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Miscellaneous - 32 PARK STREET 4/30/2018
32 PARK STREET 210/071.0-0041-0000.0 COMMONWEALTH OF MASSACHUSETTS NUMBER • Swrsn� _ • BHP-2017-0303 North Andover • BOARD OF HEALTH FEE $160.00 VFW- Club 2104 DATE ISSUED NAME March 01,2017 32 PARK STREET ------------------------------------------------------------------------------------------ ------------------------------------------------ --- ADDRESS IS HEREBY GRANTED A Food Est. - Club; Organization-Permit c�d1 Food Establishment-Club;Organization PERMIT � � �Q� 4g This permit is granted in conformity with the Statutes and ordinances relating thereto, an��,, February 28 2018 O� O expires ry unless sooner suspended or revoked. RESTRICTIONS: Function Hall BOARD OF ------------------------------- HEALTH NOTES: Contact: Joseph Lynch 978.687.9614 `"'�--� ------------------------------------------------------------ HOURS ACTIVE: Sun-Sat l lam-lam BOARD OF HEALTH CHAIRMAN COMMONWEALTH OF MASSACHUSETTS NUMBER sw d+'r • BHP-2017-0304 North Andover BOARD OF HEALTH FEE $60.00 VFW - Club 2104 DATE ISSUED NAME March 01,2017 32 PARK STREET --------------------------------------------------------------------------------------------------------------------------------------------------------------------- ADDRESS IS HEREBY GRANTED A Dumpster Permit �® Dumpster PERMIT l4 This permit is granted in conformity with the Statutes and ordinances relatinged o,an expires February 28,2018 unless sooner suspended or revo01.p p <,`, . 19� RESTRICTIONS:Republic Services 1-800-442-9006 Thurs after 9am r t BOARD OF ------------------------------------ HEALTH NOTES: Contact:Joseph Lynch;978.687.9614 ------------------------------------------------------------ ------------------------------------------------------------ ------------------------------------------------------------ BOARD OF HEALTH CHAIRMAN ji ............................................................... ............ ......... ..................*.............11*11111""*""I'll'I'll""I'll"""I'l"",","I....... 32 PARK STREET Reference No: BHF-2002-000033 ................................... Department: Permit No: BHP-2017-0303 ................................... North Andover BOARD OF HEALTH ......................................................................................... Account No: 2031207.1.5.0510.00 FeeType: .................................... Food Est. - Club; Organization PERMIT Receipt No: REC-2017-001195 ......................................................................................... .................................... Paid By: Paid in Full On: Tue Feb 21,2017 Club 2104,Inc. ................................... ..................................... ........................................... Check No: 12781 Received By: ................................... Toni Wolfenden ......................................................................................... DEPARTMENT'S COPY Amount: $160.00 ........................... ........................................................................................................................................................................... .......................... ................................................................................................................................................. 32 PARK STREET Reference No: BHF-2002-000033 ................................... Permit No: BHP-2017-0304 ................................... Department: North Andover BOARD OF HEALTH ......................................................................................... Account No: 1001001.1.5.0510.00 FeeType: .................................... Dumpster PERMIT Receipt No: REC-2017-001194 .................................... ......................................................................................... Paid By: Paid in Full On: Tue Feb 21,2017 Club 2104,Inc. ......................................................................................... Check No: 12781 Received By: .................................... Toni Wolfenden ......................................................................................... DEPARTMENT'S COPY Amount: $60.00 .......... ... ........................................................................................................................................................................ CLUB NO. VETERANS OF FOREIGN WARS 12781 TOWN OF NORTH ANDOVER 1/31/2017 Date Type Reference Original Amt. Balance Due Discount Payment 12/19/2016 Bill BHF2002-000033 220.00 220.00 220.00 Check Amount 220.00 OPERATING 6204 Acct#3190004 220.00 TOWN OF NORTH ANDOVER 4witrinsa Community&Economic Development , HEALTH DEPARTMENT 120 Main St. NORTH ANDOVER,MASSACHUSETTS 01845 Phone:978.688.9540 Fax: 978.6889542 E-mail:healthdept a northandovenna.gov APPLICATION FOR DUMPSTER PERMIT PURSUANT TO SECTION 31A AND 31B OF CHAPTER III `y�® OF THE GENERAL LAWS, AND RULES AND REGULATIONS OF THE NORTHANDOVER BOARD OF HEALTH DATE: OW f Application is hereby made for a permit to maintain a dumpster(s)on property located at � 3 a P'9'4jk 5ypee i in accordance with the rules and regulations of the Board of Health. j Applicant: . V F Vl/ - CAR D/(Property Owner: 1//-w �� JJ 0 y Name of Contact:7J5ZtP11 yrvt Owners Address: 34, �.. Address: .Yt P 34 �✓a A Owners Phone#: '?7F 6 V f4 Yeo Telephone#: QA '70 3Email address: Sac: c/Uri oldyo I&Ov 11 Dumpster Company: Re Dv.6 L iv !�e k V;Ca. Telephone#: 17(? fD Jr�D Pick-Up Schedule: On the back of this form, please sketch an outline of property, showing the proposed location of the dumpster(s). Give distance from dumpster to other buildings and lot lines or boundaries. Annual Dumpster Permit Fee: $60.00 per establishment Payable to: Town of North Andover. LATE FEE AFTER FEBRUARY 28 T" BE DOUBLED-$120.00 I *Please note that all contact information and the associated fee is required upon application submittal. i Page 1 of I DUAJO If V-, ........................................... c. .�tirpn,ke TOWN OF NORTH ANDOVER Community and Economic Development HEALTH DEPARTMENT 120 Main St. NORTH ANDOVER,MASSACHUSETTS 01845 Phone:978.688.9540 Fax: 978.688.9542 E-mail:healtlidept(@nortliandoverma.pov FOOD ESTABLISHMENT PERMIT APPLICATION (If nein establishment,application nmst be submitted at least 30 days before the planned opening date) FEE: Depends on tvpe of food establishment—Refer to your current permit or call the Health Department for fee amount 1 L Establishment Name: !1./4 V r W Cl U� 1(t �/ Date: 2. Establishment Address 3a yah j-, S—} A/,A 3. Establishment Mailing Address(if different) 4. Establishment Telephone M q-7-8 6 - V 5. Applicant Name&Title: d �� ����� S4 t `` 6. Applicant Address: 3 1 7. Applicant Telephone No.: f p, V Z f 74 V36624-Hour Emergency No.: U 7 f 8. Owner Name&Title(if different form applicant): OVJ4 4AW6 to'l 9. Owner Address(if different from applicant): 10. Establishment Owned By: 11. 1f a corporation or partnership,give name,title,and 0 An Association;>,A Corporation;F1 An individual home address of the officers or partner: Name ` Title Home Address ❑A partnership;D other legal entity -�"bew P�st��+� �i 4'y /) �/ 1 P� / l �Q1�-fl��rt( "��Li' �A�' 1 P5S i4r%e PJ ,46 0a) lip o 4i N o�r �1/.A°i�� d�y7 � ,v Ab 12. Person Directly Responsible for Daily Opel aAtions( wner,Person m Charge, upery sor,manager, c. Name&Title: �epA 1—y^" /"�4"-,,AqW Address: 3 J\ tV I Telephone No.: f-79 ( (0 Fax No.: E-mail: jr6-(—':74'6 Emergency Telephone No.: / ! 0671 z0 13. District or Regional Supervisor(if applicable) Name&Title: Address: Telephone No.: Fax No.: E-mail: Disposal: g ewa S . a ]4. Water Source: 15 � /p � NJ� 9 DEP Public Water Supply No.:(if applicable) i 16. Days and Hours of Operation: 17.No.of Food Employees i o AN Page ] of 3 NAME OF ESTABLISHMENT: AIR V 18. Name of Person in Charge—Certified in Food Protection Management(required as j10/1/2001 in accordance with 105 CMR 590.003(A)please attach copy ofcerlifieate): OSS 19. Person Trained in Anti-Choking Procedures(if 25 seats or more: es ❑No) NAME: ' 21. Length of Permit:(check one) 24. Location:(check one) mtual Krnianent Structure ❑Seasonal/Dates: Q Mobile 0 Temporary/Dates/Time: S E 22. Establishment Type(check all that apply): ❑ Retail( square feet) ❑ Food Service—( seats) i ❑ Food Service—Takeout ❑ Food Service—Institution( Meals per day) r ❑ Caterer ❑ Food Delivery ❑ Residential Kitchen for Retail Sale ❑ Residential Kitchen for Bed and Breakfast Home ❑ Residential Kitchen for Bed and Breakfast Establishments ❑ Frozen Dessert Manufac er l GP,'Other(Describe) - �b� 5i j wl /U r '/ 'C j,-, 23. Food Operations(check all that apply)—DEFINITIONS: ➢ PHF—potential hazardous food(time/temperature controls required); ➢ Non-PHFs—non-potentially hazardous food(no time/temperature controls required); ➢ RTE—ready-to-eat foods(Ex.-sandwiches,salads,muffins,which need no further processing LY'/Sale of Commercially Pre-Packaged Non-PHF's ❑ PHF Cooked to Order ❑ Hot PHF Cooked and Cooled or Hot Held for More than a Single Meal Service ❑ Sale of Commercially Pre-Packaged PHFs ❑ Preparation of PHFs for Hot and Cold Holding for Single Meal Service O PHF and RTE Foods Prepared for Highly Susceptible Population Facility ❑ Delivery of Packaged PHFs ❑ Sale of Raw Animal Foods Intended to be prepared by Consumer ❑ Vacuum Packaging/Cook Chill ❑ Reheating of Commercially Processed Foods for Service within 4 hours ❑ Customer Self-Service ❑ Use of Process Requiring a Variance And/Or HACCP Plan(including bare hand contact alternative,time as a public health control) ❑ Customer Self-Service of Non PHF and Non-Perishable Foods Only ❑ Ice Manufactured and Packaged for Retail Sale ! ❑ Offers Raw or Undercooked Food of Animal Origin ❑ Preparation of Non-PHFs ❑ Juice Manufactured and Packaged for Retail Sale ❑ Prepares Food/Single Meals for Catered Events of Institutional Food Service ❑ Offers RTE PHF in Bulk Quantities ❑ Retail Sale of Salvage,Out-of-Date or Reconditioned Food W.-Other(Describe): 1 ✓ m ` rt4i OU8 �� v �All- (2L)&!Ck age 2 of 3 i NAME OF ESTABLISHMENT: I **lF YOU DO NOT RENEW BY FEBRUARY 28"u,THE FEE WILL DOUBLE". I Please include copies of current Serve Stife/Allergen Training/Choke Saver Cerlifrcations I f I,the undersigned,attest to the accuracy of the information provided in this application and I affirm that the food establishment operation will comply with 105 CMR 590.000 and Article X of the State Sanitary Code,and all her applicable law. I have been # instructed by the Board of Health on how to obtain copies of t 105 C 590.000 the Feder 1 ood Code. 24. Signature of Applicant: g ture 7T,-60,p LAI( Print Name 4 Pursuant to MGL Ch. 62C,sec.49A,I certif},under the penalties ofpeijuy that 1, to my best knowledge and belief, have filled all i state tax returns and paid state tares required under the law. 25. Signature of Individual or Corporate Name: �!Q �/ (, 10 Signature Print Name } I i { I i Page 3 of 3 n r •; =�"�vC�.�' `' C%: �7f:. <, CERTIFICA TE OF C1 c�• V � E '7 Name of ! Joseph 'P c R Date of • • 15 9 12/28/2020 Issued `i By: /// / r /' / / / certificateC4C • G w rec/� / / erkshire / / �'// / / / .for completing an allergen awareness trainingprogram � H ,. V accordance / 9/ //' / H �. Pittsfield,Massachusetts Yhzs certificate will b .valid forfive(5)yearsfrom ' . U / s rn s r/j-� � U / <:r :. .i � U / V � YU � ;y,� � {zl �✓ � A,' x ,: W - • EXAM FORM NO. 4890 CERTIFICATE NO. 10642752 x4 Q rvSafe � . , TI FI ATION CER C TO JOSEPH LYNCH for successfully completing the standards set forth for the ServSafe' Food Protection Manager Certification Examination, is accredited by the American National Standards Institute(ANSI)-Conference for Food Protection(CFP). 4�. k � I DATE OW - 12/29/2 s DATE OF EX Local laws apply Ch or recertification requirements. 2,Anne can National Standards Institute. k t ant Association #0655 :" t ?)2012 National Rata mark of the NRAEF,used under license by National Restaurant Association Solutions,L.I.C. -.. .. r. 1 N0RTH Town of ndover 0 to h ver, Mass �a 0� . 9 cocNicKew.1. y1 R^TE O 1,P� U BOARD OF HEALTH Food/Kitchen Septic System PERfOIT T LD 6 4 tj IV N1, THIS CERTIFIES THAT ..................... ....... .... ..... �,..... � BUILDING INSPECTOR ...... .... ... .... ........................ ...... .... has permission to erect ............ buildings on �. ... �h� Foundation eN 06��'� Y � .................................... Rough to be occupied as �.�`.l1►�,..�J�.�.. .... . .�/'►�.................................................. Chimney h he person accepting this permit shall i eri ve r�ect conform to the terms of the application... provided that t pe p g p ry p pp Final ll2} �v/v on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and l� 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 STARTS Rough Service .............................:;....._...... ...................................... Final BUILDING INSPECTOR -GAS INS EP CTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises - Do Not Remove Final T No Lathing or Dry Wall 1'o Be Done, FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SUPPRESSION / INSPECTION nell Task# - ;' Date: SR# i'/ , r �,� �� NA In: � Safer. Smarter Tyco.' Inspector: /y,f .t,r ,-_ NA out:-- SHIP TO 1%s r' !si;1? �r �i Cr BILL TO: t`k.ls iiia., PSS-?13062 � 4,4W a; P 6,03-885-1110 F&M-598-2567 INSPECTION41 EXTINGUISHER INVENTORY QTY. PART LB DESCRIPTION PRICE TAMOUNFAXRT LB DESCRIPTION PRICE AMOUNT EX2010 EX Annual Maintenance Fire Ext 025 NEW EXT 2.5 LB D/C $ EX2011 EX Monthly Extinguisher Inspection 050 NEW EXT 5 LB D/C $ EX2012 EX Annual Maintenance Cart Operated 010 NEW EXT 10 LB D/CEX2014 EX Fire Hose Seryice/rerack 020 NEW EXT 20 LB D/C $ EX2015 EX Minimum Service Charge 150 NEW EXT 5 LB CO2 $ EX2032 EX Wheeled Unit Annual Maint 110 NEW EXT 10 LB CO2 $ EXTINGUISHER 6YR RECHARGES 115 NEW EXT 15 LB CO2 $ EX2060 EX Six Year Maintenance 120 NEW EXT 20 LB CO2 $ EX8025 EX Recharge 2.5 LB Dry Chemical $ EX1250 NEW EXT 5 LB FE36 Clean Agent $ EX8050 EX Recharge 5 LB Dry Chemical $ EX1210 NEW EXT 9 LB FE36 Clean Agent $ EX8010 EX Recharge 10 LB Dry Chemical $ EX1214 NEW EXT 13 LB FE36 Clean Agent $ EX8020 EX Recharge 20 LB Dry Chemical $ EX1213 NEW EXT 13 LB FE36 Non-Metallic $ EX8150 EX Recharge 5 LB CO2 $ EX1425 NEW EXT 2.5 GAL Pressurized Water $ EX8110 EX Recharge 10 LB CO2 $ EX1560 NEW EXT K-Class $ EX8115 EX Recharge 15 LB CO2 $ • INVENTORY EX8120 EX Recharge 20 LB CO2 $ EX3025 Serviced EXT Dry Chemical 2,5 LB N/C EX3499 EXFE36 Recharge $ EX3050Serviced EXT Dry.Chemical 5 LB N/C EX8030 EX Recharge K-Class $ EX3010 Serviced EXT Dry Chemical 10 LB N/C EX8035 EX Recharge Pressurized Water $ EX3020 Serviced EXT Dry Chemical 20 LB N/C EXBV20 EX Recharg6 Beverage Cylinder $ EX3021 Serviced EXT CO2 5 LB N/C EXTINGUISHER HYDROTEST EX3110 Serviced EXT CO2 10 LB N/C " EX2080 EX Hydrotest CO2(up To 20 LBs) $ EX3115 TServiced EXT CO215 LB N/C EX2084 EX Hydrotest Stored Pressure Type $ EX3120 Serviced EXT CO220 LB WN/C EX2090 EX Hydrotest Fire Hose $ EX3060 Serviced EXT Recharge K-Class EX8000 EX Hydrotest CleanGuard/Halotron/Halon $ EX3200 Serviced EXT Recharge Pressurized Water EX8070 EX Hydrotest K-Class $ EX3650 Serviced EXT FE36 5 Lb EXTINGUISHER SERVICE PARTS EX3609i'Serviced:EXT FE36 9 Cb EX2100 EX Conductivity Test And Label $ EX3613 Serviced EXT FE36 13 Lb EX4001 EX Locking Pi EMERGENCY LIGHTING INSPECTION EX4002 EX Verification Collar $ EE6001 EE Emergency Light Inspection $ EX4005 EX Valve Stem $ EE6002 EE Exit Light Inspection $ EX4100 EX Valve Retainer Seal(O-Ring) $ EE6007 EE Exit Sign AC only Inspection $ EX4200 EX Gauge $ EE6201 EE A/C Bulb $ EX4412 EX CO2 Safety Relief Device $ EE6202 EE DIC Bulb $ EX5100 EX Sign-Fire Extinguisher $ EE6004 EE Battery Disposal $ EX5200 EX Hanger-Fire Extinguisher $ ••• • • • :•- KH7000 KH Kitchen Hood Inspection $ QTY. PART LB DESCRIPTION PRICE AMOUNT KH7001 KH Additional Cylinder Inspection $ $ KH7002 KH Adjust Link Line $ $ KH7004 KH Replace Nozzle $ $ KH7005 KH Nozzle Cleaning $ $ KH7012 KH Replace Detection Line And Conduit $ $ KH7023 KH Hood 12 Year Hydrotest $ $ KH7101 KH Fusible Link $ $ KH7103 KH Rubber Blow-off Cap $ $ KH7104 KH Metal Blow Off Cap $ COMMENTS TOTAL CHARGES TOTAL SERVICES $ S :: �` .�/rrli '� -Z t}✓?f<. ! J TOTAL MATERIAL $ EX2017-HAZ MAT CHARGE $ SUBTOTAL $ g TAX %ON TOTAL SALES FUELSURCHARGE $ GRAND TOTAL $ 2 j�j•a�) IMPORTANT NOTICE TO CUSTOMER:Customer acknowledges and agrees that,in the absence-of a Service Agreement between.parties,services hereunder are performed pursuant to the terms and conditions on the reverse side of this Service Request. Customer further agrees that the services have been completed to Customer's satisfaction M6:that the system is in good working order andlrepair,unless_,a"...performed were of a temporary nature,.in which case.Customer acknowledges that part of customers system may have been bypassed or is otherwise inoperable until services can be cgmpleted. CUSTOMER'S ATTENTION IS DIRECTED TO THE LIMITATION OF LIABILITY,WARRANTY,INDEMNITY AND OTHER CONDITION& ON THE REVERSE SIDE. - Acceptance of customer or customer's representative Service Technicians Date Time Customer's Authorized Agen' PO# Print Name:/ �' :-%'�1_/y-%• HT1 4:, / lPrint Name: -/ { .y./am Ilk ,Employee Number: Sian Name: Jr � ('1 ICTfIhAFR f f1PV f/ r ;J ©SimplexGrinnell LP 2015.All Rights Reserved.! .-1-1 Office Use Only (�1E �IIIIIIIIIITIIUE�I D� c� Scll;hlIa�EfS Permit No. p Brpar1; rnt II{Public i'IIfP2U Occupancy A Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3190 (leave blank) \ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL RICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK ORRTYKE �INFORMATION) Date 8—�'S7 City or Town of 11/ t�j a0y-t To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. , re-le S;. Location (Street & Number) 2 P � ,�/ Owner or Tenant 14.t r4 � �Ev /'e � ' c w ' O sr 2` l o 7� Owner's Address Is this permit in conjunction with a building permit: Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps —J Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps_J Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Eiectrical Work 't vt eA^"4-)1N7 No. of Lighting Outlets I No. of Hot Tubs ( No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool AboveIn- grnd. '--� grnd. D Generators KVA No. c =mergency Lighting No. of Receptacle Outlets No. of C.: Burners I Battery Units No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges I No. of Air Cond. Total No. of Detection and tons Initiating Devices No. of Disposals I No.of Heat Total Total Pumps Tons KW No. of Sounding Devices No. of Self Cont.,ned No. of D,shwashers Space/Area Heating KW Detection/Sounding Devices No. of Dryers I Heating Devices KW LocalMunicipal ❑Other ❑ Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirer-�ents of Massachusetts general Laws I have a current ;.lability Insurance Polity inciudir Completed Operations Coverage or its substantial equivalent. YES ❑ NO CO I have submitted valid proof of same to the Office. YEZ� ❑ NO ❑ If you have checked YES, please indicate the type of coverage by checking the ap-py�nate box. INSURANCE 0 BOND ❑ OTHER ❑ (Please Specify) (Expiration Date) Estimated Value of Electrical Work Work to Start S�',5-- 97 Inspection Date Requested: Rough lJ�+� Final Signed under the Penaltie!,o perjury: 2 !7Q FIRM NAME J y✓�-t�v`�P' -7- C. LIC. NO.-13,5-9 Licensee S•, 7�r-7,+A14 4ZZ f. Sinature LIC. NO. ^ r [� 1,/j� Bus. Tel. No.Coe—�"�a-7 3 QO Address a7 C L0, tt..k'G S JS Alt. Tei. No. OW ER'S INSURANCE WAIVER: 1 am aware that the Licensee does nc! have the insurance coverage or its substantial equivalent as re- quire by Massachusetts Gen'Aral Laws. and that my signature on this permit application waives this requirement. Owner Agent (Ple check pne) G&•_ !r�L _73 0 !, \ co L"AtAL.4j Telephone No.(y�(p PERMIT FE_ S7 (/ U (Signature of Owner or Agent) X-6565 ,. Date.......e . .- i106 + NOR71{ "� TOWN OF NORTH ANDOVER PERMIT FOR WIRING 7SSACMUSE� I ��This certifies that ....Fn—A.v!—q.-2.!.......�'. .. ....................................... has permission to perform ....... !y:�.......i1 .".U' �./'.o e- ................. I -� I wiring in the building of....... .:...I :..Lv..:....../)0.-f... ? 3 /�t at a 1............5r ,North Andover,Mass. Fee.. 5 ...v..:.. ... Lic.No. l.�S.. .. .......................................................... E LECTR ICAL INSP EC TOR C 1, 51� �f g8/08/97 12:06 76, ppTn WHITE: Applicant CANARY: Building Dept. PIN k:7reasur'�7 Town of North Andover of NoaTH,, OfficeFr °+��tco yb•ti4�A of the Health Department Community Development and Services Division William J.Scott Division Director '� °+ �-M:.• ' 27 Charles Street 9ssACNus�t Sandra Starr P ( �978 hone North Andover,Massachusetts 01845 Tele 688-9540 Health Director Fax(978)688-9542 April 24, 2001 VFW Club 2104 Kevin Hayes, Manager 32 Park Street North Andover,MA 01845 Re: VFW Kitchen This letter is in regards to the re-opening of the lower level kitchen at VFW#2104. The current permit held by the VFW encompasses all levels of the food service operation. Presently, this includes the upstairs kitchen, which is used for catering, and the bar area. The small kitchen has been out of operation for a few years. As I understand it, the proposal is to re-establish minimal food service out of the small kitchen for approximately 20 hours per week to start,possibly to increase at a later date. The intended operators, The Smith's,requested input from this office. This correspondence follows an on site visit of your establishment and is only a summary of my findings. As there is not a pending application, this is not an official order to Correct. The permit renewal for 2001 was not taking into account the additional kitchen space and therefore it was not evaluated for its compliance to the food code. However, consideration must be given to the fact that it is in the same building. There are two possible scenarios that solely depend upon whether or not the space will be considered its own business. If the kitchen is legally considered a separate business than there should be two separate food permits. (Similar to Dunkin Donuts inside a Richdale) If there are two separate permits than the applicants must apply as any new establishment and the area must meet all aspects of the code. However, if the establishment is not a separate business, rather part of the VFW, than the present permit will cover the area. For the moment this office will consider the kitchen part of the organization for the sake of this recommendation. It is possible that this office could agree that some of the following recommendations could be scheduled as pre-opening and others as long-term improvements (see items in bold as must do pre-opening items). 1) Fluorescent light covers missing—must be covered to protect from shattering or replaced with shatterproof tubes. 2) Wooden shelves; old, porous and greasy- remove shelves on wall and replace as needed, constructed with non-porous materials BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535 i i1 3) Gas stove and hood- a. Hood does not cover total area of stove (fire dept. must be consulted) b. Stove is rusty and not cleanable in areas—should be replaced w/ commercial grade unit i c. Stainless not from floor to ceiling (fire dept. should be consulted) 4) Countertops chipping on edges, set on old wooden cabinets;much of the wood is worn, dirty and not cleanable—should replace with stainless counters 5) Floors—Behind and under equipment is caked with old grease and dirt— Remove all moveable components and clean as needed. Floor will need replacing at some point 6) Refrigerator—old and undersized for its purpose—should be replaced with commercial unit 7) The t�x�n ha��mrilk Aroulµl be adequate as long as there.S acceSS to the facilities upstairs for cleaning or to the dish machine. The present code requires a three bay, fnr prnpPr S54n;f,,7;nncr a 8) Wallpaper is old but mainly intact and cleanable. Marginally acceptable but would recommend rennovai and painting with washable epoxy paint or washable wall board material This lust should not be construed as an agreement of anv kind«nth the Health Department. Rather, it is a snapshot opinion of the situation as presented to this Inspector. As the process moves forward T will be able to he more specific in requirements versus recommendations. Thank you for your consideration of these reco?ninendwtinnc in yerunr decision concerning the renpening of this kitchen fpr retail purposes. I look forward to working with you on this project, as well as hopefully in the future with a much needed renovation for the upstairs kitchen. Sincerely, -sen Ford R.S. Health Inspector ate MORT: a TOWOF NORTH ANDOVER pf ��ao 1 PERMIT FOR PLUMBING 49 S3 C14uS� This certifies that ... . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . F2 . plumbing in the buildings of . . .L,!. -. .l.,4. . . . . . . . . . . . . . . . . . . . . . at. . . L-:1. . . . . . . . . . .,. . , North Andover, Mass. Fee/�� Lic. No..7 ?—'."7 . . . . . . . . .� PLUMBING INSPECTOR Check # �a 7501 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS ` DateBuilding Location-3li(f`�� 'f Owners NameV115-W Permit# �J Amount Type of Occupancy New Renovation Replacement Plans Submitted Yes No FIXTURES � H 0 o w a w xZ z U w o W A a 0 a A w w x x o C et A A H U a � a as F sisi%E BASE it M FLOCIR M FLOOR 3M rrJOOR 41H FLOOR 51H H M 6]HFLOOR 71H HLOCR 9IH HOM (Print or type) Check one: Certificate Installing Company Name �� �� ❑ Corp. D ,d.� filo Address � /�u.r�/�-�;rjT�/ 3�4�7 rlPartner. Business Telephone n d ` 20 er6 Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above threeinsurance signature Owner El Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts to Plumbin ode and Chapter 142 of the General Laws. BYign�a u�8f 1-icensea.riumDer Type of Plumbing License Title City/Town ice se INUMDer Master � Journeyman ❑ APPROVED(OFFICE USE ONLY Date..... o TOWN OF NORTH ANDOVER .0 Siam ; PERMIT FOR WIRING sSA USES This certifies that .......................b........_ .............................. has permission to perform .....1�..... 7�................ wiring in the building of................... ............................................................. at.................3.Z.—Pegeuce....... ............... .North Andover,Mass. Fee.!?� �"- Lic.No. l., .................... EmcrRICAL INSPECTOR7 Check # Z. 7 7 / / Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 7777 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ,f / 6/ � 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) ,T 2- Owner Owner or Tenant Telep one No.,0-7-Z&K/j Owner's Address S . Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building 41 lr7 Utility Authorization No. Existing Service e-ci Amps /.z o 'Volts Overhead'0-__-Undgrd❑ No.of Meters i New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: yyz �� f�,o�.z _ Co letion o the ollowin table may be waived b the fns ector o Wire: No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans o.of Total Transformers KVA No.of Luminaire Outlets Z No.of Hot Tubs Generators KVA Above In- o.o Emergency Lighting No.of Luminaires f/ Swimming Pool rnd. ❑ rnd. ❑ of Units No.of Receptacle Outlets 13 No.of Oil Burners FIRE ALARMS I 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 NumberTons 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.of Devices or Equivalent � No.o Water KW o.o No.of Data Wiring: r Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or E uivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: %/- (, o ;r 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 OND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: IC.NO.: 3_�r Licensee: !c s /, s,, ¢ ,//Signature LIC. NO.: (/f npplicable, ent "exempt"in the license norther line.) Bosy�ro.. Address: V <✓ Alt.Tel. No.: *Per M.G.L c. 147,s. 57-61,security work requires Departme t of Public Safety"S" License: Lie. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normall required by law. By my signature below, I hereby waive this requirement. I am the(check one ❑ owner ❑ owner's age/ Owner/Agent PERMIT FEE. $ SignaturetoreTelephone No.