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Miscellaneous - 400 OSGOOD STREET 4/30/2018 (2)
p40 OSGOOD STREET / �+ j 21 0 0000.0 1 I Permit Listinz Report Date Range:Issued between 01/01/2000 And 12/06/2016 by Permit Type Printed On:Tue Dec 06,2016 SQL Statement:Street No.like"400"AND(Street like"OSGOOD STREET"OR Work Location like"*OSGOOD STREET*")and([Type of Permit]="Building") Permit Type Address(Work Location) District Zoning Owner Work Category Est.Cost Proposed Use Details Map/Block/Lot Permit No Online Permit No Permit Status Date Issued Contractor(Phone#) Work Description Fees Paid Check# Building 400 OSGOOD STREET R-4 400 OSGOOD STREET NOMINEE TRU Commercial Alteration $27,752.00 WILLIAM F BANNISTER JR,TR 094.0/0001/ 106-14 Expired Aug-01-2013 The Carpenter's Edge(61.7)594-3350 Buildout 2 offices and 2 Bathrooms $333.00 2908 400 OSGOOD STREET R-4 400 OSGOOD STREET NOMINEE TRUST Commercial Alteration $3,300.00 &WILLIAM F BANNISTER JR,TR BP-2006-629 Expired Apr-10-2006 400 OSGOOD STREET NOMINEE TRUST& TENANT FIT UP WILLIAM F BANNISTER JR,TR $30.00 ON RECEIPT 400 OSGOOD STREET R-4 400 OSGOOD STREET NOMINEE TRU Commercial Alteration $3,000.00 WILLIAM F BANNISTER JR,TR BP-2007-398 Expired Nov-14-2006 400 OSGOOD STREET NOMINEE TRU COMMERCIAL REMOVE OFFICE WALLS WILLIAM F BANNISTER JR,TR $32.00 ON RECEIPT 400 OSGOOD STREET R-4 400 OSGOOD STREET NOMINEE TRU Commercial Alteration $1,000.00 WILLIAM F BANNISTER JR,TR BP-2007-586 Expired Mar-08-2007 400 OSGOOD STREET NOMINEE TRU TENANT FIT UP WILLIAM F BANNISTER JR,TR $30.00 ON RECEIPT GeoTMS®2016 Des Lauriers Municipal Solutions,Inc. Page 1 of 2 Permit Listing Report by Permit Type Permit Type Address(Work Location) District Zoning Owner Work Category Est.Cost Proposed Use Details Map/Block/Lot Permit No Online Permit No Permit Status Date Issued Contractor(Phone#) Work Description Fees Paid Check# Building 400 OSGOOD STREET R-4 400 OSGOOD STREET NOMINEE TRU Commercial Alteration $35,000.00 WILLIAM F BANNISTER JR,TR 094.0/0001/ BP-2010-083 Expired Jul-28-2009 400 OSGOOD STREET NOMINEE TRU TENANT FIT UP WILLIAM F BANNISTER JR,TR $420.00 ON RECEIPT 400 OSGOOD STREET R-4 400 OSGOOD STREET NOMINEE TRU Commercial Alteration $26,000.00 WILLIAM F BANNISTER JR,TR BP-2010-150 Expired Aug-25-2009 400 OSGOOD STREET NOMINEE TRU TENANT FIT UP WILLIAM F BANNISTER JR,TR $312.00 ON RECEIPT Permit Type(BUILDING)TOTALS: ESTIMATED COST: $96,052.00 NUMBER OF PERMITS: 6 FEES INVOICED: $1,157.00 FEES PAID: $1,157.00 BALANCE: $.00 GRAND TOTALS: ESTIMATED COST: $96,052.00 NUMBER OF PERMITS: 6 FEES INVOICED: $1,157.00 FEES PAID: $1,157.00 BALANCE: $.00 GeoTMS®2016 Des Lauriers Municipal Solutions,Inc. Page 2 of 2 Date.........'.... ............... TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING This certifies that ..... ...... ....... .. has permission to perform ..Le b -6,1 h�V, &4,,-,fu- '5LAu .....................................;....................I................................. wiring in the building of.4: (Ny�� t,) L st�c rosese—_ ............................................................................................................... at .4CD os>� ............................. ................................................................n North Andover,M S. FeeAZ ........Lic.No714(:�Z M ..........j&� 7 ............... ................ . . .... ELECTRICAL INSPECTOR Check: 2 1-Zf P Official Use Onl Commonwealth of Massachusetts q Department of Fire Services Permit No. 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 C),5 7 CMR 12.00 (PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: t q City or Town of. NORTH ANDOVER To the Ins ector 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 a ,; ° Owner or Tenant /J0/h E�j- Wrn Telephone No. 178 "-a30 Owner's Address 5r'Alw— Is this permit in conjunction with a building permit? Yes ❑ No (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 rd g ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: �/ E-D Y P k&3 Completion of thefollowing table may 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 No.of Luminaires Swimming Pool Above In- o.o Emergency Lighting rnd. ❑ rnd. El Satter 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.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.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 E uivalent OTHER: ,���Attach additional detail if desired,or as required by the Inspector of Wtres. Estimated Value of Elec 'cal Work: /? Q� (When required by municipal policy.) Work to Start: 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 the permit issuing office. CHECK ONE: INSURANCE (K BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties ofperjury,that the information on this application is true anal complete. FIRM NAME: . 1krr144,7 E&C hj- C LIC.NO.:oll bS?� Licensee: *111C4"- &�� 6-0 Signature LTC.NO.:5V5-L/&-� (If applicable,enter "exempt"in the license number ine.) Bus.Tel.No.•f r/3-30!-0-1S& Address: _6 �'i°��.. S �iX OL��d ®JaJ�" Alt.Tel.No.:171x-56/-/x/4 9' � *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage norrr-" required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's, O 4-,F Owner/Agent PERMIT FEE. $ I - Signature Telephone 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 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,aP electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the 't 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 0 Failed 0 Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass 0 Failed 0 Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass M Failed Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INSPECTION: Pass M Failed Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: FINAL INSPECTION: Pass[a Failed 0 Re-Inspection Required($.) ❑ Inspectors Comments: r `Inspectors Signature: Date: �=_INHOLD ...TOWN OF MERRIMAC,MA. .......dweinhold@townofinerrimac.com r The Commonwealth of Massachusetts Department oflndustriglAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): toe Address: �1' l5 LG� City/Stafe/Zip: X-� /�7 ����/ Phone#: 6 03F — 3t,9 3 --T9 Are you an employer?Check the appropriate box: Type of project(required): 1.N4 am a employer with T 4. ❑ I am a general contractor and 1 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. �• ❑Remodeling ship and'have no 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 required.] officers have exercised their 10.E1 Electrical repairs or additions 3.❑ Z am a homeowner,doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.❑Roofrepairs insurance required.] employees.[No workers1311 Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indicating they g're 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 their workers'comp.policy information. . -Taman employer that is providing workers'compensation insurance for my employees. Below is fhe policy and job site information. Insurance Company Name:. // Policy#or Self-ins.Lie.#: t7��>�G 3 Expiration Date: I t Job Site Address: I/dig 0 sq°'a 'd S/- City/State/Zip1 -Attach a copy of the workers'compensation-policy 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 statement maybe forwarded to the Office of 'Investigations of the DIA for insurance coverage verification. I do hereby cern er a pains an n ies ofper' ry that the information provided above is it e/and correct. - Si afar Date: I/ a`� /L/ Phone#: u gn 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.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - Contact Person: Phone#: Information and Instruction's 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 ofhire,• 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 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),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 anLL C or LLP does have employees,a policy is required. Be advised that this affidavit maybe 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 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 information(ifnecessary)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 Commoawoajtb ofMassarhvsetts Depafteat of Industdal Accidonts 0friee ofIntvestigation's 600 washinpl,Stxoet BostQnMA02111 Tel,#617-727-4900 est 406 or-1-877: 'ASSAk'B Revised 5-26-05 Fax# 617-727-7749 �7ffiVfFiXf_maCC an�s�i$ia OMMONWEALTH OF°=MA�SAC BOARD'-WW EfiR i Ci ANS SSUES THE FOLLOWI NG L.IENS.E AS1 RSGS'* ' RfO MASTER ELE HORKPGAN CTR iC :"(NG E 1#CH71:EL VA.-MR. f`GAN 1 s 6, T I TUk,,LW � � y . W OXFGRD MA 0- 19 2'1 261 2�4gg9 �'l i JO 033 '. Date tw TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING w This certifies that . . . . . .��h . ! r. � has permission to perform . . . . .�12`J �-c . . .f d0•+x/0 plumbing in the buildings of. Pv �T. . . . . . . . . . . .� I . . . . . . . . . . . at . . V. . . , �?�? :q7. _ . . . , . , North Andover, Mass. Fee .//k. . . . Lic. No. . . . . . . . . . . . . . . . .`?. . . . . . . PLUMBING INSPECTOR Check # a q j&�3 9 U� �j a MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY fie, _ _ MA DATE t __ R�( PERMIT# JOBSITE ADDRESS �t?� � 'f OWNER'S NAME L,— POWNER ADDRESS _ TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL 0 RESIDENTIAL 0 PRINT CLEARLY NEW: M RENOVATION:I REPLACEMENT: Q PLANS SUBMITTED: YES® NOW FIXTURES 7 FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB E ____l .__._._.� E I ( __.___J _-_.__.I _..___E __-__E ____.._I �__.E _...•.__E �.E CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM1 DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM E DEDICATED WATER RECYCLE SYSTEM E=1 _.-_____E .._..__J _._,1 _.._� _._.___I I J _ 9 __._..I ._..___._I _ I _.—..I I DISHWASHER DRINKING FOUNTAIN E ..._......I --..-_' --- f __.__J _-� .__.._( ._.___I _ _l _...._€ FOOD DISPOSER E .-_ i 1 f ..____I I -_--_1 FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) �i .------- -__.-.__._i _-...71 KITCHEN SINK LAVATORY ROOF DRAIN _,( .......... SHOWER STALL ._.___.1 ___....._I __..__.I I __.._ _f I .-_ J ...-_-___I SERVICE/MOP SINK _ EE _E _..__4 E E TOILET URINAL --------i f -__ i WASHING MACHINE CONNECTION ( J E - ,.. . E E , _-. ' WATER HEATER ALL TYPES -,.__f - --' WATER PIPING _1 I -_._! I . I l _ ( ....---I _-- -I - ._. f �E INSURANCE COVERAGE: 1 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 �I 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. 1 SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNER AGENT JEJ e(�• R hereby certify that all of the details and information I have submitted or entered regarding this application are true and acc ate to the best of my knowledge .— and that all plumbing work and installations performed under the permit issued for this application will be in compliance wit II Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME L&., a t6a, LICENSE# � NATURE MPO JPWE CORPORATION nV PARTNERSHIP P-1 LLC i COMPANY NAME e�;t1_ %� ADDRESS CITY _I STATE JI'J , _ ZIP Lyl a_� II TEL ---- G- 35 FAX _ __ j CELL _�p�e,---- I EMAIL Ct '' 9 ..._ Lt .gC1!G( '1_.._ ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ ` /1/////jC� �//Jy /1 /y FEE: $ PERMIT# PLAN REVIEW NOTES 4 4113 The Commonwealth of Massachusetts Department of IndustrialAccWnts Office of Investigations 600 Washington Street Boston,MA 02111 UT www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ,Applicant Information Please Print Legibly Name(Business/Organization/Individual): Kw4(ir�j!/l Address: ,37 Al! City/State/Zip: (,J/ / (a '( 7 Phone#: 7 " 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(full and/or part-time).* have hired the sub-contractors 2.X I am a sole proprietor or partner- listed on the attached sheet. �• E]Remodeling ship and'have no 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 required.] officers have exercised their 10. Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.]t employees.[No workers' 13.❑Other comp.insurance required.] *Any 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requireclunder 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. Ido hereby c"7 under the ai s andpenalties ofperjury that the information provided above is/true and correct. Si ature: � �- Date: �JJ Phone#• % J�" (f3 1 7 3 Q 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#: it 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 ofhire, 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 MassachUsPtts Department of Industrial Accidents Office of Investigations 600 Washingtou Stye.et Boston.,MA.02111 Tel,#617-72.7-4900 ext 406 or 1-877,7MASSAF& Revised 5-26-05 Fax#617-727-7749 www mtass.gov/dia. _CC?Ptliwp&'WEAL Hof MASSACHUSETTS , . PLUMBERS qND G E1eENSED AS ASFI1?SRS` ISSUES THE A130 EY1V1 , .d PLUMQ,ER vE LICENSE TO: KEVIN M LARKIN 37 MARCUS RD WILMINGTON MA 01887-1 :,,g 2b088 05/0 3_ 1/14. 160909�\ Y A 1 1 Date.........4............................... T TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..............�. '.. h.... ...................—.-......-.. ..7 .............. has permission to perform ..... 7. nn .....1.�..................... arm/g in the building of...........//4- � o,l c?111? ........................ ..... ............. ............................;-North Andover,Mass_ Fee..... 5.. .........Lic.No. ;M-Z EcnacAL INSPECTOR Check# ? Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. I l-7 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. ]/07] leaveblank 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: 8/7/13 N City or Town of. NORTH ANDOVER To the Inspector of Wires: `l By this application the undersigned gives notice of his or her intention to perform the electrical work described below. \\� Location(Street&Number) 400 Osgood Street 1 Owner or Tenant HomeGrown Lacrosse Telephone No. Owner's Address i Is this permit in conjunction with a building permit? Yes ❑✓ No ❑ (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 Wire the(3)new Offices,as well the(2) new Bathrooms, Relocate the(4) Switches to the Location and Nature of Proposed Electrical Work: new desk, install(3) EBU and(3) Exit signs Completion o the followingtable may 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 No.of Luminaires Swimming Pool Above ❑ In- 11 o.o Emergency Lighting ,rrnd. rnd. BatteryUnits 6� No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No. SwitchNo. GBurners No.of Detection and I o.oes o.oas Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump N..................ber 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.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: a 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:8/3/13 Inspections to be requested in accordance with MEC Rule 10,and upon completion. I.NSURANC:E 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: Dignis Electric Inc LIC.NO.:20021A Licensee: Signature LIC.NO.: (If applicable, enter "exempt"in the license number line) Bus.TeL No.' Address: 18 Samos Lane Andover Mass 01810 Alt.Tel.No.: *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: 1 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. $ � � ' ��'� r j� 1Y Date .��' -.Z-.7,. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that . . . . . ?�q. . . . . . . . . . . l .'. . . . . . . . . . . . . has permission to perform . . . �7-k.4. . �! r 7. . . . . . wiringin the buildingof . .. . ... `./. . . . . . at . / D 55: '� 5.%. . . . . . . . . . . . .!�rth Andover, Mass. Fee Lie. No.m e .qd� . . . . . . . . . ��,/?` . ELECTRICAL INSPECTOR Check# 110915 Commonwealth of Massachusetts Official t;.w Onl% /� Department of Fire Services Permit NO. /67 2 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS RRev. 11/99] (Icaw blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to he performed in accordance with the Massachusetts lilectncal Code(MEC).527 CMR 12 QO (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Cy/ 22//a City or Town of: r4 To the Inspector o f'Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street& Number) �90 © ST Owner or Tenant IVV\ e Telephone No. 107 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utilitv Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amp$ / Vol C Overhead❑ Undgrd.❑ No.of Meters Number of Feeders and'Ampacity - `1 t ,•. '�� Location and Nature of Proposed Electrical Work: Com letion o the ollm+•in table ma•be xaitird by the Inspector of 14'ires. 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 r cod.ve ❑ n-cod. ❑ Baa tts e mergency Lighting Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.of Detection an Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heatmp Number Tons KW o.of Self-Contained Totals: Detection/Alertint Devices No.of Dishwashers Space/Area Heating KW Local ❑ MunicipPI ❑ Other Connection No.of Dryers Heating Appliances KW Security ystems: Na o Devices or Equivalent No.o ea KW o.o o.o Data Wiring: Heaters Signs Ballasts No.of Devices or Duivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications firing: No.of Devices or Equivalent OTHER: Attach additional detail tJdestred.or ac required br the Impector 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: , 5D (Expiration Date) (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10.and upon completion. I certify,under the pains and penalties of perjury,that the information on application is true and complete. ECTi m g—W g$FIRM NAME: . . Licensee: 1ZdnerTN't a r"r LLLPI 0 SignatureLIC.NO.: /lf applicable,enter " m t"In the 1'eense`Jnumber lin Bus.Tel. No.: Address: 0 1 Cd Ah.Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee v.-not haw 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: $ /?�. Signature Telephone No. o00 w7fl XJ- � The Commonwealth of Massachusetts Department of Industrial Accidents OKIce of Investigations 600 Washington Street Boston, MA 02111 www.ntassgov/dia Workers' Compensation Insurance Affidavit: Builders/('ontractors/Electricians/Plumbers Apahkant Please Print Lezibl Name(liusiness/organvatiun!indi.idual): A M Address: q ft q5AX�_1_ '5 j City/State/Zip: 4f Vd)%&;Phone n: 7 , ( "S S Are you an employer?Cbeck the appropriate box: Type of project(required): 1.❑ I am a emplover with 4. ❑ 1 ant a general contractor and I 6 ❑ yew construction employees(full and/or part-time).* have hired the sub-contractor 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. = 7• ❑ Remodeling ship and have no employees These sub-contractors have & ❑ Demolition working for me in any capacity. workrn' comp. insurance. 9_ Building addition (No workers'comp. insurance 5• We are a corporation and its required.) officers have exercised their 10.E] Electrical repairs or additions 3.❑ I am a homeowner doing all %ork right of exemption per M61. I I Plumbing repairs or additions myself. (No workers'comp. c. 152. x11(4),and we have no I2.0 Roof repairs insurance required.) employees. INo workers' i comp. insurance reyuired.j I`•❑Other ll ,�. �t 'An)applicant tho chccits bo.a I roust alsti fit)out the.cetum W-o%.hawing their Norkem amtpernatxxt rxtltcr mf vmatxm 11sxne-mrs who submit this affidavit tndicaMing tkt arc dtnng all work and then htrc mamde ctmtramn%ntuu.uhrnn a nc%%atTda%it tndteming.heli k'o+ntrnkm due chc&this box must attached an Wdititxtal sheet dum ing the name of the.ttMuxrtraetur%and then wtwkcr.'c(vnp.pnlic%tnftxms im I ata an etapdoyer fiat it providixg workers'compensadon insurance for tm•eav4greec. Below is tie polio'and job sue infonsatiott. Insurance Company Name: 400 R s 5 K S e mce 5 , Policy it or Self-ins,,.``Lic. -: W c U I a��C f O q 7 Cj M A I xpiration Date: 7l L/ lt5b Site Address: "1'i�0 n.`j ('it\ State/.ip: 1.1pfA�1J��llef�yNf)UI`tSyS 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 M(i1,c. 152 can lead to the imposition of criminal penalties of a line up to$1.500.00 andlor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 a day against the violator. Be advised that a cop. of this statement may be for%arded to the Office of Investigations of the DIA for insurance coverage verification. !do ietrby calf penahlrs of/xrjurl that tie information provided abos t is free and correct :` ''���-- �. nate• �l�l� thone #: 74s/ - y35-04 3--2 F eid use ON6. De trot write in this area,to be completed br eitc or town official.y or Town: Permit/License Ning Authority(circle one): 1. (Board of Health 2. Building Department 3.C•itv/Town Clerk 3. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone N: Date. ........ p NORTH °f� 4,, TOWN TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SgACMUSE� /J This certifies that ---r''?.: f.:r.? has permission to perform ........... � �-��-�- ../ r........ ...................................... wiring in the building of......' T. -: s . .'1&4......................................... .................. z r ................. . ... .... .North Andover,Mass. 4 Fee.� %� ic.No9 �' Y.�f........ .. . ..�A 1� ELECTRICAR` Check # 9UUr1 Commonwealth of Massachusetts Official Use Only Department of Fire Services Pern„t N . BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked /& [Rev. 1/071 Qewm blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL 1/�, All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 12.00 U WORK (PLEASE PAINTT W INK OR TYPE ALL INFORMATION) Date: 5E.!,;�qr /0 City or Town of: NORTH ANDOVERTo the — By this application the undersigned gives notice of his or her intention to perform the electrical work pector of idescribed below. Location(Street&Number) d 4w Owner or Tenant /L L/ipyY� �� ` Owner's Address ddb Telephone Is this permit in conjunction with a building permit? , Purpose of Building AAPZQ jif 5_.Qvn2 ❑ (Check Appropriate Box) /UlYes No���Utility Authorization No. E�sting Service B(9 Amps y�0 / 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- IrrrA m a e e Com letio III the followin tab a may a waived by the Inspector of Wires. No,of Recessed Luminaires No.of CeiL-Sus No. of p�.(Paddle)Fans Transformers Total No.of Luminaire Outlets No.of Hot Tubs KVA Generators KVA No.of LuminairesSwimming Pool Above [IIn- o.o mergency lg g —. No,of Receptacle Outlets d �d Batte Units No.of Oil Burners FIRE ALAILMSf No.- ��;zes a• No,of Switches No.of Gas Burners No.of Detection and No.of RangesTotal Initia • Devices No.of Air Cond. Tons No.of Alek g Devices No.of Waste Disposers a a'e t Heat Pump Number Tons KW / Totals: -- _. o.of Self-Contained No.of Dishwashers _ Deteetion/Alertin Devices Space/Area Heating KW Local❑ Municipal No.of Dryers C ❑ Other HeatinAppnces KW � Security Systems:* No.of WaterKW No.of Devices or Equi valent Heaters No.of No.of Si s Ballasts . Data Wiring: No.Hydromassage Bathtubs No.of Devices or E uivalent No.of Motors Total HP Telecommunications Wiring: OTHER: r,!�.r No.of Devices or E uivalent Q� Estimated Value of Electrical Work: Attach additional detail if desired, or as required by the Inspector of Wires. + G�c,G/ Work to Start Inspections required by municipal policy.) 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 cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTS ❑ (Specify:) I certify,under the p ns and penalties of erjury,that a information on this application is true and complete. FIRM NAME: Ceryl 0 �� Licensee: l �� LIC.NO.: Signature (If applicable, enter"exe pt"in a license nu*Mne.) r /r P LIC.NO.: , F Address: /�,Cj�/ us.TeL No.: ,7— *Per M.G.L c. 147,s. 57-61,security work requires Department of Public afety"S"License: Alt Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement I am the(check one)❑owner ❑ owner's agent Owner/Agent Signature Telephone No. PERMIT FEE: $ `� r '�, �'�-� � � �. ii � /�` �� /a� �r � � ; , :. .�., . . .. ;. The Common wealth of Massachusetts kj 1! Department of Industrial Accidents ;i#fir ! Office of Investigations 600 Jf izshingjon Street ��•. 8t Boston, MA 02111 c www mass.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plambers ,kpplicant Information PleasePrint Leaibi n1 Na8 (Business/Organ/ization/Individual); �I���iI� ��' J(J/����3"l�r Address: `l lg1ee_# 1�9_' City/State/Zip: AV gLN1Phone Are you an employer?Check the appropriate box: 1.❑ 1 am a employer with 4, 77 � ject(required): ❑ l am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors construction 2.❑ I am.a.sole proprietor or partner- listed on the attached sheet,t deling ship and have no employees Th a ails-contractors have 8. ❑Demolition working forme.in any capacity, orkers' comp.insurance. [No workers'comp. insurance 5. We are a corporation and its 9' ❑B ing addition officers have exercised their 10 lectrical repairs or additions req3.❑ I am a homeowner doing all work right of exemption per MGL 11.[] Plumbing repairs or additions myself[No•workers'comp, c. 1.52, §1(4),and we have no insurance required.]uit I2.[]Roof repairs q ) employees. [No workers' comp. insumnce mquired..) 13.❑.Other *f'"Y appircartt that checks bo> tf l must also fill out the section below showing their workars'compensation policy information. t Homeowners who submit this RfF'dmust vii 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-conwwm s and their wotkzrs'comp.policy infating such. lam an employer that is providtrtg:workers'compensation imurawe for my.employees; Below is the pommy and job site informadom Insurance Company Name: ' Policy 4 or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showiag 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 faun 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. t 1 do hereby certify un the p enalties of perjury Mar the information provided above is trete and correct r Si tore: Phone#: Official use only. Do not write in this area,to be complet+od by city or town off, al City or Town: Permit/Licerim# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical InspectorE5. 6.Other Contact Person Phone#: Information a end Instructions Massachusetts General Laws chapter 152 requires all emp Ioyers 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 includirzg the legal representatives of a derased employer,or the receiver er t mstee of an individual,partnership,associatioa7 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.oV compliance with the insurance Icoverage required." Additionally, VOL 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 tmtil acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the coritracting 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)mind 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'm-rnpansation insurance. lfan LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and-date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not-the Department of Industrial Accidents. Should you have any questions rega=-ding 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-instance license number on the appropriate tine. 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 vvilI 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-currunt policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of tine affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigation would like to thank you in advance for your cooperation and should you have any questions, w 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 Investigation 600 Washington Street Boston, IIIA 02111 TeL# 617-72.74900 ext 406 or 1-11.77-MASSAF£ Fax#617-727-7743 Revised 5-26-05 wwwmass.govldia Date..J..GG}} '.. .. ............ ,10RTM TOWN OF NORTH ANDOVER PERMIT FOR WIRING ass^cMusE� s t This certifies that ..�`'<< �. �. .... �� .......................................... has permission to perform . /,J ..... �1!!e✓!'! T°7'�..................... wiring in the building of...... c�l......!,.?.10.J, �"'................................ at.....V0. ?J ......� .............. .. .North Andover,Mass. ............... Fee.. ! Lic.No.�U / �� ..... .... ............. ................... ...... .. ... ...... . ELECTRICAL INSPECTOR Check # & S� `89 : 3 Commonwealth of Massachusetts =1107] = se Oniy i Department of Fire Services ,BOARD OF FIRE PREVENTION REGULATIONS ckedk APPLICATION FOR PERMIT TO PERFORM ELECT 1/�` All work to be performed in accordance with the Massachusetts Electical Code(MEC) 527iC/+RALOU WORK (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: ] ItTl City or Town of: NORTH ANDOVER By this application the undersi ed To the Inspector of Wires: gn gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) q 0b Owner or Tenant Owner's Address -- �" -ll��1--��GA01.s4-r Telephone No.01R(pg3._82 Is this permit in conjunction with a building permit? n/ Purpose of Building-- t Yes !� No ❑ (Check Appropriate Bog) Ccr c c r, Utility Authorization No. Existing Service? Amps !c�Q /� Volts Overhead ❑ Undgrd❑ Na,of Meters New Service Amps _____L_Volts Overhead❑ Uncigrd ❑ No.of Meters Number of Feeders and.Ampacity Location and Nature of Proposed Electrical Work: �l n%+ 14 ©r\11= j Com letion of the ollowin table may be waived by the Inspector o Wires. No.of Recessed Luminaires No.of Ceil.-Sus f p.(Paddle)Fans o.o Transformers Total ` No.of Luminaire Outlets No.of Hot Tubs KVA Generators KVA No.of Luminaires Swimming pool Above ❑ )�_ o.o mergency Ig g No.of Receptacle Outlets 3 rIId Bo. Units No.of Oil Burners P•�ALARMS �� No,of Switches No'of""nes No.of Gas Burners o.of Detection and No.of RangesNo.of Air CondTotal Initia Devices . No.of Alerting Devices Hest um Tons No.of Waste Disposers p Number ons KW_ Totals: o.of Self-ContainedDetection/Alertin Devic . No.of Dishwashers Space/Area Heating KW Local❑ Municipal No.of Dryers Heatin A Con11neciaon FlOther Heating Appliances KW Security Systems: No.of Water KW No.of o of lvo.of Devices or Equivalent Heaters Si s Ballasts . Data Wiring: No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total Hp Telecommunications Wiring: OTHER: No.of Devices or E uivalent J- E Estimated Value of Electrical Work: Attach additional detail if desired, or as required by the Inspector of Wires. Work to Start I v°I (When required by municipal policy.) 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 E� BOND ❑ OTHER ❑ (Specify:) I certify,under the ains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: au CG. Licensee: C �t.e� �� SignatureLIC.NO.: 2Q2 7.3 A (If applicable, enter exem t"in the license number line) LIC.NO.: St7o2 s'(^ F Address: y Q,) 11111"O,�Ill,I r t^ t nS fan MA 18/7 Bus.Tel No.: *Per M.G.L c 147,s 57-6 1,secunty work requires D Alt Tel.No.: $S7-aa41-a'E3� OWNER'S INSURANCE WAIVER: I am aware that Livens a dons noSaft ha"S"License:y ins Lic. eNo. e required by law. By my signature below,I hereby waive this requirement I am the ve tcheck one) ❑owner ❑ owneor ally Owner/Agent gent Signature Telephone No. PERMIT FEE: ,S' �'rj-. y i ;� , � __ a 1 The Commonwealth of Massachusetts j I Department of Industrial Accidents ; r Office of Investigations X, 600 NZashinajon Street Boston, MA 02111 www_massgov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electriciaas>'pi mbers APPlicant Information Please Print Legg Name (Business/prgenization/Individual);_ Address: City/State/Zip:-�.�LLns-fon �1,A fl t�(1 Phone#: 1Ll `` �\) Are Y99 an employer?Check the appropriate box: 1.E-f am a employer with �-time 4. 77. [3 fpre17(regairetij:❑ I am a general contractor and Iemployees(full and/or p .* have bred the sub-contractorsNew construction 2.❑ I am.a.sole proprietor or partner_ Listed on the attached sheet t emodelingship and have no employees These sub-contractors haveworking for me in an ty emolition y uranr workers' comp.insurance. g Building[No workers'comp. i>zsurartce 5. ❑ We are a corporation and its ❑ ng addition required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL l I.❑ Plumbing myself[No-workers'comp. a t.52, §I e and we have L reps or additions i insurance required.]t .employees. [No workers' 12❑Roof repairs comp. insurance required_] 13 Other Any appiicam that checks boI#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, Contractors that check Chia box must attached an additionsl sheet showing e the namof the sub-conha dors and their svorkzrs'camp.policy inmtmation. 1 am an employer that is providmg:workers'compensation trisuranee f or information. , 1 v'employees: Below is the pohcq-and job site Insurance Company Name: Policy#or Self-ins.Lic. \,j E xpiration Date- O\ Job Site Address: ( Ci /State/Z' Attach a copy of the workers' compensation policy decfar-ation page(showing the policy number and expirationte). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a Je fine up to$1,500.00 and/or ori imprisonment,as well as civil penalties in the form of a STl7P WORK ORDER and a fine of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. L 1 do kereby certify under the pains and penalties of perjury that the information provided above is true ,torted Sitmature. Date: dPhone 41: "! FIDepartment only. Do not write in this area,to he completed by city or town offer iaL Town: Permit/License# Issuingarity(circle one): ealth 2. Buiiiling Department 3.City/Town'Clerk 4. Electrical Inspector 5. Pinmbing inspectorson: Phone#: Information a nd Instructions Massachusetts General Laws chapter 152 requires all emp 3 overs to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of him, express or implied,oral or written." An employer is defined as"an individual,partnership,assodiation,corporation or other legal entity,or any two or more of the'foregoing engaged in a joint enterprise,and 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 lto 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-contractors)name(s),address(es)aired phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)witty no employees other than the members or partners,are not required to cavy workers' compensation insurance. If LLC or LLP does have j 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,nottthe Department of Industrial Accidents. Should you have any.questions regarding the law or if you are requited to obtain a workers' compensation policy,please call the Department at the number.listed below. Self-insured companies should enter their self-insurance license number on the appropriate dine. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom If 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 permittlicense number which wilt be used as a reference number. In addition,an applicant that must submit multiple permitAicense 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 tine affidavit that has been officiaily stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for futum permits or licenses. A new affidavit must be filled out each year. When a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a flog license or permit to bum leaves etc.)said pers6n is NOT required to complete this affidavit f 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 Depamnent's address,telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents 4~ilfice of Investigations 600 Washington Street Boston, MA 02111 Tel.#617-7274900 ext 406 or 1-8.77-MASSAFE Fax 4 617-727-7744 Revised 5-26-115 www.mass.gov/dia Date... e- ...................... ti TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies ........ ......................./..................................... has permission to perform,..—7-1--4...... ...... ................................... wiring in the building ............ 4/,--0 at ............................ ........... North Andover,Mass. ......................................... Fe/ ............ Lic.No.............. .................if tea Check # 8 7 -;) -� //�� 00// // Official Use Only (fommonweaR of)Waasachasetb R. `7. Permit No. � I� 2epartment of ire erviced Occupancy and Fee Checked " BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1.07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK \!1\�ork Lobe performed in accordance with the Massachusetts Electrical Co7(�R / R 12.00 1\T R1L4TJO.V) Date: 7C Cite or Town of: : To the In -ector of Wires: 13. a:i, applicator the undcrsiened gives oti his or her intention erform the electrical work described below. Location (Street& Nu ber) Uts ner or Tenant o Telephone\Q ONs ner's:address Is this permit in conjunction iiith a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpnsc of Building Utility Authorization No. L.,Nistin„Service Amps r Volts Overhead ❑ Undgrd❑ No. of Meters \rss Svrvice Amps _ / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacit Location and Nature of Proposed Electrical Work: Completion of the folloivina table mal:be waived by the Inspector of kvires. 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 mergency tg mg No. of Luminaires Swimming Pool arnd. L1rnd. ❑ Battery Units ro. of Receptacle Outlets No. of Oil Burners FIRE ALARNIS No.of Zones '.Jo. of SNI itches No.of Cas Burners No.of Detection and Initiating Devices of Ranges No. of Air Cond. Total No.of Alerting Devices Tons b No. of Waste Disposers Heat Pump \umber. Tons KWNo.of Self-Contained Totals: Detection/Alerting Devices No. of Dish«ushers Space/Area Heating KW Local[ICo n nnectioecho n ❑ Other Co No. of DrNers Heating Appliances Kms, Security Systems:* No.of Devices or Equivalent No.of\N aterK"; 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 bn the Inspector of b6"ices. { Estimated \ aiue o FI cni 1\Fork: t (\\hen required by municipal policy.) r \\ork to Starr. _ Inspections to be requested in accordance with MEC Rule 10,and upon completion. y INSURANCE C N RA E: Unless\yawed by the owner,no permit for the performance of electrical work may issue unless the hcrosee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undcrs;,ned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CliL_Ch CONI=: INSURANCE Ll BOND F1 OTHER [I (Specify:) V I cevif i% under the pains and penalties of peijuiy, that the information on this application is true and complete. FIR\i N-VNIE: �'► �� LIC.NO.: Licensee: c� c, IIIc Signature 1C.NO.: 73 :l ,i;>,r ar ie cvNer 'exem r' rn the lice se na n?be.li 7e. Bus.Tel.10.. Address:,_2 r1. (l,�!��//,YQ� C��r�ir�r �7 Alt. Per \CG.L. C. 147. S. _7-61. security vyork requires Depa ment of�lic Safety"S" License: Lic.No. O\\ NER'S INSI'R,-kNCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally ;equircu I"' laic. Be my sionature below.I hereby waive this requirement. I am the(check one)❑ owner ❑ owner's ageen��t. 5i��narurc "fele hone No. PER't7IT FEE: $ Date....`S... ...�.� cI NOR7M °ft�``°:•�"a TOWN OF NORTH ANDOVER 3? ,.r - ._• of 0 SiSlAft, % PERMIT FOR WIRING ,SSACMUSEt This certifies that /� �+ .........................................�................................. has permission to perform .................................................T v �`� n ... wiring in the building of.....llmnryr.1w V.. at..........`I !Q.... ....... � ...... ......... .North Andover,Mass. 1 Fee ............. Lic.No. ?, ... ......�.......... ... . . . . . . ...... . ELECCRICAL INSPEMR V Check # 7383 May 09 07 01 : 53p best buy 978-455-3512 p. 2 Commonwealth of Massachusetts ��UseOnly Department of Fire Services permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. 11/99] !cave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),$29 CMR 12.00 (PLEASE PRINT IN INK OR TY?f ALL INFORMATION) Date: f44-Y 9. City or Town of: t±A 4A>>ft*0- To the Inspearoi,of Wires. By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 4, Owner or Tenant a Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (CLeck Appropriate Box) Purpose-of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Vans Overhead❑ Undgrd❑ No.of Meters - Number of Feeders and Ampacity Location and Nature of Proposed Eke Work: SqR r Completion sake fUla table may be waived by the L clot Wires. t No.of Recessed Fixtures o.of Cell.Susp•(Paddle)Fans o.o ata Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA Ill No.of Lighting Fixtures ,�y Swimming Pool i rnd e ❑ d. ❑ B% Units n No.of Receptacle Outlets -95-41 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners o.o on an initiatinir Devices No.of Ranges No.o-'Air Cond. Total Tons o.of Alerting Devices No.of Waste Dis ors eat p u VITUS o.o - on alne 1'os Totals; Detection/Alertlae D vlces No.of Dishwashers Space/Argg HestinP KW Local ❑ Municipal ❑ Other Connoetialr Heating Appliances security ys ears: No.of Dryers KW No.ofDevices or E uivalent Nos of Water W No.ar Data Wiriing Heaters Signs Ballasts No,of lfevices o ulvalcnt No.R dromassa a Bathtubs No.of Motors Total HP a ecommn ret ons ng: Y g No.of Devices or E uivalent OTHER: Anosh additiowal detail ffdefire 4 L or as ragafred WY the 7;;;e-00 r of Wires INSURANCE COVERAGE. Unless waived by the owner,no permit for the perfwlnance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove Se is in force,and has exhibited proof of stone tithe t issuing office. CHECK ONE: INSURANCE [BOND ❑ OTHER ❑ (Specify r. 11016°L- 0 xpirano ate) Estimated Value of Electrical Work: '9e0 • (When reWred by municipal policy.) work to Start: Q.S.c4. . Inspections to be requested in accaroanoc with NEC Rule 10,and upon completion. I cedyy,under Aie�Qenahim of peg ary,tJmt the i»fortnerti wi OWs app' n' true and complete FIRM NAMES rLr.E LIC.NO.:� �fi� Licensee: ,rft tea Signature - LIC.NO- (if O. l/IaPPlicable, r'erranpt"in the licenumber lige) I Bus.Tel.No. Address: .D.� `j9 J�A,a �'f9. �/8 Llt,'I4 No.: OWNER'S INSURAN WAIVER: am aware is ensee oer not a 11ty insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) owner ❑owner's uEnt. Owner/Agent PERMIT FEE, S._ 11 Signature Telephone No. s Y 1 a May 09 07 01: 53p best buy 978-455-3512 p. 1 i FORCE ELECTRIC, Inc. P.O.Box 99 Dracut,MA.01826 Phone Number/978-455-2789 Fax Number/978-455-3512 Email:ricog4@comcast.net Fax me w-o To: Peter Murphy From:Rico Gentile Project:Homegrown Lacrosse DateiTime Sent:519/07 Company:wiring inspector Phone: Number of Pages:3 Fax:978.688.9542 n�tessage: Peter,this is a permit for the above project as spoken to you from the owners brian and tim @ homegrown lacrosse. They have asked me to pull a permit based on another persons work, which does not include much. I have inspected this work and it looked o.k.. Please let me know what you would like from me,I have included my certificate of insurance. My cell# is 978-804-6765 Thank you, Rico Gentile VkORTN 01 I'.•o 0,1'40 O o (10 a° ��sSACHUS 1 APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION Building Permit# ADDRESS/LOCATION OF PROPERTY : 40() -S-f- Map �' Parcel cool Lot Number SUBDIVISION 4,1& DATE REQUESTED FILED/READY FOR INSPECTIONCLOSING DATE DATE ON PROPERTY: /- 31-- el 7 FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE- INSPECTION FEE OF TWENTY DOLLARS$20.00) WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES._ SIGNED ROUTING C0 SERlfATION PLANNING DPW -WATER METER SEWERIWATER CONNECTION NOTE DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST DPW 11A Signature File: OC form revised 2006 ` 4 oRTr{ Town Clerk Time Stamp BkX0608 P:9139 -0-3156 I Of Nuao 8, 1 01-29—'. 007 al 1225-6r), �� •`-�+- �'yo� OFFICE RECEIVED 2005 DEC 26 PM 2: 29 q rc�ar.rr '� This is to certify that twenty(20)days �� °""*•o�""t<°� have elapsed from date of decision,filed Ss�et+us� without filing of a appeal. T O ;'? Date' * ft/ /8, da,7 NORTH H Joyce A,Bradshaw ZONING BOARD OF APPEALS �,�;;; .,. , Town Clark a Community Development Division �''�S�"'�`� ` ATTEST: Any appeal shall be filed within Notice of Decision ��,,,MAII True Copy (20)days after the date of filing Year 2006 gra,Q adufa of this notice in the office of the Town Clerk Town Clerk,per Mass.Gen.L.ch. 40A, 17 Property at: 400 Osgood Street NAME: Bryan Brazr71,190 Chickering Road, HEARING(S): December 12,2006 #1061),North Andover,MA ADDRESS: for premises at:400 OsgoodStreet PETITION: 2006-039 North Andover,MA 01845 TYPING DATE: December 15,2006 The North Andover Board of Appeals held a public hearing at its regular meeting in the Town Hall top floor meeting room, 120 Main Street,North Andover,MA on Tuesday,December 12,2006 at 7:30 PM upon the application of Bryan Brazi% 190 Chickering Road,#106D,North Andover,MA for premises at:400 Osgood Street(Map 94,Parcel 1),North Andover requesting a Special Permit from Section 4,Paragraph 4.122.9.b in order to establish a private for profit educational facility for one-on-one lacrosse training within an existing structure. Said premise affected is property with frontage on the West side of Osgood Street within the R-4 zoning district. Legal notices were sent to all names on the abutter's list deemed by the Assessor's Office of North Andover to be affected,and were published in the Eagle-Tribune,a newspaper of general circulation in the Town of North Andover,on November 27&December 4,2006. The following voting members were present: Ellen P.McIntyre,Joseph D.LaGrasse,Richard L Byers, Albert P.Manzi,III,and David R.Webster. The following non-voting members were present: 'Phomas D. Ippolito,Richard M.Vaillancourt,and Daniel S.Braese. Upon a Mien by Richard M.Vaillancourt and 2°d with amendment by Albert P.Manzi,III,the Board voted to GRANT a Special Permit from Section 4,Paragraph 4.122.9 of the Zoning Bylaw in order to allow the .lacrosse private for profit educational facility for one-on-one training within the"Tenant 2"area per. Site: 400 Osgood Street Oft 94Parce11),North Andover,MA 10845 Site Plan Title: Non-Residential Site Plan prepared for 400 Osgood Street Nominee Trust,William F. Bannister,Trustee&Parking Layout Plan prepared for.400 Osgood Street,Lot 94-1— North Andover,Massachusetts,Owner.400 Osgood Street Nominee Trust,clo William Bannister,380 Winter Street,North Andover,MA 01845-140 Vol. 5131:Pg. 214(July 30, 1998 Date(&Revised September 1999,rev. 11/11/98, 12/30/98, 10/16/00 Dates): Registered David C.Liukkonen,R.P.E.#29381,KNA Keach-Nordstrom Associates,Inc., Professional 10 Commerce Park North,Suite 3B,Bedford,NH 03110 Engineer I Sheet/Drawm Drawl no.M-1261-L,Sheet 1 of 1&Project No.98-0811-1, Sheet 1 of 1 Page 1 of 2 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9541 Fax 978.688.9542 Web www.townofnorthandaver.com f NORTH 1 Town Clerk Time Stamp •- + - R CCiVED L TQt,s ,-ERK'S OFFICE ,y °"'►no�,.r� 2006 DEC 26 PM 2: 29 CiWs�� tr TU�,i�l G;- ZONING BOARD OF APPEALS NORTH ANDOV�" Community Development Division MASS4CF;�.��I�I� Building Plan Bannister Building Tenant#2,North Andover,MA,Floor Plan Tide By: Jensen Stenbak AmMectnre,Interiors,Project Management,4 Auburn goad, Londonderry,New Hampshire 03053 dt Floor Plan Proposed Renovation Lot 94-1 Osgood Street,North Andover,MA dt Elevations Date: 8 Oct 99,5 Nov 9918 Feb 00 Added Tenant#5 Spee prawin No.:A-101 With the following conditions: L Any change in use or in the Teunt#2 lease area,shall require the petitioner to return to this Hoard for review and approval;espcciaity for review and approval of use re:parking r+equiremeats at 400 Osgood Street. 2. The owner,400 Osgood Street Nominee Trust,shall provide a list giving the 5 tenant names, the S tenant square footage,and the uses of the 5 tenant areas. Voting in favor. Ellen P.McIntyre,Joseph D.LaGrasse,Richard J.Byers,Albert P.Manzi,III,and David R. Webster. The Board finds that the applicant has satisfied the provisions of Section 10,Paragraph 10.3 of the zoning bylaw and that granting this Special Permit from 4.122.9.b of the North Andover Zoning Bylaw for the ons on-one by appointment,only lacrosse training center will not adversely affect the neighborhood nor will this use be a nuisance or serious hazard to vehicles or pedestrians by off-street padang. The Board finds that the 400 Osgood site is an appropriate location for this use. The Board finds that adequate and appropriate facilities will be provided for the proper operation of the private for profit educational facility. The Board finds that this use is in harmony with the general purpose and intent of the Bylaw,and such change,extension or alteration shall not be substantiall1y more detrimental than the adsting structure to the neighborhood. Note: The granting of the Variance and/or Special Permit as requested by the applicant does not necessarily ensure the granting of a building permit as the applicant must abide by all applicable local,state,and federal building codes and regulations,prior to the issuance of a building permit as required by the Building Commissioner. Fwftrmore,if the rights authorized by the Variance are not exerted within one(1)year of the date of the grant,it shall lapse,and may be re-estabhshzd only after notice,and a new hearing. Furthermore,if a Special Permit granted under the provisions Contained heroin shall be deemed to have lapsed after a two(2)year period from the date on which the Special Permit was granted unless substantial use or construction has commenced,it shall lapse and may be re-established only after notice,and a new hearing. Town of North Andover Board of Appeals, &A P4. 'TL Ellen P.McIntyre,Chairman Decision 2006-039. M94P1. Page 2 of 2 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 918.688.9541 Fax 918.688.9542 Web www.townofnorthandover.com m m m w a �,mlxc�cNr � e7ti Y71f1aYa W'ilNwOlr F { W wuofaIGl1,El�1QD 100 F j 1NfM If ►� wfe.. i ; Ib e� ....,eq.,,,,,s ' / 4 � I � ' I �. ; {{• aiaw�w.�W (t}t I u.YzsoWafa111�iala /•E•A•I.=.A . �_ �y �i w � � j �' � f{ felY11« i f� ••rgR�ec�Yp. � - - _-_ari�Wea.eu _ _ ___ M = - �^�__-eQYw•!< <- b.RGGtGI •�.<..r... Yn! . f r CD co `` WI • ( � � � � �MKh + 3 1�0lN� elienr. ��� �?w,y•iM �.y� I i � 1I eesw. ffrltl m .rrrafr��aYrw.eclvatr.r.ce.w.r lf1f.M.lylgawffu.oAHUYr�lR!• RfffL AYffa OiilfOl�-oea.ofl tD +eu►far/rRN�uwfAlw�6la f 11001 flfl�N m •W.rwwlef YYC�4�fLf1lfy►i{ f/1!' 1'�Or 400 OSGOOD STREET t 4f..ffAffl�Rs M TENANT OCCUPANCY SCHEDULELO o N � � TENANT USE SQ FTr TENANT# 1 Osgood Street LP W/H storage 6,649 2 Home Grown Lacrosse Lacrosse training 9,216 Il; ; 200 N 3 Arco Excavators Storage 1,160 4 Puckmasters Hockey training 4,792 5 One to One Strength Physical training 6,203 '101 11 t r7e.=V ^WOR T H F ! RY CE DEEDS Lrt,, rENCE,MAS-- A A TRUE COPY: ST.- REGISTER TREGISTER OF DEEDS NORTH o�ATLIG wb qti 1 �D . o � � A 9SSgCHU`-+ES � •�� ZONING BOARD OF APPEALS Community Development Division Date: Dear: As you know,the Zoning Board of Appeals granted your application for a Variance and/or Special Permit or Finding for premises at: Your 20-day appeal period will have passed at midnight on the following date: 1. Once the appeal period has passed,please pick up your Town Clerk-certified copy of the Zoning Board of Appeals decision,and your ZBA Board-signed Mylar(if a Mylar was required)from the Town Clerk's office located at 120 Main Street,North Andover,MA 01845(978-688-9501) 2. Please bring the Town Clerk-certified copy of the decision Essex North Registry of Deeds, 354 Merrimack Street, Suite #304 Lawrence, [use Entry C)MA 01843 (978-683-2745),as the decision and Mylar must be filed at the Registry of Deeds as soon as possible. 3. Once this is completed,please bring:A.copy of the Town Clerk&Registry—stamped decision,B.a paper copy made from the ZBA Board-signed and&Registry-marked Mylar, &C.the Registry of Deeds receipt to the Building Department,which is located at 1600 Osgood Street,North Andover,MA 01845. Failure to file the decision and Mylar with the Registry of Deeds will result in your inability to exercise your Variance and/or Special Permit and/or Finding due to your inability to obtain a building permit from the Building Department. "Furthermore,if the rights authorized by the variance are not exercised within one(1)year of the date of the grant, they shall lapse,and may be re-established only after notice,and a new hearing. Furthermore,if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two(2)year period from the date on which the Special Permit was granted unless substantial use or construction has commenced,they shall lapse and may be re-established only after notice and a new hearing." If you have any questions, please feel free to call (978-688-9541) or fax (978-688-9542), Monday through Friday, 8:30-4:30. 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9541 Fax 978.688.9542 Web www.townofnorthandover.rom x jc COLLOPY ENGINEERING CONSULTANTS 65 AYER STREET METHUEN, MA 01844 FRANCIS H.COLLOPY RESIDENCE 685-7969 REG.PROFFESIONAL ENGINEEER OFFlCE!FAX8 685-8069 CML STRUCTURAL DYNAMICS October 17, 2006 Mr Gerry Brown, Building Commissioner Town of North Andover 400 Osgood St North Andover, MA 01845 PROJECT NAME: Renovation at 345 Osgood St, North Andover, MA PROJECT CONTRACTOR: Stephanie Moore, Lasting Impressions Design ENGINEER'S REPORT I hereby certify I have inspected the framing at the address shown above and have observed that the engineered lumber and LVL's that have been put in place correspond with those specified in design report letters sent to Stephanie Moore of Lasting Impressions, dated August 14, 2006, and September 5., 2006. It is my understanding that copies of these Report/Design sheets were presented to your Office by the Builder. The majority of the structural members that were sized for the Builder were for various headers, both on interior walls and exterior walls. There were two attic beams that were shown on the 8/14/06 report that were for longer spans than typical header lengths. Respectfully submitted, 4 r Is H. COLLOPY 20172 Francis H. Collopy, PE Structural Engineer Location '-/,-v �n� - No. 6 C2 i? Date �ORTM TOWN OF NORTH ANDOVER 3: • OL f 9 rr� Certificate of Occupancy $ -0 Building/Frame Permit Fee $ ACMus . Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check 11 �U 19, 5.1 Building Insp4t5r i; 'JJC�4 CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 629 4/10/2006) Date: August 25, 2006 THIS CERTIFIES THAT THE BUILDING LOCATED ON 400 Osgood Street- Bannister Bldg. MAY BE OCCUPIED AS Tenant Fit Ua- Puck Masters IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: William Giles,JR. 25 Sunrise Drive Bradford MA 01835 Building Inspector Town of Andover10 - � No. �aA ....... ... = � dover, Mass., vv O _ `A �. COC KICKEWICK V ADRATED PPS\ -`y 7`r BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System p � , "' BUILDING INSPECTOR THIS CERTIFIES THAT.......a)%.... A..M.N.1 . .. ..................................................�.................. Foundation has permission to erect........................................ buildings on .... ... Rough L p � s to be occupied as G . '.. ......... '... ... . JW4 .............. �himneX, ;PI provided that the rson accepting this permit shall n very respect conform to terms of the application on file in Final �- this office, and to the provisions of the Codes and By-Laws relatingto the lnspe tion, Alteration and Construction of i i Buildings in the Town of North Andover. VV �--''p GING INSPECTOR ' VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS .00 ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ARTS ....... .... .......... Service ' D G PE inal k 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. 1 SEE REVERSE SIDE Smoke Det. Rug 22 06 02: 06p NORTH ANDOVER 9786889542 p. 1 .�:Fml til '�`.�ti• _y��a � 74 �$A�Hl35E APPLICATION FOR CERTIFICATE OF OCCUPANCYIINSPECTION Buidin lg Permit# 4�2,9 ADDRESS/LOCATION OF PROPERTY : 4490 map Parcel 1 Lot Number 4 SUBDIVISION DATE REQUESTED FILED/READY FOR INSPECTION CLOSING DATE ON PROPERTY: FIVE f5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE- INSPECTION FEE OF TWENTY DOLLARS$20-00)WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNED ROUTING CONSERVATION PLANNING D DPW-WATER METER a SEWER/WATER CONNECTION NOTE DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCYRNSPECTION REQUEST DPW Signature File: OC form revised 2005 -C -rE COLLOPY ENGINEERING CONSULTANTS 65 AYER STREET METHUEN, MA 01844 FRANCIS H.COLLOPY RESIDENCE.CML (97�685-7969 REM PROFFESIONALENGINEEER OFFICE/FAX: 7 685-8069 STRUCTURAL DYNAMICS July 31; 2006 Mr Gerry Brown, Building Commissioner Town of North Andover 400 Osgood St North Andover, MA 01845 PROJECT NAME: Hockey Training Center PROJECT OWNER: Bill Giles, Puckmasters, Hockey,Training PR90JECT LOCATION: 400 Osgood' St, North Andover, MA ENGINEER'S FINAL REPORT (For Control Construction) I hereby certify I have periodically observed the work associated with the structural aspects of the Project in compliance with Section 116. of the MASSACHUSETTS STATE BUILDING CODE, as requested by your Office. It is my opinion, based on my observations and to the best of my knowledge, information and belief, that the Project noted above was constructed per the details submitted for permit and shown on the Drawings, tithed. Proposed Interior Build-out, Hockey Training Center', located at the left rear section of the building at 400 Osgood St,, North Andover, MA. On 4/24/06, 1 performed a final inspection of the structural work for the Project noted above, and based on my observations; the framing is completed and conforms to the drawings submitted to your Office by Mr Bill Giles, Manager for the Hockey Training Center. I discussed with you at that time that there are some minor shifts in the location of the partition walls and that I would provide you with a set of"marked up in reds drawings to show the as-built partition location. You indicated to me that this would,be acceptable to you..I have enclosed the marked up set for your r ' 1 � � v files. At this point in time, the final boards and skating surface is in place and ready for the intended use as a Hockey training Center. This Final Report is to indicate that the framing work was satisfactorily completed'', and the locus is ready for occupancy. Respectfully submitted, 0 0r`Nt�� FRANCIS H. COLLOPY v 0172 Francis H. Collopy, PE 4� $11; ���� Structural Engineer sslONA1.E� @� . _«z 'ILI 9 " Date...... ... I—R-6.... l NORT" 3?0 .'ef--;9" ° TOWN OF NORTH ANDOVER 0 p PERMIT FOR WIRING ,'23ACMus This certifies that /lam "�� CE '....(.... ................. ...... ... . ............. has permission to perform ......... ....... .... ....................................../«......... wiring in the building of..... .6�*411...............IM ................................... 14.............................. at �`, ............................................� .North Andover,Mass. 3s o� Fee..................... Lic.No.............. ................... ..:............ _ ELECTRICAL INSPECTOR � � Check # �a3..s N Commonwealth of Massachusetts Official Use Only • Department of Fire Services Permit No. Occupancy and Fee Checked 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(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: 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) <10 o o✓ 4 p �/ .f��e Owner or Tenant 133,c„„ ;J��r o✓w,,�r �;�� �7i r �n�w Z Telephone No.;rBi 3710 P vim Owner's Address Ufa p o f5 C C �f St: „i � . re",a- e- Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building �'�' z �'°` d� / r4 ,.,meq Cry. t r 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: Completion of the ollowin table may 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 AboveIn- o.o Emergency Lighting No.of Luminaires Swimming Pool 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.o -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 I 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.of Devices or Equivalent No. o Water Kms, No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsWiring: No.of Devices or Equivalent OTHER: GG Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Val e o Elec rical(1 Work: U0 (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COV9 AGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove e 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 ofperjtury,,,that the information on this application is true and complete. FIRM NAME: lNl(il(/1v�lt� '—tet C LIC. NO.: C)W-3 Licensee: Signature LIC. NO.J622 --'3—B (/f applicable, te �e_�en 'icfnse nzirry��ie Bus.Tel. No.: Address: --!l--- ((�� 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's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. � l �G(. TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING a - s K Section for Official Use OIil ',x��-' ��:._• �_ � K.� ��zz'�w. BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: �yBuildipA Commissioner/Inspector of Buildings Date M,.w h 1.1 Property Address: 1.2 Assessors Map and Parcel Number: -/DO oxg v e 17 4_�c p/P_Y ? _ Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zonin District Proposed Use Lot Area Frorrta (ft 1.6 BUILDING SETBACKS(ft) m Front Yard Side Yard Rear Yazd Required Provide Required 1 Provided R1 Provided 9.I/ / /Y7Z 1.7 WaterS ly M.G.L.C.40. 54) 1.5. Flood Zane Information: 1.8 Sewerage Disposal System: publk pate ❑ Zane Outside Flood Zane ❑ —i6 On Site Disposal System ❑ ��.. ME is v is ric . es o 2.1 Owner of Record !'l!! Q �• / c Hn�~S�c_�-- �flo �S5 o nc� �tl' il✓ �i�lyd� �� Q Name(Print) Xdd�dress for Service 6 Oc3' "T907 Signature g� Telephone 2.2 AuthorizedAgent Name PrintZ Address for Service: e /P� 7 — C.- G C's 7 /- O Signature Telephone M Y141 MjM. s $ 3.1 Licensed Construction Supervisor Not Applicable ❑ o Ve' '2)@ tr !rf C Address License Number O Licensed Construction Supervisor. Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ . v Company Name Registration Number M r Address r Expiration Date ^Z Signature. Telephone Y OMMU Workers Compensation Insurance affidavit must ybe completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Sign affidavit Attached Yea.......❑ No.......❑ ~ SECTION S . ROIQ1AQ1►p1 �CQx1RIS 13tQ ,, Q " T157��"i':Tt3 cQx���ta►N c��Q> ,���ct� ���a�+lyQr ��t ���� + �».;�1�� bslav�a 5.1 Registered Architect: Name: Address Signature Telephone ;: s2stexectte Area of Responsibility Name: Address: Registration Number Expiration Date Signature Total Not applicable ❑ Name: Address g Re istration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Not Applicable ❑ Company Name: Responsible in Charge of Construction New Construction 0 Existing Building Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. D Demolition ❑ Other Specify n Brief Description of Proposed Work: y /� //TSL G GL4/f/ O� Gt �O X 7O ' ��HTr �/� /Cis�T / I'75¢a6,/, fioe-7 �. aL�v 4, C� e•��.���C-e x'00^-1 �vcGtc�� Old- e `4 45-1 USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 0 IA ❑ A4 ❑ A-5 ❑ 1 B ❑ B Business ❑ 2A ❑ C Educational ❑ 2B ❑ F Factory ❑ F-1 0 F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ IInstitutional ❑ I-1 ❑ I-2 0 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use Specify: 0,-7 0- NAS COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: t�o r a u e0-7 0- Proposed Use Group:,4o,4'e X 1/'c►- Q Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floors Total Areas a,. ,tE S/ ` v XC' Total Height ft <�«-� # �P,�! t�' /► a?a�f a v� �',c, /fi Independent Structural Engineering Structural Peer Review Rapared Yes ❑ No 9-" SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT 0,R CONTRACTOR APPLIES FOR BUILDING PERMIT I> as Owner of the subject property Hereby authorize to act on My behalf, in all matters relative two work authorized by this building permit application Signature of Owner Date c Ip� /`�j f� f��• �_ / as Owner/Autno ed Ager* �G-IT C Lv T/f`� / O r T /a S�4 C 0 f �f p C/ T 4/' Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties yof perjury Print Name Signature of©wattj e ` Date �,. d Item Estimated Cost(Dollars)to be 3 , ' „"fib p h r3 wr ; Completed by permit applicant ` T S 1. Buil P (a) Building Permit Fee 06` 11-'0"AZI-C Multiplier 2 Electrical (b) Estimated Total Cost of Construction from(6) 3 Plumbing Building Permit fee (a)x(b) 4 Mechanical(HVAC) 5 Fire Protection 6 Total1+2+3+4+5 ( ) Check Number ..?4}f,vU ;Y ,rye: 1� t k. Ny*s -k.�'aa -...g.•�= t;o,` r,,� 2?,�.Jia ✓', rT3. 2 V _.�,.,,t't' x� qa.. {'r'�,"a ..b�i Vin, . i `+'ix-. s an��r,: AS.�A/Y.. t x3 s'rjr,..y� �t•�,�'3F'1 r'�'3a,};.fir,. ,. ref.. :iS; Lr :}�'�. §� �J�.,vttr3;,'i s�; . ti ?, r, :.. 4W,010��4. .v -?'va�,�'rr�?5°r+ NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINIBERS 1sr2ND 3 RD SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIlvINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 1 r a"ar cruor s FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTION APPLICANT !����� z� 71 4 S PHONE 9 7 Y 7y 4P�� 6 O LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT(S) STREET ��� `J G'TS�'�"� ST. NUMBER `f' ° OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Breakaway Enterprises, Inc. DBA Puckmasters 25 Sunrise Drive Bradford, Ma. 01835 Bill Giles-President 978-373-8360 781-910-8016 Cell wlgartlnae,aol.com bgiles@puckmasters.com Attention: Y / O COPYRIGHT REJSE OR HEPRO�IUCTiON OF-FE OONI ENT 3 OF TH'S Mf:Ylev S NOT?ERVC TEC WI-HOC"WHIT..-E:: PER.•1.SS ON OF JENS EN STE:.Brri REV1,SlONS DATE REVISION 8 00 91.4 5 Nov 99 - 18 Fab OJ ACOa:f TFnam-5 - - i EXISTING ELECTRICAL PANEL NEW 12'X 10'(H)OVERHEAD DOOR \ j NEW 3'-0"x7'-0"DOORNEW 3'-0"x7'-0"DOOR I I , 1 BRACE I I �� EXTG. BRACE I I BRACE �`. E4 Et� ET �-`' � E, E4 Lot-D': El �/ fnJHAR.4' --2 HR.FIRE SEPARATION WALL ' - j .N� v i ELECTRICAL LEGEND XISTING WALL(ttP.) /_ , ,� I El-EXIT SIGN W/EMERGENCY LIGHTING „ / I ! _4P0" 1 6 J,4EI . J FRAME FOR FUTURE DOOR 7I �� /ni I ! I E2-EXITSIGN TENANT#1 i I a�y i ! J•E N 5 E•N z / TENANT#3 REq/ b l j ?_0"` I E3-EMERGENCY LIGHT WITH REMOTE HEAIN51 �*•!�'+'R��'^^ ! I-�2.HR.FIRE SEPAr; NA L ! d t ! I y/ 2 HR. ! I / FIRE 'U c m ,� NT#4 I i E1 1 E4- EMERGENCY LIGHT(2 NERDS) •1 j --2 HR.FIRE SEPARATION WALL I -COMMON AREA ! / EI�c / WALLA\ m / I I E5- REMOTE NERD { 4".0l fi" lig'-6" 6 23'-6" 6 4=0" 1010 ,'84 01 90' ___ 6" '-0" ur.:fri retro rr I I IE4 e I Y�{-0E4 Y rtcri'�1 Et RIDGE HEIGHT 20'_O IDGEHEIGHT20-0 - .1.. AREA_C. ALCULATIONS ' p.o/.rl . v El -` : TENANT;i- 6,6495E mann,grm nnr i 2 HR.FIRE SEPARATION WALL I I 1 ! Et 2 HR.FIRE SEPARATION WALL ! 1 I I TENANT Y2- 9,216 SF -0'% 14'-4', 6" 35'-il 1/2'. 4g•-0•• 107'-G1/2•• 6•• 91•_5•• 1 TENANT Y3- 1 1605E 4 cv nnn r / , rad I 42 lun.tr E4 , l q,,l,:,nJ,r�l•,�,,.,,,,,t;A /, 4zg 5„- la.JzS yr;. TENANT#2 v TENANT Y.4- 4,7925E TENANT#5 TENANT�5- 6,203 SF '�, !/ •--SEE ENLARGEMENT I I E4 BELOW EO COMMON AREA 2,71651 ! -4 { EAVE HEIGHT 16'-0"t 1 I `BRACE I BRACE I : BRACE I NOTES: I. NOM.&"WALL:2 HOUR FIRE SEPARATION WALL-35B ST 20 @ I6"O.C.,(2)LAYERS 5/8"F.C.GYP.BOD.EACH SIDE,FILL FLUTES/TOP OF WALL W/INSULSAFE,SEAL W/ I(( FIRE CAULK,FRAME DBL DOORS(4 TOTAL)-TO DECKASO VE FLOOR PLAN 2. NOM.S WALL:358 ST25@16"O.C.W/5/8"F.C.GYP.BRD.EA.SIDE 16••_1•_0•• 3. NOM.7-WALL:60 ST 25 @ 16-O.C.W/5/8-F.C.GYP.BRD.EA.SIDE /T7 4. F/L=FAN/LIGHT - Z 5. CH CEILING HEIGHT 6, A.F.F.=ABOVE FINISH FLOOR •V ,v L � d m a O d C W = a C s o LL Z 1-. z Q m Drawing No.: A- 101 n u -n...n<.. InF Aln• IIl►•1111 -4—TOMAP M OF LOT 3 ANDOVER NAP 94, LOT 5 AAP 102; LOT 3 1,DwN20�NORTH ER 44440T" � NOTES: N. NDN STREET N. ANDOVER, MA D1845 N. ANDOVER NA 01845 1. REFERENCE THIS PARCEL AS NORTH ANDOVER ASSESSOR'S MAP 94; PARCEL 1. N. ANDOVER.MA 01813 T.. TOTAL AREA OF PARCEL IS 254,575 S.F. OR 5.844 ACRES. 3. PARCEL IS LOCATED WITHIN THE R-4 ZONING DISTRICT IN ITS ENTIRETY. 4. BUILDING SETBACKS: REQUIRED PROVIDED _ — — — —_ — EXIST• CUFZB r(pDENT 30' 147.1'± REAR 15' 19.4'± / 137.2'± 30' 229'± - — ESS ROAD EXIST. EO_P — — — (�— \ 5. TOTAL LOT FRONTAGE IS 514.75± L.F. N•A•H•C• ACCFSS— — — — — — — — — \N O� \ 6. OPEN SPACE 202,046± S.F. k PERCENTAGE OF LOT COVERAGE — 21X _J ON % \ �i S 35.5418" 870.98 osx'alDOOR ARK Aw e Xig 94-1 254.575 SQ. FT. \ 5.844 ACRES Sip S.F.t •.. IST1NG 3�' pp'f) EX (305 W AREHOust oo.a DOST.STA6 � \ F.F. e1 \ \ M81 POOND LONOMEOWNERS ASSOCIATION ,0 1y�� \ c/o ESSEX MGMT.GROUP \ P.O. BOX 2096 HAVERILL, MA 01631 ON \ \\ ZONING BOARD OF APPEALS "6+- MAP ft TOM OFNNOORTHH ANDOVER �"� wAP 94; Lor 2 � \ 120 MAN STREET TOWN OF NORTH ANDOVER N. ANDOVER. NA 01843 120 MAIN EE O/6113 GRAPHIC SCALE 40 0 20 40 Bo 160 ( IN FEET ) 1 inch = 40 ft. PROJECT x0. 98-0811-1 PLAN OF LAND: REv[s[oxs OWNID ��J/�\Q AASSOCL= INC. 400 OSGOOD STREET wie ns�eoe DATE:JUNE 09, 2004 j�L t 1 J329—NOMMO NOMINEE TRUST 400 OSGOOD STREET C/o WILLIAM BANNISTER SCALE:1• - 40' 380 WINTER STREET atr Ir/ml-of a NORTH ANDOVER. MA 01845-140 SHEET 1 OF 1 ,.�.•+m*. . , m mjs ob..w.)Wy-am LOT 94-1 — NORTH ANDOVER. MASSACHUSETTS VOL5,3i; PG. 214(JULY 30, 1s9e) ww.1111% � 'wfete;and Bounds Description FOUNDMH6 \� 4ca.;,• SITE �n t Beginning at a Nlassachusetts Highway Bound on the northeasterly side of Osgood Street,said bound $CWXL being approximately one-hundred-ninety-one(19 1)feet northerly of the centerline oTHarmway Street; = ! S1"{ � � � _ - ;•--- thence S 82°-5 7'49"W a distance of 83.32'to the point of beginning: �'! Rr./ E�EY "'»''?' v\�� '"i1 thence tumvtthence !ng and runn ing along Osgood g and terming ale ng Osgood SIIeet S 43°2l'0"4'✓a distance of 58.82'to a point at the r TO NOint: RT cCH00L ER /;n/„� / Inly. 8' PVC OUT 9 93.91)* µleµ -Cp m(tb. TABLE £L. 94.1V Y \ Sa :o ENiv northeasterly comer of land now or formerly belonging to the'fown of North Andover; 30-5 thence nuning and running ring along land now or formerly belonging to the Town of North Andover N 23°57'30"W a distance of 1060.82'to a point; Eo OG __ /__-.. thence turning and running along lanow or formerly belonging to the Townof North Andover �--; - - _ P' m N 73°41'37"E a distance of 184.65'to a Poing -BO FTrU OF POND `L 94.i _ .-.e -.� _-.cit'•'. `1 r -\ % LLE _ thence tamcroAndover and running along land w or formerly belonging to the Town of North dnver ;j �•'-- ' S 33°54'18"E a distance ol'370.98'to the point of beginning. 100' eOFFER FROM 'WET'AND -- - �P,fiAP• •, t�� "\' �il� LOCUS PLAN LOT a +/ i 70,98 til- -•_,_t- 't.1 \tom' -.uE�O �^ ' ,�• .' e \ O ST:?NE NOT To ^a IE II MAP NCRTµ ANDO 7 u 8 N3 75A \ . ecuNp a r O F AGE � . . _ �- �.��✓-- R ,- 10 NN 0 1170 P _ �,:- / PRINKLE L ✓ \.. �, �£ Q ' rr.CtaD N D R D' B E,io _ V AL 1E \; s`o;. \`�'--RK p,W A E. .,t ti✓ _ -�/ fir, -IW, o�AP '. HA p Roy V/ATERY\\\ MECO #33;5A _ CCY G DING !`� W V. \ \ \ J• .,4 AND OVY .E gUILDIN i6 .-zq _11_\ `;L�' -RIP RA� _ \ CAiCFI Bs:=IN { M T AL. pGCX �\.U3' I, W.. L =3'_ -_ i: METER.. ....)1RE :MAIL�O% Lf:� -_i--;-'\7. _. 5 ........................CPS (.LARM..... 1--.-_--- E-- `,\\ IN•1. HTPF ly 95.92. ,t EDGE OF WETLAND / EXISTING Y UNr ` ._�-;c ME" c,P GA L ro ..uPPRO;t. YIA. R,.,F -_9ti:2+iIN'V. .. R-. IDU" '3_..95' \ AC UNIT �hT 1 --_ C.f PA'X p:`.P \\ �G GRASSvOG_E i- •.` p C' " 25'NO DISTURBANCE ZONE '' / ' / `-'o�- S`' G`%=- ,-,] = __ —w5" i .f-:-` - 4 .! �,,...�_ "`1\\`;' \9L I DMH + IN 50'NO CONSTRUCTION ZONE. '� / -�\` - \ \ s BRVIELE`: 99. . �� 1/l` pRAINS ('n.£ J9r:4 - ._--/ ,rd"--,—.— 4-'t---_-�T o. - nv. t?.. uDFP IN �6•9' r, - �. \ \ ,,,,�1s•�p'>•\ �- — / /^ FR � .,r - \v 12.. riDPP -.,T-6.25' u� \�/ '-_111J__�'-'�•-•`. ,.'4�`t. _�.'- _ - ,_-:. _ _ .._ RIPRA? J' .- FLOW CQt_rl-�'�, //I Y—^ _ ^ ^-_ _./ - t,.Y., y -_/."•--�"C_� j 'TAN hTc'IR �Cr7�n�L�, - LIMIT Or' WORK FORMER LOCATION OF \i ` i`�I`J v. RCP :u ?5.97' �.� + .-.-HAY WITH 8" HDIP BALES REG!.CER4J7.\_EOSE OrVETLAND ?/H9 iFGUND 'MAP 94 LOT 1 �I �,_, A - ti__ N�)i FnUrJC .959) 2S4,575 S.F. �'� -25' NO DISTURBANCE ZONE Q O v 5.844 ACRES --A TIO v t \ P N 0 q ( -'yam\ � 'u- — - \--50' NO CONSTRUCTION ZONE "GOD -- .y.OY Q0 al N 23'57'30" W 1060.82' Z 4i � MAP 94 LOT 2 j TOWN OF NORTH ANDOVER ' n E.N.D.R.D. BOCK 1116 PACE 264 N: O C 1 ' �O � t J + i 0 U n W c N 0M I Q' oIa .0O ` 01 tn-+Tt I. ROD WAYNE STREET ;t `rn ' FOUND IP FCjNG � o _ REFERENCE PLANS: ;DOTES: GRAPHIC SCALE 1. "PLAN OF LAND IN - NORTH ANDOVER, MASS. - FORMERLY OWNED BY - _ _ _ J.P. STEVENS COMPANY, INC.", SCALE:1"=40', DATED JUNE 1968. BY 1. THE CURRENT OWNER OF RECORD OF LOT 94-1 IS 400 OSGOOD STREET _ BRASSUER ASSOCIATES. NOMINEE TRUST IN CARE OF WILLIAM F. BANNISTER, JR. 'TRUSTEE. THE u FEET 1 ASHUILT PLAN OF LAND DEED REFERENCE TO THE LOT IS VOL. 5131, PG. 214, DATED JULY 30, ?_. "PLAN OF ROAD - IN THE TOWN OF - NORTH ANDOVER -- ESSEX COUNTY - 1998 IN THE N.E.C.R.D. NORTH ANDOVER, HASSAC'HUSETTS' _ LAID OUT AS A, STATE HIGHWAY BY THE - `AASSACHUSETTS HIGHWAY COMMISSION SCALE:1"=40', DATED JULY 5. 191E 2. THE TOTAL AREA OF LOT 94-1 IS 254,575 SO. FT. OR 5.844 ACRES. PREPARED FOR 3. 'PROPERTY LINE PLAN - LAND IN NORTH ANDOVER, MASS. - AS SURVEYED r 3. ZONING FOR THE LOT IS RESIDENCE-4. BUILDING SETBACKS ARE QQ(� O.S(IOOD ,STR 'E T /l 0111INEF. TRUST - a;_Kgy; ;^g^rrt vr_ _ ., r -• 1 FOR - TOWN OF NORTH ANDOVER - SCHOOL DEPARTMENT", SCALE:1"=100', FRONT=30', SIDE=15, AND REAR=30'. DATED JULY 1970, BY MORSE AND MARTIN, N.E.R.D. PLAN #6279. 4. "PLAN a. ,�_ro nyyT t ' WILLL4:11 F. F,ANA7STER. JR., TROS'TF,F 4. THE COCHICHEWICK BROOK WAS NOT LOCATED IN THE FIELD. THE t 1 H TS OF LAND - LOCATED IN - N0. ANDOVER, MASS. SCA.LE:1"=40'. DATED LOCATION WAS DIGITIZED FROM THE ASSESSOR'S TAX MAP. ' t ., �'i SEPTEMBER, i'd69, e'r CHARLES E. CYR,C.E. L.C. PLAN #36426A. t;t. _ ;.t,9F:3g�L'S71`,'O 5. THE LOCATION OF THE UNDERGROUND ON-SITE SEWER LINE AND F ;. ...,...- PEJIB.4OKF. LAt1"D UP.VE}` CO4IPAVY' V. "PLAN OF LAND IN - NORTH ANDOVER., MASSACHUSETTS - PREPARm FOR - WATER LNE IOCAi1CNS WERE TAKEN FROM THE SITE PLAN. H PO BOX 20J, SAL£'Af. AIH 03079 NORTII ANDOVER 400 OSGOOD STREET - NOMINEE TRUST SCALE:1"=40', DATED AUGUST 27, ZONING BOARD of PO BOX 491, rVEJVBtIR}PORT, :9_9 01930 1998, BY THIS OFFICE. 6. THE EDGE OF WET SHOWN TO THE SOUTH, WEST AND NORTH OF THE BUILDINC WERE TAKEN FROM REFERENCE PLAN #6. APPEALS 5. "NON-RESIDENTIAL SITE PLAN PREPARED FOR: 400 OSGOOD STREET - LOT . -_ rr• �. -- -- ---- SCALL'' DATE DRATfINC. ,'V0. 94-1 - NORTH ANDOVER, MASSACHUSETTS", SCAL_:I"=20', DATED SEPT. 7. SEE ALSO FINAL ORDER OF CONDITIONS DATED 12/3/98, r,. ; h ___ ----- ------ ----- ------- -------- - 1998, LAST REVISED 11/11/98, BY KEACH-NORDSR2OM ASSOCIATES, INC. DEP PILE #242-940. / ' \' _ y 7",-40' .hfAT, '11 2;2, 2002 t1-1 26 1-L 6. EXISTING CONDITIONS - PLAN OF LAND' LOCATED AT - 400 OSGOOD STREET I CERTIFY `HAT I -!AVE CONFORMED ;� ---- -_ --- RIiYISI(l,ti`S JOA # 1998--41 c - NORTH ANDOVER, MA. - PROPOSED FUTURE LOCATION OF - NORTH WITH THE RULES & REGULATIONS OF \ "'� _ - - `— ---- -"'----" ------- PA I5/:52 ANDOVER YOUTH CENTER", SCALE:.i"=40' ,DATED SEPTEMBER 1, 1995. THE REGISTERS OF DEEDS IN PREPARING TH'•S PLAN. ,S'}FEET 1 OF I /I Nl<<�� a � . w Location Da-J s No. Date N�RTM TOWN OF NORTH ANDOVER f � � 9 Certificate of Occupancy $ ckusE` Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ' 6 Building Inspector s _ TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING ' .t. #li 9 ? gi m':2z 3 d R-,y� 77777 BUILDING PERMIT NUMBER: DATE ISSUED: Jj9`7SIGNATURE: Building Commissioner/Ifor ofbuildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: _6(- Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Rapired Provided Re red Provided 1.7 Water SupplyM.GL.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record 0SCoST". N�-M--+� c--�. ►C?_y�T G/"Do a�6 a�� S-�-- (�o_ a Name(Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number Address f `f 1465J--7,9 h Z ExpifatioW Date icic Signature Telephone P t 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name M Registration Number r Address z Expiration Date Q Signature Telephone Town of North Andover I RECEIVED Office of the Building Department ------------ JOYCE TOV c .ty Development and Services Division �;.- y� �b NORTHANDOVER William J.Scott, Division Director -- -- �r 27 Charles Street q C �� �, A 1: Forth Andover,Ndassachusetts 01845 D. Ro QFce Telephone (978)688-9.545 Building Cott?n?issiorlcr Fax (978) 688-9542 Woo uMoI. Any appeals shall be filed NOTICE OF DECISION /70 d e0Aor within(20)days after the Year 2000 ��� �� e}ep de ue{o aullu anotplt date of filing of this notice Property at: 400 Osgood Street P81$'U01S*"A elep tuoi;Pesdele envy in the office of the Town Clerk. IP(07-)Au"Imp W90 of s�s,yl NAME: Paul K Soucy, of DATE: 12/19/2000 One To One Strength Training,Inc. ADDRESS: 400 Osgood Street PETITION: 042-2000 North Andover,MA 01845 HEARING: 12/12/2000 The Board of Appeals held a regular meeting on Tuesday, December 12,2000,at 7:30 PM upon the application of Paul K Soucy,d/b/a One To One Strength Training,Inc.,400 Osgood Street, North Andover,MA as a Party Aggrieved of the Building Inspector and for a Variance from the requirements of S7,P7.3,for driveway width and from Section 8, Supplementary Regulations to allow for less than the required number of parking spaces, and for a Finding from Section 4.122,P 9.b(private for profit educational facilities)in order to allow for the permitted use of a"physical conditioning clinic"within the R-4 Zoning District. The following members were present:Walter F.Soule,Raymond Vivenzio,Robert Ford,John Pallone,and Scott Karpinski. Upon a motion made by Robert Ford,and tad by John Pallone,the Board voted to uphold the decision of the Building Inspector and to deny the Party Aggrieved portion of the application,voting in favor: Walter F. Soule,Raymond Vivenzio, Robert Ford,John Pallone, Scott Karpinski. Upon a motion made by Robert Ford and 2nd by John Pallone the Board voted to GRANT a VARIANCE Z} on parking of 34 parking spaces from a requirement of 61 down to 27 parking spaces on the condition that any change in use in any portion of the structure shall require the petitioner to return to this Board for review and approval of parking requirements for the building pursuant to authority granted by the Board i from S8.1.5 of the zoning bylaw. Voting in favor: WFS/RV/RF/JP/SK. Upon a motion made.by Robert Ford and 2nd by John Pallone the Board voted to GRANT a VARIANCE from S7,P 8.1.7 for 3'in aisle width in two locations to allow for use in this district and on this site,as shown on the Plan of Land prepared for 400 Osgood Street,by: David Liukkonen,#293 81,KNA, 10 Commercial Park,N. Suite 3B, Bedford,NH. 03110,dated October 2000. Voting in favor: WFS/RV/RF/JP/SK. Upon a motion made by Robert Ford and 2nd by John Pallone the Board voted to find in favor for private for profit educational use in the R-4 District in order to allow for permitted use of a physical conditioning clinic as a permitted use in that district and moved that the Board GRANT a SPECIAL PERMIT to allow this use on 400 Osgood Street. Voting in favor: WFS/RV/RF/JP/SK. g 2 D 130AR1)OF U'PI:::\%:S 6 ' ILMN—6 j3-C 4NSE 1 ' N 68S-0530 ATTEST: A True Copy 01MING DEPT - Town Clerk RECEIVED jOYCEBRADSHAW ` CONTINUED— 2nd page—dated: 12/19/2000 T OW N C L ER K NORTH ANDOVER decision for: Paul K. Soucy, d/b/a One To One Strength Training Inc. 10�� DEC 2 0 A I= address: 400 Osgood Street,North Andover,MA 01845 - i 10.4 Variances and Appeals The Zoning Board of Appeals shall have power upon appeal to grant variances from the terms of this Zoning Bylaw where the Board finds that owing to circumstances relating to soil conditions, shape,or topography-of the land or structure and especially affecting such land or structures but not affecting generally the zoning district in general,a literal enforcement of the provisions of this bylaw will involve substantial hardship,financial or otherwise,to the petitioner or applicant,and that desirable relief may be granted without substantially detriment to the public good and without nullifying or substantially derogating"from the intent or purpose of this Bylaw. Furthermore,if the rights authorized by the variance are not exercised within one(1)year of the date of the grant,they shall lapse,and may be re-established only after notice,and a new hearing. Furthermore, if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two(2) year period from the date on which the Special Permit was granted unless substantial use or construction has commenced,they shall lapse and may be re-established only after notice,and a new hearing. By order of the Zoging Board of Appeals, Raymond Vivenzio,actA Chairman m!/decisi ons2000/44/4 5 ' 11 as '- t � .w- a V CD ^madam. '3 'i O rj fti �t 'A ro =r y A O et -w 0+. CO ro C ~' C ro r m \ Ln kn Z N x O m t+ 0 � L O 4 G - O V1 O ESSEX NORTH REr;�^��� r�i- )-EDS A TRUE .H AEGI^TF..P OF O 1 TELEPHONE (978) 453-7826 MASSACHUSETTS ELECTRICAL (978) 453-8350 z CONTRACTORS ASSOCIATION FAX (978) 453-7534 � MASS. LICENSE A12566 MEMBER .L N.H. LICENSE 3826R Lowell Central Electric Co., Inc. 558 Chelmsford Street Lowell, Massachusetts 01851 Residential, Commercial&Industrial Wiring 400 Osgood Street Trust 380 Winter Street North Andover, MA 01845 1 /16/01 Reference : New Tenant #5 1 Dear Bill , I am pleased to confirm my estimate proposal for the wiring of the new tenant #5 . Included in my proposal estimate is the following : A. Owners work : 1 . 200 amp 120/208 volt three phase four wire feeder from the main service meter modual to tenant #5 . Provide a new 200 amp 42 circuit panel complete with required circuit breaker. 2 . Transfer existing circuits and wiring from existing tenant panel #4 to new tenant panel #5 . 3. Furnish , install and wire 4 new exit signs and 7 new emergency light units for tenant #5 . 4. Furnish , install and wire 3 exterior wall pack controlled by photo cell and time clock . 5 . Furnish , install and wire 6 emergency light units and 3 exit signs in tenant area #1 . 6. Provide all permits and inspections. TELEPHONE (978) 453-7826 ° (978) 453-8350 �s FAX (978) 453-7534 MASS. LICENSE A12566 .AMBER ' N.H. LICENSE 3826R Lowell Central Electric Co., Inc. 558 Chelmsford Street Lowell, Massachusetts 01851 Residential, Commercial&Industrial Wiring 400 Osgood Street trust 380 Winter Street North Andover, MA 01845 1 /16/01 Page 3 Material 4180.00 Tax 209 .00 Labor 7132 .00 Total cost $11521 .00 All of the above costs include all supervision , insur- ances, permit fees , inspections, utility company cood- ination, material , labor , overhead and profits for a complete electrical installation per local and state codes . Should you require any additional information or as- sistance, please feel free to contact us at any time . Si J..An Mantone Project Estimator/Coodinator Oct ?7 Ley 05: 08p B . !. 1 Bann). ster 978 -683-890? r , The Commonwea;th of M a�sachusetts -- ' �° Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name:--- City U am a homeowner performing all work myself. Phone �1 am a sole proprietor and have no one working in any capacity i am an employer providing workers, compensation for my employees working on this job. Com on name: Address Git � Q Insurance Co, z . # 7 Com an name: Address Ctty: Phone#: Insurance Co. Policy# Failure to secure coverage es required under Sr-.tion 25A,or MGL 1$2 can lead to the Imposrion of criminal penalties of a rine up to$1,500,00 and/or one years'imprisonment as well as civil penaUles in the form of a STOP WORK ORDER and a Ane of($100,00)a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I d0 herby ca'ity under the pains a of penattias of porlury th4zt the 1r7tbrn10uu17 provioso B ove is true and corrsct. Signature fStd Date Print name � Phone# Official use only ao not write in this area to be completed by city or town officia:' DCheck it immediate response is requiredBuilding Dept Building peel C] Lincensing Board contaot pemgn p SCleGtrridn's OfficeProne : _ Ej Health Department E3 Other ✓��ac�ivaeiGs BOARD OF BUILDING REGULATIONS License: CONSTRUCTION.SUPERVISOR :t Number: CS 058657 Birthdate:04/25/1952 Tr.no: 20502 _" ExlZires. 04125/2002 Restricted To: 00 MARK B SIEMONSMA 6 PULPIT RD Administrator BEDFORD, NH 03110 JAN-25-2001 THU 09:59 Alli FROM MT FAX:16175241037 PAGE 2 • REARQ,QN H11� �►C CORP Q Q<( , 1 1 t BOSTON,.MA 02150 t, „( 17) 5244965:` r r I a I I Pf+oNe TQ Ai1Banister /01 683-69Q? 9�8 ,ItP i 4Q0 oo Osgd .St NpM / Q13ATIoN �� t®iYaA J� -t.h Andover MA 0;18�a ,p on�l 138 JQd I 3 9 85 • . li I r i 4 ul .., -. _ �� r ,'. . V i X18 r I r. 1 a ' -• ''..,....'' .•. �.:: ,.I,:. !,,., , u Ile,•.. 11 t • 5 ORNUM1p' Ij JpB PNON� ' I I .,� ,iii r.� ... . • , •. ;... '. , ,.•.•. ..'...: ... ', :1 (I IA...Lily t'.,, . :�: • I 4upply and install 2 - 5 ton split system air conditioning systems, units to be hung from roofs supports. Price to include air handlers, 10 SEER condensing units, refrigerant piping, condensate piping, supply and return duct work and all labor to install. supply and install 2 bathroom fans and piping to outdoors for bathrooms to be added. I Supply and install 1 mini-split heat pump for office. �upply and install gas piping to new meter bar for 2 Infrared heaters that will be in ten r'nant space. 1(rice does not include electrical wireing or electric heaters for bathrooms. I I i I I I I 1 WE; PROPOSE hereby to furnish materiel and labor—complete In accordance with the above specifications,for the sum of: Tw4nty Five Thousand Four Hundred Thirty Eight and 00/100 Dollars dollars(S 25,438,00 ! Payment to be made as follo e: Te ms to be negotiated All mgterlal Is guaraniesd to be as specified.All work to be completed In a proteselonei manner according to standard prI&CM.any sitereson on deviation from above SWIllcatlons Authorized Involving extra costs will be executed only upon written orders,and will become an extra Signature charge over and above the estimate.All agneemente contingent upon etAkes,aooldents or delayil beyond our onntrot.Owner to cony firs,tomado,and other neowssaty Insurance.Our Note:This proposal may be 14 workeIs are fully covered by Worker's Compensation inaurence. withdrawn by us If not accepted within days. A4CEPTANCE OF PROPOSAL—The above prices, specification,and conditions are satisfactory and ere hereby accepted, You are Signature authoirized to do the work as specified.Payment will be made as outlined above. I Signature Date!f Acceptance: I PNODVCT 171EBT NQe81no.,Grown,MA oitm To enter Pnons Ton Pros 1.000446.0660. POLO AT,.)TO FIT COMPANION 771 OU•O•VUA 4M 8LDPa PPWT4D INM.D.A. A • (w•' NORTH Town of 7 :. 4Andover O 4 a-� -aoo � o ==_ �A o dower, Mass., COCHICMEWICK oRATED P' C� 1 V ` BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT 0 �... ... 0 .� � �.•............i�v-.......�......g.Ptb� ....�r�ty. Foundation has permission to erect...N r1O.r.... buildings on ....L to�/..... 0!. S ........ Rough .... ............ to be oCCupled aS... !!0. 1. ...... 0. `.......v� hV ... ►�!V.�.!V.4....�V�N�.�I.% Chimney provided that the person accepting this permit shall in every respect�onform to the terms of'fie 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. M q q 0 ' PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION STARS ELECTRICAL INSPECTOR e Rough ......... 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. 0 R T o . o Andover 60 No. 17 * -#-- M C% :=- 0 dover, Mass., t2—.1F)w- 00 0 L A COCHICHEWICK 0RATED P'f BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System ;� r* tk BUILDING INSPECTOR THIS CERTIFIES THAT o..5.....G.. D...s&& r. 54Tr•#U• Foundation has permission to erect...WtvT!0 r.... buildings on .... �1/Q..,,,0SOO�.........S......... Rough to be occupied as... Ke ......G.T........Std:!%O .. ... J.j Chimney provided that the person accepting this permit shall in every respectlionform to the terms of e application an 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. M 014 IN I PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMEXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARS ELECTRICAL INSPECTOR• Rough .............JAA......... .................. ........................ 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. FSEE REVERSE SIDE Smoke Det. 'd Date ��.:r /. " ... ... �J �ORTI, �. ?Ory`..ao ,e,ti0 p TOWN OF NORTH ANDOVER ' PERMIT FOR GAS INSTALLATION � 9 SA US r 1 This certifies that ./. . . .,! # . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . .:. . . . . . . . . . . . . . . . . . . . . . . . in the buildings of .. . .. . . . . . . . . at . . . :. . .'. . . . . . . . . . . . . . . . . . . . . . . . . . . .. North Andover, Mass. Fee. . . . . . . Lic. No.. :;r. . . . . . . . . . . . : . .'. . . . ' _ :. . . . . . . GAS INSPECTOR Check# r 305 7 1 _ MASSACHUSETTS UNIFORM(APPLICATON FOR PERNUT TO DO GAS FITTING ype or pant) Date NORTH ANDOVER, MASSACHUSETTS Building Locations 7 d� O'� '5-7, Permit 9 26,07 Amount S c3tiS� Owner's Name ��Lj�jy y�TE�P New ElRenovation Replacement Plans Submitted F n n J z n� =� n t . 000 ?_ 'z u tn Cn Z S E vt E .4 .r I IST. F L 0 0 R 2N D . FLOOR 3 R D . F L O O R 1•T 11 FLOG It S71711 FLOG R TT 11 F L 0 O R 7'T I1 . FLOO It 3T 11 . FLOOR (Print or typ Check one: Certificate Installing Company Name Y /Jc3/�/�S' a�' Corp. Address l7 6�e��� sT �oS/O� /. . ❑ Partner. Jusiness Telephone gel/2-- .S'Z/p-- -Ie ❑ Firm/Co. "NameofLicensed Plumber or Gas Fitter �`Jkgmf�$ L r1hav'e RANCE COVERAGE Check one: a current liability Insurance policy or it's substantial equivalent. Yes � Nou have checked ves, please indicate thetype cove a_e by checkin<�the aopropriate bo c.ility insurance policy ❑ other type of indemnity Bond wner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 1421 of the Vlass. General Laws.and that my signature on this permit application waives this requirement. Check one: Sienature of Owner or Owner's Agent Owner ❑ Agent ❑ I hert:bv certify that all of the details and information l have submitted (or entered) in above appiication are true and accurate to the best of my knowledge and that all plumbing work and installations per-tormed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. Sienature of Licensed Plumber Or Gas Fitter By: ❑ Plumber y32 - Title Gas Fitter LIc--rise �umoer Ciry/ own ❑ 1VlaS[er A-M',O •ED I�>Fric:=usF f)NI-Y) F7 Journe;man lord Associates, Inc. 520 Providence Highway, Suite 8 Norwood MA 02062-4946 Environmental Consulting&Licensed Site Professional Services Voice: 781.255.5554 Fax: 781.255.5535 www.lordenv.com May 24, 2002 Mr. Michael McGuire Building Inspector Town Offices Building Department 27 Charles St. North Andover, MA 01845 RE: Notice to Public Officials of Recording of Amendment and Ratification of Notice of Activity and Use Limitation —400 Osgood St., North Andover, MA 01845 Dear Mr. McGuire: The purpose of this letter is to inform you that on May 16, 2002, a Notice to Public Officials of Recording of Amendment and Ratification of Notice of Activity and Use Limitation ("AUL"), a copy of which is enclosed, was recorded with the Essex County Registry of Deeds instrument number 21373. The AUL identifies certain activities and uses which are inconsistent with maintaining a condition of No Significant Risk at the subject property. Such activities and uses are so identified in order to prevent exposures to residual petroleum-contaminated soil located at 5-12 feet below surface grade. The AUL identifies those activities and uses which are consistent with maintaining a condition of No Significant Risk and those obligations and conditions necessary to ensure that a condition of No Significant Risk continues to exist at the property for the foreseeable future. This public notification is being provided pursuant to the Massachusetts Contingency Plan, 310 CMR 40.1090 and 310 CMR 40.1403(7)(a). If you have any questions, please contact William Bannister, Trustee of the 400 Osgood Street nominee Trust, at (978) 683-8907. Sincerely, LORD ASSOCIATES, INC. r Ralph J. Tella, HMM, LSP Vice President and Senior Project Manager CC: DEP Board of Health Building Code Enforcement Official Zoning Official W/Enclosure A Massachusetts Certified MBE Massachusetts Department of Environmental Protection BWSC-111 tr " Bureau of Waste Site Cleanup AUDIT FOLLOW-UP PLAN TRANSMITTAL FORM Release Tracking Number & POST- AUDIT COMPLETION STATEMENT 3❑ - 14192 Pursuant to 310 CMR 40.1160-40.1170(Subpart K) A. SITE LOCATION: Site Name:(optional) Former American Textile History Warehouse Street: 400 Osgood Street Location Aid: Harkaway Road City/Town: North Andover ZIP Code: 01845 Tier Classification Status:(check one) ❑ Not Tier Classified ® Tier 2 ❑ Tier 1 Permit Transmittal Number: Related Release Tracking Numbers that this Form Addresses: B. THIS FORM IS BEING USED TO: (check one) O ❑ Submit an Audit Follow-Up Plan(complete Sections A,B.C.D,E and F). ❑ Submit a Modified or Revised Audit Follow-Up Plan(complete Sections A.B.C,0.E and F). ® Submit a Post-Audit Completion Statement(complete Sections A.B.C,D.E,and F). You must attach all supporting documentation for the use of form indicated,including copies of any Legal Notices and Notices to Public Officials required by 310 CMR 40.1400: C. LSP OPINION CERTIFICATION: I attest under the pains and penalties of perjury that I have personally examined and am familiar with the information contained in this transmittal form, including any and all documents accompanying this submittal. In my professional opinion and judgment based upon application of(i)the standard of care in 309 CMR 4.02(1),(ii)the applicable provisions of 309 CMR 4.02(2)and(3),and(iii)the provisions of 309 CMR 4.03(5),to the best of my knowledge, information and belief. > if Section 8 of this form indicates that an Audit Follow-up Plan,or a Modified or Revised Audit Follow-up Plan is being submitted,the response action(s) that is(are)the subject of this submittal(i)has(have)been developed in accordance with the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000, (ii)is(are)appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000 and(iii)complies(y)with the identified provisions of all orders,permits,and approvals identified in this submittal: > if Section B of this form indicates that an Post-Audd Completion Statement is being submitted,the response action(s),that is(are)the subject of this submittal(i)has(have)been developed and implemented in accordance with the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000,(ii)is(are) appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21 E and 310 CMR 40.0000 and(iii)complies(y)with the identified provisions of all orders,permits,and approvals identified in this submittal. I am aware that significant penalties may result,induding,but not limited to,possible fines and imprisonment,if I submit information which I know to be false, inaccurate or materially incomplete. ❑ Check here if the Response Action(s)on which this opinion is based,if any,are(were)subject to any order(s),pem9t(s)and/or approval(s)issued by DEP or EPA. If the box is checked,you MUST attach a statement identifying the applicable provisions thereof. LSP Name: Ralph J. Tells LSP#: 7473 Stamp: Street 520 Providence Highway, Suite G-8 6 � Cityfrown: Norwood State: MA02062Code: 0 2 0 6 2 '��OF � Telephone: 781-255-5554 Ext.: Iq RAL 72 P I Gam, 8. FAX:(optional) 781-255-5535 T EI.I_{� �Sp. T4T3 Signature: GIST � S SITE PFt�Fti Revised 11/30/1999 Do ftt Alter This Form Page 1 of 2 DRAFT Massachusetts Department of Environmental Protection BWSC-111 Bureau of Waste Site Cleanup AUDIT FOLLOW-UP PLAN TRANSMITTAL FORM Release Tracking Number Y & POST AUDIT COMPLETION STATEMENT 3❑ - 14192 Pursuant to 310 CMR 40.1160-40.1170(Subpart K) D. PERSON RESPONDING TO AUDIT: Name of Organization: 400 Osgood Nominee Trust Name of Contact: William Bannister Title: Trustee Street: 380 Winter St. Cityfrown: North Andover, State: MA ZIPCode: 01845 Telephone: 978-683-8907 Ext.: FAX: 978-683-8907 .❑ Check here if there has been a change in the person undertaking Response Actions at the Site since the previous submittal to DEP. E. RELATIONSHIP TO SITE OF PERSON RESPONDING TO AUDIT: ?CO RP or PRP Specify:® Owner Ej Operator Generator ❑ Transporter Other RP or PRP: Fiduciary,Secured Lender or Municipality with Exempt Status(as defined by M.G.L.c.21 E.s.2) Agency or Public Utility on a Right of Way(as defined by M.G.L.c.21E,s.50)) Any Other Person Responding to Audit Specify Relationship: F. CERTIFICATION OF PERSON RESPONDING TO AUDIT: 1. William Bannister ,attest under the pains and penalties of perjury ry(i)that I have personally examined and am familiar with the information contained in this submittal,including any and all documents accompanying this transmittal form,(ii)that,based on my inquiry of those individuals immediately responsible for obtaining the information,the material information contained in this submittal is,to the best of my knowledge and belief,true,accurate and complete,and(iii)that I am fully authorized to make this attestation on behalf of the entity legally responsible for this submittal. I rson or entity on whose behalf this submittal is made arrdis aware that there are significant penalties,including, but not limited to,possible s a mpnsonment,for *11f 11 submitting false,inaccurate,or incomplete information. By: ` Title: Trustee (signature) 400 Osgood Nominee Trust S _3 For: Date: (print name of person or entity recorded in Section D) Enter address of person providing certification,if different from address recorded in Section D: Street: City/Town: State: ZIP Code: Telephone: Ext.: FAX: YOU MUST COMPLETE ALL RELEVANT SECTIONS OF THIS FORM OR DEP MAY RETURN THE DOCUMENT AS INCOMPLETE. IF YOU SUBMIT AN INCOMPLETE FORM,YOU MAY BE PENALIZED FOR MISSING A REQUIRED DEADLINE. Revised 11/30/1999 Do Not After This Form Page 2 of 2 DRAFT i i Massachusetts Department of Environmental Protection BWSC-114S Bureau of Waste Site Cleanup } Release Tracking Number ACTIVITY& USE LIMITATION (AUL) OPINION FORM _ 14192 COMPLETE THIS FORM AND ATTACH AS AN EXHIBIT TO THE AUL DOCUMENT TO BE RECORDED AND/OR REGISTERED WITH THE REGISTRY OF DEEDS AND/OR LAND REGISTRATION OFFICE- A. FFICEA. LOCATION OF DISPOSAL SITE AND PROPERTY SUBJECT TO AUL: Disposal Site Name: Former American Textile History Museum Warehouse Street: 400 Osgood Street Location Aid: Harkaway Road City/Town: North Andover ZIP Code: Address of property subject to AUL,if different than above. Street: City/Town: ZIP Code: B. THIS FORM IS BEING USED TO: Provide the LSP Opinion for an Amendment and Ratification of a Notice of Activity and Use Limitation,pursuant to instructions provided by DEP in a Notice of Audit Findings issued to: 400 Osgood Nominee Trust and American Textile History Museum Name of Organization or person: Date issued: 09/25/2001 C. LSP OPINION: I attest under the pains and penalties of perjury that I have personally examined and am familiar with this submittal,including any and all documents accompanying this submittal. In my professional opinion and judgment based upon application of(i)the standard of care in 309 CMR 4.02(1),(ii)the applicable provisions of 309 CMR 4.02(2)and(3),and(iii)the provisions of 309 CMR 4.03(5),to the best of my knowledge, information and belief. The Amendment and Ratification of the Activity and Use Limitation that is the subject of this submittal is being provided in accordance with instructions provided by the Department of Environmental)Protection in a Notice of Audit Findings issued to: wo �1iG)Gtti! �G:�Nft /�tus� ftanlii'�tt�,zt'c'.l.s le-01EE t[IS& e 'dl Name of Organization or per/son: ---T Date issued: �/`'�10/ I am aware that significant penalties may result,including,but not limited to,possible fines and imprisonment,if I submit information which I know to be false,inaccurate or materially incomplete. Check here if the Response Action(s)on which this opinion is based,if any,are(were)subject to any order(s),permit(s)and/or approval(s) issued by DEP or EPA. If the box is checked,you MUST attach a statement identifying the applicable provisions thereof. LSP Name: Ralph J.Tella LSP#: 7473 Stamp: � Telephone: ( I g _S Jr Ext.: _ 14 FAX: 7 I _2 5--5--_! �3 S [ �' RALPH ,A�� `9 Z5 TELLA LSP Signature: t il -G•t/L�- ° � a r s� NA. 7473 S 7 �0/^ 'ice`. L Date. ST �W Fa �: -ea YOU MUST COMPLETE ALL RELEVANT SECTIONS OF THIS FORM OR DEP MAY FIND THE DOCUMENT TO BE INCOMPLETE Page 1 of 1 Revised 4/2/2001 n AMENDMENT AND RATIFICATION OF NOTICE OF ACTIVITY AND USE LIMITATION (for amending and ratifying a Notice of Activity and Use Limitation recorded on or before October 29, 1999) y WITNESSETH: This Amendment and Ratification of Notice of Activity and Use Limitation ("Amendment and 3 Ratification") is made as of this day of May, 2002, by William F. Bannister, Trustee, 400 Osgood St. Nominee Trust, 300 Winter Street, N. Andover, MA. 01845, together with his/their successors and assigns (collectively"Owner"). WITNESSETH: WHEREAS, Owner is the owner in fee simple of a certain parcel of land located in North Andover, Essex County, Massachusetts ("Property"), pursuant to a deed recorded with the Essex County Registry of Deeds in Book 1146,Page 72; WHEREAS,the Property comprises a disposal site,or part of a disposal site,as the result of a release of oil and/or hazardous material ("the Disposal Site"). Response actions have been selected for the Disposal Site in , accordance with M.G.L. c.21E("Chapter 21E") and the Massachusetts Contingency Plan, 310 CMR 40.0000 ("the MCP"). Said response actions are based upon (a) the restriction of human access to and contact with oil and/or ('„t; hazardous material in soil and/or groundwater, and/or (b) the restriction of certain activities occurring in, on, through,over or under the Property or a portion thereof. The Department of Environmental Protection has identified ' the Disposal Site as Release Tracking Number 3-14192; WHEREAS, on August 8, 1997, the American Textile History Museum filed a Notice of Activity and Use ° Limitation with the Essex County Registry of Deeds in Book 4828,Page 135 imposing an activity and use limitation on a portion of the Property("the Original AUL"). The Property affected by the Original AUL and this Amendment o and Ratification is hereinafter referred to as "the AUL Area." The AUL describes activities and uses that are permitted within the AUL Area, and defines obligations and conditions that must be maintained within the AUL Area. The AUL also describes uses and activities which, if carried out within the AUL Area, could result in Significant Risk to health, safety, public welfare or the environment due to potential exposure to residual contamination. WHEREAS, the following amendments to the Original AUL are necessary to ensure that a condition of No Significant Risk is maintained at the Disposal Site. NOW,THEREFORE,Owner hereby amends the Original AUL as follows: AUL Area The AUL Area is bounded and described in Exhibit A, attached hereto and made a part hereof. Exhibit A replaces and supersedes any description(s) of the AUL Area contained or referenced in the Original AUL. The AUL Area is shown on a survey plan recorded in the Essex County Registry of Deeds in Plan Book Plan Said plan replaces and supercedes any plan(s) of the AUL Area contained or referenced in the Original AUL. A sketch plan showing the existing surface grade elevations of the AUL Area is bounded and described as Exhibit B. AUL Opinion The basis of the Original AUL, as amended herein, is an Activity and Use Limitation Opinion ("AUL Opinion"), prepared by a Licensed Site Professional and attached hereto as Exhibit C. Said AUL Opinion replaces and supercedes any AUL Opinion contained or referenced in the Original AUL. i , C _1 Site Activities and Uses The following descriptions of Permitted Activities and Uses, Activities and Uses Inconsistent with the AUL Opinion,and Obligations and Conditions replace and supercede those contained in the Original AUL. 1. Permitted Activities and Uses. A condition of No Significant Risk to health, safety, public welfare or the environment exists for any foreseeable period of time so long as any of the following activities and uses occur within the.AUL Area: (i)Commercial and/or industrial uses and activities associated therewith,including,but not limited to,pedestrian and/or vehicular traffic,landscaping,and routine maintenance of landscaped areas,which do not cause and/or result in the disturbance and/or the re-location of petroleum-contaminated soil located at 5 to 12 feet below surface grade; (ii)Short-term(one month or less)underground utility and/or construction activities including, but not limited to,excavation(including emergency repair of underground utility lines), which are likely to disturb petroleum-contaminated soil located at 5 to 12 feet below surface grade,provided that such activities are conducted in accordance with Obligations/Conditions (i)and(ii)in Section 3 of this Activity and Use Limitation Opinion("Opinion"),the soil management procedures of the MCP cited at 310 CMR 40.0030,and all applicable worker health and safety practices pursuant to 310 CMR 40.0018; (iii)Activities and uses which are not identified in this Opinion as being inconsistent with maintaining a condition of No Significant Risk;and (iv)Such other activities and uses which,in the Opinion of an LSP,shall present no greater risk of harm to health, safety,public welfare,or the environment than the activities and uses set forth in this Paragraph. 2. Activities and Uses Inconsistent with the AUL Opinion. The following activities and uses, if implemented within the AUL Area, may result in a Significant Risk of harm to health, safety, public welfare or the environment: (i)Use of the portion of the property as a residence,school(with the exception of adult education),daycare,nursery,recreational area(such as a park or athletic fields),and/or any other use at which a child's presence on a regular basis is likely; (ii)Any activity including,but not limited to,excavation,which is likely to disturb petroleum contaminated soil located at 5 to 12 feet below surface grade associated with underground utility and/or construction work,without prior development and implementation of a Soil Management Plan and a Health and Safety Plan in accordance with Obligations(I)and(ii)of Section 3 of the AUL; (iii)Any activity which is likely to disturb petroleum-contaminated soil located at 5 to 12 feet below surface grade for a period of time greater than three months,unless such activity is first evaluated by an LSP who renders an Opinion stating that such activity is consistent with maintaining a condition of No Significant Risk and that such activity is conducted in accordance with Obligations(i)and(ii)of Section 3 of this AUL;and (iv)Relocation of petroleum-contaminated soil located at 5 to 12 feet below surface grade,unless such relocation is first evaluated by an LSP who renders an Opinion stating that such relocation is consistent with maintaining a condition of No Significant Risk. 3. Obligations and Conditions. The following obligations and/or conditions must be maintained within the AUL Area in order to maintain a condition of No Significant Risk:] (i)A Soil Management Plan must be prepared by a Licensed Site Professional(LSP)prior to the commencement of any activity which is likely to disturb petroleum-contaminated soil located 7/26/00 at 5 to 12 feet below surface grade.The Soil Management Plan should describe appropriate soil management,characterization,storage,transport and disposal procedures in accordance with the provisions of the MCP cited at 310 CMR 40.0030 et seq.Workers who may come in contact with the petroleum-contaminated soil should be appropriately trained on the requirements of the Plan,and the Plan must remain available on-site throughout the course of the project; (ii)A Health and Safety Plan must be prepared and implemented prior to the commencement of any activity which may result in the disturbance of petroleum-contaminated soil located at 5 to 12 feet below surface grade.The Health and Safety Plan should be prepared by a Certified Industrial Hygienist or other qualified individual appropriately trained in worker health and safety procedures and requirements.The Plan should specify the type personal protection, engineering controls,and environmental monitoring necessary to prevent worker and other potential receptor exposures to petroleum-contaminated soil through ingestion,dermal contact,and inhalation.Workers who may come in contact with the petroleum-contaminated soil should be appropriately trained on the requirements of the Plan,and the Plan must remain available on-site throughout the course of the project;and (iii)The petroleum-contaminated soil located at 5 to 12 feet below surface grade must remain at depth and may not be relocated,unless such activity is first evaluated by an LSP who renders an Opinion which states that such activity poses no greater risk of harm to health,safety, public welfare,or the environment and ensures that a condition of No Significant Risk is maintained. 4. Proposed Changes in Activities and Uses. Any proposed changes in activities and uses at the Portion of the Property which may result in higher levels of exposure to oil and/or hazardous material than currently exist shall be evaluated by a Licensed Site Professional who shall render an Opinion, in accordance with 310 CMR 40.1080 et seq., as to whether the proposed changes will present a significant risk of harm to health, safety,public welfare or the environment. Any and all requirements set forth in the Opinion to meet the objective of this Notice shall be satisfied before any such activity or use is commenced. 5. Violation of a Response Action Outcome. The activities,uses and/or exposures upon which this Notice is based shall not change at any time to cause a significant risk of harm to health, safety,public welfare, or the environment or to create substantial hazards due to exposure to oil and/or hazardous material without the prior evaluation by a Licensed Site Professional in accordance with 310 CMR 4011080 et seq., and without additional response actions, if necessary, to achieve or maintain a condition of No Significant Risk or to eliminate substantial hazards. If the activities,uses,and/or exposures upon which this Notice is based change without the prior evaluation and additional response actions determined to be necessary by a Licensed Site Professional in accordance with 310 CMR 40.1080 et seq.,the owner or operator of the portion of the Property subject to this Notice at the time that the activities, uses and/or exposures change, shall comply with the requirements set forth in 310 CMR 40.0020. 6. Incorporation Into Deeds, Mortgages, Leases, and Instruments of Transfer. This Notice shall be incorporated either in full or by reference into all deeds, easements,mortgages,leases,licenses, occupancy agreements or any other instrument of transfer,whereby an interest in and/or a right to use the Property or a portion thereof is conveyed. 7/26/00 Except as expressly amended herein, the Original AUL is hereby ratified and confirmed. Owner authorizes and consents to the recordation and/or registration of this Amendment, which shall be deemed to be effective as of the date the Original AUL was recorded and/or registered. WITNESS the execution hereof under seal this days of May,2002. William F.Bannister,Trustee COMMONWEALTH OF MASSACHUSETTS Essex,ss A4 �,2002 Then personally appeared the above-named William F. Bannister and acknowledged the foregoing instrument to be his free act and deed before me, Notary Public: My Commissi n Expires: ��Jb �oe The undersigned Waste Site Cleanup Professional certifies that, in his opinion, the terms of the Original AUL, as amended herein, are consistent with the AUL Opinion attached hereto as Exhibit and are appropriate to maintain a condition of No Significant Risk at the Disposal Site. Id �' �:F�ac Ralph J.fella, SP �-� J'Y/ -PS ] � rys _EL LA 74730 � COMMONWEALTH OF MASSACHUSETTS 2002 Then personally appeared the above-named Ralph J. Tella anaacwled&gethe foregoing instrument to be his free act and deed before me, Nota ubi-I ()r2 My Commission Expires: F l,6 b J Upon recording,return to: William F.Bannister,-Trustee 400 Osgood Nominee Trust 300 Winter Street North Andover,MA.01845 7/26/00 EXHIBIT A Metes and Bounds Description ` Beginning at a Massachusetts Highway Bound on the northeasterly side of Osgood Street, said bound being approximately one-hundred-ninety-one(19 1) feet northerly of the centerline of Harkaway Street; thence S 82°-57'49"W a distance of 83.32' to the point of beginning; thence turning and running along Osgood Street S 36°54'00"W a distance of 319.65' to a point; thence turning and running along Osgood Street S 43°21'30"W a distance of 58.82' to a point at the northeasterly corner of land now or formerly belonging to the Town of North Andover; thence turning and running along land now or formerly belonging to the Town of North Andover N 23°57'30"W a distance of 1060.82' to a point; thence turning and running along land now or formerly belonging to the Town of North Andover N 73°41'37"E a distance of 184.65' to a point; thence turning and running along land now or formerly belonging to the Town of North Andover S 33'54'18' E a distance of 870.98' to the point of beginning. a a� - /yay3 25974 Mar MN IA%u/i�23 `\\ &0 1.4.. oa9.ML Hlow.7 m,aJ m 9w.rm._ba "dOww SU.kWiIii Vrry w+.a. 17 a�6.d,b,rey.,.o(19T)4V a 41ml7 auL,.m.lo.aH.k,SMS: d 5W-174V W.&iN a dU.IT U IY Wnl If 6gi..iA& OI \.` m.m wry..f mrxg wxg D..P.d Rxw 5aI7170•W.JMa-dSLr2w-pod rlY _j0 NOR He34W W,din-Ni d 119.6S- ER n/^ NW IT.niv.la.x• \\\ v9wMlYrmadl.d row orf TN A- / IN, r PVC M 91.i Y 1 q SG .g'PK OJT 019-4 y owxlf._I/iAg wd,T-i If Allow; NGN MELD Q'Ia 1MAE[L 91.0' TC r.aloelWY .4wghd mwafolmlY 9.lwlgig4tlM l'oww dNDM Adww: J0- _� J ly Aaca NU•J730•W.d-(1054.11?M.P111w e.ow , ld.g.d -ma wog Md ow ar(WD ly bdw0ug N,DN T-fikm9 Aa ,G oJm E _ H 73-4177•E.Ji .f INAJ'M.PWAW te___ _ ' root.wouy ad ru,Nv.l.lq hd nuwJ f IY l YNl91o/b W Two dNaq AdPV `UD•'__.-• \TTY '. �• D}.V.9IG POND i \ s»•M•u•a.aMM.o.drTosrMlm PM.I.rl,ro.oi.9 loo elXslx rWOM 11 µAP SIA LOT X R 6-1098yI µDOVE 537 .... ^N I 1 I .�� Iti TOWN OF NOR 1170 PAGE AJL...-.. I: I�V1•' \\`•\.�. ///����I \�C� 9TDNE tJ1l• \ 'it\I V \\\�`` WAU 57 LOCUS PLAN E N.D.R.U.BOOK .. - �XK \11941W \ \ XCUN) „d•,: -y41e'Y / ,• - / r jy.,G-' e;l': .`sT .�`.. s\rl ROAD s JS / /' �/ •'01 ..-�- 'r - 1 \ \ -MCD/JJ7. ":\ .�,, i• BUILDING Lp U1IMD 1_.,p H. 1:1 1 1 \\ • 0 WY E STORY µES A4 W'A'' IY.W` �• 111 i -B4wtM� - r^„ATaf OA9n ,.........._........ps MCT .Y....F•N YMLt 6i., - Pd.nLv.99..T m0E or WEnNq-� ? \ EwSTN wnl ryMV•••• •.y,PRO%.NA x \192. V` �� +, Nv.IY NOR,IN 95.7-4 \\ ��• A �-149I JI_ yv.IY xc9 W(VS VS' ts'No asluNeula ztlxE-r-�� / k _ al.ss 1 / sa No CONSINUCIN.H zortE �"•�._\ 1"APP"os / K 'i kv '" l�L�„.S w Tww nEv..1y . /L r• __ :.�-- AAAA,-- IY IOPP IN 9I.Id . - \ _ - _9/__�_ ti �yf•` IY 1UW OT 96.23• _-_ =�ILOr� -� - �z r '\ �•_ ice". j _.�• - _'/_ _ �'1_..••g AT.- 1 i' ^� \c wv 93.6• W -�-��s-.�-------•rte=�s���H/C"'`4' \'� i �..� ...7 or W:R,I oo �' Wvs:.A�irxNO •4r'�' \ \ -A-.. a MAP 94 LOT 7 r a wry Eta:Or WEIUNo rr \. -5u99 a:w 11, z- 254,575 S.F. HI rt F $q� $0 5.844 ACRES ^1 a tpDl /f °, �. ,L 26'MO a<_naewa ZONE Not Fauxc 1996 Q.L ) o < CI •� �-so'HO Cov9TNUCna zCM[ �'7'•L.y., o"¢ N 23'5730•W 1060.82' 0 w MAP 91 LOT 2 f' TOWN OF NORM ANDOVER E.N.D.R.O.BOOK 1116 PACE a s _ 0 a� m 1 o Iyt I Rop WAYNE STREET oryAo . rcWo ': 1 SND IDUI:U AN 711 " ^'7 r EFERLE ENPLAITS: NOTES: GRAPHIC SCALE rl 'h ' .A .'PLCf LAND IN-NORTH ANDOVER.MASS.-FORMERLY OWNED BY- 1...- j • ,•-• I J.P.STE YENS COMPANY,INC.'.SCALE:I'-40',DATED JUNE IS68,BY 1.THE CURRENT OWNER OF RECORD OF LOT 94-1 15 400 OSGOOD STREET ,� •F•� BRASSUER ASSOCIATES. NOMINEE TRUST IN CME OF WTI F.BANNISTER,A.TRUSTEE. THE }'_ DEED REFERENCE TO THE LOT IS VOL.5171,PC.214,DATED JULY 30, �M.IIIT 1 'ASBUILT PLAN op"LAND .'PLAN OF ROAD-W THE TOWN OF-NORTH ANDOVER-ESSEX COUNTY- 1998 IN THE N.E.C.R.O. I a•w ° dl i s LAID OUT AS A STATE HIGHWAY BY THE-VASSACHUSETTS Na1WAY IN CONNISSION'SCALE:1'-4O',DATED JULY 5.1911. 2.THE TOTAL AREA OF LOT 94-1 IS 251,575 SO.FT.OR 5.844 ACRES. NORTH ANb06ER, MASSACIIU•SETTS 'PROPEITY UNE PLM-LAND IN-NORTH ANDOVER,MASS.-AS SURVEYED 3.ZONING FOR THE LOT is RESIDENCE-4.BULGING SET8ACKS ARE PBLPAR2D FOR ,.+. FRONT-3O',SIDE-15,AND REM-X.. '/AAWAnr Lwenrr aunt Isar tecr N. 40U OSGOOD STRF,ET NO:VfINEE TRUST FCR- T01N OF NORTH ANDOVER-SCHO0.DEPMTMENY $CALF:I•-100', 1?/L)dW1MWTBH f%N Afr TEU LN[u DATED JULY 1970,By MORSE AND MARTIN,N.E.R.D.PLAN'//6279.4.-PLAN 4.THE COCHICHEWICK BROOK WAS N07 LOCATED IN THE FIELD. RIE 0(Z3pM3�T�'A U'wNLXWID$... I /�a1 hLLIAN F'J D{%rNISTSR,JR., TAVSTLR OF LAND-LOCATED IN-NO.ANDOVER,MASS.',SCALE:1'-40',DATED ttNleuP TLu d.•RrL7S A.'N 2'.IIT S /•Ifs: -Ar/f' SEPTEMBER,1969,BY CHARLES E.CYR,C.E.L.C.PLAN/36426A. LOCATION wA5 DIGITIZED FROM THE ASSESSOR'S TAX MAP. 1713MI a7/MJUC UY Yt9vRYR 6T9.tiATd K ,,.�. ?" NAY,AUCYxOY A!A'tnb4Va9,AM'wTAT AO S.THE LOCATION OF THE UNDERGROUND ON-SITE SEWER UNE AND /nwtalln ny-rJ'/L-TCN 5T m9TfNDGNWsx „✓ / l f>_ -LAN OF LAND W-NC41TH ANDOVER,MASSACHUSETTS--PREPARED FOR- WATER LINE LOCATIONS WERE TAXEN FROM THE SITE PLAN. m:Dvoelwinaw TIAY.T.1(isrGaN• F"'-/ A.•..�c Pf'Ainrsnxe'-:LANp S(IRV�-�T,f/�•ONPA.NY' 400 OSGOOD STREET-NOMINEE TRUST',SCALE:V-40',DATED AUGUST 21, IE ,�(/ PO"DCII 20$, SALSA(, NX90M079 1998,6Y TNS OFFICE. 6.THE EDGE OF WET SHOWN TO THE SOUTH,WEST AND NORTH OF THE q 2L 3d-•f..1{. PO DOX 491. NS])'DORYPORT,ATA 019$0 BUAJIING WERE TAKEN FROM REFERENCE PLAN/e. _ . '40-RESIDENTIAL NORTH A SITE PLAN PREPARED FOR: 100 OSCOOD STREET-LOT �it�_ SCA/,-h' -"a_DATE / DRAM/NC N0: 34-1-NORTH ANDOVER,VASSACHU.'.E7T5',SCALE:1'-2U',DRIED SEPT. 7.SEE ALSO FINAL ORDER 0=CONDITIONS DATED 12/3/98, - I� 1994,LAST R>MSED 11/Il/SIB,BY NEAGH-NORDSTRCM ASSOCIATES.IMC. DEP FILE 9242-940. -- _. > 3'_70' NARCII 22, 2002 ,K-1261-L EMSTING CONNTIONS -PLAN OF LAND LOCATED AT-400 OSGOOD STREET 1 CERTIFY THAT 1 NAVE CONFORMED (-/� -NOR-H ANDOVER,MA-PROPOSED FUTURE LOCATION OF-NORM WITH THE RULES rt RE LATIMS p' " a� � -_REVISIONS .� _ JOB/ 1998-4I M03VER YOUTH CENTER',SCALE:I'-40',DATE)SEPTEMBER 1,1995. THE REGISTERS OF DEEDS IN n - PREPARING TMS PLAN. \ / TB f5152 SIISST I OF 1 /, / ��/�/ /J> MerOF'emn70 surere-cT p/rvt_ S , 11 AY AecAmry e0Llvdarlts ., EXHIBIT C REVISED ACTIVITY AND USE LIMITATION OPINION In accordance with the requirements of 310 CMR 40.1074, this Activity and Use Limitation ` Opinion has been prepared for a parcel of land owned by the 400 Osgood Nominee Trust located at 400 Osgood Street,North Andover,Massachusetts, 01845. As of the date of this Activity and Use Limitation Opinion, the property is zoned for residential use,but has a variance for limited commercial and industrial use. The property is approximately 5.8 acres in size and currently developed with a two-story, 30,000- square foot building currently used for storage and an adult strength and conditioning facility. Site History The existing building on the Site was originally known as"Machinery Hall". The Museum of American Textile History built it for storage and research on historic textile equipment. A portion of the Site was reportedly once used as a solid waste landfill for nearby textile mills. In 1997, Cygnus Group, Inc. completed a Phase I: Initial Site Investigation and Response Action Outcome Report on behalf of the Museum. The purpose of this report was to document investigations that determined the nature and extent of reported subsurface contamination related to a historic release of oil and/or hazardous materials at the Site. The release was identified based on laboratory analytical results for total petroleum hydrocarbon(TPH) by EPA Method 8100M in a soil sample exceeding the Massachusetts Department of Environmental Protection (DEP) RCS-1 reportable concentration of 500 mg/Kg. Pursuant to the requirements of the Massachusetts Contingency Plan(the"MCP," 310 CMR 40.0000), the release was reported to the DEP on September 3, 1996. The DEP listed the Site as number 3-14192. [Note: The "MCP" is the Commonwealth of Massachuestts'code of regulations for the notification, assessment, and cleanup of disposal sites where a release of oil and/or hazardous materials has occurred.] As a result of Phase II subsurface investigations, it was determined that elevated levels of petroleum hydrocarbons above MCP Method 1 cleanup standards were present in association with fill material that was deposited throughout the northwestern portion of the property. The majority of the TPH was found at a depth between 5 and 12 feet below surface grade. Only low levels of TPH were found in the southeastern boundary. Existing surface grade elevations, a drainage ditch, and a wetland area help define outer bounds of the contaminated fill material in other directions (see Site Plan in Exhibit B). All site contaminants detected in groundwater were below the potentially applicable MCP Method 1 cleanup standards. [Note: The "MCP Method 1. Cleanup Standards"refer to numerical standards for chemical contaminants in soil and groundwater, which are published in the MCP.] Reason for the Activity and Use Limitation A Method 3 Risk Characterization was conducted to evaluate the risk posed by contamination remaining in soil and groundwater within the Site boundary. This Method uses site-specific information to derive a quantitative estimate of risk of harm to human health, safety, public welfare and the enviromnent for all current and foreseeable future activities and uses. As a result of the Risk Characterization, it was determined that the Site poses "No Significant Risk"to human health, safety, public welfare or the environment for current conditions of commercial and/or industrial use. However, because the Risk Characterization assumed limited access of Site soil by infrequent visitors, trespassers, and construction/utility workers, an Activity and Use Limitation(AUL) is required to restrict certain future activities.and uses that could potentially result in a greater exposure to the affected soils. Permitted Activities and Uses The AUL Opinion provides that a condition of No Significant Risk to health, safety, public welfare or the environment exists for any foreseeable period of time(pursuant to 310 CMR 40.0000) so long as any of the following activities and uses occur on the Portion of the Property: (i) Commercial and/or industrial uses and activities associated therewith, including, but not limited to, pedestrian and/or vehicular traffic, landscaping, and routine maintenance of landscaped areas, which do not cause and/or result in the disturbance and/or the re-location of petroleum-contaminated soil located at 5 to 12 feet below surface grade; (ii) Short-terns (one month or less) underground utility and/or construction activities including, but not limited to, excavation (including emergency repair of underground utility lines), which are likely to disturb petroleum-contaminated soil located at 5 to 12 feet below surface grade, provided that such activities are conducted in accordance with Obligations/Conditions (i) and (ii) in Section 3 of this Activity and Use Limitation Opinion("Opinion"), the soil management procedures of the MCP cited at 310 CMR 40.003 0, and all applicable worker health and safety practices pursuant to 310 CMR 40.0018; (iii) Activities and uses which are not identified in this Opinion as being inconsistent with maintaining a condition of No Significant Risk; and (iv) Such other activities and uses which, in the Opinion of an LSP, shall present no greater risk of hann to health, safety, public welfare, or the environment than the activities and uses set forth in this Paragraph. Activities and Uses Inconsistent with AUL Opinion Activities and uses which are inconsistent with the objectives of this Notice, and which, if implemented at the Portion of the Property, may result in a significant risk of harm to health, safety, public welfare or the environment or in a substantial hazard, are as follows: (i) Use of the portion of the property as a residence, school (with the exception of adult education), daycare, nursery, recreational area(such as a park or athletic fields), and/or any other use at which a child's presence on a regular basis is likely; (ii) Any activity including, but not limited to, excavation, which is likely to disturb petroleum contaminated soil located at 5 to 12 feet below surface grade associated with underground utility and/or construction work, without prior development and implementation of a Soil Management Plan and a Health and Safety Plan in accordance with Obligations (I) and(ii) of Section 3 of the AUL; (iii) Any activity which is likely to disturb petroleum-contaminated soil located at 5 to 12 feet below surface grade for a period of time greater than three months, unless such activity is first evaluated by an LSP who renders an Opinion stating that such activity is consistent with maintaining a condition of No Significant Risk and that such activity is conducted in accordance with Obligations (i) and (ii) of Section 3 of this AUL; and (iv) Relocation of petroleum-contaminated soil located at 5 to 12 feet below surface grade, unless such relocation is first evaluated by an LSP who renders an Opinion stating that such relocation is consistent with maintaining a condition of No Significant Risk. Obligations and Conditions If applicable, obligations and/or conditions to be undertaken and/or maintained at the Portion of the Property to maintain a condition of No Significant Risk as set forth in the AUL Opinion shall include the following: (i) A Soil Management Plan must be prepared by a Licensed Site Professional (LSP) prior to the commencement of any activity which is likely to disturb petroleum-contaminated soil located at 5 to 12 feet below surface grade. The Soil Management Plan should describe appropriate soil management, characterization, storage, transport and disposal procedures in accordance with the provisions of the MCP cited at 310 CMR 40.0030 et seq. Workers who may come in contact with the petroleum-contaminated soil should be appropriately trained on the requirements of the Plan, and the Plan must remain available on-site throughout the course of the project; (ii) A Health and Safety Plan must be prepared and implemented prior to the commencement of any activity which may result in the disturbance of petroleum-contaminated soil located at 5 to 12 feet below surface grade. The Health and Safety Plan should be prepared by a Certified Industrial Hygienist or other qualified individual appropriately trained in worker health and safety procedures and requirements. The Plan should specify the type personal protection, engineering controls, and environmental monitoring necessary to prevent worker and other potential receptor exposures to petroleum-contaminated soil through ingestion, dermal contact, and inhalation. Workers who may come in contact with the petroleum-contaminated soil should be appropriately trained on the requirements of the Plan , and the Plan must remain available on-site throughout the course of the project; and (iii) The petroleum-contaminated soil located at 5 to 12 feet below surface grade must remain at depth and may not be relocated, unless such activity is first evaluated by an LSP who renders an Opinion which states that such activity poses no greater risk of harm to health, safety, public welfare,or the environment and ensures that a condition of No Significant Risk is maintained. LSP: Ralph J. Tella,ticensed Site Professional DATE: N2 2014 Date........ ... ........� f HOR7N " TOWN OF NORTH ANDOVER °t ' PERMIT FOR WIRING CHUS This certifies that ......... ..........�....t C JA..(..c C �. .. .............................. ................ .. has permission to perform .....Tt...r......�: :.. �^ ....... .. ................ wiring in the building of �?>v 7 `/� at..... < .........................................\......I..�rth AndoverMags? Fee. > l).�..`� Lic.No./L.. .......... LECCRICALINSiECTOR� WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Office Use Only OI� / ullP ( 0mmunwalo Iaf 4&,9Sxthus�ettn Permit No. Q� ` 41 i9eplutment of 11uhlir Oafetg Occupancy&Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date City or Town of To the Inspector of irW e The udersigned applies for a permit to perform thle electricW work dd scribed below. Location (Street & Number) ° O Owner or Tenant j �Q us _ / / C 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 7. �[�/ Location and Nature of Proposed Electrical Work UlJ� tine Q! P��G f t up No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners I Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total No. of Detection andtons Initiating Devices No. of Disposals I No.of Heat Total Total Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices ,,No. of Dryers Heating Devices KW LocalMunicipal ❑ []Other Connection No. of No. of Low Voltage No, of Water Heaters KW I Signs Ballasts Wiring { No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES NO E I have submitted valid proof of same to the Office. YES K NO C If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE X BOND ❑ OTHER ❑ (Please Specify) (�✓1 Estimated Value of Electrical Work$ t V (Expiration Date) Work to Start Inspection Date Requested: Rough Final Signed under the Penalties of perjury: --��-- FIRM NAME _/ G/� /PIC Cd 1/IlG 13s LIC. NO. S Licensee s. . V�/�.q `�/� SignatureLIC. NO. A,f'93 _3 s. el. No. LL,' Address 55-1-2C/�/t3/���2�/V� ✓C/,� o. ��/nn�il2. AO/walt.Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Own Agent (Please check one) Telephone No. PERMIT FEE$ ,v) (Signature of Owner or Agent) x6565 Date �= 3835 HaRTM TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING s o�.o -�,�• a *,n o'�•�.�h SA HUS This certifies that .... . . . . . . . . . has permission to perform . . . . . .<.I'� . ./a u?�' . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . . at. . 1/ U. . .U.'q-:y.0� . . . . . . . . . . . . ., North Andover, Mass. Fee. .'". .Lic. No.. . . . . �� I--4r ?:.. . . . . . . . . . NUMBING INSPECTOR 10/13/98 08:57 75.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer (Type or Print) i NORTH ANDOVER ,Mass. •;i:<: Date:' • 8`33. Building Location yoo ®..ad.aoe Permit 7,),, -- Owners Name lip New Renovation j] ' Replacement [� Plans Sybmitted FIXTURFS ' h ¢ o z > sA w w Y _j o' C1 h N a !� Q w 2 m < cc = O Z 0. O W #— W H V ¢ U z' ¢ a ¢ w ¢ a sn o 4 w r a a � o. a W O O W d of W U) cc J Q I to J W Z < 2 � O z x Y IL Q f- < Id < W IL X W •, F O > 1- O N y) > Y) I-. z 0 0 0 x Z W H O V 2: < f' < < _ Q Q O < J J < ¢ W < O < H Y J 07 O Q J = i- to t•. O O O < 'sc O Q SUB—,BSMT. BASEMENT IST FLOOR / 2ND FLOOR 3RD FLOOR ATH FLOOR 6TH FLOOR 6TH-FLOOR 7TH FLOOR ' BTHFLOOR l (Print or Type) Check one: Certificate Installing Company Name Corp. Address 0A Al, Partner. Q,3©2? - [j Firm/Co. Business Telephone 1403_ Name of Licensed Plumber: Insurance Coverage: Indicate the pe of insurance coverage by checking the _ appropriate box: Liability insurance policy Other type ,of indemnity 0 Bond CJ Insurance Waiver: I , the undersigned, have been made aware- that the licensee Of i this application does not have any one of the above three insurance coverages. of owner/agent of property Owner Agent�� I t hembp cutifr Wal all of Use dctails and in(oination I laa.c sul mil lcd (at cntnM cd)in a ,.e app1s limlioa c 14rc a'::1 ,:,, ,, , Signature 844 to dw bast of 1y k"wkdgc and spat all plumbing wad and installations pc•(at mcd undo rcrutil(uucd(os this appikatias uja bo caMtptiaoss aitJt W to'*"«`l atiie"of Ow ltas"uactis Sutc riumbiag Code and Chaplet 142 0((lw l:cnual LaML �v � I 1 • li By Title • Signature of Licensed Plumber City/Toon: f:,213 g`l�Pe of Plumbing License IA 000r)VFn 7aFFIC.F USE ONLY1 License Number Master 0 JourneywW MASSACHUSETTS UNIFORM APPLICATION FO RMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS �1 Date % V/ Building Location y00 Owners Name i100 0 S--t ZPermit# 1 Amount J �� Type of Occupancy New d Renovation ® Replacement ® Plans Submitted Yes El No El FIXTURES Date 4 .93 a a Pro W A a TOWN OF NORTH ANDOVER --'t d 0 4,Sao ,a Md PERMIT FOR PLUMBING �SSACHUS� This certifies that . . . . . has permission to perform . . . A plumbing in the buildings of . . • d V f' +� ti•t . (. . . . . . . . . North Andover, Mass. at. . L/l? . . . . . . Fee. ,��% .�.'Lic. No.. ✓•� F,U . . . . . . . :Y:: . GPLUMBING INSPECTOR ck one: Certificate Corp. WHITE: Applicant CANARY: Building Dept. PINK:TreasurerPartner. Business Telephone GOA- <�-6 �j Firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate the msurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent I hereby certify that all of the details and information I ha submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work stal tions performed and Perm, issued for this application will be in compliance with all pertinent provisions of the M achu Stj m p er 142 of the General Laws. By: igna ot Licenseaum er Type of Plumbing License Title /A3 ❑ City/Town icense � IN um Ber Master Journeyman APPROVED(OFFICE USE ONLY 32 3 L Date.. ... ... . .. .. .... NORTH TOWN OF NORTH ANDOVER ppya�,,ao ,e,ti O p PERMIT FOR GAS INSTALLATION _ SSACaMUSE,�� r c This certifies that`.-�. . . . . .. . . . . . ... . . . . . . . . . . . . . . . . . . . . . . � has permission for gas installation—,, nstallation- ! . .Xl�' � c in the buildings of . . . . . . . . . . . o at . . . . . . . . ., North Andover, Mas. cc Fee.��. . . .. . . Lic. No�iip?yC�:�f. . :.'i, �a�!:U1.7 ':o GGAS'INSPECTOR G' WHITE:Applicant CANARY:Building Dept. PINK:Treasurer l MAP D J� 1 PAR D a MASSA ATON FOR PERMIT TO DO GAS FEMNG ype or print) Date 19 IF NORTH ANDOVER, MASSACHUSETTS 2 Building Locations '0,1 1/ c� isd�f �' Permit 9 J d J Amount S Owner's Name New❑ Renovation d Replacement ❑ Plans Submitted ❑ L4 11 n v U z �_ c GW i W .. - i- n Z C.. Z C rn - W N W Z SU B -BASENI ENT B A S E M E N T 1ST. FLOOR 2iND . F L 0 0 R 3RD . FLOOR 4TH . FLOOR 5TH . FLOG R QrJ r/ 6 T II . F L O O R izz 7T 11 . FLOG R ✓f 4 I-Q 3"r 11 . F1, 00 R (Print ortype Check one: Certificate Installing Company Name D, ivt 1.l ,o,�l�GrrJ ❑ Corp. Address `,9 9r ze–,, -S'%• /�t�f1.�y /�,j`�1���/ ❑ Partner. Business Telephone ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter41–Z- INSURANCE COVERAGE Check on I have a current liability Insurance policy or it's substantial equivalent. Yes Nom Ifyou have checked ves,please in to the type coverage by checking the appropriate box. Liability insurance policyoz� 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.!Ws,andv ignature on this permit appiication waives this requirement. Check one: Si_natu f Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusett tate Gas Code and C ter 142 of e General Laws. By: Sina re of Licensed Plumber Or Gas Fitter Tide ❑ PI ber . !V .2 City/Town rTrGas Fittertcen� s—eN umber ❑ifvlaster APPROVED(OFFICE USE ONLY) 0 Journeyman aoerM Zoning Bylaw Review Form A , Town Of North Andover Building Department 27 Charles St. North Andover, MA. 01845 ��SSaeNus��g Phone 978-688-9545 Fax 978-688-9542 Street: p 0 .. G-S G o Map/Lot: Applicant: ?'u L.I pm-t VK ,4ry Request: N c e- Rc N 4 IY1 U s t c/-"- l -rhea e.r` Tt^i,�t N IN Date: C.- g -o Please be advised that after review of your Application and Plans that your Application is DENIED for the following Zoning Bylaw reasons: Zoning Item Notes Item Notes A Lot Area F Frontage 1 Lot area Insufficient 1 Frontage Insufficient 2 Lot Area Preexisting Ile s 2 Frontage Complies 3 Lot Area Complies 3 Preexisting frontage es 4 Insufficient Information 4 Insufficient Information B Use 5 No access over Frontage 1 Allowed G Contiguous Building Area 2 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 Complies 4 Special Permit Required je s 3 Preexisting CBA H S 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient 2 Complies 3 Left Side Insufficient 3 Preexisting Height Lt e S 4 Right Side Insufficient 4 Insufficient Information 5 Rear Insufficient I Building Coverage 6 1 Preexisting setback(s) '1 S 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies D Watershed 3 Coverage Preexisting It-f-- S 1 Not in Watershed `t e 4 Insufficient Information 2 In Watershed j Sign N 3 Lot prior to 10/24/94 1 Sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking 1 In District review required 1 1 More Parking Required 2 Not in district (e S 2 Parking Complies 3 Insufficient Information 3 Insufficient Information eFT S 4 Pre-existing Parking Remedy for the above is checked below. Item # Special Permits Planning Board Item # Variance — Site Plan Review Special Permit Setback Variance Access other than Frontage Special Permit Parkinq Variance Frontage Exception Lot Special Permit Lot Area Variance Common Driveway Special Permit Height Variance Congregate Housing Special Permit Variance for Sign Continuing Care Retirement Special Permit Special Permits Zoning Board Independent Elderly Housinq Special Permit Special Permit Non-Conforming Use ZBA Large Estate Condo Special Permit Earth Removal Special Permit ZBA Planned Development District Special Permit Special Permit Use not Listed but Similar Planned Residential Special Permit Special Permit for Sign R-6 Density Special Permit Special permit for preexisting nonconformin Watershed Special Permit The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for Any inaccuracies,misleading information,or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department.The attached document titled"Plan Review Narrative"shall be attached hereto and incorporated herein by reference. The building department will retain all plans and documentation for the above file.You must file a new permit application form and begin the permitting process. Building Department Official Signature Application Received Application Denied • a Plan Review Narrative The following narrative is provided to further explain the reasons for DENIAL for the APPLICATION for the property indicated on the reverse side: R6496r 1 ,o-- ,70tirti11 730a'-a e9 I` /4 010-Pq (S 7 S c,iPip Ce �— __14 '2,e S, �� p/A �Iew S � V , � P���„ F N O O S �-C/ n -e , Y 'f ,4/V AV l Nq D,+4/p d. �311,9© e ?' PC,Q .1c r Kj v w,os S 6 �'pC S o it,Po 7�e ren e A� 12, v m 6,e r- m �' �,a r �i ti �c �s wg S m•a . Referred To: Fire Health Police 05zonin Board Conservation Department of Public Works Planning Historical Commission Other. Building Department TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVAT5 OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. DATE ISSUED: ic SIGNATURE: Building Commissioner/inspector of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Addr 1.2 Assessors Map and Parcel Number: ro &©O/ Map Nunfber Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Diacid Proposed Use Lot Areas Frontage fl 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide RegWred. Provided R red Provided v 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT is oriCDistrict: Yes No V rn 2.1 Owner of Record / y Name(Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Z rn Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O License Number Address Expiration Date ic Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name rn Registration Number r i Address r Expiration Date ^Z Signature Telephone Y' ` f f V SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check all a Ucable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6--ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 sT2ND 3RD SPAN DEvMNSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE TO: NORTH ANDOVER ZONING FROM: JULIE PAIGE GEDIMAN DATE: JUNE 7, 2004 SUBJECT: STATEMENT OF OPERATION Per your request,the following provides an overview of my business: Business Location: 400 Osgood Street,North Andover Property of Bill Bannister Business Type: Performing Arts Studio for Children and Teens Business Offerings: Instruction in Dance,Acting, and Musical Theater Class Times: Classes are offered five days a week, after school and early evening, as well as Saturday morning. Number of Students: Currently my classes have between 5 and 10 students. Parking: As children under the age of 16 cannot drive,the business is primarily a drop-off business. Studio Layout The studio will have two full dance studios,bathroom access, and a small office and storage area. Studio Precedent One-to-One Strength was recently approved by the North Andover Zoning Board at this location Studio Opening It is my hope to bring this wonderful offering to the town of North Andover in conjunction with the start of the 2004-2005 school year. Questions Thank you for your consideration in this matter. If you have any questions, feel free to contact me: Julie Paige—Director www.paigeconservatoly.com 917-689-5196 978-475-3422 /300 fest ri - o No Date ................................. MORT11 °t,"`°:•'"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SSACMU`�� This certifies that ....... " .........................................: ............... .................................... has permission to perform .............:.:........................................I ................ wiring in the building of.... ...................:............................................. at.......t...................................:............................. ,North Andover,Mass. mFee.......:............. Lic.No.............. ............... ........... .........:................ ELEcmicAL INSPECTOR d Check 11 Z.9 WHITE:Applicant CANARY:Building Dept. PINK:Treasurer Official Use Only 76W smiw Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS (Rev. 11199) (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Ali work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 'fR I 00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: & City or Town of: Ag&/� To the In pecdr of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number : Owner or Tenant: TelephoneNo: Owner's Address: , Is this permit m conjun liar with a bui ink permit? Yes ❑ No� (Check Appropriate Box) Purpose of Building: ' •i%� - lC� Utility Authorization No: f���/ Existing Service: d Amps�W/�V01 Overhear Undgrd ❑ No.of Meters New Service: Amps—/ Volts Overhe ❑ Undgrd ❑ No.of Meters UNumber of Feeders and Ampacity: Location and Nature of Proposed Electrial Wprk- ell Completion of the following table may be waived by the Inspector of Wines. te No.of Recessed Fixtures No.of Ceil.-Susp. (Paddle)Fans No.of Total Transformers KVA a No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool: Above No.of Emerggency rnd.1:1In-grnd. ❑ Lighting Ba eery Units No.of Receptacle Outlets No.of 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 O Tons .. No. of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained q Totals: Detection/AlertingDevices CC, No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Other Connection ❑ oNo.of Dryers Heating Appliances KW Security Systems: ti No. of Devices or Equivalent No.of Water Heaters KW No.of No.of Data Wiring: Signs Ballasts No. o Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Nytang: No. of Devices Equivalent • tu oT %Gf �a a ditional detail ij red,oras reg 'red by the Ins ector Wires. Q Insurance Coverage: effless waived by a owner,no permit for the ormance of electrical ark may issue unless the licensee provides proof of liability insurance includin ompleted operation"coverag its substanial equivalent. The undersigned certifies that such coverage Qis in force,and has exhibited proo f same to the permit issuing office. V Check One: Insurance and❑ Other❑ (Specify): o' o, (Ex ration Date) ti Estimated Value_o ,le Work: (When required by municip policy). Work to Start: ki Inspections to be requested in accordance with Rule 10,and upon completion. 1 certifj; rider pains an enalties of er that the info ati n this appli do is true and com Clete. Firm Na ��`u✓1' �� .r%c le.No' Licensee: Signature• �' Lic.No: (If appli,` n ex Pt"i e bens mb r Address• Bus.Tel Ni : Alt.Tel.No: Owner's Insurance Waive,- I am that the License does no ave the liabili 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 Fe $ Signature: Telephone No: e: Date.�./�. .`.. . . No 476 TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING 1 SACNUS This certifies that . . . . . //6t . .. .. .I. . . . . . . . . . . . . has permission to perform . . . . .. . . . . . . . . . . . . . plumbing in the buildings of . . . . . ... . . . . . . . . . . . at . . . . . . . . . . . . . . . . . . . . North Andover, Mass. Fee.)/�,. Lic. No.. . . t` . . . . . . . . . . . . . . . . . ! . . . :�: .`�. . . . . . . . PLUMBING INSPECTOR Check # b WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date Building Location Owners ame �Ct/VV11,� Permit#_ Amount T e of Occ New Renovation ED Replacement Plans Submitted Yes No FIXTURES z z wLn w w F G4 U 14 FU p" F W� E-+ d� M-4 STSBM 1Ei�g1VINI' 1ST:HaR ZD FIDQZ 3MRIM d 4IH FUM 51HROM 6TH HDM 7MHIM M FIDQZ (Print or type) Check one: Certificate Installing Company Name PP+H Corp. Address S"4414El Partner. o) Business Telephone Firm/Co. Name of.Licensed Plumber: Insurance Coverage: Indicate the typ3oftfisurance coverage by checking the appropriate box: Liability insurance policy Lid Other type of indemnity Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent I hereby certify that all of the details and information I hay, itted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and' stall 'ons p ormeZumer d under Permit Is r this application will be in compliance with all pertinent provisions of the Mass h State uC Ch �14ofthe General Laws. By ign o icense Type of Plumbing License Title IC28 Iwo City/Town ricense MET= Master �Joume an APPROVED(OFFICE USE ONLY /. NN2 � ti Date... - vU � HO RTI{ TOWN OF NORTH ANDOVER . 10 PERMIT FOR WIRING ,SSACMUS� This certifies that ...... ......... .......................................... — has permission to perform .... �............. r.......�............... 1............................ wiring in the building of....` .1/....�i4..//..!!.r.S J.. . ............................... L / r^ ,'' at......7�.U ...........m:��.U.� .....�. ........................ .North Andover,Mass. �l Fee....,1 Q U....... Lic.No../.�!..� ............................................................... ELECTRICAL INSPECTOR \� f 17 S� /98 08:52 100-00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer �� �� office Use Onty Gibe �::IIIIIriI niurzifth of gasz#=ift Permit No. 3qm-tmzrrt of ITuhtir _*afstg Occupancy& Fee Checked 3M (leave blank) BOARD OF FiRE PREVENTION REGULATIONS 527 CAR 1200 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 C.M2po (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Oate (XX or Town of NORTH ANDOVER To the Inspettar of Wires: The uderslgned applies `or a permit to perform" th�}e.Leiec,*riZai work described below. Location (Street & Numcer) 60 �� � Owner or tenant C%vner's Address Y / Is this permit ;n ccnlur.ctie/n/with af-building permit: Yes No (Check Appropr,ate hex) ?urccsa cf 3ulidirc U/�12PYlc�I�S Utility Auircnzatlon No. Exisvng _cer.ice Amps •Vohs Overreac _ Uncgrnc No. of Meters Ne`.v Ser•:ice Amos Vcits Cverr.eac _ Uncgr-c _ No. of Meters Nurrtcer cf ==ecer5 arc Amcac::y /��J, it,� I effi �t 3r `:at.._ ?rccCsec E=ct. ,.a1 'Icrx 1 t�f ��1� �'• /fru f 4A� cze Total ,,,...rrr���� I No. ct -ranstcrr^.ers NC. ... _.;�:`..r^y .=l:L'e!5 � NO. -. �... .DS KVA :n- No. :r L.gr.arg =:cues / Swimming P=al S " r c. _ =.-.a.e. _ ! Generators KVA No. -t Emergency i-igritrr; No. a -____.ac:e Curets /fin Ne. ct Cil =...hers ; 3acery Units No. cf Swttcr whets No. cr Gas =_.ners I =iRE ALAPMS No. ct ones Total I No. ot =etec::on arc I No. cr Rar.ees No. ct Air ---no. ;cns Intttaung :avtces No.cr eat Total Total No. a �iscesais Pumps ans K':� I No. at Seune:ng Zevices No. of Salt Cantatnea No. .r ::,snwasners - ScaceJArea �ieaur.c KYR I Oe!e=cnrSouncing cevices I b .municiaat Na. a _r:ers t!ea:mc Cev:ces Kw I ._cat — —Other _ Cznnec::gin — rt)v© � I No. _t No. :1 I ":w �:aitage No. at 'nater :eaters 'KIN ! Sichs 9atiasts vir:hc No. :jvcro .lassace ups No. ct Motors To tat P INSUPANC= iE=nG=. P•_rsuant to Ire recwrerr.ents -r •'.4SSaCn"at:s ;eherai '_aws _ i have a current L/:acuiN insurance PClic'/ Tc:uc:ng •C rn a ec Ccerauens Coverage Cr -is suastantlal ecuivalent. YE NC — have sucr-itreC v/atiC =.--at ct same :a :he Chips. YES(/_ NO _ It -icu,:lave c-ecxea YES. -tease �noicate :he r/CB of�CCVef ege -V cheping :he ao�raenats cox. 1NSURANC=_✓= BONO = C 7 HE= = (Please S=ec:.,,,) / t�.coi�a�ion Cater 'csttrratec value at E:ectreat `.voric 5 ' ' l!o// ;•-hat Wcrx :o Star. Inscec-:on Cate Racuestac: Rcugn Signea anter ;ns Penatt:essp-at ;erlury: Y 71RM NAME `I 1i1 i� UC. Na. Lcenses S;cnature —'-:C. NO.. C ' 3.5. -at. No. �7� 4� ACCre35 5 Alt. 'el. No. OWNEP'S INSUPANCc WAIVER: I am are :hat :he Licensee ^_oes hat nave :h insurance coverage or its suostantiai eauivalent as ,e- cuirea -v .Massachusetts General Laws. aria :nat ny signature cn :r:s _err-:( acClIcauan waives this requirement. Cwner Agent (Please checx cnei etecrcre No. PEPMIT F__ 5 V Sicr.ature cr Cwr er:r.tcenn <�i5c5 ... .1/� ... 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING -ZACHU'- This certifies that,4 .. v ,/........./ has permission to perform ....... ....... .... .Ag in the building of........ ........,,?1........................... at ......... ................ North An4pver,M Fee.Z .9.. Lic.No../..YX. . ........ LE -IN7 RICAL INSP CTOR Check # ' 4 422 •4-%p t�'Cn �///j // For omae Use ody. ZA�� e awewaa&o` a:"aclwdaw (Rev 11199) cc�� cc7� Permit Number. .1JoPartnwtt o`.tiia�irvidae Occupanry i Fee BOARD OF FIRE PREVENTION REGULATIONS checited: APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK (ALS.WORK TO HE PERFORMED WITH THE MASSACHUSETTS ELECTRICAL CODE$27 CMR 12:00) PLEASE PRINT IN INK OR TYPE ALL jKFQRMATIQN � Data; 5/19P03 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 BNumber) 400 Osgood Street (temporary Town Hall location) Owner or Tenant: Town of North Andover Owners Address Is this permit in conjunction with a Building Permit? Yeses No o (Check Appropriate Box) Purpose of Building: r a m p T n t.T n N a 1 1 Utility Authorization#: Existing Service: Amps /.---Volts Overhead 0 Underground.0 #of Motors.,.,,_.. Now Service: Amps / Volts Overhead 0 Underground.0 #of Meters, . Number of Feeders and Ampacity: Lition.and Nature of Proposed Electrical Work: I:�t QmQri p n r* 1 ;"g h t i n g No.of Recessed Fba-tres No.of C&H.•Susp.(Paddle)Fans No. of Transformers Total KVA No.Of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pod: Above ground o In Ground o 0 of Emergency Lighting Battery Units Na of Receptacle Outlets 16 No. of Oriumers. Fire Alarms sot bones r of Detection fi Initiawg Devices�,.. No.of Switches No.of Gas Burners •of Sounding Devices: t3 of Self Contained No.of Ranges No. of Air Conditioners TOTAL TONS: 4 Local o Municipal Connection o Other o No. of Waste Disposals Heat Pump Totals: Security Systems: Number. TONS: KW: No.of Devices or Equivalent No.of Dishwashers Space/Area Heating: KW Data Wiring,No.of Devices or Equivalent: No.of Dryers Heating Appliances KW Telecommunications Wlrirhg:NO of Devices or Equivalent: No. of Water Heaters KW No. of Signs: M of Ballasts, OTHE a of Hydro Message Tubs No. of Motors Total HP INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the Ik*n*9.q•prpvtsVc�Q: @"ity insurance including'completed operation'coverage or Its substantial equivalent. The undersigned certifies that such coverage Is In force,and has exhl 'ted proof of same to the permmit issuing office. CHECK ONE: INSURANCE XCX BOND 0 OTHER 0 Please specify: Estimated Value of Electrical Work i (When required by municipal icy) . Work to Stant: Inspections to be requested in accordance With M yfon d upon completion. I certl y,under the pains and penalties of penury,that a Ion this appllwtlon Is trete and canPfeb. Firm Name: Andover Electric Services I tics 14302A Ltcensea R o bg r t J . Branca Signature:///% UC.tf : cep t / 1"s license numb er line) 20Andov Address: n2aeAlSh �nBel a 479-49 at.Tet. OWNERSINSWAvIVERr Iam a« aware that the Licensee does not fro liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) Owner o OR Agent o Please a d Signature of Ownw/Agent: Telephone ts___ _ PF,RMtT FEF-$164 i Date ... .... . .. .... " NORTp °�<<`'°;•1"° TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACMUSEt This certifies that.-,,4,--14v?..... �i°r �/C -L '' ........ has permission to perform ......... ...... d/^�.Al wirin ort the building of......./.. ........ ......l�t�//.. " . North Ando �s sat....... l v . ........... s: ... !.. c. ELECTRICAL I&spECTOR Check! 4. 4} , 5 •m+I f t` / For Office Use Orgy teCvnoaonweahkof msac/u0saj (Rev.11199) , Permit Number. �l.JoPartnmanj o`,tiro�iirrical ocoupanoy i Fee BOARD OF FIRE PREVENTION REGULATIONS Com`ked ' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK (ALS.WORK TO BE PERFORMED WITH THE MASSACHUSETTS ELECTRICAL CODE 527 CMR 12:00) PLEASE PRINT IN INK OR TYPE ALL IUFORMATION Date: May 2 , 2003 City or Town of: N n r t h. A n d n v p r 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) 400 Osgood Street Owner or Tenant: Town of North Andover Owners Address: 120 Main- Street is this permit in conjunction with a Building Permit? Yes p No o (Check Appropriate Box) Purpole of Building: temp . Town Hall Utility Authorization#: Existing`,Service: Amps / Volts Overhead 0 Underground.0 #of Metofs____._ New Service: Amps / Volts Overhead 0 Underground.0 #of' Motors- Number of Feeders and Ampacity: Location and Nature-of Proposed Electrical Work: T e m p o r a r y wiring- for temporary Town Hall . No.of Recessed Fiiduros No.of Coil.-Susp.(Paddle)Fans No. of Transfornors Total KVA No.Of Lighting Outlets 25 No. of Hol Tubs Generators KVA Nc of Lighting Fixtures. Swimming Pool: Above ground o In Ground o M of Emergency Lighting Battery Units No.of Receptacle Outlets No. of Onumers s Fire Alarms s of Zones 0 of Detection 3 inwatim Devices„__ No.of Switches No.of Gas Burners III of Sounding DeVices' tf of Self Contained DolloctiaLlSoun0IN Devices ` No.of Ranges No. of Air Conditioners TOTAL TONS: Local o MunlciDal Connection o Other a No. of Waste Disposals Heat Pump Totals: Security Systems: Number. TONS: KW: No.of Devices or Equivalent No.of Dishwashers Space/Area Heating: KW Data Wiring,No.of Devices or Equivalent: No.of Dryers Heating Appliances KW Telecommunications wiring:No of Devices or Equivalent: No. of Water Heaters KW No. of Signs: 8 of Ballasts: OTHER; N of Hydro Massage Tubs No. of Motors Total HP 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 incuding'compieted 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 XQX • BOND o OTHER o Please specify: Estimated Vales of Electrical worts$ 9 :-200 .99 (When required by municipal policy) Work to Star: Inspections a be requested In accordance with MEC Rule Or a upon completion. I certify,under the pains and penalties of penury,that the Info a on this application Is true and Complete. Firm Name: Andover Electric Services Inc . LICE 14302A Licensee: Robert J. Branca signawre: LIC.tt' $g (M appikawa,enter"ex I lir9,-4QQ se number line) Address: 2 0 oy e r Oyrill R�0 ' Due.Tel.rS Alt.Tel.11 OWNER'S INSURANCE WAIVER:I am aware that the Licensee does not have the liability Insurece coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) Owner o OR Agent o lease a d v i c e Signature of Owner/Agent: Telephone M^_ _. I PERMIT FEF-s vrnctar/(�,9 Comm.onwea�f� ol i"�/cxssuc!•iuseffs � , Permit No. /�1 ) oL.Je�arfinenf o��ire �ervices �� Occupancy and Fee Checked ` BOARD OF FIRE PREVENTION REGULATIONS (Rev. 11/99) (Ieaveblank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the M sachusetts Electrical C de(ME ),527 CMR 12.00 (PLEASE PRINT IN INK ORaYLAL�L NMARMAT O Date: City or Town of: To the Insp ctor of Wires: By this application the undersigned gives notice of his or'her inte on to perform the electrical work described below. Location(Street& umber) Owner or Tenant Telephone N . JY Owner's Address Is this permit in conjunction with a building,permit? Yes ❑ No Zj (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: Completion of the following table may be waived by the Inspector of Wires. No.No.of Ceil.-Sus addle Fans Transform sf Total No.of Recessed Fixtures P•(Paddle) Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA Above In No,of Emergency Lighting No.of Lighting Fixtures f Swimming Pool gmd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones o. Detection and Initiating No.of Switches No.of Gas Burners t iating Devices No.of Ranges No.of Air Cond. Tons Na.of Alerting Devices Heat Pump Number __Tons _ __ICW _ No.of Self Contained No.of Waste Disposers . Totals: Detection/Alerting Devices No.of Dishwashers S ace/Area Heating Municipal Other P g KW Local❑ Connection Security Systems: No.of Dryers Heating Appliances KW No.of Devices or Equivalent No.of Water No.of No.of Data irino: Heaters KW Signs Ballasts No.of fevices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional derail if desired,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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) e:5,P�n_ (Expiration Date) Estimated Value of Electrical Work: `�J (When required by municipal policy.) Work to Stas Inspections to be requested in accordance with MEC Rule 10,and upon completion. 1 certify, under the painf and penalties o perjury, that the information on this application is True and complete. FIRM NAME: �I �V_XQ h f t SeVlo ^ - LIC.NO.: 5U Licensee: ✓1 Tr- Signature LIC. NO.: �fO,y� (If applicable,enter'ex t' in the license nurnbe) e.) C L , l Bus.Tel.No.:g-1g CIZ 6oyLJ ddress: or oeL� �V�..4� S�'�W t`e (A)t�' ! t It.Tel. No.: WNER'S INSURANCE WAIVER:I am aware that the Licensee does nor have the liabih in coverage normally required by law.By my ture below•I hereby waive this requirement.I am the(check one) owner [i owner's agent ,ria ner/Agent _nature Telephone No. — PFRMIT FEE: S I� v JA TFJ O o 1 '4 .,roc« S-7ACHUS"- TOWN OF NORTH ANDOVER NORTH ANDOVER, MASS SIGN PERMIT DATE �k�..1/ PERMIT # ' THIS CERTIFIES THAT, has permission to erect. 431 E- NOR `r�L rOaTE:> alea 44ju�s on 40c> os - , 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 ro relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section #6, Voids this Permit. I Inspector of Buildings TOWN OF NORTH ANDOVER SIGN PERMIT APPLICATION Site Owner Applicant2e. a �. Site Address /YOo Size of Proposed Sign e How attached: a) Against the wall Illumination: a) Not illuminated bj Roof O b) Internally illuminated ( ) c) Ground ( } c) Externally illuminated ( } d) Other ( } Proposed Colors: Background Materials: ,A, .` Lettering 4 Border — Required. Attachments: Note: No permanent/temporary sign shall be erected, or enlarged until Photographs of building, an application on the appropriate form furnished by the Sign Officer has Material sample been filed with the Sign Officer containing such information including Color sample photographs, plans and scale drawings, as he may require, and a-permit for such erection, alteration, or enlargement has been issued by him. Site or.Plot Plan (Required for all free-.standing signs) Such permit shall be issued only if the Sign Officer determines that the Drawings of proposed sign sign complies or will comply with all applicable provisions of the Other, By-Law. specify 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:_ revised:jm- 8/98 tVp �� '1kt.ttP; C� PR{_ S,'O-� SIGNATURE OF APPLICANT NORTH O .11 L 16 O r,.1 t r. _ .��ri. 1 ► �, ((1 YA COCIIIC nIVICn - V SS'9CHUSE� TOWN OF NORTH ANDOVER NORTH ANDOVER, MASS SIGN PERMIT DATE PERMIT THIS CERTIFIES THAT, n N d� � )a7ti\, F:� a-1 has permission to erect. 2r.t x 3 ? provide that the person accepting this Permit shall in every respect conform to the terms cf 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. Inspector of Buildings TOWN OF NORTH ANDOVER SIGN PERMIT APPLICATION Site Owner Applicant /.o„�„ p-47 �i• ;t�o„�r- Site Address y0 0 Os9Qoc S-(r t e� Size of Proposed Sign 3 X A, How attached: a) Against the wall_( Illumination: a) Not illuminated b� Roof O b) Internally illuminated ( ) c) Ground c) Externally illuminated ( ) d) Other ( ) // Materials: Proposed Colors: Background wh; Lettering Border — Required Attachments: Note: No permanent/temporary sign shall be erected, or enlarged until Photographs of building an application on the appropriate form furnished by the Sign Officer has Material sample been filed with the Sign Officer containing such information including photographs, plans and scale drawings, as he may require, and a-permit Color sample for such erection, alteration, or enlargement has been issued by him. Site or Plot Plan (Required for all free-standing signs) Such permit shall be issued only if the Sign Officer determines that the Drawings of proposed sign sign complies or will comply with all applicable provisions of the By-Law. Other, specify 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: '7— /,j/ -Q revised:jrn- 8/98 Iud lee, �t��-►+•�•e��iq-L StCv� SIGNATURE OF APPLICANT Location No. y Date NORTIy TOWN OF NORTH ANDOVER t 1� O?O'�t`,o '••• C R Certificate of Occupancy $ *. : Building/Frame Permit Fee $ Z% 6— �o 11 �0+��0•A,� ,S* CMUSFoundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ i Building lni�e6or /�G Div. Public Works PERMIT NO. APPLICATION FOR PERMIT TO BUILD********N TH ANDOVER, MA NIAPNO. C ct LOTNO. L.orr 2. RECORD OF OWNERSHIP DATE BOOK PAGE _ 7/d7/9 ', ZONE SUB DIV. LOTNO. Os CQS\ Iv t7.v� cY�t )Gz�S j 7 g a J•3 LOCATION LD L O S G o O .d " PURPOSE OF BUILDING OWNER'S NAME NO.OF STORIES SIZE OWNER'S ADDRESS4100 d5 S'� IV•o. �/� /� BASENIENT OR SLAB 'Ls OCR Ft�ICJC©-.SQv �a . ARCHITEC''SNANIE e�cgsC S{e�bQ� SIZE OF FLOORTINIBERS' isT2 NI) 3131 BUILDER'S NAME AVoT(1 V sT Z0LT i O� SPAN DISTANCE TONEARESCBUILDING �DO a DIMENSIONS OF SILLS DISTANCE FROM STREET A DIMENSIONS OF POSTS ��77 DISTANCE FROM LOT LINES-SIDES REAR -0J DIMENSIONS7OF GIRDERS O CK C--F l O`\ k- ) 1\ AREA OF LOT , FRONTAGE Z HEIGHTOF FOUNDATION THICKNESS IS BUILDING NEW x\ST1� SIZE OF FOOTING X IS BUILDING ADDITION = MATERIAL OF CHIMNEY IS BUILDING AL'T'ERATION y (-- IS BUILDING ON SOLID OR FILLED LAN IVILL BUILDING CONFORM TO REQUIREMENTS OF CODE yF S IS BUILDING CONNECTEp TO TOWN WATER. A/F S BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEINER C IS BUILDING CONNECTED.TO NATURAL GAS LINE INSTUCTIONS 3. PROPERTY INFORNIATION LAND COST EST.BLDG.COST 'sc>oEip " PAGE I FILL OUT SECTIONS 1-3 EST.BLDG.COST PER SQ. FT. EST.BLDG.COST PER ROOM ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO. ATTACIIF.D GARAGES MUST CONFORNI TO STATE FIRE REGULATIONS 4. APPROVED BY: A'7c'c4t� PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR CIZBUILDING INSPECTOR DATE FILED OWNERS TELN .7 �'� 3 I �7 CONTR.TELH Co 03- CONTR.LIC# SIGNATURE OF-OIVNER OR AUTHORIZED AGENT ! FEE S /9 1 �_ ILLC.II PERMIT GRANTL•D tg �1 Cf O�,ls� 19 6 Revised 5151 JAl �� �� ,yam �� � ' � �� r � Oct 27 99 05 : 08p 8 i 1 1 5-6ann; ster 978 G83 - 8907 p . 1 The ConI177C tRfea','tr artm .pr1t (7?r,J?C1(jcjJ`ici dt'f�' dPnts Office Of Investigations BoSton, Mass 02111 Workers'CQm DenSatian !n„ur,Rrrco r:ffir;fuvit __ 1 �r 1 a nom2�.vrier per'fOmling all wQf* myself, r— �l am sc?e proprietc,t d,Id have no One working to any capa it " Y N' r am an employer Providing workers' Comtaensatioo for my employees working ort this job. Lo-m-Lar1_'tcImt , /lV -J- � m (� Aldr - InSUrance CO _... . - 'nlic,rD 4x,�,G�13 rvUJreS5 a,We to seG r e coverage as regll!rdd„nder Sg tl(5n 2r A or M(:L, S2;an lea i� t I r;q �rnlnal penalties of a me uq to 5pt}.;�(j and/or one Yeam,!m hsonment as aiell , � p as civil penatt,e ,n the fOrm of a$TOP WORK ORDER and a tine of($100,00)8.13y against me I understand that a copy of this statement May be fOrAarded to the Office of investigations ct the D? rwr coverage verifcai,on, 1 CO herby GAr!Ity Ur7Cer the pains d 76naN`a�of pdri'l that the lrrfvrr;tvriui7 proviloo stove is,rue a td corrdCC S�gr►atu;e��� tl _ . 4�m�ial use only qc not.Yle in trus area to be cOmptt3fed by city or town ottic,a, UChock d wr7mod ale response,s requIrarj CD SU1idirrg Dept s+dldiny Dept ;s; L Licensing 60ard C3 5e1eu!rrrdn's Ot!-rce HeaNh Departrnpr7t Other BUILDING DEPARTMENT DEBRIS DISPOSAL FORM In accordance with.the provisions of MGL c 40 S 54,a condition of Building Permit Number Is that the debris resulting form this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150A The debris will be disposed of in: L i`�0 c,V— 5 A &30 r-2 Location of Facility Signature of Permit Applicant ....Y i Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector N a The Commonwealth of Massachusetts aDepartment of Industrial Accidents W Office of Investigations 0= Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: Location: City Phone am a homeowner performing all work myself. F-1I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name: Address City: Phone# Insurance Co. Policv# Company name: Address City: Phone#• Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do herby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone# Official use only do not write in this area to be completed by city or town official' E] Building Dept ❑Check if immediate response is required Building Dept p Lincensing Board p Selectman's Office Contact person: Phone#: E] Health Department Other NORTH Town of L d0ver 0 1'1..:;.._:'_ .11. No. aWe�. _7 dover, Mass.,_J 0 a 0 of ,9 AERATED S 5� 7 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT.... QO . 50. OD. . ..... ............. . BUILDING INSPECTOR� .....D. ....TSt....................... 00 0 Foundation ;has permission to erect... I�10 1".... buil ings on .... ................. . �� ..... ....................... .......at.................... Rough to be occupied as... .t"+!..... f�h� Chimney .................................................... ................................................................ provided 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 Inspection, Alteration and Construction of Final Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough m y PERMIT EXPIRES IN 6 MONTHS Final P CA, UNLESS CONSTRUCTIONST TS ELECTRICAL INSPECTOR Rough C 4 AL40. ... ....... ......i�... ........................................ ECTOR Service B LDING INSP Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough No Lathing or Dry Wall To Be Done Final Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. SEE REVERSE SIDE Smoke Det. 1 r FORM U- LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from. Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. FILLS OUT THIS SECTION—***********'***** APPLICANT iLL� �NNtSTE� PHONE 9-7g- G<93 99 ©7 LOCATION: Assessor's Map Number `� y PARCEL LO-" SUBDIVISION LOT (S) STREET '/(DO 05 6a o� ST ST. NUMBER LI o O ** ******** OFFICIAL USE O N LY************************ *** **` RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS V PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY ERMIT FIRE DEPARTMENTNz— REC`IVED BY BUILDING iNSPECTOR DATE Revised 9`97 jm z ! d r - i- - fie i�ominzoouuea� a�✓`�avrczc�ucoeQa � ' BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR r , �w Number: CS 046118 i' Birthdate 06/20/1957 Expires 06/20/2001 Tr.no: 9999 I� Restricted To: 00 JOHN T RYAN :1 12 EMERSON WAY {{F �� SALEM, NH 03079 Administrator - - Location f 400, v s&-C,01� No. `� �¢- Date a TOWN OF NORTH AN DOVER F 9 Certificate of Occupancy $ ` Building/Frame Permit Fee $ �s Et Foundation Permit Fee $ s�cHus Other Permit Fee $ t Sewer Connection Fee $ m Water Connection Fee $ TOTAL $ �1 # (2 Building Inspector '"- 0 `) 9 Div. Public Works Location No. y Date NORtIy TOWN OF NORTH ANDOVER Certificate of Occupancy $ 41 • i Building/Frame Permit Fee $ �s E< (=6undation Permit Fee $ J4CMUS Other Permit Fee $ • (3.70sewer Connection Fee $ / Water Connection Fee $ o Ch TOTAL $ C� "4dinspe o� %1 � Div. Pu li Works PFR11JIT NO. APPLICATION FOR PERMIT TO 13U1.LD********NORT11 ANUOVER, MA Ltlr.N0. 2. RECORDOFOWNLI(S1111' DATE BOOK PACE Z,l)hl: Still Ili%,. LDrNo . - -lO( AiluN PUltl(iBE(11=8UIIUIN(7 3i/9 6 slzr OWNER's t1Al.IE '�— NO.OF STORIES / t)\VNI.R'S ADDRESSQ�O � «,�,,,�;��4{ COQ (.��..c�C,f V't N�. BASEMENT OR SI AB al:cI!;iK'1'SIJAn1E / T 3 Rn SIZE OF FLOOR IIMIIE:RS 12 2 SQrI.�� � ;)i.R NAME SPAN _ � [it Ili koTl, �rvsT , rnAe�s,r�( •� -DiSiANCE IONEARESI BUILDING I DIAIENSI(NJSt1F SILLS 308 DIS TANCE I ROM S I REFI As-t> 1 DIMENSIONS 01 VOS IS DIS I ANCE FROM LOT LINES-SIDES a u REAR o o DIMENSIONS OF GIRDERS AREA(C LUT s` �� PR(NJIA(JE 11EIGIFT OF FOUNDATION TI IICKN[SS IS BUII.DIN(i NEW SIZE OF F<XTI TNG x No ISIiUILDIN(;ADDiTi(NI MAfER1A1.OFC111hiNEY IS BUILDINGALIERATI(NJ ISOUILDIN(i(NJSOLIDOFtFit LED LAND �\il1.BuliDfNGC'()t) OftMTOREQtIIREMENISOrCODE J-S ISBIIILDINGC(NJNL'CIED'IOIOWNWAIER lirJ�i(U(N A('IEP.I.SAC1IOtJ, IF ANY ISBUILDINGCONNECTEI)rDIOWNSEWLR IS BUILDING CONNECI LD TO NA I URAL GAS 1 INE LANDC'OSI INSf Uf'7!UNS 3. 11RDI'E:It'1'1'INFORNIAIION S1.B1.1 X;.COST 2w,C>.O C4� P4;iE I Fli.i.om SECTIONS 1-3 ES V.D1.1 X;.COST PER SOi PF. ESI. BI.IX;.COSI PLRtt(X)M ELFC1R IC MEf ERS MUST BE(NI OU I SIDE OF-BUII DING SEI'I IC PE RMI I NO. At I A4:1IEI)(iARAGES MUST C(N1FORNI*I O S PATE FIRE REGI II.AI l()1JS 4. .4P1'ilO\'E:D BY: FLANS MUST BETH EDAND APPROVED BY BIIILDIN(i INSPECF(>tt BDII.DINC INSPECTOR DAIEFHED (/Z � OWNERS II:I.a � ? I ` C(NJIR.IEIN ffz—Wn _.. v' CONI R.I.ICa LS ©ski ce S 7 ti;GN•\I i IRIi tA�t)WNER(lit Al rl l N1Ill'Llil)A(iENf ` .,y.� 00a k' pew D.Lr.a i'1:'.Pill iiRAPll Tilt � r2 4..� (�• 19 T40 R T To' " 0 _ over No. dl 01 .l * z z dover, Mass., S&PT. 19 3$ '709 cOCH HE WICK 9 AOR' E S E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT... ......lzwM.......C!o ?.t��� .................... BUILDING INSPECTOR Foundation safertlo�t has permission to a■ ... � � .............i.. � !A4 ..... .p.p.... 7LRough to be occupied as...... L~�..:..Q�.°. .. �N00 C. gsg qtI��� 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION AR - Rough ................... ....................... ........................................ .................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display n a Conspicuous Place on the Premises — Do Not Remove Rough p y iP Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. 7 Smoke Det. FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verity that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTION* Z--APPLICANT zfac� OS�ootJ �T ��vS� PHONE �S8-res S5 c/o LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT (S) STREET S+' !N z �124612 ' ST. NUMBER „ **"***'*** OFFICIAL USE ONLY****"*** RECOM END I OF TO N AGENTS: r/CONSERVA N ADMI -�T TOR DATE APPROVED r DATE Ry�E'`JI CTED COMMENTS u'1 '`' � � ' 'W+ lt,..ravc TOWN PLANNER ` DATE APPROVED ►� DATE F3EJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED ` SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS UBLIC WORKS - SEWER/WATER CONNECTIONS �`l `'t/ r- 24 - 50 DRIVEWAY PERMIT /FIRE DEPARTMENT y rk. Pz!gzSs- ea),l',�g �1��14011 31 RECEIVED BY BUILDING INSPECTOR DATE �� HCOySTRR�r�� Of U®6�r, �sUPfR AffTY CS � VISOR SIC l l � �gtPd I0 ®?S/?Bpe B%?tbdat ! 6 3 LL lfyO S? f,. PpIP NSA'q E o fpRp by �� �N°sN Zoning Bylaw Denial Town Of North Andover Building Department ` • ,' 27 Charles St. North Andover, MA. 01845 �sS S Phone 978-688-9545 Fax 978-688-9542 Street: 400 Osgood Street Map/Lot: 94/1 R-4 District Applicant: Paul K. Soucy, William Bannister,owner) Request: Tenant Fix-Up for Strength Training Date: February 23, 2000 Please be advised that after review of your Building Permit Application and Plans that your Application is DENIED for the following Zoning Bylaw reasons: Zoning z-K Item Notes Item Notes A Lot Area F Frontage 1 Lot area Insufficient 1 Frontage Insufficient 2 Lot Area Preexisting Yes 2 Frontage Complies 3 1 Lot Area Complies 3 1 Preexisting frontage Yes 4 Insufficient Information 4 Insufficient Information B Use 5 No access over Frontage 1 Allowed G Contiguous Building Area 2 Not Allowed Yes 1 Insufficient Area 3 1 Use Preexisting warehouse Yes 2 Complies 4 Special Permit Required Yes 3 Preexisting CBA Yes 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply 1 I Height Exceeds Maximum 2 Front Insufficient 2 Complies 3 Left Side Insufficient 3 Preexisting Height Yes 4 Right Side Insufficient 4 Insufficient Information 5 Rear Insufficient I Building Coverage 6 Preexisting setback(s) 1 Coverage exceeds maximum 7 Insufficient Information Yes 2 Coverage Complies D Watershed 3 Coverage Preexisting Yes 1 Not in Watershed 4 Insufficient Information 2 In Watershed j Sign 3 1 Lot prior to 10/24/94 Yes 1 Sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information Yes E Historic District K Parking 1 In District review required No 1 I More Parking Required 2 Not in district Yes 2 Parking Complies 3 Insufficient Information Yes Remedy for the above is checked below. Item # Special Permits Planning Board Item # Variance Site Plan Review Special Permit Setback Variance Access other than Frontage Special Permit Parking Variance Frontage Exception Lot Special Permit Lot Area Variance Common Driveway Special Permit Height Variance Congregate Housing Special Permit Variance for Sign Continuing Care Retirement Special Permit Special Permits Zoning Board Independent Elderly Housin-g Special Permit Special Permit Non-Conforming Use ZBA Large Estate Condo Special Permit Earth Removal Special Permit ZBA Planned Development District Special Permit Special Permit Use not Listed but Similar Planned Residential Special Permit Special Permit for Sign R-6 Density Special Permit Watershed Special Permit The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for DENIAL. Any inaccuracies,misleading information,or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department.The attached document titled'Plan Review Narrative shall be attached hereto and incorporated herein by reference. The building department will retain all plans and documentation for the above file.You must file a new building permit application form and begin the permitting process. l February 23, 2000 February 23,2000 Building Department Official Signature Application Received Application Denied Denial Sent: February 24,2000 If Faxed Phone Number/Date: ti Plan Review Narrative The following narrative is provided to further explain the reasons for denial for the building permit for the property indicated on the reverse side: Item Reasons Reference' 71 B-2 K � � ., '�� rigs,I,.�f B-2 Site is located in the Residential-4 (R-4)District and the proposed use Is not allowed. The warehouse was owned and occupied by the Textile Museum. As such, it was grandfathered in the district and no other business Use is allowed. B-4 Special Permit required by Planning Board K-3 Parking—No site plan was submitted showing parking Note: Pursuant to Section 10.4 of the Zoning By-Law you may aggrieve this decision Within thirty(30) days to the Zoning Board of Appeals if you so desire. Referred To: Fire Health Police Zoning Board Conservation Department of Public Works Planning Historical Commission Other BUILDING DEPT TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING s LL � sr i 4 h n mT�113 SeCt1on for Official Use BUILDING PERMIT NUMBER: DATE ISSUED: Z SIGNATURE: Buildin Commissioner/Ins or of Buildings Date 1.1 Property Address. � 1.2 Assessors Map and Parcel Number: 9 , �; �} -0 1 G Y Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: v Zoninj District Proposed Use Lot Area Frontage R m 1.6 BUILDING SETBACKS(ft) K3 0�- Front Yard Side Yard Rear Yard RegWred Provide RaIttired Provided Reqttired Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System Public V� Private ❑ Zone ✓ . Outside Flood Zone fd001 Municipal g/ On Site Disposal System ❑ 2.1 Owner of Record n� � c qV0 Qsgos� &' 1Vawl�ulee NS �- t{ox-> 0 Name(Print) Address for Service: m Signtre Telephone 2.2 Authorized Agent Name Print Address for Service: Z 0 Signature Telephone Z Sir 90 3.1 Licensed Construction Supervisor Not Applicable ❑ Address License Number 0 bi:Cg4� m(4 ©`�lC Licensed Construction Supervisor. 4/oZJ`� �p3 r Expiration Date Vt,z, _ t—aL\� Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name Registration Number Address r Expiration Date 2 Z t, s' 1 Signature Telephone � �,,,,N� t SECTION �VQIiK1BRSL9L�A�'ENSAEiQN,(3���C� ;� i* Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. el Si ned affidavit Attached Yea....... No.......❑ SECTION.5-PRQFE IQ1 A�.DES)1Qi C 1NS #1E l+i RVTC S F , 3U D11NQS AND S°>'RITTRI S. 'T+U CONSTR111CJfION C(3NTRUL P[1R f7AN6T I" 11611P TA Q I QEE 3s, a GF ole FNCT�b.S)5 D � 5.1 Registered IArchitect: l Name: S42r C os Address 0 3 - as"--S/ CY Signature Telephone �.�Regist�ted:Professi�$��Es�''"� Area of Responsibility Name: Address: Registration Number Signature Total Expiration Date Not applicable ❑ Name: Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 50 Not Applicable Company Name: :4 Responsible in Charge of Construction SEE 'X07 F Q 'p�' 1�k alIapplcablx) '> „ . --[New Construction ❑ Existing Building HK Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑1 Other ❑ Specify Brief Description of Proposed Work: l J�-e Usk )o USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ AA ❑ A-2 ❑ A-3 ❑ ]A ❑ A4 ❑ A-5 ❑ IB ❑ B Business a 2A ❑ C Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ IInstitutional ❑ I-1 ❑ I-2 ❑ I-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ SB ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS/SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: Proposed Use Group: \--e4-ke✓ Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area sj� Total Height ft Independent Structural Engineering Structural Peer Review Required Yes ❑ No er' SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, �YfilUtvtS' Owner of the subject property Hereby authorize f -e `'`'�-�'" "`"°� to act on My behalf,in all matters relative two work authorized by this building permit application Signature of Owner Date I, as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury Print Name Signature of Owner/Agent Date NOW�SItem Estimated Cost(Dollars)to be o1 , ' w Completed by permit applicant REM", 1. Building (a) Building Permit Fee a°C>cz.`'' Multiplier 2 Electrical (b) Estimated Total Cost of 'J 00 Construction from(6) 3 Plumbing Building Permit fee (a)X(b) 4 Mechanical(HVAC) /o o 5 Fire Protection 6 Total (1+2+3+4+5) Check Number Ptn ,� ..3 pz r `4 wz+ 9{5�.,,. 7 lyu�. , } _,..{ �. F d-A w� F., y�) ; .p F{ �L. >Gayr,',-.i `�'., e �eyf'� e,Sgx 71+� 25'�k¢a'�XIL�y'Fx, s�F l:..s- t1.i,,; h { s e0 F .�5i F fi� (b r r7 t4 p r is w as k n r7°y N r K�u MW4Y...h:✓„�. °T.°s+�r:'a�f j�uF. ds,�'c9.�r'�a b -x�a: "�,r,G.;k{'?;�x '�ti ?. iw 2..-i ti z ��b� (© +p ,4i�b. NO.OF STORIES SIZE BASEMENT OR SLAB cola t SIZE OF FLOOR TIMBERS ' 1ST 2 ND 3 P SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS �� C l DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING x MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL,GAS LINE Ye 5 y a u ,,r e s`?'., r .r w i 7 9 '��` fi� *`�,jo .✓- �' #' e ^v x �e4 «k. � � E.-3., sT r�df. ¢r:, —c�..✓y..>, i k`✓t.>. c� � r�� c"f.`� � f��S F�-t� `s 1?� �r�y.z '' t: /,, 16 Haverhill Street Andover, MA 01810 508-475-1444 OMEOEMO February 14, 2000 STRENGTH TRAINING Bob Nincetta Building Department Town of North Andover Dear Bob: This letter will serve as an attachment to the building permit application submitted by Bill Banister of 400 Osgood St. and Paul K. Soucy of One To One Strength Training Inc. One To One Strength Training Inc. is a physical conditioning consulting company servicing the general public through workshops, seminars, and open clinics on the very latest in exercise science and preventive medicine. It is not by definition a"gym" or a "health club". There are no aerobic dance classes, swimming pools, saunas, locker rooms or anything of the like. All clinic hours are by appointment only and are overseen by an Exercise Physiologist. The clinic is set up to handle a maximum of 10 clients per clinic hour. The number of clients on average over the past two years per clinic hour has been six to eight. Those numbers exclude two staff persons. Under the current building plan at 400 Osgood St., One To One Strength Training Inc. would be leasing the larger portion(approximately 6,000sf) of what is considered tenant number four. The addition of two bathrooms with a small changing area and a shower in each will be indicated by the submitted drawings. There will not be a need for a sign of any type for this business. Thank you for your time and consideration of this matter. Sincer Paul K. cy sid t �' (a� ,r/ BUILDING DEPARTMENT DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 S 54,a condition of Building Permit Number Is that the debris resulting form this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11,S 150A The debris will be disposed of in: C-V- o1N,"o Location of Facility Signature of Permit Applicant - _ Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector Ij The Commonwealth oassach f MUSer`S Department of Industrial Accidents Office of Investigations I Boston, Mass. 02111 Workers'Compensation Insurance Afdovit Please Print Name: Location: bCit am a homeowner performing all work myself. Phone t�lt am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Com 9nV name: Address (,��j0 Cit Phone# - — Insurance Co. . Z Policv;ff 7 Company name: Address Ci Phone# Insurancent_Co. Polic # Failure to secure coverage as required under SF:tlon 25A or MGL I to tr a Imposrlon of cMrninal penalties cf a rine up to$l,=.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a Me of{5100,00)a day sgalnst me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the Dlq for cove age verrtication, I do herby cs0Y under the pains a d p9neltins of perjury the f the imbrmorrun proNCeC a0of t is nue and cared. Signature FSrd Date Print name Phone Ctr'clnt use only oo not write in this area to be Completed by city or town otficaar ❑Check if immediefs response is required [`j Building Dept Building Dept G Uncensing Board Coniao!person.• C3 Solectrrran's office Phone ❑ Health Department Other meq - 'left OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE ,/ Number Expires: Birthdate: CS -_ e58b51 : 942512898 84/251,951 ' Restflcted Te: Be MAR ,p -.SIENONSMA * 6 PULPIT RD BEDFORD, NH 83116 72030 4 Restricted To: 88 88 - 35,600 cf enclosed space s (NGL C.112 S.66L) 1A - Masonry only IG - 1 & 2 Family Homes i Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. #;' « ✓/ze �a»roizanu�eall/z o�;l�aa�ae�tcaeCt �1 DEPARTMENT OF PUBLIC SAFETY ? ` CONSTRUCTION SUPERVISOR LICENSE ` Number: Expires: Birthdate: 5� CS 8586$1 64/25/2006 64/25/1952 t' ,pl Restricted To: 88 ppij MARK 8 SIEMONSNA r x mud 6 PULPIT RD j BEDFORD, NH 83116 E� Location No. Date NOeTp TOWN OF NORTH ANDOVER C?O:i;.ao a 1ti0� 09 Certificate of Occupancy $ Building/Frame Permit Fee $ S� scNus`�' Foundation Permit Fee $ a Other Permit Fee Sewer Connection Feel $ Water Connection Fee $ TOTAL $ ri Building InspeC`tor I :.1Ji " Div. Public Works I:VARVIITNO. 3 APPLICATION FOR PERMIT TO BUILD********N RTII ANDOVER, 1VIA VIAA'NO. 4 Lo"r NO.�� 2. RECORD OF OWNERSHIP nA"hE ROOK PAGE ZONE SllB D V. 1.0 I NO. LOCA"IION (/0 0 DS S i PURPOSE OF BUILDING e,a ew Ito� P p ,ACJ �o� oAA'NtaR'S NAaIE VQ90 0 &-r—b 9T, C� �T2 NO.OF STORIFS 6� (•vSTI'Z—Ev O%VNER'SADDRESS /0` dS�c� Jc I BASEMENT OR SLAB ARCHT ITEC 'S NAIME G vc� SIZE of FLOOR TIMBERS l I 2ND 3RD BUILDER'SNANIE '[D { SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET DIMENSIONS OF POSTS DISI'ANCE FROM LOT LINES-SIDES REAR DIMENSIONS OF GIRDERS AItEA OF LOT FRONTAGE IIEIGIITOF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING x IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDIN ALTERATION IS BUILDING ON SOLID OR FILLED LAND \PILL 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 1NSTUCTIONS 3. PROPERTY INFORMATION LAND COST EST. BLDG. COST PAGE I FILL OUT SECTIONS 1-3 EST.BLDG. COSTPER SQ. FT. EST. BLDG. COST PER ROOM ELEC"RIC METERS MUST BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO. Al-I':ACIIED GARAGES MUSTCONFORiM TO s,r.krE FIRE REGULATIONS d. APPROVED BY: PLANS MUST RE FILET. D APPROVED Ill'BUILDING INSPECTOR BUILDING INSPECTOR _ DATE FILED OWNERS TEL# coNrll.reL# _)o 14kJ Imo, A'h/ SICN:I IIURt: OF OWNER OR All'f110121"LEU AGENT CONII(.LIC# l / FEE $ �F� PERMIT GRANTED _ "F19 / Revised 5/5/99 JNI 1 A11 d l It I). DATE(MM,'DD�I'YI CERTIFICATE; OF LIABILITY; INSURANCE 03!25/99 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Guide Insurance Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 35 Center Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. Box 36 COMPANIES AFFORDING COVERAGE Burlington MA 01803 COMPANY � A Assurance Co of America INSURED COMPANY John R. Ryan dba John T. Ryan Contracting B 264 Cambridge Street COMPANY Burlington MA 018030000 C COMPANY D COVERAGES.., THIS IS TO CERTIFY THATSTHE 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. CO POLICY EFFECTIVE FOUCY EAP*HATiON LTA TYPE OF INSURANCE POUCY NUAIBEA DATE (MM-'DD/Y'0 DATE (MM/DD YY) U41T5 A GENERAL LIABILITY TBI 03/24!99 03/24/00 GENERAL AGGREGATE S 2,000,000 X COMMERCIAL GENERAL LIABILITY PRODUCTS COMP/OP AGG S 2,000,000 ; CLAIMS MAGE FX OCCUR PERSONAL &ADV INJURY S 1,000.000 OWNER'S 8 CONTRACTOR'S PROT EACH OCCURRENCE S 1,000,000 FIRE DAMAGE(Any one fire) S 50,000 MED EXP(Any one person) S 5.000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT £ ANY AUTO ALL OWNED AUTOS BODIL" INJURY £ SCHEDULED AUTOS (Pe' Derson) H,WED AUTOS BODILY INJURY S I NON-OWNED AUTOS TPer acodenp PROPERTY DAMAGE £ GA AGE LIABILITY AUTO ONLY EA ACCIDENT is ANY AUTO: OTHER THAN AUTO ONLY EACH ACCIDENT S AGGREGATE £ EXCESS IIA ILiT`' EACH OCCURRENCE £ UMERELLA FORA' iAGGREGATE £ OTHER THAN UMBRELLA FORV Is Y;URK tiffs COL:PE!NS�TIOr: A14- IMITS E WC SIATU. OTh f TORY LF. Eti+P.OYERS UABII IT', - EL EACH ACCIDENT Is THE PROPRIETOR INC'. E! DISEASE POLICY LIMIT £ PARTNERS'EXECUTIVE OFFICERS ARE EXCL EL DISEASE EA EMPLOYEE is OTHER I i I DESCRIPTION OF OPERATIONSLOCATIONSNEHICLES'SPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LABILrv, OF ANY KIND UPON THE C01,4PANY,ITS AGENTS OR REPRESENTATIVES AUTHORIZED FIDWENtKnvE ,_ ` . ACORD 25-S`(1/95)..` B. .ACORD C ORATION'1988 ... 1 JOHN T. RYAN PROPOSAL 27 264 CAMBRIDGE ST. BURLINGTON, MA 01803 P.�,GE NO. 2 OF 2 PAGES P.O. BOX 145 LEXINGTON, MA 02173 RESIDENTIAL CONSUMER PROTECTION ' REG.# 113183 ENCLOSURES IF APPLICABLE. 781-273-9338 / 781-861-0638 FAX 781-273-9349 400 Osgood Street PHONE DATE TO: 978-683-8907 4/16/99 Attn: William Bannister JOB NAME/LOCATION -----� 400 Osgood Street Same North Andover, MA i JOB NUMBER 106 PHONE 99-CAL-136 Same We hereby submit specifications and estimates for: Permit I 1 . The Town of North Andover will require a permit for this job and will obtain and pay for permit. Roof Warranty ! 1 . The roof membrane is guaranteed for a period of 20 years from the manufacturer ac no cost- co ostto the customer. i 2. Our labor is guaranteed for a period of 2 full years following com:)letion. 3 . A labor and material warranty ,can be purchased from the manufacturer for additional charges. (approx. .08 - . 15 per foot) ! I I i We Proppose hereby to furnish material and labor—complete in accordance with the above specifications, for the sum of: Sixty fihousand and 00/100 Dollars dollars ($ 60, 000.00 ) Payment to be made as follows: $5, 000.00 Down, $25, 000.00 at start of work, $15,000.00 at 1/2 completion, $15, 00. 00 upon completion. All material is guaranteed to be as specified. All work to be completed in a professional manner according to standard practices.Any alteration or deviation from above specifica- Authorized lions invvNing extra costs will be executed only upon written orders,and will become an extra Signature charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance.Our Note:This proposal may be 1 0 workers are fully covered by Workers Compensation insurance. withdrawn by us if not accepted within days. DO NOT SIGN IF THERE ARE ANY BLANK SPACES. Acceptance of Proposal —The above prices, specifications and Signature conditions are satisfactory and are hereby accepted. You are authorized to do the work Si gna -- " -------- —--__.— as specified.Payment will be made as outlined above. Signature nate of Arxeplanr.e: .-- PROPOSAL 26 JOHN T. RYAN 264 CAMBRIDGE ST. BURLINGTON, MA 01803 PAGE NO. 1 OF 2 PAGES P.O. BOX 145 LEXINGTON, MA 02173 RESIDENTIAL CONSUMER PROTECTION REG.# 113183 ENCLOSURES IF APPLICABLE. 781-273-9338 / 781-861-0638 FAX 781-273-9349 PHONE DATE 400 Osgood Street TO: 978-683-8907 4/16/99 Attn: William Bannister JOB NAME/LOCATION 400 Osgood Street Same North Andover, MA JOB NUMBER JOB PHONE 99-CAL-136 Same We hereby submit specifications and estimates for: 1 Power broom off and or power varum off any loose gravel or stone which contain moisture j from the roof top. i i I 2 . Mechanically fasten perimeter nailers at all roof edges in order frame in rO,I insulation then install a moisture barrier over newly cleaned roof su- tace. 3. Mechanically fasten with Dekfast construction fasteners 2" poly-iso foam insulation with black coated fiberglass reinforced facers over newly installed moisture barrier. i 4 . Install .060 EPDM - black rubber roofing material fully adhered t;; the newly installed poly-iso insulation. 5. install new pre-formed vent pipe flashing at all plumbing or stack_ proyrusions . 6. Install new custom connected edge cleat at all roof edges. 7 . Install tapered insulation (reveresed to slope) at two office window locations and one proposed garage door location. 8 . Install scuppers and downspouts at two office window locations on_ proposed door section. We Propose hereby to furnish material and labor—complete in accordance with the above specifications, for the sum of: Sixty Thousand and 00/100 Dollars dollars ($ 60, 000.00 Payment to be made as follows: $5, 000.00 Down, $25, 000.00 at start of work, $15, 000.00 at 1/2 compi.etion, $15, 000.00 upon completion. All material is guaranteed to be as specified. All work to be completed in a professional manner according to standard practices.Any alteration or deviation from above specirica- Authorized bons involving extra costs will be executed only upon written orders,and will become an extra Signature charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance.Our Note:This proposal may be workers are fully covered by Workers Compensation insurance. withdrawn by us if not accepted witrun 10 days. DO NOT SIGN IF THERE ARE ANY BLANK SPACES. Acceptance of Proposal —The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work Signature as specified.Payment will be made as outlined above. Signature Date of Arxeplance Lluerty mutual vroup PO Box 7077 LIBERTY Portsmouth, NH MUTUAL. 03802-7077 Phone (603) 431-7545 May 3, 1999 Fax (603) 431-3872 JOHN T RYAN 264 CAMBRIDGE STREET BURLINGTON MA 01803 RE: Certificate of Workers Compensation Insurance Insured: JOHN T RYAN DBA JOHN T RYAN CONTRACTING & ROOFING 264 CAMBRIDGE ST BURLINGTON, MA 01803 Policy No.: WC2-31S-313733-019 Effective/Expiration Date: 01/27/199 to 01/27/200 Coverage afforded under Workers Compensation Law of the following states: MA Employers Liability: Bodily Injury By Accident: $ 100,000 Each Accident Bodily Injury By Disease: $ 100,000 Policy Limits Bodily Injury By Disease: ' $ 500,000 Each Person As of this date, the above-referenced policyholder is insured by Liberty Mutual Fire Insurance Company under the policy listed above. The insurance afforded by the listed policy is subject to all the terms, exclusions and conditions, and is not altered by any requirement, term or condition of any or other documents with respect to which this certificate may be issued. This certificate is issued as a matter of information only and confers no right upon you, the certificate holder. This certificate is not an insurance policy and does not amend, extend, or alter the coverage afforded by the policy listed above. If this policy is cancelled before the stated expiration date, Liberty Mutual will endeavor to notify you of such cancellation. Liberty Mutual Insurance Group AUTHORIZED REPRESE.:TATIVE This Certilicate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those companies. cc: Insured: Producer of Record: F JOHN T RYAN DBA JOHN T RYAN CONTRACTING & ROOFING RODMAN INSURANCE AGENCY INC 264 CAMBRIDGE ST 75 WELLS AVENUE NEWTON, MA 02459 BURLINGTON, MA 01803 L L . ��<� [a�`.� •� �� 7/70�I97/I92p�17,l.I182LUZ O�✓GZC/LJ(LCl2CC6P.�Q ° BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR fa ykF, Number: CS 046118 '$ Birthdate: 06/20/1957 P, r Expires: 06/20/2001 Tr.no: 9999 Restricted To: 00 t JOHN T RYAN _ 12 EMERSON WAY !� SALEM, NH 03079 Administrator �....�7 `rg` AORTH ' own .� 4 G`. OL over No.a9 3 _ COCH4'55'� dover, Mass., 9 DRATED P`P�GG`��� • S 54 BOARD OF HEALTH PEnMIT T Food/Kitchen Septic System a 41,THIS CERTIFIES THAT..... �................... .............. ........ BUILDING INSPECTOR �(� �! Foundation has permission to erec .. . ....... buildings on .......lj� .......................... Rough eo to be occupied as...... 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STATJ�% g t, :. ELECTRICAL INSPECTOR .. Cj.A,4, Rough T ................................................................................................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RouFinagh No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Town of North Andover t MORra Office of the Zoning Board of Appeals s °} Community Development and Services Division . 27 Charles Street • ``�' North Andover,Massachusetts 01845 D. Robert Nicetta Telephone(97 ;�88r4 1 P L�: L Building Commissioner Fax(97R)688- 2 Any appeal shall be filed Notice of Decision within(20)days after the Year 2004 date of filing of this notice in the office of the Town Clerk. Pro at: for premises at:400 Osgood Street, NAME: Julie Paige Gediman,8 Hitchcock Farm HEARING(S): July 13,2004 Road,Andover,MA ADDRESS: for premises at:400 Osgood Street, PETITION: 2004-019 North Andover,MA 01845 TYPING DATE: July 21,2004 The North Andover Board of Appeals held a public hearing at its regular meeting on Tuesday,July 13,2004 at 7:30 PM in the Senior Center, 120R Main Street,North Andover,Massachusetts upon the application of Julie Paige Gediman,8 Hitchcock Farm Road,Andover,MA, for premises at:400 Osgood Street,North Andover,requesting a Special Permit from Section 4,Paragraph 4.122.9(b)and Table 1,and Section 9, Paragraph 9.2 of the Zoning Bylaw in order to allow a non-conforming use in a portion of a pre-existing building. The said premise affected is property with frontage on the West side of Osgood Street within the R- 4 4 zoning district. The legal notices were published in the Eagle Tribune on June 28&July 5,2004. The following members were present: John M.Pallone,Ellen P.McIntyre,Joseph D.LaGrasse,Richard J. Byers,and Albert P.Manzi,III. Upon a motion by John M.Pallone and 2°a by Richard J.Byers,the Board voted to GRANT a Special Permit from 4.122.9(b)and Table 1 of the Zoning Bylaw to allow The Paige Conservatory of the Performing Arts to use a portion of the pre-existing building at 400 Osgood Street for classes in dance,acting,and musical theater per Bannister Building Tenant#2 North Andover,MA,Floor Plan/Tenant#2 Plan,red outlined Proposed Paige Conservatory,Drawing,No.:A-101,by Jensen Stenbak,Architecture and Interiors,4 Auburn Road,Londonderry,New Hampshire 03053 and Plan of Land:400 Osgood Street,Lot 94-1 —North Andover,Massachusetts Owner:400 Osgood Street,Nominee Trust,c/o William Bannister,380 Winter Street,North Andover,MA 01845-140,vol. 5131;pg.214,(July 30, 1998),Date:June 09,2004,Project no. 98-0811-1 by David C.Liukkonen,R.P.E.#29381,Keach-Nordstrom Associates,Inc., 10 Commerce Park North,Suite 3B,Bedford,NH 03110. Voting in favor: John M.Pallone,Ellen P.McIntyre,Joseph D.LaGrasse,Richard J.Byers,and Albert P. Manzi,III. The Board finds that the applicant does not require a Special Permit from Section 9,Paragraph 9.2;private, for-profit educational facilities are allowed in R4 with a Special Permit. Also,the Board finds that the applicant has satisfied the provisions of Section 4.,Paragraph 4.122.9(b)of the zoning bylaw and that such change,extension or alteration shall not be substantially more detrimental than the existing usage(temporary Town Hall)to the neighborhood and that the student age and maximum class size of 14 will not require more than the existing 25 parking spaces. Pagel of 2 Board of Appeals 978-688-9541 Building 978-688-9545 Conservation 978-088-9530 Health 978-688-9540 Planning 978-688-9535 1 i - Town of North Andover f pORTN, :..4+�•a�••./r0 Office of the Zoning Board of Appeals } Community Development and Services Division 27 Charles Street North Andover,Massachusetts 01845 ct �` D. Robert Nicetta Telephone(978)688-9541 Building Commissioner Fax(978)688-9542 Furthermore,if the rights authorized by the Variance are not exercised within one(1)year of the date of the grant,it shall lapse,and may be re-established only after notice,and a new hearing. Furthermore,if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two(2) year period from the date on which the Special Permit was granted unless substantial use or construction has commenced,it shall lapse and may be re-established only after notice,and a new hearing Town of North Andover Board of Appeals, Ellen P.McIntyre,Chair 2004-019. M94P1. Page 2 of 2. Board of Appeals 978-688-9541 Building 978-688-9545 Conservation 978-088-9530 Health 978-688-9540 Planning 978-688-9535 / Date................ ............. 1 f �aOR7►, ma TOWN OF NORTH ANDOVER '1 # ; PERMIT FOR WIRING HU This certifies that .......................................... ...r-.................................. has permission to perform wiring in the building of...Y.l..��.. t �, �� � , ;/ ........................ at. ///�/f /._?. ! .. /z .. ,North Andover,Mass. Fee. w,/�r.. Lic.No ELECTRICAL INSPE Check # 54. '10 // For Office Use ottlY/� te.�oratrnonwsa�of�alsacl�tw�f.! (Rev.11199) �U Permit Number. y, 2aPa�tawcc77d a/ im Sarvical occupancy i Fee Checked: BOARD OF FIRE PREVENTION REGULATIO APPLICATION FOR PERMIT TO RFORM ELECTRICAL WORK (A),I.WORK TO BE F ERFOILMED WITH THE MA ACHUSETTS EUXTIUCAL CODE$27 CMR 12:00) T PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: 1 2/04 City or Town of: North Andover To the Inspector of Wires: By this application the undersigned gives notice o his or her,in ntion to perform the electrical work described below. Location:(Street&Number) 400 0 s g o o S t r e t Owner or Tenant: Town of N r t h n d o v e r 120 Main. Sr t Owners Address: Is this permit in conjunction with.a Building Permit? Yes o No oo (Check Appropriate Box) Purpose of Building: Utility Authorization#: Existing Service: Amps I volts Overhead 0 Underground.0 #of Meters. New Service: Amps / Volts Overhead 0 Underground.0 #of Meters:__._. Number of Feeders and Ampacity: . Location and Nature of Proposed Electrical Work: Furnish and instal 1, 1 3 0 A _2 5 0y n ii r 1 P t _f or r e f i r g . No,of Recessed Fomes No.of Ceil.•Susp.(Paddle)Fans No. of Transformers Total KVA No.Of Lighting Outlets No. of Hol Tubs Generators KVA No. of Lighting Fixtures Swimming Pod: Above ground o In Ground o 0 of Emergency Lighting Battery Units No.of Receptacle Outlets 1 No. of OiSumers n Fire Alarms I>e of Zonas ._._.._ ft of Detection&Irduating Devices 0 of Sounding Dev : No.of Switches No.of Gas Burners M of Sell Contained DetectioNSoundktg Devices No.of Ranges No. of Air Conditioners TOTAL TONS: • Local o Municipal Connection o Other o No. of Waste Disposals Heat Pump Totals: Security Systems: Number. TONS: KW: No.of Devices w Equivalent No.of Dishwashers Space/Area Heating: KW Data wiring,No.of Devices or Equivalent: No.of Dryers Heating Appliances KW Telecommunications Wiring:No of Devices or Equivalent No. of Water Heaters KW No. of Signs: #of Ballasts: OTHER; a of Hydro Massage Tubs No. of Motors Total HP 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 XCX BOND o OTHER 0 Please specify: Estimated Value of Electrical work$ 350 .O O (When required lim ) Work toStart: 1/l/04 Inspections to be requested In accordanc10,and upon completion. I certify,under the pains and penalties of poqutation on this application Is hue and complete. Andover Electric Services LIC.a 14302A Firm Name: •. J' Licensee: Robert J . Branca _Signa LIC.0 ((t#applicable,a pt"In the license number line) Address: 2 ..A A dr.,o v im) 0 ' Bus.Tel. ) 479-49 9 5 at.Tal.9 OWNER'S INSURANCE WAIVER:I am aware that the Licensee does no a the liability insurance coverage normally required by law. By my signature b0iow.I herby waive this requirement. I am the(check one) Owner o OR Agen 1 e a s e Signature of Owner/Agent: Telephone 8 PERMIT FEE!S &►ORT1y q O O � 4 yyy yy T COC MIC M4 WICK y1 T �p044r[D O*L �y �SSAC HU`- TOWN OF NORTH ANDOVER Sign Permit Date: November 23, 2004 Permit Number: 014-2004 THIS CERTIFIES THAT, Town of North Andover- Has permission to erect a 3 ft x 4 ft x 7 ft—6 inches non illuminated wood sign On 400 Osgood Street provided that the person accepting this Permit shall in every respect conform to 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 �--� November 23, 2004 Inspector of Buildings Date Date...c.J.j........3..05 iaORT1i 3r°*-.e :` "°°� TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING �sSACHUSEt This certifies that ......:..... .j1-?WA ..................... ....;...................... .. has permission to perform .... ,_<f:. .....✓....................r/ ' v wiring in the building ofe .:4...11 . !..�'f.i..,� : Y /&V-/ i.�(--1 at..`?" � �n` f-. .. ,North Andover,Mass. Fee./ 01) ee /.���ULic.No.�- f"T„ J/ Check # ✓ � � �q ELECTRICAL INSPECTOR I � 565 ) — Commonwea& of i'1Mai6ac4a"tti Oftih .,�e 0 I c� Permit No._ o(Je�-larlmenf o��ire �ervice6 Occupancy and Fee Checked (Rev. 11/99) (1eaveblank) BOARD OF FIRE PREVENTION REGULA/IONS APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed-in accordance with the M sachusetts Electrical,Code(ME ),527 CMR 12.00 (PLEASE PRINT IN INK OR Y L NF MATO Date: City or Town of: r To the Insp .ctor of Wires: By this application the undersigned gives notice of his or`,er ince ion to perform the electrical work described below. 1 Location(Street& umber) Owner or Tenant W2 1Z Mie Telephone N . Owner's Address 5? Is this permit in conjunction with a buildin&permit? yes ❑ No (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: Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil.-Sus .Fans No,of Total P•(Paddle) No KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA Lighting Fixtures , Swimmin Pool Above In No_of Emergency Lighting No.of Li $ b $ gmd. ❑ grud. ❑ Battery 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 Tons No..of Alerting Devices No.of Waste Disposers Heat•Pump Number __Tons _ __KW _ No.of Self-Contained P Totals: IDetection/Alerting Devices No.of Dishwashers S ace/Area Heating KW Local[] Municipal❑ Other P Connection No.of Dryers Heating Appliances KW Security No.ofysteDevices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent Bathtubs No.of Motors Total HP Telecommunications Wiring: No.Hydromassage No.of Devices or Equivalent OTHER: Attach additional derail if desired,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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) e5,pz�n_ (Expiration Date) Estimated Value of Electrical Work: 1� (When required by municipal policy.) Work to Stagylocx5 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the painf and penalties o perjury, that the information on this application is trace and complete. FIRM NAME: I l V-\ U{ ' c- LIC.NO.:15700 4 - Licensee: ✓1 UIr: Signature LIC.NO.: (1f applicabl^^e,enter'ex t' in the license numbe e.) Bus.Tel.No.:q 1�9n'1 Address: �oc(� � A(��/(,(,p,� S� cx) D t;Ima Xlt.Tel. No.: `OWNER'S INSURANCE WAIVER:I am aware that the Licensee does ni i or have the liabilnsurance coverage normally required by law.By my {ignature below,I hereby waive this requirement.I am the(check one) ,_] owner C- owner's agent V Owner/Agent �— Si-nature Telephone No. — PERMIT FEE: S % March 29, 2005 Mr. D. Robert Nicetta Building Commissioner 400 Osgood Street North Andover,MA 01845 Site Inspection reports; Eaglewood Development, Route 114, North Andover,MA NO WORK INCLUDED THIS PERIOD REMARKS Site-Civil ❑x ❑ Structural ❑x ❑ Electrical FI Mechanical FI Architectural COMMENTS: Reports for March weeks of 1 to 5, 7 to 11, 14 to 18, and 21 to 25. Reinforcing steel and concrete foundation inspection reports. RECEIVED If you have questions please call me at 617-924-1770, ex 1252. MAR 3 0 2005 Vanasse Hangen Brustlin, Inc. (�f,� BUILDIN'G DEPT. Edwin H. MacArthur, P.E. �jG�J/#7 Senior Technical Advisor Cc. Ross Hamlin,Eaglewood Properties, LLC PO Box 337, Topsfield, MA 01983 Steve King,Tocci Commercial, Inc. 660 Main St. Woburn, MA 01801 Site Construction Progress Report. EAGLEWOOD DEVELOPMENT Route 114, No. Andover, MA Week of March 1 to March 5 General: Work consisted of additional blasting, earth moving activitiesiand construction of retaining walls. Earthwork: Limited earth moving was performed due to drilling and blasting being performed and excavations for a dewatering trench at building#3. Modular block retaining walls were being erected on the north (lower) end of the site. Utilities: None Paviniz: None Landscaping: None Site Amenities: None Other Comments: Planned Work for next week includes excavations for building#3 footings and continued earth fills. No inspection/testing reports were performed due to limited earth work. Report prepared by: Edwin H. MacArthur, P. E. 141) Senior Senior Technical Advisor Vanasse Hangen Brustlin, Inc. Site Construction Progress Report. EAGLEWOOD DEVELOPMENT Route 114,No. Andover, MA Week of March 7 to 12, 2005 General: Work consisted of drilling,blasting, and installing trench drains, earthwork filling, excavations for building#3 footings, placing concrete in footings, and forming for and concrete placement of a portion of building#3 walls. Earthwork: Earth excavations from Building#3 were being placed along with material being brought to the site. Concrete was being placed for Building#3. UTS Testing services were being performed on the concrete form work and on the concrete. Copies attached. Utilities: None Paving: None Landscaping: None Site Amenities: None Other Comments: Planned work for next week include continued concrete for building #3 and continued earth moving activities. Report prepared by: Edwin H. MacArthur, P. E. Senior Technical Advisor Vanasse Hangen Brustlin, Inc. " Of Massachusetts 'The Construction Testing People' -Page 1 5 Richardson Lane,Stoneham, MA 02180 781-438-7755(Voice)781-438-6216(Fax) Reinforcing Steel Report Report Date 03/10/2005 Report No. 1 Job Number 9316 Vanasse Hangen Brustlin, Inc . Project Eaglewood Shopping Center-N. Andover,MA Attn: Edwin MacArthur 101 Walnut St . -P.O.Box 9151 Watertown, MA 02272 Contractor Tocci Building Corp. CONTACT: Steve Melendy TIME OF INSPECTION: 3 : 00 PM TIME OF CONCRETE PLACEMENT: 3 : 00 PM SPECIFICATION: ASTM A615 Grade 40 Grade 60 x Grade 75 ASTM A616 Grade 50 Grade 60 ASTM A617 Grade 40 Grade 60 CONTRACT DRAWINGS: REVISION NUMBER: DATED: SHOP DRAWING(S):Ro 1 PROJECT SPECIFICATIONS: 03300 OTHER: DRAWINGS STAMPED: YES NO AREA REVIEWED: Footing and Wall Dowels at line 1 and A-C.8 ATTRIBUTES: REVIEWED Yes No Coverage(Top x Bottom x and/or Inside Face x Outside Face x ) x Clearance x Cleanliness (heavy rust,scale,mud,dirt,oil,etc. not permitted) x Bar Supports x Bar Spacing x Bar Quantity x Placement and tying x ❑X The details in the above described area(s)were complete at the time of this inspection. 0 The results of this inspection were discussed with the aforementioned contact persons prior to departure from the project site. GENERAL REMARKS: Inspector Premium Travel Name Time Hours Time A. Bradley No Min Day 1 Hr(s) Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane, Stoneham,MA 02180 781-438-7755(Voice)781-438-6216(Fax) Reinforcing Steel Report Report Date 03/10/2005 Report No. 1 Job Number 9316 Vanasse Hangen Brustlin, Inc . Project Eaglewood Shopping Center-N. Andover,MA Attn: Edwin MacArthur 101 Walnut St . -P .O.Box 9151 Watertown, MA 02272 Contractor Tocci Building Corp. .REVIEWED BY: William P. Crabtree GG/� Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: Eaglewood Properties, LLC Attn: John Allyn Weildlinger Associates, Inc. Attn: Len Dente Tocci Building Corp. Attn: Steve King Of Massachusetts 'The Construction Testing People' -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755(Voice)781-438-6216(Fax) Compressive Strength Report - Concrete Report Date 03/10/2005 Report No. 1 .lob Number 9316 Vanasse Hangen Brustlin, Inc . Project Eaglewood Shopping Center-N. Andover,MA Attn: Edwin MacArthur 101 Walnut St . -P.O.Box 9151 Watertown, MA 02272 Contractor Tocci Building Corp. Concrete Co. J.G. MacLellan ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-�9 CLASS CONCRETE: 3000# 3/411 1 No. Of Sets: 1 CUBIC YARDS: 7 SET 1 LOCATION: Footing - Column line 1 from A-C.8 Total Unit Slump(in.) 4 Lab Size Area Date Date Age Load Load Fracture Air Temp. (F.) 34 No. (in.) (sq.in.) Condition Cast Tested Days (lbs.) (psi.) Type Conc Temp(F) 51 K955 4 x 8 12.56 Good 03/10/2005 03/17/2005 7 26,000 2,070 4 Truck No. 126 K956 4 x 8 12.56 Good 03/10/2005 03/24/2005 14 Ticket No. 1101183 K957 4 x 8 12.56 Good 03/10/2005 04/07/2005 28 Time 2:45 K958 4 x 8 12.56 Good 03/10/2005 04/07/2005 28 K959 4 x 8 12.56 Good 03/10/2005 04/07/2005 28 Unit Wtlbs/cu ft Air Content(%) GENERAL REMARKS: Inspector Premium Travel Name Time Hours Time P. Leavitt No Min Day 1 Hr(s) REVIEWED BY: Steven T. Crabtree FRACTURE TYPES (1) Cone (2)Cone and Split (3)Cone and Shear (4)Shear (5)Columnar Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. CC: Eaglewood Properties, LLC Attn: John Allyn weildlinger Associates, Inc. Attn: Len Dente Tocci Building Corp. Attn: Steve King Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane,Stoneham,MA 02180 781438-7755(Voice)781438-6216(Fax) Compressive Strength Report - Concrete Report Date 03/10/2005 Report No. 1 Job Number 9316 Vanasse Hangen Brustlin, Inc . Project Ea lewood Shopping Attn: Edwin MacArthur g PPing Center-N. Andover,MA 101 Walnut St . -P.O.Box 9151 Watertown, MA 02272 Contractor Tocci Building Corp. Concrete Co. J.G. MacLellan FIELD SUMMARY REPORT -Total Pour: Footing - Column line 1 from A-C.8 Method of Placement: ❑Pump ❑X Chute Discharge ❑ Bucket ❑Other Other: Method of Concrete Consolidation: ❑X Vibrator ❑ Other Other: Cylinder Fabrication Location: ❑X Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑Curing Box ❑ Thermal Blanket ❑Hay/Straw ❑X Trailer ❑ Field ❑ Other Placement Protection: ©Thermal Blankets ❑ Heat ❑ None ❑ Other Slump Specification(in.) 5 Number of slumps out of specification reported to If rejected Approved by Remarks: Of Massachusetts 'The Construction Testing People' Page 1 5 Richardson Lane,Stoneham, MA 02180 781-438-7755(Voice)781-438-6216(Fax) Reinforcing Steel Report Report Date 03/11/2005 Report No. 2 Job Number 9316 Vanasse Hangen Brustlin, Inc . Project Eaglewood Shopping Center-N. Andover,MA Attn: Edwin MacArthur 101 Walnut St . -P.O.Box 9151 Watertown, MA 02272 Contractor 'cocci Building Corp. CONTACT: Steve Melendy (Pat Dalrymple of New England Concrete) TIME OF INSPECTION: 12 : 00 PM TIME OF CONCRETE PLACEMENT: SPECIFICATION: ASTM A615 Grade 40 Grade 60 x Grade 75 ASTM A616 Grade 50 Grade 60 ASTM A617 Grade 40 Grade 60 CONTRACT DRAWINGS: s131 REVISION NUMBER: DATED: 02/08/05 SHOP DRAWING(S):R01 PROJECT SPECIFICATIONS: 03300 OTHER: DRAWINGS STAMPED: YES x NO AREA REVIEWED: Footing Al to A2.25 ATTRIBUTES: REVIEWED Yes No Coverage (Top Bottom and/or Inside Face Outside Face ) x Clearance x Cleanliness(heavy rust,scale, mud,dirt,oil,etc. not permitted) x Bar Supports x Bar Spacing x Bar Quantity x Placement and tying x ❑X The details in the above described area(s)were complete at the time of this inspection. 0 The results of this inspection were discussed with the aforementioned contact persons prior to departure from the project site. GENERAL REMARKS: Inspector Premium Travel Name Time Hours Time H. Borrazzo No Min Day 1 Hr(s) Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane,Stoneham, MA 02180 781-438-7755(Voice)781-438-6216(Fax) Reinforcing Steel Report Report Date 03/11/2005 Report No. 2 Job Number 9316 Vanasse Haugen Brustlin, Inc . Project Eaglewood Shopping Center-N. Andover,MA Attn: Edwin MacArthur 101 Walnut St . -P.O.Box 9151 Watertown, MA 02272 Contractor Tocci Building Corp. .REVIEWED BY: William P. Crabtree 1,)PC" Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: Eaglewood Properties, LLC Attn: John Allyn Weildlinger Associates, Inc. Attn: Len Dente Tocci Building Corp. Attn: Steve King " Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane,Stoneham, MA 02180 781-438-7755(Voice)781-438-6216(Fax) Compressive Strength Report - Concrete Report Date 03/11/2005 Report No. 2 Job Number 9316 Vanasse Hangen Brustlin, Inc . Project Eaglewood Shopping Center-N. Andover,MA Attn: Edwin MacArthur 101 Walnut St . -P.O.Box 9151 Watertown, MA 02272 Contractor Tocci Building Corp. Concrete Co. J.G. MacLellan FIELD SUMMARY REPORT 'Total Pour: Footing - Column line C at 1.2-2.6 and A at 1-2.5 - Building #3 Method of Placement: ❑Pump ❑X Chute Discharge ❑ Bucket ❑Other Other: Method of Concrete Consolidation: ❑X Vibrator ❑ Other Other: Cylinder Fabrication Location: ❑X Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑Curing Box ❑ Thermal Blanket ❑Hay/Straw ❑X Trailer ❑ Field ❑ Other Placement Protection: ❑X Thermal Blankets ❑ Heat ❑ None ❑ Other Slump Specification (in.) 5 Number of slumps out of specification reported to If rejected Approved by Remarks: Of Massachusetts 'The Construction Testing People' -Page 1 5 Richardson Lane,Stoneham,MA 02180 781-438-7755(Voice)781-438-6216(Fax) Compressive Strength Report - Concrete Report Date 03/11/2005 Report No. 2 Job Number 9316 Vanasse Hangen Brustlin, Inc . Project Eaglewood Shopping Center-N. Andover,MA Attn: Edwin MacArthur 101 Walnut St . -P.O.Box 9151 Watertown, MA 02272 Contractor Tocci Building Corp. Concrete Co. J.G. MacLellan ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 .ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 3000# 3/4" 1 No. Of Sets: 1 CUBIC YARDS: 20 SET 1 LOCATION: Footing - Column line C at 1.2-2.6 - Building #3 Total Unit Slump(in.) 4 1/2 Lab Size Area Date Date Age Load Load Fracture Air Temp.(F.) 31 No. (in.) (sq.in.) Condition Cast Tested Days (lbs.) (psi.) Type Conc Temp(F) 61 L149 6 x 12 28.27 Good 03/11/2005 03/18/2005 7 53,000 1,870 4 Truck No. 225 L150 6 x 12 28.27 Good 03/11/2005 03/25/2005 14 L151 6 x 12 28.27 Good 03/11/2005 04/08/2005 28 Ticket No. 16039723 Time 4:00 L152 6 x 12 28.27 Good 03/11/2005 04/08/2005 28 Unit Wt lbs/cu ft L153 6 x 12 28.27 Good 03/11/2005 04/08/2005 28 Air Content(%) GENERAL REMARKS: Inspector Premium Travel Name Time Hours Time N. Callahan No Min Day 1 Hr(s) REVIEWED BY: Steven T. Crabtree FRACTURE TYPES f{ A }fir • I I 5 (1) Cone - (2)Cone and Split (3)Cone and Shear (4)Shear (5)Columnar Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: Eaglewood Properties, LLC Attn: John Allyn Weildlinger Associates, Inc. Attn: Len Dente Tocci Building Corp. Attn: Steve King Site Construction Progress Report. EAGLEWOOD DEVELOPMENT Route 114, No. Andover, MA Week of March 14 to 18, 2005 General: Work consisted of earth excavations, fills, and placements of concrete footings and walls for building#3 Earthwork: Work consisted of installation of foundation drains for building#3, moving of earth fills, and placement of concrete for building#3 walls and footings Utilities: None Paving: None Landscaping: None Site Amenities: None Other Comments: Planned work for next week included bringing additional fills to the site, continued concrete for building#3. Tocci superintendent Steve Melendy indicated that on Friday the 18th, the Town Conservation Agent had been on site and had expressed concern for spring thaw conditions. VHB representatives talked to the agent on Tuesday and scheduled a site walk for Friday the 25th with Tocci, VHB and the Town Agent. Attached are reports of inspections and testing of earth and concrete materials. Report prepared by- Edwin Edwin H. MacArthur, P. E. Senior Technical Advisor 9�0 Vanasse Hangen Brustlin, Inc. Of Massachusetts 'The Construction Testing People' -Page 1 5 Richardson Lane, Stoneham, MA 02180 781-438-7755(Voice)781-438-6216(Fax) Compressive Strength Report - Concrete Report Date 03/15/2005 Report No. 3 Job Number 9316 Vanasse Haugen Brustlin, Inc . Project Eaglewood Shopping Center-N. Andover,MA Attn: Edwin MacArthur 101 Walnut St . -P.O.Box 9151 Watertown, MA 02272 Contractor Tocci Building Corp. Concrete Co. J.G. MacLellan ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 3000# 3/4" No. Of Sets: 2 CUBIC YARDS: 11 SET 1 LOCATION: Footing - Column line A at 4 Total Unit Slump(in.) 4 1/2 Lab Size Area Date Date Age Load Load Fracture Air Temp. (F.) 38 No. (in.) (sq.in.) Condition Cast Tested Days (lbs.) (psi.) Type Conc Temp(F) 65 L548 6 x 12 28.27 Good 03/15/2005 03/22/2005 7 54,000 1,910 4 Truck No. 114 L549 6 x 12 28.27 Good 03/15/2005 03/29/2005 14 Ticket No. 1048007 L550 6 x 12 28.27 Good 03/15/2005 04/12/2005 28 Time 11:30 L551 6 x 12 28.27 Good 03/15/2005 04/12/2005 28 L552 6 x 12 28.27 Good 03/15/2005 04/12/2005 28 Unit Wt lbs/cu ft Air Content(%) SET 2 LOCATION: Footing - Column line C at 5 Total Unit Slump(in.) 4 Lab Size Area Date Date Age Load Load Fracture Air Temp. (F.) 44 No. (in.) (sq.in.) Condition Cast Tested Days (lbs.) (psi.) Type Conc Temp(F) 70 L553 6 x 12 28.27 Good 03/15/2005 03/22/2005 7 60,000 2,120 4 Truck No. 114 L554 6 x 12 28.27 1 Good 03/15/2005 03/29/2005 14 Ticket No. 1048030 L555 6 x 12 28.27 Good 03/15/2005 04/12/2005 28 Time 3:50 L556 6 x_ 12 28.27 Good 03/15/2005 04/12/2005 28 Unit Wt lbs/cu ft L557 6 x 12 28.27 Good 1 03/15/2005, 04/12/2005 28 Air Content(%) GENERAL REMARKS: Inspector Premium Travel Name Time Hours Time N. Puchtler No Max Day 1 Hr(s) REVIEWED BY: . Steven T. Crabtree FRACTURE TYPES - t I � �J ti (1)Cone (2)Cone and Split (3)Cone and Shear (4)Shear (5)Columnar Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane, Stoneham, MA 02180 781-438-7755(Voice)781-438-6216(Fax) Compressive Strength Report - Concrete Report Date 03/15/2005 Report No. 3 Job Number 9316 Vanasse Hangen Brustlin, Inc . Project Eaglewood Shopping Center-N. Andover,MA Attn: Edwin MacArthur 101 Walnut St . -P .O.Box 9151 Watertown, MA 02272 Contractor Tocci Building Corp. Concrete Co. J.G. MacLellan -Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: Eaglewood Properties, LLC Attn: John Allyn Weildlinger Associates, Inc. Attn: Len Dente Tocci Building Corp. Attn: Steve King Of Massachusetts 'The Construction Testing People' Page 3 5 Richardson Lane, Stoneham,MA 02180 781-438-7755(Voice)781-438-6216(Fax) Compressive Strength Report - Concrete Report Date 03/15/2005 Report No. 3 Job Number 9316 Vanasse Hangen Brustlin, Inc . Project Eaglewood Shopping Center-N. Andover,MA Attn: Edwin MacArthur 101 Walnut St . -P.O.Box 9151 Watertown, MA 02272 Contractor Tocci Building Corp. Concrete CO. J.G. MacLellan FIELD SUMMARY REPORT 'Total Pour: Footing - Column line A at 2.6-6, and C at 4-6 Method of Placement: ❑Pump ❑X Chute Discharge ❑ Bucket ❑Other Other: Method of Concrete Consolidation: ❑X Vibrator ❑ Other Other: Cylinder Fabrication Location: ❑X Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑Curing Box ❑ Thermal Blanket ❑Hay/Straw ❑X Trailer ❑ Field ❑ Other Placement Protection: ❑X Thermal Blankets ❑ Heat ❑ None ❑ Other Slump Specification(in.) 4 Number of slumps out of specification reported to If rejected Approved by Remarks: Of Massachusetts 'The Construction Testing People' Page 2 5 Richardson Lane,Stoneham, MA 02180 781-438-7755(Voice)781-438-6216(Fax) Compressive Strength Report - Concrete Report Date 03/16/2005 Report No. 4 Job Number 9316 Vanasse Hangen Brustlin, Inc . Project Eaglewood Shopping Center-N. Andover,MA Attn: Edwin MacArthur 101 Walnut St . -P .O.Box 9151 Watertown, MA 02272 Contractor Tocci Building Corp. Concrete Co. J.G. MacLellan FIELD SUMMARY REPORT 'Total Pour: Wall - Building #3 - Column line 1 at A-C Method of Placement: ❑Pump ®Chute Discharge ❑ Bucket ❑Other Other: Method of Concrete Consolidation: ®Vibrator ❑ Other Other: Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑Curing Box ❑ Thermal Blanket ❑Hay/Straw ❑X Trailer ❑ Field ❑ Other Placement Protection: ©Thermal Blankets ❑ Heat ❑ None ❑ Other Slump Specification (in.) 4-5 Number of slumps out of specification reported to If rejected Approved by Remarks: Of Massachusetts 'The Construction Testing People' Page 1 5 Richardson Lane,Stoneham,MA 02180 781-438-7755(Voice)781-438-6216(Fax) Compressive Strength Report - Concrete Report Date 03/16/2005 Report No. 4 Job Number 9316 Vanasse Hangen Brustlin, Inc . Project Eaglewood Shopping Center-N. Andover,MA Attn: Edwin MacArthur 101 Walnut St . -P.O.Box 9151 Watertown, MA 02272 Contractor Tocci Building Corp. Concrete CO. J.G. MacLellan ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 3000# 3/4" 1 No. Of Sets: 1 CUBIC YARDS: 14 SET 1 LOCATION: wall - Building #3 - Column line 1 at A-B Total Unit Slump(in.) 4 3/4 Lab Size Area Date Date Age Load Load Fracture Air Temp. (F.) 40 No. (in.) (sq.in.) Condition Cast Tested Days (lbs.) (psi.) Type Conc Temp(F) 75 L921 6 x 12 28.27 Good 03/16/2005 03/23/2005 7 64,000 2,260 4 Truck No. 218 L922 6 x 12 28.27 Good 03/16/2005 03/30/2005 14 Ticket No. xxxx165 L923 6 x 12 28.27 Good 03/16/200504/13/2005 28 Time 1:30 L924 6 x 12 28.27 Good 03/16/2005 04/13/2005 28 L925 6 x 12 28.27 Good 03/16/2005 04/13/2005 28 Air Content Unit cu ft (%) GENERAL REMARKS: Same day call in. Inspector Premium Travel Name Time Hours Time N. Callahan No Min Day 1 Hr(s) REVIEWED BY: Steven T. Crabtree FRACTURE TYPES f (1)Cone (2)Cone and Split (3)Cone and Shear (4)Shear (5) Columnar Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. CC: Eaglewood Properties, LLC Attn: John Allyn weildlinger Associates, Inc. Attn: Len Dente Tocci Building Corp. Attn: Steve King � Of Massachusetts 'The Construction Testing People -Page 1 5 Richardson Lane, Stoneham,MA 02180 781-438-7755(Voice)781-438-6216(Fax) Concrete Field Report Report Date 03/17/2005 Report No. 1 Job Number 9316 Vanasse Hangen Brustlin, Inc . Project Eaglewood Shopping Center-N. A7dover,MA Attn: Edwin MacArthur 101 Walnut St . -P.O.Box 9151 Contractor Tocci Building Corp. Watertown, MA 02272 WEATHER: TIME: CONTACT: SUMMARY: Transported one set of cylinders cast on 3/16/05 to the lab for testing. GENERAL REMARKS: Inspector Premium Travel Name Time Hours Time R. Lopes No REVIEWED BY: William P. Crabtree Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: Eaglewood Properties, LLC Attn: John Allyn Weildlinger Associates, Inc. Attn: Len Dente Tocci Building Corp. Attn: Steve King Site Construction Progress Report. EAGLEWOOD DEVELOPMENT Route 114, No. Andover, MA Week of March 21 to 25, 2005 General: Work consisted of continued earth moving, placing of concrete at building#3 Earthwork: Earth was being trucked to the site and placed in areas around building#1 and foundations for building#3. Excavations and concrete were being performed for building#3. Tocci was preparing to haul unsuitable materials off site. Utilities: Excavations and placement of utilities was beginning. Paving: None Landscaping: None Site Amenities: None Other Comments: The Town Conservation Agent, VHB, and Tocci walked the site and agreed to perform certain measures in preparation for spring thaws. UTS was on site to provide attached inspection reports of reinforcing steel and concrete placement and testing. Report prepared by" Edwin H. MacArthur, P. E. 0/0 Senior Technical Advisor Vanasse Hangen Brustlin, Inc. NORSE ENVIRONMENTAL SERVICES, INC. 130 Middlesex Road, Suite 15 ' Tyngsboro, MA 01879 TEL. (978) 649-9932 FAX(978) 649-7582 April 16, 2005 No Andover Conservation Commission 400 Osgood Street No. Andover, MA 01845 Re: DEP File #242-1057 Brooks School Commissioners: Pursuant to the above Order of Conditions, we are submitting this report on the work for the above site. The inspection was done on the day of April 8, 2005 and April 15. All erosion controls are in good condition. No site work is being done within the buffer zone at this time, all work is confined to the structure. The site appears to be in compliance with the Order of Conditions. Please contact me if you have any questions. Sincerely, RECEIVED Steven Eriksen APR 2 2 2005 Cc: John Trouvage BUILDING DEPT. 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UKC. ,rata -c y 51 7.,IM3 '4>. - ate zf:r`wj. ..i;� •,i i`�', '� s' 'y.`s �:�: r A. f � -� � J M �.f g R"' h �.7' ...3 �, k ,� �. � �'�1�.� .tl4R_ •�A�r ,�� sz�x ��j`� A- r' � �a„�'.f,f,ay r � z,:,• {'a"' � M6, ,, 'Fr r �f=^" f#'"s.is¢' 3.�f�' 1 Transportation Land Development • Environmental • Services imagination innovation energy Creating results for our clients and benefits for our communities Uanasse Hanl?en Rrustlin, [nc. January 6, 2005 Mr. D. Robert Nicetta Building Commissioner 400 Osgood Street North Andover, MA 01845 Site Inspection reports; Eaglewood Development, Route 114, North Andover,MA NO WORK INCLUDED THIS PERIOD REMARKS Site-Civil F] ❑ Structural Fx] ❑ Electrical F1 FI Mechanical Architectural FI COMMENTS: Attached weekly reports for April 4,to 8 and for April 11 to 15, 2005. Attached are soil reports and concrete test results. RECEIVED If you have questions please call me at 617-924-1770, ex 1252. 9 1005 Vanasse Hangen Brustlin, Inc. Edwin H. MacArthur, P.E. BUILDING DEPT. Senior Technical Advisor Cc. Ross Hamlin, Eaglewood Properties, LLC PO Box 337, Topsfield, MA 01983 Steve King, Tocci Commercial, Inc. 660 Main St. Woburn, MA 01801 101 Walnut Street Post Office Box 9151 Watertown, Massachusetts 02471-9151 617.924.1770 . FAX 617.924.2286 email: info@vhb.com www.vhb.com Site Construction Progress Report. EAGLEWOOD DEVELOPMENT Route 114, No. Andover, MA Week of April 4 to April 8, 2005 General: Concrete foundations and walls for building 3 were being constructed. Earthwork continued for sub-grade fills across the site. Foundation drains were placed for building 3. Earthwork: Fill was being imported and placed as sub-grade fill areas. Some shaping and dressing of embankments was performed to prep for seeding. Also, embankments were being filled in the vicinity of retaining walls. Utilities: Limited work was performed on some drains in foundation areas Paving: None Landscaping: None Site Amenities: Other Comments: Copies of concrete test and earthwork reports and testing are attached. Report prepared by: Edwin H. MacArthur, P. E. Senior Technical Advisor Vanasse Hangen Brustlin, Inc. Site Construction Progress Report. EAGLEWOOD DEVELOPMENT Route 114, No. Andover, MA Week of Aril 11 to 16, 2005 General: Earthwork fills continued with offsite granular being hauled onsite and concrete foundations being placed for Building#3. Foundation drains were being placed for building#3. Structural Pad was being prepared for.Building# 1. Retaining walls were being placed for North side of adjacent bank building property. Earthwork: Material being hauled to the site for building#1 pad and being placed in lifts. Utilities: Drainage pipes being placed around Building#3. Paving: None Landscaping: None Site Amenities: None Other Comments: None Report prepared by: Edwin H. MacArthur, P. E. Senior Technical Advisor Vanasse Hangen Brustlin, Inc. Of Massachusetts -The Construction Testing People' -Page 1 5 Richardson Lane, Stoneham,MA 02180 781-438-7755(Voice)781-438-6216(Fax) Compressive Strength Report - Concrete Report Date 03/10/2005 Report No. 1 Vanasse Hangen Brustlin, Inc . Job Number 9316 Attn: Edwin MacArthur Project Eaglewood Shopping Center-N. Andover,MA 101 Walnut St . -P.O.Box 9151 Watertown, MA 02272 Contractor Tocci Building Corp. Concrete Co. J.G. MacLellan ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 ALL COMPRESSIVE STRENWH TES TS DON E ACCORDING TO ASTM: C-39 CLASS CONCRETE: 3000# 3/4" 1 No. Of Sets: 1 CUBIC YARDS: 7 SET 1 LOCATION: Footing - Column line 1 from A-C.8 Total Unit Slump(in.) 4 Lab Size Area Date Date JD Load Load Fracture Air Temp.(F.) 34 No. (in.) (sq.in.) condition Cast Tested {lbs.) (psi.) Type Conc Temp(F) 51 K955 4 x 8 12.56 Good 03/10/2005 03/17/2005 26,000 2,070 4 Truck No. 126 K956 4 x 8 12.56 Good 03/10/2005 03/24/2005 36,000 2,870 4 Ticket No. 1101183 K957 4 x 8 12.56 Good 03/10/2005 04/07/2005 28 46,000 3,660 3 Time 2:45 K958' 4 x 8..: 12.56 Good 103/10/2005 04/07/2005" 28 45,000 3,580 4 K959 4 x 8 12.56 Good 03/10/2005 04/07/2005 28 45,500 3,620 3 Unit ft Air Content (%) GENERAL REMARKS: _ Inspector Premium Tiavel Name Time Hours Time -. P. Leavitt No Min Day 1 Hr(s) REVIEWED BY: Steven T. Crabtree FRACTURE TYPES Ile II (1)Cone (2)Cone and Split (3)Cone and Shear (4)Shear (5)Columnar Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. .-:Cc: Eaglewood::Properties, :LLC Attn John Allyn weildlinger Associates, inc. Attn: Len Dente _.- Tocci Building Corp. Attn: Steve King Of Massachusetts 'The Construction Testing People' 0 Page 1 5 Richardson Lane,Stoneham,MA 02180 781-438-7755(Voice)781-438-6216(Fax) Compressive Strength Report - Concrete Report Date 03/24/2005 Report No. 8 Vanasse Hangen Brustlin, Inc . Job Number 9316 Attn: Edwin MacArthur Project Eaglewood Shopping Center-N. Andover,MA 101 Walnut St . -P.O.Box 9151 Watertown, MA 02272 Contractor Tocci Building Corp. Concrete Co. J.G. MacLellan ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 3000# 3/4" * I No. Of Sets: 1 CUBIC YARDS: 40 SET 1 LOCATION: wall - Column line C at 6 Total Unit Slump(in.) 5 Lab Size Area Date. Date, Age Load Load Fracture Air Temp. (F.) 48 No. (in.) _ (sq:in.) Condition Cast Tested Days (lbs.) (psi.) Type. Conc Temp(F) 70 N107 6 x 12 28.27 Good 03/24/2005 03/31/2005 7 51,000 1,800 3 Truck No. 168 N108 6 x 12 28.27 Good 03/24/2005 04/07/2005 14 77,000 2,720 4 Ticket No. 1048437 N109 6 x 12 28.27 Good 03/24/2005 04/21/2005 28 Time 3:40 N110 6 x 12 28.27 Good 03/24/2005 04/21/2005 28 N111 6 x 12 28.27 Good 03/24/2005 04/21/2005 28 Unit Wt lbs/cu ft Air Content(%) GENERAL REMARKS: *l o Polarset Inspector Premium Travel Name Time Hours Time P. Pizzuto No Max Day 1 Hr(s) REVIEWED BY: Steven T. Crabtree FRACTURE TYPES (1)Cone (2)Cone and Split (3)Cone and Shear (4)Shear (5)Columnar Our reports are available in PDF form via email. Please email us at reportsOutsofmass.com for more information. cc: Eaglewood Properties, LLC Attn: John Allyn Weildlinger Associates, Inc. Attn: Len Dente Tocci Building Corp. Attn: Steve King Of Massachusetts 'The Construction Testing People' Page 1 5 Richardson Lane,Stoneham,MA 02180 781-438-7755(Voice)781-438-6216(Fax) Compressive Strength Report - Concrete Report Date 03/11/2005 Report No. 2 Job Number 9316 Vanasse Hangen Brustlin, Inc . Attn• Edwin MacArthur Project Eaglewood Shopping Center-N. Andover,MA 101 Walnut St . -P.O.Box 9151 Watertown, MA 02272 Contractor Tocci Building Corp. Concrete Co. J.G. MacLellan ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDING TO ASTM: C-39 CLASS CONCRETE: 3000# 3/411 1 1 No. Of Sets: 1 CUBIC YARDS: 20 SET 1 LOCATION: Footing - Column line C at 1.2-2.6 - Building 43 Total Unit Slump(in.) 4 1/2 Lab Size Area DateDate Age Load Load Fracture Air Temp.(F.) 31 No. (in.) (sq.in.) Condition Cast Tested Days (lbs:) (psi.) Type' Conc Temp(F) 61 L149 6 x 12 28.27 Good 03/11/2005 03/18/2005 7 53,000 1,870 4 Truck No. 225 L150 6 x 12 28.27 Good 03/11/2005 03/25/2005 14 83,000 2,940 3 Ticket No. 16039723 L151 6 x 12 28.27 Good 03/11/2005 04/08/2005 28 114,000 4,030 3 Time 4:00 L152 6 x 12 28.27 Good 03/11/2005 04/08/2005 28 110,000 3,890 4 L153 6 x 12 28.27 Good 03/11/2005 04/08/2005 28 118,000 4,170 3 Unit Wt Ibs/cu ft Air Content(%) GENERAL REMARKS: Inspector Premium Travel Name Time, Hours Time N. Callahan No Min Day 1 Hr(s) REVIEWED BY: Steven T. Crabtree FRACTURE TYPES II r (1)Cone (2)Cone and Split (3)Cone and Shear (4)Shear (5)Columnar Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information. cc: Eaglewood Properties, LLC Attn: John Allyn Weildlinger Associates, Inc. Attn: Len Dente Tocci Building Corp. Attn: Steve King Of Massachusetts 'The Construction Testing People' Page 1 5 Richardson Lane,Stoneham,MA 02180 781-438-7755(Voice)781-438-6216(Fax) Compressive Strength Report - Concrete Report Date 04/01/2005 Report No. 9 Vanasse Hangen Brustlin, Inc . Job Number 9316 Attn: Edwin MacArthur Project Eaglewood Shopping Center-N. Andover,MA 101 Walnut St . -P.O.Box 9151 Watertown, MA 02272 Contractor 'cocci Building Corp. Concrete Co. J.G. MacLellan ALL FIELD TESTS DONE ACCORDING TO ASTM: C-172 C-31 C-143 C-1064 ALL COMPRESSIVE STRENGTH TESTS DONE ACCORDINGTOASTM:- C-39 . CLASS CONCRETE: 3000# 3/4" 1 No. Of Sets: 2 CUBIC YARDS: 80 SET 1 LOCATION: wall - Column line 8 at G.4-J Total Unit Slump(In.) 4 1/2 ,Lab Size Area Date Date Age Load Load Fracture Air Temp.(F.) 58 -No. (in.) (sq..in.) Condition Cast Tested Days _ (Ibs:)( psi.) Type Conc Temp(F) 69 P424 6 x 12 28.27 Good 04/01/2005 04/08/2005 7 53,000 1,870 4 Truck No. 151 P425 6 x 12 28.27 Good 04/01/2005 04/15/2005 14 Ticket No. 1048751 P426 6 x 12 28.27 Good 04/01/2005 04/29/2005 28 Time 1:30 P427 6 x 12 28.27 Good 04/01/2005 04/29/2005 28 P428 6 x 12 1 28.27 Good 04/01/2005 04/29/2005 28 Unit Wtlbs/cu ft Air Content(%) SET 2 LOCATION: Footing - Column line 9 at E Total- Unit Slump(in.) 4 3/4 Lab Size Area Date Date Age Load, Load Fracture Air Temp.(F.) 56 No. (in.) (sq.in.) ,Condition : Cast Tested Days (lbs.) (psi:) Type Conc Temp(F) 68 P429 6 x 12 28.27 Good 04/01/2005 04/08/2005 7 55,000 1,950 4 Truck No. 153 P430 6 x 12 28.27 Good 04/01/2005 04/15/2005 14 Ticket No. 1048756 P431 6 x 12 28.27 Good 04/01/2005 04/29/2005 28 : P432 6 x 12 28.27 Good 04/01/2005 04/29/2005 28 Time 3 30 P433 6 x 12 28.27 Good 04/01/2005 04/29/2005 28 Unit Wt lbs/cu ft Air Content(%) GENERAL REMARKS: Inspector Premium' Travel Name Time Hours. Time L. Fusco No Min Day 1 Hr(s) REVIEWED BY: Steven T. Crabtree FRACTURE TYPES (1)Cone (2)Cone and Split (3)Cone and Shear (4)Shear (5)Columnar ' Of Massachusetts The Construction Testing People' Page 1 5 Richardson Lane,Stoneham,MA 02180 781-438-7755(Voice)781-438-6216(Fax) Reinforcing Steel Report Report Date 04/05/2005 Report No. 9 Job Number 9316 Vanasse Hangen Brustlin, Inc . Project Eaglewood Shopping Center-N. Andover,MA Attn: Edwin MacArthur 101 Walnut St . -P.O.Box 9151 Watertown, MA 02272 Contractor Tocci Building Corp. CONTACT: _TIME OF INSPECTION: 1 :30 PM TIME OF CONCRETE PLACEMENT: SPECIFICATION: ASTM A615 Grade 40 Grade 60 X Grade 75 ASTM A616 Grade 50 Grade 60 ASTM A617 Grade 40 Grade 60 CONTRACT DRAWINGS: R02 REVISION NUMBER: DATED: SHOP DRAWING(S):s1 PROJECT SPECIFICATIONS: 03300 OTHER: DRAWINGS STAMPED: YES X NO AREA REVIEWED: Wall Footing, Line J at 8 to 6.4, Line J at 8 to 8.6, Line J at 8.6 to 9, Lines J-G at 9.2. ATTRIBUTES: REVIEWED Ye—__ _ Coverage(Top Bottom and/or Inside Face Outside Face ) X Clearance X Cleanliness(heavy rust,scale, mud,dirt,oil,etc.not permitted) X Bar Supports X Bar Spacing X Bar Quantity X Placement and tying X 0 The details in the above described area(s)were complete at the time of this inspection. ® The results of this inspection were discussed with the aforementioned contact persons prior to departure from the project site. GENERAL REMARKS: No exceptions taken. Inspector Premium Travel Name Time Hours Time R. Carter No Min Day 1 Hr(s) 5�1� �UAW Of Massachusetts 1W 'The Construction Testing People' Page 3 5 Richardson Lane, Stoneham,MA 02180 781-438-7755(Voice)781-438-6216(Fax) Compressive Strength Report - Concrete Report Date 04/01/2005 Report No. 9 Job Number 9316 Vanasse Hangen Brustlin, Inc . Job Number Attn: Edwin MacArthur Project Ea glewood Shopping Center-N. Andover,MA 101 Walnut St . -P.O.Box 9151 Watertown, MA 02272 Contractor Tocci Building Corp. Concrete Co. J.G. MacLellan FIELD SUMMARY REPORT -Total Pour: column line 8 at G.4-J, and '9 at J-E Method of Placement: ®Pump ❑Chute Discharge ❑ Bucket ❑Other Other: Method of Concrete Consolidation: ®Vibrator ❑ Other Other: Cylinder Fabrication Location: ® Truck Discharge Chute ❑ End of Pump Hose Cylinder Storage: ❑Curing Box © Thermal Blanket ❑Hay/Straw ❑ Trailer ❑ Field ❑ Other Placement Protection: ®Thermal Blankets ❑ Heat ❑ None ❑ Other Slump Specification(in.) 5 Number of slumps out of specification reported to If rejected Approved by Remarks: SMOLAK & VAUGHAN LLP Attorneys at Law Jefferson Office Park 82o Turnpike Street, Suite 203 North Andover, Massachusetts 01845 Telephone 978-327-5220 Facsimile 978-327-5219 John T.Smolak,Esq. Direct 978-327-5215 Email:jsmolak@SmolakVaughan.com November 5, 2004 BY HAND Michael McGuire Building Inspector Building Department Town of North Andover 400 Osgood Street North Andover, Massachusetts 01845 RE: Request for Confirmation of Zoning Matters --Signage Property: 530 Turnpike Street Owner: Pico Trust Dear Mike: As a follow-up to our discussion last week, and on behalf of Salem Five, the following is a request for your office to confirm that proposed signage to be located on the east side of the Salem Five premises is permitted by right as a secondary sign. Also enclosed is a new sign permit application. Backg1ound Salem Five is currently the sole tenant located in the premises known and numbered as 530 Turnpike Street(the"Property"). As you know,John McGarry,as Trustee of Pico Trust, is the owner of the Property. The Property is located in the General Business("GB")Zoning District. On or about May 25, 2004,the Building Department issued a sign permit (Permit#15- 2004)to John McGarry on behalf of Salem Five. The sign permit authorized the erection of a 2'-8"x 12'-6" Wall Sign facing Turnpike Street(the"Primary Sign"). A copy of the Wall Sign Permit and related sign illustration is attached. Thereafter,The Sign Gallery, Inc.,on behalf of Salem Five, had requested the Building Inspector to issue a sign permit for a sign(having dimensions of 2'-10' x 12'-7.175") to be located to the east of the building(facing Fuddrucker's as one stands at the Salem Five Building). That sign permit was initially rejected by you. Based upon follow-up preliminary discussions with you, I understand that you felt it was unclear whether zoning relief(either through a special permit or variance)was required for the issuance of a sign permit for the sign. After our further discussions,you suggested that Salem Five re-file a sign permit application with a proposed Secondary Sign having dimensions smaller than the Primary Sign(the"Secondary Sign"). s 1 SMOLAK& VAUGHAN LLP Michael McGuire Building Inspector November 5, 2004 Analysis As you know,Article 6 of the North Andover Zoning Bylaw sets forth requirements for signs. Section 6.6.1)of the Zoning Bylaw establishes requirements for accessory signs in Business and Industrial Districts. Specifically, Section 6.6.D. provides that"Each owner, lessee, or tenant shall be allowed a primary and secondary sign." Accordingly,the Salem Five Building contains one Primary Sign(as defined under Section 6.3.14—Definitions of the Zoning Bylaw) which was permitted as described above in May, 2004 because it met the dimensional requirements established under Section 6.6.D.1 of the Zoning Bylaw. The term"Secondary Sign" is defined as a "...wall,roof or ground sign intended for the same use as a primary sign but smaller dimensions and lettering,as allowed in Section 6.6."See Section 6.3.17(Definitions). As noted above, Section 6.6.D.of the Zoning Bylaw allows a "primary and secondary sign." Unlike the specific dimensional requirements required for a Primary Sign described under Section 6.6.D.1,a Secondary Sign is permitted by right in a Business District provided that it simply has smaller dimensions and lettering than the Primary Sign. In this case,the proposed secondary sign(28"height x 124.497"width) is smaller than the primary sign(32"height x 150"width)which was approved in May, 2004. Therefore,it is my opinion that no relief is required to approve the sign proposed for the east side of the Building,other than a sign permit issued by the Building Inspector,because the proposed sign is a"secondary sign"and it has smaller dimensions than the Primary Sign. Accordingly,on behalf of Salem Five, I respectfully request the Building Inspector to issue a sign permit for the attached secondary sign. Thank you for your consideration of this matter and please contact me at your earliest convenience should you need any further information. Very truly yours, ;�J�ohn T. Smolak JTS/ cc: Joseph Longo,Vice President, Salem Five John McGarry,Trustee,Pico Trust Sife Owner �I(c) Trv54 ,John IM, Applicant Sr'ttPvri Site Address C,30 Size of Proposed Sign / ' �` W X C�-, 1 Q_5`_I�� How attached: a� Against the wail X ( 1 Illumination: a) Not illuminates) ( ) b' Roof _ b) Internally illuminated c) Ground ( ) Externally illuminated AY- d Other toe ,rS--++a�rt 144-e" [-' i�� F►�C i� w/ ( � . J _-m c o.1- to ip rn1 +- Materials: Proposed Colors: Background i I c( 1'nj� , Lettering 131Ue Ye Ifow �.2 lh(`c� olur�rn(,r+-r w ,�h S is -�r M0Vr1+i n Border �r�. 1 Required. Attachments: Note: No permanent/temporary sign shall be erected, or enlarged until Photographs of building. an application on the appropriate form furnished by the Sign Officer has Material sample been filed,with the Sign Officer containing such information including photographs, plans and scale drawings, as he may require, and a perrnit Color sample for such erection, alteration, or enlargement has been issued by him. Site or Plot Plan (Required for all free-standing signs) Such permit shall be issued only if the Sign Officer cletermines that the Drawings of proposed sign sign complies or will comply with all applicable provisions of flip By-Law. C)ther, specify Akovvi4�'n�_�ra�w r� `. ill sign overhang any public road or walkway Yes No f Yes, Name of Agency.who will provide liability insurance: %N INCOMPLETE APPLICATION WILL NOT BE ACCEPTED :)ATE FILED: SIGNATUR� OF APPL ,CANT evised:jm-8/98 T Q C 979) 3�-_' -7- S a iS Secondary Sign Layout Elevation Drawing Salem Five North Andover Logo Shown at 26.125"h x 186.229"w = 33.79 sq ft 104.5 ' w J Y i scdemFive Bank 13.5 ' h a_ fs AREA OFSIGN - 33.79sgft SECONDARY SIGN SALEM FIVE NORTH ANDOVER SIGN SKETCH SalemF!ive Bank 26.125 in 186.229 in SIZE: 186.229"w X 26.125"h AREA OF SIGN: 186.229" x 26.125" = 33.79 sq ft Represents 5% less than the total square footage of existing sign at front of building ( 35.69 sq ft. ) MATERIALS: 1/4" thick painted aluminum letters and graphics. COLORS: SalemFive PMS 294C; Star & Swoosh PMS 130C 11/04/2004 09:58 9785352288 SIGN GALLERY PAGE 04 CROSS SECTION 1/4" thick painted aluminum letters stud mounted to exsisting uvilll Wail 28"'h Studs for Mounting Studs affixed with silicone i A IIA0 � �9 ® Rg48D D lPN6 1` y 'QA CCCNK NlWK1t\4 °R%rev CF4U�'�� TOWN OF NORTH ANDOVER SIGN PERMIT DATE May 25, 2004 PERMIT # 15-2004 This is to certify that John McGarry for Salem Five Cents Savings Bank has permission to erect a 2'-8" x 121 — 6" Wall Sign on/ at 530 Turnpike Street Providing 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 of the Town of North Andover. Any violations of the Zoning Regulations regarding Section 6 of the Zoning By-law will void this permit. INTERIOR ILLUMINATED SIGNS ARE PROHIBITED Inspector of Buildings Date Previously permitted sign for front of building SIGN PERMIT APPLICA�N TOWN OF NORTH ANDOVER CS UGCCS Site Ower e1F. - Applicant �� C r/ hA J 3)'—Z��+ZCS Site Address <3 �. /l Ci�� Q l'� �1 " • Size of Proposed Sign LT tin 2 How attached: a)Against the waH Illumination: aY IVot illum Hated b) Roof b)Internally illuminated or 7r c)GroundOExteinally illuminated s e,4 P c « d)Other v Materials: r T� tG a '�"` Proposed Colors: Background r.��t n � . a Lettering B l v c # r tic�.- f o,- t/►., fes+ +�' ) Border �— n Reaubed Attachments: Photographs of building Note; No permanent/temporary sign shall be erected, or enlarged until an MaterW sample application on the appropriate form finnished by the Sign Office has been Color sample filed with the Sign Officer containing such information including a Site orPl+rt Plan(Required for ail free-standing signs) photographs,plans and state drawings, as he may require, and a permit z 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- rr Law. C 41 z r LI).,_ y ^-Jr, _ ! � !�t�c iY'vC.a W l it Q70f1 Avaf`hn nrY l.l:.. J 11 r �. ! —War f i J !1 r I I L 1 7-11 CL" / fT ! _.� . .,..,.�.,�, :..�j 1i11u►. ,ilau Of WiLUtWSy Yes ) !VO {/✓ 'rG 4k—,�1`? — If Yes,Name of Agency who will provide liability insurance: AN€NCONPLETE APPLICATION WILL NOT BE ACCEPTED q -t DATE FILED: ,r SIGNATURE OF APPLICANT _� CS �'�v"r�r•'C�!�S J'il'l! '�( �'`I C �`1 �'�L ���`1 ) 511E LAYOUT ,' Logo Shown C� 34 h x 151.175 w 77, ��'-S s a,, ,m, ��'g •.,} rkN -s - } .+ t �rR $ � rv�i. §. 2 +4� F fi� `� n { 1 �''� �:. is s p yy Y ik. 7 t fi� n i a rcd ,�S° r i4 rfiNF m w r t r, a fi � '3�"h,� dt( E - t X24 ��� �'� ✓tl �i � J�` a �... , J 1 ♦. r 77 s• r,s ^�' f E. �� 4 '� Y4n�'Y "!}x� I - a*„ .,._.s.,...,..„�..,:.:.,.v° 1,. � ..s«•�-:.w»: F �-^�-^.xr^.r.n. ^.>..g..^.^^.�:y{ ^^r-;^t�^"^rts'F'�?i wdnx� 1Hf.. �7 � r SMOLAK & VAUGHAN LLP Attorneys at Law Jefferson Office Park 82o Turnpike Street, Suite 203 North Andover, Massachusetts 01845 Telephone 978-327-5220 Facsimile 978-327-5219 John T.Smolak,Esq. Direct 978-327-5215 Email:jsmolak@SmolakVaughan.com November 5,2004 BY HAND Michael McGuire Building Inspector Building Department Town of North Andover 400 Osgood Street North Andover, Massachusetts 01845 RE: Request for Confirmation of Zoning Matters-- Signage Property: 530 Turnpike Street Owner: Pico Trust Dear Mike: As a follow-up to our discussion last week, and on behalf of Salem Five,the following is a request for your office to confirm that proposed signage to be located on the east side of the Salem Five premises is permitted by right as a secondary sign. Also enclosed is a new sign permit application. Back ound Salem Five is currently the sole tenant located in the premises known and numbered as 530 Turnpike Street(the"Property"). As you know,John McGarry,as Trustee of Pico Trust, is the owner of the Property. The Property is located in the General Business("GB")Zoning District. On or about May 25,2004,the Building Department issued a sign permit (Permit#15- 2004)to John McGarry on behalf of Salem Five. The sign permit authorized the erection of a 2'-8"x 12'-6" Wall Sign facing Turnpike Street(the"Primary Sign"). A copy of the Wall Sign Permit and related sign illustration is attached. Thereafter,The Sign Gallery,Inc.,on behalf of Salem Five, had requested the Building Inspector to issue a sign permit for a sign(having dimensions of 2'-10' x 12'-7.175") to be located to the east of the building(facing Fuddrucker's as one stands at the Salem Five Building). That sign permit was initially rejected by you. Based upon follow-up preliminary discussions with you, I understand that you felt it was unclear whether zoning relief(either through a special permit or variance)was required for the issuance of a sign permit for the sign. After our further discussions,you suggested that Salem Five re-file a sign permit application with a proposed Secondary Sign having dimensions smaller than the Primary Sign(the"Secondary Sign"). SMOLAK& VAUGHAN LLP Michael McGuire Building Inspector November 5,2004 Analysis As you know,Article 6 of the North Andover Zoning Bylaw sets forth requirements for signs. Section 6.6.D of the Zoning Bylaw establishes requirements for accessory signs in Business and Industrial Districts. Specifically, Section 6.6.D.provides that"Each owner, lessee, or tenant shall be allowed a primary and secondary sign." Accordingly,the Salem Five Building contains one Primary Sign(as defined under Section 6.3.14—Definitions of the Zoning Bylaw) which was permitted as described above in May,2004 because it met the dimensional requirements established under Section 6.6.D.1 of the Zoning Bylaw. The term"Secondary Sign" is defined as a "...wall,roof or ground sign intended for the same use as a primary sign but smaller dimensions and lettering,as allowed in Section 6.6."See Section 6.3.17(Definitions). As noted above, Section 6.6.D.of the Zoning Bylaw allows a "primary and secondary sign." Unlike the specific dimensional requirements required for a Primary Sign described under Section 6.6.D.1,a Secondary Sign is permitted by right in a Business District provided that it simply has smaller dimensions and lettering than the Primary Sign. In this case, the proposed secondary sign(28"height x 124.497"width) is smaller than the primary sign(32"height x 150"width)which was approved in May, 2004. Therefore, it is my opinion that no relief is required to approve the sign proposed for the east side of the Building,other than a sign permit issued by the Building Inspector,because the proposed sign is a"secondary sign"and it has smaller dimensions than the Primary Sign. Accordingly,on behalf of Salem Five, I respectfully request the Building Inspector to issue a sign permit for the attached secondary sign. Thank you for your consideration of this matter and please contact me at your earliest convenience should you need any further information. Very truly yours, , ohn T. Smolak JTS/ cc: Joseph Longo,Vice President, Salem Five John McGarry,Trustee,Pico Trust S ite Owner Pi cc)Trv;A JO 6�✓q l�l '�j� rr: (Vj}er Applicant _�>a (Y�'rr, F-1(;0 Site Address C"30 Size of Proposed Sign_Z W . x C�-, I -Z5 How attached: a� Against the wall�(� Illumination: a) Not illuminated ( ) b' Roof b) Internally illuminated c) Ground ( ) Externally illuminated ro er-L'5 .1 d) Other ( ) foe ,rS rtc`f nC 1 c�c�r c a. rn1 +- Materials: Proposed Colors: Background C15yI Lettering 131uC 1a fi�,elcr /ur��rnc,+��l W ,�-�J S'4�a -�r movn+7 n Bo�der�/q, 5 Required. Attacilmetlt$ Note: No permanent/temporary sign shall be erected, or enlarged until Photographs of building. an application on the appropriate form furnished by the Sign Officer has Material sample been filed-with the Sign Officer containing such information including photographs, plans and scale drawings, as he may require, and a permit Color sample for such erection, alteration, or enlargement has been issued by him. Site or Plot Plan (Required for all free-standing signs) Such permit shall be Issued only if the Sign Officer determines that the Drawings of proposed sign sign complies or will comply with all applicable provisions of the By-Law. Other, specify A&ou,n4 +_n draw,✓� Vill sign overhang any public road or walkway Yes No (� [Yes, Name of Agency-who will provide liability insurance: %N INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: SIGN/ATUR� OF APPLICANT evised:jin-8)98 S' !(�� ;' ( �J /'7 '4 T � C979) 332 �� Sai� Secondary Sign Layout Elevation Drawing Salem Five North Andover Logo Shown at 26.125"h x 186.229"w = 33.79 sq ft A � r . `rri+ 104.5 ' w Buir a `� '`' il4 t ro ` ,`�.t5 zc • �i - n 5 �ws.+...•kaleinEve F 13.5 ' h .. AREA OF SIGN - 33.79 sq ft SECONDARY SIGN SALEM FIVE NORTH ANDOVER SIGN SKETCH Salie ive Bank_ 26.125 in 186.229 in SIZE: 186.229"w X 26.125"h AREA OF SIGN: 186.229" x 26.125" = 33.79 sq ft Represents 5% less than the total square footage of existing sign at front of building ( 35.69 sq ft. ) MATERIALS: 1/4" thickin pa ted aluminum letters andra hics. 9 P COLORS: SalemFive PMS 294C; Star & Swoosh PMS 130C ` 11/04/2004 09:58 9785352288 SIGN GALLERY PAGE 04 CROSS SECTION 1/4" thick painted aluminum latters stud mounted to exsisting w-E.1ll Wall 28"h Studs for Mounting Studs affixed with silicone SORT (A q q 41fi ID j��•Y �qOp wc„i«eww« 1* � 4SS�C�411��� i TOWN OF NORTH ANDOVER SIGN PERMIT DATE May 25, 2004 PERMIT # 15-2004 This is to certify that John McGarry for Salem Five Cents Savings Bank has permission to erect a 2'-8" x 12' — 6" Wall Sign on / at 530 Turnpike Street Providing 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 of the Town of North Andover. Any violations of the Zoning Regulations regarding Section 6 of the Zoning By-law will void this permit. INTERIOR ILLUMINATED SIGNS ARE PROHIBITED i Inspector of Buildings Date Previously permitted sign for front of building 7 �'F'w `u�,.��•�C.z`�F�.u,ifw..yz^'�,�W. ,�3"'�.•..�%t"."�`�`,f,$`�,7y.�h .,s:'.�-�u_. r... z.�,.��.:`.1�, r�>..x.'_; M.z-x a.x,.._.> _ _ -,:t. +r s e SIGN PERMIT APPLI TOWN OF NORTH ANDOVER e Site{homer _ � � ��n �. ��'�fC'1 Applicant �a C�"'���`� ��^�'3 JA�`t'�J �'1 Sf—�`3)" Site:Address !) ! r ' Size of Proposed Sign Z � an 7- 5.'des How attached. a) the wall__ Illumination: aj Not iljuun ated b) Roof b)Internally illuminated it r c}Ground Oc Externally ilhaminated L► 6:,a*C e P « U d}Other Lk Materials: +I 2. i� T� t'c� [v�+. ',ly� �� ,sv -QS' Q Proposed Colors: Background °�+ Lettering alvc r G w .-_ ted G rte+ Border ,x,11 it ' T Reauh,ed Attac.liments: Photographs of building Note; No permanent/empormy sign shall be erected, or enlarged until an Material nmPle application on the appropriate form furnished by the Sign Office has been i Color ample filed with the Sign Officer containing such information including u Site Or Plan(Required for all free-standing signs) photographs, plans and scale drawings, as he may requirt and a permit Drawings ofproposed sign for such erection, alteration,or enlargement has been issued by him. c Other,Vecify Such permit shall be issued only of the Sign Officer determines that the r sign complies or will comply with all applicable provisions of the By- r Law. f fvNCr W111 Qioe nvn Kann l.G.. 1T i ✓ - r — r a. .,,...., J5 Mil;FUM11%, 1 VCu or wamwdy I es( ) IN f {/✓� !��' `' ���•�- If Yes,Name of Agency who will provide liability insurance: i AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED z DATE FILED. SIGNATURE OF APPLICANT a � V � � 51PE LAYOUT �, Logo Shown 034 h x 151.175 w -. r}+,.+g,. f• �� i ,.r...,. V -„.y.. ..,. .. ... �....;.. {ti:fi � r� gok.i i u �Ytrg limm- H � F V 7sj l kkt� j�{ � 4��a✓+{tyAp b fyx s $r v! �{+�;+S`+r p.- y'+ F ''' �'' 4a.. >r•.�' ¢Pr t. +. pit °_ ..`�S �•.x •q4 5' 4 •,�.�'” w:. ' f� ..,� r. �' i R'i:. ��:,, 4+ y, � ,+ 3, h r.. k� � u4; yx hRs�,yr v� ttc i-1✓, � i' $, q,u - r},a ht 1�A -,;,F.� .,xt. �,;• � ,, '?,'r � 4tt, ✓ "f s?'. !a m'J a �t'e11 �r'4tF# r �`x y .4' ',4 �' F�`l�1�'�`�i 1 . x U t a n `X t+ 4s�•k}ikka.4x4llyYt 3Vr ' } t k t a�'S' V t ft 5r, s� 1 .." 4�Y-:si �':� � � t�v ✓n v `�L� 4`r4 } i + t��,�����4k�� n$eSY�`�'re�nk,fR y��P"pn�,� •.. w��,�sr4yy�`syi'y6�y;����Yr� a� V1 x is 1�"��,�'.b,i� to 4yS rFwj�N�'�5�ye x��, x� i 1n �n tw Atli � � ��.>;•� s�4..�d�*k,,,¢,4��,�;+�.�Zs Y .'.�� �' �n�.� I f;.rk., 't s r�..i�,&S''� t b;,1 {{i t� ''3 n L /01 �7 I i Sile Owner �Icc)T(vjL Tohr, M ' '' ����= � f �}�� APPlicant �c� S i le Address C,30 TvY + � '��C' Size of Proposed SignX How attached: a Against the Wall�(� Illuminalion: a) Not illuminated b Roof _ b) Internally illuminated c) Ground { ) Externally illuminated Nc�s 'f-K) I d) Other ( l toe �rS'�eta t a -ter- e fPc�c f� *1 (YID r i Materials: Proposed Colors: Background 'n Lettering Vie 4 ye f(o('0 ; Border U./,q S'-�Je�S MOVn+r n5 F eguired. Attacl mql tS: Note: No permanent/temporary sign shall be erected, or enlarged until Photographs of building.- an application on the appropriate form furnished by the Sign Officer has Material sample been filed with the Sign Officer containing such information including photographs, plans and scale drawings, as he may require, and a permit Color sample for such erection, alteration, or enlargement has been issued by him. Site or Plot Plan (Required for all free-standing signs) Such permit shall be issued only if the Sign Officer determines that the Drawings of proposed sign sign complies or will comply with all applicable provisions of the By-Law. Other,_ specify A/Lav✓t+i 3 Yaw;ru-, 'VilI sign overhang any public road or walkway Yes No (� [Yes, Name of Agency.who will provide liability insurance: %N INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: SIG ILV OF APPLICANT evised:jm- 8198 �lG'� (/azc lj-K &-m p zm MORP r 45 10 .. ........ tv