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Miscellaneous - 43 HIGH STREET 4/30/2018 (3)
:� M, G FILE r �' NOR7M e 3rO�t�``D-+°'ishOpL TOWN OF NORTH ANDOVER ' PERMIT FOR WIRING 71 �O+,n° C: ,SSACMUSE� This certifies that .............. ... ...1/..f.............................................................. has permission to perform ...........c /� .....F....x:....... ' �.... ... F wiring in the building of......�U.�5 .t�. .../.:��1t..�t'1.�......4�c at...Y-3...! r.f�f U.?1..............5.../I.D. ............ ,Porth Andover,Mass. ��� L Yee.. ............. Lic.No. ........ .................J RICAL INSPEC 'heck # �"�3 P� �� 0709 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions of M.G.L.c.143,§3L,the ;fl permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed J' on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an electrical permit shall be issued to the person,firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall-be limited as to the time of ongoing construction activity,and may be-deemed-by the-Inspector-of-Wires abandoned_and_invalid_ifhe—_. ._ 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 complah5n of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or-the instx'Ming entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Act.-.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. 11—Permit(Date Closed: / ** Note:Reapply for new permi [!OP7er7Mft Extension Act—Permit/Date Closed: / � Official Use Only l�ommonrueall1ii �//of�//a93ac/uc.Uettd � -- 2c� �] Permit No. ,0 7 eparlment o�Ji're Serviced Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the lMassachusetts Electrical Code(�-IEQ).537 CNMR 13.00 (PLEASE PRLVT IV LVK OR T)TE:ALL 1 1FORILATION) Date: � 91 City-or Town of: /Up,2�1� l Da1l� To the In ec or of il'ires: By this application the undersigned gives notice of his or her intention to perform the electrical ,N-ork described below. Location (Street& Number) 1 (� S j S7pZ /ld C Owner or TenantU i CA-rLe- e a-g, —*L IL,C Telephone No. Owner's Address Is this permit iri 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 Servick Amps / Volts Overhead❑ Undgrd ❑ No.of ivieters Number of Feeders and Ampacity y Location and Nature of Proposed Electrical Work: ee� Completion of the following table mai•be waived bi•the lnsnecror of IYires_._ Total Tot r No. of Recessed Luminaires No.of Ceit.-Susp.(Paddle)Fans No. of. Tot Transformers No.of Luminaire Outlets No. of Hot Tubs Generators KVA -"d No.of Luminaires Swimmin Pool Above Tn- t o.of mergency tQ inng— w g arnd. ❑ Qrnd. ❑ 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_ No..of Alerting Devices Tons No.of Waste Disposers Heat Pump ]`lumber Tons KW No.of elf- on.tained Totals: - Detection/Alerting Devices No.of Dishwashers Space/Area.Heafitib KW .. Municipal . Local❑ ❑ Other Connection_ _ No.of Dryers Heating Appliances KW Security Sy,stems:* No. of Nater No.of No.of No.of Devices or Equivalent Kai/ Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total.HP Telecommunications Wiring: y b No.of Devices or Eq uiva[ent {OTHER: a �•� Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value ofl Work to Start: 3 ec {cal Work: '-' (When required by municipal policy.) Inspections"to be requested in accordance with NEC Rule 10,and upon cornpleti.: INSURANCE C VE 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) Self Insured . I certify,under the pains and penalties of perjury,that the ' ormation on this application is true and complete. FIRM NAME: ADT Security Services •LIC. NO.: C Licensee: Mark A. Brophy Signatu e LIC. NO.: C-45 _(If applicable, enter "exempt"in the license nunnber line.) Bus. Tel. No.: 603-594-5928 Address: _18 Clinton Drive Hollis NH Alt.Tel. No.: *Per M.G.L. c. 147, s. 57-61,security work requires Department of Public Safety"S"License: Lic.No. 00953 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. Sin nt PERtVHTFEE: $S$ Signature" Telephone No. .• __ ...: ..,� L A.REGISTERED SYSTEM CONTRACTbP..:.:',.., -'ISSUES THEABOVEIICENSc T0: - T. SECURIT-Y• SVICES ,'; - RK-:A :BROPHY: SR f 0iU'NIVERSITY."AVE ESTW.aOD MA".02.09.0-231.1;'::-.: r: _.. = 07/31/13 849174'.'. 4 45 C (" ,"Fold.Thon Oolzch Alwg.AN Pvfomdtl Keep top for receipt and change of address notification. ✓� DPS-CAt v 'sSM-70?C9-70162009LICENSEFORtJit '';' . J1,e•�ornmannweal�•c�,.i//ur.,1::ac�.raseCl4 �--� DEPARTMENT OF PUBLIC SAFETY Wt �j= S-License ,0-g' Number'SS CO 000953 is Expires:02/07/2013 Tr.no: 195.0 S-License: ADT j MARK A BROPHY SR 410 UNIVERSITY AVEjf DIG SAFE CALL CENTER: (888)344.7233 090 WESTWOOD, MA 02Commissioner w Location No. a ''� Date _9' C1 �aRTM TOWN OF NORTH ANDOVER 0�� . o , 1h 3? 0 . 00 a ; ; Certificate of Occupancy $ °'E<� Building/Frame Permit Fee $ '7 S swcMus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ `7 Check # F b , Building Inspector 06/01/2000 10:10 9786828713 YALE PROPERTIES PAGE 03 i TOWN OF NORTH ANDOVER BUILDING DEPARTMENT __, A ONE R TWO FAMILY DWELLING ARucpJGN..TpERMTT NUM�B> � .. srrrOVAT OR DEMOLISHDATE IS .. . , :: :.-., � SUED: .- SIGNATURE: 42!4z:z =i I Building Comrnissioner/I of Buildigffl Date z SECTION I-SITE INFORMATION I A Property Addnm: 1.2 Asseown Mop and Parcel Number: O � Media One, 43 High Street Andover, MA Map Number Parcel Number V � 13 Zmng 1vt'onnatim: 1.4 Property D® an auie: j Zatit Disuia Pr Uac lot Arca s Franc fl 1.6 BUILDING SETBACKS 00 Front Yard Side Yard Rear Yard RcqurM Provide Regsumd PMVIC d Reqgu red Provided 1.7 Wrm sapplytnta.LC.40. .14) 1.5. Rood Zom fofetasstiaa: 1.9 St margo DO-4 Syewm: fWris ❑ pdvw ❑ la.e Oaoei to Flood taw D Mwioipal a 0a Sire Diepewl system ❑ SECTION 2.PROPERTY OWNERSHIPIAUTHORIZED AGENT m 2.1 Owner of Record 1 High Street Yale North Andover, MA 01845 I Name(Pricks) Address for Servicer 978-682-9494 �f Signamm Tekphorre 2.2 Owner of Record: Name Print Address for Servioe: z M Signature Te M SECTION 3-CONSTRUCTION SERVICES 1� 3.1 Licea'ed Construction Supervisor Not Applitabte p Kevin L Cooper I iased Coaaeruction supervisor. O �tiltmor Incorporated, 544 R Salem Street Liccra9c Number In I' mean Wakefield, MA 01880 78-224-09-90 Expiration pate oNMEN �Apsah— / Telephone r, NA r eA - '4P 31 Registered dome Improvement tractor Not Applicable D Company Name M Registration Number r r � Addma Ertpimbm Date 8- R Telephone 06/01/2000 10:10 9786828713 YALE PROPERTIES PAGE 04 SECnON 4-WORKERS COMPENSATION(M.G.L C 152 2S46) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will mutt in the denial of the issuance of the building it. Si ned affidavit Meshed Yrs.......a No......p SECTION S Description of Proposed Wont geek at1 a Lee New Constntction ❑ Existing Building ❑ Repair(s) 0 Alterations(s) j7 Addition O Accessory Bldg. 0 Demolition O Other ❑ Specify Brief Description of Proposed Work: Erect interior partition wall with related electrical requirements. SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by 2trffit applicant I Building ( 000 (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of 700 Coasftuctioo 3 Plurnbsna0 Building Permit fee(a):M 4 Mechanical HVAC 0 5 Fire Protection 0 6 Total 1+2+3+4+5 Check Number --T SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT i, j� ,as Owner/Authonzed Agent of subject property Hereby authorize 8,t-Th'1 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/D�ECLARAT`IOON 1, 1/J,ti � AL,C� /H�Q2 / ,as o►r Wner/ u�onzedAgentsubject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief VIAI 6 e lc' St entre of Owner/A rn� Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TMMERS 1 2 3 SPAN DIIAENSiONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDA71ON THICKNESS SIZE OF FOOTING x MATERIAL.OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL OAS LINE 06/01/2000 10:10 9786828713 YALE PROPERTIES PAGE 05 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigstions Boston, Mass. 02111 �oricers insuranceComCompensationCompensationAtFidavit Please Print Name: Biltmor Incorporated 544 R Salem Street City— Wakefield, MA 01880 Phone 781-224-0990 am a homeowner poWorming all work myself oI 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. Biltmor Incorporated Address 544 R Salem S reP Y Wakefield MA 01880 Phone* _ _ Insurance Co. Eastern Casualty Insurance poligy# WCV 0029253 name: Address City. Phone# Insurance Co. Poli Fslkm to secure coverage as 1equhe0 under Sedion 25A or MOL 152 can lend to the Imposition d criminal penalties d a tine up to$1,500.00 andfor arm years'Imprisonnont=well as civil penalties m the form d a STOP WORK ORDER and a fine of($100.00)a day sgalnst me. I understand Brat a copy of this statanent may be forwarded to the Office of Investigations of the DIA for coverege verMeelon. I do herby cw*under dre pains and panefts orpegLNy drat the kWWmatbn pkovidsd above Is nue and correct Signature � mu_ 9' -�-�.u_aj-th - pale 6/5/00 Print name Simone E Ac`r;avert; Phone# 781-224-0990 Official use only do not write in tale area to be completed by city or town official' ❑ Building Dept []Check jkmnadals,esponse ts,epu*W Building Dept ❑ Licensing Board ❑ Selectman's Office Carrtact person: Phone a I] Heaiiir Deeps i mint 0 Other FORMWORKMANT COUMNSATroM ''✓>lte �%'a�iainaiui�ealr� ��. l��a,;�ec�ra..e/% DEPARTMENT Of PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Nueber: Expires: Birthdate: CS 070451 12/18/2000 12/18/1463 Restricted To: 00 KEVIN l COOPER `y 7 KIMBALL LN BLDG A LYNNFIELO, MA 01940 Tie nowt~n,.eaAa G ,aa BOARD OF BUILDING REGULATIONS r.a License: CONSTRUCTION SUPERVISOR i Number, CS 024978 Birthdate: 12/14/1949 Expires: 12/14/2001 Tr.no: 12353 Restricted To: 00 SIMONE E ACCIAVATTi 544-R SALEM ST WAKEFIELD. MA 01880 Administrator 11/16/99 MORRIS "Insurance Agency THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ""0010 427 Main suranc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MOLMA. TMS CERTIFICATE DOES NOT AMEND, OMMO OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Wakefield MA 01880 COMPANIES AFFORDING COVERAGE (7 81) 246-1514 COMPAW A General Star Ind_emmityCvmpa_nv. COWANY Biltmor Inc. O Eastern Casualty Insurance Company 544 R Salem Street I COWANT L 0 Arbella Mutual Insurance Company Wakefield MA 01880 COMPANY 4 781 24-01990 D t.5"!. •" ...nary.tix•i., xt„1;a,.:.irS�.�-ni...t..�.::i....� r.Y�«,.: �.tx.r ..!R s .rsay,:.,..�?.^.!:�-`.`"t...'... .�.:.: K. :: ::.j..,. THIS to TO CERTIFY THAT THE POLICIEO OF INSURANCE LISTED BELOW M AVE SEEN SoUED TO T14E INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWFTHSTRNOING ANY REQUIREMENT,TEFIAA OR COIWTTION OF ANY COPITRACT OIR OTHEA aocumor WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISBUEB OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POUCH DESCRIBED HEREIN IS SUBJECT TO ALL THE TQRMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.UNITS SHOWN MAY HAVE 3EEN REDUCED DY PMC CLAIMS. cc A(NOWML UPAMV GENERALAWFZ3ATE I—Xl7 cowMipCIALO&"rwLLd suT1'� IMA 257109B ilo/30/99 , 10/30/00 ' wz&-cTs-a up/OpAcao s2,000, 000 Q---nMAW:-i"i occup i PE i i RSG—a aw ftURY '3110 0 0,000 owWEws n,CONTIVOTOWs rirOT i , EACH accxLraaENCE ;S 1,0 0 0,0 O t) X'Contractual I r P!?E❑AMAt3E;Ant t1M*fit 1 50,o c.0 i MED EXP rAm cn.comm) 'S C~�* o 110644000000 10/10/99 10/10/00 commIsimwaLEUMIT 11,000,000 Au cavnleD AUTOS I ' DILA )RY 1(J 9Gf:X LcM AUTC8 1 _ $ F WM AJ"09 i I ' 9o[7LY tN AJRY j s KWOFMED oROPERT Y OAMASE' 1 I Gwvm UA,SLM i ALTO ONLY-EA ACCOC-TIT 1 �-ANY AUTO / j / / OTI-W THAN AU70 CNLY; ShCH ACCIDENT 1 1 AGGREGATE!S A Dosses u..r m1 EAXx+occNRAEF+ce j*2, 0001 0 0 0 X UMBRELLAFOIM 1 IUG 346255EI 110/30/99 10/30/00 i.AoWECATE 12t_000,900 — On*p THAN L wRa:A PCM B 'OOwww CO wwAATIOM ARD I I _ STATUTORY L INIM IMMI1DYM WA"m :WCV 0029253 09/24/99 09/24/00 .EACrIACC;06NT 1 100, 000 J �DucY Laub a 500,000 PAHTNEARIEMMINE —+ OFFC0Fg ARE. !E7R:L 1 axAse•BACH EMPLOY; c 100, 000 oTWs� � j i I Oescro"ON as opSRATFOfts LoCAfrom •�w�.....�., ..�i�'�` <an a a xo xs, rtt$.. �, ,..a, _ <4c a ....... .. ...... .« .:._ .:.Y _..,..,> >. .. ..,.,.,.. . . .. . T. SHOULD ANY Oi IME AWK XfiscRmm POUCK1 W CANOn4j[D SEFORE TWE WMAWON OAT! TMI TMC umme COMPANY WILL OOfAVCR TO YAK 0 GAYS worr N Memo To n&eVMPICATS MOL06Ti NAMCO TO THS L.cFT. a/T/FjYA�_1TO MAIL SVCN"07=SMALL IMPOSE MO OSUAATWO OR UANUTY OF I ANT WOM T%E CoNp&W. tTs LOfwn OR 16poss"TATnOES. AU i J�/�p�.�E .,,nv _:.z,t.o.ii,. so.:::r•:+it>:' g '� IMMIMUNTATM YAL. E June 5, 2000 Mr. Michael McGuire Building Inspector Town of North Andover - 27 Charles Street North Andover, MA 01845 Dear Mr. McGuire, This letter will serve as my approval as the representative of Yale Properties, Building Engineer for North Andover Mills,that the attached construction document as specified on Exhibit 1M for the addition of a new interior wall to be constructed within the existing Conference Room of Media One Advertising, 43 High Street is hereby `approved' based on the scope of work indicated. Attached please find a `signed' copy of this document(Exhibit 1M) If you should have any questions,please do not hesitate to call me at(978) 682-9494. Sincerely, Arthur Boujoukos Building Engineer North Andover Mills One High Street,North Andover,Massachusetts 01845 Tel.: (978)682-8708 Fax: (978)682-8713 Blitmor Incorporated 544 R Salem Street Wakefield, Ma. 01880 781-224-0990 781-224-0987 (Fax) LETTER OF TRANSMITTAL TO: DATE: 'OO JOB# /` ATTN: Aff mg BOUTwos V, PH: RE: Abld FAX: WE ARE SENDING YOU HEREWITH VIA: _ -r Fax Pages AIRBORNEHAND DELIVE FIRST CLASS MAIL UPS JOB SITE WALKTHRU PRIORITY MAIL FED EXPRESS OTHER THE FOLLOWING ITEMS: DRAWINGS SAMPLES PRODUCT LITERATURE SPECIFICATIONS CHANGE ORDER OTHER COPIES DATE DRAWING NO. DESCRIPTION WILMA THESE ARE TRANSMITTED AS CHECKED BELOW: FOR APPROVAL W,8 OMMENT FOR YOUR USE AS REQUESTED INFORMATION RECORD FOR BIDS DUE OTHER rwREMARKS: (L , .0000-1 ulL14 COPIES TO: FILE If enclosures are not as noted, please info immediately. SIGNED: ALAA Lord Allen 06/01/2000 10:10 9786828713 YALE PROPERTIES PAGE 01 Town of North AndoverMORTH O�4t.'° �1ti Building Department 27 Charles Street North Andover,Massachusetts 01845 (978)688-9545 Fax(978)688-9542 4 + y 1'-VACMU �tty I DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit# the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MOL cl 1, s150a. ✓The debris will be disposed of in/at.• Raynaham Landfill, 1958 Broadway Street, Raynaham, MA Facility location _ 1 Signature of Applicant SimoneE Acciavatti June 5, 2000 Date i NOTE: A demolition permit from the Town of North Andover must be obtained for this' project through the Office of the Building Inspector. i tAORTH own 0 4Andover 0 No. �I Z. ~ Y �o 0 LA E dover, Mass., COCHICHEWICK 0R ATED P,?9- Cl S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System 0.19 ;> 1PA00f4MI 400- m�d &fw j00 ##0dBUILDING INSPECTOR THIS CERTIFIES THAT............... ........ . f .................... ......................... Foundation has permission to erect #1 buildings on ....... .. (S� ...... Rough Chimney PWILV f Ww to be occupied as..... ... . �.v ..................................................... .. .. ................................. 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 Ins 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 T ELECTRICAL INSPECTOR Rough .. ................. ..... .......... .................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough 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. TOWN OF NORTH ANDOVER BUILDING DEPARTMENT -U I APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING M OTHER THAN A ONE OR TWO FAMILY DWELLING -"M z (r nm Nng, 2-1 -ff 4 � , S�, for Official Use OnI ,AT�Ws Se�ction BUILDING PERMIT NUMBER: <9a3 DATE ISSUED: 0 SIGNATURE: /9 b BuildiN Commissioner/Ior ofuildings Date 1.1 Property Address: 1-2 Assessors Map and Parcel Number:, N. A;QDy;Jd— M%0—S Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sf) Frontage(ft) 1.6 WELDING SETBACKS(ft) M Front Yard Side Yard Rear Yard Required Provide Raluired Provided Re(*red Provided 1.8 Sewerage Disposal System: 1.5. Flood Zone Information:1.7 Water Supply UG.L.C.40.§7�) Public 0 Private 0 zone Outside Flood Zone 0 municipal On Site Disposal System 0 - NO Historic District: Ye 05 1 44". 11 � :K SEEM "I M 0111eT,M��-M— s----No 2.1 Owner of Record /\//-I In P ft P-T-rjE ms/ L P. y A L.F- f#.a&*--)A k-$ U-S 114, 11 C-, WW NOnA� A000,id- V\kcl-k ST. L 7oz Glut-MS fbLo Sr LjE-LL- Name(Print) Address for Service: M Signature Telephone X 2.2 Authorized Agent > Name Print Address for Service: z 0 Signature Telephone z M 3.1 Licensed Construction Supervisor Not Applicable 0 J-G Hj 9 Z� Address License Number 0 L4LjF-LL--1-%rt O i a sc-t Licensed Construction Supervisor: a-2-7-OL/ > /. q -7g. ?6r-u QCA=A jsl-- /-- 5D 8 SZP(- JW0 Expiration Date CL" Signpe(ure Telephone 3.2 Registered Home Improvement Contractor < Not Applicable 0 Company Name'. Registration Number M Address Expiration Date z Signature Telephone 0 SECTION 4-'9VO RS COMPENSA?IOT G.L C I52 .¢... �� 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 Yea..... No.......❑ SEC'l`ION S-P.ROnSSIONAL ESIGN AND CONS�RUCfiION.S)�RVi ES )�CORBUILDMGS AND STRdTCT[JRES. CONSTRIICTIt71Y COAT IRDL Pt3KK5'ttATT Tb 7fT(l CiIfiR 116(C0NTATG MORE THAND35,(!OU GF OF El�t"I,OS1b D SI!ACE) ... .. . _. 5.1 Registered Architect: (7 pm5 C.AM�-� Name: Address • 203 • 26.5.3 S� Signature Telephone ,5.2 R ttir6d°Professitifiil Area of Responsibility Name: Registration Number Address: SExpiration Date Signature Total - Not applicable 0 Name: Registration Number Address .Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number r Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature, ' Telephone Expiration Date y�.,,,�`;, Qy t Z- may- &SSCcA-QS //°;,c— Not Applicable 0 Company Nam Q� Responsible in Charge of Construction !`� ,K�tE�tl�'`I�,+�1„►N�'�Pi�Q �+Cl�$ {c}Zeck�,�tpl .��., New Construction ❑ Existing Building Repair(s) 0 Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: W D USE GROUP jCheck as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 0 A-2 ❑ A-3 ❑ lA ❑ A4 ❑ A-5 ❑ 113 ❑ B Business V 2A ❑ C Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A IInstitutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R residential 0 R-] ❑ R-2 ❑ R-3 ❑ 5A 0 S Storage 0 S-1 ❑ S-2 ❑ 5B ❑ 1 U Utility ❑ Specify: M Mixed Use 0 Specify: S Special Use 0 Specify: 4 COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: ,� r-141 CQ,, Proposed Use Group: O Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: Z BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels } Floor Area per Floor s Total Area s Total Height ft Independent Structural Engineering Structural Peer Review Required Yes ❑ No SECTION 10a Owner Authorization- TO BE COMPLETED WHEN j OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property Hereby authorize o4 i, -- to act on " My behalf, in all matters relative two work authorized by this building permit application S"g4Zt��3nature of Owner Date s 2 `Wal -, =L as-9,�uthorized 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 11 pains and penalties of perjury Print Name Signature of Owner/Agent Date Si it 'MR-10011"Of Item Estimated Cost(Dollars)to be Completed by permit applicant 1. Building (a) Building Permit Fee 2--L, 000 Multiplier 2 ElectricalO O (b) Estimated Total Cost of Construction from(6) 3 Plumbing -4G�- Building Permit fee (a)x(b) 4 Mechanical(HVAC) Soo 5 Fire Protection 6 Total (1+2+3+4+5) Z O Check Number a s aU a y ri7Z�'at t � "y t �'' a +t'7 a� > 3! •i.� "a y t �y, ?� 3.x� x � �""! 4�a t} �(zF s t,�y- t y -: z s' +^ �t NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1T 2ND 3RD SPAN DEMENSIONS OF SILLS DEMENSIONS 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 Location � No. �3 Date 7— 4 a 3 NORT„ TOWN OF NORTH ANDOVER + .. oR a • • Certificate of Occupancy $ ��a ^'•'t�' Building/Frame Permit Fee $ '2-70 s�C14U Foundation Permit Fee $ Other Permit Fee $ V— TOTAL $ 2'0 � Check # 16 5 � -- Building Inspector The Commonwealth of Massachusetts Department of Industrial Accidents office al/aYestivat/oos 600 Wzs/di`,+on Street :y Boston, Mass. 02111 Workers' Compensation Insurance Affidavit - - u ---.� lszcatinn• L1IY When zY ❑ I am a homeowner performing all work myself. ❑ I 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. comoanrname• V OT E 13I.ITLE-1Z a ASSOCIATES address: STED/ngA/ S%REp_/ SU/TE city: a wi✓cL , /�Il�. q 7F- "159- 76 00 -, i /� nhone N: insurances GRINUITE STcrs .;-)s. Con1m0yf� poficyN W 5 310-1.,7'c26 ❑ i am a sole proprietor,general contractor,or homeowner(girt[one) and have hired the contractors listed below who have the following workers' compensation polices: address: city: phone N insurance to. oelic„� - ttawaw�w comnanv name• address• city: nhone# insurance co. nnliev# Attic a �tnona a neeessaty Failure to secure coverage as required under Section 25A of MGL IS2 can lead to the imposition of criminal penalties of a fine up to S1400.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 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. /do hereby certify under the pains and penalties of perjury that the information provided above is true and correct i Signature �� Date Print name Phone# 9,hp3 ' 5-5 ` Official use only do not write in this area to be completed by city or town official city or town: 7 permit license# nBuilding Department 0 check if immediate response is required OLicensing Board ❑Selectmen's Orrice Health Department I contact P ent person: phone N; --Other 1—..d)AS FJA) YA.L. E July 8,2003 Michael McGuire Building Inspector Town of North Andover 27 Charles Street North Andover,MA 01845 Re: Town of North Andover School Committee-43 High Street,North Andover North Andover Mills Dear Mr.McGuire: We have reviewed the proposed construction documents for the interior build out and modifications to Buildings 9/9A 2nd Floor and Building 44E 3rd Floor, 43 High Street,North Andover Mills Complex for our tenant — Town of North Andover School Committee and approved the following construction documents— J.D.Enterprises(Davis Caplan),Drawing Al dated June 27,2003 Attached please find three (3) complete sets of plans along with affidavits from all necessary architects and engineers involved. If you should have any questions in regard to these construction documents, please do not hesitate to contact my office at any time. We would like to thank you in advance for your time in reviewing these documents as quickly as possible in order that we may commence construction and realize critical time elements. Sincerely, r YALE P PERTIES USA Stephen K. Smith Senior Property Manager cc: James E. Lesko III,Regional Director of Operations,Yale Properties USA Cross Point,900 Chelmsford Street,Lowell,Massachusetts 01851 Tel.: (978)453-6666 Fax: (978)454-6394 BOARD OF BUILDING REGULATIONS i N!License ,CONSTRUCTION SUPERVISORkop iNsn . Number: C5 053952 1 I Birthdat@ 02/27/1952 Expires: 02/27/2004 Tr.no: 19498 Restncted: 00 JOHN E BUTLER 67 PAUL REVERE RD -i elv- 9 CONCORD, MA 01742 Administrator i 1 OFFICE OF BUILDING INSPECTOR of aae, 'dry TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL. 7sSACH PROJECT NUMBER: PROJECT TITLE: North Andover Public Schools PROJECT LOCATION: 43 High Street, North Andover, MA 01845 NAME OF BUILDING: sections 9 , 9A, 44E (see Key Plan on drawing) NATURE OF PROJECT: Repairs and ,decor. including non load bearing partitio: S IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, Davi -, C'ap1 an REGISTRATION NO. 5697 BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFIC ONCERNING: ENTIRE PR.OJEC ARCHITECTURAL a STRU URAL MECHANICAL FIRE PROTECTION ELECTRICAL OTHER(SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE,.ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE.AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conformance to the design concept, shop drawings,samples and other submittals which are submitted by the contractor in accordance with the requirements of the constriction documents. 2. Review and approval of the quality control procedures for all code-required Controlled materials. 3. Be present at intervals appropriate to the stage of construction to become, generally familiar with6the progress and quality of the work and to determine, in general, if the work is being performed in a.manner consistent with the construction documents. PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT �tigED �RCyll TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOCAp� �J UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE o No.5647 SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FUPAN 01, NEwrm MA SIGNATURE ok��glTN p f MAS�P�� SUBSCRIBED AND SWORM TO BEFORE ME THIS DAY OF 20 NOTARY PUBLIC MY COMMISSION EXPIRES ✓vi _3a0 / Locationrr �u 1Je�v cS�L X07 Date . ��1--- Ga- • ' TOWN OF NORTH ANDOVER O • Certificate of Occupancy $ v - . Building/Frame Permit Fee $ Vt Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#1 25094 Building Inspector NORTH TONM of No. .,. SW LAKE Of dover, Mass., � 110COCMICMEWICK ADRATED S BOARD OF HEALTH 4 PERMIT T D Food/Kitchen Septic System pp BUILDING INSPECTOR THIS CERTIFIES THAT........ .�....X.�5.. ............. � �.:... OSO��....................................................... : Foundation has permission to erect............:........................... buildings on ............... �. g ` �� 0 f �11............ ................................... ough 46 Chimney�� ® Chimney to be occupied as ...... :i ....... .:........................ ...:. � ....... ... �� .......� ......... ,................... provided that the person accepting this permit shall in every respect conform to terms of the application on file in _Finai r6< t' this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of 7 Buildings in the Town of North Andover. " PLBIN INECTOR • h VIOLATION of the Zoning or Building Regulations Voids this Permit. Rou g o 3 Final PERMIT -EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION TARTS Ra' P, +� oug ,� ..................... ......... .. . . ....... �.................. Service BUILDING INSPECTOR 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. of ,•nT•q Y ' • -r CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH A IDCVER Building Permit Number 5(00 Date: March 13, 2012 THIS CERTIFIES THAT THE BUILDING LOCATED ON 43 High Street, North Andover, MA 01845 Simplicity Salon MAY BE OCCUPIED AS as a Beauty Salon, IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Simplicity Salon 43 High Street Suite 320 North Andover,MA 01845 Building Inspector Fee: 1.00.00 Receipt 25094 f 9289 Datel .'�' --. ri ,4, TOWN OF NORTH ANDOVE PERMIT FOR PLUM 1 G ,SSACNU`�� , v!YF!F!, `r!�h� This certifies that . . . . . . . . . . . . . . . . . . r: r has permission to perform . . . . . . . . . . . . . . . plumbing in the buildings of . , . , , , , at . . nl�h. ,.SIa11�, North Andover, Mass. Feelle. . . . .Lic. No../0 PLUMBING INSPECTOR Check # �� r MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK. i CITY I IU AdoJ e I, - I! � SIA DATE( ] -W-1 i PERMIT# JOBSITE ADDRESS '�3 I-I t S� 5�>�� L� I OWNEITS NAME�,en !k1_ - `� S.0/t)✓ OWNER ADDRESS Q3 H g h 51 TEL IFAX f r # TYPE OR OCCUPANCY TYPE COMMERCIAL I l EDUCATIONAL ( I RESIDENTIAL) .1 PRINT CLEARLY NEW: ( I RENOVATION:I REPLACEMENT:! PLANS SUBMITTED: YES I I NO( FIXTURES-1 FLOOR-* BSM 1 2 3 4 5 6 7 tl 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SBEWL WASTESYSTEM DEDICATED GAS/OIUSAND SYSTEM I 1 DEDICATED GREASE SYSTEM 11 t DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR INTERIOR KITCHEN SINK LAVATORY ROOF DRAIN - - - -- - y SHOWER STALL SERVICE IMOP SINK TOILET URINAL - WASHING MACHINE CONNECTION ; WATER HEATER ALL TYPES. --- WATER PIPING OTHER I INSURANCE COVERAGE: v have a ctirrent liabilit insivance policy.or its substantial equiValentwhich meets the requirements of MGL'Ch.142. YES(�NO ( i 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. 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. CHECK ONE ONLY: OWNER ( AGENT SIGNATURE OF OWNER OR AGENT I liereby certify l ha.1 all of the details and information I have subnutted or entered regarding this application aid tfue and accurate to the best of my knowledge and that all pfurhbing work and Installations perfotnhed under the permit issued far this applicafion will be in compliance vAlh all Pertinent pro ' ion of the Massachusetts Slate Plumbing Code and Chapter 142 of the Genera!Laws. I PLUMBEWS,NAME( �Ta m-S brilei LICENSE#I 1a(it,,9 I SIGNATURE --~� i MPS( JPl ( CORPOf;ATlON1 ldt! 7DLSPARTNERSFIIPI I111 ILLGI W1 COMPAW NAME 1 800j�& r,S M' �c� � 1 ADDRESS i P.'pI� CITY1 G�v <s O-4Na STATE I !'P�1 ZIP b1 3`I. TEL( � 3�y7�3`�➢ FAX 19% ? JS CELL 17)0 _O/531EMAIL j �Tir► Q�riK AI�MtU'5P)U/116,r, - coo- I € ( i ROUGH P LUM]3ING][NE T ION NOTES: ML-p-1 FOR or� �ICE USE,:ONLY ENAL$NSPEC"g ION NOTES Yes No i67 © f a �� THIS APPLICATION SMVES AS THE PERMIT c] [] /� FEE::$. PERMIT 9 x E 3 r flrCpfitiloii�>•�eci111�r��Y1�is��cc1i��s��t� , !'i!i` gitti�tIs x i#SfogMtf.02171 '��'cit•tcE.t�s�'G$ont�oti5(itnote°�i[s(t>E ����fficla�►i�:l�rJd`e��;..st+c"®�€i•�iE>Cos!l�le���Ycifitisl� �,�%:��� �i :�t�»liesesi(:Elirt~et�trrrt�oii 1 I��Riti2�R�43iu��rOi�l!ti3iitien7irilirydualj:, �fJC moi', t_�l�n'$+ R �7 ��'1'�. f /�C�f�EBSS:. � �.•Z - 9 ..:... R[` tr��rtertTl�i�ti:e[?Lirecfirt6rcttip�r�uC�r#�lebow , _VD TS Tbv`Ttojcct(,Vc ff e : !Alf-tMnTtrenTpto cr«itk. rl.[ [auttTgcuctnlctii[lracto;tutt l t enipto}:ecs(fidinuct�oritattCitr!c):�= haveitfrcdlltesaii-sori{rncloT� � d'KGtEC6fistniclio[t i 2.DXamasolo proprie€oror.portncr.- IistettcimtTe[titacilttls>eef t 7. ]12cn►oticlisg Still,1110110muto crapiogcos 7licscsub eoti(roOft havo S QjDeutolRigil [ xeort ibg.for. thPD),ftpfa '. %olker..'comp_fesiumtte. � it []`13Tttichlrgadtlifio>t g {IQa9�orgcis`coliip.:Jnstlrnnce $.❑�Vc�e:ecoltro;aliouanilitr n�itlttF.}• ofticersli.•Tvec.�ercisecttliciz �: . )t)�tsfecEucrd:leil,ititstm.acCditio3u: ; ` �.ClHitm.aliottjeoaxertion>siip��oz� tt,�titol`ereauption�crl4iGI. ,'� I1,��.'TuntGtugtt.�rtir�•ogatittitiou4 � }� t1[�sell [itlo�rbrkcr�.cotulr. �.tS2i11��1) Auti9va[�ateho _ ;' i�,[�itoof'repali,�, insuranccrcgairecllfi vhpfoyos.tNo,sorticis` !: .. ct+ttlp.f»sTlr:iacerzgt;trecfj 13,�Ot11ec - - °It•11fFd+��)icnCf6�Ccfta)sb,tllairs{rl;ofi4ituClT.C:CfEic;lit€Ja`s)!JUE+1c11tarllL'r€'iry'COitt�:�11.8ti0ttj{J)tC}ItfCOrtllBfin - •Ft+yin:autt�fs�+)msulmtitlt3ise�i;tuitf+>aie�tia,�ri:c}•rreda:l!�rTln•.�tF:rr.811!eitttfrednGE4tEculraCibisuial;lsu�alitnhttet!1t}�teitt<tlita:m�str,tr. fLbari ;fti;;l)�t �t,ikl4:ilo>;ta+r,[;:tat€:t�9.nr:.iJiiio�tTsi:re[SLatrut�l):.t�r,Ce�iFlStstiU•tapir;ntt�,rdtiuiitti+iFcn'at�a_r�ic�F�+C.viuu'r�r_ F lrurdrrrc°. ,ri�il�t:c�rlknllrlirvtlrtittb�n�nrl��rs'cnill,E=rrsrrii�rrfirruraneefrmEreiryrfvgees 1etc+tr�frtL��,dlk{�nurjob sl&��� � lrifnritrrrtlott. 1.i's ara'cc Coll 11Mw}:I�'ruiTe n..4YUG cI��D�U�Ia ,�lL porlewikorteifitts.Lie./1: ��ti `1 ._ jiiritti[it4tJ3fC:•. �. 3b1tSi1¢1ittri�ss:•�t, t t Li1CaEilil�-. //E.�l .'•! AUacit co - a j>�;gf(E�c►Eoitstxs colt[JteTls�itpohirbloG"tlecilu•nE�rClage s�Q[�a'8ie ' ev iui�r r ' i t�.'iilltcCaao�ur>�.t:6r?ei: aasre uo'zdtnrtt'e�See)itTit `• � R �3/i.oC�rltjT�t5�2ert�T['eatlfuCircittiJ,ursiEromQfccnttirinpkttatfie.�,cT1'a €ii10 u1f is I., Op.60:+uc i oi► }ean it►1prisQHrrTent;as[ralGas eu CK-ir1? aleics iiLtl< forar.t?fa STOPr[�'E11tKiI(i.�ii!itGatil�C 1 € ti€lip(oS256):OOaday ag'.111S€t;1Gviolillor. 13cattvsc<ttltat:ttce y af(tiirs(aEeallerttfnzshefonvaretetl(c+(Etep(�teeotr ; tltveslrgatiQtrs_af"ffie Tpthfnsiustrmuce�>icrr►ga teeifrcatibaa IrlolrereLj•certr rrrrlrretL�Iurt,�crtrtrurti€esa�fperf ,�llrtrfllrc/rlorrWtrliir�Ejr�s6rtifitwi�6firreairti°�cr�rE. .�feriafttre:• 13 e � r Z Pti ue `7 5 3 :. rolinl � rcWf-acr�in 00itatIItirt�r`r Mm-area,tobeColluiFc�r�Lsct�oPlo�r,s�`lrfl.tziCt'iolTieAL•iketr2cn�frsslaet(opt-1'1�[rrt�#irgfrrs)leow ci�oxlP b-form fi'Iassttchus�fts,GeneralL�t�vs Chapter 152 regtti�ct][erityIbyers•ioaitati�id'e:iY�lcrs'cQln�ibitsfiton foFflleir•�ntpTn�ees., 'tt(stiattttotnts'stafttfe;_:aneri�i'o��e,3.i��Te6ltec)<as`:.t)i�ei�persoitfni�ie>setslce ot'onothcr tititler�t�+•calttractoflnte,. etpce�orititpliect,Pm1oF15�•itteit:.' - 11 ctrl la�eriste ilted "tsi nillvicTcisl ya itctsliip;,n�4 iatiott;c¢ppi tion orotherlegi#LetitiGyFoirap}+ itaaaaiioiz nEtlt�f0izgo1n9eii9agg1-kajAV Iterprise,aitiIfit-hm,ugthe:hgalisproolltath,r S.Of ideceased-W1Ptci}_et;or)he recentesorF�ztste ofetfutclit•.idt4al,)aarGtersiiip,.RsS' ci�rtiono>oUterlegilen its; tifiiy'ittg.olopIayees linzueiert e oiy'19 noitlibrz iltau tFu ee apartutents:ancl vrlia r sicfestliereiir;or the occupant offht tti�ef(iitgltottseofatioflierivlioetnplo3ts�ietsousf6do•ntaiistenauce,constntctione tepatrtor eo.oil saclidwtlliitgltoiis r t pu_Ilii;grotnidsor Gttltcliilgp�Ipuriett�tttttltereto!11a11�no6bzcatrse ofsucll.einployntentbe d entecT tb l e t entplayetr'= 11�GLcIlaptcrl$2,° �C 6.atso'slatesf]tat'``ever�shtfcut.itoealiicells!]tgg 1*190,19 61"XivIthhot(Ttlidustiattceor t) . }�etteii;a'G'a�'niteells�b�perntitEoapera'tettbttsiteessot�foeonstt�itctittilldlugsinfltcconnrioiu�eatflt3'oi•sttt� ,np�lleanE 1s1a�fias,iiotprotluceci nccepfitlrleei�ictelice of coniil}iattcetviflLihe:4lrs[irsiucegottet•�ge i:ettttitec�." Additioitalty;llQGT:cll�liter152,§25C(?}states."�l`elther thecomntonlvt;altlt ttorad}'o�itsp;aliticai$abdivision�s11zT! giitfrinto'MY colitiad fortltcperFormaitccofpubligivork-untilacceplabTeevidenceofFottipliatimWitltthe insurance reffiitieinents ofttis cltapterltavail;;cltprE;setitec(;to tliG c6lttr�icting PuflloYit}" . Please lCouttltYi4or:erz'cotitfieiisationaTfnl titt6piple�tal >>ji3eiV71ec1:iitgtliebosesih tapply�(ayolirsituatipnazitt,if 3tecessar�;stt lysub-contractors value s address es slid Ttottenuihtiei(s alottgxtiilhtheu cectcale(s)qP ppy {� ), ( ) p insttra►icc.UnitedMabilits Cotnpafties(LLQ orMnRed Lialii ityPxttnetships(LIP 34ilit na eulplgkyezSotltet lligti:t to lite-nibers orparfners;:ireitotreoutredto eatxyt"workers`conlpollhCtoit insual",e. IfanL1;G orLI,P floes have etytplopees,apolicyisregaired.,B$z-tdvisedthat WISO ''daviltntaybesiibntittecitotheDep;•riiiientof7ndustj I - Accideiifsforconftrniafioitofinstn-ancecovetage. A'isbbasucetosigitrid(latetliettrf[tlrtvlt< ?lter;€Lidavifshotltd be reftmiedto the.cit}or town that Ilia application for Ilia permit or license is being requ sted,noJ'tlteDcla. ett`s of Fnitttstrt'nl r'Lccideiifs. Should yoit hrii Z alty'�uesi qns rcgarditigdlte late•n:)fyroit€ire required to obtaki a lwrltet's' Pollipt;ii ltionpolicy,pleasecalltine'D jiailinefti•rittitenuntber-listedbelo .= e]f-itisttre<i.cotilliattiessltoulclenfertllcir iielf-itisutattce license numberottthe,i ropiiate-line. i City or Tpji7i Officials I'lettsebdsetrefiiitttlieaf idavitiscotioeteattclprintetl,lealbiy�. liebep8lttlle)It11aS 11'OY1C�CfIPSjfitCeil IlI�GDItOttt ! ftiie.2ftidavltf0t s0ft.f6ftlbiOntheevaiit.theOfticetifhivestigationshastocotttnctyoure6rcluigilit appfieant, PleasebeRnO Wfill in the pennifFilconseliumb'lvlltch tvlILbelised as a:reforeneeriluliber. 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The Conitrtmmolf q �\'i{;sir,:�liillefts - .Ne adfflle tt Ofhidttsteltil Aeofdemts Office of lvgllghf[ok 6001vashingtott Street Boston,14&02111 'eT.it 617"727- 000 W406 Di'1477 MASSAP- I�ei{lseil �t�e��.iuttssgofrlclia Date.... '.�.z.� / 2 pOR7M TOWN OF NORTH ANDOVER PERMIT FOR WIRING f. CMUSE� r Thiscertifies that ................ .....i ../I......................................................... has permission to perform ..... , fG�t s�"`7 -S '� �°�! ........ .......... .. . .............................. z; wiring in the building of.....5�. �-...C.i � �Q Q!V �3 !� y at...... ........ ... ................................................... ,North Andover,Mass. y: Fee....7...5....` '.. Lic.No...`..7.✓. ................. RICAL INSPECTOR. Check # 35-112?76 10693 t 4o1f/LornanoFveafa66acnu6e Official Use Only Permit No. _ <.IJe�artrrFen('o�.rirs�ervi-oe3 - _ Occupancy and Fee Checked OF FIRE PREVENTION REGULATIONS [Rev. 1/U/] (leave blank) ' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electncal Code C,527 CMR 12.00 (PLEASEPRINTININKOR TYPE ALLiNFORAMTION) Date: City or Town of: 000-jg+ Iry p o U+�-2 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)•L/3 — Owner'or Tenant 57MpL.F-c rpt 4LLO�J _ Telephone No.4`7$- 791-(-0-Y0/ Owner's Address _ Is this permit in conjunction with a kuilding.permit? Yes ❑ • No (I heck 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: � ,11�5� Com letion of the followin-table maybe waived by the Inspector of Wires. No.of Recessed Luminaires No. of Cell.-Susp.(Paddle)Fans Ro,of 'Total Transformers KVA No.of Luminaire Outlets No, of Hot Tubs Generators KVA Ab -- No.of Luminaires S%immin ove In- o„ei Klinergency ,fig g Poa1 rnd. ❑ arnd. �� BatterUnits No.of Receptacle Outlets No, of Oil Burners FIRE ALARMS No.of?-ones No. of'Switches No.of Gas Burners No, of Defection and Initiating Devices Na. of RangesNo..of Air Cond. Tons No. of Alerting Devices No.of Waste Disposers Heat Pump I�Itim,be� Tons KEN No. ofSelf-Contained .... _.. Totals: Dete.rtion/Aleitincr Devices_—_ • No. of Dishwashers Space/Area d'`Ieating KW Loc�el❑,Mrrr�icipal ❑ Other connection No.of Dryers heating Appliances K w Security Systems:Y No. of Water tdo.of'Devices or Equivalent_ heaters KW No.of No. of Data Wiring: Signs Ballasts No. of Devices or E uivalent 3- rNo. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: — No,of Devices or Equivalent OTHER: 0! Aflach additional detail if desired, or as required by the Inspector of Wires. Estimated Value f Elctrical Work: �`�� (When required by municipal policy.) i Work to Start: 2 -,7$ /Z , Inspections to be iequested in accordance with MEC Rule 10,and upon completion. INSURANCE OV RAGE: Unless waived by the owner,no permit for the performance-of electrical work may issue unless the licensee provide, proof of liability insurance including"completed opetation"coverage or its substantial equivalent. The -undersigned c6rtifies that such coverage is in force,and has exhibited proof of same to the permit issuing office, CHECK ONE: INSURANCE [A BOND ❑ OTHER ❑ (Specify:) I certify, cruder the pains and penalties ofperjury,chat the information.on this application is true and complete. FIRM NAME: -S�T ---ScCS�r\ S� ,t � LIC.NO,: Licensee: r+�� }o Signatur94 . LTC.NO, G(Ifapplicable, enter "exem t"in the license number eAddress: 1C,t-i Yi d-n r. ,4 `t�S,da-0 AICTe1.N'o.: `Per M.G.L. c. 147, s.57-6I,security work requires Department of Public Safety"S"License: Lic• No, OQ Y5.3 OWNER'S INSURANCE WAIVER:, I am aware that the Licensee does not have the liability insurance coverage normally re•uired b Iati* - t. F� m in , q y signature below,I hereby waive t ' Y Y g y his requirement. I am the(check one) []owner �=]owner s aeent. Ovener/Agen t Signature — Telephone No. 1'E1IT F ---- AP:EGISTERED SYSTEM CONT�ACTOP=' . = - ISSUESTHEABOVELICENSE I;O: - - RDi;'SECURTT-Y S_SERVIL'ES•, :.INC: MAP,,K:-:A BP,OPHYR -':4•lo 'UNZVERSITY.-AVE . - r1 C o. -:. ES-! W.CI O D C' 07/3]./1.3 -'cad-,•-��y�11} �� 7 tJl••t tl• 15 �•'11 ;�•tr ,,` .. (";•.._ _ •.poW.Than Dal3cn Alan¢.AA Ptroradons .� eZ Keep top for receipt and change of address notification. DPS•OA1 a zSIJ46'D9dD162009LiCENSEFOAMI ✓/;e•�v,:.n�noau�edl�,c��I%�awa�r4:et�t . DEPARTMENT OF PUBLIC SAFETY S-License : A Numbe�:'SS CO 000953 / - - "u�y Expires:'•02/07/2013 Tr.no: 195.0 S-License: ADT . MARKA BROPHY•SR' 410 UNIVERSITY AVE (J'� L WESTINOOQ, MA 02090 L---- — DIG SAFE-CALL CENTER: '(888)344-7233, j Commissioner , Date.......... �a0RTM °�-�``°:•'"� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING IL CHU This certifies that ...........`... .................... .... Z1j. a` ...... ....... �46) has permission to perform ........cwiring in the building of. ,) -/e�T7 � .......... ST". S� at y3 ......y 3 Z� /:51,* ,orth Andover,Mas Y Fee...!. ^"". ' Lie.No...v.(�.a I/ ................ . . ........ .. j ELEchucALINSPECTOR 6 r Check # 0 6'1'5 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town ofVp, Ode„ YW4 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) 6/� //1354; --,j `" 4-320 Owner or Tenant .Sih7 ` ` �� �;� Telephone N 9J4,;1 X/-C�t!- / nC� G r�Y' J 9 / .., �J Owner's dress k.0 /L ►r!L>y�{1/i� /A LL �� om Q 7 &kkt? .Sh t .`.xP %; Adry' /� Is this permit in conjunction with a building permit? / Yes ® No [:] (Check Appropriate Boa) Purpose of Building fain;,,.-,f.;.-I R, fps I 1 Utility Authorization No. Existing Service ;''t) Amps aQ / C',','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: _8 1y/ jf, Ir Completion o the ollowin table maybe watvedby the Inseectorof Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans o.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of LuminairesSwimming Pool Above [:] n- ❑ o.o Emergency Lighting rnd. grnd. Battery Units No.of Receptacle Outlets Y No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.of Detection an InitiatingDevices g Tons o.og No.of Ranges No.of Air Cond. Tocol No. Alerting Devices No.of Waste Disposers eat Pump .um .er. .ons " . -""' o.o e - ontaine Totals: ..... Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local[:1Conneectiuniction E3 other No.of Dryers Heating Appliances Key Security Systems:* �' No.of Devices or Equivalent No.of WaterKW o.of o.o Data Wiring: Heaters y Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP a¢communications Wiring: No.of Devices or Equivalent 1 OTHER: IF Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work-. (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such covers in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Er BOND ❑ OTHER ❑ (Specify:) I certify,under the pains andpena/ties of perjury,that the in ormadon on this application Is true and complete. FIRM NAME: W LIC.NO.: Licensee: W.4 7�- r F. Day Signature —1CIC.NO.: (If applicable,enter "exemph 11 in the license number line. ,,// // Bus.Tel.No.: '-6 !� 2 Address: /y2 A-I%&" e e 3 e -5 / Ys✓N i^/� �f, 40/220 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 r�nrequired by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent �ture Telephone No. PERMIT FEE: $ �'�, �� � 7. 8`h.. 3 � � �� Dom- ��l z t Z �" y� II i s !� '4 urri C Vi' CUILUINU IN,f tG I UK TOWN OF NORTH ANDOVER s: CONSTRUCTION CONTROL 218410018 PROJECT NUMBER: PROJECT TITLE: Simplicity Salon PROJECT LOCATION: East Mills North Andover, 43 High Street NAME OF BUILDING: 43 High Street Tenant Fit-Out NATURE OF PROJECT: IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, I, I lJOA. S M I L—ay REGISTRATION NO. Loo80 BEING A REGISTERED PROFESSIONAL ENGINEERIARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT ❑ ARCHITECTURAL ;< STRUCTURAL ❑ MECHANICAL ❑ FIRE PROTECTION ❑ ELECTRICAL ❑ OTHER(SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE,SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATICES. I t AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. `: t I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B ! C EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT 5s THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILD[NG°: PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 ; 1. Review, for conformance to the design concept,shop drawings,samples and other submittals � p which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials• _ f It - 3. Be present at intervals appropriate to the stage of construction to become,generally familiar ' I x r with6the progress and quality of the work and to determine,in general, if the work is being a r•, performed in a manner consistent with the construction documents. toy! PURSUANT TO SECTION 116.2.2 I SHALL SUBMIT WEEKLY. A PROGRESS REPORTi ' ~� TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOf x r UPON COMPLETION OF THE WORK, t SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OC UFANCY. S SIGNATURE SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF J4 u � --),0/ 2Li z2j��/ NOTARY PUBLIC MY COMMISSION EXPIRES W�3 The Commonwealth of MaaRaschuadtts a m a- day of -�a n un 20—L' lida►e me,the pDbc.Dmh�appered LIS SYM,SFU ' prosect to menxouph sxistxtoq of�dain�at�a..lad►i�en_�n`___w�rn e roDetdepen�slaserwneiss�edoohe,pr:tedinpaatbdreOQournerrtln,4_' odororde lome1w *Wp i britt.. pie T IE M. SAWM.iwt Puok CMWftbQ MasOCWW4.2013 1 2 3 •�.�c��cr��Rc s. c NRA(BURYP0,J MASS. 5 o� J SIMPLICITY SALON 0 A 43 HIGH STREET N . ANDOVER , MA X� r y { l I � _I COVER SHEET $ u R- -IF , H I L L Sheet Issued Drawing Number 01/25112 A.000 East Mill 43 High Street North Andover,MA ARCHITECTURE ENGINEERING INTERIOR DESIGN LANDSCAPE MASTERPLANNING 303 Congress Street 6th Floor Boston, MA 02210 Scale Project No. SIMPLICITY SALON Project Issued JANUARY 25,2012 TEL:617 423 4252 FAX:617 423 43333/8"=1'-0" 07804.18 ©BURT HILL INC. s 1 2 3 DOOR TYPES FRAME TYPES Y. J Al? 3 0 0'_2" 3' L2 0'-2" �+ PAINTED P10.14060 o HOLLOW METAL NEWBUR`r'Rt'iRT SOLID CORE FRAME , MASs. �v WOOD DOOR TO MATCH BUILDING STANDARD. a NOTE:ALL HARDWARE TO BE r� COORDINATED BETWEEN TENANT& A BUILDING OWNER B 1 GENERAL NOTES PARTITION NOTES 1. ALL WORK PERFORMED ON THIS BUILDING SHALL BE IN COMPLIANCE WITH ALL PERTINENT CODES,RULES, ORDINANCES,AND REGULATIONS 1. ALL STUD PARTITIONS SHALL HAVE DOUBLE STUDS AT ALL DOOR JAMBS,OPENINGS, AND CORNERS. OF THE LOCAL,STATE, AND FEDERAL GOVERNING AUTHORITIES. 2. ALL JOINTS IN GYPSUM BOARD ARE TO BE TAPED AND JOINTS TREATED OVER THE FULL 2. CONTRACTOR SHALL NOTIFY THE ARCHITECT,IN WRITING,OF DISCREPANCIES FOUND ON THE DRAWINGS OR IN THE SPECIFICATIONS. HEIGHT OF THE PARTITION. 3. THE CONTRACTOR SHALL FIELD-VERIFY ALL DIMENSIONS AND JOB CONDITIONS,AND WILL NOTIFY THE ARCHITECT,IN WRITING,OF ANY 3. ALL FIRE RATED PARTITIONS SHALL HAVE TYPE"X"FIRE RATED GYPSUM BOARD AND SHALL EXTEND FULL HEIGHT FROM TOP OF FLOOR TO CONFLICTS OR DEVIATIONS FROM THE DRAWINGS. DECK ABOVE. ALL VOIDS BETWEEN THE STRUCTURE AND TOP OF WALL SHALL BE PACKED WITH AN APPROVED FIRE STOPPING MATERIAL. FLOOR TRACK SHALL BE SET IN A BED OF SEALANT. PROVIDE FOR DEFLECTION AT UPPER STUD RUNNER. 4. ALL WORK PERFORMED UNDER AND IN CONNECTION WITH THESE DRAWINGS SHALL BE IN STRICT COMPLIANCE WITH THE LATEST O.S.H.A. SAFETY AND HEALTH STANDARDS. 4. AT ALL PARTITIONS WHICH INCLUDE SOUND INSULATION,CAULK W/CONTINUOUS BEAD OF USG ACOUSTICAL SEALANT(NO SUBSTITUTIONS)UNDER THE TRACK AND UNDER THE EDGE OF EACH BASE LAYER OF GWB,AND AT ALL INTERSECTIONS,PERIMETERS,AND 5. ALL CUTTING,DEMOLITION,AND PATCHING OF NEW CONSTRUCTION,WHICH IS NECESSARY FOR THE INSTALLATION OF NEW PENETRATIONS. CAULKING PROCEDURE SHALL BE TO PLACE A HEAVY FILLET BEAD OF CAULKING ADJACENT TO THE RUNNER PRIOR TO THE CONSTRUCTION OR EQUIPMENT,SHALL BE PERFORMED BY THE CONTRACTOR WHO IS TO SUPPLY AND INSTALL THE NEW CONSTRUCTION INSTALLATION OF THE GWB SUCH THAT WHEN THE BOARD IS SUBSEQUENTLY INSTALLED IT COMPRESSES THE BEAD COMPLETELY FILLING OR EQUIPMENT,UNLESS NOTED OTHERWISE. INSTALL LINTELS WHERE REQUIRED. MAINTAIN FIRE RATINGS AS REQUIRED BY APPLICABLE THE GAP OF EACH GYPSUM BOARD LAYER.SEE PARTITION SCHEDULE FOR ADDITIONAL REQUIREMENTS. CODES AND AS INDICATED ON THE DRAWINGS AND SPECIFICATIONS. 5. ALL PARTITIONS SHALL BE SECURELY FASTENED WITH APPROVED FASTENERS. 6. THE CONTRACTOR SHALL PROVIDE ACCESS PANELS AS REQUIRED FOR ACCESS TO MECHANICAL CONTROL DEVICES. CONTRACTOR SHALL COORDINATE REQUIREMENT FOR FIRE RATED ACCESS WITH PARTITION RATING. ALL ACCESS PANELS IN RATED PARTITIONS MUST MEET OR 6. PROVIDE ADDITIONAL BRACING AT PARTITIONS AS REQUIRED,TO ASSURE ADEQUATE LATERAL RIGIDITY. EXCEED CODE REQUIREMENTS, THE CONTRACTOR SHALL COORDINATE INSTALLATION OF ACCESS PANELS WITH ALL FINISH WORK. B 7. STC RATINGS ARE LABORATORY TEST RATINGS. 7. CONTRACTOR SHALL PROVIDE F.R.T.WOOD OR STEEL STRIP BLOCKING BETWEEN STUDS FOR WALL-MOUNTED EQUIPMENT. 8. ALL GYPSUM BOARD SHALL BE 5/8"THICKNESS,UNLESS NOTED OTHERWISE. 8. CONTRACTOR SHALL COORDINATE LOCATION OF BLOCKING FOR WALL-MOUNTED ELECTRICAL EQUIPMENT WITH ELECTRICAL REQUIREMENTS AND FOR OTHER WALL-MOUNTED EQUIPMENT WITH APPROPRIATE REQUIREMENTS. 9. PROVIDE FULL HEIGHT VERTICAL CONTROL JOINTS AT ALL GYPSUM BOARD PARTITIONS. SPACE CONTROL JOINTS AT A 30'-0"MAXIMUM OF HORIZONTAL RUN. PROVIDE CONTROL JOINTS AT ONE SIDE OF DOOR FRAME FROM DOOR HEAD TO CEILING IF POSSIBLE. PROVIDE CONTROL 9. ALL SURFACES SHALL BE PUT INTO PROPER CONDITION TO RECEIVE PAINT AND OTHER FINISHES. CONTRACTOR IS RESPONSIBLE FOR JOINTS AT COLUMN CENTER-LINES OR AS CLOSE TO COLUMN CENTER-LINE AS POSSIBLE. DEFECTIVE WORK FROM ANY CAUSE, INCLUDING UNSUITABLE AND IMPROPERLY PREPARED SURFACES. FOLLOW MANUFACTURER'S RECOMMENDATIONS. 10.CO-ORDINATE LOCATIONS OF SPECIAL DOOR HARDWARE REQUIRING REINFORCEMENT OF PARTITIONS. 11.MINIMUM STUD GAUGE TO BE STE-25.PROVIDE HEAVIER GAUGE WHERE INDICATED OR WHERE REQUIRED BY HEIGHT OF PARTITION. 12. EXISTING GWB WHICH IS INDICATED TO REMAIN&IS NOT BEING COVERED BY NEW GWB SHALL BE PATCHED/REPAIRED AS REQUIRED TO PROVIDE A LIKE NEW CONDITION IN ALL FINISHED SPACES. NOTES,DOOR&FRAME TYPES B V R T Sheet Issued Drawing Number 01/25/12 A.001 East Mill 43 High Street North Andover,MA ARCHITECTURE ENGINEERING INTERIOR DESIGN LANDSCAPE MASTERPLANNING 303 Congress Street 6th Floor Boston, MA 02210 scale Project No. SIMPLICITY SALON Project Issued JANUARY 25,2012 TEL:617 423 4252 FAX: 617 423 43331/4"=1'-0" 07804.18 0BURT HILL INC. � 2 3 D,ap�h� No.10030 CJ FLOOR OR ROOF ca NEWBURYP04T STRUCTURE ABOVE �o Miss. METAL STUD RUNNER METAL STUD BRACING A TO STRUCTURE ABOVE AT 48"O.C.MIN. 3 5/8"METAL STUD '--10'-5" SOUND ATTENUATION INSULATION, NOM.THICKNESS TO MATCH FRAMING DEPTH 5/8"GWB BOTH SIDES METAL STUD RUNNER B V////1111111111141�11— FLOOR STRUCTURE TYPE CO3 WALL TYPES B U R 1 1 1 I L L Sheet Issued Drawing Number 01125/12 A.002 East Mill 43 High Street North Andover,MA ARCHITECTURE ENGINEERING INTERIOR DESIGN LANDSCAPE MASTERPLANNING 303 Congress Street 6th Floor Boston, MA 02210 Scale Project No. SIMPLICITY SALON Project Issued JANUARY 25,2012 TEL:617 423 4252 FAX: 617 423 4333 BURT HILL INC. 1 1/2"=VI 07804.18 © 1 2 3 FINISH LEGEND: AR��� I( NO 10080 � SHEET VINYL FLOORING i NEI ROAT r NOTE:EXISTING FLOORING TO REMAIN UNLESS NOTED AS TO RECEIVE SHEET VINYL FLOORING. LIMIT OF WORK GENERALKEYNOTES: WH REUSE EXISTING DOOR AND FRAME IF ' WD] TALL ' POSSIBLE.RE HANG DOOR TO SWING OUT. ' CABINETS UNISEX BATHROOM ' O2 REMOVE AND REUSE EXISTING DOOR IF ' ELEC. MECH. MASSAGE FACIAL 'WAXING = YSHAMPOOROOM ® ' POSSIBLE. , ' ¢ VESTIBUL f FLOOR PLAN LEGEND: ' MECH.ROOM ' 13 0" c z ' CO3 EXISTING PARTITION TO REMAIN ' STORAGE ROOM 2 MANICURE 2 MIN �., NEW PARTITION ' I' -0, ALIGN FEC 0 )( - ® NAIL DRYER ® NAIL TABLE ® TABLE �l EXISTING DOOR TO REMAIN B 1 CO3 NAIL TABLE ' ®ENTRY / 1 SHELVING 9'-0. 4'-0' 91-0. ( DOOR TO BE REMOVED ' 14'-3" CO3 ., COLOR• D CLOSET ' CO3 - i RADIO NEW DOOR FAx coPv LOBBY ' RECEPTION EL TOR B f STAIRWELL PEDICURE AREA :• -. ' CUTTING DN B44-Floor-3 Simplicity Salon PARTITION PLAN B u R 'T H I L L Sheet Issued Drawing Number 01/25/12 A•200 East Mill 43 High Street North Andover,MA ARCHITECTURE ENGINEERING INTERIOR DESIGN LANDSCAPE MASTERPLANNING 303 Congress Street 6th Floor Boston, MA 02210 Scale Project No. SIMPLICITY SALON Project Issued JANUARY 25,2012 TEL:617 423 4252 FAX: 617 423 4333 ®BURT HILL INC. As indicated 07804.18 � > 1 2 3 EA s s ��• �`�pA Mi�F T No.10030 o NE AYBURYP RT BRASS.SIMPLICITY SALONL A A 43 HIGH STREET N . ANDOVER , MA r- i B . 4 iJ.� -1...1 L - Y (L,' COVER SHEET B u R T ' 11 1 L T Sheet Issued Drawing Number L 01/25/12 A.000 East Mill 43 High Street North Andover,MA ARCHITECTURE ENGINEERING INTERIOR DESIGN LANDSCAPE MASTERPLANNING 303 Congress Street 6th Floor Boston, MA 02210 Scale Project No. SIMPLICITY SALON Project Issued JANUARY 25,2012 TEL:617 423 4252 FAX: 617 423 4333 ©BURT HILL INC. 3/8"=1Y-0" 07804.18 Location- No. oe?�' Ul�, Date �aRTM TOWN OF NORTH ANDOVER F w Certificate of Occupancy $ MUs<�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ ' TOTAL $ Check # L Building'Inspector 247 '13 • p. {d�cxu�4 CERTIFICATE OF USE & OCCUPANCY TOWN OIF NORTH ANDOVER Building Permit Number 087-2012 Date: October 14, 2011 THIS CERTIFIES THAT THE BUILDING LOCATED ON 43 High Street, Suite 110E and 110C, North Andover, MA 01845 Dr. Marasco, Plastic Surgeon Suite 110B, and Pulse Care Medical, Suite 1100 MAY BE OCCUPIED AS tenant fit-up for office IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: RCG N.A. Mills,LLC 43 High Street North Andover,MA 01845 Building Inspector Fee: 100.00 Receipt: 24713 ti TH ONM of _ Andover .. P7 _ o dower, IV1ass., o _ �. COCCHEWICK � "i �ADHIRATED '9S BOARD OF HEALTH PER .M .IT T D Food/Kitchen Septic System LL BUILDING INSPECTOR THISCERTIFIES THAT.... `..3..............................:....................................................................................................................... Foundation has permission to erect...........:............................ buildings on s .:. .. ........................................................... ............. RougvV4�/ to be occupied as.......i .......... ..... .� A?e:3��':?Pc�.t'�°.�....:..... �...:`:..�>.: 5��...`moo aQ G?�� s G!a.:���:�v!:��.�::.................. 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 Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final a PERMIT,EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST.ARTS Rough ✓/ oeei�-_ ..... ....................................... Service BIALDING INSPECTOR n /'q-7-' 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'Q"``' f Stantec Architecture Inc. 303 Congress Street,6th Floor Boston MA 02210 Tel:(617)423-4252 Fax:(617)423-4333 Stantec October 14, 2011 Mr. Gerald Brown Inspector of Buildings Town of North Andover 1600 Osgood Street North Andover, MA 01845 Re: Pulse Care Fit-Out East Mills, North Andover Stantec Project 07804.20 Dear Mr. Brown: Pulse Care tenant fit-out, located at 43 High Street, Suite 110C on the first floor at East Mills in North Andover, MA,was to the best of my knowledge, belief, and understanding constructed in conformance with the construction documents issued for building permit dated August 1, 2011, Permit#087-2011 in accordance with 780 CMR Commonwealth of Massachusetts building code. During the course of construction, representatives of our office made periodic visits to the site to observe the progress of the work. Respectfully, STANTEC ARCHITECTURE INC. n d a. Digitally signed by linda. +smiley@stantec.com smile @stantec.com DN:cn=linda.smiley@stantec.com y Date:2011.10.1408:59:14-04'00' Linda Smiley Senior Associate Tel:617-654-6003 Fax: ' Linda.Smiley@stantec.com Attachment: c. David Steinbergh Kieran Whelan Iss documentl 7y7 Date.................................. TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING SSACHU Thiscertifies that .. ............ ........................................................... has permission to perform ......?W........... 1//...../t4........ wiring in the building of..... C.11- ............................................................................. at . .... . .. ....................... .North Andover, ass. Fee Z.��...n..... Lic.No,,&Af��l.......... ..... ...... ICAL INSPE Check # Commonwealth of Massachusetts Official Use Only Permic Pen-nit No. L 0 2— Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) �f ,7 ��� ,or V . ` Ac 44, Owner or Tenant 7m, Telephone No. Owner's Address IA -00 Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building eie2h,144 ereyfI-li Utility Authorization No. Existing Service_ZWAmps 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: 'Flr IN A Completion of the ollowing table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA ,o.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- 1:1o.o mergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatin 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 Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: `i Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. IURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the lie�nsee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned c ►-ifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CH""ECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the painsn penalties of perjury that the in mation on this application is true and complete. FIRM NAME: 2I�P � LIC.NO.: Licensee: Signature LIC.NO.: //� (If applicable, en r "ex m t"in th 1'c ns u ine.) A/ Bus.Tel.NO.' ✓V>9� 7Q, Address: ��4l Alt.Tel.No.: 3 *Per M.G.L c. 1747, s. 57-61,security work requires Department of Public Safety"S"License: Lie.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the(check one) ❑ owner ❑ owner's Owner/Agent 7 Signature Telephone No. PERMIT FEE: $ � ,� � � y- z�-�� �U�� J rG ��W ,�� �� ��� � '� �, �. r' ��' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 10 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: d " AQJ �2 Phone #: 01,i/,/ Are you an employer?Check the appropriate box: Type of project(required): 1.P�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.❑ 1 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.❑ 1 am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors 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: t Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: "/ City/State/Zip:&l'l///"� / Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pai andpe alties ofperjury that the information provided above is true and correct. / Si nature: Date: l Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Date....:tZ.,1-- .,1-- NORTPt <,``°.:•.. TOWN OF NORTH ANDOVER p PERMIT FOR WIRING c•„444"`” �.•'• SACMUSE� f This certifies that ......:..::`...E. .... �...... c: c.............................. has permission to perform ..! - -., -'.......... .............................. wiring in the building off-z;�- ': �f . !`,.. � .: f .... ....... at. .... ' �_ ' "'.. '..................... °.?eNorth Andover',,Mass. Fee. .............. Lic.Nod :....`:R" . ........... . ... Vin, '... ELECTRIC INSP R` Check #,5,9 i' // �///� / 1� Orficiai Use Only —� 1. ommonLusalm a/Ma»aCL..JeLiU ( Pcrmit No._ `t - e�arfineni`ol5ire SSJ erueca" � Ila—r` I' Occupancy and Fee Checked BOARD OF FIREPREVENTION REGULATIONS (Rev. 1/07 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK .. All \pork to be performed in accordance with theiMassachusens Electrical Code (.\4EC). 52: CyIR 13.00 (PLEASE PRfiVT IN IYK OR TYPE ALL I.A1-FORAL4 TION) Date: City or Town of: )Oor4 g4)(b004nP_ To the Inspector 0J,Wires.- By 6 ires:By this application the undersigned gives n tic.-of his or her intention to perY.I the electrical wcrk described below. Location (Street & Number) [ <(r-�� Sj; 6/7Qi Owner or Tenant ) C, 0We. ,S&-4.A:f TeIel?hone ;Nc. 9 V6,h?g &.Z Owner's Address Is this permit in conjunction with a building permit.' Yes.❑ No (Check Appropriate Bcx) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of tfleters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Tti StCc l(C��te'r� C L SPC et'cLI y Sre,_) Completior of the follo.vinx table may be waived br the lnsD,c of]fires. No." f Reces ed Luminaires•> No.of Ceil.-Susp. (Paddle) Fans f . Total Transformers KVA No. of Luminaire Outlets No:of Hot Tubs Generators KVA Above In- t o. n mergence to nhg No. of Luminaires Swimming Pool grnd. ❑ arnd_ ❑ IHattery Units' M No. of Receptacle Outlets No. of Oil Burners FIRE ALARNIS INo.of Zones No. of Switches No. of Gas Burners No. of Detection and Initiatinz Devices No. of Ranges. No. of Air Cond. Total TonsNit.,. of 41er;ing Devices _ No. oCWaste D"isposers Heat Pump ..![umber Tons _ KW No. of elf-Contained _ Totals: Detection/Alerting Devices No. of Dishw2shers S ace/Arca Heating Tons Loca !1'iunicipal El other _ P o on on No. of Dryers Heating.AppliancesKW' ecurity Systems;" �-"ib3-of' ices or E uiva;ent Nu. of WaterK��, No. of No.of• Data Wiring: Heaters Sins Ballasts No. of Devices or Equivalent elecommunications Wiring: No. H}dromassage Bathtubs No. of Motors Total HP No. of Devices or Equivalent OTHER: p & Attach additional detail if desired, or as required by the Inspector of if"ires. Estimated Value ofElectricai Work: 7' (When required by municipal policy.) Work to Stam. Inspections to be'requested in accordance with MEC•Rule 10, and upon crmpt.-tion. INSURANCE COVERA E: 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 uncle:siened certifies that such coverage is in Force,and has exhibited proof of same to the permit issuint office. CHECK ONE: MSU^ANCE (A BONFD ❑ OTHEi? ❑ (Specify:) Self .Insi:red I cerinl,,,under the pains and penalties of perjury,that the"ormation on this applicalio�z is true and complete. FIRM NAME: A_DT 'Security- Services LIC. NO.: C - Licensee: . :dark A. Brophy Signatu e LIC. NO.: C-45 '(ljapplicab/a:enter"esenyot"iii the license number tine.) Bus.Ycl. No.: 6 03-594-S 928- -Address- 16. Clinton Drive Hollis . T IH Alt.Tel. No.: ' *Per M.G.L. c. 147,s. 57-61, security.work requires Department of Public Safety:'S"Licensc: Lic.No. 00953 O�vNER'S INSURANCE WAIZ-ER: I am aware that the Licensee does not have the liability insuranc:coverage norna:ly required by law. By my sigrarire beEow, i hereby waive this requirement. I am the(check one) [,owner ❑owner's agent. � Owner/Agent '� Signature_ _ _—Te.;.-phoneNlo. 'F,?Z"rII1 fj: __.____._ y�/te '(OonNncttulco� OG�✓V�dAa-Ur[%d:�11 . , -�� DEPARTME;dT OF PUBLIC SAFETY LICENSE Tivmbef; SS CO .00OSSJ • ©Irihdale; 02/07/1950 r_xp1ras; 02/071260'.. , -.-,-Tr, no; 107,0 5-License; ADT SECUF1ITY SERVICE MARK A DROPHY SR I I I MORSE ST V %yJ. NORWOOD, MA 07062 DIG SAFE CALL CENTER; �( COMM1t710r11r •• - - - Fold,Thln G3iicli Nong Al'P ltlotadoAI COMMONWEALTH-OF MASSACHUSETTS I Oi CL E0�rWC!ANS. DOARD FA- HEG!8•TMC-D SYSTEM UNTRACToR ISSUES TH19 LICENSE TO TYPE A1)'f ECUrITY SERVU.ES INC , �. MARK' A %BE UPH 'r - SR -C: .. 111. `N 0 R S E ST j� rl rr ?IOR1?OOD HA 02062- 46.02- �i5C 07/3)_/10 353795 - 353795 ' .�� Fold,Thin011A6AVxg UPrrforrllnnr _ x'11 �•`i o • I - ✓j Department of P blic Safety One Ashburton Place, Rm 1301 Boston, Ma•:.02108-1618 Licensc: s-Lic:-)nse o00053 Expires: 02!07/201-1-=:-_-_--_ = Rostricted To: 00 Number: SSCC' j MARX n 5R()r1-1 Y SR MORSE ST NORW000, MA 02062 "`-�. !lam• 117.0 7r.no: Kuep top for rocelpt and chanfle of address noUflcation. II jP::LAt 0 .0M,0W00•o U`.UFMACA10021'LOUB ...__..._.... .. CWA,;TMENT OF PUBLIC SAFETY .. T /T S-LIc0"5E' rt,._r..... Nur7���kCO 000053 Tr. ,o_ 117,0 . lia-0J0.f�'EURITY SFr2Vl;r - - SJ4�co� MARK A DROPY1 Y I 1 I1 MORCE t C/1/=_:4�� JIG ::AGF-CALL CC. .,'ESP)3dd-7233 NORWOOD, MA ComTlSsior.cr . e Fold,Th:n 0`Udt N�4 1 t r uloiAl1 COMNIC)NWEA�TH•OF. MASS ACHUSE I 1 S D OAP, D I - Oc.CLtL; CONTRACTOR REGI!s'7ERi=� SYSTEN' I55UEs 7Fwq LICENSE TO F . ECUrIIY SERVTCES , INC , TY E q1) i HARK A -B; orHY C I1 •MORSE . ST NORIIOOD MA 020G2 - 46OZ r r 31/10 , 3537 °5 353745 5 C 7/ 1 F-14,Thin 1),1Ac\Jk+?0 Al r , I v vmcial vsc vu�y Q 14 -� Lommonwea`ut of yf/am"Au.4efh cc Permit No. 2aparlment'/Ji �ervicee Permit Fee Assigned 14,114 . BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99) leave blank r APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK FOR INSTITUTIONAL* USE ONLY This form is for use by institutions employing licensed electricians and others for which notice df electrical installations to municipal Inspector of Wires is required for work on the premises of the institution. If you are not an employing utstitut pursuant to C. 141 §3 of the Massachusetts General Laws,stop here. You cannot use this form. Use the standard form only. (PLEASE PRINT IN INK OR TYPE ALL INFORM AT1ON) Date:j " 6 1-' Cit• or Town of• A&61-4 1.D dy To the Inspector of Wires: By this application the undersigned gives notice of the on-premises performance of electrical work by employees. Institution//MA j?(43LI C Sc, Address -1 3 / C,i�r� S-7 4 Location-and Nature of Proposed Electrical 1Vork: NOTE: C. 143 §3L of the Massachusetts General Laws obliges those who perform electrical installations to give notice i same to the municipal Inspector of Wires. You may do so by filing this form upon each such occasion, or if so conten plated in an annual permit fee schedule set by the municipality you may maintain a contemporaneous log of such wor which shall be exhibited to the Inspector of Wires during normal business hours without advance notice. Some municipal ties may set nominal fees for annual permits and require individual permits for work above a stated magnitude. check one): YES ❑ NO ❑ n each such occasion ) We will file this form o ( We will maintain one or more contemporaneous log(s) (check one): YES ❑ NO ❑' This option is available where so contemplated by the municipality. In these cases, you must renew-this application annua and upon significant changes in employment. j The following individual(s)will be responsible for the accuracy of the log(s), if maintained. You agree that the log(s)will b located as indicated below. The coverage in any individual log must be for contiguous property except by arrangement with % the Inspector of Wires. Attach supplementary sheets ifrequired for additional log location Log coverage,and location where it will be maintained Responsible person L, You may maintain the logs electronically upon agreement with the Inspector of Wires. if you intend to apply for such a pre dure,indicate below how the Inspector of Wires should access the log: How many electricians*and/or system technicians(as licensed by the Board of State Examiners of Electricians) do you eml at your facility? Indicate the total number and also indicate the number of full-time equivalent staff that number includes: Total electrical employment: Full-time equivalent electrical entploynnenl: I tow many helpers or apprentices do you employ to assist your licensed staff,under their direct supervision(see c. 141 §3)': general, this number must not exceed the ratio of one licensed individual to one unlicensed individual. Limited exceptions ply for veterans (see St. 1962,c. 582§3 as amended by St. 1979,c. 156). Indicate the total number and also indicate the tt ber of full-timeequivalent staff that number includes: Total electrical employment: Full-time equivalent electrical employment: Not all electrical work for which notice to the Inspector of Wires is required must be performed by licensed personnel. Hov many such persons,not required to be licensed,do you have in your employ? Indicate the total number and also indicate th, number of full-time equivalent staff that number includes: Total electrical employment: Full-time equivalent electrical employment: *Institutions are def bred for 1he5e purposes as an. person,firm, or cotporation operating under c. 141§8. 1Plrr gccee rrver.ee cine for rertiliratinnc and required sienah 1 Institutional Permit Form,P 1 a e 2 NOTE: Some institutions enter into contracts with contractors to perform ongoing electrical work at an institution, simil to institutional employees. If, by the terms of such a contract, you direct the performance of such work, include the nu► bers of such employees in this application. If the contractor directs such performance, of if the contract period is for le than one year, application must be made by the contractor on the standard form for such work. Do not include such e► ployees in this application. Please give your official title, such as "Director of the Physical Plant" or "Director of Facilities" or equivalent. In addil provide a statement that substantiates your authority to hire electricians pursuant to c. 141 §3 for electrical work on the pi ices of your institution, and to establish priorities for the performance thereof. This form is not to be construed as a grar authority to direct any licensee of the Board of State Examiners of Electricians to perform work in contravention of the rule said Board,or in contravention of the iv[assachusetts Electrical Code. i1•Iy title is: 10 lit/» 6--72 My authority to act.for the aforenientioned institution is: certify, under the pants and penalties of perjury,that the information on this application is true and complete. (Signature) (Dated) (Print name) ,{ j (work telephone number)�<7� y�—K/lAtension) (facsimile number) I L 634 AQ y .�o Town of NORTH ANDOVER g REP BUILDING PERMIT INSPECTIONRT O PERMIT N0. o PROJECT: INSPECTION DATE: UNIT NO.: FLOOR: WING: BUILDING NO.: REMARKS: r 7 dd . Excavation-depth and soil conditions Framing- Other: Date: Date: Date: Inspector Inspector. Inspector Footings and foundations and drains- Insulation- Other: Date: Date: Date: Inspector Inspector. Inspector Electrical-rough- Plumbing and/or gas-rough- Other: Date: Date: Date: Inspector Inspector. Inspector Electrical-final Plumbing and/or gas-final Other: Date: P a Date: Date: Inspector Inspector Inspector Fire Dept- oil burner,tank, stove, smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: --Cof 0# Inspector Inspector Inspector I 4,�4 O o, Town of NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT PERMIT NO.: '067 / PROJECT: INSPECTION DATE: UNIT NO.: FLOOR: WING: BUILDING NO.: REMARKS: d�L do j a4- S Excavation-depth and soil conditions Framing- Other: Date: Date: Date: Inspector Inspector. Inspector Footings and foundations and drains- Insulation- Other: Date: Date: Date: Inspector Inspector. Inspector. Electrical-rough- Plumbing and/or gas-rough- Other: Date: Date: Date: Inspector Inspector. Inspector Electric - mal Plumbing and/or gas-final Other: 2��a Date: Date: Date: Inspector Inspector Inspector Fire Dept- oil burner,tank, stove,smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: C of O# Inspector Inspector Inspector Town of ;_2c�'�`' NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT PERMIT NO.: —PROJECT: INSPECTION DATE: `-3© UNIT NO.: FLOOR: WING: BUILDING NO.: REMARKS: 5' - w Oldz, a-� 6 114, } O/ Excavation-depth and soil conditions Framing- Other: Date: Date: Date: Inspector Inspector. Inspector Footings and foundations and drains- Insulation- Other: Date: Date: Date: Inspector Inspector. Inspector Electrical-rough- Plumbing and/or gas-rough- Other: Date: Date: Date: Inspector Inspector. Inspector. Electric -.fi al Plumbing and/or gas-final Other: Date: ?`,297 Date: Date: Inspector 4W Inspector Inspector Fire Dept- oil burner, tank,stove,smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: -Cof 0# Inspector Inspector Inspector I Date....g-....../....©.4 NORTF, Ot t.�ac;�,ti0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACMUS� This certifies that ..........., ....1:/gy -.0 .17.lz................................... has permission to perform S'«'✓&off 7. . !... ...h�...../.. ................................ .. ............. t wiring in the building of......AX AXPc at................ 11/..rc-? Je ............................... ,North Andover,Mass. Fee A*....... Lic.No ............. —< .. ............................................ ..... ELECTRICAL INSPECTOR` Check # G 68u2 Commonwealth of Massachusetts Official Use Only Department of Fire Services Pennit No. Z BOARD OF FIRE PREVENTION REGULATIONS Permit Fee Assigned [Rev. 11/99] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK FOR INSTITUTIONAL* USE ONLY This form is for use by institutions employing licensed electricians and others for which notice of electrical installations to the municipal Inspector of Wires is required for work on the premises of the institution. If you are not an employing institution pursuant to C. 141 §8 of the Massachusetts General Laws, stop here. You cannot use this form. Use the standard form only. (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ���� City or Town of: 4/11>L11/ __ To the Inspector of Wires: By this application thp undersigned gives notice o the on-premises performance of electrical work by employees. Institution fir/. ,✓, ,J U�/��. s� � p �J Address Location and Nature of Proposed Electrical Work: �/� /-k? 4xz, I NOTE: C. 14S §3L of the Massachusetts General Laws obliges those who perform electrical installations to give notice of same to the municipal Inspector of Wires. You may do so by filing this form upon each such occasion, or if so contem- plated in an annual permit fee schedule set by the municipality you may maintain a contemporaneous log of such work, which shall be exhibited to the Inspector of Wires during normal business hours without advance notice. Some municipali- ties may set nominal fees for annual permits and require individual permits for work above a stated magnitude. We will file this form on each such occasion(check one): YES ❑ NO 0 j We will maintain one or more contemporaneous log(s) (check one): YES NO ❑ This option is available where so contemplated by the municipality. In these cases, you must renew this application annually, and upon significant changes in employment.. The following individual(s)will be responsible for the accuracy of the log(s), if maintained. You agree that the log(s)will be located as indicated below. The coverage in any individual log must be for contiguous property except by arrangement with the Inspector of Wires. Attach supplementary sheets if required for additional log locations. Log coverage,and location where it will be maintained Responsible person , 63 You may maintain the logs electronically upon agreement with the Inspector of Wires. if you intend to apply for such a proce- dure, indicate below how the Inspector of Wires should access the log: How many electricians and/or system technicians (as licensed by the Board of State Examiners of Electricians)do you employ at your facility? Indicate the total number and also indicate the number of full-time equivalent staff that number includes: Total electrical employment: Full-time equivalent electrical employment: How many helpers or apprentices do you employ to assist your licensed staff, under their direct supervision(see c. 141 §8)? In general, this number must not exceed the ratio of one licensed individual to one unlicensed individual. Limited exceptions ap- ply for veterans(see St. 1962, c. 582 §3 as amended by St. 1979, c. 156). Indicate the total number and also indicate the num- ber of full-time equivalent staff that number includes: Total electrical employment: Full-time equivalent electrical employment: Not all electrical work for which notice to the Inspector of Wires is required must be performed by licensed personnel. How many such persons,not required to be licensed,do you have in your employ? Indicate the total number and also indicate the number of full-time equivalent staff that number includes: Total electrical employment: Full-time equivalent electrical employment: (� *Institutions are defined for these purposes as any person,firm, or corporation operating under c. 141 §8. (Please see reverse side for certifications and required signature.) 4— Institutional Permit Form,page 2 NOTE: Some institutions enter into contracts with contractors to perform ongoing electrical work at an institution, similar to institutional employees. If, by the terms of such a contract, you direct the performance of such work, include the num- bers of such employees in this application. If the contractor directs such performance, of if the contract period is for less than one year, application must be made by the contractor on the standard form for such work. Do not include such em- ployees in this application. Please give your official title, such as "Director of the Physical Plant" or "Director of Facilities" or equivalent. In addition, provide a statement that substantiates your authority to hire electricians pursuant to c. 141 §8 for electrical work on the prem- ises of your institution, and to establish priorities for the performance thereof. This form is not to be construed as a grant of authority to direct any licensee of the Board of State Examiners of Electricians to perform work in contravention of the rules of said Board,o�r`inn contravention of the M ss etts Electrical de. s My title is- My 1 My authority to act for the aforementioned institution is: /certify,under the pains and penalties of perjury,that the information on this application is true and complete. i l (Signature) �, ,,f� • � (Dated) /� 0 (Print name)Le--b 4� 7�! (work telephone number) (extension) (facsimile number) 1 i J, �. � Town of NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT o��Z � -- PERMITNO.- � PROJECT: �` � 2!/�'� �CA40og� INSPECTION DATE: UNIT NO.: FLOOR: a ��� WING: BUILDING NO.: REMARKS: v -441j j- Excavation-depth and soil conditions Framing- Other: Date: Date: Date: Inspector Inspector Inspector Footings and foundations and drains- Insulation- Other: Date: Date: Date: Inspector Inspector Inspector. Electrical-rough- Plumbing and/or gas-rough- Other: Date: Date: Date: Inspector Inspector. Inspector Electrical final Plumbing and/or gas-final Other: Date: ' "o Date: Date: Inspector Inspector Inspector. Fire Dept- oil burner, tank, stove, smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: C of O# Inspector Inspector Inspector Town of NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT PERMIT NO.. dc�-- PROJECT: Com ` INSPECTION DATE: UNIT NO.: FLOOR: WING: BUILDING NO. �' J '� REMARKS: W Excavation-depth and soil conditions Framing- Other: Date: Date: Date: Inspector Inspector. Inspector Footings and foundations and drains- Insulation- Other: Date: Date: Date: Inspector Inspector. Inspector. Electrical-rough- Plumbing and/or gas-rough- Other: Date: Date: Date: I Inspector Inspector. Inspector. Electrical 4' al / Plumbing and/or gas-final Other: Date: 6 f— 3^—� ' Date: Date: Inspector Inspector Inspector Fire Dept- oil burner, tank, stove,smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: C of O# Inspector Inspector Inspector Town of NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT r g 7 PERMIT NO.:W 6 PROJECT: ✓` ^-J INSPECTION DATE: ! UNIT NO.: FLOOR: _WING: BUILDING NO.: REMARKS: I L/ ✓`" - ` Excavation-depth and soil conditions Framing- Other: Date: Date: Date: Inspector Inspector. Inspector Footings and foundations and drains- Insulation- Other: Date: Date: Date: Inspector Inspector. Inspector Electrical-rough- Plumbing and/or gas-rough- Other: Date: Date: Date: Inspector Inspector Inspector. Electrical-&-n-;�) Plumbing and/or gas-final Other: Date: 7- 11 -c27 Date: Date: Inspector AM Inspector Inspector Fire Dept- oil burner,tank, stove, smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: C of O# Inspector Inspector Inspector O �.•e..,40 Town of NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT PERMIT NO.: Lo PROJECT: 1�` INSPECTION DATE: UNIT NO.: FLOOR: _1� WING: BUILDING NO.: REMARKS: Zr I I Excavation-depth and soil conditions Framing- Other: Date: Date: Date: Inspector Inspector. Inspector Footings and foundations and drains- Insulation- Other: Date: Date: Date: Inspector Inspector. Inspector. Electrical-rough- Plumbing and/or gas-rough- Other: Date: Date: Date: Inspector Inspector Inspector. Electrical- final Plumbing and/or gas-final Other: Date: ��� Date: Date: Inspector Inspector. Inspector Fire Dept- oil burner, tank, stove,smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: -Cof 0# Inspector Inspector Inspector a Town of NORTH ANDOVER BUILDING PERMIT IPJSP,ECI, "91T, O T, PERMIT NO.: PROJECT: INSPECTION DATE:/ —A^ad UNIT NO.: FLOOR: WING: BUILDING NO.: REMARKSA cJt-7) ✓ , - d 4,1 �/ .� ��: n � � �� boa �,�► �'�, =r, I Excavation-depth and soil conditions Framing- Other: Date: Date: Date: Inspector Inspector. Inspector Footings and foundations and drains- Insulation- Other: Date: Date: Date: Inspector Inspector. Inspector. Electrical-rough- Plumbing and/or gas-rough- Other: Date: Date: Date: Inspector Inspector Inspector Electri --Rfin Q Plumbing and/or gas-final Other: Date: /' 2, " Q C� Date: Date: Inspector � Aldf Inspector Inspector, i Fire Dept- oil burner, tank,stove,smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: —Cof 0# Inspector Inspector Inspector Date..... ........................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING S us _.� This certifies that ........................... ......... .................................. has permission to perform .......... ...................... wiring in the building of.......................... ........................ 7.................... at................................................... ... .. North Andover,/ ss. Feez�......... Lic.No/2F,9? .............. .. . I PEc-ro Check # 0 U II .� Commonwealth of Massachusetts Official Use Only _ Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked - W— [Rev. 1/07J .. (leave blank APPLICATION ON FOR PERMIT TO PERFORM ELECTRICAL WORK All work K to be performed in accordance P with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: °I—S6 —p 5 City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 6 N 0 U e Owner or Tenant v y(?t k)�ZN�L) ISTelephone No. Owner's Address Is this permit in conjunction� ith a buildinit? Yes ❑ Nof-0� r �, g permit? (Check Appropriate Bog) .Purpose of Building r>A( Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Und rd g ❑ No.of Meters New Service Amps / Volts Ove rhead ❑ Undgrd ❑ No.of Meters Number of Feeders and.Ampacity Location and Nature of Proposed Electrical Work: ( m 1 Lb lk, Com letion of the followin table may be waived by the Ins ector of Wires. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans 0.of Total . Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- o.of Emergency ig g d. nd. BatteryUnits No.of Receptacle Outlets No.of Oil Burners FIRE A_1 ,k MS No,of Zones No.of Switches No.of Gas Burners o,of Detection and initiating Devices No.of Ranges No.of Air Cond. T° � Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW _ No.of Self-Contained Totals: _._..._.___.._._. _.._._._.....__. _. Detection./Alerting Devices No.of Dishwashers Space/Area Heating KWLocal❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances W Security Systems: `� K No.of Water No.of No.of Devices or Equivalent Heaters KWNo.of Data Wiring: Signs Ballasts . No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent 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 StartInspections to b InsP ere requested in accordance ordance 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 a 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. l FIRM NAME: /,L.ib4 x p JJ�7 LIC.NO.: I Licensee: i Signature (If applicable, en er"exe "in the licen a number lin .) a LIC.NO../ Address: 6 Bus.TeL No.: -44-'- *Per M.G.L c. 147,s. 57-61,security work requires epartrnent of Public Safety"S"License: Alt.L c.No. a 6- 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: $ ' The Commonwealth of Massachusetts 41 f Department of Industrial Accidents ,. Office of Investigations ilk / 600 N,'ashington Street Boston, MA 02111 www.nwss gov1d6a Workers' Compensation Insurance Affidavit. Builders/Contractors/Electricians/Plumbers Apnficant Information p Please Print LeQibiv Name rgan Nae (Business/Oization/Individual):__ L`5 �� 1 e— Address: c3 City/..State/Zip: Phone 0: Are you an employer?Check the appropriate box: T of reject(required): I.❑ I am a employer with 4, ❑ 1 am a general contractor and I Type e 1 ( � trn'oay�le (full and/orpart-time).* have hired the sub-contractors 6• ❑New construction 2.� proprietor or partner- listed on the attached sheet.= 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me.m any capacity, workers' comp.insurance. g, ❑Building addition [No workers'comp, insurance 5. ❑ We are a corporation and its required.) officers have exercised their 10.0 Electrical repairs or additions 3.❑ 1 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. Roof insurance requited.)temployees, ❑ repairs �1 ) • [No workers' comp. insurance required..] 13.0,other •Any applicant that checks bme#t must also fill out the section blow showin their workers'i om g pensmion policy information r Homeowners who submit this affidavit indicating they are;doing all work and then hire outside contractors must submit a new affidavit indicating such. tComractors that check this box mustattached an additional sheet showing the name of the sub-contractors and their workers'comp.policy intarcn t an. 1 am an employer that is providing:workers'compensation insurancefor nr employees; information. Below is she policy mid job site . 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(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties fine to P of a up $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 tip to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c ify under the pains a d pen 1 es of perjury that the information provided above is true and correct Signature: Phone#: Official use only. Do not write in this area,to be completed by city or town of ciaL r City or Town: Permit/License# Issuing Authority(circle one): ' 1. Board of Health 2.Building Department 3.City/Towu Clerk 4.Electrical Inspector S. PlumbinjInspect 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,,partnership,'association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or timstee 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 matTitenance,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 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, MOL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation.affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es),acid 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'cornpensation 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,notthe 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 Iicense 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 will be used as a reference number. In addition,an applicant that must submit multiple pennit/license applications in any given year,need only submit one affidavit indicating current policyinformation(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of'the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth of Massachusetts , Department of Industrial Accidents Office of Investigations t� 600 Washington Street Boston, MA 02111 Tel.#617-727-4900 ext 406 or 1-8.77-MASSAFE Fax:9 617-727-774 Revised 5-26-Q5 www.mass.gov/dia Town of � NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT PERMIT NO.: PROJECT: INSPECTION DATE: & � UNIT NO.: FLOOR: WING: BUILDING NO.: REM RKS: 66 c V/ a Excavation-depth and soil conditions Framing- Other: Date: Date: Date: Inspector Inspector. Inspector Footings and foundations and drains- Insulation- Other: Date: Date: Date: Inspector Inspector. Inspector Electrical-rough- Plumbing and/or gas-rough- Other: Date: Date: Date: Inspector Inspector Inspector. Electrical-final Plumbing and/or gas-final Other: i Date: Date: Date: Inspector Inspector Inspector. Fire Dept- oil burner, tank, stove, smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: C of O# Inspector Inspector Inspector I I C•~ ,h0 �. � Town of NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT PERMIT NO.: PROJECT: INSPECTION DATE: 7— l UNIT NO.: FLOOR: WING: BUILDING NO.: ll �. REMARKS: .: Q o� V. n A- �j� 6_A andExcavation-depth and soil conditions Framing- Other: Date: Date: Date: Inspector Inspector. Inspector Footings and foundations and drains- Insulation- Other: Date: Date: Date: Inspector Inspector. Inspector. Electrical-rough- Plumbing and/or gas-rough- Other: Date: Date: Date: Inspector Inspector Inspector. Electr' al- Plumbing and/or gas-final Other: final `7 t c'� t . Date:• 2 Da e• Date: Inspector Inspector Inspector Fire Dept- oil burner, tank, stove,smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: C of 0# Inspector Inspector Inspector Date.7./,z TOWN OF NORTH ANDOVE ° PERMIT FOR PLUM I G ♦ � a ,SSACMUS� This certifies that . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . plumbing in the buildings of . . . . ... . . . . . . . . . . . . . . . . . . . at . . .��-�. . . ! .�. . .� . . . . . . . . . . . . . . . . North Andover, Mass. Fee.,?� Lic. No.. 5•/ .?. . . . . . . .. .. ' . . . . . . . . . LUMBING INSPECTOR Check y c1 7 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town: A-lo Al f) D Ve , MA. Date: 7/A7 b Permit# r Building Location:�3 6h 5� Owners Name: C G L C Type of Occupancy: Commercial M Educational❑ Industrial❑ Institutional❑ Residential❑ New: Alteration:❑ Renovation:❑ Replacement:❑ Plans Submitted: Yes❑ No❑ FIXTURES DEDICATED z SYSTEMS VA > z 4A = V1 Ln WW O H H Q W Q CC W zz cc o: z QQ a ,,QQ,77 Q C in Z � N H W Z 3 V1 = Z W ? H � L Q O m W O Z H V d 0 J U a W 0 O C W W z �' �' 05 0 W 3 fA W Q W x = d 0 3 z Q o LA. 3 a U z H 1- "' o a Q H 47 U F- VI Vl O H > > O O Z rzQ Q a H V Q C CC a LU a m m c o � i Y S 5 ooc tA � 3 3 3 SUB BSMT. BASEMENT 1 FLOOR 2''1D FLOOR TO FLOOR C FLOOR 5m FLOOR 6m FLOOR -"FLOOR 8m FLOOR Check One Only Certificate# Installing Company Name: 6j f'ey 4zc �;1,41 �c Corporation Address: 7 k' � y City/Town: A�? N) State: �ii� ❑Partnership Business Tel: 9 7 - ya3- 74 9 y Fax: Firm/Company Name of Licensed Plumber: J 1 6 r{e:N!' INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes No❑ If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy T1 Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Type of License: Title M Plumber Signa a of Licensed Plumber City/Town Master License Number: /.APPROVED OFFICE USE ONLJoumeyman MOR71r +" r- t ,SSACMUSt CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 813 Date: August 27, 2010 THIS CERTIFIES THAT THE BUILDING LOCATED ON 43 High Street, building- 44, 1 St floor, North Andover, MA MAY BE OCCUPIED AS Serenity Massage IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: RCG North Andover Mills, LLC uilding Inspector Fee: $100.00 Receipt: 23372 71 Date.# G.�. HORTp �'<. •° .�� TOWN OF NORTH A DOVE PERMIT FOR PLUM G • '. ' ,SSACMUS� This certifies that . . . . . . . . . n . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . . ` ' .'. . . . . . . . . . . . . . . . plumbing in the buildings of . . . -.`.�.`�. .. .`. . . . . . . . . . . . G at. . . �. . ./.f. . . . . . . . . . North Andover, Mass. Fee/.?)P. . Lic. No./�/.f7.). . . . . . . . . . . . . PLUMBING INSPECTOR Check y �G MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS J/ /^// Date Building Location ` "5� l/�'S/1 5 7ze; — Owners Name ,�� !('�:' Permit#_ 772T f y Amount � Type of Occupancy New Renovation ©� Replacement Plans Submitted Yes No FIXTURES H a a CC � w w x o a w U Zas x A �" z a COO Cn d QF x .a oa D O a x F� Un M d 00 = SLDB%E &1SEM[NI' ]ST)FLOOR � 2NU7'��Hf Jn 'ilii Jill i'iJl.M i 6M RfM p��� Olil i'iJl= (Print or type) Check Corp.. Certificate Installing Company Name UGC ❑ Address O / rj Partner. usiness Telephone 7 ss dt 6 Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy �/ Other type of indemnity ❑ Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent El I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State PI lumb�i Cod nd Chap r 1 f the General Laws. By: igna ure 5T Eicensea rium er Type of Plumbing License Title A r-7 City/Town cense NumDer Master Journeyman ❑ APPROVED(OFFICE USE ONLY �a Date.. 7 -s ORT/ TOWN OF NORTH ANDOVER p PERMIT FOR WIRING SSCMUS� This certifies that < ' .............. has permission to perform . ............................................................................. wiring in the building of....X. c! -i- .......................................... at...�........... . .... North Andover-Mass. 4, y Fee.. ......... Lic.No.-.. . ..t.. ............. .., . / v ,�/ .. ! .., ELECTRICAL INSP U a Check # 7859 %wwisliisLori,wCdltl7 OT Massachusetts Official Use Only �•`` Department of Fire Services L nut No. BOARD OF FIRE PREVENTION REGULATIONS 1/0 07]Occupancy and Fee Checked eave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M ),5 7 CMR 12.00 (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: City or Town of: NORTH ANDOVER To the Inspe ,to of fres: By this application the undersigned gives notice of his or her in tion to perform the electrical work described below. Location(Street&Number r Owner or Tenant 1,0- Telephone No. Owner's Address Sa w,P Is this permit in con,uncti n w' 'itha permit? YesNo��-�^• 4� ❑ (Check Appropriate Boz) Purpose of Building a I U1/1 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: Completion of the followin table ma be waived by the Inspector of Wires. No,of Recessed Luminaires Nb---0f4;0ftxSuPaddl Fans+ Tra°•°f KVA Total nsformers� No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires x. Swimming Pool Above ❑ In- o. o mergency g f nd. d. Butte Units No.of Receptacle Outlets 3 No. of Oil Burners 1N ALARMS No. of Zones No.of Switches No. of Gas Burners o.of etection an InitiatingDevices No.of Ranges No.of Air Cond. otal Tons No.of Alerting Devices No.of Waste Disposers eat ump _ umber Tons _ o,of a -Contained Totals: -"" -"--� Detection/Ale I w Devices No.of Dishwashers Space/Area Heating KW Local❑ unicipal Connection Other No.of Dryers Heating Appliances KW Security Syystems:* o.of No.of water No.of Devices or Equivalent Heaters KW Si s Ballasts Data Wiring: No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or E trivalent i OTHER: ii -- J Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of le trical Work: U (When required by municipal policy.) Work to Start: o Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CORA E: 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: INS CE R[ BOND ❑ OTHER ❑ (Specify:) I certify,under the a s and penaltiesJ p jury,tha�information o th application is true and complete. FIRM N : Licensee: \ gn LIC.NO.: (Ifapplicable, enter"exempt"in i e license number line,f Signature LIC.NO.: '7j��S Address: — "Bus.TeL No.: O U.(w' *Per M.G.L c. 147,s.57-6'1, !:!a ty work requires Deparun ' of ublic Safety"S"License: Alt L cl.No. did 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 Owner/Agent am.the(check one) El owner ❑owner's agent Signature Telephone No. PERMIT FEE.S s- \��� 12 � <l _ � � f� v � � �� ��.� o� �- Z z �� �P� l I The Commonwealth of Massachuse& Department of Industrial Accidents • Office of Investigations . l'�•, 600 Washington ilii{► f' gton Street i Boston, MA 02111 www.nmss gov/dia . Workers' Compensation Inseirance Affidavit: Builders/Contractors/Electricians/Plumbers A licznt Informafion Please Print Lembl --------------- Name (Business/Organization/Individual): Address:. LV�'h City/:State/Zip: Phone#: . r 4a —xL= Are you an employer?Cheek.the appropriate boz: 77 � ject(requited): l`[j am a employer with_ 4. ❑ 1 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.:. deling ship and have no employees These subcontractors have 8. ❑Demolition working for me.in any capacity, workers' comp.insurance. g• ❑Building addition [No workers'comp. insurance5. ❑ We are a corporation and its required.] officers have exercised their 10•0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MOL 1 I.!] Plumbing repairs or additions myself. [No-workers'comp, c, I.5Z §1(4)'andwe have no �. insurance required].t employees. [No workers' 12.0 Roof repairs comp. insurancerequired..] 13.M Other 1 *Any applicant that checks boil#l must also fill out the section below showingtheir wotkort'aompenaation policy information.. !, Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box mustattaeW an.additional sheet showing the name of the sub-contractors and their worker'eom p.policy infnrmadon I am an employer that ss.provrding_workers'compensation insurance for my.entployem. Below is-the policy and job site information. Insurance Company Name: V ' Policy#or Self-ins. Lie.#:_ i4' — 8ipiration Date: i Job Site Address: City/State/Zip: Attach a copy of the workers"compensation policy declaration page(showp (showing the policy num er and expiration date Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition erof criminal penalties of a fine up to$1,500.00 and/or one-y imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day agai violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the D u ance coverage verification. Ido hereby Cerci un r e pains and penalties ojperl that the information provided above is true and correct Si tzn e Date- Phone#: p U Le Official use only. Do not write in dds area,to be completedby city or town official City or Town: Permit/License# Issuing Authority(circle one): I. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector S. Pinmbing Ir►spector 6.Other Contact Person: Phone#• Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,,partnership,association,corporation or other legal entity,or any two or more of the'foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver ortrustee-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 perform-ance 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),addmss(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 cavy 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 bate the affidavit The affidavit should be returned to the city,or town that the application for the permit or license is being requested,notthe Department of t Industrial Accidents. Should you have any quesEions 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 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 permitAicense applications in any given yeas,need only submit one affidavit indicatin¤t policy information(if necessary)and under"Job Site Address"the applicant should-write"all locations in (city or town)."A copy of1he 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 fiiture 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 fo complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not,hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 42111 Tel. #617-727-4900 ext 406 or 1-977-MASSAFE Fax#617-727-7744 Revised 5-26-05 vvww.mass.govIdle CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 386(11/14/07) Date: January 23, 2008 THIS CERTIFIES THAT THE BUILDING LOCATED ON 43 High Street MAY BE OCCUPIED AS Yoga Studio IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Rcg LLC Bikran Yoga Merrimack Valley 43 High Street North Andover MA 01845 0� Building Inspector NORTH 0 0 _ . TAndover ....... .1 0 :. �. No. JR6 CO, Lk= o '� dover, Mass. O COC MIC KE WICK 11' 7�ADRATED p5 `r BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT :.......'. p ................y.................................................................... Foundation has permission to erect........................................ buildings on ... ..:.- ........;:.. ...... Rough to be occupied as............................. -:..;. ?:a..a... ... J......... .�.. -..:...... ......... �f:...... . 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 1 UNLESS CONSTRUCTION.=STARTS ELECTRICAL INSPECTOR Service:/ BUILDING INSPECTOR Dina �f� � .,�_�'I� Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough 3 0 Y Display in a Conspicuous Place on the Premises — Do Not Remove i l '' No Lathing or Dry Wall 1 To Be Done FIRE DEP ENT Until Inspected and Approved by the Building Inspector. Burner Street No. :a SEE REVERSE SIDE Smoke Det. 3 SCOTT M BR0WN , AIA 1 8 4 M a i n S t r e e t A m e s b u r y M A 0 1 9 1 3 O 978. 388.6996 C 339.368.01 65 January 15, 2008 Gerald Brown Inspector of Buildings Town of North Andover 400 Osgood Street North Andover, MAO 1845 To The Inspectional Services Commissioner. In accordance with Section 780 CMR 1 16 Construction Control of the Sixth Edition of the Massachusetts State Building Code I hereby certify that I am a registered architect in the State of Massachusetts, License No. 10698. To the best of my knowledge, information, and belief the work associated with the following project Bikram Yoga Merrimack Valley at East Mill 21 High Street North Andover, MA O 1845 has been completed in general conformance with the contract documents approved for the building permit I have been present at the construction site at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of work, and in my professional opinion the project is in compliance with applicable laws, codes and ordinances. Sincerely, Scott M. Brown, AIA ED A a O No. 10698 � a o AMESBURY, x�P �/ ter,.,.MA as i ���_ �8 - Coo f 10RTN 1 Town of North Andover '' � �A Office of the Planning Department * Community Development and Services Division r Osgood Landing CNusEth 1600 Osgood Street Building#20,Suite 2-36 Lincoln Daley North Andover,Massachusetts 01845 Town Planner P(978)688-9535 F(978)688-9542 November 7, 2007 Ms Teri Almquist C/o 43 High Street Nrto h Andover, M 01845 Re: Bikram Yoga Merrimack Valley Studio Dear Ms Almquist: At the regularly scheduled Planning Board meeting on November 6, 2007 the Planning Board voted unanimously to grant a waiver from the requirements of Section 8.3 of the North Andover Zoning Bylaw of a Site Plan Review Special Permit for the proposed business located at 43 High Street, North Andover, MA. The proposed business, Bikram Yoga Merrimack Valley Studio is to be located within the interior footprint of the existing 21 High Street building. As parking is available the Board voted unanimously to grant a waiver from the Site Plan Review Special Permit requirements. If you have any questions please feel free to contact me. Best regards, Lincoln Daley, Town Kanner BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Location No. Date 41Z NpRTq TOWN OF NORTH ANDOVER f R 9 i A" Certificate of Occupancy $ E Building/Frame Permit Fee $ s�►CMUS Foundation Permit Fee $ Other Permit Fee C',o C) $ TOTAL $ Check # 20 965 Building Inspector • M1.�itat. • CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 386 (11/14107) Date: January 23, 2008 THIS CERTIFIES THAT THE BUILDING LOCATED ON 43 High Street MAY BE OCCUPIED AS Yoga Studio IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Rcg LLC Bikran Yoga Merrimack Valley 43 High Street North Andover MA 01845 Building Inspector w d NORTH '9 Tovm of _ _ 6Andover No. Aft 6 - o dover, Mass. ' o LA �. COCKICKEWICK V 7� ORATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING.INSPECTOR THIS CERTIFIES THAT............... Foundation sv....................................................................................... / ;' �: , r has permission to erect........................................ buildings on . ............................................. Rough to be occupied as.........................::. ...................... _ .:.. `..., ,...a� 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 ` ELECTRICAL INSPECTOR..-, UNLESS CONSTRUCTION STARTS .................. ......� Service BUILDING INSPECTOR Dina ok Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough 3 a Y Display in a Conspicuous Place on the Premises — Do Not Remove l v No Lathing or Dry Wall To Be Done FIRE DEP ENT Until Inspected and Approved by the Building Inspector. Burner -, Street No. � � � 3 SEE REVERSE SIDE j Smoke Det. � Date. ,f o'<".O RT:'tio TOWN OF NORTH DOVER p PER IT FORS' LUM 1 G SA US i s- A This certifies that . . .o'! .� u� .� ( •f. • • . . . . . . . . . . . . has permission to perform . . . . . .t !'.kt.q. !1-.{' `. ' plumbing in the buildings of . . /. � ". .a . . . . . . . . . . . at l. . . . . . . . . . . . .. North 'Andover, Mass. Fee.16.1 . . .Lic. No..I 1.). y. �!- ''? � PLUMBING INS EP CTOR Check H 7599 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) AA(k0NR)Q_ ,Mass. Date beC.7 200"7 Permit# ra _ Building Location Owner's Name8 i kQRn q I� Owner Tel# Type of Occupancy �f QCr, S�y 1 d New ❑ Renovation Replacement ❑ Plan Submitted: Yes ❑ No ❑ FIXTURES s o � w ` U 04 z cL �i cy, 94 co Y Q w q ¢ Z `t a ¢ 3 X ��. P{3347 O xx Y a c4 O u F 2 R vxi F, LL O h Z Z W 0O U h o o 3 x H o o ¢ �a a a a 0 ¢ F `Cr V c� ca ¢ 3 a co 01 1 SUB-BSMT BASEMENT. IST FLOOR ND FLOOR 3RD FLOOR 3 4T"FLOOR T"FLOOR TH FLOOR ru FLOOR r" Installing Company Name t IN�'J' P lCj Check one: Certificate Address a(D :S-t ❑ Corporation Rec,&Nn M4 01!W 11 Partnership Business Telephone/t L g j -1 qa - 7,30,0 G2.[[ 61-7-c-37-e633' Kirm/co. Name of Licensed Plumber �� INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No 13If you have a ed Les,please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws,and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted(ore tered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit is ed for thi ication will be in compliance with all pertinent provisions of the Massachusetts State PlumbingCode and Chapter 142 of the Gener By Signature icense P mber Title Type of License: Maste Journeyman ❑ City/Town APPROVED(OFFICE USE ONLY) License Number Print Form S C O T T M . B R O W N , A I A 1 8 4 M a i n S t r e e t A m e s b u r y M A 0 1 9 1 3 O 978. 388 .6996 C 339.368.01 65 November 16, 2007 Gerald Brown Inspector of Buildings Town of North Andover 400 Osgood Street North Andover, MA 01845 To The Inspectional Services Commissioner: In accordance with Section 780 CMR 116 Construction Control of the Sixth Edition of the Massachusetts State Building Code I hereby certify that I am a registered architect in the State of Massachusetts, License No. 10698. To the best of my knowledge, information, and belief the work associated with the construction documents for the following project Bikram Yoga Merrimack Valley at East Mill 21 High Street North Andover, MA 01845 has been completed in general conformance with applicable laws, codes, and ordinances. I also certify that I will be present at intervals appropriate to the stage of construction to become, generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. Sincerely, Scott M. Brown, AIA OFFICIAL SEAL MATTHEW J.SHERRILL NOTARY PUBLIC No. 10698 COMMONWEALTH OF MOACOM AMESBURY, Com In.Expireyo22,4011 ISA Date. . .... . sj °T°,ti0 TOWN OF NORT ANDOV R PERMIT FOR S INSTALLATIO ,SSgCHUSEt This certifies that . . .� ,'. .�.i,R... h .�. . .�14�. . . . . . . . . . . . . . . has permission for gas installation . . . . . . . . . . . . in the buildings of . .7/t.. 0,9 \/, t��4 A. . . . . . . . . . . . . . . . . . . . I'at . . . . . . . . North Andover, Mass. Fee.?P .? Lic. No.. CTAS INSPECTO Check 2J MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASI.1I I NG tPrintiar Typal ^ / N, Anoo�t�1Z- . Masa Date IJeG 202 Pem�it owners NameBUk*V Location kQ 10 ' ►� �(, �/O�i Type ot Occupancy Naw ❑ Renonration ❑ Replacement ❑ Plans Submitted: Yes❑ NO ❑ H Z C �r1 qQ W W q C O V m t� J CF' < C Z O Z W Z O W 'i< S5IS5100I W O C d C W < C W < = Z ~ H O W ulim Y U. W W W ; C W Z < 6 < < O O W C O pw MS- CtC = O d = tV 7 O d J V C Y ' sue—BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR GTH FLOOR TTHFLOOR STH FLOOR installing company Name ► Check one: Certificate Address . ❑ Corporation zi r NAA p l ❑ Partnership Business Telephone Firm/Co. Name Of Ucensed Plumber or Gas Fltter IYA O—E JJ 1 LL R-y INSURANCE COVERAGE: I have acur liability insurance pocky or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ H you have ed y-9, please Indicate the type cOverage by checking the appropriate box. A IWARy Insurance pot CY X Other type of Indemnity❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit applicationne�es this requirement Owner❑ Agent ❑ S4,Ature of Owner or a Agent I hereby certify that all of t fthe details and information I have submitted(or entered)in above application are true and accurate to the best of my bwmiedge'and that all provisions of the Massachusetts State Gas Codeerformed under the permit and Chapter 142 of the General for this app)g tion will be in compliance with all path on License. 1.4,1111 umber re o n um a Mer Too Gas litter i or License Number f 2 License: