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Miscellaneous - 190 ACADEMY ROAD 4/30/2018 (2)
J190 HcADF-my ROAD J t I i i I E 251 Date.(. �zte.h%4 .. . ..... NORTH TOWN OF NORTH ANDOVER pf ��io ,e'e 00 aj O '� PERMIT FOR MECHANICAL INSTALLATION r. ` m f P ,t ♦ 7 -•h 6 this certifies that /. .�j + �? . • . . . .. . . . • • • has permission for mechanical installation .-0\ . . . . . . .. . .. . . . n the buildings of . :�.1� ( fi¢ '�.I!^ C� `A•rl ��. . . . . . .. at . . . . U. .'. - .ECAC--Vn . . • • • • •, North Andover, Mass. Fee. �. . . Lic. Jt--�. . . . . . . . . . . . ... .. . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Commonwealth of Massachusetts Sheet Metal Permit Date : Permit# Estimated Job Cost: /99M .00.1 Permit Fee: Plans Submitted: YES ✓NO Plans Reviewed: YES✓ NO Business License# Applicant License# Business Information: Property Owner/Job Location Information: Name r Q. S 5-Tc n� Name: h AA R s`1 &-�"TJA Street: / l^6� Street: l Ca� ��✓ City/Town: //G� ��:I /t)/� City/Town: t4,7 Telephone: �j? 8 Y6,9 316°0 Telephone: g-2 129 Sia Photo I.D. required/Copy of Photo I.D. attached: YES NO Building Type: Residential: 1-2 family Multi-family Condo/Townhouses Commercial_: Office Retail Industrial Educational Institutional ✓ Building Cubic Footage: under 35,000 cu.ft. V over 35,000 cu. ft. Sheet metal work to be completed: New Work: Renovation: HVAC_L/Metal Roofing Kitchen-Exhaust System Chimney/Vents r Provide brief description of work to be done: f e INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes X No❑ If you have checked Yes,indicate the type of coverage by checking the appropriate box below: A liability insurance poli Other type of indemnity ❑ Bond ❑ OWNER'S INSURANC RIVER:)aaware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts Gen e1 Laws, t my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent Signature o wner or Owner's Agent 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 sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Progress Inspections Date Comments i s Final Inspection Date Comments Type of License: 3y Master rltle ❑Master-Restricted ,itylTown ❑Journeyperson nature of Licensee permit# /I ❑Journeyperson Restricted License Number: =ee$ rl Check at www.mass.gov/dpl ispector Signature of Permit Approval The Commonwealth ofit2"assachusetts - Depa�tmentoflnrlus€vrczlAcczcler�ts Office of Investigations 600 Washington.Mreet loston,NMA 02111 www.mass govIdla Workers'Compensationbsuran-ceAffidavit:Baders/Cont°actors)ElectriciansfPliimbers APpReant Xnformation ! Please Prim Le�ibXy Name(Business/Organization&dividual): Address:A Cmlk City/State/Zip: s-\�V g� Phone#: 2,6 3 D Oy Are yo an employer?Check th"pp�ropriate box: Type of project(required): 1. i am a employer with.Z 4. [l I am a general contractor and I 6, ]New construction employees(full and/or part tim.e).* have hired the sub-contractors 2.❑ I am a sola proprietor or partner listed on the attached sheet. 7. []Remodeling ship and'lava no employees These sub-contractors have 8. [Demolition working forme is any capacity. workers'comp.insurance, g, []Building addition (No worlters'comp.Insurance 5. 0 We are a Corp orafion and its required.] officers have oxercised.thoir 10.[]Electrical repairs or additions S.[l X am a homeowner ttoing all work right of exemption per MGL 11.[]Plumbing.xepairs or additions myself:[No workers'comp. c.152,§1(4),andwehaveno 12,[]Roofxepairs insurance re edemployees.[No workers, �' .a 13.[�tlier }�J$G comp.insurance required.] NAny applicautthat checks box#I must also fill outthe section below showingtheir workers'compensatioapolicy information. Homeownerswho sabmitibisaffidavitindicatingtheytiedpingallworlcandthenhireoutsidecontractorsmustsubmitanewaffidavitindicatingsiroh. TContractors that checkthis box must attached an additional sheet sbowingthe.name o£the sub.-contractors andtheir workers'comp.policy information. X am an em.,ployer that isprovirlfng workers'compensation insurance for my employees Below zs thepolley andlab site information. Insuxance Company Name: (V JacA Policy#or S elf'-ins.UG.M. L( 6 S Q 0 Expiration Date: �j I`�•� Job Site Address: Attacha,copy oldie workers'compensation-policy declaration page(showing the policy number and expiration date). ]ailure to secure coverage as required er Section 25A ofMGL o.152 can lead to the imposition of criminal penalties of a flue up to$1,500.00 and/or one=ye prisonmm &,as well as civil penalties in the form of a STOP WORK ORDER and a fine of-up to$250.00 a day agaivs . olator. B adthat a copy of this s-tatementmay bo forwarded to the Office of Investigations ofthe DIA fox " urance co age verification. X do liereby eel tz un the p ' r of rju Mat tree information,provided above is true and correct. - Signature: - Data: Phone##: oo Oficial use only, Do not write in this area,to be completed by city or tort official City or Town: PermitlLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - - Contact Person: Phone#: Information and Instrnctions 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 isi.the service of another under any contract ofhixe, express orimplied,oral orwritten:' An employe, is defined as"an.individual,partnership,association,corporation or other legal entity,or any two or more of the Foregoing engaged in a j oint enterprise,and including the legal representatives of a:deceased employer,or the xedeiver 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 employes." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shalt withhold the issuance or renewal of a license or permit to op erate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage reclnired" 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 chapterhave bompresentedto the contracting authority." Applicants Please Rff out the workers'compensation affidavit completely,by checking flo 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 insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are notrequired to carryworkers'compensation insurance. If an LL C or LLP does have employees,apolicy 1s required. Be advised thatthis affidavit maybe submitted to the Department of ludustrial Accidents fox coniumation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be xetumed to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Shouldyou have any questions regarding the law or ifyou are required to obtain a*orkers' compensationpoliey,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 till in the permit/license number whichwill be used as a reference number, In addition,an applicant thatmust submitmultiple permit/license applications in any given year,need only submit one affidavit indicating current Policy in:fonnation(ifneeessary)and under"Job Site Address"the applicant shouldwrite"all locations in (city or towix):'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 orliermit to burn leaves eta.)saidperson is NOT required to complete this affidavit, The Office of Investigations would like to thank you in advance.for your cooperation and shquld you have any questions, please do not hesitate to give us a call. The Department's address,telephone acrd fax number: The CQx Uwa-woalt� ofY-0s�6h,-V&Pttl Department;Q fndusftial,Accide-uta Office QUAVONtipfiona 60Q Wa�hi4on eruct TOL#&M-27,4900 and 406 4x I-WY.:MA F Revised 5-26-05 Fax 617-727-7749 ' wc�v.�ta�s,g�vfdia . ® FDATE(MM/DDIYYYY) A� CERTIFICATE OF LIABILITY INSURANCE 06/25/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: PHONE FAX Automatic Data Processing Insurance Agency,Inc. (A/C,No Ext); alc,No 1 Adp Boulevard ADDRESS: Roseland,NJ 07068 INSURER(S)AFFORDING COVERAGE NAIC n INSURERA: NorGUARD Insurance Company 31470 INSURED INSURER B: DRY AIR SYSTEMS INC INSURER C: 18 Graf Rd Unit 10 Newburyport,MA 01950 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 243805 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MM/DD MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ O COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE D OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM IOP AGG $ POLICY jEa LOC $ AUTOMOBILE LIABILITY COMBINED)SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDSCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED _FETENTION$ $ WORKERS COMPENSATION X WC STATU- O AND EMPLOYERS'LIABILITY TORY LIMITS ERR ANY PROPRIETOR/PARTNERIEXECUTIVE Y/N❑Y NIA N DRWC446520 11/01/2013 11/01/2014 E.L.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBEREXCLUDED? (Mandatory in NH) E.L._DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,N more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town OF North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main St North Andover,MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD OP ID:OUJA CERTIFICATE OF LIABILITY INSURANCE DATE(M 06/224/14/1YYY) 4 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone:978-688-6921 CONTACTNAME: Macdonald&Pangione InsurancePHONE FAX P.O.Box 428 Fax:978-688-5350 A/c No Ext): AIC No): 104 Main Street E-MAIL North Andover,MA 01845 ADDRESS: PRODUCER DRYAI-1 Michael Pangione CUSTOMER ID*: INSURERS)AFFORDING COVERAGE NAIC# INSURED Dry Air Systems,Inc. INSURER A:Hartford Fire Insurance Co 00914 Diversified Automation INSURER B:Commerce Ins Co 34754 Services,Inc. INSURER 18 Graf Road,Unit 10 suRERc:Guard Insurance Group Newburyport,MA 01950 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE DL UBR POLICY EFF POLICY EXP LIMITS LTR R POLICY NUMBER MM/DD MM/DD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY 08SBAPT0911 07/11/13 07/11/14 DA AG PREMISES[Ea occurrence) $ �1 000,00 CLAIMS-MADE FxI OCCUR MED EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 B ANY AUTO BDJNWZ-1 07/11/13 07/11/14 (Ea accident) BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Per accident) X NON-OWNED AUTOS X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 4,000,00 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 4,000,00 A 08SBAPT0911 07/11113 07/11/14 DEDUCTIBLE $ X RETENTION $ 10,000 $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETORIPARTNERIEXECUTIVEF—] NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A ERISA(401K) 08 SBA PT0911 07/11/13 07/11/14 100,00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main Street North Andover,MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD X >COMMONW�gLTH OF MA $ACHUSeTT SHEET ORKERS ISSUES THE FOLLOWI{V LJCEN-S t ASA MASTER UNRESTRICTEDAid: KENNETH B PA7T'EN I 10 LANJ) R. FtD I E L D MA 01940-21 19b3 06/28/15 19191 I t 'T ' H ofNSE A . s...�an 4d NUM�r��jtO, . YNNFIELD MA 0.1840 2117. : tq' B:DD 05.10-2010 '' . 06/0412014 09:15 DEC-TAM Corporation OW)6178 4701017 P.0021006 h.• s DEGTAM ENVIRONMENTAL SERVICES RECEIVED JUN 0 9 2014 7�VV14 OF NORTH ANDOVER �JEALTH DEPARTMENT June 3, 2014 North Andover Board of Health 1600 Osgood Street Bldg 20, Suite 2-36 North Andover, MA 01845 RE: North Parish Church, 190 Academy Road,North Andover,MA 01845 (Attic Area Roof Enclosure) Dear Sir or Madam: Please be advised that Dec-Tam Corporation will be performing an asbestos abatement projects at the above referenced locations. This work has been scheduled for June 04, 2014 thru June 06, 2014 All applicable local, state and federal agencies have been notified of this work. Please let me know if you have any questions. Sincerest regards, Brenton Morgenstern Sales Estimator BM/cam Enclosure I SO Concord Street,North Reading,MA 01864 P:978.470.2860 F:978.470.1017 www.dectam.com 06/04/2014 09:16 DEC-TAM Corporation (FAX)978 4701017 P.0031006 Commonwealth of Massachusetts 100200272 Asbestos Notification Form ANF-001 Asbestos Project# C ProjectRevision f Project Cancellation A.Asbestos Abatement Description 1.Facility Location: NORTH PARISH CHURCH 190 ACADEMY ROAD Name of Facility Street Address NORTHAN30VER ^_.,_i; MA 01845 9788877948 CityRown Slate Zap Code Telephone REV SARAH STEWART MANAGER Faddy Contact Person Name Faciflly Contact Person Title Worksite Location: ATTICAREAROOF ENCLOSURE Building Name,Wing,Floor,Room,etc, 2.Is the facility occupied? C Yes r No Instructions 1.All sections of this form 3.Is this a fee exempt notification(city,town,district,municipal housing authority,state facility,or must be completed in owner-occupied residential property of four units or less)? r Yes G No order to comply with MawDEP notification 4.Blanket Permit Project Approval,if applicable: requirements of 310 CMR 7.15 and Approval ID# Department of Labor Standards(DLS) 5.Non-Traditional Asbestos Abatement Work Practice notification Approvalifapplicable: requirements of 453 pp ' aPp Approval ID# CMR6.12 6.Asbestos Contractor: DEr—TAM CORPORATION 50 CONCORD STREET 2.Submit Original Name Address Form To: NORTH READING MA 01864 9784702860 Commonwealth of Massachusetts Cityrrown State Z1p Code Telephone Asbestos Program AC000035 ContractT I✓Written ❑Verbal P.O.Box 120087 �e. Boston,MA 02112- DLS License 0087 7. GEORGEA.PAGE AS071933 Name of Contractor's On-Site Supervisor/Foremen DLS Certification# 8. ENVIRONMENTAL HEALTH INC AA000044 Name of Project Monitor DLS Certification# 9. ENVIRONMENTAL HEALTH INC AA000044 Name of Asbestos Analytical Lab DLS Certification# 10. 6/4/2014 6/612014 Project Start Date(MMIDWYYYY) End Date(MM/DDNYYY) 7A-4P N/A Work Hours-Monday Through Friday Work Hours-Saturday&Sunday 11.What type of project is this? Cs Demolition FF Renovation Ci Repair G Other-Please Specify: Revised 11/1312013 Page 1 of 06/04/2014 09:17 DEC-TAM Corporation TAX)978 4701017 P.0041006 Commonwealth of Massachusetts 100200272 ; - Asbestos Notification Form ANF-001 Asbestos Project# . G Project Revision G Project Cancellation A.Asbestos Abatement Description: (cont.) 12.Abatement procedures(check all that apply): G Glove Bag G Encapsulation 1 i Enclosure G Disposal Only G Cleanup G Full Containment R.1 Other-Please Specify: REGULATED AREA 13.Job is being conducted: r Indoors G Outdoors 14.Total amount of each type of asbestos Containing materials(ACM)to be removed,enclosed,or encapsulated 400 Unear Feet(Lin.Ftl Square Feet(Sq.FLl Boiler,Breaching,Duct, Transite Pipe Tank Surface Coatings Un.FL Sq.Ft Un.Ft Sq.Ft. Pipe Insulation Transite Shingles Un.Ft Sq.FL Un.Ft Sq.Ft Spray-On Fireproofing Transite Panels Lin.FL Sq.Ft lin.FL Sq.Ft Cloths,Woven Fabrics Other-Please Specify: Un.Ft Sq.Ft Insulating Cement VERMKXUTE 400 Lin.FL Sq.FL Lin.FL Sq.FL 15.Describe the decontamination system(s)to be used: THREESTAGE 16.Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2)(g): MATERIAL WIl BE WETTED AND PLACED IN PRELABELED BAGS FOR DISPOSAL 17.For Emergency Asbestos Operations,the MassDEP and DLS officials who evaluated the emergency: JN JORDAN INSPECTOR Name of MassDEP Official Title of MmDEP Official 6=014 14-06-996 Date of Authorization(MMIDDNYYY) - Waiver# MELISSA BUTTS 14SPECTUR Name of DLS Official Title of DLS official 6/211014 9748-2014 Date of Authorization(MM/DD/YYYY) Waiver# 18.Do prevailing wage rates as per M.G.L.c.149,§26,27 or 27A—F apply to this r; yes E-1 project? Revised: 11/13/2013 i Page 2 of 4 i 0610412014 09:17 DEC-TAM Corporation T'AX)878 4701017 P.0051006 Commonwealth of Massachusetts 100200272 Asbestos Notification Form ANF-001 Asbestos Project## r ti r Project Revision ❑ Project Cancellation B.Facility Description 1.Current or prior use of facility: Cts 2.Is the facility owner-occupied residential with 4 units or less? G Yes G No 3.NORTH PARISH CHURCH 180 ACADEMY ROAD Facility Owner Name AdNORTHANDOVER MA 01845 9786877948 Cityrrown State Zip Code Telephone 4.REV SARAH STEWART 190 ACADEMY ROAD Name of Facility Owners On-Site Manager AdNORTHANDOVER MA 01845 9786877948 Cityrrown State Zip Code Telephone i 5.DED TAM 5000NCORDST Name of General Contractor AdNREApW MA 01864 9784702860 Cityfrown State Tip Code Telephone GREATDMDE 153726612 12282014 Contractors workers Compensation Insurer Policy# Eviration Date(MMfODNYYY) Note:Temporary 6.What is the size of this facility? 15000 3 storage of Asbestos j containing waste material is only Square Feet >i of Room allowed at the place C. Asbestos Transportation&Disposal of business of a OLS licensed Asbestos 1.Transporter of asbestos-containing waste material from site of generation: oontraewr or a transfer P g station that Is permitted by r Dirwdy to Landfill or ❑ To Temporary Storage LocationtTrmfer Station MassDEP and operated in compliance with Solid SERVICETRANSPORT 58 PYLES LANE Waste Regulations Name of Transporter Address 310 CMR 19.000 NEWCASTLE CE 19720 8779999559 Cityrrown State 27p Code Telephone 2.If a temporary storage locationitransfer station is used,list name of transporter of asbestos containing waste material from temporary storage location/transfer station to final disposal site: Name of Transporter Address Chyylrown Slate Zip Code Telephone Revised:11/13/2013 Page 3 of 06/0412014 09:18 DEC-TAM Corporation (FAX)978 4701017 P.0061006 Commonwealth of Massachusetts lollzoo272 Asbestos Notification Form ANF-001 Asbestos Project# C Project Revision 171 Project Cancellation C.Asbestos Transportation&Disposal:(cont) 3.Name and address of temporary storage location/transfer station for the asbestos containing waste material: Note:Contractor must sign this form for DLs Temporary Storage Location Name Address notification purposes j Cily/rown State Zip Code Telephone 4.Name and location of final disposal site(asbestos landfill): MINERVA LANFDFILL CIO RANDY BRIDGES Final Disposal She Name Final Dlsposel Ste Owner Name 9000 MINERVA HIGHWAY Address WAYNESBURG CH 99546 8779999559 Cityfrown State Zip Code Telephone D. Certification 1 certify that I have personally examined the foregoing and am BRENI MORGENSTER BRENrMORGEN.STER familiar with the Information Nare Authorized Signature contained in this document and SALES 6/3/2014 all attachments and that,based on my inquiry of those Posilionrl itte Date(MMIDDNYYY) individuals immediately 9784702860 CEC-TAM responsible for obtaining the Telephone Representing information,I believe that the 50 CONCORDST N READING Information is true,accurate,and complete.I am aware that there Address Citylrown are significant penalties for MA 01864 submitting false information, State Zip Code including possible fines and imprisonment The undersigned hereby states,under the penalties of perjury,that I have read the Commonwealth of Massachusetts regulations governing asbestos abatement (453 CMR 6.00 promulgated by the Department of Labor Standards and 310 CMR 7.15 promulgated by the Department of Environmental Protection), and that I am aware that this permit application or notification shall not be deemed valid unless payment of the applicable fee is made." Revised 11/13/2013 Page 4 of i Location s�C No. Date • - TOWN OF NORTH ANDOVER WIT Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permiffee $ Other Permit Fees $-3a6'�2 TOTAL $ Check#Y f 2 3 b Building Inspector i TOWN OF NORTH ANDOVER I APPLICATION FOR PLAN EXAMINATION Permit NO /41 Date Received 3l Date Issued: 1 i i IMPORTANT: Applicant must complete all items on this page. Cvh" LOCATION" _ _ °l o Ck d Print PROPERTY OWNER- AI � �yrt� y ✓r ` - Prins 100 Year Old Structure 4es s n i MAP NO:��PARCEI-0 (-t Z- ZONING DISTRICT: Historic District no Machine Shop Village yes no TYPE OF IMPROVEMENT. PROPOSED USE ResidentialNon- Residential Li New Building El One family ElAddition ElTwo or more family 11 Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: Demolition ❑ Other 1 Septic ❑Well ❑ Floodplain: ❑Wetlands ❑ Watershed District ❑Water/Sewer- DESCRIPTION OF WORK TO BE PERFORMED: T o I )(J--J I lVv PfV7l'o►ti s ►� C�YiY�+�► Identification Please Type or Print Clearly) OWNER: Name: /Vc),( A--I'J, C4rVV-C^ Phone: Address: qQ A-c4f9 nj Rv-,,4 L TOR Name: W a nr��✓'� Cv�,3 fir, %�� Phone' / �'s Construction License: C ' 1 d H 22 Exp. Date:rovement License: Exp. Date: ARCHITECT/ENGINEER h( rc b I+C C,+ Phone: (-/— L2-7— /q7-7— Address: x(7-7Address: 71" klVee i0IJ S Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ A7, L Y3 FEE: $ 3202. Check No.: 3 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund S gnanre of Agent%Own_er4Stped Plans Submitted LJPlans Waived ❑ Certified Plot Plan El Plans ❑ f Plans-Submitted ❑ Plans Waived ❑ .Certified Plot Plan ❑ Stamped Plans ❑ :TYPE OF.SEWERAGEDiSPOSAL Public Sewer ❑ Tanning/Massage/Body Art r ❑. . Swimming Pools ❑ j Well ❑ Tobacco Sales 0 Food Packaging/Sales ❑ Private(septic tank,etc.._ ❑ =Permanent Di npster on Site THE.FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE.APPROVED PLANNING & DEVELOPMENT` ❑ ❑ COMMENTS I t CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decisionfreceipt submitted yes Planning Board Decision: Comments i 1 { I Conservation Decision: Comments Water & Sewer Connection/S_ignature&Date Driveway Permit • DPW T'o`vz Engineer: Signature: b -- Located 384 Osgood Street FIRE DEPARTM�_NT -:Temp Dumpster on site yes no L•ocated'at 124,Mair,Street: -`Fire ''��'' ..._ .. Departme►it signatareldate Number of Stories: Total square feet of floor area, based on Exterior dimensions. _Total land area; sq. ft.: ELECTRICAL: Movement of.Meter location, rust or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL.Chapter 166 Section 21A-F and G min.$100-$1000 fine NOTand DATA— (For department use El Notified for pickup - Date Doc.Building Permit Revised 2010 I Building Department The following is`a=list ofIhe required.forms to be-filled out for theappropriate.permit fo be obtained. Roofivg, Siding, Interior Rehabilitation Permits I o, Biailding Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (if Applicable) o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application o Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract Li Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases.if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apo•,al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doe: Doc.Building Permit Revised 2012 NORT#1 Town of - E : n over toHf No. 67M, 1 � _ h Ma alel o ver, ss, 3 tl BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT.............. a/ fh �' `r��s �� BUILDING INSPECTOR ........ ....................... ........................ ............................................... g Ir C.a A11V y lqw Foundation has permission to erect .......................... buildings on ... ... ................. ................................. v� 4 ve/r'DA4 Rough tobe occupied as ......A�?-W4.4�............ .......................................................................... Chimney provided that the.person accepting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION TARTS Rough Service ......... ...... .. . ......... ............................................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. cio.'a < ST x�c s'k z yrs. r x f g r' a 1 DEOTAM L ENVIRONMENTAL SERVICES Lb 2014 '.lf'Ni OVER DEPART,IMENT February 21, 2014 North Andover Board of Health 1600 Osgood Street Building 20, Suite 2-36 North Andover, MA 01845 RE: North Parish Church, 190 Academy Road,North Andover,MA 01845 (School House Addition) Dear Sir or Madam Please be advised that Dec-Tam Corporation will be performing an asbestos abatement projects at the above referenced locations. This work has been scheduled for March 03, 2014 to March 14, 2014. All applicable local, state and federal agencies have been notified of this work. Please let me know if you have any questions. Sincerest regards, Brenton Morgenstern Sales Estimator BM/cam Enclosure 50 Concord Street,North Reading,MA 01864 P:978.470.2860 F:978.470.1017 www.dectam.com t Commonwealth of Massachusetts 100193230 Ll Asbestos Notification Form ANF-001 Decal Number FEB 26 2014 TMi:Ur rl AO'UUVER HEAL'ra DFP4Ft;'""E"'T_. Important: A. Asbestos Abatement Description When filling out p forms on the computer,use 1. a. is this facility fee exempt-city, town,district, municipal housing authority,owner-occupied only the tab key residence of four units or less?®Yes ✓ No to move your cursor-do not b. Provide blanket decal number if applicable: use the return Blanket Decal Number key. 2. Facility Location: NORTH PARISH CHURCH 190 ACADEMY ROAD a.Name of Facility b.Street Address North Andover l A 01845 1 1(978)687-7948 a City/Town d.State e.Zip Code f.Telephone Number INSTRUCTIONS 3. Worksite Location: 1.All sections of this SCHOOLHOUSE ADDITION � J L,,d W r form must be a.Building Name/Building Location b.Building# c.Wing d.Floor e.Room completed in order to comply with 4. Is the facility occupied? ❑Yes ❑✓ No DEP notification requirements of 310 CMR 7.15 5. Asbestos Contractor: and the Division of Occupational DEC-TAM CORPORATION 50 CONCORD STREET Safety(DOS) a.Name _ b.Address notification requirements of 453 NORTH READING 19784702860 ^� CMR 6.12 c.Ci /Town d.Zip Code e.Telephone Number AC000035 f.DOS License Number g. Contract Type: ✓❑Written Verbal BRENT MORGENSTERN SALES h.Fac']'t Contact Person i.Contact Person's Title GEORGE A. PAGE AS071933 6' a.Name of On-Site Supervisor/Foreman b_Supervisor/Foreman DOS Certification Number 7' EHI IAA000044 a.Name of Project Monitor b.Project Monitor DOS Certification Number EHI AA000044 r 8. a.Name of Asbestos Anal ical Lab b.Asbestos Analytical Lab DOS Certification Number —�0 9. 03/03/2014 1 103/14/2014 a.Project Start Date(mm/dd/yy,yy) b.End Date mm/dd/ yyy) �0 7A-4P I L. �� c.Work hours Mon-Fri. d.Work hours Sat-Sun. 0 10. a. What type of project is this? 0 ❑✓ Demolition ❑Renovation ^R Y � ❑ Repair ❑Other, please specify: b.Describe 11. a. Check abatement procedures: ❑Glove bag ❑ Encapsulation o ❑ Enclosure ❑ Disposal only =L ❑Cleanup ❑ Other, specify: CRIT/NEGAIR/DECON/WET METHODS ❑ Full containment b.Describe —�-z �Q 12. Is the job being conducted: ❑✓ Indoors? ❑Outdoors? anf001 ap.doc-10/02 / Asbestos Notification Form-Page 1 of 3 i Commonwealth of Massachusetts `g-� 100193230 Asbestos Notification Form ANF-001 Decal Number A. Asbestos Abatement Description (cont.) d 13. Total amount of each type of Asbestos Containing Materials(ACM)to be removed, enclosed, or encs sulated: 200 1 4500 a.Total pipes or ducts(linear ft) o a o er su aces square c.Boiler,breaching,duct,tank �] d.Insulating surface coatings Lin.ft. Sq.ft. cement Lin. l LS—q — J e.Corrugated or layered paper 200 = f.Trowel/S ra er coatings pipe insulation Lin.ft. Sq.ft. p y g q Lin.ft. Sq.ft. � g.Spray-on fireproofing LI h.Transite board,wall board Lin.ft. Sq.ft. Lin.ft. I.Cloths,woven fabrics L____1 Other, lea C� 4500 Lin.ft. S .ft. 1 please specify: Lin.ft. SS� k.Thermal,solid core pipe VERM/VAT/MAST I insulation Lin.ft. Sq.ft. I.Specify 14. Describe the decontamination system(s) to be used: THREE STAGE i 15. Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2)(g): MATERIAL WILL BE WETTED AND PLACED IN PRELABELED BAGS FOR DISPOSAL 16. For Emergency Asbestos Operations,the DEP and DOS officials who evaluated the emergency: a.Name of DEP O ficial b.Title c.Date(mm/dd/yyyy)of Authorization d.DEP Waiver# e.Name of DOS Official f.DOS Official Title g.Datemm/dd/ N ( yyyy)of Authorization h.DOS Waiver# 0 17. Do prevailing wage rates as per M.G.L. c. 149, §26, 27 or 27A—F apply to this project? ❑Yes Q No ° B. Facility Description E�o 1. Current or prior use of facility: CHURCH —o 2. Is the facility owner-occupied residential with 4 units or less? ❑Yes 2 No NORTH PARISH CHURCH 190 ACADEMY ROAD 3" a.FacilityOwner Name b.Address NORTH ANDOVER —�1 01845 9786877948 o c.Ci /Town d.Zip Code e.Telephone Number area code and extension LL 4' [REVEREND SARAH STEWART SAME AS#3 � .Name of Facility Owner's On-Site Manage��Z at,� r._ b.On-Site Manager Address 4 c.Cit /Town y d.Zip Cade e.Telephone Number(area code and extension) anf001 ap.doc•10102 Asbestos Notification Form•Pa e 2 of 3 � e 1 1 Commonwealth of Massachusetts 100193230 Asbestos Notification Form ANF-001 Decal Number B. Facility Description (cont.) 5. a.Nal me of General Contractor � � � � b.Address c.Cit /Townd.Zi Code e.Telephone Number area code and extension) GREAT DIVIDE -_ CAI 53726612 1 112128/2014 f.Contractor's worker's Comp.Insurer g.Policy Number h.Exp.Date mm/dd/ 3 6. What is the size of this facility? 15000a.Square Feet b.Number of floors C. Asbestos Transportation and Disposal 1. Transporter of asbestos-containing material from site to temporary storage site (if necessary): Note:Transfer a.Name of Transporter __ tb Address Stations must ^^--� comply with the c.City/Town d.Zip Code e.Telephone Number Solid Waste Division 2. Transporter of asbestos-containing waste material from removal/temporary site to final disposal site: Regulations 310 _ CMR 19.000 IERVICE TRANSPORT 58 PYLES LANE a.Name of Transporter b.Address NEWCASTLE -�� 19720 (877)999-9559 c.Ci /Town d.Zip Code e.Telephone Number 3. a.Refuse Transfer Station and Owner b.Address c.Ci /Town d.Zip Code e.Telephone Number 4. IMINERVA ENTERPRISES INC a.Final Disposal Site Location Name b.Final Disposal Site Location Owner's Name 9000 MINERVA ROAD I IWAYNESBURG c.Final Dis osal Site Address _ d.Cii fTown _ OH 44688 I- M e.State f.Zip Code g.Telephone Number 0 D. Certification The undersigned hereby states, under the 113RENT MORGENSTERN —0 penalties of perjury, that he/she has read the a.Name b.Authorized Signature �0 Commonwealth of Massachusetts regulations ISALES 2/612014 for the Removal, Containment or r c.Position/Title d.Date mm/dd Encapsulation of Asbestos, 453 CMR 6.00 and_ 978 470-2860 � DEC-TAM— 310 CMR 7.15, and that the information ( ) contained in this notification is true and correct e.Telephone Number f.Re resentin 0 to the best of his/her knowledge and belief. 150 CONCORD ST 0 q.Address - �LL N READING 101864 � z h.City/Town i.Zip Code anf001 ap.doc-10/02 Asbestos Notification Form•Page 3 of 3 I I , TOWN OF NORTH ANDOVER pORTIi Office of the Building Department 0. «�o , qtiCommunity Development and Services �6 �O ti . . �0 1600 Osgood Street, Bldg.20, Suite 2035 _ North Andover, MA 01845 ^o er Ar �4SSACHU`����5 Gerald Brown, Inspector of Buildings November 18, 2013 John T. Smolak, Esq. Smolak&Vaughan LLP 21 High Street,Suite 301 North Andover, MA 01845 Re:North Parish Renovation and Addition Project 1�0 1 1 Dear Attorney Smolak, As you identified in your June 7,2013 letter,the E setback of eight (8)feet,while the North Andover Zoning As you know,the burden is upon the North Parish requirements unreasonably impact the religious use. See 415 Mass.753 (1993).The reasonableness of the local zoi particular facts of each case." See Martin v.The Corporat Jesus Christ of Latter-Day Saints,434 Mass. 141, 150(200 Therefore,could you please provide me with all o proposed project which are applicable with regard to the impact of the local zoning requirements upon your client's religious use. 111 I Sincerely, K— Gerald Brown Inspector of Buildings Cc: File 1 I V d J TOWN OF NORTH ANDOVER p10RT1l Office of the Building Department o�tt,Eo qti Community Development and Services + t.,, , o Lp 1600 Osgood Street, Bldg.20, Suite 2035 North Andover, MA 01845 ACHU5�t�� Gerald Brown, Inspector of Buildings November 18, 2013 John T.Smolak, Esq. Smolak&Vaughan LLP 21 High Street,Suite 301 North Andover, MA 01845 Re:North Parish Renovation and Addition Project Dear Attorney Smolak, As you identified in your June 7, 2013 letter,the proposed project would have a side yard setback of eight (8)feet,while the North Andover Zoning Bylaw requires twenty(20)feet. j As you know,the burden is upon the North Parish Church to prove that the local zoning requirements unreasonably impact the religious use. See Trustees of Tufts College v. City of Medford, 415 Mass.753 (1993).The reasonableness of the local zoning requirement"will depend on the particular facts of each case." See Martin v.The Corporation of the Presiding Bishops of the Church of Jesus Christ of Latter-Day Saints,434 Mass. 141, 150(2001). Therefore,could you please provide me with all of the "particular facts" relating to this proposed project which are applicable with regard to the impact of the local zoning requirements upon your client's religious use. Sincerely, 1 Gerald Brown Inspector of Buildings Cc: File I + I November 1, 2013 John T. Smolak, Esq. Smolak&Vaughan LLP East Mill, 21 High Street, Suite 301 North Andover, MA 01845 Re: North Parish Renovation and Addition Project 190 Academy Road (North Andover Assessors Map 96, Lot 72 Dear Attorney Smolak: I have reviewed your June 7, 2013 letter to me, including the proposed site plan related to the construction of the new religious educational wing addition,the Massachusetts court decisions concerning the Dover Amendment, and other attachments you have provided to me. Based upon the information provided, you have indicated that North Parish will use the space within the proposed addition for religious/educational uses along with limited office space for church use. These uses within the Residence 3 (R-3) zoning district are consistent with the use of the premises as a"place of worship"and related accessory uses described under Section 4.121 of the Zoning Bylaw, all of which are permitted by right under the Zoning Bylaw. As to dimensional and other requirements of the Zoning Bylaw, the use of the property as a religious use qualifies for certain protections under the Dover Amendment described in Section 3 of M.G. L. c. 40A which provides that no zoning bylaw may prohibit, regulate or restrict the use of land or structures for religious purposes or for educational purposes on land owned by a religious sect or denomination. However,the land or structures may be subject to reasonable regulations concerning the bulk and height of structures and determining yard sizes, lot area, setbacks, open space,parking and building coverage requirements. The determination of what is reasonable is based on whether the literal enforcement of the proposed zoning would substantially diminish or detract from the usefulness of a proposed structure, or impair the character of the church without appreciably advancing the Town's concerns. Your June 7, 2013 letter suggests the reasons why the application of the Town's minimum front and side yard setback,minimum parking, and site plan review requirements under the Zoning Bylaw would be unreasonable under the circumstances. I have reviewed your June 7 letter, the caselaw, and other information concerning this matter. Location No!Q ^� Date �Z-" id NaRTh TOWN OF NORTH ANDOVER f � 3?O'..•� ••tido 0 � s 9 Certificate of Occupancy $ �'�s''••�'t<�' Building/Frame Permit Fee $ J^CHUS Foundation Permit Fee $ Other Permit Fee $ 30 " TOTAL $ Check # 3 233 - 6 Building Inspector tAORTH . t e D 'qIy � , L 16 0 - � TOWN OF NORTH ANDOVER � °� ° ;w,•,�� # SIGN PERMIT �.q ORATED rPP�'�� SSACHUS� DATE: August 11, 2010 PERMIT: S05 -2011 THIS CERTIFIES THAT North Parish of North Andover, at 190 Academy Road has permission to erect. Two signs — 8"x 24" with possible 6"x18" attached (NOT ILLUMINATED) on Massachusetts Avenue - off Rte. 495 North Andover MA provide that the person accepting this Permit shall in every respect conform to the.terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section #6, Voids this Permit. INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED .9 Inspector of Buildings Receipt: 23316 Paid 30.00 NORTH q p T L E° 6 y6 0 " '' . TOWN OF NORTH ANDOVER VL n °R c°c.l° °• SIGN PERMIT SSACHUS� DATE: August 11, 2010 PERMIT: S05 -2011 THIS CERTIFIES THAT North Parish of North Andover, at 190 Academy Road has permission to erect. Two signs — 8"x 24" with possible 6"x18" attached (NOT ILLUMINATED) on Massachusetts Avenue - off Rte. 495 North Andover MA provide that the person accepting this Permit shall in every respect conform to the.terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section #6, Voids this Permit. INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED Inspector of Buildings Receipt: 23316 Paid 30.00 SIGN PERMIT APPLICATION 1600 Osgood Street—Building 20, Suite 2-36 TOWN OF NORTH ANDOVER Map Parcel 4 s DATE SUBMITTED_ /f '!/ /1 Site Owner' 61' :` 6 � yJ OG�/1- Applicant � � Tel 9 T Site Address ///G/SS Nye- llr / �� Size of Proposed Sign INTERNALLY ILLUMINATED SIGN PROHIBITED How attached: a)Against the wall b) Roof Illumination: a)Not illuminated 0;-> (P Ground S ) Externally illuminated d) Other Materials:�Q�__��� _. Proposed Colors: Background ,. Lettering R la,1-)Z-- Border �Q Required Attachments: Photographs of building Note: No permanent/temporary sign shall be erected, or enlarged until an Material sample application on the appropriate form furnished by the Sign Office has been Color sample filed with the Sign Officer containing such information including Site or Plot Plan(Required for all free-standing signs) photographs,plans and scale drawings, as he may require, and a permit Drawings of proposed sign for such erection, alteration, or enlargement has been issued by him. Other, specify Such permit shall be issued only of the Sign Officer determines that the sign complies or will comply with all applicable provisions of the By- Law. Will sign overhang any public road or walkway Yes O No If Yes, Name of Agency who will provide liability insurance: / AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: SIGNATURE OF APPLICANT. D ' �� ( M - i 1. 5 t I I - 1 __. �. 1 �. i C . �. _ . _ � � � - .. . . 1.. r + ' k� l .. , r � a ' Q�D � � _. c �� c. r rye _ DETOUP 3 - no3 91 a W r� r !l(Yl �r ;r(}i� ,y I �I J �' �/IlLlll S Ex;f X13 (�fk�.F6 Wiab✓tP •M�lSlIA�EJ vi{ of 11fr Nom 4151&41,15f 16 1&tsi � mot is/wwt a� ✓acrtnf sue/ al ,�r�A, �o AJnSf .� theft griw� ww/A pole _._�j rill t . rk " F III � a r f � LL.Y iss A,moi UN U � 1 , �{ w 4- .. 4 s 4 �1 r C a � 9 6 � e f v .n, r ter_ �� �� yr r�_.._. •-, i� �� l�ntvrod �ueb y.� � p��v2 a�s aerN ,,Po/ ssvW vo uilsd'./S fd �i*i �'�s tihA ;Pig�t° Y�' OSSbti Sh 1AP !A:7 first universalist church of dexter,main Page 1 of 2 " i FIRST UNIVERSALIST CHURCH OF DEXTER,MAINE ABOUT THE CHURCH HISTORY FUNDRAISING UU Road Signs SEE AN ARTICLE ABOUT OUR UU SIGNS IN THE NOVEMBER 2002 UU WORLD PAGE 60! I� Dear Friends. Let us help you guide people to G „n / your welcoming doors with signs l�J�` placed at the entrance to your " town. With about 1000 societiesr" r, 5 in all of the United States, we do ���R��� /j need to announce our local Ja presence. ,IQ w 6 The First Universalist Church of V Dexter, Maine is offering a G classically simple highway sign. The UU logo with chalice is printed on a 30-inch disk of hea a �1 aluminum, in reflective black and ffliftatGEfEB t 6� white, with the words "Unitarian _ 4 I Universalist arranged around the y outer circumference of the circles. Small oblong signs can be � � ,. ��' �� +ncaIwnr SIGNS purchased with a direction arrow, DyYl�1/ location, or other pertinent ar J�� R/qA information as desired. Signs are punched for mounting on a single 4 (IINNN post. All you have left to do is � red ' G purchase poles and place them (� along the road at the entrance to �VfRSA� \/ your town. You have seen similar 30-inch signs announcing the presence of _ f' Kiwanis, Rotary, and Lions, among others. These signs have the advantage of iuniformity-they are immediately recognizable as "official" by the traveling public and serve several purposes they acquaint the general public with the UU logo, V� they let passing drivers know we are active in town, they inform traveling UU's that there is a local church or society available, and they show we care about spreading our message. Most churches and societies will need several signs for separate highway accesses to their communities. The sign can also be mounted in front of your church. Congregations using other facilities can hang it temporarily at the time of their service. Mass production of the chalice logo sign has brought unit costs well within the reach of most congregations. The small customized signs are available at a modest additional cost. All of the signs ordered are shipped via UPS in one package. This project has the approval of the UUA. Features: http://www.dexterau.org/htrni/road—signs.htm 6/6/2009 Menders,Torrey&Spencer Architecture Preservation. 123 North Washington Street Boston,MA 02114 Phone 617.227.1477 Fax 617.227.2654 www.mendersarchitects.com David W.Torrey,AIA Lynne M.Spencer Arthur 0.Vogt,AIA Architect's Memorandum PROJECT: Renovation of the North Parish Church of North Andover,MA Date: 429-09 From: David W.Torrey,AIA,Project Architect To: Gerald A.Brown Inspector of Buildings Town of North Andover Building Dept 400 Osgood Street North Andover MA 01845 RE: Railings at new entry At your request we are hereby clarifying the existing conditions of the completed site work at the North Parish Church at 190 Academy Road. The main entry to the church has been modified to comply with 521 CMR MAAB regulations. The main entry doors are now level with the sanctuary and are accessed from designated accessible parking spaces on Academy Road by means of a new concrete and granite sloped walkway at a maximum grade of 5%.There are no ramps on this project,therefore there are no ramp handrails. However,for the assistance of users and to coordinate with the handrails installed for the 780 CMR-and 520 CMR-compliant integral steps leading onto an accessible terrace,there are metal handrails on a portion of the sloped walkways referred to above. Menders,Torrey&Spencer,Inc. Page I of 1 i Structures North ®®® 60 Washington St,Suite 401 Salem, Massachusetts 01970-3517 CONSULTING ENGINEERS, INC. P.O. Box 01971-8560 T978.745.6817 I F978.745.6067 www.structures-north.com 4 May 2007 Menders Torrey and Spencer, Inc. 123 North Washington Street Boston, MA 02114 Attention: David Torrey 90 Reference: North Parish Church Renovations North Andover, MA Dear David: This is to state that I, or my representative, have visited the above-referenced project site on at least five occasions during construction and that the work that the completed structural work we have inspected to date has been in accordance with the requirements of the contract documents, our field instructions and sketches, and the applicable. requirements of the Massachusetts State Building Code. Please contact me if you have any questions. JAQ Respectfully yours E°Aoai4FJE y e�tn�c�uwnt: £ Structures North Consulting Engineers, Inc. ohn M. Wathne, PE, Presidenth Date...... 'Z 2- ..07 .... .. .... ...... ... HORTM TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSoz' '4 MUS LIME Thiscertifies that ............................................................................................. p' �I^V'67 has permission to perform .... ................i;/q............. 11/......(21 wiring in the building of ... .................... a at.................. ................... .—North Andover,Mass. Lic.No.............. ....................... �2) ELECTRICAL INSPECTOR # 72- 5,0 7941 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. �9yj Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:— LZ'Z' Z 1 .0 City or Town of. NORTH ANDOVER To the Inspector of Wires By this application the undersigned gives notice of his or her i tention to perform the electrical work described below. Location(Street&Number) A c6d e M � P-J Owner or Tenant Zvp t-A 1pct r f S)n (l h ore V� Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building 61 h V fC�X Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service gL12— Amps 12p /2!y Volts Overhead❑ Undgrd 2F No.of Meters p Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: R E— FEED D DEL 6e-r V1'(-e— u nS ril CiovictUr �a� P)10-e- -i- G►1k&-L--7 1—` Completion of the ollowin tablem be waived b the Inspector o Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above [IIn- ❑ o.o mergency ig ing rnd. rnd. Batter Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection an Initiating Devices No. of Ranges No.of Air Cond. Tonal No.of Alerting Devices No.of Waste Disposers Heat PumpNumber Tons KW No.of Self-Contained Totals: ..._ -"" " """"'""-"'""""'"'"""""'"'""""' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No. o No.of Devices or E uivalent Heaters Water KW No.of No.of Data Wiring: Signs Ballasts t No.of Devices or Equivalent i No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eq uivalent OTHER: i C Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: . 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 and penalties of perjury,that the information on this application is true and complete. FIRM NAME: q J o�C�i+t� �' ���r'/C cr c�c�r LIC.NO.: Ad6 ce Licensee: 6' CkO l e�-S /l G o(c Signature,�7'' LIC.NO.•�J� (If applicable,enter`exempt"in the license Bus.Tel.No,- .7 7F/ numbgg r line.) " 7�7 Address: 1()d W,riC (,132 sle f- l`� Alt.Tel.No.,-7V7 — ML2S36 *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's Ment. Owner/Agent Signature Telephone No. PERMIT FEE.$ %Z3 Structures North O ��® 60 Washington S 401 Salem, Massachuss Suiteetts 019797 0-3517 P.O. Box 01971-8560 T 978.745.6817 1 F 978.745.6067 vvvvw.structures-north.corn 31 May 2007 Menders Torrey and Spencer, Inc. 123 North Washington Street Boston, MA 02114 Attention: David Torrey Reference: North Parish Church North Andover, MA Dear David: This is to state that I have inspected the fire escapes at the above-referenced location and have found them to be in a general state of good repair, and structurally equivalent to the condition at which they were originally installed. Please contact me if you have any questions. ; .d 5, Respectfully yours, JOHN M. Y wA7HVE �. v. Structures North Consulting. Engineers, Inc. John M. Wathne, PE, President ,aORTM TOWN OF NORTH ANDOVER O� �h d 3r '�•.��� .ppc PERMIT FOR PLUMBING "S US ff This certitie' that has permission to perform . . . . . . .�. . . . . . . . . . . . . . plumbing in'the buildings of . .kt .�. !'.�.t �. .Cy �.�-.� �. �. . . . . . at. . . . . . .� . . . . .�Notth Andover, Mass. Fee 2.3o. Lic. No..O/P>. G. . 1/ PLUMBING INSPtCTOR Check # /771 ? 7245 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) ALA 66r- MA Date 0 R°O 8— Permit* Building Location _Owner'sName -kLA- Map: Lot: Zone: , Type of oocupancy New ❑ Renovation Replacement O Plana Submitted: Yes❑ No FIXTURES Fee: M = N Z H M Z Y W Y J W O Z y Z W J 0 t V < W Z W W O W Q W ¢ = J W W m S W F V ¢ el ` LL Z = Z d cc W O m Z y W > < F ce = tY C < < >X ut 3 FX J mVI3t r0q Z HY+ ddl ¢ ¢cQ <W¢ F <9 F O 0 O ~ _ LL <Y HW 3Z OO W` J < Q _1A W 0 O D Q >< Q m O SUB-BSMT. BASEMENT IST FLOOR 2ND FLOOR ' 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR aTHFLOOR 4L� - Installing CompanyNaJ.p C MDUIMT T INC-- Checkone: Certificate Address ( E .M CT n n wn>c++G MA01323 Corporation 19 9 7[' EstlmateValueof Work: 0 Partrterahlp Business Telephone_ 978-777-2RtIA O Firm/Co. Name of Licensed Plumber orGasFitier_--ZAISL_pg p t'AMpRFT T INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 19 No ❑ If you have checked M please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity❑ Bond f] OWNER'S INSURANCE WAIVER: I am aware that the licensee d_ no_t haves the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Checkone: Signature of Owner or Owner's Agent Owner O Agent❑ 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 rmitissued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Ch 42 of Laws. By_- me Signature of Licen lumber City/Town Type of License: Master Journeyman O APPROVED OFFICE USE ONLY ucenseNumber %/Gid Rimsed 0&17= Date. Of 4~ORtM 1 �O TOWN OF NORT ANDOVER f P • PERMIT FOR `C S INSTALLATION 9 �,SSACMUSES k This certifies that . . . . :. J . j!z ...... . . . . . . . . . . . . . has permission for gas installation . . . .Re-A .u. -.A:07`i. . . . . . . in the buildings of !.f . . . . . . . . . . . . . . . . at . . . . . , North Andover, Mass. Fee.IA4%i2�. Lic. No.0-g.6.I-.( . . . . . . . ---- - -- - - - - - GAS . .. . . . - . GAS INSPEC OR Check# ! 7?t L `5873 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTINo ftnt or TTyppe) A/a� — Wass. Date 2.0 b 1 permit*_.Q7 3 BuildingLocatlort 17d �Mrzt �� t7, Owner's Name�l/D,�fl4�� �'.. Type of Occupancy NOW ❑ RerwvatiOn �� Replacement p Plans St Yesp No p H � Y W ic 2 ¢ y ¢ y W V = S O N j d J m W H V = O W f' i } _ = O 00 C m Ol b y W p > O F to d Wi S z F N 6 > d W W O J z < W 0 rZ W 44 W0 W � _ •� J M 2 W W d 0 > a F V O O W ¢ ` a: z 0 d t u. O 3 O d J v ¢ > p d 0 v SUB—BsMT. BASEMENT f7 I 1ST FLOOR 2ND FLOOR a 3RD FLOOR 4TH FLOOR i STH FLOOR 6TH FLOOR TTH FLOOR 8TH FLOOR insWihtg Company Name J.P. CAMPBELL,INC. Check one: Certlllialte Add ross 6 9 EL.M ST_ Corporation 1 9 9 2 G ❑ Partnership Business Talept►one_ 9 7 R—7 7 7—2 fa fl R ❑ Firm/Co. Name Of Ucensed Plumber or Gas Fitter JOSEPH P. CAMPBELL INSURANCE COVERAGE: I have aYre ! MARY Ntwunce Policy or Its subatantw o 0 equNakrd which meets the requirements of MQL Ch. 142. If you have ced yam, please indicate the type coverage by checking the appropriate box. A IIabNRy, insurance policy K Other type d indemnity❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the kmnnce Coverage roqulred by Chapter 142 Of the Klass. General Laws, and that my signature on this permit application waives this Nquirement. Check one: nature of or s Agent Owner❑ Agent❑ IWwwWo hereby certify that all of the details and information i� in��aro true and aaxuate to the bed of my PerUnent pfo�RW00 off thMasch�usetfs� pert will be In with W Chapter 142 of Me . T of License: t!sc.�i�,_ Tltle Plumber Ga8ftr e e M or a! of R01Nn License Number - ( ( E , Date.....`.": . 7 ................ NORT/{ TOWN OF NORTH ANDOVER ' PERMIT FOR WIRING �SSACMUS� AY 1. This certifies that ..........V.. /'/ lfJ. �F.- f. ... .... ............................... has permission to perform ..�-�ie 9A.R. ... l.x wiring in the building of... �!e T�{..f A.!.Z.S ..4��K�'V.......... at......!.q?.( /!. ....` � ..........................North Andover,Mass. B b / i Fee 3e?* Lic.No.13"Z4........ . ti!.. ..... . . .. ELECTRICAL INSPECTOR Q ck # 9 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/991 (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 01/08/06 City or Town of. North Andover to the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 190 Academy Rd Owner or Tenant North Parish Church Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) Purpose of Building CHURCH Utility Authorization No. #1852459 N-STAR Existing Service 200 Amps/120/240 Volts Overhead ❑ Undgrd® No.of Meters l New Service 400Amps 120/240 Volts Overhead® Undgrd ❑ No. of Meters ] Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: RENOVATIONS/NEW SERVICE/NEW FA and FIXTURES .No. of Recessed Fixtures 11 No.of Ceil.-Susp.(Paddle)Fans No.of Tota ; Transformers KVA No. of Lighting Outlets No.of Hot Tubs Generators KVA No. of Lighting Fixtures 12 Swimming Pool Above ❑ In- ❑ o.of Emergency Lighting 16 d. 91711d. Battery Units No. of Receptacle Outlets 4 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 12 No.of Gas Burners 4 No.o Detection and 10 add Initiating Devices No. of Ranges] No.of Air Cond. Total No.of Alerting Devices 31 Tons ADDITIONAL No.of Waste Disposers] Heat Pump Num er I.Tons J.KW No.o Se -Contame Totals: Detection/Alertin4 Devices No.of Dishwashersl Space/Area Heating KW Local ❑ Mumcipal ® Other Connection No. of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent o. o Water KW No.of No.o Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydro massage Bathtubs No.of Motors Total HP I e ecommumcations Wiring: No.of Devices or Equivalent OTHER: INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licen- see provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certi- fies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify :) (Expiration Date) Estimated Value of Electrical Work: $80,000 (When required by municipal policy.) Work to Start: 9-29-2005 Inspections to be requested in accordance with MEC Rule 10,and upon completion. li I cert, under the pains and penalties ofperjury, that the informatio n this application is true and complete. FIRM NAME: WILLIAM J.IANNAZZI,INC. LIC.NO.: 13592A Licensee: WILLIAM J.IANNAZZI Signature .NO.: 13592A (If applicable, enter "exempt"in the license number line) dus.Tel.No.:_978-686-7300 Address: 191 CHANDLER ROAD ANDOVER MA 01810 Alt. Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the ity 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 PERMIT FEE: S 330, � Signature Telephone No. I Gt 2 7 o 7 poll j2 q- r-,::: Z /-21 5eC- i i, Location 17 0 p ` No. �,� Q / Date MOR.M TOWN OF NORTH ANDOVER 3? i 0 f 9 • y L Certificate of Occupancy $ �M�s<� Building/Frame Permit Fee $ � Foundation Permit Fee $ r Other Permit Fee $ TOTAL $ Check # 19870 Building Inspector TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION of"�oT 6�tio APPROVED ZA� j Permit NO: Date Received Date Issued: �9vS•ac►+us���y IMPORTANT: Applicant must complete all items on this page LOCATION 1�1pR.N fAIRIr,M (A0&)A 1 RD AtAM*P Print PROPERTY OWNER b)0"1 ?4*_tr5b1 G409C% Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ❑One family ❑ Addition ❑Two or more family ❑ Industrial X Alteration No. of units: ❑ Repair, replacement ❑Assessory Bldg ❑Commercial ❑ Demolition ❑ Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED \f3V-Ur(;. OFIW 14t .�. WG U P�r1ftA�D6S ANO ,w1 raiz raft Identification Please Type or Print Clearly) OWNER: Name: N0iLW PAkVP%A GNJRGy Phone: l Address: No AX14V&mY AolwO CONTRACTOR Name:_.__KpfwltN Phone:61T- Z3L•330G Address: It 6 H1ALy4W STAT &ZOGKUMS IMM, OZ%446 Supervisor's Construction License: CS Oct 2 4 710 Exp. Date: l l !10108 Home Improvement License: tJ/A Exp. Date: W f A M1Noi&s -mumy+ ARCHITECT/ENGINEER 5 Papa&G-1R 14C.. Name: Phone: 07 S27- 1417 Address: l'L�s WOM V 064*( 4� X M 14 Reg.No. 04 O 61 COP 811101 FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ to 4T A ZA FEE:$ '74� Check No.:— Receiptd 7 No.: �� Page I of 4 TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ Tanning/Massage/Body Art ❑ g Public Sewer Tobacco Sales Well F1 �_ Food Packaging/Sales 11 Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ -- 'Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaran fund i Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit r . ❑ Other COMMENTS DATE REJECTED . DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ Z COMMENTS. Zoning Board of.Appeals- Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Si nature& Date Driveway Permit Temp Dumpster on sit ye no Fire Department signature/date I R Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area,sq. ft.: NOTES and DATA—(For department use) I T I Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORMOS Created JMC.Jan 2006 I Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits f I ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENTMITORM05 III Pace 4 of 4 S1V OLAK &VAUGH,AN t Robert R. Pellegrini T: 978.327-5570) F: 978-327-5219 ATTORNEYS AT LAW rpellegrini(usmolnkvaughan.,:om November 2,2006 Via Email Recipients: Clem Karl Deb Putnam David Torrey RE: North Parish Unitarian Universalist Church 190 Academy Road North Andover, MA 01845 Architectural Access Board approval Dear Clem, Deb, and David: I have attached the.MAAB approval letter,dated October 31, 2006. There is a 30- day appeal period,which began running on the 31'l,according to M.G.L. c.30A, §14. It is entirely within your discretion to begin construction during the appeal period, but you would risk the possibility of being delayed by a Superior Court process,which can be quite time consuming. I highly recommend that you review the approval in detail and contact me if you have any questions. During your review, among other details,please pay close attention to the conditions placed upon the approvals,as well as the October 31,2016 deadline to bring the religious education building into compliance. Please also note Deb's comments on kitchen compliance,which were echoed by the Board on page 4 of the decision. You will want to make sure that you follow through with the promised improvements. Likewise,l am in the process of drafting your new policy restricting use of the historic balcony. I will of course send along a draft for comment before forwarding same to the Board. Please contact me should you need additional information or if you have any questions. Thank you. Very truENIIBegrin , i Robert r. Attachment Jefferson Office Park,820 Turnpike Street,Suite 203,North Andover,MA 0184.5 W WW.SMOLAKVAUGHAN.C:OM i © �>! >y/D Mitt Romney � �' v' Qd�CfGGGd?�iLFd O��O�,v'� Thomas G.Galzunls,P.E. Governor Commissioner Kerry Healey �+ y �j y /� Thomas P.Hopkins Lieutenant Governor �/-/�/-�D�cY Director Robert C.Haas Secretary t/7/-/�/-DC/lJ� www.mass.govlaab SENT VIA CERTIFIED MAIL: 7006 0100 0000 7800 0850 DECISION i RE: NORTH PARISH UNITARIAN UNIVERSALIST CHURCH, 190 Academy Road,North Andover 1. The variance hearing was held in regards to the following Rules and Regulations of the Architectural Access Board: Section 28.1 —General (Elevators) 2. The hearing was held on: Monday, October 16,2006. 3. The following person(s)appeared:Robert Pellegrini,Attorney for the Church; David Torrey,Architect; Gail Forsyth-Vail,Director of Religious Education for the North Parish Church; Deborah Putnam,Member of the North Parish Church Building Task Force; Prudence Barker,North Parish Church Parishioner;Frank Clarkson, Assistant Minister for the North Parish Church; and Clem Karl,Chair of the North Parish Church Building Task Force. All were sworn in by the Chairman and the hearing was called to order at 3:15 p.m. 4. JURISDICTION: The Board took jurisdiction over the facility under Section 3.3.2,in that the work to be performed was going to amount to 30%or more of the full and fair cash value of the building, therefore the entire building is required to comply in full with 521 CMR. 5. FINDINGS AND DECISION: The Board having considered the evidence hereby decides and finds as follows: Mr. Robert Pellegrini started the presentation by stating that the main portion of the church was constructed in 1833 and is listed on the National and State Registry of Historic Buildings. The project that the church is intending to undertake has been in the works for the past seven years, The Unitarian Church must acquire all of their funds for projects from the parishioners,noting that they are spending just over$399,000 on barrier removal and$328,000 on HVAC,plumbing, electrical, and life safety upgrades, with an additional$20,000 being spent on other miscellaneous upgrades. Mr.Pellegrini stated that the largest project is at the front entrance of the church. *The current configuration requires parishioners to traverse a set of stairs up to the large entry doors and then enter into the vestibule area and traverse additional stairs to access the main part of the I church. The church is proposing to raise the grade at the front of the church,creating an at-grade entry via a sloped walkway at the front of the building. The noncompliant interior doorway will be removed and a compliant doorway will be installed. The church will also be installing accessible pews with accessible seating locations at the front and rear of the church. The stage area at the front of the church will also be accessed via sloped aisles and an accessible podium will be in place. The one variance that is being sought at the interior is for maintaining the existing historic pulpit,noting that the podium on the stage will be an alternate location for speakers. On the basement level, there is a narrow set of stairs connecting the church and the basement, which will be replaced with compliant stairs. Another variance request was for the existing elevator to remain due to the constraints of the building. Mr. Pellegrini also added that there is also a compliant walkway along the side of the church connecting people from the front of the building to an accessible entrance to the basement area. The offices with noncompliant doorways will be converted into a nursery and brought into compliance,along with the noncompliant stage at the basement area being removed. The kitchen will require a variance for the lack of compliant height at the countertops. Mr.Pellegrini stated that all of the other variances that were originally requested were being withdrawn,as the church is going to comply with all areas except for the height of the existing counters. Mr.Pellegrini stated that there was currently only one set of bathrooms for the church, located in the basement area, and that the church was proposing to make the existing bathrooms comply in full with 512 CMR. He noted that the religious education area, located in the basement is located on two levels, with the proposal to continue the exterior walkway to provide an accessible entrance to the first level of the religious education classes. The upper level of the religious education classes is up a set of stairs. The petitioners are proposing to install a compliant stairway to this upper level,but there will be no vertical access to this space. Mr. Pellegrini stated that the classes can be moved to the accessible level if necessary to accommodate the students. In regards to the variance for the noncompliant elevator,Mr.Pellegrini stated that they have received cost estimates from elevator companies and found that due to the size of the existing shaft,even a compliant vertical wheelchair lift would not be feasible. Creating a compliant shaft would require that the shaft be demolished, which would result in having to demolish part of the structure that holds up the balcony and require removal of the organ. In lieu of creating a compliant means of vertical access, the church was proposing to create the walkway which connects the front of the building with the lower accessible entrance. Mr. Pellegrini stated that creating vertical access would be technologically infeasible. At this point, Mr. Martin Ebel asked for clarification as to the reason for the variance request for the lack of vertical access was that compliance was technologically infeasible because the demolishing would require that portions of the balcony be removed and the organ relocated,to which Mr. Pellegrini responded and clarified was correct. Ms.Nancy Angney asked for the specific dimensions of the existing elevator. Mr. Pellegrini stated that the elevator was 34 inches by 42 inches,noting that they have looked into the shaft and found that the shaft is only marginally larger than the elevator car. He went on to state that the balcony was used for overflow seating and housed the organ,noting that the balcony was historic to the church. Ms. Angney then asked if the elevator was able to access the other portions of the church and the addition. Mr.David Torrey, Architect for the Church,added that the Church had looked at Limited-Use-Limited-Access(LULA) elevators, vertical wheelchair lifts as another means of vertical access,but found that all means were infeasible due to the present makeup of the church and the existing shaft size. Ms. Angney then asked if the call buttons were located at the required height. Mr. Torrey stated that they were willing to make the features of the elevator that they were able to bring into compliance compliant. After reviewing the matter,Ms.Angney made a motion to GRANT the variance requested for the use of the existing elevator as a means of vertical access on the condition that any improvements not requiring changing the actual elevator,such as the hall call button height and location,were brought into compliance with Section 28 of 521 CMR. The motion was seconded by Ms. Myra Berloff and carried unanimously upon a vote from the Board. 2 I The next matter that the Board discussed was the lack of access to the balcony. Mr. Pellegrini stated that the balcony is not used by the choir and is only used by the organist and for overflow seating during Christmas, Ms.Berloff made a motion to GRANT the variance for the lack of vertical access to the balcony, on the condition that there be a written policy that the balcony is used for overflow seating only with the policy to be submitted upon receipt of the Decision of the Board,noting that her decision was based on the historical significance of this space. The motion was seconded by Ms.Diane McLeod and carried unanimously upon a vote from the Board. The next variance request was in regards to the pulpit. Mr. Pellegrini stated that the pulpit is approximately four feet above the church floor, and that due to the construction the only means of access would be a vertical wheelchair lift. He added that the lectern located at the altar was more frequently used than the pulpit and was accessible. Ms.Deborah Putnam stated that the smaller lectern was often used for many of the ceremonies and services held in the church,adding that they are also currently using a portable lectern in the space that they are leasing and are proposing to use it at the renovated church. Ms. Berloff then made a motion to GRANT the variance requested for the lack of access to the existing historic pulpit,based on the historic significance of the structure. The motion was seconded by Ms. Angney and carried unanimously upon a vote from the Board. Mr. Pellegrini then presented the variance request for the lack of access between the two levels of the religious education portion of the church. He reiterated that the church would like to raise the entire area and build a new religious education building,adding that the accessible walkway will be at the exterior to create a means of access between the lower and upper levels of the religious education section, as well as creating a means of access from the main sanctuary to the lower level religious education area of the building. Ms. Angney asked for clarification that a person located on the accessible lower level of the religious education area would have to exit the building and reenter at the upper level to access the bathrooms, which Mr. Pellegrini verified was correct. Ms.Angney then questioned when the religious education portion of the building was built,to which Mr. Pellegrini clarified that this portion of the building was constructed in the 1950's. Ms.Angney then asked if the petitioners had looked at an exterior means of vertical access. Mr.Pellegrini stated that this was probably restricted by the Preservation Restriction which was put on the building. Mr. Torrey stated that it was a Historical Restriction due to the building's historic nature, clarifying that the only portion of the church that was preserved historically was the main area of the church. He added that the Church is proposing to create a new religious education facility in Phase 2 of the construction which will begin once the proper funding is achieved. Mr. Pellegrini clarified that the church therefore did not look at an exterior lift. Mr. Torrey noted that a similar means of exterior access was reviewed but found to be infeasible due to the cost being beyond the budget of the church. At this point,Ms.Angney made a motion to CONTINUE this matter regarding the lack of vertical access between the two levels of the religious education portion of the church so that the petitioners may submit cost estimates for a lift to access the two levels. Mr. Pellegrini stated that the vertical wheelchair lift was estimated at$120,000,noting that this cost was shown in the original submittal of the variance application. He added that the work to create a fully accessible religious education area would most likely be completed within the next ten years. Ms.Gail Forsyth-Vail added that as the Director of the Religious Education for the church,the policy would be to move any students that were in need of accessible features to the accessible level of the religious education area. At this point,Ms.Angney withdrew her motion. Mr.Ebel then made a motion to DENYthe variance for lack of vertical access between the two levels of the religious education center., but GRANT a 10 year variance to the Church to bring this religious education center into full compliance with Section 20 and 28 of 521 CMR,therefore allowing until October 31, 2016,noting that the Board should be made aware of any upgrades to this 3 . I portion of the church when they are planned. The motion was seconded by Ms.Berloff and carried unanimously upon a vote from the Board. The next variance request was in regards to the lack of compliant countertop height.in the existing kitchen. Mr. Pellegrini stated that the existing countertop is 3 inches above the maximum required height of 34 inches. Ms. Berloff asked if the kitchen was part of the religious education center, to which Mr.Pellegrini responded that it was not located in the religious education center,but directly adjacent to the parish hall in the existing church building. Ms. Berloff then asked if there was any alternative proposed for an accessible space within the kitchen. Ms. Putnam stated that they were proposing to make both sinks at the center have the required knee space and build a lower counter adjacent to the stove,where a temporary shelving unit is currently located. Ms. Berloff stated that based on Ms. Putnam's testimony,she would make a motion to GRANT the noncompliant countertop heights in the kitchen. The motion was seconded by Ms.Angney and carried unanimously upon a vote from the Board. Mr.Pellegrini then presented the variance request for the doorways at the upper level of the religious education center,stating that all of the existing doorways are 32 inches wide measured from door jam to door jam, resulting in a violation of Section 26.5 of 521 CMR which requires a clear width of not less than 32 inches. He added that all of the doorways in the other areas of the church will have the compliant clear width opening. Upon further review of the request,Mr. Ebel made a motion to DENY the variance requested for the lack of clear width at the doorways at the upper level of the religious education center,but GRANT a 10 year variance to the Church to bring this religious education center into full compliance with Section 26 of 521 CMR,therefore allowing until October 31, 2016,noting that the Board should be made aware of any upgrades to this portion of the church when they are planned. This motion was seconded by Ms. Berloff and carried unanimously upon a vote from the Board. The final variance that was being requested was in regards to the lack of compliant stairways in the existing buildings. Mr.Pellegrini stated that the Church was WITHDRAWING this variance request since they planned to bring all of the stairways within the facility into full compliance with Section 27 of 521 CMR. A true copy attests: This constitutes a final order of the Architectural Access Board entered pursuant to G.L. c. 30A.Any aggrieved person may appeal this decision to the Superior Court of the Commonwealth of Massachusetts pursuant to Section 1.4 of G.L. c.30A. Any appeal must be filed in court no later than thirty(30) days of receipt of this decision. DATE: October 31, 2006 ARCHITECTURAL ACCESS BOARD cc: Local Building Inspector erald LeBlanc,Chairman )0 Commission on Disability Independent Living Center 4 Page 1 of 2 Wright Dickinson From: Russ Moore [RMoore@ega.net] Sent: Tuesday, November 14, 2006 12:24 PM To: kevin.goggin@peabody-ma.gov Cc: Wright Dickinson; Gifford Perry Subject: JRC -Woodbridge Special Care Kevin - While walking the Site Monday afternoon-you had mentioned that you believed that the Lean Rail was impeding into the 12" clear space that is required for the door into the Mens Rooms and the Ladies Room on the 1st Floor. Having Review the Massachusetts Architectural Access Board Regulations 521 CMR,I respectfully disagree. I Section 521 CMR 26.6 lists the"minimum clear floor area"for doors. Section 26.6.4 lists the clear floor area for the Push Side Clearance with Figure 26e-which requires 12"on the push side of a door min.with both a latch and a closer. The definition of"Clear Floor Space"per 521 CMR 5.23 "The minimum unobstructed floor or ground space required to accommodate a single,stationary wheelchair and occupant. Unless otherwise stated,the dimensions of clear floor space shall be 30 inches by 48 inches and shall be level." That being said-since the Lean Rail is at 2'-10" a.f.f.,(and less than 4 inches in depth)it is our determination,that it does not impede on the clear floor space required on the push side for the door. Please feel free to contact me with any questions,or concerns you may have regarding this issue. Russ Russeli A. Moore EGA, p.c. -12 Auburn Street Newburyport,MA 01950 (p)978.462.5515 (f)978.462.5525 www.ega.net<http://www.eaa.net> wwwwwwwwwwwwwwwwwwxxwwwwwwxwxwxxwwwx NOTICE--This e-mail is confidential and should not be used by anyone who is not the original intended recipient. If you have received this e-mail in error, please inform the sender and delete it from your mailbox or any other storage mechanism. It is possible for data transmitted by email to be deliberately or accidentally intercepted or corrupted. If you feel that this has occurred, please notify the sender immediately, and a hard copy will be sent. EGA p.c. cannot accept liability for any statements made which are clearly the sender's own and not expressly made on behalf of EGA p.c. 11/14/2006 Page 2 of 2 I 11/14/2006 i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street J, Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information .Please Print Legibly Name(Business/Organization/Individual): 9MOW4 *#.i Address: ��, MA+Q.AM" SV_ City/State/Zip: .4 A% Phone#: b 17 Z112 • s7 w Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. P I am a general contractor and I employees(full and/or psrt-time). * have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These.sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp. insurance.$ required.] 5. E] We are a corporation and its 10.El Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.F1 Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 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.Lic.#: A� JA oO;01 q •0 6 Expiration Date: Q Job Site Address: I TO /4G"6w%y KRCity/State/Zip: 0 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' ace coverage verification. I do hereby cert' u t a d penalties of perjury that the information provided above is Ire and correct. Si ature: Date: Phone#: M 7 44 701 1rl 700 Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# j Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i KAPLAN CORPORATION 116 HARVARD STREET BR : ALINE, MA 02446 Project North Parish llln'tarian.Uhiversalist Church< Location North Andover,MA Architect: Menders,>ToOrev.& Spencer, Inc S.F.Area oP Construction. 1x,560 29=Nov-06 CDNSTI7lJCT/dN COST -(86s6d on Plans Dated puaust 2 20061' DIV.# TRADE ITE DIMS.COST NOTES:-...... ..... 02 Selective Demolition & Removal 41,710 02 Sitework/ Utilities 37,050 03 Landscaping & Improvements N.I.C. 03 Cast-in-Place Concrete 24,491 04 Masonry N.I.C. 05 Metals 13,768 06 Wood & Plastics 102,271 07 Thermal&Moisture Protection 4,750 08_ Doors &Windows 66,674 09 Gypsum Board Systems 32,740 09 Acoustical Ceilings 19,205 09 Flooring 30,000 09 Painting & Finishing 25,000 ! 10 Specialties 8,655 11 Equipment N.I.C. 12 Furnishings-Pew Modifications 6,800 13 Special Construction N.I.C. 14 Conveying Systems 4,000 _ 15 Fire Protection 57,500 15 HVAC 27,450 _ 15 Plumbing 16,365 16 Electrical 127,500 CONSTRUCTION COST: $645,929 I 4 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID K3 DATE(MMIDONYYY) KAPLA-2 12/06/06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE TD Banknorth Ins Agcy Inc (SF) HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P.O. Box 9040 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Springfield MA 01102-9040 Phone: 413-781-5940 Fax:413-733-7722 INSURERS AFFORDING COVERAGE NAIC4 INSURED INSURER A: ABC MA WC SELF-INSURED GROUP INSURER B: Ka lan Corporation INSURER C: 11 Harvard Street INSURER D Brookline MA 02446 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MiK RUUL POLICY EFFECTIVE POLICY EXPIRATION LTR 'NSRC TYPE OF INSURANCE POLICY NUMBER DATE(MMIDD/YY) DATE(MMIDDIYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PRFMISES(Ea occurence) $ CLAIMS MADE ❑OCCUR MED EXP(Any one pernon) $ PERSONAL d ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG POLICY PRO- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENIION $ $ WORKERS COMPENSATION ANDX TORY LIMITS ER A ANY PROPRIETOR/PARTNER/EXECUTIVE EMPLOYERILITYPARTNER/EXECUTIVE ABCMA 005014-06 01/01/06 01/01/07 EL.FACHACCIDFNT. $ 1000000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 1000000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 1000000 OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS Job: 06-11 North Parish Church CERTIFICATE HOLDER CANCELLATION NORTPAR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATI DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTI NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHAL j North Parish Church 190 Academy Road IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR North Andover MA 01845 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Joe Blanche ACORD 25(2001108) ©ACORD CORPORATION 1 AC-08D. CERTIFICATE OF LIABILITY INSURANCE OP ID CDATOE9(bMIOD/YYYY) KAPLA-1 09/25/06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE DeSanctis Insurance Agcy, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 36 Cummings Park ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Woburn MA 01801 Phone: 781-935-8480 Fax:781-933-5645 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Acadia Insurance Company ' INSURER B: Kaplan Corporation INSURERC: 11b Harvard Street INSURER D: Brookline MA 02446 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SI TOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -LTR NSR TYPEOFINSURANCE POLICY NUMBER OLC F1D,,FECE P LI DATE MMIDO DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERAL LIABILITY CPA009808113 09/01/06 09/01/07 PREMIS_ aoceurence) s250,000 CLAIMS MADE OCCUR MED EXP(Any one person) $5,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: _ PRODUCTS-COMPIOP AGG s2,000,000 POLICY X PRO LOC JECT AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $1,000,000 ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ A X SCHEDULED AUTOS MAA009478613 09/01/06 09/01/07 (Per person) - X HIREDAUTOS BODILY INJURY $ X NON-OWNEDAUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EAACC $ - AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $10,000,000 A X OCCUR 7 CLAIMSMADE CUA009811013 09/01/06 09/01/07 AGGREGATE S10,000400 DEDUCTIBLE - RETENTION $, $ WORKERS COMPENSATION ANDIT- EMPLOYERS' EMPLOYERS'LIABILITY - TORYLIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? If yes,describe under E.L.DISEASE-EA EMPLOYEE $ SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Illustration of Coverages CERTIFICATE HOLDER CANCELLATION ILLUS-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN ILLUSTRATION OF COVERAGE NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL � IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESEN A S. AUTHO RES ATIVE� ACORD 25(2001108) © CORD CORPORATION 1988 i i Andover,MA Richard D.Kimball Company,Inc. P 978-475-0298 Boston,MA 200 Brickstone Square F 978-475-5768 New Brunswick,NJ Andover,MA 01810-1488 W www.rdkengincers.com ENGINEERS DESIGN CERTIFICATION In accordance with Section 116.2.1 of the Massachusetts State Building Code 780 CMR,6'''Edition,I, Dennis O'Leary being a registered professional engineer hereby certify that the Richard D. Kimball Company's employees, under my direct supervision, have prepared the construction documents including plans, specifications and required computations, which are in accordance with the requirements of the Massachusetts State Building Code and all other applicable laws and ordinances. Project: North Parish Church Location: North Andover, Massachusetts Construction Documents: Drawings: 1-10.00, 1-10.01, H2.00, H2.01, H2.02, H3.00 Date on Plans and Specifications: August 2, 2006 Stt OF M,q, /G � qc Sod Dennis yGN ature P. Q O'Leary Heating&Ventilation No.43354 HVAC �FGISTER �`��%+ Discipline-Area of Responsibility SS4ONA M.G.L. Chapter 112,231 CMR,250 CMR Professional Engineer(Original Seal) Date L:Uobs\2006\26357-North Parish Church\Affidavits\I-IVAC Design Cert.doc I Andover,MA Richard D.Kimball Company,Inc. P 978-475-0298 LNBoston,MA 200 Brickstone Square F 978-475-5768 ENGINEERS New Brunswick,NJ Andover,MA 01810-1488 W www.rdkengincers.com DESIGN CERTIFICATION In accordance with Section 116.2.1 of the Massachusetts State Building Code 780 CMR,Oh Edition,I, Gilbert E. Martin being a registered professional engineer hereby certify that the Richard D. Kimball Company's employees, under my direct supervision, have prepared the construction documents including plans, specifications and required computations, which are in accordance with the requirements of the Massachusetts State Building Code and all other applicable laws and ordinances. Project: North Parish Church Location: North Andover, Massachusetts Construction Documents: Drawings: E0.00, E0.01, E0.02, E2.00, E2.01, E7.00, E8.00, E9.00 Date on Plans and Specifications: August 2, 2006 III ZA 0f M,ts j GILBERT E. MARTIN,JR. ELECTRICAL y No.33353 16.14-NALE� ELECTRICAL Discipline-Area of Responsibility M.G.L.Chapter 112,231 CMR,250 CMR Professional Engineer(Original Seal) Date L:Uobs\2006\26357-North Parish Church\Affidavits\Elec Design Cert.doc i BOARD OF BUILDING License: CONSTRUCTION SU ULATI RS i Number: CS 092420 I .: Birthdate: 11/10/1963 t t Expires: 11/10/2008 Tr.no: 92420 Restricted: 00 WRIGHT C DICKINSON 52 HARDING STREET MEDFIELD, MA 02052 Commission i COMMONWEALTH OF MASSACHUSETTS Construction Control Affidavit Project Number: Project Title: U •'P>AS t, U - 1?ENOIi'4Tlp1�j� Project Location: o N �Vi✓� Name of Building: N D t GGf� Nature of Project: g-i5 to 4&!neeN< In accordance with Section 116.0 Registered Architectural and Professional Engineering Services- Construction Control of the Massachusetts State Building Code,I Q&-4tD W Registration No.�being a Registered Professional FjHOueWArchitect,HEREBY CERTIFY that I have prepared or directly supervised the preparation of all design,plans,computations and specifications concerning: Entire Project Architectural _ Structural Mechanical Fire Protection Electrical Other (specify)foundation FOR THE ABOVE NAMED PROJECT AND THAT SUCH PLANS,COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE 780 CMR MASSACHUSETTS STATE BUILDING CODE. ALL ACCEPTABLE ENGINEERING PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING SPECIFIED IN SECTION 116.2.2, 1. Review,for conformance to the design concept,shop drawings,samples and other submittals,which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code required controlled materials. 3. Be present at intervals appropriate to the state construction to become generally familiar with the progress and quality of the work and to determine,in general,if the work is being performed in a manner consistent with the construction documents. UNDER SECTION 116.4,I SHALL PERIODICALLY SUBMIT A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS,TO THE COMMONWEALTH OF MASSACHUSETTS BUILDING INSPECTO . UPON COMPLETION OF THE WORK,I SHALL SUBMIT A FINAL REPORT AS NOTICE OF SATISFACTORY COMPLETION AND REDINESS OF THE PROJECT FOR OCCUPANCY. �NE1 Signature and St a88 SUBSCRIBED AND SWORN IS DAX OFM. rh. OF .�. 9. �. .� NOTARY BLIC s w _COMMISSION EXPIRES: •.,y�,�•....OF*.s`�p�a• d%Offy P N0�,•� CONSTRUCTION CONTROL AFFIDAVIT Project Number: 06-092 Date: July 2, 2006 Project Title: North Parish Church, North Andover Project Location: 190 Academy Rd., North Andover, MA Name of Building: North Parish Church Scope of Project: structural renovations shown on structural drawings IN ACCORDANCE WITH SECTION 116.0 OF THE MASSACHUSETTS STATE BUIDING CODE, I John M. Wathne, MASS. REGISTRATION NO. 34420 BEING A REGISTERED PROFESSIONAL ENGINEER HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS, AND SPECIFICATIONS CONCERNING: Entire Project Architectural Structural X Mechanical Electrical Fire Protection Other(specify) FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEDGE, SUCH PLANS, COMPUTATIONS, AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRACTICES AND ALL APPLICABLE LAWS FOR THE PROPOSED PROJECT. I FURTHER CERTIFY THAT I OR MY DIRECTLY SUPERVISED REPRESENTATIVE SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2. 1. Review of shop drawings, samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit, and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code required control materials. 3. Special architectural or engineering professional inspection of critic R"'cron components requiring controlled materials or constructionspecified in the accepted eng andards listed in Appendix I. t �z WA 0 F Vit. PURSUANT TO SECTION 116.4, 1 SHALL SUBMIT PER [ "C GRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE BUILDI I PE COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO �k RY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. Signature S B CRIB r D SWORN TO BEFORE ME THIS 2-K4 DAY OF 200,9 My commission Expires: No ary Public • I I I i Andover,MA Richard D.Kimball Company,Inc. P 978-475-0298 10 Boston,MA 200 Brickstone Square F 978475-5768 ENGINEERS New Brunswick,NJ Andover,MA 01810-1488 W www.rdkengineers.com DESIGN CERTIFICATION In accordance with Section 116.2.1 of the Massachusetts State Building Code 780 CMR,6"'Edition,I, Dennis O'Leary being a registered professional engineer hereby certify that the Richard D. Kimball Company's employees, under my direct supervision, have prepared the construction documents including plans, specifications and required computations, which are in accordance with the requirements of the Massachusetts State Building Code and all other applicable laws and ordinances. Project: North Parish Church Location: North Andover, Massachusetts Construction Documents: Drawings: P2.00 Date on Plans and Specifications: August 2, 2006 � Qc\ Dennis yGN S ature P. a chi O'Leary cn Heating 6 Ventilation No:43354 C4 PLUMBING ISTE���4� Discipline-Area of Responsibility �SS�ONAL��G\ M.G.L.Chapter 112,231 CMR,250 CMR Professional Engineer(Original Seal) Date L:Uobs\2006\26357-North Parish Church\Affidavits\Plum Design Cert.doc C ` NORT1y '9 Town of _: Andover No. tf6 o Adover, Mass., �� Z A_4 COCHICKEWICK V� / Ids RATED PO' S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..../. Q6!. ... .....�/ .t..r .�� ..�. .. .�...: ... """"""""""" "'�' Foundation has permission to erect........................................ buildings on/ ... . id t<. 4 Rough t0 be Occupied as�6�11i.at � lChimney provided that the accept ng this p/�mit shall in every respect conform to the terms of t e ap jcation on file in E this office, and to the provisions of the Codes and By-Laws relating tope Inspection, Alteration and C ruction of d Buildings in the Town of North Andover. :, I'1 orle0e wry' LUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough 41, 7 S/ PERMIT EXPIRES IN 6 MONTHS Final �v t' UNLESS CONSTRU TARTS ELECTRICAL INSPECTOR Rough s/ ...................... Service Bf3lDINGZIVSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFina, No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner J Street No. SEE REVERSE SIDE Smoke Det. a � �0 a i /npz/ /�p0 Mitt Romney �' " a,?1 -AM Thomas G.Gatzunis,P.E. Governor �Iy�y0�6O//p0O Commissioner Kerry Healey y yC�7y_C/ /n G / Thomas P.Hopkins Lieutenant Governor 6� �Q/eY Director Robert C.Haas www.mass.gov/aab Secretary DECISION RE: NORTH PARISH UNITARIAN UNIVERSALIST CHURCH,190 Academy Road, North Andover 1. The variance hearing was held in regards to the following Rules and Regulations of the Architectural Access Board: Section 28.1 —General(Elevators) 2. The hearing was held on: Monday, October 16, 2006. 3. The following person(s) appeared: Robert Pellegrini,Attorney for the Church; David Torrey, Architect; Gail Forsyth-Vail,Director of Religious Education for the North Parish Church; Deborah Putnam, Member of the North Parish Church Building Task Force;Prudence Barker, North Parish Church Parishioner; Frank Clarkson, Assistant Minister for the North Parish Church; and Clem Karl, Chair of the North Parish Church Building Task Force. All were sworn in by the Chairman and the hearing was called to order at 3:15 p.m. 4. JUtcISDICTION: The Board took jurisdiction over the facility under Section 3.3.2, in that the work to be performed was going to amount to 30%or more of the full and fair cash value of the building,therefore the entire building is required to comply in full with 521 CMR. 5. FINDINGS AND DECISION: The Board having considered the evidence hereby decides and finds as follows: Mr. Robert Pellegrini started the presentation by stating that the main portion of the church was constructed in 1833 and is listed on the National and State Registry of Historic Buildings. The project that the church is intending to undertake has been in the works.for the past seven years. The Unitarian Church must acquire all of their funds for projects.from the parishioners, noting that they are spending just over$399,000 on barrier removal and$328,000 on HVAC,plumbing, electrical, and life safety upgrades, with an additional $20,000 being spent on other miscellaneous upgrades. Mr. Pellegrini stated that the largest project is at the front entrance of the church. The current configuration requires parishioners to traverse a set of stairs up to the large entry doors and then enter into the vestibule area and traverse additional stairs to access the main part of the church. The church is proposing to raise the grade at the front of the church, creating an at-grade entry via a sloped walkway at the front of the building. The noncompliant interior doorway will be removed and a compliant doorway will be installed. The church will also be installing accessible pews with accessible seating locations at the front and rear of the church. The stage area at the front of the church will also be accessed via sloped aisles and an accessible podium will be in place. The one.variance that is being sought at the interior is for maintaining the existing historic pulpit, noting that the podium on the stage will be an alternate location for speakers. On the basement level, there is a narrow set of stairs connecting the church and the basement,which will be replaced with compliant stairs. Another variance request was for the existing elevator to remain due to the constraints of the building. Mr. Pellegrini also added that there is also a compliant walkway along the side of the church connecting people from the front of the building to an accessible entrance to the basement area. The offices with noncompliant doorways will be converted into a nursery and brought into compliance, along with the noncompliant stage at the basement area being removed. The kitchen will require a variance for the lack of compliant height at the countertops. Mr. Pellegrini stated that all of the other variances that were originally requested were being withdrawn, as the church is going to comply with all areas except for the height of the existing counters. Mr. Pellegrini stated that there was currently only one set of bathrooms for the church, located in the basement area, and that the church was proposing to make the existing bathrooms comply in full with 512 CMR. He noted that the religious education area,located in the basement is located on two levels, with the proposal to continue the exterior walkway to provide an accessible entrance to the first level of the religious education classes. The upper level of the religious education classes is up a set of stairs. The petitioners are proposing to install a compliant stairway to this upper level,but there will be no vertical access to this space. Mr. Pellegrini stated that the classes can be moved to the accessible level if necessary to accommodate the students. In regards to the variance for the noncompliant elevator, Mr. Pellegrini stated that they have received cost estimates from elevator companies and found that due to the size of the existing shaft, even a compliant vertical wheelchair lift would not be feasible. Creating a compliant shaft would require that the shaft be demolished, which would result in having to demolish part of the structure that holds up the balcony and require removal of the organ. In lieu of creating a compliant means of vertical access,the church was proposing to create the walkway which connects the front of the building with the lower accessible entrance. Mr. Pellegrini stated that creating vertical access would be technologically infeasible. At this point,Mr. Martin Ebel asked for clarification as to the reason for the variance request for the lack of vertical access was that compliance was technologically infeasible because the demolishing would require that portions of the balcony be removed and the organ relocated,to which Mr. Pellegrini responded and clarified was correct. Ms:Nancy Angney asked for the specific dimensions of the existing elevator. Mr. Pellegrini stated that the elevator was 34 inches by 42 inches,noting that they have looked into the shaft and found that the shaft is only marginally larger than the elevator car. He went on to state that the balcony was used for overflow seating and housed the organ,noting that the balcony was historic to the church. Ms. Angney then asked if the elevator was able to access the other portions of the church and the addition. Mr. David Torrey,Architect for the Church, added that the Church had looked at Limited-Use-Limited-Access (LULA) elevators,vertical wheelchair lifts as another means of vertical access,but found that all means were infeasible due to the present makeup of the church and the existing shaft size. Ms. Angney then asked if the call buttons were located at the required height. Mr. Torrey stated that they were willing to make the features of the elevator that they were able to bring into compliance compliant. After reviewing the matter,Ms. Angney made a motion to GRANT the variance requested for the use of the existing elevator as a means of vertical access on the condition that any improvements not requiring changing the actual elevator, such as the hall call button height and location,were brought into compliance with Section 28 of 521 CMR The motion was seconded by Ms. Myra Berloff and carried unanimously upon a vote from the Board. 2 The next matter that the Board discussed was the lack of access to the balcony. Mr. Pellegrini stated that the r balcony is not used by the choir and is only used by the organist and for overflow seating during Christmas. Ms. Berloff made a motion to GRANT the variance for the lack of vertical access to the balcony, on the condition that there be a written policy that the balcony is used for overflow seating only with the policy to be submitted upon receipt of the Decision of the Board, noting that her decision was based on the historical significance of this space. The motion was seconded by Ms. Diane McLeod and carried unanimously upon a vote from the Board. The next variance request was in regards to the pulpit. Mr. Pellegrini stated that the pulpit is approximately four feet above the church floor, and that due to the construction the only means of access would be a vertical wheelchair lift. He added that the lectern located at the altar was more frequently used than the pulpit and was accessible. Ms. Deborah Putnam stated that the smaller lectern was often used for many of the ceremonies and services held in the church, adding that they are also currently using a portable lectern in the space that they are leasing and are proposing to use it at the renovated church. Ms. Berloff then made a motion to GRANT the variance requested for the lack of access to the existing historic pulpit, based on the historic significance of the structure. The motion was seconded by Ms. Angney and carried unanimously upon a vote from the Board. Mr. Pellegrini then presented the variance request for the lack of access between the two levels of the religious education portion of the church. He reiterated that the church would like to raise the entire area and build a new religious education building, adding that the accessible walkway will be at the exterior to create a means of access between the lower and upper levels of the religious education section, as well as creating a means of access from the main sanctuary to the lower level religious education area of the building. Ms. Angney asked for clarification that.a person located on the accessible lower level of the religious education area would have to exit the building and reenter at the upper level to access the bathrooms,which Mr. Pellegrini verified was correct. Ms. Angney then questioned when the religious education portion of the building was built,to which Mr. Pellegrini clarified that this portion of the building was constructed in the 1950's. Ms. Angney then asked if the petitioners had looked at an exterior means of vertical access. Mr. Pellegrini stated that this was probably restricted by the Preservation Restriction which was put on the building. Mr. Torrey stated that it was a Historical Restriction due to the building's historic nature, clarifying that the only portion of the church that was preserved historically was the main area of the church. He added that the Church is proposing to create a new religious education facility in Phase 2 of the construction which will begin once the proper funding is achieved. Mr: Pellegrini clarified that the church therefore did not look at an exterior lift. Mr. Torrey noted that a similar means of exterior access was reviewed but found to be infeasible due to the cost being beyond the budget of the church. At this point,Ms. Angney made a motion to CONTINUE this matter regarding the lack of vertical access between the two levels of the religious education portion of the church so that the petitioners may submit cost estimates for a lift to access the two levels. Mr. Pellegrini stated that the vertical wheelchair lift was estimated at $120,000,noting that this cost was shown in the original submittal of the variance application. He added that the work to create a fully accessible religious education area would most likely be completed within the next ten years. Ms. Gail Forsyth-Vail added that as the Director of the Religious Education for the church, the policy would be to move any students that were in need of accessible features to the accessible level of the religious education area. At this point, Ms.Angney withdrew her motion. Mr. Ebel then made a motion to DENY the variance for lack of vertical access between the two levels of the religious education center, but GRANT a 10 year variance to the Church to bring this religious education center into full compliance with Section 20 and 28 of 521 CMR,therefore allowing until October 31, 2016, noting that the Board should be made aware of any upgrades to this portion of the church when they are planned. The motion was seconded by Ms. Berloff and carried unanimously upon a vote from the Board. 3 r The next variance request was in regards to the lack of compliant countertop height in the existing kitchen. Mr. Pellegrini stated that the existing countertop is 3 inches above the maximum required height of 34 inches. Ms. Berloff asked if the kitchen was part of the religious education center, to which Mr. Pellegrini responded that it was not located in the religious education center,but directly adjacent to the parish hall in the existing church building.. Ms. Berloff then asked if there was any alternative proposed for an accessible space within the kitchen. Ms. Putnam stated that they were proposing to make both sinks at the center have the required knee space and build a lower counter adjacent to the stove,where a temporary shelving unit is currently located. Ms.Berloff stated that based on Ms. Putnam's testimony,she would make a motion to GRANT the noncompliant countertop heights in the kitchen. The motion was seconded by Ms.Anguey and carried unanimously upon a vote from the Board. Mr. Pellegrini then presented the variance request for the doorways at the upper level of the religious education center, stating that all of the existing doorways are 32 inches wide measured from door jam to door jam, resulting in a violation of Section 26.5 of 521 CMR which requires a clear width of not less than 32 inches. He added that all of the doorways in the other areas of the church will have the compliant clear width opening. Upon further review of the request,Mr. Ebel made a motion to DENY the variance requested for the lack of clear width at the doorways at the upper level of the religious education center, but GRANT a 10 year variance to the Church to bring this religious education center into full compliance with Section 26 of 521 CMR,therefore allowing until October 31, 2016, noting that the Board should be made aware of any upgrades to this portion of the church when they are planned. This motion was seconded by Ms. Berloff and carried unanimously upon a vote from the Board. The final variance that was being requested was in regards to the lack of compliant stairways in the existing buildings. Mr. Pellegrini stated that the Church was WITHDRAWING this variance request since they planned to bring all of the stairways within the facility into full compliance with Section 27 of 521 CMR. A true copy attests: This constitutes a final order of the Architectural Access Board entered pursuant to G.L. c. 30A.Any aggrieved person may appeal this decision to the Superior Court of the Commonwealth of Massachusetts pursuant to Section 14 of G.L. c.30A. Any appeal must be filed in court no later than thirty(30)days of receipt of this decision. DATE: October 31, 2006 ARCHITECTURAL ACCESS BOARD cc: Local Building Inspector Gerald LeBlanc, Chairman Commission on Disability Independent Living.Center 4 i d t xme Mitt Romney � ' ' a-empl61e Governor 0 x P-�.��J0660y�1�00-�,z� ,�,�' Thom Comm sones,P.E. Kerry Healey Thomas P.Hopkins Lieutenant Governor P Director Robert C.Haas Secretary www.mass.gov/aab TO: Local Building Inspector Variance Number:06 124 Local Disability Commission Independent Living Center FROM: ARCHITECTURAL ACCESS BOARD RE: North Parish Church 190 Academy Road North Andover Date: 8/18/2006 Enclosed please find the following material regarding the above location: V A pp lication for Variance Decision of the Board Notice of Hearing Correspondence Letter of Meeting The purpose of this memo is to advise you of action taken or to be taken by this Board. If you have any information which may assist the Board in reaching a decision in this case, you may call this office or you may submit comments in writing. Robert R. Pellegrini T: 978-327-5570 ; F 978-32',-5219 , 7 .F. rpellegrini vsmolakvaughan Coln August 16, 2006 Via Federal Express Mr. Tom Hopkins Architectural Access Board One Ashburton Place, Room 1310 Boston, MA 02108-1618 RE: North Parish Unitarian Universalist Church 190 Academy Road North Andover, MA 01845 Application for Variances Dear Tom: This firm represents the North Parish Unitarian Universalist Church(the"North Parish"). On behalf of the North Parish, I have enclosed an Application for Variance for its place of worship located at 190 Academy Road in North Andover. In connection with the Variance Application, you will find the following: Exhibit A: Fifty dollar check payable to the Commonwealth of Massachusetts to cover the application fee; Exhibit B: One original set of full-size Plans showing the location of the requested variance relief and one set of 8 %2 x 11 Plans; Exhibit C: List of construction costs,together with the original letter detailing costs from North Parish's contractor, Kaplan Corporation; Exhibit D. Copy of the Building Inspector's letter of support(which you may already have received); Exhibit E.Photographs of the North Parish building(with an attached Table of Contents); and, Exhibit F. Three copies of the complete application package. A letter of support is also being mailed directly to you from the Town of North Andover Old Center Historic District Commission. The North Parish is operating a place of worship in an historic building, constructed in 1833. Within the last several years, the North Parish initiated an ambitious funding campaign,but unfortunately they were only able to raise less than half of the funds that would have been required to undertake the project that they had originally envisioned. Nonetheless, the applicant is proposing to spend$399,243 on barrier removal, and$328,928 on life safety improvements. Only $24,313 is being spent on upgrades not related to either of the above. Additionally, in the recent past,the North Parish has spent a significant amount of money to preserve the badly weathered exterior Jefferson Office Park,820 Turnpike Street,Suite 203,North Andover,MA 01845 WWW.SMOLAKVAUGHAN.COM ' SMOLAK & VAUGHAN LLP Tom Hopkins August 16,2006 Page 2 of the building. This work could not have been delayed due to the fact that the building's infrastructure was badly deteriorating. Despite the level of expenditures,the North Parish is still unable to meet full compliance, both because of budgetary constraints and the fact that some of the measures required for full compliance would result in the destruction of critical historic aspects of the building. As you will see in the application, the North Parish is proposing to take great strides towards full compliance, in the most critical areas of the building. For example,the North Parish building currently is inaccessible from the street, and only can be accessed from one side. The project proposes to raise the front doors of the church building to make the front entrance accessible. In the sanctuary, there are currently no accessible pews,and the stage where the Choir practices and performs is inaccessible. The project proposes to create both accessible pews and to make the stage accessible. Currently,none of the doorways are accessible. If the plans are implemented, however, almost all the doorways which are currently inaccessible will become accessible. The parish hall,the first floor of the religious education area, and the nursery will also become accessible under the proposed plan. While the North Parish is regrettably unable to reach full compliance under its present plans, it is proposing significant improvements which would greatly improve access for persons with disabilities. The areas that are proposed to be left alone (the historic balcony and pulpit, the kitchen,and the second floor of the religious education area)are areas that are rarely, if ever, used by the public, are of historical significance and should not be destroyed, and are areas where compliance would result in excessive cost without any substantial benefit to persons with disabilities. In order to achieve full compliance,the North Parish would have to somehow raise another$657,000,a significant sum of money which the North Parish has been unable to raise. Please contact me should you need additional information or if you have any questions. Thank you. Very_truly yours Robert R. Pellegrini, r. cc: Clem Karl (cover letter only) Attachments I i The Commonwealth of z W Massachusetts a �c o" Department of Public p�M SJov Mitt Romney Safety Joseph S.Lalli Governor Architectural Access Board Commissioner Kerry Healey Thomas P.Hopkins Lieutenant Governor One Ashburton Place , Room 1310 Director Edward A.rl nn wwwstate.ma.us/aab Secretaryy Boston , Massachusetts 02108-1618 Phone ( 617 ) 727 -0660 Voice and TDD 1-800-828-7222 Fax ( 617 ) 727-0665 APPLICATION FOR VARIANCE In accordance with M.G.L., Chapter 22, Section 13A, I hereby apply for modification of or substitution for the rules and regulations of the Architectural Access Board as they apply to the facility described below on the grounds that literal compliance with the Board's regulations is impracticable in my case. 1. State the name and address of the owner of the building/facility: North Parish Church 190 Academy Road North Andover, MA 01845 Tel: (978) 687-7948 2. State the name and address or other identification of the building/facility: North Parish Church 190 Academy Road North Andover, MA 01845 Tel: (978) 687-7948 3. Describe the facility: (Number of floors,type of functions, use,etc.) The subject structure consists of a two-story, wood-framed church and parish hall with mezzanine balcony, constructed in 1836. 4. Total square footage of the building: 10,840 square feet. Lower level: 5,655 square feet; Upper level: 5,184 square feet. a. total square footage of tenant space (if applicable): n a 5. Check the work performed or to be performed: New Construction Addition X Reconstruction, X Remodeling, alteration_Change of Use. 6. Briefly describe the extent and nature of the work performed or to be performed: (Use additional sheets if necessary). The project includes new accessible toilets, a new staircase, new accessible doors, modifications of box pews, a new sloped aisle for access to the chancel platform, removal of a non-accessible stage, installation of new acccessible doors to the nursery, a new accessible entry door into the religious education area (lower level), new accessible signage throughout, a new life safety system consisting of alarms and emergency detection, a new sprinkler system, new lighting, and paint. 7. State each section of the Architectural Access Board's regulations for which a variance is being requested: 7a. Check appropriate regulations: 1996 Regulations 1982 Regulations X 2002 Regulations SECTION NUMBER LOCATION OR DESCRIPTION 3.9 Historic Buildings This Variance Application seeks to allow certain existing conditions to remain unaltered and not in full compliance with 521 CMR because full compliance would require excessive costs and would harm the historical integrity of the structure. The church is located in the Old Center Historic District and is considered one of the more cherished historic structures in Town. A letter will be submitted from the Massachusetts Historical Commission, as required by 521 CMR, item 4.1. The Massachusetts Historical Commission will be holding an Historic Preservation Restriction on the building. 16.1 Houses of Worship !, Since the church is a listed historic structure, located in the Old Center Historic District and considered one of the more cherished historic structures in Town,this variance seeks to allow occasional use of existing raised floor areas without modifications for compliance with 521 CMR. 16.1 Houses of Worship There is a pulpit in the sanctuary that is not accessible. The proposed project provides for this historic pulpit to remain intact. 16.1 Houses of Worship The second floor of the religious education area is not accessible. The proposed project provides for this area to remain intact. 16.1 Houses of Worship The balcony located above the sanctuary is not accessible. The proposed project provides for this historic balcony,with its unique architecture,to remain intact. 16.1/26.5 Houses of Worship/Doors and Doorways All the doors and doorways will be accessible, except for six doors on the second floor of the religious education area. Unfortunately, this area was built with 32" wide doorways. 16.1/27.2,27.3,27.4 Houses of Worship/Stairways The stairway to the second floor of the religious education area does not comply with 521 CMR with respect to tread and riser dimension, nosing design, handrail height, and grip and extensions (at top and bottom of stair runs). 32/32.1 Kitchens The kitchen in the religious education area does not fully comply with 521 CMR. 8. Is the building historically significant?X yes no. If no, go to number 9. 8a. If yes, check one of the following and indicate date of listing: National Historic Landmark Listed individually on the National Register of Historic Places X Located in registered historic district i `X Listed in the State Register of Historic Places Eligible for listing i 8b. If you checked any of the above and your variance request is based upon the historical significance of the building, you must provide a letter of determination from the Massachusetts Historical Commission,80 Boylston Street, Boston, MA 02116. Pending 9. For each variance requested, state in detail the reasons why compliance with the Board's regulations is impracticable. State the necessary cost of the work required to achieve compliance with the regulations. PLEASE NOTE THAT YOU SHOULD SUBMIT WRITTEN COST ESTIMATES AS WELL AS PLANS JUSTIFYING THE COST OF COMPLIANCE. Use additional sheets if necessary. 3.9 Historic Buildings The subject building, known as the "meetinghouse of the North Parish" was built in 1836. Richard Bond, a Boston architect who also designed Harvard's Gore Hall, designed the North Parish meetinghouse. It is a simplified Gothic plan based on the First Parish Church of Cambridge, The 1807 Paul Revere Bell was moved from the old meetinghouse to the existing tower, where it remains today. The meetinghouse is located in the Old Center Historic District and is considered one of the more cherished historic structures in Town. This Variance Application seeks to allow certain, noncompliant existing conditions to remain unaltered, because full compliance would require excessive cost without substantial benefit to people with disabilities, and would harm the historical integrity of the structure. The Massachusetts Historical Commission will be holding an Historic Preservation Restriction on the building. 16.1 Houses of Worship With respect to the pulpit in the sanctuary, no work is proposed. The existing historic pulpit is used by the Minister for sermons. It could only be made accessible if a wheelchair lift was installed. In order to do this, the historic pulpit would have to be destroyed. This would harm the historical integrity of the parish hall and has been estimated to cost $45,000. Funds for this improvement are unavailable. As it is infrequently used by the public, the cost of compliance is excessive without any substantial benefit to persons with disabilities. 16.1 Houses of Worship The second floor of the religious education area is not accessible, and could only be made accessible with the installation of a 3-level wheelchair lift. The cost for installation of the lift is estimated to be$120,000. Funds for this improvement are unavailable, and other accessible space is available on the lower level to accommodate the parishioners. Therefore, the cost of compliance is excessive without any substantial benefit to persons with disabilities. 16.1 Houses of Worship The balcony is not accessible and could only be made accessible if a 3-stop elevator was installed. To make the balcony accessible would require an elevator to be placed in the middle of the sanctuary and the organ would have to be removed. In addition, the required location of the elevator would require destruction of the historic balcony structure and details, which would in turn destroy the historic architecture and would block egress paths from occupied spaces. The cost for this work has been estimated to be$250,000 and the funds for this improvement are unavailable. Therefore, the cost of compliance is excessive without any substantial benefit to persons with disabilities. I 26.5- Houses of Worship/Doors and Doorways All the doors and doorways will be made accessible, except for the second floor of the religious education area. The cost to replace the doorways is estimated to be $12,000. Funds to pay for these improvements are unavailable. Therefore, the cost of compliance is excessive without any substantial benefit to persons with disabilities. As an alternative to compliance, the congregation could leave the noncompliant doors open when the rooms are in use. 16.1/27.2,27.3,27.4 Houses of Worship/Stairways The proposed project provides for the existing staircase between levels in the religious education area to remain. The cost to replace the stairs is estimated to be$200,000. Funds to pay for these improvements are unavailable. Compliance with 27.2, 27.3, and 27.4.1 is infeasible due to the dimensional constraints of the building. If the staircase was renovated within the existing space, it would compromise the accessible access routes, thereby violating Sections 20 and 20.2. Therefore, the cost of compliance is excessive without any substantial benefit to persons with disabilities. 32/32.1 Kitchens The kitchen in the religious education area is not used as a classroom or an assembly area. The proposed project provides for the existing kitchen to remain. The cost to bring the kichen into compliance is estimated to be $30,000. Funds to pay for these improvements are unavailable. Furthermore, as this is rarely used by the public, there would be no substantial benefit to persons with disabilities. 10. Has a building permit been applied for? NO Has a building permit been issued? NO 10a. If a building permit has been issued,what date was it issued? 10b. If work has been completed,state the date the building permit was issued for said work. 11. State the estimated cost of construction as stated on the above building permit. 11a. If a building permit has not been issued, state the anticipated construction cost:$752.484.00 12. Have any other building permits been issued within the past 24 months?YES 12a. If yes, state the dates that permits were issued and the estimated cost of construction for each permit: Exterior repairs and painting--$373.903 13. Has a certificate of occupancy been issued for the facility? X currently occupied. If yes, state the date:1836 14. To the best of your knowledge, has a complaint ever been filed on this building relative to accessibility? NO. 15. State the actual assessed valuation of the BUILDING ONLY, as recorded in the Assessor's Office of the municipality in which the building is located. $693,000. Is the assessment at 100%? NO. If not, what is the town's current assessment ratio?950% 16. State the phase of design or construction of the facility as of the date of this application: construction documents completed. 17• State the name and address of the architectural or engineering firm including the name of the individual architect or engineer responsible for preparing drawings of the facility: Menders,Torrey&Spencer, Inc, 123 N.Washington Street Boston,MA 02114 Telephone: 617-227-1477 18. State the name and address of the building inspector responsible for overseeing this project: Gerald Brown, North Andover Inspector of Buildings 1600 Osgood Street N.Andover, MA 01845 j Telephone: 978-688-9545 PLEASE NOTE: The Board may, in its discretion, hold a hearing on your application for variance. The Board may also decide your application without a hearing, based upon the information you submit. You should therefore include all relevant information with your application. At minimum the plans should include a site plan, all floor plans, elevations,sections and details. 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ViMrt�hNGE -zx�w9o0.Wtl.®,doe -J EA1•W.INa.®,enC. -1A18'.tl..lu- coo. -c.tl.eWO.®tc D.a -AN.n .m r l d.bwl -]SIB'b.RUM®,c ae -S mil.pdy npu tlamer WromaCD.%btlnp -MaIh/a .CauNtNenketmWl, e.oufticdmkminN, -1.11 tl..Wd.®18^aa -m..m.lgenkain.a. -wa.herninprommcn.rbtlpwli �BQv1� rl 5B'pwE -Anpn -AIS'9w0 ' -S/A'px9 -24yx.WSwb -S'Ihamel Cetl Ob9as+ -rtnos -ANen -finbn -AnUn -ANfn In.Ulvtlon(R-,9) 'ro epAmie row•taR fmneltltep.EGbw -SlS'ofa plywooE Nea9Ar19 2 PARTITION TYPES -nn.rtvmla,ea,n.. SME.,,7=t'4' -e(dngtD motto 9xiaNlp New New 4L49wc:, roaHmy ,t Rerrol.E•s-r�s, r_LTAIR 1: j I p ss A1sLEu. — r I I 8T. �g II N6N+ i� 83A xgd I it I FOYERLffi];�I j C;� I PULPIT TOWER I OPEN TO ARV urkn SANCTUARY (jam gµC7U BELOW 17 ( ST. •�— '� BALCONY qa _ t aEvATOR ,� 'WHINE I NO urr 7-0uarNrS ® j q i p ! I I Pv�sar o <€ I I ; Zsm $z U PART MAIN LEVEL PLAN SANCTUARY 2 PART BALCONY LEVEL PLAN SANCTUARY OZ SC:IIE 1N51'V 9CNE:INbt'-0' ? N z 03 rkNO[P u.ODORHtyu, LL oos-rmcxnr> [n Nrae I,...I ...i 'wr -4/ I_lull Vrooe sr5�vlwureo [o s N 70 ra:[sravc'e n�� an GW -'T ii i I II � � 4 DEMOLITION ELEVATIa'1TI :_,Al arin.;owu 6GLE:1?•1'D' I eimww iAL. a _ �'^[^� � Cmc Win: IN"•1'-0' �: I[r[n ,' uma...nn eiaoG[T ' uuae[es,s»[, 'I %:0"3"[[,:°o.. .µc.W .N� r'•ra'' EdfVKL6U a[u[e w: ox'r PERMIT SET PLAN DETAIL AT MODIFIED PEW 7R(PEW IL MIRROR IMAGE) MODIFIED PEW ELEVATION PLAN DETAIL AT MODIFIED PEW 12R(PEW 12L MIRROR IMAGE) 6CA[E:L.•.,•L• SGLE:,?.T> SGLE:LI•„•�' 08-02-06 fZ��.i,cE 7�ON-oeMPuhMTs�AS VA2IANGE 2ahuvE padR 6rrrt tMBs,W/OCN MO NEV FiM�S T1�. '� \ ,\ 6SCAYFE r-1- Puu-�N'aC IR6/\ � GLBM2-.�NGE VAttII�W.B'#�' � VAtZ1ANGE#hS �•,SC.- m0 e�� titw STk - no new s�7tu2s� fT9GN �'\ aPPInoN i E CISROOM 02 GRADES 58 �a 0 1zEC�AoE Nam- c.oMpW AHTTbILETS I�� ,ot. ® zezw, WLT14 N8W CHM1ORFN "ter'' I qh RCCM9+ FEE is `• \ - WGRbrWI is $ GRADE9 'TfOUTH 4 g S77 �� Si O I ROOM sc COROR to \ RIDK„w„ .ertm l �` trio. +°.� .•.'RO sC MF+ o GRADES -i u _ rzfiT __ _ •°ul• ° ®. ,°,gmE�•Z a. T •., _ t GOMPfJMK LYdILS STAIR HjLLrm. `\.. \•, \ 43 �\ •!C-P� ®NS .,.-- o*�� ROOM MB nE,mu U am Aou AtvTO- RESTROOM ®, ,,.,,., j D{�ERq+TOR ro woMEN Z,- ` �MT hql� RESTR YRf�IANG� 3 GLCM+A1aGE5 °� R.E.wBiG me vcQ91(-41— STAIRILOBBY No v57R9 YI ' zB,o,. 0 a n UPPERLEVEL PLAN @ RE.WING snue w+ra 0,L10WER LEVEL PLAN RE.WING B LOWER L L PART.PLAN @ RFAR ENT. z BOILER � ® ROOM Z dW'' --- STnR924A60 --- --- --------- 0 ®' \\ ro A New 9771 0 h UJ r.cn,u�rm.oan q p BOILER°�'° 9 �®' i RE WING i mroz` N — ROOM_ yy} i) STAR/LOBBY'. UNFINISHED SPACE Spm CRAWL - _ _ ._ _ �t t ✓ Iia+" � I O.ctsl h: DYR _� --____ -0�___ I SPACE SECTION @ NEW BOILER ROOM STAIR --------------------- A-1.3 4 PPERMIT SET RT ROOF PLAN @ LINK + BASEMENT PLAN @ R.E.WING OB-OIT __.SClaE 11411Z CIE Ir �ELNG7F5 U 1. ALL DIMENSIONS SHOTN ARE N METERS UNLESS OIwERWISE NOTED. O. ANTICIPATED NO-COST CHANGES FJMLDN0 FROM WORK SHOWN ON _C LE GIESE PLANS IW%UOE,BUT ARE NOT LIMITED TO (ii•V f4 2. THE INTENT OF THIS PROJECT IS TO IMPROVE ACCESSIBILITY TO THE A. ACCES4EMF RAW iP NORTH PARISH CHURCH N CONJUNCTION NTH THE ADJACENT OLD IL CB 128 CD1Tp!/CgINON AREA NA5911WWAY IMPROVEMENT PROJECT C. 1.T SIOMAUt ALONG CUL-OE-SAC CONSTRUCTION. D. CCI.CCNG WALK FROM CGL-OE-SAC TO 70AACE j E. TERRACE WTI PAYERS 10 I THE PROPOSED WOW(AROUND NORTH PAIOSH CHINCH SNONN ON F. LANDSCAPE PLANTINGS l U R PLANS C-1 TO C-5 SNAIL STIPERCEDE THE PROPOSED WOW(SOW G. LOAM AND SEED N FRONT OF THE CRUNCH BUILDING -•i $ \ 1 ON MA59MNIWAY CONSTRUCTION PLANS OF OLD CENTER mom AREA.PREPARED BY GUERTN ELIERTON!ASSOCIATES.TNG.. 8. THE LOCATIONS OF PLANTINGS N FRONT OF THE NORTH PAWSH �� Q _I PROJECT FILE NO,80273. DAMOH aUN RMNO SHALL BE LOCATED AS DIRECTED THE FIELD. Ly T- 4. WORK SHOWN HN PLANS C-1 TO C-8 THAT WAS NOT A PMT OF THE fy \ MA591GH11'AY CONSINUCIICI PI.INS AND MODIFICATIONS TO NARK ON THE WL49HIGNWAY CONSTRUCTION PIANS SHALL BE PAID t �,.. ROTI BY THE NORM PAR194 CHURCH UNLESS OTHERWISE NOTED OR IS M UNRATED NO-COST CHANGE. \ m �APPRO%.PROPENE'UNE \ 1.5 VEL LANDING PLANTING BED (75 mm ACO)PINE BARB MULCH) .... _.. CEM.CON"STEPS. .-WOE 304.14MASSHIGH DESICNWTA•Y) '. CEM.CONC.STEPS,1.$2 m OE - W IE , V`--CEM.02NC I I _ >■• CO B LOC(I BAER (NWAY SIDM MCRWASG M/E 203.10) 60.460 (7 � (NASSN)GHWAY STD JN 1.0. INV.IN-59.010O 1.5 / ,•LEVEL LANCING JORNAMENTAL 1. r ►�BARK ATu;CHY.. iF ; LOAN 6 SEED .A SSIBIE RHO'I1 Lj 1 4", /. ADA O `APPROIL UNIT Of I `� �� GRADING(TYR.) mv-60.500 ". MAMENTAL M/P ` ARA DA NMARi yw 1 170 t�9 -7.77 \ OLOAM 8 SEDLANI m ... .... F, `HS 128!�' `' 1:40 ♦T1 REMOVE&R6C+CATE SIGN J0.2 m 13knm PPE SLBORAIN RETAIN EXISTING—, II PUCE WAT]RPROOF MEMBRANE (MASSWA.N/E 200.1.0) CEN.LONG APROCNWAY S / O 1 T-IOAi!SEED ` FOEMEEN FULL UNDATION ARCO CIOSTNG ( ) PS if APRON TTP. STEM h iCBT CONCRETE .��j (SEE MASSHIfA1MAY SID. VATHI CIIMIITE FANO MIq'FN TP'1 Y 11�Y J04.T.0 DESGH•A) AND ADI(MANIFRAIL( ) V T (PND FOR UNDER BBED n ALI�iGqNE s. MASWGWAY CONTRACT) \t YI OBHAXMDEN MMD RELOCATE GRANITE L .1ERLNG ` 60 AAW- NL ;WTR %MATO FRONT � ®It®Tl 8B EOFCONC FRONT ° PEDESTRIM ACCESS SEISE IF aa+AaEJlT1�L EN MCE LAN No LIN Wm IEFLEC(OWZED rli / A a A d • YPTN Ao-' AIL wes ry�attD>s18 o.a (1' c - j CGA ! O �[✓ i TEWRAC[.WTH CEM,CONCRETE WALL PFAESTWMRAMP PON PAVERS' WTi GRANITE FACING PROP.HER)CANOPY 4 > '9 I AND ADA HANDRAIL (BY OTHERS) CC I(I / HATCH E%ISTINO OCNC `. / WALK "! V 4CEN.CONG STEPS I _ 11460 SEE VETAI4 S)7CET C-3 ` • O � I IOAJTI!SES 06 NQ WALK R T' PROGRESS SET • 'A � � 4 20 " Gvm6D �Z� ��ASt2KGh1 6r o. '�� DRAINAGE DATA LOCATION RIM ELEV- INV. ELEV.IN INV.ELEV. OU 7 LOCATION REMARKS M.C-1 126 CB 0+43,1 62.55 - 61.39 CADEMY ROAD i Exhibit C i Construction Costs North Parish Unitarian Universalist Church North Andover, MA Activity Amount Selective Demolition including excavation required for new toilets, paved $39,750 walk for access,and foundations drainage improvements! Abatement $5,000 Site Work including excavation required for new toilets, paved walk for $87,310 access, and foundation drainage improvements. Landscaping and Improvements $45,252 Cast-in-Place Concrete,which includes new boiler stair required for $23,865 accessible toilets, and raising the front door of the church for improving access based on State work). Hand rails for the new boiler stair,which are required for accessible $2,150 toilets.2 Wood and Plastics: including wood framing, door framing and trim, new $81,784 code-compliant staircase, and ceiling trim.3 Thermal and Moisture protection. $4,750 Door replacement and door hardware replacement to achieve accessibility. $55,052 Window replacement. $18,350 Gypsum Board Systems, including drywall around new toilets, new stair, $34,460 new RE wing room configuration.4 Acoustical Ceilings to help enhance acoustics in the Parish Hall, and $20,345 ceilings above the new toilets s Flooring. $42,841 Painting. $62,950 Specialties, including accessible toilet accessories, Braille signage,and fire $8,105 extinguishers.$ Pew Modification to enhance accessibility. The applicant is proposing to $10,000 add 4 accessible pews. There are currently no accessible pews and 240 seats. Fire Protection, including a newsprinkler system and a new water line. $57,500 HVAC, including exhaust fans,and relocated pipes required for new $28,850 accessible toilets. Plumbing, including a new accessible toilet. $19,170 Electrical, including emergency and exit lights,fire alarm panel and $105,000 devices, new wirin for toilets, and in various other locations. 1 All but$750 is related directly to increasing accessibility. The entire amount is related directly to increasing accessibility. 3 From this amount,$67,104 is related directly to increasing accessibility. 4$22,460 is related directly to increasing accessibility. 5 From this amount,$10,345 is related directly to increasing accessibility. 6$20,000 is directly related to increasing accessibility. $20,000 is directly related to increasing accessibility. 8$6,165 is related directly to increasing accessibility. i Total: $752,484 Amount related directly to remoyLng.barriers to accessibility: $399,243 Amount above related to Life Safety: $328,928 Amount unrelated to accessibility or life safety_ $24,313 KAPLAN CORPORATION, Contractors and Builders 116 Harvard Street Brookline, Massachusetts 02446 617-232-3300 Fax 617-232-4279 August 15,2006 Renovations of the North Parish Church of North Andover,MA Cost Estimates for MAAB Variance Application V#1 Sanctuary Level Raised Pulpit Vertical Lift: $45,000 Scope of work: Demolish wooden baluster at one side. Install vertical wheelchair lift from platform level to a new platform located at upper level,built as a bridge over the existing stairs on one side. Provide wooden painted enclosure. V#2 Sanctuary Balcony Level 3-Stop Elevator: $250,000 Scope of work: Demolish existing elevator. Install new shaft from parish hall floor with pit to the ceiling at the balcony, enclosed in painted drywall,with vent to the exterior sidewall. Install elevator machine room at Parish Hall former stage level. Install new partitions and elevator access doors. Relocate existing historic organ console(if feasible)as required for elevator shaft. V#3 Religious Education Wing Vertical Lift:$120,000 Scope of work: Demolish existing classrooms. Install 3-stop wheelchair lift. V#4 Religious Education Wing Door&Hardware Replacement: $12,000 Scope of work: Re-frame door openings and replace six classrooms doors with 36"wide solid core wood doors,lever hardware. Door similar to door#105. Repair GWB and door frames,add new low profile floor threshold. V#5 Religious Education Wing MAAB Complying Stairs: $200,000 Scope of work: Demolish existing stairs. Reframe new for 7 riser, 11"treads, install rubber treads,fir 1 3/8"handrails both sides, extending 12"beyond top riser,23"beyond bottom riser. Requires addition at side of RE Wing to accomplish clearances. V#6 Parish Hall/Sanctuary Vertical Lift: $120,000 Scope of work: Demolish existing elevator, install new two-level vertical wheelchair lift in new rated shaft V#7 Parish Hall Kitchen: $30,000 Scope of work: Reframe and install new entrance door,demolish existing cabinets and counters as required, install pantry storage cabinet, install new refrigerator, install new accessible cooktop,sink and countertop. Exhibit D 08/16/2006 11:24 9786888476 HEALTH HAUL b4�b5 II' t 0 r dh•R Teo►P?,.(pJ 3l1RDING 0EPARTMEIT Community Development Division .August 11, 2006 Commonwealth of Massachusetts,Department of public Safety Architectural/access Board One Ashburton Place Room 1310 B09tvtt,MA 02108-1618 RE: Application for Variances c,-Noxth Parish Unitarian Universalist Church Dear Board Members: As the Inspector of Buildings in the Town ofNocth Atadover, I have reviewed building application for the above-referenced.applicant and have determined that ththe estimated construction costs trigger review by the Architectural Access Board(AAB). The assessed value Of the building is$693,000 and the'Town's A messment Ratio is 95%, thereby Yielding a value of$729,491, as described in 521 CMR 5. Fue a as determined by 521 C,M 3, if more than $21 9,848.20 is expended(30%of the lding value) within a three-year period, in this case on remodeling and repairs, the AAB relations am implicated. Although all but $24,313 of the applicant's costs are derived from Life Safety and Accessibility improvements, the regulations triggered, are nonetheless The subject propefty is a house of warship and is notably one of the more 1herished historic s7tructu"in Town. 1t is listed in the National Register of.T�istoric 'laces and is located in the Old Canter i�iistoric District_ The property is also subject to a TESto•ric Preservation restriction. This project is also being hrnded entirely with subject funds. The applicant is spending$399,243 on improving accessibility and$328,928 on ife safety Mork. Thesegrri;Hcatat expenses have already caused the appli.earat to `xterxsivgly rMdlicc the sCopc of its project 'The proposal, Yn c>t11er%()Jos, 'rs lore rvinQ -be htsFc;rG intc;,rity Of Ile 0ructLre, while i:rrprc'ying public solely and accessibility. pie1. ;Yf2 , J 'x,`1or•'h,.iadayar, �tts�nc�'t)Srats `if 9-l5 "•�1 •d'•VW.1n7111gfFl�l'ibti/}tS�yaC Y.j{� AUCs-16-2006 11:17AM From: 9786888476 ID: Paee:004 R=97% 08/16/2006 11:24 9786888476 HEALTH PAGE 05/05 r - $ .3c7NTyq..q 7 4rrp �s SAG HIJ 3U1LD11110 IMPARTMENT CtIMMUnity Development Division In order fbr the property to fully comply with AAB regulations, significantly more money would need to be expended and parts of the bWding would most likely need to be removed Or at least significantly altered, which would violate the I iistoric Preservation restriction. For these reasons, I suppon the project as proposed with as requested variances, as fisted on the applicant's Application for Variance. Sir-ftely, Gerald A Brown Inspector of Buildings cc: Mark Caggiano, Selectman Linda Tremblay,Mstoticak Commissioq 1010 ]Page 2 of 2 100+ 3%gonditreetn+76,hr-,inyf;r,*Mdrhosalts 31F45 Phnur, a7E.FR$4511 Fax 978.698,1517 ';��h +rww.Pnw�+>fnnrthandnyor.r:nm RUG-16-2006 11:17RM From: 9786888476 ID: Paae:OO5 R=97% Exhibit E i Photograph Table of Contents Page 1 ` 1 A: Showing the"South Elevation". This is the side entrance and is accessible. No changes are proposed. 113: Showing the raised platform and the Pulpit. The raised platform will be made accessible. It is used by the Choir. 2A: Showing the raised stage (on the left). See 2B. 213: Showing the raised stage. The raised stage will be removed, thereby making this area accessible. 3A: Showing the existing elevator(yellow door)from the Parish hall. 313: Showing the existing nursery area from the Parish hall. The doors will be removed and archways built to allow accessibility. 4A: Showing the existing kitchen area. A variance is requested to allow the applicant to leave the existing kitchen as-is for the time being. 413: Showing the existing kitchen. 5A: Showing the Parish hall. 513: Showing the hallway leading to the Religious Education area(hereinafter"RE area"). 6A: Showing the same hallway as 5B,but further along. 6B: Showing the entrance to the existing restrooms. One of the existing restrooms has been modified to assist with accessibility,but it is not currently to code. 7A: Showing one of the existing restrooms(not accessible). Under the proposal, all bathrooms will become accessible. 7B: Showing the other existing restroom. 8A: Same. 8B: Same. 9A: Showing the existing hallway leading down to the RE area. Unfortunately,this area was built to match the outside grade before the AAB or ADA regulations were in place. A variance is being requested for this nonconformance. r Photograph Table of Contents Page 2 9B: Same,but looking up. 1OA: Showing the RE classrooms on the first floor(looking left from photograph 9B). 1OB: Showing a classroom. 11A: Same. 11B: Showing the outside entrance to the RE area. This will be made accessible under the proposal. 12A: Showing a classroom on the first floor of the RE area. 12B: Showing the staircase leading to the second floor of the RE area. 13A: Showing the entire staircase between the two floors of the RE area. A variance is requested to allow this staircase to remain as is for the time being. 13B: Showing the hallway (through the fire door)of the second floor of the RE area. 14A: Showing classrooms on the second floor of the RE area. A variance is requested for the doorways on this second floor of the RE area. 14B: Same. 15A: Showing the hallway of the second floor of the RE area. 15B: Showing a classroom on the second floor of the RE area. 16A: Showing the outside doorway that will become accessible under the proposed project. 1613: Showing the existing front entranceway. The door and exterior grades will be raised, pursuant to the proposal, thereby making the entranceway accessible. 17A: Showing the entrance doors from the entranceway to the sanctuary. This door will be removed and the entrance to the sanctuary made accessible. 1713: Showing doorways located in the entranceway. All doorways, except for the second floor of the RE area,will be made accessible. 18A: Showing a sign on the door leading to the balcony. Photograph Table of Contents Page 3 1813: Showing doors located in the entranceway. 19A: Showing the stairway to the balcony. 1913: Showing the balcony and a portion of the organ. 20A: Same. 2013: Showing the pulpit through the sanctuary(and over the pews). Several pews will be made accessible under the proposed project. 21A: Showing the balcony through the sanctuary. 21B: Showing the existing assistive listening system. 22A: Same. 22B: Showing the raised platform that will become accessible. 23A: Showing the historic Pulpit. i4i � �^• IN 11111/11 /1111 � '� � +�J ' 4 •, - - +fid ,;' 3 ;t T .t� r .�!:{L, - :1 cS . • r -3 �In �ii�l� .E;�'�. s 2�;• x�i} �i�' / � :■I � _ i x ,�,t � sib. "'�;i'�+ yF. Vy' islllt}3t1;��Z all 14 ol 11 '^A � s �t w pin i j; � §# } c tr s!I t 4vti . s . .ti 1 �. 3 � r i a i .. � .. '� - --•' ter`-rid"` �.. i x ! 1i+ Al et �4 aF is n w.' , ` uf s ni_ III Y I 3 ii s 3 a c �'`. asi...9 -k p• ^� i.w�pn` r�.1 ;r• [f it r..' S ¢� 6i _ � ;�•` a '✓ 4 tir _ t•� _ t a� 7•!'s A is + 4 E 1 z g- d .,:rasp>Ck {1 +.•.Ad'k,r Y-• $t�'�..;:. f 3 9 i� tea•'.'1. i Vh � • �i 1 r - w -x I� ��k`y�6i - u r .• oar a • I zmw I ss_ 3 �t s t h � - r t 1 w aY",:., YicSY'P �^ x�• M1p ��""' ,t{j '+o A III i .Y x �d x ° " �•. _�... -. _ -,} Sys".-u '�r,�•y�.�'4 � - i yw {, G. A �Y o. .� •crrti f, � � t $ r i I � 1 4 1 - B i � I 8 ggw bM � 10 • f � r s ` U. -•� .._ r x r ,r fi. H. � ca i _r f) 1' s u w r II� �. �.. a aim� �t�:I_ • q � r 1 Y Lh + , N I a x i I k 4 � 7 y � I O • �i J , i 2G ' w i�*ry �•� er 771 1 j r M 0 y t ♦5 ..99„ i VLly 41 spa.; bd �I ' I T- e • � a ci s f � W sem' s . � � N f 15 ; r > oa M i I a i ,�,o� ;; �� � l): a�•t Irl '�: Fifa i 5 } ) tit 1 �l A.' F.F.P ' [ills DOOR '��'� 00 r t WHEN BALCONY 1%KOT IN USF! �.. �t�lry 6T IT f 1 15 1 i t I V � t, n ,.. -- -- - �rmsnuurr_anlpttgli�T—•, ' �r, , 1 11 4 N' r IAMW i rMil IOU t.tl1ltlBtllll��� ////���_��, � { .+...•� �'j L... � 1. � \ ��_ _ ' { � �"�_"'�,.rf- a , `' ' l� •` � it I i(III I I .. s r Ilk B SR-50 • 5 �� f 21 M LL 1! MINE] ,. f� � ►+ail�. \�,\ 1- �, ter• pp : e ' i I r 23 -AOR i�t t � ffi �S3AC)Iust� 8UILDINls DEPARTMENT Community Development Division August 11, 2006 Commonwealth of Massachusetts, Department of Public Safety Architectural Access Board One Ashburton Place Room 1310 Boston, MA 02108-1618 RE: Application for Variances North Parish Unitarian Universalist Church Dear Board Members: As the Inspector of Buildings in the Town of North Andover, I have reviewed the building application for the above-referenced applicant and have determined that the estimated construction costs trigger review by the Architectural Access Board (AAB). The assessed value of the building is $693,000 and the Town's Assessment Ratio is 95%, thereby yielding a value of$729,494, as described in 521 CMR 5. Furthermore, as determined by 521 CMR 3, if more than $218,348.20 is expended (30% of the building value)within a three-year period, in this case on remodeling and repairs, the AAB regulations are implicated. Although all but $24,313 of the applicant's costs are derived from Life Safety and Accessibility improvements, the regulations are nonetheless triggered. The subject property is a house of worship and is notably one of the more cherished historic structures in Town. It is listed in the National Register of Historic Places and is located in the Old Center Historic District. The property is also subject to a Historic Preservation restriction. This project is also being funded entirely with public finds. The applicant is spending $399.,243 on improving accessibility and $328,928 on life satety work. 'These significant expenses have already caused the applicant to 'Atensively reduce the scope of its project. The proposal, in other words, is preserving .he historic intc,f,rity of the structure, while improving public safety and accessibility. =:?ge 1 of 2 11345 r"i+ine ')i8.��i8.U5�1 r,x 97R.�,83.1!;12 °d>,i� ,v.vsa.t�ax,�ofoor#ltm�iov�r.crim , 9 O , T�^o'3LSM`'� RDan T �.O rAq�L�4T luy tv¢``yt,t� ��AC P1u�41 HILDING DEPARTMENT Community Development Division In order for the property to fully comply with kAB regulations, significantly more money would need to be expended and parts of the building would most likely need to be removed or at least significantly altered, which would violate the Historic Preservation restriction. For these reasons, I support the project as proposed with all requested variances, as listed on the applicant's Application for Variance. Sincerely, Gerald A. Brown Inspector of Buildings cc: Mark Caggiano, Selectman Linda Tremblay, Historica Commission7 lRo,,d M9& Page 2 of 2 11 !!)00 OGood Stu�,O,Worth 01845 ilhone 978.W9541 Fax 978.688.9542 'dleb til�vavtas�tiiofilaifhandnvor.cont TRANSMISSION VERIFICATION REPORT TIME 08/1612006 11:25 NAME HEALTH FAX 9786888476 TEL 9766888476 SER.# 000B4J120960 DATE DIME 08116 11:24 FAX NO./NAME 89783275219 PAGES}N 0:00:44 RESULT OK MODE STANDARD D C C-� TRANSMISSION VERIFICATION REPORT TIME : 08/11/2006 15:47 NAME : HEALTH FAX : 9786888476 TEL : 97868$8475 SER.# : 000W120960 DATE,TIME 08111 15:47 FAX NO./NAME 89783275219 DURATION 00:00:46 PAGE(S) 85 RESULT OK MODE STANDARD ECM M2 iii 4ti�e e�'�' i PM s�+c ZONING BOARD OF APPEALS Community Development Division FAX TRANSMSSIO Y Location No. S Date 2 f NORTH TOWN OF NORTH ANDOVER f 1 9 • i • ; Certificate of Occupancy $ ;�S�cwuSEt� Building/Frame Permit Fee $ 1 - ' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 7 V ', Building Inspector Of tkORT11 7ti p 9 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 9SSACRU`�E4 Permit NO: Date Received: Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION - /A S- AD r 1-1 Print PROPERTY OWNER /VU /Z 1'/-f ill-1 0 /X H/ Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential C New Building ❑ One family ❑ Addition ❑ Two or more family 11 Industrial ❑ Alteration No. of units: C Repair, replacement D Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) L Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED Id entific ation Please Type or Print Clearly) i/ OWNER: Name: Phone: `171r-/e0` 9°t V Address: Kd A C-OL *,"I% CONTRACTOR Name: f—,MU 1 c A10 1�` /�L /= Phone: Address: 7 3 L'SSC V- 5-7-- S' G1 G 4'1 1"1 A-C 1- Supervisor's Construction License: A -e �r `� 0 _Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:510.00 PER$1000.00 OF THE TOTAL ESTIMATED COSTBASED ON$125.00 PER S.F. ITotal Project Cost :S a00 x10.00=FEE:$ �� Check No.: Receipt No.: 4 Page Ior4 �,/+ TYPE OF SEWARGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art (J Swimming Pools El Well Tobacco Sales ❑ Food Packaging/Sales ❑ Permanent Dempster on Site F1Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors tlo not have access to the guaranty firnd V^ Signature of Agent/Owner n Signature of Contrac Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ S lat ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS T a D�AjE'REJECTED DATE APPROVED HEALTH ❑ �❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection signature&date Temp Dempster on site yes_no_ Fire Department signature/date Building Permit Approved and Issued by: 9J1_I jeln - Page 2 of 4 Building Setback (ft.) Front Yard Side Yard Rear Yard jRequired Provided Required Provides Required Provided DIMENSION Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use) Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan,2006 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work E I Addition Or Decks I, ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) i ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ -Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report I In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL.SERVICES DEPARTMEN"r:nPF0RN*105 1 • I rt-e 4 44 r i menders, torrey&spencer, inc. architecture a preservation 123 North Washington Street,Boston, MA 02114 617.227.1477 (tel) 617.227,2654 (fax) www . mendersarchi tects cam May 2,2006 Mr.Gerald.A. Brown Inspector of Buildings Town of North Andover Building Department 400 Osgood Street North Andover, MA 01845 Dear Mr. Brown: Thank you for contacting our office this morning regarding the exterior repair work permit at the North Parish Church.We are submitting this letter.describing the work and qualifying components we believe fall tinder the provisions of 521 CMR Chapter 3,Jurisdiction. We understand that the total value of the project receiving a building permit is greater than thirty percent of the currently assessed value of the building, but would suggest that the value of work for which 521 CMR 3.3 applies is no greater than 14%or perhaps 31%of this building value.Therefore,the building should not be required to. fully comply with the MAAB regulations for accessibility due to this work. Restoration:Project The total contracted cost of this painting and repair project is$358,700,including General Conditions. Ordinary Repairs We would submit that the scope of work at North Parish Church is largely"ordinary repair"of the existing exterior envelope where"ordinary repair"is defined in 780 CMR Chapter Two as"any maintenance which does not affect the structure,egress, fire protection systems,fire ratings,energy conservation provisions,plumbing, sanitary,gas,electrical or other utilities". This repair work is identified on the bid form as Wood Repair,Architectural Woodwork, Painting, Smaltz—repainting the clock face and Gilding—for the weather vane.This work amounts to$212,700 of the bid price. Exempted Work per 52:1 CMR Additional work that we believe falls under the definition of"ordinary repairs"under 780 CMR,but is specifically identified as exempted work under 521 CMR 3.3.1 c., includes the Masonry(repointing),Thermal and Moisture Protection(flashing), and Menders,Torrey&Spencer Inc. 11HPNOV2620041SNAREDDOCSIProjects 200510431.00 North Andover,North Parish ChurchWO CA-Preservetionlarch\code16.2.06 bi MMB latterdoc Door and Window Repair--part of the paint project.This work totals$74,500 of the bid price. Structural Repairs Finally,the structural repairs,which are not exempt,total $19,500 of the.bid price. Work Value vs.Building Value The current year assessed value of the North Parish Church Building is$693,000 as listed on the Town Assessor's:Public Access.The combined total of the 521.CMR exempted work and the structural repairs is$94,000(approximately 14%,rounded up)of the assessed value.,Further,we leave it to your interpretation,but would request.that the structural repairs of$19,500(approximately 3%,_rounded up)be the sole work value considered in 521 CMR jurisdictional evaluations since that is the only work not classifiable as"ordinary repairs." Thank you again for your attention to this project and working with the North Parish Church on its restoration. Sincerely, David W.Torrey, AIA Principal Menders,Torrey.&Spencer, Inc. II I Lvt.tu i ai Lau i.uuttal P7mcxl ul I2AJC1 Y41iV11 DOCUMENT 00410 BID FORM.' 1. Submit bids in compliance.with Document 00200-Instructions to Bidders. Fill in blanks. The Owner reserves the right to reject incomplete bid forms. 2. This Bidding document is not part of the Contract Documents,unless specifically referenced in.the Owner/Contractor Agreement. Project Name: /u 4'-_I N:, t'^r•51 c Project Owner: Name of Bidder: A i l t 1- �- 3.- Base Bid: The Bidder proposes to perform all of the Work required by the Contract .-Documents for the amount of (Fill in amount in words and numbers for each:CSI category below. List the total amount on the total line.) General Conditions Section 04000 Masonry Section 06000 Wood&Plastic 7 Rough Carpentry rt. ° c , c', 1�. �z . :� ,*.,T.;, 1 �•c. 'y W :>.. i Woad Repair _�i -L '�, r:,c.� r_; >��.�'a r. :..;�;.• � . Architectural Woodwork Section 07000 Thermal&Moisture ', ` )t r"s : •- j Section 08000 Doors&Windows Section 09000 Finishes �1f.L ':`, .., T'' J �,sY L 4 ♦ j•'' ., ~i��`....s.... -c.,meg-� NSM_I ` Total of Above 00410-1 BID FORM 00410- 1 North Andover Board of Assessors Public Access http://csc-ma.us/NandoverPubAcc/jsp/Home jsp?Page=3&Linkld=806971 dF,t,...„pry ` �� ""v�cC► : .._. R � F n � C ; ' Property Hwu Return to the Home page click on logo Record Card Parcel ID:210/096.0-0072-0000.0 Community: North Andover : Pr SKETCH PHOTO V, S eaClick on Sketch to Enlarge , u rea Summary Residence A.901able Detached Structure Condo Cornmerciai Comparable Sales Location: ACADEMY ROAD Owner Name: NORTH PARISH CHURCH OF NORTH ANDOVER Owner Address: ACADEMY ROAD City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 7-7 Land Area:0.52 acres Use Code:906-CHURCH-PROP Total Finished Area: 11652 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 890,200 791,200 Building Value: 693,000 608,800 Land Value: 197,200 182,400 Market Land Value: 197,200 Chapter Land Value: LATEST SALE Sale Price:0 Sale Date: 12/31/0999 Arms Length Sale Code: N-NO-OTHER Grantor: Cert Doc: Book: Page: 1 of 1 5/2/2006 9:45 AM 04/05/2006 16:49 976-741-7605 THE BURKE INS AGENCY PAGE 32 a2"R . CERTIFICATE OF LIABILITY INSURANCE DATE(MNJDDNyyf1 PRebucit THIS CeRTIFICATC IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE THE SLTRXIII INSURANCE AQUOY HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 18 zrov ft Street ALTER THE COVERAGE AFFORDED 6Y THE POLICIES 9ELOW. Salem M 01970 Phone: 978-741-7910 Paz:978-741-7805 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA; R, T. BAILEY ILIBURMUZ AGIRMY INSURER B. Ambe"A PmtauUvn inmuoanaw A331'e33 is n a It 9 Towels Co. INSURE(C: Aalbiow infaenatiovi Gtr Bs.J.= Hi<i 0� INsuRaa nrsURER E: GOVERACES THE POLIC1E80P INSURANCE LIETjQ 116LOWHAVE BEEN 164UEC TOTWE INSUREC NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY R6CUIRFIENT.TERM OR CONDITION OF ANY CONTRACT OR 4TH6R OOC WNT NTH F'E$PECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY CERTAIN,THE INSURANCE AFFORDED BY TME POLICES DESCRMED HEREIN 13 SUBJECT TO ALL THE TERNS,EXCLUSIONS.AND CONDITIONS CP$UCH PoLICu,AGGREGATE LIMR9 94OWN MAY HAVE BEEN Rrs>rBo BY PAIo CLAIN4t LTRIN3RO Tft 9f INSURANCE POLICY NUMBER M &' LINTS 1 GENERAL LSA MM I EACH OCCURRENCE S 1 0 0 0,0 00 A XI CO'0MERCIALGENERALLIABILITY NPP889569 05/20/05 i 05/20/06 r Mr9B5(EoxaurnnWi. s300'000 CLA*$MADE I OCCUR MED O(P(Any cne porion) t PERSONAL&ADV INJURY I31'000'000 L OENENAL AGGREt�t 1,000,0 00 ORRI-XIO EGATE LIMIT APPUSS PER' PROOUCTB•COMP/GP A0(#!t 1,000 r 0 00 POLICY PR LOC I + I AUTOMOBILE I.IAsury COMBINED$INGLE LIMIT iX ANY AUTO SEa acodslq t ALL"ED AUTOS I BODILY INJURY a260000 B i X scHEDaLBDAu*os , 31051400002 12/16/05 12/16/06 �F''"P0f°°') _ VIREO AUTO$ �^ BODILY INJURY Is 500000 8 7( NON-OV^IFO AUTOS lP�aaeWorrtl PRpwOFtm"R)D�ayuGE x250000 GARAGE LABILITY I AUTO ONLY.6A ACCIDENT I ANY AUTO I EA ACC t � TH R THAN ONLY! AGO I EEFES91 IMARE1.1 4 LIABILITY EACH OCCURRENCE S -,- 71 OCCUR CLAIMS MADe I AGGREGATE t f `.,.,,..�._ t 1 ORDUGTIBLE � 1 I RETENTtCN s t WORKERS COMPENSATION AND EMPLOYERS!'LIABILITY C I I t 5 0,000 ANY PROPRITORIPATNEF1WC108-86-77 04/07/05 04/07/06 E.L. AHAGDENT OFIM ��07 6,L.DISGAR-&AOMPLOYEE a 500 000 a pn,d@Wba undo $PECIAL PWASIONSbrotow EL.DISEASE-POLICY LIMIT 5500,000 OTNE I + D69CRIPTIONOFOPERATIONS!LOCATION'SIVIFtCLESIEXC S "CEO BYENDORSEMENT161101..1.PROVISIONS North Church - Portsmouth, NH Per proyoet Aggregate applies to General Liability Policy, Xilestone Engineering 9 Construction, Inc. and North Churob are named as an Additional Insured. A 30 day written notice oC cancellation applies. CERTIFICATE HGLD6R CANCELLA71ON MIIIESTO OHOtnD ANV OP TNS ABOVE DWOM01E11 POW011M 9E CANCtLLBB SEFORN 7N!9ZP1f%TWI MILESTCM ENGINEZRING & DATE THEREOF,7W MOVING INSURER MLL WEAVOR 10 MAIL 30 OAYAC WRITTEN WKSMC7TION, rXC. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO 80 SHALL Frank en ay Road 6 Louden Edad INFO21 NO 011160A71011 09 LIABILITY OF ANY KIND UPON THE INSURER,ITB A ENto OR Concord NN REPRESENTATIVIK 6(OR2E0 REPREBINTA S1JP3G^y 9CIRANC.� ACORD 28(2001108) 0ACO D RPORATION 1M ;/64 9-` 04/24/2006 13:19 FAX 6172272654 MTS ARCHITECTS 10002 OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER CO TRUC ION CONTROL PROJECT NUMBER, PROJOCT'TITLE: '? i Y 11Qi, PROJECT LOCATION: a� NAME OF BUILDING: NATURE OF PROJECT: -7. �rt� '*'�' , ACCORDANCE W�rrHH RtIICLE 116 OF THE MASSACHUS1=M STATE BUIL REGISTRATION NO. BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNIN�3: ENTIRE PROJECTARCHITECTURAL 0 ;TRUCTURAL 0 MECHANICAL Lif n FIRE PROTECTION LI . ELECTRICAL D OTHER(SPECIFY) � FY) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE 8E'3T OF MY KNOWLEGE,SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING,VATICKS. ANIS APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALT_PERFORM THE NECESIRARY PROrESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC WIS TO DETERMINE THAT THE WORK IS PROCEEED)ING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 118.0 1. Review,for confurrnanoe to the design concept,shop drawings,samples and other submittals which Ore submitted by the Cwdractor in woordance v4th the requirements of the construction documentiL 2. Review and approval of the quality control Praaadum!i for all code-required controlled materials. 3. Be present at intervals appropriate to the stege of con stnMon to became,generally familiar vMh8the progress and quality of the wont and to deterrAne,in general, if the work is being perfa in a refiner owsiS6ent with the ounshtQlon d=merb. -AIli PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT +v�i�,iminr TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSP R. eeppo� , .�1bt+►.ik,•� UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND R F THE PROJECT FOR OCCUPANCY. rti0 SUBSCRIBED AND SWORN TO BF. f DAY OF LL NOTARY IC .: �.. COMMISSION EXPIRES—LL- j ti i TOWN OF NORTH ANDOVER MASSACHUSETTS OLD CENTER HISTORIC DISTRICT COMMISSION VIA FACSIMILE 978 6889542 RF: North Parish Church exterior restoration Building Inspection Town of North Andover North Andover, MA 01 845 TO WHOM IT MIGHT CONCERN: Please be advised that the exterior restoration of the North Parish Church does not need approval of the Historical Commission. Section 6 B 1 exempts ordinary maintenance and repair from the bylaws. It therefore does not need approval from the Olde Center Historical District Commission. Any questions please call me at 978 685 5000. Sincerely, II �� George H_ Schruender, Jr. Chairman NA Olde Center Hist District Commission i i i I BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR I } , Number: CS 058340 t r Birthdate: 03/12/1965 k Expires: 03/12/2008 Tr.no: 19748 Restricted: 00 STEVEN L BRAY 470 WINTHROP ST e, WINTHROP, MA 02152 Commissioner NORTH I It T . .."�O" Of Andover 0 lv Aar, No. i ?.3 VL over, Mass.9—SNO o LA COCHICHEWICK RATED A"O� C) WARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT...I. .......... ' w. -A.. . ................ ........ ................................................................................ BUILDING INSPECTOR ""0% Foundation has permission to erect........................................ buildings on...... ..OA*o ..... ...... Rough to be occupied as........ ... ..... .�� Chimney J""'a ....... rlii� every respect conform to the Final provided that the person accep ing is pe7iii it'ng ...... It! terms application on file this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTI STARTS Rough Service BUILDING Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. .Date.. .. ../wh.. .. . .... Of N0R TM 1H o� TOWN OF NORTH ANDOVER ~ . F • PERMIT FOR GAS INSTALLATION �ISSACMUSE� �, &This certifies that . . . . . . . . . . . . . . . C . has permission for gas installationl�t -. . . . . . . . . . . in the buildings of ..�,.:- . . . . . . . . . . . . . . . . . . . . . . . . at�. . .�C-:. . . . . . . .: Jl Z./�. . . . . . .. North Andover, Mass. Fee :�� Lic. No'A—M�! . . . . . . . . . . . . . . . . . . . . . .. . . . GAS INSPECTOR Check# // 5041 MASSACHUSETTS UNIFORM APPLICATION OR PERMIT TO DO GASFITTING (Print or Type) s7 AA—l6ila-- . Mass. Date 1- `� 19o266s' Permit # 6 Building Location—1 /TGr amt Owner's Name �, T// Type of Occupancy Clo/Cil New ❑ Renovation ❑ ��eplacernent.o Plans Submitted: Yes❑ No ❑ N N W N Y Z (c V! N H V C F S y Q N Q 0 y r S W J H W 0 V m F T ?I O G i— } Z a Q O u i <¢ C ZO O O i' W m N F y W 0 = _W 0 W W 2 N J Z < Q ¢ us 0 {� W Q V H 2 J 1� Z }. W .W 0 > 4 ! V J y. W Z < W < C N m Z O Z OW. O (A = < W > ¢ W < < < O O W Z O V 2 U. 3 n V -1 V C > p a /- O SUB—aSMT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4:14, 1 4TH FLOOR 5TH FLOOR 8TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name Boule's Gas Check one: Certificate Address _ 39 Oxford Avenue ❑ Corporation Haverhill, MA 01835 ❑ Partnership Business Telephone 978-372-6783 Form/Co. Name of Licensed Plumber or Gas Fitter Charles H. Boule' 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 Ye, please Indicate the type coverage by checking the appropriate box. 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 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 C1 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 f r this ap ica7�onmll in comp!' ea with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the al ws. �%/ BY TjGLaUmfit't*.63rof licnse: r Signature of licensed umber or fitter Title ter License Numbiar h 7 26_/ .T 3 5 5$-- City/Townl Journeyman Location No. r 7 GDate NORTH TOWN OF NORTH ANDOVER 40 9 Certificate of Occupancy $ ,SSAC MUSBuilding/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Z Check # 15S80 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING MUM- BUILDING PERMIT NUMBER: a a n DATE ISSUED: ic SIGNATURE: /vim Building Commissioner/Inspector of Buildings Date SECTION 1-SITE INFORMATION z 1.1 Property Address: 1.2 Assessors Map and Parcel Number: _P ►2 T H tPA2LSF( <a U/2 C DA Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Distrid Proposed Use Lot Area(so Frontage ft 1.6 BURDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re 'red Provided 4- 1.7 Water S 1.5. Flood Zone Information: 1.8 Sew Supply Private .40. 54) Zone Outside Flood Zone 0 Municipal 0 Sewerage Disposal System:On Site Disposal Public ❑ Private ❑ 4� poral System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.10w, er of Record - V2 T 4-e PA J CMa N 190 G Ar� Name(Print) Address for Service Signature Telephone t 2.2 Owner of Record: Name PrintAddress for Service: z Signature' Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ St,,g£LL Licensed Construction Supervisor: ��� 2 3 Z ® a License Number Address � QQ ` 2 - /y- 0y Ye( Q�Iz(BACOOLIZ D2. A)be_rly 1jxJ941a/t; Expiration Date Signature Telephone 3./2//Registered Home Improvement Contractor Not Applicable ❑ ® ^i 16alf-tc_ d)f.STGti ellml-1`3 . Company Name / 2 J Z 3 7 TT r� Registration Number e,� ti y�/ �ErCF/c�.tavo JJ2- /Ucs2rt-r �i�o�� � Addressf L / - /0 - 62 � Expiration Date nature Telephone �� --- Jl BOARD OF BUILDING REGULATIONS F License: CONSTRUCTION SUPERVISOR Number: CS 068232 I � Birthdate;.02/14/1962 Expires:02/14/2004 Tr.no: 17808 Restricted: `00 STEPHEN D HOWELL 15 MT VERNON RD BOXFORD, MA 01921 Administrator ' ✓die {Jar�vnwau�s o�.�a�aac�ivaeC��, Board of Building Regulations and Standards Ii HOME IMPROVEMENT CONTRACTOR Registration: 123237 Expiration: 01110/2003 Type: DBA HOWELL DESIGN&BUILD "TEPHEN HOWELL 44 BEECHWGCD DRIVE , �a! 1v.ANDOVER,Iv1A 01845 Administrator - I I i a I Date:6/10/02 04.02 PM Sender's Fax ID:9789880038 Page 2 of 2 AeoRD CERTIFICATE QF LIABILITY INSURANCE OP ID CL DATE(MMIDDJYY) PRODUCER ROWEL-1 06/10/02 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brenton Tyler/Ralph Rubin Ins. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The McCarthy Companies HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P.O.Box 540169 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Waltham MA 02454-0169 Phone: 781-893-4808 Fax: 781-893-6679 INSURERS AFFORDING COVERAGE INSURED INSURER A'. Hartford Insurance INSURER.8: MI SC.INS.Co- Howell Desiqn & Build,Inc INSURER C: Safety Insurance Company 44 Beechwood Dr. North Andover MA 01845 INSURER D. Atlantic Charter IN^uI�RER E'. - COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERMOR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE MMIDDIYY) DATE MMIDDIYY LIMITS GENERAL LIABILITY EACH OCCLRRENCE $ 1,000,000 A % CCMMERCIALGENERAL LABILITY OBSBAGH6835 06/01/02 06/01/03 FIRE DAMAGE(Any one flre) $ 300,000 CI AIMS MMF �()CCI IR MFD FXP(Anynne parson) $ 10,000 PERSONAL 3 ADV INJURY $ 1,000,000 GLNL-RALAUGHtGAIE s 2,000,000 GEN'L AGGREGATE UMR APPLIES PER' JECT POLICY PRC_ PRODUCTS-COMP/OP AGG $2,000,000 LOC AUTOMOBILE LIABILITY C ANY AUTOCOMBINEO SINGLE UMIT 1500162 04/17/02 04/17/03 (Eaaccldent) $ ALL OWNED AUTOS $ SCHEDULED AUTOS BODILY INJURY $250000 S HIRLDAUIUS NON OWNED AUTOS BODILY INJURY $500000 (Per accident) PROPERTYDAMAGE $2S000O (Pcr accident) GARAGE LIABILITY ANV ALITO AUTO ONLY-EAACCIDENT $ OTHER THAN FAACC $ AUTO ONLY. AGG $ EXCESS LIABILITY B OCCUR ❑CLAIMS MAGE QUOT EACH UCLLRRENCE $ 1,000,000 07/10/01 07/10/02 AGGREGATE $ 1,000.000 � DECUCTIBLE $ RETENTION $ !! WORKERS COMPENSATION AND WCSIAIIY UTH- D EMPLOYERS'LIASILITY TORY LIMITS $ ER WCA0012701 06/01/02 06/01/03 E.L.EACH ACCIDENT $ 100000 E.L.DISLASE-LA EMPLOYtt $ 100000 OTHER E.L.DISEASE-POLICYLIMfI $ 500000 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER N ADDITIONAL INSURED;INSURER LETTER: CANCELLATION EVIDE02 SHOULD ANY OF THE ABOVE DESCRIBEDPOLICIES BE CANCELLED BEFORE THE EXPIRATION ! DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Evidence of Coverage IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES, AUTHORMED RE SENTATIVE I NCORD 25-S(7197) ©ACORD CO ORATION 1988 0 OQc�7 P HOWELL DESIGN&BUILD,INC. 44 BEECHWOOD DR. N NORTH ANDOVER, MA 01845 978-989-9440 N HANDRAIL 4 3/4" X 1 1 /2" 0 BALUSTER 1X3 BASE 1X4 BASE d- N NORTH PARISH CHURCH NORTH ANDOVER, MA HANDRAIL DESIGN, NOT TO SCALE y,. „��,j�. LLff � _,�.,w.�.r.�++r rar... __,,,__._,,,,. A ��P �Jl�'f 1 `. � 3�. � � +' �� 4p ,. ' , .. r T Y-I WiL AV �i; NORTH T ED own of Andover 0 No. 0 IS1 L A dover, Mass., H BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..... ..................... ...... .......................................................... Foundation has permission to erect'_#.... ................ buildings on.... .......APoq-oo4.......;r...... Rough to be occupied as............. .. ...... ........ *A3 Chimney ..... .......... .... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 9& 143 4/ 40 07 to 000* PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTH$ Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Ad-M C-0 4 ft Rough . ..........a. ........ ......... o ................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Location /9v Ao_.Ai��If/ 9 t No. �`�/ Date j 0 NaTOWN OF NORTH ANDOVER Of . ���h Certificate of Occupancy $ Building/Frame Permit Fee $ '— 'sswcMustt Foundation Permit Fee $ Other Permit Fee $ A4Sewer Connection Fee $ �® ater Connection Fee $ -v TOeCak $ PI . `� x,, 10 O, �1 � � Building Inspector .�ov vy��C �R Div. Public Works PERafIT NO. I APPLICATION FOR PERMIT TO BUILD— NORTH ANDOVER, MASS. PAGE 1 i tMAP'KJO. LOT NO. 2 RECORD OF OWNERSHIP (DATE BOOK PAGE ZONE ^ I SUB DIV. LOT NO. I LOCATION /��j �I,A{��'�l�• Ri;` PURPOSE OF BUILDING OWNER'S NAME I r -4�Jj'�/� `I NO. OF STORIES ` V SIZE �,•/ Q Iy6Q�L-�l OWNER'S ADDRESS I o�d Jl ff n BASEMENT OR SLAB ARCHITECT'S NAME 1• 4w SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS 15 BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION ` IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE �./� � IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY Yt tG.l ' IS BUILDING CONNECTED TO TOWN SEWER sy lJ IS BUILDING CONNECTED TO NATURAL GAB LINE 3 PROPERTY INFORMATION INSTRUCTIONS LAND COST I SEE BOTH SIDES EST. BLDG. COST I 9 CQ PAGE 1 FILL OUT SECTIONS 1 3 EST. BLDG. COST PER 8Q. FT.L! PAGE 2 FILL OUT SECTIONS 1 12 EST. BLDG.COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS 7 PLANS MUST BE FIL.E�D1 ANDt APPROVED BY BUILDING INSPECTOR -7� DATE FILED i�y�-` L , �l ciI -! BOARD OF HEALTH -` SIG NA E OF O UTHO IZED AGENT FEE OWNER TEL.0.1-dr PLANNING BOARD PERMIT GRANTED CONTR.TEL. ..- CONTR.LIC.N 7 y 19 �— BOARD OF SELECTMEN BUILDING INSPECTOR BUILDING RECORD I OCCUPANCY 12 SINGLE FAMILY StORIEs THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY _ OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS I I RAGES, ETC. SUPERIMPOSED.THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE _ 3 l 7 I3 CONCRETE BL'K. PINE _ BRICK OR STONE HARDWD —_ •r^+^�`^""'"""�°"""` PIERS PLASTER _ DRY YJALL _ UNFIN. 3 BASEMENT il AREA FULL FIN, B M T' AREA 1( _ " I/r FIN. ATTIC AREA N_O B M FIRE PLACES _ HEAD ROOM _ MODERN KITCHEN _ —1%4 WALLS 9 FLOORS CLAPBOARDS .�B J 1 2 3 DROP SIDING CONCRETE —�— WOOD SHINGLES EARTH ASPHALT SIDING HARDlI✓'D ASBESTOS SIDING _ COMMON VERT. SIDING ASPH.TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS.& FLOOR _ BRICK ON FRAME CONC.OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIORI� POOR _ ADEQUATE NONE $ ROOF 10 PLUMBING GABLE HIP BATH 13 FIX.) _ GAMBREL MANSARD TOILET RM. 12 FIX.) _ FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING (l 11 HEATING WOOD JOIST PIPELESS FURNACE _ FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. _ HOT WT'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING- RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd INO HEATING A XAORTH own of6Andover O � L No. 30 � � � v 'A J1`46 � L�WAY ENTRY PERMIT- -74 �Y.��E er, Mass., 199/ �• � .� .4 SSA BOARD OF HEALTH I T T LU0 THIS CERTIFIES THAT........ .. . ..... . . .0�. ..... .. .. ........... BUILDING INSPECTOR has permission to erect ... ........�.. gs on ...... Rough pp Chimney to be occupied as................. ll. ....... .... .. .. .... ...................................... Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough Buildings in the Town of North Andover. , Final VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Rough UNLESS CONSTRU STAR Service Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises Do Not Remove Burner FIRE DEPT. No Lathing to Be Done Until Inspected and Approved by STREET o e oNO. Building Inspector SPECIFICATIONS FIRE ESCAPE NORTH PARISH CHURCH NORTH ANDOVER, MASS_ IT IS THE INTENT OF THESE SPECIFICATIONS TO PROVIDE A PROPER AND SATISFACTORY EMERGENCY EGRESS FROM THE CHURCH SANCTUARY. ALL ASPECTS OF THE WORK AND FINISHED FACILITY SHALL COMPLY WITH ALL APPLICABLE CODES AND REQUIREMENTS, SPECIFICALLY THE MASSACHUSETTS STATE BUILDING CODE SECTION 621 . 0, AS WELL AS ALL REQUIREMENTS OF THE NORTH ANDOVER BUILDING INSPECTOR AND NORTH ANDOVER FIRE CHIEF . JOB DESCRIPTION lst Revision Sept . 14, 1990 1 . CUT AN OPENING OF THE PROPER SIZE AND CONFIGURATION IN THE NORTH WALL OF allE SANCTUARY, * FT. * IN BEYOND THE MOST EASTERLY WINDOW. 2 . PROPERLY FRAME AND SUPPORT THE WALL STRUCTURE, BOTH DURING THE WORK AND AT COMPLETION OF THE JOB. THIS SUPPORT MAY INCLUDE BRIDGING, ADDITIONAL FRAMING, OR OTHER SUPPORTING METHODS WHICH WILL RETAIN THE STRUCTURAL INTEGRITY OF THE WALL, TO THE SATISFACTION OF THE NORTH ANDOVER BUILDING INSPECTOR AND THE OWNER. 3 THE DOOR FRAME SHALL ACCOMMODATE A 42 INCH WIDE EXIT DOOR WITH FRAMING, DOOR, AND DOOR HARDWARE AS APPROVED BY THE NORTH ANDOVER BUILDING INSPECTOR. 4 . THE CONTRACTOR SHALL SUBMIT COSTS FOR BOTH METAL AND WOOD FIRE ESCAPE STAIRS OF APPROVED TYPES , WITH SELECTION OF THE MATERIAL USED TO BE MADE BY THE OWNER, WITH THE APPROVAL OF THE NORTH ANDOVER BUILDING ISPECTOR. 5 . AN APPROVED ILLUMINATED "EXIT" SIGN SHALL BE INSTALLED ON THE INSIDE WALL OVER THE EXIT DOOR. 6 . APPROVED EMERGENCY LIGHTS, TO BE ILLUMINATED IN THE EVENT OF ELECTRICAL POWER FAILURE, SHALL BE INSTALLED ON BOTH THE INSIDE AND OUTSIDE WALLS , ADJACENT TO THE EXIT DOOR. LOCATION OF THESE LIGHTS SHALL BE AS SPECIFIED BY THE NORTH ANDOVER BUILDING INSPECTOR. 7. A CONVENTIONAL EXTERIOR LIGHT, CONTROLLED BY AN INTERIOR WALL SWITCH, SHALL BE INSTALLED ON THE OUTSIDE WALL, ADJACENT TO THE EXIT DOOR. 8 . AN APPROVED FIRE ALARM PULL STATION SHALL BE INSTALLED ON THE INSIDE WALL, WITHIN 6 FEET OF THE EXIT DOOR, ANE WIRED INTO THE EXISTING FIRE DETECTION SYSTEM. * TO BE DETERMINED 7 fter» tt * }t.rty� 1 `ratt'l l`li Page No. of pages ................_.Y...' . .._ ........ ._......... . ..... ......... __1111 ... 11.....11... ......... - AJC _ � _a'1�- .. .C'�t-�t1ZC�_ �VZC55 sC25)_1��>i ..... ......... _1111_ ._..._.. .... ......... ........ ......... .............. ..................._......... .................. _ 5'T("1 IL2S ... _. J .... 1111..... ......... ,-! `i....+c .�.! " �- ! c�_ �G ........ 2)_ V ')w f.......................... 1_tl� CL.S ........ '� `` I``- ......... _ _ ....nf) - C c ................... .......... 5 _ flc ........ ........ .............. . .. ....... . F) .......... �R- cs... . .... . ......... ___ ........ . ... .... ......... ...... ....... . . . _. _ 'D_ _ ........ ..... ........... ....... ....... . ........_ ........... Ct � TC,.........t.fZZ�T LC (u� S�....... S ..... 1 ......... ......... _ .. . ............ ........ . ....... ........... ............... .............. ...................................... ............. .. ..........................._._...... ........ ...O..._�lq.. - .. ....... _1111 ) z c vk...zcs� - 6 III ......... ... . ..... .. .... ........................................................................................ _... ......... _........... ... ...... ...... _.............. ........ .... ......... _ 11 11........ .. ........... ........ _.. ...... ... CESS�: .............. ........ ... .......... . ... .. ................ ...._.......... ...... ........ ..................................... _ ... ................. .. ....... ..................... .... ............. ........ ........ .................................._ .. ..... ........ ....... .......... ..... .... _ ............. .......... ........ STEVEN J. LANGLOIS THIS PAGE BECOMES PART OF AND IN CONFORMANCE WITH PROPOSAL NO. BUILDING & REMODELING Job Name Accepted by Date 19 R Submitted byQDS Dater7 � 19 Accepted by (INITIALS) Date 19 (INITIALS) (INITIALS) "`- ------- �-- -- _-PEWS Ua cAr avz) l i If b y �1 — rncxscc�:xss + 81RL4►Dtt62 S Rt?Vr�2 TU R-�Cs� �Lo I 5'-4c�sW �' .lt•�LS Gt-25�5 f sLX<, ICA�3 i l 5� -366--5Wa D. Location /90 No. X22 Date i J 51` { NOR7M TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ ` Building/Frame Permit Fee $ AcMuFoundation Permit Fee $ ss Other Permit Fee $ _ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ /at tUuL B 'Idi fGpector 1 10062111 Div. Public Works PI wmrr No. 32.2.,4 APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. I LOT NO. 12 RECORD OF OWNERSHIP DATE BOOK '.PAGE — ZONE SUB DIV. LOT NO. F LOCATION /go /'.�jy��y�� � `�` PURPOSE OF BUILDING C OWNER'S NAME 1 �`0�, h 1Lj,.�. Cly. - NO. OF STORIES ^7 SIZE U� OWNER'S ADDRESS L q 0 ,y�e/ykl- 1 + D BASEMENT OR SLAB Gw - ARCHITECT'S NAME 1^ {�•-/'i Il SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME 9- Ccv 1 c) u, ►1w 1 ')� SPAN --- DISTANCE TO NEAREST BUILDING I! /"��+ 'v DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES r REAR " " GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW t SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST i PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED l('01 �L• BUILDING INSP[CTOR SIGNATURE OF OR AUTHORIZED AGENT �(c V) I M FEE , 7 `r12C�S� OWNER TEL.# PERMIT GRANTED N OY2�12r CONTR.TEL.x r� 19 Ice — CONTR.LIC.# 0/ Z-6) Z -77 H.I.C.# �� D 1 BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY S"ORIEs ITHIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY _ OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS L RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION _ 8 INTERIOR FINISH CONCRETE CONCRETE BL K. PINE BRICK OR STONE HARDW D PIERS — PLASTER = ___ \/f 1� /Sln ice) �✓ ' r / � /\/J �I �<^,\►�'�JV DRY WALL UNFIN. $ BASEMENT AREA FULL FIN. B M'TAREA r�� /� �•A./�V� ` _ '/ 1/1 '/ FIN. ATTIC AREA / NO SMT FIRE PLACES HEAD ROOM _ MODERN KITCHEN 4 WAILS I 9 FLOORS CLAPBOARDS B t 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDV,/*D COMM ASBESTOS SIDING _ COMMCN O T VERT. SIDING ASPH. TILE v �� STUCCO ON MASONRY _ COFRAME BRICK BRI ON MAS NRY '.ATTIC STIRS. 8 FLOOR BRICK ON FRAME CONN. OR CINDER BILK. / ' ! � STONE ON MASONRY WIRING STONE ON FRAME ^ us SUPERIOR I� ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH (3 FIX.) GAMBQEL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET = C ' ASPHALT SHINGLES LAVATORY J WOOD SHINGES KITCHEN SINK SLATE PLUMBING ST TAR 8 GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES _ TILE FLOOR �7 TILE DADO � 1 6 FRAMING it HEATING \ WOOD 101ST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 3 COLS. STEAM STEEL BMS. &COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING r J v RADIANT H'T'G t UNIT HEATERS 7 NO. Of ROOMS GAS OI l /� B'M'T 2nd _ ELECTRIC Jr(�J} 1ft 13rd NO HEATING NORTM 0VM of . OL dover ONo.'522A i S� .� � �, t I199G �. 0 4- ^�- �<� rt dower, Mass., �JIra COCHICHEWICH 5 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..... Olrt ... RK # .... ! ....�1� ........... Foundation has permission to dW...... . ......... buildings on...i1°'....All�!K��, .... ..... �'�'.��..+............. Rough s �I.1� Chimney to be occupied as.'�t.'�' f.1. j....RO.42�o. .�...!lit!!t' '!c�. .....................A...............................I............I..........I...... y provided that the person accepting this permit shall in every resp t conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR ' Rough ........................................ ...................................................................... ZDUACO.. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove F Rounal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. 7 �' Smoke Det. - -_.._ _ - _._ .. .-_ -_ w:� - •': -ems`-.:r:G.�-.-- _ — _ _ .-a,Y'^t3...., t c '.'s `. - .. _ T OEFiCES OE: �� _~ r _own of �� .= — .120 Main Street APPs.us •�r:��y': NORTH ANDOVER -tvonr,�ndovez. BUILDING `� ;.� - Massdchtisetts O 18-15 CONSERVATION Dri1SION OF HE.-kLTH P"N.NING PLANNING & COMMUNITY DEVELOPMENT In a=--rdcnce with the Yrc-'sic_s ... %'—' c S S•:, a condicen of Building Nuriber 152-7 . 'Me d^ , s ;:qac -is resulting trcm this work shall be disposed of" in a prcne .,zz- ;� scud xasc _f�^ :ac.. ..-:..cd by NtG iC iI:. S i ne debris -rill be disposed of in: ��cicn Cf =aciiic ; �zenacu:Z( F Z- L NOT': Demolition permit from the To---a of North Andover must be obtained for this project through the Office of the Building Inspector. CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 460(12/12/06) Date: July 6, 2007 TEMPORARY CO THIS CERTIFIES THAT THE BUILDING LOCATED ON 190 Academy Road MAY BE OCCUPIED AS Interior Fit to Church IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: North Parish Church 190 Academy Road North Andover, MA 01845 Building Inspector Town of Andover ...... ----- moo. �fG o �. o . dover, Mass., /I/Z • I� COCHICHEWICK V� 7�S RATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....N. 460.r4.... .....� .t.,r.�� ..�. .. �' •��• Foundation has permission to erect........................................ buildings on.�. Q.. ... . 4 ou to be occupied as�peese�n� imn. e!Alg' � provided that the accepting this p/�mit shall in every respect conform to the terms of t e 4,19 at on on file in Fina# ��VA�?� �, 7 this office, and to the provisions of the Codes and By-Laws relating t%po Inspection, Alteration and Co ruction of Buildings in the Town of North Andover. �, A..* 1'600-0%r' �#'�� LUMBIN INP OR VIOLATION of the Zoningor Building Regulations Voids this Permit. °2. �� � 9 9 PERMIT EXPIRES IN 6 MONTHS cippy ��* ", * ELECTRICAL INSPECTOR �' (0 /v �� UNLESS CONSTRU TARTS Rough v r' -� 41/. ....... .......... ......................... BUILDING INSPECTOR Final d Occupancy Permit Required to Ocmpy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner `n ' Street No. � Uv SEE REVERSE SIDE__Jl Smoke Det. ( 3 1 d I KAPLAN CORPORATION, Contractors and Builders 116 Harvard Street Brookline, Massachusetts 02446 617-232-3300 Fax 617-232-4279 Date July 6, 2007 To Town of North Andover Division of Community Development&Services Building Department 1600 Osgood Street North Andover, MA 01845 Attn: Gerald A. Brown Reference: Building permit#460 issued 12/12/06 North Parish Church 190 Academy Road North Andover, MA Dear Mr. Brown, I am writing to request a Temporary Certificate of Occupancy for the North Parish Church located at 190 Academy Road in North Andover. We request a Temporary Certificate of Occupancy until such time within the next 12 months that the main entrance to the church is completed under separate contract by Belli Construction. Sincerely, Wright Dickinson Project Manager CC Pat Saitta Municipal Planning Clem Karl North Parish Building Committee Chairman i poR7y TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 400 Osgood Street North Andover,Massachusetts 01845 �ss4causts D.Robert Nicetta, Telephone(978)688-95454 Building Commissioner Fax (978)688-9542 CONTROL CONSTRUCTION— SECTION 116.0 M.S.B.C. CERTIFICATE OF ENG RI /ARCHITECTURE BULDING INSPECTOR . TOWN OF NORTH ANDOVER 'S ` 400 OSGOOD STREET NORTH ANDOVER MA 01845 a I, ,� cr� �✓, T � , ,. HEREBY CERTIFY THAT THE BUILDING CONSTRUCTED AT DOES CONFORM IN ALL RESPECTS TO THE MASSACHUSETTS STATE BUILDING ji CODE AND APPLICABLE FEDERAL REGULATIONS FOR THE FOLLOWING: IN ATT "EQN AF-PrP4ALA-T- AUTHORIZED SIGNATU VV �A -7 DATE: REGISTRATION: NOTE: ENGINEER"WET STAMP"MUST BE AFFIXED TO THIS FORM Control Constriction Form revised 11.15.2004 BOARD OF.APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 i menders, torrey & spencer, inc. architecture . preservation 123 North Washington Street,Boston, MA 02114 617.227.1477 (tel) 617.227.2654 (fax) www . mendersarchi tects conn ARCHITECT'S FINAL AFFIDAVIT DATE: July 6,2007 RE: North Parish Church 190 Academy Road North Andover,MA 01845 I certify that I, or my authorized representative have observed the work associated with locus at North Parish Church, 190 Academy Road on at least 26 occasions during construction,have had frequent communication with the Contractor, and that to the best of my knowledge, information and belief the work has been completed in conformance with the permit plans approved by the Town of North Andover, our field instructions and supplementary documents and with the provisions of the Massachusetts State Building Code and other pertinent laws and ordinances, except as noted below: 1. Sanctuary Level entrance doorway permanent access walkway is incomplete; a code—compliant temporary egress landing and stair is complete,however. The permanent entrance landing, steps and walkway cannot be completed until the completion of the Mass Highway Old Town Center project. Please contact A.R Belli for schedule. 2. Exterior streetlight fixtures cannot be completed until the completion of the Mass Highway Old Town Center project. Please contact A.R Belli for schedule. 3. Miscellaneous Architectural and Engineering incomplete Punchlist items. DWI '�Art1EF,�.IkrC7ifif David W, Torrey,AIA #6061 ,,,., 0). Registered Architect Mass Reg.No. moss- Menders, r.ss Menders, Torrey and Spencer, Inc. �t iN Of Company 123 N. Washington Street Boston,MA 02114 Address 617-227-1477 telephone Architect's Affidavit pagel of 1 0ORT14 TOWN OF NORTH ANDOVER a�Oot OFFICE OF BUILDING DEPARTMENT 400 Osgood Street North Andover,Massachusetts 01845 �SSAcxus�` D.Robert Nicetta, Telephone(978)688-95454 Building Commissioner Fax (978)688-9542 CONTROL CONSTRUCTION- SECTION 116.0 M. .B S .C. r CERTIFICATE OF ENGINEERING/ARCHITECTURE BULDING INSPECTOR TOWN OF NORTH ANDOVER 400 OSGOOD STREET NORTH ANDOVER MA 01845'' ' s`y ill' �l wart. R�'4.t'r::. I, ),G t-4 (�/G ''i {��' ,HEREBY CERTIFY THAT THE BUILDING CONSTRUCTED AT NdP-Tk /,9K1,ZC5- C4 /.y(0",4 ,0-Q, Al- Da 7,J j. DOES CONFORM IN ALL RESPECTS TO THE MASSACHUSETTS STATE BUILDING CODE AND APPLICABLE FEDERAL REGULATIONS FOR THE FOLLOWING; AUTHORIZED SIGNATURE: DATE: 6— Z —O 7 REGISTRATION: NOTE: ENGINEER"WET STAMP"MUST BE AFFIXED TO THIS FORM Control Construction Form revised 11.15.2004 BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Structures North O O ®®® 60 Washington St,Suite 401 Salem, Massachusetts 01970-3517 CONSULTING ENGINEERS, INC. P.O. Box 01971-8560 T978.745.6817 I F978.745.6067 www.structures-ncrth.com 2 July 2007 Menders Torrey and Spencer, Inc. 123 North Washington Street Boston, MA 02114 Attention: David Torrey Reference--- North Parish Church Renovations North Andover, MA Dear David: Based upon numerous periodic site visits that I or my representative have performed during the progress of the work, and from frequent communication with the contractor, I am satisfied that to the best of my knowledge, and with the exception of a limited area of second floor ceiling over which supplemental support work is still in progress and soon to be completed, the structural portion of the renovation work at the North Parish, has been completed in accordance with the requirements of the contract documents, our field instructions and sketches, and applicable requirements of the Massachusetts State Building Code. Please contact me if you have any questions. r 1Y Respectfully you F � y3a, Cuct�ures North Consulting Engineers, Inc. John M. Wathne, PE, President I I I Andover,MA Richard D.Kimball Company,Inc. P 978-475-0298 Boston,MA 200 Brickstone Square F 978-475-5768 ENGINEERS New Brunswick,NJ Andover,MA 0 1810-148 8 W www.rdkengineers.com ENGINEER'S PROJECT COMPLETION In accordance with Section 116.2.2 of the Massachusetts State Building Code 780 CMR,6`''Edition,I, Francis A.Kneeland being a registered professional engineer hereby certify that the Richard D. Kimball Company's employees, under my direct supervision, have been present on the construction site at intervals appropriate to the stage of construction to determine that, in general,the work has proceeded in a manner consistent with the documents approved for the building permit with the exception of those items identified on the attached Punch List dated : July 3, 2007 Project: North Parish Church Location: North Andover,Massachusetts Construction Documents: Drawings:E0.00,E0.01,E0.02,E2.00,E2.01,E7.00,E8.00,E9.00 Date on Plans and Specifications submitted for approval and issuance of the Building Permit: August 2,2006 Addendum(a)/Revision(s) Date(s): .-n 4 n4 OF Mgss .p FRANCIS~ i KNEELAND ignature cOi ELECTRICAL No.33M ELECTRICAL Discipline-Area of Responsibility ".: M.G.L.Chapter 112,231 CMR,250 CMR Professional Engineer(Original Seal) ::Z 13/0-7 Date L:Vobs\2006\26357-North Parish Church\Affidavits\Elec Project Comp Cert.doc i UM Andover,MA Richard D.Kimball Company,Inc. P 978-475-0298 Boston,MA 200 Brickstone Square F 978-475-5768 ENGINEERS New Brunswick,NJ Andover,MA 01810-1488 W www.rdkengineers.com ENGINEER'S PROJECT COMPLETION In accordance with Section 116.2.2 of the Massachusetts State Building Code 780 CMR,6t"Edition,I, . Dennis O'Leary being a registered professional engineer hereby certify that the Richard D. Kimball Company's employees, under my direct supervision, have been present on the construction site at intervals appropriate to the stage of construction to determine that, in general,the work has proceeded in a manner consistent with the documents approved for the building permit with the exception of those items identified on the attached Punch List dated : July 3, 2007 Project: North Parish Church Location: North Andover,Massachusetts Construction Documents: Drawings: HO.00,110.01,H2.00,H2.10,H2.02,H3.00 Date on Plans and Specifications submitted for approval and issuance of the Building Permit: August 2,2006 Addendum(a)/Revision(s) Date(s): uP%J'A OF M4Ss Dennis yGs Signature � O 'Leary � Heating&Ventilation No.43354 F HVAC S fO AL�e' �¢ Discipline-Area of Responsibility lay M.G.L.Chapter 112,231 CMR,250 CMR Professional Engineer(Original Seal) -71 SJO-7 Date L:\Jobs\2006\26357-North Parish Church\Affidavits\HVAC Project Comp Cert.doc I i Andover,MA Richard D.Kimball Company,Inc. P 978-475-0298 pBoston,MA 200 Brickstone Square F 978-475-5768 ENGINEERS New Brunswick,NJ Andover,MA 01810-1488 W www.rdkengineers.com ENGINEER'S PROJECT COMPLETION In accordance with Section 116.2.2 of the Massachusetts State Building Code 780 CMR,6`h Edition,I, Rand J.Refrigeri being a registered professional engineer hereby certify that the Richard D. Kimball Company's employees, under my direct supervision, have been present on the construction site at intervals appropriate to the stage of construction to determine that, in general,the work has proceeded in a manner consistent with the documents approved for the building permit with the exception of those items identified on the attached Punch List dated : July 2, 2007 Project: North Parish Church Location: North Andover,Massachusetts Construction Documents: Drawings: FP2.0,FP 2.1,FP 2.2,FP 3.0 Date on Plans and Specifications submitted for approval and issuance of the Building Permit: August 2,2006 I Addendum(a)/Revision(s) Date(s): i OF MAS Sq�y Signature RAND JOHN � REFRIGERI ,, FIRE PROTECTION N No.38694 FIRE PROTECTION o 9F Discipline-Area of Responsibility 9oFFSSGlSli M.G.L.Chapter 112,231 CMR,250 CMR Professional Engineer(Original Seal) Dat�/ L:\Jobs\2006\26357-North Parish Church\Affidavits\Fire Protection Project Comp Ccrt.doc w Andover,MA Richard D.Kimball Company,Inc. P 978-475-0298 n Boston,MA 200 Brickstone Square F 978-475-5768 ENGINEERS New Brunswick,NJ Andover,MA 01810-1488 W www.rdkengincers.com ENGINEER'S PROJECT COMPLETION In accordance with Section 116.2.2 of the Massachusetts State Building Code 780 CMR,6`h Edition,I, Dennis O'Leary being a registered professional engineer hereby certify that the Richard D. Kimball Company's employees, under my direct supervision, have been present on the construction site at intervals appropriate to the stage of construction to determine that, in general,the work has proceeded in a manner consistent with the documents approved for the building permit with the exception of those items identified on the attached Punch List dated : July 3, 2.007 Project: North Parish Church Location: North Andover,Massachusetts Construction Documents: Drawings: P2.00 Date on Plans and Specifications submitted for approval and issuance of the Building Permit: August 2,2006 Addendum(a)/Revision(s) Date(s): AA N OF Mgss9 v C, �G Dennis yGm R Si ature 0 O'Leary N Heating 8 Ventilation N0.43354 p Q PLUMBING /ST Discipline Discipline-Area of Responsibility SS�DNAL�NG M.G.L.Chapter 112,231 CMR,250 CMR Professional Engineer(Original Seal) `?1310- Date j i L:Vobs\2006\26357-North Parish Church\Affidavits\Plumbing Project Comp Cert.doc _.�27 $ q Date..... .w. ..1.—..0. NORTH °f'"'° ° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �,SS�CHUS� This certifies that ...........�. j NE "�!/Xi �c ................... ..... .. ......... � has permission to perform &T Z v oc l y /—���//�. 9 wiring in the building ofJl?Q7 G at....... y...'e ................... North Andover,Mass. Fee�.D............. Lic.No/..7..3.-S-31................l........u.:.............. ...... ELECTRICAL INSPECTOR Check # ` �! i Commonwealth of Massachusetts Official Use Only ' Department of Fire Services Permit No. 62-79 Occupancy and Fee Checked 14% BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/051 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(NEC),527 CMR 12.00 (PLEASE PRNT IN INK OR TYPE ALL MFORMATIOA9 Date: City or Town of: NAndover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 190 Academy Rd Owner or Tenant North Parish Of N.Andover Telephone No. 978 687 7948 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No X❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Retrofit lighting Completion o the ollowin table moy be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- o.o Emergency Lighting No.of Luminaires Swimming Pool rnd. El In- ElBatte 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 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump Number Tons KW No.o Self-Contained Totals: ........'.."'""'"".."'"""........ Detection/Alerting Devices �{ No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring No.of Devices or Equivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires_ Estimated Value of Electrical Work: $500.00 (When required by municipal policy.) Work to Start: ASAP 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 X❑ BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties ofpedury,that the information on tis application is true and complete. FIRM NAME: Maureen Electrical Inc. LIC.NO.: A17353 Licensee: Maureen Thompson Sign % LIC.NO.: t (If applicable,enter "exempt"in the license number line.) us.Tel.No.: 978 374 2476 Address: 9 Berkshire ST Haverhill Ma 01832 Alt.Tel.No.: r *Security System Contractor License required for this work;if applicable,enter the license number here: l 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE.$60. Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. (i�,- 2 7 now Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATIOII9 Date: City or Town of: NAndover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 190 Academy Rd Owner or Tenant North Parish Of N.Andover Telephone No. 978 687 7948 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No X❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Und rd g ❑ No.of Meters New Service Amps / Volts Overhead❑ Und d gr ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Retrofit lighting Completion of thefollowink table inay be waived by the Inspector o'[Vires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- El o mergency Lighting O rnd. rnd. Battu 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 Initiating Devices No.of Ranges No.of Air Cond. TotalTonsNo.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.o Self-Contained Totals: "' ' " """ """"'" """' Detection/Alerting Devices t No.of Dishwashers Space/Area Heating KWLocal❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.o ea KW o.of o.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent M OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: $500.00 (When required by municipal policy.) s Work to Start: ASAP Inspections to be requested in accordance with MEC Rule 10,and upon completion. i 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 X❑ BOND ❑ OTHER ❑ (Specify:) I certii,under the pains and penalties of perjury,that the information on ds application is true and complete. FIRM NAME: Maureen Electrical Inc. ----- -� LIC.NO.: A17353 Licensee: Maureen Thompson Sign LIC.NO.: (If applicable, enter "exempt"in the license number line.) Address: 9 Berkshire ST Haverhill Ma 01832 ",.Tel.No.: 978 374 2476 Alt.Tel.No.: *Security System Contractor License required for this work,if applicable,enter the license number here: 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'sa,ent. Owner/Agent Signature Telephone No. PERMIT FEE:$60. J � �-Gu a„� Q�'C 3 `27'0 � i `2/ 1 r � URBELIS&FIELDSTEEL,LLP 155 FEDERAL STREET BOSTON,MASSACHUSETTS 02110-1727 lTelephone 078-475-4552 THOMAS J.URBELIS Telephone 617-338-2200 e-mail tju@uf-law.com Tciccopier 617-338-0122 March 14, 2016 Andrew A. Caffrey, Jr., Esq. Caffrey& Caffrey One Elm Square Andover,MA 01810 Re: North Parish Church Solar Panels Dear Andy: Enclosed please find a Historic Preservation Restriction Agreement which was recorded in 2008. You will note that North Andover Historical Commission approval is required for any major renovations to the roof such as the addition of solar panels. Very truly yours, ThoZ?Urbeli's TJU/saf Enclosure cc: Erik Kfoury(w/enc.) Gerald Brown (w/enc.) Olde Center Historic District Commission(w/enc.) North Andover Historical Commission(w/enc.) w:\wp5 I\work\n-andove\couesp\caffrey.ltr.docx 00c'96-V22 OV— Esax lbrth Land Court Raslsttrry "2QOr8 11932 1R STORIC,PR1?8P_q.VA77 0N RF.STRICTiON AGR EEMENT between the TOWN OP NORTH ANDOVER bY NORTH ANDc)VER HISTOR7 AL,COMMISSION and THE NORTH P, NSF UNITARW ASK P TNR NORM 04,t ISR o OR 70 .4,v&,&I �HMCN OT NORTH ANDOVER The parties to this�s wtemd Wo as of this Andover,by and through W hs Hi 116y ofAugust,2008,ate the Town of North 40C.havingstmcal�� q ped Pursuant"to authorit an address located at e!o To►rn fvt Y granted under MGL c. 01845 heroinaflernt'erred to on',.and Office, 120 Main Stneet,North Andover,Massachusetts �the"Contrttissitm,"rnd Ole Noah parish Unitarian North Andover,having an address located'at I c Universalist Church of Jerred to as the C*10r. b�dmy Road,North Andover,MA 01845 hercimfler WHEREAS,the Gmicr is the owner in fee simple of certain real known its the North,Padsh of North An Property with improvenrents District Registry 13istri dov+er,thereon as described in a deed filed with the Essex North etof the Land Coun and noted on Certificate of Title Number 4300 a nd Book 29,page 201,and which is iomted at 190 Academy Road,North Andover,Mfassachusetts recorded at alerted to as the Property, ,hereinafter WHEREAS,the Property includes a wand frame,Gothic Revival church building constructed in 1833 together with an attached wood-frame"education wing"addition built in 1959,together hereinafter referred to as the Building; WHEREAS,the Property,due to its historic,cultural and architectural significant,is listed in the State and National Registers of Historic Places as a contributing resource to the North Andover Center National Register Historic District and the locally,tesignated North Andover Historic District, WHEREAS,the Gmtor wishes to impose certain restrictions,obligations and duties upon it as the owner of the Property with Mspect to maintenance.lmotection,and preservation of certain portions of tl�le exterior of the proparty,sub ct to the limitations and exemptions described heroin. The area upon which the restrictions arc to be imposed include all exterior surfaces(including but not limited to all exterior walls, foundations,roofs,window sash and frames,doors,stairs,gutters,downspouts,and associated hardware, structural fieatums,decorative elements,and visible details)which are in contact with the outside of the Building,and which are illustrated in Exhibit A attaabed hereto on a set of site and elevation plans,consisting 1 Of four(a)sheets,entitled"North Parish Chunoh,' dated as shov ( vn),prepared by Menders.TotTey&Spencer, Inc.,including shed 1 (Basetriptt surd bower Level Floor plana),Sheet 2(Exterior Renovations West and South Elevations),Shoe(3(Exterior Renovations—,Bast and North Elevations),and Sheet 4(Building SectionsxcoNectively,the»Premise ")(and the plans referenced above,collectively,the Site Plans,and each,a Site Plan),subject to the exemptions described below; WHREAS.in order to protect the architectural and historical integrity of the Ptraaises,the Grantor intends to undertake certain work on the Premises,including but not limited to,that work specifically described. in Exhibit B(the"Work"}attached hereto; WHEREAS,the preservation ofthe premises is important to the public for the cAjoyment and Appreciation of its architeahrral and historical heritage and will serve the public interest in a manner consistent with the purposes of M.G.L.Chapter 184,sections 31,32 and 33„hereinafter referred to as the Act; WHEREAS.the Commission is a government body organized under the laws of the Conunonwealth of Massachusetts and is authorized pursrramt to the vote on Article lb of the North Andover 2005 Annual Town Meeting to accept these Preservation restrictions as the holder of said restrictions under the Act. WHEREAS,these prraetvation restrictions set forth below in this Agreement are intended to ensure the preservation of those characteristics which contribute to the architectural and historical integrity of the exterior of the Premises,andthe characteristics which contribute to the architectural and historical integrity of the Premises include,but are not litnited to.the artifacts,features;materials,appearance,and workmanship of the exterior of die Pmnises. NOW,THEREFORE,for good turd valuable consideration,thereceipt and sufficiency of which is hereby acknowledged,the Grantor conveys to the Commission the following preservation restrictions,which shall apply to the Prwnises for the term described below,and the terms of the Preservation Restriction areas follows: 1. M intelL++re of - M: Upon completion of the Work and subject to other provisions within this Agr+eerrient,the Grantor agrees to maintain the exterior of the premises in the same structural condition and state of Mair to that existing on the date of this Agreement (and to assume the total cost of continued maintenance,repair and azdmir:ilstntion of the Premises) so as to prrsetve the characteristics that contribute to the imivtectural and historical integrity of the Premises in a nater satisfactory to the 2 Commission according to the Secretary of Interior's -ftndardsr rIv , fo Wien/of Xia/erre Pralwrlier 'rill' Gui(reiine»r for Prvsen�ing, Rehubilmaiing Resiortirrg chid Reco»siracting Nrstoric (36 &rildi»;qs" CFR Parts 67 and 68), as amended it r time to time(collectively, the "Secrerury s StandB'd dY")to the extent applicable. The Grantor may seek financial assistance fimrn any source "table to it. The Commission does not assume any obligation for maintaining,repairing or administering the Promises. 1• Inspection: The Commission or its represrntativcs shall be perruitted at reasonable tines to inspect the Premises from time to time upon removable notice to'.determine whether the Grantor is in compliance with the teturs of this Agreement 3• & :. The Grantor agrees that Ito alterations shall be wade to the exterior of the Premises except as detailed in Exhibit B and/or Item 5 and/or unless: (a) such alterations constitute "Ordielary Maintenance"(as defined below)4b)the Commission has previously determined that the alterations will not impair such characteristics after rimming plans and specifications submitted by the Grantor, and such review and approval shall be bused upon conformance of the alteration to the Secretary's Standards to the extent applicable,or(c)required by casualty,damage or other emergency promptly repotted to the Commission in accordance with Section 13. The tern"Ordinary Maintenance"means alterations of a minor nature involving ordiaary sad customary repair and maintenance of the Premises which may be made without the written permission 01,the Commission. For purposes of this section,interpretation of what constitutes "Ordinary Maintenance" Is governed by the examples provided in the Restriction Guidelines which art attached as Exhibit C to this Agreement and hereby incorporated by reference Notwithstanding anything to the contrary in this Agreement,notlti4g,in this Agreement shall provide;the Cornlnis$ion with any right to require or recommend any improvements to the interior of any structure, or to dictate any improvement in Ste interior or on the exterior of ' flee Ptetmis"which conflicts with the Grantee's rights to freely exercise its rights of religion. 4. Notice and n vpI. Whenever approval by the Cortvtt Won is required under this Restriction,Grantor shall in writing request specific approval by Lite Commission not less than(30)days prior to the date Grantor-intends to undertake the activity in question unless otherwise agreed by the parties. A written request for smell approval by the grantor shall be reasonably sufficient as a basis for the Commission to li approve or disapprove the request.The notice shall include two copies of the information which describes the natwti,scope,design,location,timetable and any other material aspect of the , proposed activity in sufficient detail to permit the(:otmmission to make an infmwed judgment as to its consistency with the purposes of this Preservation Restriction). The Commission,in its sole reasonable diseretioo,shall decide whether a wryest is sufficiently detailed but such detail shall be eontntensurate with the scope of the proposed work to be undertaken. Certified Architect's or Engineer's plans of the proposed work slull not be required unless requested by the Commission. 3 Within(30)days after r ftipt of Grantor's reasonably sufficient request for said approval,the Commission shall certify,in writing,that(a)it approves the plan or request;(b) it disapproves the plan or request as submitt4 itn which case the Commission$hall provide the Grantor with written suggestions for modification or it written explanation for the Commission's disapproval or,(c)request . additional information relevant to the irequest and necessary to provide a basis for its decision. The Commission's appieval shall not be ti='wsonably withheld or delayed,$tad shall be granted upon a reasonable showing that the proposed activity shall not materially impair the purpose of this Preservation Restriction. Faihme of tide Commission to make a decision within seventy-five(75)days from the date op which the request is filed with the Commission or notice of a time extension is received by the Grantor sliall be deemed to constitute approval of the request.and permit Grantor to undertake the proposed activity in accordance with the plan or request as submitted.. S Notwttinstanding anything to the contrary in this Agreement,the Grantor reserves the right to display temporary banners,on the building to announce festivals,events or other messages as may be displayed by the Grantor,. 6. Aa+m�r „.M�: The Commission may assign this Agreement to another govemmental body.or to ally charitable corporation or trust qualified under the Act,whose purposes ate to promote the maintenance and preservation of historic propettiea,only in the event that the Commission should case to function int hs present capacity,provided that any such conveyance,transfer or assignment or transfer requires that, the pwposes for which this Agreement was created will continue to be carried out. Notwithstanding die foregoing, should the Commission cease to exist at any time, the Commission's rights under this restriction,including but not limited to its rights of enforcement and prior approval as set forth in p'k agrapb 4 ab6ve shall immediately vest with the Board of Selectmen of the Town of North Andover or their designee. The Grantor shall have the right to assign or convey the Property subject to !, this Agreement without approval of the Cotnritission, provided that any deed or instrument of conveyance shall incorporate this Agm rnent by reference. Notwithstanding anything to the contrary in this Agreement,an Owner of the Property shall have no obligations pursuant to this Agreemeat where such owner ihall cease to have any ownership interest in the Property by reason of a bons fide transfer. The restrictions, stipulations,and covenants contained within this A grbcmeat shall be incorporated by reference and as an exhibit in any subsom=l deed or other legal instrument bj which Grantor divests itself of the fee siumple title to the Property.Grantor shall pmmpdy'notify the Commission in writing of any proposed sale of the property and provide the opportunity for the Commission to explain the tems'of the restriction to potential new owners prior to the closing of the sole. 7. gum With JhLI"wl The obligations and restrictions imposed by this Agreement shall be effective for the Tam described in Section 12 and shall be deemed to run as a binding servitude with the Property, 4 This Agreement shall extend and be binding upon Grantor,the Commission,their respective successors in interest and all persons hereafter claiming under or throug>t the Grantor and the Commission,and the words "Grantor'' and "Commission" when used herein shall include all such persons. The burden of these restrictions shall run with the land and shall be binding on-all future owner of the interest therein. B. DiMutc Resolution, The Commission and Grantor shall first endeavor to resolve their disputes by mediation which request for mediation(the"Mediation Notice")shall be filed in writing with the other party to this Agreemart. The Commission and Grantor shall meet within thirty(9t?)days after the date the other party receives the Medurtion Notice in an attempt to resolve such dispute, 4. Commission's.It•�••4M. The tight ofeaforcenoent"be provided for in the Act as it may be amended from time to time,or any other applicable law. Subject to the provisions in Section 8,the Commission enay institute suit(s)to erlj vin any violation of the terms of this Raetiiction by ex parte, ternpaary,Preliminary,and/or permanent injunction,including prohibitory and/or rnaadatory injunctive relief,and to require the tettoration of the.property to the condition and appearance required under this Restriction. The Commission sWj also have available 0 legal and other equitable remedies to enforce Grantor's obligations hereunder. In tl►e event Grantor is found to have violated any of its obligations,Grantor shall reimburse the Commission for any costs oraxpenses incurred in connection with the Commission's enforcement of the terms ofthis Restriction,including all resswtable Court costs,and attorney's,architectural,engineering, and/or expert witness ram. Exercise of'the Commission or Grantor of one remedy hereunder shall not have the eflbct of waiving or limiting any other remedy,and the failure to exercise any remedy shall not have the effm of waiving or limiting the use of any other remedy or the use of such rmnedy at any other time. 14, Validity and S_ev_eraWJW. The invalidity of the Act or any part thereof"I not affect thevalidity and enforceability of this Agreement according to its terns. The invalidity or.unenforceability of any provision of this Agteeraent shall not affect the validity or 'enforceability of any other provision of this Agreement. 11. $gMV&x : The Grantor agrees to record this Agreement with the eppmpriate Registry and Erle a copy of such recorded instrument with the Commission, 12• TQM: Subject to the provisions set forth herein,the term of this Agreement shall be for a period of thirty-.five (35) yearn, cOnUencing upon date that this fully executed and approved Agreement is recorded with said Registry. 13. In the event that the Building or any part thereof shall be damaged or destroyed by fire,flood,windstorm,hurricane,earth movernent or other txneualry,Grantor altall notify the Commission in writing within fourteen (14) days of the damage or destruction. such notification III S including what, if any, emergency work has been completed. No repairs or reconstrartion of any type other than temporary emergency woti to prevent further damage to the Building and to protect public safety. shall be undertaken by Grantor without GMA"'s prior written, approval of the work. Within thirty(30)days of the date of damage or destruction,if required by the Commission,Grantor at Grantor's expense shall submit to the.Commission a written report prepared by a Raalified rtst(1rrstion architect mid an engineer who are acceptable to the Grantor and-Commission,which report shall include the following: (a)an assessment of the nature and extdrit of the damagegb) a determination of the feasibility of the restoration of the Building and/or reconstruction of damaged or desttoytd portiobs of the Building,and (c) a report of such TeStaration and/or reconstruction work necessary to return the Building to the condition existing at the date thereof along with a cost estimate for the sancre. J 3.tTemrinatio in th vent Qf Dmr� n W.Q— In the event of damage to the property in An amount greater than twerity-five percent 25%of its total market value immediately prior to the accident,whether through Act of God,Act of war,natural disaster,fire,flood,wind storm,hurricane,cart,movement or other so-called force majetue or other casualty events,the Grantor and Ceeomnission agree that such event may serve to tenninate this Agreement but only in accordance with the provisions set forth in the Act, including approval of the North Andover Town Meeting,the North Andover Board of Selectmen,the North Andover I•fistorical Commission,.and the Massachusetts Historical Commission, In the event the Grantor believes such damage to have occurred,the Grantor shall,within fourteen(14)days of its discovery of the damage provide written notice of the damage and of the Grantor's contention that such damage may be of a severity which would entitle Grantor to seek termination of this Agreement. Within thirty(30)'days of the date of such dammalle or destruction.and if required by the Commission,the Grantor at its expense shall submit to the.Commission a written report prepared by a qualified appraiser which is acceptable to the Grantor and the Commission,which report shall include an appraisal of the Property prior to the damage having occurred(the"Appraisal Report''). If after reviewing the reports prepared(if any)above,and assessing the availability of insurance and other funding proceeds after satisfaction of any mortgagee's/lendees claims,Grantor and die Commission agree that the purpose of this Restriction Agreement will be served by such motoration/recotrstnrction, then the Grantor shall establish a schedule under which the Grantor shall complete the restoration/reconstruction of the Premises in accordance with plans and specifications prepared,upon the Commission's reasonable review and approval,to a level at least equal to the total of the casualty insurance proceeds available to Grantor. If,on the other hand,after reviewing the:reports above,and after assessing the availability of insurance proceeds after satisfaction of arty'mortgagee's/lender's claims,the Grantor and the Commission reasonably determine that either:(a)'damag;e to the Property is in an amount greater than twenty-five 6 percent 25V*of its total market value ira Lely Fn?c to the oaaualty event or damage;or,(b)the Grantor and Commission agree that*ach the Raton 0ROMonsinaxion is oomwise impractical or impossible,or the purposes of the restriWIons within the Agreement will not otherwise be-served by such rtstoratiodiecotrstruct �flrerr'firarrtvr aitd iCarnmissioe'm*y,*t OraMor's'elC0ion,-s&rk to ton6inate this AV""'in accotY Cc witb the M airemen is of the Act. If the parties fail to*gra to any condition herein mer t+auosoatk`ei�ori ,tlio mutter shall be referred to Dispute Resolution as provided in . Section 8 herein., 14. COgdOM041 on..If all or any pert of the 1„ Y H tat> n'tdider thewfr'of etni Ira nbnt datmia by.#Ublic or other Authority,or otherwisp.acquired by-such audtority throw a gb, pnruheae,in lieu of talrbrg,Grantor and the Commission,shall Join in appirop�;iate prwoodiugs at the time of such taking to recover the full value of those interests in the Property tkat are subject to the taking and nil incidental and direct damages resulting from the taking. Au Oqftm ably incurred by the Grantor and the ComrWssion in connection with:web ItAking shall be paid au of the recovered Proceeds.,.Such tecovere'd pis shalt be paid to theGtjantoc l S. ,,,Gratttgrpclmowledges that approv#1.17 The Cotrunissiou of a request pursuant to ScOon 4 does trot relieve Grantor of its tespootulbility to obfsat the approval(ifrequired by law)of any o*autbwity Welfipolr udiag but sot limited to the North.Andover Cottservataan Commisaima w” p BQOd the NoM Andover Health Department °r sWMV11h"Ubed by any aguy efrho Com ftwalth of Maaascbtuetts for the work proposed to be done. 16. Evidence of doral' .' ,yu of the Grantor,the Commission shall within a reasomble time furnish Gnurtot with a.Certification ilrar, to the best.of the Commissiort s knowledge. Grantor is in compliance with the PbGgationrA of oritntm coftdjkd- 1w(.eK or that othetwise evidences the status of this Agreement to the extent ofthe Commimtion's.knowlodge thereof. 17. Fffs�ct v�Date. The Petrna of this Agrr Am=t shall not talus full fnroe or eflSoct until AXwmd and Signed by the Opentor.the Nortb Andover Historical Commiaeiau.do N"Andover Hoard of Sakctmen,the!' :husetts Hietosip}Ctanu>ia oq and;recorded with*pros Registry of Deeds. The Grantor Www MM d t}lis document with the properRegistry of Deeds within ten(t 0)days afterthe document is signed by the foregoing parties,liovided,however,that Grantor has obtained satisfactory assuranoes that funding from the Town of Notih Andover shall lie received forthwith. 1S. CondidarLA_1 Rit#htA Rrniii�►d�tr�A The conduct of archeological activities on the Property,inchtding without limitation, survey,excavation and artifact aetrieval,may carts only following the submission of an archeological field investigation plan 7 prepared by the Grantor and�appmvW ju writi*by t1u,State Archeblogiat'of tiff UmftA t*W ...::'... Historical Commission(MG.L;.Ch-9,Section 27C,9S0 CMR 70.00) ti. r, IN WITNFSS WHEREOF,.we have Vseau.hwA unde gfortbow. al a1 f ,Ili¢:} .set GRANTOR; C4MMJS&�UN;. North parish Univemalist Church of North�►atkw Notth.AndomHbtmal Co udolion ..A/,X/h rKE N.R.ry rA�t r1H of NoQn(.IivW�rl 31.9 9 Its: Co-Chsirpergon,Board ofTmstees Carol Wv1din " •Its. Co•Clwhpersm,Board of Trustees :.�-:;► .,.,: :1.::, ' , By Dated:'Aujt;2W• !".• r t , Mel Marchese,Its;.Triemumr Dated. August 2008 ,•,,. , ,. COMMONWEALTH OF•MASSACHUSETFs . On this day of Aupst.•2008 before ase,the w►demiped aparry.pubJic,petaeaoy and Carol Weldrn, proved to me thmugb satisfactory evidenm of ideartie"don, which was. personally known to me,or.ryperganaily known to 3't party rvitiiretir jittkiattXllli blirti!u'tb `i$'6fd'ili64WJtdire nam"are sIPW on dee pteoeding or attacbed dotnmoW,and�WledpM. me that. sawed purpose as a CoChaaprresas of the Board of Tmstees aftbe p tlnitar'bin' ,lIN!ed it,vomt Andover. ; S C COMMON LTH,OF M�kSSAWIi V S S` r � •. :1 is �: .. ?t .. J. On this A day of August,2006 before sae..the wW**pW'g public, _ rgrp�d 11!?l�Mtl�!AaF, Proved to me through satisfactory evidence of identif'icadom which woJ3riva's ticenae. 16"ma �eraonaUy known to 3 Party wiums pews wtly 6owr►w me,14 be tb6 pi%i wboire 1Wk m� or attached docwonent,and acknowledged to ore that.he signed it volmmon y f .1ts pnytppea 8t Ate3'ta�tt+gpr.of the North Parish Unitarian Univnarsali.�t Church ofNorth Ant$)ver; Notary Public �lll LIIM!►�r3Slol1y / AV"7j;&0 APPROVAL AND ACCEPTAIJCE BY TIH,yF�NORTH A1v'MVER hs�RI'f Cob ;;c lgN Dared: August i1,2608 Kath IS: Chaupe wk duly Essex,as Common .Jr,ILT,tt OF MAUACHUsETTS On this day of August, 2008 be$ja sue, the under SWd nosy publk.persoaaUy a d Kathleen Szyatcs,proved to me tbrc�ugb satisfactory!OW* x of WentlfkSUM which was`)driver's license.fi voent ly known to me.or V.pmornrlly known to 310 p�rty Mitae,k PMY lowwa to me,to be the preceding or attached down and acknowied O0°whose MW is Signed on the ,Scd.to the ttdf she/he signed it voluntarily�its statedd prupaye u Chairperaoa for tbt:Nmth Andover Hkaieal Corrtmirai in.n .j.y 2�-4�1L_ 9 APPROVAL AND AC('-CUT A CER V H Mark J.T.ceggiano� I�armei K liii� Dated: August�,2008 Esxex,as COMMONWEALTH Of MASSAt2Wttfts on this k day of August, 2408 WOW roe, the unde signed not�uy Rosemary Connelly Smedik, proved to me thruu�gh saticfac mak,. tory evitlestca of idlkalillt cm;.srl A was,r driver's license, , ... . Wally known to me,or't Penonally k amm to 3w party q pi qty bt&m to me;to W the ptYmn whose name is Signed on the preceding or attadwdou that she signed it voluntarily for its stated purpose m Che '64 .�me irner�on for the 1Vortb q>xbvbroi►geyp Notary Pubb: s�sss.•K P�:yes Lie", .10 APPROVAL BY THE-NASA QjjVsBM HIUt71ZISSIO r The undersigned Executive Director turd Clark of the Massachusetts Historical Commission Jteneby certifies that the foregoing preservation restrictions have leen approved by the Massachusetts Historical Cormaission in the public interest pursuant to Massachusetts General Laws,Chapter 184,Section 32. MASSACHUSEIi.'S HISTORICAL COMMISSION BrQue Sinton,ExmudveDirector and Clerk Sutfolk,sa COMMONWEALTHMASSACHUSETTS OF MASSACHUSE on thised5yof.r, ., 2008 before me, the undersigned notary public, personalty appeared Brona Simon,;proved to me tit wSh sapslactory evidence of identification, which was�; driver's license,L personally known to rine,or I-)personally known to;314 patty witness pertomally known to me.to be the pemoa whose name is signed on the preceditrg or attached document, and acknowledged to me that she signed it voluntarily for its stated purpose as Acting.Executive Director and CW[of the Massachusetts Historical t=ote mk%ioa NotaryPpbiic My Corrunission Expires�- 11 ii . f i EXHIBIT A S'te Pips �I I I I 12 I � II i NOIES I. PROPERTY UNES FROM EXISITNG PLANS AND RECMDS. SEE TOWN OF NORTH ANDOVER ASSESSORS MAP 006 LOT /72 � AND LAND COURT DEED #29, PAGE #201 FOR Slit. 2. ZONE DISTRICT IS R3 WHl0f REQUIRES 30' FRONT, 20' SIDE AND 30' REAR YARD SETBAWS I J y ev PLAN OF LAND IN NORTH ANDOVER PREPARED FOR NORTH PARISH CHURCH 190 ACADEMY ROAD NORTH ANDOVER, MA to 0 is 60 OF R�23.00 SCALE; 1" = 80' 40 IL DATE- AUGUST 5, 2008 IMERRIMACK ENGINEERING SERVICES 66 BARK STREET I .- ANDOVER, MASSACHUSETTS 01810 i ii. o� 28 .08 NORTH PARM�� Scales X40 AGDB Y RD,NOE'IS ANDO`W.MA 01843 IM. �.ru � w LI I I Dater NORTH 07.28.08 N Scateo Nosh or2 190ACA,D96CY RD,NOUR AMOVMP.MA.01845 . `Q 1 G' ai tel NORTH PAR=CHUMC H """'•"�"" ,� .. 3 Scatei MAC.ADBMYRD,NORT8ANDOVER,MA0130 ����w I' 1 v [DQtes NORTH P �.2e,os AA;18H CHURt�i cale? 190ACAVWY M,MR=AtQIDov 4MAolw y "'�► •'�"• 4 i i �r 4 M 111r � � rle j { a I, Date NORTH PARISH CHURCH •�"'�+� a�.z8.o8 stater 190ACADEMY ILD.NaeTHANDOV LMAOIW EXHIBIT B The Work The Work shall include the preservatioli of the 1836 steeple tower and fotuidation. Steeple work includes mplaeenrent of ngled tower posts,rasupport of Paul Revere bell bearings and pillow blocks,and restoration of balustrades. Foundation work includes realignment of four pilasters,reconstruction of front steps,and re-pointing mortar to Prevent further water damage. 13 EXHIBIT C RaWcfion Guidelines The purpose of the Restriction Guidelines is to clarify paragraph three of the terms of the preservation Restriction within this Agreement, which deal with alterations to the premises, Under this section,permission from the North Andover Historical Commission is required for any major alteration. Alterations of a minor Datum.which aro part of Ordinary Maintenance and repair,do not require Commission review. In an effort to explain what constitutes it minor alteration and what constitutes a major change,which must be reviewed by the Commission,the following Iist bas been developed.By no mans is this list comprehensive:it is only a sampling of some of the more common alterations which may be contemplated by building owners. PAINT MW--Exterior harm scraping and repainting of non-decorative and non-significant surfaces as part of periodic maintenance. Mta O-painting or fully stripping decorative surfaces or distinctive stylistic features including murals, stenciling,wallpaper,ornamental woodwork,stone,decorative or significant original plaster. WINDOWS AND DOORS .r-Regular maintenance including caulking,painting and necessary mglazing. Repair or in-kind replacement of existing individual decayed window parts. Major-Wholesale replacement of units; change 41 fenestration or materials; alteration of profile or setback of windows.The addition of storm windows is also considered a major change;however,with notification it is commonly acceptable. EXTERIOR Minor- Spot repair of existing ciaddirig and mofutg including in-kind replacement of clapboards, shingles,slates,etc. MWX - Large-scale repair or replacement of cladding or roofing. Change involving ineppmpriate li removal or addition of materials or building elements (i-e,removal of chimneys or cornice detailing; installation of architectural detail which does not have a historical basis); altering or demolishing building additions; spot repointing of masonry. Structural stabilization of the property is also considered a major alteration. Changes classified as major alterations are not necessarily unacceptable.Under the Preservation Restrictionsuch changes must be reviewed by the Commission and their impact on the historic integrity of the Premises assessed. It is the responsibility of the property owner to notify the Commission in writing when any major alterations are contemplated, Substantial alterations may necessitate review of plans and specifications. Should any plans and specifications be required,they shall be prepared at the owner's sole expense. The intent of the Preservation Restriction Agreement is to enable the Commission to review proposed alterations and assess their impact On the integrity of the Pmmises,not topmelude future change.Commission staff will attempt to worts with property owners to develop mutually satisfactory solutions,which are in the best interests of the property gird which are consistent with the purposes of this Agreement. 14 DOC=96s922 09-04-2.008 11232 Essex North Lad Court Rmistri ,( A I d Deval L.Patrick ' Governor �i�� p�QQQQ Thomas G.Gatzunis,P.E. Commissioner Andrea J.Cabral Secretary 6'j- ��QQQJ Thomas P.Hopkins � / Director c6wz L(y.11LflQbO y 10& TO: Local Building Inspector Docket Number V 06 124 Local Disability Commission Independent Living Center FROM: ARCHITECTURAL ACCESS BOARD RE: North Parish Church 190 Academy Road North Andover Date: 12/2/2014 Enclosed please find the following material regarding the above location: Application for Variance .Decision of the Board Notice of Hearing 1 Correspondence Letter of Meeting The purpose of this memo is to advise you of action taken or to be taken by this Board. If you have any information which may assist the Board in reaching a decision in this case, you may call this office or you may submit comments in writing. RECEIVED 0 N't"t, DEPARTMSNT OF PUBLIC SAFETY ARCHITECTURE 75 Kneeland Street NOV 2 6 2014 Boston,MA o2in 617-227-1477 ARCHITECTUAL ACCESS BOARD November 24,2014 Thomas P.Hopkins,Director Arclvtectural Access Board One Ashburton Place,Rm. 1310 Boston,NIA 02108-1618 RE:Variance Dear Thomas, It is with great pleasure that I send the Architectural Access Board a copy of the October 7,2014 Occupancy Permit for North Parish Church Unitarian Universalist, located at 190 Academy Road in North Andover,MA. With the completion of the recent renovation/addition work,all occupied levels of the religious education center(and church offices as well)are now in full compliance with 521 CMR,two years prior to the 10-year Variance granted to the church in the Board's Decision of October 31,2006. About the Project: On October 19,2014,North Parish Church of Noith Andover Unitarian Universalist fu#lled its `Together Under One Roof' campaign by dedicating the New Wing of the Meeting House while celebrating the 369thyear of the Congregation. The 8,300 Sq. Ft. two-story addition and four-level elevator tower was built by Windover Construction between April and October 2014, replacing and expanding the 1958 Religious Education Wing with flexible classrooms,meeting rooms and storage,whileadding office space for clergy and administration. The Sanctuary,Parish Hall, Religious Education and Office levels am now connected together and to the surrounding gardens by means of a four-stop elevator and accessible pathways from two levels of curbside access on the church's wooded site in North Andover's Old Center Historic District. I am also copying a letter received by the church and read aloud at the dedication,commending the church for its commitment to inclusivity on behalf of EgUUal Access,a committee of the Unitarian Universalist Association. Sincerely yours, David W.Torrey,AIA Principal,Torrey Architecture,Inc. Cc: david@torreyarchitecture.com www.torrcyarchitecture.com 'f s Page 2 of 2 Gerald A. Brown Inspector of Buildings Building Department 1600 Osgood Street Bldg 20,Suite 2035 North Andover,MA 01845 North Parish Church Building Task Force 190 Academy Road North Andover,MA 01845-4022 Attachments: -Occupancy Permit 10-07-2014 -Letter from EgUUal Access 10-19-2014 -Decision of AAB 10-31-2006 david@torreyarchitecture.com www.torreyarchitecture.com The Commonwealth of Massachusetts City\Town of North Andover Cerci is of Ins ection In accordance with 780 CMR,Chapter 1 (The Sixth Edition of the Massachusetts State Building Code)'and Chapter 304 of the Acts of 2004 (an Act to further enhance fire and life safety),this temporary certificate of inspection is issued to the premise or structure or part thereof as herein identified. Identify Name of Establishment Certificate No. Issued to 190-2014 North Parish Unitarian Church 190 Academy Road, North Andover,MA 01845 Certificate Located at Ex iration Sept.2015 Use Group Church Assembly- 624 Pews,25 Choir,28 Balcony Allowable Classification(s) 2014 Addition-Lipper Level 110 Occupants,Lower Level 55 Occupants Occupant Load See Detail This temporary certificate of inspection is hereby issued by the undersigned to certify that the premise,structure or portion thereof as herein specified has been inspected for general fire and life safety features. This certificate shall allow for the temporary use as herein described and in conformance with any and all conditions as identified below. It shall be framed behind clear glass and\or laminated and posted in a conspicuous place within the space as directed by the undersigned. Failure to post the certificate,failure to comply with conditions or,tampering with the contents of the certificate is strictly prohibited. Conditions of Temporary Use Name of Municipal Andr Melnikas,Fire Chief Name of Municipal Gerald Brown,Bldg.Insp. Date of October 7,2014 Fire Chief Building Commissioner Inspection a Signature of Municipal // Signature of Municipal Fire�i� � c�,,� rDate of October 7, 2014 Building Commissioner �?/ „� Issuance r' i I 4. 19 October 2014 The North Parish of North Andover, Unitarian Universalist 190 Academy Road North Andover, MA 01845 Congratulations to the congregation of the North Parish of North Andover on the occasion of the dedication of your new building! We applaud North Parish's commitment to inclusive and accessible spaces. The building you dedicate today opens the way for participation in areas of parish life that are often inaccessible:religious education,administration,and serving the larger community through the food pantry. Making your memorial garden and labyrinth accessible demonstrates your commitment to the full inclusion of people with disabilities in the life of your congregation. Together with your earlier renovation of your historic Meeting House,this new building puts the North Parish of North Andover among the leaders in accessibility in our Association. In the disability community,we have a goal that places of worship should be places where all can worship,can serve,and can lead. Congratulations to all of you in the North Parish for caring and creating spaces where all of those important aspects of religious life are accessible to all. May this new building be a house of hope and joy for your community for many years to come. Sincerely, Suzanne Fast President, EgUUal Access The mission of EgUUaI Access is to enable the full engagement of people with disabilities in Unitarian Universalist communities and the broader society. -o Mitt Romney A-�' �GdPrl�`d DG,D����i� Thomas G.Ga#unis,P.E. Governor �� 6��. 066D��cPDI�.� , Commissioner Kerry Healey �+/y !� n Thomas P.Hopkins Lieutenant Govemor �G�DD�sY Director Robert vrww.mass.gnvlaab «et Haas se e>ary �a�6���.��'D�6�" SENT VIA CER.TIMED MAIL:'7006 0100 0000 7800 0850 DECISION RE:NORTH PARISH UNITARIAN UNIVERSALIST CHURCH,190 Academy Road,North Andover 1. The variance hearing was held in regards to the following Rules and Regulations of the Architectural Access Board: Section 28.1 —General(Elevators) 2. The hearing was held on: Monday,October 16,2006. 3. The following person(s)appeared:Robert Pellegrini,Attorney for the Church;-David Torrey,Architect;Gail Forsyth-Vail,Director of Religious Education for the North Parish Church;Deborah Putnam,Member of the North Parish Church Building Task Force;Prudence Barker,North Parish Church Parishioner;Frank Clarkson, Assistant Minister for the North Parish Church;and Clem Karl, Chair of the North Parish Church Building Task Force. All were sworn in by the Chairman and the hearing was called to order at 3:15 p.m. 4. JURISDICTION: The Board took jurisdiction over the facility under Section 3.3.2,in that the work to be performed was going to amount to 30%or more of the full and fair cash value of the building,therefore the entire building is required to comply in full with 521 CMR. I 5. FINDINGS AND DECISION: The Board having considered the evidence hereby decides and finds as follows: Mr. Robert Pellegrini started the presentation by stating that the main portion of the church was constructed in 1833 and is listed on the National and State Registry of Historic Buildings. The project that the church is intending to undertake has been in the works for the past seven years. The Unitarian Church must acquire all of their funds for projects from the parishioners,noting that they are spending just over$399,000 on barrier removal and$328,000 on HVAC,plumbing,electrical, and life safety upgrades, with an additional$20,000 being spent on other miscellaneous upgrades. Mr. Pellegrini stated that the largest project is at the front entrance of the church. The current configuration requires parishioners to traverse a set of stairs up to the large entry doors and then enter into the vestibule area and traverse additional stairs to access the main part of the + church. The church is proposing to raise the grade at the front of the church,creating an at-grade entry via a sloped walkway at the front of the building. The noncompliant interior doorway will be removed and a compliant doorway will be installed. The church will also be installing accessible pews with accessible seating locations at the front and rear of the church. The stage area at the front of the church will also be accessed via sloped aisles and an accessible podium will be in place. The one variance that is being sought at the interior is for maintaining the existing historic pulpit,noting that the podium on the stage will be an alternate location for speakers. On the basement level,there is a narrow set of stairs connecting the church and the basement,which will be replaced with compliant stairs. Another variance request was for the existing elevator to remain due to the constraints of the building. Mr.Pellegrini also added that there is also a compliant walkway along the side of the church connecting people from the front of the building to an accessible entrance to the basement area. The offices with noncompliant doorways will be converted into a nursery and brought into compliance,along with the noncompliant stage at the basement area being removed. The kitchen will require a variance for the lack of compliant height at the countertops. Mr.Pellegrini stated that all of the other variances that were originally requested were being withdrawn,as the church is going to comply with all areas except for the height of the existing counters. Mr.Pellegrini stated that there was currently only one set of bathrooms for the church, located in the basement area, and that the church was proposing to make the existing bathrooms comply in full with 512 CMR. He noted that the religious education area,located in the basement is located on two levels, with the proposal to continue the exterior walkway to provide an accessible entrance to the first level of the religious education classes. The upper level of the religious education classes is up a set of stairs. The petitioners are proposing to install a compliant stairway to this upper level,but there will be no vertical access to this space. Mr.Pellegrini stated that the classes can be moved to the accessible level if necessary to accommodate the students. In regards to the variance for the noncompliant elevator,Mr.Pellegrini stated that they have received cost estimates from elevator companies and found that due to the size of the existing shaft, even a compliant vertical wheelchair lift would not be feasible. Creating a compliant shaft would require that the shaft be demolished, which would result in having to demolish part of the structure that holds up the balcony and require removal of the organ. In lieu of creating a compliant means of vertical access,the church was proposing to create the walkway which connects the front of the building with the lower accessible entrance. W. Pellegrini stated that creating vertical access would be technologically infeasible. At this point,Mr.Martin Ebel asked for clarification as to the reason for the variance request for the lack of vertical access was that compliance was technologically infeasible because the demolishing would require that portions of the balcony be removed and the organ relocated,to which Mr.Pellegrini responded and clarified was correct. Ms.Nancy Angney asked for the specific dimensions of the existing elevator. Mr.Pellegrini stated that the elevator was 34 inches by 42 inches, noting that they have looked into the shaft and found that the shaft is only marginally larger than the elevator car. He went on to state that the balcony was used for overflow seating and housed the organ,noting that the balcony was historic to the church. Ms. Angney then asked if the elevator was able to access the other portions of the church and the addition. Mr.David Torrey,Architect for the Church,added that the Church had looked at Limited-Use-Limited-Access(LULA)elevators,vertical wheelchair lifts as another means of vertical access,but found that all means were infeasible due to the present makeup of the church and the existing shaft size. Ms.Angney then asked if the call buttons were located at the required height. Mr. Torrey stated that they were willing to make the features of the elevator that they were able to bring into compliance compliant. After reviewing the matter,Ms.Angney made a motion to GRANT the variance requested for the use of the existing elevator as a means of vertical access on the condition that any improvements not requiring changing the actual elevator,such as the hail call button height and location,were brought into compliance with Section 28 of 521 CMR. The motion was seconded by Ms. Myra Berloff and carried unanimously upon a vote from the Board. 2 + i The next matter that the Board discussed was the lack of access to the balcony. Mr.Pellegrini stated that the balcony is not used by the choir and is only used by the organist and for overflow seating during Christmas. Ms.Berloff made a motion to GRANT the variance for the lack of vertical access to the balcony,on the condition that there be a written policy that the balcony is used for overflow seating only with the policy to be submitted upon receipt of the Decision of the Board,noting that her decision was based on the historical significance of this space. The motion was seconded by Ms.Diane McLeod and carried unanimously upon a vote from the Board. The next variance request was in regards to the pulpit. Mr.Pellegrini stated that the pulpit is approximately four feet above the church floor,and that due to the construction the only means of access would be a vertical wheelchair lift. He added that the lectern located at the altar was more frequently used than the pulpit and was accessible. Ms.Deborah Putnam stated that the smaller lectern was often used for many of the ceremonies and services held in the church,adding that they are also currently using a portable lectern in the space that they are leasing and are proposing to use it at the renovated church. Ms. Berloff then made a motion to GRANT the variance requested for the lack of access to the existing historic pulpit,based on the historic significance of the structure. The motion was seconded by Ms. Angney and carried unanimously upon a vote from the Board. Mr. Pellegrini then presented the variance request for the lack of access between the two levels of the religious education portion of the church. He reiterated that the church would like to raise the entire area and build a new religious education building,adding that the accessible walkway will be at the exterior to create a means of access between the lower and upper levels of the religious education section, as well as creating a means of access from the main sanctuary to the lower level religious education area of the building. Ms.Angney asked for clarification that a person located on the accessible lower level of the religious education area would have to exit the building and reenter at the upper level to access the bathrooms,which Mr. Pellegrini verified was correct. Ms.Angney then questioned when the religious education portion of the building was built,to which Mr. Pellegrini clarified that this portion of the building was constructed in the 1950's. Ms. Angney then asked if the petitioners had looked at an exterior means of vertical access. Mr. Pellegrini stated that this was probably restricted by the Preservation Restriction which was put on the building. Mr.Torrey stated that it was a Historical Restriction due to the building's historic nature, clarifying that the only portion of the church that was preserved historically was the main area of the church. He added that the Church is proposing to create a new religious education facility in Phase 2 of the construction which will begin once the proper funding is achieved. Mr. Pellegrini clarified that the church therefore did not look at an exterior lift. Mr. Torrey noted that a similar means of exterior access was reviewed but found to be infeasible due to the cost being beyond the budget of the church. At this point,Ms.Angney made a motion to CONTINUE this matter regarding the lack of vertical access between the two Ievels of the religious education portion of the church so that the petitioners may submit cost estimates for a lift to access the two levels. Mr.Pellegrini stated that the vertical wheelchair lift was estimated at$120,000, noting that this cost was shown in the original submittal of the variance application. He added that the work to create a fully accessible religious education area would most likely be completed within the next ten years. Ms. Gail Forsyth-Vail added that as the Director of the Religious Education for the church,the policy would be to move any students that were in need of accessible features to the accessible level of the religious education area. At this point,Ms.Anguey withdrew her motion. Mr.Ebel then made a motion to DENYthe variance for lack of vertical access between the two levels of the religious education center,but GWANT a I0 year variance to the Church to bring this religious education center into full compliance with Section 20 and 28 of 521 CMR,therefore allowing until October 31,2016,noting that the Board should be made aware of any upgrades to this 3 portion of the church when they are planned. The motion was seconded by Ms.Berloff and carried unanimously upon a vote from the Board. The next variance request was in regards to the lack of compliant countertop height in the existing kitchen. N r. Pellegrini stated that the existing countertop is 3 inches above the maximum required height of 34 inches. Ms. Berloff asked if the kitchen was part of the religious education center,to which Mr.Pellegrini responded that it was not located in the religious education center,but directly adjacent to the parish hall in the existing church building. Ms.Berloff then asked if there was any alternative proposed for an accessible space within the kitchen. Ms. Putnam stated that they were proposing to make both sinks at the center have the required knee space and build a lower counter adjacent to the stove,where a temporary shelving unit is currently located. Ms. Berloff stated that based on Ms.Putnam's testimony,she would make a motion to GRANT the noncompliant countertop heights in the kitchen. The motion was seconded by Ms.Angney and carried unanimously upon a vote from the Board. Mr.Pellegrini then presented the variance request for the doorways at the upper level of the religious education center,stating that all of the existing doorways are 32 inches wide measured from door j am to door j am, resulting in a violation of Section 26.5 of 521 CMR which requires a clear width of not less than 32 inches. He added that all of the doorways in the other areas of the church will have the compliant clear width opening. Upon further review of the request,Mr.Ebel made a motion to DENYthe variance requested for the lack of clear width at the doorways at the upper level of the religious education center,but GRANT a 10 year variance to the Church to bring this religious education center into full compliance with Section 26 of 521 CMR,therefore allowing until October 31,2016,noting that the Board should be made aware of any upgrades to this portion of the church when they are planned. This motion was seconded by Ms.Berloff and carried unanimously upon a vote from the Board. The final variance that was being requested was in regards to the lack of compliant stairways in the existing buildings. Mr.Pellegrini stated that the Church was WITHDRAWING this variance request since they planned to bring all of the stairways within the facility into full compliance with Section 27 of 521 CMR. A true copy attests: This constitutes a final order of the Architectural Access Board entered pursuant to G.L. e. 30A. Any aggrieved person may appeal this decision to the Superior Court of the-Commonwealth of Massachusetts pursuant to Section 14 of G.L.c.30A. Any appeal must be filed in court no later than thirty(30)days of receipt of this decision. DATE: October 31, 2006 ARCHITECTURAL ACCESS BOARD cc: Local Building Inspector derald LeBlanc,Chairman Commission on Disability Independent Living Center 4 o1sH2ss2312s- ���el.lalllw $00.690 0.Q1/d _6M -✓L -j.3 0 R 12/03/2014 ,/� Mailed From 02108 aalar�, /�aaaactu.�eff.0208 —-- — US POSTAGE D. Robert Nicetta Inspector of Buildings 120 Main Street North Andover, MA 01845 ® wt iM:,�s =• ,i:)i11, Jjflloll,till„ _�1�„iti3�ltlt�,ii,�ll�'I'�'�'I111'}�il 50%RECYCLED PAPER -3D%POST-CONSUMER i I 4- � North Andover Board of Assessors Public Access Page 1 of 1 NORTH North handover Board of Assessors OF♦ • ♦'s f t.�roperty Record Card Click Seal To Return Parcel ID:210/096.0-0072-0000.0 FY:2013 Community :North Andover SKETCH PHOTO Click on Sketch to Enlarge Search for Parcels i Search for Sales No c rI Summary Available Residence Detached Structure Condo Commercial Location: 190 ACADEMY ROAD j Owner Name: NORTH PARISH CHURCH OF NORTH ANDOVER Owner Address: ACADEMY ROAD City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 7-7 Land Area: 0.52 acres Use Code: 906-CHURCH-PROP Total Finished Area: 11652 sgft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 1,138,900 1,106,300 Building Value: 922,200 891,300 Land Value: 216,700 215,000 Market Land Value: 216,700 Chapter Land Value: LATEST SALE Sale Price: 0 Sale Date: 01/01/1000 Arms Length Sale Code: N-NO-OTHER Grantor: Cert Doc: Book: Page: http://csc-ma.us/PROPAPP/display.do?linkld=2256053&town=NandoverPubAcc 3/19/2013 Commercial Property Record Card PARCEL ID:210/096.0-0072-0000.0 MAP:096.0 BLOCK:0072 LOT:0000.0 PARCEL ADDRESS:190 ACADEMY ROAD FY:2013 PARCEL INFORMATION Use-Code: 906Sale Price: 0 Book: Road Type: T Inspect Date: 03/17/2005 Tax Class: E Sale Date: 01/01/00 Page: _ Rd Condition: P Meas Date: •63/17/2005 Owner: - 6-52F �.__,•. - - a --- -.._ NORTH PARISH CHURCH OF Tot Fm Area: _ 11Sale Type: Cert/Doc: Traffic: M� Entrance _ X NORTH ANDOVER Tot Land Area 0.52 Sale Valid: N W _ _ Water. Collect Id RRC Sewer: Grantor: Inspect Reas: C Address: - _ _._ _ a _ -_ ACADEMY ROAD Exempt-B/L% / Resid-B/L%/ Comm-B/LP/o Indust-131% / Open Sp-B/L% / NORTH ANDOVER MA 01845 COMMERCIAL SECTIONS/GROUPS LAND INFORMATION Section: ID: 101 Use-Code:906 NBHD CODE: 7 NBHD CLASS: 7 ZONE: R3 """Story - Se T e Code. Method- $�Ff Acres - Influ Y%NValue Class Category -Gond-Fl-Area Height Bldg-Class Yr Built �"-Eff-Yr-Built�CosfBldg 6 4880 1.0 D 1800- 1978 808,400' " 1 P 906 S 225000.520 � 216,677 R _ Groups: VALUATION INFORMATION Id Cd B-FL-A Firs Unt Current Total: 1,138,900 Bldg: 922,200 Land: 216,700 MktLnd: 216,700 1 906 4880 1 1 Prior Total: 1,106,300 Bldg: 891,300 Land: 215,000 MktLnd: 215,000 2 906 4880 1 1 Section: ID: 102 Use-Code:906 Category Grnd-FI-Area Story Height Bldg-Class Yr Built W Eff-Yr Builfeost Bldg 6 1892 2.0 D 1800 1978 113,800 Groups: Id Cd B-FL-A Firs Unt 1 906 1892 1 1 SKETCH PHOTO in M q.Ft 44 44 N r`aicture '. 2671 S9.Ft 27 C;74 A b I ffig t - - - - 90 .90 10 Parcel ID:210/096.0-0072-0000.0 as of 3/19/13 Page 1 of 1 Date.0.. ....._�tq............. o'erOnr#i yyo�aN4tioom TOWN OF NORTH ANDOVER PERMIT FOR WIRING ss�cNUS� l � This certifies that ...... ...........�A.K6...1!`h.�� t P t•tP... .................... .. ............ has permission to perform�.Q--,.)..........✓ .... wiring in the building of..........c?61` E at ....�.....�.. ...... .......... 1. ��...... ...'................. . N rth Andover,M ss. { Fee....l. .�'? .....Lic.No. 1 ... ..... ....... ................ ELECTRICAL INSPECTOR Check# `E � 7 11 Commonwealth of Massachusetts Official Use Only o Department of Fire Services Permit No. 17A �, Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/071 ileaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASEPRINTWINK OR TYPE ALL INFORMATION) Date: /O - 2/. /y City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) /q 0 Aca de rn 'Rd. ICY Owner or Tenant e Nor 7A Parl'-r,6 o F )Va,A 14h 010Ver Telephone No. Owner's Address $G m C Is this permit in conjunction with abuilding permit? Yes ❑ No ®� (Check Appropriate Box) Purpose of Building P))611^C/`7 11)FE('I-S Utility Authorization No. _ Existing Service Amps Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: /a)l r;AO 1`o,- ne-to Gas %)) Completion of the following tab e may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans TransTotal Trsformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA - ,� Above In- o.o mergency ig ting +1 No.of Luminaires Swimming Pool Md. Elrnd. El Battery Units M No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump NumberI Tons I KW No.of Self-Contained Totals: ""I *" * -I----- Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal [IOther Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent t OTHER: Attach additional detail if desired,or as required by the Inspector of 97res. " Estimated Value of Electrical Work: f D 0 D, y v (When required by municipal policy.) Work to Start: l4.a,) .1' 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 thepermit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and enalties q f"perjury,that the information on this application is true and complete. FIRM NAME: fi d�b 17 Ce. LIC.NO.: A)!l/8 a 4 Licensee: �)o6P�i- A. SuraAJskt" Signature y LIC.NO.: Fol 0/ I (If applicable,enter "exempt"in the license numb line Bus.Tel.No.• q7 S87 d 35.E Address: lS n/'c/ —Tr r-, Yea e OY.. M .9. 60 Alt.Tel.No..228 A ,3.67 *Per M.G. c. 147,s.57-61,security work requires Dep rtment 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)❑owner ❑owner's agent. Owner/Agent PERMIT FEE:$ SignatureturaTelephone No. ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance with the provisions of M.G.L.c.143,§3L,the r permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§ 32,an electrical permit shall be issued to the person,firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall.be limited as to the time of ongoing construction activity,and may be deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending through August 15,2012. ❑ Rule 8—Permit/Date Closed: ***Note:Reapply for new permit ❑ ❑Permit Extension Act—Permit/Date Closed: Trench Inspection Pass Failed❑' Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass Failed 0 Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass M Failed Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INSPECTION: Pass 0 Failed Re-Inspection Required($.) ❑ Inspectors Comments: N� Inspectors Signature: Date: FINAL INSPECTION: Pass 0 Failed Re-Inspection Required($.) ❑ Inspectors Comm s: Inspectors Signature: ate: DEB WEINHOLD ...TOWN OF MERRIMAC,MA. .......d i hold@townofinerrimac.com The Commonwealth of Massachusetts . - Devai tment oflndusftigrAccidiints Office ofInvestigaflons 600 Washington Street Roston,MA 02111 -www.mass.gov/dia Workers' Compensation.Jaisurance Affidavit:Builders/Cony°actor6/E1ectricxans/Plibmbers Applicant Information Please Print Led-Y Name(Business/Organization/.tndtvidual):�L6Prt il S(jqWS j�i Dt3,4 Ih Vai)Ce� rCtr/(Q.` .�1G(sremf Address: �� 7in/PTerrace rrace ✓' dl Q60 Phone#: On) ?a l..36 ) Are you an employer?Check the appropriate box: Type of project(required): 1.C] I am a er with employer 4• ❑ a g I am general contractor and I ' p y 6, ❑New construction ployees(full and/or part lime).* have Hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet �• F1 Remodeling ship and'haveno.employees These sub-contractors have 8. []Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition, [No workers'comp.insurance 5. [] We are a corporation and its 10.❑Electricalrepairs or additions required.] officers have exercised.their 3.❑ I am a homeowner doing allworlt right of exemption.per MGL 1111 Plumbingrepairs or additions myself.[No workers'comp. c.152,§1(4),and we have no 12.❑Roofrepairs insurancerequired.]i employees.[No workers' 1311Other comp.insurance required.] xAnyapplicantthatchecks box#I must also fill out thesectionbelowshowiagtheir- Porkers'compensatioapolicyinformation. �'Horneowners who submit Phis affidavit indicatingthey ki doing all work and then hire outside contractors must submit a new affidavit indicating such. iContractors that checktbis box must attached m additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an emyroyer that isp�ovidirzg workers'compensation insurance for•my employees Below is the pokey and job site info;�mation. Insurance Company Name: Policy 4 or Self-ins.Lie.ff: Expiration Date: Job Site Address: City%State/zip: Attach a copy of the workers'comp ensation p olicy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A ofMGL o.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 statementmay be forwardedto the Office of Investigations ofthe DIA-for insurance coverage verification. I do Xrereby ce t under the pains and penalties ofperjury that Phe information provided above Is true and correct signature' /�N � � Date: /0 a/. /y Phone#:(ITA 19011. 301 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Autlicrity(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other ContactPerson: Phone ff: 4 A Information and.Instrnctions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an ernployee is defined as"...every person iu the service of another under any contract of like,- express or implied,oral or written." An employei is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a j oint 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 Douse 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 p ermit to op orate 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 ofits political subdivisions shall enter into any contract for the performance ofpublic 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 completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),addresses)and phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(ILP)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. Deadvised that this' affidavit may besubmitted tothe Department of Industrial Accidents fox 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,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensationpolicy,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 andprinted 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 submitmultiple permit/licome applications in any given year,need only submit one affidavit indicating current PORGY information.(ifnecessary)and under"lob 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-ii on file for future Hermits or licenses. A.new affidavit must b e filled out each year,'Where a home owner or citizen is obtaining a license ox permit not related to any business or commercial venture Q.e,a dog license orliermit to burn 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 CaMMOuw.ealth of MID - Depat(aeA.# Ac01dallts oface 0fl*esliga-Qox3 600 WaMagtm Saxe-et Boston, 02111 �4 00 e 40C Qx x-g :MS Revised 5-26-05 Fay,9 617-72'1-7749 I I COMMONWEALTH OF MASSACHUSETTS e o • - o o B'Ok..,P+Df is f ISSU.E;S. T.HE FOLLOWING '°LICENSE AS A REG JOURNEYMAN ELE.CTRICI;AN r l ROSERT A SURAWSK I 1 15 DAN FEC P;EABODY I�IC C]960-620 20o E o7/365 i1r6032 COMMONWEALTH OF MASSACHUSETTS; BOARD fyF E imiCIANS SSUES ,THE FOLLOWING L.IGENSE REGISTERtD MASTER ELECTRI AN - R.pSERT A SURAWSKI l'5 DAN SEL TE RRA CEI P,E i30DY J4 oi960 6207 i482g A 0 %31F� 6 0 10813 TOWN OF NORTH ANDOVER ° p PERMIT FOR PLUMBING 88,�CMU46 This certifies that.L:C . . ......... ...e ` ' 1 !. ...... ......... ...C .,. ............ 4 has permission to perform. �Y:}a:�:.:.... �.................. plumbing in the buildings of ,.,... „t....... �! :�!^-........ at.A<..O.�Mi!!f nv.... ..:......................,North Andover,Mass. Fee .�..........Lic.No. }�.�. ... ................................................................. PLUMBING INSPECTOR Check# ' �7&Zif!� MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY _ ort -- An over_ MA DATE 10/21/14j PERMIT# I b JOBSITEADDRESS 1190 Academy Road OWNER'S NAME orth Parish Church .... POWNER ADDRESS 190 Academy Road �j TEL 978-8525033 FAX -i TYPE OR OCCUPANCY TYPE COMMERCIAL El EDUCATIONAL El RESIDENTIAL PRINT CLEARLY NEW:0 RENOVATION:CD REPLACEMENT:ffj PLANS SUBMITTED: YES D NOM FIXTURES Z FLOOR--r BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB .--- CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GASIOIUSANDSYSTEM _ J - __i _._. I DEDICATED GREASE SYSTEM ---.._.J _.._...I DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN _...__I .._._. _I __._-J I ..._._._. .. _._.I . _-- ...... ..J INTERCEPTOR INTERIOR _..__..._i ...............' ......_._.-_ ----- r: ..__..__._... __.___.-- --._._.. J .....__..I _....__I .__...._._._i' KITCHENSINK I _..._._-- _—J _...-- .._l ..._..._._- _-- ..-_____I _._._._ ._.__.-_..J .,.___.._..l .__...-__I .-- __I LAVATORY ROOF DRAIN EE SHOWER STALL i SERVICE I MOP SINK TOILET J l J .—_J _._.._ URINAL I WASHING MACHINE CONNECTION i — WATER HEATER ALL TYPES WATER PIPING -- - — - i OTHER _1.1 . . ._._.1 ....... ...... .... ....._.__ 1 ...__._.I ____-_. _ f _ J _ .. ....I INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES xI NO []1 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY BOND 0 OWNER'S INSURANCE WAIVER:II am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER 0 AGENT 0 SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application wi11 be in mpliance with all e ent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General laws. PLUMBER'S NAME Larry O'Keefe LICENSE# -10492 RE MPO JPD CORPORATION�X # 2047 PARTNERSHIPL�#r- ._... . _j LLC 0# .. COMPANY NAME C'Keefe Plumbing & Heat 1AQDRESS 56 Pulaski St Unit 9 ole 13� CITY Peabody STATE ��ZIP 01960 TEL L8-762-7622 FAF�78`-560 �H978-3�`02 IL (�laarry@okeefeplumbing.com I Date................................................. OF r►ORTM,� TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION A0 6 , �,c (-4fThis certifies that . .t:...- !.Ux�e- ... ............................. has permission for`gas installation ......._V�.:P�-........................................ in the buildings of A.......VA z .-2," ....n,,L C �--- ............................................. at........1..5�...�.... .. e P,.........:e d:.............. North Andover, Mass. Fee.. .�U.. Lic. No. .................. ..!.:1'�..'.......................................................... GASINSPECTOR Check#� 9610-? z(,As MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY or AnCover MA DATE10 21 14 PERMIT#—IU( b(;' JOBSITEADDRESS1190 AcaEemy Road OWNER'S NAME North_P_-a T-1-s-F-C h GOWNERADDRESS 190 Academy R o ad TE 97 = 5- __17 FAX TYPE NT OR OCCUPANCY TYPE COMMERCIAL[A EDUCATIONAL RESIDENTIAL PRI CLEARLY NEW: RENOVATION:El REPLACEMENT., PLANS SUBMITTED: YES 0 NOW APPLIANCES I FLOORS BSM 1 2 3 4 5 8 7 8 9 10 11 12 13 14 BOIL BOOSTER J CONVERSION BURNER I ------ -------- COOKSTOVE DIRECT VENT HEATER DRYER FIREPLACE —11 LJ E71 L_ L__J FRYOLATOR FURNACE GENERATOR GRILLE F=I --. ] INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM I SPACE HEATER ROOF TOP UNIT TEST .....--------IF J J UNIT HEATER t. J[7-1. LINVENTED ROOM HEATER F___1 F7_1 F-_ -A I WATER HEATER OTHER117-1 71 F771 INSURANCE COVERAGE I have a current liability Insurance policy or Its substantial equivalent which meets the requirements of MOL.Ch.142 YES EX]NO nj I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY M;S] OTHER TYPE INDEMNITY 07 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: OWNER F]J AGENT SIGNATURE OF OWNER OR AGENT -- hereby certify that all of the details and Information I have submitted or entered regarding this application are true and accurate to the b esof my knowledge and that all plumbing work and Installations performed under the permit Issued for this application Will be In co liancewith ail Pe7rt�entlrvision ofthe Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME Larry 0'7Keefe LICENSE#110 921 siCNATP� MP F] MGF JP 0 JGF[j LPGI CORPORATION W# 2 04 7 PARTNERSHIP[j#L_ LLC[.]jJ#F____ COMPANY NAME: AWRESS T67Pulaski St Unit 9 --------------------------- CITY I-P'6abody Da- ZIPJ_ TEL 2 STATE 76 FAXF978-_560-5hLELL978-3d2-1larry@okeefeplumbing.com IL A/ g��l�JPi �� 4�COMMONWEALTH OF MASSAOHUSETTS o e o -o e " BOARD; F PLUMBERS "A 'D -GAS F I TIERS <: ISSUES.THE FOLLOWING L'1 CENSE REGA S71=RED AS A PLUMB I N0CORP Al�tREN CE P OKEE>'E ?rr1, .: .. t11�EEF`E P19 :� 1{TG INC M.104�2 �� 4/1 ;f• �� a Ul ST 56 PULAS UNIT J I«AIsoDYMA 01960-1830 204 05/01/ 6.. 204718 COMMONWEALTH OF MASSACHUSE7 TS. BOARD:OF FLUMBEKt .AH1.1 GAS FITTERS <' ISSUES THE FOLLOWING"LIiGEN E L I C1 NSE1) A5 A MASTER P{�U1MB'E,R LAWRACE P OKEEF'C �' Lq iz 18 WILDWOOD RD ��4f kRERS01923-1754 44Az 1042 ,.. 05/01/.I.6 204532 +rOMMONWEALTH OF.MASSACHUSETTS BOARD:OF " PLUMBE}'t5; AN13 GASF.1 ITERS ISSUES THE FOLLOWII+jG LICENSE L 1"UD AS A JOURNEYMAN Rb%lf R L AWR E:V CE P OKE E 'E r` n r 18 W1.L DWOOti RO tj A1�kU1S M1 01923-17 19987 05/01I <6. 204531 The Commonwealth of Massachusetts _Print Form Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 4 U1 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): O'Keefe Plumbing&Heating,Inc. Address: 56 Pulaski St. City/State/Zip:Peabody, MA 01960 Phone #: 978-762-7622 Are you an employer? Check the appropriate box: Type of project(required): 1.Rl I am a employer with 19 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees and have workers' y9. ❑ Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site information. EastGuard Insurance Company Insurance Company Name: Policy#or Self-ins.Lic.#: OKWC516099 Expiration Date: 5/11/2015 Job Site Address:190 Academy Rd City/State/Zip:N.Andover, MA 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 Si nature: Date: 10/21/2014 Phone#: 978-762-7622 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: 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 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-contractor(s)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,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 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 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 burn 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 Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax 4 617-727-7749 www.mass.gov/dia ,4c o® CERTIFICATE OF LIABILITY INSURANCE D21E201 /DD/YYYY) 5/12/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. #IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Gerry McDonald McSweeney&Ricci Insurance PHONE 781-B48-860 (FAX X No:7 1-84 - 07 420 Washington Street JAIC E-MAIL P.O. Box 850984 ADDRESS: r Braintree MA 02185 INSURERS AFFORDING COVERAGE _ NAIC# _ INSURERA:INSURED OKEEF-1 INSURERS: and Insurance Group O'Keefe Plumbing&Heating Inc INSURER C: 56 Pulaski Street-Unit 9 INSURER D: Peabody MA 01960 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:172636032 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE NSR WVD POLICY NUMBER ADDLSIJBR MM/DDIYYYYY POLICY/YY P LIMITS A GENERAL LIABILITY CBP8407438 /11/2014 /11/2015 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PRETED REM SAGE ESOEa occurrence $100,000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY X PRO- LOC $ A AUTOMOBILE LIABILITY BA8407738 /11/2014 /11/2015 Ea accident $1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY Per accident $. AUTOS AUTOS ( ) X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident A X UMBRELLA LIAB OCCUR CU8402139 /11/2014 /11/2015 EACH OCCURRENCE $5,000,000 EXCESS UAB HxCLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$10,000 $ B WORKERS COMPENSATION KWC413134 /11/2014 /11/2015 X I SSTATU- I DTH- AND EMPLOYERS'LIABILITY Y I NLIM ER ANY PROPRIETOR/PARTNE OFFICER/MEMBER EXCLUDED9 R/EXN❑ N/A ECUTIVE E.L.EACH ACCIDENT $1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 Ifyes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 A Property CBP8407438 /11/2014 /11/2015 Equipment I I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Sample Certificate CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Sample Certificate ACCORDANCE WITH THE POLICY PROVISIONS. •' AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 10676 Date..q.s/!y...... TOWN OF NORTH ANDOVER oar�, `` •• 09 PERMIT FOR PLUMBING 7 01'�l� /� n 1 This certifies that jI.(�......1,,...a t!,.,p ,iY.zsf3P ` G Q"'� has permission to perform...�..!..� c r ...�:�1. ! ...... .-f ... °P plumbing iT.n.�f�nft buildings of ..... �. ..... .......�`^.......�.. _- at.�C, .....1)................. .....��..j.:......................, North Andover, Mass. Fee..w�.........Lic. No.1.�'..... M ................................................................................. PLUMBING INSPECTOR Check# ��3Z MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK e U�D] - CITY _.__. Ver _ � MA DATE � / �PERMIT# JOBSITE ADDRESS 1/9 C) aQ, 2►►'/ ,` NE OWR'S NAME POWNERADDRESS TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL ✓ EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION:,„ REPLACEMENT:Ej PLANS SUBMITTED: YES F74 NO FIXTURES-1 FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB I :. 1: L _ CROSS CONNECTION DEVICE -- DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OILISAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM € , s DEDICATED WATER RECYCLE SYSTEM I.._ DISHWASHER -- - -- , DRINKING FOUNTAIN ===F-- FOOD .. � ,,;��! FOOD DISPOSER I y' t _ 1 FLOOR/AREA DRAIN ; 3 INTERCEPTOR(INTERIOR) KITCHEN SINK " LAVATORY _ .. ROOF `... ROOF DRAIN . - - I SHOWER STALL SERVICE/MOP SINK ( TOILET URINAL ! ��I_ i WASHING MACHINE CONNECTION �_.. ......... : WATER HEATER ALL TYPES �) WATER PIPING �1{ .' OTHER ! ` £3 I w- 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 CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW 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: OWNER L l AGENT D SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be incom n with all rtinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME 11_ �rnRpnRATION LICENSE# _ O SIGNATURE Mp[ , JP j� ARTNERSHIPL]# LLC # COMPANY NAME J. � C ADDRESS CITY c Rte,r(. - _STATE ZIP ��I-1 .7 — TEL 11 FAX CELL EMAIL all r,0 JCJ ej I r�'Wzpfl-�. C .� ?(A,2 Date......... .................... NQwrh r TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION o �s�cMusE This certifies that .. ...................................... ....................................................................... has permission for gas installation . oZ. P ...................................... in the buildings ofW�!.�:'... u" �- .............................................................................. at....:nv... ��.:.................... North Andover, Mass. Q,rv, ..... ............ ................ Fee.�AD....... Lic. No. .........�'�... ........�................................................. c GASINSPECTOR Check 04. 63 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK 0 6 . IO y� CITY 61C. .. «.� 1) r.: ,r MA DATE PERMIT# o1 I `r llr i JOBSITE ADDRESS c OWNER'S NAME QI! •" G OWNER ADDRESS I TELA FAX' TYPE OR PRINT OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL CLEARLY NEW: . .. RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES I NO APPLIANCES 7 FLOORS— BSM 1 2 3 4 5 6 7 6 9 10 11 12 13 14 BOILER _. I E BOOSTER CONVERSION BURNER ., W_ COOK STOVE DIRECT VENT HEATER I DRYER iI FIREPLACE FRYOLATOR m ' FURNACE g� GENERATOR _ tl m� I GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN k' m _ o- 1 POOL HEATER ROOM/SPACE HEATERm ROOF TOP UNIT ` € .7-1 TEST UNV NTED ROOM HEATER WATER HEATER , OTHER I _ _ _. .. I t t jt 7-1 _ ,v. E INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YESj NO I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW i LIABILITY INSURANCE POLICY jj OTHER TYPE 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. CHECKONEONLY: OWNER AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compli with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBE -GASFITTER NAME� J= ��yL -ENSE#� SIGN URE MP MGF [ JGF[j, LPGI CORPORATION ow, – PARTNERSHIP . # LLC # COMPANY NAME: ! �I mC- ADDRESS CITY ✓b V �� STATE 050 ZIP TEL FAX CELL EMAIL I i BQAftQ�F ._ PLUMBEtS` ANq GASF IT°TERS fSSUE„S.THE FOLLOWING -LICENSE IIII L 1 LENS V As.,A. 4.0URN 1MAN!PL�IM9ER JOSEPH P CAMPBELL {y 60 FULLER POND .DR W 1I DOLETON ISA '01949 2507 1761 05/Q1/11:6 247329 { i:COMMONW 1Tl OF M '.S�tCHUS S , OMMONWEALTH OF MJIISSACHUSETTS : <: 40A1gI?OF ei0AF1P QF PLUMBERS AND GASFITTE*,RS PLUMB06:4NO GASFITTECtS ISSUES..THE FOLLOWG LICENSE; S ISSUETHE FOLLOWING' LIC INENSE LtCENSE'D AS A MASER,PUMBEI2"� ft'EGISERED AS A- P:LUMBt*NG�CORP JIISEPH P CAMPBELL ' ,,, 1 JOSEPH P CAMPBELL a - � �' 1. J`P CAMPBELL1_ INC MP 9050 �. by � = f POND Rp 60 FULLER POND Rp 60 FULL R" MibQLETON MA 01949 .2507 MIi3ULfTQN �fiA o 1949 2507 gR0 Q�/0 /16 2470; ) 0;!7 . ;'13627, 179.2 0'S/ Department of P lic Safety One Ashburton Place, Rm 1301 Boston, Ma 02108-1618 Commonwealth of Massachusetts �f Department of Public Safety Restricted To: 00 Sprinkler Contractor License: SC-002280 JOSEPH P CAMPBELL 69 ELM STREE 1F` s DANVERS MA 181923 y Tr.no: 653.0 Expiration: Keep top for receipt and change of address notifi Commissioner 03/15/2015 1 STATE EXAMINERS OF 'sem a PLUMBERS AND GAS FITTERS Certificate of a Plumbing Corporation This is to certify that eek Joseph P. Campbell Master License Number 9050 � Is duly granted a Certificate of a Plumbing Corporation authorizing him to conduct this plumbing business as an officer of J.P. Campbell, Inc ' Organized under the laws of the Commoq`a: • • • • • Massachusetts to engage in the business ; ,. rj I.SSI)ES THE bI I t1 Y1 EC 5'*9 Certificate No. 3127 C r7- Date of Issue 9/16/2009 khleluso. Jos Jr., Exec J ; � C11"# t 5[Ff4 fY '� State Examiners of Plum[ '61t<lLiEl #i Expiration Date 5/1/2010 ry �2....w5(,k� s. � MR. Nil ryr y rk xm.a t� v o Town of x NORTH ANDOVER CHOSYt PLUMBING PERMIT FEES - Fees adopted by the Board of Selectmen: 6-24-2002 Effective: 7-1-2002 I�I 1. Rate Schedule For New Building,Additions and Alterations(Residential,Commercial or Industrial &Education) 1/10th of 1.5%of the estimate(' cost of construction or the minimum fee,whichever is greater. 2. Residential (One(1)permit per building/unit required) `1 (2) Minimum Fee i Single Dwelling $55.00 Fl$S SOxture Fee ti l Single Dwelling—Renovation to Existing 25.00 5.50ea. Single Dwelling—Addition 25.00 5.50 ea. { �1 Condominium/Townhouse-Unit45.00 5.50 ea. Replacement of Existing Fixtures Only 30.00 2.50 ea. Reinspection Fee $30.00 ea. r ' 3. Commercial&Industrial (One(1)permit per building/unit required) Minimum Fee. Fixture Fee , Large.Building $175.00 $S.SO ea. Large or Small Building Divided into Store 1 Office,Manufacturing Units,etc. 85.00 5.50 ea. Additions,Renovations 85.00 5.50 ea. Reinspection Fee $30.00 ea. (per trip) 4.` Miscellaneous Fees (�� Minimum Fee 1 Electric or Gas Hot Water Heaters C61-5 22- (Plumbing Replacement Only) $30.00 ea.' Residential Backflow Preventers (Lawn Sprinkler&Sprinkler Head for Boiler(s) 25.00 ea. Commercial Backflow Preventers 60.00 ea. Capped Sewer Lines for Demolition 30.00 ea. Reinspection Fee fol'Miscellaneous Work Special Fees 30.00 ea.(per trip) " ° 5. , Repair and Maintenance Permit(for condominium (s) townhouse(s),commercial,Industrial and educational), up to two(° plumbers(must have licensed plumber on staff). $250.00 per quarter. + Log must be kept for inspection when permit is renewed each quarter or as requested by the Plumbing'Inspector. Other fees, if not listed,to be determined by the Plumbing Inspector and shall not exceed$250.00. The applicable fee will dole when work begins without the proper Plumbing Permit. j 'N wcNus TOWN OF NORTH ANDOVER LP&GAS PERMIT FEES C t' Fees adopted by the Board of Selectmen: 6-24-2002 ,Effective 7-1-2002 + 1. Rate schedule for U i� New Building,Additions and Alterations(Residential,commercial or Industrial&Education) 1/10th of 1.5%of the estimated Ct cost. 2. Residential(One(1)permit per buildinglunit required) Minimum Fee Fixture Fee New Single Dwelling 1 up to 3 appliances $25.00 $5.50 New Single Dwelling-4 Appliances or more 55.00 }. j Single Family Renovation 5.50 ea: 25.00 5.50 ea. II Residential Replacement of Existing Appliances only 25.00 Replacement of Water Heater 5.50 ea 20.00 Residential Gas Boiler Replacement and Conversion Burner 30.00 Reinspection Fee 30.00 ea.(per trip) 3. Commercial&Industrial(One(1)permit per building/unit required) I New Commercial IndustrialMinimum Fee Fixture Fee,Educational Buildings 00 $5.50 ea. $80. Renovation,Commercial,Industrial,Education Buildings 5 0.0 5.50 ea. Replacement of Existing Fixtures 20.00 5.50 ea. ff Commercial Gas Boiler Replacement and Conversion Burners 55.00 I �� Reinspection Fee 30.00(pre trip) .4. Miscellaneous Fee Remodeling of Gas Piping-Residential Minimum Fee Remodeling of Gas Piping-Small Commercial $30.00 (per unit) 80.00 Swimming Pool Heater 20.00 Temporary Heater 35.00 L.P.Gas Installation Permit 35.00 i Roof Type Heat and Air Conditioner Units Up to 25 tons 35.00 Over 25 tons 6.50 per ea.ton Air Conditions Up to 25 tons 35.00 Over 25 tons 6.50 per ea.ton 5• Special Fees i Repair and Maintenance Permit(for condominium(s)Townhouse(s)Commercial,Industrial and Educational),up to two(2) . Plum (must have licensed plumber on staff). $250.00 per quarter. r, Log must be kept for inspection when permit is renewed each quarter or as requested by the Plumbing Inspector. Other fees,if not 1.listed,to be determined by the Plumbing Inspector and shall not exceed$250.00. /, The applicable fees will ' n o ble when work begins without the proper Plumbing Permit. 1 f 712,1l� Town of North Andover Your permit has been sent back to you for the following reasons: q 1) Check amount incorrect 2) No copy of current license (�-A j 3) Insurance Binder not on file o expired (� 9. 4) No Workers' Compensation Insu nce Affadavit Form Please call with any questions 978-688-9545. 1 Workers' Compensation Form and Schedule of Fees can be found on the Town of North Andover Website under Building Department. Date..5.h .......... 10524 TOWN OF NORTH ANDOVER 0 PERMIT FOR PLUMBING This certifies t at..................------------0................................. has permission to p o .....6&11 A-) 1+1 k,L plumbing in the Puildings of .0 )J . ................................................. vv\. k at.........1 10 /\ A North Andover, Mass. .............................................................V.............................. Feed.1' .LH Lic. No. ..... ...4.�......... .................................................................... ........ PLUMBING INSPECTOR Check# A0 2)� G) -a MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ,WK CITY .&t4h 1qn4oV1ti_r MA DATE PERMIT# OBSITEADDRESS! z. � OWNERSNAMEObZ(/ '5-6-L.h.U. CIL OWNER ADDRESS TELZ FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW:[.� RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES N, FIXTURES 1 FLOOR— ESM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE ............ T DEDICATED SPECIAL WASTE SYSTEM ............ DEDICATED GAS/OIL/SAND SYSTEM L DEDICATED GREASE SYSTEMA j. ............ .............. DEDICATED GRAY WATER SYSTEM .................... ........... . ......... ....... ........ ..................... ............ DEDICATED WATER RECYCLE SYSTEM ...... IT ............ ..................... .......... .............. .............. ............ 711 I .:nn A .................... .............. DISHWASHER ............ ... ....... ............... ---------- DRINKING FOUNTAIN ....... ............. ................ .................. FOOD DISPOSER Al ............. ..................... T--------7 ................... FLOOR/AREA DRAIN .......... .................... ............ 7 INTERCEPTOR(INTERIOR) ............... KITCHEN SINK ............... ............. .... ................. LAVATORY .................... .................. ................ .......... ROOF DRAIN ....................... ............ .......... ........... SHOWER STALL ............. .................. ............ ........... SERVICE/MOP SINK 7;.............. —7 .............. TOILET ........... .................. .......... ................. ............ .......... URINAL ............. ............ WASHING MACHINE CONNECTION Ix ........... ................. ................ V WATER HEATER ALL TYPES .................. ..... WATER PIPING 7 OTHER ................. .............. .................... A .......... .................. ............. ............. ....... ....... ........... ........... ............... .................. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES c NO IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY R�;K OTHER TYPE OF INDEMNITY BOND OWNERS INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER I AGENT SIGNATURE OF OWNER OR AGENT 7—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 com an with all rtinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME )"Wn LICENSE# V SIGNATORV�' ip CORPORATIO MF N T!_FARTNERSHIP0# LLC E:-,#7 ................... COMPANY NAME ADDRESS 1--j.n-1—L CITY TEL STATE ZIP —_7 FAX CELL EMAIL L Vj Division of Professional Licensure: License Search Page 1 of 1 y The Official Website of the Office of Consumer Affairs and Business Regulation(OCABR) Division of Professional Licensure Mass.Gov Mass.Gov Home State Agencies A-Z Topics Home>Division of Professional Licensure> ONLINE SERVICES ..........................................................................................................................................................................................,........................................................................ ........... Check a License Check A Professional License Locate a Licensed Professional By the Division of Professional Licensure Online Address Change Contact the Agency LICENSEE more... Name:JOSEPH P. CAMPBELL REFERENCES& MIDDLETON,MA RELATED INFO Disclaimer Regarding **This Licensee has additional Licenses,click here to view them.** Website License Searches Glossary of License Status Codes Licensing Board: PLUMBERS ft GASFITTERS License Type: MASTER PLUMBER More... License Number: 9050 Status: SELECTED FOR AUDIT Expiration Date: 5/1/2014 Issue Date: Exam Date: School: This web site displays disciplinary actions dating back to 1993. This license has had no disciplinary actions taken during this time. li The page above has been generated by the Division of Professional Licensure web server on Wednesday,May 07,2014 at 11:37:03 AM. ©2007-2011 Commonwealth of Massachusetts Site Policies Contact Us http://Iicense.reg.state.ma.us/public/pubLicenseQ.asp?board code=PL&type—class=—M&1ic... 5/7/2014 Division of Professional Licensure: License Search Page 1 of 1 The Official Website of the Office of Consumer Affairs and Business Regulation(OCABR) i Division of Professional Licensure Mass.Gov Mass.Gov Home State Agencies A-Z Topics Home>Division of Professional Licensure> ONLINE SERVICES ......................................................................................................................................_..................................................._........................................................................................... Check a License Check A Professional License Locate a Licensed Professional By the Division of Professional Licensure Online Address Change Contact the Agency LICENSEE More... Name:JOSEPH P. CAMPBELL REFERENCES& MIDDLETON,MA RELATED INFO Disclaimer Regarding -This Licensee has additional Licenses, click here to view them.** Website License Searches Glossary of License Status Codes Licensing Board: PLUMBERS ft GASFITTERS License Type: JOURNEYMAN PLUMBER More... License Number: 17615 Status: SELECTED FOR AUDIT Expiration Date: 5/1/2014 Issue Date: Exam Date: School: This web site displays disciplinary actions dating back to 1993. This license has had no disciplinary actions taken during this time. The page above has been generated by the Division of Professional Licensure web server on Wednesday,May 07,2014 at 11:38:47 AM. ©2007-2011 Commonwealth of Massachusetts Site Policies Contact Us http://license.reg.state.ma.us/public/pubLicenseQ.asp?board_code=PL&type class=_J&lice... 5/7/2014 Fold,Then Detach Along All Perforations Q.COMMONWEALTH OF MASSACHUSETTS Mal VA • • • • 6OARD'OF PLUMBERS AND GASFITTERS ISSUES THE FOLLOWING 'L i CENSE . REGISTERED AS., A .R UMBING CORS ?z JS ;f�H P CAMPBELL W:..: J P CAMPBELL INC MP 9050 : IN. 60 FULLER 'POND RDIz ..:: :::: .. .. !J hlllabLETON 1A 01949 2507 2 0"5/Qlft:;6 228627 • Fold,Then Detach Along All Perforations .:COMMONWEALTH OF MASSACHUSETTS 13GARUDIF PLUMBE'RS'`AND GAS.;F:I;TTERS ISSUES.;THE FOLLOWING LICENSE ' G. S1`ERED AS A PLUMB I NG CORP''' i= J:QSE9H P CAMPBELL W<< T. CRMPBEL fNC 60 FULLER POND » M1 DDLITON F1A 01949-2507 X127 : 05/Q1116 228628 PLUMBE1..S ANEt LICENSED .41 A JOURNEYMAN PLUMBER t ISSUES THE ABOVE LICENSE TO: r JOSEPH ._P CA1PBEL1_ � 60 FULLER FUND DR U) { MA 01949-2507, MIDDLETON 17615 15/01/14 168723 � <+ • • I -- Fold,Then Detach Along All Perforations :. COMMONWEALTH OF MASSACHUSETTS' • '-;•• so COMMONWEALTH OF MASSACHUSETTS PLUMBERS AND GAS ED "• LICENSED AS A MASTER PLUMBER .l PLUMBERS AND GASFI, ERS `ISSUES THE ABOVE LICENSE TO:, REGISTERED AS A PLUMB.NG CORP IISSUES THE ABOVE LICENSE TO: tOSEPH' P .CAMPBELL . I; lam. "JOSEPH P CAMPBELL t[" OUL`LER POND RD co J "P CAMPBELL INC MP 90:51 60 FULLER POND RD t`n- Mt�DLE`TON MA 01949-2507' {` 9050 05/01/14 16B722 MIDDLETON MA 01949 2�J7 • . ., • ., 1992 05/01/14 EXPIRATION DATE SERIAL NO. LICENSE Fold,Then Detach Along All Perforations - r - - Fold.Then Detach Along All Perforations t Department 'of P lic Safety One Ashburton Place, Rm 1301 Boston, Ma 02108-1618 Commonwealth of Massachusetts Department of Public Safety Restricted To: 00 Sprinkler Contractor "7 License:SC-002280 t,t.l.y JOSEPH P CAMPSELL ' 69 ELM STREET` . DANVERS MA 019 Tr.no: 653.0 Expiration: Keep top for receipt and change of address notifi Commissioner 03/15/2015 s _ - 0- a f F • The Commonwealth o Massachusetts - Department oflnrlustrial-4ccidl nts Office oflnvestigations 600 WashingtonMeet .Foston,MA 02 Ill www.mass.govhlia Workers'Compensation Insurance Affidavit:Builders/Cont°actors/Electriclans., I bers, .AppReant hforrnation Please Prim Le ibXy Name(Businessiorganization/tvdividual): JI P, ( V. Address: b9 E1(-4 City/State/Zip: i'1 t��/�'.� l� hone#• Are you an employer?Check the appropriate box: Type of project(required): I.0 I am a employer with 4. ❑1 am a general contractor and 1 6. 0 New construction employees(full and/or part-time).* have hired the sub-contractors 2.0 I am a sole proprietor or partner listed on the attached sheet. 7. ❑Remodeling These sub-contractors have 8. ❑Demolition ship and'have no.employees worldng forme in.any capacity. workers'comp.insurance, g, (J Building addition [No workers'comp.insurance 5. 0 We area corporation and its 10.0 Electrical repairs or additions required.] officers have exerdsed.their 3111 am a homeowner doing all work right of exemption per MGL II-D Plumbing repairs or additions myself.[No workers'comp. c.152,§1(4),andwehaveno 12.0 Roofrepairs insurancerequixed.]i employees.[No workers' 13.0 Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'comp ensation policy information. t-Homeowners who submit this affidavit indicating they bir doing all work and then hire outside contractors must submit a new affidavit indicating such. TContractors that cherlcthis box must attached as additional sheets1lowingthe name ofthe sub.-contractors andtheirworkers'comp.policyinformation. 1 am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. C Insurance CompanyName:- Policy#or Sel£ins.Lio.#: Expiration Date: — J Job Site Address: ' alC-M V fi, City/State/Zip: Attach a copy of the workers'compensation olley tleclaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A ofMGL o.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 iu 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. X do hereby certy uri aepains andpenalties of perpry Mat the information provided above is true and correct. - Signature: /�, �q Date: Phone#• 9; X 7,7—,96"06 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CityNown 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,m eniiployee is defined as"...every person iii the serviceof another under any contract o hire, express crimplied,oral orwxitten." An employer is defined as"an individual,partnership,asso ciation,corporation or other legal entity,or any two or more of the foregoing engaged in a j oint enterprise,and including the legal representatives ofa deceased employer,or the receiver or trdstee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having notmore 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 fox any applicant who has not produced.acceptable evidence of compliance with the insurance coverage required.- Additionally,MGI,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 chapterhave beenpresentedtathe 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 partuexs,are notrequired to carry workers'compensation insurance. If an LL C or LLP does have employees,a policy is required. Do advised thatthis affidavit may be submitted to the Department of Industrial Accidents fox 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,not the Department of Industrial Accidents. Should you have any questions regarding the Iaw 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 a.f ridavit 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 pennit/license number whichwill 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 infonnation(if necessary)and under"Yob Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been o fficially stamp ed or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file fox future p ermits or licenses. Anew affidavit must be.filled out each year.Where a home owner or citizen is obtaining a license ox 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 Offtce of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do nothesitate to give us a call. The Department's address,telephone and fax number: `rho Gorr_Monwealthofmfmachv._ atta Depar amcnt d1admtxial,A,ccxdeata Off toe QfIuvesugatiolas (00 wawjaskm sfxt a )304012,9-A02111 TO,9 617-727-4900 QA 496 Qx 1-877..UASS.F9 Revised 5-26-05 Fax 617-727-7749 The Commonwealth ofMassachaeseUs DeparhnentoflndustrialAceidle is Office of-Investigations 600 Washington Meet .Boston,MA 02111 www.mass gov/dza Workers'Compensation Insurance Affidavit:BuildersIContractors/Electriexans/l.'lumber.a Applicant Information Please PrintLegibXy 'Name(Businesslorganizaiion&dividual): . 19• CA ni OQ b P_t� Zoll G Address: 6 � P t M S-r - City/Stage/Ztp:7DA'�u-trs 01 q. `3 Phone#: 9 7 Jq-- 77 7r—02 Sd Are you an employer?Check the appropriate box: Type of project(required): 1.[] I am a employer with 4. ❑I am a general contractor and I 6. New construction employees(fa11 and/or part-time).* have hiredthe sub-contractors 2.[l I am a solo proprietor or partner- listed on the attached sheet. 7. Remodeling ship anTlave no.employees These sub-contractors have 8. ❑Demolition working forme in any capacity. -Workers'comp.insurance. 9. [�g��g addition [No work-ors'comp.insurance 5. We are a corporaf on and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.[] I am a homeowner doing all work right of exemption per MGL IL[]Plumbing repairs or additions myself.[No workers'comp. c.152,§1(4),and we have no 12.❑Roofrepairs iusurancere ed. employees.[No workers' .a 1311 Other comp.insurance required.] 'Any applicantthat checks box#f must also fiff outthe section bel6w showingtheir workers'compensationpolicy information. 1 Homeowners who submitthis affidavit iudicatingthey Rdoing all work and then hire outside contractors must submit anew affidavit indicating such. (Contractors that checkthis box must attached as additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for fny employees Below as the policy=410b site information. Insurance Company Name:. Pee_r . Policy#or Self-ins.Lic.#: CC P 83 o 80 3 9 Expiration Date: 7-1 f�T Job Site Address; -Pity/State/Zip:_ 4), /�d)c/o ufit/` Attach a copy of the workers'compensation-policy tleclaration page(showing the policy number and expiration date). Failure to secure coverage.as requiredunder Section 25A ofMGL o.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 iiisurance coverage verification. I do hereby certi deVl inns and penalties of perjury treat the information provided above is true and correct. - Si afore• Data: Phone# �17�' Official use only. Do not write in tries area,to be completed by city or town official. City or Towyn: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuax t to this statute,an employee is defined as"...every person in the service of another under any contract of hire,- express orimplied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the f6regoing engaged in a joint enterprise,and includingthe,legal repxesentatives 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 pexsous 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,MGI,chapter 152,§25C(7)states"Neitherthe comm onwealthnor any of its political subdivisions shall enter into any contract for the performance ofpublic 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'compensaiion affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-coniractor(s)name(s),address(es)and phone numbers)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 notrequired to carry workers'compensation.insurance. IfanLLC orLLP does have employees,apolicy 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 thepemrit 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 number listed below. Self-insured companies should enter their self insurance license number on the appropriate no. City or Towns Officials Please be sure that the affidavit is complete andprinted 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:M inthe peimit/license number whichwill be used as a reference number. In addition,an applicant ihatm-ust submit multiple permit/license applications in any given year,need only submit one affidavit indicating current Policy information(ifnecessary)and under"Job Site Address"the applicant should write"alI 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.'Wh.ere a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license orpermit to burn leaves eta.)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 anyquestions, please do nothesitate to give us a call. The Department's address,telephone anal fax number: `rho COMIAOx-wealthofMassach-usetts Depart ent ofladu.9xial Accidents • Qrffzce o�'7n,'�e�tiga�Q.>as. ' 600 Wubiiatgon 8fxoet Boson,MA 02111 Tei,9 61M27 49QQ e 406 ox 1-877-:N A Revised 5-26-05 Fax 9 617"727'7249 ' wwR€.x�a�s,govfclia MAY-07-14 10:52AM FROM-E-A STEVENS CO 1781-397-7672 T-023 P.001/001 F-463 C4['_>Rff CERTIFICATE OF LIABILITY INSURANCE U ,UU/YYYY) s/7/2/�/zoia TWIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE: POLICIES BELbW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT 13ETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed, If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement- A statement on this Certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT BArnadetter M. Davis, CPCU NAME: EA Stevens Company, Inc. PHONE (781)322-2324 PAXAle,No (781)397-7672 389 Main St. EMAIL A ESS,bernadetted@eastevensins-com P. O. BOX 188 INS!IBER3CJAFFORDINGCOVERAGE NAICft Malden MA 02148 INSURBRA-P®®riGSS Ins 24198 INSURED INSURER B-.E71:Ge1,S7-Or 11045 JP Campbell Inc INSURERC00000 Ins Co 69 Elm Street INSURER 0: INSURER E: Danvers MA 01923 INSURER F: COVERAGES CERTIFICATE NUMBER-.201-S-2014 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A66N E FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IXP ITR TYPE OF INSURANCE IM BR POLICY NUMBER FAM1 POLICY FFP MMiKMAFVV LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITYPREMI ES Ea occurmnco S 50,000 'A CLAIMS-MADE FX OCCUR CP8308038 /1/2013 7/1/2014 MED EXP(Any Ona oryon 3 5,000 PERSONAL 8 ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 3 2,000,00-0 POLICYX 711R0_ LOC 3 AUTOMOBILE LIABILITY OMaBINEDSINGLE LIMIT 1 000 000 ANYAUYO BODILY INJURY(Por porson) $ ALL OWNED SCHEDULED 8301336 /1/2013 7/1/2014 AUTOS X AUTOS BODILY INJURY(Por acdclanl) 3 NON-OWNED PROPERTY DAMAGE $ X I4IRED AUTOS X AUTOS Per accident Undarinsurod rnOlonsl 81 split $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE 3 3,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE 3 3,000,000 DED I I RETENTIONS 08305039 /1/2013 /1/2014 g C WORKERS COMPENSATION X WC STATU- OTH- ANO EMPLOYERS'LIABILITY Y/NLIMPR ANY FROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT 3 500,000 OFFICERIMEMBEREXCLUDEE NIA (Mandatory In NH) 3063758 /1/2013 /]/2014 E.L.DISEASE.EA EMPLOYE 3 500,000 ]fee de9rlibe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT 3 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If mom spaea Is mqulrea) CERTIFICATE"HOLDER CANCELLATION (978) 688-9542 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood St- Bldg 20, Suita 2035 AUTHORIZEDk9PKESeNTATIVE North Andover, MA 01845 Thomas Cares, Jr/wv � 5 ACORD 25(2010105) ®1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005)01 The ACORD name and logo are registered marks of ACORD • Date ..................... TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING C u This certifies that ..........a............. ............ ........................ has permission to perform \. .......................... wiring in the building of.. Aa, ...... ....... ..........:..........................hal j1hAuidover,Mass. "or ........ ...... Lie.No. AA ........................... i... ✓ .... ELi�4�eAL INSATOR 'Check# 14 vn 1v 114 1 ? Fin 7 Commonwealth of Massachusetts Official Use Only + Department of Fire Services Permit No. 1��l BOARD OF FIRE PREVENTION REGULATIONS [ Occ Ip nc and Fee Checked leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK A All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5;7 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7// y/— City or Town of: nl� RYIJ �NooveP- To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. r, Location(Street&Number) f 9 Q �(�� hA U Owner or Tenant �t,p`h l �q(Z t S Ft 4, )a GGA Telephone No. i – 1\C Owner's Address h A Q?WAA &yam(' Is this permit in conjunction with a building permit? v Yes lig, No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. /a 9 Existing Serviced Amps / / Volts/ Overhead❑ Undgrd[� No,of Meters / New Service Amps /�V01ts340Overhead❑ Undgrd No.of Meters 1_ Number of Feeders and Ampacity 1v,00 &4,a Location and Nature of Proposed Electrical Work: A 4( / aqd Completion o theollowln table may be waived b the Inspector of Wires. �S No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans No.of Total _ Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ n- ❑ o.o mergency Lighting 11yrrid. rnd. Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of SwitchesDetection No.of Gas Burners o. In and � Initiatin Devices No,of Ranges No.of Air Cond. Tonal No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances Kir Security Systems: � No.of Devices or Equivalent 0 of Water10.KW No.o o.of Data Wiring: /0 Signs Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No,of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail ifdesired,or as required by the Inspector of Wires. 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 c over e is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: T/3 J> Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under thepains and penalties of perjury,that the information on this application is true and complete. FIRM NAME:-7 e3d O 2 -7-1 LIC. NO.: /�j4- Licensee:, Signature LIC. NO.: (Ifapplicable, enter "e , t"in the license number line. Bus.Tel.No.: 9V1 -6163 I3a9.� Address: 0 Q , l D/ Alt.Tel.No.: OWNER'S INSURANCE WAIVER: am aware that the L censee 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 E]owner's agent. Own tura nt p I Signature Tele hone No. PERMIT FEE: $ O -1-111 J 12z 1�� Mil W1 316 -2 7 ' f 7- �! ig 7- P"7 ;22 ,y The Commonwealth of Massachusetts ' Department of Industrial Accidents Office of Investigations 600 Washington Street E Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information f Please Print LeAW Name (Business/organizatiowlndividual): TO C.C.O Co to P. Address: 2.9 C'ooe S,_ City/State/Zip: 8 t(�L E IZ t CA. A 01 157-1 Phone t 9713-"3-0792- Are ?13-"3-0z92- Are you an employer?Check the appropriate box: Type of project(required): 118 I am a employer with_ 1 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees ., These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' insurance.t 9. E] Building addition comp.[No workers' comp. insurance p• required.) 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. n/� Insurance Company Name: A8C N4Ss rlticF WopXE2S' ntrbt3n1S.477t�n1 SELF INsaR (�Rour? 1 Policy#or Self-ins.Lic.#: MC-PA- COS 0 24 -14 Expiration Date: ►2 �3 f I Job Site Address:_ 120 A of& Imo( City/State/Zip: AIP-77V ,Q 0d uer A4 A o�8 y5 ' 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. Si.- ature: Date: 7 � •Zo/y Phone#: Official use only. Do not write in this area,to be completed by city or town official r City or Town" Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other _ Contact Person: Phone#: i Pie" ase visit our web site at http://www.mass.gov/dpI/boards/EL TOCCO CORPORATION JOSEPH V CAMILO (EL) 29 COOK ST BILLERICA MA w821-6o44 Fold,Then Detach Along All Perforations 4 :COMMONWEALTH OF.MASSACHUSETTS. BOARD OF, ELECTRICIANS ISSUES THE FOLLOWING LICENSE AS A REGISTERED MASTER E;LECTR I.0^IAN .0CC0`CORPORATION i N 'JOSEPH V CAM1L0 29 COOK STAU B.I.LLERICA .:;.. MA 0182176044 21659 V; o �31L16 9509.8 • em„mtiad-'1a.l/.t>atUL iaa NORTH TOWN OF NORTH ANDOVER rEDSIGN PERMIT �9SSACHUS���� DATE: July 18, 2014 PERMIT: 002-15 THIS CERTIFIES THAT North Parish Church of North Andover_has permission to erect a sign on 190 Academy Road - 30"x48" supported by 2 7"x7" granite posts "North Parish Unitarian Universalist" provide that the person accepting this Permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section #6, Voids this Permit. INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED Inspector of Buildings Amount Paid: $36.00 Check#17428 Receipt#27791 Location Iq o A No. (-,b2 I h Date -I I-I e - TOWN OF NORTH ANDOVER e stZU1, . Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ "'� TOTAL $ Check# 2i 75 �/ Building Inspector SIGN PERMIT APPLICATION 1600 Osgood Street Building 20,Suite 2-36 TOWN OF NORTH ANDOVER Site Owner North Parish Church of North Andover Applicant The Sign Center Tel 978-372-3721 Site Address 190 Academy Road Size of Proposed Sign 30"x 48"(10 SF) Map 096 Parcel 0072 Illumination: [7a)Not illuminated How attached: a)Against the wall b) Internally illuminated b)Roof c) Externally illuminated 7/ c) Ground post&panel d) Other Materials: 18#signfoam carved,digitally printed chalice graphic Proposed Colors: Background white 7"x T'pyramid topped granite posts Lettering black/gold Border gold Cost of Sign $3125 Required Attachments: Note: No permanent/temporary sign shall be erected, or enlarged until an. Photographs of building application on the appropriate form furnished by the Sign Office has been filed Material sample with the Sign Officer containing such information including photographs, plans .a Color sample and scale drawings,as he may require,and a permit for such erection, alteration, Site or Plot Plan (Required for all free-standing signs) or enlargement has been issued by him. Such permit shall be issued only of the Drawings of proposed sign Sign Officer determines that the sign complies or will comply with all Other,specify Historic District Commission Certificate of Appropriateness applicable provisions of the By-Law. Will sign overhang any public road or walkway Yes ( ) NoF7 If Yes,Name of Agency who will provide liability insurance: t AN INCOMPLETE APPL CATION WILL NOT BE ACCEPTED DATE FILED: 7 n (-1 Receipt# Check# Revised 1.0.31.2006Form Sign Permit Application dNATURE APPLICANT APPROVED BY - 4M � r r. Site Plan, North Parish Church — March 2014 j Proposed location I , i_____ for new sign ........ PROPOSED CONCRETE SLOPE POLE RELOCAND WIRES AREA-29,994 O— S.F, y d {{ ' ( RELOCATE GATEAND __ I SEGMENTED BLOCK FENCE AROUND PATIO ;- ppd '� r WALL SEE DETAIL _ ,y' nP�M..• IIII{[1 IIII S V f E PROPOSED PROPERTY LINE PROEL WALK '�r }• ��I1011 N I 1 Pln� IIVI �� RAV j���. """ I I I��y�Ih�l I I���jl P •Ir � f PROPOSED L 1 I t: .zo°'uP a _- .°'o ��� Fr wenaNDA FER - yPl��lj M�I�Iu�III III I����� iI IV�._IR III Inl IlRl hoq tl.11 Ip Iq3 J" :./ •E• 1 µ d EE ATCOMPLETIONROU4' f ,Qa N A h9� +. „IIII r1Mi 6l I�;��jfl l£ IIII IIIA .8p°°, �ka II fI 4F'II Ifl IIII OFCONSTRUCTION ? .�REPAIR AND REPLACE E CE j r II ;Ip p„yIIII �IIll 1111 NIM hI ' DISTURBEDBYCONS RUCT llhll Ptl IP I' Y SXR' I � _ "'o~ T�J6®W ,r'”yul hgl��ul IIII��M�lo� IINP�II��l�l�wl��l� u�lll I" I�;u�l NDENSES , REPA OTED'�`Jy / .�III jI,' IIII�I IIpi TIMlow I.ROPOSED OR/P EDGE ; hm ud II II I Illlr{IQ II IO tIilf I�111p1�ghlYIII�6�I111 IIIflI IIIIII,.�. A-zz -za p EXISTING BASIN � IIIIIII A TOBEREMOVEDi s'•• q� �y M pI'�IM 11 II II�Y M PI A-20 A-21 p III om'` j 61 I I i II I I I �' 1 s1 II VI u IIII III pyil,,. i I air x III hp � 111 A-19 y I��H��II11 h, III I��Vn pool I a ud1 �q SEGMENTED BLOCK EXISTING STON wa �" y`�I II III MINI III ,y- Ni IIA h III III I, -3• WALLole d IIII hl II Id1 111111 pl � DRIP EDGE un^�Y li„ �11y , jjl tlI I pP IIj I wF-IT �I 1 _ .x,, IPI„pI IJu IIIul��I�ljlll INI mluu ill �r� e AIM �p IB M�E IIIIII III I II S �I{I lrI I I I MI II SERIES BY HAVES ENGINEERING ryF. 'I IIIIIII �IIII I{IIf� I� Q j Ib A SERIES BVWETLANOSPRESERVATIONINC I III i ��� °' 11111 N uV111 n N I II I I I111111 - Ji �j I I ;IIII� �� M •� q II j j^soti'—. � IIIIII jell I ,Mlre hliplVlp ,,, s 1 IIII a __ �°� rlm� (IIII Itl. VIII rIP Iii u r� II m. __ - 6 Mllp jli E uNDLWE �NI il�l,k ''� � � p� II19nj I{IIIIII , IJ��I ,y Ffa J�:I IIII' IIIIII uopf�,fl� ypalV VIII I ,1j II M m@�Ih�.1II� IN'I� NEW 4FT WIDE II SNN�II CONCRETEWALK ILIk III � I pppyl ulll I Illf�1 I x"111 I�`IIi G I b T III l}y, II: UI VIII IIIIIII Ili IIII I� ��Ih p�y� Vt 1pl�l III IIIIIII Iy IIIb allln tl MAX S%SLOPE C IIII 7 /�` III.. l 1 IIII II PIP11111 ul Iq III IIgM@f"fi 1 NEW ONCRETE WF-f3 1j I:li II li '> �� 4 Ih11 n Ih11 VIII IP Iu pll STAIRS AND LANDING 11 IIII II <II II n II I'd lliph ��d :,IUAf I��lsl1, 3 III ;�VIII Ilii=/ j II� Iii II I i Pllumi Illi IIIIII I IV'I I i ( dl II IIIIII ,P p Illj l —12�1upalWEcVavhliuuulPmmllulll a * F ns 1 cue �� G VIIIe �,� & pl I i� d'piN'��s Ib �yp>' '� / ` ysSd• F.fO F-9 PLAN F° 20' 0 20' 40' SCALE:1'=20' 48 in rORTH PARISH 1. UMT it r 6RMN 4► O . -. 54.. '1 10 square feet ; 7" x 7' pyramid topped granite posts �. r (2 sides smooth, 2 rough) (_ r > THE SIGN CENTER IN ° North Parish Church date 4-25-14 � �oo sign center designed by L Busteed 3 Great Pond Rd., North Andover file name North Parish Church Post& Panel v3.plt Sales Associate Jay Kahn details 10 sq ft,single-faced,2°18"signfoom V carved&painted white/black/Matthews Gold -digitally printed chalice (10 sq.ft.limit per Town of North Andover zoning bylaws) Print file for chelice:J:/Art/Logos/rainbow chalice soft gradient.eps 7'x7'x7'pyramid top granite post Bing Maps Page 1 of 1 �']nnt `this page M f � r / i rF_ 46�. �. ma http://www.bing.com/maps/ 7/9/2014 ol t ` lx� r (` J J North Andover MIMAP June 30,2014 096 x0931 ♦ ♦ 411 STEVENS ST ♦ 096.0-0078 N 40 140 ACADEMY RD o 096.0-0048 ✓ 239.02 096.0-0033 096.0-0077 421 STEVENS ST � U Nb oo ¢o •. a2,21 - N 0 ._ 0960-0040 y, ° j �4� ::::a 096:0-0005 ' O+ a� G� 096:0-0072 .:_:_. :. = h :.: . q I, > " / _ ::_: •":`_:Valu_ w �- f 096.0-0006 190rACA'DEMIY RD {::__:,: :. 096.0-0019 447 STEVENS$T 450 STEVENS ST 096.0-0018 se 096.0=0'020=;=:_:451 STEVENS ST 9`�bOe 3 GREAT POND RD1 ::' -0042096.0-0017 I . 096.0-0021 ' ` ` `"?.)k do - ==°=;:.' 455 STEVENS STi 454 STEVENS S :.._. 2 JOHNSON ST I' _"`-' 096.0-0024 = :_, 096.0-0016 459 STEVENS ST 096.0-0007 fro /14 OHNSO ST ,:__'? ::::::: I 460 STEVENS ST d 096.0-0022 =!=':y 096.0-0025 <1' -..:r. 10,JOHNSON ST t 096.0-0015 i 3 JOHNSON ST v1i� .'-',_:-•i'..:_ S,.JOHNSON ST \ 096.0-0023 - 465 STEVENS ST 096.0-0008 —Rail Line Interstates I Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, SR Meters Data Sources:The data for this map was produced by Merrimack Roads f T►ORTN, Valley Planning Commission(MVPC)using data provided by the Town of Q t�ao �r L t Easements North Andover.Addltional data provided by the Executive Office of �� �• ? � � Q Environmental ANeirs/MassGIS.The information depicted on this map is 0MVPC Boundary 03 for planning purposes only.It may not be adequate for legal boundary definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER 0 Municipal Boundary ~ 9 MAKES NO WARRANTIES,EXPRESSED OR IMPLIED.CONCERNING - Trails ♦ ♦ THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY t ^♦ OF THESE DATA,THE TOWN OF NORTH ANDOVER DOES NOT t Parcels • o O • ASSUME ANY LIABILITY ASSOCIATED WITH THE USE CR MISUSE OF C:Hydrographic Features �f''+0+���c��•`� THIS INFORMATION —Streams ,'rSAEMUS�t "w Wetlands C:Exempt Lands 1"=90 ft ` NORTH ANDOVER OLDE CENTER HISTORIC DISTRICT COMMISSION Certificate of Appropriateness This certificate of Appropriateness is issued this First day of May 2014 to North Parish Church for 190 Academy Road in accordance with Chapter 40C of the General Laws of the Commonwealth of Massachusetts as amended and the by-laws of the North Andover Olde Center Historic District Commission. This will allow for a new sign at the North Church with THE PROOF APPROVED BY THE COMMISSION A HIS ME TING &ge j=der,/Jr. Chairman kktfleen SZ'j4/ i Robert Stevens —At" Martha Larson Leslie Frazier Harry Aznoian 'char ly D id Mermel 'n g aws The NORTH PARISH of NORTH ANDOVER Unitarian Universalist 0! Spirit• Community- Equality Town of North Andover Building Department 120 Main Street North Andover,MA 01845 6/30/2014 RE: North Parish Church 190 Academy Road North Andover,MA 01845 To whom it may concern: Please accept this letter as formal authorization for The Sign Center of Haverhill,MA to act on our behalf and as our"agent"for the purposes of securing all the necessary permits and approvals (including signing of all documents relating to these matters)required by the Town of North Andover for the proposed sign to be built and installed at 190 Academy Road,North Andover,MA 01845. (Note: until completion of construction, church office located at 3 Great Pond Road.) The Old Center Historic District has approved both the sign and its location. Their Chair, George Schreunder, filed the signature form with the Town on June 23, 2014. Should you have any questions or concerns,please contact me at 978-852-5033. Thank you, Debb Putnam Co-chair House&Grounds North Parish Church 978-852-5033 (cell) 3 Great Pond Road, North Andover Massachusetts 01845 4 978-687-7948 4 www.northparish.org INSIG-1 OP-ID:CH A`...�� CERTIFICATE OF DATE(MMIDDIYYYY) LIABILITY INSURANCE 12104/13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE `DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 413-306-6092 CONTACT Sinclair Insurance Group Inc. "AME: 1 Monarch Place 413-306-6097 lAIC No Ext); FAX Springfied,MA 01144-2410 E-MAIL AIC No: Salvatore Damato ADDRESS: INSURERS AFFORDING COVERAGE NAIC N INSURER A:Peerless Insurance Company 24198 INSURED Insignia Inc.dba The Sign INSURER 8: Center and The Instant Sign Center INSURER C: Kahn Realty Trust INSURER D: 40 Orchard Street ' ,'Haverhill,MA 01830 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES-OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE-INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRL S POLICY EFF POLICY E P LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CBP2051006 12112113 12112114 PREMISES Ee occurrence $ 100,000 CLAIMS-MADE �OCCUR MED EXP(Any one person) $ 15,000 X BLKT Alt P&NC X BLKT WOS PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICYFX PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 AANY AUTO BA8731653 12/12113 12/12114 BODILY INJURY(Per person) $ X AUTOS ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS X HIRED AUTOS X AUTOS PROPERTY PROPERTY DAMAGE $ X bkt b Per accident contract Hired phys dam $ 50,00 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB HCLAIMS-MADE CU8734753 12112/13 12/12114 AGGREGATE $ 51000,000 DED X RETENTION$ 10000 $ WORKERS COMPENSATION WC STATU- 0TH• AND EMPLOYERS'LIABILITY X I ER A ANY PROPRIETOR/PARTNER/EXECUTIVE WC8734253 12/12113 12/12114 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH)- If E.L.DISEASE-EA EMPLOYEE $ 500,000 yea,describe under _ _ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 A Bikt Bldg&BPP CBP2051006 12/12/13 12/12114 Blkt Bldg Spec incl Theft &BPP 3,133,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Insignia, Inc.dba The Sign ACCORDANCE WITH THE POLICY PROVISIONS. Center&instant Sign Center Attn: Jay Kahn AUTHORIZED REPRESENTATIVE 40 Orchard Haverhill MAA 01830 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts . Department of IndustrialAccidents Office of Investigations l; 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Let=_ibly Name (Business/Organization/Individual): Insignia, Inc. dba: The Sign Center Address: 40 Orchard Street City/State/Zi ;Haverhill,MA 01830 Phone#:978-372-3721 Are you an employer?Check the appropriate box: Type of project(required): 1.K I am a employer with 48 4. Q I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. Q Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp.insurance.i 9. Building addition required.] 5. F1We are a corporation and its 10.[:]Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 IQ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.0 Other comp. insurance required.] *My applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Peerless Insurance Company Policy#or Self-ins. Lic. #:WC8734253 Expiration Date: 12/12/14 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 Investigation of the DIA for insurance coverage verification. I do hereby rt6 under the pain"nd penalties of perjury that lite Information provided above is true and correct. Signa6e: CDate: e Oficial use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• Ofs O r N�ti . O � 9 TOWN OF NORTH ANDOVER cous^_ BUILDING PERMIT FEES S^ U4E Building Permit Fees exclusive of mechanical and utility fees A. The estimated cost of new construction shall be based on a cost factor of one hundred twenty five ($125.00)dollars per square foot. B. Estimated construction of additions,alterations,and remodeling shall be the actual contract price. The permit fees shall be twelve dollars($12.00)per thousand based on the estimated costs of construction. C. Copies of actual contract price may be required with building permit application. Fees adopted by the Board of Selectmen: 6-26-2006 Effective 7-1-2006 Miscellaneous Fees Fee Minimum Building Permit Fee $30.00 First$4,000.00 cost(or$12.00)per thousand of estimated construction cost,which ever is greater Certificate of Occupancy—For Existing Structures $100.00 Certificate of Occupancy—New Construction $100.00 (to be paid upon issuance of Building Permit) $50.00 Temporary or Partial Certificate of Use,$50.00 and or Use and Occupancy,per month Chimney/Fireplace—First$1,000.00 cost $30.00 (or$12.00)per thousand of estimated construction cost,whichever is greater) Signs $30.00 (or$12.00 per thousand of estimated construction cost,whichever is greater Temporary Construction Sign—6 mos.Permit $50.00 Temporary Construction Trailer—6 mos.Permit $50.00 Reissue of Revoked/Suspended Building Permit $100.00(per time) Extension of Building Permit—6 mos.,two time limit $50.00 Replacement of Building Card $50.00 Demolition Permit $1.00 to$2,000.00 $30.00 (or$12.00 per thousand of estimated demolition cost, whichever is greater Reinspection Fee—Residential Structures $30.00 per trip Reinspection Fee—Commercial,Industrial or Education Structures $30.00 per trip Certificate of Inspection&Certificate of Structures Per See Table 106—Restaurants,Bars $100.00 Certificate of Inspection -Lodging +5 Units ea add unit $100.00 $ 10.00 In the event that work is started prior to the issuance of building permit,the permit fee will double � 1\ John T. Smolak, Esq. T: 978-327-5215 1 F: 978-327-5219 ATTORNEYS AT L A W jsmolak@smolakvaughan.com April 16, 2013 BY HAND Gerald Brown Building Commissioner Building Department Town of North Andover 1600 Osgood Street North Andover, Massachusetts 01845 Re: North Parish Renovation and Addition Project 190 Academy Road(North Andover Assessors Map 96, Lot 72) (the "Property") Request for Zoninu Determination Dear Mr. Brown: This firm represents the North Parish Unitarian Universalist Church of North Andover("North Parish") in connection with the North Parish's proposed renovation and redevelopment project proposed to be undertaken with regard to the Religious Educational Wing of the Meeting House at 190 Academy Road. Specifically,North Parish proposes to raze the existing Religious Educational Wing and replace the same with a 7,700 s.f. addition(the"Project"). The Property, consisting of 0.69 acres of land, is located entirely within the Residence 3 (or R-3) Zoning District as described in the Zoning Bylaw of the Town of North Andover(the "Zoning Bylaw"). Both the Property r and the footprint of the proposed Project are depicted on the attached site plans. North Parish is requesting confirmation that as a result of the provisions of Section 3 of M.G.L. c. 40A (the so-called Dover Amendment"),the enforcement of the provisions of the Town of North Andover Zoning Bylaws would substantially diminish or detract from the usefulness of Building without appreciably advancing the Town's legitimate concerns, and go beyond the reasonable bulk and dimensional regulations that the Zoning Bylaw could legitimately impose on religious and educational buildings and uses under the Dover Amendment. Section 4.121 of the Zoning Bylaw expressly allows a"place or worship" and related accessory uses within the Residence 3 District, so such uses are permitted by right. Moreover, Section 7 of the Zoning Bylaw establishes dimensional requirements applicable to buildings and structures within the R-3 Zoning District as follows: East Mill,21 High Street,Suite 301,North Andover,MA 01845 WWW.SMOLAKVAUGHAN.COM �, SMOLAK & VAUGHAN LLP April 16,2013 ZONING REQUIREMENTS R-3 ZONING DISTRICT Zoning Provision Required Proposed Min. Lot Area(Section 7.1 25,000 s.f. 29,994 s.f. and Table 2) Max. Height(Section 7.4) 35 feet >35 feet Street Frontage (Min.) 125 feet >125 feet (Section 7.2) Minimum Setback(Section 7.3) -- Front 30 feet <30 feet -- Side 20 feet <20 feet -- Rear 30 feet N/A Min. FAR(Section 7.6 and N/A N/A Table 2) Contiguous Buildable 75%of Min. Required Lot Not applicable to lots Upland (Section 7.1.1) Size created before April 28, 1986 per Section 7.1.1 of NAZB Min. Lot Width(Section N/A Not applicable to lots 7.1.2) created on or before May 1, 1995 per Section 7.1.2 of NAZB Max. Lot Coverage (Section N/A N/A 7.5 and Table 2 Parking (Section 8.1) 0.6 spaces per seat for As currently provided. religious centers Note than municipal parking lot is less than 500 feet from Property as per Section 8.1.8(c) of NAZB. Site Plan Review(Section Any new construction 8.3) containing more than 2,000 s.f. of GFA Based upon the foregoing,the Project would not comply with the Maximum, Height, Front Yard Setback(no closer than existing conditions), Side Yard Setback, Parking and Site Plan Review requirements under the Zoning Bylaw. However, as you know, Section 3 of the Massachusetts Zoning Act(M.G.L. c. 40A), also known as the so-called Dover Amendment,provides that "no zoning ordinance or by-law shall ... prohibit,regulate or restrict the use of land or structures for religious purposes or for educational purposes on land owned or leased by the commonwealth or any of its agencies, subdivisions or bodies politic or by a religious sect or denomination, or by a nonprofit educational corporation; provided,however,that such land or structures may be subject to reasonable regulations concerning the bulk and SMOLAK & VAUGHAN LLP April 16,2013 height of structures and determining yard sizes, lot area, setbacks, open space,parking and building coverage requirements." See M.G.L. c. 40A, s. 3. Based upon the regulatory provisions cited above, it is North Parish's position that such regulatory provisions, if applied to the Project, would be unreasonable and in direct contravention of the purposes of the Dover Amendment in that the imposition of these provisions would "go beyond the reasonable bulk and dimensional regulations that a bylaw could legitimately impose on religious and educational buildings and uses under Section 3." The Bible Speaks v. Bd ofAppeals of Lenox 8 Mass. App. Ct. at 33. Such a grant of discretion would allow the board to impose restrictions that would nullify or diminish the institution's entitlement to growth and limit the types of education or religious denominations that would be welcome in the community. See Bible Speaks v. Bd. ofAppeals of Lenox, 8 Mass. App. Ct. at 33(holding as invalid a zoning bylaw adopted by the Town of Lenox that required a special permit for all new religious and educational uses or changes in such uses, and also required that a site plan be submitted with any application together with an information statement describing the impacts of the project). The court held that it was precisely this type of discretion that was to be eliminated by the Dover Amendment and its progeny. The Bible Speaks v. Bd ofAppeals o Lenox 8 Mass. App. Ct. at 33; The determination of whether specific regulatory requirements are"reasonable" rests of whether compliance with dimensional and other non-use requirements would substantially diminish or detract from the usefulness of a proposed structure, or impair the character of the institution's campus(whether religious or educational), without appreciably advancing the municipality's legitimate concerns." See Trustees of Tufts Coll. v. City of Medford, 415 Mass. 753, 757 (1993). Accordingly, the courts have determined that a limitation on height was unreasonable and in violation of the Dover Amendment. In Martin v. Corporation of the Presiding Bishop of the Church ofdesus Christ of the Latter-Day Saints 434 Mass. 141 (2001), the Supreme Judicial Court overturned a lower court's determination that a Mormon Temple steeple which exceeded the height limitations of the Belmont Zoning Bylaw was unreasonable as applied to the steeple, which would rise eighty-three feet above the temple roof. The Supreme Judicial Court concluded that the trial court judge erroneously considered the religious purpose of the steeple, standing alone, rather than the purpose of the temple as a whole. "To view each element, each section of a'structure,' as requiring an independent'religious'use leads to impossible results: Is a church kitchen or a church parking lot a'religious' use? We have not formulated the test so narrowly." Martin v. Corp. of the Presiding Bishop of the Church of Jesus Christ of the Latter-Day Saints, 434 Mass. at 149. Moreover, the trial judge erred in evaluating the reasonableness of the application of the height restriction to the steeple based on whether the requirement diminished the temple's usefulness. An applicant may demonstrate unreasonableness by showing that the requirement impairs the character of a proposed structure and "matters of aesthetic and architectural beauty are among the factors to be considered in deciding whether a zoning requirement'impairs the character' of a proposed exempt use . . . The SMOLAK & VAUGHAN LLP April 16,2013 record is replete with evidence that the steeple is integral to the specific character of the contemplated use." Martin v. Corp. of the Presiding Bishop of the Church of Jesus Christ of the Latter-Day Saints, 434 Mass. at 152. Further,there appears to be no valid municipal concern served by limiting building height. i Similarly, we feel that the setback requirements would be an unreasonable imposition, and would have a substantial impact on, and infringement of, the North Parish's ability to carry out its religious mission. Specifically,mandated compliance with dimensional and other non-use requirements would substantially diminish or detract from the usefulness of a proposed structure, and impair the character of the property, without appreciably advancing the municipality's legitimate concerns. See Trustees of Tufts Coll. v. City of Medford, 415 Mass. 753, 757 (1993). For example, in Trustees of Boston College v. Board of Aldermen of Newton, 58 Mass. App. Ct. 794 (2003),the Appeals Court determined that in light of"BC's demonstrated need for more adequate space to house existing campus activities and serve its student body and the judge's finding that the Campus Plan will provide little in the way of extra growing room,we think BC has demonstrated on this record that the dimensional regulations [including the parking regulations] applicable as a whole to the Plan are unreasonable. Compliance with the dimensional regulations would "substantially diminish or detract from the usefulness of[the MCP], or impair the character of [BC's] campus,without appreciably advancing the municipality's legitimate concerns."Id. at 759. Moreover,North Parish feels.that site plan review should not be imposed on the Project. In Bay Farm Montessori Acad., Inc. v. Town of Duxbury, 2009 Mass. App. Unpub. LEXIS 1017 (Mass. App.Unpub. 2009),the court held that the denial of site plan review via special permit See also,The Bible Speaks v. Board of Appeals of Lenox, 8 Mass. App. Ct. 19, 391 N.E.2d 279 (1979). (holding invalid a by-law that required site plan review for educational uses by declaring that "those portions . . . of the Lenox zoning by-law which impose the requirements of a site plan, informational statement, and special permit before religious and educational institutions can expand their uses are invalid. The court added that"[t]he legitimate municipal concerns manifested in local zoning by-laws are properly served by the involvement of the zoning enforcement officer, rather than the exercise of discretion by an elected or appointed board." In Trustees of Boston College v. Board of Aldermen of Newton, 58 Mass. App. Ct. 794 (2003),the Appeals Court considered whether and to what extent the Dover Amendment would allow application of certain dimensional, parking, and other regulations within the Newton zoning ordinance to a construction project planned for the Boston College (BC) campus. Further,the North Parish Project has certain protections under Federal law. Specifically,the Religious Land Use and Institutionalized Persons Act of 2000, 42 U.S.C. §§ 2000cc-2000cc-5 (RLUIPA), essentially operates as a mechanism for the enforcement of the Free Exercise Clause of the First Amendment of the U.S. Constitution. Specifically,RLUIPA provides,among other things, that no government shall impose a A SMOLAK & VAUGHAN LLP April 16,2013 land use regulation that imposes a substantial burden on the religious exercise of a person, including a religious assembly or institution. 42 U.S.C. § 2000cc(a)(1). Further, land use regulation cannot treat a religious assembly or institution "on less than equal terms with a nonreligious assembly or institution, "discriminate against any assembly or institution on the basis of religion or religious denomination;totally exclude religious assemblies from a jurisdiction; or unreasonably limit such assemblies,institutions, or structures within a jurisdiction. 42 U.S.C. § 2000cc(b). We note,however, that we acknowledge the applicability of wetlands requirements, as well as other health and safety requirements unrelated to zoning requirements, in connection with the Project. See The Southern New England Conference Ass'n of Seventh-Day Adventists v. Town of Burlington, 21 Mass. App. Ct. 701, 706-07 (1986)(where the Appeals Court held that Section 3 did not exempt a religious use from lawful wetlands control under a local zoning bylaw. Referring to The Bible Speaks, the court reasoned that,because under the wetlands regulations all activities inimical to wetlands are prohibited,the municipality could not exercise preferences as to what kinds of religious uses it would welcome. The Southern New England Conference Ass'n of Seventh-Day Adventists v. Town of Burlington, 21 Mass. App. Ct. 701, 706-07 (1986). Accordingly, we are requesting your office to confirm, based upon the facts described herein, that the Dover Amendment applies to the zoning nonconformities described above such that no Planning Board or Zoning Board of Appeals review is required for the Project described above. Please contact me should you have any questions concerning this matter. Sincerely, John T. Smolak JTS/ Enclosure(s) 5 LEGEND TOPOGRAPHIC AREA DIAGRAM Imenders,.torrey&spencer,Inc. OS8 DN STDIE BWND DMU.NC1t RCP REINFORCED CONCRETE PIPE PLAN Off' LAND 4-16-13 architecture . preservation F `4 0. 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