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Home My WebLink AboutMiscellaneous - 565 TURNPIKE STREET 4/30/2018 (9)c�. ZA N �i. Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 27 Charles Street North Andover, Massachusetts 01845 WILLIAM J. SCOTT Director (978)688-9531 Peter G. Shaheen Chestnut Green 565 Turnpike Street, Suite 81 North Andover, MA 01845 August 25,2000 RE: Chestnut Green Via mail and facsimile Dear Mr. Shaheen, SO , Fax(978)688-9542 I am .in receipt of your letter to Mr. William Scott regarding the expansion of the parking facilities at the above referenced site. Please be advised that a site plan will be required to determine if there are issues that may require Zoning Board approval, be further advised that expansion or addition of 5 parking spaces or more requires Planning Board Approval, If I may be of further assistance I may be reached between the hours of 8:30 — 10:00 AM and 1:00 —2:00 PM at 688-9545. Res ectfu , Michael McGuire Local Building Inspector BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 - Peter G. Shaheen Chestnut Green 565 Turnpike Street, Suite 81 North Andover, MA 01845 August 25,2000 RE: Chestnut Green Via mail and facsimile Dear Mr. Shaheen, I am in receipt of your letter to Mr. William Scott regarding the expansion of the parking facilities at the above referenced site. Please be advised that a site plan will be required to determine if there are issues that may require Zoning Board approval, be further advised that expansion or addition of 5 parking spaces or more requires Planning Board Approval. If I may be of further assistance I may be reached between the hours of 8:30 — 10:00 AM and 1:00 —2:00 PM at 688-9545. Respectfully, Michael McGuire Local Building Inspector Ication - I IJ Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ tr Building/Frame Permit Fee $ Foun � --' N Other AeRmiff eee NMTONRT $ Sewer Connection Fee $ Water Connection Fee $ TOTAUTE 3 1993 $ Building Inspector Div. 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OST oI •a % � � - d w GG cn b c �� t �, W w an 0 w 2° Q c L ° U w ° w cn w a: ii w cin cn umlC� z CL V. o :mCD c c � o o o c ca v A 1► �! m ccc 0 L lk =CO 0 0 CO .. ICWL o rr� •��om Q o v $ vz cm vi .11�a ca • � JU 3 s N rt+ cm m . N CIO COD y R O E m •ev Nmo cm Le m m = 0 c_ M. CD •m O m V C', •— Z o c o c = •O _ m p N COD = W = m S W O •O � C y=•„ ..� _y O:t O•C Z v� vy O LU C.2 m c m c_ COD co m _ '� H = 0- CL *- m `J O O O o� � o LA LA E O CL 1-t CD O w ea CO) Q O <o w cm Z CL y O C V � cv LaLAJ •C y W G 0 aLU Z r - CD CM w 0.= Q o� cr_ a cU w CC) m Z > H CD O �ft� CD CL cm< � c J Q J -p Z O � o _! Z co Z Q CO2 C LU H CD Z � Z cr Z LLj a_ Uw V Z Q a V5 V O� O W LL 00W V �- LL. H W V 0 R uE -Volco P4 a4 > C Date .... ��//� ............................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... / ...... , ....................................... ................................ .1'71 has permission to perf orm wiring in the building of/ ......................... ........... , — ........... ....... at ...... ...... ..... ZZ ................ .North Andover, Mass. Fee........./:.:...... Lic. No./. ZIZ-& ....................................................... ELECTRICAL INSPECTOR Check 45171 i Office Use On \The Commonwealth of Massa .uSettS Permit No. G Department of Public Safety Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 27 CMR 12:00 .3/90 (leave blank) APPLICATIONFOR PERMITT PERFORM ELECTRICAL ®RK All work to be performed in accordance.wl the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date January 15, 2004 N. Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 565 Turnpike Street Suite 83 Owner or Tenant Diagnostic Laboratory Medicine Owner's Address Same Generators KVA Is this permit in conjunction with a building permit: Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Commercial Utility Authorization No. Existing Service Amps j 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 New outlet for refrigerator in lab No. of Air Cond. tons OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES I have submitted valid proof of same to. this office. YES © NO ❑. If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE 0 BOND EI OTHER ❑ (Please Specify) — NO ❑ r (Expiration Date) Estimated Value of Electrical Work $ Work to Start Inspection Date Required: Rough Final Signed under the penalties of perjury: FIRM NAME CROWE & SONS ELECTRICAL CORP . LIC. NO. 1716 8A Licensee JAMES B. CROWS Signature LIC. NO 17168A — Bus. Tel. No. 9 7 8) 4 5 Address 543 MIDDLESEX STREET, LOWELL, MA 01851 AIt.TeLNo. (978)251-85/3 ' OWNER'S INSURANCE WAIVER: I am aware that the licensee 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 $ 75.00 lCinnntb iro of nwnpr nr Anpnfi Total No. of Lighting Outlets No. of Hot Tubs No. of Transformers KVA No. of Lighting Fixtures Swimming Pool Ag o d 1:1gmd ❑ Generators KVA No.of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Bery Units Batt No. of Switch Outlets No. of Gas burners FIRE ALARMS No. of Zones No. of Detection and Total No. of Ranges No. of Air Cond. tons Initiating Devices Heat Total TotalPumps No. of. Disposals No. of Tons KW No. of Sounding Devices. No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices Municipal Local ❑ Connection ❑ Other No. of Dryers Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES I have submitted valid proof of same to. this office. YES © NO ❑. If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE 0 BOND EI OTHER ❑ (Please Specify) — NO ❑ r (Expiration Date) Estimated Value of Electrical Work $ Work to Start Inspection Date Required: Rough Final Signed under the penalties of perjury: FIRM NAME CROWE & SONS ELECTRICAL CORP . LIC. NO. 1716 8A Licensee JAMES B. CROWS Signature LIC. NO 17168A — Bus. Tel. No. 9 7 8) 4 5 Address 543 MIDDLESEX STREET, LOWELL, MA 01851 AIt.TeLNo. (978)251-85/3 ' OWNER'S INSURANCE WAIVER: I am aware that the licensee 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 $ 75.00 lCinnntb iro of nwnpr nr Anpnfi Location • 5� _� ��+._ % �/�� No. %J�� Date--,7-� TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $� .D Foundation Permit Fee $ Seat M06"n"Pee $ ____--- Water Connection Fee $ TOTAL' - - $ /Y, 19ffl Building Inspector '^t Div. Public Works U) `JVIV) �u i ,°r��, I- x NU rc Dy I li < 3 If I a N W J m J_ J F a wC 0 0 0 _ i ~IL O 4 W 4 a ° W w Z W O < N d i Z m N a ° Nlm W ° m C a W C F < O Z I 0 LL U. 0 F I 2 W Z w W Z I u LL 0 J < w W f �lol7(j cJ� m�Z aF W J 0 ° < W < z N ► / w f Z K W z O ~ a f m w 0 J f m w h- 0 3 z 0 z F a 0 z C ~ i O z F N W Z Z Z J O O J ° J ° J < W ° 0 u 4 0 N f Z W I W K 7 � 1 Q Z w a t ix 4 0 Z f 0 C F a a Z a 0 J U < 0 W _z a IL Q < J LL 7 0 m Q C J < m J z 0 Q S Q 0 0 O z z z 0 Q W � r 6 Q w 2 ® C- ti Z O ir I` O J W Q G w a ^ W Z `� \ p 0: N _Z W 0 Z 0 J 4 Q J W J F (~ m F Z 0 m m 1�x iz w Z F > l 0ZZ d�lO UWZ Z mZO O F j s. f o J W W a J Z N a a U, 4 3 • vh Q .. , W > > w K W ' 0 �� O W I ± O O F m U. (' F 0 J J W 0 f 0 1 4 �i I a J J 1 ° 0 w a I w F- Itr fa 04 U W 0N H U N Y• m w w < W W < < J J < z W W _ NL d W < d. Q�m 4. G .. N >01 N -+ - O N OAD A > OO y - 0 0V 0 z MMO O T mmp°TD z O�A Cox m �X--1 DN; O D n OA > =N 0�0 ZZ Z N N ti mim Z S Itzn0 moo NOn �z- Or `^� ^; x O ;O n'O a w ov C u 0 m000 n m D v r p ^ Z N r r +' OOO Z O K � - -4 C D*D m O A 0 _ 3 N .1 ,r r Cv V 4 70 C 70m 0 0z Y r mm ' , Z�OGICpDim O z A O v T O y Z7� D O �tim 0 DC f1 N O ti Dn A T T mr n<> Dmm= 0 T Op T TJO �ZO�;ON DTANCmOJOti W x O O G� N~ Z A y G MR mA Om x c f O O Z< A D T N N 1 C n� A 11 c: A m N T x an74 z ZOO Cf A ? mIA � N G D D v n m Z; D o m n n D; N ~ S �ncmwoOpa A DO JO W m�00 N DMZ ... nn v xOv� om D N�cnn A ,O O O N D v N 0 A;_ m m ; O O v o N x v A O+ c p m m w z D T A; v O 0 3 N O C N; S -Z y "' Z DN n G <� m O O N T K y z 0 0 _IIII_IL111IZ c Dnx n Oa K co C O DZ O?c 3: Z'D Z Z D 0 Z n n n + 0 < w n N p D A z O = D m ° 'o O I I I I EI I 1 i. l I I Iv = >01 - N Nrm z MMO DO z Cox C �X--1 D n 0�0 Nog mim mx Itzn0 moo �z- m(A3 50Z �N ov C m000 Ncz r p r r +' OOO Z �clr � - -4 C D*D m ?_Z A 0 ID .1 ,r r Cv V 4 70 C 70m 0 0z Y r mm ' , m 00 F f s r=LU'CLLY Ly viease tie actvisect that T & E Construction Corp. of 31 Turner Drive, No. Reading is authorized by the Trustees at Chestnut Green at the Andovers to complete the build out of units 82 & 85 of 565 Turnpike Street, No. Andover. The authorization is based on the plan submitted to your department on January 29, 1993 by Mr. Citroni. Should.you have any further questions please fell free to contact me at the above -telephone number. Sincerely, r4l"2 S h hy cc Trustees air --M Mr. Walter Cahill February 1, 1993 Building Inspectional Services 120 Main Street N. Andover, Ma. 01845 RE: Merrimack Valley Pulmonary Assoc. project/Chestnut Green Dear Mr. Cahill, Attached for your review is the proposed location for the toilet room as per the original construction plans being submitted for review and permit. The door to this toilet roam has been revised in that entry is from the office side and not from the corridor side. The toilet room is for the convenience of the physicians and will not be used by patients. There presently exists on the same floor as this office separate male and female toilet facilities that are handicapped accessible. All other elements of the proposed build out have been designed to meet current ALTA criteria with respect to door opening sizes, corridor sizes and the use of lever type hardware throughout the project area. Although the project contractor is involved with the permit filing process please let me know if there is additional information we may provide your office with. Sincerely, Mark J. Whi Space Planning And Commercial Environments, Inc. President cc: Nancy Henry/MVPA U 2 ,993 ,33U11,DiN'U D�� .�� i r.1ic!Y � o SPACE PLANNING AND COMMERCIAL ENVIRONMENTS, INCORPORATED E3 11 Trafalgar Square, Nashua, New Hampshire 03063 603.883.7407 Fax 603.883.7052 .. 0 S. P A. C. E. Mr. Walter Cahill February 1, 1993 Building Inspectional Services 120 Main Street N. Andover, Ma. 01845 RE: Merrimack Valley Pulmonary Assoc. project/Chestnut Green Dear Mr. Cahill, Attached for your review is the proposed location for the toilet room as per the original construction plans being submitted for review and permit. The door to this toilet roam has been revised in that entry is from the office side and not from the corridor side. The toilet room is for the convenience of the physicians and will not be used by patients. There presently exists on the same floor as this office separate male and female toilet facilities that are handicapped accessible. All other elements of the proposed build out have been designed to meet current ALTA criteria with respect to door opening sizes, corridor sizes and the use of lever type hardware throughout the project area. Although the project contractor is involved with the permit filing process please let me know if there is additional information we may provide your office with. Sincerely, Mark J. Whi Space Planning And Commercial Environments, Inc. President cc: Nancy Henry/MVPA U 2 ,993 ,33U11,DiN'U D�� .�� i r.1ic!Y � o SPACE PLANNING AND COMMERCIAL ENVIRONMENTS, INCORPORATED E3 11 Trafalgar Square, Nashua, New Hampshire 03063 603.883.7407 Fax 603.883.7052 O 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***************** . APPLI CANT : • ter: " r 4. Phone LOCATION: Assessor's Map Number Parcel Subdivision Lots) Street f77 St. Number v ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Conservation Administrator Comments Town Planner Comments Food Inspector -Health Septic Inspector -Health Comments Public Works - sewer/water connections - driveway pe 't 1, Fire Department p Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Received by Building Inspector �. Date 0 i 0 MERRIMACK VALLEY PULMONARY ASSOCIATES, P.C. Board Certified Pulmonary and Critical Care Medicine Barry M. Pisick, M.D., FCCP Daniel E. Coleman, M.D., FCCP Glenn S. Newsome, M.D., MPH, FCCP January 25, 1993 Tony Citroni T & E Construction Corporation 31 Turner Drive North Reading,.Massachusetts 01864 Re: Merrimack Valley Pulmonary Associates - Chestnut Green, Building Number 3, 3rd Floor North Andover, Massachusetts Dear Tony, We are pleased to offer you the construction contract for the above referenced property. We have outlined the parameters of this work as it appears in your attached proposal dated January 14, 1993. T & E Construction will supply and install materials, according to S.P.A.C.E., Inc.'s plans* and new changes dated January 4, 1993. In addition, T & E Construction Corporation will carry, separate from the contract price, $5,000 to be placed in escrow with the Chestnut Green Trustees. The work will be completed in a good and workmanlike manner and prior to final payment, T & E Construction will produce evidence that all subcontractors have been paid. Also, T & E Construction must furnish proof of workmans compensation and liability. The contract price is $101,997.00. Below is an outline of the agreed upon payment schedule: 1. 10% upon signing of contract. 2. 15% demolition, rough plumbing and walls. 3. 15% rough wiring, insulation walls, sheetrock, sprinkler system. 4. 15% frames, doors, hardware, acoustical ceilings, HVAC. 5. 15% wallcovering,'millwork, painting. 6. 15% finish wiring, plumbing. 7. 15% carpet, vinyl flooring, base. �a► — - --1 ii " 114N 2 8 L^'� �, , 1. 411 Merrimack Street Methuen, Massachusetts 01844 • (508) 689-2247 r 138 Haverhill Street • Andover, Massachusetts 01810 (508) 470-2687 FAX (508) 689-7305 Tony Citroni January 25, 1993 Page Two *Plans to include: Demolition and Construction flan DC -1 - 11/25/92 Construction Plan C-1 11/25/92 Power and Telephone Plan PT -1 - 11/25/92 Reflected Ceiling Plan R-1 - 11/25/92 Details D-1 - 11/25/92 Finish, Door and Hardware Specs F-1 - 11/25/92 You have advised that completion of the project will take place in approximately seven weeks. You will work closely with Mark White of S.P.A.C.E. and Nancy Henry from our office will be happy to field any questions which may arise. Yours truly, ZAAk-- Barry Pisick, M.D Tony Citroni President T & E Construction Corp. Merrimack Valley Pulmonary, P.C. BP/ndh Enclosure. ar >- i w w LL z05 r,o w 0 w o z ar LL NyQ =F N Z z p J O p Q O Q O w i Z = N Q Z w LL O J Q ^a 5 a z O 2 p wm J D CSR �e C7 co a` w a= m a a LL Z�-a t3 w 0 a O t!° '� a wc w w Q'A J 7 O Q Z LA— z w 0 _O Ui m w i m 0 z U z O w U 2 FOLD ALONG LINE i W �J N tT•1"• y � V j N - �t tii i -k •moi a = Yo i 222 4c tl1 elf i••I ! f :i. w z �,'6e 7 F h !J ! 11 m S� Q n t: •. Z O = vJ _I I . g y y d� Z LU p e: •tit U O I ?' w _ Z •! 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' • c ao Q N m C _ 0 O .30 CIO coo teWD— W C �-aD .y 'dt ea C ii .E o �' � a os CLCD O p m C Q COD a o� o-0 _ � i y'O H rCDCK cr- cm C e 9 r - .S, m•.- i ; m - � -tea• o m O 'V 0 LA- i 0 O OLLJ O tom' . Quo 0 • Q CO)_ .O r vJ^ w i ca O W cm U m cr- cm C e 9 r - .S, m•.- i ; m - � -tea• o m O 'V CD LA- i 0 O OLLJ O tom' . Quo 0 I oCIO co — A O .O m m .C13 O O co O i O CD L Cd O d CL Q C2 CcCc v J� .c Z as ts CD 0 CL V y O � C cc CLCO2 i - V z Q V � O otsW ZD LL 0 � W o LL I— W V G Ev U � Q� x 0 ca P-4 W E w •--I P-1® A d `}., >� �„�.:�'V?.`��`'-+'yr` mea.• .. fr.:`�e.�1�r ♦. _`n., ��,a,...�:��.-->.�'}•-..`",.,.�,.r'�+r'” _�+.��iF Location 565s'T."�xoi1 8(,� No. 'y Date 1 0.N°RT" TOWN OF NORTH ANDOVER 00 ece.ccupcy$o f >_ Building/Frame Permit Fee $ 2Z-? 4 00 --- � _ 'sr cbmusEt Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL 739-7 $ �7 B u U d ing 39- Buildin. pector Div. Public Works Wt Location SG. 5.TLt t2tj Sc,17'e No. Date 1-h-7 TOWN OF NORTH ANDOVER, 0 oA Certificate of Occupancy $ Building/Frame Permit Fee $ rt SAUS Foundation Permit Fee $ Other Permit Fee bon) $ � Sewer Connection Fee Water Connection Fee TOTAL 7398 $ Building ini-pector PAID Div. Public Works i C9 W tJ O F G I . U W o, d- Z 0 z a z O °� z 0 °z 0 o a g 9 m t a l,.W zi _ Y i �W WW iW �= Z W Z O `" a o 0 o taW < FU u u d0 L m l7 l7 V W Q ` 3 ° L1� m Z W J u m m m o ( < 3 m < u 1/1 d I^ J Z Z 7 Z 1- F- F W 0 0 a �'1 J W W 0 6 IN Y1I J Z O 0 0 W Z rc C3 I I M z p 0 0 0 0 m j H p W 0 U u U T" ^ Z U. '0 m Z _J N _w < i O Z Z Z J F m ld 0 Z p= mz z z Pr i O W m 4 7 Z U Z O O O N �. = it rc p 0 = p F 4 0 u u u cr U O O- JJ Z 1L 0 Z Z Z Z LL 4 Q Z N LL w 4 y o 4< 0 0 0 0 0 L O 41 W Z 41 (Z'J W W7 7 7 7 i C m N< f m m m m N ' uj N 7 z m N N 0 I 111 f to N N m H CD CD rd F � N Z ° 0 LU W O O 14 d Y, N d < Z 0 z 7 4 C W U C( V m 0 N Z Z 4 u Z 4 - �h 0. z � a c o J Q W 0 7 F O Y m 1• 5 z A N u < �' (Z � li1 Z � �. � m c1 Z D O N IL I � x (A .! H >• z Im- UL W > T s w Ir 0 7J J m F Z N m W 0 ` p Lli J (nd 1 7 w f O Z Z m N Z K� (��^Qact N W J Z 0 < u u j i O m �7 R r: ` N W r m F 0 0 W 0 J m N W J Z• �`G G'" 4 E`1•.. W < W W N J 3 0 U < N F F R < W 0 y1 C Z f Z f f W O J U W- W 7 7 W C n E O < 0 0 Z<< Z a 0 0 O W < m it N Z Z < m Z 0 W w 0 O 0 U p < m j J f 0 N 0 } t Ib ,0 O m H W C u u u 4 J J J 7 Ix O 1- w 4 N C I LL F ►O- !J6 :••" a 'r K 1Y f W Z z Z 0 m p 0 H U m C Wa- z Q W W = O < < < < 7 7 7 J K m W W u < Z W Z IE 0 0 3 3 m 7 N m N Wa, m m m J O W < < J I- J < O W m -...4 -. O m m N ; m m d d W < d O W 4. d W : H mi O Q, D OvD 1G° DNDGmS CwmD) tip G OAf 0 nm' .T_ - N0 C NZOC. AZ _m{ • c OpD 1 m m m n x7C(1 1 DO v m A ( !1 AND r ZO OO NaO C m m A N m �T Az vO Nz OO 0Z er T'� �AA Cz Gi ADZN ;D Z N p ZO 0rNp aV ' T ZmZ30 ms m m ON N Z N { { A aA z Z r • O { i. N 0 J_LI Z ^y- OGN AO DSD CNDA O m p�0 GDO Omzz n _ C O{a vm �' C.'a p NN A < ; AS +111 m TA m_ti r<7_1C m S OC m A nND_ SS;OA=m z A y_.y TZ NvA2<< OprDZ ^mp nmZ O y 0ZC �AI D O zv Zya Z 0 Nn Sv -1 O O O 0. Z Z C A z O OZ m A D ~ N ~T >o T DD D >o III i, D m C1 TAO X m ZC1 ZZ C1 O Z Z O -LiA 1ILE _1_LILL T A — I � • c 1 :tj rr � ~ ,•A \ • >r02 IN m N yrN Zm mmo qU)-1 y0 Nzz °c �XN X>w 'D -4 env* Maim mx -i z x(nn,, N0 m U) TOM - z mv0 Jth C lZfl F, rv0 OZm vtn0. r -� ;a y z z N Ma n In N M m M 00 3 1 Per ©, (� St x--02 0�►-�?"®'el ZP9 , acv ' FORM U - IAT 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***************** VdPLICANT: �.10UW� .SVL UVAN S2. C6ga. oa",i1� , Phone 0 l" 1 -71 i } 3 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***************** VdPLICANT: �.10UW� .SVL UVAN S2. C6ga. oa",i1� , Phone 0 l" 1 -71 M LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) treet 5(&5 7-U'RAf piEx ST. S v .7'5 St. Nunber Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Annroved Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-ealth Date Rejected Date Approved Settic Inspector -Health Date Rejected Co=erts Publ=c Wcr�;sseTaer'water conne 4-; ons 1 C�SGC90 dr-vewav perm. Fire Depart:.ie. t Received icy Building Ihstector 6_1 Date } t arr71 3 o M .r. M- ..n. . z M LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) treet 5(&5 7-U'RAf piEx ST. S v .7'5 St. Nunber Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Annroved Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-ealth Date Rejected Date Approved Settic Inspector -Health Date Rejected Co=erts Publ=c Wcr�;sseTaer'water conne 4-; ons 1 C�SGC90 dr-vewav perm. Fire Depart:.ie. t Received icy Building Ihstector 6_1 Date r. a z a CL W W Ix n W 0o 0 0 0 x <c L_ J Lrrl LL_ e� 11 I I W JWfN T. ' BRENIr AN SCALE: OFFICE FIT -UP ASSOCIATES ��1'-�' CHESTNUT GREEN OFFICE PARK LA ArdNffn= a- CONCrAWMN � DAT : 565 TURNPIKE STREET. SUITE 88 SK1 ps aamg cd5aa>' SALEM, oo 1.1500 ,A)LY ?2, 1994 WORTH ANDOVER, MASSACHUSETTS -o = R WASH MO7JF AMBIENT ROOM TEMPERATURE REQUIREMENTS. 5°C (9°F) lower than the operating developer temperature, or 3.5'C (6'F) lower than the operating developer temperature it the DRYER is set at 54°C (130° F) of lower. NOTE Use the non -ambient wash water mode it you do not have the preceding requirements. SAFE -LIGHT FIXTURE (NOT FURNISHED) CONNECT TO SAFE -LIGHT OUTLET OF PROCESSOR. (FOR VISUAL FEED INDICATOR) OR MANUAL FOR REPLUf,rBING DEV. SYSTEM, WURE CONTROLLED TO 29.5-32°C (65— 4G VALVE. PRESSURE OF 130TH HOT- AND y SERVICE SAME. LIGHTED AREA DYQrROO!'I I LINT- LOCK c7r.;p � CG'.'PRf 5 t 5 70 _-- z2 //z — 1 _- r✓ o I \ `ENTRANCE RULLE R= ROLLERS D/Ud - 2 NOL ES CAPS. AL T_`RN<TE INN TS FG1P REPLN!/y:ER TL✓a'1G 10comlN6 ELfC?;,tCAI I SERV/CE P4VIL - fF _ 000 CIRCUIT BREAKER -- 33/4 NPT ELECTPrCgL COnwE CTIG/✓ � 3% WASH_ F/XTR FF DEVELOPER DRAW VANE_ 44E EEHU/,O `\ Z TraE ACC; SS DOOR F MOUN71KA3 HOLES F'OR FEED I - SAFEL LIGHT OLTL_T AND �p F-A;,IE L 10comlN6 ELfC?;,tCAI I SERV/CE P4VIL - fF _ 000 CIRCUIT BREAKER -- 33/4 NPT ELECTPrCgL COnwE CTIG/✓ � 3% z 7 750 _ I -17-50 3.7. � G DI AM 2 HOLES ' WITH CAPS FOR SILVER RECOVERY 1/2•' NPT COLD WATER CONNECTION 1 1/2 gal/min. VALVE FURNISHED I NPT DRAN Ji11,Y71ON EC7K COVER (FCP 7W.i+5FORMER) 1-_-1 F o \ — F.5HE0 "0-"q 13'16" DIAM 2 HOLES WITH CAPS. REPLENISHER 2 TUBING INLETS FROM REMOTE TANKS AL f CRNA;:: HEAT EX. EXHAUST LOCATIONS 4 �I EYHAUST PORT EXTE//05 PANEL S/6' - �p ? TI 2, ro 3.. A04 oTER j O i ------- - ..OD 2Qj I t^ j Q1� •. �s W lkj T a - - ----, -- r ► l _ , rz I __ FOR EASE IN CLEANING DRAIN, 1" NPT CROSS 8 PLUGS ARE RECOMMENDED EX/i=,U57 - -5;- E NIPPLES. CROSS & PLUGS ARE NGT L-. `'•"u'^/`-'` " -'^'^t �''O°% FURNISHED Willi PROCESSOR. DO NOT USE BRASS OR COPPER FOR GRAIN UNE_`:. z 7 750 _ I -17-50 3.7. � G DI AM 2 HOLES ' WITH CAPS FOR SILVER RECOVERY 1/2•' NPT COLD WATER CONNECTION 1 1/2 gal/min. VALVE FURNISHED I NPT DRAN Ji11,Y71ON EC7K COVER (FCP 7W.i+5FORMER) 1-_-1 F o \ — F.5HE0 "0-"q 13'16" DIAM 2 HOLES WITH CAPS. REPLENISHER 2 TUBING INLETS FROM REMOTE TANKS AL f CRNA;:: HEAT EX. EXHAUST LOCATIONS GENERAL INFORMATION ACCESSORIESKODAK SILVER RE::OV FRY ASSEMBLY K-3275: KODAK RP X-OMAT STANDBY CONTROL. MODEL PAiA-N: KOOAC THERMOSTATIC MIXING VALVE. �12 Nil- CHE5 .K VALVE -1 VACUUM BREAKER I H IGHI BY LOCAL. CODE SIIUTQf l VALVF 1/2 NPI \\ li 2 RE00 AVAILABLE FHOtat vv� K00,%K PARI NO. S;9;i81 KODAK THERMOSTATIC , MIXING VALVE 1/2" NPTWATEi1 1 SUPPLY 1✓2" NPT JE Yr L01'[P Tn iF . RMOMTCA _— AVAILABLE FROM KODAK fL-r,i; DUj PART NO 467621 (NOT SUPPLIED WITH ) \ :� 30 A. 2 -POLE. PROCESSOR) Ty)- THERMOMAGNETIC CIRCUIT BREAKER (LOCATE SAFE DISTANCE FROM WATER SERVICE) THIS AREA MUST BE �'�=- -- SHUTOFF VALVES 1/2' NPT -m LEFT CLEAR FOR I „_�� ,Coin 2 ADDI i IONAL REO'D RACK REMOVAL AVAILABLE FROM KODAK --- -_-_ PART NO 459981 1107 - A COLD - WATER �81�2 SUPPLY 112'" NPT Fri L,O �� I I,II -----I _ -- SERVICE HOSE - LENGTH ,'1----- II TO REACH AI.I. PROCESSOR TANKS I \ yJ'_ PASS SERVICE T�'RD W4L4 / I TO FRONT OF P40CE S SOR /i✓ O<gK�ON, N'TE SERVICE CONTROLS MAqY -- -� BE 40CATED GV.' EITNE4 I SIDE OF PRpCtSsOa F04 EASY ACCESS/6.L/7, % ., NPT Z UN/pQOC.FSS0 AS CLOS£ TG P40CES 504 AS "15 ;19CE ELEVATION SHOWING WATER AND ELECTRICAL SERVICE, PARTS NOT FURNISHED BY KODAK EXCEPT AS NOTED IMPORTANT, FDLLOw L0 -4L -__CTRICAL 4/JO PLU1'48I0G ,. 5. NOTE: THE PROCESSOR MEETS ALL NORMAL CODE REOUIREMENTS AND IS UL LISTED (FILE NO. E5119) AND CSA APPROVED, SPECIFICATIONS SUBJEC 1 i0 CHANGE WITHOUT NOTICE. /J --)A,/ n448 /ENT WATER W17514 (nJ_'!--IONAL RZ-O(AREMENTS NOTED IN SOKc �)) SEE PROCESSOR MANUAL WASH 'TEMPERATURE CONI 90"F) BY MIXING VALVE. PR COLD -WATER SERVICE SAN GY'YE4' T1,154M0574T PEPLE,VISHER METERS CaV rROL PANEL -, 097YER PILOT LIGHT - REPLENISHER 5WITCH DEVELOPER PLOT — USUT RECEIVING BIN I— END PAv& w5rANTLY REMOVA&E FOR ACCESS TO OPY't=�,gNC> 30 " BU ILDIIJG CkKT �-----`------ 'i -- DUCT FROM PROCESSOR IE 2 SERVICE' REQUIREMENTS AND CONNECTIONS: KODAK RP X-OMAT PROCESSOR, MODEL F+116AW VIEW 'A:' (October 1978) EXIT ROLLER=\ J I+ FOR EA JOSS NIPPLE FURNIS DO NO FOR DF - AMBIENT WATER WASH MODE ELECTRICAL: 1201208 VOLT 3 -WIRE: 120/240 -VOLT 3 -WIRE. or 230 -VOLT 2 -WIRE, GROUNDED NEUTRAL ALL 50/60 -CYCLE, ac, 25 -AMPERE, SINGLE-PHASE WATER CONTROLLED AT THE PROCESSOR TO 5.7 L/min (1 1/2 gal/min): TEMPERATURE UNCONTROLLED FROM 4-32'C (40-90`F): PRESSURE OF COLD WATER SERVICE TO PROCESSOR SHOULD BE KPA 172-448 (25-65°psi). FILTRATION IS NOT NORMALLY REQUIRED. AIR EXHAUST OF THE DRYER: 2.12 m'/min (75 h'/min) AT 65.5`C (150"F) FULL CAPACITY UP TO 7.6 m (25 -loot) - RUN: 2 ELBOWS. 7.6 cm (3 -IN.) DUCT REOD, 7.6 m (25 Iee1) OR LONGER, 34 ELBOWS, 10.2 cm (4 -IN.) DUCT REDD (SEE VIEW A). DRAINAGE: 5.7 L/min (1 1/2 gal/min( NORMAL. 15.1 L/min (4 gay/min) WHEN DRAINING TANKS. DO NOT USE BRASS OR 00i'PEH FOR DRAIN LINES. WEIGHT: AP.^I:OX 236 kg (525 poundi) WITH FROCFSSING TAN! S RLLEij n'i i H SOLUTION. PAC—:; :.l" THE COMPLETE PROCES>OR IS CONTAINE() IN A SINGLE CASE WEIGHING Ar,„,.,:, <I:) Kg (475 poundS) AND MEASURING AG'PROX 91 4 cm (36 in) LONG, 71.1 cm (28 in.) WIDE AND 142 2 cm (5G in.) HIGH PASSAGE: UNCRAT ED, V;IT:+. FEED MAY REMOVED, PROCESSOR Wli_1. PASS THROUGH A 59.7 cm (23 1/2-m ) WIDE , 127 Cr, (50 11) HIGH OPENING AIR CONDITIONING (75 ItVmm) A.li MAKEUP TO LIGHTED ROOM AREA. EXHAUST MOISTURE GAIN (FULL LOAD) 300 GRAIN':: PER MINUTE OR 121 GRAINS/kg (55 GRAINS/)D) OF AIR, PROCLS^OR ILEA. -I LOAD l O L IGHTED ROOM (NORMAL LOAD) 470'J Btu PER HR (DEWAIR HEAT CX. 5.7 W -m ( 00 f1'/m il�(, 7LKJ Btu/hr). ACCESSORIESKODAK SILVER RE::OV FRY ASSEMBLY K-3275: KODAK RP X-OMAT STANDBY CONTROL. MODEL PAiA-N: KOOAC THERMOSTATIC MIXING VALVE. �12 Nil- CHE5 .K VALVE -1 VACUUM BREAKER I H IGHI BY LOCAL. CODE SIIUTQf l VALVF 1/2 NPI \\ li 2 RE00 AVAILABLE FHOtat vv� K00,%K PARI NO. S;9;i81 KODAK THERMOSTATIC , MIXING VALVE 1/2" NPTWATEi1 1 SUPPLY 1✓2" NPT JE Yr L01'[P Tn iF . RMOMTCA _— AVAILABLE FROM KODAK fL-r,i; DUj PART NO 467621 (NOT SUPPLIED WITH ) \ :� 30 A. 2 -POLE. PROCESSOR) Ty)- THERMOMAGNETIC CIRCUIT BREAKER (LOCATE SAFE DISTANCE FROM WATER SERVICE) THIS AREA MUST BE �'�=- -- SHUTOFF VALVES 1/2' NPT -m LEFT CLEAR FOR I „_�� ,Coin 2 ADDI i IONAL REO'D RACK REMOVAL AVAILABLE FROM KODAK --- -_-_ PART NO 459981 1107 - A COLD - WATER �81�2 SUPPLY 112'" NPT Fri L,O �� I I,II -----I _ -- SERVICE HOSE - LENGTH ,'1----- II TO REACH AI.I. PROCESSOR TANKS I \ yJ'_ PASS SERVICE T�'RD W4L4 / I TO FRONT OF P40CE S SOR /i✓ O<gK�ON, N'TE SERVICE CONTROLS MAqY -- -� BE 40CATED GV.' EITNE4 I SIDE OF PRpCtSsOa F04 EASY ACCESS/6.L/7, % ., NPT Z UN/pQOC.FSS0 AS CLOS£ TG P40CES 504 AS "15 ;19CE ELEVATION SHOWING WATER AND ELECTRICAL SERVICE, PARTS NOT FURNISHED BY KODAK EXCEPT AS NOTED IMPORTANT, FDLLOw L0 -4L -__CTRICAL 4/JO PLU1'48I0G ,. 5. NOTE: THE PROCESSOR MEETS ALL NORMAL CODE REOUIREMENTS AND IS UL LISTED (FILE NO. E5119) AND CSA APPROVED, SPECIFICATIONS SUBJEC 1 i0 CHANGE WITHOUT NOTICE. /J --)A,/ n448 /ENT WATER W17514 (nJ_'!--IONAL RZ-O(AREMENTS NOTED IN SOKc �)) SEE PROCESSOR MANUAL WASH 'TEMPERATURE CONI 90"F) BY MIXING VALVE. PR COLD -WATER SERVICE SAN GY'YE4' T1,154M0574T PEPLE,VISHER METERS CaV rROL PANEL -, 097YER PILOT LIGHT - REPLENISHER 5WITCH DEVELOPER PLOT — USUT RECEIVING BIN I— END PAv& w5rANTLY REMOVA&E FOR ACCESS TO OPY't=�,gNC> 30 " BU ILDIIJG CkKT �-----`------ 'i -- DUCT FROM PROCESSOR IE 2 SERVICE' REQUIREMENTS AND CONNECTIONS: KODAK RP X-OMAT PROCESSOR, MODEL F+116AW VIEW 'A:' (October 1978) EXIT ROLLER=\ J I+ FOR EA JOSS NIPPLE FURNIS DO NO FOR DF - 47,7 ,o joa <�VtSL�7 "-4-4/V Avoille? %e BUSSIERE ENGINEERING SHEET NO. OF 1217 Elm Street CALCULATED BY DATE i MANCHESTER, NEW HAMPSHIRE 03101. (603) 622.2639 CHECKED BY DATE SCALE y- 2414 ) , 4 'oteq-trew w Gvavo! -sc&-6 1137, /oAloi �4 k IFF ROBERT 4s r f\--4 \ T easi -24 f 6,c Go r- C7CON. to r - C) Ch U r ' e � COOee LA- - 1 W E mo w "A" 208 single nhase 100 amn flush mounted disconnect; bottom edge 65" above finished floor - "B" 12"x l2"x4" J box flush .mounted at floor C /L 16" frpm corner, "C" 12"x12"x4" J box flush mounted bottom edge 28" above floor locate near right rear corner of room. "E1" Normally open door switch Edwards type or equivalent. rated 115 VAC, 1 amp WIRING "A" to "B" two #4 one #8 ground 10' pigtails "B" to'"C" two #4 one #8 ground ten #12 twenty # 16 10' nigtail both ends "B" TO "El" two #18 All wire to he stranded THHN corner- Supply ten each 1 1/2" Romex connectors with bushings and eight each 1" Romex connectors with bushings - II. MAMMOGRAPHY SYSTEM Power sunnly for mammogranhv unit "M" .208 volt/30 amp, single phase disconnect 60" cuff finished floor "M 1" Sunnly/feed from "M, " S' nigtail with SO or SJ type cord at marked ` location ("M I" 24,from corner of room- 8 above finished floor. III. DARKROOM/PROCESSING .208 volt, 30 amp disconnect and feed for automatic film processor N "Y" Minimum 2" open floor drain (no brass or copper) -'--"Z" Gold water feed 22" above finished floor with shutoff clear cartdrige filter and anv annlicahle backflownreventor valves per local code `THE ABOVE ENGINEERING SPECIFICATIONS ARE OF A "GENERIC X-RAY FACILITY. AND CAN BE MODIFIED, ACCORDING TO SPECIFIC EQUIPMENT _AND SYSTEMS BEING INSTALLED `MEDICAL X=RAY SYSTEMS EQUIPMENT • StIPPL1ES SERVICE F f North Andover Radiology Chestnut Green N. Andover,Ma. f JUN 2 3 I9gn ! 4 ,h E, N CHESTNUT GREEN SALEM RADIOLOGY SPECIFICATIONS DEMOLITION 1) All flooring will be removed. 2) Walls will be removed to allow for the new layout. 3) We will remove the plywood subfloor below the location of the x-ray machine for the placement of lead foil. 4) All debris will be placed in a dumpster and disposed of. LUMBER 1) New subfloor will be furnished and installed in the x-ray room. 2) Blocking will be furnished in the new door openings and for the x-ray control box. 3) Blocking will be provided below the x-ray equipment per the structural sketches. This will require access to the suite below on the second floor. MILLWORK 1) We will furnish a new countertop with three base cabinets at the reception desk. 2) A matching top countertop will be provided at the reception desk. 3) 50 LF of shelving will be furnished and installed in the storage room. 40= l) Four new 3'0" x 6'8" solid core birch doors with metal frames and hardware will be furnished and installed. 2) The x-ray room door will be a lead door. This door will be 3'6" x 7'0". 3) The darkroom door will be weatherstripped. 4) The mammography room does not have a lead door. DRYWALL 1) All new partitions will be 3 5/8" metal studs with 5/8" sheetrock on each side. These walls will be constructed to 8' high. 2) The bathroom walls will be insulated with 3 5/8" batts. 3) The x-ray room will receive 1/16" lead sheetrock. 4) The mammography room does not have lead sheetrock. ACOUSTICAL CEILINGS 1) The existing acoustical ceiling system will be patched as required to accommodate the new layout. FLOORING 1) A $13 per SY flooring allowance is being carried for the new flooring for this suite. This includes vinyl baseboard. The x-ray room, mammography room, bathroom, and processing room will have VCT. The remainder of the suite will have carpet. PAINTING I) All existing walls will receive one coat of paint. 2) All new walls will receive two coats of paint. 3) All new doors will receive two coats of paint or stain. 4) The 50 LF of shelving will receive two coats of paint. BATHROOM ACCESSORIES 1) The following items will be furnished and installed: a) One mirror b) One toilet paper holder C) One paper towel dispenser d) Two grab bars SPECIAL CONSTRUCTION 1) The following items will be furnished and installed a) Lead sheetrock b) One 3'6" x 7'0" lead door 2) The following items will be furnished and installed by Associated X -Ray Imaging. a) X-ray equipment and controls (JBS will wire) - b) Mammography equipment and controls (JBS will wire) C) Acid neutralizers (JBS will install) d) Processors and mixers (JBS will provide cold water) e) %' iew screen The pricing for items a - e are not included as part of this proposal. 3) John B. Sullivan, Jr. Corp. of NH, Inc. will install the lead glass and frame at the control panel for the x-ray machine. This will be provided by Associated X -Ray. The cost of the lead glass and frame is not part of this proposal. PLUT\IBING 1) A new bathroom toilet and sink will be furnished and installed. 2) A deep sink will be furnished and installed in the dark room. 3) Cold water will be fed to the processor and mixer in the dark room (3/4" lines). These lines will be copper. 4) An acid resistant drain with 12' of acid resistant piping will be furnished and installed in the darkroom. Note: Acid resistant piping will connect to regular cast iron piping at the 12' point. 5) An acid resistant flue pipe will be furnished and installed. SPRINKLER - None included. _HVAC l +The existing HVAC system will be reused in this suite. Registers and diffusers will be located as required for the new layout. 2) The processor will have a direct vent to the exterior. 3) An exhaust fan will be furnished and installed in the bathroom. ELECTRIC 1) The following items will be furnished and installed: a) New 200 amp main breaker and subpanel. b) Two new 100 amp breakers, one to feed the existing panel and one to feed the new x-ray equipment. C) One new 100 amp feeder to this suite. d) The existing panel will be relocated in the suite including all circuits and the feeder. C) One circuit under the reception desk with two duplex receptacles. f) One 2 x 2 fixture in the bathroom with exhaust. g) Install four GFCI receptacles (One in the bathroom, three in the processing room). h) Install power requirements for the x-ray equipment as specified by Associated X -Ray Imaging (4/12/94). i) Install one 110 volt circuit for view screen. J) Install two "El " switches which will connect directly to the x-ray and mammography equipment. The x-ray and mammography equipment will have a simple electrical connection. This equipment is prewired to accept "El". k) All emergency and exit lighting to code. 1) Two conduits will be fed overhead in the X-ray room to 12" x 12" boxes on each end. The electrical contractor will pull the wires throueh his conduit. m) in the mammography room from the door switch E1 we will run ?, -'18 wires through a conduit to Mi. n) The processor will be provided with 220 or 20S power. It draws 30 amps. o) Three switches will be furnished and insualled. P) All necessary permits. q) The panels %vill be labeled. r) The electrical pricing does not include phone wiring, computer data wiring, or electrically stamped drawings. S) As built electrical drawings will be furnished at the end of the project. GENERAL CONDITIONS 1) The following items are included: a) Supervision b) Project Management C) Structural Engineering for equipment loads provided by AXI. d) Building Permits e) Rubbish Removal f) All necessary labor to complete the above scope of work. k-uu410 u P,ECEPTIC)N ----------------- t4- Ei IWA I T I N F -1111-1 L= Li ii 0 SAD 16 b D r x 141 777 0 SUSSIERE ENGINEERING 1217 Elm Street MAN--HESTER, NEW HAMPSHIRE C3101 (603) C 2.2638 Er4 EC6 C .JOG �.r�� !J i �r, � � � � �F �%,� ✓� �C ��'� +' amm uc. or CALCULATED NY DATE 7 y CHECKED IY DATE iCAIC � r• c_ r F �x 3 / /' R \ --•-�-��Trv— L \ 1 \ \ 'TE,�'G l� k t AR �Ju I�-- !�Fp Ae,dlOXJIL `t 1UN 21 em @Ft ;i�3o DEQ*AF�REJiE�!'I ASSOCIATE 4/12/94 t'iI GING CORP. SALEM RADIOLOGY NORTH ANDOVER OFFICE SUITE . SITE SPECIFICATIONS / ENGINEERING. I. X-RAY SYSTEM "A_ 208 ei tole Phase flush mounted diScn'tnect, hottcm od`c ``« :h,)ve finishcyd , _. " i2"x12"x4" _ bn :lash mounted at floor C /L 1 f-r,,M cnrT:er "C« 12"zI2"z4" J hoz flush mounted bottom edge 28" above floor locate near rt'ht rear corner of room. "F i" Normaliv open door switch Edwards type or equivalent rated 115 VAC, 1 amp WIRING "A" to 'B" two one #T 8 ground 10' pir tails "B" to "C" two ;4 one #8 s*round ten "12 twenty e)6 l0'' nic;ail both ends "B" TO "F I" two f 18 All wire to he -,;-2n6ed TH HN cmmner. Sunni- ten each 1 1 /2" Romex connectors with hirShincc and ei__^nt each 1" Rornez connectn:"s xvith hushin^c II. M AMM 0GR.AP14 ' S�rSTF.M Power supply for rr,3mm(g a^hy unit "M" 20R phase di. connect 60" off finished flog " 31" Summly%feed from "M, " F' nictail -\vith SO nr SJ t -\,Pe cord at marked l,>catir.n R" from corner of room, ih" ahove finished floor. III. DARKROOM /PROCESSING 208 vnl:. 30 amp discnnnect and feed for automatic film Proceceor rt Minimum 2" open floor drain (no hrass or cnPnerl "?_" Cold «ate- feed 22" above finished floor kith shutof-, clear cartdriSe filter, and any aPPlicahle hackfiow nreventor v2lves per local code. TF,:–:' AROVF- ENGINFERING SPECIFICATIO'N'S .ARE OF A "GENERIC X-RAY" FACILITY AND CAN BE MODIFIED, ACCORDING TO SP1=CI: IC FQU1IPA,1,ENT AND SYSTEM—S BE1NG INSTAI-LFD. " Sul ---------------- ------------------ I IJ Ju J �y AOR HA�VrIf.J P�l�(P DF "� �� IV � �`-"_� L• u� � 5I`-"� �-.;.��.1`:��-- -moi N i G s - 0.o J i fil GoRRIc�� CERTIFICATE OF USE & OCCUPANCY ,:;wNorth Andover Building Permit Number 260 Date AUGUST 29, 1994 THIS CERTIFIES THAT THE BUILDING LOCATED ON 565 TURNPIKE STREET - SUITE #86 MAY BE OCCUPIED AS DOCTOR OFFICE IT -UP IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO Barcole Realty Trust 565 TURNPIKE STEET ADDRESS ,,NORTH ANDOVER MA Building Inspector t' CN S•i E I �I O F=04 cc CV O ori O CO C ;;C O C V H :oma ao tlx: t O •%': CD VN = Ea o C3 d o a 1 fEIS' mod z o0 +. L a r C.) c C i O • `: N a. 3 C T R O:yc CC Iv: - N 1: coo act �j N 4i T :tL c N d O � C.3' N O : cc :a F- N mom~ W O � +L-• C r.+ •N aL O C B•- �E c� -o CO2 ch uj W C.3 m C V m COD a. m� O_�CD E d N :O O i N C C, CD C: cm c m `o cm C �C O N m Z O Z 0 M r Ei3 r uG V F-� O cm C ca p 'o E. m m co 0 CD O i O O i CC O d S C) Cc V —3-0 •a o .w C Z CD V CO) C R •C J Q z z O LLJQ z 0 U I W CL z U-1 Q cr w M J Q z W Q W W U) + o v ° x H a G D aw C, a v x w z v O °�° w = > ca°�° o ri cn G c° w2' U w G cL cin U. G rL w c4 cn rn E I �I O F=04 cc CV O ori O CO C ;;C O C V H :oma ao tlx: t O •%': CD VN = Ea o C3 d o a 1 fEIS' mod z o0 +. 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O = A � 4- 45 E m d N s N O Z30 N C1 m C: cm c 000 O cm c 'c N m 0 z 0 O y'.Lr U i �s I 1 QQ/ rrD 1 L U I^ cm L C_ H � � y O •O m m /co H L ii.n •� co cn � O.G L L� 0- O7 Q C O C •y Z C.1 O y V R C Q CO) G cc LU z Cl - a n r LU Q w cr 0 a o 4 k I, O w �- x O H W � fl a A z z � u� � Q m C o ►� C -C �J W ® v`� W 2 j. v v 0 CL W G :3E 1.4 �' °�° m u W °�° � w x _ °�° @ w � u w° cn w a0' U w u: n�' cn m� cn cn az o c w • L O N C.3� a� c 0 L E Q �• ; o d Mme+ •L w C c N C O co Q� • � r: O IS 'n � JY' : cm c N Cd L y� C N 0 2C333 A hi m N CC N N �*d CD cz Q V i c o Q V'a,cz CSas o y O Cc,, o .� �ao H o c W c �� LL 'y m R E =2 C H N •n= - CO �E w�wcm v m wow COD d m. O = A � 4- 45 E m d N s N O Z30 N C1 m C: cm c 000 O cm c 'c N m 0 z 0 O y'.Lr U i �s I 1 QQ/ rrD 1 L U I^ cm L C_ H � � y O •O m m /co H L ii.n •� co cn � O.G L L� 0- O7 Q C O C •y Z C.1 O y V R C Q CO) G cc LU z Cl - a n r LU Q w cr 0 K E B B PROPERTY MANAGEMENT CHESTNUT GREEN AT THE ANDOVERS 565 TURNPIKE STREET, SUITE 82 e N. ANDOVER, MA 01845 " (508) 683-3574 July 8, 1994 Town of North Andover Building Inspector Robert Nicetta 120 Main Street No. Andover, MA 01845 Dear Mr. Nicetta, __7' our,(.request. I'm writing to inform you regardin Suite 87 "565 npike Street, No. Andover, MA 01845. sed on the plans submitted by Salem Radiology, on behalf of the Trustees at Chestnut Green at the Andovers these plans were approved providing they are in compliance with North Andover Building Code. Should you have any further questions please do not hesitate to contact my office. Sincerely, AI41an . Sheehy nt for Chestnut Green-' at the Andovers BJS/lam 1 E 51994. O FM4 W cd EFl * *- x w A aG �w° cn c•n�- Icza ° w � z z A � o wc °P4 � E U w w 24 z z �� om ° a u x U �W P4 > C/5 co w x p U w z w w A w� a°, cn O� �oo cn 4 O .L J� CD cc LM N 0 CL z :;C C C V O � O N o a � : ac M ca CD c o .: CD � 0 : as CO �a . o c is f E N TLL 0 CD O O N m m d d N N r. Of W d 'Q C CO O to N 0 d RCL 6 os N m i t = O Qf C C7 H O i C'O :coo cm CLc CD CD 1*4 � � y O C •C CO) �-. OLS. m LU .y �CL2 Z cW.2 .CD om=c g y CL .8.== .5 0:5 2 AH•� O �. ._s .ZZ a= m L U CD O CD O O D y CD CA L CD C O CD G) _Q a - 0O2 C O Q Q .Q CA C 0 V O W CM C O .= COO m H � Q i co 0 Q Q C. C. cma C � C Q Q J .a O CO Z C_ H C J Q z CL AS:_.„OCIR T ED )1F,,AY I IH IN TEL No .50,0-521—?214 Jun 20 , 94 10 : 213 No. 005 F . 01 . ASSOCIATED X-RAY IMAGING FAX COVER SHIRET DATE:.G> �_> ,lam: _ TIME : -S, PLEASE DIRECT THIS FAX 'iCi:�._. COMPANY': Ale A THIS FAX IS FIS®M:�---�-- 441-1 Associated X -Ray Ima Zn Number o gage :- ` (Incluc n,g cover page, If all pages are not received Tease caH: 800-356-3388 M FSSAGE: i ti' /” � 1 �,��Cr, G� C%uY�-h c (� r �-1 � ,c. �,`•i'%.<.t/2�'-s:,..c� ��r-7. c�.i Ct_... Lam' 1.,�� i [_ � }`G•Zfc`K...v � •�uL, �� .�'. �'r-.r • r'�-EC bE-c�C' l O� ��_ :;:� �:GG �lLJ ,c f (] r 7�1 c Rie r f;�:i � f E JUN 2 0 1994 ! Number:/_ —c2926 - — i ASSOCIATE;) ""RAY IMAs IhJ TEL No .508-521-2214 ?u.n 20,94 10 23 No.J05 P.02 GREATER LAWRENCE SA�e�TA�1' DISTRICT RICHARD D.tULLFR,ACTINGE ECUIiVEWRECTOR LAWRENCE ANDOVER LEONARD bEGNAN ROBERT E. I&QUADE Ci.EMENTP ABASCAL NORTH AND JAMES M. GARVEY; CHAIRMAN G0OrUiE SLITTER MEMTHUAEN, COSTA SALEM., N.I4. CHARLES P. HOMPSON EVERETT MtBRIbE T ATTY. J01IN T. POLLANOt CPA TRE"URPR June 16, 1994 Mr. Bob Nicetta North Andover Building Inspector 'town Hall 120 Main Street North Andover, Ha. 01645 Rea Discharge Approval Treated Rhotographic Wastewater Dear Mr. Nicettae Following a review of the information submitted by Andy Mammay, Associated X -Ray Tmaging Company on behalf of North Andover Radiology Company, Chestnut Green, North Andover, the District is approving the connection and installation of photographic equipment and discharge of wastewater from the above-mentioned facility with the following conditionba * Developer and fixer must be treated before disposal for silver bearing compounds Treatment units must be capable of removing silver to 1.0 mg/1 at the discharge Spent fixer and developer must be blended at the discharge point * Mixtures must be disposed of at a slow flow rate Any problems relating to the operation and disposal of waste must be documented on --site for review by the District 240 CHARLES STREET • NORTH Ak."DOVER, MASS. 01845-1649 • TEL. 508-685-1622 FAX: 506-685.7730 IFE UN 2 0 1994 240 CHARLES STREET • NORTH Ak."DOVER, MASS. 01845-1649 • TEL. 508-685-1622 FAX: 506-685.7730 ASSOCIRTED XFIH`�' IMA IN TEL No . 5,1--"X-521-221 --1 .3 u t -i 2 0 - 9 4 10 : 2 3 N o . 0 0 5 P .073 14r, Bob Nicetta June 1994 Paeje The District is approving this request with the conditions ratanding e that if notifiedconditions change outlined above and with the unde b fied immediately - at this facility# the District will Should you have any -queationfs or comments, Please feel free to contact me - very truly YourOt GREATP,R LAWRENCE SANITARY DISTRICT n P, C3' Mare dustrialntrial Pretreatment 14anger jpo/pao Cl Andy MaMMaY JUN 2 0 994 f', \ ( \ � \ \{\\\ \ \ ) / aG/ -;21 z a 2 C) . ;2! c Mo 122}7�2 ? - Zz aG 10, -9& m m \ m / { � . .. .. . . . .. . . .. . .. . . . , . . . , . . - - �x��z��':��592?my»m2»z©:�>2«yy«»�s4«:w».w2.y©» I??� w -n -0 of:� /co m/ Mo 122}7�2 0/ƒ\\�}■ Zz \\ /$ _/�) d �> 2\�/ �2- §4 $��D �`■ /ƒ /Ek _\ � . .. .. . . . .. . . .. . .. . . . , . . . , . . - - �x��z��':��592?my»m2»z©:�>2«yy«»�s4«:w».w2.y©» JUN 28 '94 16:27 William F. Weld Covemor Charles D. Baker Secretary David H. Mullism Commissioner P.2 RCN: (in Progress) Associated X-ray Imaging coo Andy Mammay 49 Newark St. Haverhill, MA 01832 Dear Mr. Mammay: The Radiation Control. Program consisting of floor plans, information, and use factors. June 28, 1994 RE: Shielding design for North Andover Radiology Chestnut Green xray suite North Andover, MA has reviewed a shielding design workload information, occupancy itted The Radiation Control program Is 01 mance the pwith radiologicalthbhealth shielding design is drawn practice and hereby approves it. Compliance with 105 CMR 120. the Departments Radiation Control rules and regulations, require in sub -chapter 120.103 (b) and (c) that each person that intends shallapplyto theMassachusetts smaintain facility acquire a source of ionizing radiatio department of Public Health's Radiation Control Program ra to regi ter the facility prior to acquiring, installing to maintain the facility. The enclosed "Application For Registration of Ionizing Installations. + shall be file with Program Massachusetts according ton the of Public Health's Radiation con regulations outlined above. S cerely, • RIO M. MLISEY irector Radiation Control Program RMH/LVH-W/ecc H-�'.-,-S't-CtATED �:RHY I IIAG I 1�1 TEL Nci .508-521-2214 J Un 28 94 14 :23 h,io .010 F .01 ASSOCIATED X-RAY IMAGING VAX COVER SHEET DATE- T I M F.:. A PLEASE DIRECT THIS FAX -r6-,- 16-7;c1' 1C',"7/ COMPANY: THIS FAX IS FROM: Associated X -Ray ........... Fax'# 508' Number of Pages: (Including cover page) If all pages are not received please call: 800-356-3388 MESSAGE.- JUN 2 9 99A Recipient Fax Number: _ _s N `+ L! i_:1 N T E Ii X r' n 7' i �+ C� l h " . 5 �; - )11 h9 ! TEL In -"t -221 71 .jun 28 . 94 14 23 [%I .010 P .02 s June 28, 1994 Bob Nicetta, bui tdina Tns.Pector North Andover, MA 01845 sub ject $ North Andover Radiology Chestnut Green Mfr. Nic,ettas Y i just received verbalaPPrOval ArrJT? Baum 6�il'�J`8� Massachusetts I�adison of at'On ^ont cl fur the shieldingdesign for North Andover Rad4 ology. Fcr!Pal Written approx al will take a feta days tQ get through the system. issue the permit so we Please can get the project under way. Enclosed is a eOpy of the shielding design. Regards, Andy Mammay Project Manager AJM/rmc Enclosure MEDICAL X-RAY SYSTEMS 0 EQUIPMENT SUPPI_IF�; * SERVICE 2 9 1994 t F .JUN p MEDICAL X-RAY SYSTEMS 0 EQUIPMENT SUPPI_IF�; * SERVICE - � tR 1-1 IZ 0 C'T � HT ED 1 h--IRG i N TEL No 1-22'14 3 u. n 2 94 14 : 2, -3 N C, 10 P . Cj 3) co C-4 1p, I 0 inn ru 0 n LQ 3 u. n 2 94 14 : 2, -3 N C, 10 P . 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D y Z y ? N O O Z= c Z o n A W y A mxolo O OO„Oo,u+{ 3T T Gl NyOA DZ m A'�M0x ONx c A y 1 O? C A �� y A T Z v T Z n x o A Z zl0 � 0 3 c 3 C m � C z a y G D D* v n (inpN 00� Ov 00 N O y n 0 MOO_ ; Z Z 3 0N v o� 0 0 i �2 O N T Z < W co n LO00 n N A� D; >clz N .. icnn 0 to D z y i T A T y NZ2 T m r O T T w 0 { p Np� M- Z lc z Z { 1 (A0I . H a1Zp m U, rTomas C DAN m000 w v F_ -�C)r- I` vm0 - r• : Day' os m 0 0 C O v x Z<Npm A� OD C 0 to D z O Tp i Z Y A NZ2 N A N 0 r O MXN 3nu► { p Np� M- 10 Z -IZD N_0 (A0I . a1Zp m U, rTomas C DAN m000 w v F_ -�C)r- I` 1�.`N 6 N U) . Zm MMO yo NZ2 Cox MXN 3nu► - 0�0 Np� M- r vmJX. -IZD N_0 (A0I . a1Zp m U, rTomas C DAN m000 w v F_ -�C)r- O vm0 - r• : Day' os m ` oN v �D. f1 Z In . mm D3 OFF APPEALS 1'. ;t! ! ' NORTH ANDOVER BUILDING DIVISION OF CONSERVATION HEALTH PUNNING PLANNING & COMMUNITY DEVELOPMENT • KAREN H.P. NELSON, DIRECTOR North Ancove . Massachusetts O 1845 (617) 6854775 r > In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number "e=- L--*--) is that the debris resulting from this work shall be disposed of in a preperiv licensed solid waste disposal facility as defined by ,MGL c 111, S 150A.. The debris will be disposed of in: (Location of Facility) / `7 A NOT=: Demolition permit from the Town of North kndover must be obtainer for i Inspector. this project through the Office of the Building C' 4- ON- ON W z h IrAI� VI cd w A o w° a cn o z z00 W - o w° :to 3 a v c E U w O w z '� °�° m w O w W x °�° ig u cz > ci) m w o u a cG w w c ` w v ° z cn 1 Q v E cn ui Y' ' O O C a.. r . p y �• ` A R r C O O i O CF Ea m •�': as a ts y o.c Ire • c . o 0 v .. r CD o. 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Z F c o a eo cn cn m ^n o C/) o _. aa =r- a tis F CL O O ^ r -< O r ° a z O • X6 4 A r GENERAL BUILDING NOTES/CHECKLIST- NOT LIMITED TO ITEMS BELOW POST ALL LOT NUMBERS, ADDRESS, ,AND PERMIT (COPY OK)..or no inspections INSPECTIONS: (Minimum) Excavation , Footing, Foundation, Frame, Insulation, Final. FOOTINGS: Continuous Full 2x4 Keyway Continuous strip footings for interior columns FOUNDATION: Rebar as required Anchor bolts or straps Damproofing Foundation drain - pipe/stone/fabric filter/cover and outlet connection. FRAME: Fireblock - over girts/plates between floor joist Penetrations for plumbing, heat, elec, etc. Walls at stair stringers. Windbram corners and center bearing partitions. Size ridge to provide full bearing at rafter cuts. Hip and Valley rafters - watch bearing at walls. Ridge & Hip - Provide proper connections. Cathedral roof rafters provide proper connections and use "Hurricane Clips" tie to plate. Stair stringers - watch cuts and heal support. Joist hangers - fully nailed w/ hanger nails. Sill plates 2-2X6 (1 PT) w/sill seal. Girls - solid brick or steel plate bearing at foundations air space at sides in foundation pockets. Lateral bracing at ends. Certified calculations. required for Beams/LVL's Trusses. j Solid bearing support for Headers/Beams etc. Check headroom clearances - stairways, under beams Attic Access. (min. 22x30 w/3' headroom above). Crawl space access. (min. 18x24). Bath exhaust fans to have metal duct to exterior (not in soffit).. Firecode S/R wood frame of "0" clearance fireplaces & stoves Window Schedule or Every Habitable Roorrl,Must Have: Natural light equlr to 8% of floor area. '/ of required.glazing shall be openable. Bedrooms required min. 20x24 egress window or door. Vent attic spaces - "proper vent", soffit and required ridge vents. Firecode under stairs if used for storage FIREPLACES: Separate permit required. Inspections at Footing - Smoke Chamber - Finish Smooth parging, clean joints, 8" solid @ combust. Surf. DECKS: Separate permit required: Lag to house, provide flashing. Rails min. 36 " high, Baluster max space 5" on center. Over 8' above grade, use 6x6 posts w/lateral bracing. Lag all posts and rails. Pier footings down 48", Conc. pad at stair base. s FINISH: Handrails returned to wall/newall post. Guardrails required alongside open cellar stairs. Exterior grading complete. Certificate or occupancy required prior to occupying structure. Temporary Stairs required for inspection. Re -inspection fee - $25.00 (Be Ready). Certificate of occupancy required prior to occupYinq structure. +a t ^Location? v No. b Date oZ ltd s NORTq TOWN OF NORTH ANDOVER F?O• �•`,o I. 1hO Lp Certificate of Occupancy- $ + ; ; Building/Frame Permit Fee $ 1 �'�b'••'•'•t� Foundation Permit Fee $ SSACMUst Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee TOTAL 7' / tr23 17 Buildin • Inspector PAID 12967 02/16/99 11:48 1pd nn Div. Public Works Mr. ■■3 I XI d d c Q w� � a O M F 0 � w m O � m O pa Qa V1 N zz U zz a � Fv� d A I� Mr. ■■3 I XI O z Q+ o y �o u o d z o ,z � z z x o y 4- - W ¢ mQ A A d c Q w� � a O a� F 0 � w m 3 F m O pa zz U zz a � Fv� F O z Q+ o y �o u o d z o ,z � z z x o y 4- - W ¢ mQ A A C d c Q w� a O a� F 0 � w m F U a EF Fv� F I� C1 V C d c Q � a O [� V A o F 0 � w C • r� w A w z a a P � a W A L o w° > a Cf) zo 0 w° t :' a U w a 0 O G W w D0 O G Ci p G w d v) v O cn +� �CO c C V O = • � C H C r O ca L) .n Mm ® O CD i m �0n N e` : C v: � N 16- � �: H Ovo :t; rn Qm c �N O Qc m m N 4. Zn Cc m �0 aco3 ® ♦: LO, m m p,Ct O• O N O op o n mN m C = m O.2 O CO LL C eo _-+ - L C!.S •CA •� V V O) y n m� c. C42 CL= m i H = ,$ CL..- CO E v O N L N O N C O A cm m cm .O m 0 m �C N m 0 Z cm J O O V. I z O U �1 Mi 4 co CD C C H co co •� W W L O CD C ~ � 03 0 0 C13 I- M CDd CL Qi Q CO2 � CD c cv � J _ J •� .FL O CD C Z Q CD V y cc .0 C CL CO2 Q FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. --��--•••-•*•*•••*~"*"*"�*APPLICANT FILLS OUT THIS SECTION' APPLICANTS �i % �•%f I �`—�G�` ��y �'� PHONE Z/%�/ j �. ,,LOCATION: Assessor's Map Number PARCEL SUBDIVISION STREET___ LOT (S) ST. NUMBER a- J 9-6 --r--=--------*--•.*••..••**"'*'"***'OFFICIAL USE RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR COMMENTS TOWN PLANNER COMMENTS FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMMENTS DATE APPROVED DATE REJECTED. DATE APPROVED DATE REJECTED_ DATE APPROVED DATEREJECTED- DATE APPROVED DATE REJECTED_ PUBLIC WORKS - SEWER/WATER CONNECTIONS DRJVEEjW�AY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE N2 2274 NORTH 0 Date .�2: ....... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .... .15 ........... ... . has permission to perform,-,.'I� .... ......... 4.74.. wiring in the building of Z.................. ................... ............. ...... ............ '4r - at ... .................... I . .................. North Andover, Mass. ....................................... ELECTRICAL INSPECMR 02/23/99 09.-57 100 M X -CA -It WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 07:37A j b sullivan jr corp of n THEG0AMAffF4UH0FMAS'S4CW5= DEPARTAf 7iV •OFPUBUCS4FM BOARD 0FFREPREVIMT0NREGUL4TI01V 57/CNR 12.-00 P.02 Office Use only Permit No. a % Occupancy & Fees Checked -� APP11CATTONF'OR PII Aff TO PERFORM =CMCAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSAoiUSSTs ELEc-m AL CODE, 527 cwm 12:00 (PLEASE PRINT -IN INK OR TYPE ALL INFORMATION) Date Town of North Andove? To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) S4,,- vEt4 f.7R KF Llnlf� Owner or Tenant�— Owner's Address -.S(A s, -r,-,e pi'm S4. , 26 Is this permit in conjunction with a building permit: Yes IZI No a (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead a Underground Q No. of Meters New Service Amps / Volts Overhead Underground = No. of Meters Number of Feeders and Ampacity Location and NatureofProposed Electrical Work ! .r -A �p V--Out0i£x O __41, I I-st�i:�i, No. of Lighting Outlets No. of Ho( Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground 171 grourid. No. of Rcceptacle Outlets No. of Oil Bumem No. of Emergency Lighting Battery Units No. of Such Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total r Tons No. of Detection and No. of Oisposals No. of Heat Total Toted Pump3 Tons KW Initiating Devices No. of Sounding Devices _ No:lof Dishwashers Space Arae Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW Connections a No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro tdamage Tubs No. of Motors Total HP OTHER' 11- ve ILI 4 -Le t • i :• . • ;.:• •.: .:•r .. ZY .: •: 1 FAXMW Dam Fs mai:dvah d1kc:nml Wc& S Raigh Faai LimrwNa &4 yy L, a TZ a /.A,.,.� u., K �; _ s em -� Ire I�io 1.7"!�/�i� 0 Buss Tet tufa a D ale Y- S_tllr Alt Tet Nct OWNER'SNEURANCEWANFR lamauaethatheLi tio0rpthgtetherttstrarz cue t> es stt�rimic�tital3castt�gmedby�C Laws and that my �ueo-t the p�nit a�bc�art wai.es 4`is �� (Please check one) Owner o Agent Telephone No. PERMIT FEE S r' N .. fn t � CL LLI M CC M 3 W m s m p - - z C.0 � c Location -111 rti 121 (` No. Date o -( ♦ i ssACHU Check # .2 n TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL 16154 Building Inspector The Commonwealth of Massachusetts 56'S- Ttrv-yAp t 1" 5+. U01"K 76 � 7 State Board of Building Regulations and TOWN OF NORTH ANDOVER Standards BUILDING DEPARTMENT Massachusetts State Building code 780 CMR Address APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE OF OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING Building Permit Number: 3 9 cr I Date Issued: '1 ` ( O _ 07 0 0 3 Signature: A /it Lam` Building Commissioner/Inspector of Buildings Date SECTION I- SITE INFORMATION 1.1 Propgtty Add i 1.2 Assessors ap and Parcel Number. Map Number Parcel Number IA Zoning Information: 1.4 Property Dimensions: Lot Area (sq) Frontage(ft) Zoning District Proposed Use 1.6 Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided 107 Water Supply 9M.G.L.C.40.4 54 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public O Private b Zone l Outside Flood Zone o Municipal Q On Site Disposal System 2.1 Owner of Record C -e'O L T v-us-�- 56'S- Ttrv-yAp t 1" 5+. U01"K 76 � 7 Name (Print) Address: 9-77- 6a9 Signature Telephone 2.2 Authorized Agent: Zo Gt n H� n A 6 1 1 Name (Print Address Signature Telephone STi r rTnN 2 rnNSTnTTr TTf1N SRRVV97S vnu Pi2n rr `TS T FSS THAN 2Q ann rITRYC Rri FT nv rNjrT ncrn SPArr 3.1 Licensed Construction Supervisor: Not Applicable Q Licensed Construction Supervisor: O ✓C, U✓� l J V -00j t/\ License Number C S O 7 Z2 Address r�60 ViuG- Expiration Date t 2 _2 l -Zooms 3 6<h -17T1 Signature Telephone 3.2 Registered Home Improvement Contractor. Not Applicable Q Company Name Registration Number Address Expiration Date Signature Telephone Kevised PJY/ JMC; SECTION 6 - DESCRIPTION OF PROPOSED WORK (check all applicable) New Construction (3 Existing Building G) Repairs ® Alterations Q Addition Q Accessory Bldg. 0 Demolition 0 Other [3 Specify Brief Description of Proposed:to '� � � � �� r � � �C.X �S Wei' �2� ii✓t S �(�zlr SECTION 7 - USE GROUP AND CONSTRUCTION TYPE USE GROUP Check as applicable) A Assembly A-1 A-2 A-3 A-4 A-5 B Business 0 E Educational Q F Factory E3 F-1 F-2 H High Hazard 1B I Institutional Q I-1 I-2 I-3 M Mercantile Q 2B R Residential 13 R-1 R-2 R-3 S Storage E3 S-1 S-2 U Utility Q Specify: M Mixed Use Q Specify: S Special 0 Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS. ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index (780 CMR 34) SECTION 8 - Building Height and Area BUILDING AREA Number of Floors or stories include basement levels Floor Area per Floor (sf) Total Area (sf) Total Height (ft) CONSTRUCTION TYPE IA 13 1B Q 2A 0 2B Q 2C 0 3A 13 3B Q 4 Q 5A 0 5B 0 Proposed Hazard Index (780 CMR 34) Existing (if applicable) Proposed SECTION 9 -STRUCTURAL PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes Q No Q SECTION I Oa - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, , As Owner of subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Date revised bldg form/state JMC t FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** 1\ fi APPLICANT LNk" 7 iZs- PHONE b G 3— 7 1 771 LOCATION: Assessor's Map Number 2-5PARCEL SUBDIVISION LOT (S) STREET C 5 Tv► -'Y) P, �Q---� 1 ST. NUMBER nr ro do0-P.c— �t1�aj�L0 ************************************OFFICIAL USE ONLY*********************************** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER COMM FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED I PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT — FIRE DEPARTMENT O RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm NOTICE TO EMPLOYEES NOTICE �TO EMPLOYEES The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 - http://www.state.ma.us/dia As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I (we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: ACADIA INSURANCE COMPANY NAME OF INSURANCE COMPANY 23 COMMERCE DRIVE, BEDFORD, NH 03110 ADDRESS OF INSURANCE COMPANY WCF-0059694-11 POLICY NUMBER Chase & Durand Aswsoc. NAME OF INSURANCE AGENT 04/01/02 - 04/01/2003 EFFECTIVE DATES 119 Walnut Street, Manchester NH 03104 603/669-4557 ADDRESS PHONE # John B. Sullivan, Jr. Corp. of NH, Inc., PO Box 10716, 25 South River Rd., Bedford, NH 03110 EMPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) MEDICAL TREATMENT DATE The above named insurer is required in cases of personal injuries arising out of and in the course of ,employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the ser- vices provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER 'C 2001 G.H61 I a CENTIS-Company 720 Inscr—ional Pukway. Sunrisc, FL 33325 Call 800-999.9111 or shop online as—HROne.corn to reorder Worken' Compemadon (Larnimsed) ORI-ENWD (Non -Laminated) tR11-DAA10 0109 Rmuircd by: Mass. Gcn. Laws Ch. 152 Scc. 21 (fur all cmploycrs). H G F E D C b CEILING HT = 92" H G F E D C B B ASSOCIATED X-RAY IMAGING CORP AMATORY NORTH ANDOVER RADIOLOGY RADIO RArxic ANDOVER, MA SUITE A A BY: R. LEIBE FOR DESIGN PWOSIE PMEUM WY OW -M -3M /! FAX-rM 5212M air tPl t'.o inew t of t 8 7- 6 5 A 11 3 0 � 1 /20 '� l� I GD G/rrnG[Q� �_ l `'O 44 co K Co„ do 4 N_7 Z C�4' ``�2-0rs8-��/ //�� G D C ASSOCIATED X-RAY IMAGING CORP ANDULATM WORTH ANDOVKK RADIOLOGY RADICCRAPMC sum ANDOVER, MA A BY: R. SEISE room* =,=-lM Il FAX -M 5212214 mot ICFi 8 7 1 6 5 4 3 2 1 H F D C SHIELDING SPECIFIC i SONS IUU NORTH ANDOVER RADIOLOGY GENERAL ASSUMPTIONS A. Waidoed: Radiographic Room- 45 mA'min per week at 100 kVp to wall Cassette holder, equivalent to 15 patients per day. B. Occupancy Factors and Design Expowres Assume that the wall along which the x-ray machine is p1ac*d is Well A, and the wall cassette holder is mounted on Wall B. Roomlbarr er ¢==V Qesigp Ennwa8Mmk Wall A 0.125 2 mR WAIL B 0.125 2 mR. Wall C 0.125 2 mR {door C 0.125 2 mR Wall D 0.125 2 mR Contral Booth 1.00 10 mR Floor 1.00 2 mR Ceiling 1.00 2 mR C. Construction Details: All interior walls, disregarding shielding, are two thicknesses of 51&inch gypsum wallboard. There is occupancy above and Wow the Radiographic Room. The door and ceiling heights are 12 feet, 8 inches. Wall C is taken to extend from the Control Booth partition to Wall B since that Is the only portion that requires shielding. D. The x-ray equipment meets all applicable DHHS and State of Massachusetts Regulations_ SHIELDING REQUIREMENTS Wall A three thickness$% of gypsum wallboard in total Wali B: 1132 -inch lead Wall C: none In addition to gypsum wallboard Dear C: none Wall D: none in addition to gypsum wallboard Control Barth: 0.3 mm or 1164 -inch of lead Ceiling: 1164 -inch lead extending 8 feet from Wall B and to the Control Booth from wall A. Floor. 1164 -Inch lead extending 8 feet from Wall B and to the Control Booth from Wall A. The above are the minimum required thicknesses. AJI Dead shielding in walla must extend least seven feet above the finish floor. 7_ Dovid L_ North, Sc. Certified Medical Physicist MA Reg: 65-0003 A WC X-rsy/NaAndovwRgwidoW 11110/02 ASSOCIATED X-RAY RAGING CORP. 49 NEWARK S'TREE'T HAVERH1LL,MA 01832 1-800-356-3388 FAX 1-978-521-2214 e L�L�y"IJ SM SPEC1_F'ICATIONS North Andover Radiology Chest room Turnpike Street N.Andover,Ma "A" 208VAC, 10QA circuit breaker,feed 4/3 SIO cord to "B" box,leave 6' pigtail. "B" 12" x 12" x 4" flush mount electrical box,C/L under window ,bottomedge close to floor, (1) 1 '/,2" ,(1) 1 '/4",(2)'/4" romex connectors in cover. "C" 12" x 12" x 4" electrical boat, surface mount C/L 12" from comer, bottorn edge ,24" AFF. (2) 1 %" romex connectors in bottom,(3)'/4" romex connectors in sight side. "D" Not required "E" Door switch interlock,(Bdwards type 60 or equiv.) (2) # 18 stranded wires to "B",leave 6' pigtail. WIRING "H"- "C" (2) # 6, (#8) gnd, (15) 4 18, (6) #12, all stranded TITHN capper or equiv,6' min Pigtail each end,wire markers on each wire. M €. 1 ✓ �� L/li?tir%ft.�f/iE.Q�i/L '��,.✓��ti':Q[�/�{{lN.Yfitf rrEE 41 BOARD OF BUILDING REGULATIONS �{ License: CONSTRUCTION SUPERVISOR Number: CS 072239 -I Birthdate: 12/21/1959 Expires:.1272172003 Tr. no: 93781 Restricted: 00 GORDON L BROWN 460 RIVER RD I WEARE, NH 03281 a.b 1 Administrator � V u a.o �. ®'� d � � i V � i ` UF L IA � I - � � � � 1 � V �/`1 � \ V � DATE (MM/DDM') UC PROpER 603 -669-4567 FAX 603-669-4108 THISCERTIFICATE 15 ISSUED A3 A MATTER OF INFORMATION O003 Chase &Durand Assoc. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 119 Walnut Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Manchester, NH 03104 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED JOHN B SULLIVAN JR CORP OF NH INC. JOHN B SULLIVAN JR CORP INSURER A: ACADIA INSURANCE CO. P.O. BOX 10716 INSURER B: BEDFORD, NEW HAMPSHIRE 03110-6708 INSURER C: INSURER D: COVERAGES INsuRER E THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THF 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, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED 15Y PAID CLAIMS. rA NSURANCE POLICY NUMBER ii�� FFEC POLIC RATI N M/DD DAT DYY LIMITS Y PA0005754-18 /2002 04/01/2003 EACHOCCURRENCE $ GENERAL LIABILITY 1'00+� FIRE DAMAGE (Any one fire) $ 2 5D 0 ADE X� OCCUR � MED EXP (Anyone person) $ ` S.0 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY iEU JECT !OC J OMOBILE LIABILITY�_ANY AUTO ALL OWNED AUT03 SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS GARAGE LIABILITY 7 ANY AUTO EXCESS LIABILITY ] OCCUR EICLAIMS MADE A DEDUCTIBLE RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY A A STALLATION FLOATER y ONTRACTORS EQUIPMENT DESCRIPTION OF PERSONAL R ADV INJURY $ 11000 )05731-]804/01/2002 05760718 59694-12 66298-12 XCLUStON8 ADDED BY ENDORSEMENTISPECIAL 04/01/2002 04/0],/2002 04/0./2002 PROVISIONS 04/01/2003 04/01/2003 04/01/2003 04/01/2003 GENERAL AGGREGATE $ 2 OQO, PRODUCTS - COMP/OP AGG $ 2,000, COMBINED 81NGLE LIMB $ (Ea accident) 11000m (pperson)URY $ BODILY INJURY $ (Per accident) PROPERTY DAMAGE (Per acc(tlent) $ AUTO ONLY • EA ACCIDENT S OTHER THAN EA ACC S AUTO ONLY: AGG S EACH OCCURRENCE $ 10,000, AGGREGATE $ 10,000,• $ $ $ STATU TO Y IMITs X ER E.L. EACH ACCIDENT $ -.1i.000`I E.L. DISEASE - EA EMPLOYE $ • 1 d00 ,1 E.L. DISEASE - POLICY LIMIT 8 1,000 $100,000 Leased, 12erttpd or Borrowed Items ' I HARD COPY OF THIS TRANSMISSION WILL NOT BE FORWARDED, GERTIFICATE HOLDER ADDITIONAL JOHN B SULLIVAN JR CORP OF NH P 0 BOX 10716 25 SOUTH RIVER ROAD BEDFORD, NH 0311.0 FAX: (603)647-1888 INSURER LETTER; tNCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE "IFIRATiON DATE THEREOF, THE 19AUIN4 COMPANY WL.LENDEAVOR TO MAIL DAYS WRr)7EN NOTICE TO THE CERTIFICATE -11002R NAMED TONNE LEFT, BUT/F,yILUI`W-TR\MAIL SUCH NOTICE SHALL IMPOSE NO 09LIOATION OR LIABILITY O ANY KIND )4N THE COMPANY. r-AAERM OR VEPRRSENTATNE3. ORIzE WRESBNTATI M3 x Fy x a � L LL N cn °u w � c� Q W G w Ob E U u, w a w ao' w O a w 04 cn w x p N z d w z w w Q W w rA z cn o v v� CO) co CO! .co L CL CD G 0 co 0 ey CO, 0 V .Q CO) G Cl V m L O V co C. CO) G CO CM C o .0 co m m C O C •`'�: me J :ccs C. C7 • O y O •Cyi \' . C� Ij ' co CD C t a IE a 1� Cef �. m . m E S c.1 o m co E w:y v ` ca L " cc Fan • c�m0 C Q L:' acs yco 'o (Y� v > z o Q = C m CO2 m O 3 O N L r.+ C� CAA CitC `r m .y Z O C.3m O p m E C O O� CA m'� o y CD CO) co CO! .co L CL CD G 0 co 0 ey CO, 0 V .Q CO) G Cl V m L O V co C. CO) G CO CM C o .0 co m m .0 C C. /771 A�03 U 4-4 m N 0000