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Miscellaneous - 65 FLAGSHIP DRIVE 4/30/2018
65 FLAGSHIP DRIVE 210/107.C-0076-0000.0 J 1 Leo 'own Am ovER ioun.Di1 'DEPARTMENT 1600 Osgood Street ��sRCflLlS�K . No#A,"doh ' r TI: 979-698.99545 Fax: 979.688.9542 NAME J�►�c�S C , �� l�c�n t�S �i 0� 1 v iv,) k4,f)''I ADDRE ;^ ,4 T� T. ' '� F IS � . TYPE,OF BUSMESN-4L Z0NM BYIAWU,9A. E: 'YES TOR EUSIMssFORMFORTO MCLBRX 2.4a ITOMe Occupation(1989132) An accessorsr use conducted within a dwelling by a reszde�� who resides is the dwelling as .bis prinoipal address, which is clearly �ccondacy oto the use-of the building for Hifi proposes. Home occupations shall 'incTiide,"but iiot'.Iimited to the following uses;personal services such as famished by an,artist or instructor, but not occupation involved wiih motor vehiclo repairs, beauty parlors, animal. kennels, or the conduct of retail business,ox the a„ufactUring ofgoods,which impacts the residmflal rtaturo ofthe neighborhood; d. For use of a dwelling in any residential. &td.ct or multi family district for a horse occupation,the following conditions shall apply; a, 1tiTat more than a total of three (3) people mail be emoye rnl;e� o1pe occupation, one of whom shall bothe--ovv iar of the. oane om-apatton and residing m said dtr"elfmg; b. The use is tamed on strictly within.the principal building; o, There shall be no exterior alterations, accessory buildings, or display which are not customary • with residential buildings; . d. Not more than twenty-fivo(25)percmt offho exis hg gross floor area og;the dwelling unit. so used not to exceed ono thousand (1000) square feet, is devoted to'such use. h connecdon.with such use,there,is to be.kept no stock in trade, cotxamoMes or products which occupy space beyondthesoWts; e. Therewill be no display ofgo6&or wares visiblefrom the stroct; f Tho building or premises occupied shall not be rendered objectionabT6 or detrimental to the residential character of fhe neighborhood due.to the ex=terior appearance, emission of odor, gas, smoke, Aust, noise, disturbance, or in any other way became objectionable or detrimental to any residentid use within the ndghb orhood; g. Any such building AA md-ado no features of desip not cusmnaw id b-ulctings for residenU use. t F • t f, Pith Andover III July 6, 2016 807 TURNPIKE ST 098.D-0054 098.D-0044 098.D-0050 Willow Street, 168- 60 WILLOW ST A r tj 098.D-0018 a 30 WILLOW ST 30 WILLOW ST 107.0-0074 10 C-0072 35 FLAGSHIP DR M 37 FLAGSHIP DR +L 33 FLAGSHIP DR `y 107.0-0075 31 FLAGSHIP DR -j&::- .. �� 39 FLAGSHIP DR ,02510=0078 ..._ .•;. alt \\ �\ ,.'0) 107.0-0076 ry 65 FLAGSHIP DR 30 FLAGSHIP D 107.0-0071 85 FLAGSHIP DR A 65 FLAGSHIP DR °= 85 FLAGSHIP DR 'i - 7.0-0113 85 FLAGSHIP DR / - --� � 85 FLAGSHIP DR \, O d .� 85 FLAGSHIP DR !Q _ b it1cc 107.0-0023 115 FLAGSHIP^D . d; 40 FLAGSHIP DR 107.0-0083 107.0-0079 107.0-0078 70 FLAGSHIP DR 025.0-0083 107.0-0077 70 FLAGSHIP DR 01 MVPC Bo Zoning Overlay Zoning 13 Municipal Boundary 0 Adult Entertainment Distdc '.Busine s 1 District 0 Machine Shop Village Ove C Busine s 2 District Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, —Rail Line 0 Watershed Protection Dist C Busine s 3 District Meters Data Sources:The data for this map was produced by Merrimack Interstates 0 Historic Mill Area C Busine s 4 District NQRT&t Valley Planning Commission(MVPC)using data provided by the Town of —1 0 Medical Marijuana 0 Genera,Business District QE ao '1,4 North Andover.Additional data provided by the Executive Office of —SR 0 Downtown Overlay District C PlanneCommercial Dev2 �.�t� 'wee 00 Environmental Affairs/MassGIS.The information depicted on this map is 0.Historic District 0 Corido Development Dist ; L for planning purposes only.It may not be adequate for legal boundary Roads 1:.1 Osgood Smart Growth(40 C Corido Development Dist 0A definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER i r Easements C Hydrographic Features 0 Corrido Development Dist 16 _ l 7i MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING Industd 1 District # THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY ©Parcels - Streams ^.Industri 12 District • t OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT -:Wetlands C Industd 3 District o __- t, f ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF C Industri I S District C Exempt Lands Reside ce 1 District THIS INFORMATION Reside ce 2 District SS�lCFNIS Rrcide cc 3 District de ce 4 Di Id 1"=142 ft Ede ce 5 District I de ce 6 District age esidential District 7/1/2016 tr 1 Date:July 01,2016 20.822 This is an e-permit.To learn more,scan this barcode or visit northandoverma.viewpointcloud.com/#/records/20822 TOWN OF NORTH ANDOVER Q•`a PERMIT FOR PLUMBING on This certifies that Russell L Smith has permission to perform Installing an indirect water geater plumbing in the buildings of KEYO.KEVIN S. at 103 FULLER ROAD , North Andover,Mass. Lic.No;23128 1/1 A, The Commonwealth of Massachusetts z f Department oflndustrialAccidents 1 Congress Street,Suite 100 Boston,A 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): 'CV 4 s,1 i Address: 28 No2TJA; IJ City/State/Zip: /4J(FW S U V p 0)Z'7' Phone Are you an employer?Check the appropriate box: Type of project(required): LF]I am.a employer with employees(full and/or part-time).* 7. ❑New construction 2.®I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3..❑I 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 10❑Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12:®Plumbing repairs or additions 5.FJ I 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.$ 13.❑Roof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§l(4),and we have no.employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who stbiiiif#his 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-coriiractors have employees,ley must provide their workers'comp.policy number. Iain an employer tfiat is p/'ovidiing workers'compensation insurance for my employees.'Below is the policy acid job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: l 0� `t,t��` �-2'• N �n1�Av:.n City/State/Zip: ill .4-�c�►�' 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. I do herebyc under the pains �andd penalties of pei jury that the information provided above is true and correct. Signature: ��j iv✓,e.(, 7 / Date: Phone Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ;.I Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contractof1& express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required.'.' Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall. enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill-out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub=contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to cavy workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Deparhnent of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should'enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel. # 617-727-4900 ext.7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia `r Date.../..UB...... NOR7M °!t"`°:•�"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING I1 • ° "•�+ SSACHUSf CThis certifies that . has permission to perform - .. ...-� ........ wiring in the building of .................................................... G'fit i at... ............... ...... . ... North Andover Mass.� , Fee��-0°......... Lic No./'..4../ ....... . . .......... ..... ....... .. ...T ......... ELECTECAL INSP Check # 8 '130 %0`1118 full or massachusetts official Use Only wyx Department of Fire Services Permit NO. ?1c3 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked_ 130 UV v. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFOR All work to beperformed;n accordance with the Massachusetts Electrical Code WORK (PLEASE PRINTWINK OR TYPE ALL E&ORAMYYON. (MEC),527 CMR 12.00 City or Town of. NORTH ANDOVER ) Dater"�0 BY application the undersigned gives notice of his or her intention to perform the electrical work ecto Mees: Location(Street&Number) scribed below. Owner or Tenant /G4! C e Owner's Address Telephone No. Is this permit in conjunction with a uBding permit? Yes Purpose of Building 7"Ce J�'� N0 11 (Check Appropriate Boz) sl`yiA", Utility Authorization No. Existing Service Amps Q/ �VVts Overhead ❑ UnNo. dgrd .of Meters New Services / --__ AmP Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: e(.UO /C 92 It yl�,� - Co letion of the followin table may be waived b the 1 ector of Wires. No.of Recessed Luminaires No.of Ceil.-Sus No.of p.(Paddle)Fans o No.of Luminaire OutletsTransformers gyA No.of Hot Tubs Generators KVA No.of Luminaires (/- swimming Pool �� ove El dNo.of Receptacle Outlets � Baot .toe IImn eirtgs ency ig of Oil Burne FIRE ALARMS No. of Zones No.of Switches No, of Gas Burners o.ofetection and No.of Ranges Devices g No. otal of Air Cond. . No,o 13 Tone � f Alerting Devices No.of Waste eat Pum Disposers P Number P. __ Tons o. of elf:Contained Totals: "' Detection/Aler[in Devices No.of Dishwashers Space/Area Heating KW Local❑ C nmcipal Other No.of Dryers g�� A Connection Heating PPliances KW Security systems:* No.of stet o.of0. No.of Devices or E uivalent Heaters ICRC Ballasts. Data Wiring: Si s No.of Devices or Equivalent 1 No.Hydromassage Bathtubs No. of MotorsTotaTelecommunications l HP OTHER: No.of Devices or rent ► Estimated Value of Ele rical Work: d Attach additional detail if desire4 or as required by the Inspector of Wires. Work to Startp/ (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion INSURANCE C GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance .. ty ce including completed operation"coverage or its substantial equivalent The undersigned certifies that such cive3g6is in force,and has exhibited proof of same to the CHECK ONE: INSURANCE BOND [] OTHER permit issuing office.. (Specify-)I cerci under ❑ ( P ify-) h fY, the Qins and penalties of perjury,that the information on this appl�adon is true and complete. FIRM NAME: e!"yJ ,��. `C, Licensee: i///' ✓� l��oil2/` < �'G / LIC.NQ: , (.�� 4J� (If applicable, enter'exempt"in the license number 1i e.),oS stare LIC.NO.: Z� � Address: / n�`i — - ,� GL,� Bus.TeL No.: —2_ y�'E *Per M.G.L c 147,s 57-61,security work requires D Alt Tel.No.: OWNER'S INSURANCE W ePartment of Public Safety ,S"License: Lic.No. RIVER: I am aware that the Licensee does not have the liability insurance coverage.normally Orequired by law. By my signature below,I hereby waive this requirement I am the(check one)❑owner wner/Agent ❑owner's agent Signature e Telephone No. PERMIT FEE.s 13o `� .r P44 � "`� j A The Commatrrwealth of Massachusear Department of Industrial Accidents N 1 Office o{Investigations i 1 600 Washington Street ti � Boston, MA 02111 www massgov/dia Workers' Compensation Ineitrance Affidavit: Builders/Conhwtors�iectricianslPf Applicant Infarn�atioa ambers j Please Print Legibi Name.(Busincssl. `p Orgataization/inarviaual)1_ eel �( Address: n city/'S Phone 9`L / Are yo an employer?Check the app roprote box: 1. 1 a n a employer with /,, 4, ❑ 1 am a •of prep(required): employees(full and/or part-time).* have bred the sub-contractors 6 Naw construction 2.❑.ZIP proprietor.or partner- listed on the attached sheet,3 7• ❑Remodeling ship and have no employees These st6-contractors have working for me.in any capacity, workers° comp.insurance. 8' Q Demolition` [No workers'comp,insurance S. ❑ We are a corporation and its.: 9' ❑Building.addition required.] officers have exercised their 10•0 Electrical repairs or additions 3. ram a homeowner doing all work right of exemption per MGL 11.[]Plumbing repairs or additions myself,.[No•workin,comp. c..152; §1(4),'and we have no insurance required:]t .amplayees. [No workers' 12•❑Roof repairs Comp• insurance required.]. I3.0.0mL 'Arty applicant that checks boj#I must also fill out the section below ehDwing their workers'bompenutiou pokey information $t Homeowners who submit this affiidsvit'indicating they are.doing 211 wotk and then him-DUIside eon troatraatotg that cheap this box mustattached an additional shotshow nctm must submit a new affidavit indicsfiq such. tog the rmrne of the sub-cottuecmrs atm tbmir Work'comp.Policy information. 1 am an employer tkat.is prove 16,:workers'¢owpewa6on insurance or fnfornuza0m. f mY ploYees: Below ir.thePO4 andlobsite Insurance Company Name: ©l?e �e OK Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address.-_'(a4 l' Attach a copy of the.workers'e m Crty/StatelZrp' peusatiota policy decia•.IStion page(showing the policy number and expiration date] Failure to se=re coverage as required under Section 25A of MGL e. 152 can lead to the imposition of crirriina! fine'up to$1,SOU,00 and/or one-year imprisonment,as well es civil penalties in the forte of a STOP Wpm ORDER of a 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 and a nee investigations of the DIA for insuramm coverage verification. IdZ reby c"Iy tin er the pains enalties o e 'u1 P rl �'mat the informationprovidedve is tine ana'eonBd Si e Dated D Phone#: f EE only. Do not write lit tiers area to be complet�d try city or town officio( . y n: Permit/Limnse# ority(circle ode): Health Z Suildiaig Department 3.City/Town Cleric.4,Electrical Inspector S.Plumbing lits r p�son: Phone#: t r Information and Instructions Massachusetts General Laws chapter 152 requires all emp 11 oyers 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." Am employer is defined as"an individual,partnership, assodiation,corporation or other legal entity,or any,two ormore ofthe'fbmping engaged in&;joint enterprise,and including the iegal represmrtatives of a deceased employer,or the receiver ortrustee-of an individual;partnership,association or other legal entity,employing empioyees.'However the owner.of a dwelling house having not more thatt 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 shaU not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or- local Eiednsieg 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 applicard who has not produced acceptable evidence-of compliance with the insurance coverage required." Additionally,MOL chapter I52,§25C(7)states"Neither the commonwealth'nar any of its political subdivisions shall eater into any contract for the performance of public work until acceptable evidence of compliance with the instaance 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)axsd phone number(s)along with their certific ate(s)'of insurance., Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members r 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.. Also be sure to sign.and date the affidavit The alxrdavh 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,pleasrcall the Delmatment at the nu mber.listed below. Self-insured companies should entertheir self-insmance: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 permittlicense number which will be used as a reference nurmber. in addition,an applicant that.must submit multiple pormitllicense applications in any given year,need only submit one affidavit indicating•cturmt policy information(if necessary)and umdw"Job Site Address"the applicant should write"all locations in (city or town)."A copy of`Ihe afndavit that has been officially stamped or marked by the city or town may beprovided to the applicant as proof that a valid affidavit is on file for fiihm 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 votae (i.e. as dog license or permit to bum leaves atc.)said person. is NOT required to complete this affidavit The Office of investiptions would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Lnveafidstions 600 Washington Sheet Boston, MA 02111 TeL# 617-7274900 oxt 406 or I-977-MASSAFE Revised 5-26-05 Fax#617-727-774 urvvw.mass.govldia Date. . . . . . . . . . 40 P':'�c TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING s o •'a ,SSACMUSE� � ! This certifies that . . . . . . . . . . . . .cam!. . . . . � a . . has permission to perform . . . . . ^^:^ . . . `: .. .. .. ..-'.�. . . . . . plumbing in thebuildingsof .'. . . . . . . . . . . .� . . . . . . . . . . . . . . . . ... . . at. .�'``".. . . . .7--'. . . . . . . . . . . orth Andover, Mass. Fee//,al . . .Lic. N!. . . . . .... . .,. . . . '/ . . . . . . . / �PIUMBINGJzS TOR Check # �3� �� /, 7735 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Townr7p0 V , MA. Dateermit# s 3 Building Location: �'GF} ,t �/��Q, Owners Name:'j Type of Occupancy: Commercial l Educational'Lj Industrial i i Institutional Residential _ a .a New: Alteration:i .� Renovation Replacement:— eplacement ' Plans Submitted: Yes0 No( 3 FIXTURES z 0 Y y a z z Y } rn Q U N 0 z M co X a IY I H rn a Z �a 0 M W w o rn z IY IY 9 z w fn c7 v a o a y �a a D o w Z Lu V = 0 O N V i Q 0 a Y Z T Huj w a a y ° a 0 00 = ° a a a a 3 0 SUB BSMT. BASEMENT 15T FLOOR 2 FLOOR 3pu FLOOR 4 FLOOR XH FLOOR 6 FLOOR 7 FLOOR 8 FLOOR Coheck One Only Certificate# Installing Company Name FARFARAS&SON PLUMBING&HEATING CO.,CO INC ,/ � Corporation 773C Address:i UNHAM ROAD City/Town y ILLERICA State MA;, -- Partnership Business Tel. 1-800-924 1112 Fax: !1-978-663-500 ... FirmlCompany Name of Licensed Plumber:,PETER G. FARFARAS ,� INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes` ✓ No LJ If you have checked Yes,please indicate 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 1 Agent Signature of Owner or Owner's Agent Li 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 appli tion will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of theoral Laws. ng I By Type of License: Title ` ✓� Plumber Signature of Licensed Plutnb r Master _._. City/Townl License Number: M8228 APPROVED OFFICE USE ONLY Journeyman10 „ i I FINAL INSPECTION BELOW FOR OFFICE USE ONLY PROGRESS INSPECTION(S) FEE: $ PERMIT# APPLICATION FOR PERMIT TO DO PLUMBING NAME&TYPE OF BUILDING LOCATION OF BUILDING SKETCH L�j PLUMBER LICENSE NUMBER: PERMIT GRANTED❑ DATE: PLUMBING INSPECTIOR t Date. . �`.q.`0 Z TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING 41 SSA US Thix certifies that . . . . . . has permission to perform . . . . . . . . . . . . plumbing in the buildings of . i���`. . . �.'. �.`. . . . . . . . . . . . . . . at . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. No h And er, Mass. . . . . . . t Fee. . -� .Lic. No. .... . . . . . `.:.IOZ2. . . . . . . . . . . . . PLUMBI G INSPECTOR Check # 5260 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) 1 , NORTH ANDOVER,MASSACHUSETTS Date Building Location r O Permit# Amount Owner New ❑ Renovation Aj Replacement 1:1 Plans Submitted Yes No i FIXTURES F Z (A a x P; PQ z a z a F x a H w w 3 a ACn M a d 9 ao Rk%N[Nr 1EHDM M Fl oat FLOCIZ afFUM —SM 6M HDM r71HHDCIR 9fflHDM \ (Print or type) Che k one: Certificate Installing Company Named ��� Corp. Address C1 ( L` ❑7► Partner. Business a ep one Firm/Co. Name of Licensed Plumber: � f"!Q 0f Insurance Coverage: Indicate t type of insurance coverage by checking the appropriate DOX: Liability insurance policy Other type of indemnity El Bond ❑ 'A C� Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent El I hereby certify that all of the details and information I have submitte r ente ed)in above application are true and accurate to the , best of my knowledge and that all plumbing work and installations erformed der Pe sued for this application will be in compliance with all pertinent provisions of the Massachusetts Slu 1 o f OMAthe Ge BY PMR/467 gse er T.Yve,of Plum g License Title City/Town icen a NumDer Master Journeyman ❑ APPROVED(OFFICE USE ONLY r r r Av ,. i3f V Date ?- 1 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that . . �9.. . t f� has permission to perform . . . . . � wirin in the building of . . . . . �.C. . . . . . . . . . . . . . . . . . . . . . at . . .. 5�7,A.. .51?i� �,. . �orth Andover Mass. Fee C. . . . . . . . L>c. No. . . . . . . . . . I. . . . . . . . . . ELECTRICAL INSPECT6R Check# 11171 r Official Ilse Olnl% -Commonwealth of Massachusetts -7 Permit No. 1. Department of Fire Services occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. 11/99] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL.WORK All work to be performed in a wdanw with the MaS achusetts Fketncel ecce(MEC).527 CMR 12 00 (PLEASE PRINT IN 1NK oR TYPE ALL INFORMATION) Date:1O-/5-1 City or Town of: p Y To the laspector of Wires: By this application the undersigned gives nc*ice of his or her intention to perform the electrical work described below. Location(Street& Number) rj n 1r Owner or Tenant bovA 6 DC ke2 Tekphoae No. q L1-3 %P Owner's Address Is this permit in conjunction with a buiktiag permit? Yen ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No, Existing Service Amps / Vohs Overhead❑ tiodgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Ekarkal Worts: 40, -` (' etio+r a thr Itmr' table nerry be xianwd bt tht LA Tmo,.of Wines. NO.or Total No.of Recessed Fixtures No.of C.eiL,%sp.(Puddle)Fans Transformers KVA No.of Lighting Outfits No.of Hot Tubs Generators KVA No.of Lighting FixturesSTM 5r Lmervmcy upting wimming Pool rude ❑ r%NL ❑ Batftff ulaft No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No,of Switches No.of Gas Somers hibiatim Devices No.of Range No.of Air Coad. Toa No.of Ab ting Devices No.of Waste Disposers Heat ftp[Number ons I KW 140.or SdFcAatsbw No.of Dishwashers Spoce/Area Heating KW Local ❑ misom ❑ Other r No.of Dryers Hating Appliances KW 'WN"&YoT=or Eavivalleat No.ofWater KW o.of Bo.of Data Wi t Heaters nsNo.of or I' Na Hydromossage Bathtubs No.of Motors Total HP No.of Devices or Eaulvii1lat OTHER: Mrarh ad&1wna1*1011 if dts/rtd.M as mqw^W Ar Ow t�pavc+of Wrns. INSURANCE COVERAGE: Unless waived by the owner.no permit for the performance of electrical walk may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such ooverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHFR ❑ (Specify:) (ENpiration hate) Estimated Value of Electrical Work:r2 4 C9 (When required by municipal policy.) Work to Start:/D-J 7-/a inspections to be requested in accordance with MEC Rule 10,and upon completion. cffgfy,mukr At pains andpewsililles of perjlury.Mrat Me itrfjmniollon gVlicaten is traw and cnatp/da FIRM NAME. LIC.NO.:11 k-16�I licensee: 1Zda�rT' Wltrr Wt�I lJ sigasta LIC.NO.: t/j iocble k dMr I' 1prrtber li Bus'TeL 114W ,�� Ale.Tel Na• OWNER'S 1aW51�WA R: !am aware that the Ltoensee a not fiavr the lis!►iiity irtsurtutCe aovertye normally trgttined by law. By my signature below,l hereby waive this requirement. I am the(check one owtFer owtrer's Owuer/Agent PE�rr'FEE:s aS Q $i=riattrre 1'ekphone tie. �aJ2� e w jej 1 w The Commonwealth of Massachusetts Department Of Industrial Accidents Office of Investigations kvi 600 Washington Street Boston, MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): e C_ 4 C 14 Address: qac- City/State/Zip: aCCity/State/Zip: Sid tJ e\AA Nil F M A GI 146()Phone #: A 1 4135-09 3 a Are you an employer?Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. ❑ 1 am a general contractor and l 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 7. 2.Eli am a sole proprietor or partner- listed on the attached sheet. *+ ship ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. q• ❑ Building addition [No workers'comp. insurance 5.A=ers re a corporation and its required.] have exercised their 10.[] Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I i.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152.§1(4),and we have no 12.❑ Roof repairs insurance required.] employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation police information. f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. insurance Company Name:J©tst_�S k `J, ,f i (;t` !s F r" 1 o t*t l)(4 Policy#or Self-ins. Lic. #: k) _C, 0 Expiration Date: 7 13 Job Site Address: 14�i Sl,+,to r City/State/Zip: u® l eay�T L�I eSy� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cerci nder the sand penalties of perjury that the information provided above is true and correct. ature: Date: 16211 Phone# 7461 - 4135=-0q 3a1 Official use only. Do not write in this area,to be completed ht:city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Date. .... ... . - N°RTh o= '` TOWN OF NORTH ANDOVER " PERMIT FOR GAS INSTALLATION SACHUSEt •. G � r This certifies that . r ? r r' S'!?r�'�. . . . o0� has permission for gas installation in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . at . �o .s/i��.Qr. .u.�11 .?�., North ndover-b Mass. Fee. . t!`'.,5.� Lic. No., 4?A4a. . . GAS INSPECTOR Check# 7853 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO DO GAS'FITTING CrrYfrOWN: © fAlVi (j 1 STATE:MA APPLICATION DATE: j_.. 1Y (:.I JOB ADDRESS: 65... ..r A(S1 .r GOCCUPANC TYPE: COMMERCIAL RESID TIAL M PLANS SUBMITTED: YES a NO ALTERATION NEWS � REPLACEM REMOVAUDEMOUTION' l NATURAL&LIQUEFIED PETROLEUM GAS:PIPING-EQUIPMENT-APPLIANCES-SYSTEMS -I ENTER TOTAL AMOUNT FOR EACH SELECTION QJMITED TO FIVE NUMERALS AIR ROTATION UNIT FURNACE: ALL TYPES TEMP HEATING EQUIPMENT BOILER:ALL TYPES GAS PIPING THERMAL OXIDIZER BOOSTER GENERATOR(STATIONARY ENGINE) TURBINE BROILER "+ ILLUMINATING APPLIANCE UNIT HEATER BURNEF;t ALL TYPES "_ INCINERATOR T_ WATER HEATER ALL TYPES CO-GENERATION UNITINDUSTRIAL AIR HANDLER EQUIPMENT OVER 1 5"BH COFFEE ROASTER INFRARED HEATER POTHER NOT LISTED I _ COOK APPLIANCE HOUSEHOLD, i KILN 1 GLORY HOLE I CRUCIBLE COOK APPLIANCE COMMERCIAL [ LABORATORY COCKS DECORATIVE APPLIANCE __`1 MAKEUP AIR UNIT DIRECT VENT APPLIANCE -_ MECHANICAL EXHAUST EQUIPMENT DRYER: ALL TYPES "1 OVEN: ALL TYPES FIREPLACE:VENTED I UNVENTED POOL HEATER FRYOLATOR ROOF TOP UNIT r- FUEL CELL ROOM HEATER-VENTEDNENTLESS PLUMBING/GAS FITTING FIRM INFORMATION CHECK ONE ONLY �-° D J a ^_sY on Business# NAME - _ G ._ ._. SADhESS: D _ _ CITY: 1J,LLVO f CA STATE MA;;Zip 0 (��C nP:rr6mersfiip Business . ----� Q�7 aLLC Business#[_._._� TEL:1% �CJ .7 .D FAX:. EMAIL .. ... W01600 1 Unincorporated NAME OF LICENSED PLUMBER 1 GAS FITTER: Y_ ��,t�{ [ � INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142 YES 0 Q If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy - Other type of indemnity E] BondEl OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General 'Law,and that my signature on this permit application waives this requirement CHECK ONE ONLY Signature of Owner or Owner's Agent - OWNER AGENTE] OWNERS NAME TEL. FAX 1 hereby certify that all of the details and information I have submitted(or entered)regarding this permit application is true and accurate to the best of my knowledge.I certify that all plumbing work and installations performed under the permit issued,will be in compliance with all pertinent provisions of the Massachusetts Uniform State Plumbing Code,and Chapter 142 of t General Laws. ((OFFICE USE7,Y) Type License: Permit Ptu DGasfrtter Inspector Z /l C� � ❑Journeyman Si of Licensed Plumber Gas Fitter Undiluted LP Installer License Number: Fee: Q limited LP installer ROUGH GAS INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES rt ?5 11 07:24a p.1 :: .;. . ' VT CONIMERCIkt-0sll� i'SLICENSE:. �. . SS67 421 0111Fr2010 N �' DOD... p yn' : s'�nt.•:.;.: »qr;,+ .'p MASS AF--r' ecr sa BIW 6-W M z _ p"Rice MARK 19 MARGARET LN BILLERICA,RfA 01821 . d �33'1110;aWat�s;SS,�CH�SI`TTS a' iat�46...9. • . LICENSED , AS AM AS TE RP PLUMBER ISSUES r:':S�..�'+.•SF tr i _MARK . E SPENCE : P O $.OX .893 NUTTING LAKE NA 01865'-0893t' 11382 05/01/12 75937.1 � c' t v ISORtq f CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 427(12/3LE Date: January 8. 2010 THIS CERTIFIES THAT THE BUILDING LOCATED ON 65 Flallu'�p Drive MAY BE OCCUPIED AS Tenant fit ul) - Just Dance Studio IN' ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Turnpike Flagship LLC 65 Flagship Drive North Andover MA 41845 Building Inspector NORTH To o RAnd over i LA } �dover, Mass. .6 L A COCHICHEWICK �t ADRATED S ` BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........... " ' ..,!�: :..:...... . ......... .......................... ... . `' .. .............. .;....................................... Foundation has permission to erect.......................................... buildings on .....:. � . Rough to be occupied as............... ' , a �, x t°'x..1:4/ . �.....::.��..� � e �� Chimney 4 A// �rChimn provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Fi ai� ' �' this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of ` final= Buildings in the Town of North Andover. PLUMBINSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ......................... ...:.. � � a. .. Service BUILDING INSPECTOR ` �. Fin.aJJ J � �' �. if>•- Q l� Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To BeDone FRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDEJ1 Smoke Det. Date.................................. NORTH TOWN OF NORTH ANDOVER PERMIT FOR WIRING ��sS�cMusf� ,.. L This certifies that .�:. .....��:.r...... ..::�:�::.:.�.:..��.. ..,,............................ has permission to perform .: .'x:....:.:•.:-.�... -4: .................................. wiring in the building of . �'`'`^'`J fallorth Andover,Mass. t Fee................ Lic.No. / ELECTRICAL INS R Check # 9.1 82 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked/�v [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 WINK OR TYPE ALL INFORMATION Date: City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Owner or Tenant � � cp �<C. Telephone No-�'17F!'3`�C Owner's Address . 1), a aZ 2 7 0 I Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building (^1 Utility Authorization No. Existing Service 2-g,t- Amps J la-v/7-Lt o Volts Overhead ❑ Undgrd® No.of Meters New ServiceAm s -----. p / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and.Ampacity Location and Nature of Proposed Electrical Work: Completion o the ollowin table may be waived b the Ins ector o 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 SwimmingPool Above In- o.o Emergency ig g d. d. ❑ Batte Units 3 No.of Receptacle Outlets f No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No..of Detection and Initiatin Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: __ .....__.........._....._........ • Detection/Alerting Devices No.of Dishwashers Space/Area Heattin KW Municipal ----------------------- g Local❑ Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of WaterNo.of Devices or Equivalent No.of No.of Heaters KW Si s Ballasts Data Wiring: No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total Hp Telecommunications Wiring: OTHER: No.of Devices or Equivalent � � �Q w� 'r Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) i11 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 g in force,and has exhibited proof of same to the permit issuing office. t CHECK ONE: INSURANCE lZ BOND ❑ OTHER ❑ (Specify:) { I certify,under the pains and penalties of perjury, that the information on this application is true and complete- FIRM N p �.. T- 0-111; �e le- � LIC.NO.: Licensee: Signator LIC.NO.: J 7 (If applicab , ent r"exempt"in the license number line) Address: Bus.Tel.No.• "7773 * Alt.Tel.No.: Per M.G.L c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. B m signature below,I Y Y hereby waive this Owner/Agent Y requirement. I am the(check one) ❑ owner E]owner's agent. ;Signature Telephone No. PERMIT FEE. $/mss' The Commonwealth of Massachusetts i Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, 2IIA-02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricans/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): OOL,I-, M'Cjz__ ?2 Q—r, Address: _,r� City/State/Zip: Phone#: 372 7_??( Are you an employer? Check the appropriate bog: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. E]New construction employees(full and/or part-time).* have hired the sub-contractors 2%I am a sole proprietor or partner- listed on the attached sheet t 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. No workers' 13.❑ Other comp. insurance required.] .y rrl. "'"that checks box 41 mu;also ill out the section below showing their workers'compensation policy information t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: (`S F&3 S °j2 2 , ,,� City/State/Zip-,_A/0,.q,2 m, 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 1 fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereb a fy er the pains and pe of perjury that the information provided above is true and correct Signafore: Date: �—S� 8 Phone#: 9 7�'3 �7 2-'7� '7 b Official use only. Do not write in this area,to be completed by city or town official City or Town: PermitlLicense# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions - -. Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if, necessary, supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability.Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate tine. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permittlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. 6 The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us`a call. The Department's address,telephone and fax number: The Commonwealth.of Massachusetts Department of Industrial Accidents Office of fnvestiptions 600 Washington,Street Boston,IIIA. 02111. Tel. # 617-7274900 ext 406 or 1-877 M-ASSAFE Revised 5-26-05 Fax# 617-72.7-7749 www.mass.govfdia Location No. Si Date ,+oRTti TOWN OF NORTH ANDOVER o� ,4, f ro' - 9 Certificate of Occupancy $ s';CH <� BuildinglFrame Permit Fee $ Foundation Permit Fee $ Other Permit Fee S15'J $ _ TOTAL $ Check # Building Inspector MORT4 - O 0 W " TOWN OF NORTH ANDOVER +. •��g�` SIGN PERMIT ��8s�►CHUS t- DATE: December 30, 2009 PERMIT: S23-2010 THIS CERTIFIES THAT Turnpike Flagship LLC — Just Dance has permission to erect. 22" X 96" x .75" Wall Sign on 65 Flagship Drive provide that the person accepting this Permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section#6, Voids this Permit. INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED 6., Inspector of Buildings SIGN PERMIT APPLICATION 1600 Osgood Street Building 20, Suite 2-36 TOWN OF NORTH ANDOVER Site Owner _// Q Applicant Tel Site Address 60 Fon&SOt / 1)K > �,60 ?C Size of Proposed Sign May Parcel '�afinated Illumination: Not How attached: a) Against the wall � b) n e b) Roof c) Externally illuminated c) Ground d) Other Materials: /p y C ♦ 7 L✓II-rY J11N Proposed Colors: BackgroundL Lettering (,4 t`r'y Border ey-2. N _ Cost of Sian - Required Attachments: Note: No permanent/temporary sign shall be erected, or enlarged until an e Photographs of building application on the appropriate form furnished by the Sign Office has been filed Material sample with the Sign Officer containing such information including photographs, plans Color sample and scale drawings, as he may require, and a permit for such erection, alteration, Site or Plot Plan(Required for all free-standing signs) or enlargement has been issued by him. Such permit shall be issued only of the Drawings of proposed sign Sign Officer determines that the sign complies or will comply with all Other, specify applicable provisions of the By-Law. Will sign overhang any public road or walkway Yes ( ) No N- If Yes,Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: Receipt# Check# Revised 10.31.2006Form Sign Permit Application SIGNATURE OF APPLI NT APPROVED BY 1 9.6in Just Dance 65 flagship Dr , N. Andover Ma l� Install 22 " x 96" x .75 in non illuminated sign on wall over door Material: .75" PVC INTERIOR/EXTERIOR SIGNAGE Back ground color: Black ENEMCATION•SERVICE•INSTALLATION 30 OSGOOD ST.METHUEN,MA 01844 Graphic colors: White & Green E-MAIL:info@harveysigninc.com 978.794-2071•FAX 978.686-1841 06/17/2008 15:01 FAX 9786885717 GSD-ASSKIATES.2300 IA002/002 GSD Associates, LLC i . 148 Main Street,Building A,North Andover MA 01845 Tel:978 688 5422 Fax:978 688 5717 Web:www.gsd-assoc.com Computer Aided Design • Architecture • Planning • Interiors • Development Consulting TO: DATE: 7 0 JOB NAME AND#: TIME START: TEMP: Shat WEATHER: LOCATION: _65" T�'i./►d. �f?� TIME END: SITE OBSERVATION/PROSECT MEETING REPORT xA I I t I 1 1 • ' 1 I t 1 + t • t 1 I ! I �• I uR , .t�ttr�c3+,- is" I + 1 I • r t I i f I I i I , r + t i + • t ! 1 I 1 F ( i � t I 1 t -1 + + + f I i i , i i -_, -•,f __.•`__Y�_ _I __v-.. _._��C.-.__ iii�% 1.�� �_'_-. ' i I , r f t I r � t + ! c + ; I + A�f� I �� �i-Y� l 1�•A.rlVr�(�� __ _,�_ `_�L ' TTI ..!_ -�i + I t } + 1 t 1 I I I i r I I .. i . K, f i i t 1 . T ' 'F(' ! 1--'1,��—��_ -- -----,`';1��—---�C1i�.1.�(1� - ' t4'��^�-.,'• .1 ..i.. .' , I ! + I `S r , ' I • i ' ' I I i 1 r I i • + E i 1 1 1 ! I , 1 1 1 1 t { { + r I : + ± 1 1 : I f WORk :- �A+C>ki 1 003 - -ftp' y , + joy ' t S I +I = I I I � Recorded BY Reviewed by Page No: NORTH '9 Town of _ .. over O �_ N .t ;'fes 1 -No. _ - - 10o over, Mass., o �. COCFIICKEWICK V 7�S RATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING .INSPECTOR THIS CERTIFIES THAT V�tNr t. Op , 7 . ..�. � •...•...•••�• •••• .... 4 •.................................. Foundation has permission to erect...... ................................ buildin s on .......(p.. .......P.CflarAelo ..... ..................... Rough to be occupied as..tiii� .�r. A ....... ... /.� ..... .L �4 .,J.1.... imney ,�� h' provided that the p accepting this permit shall m every respect o� nform to the terms of the lication on file in Final 6 this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS • N STARTS ELECTRICAL INSPECTOR' UNLESS COTRUCTIO S Rough Service BUILD SPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a. Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. I ,I TOWN OF NORTH ANDOVER i ' Construction Control Affidavit Project Number: 0804044 (Architect's Job Number) Project Title: Sidewalk Renovation Project Location: 65 Flagship Drive, North Andover Name of Building: Nature of Project: New sidewalk and window replacement In accordance with Section 116.0 Registered Architectural and Professional Engineering Services-Construction Control of the Massachusetts State Building Code, I, Gregory Smith Registration No. 8688 being a Registered PFefessienal Engineer/Architect, HEREBY CERTIFY that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: .Entire Project Architectural )00000(Structural Mechanical Fire Protection Electrical Other(specify) FOR THE ABOVE-NAMED PROJECT AND THAT SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE 780 CMR MASSACHUSETTS STATE BUILDING CODE. ALL ACCEPTABLE ENGINEERING PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the state of construction to become, generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner--- consistent with the construction documents. UNDER SECTION 116.4, I SHALL PERIODICALLY SUBMIT A PROGRESS REPORT,TOGETHER WITH PERTINENT COMMENTS,TO THE BUILDING INSPECTO PON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMP ADINESS OF THE PROJECT FOR OCCUPANCY. Signature and Stamp(no facsimile) P" oto.�s VA. hhyy�r f SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF { IG1Ja 2008 �Q-4at- ul� _ MY COMMISSION EXPIRES //�� �D OF NOTARY PUBLIC May 12. 08 11 : 32a Fe N. Lucero Yako 978-352-7787 C N Client- 61, N STRUCTURAL T CoMp- FNLY Dates oL .bkd_ By: nate: N Sheet 'Z of Job Number so T f• (.r�- amu BLDC \ J \ ulbx.� To of I oj4,A 67 2 / 8 S 3/ r BMl -goar o m m Ream ulafio sand Standards Construction Supervisor License License: CS 99016 j xpiration ,15/12/2011 Tr# 99016 y �� r et�ction OQ DOUGLAS LOCK }r" PO BOX 220r S .' BOXFORD, MA 01921 C r Commissioner Location No. NORTh TOWN OF NORTH ANDOVER 4- s ' Certificate of Occupancy $ do • i • ss�►cMusE^°•'<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # �I 202 Building Inspector i CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 556(2/21/2007 _ Date: May 30, 2007 THIS CERTIFIES THAT THE BUILDING LOCATED ON 65 Flagship Drive MAY BE OCCUPIED AS Tenant Fit Un JN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Micro Ice Training Center 55 Fla sg�lup Priye North Andover MA 01845 F Building Inspector NORTH Town of o ,. over, Mass., a-a 1 -o�-- O COC MICME WICK �,95 RATE D BOA-R.-D�� OF HEALTH PERMIT T D Food/Kitchen/f'�� C , Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.....1)914AO.....&A!:�......77. 4vgA 1j.'......... 4—ro<................................................... Foundation has permission to erect........................................ buildings on.. ► .. � f... A.j.0......Ao ( ..C................... Rough to be occupied as........ . . � ... � .... t h ..... 17... ..? �.r........... ........... C ney . . .... . ., . .. provided that the person accepting this permit shall In eery respect confo to the terms of the application on file in Final �j this offfee, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. I!£ h-�, ��i� PERMIT EXPIRES IN 6 MONTHS _ L/ Z �� ✓ ELECTRICAL R , UNLESS CONSTRUCTION -ErT INS Rough' ................ ...........,............................................................................ Service f BUILDING INSPECTOR Occupancy Permit Required to Occupy Building GAS INSPEC"TO Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final -- No bathing or--Dry Wall To Be Done FIRE Until Inspected and Approved by the Building Inspector. Burner DEPAR Street No. _ SEE REVERSE S1 Smoke Det. �� _( FORTH Town of 4Andover No. ~ -�� - J.P.- l E dower, Mass., 1+ A COCHICHEwICK V ADRATE D S BOARD OF HEALTH PERMIT T Food/Kitche r �n � ;-e ' Septic System dC BUILDING INSPECTOR THIS CERTIFIES THAT..... 1441 ...... .......r ' Gl .. .................................................. Foundation a has permission to erect........................................ buildlggs on ...o6r..Fief.f'�1 ...... J ................... Rough to be occupied as ✓ �t .? .r Chimney ........ ...Vic....��G...�............l�ih,�.....T..?�.... ........�..�.................................................. . ... y provided that the person accepting this permit shall in eery respect confornrto the terms of thea lication on619"'!n - this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final Buildings In the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS E9 z �� ELECTRICAL INSR UNLESS CONSTRUCTION T i- Rough', ------------ ................ ....................................... ................................................. Service BUILDING INSPECTOR Final?. 4 1 s.ej I Occupancy Permite Required Occupy un ` p � Rid tO q � Bildig GAS INSPEC'PO Display in a Conspicuous Place on the Premises — Do Not Remove Rough P Y P Final - --�-- -- - No Lathing or Dry Wall To Be Done FIRE DEPAR Until Inspected and Approved by the Building Inspector. Burner`' Street No. - - - -- Smoke Det. -- SEE REVERSESI / 1 TOWN OF NORTH ANDOVER Final Design Affidavit Project Number: 0611098 Project Title: MicroIce Training Centers of America Project Location: 65 Flagship Drive, N. Andover, MA Name of Building: 65 Flagship Drive Nature of Project: Renovation of former martial arts center into an Ice Hockey Training center. In accordance with Section 116.0 Registered Architectural and Professional Engineering Services-Construction Control of the Massachusetts State Building Code, I, Gregory P. Smith Registration No. 8688 being a Registered PFefessienal Engineer/Architect, HEREBY CERTIFY that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Architectural XXXX Structural Mechanical Fire Protection Electrical Other(specify) FOR THE ABOVE-NAMED PROJECT, AND THAT SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE 780 CMR MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I HAVE PERFORMED THE NECESSARY PROFESSIONAL SERVICES AND EITHER MY REPRESENTATIVE OR I HAVE BEEN PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK HAS PROCEEDED IN ACCORDANCE WITH THE DOCUMENTS SUBMITTED FOR THE BUILDING PERMIT, AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2 1. Review for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the state of construction to become generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. I AM SUBMITTING THIS FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. Signature and Stamp (no facsimile) Vky P. SUBSCRIBED AND SWORN TO BEFORE ME THIS 73d DAY OF 2007 �• �'� � MY COMMISSION EXPIRES NOTARY PUBLIC �E STATEMENT OF PROJECT COMPLETION GENERAL CONTRACTOR Permit Number: 556 Project Location: 65 Flagship Drive North Andover MA Name of Project: Micro Ice Training Centers of America Nature of Project: Private Ice Rink For Profit In accordance with Section 116.3 of the Massachusetts State Building Code, I, Joseph P. Pandolfo the general contractor for the project noted above, have assumed responsibility for the following as they relate to this project: 1. Execution of all work in accordance with the approved construction documents. 2. Execution and control of all methods of construction in a safe and satisfactory manner in accordance with all applicable local state, and federal statues and regulations. The project has been constructed in substantial accord with the construction documents submitted with the building pe it application and the applicable provisions of the Massachus s St to Buildin ode. Signe Jo ph P. P olfo Date Commonwealth of Massachusetts Middlesex Date: The person lly appeared the above named 36 V1 Gy,(c 01FO , and acknowledged the foregoin instrument to a is/her free act and deed bef r me. , otary Pub 'c IL Y~ mien topts.Fi1.I'M I GSD Associates, LLC ' . 148 Main Street, Building A, North Andover MA 01845 Tel: 978 688 5422 Fax: 978 688 5717 Web: www.gsd-assoc.com • Computer Aided Design • Architecture • Planning • Interiors • Development Consulting TO: •?A D6. (Nsft-C T4K DATE: 2007 JOB NAME AND #: M(CCO(a TP-A,NING �^+1 ReS of A*VM U TIME START: ?() RvITEMP: ?-C WEATHER: SRM. SUNNY LOCATION:66 F(-AGSrtir t:RtuE:,A3o Rft+ TIME END: SITE OBSERVATION/PROJECT MEETING REPORT .. ..... . _ f f ��T; �i�6 , �-►v � �y ltGtk'fiS ;�i�7 "'izIq s`o'rt- BSS �1�►.�Q�EP 'f _ C)�v MJ n: h ; . 1 ..... ..... s.__. y ... �... ...i.... ! I I I 1 f ....... ..... .. ..........._._ ... i t I t 1 1 i . .Ir�ft+2oK1S ;niErnK C�3KtP�EfiiDN1 �Xv�'L f� ;(IJr�T A _ ra�o �v ; . _ ��51124 ih ,. Com- , _ ,.�o'!�. '�.c; hrQ-sr s; w;orrlanjS �-� �tsL� ....... ........... t lt)©frl .o� E ial fS ©hr�0lvc opt- f SAI w1 ae, f ib; ICS ► ��, ..:....,. i Y YY•. Pte'..... ��,�V� ��11 .1 1 t ' ! 1 1• ! 1 t .. .i 77���' ....t... ..... ... ....1... 1 .....1 1...... i ...... �, , • f 3 1 1 �ev��,,►�'G_;. �,, hts.S' owe �. _'��5�E-�1�-�-c� , !�`; �C��h T��_��'S � _� ��;�_ X45;}-���� {.� 1 i 1 1 t 1 I I ! f ...�.. .. .1 1 t 1 1 1 1 I -— ! IL 1 f f b , : 9-Alif 4../e.(.�(N..4'/ _t...`.' Y ...f... i.l......i�/ K I T t w v _JG0 ...ec.;FA4e e ; . �r, ,r., �� v ,s �,.,.� ; c�,� ,. ► ��,� , (s J f 1 . ... ,..._..... ........... .. ......... ... 3...........{_.......,. ..t... ... r f 1 P r r 1 1 I f 1 1 I 1 f . 1 6 T � U1CS_ Y►, � � l,G � �b ' s a a t. . _ „d3- , ►�,a _S 5 i 1 1 1 i t ! 1 1 f i 1 ... '. ! t , 7-: U&-,s ; ! I om- ItI tlf ..►1`�..l���� .. ! .. r r ! I , , .. ..i...... C........1... .....C........_1..... ...i....._ ... i....... ...i... ...a.........3 ..!...... ..1_...._.1...... A .._....l.... ...E _._.. ...... _. ... A _ ._1... ... C.... ...1 ....G.... ' ... _V..3_..... r D� uc�arjs _� ��rT" 1 1 f r : 1 3 1 L. t I 1 f ..... '...... ...i........_I .,....1... ..A. ........f... ...�.. �.... .�.A .......1_....... } .. ..4...... _1.. .....t... __f_........ ........ . ........ 3, ........1.... 1.._ .,...1 .. ....... ...1 ......... ., 1 I 1 VV" 1 1 1 Recorded By-r9,!-525-4 ►. Reviewed by(WA !I'►�k�10 Page Nod Date i NoarM TOWN O.F`NORTH ANDOVER PERMIT FOR PLUMBING 41 sSACMUS� This certifies that . . . . . . . . . . . . . . . . . . . has permission to perform plumbing in the buildings of . . ! . . at .0! !4 ,;e t • :!f' . . t. . . ...! . .,North Andover, Mass. (J PLUMBING INSPECTOR Check 7331 i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) IVPerMass, Date3 01 v 7 19 City, Town Building mh AT: Location-6 J57 1F)A,- r�,0 0 Owner's NaT'e P,�N00 PC �a � 40, PType of Occupancy: Comm.,:�e_„nc., New ❑ Renovation Replacement ❑ l FIXTURES Plans Submitted Yes ❑ No ❑ y z Id Q to o z t y N W Y J W �' Q Q , N z W W Z V) �' O tL tZ a i o z D h W y N a: go = to 1- Q W N Y Q N lL d z 11 H W 0 7 tr Q y z d W Z O Q N = 4 O W =.. : z a J ¢ J d � • O O J : C. < W a Y -4 Y c -O j W W d W Q F: < < z N :y O N '� z O ,O V _Z _z W I O U x 1C J ® N O 'O J < '.Y 4 J J < rL rr LG < O < F. 3 ►- rn u. v � a o < 3 ¢ m o SUB"BSMT. BASEMENTF4 1ST FLOOR ` p� 2ND FLOOR t R i 3 D FLOOR t t • 4TH FLOOR STH FLOOR 6TH FLOOR - 7THFLOOR 77 I 8TH FLOOR (Print or Type) Fiz f—lgp— ,5 sc lv //V Check One: Certificate Installing Company Name C �i Address —_ Corp, 6 Q jQ V/JH,+r t ZO ❑ Partnership QI«c�'2sc�! VtrA O�i<Z� ❑ Firm/CompanyBusiness Telephone — ':�7 rr 66-.) 1 t// Name of Licensedum bcr or Gasfittcr 1 hereby certify that all of the details and information I have submitted(or entered)in above application arc true and accurate to the bat of my knowledge and that all plumbing.work and installations performed under Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 or the General Laws, 1 have informed the owner or his agent that 1 do not have liability insurance including completed operations coverage. ' S"puwrc of 0-no/Alcm I have a current liability insurance policy to include completed operations coverage. By Title Signature of Licen d PI tuber City/Town Type of Plumbing License �i2k l�l�f1 APPROVED (OFFICE USE ONLY) Master License Number '" El Journeyman BELOW FOR OFFICE USE ONLY PROGRESS INSPECTIONS FINAL INSPECTIONS FEE NO. APPLICATION FOR PERMIT TO DO PLUMBING NAME l TYPE OF BUILDING LOCATION OF BUILDING PLUMBER i PERMIT GRANTED DATE 19 i PLUMBING INSPECTOR Date........ .t!6'- IID "" '•�"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �,SSACNUs�� This certifies that .Ae4.....y.... o vl,A= p.... �� ,, .'...... has permission to perform ...O �C..pa�.t�.,/ �....1,.?.�.e./ �?.t� �...... wiring in the building of-7.-J( ...04!>'4................................................. at...J!:'�I. e........ l'. Z. ...... !' ...,North Andover,Mass. Fee..RJ .......... Lic.Noxi.?�/ .... ... . ........... .... ELECTRICAL S CTOR Check #fit 7287 Commonwealth of Massachusetts Official Use Only y Department of Fire Services Permit No. `77 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: A City or Town of. NORTH ANDOVER To the I p nor of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street& Number) ��' [3 �l¢�y4� W2 Drs'-4-,- 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—re C Utility Authorization No. Existing Service 440d Amps 12dl Volts Overhead ❑ Undgrd F!�]�No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: All c4el- �114 wrnA,::S" 1 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 9 Swimming Pool Above In- o.o Emergency Lighting 1 g rnd. ❑ rnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total o,o No. Alerting Devices Tons g No.of Waste Disposers Heat Pump Number Tons KW No.oSelf-Contained Totals: ,... Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No."of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP a No of Devices or Equivalent No.of Devices or E uivalent OTHER: x 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 O RAG : Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such covers e ' in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: !RI• 47"�1' LIC. NO.:1,740$//g Licensee: IV/IV#, Signature LIC. NO.:Lf(Gf.3Pe (If applicable, enter "exempt"in the license number line.) Bus.Tel. No.: Address: 0. Alt.Tel. No.: *Per M.G.L c. 147,s. 57-61, security work requires Department of Public Safety "S" License: Lic.No. OWNER'S INSURANCE WAIVER: 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 n Signature Telephone No. PERMIT FEE: $ jS . � ��- y_ ilr a 7 � � v _ � . . �--� a VtORTF1 Ib�tiO OL O �► O.9A COCMIL,tWKM`y7• c Too PUB[ Comn i�✓�C7 Joe Pandolfo, Partner Micro Ice Training Centers of America, P. 0. Box 427 (, C North Andover, MA 01845 �v` r�-- Re: Food Permit Application for 65 Flag Dear Mr.Pandolfo, U This.correspondence is to inform you th&..-.. L111CHr11a5-reviewed your application for a new food permit at Micro Ice Training Centers of America to be located at 65 Flagship Drive. The plan has been approved for the purpose of retail sales of non-potentially hazardous foods. A copy of this approval will be forwarded to the Building Department. Be advised, if any substantial changes in the plans occur during construction you are expected to advise the Health Department. Once basic construction is complete and the equipment is in place,please contact the health office for a construction inspection to verify that you have built it to plan. At that time we will sign'off the building permit. The final health inspection should be requested approximately 24- 48 hours prior to opening the establishment. This correspondence is a Health Department approval only. Please be advised that other departments may have specific requirements. This approval does not supersede any other department's request regarding other town or state regulations. Sincerely, F � LIE Susan Sawyer, REHS/RS Public Health Director Cc: file /CC. Building Dept. 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 918.688.9540 Fax 918.688.8416 Web www.townofnorthandover.com lUIkro k , 7"r4ining Centers of America North Andover "PLAN CHANGES" Changes #1 ■ The vestibule area will go back to exactly the way it was prior to us making any changes to the Yang's plan. ■ The manager's office moves next to the vestibule area as shown. Notice that we bumped out the manager's wall a bit so that the room size meets minimum square footage needed. ■ Door 102 to the big room needs is relocated as per plan. ■ Lounge shown as plan with %walls and a 42" opening near existing bathroom. ■ The new hallways are increases to be 6' wide in this area. ■ From vestibule, you walk in level, 6' deep by 6' wide,then ramp up to level area at office and rest of building. Changes#2 ■ We are taking some of the women's locker room to make room for two vending machines as per plan.. ■ Change needed at the two existing baths between doors 104 and 105. ■ Board of Health wants a little sink, counter and refrigerator area. ■ The baths are big enough to move both sinks closer to toilets and still be handicap. Changes#3 ■ We are sliding down the rink a bit off the other end wall by 18" so see new clear dimensions as shown on plan. Changes #4 ■ Where we had the handicap shower, we are making this a full handicap bath as per plan. ■ Add a janitor sink as per plan. ■ Add a water cooler as per plan. 65 Flagship Drive,Suite B ■ North Andover,MA o 18415 ■Phone: 8;7.8s.MICRO ■ Fax: 9 7 8.651.7731 Website: www.ir icroicecenters.com■ E-Mail:derek@microicecenters.com Date........... NORTI� °`t"`°;• '"° TOWN OF NORTH ANDOVER PERMIT FOR WIRING 41 •O•+r.°A�,�� �,sSACHus This certifies that ............. l�Nf�/ !�/j - ...P. -aif............................. ........................ . has permission to perform ........ .—,4 /� v / f. .......W'..... ..,.. .......T........................ wiring in the building of.............. ©4�7.. art at.........4 1V"�-. J hs� dIf North Andover,Mass. Fee.: Lic.No. 7. �...... ..... ELECTRICAL INSPECTOR V 1 Check # 3 Z�� �/ 7041 °w Commonwealth of Massachusetts official U.W Only �� Pei mit No. Department of Fire Services Occupancy and Fcc C'hcckcCl BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] i (leave blank) APPLICATION FOR-PERMIT TO PERFORM ELECTRICAL WORK All work to be pertbrmed in accordance with the Massachusetts Electrical Code(MEC),537 CMR 12.110 (PLEASE PIUNT IN INK OR TYPE ALL INFORAI ATION) Date: / _ 7_ City or Town of: �/ � A• O�i e ✓� To 1/l.e Inspector gJ•Wires•: By this application the undersigned gives notice of his or her intention to perform the electrical work desu-ibcd below. Location (Street&. Number) fj 6`5' f►%f a9 SAI in D r Owner or TenantT 1)c.,KC, Telephone Noq- Ay 37'ir3f Owner's Address �J O. Q a,2 p Qo x4 J Lt 1a• this permit ur conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box) Purpose of'Building CC Utility AuthorizationNo. j�2,j-7q_�,7 Existing Service/ oiD Amps J;t�► /�oIr�ICrlts Overhead ❑ Undgrd® No. of Meters New Service Amps / Volts Overhead❑ UnClgrd ❑ No. oi'Meters Number of Feeders and Ampacity I Location and Nature of*Proposed Electrical Work: / , �irlc�vtS �o ��is•rr<,.a ScaJ•Vct_e.� i a i�^��r Jai 0 A ai S r cs n u�c 7' �jl7e t—P✓ ©<�j�e�'7` Can)lelion of the fnilorring/able mat•he waived br the los)ec•lor of Il'irr.�. No. of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot TubsGenerators KVA No. of Lighting Fixtures SwimmingPool Above ❑ In- ❑ o.o mergency ig►ting . i-nd. �rnd. Battery Units No. or Receptacle Outlets No. of Oil Burners FIRE ALARMS No.of'Zones No. of Switches No.of Gas Burners No.of Detection and Initiating Devices No. of Ranges Total b' No.of Air Cond. 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 S ace/Area.Hcatin J KW Local Munieipal p g ❑ Connection ❑ Other No.of Dryers Heating;Appliances KN/ Security Systems: No.of Devices or Equivalent No. of Water No.of No.of Heaters KW Signs Qallasts Data Wiring: No.of Devic s or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: I' No.of Devices or Equivalent It OT!-AER: Allach rtrGliliunul rl:Irdl i/rlctrircrl,ur as required ht'the Inspec for o/' 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"coihpleted operation"coverage or its substantial equlvalcm. The unClersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. j 0.-iEC'K ONE: INSURANCE ®, BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: / p 6 Inspections to be requested in accordance with MEC Rule 10, and upon arinPlction. I certify, under the pains andpena/ties of'peljary, that the rinfil/lna//(/n o/I 1hiS all/JI7C(/tlOn rS t/!/L'(/n(l C'OI/117IL'CL'. FIRM NAME: c1A 1, 1-- 44 ;r LIC. NO.-_L-r7— Licensee: .: /'7Z•Licensee: Signature LIC. NO.: ((/appliccrhle, en/cr „erent�j�l"in the license int nherfne.) � � Bus.Tcl. No.:,17Z7?7S' Address: 5�2j Gin Ceti- 1C Q� oda oSS" Alt.`I'cl. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally I-Cduired by law. By my signature below, I hereby waive this requirement. I ant the(check one)❑ owner ❑ owner's a"cnt. Owner/Agent Si-nature Telephone No. PERMIT FEE: ,$ Date....-�—....—..Z.-..,0.6 .... .... .... ..... AORTpt TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING US This certifies that .. has permission to perform ..... ...... ?-�S ............... wiring in the building of... /./ ............................ at.....6....5............ .. VII51- 1,.............(.................... North Andover,Mass. 4 Fee.................. .... L i c.N o. &—.7. .&. ................ . ELECTRICAL INSPECTOR Nsp R Check # ad 7 Z 0,o© 66 I Commonwealth of Massachusetts Official Use Only ��2 L Department of Fire Services Permit No. Occupancy and Fee Checked BOA �REPRE � REGULATIONS [Rev. 9/051 (leave blank APPLICA N FOR MIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MLC:).527 CMR 12.00 (PLEASE PRINT IN INK OR TYIE ALL 1 FORMATION) Date: �f (o City or Town of: AOi l t�,dJEj 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& Nuler) 6 S Owner.or Tenant 4� d4Q/ 1,q Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No I (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters III New Service i Amps / Volts Overhead —1 Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work:' Com letion 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 Above ❑ In- ❑ o. o Emergency Lighting No. of Luminaires Swimming Pool ornd. grnd. Battery Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones No. No. of Switches No.of Gas Burners of Detection and Initiating Devices No. of Ranges No. of Air Cond. Tonal No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons KW No. of Self-Contained ....................................................... Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection Heating Appliances No. of Dryers g pp KW Security Systems:*No.of Devices or Equivalent No. of Water KW No.of No. of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP ►el No of Devicesons Wiring: No.of Devices or E uivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Ele trical Work:,, - (When required by municipal policy.) Work to Start: inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE. O ERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) I certify, under the pains andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: ADT Security Services, Inc. LIC. NO.: 1533 C Licensee: Jim Crotty Signature LIC. NO.: 1 167D (If applicable, enter "exempt"in the license number line.) Bus.Tel. No.: 6Q3-594-5900 Address: 18 CLINTON DRIVE HOLLIS N.H.03049 Alt.Tel. No.: 603-594-5930 *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. FPERMIT FEE: $ , k 4 µgRTiy of ciao a'�yA ti A Ic M �gsSRGiW$ES CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number Date 9- d 0 D THIS CERTIFIES THAT THE BUILDING LOCATED ON 6�� �~ /9 5 l� ,� :]12 00 1 U �- MAY BE OCCUPIED AS tn �01 t1ky r'(I!d / 0 C f- 3 P4 C � IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. ,CEJRTMCATE ISSUED TO L7 C; 30?ido L71L-0 Cck c-1,4— �`taSbcr� Building Inspector Nvrc ray Town of ower No. S'1' OL A o dover, Mass., COC HICH WICK V ORATED S BOAT OF HEADY* Food/Kitcheg Septic System PERMIT T D 4 BUILDING INSPECTOR THIS CERTIFIES THAT........ ..�.. ) C� b •• • ••• Foundation /' '� has permission to erect.... N. �O.... buildings on ....�.V�� �� .................. Rough,,,/ ��,,�.,G/ LJ ............. . . ....... . .. .. . ... ��l ............... to be occupied as Com.. .mv.p.c.1Z.'........�*.....MO�'j......../Q �� Chimney ...... . ............................................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in w: i this office, and to the provisions of the Codes and -Laws relating to the Inspection, A oration and Construction of B Buildings in the Town of North Andover. ® 0 &? jo " 3PLUMBING IN PECTOR VIOLATION of the Zoning or Building Regulations Voids this Perm' . su < —"?- / - o PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION START ELECTRIC INSP _ C ou � ......... ...... ...... ..... ... ..... Service BUILDING INSPECTOR , acupan.cy Permit Required t0 Occupy Building GAS INSPECTOR Rou h Display in a Conspicuous Place on the Premises — Do Not Remove F No Lathing or Dry Nall To Be Done FIRE DEPARTMENT Until inspected and Approved by the Building .Inspector. Burner , //// Street No. SEE REVERSE SIDE Smoke Det. i `1 CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number 0702 Date T —0 DD/ lig-/9-vo THIS CERTIFIES THAT THE BUILDING LOCATED ON MAY BE OCCUPIED AS A� Jifa/ ,94fs �,S/vel/-D IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. O' MORTN ,y CERTIFICATE ISSUED TO ADDRESS (� A > 1 / V E • s ''A Building Inspector I NORTH Town of 4 over 0 .No. Y, '° z , _ , $ -oo o = LA o dover, Mass., COCHICHEWICK -�-� AOAQATED S H BOARD OF HEALTH PERMIT T Food/Kitchen Septic System 4 ( ' BUILDING IN PECTOR THIS CERTIFIES THAT..KQV4!.V... ......yAw.6.1....... A *+14�........A;t.s.. Foundation has permission to ...1.N 1►.t1�.... g ...If...YS....... � .4�� t.. ..... ..... buildings ... ........... . Rough R**+INO i ......�N. .h .41.......l�.r..tu.......64M.0O t0 t)8 OCCUp18d aS.......................�.............�r' .�..................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. M 1 0 111 C P r1 4 PLUMBING INSPKTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL SP UNLESS CONSTRUCTIONT yy �; / ....4M-....... :................... BUILDING INSPECTOR in Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Fina No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. o Smoke Det. SEE REVERSE SIDE 1 J Location la's, / '",r No. Date _o?U,661 „pRT1y TOWN OF NORTH ANDOVER 3?per t„`O .•,M p � A 41 i Certificate of Occupancy $ Buildi /Frarr?e Permit Fee $ -3 d^CHUSk Foundation Permit Fee $ Other Permit Fee $ TOTAL $ --� Check # 15 5 4 uilding Inspector RECEIVED MAY 7 2002 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT EMNqMn" TRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING s Section for Official Use 01fly ic WELDING PERMIT NUMBER: ni 0 DATE ISSUED: SIGNATURE: BwidiN Commission or of Buddings Date 1.1 Property Address: 1.2 Assessors Map and Parcel Number. 1o7C Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: > Zoning District Proposed Use Lot Area(sf) Frontage(11) --q 1.6 BUILDING SETBACKS(ft) M Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40.§54) 1.5. Flood Zone lidimnation: 8 S—e!86-Disposal System: Public otn Private 0 zone Outside Flood Zone 0 On Site Disposal System 0 4W.IVI�O IIA1,12 -1 WWI1h � 2.1 Owner of Record icL "Cu —\ EVJ-, Z- 0 Na c ri Address for Service 1?E ?fq—gy/Z_ M Signature Telephone 2.ZAuthorized Agent k�A &S- -( 1, Oz. > Address for Service: z 0 Signature v Telephone z M & 90 3.1 Licensed Construction Supervisor Not Applicable 0 0,C6 sqf� Aqress License Number 0 e. Li n ction YSupervisor: >Z 6 A Expiration to Signa re V Telephone 3.2 Registered Home Improv&ent Contractor Not Applicable [I < Company Name', Registration Number M Address Expiration Date z Signature Telephone G) z Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yea ..❑ No ❑ sEcxtorl s >rz�lc>► a.� Ir >� lr Exvl<+ s lr�clrs ► s i CbN '18TCTit31�T C`( ITI�mL 11" d�t` a ' 11611!T'I' r lytQRl5, Grp b `�>lvlk slp�t 5.1 Re istered Architect: 4tRARC� /will- LONDO Ad V�� �• KH 9�8• X088• X2a3 , q� S Signature Telephone g a� 1, Name: Area of Responsibility Address: Registration Number Expiration Date Signature Total Not applicable ❑ Name: Registration Number Address Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 5. Not Applicable ❑ y Name: c� s e Responsible in Charge of Constructi 1St 'r +E3L {mak applicable. New Construction 0 Existing Building Repair(s) ❑ Alterations(s) 0 Addition ❑ Accessory Bldg. ❑ Demolition 0 Other ❑ Specify Brief Description of Proposed Work: 1AIZ WWA., 7'XIVAA/r )L-Yr-UP 011RIN 6PCiMIM!N OUO�PA* /V&U AqMVP- Gt!<�vyeius, NAV HURT, �Iaoify �aST. �GE� ��, s/WAM AS. f XAA1g 4 EME�6EJ�G`1 (,,l�l�u6 ��rSl6✓vAGE . USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 0 A-3 X IA ❑ A4 ❑ A-5 0 1B ❑ B Business 2A ❑ C Educational ❑ 2B ❑ F Factory ❑ F-1 0 F-2 ❑ 2C ❑ H High Hazard ❑ 3A 0 IInstitutional ❑ I-1 ❑ I-2 0 I-3 0 3B M Mercantile ❑ 4 ❑ R residential 0 R-1 ❑ R-2 0 R-3 ❑ 5A 0 S Storage ❑ S-1 ❑ S-2 0 5B ❑ U Utility 0 Specify: M Mixed Use 9 Specify: •g f BW19 < A• - /V/VOLS S Special Use 0 Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group:Alow V.z //- e 7 Proposed Use Group:// ow &M 4-06 Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: - IN"i s M BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels © CAtA J&6 Floor Area per Floors 04ro O No e; Total Areas O 6C Total Height ft 0 n M 71 Independent Structural Engineering Structural Peer Review Required Yes ❑ No ❑ SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property Hereby authorize to act on My behalf,in all matters relative two work authorized by this building permit application Signature of Owner Date i a � I, )A&., as�O /Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury Pri t m Signature of Aeenk bad Item Estimated Cost(Dollars)to be ( Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of o-D Construction from(6) 3 Plumbing Building Permit fee tl X(b) 4 Mechanical(HVAC) ya,00 a-V 5 Fire Protection >Z'00 0,o--o 6 Total '(1+2+3+4+5) Check Number T`<r;YS.✓bs,.'�z-� 7:5°kt r��.4:1 �� t ; £�47'4<4. �'/ �:dmFFAS� 'A'�. .Ll :3. , '.'�; 5 �" � ;t�".m i �"'7"1t., d'k r',v".r :and"V t .$try" Y 7Af. fF,,,�A'.:'.,?I'F`.- 9,+:'+':j^`�$� rC,3� z 3 .Y. -S ) '�i1 �.3 ilp. Tp�i• M_.ikt1 � .,tt'y^ { :r,Vel r }r'\!.�i �' C;': T6 Y'�#:t 1�3sp,;tkxi�'vd \—,.^M rb;�t!^XkF,-hr ;�._r.- `,�.�. ix., ;l.>.. ?t +'"!$.C,,'rn '�...' ,$' .s; k R,rn��;ei2.'.+fr ? .✓'< •`"`tt z+. M.,. �`pfr ¢pr ?{s�rl� r ,f z�5� r NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1T 2 ND 3RD SPAN a DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING x MATERIAL OF CBRviNEY IS BUILDING ON SOLID OR FILLED LAND a IS BUILDING CONNECTED TO NATURAL GAS LINE - ,5r `z .N ✓ w.�N��' ,.�� � .. +v.�,r yr �;x•- r �r �� z>:k' ``�o'-�"�'�"..;��y�itie`� sa• r��e �„"�.� 'a 1�-� .� sky ^n ,� a cw ,.'�<.�'',.�;`�,eiir,�":;s'� ,�"�:.:,:�F" � "�9 .vim s�g;,, ::� s'�x .fie-.'�"�mak`'k,g +'r'� r„uti �.,r'*`.` �-�r�-,z`` � r;.s •�r �,�'z it I Town of over ,� 1 0 No. S'T8 _ . L A o dover, Mass., �► "a `�a? 0" 'COC MIC W CR A0RATED .q T BOARD OF HEALTH PERMIT T Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........G o).......... ....... a. ... ..... . ..... .................. Foundation has permission to erect....1N.1tWW buildings on....06. Rough ... ... .... to be occupied as..... ©.h!�!. ! .�!. .�! .�.......As..... 0I........�Q..........�,rti.3................ Chimney provided that the person accepting this permit shall In every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and 7X� lating to the Inspection, eration and Construction of Buildings In the Town of North Andover. C/071 " 3, ...• PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this PeRough PERMTT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCnTON STAR ELECTRICAL INSPECTOR C Rough /I�:�l........ Service.. . .. . . . ............. ......... BUILDING INSPECTOR Final i Occupancy Permit Required t0 Occupy Bwlding GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises -- Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT _ Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE SmokeDet. OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER .` CONSTRUCTION CONTROL 31CNU5� PROJECT NUMBER: 200�t PROJECT TITLE: SGH lea Ieam A5►,&4=raTSs Tg.WANT F!T-OP. PROJECT LOCATION: 4151�I✓ FLA&C H lP PIZIVo (empar IeBAR) NAME OF BUILDING: 67✓ F�A&SmIP Pplva NATURE OF PROJECT: TWA+4 4=►r-NP. orlr�. IN-ACCO)RDANCE WI ARTI 116 OF THE MASSACHUSETTS STATE BUIL ING CODE, rz��o�y AUL < 11114 REGISTRATION NO. BEING A REGISTERED PROFESSIONALENGl 4K-WARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN P COMPUTATIONS AND SPECIFICATIONS CONCERNING: AAC GpRY P•s� No.8688 ENTIRE PROJECT ARCHITECTURAL STRUCTURAL 0 MECHANI DONUEMY, 0 NH 0 9l FIRE PROTECTION 0 ELECTRICAL 0 OTHER(SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE.AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND 131; PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become, generally familiar k-"-- with$the progress and quality of the work and to determine, in general, if the work is being perfomied in a.manner consistent with the construction documents. PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT ✓� TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FI EP RT AS TO THE SATISFACTORY COMPLET iON AND FeEADI NESS OF T ETF OCCUPAN ./ ,a f� NATURE SUBSCRIBED AND SWORM TO BEFORE ME THISDAY OF 20Dc� ARY PUBLIC �DdS MY COMMISSION EXPIRES A /,,t�G. e - Jle �Samsnmruoaallli a�'✓��aaaac%uvelta y - BOARD OF BUILDING REGULATIONS p License: CONSTRUCTION SUPERVISOR i Number: CS 056848 " Birthdate: 04120/1963 ` Expires:04/20/2003 Tr.no: 9411 + - Restricted To: 00 DAVID E MURRAY _ a 1 LEE ROAD L•G«..e ! , N READING, MA 01864 Administrator M DATE MM/DD/YY' i:i:....i. ii iy asiji:i :y::?;ij:i3: i>:iii:i:°(i..... '::; ::: :;:i;:;:i;:;:::%:3: ......j :......ijii;Yi`t'i3i'tZi :: is i:;:: i%:i: asij i%; i;i iiiii:::i?:i: ii;ii:ii:'iii't? 5........ /13/02 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION A & K Fowler Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 200 Park St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. N. Reading, MA 01864 COMPANIES AFFORDING COVERAGE COMPANY A Zurich Insurance Co. INSURED COMPANY Ranger Development Corp. B 65 Flagship Dr. COMPANY N. Andover, MA 01845 C COMPANY D 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DD/YY) DATE(MMIDD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000 A g COMMERCIAL GENERAL LIABILITY SCP31470975 5/15/02 5/15/03 PRODUCTS-COMP/OPAGG $ 2,000,000 CLAIMS MADE 7 OCCUR PERSONAL&ADV INJURY $ 11000,000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE(Any one fire) $ 50,000 MED EXP(Any one person) $ 10,000 AUTOMOBILE LIABILITY A ANY AUTO CA90544362 5/15/02 5/15/03 COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ 500,000 HIRED AUTOS BODILY INJURY $ 11000,000 NON-OWNED AUTOS (Per accident) 1 PROPERTY DAMAGE $ 100,000 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND WC STATU- OTH- TORY LIMITS ER :.. EMPLOYERS'LIABILITY EL EACH ACCIDENT $ 500,000 A THE PROPRIETOR/ INCL WC95785136 5/15/02 5/15/03 EL DISEASE-POLICY LIMIT $ 500,000 PARTNERSIEXECUTIVE OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 500,000 OTHER I DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/SPECIAL ITEMS Insurance verification ERTEFIA `•FOLLIEf> > ><> > > « >> > >< < >>> >> > >>; 'CANCELLATION ;:. .,: :..:...:.. ' >>'>» > < ;;> :>::>:;:; : ::;>:::::»:> >>> :<:>:»:>:::::::::: ...... ...:..........::.::............... ......:::..:::.....::..............;::::.:.::::::::.. �ANCELtAT1 kN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Town Of North Andover EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL North Andover, MA 01845 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Lisa A. Daly, CISR ..:..:..:::.,. . .... . . :::::::::::::. ::::::::::::::::::::::::::::::::.::::::::::::::::::::::::::......:...::................................................................................................................................................. �.:.:. .) ::. ... :: .;......... .: ...........::.;:::.......:::... c� G#r l f ORA t it 1 88. IVorth Andover Building Department Tel: DEBRIS DISPOSAL FORM in accordance with the provision of MGL c 40 S ,54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of irl a properly licensed solid•waste disposal facility as defined b c 11, S 150 A. y MGL The debris will be disposed of in: (Lo 'on of Facility) Signa re of P it Applicant Date NOTE: Demolition permit from tF a Town of North Andover must be obtained for this project through the Office of the Building Inspector FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT — G PHONE LOCATION: Assessor's Map Number /6 PARCEL -G SUBDIVISION LOT(S) STREET37S-Vf �, ST. NUMBER ***************************************** OFFICIAL USE RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT 7 RECEIVED BY BUILDING INSPECT -R DATE_ Revised 9\97 jm Location 60— No. �i Z U Date NORTh TOWN OF NORTH ANDOVER F w t s Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ s•►CHuse 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # ff', 7 17635 ` Building Inspefor t COMMONWEALTH OF MASSACHUSETTS TOWN OFNORTHANDOVER 27 CHARLES ST APPLICATIONFM-CERTIFICATE OFINSPECTION Date � ' I Ai�� O Fee Required(Amount) 0. O No Fee Required Accordance with the provisions of the Massachusetts State Building code, Section 108,15, I hereby apply foi Certificate of Inpectien for-thebelew-named prusesleca#ed-at-the followan -addess: Street and _ Number D IT7 FL ACa 15tt)P (A Name of Premises� La 5 IVV_T1kt__. ARTS Purpose for which Premises is Used MA12nkl, Y1DQPV Licenses (s) or Pegrm t-�s)Required for-the Premises by-Other�Goverwnwval Agovies: License or Permit Agenc i Certificate to be issued to Address 06 Ft.A�(aSt-hP pR• —rte Telephone q R -7255 Owner of Record of Building Address M/kr► :� M N,T7�. ® � 2 Name of Present Holder of Certificate SA-fh�l Aci.. ,Y'`tZ Name of Agency, if any SIGNATURE OF PERSONS TO WHOM CERTIFICATE TITLE IS ISSUED OR J 1US A UTHOIRIZED AGENT 9114101 DATE INSTRUCTIONS: 1) Make check payable to• Town of North Andover _ 2) Return this application with your check to: RuddingDeept 27 Charles Street,North Andover MA 01845 PLEASE NOTE. Application form with accompanying FEE must be submitted for each building or structure or part thereof to be cert 3) Application and fee must be received before 4he-certf cate Paull-be Issued. 4) The building officials shall be notified within ten (10) days of any change in the above information. CERTIFICATE# EXPIRATIONDATE: FOPMSBCC-3-74 kERSEB21994me THE COMMONWEALTH OF MASSACHUSETTS TOWN OF NORTH ANDOVER In accordance with the Massachusetts State Building Code, Section 106.5 this CERTIFICATE OF INSPECTION IS ISSUED TO... YANG'S MARTIAL ARTS I CERTIFY THAT I have inspected the premise known as YANG'S MARTIAL ARTS Located at 65 FLAGSHIP DRIVE SUITE B in the TOWN of NORTH ANDOVER, COUNTY OF ESSEX Commonwealth of Massachusetts. The means of egress are sufficient for the following number of persons: BY STORY 1 Story Capacity Story Capacity Story Capacity T 5 Place of assembly Place of assembly Capacity Capacity Location Location Place of assembly Place of assembly Capacity Capacity Location Location '¢ 17635 SEPTEMBER 28,2004 SEPTEMBER 28,2005 Certificate Number Date Certificate Issued Date Certificate Expires Building Official r Location 6-5- ' a-djP No. o Date N�RTM TOWN OF NORTH ANDOVER 1O? • • OR 41 .. 9 • Certificate of Occupancy $ sACHU <� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ � Check # a (/ Bu tling Inspector 3 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT l APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING T OTHER THAN A ONE OR TWO FAMILY DWELLING /r Section for Oficial Use Onl BUILDING PERMIT NUMBER: 617c� DATE ISSUED: Z SIGNATURE_ : An Y C0 Buildin `Gummi Toner ®rofBuildings Date 1.1 Property Address-, 1.2 Assessors Map and Parcel Number. ��« pmt v� ( ✓ ��1�v�2' a Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: v Zoning District Proposed Use Lot Areas Frontsge(11) m 1.6 BUILDING SETBACKS(ft). Front Yaro Side Yar Rqar Yard Re r Provide R ed Provided Required Provided 1.7 Water Supply M.G .C.40. 54) 1.5. Flood Zone h 1.8 Sewerage System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal Oa Site Disposal System ❑ ^F 2.1 Owner of Record Qy .101 . 6 ,/�� Naifie(Print) Address for Service 917r- Signature Telephone 2.2 Authorized Agent D Name Print Address for Service: z 0 Signature Telephone z 90 3.1 Licensed Construction Supervisor Not Applicable ❑ Address License Number 0 AIOO D 12- I 441 .s llovo, Nhill is n Con / upervisor. ✓ / ._ --;F�/ Expiration to gnature Telephone 3.2 Registered Home Improvement eontractor Not Applicable a� 0 Company Name,_ Registration Number m r Address Expiration Date ^Z Signature Telephone /'1 i s c rox a c+ xMa xsa cl +r �.V ; Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Si ned affidavit Attached Yea.......❑ No.......❑ SIMox srxn> tori y+�x ry cy��v�+ ►yy��+� TRI 5.1 Registered Architect: -OARP r 0 YP C Mame: _ No.6688 Address F 1A G� Signature Telephone a t t? �%2j jj0�►(� Name: Area of Responsibility Address: Registration Number E Signature Total Expiration Date Not applicable ❑ Name: Address Registration Number - Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date , Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date b ^9 Not Applicable ❑ Company Name: Responsible in Charge of Construction u y I J )11I 'lll " ck alIpcable v New Construction ❑ Existing Building Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition 0 Other ❑ Specify Brief Description of Proposed Work: ��NdyP,T1bN ©>✓ l N'(�R6oFl ��� Fo�. t�I�ZTtorl.- ��fs sTv til o � USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 IA ❑ A4 ❑ A-5 ❑ IB ❑ B Business ❑ 2A ❑ C Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C H High Hazard ❑ 3A ❑ IInstitutional ❑ I-1 ❑ I-2 ❑ I-3 ❑ 3B M Mercantile ❑ 4 ❑ R residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE TIIIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE a-3 Existing Use Group: F—:A—C JQ/( Proposed Use Group:_A50%- I>6'( Existing Hazard Index 780 CMR 34: �j Proposed Hazard Index 780 CMR 34: 5 BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floors 0M z Total Areas Total Height ft ► �- b i f Or��Y (0=0 SF ®V `n*F_ 2,+,o00 IS ACKUtCAI-6L TO'Trb-->Ac9PLA c/Yf1 01-1 , Independent Structural Engineering Structural Peer Review Required yes ❑ No SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, D N\J i D M l�(�(�/kas Owner of the subject property He u e to act on My , all rs relative two work authorized by this building permit application dAZv-vU Signature of Owner r as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury Print Name Signature of Owner/Agent Date � y: Item Estimated Cost(Dollars)to be Completed by permitapplicant g 1. Building (a) Building Permit Fee 41 DOD Multiplier 2 Electrical (b) Estimated Total Cost of oco Construction from(6) 3 Plumbing Building Permit fee (a)X(b) loco 4 Mechanical(HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) �' Check Number .dN... 00, T�� ise�'!�� -�`'414 4P ,�dF,_�Yk a��.3 '�"+Z'.� �a '4r �a �' '�'d.J �' S3 i:.'�s yr `' 'y�`�2f�i��„>; .:�; �"1x1.�r� t Bt rL,"..1 d s..�kx r �: ,���•.., ,r. .:�• .•dq#,7q 5 ,€�. ./xr,�-:a..t ct "', 4r s�R:� ye. li^x� pb, ?Vh .,�'JYfivu rk rs. t t.N•"i:��•'r�k r:rdEi duel k�. ,�Sr...,2 wda ��''k4..y3"` Ri,.td,;_.� 3,`z1'�,�v��i* � a} �.�.t u�" 1r' � "-:n�t..:.a,�`r.-� � �t •43s- a �:.,irk� �i,}�:" a3 ,*h:Y',i�'J�A� �":.�',? NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR T?%4BERS iST 2ND 3RD SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DMIENSIONS OF GIRDERS HEIGHT OF FOUNDATION _ THICKNESS SIZE OF FOOTING X MATERIAL OF CHRANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE M.a t ��[^['2d SS d' �i ' x 3q_. �i' "r I i l FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all- necessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. .............................................■............s................• APPLICANT I b 0rLLI PHONE ASSESSORS MAP NUMBER l_ LOT NUMBER SUBDIVISION �'" LOT NUMBER STREET Flip- Ss STREET NUMBER Z2 Ism N.mm was a anon allow ouvo onus ONUS a ago a NEWS so a as Sam as Ono am Mao an ass a ME No a I OFFICIAL USE ONLY RECOMNIENDATIONS OF TOWN AGENTS DATE APPROVED CONSERVATION ADMINISTRATO DATE REJECTED COMMENTS DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD INSPECTOR-HEALTH D REJECTED TE APPROVED SEPTIC INSPECTOR-HEALTH REJECTED COMMENTS / PUBLIC WORKS-SEWER/WATER CONNECTIONS /D WAY PERMIT �'JC DATE APPROVED FIRY DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE NORTH ONXM . 0 f dover 0 _=� over Mass. COC MICIC ME WICK � � , ADRATED oPly 5 S H E BOARD OF HEALTH PERMIT T Food/Kitchen Septic System THIS CERTIFIES THAT..�'1.Qv�l y .........,� R�'�' �� BUILDING INSPECTOR `. Y�Wo ...................... • " """"""""""' Foundation has permission to eo. buildings on ....to... F� P...... . g Rough .... .. . . .. Rtf�0�� to be occupied as r.... A h �r�.......A.rt% M V Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. O C PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTION T TS Rough , .... ........ .............. ............... .. Service ............... . . ..... ........ BUILDING INSPECTOR Final OccuPclncy Permit Required to Occupy Building GAS INSPECTOR M Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final - - No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner f Street No. - SEE REVERSE SIDE Smoke Det. !! - f CERTIFICATE OF INSURANCE ___________-------------------I 12/14/190 - ------------------------------------------------------- PRODUCERCOMPANIES AFFORDING COVERAGE COMPANY A: Maine Mutual S.I..I.M,Insurance Policy #' SC 01001 90 P.O. Box 1019 Eff.. Date: 07/11/00 Exp. Date: 07/11/01 Raymond„NH 03011 = COMPANY B: NCCI Policy #: Binder/App `--`----`------------------- Eff. Date: 12/15/00 Exp. Date: 12/15/01 INSURED =COMPANY C: Policy #: �_______- KDS Builders & Contracting Eff. Date: / / Exp. Date: 9 Old Ham Rd =COMPANY D: Raymond, NH 03077 Policy •# I ----=__- - Eff. Date: / / Exp. Date: ---------------------------------------------------- THIS CERTIFICATE IS ISSUED AS INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERT. HOLDER. IT DOES NOT AMEND, EXTEND OR ALTER COVERAGE BY POLICIES HEREIN. COVERAGES This is to certify that 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. - Col TYPE OF INSURANCE ( All limits in THOUSANDS --+---------------------------------+--------------------------------------- GENERAL LIABILITY $ 600 General Aggregate A [X] Comm. General Liability $ 600 Products/CompOps Aggregate A [X] Occurrence [ ] Claims Made $ 300 Personal/Advertising Injury [ ] Owners/Contractor Protective $ 300 Each Occurrence $ 50 Fire Damage (any one fire) [ ] $ 5 Medical Expense (one person) --+---------------------------------+--------------------------------------- AUTOMOBILE LIABILITY [ ] Any Auto $ Combined single limit [ ] All Owned Autos Bodily Injury and Property [ Scheduled] uled Autos Damage [ ] Hired Autos [ ] Non-owned Autos $ BodilyInjury [ [ ] Garage Liability $ BodilInjury (per person)J y Injury (per accident) $ Property Damage ---------------------------------------------------------------------------- EXCESS LIABILITY $ Each Occurrence ] Umbrella Form $ Aggregate [ J Other than Umbrella $ Self-insured retention --+---------------------------------+--------------------------------------- WORKERS COMPENSATION $ 100 Each Accident B I AND $ 500 Disease Policy Limit EMPLOYERS LIABILITY $ 100 Disease Each Employee --+---------------------------------+--------------------------------------- $ ----------------------------------------------------------------------------- Description of operations/locations/vehicles/other 65 Flagship Drive N Andover MA -- ) CERTIFICATE HOLDER I -------------- I CANCELLATION I ----------------------- Bodies In Motion Inc d/b/a If cancelled prior to expiration date, Yangs Martial Arts issuing company will endeavor to send 3 Dundee Park Suite 15 10 days written notice to cert. holder. Andover MA 01810 ---------------------------------------- -------------------------- --------Authorize rest a vel - t�-lg-�7j-=1 y -------------- Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print mum Name: Location: 105 ✓e . Phone ® � am a homeowner performing all work myself F�11 am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. Company name: Address City: Phone# Insurance Co. Policy.# Company name: KEo �d Address Ci Phone#: Insurance o. Al Policv# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. t understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify un pains and penaNies perjury that the information provided above is true and correct Signature Date Print name Phone# Official use only do not write in this area to be completed by city or town official' C]• Building Dept ❑Check if immediate response is required Building Dept E] Licensing Board Q Selectman's Office Contact person:_ Phone#: E] Health Department Other FORM WORKMAN'S COMPENSATION g4- �J lf � , '67 a�.. i BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 049661 _ Birthdate: 11/13/1949 Expires: 11/13/2002 Tr.no: 4022 Restricted To: 00 PAUL ETERIAN JR 34 BAYWOOD DR ' HAMPSTEAD, NH 03841 Administrator •°�_» OFFICE OF BUILDING INSPECTOR TOWN OF NORTH-ANDOVER CONSTRUCTION CONTROL PROJECT NUMBER: PROJECT TITLE: PROJECT LOCATION: NAME OF BUILDING: 09 �o� FLAGSHIP BIZ/v� NATURE OF PROJECT: K�eNbVA77aN or- llym alz- r-ax- �YlH217f P19TS 67 UO/v IN AC ORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE.BUILDING CC DE, �2O&V rz� (�. S 44 171'f' REGISTRATION NO. B(og BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, . COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT ❑ ARCHITECTURAL STRUCTURAL ❑ MECHANICAL ❑ FIRE PROTECTION ❑ ELECTRICAL ❑ OTHER (SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE. ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCt7:RDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. -� 2. Review and approval of the quality control procedures for all code-required controlled mated ��,ZRp P �y�lF� 3. Be present at intervals appropriate to the:stage of construction to become, generally famili NO.g� with the progress and quality of the work and to determine, in general, if the work is being 8 LorrooNotRRr, performed in a manner consistent with the construction documents. o NH A PROGRESS REPORTq PURSUANT TO SECTION 116.2 .2 I SHALL SUBMIT WEEKLY , lny OF Mt,S TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTO . UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FJQR OCCUPAN GTURE SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF 19 NOTARY PUBLIC MY COMMISSION EXPIRES I TOW i4 OF NORTH ANDOVER Oflbce of the Building Department Commomity Development and. Services 27 Ch.isles Street * � Norlh Ando er,.i 1a.ssachusetts 01845 aRR7lP AP*' �S�AC!l15�S D. Robert l4iCetfa, Telephone(978)688-9545 Mlikfin 0111I1t2€,4FFoller FAX(978')6'88-9542 i July 23, 2.002 Gregory P. Smith GSD Associates 148 Main Street North Andover, MA 01845 RE: 65 Flagship Drive Dear Mr. Smith: Please be advised that upon review of the paperwork for the project at 65 Flagship Drive for Schreiber&Associated,P.C. it had been overlooked that the parking lot has been reconfigured for additional parking spaces. Please be advised that any increase of 5 (five)or more parking spaces requires either a site plan review or a site Plan review waiver through the Planning Department. The contact person in the Planning department is ClayMitchell interim Town Planner @ 978-688-9535 and his hours are Tuesday's from 10:00 AM to 4:00 Pm and Thursday's from 9:30 AM to 4:00 PM. Thank you in advance for your prompt attention to this matter. I may be reached between the hours of 8:30 to 10:00 AM and 1:00 to 2:00 PM at 978-688-9545. Respectfully, Michael McGuire Local Building Inspector Date.. ... ......... 304- 2 f HORTF,� 1om`' TOWN OF NORTH ANDOVER A PERMIT FOR WIRING SSS^CHus� This certifies that .... !� .r � . ................. ....................................................... has permission to perform T ...................... US.............. wiring in the building of.............................. .................................. `� S �,� 2 ... ,No Andover,Mass. at........................�... .....�....... t........ T. Fee... Lic.No.............. ................. ELECTRICAL I SPECTOR 5' Check # Official Use Only Permit No. a est 4;D-04 S44 Occupancy&Fee Checked BOARD OF FIRE PREVENTION REGULATIONS.527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 2: (Please Print in ink or type all information) Date 7 0 To the Inspector of Wires: Town of North Andover The undersigned applies for a pen-nit to perform the electrical work described below. Location(Street&NumA?)Ulf owner or Tenant 6t-0194c Owner's Address o� /3RlDGC'U/(�C,� Ci2CC� %yMLU/302U � Is this permit in conjunction with a building permit Yes No ❑ (Check Appropriate Box) Purpose of Building JP7,-ian t..a, J n%IA-ul Utility Authorization No. Existing Service /QUO Amps -2 Voits Overhead ❑ Undgmd kD No.of Meters New Service Amps Voits Overhead ❑ Undgmd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work J�'/�t({ Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA Above ❑ In ❑ No.of Lighting Fixtures 0 Swimming Pool grnd ❑ grnd ❑ Generators KVA No.of Emergency Lighting No.of Receptacles Outlets 0 0 No.of Oil Burners Battery Units No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone 7 Total No.of Detection and No.of Ranges No of Air Cond J Tons a Initiating Devices Heat Total Total No.of Di sal No. Pumps Tons KW No.of Sounding Devices No./of Self Contained No.of Dishwashers Space/Area Heating KW Detection/SoundingDevices ❑ Municipal ❑ Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW I Signs Bailases Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES= NO = haye submitted valid proof of same to the Ofticq:y� NO = If you have checked YES please indicate a type of coverage by checking the appropriate box CTN- ------ (Expiration BOND = OTHER = .(Please Specify) w (Expiration Date) Estimated Value Of Electrical Workb �U DCD Work to Start Inspection Date Resquested Ijh-L Cr9LL Rough Final Signed under the Penalties of perjury: FIRM NAME LIC.NO. Li ensee'y-a'l"K D Gam'i U cA Signature "�- LIC.NO. Bus.Tel No. 9'71-(e 7o- 9R/.3 Address o• L702L o?D S 0//j1f,4V/Q r Aft Tel.No. OWN IS INSURANCE WAIVf-R: I am aware that the Licenses 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) t Telephone No. PERMIT*EE $ (Signature of Owner or Agent) / i I G *S *D COMPUTER AIDED DESIGN ARCHITECTURE ASSOCIATES PLANNING INTERIORS DEVELOPMENT CONSULTING AFFIDAVIT FROM THE REGISTERED ARCHITECT IN THE COMMONWEALTH OF MASSACHUSETTS re: Yang's Martial Arts , 65 Flagship Drive, North Andover, MA On this 5" day of February, 2001, 1 Gregory P. Smith, being a Registered Architect in the Commonwealth of Massachusetts, #8688 Certify the following. I certify that I have observed the work associated with the construction of the above mentioned project and associated work for the tenant fit-up space at the location listed above. To the best of my knowledge, information and belief, the work completed to date is in conformance with the approved plans and the provisions of the Massachusetts State Building Code, subject to completion of the below items. This affidavit is for the work completed to 2-5-2001 upon which our last inspection was made. The work listed below is required to be completed. 1. Complete the installation of the exit hardware at the front entrances. As required by Section 1017.4.1 and Section 1017.4.2 of the Massachusetts State Building Code. 2. Provide HVAC balancing report to Architect to verify completion and operation of the HVAC system. 3. Completion of the handrails at the entrance and ramp. �S_EaEo AR,- � No.8688 y LONWNDERRY, OF Registration # 8688 Registered Archit cNSealdSignature Gregory P. Smith, AIA Architect GSD Associates 148 Main St. Bldg. A North Andover, MA 01845 TEL:(978)688-5422 E-MAIL: gsd-assoc@worldnetatt.net FAX. (978)688-5717 148 MAIN STREET, BUILDING A" N.ANDOVER, MA 01845 03/12/15 THU 00:36 FAX Q002 S*D COMPUTER AIDED DESIGN ARCHITECTURE ASSOCIATES PLANNING INTERIORS DEVELOPMENT CONSULTING February, 2, 2001 Mr. Michael McGuire North Andover Building Department 27 Charles St. N. Andover,MA 01845 RE: Yang's Martial Arts, 65 Flagship Drive,N. Andover,MA 01845 Dear Mr. McGuire, On February 1., 2001 we again visited the site for an inspection of the property in anticipation of the space ready for occupancy by Monday, 2-5-2001. The construction has progressed to where it is possible that they will be ready for occupancy on this coming Monday. At the time of our latest visit carpet had not yet been installed, and interior doors had not been hung,but these were expected to be completed by Monday according to the owner. The plumbing connections were being completed during the visit. The handicapped ramp has been constructed and they were finishing the handrails. The interior finishes are generally completed except for misc. punchlist items. Items that should be tested include the fire-alarm and sprinkler system to verify that they are working. The HVAC system will require a balancing report to verify that it is in operation. I am planning to be out at the site today 2-2-2001 during your visit at 2:00-2:30 time frame. If there is any items that need to be addressed prior to his opening. Sincercly, GSD Associates Vw" Gregory P. th, AIA Architect TEL'(978)688-5422 E-MAIL: gsd-assoca wondnet.att_net FAX (978)688-5717 148 MAIN STREET,BUILDING A" N.ANDOVER,MA 01845 Nov-07-00 05: 31P THORNTON LAW OFFICE 978 921 5387 P.01 Global Rcalty Trust. David R. Murray, 'Trustee 65 Flagship Drive North Andover,MA 01845 November 1, 2000 i Town of North Andover Building lnspect.or's Office Charles Strect North Andover, MA 01845 j To Whom it May Concern: i am writing this lcuer at the request of Bodies In Motion,d/h/a Yang'y Martial Arts a prospective tenant in a building owned by Global Realty Trust., which building is situated at 65 Flagship Drive,North Andover. As a condition to(he lease,Bodies In Motion must apply for a Permit with the Building Inspector to operate a Martial Arts studio in an area designated by the Planning Board as an Industrial 1 District. My understanding is that prior to granting the permit your office would like to gain a better understanding of the current and in(crnded use of the facility.To assist the prospective tenant in obtaining the nucessary permit, l would therefore like to make the following explanation of the use of the facility, The building contains 24,000 square feet of gross floor area on one floor.Global Electronics,111-1 occupies 12,000 square foot that it uses in its light manufacturing operation_Global is engaged high tech assembly of printed circuit boards. It does not manufacture the components,but instead assembles cornponent.s that it acquires from various suppliers in the:production chain. It is intended,provided the permit is approved,that Bodies in Motion d/b/a Yang's Martial Arts will occupy an additional 6000 square feet.The remaining 6000 square feet is currently unoccupied. Based on our attorney's assessment of the Zoning Ordinances of the'town of North Andover,this use is consistent with permitted uses in an Industrial 1 District.Further, it appears from)my own review that a Martial Arts Studio would be ermitted, albeit b Permit. As cacti unt.it would be P Y Y self-contained,and none of the occupying businesses in any way create any condition that could be considered a nuitiance or cif a noxious character,it is my strong hope that.you approve the Permit requested by Yang's Martial Arts, it'you have any questions or if 1 can be of any norther assistance, please do not hesitate to call_ R s ctfu y, G1 ba Rea i.y rust 1 David C. Mut Trus 'c Dr.M/cjt. PETER J. CAKUSO ATTORNEY AT LAW TEL:(978)475-2200 ONE ELM SQUARE FAX:(978)475-1001 ANDOVER MA 01810 carusolaw@msn.com Flagship Commercial Real Estate,Inc. 1 - 867 Turnpike Street,North Andover,MA 01845 4 Q �'� 1�� i� 978/686-2111 Fax.978/6862237--------------------------- X �j Q o tOVZ o � x i IMN8Yd _ � K i 1 1 I I �a t tJ w � .06 ----- A All- 'tom •'4 Nw. / ' �; ►�' � 1.•1i. �\'.i 117l't CIA CO ip -\ `_ � '• ,�` 1 r , ill w1 � f � �`',w•\ .- "'' � ... '` ?� .� mot ., • ;• . Flagshlp Commercial J ^ f fr Real Estate,Inc. 867 Turnpike Street t North Andover, Mass.01 M5 1 NUU S TRJ K LOT E' \ CA 3.71 AO. 1 - r- ....................................................................................................................................................................... OCT-06-00 10 :53 PM, P. 02 the of passuchusetts OFFICE OF THE MASSACHUSETTS SECRETARY OF STATE :.miner MICHAEL, J, CONNOLLY. Secretary ONE ASHBURTON PLACE, BOSTON, MASSACHUNE 1'I S 02108 ARTICLES OF ORGANIZATION (Under Gar Ch. ISM ARTICLE I an►e The name of the corporation u: pproved Traditional Chinese Martial Arts Centerr Inc. ARTICLE a The purpose of the Corporation is to enpapt•ip the following business aclivitisi: (1) To engage in the study and teaching of the art of traditional Martial Arts. (2) To carry on any business or other activity which may be lawfully carried on by a Corporation or aniz d under der the law of the Commonwealth of Massachusetts, whether uornnot related tion to those referred to in the foregoing Paragraph. 9-36 C P . M R Q t Note: If the space provided under any article or item on this form is insufficient,additions shall be set forth on separate 8':it 1 I shots ol'•paper 'leavins a left hand margin orat least 1 inch.Additions to more than one anicle maybe continued on a single sheet so long as each articreregviriny C , each such addition is clearly indicated, t• 2 Premiiminary & Tentative fie"o Door with Viewing Window Interior viewing window ® Front Desk Counter/Workspace XN\\\ Existing overhead door Solid Door O Window Front Q Exterior Office Entrance commercial rile Women Men Est. Est. 10'x 10 9'x 13' Glass 117 SF interior Countor/Workstaiton enclosure Front Desk/Counter Room 3 22'x12 Commercial Tile 35x35 ' 225 SIF 1225 SF Carpeted 2'x 4'Sub Floor - - - - - - - - - - - - - - - - - - - - - Carpeted 60' Carpeted swommo Room 1 30'x 40' 1200 SF 2'x 4'Sub Floor Room 2 commercial the Note: Drop ceiling 60 x 25 throughout Office 1500 SF 2'x 4'Sub Floor Est. Carpeted _l 0'x 15' 150 SF 1 Carpeted s _ - 100, R: 10/20/00 65 Flagship Drive - Alex or Diana Klesei (978) 474-0509 • Confidential LAW OFFICES PETER J. CARUSO ONE ELM SQUARE ANDOVER,MASSACHUSETTS 01810 PETER J. CARUSO TELEPHONE: (978)475-2200 PETER J. CARUSO II FACSIMILE: (978)475-1001 November 21, 2000 Heidi A. Griffin, Town Planner Town of North Andover 27 Charles Street North Andover, MA 01845 RECEIVED RE: 65 Flagship Drive (Map 107C, Lot 76 (J)) NOV 2 1 2000 North Andover, MA Site Plan Review-Warner NORTH ANDOVER PLANNING ING 14EPA1=e FM NT Dear Ms. Griffin: This office represents Bodies In Motion,Inc., d/b/a Yang's Martial Arts. They have entered into a lease at 65 Flagship Drive for use of 6,000 square feet of the existing building. See attached sketch for location of parking space and number of P g P s aces available. We respectfully request a waiver of a full site plan review. The building is an existing structure. No exterior work will be performed. The back 6,000 square feet are now vacant. There is sufficient parking available. Please place this matter on the agenda for the next planning board meeting on December 5, 2000. Sincerely, Caruso & Caruso Peter J. Caruso, Esquire PJC/pdc Enc: Brush/Trees cn — V t4 Pavement 2 s aces _ throughout z�' U_ — N Est. Q— U 6,000 SF cn— — Vacant C �— — .Q = � CL- _ Est. 6,000 SF �_ Q. Yang's C -_ Martial Arts Est. — Q— 12,000 SF Owner Pavement Occupied throughout yo Co _— 65 Flagship Drive P Entrance Flagship Drive premilminary & Tentative o poor with Viewing Window Intedog viewing window Sca4-=10 Feet CL O Front Desk Counter/Workspace \\\\\\ Extstfng overhead door, Solid Door O Window Front Office Enter C Too w9 i Est. Est 9'x 13' IcrX19 117 SF rAwior cortwrwo"aMon encioass Front Room 3 DeskCour*er 4S x34' 22'x17 Commerdor rs 1413 SF 225 SF Carpeted 2'x 4 Sub Rom ---- - --- - -- - ---- -- Capered Carpeted cn Room 1 35'x 40' 1400 SF CL` 2x 4'Sub rano. Room 2 CorTo'mu toe 55'x 261/4' Office 1.430 SF refs roam wig be ~ Est. rnoned wag to m 10 x 15' wW. No sub-Aba. j MSFOD f c Carpeted f o z \\\\\\\\\\\\\\\\\\ 65 Flagship Drive - Alex or Diana Mosel (978)474-0509 • Confiderillol ff i Town of North Andover ,NORTH Office of the Building Department Community Development and Services Division William J. ScottDivision Director '� °* .. s:.•�a + r.°►� 27 Charles Street �SS�CHuS North Andover, Massachusetts 01845 978 hone Tele 688-9545 D. Robert Nicetta P ( ) Building Commissioner Fax(978)688-9542 TO: Heidi e di Gnffin, Town Planner FROM: Michael McGuire, Local Building Inspector DATE: 12/1/00 RE: Proposal for Bodies In Motion, Inc./Yang's Martial Arts 65 Flagship Drive Upon review of the proposal to locate the above referenced use at this location please be aware of the following issues. 1) This is a change of use in a 6000 square foot facali g q ty. 2) The use is allowed by zoning but requires Planning Board approval due to the change of use and size 3) The parking for the existing manufacturing/assembly requires 1 space per 1000 square feet which results in 12 spaces. 4) The parking for the Martial Arts requires 36 spaces. This results in the need of 48 parking spaces for the existing and proposed uses. There are 82 spaces showing on the site plan. BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 44 0 7 10 Date......7/ TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING CHUS J This certifies that ..... ............ ..............(... ................................. has permission to perform ..... ........... ........................... wiring in the building of............ .. ....... ....................................I........... at..:..6 ................ r... ........./L�........... North Andover,Mass. ..... Feel.,.'............... Lic.N0,41-IjO.... (ELECTRICAL INSPECTOR- Check # "'I L.omatontvsA a/ assaclucsells ollicial Use Only afstaii® ira Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked Rev. 11/991 ttrave blank) ``-"` APPLICATION FOR PERMIT TO PERFORM ELECTRICAL All work to be performed in 2&xm ance wills the Massachusetts Ekxtriml Code(MEC),527 Ch12 t2-OO WORK tYLL•Asl;l'Rlt�rl'fiY 11N1C'Olt TY/�E A�nrlmlrr /NI:Om'-ITIONJ Date: j City or 1'otivti of: a _ ' By this application die undersigned gives notice of his or her intention to foml V ector of l 'res: G l echicat work described belo w. Locatiorn(Street�C t� err Owner or Tenant C. ! Owner's Address _ Telephone Na. _ i Is this permit in conjunction Ivi!h a building permes it" Y11No ❑ (Chea:Appropriate Box) Purpose of Building Utility Authorixatinnt m. Existing Service Annps _ / Volts Overhead❑ Undgrd ® No.of itiIrtcrs . Nc�;Scrrice Anips / Volts Overhead❑ Undgrd Number of Feeders and Ampacity ❑ No.of Meters.': Loc:tion and Nature of Proposed ElectricA Work: Completion oldieolial !able nua be nvitvd b•the leis ector or Wires. No.of Recessed Fixtures NO.of Cell-Susp.(Paddle)Fa-us of !otal ransfortucrs KVA No.of Lighting Outlets No.of Hot Tubs Generators hVA No.of Lighfing Futures S Pool. ar-, o•o merge»cy )g d: rnd Batt Units No.of Receptacle Outlets No.of Oil Burners FIRE ALAR IS No.of Zones No.of Switches. No:of Gas$users a electron and Initiating Devices No.of Ranges No.of Air Cond. Fon Tons No.of Alerting Devices _ 1111 111� K.O.of Waste Disposers eat ramp i Tans � onta>rrctt Total). letection/AlertIn Devices No.of Dishivasl)ers SpacelArea Heating MV Local ❑ unicipa t Connection ❑ Other No.of Dryers Heating Appliances 1(W Security Systems: No.ofglen No,of Dc�.ces or E uivatent Heaters KiV No.S t o.o asts Data Wiring- No.No.orXAces orivatent No.Hydromassage Bat1)tubs No.oftllotors Total lip !' ecommunicattons irnng: OTHER: NO.of Devices or E uivalcnt Assoc!,additional detail of desired!or as""red ba•the Inspector of Wires. INSURANCE COVERAGE: Unless Neaived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability i))sarame including"completW opemtrotr"coverage or its substantial equivalent. Theundersigned ccrtifnes that such cow ge is in force,and exhibfted proof of same to the permit issuing office. CHECK ONE: INSUMNCE W BOND ❑ OTHER ❑ (Specify:) E-stirnated Value of Electrical%Vor1::' (When required by municipal police.) (Expiration Date). Wort:to Start: Inspections to be requested in accordance will)MEC Rule 10,and upon completion. ecr fi�(j; ait(ter lI pains and! enaIt* of perja�•,that the th onnation on this ap • true and cvrrrplcte: FIItNj NAME: C LIC.NO.:_ (� LicenseemsSigmas e (Jf atnt?lieaLie: r" �► t"i r 'ce nra rberlirrej ,t/ ® lG,�/ 13us.Tel.i`io. 73 Address: /X l (� r11t.Tel.No.: ^ O\ti'NER'S INSU1tANCh 1VAIVEI2: 1 am an •ilxit the Ltcenssedors trot parr We liability irsuranee cateragc normally required by tag• 13}uiy signaitrrc belay i hereby wain tlds agairefnent. I stn Eltd (dined k azcj❑o�emcr ❑o��men's gem. O)rtterlAaertt by Signature Telephone NO. Pj,'R41HT r-E-E-•: N° 2704 Date..1..`'.`./......./ � '� NORTI, °�,�`'° '•�"� TOWN OF NORTH ANDOVER PERMIT FOR WIRING SsAcHusE� This certifies that .. �......el.. F..��....1.:... `.................................................... / has permission to perform ... (!. .......... �;n..: 1... :.!� ......................................... wiring in the building of...... at. � .5..... �<<�-'� ./�........ «......./ ,North Andov Z�� Lic.No/Ll<-'-P .\C . 7 .... . ....... Check # �^���' G ELECTRICALINSPECfOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer THE(,VMMUNWEALlHui+MAJ;.M(,HUN IIN Utnce Use only DEPARTMENTOFPUBLICS4FM Permit No. BOARD OFMEPREVEVHONRWU ATIOAN527CMR12:00 ' Occupancy&Fees Checked i APPUCATIONFOR PERW TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat 11441 Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) 9 Owner or Tenant. Al / P«2 11r/iqn Owner's Address Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead Underground No.of Meters New Service Amps / Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 777777 5L�e V,- /M 4o.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA 'No.of Lighting Fixturesr-7 7 Swimming Pool Above Below Generators KVA _ < / andg1:3round No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total /� FIRE ALARMS No.of Zones .2Tons "t No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heat' Devices KW Local Local Municipal a Other AO . 6 Connections No.of Water Heaters KW No.of No.of Signs Bailasis �Jo.Hydro Massage Tubs No.of Motors Total HP OTHER- IrstamreCaaage Acs<m>tbthetegt>aaraa��CalaalLaws IhacatzaattI tlAyhastrasreioePbbcystdudQgCar Caaa�FcrAs eWvalat YES NO Itta�es�rn9>edvafid}xoofofs�raetotheO�ce YES M No Ifj ubmedaeckedYES,plmeit thetypecfwwragpbydtedrgic 1NSi1RANC� BOND OTHER (Pleasespedfy) EViratim D& EstgtEkdvahte Wrack$ `r'Jj 6k �a/Wodc�Slatt � DAe Fecal Signed under'&Rnahies /7�-/ FIRMNAME �! ( C Lkenxe /.-o 'r�?/ �� re �i�7�� _._ Licawj b 74 iG Bukm TeLNa 7,f/ %4/yr—3/5%?— Add= 3/S ? �JO G Y�t� � , AiLTeLNa OWNER'S MURANCEWAIVER,lammmftatthe ' does�theinst=xeomaeraForilssksmiale4ala>tasm#WbyNlmdasettsCavdl-aws andthatmysigukseonthispanteepp6cimwainthismqui . (Please check one) Owner F-1 Agent 7 Telephone No. PERMIT FE ' VIVII-virlIM APPI-WAI1UN FO PERMIT TO DO GASFI ING F (Print or Type) NORTH ANDOVER, , Maas, Date 7 1g / Building Loco Permit Location ,,�/�j . All . C( (I✓�9 t l/CLl1�'�l � CCD Name me Aff New Renovation d Replacement p Plana Submitted: Yea E) No EQ . to hse h N « O y s1 S F` d J til w 0 V C 0 O >INC ~ K h r IOi 0 Q h lr I 'o d #, o v G! > o a o tun—esMT. LA SASKMENT 116TFLOOR IND,FLOOR SRb FLOOR 4TH FLOOR ETN FLOOR i STH FLOOR 7TH FLOOR ETH FLOOR ' Check one: Certificate Installing Company Name_GQ Corp. Address 2v" [j Partnership t- VW KY 1 FY 3 O Firm/Co. Business Telephone 7 Name of Ucensed Plumber or Gas Fitter 0( C Ao"0 /y INSURANCE COVERAGE: ;Check one have a current liability Insurance policy or Its substantial equivalent. Yea �C No El If you have checked yes, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy Other type of Indemnity d Bond O OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: %natute of Owner or Owner's Agent Owner O Agent O I hereby certify that all of the details and Information I have submitted(or snleradljk-v ve application are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the fnH Iss for this application will be In co pllance with all pertinent provisions of the Massachusetts Slate ass Cods and Chapter 142 al AIDIS Ucense:umber na urs o nae um a or aser THIS afilterasterLicense Number �'Rown urneyman AIT"ONED(OFFICE USE ONLY) - I I Date. . . :. . . . . . . . 1z �f kO oTH , TOWN OF NORTH ANDOVER o A PERMIT FOR GAS INSTALLATION SSACHUSE� This certifies that . ..: . : . . . . . . R has permission for gas installation . .1. ..: . . . . . . . . . . . . . . . . . . . . . . . in the buildings of . . e . . . . . .L_. .. .. . ... . . . . . . . . . . . . . . . . . . . . . . at ...� ?. .'..�`,�: :� yt ?. :. . . . . . . . . . . .. North Andover, Mass. I Fee. /.). . . . . Lic. No..:-.-'-./... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File 345111" Date.. ...... 'e MpR*M TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION R , SACHUSE� This certifies that . . !! : . .' � . . . .�.�./a. . . . . . . . . . . . . . . has permission for gas installation . . . ?. . . . . . . . . . . in the buildings of . . . .!, .S . . .�. �% ; l:,!: . . . Q/ . . . . . . . at A).r-! Wqe? �/'' . . .�' �,,North Andover, Mass. Fee. s .v: ". . Lic. No..P.'. .�(. . . . . . . . . ::. ;�. . . . . GAS INSPECTOR J WHITE:Applicant CANARY: Building Dept. PINK:Treasurer -N 1 ; MASSACHUSETTS nt TFORM APPLICATON FOR PER UT TO DO GAS FITTING ype or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations LZ-- permit 93 �r I Amount S Owner's Name *&,5 New Renovation ❑ Replacement ❑ Plans Submitted;;� ❑ A n z — — z y n y n z Cn sua -[3 :LSErtEv "r - BASE .w KF4 'r 1sT. FLUOR 2Y D . FLOUR 3RD . FLUOR 1-4"r If FLUO It ST 11 . FLUOR 6T I1 . F L U O R 7"r If FLUOR 3T II FIt L O O R (Print or type) Check• Check one: Certificate Installing Companv Name �Jn / ( ❑ Corp. Address �� /�/ Ol 1�G� ��— ❑ Partner. Business Telephone �C�� �6._ r�,/ ❑ FirmiCo. Name of Licensed Plumber or Gas Firter �� INSURANCE COVERAGE Chec. one: I have a current liability Insurance policv or it's substantial equivalent. Yes11 No❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy ❑� Other type of indemniry ❑ Bond ❑ Owner's Insurance Waiver: l am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the ivlass.General Laws,and that my signature on this permit application waives this requirement. Check one: Sianarure of Owner or Owner's Agent Owner ❑ Aoent ❑ 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 pertormed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massaeh St Gas Code ao Chapter 142 ofthe General Laws. Bv: Signature of Lic::nsed Plumber Or Gas Fitter Title Plumber / g-G City/Town ❑ Gas FitterI�seNumoer Master %PPRU'v"ED i()Frlc;:usF i)NI-Y) ❑ Joumeyman s Date. . . �1, .. . NORTH TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION . h �,SSACMUSESS 1 This certifies that . . . . ... . . . .. has permission for gas installation,. . - �. . . in the buildings o • . . .. endover, at . !�. . . orth Mass. Fe .�. . . . Lic. . gp. . . . . . . . L,. . . . . . . . . . /C) GAS ;VOrS Check# --_ 4092 Z�J � MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITI'11v (Type or print) ate NORTH ANDOVER,MASSACHUSETTS , �/ Building Locations �-1-2' Permit# Owner's Name Amount61 M" dL6�2L New❑ Renovation ❑ Replacement , Plans Submitted ❑ d a Ha a o U a ° c a e C SUB-BASEMENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH . FLOOR STH. FLOOR 6TH. FLOOR 7'.'H. FLOOR 8 H. FLOOR , (Print or typej ftone: Certific to •lling Colnpany NameL Address �' Partner. Business Telephone — ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter j! �/ j►�G o'1 //� INSURANCE COVERAGE Check on I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked�please' dicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 13Bond ❑ Owner's Insurance Waiver. I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work andinstall�aihous performed under Permit Issued for this application will be in compliance with all pertinent provisions ofthe M sachusetts State- od aA C er 142 ofthe G ral La7S 4 r /_// f By: ignature o Lensed Plum Or Gas Fi Title ❑ Plumber City/Town ❑ Gas Fitter License Number Master APPROVED(OFFICE USE ONLY) Journeyman Date. . . . . . .I ^!. No 41 i ^ � v , v rot "I. " ti° TOWN OF NORTH ANDOVER F PERMIT FOR PLUMBING 49 •0�,r„ <5 cmus i This certifies that . . . . . . . . : "^ :�'`-� ......... . . . . . . . . . . . . . . . . . has permission to perform plumbing in the buildings of . ' -. r:!. . .!� .. . ^.I at. ��?. . . '%t? . _.�`. .. . .. . . . . . . .. North Andover, Mass. . Feed' . . . . .Lic.vNo.�-�.rrr�-r> . . . . . . . . . . . .. :. . . . . _... . . . . . PLUMBING INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS i i r Date — Building Location rJ� ���GcS�'► Owners Name �IU 1 _(��/ ermit# Amount S 1 Z Type of Occupancy o� - NewRenovation Er Replacement riPlans Submitt Yes No FIXTURES r Cc CA Z CC w � a w x Cn 1zF x x x w w x x w . Q a a x w �. p,, d H A A d �BgV� II�91VII�iT l5�PIO(R �Il F1�(It �FIOQt MF OCR 5M;FIlJQt l�] 6M ROM 7M RDM 9IR F OQt I (Print or type) — Check one: Certificate Listalling Company Name Corp. Address i aZ J1 K...`� i 1 Ce r`.`e Wt Partner. 1 Business Tel — 0—o? El Finn/Co. )3 Telephone ? f�7 Name ofLicensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 0'' Other type of indemnity ❑ Bond Insurance Waiver. I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Mas q;husetts State um ' g d Chapter 142 of the General Laws. By: 7ignature of Licens'prriumoer Type of Plurr6mgLicense Title coc�) City4Town icense MOW Master t. Journeyman ❑ APPROVED(OFFICE USE ONLY u THE COMMONWEALTH OF MASSACHUSETTS %%ORTAt r0��s,,�° •a��O TOWN OF NORTHANDOVER � o .... In accordance with the Massachusetts State Building Code,Section 106.5 this CERTIFICATE OF INSPECTION CHU`i�� IS ISSUED TO... Yang's Martial Arts Suite B I CER TIFY that I have inspected the PREMISES............ known as Yangs Martia/Arts Suite,6 located 65 Flagship Drive .in the TOWN of NORTH ANDOVER I COUNTY OF...................ESSEX..............................Commonwea/th of Massachusetts The means of egress are sufcient for the following number of persons., BY STORY SEMY CapaaYy Sf Ply Capacity simy QvaclW SfvrY Capacfty Place of Assembly Capacity Location ,. Place of Assembly Capacity Location or structure or structure 65-02 July 24, 2002 July, 2003 Certificate Number Date Cetwficate Issued Dane Certificate Expires Building Official Location No. y Date -ate )Z NaRTM TOWN OF NORTH ANDOVER 'O O? � • ow 41 Certificate of Occupancy $ b'••°•'tom Building/Frame Permit Fee $ Must Foundation Permit Fee $ Other Permit Fee $ TOTAL $ .� Check # G �7 Building Inspector J / U COMMONWEALTH OFMASSACHUSETTS TOWN OF NORTHANDOVER 27 CHARLES ST APPLICATIONFOR-CERTIFICATE OF INSPECTION 'V V� Date I ( Fee Required(Amount)__ L% O No Fee Required Accordance with the provisions of the Massachusetts State Building code, Section 108,15, I hereby apply foi Certificate of Ins ction for-the below-named przmises-located at-thefollowing -ess: Street and rr Number (Q(:5FI Aca cAb P D e) 00 "DOVER, Name of ( Premises Purpose for which Premises is Used MA)Z-lkI., fIT ��, Licenses (s) or Permits)Required for-the P-mmises by-Og -Gavernmenxal Agencies: License or Permit A_gency Certificate to be issued to Address 17r-) FUPc(-,�c2tbP QQ- S IY N 0 pj\�00 LTelephone 9q8 -12 3(�( Owner of Record of Building Address DAq iQ MOQQ'6� p6b, laW e>P< - Q e:-ftLTJ T2 ,f 1ST 26f.i(Yc?e1 t F:::� Cf( ct Z Name of Present Holder of Certificate �/ L-�S N_AAT t/k-J, pqZJ t-�L-1 G 6 Dc2 M/� Name of Agency, if any (� ► O(.Ut�C1'Z SIGNATURE OF PERSONS TO WHOM CERTIFICATE TITLE IS ISSUED OR HISA-UTHOIRIZED AGENT DATE INSTRUCTIONS: 1) Make check payable to: Town of North Andover 2) Return this application with your check to: Aff lY : Dept 27 Charles Street,North Andover MA 01845 PLEASE NOTE: Application form with accompanying FEE must be submitted for each building or structure or part thereof to be cert 3) Application andfee-must-be received beforne-the-cer-tift4cate will-be-issued. 4) The building officials shall be notified within ten (10) days of any change in the above information. CERTIFICATE# EAPIRATIONDATE: FORMSBCC-3-74 REWSEB2J99ime CuOseO FyZi DAY SN-1 BPdv4- 1 o'4-S A A4 TOWN OF NORTH ANDOVER INSPECTOR'S NAME OFFICE OF THE INSPECTOR OF BUILDINGS MICHAEL MCGUIRE INSPECTION-REPORT-FORM CLASSIFICATION PASSES INSPECTION yes2no 0 DATED OWNER ( ,( BUILDING NAME OR-NO. C1 I STREET LOCATIONS TYPE OF OCCUPANCY {Day -Care-Center D -Aud.,0 -Cam B -Gym -k- Apt. 0 School 0 Common Victualer's 0 Liquor 0 Place of Assembly 0 Other OCCUPANCY NUMBER {inckide-steries -eer4loor— use4everse side EXISTING EXIST SIGN yeses no 0 LIGHTED EXIT SIGNS -operable -yes-0 -no -0 EMERGENCY LIGHTING SYSTE M operable dry cell 0 wet cell 0 SPRINKLER SYSTEM operable ,` gage pressure yes 0 no 0 SMOKE DETECTOR operable yes 0 no FIRE ALARM SYSTEM -ooratien-date -yes )Er, -no � ANSUL SYSTEM yes 0 no FIRE ALARM SYSTEM operable municipal 0 yes '0 no 0 hECTRIC EQUIPMENT PROPERLY PROTECTED yes 0 no 0 EGRESSES LAWFULLY-DESIGNATE unobstructed --yes X` -no 0 STAIRS PROPERLY RAILED yes 0 no 0 e HALLS AND STAIRWAYS LIGHTED yes no 0 RADIATOR GUARDS yes 0 no 0 COMPLIES HANDICAPPED PERSONS LAWS les --no 41 FIRE RESISTANT CURTAINS OR DRAPERIES HOW HEATED r �/ )- NO. FIREPLACES yes 0 ,c BOILER ROOM CONDITION VENTILATION ®0 7a UTILITY ROOM - CLOSETS NUMBER OF GRADE FLOOR MEANS OF EGRESS DOORWAYS NUMBER OF SEPARATE STAIRWAYS ACCESSIBLE PER STORY LLA SHOPS FOR INSPECTOR USE ONLY Revised tiss SMC Y Location 5 I' PCS S N I No. I16�f�3 Date of N°R,M TOWN OF NORTH ANDOVER O L 0 ? 9 y ; i Certificate of Occupancy $ s�CMUS t� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �' U Check # 6500 z �. Building Inspq-616r TOWN OF NORTH ANDOVER INSPECTOR'S NAME OFFICE OF THE INSPECTOR OF BUILDINGS MICHAEL MCGUIRE INSPECT40WREPORT-FORM CLASSIFICATION---L PASSES INSPECTION yes no 0 DATED _0 3 OWNER A-to 1( aP"A Ve die BUILDING NAME ORWO. STREET LOCATION TYPE OF OCCUPANCY-- Tray Care-Center -0 -Aud.11 -CA -0 -Gym -Apt._0 � Opp School 0 Common Victualer's 0 Liquor 0 Place of Assembly 0 Other I OCCUPANCY NUMQE-R -fhokide-steries-# and-ecetwancv jw4loor - �+se averse side ��� EXISTINGS EXIST SIGN. Yes V no 0 LIGHTED EXIT SIGNS operable Q EMERGENCY LIGHTING SYSTE M operable dry cell wet cell 0 §PRINKLER SYSTEM operable gage pressure yesno 0 SMOKE DETECTOR operable yes no FIRE ALARM SYSTEM -expiration-date -yes- fie .� ANSUL SYSTEM yes no FIRE ALARM SYSTEM operable municipal 0 yes no 0 5.LECTRIC EQUIPMENT PROPERLY PROTECTED yes no O EGRESSES LAWFULLY-DESIGNATE unobstructed -yes 10 0 STAIRS PROPERLY RAILED yes 18— no 0 HALLS AND STAIRWAYS LIGHTED yes , r- no 0 RADIATOR GUARDS yes 0 no COMPLIES HANDICAPPED PERSONS LAWS -yes -no FIRE RESISTANT CURTAINS OR DRAPERIES HOW HEATED NO. FIREPLACES yes 0 no BOILER ROOM CONDITION 1 /Q VENTILATION �L UTILITY ROOM - CLOSETS C� NUMBER OF GRADE FLOOR MEANS OF EGRESS DOORWAYS v I NUMBER OF SEPARATE STAIRWAYS ACCESSIBLE PER STORY ,/v[-A SHOPS �I FOR INSPECTOR USE ONLY Revised 2/99 SMC i I THE COMMONWEALTH OF MASSACHUSETTS /iTOWN OF NORTH ANDOVER . Building In accordance with the Massachusetts State g Code, Section 106.5 this CERTIFICATE OF INSPECTION IS ISSUED TO... YANGS MARTIAL ARTS I CERTIFY THAT I have inspected the premise known as YANGS MARTIAL ARTS Located at 65 FLAGSHIP DRIVE in the TOWN of NORTH ANDOVER, COUNTY OF ESSEX Commonwealth of Massachusetts. The means of egress are sufficient for the following number of persons: BY STORY Story Capacity Story Capacity Story Capacity Place of assembly YANGS MARTIAL ARTS Place of assembly Capacity 75 Capacity Location 18T FLOOR Location Place of assembly Place of assembly Capacity Capacity Location Location 16583-2003 September 30, 2003 September 30,2004 �, Certificate Number Date Certificate Issued Date Certificate Expires Building Official r