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Home My WebLink AboutMiscellaneous - 565 TURNPIKE STREET 4/30/2018 (4). -- _ _� � � � ', I � `� R ' I Date .... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ................ ................................................... has, permission to perform ...... ................................................. wiring'in the building of k2f I w ............ at .... An over, Mass. ......... �.( ................... N,�rth d Fee..'%� Lic. Nom/. . ..... ... .................. ELECTRICAL INSPECTOR Check' 67- 3 Y Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: AUGUST 14, 2015 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) 565 TURNPIKE STREET Owner or Tenant CHESTNUT GREEN CONDO ASSOCIATION Telephone No. 978-453-6696 Owner's Address C/O PMA P.O. BOX 488, ANDOVER, MA 01810 Is this permit in conjunction with a building permit? Ves ❑ No X❑ (Check Appropriate Box) Purpose of Building COMMERCIAL Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. ��Me&ers New Service Amps / Volts Overhead ❑ Undgrd ❑ No. Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: REPAIR WIRE FOR OUTSIDE WALLPACKS FOUND CUT IN DENTIST'S OFFICE BY DENTIST'S CONTRACTOR Completion of the ollowin table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans TransTotal Trsformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- ❑ rnd. rnd. o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection andInitiating Devices No. of Ran Ranges g No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number I Tons J.KW........... of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water Kms, Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtrbs No. of Motors Total HP Telecommunications Wiring: No. of Devices or E uivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: $1, 19 5 . 0 0 (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) I certify, under thepains andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: CROWE & SONS ELECTRICAL CORP—., n n n . LIC. NO.: 17168A Licensee: JAMES B. CROWE Signature( �(t (}-�QJ l., LIC. NO.: 17168A (If applicable, enter "exempt" in the license number line.) Bus. Tel. No. -9 78 - 4 53 - 6 6 9 6 Address: 590 MIDDLESEX STREET, LOWELL, MA 01851 Alt. Tel. No.:978-453-6696 *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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $12 5. 0 0 �1 AC ORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 6I'M' 5 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER New Agency Partners, LLC 99 Cherry Hill Road Suite 200 Parsippany NJ 07054 CONTACT ClareBelfiore NAME: FAi PHON o E (973) 588-1800 A/C No: (973)588-1801 ADDRESS:cbelfiore@newagencypartners.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Selective Ins Co of South Carolina 19259 INSURED CROWE & SONS ELECTRICAL CORP 590 MIDDLESEX ST LOWELL MA 01851-1428 INSURERBFIartford Ins Co of the Midwest INSURERC: INSURER D: INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER:15-16 Master rev'd REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDD POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE � OCCUR DAMAGE TO RENTEDe $ 500 , 000 PREMISE S Ea occurrenc MED EXP (Any one person) $ 10,000 S 2151503 3/22/2015 3/22/2016 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY a JE � I LOC PRODUCTS - COMP/OP AGG $ 3,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS A 9093023 3/22/2015 3/22/2016 BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident NON -OWNED X HIRED AUTOS X AUTOS X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 A EXCESS LIAB CLAIMS -MADE DED I X I RETENTION$ NONE $ I IS 2151503 3/22/2015 3/22/2016 WORKERS COMPENSATIONPER AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 13WECBY9793 5/24/2015 5/24/2016 X OTH- STATUTE ER E.L. EACH ACCIDENT $ 500,000 B OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS0251Mm40n SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Electrical Inspector's Office ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood Street AUTHORIZED REPRESENTATIVE Suite 2035 N. Andover, MA 01845 Clare Belfiore/CIB J,C-h--L ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS0251Mm40n ;. The Commonwealth of Massachusetts Department of Industrial Accidents d 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): CROWE & SONS ELECTRICAL CORP. Address: 590 MIDDLESEX STREET City/State/Zip: LOWELL, MA 01851 Are you an employer? Check the appropriate box: Phone 4:(978)453-6696 I. E] I am a employer with employees (full and/or part-time).* 2.❑ I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3711 am a homeowner doing all work myself. [No workers' comp. insurance required.] t 4.❑ I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5.M 1 am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance., 6. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, §1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 7. ❑ New construction 8. ❑ Remodeling 9. ❑ Demolition 10 ❑ Building addition 11.❑✓ Electrical repairs or additions 12. ❑ Plumbing repairs or additions 13.F] Roof repairs 14. ❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ,Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: HARTFORD INS CO OF THE MIDWEST Policy # or Self -ins. Lic. #: 13WECB79793 Expiration Date: 5/24/16 Job Site Address: 565 TURNPIKE STREET City/State/Zip: N. ANDOVER 01845 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. r I do herebyerti� under the )453-6696 that thripformation provided above is true and correct. AUGUST 17, 2015 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Pl,ease visit our web site at http://www.mass.gov/dpl/boards/EL CROWE & SONS ELECTRICAL CORP JAMES B CROWE (EL) 590 MIDDLESEX STREET LOWELL MA 01851-1428 Fold, Then Detach Along All Perforations (Yk::COMMONWEALTH OF MA"ACHUSETTS e�IColel_•I:teJa�+`�►7Col►/_1�1y[aJa►F•'1U:1 ELECTRICIANS ISSUES THE. FOLLOWING L1C`ENSE AS R , REGISTERED MASTER ;ELECTftI CI'AN . is CR:.UWE & SONS ELECTRICAL CORP L `N - JAMES B CROW'E 590 MIDDLESEX STREET IU ::- �J LOWELL :MA 01851-1428 l 168.A 07/:3.1116 57010 :j This certifies that Date .... 4A -�A� .......... TOWN OF NORTH ANDOVER RMIT FOR WIRING ........... ...... ; ............... F..'Fo ............................................... has -permission to perform ... ...... Y-- CX--....:........................ wiring in the building of ............ V21 .. . . ...................................................................................... at ......... 151015-7111"erlpllt-t- 4&44 0, North Andover, Mass. ............................................................................................ . O Fee.2-...�56. .. .... Lic. No. .20 . N............. ............ [,) .. . ...... ... ..... .......... ........ .. ELECTR CAL INSPECTOR Check It Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS r` (Please add zip codes & electrician's cell #; contract # & bid permit # if applicable.) Official Use Only. Permit No. 1 2 1 1 Occupancy and Fee Checked [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /3 City or Town of: ,�Iiy/1-h To the 17nspe6tor of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 5�l S ,��,,o-� S'Ut j Owner or Tenant Telephone No. 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 Location and Nature of Proposed Electrical Work: ,el��rS� Gy e Completion ofthefollowing table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil: Sus Paddle Fans No. o Total �0 p' (Paddle) Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators V KVA No. of Luminaires Swimmin Pool ,"ove E]in- E]Plu. ul r 111ergelicy 1,ignu11g g 2rnd. 2rnd. Battery Units No. of Receptacle Outlets o. of Oil Burners FIRE ALARMS No. of Zones No. of Switches 3 No. of Gas Burners No. o Detection and Initiating Devices No. of Ranges No. of Air Cond. Tons Tot No. of Alerting Devices No. of Waste Disposers Heat PumpSelf-Contained Number Tons KW No. o Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Mumcipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. o Water . KW No. o No. o Data Wiring: yS Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Eauivalent 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 ❑ BOND ❑ OTHER X❑ (Specify:) General Liability 12/31/15 I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Boissonneault Electric Corp. LIC. NO.: 11823A Licensee:1;20)ei0 119' (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: (978)454-0383 Address: 36 Chuck Drive —Dracut, MA 01826 Alt. Tel. No.: (978)458-9977 *Security System Contractor License required for this work; if applicable, enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $7- �jVj� N �� The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 Boston, MA 02114-2017 a ° www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Boissonneault Electric Corp. Address: 36 Chuck Drive - P.O. Box 639 /State/ZiD: Dracut, MA 01826 Phone #: 978-454-0383 Are you an employer? Check the propriate box: re 1. �I am a employer with /7 4• ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 3. ❑ I am a homeowner doing all work officers have exercised their myself. [No workers' comp. right of exemption per MGL insurance required.] t c. 152, $1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 1 L❑ Plumbing repairs or additions 12.0 Roof repairs 13.❑ Other *Any applicant that checks box # I must also fill out the section below showing their workers' compensation policy intonnation. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new a 111davit indicating such. tContractors that check this box must attached an additional sheet showing the name MAW sub -contractus and state whether or not (hose entities have employees. If the sub -contractors have employees. they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees..Below is the policy and job site information. Insurance Company Name: Utica National Insurance Group Policy # or Self -ins. Lic. #: 4386559 Expiration Date: 1/1/16 Job Site Address: S / UlrJ,j%/ %jG s%/,✓ _�cle ?City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine J 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 certif�� the pains and penalties of perjury that the information provided above is true and correct. %3/ 978-4540383 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: r Date.....Z . . ... .....5- ........... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifiesthat ............. .............. ...................................... !....:....� .............................. Ig d -c do j k has permission to perform .... �? ..... . . 6 46 ....................................................... A � Qw plumbing in the buildings of.....6 at .... .............................................. North Andover, Mass. FeeI ........ L c. No. IY4- .......... ........................................................ PLUMBING INSPECTOR Check �oa7—�S rpt. i�iv/�5 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ' CITYii/o 7' /C%�i� as MA DATE PERMIT # �� JOBSITE ADDRESS $ OWNER'S NAME OWNER ADDRESS TEL Lj2PFAX j TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL © RESIDENTIAL fl PRINT CLEARLY NEW: RENOVATION:) REPLACEMENT: Q PLANS SUBMITTED: YES ® NO 011 FIXTURES'l FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OILISAND SYSTEM I i .__.__) __..-_.J ----jI -A DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM { - _ I —I _ I _ I J { -__ - { DEDICATED WATER RECYCLE SYSTEM _ S __ __.J .. I __�• (__,._�1 ___..,_J _ ` _.___f .._i .____-_1 ._..._._..{ _- _..__f -.__ __( _..1 DISHWASHER c ...... _ .__._ I _—. ! _—_! _.._J ' ... _ i DRINKING FOUNTAIN { _._._._{ 11. _! FOOD DISPOSER FLOOR/AREADRAIN INTERCEPTOR (INTERIOR) KITCHEN SINK LAVATORY{ A-11 .--I ! ----J ROOF DRAIN ( r__j _,_! SHOWER STALL _( � 1 I SERVICE / MOP SINK f _.-1 I I — F _. ! (._. _.-{ - I _-.- __—J _ .__._�1 _ __ E { TOILET URINAL { J 4 i WASHING MACHINE CONNECTION { 1 - WATER HEATER ALL TYPES WATER PIPING I OTHER { {---•----�---..--� ��------(--- --._s ...___€ I _.---.i _� _---' _ INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES NO y 1117 YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY 0 BOND !S OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER [] AGENT �] SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance wit all Pert i ent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME LICENSE # ANATUIRE iVIP" JP�]�f( CORPORATION .i PARTNERSHIP#LLC _ } COMPANY NAME �� a _ ;ADDRESS --- — CITY�j�_ _..._ STATE/y ZIPTEL FAX � J.��' Zf CELL . � d✓�i'. MAIL N ❑ w W The Commonwealth of Massachusetts Department of Industrial Accidints Office of Investigations 600 Washington Street Boston, MA. 02111 www.mass gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Address: /%-l�lr City/State/Zip _��hone �� . Are you an employer? Check the approbriate box: Lfiffam a employer with / Z 4. ❑ Zam a general contractor and T employees (full and/or part-time).* have hired the sub -contractors listed the attached sheet. t 2. ❑ I am a sole proprietor or partner- on ship and'have no employees These sub -contractors have working for mein any capacity. workers' comp. insurance. 5. ❑ We are a corporation and its [No workers' comp. insurance required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, §I(4), and we have no insurancerequired.] employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. E] Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.0 Electrical repairs or additions 1Plumbing. repairs or additions 12.❑ Roofrepairs 13.❑ Other 'Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. T 'Homeowners who submit this affidavit indicating they tie doing all work and then hire outside contractors must submit a new affidavit indicating such. ?Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees Below is the policy and job site information. Insurance Company Name:. ' Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address:e�S �� 4 6T City/State/Zi_ /t Attach a copy of the workers' compensation -policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL o. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one=year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine ofup to $250.00 a day against the violator. Be advised that a copy ofthis statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. X do hereby cert Un r the pains and Pga attics ofperjury that the information provided above is true and correct. V Official use only. Do not write in this area, to be completed by city or town official. C' o Town• Permit/License # xiyr Issuing Authority (cycle one): 1. Board of Health 2. Building Department 3. CityMown CIerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other - Contact Person: Phone #: Informati®n 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 employes is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a -deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced -acceptable evidence of compliance with the insurance coverage required:' Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out: the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) andphonenumber(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 maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. AIso be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their seY iusurance license number on the appropriate line. ' City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom Of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be -sure to fill in the permit/license number which will. be used as a reference number. In. addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (ifnecessary) and under "Job Site Address" the applicant should write "all locations iu . (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: `Z`he Co onw-ealthofA416uarhvsPtts aQepat'lmajit o£.TxtdusWal Accidents Me ofhavestigatlow 6.00 Washuagton Strut Boston} MA 0.2111 TQJ, # 61.7-7-27-4900 at 406 Qx 1-877- ASSAkB Revised 5-26-05 Fax # 617"727'7749 wwwxmm,%gov1d1a aP CERTI'F1CATIE .OF`-'USE & OCCUPANCY Town of North Andover Building Permit Number 460 Date October 18, 1999 THIS CERTIFIES THAT THE. BUILDING LOCATED ON 565 Turnpike Street MAY BE OCCUPIED AS Doctors office - 1 IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS,AS MAY APPLY. - CERTIFICATE ISSUED TO Ernesto Lopez, M.D. ADDRESS 656 Turnpike St No. Andover MA 01845 O A �1AlYIIS� � ADDRESS 656 Turnpike St No. Andover MA 01845 MASSACHUSETTS UNIFORM .APPLICATION FOR PERMIT TO DC PLUMBING�� (Print or Type) 0 `J N. Aroclove—fLz \�� Mass. Date S'/.2 19'17_Permit#-_ � �� - `•s,, ,� Building Location Owner's Name r45- rQLAjPike Si SviTt C 3 /i _Type of Occupancy New ❑ Renovation a Replacement ❑ Plans Submitter: Yes ❑ No ❑ FEATURES r Installing Company Name Aj? a 0 n—P1ti Check one: Certificate Address - I L S7-, M�,,`Corporation w " vice j—�L��❑ Partnership Business TelephoneS'S 01 Q� �{ �� ❑Firm/Co. Name of Licensed Plumber—D-0 INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142. Yes e No ❑ If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy Other type .of indemnity ❑ Bond O OWNERS -INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General_ Laws_and_that my signature on -this permit -applicaticih waives this requirement. Check one:. Signature of Owner or Owner's AgOwner ❑ Agent ❑ ient ' I nereoy certity 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 wc.-k and installations porformca under the permit issued for this application will be in compliance with all pertinent provisions of th:; Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By 1 (C�t� ( Signa ure o L- icons©d'Pfu�,, Title MAY Type of Liccanse: Master � Journeyman C City/Town License Number 8 C-, Q t _ APPRn1/Pn nFFlnr i IPF nhl! Y1 I F- U7 I J U) O Y z Q z W W U) Y Z U)W Q tr Q = z U7 lz o U) w < w z o¢ ¢ 3 x Ll z O m m Q U L Q o Q Cn z m a m O W i W OW LU CC o t- Q U Q H O= cn co v7 Q~ Y z o O O O z z< W W O Y U= W x g Q= u) MJ¢ nCoQ Z°com o f SUB•BSMT. BASEMENT ' 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR i 5TH .FLOOR 77 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name Aj? a 0 n—P1ti Check one: Certificate Address - I L S7-, M�,,`Corporation w " vice j—�L��❑ Partnership Business TelephoneS'S 01 Q� �{ �� ❑Firm/Co. Name of Licensed Plumber—D-0 INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142. Yes e No ❑ If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy Other type .of indemnity ❑ Bond O OWNERS -INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General_ Laws_and_that my signature on -this permit -applicaticih waives this requirement. Check one:. Signature of Owner or Owner's AgOwner ❑ Agent ❑ ient ' I nereoy certity 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 wc.-k and installations porformca under the permit issued for this application will be in compliance with all pertinent provisions of th:; Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By 1 (C�t� ( Signa ure o L- icons©d'Pfu�,, Title MAY Type of Liccanse: Master � Journeyman C City/Town License Number 8 C-, Q t _ APPRn1/Pn nFFlnr i IPF nhl! Y1 \l m 0 0 x a C I m rn — 12+ C7 m ca o 1 r W c� yam' C) � c to o m m `° �7 al . o m O N' Date 056 .. TOWN OF NORTH ANDOVER —PERMIT FOR PLUMBING This certifies that ................... has permission to perform .... 5/ K .............................. plumbing in the buildings of ......... ...................... at... 5� T1 North Andover, Mass. Fee. L ..... . ....... IVIBING INSPECTOR t 05/16/97 09:05 75.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Date.//.!' ?p" S S� ' 4013 �aOR7►, 01,•�•D •'tic TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING �I This certifies that 'r. �` ...... .. has permission to perform ... P Je k: «. it .� plumbing in the buildings of at. t�� .��..u�;��r./�r .......... !1 .. , North Andover, Massa t. Fee.?J.r -.. Lic. No../, O.?P /. . PLUMBING INSPECTOR 04/29/99 14:42 75:00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS -99/ �l o � / Date `? Building Location,5" JL�r� i re Si— Owners Name <4C /ra14-1 Permit #— O / 3 Amount.— Type of Occupancy�llC a Grt� i�� New ® Renovation ® Replacement ® Plans Submitted Yes ❑ No El FIXTITRES (Print or type)/ /� / Check one: Certificate Installing Company Name G'/ �C� 6114 -*- l ® Corp. Address •' c4 s J-7- Partner. P6- o/fti- Business Telephone 1/1 ,r o -? 3 & ff Finn/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurana676bverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner El Agent I hereby certify that all of the details and information ave bmitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work d installa 'ons onn under sued for this application will be in compliance with all pertinent provisions of the M sac efts Stat 1 Code eapter 142 of the General Laws. By:Signature o ice Type of Plu g Li se Title 14361' City/Town TIcense Mumuer Master Journeyman ❑ APPROVED (OFFICE USE ONLY Date .. . N° 4.349 TOWN OF NORTH ANDOVER .o p PERMIT FOR PLUMBING 17 This certifies that �.... .. C ' .?�.? ............. . has permission to perform ...%'.f..... Z plumbing in the buildings of ..^. at . a �. f9 `. .r' T �.1........ .... ,. North Andover, Mass. FeeZUU: Lic. No..I ....... ........... J:: -a`,. ;......... PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PE TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS ate 3 D Building Location '' Owners Name a Permit # 3 ttcl Amount % /�J Type of Occupancy 610,'1 In_e% -6 AL_ New Renovation El Replacement 0 Plans Submitted Yes No El FTXTTTR F. S (Print or type) Check one: Installing Company Named o Wl'% � �orp. LjPartner. Firm/Co. Name ofLicensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate boat Liability insurance policy Other type of indemnity 1:1 Bond ❑ Certificate 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 Signature Owner Agent E] 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 and P Issued for this application wppbe compliance with all pertinent provisions of the Massachusetts State Plumbing C C of Gen . By: Signatureo ucens um T � Plu�mg Li e Title City/Town rae i um er Master Journeyman 0 APPROVED (OFFICE USE ONLY . Department of Public Safety BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use Only Permit No. Occupancy & Fee Checked 3190 dea- a blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT.IN INK OR TYPE ALL INFORMATION) Date — T% City or Town of Anda �,f To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. ` Location (Street & Number) Owner or Tenant Id L`� L l f GL -4 r"� 0 4 ZLd l Sc.rv;L�S Owner's Address Is this permit in conjunction with a building permit: Yes � No (Check Appropriate Box) Purpose of Building Existing Service New Service Nunber of Feeders'and Ampacity Amps Amps /. Location and Nature of Proposed Electrical Work Volts Volts Jtility Authorization No. Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ No. of Meters No. of h1e!ers OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusnes General Laws have a current Liability, Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES NO ! have submitted valid proof of same to this office. YES LX NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ® BOND ❑ OTHER❑ (Please Specify) ( See Attached) (Expiration Date) Estimated Value of Electrical pWork S _1r 06 0 F Work to Start .S-- )" Inspection Date Requested Signed under the penalties of perjury: FIRM NAME Licensee _ Rough Will Call Final LIC. NO. A— 5 21 LIC. NO. Address /U 'Treble Love Road , N. Billerica, MA Ol R 6 9 " / Bus. Tel. No. 0 Rfad=�?L1�1 All. Tei. No.ekt- 257 OWNER'S INSURANCE WAIVER: I am avyare that the Licenee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S (Signature of Owner or AFentl TOTAL No. of Lighting Outlets No. of Hot Tubs No. o: Transformers KVA I Above In - ❑ E] No.KVA, No. of Lighting Fixtures Swimmine Pool prnd. grnd. No. of Emergency Lighting No. of Receptacle OutletsLl I No. of Oil Burners Banery Units No. of Switch Outlets No. of Gas Burners I FIRE ALARMS No. of Zones No. of Detection and Total No. of Ranges No. of Air Conditioners Tons Initiating Devices No. of Sounding Devices Heat Total Total No. of Disposals No. of Pumps Tons KW No. of Self Contained Detec:ion,'Soundinz Devices No. of DlShwaihers Space.rArea Heating KW Municipal Local❑ Connection ❑Other No. of Dryers Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW Siens Ballasts W;rinz No. Hydro Massage Tubs I No. of .Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusnes General Laws have a current Liability, Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES NO ! have submitted valid proof of same to this office. YES LX NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ® BOND ❑ OTHER❑ (Please Specify) ( See Attached) (Expiration Date) Estimated Value of Electrical pWork S _1r 06 0 F Work to Start .S-- )" Inspection Date Requested Signed under the penalties of perjury: FIRM NAME Licensee _ Rough Will Call Final LIC. NO. A— 5 21 LIC. NO. Address /U 'Treble Love Road , N. Billerica, MA Ol R 6 9 " / Bus. Tel. No. 0 Rfad=�?L1�1 All. Tei. No.ekt- 257 OWNER'S INSURANCE WAIVER: I am avyare that the Licenee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S (Signature of Owner or AFentl 44 Date.... e2 904 TOWN OF NORTH ANDOVER MOW PERMIT FOR WIRING ...... ................................ This certifies that ...... .. .......................... has permission to perform ............. ................... ..... ......................... ....... wiring in the building of ..... ........... ...... . .. ............. ..... . .... at .... ........ ...................................... . North Andover, Mass. Fee/<>.0 ... L\ic. N 4�� 4................................................ ............. ELECTRICAL INSPECTOR /o7) Cf oo PAID I 05/62/97 08:52 1()O. WHITE: Applicant CANARY: Building Dept, PINK: Treasurer Location '�p :z) No. �` Date TOWN OF NORTH At ` p Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ $ Sewer Connection fee $ M Water Connection Fee $ 5' TOTAL 40 v" 2 10-925 Building Inspector Div. Public Works k°» Location- oc !%& . \ Date Date 7 % - . y.. w.. . . « / TN\ TOWN OF NORTH ANDOVER Bm£c� ke U Occupancy. $ Building/Frame PrR Fee $ ) {. «:z\�. ��\Foundmbn Permit Fe $ 2�Other Permit Fee . $ Sewer Connection Fee $ Water Connection Fee $ ! \\ \ TOTAL �� ) 0,4 . �iim�Gmcr a 1/ g!» ` !is / m� ) � . . . . . . Div. Public Works w IlTk 0 'd < p IL n o m W Z I Y u 0 I f x < Z W N 'I0 V F- 0 IJ L Q � Z V. ,S W f Z < 0 0 m a Ir w < m Z U z N J O C W C W F Z 0 It LL S © F �N �. 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N_ < n 3 m N m Z 0 m O -r O z A ~ p "' A x A X< C Z Z 0 .-, X r Q, T -� V' D D A z N oz OA D Al Z y A m 1 T I I I I�>> n OA m N x Ci Z Q C1 z I I I Z �moo �'?j II ILL IIIAIIIIVIIII" m A I III !I I V III --I IW IIII SON N Nrm M, -14n `" >0 yzz TCC MXNj D n 0�0 U)v:E mim mx 1Z> Xon a6-1 Mz- MOM � OZ -nN M 0 L04 r roO -�C)r ANO ?�z "1v xv MD n x mm cn m w m A O v I FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state.law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: !.,/ • CA4Q Phone &03-&V 7'/ x'77 LOCATION: Assessor's Map Number Parcel Subdivision 6?6 7VPAJP1e= CST.. A17T V 1/ae_ot (s) Street St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Conservation Administrator Comments Date Approved Date Rejected Date Approved Town Planner Date Rejected Comments Food Inspector -Health Septic Inspector -Health Comments Date Approved Date Rejected Date Approved Date Rejected Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date 0 general Contractor 21 Kilton Road Bedford, New Hampshire 03110-6522 (603) 647-1777 Facsimile (603) 647-1888 **THIS DOCUMENT SENT VIA FACSEYnE @ 1-508-774-4772 AND U.S.1VLkffi** February 13, 1997 Ms. Cherie Boise N.M.C. Diagnostic Services, Inc. 140 Commonwealth Avenue Danvers, MA 01923 RE: Proposed new first floor office - Chestnut Green - N. Andover, TNLk Dear Cherie: The John B. Sullivan, Jr. Corp. of NH, Inc. respectfully submits the following proposal for the above referenced scope of work: DEMOLITION • Remove approximately 31 lineal feet of existing partition wall (to just below existing acoustic ceiling height) • Remove and save for re -use two existing doors and frames • Remove approximately 320 square feet of existing carpeting • Remove and/or relocate existing electrical in removed partition walls • Demolition of existing wall to accommodate plumbing for wall mounted handicap accessible hand wash sink DRYWALL/FRANT [ING • Furnish and install approximately 39 lineal feet of new partition wall to include the following: • 3 5/8" metal stud framing (to just below existing acoustic ceiling) • Wood blocking at doors and window (as needed) v • One layer 5/8" fire code drywall on each side • Drywall to be taped, three coats joint compound finish sanded ready for paint • Finish off remaining portion of previously removed partition wall (to just below existing acoustic ceiling) • Miscellaneous drywall patching as needed Ms. Cheiie Boise RE: Proposed new first floor office - Chestnut Green - Andover, MA February 12, 1997 Page 2 • Relocate one (1) previously removed existing window and frame • Furnish and install one (1) new 3' 0"x6' 8" wood door and frame to match existing includes all necessary hardware and lever handle passage set MILLWORK • Remove one (1) existing 6'x6' "L" shaped countertop and necessary supports from second floor office and reinstall in new first floor office • Furnish and install 8' of new work station countertop and supports. (Please note we will try to match as closely as possible to existing relocated countertop color. FLOORING • Prepare sub floor as needed for vinyl tile installation • Furnish and install approximately 320 square feet of new vinyl tile (stone tex the or equal, it is somewhat skid resistant) • Furnish and install approximately 75 lineal feet of vinyl cove base (to match existing) ACOUSTIC CEILING Replace ceiling tiles as needed PLUMBING • Furnish and install one (1) new wall mounted handicap hand wash sink to include the following: • One (1) six gallon point of use hot water tank All necessary hot/cold water and sanitary waste and vent piping Wall mounted handicap accessible hand wash sink • Includes plumbing permit and necessary inspections • Allowance $1,200.00 ELECTRICAL • Demolition or relocation of existing electrical as needed at partition walls to be removed • Furnish and install the following: • Two (2) new single pole light switches • three (3) new duplex receptacles 110 volt • One (1) new 208/240 volt receptacle for treadmill • Relocate and/or refeed existing lighting to accommodate the proposed new floor plan • Includes permit and necessary inspections H.V.A.C. • Relocate existing supply and/or return air diffusers to accommodate the new floor plan • Relocate the existing thermostat to new location SPRINKLER 0 None included 'r 6 Ms. Cherie Boise RE: Proposed new first floor office - Chestnut Green - Andover, MA February 12, 1997 Page 3 CLARIFICATIONS • Does not include any unforeseen conditions • Assumes partition walls that are to be removed are not "bearing walls" • Assumes availability of existing sanitary waste line in area of new hand wash sink location. (Please note: We have tried to get existing plumbing plans for this suite from the building maintenance people, to no avail. Also, please note allowance of $1,200.00 for plumbing.) • Does not include any concrete floor sawcutting or removal GENERAL CONDITIONS • Includes all necessary labor, supervision and project management • Dumpster rental • Daily and final (professional) clean-up • Building Permit and necessary inspections If the above is acceptable to you, please sign and date in the space provided below and return this original signed document to me. Accepted by: If you have any questions, please feel free to call me. Si cerely, Frank o dy Project Manager cc: John B. 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M>1 ; "0 z c c rA M O Z 00 W O LD Date TOWN OF -NORTH ANDOVER PERMIT FOR PLUMBING 74 z This certifies that .......... t ................. has permission to perform .............. plumbing in the buildings of .... ........... K . 4� at ....` ....... North Andover, Mass. C, Fee. .... Lic. No. PL Check # .8 5 56 "T/� P ,5 0 . 00 `� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING ras..rr.... E ' v/� //I / 1 � J� 2 eew n s... � ^3 0 vny1Ta&-n: nuy. L, is: rclnuarr Buildina Location: 7 �IQAI / ' i U/��% 6 7 Owners Name: Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential ❑ New: ❑ Alteration: ❑ Renovation: ❑ Replacement: 02/ Plans Submitted: Yes ❑ No ❑ FIXTURES INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes ❑ No ❑ If you have checked Yes, please ind' to the type of coverage by checking the appropriate box below. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information 1 have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Type of License: retie ❑ I�Iumber Signature of Licensed Plumber FCMaster 1 l 9 r / 02 Citylrown Journeyman I License Number: �bb�f1\211IAGGII+G' IICG ^U1 %n z z Co N Y Z Z H Y} !n JQ O LJ V M j ? 3 N Z 0 N Z to Z W N ~ W N (n N OJ Z Z a H IMQ X w s e? n z WCn z v a II�e ISI I ISI>I�I ISI? lalal al =l I I I I 1eOr s i Y M M to rn in 51 3 3 3:1 0 SUB BSMT. BASEMENT 1 FLOOR 2 FLOOR 3 FLOOR -4m-FLOOR 8 FLOOR 6 FLOOR FLnnR 81" FLOOR G , /C Name: /,/ t 061 Check One Only Certificate # Installing Company 0 *� [jdorporationC- Address: 9(6 ,9 $ Cityrr wn: rU% l .62VY !1 Statd4V 171 Partnership Business Tel: 22� �Y / 7�� Fax: a 93 % % LZ ❑Firm/Company Name of Licensed Plumber: INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes ❑ No ❑ If you have checked Yes, please ind' to the type of coverage by checking the appropriate box below. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information 1 have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Type of License: retie ❑ I�Iumber Signature of Licensed Plumber FCMaster 1 l 9 r / 02 Citylrown Journeyman I License Number: �bb�f1\211IAGGII+G' IICG ^U1 %n Date .... ;- 2-3,04 ......................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........ Apr .... has permission to perform .................................5er&A-t?�.... ..... .... .......... USS .............. 6. wiring.in the building of ...... ..... ... ............................. ...................... 577' North Andover, Mass. at ........ 5 ............... . Fee -0 ............. Lic. No. ......... 1�%.b ....... �.�.&-e.. ELECTRICAL INSPECTOR Check It 6470 ;. Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. 0-7V Occupancy and Fee Checked [Rev. 9/051 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT ININK OR TY . ALL IN ORMATION) Date: J1j .— J( City or Town of: ) To the Inspector of Wires: By this application the undersigned gives nhti e of his -or her intention to pew orm the ectricaa work described below. Location (Street & N mber) Owner or Tenant Owner's Address Is this permit in conjunction with a building permit? Purpose of Building Existing Service Amps New Service Amps Number of Feeders and Ampacity Telephone Yes ❑ No (Check Appropriate Box) Utility A thorization No. Volts Overhead ❑ Undgrd ❑ Volts Overhead ❑ Undgrd ❑ Location and Nature of Proposed Electrical Work: No. of Meters No. of Meters Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil: (Paddle) Fans of Total TransSusp. Trsformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above In- Swimming Pool rnd. ❑ rnd. ❑ o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners of No. In Detection and InDetection Devices No. of Ranges No. of Air Cond. Tonsl No. of Alerting Devices No. of Waste Dis osers P Heat Pump Totals: Number Tons .................... KW " — No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW SP g Local ❑ Municipal El Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of WaterKW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. hydromas age Bathtubs No. of Motors Total HP. Telecommunications Wiring: No. of Devices or . u:aale- OTHER: Attach addition[ derau q desired, or as required by me inspecror oi rrires. Estimated Value oflectrical Work: (When required by municipal policy.) Work to Start: ? Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation' coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) certify, under the pains andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: ADT Security Services, Inc. LIC. NO.: 1533 C Licensee: DOUG BUCKERIDGE SignatureLIC. NO.: 2306D (If applicable, enter "exempt" in the license number line.) us. Tel. No.: 60.3-594-5900 Address: 18 CLINTON DRIVE HOLI.IS N.H. 03049 Alt. Tel. No.: 603-594-5930 *Security System Contractor License required for this work; if applicable, enter the license number here: SS CC 001594 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE: $ �` 00 Signature Telephone No. Date Z,� TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .................. has permission to perform wiring in the building, of at ........ ........ ........... . North Andover, Mass Fee. LIS7. Lic. No.. .... . ......... ... ELECTRICAL INSPECTOR Check # 10920 (f�� ommonwea& of MaacLef 2epart..t of -%e Semice4 BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. Occupancy and Fee Checked [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 521 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: June 26, 2012 City or Town of: N. 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) 63A Back 565 Turnpike Street Owner or Tenant Dr. Coppola Telephone No. (978)686-2231 Owner's Address Same Is this permit in conjunction with a building permit? Yes ❑ . No ❑ (Check Appropriate Box) Purpose of Building Commercial Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Add (1) horn/strobe to existing fire alarm system Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- ❑ rnd. rnd. o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners of Detection and No. Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons KW ....................... No. of Self -Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal El Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water, 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 x❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Crowe & Sons. Electrical Corp.LIC. NO.: 17168A Licensee: James B. Crowe Signatur LIC. NO.: (If applicable, enter "exempt" in the license number line) Bus. Tel. No.: (978)453-6696 Address: 576 Middlesex Street, Lowell, MA 01851 Alt. Tel. No.: (978)453- 6 *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. SS CO 001051 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE: $45.00 Signature Telephone No. Locations(, 'TofiNP/K-e S I No. -57/5 Date *°"T" TOWN OF NORTH ANDOVER p Certificate of Occupancy $ * > Building/Frame Permit Fee $ SswCH u • E�� Foundation Permit Fee $ s Other `Permit Fee $ �QOS r0onnection Fee $ er Connection Fee $ a,® aliYl� Building Inspector Div. Public Works � a aw a a m I . z O 0 !_- W m - W N W Q a 00 G Z 0 p� W > W 3 m' m c Z Q 0 W 0 m z o J m J m H 0: Ir 0 F LL 0 W K 0IL � 0 C u J Z W w 1,�• N a m 0 w W LL 0 p N K d Z m m W N m WK 8 m in oi W V 4 I- Q Z � X S \\ \ �\ s a p O d Im J J N LL O N Z 0 U) z a I N 0 N C W 0 m N a W Z Y U I r x I Z U O W z J a 1 N 0 Z O Z U ZO 0 f O 0 (7 LL 0 J Z O a 0 LL x 0 J V W W F- m W N a a I W a F O 4 Z O W 0 0 U LL O N H Z W I W C Q W C O f K O LL Z O U 0 _z 0 J 5 m J J } Z a LL Z O_ f U a N J a W CL IL a LL O 0 K a 0 m z O !_- W m w U 00 G Z 0 f O 0 z z m H Z F m N 0 s .W 1,�• i N N l m m Z WK 8 m A W V 4 I- Q Z O S \\ \ �\ 0 a p O d d 0 (7 u c oz u ii c x s N F m W N U 0 m m m U J O M j W W W ear 4f� W VI Wm ¢ W F 0 ` W Ni W a Z a W z N J I a Z O 0 a a N Z 0 0 U.m O m O 0 N N m W K U U U a Z' U Z z V O FFH .0 N J 0 0 < m 0 0 W a�11 IN. N a W Z Y U I r x I Z U O W z J a 1 N 0 Z O Z U ZO 0 f O 0 (7 LL 0 J Z O a 0 LL x 0 J V W W F- m W N a a I W a F O 4 Z O W 0 0 U LL O N H Z W I W C Q W C O f K O LL Z O U 0 _z 0 J 5 m J J } Z a LL Z O_ f U a N J a W CL IL a LL O 0 K a 0 m N z !_- K w U 00 G Z 0 f O 0 z z m H Z F m N 0 i 0 1,�• i N N l m m Z WK 8 m A W V 4 I- d Z W \\ \ �\ 0 p O d d 0 (7 u c u o u ii c f W a Q N F m W W U 0 m m m U O M j W W W W a N z U � f N Z F N N � i N N l Z z t O O F U V W -W p O O z LL 4 0 N F m W W W 0 0 l N a LL t F- J 0= w t- O O O U U �W� � 00 IL ww _ - UI Z N 0 -. _a o= , Z3z Q .. 0 J U F WZO Ooa _ N ZEN .r 0mU 6LL3 w0a IV)w p Z 0_N_ Uu►I QZF- W1W Es (n 0 a U F K jWW 1.. a �Z� zQN 0tj UWW WZ 01 J W N =o<0 U Z Q a D U 0 = hI I I `�I 11 1 I1)4 O O O oZ c� _ Z LL -�, o ._ap :; z Z _III I K O i I O LL w Z -2 O O 2 T _2 m LL ~ w N W u ) Z Z W a s ~, w_ Y 3 — 6 �y �( _ i Y Q Z v U Z :( K 3 m p i 0 = Z¢ LL H O U.2 O o .F- a N - Z w w F'_ 7 u ti u a Z a w 0 r N O a f7 r u O Z co, N- LL a O Z W - =� ¢ y U 0 U Z<QY.Z' >o N Z m C .� U? Zc�i» O S 2 V s Ci do��Ja>up¢�O� x "' ¢ S a J V 3 a u S V. wo �axd��.' ZZ LL LL O LL d1 Oa u a0 w x v a a s a03 m ¢xZv,�r— �auwLp. aDin°S¢o¢c? 0Ou'Ji2 I ITTT I TFT I I 1 11 111 I� z U N o z O Z > a O Q J < W O z K Z O G a x�v, S W Q O p O rco J _ = xZ O uii R ; 00 ZZ ppi QLL��o�< ¢aZaLL O ec Vim, Z0 -0 Z LL .,6U_ aaz i �ZZ�v,zZZiLLv� xZ i°°m<m � _� v LL Z Wo ~Oo ¢oN N- 00000z000 o w Z R) �o02 s et ¢ w Q V VUUZZZ o Uw IA mi�x� l'i ^au�w O mOoN WOv, f ¢ °u � m a < � °Z = JOpdm��] u a 3 < < > ,n v, m m 00 °U ,~i„~i, 0 ¢aQ��tD < � , r O 3:1�= i u~i 3 m ti H. Manning Curtis, M.D., F.A.C.C., F.C.C.P. 555 Turnpike Street Suite 56 North Andover, Massachusetts 01845 Telephone (508) 688-2206 Board Certified in Cardiovascular Diseases December 3, 1991 Robert Nisetta North Andover Building Inspector 120 Main Street North Andover, MA. 01845 Dear Mr. Nisetta, American Board Of Internal Medicine As per our discussion November 27, 1991, I will change the entry into the employee's only bathroom. The new entry will be in the office portion instead of the hallway. The bathroom will also be marked with a sign "Employees Only". Once again, thank you for your assistance. Sincerely, 'whoH. Manning Curtis, M.D., FACC i LL T10 DEC 5 1991 ,� , E 1B(JELDING DEPARTMENT KAREN H.P. NELSON Director ir B' ILDING CONSERVATION PLANNING 4 NOwT�, Town of •Qr •"y,.•�' NORTH ANDOVER to me�cHue�� DIVISION OF PLANNING & COMMUNITY DEVELOPMENT FAX TRANSMISSION 120 Main Street, 01845 - (508) 682-6483 Fax: 508-682-2996 s� P! DATE: 11/22/91 TIME: NO. of PAGES: 3 TO: Dr. Manning Curtis D. Robert Nicetta . Ins ecto FROM: , Bldg. p y SUBJECT: Plumbing FAX NO.: 508-683-6918 REMARKS: F.Y.I as per our conversation. i r 248 CMR: BOARD OF STATE EXAMINERS OF PLUMBERS AND GAS FITTERS ` Yµf'at k •rys L 2.10: continued TABLE 3 0 i f i r PLUMBING FIXTURES REQUIRED IN DORMITORIES iy 1. One (1) toilet for each eight (8) occupants or'portion thereof. For males, . y urinals may be substituted for one half the number of toilets required on the basis of one (1) urinal substituted for one (1) toilet. 2. One (1) wash basin for each eight (8) occupants or portion thereof. I . 3. One (1) shower or bathtub for each eight (8) occupants or portion thereof. f.. 4. In a room with more than one (1) toilet, each toilet shall be separated by h walls or partitions which afford privacy. 5. Toilet, shower and handwash facilities shall be accessible from within the i n .. building and shall be so placed as to not require passing through any part of f h•.� �, �' another dwelling unit or rooming unit. X a 6. One (1) laundry tray for each fifty (50) persons. s ';. 7. One (1) slop sink for each one hundred (100) persons. < 8. One (1) drinking fountain for each seventy-five (75) persons. r t ,. ti, TABLE 3A j �• i .; PLUMBING FIXTURES REQUIRED IN DETENTION FACILITIES z1. A toilet and handwash sink in each cell in which a person is locked for any '!j part of a twenty-four (24) hour day. 2. The sink shall be connected to the hot and cold water systems. 3. Where individual facilities are not required by number one above, there shall qq be one (1) toilet and one (1) handwash sink for each six (6) inmates. Urinals may be substituted for one third (1/3) of the required male toilets. 4. There shall be one (1) shower or bathtub for each six (6) inmates. '. (e) Plumbing Fixtures Required. �In—every establishment other thank industrial establishments, where people are employed, there shall be�-� V separate_ bathrooms for each sex in each establishment and shall be plainly y so designated. Such bathrooms shall be installed within the premises of the k J establishment. Unisex toilet rooms areprohibited except _as,stated '1 _underl _L248 CMR 2.10(19)(f), d TABLE 4 PLUMBING FIXTURES REOUIRED FOR NON -INDUSTRIAL ESTABLISHMENTS WHERE PERSONS ARE EMPLOYED , (EXCEPT PLACES OF ASSEMBLY) 'i Persons of - Minimum Number - Minimum Number - 1 Each Sex of Water Closets` of Lavatories 1 - 15 1 1 16 - 35 2 2 l' 36 - 55 3 2 56 - 80 4 3 81 - 110 5 3 111 - 150 6 4 More than 200 One (1) per 40 addition- al persons. ` Note: Where urinals are provided for men and women, one (1) water closet less than the number specified may be provided for each urinal installed, except that the number of water closets in such a case shall not be reduced to less than two-thirds (2/3) of the minimum specified. r j 9/30/86 248 CMR - 62 - :r, 248 CMR: BOARD OF STATE EXAMINERS OF PLUMBERS AND GAS FITTERS 0 2.10: continued (.f) Plumbing "Fixtures Required*(Minimum): In every establishment other thanindustrial establishments, where the area is less than 500 square -feet cone bathroom -may be installed when.approved,by the Board. Suchbathroom "shall be installed in each establishment. — (g) Minimum Facilities for Accredited Bathing Beaches. The number of plumbing fixtures required for each sex at an accredited bathing beach shall be in compliance with Table 5 in 248 CMR 2.10. TABLE 4A ,` �,,,a yT4a1_ PLUMBING FIXTURES REQUIRED INDUSTRIAL ESTABLISHMENTS t r + than the number Less than specified may be provided for each urinal installed, except that the number d Persons of Minimum Number # Persons of Minimum Number (2/3) of the minimum specified. Each Sex of Water Closets Each Sex of Lavatories 4 or 20 inches of 1000 persons in a circular basin, when provided with water outlets for each space, shall be 1 - 10 1 (j) Deluge Showers. Deluge showers shall be installed in every school ! ,•r Y: 11 - 25 2 16- 35 2 .4 26 - 50 3 36 - 60 3 ck 51 - 75 4 61 - 90 4 ' tk • " 91 - 125 5 101 - 160 t.• t t P - 151 - 200 8 More than 200 one (1) per More than one (1) per t i 25 addition- 125 additional <: al persons persons r„ t TABLE 5 Minimum Number of Plumbing Fixtures Required at Accredited Bathing Beaches ,j No. of * Note - Where urinals are provided, one water closet less than the number Less than specified may be provided for each urinal installed, except that the number d of water closets in such a case shall not be reduced less than two-thirds 1000 persons in (2/3) of the minimum specified. excess of 1000 _ 1/3 of the **In a multiple use lavatory, 24 lineal inches of wash sink or 20 inches of 1000 persons in a circular basin, when provided with water outlets for each space, shall be excess of 1000 considered equivalent for one (1) lavatory. (j) Deluge Showers. Deluge showers shall be installed in every school ! t TABLE 5 Minimum Number of Plumbing Fixtures Required at Accredited Bathing Beaches ,j No. of Water Closets Persons Male Female Less than 2 2 1000 2 2 Over Add 1 for every 1000 1000 persons in tuted for excess of 1000 Urinals Lavatories Showers (optional) 1. Authority. Plumbing fixtures for the physically handicapped shall be Male Female Male Female May be 2 2 1 1 substi- (i) Toilet Rooms for Public Use. Toilet rooms accessible to the for public tuted for which have two (2) or more water closets or urinals or two (2) or more _ 1/3 of the Add 1 for every Add 1 for every water clo- 1000 persons in 1000 persons in sets for excess of 1000 excess of 1000 each sex (j) Deluge Showers. Deluge showers shall be installed in every school ! 248 CMR - 63 024B0 (h) Facilities for the Physically Handicapped Person. 1. Authority. Plumbing fixtures for the physically handicapped shall be installe in conformance with Me most recent rules adopted the Architectural Barrier Board. d1 d 2. Scope. The provisions of these rules and regulations are designed to facilitate the use of certain buildings for the physically handicapped. (i) Toilet Rooms for Public Use. Toilet rooms accessible to the for public c ri which have two (2) or more water closets or urinals or two (2) or more _ thereof in combination, shall have a floor drain and a valved hose bibb j connection equipped with an approved backflow preventer, for the purpose i of flushing and/or sanitary hosing. Said floor drain shall be of an approved 4 design, shall be installed in the vicinity of the urinal(s) and at a grade to permit floor drainage to it from all directions. i (j) Deluge Showers. Deluge showers shall be installed in every school ! chemistry laboratory classroom or any room used for similar purposes 248 CMR - 63 024B0 c ri }R C }1 � i x i c ( t.• t t P - r t i 1 _ H. Manning Curtis, M.D., F.A.C.C., F.C.C.P. 555 Turnpike Street Suite 56 North Andover, Massachusetts 01845 Telephone (508) 688-2206 Board Certified in American Board Of Cardiovascular Diseases Internal Medicine November 20, 1991 Robert Nisetta North Andover Building Inspector 120 Main Street North Andover, MA. 01845 Dear Mr. Nisetta, This letter is to certify that the bathroom facility proposed for Suite #75 at 565 Turnpike Street, North Andover will be an "Employee only" facility and will not be a public bathroom, thereby exempting Suite #75 from the need of including handicapped bathroom facilities. Sincerely, H. Manning Curtis, M.D., FACC cc. Deborah Ryan Architecture Access Board 1 Ash Burton Place Room 1310 Boston, MA. 02108 NOV 2 2 rn, H. Manning Curtis, M.D., F.A.C.C., F.C.C.P. 555 Turnpike Street Suite 56 North Andover, Massachusetts 01845 Telephone (508) 688-2206 Board Certified in American Board Of Cardiovascular Diseases Internal Medicine November 20, 1991 Robert Nisetta North Andover Building Inspector 120 Main Street North Andover, MA. 01845 Dear Mr. Nisetta, Enclosed is a certified letter which was drafted after a prolonged conversation with Nancy at the Architecture Access Board. I explained to her that this bathroom was not a public facility but was an "Employee only" bathroom. She stated that before you could approve the bathroom as being exempt, I had to certify that this would only be utilized by myself and employees, thus exempting the need for the handicapped bathroom facility. Please let me know if there is any further questions. Nancy said she would be happy to talk to you concerning this issue if you choose. Thank you for your cooperation and assistance. Sincerely, WW H. Manning urtis, M.D., FACC 1i�' LM22i� k BUILDING DEPARTIVIENT1 u CU Q -o L2 } Lo o 00 0 � }Q tL 0 U Q� cC c�Q -cLo c Lz �L O U �L a H Lr) 4� b0 coCD + n .H O LU CC13 PCI 41 «i N 41 p (v is 1.� N Sa G1 N > +J > w O co O rl "d 'Li +J co �4 �Fj� (1) 41 +1 ,n P O �4 O O N O P4 z E Is your RETURN ADDRESS completed on the reverse side? y •031AJOS idlaoaa ujn;aa 6uisn jo; nog( )Iueyl H. Manning Curtis, M.D., F.A.C.C., F.C.C.P. 555 Turnpike Street Suite 56 North Andover, Massachusetts 01845 Telephone (508) 688-2206 Board Certified in Cardiovascular Diseases Robert Nisetta North Andover Building Inspector 120 Main Street North Andover, MA. 01845 Dear Mr. Nisetta, November 25, 1991 American Board Of Internal Medicine Thank you for kindly forwarding the plumbing regulations from the Board of State Examiners of Plumbers and Gas Fitters. I was reviewing the requirements for plumbing fixtures required on page 62 and from what I understand, we meet the requirements in Section C. I purchased, as part of my establishment, a common share in 2 bathrooms which are not unisex, but rather, male and female. They are part of my establishment located on the same floor of my condo and are considered a legal part of my establishment. Therefore, we have met the requirements under Section C and the additional bathroom, being added to my establishment is merely and additional convenience over and above the two bathrooms already purchased as part of my establishment. Thank you again for your cooperation and assistance in understanding these complex regulations. Sincerely, H. Manning C rtis, M.D., FACC �n U cc. Board of State ExaminersF� of Plumbers and Gas Fitters 100 Cambridge Street Z 7 Room 1511 Boston, MA. 02202 6116LUVi AM PAD NO. 23-176-400 SETS NO. 23-376-200 SETS TO DA;F /7.,� TIM�/�• FROM PFA CODE NLA of r rOF F � r33 ui N N ID � I SIGNED SNS, Vim, { C RETURNM ALL PNO'CALL �� EL C.�,-c zSURM T4 i3lp r3AC: _ �� sAf1Tt , ii17GEIST ❑ CALL I AM PAD NO. 23-176-400 SETS NO. 23-376-200 SETS cn ,;(ce U U Q -o L }LO o� �CO o a) Q 0 CJ Q u � CQ Loz �Lo ni cc f�- O A7 p O 4J U U a Ch H Lr) G 00 •rl O 'd r-1 W 4-) ct (1) w {.l d > > fA O rn O -H b b N 41 4j O O N O az - z 0 U U Q -o L }LO o� �CO o a) Q 0 CJ Q u � CQ Loz �Lo ni cc f�- O A7 p O 4J U U a Ch H Lr) G 00 •rl O 'd r-1 W 4-) ct (1) w {.l d > > fA O rn O -H b b N 41 4j O O N O az - z 0 i Your RETURN ADDRESS -evPrse •aainaas ., 6uisn jo} noA )Iueyl K E B B PROPERTY MANAGEMENT CHESTNUT GREEN AT THE ANDOVERS 565 TURNPIKE STREET, SUITE 82 • N. ANDOVER, MA 01845 • (508) 683-3574 November 15, 1991 John Nicetta Town of North Andover Building Inspector 120 Main Street North Andover MA 01845 Dear Mr. Nicetta, The plans to renovate unit #75 at 565 Turnpike Street, by H. Manning Curtis, M. D. have been approved by the trustees of Chestnut Green at the Andovers. If you have any questions regarding this matter, please call me at (508) 683-3574. Thank -you for your cooperation. Sincerely, Brian Sheehy Agent for Chestnut Green at the Andovers -i-) 0 a 4--) a +-) S.- (3) -N 0 V) =3 a) U •r N Q N C: ro L57 L Ln a) 1�0 > Ln 0 L0 Q +) +) S_ C 0 � z a 4-3 L QJ CL 0 L a UNIT DEED GRANTOR: Merchco Investment Corporation, a Massachusetts corporation GRANTEE: H. Manning Curtis, Trustee of HMC Realty Trust, under Declaration of Trust dated Nay. 8 1 / Q 4 ( , 1991 recorded in the Essex North Registry of Deeds herewith UNIT #: 75 PERCENTAGE INTEREST:_ 3.48 AREA: 2202 UNIT POST OFFICE ADDRESS: 565 Salem Turnpike, North Andover, Massachusetts CONSIDERATION: $150,000.00 Merchco Investment Corporation, a Massachusetts corporation with a principal place of business at 124 Grove Street, Franklin, Massachusetts (the "Grantor"), for consideration paid of One Hundred Fifty Thousand and 00/100 ($150,000.00) Dollars hereby grant to H. Manning Curtis, Trustee of HMC Realty Trust, (the "Grantee"), with QUITCLAIM COVENANTS, Unit No. 75 (the "Unit"), a Unit in the condominium located at 565 Salem Turnpike, North Andover, Massachusetts, known as CHESTNUT GREEN AT THE ANDOVERS CONDOMINIUM, (the "Condominium"), created pursuant and subject to the provisions of Chapter 183A of the General Laws of Massachusetts, by Master Deed dated February 15, 1985 and recorded with the Essex North.Registry of Deeds in Book 1928, at Page 309, as amended by instruments of record (hereinafter, the "Master Deed"). The Unit is conveyed together with an undivided 3.48 percentage interest appertaining to said unit in the common area and facilities of the Condominium, together with the rights and easements appurtenant to the Unit as set forth in said Master Deed as same may be amended from time to time. The Grantee may be granted the exclusive right, as appurtenant to their Unit, to use a parking space or spaces, as provided in the above -referenced Master Deed. If such permission is given, said exclusive right shall not be severable from the Unit to which it is appurtenant, and upon a conveyance, said exclusive right shall be conveyed along with the fee of said Unit. The Unit contains approximately 2202 square feet, and is laid out as shown on a plan recorded with the Unit Deed dated December 15, 1989 recorded in said Registry in Book 3048, Page 163, and affixed to which is the verified statement of a registered land surveyor, certifying that the plan shows the unit designation of the unit hereby conveyed and of the immediately adjoining units, and that it fully and accurately depicts the layout of the Unit, its location, dimensions, approximate area, entrance, and immediate common area to which it has access, as built. 131' 134 The Unit hereby conveyed is intended to be used for the following purposes, and is subject to the following restrictions, as set forth in Sections 8 and 9 of said Master Deed, as same may be amended from time to time: 11(8) Statement of Purposes. The purposes for which the buildings and the Units and other facilities therein, are intended to be used are as follows: (A) The buildings and the units and other facilities therein are intended to be used for medical, professional, business, banking, and/or commercial offices and any other uses specifically related, supporting, or accessory thereto. No unit shall be used for any purposes other than the maintenance of medical, professional, business, banking, and/or commercial offices therein and purposes which in the case of each unit owner or occupant are incidental to the maintenance of such offices by that unit owner or occupant including, but not limited to, x-ray equipment, medical laboratories, business machines, office equipment, and accounting and record keeping facilities otherwise consistent with the provisions of this Section 8 and purposes for which said units are designed as shown on the Floor Plan. (B) No use, including without limitation, a medical, professional, business, and/or commercial use, shall be permitted which in the opinion of the Trustees of the Chestnut Green At The Andovers Condominium Trust (herein, the "Condominium Trust") or the Grantor is inconsistent with the maintenance of the general character of the building as a professional office building of the first class in the quality of its maintenance, use and occupancy. (C) Notwithstanding anything to the contrary contained herein, Units 10, 11, 12, 14, 15A, 15B, 16, 21A, 22A, 23A, 24A, 25A, 26A, 27, and 28A, shall not be used by an Endodontist or other physician for the practice of endodontry, except with the written consent of the owner(s) of Unit 17. (D) The use of parking spaces is to be granted by the Trustees of the Condominium Trust. To that end, said Trustees may (i) establish rules and regulations with regards parking, and, if deemed necessary by said Trustees, (ii) grant exclusive rights of use with regards parking or parking spaces. The following restrictions and regulations shall initially apply to the use and occupancy of the parking spaces: (i) The Parking Spaces may be used only for parking of private automobiles, motorcycles, and noncommercial vans and for the personal use of Unit Owners entitled to use said Parking Spaces, and their employees, clients, visitors, guests, or licensees, no trucks, boats, trailers (whether capable of 2 J independent operations or attached to an automobile or other vehicle), except with the written consent of the Trustees of the Condominium Trust (hereinafter defined). Only one vehicle is allowed in each Parking Space. This paragraph shall not be deeded to restrict temporary use of the Parking Spaces by trucks while making delivery or pick-up at a Unit, subject, however, to any rules or regulations which may be promulgated pursuant to the Condominium Trust. (ii) All vehicles shall be parked within their respective Parking Spaces. (iii) All parties using said Parking Spaces shall comply with the provisions relating to such use contained in this Master Deed, the Condominium Trust, and the rules and regulations promulgated pursuant to said Condominium Trust. (iv) In instances where vehicles using the parking areas and facilities of the Condominium or Parking Spaces do not comply with the foregoing provisions, the Trustees of the Condominium Trust are authorized to allow the towing of the noncomplying vehicles at the expense of the owners of such vehicles. (E) The following conditions and restrictions shall apply to the tenanting, renting, or leasing of Units: (i) Each and every lease, license, and/or tenancy agreement may be for the entire Unit or a portion of the unit and each and every lease must be in writing. Leases for a term of less than one (1) year and/or for less than the entire Unit must, in order to be valid, be approved in writing by the Trustees of the Condominium Trust, which approval shall not be unreasonably withheld; Every lease, license, or tenancy agreement permitting outside occupants use or possession of a Unit shall include a provision requiring the outside occupant to comply with all terms and conditions of this Master Deed, specifically including but not limited to this Paragraph (8) and Paragraph (9), the Condominium Trust, and the Rules and Regulations of the Condominium (if any said Rules and Regulations have been promulgated by the Trustees of the Condominium Trust) and that the failure of said outside occupant to comply with any of the terms of said Master Deed, Condominium Trust, an/or said Rules and Regulations shall be a default under said lease, license, or tenancy arrangement. There shall be attached to each such written instrument a copy of the Rules and Regulations and a copy of Paragraphs (8) and (9) of the Master Deed; (iii) No outside occupants shall keep, house, or harbor any pets or animals in a Unit unless authorized pursuant to the Rules and Regulations of the Condominium Trust; 3 t 34.. J 13f; (iv) Notwithstanding anything to the contrary contained herein, Units 10, 11, 12, 14, 15A, 15B, 16, 21A, 22A, 23A, 24A, 25A, 26A, 27, and 28A shall not be leased for use or used by an Endodontist or other physician for the practice of endodontry, except with the written consent of the owner(s) of Unit 17. (F) Notwithstanding the provisions contained in Paragraphs (8) and (9) hereof, the Grantor, or any successor to its interest in the Condominium, hereby reserves the right, until all of the units in each phase have been sold by Grantor or such successor, to (i) let or lease any Units or parking spaces owned by the Grantor; (ii) use any Units owned by the Grantor as models for display for purposes of selling or leasing the Units or for other lawful purposes; (G) Use of the Units, and Common Areas may also be restricted under provisions of the Condominium Trust and "Rules and Regulations" promulgated pursuant thereto. 9. Restrictions on Use. (A) No Unit shall be used for any purpose not specified in Paragraph (8) above; (B) Each unit shall be used only for such purposes and to such extent as will not overload or interfere with any common area and facility or the enjoyment thereof by the owners of other units; (C) If any governmental license or permit (other than a certificate of occupancy, or a license or permit applicable to the buildings as a whole and required in order to render lawful the operation of the buildings for office purposes) shall be required for the proper and lawful conduct of business in any particular unit, and if failure to secure such license or permit would in any way affect any other unit or the owner thereof or the Condominium Trust or the Trustees, the owner of such particular unit at its expense shall procure and maintain such license or permit, submit the same to inspection by the Trustees and comply with all the terms and conditions thereof; (D) No unit owner or occupant shall discharge, or permit to be discharged, anything into waste lines, vents or flues of the buildings which might reasonably be anticipated to cause damage thereto, spread odors or otherwise be offensive; (E) All business machines and equipment and all other mechanical equipment installed in any unit shall be so designated, 4 installed, maintained and used by the owner and occupant of such. 13' unit, at the expense of such owner, as to minimize insofar as possible and in any event reduce to a reasonably acceptable level the omission and transmission of noise, vibration, odors, and other objectionable transmissions from such unit to any other area of the buildings. (F) The owner of any Unit may at any time and from time to time change the floor plan of any room or space within said Unit or any adjoining Unit owned by such owner subject to the provisions of hereof, and may modify, remove and install non-bearing walls or ceilings lying wholly within said Unit or between said Unit and any adjoining Unit owned by such owner (which may include Unit above or below the subject Unit) provided, however, that any and all work with respect to the removal and installation of interior non- bearing walls or other improvements shall be done expeditiously in a good and workmanlike manner, pursuant to a building permit duly issued therefor (if required by law and pursuant to plans and specifications which have been submitted to and approved by the Trustees of the Condominium Trust, hereinafter referred to, which approval shall not be unreasonably withheld or delayed. (G) Except as provided herein, the architectural integrity of the Building and the Units shall be preserved without modification, and to that end, except as provided herein or in the Rules and Regulations of the Condominium Trust, no awning, screen antenna, sign, banner or other devise, and no exterior change, addition, structure, projection, decoration or other feature shall be erected or placed upon or attached to the Building, any Unit, or any part thereof. This Paragraph (G) shall not restrict the right of Unit Owners to decorate the interiors of their Units as they may desire. (H) Any Unit may be divided by the Unit Owner thereof into two (2) or more Units provided that the following terms and conditions are satisfied: (i) each Unit shall have either (x) direct access, (y) access through a Common Area or Facility or (z) access through an adjacent unit and Common Area or Facility to the exterior of the Building in which the Unit is located; (ii) the percentage interests in the Common Areas and Facilities of the Units created shall aggregate the percentage interest of the unit which was divided and shall be determined based upon the relative fair value of each Unit; (iii) the said Unit Owner, at his sole cost and expense, shall prepare any and all Plans and documents deemed necessary by the Trustees of the Chestnut Green At The Andovers Condominium Trust (each in form and substance satisfactory to the said Trustees) for the subdivision of the unit and (iv) the Unit Owner shall pay all costs and expenses incurred by the said Trustees in connection with the review of such plans and documents, the execution thereof by the necessary parties, the administrative work necessary to provide for the new units, and the recording of the appropriate documents. 5 (I) No Unit shall be used or maintained in a manner contrary to or inconsistent with (i) this Master deed, (ii) the Condominium Trust and the rules and regulations promulgated thereto, or (iii) Chapter 183A. These restrictions shall be for the benefit of all Unit Owners and shall be administered on behalf of the Unit Owners by the Trustees of the Condominium Trust and shall be enforceable solely by one or more Unit Owners or Trustees, insofar as permitted by law, and, insofar as permitted by law shall be perpetual; and to that end may be extended at such time or times and in such manner as permitted or required by law for the continued enforceability thereof. No Unit Owner shall be liable for any breach of the provisions of this paragraph except such as occur during his or her Unit ownership." The Unit and the undivided interest in said common areas and facilities hereby conveyed are conveyed (i) subject to the provisions of said Chapter 183A and to taxes attributable thereto for the current fiscal year as are not now due and payable; (ii) subject to and with the benefit of the provisions hereof and all the rights, restrictions, easements, agreements and other matters referred to or set forth in said Master Deed (including, without limitation, in Exhibit A thereof), and the Declaration of Trust for the said Chestnut Green At The Andovers Condominium recorded with Essex North District Registry of Deeds in Book 1928, Page 326 and the By-laws contained therein and any rules and regulations promulgated pursuant thereto, and the obligations thereunder to pay the proportionate share attributable to said Unit of the expenses of the Condominium set forth in said Declaration of Trust; all as amended from time to time in accordance with their terms; (iii) subject to all easements, restrictions, agreements and other matters of record affecting said Unit and said common areas and facilities insofar as now in force and applicable; all of which the grantee (jointly and severally, if more than one grantee) by acceptance and recording hereof agrees to comply with, perform, assume and pay; and (iv) subject to real estate taxes attributable to said Unit which are not yet due and payable. This sale shall not constitute a sale of substantially all of the assets of the Grantor. For title see Unit Deed from Walter C. Grover and Richard R. Ruggiero, Trustees of Chestnut Green Realty Trust to Merchco Investment Corporation dated December 15, 1989 recorded in said Registry in Book 3048, Page 163. C: WITNESS the execution hereof, under seal, this x,39 % day b October, 1991. MERCHCO INVESTMENT CORPORATION By: Ann M. Jar 'ewcz, r sident By: Charles Eisenberg, easurer COMMONWEALTH OF MASSACHUSETTS NORFOLK, SS. October c2/ , 1991 Then personally appeared the above-named Ann M. Jarosiewcz and Charles Eisenberg, the President and Treasurer of Merchco Investment Corporation, as aforesaid, and acknowledged the foregoing instrument to be their free act and deed and the free act and deed of Merchco Investment Corporation, before me, f --a li'�A Notary Publ' My Commiss , ' n Expir .. /0) 7 ESSEX NORTH REGISTRY OF DEEDS' .1 LAWRENCE, MASS. A TRUE COPY: ATTEST: REGISTM OF DF -036. mr! Q • -n < CD ID Qj co Cc Ln u) (D (D C, ESSEX NORTH REGISTRY OF DEEDS' .1 LAWRENCE, MASS. A TRUE COPY: ATTEST: REGISTM OF DF -036. UNIT DEED GRANTOR: Merchco Investment Corporation, a Massachusetts corporation GRANTEE: H. Manning Curtis, Trustee of HMC Realty Trust, under Declaration of Trust dated Nov. 91 / 4q , 1991 recorded in the Essex North Registry of Deeds herewith The Unit is conveyed together with an undivided 3.48 percentage interest appertaining to said unit in the common area and facilities of the Condominium, together with the rights and easements appurtenant to the Unit as set forth in said Master Deed as same may be amended from time to time. The Grantee may be granted the exclusive right, as appurtenant to their Unit, to use a parking space or spaces, as provided in the above -referenced Master Deed. If such permission is given, said exclusive right shall not be severable from the Unit to which it is appurtenant, and upon a conveyance, said exclusive right shall be conveyed along with the fee of said Unit. The Unit contains approximately 2202 square feet, and is laid out as shown on a plan recorded with the Unit Deed dated December 15, 1989 recorded in said Registry in Book 3048, Page 163, and affixed to which is the verified statement of a registered land surveyor, certifying that the plan shows the unit designation of the unit hereby conveyed and of the immediately adjoining units, and that it fully and accurately depicts the layout of the Unit, its location, dimensions, approximate area, entrance, and immediate common area to which it has access, as built. UNIT #: 75 PERCENTAGE INTEREST: 3.48 AREA: 2202 UNIT POST OFFICE ADDRESS: 565 Salem Turnpike, North Andover, Massachusetts M-3 N v CONSIDERATION: $150,000.00 Ln Merchco Investment Corporation, a Massachusetts corporation ru with a principal place of business at 124 Grove Street, Franklin, Ln Massachusetts (the "Grantor"), for consideration paid of One s Hundred Fifty Thousand and 00/100 ($150,000.00) Dollars hereby - grant to H. Manning Curtis, Trustee of HMC Realty Trust, (the v "Grantee"), with QUITCLAIM COVENANTS, Unit No. 75 (the "Unit"), a o' Unit in the condominium located at 565 Salem Turnpike, North >Q Andover, Massachusetts, known as CHESTNUT GREEN AT THE ANDOVERS CONDOMINIUM, (the "Condominium"), created pursuant and subject to �4--) the provisions of Chapter 183A of the General Laws of �.- Massachusetts, by Master Deed dated February 15, 1985 and recorded with the Essex North Registry of Deeds in Book 1928, at Page 309, as amended by instruments of record (hereinafter, the "Master Deed"). The Unit is conveyed together with an undivided 3.48 percentage interest appertaining to said unit in the common area and facilities of the Condominium, together with the rights and easements appurtenant to the Unit as set forth in said Master Deed as same may be amended from time to time. The Grantee may be granted the exclusive right, as appurtenant to their Unit, to use a parking space or spaces, as provided in the above -referenced Master Deed. If such permission is given, said exclusive right shall not be severable from the Unit to which it is appurtenant, and upon a conveyance, said exclusive right shall be conveyed along with the fee of said Unit. The Unit contains approximately 2202 square feet, and is laid out as shown on a plan recorded with the Unit Deed dated December 15, 1989 recorded in said Registry in Book 3048, Page 163, and affixed to which is the verified statement of a registered land surveyor, certifying that the plan shows the unit designation of the unit hereby conveyed and of the immediately adjoining units, and that it fully and accurately depicts the layout of the Unit, its location, dimensions, approximate area, entrance, and immediate common area to which it has access, as built. 34 The Unit hereby conveyed is intended to be used for the following purposes, and is subject to the following restrictions, as set forth in Sections 8 and 9 of said Master Deed, as same may be amended from time to time: "(8) Statement of Purposes. The purposes for which the buildings and the Units and other facilities therein, are intended to be used are as follows: (A) The buildings and the units and other facilities therein are intended to be used for medical, professional, business, banking, and/or commercial offices and any other uses specifically related, supporting, or accessory thereto. No unit shall be used for any purposes other than the maintenance of medical, professional, business, banking, and/or commercial offices therein and purposes which in the case of each unit owner or occupant are incidental to the maintenance of such offices by that unit owner or occupant including, but not limited to, x-ray equipment, medical laboratories,.business machines, office equipment, and accounting and record keeping facilities otherwise consistent with the provisions of this Section 8 and purposes for which said units are designed as shown on the Floor Plan. (B) No use, including without limitation, a medical, professional, business, and/or commercial use, shall be permitted which in the opinion of the Trustees of the Chestnut Green At The Andovers Condominium Trust (herein, the "Condominium Trust") or the Grantor is inconsistent with the maintenance of the general character of the building as a professional office building of the first class in the quality of its maintenance, use and occupancy. (C) Notwithstanding anything to the contrary contained herein, Units 10, 11, 12, 14, 15A, 15B, 16, 21A, 22A, 23A, 24A, 25A, 26A, 27, and 28A, shall not be used by an Endodontist or other physician for the practice of endodontry, except with the written consent of the owner(s) of Unit 17. (D) The use of parking spaces is to be granted by the Trustees of the Condominium Trust. To that end, said Trustees may (i) establish rules and regulations with regards parking, and, if deemed necessary by said Trustees, (ii) grant exclusive rights of use with regards parking or parking spaces. The following restrictions and regulations shall initially apply to the use and occupancy of the parking spaces: (i) The Parking Spaces may be used only for parking of private automobiles, motorcycles, and noncommercial vans and for the personal use of Unit Owners entitled to use said Parking Spaces, and their employees, clients, visitors, guests, or licensees, no trucks, boats, trailers (whether capable of 2 independent operations or attached to an automobile or other vehicle), except with the written consent of the Trustees of the Condominium Trust (hereinafter defined). Only one vehicle is allowed in each Parking Space. This paragraph shall not be deeded to restrict temporary use of the Parking Spaces by trucks while making delivery or pick-up at a Unit, subject, however, to any rules or regulations which may be promulgated pursuant to the Condominium Trust. (ii) All vehicles shall be parked within their respective Parking Spaces. (iii) All parties using said Parking Spaces shall comply with the provisions relating to such use contained in this Master Deed, the Condominium Trust, and the rules and regulations promulgated pursuant to said Condominium Trust. (iv) In instances where vehicles using the parking areas and facilities of the Condominium or Parking Spaces do not comply with the foregoing provisions, the Trustees of the Condominium Trust are authorized to allow the towing of the noncomplying vehicles at the expense of the owners of such vehicles. (E) The following conditions and restrictions shall apply to the tenanting, renting, or leasing of Units: (i) Each and every lease, license, and/or tenancy agreement may be for the entire Unit or a portion of the unit and each and every lease must be in writing. Leases for a term of less than one (1) year and/or for less than the entire Unit must, in order to be valid, be approved in writing by the Trustees of the Condominium Trust, which approval shall not be unreasonably withheld; (ii) Every lease, license, or tenancy agreement permitting outside occupants use or possession of a Unit shall include a provision requiring the outside occupant to comply with all terms and conditions of this Master Deed, specifically including but not limited to this Paragraph (8) and Paragraph (9), the Condominium Trust, and the Rules and Regulations of the Condominium (if any said Rules and Regulations have been promulgated by the Trustees of the Condominium Trust) and that the failure of said outside occupant to comply with any of the terms of said Master Deed, Condominium Trust, an/or said Rules and Regulations shall be a default under said lease, license, or tenancy arrangement. There shall be attached to each such written instrument a copy of the Rules and Regulations and a copy of Paragraphs (8) and (9) of the Master Deed; (iii) No outside occupants shall keep, house, or harbor any pets or animals in a Unit unless authorized pursuant to the Rules and Regulations of the Condominium Trust; 1315. a 1316 (iv) Notwithstanding anything to the contrary contained herein, Units 10, 11, 12, 14, 15A, 15B, 16, 21A, 22A, 23A, 24A, 25A, 26A, 27, and 28A shall not be leased for use or used by an Endodontist or other physician for the practice of endodontry, except with the written consent of the owner(s) of Unit 17. (F) Notwithstanding the provisions contained in Paragraphs (8) and (9) hereof, the Grantor, or any successor to its interest in the Condominium, hereby reserves the right, until all of the units in each phase have been sold by Grantor or such successor, to (i) let or lease any Units or parking spaces owned by the Grantor; (ii) use any Units owned by the Grantor as models for display for purposes of selling or leasing the Units or for other lawful purposes; (G) Use of the Units, and Common Areas may also be restricted under provisions of the Condominium Trust and "Rules and Regulations" promulgated pursuant thereto. 9. Restrictions on Use. (A) No Unit shall be used for any purpose not specified in Paragraph (8) above; (B) Each unit shall be used only for such purposes and to such extent as will not overload or interfere with any common area and facility or the enjoyment thereof by the owners of other units; (C) If any governmental license or permit (other than a certificate of occupancy, or a license or permit applicable to the buildings as a whole and required in order to render lawful the operation of the buildings for office purposes) shall be required for the proper and lawful conduct of business in any particular unit, and if failure to secure such license or permit would in any way affect any other unit or the owner thereof or the Condominium Trust or the Trustees, the owner of such particular unit at its expense shall procure and maintain such license or permit, submit the same to inspection by the Trustees and comply with all the terms and conditions thereof; (D) No unit owner or occupant shall discharge, or permit to be discharged, anything into waste lines, vents or flues of the buildings which might reasonably be anticipated to cause damage thereto, spread odors or otherwise be offensive; (E) All business machines and equipment and all other mechanical equipment installed in any unit shall be so designated, 4 installed, maintained and used by the owner and occupant of sugh, 13'7• unit, at the expense of such owner, as to minimize insofar as possible and in any event reduce to a reasonably acceptable level the omission and transmission of noise, vibration, odors, and other objectionable transmissions from such unit to any other area of the buildings. (F) The owner of any Unit may at any time and from time to time change the floor plan of any room or space within said Unit or any adjoining Unit owned by such owner subject to the provisions of hereof, and may modify, remove and install non-bearing walls or ceilings lying wholly within said Unit or between said Unit and any adjoining Unit owned by such owner (which may include Unit above or below the subject Unit) provided, however, that any and all work with respect to the removal and installation of interior non- bearing walls or other improvements shall be done expeditiously in a good and workmanlike manner, pursuant to a building permit duly issued therefor (if required by law and pursuant to plans and specifications which have been submitted to and approved by the Trustees of the Condominium Trust, hereinafter referred to, which approval shall not be unreasonably withheld or delayed. (G) Except as provided herein, the architectural integrity of the Building and the Units shall be preserved without modification, and to that end, except as provided herein or in the Rules and Regulations of the Condominium Trust, no awning, screen antenna, sign, banner or other devise, and no exterior change, addition, structure, projection, decoration or other feature shall be erected or placed upon or attached to the Building, any Unit, or any part thereof. This Paragraph (G) shall not restrict the right of Unit Owners to decorate the interiors of their Units as they may desire. (H) Any Unit may be divided by the Unit Owner thereof into two (2) or more Units provided that the following terms and conditions are satisfied: (i) each Unit shall have either (x) direct access, (y) access through a Common Area or Facility or (z) access through an adjacent unit and Common Area or Facility to the exterior of the Building in which the Unit is located; (ii) the percentage interests in the Common Areas and Facilities of the Units created shall aggregate the percentage interest of the unit which was divided and shall be determined based upon the relative fair value of each Unit; (iii) the said Unit Owner, at his sole cost and expense, shall prepare any and all Plans and documents deemed necessary by the Trustees of the Chestnut Green At The Andovers Condominium Trust (each in and substance satisfactory to the said Trustees) for the subdivision of the unit and (iv) the Unit Owner shall pay all costs and expenses incurred by the said Trustees in connection with the review of such plans and documents, the execution thereof by the necessary parties, the administrative work necessary to provide for the new units, and the recording of the appropriate documents. 5 138 (I) No Unit shall be used or maintained in a manner contrary to or inconsistent with (i) this Master deed, (ii) the Condominium Trust and the rules and regulations promulgated thereto, or (iii) Chapter 183A. These restrictions shall be for the benefit of all Unit Owners and shall be administered on behalf of the Unit Owners by the Trustees of the Condominium Trust and shall be enforceable solely by one or more Unit Owners or Trustees, insofar as permitted by law, and, insofar as permitted by law shall be perpetual; and to that end may be extended at such time or times and in such manner as permitted or required by law for the continued enforceability thereof. No Unit Owner shall be liable for any breach of the provisions of this paragraph except such as occur during his or her Unit ownership." The Unit and the undivided interest in said common areas and facilities hereby conveyed are conveyed (i) subject to the provisions of said Chapter 183A and to taxes attributable thereto for the current fiscal year as are not now due and payable; (ii) subject to and with the benefit of the provisions hereof and all the rights, restrictions, easements, agreements and other matters referred to or set forth in said Master Deed (including, without limitation, in Exhibit A thereof), and the Declaration of Trust for the said Chestnut Green At The Andovers Condominium recorded with Essex North District Registry of Deeds in Book 1928, Page 326 and the By-laws contained therein and any rules and regulations promulgated pursuant thereto, and the obligations thereunder to pay the proportionate share attributable to said Unit of the expenses of the Condominium set forth in said Declaration of Trust; all as amended from time to time in accordance with their terms; (iii) subject to all easements, restrictions, agreements and other matters of record affecting said Unit and said common areas and facilities insofar as now in force and applicable; all of which the grantee (jointly and severally, if more than one grantee) by acceptance and recording hereof agrees to comply with, perform, assume and pay; and (iv) subject to real estate taxes attributable to said Unit which are not yet due and payable. This sale shall not constitute a sale of substantially all of the assets of the Grantor. For title see Unit Deed from Walter C. Grover and Richard R. Ruggiero, Trustees of Chestnut Green Realty Trust to Merchco Investment Corporation dated December 15, 1989 recorded in said Registry in Book 3048, Page 163. 11 WITNESS the execution hereof, under seal, this % October, 1991. day bf MERCHCO INVESTMENT CORPORATION . liG -- By - Ann M. Jar 'ewcz, r silent a By: Charles Eisenberg, easurer COMMONWEALTH OF MASSACHUSETTS NORFOLK, SS. October c�? / , 1991 Then personally appeared the above-named Ann M. Jarosiewcz and Charles Eisenberg, the President and Treasurer of Merchco Investment Corporation, as aforesaid, and acknowledged the foregoing instrument to be their free act and deed and the free act and deed of Merchco Investment Corporation, before me, f"f fJ i Notary Publ' My Commiss' n Expir . / y & 7 rl'i 41.1 qkl ESSEX NORTH REGISTRY OF DEEDS LAWRENCE, MASS. A TRUE COPY: ATTEST; R9GISTER OF DEEf)§ A'L o 41>M CD ;o 0 0- -n O < CD ID Qj co PO Qj C -f- ;10 LA 0 (D iJ • (D to -F rl'i 41.1 qkl ESSEX NORTH REGISTRY OF DEEDS LAWRENCE, MASS. A TRUE COPY: ATTEST; R9GISTER OF DEEf)§ A'L r m m y ,z umi r Z5 w D r '' _m � O o V1 m CTS O RD1 F oi�x �O m m 1 f . z=D� Wm -6m N N = 00 C:) � 2 O O AM, n r v WA h 4 C—C zo y0z c'nom `O "t H o i1N6 r o p < f7l %A C> -6 m T m a `d22 W y Z O Z f a F X CA C. O m ; m s. y m S .� .o > z C o m z bCyt?1 bZ H �. 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'sa i .qq� 4f1 Y '�„y%'f' i k, a- T, v 248 CMR: BOARD OF STATE EXAMINERS ' OF PLUMBERS AND GAS FITTERS 2.10: continued wherein flammable liquids and open flame devices are used in conformance with the most recent regulations adopted by the Board of Fire Prevention. (k) Funeral Parlors. Funeral Parlors having embalming facilities or autopsy facilities shall have a flushing rim sink and a floor drain. 0) Medical and Health Care Buildinizs. In all medical and healthcare office buildings there shall be separate designated toilet facilities on each floor for male and female (including handicapped) patients and visitors. The toilet facilities may be in a common or core area that is within 300 (three hundred) *feet of all offices on each floor. Accessibility shall be direct; it shall not require going from one medical office through another. Table 6 Plumbing Fixtures Required in Medical and Health Care Office Buildings for Patients and Visitors. Persons Water Urinal Lavatories Water Lavatories of Each Closets (Male (Male Closets (Female) Sex (Male) (Female) 1- 25 1 0 1 1 1 26 - 100 1 1 1 2 1 101 - 250 1 1 1 3 1 251 - 500 1 2 2 4 2 over 500 One (1) per 250 additional persons in excess of 500 Note:' A minimum of one (1) drinking fountain shall be installed for each set of toilet rooms. (m) Shopping Plazas and Malls. In all shopping plazas and malls there shall be separate designated public toliet facilities for male and female (including handicapped) centrally located in the common area on each floor. These are in addition to 248 CMR 2.10(19)(e) and (f) regarding toilet facilities for male and female employees. Table 7 Plumbing Fixtures Required in Shopping Plazas for Public Use. Gross Female Male Leasable Water Lavatories Urinal lavatories Square Feet Closets Closets 0- 200,000 3 1 200,001 - 400,000 4 2 2 �'1 ,` 2 400,001 - 800,000 5 3 2 2 __.2 800,001 - 1,200,000 6 4 2 3 3 1,200.001 and up 5 3 4 4 • 2.11: Hangers and Supports " (1) General Piping shall be installed with provisions, when necessary, for expansion, contraction or structural settlement. ' (2) Material. Hangers, anchors, and supports shall be of metal or other material of sufficient strength to support the piping and its contents except that piers may be of concrete, brick, or other approved material. (3) Attachment to Building. Hangers and anchors shall be securely attached to the building at sufficiently close intervals to support the piping and its contents. (4) Intervals of Supports. (a) Vertical Piping. Vertical pipe of the following materials shall be supported at not more than the distance intervals shown: 1. Cast iron soil pipe — at base and at each story height. 2. Threaded pipe (SPS) — every other story height. 3. Copper tubing — at each story height but not more than 10 -foot intervals. 4. Plastic (PVC and ABS) pipe at each story height, but not more than 10 foot intervals and elsewhere as required to maintain proper alignment. 5. Plastic Polybutylene (PB) tubing at 5 foot intervals, the tubing is to be secured with plastic hangers. 12/8/89 248 CMR - 64 { TaT'1. , • - Wit: _ _ - . . r j 1. r ,• - !!A! 5�ILI- +y}�L�i(�Ip'�' AMID T +yi a YYi. l'•t�i��%��R�(� .'. .• .y :_ �.... Y` P A r.�l, It { �+`^R}�. it .r'}y: x, - �`J� � '\ _ +" � >'� i ,`i:^'=.::. �;•':' ::M!ir- f: - vn -.i: t �• { tel.- ��\ \ •'♦•\ F•'e h- •�' �\� _ ,` F*;.1�•;\\. 7K- j(r J � - 7j ♦ r *. ' _i r ate, � ,� . �v: t ,, •� • a ♦:� a ` � �: \♦ .1�\?'♦ s .A, \ � ~� r � :�.'•. \'. �•^v \e it } _ e _• .! { . `..♦ - -� \\ ' .- � ", "-moi•' S; ` .; •, . a. _ 4\• \ . �� - �\'T -„a .. ? ."` r � , i *•aye f r�:•� .'w.., r `_ !{ - �L��7GI ^• f . 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C J 0 Z J � 4s ---_ 04e (90011110uweulill of Mull ur4ugettg 13cpartment of Public f3ufrtu E BOARD OF FIRE PREVENTION REGULATIONS 517 CMR 12:40 Office Use Only Permit No. Occupancy ,& Fee Checked _ 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN IN OR TYPE ALL INFORMATION) Data -16-,.I City or Town of- To the Inspector of Wires. The udersigned applies for a permit to perform the electrical work \de -scribed below. Location (Street & Number) 6 1I )y r ��n 0 -� SL)'t 4L 65 Sentry Vendor Code �a � Owner or Tenant ��Uy `�) Q ��!? USSQa ��AnC6' Circuit # Qq, �p Owner's AddressIs this permit in conjunction with ot building permit: Yes ❑ No 91 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps J VoltsN ,,_,,,,..Overhead ❑ Undgrnd ❑ New Service Amps. J Vol t,d Overhead ❑ Undgrnd ❑ Number of Feeders and Ampacity No. of Meters No. of Meters Location and Nature of Proposed Electrical Work LOW VOLTAG=E ALARM SYSTEM No. of Lighting Outlets No. of tiot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and No. of Ranges No. of Air Cond. Total tons Initialing Devices No. of Sounding Devices No. of Self Contained No. of Disposals No.of Heat Total Total Pumps Tons KW No. of Dishwashers Space/Area Heating KW Detection/ Sounding Devices Lo {.- Municipal ❑Other ` No. of Dryers Heating Devices KW onnI. n No. of No. of Low Voltage rg ❑Fire No. of Water Healers KW Signs Ballasts Wiring - ;.Card Access.-C°CCN rb No. Hydro Massage Tubs No. of.Molors Total HP OTHER: _ OCT 2 2 1996 INSURANCE COVERAGE: Pursuan! to the requiromenls of Massachusytt9 general Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalont.-YES' O "'NO_y 0' 1 have submitted valid proof of same to the 011ico. YES ❑ NO ❑ It you have chockod YES, please Indicate the type of coverage by checking the appropriate box. INSURANCE [jar BOND 1.-J OTHER LJ (Phase Specify) Royal Insurance Cmpanny 10/8/ 0i (Expiration Date) Estimated Value of Electrical Work $ Work to Start _ Inspection Dale Requosled: Rough _ Final Signed under the Penalties of porjury: FIRM NAME SPntry SvtPm�LIC. NO. _1109 C Licensee James W. Lees Signature LIC. NO. 000080 MbhC Bug. Tel. No. 617-388-9700 Safety) Address 110 FlCrII]Ce Stznet Ma1c7En NA _ All. Tel. No. 800=4 " 505 OWNER'S INSURANCE WAIVER: I am awarn that the Licensee bogs not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and !hat my signature on this permit application waives this requirement. O,fvnerAgent (Pleaso check une) %_ Telephone No. PERMIT FEErs �`a-+' (Signature of Ownor or Agent) 9 Date ..... &A P-.12 53 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING SSACHU This certifies that ........ has permission to perform ....... ..... �..yskn .. ............ . ................................ wiring in the building of ... (,j Q at ...... 5 ........... ............................... . North Andover, Mass. Fee.....?�a'.',AA) ... Lic. No. ...................... * ELECTRICAL INSPECTOR 10/24/96 10:51 75.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer