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HomeMy WebLinkAboutMiscellaneous - 478 CHICKERING ROAD 4/30/2018 (3) / Ch, C 478 CHICKERING ROAD 210/071.0-0027-0000.0 I I I I I I Location 7W< ID � No. Date NORTH TOWN OF NORTH ANDOVER f P Certificate of Occupancy $ Building/Frame Permit Fee $ sACHU Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2 Building Inspector NORTH �9 p 0 cac"Ic NIWKN 404ATEO SSACHUS� TOWN OF NORTH ANDOVER Sign Permit Date: January 232009 Permit Number: S015-2009 THIS CERTIFIES THAT Anne Todd Orthodontics (Sal's Pizza owner) Has permission to erect a 45" X 72" Ground Sign Non Illuminated On 478 Chickering Road provided that the person accepting this Permit shall in every respect conform to the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section#6 Voids this Permit Internally Illuminated Signs are Prohibited Receipt# 21805 Amount Paid 60.00 Inspector of Bu' dings SIGN PERMIT APPLICATION 1600 Osgood Street Building 20,Suite 2-36 TOWN OF NORTH ANDOVER i ,>J Mr NflND1rJv { p Site Owner $ � -� �L,(�n _ '3,i?�. Applicant � N 1 7Lq � l Tel �U� It7 -72MaSite Address . cl Size of Proposed Sign L45 7--,--72- Map n Parcel Illumination: (a�)>qot illuminated Internally illuminated How attached: a) Against the wall c)Externally illuminated b) Roof c) Ground %ogr" Materials: /_)\L V M I N NM d) Other Proposed Colors: Background Lettering Cost of Sign Border Note: No permanent/temporary sign shall be erected,or enlarged until an Required Attachments: application on the appropriate form furnished by the Sign Office has been Photographs of building filed with the Sign Officer containing such information including Material sample photographs,plans and scale drawings, as he may require, and a permit Color sample for such erection; alteration, or enlargement has been issued by him. r Site or Plot Plan (Required for all free-standing signs) Such permit shall be issued only of the Sign Officer determines that the Drawings of proposed sign sign complies or will comply with all applicable provisions of the By- Other, specify, Law. Will sign overhang any public road or walkway Yes( } Nom If Yes,Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: `• dj"C/ Receipt# Check# fL Revised 10.31.2006 Form sign Permit Application SIGNATURE OF APPLICANT 77 1/ - 1 f a S!I R� '� Transforming Smiles frt� SAN DWI C H E S-- - w _--------- _ r -- . s a„ 7w • Location Y 71f- 7j�Gt No. /�N • Date ��`�f NORTH TOWN OF NORTH ANDOVER Of t . o .•�{r0 ' F a { Certificate of Occupancy $ • __ Building/Frame/Frame Permit Fee $ s�cHust 9 Foundation Permit Fee $ Other Permit Fee $ () �— TOTAL $ Check # �� Z Zi 2 G '/ Building Inspector �10RTti OE t TOWN OF NORTH ANDOVER 41 9MI�swu•, SIGN PERMIT sACHd5 DATE: December 29 2009 PERMIT: S23-2010 THIS CERTIFIES THAT Dr Ann Todd has permission to erect. TxV Wall Sign on 478 Chickering Road provide that the person accepting this Permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section #6, Voids this Permit. INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED Inspector of Buildings SIGN PERMIT APPLICATION 1600 Osgood Street Building 20, Suite 2-36 TOWN OF NORTH ANDOVER Site Owner-':- Ann 2 —FOC I ApplicanCQ -P-.d Tel �� 0�0� 67 ? y 7 Site Address 47 .g C�l iC.K 2�(l q I�1G C > n&,K' Size of Proposed Sign =, ' Man Parcel Illumination: a) Not illumtnate� �b) Internally illuminated How attached: a) Against the wall ✓ c) Externally illuminated b) Roof _ c) Ground Materials: d) Other Proposed Colors: Background C ceearM Lettering-YS�c-,c-K - Cost,of Sins a a C .o Border * Note: No permanent/temporary sign shall be erected, or enlarged until an Required Attachments: application on the appropriate form furnished by the Sign Office has been Photographs of building filed with the Sign Officer containing such information including Material sample photographs, plans and scale drawings, as he may require, and a permit Color sample for such erection,alteration, or enlargement has been issued by him. Site or Plot Plan (Required for ail free-standing signs) Such permit shall be issued only of the Sign Officer determines that the Drawings of proposed sign sign complies or will comply with all applicable provisions of the By- Other, specify Law. Will sign overhang any public road or walkway Yes O No (✓f If Yes, Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: Receipt # Check # z4)o I Revised 10.31.2006 Form Sign Permit Application SIGA URE OF APPLICANT ,{.,+'—1,.;�'9 s rµ�.b �: Y �I,V,��rdS :,�qm� i-.. � L me t ,� � Irl Im 'r h,r }y °,,I I I }a ,.�;,,;, h Ih�h .;.• v"Y I�4ap@,�INI IyII'lillm Ya'4 R > dI41pI 91r IIP If # i,ti,'harra�"k�' }II d;+,q� Y� a r k y r„III IIn li I" Y idlll�II Iti,lr ""i, Ylv II iI, } ""`dt ,r.r,l.wY aIl1V I6 k IVI II I," 1111+III^.: f.w GIrwIIV'�up ++' r l l i NI 11 d M r- r m I" Cl 4 I' - r a 4111"IYIil1� II1111VIII�ifN u d r y+II lII411�1 a M VI an ".. 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Owl «-- 77-4 P , r�.-0a .rranR„ a _ ..mow.... ,"� 9 µ � w z ............. pORT1, TOWN OF NORTH ANDOVER O p PERMIT FOR WIRING ss�CHU This certifies that-- � ` jf a -� �-� - — has permission to perform ..%tr-r� u ..f'`9: rf�....... wiring in the building of.....� . ........... ..k................................................. at..t .7°............. .-1............. North Andover,Mass. Fee Lic.No/• f'...' ..••••..•.. . ..........u:. ELECTRICAL INSPEC Check !! /� '79/ 66 C &�oI Official Use Only ommontvea a��ac u�ett.� k�1 Permit No. 2epartment of Jire Services off, Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [R BOARD (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: February 27,2009 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) 478 Chickering Road Job#26389 Owner or Tenant Anne M Todd Orthodontics Telephone No. 978-208-4677 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ®✓ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead® Undgrd ® No.of Meters Number of Feeders and Ampacity i Location and Nature of Proposed Electrical Work: Installation of burglar alarm Completion of the ollowin table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above Ei In- 'N-o—.of Emergency Lighting rnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS JNo.of Zones r 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 Heat�a Pum Number Tons KW No.of Self-Contained No.of Waste Disposers Totals ' "-'T. - "" "" " ' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 8 Municipal 0 Other �( x`o1 Connection No.of Dryers Heating Appliances Kms, Security Systems: nj No.of Devices or Equivalent l No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE C) BOND ❑ OTHER ® (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Ultraguard Protective Systems LIC.NO.: 1608C Licensee: Michael A. DeCosta Signature LIC.NO.: (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.:781-937-0555 Address: 18 North Maple Street,Woburn,MA 01801 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. 000986 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: $f . The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 � www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Led Iv Name (Business/Orgmiizabion/Individuai): U_t-r aqua rd P r o t P r t i vP 5 V G t Pm.-, , T n r- Address: Ct YAAt City/State/Zip:_ Wnhu r MA n i R n 1 Phone#:_ 7,q 1_a-I 7=0555 Areyou an employer?Check the appropriate box: I. I am a employer with- (� general of project(required): � �4. ❑ I am a contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction, 2.❑ I am a sole proprietoror partner-, listed on the attached sheet.+ ?• ❑lemodeliig ship and have no employees These sub-contractors have 8. []Demolition working for me in_any capacity, workers' comp,insurance. [No workers' comp,insurance 5. ❑ We are a corporation and its 9' El Building addition required.] officers have exercised their .10 Z Electrical rep airs of additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11:[]Plumbing repairs or additions . . myself.[No workers' comp, c. 152, §1(4),and we have no 12.[]Roof repairs insurance required.]t employees. [No workers' comp,insurance required.] 13.❑Other "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowner;who submitthis amdavit 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-contactors and their workers'comp,policy information. Lam an employer that is providing workers'compensation insurance for my employees: Below.is the policy and job site information. Insurance Company Name: Durkin and De Vr i e s Policy#or Self-ins.Lic. #: wC,- 9 v 7 2 7 a Expiration Date: - 11/07/19 40bSite Address: City/State/Zip: Attach.a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisommen.t, as well as civil =alties n the form of a STOP WORK ORDER and a fine of u to$250.00 s day against' p P ) gaunt the violator. Be advised a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insuran a coverage verification. I,do hereby cerci rider t e p s an enakiq of perjury that the information provided.above is true and correcr;. . Si Date: Phone# F only. Do .,nr umi}o;,,tkhv area to be completed by city or town official n• Permit(Ucense# ority(ciHeal 2.Building Department City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector on: Phone#: S L "_ Cor to of 0kw*Awe rt y= CO Number, CCD> ' Expires: 08/2-1/2010 Tr. nd: 6.0 10 W.ow: 149.0 S-License: ULTRAGUA S. RD PROTECTIVE ;�Y �MTECTIVE SYS, MICHAEL A ' - DECOSTA 18 N MAPLE ST MICHAEL A DE C6 WOBURN, MA 01801 G 18 N MAPLE ST WOBURN, MA 018b{ �s s k i !M ji I� � CoMMC3NV��ALTH T a 9j, Aft j ISSLJ S•T#ffs TO LTRAGU•ARA, ,ORS. t ii TCH'AEL A , E. '', Sys-Te I18 NORTH PEEI , IWOBURN. 'I A• ::0;Cry 1 ''' 1727 I'' 1608 C 07/�Y/10 �41Z.78 • t;l cif i w v +r !' f MD siN �S$�cwud CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Permit 224(9/3012008), Date: Janu ry 21,2009 'HIS CERTIFIES THAT THE BUILDING LOCATED ON _ 478 Chickering Road MAY BE OCCUPIED AS Dental Suite ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to : Anne Todd, Orthodontics 478 Chickering Rd North Andover MA 01845 Building Inspector i tkORTH Town of No. 91f 0 11a F _= Y �( �, o over, Mass., LAKE GOCMICMEWICK %S RATED E BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System r 601� BUILDING INSPECTOR THISCERTIFIES THAT.................... .................................................r.................................... ......... Foundation has permission to erect........................................ buildings on ....................... > ... �....�Sri<«, ......... ......... Rough to be occupied as ( �F . U<.7 c� e7ee7. �............................. nnal... provided that the person accepting this permit shall in every respect conform to the t rms 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. LUM ININ 'ECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. EXPIRES IN 6 MONTHS v l PERMIT ELECTRICAL IN CTOR UNLESS CONSTRUCTION STARTS .................. Service BUILDING INSPECTOR Occupancy Permit Required t0 Occupy Building GAS INSPECTOR Rough a Display in a Conspicuous Place on the Premises — Do Not Remove p Y No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner �Street No. IL SEE REVERSE SIDE Smoke Det. CON CTIO CONTROL TR -FINAL S U l�j NTRO AFFIDAVIT NAMEOFBUILDING Buildout of Dental Offices for Dr. Anne Todd PROJECT NUMBER PROJECT LOCATION 478 Chickering Road in North Andover IN ACCORDANCE WITH SECTION 116.0 OF THE MASSACHUSETTS STATE BUILDING CODE, SEVENTH EDITION,I, DAVID A.FARMER REGISTRATION NO. 8333 BEING A REGISTERED PROFESSIONAL ARCHITECT HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT XXX ARCHITECTURAL STRUCTURAL MECHANICAL FIRE PROTECTION ELECTRICAL OTHER(SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT SUCH PLANS,COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRACTICES,AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I HAVE PERFORMED THE NECESSARY PROFESSIONAL SERVICES AND BEEN PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK PROCEEDED IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT,AND THAT I WAS RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2: 1. Review,for conformance to the design concept,shop drawings,samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled material. 3. 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. I FURTHER CERTIFY THAT THE WORK WAS COMPLETED IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AS PER SECTIONS 116.2.2 and 116.4,SEVENTH EDITION OF THE MASSACHUSETTS STATE BUILDING CODE. No.8333 n NCORD, DAVID A.FARMER PERSONALLY APPEARED BEFORE ME AND SUBSCRIBED AND SWORN TO BEFORE ME THIS 1 4thDAY OF January; 2009 - I . QF;9GIA SEAL P. KING dst � CC`rii in;d'cr;`Ti Grft'ASSACHUSEM Ni c:;xn. _x ttc,�tRar. ,2013 N � r10RTp 4 Town of North Andover * Office of the Planning Department `°k�•° �`� Community Development and Services Division �SSACH. Osgood Landing 1600 Osgood Street Building#20,Suite 2-36 North Andover,Massachusetts 01845 P(978)688-9535 F(978)688-9542 Anne Todd,DMD,MMSc 27 Mulberry Lane West Boxford,MA 01921 September 11,2008 Dear Ms.Todd, According to the North Andover Zoning Bylaw Section 8.3.2.c.i,Waiver of Site Plan Review,your request for a'Change of Use at 478 Chickering Road, will not require an application for Site Plan Review. The waiver request is granted based on the following information: • The property will be converted from its current use as a restaurant to a dentist office,a use which is permitted in the General Business District, according to the Town of North Andover Zoning Bylaw section 4.131(1). • The only exterior changes that will be made to the building will be the relocation of the double door that faces the parking lot. That door will be relocated from the right side of the building to the left side, closer to the accessible parking spot,making the entrance more convenient for individuals with disabilities. • There will be no changes to the parking and landscaping areas. The number of parking spaces will remain the same. • A new sign will replace the existing sign in the parking lot as well the,sign on the roof. You will need to contact the Building Inspector for a sign permit. If there are any questions,please let me know. Regards, Ju Tymon,AICP Town Planner cc: Jerry Brown, Inspector of Buildings BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 ............ TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING ArID& CHUS This certifies that .....,z2'�........... .. .......... has permission to perform ............... .................................. wiring in the building,of _l?'49 ................................................................................ ....... .........!... North Andover,Mass. it ,. Fee .. ... ..... Lic.No4 .... . .. ..... ................... -It .... .. ......lyc;;�ICAL NSPECrOR Check # /I/t/ 8 4 Y The Commonwealth of Massachusetts { U, ! Department of Industrial Accidents d , : : Office.of Investigations 600 Washington Street 11itU Boston, MA 02111 i www.mass.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/plumbers Applicant Information Please Print Leaibiy Name (Business/Organization/individual):_ ��'sytv�a �L�CT2c c Address:_ City/State/Zip: �a 5ro,,/ Wg 02-/ 2-5 _ Phone#: . &17 o 3-3 Are you an employer?Check the appropriate box: Type of project(required): 1.IS"f am a employer with 3 4. ❑ 1 am a general contractor and I 6. [1 New construction employees(full and/or part-time).* have hired the sub-contractors .� 2.❑ I am a.sole proprietor or partner- listed on the attached sheet x 7• E, Kemodeling ship and have no employees These subcontractors have 8. Q Demoiition working for mein any capacity, workers' comp.insurance. q, (� Building addition [No workers'comp. insurance 5.,E] We are a corporation and its required.] officers have exercised their 10.5191eetrical repairs or additions 3.0 1 am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No-workers'comp. c. 1.52, §1(4),and we have no 12.[ Roof repairs insurance required.]t employees. [No workers' comp. insurance required.] 13•[]Other "Any applicant that checks boil!f I must also fill out the section below showing their workers'compensation policy information, t Homeowners who submit this affidavit indicating they are daring 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. 1 am an employer that is providing workers'compensation insurance for my employees: Below is the policy and job site information. Insurance Company Name:_ Policy#or Self-ins:Lie.#; 7,4 ddslQwl W 5 G 7 // ?-5z8 Expiration Date: Job Site Address: Y 79-- 1�ic Ciao�.-✓ ,�oQQ City/State/Zip: /1/ %,wove-, /yA. pje y. r 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. 1 do hereby ce�.fy under the and penalties of perjury that the information provided above is true and correct Si Lure: Date: Phone#: -6033 Of,j`icia1 use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions r. Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the'foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees.'however the owner-of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence.of compliance with the insurance'eoverage required." Additionally, MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation.affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es).and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to cant'workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,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'license number on the appropriate cine. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicatingcurrent policy information(.if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 01 flee of Investibattions 600 Washington Street Boston, MA 0.2111 Tel.#617-7274900 ext 406 or 1-11.77-MASSAFE Fax#617-727-774 Revised 5-26-QS www.mass.gov/dia —�� Commonwealth of Massachusetts Official Use Only A kiIF Department'of Fire Services Permit No. k,�/j-3 Occupancy and Fee Checked tea,, ellBOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] eaveblank 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 W INK OR TYPE ALL INFORMATION) Date: /i1,310 f City or Town of. NORTH ANDOVER - To theIn pec or of Wires: By this application the undersigned gives notice of his or her intention torfonn e p the electrical work described below. Location(Street&Number) Owner or Tenant0101�0- % Tel hone No. Owner's Address � � Is this permit in conjun 'on with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building -19-w Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps -7- � l 12-0 Volts Overhead Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location.and Nature of Proposed Electrical Work: QQ ` o% 7 Completion of the followin table maybe waived b the Ins ector of Wires. No.of Recessed Luminaires y0 No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In [Ello.o Emergency g g Q d. d. Batte Units U No.of Receptacle Outlets 1/a No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas BurnersTo No.of Detection and Initiating Devices No.of Ranges £x,s T Tons No.of Alerting Devices g No.of Air Cond. Heat Pump Number ons KW No.of elf-Contained No.of Waste Disposers Totals: -'" p -iE `-""___.. _......._. _._. Detection/Alertin Devices No.of Dishwashers S ace/Area Heating KW Municipal p g IiO�❑ Connection El other No.of Dryers. Heating Appliances , Sectio o D viurimces or Equivalent Heaters KW Si o.of Water No.of No.of s Ballasts . Data Wiring' ° No.of Devices or E uivalent y No.Hydromassage Bathtubs No.of Motors Total Hp Telecommunications Wiring: a,4kA, No.of Devices or E uivalent OTHER: wig �� cerci , Ar-It y (S) Biu vL Attach additional detail if desired, or as required by the Inspector ef Wires. Estimated Value of Electrical Work: 2d,dz�-e (When required by municipal policy.) Work to Start: 11Z3 o P' 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 a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE OND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: :S v�d EL- c LIC. Licensee: /Po8�r7� �,'S•4cvfd Signature LIC.NO (If applicable, enter"exem t"in the license number line.) Bus.Tel.No.: roll-SS'O 033 Address: ;yo- fyc�i v J B v0, fes,57V,✓, �-(6g a 2<z f� fit,Tel.No.: *Per M.G.L c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE.$ 3, / t TP14,tj rn - mom U� r1, 1, °f tNORTI�,M° TOWN OF NORTH ANDO R p PERMIT FOR PLUM NG s o •'a SSACNUS� / J This certifies that ff �VVJJ . . . ��?��� . . µ. . . . . . . . . . . . . . . . has permission to perform ,-. . . ." t ice. . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . at .'. ��c�. . . .- . .- - . . . ., North Andover, Mass. pee�c-^c'. . .Lic. Nolte �. . . . . . . . . . . . _ PLINSPECTOR Check # 7 8 G 1 King Design Associates, Inc. ARCHITECTURE PLANNING INTERIOR DESIGN 10 HIGH STREET MEDFORD,MA 02155 (781)393-0400 FAX(781)393-4228 EMAIL:INTERIORSQKINGDA.NET December 1, 2008 ROUGH INSPECTION LETTER Brian Leathe Local Building Inspector Town of North Andover 1600 Osgood Street North Andover, MA 01845 RE: Buildout of New Dental Offices for Dr. Anne Todd 478 Chickering Road in North Andover Dear Brian: I inspected the project noted above this morning. The following has been done to date in compliance with our documents: Rough Framing has been Completed. Rough Plumbing has been Completed. Rough Electrical Work has been Completed. Please call me if you have any questions. Thank you. Sincerely, King Design Associates, Inc. aED ^,tic 140.8333 Cl) CORD, p 1P David A. Farmer. AIA Architect MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Building Location , �i L HIGKC-QiNC nU. Date I5 GGZoCe�R 000P Owners Name DR A NNr To D\ Permit—# / Amount Type of Occupancy New Renovation Rep lacementPlans Submitted Yes No c. FIXTURES � H y U p ", OrA LZ W _0 z O q O W A j s O ~ cq A A STS84�� BA9ffVM p 4IH FLOCK M FLOOR 6MFLaR 7W FLtOCJEt 91R FLOOR i (Print or type) Check one: Installing Company Name_��� M 0 R E t.t_o , ['N C 13, Corp. Certificate Address 10101 R EU C R E G e* Plea a q r_o ee En+ AAA, � Partner. usmess Telephone W-1-_ 39-1_ to 6 -13 ri Firm/Co. Name of Licensed Plumber: S51-kto Mog v--'LL Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type.of indemnityElBond Insurance Waiver. L the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance iSn ature O canerElAgent ❑ 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 Massau is S (te�hrg Code and Chapter 142 of the General Laws. By: Signalpre o rcense um er Title ype of Plumbing License City/Town 166(.P1 icense INUMDer Master Journeyman ❑ APPROVED(OFFICE USE ONLY OP ID DATA IMMIDDIYYYY) Acony. CERTIFICATE OF LIABILITY INSURANCE R,T�aoR 1 0.5 20 oe PRODucEA CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION THIS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE ODES NOT AMEND,EXTEND F.J. LAROVERE INSURANCE AGENCY ALTER THE COVERAGI=AFFORDED BY THE POLICIES BELOO W. 492 BROADWAY NAIL 0 &VERE,TT MA 02149-3617 INSURERS AFFORDING COVERAGE Phone: 617-387-9700 Fax:617-387-9702 _ 23965_ INSURER A: NORIIQLK i nrnMxi INS. conT�__ 23965 ' INSUREp INSURERS: NoaV= t asnuAN IAB- CONFANT INSURER Ct RJ MORELLO INC- PARKWAY INSURER D: - giVEnTT MR 02149 INSURER E: COVERAGES SRN,$,QXCLU$IONS AND CONDITIONS OF SUCH OR OTHER DOCUMENT WITH RESPECT T EICH T4113 CERTIFICATE MAY BE 15SUED OR TOE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO TIiC•INSURED NAMED At FOR THE POLICY PERI00 INDICATED.NO WITHSTANDING ANY REOUIREMENT,TERM OR CONOTIION OF ANY CONTRACT rs MAY PERTAIN,THC INSURANCE AFFORDED BY THE POLICIES CED B DESCRIBED SUBJECT EPF�CA PO mlou y 1 OOO 000 POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED NUMBER DATE MWOO EACH OCCURRENCE TYPE OF INSURANCE "DTti�IXGETU_RL•NTEO $50 00_. ILYR "b 04/15/08 04/15/09 PKEnnISEBoca,Io +1 GENERAL LIABILITY MED EXP(Any onn parson) s5,000 B x COMMERCIALGENERALLIAWLITY PO09823 rY�OCCUR PERSONAL S�A�V INJURY 61,000,000 CLAIMS MADE I•� J 000 000 GENERAL AGGREGATE _i 2 r PROD UCfS-COMP�OPA—GG $1 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: COMBINED SINGLE LIMly 6$1MIL. CSL PRO• POLICY JECT LOC (E6 gcoident) ..--- AUTOMOBILE LIABILITY BODILY INJURY ANY AUTO 3 04/15/09 IPer Poraon) ALL OWNED AUTOS 8003823 04/15/08 $ X SCHCOULED AUTOS (P r gitewINJURY B - x HIRED AUTOS �( NON.OWNED AUTOS PROPERTY bcc7dcddY DAMAGE Y ani) AUTO ONLY•EAAGCIDEN•P 8 EA ACC S OTHERTHAN pGG $ QARAGE UABILJTY AUTO ONLY ANY AUTO EACH OCCURRENCE $$5MIL AOGREGAI'E S$5 �---- FXcESSIUM FELL-A�Up91UTY Oa/15/Oe 04/15/09 b B OCCUR Ll CLAIMS MADE U001422 9 �-----u A DEDUCTIBLE X TORY uMrrs ER RETENTION S S 1 OOO OOO pa/15/09 04/15/09 E•L@ACHACCIDENT WORK ERS COMPENSATIONAND yiC7689793 E.L.0SEA6E•EAEMPLOYE 51,000r0OD EMPLOYERS'LIABILITY — —�~^ B ANY PROPRIETORIPAR'E�EXECUTNE E.L.DISEASE-POLICY LIMIT i 1 OOO r 000 DFFICERIMEMBER EXCLUDED? Il yyo-daecrlbo-Ilar FIDELITY 100000 SPECIAL PROVISIONS b-1-- 04/15/09 b4/15/09 OTHER P009923 p, FIDELITY BOND I SPECIAL PROVISIONS OPERATIONS I LOCATIONS I VEHICLES I EXCLUSION DESCRIPTION OF S ADDED(jYppASEMENT CANCELLATION DER DAYS WRITTEN KATE HOLDER O OZ SHOULD ANY OF THE ABO NG NSURER WIl.6LEN ENDEAVOR ToICIES Be MAILD BEFORE THE EXPIRATIO CERTIFICATE BLAH DATE THpREOF,THE ISSUING SHALL ITS AGENTS OR NOTICE 1T)THE CERTIFICATE HOLDER NAMED TO THe LEFT.BUT FAILURE TO 00 SO IMPOSE NO 08L1GATION OR LIABILITY OF ANY KIND UPON THE INSURER, RE.PAES EAREpSE REPRESENT E ALITHORI�D CpCU LIA TIMOTHY j,ARA� p ACORD CORPORATION 1988 ACORD 25(2001108) rT*1]T AAAI/0Z/50 AND WORKERS COMPENSATION UOLICY��NFORMATION PAGE POLICY NO: t EO16473A INSURER: RENEWAL NORFOLSS& DEDHAM MULL ?IRL INSORANCE COMPANY 21059 2 go22 NCCI Company No: DEDgAM, MA 02026 Account No: FEIN: 04-3063076 AGENT NAME AND ADDRESS; ITEM 1. NAMED INSURED AND MAILING ADDRESS: FRANCIS J. LAROVERE RJ MORELLO INC YNSVRANCE AGENCY' INC 1901 REVERE BEACH PBWY 492 BROADWAY EV TT MA 02149 EVERSTT, MA 02149 AGENT NO.: 20129 LEGAL ENTITY: CORPORATION (See Workers Compensation Classification Schedule) OTHER WORKPLACES NOT SHOWN ABOVE: ITEM 2. POLICY PERIOD: From: 04/15/2008 To: 04/15/2009 Effective 12:01 A.M.Standard Time at the Insured's mailing address. ITEM 3. COVERAGE: A. Workers Compensation insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA a ars'Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3A. The limits e. Empl y j of liability under Part Two are: Bodily injury by Accident: $ 1,000,00a each accident u b Disease: $ 1,000,000 policy limit BoBodilyIn injury Y $ 1,000,000 each employee Bodily Injury by Disease: C. Other States Insurance: Part Three of the policy applies to the states,If any,listed here: SEE ENDORSBE ENT wC 20 03 06 A p. This Policy iud�os�es�Endorsements d Endorsements d Schedules: See Scheduleof ITEM 4. PREMIUM:The premium for tispolicyn ill beeldetke s�Compensation Classals ification SchedulUISS Classifications. Is subjecttto an Rating Plans. All infbrmabonrequired verification and change by audit. Total Estimated Minlrnum Premium: $ 348 Annual Premium: $ 22.695 Additional I Return Premium: Audit Period: 3>,DTDiOAL Comments Issued At: Date:0 3/11/2 0 0 8 Countersigned by WC ao co 01 A Copyght 1907 Nasional COuncll on CompeAsatlon l"Sumnee paMUCER COPY ....r Jnr P TO IP:F.T. 800Z/1Z/50 F The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.g ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Q A. IE (_Lo Address: 1OlO1 8EAC0 Pkw City/StatelZip: C v irr2 tT, h� d a 1 V j _ Phone #: (Q 1 ' 3£3 - �i Are ygu an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6 ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. # 7. L1 Kemodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9, ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised.their 10:❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1 I.❑ 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' comp. insurance required.] 13.0 Other *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. Homeowners who submit.this affidavit it indicating they arc doing ail wurk and!hen hire outside contractor must submh 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: NOIR(=OZ ' -4- f3t,O_tE AgA PVA U ZyrjL �'i t2 C TNse,QA�uC `o Policy#or Self-.ins. Lie.#: `J,.J1103(, A Expiration Date: a00 r Job Site Address: 91 S 1 1-11 Ck LM Ir,1q (Qn OJOIZ10 AfkZ0VL-R City/State/Zip: j'►')(} . 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 P P STOP WORK ORDER and a fin„ 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 nodrains and penalties of perjury that the information provided above is true and correct Sian Date: d 11 6 8 Phone#: (o17— 3 - to 07 3 Official use only. Do not write inn this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract-of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Notal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es) and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC.or LLP does have . employees,a policy is required. Be advised that this affidavit may.be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to siDn and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self.-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/iicense number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. 4 617-7274900 ext 406 or 1-8.77-MASSAFE Fax#617-727-7749 Revised 5-26=05, www,mass,gov/dia Locatiorc� 8 ^No. _ Date 47 NORTH TOWN OF NORTH ANDOVER 9 } ° Certificate of Occupancy $ Building/Frame Permit Fee $ ACNUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ /--q Check # 20803 - , Insp r COMMONWEALTH OF MASSACHUSETTS TOWN OF NORTH ANDOVER 0 1600 OSGOOD STREET Building 20. Suite 2-36 APPLICATION OF CERTIFICATE OF INSPECTION 2007 ; Fee Required (Amount) $100.00 Date; (�'- cu�OC37 O No Fee Required Accordance with the provisions of the Massachusetts State Building code, Section 108,15, 1 hereby apply for Certificate of Inspection for the below-named premises located at the following address: Street and Number _[7 ckc,6-e-,% ' Name of AAO'r� Premises (JC\S Purpose for whic Premises is Used R-es G)M"+ Licenses(s) or Permit(s) Re uired for the Premises by Other Governmental Agencies: Contact Person --4 r� A Re Telephone 9.Z$- 6,$$•=3 License or Permit Agency f-ov cQ P-e.rr' �-. e�,l �k Certificate to be issued to Addressrj_g Telephone 9 7 t -6t- '�?7-33 Owner of Record of Building Address Name of Present Holder of Certificate Gr - f Name of Agency, if any SIGNATURE OFPE9*6VS TO WHOM CERTIFICATE TITLE IS ISSUED OR Hl3'AUTHOIRIZED AGENT l(� — 2a)7 DATE INSTRUCTIONS: 1) Make check payable to: Town of North Andover 2) Return this application with your check to: Building Dent, PLEASE NOTE: 1600 Osgood Street, BLDG 20 STE 2-36 North Andover MA,01845 Application form with accompanying FEE must be submitted for each building or structure or part thereof to be certified. ' 3) Application and fee must be received before the.certificate will be issued. 4) The building officials shall be notified within ten(10) days of any change in the above information. CERTIFICATE# EXPIRATION DATE: Application for Cl, revised 5/07 jmc i Location No. Date 6,h ,,ORTq TOWN OF NORTH ANDOVER 0S+ ••O .6.. Cis &/ad 200 i Certificate of Occupancy $ } °1 • ti• • s'•••°•E<� Building/Frame Permit Fee $ Mus Foundation Permit Fee $ Other Permit Fee $ j TOTAL $ d Check # 4-1935 Z74- 19362 62 Building Inspector Location SA LS P/9-- . No. Date 0 dam t NO�TM TOWN OF NORTH ANDOVER. j.. • `INTO qw 200 Certificate of Occupancy $ Ke t�' Building/Frame Permit Fee $ ` Foundation Permit Fee $ Other Permit Fee $ r TOTAL $ Check # Building Inspector COMMONWEALTH OFMASSACHUSETTS TOWN OFNORTHANDOVER { 1600 OSGOOD ST APPLICA 77ON FOR CER 77FICATE OFINSPEC770N. Date ( ) Fee Required(Amount)__O -------- -- No Fee Required Accordance with the provisions of the Massachusetts State Building code, Section 108,15, I hereby apply for Certificate Inspection for the below named premises located at the following addres : Street and Number Name of Premises____—__ G.y_ Purpose for which Premises is Used-----------------L—`—e = — ----------------------------------------------------------- Licenses (s) or Permit (s) Required for the Premises by Other Governmental Agencies: License or Permit Affeno Certificate to be issued to Address------_-- ___--- Telephone------------ -- -- ----------------------------------------- Owner of Record of Building Address-- — --�'-- ---�--------�C�-�C —kA-----03077 Name of Present Holder of Certificate____ ' y_4`5_�� � --------------- Na if any--------------------------------------------------- ----- S"TU OF PERSONS TO WHOM CERTIFICATE TITLE IS ISSU OR HIS AUTHOIRIZED AGENT DATE INSTRUCT70NS.- 1) Make check payable to: Town of North Andover ___________ r ---------- -- 2) Return this application with your check to: Building Dept. 1600 Osgood ST, North Andover MA 01845 PLEASE NOTE Application form with accompanying FEE must be submitted for each building or structure or part thereof to be certified. 3) Application and fee must be received before the certificate will be issued. 4) The building officials shall be notified within ten(10)days of any change in the above information. CERTIFICATE# EXPIRA77ONDATEr CERTIFICATE OF INSPECTION WORKSHEET ! REVISED 3.2006 jmc INSPECTION REPORT FORM CLASSIFICATION PASSES INSP1E_C ON yes no DATED 06 OWNER BUILDING NAME OR NO y 7a,-- PGf ' STREET LOCATION y TYPE OF OCCUPANCY - Day Care Auditorium. Restaurant Cafe Gym Apt. School Common Victualer's Liquor Place of Assembly RABLE EXIT SIGN yes no LIGHTED EXIT SIGNS yes no NUMBER OF GRADE FLOOR MEANS OF EGRESS DOORWAYS "2 NUMBER OF SEPARATE STAIRWAYS ACCESSIBLE PER STOREYS U EMERGENCY LIGHTING SYSTEM d cel t cell operable SPff140 N .n ,N . _ .._ a kk FIRE RIVF STII - Xirt tfalti T hy .3 k FII � IIS1!�E,It C p yy 8 c x �'zr..;.. +.; ,w 4il�,.�,,., ...,.,artr�ic �`.,: ;`« �i .y:Yc ,... 4 'Y .." ' ELECTRIC EQUIPMENT VIOLATIONS yes no FIRE RESISTANT CURTAINS OR DRAPERIES �► EGRESSES LAWFULLY DESIGNATE unobstructed yes no HANDICAP ELEVATOR yes n STAIRS PROPERLY RAILED ^Yo_ yes no HALLS AND STAIRWAYS LIGHTED " - - - yes no UTILITY ROOM - CLOSETS RADIATOR GUARDS AJ,4 yes no COMPLIES HANDICAPPED PERSONS LAWS yes no HOW HEATED 454/ Q NO. FIREPLACES yes no BOILER ROOM CONDITION ©L�" 1ST FLOOR SEATS A,ff�� 1ST FLOOR BAR SEAT /V OTHER LEVELS OCCUPANCY NUMBER (INCLUD NG STORIES#AND OCCUPANCY PER FLOOR USE REVERSE SIDE 1 C ALTH OFMASSACHUSETTS T WN OFNOR THANDOVER 1600 OSGOOD ST APPLICATIONFOR CERTIFICATE OFINSPECTION. r Fee Required(Amount) __ Date _ _ No Fee Required Accordance with the provisions of the Massachusetts State Building code, Section 108,15, I hereby apply for Certificate Inspection for the below-named premises located at the following address: Street and Number lX (�v� C 'U��'� Name of Premises------ ----------------------------------------- Purpose for which Premises is Used )q6sr I I ------------------------------------------------------------------------------------- Licenses (s)or Permit (s) Required for the Premises by Other Governmental Agencies: License or Permit Affeno Certificate to be issued to Address--------------------------------------------------------- Telephone--------------- Owner of Recor of wilding –– – -- —-- 01 _ _ 7AddressLL !` 4 �3 0Q NameLL--L2 – of Present Holder of Certificate__��S_ L21 r4_—_________________—_ ----------------- JIS PUEDOR if any_ -------------------------------------------------------------------- PERSONS TO WHOM CERTIFICATE TITLE HIS AUTHOIRIZED AGENT --___ DATE INSTRUCTIONS.• 1) Make check payable to: Town of North Andover ______________________z 2) Return this application with your check to: Building Deyt. 1600 Osgood ST, North Andover MA 01845 PLEASE NOTE: Application form with accompanying FEE must be submitted for each building or structure or part thereof to be certified. 3) Application and fee must be received before the certificate will be issued. 4) The building officials shall be notified within ten (10)days of any change in the above information. CERTIFICATE# EXPIRATIONDATE.- CERTIFICATE OF INSPECTION WORKSHEET REVISED 3.2006 jmc INSPECTION,'IRWORT FORM MM CLASSIFICATION y\ PASSES INSPECTION yes no .�,. DATED' b OWNER BUILDING NAME OR NO.� I, L&LreA I d STREET LOCATION TYPE OF OCCUPANCY - Day Care Auditorium. <CZ urant Cafe Gym Apt. School Common Victualer's Liquor Place of Assembly OPERABLE EXIT SIGN yes no LIGHTED EXIT SIGNS es no NUMBER OF GRADE FLOOR MEANS OF EGRESS DOORWAYS vt� NUMBER OF SEPARATE STAIRWAYS ACCESSIBLE PER STOREYS 2 EMERGENCY LIGHTING SYSTEM r--- ce cell operable {��rjj� f Spl {IIMFF2.:.. :, u g ^GOiGFI/ ^6., ^. y x. s la blO�E x �ed Sla� u � has s FIRE," ncr AI•�CF� t $ "' 'a�, �5r a"d g " gam' $ s - n - j t ct.p�qq�� r r �' z. pi € FI�/ � Yw7a4 OP@Mb lo, ELECTRIC EQUIPMENT VIOLATIONS 0 yes no FIRE RESISTANT CURTAINS OR DRAPERIES EGRESSES LAWFULLY DESIGNATE �� unobstructed yes no HANDICAP ELEVATOR yes no�V STAIRS PROPERLY RAILED 5... yes no HALLS AND STAIRWAYS LIGHTED - yes - no UTILITY ROOM - CLOSETS RADIATOR GUARDS �,J/r ' yes no COMPLIES HANDICAPPED PERSONS LAWS S yes no HOW HEATED NO. FIREPLACES yes no BOILER ROOM CONDITION fe% 1ST FLOOR SEATS- 1 ST EATS1ST FLOOR BAR SEAT OTHER LEVELS OCCUPANCY NUMBER (INCLUDING STORIES#AND OCCUPANCY PER FLOOR USE REVERSE SIDE PASTAE SANDWICHES �. PIZZA 29 N BROADWAY SALEM NH 03079 VISIT OUR WEB SITE: sals-pizza.com CHRIS SMITH OFFICE: (603)894.7396 DIRECTOR OF CELL: (978)729.4682 SALES AND MARKETING FAX: (603)894.7054 EMAIL:csmith@sal"iaa.com cr Location No. a � Date f NORTH TOWN OF NORTH ANDOVER t 1,y � w j p �• � ; ; Certificate of Occupancy $ �'�s''^•''<� Building/Frame/Frame Permit Fee $ s,K�,st 9 Foundation Permit Fee $ Other Permit Fee5)a N $ TOTAL $ Check # ` �O 1. 8%689- 4A Building Inspector F ttORT1i A 4,66. '9A c«.acmw.c« 41 ID sSr9G HU`-'E TOWN OF NOR'T'H ANDOVER SIGN. PERMIT DATE October 18, 2005 PERMIT # 20-2006 This is to certify that Sal Lupoli for Marys Pasta and Sandwiches has permission to erect a 2 70-Square foot roof Signs on/ at 478 Main Street Providing that.the.person accepting this permit shall in every respect:conform.to the terns of the application onBe:in flus office, and:to the provisions of the Codes and By-laws relating to the sign regulations of the.Town of North Andover: Any violations of the Zoning'Regulations regarding Section 6 of the Zoning By-law will void this permit. INTERIOR ILLUMINATED SIGNS ARE PROHIBITED Inspector of Buildings Date y . TOWN OF NORTH ANDOVER SIGN PERMIT APPLICATION Site Owner Applicant_ Site Address �7g �cilLYt,wl2� Size of Proposed Sign �5 k -2— Z How attached: a Against the wall_ Illumination: a) Not illuminated b Roof c) Ground b) Internally illuminated_ f ) d) Other c) Externally illuminated fes" Proposed Colors: Backgrounds Materials:-- ar11�1J11 ST�i2f ,� Lettering Border Required. Attachments: Note: No permanent/temporarysign shall be erected, or enlarged until- .. . Photographs of building an application on the appropriate form furnished by the Sign Officer has Material sample been filed with the Sign Officer containing such information including Color sample photographs, plans and scale drawings, as he may require, and a.perrni Site or.Plot Plan (Required for all free-standin si for such erection, alteration, or enlargement has been issued by him. Drawings of proposed sign ns g g ) Such permit shall be issued only if the Sign Officer determines that the Other, specify sign complies or will comply with all applicable provisions of the By-Law. - JVill sign overhang any public road or.walkway Yes O No ( L f Yes, Name of-Agency.who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED:_ to revised:jrn- 8/98 SIGNATURE OF APPLICANT ' I i { r i 10 a R 0. 4 ^ IN �i ;Jay., h+• ... ........... .... ........... . ........... L Ol1. r @ O CL ill. 4' m Route c� c� Ville 0 fy -J .. Bead � V tel/ yN 4 die '. M P a _ • 4 i 1 d/� Y - PREP..NBLE --- r a,I;�I I•t I I;11 l I ' - � "3 _ _m<nrt�n/�s"=`E snslw'----- _ _ � V'a Ira mean • g ii''(; n ''I'i it - --- — ICD) f � l o ❑ f L I 3 I O ®o (p n COFFEE DOtMIER \/ I !. ° it 1 I 11��1i i EM2 i ► Xl at --- - ° _ ,.I #11;1 , ------- � i • �— - — I - ,w r, I� t I ;' I'ttf Ii1t�I1 GROOM GONDOLA ij f 11 li ll ,I -- - - - • t ? F REM1i IN WN BOY)FT S IA LF]iGOI :•. { I -f )+ .lir •a L sea' Drai"F` 'u Project Name: Mary's Pasta ch Joel David Sllverwatch, Architect AIA Prepared For: Silvestri Deviopment Corporation 014 ' XXX Archltecture - Engineering - Land Plenning XXX Chickering Road - Route 125 scale: u4••r-o• Project Address: North Andover, Massachusetts 769 Matn Street Salam, Now Hampahhe 09078 D.ta: 9/20/00 Sheet Title: Presentation Plans S8&894AM eoas,e.erag MIKATMINDAGLcott Pro N • JDS-26-00 I NMI I . I . x 'd' r �rSStr'•e:. �F�tt M k,�x �, yas,A$� i i yF. Abmkmm W77 Ai Toll h`o,� , i DYmo 4h F xhF'C yM# p.' P � a •C a ' �+�d � xr.#. x I t � g 4 r I 'YsdZ„1 Xb+ � f n9s k7r I � � ITS J1. Ot it I �;.=� -- � ;�,.'�4'a� ,��� �r•. ` t kwP T I t � S•' 1 i , I. I t' 1y {{ f I s i ti 1 3 RECEIVED JAN 2 q 2004 BUILDING DEPT I NOY-19-03 01 :34 PM SAL"S JUST PIZZA 603 894 7054 P, OZ I MORMERM.; I f b i h �rw '� j i i Fr 1 RECEIVED JAN 2 9 2004 BUILDING DEPT. t eR r:F x l!. +a <r X�y J:Y x, l i � 5� 7 e r t �F x i s ori c-k +a t{ ^y � IJ 4't k3 t t • ` X � II 4 SY4`S`a�Cp�� Ilil' I ski �fr i i #rf II .» •� tax Hr�. � ;,�.t .=C.E`+�"�s ���"-�. '4 r u , X vena r m n � i i I I RECEIVED JAW 2 a 2004 13UILD# G DEPT: I r 1 7'AX X 0.3 C) 5 1 W L� I 4 rya 1 .a I 7 JOSEPH LABELLE dvanced New Engiand Sales Representative Ire E 181 Broadway rotection, Inc. Everett, 02149 Manufacturer of Stainless Steel Kitchen Equipment, Exhaust Hood Systems and ANSUL®Fire System Installation (508)993-4080 Cell (617)839-9679 jlabelle@afprotect.com Fax (508)993-2313 �1 g BRENDON DONAi dvanced Operations Manage ire ' rotection, Inc. Manufacturer of Stainless Steel Kitchen Equipment&Exhaust Hood Systems ANSUVg Fire System Installations and Service ANSUI!Fire Extinguisher Installations and Service Office:(508)993-4080 Toll Free:(800)322-6785 E-mail:bdonatio@afprotect.com Fax:(508)993-23 1 i i i t I i i 1 } ; I w ,s- r NNW,, .. v 4 ,rtg y.`f^ 'nr r.x'` N'l n .av,.r rJ .. 'tN "%', g,a`" ` *amu �.:•,"art " z�a�C''^ N. .�; a `: * ,.xr •;:�a" ? µu'', +"__ ^ t✓!> ar'1'' �a-'Y �Y"w' .tir /;,„,r�R �}�� .+w„ _ g r� t 21 r 4 i T 4 ,x � ae"�x"" "`� mam. 7 7- - '-{ ;�'°�� ,,_ "."'"�in4K.' �' Fa,� € '�' -� .��+..•F--may-- . .3 -• e � I I , I l °s nyl,9xlttiN'u��"^�5iy,✓x rlyd"*„ti'w�'A/,/��y,,'"�,rrrr^n� �r � _ _ , ,r[°✓k� byW/lM' _ r � /�� pry _ w � b r;r ,� �tV44,vk rnr � .. c �+ f F ` O u a r O O V Z Q; LO w OM l � ,(' 3 ^ i _ hd N'J'I K i coo Q) L O r kr 6 GALLON SYSTEM=22 FLiOW�WS FLOWS USED=13 21W 2w EXHAUST HOOD 14' T -rr m-_rt .r-p-- ,. -- - 1N 1N a ANSUL R102 FIRE SUPPRESSION SYSTEM INSTALLED TO UL300 STANDARDS,IN COMPLIANCE WITH NFPA96,17A,AND ALL LOCAL CODES AND REQUIREMENTS. 1N 1F 1F 1F 3N PULL STATION s__• .,. TO BE LOCATED 48 A.F.F. GAS VALVE O PASTA TABLE BROILER RANGE TABLE FRYER COOKER L2CATION: MARY'S PIZZA INSTALLED BY: ADVANCED FIRE PROTECTION 490 MAIN STREET 132 N. FRONT STREET N.ANDOVER, MA NEW BEDFORD, MA ELECTRICAL NOTES:-A MICRO SWITCH IS PROVIDED FOR ELECTRICAL SHUT ALARM NOTE:-A MICRO SWITCH IS PROVIDED FOR ALARM DOWN TO ALL APPLIANCES AND OUTLETS UNDER THE INTERPHASE. EXHAUST CANOPY. -EXHAUST FAN 15 REQUIRED TO CONTINUE OPERATING. THIS DRAWING IS NOT PREPARED TO SCALE. -MAKE-UP AIR IS REQUIRED TO TO SHUT OFF. ALL FIRE SYSTEM COMPONENTS ARE TO BE FIELD LOCATED. 1 Restaurant Fire Suppression Systems „ e 15 Fv k The An'sul R-1 02 System. • protectio Meeting the fire protection challenge. In 1962,Ansul recognized that there was companies and local fire inspectors were Over 30 years later,Ansul is still the most no effective system to combat dangerous quick to recognize the new system as an well-known name in restaurant fire and frightening restaurant fires. effective solution to a major problem in protection.The high quality Ansul R-102 Dangerous because a fire can begin on a the restaurant industry.A new and System is the preferred choice of cooking appliance or in a hood or improved model,the Ansul R-101 Dry architects who design kitchens, ductwork and quickly spread to involve an Chemical System replaced the initial R- restaurateurs who own and operate entire kitchen or restaurant. Frightening 100 unit a short time later. them,insurance underwriters who because statistics show that many provide coverage and fire inspectors who restaurants never reopen after a major In 1982,we introduced the Ansul R-102 enforce the codes.These people know fire. Wet Chemical Restaurant Fire that without a system like the Ansul R- Suppression System. It was our answer 102,restaurant fire insurance would be Ansul responded by developing the R-100 to the industry's requests for 1)a system difficult(if not impossible)to obtain at any System,the first dry chemical fire to protect the innovative new cooking price.And they trust the Ansul System to suppression system designed exclusively appliances making their appearance in react quickly to a fire,automatically, for restaurant hood and duct protection. restaurants;and 2)a system with an before the fire has the opportunity to Restaurant owners,their insurance extinguishing agent that is easier to clean grow and spread. In short,the Ansul R-102 System meets the fire challenge.It detects and suppresses fires with or without someone present...24 hours a day. Its simple design permits quick and easy installation in single or multiple system configurations.So it can handle a single Ur mesquite grill and hood or an entire kitchen full of cooking appliances. 1. And the Ansul R-102 System features a } great,new extinguishing agent- - - _ ANSULEX®Low pH liquid fire 4 . suppressant—developed by Ansul scientists to provide better,cleaner fire WN protection.All good reasons why Ansul systems continue to protect more © � 4 restaurants worldwide—exclusive { '$ gourmet,major chain,fast food or a institutional than any other brand. s�6 01M WW n� 4WAUTED FOR USE ONLY IH LIQUID FIRE N PPRESSANT• t7 19.11102 RESTAURANT FIRE - S '010MISON SYSTEMS .1 i "&AZUSLY PART NO. 79372 S _ 'IIIII�IIIINI�I CONSUL'—WARNMI Die CONSUL' REVERSESIDE EUA 1 .a..,...- taw`.> _ `sew«.:'-•.^-�." I 1 What makes the Ansul R-102 Restaurant System better? A better fire extinguishing agent. Great looking fire protection.Architects Simple to install,easy to service.The ANSULEX Low pH liquid fire suppressant and kitchen designers appreciate the fact design of the Ansul R-102 System is a true breakthrough in restaurant fire that the Ansul R-102 System is designed features simplified piping and nozzle protection.An equipment-friendly, near- with aesthetics in mind.The R-102 neutral pH agent-it rapidly suppresses System's exclusive stainless steel placement.And thanks to its cartridge fires,cools hot surfaces to help prevent enclosure blends right into the operation,the Ansul R-102 System is fire reflash,and cleans u fast.Which g reliable and can be recharged faster on p surroundings of today's modern kitchens. site than stored pressure systems.All of means that if fire strikes,you're back in It's completely self-contained so which business faster with less damage and components can be installed out of sight systemnthat can be installed eans a more flexible, rand clean-up cost. where they won't interfere with the visual with less disruption to your facility. appearance or operation of the kitchen. rLL6lq y1lAW0 Flue w1lrtll� :"` .rte�� s( '. � e d f ..Fl.oa ueoreur `o _796 p�. - ! - - - w •.:\ ���' 79372 — _ - � 91 - �- s _ 4 L - F°'°a+"°" c Ys/epic as�4cts _ iysucrobeq�r,e0rOa°Shj�ea�essr�atCmp�oi ve1aahsSieeajd°oitc e warhoA9e bseyoayoweni sR °a °W,d kou 07 m� t rne°� � dnaswe9n UC / Of anay e - por °°na;S?ab teen t is tts°rep/aCeeoa Versatility.The Ansul R-102 System Backed by the best warranty in the A distributor./installer network second comes in 1.5 and 3 gallon sizes.These business.Ansul's five year limited to none.Ansul's worldwide network of systems can be connected in various warranty makes it five times better than restaurant systems distributors is the configurations to provide even greater any other restaurant system. In addition, largest in the fire protection industry.Our capacity.Also,our systems are designed the first major servicing of the systemtrained, j to protect a wider variety of appliances which includes both a regulator pressure distributors all your firretprote ton neetake ds. found in today's food service facilities... test and hydrostatic test of the tank, everything from grills and gas radiant doesn't come u for 12 ears.That's a Ansul system is bestforeou,n quickly and charbroilers to chain broilers and real money-saving advantage because efficientlinstall the system,and provide mesquite wood cooking appliances. most of our competitors require a major the proper maintenance and service.All servicing of their systems after onlywith a minimum amount of disruption to six years. your business.Your nearby Ansul Distributors...when it comes to fire- protection,they're good people to know. Designed and built by Ansul.Which means,simply,that like all Ansul equipment,your Ansul R-102 System is rugged, reliable, built to last and U.L.listed.Only the finest quality materials go •11 into its manufacture.And only those systems which pass Ansul's rigid quality assurance tests ever make it out our doors.You have our word—and our name—on it. I How © ANSU LEX Low pH liquid fire suppressant flows through the piping and is j discharged into the plenum and duct areas and onto the cooking appliances. OWhen a fire occurs in a protected area,it quickly uickly sensed by detectors located in the ductwork or cooking appliance hood. 4 I r: x C — a QThe ANSULEX agent is applied directly on the fire in specific spray patterns, suppressing the fire in seconds.As it smothers the hot cooking greases,a foam blanket is formed,sealing off combustible vapors to help prevent fire reflashes. © The detectors trigger the ANSUL AUTOMAN®release mechanism which actuates the system...pressurizing the agent storage tank and automatically shutting off appliance energy sources in the event of afire. Check out the features of the Ansul R-102 System... Stainless Steel Enclosure...An Ansul ANSUL AUTOMAN Release...Visible exclusive...aesthetically appealing... cocked/fired indicator...provides positive blends in with kitchen equipment... actuation of system...needs no periodic protects against tampering,damage. adjustment. Agent Storage Tank...Stainless steel... f Regulator... 100 psi(6.9 bar)regulated pressurized only when system is -__ pressure ensures constant flow of agent actuated...leak-proof...low = and consistent nozzle discharge pattern. maintenance...allows for fast,on-site v recharging. - Expellant Gas Cartridge...Positive seal, self-contained,no maintenance of valve required.Nitrogen or carbon dioxide. Manual Pull Station...Permits quick, Fuse Link Detection System...Unique Hood-Seal Adaptors...Threaded or sure manual actuation of the system by bracketing provides positive actuation compression-seal options provide tight anyone regardless of fire fighting upon exposure to heat. seal for hood penetrations required for experience...break rod indicating manual distribution pipe or detection lines...more system operation. aesthetically appealing than welded seal. iNml I IN CASE OF FIRE ANSUL.. Lf 10 .f ANSUL, � I FlRE �,r - I i i •_— O®'—_ - • Y N PWNQ�b1VE 37 S y AIIIIIBIIY r111R E `EYEE�Iff'R Nozzles...Designed to provide agent Mechanical or Electrical Gas Shutoff ANSULEX LowpHAgent...At j discharge coverage to each special Valve...Shuts off fuel or power source approximately 8.2,it has the lowest pH of hazard area...special blow-off caps upon detection of fire...clearly marked any wet chemical restaurant agent on the reduce the risk of grease vapor open/closed indicator. market.As a result,it's safer for your contamination...chrome plating matches equipment and employees...especially hood and appliances. when compared to some other high pH restaurant agents. �I i There are various types of Ansul R-102 System configurations.Each is Single Tank designed to economically fit particular 9 sizes of kitchen equipment arrangements 3 gallon as indicated by the following examples. 11 flow numbers The type of system required to protect a specific installation facility is determined by a careful analysis of the following variables: —Size of duct,plenum 4 —Number and size of appliances —Number of nozzles required —Number and size of R-102 System tanks —Number and type of accessory devices needed Following an analysis of the hood/duct and appliances to be protected,your Authorized Ansul Restaurant Systems Distributor can recommend the proper _ system for your application in accordance with NFPA Standards 17, 17A and 96. Double..Tank 3 gallon and 1.5 gallon 16 flow numbers I o 0 0 tl Double Tank 6 gallon (two 3-gallon manifolded tanks) -- 22 flow numbers Listings and Approvals.The Ansul R-102 System hardware has been subjected to the rigorous Underwriters Laboratories Inc.UL-300 test standards and carries the UL:listing for pre-engineered restaurant fire o 0 suppression systems.In addition,the o R-102 System is also listed by Underwriters'Laboratories Inc.of Canada and carries New York City Board of Standards and Appealsapp under Materials and Equipment Acceptance (MEA)No.59-957-E. Number of Typical Applications Description of Protected Areas Nozzles Basic Components Accessory Devices 3 gallon single tank system One One One One designed to provide fire 75 in.(1.9 m)perimeter duct 3 gallon agent tank mechanical gas protection for the small One One and releasing device shutoff valve kitchen appliance arrangement with a 8 ft.(2.4 m)low profile hood Three backshelf hood using One One fusible link detectors low proximity nozzles 48 in.x 30 in.(1.21 x.76 m) Five 13 to 16 in.(.33-.41 m) griddle agent distribution away from hazard TWO Two nozzles 18 in.x 18 in. (.46 x.46 m) One fryers remote manual pull actuation device j II t II 3 gallon and 1.5 gallon Two Two One One non-manifolded system 75 in.(1.9 m)perimeter ducts 3 gallon agent tank electrical gas shutoff designed to provide fire One Two and releasing device valve and controls protection for the medium- 16 ft. (4.9 m)hood One sized kitchen appliance 3 gallon add-on agent Two arrangement One tank 20 in.x 20 in. (.51 x.51 m)fryer One One Five 24 in.x 28 in.(.61 x.76 m)range fusible link detectors One One Eleven 48 in.x 30 in.(1.22 x.76 m)griddle distribution nozzles One Two One 32 1/2 in.x 30 in. (83 x.76 m) remote manual pull upright broiler actuation device One One 24 in.x 22 in. (.61 x.56 m) gas radiant charbroiler 6 gallon manifolded system Two Four One One designed to provide fire 1.02 in.(2.6 m)perimeter ducts 3 gallon tank and mechanical gas protection for the large- One Three releasing device shutoff valve sized kitchen appliance 21 ft. (6.4 m)hood One -- - arrangement Two Two 3 gallon tank 19 1/2 in.x 25 3/8 in.(.50 x.64 m) Six fryers fusible link detectors One One Fourteen 36 in.x 30 in. (.91 x.76 m)griddle distribution nozzles One Two One 26 in.x 24 in.(.66 x.61 m) remote manual pull lava rock charbroiler actuation device One Two 48 in.x 28 in. (1.22 x.71 m)range NOTES: Other R-102 system size combinations up to 30 gallons are available to provide fire protection for larger kitchen appliance arrangements. Nozzle coverage for other appliances is available such as chain,lava rock,charcoal,mesquite broilers,and woks. Other accessories such as hood sealing adaptors,electric alarms,shutoff switches and devices are available. I i yo-ur nearbyRestaurant 'distributor... They can help you analyze your fire protection needs,design the right system,install it,and provide 24-hour service.And they're only a phone call away.Check the Ansul listing in your Yellow Pages under"Fire Extinguishers..."or call toll-free 1-800-TO-ANSUL. riot Ansul.Experts in Global Fire Solutions. RED LINE Fire Equipment•SENTRY Fire Extinguishers•AUTOPULSE Detection and Control Systems•Ansul R-102 Restaurant Systems with ANSULEX Low pH Liquid Fire Suppressant•Ansul Carbon Dioxide, Foam, Dry Chemical and INERGEN ANS Systems•ANSULITE"Class B"Foam Concentrates•SILV-EX"Class A"Foam Concentrate•Ansul Dry Chemical and Dry Powder Extinguishing Agents• SPILL-X Spill Control Agents and \ Applicators i Your Authorized Ansul Distributor: e ANSUL,SENTRY,ANSULAUTOMAN,AUTOPULSE,ANSULEX,INERGEN,SILV-EX,SPILL-X,and ANSULITE are registered trademarks; RED LINE is a trademark. ANSUL INCORPORATED,ONE STANTON STREET,MARINETTE,WI 54143-2542 715-735-7411 Form No.F-8879-7 ©2001 Ansul Incorporated Litho in U.S.A. Advanced Fire Protection, Inc. Proposal Everett, MA Manufacturing Facility: New Bedford, MA Boston 617-389-8700 Advanced Restaurant Ventilation 508-993-4080 1-800-23-ANSUL 617-3894488 1-800-32-ANSUL (Fax) 617-389-5179 (Fax)617-387-0042 (Fax) 508-993-2313 PROPOSAL SUBMITTED TO PHONE DATE SAL's JUST PIZZA 603-894-7054 August 22,2003 STREET JOB NAME Mary's Pasta CITY,STATE and ZIP CODE JOB LOCATION MAIN STREET,NORTH ANDOVER,MA ARCHITECT DATE OF PLANS CONTACT JOB PHONE ATTN: SAL I I FAX CELL 603-553-1111 We Propose hereby to furnish material and labor—complete in accordance with specifications below,for the sum of: Payment to be made as follows: Dollars($ 1/3 DOWN,1/3 AT DELIVERY,BALANCE ON COMPLETION All material is guaranteed to be as specified.All work to be completed in a workmanlike Authorized manner according to standard practices.Any alteration or deviation from specifications Signature below involving extra costs will be executed only upon written orders,and will become an g extra charge over and above the estimate. All agreements contingent upon strikes, Note:This proposal may be accidents or delays beyond our control.Owner to carry fire,tornado and other necessary withdrawn by us if not accepted within 30 - days. insurance.Our workers are fully covered by Workman's Com salon Insurance. We hereby submit specifications and estimates for: 14'STAINLESS STEEL MAKEUP AIR HOOD WITH ALUMINUM BAFFLE FILTERS AND PREWIRED HOOD LIGHTS BUILT TO N.F.P.A.96 STANDARDS. LOREN COOK EXHAUST FAN WITH HINGE KIT AND GREASE TERMINATOR LOREN COOK MAKEUP AIR FAN MAKEUP AIR DUCTWORK SPIRAL 12" ALL WELDED 16-GAUGE EXHAUST DUCTWORK 3 SHEETS OF 4'X10'STAINLESS STEEL WALL PANEL AND TWO ANGLES FOR ENDS ANSUL R-102 FIRE SUPPRESSION SYSTEM INSTALLED TO U.L.300 STANDARDS B-VENT TO VENT CONVECTION OVENS WITH ROOF MOUNT CAP LABOR TO INSTALL,PERMIT AND FIRE TEST NOTE: STAMPED ENGINEERED DRAWINGS IF REQUIRED WILL BE AN EXTRA$1200.00 CLEARANCE TO COMBUSTIBLES BY OTHERS SCHEDULED INSTALL DATE THREE WEEKS FROM APPROVAL AND SIGNATURE All cutting and patching of roofs,walls,and drop ceilings for installation of curbs and ductwork along with electrical wiring for fan motors,hood lights,and installation of gas valve is the responsibility of others.Valves over 2 inches or electric valves are an extra charge. Any engineered stamped blueprints;clearance to combustibles or any odor control devices will be an extra charge unless noted above. It is mutually understood and agreed that this contract shall be governed by the laws of the Commonwealth of Massachusetts,both as interpretation and performance. Any action in regard to the contract or arising out of its terms and conditions shall be instituted and litigated in the courts of the Commonwealth of Massachusetts and in no other. Any extra labor or material added to the above proposal must have a signature authorizing the extra work and the payment schedule. Approval Signature PP g �i3 I! i i! 1 k 1 i C � 5 f i t E j �; S / J r=A P Ar 3 300CF -� I�^ 4' -\'Y ti 7:7- I r - ; 1 I ACRU-B Specifications and Dimension Data Upblast Centrifugal Description- Fan shall be a spun aluminum, roof mounted, belt driven, upblast cen- ExhaustVentilator trifugal exhaust ventilator. Certifications - Fan shall be listed by Underwriters Laboratories (UL 705) and UL Roof Mounted listed for Canada (cUL 705). Fan shall bear the AMCA certified ratings seal for / sound and air performance. Belt Drive Construction-The fan shall be of bolted and welded construction utilizing corrosion resistant fasteners. The spun aluminum structural components shall be con- structed of minimum 16 gauge marine alloy aluminum, bolted to a rigid aluminum support structure. The aluminum base shall have a one piece inlet spinning and continuously welded curb cap corners for maximum leak protection.The windband shall have a rolled bead for added strength. A two piece top cap shall have quick release r latches to provide access into the motor compartment.An integral conduit chase shall be provided into the motor compartment to facilitate wiring connections. The motor, bearings and drives shall be mounted on a minimum 14 gauge steel power assembly, isolated from the unit structure with rubber vibration isolators. These components shall be enclosed in a weather-tight compartment, separated from the exhaust airstream. Unit shall bear an engraved aluminum nameplate and shall be shipped in ISTA certified transit tested packaging. B Wheel - Wheel shall be centrifugal backward inclined, constructed of 100% alumi- num, including a precision machined cast aluminum hub.Wheel inlet shall over- lap an aerodynamic aluminum inlet cone to provide maximum performance and efficiency.Wheel shall be balanced in accordance with AMCA standard 204-96, balance quality and vibration levels for fans. Motor-Motor shall be heavy duty type with permanently lubricated sealed ball bear- A C ings and furnished at the specified voltage, phase and enclosure. Bearings - Bearings shall be designed and individually tested specifically for use in air handling applications. Construction shall be heavy duty regreasable ball type r in a cast iron housing selected for a minimum L50 life in excess of 200,000 hours G at maximum cataloged operating speed. Belts and Drives- Belts shall be oil and heat resistant, non-static type. Drives shall �--- T-Sq. be precision machined cast iron type, keyed and securely attached to the wheel 'a and motor shafts. Drives shall be sized for 150 percent of the installed motor a Loren Cook Company certifies that horsepower.The variable pitch motor drive must be factory set to the specified the ACRU-B shown herein are fan RPM. licensed to bear the AMCA Seal.The ` 1O ratings shown are based on tests Product- Fan shall be model ACRU-B as manufactured by Loren Cook Company of and procedures performed in Springfield, Missouri. accordance with AMCA Publication 211 and AMCA Publication 311 and comply with the requirements of the ACRU-B Dimension Data AMCA Certified Ratings Program. Approx.Ship. Size A B C G T S Roof Opening Type ACRU-B is furnished q' Square* Wt:Lbs Ustandard with UL 705 and cUL Less Motor C m L US 705 listings(Power Ventilator/ 100 12-1/2 25-1/4 20-7/16 2, 18 13-1/2 30 ZACT)when furnished with 120 19-1/4 30-1/4 24 2 20 15-1/2 55 factory supplied motor. 135 19-1/4 30-1/4 24-5/16 2 20 15-1/2 60 150 21-1/8 34-3/4 29 2 24 19-1/2 70 165 21-1/8 34-3/4 29-7/16 2 24 19-1/2 75 180 25 391/2 31 3/8 3 30 25-1/2 90 195 25 39-1/2 32-7/8 3 30 25-1/2 100 210 26-1/8 45-1/4 34-1/8 3 30 25-1/2 200 225 i6--1/8 —T5--1/4 __3_4-1/4 3 30 25-1/2 220 245 28-3/4 49-5/16 36-3/4 3 30 25-1/2 240 270 28-3/4 49-5/16 37-1/2 3 36 31-1/2 260 300 34-1/16 54-5/16 44-9/16 3 36 31-1/2 300 330 34-1/16 54-5/16 45-9/16 3 42 37-1/2 365 365 36-9/16 64-5/16 49 3 42 37-1/2 380 402 38-1/16 64-5/16 51-3/16 3 48 43-1/2 440 445 43-1/16 76-5/16 54-11/16 3 54 49-1/2 500 490 1 44-13/16 1 76 5/16 54-13/16 1 3 1 54 49-1/2 650 All dimensions in inches.'Roof opening size for curbs supplied by Loren Cook Company only. 17 A6RU-B 225 ACRU-B(continued) Catalog Mtr.HP/ Fan Tip OSP 1/8 SP 1/4S 3/8 SP 1/2 SP 5/8 SP 3/4 SP 7/8 SP 1 SP 1-1/4 SP 1-1/2 SP Number Orv.Wt. RPM Speed one BHP Son BHP Son BHP Son BHP Son BHP Son BHP Son BHP Son BHP Son BHP Son BHP Son BHP 1035 6096 7149 6997 6831 6648 6447 6223 5975 5706 5423 4872 4418 29 1.56 29 1.60 28 1.64 28 1.68 27 1.70 27 1.72 26 1.74 26 1.74 25 1.75 24 1.78 23 1.81 2 7391 7244 7085 6911 6720 6510 6279 6027 5758 5206 4757 225R96 1070 6302 31 1.72 31 1.77 30 1.81 30 1.85 29 1.88 29 1.90 28 1.91 28 1.92 27 1.93 26 1.95 25 1.99 50 lbs. 1110 6538 7667 7256 7374 7209 7029 6833 6618 6384 6133 5602 5124 33 1.92 33 11-97,_52 2.01 32 2.05 32 2.09 31 2.11 31 2.13 30 2.14 30 2.15 28 2.17 27 2.20 245 ACRU-B 405 2596 3718 3260 2603 7.0 .16 6.51 .18 5.6 .18 1/4 3948 3516 2950 245R313430 2756 15 lbs. 81 20 460 29494223 3820 3333 2431 9.1 .24 9.2 .26 8.3 .27 7.5 1 .24 475 3045 4361 3971 3518 2793 10.1 .27 1/3 4499 4120 3700 3092 245R48 490 3141 19 lbs. 10.8 29 10.5 .31 10.0 .33 9.5 .33 500 3205 4591 4220 3819 3248 11 11.5 .31 110.91 .33 10.6 .35 10.1 .35 525 3365 4820 4467 4105 3591 2671 12.7 .36 12.3 .38 11.9 .41 11.4 .40 10.9 .36 1!2 5050 4713 4372 3913 3260 245R58 550 3526 13.7 .42 13.2 .44 12.8 .46 12.4 .47 12.0 .46 23 lbs. 575 3686 5279 4957 4633 4226 1 3716 2756 14.6 .48 14.2 .49 13.8 .52 13.4 .54 1 12.6 .53 12.1 .46 610 3910 5601 5297 4992 4650 4196 3529 15.3 .57 15.5 .59 15.1 .63 14.7 .64 13.9 .64 13.5 .61 3/4 5876 5587 5296 4994 4581 4110 3208 245R66 640 4102 31 lbs. 16.6T.66 16.3 .68 15.9 .71 15.6 .74 15.1 .74 14.8 .73 13.8 .66 660 4231 6060 5779 5498 5211 4831 4397 3666 17.8 .73 17.4 .75 17.0 .78 16.5 .81 16.1 .81 15.2 .80 14.8 .77 680 4359 6243 5971 5698 5422 5076 4665 4132 3255 18.1 .79 18.0 .82 17.5 .86 17.1 .88 16.7 .89 16.2 .88 15.3 .87 14.9 .77 �� 1 6427 6162 5897 5630 5317 4924 4486 3653 ' 245R713 36 lbs. 700 4487 19.2 .87 18.9 .90 18.6 .90 18.1 .94 17.2 .98 17.0 .97 16.5 .96 16.1 .88 725 4647 6656 6401 6145 5888 5610 5240 4844 4253 3444 19.9 .96 19.5 .96 _192T1.01 19.0 1.05 18.6 1.09 18.2 1.08 17.8 1.07 16.8 1.06 16.4 .93 760 4872 6978 6734 6490 6245 5995 5672 5306 4906 4181 22 1.11 22 1.12 21 1.17 21 1.18 21 1.24 19.7 1.24 19.3 1.23 18.6 1.23 18.0 1.19 11/2 7299 7066 6833 6599 6363 6091 5750 5393 4961 245R86 795 5096 24 1.27 24 1.28 23 1.35 23 1.36 23 1.41 22 1.43 21 1.42 21 1.41 20 1.41 38 lbs. , 835 5352 7666 7445 7223 7000 6777 6544 6243 5912 5564 4328 26 1.47 26 11.491 26T-1.51 26 11.531 25 11.61 25 11.66 25 1.66 23 11.641 23 11.63 22 11.50 860 5513 7896 7681 7465 7249 1 7033 6812 6544 6227 5899 4927 29 1.61 29 1.63 28 1.65 27 1.68 27 1.77 26 1.80 26 1.82 26 1.80 26 1.79 24 1.74 2 8125 7916 7707 7497 7287 7074 6837 6537 6223 5474 245R913 885 5673 50 lbs. 30 1.76 30 11.78 30 1.80 30 1.84 29 1.87 29 1.95 28 1.98 27 1.97 27 1.96 26 1.94 915 58658401 1 8199 7996 7793 7590 7386 7172 6901 6603 5960 4748 270 ACRU-B 32 J1.941 32 1 1.97 32 2.00 31 2.04 31 2.08 31 2.11 0 2.18 30 2.18 3 30 1 2.171 28 12.15127 1.98 340 2404 4178 3571 2386 5.3 .16 4.3 .18 3.8 .16 1/4 4485 3924 3109 270R36 365 2581 6.1 .20 5.2 .22 15 lbs. 395 2793 4854 4336 3666 7.2 .25 6.3 1 .27 5.5 .28 405 28634977 4472 3838 76T-27 6.6 .29 5.9 .30 1/3 270R46 5161 4674 4091 3035 420 2969 8 4 .3 6.5 .34 6.0 .31 19 lbs. 0 7.3 .32 430 3040 5284 4809 4256 3360 H8.8 .32 7.7 .35 6.9 1 .36 -6.3-F.-36 450 3182 5530 5076 4580 3870 9.4 .37 8.5 .39 7.7 .42 7.1 .41 1/2 5776 5341 4891 4247 3075 270R56 470 3323 10.5 .42 9.2 .44 8.6 .48 8.0 .47 7.4 .41 23 lbs. � 490 3464 1 6021 5605 5182 4598 3668 11.6 .48 10.2 .51 9.31 .54 8.6_1_.53 1 8.3 1 .51 Performance shown is for installation type A:free inlet,free outlet.Power rating(BHP)does not include drive losses.Performance ratings do not include the effects of appurtenances in the airstream.The sound ratings shown are loudness values in fan sones at 5 ft.(1.5m)in a hemispherical free field calculated per AMCA Stan- dard 301.Values shown are for installation type A:free inlet fan sone levels. 23 ­K­SPB - Belt Drive The Loren Cook Company KSPB Filtered Kitchen Supply Packaged Ventilator is a belt drive unit available in six sizes in wheel diameters ranging from 9"to 20", supplying air volumes from 400 CFM to 12,000 CFM with static pressures to 2". Installation is quick and easy through an integral 3" skirt provided for attachment to a roof curb or a curb cap. (See Curb Cap Dimension Data, page 4). Weather protection and long life is insured by an enclosed galvanized steel cabinet with a hooded, filtered intake.The cover is reinforced with ribs to prevent drumming.Washable aluminum filters are standard. Optional fiberglass or polyester filters also are available. The KSPB intake velocities are below 400 FPM to protect against rain infiltration while the fan is in operation. To prevent motor and blower vibration isolators are installed at the factory. The motor and blower use permanently lubricated ball-bearings. The Loren Cook KSPB is engineered to require very low maintenance and has been tested in the Company's AMCA Registered Laboratory. KSPB Exterior View KSPB Interior View Quick release latches hold the top A pivoting motor mount with a screw adjustment is The filter retainer cap in place. provided for ease of maintaining proper belt tension. is held in place by thumb screws. e, A .--- Mt oorsare The filters are J heavy duty, As permanent, sealed ball one inch bearing type washable, r aluminum type. Optional - Iii il��l �J fiberglass be lass or 9 The blower is a dol bl -wi e de double-inlet DWDI polyesterilablmedia ( ) ;i ) available. forward-curved centrifugal type.Bearings are permanently lubricated,ball-bearing type.All shafts are ground and polished steel. Typical Specifications Roof-mounted, side-intake, filtered air supply units shall be belt-driven, double-width, double-inlet (DWDI), forward-curved centrifugal blower type.The unit's blower assembly shall be mounted on vibration isolators. Motor drives shall be machined cast iron and variable pitch through 5 HP. Belts shall be non-static and oil resistant. Both motor and blower bearings shall use permanently lubricated sealed ball-bearings.The blower housing shall be fabricated of heavy gauge painted steel.The unit shall have a galvanized steel hood of adequate size to prevent moisture from entering the building.An insulated cover shall be held in place with four secure latches for quick and easy access. Filters shall be of the permanent, one-inch, washable aluminum type and shall be easily removed for cleaning. Units shall carry the AMCA Certified Ratings Seal for Air and Sound performance with filters in place. Units shall be available by specification as UL and AUL listed models. Q The Loren Cook Company certifies that the The type KSPB is furnished stan- The type KSPB is furnished stan KSPB as shown herein is licensed to bear the dard with UL 705 listingPower Ven- dard with CUL 705 listing (Power AMCA Seal. The ratings shown are based on ® ` tilator/ZACT) when furnished with C ®� Ventilator)when furnished with fac- Atests and procedures performed in accordance factory supplied motor. tory supplied motor. with AMCA Publication 211 and AMCA Publication 311 and comply with the requirements of the AMCA Certified Ratings Program. 2 i 180 KSPB 180 KSPB 3.2 2.8 \ \ \ (� 24 3 B C N 2.0 \ R , U C ko00o 00 7 )10R R N 12 PM EL \ 180 KSPB Dimension Data o � \ 0'4 \ Model A-Sq. B C D WtpLbs oa ° \ \ 180 KSPB 36-3/16 41-7/16 35-7/16 x 30-1/4 34=13/16 392 0 1060 2000 3000 4000 6000 6000 7000 8000 9000 10000 Flow(CFM) 180 KSPB Capacity Data Out. 0 SP 1/8 SP 1/4 SP 3/8 SP 1/2 SP 3/4 SP 1 SP 1-1/4 SP 1-1/2 SP 1-3/4 SP CFM Vel. RPM BHP RPM BHP RPM BHP RPM BHP RPM BHP RPM BHP RPM BHP RPM BHP RPM BHP RPM BHP 2450 876 257 .12 326 .19 388 .26 442 .35 493 .44 O 2652 948 278 .16 342 .23 401 .31 454 • .40 501 .49 2850 1019 299 .20 359 .27 414 .35 466 .44 511 .54 599 .76 3066 1096 322 .25 378 .32 428 .40 480 .51 524 .61 607 .84 3577 1279 375 .39 424 .48 469 .57 512 .67 556 .79 631 1.04 702 1.30 4089 1462 429 .58 471 .69 513 .79 551 .90 589 1.02 663 1.28 727 1.58 788 1.88 4601 1645 483 .83 521 .95 558 1.07 593 1.18 627 1.31 695 1.59 758 1.89 814 2.22 868 2.56 5110 1827 536 1.13 571 1.27 604 1.40 637 1.53 668 1.66 728 1.94 790 2.28 845 2.62 896 2.98 943 3.35 5625 2011 590 1.51 622 1.66 651 1.80 682 1.95 711 2.09 766 2.38 822 2.72 877 3.09 927 3.46 974 3.87 6134 2193 643 1.96 673 2.12 700 2.28 728 2.44 755 2.59 808 2.92' 856 3.23 909 3.63 959 4.03 6646 2376 697 2.49 724 2.67 750 2.84 775 3.01 801 3.18 850 3.52 897 3.87 943 4.24 7152 2557 750 3.11 776 3.30 800 3.49 823 3.67 847 3.85 894 4.22 938 4.58 7650 2735 802 3.80 826 1 4.00 849 4.20 871 14.40 892 4.59 937 4.98 979 5.37 8150 2914 854 4.58 877 4.81 899 5.03 919 5.23 939 5.43 8648 3092 907 5.49 928 5.72 949 5.96 968 6.16 9152 3272 959 6.49 Performance shown is for installation type B:Free inlet,Ducted outlet.Power rating(BHP)does not include drives losses.Performance ratings include the effects of air filters in the airstream. l 11 i i 1 FIRE EQUIPMENT CERTIFICATE OF COMPETENCY Issued To: Donald A.Dennis 361 Cotuit Bay Drive Cotuit,MA 02635 Issue Date: 6/5/2003 Expiration Date: 5/18/2005 Certificate Number: CC 304 Restricted to: 46,47,48 Civil Engineers TMLand Surveyors Scientists TFIVIORAN INC. Land Planners Landscape Architects October 8, 2003 North Andover Planning Board 27 Charles Street North Andover, MA 01845 Re: Marys Just Takeout 478 Chickering Road To the North Andover Planning Board: On October 7,2003,TFMoran Inc.performed an as-built survey of Mary's Just Takeout at 478 Chickering Road. A copy of the as-built plan prepared by this office as a result of that survey is attached for your review. The location of the site improvements are as shown on the attached plan and are substantially in compliance with the plans approved by the Planning Board. Please note at the time of the survey, the sign had not been installed. Sincerely, TFMoran Inc. David R. Jordan, P.E., P.L.S. Vice President Cc: Sal Lupoli 68 Stiles Road, Unit G Salem,NH 03079 Phone(603)898-8788 Fax(603)898-8820 wwvv.tfmoran.com Bedford,NH Manchester,NH • Salem,NH Keene,NH 1 52 Article 110 Requirements for Electrical Installations Article 110 Requirements for Electrical Installations 53 Because Article 450 specifically exempts current transform- specified in Table 110.26(A)(1)unless the requirements of ers,the practical solution to prevent damage to current trans- 110.26(A)(1)(a),(b),or(c)are met.Distances shall be mea Effectively insulated formers not connected to a load or for unused current sured from the exposed live parts or from the enclosure or Electric transformers has been placed here as a new requirement for opening if the live parts are enclosed. a switchboard 61 the 2002 Code. Exposed 150 V, i ( _ Table 110.26(A)(1) Working Spaces live parts nor less 31t E-31t—> H 600 Volts,Nominal,or Less Minimum Clear Distance q Rear Front Nominal Voltage 110.26 Spaces About Electrical Equipment. to Ground Condition 1 Condition 2 Condition 3Condition 1 Electric Sufficient access and working space shall be provided and ) (3 ft min.for 151-600 V) 30 in. UPS switch- 0-150 900 mm(3 ft) 900 mm(3 ft) 900 mm(3 ft)! ^^ equipment board maintained about all electric equipment to permit ready and 480/277151-600 900 mm(3 ft) 1 m(3 ft) 1.2 m(4 ft) Grounded parts,concrete,etc. i 1 safe operation and maintenance of such equipment.Encl- A / Air' Electric filter 1 sures housing electrical apparatus that are controlled by lock Note:where the conditions are as follows: j iswitchboard I and key shall be considered accessible to qualified persons. Condition 1—Exposed live parts on one side and no live or grounded 150 V. j parts on the other side of the working space,or exposed live parts on Exposed nominal, i - --- - - - -- - -- - - - - both sides effectively guarded by suitable wood or other insulating live parts or less - • 9 ° Key to understanding 110.26 is the division of requirements materials.Insulated wire or insulated busbars operating at not over 1 F—3 ft—► for spaces about electrical equipment in two separate and 300 volts to ground shall not be considered live parts. I Exhibit 110.8 Example of the 30-in.minimum working space at Condition 2. Exposed live parts on one side and grounded parts on _tio _ the rear of equipment to allow work on nonelectrical parts,such distinct categories:working space and dedicated equipment the other side.Concrete,brick,or rile walls shall be considered as Condition 2 { j space.Working space generally applies to the protection of grounded. (Space Would Increase to 3'h ft for 151-600 V) as the replacement of an air filter. the worker, and dedicated equipment space applies to the Condition 3—Exposed live parts on both sides of the work space e (not guarded as provided in Condition 1)with the operator between. ! Exposed space reserved for future access to electrical equipment and i Electric Electric p live parts (c) Existing Buildings. In existing buildings where to protection of the equipment from intrusion by nonelectri_ 1 switchboard switchboard 150 V. � � 150 v, electrical equipment is being replaced,Condition 2 working Cal equipment.The performance requirements for all spaces " ' '" "' _ { nominal, nominal, clearance shall be permitted between dead-front switch- about electrical equipment are set forth in the first sentence. . Included in these clearance requirements is the step-back a less1`13 or less distance from the face of the equipment.Table 110.26(A)(1) boards,panelboazds,or motor control centers located across Storage of materials that blocks access or prevents safe work n—► provides requirements for clearances away from the 1 the aisle from each other where conditions of maintenance practices must be avoided at all times. } .,.,;, ^•,�..or _. equip- ment, based on the circuit voltage to ground and whether +a �' � ' and supervision ensure that written procedures have been there are rounded or ungrounded objects in the step-back back Condition 3 adopted to prohibit equipment on both sides of the aisle j g g J p- ,( ' (Space Would Increase to 4 it for 151-600 V) from being open at the same time and qualified persons who S (A) Working Space. Working space for equipment op- space or exposed live parts across from each other. The j are authorized will service the installation. I erasing at 600 volts,nominal,or less to ground and likely to voltages to ground consist of two groups:0 to 150 and 151 j Exhibit 110.7 Distances measured from the live parts if the live require examination,adjustment,servicing,or maintenance to 600,inclusive.Remember,where an ungrounded system f parts are exposed or from the enclosure front if the live parts are while energized shall comply with the dimensions of is utilized, the voltage to ground is the greatest voltage enclosed.If any assemblies,such as switchboards or motor- This section permits some relief for installations being up- 110.26(A)(1),(2),and(3)or as required or permitted else- between the given conductor and any other conductor of the control centers,are accessible from the back and expose live graded. When dead-front switchboards, panelboards, or where in this Code. circuit. For example,the voltage to ground for a 480-volt parts,the working clearance dimensions would be required at motor-control centers are replaced in an existing building, ungrounded delta system is 480 volts.See Exhibit 110.7 for the rear of the equipment,as illustrated.Note that for Condition the working clearance allowed is that required by Table The intent of 110.26(A) is to provide enough space for general working clearance requirements for each of the three 3;where there is an enclosure on opposite sides of the working 110.26(A)(1),Condition 2.The reduction from a Condition personnel to perform any of the operations listed without conditions expressed in Table 110.26(A)(1). space,the clearance for only one working space is required. 3 to a Condition clearance is allowed only where a written ijeopardizing worker safety.These operations include exami- procedure prohibits facing doors of equipment from being nation, adjustment, servicing, and maintenance of equip- open at the same time and where only authorized and quali- ment. Examples of such equipment include panelboards,i (a) Dead-Front Assemblies. Working space shall not fied persons service the installation.Exhibit 110.9 illustrates switches,circuit breakers,controllers,and controls on heat- . be required in the back or sides of assemblies, such as in 110:26(A) must meet the requirements of Table 110.26(A I y equipment this relief for existing buildings. ing and air-conditioning equipment.It is important to under- connections switchboards or motor control centers,where all )O In man cases, e ui merit of "dead-front" connections and all renewable or adjustable parts,such as l assemblies requires only front access.'For equipment that stand that the word examination, as used in 110.26(A), requires rear access for nonelectrical activity, however, a for the presence of voltage fuses or switches,are accessible from locations other than (2) Width of Working Space. The width of the working includes such tasks as checking P g using a portable voltmeter. the back or sides.Where rear access is required to work on f reduced working space of at least 762 mm(30 in.)must be space in front of the electric equipment shall be the width Minimum workingclearances are not required if the nonelectrical parts on the back of enclosed equipment, a provided.Exhibit 110.8 shows a reduced working space of of the equipment or 750 mm(30 in.),whichever is greater. minimum horizontal working space of 762 mm(30 in.)shall 30 in.at the rear of equipment to allow work on nonelectrical In all cases,the work space shall permit at least a 90 degree equipment is such that it is not likely to require examination, parts, opening of equipment doors or hinged panels. adjustment, servicing, or maintenance while energized. be provided. However, "sufficient" access and working space are still - - - -- required by the opening paragraph of 110.26. The intent of this section is to point out that work space is Regardless of the width of the electrical equipment, the - required only from the side(s)of the enclosure that requires (b) Low Voltage. By special permission,smaller work- working space cannot be less than 30 in.wide.This allows access.The general rule still applies:Equipment that requires 1118 spaces shall be permitted where all uninsulated parts an individual to have at least shoulder-width space in front (1) Depth of Working Space. The depth of the working front,rear,or side access for electrical activities described oPerate-at not greater than 30 volts rims,42 volts peak,or of the equipment. This 30-in. measurement can be made . space in the direction of live parts shall not be less than that 60 volts dc. 2002 National Electrical Code Handbook National Electrical Cade Handbook 2002 I. 52 Article 110 • Requirements for Electrical Installations ; - Article 110 Requirements for Electrical Installations 53 Because Article 450 specifically exempts current transform- specified in Table 110.26(A)(1)unless the requirements of ers,the practical solution to prevent damage to current trans 110.26(A)(1)(a),(b),or(c)are met.Distances shall be mea- `4 Effectively Insulated t.formers not connected to a load or for unused current sured from the exposed live parts or from the enclosure or i Electric transformers has been.placed here as a new requirement for opening if the live parts are enclosed. i switchboard the 2002 Code. Exposed 15o V, .. Table 110.26(A)(1)Working Spaces live parts nominal, or less <-3 H— H. 600 Volts,Nominal,or Less Minimum Clear Distance i Rear Front Nominal Voltage 110.26 Spaces About Electrical Equipment to Ground Condition 1 Condition 2 Condition 3 r Condition 1 Electric (3 it min.for 151-600 V) - 30 in. switch- Sufficient access and working space shall be provided and :.- . UPS maintained about all electric equipment to permit ready and 0-150 900 mm(3 ft) 900 mm(3 ft) 900 mm(3 ft)� i Grounded parts,concrete,etc. m1°' equipment 480/2boar77 151-600 900 mm(3 ft) I m(3 ft) 1.2 m(4 ft) safe operation and maintenance of such equipment.Encic Ale // Electric filter sures housing electrical apparatus that are controlled by lock Note:where the conditions are as follows: ! d switchboard' and key shall be considered accessible to qualified persons. Condition 1—Exposed live parts on one side and no live or grounded / iso v, i parts On[he other side of the working space,or exposed live parts on 1 _ Exposed nominal, both sides effectively guarded by suitable wood or other insulating ? live parts or less Key to understanding 110.26 is the division of requirements materials.Insulated wire or insulated busbazs operating at not over E —3 H . for spaces about electrical equipment in two separate and 300 volts to ground shall not be considered live parts. i Exhibit 110.8 Example of the 30-in.minimum working space at Condition 2—Exposed live pato on one side and grounded parts on - •> the rear of equipment to allow work on nonelectrical parts,such ,distinct categories:working space and dedicated equipment the other side.Concrete,brick,or the walls shall be considered as t • c - r Condition 2. as the replacement of an air filter. space.Working space generally applies to the protection of grounded. ; (Space Would Increase to 31h it for 151-600 V) the worker,and dedicated equipment space applies to the Condition 3—Exposed live parts on both sides of the work space ? (not guarded as provided in Condition 1)with the operator between. ! Exposed - space reserved for future access to electrical equipment and § I TEido live arts ElectricP (c) Existing Buildings.In existing buildings where to protectpn of the equipment from mtruston by nonelectri- I board switchboardcal equipment.The erformance re uirements for all s aces _ _ _ _ _ V, 150 V, - electrical equipment is being replaced,Condition 2 working P 9 P _ - _• nominal, nominal, clearance shall be permitted between dead-front switch- about electrical equipment are set.forth in the first sentence. - Included in these clearance requirements is the step-back , or less or Is .Storage of materials that blocks access or prevents safe work distance from the face of the equipment.Table 110.26(A)(1) I boards,panelboards,or motor control centers located across '-3 H—� the aisle from each other where conditions of maintenance practices must be avoided at all times. provides requirements for clearances away from the equip- , _. ment,based on the circuit voltage to ground and whether and supervision ensure that written procedures have been Condition 3 adopted to prohibit equipment on both sides of the aisle there are grounded or ungrounded objects in the step-back j (Space would Increase to 4 It for 151-600 V) from being open a[the same time and qualified persons who (A) Working Space. Working space for equipment op- space or exposed live parts across from each other. The erating at 600 volts,nominal,or less to ground and likely to voltages to ground consist of two groups:0 to 150 and 151 are authorized will service the installation. require examination,adjustment,servicing,or maintenance to 600,inclusive.Remember,where an ungrounded system Exhibit exp Distances the sured from the live parts p the live i parts are exposed or from the enclosure front if the live parts are while energized shall comply with the dimensions of is utilized,the voltage to ground is the,greatest voltage enclosed:If any assemblies,such as switchboards or motor- This section permits some relief for installations being up- 110.26(A)(1),(2),and(3)or as required or permitted else- between the given conductor and any other conductor f the control centers,.are accessible from the back and expose live graded. When dead-front switchboards, panelboards, or where in this Code. circuit.For example,the voltage to ground for a 480-volt - parts,the working clearance dimensions would by required at motor-control centers are replaced in an existing building, ungrounded delta system is 480 volts.See Exhibit 11.0.7 for _ the rear of the equipment,as illustrated.Note that for Condition the working clearance allowed is that required by Table The intent of 110.26(A) is to provide enough space for .general working clearance requirements for each of the three t 3,where there is an enclosure on opposite sides of the working 110.26(A)(1),Condition 2.The reduction from a Condition personnel to perform any of the operations listed without . conditions expressed in Table 110.26(A)(1). space,the clearance for only one working space is required. 3 to a Condition 2 clearance is allowed only where a written ! jeopardizing worker safety.These operations include exami- `"" - - '"""'""'-•`- "'""" iy - procedure prohibits facing doors of equipment from being !1 nation, adjustment, servicing, and maintenance of equip- '+ open at the same time and where only authorized and quali- ment. Examples of such equipment include anelboards, (a)Dead-Front Assemblies. Working space shall not' �# fied persons service the installation.Exhibit 110.9 illustrates PP in 110.26(A) must meet the requirements of Table be required in the back or sides of assemblies, such as + this relief for existing buildings. switches,circuit breakers,controllers,and controls on heat- g dead-front switchboards or motor control centers,where all 110.26(A)(1).In.many cases,equipment of"dead-front" ing and air-conditioning equipment..It is important rounder- - assemblies requires connections and all renewable or adjustable parts,such as q res only front access.For equipment that (2) Width of Working Space. The width of the working stand that the word examination, as used in 110.26(A), fuses or switches,are accessible from locations other than requires rear access for nonelectrical activity,however,a includes such tasks as checking for the presence of voltage reduced working space of at least 762 mm(30 in. must be using a portable voltmeter. the back or sides.Where rear access is required to work on g P ) space in front of the electric equipment shall be the width nonelectrical parts on the back of enclosed equipment,'a Provided.Exhibit shows a reduced working space of of the equipment or 750 mm(30 in.),whichever is greater. Minimum working clearances are not required if the 30 in.at the rear of a ui meat to allow work on nonelectrical equipment is such that it is not likely to require examination,. minimum horizontal working space of 762 mm(30 in.)shall ails q P.. In all cases,the work space shall permit at least a 90 degree adjustment, servicing, or ma ntenance while energized. be provided. p opening of equipment doors or hinged panels. However, "sufficient" access and working space are still required by.the opening paragraph of 110.26. The intent of this section is.to point`out that work space is Regardless of the width of the electrical equipment,the required only from the side(s)of the enclosure that requires (b) Low Voltage. By special permission,smaller work- working space cannot be less than 30 in.wide.This allows access.The geueralrule still applies:Equipment tt at requires mg spaces shall be permitted where all uninsulated parts an individual to have at least'shoulder-width space in front (1) Depth of Working Space. The depth of the working front,tear,or side access for electrical activities described operate at not greater than 30 volts rtes,42 volts peak,or of the equipment.This 30-in.measurement can be made space in the direction of live parts shall not be less than*that ". w _...r,." ._. ._„ 60 Volts dc. A« 2002 National Electrical Code Handbook National Electrical Code Handbook2002 Nsin le Roofing and mechanical contractors are cautioned to stack trusgs materials only along outside supporting members or direct- ly over inside supporting members. Trusses are not NEVER OVERLOAD SMALL GROUPS designed for dynamic loads(i.e., moving vehicles).Extreme OR SINGLE TRUSSES. POSITION LOAD care should be taken when loading and stacking construc- OVER AS MANY TRUSSES AS POSSIBLE, tion materials (rolled roofing, mechanical equipment, etc.) on the roof or floor system. Sleepers e 71�1 Panel point Sleepers for mechanical equipment should be located at NEVER CUT ANY STRUCTURAL panel points (joints) or over main supporting members, and MEMBER OF A TRUSS. only on trusses that have been designed for such loads. CAUTION NOTES Errors in building lines and/or dimensions, or errors by others shall be corrected by the contractor or responsible construction trade subcontractor or supplier BEFORE erection of trusses begins. Cutting of nonstructural overhangs is considered a part of normal erection and shall be done by the Installer. Any field modification that involves the cutting, drilling, or relocation of any structural truss member or connector plate shall not be done without the approval of the truss manufacturer or a licensed design professional. Under industry guidelines, trusses that have been field altered on the jobsite or overloaded during the installation phase of construction may null or void your truss manufacturer's limited warranty. Check your truss manufacturer's limited warranty for specific information. The methods and procedures outlined are intended to ensure that the overall construction techniques employed will put floor and roof trusses SAFELY in place in a completed structure.These recommen- dations for bracing wood trusses originate from the collective experience of leading technical person- nel in the wood truss industry, but must, due to the nature of responsibilities involved, be presented only as a GUIDE for use by a qualified Building Designer.or Installer.Thus, the Wood Truss Council of America expressly disclaims any responsibility for damages arising from the use, application, or reliance on the recommendations and information contained herein. Selected text and figures referenced or reproduced from HIB and DSB with permission of the Truss Plate Institute, Madison,WI. WOOD TRUSS COUNCIL OF AMERICA TM One WTCA Center 6300 Enterprise Lane - Madison, WI 53719 608/274-4849 • 608/274-3329 fax wtca@woodtruss.com - www.woodtruss.com Copyright 0 1986-2003 Wood Truss Council of America WTCA-131 ES 030324 N Opp S .P AA O C CO R Table V Clearances to Combustible Material for Furnaces and Boilers Installed in Rooms Which Are Large in Comparison 00 With Size of Equipment, Except as Provided in 6.3.1(a) (See Note 9) Minimum Clearance, Inches t_j 00 Jacket Front Vent O 0 Above and Sides Draft Hood and Connector. `71 Sides of and (See Barometric Draft Plenum Rear Note 1) Regulator (See Note 2) t" I. Listed automatically fired, forced air or 2 tZ0 6 6 gravity system, with 250 F temperature (See Notes 6 18 � 9 limit control. 3 and 4) (See Note 10) N II. Unlisted automatically fired, forced air or Z III O gravity system, equipped with temperature 6 6 18 18 18 y limit control which cannot be set higher (See Note 5) (See Note 6) (See Note 6) y than 250 F. N r III. Listed Automatically Fired Heating Cn Boilers—Steam boilers operating at not 6 6 18 6 6 over 15 psi gage pressure and hot water (See Note 7) (See Note 10) O boilers operating at not in excess of 250 F. IV. Unlisted Automatically Fired Heating Boilers—Steam boilers operating at not 6 6 18 18 18 N over 15 psi gage pressure and hot water (See Note 7) 00 boilers operating at not in excess of 250 F. (See Note Note 6) (See Note 6) C) V. Central heating boilers and furnaces, other 18 18 18 18 18 than above. (See Note 8) (See Note 6) (See Note 6) N For Sl units: 1 inch = 2.54 cm; 250°F = 121°C n � a +.s r F3F i �O M 1 l.� • a O 11 1 V 1 f f 1 40R7►l — fl s; �O,+r``O OL 4 r} RECEIVED °�•",ti JOYCE BRADSHAW TOWN CLERK C86+rfth+b (20)days NORTH ANDOVER NORTH ANDOVER eWPSW tram deq of dec Wm,filed OFFICE OF �V*f29. - 2000 APR 2to All: 18. crane > oov THE ZONING BOARD OF APPEALS •V)"A 27 CHARLES STREET Tmr CMlt NORTH ANDOVER,MASSACHUSETTS 013-4. FA.\(973)638-9542 Any appeals shall be sled NOTICE OF DECISION �t�' . w' "•;, !thin 20 days after the ama ' O Year 2000 date of film of this notice a; Property at: 478 Chickering Road in the office of the Town Clerk. NANE: Salvatore Lupoli DATE: 4/12/2000 ADDRESS: 478 Chickering Road PETITION: 011-2000 North Andover,MA 01845 HEARING: 4/11/2000 The Board of Appeals held a regular meeting on Tuesday evening, April 11, 2000 at 7:30 PM upon the application of Salvatore Lupoli, for premises at: 478 Chickering Road, North Andover, MA. Petitioner is requesting a variance from the requirements of Section 7,paragraph 7.1,7.2&7.3 of Table 2, G-B Zoning District,in order to allow a front, side and rear setbacks and from Section 8, Supplementary Regulations. Petitioner is requesting a finding from Section 9.3 in order to demolish an existing non-conforming structure. Petitioner is requesting a Special Permit from Section 9,Paragraph 9.1, 9.2& 9,3 to allow the �~ new construction of a structure on the pre-e.dsting non-conforming lot. The following members were present: Walter F. Soule,Raymond Vivenzio,Robert Ford, Scott Karpinski and George Earley. ' Upon a motion made by Scott Karpinski and 2"d by Walter F. Soule the Board voted to GRANT a P" dimensional variance for relief of a front setback of 20', side setback of 22' and rear setback of 32', and that the proposed building doesn't extended higher than 30'on the condition and basis that the petitioner has satisfied the provisions of Section 10,paragraph 10.4 of the Zoning Bylaw and that the granting of •�.i these variances will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning Bylaw. The Board voted to GRANT a Special Permit for a finding from Section 9.2 in order to demolish an existing non-conforming structure on a non-conforming lot,and GRANT a Special Permit from Section 9, 9.1,8.2&9.3 to allow the new construction of a structure on a pre 'sting non- Pr g conforming lot. The Board finds that the applicant has satisfied the provision of Section 9, paragraph 9.1 of the Zoning Bylaw and that such change,extension or alteration shall not be substantially more detrimental than the existing non-conforming structure to the neighborhood. In accordance with the Plan of Land by: Hans-Georg A.Mertsch,Jr. #33941, Civil Engineers,2 1 A Street,Burlington, MA,dated: 3/10/2000'! Voting in favor: Walter F. Soule,Raymond Vivenzio,Robert Ford, George Earley and Scott Karpi nski. pe" Furthermore,if the rights authorized by the variance are not exercised within one(1)year of the date of the grant,they shall lapse,and may be re-established only after notice,and a new hearing. Furthermore,if a Special Permit granted under the provisions containedrt herein shall be deemed to have lapsed after a two(2)year period from the date on which the Special Permit was granted unless , substantial use or construction has commenced,they shall lapse and may be re-established only after notice,and a new hearing t;- By order of the Z and of Appeals, \a { Raymond Vivenzio, an 1 02%) � Y111J.•�,� ml/d i 000/ eas�ons2 10 BOARD OF APPEALS 688-9541 BUILDINGS 688-9543 CONSERVATION 688-9530 HEALTH 688-9510 PLAT i`1NO 688-9535 i Re gistry of Deeds Northern;D strict of Essex.County Lawrence, MA 41840 0.4/23/01 DEVINE MILLIMET AN # 24 Rec: h Type PLAN 45..00 Inst 120.16 Copies 2.25 # .25 f ec: Type DECU 30.00 Inst,' 12017 CopiLs 0.15 Total 78.00 # 26 Payment Check 330.75 # 27 Payment Check 47.25 THANK YOU! Thomas J. Burke j Register, of meds 1 W , o { W b U- 0 /4) Ix U) w � ) T d 4 F- 0 rC) Z U.. X W U) NORTH Ot F 9 3SACHU3?i NORTH ANDOVER OFFICE OF THE ZONL TG BOARD OF A?PEALS 27 CHARLES STREET NORTH ANDOVER,MASSACHUSETTS O l345 FA.`((973) 633-9542 Notice is hereby given.that the Board of Appeals will hold a public hearing at the Senior Center, 120R Main St.,North Andover, MA,, on Tuesday the I It" day of April, 2000 at 7:30 PM to all parties interested in the appeal of Salvatore Lupoh, for premises at: 478 Chickering Road, North Andover. Petitioner is requesting a Variance from the requirements of Section 7, Paragraph 7.1, 7.2 & 7.3 for front, side& rear setbacks, and from Section 8, Supplementary Regulations. Petitioner is requesting a finding from Section 9.3 in order to demolish an existing non-conforming structure. Petitioner is requesting a Special Permit from Section 9, Paragraph 9.1, 9.2, & 9.3 to allow the new construction of a structure on the pre-existing non-conforming lot. Said premises affected is property with frontage on the West side of Chickering Road within the G-B Zoning District. Plans are available for review at the office of the Building Dept., 27 Charles Street, North Andover, MA Monday through Thursday from the hours of 9:00 AM to 1:00 PM. By order of the Board of Appeals, William J. Sullivan, Chairman Published in the Eagle Tribune on March 28, and April 4, 2000. Ml/legalnotice 2000/10 BOARD OF APPEALS 688-9541 BUILDINGS 688-9545 CONSERVATION 688-9530 HEALTH 683-9540 PL.kNNING 688-9535 TOWN OF NORTH ANDOVER BUILDING DEPARTME- APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, DEMOLISHBUILDING M OTHER THAN A ONE OR TWO FAMILY DWELLING _)NY ME§ .This Section for Official Use Onl w, BUILDING PERMIT NUMBER: ;2 DATE ISSUED: i G SIGNATURE: r o Bulldin Commissioner ordBuildings Date 1.1 Property Address: 1.2 Assessors Map and Parcel Number: �`�� C�tC�ercNcq r0. Map Number Parcel Numbal 1.3 Zoning Information: 1.4 Property Dimensions: v a Zonin District Proposed Use Lot Area Frontsge(ft) m 1.6 BUILDING SETBACKS(ft) Front Yard Side Yard Rear Yazd Required Provide RNuired Provided R red Provided 1.7 Water Supply NLGL.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ ZO6e Outside Flood Zone ❑ Municipal On Site Disposal System ❑ 2.1 Owner of Record Name(Print) Address for Service S -M L...V IL ��3 .4 �q-73q R=1 Signatu Telephone 2.2 Authorized Agent N et Address for Service: Z Signature Telephone Z M & pi, * '` 90 3.1 Licensed Construction Supervisor Not Applicable ❑ Address License Number 0 Licensed Con Supervisor: s3J_ v z_ a 3 � Ll3 Expiration Date � r gnature _ Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name Registration 24:nnber r Address r Expiration Date ^Z Signature Telephone P1 Location rill(�I 11t1011jY /'" No. Date MaRTM TOWN OF NORTH ANDOVER Certificate of Occupancy $ 1'�s � E<�' Building/Frame Permit Fee $ s�C lus Foundation Permit Fee $ Other Permit Fee $ d' TOTAL °` $ Jia r Check # v 03 Building Inspector �xsx 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......it No.......0 'S�C" 'f41+i 5- USSQNA��I&fit CPtSt> N R'V�'LS '43�ii+tG&A Nb S' tU 'IS x'13 �QNSit1€tCTt3N+C`#3) tUI,1� � 'C3Z C�iR 16 +�QI!TTT "M T1D .4,Otll GF UFT1 S>pA 5.1 Registered Architect: Name: Address Signature Telephone Name: Area of Responsibility Registration Number Address: Signature Total Expiration Date Not applicable ❑ Name: Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Company Ne: Not Applicable � . Responsible in Charge of Construction i I II t J 1 New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition 0 Accessory Bldg. 0 Demolition Other 0 Specify Brief Description of Proposed Work: C-1t- CO, U YyjTON r r USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 0 A-3 ❑ IA 0 A4 0 A-5 ❑ 113 ❑ B Business ❑ 2A ❑ C Educational ❑ 2B 0 F Factory 0 F-1 0 F-2 0 2C 0 H High Hazard ❑ 3A ❑ IInstitutional ❑ I-1 ❑ I-2 ❑ I-3 ❑ 3B ❑ M Mercantile ❑ 4 0 R residential 0 R-1 ❑ R-2 0 R-3 ❑ 5A ❑ j S Storage 0 S-1 0 S-2 ❑ 5B ❑ U Utility 0 Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34:' Proposed Hazard Index 780 CMR 34: MIT 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 i Independent Structural Engineering Structural Peer Review Required Yes ❑ No ❑ SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, C ty'ATtE as Owner of the subject property Hereby authorize 1JeS;Q', C��s6Qu�i «= to act on My behalf, in all matters relative two work authorized by this building permit application Signature of OwAdr Date q a _. es ,as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury 4; Print Name Signa of Owner/Agent Date Item Estimated Cost(Dollars)to be 4 � � Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical ) Estimated Total Cost of C-eftstfwtieft4om 3 Plumbing Building Permit fee (a) x(b) Q r 4 Mechanical(HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) Check Number Lr .:`T' '" .�5�;.Z€S✓�"}a„�,.rq°ArSr',^ -:.-. Jr *i•.�r 7'a �.; �1 x -,ra rX ;4'12 •:'05,�,�7 q'�v.�':.r�„ f ,t� �,}p i.���`3ed -�tt t �:Y i u{ i}'�F k:.o- ty":i:g r P4,,��`.d:�€:.¢Y,,'`y.r7;u'M3S.Rqr.nh 4�.*.�i.t �..l.`ai•,iL"?.;Fv�.s4`1)r7.`5rr'L;xw'.r�r..s,dY�3�ir'rS-,t `�`.'. t.qs<.t.kJ.ka ai1Y,-ta,-�4::�q�"xw+.T.�F}�z.r.�'��`'�rd.�J+i,�r,�z�f c�'�:t \ OEM' Nk7r� �+ryr r NO.OF STORIES C SIZE BASEMENT OR SLAB r : SIZE OF FLOOR TIMBERS I sT2ND 3 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 I IS BUILDING CONNECTED TO NATURAL GAS LINE azvmg I I I • r Town of North Andover °� pORTH .� tz's° '6w Building Department 27 Charles Street o North Andover, Massachusetts 01845 4 (978) 688-9545 Fax (978) 688-9542 O �w„■ COCNK �wKN �ORArlo p•PP"�y Building Demolition Affidavit 9SsgcNus���c DATE r, OWNERS NAME&ADDRESS S I s R nn PROPERTY LOCATION �{ 78 C{ti o Kc-9l tv� a/ta DESCRIPTION !) � Vn 0 { 1 I o r\ CONTRACTORS NAME &ADDRESS S � DEPARTMENT SIGN-OFFS D.P.W./WATER SEWER -Cz GAS ELECTRIC CFO V e,#`2 u- J.I 111 TELEPHONE , CABLE f ! TAXES POLICE �"�' 3-- C)/ FIRE EXTERMINATOR •! - �i �- DUMPSTER-O /OFF STREET DIG SAFE NUMBER ®� o o G 6 BLDG. INSPECTOR ' DATE REC D fie tioamntanrrircalll o�j�a�aclrrcaead } BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 059778 Birthdate: 01/3111973 Expires: 01/31/2002 Tr.no: 13199 Restricted To: 00 CHRISTIAN W SILVESTRI _ 24 STILES RD#101 SALEM, NH 03079 Administrator I The Commonwealth of Massachusetts d Department of Industrial Accidents W Office of Investigations WF Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: Location: Ci Phone # 0 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. Comgany name J'' j r/ �`� C° Address a Y fill Ci dale ,�'` Al Phone#: Insurance Co. C%`D`°rte Y� Policv# Company name: , Address City Phone#' Insurance Co Policv# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment-as cell-as.civil..penalties in theform-d-aSTOP-WORK_ORDER.and_afine_of,(.$100.DD)-a iay.against.me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify under the pains an n of�erfu a infor tie provided above is true and correct. Signature Date Print name C���,C oar S, �`'�if�r� ' Phone# � �1-2 2L l yy Official use only do not write in this area to be completed by city or town official' I City or Town Permit/Licensin 0 Building Dept ❑Check if immediate response is required 0 Licensing Board p Selectman's Office Contact person: Phone#: Health Department Other 1 orrr .K4 uv Notification Prior to.Construction or Demolition General Construction or Demolition Description 1. Construction or demolition contractor 9 yes,who conducted the survey? Amar Aura as dcaoaraw-I'm in&trcaftMOWN • -_ !' UAarlaw� 7. Construction of demolition 9�Y -y sarin. �aeaa. 2. On-Site Supervisor 8. For demnGtion•and construction projects,indicate dust suppression Dp tech 'ruQ d ues to be use -. - Aaar _ am-�etu o parmo - - 3. Is the esti faeTity to be demolished? ng shrouding 0 covering l7 other es ❑ Nc 4. Describe the uea(s)to be demolished: 9• For Emergency Demolition Operations,who is the boo State or local offtaial who evaluated the emergency. / ✓ � G./ua�� ��o•�j _� .... wM tzar 5. If this is a construction project.describe the budding(s)or addition to be constructed: /'wyx P }� (�r 6. ff this is a demotion project were the structure(s) AEP f'u`rl surveyed for th ence of asbestos containing material (ACM)? esO No (General StatemwtC a asbestos is found during a Construction or to.filing an asbestos removal notification with the Oepartment Demolition operation.all responsible pasties must comply with and/or a notice of a releauNweat of release of a hazardous 310 CMR 7.00,7.09.7.15 and Chapter 216 of the General Laws of substance to the Deputmertt,fi applicable.) the Commonwealth.This would include,but would not be limited Certification _ �� I certify that I have examined the above and that to the best of Prier kine my knowledge it is true and complete.The signature below subjects the signer to the general statutes regarding a false .....__ .................... .:................. _..........._,_ and misleading statement(s). AWk"edSujruwe An�uo/ripe Oxr P.E1 Rev.6/92 Noe 2d2 P � BWP AQ 06 �r -�:. � fl } Notification Prior to Construction or Demolition ------------ Lu y ' Applicability tylln NS A Construction or Oemotltion operation of an industrial, tions 310 CMR 7.09.Notification of Construction or i Al semom of the commercial.or M' tdutional-budding,or residential 0emolition operations is required under 310 CMR 7.09(Z) bteidN with 20 or more units is repulited bran most be by the ten(10)days poor to any work being performed.The Mobwn order m Department of Environmental Prowlion(DEP),Bureau of following information is required Pursuant to 310 CUR 7.tt9c C *Wtktw Waste Prevention-Air Ouft Owion,under Regula- t ^� General Project Description Mq*4=Masic 0L� A CM 1D9 t. fzr►r z sum Oriprgl S ILI ,j � Fm To: Adm Iwo C�:C u ✓,fn K�,� , Manachmft AMW ee ►.OJ.120oti'! A ' �rl odd 14er — (af kYJ latm MA oras- ` r°"°ow 3�� sue :voaa.aeo.r l�U Z i b.a o. Aamsafluxs Nasavr:ftmeow b 1=7 ra ❑ w Current or prior use of tacft Is the Facility a facility? V10, . • / t7 Yes _ a Yes,how many units? 2.Facility Owner AMU AMM i mat Ataypei . 3.General Contracto r f 111f,0 n` oI .__. � .....�./.:. ... /w A&Wm S n �- __._...=.. Gh/low / ldioarr on-5............. ........... ___ 1f"Zug& r I e I i • Town of North Andover o¢ �st�o ti ! O Building Department o 27 Charles Street North Andover, Massachusetts 01845 4 - o LAKE . Ty COG�u[MWK■ 7' 978 688-9545 Fax 978 688-9542 e AcHus���� 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 MGL cl 1, s150a. The debris will be disposed of in/at: Facility location Signature of Applicant Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. x ORTH E Town of over O ..k i� TT Z 5 TT ` ` 00 o� �o� � dower, Mass., �O� 07 ADRATED 5 S H � BOARD OF HEALTH PERMIT T Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...&....... A).....#? .......V......................................... """••• :: :: Foundation has permission to t..'1 ..,IQ..Z..E..... buildings on ... .. ... ....�,b l C.......Cr...N Rough to be occupied as.. P . ......... ........IV...................... . � Chimney . w ..C .N 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.. II ' /a f PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Fina' UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR IL Rough • ........ Service BUILDING INSPECTOR Final Occupancy Permit Required t0 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' NV a'f/— I,ZjlQ TFMORAN INC. � waft Land Planners . Landscape Architects • Graphic Artists , 48 Constitution Drive,Bedford,NH 03110 (603)472-4488 Fax(603)472-9747 9�epa� ©Copyright 1998 R.II/R.W rz a->AwwC rut —- -- - - -- - -- - - caxre e resit srrro r7/±')-��/ \� �i,o'+ afcjmc oar,, 4 ' .'u Aw i—, i.NV-' j.xf�7 :ri' —`� �jM' /\ ` \ `' I �• wv 6e NY q/I_!N.I9 1•I")J l. f ��♦'M.N+`//// "' f !l -511 e. Ic .urw.;��kr Z St t f ..� \• ___� -i Y ve117.71[IIM.w: Yol t , Ll �' 111���fff YAG'J1C:/I!'A ..� {j ' `�i .M(•f•/ .yVpiS. wG , �,L' w { ;`5 r_ �� \ 11V411 •�d�V -r / '�-� .._ ' t �Fra s EFT- "" � _ r �� ,,•• 1 AO PARING-vm\ ✓2 /er A,eg7lr AVr a-Te- 1 CSI Date. . . bZ TOWN OF NORTH ANDOVER 010 PERMIT FOR PLUMBING ,sSACHUSf' This certifies that --f �J . . cD has=permission to perform . .!`.�-� avr a v�t/� plumbing in the buildings of . Sf -I;i * a... �+ at . ' . �. . �/!'.(.0 .� � . �.'•` . . . . . . . . . .. North ndover, Mass. Fee. 9�:l'.( .Lic. No/c;�D.t7.P . . . .3' T4UZZ.` —,V-Cl., PLUMBING I POR Check # ECT 5363 r A i I MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date Building Location I 4 , C pyd Owners Name i 6'f/'0— Permit# Amount Type of Occupancy (es`z t-u- New Renovation Replacement1:1 Plans Submitted Yes ❑ No ❑ FIXTURES � I i H w a w w x Cr U w > a as A rx as SL13-BM RMEVEW 4M>F>-OM 5MlDM 6M H-CM 7M K" gm R" (Print or type) �l. c h Check one: Certificate Installing Company Name , ❑ Corp. Address Partner. u mess Telephone 7 — Firm/Co. Name of Licensed Plumber: e� Insurance Coverage: Indicate e type of insurance co)(erage by checking the appropriate box: Liability insurance policy Other type of indemnityBond rl Insurance W ' er I ed,have been made aware that the licensee of this application does not have any one of the above three i i atur Owner Agent I hereb= fy that all of -details and information I hav °submi ed entered in above application are true pp and accurate to the best of a ge and that all plumbing work and i +alla o e rmed under Permit Issued for this application will be in complia'1ce with all pertinent provisions of the Mass u ett e u ing CS e and Chapter 142 of the General Laws. By: na ZU e - um er— TTitle um ing License City/Town License um Master Journeyman ❑ APPROVED(OFFICE USE ONLY Date... . w ► 40RTH 3j y` TOWN OF NORTH ANDOVER t > PERMIT FOR GAS INSTALLATION SACHUSEt This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . -� ��:>. . . . . . . . . . in the buildings of . .. . . . . �-. . . . . . . . . . . . . at .y . . . . .. North Andover, Mass. . . . % ?Fee�q. . . Lic. Nof . . .�. . GAS INSPEvrQR Check# V pl q L v 44 %.- u MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS F MING r (Type or print) Date NORTH ANDOVER,MASSACIMSETTS Building Locations �78 `� Permit# 41y0 to < Amount$ G�� eA rfTaT— e u Owner's Name New Renovation ❑ Replacement ❑ Plans Submitted ❑ w U a UO _ flea F o >0 1 a O w xO H w0 ., � U wa� O x a O ` F >+ v� O O O m d 3 a SUB-BASEM ENT BASEMENT ]ST. FLOOR 2ND . FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH . FLOOR 7TH , FLOOR 8TH . FLOOR Lij I I I I I I I I LL I I (Print or type Check one: Certificate Installing Company Name ❑ Corp. Address © - ❑ Partner. Business Telephone — - irm/Co. Name of Licensed Plumber or Gas Fitter 4.t" INSURANCE COVERAGE Chec one: I have a current liability InIce policy or it's substantial equivalent. Y No❑ Ifyou have checked yes,pn ' to the type coverage by checking the appropriate boxLiability insurance policy Other type of indemnity ❑ Bond ❑Owner's Insurance Waiveaware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent [I I hereby certify that all of the details and information I have submitted(c en above application are true and accurate to the best of my knowledge and that all plumbing work and install 'ons er Permit Sued for-this application will be in compliance with all pertinent provisions of the lviassach S and Chapter 142 of the General Laws. By: pGa o icensed lumber Or Gas— By: Title CityfTownr um er APPROVED(OFFICE USE ONLY) an 1 06- 242 Date...Ia.-y.-0 a f NORTIf, ?;.,„`` ;•�.."�o� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,3'SACMUSE� 4 This certifies that ....1.. '... / has permission to perform ...../.` .e-%4 3� r, v"' �.. wiring in the building of �A 9 y S �T us ..................................... .............................................. at 8 'c �(P�' `' ............ .NortAndover,Mass. Fee Lic.No. f QQ r ELECTRICALINSPECTOR Check # I VC` ` THECOMMOINWEALTHOFMASSACHUSETTS Office Use only DEPARTMEN1'0FPUBL1CS9FNY ��/ °� BOARDOFFIREPREVj70N1'1�GUjATjONS527CMR12.� Permit No. / Occupancy&Fees Checked APPLI KTTIONFOR PERMIT TO PERFORMELECTRICAL W ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MA WORK PLEASE P SSACHUSSTS ELECTRICAL CODE ( PRINT IN INK OR ,527 CMR 12:00 TYPE ALL INFORMATION) Town of North Andover Date /1�it /i -� The undersigned applies for a permit to perform the electrical work described below. To the Inspector of Wires: Location(Street&Number) fo r��� Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes ©/ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead � Underground g No. of Meters New Service --C�_ Amps/�o�/�yvolts Overhead ndergiound Number of Feeders and Ampacity No. of Meters Location and Nature of Proposed Electrical Work No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total No.of Lighting Fixtures Swimming Pool Above Below TVA Generators No.of Receptacle Outlets round ound O No.of Oil Burners No.of Emergency Lighting Battery Units KVA No.of Switch Outlets d��7 No.of Gas Burners No.of Ranges No.of Air Cond. Total No.of Zones / 7- r FIRE ALARMS No.of Disposals Tons 3 J No.of Heat Total Total No.of Detection and No.of DPumps Tons KW Initiating Devices --�� ishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained No.of Dryers Detection/Sounding Devices Heating Devices KW Local Municipal � other' Vo.of Water Heaters KW No.of No.of Connections / Signs Bailasis Jo.Hydro Massage Tubs No.of Motors Total HP f HER- -------------- uanoeCovetagt~R � �Massad><>seflsG UalLaws ,eaailraDdYjdprwf f=ne1fiCy>n � 0 �ha�Cov gRcritsakriataFNaq � vevalidproofofsametotheOfce YES {�--'� NO �Igthe box LTJ ffyotiha�echec dYFS,ppa� ethetypeolco eta�by URANCE[BpND OUIER '� FxpuationDate ! ' F�r>*dVat&ofl cft1calWodc$ die 3dmde ; ofpojurY Raigh Final 4NAME !s&/ C_ See; R6 g Err G �o7LTlty,7/j,Si�rahuei��G f� Liar>9eNo /�iL�3 � f`f BtmressTd No. 5V 0#,,7`-A-2_ aXLYQA_-,' IVeq r—>365-13 Z9 S4— SS 73 UZ7SINSURANCEW Alt Tel No. AIVIItIamawarethattheLioensedoesnothavetheir�stuancecoveraggeoritssullintiaiegtrivalff Aastaquk)dbyeC Laws atnrysig mhueonthispe=,TplicadonwatmN ihisrequumtErj se check one) Owner Agent 17 Telephone No• —PERMIT FEE rgna ure o caner or gen l i W The Commonwealth of Massachusetts >r d Department artment o f Indu stnal Accidents Office of Investigations a Boston, Mass. 02111 M 5 Workers Compensation Insurance Affdavlt Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. aI am a sole proprietor and have no one working in any capacity aI am an employer providing workers' compensation for my employees working on this job. Company name: Address I City Phone#: Insurance Co. Poli # Company name: Address City: Phone# Insurance Co. Poli # cv Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition o(criminal penalties of.a fine up to$1,500.00 and/or one years'imprisonment_as_well_as_civil.penattiesin-thetnrmnfa_STOP.WORKORDFR,and..a.fine_cf.($1-OOM)-a day.againstme. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. !do hereby certify under the pains and penalties of 0 that the information provided above is true and correct Signature G date fy cs z Print name ` Phone.# Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing El ❑Cheek if immediate response is required Building Dept 0 Licensing Boar Selectman's Office Contact person: Phone#. E] Health Department 0 Other 1 0 Date.. ....................... NORTH °!t"`° '•�"a TOWN OF NORTH ANDOVER , . p PERMIT FOR WIRING .SS US This certifies that N . ........ ..... . ...... �../... has permission to perform .......... P ,v6 f-P C 7 f v,J wiring in the building of.... .......................... .................. ........................ t C C f �``� TV........ ,North Andover,Mass. at...... ........................ .................. . .... Fee.....��'_� Lic.No.............. .. :. -�Cv C4.... - J� ELECTRI AL INSPECTOR Check # CAS 43 �. � MQN got. A BHP 2003-0819; r gip« y'€ gown loll se 4 '�� �� t01 .' 9 Ha ' �� ` �?yY z€ 7 2UO3 , 4 "` IJAUF my # r +s..+., 'll.."I, "",",.;"€ s* ��d '�+ yF3 u t 1 fl3°- �t k �Y i�� �:w € x n11+1✓c#+�`Fd7fir "4;"' a'� qs � q,$.� " � w� }t'�,�{'k�12'�,�x Sr q7G.�� �r ". ;<r�y�s k,�srsi.;: qt,z.a "S � '�C•' � w ('�a i ls, t yt Tee 9VI k, h i;t,� 5t y9 ti�x € t r pz s9€I�{ r y"t I a « g Y Ix h si z �a t x v ^rn � _ Board Uf : Amms THE COMMON,>iVEA H 0, M ASSACHUSETTS TOWN OR CITY OF Massachusetts Department of Public Health Division of Food and Drugs FOOD ESTABLISHMENT INSPECTION REPORT Name D T of Operation(s) Tvae'of Insaection kkf `')t-\ i(� 6 Food Service ❑Routine Address Risk LJ Retail I 1 ❑Re-inspection Telephone Level ❑ Residential Kitchen Previous Inspection '�- *5- ❑ Mobile e: ❑ Temporary Pre-operation Owner 151�.I �� G ` HACCP Y/ • ❑ Caterer Suspect Illness Person in Charge(PIC) Time ❑ Bed&Breakfast ❑General Complaint. In: `L`,X ❑HACCP Inspector ��, Out: 3�06 Permit No. ❑Other Each violation checked requires an explanation on the narrative page(s) and a citation of specific provision(s) violated. Nomcwnplfance*a►: Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) anti-Choking Tobacco Violations marked may pose an imminent health hazard and require immediate corrective 590.009(E) ❑ 590.008(F) ❑ action as determined by the Board of Health. 1:doo:PR07ECTI©N MANACiEMNT ❑ 12. Prevention of Contamination from Hands ❑ 1. PIC Assigned/Knowledgeable/Duties I~MPLOYEE;HE/lLTli ❑ 13. Handwash Facilities PROTECTION FRO CHEMICAL$. ❑ 2. Reporting of Diseases by Food Employee and PIC ❑ 14.Approved Food or Color Additives ❑ 3. Personnel with Infections Restricted/Excluded FIaoD OM APPROtIEDSO[IRCE ❑ 15.Toxic Chemicals ❑ 4. Food and Water from Approved Source TtME/TEMPERI►TtiitE,CONTROLS 1Potentially Hazardous ❑ 5. Receiving/Condition ❑ 16. Cooking Temperatures ❑ 6. Tags/Records/Accuracy of Ingredient Statements ❑ 17. Reheating ❑ 7. Conformance with Approved Procedures/HACCP Plans ❑ 18. Cooling :PR07"�CTiON FRAM CONTAMNIIA'r10N;;:` . ❑ 19. Hot and Cold Holding ❑ 8. Separation/Segregation/Protection ❑20. Time As a Public Health Control ❑ 9. Food Contact Surfaces-Geanitl4 and Sanitizing 1ZEQUIREMENTS FOR HAY"SUSETiTIBLE hOPUL11TlONS.II'1 . ❑21. Food and Food Preparation for HSP ❑ 10. Proper Ad a Handwashing ❑ 11, ygienic Practices COMSIiMRAQVISORY,, ��u�� i 10 ❑22. Posting of Consumer Advisones Violation Related to Good etail Prac ices (BI Number of Violated Provisions Related Items) Criti rrected To Foodborne Illnesses Interventions immediately or within 10 days as determined by the Board and Risk Factors(Red Items 1-22): of Health. Non-critical (N)violations must be corrected Official Order for Correction: Based on an inspection immediately or within 90 days as determined by the Board of Health. today,the items checked indicate violations of 105 CMR 590.000/federal Food Code.This report,when signed below by a Board of Health member or its agent constitutes an 23. Management and Personnel (Fc-2)(590.003) order of the Board of Health. Failure to correct violations 24. Food and Food Protection (FC-3)(590.0D4) order in this report may result in suspension or revocation of 25. Equipment and Utensils (FC-4)(590.005) the food establishment permit and cessation of food 26. Water, Plumbing and Waste (Fc•5)(590.006) establishment operations. If aggrieved by this order, you 27. Physical Facility (FC-&)(580.007) have a right to a hearing.Your request must be in writing. 28. Poisonous or Toxic Materials (FC-7)(590.000) and submitted to the Board of Health at the above address 29. Special Requirements (590.009) within 10 days of receipt of this order. 30. Other DATE OF RE-INSPECTION: Inspector's Signature: ti Print:42 PIC's Signature: Print: d Page of Pages FnRM 734A A.M.SULKIN r.n - i s a ssac"u, CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number cR Date 03 THIS VRTMS TTHE BUILDING LOCATED ON MAY BE OCCUPIED AS �e- l i T—rte c� CJ IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO pat Building Inspector T CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number cP, ej Date t10-10 03 S CE .THE BUILDING LOCATED ON THIr1 MAY BE OCCUPIED AS --Rl a C) ` IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO /�>m Building Inspector '-'Of-,�t o kt i!I --K _.- ® of r�or over P"11 r No. 'tib -1 rth -Andover, Mass.,ATE D . A Y PERMIT TO B BOARD OF EALpTH Food/Kitchen fx 4, . a Septic System FoundationDING / BUILDING INSPECTOR THIS CERTIFIES THAT..�O.!?.�!!�..... ............ ... 41:, j,le's.....��...l..Cl.�!p��..5.....�V.....^..... � D � ��-- has permission to erect...............�...................... b Wings on S c elP1yJ Rouges D ' 1 Z f'`5., 7 V li ./'� r Chimney /V1 to be occupied as.. .................,.......... provided that the person accepting this permit shall in every res pec t,.conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 71162 r7 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit." Rough 3 1 P RrAIT EXPIRES IN 6 MONTHS � UNLESS CONSTRUC T[ON S-TAR t`S '.., ELEC ICAL INSPECTOR Rough ��� :�..C ....... Service BUILDING INSPECTOR . F' Occupancy Permit Required t® Occupy Building GAS INSPECTOR k Rough .d 3 Display in a Conspicuous Place on the Premises — Do Not Remove A;V .4 No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner- Street No. c� Smoke Det. SEE REVERSE SIDE O .ai:h'N•pi p m m "� m 0A 0 " 'svciaus .CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number o2 / 6- Date THE BUILDING LOCATED ON T41 HIS RTS SHA MAY BE OCCUPIED AS------------ cf PAY�4) IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO - l j ` r- ,/V Building Inspector Town do'ver of ,,,- . * . � �r' .` .. y�r �x• 1..etl z 4I ,Qrti� ,'ndover, Mass., v G, _ BOARD OF E/ALpTH Food/Kitchen f Septic System / // A /J� 1 7.4 /�_p D PE RMIT TO ILD Bi IILDINGTHIS CERTIFIES THAT.. O.V.Kl!! ...... ............ .. d!6S.... R..�.'�1. !p �UcS1 . . EC R TO....................................... Foundation ' has permission to erect. ... ............... b ildings on c..:...C � RoughP (�/` _ t Chimney y /V 11 v�� tobe occupied as...f.`.�43�.............�........................�..........................................4F..............................................;........... provided that the person accepting this permit shall in every respect.conform to the terms of the application on file in Final Afxt ,f, '617A 3 this office, and to the provisions of the Codes and By-Laws relating to the Inspecti�,n, Alteration and Construction of Buildings in the Town of North Andover. 7//(Q 7 l/pp,?, PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough FERN EXPIRES IN 6 MONTHS EV 4111100)000 UNLESS CONSTRUCTION STARTS. ' ELEC ICAL INSPECTOR Rough ............................ . ....... ......................................... Service BUILDING INSPECTOR F' OcaL ancy Permit Required t® Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Dry w No Lathing or D• 7 Wall 1 T o Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner _ Street No. 6 C SEE REVERSE SIDE Smoke Det. C� CHIMNEY CONSTRUCTION The chimney should be supported on a foundation of masonry or reinforced concrete or other noncombus- R less TE not UN f CO 0 resistance rating' ac material having afire res Ist 9 FLASHING tibia mat 9 than 3 hr.When installed on an appliance,the chimney BASE should be so supported as to not place excessive stress AIR FLASHING on the appliance. The base of the chimney should be VENT secured to prevent movement of the chimney and )N anchor lugs should be used for this purpose whenever possible. A cleanout section may be used in the chimney assembly �l but must not be used above the chimney inlet. CLEARANCES 1� Chimneys of the medium heat appliance or commercial- industrial incinerator type are not intended to be enclosed in walls of combustible materials. These ON COMBUSTIBLE chimneys should be placed in fire resistive or noncom- INSULATED ROOF bustible shafts where they extend through any story THIMBLE CONSTRUCTION of a building above that In which the connected �v= appliance is located. CHIMNEY AT ROOF OPENING ( ZERO An enclosed chimney may be placed adjacent to walls CLEARANCE I of combustible material with the following minimum FLOOR SUPPORT SECTION clearances: OPENING 10 to 15 in.I.D.requires 16 in.clearance ET 15 to 21 in.I.D.requires 18 in.clearance DOUBLE 21 to 27 in.I.D.requires 20 in.clearance TION BRACKET 27 to 36 in.I.D.requires 22 in.clearance o Where the chimney passes through a roof of combust- ti 1f ible material it shall be installed with an insulated f' CONTINUOUS thimble and flashing. This insulated thimble may be FIELD WELD installed at zero inch clearance to combustibles. 4" -* BOTH SIDES MAx. AND TOP The chimney should extend at least 3 ft above the BI/2 SINGLE BRACKET OR CLIP highest point where it passes through the roof and 2 .EMBLY SUPPORT AT FLOOR OPENING ft higher than any ridge within 10 ft. IT CHIMNEY8 STACK DIAMETER—SINGLE BOILER VENT STACKS VENT OR STACK The purpose of a vent stack is to conduct the products BOILER STACK of combustion to a point of safe discharge(atmosphere). HORSE. DIAMETER A B C Forced draft design eliminates the need for a stack POWER .(IN.) (IN.) (I N.) (IN•) designed to create a draft. An offset type of stack 15-20 6 15 15 12 connection to the stub vent on the boiler is preferred. A direct vertical connection can also be made when 0 Z 25-40 8 20 20 16 boiler vent outlets can withstand the direct vertical tv 50-60 10 25 25 20 load of the stack, including the effect of wind and TOP 70-100 12 30 30r24guy wires. B1 OF125-200 16 40 40 STACK CONSTRUCTION ROOF250-350 20 50 50 The stack can be terminated several feet above the 400-800 24 60 60 top of the roof. (State and local codes may govern the c stack height above the roof.) If down drafts are un- STACK avoidable, the stack outlet can be provided with a DIA. ventilator. Minimum 12 gauge steel is recommended STACK DIAMETER—MULTIPLE BOILERS: for stack sections. If the stack will be inaccessible, RATION COMMON BREECHING AND STACK the use of a noncorrosive material (e.g., glass lining) MINIMUM STACK - should be considered. - HT SEAL STACK DIAMETER(IN.) A rain cap or hood should be used at the top of the ANOUT NUMBER OF BOILERS stack t0 minimize the entrance of rain or snow. - 2 3 4 CLEANOUT BOILER- . HORSE. 100 200 100 200 100 200 POWER FT FT FT FT FT FT 0 25-40 11 12 13 14 14 16 BREECHING DIAMETER— DRAIN CONNECTION 50-60 13 14 15 16 17 18 SINGLE AND MULTIPLE BOILERS O D 70-100 16 17 19 20 21 23 MINIMUM BREECHING DIAMETER(IN.OD) 125-200 21 22 24 26 28 30 C D 26 28 32 34 34 40 A s - 50 IN. IN.) (IN.) (IN.) 03 1 25 l 1 2 3 4 NEC TION 42 46 1 T CON $ 4O - BOILER OFFSET 34 3 _ 2 RECOMMENDED) 4OO 600 3 HORSE- BOIL- BOIL- BOIL- BOIL POWER ER ERS ERS ERS A B C D 15-20 6 8 9 9 \ STACK 12 1 TRANSITION 25-40 8 10 11 G PIECE -- 50-60 10 12 14 15 CLEANOUT 70-100 12 15 17 18 DRAIN 125-200 16 20 22 24 CONNECTION 250-350 20 25 28 30 ® ® 0 400-600 24 30 33 36 700-800 24 34 38 42 Note: Stack diameter should be larger than breeching IOILERS WITH COMMON BREECHING diameter. CKIS essy,Consulting Engineers;New York,New York HEAT GENERATION ) i SILVERWATCH ARCHITECTS, LLC Architecture Engineering Land Planning Design Wednesday, October 29, 2003 Building Inspectors Office Town of North Andover, Massachusetts RE: Marys Pasta Building 494 Main Street North Andover, MA Dear Sir/Madam, I have been informed by the Owner of the Mary's Pasta Building, Sal Lupoli, that your office has requested that we, as architects of the building certify that the construction was done in accordance with the construction drawings and that all work performed that was observed by this office is satisfactory and meets the requirements of the MSBC. Of particular note, and of concern to your office are the following items: The HVAC located above the rear hallway has struts that transfer the weight of the unit to the hallway walls. The weight of these units does NOT bear on the roof trusses above. The exhaust duct from the kitchen area thru the roof bypasses the trusses without the cutting of any trusses. (Certification of this fact is supported by attached letter from installer). Handicapped sign for parking space has been placed and sized to meet ADA requirements. I hope that this certification meets with our approval and if I can be of further assistance to P Y pP your office please don't hesitate to call the number below. Sincerely, FO.A > No.9671 2 J David Silverwatch, Architect AIA © SALEM Jy Silverwatch Architects, LLC NH G.Z. OF MPS�,P 163 Main Street Salem, New Hampshire 03079 603.894.4450 j vance rotecti tis 121C* i Manufacturer o#_ Stasn4 g51 KAchen�ipnent&W81-14? Systems ANSULS Fire System► lnstalobn r�c�rn New fiord,MA Manufacturt�f Y� Everett, NSA Afv~3nc$d Rcu 50-993-4080 sta Boston 617-389-3700 597-38g-4488 1-800-32 ANSUL. 1-8023-ANSUL ( )517 7-,%92 (Fax)500-993-2313 9. QlJ�O��5179 {FeX)61738 R 24, 2003 ATTENTION: JOSEPH SILVERWATOH NORTH ANDOVER BUILDING DEPARTMENT F Advanced d=ire protection, Inc, installed the hoW, ducfwark and tyre system at Mary's Pasta, 494 Main Strutt, Neth Mdaver. The installation was done according to N.F.P_A and UL 300 Standards. We did not out any trusses to install ductwork. All duct "W run bet'+veen the trusses and wrapped with "0" clearance duct wraP. JOSEPH G LABELLE NEW ENGLAND SALES REPRESENTATIVE :4t TOTAL P.02' . r r • �\ _ /p\%��/D\i ,,,,. ..://\,, ,._' ,.'•.•,..•,die .�/O\�i�,,\"�. •.ice i- � � �•. �\\/: ' .i/ � � I..�.i. i � � �����,/..�� �/,,_•, _, ���/�\\\/p �\\�\\\Q�\���� WN as 8sim+ly Ore `' R` MONIES ., '..yid =`'���I�•'`� .• 2 . O 5 b ED � OPEN REFRIGERATION � = 9 CAPPUCINO COUNTER /3'LENM t a Lay. ni Lav z.° Bakery g 3 y Hall Retail Floor Silvestri. Constructio Corporation � Stiles Road Salem, New Hampshire 603-8." ti 1 GROCERY aONDOLA p 20'x41f SHOWCASE\SEANCE COUNTER REGISTFAS 0 a d ��h `,.� 9 Service Counter ��� a= Walk-In 3 BAY Sm HANG Sm Ip Freezer i_-_ .__._ _; Q Q � WORK COUNTER � SODA C CL tA L.._� q O,( 40, - I m /�%? V �i CL E PROW CL b `� c,1(S Portico % m a 0 y all O V C Signage Elevation C C V .4e Y 40 Main Floor Plan SCALE v.-1'-d' Uli�/S�-� 6/9-�('t?H B 0 � N c�z a BUILOINO F001PRINr AREA-137a SF W f73 LL V VT Z 90 METAL RAILING WAD SORE Q NCj'•�RK ` v C y BRICKFACE VENEER CHIMNEY UE OIASS PANEL O lb I q i PAI WINOOW UNIT STANDING SEMI METAL PANEL ROOFING 'I�1 Il jX2 MOO FRIEZE may\ CLASSICAL COLUM iS ao PAINTED MDO RAISED BRONZED ALUUNUM STOREFROHf shoot 1 of 1 Chickering Road Elevation Entrance Elevation A-1 SOME 1/4'-1'-C SCALE 1 I I )nA ry �.v �-� TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING >-1 om 'Phis Section for Official Use OnlX :: �g A. . BUILDING PERMUT NUMBER: J t DATE ISSUED:Y ` ,-p 7 C? Ar r+A or of Bulldiii" �'^' �" Date - 111..2'_:7Assessors Map and Parcel Number: v Map Number Parcel Number •uy.+r�� 1.3 Zoning Information: 1.4 Property Dimensions: v Zoning District Proposed Use Lot Area Fronts 11 1.6 WELDING SETBACKS(ft) m Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water S° M.G.L.C.40. 54) 1.5. Flood Zone Infornution: 1.8 Sewerage Disposal System: Public SV Pnvate ❑ Zone Outside Flood Z. W--' Municipal L.-- On Site Disposal System ❑ ti k 2.1 Owner of Record D40(J6(1q— N 0 Name(Print) Address for Service m Signature Telephone 2.2 Authorized agent / ,fir. S.l,/ � �/��" �'�,'C�e�-rr �✓ D Name Print Address for Service: Z Signature Telephone m F" 90 3.1 Licensed Construction Supervisor Not Applicable ❑ ay S ..1.o R-. s I, �/� 6�o cs - - 7 k Address License Number O Licensed Constructi uperviso Expiration Date Signature Telephone r � I 3.2 Registered Home Improvement Contractor NotAPP licable Company Name„ Registration Number rn r Address r Expiration Date Z Signature Telephone n Location i C� No. a�' S Date i TOWN OF NORTH ANDOVER S ?o•tt••n ,•,h,O 3 ° D _ s i ; Certificate of Occupancy $ c /Frame Permit Fee $ s�cMust Building/Frame 9 , Foundation Permit Fee $ o U Other Permit Fee $ TOTAL $ J S—d Check # 15 `2, 7 3 Building Inspector I Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yea.......❑ No.......❑ 5.1 Registered Architect j - t � ,3 Name:- Con163 MAIN STREET 01 P CL�Ak, NH 0307 Ad a CG��` Or Si afar Telephone :.,o //� Of MV1�� drA !!/ 1 1 t 1 11 tl ... .. ......... ... ... :.................. -- 111 Name: Area of Responsibility Address: Registration Number Signature Total Expiration Date Not applicable ❑ Name: Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date . M Not Applicable ❑ Company Name: Responsible in Charge of Construction `1 't? (clerk allP New Construction Existing Building ❑ Repair(s) 0 Alterations(s) 0 Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other 0 Specify Brief Description of Proposed Work: Neci Ca,,S4-fu c �W J 5� c. 110 s�' Re- a•'J-Q: G I a S�d m rd SeAr— ✓ovt- USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 0 A-2 0 A-3 ❑ 1A ❑ A4 0 A-5 0 113 ❑ B Business ❑ 2A 0 C Educational 0 2B 0 F Factory 0 F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ IInstitutional ❑ I-1 ❑ I-2 ❑ 1-3 ❑ 3B ❑ M Mercantile Ij/" 4 ❑ R residential ❑ R-1 0 R-2 0 R-3 0 5A ❑ S Storage ❑ S-1 ❑ S-2 0 5B per, U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floors ✓� Total Area s Total Height ft Independent Structural Engineenngg Structural Peer Review Required Yes 0 No 0 SECTION 10a Owned Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I I, '541vATo96' Lu PoLl as Owner of the subject property Hereby authorize to act on My behalf,in all matters relative two work authorized by this building permit application Signature of Owner Date 1, Al u d D3 Ce- L u,0d L as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury SALYATOP.r LupoL: Print Name $So XqI Signature of 04er/Agent Date Item Estimated Cost(Dollars)to be Completed by permit applicant 1. Building (a)` Building Permit Fee 6,5-OV ,5-Q Sp p 1 B gV Multiplier t5 2 Electrical (b) Estimated Total Cost of p G e J Construction from(6) 3 Plumbing Building Permit fee (a)x 000 4 Mechanical(HVAC) l S Qo 0 5 Fire Protection 6 Total$(1+2+3+4+5) �s b o u Check Number 25 �,t�5.-r'(s�1 . Aid kFi +F�' `'�.:r ri' .. ixn t} ¢Sr kit �n x a, \�*r �v �£ 4 Wuf S7ek. a!' t .i :k -•*,.F.:v 3#1vaYvrr:. .Fs .- '"w�r�''i� �2'i'l. NO.OF STORIES / SIZE BASEMENT OR SLAB SIZE OF FLOOR T11vIBERS ( 1 2 ND RD SPAN DEMENSIONS OF SILLS X DEMENSIONS OF POSTS DUMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS t( SIZE OF FOOTING r X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE N ns*��:�€a�"e"�` t06 FORM — U _ LOT RELEASE FORM 5{N_jS t (VI A INSTRUCTIONS- This form is used to verify that all-necessary approval/permits from Boards,and Departmeirts having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. ` ...•.....■■..■............................■..�..................s.was now aas APPLICANT" QS PHONE 6�3 ASSESSORS MAP NUMBER- LOT NUMBER �- SUBDIVISION LOT NUMBER STREET OK`c�J (� STREET NUMBER �...................• ■.......a...amuseum a.■r...a.....a.a..................■ OFFICIAL USE ONLY RECONDAENDATIONS N TOWN AGENTS ..... ......-....■ ■...aa.a.a.a.a...aaaa...■■a..a.....aaa..a.*a0aa0a.aa...■ . r DATE APPROVED U CO NSEAVAIION ADIvIlNISTRA OR DATE REJECTED comm-NTS DATE APPROVED TOWN P r DATE REJECTED i COM ENTS VIle —V DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED 'A/A? DATE APPROVED SEPTIC INSPECTOR-HEALTH DATE REJECTED PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERI\RI D DATE APPROVED K DEP DATE REJECTED COMMENTS RECETJED BY BUILDING INSPECTOR. DATE i I i M ' � ! . �i a 7 c'� S c Q�,a o,�� + w W�4�P't:t-g t�-u�� , . } �' � b/'w s� � n � �+ (i i 1 � C �t��e,l'L (,cam�!-a��1" � T j y �A�� 'jJ �- - - � - - � t%ORTH • TOWN OF NORTH ANDOVER O��+t`D 6'9•yo HEALTH DEPARTMENT 27 CHARLES STREET NORTH ANDOVER, MASSACHUSETTS 01845 �9S r s CHUS Sandra Starr Telephone(978)688-9540 Public Health Director FAX(978)688-9542 October 30, 2001 Silvestri Development Corporation 24 Stiles Road Salem, New Hampshire 03079 Re: Mary's Just Take-Out Dear Sir: Enclosed you will find documents that comprise the procedure for opening a new food establishment in North Andover. Please complete the Plan Review Application form and submit the form with the appropriate fee, completed kitchen plans, specification sheets for all equipment, and a menu to the Board of Health as soon as possible. Once the plans have been reviewed we can set up a time to meet and discuss them. Please do not hesitate to call the office should you have any questions. Sincerely, Sandra Starr, Health Director Cc: aiding Dept. File The Commonwealth of Massachusetts i d Department of Industrial Accidents Office of investigations w Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print i Name: Location: City Phone # 1 am a homeowner performing all work myself. 0 I am a sole proprietor and have no one working in any capacity 0 I am an employer providing workers'compensation for my employees working on this job: Company name: s Address i City: Phone#: Insorance.Co.. _. .Policy# Coimpany.:name: .'S y�, C Co F Address 'a•`� S�`l{-3 K-� Phone..#: '5e;_3 ( (-CJ7rN . Polr_: Cpl - I Syo. Insurans�:Co. : . -- cy#. Failure tq secure coverage as required under`S§ ` on 2646r WL 15�can lead to the frr position of criminal penalties of; fine up fid�1,50b.UU and/or one years'impris,anment.os well_as.ciol penaltiesie-MalnrmifAB-MP_W.ORK 0RE)Mand_afina-of�$IAOM)-a la. y-ogainstme. I understand that a copy of this statement maybe fo d to the Office of Investigations of the DIA for coverage vetfication. I do hereby certify under the pa' an Hallie �!ry at the information provided above is true and correct' Signature Date il — 1l o Print name f'&�/ CAS �'�Jp s��� Phone# �V x`73 yw Y Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing Building Dept OCheck if immediate response is required 0 Licensing Board m Selectman's Office Contact person: Phone#: Health Department I] Other Town of North Andover ttORTfi -I'T"F O P Building Department 27 Charles Street North Andover, Massachusetts 01845 , $„^ (978)688-9545 Fax(978) 688-9542 a� `oexlc�twxx ACHU 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 MGL cl 1, s150a. The debris will be disposed of in/at: Facility location Signature of Applicant Date NOTE: A demolitionermit from the Town of North Andover must ust be obtained for this project through the Office of the Building Inspector. i BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 059778 Birthdate: 0113111973 Tr.no: 13199 Expires:01131/2002 I. Restricted To: 00 ! CHRISTIAN W SILVESTRI � 1 24 STILES RD#101 SALEM, NH 03079 Administrator i a DOUBLE N INC. ........................................................... 490 Main St. N.Andover,MA (603)-894-7396 April 25, 2001 Board of Appeals Town of N. Andover Dear Board, I'm writingthis letter to let you know I have begun to work on Mary's Pasta located 478 Y b'u ry at Chickering Road. I will be raising the building in the month of May. My time frame for my variance might be getting close, so if I need an extension of that variance I hope that you could grant me one. Just to let you know,there are no changes to the plan from what was agreed upon by the Board. Sincerely, &C"T, �--J�� Salvatore Lupoli Owner, Sal's Just Pizza i I HORTM O - p RECEIVED ��a''tie�►`�x JOYCE BRADSHAW This is SACHUg� ' TOWN CLERK ' haveetocerbfMMdoofft y�pkn NORTH ANDOVER NORTH ANDOVER have�P�d(�d�M d �� OFFICE OF joyviA -4 v THE ZONING BOARD OF APPEALS 1000 APR 2u All18 to"CIO 27 CHARLES STREET NORTH ANDOVER,MASSACHUSETTS 01,45 FA.Y(978)688-9542 Any appeals shall be filed NOTICE OF DECISION within(20)days after the Year 2000 �i `' '✓' date of filing of this notice Prove at: 478 Chickering Road °'``u• :'= in the office of the Town Clerk. NMR- Salvatore Lupoli DATE: 4/12/2000 ADDRESS: 478 Chickering Road PETITION: 011-2000 North Andover,MA 01845 HEARING: 4/11/2000 The Board of Appeals held a regular meeting on Tuesday evening, April 11,2000 at 7:30 PM upon the application of Salvatore Lupoli, for premises at:478 Chickering Road, North Andover, MA. Petitioner is requesting a variance from the requirements of Section 7,paragraph 7.1, 7.2&7.3 of Table e 2 ct,in order to allow a front,side and rear setbacks and from Section 8, Supplementary G-B Zoning Petitioner is requesting a finding from Section 9.3 in order to demolish an existing non-conforming Regulations. structure. Petitioner is requesting a Special Permit from Section 9,Paragraph 9.1, 9.2&9,3 to allow the new construction of a structure on the pre-existing non-conforming lot. The following members were present: Walter F. Soule, Robert Ford,Raymond Vivenzio,RobScott Karpinski and George Earley. Upon a motion made by Scott Karpinski and 2`d by Walter F. Soule the Board voted to GRANT a dimensional variance for relief of a front setback of 20',side setback of 22' and rear setback of 32',and that the proposed building doesn't extended higher than 30'on the condition and basis that the petitioner has satisfied the provisions of Section 10,paragraph 10.4 of the Zoning Bylaw and that the granting of these variances will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning Bylaw. The Board voted to GRANT a Special Permit for a finding from Section 9.2 in order to demolish an existing non-conforming structure on a non-conforming lot,and GRANT a Special Permit from Section 9,9.1,8.2&9.3 to allow the new construction of a structure on a pre-existing non- conforming lot. The Board finds that the applicant has satisfied the provision of Section 9,paragraph 9.1 of the Zoning Bylaw and that such change,extension or alteration shall not be substantially more detrimental than the existing non-conforming structure to the neighborhood. In accordance with the Plan of Land by: Hans-Georg A-Mertsch,Jr.#33941, Civil Engineers,2 1 A Street,Burlington, MA,dated: 3/10/2000. Voting in favor: Walter F. Soule,Raymond Vivenzio,Robert Ford, George Earley and Scott Karpinski. Furthermore,if the rights authorized by the variance are not exercised within one(1)year of the date of the grant,they shall lapse,and may be re-established only after notice,and a new hearing. Furthermore,if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two(2)year period from the date on which the Special Permit was granted unless substantial use or construction has commenced,they shall lapse and may be re-established only after notice,and a new hearing. By order of the Z and of Appeals, ml/decisions2000/10 Raymond Viveiizic,4, Aftan BOARD OF APPEALS 688-9541 BUILDINGS 688 95.15 CONSERVATION 688-9530 HEALTH 688'9540 PLAINWING 68&9535 O �"60 •.+ F A "►o ._.. ��: RECEIVED '°•..a�• �ti JOYCE BRADSHAW ,3SACHU5et TOWN CLERK This is tocertitythattweniy(20)days NORTH ANDOVER NORTH ANDOVER have elapsed from dao 0rd9C4jM OW OFFICE OF withoutMVd=apps& 1000 APA 2l� All: 18 Do -, / oav THE ZONING BOARD OF APPEALS TOMG~"e�lt 27 CHARLES STREET NORTH ANDOVER, MASSACHUSETTS 014-15 FA-X(978)683-9542 Any appeals shall be filed NOTICE OF DECISION ' ' within(20)days after the Year 2000 '"R•'':• date of filing of this notice Property at: 478 Chickering Road in the office of the Town Clerk NAIME: Salvatore Lupoli DATE: +/12/2000 ADDRESS: 478 Chickering Road PETITION: 011-2000 North Andover,MA 01845 HEARING: 4/11/2000 The Board of Appeals held a regular meeting on Tuesday evening, April 11, 2000 at 7:30 PM upon the application of Salvatore Lupoli,for premises at:478 Chickering Road, North Andover,MA. Petitioner is requesting a variance from the requirements of Section 7,paragraph 7.1,7.2&7.3 of Table 2, G-B Zoning District,in order to allow a front,side and rear setbacks and from Section 8, Supplementary Regulations. Petitioner is requesting a finding from Section 9.3 in order to demolish an existing non-conforming structure. Petitioner is requesting a Special Permit from Section 9,Paragraph 9.1, 9.2&9,3 to allow the new construction of a structure on the pre-existing non-conforming lot. c The following members were present: Walter F. Soule,Raymond Vivenzio,Robert Ford, Scott Karpinski and George Earley " Upon a motion made by Scott Karpinski and 2"d by Walter F. Soule the Board voted to GRANT a Pool dimensional variance for relief of a front setback of 20',side setback of 22' and rear setback of 32',and that the proposed building doesn't extended higher than 30'on the condition and basis that the petitioner has satisfied the provisions of Section 10,paragraph 10.4 of the Zoning Bylaw and that the granting of these variances will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning Bylaw. The Board voted to GRANT a Special Permit for a finding from Section 9.2 in order to demolish an existing non-conforming structure on a non-conforming lot,and GRANT a Special Permit from Section 9, 9.1,8.2&9.3 to allow the new construction of a structure on a pre-existing non- conforming lot. The Board finds that the applicant has satisfied the provision of Section 9,paragraph 9.1 of the Zoning Bylaw and that such change,extension or alteration shall not be substantially more detrimental than the existing non-conforming structure to the neighborhood. In accordance with the Plan of Land by: Hans-Georg A.Mertsch,Jr. #33941, Civil Engineers,2 1 A Street,Burlington,MA,dated: 3/10/2000, ; Voting in favor: Walter F. Soule,Raymond Vivenzio,Robert Ford, George Earley and Scott Karpinski. Furthermore,if the rights authorized by the variance are not exercised within one(1)year of the date ofthe grant,they shall lapse,ani may be re-established only after notice,and a new hearing. Furthermore,if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two(2)year period from the date on which the Special Permit was granted unless substantial use or construction has commenced,they shall lapse and may be re-established only after notice,and a new hearing. u a By order of the Z and of Appeals.. 4: Raymond Vivehzio an :. ' +i�s` .Ck� is mUdecisions2000/10 r BOARD OF APPEALS 688-9541 BUILDINGS 688-95.15 CONSERVATION 688-9530 HEALTH 688-9540 PLA NNIN0 688-9535 Of NORTh !' p I RECEIVED '°•,..��• �h JOYCE BRADSHAW s ,s "Uge, TOWN CLERK This is to certlty that twenty(20)days NORTH ANDOVER NORTH AND0VER have elapsed trap do old$CWM filed W txd Mv of an OFFICE OF Do.— - 1�U0 APR 2la All: 18 Do " > �v THE ZONING BOARD OF APPEALS Tom 27 CHARLES STREET NORTH ANDOVER, MASSACHUSETTS 01445 FAX(978)683-9542 Anv appeals shall be filed NOTICE OF DECISION 'S 14` within(20)days after the Year 2000 a aZ ✓' date of filing of this notice Property at: 478 Chickering Road • � '`� `� ''' in the office of the Town Clerk NANv>E: Salvatore Lupoli DATE:4/12/2000 ADDRESS: 478 Chickering Road PETITION: 011-2000 North Andover,MA 01845 HEARING: 4/11/2000 The Board of Appeals held a regular meeting on Tuesday evening, April 11,2000 at 7:30 PM upon the application of Salvatore L PP upoli,foremises at:478 Chickering Pr g Road, North Andover,MA. Petitioner is requesting a variance from the requirements of Section 7 h 7.1 7 _ qu ,paragraph .2&7.3 of Table 2, G B Zoning District,in order to allow a front, side and rear setbacks and from Section 8, Supplementary Regulations. Petitioner is requesting a finding from Section 9.3 in order to demolish an existing non-conforming stricture. Petitioner is requesting a Special Permit from Section 9,Paragraph 9.1, 9.2& 9,3 to allow the new construction of a structure on the pre-existing non-conforming lot. � The following members were present: Walter F, Soule,Raymond Vivenzio,Robert Ford, Scott Karpinski and George Earley. " Upon a motion made by Scott Karpinski and 2"a by Walter F. Soule the Board voted to GRANT a dimensional variance for relief of a front setback of 20',side setback of 22' and rear setback of 32',and that the proposed building doesn't extended higher than 30'on the condition and basis that the petitioner •� has satisfied the provisions of Section 10,paragraph 10.4 of the Zoning Bylaw and that the granting of these variances will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning Bylaw. The Boardvoted to GRANT a Special Permit for a finding from Section 9.2 in order to demolish an existing non-conforming structure on a non-conforming lot,and GRANT a Special Permit from Section 9,9.1,8.2&9.3 to allow the new construction of a structure on a pre-existing non- conforming lot. The Board finds that the applicant has satisfied the provision of Section 9,paragraph 9.1 of the Zoning Bylaw and that such change,extension or alteration shall not be substantially more detrimental than the existing non-conforming structure to the neighborhood In accordance with the Plan of Land by: Hans-Georg A.Mertsch,Jr.#33941, Civil Engineers,21A Street,Burlington,MA,dated 3/10/200Q ! Voting in favor: Walter F. Soule,Raymond Vivenzio,Robert Ford, George Earley and Scott Karpinski. Furthermore,if the rights authorized by the variance are not exercised within one(1)year of the date of the grant,they shall lapse,ani may be re-established only after notice,and a new hearing. Furthermore,if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two(2)year period from the date on which the Special Permit was granted unless substantial use or construction has commenced,they shall lapse and may be re-established only after notice,and a new hearing ' By order of the Z and of Appeals, Raymond Vivenzio ';d3 ml/decisions2000/10 L BOARD OF APPEALS 688-9541 BUILDINGS 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLAIWI NG 688-9535 zs74+ reoz, • Town of North Andover OFFICIY OF COMMUNITY DEVELOPMENT AND SERVICES 27 Charles Street + y WILLIAM 1. SC07T North Andover, Massachusetts 01845 ;►•" ass^cNuet�i Diree for (978)688.9531 Fax (978)688-9542 NOTICE OF DECISION Any appeal shall be filed Within (20)days after the .�� Date of filing this Notice In theO J'xWC" Office of the �- m Clerk N z r a oM -� tn e:.) Date: July 12,2000 N � Date of Hearing: July 11,2000 Ln Cr Petition of: Salvatore Lapoli 28 North Broadway, Salem,NH 03079 Premises affected: 478 Chickering Road Referring to the above petition for it site plan special permit from the requirements of Section i 1 of the Zoning Bylaw So as to allow: the construction of a 1763 square foot retail building resulting in nine new parking spaces at 478 Chickering Road. After a public hearing given on the above date,the Planning Board voted to APPROVE the site plan special permit, based upon the following conditlons: Signed ' Alli qp.,�,s� rbeau,Chairman CC: Applicant Engineer John Simo9 yjSj Chairman Alberto Anales,Clerk _Richard Nardella Richard Rowen Willirlm C nninQham BOARD OF APPEALS 688-9541 HUILDINO 688-9545 CONSERVATION 688.9530 HEALTf1 688.9540iO Pi,ANNtr 6894515 S S JUL-24-00 05 : 18 PM SAL'S JUST PIZZA 603 894 7054 P. 03 479 Chickering Road Site Plan Review- Special Permit The Planning Board herein approves the Special Permit/Site Plan Review for the construction of a 1,763 square foot retail building located in the G-B Zoning District. This Special Permit was requested by Salvatore Lupoli, 28 North Broadway, Salem, NFI 03079. This application was filed with the Planning Board on May 5, 2000. The Planning Board makes the following findings as required by the North Andover Zoning Bylaws Section 8.3 and 10.3: FINDINGS OF FACT- 1. Thespecific site is an appropriate location for the project as it is located in the General Business Zone and involves theconstruction co struct on of a retail ail buildin . 8 2. The use as developed will not adversely affect the neighborhood as a sufficient buffer has been provided. Extensive landscaping has been provided around the frontage of Chickering Road and a portion of Main Street Landscaping is also proposed along the rear of the building and near a portion of the parking lot. 3. There will be no nuisance or serious hazard to vehicles orp edestrians. BY , eliminating the curb cut on Chickering Road and reducing the opening of the curb cut on Main Street the site will i m rove both traffic and pedestrian flow. 4. The landscaping in approved as a part of this plan meets the requirements of Section 8.4 t as amended by the Planning Board, of the North Andover Zoning Bylaw; 5. The site drainage system is designed in accordance with the Town Bylaw requirements and has been reviewed and approved by the Outside Consulting Engineer, Vanasse, FIangen Brustlin, Inc; 6. The applicant has met the requirements of tho Town for Site Plan Review as stated in Section 8.3 of the Zoning Bylaw; 7. Adequate and appropriate facilities will be provided for the proper operation of the proposed use. Finally the Planning Board finds that this project generally complies with the Town of North Andover Zoning Bylaw requirements as listed in Section 8.35 but requires conditions in order to be fully in compliance. The Planning Board hereby grants an approval to the applicant provided the following conditions are met: JUL-24-00 05 : 19 PM SAL'S JUST PIZZA 603 894 7054 P. 04 SPECIAL CONDITIONS: 1. Prior to the endorsement of the plans by the Planning Board, the applicant must comply with the following conditions: a) The final plan must be reviewed and approved by the DPW and the Town Planner and subsequently endorsed by the Planning Board. The final plans must be submitted for review within ninety days of filing the decision with the Town Clerk. b) A bond in them a Dunt of five thousand (55,000) dollars must be posted for the purpose of insuring that a final as-built plan showing the Iocation of all on-site utilities, structures, curb cuts, parkin spaces, topography, and drainage facilities is submitted. The bond is also inP lace to insure that the site is constructed in accordance with the approved plan. The form of security must be acceptable to the Planning Department. 2. Prior to the start of construction: a) A construction schedule shall be submitted to the Planning Staff for the purpose of tracking the construction and informing the public of ' anticipated activities on the site. b) During construction,the site must be kept clean and swept regularly. C) The applicant must supply a copy of the Massachusetts Highway Department permits necessary for construction of the site to the Planning Department. d) Dust mitigation and roadway cleaning must be performed weekly,or as deemed necessary by the Town Planner,throughout the construction process. 3. Prior to FORM U verification (building Permit Issuance): a) The Planning Board must endorse the final site plan mylars and three (3) copies of the signed plans must be delivered to the-Planning P 8n P annin Department. b) One certified copy of the recorded decision must be submitted to the Planning Department. PM SAL'S JUST PIZZA 603 8947054 P. 05 4. prior to verification of the Certificate of Occupancy: a1 Thea � applicant must submit a letter from the architect and engineer of the project stating that the building, signs, landscaping, lighting and site layout substantially comply with the plans referenced at the end of this decision as endorsed by the Planning Board. b) The Planning Staff shall approve all artificial lighting used to illuminate the site. All lighting shall have underground wiring and shall be so arranged that all direct rays from such lighting falls entirely within the site and shall be shielded or recessed so as not to shine upon abutting properties or streets. The Planning Staff' shall review the site. Any changes to the approved lighting plan as may be reasonably required by the Planning Staff shall be made at the owner's expense. All site lighting shall provide security for the site and structures however it must not create any glare or project any light onto adjacent residential properties. C) The building must have commercial fire sprinklers installed in accordance with the North Andover Fire Department. 5. Prior to the final release of security: a) The Planning Staff shall review the site. Any screening as may be reasonably required by the Planning Staff will be added at the applicant's expense. cifiS ec all after the detention pond is completed, the Town Planner will review the site and any screening as may be reasonably required by the Town Planner will be added at the applicant's expense b) A final as-built plan showing final topography, the location of all on- site utilities, structures, curb cuts, parking spaces and drainage facilities must be submitted to and reviewed by the Planning Staff' and the .Division of Public Works. 6. Any stockpiling of materials (dirt, wood, construction material, etc.) must be shown on a plan and reviewed and approved by the Planning Staff' Any approved piles must remain covered at all times to minimize any dust problems that may occur with adjacent properties. Any stock piles to remain for longer than one week must be fenced off and covered. 7. In an effort to reduce noise levels, the applicant shall keep in optimum working order, through regular maintenance, any and all equipment that shall emanate sounds from the structures or site. AUL L4—fdW 05 :20 PM SAL'S JUST PIZZA 603 894 7054 P. 06 $. The hours for construction shall be limited to between 7:00 a.m. and 7:00 p.m. Monday through Friday and between 8:00 a.m. and 5:00 p.m. on Saturday. 9. Any plants, trees or shrubs that have been incorporated into the Landscape Plan � approved in this decision that die within one year from the date of planting shall be replaced by the owner. The contractor shall contact Dig Safe at least 72 hours prior to commencing any excavation. 11. Gas, Telephone, Cable and Electric utilities shall be installed underground as specified by the respective utility companies. 12. No open burning shall be done except as is permitted during burning season under . the Fire Department regulations. 13. No underground fuel storage shall be installed except as may be allowed by Town I_ Regulations. 14. The provisions of this conditional approval shall apply to and be binding upon the applicant, its employees and all successors and assigns in interest or control. 15. Any action by a Town Board, Commission, or Department, which requires changes in the plan or design of the building, as presented to the Planning Board, may be subject to modification by the Planning Board. 16. Any revisions shall be submitted to the Town Planner for review. If these revisions are deemed substantial, the applicant must submit revised plans to the Planning Board for approval, 17. This Special Permit approval shall be deemed to have lapsed Atter July 12, 2002 (two years from the date permit granted) unless substantial use or construction has commenced. Substantial use or construction will be determined by a majority vote of the Planning Board. 18, The following information shall be deemed part of the decision: Plan Titled: Mary's Just Pasta Prepared for: Silvestri'Development Corporation Prepared By: Joel David Silverwatch, 163 Main Street, Salem, NH 03079 Scale- ya)�..1,0„ Date: 3/29/00 i A JUU-24-00 05 :20 PM SALAS JUST PIZZA 603 894 7054 P_ 07 Plan Titled: Mary's Just Takeout Prepared for: Salvatore Lupoli, 28 North Broadway, Salem, NH 03079 Prepared By: TF Moran, 21 A Street,Burlington, MA 01803 Scale- 1"=10' Date: April 28, 2000, revised 6/5/00 cc' Applicant Engineer File NORTH LED Town . of o I�0�A-o«;,� �, dower, Mass., r_1 DRATED S H E BOARD OF HEALTH PEI'RMIT T Food/Kitchen Septic System / / BUILDING INSPECTOR THIS CERTIFIES THAT...,JO.V�jI,G......,N...., , pl /5..,.. R..�'�l1... . ............................................... Foundation 7 /S GL C/'�C/P/y has permission to erect............... ...................... b ildings on ��f....,.....�G�.................... Rough to be occupied as...1.. 431.. .......!' 5....� CJS ................................................................. Chimney ............................. ......................... provided that the person accepting this permit shall in every respect,conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 7//a r7 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Z 64 PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR C Rough ........................ ... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. ORTH Town o y.: �.o Andover No. Y CON z__ = o dover, Mass., T LAKE YY Q T COC MIC HE WICK SAO SSAC RUSE FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT 0��?.1 .. V ��!/�`�'!`�'..-:?....,7:�r... 1.9 n.yS....�/ V. ... l.`t..� LSC, .... ........... ...... ...... .... has permission to excavate and pour foundation at ....:7.:.:.f...0 ....C.(K.. (4.e!.Iev. ......;D,a, for the purpose of....f.Y az..Q..' �en e d N T1 ��- �2 v LTV r .................................................... .......................................................................... The person accepting this permit must return to the office of the Building Inspector a certified plot plan show of building thereon before Foundation will be inspected. ' //027 04 A PPrvo 4L S -Dec,. *k I ( /oZ000 Qom• - 11- dolma �SD. VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. w�'...4...C................................... BUILDING INSPECTOR i MEMORANDUM To: Heidi Griffm From: Bob Nicetta. Date: October 25, 2003 RE: Mary's Pasta & Sandwiches I have been speaking with a Mr. Sam Conte for Sal Lupoli an have suggested that we have Mr. Lupoli's architect check the roof system that has been built at the location. I would accept it if the architect gives the budding department a sketch of the portion of the roof in question and he certifies the trusses and the cutting, if any. I have also suggested that he may be able to find a way to hide the mechanical vents and chimneys. In any case I believe the Planning Board would have to approve the`hiding" and also the fact that the Portico Pilasters and roof have not been constructed. It appears that Sal will work with my suggestions,however I will not guarantee it until I hear from him Wednesday the 20''. Sal does not understand how the inspector signed the building card and issued the certificate of occupancy with these construction problems. Town of North Andover Office ®f the Building Department Community Development and Services Division l 27 Charles Street " North Andover,Massachusetts 01845 QSsgCED D. Robert Nicetta Telephone (978) 68 Fax(978)688-9542 Building Commissioner MEMORANDUM To: Heidi Griffin,Director CD&S From: Robert Nicetta,Building Commissioner Date: October 25, 2003 Re: Building Permit#265 (Nov. 09,2001) Mary's Pasta& Sandwiches (a/k/a Mary's Takeout) 478 Chickering Road Local Building Inspector Mchael McGuire is the inspector of record on the referred project. Inspector McGuire was ill and not in the office on October 17'b when the Town Clerk's Office called and inquired if a Certificate of Occupancy had been,issued for the location? The Clerk's office indicated that the business was operating without the benefit of a Common Victualler License. It was at this time that the building file was consulted. The building drawings indicated the Structural Engineer Stamped Roof Design as having a top flat area of 5'-8"x 49'-4" enclosed by a 36"high decorative panels to hide the mechanical vents and units. The roof design has been changed to pre-engineered trusses with all vents exposed and the HVAC unit placed in the building. Pursuant to the Massachusetts State Building Code no person may change the structural drawings without notifying and receiving approval by the inspector of record In this particular case the pre-engineered trusses where installed without stamped drawings and calculations being supplied and the approval of the inspector of record. The interior hard ceiling of the structure prevents the inspection of the trusses to see if the truss cords had been cut to install the mechanical vents. Additionally,it cannot be seenif the HVAC unit is anchored to the bottom cord of the trusses. Pursuant to the Wood Council of America— CAUTION NOTES—"Any field modification that involves.the cutting,drilling,or relocation of any truss member or connection plate shall not be done without the approval of the truss manufacturer or a licensed design professional". In this instance this is all unknown and a structural failure may result. The drawi*that where submitted for the building permit indicates a front left and right brick pilasters from the sidewalk to the underside of a front roof overhang which would create a Portico. These where not constructed. I BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 (Page 2) The structural drawings as designed by Joel David Silversmith,P.E.#967 were changed and in violation of the Planning Board site plan special permit, dated: July 12, 2000. Pursuant to Paragraph 4–Prior to verification of the Certificate of Occupancy—Sub-Paragraph(a). The applicant must submit a letter from the architect and engineer of the project stating that the building signs,landscaping and site layout substantially comply with the plans referenced at the end of this decisions endorsed by the Planning Board. Sub-Paragraph(18):The Following Information shall be deemed a part of this decision: Plan Titled: Mary's Just Pasta Prepared for: Silvestri Development Corporation Prepared by: Joel David Silverwatch 163 Main Street Salem,NH03079 Scale: '/a"=1'0" Date: 3/29/00 It was inquired of the Inspector of Record how the Building Permit inspectional card could be signed off and the Certificate of Occupancy issued with all the apparent deficiencies in the actual construction and the approved construction drawings. His reply was–quote"The permit was issued so long ago and the time of construction that I forgot what was being built"unquote. The Building Commissioner reply was that that was no excuse as he should have gone back m the file to refresh himself on the project. i l /l Nicetta, Robert To: jeaton@town of north andover.com Subject: Mary's Pasta&Sandwiches To: Janet L Eaton Assistant Town Clerk From: Robert Nicetta Building Commissioner Date: October 17, 2003 Re: Mary's Pasta& Sandwiches 478 Chickering Road Local Inspector Michael McGuire has issued a Certificate of Occupancy for the referred business. The issuance of the Certificate of Occupancy indicates that the establishment has been built according to the filed building department plans and specifications and according to the Massachusetts State Building Code-780 CMR. As such,the building department does not object to the issuance of the Common Victualler License. TOWN OF NORTH ANDOVER OFFICE OF LICENSING COMMISSION 1.20 MAIN STREET NORTH ANDOVER,MASSACHUSETTS 01845 f pOR7y Donald B. Stewart,Chainncxn 3z�,��O.o�•' °� William B.Duffy,Jr. ° < = Telephone(978)688-9500 Susan M Haltmaier. * * FAX(978)688-9556 Rosemary C. Smedile °,4<e<-,-�. •>� �q�TFP Py� James M Xenakis pSs�cauSEs Memorandum To: Building Inspector Chief of Police Fire Chief Board of Health Commission on Disability Issues From: Janet L. Eaton, Assistant Town Clerk .Date: October 17, 2003 Subject: Mary's Pasta & Sandwiches 478 Chickering Road Mary's Pasta& Sandwiches, 478 Chickering Road is looking for a common victuallar license. An Occupancy Permit has been issued for the premises. A temporary Common Victualler License has been issued with the approval of the Licensing Commission Chairman, until such time as the applicant can go before the Commission. The hearing has been set for November 10, 2003,which is the next meeting. Recommendations are needed for your department prior to the scheduled hearing. You can E-mail me at jeatonntownofnorthandover.com with your recommendations. Thank you in advance for your immediate attention in this matter. , ( ' �1� ,t�• ,p t i i , 1 ii i I1 II MEMORANDUM To: Heidi Griffin From: Bob Nicetta. Date: October 25, 2003 RE: Mary's Pasta & Sandwiches I have been speaking with a Mr. Sam Conte for Sal Lupoli an have suggested that we have Mr. Lupoh's architect check the roof system that has been built at the location. I would accept it if the architect gives the building department a sketch of the portion of the roof in question and he certifies the trusses and the cutting, if any. I have also suggested that he may be able to find a way to hide the mechanical vents and chimneys. In any case I believe the Planning Board would have to approve the "hiding" and also the fact that the Portico Pilasters and roof have not been constructed. It appears that Sal will work with my suggestions,however I will not guarantee it until I hear from him Wednesday the 20. Sal does not understand how the inspector signed the building card and issued the certificate of occupancy with these construction problems. I t o y KC-oz fo t; c�-t, 2 �n N.atii . �C To 6PAIW ;or MEMORANDUM a To: Heidi Griffin a From: Bob Nicetta. 'a Date:e: Oct ober 25, 2003 � RE: Mary's Pasta & Sandwiches I have been speaking with a Mr. Sam Conte for Sal Lupoli an have suggested that we have Mr. Lupoh's architect check the roof system that has been built at the location. I would accept it if the architect gives the building department a sketch of the portion of the roof in question and he certifies the trusses and the cutting, if any. I have also suggested that he maybe able to find a way to hide the mechanical vents and chimneys. In any case I believe the Planning Board would have to approve the`biding" and also the fact that the Portico Plasters and roofhave not been constructed. It appears that Sal will work with my suggestions,however I will not guarantee it until I hear from him Wednesday the 29a'. Sal does not understand how the inspector signed the building card and issued the certificate of occupancy with these construction problems. 3 �d � r l Town of North Andover E NORTk, ° ,to ° Office of the Building Department 3+ ='°° Community Development and Services Division 27 Charles Street '/ °�~�'~•• North Andover,Massachusetts 01845 9SSwcNus�t -D. Robert Nicetta Telephone (978)688-9545 Building Commissioner Fax(978)688-9542 MEMORANDUM To: Heidi Griffin,Director CD&S From: Robert Nicelta,Building Commissioner Date: October 25,2003 Re: Building Permit#265 (Nov. 09,200 1) Mary's Pasta& Sandwiches (a/k/a Mary's Takeout) 478 Chickering Road Local Building Inspector Michael McGuire is the inspector of record on the referred project. Inspector McGuire was ill and not in the office on October 17'b when the Town Clerk's Office called and inquired if a Certificate of Occupancy had been issued for the location? The Clerk's office indicated that the business was operating without the benefit of a Common Victualler License.It was at this time that the building file was consulted The building drawings indicated the Structural Engineer Stamped Roof Design as having a top flat area of 5'-8"x 49'4"enclosed by a 36"high decorative panels to hide the mechanical vents and units. The roof design has been changed to pre-engineered trusses with all vents exposed and the HVAC unit placed in the building. Pursuant to the Massachusetts State Building Code no person may change the structural drawings without notifying and receiving approval by the inspector of record In this particular case the pre-engineered trusses where installed without stamped drawings and calculations being supplied and the approval of the inspector of record. The interior hard ceiling of the structure prevents the inspection of the trusses to see if the truss cords had been cut to install the medianical vents. Additionally,it cannot be seenif the HVAC unit is anchored to the bottom cord of the trusses. Pursuant to the Wood Council of America— CAUTION NOTES—"Any field modification that involves.the cutting,drilling,or relocation of any truss member or connection plate shall not be done without the approval of the truss manufacturer or a licensed design professional". In this instance this is all unknown and a structural failure may result. The drawings that where submitted for the building permit indicates a front left and right brick pilasters from the sidewalk to the underside of a front roof overhang which would create a Portico. These where not constructed. BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 i (Page 2) The structural drawingsas designed by Joel David Silversmith,P.E.#967 were changed and in violation of the Planning Board site plan special permit,dated: July 12,2000. Pursuant to Paragraph 4–Prior to verification of the Certificate of Occupancy—Sub-Paragraph(a). The applicant must submit a letter from the architect and engineer of the project stating that the building, signs,landscaping and site layout substantially comply with the plans referenced at the end of this decisions endorsed by the Planning Board. Sub-Paragraph(18):The Following Information shall be deemed a part of this decision: Plan Titled: Mary's Just Pasta Prepared for: Silvestri Development Corporation Prepared by: Joel David Silverwatch 163 Main Street Salem,NH03079 Scale: 1/a"=1'0" Date: 3/29/00 It was inquired of the Inspector of Record how the Building Permit inspectional card could be signed off and the Certificate of Occupancy issued with all the apparent deficiencies in the actual construction and the approved construction drawings. His reply was–quote"The permit was issued so long ago and the time of construction that I forgot what was being built"unquote. The Building Commissioner reply was that that was no excuse as he should have gone back in the file to refresh himself on the project. I Page 1 of 2 I Nicetta, Robert From: Bob Nicetta[micetta@townofnorthandover.com]on behalf of Nicetta, Robert Sent: Friday, October 24, 2003 3:46 PM To: Nicetta, Robert Subject: RE: Heidi —I apologize for returning to this e-mail, however the first paragraph of your e-mail is causing great concern to me. Perhaps I am reading too much into the paragraph—but! Bob -----Original Message----- From: Bob Nicetta [mailto:micetta@townofnorthandover.com]On Behalf Of Nicetta, Robert Sent: Friday, October 24, 2003 11:29 AM To: Griffin, Heidi Subject: RE: Heidi —You will get a report on the situation of the assistant building inspector and the structure. I anticipate having it complete this weekend. I am still thinking over the suspension/other issues and would like to have input with you prior to writing the report. I have been in conversation yesterday and this morning with a Mr. Sam Conte for Sal Lupoli on the matter. I have suggested confirmation on the condition of the present roof by the Structural Engineer of record. After which,the issue of the Planning Board condition will then be addressed. Mr. Lopoli has agreed to this possible solution. Meeting is important. Thanks, Bob -----Original Message----- From: Griffin, Heidi Sent: Friday, October 24, 2003 9:57 AM To: Nicetta, Robert Cc: Santilli, Ray Subject: Hi Bob: It is my understanding that you met with Ray Santilli yesterday regarding some issues you have with the Building Inspector. Ray indicated to me that he informed you that you need to make a written recommendation to me outlining why and what reasons you believe Mr. McGuire should have disciplinary action enforced. At that pant, I will then make a written recommendation to the Town Manager and Asst.- Town sst.Town Manager either agreeing or not agreeing with your recommendation. Your recommendation needs to specifically address the type of disciplinary action you feel will be appropriate. However, you should be aware that since Mr. McGuire was previously provided with a written warning,the next level of action would be a suspension. That recommendation needs to come from you if you believe it is appropriate. Thanks! 10/24/03 Page 1 of 1 Nicetta, Robert From: Bob Nicetta[rnicetta@townofnorthandover.com] on behalf of Nicetta, Robert Sent: Friday, October 24,2003 11:29 AM To: Griffin, Heidi Subject: RE: Heidi —You will get a report on the situation of the assistant building inspector and the structure. I anticipate having it complete this weekend. I am still thinking over the suspension/other issues and would like to have input with you prior to writing the report. I have been in conversation yesterday and this morning with a Mr. Sam Conte for Sal Lupoli on the matter. I have suggested confirmation on the condition of the present roof by the Structural Engineer of record. After which,the issue of the Planning Board condition will then be addressed. Mr. Lopoli has agreed to this possible solution. Meeting is important. Thanks, Bob -----Original Message----- From: Griffin, Heidi Sent: Friday, October 24, 2003 9:57 AM To: Nicetta, Robert Cc: Santilli, Ray Subject: Hi Bob: It is my understanding that you met with Ray Santilli yesterday regarding some issues you have with the Building Inspector. Ray indicated to me that he informed you that you need to make a written recommendation to me outlining why and what reasons you believe Mr. McGuire should have disciplinary action enforced. At that point, I will then make a written recommendation to the Town Manager and Asst.Town Manager either agreeing or not agreeing with your recommendation. Your recommendation needs to specifically address the type of disciplinary action you feel will be appropriate. However, you should be aware that since Mr. McGuire was previously provided with a written warning,the next level of action would be a suspension. That recommendation needs to come from you if you believe it is appropriate. Thanks! Community Development&Services Director 27 Charles Street North Andover, MA 01845 (978)888-9531 (978)6188-9542 fax i 10/24/03 Page 1 of 2 Nicetta, Robert From: Bob Nicetta[micetta@townofnorthandover.com]on behalf of Nicetta, Robert Sent: Saturday, October 25, 2003 12:51 PM To: Griffin, Heidi Subject: RE: -----Original Message----- From: Bob Nicetta [mailto:micetta@townofnorthandover.com]On Behalf Of Nicetta, Robert Sent: Friday, October 24, 2003 3:46 PM To: Nicetta, Robert Subject: RE: Heidi —I apologize for returning to this e-mail, however the first paragraph of your e-mail is causing great concern to me. Perhaps I am reading too much into the paragraph —but! Bob -----Original Message----- From: Bob Nicetta [maitto:micetta@townofnorthandover.com]On Behalf Of Nicetta, Robert Sent: Friday, October 24, 2003 11:29 AM To: Griffin, Heidi Subject: RE: Heidi —You will get a report on the situation of the assistant building inspector and the structure. I anticipate having it complete this weekend. I am still thinking over the suspension/other issues and would like to have input with you prior to writing the report. I have been in conversation yesterday and this morning with a Mr. Sam Conte for Sal Lupoli on the matter. I have suggested confirmation on the condition of the present roof by the Structural Engineer of record. After which, the issue of the Planning Board condition will then be addressed. Mr. Lopoli has agreed to this possible solution. Meeting is important. Thanks, Bob -----Original Message----- From: Griffin, Heidi Sent: Friday, October 24, 2003 9:57 AM To: Nicetta, Robert Cc: Santilli, Ray Subject: Hi Bob: It is my understanding that you met with Ray Santilli yesterday regarding some issues you have with the Building Inspector. Ray indicated to me that he informed you that you need to make a written recommendation to . me outlining why and what reasons you believe Mr. McGuire should have disciplinary action 10/25/03 Page 2 of 2 enforced. At that point, I will then make a written recommendation to the Town Manager and Asst.Town Manager either agreeing or not agreeing with your recommendation. Your recommendation needs to specifically address the type of disciplinary action you feel will be appropriate. However,you should be aware that since Mr. McGuire was previously provided with a written warning,the neat level of action would be a suspension. That recommendation needs to come from you if you believe it is appropriate. Thanks! �fGriTf*V Community Development&Services Director 27 Charles Street North Andover. MA 01845 (978)5889531 (978)688-9542 fax I, i 10/25/03 MEMORANDUM To: Heidi Griffin,Director CD&S From: Robert Nicetta,Building Commissioner Date: October 25,2003 Re: Building Permit#265(Nov. 09, 200 1) Mary's Pasta& Sandwiches (a/k/a Mary's Takeout) 478 Chickering Road Local Building Inspector Michael McGuire is the inspector of record on the referred project. Inspector McGuire was ill and not in the office on October 171'when the Town Clerk's Of called and inquired if a Certificate of Occupancy had been issued for the location? The Clerk's office indicated that the business was operating without the benefit of a Common Victualler License. It was at this time that the building file was consulted. The building drawings indicated the Structural Engineer Stamped Roof Design as having a top flat area of 5'-8"x 49'-4"enclosed by a 36"high decorative panels to bide the mechanical vents and units. The roof design has been changed to pre-engineered trusses with all vents exposed and the HVAC unit placed in the building. Pursuant to the Massachusetts State Building Code no person may change the structural drawings without notifying and receiving approval by the inspector of record In this particular case the pre-engineered trusses where installed without stamped drawings and calculations being supplied and the approval of the inspector of record. The interior hard ceiling of the structure prevents the inspection of the trusses to see if the truss cords bad been cut to install the mechanical vents. Additionally,it cannot be seen if the HVAC unit is anchored to the bottom cord of the trusses. Pursuant to the Wood Council of America— CAUTION NOTES—"Any field modification that involves the cutting, drilling,or relocation of any truss member or connection plate shall not be done without the approval of the truss manufacturer or a licensed design professional". In this instance this is all unknown and a structural failure may result. The drawings that where submitted for the building permit indicates a front left and right brick pilasters from the sidewalk to the underside of a front roof overhang which would create a Portico. These where not constructed. Mary's Just Takeout 478 Chickering Road Building Permit issue prior to Comm Vic Lic. Hearing&granting. No notification To Town Clerk to issue Comm. Vic. License. (Did not have licensing commission hearing). No handi-cap pole mounted sign. Entrance door heavy to open(*handicap). Sign in violation of setbacks. Sidewalk curb line varies from 7"to 10" s/b 6"tripping danger. No sign off for water meter prior to Issuance of COfO. Change in building roof design to pitched trusses. Without approval. Original roof designed to have fenced flat area for HVAC unit, Exhaust vent, and Air venting shaft. No structural engineering calculations submitted for truss roof design. Pitch roof trusses cut and penetrated for installation of exhaust vent and air venting shaft without permission of building department inspector. The cutting of roof trusses must be approved by the joist manufactures. None supplied to building department. The enclosed flat spot to hide the mechanical equipment was a condition of the Planning Board Site Plan Approval. �oR it b9w�2 fC>ALlV-&@� �j-r