the applicable provisions of 780 CMR. Please let me know at your earliest convenience if there is more information you need to process the application for an occupancy permit, so that I may be able to provide it in a timely manner. CC: Gary Belanger, Andover Construction Company B egards, 6'A -.44V J E. Crowell AIA Deer Hill Architects LLC 4 0 L 0 W E L L S T R E E T P E A B 0 D Y, M A 0 1 9 6 0 T 9 7 8. 5 3 2. 8 6 6 0 F 9 7 8. 5 3 2. 3 1 3 0 Of Massachusetts mThe Construction Testing Peoplem -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Concrete Field Report Report Date 09/12/2008 Gerald A. Brown Report No. 9 N. Andover Building Dept. Job Number 11647 1600 Osgood Street Project Stonewall P1aza,Turnpike St,N.Andover N. Andover, MA 01845 Contractor GFM WEATHER: _TIME: CONTACT: SUMMARY: Transported four sets of cylinders cast on 09-11-08 to the lab for testing. GENERAL REMARKS: Inspector Name Premium Time Hours Travel Time Al McGillicuddy No REVIEWED BY: William P. Crabtree Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information.' cc: GFM General Contracting Corp. Gino Fodera � tie ■.fes � Of Massachusetts r .4 The Construction Testing Peoplew 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date Gerald A. Brown Report No. N. Andover Building Dept. Job Number 1600 Osgood Street Project N. Andover, MA 01845 Page 1 09/04/2008 8 11647 Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete CO. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 .ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/811 * I No. Of Sets: 4 CUBIC YARDS: 154 SET 1 LOCATION- S.O.D., column line ,7 at 1 _ 1 PVP1 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type B300 4 x 8 12.56 Good 09/04/2008 09/11/2008 7 36,000 2,870 1 B301 4 x 8 12.56 Good 09/04/2008 09/18/2008 14 49,000 3,900 2 B302 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 B303 4 x 8 12.56 Good 09/04/2008 10/02/2008 1 28 B304 4 x 8 12.56 Goode 09/04/2008 10/02/2008' 28 SET 2 LOCATION: S.O.D., column line F at 4, level 2 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type B310 4 x 8 12.56 Good 09/04/2008 09/11/2008 7 51,000 4,060 3 B311 4 x 8 12.56 Good 09/04/2008 09/18/2008 14 53,000 4,220 1 B312 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 B313 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 B314 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 SFT 3 1 OrATIOW S.O.D. . column line F. ;;t 7 1 a-1 1) Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type B305 1 4 x 8 12.56 Good 09/04/2008 09/11/2008 7 38,000 3,030 2 B306 4 x 8 12.56 Good 09/04/2008 09/18/2008 14 51,000 4,060 2 B307 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 B308 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 B309 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 SET 4 LOCATION: S.O.D., column line A at 6, level 2 Slump (in.) Air Temp. (F.) Conc Temp (F) Truck No. Ticket No. Time Unit Wt lbs/cu ft Air Content (%) 7 1/2/6 63 72 304 10432 6.:35 Slump (in.) 8/6 1/2; Air Temp. (F.) 65 Conc Temp (F) 71 Truck No. 307 Ticket No. 10435 Time 7:30 Unit Wt lbs/cu ft Air Content (W Slump (in.) 5 Air Temp. (F.) 74 Conc Temp (F) 72 Truck No. 205 Ticket No. 10441 Time 8:35 Unit Wt lbs/cu ft Air Content (%) Of Massachusetts Page 2 5 Richardson Lane, Stoneham, MA 02180 781438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Report Date 09/04/2008 Report No. 8 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type B295 4 x 8 12.56 Good 09/04/2008 09/11/2008 7 35,000 2,790 4 B296 4 x 8 12.56 Good 09/04/2008 09/18/2008 14 45,000 3,580 1 B297 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 B298 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 B299 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 GENERAL REMARKS: * Lightweight Slump (in.) 6 1/2 Air Temp. (F.) 77 Conc Temp (F) 73 Truck No. 207 Ticket No. 10448 Time 10 : 15 Unit Wt lbs/cu ft Air Content (%) Inspector Name Premium . Time Hours Travel Time D. Campolini " """"" No Max bay 1 Hr(s) REVIEWED BY: Robert S. Granada FRACTURE TYPES f II `5 (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GPM General Contracting Corp. Gino Fodera " Of Massachusetts The Construction Testing People' Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Report Date 09/04/2008 Report No. 8 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT Total Pour: S.O.D., column line A -J at 1-7, level 2 Method of Placement: © Pump ❑ Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ❑ Vibrator ❑ Other Other: Cylinder Fabrication Location: ❑X Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑X Field ❑ Other Placement Protection: []Thermal Blankets ❑ Heat ❑X None ❑ Other Slump Specification (in.) 5-6 Number of slumps out of specification reported to If rejected Approved by Remarks: Slumps approved by Gino Fedora. Set #1 & #2: two slumps at truck discharge/end of hose. UTS of Massachusetts, Inc. 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Attachment Page 4 Report Date 09/04/2008 Report No. a Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover a000000 , �. r, • A� ■�jy�� 0000F Ulu C ��' viii �i/ �►astingftopk Page # DAILY REPORTOF • PROJECT NAME_, 7rot4 P L4:g.A- PROJECT NO.: DATE: 9 - 4 ,-- 0'9 AIR TEMP.: -43 -TOTAL YARDS:__ LOCATION OF POUR: Load & Slump Truck # Inches Batching In Batching Out Time In Yards Concrete % of Minutes Ticket # No. of Temp. Air Cylinders 3y /0y 33 aj D�3s a -S. -30 ,3 303 L9 5� �:rs fi� P�0� ?=.3o gss y-- Gc5 r1 3 0 5_�� o 7:06lob 0 1.00 i0'. Ba D '0 34 17-3 .TOR- C m PpLj_L1 I REMARKS: dson lane, Stoneham, Massachusetts 021180 (781) 438-7755 Fax (781) 438-6216 .1Of Massachusetts � tie •,i��mThe Construction Testing PeopW 5 Richardson Lane, Stoneham, MA 02180 781438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Page 1 Report Date 09/11/2008 Report No. 9 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/81, * I No. Of Sets: 4 CUBIC YARDS: 155 SET 1 MrATInN° S.O.D., column line 1 at u_ lar flnn,^ Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type C902 4 x 8 12.56 Good 09/11/2008 09/18/2008 7 37,500 2,990 4 C903 4 x 8 12.56 Good 09/11/2008 09/25/2008 14 09/25/2008 14 C904 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 09/11/2008 10/09/2008 C905 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 Good 09/11/2008 C906 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 Good SET 2 LOCATION: S.O.D., column line 3 at J, 1st floor Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type C917 4 x 8 12.56 Good 09/11/2008 09/18/2008 7 35,000 2,790 3 C918 4 x 8 12.56 Good 09/11/2008 09/25/2008 14 C914 4 x 8 12.56 C919 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 4 x 8 12.56 Good C920 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 12.56 Good 09/11/2008 C921 4 x 812.56 Good 09/11/2008 10/09/2008 28 SET 3 MrATInN° S. O. D .. column line S At- F 1 at- f l Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type C912 4 x 8 12.56 Good 09/11/2008 09/18/2008 7 38,000 3,030 1 C913 4 x 8 12.56 Good 09/11/2008 09/25/2008 14 C914 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 C915 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 C916 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 SET 4 LOCATION: S.O.D. , column line 4 at G, 1st floor Slump (in.) 7 Air Temp. (F.) 62 Conc Temp (F) 73 Truck No. 309 Ticket No. 15024 Time 6:15 Unit Wt lbs/cu ft Air Content (%) 121.0 Slump (in.) 7 Air Temp. (F.) 69 Conc Temp (F) 74 Truck No. 307 Ticket No. 10619 Time 7:20 Unit Wt lbs/cu ft Air Content (%) Slump (in.) 7 Air Temp. (F.) 68 Conc Temp (F) 75 Truck No. 305 Ticket No. 10622 Time 8:00 Unit Wt lbs/cu ft Air Content M Of Massachusetts �The Construction Testing Peoplew Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Report Date 09/11/2008 Report No. 9 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type C907 4 x 8 12.56 Good 09/11/2008 09/18/2008 7 36,000 2,870 2 C908 4 x 8 12.56 Good 09/11/2008 09/25/2008 14 C909 4 x 8 12.56 Good 09/11/2008 1 10/09/2008 1 28 C910 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 C911 4 x 8 12.56 Good 09/11/2008 10/09/2008 28 GENERAL REMARKS: * Lightweight Slump (in.) 7 Air Temp. (F.) 64 Conc Temp (F) 73 Truck No. 304 Ticket No. 10626 Time 10:00 Unit Wt lbs/cu ft Air Content (%) Inspector Name Premium Time Hours Travel Time D. Monte11`0 No Max bay 7 .Hr(s) REVIEWED BY: Robert S. Granada FRACTURE TYPES i 1 (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. CC: GFM General Contracting Corp. Gino Fodera Of Massachusetts The Construction Testing People' Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 09/11/2008 Report No. 9 Gerald A. Brown N. Andover Building Dept. Job Number 11647 1600 Osgood Street Project Stonewall Plaza,Turnpike St,N.Andover N. Andover, MA 01845 Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT Total Pour: S.O.D., column line 1-7 at A -J Method of Placement: © Pump ❑ Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ❑ Vibrator ❑X Other Other: motor screed Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑X Field El Other ' Placement Protection: []Thermal Blankets ❑ Heat 0 None ❑ Other :.. .._ ._ Slump Specification (in.) --4-7 Number of slumps out of specification reported to If rejected Approved by Remarks: UTS of Massachusetts, Inc. 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Attachment Page 4 Report Date 09/11/2008 Report No. 9 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Of Mw&=husetts Inc. "'rhe Construction Test:" :oW # DAILY REPORT OF CONCRETE POUR Page /ROJECTME: - 1�nr PROJECT NO.: DATE: 2! – �>/ ' 0S AIR TEMP.: TOTAL YARDS:___ f� LOCATION OF POUR:/r,41- Load OUR: ; /- 1 ✓(7f / s' ; %�J .i Load & Truck # Slump Inches Batching In Batching Out Time In Minutes Yards Concrete Temp. % of Air Ticket # No. of Cylinders -;r ter` < G� r i & F-7 7 INSPECTOR: %� _���� REMARKy�i�i 5 Richardson Lane. Stoneham_ Maeeaehnao#c A04An 17SZ41 n,2a_,7-ye= V-- t -7041k wen_rn4& Of Massachusetts 'The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Reinforcing Steel Report Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 -Page 1 Report Date 09/11/2008 Report No. 7 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM CONTACT: Gino Fodera, GFM Premium Time Travel Hours Time _TIME OF INSPECTION: 6:00 AM No Min Day 1 Hr (s) TIME OF CONCRETE PLACEMENT: 6:30 AM SPECIFICATION: ASTM A615 Grade 40 Grade 60 X Grade 75 ASTM A616 Grade 50 Grade 60 ASTM A617 Grade 40 Grade 60 CONTRACT DRAWINGS: S1-5400 REVISION NUMBER: DATED: SHOP DRAWING(S): PROJECT SPECIFICATIONS: 03300 OTHER:'' DRAWINGS STAMPED: YES X NO AREA REVIEWED: p First floor slab on deck: lines A -D at 1-6,- -6;ATTRIBUTES: ATTRIBUTES: REVIEWED Yes No _ Coverage (Top x Bottom x and/or Inside Face x Outside Face x ) X Clearance X Cleanliness (heavy rust, scale, mud, dirt, oil, etc. not permitted) X Bar Supports X Bar Spacing X Bar Quantity - - — x .. Placement and tying X ❑X The details in the above described areas) were'complefe at the time of this inspection. , Q The results of this inspection were `discussed with the aforementioned contact persons prior to departure from the project site.,, GENERAL REMARKS: welded wire fabric was placed accordingly, without exception. Inspector Name Premium Time Travel Hours Time L. Bastoni No Min Day 1 Hr (s) Of Massachusetts 'The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Reinforcing Steel Report Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 .REVIEWED BY: William P. Crabtree Page 2 Report Date 09/11/2008 Report No. 7 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Our reports are available in PDF form via email. Please email us at reportsOutsofmass.com for more information. cc: GFM General Contracting Corp. Gino Fodera � Of Massachusetts �The Construction Testing Peoplem -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Reinforcing Steel Report Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Report Date 09/04/2008 Report No. 6 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Contractor GFM CONTACT: Gino Fodera _TIME OF INSPECTION: 6: 00 AM TIME OF CONCRETE PLACEMENT: 6:30 AM SPECIFICATION: ASTM A615 Grade 40 Grade 60 X Grade 75 ASTM A616 Grade 50 Grade 60 ASTM A617 Grade 40 Grade 60 CONTRACT DRAWINGS: S1 -S300 REVISION NUMBER: DATED: SHOP DRAWING(S): PROJECT SPECIFICATIONS: 03300 OTHER: -} F.% DRAWINGS STAMPED: YES X NO :Jo-,,�isn,j4 AREA REVIEWED: Welded wire fabric: 2nd floor, column line A -D at 1-6 ATTRIBUTES: REVIEWED Yes No _ Coverage (Top x Bottom x and/or Inside Face x Outside Face x ) X Clearance X Cleanliness (heavy rust, scale, mud, dirt, oil, etc. not permitted) X Bar Supports X Bar Spacing X Bar Quantity X Placement and tying AHA a. X x.' Thidetails in the above described area(s) were complete at the time of this inspection. he resultsof this inspection were discussed with the aforementioned contact persons prior to departure from the project site. GENERAL REMARKS: All welded wire fabric and reinforcinq steel placed accordinaly w; thn„r Pltr ant; nn Inspector Premium Travel Name Time Hours Time L. Bastoni No Of MassachusettsmThe Construction Testing PeopW-' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Reinforcing Steel Report Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 REVIEWED BY: William P. Crabtree Page 2 Report Date 09/04/2008 Report No. 6 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Contractor GFM yG/t Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Gino Fodera 1. �. . Of Massachusetts & It -- The Construction Testing Peoplem �,►dr4i� 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Structural Steel Inspection Report Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 -Page 1 Report Date 09/04/2008 Report No. 2 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Contacts: Gino Fodera - GMF, Inc. Description Of Details Inspected: Deck, bolts, shear stud connectors; Area Reviewed: Second floor: lines A -D, 1-6; Specification Reference Contract Drawing Reference: S1 -S300 Project Specification Reference: 05120 Shop Drawing Reference: Sketch Reference: Code Reference: AWS D1.1-06, AISC Other: Inspection Method © Visual ❑ Other: Type of Inspection: Verify: Deck Bolts Connectors Status Complete Complete Complete Qualifications yes yes yes Material Specification yes yes yes Material Grade yes yes yes Material Type yes yes yes Size yes yes yes Length yes yes yes Surface Preparation yes yes yes Coating yes yes yes Spacing yes yes yes Quantity yes yes yes ® -The details in the above described area(s) were complete at the time of this inspection. Q The results of this inspection were discussed with the aforementioned contact persons prior to departure from the project site. Marking Methodl a GENERAL REMARKS: No unacceptable conditions or 'practices observed.' Inspector Name Premium Time Hours Travel Time L. Bastoni No Min Day 1 Hr (s) ° Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781438-6216 (Fax) Structural Steel Inspection Report Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 ,REVIEWED BY: William P. Crabtree Report Date 09/04/2008 Report No. 2 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Our reports are available in PDF form via email. Please email us at reports®utsofmass.com for more information. cc: GFM General Contracting Corp. Gino Fodera " Of Massachusetts 'The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date Gerald A. Brown Report No. N. Andover Building Dept. Job Number 1600 Osgood Street Project N. Andover, MA 01845 -Page 1 08/28/2008 7 11647 Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 .ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/811 No. Of Sets: 4 CUBIC YARDS: 160 SFT I I [KATION- S.O.D.. 3rd floor. northeast cnrner Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type A393 4 x 8 12.56 Good 08/28/2008 09/04/2008 7 39,000 3,110 3 A394 4 x 8 12.56 Good 08/28/2008 09/11/2008 14 50,000 3,980 2 A395 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 A396 4 x 8 12.56 Good 08/28/2008 09/25/2008 28' - A397 4 x 8' 12.56 Good 08/28/2008 09/25/2008 28 SET 2 LOCATION- S.O.D. , 3rd floor. southeast corner Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type A211 4 x 8 12.56 Good 08/28/2008 09/04/2008 7 40,000 3,180 3 A212 4 x 8 12.56 Good 08/28/2008 09/11/2008 14 50,000 3,980 3 A213 4 x 8 1 12.56 1 Good 1 08/28/2008 09/25/2008 1 28 A2144 x 8 12.56 Good 08/28/2008 09/25/2008 28 - A215 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 SET 3 LOCATION- S.O.D. , 3rd floor. southeast cnrner Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type A216 4 x 8 12.56. _.Good-.., 08/28/2008 09/04/2008 7 41,000 3,260 2 A217 4 x 8 - -12.56 Good 08/28/2008 09/11/2008 14 51,000 4,060 2 A218 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 A219 4-x,8, , "12.56; Good OSJ;28/2008; 109/25/2008 28 - 3220- 9-z'S`" 1-12`:56' ; Good 08/28/2008_ 09/25/2008 28 SET 4 LOCATION: S.O.D. , 3rd floor, northwest corner Slump (in.) 6 Air Temp. (F.) 70 Conc Temp (F) 76 Truck No. 304 Ticket No. 10775 Time 6:45 Unit Wt Ibs/cu ft _ Air Content M Slump (in.) 6 1/2 Air Temp. (F.) 70 Conc Temp (F) 77 Truck No. 207 Ticket No. 10280 Time 7:30 Unit Wt lbs/cu ft _ Air Content M Slump (in.) 6 3/4 Air Temp. (F.) 70 Conc Temp (F) 79 _ Truck No. • 309 . - Ticket No. 10287 Tune, 1 8:15 iUnit Wt lbs/cu ft _ Air Content (%) Of Massachusetts 'The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Page 2 Report Date 08/28/2008 Report No. 7 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type A221 4 x 8 12.56 Good 08/28/2008 09/04/2008 7 38,000 3,030 4 A222 4 x 8 12.56 Good 08/28/2008 09/11/2008 14 47,000 3,740 3 A223 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 A224 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 A225 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 GENERAL REMARKS:. * Lightweight Slump (in.) 6 1/2 Air Temp. (F.) 75 Conc Temp (F) 80 Truck No. 309 Ticket No. 10299 Time 11:00 Unit Wt lbs/cu ft Air Content (%) Inspector ;+`q" : Name Premium Time Hours Travel Time Jim Connolly ' "' _ "'"` "�" `""' °' "' "' " No Max Day 1 Hr (s) REVIEWED BY: Robert S. Granada FRACTURE TYPES (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. Cc: GFM General Contracting Corp. Gino Fodera Of Massachusetts The Construction Testing People' Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 08/28/2008 Report No. 7 Gerald A. Brown N. Andover Building Dept. Job Number 11647 1600 Osgood Street Project Stonewall P1aza,Turnpike St,N.Andover N. Andover, MA 01845 Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT -Total Pour: S.O.D. , 3rd floor Method of Placement: ® Pump ❑ Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ❑ Vibrator ❑ Other Other: Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: [-]Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑X Field ❑ Other -. .. Placement Protection: []Thermal Blankets ❑ Heat ® None ❑ Other Slump Specification (in.) 576 Number of slumps out of specification reported to If rejected Approved by Remarks: Slumps and cylinders performed at truck discharge chute -1" slump loss at end of hose. LITS of Massachusetts, Inc. 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Attachment Page 4 Report Date 08/28/2008 Report No. 7 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Of Massachusetts Inc. 'The Construction Testi-sM peopw` DAILY REPORT OF CONCRETE POUR Paoev PROJECT NAME: 1`32Z T z4i fic PROJECT NO.: DATE: (;3 -29) n AIR TEMP.: 96 -s TOTAL YARDS:— LOCATION ARDS:LOCATION OF POUR: S(:2)0 3.,t _ 0", ! Load & Slump j Batching Batching Time In i Truck # I Inches I) Out Minutes Oq U` �j Z S� 1 ,-, • Z� i s Yards , 32 I Concrete 1 %of Ticket # Na. of Temp. ! Air I Winders 963o`t 10Z 6 i S9 6 i3 ( �r i J JZ I��c.l �� I nF �: J. .`�• ,c;,` .,O 11� f t II�ZBQ � i T ss 65 1 160 L10 (`l, IS�Pa 60 t�� i 15� 5 (� S i %C) I I 110f o C) bC) - s 16 2-0 I B Z5 Iq%� �11Z 3Ui I ��•5� i9<<(S 1160 s J INSPECTOR: iia, �Ovla I 1 REMARKS: Ichardson Lane, Stoneham. Massachusetts 02180 M11 A2A.774S R=r (7241 QZn-oZo4sz Of Massachusetts 'The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date Gerald A. Brown Report No. N. Andover Building Dept. Job Number 1600 Osgood Street Project N. Andover, MA 01845 Page 1 09/04/2008 8 11647 Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 .ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/811 No. Of Sets: 4 CUBIC YARDS: 154 SET 1 LOCATION- S.O.D., column line J at 1. level 2 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type B300 4 x 8 12.56 Good 09/04/2008 09/11/2008 7 36,000 2,870 1 B301 4 x 8 12.56 Good 09/04/2008 09/18/2008 14 B302 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 B303 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 B304 4 X 8 1 12.56 1 Good 09/04/2008 10/02/2008 28 SET 2 LOCATION- S.O.D., column line F at 4. level 2 -• ' Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type B310 4 x 8 12.56 Good 09/04/2008 09/11/2008 7 51,000 4,060 3 B311 4 x 8 12.56 Good 09/04/2008 09/18/2008 14 B312 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 B313 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 B314 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 SET 3 LOrATInN- S.O.D., column line E at 7. level 9 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load Obs.) Unit Load Fracture (psi.) Type B305 4 x 8 12.56 Good 09/04/2008 09/11/2008 7 38,000 3,030 2 B306 4 x 8 12.56 Good 09/04/2008 09/18/2008 14 B307 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 B308 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 B309 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 SET 4 LOCATION: S.O.D., column line A at 6, level 2 Slump (in.) 7 1/2/6 Air Temp. (F.) 63 Conc Temp (F) 72 Truck No. 304 Ticket No. 10432 Time 6:35 Unit Wt Ibs/cu ft Air Content (%) Slump (in.) 8/6 1/2 Air Temp. (F.) 65 Conc Temp (F) 71 Truck No. 307 Ticket No. 10435 Time 7:30 Unit Wt Ibs/cu ft Air Content M Slump (in.) 5 Air Temp. (F.) 74 Conc Temp (F) 72 Truck No. 205 Ticket No. 10441 Time 8:35 Unit Wt Ibs/cu ft Air Content M) :t Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Report Date 09/04/2008 Report No. 8 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type B295 4 x 8 12.56 Good 09/04/2008 09/11/2008 7 35,000 2,790 4 B296 4 x 8 12.56 Good 09/04/2008 09/18/2008 14 B297 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 B298 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 B299 1 4 x 8 12.56 Good 09/04/2008 10/02/2008 28 GENERAL REMARKS: * Lightweight Slump (in.) 6 1/2 Air Temp. (F.) 77 Conc Temp (F) 73 Truck No. 207 Ticket No. 10448 Time 10 :15 Unit Wt Ibs/cu ft Air Content (%) Inspector Name Premium Time Hours Travel Time D. Campolini `No`' Maz Day` 1 Hr(s) REVIEWED BY: Robert S. Granada FRACTURE TYPES (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Gino Fodera Of Massachusetts 'The Construction Testing People' Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Report Date 09/04/2008 Report No. 8 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT 'Total Pour: S.O.D. , column line A -J at 1-7, level 2 Method of Placement: ® Pump ❑ Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ❑ Vibrator []..Other Other: Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑X Field ❑ ...Other Placement Protection: [-]Thermal Blankets ❑ Heat ®'None ..: . -0 Other Slump Specification (in.) 5-6 Number of slumps out of specification reported to If rejected Approved by Remarks: slumps approved by Gino Fedora. Set 41 & #2: two slumps at truck discharge/end of hose. UTS of Massachusetts, Inc. 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Attachment Page 4 Report Date 09/04/2008 Report No. 8 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover r• Of rl=Whusetfs WC. M'rhe Construction TesthV Peop6-2 DAILY REPORT OF CONCRETE POUR Page # PROJECT NAME: Sr0146 u -,61-t- I)L 3. PROJECT NO.: DATE:—9 - 4 .- D S _AIR TEMP.:-43—TOTAL YARDS: LOCATION OF POUR: 6 p 0 t o _J: @ f_ r? L- a Load -&— Truck # Slump Inches Batching In Batching Out Time In Minutes Yards Concrete % of Ticket # No. of Temp. Air Cylinders a` S 35 4-5 30" lob 33 µ SS rl -- 3D go V D, Gos 303 ?:�� �S" y - --1 r7 _s-- 113 30 Boa qS % 104-14 0�L' .00 to,. 40 3 o :d5 IO:Io �5'� ,TOR:__D. C,4 f4 PLj I REMARKS: dson Lane, Stoneham, Massachusetts 02180 (781) 438-7755 Fax (781) 438-6216 Of MassachusettsmThe Construction Testing People- 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Structural Steel Inspection Report N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Contacts: Gino Fodera Report Date 08/28/2008 -Page 1 Report No. 1 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Contractor GFM Description Of Details Inspected: Deck, shear stud connectors; Area Reviewed: 'third floor: lines A -D, 1-6; Specification Reference Contract Drawing Reference S1 -S300 Project Specification Reference: 05120 Shop Drawing Reference: Sketch Reference: Code Reference: AWS D1.1-06, AISC Other: Inspection Method 0 Visual - ❑ Other: _.. . Type of Inspection: Verify: Deck Connectors Status Complete Complete Qualifications yes yes Material Specification yes yes Material Grade yes yes Material Type yes yes Size yes yes Length yes ys Surface Preparation yes yes Coating yes yes Spacing yes yes Quantity yes yes ❑X The details in the above described area(s) were,complete at the time of this inspection. The results of this inspection were-discussed.with the. -aforementioned contact persons prior to departure from the project site." Marking Method: GENERAL REMARKS: Deck and shear connectors were completed without exception. Inspector _ _ _ _ _ Premium Travel Name Time Hours Time L. Bastoni No Min Day 1 Hr (s) Of Massachusetts The Construction Testing People' Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Structural Steel Inspection Report N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 REVIEWED BY: William P. Crabtree Report Date 08/28/2008 Report No. 1 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM o C/ Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera 1• .F� .Of Massachusetts"The Construction Testing PeopW Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Reinforcing Steel Report N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 CONTACT: Gino Fodera, GFM Report Date 08/28/2008 Report No. 5 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Contractor GFM _TIME OF INSPECTION: 6:00 AM TIME OF CONCRETE PLACEMENT: Unscheduled SPECIFICATION: ASTM A615 Grade 40 Grade 60 X Grade 75 ASTM A616 Grade 50 Grade 60 ASTM A617 Grade 40 Grade 60 CONTRACT DRAWINGS: S1.1 REVISION NUMBER: DATED: SHOP DRAWING(S): PROJECT SPECIFICATIONS: 03300 OTHER: DRAWINGS STAMPED: YES X NO AREA REVIEWED: Third floor slab on deck: lines A -D, 1-6; ATTRIBUTES: REVIEWED Ye—__ s No _ Coverage (Top x Bottom x and/or Inside Face x Outside Face x ) X Clearance X Cleanliness (heavy rust, scale, mud, dirt, oil, etc. not permitted) X Bar Supports X Bar Spacing X Bar Quantity X Placement and tying X Q The details in the above described area(s) were complete at the time of this inspection. Q The results of this inspection were discussed with the aforementioned contact persons prior to departure from the project site. No reinforcing steel on edge of floor; contractor installed reinforcing steel prior to GENERAL REMARKS: concrete placement. All work is complete and acceptable. �JV - Of Massachusetts mThe Construction Testing Peoplem 5 Richardson Lane, Stoneham, MA 02180 781438-7755 (Voice) 781-438-6216 (Fax) Reinforcing Steel Report N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Page 2 Report Date 08/28/2008 Report No. 5 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Inspector Name Premium Time Hours Travel Time L. Bastoni No REVIEWED BY: William P. Crabtree K!t Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera UTS of Massachusetts, Inc. 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Attachment Page 4 Report Date 08/28/2008 Report No. 7 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Of Massachusetts Inc. ■TM`NCti ■ TeSfM-14 ft0*i Pane DAILY REPORT OF CONCRETE POUR V PROJECT NAME: 1? -Z L rpt f�c 5f _ PROJECT NO.: DATE: ZY) 0� AIR TEMP.: 96 S TOTAL YARDS:—.I 6C LOCATION OF POUR: Sd 0 -3"J -n"', Load & I Slump Batching Batching ' Time InI Truck # I Inches In . Out Minutes Yards G Concrete —% of ' Ticket # -No. of Temp. ! Air ! Cviinders 60 Ib Z S I9 ZU 1 SS 10/3 z ,59643 i C� 3 ' `�;3�oU f9�Lt I L 0 S 1/30 --J -5' � 6 5 1'76C) Z-/0 ! 06 60 U s 3cb i L� 5 g so bSJ i A-� ! 1 �. a IG-S►�� , ��ga. z -o a Z s ;q �O .;7 �2- I0 f i 30`1 :�%`��� . s 3 ss' 13 c6' �' 9 LIS So il"lyy I 10711 �0C�jfo.zs- 1t w bs- 16a I INSPECTOR:. i6l (auivlo I I REMARKS: Ichardson Lane. Stoneham. Massachusetts 02i80 M11 d2A-7745 Fa. r7R,1 &IM -no -In Of mThe Construction Testing Peoplem 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Report Date 08/28/2008 Report No. 7 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT Total Pour: S.O.D. , 3rd floor Method of Placement: ® Pump ❑ Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ❑ Vibrator ❑ Other Other: Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑i.Trailer ❑X Field ❑ Other,..r , PlacementProtection: ❑Thermal Blankets ❑ Heat ® None kq ~Slump Specification (in.) 5-6 Number of slumps out of specification reported to If rejected Approved by Remarks: Slumps and cylinders performed at truck discharge chute -1" slump loss at end of hose. Of Massachusetts 'The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Page 1 Report Date 08/28/2008 Report No. 7 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/811 * I No. Of Sets: 4 CUBIC YARDS: 160 SET 1 LOCATION- S.O.D., 3rd floor. northeast corner Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type A393 4 x 8 12.56 Good 08/28/2008 09/04/2008 7 39,000 3,110 3 A394 4 x 8 12.56 Good 08/28/2008 09/11/2008 14 A395 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 A396 4 x 6 12.56 Good 08/28/2008 09/25/2008 28 A397 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 SET 2 LOCATION- S.O.D., 3rd floor, southeast corner Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type A211 4 x 8 12.56 Good 08/28/2008 09/04/2008 7 40,000 3,180 3 A212 4 x 8 12.56 Good 08/28/2008 09/11/2008 14 A213 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 A214 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 A215 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 SET 3 LOCATION- S.O.D., 3rd floor. southeast corner Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type A216 1 4 x 8 12.56 Good 08/28/2008 09/04/2008 7 41,000 3,260 2 A217 4 x 8 12.56 Good 1 08/28/2008 09/11/2008 14 A218 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 A219 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 A220 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 SET 4 LOCATION: S.O.D., 3rd floor, northwest corner Slump (in.) 6 Air Temp. (F.) 70 Conc Temp (F) 76 Truck No. 304 Ticket No. 10775 Time 6:45 Unit Wt lbs/cu ft Air Content M Slump (in.) 6 1/2 Air Temp. (F.) 70 Conc Temp (F) 77 Truck No. 207 Ticket No. 10280 Time 7:30 Unit Wt lbs/cu ft Air Content M Slump (in.) 6 3/4 Air Temp. (F.) 70 Conc Temp (F) 79 Truck No. 309 Ticket No. 10287 Time 8: 15 Unit Wt lbs/cu ft Air Content M) oaf Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Gerald A. Brown N. Andover Building Dept. 1600 Osgood Street N. Andover, MA 01845 Report Date 08/28/2008 Report No. 7 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type A221 4 x 8 12.56 Good 08/28/2008 09/04/2008 7 38,000 3,030 4 A222 4 x 8 12.56 Good 08/28/2008 09/11/2008 14 A223 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 A224 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 A225 1 4 x 8 12.56 Good 08/28/2008 09/25/2008 28 .GENERAL REMARKS: * Lightweight Slump (in.) 6 1/2 Air Temp. (F.) 75 Conc Temp (F) 80 Truck No. 309 Ticket No. 10299 Time 11:00 Unit Wt lbs/cu ft Air Content (%) Inspector Name Premium Time ;;^ ., Hours iy:... Travel Time Jim Connolly No 1 Hr (s) REVIEWED BY: Robert S. Granada FRACTURE TYPES (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Gino Fodera Of MassachusettsmThe Construction Testing Peoplem -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Concrete Field Report Report Date 08/29/2008 Report No. 7 Gerald A. Brown Job Number 11647 N. Andover Building Dept. 1600 Osgood Street Project Stonewall P1aza,Turnpike St,N.Andover N. Andover, MA 01845 Contractor GFM WEATHER: _TIME: CONTACT: SUMMARY: Transported four sets of cylinders cast on 08-28-08 to the lab for testing. GENERAL REMARKS: Inspector Premium Name Time Hours Travel Time Jacob Schmidt No REVIEWED BY: William P. Crabtree Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Gino Fodera Of Massachusetts -The Construction Testing People -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Concrete Field Report Report Date 09/05/2008 Report No. 8 Gerald A. Brown Job Number 11647 N. Andover Building Dept. 1600 Osgood Street Project Stonewall P1aza,Turnpike St,N.Andover N. Andover, MA 01845 Contractor GFM WEATHER: _TIME: CONTACT: SUMMARY: Transported 4 sets of cylinders cast on 9/4/08 to the lab for testing. GENERAL REMARKS: Inspector Name Premium Time Travel Hours Time D. Campolini No REVIEWED BY: William P. Crabtree Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Gino Fodera Pae 1 of 1 Project / Location Inspector Name: Inspection Date 1820Y Turnpike Street N Andover MA D. Comerford 08/20//2008 Project Name: I ime: weather on i ions: Stonewall Plaza 10:30 pm clear / 80° F Remarks SCOPE OF INSPECTION: This inspection is provided in accordance with Section 116.2.2 of the Massachusetts State Building Code to determine if the work is in general accordance with the designs and with standard practice. While reasonable care shall be exercised in performing these inspections, responsibility for conformance with the plans and specifications, compliance with safety regulations, means and methods of construction, and all activities and associated with control of the work shall lie with the Contractor. GENERAL OBSERVATIONS & FINDINGS: ■ Steel erection completed ■ Noted all TC Bolts torqued to compliance. ■ Welded connections completed and reportedly inspected by UTS inspection. ■ Steel decking and pour stops in place — no shear studs installed. ■ Elevator shaft construction in process. Noted reinforcing size and spacing to be per requirements. ■ No significant exceptions noted RECOMMENDATIONS: E Mess q D. G. COHERE p CIVIL E' 9 IYO. 41726 �O/STF-fk 4Q �SS�OkAI Pae i of 1 Project / Location Inspector Name:Inspection Date 1820 Turnpike Street N Andover MA D. Comerford =06/26//2008 Project Name: I ime: weatner on i ions: Stonewall Plaza 10:30 pm clear / 80° F Remarks SCOPE OF INSPECTION: This inspection is provided in accordance with Section 116.2.2 of the Massachusetts State Building Code to determine if the work is in general accordance with the designs and with standard practice. While reasonable care shall be exercised in performing these inspections, responsibility for conformance with the plans and specifications, compliance with safety regulations, means and methods of construction, and all activities and associated with control of the work shall lie with the Contractor. GENERAL OBSERVATIONS & FINDINGS: ■ Steel Erection in continues Col. Line F thru J ■ TC Bolts in place all connections snug tight only. TC bolt tightening required all connections ■ Welded connections to be inspected by UTS inspection. ■ Cable bracing in place at upper most level. ■ Verified general compliance with specifications RECOMMENDATIONS: -110H OF Mess �c ti D.6. OMERFOR CIVIL `n A 9 No. 41726 90 �01sT>`P�� SS�ONAL ENG�� Pae 1 of 1 Project / Location Inspector Name: Inspection Date 1820 Turnpike Street N Andover MA D. Comerford 06/24//2008 Project Name: I ime: weatner on i ions: Stonewall Plaza 12:30 pm clear / 95° F Remarks SCOPE OF INSPECTION: This inspection is provided in accordance with Section 116.2.2 of the Massachusetts State Building Code to determine if the work is in general accordance with the designs and with standard practice. While reasonable care shall be exercised in performing these inspections, responsibility for conformance with the plans and specifications, compliance with safety regulations, means and methods of construction, and all activities and associated with control of the work shall lie with the Contractor. GENERAL OBSERVATIONS & FINDINGS: ■ Steel Erection in process Col line A thru F ■ TC Bolts in place all connections snug tight only. TC bolt tightening required all connections ■ Verified general member sizes provided at columns and randomly selected main members. RECOMMENDATIONS: ■ Recommended additional cable bracing be placed during erection and to remain in place until TC bolts are fully torqued to specifications i► ZN 0 MAssq O.G.COMERF CIVIL No. 41 6 A9 9FG/STO. Q`�Q oFFSS�ONAI ENG\ �Of Massachusetts 'The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781438-7755 (Voice) 781-438-6216 (Fax) Ultrasonic Inspection Report N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Length: Varies -Page 1 Report Date 08/04/2008 Report No. 1 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM 'Test Method Standard: AWS -D1.1-06 UT Unit Serial No.: DFX-244 2300010 Acceptance Standard: AWS -D1.1-06 Thickness: Varies A 1 53 5H south X 1 70 A Decibels 53 5F north X Discontinuity 70 A 1 53 5F south X 1 Distance A 1 53 2H north X 1 70 ai 1 53 2H south X 1 70 A 1 53 2F north X 1 70 A 1 53 2F south X 1 70 A 1 53 2.9E north X � 0 70 A 1 53 L 0 X 1 70 v 1 53 6E north X 1 70 A 1 53 6E south X 1 R ca 1 53 6C north X 1 70 A 1 53 6C south X 1 70 A 1 J J = 1 70 A N 53 3 Q 0 C C w Q v m JZ C ` v v o C N c m N p O' U p 3 0 7 t0 � v d C U p L � Weld H V C N LL 'O C d w Q ' C t •' M LL C c c a� a From From a b c d ID/Location ti a` __ LL J Q o X Y �� •a.w�i• riuuis i -S iiein we,inpn mnmPnr r•nnnartinnc t -nn -1 hl,+-tl,.., 4'1_ 5H north X 1 70 A 1 53 5H south X 1 70 A 1 53 5F north X 1 70 A 1 53 5F south X 1 70 A 1 53 2H north X 1 70 A 1 53 2H south X 1 70 A 1 53 2F north X 1 70 A 1 53 2F south X 1 70 A 1 53 2.9E north X i 70 A 1 53 2.9E south X 1 70 A 1 53 6E north X 1 70 A 1 53 6E south X 1 70 A 1 53 6C north X 1 70 A 1 53 6C south X 1 70 A 1 53 4C north X 1 70 A 1 53 Couplant: Exosen Frequency 2.25 MHz Calibration Technician: R. Carter Surf ace_Conditions: As welded Technician: R. Carter Level: II I Interpreter 'R• Carter Level: II GENERAL REMARKS: Inspector Premium Travel Name Time Hours Time R. Carter No Min Day 1 Hr (s) Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Ultrasonic Inspection Report Report Date 08/04/2008 Report No. 1 N. Andover Building Dept. Job Number 11647 Attn: Gerald A. Brown Project Stonewall P1aza,Turnpike St,N.Andover 1600 Osgood Street N. Andover, MA 01845 Contractor GFM REVIEWED BY: William P. Crabtree Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. Cc: GFM General Contracting Corp. Attn: Gino Fodera f -t44-' ✓ VA-c.st.. NJ +�ld� To: Mark Rees, North Andover Town Manager FROM: Chris Nobile, North Andover School Committee Member RE: Proposed Sponsorship Partner Program Signage DATE: July 16, 2008 This Is a formal request from the North Andover School Committee for permission to install signage on fencing at the North Andover High School. The request is part of a program the NA School Committee is looking to commence. The objective is to generate fee income to offset the pending increase in Athletic Fees charged at NAHS. As you may know, nearly 60% of our students participate in 23 sports. Nearly 25% of the students are in 2 or more, so our participation is very high, and their performances have been stellar. Ongoing budget constraints, and growth in costs have necessitated these fees be increased unless other revenues can be secured. Hence the Sponsorship Partner Program is being launched to attract advertising revenue via signage around the stadium and fields. The program is shaped from extensive research and discussion with other districts, including Haverhill, Winthrop, Newburyport and other State programs. Attached is a brochure developed to explain the need, and objectives of the program. Pursuant to Initiating our contacting prospective sponsors, the North Andover School Committee requests approval for the installation of these banners along fencing at the NAHS stadium and fields. We areproposing these banners follow the recommendations of other communities as follows: 1) Heavy duty vinyl banners in full color with grommets for securing with industrial strength ties for a permanent (wind resistant) placement. 2) Sizes will based upon 4'x8' blocks (e.g. 2'x4', 4'0', 4'x16', etc.) 3) The banners around the fence at Walsh Stadium, and baseball field, and at the area of fencing near the track along Rt. 125 4) It Is anticipated the total number of signs would not exceed 15. S) We have a very good bid from Sign -O -Rama in Salem which has done numerous similar school projects. it is the hope of the North Andover School Committee that you find this proposal satisfactory. Please advise if you need further information, or have questions. Thank you for the consideration Aou r 4 v Al �@ Lo 1)%00 Oki" V'C pe/al tPP Lw�``��ai' �� Of Massachusetts 'The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 -Page 1 Report Date 04/18/2008 Report No. 6 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 .ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/4" No. Of Sets: 4 CUBIC YARDS: 192 SET 1 LnCATInN- S.O.G.. column line A at 7 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type Q618 4 x 8 12.56 Good 04/18/2008 04/25/2008 7 43,000 3,420 1 Q619 4 x 8 12.56 Good 04/18/2008 05/02/2008 14 55,000 4,380 2 Q620 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 75,000 5,970 1 Q621 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 73,000 5,810 3 Q622 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 72,000 1 5,730 1 SET 2 LOCATION• S.O.G. , column line E at 7 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type Q623 4 x 8 12.56 Good 04/18/2008 04/25/2008 7 42,000 3,340 4 Q624 1 4 x 8 12.56 Good 04/18/2008 05/02/2008 14 53,000 4,220 4 Q625 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 74,000 5,890 2 Q626 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 73,000 5,810 4 Q627 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 71,000 5,650 4 SFT 3 1 OCATION• S. O. G., column line F at S Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type Q613 4 x 8 12.56 Good 04/18/2008 04/25/2008 7 45,000 3,580 2 Q614 4 x 8 12.56 Good 04/18/2008 05/02/2008 14 58,000 4,620 4 Q615 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 1 80,000 1 6,370 1 1 Q616 4 x 8 12.56 Good 04/18/2008 05/16/200828 78,000 6,210 4 Q617 4 x 8 12.56' Good 04/18/2008 05/16/2008 28 77,000, 6,130 2 SET 4 LOCATION: S . O . G . , column line J at 1 Slump (in.) 5 Air Temp. (F.) 40 Conc Temp (F) 62 Truck No. 1719 Ticket No. 7479 Time 7:15 Unit Wt lbs/cu ft Air Content M Slump (in.) 4 3/4 Air Temp. (F.) 43 Conc Temp (F) 64 Truck No. 66 Ticket No. 7484 Time 8:00 Unit Wt lbs/cu ft Air Content M Slump (in.) 4 1/2 Air Temp. (F.) 62 Conc Temp (F) 66 Truck No. 309 Ticket No. 7489 Time 9: 15 Unit Wt lbs/cu ft Air Content (%) Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Report Date 04/18/2008 Report No. 6 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type Q608 4 x 8 12.56 Good 04/18/2008 04/25/2008 7 41,000 3,260 1 Q609 1 4 x 8 12.56 Good 04/18/2008 05/02/2008 14 52,000 4,140 3 Q610 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 70,000 5,570 1 Q611 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 67,000 5,330 2 Q612 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 68,000 5,410 4 GENERAL REMARKS: Slump (in.) 5 1/4 Air Temp. (F.) 70 Conc Temp (F) 68 Truck No. 66 Ticket No. 7494 Time 10 : 05 Unit Wt lbs/cu ft Air Content (%) Inspector Name Premium Time Hours Travel Time D. Boyden No Max Day 1 Hr (s) REVIEWED BY: Robert S. Granada FRACTURE TYPES r (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera " Of Massachusetts 'The Construction Testing People' Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Report Date 04/18/2008 Report No. 6 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT 'Total Pour: S -0-G., column line A -J at 1-7 Method of Placement: ❑ Pump ® Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ❑ Vibrator ❑X Other Other: Power screed Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑X Field ❑ Other Placement Protection: ❑ Thermal Blankets ❑ Heat ❑X None ❑ Other Slump Specification (in.) 5 Number of slumps out of specification reported to If rejected Approved by none Remarks: R1 t� � t1� , LITS of Massachusetts, Inc. Page 4 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) N. Andover Building Dept. Report Date 04/18/2008 Attn: Gerald A. Brown Report No. 6 1600 Osgood Street Job Number 11647 N. Andover, MA 01845 Project Stonewall Plaza,Turnpike St,N.Andover Attachment mi==chusenis Inc. \~� _ABLY -Com"' �,F CNC —= , :tic. - 1'759 5 5,38 '7,'�O lob tl - 30� 5x53 � 3 a q 7 3o g G' ty- A07G T55 q'`t 9 �a 7Atg 305 14 300 7�igG y i 517 q A:x? q Lan - ___-_�� .._c C _.nQi� :,-- �!i�SSaC'..:52:.: ��� CQ ^C �.:c"� :� .'-.. r�•i,+vL�`�Cr . 7 UTS of Massachusetts, Inc. Page 5 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) N. Andover Building Dept. Report Date 04/18/2008 Attn: Gerald A. Brown Report No. 6 1600 Osgood Street Job Number 11647 N. Andover, MA 01845 Project Stonewall Plaza,Turnpike St,N.Andover Attachment NAV C 4r 5Inc. Q A I L RE rJrC i QF C0NCR, E__ C U F 'E - i N=.N1E: STa�EWA1� � R—NaTn-AF C J E C NC.. - Alp ..^.l ,;�.L YAFDS 19� 1-- -7 �, Ic ;;me n j "=rc� i .cnc;a:- i °'o c. c:<�:= NG. or i C1u.Z Minutes �iince-� ��( ! S"h2 56 97 X92 1� I j I I j i Sticneiiarn, ,Massaciwzsa:;5 tO ;iG� Of Massachusetts 'The Construction Testing People' -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 03/18/2008 Report No. 5 Job Number 11647 N. Andover Building Dept. Attn: Gerald A. Brown Project Stonewall P1aza,Turnpike St,N.Andover 1600 Osgood Street N. Andover, MA 01845 Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 ALL COMPRESSIVE STRENGTH CLASS CONCRETE: 3000# 3/4" SFT 1 1 nCATIr1N- Spread footing STS DONE ACCORDING TO ASTM: No. Of Sets: 1 column line 3 at E C-39 CUBIC YARDS: 27.5 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type E535 4 x 8 12.56 Good 03/18/2008 04/01/2008 14 33,000 2,630 1 E536 4 x 8 12.56 Good 03/18/2008 04/01/2008 14 31,000 2,470 2 E537 4 x 8 12.56 Good 03/18/2008 04/15/2008 28 45,000 3,580 3 E538 4 x 8 12.56 Good 03/18/2008 04/15/2008 28 46,000 3,660 2 E539 4 x 8 12.56 Good 03/18/2008 04/15/2008 28 47,500 3,780 3 GENERAL REMARKS: SAME DAY CALL IN Slump (in.) 5 Air Temp. (F.) 43 Conc Temp (F) 70 Truck No. 306 Ticket No. 6985 Time 3:30 Unit Wt lbs/cu ft Air Content M Inspector Premium Name Time Hours Travel Time B. Chan No Min Day 1 Hr(s) REVIEWED BY: Robert S. Granada FRACTURE TYPES (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera r Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 03/18/2008 Report No. 5 Job Number 11647 N. Andover Building Dept. Attn: Gerald A. Brown Project Stonewall Plaza, Turnpike St,N.Andover 1600 Osgood Street N. Andover, MA 01845 Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT 'Total Pour: wall, elevator pit; spread footing, column line 3 at E, 2 at F Method of Placement: ❑ Pump © Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: © Vibrator ❑ Other Other: Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑X Trailer ❑ Field ❑ Other Placement Protection: ® Thermal Blankets ❑ Heat ❑ None ❑ Other Slump Specification (in.) 4 Number of slumps out of specification reported to If rejected Approved by Remarks: Load 41 -slump out of specification -no water added on site -super Frank Fodera was informed -approved usage. UTS of Massachusetts, Inc. Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) N. Andover Building Dept. Report Date 03/18/2008 Attn: Gerald A. Brown Report No. 5 1600 Osgood Street Job Number 11647 N. Andover, MA 01845 Project Stonewall Plaza,Turnpike St,N.Andover Attachment '.00000 Of Haumhusem Im NTM commiKH" 1r"t11* P"Pk n Page # DAILY REPORT OF CONCRETE POUR PROJECT NAME'�g yj A Woil MrA Za — (.PROJECT NO.: DATE:'M6f-tk 19_2a2e AIR TEMP.:JZj_TOTAL YARDS. J LOCATION OF POUR: Load & i Slump Truck # Inches Batching In Batching Out Time In Minutes Yards Concrete i % of Ticket # i No. of i Temp. Air Cylinders "V �- uko a: s' 5-k a° �s . xil tag "'a 9�� I L INSPECTOR: REMARKS: 5 Richardson Lane, Stoneham, Massachusetts 02180 (781) 438-7755 Fax (78.1) 438-6216 Of Massachusetts 'The Construction Testing People -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Concrete Field Report Report Date 04/21/2008 Report No. 6 Job Number 11647 N. Andover Building Dept. Project Stonewall P1aza,Turnpike St,N.Andover Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Contractor GFM WEATHER: TIME: CONTACT: SUMMARY: Transported four sets of cylinders cast on 04/18/08 to the lab for testing. GENERAL REMARKS: Inspector Name Premium Time Hours Travel Time Matthew Marsh No REVIEWED BY: William P. Crabtree Wp / �pc/ Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera 1. 1� •�Of MassachusettsmThe Construction Testing Peoplem 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Page 1 Report Date 04/18/2008 Report No. 6 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/4" 1 No. Of Sets: 4 CUBIC YARDS: 192 SET 1 LOCATION- S.O.G. , column line A at 7 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type Q618 4 x 8 12.56 Good 04/18/2008 04/25/2008 7 43,000 3,420 1 Q619 4 x 8 12.56 Good 04/18/2008 05/02/2008 14 Q620 4 x 8 12.56 Good 04/18/2008 1 05/16/2008 28 Q621 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 Q622 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 SFT 21OCATION• S.O.G.. column line E at 7 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type Q623 4 x 8 12.56 Good 04/18/2008 04/25/2008 7 42,000 3,340 4 Q624 4 x 8 12.56 Good 04/18/2008 05/02/2008 14 Q625 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 Q626 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 Q627 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 SFT I I nr:ATI(W- S.O.G.. column line F at 5 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type Q613 4 x 8 12.56 Good 04/18/2008 04/25/2008 7 45,000 3,580 2 Q614 4 x 8 12.56 Good 04/18/2008 05/02/2008 14 Q615 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 Q616 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 Q617 1 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 SET 4 LOCATION: S . o . G . , column line J at 1 Slump (in.) 5 Air Temp. (F.) 40 Conc Temp (F) 62 Truck No. 1719 Ticket No. 7479 Time 7: 15 Unit Wt Ibs/cu ft Air Content (W Slump (in.) 4 3/4 Air Temp. (F.) 43 Conc Temp (F) 64 Truck No. 66 Ticket No. 7484 Time 8:00 Unit Wt lbs/cu ft Air Content M Slump (in.) 4 1/2 Air Temp. (F.) 62 Conc Temp (F) 66 Truck No. 309 Ticket No. 7489 Time 9: 15 Unit Wt lbs/cu ft Air Content M) " Of Massachusetts 'The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Page 2 Report Date 04/18/2008 Report No. 6 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento Lab No. Size (in.) Area (sq. in.) - Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type Q608 4 x 8 12.56 Good 04/18/2008 04/25/2008 7 41,000 3,260 1 Q609 4 x 8 12.56 Good 04/18/2008 05/02/2008 14 Q610 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 Q611 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 Q612 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 GENERAL REMARKS: Slump (in.) 5 1/4 Air Temp. (F.) 70 Conc Temp (F) 68 Truck No. 66 Ticket No. 7494 Time 10 : 05 Unit Wt lbs/cu ft Air Content (%) Inspector Name Premium Time Hours Travel Time D. Hoyden No Max Day 1 Hr (s) REVIEWED BY: Robert S. Granada (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera Of Massachusetts -The Construction Testing People' Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 04/18/2008 Report No. 6 N. Andover Building Dept. Job Number 11647 Attn: Gerald A. Brown Project Stonewall P1aza,Turnpike St,N.Andover 1600 Osgood Street N. Andover, MA 01845 Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT 'Total Pour: S.0 -G., column line A -J at 1-7 Method of Placement: ❑ Pump ® Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ❑ Vibrator ® Other Other: power screed Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑X Field ❑ Other Placement Protection: []Thermal Blankets ❑ Heat ® None ❑ Other Slump Specification (in.) 5 Number of slumps out of specification reported to If rejected Approved by none Remarks: UTS of Massachusetts, Inc. Page 4 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) N. Andover Building Dept. Report Date 04/18/2008 Attn: Gerald A. Brown Report No. 6 1600 Osgood Street Job Number 11647 N. Andover, MA 01845 Project Stonewall Plaza,Turnpike St,N.Andover Attachment Of M==Chusetft "The C E ''VIE T s 1-7 C 7 Z J 3C4- 0 5 "T 4 , 1 1 3at5� 'fig ' 7 ��' ��! L) L; ---�z 21 E z c,—! � Zzo 4Z S - 7 7 =7, In 7 C N C. 7 0 0 27 7AYl a A07 6, A I T55 Ct /f 71Y91V 5 flt 365 41, ILI 0 I A A /_1 .4 � i g13O 16� 3C4- 0 5 "T 4 , 1 1 3at5� 'fig ' 7 ��' ��! L) L; ---�z 21 E z c,—! � Zzo 4Z S - 7 7 UTS of Massachusetts, Inc. Page 5 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) N. Andover Building Dept. Report Date 04/18/2008 Attn: Gerald A. Brown Report No. 6 1600 Osgood Street Job Number 11647 N. Andover, MA 01845 Project Stonewall Plaza,Turnpike St,N.Andover Attachment ,Of Mas3achUSL ft Inc. -- a Camft ion T'estii�eo,pi�' QA.ILv REFCFT CF C :0NCR, E7F =C'UR EC v=.IvlE:�rpIJEt�JALL-Atonff As3te/2 =FCJE: NC. _C'C,=7;CN CF -Cu-: 1-'7 `i;.ai�Cime in NG. GT i ^ •,ti f Ces J i; i f'�I^ Minutes ! I i = -` C'✓iinder=. i i I i i I i i i I i I Ji�r�e�aR. 3Pas C-Ls2^s �2� 30 7 21? 4ZC-- . E� F= (7 8.1 " Of Massachusetts 'The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date Report No. Job Number N. Andover Building Dept. Attn: Gerald A. Brown Project 1600 Osgood Street -Page 1 04/18/2008 6 11647 Stonewall P1aza,Turnpike St,N.Andover N. Andover, MA 01845 Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 .ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/4" 1 No. Of Sets: 4 CUBIC YARDS: 192 SET 1 LOCATION- S .0. G. , column line A at 7 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type Q618 4 x 8 12.56 Good 04/18/2006 1 04/25/2008 7 43,000 3,420 1 Q619 4 x 8 12.56 Good 04/18/2008 05/02/2008 14 55,000 4,380 2 Q620 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 Q621 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 Q622 4 x 8 12.56 Good 04/18/2008 05/16/2008 1 28 SFT 71OrATMW S.O.G., column line E at 7 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type Q623 4 x 8 12.56 Good 04/18/2008 04/25/2008 7 42,000 3,340 4 Q624 4 x 8 12.56 Good 04/18/2008 05/02/2008 14 53,000 4,220 4 Q625 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 Q626 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 Q627 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 SFT 3 1 OCATIOW S.O.G. , column line F at 5 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type Q613 4 x 8 12.56 Good 04/18/2008 04/25/2008 7 45,000 3,580 2 Q614 4 x 8 12.56 Good 04/18/2008 05/02/2008 14 58,000 4,620 4 Q615 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 Q616 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 Q617 4 x 8 12.56 Good 04/18/2008 1 05/16/2008 28 SET 4 LOCATION: S.O.G. , column line J at 1 Slump (in.) 5 Air Temp. (F.) 40 Conc Temp (F) 62 Truck No. 1719 Ticket No. 7479 Time 7:15 Unit Wt lbs/cu ft Air Content (%1 Slump (in.) 4 3/4 Air Temp. (F.) 43 Conc Temp (F) 64 Truck No. 66 Ticket No. 7484 Time 8 : 00 Unit Wt lbs/cu ft Air Content (%) Slump (in.) 4 1/2 Air Temp. (F.) 62 Conc Temp (F) 66 Truck No. 309 Ticket No. 7489 Time 9: 15 Unit Wt lbs/cu ft Air Content (%1 ' Of Massachusetts "The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date Report No. Job Number N. Andover Building Dept. Project Attn: Gerald A. Brown 1600 Osgood Street Contractor N. Andover, MA 01845 Concrete Co. Page 2 04/18/2008 6 11647 Stonewall P1aza,Turnpike St,N.Andover GFM Benevento Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type Q608 4 x 8 12.56 Good 04/18/2008 04/25/2008 7 41,000 3,260 1 Q609 4 x 8 12.56 Good 04/18/2008 05/02/2008 14 52,000 4,140 3 Q610 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 Q611 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 Q612 4 x 8 12.56 Good 04/18/2008 05/16/2008 28 Slump (in.) 5 1/4 Air Temp. (F.) 70 Conc Temp (F) 68 Truck No. 66 Ticket No. 7494 Time 10: 05 Unit Wt lbs/cu ft No Air Content (%) 1 Hr (s) V CIYGRML n�mrv�n.a. Inspector Premium Travel Name Time Hours Time D. Boyden No Max Day 1 Hr (s) REVIEWED BY: Robert S. Granada FRACTURE TYPES (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar our reports are available in PDF form via email. Please email us at reportseutsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera ° Of Massachusetts 'The Construction Testing People' Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 04/18/2008 Report No. 6 Job Number 11647 N. Andover Building Dept. Project Stonewall P1aza,Turnpike St,N.Andover Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT 'Total Pour: s.o.G. , column line A -J at 1-7 Method of Placement: ❑ Pump ® Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ❑ Vibrator ® Other Other: power screed Cylinder Fabrication Location: © Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑ Trailer 0 Field ❑ Other Placement Protection: ❑ Thermal Blankets ❑ Heat ® None ❑ Other Slump Specification (in.) 5 Number of slumps out of specification reported to If rejected Approved by none Remarks: i. � LITS of Massachusetts, Inc. Page 4 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) N. Andover Building Dept. Report Date 04/18/2008 Attn: Gerald A. Brown Report No. 6 1600 Osgood Street Job Number 11647 N. Andover, MA 01845 Project Stonewall Plaza,Turnpike St,N.Andover Attachment Of Mcsscghusenls Inc. CNCRE7= =r -LIF WRIM-0 M—P — me ��111�111 I piii 111pq 1111111q�111 q JIM, .10-1 71 97 Qri 33 1 71321 JAI Ct At A07 53 7,qgq AL ----------- WRIM-0 M—P — me ��111�111 I piii 111pq 1111111q�111 q JIM, .10-1 I LITS of Massachusetts, Inc. Page 5 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) N. Andover Building Dept. Report Date 04/18/2008 Attn: Gerald A. Brown Report No. 6 i 1600 Osgood Street Job Number 11647 N. Andover, MA 01845 Project Stonewall Plaza,Turnpike St,N.Andover Attachment "f Of dUlset" Inc. - 0000 QA.iL" KE,=JF OF CONC,FE i = -CLEF NAME. ' sC,^,;r: �3: if G i !C E it C,i NC. �T :<<c =a. _ CMinus= ! f `b! - ✓iince (0-2430 !72-44) C C --7E., Fs;z Of Massachusetts 'The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 -Page 1 Report Date 03/18/2008 Report No. 5 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 .ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 30004 3/4" 1 No. Of Sets: 1 CUBIC YARDS: 27.5 cGT 1 1 nrAT1r)M- Spread footing, column line 3 at E Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type E535 4 x 8 12.56 Good 03/18/2008 1 04/01/2008 14 33,000 2,630 1 E536 4 x 8 12.56 Good 03/18/2008 04/01/2008 14 31,000 2,470 2 E537 4 x 8 12.56 Good 03/18/2008 04/15/2008 28 E538 4 x 8 12.56 Good 03/18/2008 04/15/2008 28 E539 4 x 8 12.56 Good 03/18/2008 04/15/2008 28 GENERAL REMARKS: SAME DAY CALL IN Slump (in.) 5 Air Temp. (F.) 43 Conc Temp (F) 70 Truck No. 306 Ticket No. 6985 Time 3:30 Unit Wt lbs/cu ft Air Content (%) Inspector Name Premium Time Hours Travel Time B. Chan No Min Day 1 Hr (s) REVIEWED BY: Robert S. Granada FRACTURE TYPES r (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Our reports are available in PDF form via email. Please email us at reportsOutsofmass.com for more information. CC:- GFM General'Contracting Corp. Attn: Gino Fodera ^ Of Massachusetts -The Construction Testing People' Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Report Date 03/18/2008 Report No. 5 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT -Total Pour: Wall, elevator pit; spread footing, column line 3 at E, 2 at F Method of Placement: ❑ Pump © Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: Q Vibrator ❑ Other Other: Cylinder Fabrication Location: ❑X Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: []Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑X Trailer ❑ Field ❑ Other Placement Protection: ❑X Thermal Blankets ❑ Heat ❑ None ❑ Other Slump Specification (in.) 4 Number of slumps out of specification reported to If rejected Approved by Remarks: Load #1 -slump out of specification -no water added on site -super Frank Fodera was informed -approved usage. UTS of Massachusetts, Inc. 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Page 3 N. Andover Building Dept. Report Date 03/18/2008 Attn: Gerald A. Brown Report No. 5 1600 Osgood Street Job Number 11647 N. Andover, MA 01845 Project Stonewall Plaza,Turnpike St,N.Andover Attachment Of HkiswchuseM Inc. wArm9 � n Con"wim Testing rqWW Page # DAILY REPORT OF CONCRETE POUR PROJECT NAME %A gil 60_r- PROJECT NO.: DATE: I AIR TEMP.:It!_TOTAL YARDS. - LOCATION OF POUR: Load & i Slump 1 Truck # Inches Batching In Batching Out Time In Minutes Yards Concrete Temp. % of Ticket # 1 No. of Air I Cylinders o� )_:q 70—* �0 �.a5�i ;a9f "'a I INSPECTOR: REMARKS: 5 Richardson Lane, Stoneham, Massachusetts 02180 (781) 438-7755 Fax (78.1) 438-6216 IofI ��� u•" inspector Name: Inspection Date &24 �tplke,Sx et N Andover MA A Comerford 1/29//2008 rolec ame:Time: Weather Conditions: Stonewall Plaza 9:00 am clear / 28° F Remarks SCOPE OF INSPECTION: This inspection is provided in accordance with Section 116.2.2 of the Massachusetts State Building Code to determine if the work is in general accordance with the designs and with standard practice. While reasonable care shall be exercised in performing these inspections, responsibility for conformance with the plans and specifications, compliance with safety regulations, means and methods of construction, and all activities and associated with control of the work shall lie with the Contractor. GENERAL OBSERVATIONS & FINDINGS: ■ Performed dimensional check of previously poured elements for incorporation into as -built drawings and for verification of anchor bolt placement. RECOMMENDATIONS: p N Andover MA I D. Comerford 1 1820 Turnike Street 1/28//2008 Stonewall Plaza 9:00 am clear / 32° F Remarks SCOPE OF INSPECTION: This inspection is provided in accordance with Section 116.2.2 of the Massachusetts State Building Code to determine if the work is in general accordance with the designs and with standard practice. While reasonable care shall be exercised in performing these inspections, responsibility for conformance with the plans and specifications, compliance with safety regulations, means and methods of construction, and all activities and associated with control of the work shall lie with the Contractor. GENERAL OBSERVATIONS & FINDINGS: ■ Visual inspection of stripped forms for full ht pours at north end of structure. ■ No " rat -holes, areas of segregation or obvious imperfections noted. ■ Wall forming at the area of proposed garage entrance in process at the south end of the structure. ■ Verified vertical and horizontal reinforcement size and spacing. ■ Lap Splices found to be in conformance with requirements. ■ No exceptions noted to work in process. RECOMMENDATIONS: 101 Project / Location I Inspector Name: Inspection Date raeiori —T— 1820 Turnpike Street N Andover MA D. Comerford 1/09//2008 Project Name: I ime: weather Conditions: Stonewall Plaza 9:00 am clear / 28° F Remarks SCOPE OF INSPECTION: This inspection is provided in accordance with Section 116.2.2 of the Massachusetts State Building Code to determine if the work is in general accordance with the designs and with standard practice. While reasonable care shall be exercised in performing these inspections, responsibility for conformance with the plans and specifications, compliance with safety regulations, means and methods of construction, and all activities and associated with control of the work shall lie with the Contractor. GENERAL OBSERVATIONS & FINDINGS: ■ Visual inspection of forms work & reinforcing steel in place at north end of building. Full ht forms in place w / 50% of east and west walls also formed. ■ Verified size & spacing of vertical & horizontal wall reinforcement. Noted sufficient lap splices to hooked dowel bars cast with footing. ■ No exceptions noted to work in process. RECOMMENDATIONS: Project / Location Inspector Name: Inspection Date Page lofl 1820 Turnpike Street N Andover MA D. Comerford 12/21//2007 Project Name: I ime: Weather Conditions: Stonewall Plaza 9:00 am clear / 35° F Remarks SCOPE OF INSPECTION: This inspection is provided in accordance with Section 116.2.2 of the Massachusetts State Building Code to determine if the work is in general accordance with the designs and with standard practice. While reasonable care shall be exercised in performing these inspections, responsibility for conformance with the plans and specifications, compliance with safety regulations, means and methods of construction, and all activities and associated with control of the work shall lie with the Contractor. GENERAL OBSERVATIONS & FINDINGS: ■ Visual inspection of stripped section of partial ht pour @ south end of the structure ■ Verified shear keys and reinforcing continuous through construction joints ■ No "rat -holes", areas of segregation or obvious imperfections noted. • No exceptions noted to work in process. RECOMMENDATIONS: 0. 0, COMERFORD. , ` a CIVIL No. 41726 .a9 FFG/STE1k ��FSS/ONAL I of 1 Inspector Name: Inspection Dat( 1820 Turnpike Street N Andover MA D Comerford 12/20//07 rotecName: Time: We—aTe—r7on i Stonewall Plaza 9:00 am Snow / 28" F Remarks SCOPE OF INSPECTION: This inspection is provided in accordance with Section 116.2.2 of the Massachusetts State Building Code to determine if the work is in general accordance with the designs and with standard practice. While reasonable care shall be exercised in performing these inspections, responsibility for conformance with the plans and specifications, compliance with safety regulations, means and methods of construction, and all activities and associated with control of the work shall lie with the Contractor. GENERAL OBSERVATIONS & FINDINGS: • Visual inspection of forms work & reinforcing steel in place at east end of building. Partial ht pour with limits of east wall and returns on the north and south walls of approx 40 ft of. (approx 27 cy ). ■ Area of work tented & protected from the weather. ■ Verified size & spacing of vertical & horizontal wall reinforcement. Noted sufficient lap splices to hooked dowel bars cast with footin),. ■ UTS Concrete inspector on site and sampling mix. ■ Verified order slip for 4000'/4" conc. mix as specified. (approx 4" Slump. Conc Report to verify) ■ Witnessed portion of placement at southeast comer using chutes and vibrating after placement. ■ No exceptions noted to work in process. RECOMMENDATIONS: GF 7,4 +J 1820 Turnpike Street Project Name: Stonewall Plaza N Andover MA D. Comerford Tme: 11:00 am Remarks 12/12//07 Weather UonditZ Cloudy / 45" F SCOPE OF INSPECTION: This inspection is provided in accordance with Section 116.2.2 of the Massachusetts State Building Code to determine if the work is in general accordance with the designs and with standard practice. While reasonable care shall be exercised in performing these inspections, responsibility for conformance with the plans and specifications, compliance with safety regulations, means and methods of construction, and all activities and associated with control of the work shall lie with the Contractor. GENERAL OBSERVATIONS & FINDINGS: ■ Footing form placement continues at east wall line. ■ Hooked dowel bars completed at west wall line and in process at north and south wall lines. ■ Verified additional footing reinforcement in place at piers. ■ Verified additional vertical reinforcement at wall piers ■ No exceptions noted to work in process. RECOMMENDATIONS: 1011 1820 Turnpike Street I N Andover I MA D. Comerford Project Name Time: Stonewall Plaza 2:00 PM Remarks Inspection Date Page I of 1 12/07/07 weatner conditions Clear / 35° F SCOPE OF INSPECTION: This inspection is provided in accordance with Section 116.2.2 of the Massachusetts State Building Code to determine if the work is in general accordance with the designs and with standard practice. While reasonable care shall be exercised in performing these inspections, responsibility for conformance with the plans and specifications, compliance with safety regulations, means and methods of construction, and all activities and associated with control of the work shall lie with the Contractor. GENERAL OBSERVATIONS & FINDINGS: • Excavation for perimeter foundation footing in process. Bottom of trench shows medium dense sand / sand gravel with little or no silt. ■ Placement of 12" +/- crushed stone sub -grade placement in -process. Placement and compaction performed in two lift operations — 3" coarse stone followed with a 6" lift of 3/4" crushed stone. ■ Dewatering operations in process at east end of trench. ■ Footing forms being erected at west end of structure. Performed random check of footing dimensions and recommended additional depth be provided at pier footings. • Noted insulating blankets on site and in use. RECOMMENDATIONS: •G� ,�,,'�r�'n4 SQL%�!�� rp Project / Location Inspector Name: Inspection Date ra elofl 1820 Turnpike Street N Andover MA D. Comerford 3/13//2008 rojecName: ime: weatner Conditions: Stonewall Plaza 9:00 am clear / 43° F Remarks SCOPE OF INSPECTION: This inspection is provided in accordance with Section 116.2.2 of the Massachusetts State Building Code to determine if the work is in general accordance with the designs and with standard practice. While reasonable care shall be exercised in performing these inspections, responsibility for conformance with the plans and specifications, compliance with safety regulations, means and methods of construction, and all activities and associated with control of the work shall lie with the Contractor. GENERAL OBSERVATIONS & FINDINGS: ■ Excavation at elevator pit and dewatering operations in process. ■ Reinforcing mats for spread footings and elevator pit being tied. ■ Verified size & spacing of reinforcement exceeds min specified. ■ No exceptions noted to work in process. RECOMMENDATIONS: 1AW Of Massachusetts . 'The Construction Testing People' -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Reinforcing Steel Report Report Date 03/18/2008 Report No. 4 Job Number 11647 N. Andover Building Dept. Project Stonewall P1aza,Turnpike St,N.Andover Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Contractor GFM CONTACT: Frank Fodera TIME OF INSPECTION: 2: 3 0 PM TIME OF CONCRETE PLACEMENT: 3: 00 PM SPECIFICATION: ASTM A615 Grade 40 Grade 60 X Grade 75 ASTM A616 Grade 50 Grade 60 ASTM A617 Grade 40 Grade 60 CONTRACT DRAWINGS: S-1.01 REVISION NUMBER: 1 DATED:10/5/07 SHOP DRAWING(S): PROJECT SPECIFICATIONS: 03300 " OTHER: DRAWINGS STAMPED: YES X NO AREA REVIEWED: Wall, elevator pit; spread footing, column line 3 at E, 2 at F & H ATTRIBUTES: _ Coverage (Top x Bottom x and/or Inside Face x Outside Face x ) Clearance Cleanliness (heavy rust, scale, mud, dirt, oil, etc. not permitted) Bar Supports Bar Spacing Bar Quantity Placement and tying REVIEWED Ye—__. s NN 0 X X X X X X X QX The details in the above described area(s) were complete at the time of this inspection. Q The results of this inspection were discussed with the aforementioned contact persons prior to departure from the project site. Vertical bars vary from 16" to 20" - on walls, additional bars added to correct GENERAL REMARKS: spacing; completed prior to placement. Of Massachusetts he �aia�' -'mThe Construction Testing Peoplem 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Reinforcing Steel Report N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Page 2 Report Date 03/18/2008 Report No. 4 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Inspector Name Premium Time Hours Travel Time B. Chan No REVIEWED BY: William P. Crabtree Wt Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera Of Massachusetts 'The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Concrete Field Report N. Andover Building Dept Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 -Page 1 Report Date 03/19/2008 Report No. 5 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM WEATHER: _TIME: CONTACT: SUMMARY: Transported one set of cylinders cast on 03/18/08 to the lab for testing. GENERAL REMARKS: Inspector Name Premium Time Hours Travel Time Joseph O'Toole No REVIEWED BY: William P. Crabtree O Q v Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp Attn: Gino Fodera j Of Massachusetts 'The Construction Testing People' -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Report Date 01/23/2008 Report No. 4 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/4" * I No. Of Sets: 2 CUBIC YARDS: 62 SET 1 LOCATION- Wall, column line F at 1.5 Lab No. Size (in.) Area (sq, in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type R669 4 x 8 12.56 Good 01/23/2008 01/30/2008 7 41,000 3,260 2 R670 4 x 8 12.56 Good 01/23/2008 02/06/2008 14 53,000 4,220 1- R671 4 x 8 12.56 Good 01/23/2008 02/20/2008 28 75,000 5,970 2 R672 4 x 8 12.56 Good 01/23/2008 02/20/2008 28 73,000 5,810 1 R673 1 4 x 8 12.56 Good 101/23/2008 02/20/2008 1 28 1 72,000 51730 4 SET 2 LOCATION- Wall, column line 7 at F Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type R664 4 x 8 12.56 Good 01/23/2008 01/30/2008 7 38,000 3,030 1 R665 4 x 8 12.56 Good 01/23/2008 02/06/2008 14 52,000 4,140 4 R666 4 x 8 12.56 Good 01/23/2008 02/20/2008 28 67,000 5,330 1 2 R667 4 x 8 12.56 Good 01/23/2008 02/20/2008 28 68,000 5,410 1 1 R668 4 x 8 12.56 Good 01/23/2008 02/20/2008 28 65,000 5,180 1 4 GENERAL REMARKS: * 1% accelerant Slump (in.) 4 1/4 Air Temp. (F.) 30 Conc Temp (F) 58 Truck No. 305 Ticket No. 6463 Time 10:15 Unit Wt Ibs/cu ft Air Content M Slump (in.) 4 1/2 Air Temp. (F.) 34 Conc Temp (F) 55 Truck No. 302 Ticket No. 6467 Time 12:30 Unit Wt !bs/cu ft Air Content M Inspector Name Premium Time Hours Travel Time B. Lumenello No Min Day 1 Hr (s) REVIEWED BY: Robert S. Granada FRACTURE TYPES - (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar OfWassachusetts"The Construction Testing Peoplem 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date Report No. Job Number N. Andover Building Dept. Project Attn: Gerald A. Brown 1600 Osgood Street Page 2 01/23/2008 4 11647 Stonewall Plaza,Turnpike St,N.Andover N. Andover, MA 01845 Contractor GFM Concrete Co. Benevento Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp Attn: Gino Fodera Of Massachusetts 'The Construction Testing People' Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 01/23/2008 Report No. 4 Job Number 11647 N. Andover Building Dept. Project Stonewall P1aza,Turnpike St,N.Andover Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT 'Total Pour: wall, column line 1 at F -J, J at 1-4, 5.5-7, 7 at E -J Method of Placement: ❑ Pump ® Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: © Vibrator ❑ Other Other: Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ curing Box © Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑ Field ❑ Other Placement Protection: ❑ Thermal Blankets ❑ Heat ® None ❑ Other Slump Specification (in.) 4-5 Number of slumps out of specification reported to none If rejected Approved by Remarks: UTS of Massachusetts, Inc. Page 4 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) N. Andover Building Dept. Report Date 01/23/2008 Attn: Gerald A. Brown Report No. 4 1600 Osgood Street Job Number 11647 N. Andover, MA 01845 Project Stonewall P1aza,Turnpike St,N.Andover Attachment Of 14m3achusaft`' m STM Commwim s Tating Paae # DAILY REPORT OF CONdRETE POUR JECT NAME: Sr U PROJECTNO.: ATE: r 1LL k, �B AIR TEMP.: 60 TOTAL YARDS: LOCATION OF .'POUR: J m INSPECTOR: �/ REMARKS. � ruFc(Qt490 OF L4D 5 Richardson Lane, Stoneham, Massachusetts 02180 (781) 438-7755 Fax (781) 438-6216 Batching Out 10'A t("00 I I a; A 51 I Time In Minutes t Q e 1105 13° «o I Yards' r 11 �I 3a r� I q Irr 55 Concrete Tempa 55' 55. % of Ticket Air G 3 1!l!aG�fGS 11 �� 16Ifep9 No, of Cylinders i 13 (A) J Lead & Truck # JInches II 30 5 1 30� I 307 3 p 305 Slurnp I %I% I Batching j In g; 3 fi 9 1 I 5 111;36 t O o I 01 I I I �I I I I I I I I I I I I i 1 INSPECTOR: �/ REMARKS. � ruFc(Qt490 OF L4D 5 Richardson Lane, Stoneham, Massachusetts 02180 (781) 438-7755 Fax (781) 438-6216 ' Of Massachusetts 'The Construction Testing People' -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Report Date 01/09/2008 Report No. 3 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 .ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/4 ° I No. Of Sets: 2 CUBIC YARDS: 55 SET 1 LOCATION- Wall, column line F at 7 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type P486 4 x 8 12.56 Good 01/09/2008 01/16/2008 7 36,000 2,870 1 P487 4 x 8 12.56 Good 01/09/2008 01/23/2008 14 46,000 3,660 3 P488 4 x 8 12.56 Good 01/09/2008 02/06/2008 28 53,000 4,220 1 P489 4 x 8 12.56 Good 01/09/2008 02/06/2008 28 55,000 4,380 2 P490 4 x 8 12.56 Good 01/09/2008 02/06/2008 28 56,000 4,460 1 SET 2 LOCATION- Wall, column line A at 3 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type P491 4 x 8 12.56 Good 01/09/2008 01/16/2008 7 40,000 3,180 2 P492 4 x 8 12.56 Good 01/09/2008 01/23/2008 14 48,000 3,820 4 P493 4 x 8 12.56 Good 01/09/2008 02/06/2008 28 62,000 4,940 3 P494 4 x 8 12.56 Good 01/09/2008 02/06/2008 28 63,000 5,020 1 P495 4 r. 8 12.56 Good 01/09/2008 02/06/2008 28 65,000 5,180 4 GENERAL REMARKS: Slump (in.) 4 Air Temp. (F.) 60 Conc Temp (F) 58 Truck No. 308 Ticket No. 6296 Time 1:00 Unit Wt lbs/cu ft Air Content (% Slump (in.) 3 3/4 Air Temp. (F.) 63 Conc Temp (F) 60 Truck No. 307 Ticket No. 6302 Time 3 :00 Unit Wt lbs/cu ft Air Content (% Inspector Name Premium Time Hours Travel Time Mario Messina No Min Day 1 Hr(s) REVIEWED BY: Robert S. Granada FRACTURE TYPES (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Of Massachusetts mThe Construction Testing Peoplem cam. 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Page 2 Report Date 01/09/2008 Report No. 3 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento -Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera A• Of Massachusetts 'The Construction Testing People' Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Report Date 01/09/2008 Report No. 3 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT 'Total Pour: Wall, column line A at 3-4, A F at 7, A -F at 3-2 Method of Placement: ❑ Pump ® Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ® Vibrator ❑ Other Other: Cylinder Fabrication Location: © Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑X Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑X Field ® Other by yellow shed Placement Protection: ® Thermal Blankets ❑ Heat ❑ None ❑ Other Slump Specification (in.) 3-5 Number of slumps out of specification reported to none If rejected Approved by Remarks: LITS of Massachusetts, Inc. Page 4 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) N. Andover Building Dept. Report Date 01/09/2008 Attn: Gerald A. Brown Report No. 3 1600 Osgood Street Job Number 11647 N. Andover, MA 01845 Project Stonewall Plaza,Turnpike St,N.Andover Attachment Of mcismhuseft Inc.*The Constrwim Testing PeopDAILY REPORT OF CONCRETE POUR PROJECT NAME: P I u y,, PROJECT NO.: DATE: I c, AIR TEMP.: 3 • TOTAL YARDS: S 5 LOCATION OF POUR: we. al S .q E ¢ 3 -- A - F 6 ¢ Load & Slump Batching I Truck # Inches In 18atching Out Time In Yards Minutes , Concrete i % of Ticket # No. of Temp. i Air Cylinders VLZ i I -i -7 ! I 3U$ I i I GO I I Ho Z Fs GG I 12 �o I Z zo ! rv ��4 y i I C:ZS9 f � I I i- I INSPECTOR: N1 , , o "r s s . - e REMARKS: p' 44 5 Richardson Lane, Stoneham, Massachusetts 02180 (781) 438-7755 Fax (781) 438-6216 Of Massachusetts Testing 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Page 1 Report Date 01/23/2008 Report No. 4 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/4 No. Of Sets: 2 CUBIC YARDS: 62 SFT 1 IOrATInN- Wall, column line F at 1.5 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type R669 4 x 8 12.56 Good 01/23/2008 01/30/2008 7 41,000 3,260 2 R670 4 x 8 12.56 Good 01/23/2008 02/06/2008 14 53,000 4,220 1 R671 4 x 8 12.56 Good 01/23/2008 02/20/2008 28 R672 4 x 8 12.56 Good 01/23/2008 02/20/2008 28 R673 4 x 8 12.56 Good 01/23/2008 02/20/2008 28 SFT 2 LOCATION- Wall, column line 7 at F Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type R664 4 x 8 12.56 Good 01/23/2008 01/30/2008 7 38,000 3,030 1 R665 4 x 8 12.56 Good 01/23/2008 02/06/2008 14 52,000 4,140 4 R666 4 x 8 12.56 Good 01/23/2008 02/20/2008 28 R667 4 x 8 12.56 Good 01/23/2008 02/20/2008 28 R668 4 x 8 12.56 Good 01/23/2008 02/20/2008 28 GENERAL REMARKS: * 1% accelerant Slump (in.) 4 1/4 Air Temp. (F.) 30 Conc Temp (F) 58 Truck No. 305 Ticket No. 6463 Time 10:15 Unit Wt Ibs/cu ft Air Content (% Slump (in.) 4 1/2 Air Temp. (F.) 34 Conc Temp (F) 55 Truck No. 302 Ticket No. 6467 Time 12:30 Unit Wt lbs/cu ft Air Content (% Inspector Name Premium Time Hours Travel Time B. Lumenello No Min Day 1 Hr (s) REVIEWED BY: Robert S. Granada FRACTURE TYPES (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar °• Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 01/23/2008 Report No. 4 Job Number 11647 N. Andover Building Dept. Project Stonewall P1aza,Turnpike St,N.Andover Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Contractor GFM Concrete CO. Benevento -Our reports are available in PDF form via email. Please email us at reportsOutsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera ,. Of Massachusetts: 'The Construction Testing People' Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 01/23/2008 Report No. 4 Job Number 11647 N. Andover Building Dept. Project Attn: Gerald A. Brown Stonewall P1aza,Turnpike St,N.Andover 1600 Osgood Street N. Andover, MA 01845 Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT -Total Pour: Wall, column line 1 at F -J, J at 1-4, 5.5-7, 7 at E -J Method of Placement: ❑ Pump ® Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ® Vibrator ❑ Other Other: Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box 0 Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑ Field ❑ Other Placement Protection: [-]Thermal Blankets ❑ Heat ® None ❑ Other Slump Specification (in.) 4-5 Number of slumps out of specification reported to none If rejected Approved by Remarks: UTS of Massachusetts, Inc. Page 4 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) N. Andover Building Dept. Report Date 01/23/2008 Attn: Gerald A. Brown Report No. 4 1600 Osgood Street Job Number 11647 N. Andover, MA 01845 Project Stonewall Plaza,Turnpike St,N.Andover Attachment INSPECTOR: _QiCI-VAI;���•!- REMARKS.5 5 Richardson Lane, Stoneham, Massachusetts 02180 (781) 438-7758 Fax (781) 438.6216 of f4aSS ieftim' S' JWJorm Cr01' sbuilm r Page # DAILY REPORT aF CONCRETE POUR JECT NAME: ST-cvJZL`�_-_ P�o �� � PROJECT NO.: ZATE: 11#rJ, AIR TEMP.: 60 .s TOTAL YARDS:_��. LOCATION OF'POUR: e E-1 Load & lump Batching Batching Time In Yards' I Concrete Temp. % of Ticket # Air No. of I Cylinders Truck # ! Inches In Out Minutes 307 I 111,136) 105 33 55° Oil 30 10 13 q4i 302. � eta io, (oo rr� 55. � �(o"Flo9 D5 3 i I '� f 11,0 138 to { INSPECTOR: _QiCI-VAI;���•!- REMARKS.5 5 Richardson Lane, Stoneham, Massachusetts 02180 (781) 438-7758 Fax (781) 438.6216 Of Massachusetts 'The Construction Testing People' -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Report Date 01/23/2008 Report No. 4 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 -ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/4" No. Of Sets: 2 CUBIC YARDS: 62 SET 1 LOCATION- Wall, column line F at 1 S Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type R669 4 x 8 12.56 Good 01/23/2008 01/30/2008 7 41,000 3,260 2 R670 4 x 8 12.56 Good 01/23/2008 02/06/2008 14 R666 4 x 8 12.56 R671 4 x 8 12.56 Good 01/23/2008 02/20/2008 28 4 x 8 12.56 Good R672 4 x 8 12.56 Good 01/23/2008 02/20/2008 28 12.56 Good 01/23/2008 R673 4 x 8 12.56 Good 01/23/2008 02/20/2008 28 SET 2 LOCATION- Wall, column line 7 at F Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type R664 4 x 8 12.56 Good 01/23/2008 01/30/2008 7 38,000 3,030 1 R665 4 x 8 12.56 Good 01/23/2008 02/06/2008 14 R666 4 x 8 12.56 Good 01/23/2008 02/20/2008 28 8667 4 x 8 12.56 Good 07./23/2008 02/20/2008 28 R668 4 x 8 12.56 Good 01/23/2008 02/20/2008 28 GENERAL REMARKS: * 1% accelerant Slump (in.) 4 1/4 Air Temp. (F.) 30 Conc Temp (F) 58 Truck No. 305 Ticket No. 6463 Time 10 : 15 Unit Wt lbs/cu ft Air Content M Slump (in.) 4 1/2 Air Temp. (F.) 34 Conc Temp (F) 55 Truck No. 302 Ticket No. 6467 Time 12: 30 Unit V':t lbs/cu ft Air Content M Inspector Premium Name Time Hours Travel Time B. Lumenello No Min Day 1 Hr (s) REVIEWED BY:. Robert S. Granada FRACTURE TYPES (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar °w Of Massachusetts The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Report Date 01/23/2008 Report No. 4 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Contractor GFM Concrete CO. Benevento .Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera Of Massachusetts 'The Constiruction Testing People" 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 01/23/2008 Report No. 4 N. Andover Building Dept. Job Number 11647 Attn: Gerald A. Brown Project Stonewall P1aza,Turnpike St,N.Andover 1600 Osgood Street N. Andover, MA 01845 Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT �TotalPour: Wall, column line 1 at F -J, J at 1-4, 5.5-7, 7 at E -J Method of Placement: ❑ Pump ❑X Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ❑X Vibrator ❑ Other Other: Cylinder Fabrication Location: ❑X Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑X Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑ Field ❑ Other Placement Protection: ❑ Thermal Blankets ❑ Heat © None ❑ Other Slump Specification (in.) 4-5 Number of slumps out of specification reported to none If rejected Approved by Remarks: ` UTS'of Massachusetts, Inc. 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) N. Andover Building Dept. Report Date Attn: Gerald A. Brown Report No. 1600 Osgood Street Job Number N. Andover, MA 01845 Project Attachment 01/23/2008 Page 4 4 11647 Stonewall Plaza,Turnpike St,N.Andover Of ".011umhusot I "TM Const Ttin9 Pace # DAILY REPORT OF CONCRETE POUR JECT NAME: Sr o PROJECTNO.: ATE: ��� 3, �,®p� AIR TEMP.: ms's TOTAL YARDS: �+• �' `�� oaf��! LOCATION OF POUR: Load & Truck # Slump Inches I Satching In Batching Out I Time In Minutes I Yards' Concrete Tempa % of Ticket Air NQ. of Cylinders o 307 5o5 I � � 11136 a I 0 I ►05 138 ,+ 33 q4 (a 55' � 5'f° �f;fp�6�fL5 If, bll�f6G I I I I � I I I I � INSPECTOR: -r�A9 / -� �� REMARKS: �xu�4p490 of Lit ' 5 Richardson Lane, Stoneham, Massachu5ett5 02180 (781) 438-7755 Fax (781) 438-6216 Of Massachusetts "The Construction -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Concrete Field Report Report Date 01/24/2008 Report No. 4 Job Number 11647 N. Andover Building Dept. Project stonewall plaza,Turnpike St,N.Andover Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Contractor GFM WEATHER: .TIME: CONTACT: SUMMARY: Transported two sets of cylinders cast on 01/23/08 to the lab for testing. GENERAL REMARKS: Inspector Name Premium Time Hours Travel Time Matthew Marsh No REVIEWED BY: William P. Crabtree Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera Of _ oplem -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Reinforcing Steel Report N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 CONTACT: Gino Fodera _TIME OF INSPECTION: 9: 3 0 AM TIME OF CONCRETE PLACEMENT: lo: lo AM SPECIFICATION: ASTM A615 Grade 40 ASTM A616 Grade 50 ASTM A617 Grade 40 CONTRACT DRAWINGS: S - 1. 02 Report Date 01/23/2008 Report No. 3 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Grade 60 X Grade 75 Grade 60 Grade 60 REVISION. NUMBER: DATED: 10/5/07 SHOP DRAWING(S): PROJECT SPECIFICATIONS: 033 00 OTHER: DRAWINGS STAMPED: YES X NO - AREA REVIEWED: Wall, column line 1 at F -J, J at 1-4, 5.5-7, 7 at E -J ATTRIBUTES: REVIEWED Yes No Coverage (Top Bottom and/or Inside Face x Outside Face x ) X Clearance X Cleanliness (heavy rust, scale, mud, dirt, oil, etc. not permitted) X Bar Supports X Bar Spacing X Bar Quantity X Placement and tying X ❑X The details in'the above described area(s) were complete at the time of this inspection. Q The results of this inspection were discussed with the aforementioned contact persons prior to departure from the project site. GENERAL REMARKS: Inspector Name Premium Time Hours Travel Time B. Lumenello No ° Of Massachusetts 'The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Reinforcing Steel Report N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 .REVIEWED BY: William P. Crabtree Page 2 Report Date 01/23/2008 Report No. 3 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM v Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. CC: GFM General Contracting Corp. Attn: Gino Fodera 4. Of Massachusetts 'The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 f�_- -Page 1 Report Date 12/20/2007 Report No. 1 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete CO. Benvento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/4" 1 No. Of Sets: 1 CUBIC YARDS: 25 SFT 1 1OrATInN• Wall, column line J at 3-7 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type H816 4 x 8 12.56 Good 12/20/2007 12/27/2007 7 35,000 2,790 3 H817 4 x 8 12.56 Good 12/20/2007 01/03/2008 14 46,000 3,660 3 H818 4 x 8 12.56 Good 12/20/2007 01/17/2008 28 67,000 5,330 2 H819 4 x 8 12.56 Good 12/20/2007 01/17/2008 28 68,000 5,410 1 H820 4 x 8 12.56 Good 12/20/2007 01/17/2008 28 65,.000 5,180 4 GENERAL REMARKS: Slump (in.) 4 1/2 Air Temp. (F.) 35 Conc Temp (F) 64 Truck No. 306 Ticket No. 6104 Time 9:35 Unit Wt lbs/cu ft Air Content M) Inspector Name Premium Time Hours Travel Time S. Phelan No Min Day 1 Hr (s) REVIEWED BY: Robert S. Granada FRACTURE TYPES r (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for.more information. CC:..... -GFM General Contracting Corp. Attn: Gino Fodera - Of Massachusetts mThe Construction Testing Peoplem 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Page 2 Report Date 12/20/2007 Report No. 1 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benvento FIELD SUMMARY REPORT Total Pour: Wall, column line J at 3-7, H -J at 0-1.25 Method of Placement: ❑ Pump © Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ® Vibrator ❑ Other Other: Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑X Field ❑ Other Placement Protection: []Thermal Blankets ❑ Heat © None ❑ Other Slump Specification (in.) 5 Number of slumps out of specification reported to If rejected Approved by Remarks: LITS of Massachusetts, Inc. Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) N. Andover Building Dept. Report Date 12/20/2007 Attn: Gerald A. Brown Report No. 1 1600 Osgood Street Job Number 11647 N. Andover, MA 01845 Project Stonewall P1aza,Turnpike St,N.Andover Attachment �.Lv .. Ill�.,i/�`.- Sll Y�f LCHaI l- &gy ! J �:C 3� .3= 1 +}-=r,:;?n +.?� CcncrztE I J1 ZALkz-i 4Jcry. , , , _.� Zss +� 0 1. t_ + r; i Of Massachusetts 'The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 -Page 1 Report Date 01/09/2008 Report No. 3 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benevento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 -ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 4000# 3/4" No. Of Sets: 2 CUBIC YARDS: 55 SET 1 LOCATION- Wall, column line F at 7 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type P486 4 x 8 12.56 Good 01/09/2008 01/16/2008 7 36,000 2,870 1 P487 4 x 8 12.56 Good 01/09/2008 01/23/2008 14 P488 4 x 8 12.56 Good 01/09/2008 02/06/2008 28 P489 4 x 8 12.56 Good 01/09/2008 02/06/2008 .28 P490 4 x 8 12.56 1 Good 01/09/2008 02/06/2008 28 SET 2 LOCATION- Wall, column line A at 3 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load Fracture (psi.) Type P491 4 x 8 12.56 Good. 01/09/2008 01/16/2008 7 40,000 3,180 2 P492 4 x 8 12.56 Good 01/09/2008 01/23/2008 14 P493 4 x 8 12.56 Good 01/09/2008 02/06/2008 28 P494 4 x 8 12.56 Good 01/09/2008 02/06/2008 28 P495 4 x 8 12.56 Good 01/09/2008 1 02/06/2008 28 GENERAL REMARKS: Slump (in.) 4 Air Temp. (F.) 60 Conc Temp (F) 58 Truck No. 308 Ticket No. 6296 Time 1:00 Unit Wt lbs/cu ft Air Content M Slump (in.) 3 3/4 Air Temp. (F.) 63 Conc Temp (F) 60 Truck No. 307 Ticket No. 6302 Time 3 : 00 Unit Wt lbs/cu ft Air Content M Inspector Name Premium Time Hours Travel Time Mario Messina No Min Day 1 Hr(s) REVIEWED BY: Robert S. Granada FRACTURE TYPES Y (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 01/09/2008 Report No. 3 N. Andover Building Dept. Job Number 11647 Attn: Gerald A. Brown Project Stonewall P1aza,Turnpike St,N.Andover 1600 Osgood Street N. Andover, MA 01845 Contractor GFM Concrete Co. Benevento -Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. Cc: GFM General Contracting Corp. Attn: Gino Fodera ice= Of MassachusettsmThe Construction Testing Peoplem Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 01/09/2008 Report No. 3 N. Andover Building Dept. Job Number 11647 Attn: Gerald A. Brown Project Stonewall Plaza,Turnpike St,N.Andover 1600 Osgood Street N. Andover, MA 01845 Contractor GFM Concrete Co. Benevento FIELD SUMMARY REPORT 'Total Pour: Wall, column line A at 3-4, A F at 7, A -F at 3-2 Method of Placement: ❑ Pump ❑X Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: Q Vibrator ❑ Other Other: Cylinder Fabrication Location: ❑X Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑X Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑X Field © Other by yellow shed Placement Protection: © Thermal Blankets ❑ Heat ❑ None ❑ Other Slump Specification (in.) 3-5 Number of slumps out of specification reported to none If rejected Approved by Remarks UTS of Massachusetts, Inc. Page 4 5 Richardson Lane, Stoneham, MA 02180 781438-7755 (Voice) 781-438-6216 (Fax) N. Andover Building Dept. Report Date 01/09/2008 Attn: Gerald A. Brown Report No. 3 1600 Osgood Street Job Number 11647 N. Andover, MA 01845 Project Stonewall Plaza,Turnpike St,N.Andover Attachment 00 "Of flkwwhusetts Inc. ■estilm -00 aft1i• Ail/��� -,,�PageDAILY REPORT OF CONCRETE POUR 104 40' PROJECT NAME: P i e a,, PROJECT NO.: DATE; l AIR TEMP.: .5Z, TOTAL YARDS: _S S LOCATION OF POUR: We. 11 s q (F z -7 A _ F..( -t -7 4 F. f _: 4 ILoad & SlumpBatching Batching Time In Yards Truck # Inches In Out Minutes , Ll i Concrete % of I Ticket # i No. of Temp. i Air Cylinders i I GG I 12 `o 2 ZO25� 30-7 c30Z !' S I I I I I l I I I I I I I � I i I I I I I � I � I i INSPECTOR: t - -1c ,, , c, r`1 c S s ,, REMARKS: . Jo ; y 5 Richardson Lane, Stoneham, Massachusetts 02180 (781) 438-7755 Fax (781) 438-6216 q Of Massachusetts The Construction Testing People' Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Reinforcing Steel Report N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Report Date 01/09/2008 Report No. 2 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM CONTACT: Gino Fodera _TIME OF INSPECTION: 11: 00 AM TIME OF CONCRETE PLACEMENT: 12:30 PM SPECIFICATION: ASTM A615 Grade 40 Grade 60 X Grade 75 ASTM A616 Grade 50 Grade 60 ASTM A617 Grade 40 Grade 60 CONTRACT DRAWINGS:S-1.02 REVISION NUMBER: o DATED: 10 / 5 / 0 7 SHOP DRAWING(S): PROJECT SPECIFICATIONS: 03300 OTHER: DRAWINGS STAMPED: YES NO X AREA REVIEWED: Wall, column line A at 3-7, 7 at A -F, A -F at 2-3 ATTRIBUTES: REVIEWED Yes No Coverage (Top Bottom and/or Inside Face x Outside Face x ) Clearance Cleanliness (heavy rust, scale, mud, dirt, oil, etc. not permitted) Bar Supports Bar Spacing Bar Quantity Placement and tying X X X X X X X 14 The details in the above described area(s) were complete at the time of this inspection. The results of this inspection were discussed with the aforementioned contact persons prior to departure from the project site. GENERAL REMARKS: Inspector Premium Travel Name Time Hours Time Mario Messina No Of dwThe Construction Testing Peoplem ,�rz�ar#jam 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Reinforcing Steel Report N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 .REVIEWED BY: William P. Crabtree Page 2 Report Date 01/09/2008 Report No. 2 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Wz Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera Of Massachusetts The Construction Testing People' 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Concrete Field Report Report Date Report No. Job Number N. Andover Building Dept. Project Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Contractor WEATHER: .TIME: CONTACT: -Page 1 01/10/2008 3 Premium 11647 Travel Stonewall P1aza,Turnpike St,N.Andover If 3o Time GFM No SUMMARY: Transported 2 sets of cylinders cast on 1/9/08 to the lab for testing. GENERAL REMARKS: Inspector Premium Travel Name Time Hours Time Matthew Marsh No REVIEWED BY: William P. Crabtree / Wi Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera Of MassachusettsmThe Construction Testing Peoplem 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 -Page 1 Report Date 12/12/2007 Report No. 2 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benvento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 .ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-3; CLASS CONCRETE: 3000# 3/4" No. Of Sets: 2 SFT 1 I 0CAT1nN• Font i no _ enl Imn 1 in a u_.T � r 1 -1 c CUBIC YARDS: 82 Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type G897 4 x 8 12.56 Good 12/12/2007 12/19/2007 7 25,000 1,990 3 G898 4 x 8 12.56 Good 12/12/2007 12/26/2007 14 37,000 2,950 2 G899 4 x 8 12.56 Good 12/12/2007 01/09/2008 28 48,000 3,820 1 G900 4 x 8 12.56 Good 12/12/2007 01/09/2008 28 45,000 3,580 2 G901 4 x 8 12.56 Good 12/12/2007 01/09/2008 28 47,000 3,740 3 SFT 9 1 C)rATION• Foot ina . cnl mmn l i na (l_ r .+.- 1 7G _ i An Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type G892 4 x 8 12.56 Good 12/12/2007 12/19/2007 7 24,000 1,910 2 G893 4 x 8 12.56 Good 12/12/2007 12/26/2007 14 36,500 2,910 1 G894 4 x 8 12.56 Good12/12/2007 01/09/2008 28 44,000 3,500 2 G895 4 x 8 12.56 Good 12/12/2007 01/09/2008 28 42,000 3,340 1 G896 4 x 8 12.56 Good 12/12/2007 01/09/2008 28 45,000 3,580 4 GENERAL REMARKS: Slump (in.) 4 3/4 Air Temp. (F.) 43 Conc Temp (F) 75 Truck No. 307 Ticket No. 6038 Time 12:45 Unit Wt lbs/cu ft Air Content (%) Slump (in.) 4 1/2 Air Temp. (F.) 43 Conc Temp (F) 72 Truck No. 401 Ticket No. 6044 Time 2 : 05 Unit Wt lbs/cu ft Air Content M Inspector Premium Travel Name Time Hours Time S. Phelan No Max Day 1 Hr(s) REVIEWED BY: Robert S. Granada .FRACTURE TYPES - V (1) Cone (2) Cone and Split (3) Cone and Shear (4) Shear (5) Columnar Of Massachusetts mThe Construction Testing Peoplem 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Page 2 Report Date 12/12/2007 Report No. 2 Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benvento .Our reports are available in PDF form via email. Please email us at reportsOutsofmass.com for more information. cc: GFM General Contracting Corp. Attn: Gino Fodera + Of Massachusetts -The Construction Testing People' Page 3 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 Report Date 12/12/2007 Report No. 2 Job Number 11647 Project Stonewall Plaza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benvento FIELD SUMMARY REPORT Total Pour: Footing, column line A -J at 1-7 Method of Placement: ❑ Pump ® Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: ® Vibrator ❑ Other Other: Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑ Trailer 0 Field ❑ Other Placement Protection: ® Thermal Blankets ❑ Heat ❑ None ❑ Other Slump Specification (in.) 4-6 Number of slumps out of specification reported to If rejected Approved by Remarks: UTS of Massachusetts, Inc. Page 4 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) N. Andover Building Dept. Report Date 12/12/2007 Attn: Gerald A. Brown Report No. 2 1600 Osgood Street Job Number 11647 N. Andover, MA 01845 Project Stonewall Plaza,Turnpike St,N.Andover C A;Ly FEHCK— C 1G-NC!zP AiR TEMP.: 7-: 7A L YA F S: ffa=6.1 jM 60 1-26206 -37 Za 7, in r- 5arcninq 7 -me lgi--s C.r 7ck,-:;t=';r i S emc. j Air a[2F= PC ftimL Z- Of Massachusetts $1ida The Construction Testing Peoplem ■fir 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete N. Andover Building Dept. Attn: Gerald A. Brown 1600 Osgood Street N. Andover, MA 01845 -Page 1 Report Date 12/20/2007 Report No. Condition Job Number 11647 Project Stonewall P1aza,Turnpike St,N.Andover Contractor GFM Concrete Co. Benvento ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 .ALL COMPRESSIVEE STRENGTH TESTS DONE ACCORDING 10 ASTM: C-39 CLASS CONCRETE: 4000# 3/4" 1 No. Of Sets: 1 CUBIC YARDS: 25 SET 1 1 OrATIOM- Wall. rnl umn l i na .1 a r Z_ � Lab No. Size (in.) Area (sq. in.) Condition Date Cast Date Tested Age Days Total Load (lbs.) Unit Load (psi.) Fracture Type H816 4 x 8 12.56 Good 12/20/2007 12/27/2007 7 35,000 2,790 3 H817 4 x 8 12.56 Good 12/20/2007 01/03/2008 14 46,000 3,660 3 H818 4 x 8 12.56 Good 12/20/2007 01/17/2008 1 28 H819 4 x 8 12.56 Good 12/20/2007 01/17/2008 28 H820 4 x 8 12.56 Good 12/20/2007 01/17/2008 28 GENERAL RFMARKS- Slump (in.) 4 1/2 Air Temp. (F.) 35 Conc Temp (F) 64 Truck No. 306 Ticket No. 6104 Time 9:35 Unit Wt Ibs/cu ft Air Content (%) Inspector Premium Travel Name Time Hours Time S. Phelan No Min Day 1 Hr(s) REVIEWED BY: Robert S. Granada FRACTURE TYPES r � r r (1) Cone (2) Cone and Split (3) Cone and Shear4 () Shear (5) Columnar Our reports are available in PDF form via email. Please email us at reportsOutsofmass.com for more information. cc: GFM General Contracting' Corp. Attn: Gino Fodera Of Massachusetts The Construction Testing People' Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) Compressive Strength Report - Concrete Report Date 12/20/2007 Report No. 1 Job Number 11647 N. Andover Building Dept. Project Stonewall P1aza,Turnpike St,N.Andover Attn: Gerald A. Brown 1600 Osgood Street N. Andover, NIA 01845 Contractor GFM Concrete Co. Benvento FIELD SUMMARY REPORT 'Total Pour: wall, column line J at 3-7, H -J at 0-1.25 Method of Placement: ❑ Pump © Chute Discharge ❑ Bucket ❑ Other Other: Method of Concrete Consolidation: © Vibrator ❑ Other Other: Cylinder Fabrication Location: ❑X Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑ Curing Box ❑ Thermal Blanket ❑ Hay/Straw ❑ Trailer ❑X Field ❑ Other Placement Protection: []Thermal Blankets ❑ Heat ❑X None ❑ Other Slump Specification (in.) 5 Number of slumps out of specification reported to If rejected Approved by Remarks: of Massachusetts, Inc. Page 3 ardson Lane, Stoneham, MA 02180 781-438-7755 (Voice) 781-438-6216 (Fax) ndover Building Dept. Report Date 12/20/2007 Gerald A. Brown Report No. 1 Osgood Street Job Number 11647 ndover, MA 01845 Project Stonewall Plaza,Turnpike St,N.Andover hment too -41ft I- /P j 7 7 7cicat:;:- 7, Ut MirQtSS J r go i-' M Date... ............. 0 - TOWN OF NORTH ANDOVER PERMIT FOR WIRING 4L 0 0 This certifies.. .... .............................................................. has permission to wiring in the bu of .......... ................................................................ at ........... .. ........ ......... . . -North Andover, Mass. ...... Lic. NoV92�;E . ................ . .......... .... . .... . ..... CLEcrmc�AL INSPEC�T'O Check # fi J N Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Offirc7Use ,, s//e Only Permit No. / 9�`1�f 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), CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 2— © y City or Town of. NORTH ANDOVER To the I spec or of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) <2, p o Y-inolt. St Owner or Tenant c--- .ic�/t( Telephone No. ?,p _7J7_,0p p7 Owner's Address 3 �— C' /l M, M lt45 r1- -1 fl/n Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Ae�Y-C-t A Utility Authorization No. Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: O ti Overhead ❑ Undgrd ❑ No. of Meters Overhead ❑ Undgrd ❑ No. of Meters oIk /7c ep,ee�,r- Com letion nf theollowin tabl b d b h L No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans may a waive y t e Ins ector of Wires. No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool AboveElIn- ❑ rnd. rnd. o. oEmergency-righting BafteEy Units No. of Receptacle Outlets No. of Oil Burners' FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and InitiatingDevices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number Tons KW ,. No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers No. of Water Heaters' Heating Appliances KW No. of No. of Signs Ballasts Security Systems:* No. of Devices or Equivalent Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: `-� Attach additional detail if desired, or as required by the Inspector of Wires. kEstimated Value of Elec 'cal Work: (When required by municipal policy.) 0) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE CO RAGE: 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 El BOND F1 OTHER ❑ (Specify:) I certify, under the pains andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: �� i/ (e LIC. NO.: 1973 Licensee: - Lo /,- ��,- Signature _LIC. NO.: (If applicable, enyr "exempt" in the license number line.) �/ r\ Bus. Tel. No.: Address: f Pe A -f rp.-, -5An yl llp �i� ,o 3�/ Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. 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) F] owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $�= i. The Commonwealth of Massachusetts �i ! Department of Industrial Accidents 6! `i Office of Investigations . 600 Washington Street Boston, MA 02111 www.nwss.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plambers Applicant Information Please Print Legibl Name (Business/Organization/individual):r,115 evi,,— ' Address: moi' /5 e City/State/Zip: i /I Phone #: . Are you an employer? Check the appropriate box: c1r b t. E�-I am a employer with �_ 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a.sole proprietor or partner- listed on the attached sheet. t 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. ❑ 1 am a homeowner doing all work right of exemption per MGL myself. [No -workers' comp. c. 1.52, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] An a U t th k Type of project (required): 6. &New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 1 l .❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other J pp can at cc s OX Ft l must also nil out the section below showing their workers compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their wor4cers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees: Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lie. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required. under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. do hereby certify ujtder, ftpainsgnd penalties of perjury that the information provided above is t e and correct 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): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the'foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner -of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance 'coverage required." Additionally, MGL chapter 152, §25C(7) states' Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance reTaireMUnts of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial • Accidents for confirmation of insurance coverage.. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, nofthe Department of r Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate dine. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts u Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-7274900 ext 446 or 1-8.77-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia