Loading...
HomeMy WebLinkAboutMiscellaneous - 815 CHESTNUT STREET 4/30/2018 (3)o m Locationr— No. Check # �©� Date. j 9 � i't91, TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ I Foundation Permit Fee $ u Other Permit Fee $ TOTAL $ Building Inspector Commonwealth of Massachusetts Sheet Metal Permit Date: q, , / OC Estimated Job Cost: Plans Submitted: YES _jel NO Business License # 9 3 Business Information: Name: �• la i C Street: WA rJ � City/Town:----- Telephone: ve --7-z - 2-0/ -7- Permit # -3'%g� Permit Fee: $ Plans Reviewed: YES NO Applicant License # a % 3 Property Owner / Job Location Information: Name: I kbk �,[/,A'��rt _"+ Street: g 6 r Cke'SI&VV r City/Town: /l)� 19+w t�✓t/1 Telephone: Photo I.D. required/ Copy of Photo I.D. attached: YES NO Building Type: Residential: 1-2 family Multi -family Condo / Townhouses Commercial: Office _,Z Retail Industrial Educational institutional. Building Cubic Footage: under 35,000 cu. ft. over 35,000 cu. ft. ---- Sheet Sheet metal work to be completed: New Work: Renovation: HVAC ✓ Metal Roofing Kitchen -Exhaust System Chimney / Vents Provide brief description of work to be done: �r I Sheet Metal Commercial Guidelines / Life Safety / Critical Systems Inspection Checklist Yes No NIA, Set of stamped engineering documents and detailed description of mechanical system to be installed has been provided All workers performing sheet metal work onsite has valid Massachusetts sheet metal license All sheet -metal work being performed with proper journeypars on -to -apprentice ratios Fire dampers with access door properly installed and checked for operation Smoke and combination fire / smoke dampeis with access doors properly installed - actuator checked for proper operation (May also be verified by fire department during fire.alarm testing) Duct smoke detectors with access doors properly located (May also be verified by fire department during fire alarm testing) Smoke / atrium exhaust systems installed and operation verified (May also be verified by fire department during fire alarm testing) Stair pressurization systems installed (where required) and operation verified (May also be verified by fire department during fire alarm testing) V Grease / kitchen hood exhaust system installed with all seams and connections welded aright with properly located cleanouts. Proper cle;�'anees, fire rated enclosures and pressure testing required. iinstal'e -offi r reg1t]T6Cl 011 Pglir went and Duct penetrations in fire'ratc wall -3 and flaors sealed /Metal roofing systems installed watertight using proper materials and fasteners ✓ Flexible duct runs installed 6'•-0" maximum length J Ductwork installed using proper hanger spacing, hanger stock, threaded rod and angle / iron y Ductwork / plenum connections sealed substantially airtight ✓ Ductwork insulated by means of external covering or internal lining v Volume dampers installed for each supply air branch duct New/clean - properly sized filters installed (final inspection) Testing and Balancing report complete (final sign -oft) Sheet Metal Residential Guidelines / Ihsnection Checklist Yes No N/A .� Detailed description and sketch of sheet metal system to be installed has been provided / All workers performing sheet metal work onsite has valid Massachusetts sheet metal license All sheet metalwork being performed with proper journeyperson-to- apprentice ratios Equipment sized per heating / cooling load calculations Duct work sized per manual "D" calculations Bath / shower rooms contain mechanical exhaust fan vented outdoors Electric dryer exhaust properly installed maximum total run 35'-011 , maximum flexible run 8'-0" Flexible duct runs installed 14'-•0" maximum length Volume dampers installed for each supply air branch duct Ductwork installed using proper gauges and hangers Ductwork / plenum connections sealed substantially airtight Ductwork insulated by means of external covering or internal lining New/clean - properly sized filter installed (final inspection) Testing and Balancing report complete (final sign -off} V r INSURANCE COVERAGE: 1 have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes [I-JeIQo ❑ If you have checked Yes, indicate the type of coverage by checking the appropriate box below: A liability insurance policy 0Other type of indemnity f-1 Bond n OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box[], 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 sheet metal work and installations performed under the permit issued for this application will be In compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Date Progress Inspections Comments Final Inspection Date Comments Type of License: By (tClvlaster Title c ❑ Master -Restricted City/Town ❑Journeyperson Permit Signature of Licensee # Fee ❑Journeyperson-Restricted License Number: 171$ Check at www.massmov/dpi Inspector Signature of Permit Approval The Commonwealth of Massachusetts Department oflndustrialAccidents I Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE TILED WITH THE PERMITTING AUTHORITY. Apalicant Information Please Print Legibly Name (Business/Organization/Individual): �. � J (� f7Q co Address: City/State/Zip Are you an employer? Check the appropriate box: Phone #: goe a evo l.�am a employer with employees (full and/or part-time).* 2.FJ I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3.0 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 ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5.❑ 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., 6.n We are a corporation and its officers have exercised their right of exemption per MGL C. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 7. ❑ New construction 8. Lh Kemodeling 9. ❑ Demolition 10 0 Building addition 11.[] Electrical repairs or additions 12.E] Plumbing repairs or additions 13. [] Roof repairs 14. Fl Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ]Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providittg workers' compensation insurance for my employees. Below is the policy and job site information. _ Insurance Company Name: CEJ`) Q� 1/tl at,4, 1.j Policy # or Self -ins. Lie. MI D (,UC660 91,9 � _ Expiration Date: Job Site Address: j/, — eap S / City/State/Zip: W 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. Ido hereby c tt y under the pains an penalties of peijuiy that the infotvnation provided above is true and correct. C1.*___-__. b ./ / , / do\ e 0— 0 . Je 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 Cleric 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Location X515 C�lj IA )v-- - No. Il -2r -)b11 -11121-5 Check,, Date 'A' TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ .� Other Permit Fee $ TOTAL $ r f~ Building Inspector (/ Nick Cuzzupe ncuzzupe@wiseconstruction.com CONSTRUCTION 21 East Street Winchester, MA 01890 T 781.721.1100 C 781.799.1098 Wiseconstruction.com �►ORT!—!- BUILDING, PERMIT r �•3,��y st`�o ' "°� T TOWN OF NORTH ANDOVER ° APPLICATION FOR PLAN EXAMINA Permit NO: Date ReceivedATOD e/ .L Date Issued: a �9SSACNUS��� IMPORTANT: Applicant must complete all items on this pate LOCATION 815 Chestnut Street Print PROPERTY OWNER Watts Water Technologies Print MAP NO: PARCEL:_ ZONING DISTRICT: Historic District yes Machine Shop Villaqe ves TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial IXAlteration No. of units: RCommercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other F Septic ❑ Well ,-I Floodplain -1 Wetlands -1 Watershed District G Water/Sewer PdAN8 � F Interior Renovation of the 2nd floor Annex building & HVAC upgrades. Identification Please Type or Print Clearly) JNER: Name: Watts water Technologies Phone: 978-689-6067 ress: 815 Chestnut Street R Name: Wise Construction Phone: 781-721-1100 21 East Street, Winchester MA 01890 s Construction License: Improvement License: Exp. Date: CS -107883 09/19/2017 Exp. Date: Architect - Isgenuity- Martin J. Batt A - 617-419-4660 r ;HITECT/ENGINEER Engineer - RDK - Chris Cummings Phone: E - 978-296-6204 cess: A-321 Summer Street Suite 401 Boston MA Reg. No. A - 11098 ,y E - 200 Brickstone Square, Andover MA E - 32298 FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Project Cost: $ 6 8 0, 6 9 3 FEE: $,H62 /171 '(No.: 71125 Receipt No.: 0 Persons contracting wit u e flred contractors do not have access t�uantyfund re of Agent/Owne _1gnature of contractor Plans Submitted ❑ Plans Waived ❑ Certified C,ioi Plan n Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED - PLANNING & DEVELOPMENT ❑ I Z(I� COMENTS 14[falor wo --� Dff1Ck5 TV N 5 9 W100 �j ,coo+A CONSERVATION COMMENTS HEALTH COMMENTS ❑ ❑ DATE REJECTED DATE APPROVED ❑ ❑ Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit 11ocated at 384 Osgood Street (EIRE DEPARTMENT -Temp Dumpster on site yes no I ,*ated at 124 Main Street Department signature/date COMMEN`` '.S S Location F/ ,�- �__ �t 1I�C �. �1`s� �^ . 7 Date r No. J %o? - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # (()"?V / Building Inspector i 11 's O, NORtN •�M O • 4 �! 1 as4[NIIb' CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 172-2017 on 8/18/2016 Date: November 8, 2016 THIS CERTIFIES THAT THE BUILDING LOCATED at 815 Chestnut Street MAY BE OCCUPIED AS a second floor annex and HVAC upgrades IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Watts Water Technologies 815 Chestnut Street Fee: $100.00 Receipt: 31151 Cheek: 624 North Andover, MA 01845 Building Inspector ,. b y 4: e cl: LLS x0 CL Z `� t �� Wd �' Z O � 1 a W V LL O Z^N J Ln Z � Q W Q m -Cm •��- C � A `V;`� `W Lu LL u \ U o a O C1: "O C •tel >to ..0 t {�j t °�° 4J z Y o a, LL N o o E LL d' U LL o d' LL o a) o U- CD (% N i z O Z W w a w H W a. O V J M �i .N E O O d Z N D C a �_ .E m m v D O CL C � Q O AW ca CU _v J �Or O }; = Z 0 CL V N m r_ r — Q D a t. r Final Construction Control Document To be submitted at completion of construction by a Registered Design Professional w for work per the 8t' edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology Annex — Level 1 Date: November 7, 2016 Permit No. Property Address: 815 Chestnut Street, North Andover Massachusetts Project: Check (x) one or both as applicable: 4 New construction X Existing Construction Project description: Renovations of approximately 4,000 sq ft to Level 1 including a new cubical/workstations layout,a revised layout for the perimeter offices and new ceilings and flooring through the space I, Martin J. Batt, MA Registration Number: 11098 Expiration date: 8/31/17 , am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: X Architectural Structural Fire Protection Electrical Mechanical Other: Describe for the above named project. I, or my designee, have performed the necessary professional services and was present at the construction site on a regular and periodic basis. To the best of my knowledge, information, and belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit and that I or my designee: 1. Have reviewed, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. Enter in the space to the right a "wet" i electronic signature and seal: Phone number: 617-419-4660 Email: mbattna,isgenuity.com Building Official Use Only Building Official Name: Permit No.: Date: Version 06 11 2013 Final Construction Control Document To be submitted at completion of construction by a ' a Registered Design Professional for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology, Annex — Level 1 Date: November 7, 2016 Property Address: 815 Chestnut Street North Andover Massachusetts. Project: Check (x) one or both as applicable: New Construction X Existing Construction Permit No. Project description: Renovations of anuroxiniately 4.000 sa ft to Level l includin cubidal/w6rktiAtioit La out a .revised Inout for the perimeter ice and new ceilings and flooring through the space. I, Keith Giguere, MA Registration Number: 49637 - Expiration date: 6/30/18, am a registered design professional, and that I or my designee, have performed the necessary professional services during construction concerning: ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC ] Fire Suppression — NFPA 13 [ ] Electrical [X] Fire Alarm - NFPA 72 [ ) Plumbing for the above named project. I, or my designee, have performed the necessary professional services, in accordance with the Professional Standard of Care, and was present at the construction site on a periodic basis. The work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit with the exception of those items so noted on the attached punch list and that I or my designee: 1. Have reviewed, for conformance to this code and the design concept, shop drawings, samples and other submittals by the Contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. The Contractor is responsible for performance of the work in accordance with the contract documents and is exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 107: Enter in the space to the right a "wet" OF or electronic signature and seal: KEITH E. GIGUERE ELECTRICAL No, 49637 Phone number: 978-296-6357 Building Official Use Only Building Official Name: Permit No.: Date: Email: kgiguere@rdkenizineers.com Final Construction Control Document To be submitted at completion of construction by a a > Registered Design Professional r ,y for work per the 8t' edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology, Annex — Level 1 Date: November 7, 2016 Permit No. Property Address: 815 Chestnut Street North Andover Massachusetts Project: Check (x) one or both as applicable: Project description: New Construction X Existing Construction L Keith Gi ug ere, MA Registration Number: 49637 - Expiration date: 6/30/18, am a registered design professional, and that I or my designee, have performed the necessary professional services during construction concerning: ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC ] Fire Suppression — NFPA 13 [X] Electrical ] Fire Alarm - NFPA 72 ( ] Plumbing for the above named project. I, or my designee, have performed the necessary professional services, in accordance with the Professional Standard of Care, and was present at the construction site on a periodic basis. The work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit with the exception of those items so noted on the attached punch list and that I or my designee: 1. Have reviewed, for conformance to this code and the design concept, shop drawings, samples and other submittals by the Contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. The Contractor is responsible for performance of the work in accordance with the contract documents and is exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 107, Enter in the space to the right a "wet' or Njr�,, a or electronic signature and seal: KEIVE CP ': rlGVEzE �� C EIE.G+RIGAL 1 kll,�17 '`y"�� 61-1-i(► Phone number: 978-296-6357 Building Official Use Only Building Official Name: Permit No.: Date: Email: kgig_uere@rdkengineers.com Final Construction Control Document To be submitted at completion of construction by a Registered Design Professional for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology, Annex — Level 1 Date: November 2, 2016 Property Address: 815 Chestnut Street North Andover Massachusetts Project: Check (x) one or both as applicable: Project description: New construction X Existing Construction Permit No. I Scott G. Guertin, MA Registration Number: 46837 Expiration date: 6/30/18, am a registered design professional, and that I or my designee, have performed the necessary professional services during construction concerning: [ ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC [X] Fire Suppression —NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project. I, or my designee, have performed the necessary professional services, in accordance with the Professional Standard of Care, and was present at the construction site on a periodic basis. The work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit with the exception of those items so noted on the attached punch list and that I or my designee: 1. Have reviewed, for conformance to this code and the design concept, shop drawings, samples and other submittals by the Contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. The Contractor is responsible for performance of the work in accordance with the contract documents and is exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 107. Enter in the space to the right a "wet" or electronic signature and seal: AF Mq SCOTT G. GUERTIN MECHANICAL No. 48837 Phone number: 978-296-6338 Building Official Use Only Building Official Name: Permit Nos., Date: Email: sgueitin@rdkenp-ineers.com u i. Final Construction Control Document To be submitted at completion of construction by a Registered Design Professional K N for work per the 8"' edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology, Annex — Level 1 Date: November 2, 2016 Property Address: 815 Chestnut Street North Andover Massachusetts Project: Check (x) one or both as applicable: Project description: New construction X Existing Construction Permit No. I Scott G. Guertin, MA Registration Number: 46837 Expiration date: 6/30118, am a registered design professional, and that i or my designee, have performed the necessary professional services during construction concerning: [ ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC [ ] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [X] Plumbing for the above named project. I, or my designee, have performed the necessary professional services, in accordance with the Professional Standard of Care, and was present at the construction site on a periodic basis. The work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit with the exception of those items so noted on the attached punch list and that I or my designee: 1. Have reviewed, for conformance to this code and the design concept, shop drawings, samples and other submittals by the Contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. The Contractor is responsible for performance of the work in accordance with the contract documents and is exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 107. Enter in the space to the right a "wet" or electronic signature and sea]: ,ot OF SCOTT G. GUERITI MECHANICAL y No. 48837 Phone number: 978-296-6338. Building Official Use Only Building Official Name: Permit No.: Date. Email: sguertin@rdkengineers.com L Final Construction Control Document To be submitted at completion of construction by a Registered Design Professional for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology, Annex — Level 1 Date: November 2. 2016 Property Address: 815 Chestnut Street North Andover Massachusetts Project: Check (x) one or both as applicable: New construction X Existing Construction Permit No. Project description Renovations of approximately 4,000 sq ft to Level 1 including a new cubical/workst AJ611 Layout a revised layout for the perimeter offices and new ceilings and flooring through the space. I Scott G. Guertin, MA Registration Number: 46837 Expiration date: 6/30/18, am a registered design professional, and that I or my designee, have performed the necessary professional services during construction concerning: [ ] Entire Project [ ] Architectural [ ] Structural [X] HVAC [ ] Fire Suppression — NFPA 13 [ ] Electrical [ J Fire Alarm - NFPA 72 ( ] Plumbing for the above named project. I, or my designee, have performed the necessary professional services, in accordance with the Professional Standard of Care, and was present at the construction site on a periodic basis. The work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit with the exception of those items so noted on the attached punch list and that I or my designee: 1. Have reviewed, for conformance to this code and the design concept, shop drawings, samples and other submittals by the Contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. The Contractor is responsible for performance of the work in accordance with the contract documents and is exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 107. Enter in the space to the right a "wet" or electronic signature and seal: OF 4 5CO1T G. G GUERIIN n MECHANICAL No. 48837 Phone number: 978-296-6338s p j f 9�'/� Email: sguertin@rdkengineers.com Building Official Name: Permit No.; Date: Building Official Use Only O� wORTN 1h40 '�� ba'TMra"Q as�cR+ts� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 172-2017 on 8/18/2016 Date: November 8, 2016 THIS CERTIFIES THAT THE BUILDING LOCATED at 815 Chestnut Street MAY BE OCCUPIED AS a second floor annex and HVAC upgrades IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Watts Water Technologies 815 Chestnut Street North Andover, MA 01845 Building Inspector Fee: $100.00 Receipt: 31151 Check: 624 Nick Cuzzupe ncuzzupe@wiseconstruction.com Plans Submitted ❑ Stamped Plans ❑ TYPE OF SEWERAGE DIS] III ® M ►ISU Public SewerCONSTRUCTION 'ools El Well 21 East Street Winchester, MA 01890 ling/Sales ❑ T 781.721.1100 Private (septic tank, etc. C 781.799.1098 wiseconstruction.com THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED - PLANNING & DEVELOPMENT ❑ + COMENTS _4l-01flar WO CffIceS -tv f ts��-Si.96t�. w04t CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit Located at 384 Osgood Street r, FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS p°�° °1 = =`D•(Do n r z c =r =r p CD N rt o•o �Q. m cD W N rs. CR �D N S. D 'a CD 2 CD Q• °1 i C n O O O CD O p C O � •a p O • O 0 N -+• "a z CD fli O°+. rr � c .=r ° � CD EL C 0 Q. to �: U) (D p QQ: N � Qo: rN � CD .0 :•• y rt n �+ . O :0 .�+&:� :t to ° :• � '* C CD cD (A CD CD � rt D (D03 �D •a C1 0 C . C1 O r= p ry '+ v -n :0 N aqC S T v, ID y z n z 0 OQ S T p7 mC Z C � O m N O A: r- f O W S O � '^ m n.l. C •CD ar, OZ .0 A 0• mann mH S. W 0 C. C c 0 --i >= �O� z O Z "' Z X T to r v � O 70 D0 m CL Cl) cr Z —`D O V V m m m y r CD OCD O -1 Q:o� 0 0 -� 0 2 to N O a: o0 Z PQP r n o O 7 CD C 0 CD shh;- p°�° °1 = =`D•(Do n r z c =r =r p CD N rt o•o �Q. m cD W N rs. CR �D N S. D 'a CD 2 CD Q• °1 i C n O O O CD O p C O � •a p O • O 0 N -+• "a z CD fli O°+. rr � c .=r ° � CD EL C 0 Q. to �: U) (D p QQ: N � Qo: rN � CD .0 :•• y rt n �+ . O :0 .�+&:� :t to ° :• � '* C CD cD (A CD CD � rt D (D03 �D •a C1 0 C . C1 O r= p ry '+ (D -n :0 N aqC S T v, ID y z n z 0 OQ S T p7 mC Z O m N O A: r- f O W S '^ m mH W 0 z a Z G o to r O 3 O V V m m m y r -1 0 0 0 2 O ==Now J N i� Page 1 of 1 Vilhe CONSTRUCTION CSI # Client: Watts Water Technologies Project: Annex HVAC Upgrades Location: 815 Chestnut Street - North Andover, MA Date of Estimate: 12 -May -16 Plan Date: 22 -Apr -16 Estimate #: E16-064 Estimate Summary Trade Cost 02100 Demolition $10,550 02500 Sitework $1,748 03300 Concrete $3,800 04500 Masonry NIC 05500 Structural Steel/Misc. Metals $24,570 06000 Rough / Finish Carpentry $51,860 07000 Thermal and Moisture Protection $7,480 08100 Doors, Frames and Hardware $5,165 08800 Glass & Glazing NIC 09250 Drywall $20,490 09500 Acoustical Ceilings $25,500 09650 Flooring $37,900 09900 Painting $5,350 10100 Specialties $8,230 11100 Equipment $2,096 12100 Furnishings $3,042 15300 Fire Protection $30,040 15400 Plumbing $54,810 15500 HVAC $262,116 16000 Electrical $87,190 17000 Tel/Data Total Owner $38,756 $680,693 Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the 8th edition of the a ve Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology, Annex — Level 1 Date: August 2, 2016 Property Address: 815 Chestnut Street, North Andover, Massachusetts Project: Check (x) one or both as applicable: New construction X Existing Construction Project description: Renovations of approximately 4,000 sq ft to Level 1 including a new cubical/workstations Layout a revised layout for the perimeter offices and new ceilings and flooringthrough the space I, Martin J. Batt, MA Registration Number: 11098 Expiration date: 8/31/2016, am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning': X Architectural Structural Fire Protection Electrical Mechanical Other: for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. Enter in the space to the right a "wet" electronic signature and seal: Phone number: 617-419-4660 Building Official Use Only Building Official Name: Permit No.: Date: Email: mbattaisizenufty.com Note 1. Indicate with an `x' project design plans, computations and specifications that you prepared or directly supervised. If `other' is chosen, provide a description. Version 06 11 2013 Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the 81h edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology, Annex — Level l Date: July 28, 2016 Property Address: 815 Chestnut Street, North Andover, Massachusetts Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Renovations of approximately 4,000 sq ft to Level 1 including a new cubical/workstation Layout, a revised layout for the perimeter offices and new ceilings and flooringthrough hrou ht? the space. I, Christopher J. Cummings, MA Registration Number: 32298 - Expiration, date: 6/30/18, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [ ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC [X] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to 1 ii OF &74 Enter in the space to the right a "wet" �a CHRISTOPHER CUMMINGS or electronic signature and seal: I MECHANICAL No. 32293 _ Phone number: 978-296-6204 Building Official Name: Permit No.: Date: official a `Final Construction Control Document'. Building Official Use Only Email: ccummings@rdkengineers.com Initial Construction Control Document F To be submitted with the building permit application by a Registered Design Professional for work per the 8`h edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology, Annex — Level 1 Date: July 28, 2016 Property Address: 815 Chestnut Street, North Andover, Massachusetts Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Renovations of approximately 4,000 sq ft to Level 1 including a new cubical/workstation Layout, a revised layout for the perimeter offices and new ceilings and flooringthrough hrou hg the space. I, Christopher J. Cummings, MA Registration Number: 32298 - Expiration date: 6/30/18, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ] Entire Project [ ] Architectural [ ] Structural [X] HVAC ] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to tlofficial a `Final Construction Control Document'. OF &14,5 ��z v sq°ti Enter in the space to the right a "wet" CHRISTOPHER J cP CUMMINGS or electronic signature and seal: I ; MECHANICAL No. 32298 -0 p 4 iFR� `4 10{ L Phone number: 978-296-6204 —. Email: ccummings(a,rdkengineers.com Building Official Use Only Building Official Name: Permit No.: Date: Initial Construction Control Document H To be submitted with the building permit application by a Registered Design Professional . for work per the 8th edition of the 5" Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology, Annex — Level 1 Date: July 28, 2016 Property Address: 815 Chestnut Street, North Andover, Massachusetts Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Renovations of approximately 4,000 sq ft to Level 1 including a new cubical/workstation Layout, a revised layout for the, perimeter offices and new ceilings and flooringthrough the space. I, Christopher J. Cummings, MA Registration Number: 32298 - Expiration date: 6/30/18, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC ] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [X] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit tot official a `Final Construction Control Document'. cR�TN Of f,14 S.(, ��v 9cti Enter in the space to the right a "wet" sCHRISTOPHER J. Gm or electronic signature and seal: CD MECHANICS C MECHANICAL y� C, ��f 1 NQ,32298 w % Phone number: 978-296-6204 '" V Email: ccummings@rdkengineers.com Building Official Use Only Building Official Name: Permit No.: Date: Initial Construction Control Document H To be submitted with the building permit application by a Registered Design Professional w` for work per the 8t" edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology, Annex — Level 1 Date: July 28, 2016 Property Address: 815 Chestnut Street, North Andover, Massachusetts Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Renovations of approximately 4,000 sq ft to Level 1 including a new cubical/workstation Layout, a revised layout for the perimeter offices and new ceilings and flooringthrough hrou h�pace. I, Gilbert Martin, Jr., MA Registration Number: 33353 - Expiration date: 6/30/18, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: r [ ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC [ ] Fire Suppression — NFPA 13 [X] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document': Enter in the space to the right a "wet" or electronic signature and seal: Phone number: 978-296-6247 Building Official Name: Permit No. " OF 414�,�9 GILBERT E. Cay MARTIN, JR. o ELECTRICAL y U No 33353 .090 9F Rg0 ��a uil inXfficial Use Only Date: \ Email: martin@rdkengineers.com Initial Construction Control Document N To be submitted with the building permit application by a Registered Design Professional W` for work per the 81h edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology, Annex — Level 1 Date: July 28, 2016 Property Address: 815 Chestnut Street, North Andover, Massachusetts Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Renovations of approximately 4,000 sq ft to Level 1 including a new cubical/workstation Layout, a revised layout for the perimeter offices and new ceilings and flooringthroughthe space. I, Gilbert Martin, Jr., MA Registration Number: 33353 - Expiration date: 6/30/18, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [ ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC [ ] Fire Suppression — NFPA 13 [ ] Electrical [X] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. Enter in the space to the right a "wet" or electronic signature and seal: Phone number: 978-296-6247 LSH OFMgss GILBERT E. qcG MARTIN, JR. N U ELECTRICAL !:' N9► 53353 Z 4 1 Use Only Building Official Name: Permit No.: Date: Email: gmartin@rdkengineers.com COMMONWEALTH OF MASSACHUSETTS STATE BUILDING CODE 780 CMR, 8TH EDITION CHAPTER 9 FIRE PROTECTION SYSTEMS NARRATIVE REPORT 780 CMR - 901.2.1 PROJECT NAME: ADDRESS: RDK PROJECT #: DATE OF ISSUE: Watts Water Technology Annex, Level 1 Renovation 815 Chestnut Street North Andover, MA 20160156.00 July 29, 2016 Andover I Amherst I Boston I Charlotte I Durham www,rdkenkirieers.corr, 780 CMR 901.2.1 Fire Protection Systems Narrative Report — July 29, 2016 Project Name: Watts Water Technology - Annex, 2nd Floor Renovations RDK Project Number: 20160156.00 As required by 780 CMR §901.2.1, this narrative report is a written description of the proposed fire protection system features to be installed as part of the Watts Water Technology Annex, Level 1 Renovations project located at 815 Chestnut Street in North Andover, Massachusetts. 901.2.1 (1)(i) - BASIS (METHODOLOGY) OF DESIGN Section 1 - Building Description A. "Use" Group(s) within Scope of Renovation: "B" Business (office). B. Location & Area of Renovation: 4,000 sqft on the First Floor. C. Existing Building Height & Area 1. Height: One (1) stories above grade; one (1) story below grade. 2. Area: — 66,500 sqft total. D. Type(s) of Construction: 1. Existing protected non-combustible. E. Hazardous Material Usage and Storage: None in excess of exempt amounts within scope of renovation. F. High -pile Storage (over 12 ft.) of Commodities: None within scope of renovation. G. Site Access Arrangement for Emergency Response Vehicles: Existing features to remain; not affected by scope of renovation. Section 2 - Applicable Laws, Regulations & Standards A. Massachusetts State General Laws (MGL), Chapter 148 1. MGL §148, sections as applicable. B. 780 CMR — Massachusetts State Building Code, 8th Edition (amended, IBC -2009) 1. Chapter 9 "Fire Protection Systems" 2. Chapter 34 "Existing Structures" C. Existing Building Code of Massachusetts (amended IEBC-2009) 1. Chapter 7 "Alterations — Level 2" 527 CMR — Massachusetts State Fire Prevention Regulations 2. Chapter 10 "Fire Prevention, General Provisions" 3. Chapter 12 "2014 Massachusetts Electrical Code Amendments" D. 521 CMR — Massachusetts Architectural Access Board Page 1 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — July 29, 2016 Project Name: Watts Water Technology - Annex, 2nd Floor Renovations RDK Project Number: 20160156.00 Section 40 "Visual Alarms" E. National Fire Protection Association (NFPA) Standards: NFPA 13 (2013) — "Installation of Sprinkler Systems" 2. NFPA 70 (2014) — "National Electric Code" as amended by 527 CMR Chapter 12 "Massachusetts State Electrical Code" NFPA 72 (2010) — "National Fire Alarm Code" F. Federal Regulations (significant requirements thereof to the extent applicable to RDK scope) 28 CFR Part 36, ADA Standards for Accessible Design 2. 29 CFR Part 1910, Occupational Safety & Health Standards G. Documented Local Ordinances (Voluntary Compliance) 1. local bylaws and ordinances Section 3 - Design Responsibility for Fire Protection Systems A. Engineer of Record: RDK Engineers (RDK) has engineered and specified the fire protection systems to be installed. For each fire protection system designed by RDK, RDK shall review the installing contractor's Tier II shop drawings for conformance to the approved construction documents and be present at the site at intervals appropriate to become generally familiar with the progress and quality of work and to determine if the work is being performed in manner consistent with the construction documents and 780 CMR. RDK shall certify each fire protection system installation to the extent required by 780 CMR §901.5.1(1). B. Architect of Record: Isgenuity LLC has designed and specified the architectural features to be constructed, including means of egress, fire resistance construction and interior finish. Isgenuity LLC shall review the installing contractor's Tier II shop drawings for conformance to the approved construction documents and be present at the site at intervals appropriate to become generally familiar with the progress and quality of work and to determine if the work is being performed in manner consistent with the construction documents and 780 CMR. Section 4 - Fire Protection Systems to be Installed A. Fire Mains & Hydrants: Existing features to remain; not affected by scope of renovation. B. Automatic Sprinkler System: Existing sprinkler system service equipment, pumps, zoning, mains, alarm devices, etc. to remain and are not affected by the scope of renovation. Existing wet -pipe fire sprinkler system to be modified to accommodate new partition layout. Modifications shall predominantly include new return -bend piping to new sprinklers and new branch piping from existing cross -mains. C. Standpipe System: This building is not equipped with a standpipe system. D. Fire Alarm System: Existing fire alarm system head -end, back -bone, sequence of operation, etc. to remain and are not affected by the scope of renovation. Page 2 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — July 29, 2016 Project Name: Watts Water Technology - Annex, 2nd Floor Renovations RDK Project Number: 20160156.00 Existing initiating circuits (SLC or IDC) within scope of renovated area to be modified to accommodate new or relocated initiating devices. New circuits may be added as dictated by the capacity of the existing circuits as determined by the installing contractor; the style and class of new circuits shall match that of the existing system. The following types of initiating devices shall be added: a. Smoke detector; common area, electrical closet, etc. b. Manual pull box 2. Existing notification appliance circuits (NAC) within scope of renovated area to be modified to accommodate new partition layout. New circuits may be added as dictated by the capacity of the existing circuits as determined by the installing contractor; the style and class of new circuits shall match that of the existing system. 3. Audible notification appliances within scope of renovation shall be UL 464 horn type. 4. Visual notification appliances within scope of renovation shall be UL 1971 strobe type and shall flash in a synchronized manner. E. Emergency Power: Existing generation equipment, feeders, transfer switches, panel boards, etc to remain and are not affected by the scope of renovation. Where required, NAC remote power supplies added to support new circuits shall be provided with standby batteries. 2. Means of egress lighting and exit signs within the scope of renovation shall be provided with emergency power supplied from existing "base building" emergency circuits if available or standby batteries local to the fixtures. F. Smoke Control Systems: Existing features to remain; not affected by scope of renovation. G. Commercial Cooking: Not applicable to the proposed renovation. H. Hazardous Materials Monitoring: Not applicable to the proposed renovation. Section 5 - Features Used in the Design Methodology A. Occupant Notification Procedures: Existing occupant notification via the fire alarm system and subsequent building management personnel procedures shall remain and are not affected by the scope of renovation. The existing fire alarm system treats the building as a single evacuation zone. B. Emergency Response Features: Existing features to remain; not affected by scope of renovation. C. Safeguards: Existing fire protection systems shall be maintained throughout the construction as required by the Authority Having Jurisdiction (AHJ). Impairment to existing fire protection systems shall be approved by the AHJ and Owner prior to commencing work. A fire watch shall be provided during impairments to the fire suppression or fire alarm system in accordance with AHJ requirements. D. Future Testing & Maintenance: Modifications performed as part of the scope of renovation shall be warranted by the installing contractors for a period of one year covering defects in materials and workmanship. NFPA required inspection, maintenance and testing activities associated with Page 3 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — July 29, 2016 Project Name: Watts Water Technology - Annex, 2nd Floor Renovations RDK Project Number: 20160156.00 the building fire protection system are the responsibility of the owner and are to be conducted under existing and/or future maintenance contracts held by the Building Management Company. Section 6 - Special Consideration and Description A. Unless otherwise noted, the design of the fire protection systems does not utilize alternative compliance design methods and is not intended to deviate from the prescriptive requirements of 780 CMR or other applicable codes and standards. 901.2.1 (11100 - SEQUENCE OF OPERATION A. The existing "base building" coordinated fire protection system basis of design and sequence of operation shall remain unchanged and shall not be modified under the scope of renovation. The general arrangement of the existing sequence of operation is described below and is subject to confirmation by the installing contractor and fire alarm system control unit technical representative. B. Activation of an existing or new manual pull station, smoke detector, heat detector or sprinkler system waterflow switch shall initiate the predefined fire alarm system "alarm condition" sequence: Display alarm condition at fire alarm control unit and remote annunciator(s). Energize audible (temporal -3 pattern) and visual (UL 1971 synchronized strobe) occupant notification circuits within evacuation zone(s) as designated by pre -established control unit sequence of operations. 3. Perform auxiliary fire safety functions as designated by pre -established control unit sequence of operations such as elevator recall, damper activation, door closure, AHU shutdown, pressurization systems, etc. 4. Transmit alarm condition to central / supervising station and/or local fire department via municipal alarm system. 5. In addition, the operation of an existing in -duct smoke detector shall initiate the following: a. Operation of an existing or new in -duct smoke detector provided at air handling units (AHU's) shall shut -down the corresponding AHU. b. Operation of an existing or new in -duct smoke detector provided for control of a smoke damper shall close the corresponding damper. C. The operation of an existing sprinkler tamper switch shall initiate the predefined fire alarm system "supervisory" sequence: Display supervisory condition at fire alarm control unit and remote annunciator(s). 2. Transmit supervisory condition to central / remote supervising station. D. Normal power failure to fire alarm system remote power supplies, ground faults, short circuits and open circuit conditions shall initiate the predefined fire alarm system "trouble" sequence. Display supervisory condition at fire alarm control unit and remote annunciator(s). 2. Transmit trouble condition to central / supervising station. 901.2.1 (1)(iii) — TESTING CRITERIA Page 4 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — July 29, 2016 Project Name: Watts Water Technology - Annex, 2^d Floor Renovations RDK Project Number: 20160156.00 Section 1 - Testing Criteria A. Fire Protection System testing shall be scheduled, administered, conducted and overseen by the general contractor, subcontractors and manufacturer's technical representatives. B. The following fire sprinkler system inspections and testing shall be performed: Visually inspect system installation for completeness, presence of defects or damage, and confirm system is placed into "all normal" operational service. 2. Hydrostatically test system piping for a period of 2 -hours. Piping shall be tested to normal system operating pressure where new installed piping cannot be isolated from the existing piping. Functionally operate any new sprinkler waterflow or valve supervisory switches as part the fire alarm testing. C. The following fire alarm system inspections and testing shall be performed: Confirm integrity of new or modified circuits (free of grounds, shorts, opens) prior to the installation of devices, appliances or equipment. 2. Visually inspect system installation for completeness, presence of defects or damage; and confirm system is placed into "all normal" operational service. Confirm correct system supervision of wiring faults, missing devices and status of normal and standby power supplies (for new equipment installed as part of the work). 4. Functionally operate new devices installed as part of the work and confirm correct sequence of operation and address/zone identification at the fire alarm control unit. 5. Confirm audibility / intelligibility and visual synchronization of notification appliances. 6. Where fire alarm control unit software is updated as part of the work, functionally operate 10% of existing devices not affected by the work and confirm correct sequence of operation and address/zone identification at the fire alarm control unit. Confirm correct operation of circuits under fault conditions in accordance with installed circuit style and class. D. Documentation, to be submitted to the Engineer of Record and AHJ: Sprinkler System: NFPA 13 "Contractor's Material and Test Certificate", accurately completed and endorsed by installing contractor's signature. 2. Fire Alarm System: NFPA 72 "Fire Alarm System Record of Completion", accurately completed and endorsed by installing contractor's signature. E. Upon completion of the work, and receipt of the appropriate close-out documentation, the Engineer of Record shall certify completion for each fire protection system to the extent required by 780 CMR §901.5.1 F. The general contractor shall then schedule final acceptance demonstration testing with the AHJ in order to obtain approval for a Certificate of Occupancy. Page 5 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — July 29, 2016 Project Name: Watts Water Technology - Annex, 2nd Floor Renovations RDK Project Number: 20160156.00 Section 2 - Equipment and Tools A. The contractor shall provide all required tools and equipment necessary to perform full functional testing as outlined. As a minimum these items shall include: 1. NFPA Forms 2. Manufacturer's Instructions 3. Fire Protection Systems Narrative Report 4. UL smoke candles or aerosol spray 5. Sound meters 6. Voltage Meters 7. Gauges 8. Communication Radios 9. Printer or data transfer device for recording each FACP event Section 3 - Approval Requirements A. The contractor shall obtain written acceptance of the installed system from the AHJ prior to the owner request for a Certificate of Occupancy. B. The contractor shall replace and/or repair each system or component of a system that fails to pass the Final Acceptance Test satisfactorily. Preliminary and Final Testing shall be rescheduled and testing shall be conducted until compliance is fully demonstrated. The contractor shall be liable for all additional charges as a result of retesting. C. Final certification shall be provided from the contractors that the installation is in accordance with the approved construction documents and applicable codes. The Engineer shall certify that the installation complies with the approved construction documents per 780 CMR 901.5.1. D. Operations Manuals and Record as -built drawings shall be submitted with any modifications as a resultant of changes that were dictated from the Final Testing process. E. The Owner shall provide an emergency contact list for use by the AHJ in the event of an emergency at the protected property. END OF NARRATIVE Page 6 of 6 COMcheck Software Version 4.0.0 Interior Lighting Compliance Certificate Project Information Energy Code: 20121ECC Project Title: WATTS WATER TECHNOLOGIES - ANNEX Project Type: Alteration Construction Site: ANDOVER, MA Allowed Interior Lighting Power Owner/Agent: Designer/Contractor: RDK ENGINEERS 200 BRICKSTONE SQ ANDOVER, MA 01810 A B C D Area Category Floor Area Allowed Allowed Watts (ft2) Watts / ft2 (B X C) 1 -Common Space Types:Office - Open plan 2578 1 2578 2 -Common Space Types:Office - Enclosed 719 1 .10 791 3 -Common Space Types:Restroom 183 1 183 4 -Common Space Types:Conference / Meeting / Multipurpose 235 1 .19 282 5 -Common Space Types:Corridor / Transition 60 0.70 42 6 -kitchenette (Common Space Types:Food preparation) 94 1..19 113 7 -TELE DATA CLOSET (Common Space Types:Electrical/mechanical) 19 1.10 21 Total Allowed Watts = 4010 Proposed Interior Lighting Power A B C D E Fixture ID : Description / Lamp / Wattage Per Lamp / Ballast Lamps/ # of Fixture (C X D) Fixture Fixtures Watt. Common Space Types:Office - OpenIR an (2578 sq.ft.) LED 1: LT1: 2X2 RECESSED LED: Other: 1 42 50 2100 Common Space Types:Office - Enclosed (719 sq ft 1 LED 2: LTi: 2X2 RECESSED LED: Other: 1 10 50 500 Common Space Tvoes:Restroom (183 sq.ft.) LED 3: LT1: 2X2 RECESSED LED: Other: 1 4 50 200 Common Space Types:Conference / Meeting / Multipurpose (235 sq.ft.) LED 4: LTi: 2X2 RECESSED LED: Other: 1 4 50 200 Common Space vpes:Corridor / Transition (60 sq.ft.) LED 5: LTi: 2X2 RECESSED LED: Other: 1 2 50 100 kitchenette ( Common Space Types:Food preparation 94 sq.ftj LED 6: LTi: 2X2 RECESSED LED: Other: 1 2 50 100 TELE DATA CLOSET ( Common Space Types: Electrical/mechanical 19 sq ft LED 7: LT4: 1X4 LED STRIP: Other: 1 1 28 28 Total Proposed Watts = 3228 Project Title: WATTS WATER TECHNOLOGIES - ANNEX Report date: 04/14/16 Data filename: Q:\2016\20160156 - WWT Annex 2nd Floor Renovations\0600 Electrical Design\603 Page 1 of 7 Lighting\20160156.0 WATTS ANNEX COM CHECK.cck Interior Lighting Compliance Statement Compliance Statement. The proposed interior lighting alteration project represented in this document is consistent with the building plans, specifications, and other calculations submitted with this permit application. The proposed interior lighting systems have been designed to meet the 2012 IECC requirements in COMcheck Version 4.0.0 and to comply with the mandatory requirements listed in the Inspection Checklist. Name - Title Q Signa ,� '- Dat Project Title: WATTS WATER TECHNOLOGIES - ANNEX Report date: 04/14/16 Data filename: Q:\2016\20160156 - WWT Annex 2nd Floor Renovations\0600 Electrical Design\603 Page 2 of 7 Lighting\20160156.0 WATTS ANNEX COM CHECK.cck COMcheck Software Version 4.0.0 Inspection Checklist Energy Code: 2012 IECC Requirements: 94.0% were addressed directly in the COMcheck software Text in the "Comments/Assumptions" column is provided by the user in the COMcheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. 2012 IECCI Plan Review Complies? Comments/Assumptions C103.2 Plans, specifications, and/or ❑Complies : Requirement will be met. [PR4]1 calculations provide all information ❑Does Not with which compliance can be ❑Not Observable determined for the interior lighting ❑Not Applicable and electrical systems and equipment and document where exceptions to the standard are claimed. Information provided should include interior lighting power calculations, wattage of .bulbs and ballasts, transformers and .control devices. Additional Comments/Assumptions: 1 High Impact (Tier 1) 2 1 Medium Impact (Tier 2) 1 3 Low Impact (Tier 3) ....................._................._............................................................. ....................................................... .................... .............. ............... .......... _.._..:........ ............. ........................................................ _...................... _.._.; Project Title: WATTS WATER TECHNOLOGIES - ANNEX Report date: 04/14/16 Data filename: Q:\2016\20160156 - WWT Annex 2nd Floor Renovations\0600 Electrical Design\603 Page 3 of 7 Lighting\20160156.0 WATTS ANNEX COM CHECK.cck Rough -In Electrical Inspection Complies? ................ :...:..::..................... ._._.............:...__........................ ................. ........ , ..:_...... C405.2.2. Automatic controls to shut off all 1 building lighting installed in all [EL22]2 buildings. Comments/Assumptions ....... . .............................. ................................................. .................. _........... _...... __._............ .. ❑Complies Requirement will be met. ❑Does Not ❑Not Observable ❑Not Applicable _.__.............. ._.............................._..........__...._..-.._..._.......................... - –.._._........................................._..........._._..__..;.......................... ..._._..—..__..._...................................._ C405.2.1. Independent lighting controls installed ❑Complies Requirement will be met. 1 per approved lighting plans and all ❑Does Not Exit signs do not exceed 5 watts per [EL23]2 manual controls readily accessible and; ❑Not Observable C405.2.3 visible to occupants. ❑Not Applicable allowed for special functions per the 0405.2.1. Lighting controls installed to uniformly::❑Complies Requirement will be met. 2 reduce the lighting load by at least ❑Does Not [EL15]1 50%. ❑Not Observable ❑Not Applicable 0405.2.2., Daylight zones provided with ❑Complies Requirement will be met. 3 individual controls that control the ❑Does Not [EL16]2 lights independent of general area ❑Not Observable . lighting. ❑Not Applicable 0405.2.3 ;Sleeping units have at least one ❑Complies Exception: Requirement does not apply. [EL17]3 master switch at the main entry door❑Does Not that controls wired luminaires and ❑Not Observable':. 'switched receptacles. ❑Not Applicable C405.2.2. :Occupancy sensors installed in ❑Complies Requirement will be met. 2 required spaces. ❑Does Not [EL18]1 ❑Not Observable ❑Not Applicable C405.2.2. Primary sidelighted areas are ❑Complies Exception: Requirement does not apply. 3 equipped with required lighting ❑Does Not [EL20]1 controls. ❑Not Observable ❑Not Applicable C405.2.2. ; Enclosed spaces with daylight area ❑Complies Exception: Requirement does not apply. 3 under skylights and rooftop monitors ❑Does Not [EL21]1 :are equipped with required lighting ❑Not Observable controls. ❑Not Applicable C405.2.3 Separate lighting control devices for ❑Complies Requirement will be met. [EL4]1 :specific uses installed per approved ❑Does Not lighting plans. ❑Not Observable ❑Not Applicable i C405J Fluorescent luminaires with odd ❑Complies Exception: Requirement does not apply. [EL19]3 numbered lamp configurations that ❑Does Not are with 10 feet center to center (if ❑Not Observable F ecess mounted) or are within 1 foot ❑Not Applicable edge to edge (if pendant or surface Additional Comments/Assumptions: LJComplies Requirement will be met. ❑Does Not ❑Not Observable ❑Not Applicable ❑Complies Requirement will be met. ❑Does Not ❑Not Observable ❑Not Applicable 1 !High Impact (Tier._ 1)_.._....__........2._.. Med.�_�_m_..Imp_act (Tier._z�........._........._3...._!Low Impact (Tier._ 3)..._.__..._..... Project Title: WATTS WATER TECHNOLOGIES - ANNEX Report date: 04/14/16 Data filename: Q:\2016\20160156 - WWT Annex 2nd Floor Renovations\0600 Electrical Design\603 Page 4 of 7 Lighting\20160156.0 WATTS ANNEX COM CHECK.cck mounted) shall be tandem wired. C405.4 Exit signs do not exceed 5 watts per [EL6]1 :face. C405.2.3 :Additional interior lighting power [EL8]1 allowed for special functions per the approved lighting plans and is automatically controlled and separated from general lighting. Additional Comments/Assumptions: LJComplies Requirement will be met. ❑Does Not ❑Not Observable ❑Not Applicable ❑Complies Requirement will be met. ❑Does Not ❑Not Observable ❑Not Applicable 1 !High Impact (Tier._ 1)_.._....__........2._.. Med.�_�_m_..Imp_act (Tier._z�........._........._3...._!Low Impact (Tier._ 3)..._.__..._..... Project Title: WATTS WATER TECHNOLOGIES - ANNEX Report date: 04/14/16 Data filename: Q:\2016\20160156 - WWT Annex 2nd Floor Renovations\0600 Electrical Design\603 Page 4 of 7 Lighting\20160156.0 WATTS ANNEX COM CHECK.cck I 2012 IECC ; Final inspection Complies? Comments/Assumptions .......................... . : C408.2.5. ...:.....::_..._.............---......................................... _..._........_.....:::............................................................................................. Furnished as -built drawings for .:..... .. _ _.-I.- ....................................... ._._....... .......................... .. _. =.:i: ❑Complies Requirement will be met. 1 electric power systems within 30 days ❑Does Not [FI16]3 of system acceptance. ❑Not Observable. .are less than or equal to allowed ❑Not Applicable C303.3,C4 ...................................... .-------.-...............................__.-............. -- Furnished O&M instructions for ..-................... ....... _....... _........ -...... -..._....._..........._._..._......_.._.._... _........ _._..._...................... ......--.._._..-_... _............................... _.__......... _........... _..__.................... ............. _..-_............. ❑Complies Requirement will be met. 08.2.5.2 :systems and equipment to the ❑Does Not .[FI17]3 building owner or designated ❑Not Observable programming, and operation. representative. ❑Not Applicable C405.5.2 Interior installed lamp and fixture ❑Complies see the Interior fighting fixture schedule for values. [FI18]1 lighting power is consistent with what ❑Does Not is shown on the approved lighting Observable plans, demonstrating proposed watts :❑Not ❑Not Applicable .are less than or equal to allowed watts. C408.3; Lighting systems have been tested to ❑Complies Requirement will be met. [F133]1 ensure proper calibration, adjustment, ❑Does Not programming, and operation. ❑Not Observable ❑Not Applicable C406 Efficient HVAC performance, efficient ❑Complies [FI34]1 lighting system, or on-site supply of ❑Does Not renewable energy consistent with ❑Not Observable what is shown the approved plans. ❑Not Applicable Additional Comments/Assumptions: ^1 High Impact(Tier 1) 2 Medium Impact (Tier 2) 3 Low Impact (Tier 3) Project Title: WATTS WATER TECHNOLOGIES - ANNEX Report date: 04/14/16 Data filename: Q:\2016\20160156 - WWT Annex 2nd Floor Renovations\0600 Electrical Design\603 Page 6 of 7 Lighting\20160156.0 WATTS ANNEX COM CHECK.cck WISEC-1 OP ID: LO ACORD' CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) F08/03/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER DeSanctis Insurance Agcy, Inc. 100 Unicorn Park Drive CONTACT NAME: PHONE781-935-8480 Fac No):781-933.5645 ac No Ext: E-MAIL ADDRESS: Woburn, MA 01801 INSURERS AFFORDING COVERAGE NAIC # 06/27/2017AMA JNSUREIR A: LibertV Mutual Insurance Cos. 23043 RENT€[i- 300 00 PREMISES Ea oxurrence$ INSURED Wise Construction Corp. 21 East St. Winchester, MA 01890-1127 INSURER 8: Associated Employers 11104 INSURER C: Nautilus Insurance Company 17370 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X JPE Q El LOC OTHER: GENERAL AGGREGATE $ 2,000,00 INSURER D: INSURER E: A INSURER F: LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS COVERAGES CERTIFICATE Nt1MRER- REVISION NIIMRER- 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. /LTR TYPE OF INSURANCE ADDL SUB POLICY NUMBER MOM/DDY EFF POLIMM/DD FSP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I—XI OCCUR X Per Project Agg TB2Z11261323026 06/27/2016 06/27/2017AMA EACH OCCURRENCE $ 1,000,00 RENT€[i- 300 00 PREMISES Ea oxurrence$ MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X JPE Q El LOC OTHER: GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGG $ 2,000,00 $ A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS AS2Z11261323016 06/27/2016 06/27/2017 COMBINED SINGLE LIMIT Ea accident $ 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTYDAMAGE $ Per. accident $ A X UMBRELLA LU16 EXCESS LIAR X OCCUR CLAIMS -MADE TH7Z11261323036 06/27/2016 06/27/2017 EACH OCCURRENCE $ 10,000,00 AGGREGATE $ 10,000,00 DED I X I RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y /N❑N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WCC50050135352016A MA 06/27/2016 06/27/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 C Pollution Liability CPP201858610 06/27/2016 06/27/2017 Aggregate 3,000,00 Occurrenc 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) "ADDITIONAL INSURED LIMITS ARE NO GREATER THAN REQUIRED BY WRITTEN CONTRACT" RE: Annex Upgrades at 815 Chestnut St., North Andover, MA. Watts Water Technologies, Inc. is Additional Insured with respects to the GL. CERTIFICATE HOLDER CANrFI 1 ATInN WATTS -1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Watts Water Technologies, Inc.THE g EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 815 Chestnut Street North Andover, MA 01845 AUTHORIZED REPRESENTATIVE ACORD 25 (2014/01) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WISEC-1 OP ID: LO ACORO0 CERTIFICATE OF LIABILITY INSURANCE �� FDATE(MM/DDNYYY) 08/03/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER DeSanctis Insurance Agcy, Inc. 100 Unicorn Park Drive CONTACT PHONE-----FF-AX o x:781-935-8480 A/c No: 781-933-5645 ac No. E-MAIL ADDRESS: Woburn, MA 01801 INSURERS AFFORDING COVERAGE NAIC # 06/27/2017 INSURER A: Liberty Mutual Insurance Cos. 23043 DAMAGE TO ENTED 300,00 PREMISES Ea occurrence $ INSURED Wise Construction Corp. INSURER B: Associated Employers 11104 21 East St. Winchester, MA 01890-1127 INSURER C: Nautilus Insurance Company 17370 GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGG $ 2,000,00 INSURER D INSURER E: AUTOMOBILE X X INSURER F: COVERAGES CERTIFICATE N"MRFR- RFVISIAN NIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADOL SUB POLICY NUMBER POLICY EFF MM/DD POLICYEXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X Per Project Agg TB2Z11261323026 06/27/2016 06/27/2017 EACH OCCURRENCE $ 1,000,00 DAMAGE TO ENTED 300,00 PREMISES Ea occurrence $ MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JET LOC OTHER: GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGG $ 2,000,00 $ A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X NON -OWNED HIRED AUTOS AUTOS AS2Z11261323016 06/27/2076 06/27/2077 COMBINED SINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PeOaccidenDAMAGE $ $ A X UMBRELLA LIAR EXCESS LWB X OCCUR CLAIMS -MADE TH7Z11261323036 06/27/2016 06/27/2017 EACH OCCURRENCE $ 10,000,00 AGGREGATE $ 10,000,00 DED I X I RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? FRI (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WCC50050135352016A MA 06/27/2016 06/27/2017 X I PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 C Pollution Liability CPP201858610 06/27/2016 06/27/2017 Aggregate 3,000,00 Occurrent 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) "ADDITIONAL INSURED LIMITS ARE NO GREATER THAN REQUIRED BY WRITTEN CONTRACT" Evidence of Coverage. RE: Watts Water Technologies Annex Upgrades, 815 Chestnut St., North Andover, MA. CERTIFICATE HOLDER flANrpt I ATInN NORTA-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood St., Suite 2043 North Andover, MA 01845 I I AUTHORIZED REPRESENTATIVE 00"� I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ]he (;ommonwealth of -Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Nkw www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/OrganizationAndividual): Wise Construction Address: 21 East Street Winchester. MA 01 Phone #: 781-721-1100 Are you an employer? Check the appropriate box: 1. Q I am a employer with 4. ® I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. Q I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. Q I am a homeowner doing all work myself. [No workers' comp. insurance required.] t listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.$ 5. Q We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' insurance Type of project (required): 6. Q New construction 7. ® Remodeling 8. Q Demolition 9. Q Building addition 10. ❑ Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12.Q Roof repairs 13. Q Other "Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: DeSantis Policy # or Self -ins. Lic. #: WCC50050135352016AMA Expiration Date: 6/29/17 Job site Address: 815 Chestnut Street city/state/zip: North Andover, MA 01845 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under 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 cen*i ndy�j*e pains and penalties of perjury that the information provided above is true and correct. Phone #: 781-721-1100 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 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-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to 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 Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFB Revised 4-24-07 Fax # 617-727-7749 www.mass.gov/dia 3 IVlassachusetts - Department of Public Safety ` Board of Building Regulations and Standards Construction Supcn itiur L-icense; CS -107883 NICHOLAS CUZ;MPE 3 LLOYD ROAD. Tewksbury MA 01876 Expirationji Commissioner 09/19/2017.:`:' Enter construction cost for fee cal - North Andover Fee Cakulation Construction Cost $ 6803693.00 m $ - $ 8,168.32 Plumbing Fee $ 1,021.04 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 1,021.04 Total fees collected $ 10,310.40 815 Chestnut Street 172-2017 on 8/18.2016 Interior Renovation of Second Floor Annex Building and HVAC Upgrades 7/8/2016 s 20863 This is an e -permit. To learn more, scan this barcode or visit northandoverma.viewpointcloud.com/#/records/20863 TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that Joseph R Harold has permission for gas installation New Boiler installed to serve Snow melt test plot system for Watts in the buildings of WATTS WATER TECHNOLOGIES at 815 CHESTNUT STREET, North Andover, Mass. Lic. No. 12267 Date: July 08, 2016 7/8/2016 This is an e -permit. To learn more, scan this barcode or visit northandoverma.viewpointcloud.com/#/records/20864 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that Joseph R Harold has permission to perform New Hot Water Recir Line with Pump plumbing in the buildings of WATTS WATER TECHNOLOGIES at 815 CHESTNUT STREET, North Andover, Mass. Lie. No. 12267 Date: July 08, 2016 4 ry-tpsGasPe—armee.--v�awr x n , Y E -� C L htitrainortliandoverma.vlewpolrthloud.com/Y.(reccrls,/2CJfro"s ---------....._..---_.._..______---.._-._.--------_------------_-----_-._._.._..._.__---_-------__------- Y �, iinros j:,llvlewart Town of North Andover, MA'search _ Q - ,..1... _ -- .. Friday, Jul 08, 2016 08:39 AM 20863 *Gas Permit - In conjunction with a Ruflding Permit (Commercial or Residentiah TIMELINE 0 Submission received 1I1e,2016at8:28— /moi Your request Is in progress We'R letuknaw of yo any uptlates Na email. Feel free to check the status at anytime by coming back to this page. Gas Permit Revlew la Prpgress PEM. IT Fee - x \nf.. FkNeSerfb\�maab'�LVMDEVRIWH �'Y�, Capy Nvrh 1 Q Pend. Ilsuante Est welswate, Tahnly. bpllcar. Lacanon Brian Monaghan 875 CHESTNUT STREET, NORTH ;AN DOVER, MA Owner WATTS WATER TECHNOLOGIES Attachments ', ytlpmac ela ' -OTYWM61001F Fri-jul 08 2016 12:38:.PDF Primary Contractor Search for your contractor ussirg The search bar below. Either the Firm's Name or R—ee s Is required. Flrtn's (3uslness)Yame PI t rGesfim N WcsmsePJ• ®Qat % a:�aM 1/8016 . t. tipl•vssmn9— — ,: x a E 3 Ci p hyns://norhff)cbverma.viewpointioLid.com/g/records/211851 iii Apps jlxewdt Town of North Andover, MA LCL I search... R 20864 *Plumbing Permit- RenovatfamAltemtionfAddition Fixtures andlor appliances (Commercial or Residential) TIMELINE 0 Submission received Jul 8, 2016 at 8:39am Plumbing Review In Progress 0 Permit Fee Pros- 0 4jyn:eM 0 Permit Issuance ! -0 M 0 Friday, Jul 08, 2016 08:44 AM Your request is in progress We'll let you know of any updates via email. Feel free to check the status at any time by coming back to this page. ln�, RCMe SaRM\\sneery\COMDEv_flICOH ,M '� � N N_ D� Capy Nurbe:l ESC Twhnnologir b9ies 4: pllca�: Lataucn Brian Monaghan 815 CHESTNUT STREET, NORTH %DOVER, MA 0— WATTS WATER TECHNOLOGIES Attachments t.�pmee rue -OTORHIIOOIF Frljul OS 2016 12:a1:.PDF Primary Contractor Search for your contractor using the search bar below. Either the Firm's Neme or licensee! Is required. e.m s lsusmes:; Hame Pmmbers rvem< luce�see, W ®4 sa S� tla 6 71:8,0-16 12 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY lNorth Andover MA MA DATE 107/07/16 PERMIT # JOBSITE ADDRESS 1815 Chestnut Street OWNER'S NAME Watts Water Technologies POWNER ADDRESS 815 Chestnut Street TELI FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL ® RESIDENTIAL PRINT CLEARLY NEW: E] RENOVATION: E] REPLACEMENT: ® PLANS SUBMITTED: YES ® NO® FIXTURES Z FLOOR BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE i DEDICATED SPECIAL WASTE SYSTEM _= DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM s 1 DEDICATED GRAY WATER SYSTEM _ DEDICATED WATER RECYCLE SYSTEM i DISHWASHER DRINKING FOUNTAIN r FOOD DISPOSER I FLOOR /AREA DRAIN _ INTERCEPTOR (INTERIOR) KITCHEN SINK LAVATORY f ROOF DRAIN SHOWER STALL SERVICE / MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING 1 l OTHER Re -Circulation Pump 1 i i ( F i I INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES E] NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY [3 OTHER TYPE OF INDEMNITYE] BOND Ej OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER [:] AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME I Joseph R. Harold III LICENSE # 12267 MP(D JPO CORPORATION# 2128C PARTNERSHIP# LLC E]# COMPANY NAME Sagamore Plumbing &Heating Inc. ADDRESS 75 Research Rd CITY Hingham STATE MA ZIP 02043 TEL781-331-1600 FAX 781-331-9900 " CELL 617-365-1600 1 EMAIL jharold@sagamore.com MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK -- UV CITY jAndover MA DATE 07/07/16 PERMIT # JOBSITE ADDRESS 1815 Chestnut Street OWNER'S NAME 1815 Chestnut Street GOWNER ADDRESS 1815 Chestnut Street TEL IFAXI TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL ❑ PRINT CLEARLY NEW: ❑ RENOVATION: ❑ REPLACEMENT: ❑ PLANS SUBMITTED: YES ❑ NO ❑ APPLIANCES -1 FLOORS BSM 1 1 1 2 3 4 5 1 6 7 8 1 9 10 11 12 13 14 BOILER 1 BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES 0 NO ❑ I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ❑ OTHER TYPE INDEMNITY ❑ BOND ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in comnlinnc.P with all Partinant nrnvision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws._ PLUMBER-GASFITTER NAME I Joseph R Harold III LICENSE # 12267 MP ❑ MGF ® JP ❑ JGF ❑ LPGI ® CORPORATION Q# 2128C PARTNERSHIPLJ#j LLC Lj#� COMPANY NAME: Sagamore Plumbing & Heating, Inc. ADDRESS 175 Research Rd CITY I Hingham STATE = ZIP 102043 TEL 781-331-1600 FAX 781-331-9900 CELL 617-365-1600 EMAIL I jharold@sagamore.com The Commonwealth of Massqchusetts Department oflndustrialAceldents I Congress Street, Suite 100 Boston, MA. 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. . Applicant Information Please Print Legibly Name (Business/Organizationllndividual):Cc Address: 7 re.-Sro-crh ' cno-6 City/State/Zip: 141, Are you an employer? Check the appropriate box: g3 Phone #: 751 - 3 31 - l (00 U 1. [gram. a employer with , employees (full and/or part-time).* 2.F1 I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3.FJ 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 ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5. Q 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.$ 6.FJ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no. employees. [No workers' comp. insurance required.] Type of project (required): 7. [] New construction 8. [] Remodeling 9. ❑ Demolition 10 ❑ Building addition 11.❑ Electrical repairs or additions 12.,[dumbing repairs or additions 13. [] Roof repairs 14. ❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy infonnation. i Homeowners who subi iif Phis affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must -attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees.' Below is the policy acid job site information. M M Insurance Company Name: I I / 113 u� l t'i UYCa'�C- C)MO Policy # or SeIf-ins. Lic. #: W %� 2- 00 Q 6ar\•,5 ,5 6 & J b'E,[�xpiration Date: 01 7 Job Site Address: O / C W-ock City/State/Zip: Q `I' ` AnC'w'&—,M1fi 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 hereby certify unA&r the pains and penalties of perjury that the information provided above is true and correct n.k_,..,,..,.. "-' �"/ 7 � Harp• Q 7/ IV - 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 #: ., A Information and Instructions Massachusetts General Laws chapter 1.52 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 oilier 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 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 fok 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' compensatioii policy, please call the Department at the number listed below. Self -insure_ d 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 AC40RV CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) F7/5/2016 ,THIS -CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Alliant Insurance Services, Inc. 131 Oliver Street, 4th Floor Boston MA 02110 CONTANAME: Maria McNulty PHONE 617-535-7200 FAX 617-535-7205 C "o EMAI MESS: Maria.MeNulty@alliant.com INSURERS AFFORDING COVERAGE NAIC # Y INSURERA:Unlon Insurance Company 25844 0308-7691 INSURED INSURER B :Travelers Property Casualty Co of A 25674 Sagamore Plumbing & Heating, Inc. INSURER C: Allied World Natl Assurance Co 10690 75 Research Road Hingham MA 02043 INSURER D:A.I.M. Mutual Insurance Company 31 INSURER E,. INSURER F: DAMAGE TO RENTED PREMISES Ea occurrence $300,000 COVERAGES CERTIFICATE NUMBER: 1662406783 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I LTR TYPE OF INSURANCE NSD WVD POLICY NUMBER EFF MMIDIDY/YYYY POLICY EXP MMIDDNYYY LIMITS C X COMMERCIAL GENERAL LIABILITY Y 0308-7691 1/1/2016 1/1/2017 EACH OCCURRENCE $1,000,000 CLAIMS -MADE FX OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $300,000 MED EXP (Any one person) $10,000 X XCU X Contractual PERSONAL& ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY a ECT—] LOC PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y 5187331-11 1/1/2016 1/1/2017 COMBINED SINGLE LIMIT $ Ea accident 1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY Per accident $ ( ) X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE $ Per accident B X UMBRELLA LIAB X OCCUR Y ZUP-14T57686-16-NF 1/1/2016 1/1/2017 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION$$0 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N WMZ-800-8005566-2016A 1/1/2016 1/1/2017 PER oTH- X STATUTE ER E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � N I A E.L. DISEASE - EA EMPLOYE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Cohasset Perch Restaurant. Hybrid Construction & Development LLC is included as Additional Insured as required by written contract and executed prior to a loss, but limited to the operations of the Insured under said contract, with respect to the Automobile, General Liability and Umbrella/Excess Liability policies. CERTIFICATE HOLDER CANCELLATION Hybrid Construction & Development LLC Peter Vanderweil PO Box 534 Hingham MA 02043 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE at,ltz;v kA t.^- @1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ci co 5. w _� • _3 OZ CC37 C) (Q �• N n j • 3 m�� N �. O N) v _ m Z� �, y • pCD mOD Z 0- _• O q� 3 C _ O �• o CQ E D W (n v 7 m O O 3 O m D 0 Z O cn W D p D m _Q O o 7[l 0 m o / ``j: m CD m z o o oQ Fn o J —1 O m n 0 S o CD o = cu` 3 — D 0 o c p z 0 b 90O n — Z v 3 O v O CD C o m Q cn N O O 00 O o a $- C- a 0 N O T� V/ Location t� �� % r• .,�� `�''` �'1 No. .? U� / Date �01 I kf%il Check # TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $—..` Other Permit Fee $ TOTAL Building Inspector r'a Issued: k4P1 r BUILDING PERMIT �.�°�tt."•° 6 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received /IMPORTANT: Applicant must complete all items on this pa Print PROPERTY a Se s sMAP NO- A�ZLPARCEL��� �ONING DISTRICT'. -Historic Mach q, Rint District yes no Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building 0! One family 0 Addition _ Two or more family Industrial Alteration No. of units:' Commercial _ Others: 0 Repair, replacement Assessory Bldg C Demolition Other Septic Well Floodplain Wetlands _ Watershed District Water/Sewer J ,IA /r Identification Please Type or Print Clearly) OWNER: Name: Jcc�llt✓ C�rhit �C-P t1 Phi Address* CONTRACTOR Name: Phone, —79 06 !� by Address: ' skiOW OM40 Supervisor's Construction License: Exp. Date: Horne Improvement License: Exp. Date ARCHITECT/ENGINEER JQD k�/VOee/1 Phone: Vl - yTS"- 624 �. Address: X0 gii&S fA P. 5. 47<,j i l„A�/yvo,-A Reg. No. s.. FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. ` Total Project Cost: $ FEE: $ Check No.. Receipt No.: sb'i 34 NOTE: Persons contracting wit, unre red contractors do not have access to tit larcry, tread w. -.__w-- - 5ignature of AgeFt_/0 � '' Signature of contract i Plans Submitted ❑ ' flans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT ❑ COMENTS CONSERVATION COMMENTS HEALTH COMMENTS ■❑ C DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/signature & Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS r0, k Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 125,455.00 m $ - $ 1,505.46 Plumbing Fee $ 188.18 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 188.18 Total fees collected $ 1,981.83 815 Chestnut Street Replacement of existing fire pump and sprinkler room 1242-20136 on 6/1/2016 s LL Q m C= Z \ O LLL 41 VI U Q V) O LU U Z Z m C ~ 'O 7 LL t D = T C U LL O0 W Z Z Cm G J a _ -C 7 C' LL a z Q U F {U W L 7 K U i. N C LL a Z Q -C .:3 W C LL/ z W W W LL E m O z 0) (% Y v 0 Y O N *7 uu am O W :a z Z 0 U)� �a Z CG 0 Z V LU I.L ) a Z w0 W m Z s w N S Page 1 of 1 ViThe CONSTRUCTION CSI # Client: Watts Water Technologies Project: Fire Pump/Sprinkler Room Location: 815 Chestnut Street - North Andover Date of Estimate: 12 -May -16 Plan Date: 14 -Apr -16 Estimate #: E16-064 Estimate Summary Trade Cost 02100 Demolition $3,472 03300 Concrete $1,236 06000 Rough / Finish Carpentry $19,750 07000 Thermal and Moisture Protection $650 08100 Doors, Frames and Hardware NIC 08800 Glass & Glazing NIC 09250 Drywall See Carpentry 09500 Acoustical Ceilings $750 09650 Flooring NIC 09900 Painting $1,089 10100 Specialties NIC 11100 Equipment NIC 12100 Furnishings NIC 15300 Fire Protection $63,600 15400 Plumbing $9,918 15500 HVAC $1,000 16000 Electrical $23,990 TOTAL $125,455 Wise Construction - Eric Libby WP(A- Jackie Co ' key m 77, e _a •'�r ar�v3^s&S''E':r,�, ,-'" ny€>..� yv v; ks ,�,,, xx r �€ ,"x a'' 121010 ENGINEERS 200 Brickstone Square I Andover, MA 01810-1488 P: 978-296-6200 1 F: 978-296-6201 TO: Wise Construction 21. East Street Winchester, MA 01890 Attached ❑ Shop drawings ❑ Specifications ❑ Other LETTER OF TRANSMITTAL DATE: 5/26/16 RDK Understands Hoof Engineering Affects People PROJ. NO: 20160157.00 ATTN: Mr. Eric Libby RE: Watts Water Technology — Permit Package Sprinkler Room Equipment Upgrades WE ARE SENDING YOU Under separate ❑ via Wise to Pick Up on 5/26/16 Prints . ❑ Plans ❑ Submittal ❑ Copy of letter ❑ Change order ❑ Diskettes ❑ COPIES DATE NO. DESCRIPTION 3 sets 5/26/16 1 Permit drawings 1 set 5/26/16 2 Design Affidavits 1 5/26/16 3 Narrative 1 5/26/16 4 COMcheck THESE ARE TRANSMITTED AS NOTED BELOW For approval ❑ Approved as submitted ❑ Resubmit copies for approval For your use ❑ Approved as noted ❑ Submit copies for distribution As requested ❑ Returned for corrections ❑ Return corrected prints For review and comment ❑ Prints returned after loan ❑ DUE ON: REMARKS CC: RDK File If enclosures are not as noted, kindly notify us at once. Signed: Q:\2016\20160157 - WWT Sprinkler Rm Equipment Upgrades\0200 Correspondence\202 Transmittals\16 LtrTrans Wise Libby Permit 5-26.doc Andover I Amherst I Boston I Charlotte I Durham www,rdkengineers.com Initial Construction Control Document To be submitted with the building permit application by a W Registered Design Professional ti= for work per the 8th edition of the " V Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology - Sprinkler Room Equipment Upgrades Date: May 23, 2016 Property Address: 815 Chestnut Street, North Andover, Massachusetts Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Sprinkler equipment repairs and piping, revisions within existing fire pump room (basement). Relocation of plumbing system booster pump and irrigation pumps out of sprinkler room and into the adjacent janitor's closet (being converted into mechanical room). Note: Repairs as outlined in International Building; Code. It is not the intent of this project to bring the entire room up to code as this would require additional architectural and electrical scope not included in this project I, Jeffrey Faucon, MA Registration Number: 47208 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [ ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC [X] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to t fficial a `Final Construction Control Document'. OF M48s9cti Enter in the space to the right a "wet" JEFFREY T. J, or electronic signature and seal: FAuc°N �+, v FIRE PRO, EC 710N C No. 47208 A'D'O G Phone number: 978-296-6375 S a9' Email: ifaucon@rdkengineers.com wilding Official Use Only Building Official Name: Permit No.: Date: Initial Construction Control Document W To be submitted with the building permit application by a d Registered Design Professional for work per the 8' edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology - Sprinkler Room Equipment Upgrades ades Date: May 23, 2016 Property Address: 815 Chestnut Street, North Andover, Massachusetts Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Sprinkler equipment repairs and piping revisions within existing fire hump room (basement). Relocation of plumbing system booster pump and irrigation pumps out of sprinkler room and into the adjacent janitor's closet (being converted into mechanical room Note: Repairs as outlined in International Building Code. It is not the intent of this project to bring the entire room up to code as this would require additional architectural and electrical scope not included in this project I, Scott Guertin, MA Registration Number: 46837 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC ] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [X] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the f(ffV( SCOTT G. Enter in the space to the right a "wet" gGUERTIN or electronic signature and seal: MECHANICAL No. 46837 Phone number: (978)296-6338 Building Official Use Only Building Official Name: Permit No.: Date: Construction Control Document'. Email: sguertin@RDKEngineers.com Initial Construction Control Document W To be submitted with the building permit application by a Registered Design Professional °w for work per the 8a' edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology - Sprinkler Room Equipment Upgrades Date: May 23, 2016 Property Address: 815 Chestnut Street, North Andover, Massachusetts Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: the adjacent janitor's closet (being converted into mechanical room). Note: Repairs as outlined in International Building Code. It is not the intent of this project to bring the entire room up to code as this would require additional architectural and electrical scope not included in this project I, Keith Gi uere, MA Registration Number: 49637 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [ ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC [ ] Fire Suppression — NFPA 13 [X] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. ZN OF M,,gss c Enter in the space to the right a "wet" ya 9y or electronic signature and seal: o� KEITH E. � GK,UERE � ELECTRICAL in No. 49837 Abp 9FG1ST � 9•�g �4 Phone number: 978-296-6357 'sS! Email: kgiguere@rdkenizineers.com Buil in ficial Use Only Building Official Name: Permit No.: Date: Initial Construction Control Document To be submitted with the building permit application by a W Registered Design Professional r` for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology - Sprinkler Room Equipment Upgrades Date: May 23, 2016 Property Address: 815 Chestnut Street, North Andover, Massachusetts Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Sprinkler equipment repairs and piping revisions within existinp, fire puma room (basement). Relocation of plumbing system booster pump and irrigation pumps out of sprinkler room and into the adjacent janitor's closet (being converted into mechanical room), Note: Repairs as outlined in International Building Code. It is not the intent of this project to bring the entire room up to code as this would require additional architectural and electrical scope not included in this project I, Keith Gi uere, MA Registration Number: 49637 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [ ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC [ ] Fire Suppression — NFPA 13 [ ] Electrical [X] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to t i ial a `Final Construction Control Document'. KEITH E_ G Enter in the space to the right a "wet" QIQUEAE or electronic signature and seal: o ELECTRICAL No 49W7 A9p�9FG1si"tF���a``�� �SSIONAL Phone number: 978-296-6357 Email: kgilzuere@rdkengineers.com Building Official Use Only Building Official Name: Permit No.: Date: COMMONWEALTH OF MASSACHUSETTS STATE BUILDING CODE 780 CMR, 8TH EDITION CHAPTER 9 FIRE PROTECTION SYSTEMS NARRATIVE REPORT 780 CMR — 901.2.1 PROJECT NAME: Watts Water Technology Sprinkler Room Equipment Upgrades ADDRESS: 815 Chestnut Street North Andover, MA RDK PROJECT #: 20160157.00 DATE OF ISSUE: May 24, 2016 M- I Dr) " E ENGINEERS Andover I Amherst I Boston I Charlotte I Durham xr•,°sE.r_,kregi= s,com 780 CMR 901.2.1 Fire Protection Systems Narrative Report — May 24, 2016 Project Name: Watts Water Technology Sprinkler Rm Equip. Upgrades RDK Project Number: 20160157.00 As required by 780 CMR §901.2.1, this narrative report is a written description of the proposed fire protection system features to be installed as part of the Watts Water Technology Sprinkler Room Equipment project located at 815 Chestnut Street in North Andover, Massachusetts. 901.2.1 (1)0) - BASIS (METHODOLOGY) OF DESIGN Section 1 - Buildina Description A. "Use" Group(s) within Scope of Renovation: "B" Business (office). B. Location & Area of Renovation: Renovation to the Fire Pump Room located on the Basement Level. This building is not a high rise. C. Type(s) of Construction: 1. Non-combustible. D. Hazardous Material Usage and Storage: None in excess of exempt amounts within scope of renovation. E. High -pile Storage (over 12 ft.) of Commodities: None within scope of renovation. F. Site Access Arrangement for Emergency Response Vehicles: Existing features to remain; not affected by scope of renovation. Section 2 - Applicable Laws. Regulations & Standards A. Massachusetts State General Laws (MGL), Chapter 148 1. MGL §148, sections as applicable. B. 780 CMR — Massachusetts State Building Code, 8th Edition (amended IBC -2009) 1. Chapter 9 "Fire Protection Systems" 2. Chapter 34 "Existing Structures" C. Existing Building Code of Massachusetts (amended IEBC-2009) 1. Chapter 6 "Alterations —Level 1" 527 CMR — Massachusetts State Fire Prevention Regulations 2. Chapter 1 "Massachusetts Comprehensive Fire Safety Code' 3. Chapter 12 "2014 Massachusetts Electrical Code Amendments" D. National Fire Protection Association (NFPA) Standards: 1. NFPA 10 (2007) — "Portable Fire Extinguishers" 2. NFPA 13 (2013) — "Installation of Sprinkler Systems" Page 1 of 5 780 CMR 901.2.1 Fire Protection Systems Narrative Report — May 24, 2016 Project Name: Wafts Water Technology Sprinkler Rm Equip. Upgrades RDK Project Number: 20160157.00 NFPA 70 (2014) — "National Electric Code" as amended by 527 CMR Chapter 12 "Massachusetts State Electrical Code" NFPA 72 (2010) — "National Fire Alarm Code" E. Federal Regulations (significant requirements thereof to the extent applicable to RDK scope) 28 CFR Part 36, ADA Standards for Accessible Design 2. 29 CFR Part 1910, Occupational Safety & Health Standards F. Documented Local Ordinances (Voluntary Compliance) local bylaws and ordinances Section 3 - Design Responsibility for Fire Protection Systems A. Engineer of Record: RDK Engineers (RDK) has engineered and specified the fire protection systems to be installed. For each fire protection system designed by RDK, RDK shall review the installing contractor's Tier II shop drawings for conformance to the approved construction documents and be present at the site at intervals appropriate to become generally familiar with the progress and quality of work and to determine if the work is being performed in manner consistent with the construction documents and 780 CMR. RDK shall certify each fire protection system installation to the extent required by 780 CMR §901.5.1(1). B. The existing installation, including means of egress, fire resistance construction to be utilized. RDK Engineers shall review the installing contractor's Tier II shop drawings for conformance to the approved construction documents and be present at the site at intervals appropriate to become generally familiar with the progress and quality of work and to determine if the work is being performed in manner consistent with the construction documents and 780 CMR. Section 4 - Fire Protection Systems to be Installed A. Fire Mains & Hydrants: Existing features to remain; not affected by scope of renovation. B. Automatic Sprinkler System: The existing sprinkle system piping and sprinkler layout downstream of the main riser alarm valves will remain unchanged. C. Fire Pump / Main water service entrance: The existing fire pump room and associated equipment will be demolished and replaced in kind with new equipment including a new backflow preventor, vertical electric fire pump, main pump bypass, relocated jockey pump, jockey pump controller, and fire pump test header. The equipment selected is the same service rating and duty unless otherwise required for new installation per code. D. Standpipe System: there is no standpipe system in this building. E. Fire Alarm System: Existing fire alarm system head -end, back -bone, sequence of operation, etc. to remain and are not affected by the scope of renovation. Existing initiating circuits (SLC) within scope of renovated area to be modified to accommodate new or relocated initiating devices. New circuits may be added as dictated by the capacity of the existing circuits as determined by the installing contractor; the style and class of new circuits shall match that of the existing system. The following types of initiating devices shall be added: Page 2 of 5 780 CMR 901.2.1 Fire Protection Systems Narrative Report — May 24, 2016 Project Name: Watts Water Technology Sprinkler Rm Equip. Upgrades RDK Project Number: 20160157.00 a. Automatic sprinkler waterflow switch b. Automatic sprinkler valve tamper switch F. Hazardous Materials Monitoring: Not applicable to the proposed renovation. Section 5 - Features Used in the Design Methodology A. Occupant Notification Procedures: Existing occupant notification via the fire alarm system and subsequent building management personnel procedures shall remain and are not affected by the scope of renovation. 1. The existing fire alarm system treats the building as a single evacuation zone. B. Safeguards: Existing fire protection systems shall be maintained throughout the construction as required by the Authority Having Jurisdiction (AHJ). Impairment to existing fire protection systems shall be approved by, the AHJ and Owner prior to commencing work. A fire watch shall be provided during impairments to the fire suppression or fire alarm system in accordance with AHJ requirements. C. Future Testing & Maintenance: Modifications performed as part of the scope of renovation shall be warranted by the installing contractors for a period of one year covering defects in materials and workmanship. NFPA required inspection, maintenance and testing activities associated with the building fire protection system are the responsibility of the owner and are to be conducted under existing and/or future maintenance contracts. Section 6 - Special Consideration and Description A. Unless otherwise noted, the design of the fire protection systems does not utilize alternative compliance design methods and is not intended to deviate from the prescriptive requirements of 780 CMR or other applicable codes and standards. 901.2.1 (1)(ii) - SEQUENCE OF OPERATION A. The existing "base building" coordinated fire protection system basis of design and sequence of operation shall remain unchanged and shall not be modified under the scope of renovation. The general arrangement of the existing sequence of operation is described below and is subject to confirmation by the installing contractor and fire alarm system control unit technical representative. B. Activation of an existing or new manual pull station, smoke detector, heat detector or sprinkler system waterflow switch, taper switch or pressure switch shall initiate the predefined fire alarm system "alarm condition" sequence: 1. Display alarm condition at fire alarm control unit and remote annunciator(s). 2. Energize audible (temporal -3 pattern) and visual (UL 1971 synchronized strobe) occupant notification circuits within evacuation zone(s) as designated by pre -established control unit sequence of operations. 3. Perform auxiliary fire safety functions as designated by pre -established control unit sequence of operations such as door closure, AHU shutdown, etc. Page 3 of 5 780 CMR 901.2.1 Fire Protection Systems Narrative Report — May 24, 2016 Project Name: Watts Water Technology Sprinkler Rm Equip. Upgrades RDK Project Number: 20160157.00 4. Transmit alarm condition to central / supervising station and/or local fire department via existing alarm system. C. The operation of an existing or new sprinkler tamper switch or tamper switch shall initiate the predefined fire alarm system "supervisory" sequence: Display supervisory condition at fire alarm control unit and remote annunciator(s). Transmit supervisory condition to central / remote supervising station. D. Normal power failure to fire alarm system remote power supplies, ground faults, short circuits and open circuit conditions shall initiate the predefined fire alarm system "trouble" sequence. Display supervisory condition at fire alarm control unit and remote annunciator(s). Transmit trouble condition to central / supervising station. 901.2.1 (1)(iii) — TESTING CRITERIA Section 1 - Testing Criteria A. Fire Protection System testing shall be scheduled, administered, conducted and overseen by the general contractor, subcontractors and manufacturer's technical representatives. B. The following fire sprinkler system inspections and testing shall be performed: Visually inspect system installation for completeness, presence of defects or damage, and confirm system is placed into "all normal" operational service. 2. Hydrostatically test system piping for a period of 2 -hours. Piping shall be tested to normal system operating pressure where new installed piping cannot be isolated from the existing piping. 3. Functionally operate any new sprinkler waterflow or valve supervisory switches as part the fire alarm testing. C. The following fire alarm system inspections and testing shall be performed: Confirm integrity of new or modified circuits (free of grounds, shorts, opens) prior to the installation of devices, appliances or equipment. 2. Visually inspect system installation for completeness, presence of defects or damage, and confirm system is placed into "all normal' operational service. Confirm correct system supervision of wiring faults, missing devices and status of normal and standby power supplies (for new equipment installed as part of the work). 4. Functionally operate new devices installed as part of the work and confirm correct sequence of operation and address/zone identification at the fire alarm control unit. Confirm audibility / intelligibility and visual synchronization of notification appliances. 6. Confirm correct operation of circuits under fault conditions in accordance with installed circuit style and class. D. Documentation, to be submitted to the Engineer of Record and AHJ: Page 4 of 5 780 CMR 901.2.1 Fire Protection Systems Narrative Report — May 24, 2016 Project Name: Watts Water Technology Sprinkler Rm Equip. Upgrades RDK Project Number: 20160157.00 1. Sprinkler System: NFPA 13 "Contractor's Material and Test Certificate", accurately completed and endorsed by installing contractor's signature. 2. Fire Alarm System: NFPA 72 "Fire Alarm System Record of Completion", accurately completed and endorsed by installing contractor's signature. E. Upon completion of the work, and receipt of the appropriate close-out documentation, the Engineer of Record shall certify completion for each fire protection system to the extent required by 780 CMR §901.5.1 F. The general contractor shall then schedule final acceptance demonstration testing with the AHJ in order to obtain approval for a Certificate of Occupancy. Section 2 - Equipment and Tools A. The contractor shall provide all required tools and equipment necessary to perform full functional testing as outlined. As a minimum these items shall include: NFPA Forms 2. Manufacturer's Instructions 3. Fire Protection Systems Narrative Report 4. Voltage Meters 5. Gauges 6. Communication Radios 7. Printer or data transfer device for recording each FACP event Section 3 - Approval Requirements A. The contractor shall obtain written acceptance of the installed system from the AHJ prior to the owner request for a Certificate of Occupancy. B. The contractor shall replace and/or repair each system or component of a system that fails to pass the Final Acceptance Test satisfactorily. Preliminary and Final Testing shall be rescheduled and testing shall be conducted until compliance is fully demonstrated. The contractor shall be liable for all additional charges as a result of retesting. C. Final certification shall be provided from the contractors that the installation is in accordance with the approved construction documents and applicable codes. The Engineer shall certify that the installation complies with the approved construction documents per 780 CMR 901.5.1. D. Operations Manuals and Record as -built drawings shall be submitted with any modifications as a resultant of changes that were dictated from the Final Testing process. E. The Owner shall provide an emergency contact list for use by the AHJ in the event of an emergency at the protected property. END OF NARRATIVE Page 5 of 5 eCOMcheck Software Version 4.0.0 �(, Interior Lighting Compliance Certificate Project Information Energy Code: 2012 IECC Project Title: Watts Sprinkler Rm Upgrades Project Type: Alteration Construction Site: Owner/Agent: Designer/Contractor: North Andover, MA 01845 RDK Engineers 200 Brickstone Square ANDOVER, MA 01810 Allowed Interior Lighting Power A B C D Area Category Floor Area Allowed Allowed Watts (M) Watts / ft2 (B X C) 1 -SPRINKLER ROOM (Common Space Types:Electrical/mechanical) 98 1.10 108 Total Allowed Watts = 108 Proposed Interior Lighting Power A B C D E Fixture ID : Description / Lamp / Wattage Per Lamp / Ballast Lamps/ # of Fixture (C X D) Fixture Fixtures Watt. SPRINKLER ROOM ( Common Space Types• Electrical/mechanical 98 sq ft ) LED 1: S1 E: 4' LED LENSED STRIP: LED Linear 33W: 1 2 33 66 Total Proposed Watts = 66 Interior Lighting Compliance Statement Name - Title Signature Date Project Title: Watts Sprinkler Rm Upgrades Report date: 05/23/16 Data filename: Q:\2016\20160157 - WWT Sprinkler Rm Equipment Upgrades\0600 Electrical Design\603 Page 1 of 6 Lighting\20160157 com check.cck eCOMcheck Software Version 4.0.0 l�(, Inspection Checklist Energy Code: 2012 IECC Requirements: 94.0% were addressed directly in the COMcheck software Text in the "Comments/Assumptions" column is provided by the user in the COMcheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. 2.012 IECCPlan Review C103.2 [PR4]1 Complies? i Comments/Assumptions { Plans, specifications, and/or ❑Complies Requirement will be met. ;calculations provide all information ❑Does Not 'with which compliance can be ;determined for the interior lighting []Not Observable and electrical systems and equipment ❑Not Applicable and document where exceptions to ;the standard are claimed. Information provided should include interior lighting power calculations, wattage of :bulbs and ballasts, transformers and control devices. Additional Comments/Assumptions: € 1 High Impact (Tier 1) 2Medium Impact (Tier 2) j 3 Low Impact (Tier 3) Project Title: Watts Sprinkler Rm Upgrades Report date: 05/23/16 Data filename: Q:\2016\20160157 - WWT Sprinkler Rm Equipment Upgrades\0600 Electrical Design\603 Page 2 of 6 Lighting\20160157 com check.cck 20312 IECC Rough -in Electrical Inspection Complies? ! Comments/Assumptions ._....... _.. C405.2.2. ;Automatic controls to shut off all ❑Complies b..:..:... ; ._......_ ...•... _._._,.__ ..._... .................._..._ : _ —_._....,,......................._.... Exception: Emergency egress lighting. 1 building lighting installed in all ❑Does Not [EL8]1 allowed for special functions per the [EL22]2 buildings. ❑Not Observable ;separated from general lighting. .............::.__.::............... _._._..................................... _._—_........................... ...... ❑Not Applicable 0405.2.1. ;Independent lighting controls installed ❑Complies Exception: Areas such as security or emergency areas that 1 per approved lighting plans and all ❑Does Not need continuous lighting. [EL23.]2 manual controls readily accessible and ❑Not Observable' ...... _..... _..................... Ivisible to occupants. ........... _........ __.—._.......................... _... _......... __.... -_..... _............ _. A..... pplicable C405.2.1. ..... -----._. Lighting controls installed to uniformly -N...t ...... _....... ....._....._.......... ... ❑Complies _....... _........ _....... .............................................. _.._......................... _....... --- ... ------ - ._.. Exception: Corridors, equipment rooms, storerooms, 2 reduce the lighting load by at. least ;❑Does Not restrooms, public lobbies, electrical or mechanical rooms. [EL15]1 50%. ❑Not Observable . .............. _..... _...... ,_..--._.._....... ...._.__.._..____............ _._.._.......... - --- .._.__..._.._...._.. ❑Not Applicable 0405.2.2. ------ :Daylight zones provided with _....__..._ ❑Complies .__..._........................._...._..__...._................................... ---- ......................_....----....................-....._........ Exception: Requirement does not apply. 3 individual controls that control the ❑Does Not [EL16]2 Jights independent of general area ❑Not Observable lighting. :❑Not Applicable w_ 0.405 2 3 - ------- ._..._..---.._--.._.._._.._..._.._...------_..._......__...—_—_..._...: Sleeping units have at least one ........................ . ....... ❑Complies Exception: Requirement does not apply. [EL17]3 master switch at the main entry door ❑Does Not ;that controls wired luminaires and ❑Not Observable .... _..... ..........::.:.:.. switched receptacles. °....... ......... ---_--._... _.................. ---__-............ _._.._ ❑Not Applicable C405.2.2. ........ .._.... Occupancy sensors installed in ------._..........................._._..__.V...._........................ ❑Complies _..... --•--.._........ _................. _............ ... _... _...... - —-----...... ..... Exception: Requirement does not apply. 2 required spaces. ]Does Not [EL18]1 ❑Not Observable --.................. .............._...._.... -........................... __._... -—_........... ❑Not Applicable C405.2.2. ;'Primary sidelighted areas are -...._...._............._..._....._..._......__....._........_......__._.._.__................_..........................._._._...----..__..._.......................__._.._ ❑Complies ............ _............_.._.._...._.._._....... _..... _......... . Exception: Requirement does not apply. 3 !equipped with required lighting ❑Does Not [EL20]1 :controls. ❑Not Observable. -- . ....................... _.......... ....... ... --....._... -_......... ..................... ------- ❑Not Applicable _:................ 0405.2.2. -........ ; Enclosed spaces with daylight area _-._.................. ...........__._._ ❑Complies _.._..._....._.............................._........_.._._._......._.............. _......._._....._.._..............._.......-_.......... _............. _..—_..._._ Exception: Requirement does not apply. 3 under skylights and rooftop monitors ❑Does Not [EL21]1 are equipped with required lighting ❑Not Observable _......................... controls. .................... _ —_._..........._........__v_......._..__.........._.........__...__.._..- ❑Not Applicable :.............................. C405.2.3 ; 'Separate lighting control devices for ❑Complies .._....... _..... _................................ __.... _.._._..................................... ------__.._.._..__.._... _................... Requirement will be met. [EL4]1 'specific uses installed per approved ❑Does Not ;lighting plans. ❑Not Observable ............ __._.................:............... ----- ❑Not Applicable C405.3 . _.........._....---.. "Fluorescent luminaires with odd ....................... _..... _............................. ........... _..; ❑Complies ...... ........... ---...................................... _.... ----....... _................ ------._...._._................ _____---._......... .............. _.._._.._ Exception: Requirement does not apply. [,EL19]3 'numbered lamp configurations that ❑Does Not are with 10 feet center to center (if ❑Not Observable recess mounted) or are within 1 foot edge to edge (if pendant or surface ❑Not Applicable mounted) shall be tandem wired ............ :... _.-_------ _..._;._.........................--_..__.._........................... -------_.... _............... _�-_.._.--..-......_......................... C405.4 Exit signs do not exceed 5 watts per ...__... _...... _._... _..................... _... _... __.._... _.._............................. _._—_._._.... ......... ----- ......... ....... ❑Complies 'Exception: Requirement does not apply. [EL6]1 face. ❑Does Not ❑Not Observable ---- .................._...--- .._...----._.._.............. _..... ---._... .................... .... ❑Not Applicable ........ ............ - — C405.2.3 ;Additional interior lighting power ......__...._...._...._........................ ........_...................._......_..._......._......... ---___-._._..... ._.._............_..- _ - - ;❑Complies ! Requirement will be met. [EL8]1 allowed for special functions per the ❑Does Not ,,approved lighting plans and is automatically controlled and ❑Not Observable ;separated from general lighting. ❑Not Applicable Additional Comments/Assumptions: 1 'High Impact (Tier 1) 2 � Medium Impact (Tier 2) � 3 Low Impact (Tier 3) Project Title: Watts Sprinkler Rm Upgrades Report date: 05/23/16 Data filename: Q:\2016\20160157 - WWT Sprinkler Rm Equipment Upgrades\0600 Electrical Design\603 Page 3 of 6 Lighting\20160157 com check.cck 1 i High Impact (Tier 1) p 2 Medium Im act (Tier 2) ;3 ,jLow Impact (Tier 3) Project Title: Watts Sprinkler Rm Upgrades Report date: 05/23/16 Data filename: Q:\2016\20160157 - WWT Sprinkler Rm Equipment Upgrades\0600 Electrical Design\603 Page 4 of 6 Lighting\20160157 com check.cck 2012 IECC Final Inspection Complies? Comments/Assumptions .................................... ---—...............:.. C408.2.5.: ',Furnished as-built drawings for _ .......... ............. ...... ❑Complies r a._... .— ..............................._.__.. ......,.. — — . Requirement will be met. electric power systems within 30 days ❑Does Not [FI16]3 of system acceptance. ❑Not Observable r....__..,..... _.._...__._.._.........._.__..__......_......................___....._.........................__.._..........._....................... ❑Not Applicable C303.3,C4 !]Furnished 0&M instructions for _............ _._.._.......__-....._ ❑Complies .........._....__._..........._......_........_............- --.._...................................._.. _........._ _ - ....._._._................. Requ..irement..will.. be met. 08.2.5.2 :systems and equipment to the ❑Does Not [FII17]3 building owner or designated ❑Not Observable representative. ❑Not Applicable C405.5.2 'Interior installed lamp and fixture EComplies see the Interior Lighting fixture schedule for values. [F118]1 =lighting power is consistent with what ❑Does Not is shown on the approved lighting ;plans, demonstrating proposed watts ;❑Not Observable' are less than or equal to allowed ❑Not Applicable watts. C408.3 ; Lighting systems have been tested to ❑Complies Requirement will be met. [FI33]1 lensure proper calibration, adjustment, ❑Does Not programming, and operation. ;[]Not Observable. ❑Not Applicable C406 !Efficient HVAC performance, efficient ❑Complies [FI34]1 ' lighting system, or on-site supply of ❑Does Not renewable energy consistent with ;what is shown theapproved plans. ❑Not Observable. ❑Not Applicable Additional Comments/Assumptions: Project Title: Watts Sprinkler Rm Upgrades Report date: 05/23/16 Data filename: Q:\2016\20160157 - WWT Sprinkler Rm Equipment Upgrades\0600 Electrical Design\603 Page 5 of 6 Lighting\20160157 com check.cck Project Title: Watts Sprinkler Rm Upgrades Report date: 05/23/16 Data filename: Q:\2016\20160157 - WWT Sprinkler Rm Equipment Upgrades\0600 Electrical Design\603 Page 6 of 6 Lighting\20160157 com check.cck The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/OrganizatiorAndividual): Wise Construction Address: 21 East Street City/State/Zip: Winchester, MA 01890 Phone #: 781-721-1100 Are you an employer? Check the appropriate box: i. ❑ I am a employer with 4. ® I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors >.. ❑ I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t employees and have workers' comp. insurance.1 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ® Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.0 Electrical repairs or additions 11.❑ Plumbing repairs or additions 121-1 Roof repairs 13.❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: DeSantis Policy # or Self -ins. Lic. #: WCC50050135352015AMA Expiration Date: 6/27/16 Job Site Address: 815 Chestnut Street City/State/Zip: North Andover, MA 01845 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under 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 verificgiJon. Ido hereby certify under the pains and pe res of'perjury that the information provided above is true and correct. Phone #: 781-721-1100 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 #: OP ID: LO CERTIFICATE OF LIABILITY INSURANCE 7061241E(MWDD/YYYYl 15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: 781-935-8480 DeSanctis Insurance Agcy, Inc. Fax: 781-933-5645 100 Unicorn Park Drive Woburn, MA 01801 NAME: CT PHONE F C No Ext): AIC No): EMAIL ADDRESS: FR COST MER ID M: WISEC-1 INSURERS AFFORDING COVERAGE NAIC 9 INSURER A: Libe Mutual.lnsurance Cos. INSURED Wise Construction Corp 21 East Street Winchester, MA 01890 INSURER 8: Associated Employers INSURER C: Nautilus Insurance Company 17370 INSURER D: American Insurance Company EACH OCCURRENCE $ INSURER E: A X COMMERCIAL GENERAL LIABILITY TB2Z11261323025 06/27/15 06/27/16 INSURER F : AAIMw.w�w . vV V GfViVG17 UI -H I IMCATF NI IMRFR• 0G%tl01Aa1 ar mere. _ _ �___��. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TR TYPE OF INSURANCE POLICY NUMBER FOLIC EFF MOPOLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY TB2Z11261323025 06/27/15 06/27/16 DAMAGE DE T Ea occurrence $ 300,00 CLAIMS -MADE FX OCCUR MED EXP (Any one person) $ 10,00 X Per ProjectAgg PERSONAL 8 ADV INJURY $ 11000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,00 POLICY X JFCPRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMB $ 1,000,00 A X ANY AUTO S2Z11261323015 06/27115 06/27/16 (Ea accident) BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILYINJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,00 A EXCESS LIAR CLAIMS -MADE TH7Z11261323035 06127115 06127/16 AGGREGATE $ 10,000,00 $ DEDUCTIBLE X RETENTION $ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' WC STATU- OTH- X LIABILITY YIN E.L. EACH ACCIDENT $ 11000100 B OFFICERIMEMBANY ER/EXARTNERE CUTIVE N NIA CC50050135352015A 06127115 06/27/16 E.L. DISEASE - EA EMPLOYEE $ 11000100 (Mandatory In NH) Nyes describe under We MA E.L. DISEASE - POLICY LIMIT $ 11000100 OF OPERATIONS below C Pollution L(ab CPL201193411 06/27/15 06/27116 Aggloccur 3miUlmi DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N more space is required) ADDITIONAL INSURED LIMITS ARE NO GREATER THAN THOSE REQUIRED BY WRITTEN CONTRACT." Evidence of Coverage AC!\TIf•1A.Tr I AAI w.-. EVIDE-1 EVIDENCE OF INSURANCE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED 1--V 1996.2009 ACORD CO OE`-. J II rights reserved. ACORD 26 (2009109) The ACORD name.and logo are registered marks of ACORD V Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS -097661 Construction Supervisor ,t 4 d ti ERIC S LIBBY 200 JTT ST r. � GEORGETOWN MA; 3 _ ��_�✓ Expiration: Commissioner 08/09/2017 AA) 4 S rr J •it BUILDING PERMIT TOWN OF NORTH ANDOVER to ; t jr� APPLICATION FOR PLAN EXAMINATION - Permit N0: 1 "1 � �7 Date Received t -T Date ►���(9 Date Issued: t. SSACHU � LOCATION PROPERTY OWNS ANT: Applicant must ci all items on this pale oric District yes no ,hints ghnn kh lira tlae, nn TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential E New Building 0, One family '1:l Addition Two or more family Industrial . Alteration No. of units ' commercial I] Repair, replacement Assessory Bldg Others: Demolition v Other Septic Well Floodplain Wetlands v Watershed, District I WaterlSewer l l ) I 643 n9 Aa1.J4A- /G C.) OWNER: Name: Address: Identification Please '41)c or Print Clearly) n t ►. !l, . WIN , ARCHITECT/ENGINEER-_ fl//k Llq/h &6 Phone: Address: X20rl ,Ik o A7151 6 AMk&Z/hreg. No. FEE SCHEDULE. BOLDING PERMIT: 512.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ J *?a 0 q FEE: $ Check No.: 4 Receipt No.: x`33 NOTE: Persons contracting ivi yt ►rnreg' t red contractors do not have access to tiara fund Signature of Agent/0 ., - Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools 0 Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED PLANNING & DEVELOPMENT ❑ COMENTS CONSERVATION ■ ■ COMMENTS HEALTH COMMENTS DATE REJECTED El DATE APPROVED DATE APPROVED "Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit f, Located at 384 Osgood Street FIRE DEPARTMENT -T t Location S 1 S C,V j 5-L"14 t1uZ� No. L k` 20y Date b i lq Check # Y TOWN OF NORTH ANDOVER Certificate of Occupancy $ _ Building/Frame Permit Fee $L,4� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Building Inspector Enter construction cost for fee ca► - North Andover Fee Calculation Construction Cost $ 122,109.00 m $ - $ 1,465.31 Plumbing Fee $ 183.16 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 183.16 Total fees collected $ 1,931.64 815 Chestnut Street replace electric water heater with building hot water loop 1241-2016 on 6/1/2016 CD C O CQ. CD 57 U) CD n V••f O 7 �G O r_ i n 0 CD CD tn' cn 0 O r•F CD a C CD k O D z O s CDN O c° O W Q tQ CD (O C 0 0 CD3 0 = 'n N=<0 . N °, CD n CL m 3 O g1Oy CD'TI N O O •-• C m ��CD U) a T Ma m C.) 0 OO O rtM0 S O CD - 'i O 6 U2 O 0 N - -w _ 00-A o- > CD CL 0 co � n C � o A �� ��CD Q� ' W , r� as ID m co) O °: 0, T ..J �O O ?� •• �D T <D N O 0+ = . n CD CD '0 • Q. O L cn W T 7p T fn�p T T n W T In T C O O O O 3 O O S O O (D O O (D 0) C' D) < C D) C D1 C C 'O O \ O S S S 3 S Q n om z a N CD p �i A mr- S I3 W T_ m C C 3 3 W O m D z v+ O 3 m O m m m m r O 2 0 0 / 1 1'1111 CONSTRUCTION Client: Watts Water Technologies Project: Water Heater Upgrades Location: 815 Chestnut Street - North Andover Date of Estimate: 30 -Mar -16 Plan Date: 7 -Mar -16 Estimate #: E16-042 Page 1 of 1 CSI # Estimate Summary Trade Cost 02100 Demolition $1,800 06000 Rough / Finish Carpentry $23,550 07000 Thermal and Moisture Protection $1,300 08100 Doors, Frames and Hardware NIC 08800 Glass & Glazing NIC 09250 Drywall See Carpentry 09500 Acoustical Ceilings $1,850 09650 Flooring NIC 09900 Painting $1,450 10100 Specialties NIC 11100 Equipment NIC 12100 Furnishings NIC 15300 Fire Protection NIC 15400 Plumbing $34,159 15500 HVAC $54,750 16000 Electrical $3,250 TOTAL $122,109 Wise Constructio - Eric Libby W S - Jackie C skey [BIDES ENGINEERS 200 Brickstone Square I Andover, MA 01810-1488 P: 978-296-6200 1 F: 978-296-6201 TO: Wise Construction 21 East Street Winchester, MA 01890 Attached ❑ Shop drawings ❑ Specifications ❑ Other DUE ON: COPIES 3 sets DATE 5/26/16 NO. 1 1 set 5/26/16 2 For approval ❑ For your use ❑ As requested ❑ For review and comment DUE ON: ❑ RDK Understands How Engineering Affects People LETTER OF TRANSMITTAL DATE: 5/26/16 ATTN: Gerard Blanchette PROD. NO: 20150277.03 RE: Watts Water Technology Water Heater Upgrades — Permit Pkg. WE ARE SENDING YOU Under separate ❑ ` via Wise to Pick -Up 5/26/16 Prints ❑ Plans ❑ Submittal ❑ Copy of letter ❑ Change order ❑ Diskettes ❑ DESCRIPTION Permit Drawings Design Affidavits THESE ARE TRANSMITTED AS NOTED BELOW Approved as submitted ❑ Resubmit Approved as noted ❑ Submit Returned for corrections ❑ Return ❑ Prints returned after loan ❑ REMARKS CC: RDK File If enclosures are not as noted, kindly notify us at once. Signed: copies for approval copies for distribution corrected prints Q:\2015\20150277.03 - WWT Training Center HW System Upgrade\0200 Correspondence\202 Transmittals\16 Wise Libby Permit Package 5-26.doc Anrinupr I Amharct I Rnctnn I rharintta I nierham ;h ww,rdItPneineers.com Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the 8' edition of the JO v�V Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology Water Heater Upgrades Date: May 24, 2016 Property Address: 815 Chestnut Street, North Andover, Massachusetts Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Removal of individual water heaters throul;ht the Basement First and Seconf floors Pipe the domestic hot water service back to new Smartplace Heat Exchanger recently installed I, Keith Gi uere, MA Registration Number: 49637 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ] Entire Project - [ ] Architectural [ ] Structural [ ] HVAC ] Fire Suppression = NFPA 13 [X] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. Enter in the space to the right a "wet" or electronic signature and seal: Phone number: 978-296-6357 �►'`-Py�H OF Mgss9 KEITH E. CyG g GIGUERE M c� ELECTRICAL y No: 49637 �0.�F9FG /ST �� Use Only Building Official Name: Permit No.: Date: Ema!llj�uere a,rdkengineers.com Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the 8t" edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology Water Heater Upgrades Date: May 24, 2016 Property Address: 815 Chestnut Street, North Andover, Massachusetts Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Removal of several small water heaters throughout the building and revise distribution Piping back to Smartplate Water heater System. I, Scott Guertin, MA Registration Number: 46837 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC ] Fire Suppression —NFPA 13 [X] Electrical [ ] Fire Alarm - NFPA 72 [X] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the SCOTT G. GUERTIN Enter in the space to the right a "wet"MECHANICAL or electronic signature and seal: f(941(No. 46837 Phone number: (978)296-6338 Building Official Use Only Building Official Name: Permit No.: Date: Construction Control Document'. Email: sguertin@RDKEnizineers.com The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Wise Construction Address: 21 East Street to/Zip: Winchester, MA 01890 Phone #: 781-721-1100 Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ® I am a general contractor and I employees (full and/or part-time).* 2. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.1 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' insurance Type of project (required): 6. ❑ New construction 7. ® Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12. ❑ Roof repairs 13. ❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: DeSantis Policy # or Self -ins. Lic. #: WCC50050135352015AMA Expiration Date: 6/27/16 Job Site Address: 815 Chestnut Street City/State/Zip: North Andover, MA 01845 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains an4,pehnalties of perjury that the information provided above is true and correct. ol Phone #: 781-721-1100 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 #: _ 1 %J IU" LU .4c7"j?"" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 06124/15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPOR1ANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on th,s certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCERPhone:781-935-8480 DeSanctis Insurance Agcy, Inc. Fax: 781-933-5645 100 Unicom Park Drive Woburn, MA 01801 NAMEACT PHONE F ac No Ext : ac No EMAIL ADDRESS: PRODUCER WISEC-1 CUSTOMER ID k: INSURER(S) AFFORDING COVERAGE NAIC it GENERAL LIABILITY INSURED Wise Construction Corp 21 East Street Winchester, MA 01890 INSURER A, Liberty Mutual Insurance Cos. INSURER B: Associated Employers INSURER C: Nautilus Insurance Company 17370 INSURER D: American Insurance Company EACH OCCURRENCE $ 1,000,00 INSURER E: X COMMERCIAL GENERAL LIABILITY CLAIMS MADE �X OCCUR X Per Project Agg INSURER F : 6V VtKAl9tl CERTIFY _ATF MI IMRGD. nrv,c„n►, Lu ufinrn. 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. INSRPOLICY LTR TYPE OF INSURANCE POLICY NUMBER EFF MMIDD POLICY EXP MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE �X OCCUR X Per Project Agg T 12Z11261323025 06/27/15 06/27/16 DAMAGE TO RERTEIT_ PREMISES Ea occurrence $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL &ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICYX PRO- LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ A AUTOMOBILE X LIABILITY ANYAUTO AS2Z11261323016 06127/15 06/27/16 COMBINED SINGLE LIMIT $ 11000,00 i BODILY INJURY BODILY NJURY (Par person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,00 ATH7Z11261323035 EXCESS LIAR CLAIMS -MADE 06/27/15 06/27/16 AGGREGATE $ 10,000,00 DEDUCTIBLE $ X RETENTION $ 10,000 $ B WORKERS COMPENSATIONX AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y / N OFFICERIMEMBER EXCLUDED? aN (Mandatory In NH) ifes, describe under N I A CC50050135352015A MA 06/27/15 06/27/16 WC STATU- 0TH. T Y M E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS below C Pollution Llab CPL201193411 06!27/15 06/27/16 Agg/occur 3mil/1mi DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) "ADDITIONAL INSURED LIMITS ARE NO GREATER THAN THOSE REQUIRED BY WRITTEN CONTRACT." Evidence of Coverage EVIDE-1 EVIDENCE OF INSURANCE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED 1--Z 1988-2009 ACORD CO ORf0N) All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD �%---..0 Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS -097661 Construction Supervisor ERIC S UBBY 200 JEWETT ST , GEORGETOWN MA ka iti 1.1 � Expiration: ' Commissioner 08/09/2017 i r _ Location r Na Date �0 It Check #J TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Building Inspector 5iy n4a� �P' BUILDING PERMIT �� ,t,".°..,�•, o TOWN OF NORTH ANDOVER ° APPLICATION FOR PLAN EXAMINATION+ Permit NO:20 Date Received ,? 7 natn 1cm1PfI. �C I Y' �9SSACHUs���h IMPORTANT: A licant must complete all items on this ale LOCATION � ��u � AtA 6 Pnr�t "PROPERTY OWNER r" t Print MAP NO:",/076PARCEl_._0 ZONING DISTRICT.�,�Historic District yed no -- Machine Shop Village ye no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 1 New Building ;— One family D Addition `^ Two or more family '...'Industrial Alteration No. of units: Commercial Ci Repair, replacement :- Assessory Bldg r, Others: C Demolition D Other Septic Wel! Floodplain Wetlands _ Watershed District , Water/Sewer 0% 1 t.J/,snow % old --�� identification Plcasc T��pc or Print (Nearly) OWNER_ Name: tJ6J< I;�Phone: p��1 Address: ARCHITECT/ENGINEER'_ UVA-el'6vot, Phone: %4Z2 Address: LP e_ 3 Reg. No. FEE SCHEDULE. BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125,00 PER S.F. Total Project Cost: 0 9 FEE: $ Check No.: MOS3 Receipt No.: NOTE: Persons contruefing tvit r unreg' t red contractors do not have access to uar r nd _tgnature of Agent/0 Signatu.r� of contract Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMENTS Vi ♦ l - I x"W"V I V V V/-1 I L-1 1 %W V I-V Y\ CONSERVATION EI❑ a, �O C MMENTS " �� �� L�� W I Oi01 Dcopc&ad S 16'X)u` L4 DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit :` Located at 384 Osgood Street Enter construction cost for fee cal - North Andover Fee Cakulation Construction Cost 125,092.00 m $ - $ 1,501.10 Plumbing Fee $ 187.64 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 187.64 Total fees collected $ 1,976.38 815 Chestnut Street installation of 5 10x10 concrete pads with snowmelt system 1240-2016 on 6/l/2016 00 O J w LL pZ mN r \ O LL 41 > N0 U NO (n p LLI a Z Z m c O i=- "a LL t O � > C ..0 U C LL p a M Z J d t 0 cr C LL O LLI Z Q U J UJ t p M V v N C LL cl: OI-- w CL Z Q i O cr C I..L Z LLJ CL w W LL v CO z N }+ N u E (n H� W- J z O m coz W w CL W F- W CL 0 E � O O z y � 0 a� v � O O Q IL CL ca o c .Q O 4) Cz a V N 0 ❑ MVPC Bo Interstates — I — SR Roads l r Easements Parcels 1" = 93 ft ^�° Horizontal Datum: MA Stateplane Coordinate System, Datum NAD83,, Meters Data Sources: The data for this map was produced by Merrimack 1&0li Valley Planning Commission (MVPC) using data provided by the Town of �6 q� Of `� c'6V6 North Andover. Additional data provided by the Executive Office of V6 00 Environmental Affairs/MassGIS. The Information depleted on this map Is for planning purposes only. It may not be adequate for legal boundary 9 definition or regulatory interpretation. THE TOWN OF NORTH ANDOVER • MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING " >< THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY 'r. ♦ OF THESE DATA. THE TOWN OF NORTH ANDOVER DOES NOT • ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION The H.L. Turner Group Inc. 27 Locke Road phone: (603) 228-1122 Concord, NH 03301 fax: (603) 228-1126 LETTER OF TRANSMITTAL To: Wise Construction Date: 05/23/2016 21 East Street Project Name: WATTS HQ - National Training Center Project Winchester, MA 01890 Project #: 4230 " Attn: Eric Libby - Re: Permit Drawings - Stamped We are sending the following attached items via UPS Ground: ❑ Plans ❑ Submittals/Shop Drawings ® Other ❑ Specifications ❑ Submittals (Other) COPIES DATE IDENT. NO. DESCRIPTION 3 08/25/2015 2436 Originals Snow Melt Test Plots - Stamped & Signed Permit Drawings 3 08/25/2015 8.5x11 Initial Construction Control Document - Snow Melt Test Plots These are transmitted as checked below: ® As requested ❑ For your approval ❑ Other (see remarks) ❑ For review and comment ❑ For your information ❑ See submittal stamp(s) Copy to: -Page 1- 121MIS ENGINEERS 200 Brickstone Square I Andover, MA 01810-1488 P: 978-296-6200 I F: 978-296-6201 TO: Wise Construction 21 East Street € DK Understands How Engineering Affects People LETTER OF TRANSMITTAL DATE: 5/26/16 PRO1. NO: 20160033.00 ATTN: Mr. Eric Libby Winchester, MA 01890 RE: Watts Water Technology Snow Melt System Test Plot-= Permit Pkg. Attached ❑ Shop drawings ❑ Specifications ❑ Other 1 Permit Drawings WE ARE SENDING YOU Under separate ❑ via Wise to Pick-up on 5/26/16 Prints ❑ Plans ❑ Submittal ❑ Copy of letter ❑ Change order ❑ Diskettes ❑ COPIES DATE NO. DESCRIPTION 3 sets 5/26/16 1 Permit Drawings 1 set 5/26/16 2 Design Affidavits 1 5/26/16 3 Narrative 1 5/26/16 4 COMcheck THESE ARE TRANSMITTED AS NOTED BELOW For approval ❑ Approved as submitted ❑ Resubmit copies for approval For your use ❑ Approved as noted ❑ Submit copies for distribution As requested ❑ Returned for corrections ❑ Return corrected prints For review and comment ❑ Prints returned after loan ❑ DUE ON: REMARKS CC: RDK File Signed: If enclosures are not as noted, kindly notify us at once. Q:\2016\20160033 - WWT Snow Melt Test Plots\0200 Correspondence\202 Transmittals\16 LtrTrans Wise Libby Permit Pkg 5-26.doc Andover I Amherst I Boston I Charlotte I Durham a$,rww.rdkengineers.coni Initial Construction Control Document H r To be submitted with the building permit application by a W Registered Design Professional tia for work per the 8t" edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology — Snow Melt Test Plots Date: May 23, 2016 Property Address: 815 Chestnut Street, North Andover, MA Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Construction of five (5) new snow melt test areas off back of the Annex Building, I, Keith Gi uere, MA Registration Number: 49637 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC ] Fire Suppression — NFPA 13 [X] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. Enter in the space to the right a "wet" or electronic signature and seal: Phone number: 978-296-6357 Building Official Name: Permit No. MA �V�,<�, OF SSgC �yG KEITH E. ,P GIGUERE a ELECTRICAL No. 49637 .09 9fiGlS�'��� FESS/ NAL' Email: kaiauereaa.rdkensineers.com Building Official UsA Only Date: Initial Construction Control Document To be submitted with the building permit application by a w Registered Design Professional for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology - Snow Melt Test Plots Date: May 23, 2016 Property Address: 815 Chestnut Street, North Andover, MA Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Construction of five (5) new snow melt test areas off back of the Annex Building._. I, Keith Gi uere, MA Registration Number: 49637 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC ] Fire Suppression — NFPA 13 [ ] Electrical [X] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. Enter in the space to the right a "wet" or electronic signature and seal: Phone number: 978-296-6357 Building Official Name: Permit No.: Date: 11%N OF Mgss9� KEITH GIGUERE ELECTRICAL 6 - No. 4%3 a�F+SB�nnir.� c�' Building Official Z's +r Email: kkiguere@rdkengineers.com Only Initial Construction Control Document To be submitted with the building permit application by a w Registered Design Professional for work per the 8t" edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology — Snow Melt Test Plots Date: May 23, 2016 Property Address: 815 Chestnut Street, North Andover, MA Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Construction of five (5) new snow melt test areas off back of the Annex Buildin&. I, Jeffrey Faucon, MA Registration Number: 47208 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [ ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC [X] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm = NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to th official a `Final Construction Control Document'. F &140 Enter in the space to the right a "wet" �` JEFFPE`! T. tiN Auc Or electronic signature and seal For�FIRE PROTECTION No. 47208 _ ��04�Phone number: 978-296-6375 �II b 63 Email: jfaucon@rdkengineers.com Building Official Use Only Building Official Name: Permit No.: Date: Initial Construction Control Document To be submitted with the building permit application by a d Registered Design Professional q for work per the 8t" edition of the 1 s° Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology — Snow Melt Test Plots Date: May 23, 2016 Property Address: 815 Chestnut Street, North Andover, MA Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Construction of five (5) new snow melt test areas off back of the Annex Building, I, Scott Guertin, MA Registration Number: 46837 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ] Entire Project [ ] Architectural [ ] Structural [X] HVAC ] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the buildin ficial a `Final Construction Control Document'. P\ ?N OF MgssgO Enter in the space to the right a "wet" SCOTT G. tiG or electronic signature and seal: c GUERTIN c� MECHANICAL y No. 48837 -o ST Phone number: 978-296-6338 E Email: s ug ertinnaexdkengineers.com Building Official Use Only Building Official Name: Permit No.: Date: Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional °a for work per the 8h edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technology — Snow Melt Test Plots Property Address: 815 Chestnut Street, North Andover, MA Date: May 23, 2016 Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Construction of five (5) new snow melt test areas off back of the Annex Building, I, Scott Guertin, MA Registration Number: 46837 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC ] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [X] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the b jf&ial a `Final Construction Control Document'. OFl�gss Enter in the space to the right a "wet" scow G. tiN or electronic signature and seal: GUERTIN 1-04 b v MECHANICAL y No. 46837 O Q Phone number: 978-296-6338 mail: sf4uertin@rdkengineers.com rwow Building Official Use Only Building Official Name: Permit No.: Date: COMMONWEALTH OF MASSACHUSETTS STATE BUILDING CODE 780 CMR, 8TH EDITION CHAPTER 9 FIRE PROTECTION SYSTEMS NARRATIVE REPORT 780 CMR — 901.2.1 PROJECT NAME: ADDRESS: RDK PROJECT #: DATE OF ISSUE: Watts Water Technology Snow Melt Test Plots 815 Chestnut Street North Andover, MA 20160033.00 May 24, 2016 Andover I Amherst I Boston I Charlotte I Durham urrsr.rekrr?r;-?t rs.cu r 780 CMR 901.2.1 Fire Protection Systems Narrative Report — May 24, 2016 Project Name: Watts Water Technology Snow Melt Test Plots RDK Project Number: 20160033.00 As required by 780 CMR §901.2.1, this narrative report is a written description of the proposed fire protection system features to be installed as part of the Watts Water Technology Snow Melt Test Plots project located at 815 Chestnut Street in North Andover, Massachusetts. 901.2.1 (1)(i) - BASIS (METHODOLOGY) OF DESIGN Section 1 - Building Description A. "Use" Group(s) within Scope of Renovation: "B" Business (office). B. Location & Area of Renovation: 1600 sqft on the Ground Floor. C. Existing Building Height &. Area 1. Height: One (1) story above grade; one (1) story below grade. D. Type(s) of Construction: 1. Existing protected non-combustible. E. Hazardous Material Usage and Storage: None in excess of exempt amounts within scope of renovation. F. High -pile Storage (over 12 ft.) of Commodities: None within scope of renovation. G. Site Access Arrangement for Emergency Response Vehicles: Existing features to remain; not affected by scope of renovation. Section 2 -Applicable Laws, Regulations & Standards A. Massachusetts State General Laws (MGL), Chapter 148 1. MGL §148, sections as applicable. B. 780 CMR — Massachusetts State Building Code, 8'h Edition (amended IBC -2009) 1. Chapter 9 "Fire Protection Systems" 2. Chapter 34 "Existing Structures" C. Existing Building Code of Massachusetts (amended IEBC-2009) 1. Chapter 8 "Alterations — Level 3" 527 CMR — Massachusetts State Fire Prevention Regulations 2. Chapter 1 "Massachusetts Comprehensive Fire Safety Code" 3. Chapter 12 "2014 Massachusetts Electrical Code Amendments" D. 521 CMR — Massachusetts Architectural Access Board 1. Section 40 "Visual Alarms" Page 1 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — May 24, 2016 Project Name: Watts Water Technology Snow Melt Test Plots RDK Project Number: 20160033.00 E. National Fire Protection Association (NFPA) Standards: NFPA 13 (2013) — "Installation of Sprinkler Systems" 2. NFPA 70 (2014) — "National Electric Code" as amended by 527 CMR Chapter 12 "Massachusetts State Electrical Code" NFPA 72 (2013) — "National Fire Alarm Code" F. Federal Regulations (significant requirements thereof to the extent applicable to RDK scope) 28 CFR Part 36, ADA Standards for Accessible Design 2. 29 CFR Part 1910, Occupational Safety & Health Standards G. Documented Local Ordinances (Voluntary Compliance) North Andover Fire Department Fire Alarm Order, local bylaws and ordinances Section 3 - Design Responsibility for Fire Protection Systems A. Engineer of Record: RDK Engineers (RDK) has engineered and specified the fire protection systems to be installed. For each fire protection system designed by RDK, RDK shall review the installing contractor's Tier II shop drawings for conformance to the approved construction documents and be present at the site at intervals appropriate to become generally familiar with the progress and quality of work and to determine if the work is being performed in manner consistent with the construction documents and 780 CMR. RDK shall certify each fire protection system installation to the extent required by 780 CMR §901.5.1(1). B. Architect of Record: H.L. Turner, has designed and specified the architectural features to be constructed, including means of egress, fire resistance construction and interior finish. H.L. Turner shall review the installing contractor's Tier II shop drawings for conformance to the approved construction documents and be present at the site at intervals appropriate to become generally familiar with the progress and quality of work and to determine if the work is being performed in manner consistent with the construction documents and 780 CMR. Section 4 - Fire Protection Systems to be Installed A. Fire Mains & Hydrants: Existing features to remain; not affected by scope of renovation. B. Automatic Sprinkler System: Existing sprinkler system service equipment, pumps, zoning, mains, alarm devices, etc. to remain and are not affected by the scope of renovation. Existing wet -pipe fire sprinkler system to be modified to accommodate new partition layout. Modifications shall predominantly include new return -bend piping to new sprinklers and new branch piping from existing cross -mains. C. Standpipe System: Existing features to remain; not affected by scope of renovation. D. Fire Alarm System: Existing fire alarm system head -end, back -bone, sequence of operation, etc. to remain and are not affected by the scope of renovation. Existing initiating circuits (SLC or IDC) within scope of renovated area to be modified to accommodate new or relocated initiating devices. New circuits may be added as dictated by the capacity of the existing circuits as determined by the installing contractor; the style Page 2 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — May 24, 2016 Project Name: Watts Water Technology Snow Melt Test Plots RDK Project Number: 20160033.00 and class of new circuits shall match that of the existing system. The following types of initiating devices shall be added: a. Smoke detector; common area, etc. 2. Existing notification appliance circuits (NAC) within scope of renovated area to be modified to accommodate new partition layout. New circuits may be added as dictated by the capacity of the existing circuits as determined by the installing contractor; the style and class of new circuits shall match that of the existing system. 3. Audible notification appliances within scope of renovation shall be UL 464 horn type. 4. Visual notification appliances within scope of renovation shall be UL 1971 strobe type and shall flash in a synchronized manner., E. Emergency Power: Existing generation equipment, feeders, transfer switches, panel boards, etc to remain and are not affected by the scope of renovation. 1. Where required, NAC remote power supplies added to support new circuits shall be provided with standby batteries. 2. Means of egress lighting and exit signs within the scope of renovation shall be provided with emergency power supplied from existing "base building" emergency circuits if available or standby batteries local to the fixtures. F. Smoke Control Systems: Existing features to remain; not affected by scope of renovation. G. Commercial Cooking: Not applicable to the proposed renovation. H. Hazardous Materials Monitoring: Not applicable to the proposed renovation. Section 5 - Features Used in the Design Methodology A. Occupant Notification Procedures: Existing occupant notification via the fire alarm system and subsequent building management personnel procedures shall remain and are not affected by the scope of renovation. The existing fire alarm system treats the building as a single evacuation zone. B. Emergency Response Features: Existing features to remain; not affected by scope of renovation. C. Safeguards: Existing fire protection systems shall be maintained throughout the construction as required by the Authority Having Jurisdiction (AHJ). Impairment to existing fire protection systems shall be approved by the AHJ and Owner prior to commencing work. A fire watch shall be provided during impairments to the fire suppression or fire alarm system in accordance with AHJ requirements. D. Future Testing & Maintenance: Modifications performed as part of the scope of renovation shall be warranted by the installing contractors for a period of one year covering defects in materials and workmanship. NFPA required inspection, maintenance and testing activities associated with the building fire protection system are the responsibility of the owner and are to be conducted under existing and/or future maintenance contracts held by the Building Management Company. Page 3 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — May 24, 2016 Project Name: Watts Water Technology Snow Melt Test Plots RDK Project Number: 20160033.00 Section 6 - Special Consideration and Description A. Unless otherwise noted, the design of the fire protection systems does not utilize alternative compliance design methods and is not intended to deviate from the prescriptive requirements of 780 CMR or other applicable codes and standards. 901.2.1 (1)(H) - SEQUENCE OF OPERATION A. The existing "base building" coordinated fire protection system basis of design and sequence of operation shall remain unchanged and shall not be modified under the scope of renovation. The general arrangement of the existing sequence of operation is described below and is subject to confirmation by the installing contractor and fire alarm system control unit technical representative. B. Activation of an existing or new manual pull station, smoke detector, heat detector or sprinkler system waterflow switch shall initiate the predefined fire alarm system "alarm condition" sequence: Display alarm condition at fire alarm control unit and remote annunciator(s). Energize audible (temporal -3 pattern) and visual (UL 1971 synchronized strobe) occupant notification circuits within evacuation zone(s) as designated by pre -established control unit sequence of operations. 3. Perform auxiliary fire safety functions as designated by pre -established control unit sequence of operations such as elevator recall, damper activation, door closure, AHU shutdown, pressurization systems, etc. 4. Transmit alarm condition to central / supervising station and/or local fire department via municipal alarm system. 5. In addition, the operation of an existing in -duct smoke detector shall initiate the following: a. Operation of an existing in -duct smoke detector provided at air handling units (AHU's) shall shut -down the corresponding AHU. b. Operation of an existing in -duct smoke detector provided for control of a smoke damper shall close the corresponding damper. 6. In addition, the operation of an existing waterflow switch and/or an existing or new smoke detector shall initiate building smoke control systems. C. The operation of an existing sprinkler tamper switch shall initiate the predefined fire alarm system "supervisory" sequence: Display supervisory condition at fire alarm control unit and remote annunciator(s). 2. Transmit supervisory condition to central / remote supervising station. D. Normal power failure to fire alarm system remote power supplies, ground faults, short circuits and open circuit conditions shall initiate the predefined fire alarm system "trouble" sequence. Display supervisory condition at fire alarm control unit and remote annunciator(s). 2. Transmit trouble condition to central / supervising station. Page 4 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — May 24, 2016 Project Name: Watts Water Technology Snow Melt Test Plots RDK Project Number: 20160033.00 901.2.1 (1)(iii) - TESTING CRITERIA Section 1 - Testing Criteria A. Fire Protection System testing shall be scheduled, administered, conducted and overseen by the general contractor, subcontractors and manufacturer's technical representatives. B. The following fire sprinkler system inspections and testing shall be performed: Visually inspect system installation for completeness, presence of defects or damage, and confirm system is placed into "all normal" operational service. Hydrostatically test system piping for a period of 2 -hours. Piping shall be tested to normal system operating pressure where new installed piping cannot be isolated from the existing piping. 3. Functionally operate any new sprinkler waterflow or valve supervisory switches as part the fire alarm testing. C. The following fire alarm system inspections and testing shall be performed: Confirm integrity of new or modified circuits (free of grounds, shorts, opens) prior to the installation of devices, appliances or equipment. 2. Visually inspect system installation for completeness, presence of defects or damage, and confirm system is placed into "all normal" operational service. 3. Confirm correct system supervision of wiring faults, missing devices and status of normal and standby power supplies (for new equipment installed as part of the work). 4. Functionally operate new devices installed as part of the work and confirm correct sequence of operation and address/zone identification at the fire alarm control unit. 5. Confirm audibility / intelligibility and visual synchronization of notification appliances. 6. Where fire alarm control unit software is updated as part of the work, functionally operate 10% of existing devices not affected by the work and confirm correct sequence of operation and address/zone identification at the fire alarm control unit. 7. Confirm correct operation of circuits under fault conditions in accordance with installed circuit style and class. D. Documentation, to be submitted to the Engineer of Record and AHJ: Sprinkler System: NFPA 13 "Contractor's Material and Test Certificate", accurately completed and endorsed by installing contractor's signature. 2. Fire Alarm System: NFPA 72 "Fire Alarm System Record of Completion", accurately completed and endorsed by installing contractor's signature. E. Upon completion of the work, and receipt of the appropriate close-out documentation, the Engineer of Record shall certify completion for each fire protection system to the extent required by 780 CMR §901.5.1 F. The general contractor shall then schedule final acceptance demonstration testing with the AHJ in order to obtain approval for a Certificate of Occupancy. Page 5 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — May 24, 2016 Project Name: Watts Water Technology Snow Melt Test Plots RDK Project Number: 20160033.00 Section 2 - Equipment and Tools A. The contractor shall provide all required tools and equipment necessary to perform full functional testing as outlined. As a minimum these items shall include: 1. NFPA Forms 2. Manufacturer's Instructions 3. Fire Protection Systems Narrative Report 4. UL smoke candles or aerosol spray 5. Sound meters 6. Voltage Meters 7. Gauges 8. Communication Radios 9. Printer or data transfer device for recording each FACP event Section 3 - Approval Requirements A. The contractor shall obtain written acceptance of the installed system from the AHJ prior to the owner request for a Certificate of Occupancy. B. The contractor shall replace and/or repair each system or component of a system that fails to pass the Final Acceptance Test satisfactorily. Preliminary and Final Testing shall be rescheduled and testing shall be conducted until compliance is fully demonstrated. The contractor shall be liable for all additional charges as a result of retesting. C. Final certification shall be provided from the contractors that the installation is in accordance with the approved construction documents and applicable codes. The Engineer shall certify that the installation complies with the approved construction documents per 780 CMR 901.5.1. D. Operations Manuals and Record as -built drawings shall be submitted with any modifications as a resultant of changes that were dictated from the Final Testing process. E. The Owner shall provide an emergency contact list for use by the AHJ in the event of an emergency at the protected property. END OF NARRATIVE Page 6 of 6 NEER ENG,� 'Iers,c,'",m www,rdkenginu, RDK ENGINEERS 200 BRICKSTONE SQ SUITE 201 ANDOVER, MA 01810 978-269-6200 Job Name Watts Water Technologies - Snow Melt Building FP1.1 Location N. Andover System 1 Contract 20160033.00 Data File 20160033.00 Watts Sno Melt Calculation.WX1 Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 j(19 RDK ENGINEERS Watts Water Technologies - Snow Melt HYDRAULIC CALCULATIONS for Project name: Watts Water Technologies, Snow Melt Location: N. Andover Drawing no: FP1.1 Date: Design Remote area number. 1 Remote area location: Lower Level Occupancy classification: Light/ Ordinary Hazard Density. .1 - Gpm/SgFt Area of application: 1602 - SgFt Coverage per sprinkler. VARIES - SgFt Type of sprinklers calculated: Concealed Pendent - Quick Response No. of sprinklers calculated. 18 In -rack demand. - GPM Hose streams: 250 - GPM Total water required (including hose streams): 607.120 -GPM @ 28.315 - Psi Type of system: WET Volume of dry or preaction system: -Gal Water supply information Date: 5-13-15 Location: Watts Pump Room Source: Pump Name of contractor. Address: Phone number: Name of designer. Authority having jurisdiction: Notes: (Include peaking information or gridded systems here) Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 Page 1 Date 02/12/16 N N O N N m CO ao W 2 N Lf) N Cl) MSM �0 NM NN( V ED m to E oa)(D C:LLm co 0i w rn u a�Ei a216 >v,coQorn� w cn cn ""cn w cnN NN O OM (p Coo oo22otn E N O 0 co 0 C) p - LO r 0 C ,O J 0 L O LL N U. 0 0 0 C) � o COCDLO m L o 0 N N O M cnaE= L � =3 Q,U�-0 o O ' 0 U 7 " (A w �65OfOf N Cl (D 0 � UUU o 0 0 0 0 o O 0 0 O O o O o 0 U — — — — — — M M f— CD In � M N m Of w w 0 0 G� w I -- co 0 co O Q 2 Z E m t c E J r r� r 0 w oo§/§ 002/§ 00<�2 ooLOc- oo«=< ooCl) 1�c ooC\lLOLO ooCNLO« oo��n ( k 2 _ D D 0 0 $555 oo2E� ELL>r2 §Q�>% 0 -C a) $ a) E 2 \CO : Qua)ƒ »0§@£L %�Uo CZ IT > o• - a a) ƒ \ \ 5=o07o 3\oc-0 c o= m M o - Q=$ / =E\% [ /.m»$\a 0_ = 5 / �ƒ� \ t \cat/2% °K\ca -a) a) - cn m �ƒ0 . 0 \2�$%=§ 0)Q Co'o f Co \ \ k / / &o=:3(D =(D o� _ ® 0 q 2 & ceeee= >® E )Co uac) 0-E<% Lc0 >Ck U- 6 0 2 E.aO zWomm0 co \ < U) e 3 2 E f 2 ¢ $ ƒ k g / z 2 E \ � k E / Pressure / Flow Summary - STANDARD RDK ENGINEERS Page 4 Watts Water Technologies - Snow Melt Date 02/12/16 Node Elevation K -Fact Pt Pn Flow Density Area Press No. Actual Actual Rea. 101 12.0 5.6 12.37 na 19.7 0.1 144 7.0 102 12.0 5.6 13.22 na 20.36 0.1 144 7.0 103 12.0 5.6 13.12 na 20.28 0.1 180 7.0 104 12.0 5.6 9.88 na 17.6 0.1 176 7.0 105 12.0 5.6 10.55 na 18.19 0.1 130 7.0 106 12.0 5.6 11.72 na 19.17 0.1 120 7.0 107 12.0 5.6 11.49 na 18.98 0.1 120 7.0 108 12.0 5.6 13.1 na 20.27 0.1 132 7.0 109 12.0 5.6 8.22 na 16.06 0.1 60 7.0 109A 12.0 5.6 9.16 na 16.95 0.1 60 7.0 110 12.0 5.6 11.57 na 19.05 0.1 80 7.0 111 12.0 5.6 8.98 na 16.78 0.1 70 7.0 112 12.0 5.6 9.4 na 17.17 0.1 70 7.0 113 14.0 5.6 10.34 na 18.01 0.15 90 7.0 114 12.0 5.6 13.08 na 20.25 0.1 130 7.0 115 12.0 5.6 12.83 na 20.06 0.15 28 7.0 116 12.0 5.6 10.98 na 18.56 0.1 72 7.0 117 12.0 5.6 12.48 na 19.79 0.1 72 7.0 118 12.0 5.6 12.63 na 19.9 0.1 132 7.0 201 13.0 13.46 na 202 13.0 14.16 na 203 13.0 15.4 na 204 13.0 10.99 na 205 13.0 12.49 na 206 13.0 14.71 na 207 13.0 15.76 na 208 13.0 14.13 na 209 13.0 15.32 na 210 13.0 16.45 na 212A 13.0 9.3 na 211 13.0 10.15 na 212 13.0 12.92 na 213 13.0 12.91 na 214 13.0 14.21 na 215 13.0 15.14 na 216 13.0 12.82 na 217 13.0 13.62 na 218 13.0 15.95 na 301 12.0 17.25 na 302 12.0 17.26 na • 303 12.0 17.3 na 304 12.0 17.32 na 305 12.0 17.55 na 306 12.0 16.8 na 501 12.0 19.37 na 502 14.0 21.12 na 503 2.0 26.62 na 504 2.0 26.79 na 250.0 PUMP 2.0 28.32 na The maximum velocity is 14.2 and it occurs in the pipe between nodes 213 and 214 Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 Final Calculations - Hazen -Williams RDK ENGINEERS Watts Water Technologies - Snow Melt Page 5 Date 02/12/16 Hyd. Qa Dia. Fitting 10.500 Pipe Pt Pt to Ref. 120.0 "C" or -0.433 Ftng's Pe Pv **`**** Notes Point Qt Pf/Ft Eqv. Ln. Total Pf Pn 101 19.70 1.049 1T 5.0 7.000 12.371 K Factor = 5.60 to 9.304 120.0 109A 0.0 5.000 -0.433 4.000 201 19.7 0.1265 0.0 12.000 1.518 Vel = 7.31 0.0 16.95 0.0957 0.0 6.000 0.574 Vel = 6.29 19.70 13.456 K Factor = 5.37 102 20.36 1.049 0.0 5.000 13.216 K Factor = 5.60 to 120.0 0.0 0.0 -0.433 201 20.36 0.1346 0.0 5.000 0.673 Vel = 7.56 0.0 20.36 13.456 K Factor= 5.55 103 20.28 1.049 1 T 5.0 4.000 13.120 K Factor = 5.60 to 120.0 1 E 2.0 7.000 -0.433 202 20.28 0.1335 0.0 11.000 1.469 Vel = 7.53 0.0 20.28 14.156 K Factor= 5.39 104 17.60 1.049 1 E 2.0 8.000 9.878 K Factor = 5.60 to 120.0 IT 5.0 7.000 -0.433 204 17.6 0.1027 0.0 15.000 1.540 Vel = 6.53 0.0 17.60 10.985 K Factor = 5.31 105 18.19 1.049 1 T 5.0 3.000 10.545 K Factor = 5.60 to 120.0 0.0 5.000 -0.433 204 18.19 0.1091 0.0 8.000 0.873 Vel = 6.75 0.0 18.19 10.985 K Factor= 5.49 106 19.17 1.049 1 E 2.0 3.000 11.721 K Factor = 5.60 to 120.0 IT 5.0 7.000 -0.433 205 19.17 0.1204 0.0 10.000 1.204 Vel = 7.12 0.0 19.17 12.492 K Factor= 5.42 107 18.98 1.049 3E 6.0 15.000 11.491 K Factor = 5.60 to 120.0 1 T 5.0 11.000 -0.433 208 18.98 0.1182 0.0 26.000 3.072 Vel = 7.05 0.0 18.98 14.130 K Factor= 5.05 108 20.27 1.049 1 E 2.0 4.000 13.096 K Factor = 5.60 to 120.0 1 T 5.0 7.000 -0.433 208 20.27 0.1334 0.0 11.000 1.467 Vel = 7.52 0.0 20.27 14.130 K Factor= 5.39 109 16.06 1.049 IE 2.0 10.500 8.221 K Factor = 5.60 to 120.0 IT 5.0 7.000 -0.433 212A 16.06 0.0866 0.0 17.500 1.516 Vel = 5.96 0.0 16.06 9.304 K Factor= 5.27 109A 16.95 1.049 1 E 2.0 4.000 9.163 K Factor = 5.60 to 120.0 0.0 2.000 -0.433 212A 16.95 0.0957 0.0 6.000 0.574 Vel = 6.29 Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 Final Calculations - Hazen -Williams RDK ENGINEERS Page 6 Watts Water Technologies - Snow Melt Date 02/12/16 Hyd. Qa Dia. Fitting Pipe Pt Pt Ref. "C" or Ftng's Pe Pv ******* Notes Point Qt Pf/Ft Eqv. Ln. Total Pf Pn 0.0 16.95 9.304 K Factor= 5.56 110 19.05 1.049 3E 6.0 4.000 11.570 K Factor = 5.60 to 120.0 1 T 5.0 11.000 -0.433 212 19.05 0.1189 0.0 15.000 1.784 Vel = 7.07 0.0 19.05 12.921 K Factor= 5.30 111 16.78 1.049 2E 4.0 8.000 8.983 K Factor = 5.60 to 120.0 IT 5.0 9.000 -0.433 211 16.78 0.0941 0.0 17.000 1.599 Vel = 6.23 0.0 16.78 10.149 K Factor = 5.27 112 17.17 1.049 2E 4.0 8.000 9.404 K Factor = 5.60 to 120.0 0.0 4.000 -0.433 211 17.17 0.0982 0.0 12.000 1.178 Vel = 6.37 0.0 17.17 10.149 K Factor = 5.39 113 18.01 1.049 2E 4.0 11.000 10.338 K Factor = 5.60 to 120.0 IT 5.0 9.000 0.433 213 18.01 0.1072 0.0 20.000 2.143 Vel = 6.69 0.0 18.01 12.914 K Factor = 5.01 114 20.25 1.049 0.0 2.000 13.080 K Factor = 5.60 to 120.0 0.0 0.0 -0.433 213 20.25 0.1335 0.0 2.000 0.267 Vel =, 7.52 0.0 20.25 12.914 K Factor= 5.64 115 20.06 1.049 3E 6.0 10.000 12.826 K Factor = 5.60 to 120.0 IT 5.0 11.000 -0.433 215 20.06 0.1308 0.0 21.000 2.747 Vel = 7.45 0.0 20.06 15.140 K Factor= 5.16 116 18.56 1.049 2E 4.0 11.000 10.984 K Factor = 5.60 . to 120.0 IT 5.0 9.000 -0.433 216 18.56 0.1133 0.0 20.000 2.266 Vel = 6.89 0.0 18.56 12.817 K Factor= 5.18 117 19.79 1.049 1 E 2.0 4.000 12.485 K Factor = 5.60 to 120.0 0.0 2.000 -0.433 216 19.79 0.1275 0.0 6.000 0.765 Vel = 7.35 0.0 19.79 12.817 K Factor= 5.53 118 19.90 1.049 1 E 2.0 4.000 12.630 K Factor = 5.60 to 120.0 1 T 5.0 7.000 -0.433 217 19.9 0.1290 0.0 11.000 1.419 Vel = 7.39 0.0 19.90 13.616 K Factor = 5.39 Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087. Final Calculations - Hazen -Williams RDK ENGINEERS 0.0 Page 7 Watts Water Technologies - Snow Melt 17.304 K Factor= 9.44 212A Date 02/12/16 Hyd. Qa Dia. Fitting to Pipe Pt Pt 0.0 2.000 0.0 Ref. 212 "C" or 0.0 Ftng's Pe Pv "***'*' Notes Point Qt Pf/Ft Eqv. Ln. Total Pf Pn 33.01 12.921 K Factor = 9.18 211 33.96 1.049 IT 5.0 3.000 10.149 to 120.0 0.0 5.000 0.0 212 33.96 0.3465 201 40.05 1.61 Vel = 12.61 0.0 12.000 13.456 IT 12.307 10.000 12.921 to to 120.0 120.0 0.0 0.0 0.0 214 86.01 202 40.05 0.0583 1.289 0.0 12.000 0.700 Vel = 6.31 202 20.29 1.61 0.0 10.000 14.156 to 120.0 0.0 0.0 0.0 203 60.34 0.1246 0.0 10.000 1.246 Vel = 9.51 203 0.0 2.157 2E 12.307 35.000 15.402 to 120.0 0.0 12.307 0.433 301 60.34 0.0300 0.0 47.307 1.419 Vel = 5.30 0.0 60.34 17.254 K Factor= 14.53 204 35.79 1.38 2E 6.0 9.000 10.985 to 120.0 0.0 6.000 0.0 205 35.79 0.1005 0.0 15.000 1.507 Vel = 7.68 205 19.17 1.38 0.0 10.000 12.492 to 120.0 0.0 0.0 0.0 206 54.96 0.2220 0.0 10.000 2.220 Vel = 11.79 206 0.0 1.61 0.0� . 10.000 14.712 to 120.0 0.0 0.0 0.0 207 54.96 0.1048 0.0 10.000 1.048 Vel = 8.66 207 0.0 2.157 1 E 6.153 24.000 15.760 to 120.0 IT 12.307 18.460 0.433 302 54.96 0.0252 0.0 42.460 1.072 Vel = 4.83 0.0 54.96 17.265 K Factor= 13.23 208 39.25 1.38 0.0 10.000 14.130 to 120.0 0.0 0.0 0.0 209 39.25 0.1191 0.0 10.000 1.191 Vel = 8.42 209 0.0 1.61 0.0 20.000 15.321 to 120.0 0.0 0.0 0.0 210 39.25 0.0562 0.0 20.000 1.125 Vel = 6.19 1210 0.0 2.157 1 E 6.153 13.000 16.446 to 120.0 IT 12.307 18.460 0.433 303 39.25 0.0135 0.0 31.460 0.425 Vel = 3.45 Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 0.0 39.25 17.304 K Factor= 9.44 212A 33.01 1.049 1 E 2.0 9.000 9.304 to 120.0 0.0 2.000 0.0 212 33.01 0.3288 0.0 11.000 3.617 Vel = 12.25 0.0 33.01 12.921 K Factor = 9.18 211 33.96 1.049 IT 5.0 3.000 10.149 to 120.0 0.0 5.000 0.0 212 33.96 0.3465 0.0 8.000 2.772 Vel = 12.61 212 52.05 2.157 IT 12.307 10.000 12.921 to 120.0 0.0 12.307 0.0 214 86.01 0.0578 0.0 22.307 1.289 Vel = 7.55 Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 Final Calculations - Hazen -Williams RDK ENGINEERS Page 8 Watts Water Technologies - Snow Melt Date 02/12/16 Hyd. Qa Dia. Fitting Pipe Pt Pt Ref. I. C. or Ftng's Pe Pv ******" Notes Point Qt Pf/Ft Eqv. Ln. Total Pf Pn 0.0 86.01 14.210 K Factor= 22.82 213 38.26 1.049 0.0 3.000 12.914 to 120.0 0.0 0.0 0.0 214 38.26 0.4320 0.0 3.000 1.296 Vel = 14.20 214 86.01 2.157 1E 6.153 2.000 14.210 to 120.0 0.0 6.153 0.0 215 124.27 0.1141 0.0 8.153 0.930 Vel = 10.91 215 20.06 2.157 1E 6.153 2.000 15.140 to 120.0 0.0 6.153 0.433 306 144.33 0.1506 0.0 8.153 1.228 Vel = 12.67 0.0 144.33 16.801 K Factor= 35.21 216 38.35 1.38 0.0 7.000 12.817 to 120.0 0.0 0.0 0.0 217 38.35 0.1141 0.0 7.000 0.799 Vel = 8.23 217 19.90 1.61 0.0 20.000 13.616 to 120.0 0.0 0.0 0.0 218 58.25 0.1167 0.0 20.000 2.334 Vel = 9.18 218 0.0 2.157 1 E 6.153 23.000 15.950 to 120.0 1T 12.307 18.460 0.433 305 58.25 0.0281 0.0 41.460 1.165 Vel = 5.11 0.0 58.25 17.548 K Factor= 13.91 301 60.34 4.26 0.0 10.000 17.254 to 120.0 0.0 0.0 0.0 302 60.34 0.0011 0.0 10.000 0.011 Vel = 1.36 302 54.96 4.26 0.0 11.000 17.265 to 120.0 0.0 0.0 0.0 303 115.3 0.0035 0.0 11.000 0.039 Vel = 2.60 303 39.24 4.26 0.0 2.000 17.304 to 120.0 0.0 0.0 0.0 304 154.54 0.0065 0.0 2.000 0.013 Vel = 3.48 304 144.33 4.26 0.0 11.000 17.317 to 120.0 0.0 0.0 0.0 305 298.87 0.0210 0.0 11.000 -0.231 Vel = 6.73 305 58.25 4.26 1E 13.167 49.000 17.548 to 120.0 0.0 13.167 0.0 501 357.12 0.0293 0.0 62.167 1.819 Vel = 8.04 0.0 . 357.12 19.367 K Factor= 81.15 306 144.33 4.26 1 T 26.334 68.000 16.801 to 120.0 0.0 26.334 0.0 304 144.33 0.0055 0.0 94.334 0.516 Vel = 3.25 0.0 144.33 17.317 K Factor= 34.68 Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 Final Calculations - Hazen -Williams RDK ENGINEERS Page 9 Watts Water Technologies - Snow Melt Date 02/12/16 Hyd. Qa Dia. Fitting Pipe Pt Pt Ref. "C" or Ftng's Pe Pv ******* Notes ****** Point Qt Pf/Ft Eqv. Ln. Total Pf Pn 501 357.12 4.26 3E 39.501 50.000 19.367 to 120.0 0.0 39.501 -0.866 502 357.12 0.0292 0.0 89.501 2.617 Vel = 8.04 502 0.0 6.357 1A 33.948 16.000 21.118 to 120.0 1 E 17.603 57.838 5.197 503 357.12 0.0042 1 Eql 6.287 73.838 0.308 Vel = 3.61 503 0.0 6.357 1 B 12.573 10.000 26.623 to 120.0 1 E 17.603 30.176 0.0 504 357.12 0.0042 0.0 40.176 0.167 Vel = 3.61 504 250.00 6.357 1 Fsp 0.0 7.000 26.790 Qa = 250 to 120.0 1S 40.235 40.235 1.000 * Fixed loss = 1 PUMP 607.12 0.0111 0.0 47.235 0.525 Vel = 6.14 0.0 607.12 28.315 K Factor= 114.09 Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 COMcheck Software Version 4.0.1 Interior Lighting Compliance Certificate Project Information Energy Code: Project Title: Project Type: Construction Site: 815 Chestnut Street North Andover, MA 01845 Allowed Interior Lighting Power 2012 IECC Watts Water Technology - Snow Melt Test Plots Alteration Owner/Agent: Designer/Contractor: RDK Engineers 200 Brickstone Square Andover, MA 01810 A B C D Area Category Floor Area Allowed Allowed Watts (ft2) Watts / ft2 (B X C) 1 -Common Space Types:Lobby 337 1.10 371 2 -Common Space Types: Electrical/mechanical 59 1.10 65 3 -Common Space Types:Stairway 160 0.70 112 Total Allowed Watts = 548 Proposed Interior Lighting Power A B C D E Fixture ID : Description / Lamp / Wattage Per Lamp / Ballast Lamps/ # of Fixture (C X D) Fixture Fixtures Watt. Common Space Tvoes:Lobby.. (337 sq.ft.) LED 1: LT1/LT1E: 2'X2' LED: Other: 1 5 34 172 Common Space Types: Electrical/mechanical (59 sq.ft.) LED 2: LT4: 4' LENSED LED STRIP: Other: 1 1 28 28 Common Space Tvoes:Stairway 1160 sq.ft.) LED 1 copy 1: LTi E: 2'X2' LED: Other: 1 1 34 34 LED 1 copy 2: XM: 2'X2' LED: Other: 1 1 34 34 LED 5: XM: 4' WALL MTD LED: Other: 1 1 28 28 Total Proposed Watts = 298 Project Title: Watts Water Technology - Snow Melt Test Plots Report date: 05/23/16 Data filename: Q:\2016\20160033 - WWT Snow Melt Test Plots\0600 Electrical Design\603 Page 1 of 6 Lighting\20160033.00_WWTTest Plots.cck COMcheck Software Version 4.0.1 Inspection Checklist Energy Code: 2012 IECC Requirements: 58.0% were addressed directly in the COMcheck software Text in the "Comments/Assumptions" column is provided by the user in the COMcheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. 2022 IECC� Plan Review Complies? Comments/Assumptions C103.2 ;Plans, specifications, and/or ❑Complies [PR411 :calculations provide all information ❑Does Not with which compliance can be ❑Not Observable determined for the interior lighting ❑Not Applicable and electrical systems and equipment :and document where exceptions to :the standard are claimed. Information provided should include interior ;lighting power calculations, wattage of bulbs and ballasts, transformers and control devices. Additional Comments/Assumptions: 1 High Impact (Tier 1) 2 Medium Impact (Tier 2) 3 Low Impact (Tier 3) Project Title: Watts Water Technology - Snow Melt Test Plots Report date: 05/23/16 Data filename: Q:\2016\20160033 - WWT Snow Melt Test Plots\0600 Electrical Design\603 Page 2 of 6 Lighting\20160033.00_WWTTest Plots.cck 2012 IECC Rough In Electrical Inspection Complies? Comments/Assumptions C405.2,2.. ... _.......... _.----...... _...... _....... .__.... __...... _._._._............... `Automatic controls to shut off all .................... __............ _.._ _. _._.._.................... ❑Complies :Exception: - -- ........ _ _....._ ._: Lighting controlled by occupancy sensors. 1 building lighting installed in all ❑Does Not [EL22]2 buildings. ❑Not Observable, ❑Not Applicable 0405.2.1. ---._........_..._................... _._.._... ----.--._.... _....................- , Independent lighting controls installed - ._ ._..................... _......_. :❑Complies _.._._.............._.._.................._._....._.... ....... _ .... ............ _.... -_-..__... ._._......__._ . Requirement will be met. 1 .per approved lighting plans and all ❑Does Not [EL2312 ;manual controls readily accessible and; ❑Not Observable ; visible to occupants. ❑Not Applicable C405.2.1. Lighting controls installed to uniformly ❑Complies Exception: Areas that are controlled by an occupancy sensor. 2 reduce the lighting load by at least ❑Does Not [EL15]1 50%. ❑Not Observable ❑Not Applicable C405.2.2.: Daylight zones provided with ❑Complies Exception: Requirement does not apply. 3 individual controls that control the ❑Does Not [EL16]2 ; lights independent of general area ❑Not Observable lighting. ❑Not Applicable C405.23' Sleeping units have at least one ❑Complies Exception: Requirement does not apply. .[EL17]3 master switch at the main entry door❑Does Not !that controls wired luminaires and ❑Not Observable switched receptacles. ❑Not Applicable C405.2.2. :Occupancy sensors installed in ❑Complies Requirement will be met. 2 required spaces. ❑Does Not [EL18]1 ❑Not Observable ❑Not Applicable C405.2.2. Primary sidelighted areas are ❑Complies Exception: Requirement does not apply. 3 equipped with required lighting ❑Does Not [EL20]1 - controls. ❑Not Observable ❑Not Applicable C405.2.2.: Enclosed spaces with daylight area ❑Complies Exception: Requirement does not apply. 3 wunder skylights and rooftop monitors ❑Does Not [EL21]1 are equipped with required lighting ❑Not Observable controls. ❑Not Applicable C405.2.3 Separate lighting control devices for ❑Complies :Requirement will be met. [EL4]1 specific uses installed per approved ❑Does Not lighting plans. ❑Not Observable ❑Not Applicable 0405.3 - ' Fluorescent luminaires with odd ❑Complies Exception: Requirement does not apply. [EL19]3 'numbered lamp configurations that ❑Does Not are with 10 feet center to center (if ❑Not Observable recess mounted) or are within 1 foot edge to edge (if pendant or surface ❑Not Applicable mounted) shall be tandem wired. C405.4 Exit signs do not exceed 5 watts per ❑Complies [EL6]1 !face. ❑Does Not ❑Not Observable'. ❑Not Applicable C405.2.3 :Additional interior lighting power ❑Complies [EL8]1 allowed for special functions per the ❑Does Not .approved lighting plans and is ❑Not Observable automatically controlled and separated from general lighting. ❑Not Applicable Additional Comments/Assumptions: 11 High Impact (Tier 1) 2 Medium Impact (Tier 2) 1 3 Low Impact (Tier 3) Project Title: Watts Water Technology - Snow Melt Test Plots Report date: 05/23/16 Data filename: Q:\2016\20160033 - WWT Snow Melt Test Plots\0600 Electrical Design\603 Page 3 of 6 Lighting\20160033.00_WWTTest Plots.cck 1 1 High Impact (Tier 1) 2 Medium Impact (Tier 2) _ _ i 3 Low Impact (Tier 3) Project Title: Watts Water Technology - Snow Melt Test Plots Report date: 05/23/16 Data filename: Q:\2016\20160033 - WWT Snow Melt Test Plots\0600 Electrical Design\603 Page 4 of 6 Lighting\20160033.00_WWTTest Plots.cck Comments/Assumptions :See the Interior Lighting fixture schedule for values. Js shown on the approved lighting ❑Not Observable plans, demonstrating proposed watts 2012IECC� Final Inspection Complies? 0408 2.5. Furnished as -built drawings for ❑Complies 1. Jelectric power systems within 30 days ❑Does Not [FI16]3 of system acceptance. ❑Not Observable ❑Not Applicable ....... ❑Not Applicable 6303 3 C4 _..... ._-... _..... _.................................... _.....----_.___..._........_._......._..... __— Furnished O&M instructions for ..._.................-- - :❑Coplies 082.5.2,.'systems and equipment to the ❑Does Not [FI17]3' building owner or designated ❑Not Observable representative. ❑Not Applicable ....... ...._.__... ..< C405.5.2 :Interior ---....................... __...._–•-------..........................._.. installed lamp and fixture _........... ❑Complies [FI18]1 lighting power is consistent with what ❑Does Not Comments/Assumptions :See the Interior Lighting fixture schedule for values. Js shown on the approved lighting ❑Not Observable plans, demonstrating proposed watts ❑Not Applicable are less than or equal to allowed ❑Not Observable watts. ❑Not Applicable C408.3 Lighting systems have been tested to ❑Complies [FI33]1 ensure proper calibration, adjustment, ❑Does Not . programming, and operation. ❑Not Observable ❑Not Applicable C406 Efficient HVAC performance, efficient LJComplies [FI34]1 ;lighting system, or on-site supply of ❑Does Not .renewable energy consistent with ❑Not Observable what is shown the approved plans. ❑Not Applicable Additional Comments/Assumptions: j 1 High Impact (Tier 1) 2 Medium Impact (Tier 2) 3 Low Impact (Tier 3) Project Title: Watts Water Technology - Snow Melt Test Plots Report date: 05/23/16 Data filename: Q:\2016\20160033 - WWT Snow Melt Test Plots\0600 Electrical Design\603 Page 5 of 6 Lighting\20160033.00_WWT Test Plots.cck Project Title: Watts Water Technology - Snow Melt Test Plots Report date: 05/23/16 Data filename: Q:\2016\20160033 - WWT Snow Melt Test Plots\0600 Electrical Design\603 Page 6 of 6 Lighting\20160033.00_WWT Test Plots.cck Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Snow Melt Test Plots Property Address: 815 Chestnut Street, North Andover, Massachusetts 01845 Project: Check (x) one or both as applicable: New Construction X Existing Construction Date: May 23, 2016 Project description: Building renovation for installation & monitoring of new exterior snow melt test plots. I Harold Turner Jr. MA Registration Number: 30941 Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [] Entire Project [X] Architectural [X] Structural [ ] HVAC [ ] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. Enter in the space to the right a "wet" or electronic signature and seal: Phone number: 603-228-1122 Email: gblanchette@hltumer.com or hturner@hlturner.com Building Official Use Only Building Official Name: Permit No.: Date: Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Snow Melt Test Plots Property Address: 815 Chestnut Street, North Andover, Massachusetts 01845 Project: Check (x) one or both as applicable: New Construction X Existing Construction Date: May 23, 2016 Project description: Building renovation for installation & monitoring of new exterior snow melt test plots. I Harold Turner Jr. MA Registration Number: 30941 Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [] Entire Project [X] Architectural [X] Structural [ ] HVAC [ ] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. Enter in the space to the right a "wet" or electronic signature and seal: Phone number: 603-228-1122 Email: gblanchette@hltumer.com or htumer@hlturner.com Building Official Use Only Building Official Name: Permit No.: Date: Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the 8`" edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Snow Melt Test Plots Property Address: 815 Chestnut Street, North Andover, Massachusetts 01845 Project: Check (x) one or both as applicable: New Construction X Existing Construction Date: May 23, 2016 Project description: Building renovation for installation & monitoring of new exterior snow melt test plots. I Harold Turner Jr. MA Registration Number: 30941 Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [] Entire Project [X] Architectural [X] Structural [ ] HVAC [ ] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. Enter in the space to the right a "wet" or electronic signature and seal: Phone number: 603-228-1122 Email: gblanchette@hlturner.com or htumer@hlturner.com Building Official Use Only Building Official Name: Permit No.: Date: Initial Construction Control Document To be submitted with the building permit application by a W d Registered Design Professional ' w~ for work per the 81h edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Snow Melt Test Plots Property Address: 815 Chestnut Street, North Andover, Massachusetts 01845 Project: Check (x) one or both as applicable: New Construction X Existing Construction Date: May 23, 2016 Project description: Building renovation for installation & monitoring of new exterior snow melt test plots. I Harold Turner Jr. MA Registration Number: 30941 Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [] Entire Project [X] Architectural [X] Structural [ ] HVAC [ ] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. Enter in the space to the right a "wet" or electronic signature and seal: Phone number: 603-228-1.122 Email: gblanchette@hlturner.com or hturner@hlturner.com Building Official Use Only Building Official Name: Permit No.: Date: Page 1 of 1 Dille CONSTRUCTION CSI # Client: Watts Water Technologies Project: Snow Melt Test Plots Project Location: 815 Chestnut Street - North Andover, MA Date of Estimate: 24 -Mar -16 Plan Date: 4 -Feb -16 Estimate #: E16-022 Estimate Summary Trade Cost 02100 Demolition $1,046 02300 Sitework $19,750 03300 Concrete $17,250 06000 Rough / Finish Carpentry NIC 07000 Thermal and Moisture Protection $750 08100 Doors, Frames and Hardware $1,752 08800 Glass & Glazing $1,600 09250 Drywall $4,750 09500 Acoustical Ceilings $530 09650 Flooring $1,495 09900 Painting $1,564 10100 Specialties NIC 11100 Equipment NIC 12100 Furnishings NIC 15300 Fire Protection $2,255 15400 Plumbing $13,362 15500 HVAC $49,298 16000 Electrical $9,690 TOTAL $125,092 Wise Construction - Eric Libby WATTS - J kie Comiskey The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Wise Construction Address: 21 East Street City/State/Zip: Winchester, MA 01890 Phone #: 781-721-1100 Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ® I am a general contractor and I employees (full and/or part-time).* 2. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ 1 am a homeowner doing all work myself. [No workers' comp. insurance required.] t have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.$ 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ® Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12. ❑ Roof repairs 13.❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: DeSantis Policy # or Self -ins. Lic. #: WCC50050135352015AMA Expiration Date: 6/27/16 Job Site Address: 815 Chestnut Street City/State/Zip: North Andover, MA 01845 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains an enalties of perjury that the information provided above is true and correct. Phone #: 781-721-1100 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 #: yr lu- LV ACORLO% CERTIFICATE OF LIABILITY INSURANCE __[06124/15 DAT E (MMIDD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER PRODUCER Ph DeSanctis Insurance Agcy, Inc. Fax: 781-933-5645 100 Unicorn Park Drive Woburn, MA 01801 CONTACT NAME: PHONE FAX A/c No Ext): ac No): E-MAIL ADDRESS: PRODUCER CUSTOMER ID ll: WISEC-1 INSURERS AFFORDING COVERAGE NAIC S INSURED Wise Construction Corp INSURER A: Liberty Mutual Insurance Cos. 21 East Street Winchester, MA 01890 INSURER B: Associated Employers INSURER C: Nautilus Insurance Company 17370 INSURER D: American Insurance Company INSURER E: TB2Z11261323025 INSURER F: 06/27/16 COVERAGES CERTIFICATE N11MRFR- RFVIRIAN NIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR TB2Z11261323025 06/27/15 06/27/16 PREMISES Ea occurrence $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 X Per Project Agg GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGG $ 2,000,00 GEML AGGREGATE LIMIT APPLIES PER: POLICY X PRO- LOC $ A AUTOMOBILE X LIABILITY ANY AUTO AS2Z11261323015 06127/15 06/27116 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ X SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE $ (Per accident) X NON -OWNED AUTOS $ $ X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 10,000,00 A EXCESS UAB CLAIMS -MADE TH7Z11261323035 06/27/15 06/27/16 AGGREGATE $ 10,000,00 DEDUCTIBLE $ X RETENTION $ 10,000 $ B WORKERS COMPENSATIONH- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? a (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A CC50050135352015A MA 06/27/15 06/27/16 X TWC MSTATU- OT E.L. EACH ACCIDENT $ 11000,00 E.L. DISEASE - EA EMPLOYEE $ 11000,00 E.L. DISEASE - POLICY LIMIT $ 11000,00 C Pollution Liab CPL201193411 06/27/15 06/27/16 Agg/occur 3miUlmi DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) "ADDITIONAL INSURED LIMITS ARE NO GREATER THAN THOSE REQUIRED BY WRITTEN CONTRACT." Evidence of Coverage EVIDE-1 EVIDENCE OF INSURANCE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED ia- p 1986-2009 ACORD CO 0t!FON. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD�----�� Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS -097661 Construction Supervisor E4 .� ERIC S LIBRY 200 JEWETT ST i ._ 'M GEORGETOWN MA 3 its Commissioner Commissioner 08/09/2017 Location /r No. Check # ? n Y - Date TOWN OF NORTH ANDOVER - Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ f Building Inspector BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: L Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page I1S, at -5 tv,, N ► A,Jo mss' LOCATION Print PROPERTY OWNER 0"145�+r' . Pnnt 100.Year Structure yes no MAP _PARCEL: ZONING DISTRICT:_HistoricDistrict yes no Machine Shop Village yes. no . rnccr1D1DT1nAI nF WORK TO BE PERFORM Identification - Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Val, � le Email Address: Supervisor's Construction License: Phone: ��— 8Sl� 2®p oZ C v v✓1 Exp. Date: Home Improvement Licenser Exp. Date: ARCHITECT/ENGINEER Phone:_ Address: Reg. No. FEE SCHEDULE. BULDING PERMIT: $12.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ D 0 FEE: $ Check No.: U 2 7 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have accesj o he guarArity fund Building Department in is a list of the required forms to be filled out for the appropriate permit to be obtained. The following Roofing, Siding, Interior Rehabilitation Permits Building Permit Application Workers Comp Affidavit S.L. Licenses Photo Copy Of H.I.C. And/Or C Copy of Contract Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered p o uartment cts prior to issuance of Bldg Permit OTE: All dumpster permits require sign off from Fir p .Addition Or Decks Building Permit Application Certified Surveyed Plot Plan Workers Comp Affidavit CaAnd C.S.L. Licenses Photo Copy of H.I Copy Of Contract tion/Elevation Plan Of Proposed Work With Sprinkler Plan An Floor/Cross Sec Hydraulic Calculations (If Applicable) Report ort If Applicable) 4. Mass check Energy Compliance p Engineering Affidavits for Engineeredartment prior to issuance of Bldg Permit ucts TE: All dumpster permits require sign off from Department New Construction (Single and Two Family) Building Permit Application Certified Proposed plot SPIaLicenses Photo of H.I.C. And Workers Comp Affidavit f Buildin Plans (One To Be Returned) to Include Sprinkler Plan An .� Two Sets o g Hydraulic Calculations (If Applicable) Copy of Contract 2012 IECC Energy code Engineering Affidavits for Engineeredproducts ro artment prior to issuance of Bldg. Permit OTE: All dumpster permits require sign off from p Registry of Deeds. One copy and proof op f peals recording In all cases if a variance or special permit was required the Town Clerks office must stam the decision from the Board of p that the appeal period is over. The applicant must then get this recorded at the 12e must be submitted with the building application Doc: Building Permit Revised 2014 0 EEO �I JO Q = LL DZ � Q m v L "a O LL Em +O+ T y Y O. /n U W H Z Z C O -0a C 7 LL M a w U f0 LL. W N Z m J a to 3 1= fa LL u W a N ? Q V W W tw a G' v In (a LL OC Q F- U a Z N Q on . 7' w m LL Z W oc W C LU Y. N m O a1 a) (% a+ N Y O N L ELM � Q J Z O m ccZ W�/ w CL W CH G W G. O a Z z m O V Z U CO /1 J LS W-1 01- 02 G2 CD 00 CL CL �Q Cc M J -0 Z v CL L 0 V O •� L ELM � Q o E cL L N O O d ch CL M N J N V: y = O O 0 0 c o OO O O H •N C � a, >o c �--• = =a CL d '� a) _ m RS�O,•N O ti O r _ cm .O m Qi y d LL •� O O N1 C O O LU W E 0 0 V co G1 0-0'0 4) ++ cn N.O t O O F- .... CL 0 0 > Z O m ccZ W�/ w CL W CH G W G. O a Z z m O V Z U CO /1 J LS W-1 01- 02 G2 CD 00 CL CL �Q Cc M J -0 Z v CL WATIV WATER TIECHNOMIES 815 Chestnut Street • North Andover, MA 01846-6098 • Tel, (076) 688-1811 e,F*: (970) 794 1W, , Apr17 2016 , To Whom it May Concern,,. This letter isto confirm that Watts Water Technologies gives pertnission to Bay State Tent to efect a 60" x 120" tent on our property at 815 Chestnut Street, in North Andover, MA. Rpgards, Michael Gauhn Marketing Communications Manager :Watts Water Technologies, Inc. lrinovbtlVe Water Solutions Since 1874 ACOR& CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDIYYYY) ILS TYPE OF INSURANCE . 4/1/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. If SUBROGATION 15 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does hot confer rights to the certificate holder in Ileu of such endorsement(s). PRODUCER NAME:. Darlene Villaras Merrimack Valley Insurance Agency I,nc PHONE (978) 667-2541 1 RAI&No: (978)671-4514 655 Boston Road, Suite lA A�DRLSS:dvillaras@mvins.com Eu- occurrence S 300,000 INSURER(S) AFFORDING COVERAGE . NAIL M Billerica MA 01821 INSURERAAATrust North America Inc. 15954 INSURED INSURER B :The Hartford Baystate Electronics Inc INSURERC: 150 LOrum Street INSURER D: INSURER E Tewksbury to . 01876 INSURERF: COVERAGESCERTIFICATE NUMBER CL164102412' RFVIcinN w IUlaco. 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, TERMOR 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. ILS TYPE OF INSURANCE DD R POLICY NUMBER MOLIC EFF MPY OOLIC EXP LIMITS B COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR 08WN0112387 4/1/2016 4/1/2017 EACH OCCURRENCE $ 1,000,000 Eu- occurrence S 300,000 -PREMISESE MED EXP (Any one person) E 10, 000 PERSONAL& ADV INJURY E 1,000,000 GERL AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC OTHER: GENERAL AGGREGATE E 2 , 000 , 000 PRODUCTS -COMP/OPAGG $ 2,000,000 $ AUTOMOBILE LIABILITY81 ANY AUTO AUTOS JED SCHEDULED AUTOS NON -OWNED HIRED AUTOS AUTOS i INGL LIMIT $ soddent BODILY INJURY (Per person). E BODILY INJURY (Per accident) $ PROPERTY DAMAGE per ecc{dant $ $ B UMBRELLA LIAR EXCESS LIAR HOCCUR CLAIMS -MADE OSHHUGH2389T EACH OCCURRENCE y AGGREGATE $ 1,000,000 DED I I RETENTI N $ A WORKERS COMPENSATIONP AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WWC3188209 1/31/2016 1/31/2017 R TH- STATUTE OR E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE S 1,000,000 E.L. DISEASE.- POLICY LIMIT 8 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) GEK I71-IGAlt 11ULUER CANCFI 1 ATIAN ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014161) . The ACORD name and logo are registered marks of ACORD INS026 r2oumi SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL' BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE A Lucacio/DVI`LLA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014161) . The ACORD name and logo are registered marks of ACORD INS026 r2oumi Q17L.'ertif i rate of REGISTERED AZTEC TENTS Date treated or APPLICATION 2665 COLUMBIA ST manufactu CONCERN NO. ed _ TORRANCE, CA 90503 (800)228-3687 07/2008 CAL COME P ars.of This is to certify that the materials descnbed below hereof have been Name retardant treated (or are inherently nonflammable). FOR BAY STATE APRTY RENTALS i4 , 150 LORUM STREET TEWKSBURY, MA 01876 ' AiTN. DAVE KNIGHT , o � Certification is hereby made that. (check "a" or "b') (a) The articles described below this certificate have been treated with a flame retardant chemical approved and registered by the State Fire Marshal and that the appiicationof said chemical was done in confor- mance with the laws of the State of California and the Rules and Regulations of the State Fire Marshal. Name of chemical used ............................................ Chem. Reg. No......................... Meathodof application ......... .......................................................................... __... _ (b) The articles described below hereof are made from a flame -resistant fabric or material registered and Trade be the State Fire Marshal for such use; Fabric has been tested and passes NFPA701.96. Trade name of flame -resistant fabric or material used.. 4m'-kd-' 6, . Reg. No. ...... fa??At...... The Flame Retardant Process Used w!t L dvot Be Removed by Washing (win or wN nal David Bradley Chuck Miller - President Name d App00 or roduclon supednwndma Ttft The Commonwealth of Massachusetts a Department of IndustrialAccidents b Y d I Congress Street, Suite 100 �r Boston, MA 02114-2017 M www mass.gov/dia Workers' Compensation Insurance Affidavit: General Businesses. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Business/Organization Name: Address: 1! Q Lo r U W% City/State/Zip: Ttw S �ov 0 70hone #: 9 7 7- g S 1- 'ZG G a1 Are you an employer? Check the appropriate box: 1. R I am a employer with a s employees (full and/ or part-time).* 2. ❑ I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required] 3. ❑ We are a corporation and its officers have exercised their right of exemption per c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required]* 4. ❑ We are a non-profit organization, staffed by volunteers, with no employees. [No workers' comp. insurance req.] *Ana lica tth t h k b #1 y pp n a c ec s ox must also fill out the section below showing their workers' compensation policy information. **If the corporate officers have exempted themselves, but the corporation has other employees, a workers' compensation policy is required and such an organization should check box # 1. I am an employer that is providing work' compensation insurance for my employees. Below is the policy information. Insurance Company Name: Insurer's Address: G S Ocr; o C Nif-A V e G City/State/Zip: `. Vit Policy # or.Self-ins. Lic. #_ Q t5 U V 1 V 0 'K 2-3!B -7_ Expiration Date:_ G! I 120 G% Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify, unAer the pains and penalties ofperjury that the information provided above is true and correct Phone #: 9-7(8- S6'`- 100 a 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. Licensing Board 5. Selectmen's Office 6. Other Contact Person: Phone #: w W W.u1ass.guwwa Co -kA"" .l 4, r ., / Date...' /� r� i �;7 �l/�...... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING 11t, ,gs'�CHUs�t�- 1 c 'This certifies that& ,.. lc_ 1„( ....` ..................................... o G .......... ..................... .. ........... .......... has permission to perform.X T` .,.14.. .................................................. plumbing in the buildings of... � ', Aid ...................................................... . at ........... ?..1..... ..........:...`^ ;.1 0 _� .. ..” , North Andover, Mass. ............. ...... (S n �. Fee ......:............... Lic. No. U. H D................................................................................. PLUMBING INSPECTOR Check # y 'J� 7�.• MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY I North Andover MA DATE 3lug 122116 PERMIT # JOBSITE ADDRESS 815 Chestnut Street OWNER'S NAMEJ Watts POWNER ADDRESS 815 Chestnut Street TELL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL Q EDUCATIONAL ® RESIDENTIAL ❑ PRINT CLEARLY NEW: ❑ RENOVATION: REPLACEMENT: ❑ PLANS SUBMITTED: YES Q NOD FIXTURES Z FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUBL:::J CROSS CONNECTION DEVICE 1 DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR I AREA DRAIN INTERCEPTOR (INTERIOR) r KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL i SERVICE / MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES i WATER PIPING OTHER I INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES ❑ NO ❑ IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 0 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 0 AGENT ❑ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in com �anQe moth all Pertinent provision of tF�e Massachusetts State Plumbing Code and Chapter 142 of the General Laws.% PLUMBER'S NAME Patrick D Harold LICENSE # 12459 �' SIGNATURE MPQ JP❑ CORPORATION ED #F3-20-6----1 PARTNERSHIP ❑#LLC❑#D COMPANY NAME I Harold Brothers Mechanical Contractors Inc ADDRESS 144 Woodrock Road CITY Weymouth I STATE MA ZIP 102189 TEL781-871-2111 FAX 781-871-2002 1 CELL I�EMAIL bprescott@haroldbros.com CA c2:::)J r z z 0 H w a a d z w oE] Z Z o � � w O W O WIL vt z O ¢ w a W a a o N a c a o a w a � � U J CL a Cii = W H LL. W H O z z 0 U W CL z u z a a C7 O 99 .,..sa•^'•..r+.i.'r*�++.•wwwi..ti- S,.y �n.i_:. �!r.w+n.,,-,..s `AM!�nww,n"cnvu�,. g:Co OMM NW ._ -FASSAguml .. x . • • ••• • "`7,BOARD OF,, PLUMBE 5S ANt�,AASF HERS ISSUES THE FOLLOWINGLI'CENSE;.? _ + 1 w. REGISTERED ASFxAp¢ PLUM_ i`h'u /` 4L Fr2:i. ♦" 1[ 1LLL^."t PAIR LCK ,D HAROL'0 yw HAROL`0 BROTHEL' MECHAN I CAL IT CONT ' }! 76 CLUBHOUSR, H I NGHAM xMA 02843, 4$ _ 3026¢.o5%L-1:111 Fll 0 19, 151M at%t6�12110634 y'ct4�wvm .w k &COMMONWEALTC^eHr0e.' F�MA• CSRuAH'�`,+AUryS. ETTSw«.p,J„ 01 LVA 61•9 IM a a otel a =Ri Lei 0 w 0 INN• ta SPLUMBERS, AND LGASFi'TTERS .ISSUES, THE FOLIOWING4 L`I`CENSE' v • l �xi §'+, rays lL'I CENSER AS' �A MAST.ERP,"LUMBE PATRICKS D HAROLD rti ✓,1 ry �f 1 i1 7 NGHAM -�MA 0204 Y 3�„F" 12459, X05/d /1b_= �rABOARD PLUMBERS AVD" GASNTfMP -ISSUES THE FOLL�OWING��L�ICENSE�Tk� j N YMAN PLUMB SPATE 1 CK D HA—RQ E " T ! b ]6 ,CLUBHOUSE' DR rc =2ot •=�'*'`�, r wl'INGHAM MA 02043 k8$$ t"` 2418405/O1/.162.19702�_ ACC>RD CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) 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, 2/11/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Herlihy Insurance Group 51 Pullman Street aco"N E�t:50 -7 6-515 FAX No :5 -751-5747 E-MAIL ADDRESs:lsaarl h rlih rou .com Worcester MA 01606 INSURERS AFFORDING COVERAGE NAIC p 2/8/2015 INSURER A:Travelers Insurance Company INSURED INSURER B :Evanston Insurance Co. INSURER C:Phil del hia Insurance Companies Harold Brothers Mechanical Contractors, Inc. 44 Woodrock Road INSURER D:A.I.M. Mutual Insurance Company INSURER E Weymouth MA 02189 INSURER F: COVERAGES CERTIFICATE NUMBER: 1636358527 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR S BR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERALLIABILITY Y Y CO2F654559 12/8/2014 2/8/2015 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $500,000 MED EXP (Any one person) $15,000 CLAIMS -MADE � OCCUR PERSONAL & ADV INJURY $1,000,000 X Inc. Contr. Prot GENERAL AGGREGATE $2,000,000 GEN'LAGGREGATE LIMITAPPLIESPER: PRODUCTS - COMP/OPAGG $2,000,000 POLICY X PRO- LOC JFCNED $ A AUTOMOBILE LIABILITY Y Y BA2F649642 12/8/2014 2/8/2015 SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident $ ( )X HIREDAUTOS NON -OWNED AUTOS Ix PROPERTY DAMAGE $ Per accident A X UMBRELLA LIAB X OCCUR Y Y ZUP14T5496112NF 12/8/2014 2/8/2015 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $10,000,000 DED I X I RETENTION $10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N❑ N / A y MCC20020004102014A 12/8/2014 2/8/2015X VOCSTATU- OTH- M I ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below B C Pollution Liability Professional Liability Y y Y y 14CPLCNE60092 PHSD946328 /27/2014 /27/2014 /27/2015 /27/2015 Each Occurance 1,000,000 Aggregate 1,000,000 Prof.Occ/Aggregate 1000000/1000000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is listed as additional insureds with respects to general liability (CG D604 08/13), automobile liability and umbrella liability as required in a written contract for work performed by, or on behalf of, the named insured on a primary and noncontributory basis. Waiver of Subrogation applies in favor of all additional insureds on all policies. Per project aggregate applies to General Liability and Excess Liability CERTIFICATE HOLDER CONCFI I ATInNSin nave © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Harold Brothers Mechanical Contractors Inc. ACCORDANCE WITH THE POLICY PROVISIONS. 44 Woodrock Road Weymouth MA 02189 AUTHORIZED REPRESENTATIVE ry)ta„ �. CNS © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of btdustrialAccidents I Congress Street, Sitite 100 Boston, M4 02114-2017 U1 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): Harold Brothers Mechanical Contractors Address: 44 Woodrock Road, Weymouth City/State/Zip: Weymouth, MA, 02189 Phone #:781-871-2111 Are you an employer? Check the appropriate box: Type of project (required): 1.0✓ I am a employer with 200 employees (full and/or part-time) 7. New construction 2.[]l am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity, ]No workers' comp, insurance required,) 9. El Demolition 3.01 am a homeowner doing all work myself (No workers' comp. insurance required.] t 4,[:]l am a homeowner and will 6e 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.E] Plumbing repairs or additions 5.[] 1 am a general contractor and I have hired the sub -contractors listed on the attached sheat. Thesc have t 13 Q Roof repairs sub -contractors employees and have workers° comp, insurance 6.❑ We are a corporation and its officers have exercised their right of exemption per NIGL c. 14.[:]Other 152, § 1(4), and we have no employees, INo workers' comp insurance required,J 'Any applicant that checks box # i must also fill out the section below showing their workers' compensation policy information. t Homcowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit anew affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp, policy number. lam an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. insurance Company Name: A.I.M. Mutual Insurance Company Policy # or Self -ins. Lic. #: MCC20020004652015A Expiration Date: 12/8/16 Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to S 1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to 5250.00 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 hereby certify under the paiinjsand pe !ties of perjury that the information provided above is true and correct. Sienature: r ► ! rate. -I Igh1, Phone#: -7b)— b?/z 02.1 ! L I f 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 S. Plumbing Inspector 6. Other Contact Person: Phone #: *MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY MA DATE PERMIT # I lP1 JOBSITE ADDRESS / C l/7S7` OWNER'S NAME r� GOWNER ADDRESS I O -- El] _ FAX TYPE OR PRINT OCCUPANCY TYPE MCOMMERCIAL EDUCATIONAL I RESIDENTIAL CLEARLY NEW: [I RENOVATION: 0/' REPLACEMENT: 13 PLANS SUBMITTED: YESE] NO3 APPLIANCES Z FLOORS - BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/ SPACE HEATER ROY TOP UNIT TEST- UNIT_4rIEATER UNVENTED ROOM HEATER WATER HEATER BSM 1 1 1 2 1 3 1 4 1 5 1 6 I have a current liability insurance policy or its IF YOU CHECKED YES, PLEASE INDICATE THE TY LIABILITY INSURANCE F OWNER'S INSURANCE WAIVER: I am aware th; Massachusetts General Laws, and that my sign SIGNATURE OF OWNER OR AC hereby certify that all of the details and information and that all plumbing work and installations perform( Massachusetts State Plumbing Code and Chapter I. PLUMBS - ASFITTER NAME MP & MGF JP ® J�GF�D( LPGI COMPANY NAME:MU► �.l° CITY FSO I -F- 1 0 W N. "9 FAX–� CELLS 7 1 8 1 9 1 10 1 11 1 12 1 13 1 14 1 Date .... hiill20/ .................. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION ��y�� k �1 Thiscertifies that.........................................r'.......'.'.................................................... has permission fo�rgas installation ... f,.!)..!.!i................... in the -buildings of '/5 .................... ... J.A..................................... . North Andover, Mass. `� .......................................... GASINSPECTOR Check # 30 7 9j"7U vl E O O F U W W � a o z o W yEl � F,_ W W H � Q w CO w a O w w w a a, o a H U J a a CO w x w i- LL z H U W L"J C�7 •,y The Commonwealth of Massackusetts Department oflndustrial AccWhis Office of Investigations 600 Washington Street .Boston, .MA 02111 •www mass govIdla Workers' Compensation Insurantce Affi'idayff: Builders/Contrac Name (Business/Oxgauizationlindividud):. ��DS�v' G� s7`• Address: `6' 0(.). 6- 14 1 c O_ q M, City/State/Zip: s2 % © cw 14' Phone X 0 3 6 7 Are your an, employer? Check the appropriate box: Type of project (required): 1. ❑ I a employer with e (full and/or 4. ❑ 1 am a general contractor and 1 have Hired the sub -contractors 6. [� construction, ployees paxi-time) listed on the attached sheet. t 7• Remodeling 2. am a sole proprietor or Partner ship and'have no.employees These sub -contractors have 8. E] Demolition working forme in any capacity. workers' comp. insurance. y, L] Building addition Wo workers' comp. insurance 5. ElWe area corporation and its 10.[j Electrical repairs or additions required.] 3. El X am a homeowner doing all work officers have exercised.their right of exemption per MGL 11. [] Plumbing repairs or additions myself [No workers' comp. c.152, §1(4), andwehaveno 12,QRoofxepairs insurancerequixed.j ? employees. [No workers' 13.❑ Other comp, insurance required.] Mny applicant that checks box#1 must also fill out the section below showingtheir workers' compensation policy information. 7Homeowners who submit this affidavit indicatingthey tie doing all work and then hire outside contractors must: submit a new affidavit indicating such. lContractors that checkthis box must attached mn additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' comperzsafion insurance for my employees Below is the policy and jati sife information. Insurance Company N Policy # or Self ins.Lic. M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of tete workers' comp ensationpolicy declaration page (showing the policy number and expiration date). failure to secure coverage as requiredunder Section 25A ofMGL o. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA. for insurance coverage verification. Ido Hereby eert' uri , tiieep'ains and penalties ofperjury Mat the information provi (d�ed above is true and correct. Nfomafirre- A e0 A ` q /" _� /- Date: 1 � —A.06 1 Phone #: Official use only. Do not write in this area, to be complefed by city or town ofcial City or Town: PermlMicense 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. Pursuarit to this statute, an employee is defined as "...every person in the service of another under any contract ofhire,- express orimplied, 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 irdstes of an individual, partnership, association or other legal entity, employing employees. 1%wever the owner of a dwelling house havingnotmore 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 ofpubiic work until' cceptable evidence of compliance with the insurance requirements of this chapterhave 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, supplysub-contractor(s)name(s), address(es) and phonenumber(s) along with theircertificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are notrequired to cant' 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 theaffidavit. The affidavit should be returned to the city or town that the application for theperinit 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 *orkers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate he. ` 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 pemiit/license number which will be used as a reference number, In addition, an applicant that must submit multiple permit/Rcense 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 maybe provided to the applicant as proof that a valid affidavitis on file for future permits or licenses. Anew affidavit must be filled out each year. Where a liome owner or citizen is obtaining a license ox peimit.not related to any business or commercial venture (i.e. a dog license orliermit to burn leaves eta) said person is NOT required to complete this affidavit. The Office of lnnvestigations would like to thank you in advance for your cooperation and shouldyou have any quesgons, Please, do not hesitate to give us a call. The Department's address, telephone and fax number: Tho Cox oawaTt� o;FMas�ao�?usPtE� INvart ent Offndustrial .Araddents Ofoe QUAWStiPUM 600 Waft&a Strut Boston,, . 0.21. X 1 Tel, # 61.7-227-4900 et 406 0x 1-877-MASSAM Revised 5-26-05 Fax -0 617-727-7749 Www.x>aa5S.&QVAhd � � i v _ } �r �` / // w f ��� w��G � � .� ��' �- � � �� �� INWATTS A Watts Water Technologies Company March 3, 2016 James Hurley Town of North Andover Building Department 1600 Osgood Street Building 20, STE 2035 North Andover, MA 01845 815 Chestnut Street • North Andover, MA • 01845-6098 * Tel. (978) 688-1811 + Fax: (978) 794-1848 RE: Watts Water Technologies Snow Melt System Gas Permit 9678 Dear Mr. Hurley: Per our discussion earlier this week, Watts Water Technologies is hear by requesting that the Town of North Andover revoke Gas Permit 9678 issued on 11/20/14 requested by Richard Coughlin of Coughlin Plumbing for a snow melting project located at our corporate headquarters here at 815 Chestnut Street in North Andover MA. As directed and due to circumstances beyond our control, we have retained a new licensed plumber, Ken Westfall, who has reviewed the work completed to date by Coughlin Plumbing. He will be coming by your office to pull a new permit, will make any modifications needed to the system completed to date and will schedule a meeting with you to review the work and then close out the permit. I apologize for any inconvenience this has caused your office. Sincerely, 461d4 Comiskey ire for of Facilities Wt(fts Water Technologies Cc: Gerald Brown — Inspector of Buildings, North Andover Wayne Washburn - Watts.Water Technologies Watts Regulator Company Since 1874 watts.com 11687 Datee�/�. .... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING 4 This certifies that ....k ... 'A ...........-....)%0.r,s3 e— .................................... has permission to perform .... Y ....... C o o ...................... plumbing in the� buildings of.... "', k� ....... T ......... /--/-% - I at .......... V .. t. ...... ........... North Andover, Mass. FeAP-0--... Lic. No. . ....................................................... .......................... PLUMBING INSPECTOR Check # ` MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY North Andover � MA DATE 2123116 PERMIT # ,t JOBSITE ADDRESS 815 Chestnut Street OWNER'S NAME Watts Technology „ OWNER ADDRESS Same TELL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL E:3 EDUCATIONAL PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: FIXTURES 1 FLOOR- BSM BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR / AREA DRAIN INTERCEPTOR (INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE / MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER 2 1 3 14 15 1 6 1 7 RESIDENTIAL PLANS SUBMITTED: YES E] NDE] 8 1 9 1 10 1 11 1 12 1 13 1 14 INSURANCE COVERAGE: I have% current liabili insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES Ej NO (� IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Ej OTHER TYPE OF INDEMNITY 0 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 0 AGENT E] SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and that all plumbing work and installations performed under the permit issued for this application will be in compli; Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME Paul Dionne LICENSE #11164 —_-17 _. .. , ,.._. SIGNATURE my MPEI JPEl CORPORATION [Z]#2=PARTNERSHIP(J# LLC E3# " COMPANY NAME PJ Dionne Company, Inc ADDRESS 72 Jonspin Rd CITY Wilmington STATEF MA ;ZIP 01887 � TEL 978-657-3990 FAX 978-657-3992 CELL 617799 7552 EMAIL pdionne dionne.com 61151�y bi ,rnV0A. of the V, The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass gov1&a NNrorkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeibly Name (Business/Organization/individual): P.J. Dionne Company, Inc. Address: 72 Jonspin Road City/State/Zip: Wilmington, MA 01887 Are you an employer? Check the appropriate box: Phone #: 978-657-3990 1. Q I am a employer with employees (full and/or part-time). 2.[]I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3.Q 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 ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. So 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.t 6.❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 7. ❑ New construction 8. [:] Remodeling 9. ❑ Demolition 10 E] Building addition 11.0 Electrical repairs or additions 12. [:]Plumbing repairs or additions 13. ❑ Roof repairs 14.0 Other .Any applicant mat cneclrs box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such =Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and stats whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I ani an employer that is providing workers' compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Amguard insurance Company Policy # or Self -ins. Lic. M PJWC556297 Expiration Date: 8/15/2016 Job Site Address: Ch-e4nuk City/State/Zip: P�Od OV4 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. Ido hereby certify und�rpepaimll dpenaUks of perjury that the information provided above is true and correct Date: 978-657-3990 II Official use only. Do not write in this area, to be completed by city or town official ee 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 #: PLUMBERS AND GASFITTEMS ISSUES THE FOLLOWING:LICENS. LICENSfD AS A JOURNEYMAN PLUMB S PAUL. J D I ONNE P J D I O.N:N.E C`0 I NC .72 JONSPIN RD Y`[ ItitiM NC70N0 ©�, r CONTROL# J1225002 IMPORTANT If your license is lost, damaged or destroyed; is inaccurate; or needs to be corrected, visit our web site at mass.gov/dpi for instructions to ensure the proper mailing of your Renewal Application and any other correspondence. This license is subject to Massachusetts General Laws and regulations. Your license is a privilege, and cannot be lent or assigned to any person or entity under penalty of law. Keep this license on your person or posted as required by law and/or regulations. CONTROL# J2073®9 IMPORTANT If your license is lost, damaged or destroyed; is inaccurate; or needs to be corrected, visit our web site at mass.gov/dpl for instructions to ensure the proper mailing of your Renewal Application and any other correspondence. This license is subject to Massachusetts General Laws and regulations. Your license is a privilege, and cannot be lent or assigned to any person or entity under penalty of law. Keep this license on your person or posted as required by law and/or regulations. CONTROL# J225023 IMPORTANT If your license is lost, damaged or destroyed; is inaccurate; or needs to be corrected, visit our web site at mass.gov/dpl for instructions to ensure the proper mailing of your Renewal Application and any other correspondence. This license is subject to Massachusetts General Laws and regulations. Your license is a privilege, and cannot be lent or assigned to any person or entity under penalty of law. Keep this license on your person or posted as required by law and/or regulations. Date 1 Town of North Andover Your permit has been sent back to you for the following reasons: 1) Check amount incorrect 2) No copy of current license_ ,Q- 3) Insurance Insurance Binder not on file or expired 4) No Workers' Compensation Insurance Affadavit Form Please call with any questions 978-688-9545. Fax 978-688-9542 Workers' Compensation Form and Schedule of Fees can be found on the Town of North Andover Website under Building Department. Mailing Address: 1600 Osgood Street, Building 20, Suite 2035, North Andover, MA 01845 t1 This certifies that......4 41AA-9A..Q-AL:� �A4 ... 1).k.CY ..................................... ....................... ......... .. .. ..... has permission to perform .............. ..... pluml, in the buildings of.,. ................................................... at............................................ ........................................................ North Andover, Mass. Fe?h Lic. No. ..... ................................................................................. PI MRING INSPECTOR I, Ched,L, e)(4511 Date.. ,012-(PJK' ................ .............. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY I North Andover MA DATE 9123/15 JPERMIT# I (- ` ! _ JOBSITE ADDRESS 815 Chestnut St OWNER'S NAMEJ Watts Water Technologies POWNER ADDRESS 815 Chestnut St. TELI 978-688-1811 FAX 978 794-1848 TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ EDUCATIONAL ® RESIDENTIAL ❑ PRINT CLEARLY NEW: ❑ RENOVATION: ❑ REPLACEMENT: ® PLANS SUBMITTED: YES ❑ NO[] FIXTURES71 FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE 3 DEDICATED SPECIAL WASTE SYSTEM V DEDICATED GAS/OIL/SAND SYSTEM (� DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN 1 1 FOOD DISPOSER FLOOR / AREA DRAIN 6 2 INTERCEPTOR (INTERIOR) KITCHEN SINK LAVATORY 6 4 ` ROOF DRAIN VU SHOWER STALL SERVICE / MOP SINK TOILET 6 5 z URINAL 2 LIJ WASHING MACHINE CONNECTION WATER HEATER ALL TYPES 1 WATER PIPING 1 1 i % OTHER Hose Bib 2 2 Sanita Cut Ca And make safe 1 Ejector Pum 1 INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES 0 NO ❑ w IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 0 OTHER TYPE OF INDEMNITY ❑ BOND ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT (hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent pro sion of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. ' PLUMBER'S NAME I Patrick D Harold LICENSE # 12459 IGNATURE MP El JP❑ CORPORATION O# 3206 PARTNERSHIP❑#®LLC ED COMPANY NAME Harold Brothers Mechanical Contractors Inc ADDRESS 144 Woodrock Road CITY Weymouth � ISTATE . MA ZIP 02189 TEL 781-871-2111 1V FAX 781-871-2002 CELLI EMAIL I bcurtis@haroldbros.com Lm Date....�P� � I.�}................. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that P c'� `-" � 4 vks ............................................................................................................... has permission for gas inst lation m the buildings f ....��..... I ......................................................................... at ...................... 5..l.... :................................ North Andover, Mass. Fee.............. Lic. No. r y. .............................................................................. GASINSPECTOR Check # n- 1G2bu ;P—,P. — . 10/3 1, — 2 o qo `aN-MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK u,p- CITY I North Andover MA DATE 09/23/151 PERMIT # I *6� &* JOBSITE ADDRESS 1815 Chestnut St OWNER'S NAME I Watts Water Technologies GOWNER ADDRESS 1815 Chestnut St TE 978-688-1811 1FAX 978-794-1848 TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL❑ PRINT CLEARLY NEW: ❑ RENOVATION: Q REPLACEMENT: ❑ PLANS SUBMITTED: YES ❑ NO ❑ APPLIANCES -1 FLOORS— BSM 1 2 3 4 5 6 7 8 9 1 10 11 12 13 14 BOILER . L 2 BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER i DRYER FIREPLACE FRYOLATOR FURNACE i GENERATOR GRILLE .__ - � INFRARED -HEATER L::J LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER rUNVENTED ROOM HEATER 'WATER HEATER OTHER I INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL: Ch.142 YES Q NO ❑ I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Q OTHER TYPE INDEMNITY 0 BOND El 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 requiretnent. CHECK ONE ONLY: OWNER Q AGENT ❑ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in c mpliance wit all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. ,rL1( PLUMBER-GASFITTER NAME Patrick D Harold LICENSE #:9 SIGNATURE MP Q MGF ❑ JP ❑ JGF ❑ LPGI (1 CORPORATION ❑# 3206 PARTNERSHIP ❑#D LLC ❑#O COMPANY NAME: Harold Brothers Mechanical Contractors Inc ADDRESS 144 Woodrock Road CITY We mouth STATE MA ZIP 02189 TEL 781-871-2111 FAX 781-871-2002 i CELLI EMAIL Tmaimone@haroldbros.com AIX I �b W F °z z 0 F U w a iQ �ol >, °❑ a z z ) o ❑ � w � � w ce O W O U w z z cn w N a W x W a w W w y a zz a a a ►� J F„ a a 40 Q � W x w W E� O z z 0 H U W a z d x c� a 0 cc '\ The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 U1 www massgovtdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbet•s. TO BE FILED WITH THE PERMITTING AUTHORITY. Analicant Information Plpocp Print l .nn:M Name (BusinesstOrgttnixotion/Individual):� Address:_ 4/4 YRb City/State/Zip:�11� _ % �T�} �� rl Phone #: '19f 4112- t I Are you an employer' Check the appropriate box: 1'el am a employer xvitl - employees (full and/or pan -time). • 2 1 am a sale proprietor or partnership and have no employees working for me in any capacity [No workers' comp. insurance required] 3 Q 1 wn a homeowner doing all work myself. [No workers` comp. insurance required) t 4,01 am a homeowner and will be hiring contractors to conduct all work on my property 1 will ensure that all contractorseither have workers' comperrsation insurance or are sole proprietors with no employees. S,❑ 1 am a general contractor and I have hired the subcontractors listed on the attached sheet. 'these subcontractors have employees and have %wrkers' comp insurance,: 6 a we arc a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees [No workers' camp. insurance required.] Type of project (required): 7. New construction 8. Remodeling 9. ❑ Demolition 10 0 Building addition 11.❑ Electrical repairs or additions 12. Q Plumbing repairs or additions 13Q Roof repairs 14.�]Other .... •Any applicant that checks box ql must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a newaffidavit indicating such, tcoiitroctors that check this box must attached an additional sheet showing the name of the xub•contractorsand state whether or not those entities have employees. If the subcontractors have employees, they must provide their workers' comp. policy number, I am an employer that is providing workers' compensation Insurance for my employees. Below is the policy and job site Information. Insurance Company Name:SSli1%M (►IjAj1 " Policy # or Self -ins, tic. 9: 00 _ n —201A A Expiration Date: R Job .Site Address: 15 CityfState/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under 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. 1 do hereby certify under the pains and penaltire�s, oof�perrjuty that lite information prot>tded above is true and• correct. Signature:�� . `� Date 1D{ t Phone #: Offidal use only. Do not write in this area, to be completed by ciq, or town official. City or Town: Permit/License # Issuing Authority (circle one): L Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6: Other Contact Person: Phone #- ACORbr CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DO/YYYY) F2/11/2015 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. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements). PRODUCER Herlihy Insurance Group 51 Pullman Street Worcester MA 01606 CONTACT NAME: PHONE FAX Alc No Ext:508-756-5159 A/c No:508-751-5 4 a DRess:l aari herlih rou .com INSURERS AFFORDING COVERAGE NAIC # LIMITS INSURERA: r S GENERAL LIABILITY INSURED INSURER B:EvanS on Insurance CO. INSURER C:Philadel hia Insurance Companies Harold Brothers Mechanical Contractors, Inc. 44 Woodrock Road INSURER D: A.I.M. Mutual Insurance Company INSURER E: Weymouth MA 02189 INSURER F: VVrL1�MVGJ. LCR I Wit." IF mllnnmFK' 4a' a =Q=n� V xllwpl kl \II IRammn THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, .EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE MD—DL INSR SUBR WVD POLICY NUMBER EFF MM/DDY POLICY PI MMIDD/YYYY LIMITS A GENERAL LIABILITY Y Y CO2F654559 12/8/2014 2/8/2015 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY RAMAGE PREMISES (Ea occurrence) $500,000 CLAIMS -MADE OCCUR MED EXP (Any one person) $15,000 PERSONAL & ADV INJURY $1,000,000 X Inc. Contr. Prot GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 17 POLICY R PRO- LOC I$ A AUTOMOBILE LIABILITY Y Y BA2F649642 12/8/2014 2/8/2015 COM Ell NED1'rffGrI!TrM=. Ea accident $1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED X BODILY INJURY Per accident $ ( ) AUTOS AUTOS X HIRED AUTOS : X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ $ A X UMBRELLA LIAR X OCCUR Y Y ZUP14T5496112NF 12/8/2014 2/8/2015 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $10,000,000 DED X I RETENTION $10,000 $ D WORKERS. COMPENSATION y MCC20020004102014A 12/8/2014 2/8/2015 X WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN JQSY LIMITS E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � N / A E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory In NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below B C Pollution Liability Y Y 14CPLCNE60092 /27/2014 /27/2015 Each Occurance 1,000;000 Professional Liability y y PHSD946328 /27/2014 /27/2015 Aggregate 1,000,000 Prof.Occ/Aggregate 1000000/1000000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Certificate holder is listed as additional insureds with respects to general liability (CG D604 08/13), automobile liability and umbrella liability as required in a written contract for work performed by, or on behalf of, the named insured on a primary and noncontributory basis. Waiver of Subrogation applies in favor of all additional insureds on all policies. Per project aggregate applies to General Liability and Excess Liability l u Ivrl 1 1_ n V w�r� Harold Brothers Mechanical Contractors Inc. 44 Woodrock Road Weymouth MA 02189 ACORD 25 (2010/05) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE CA4 ': d ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ,. LTH QF BOARC OF, PLUMBERS• ANii GASSFITTERS ISSUES THE FOLLOWING LICENSE'. REGISTERED - x � AS A ,{PLUMB I NGICORp � 4 PATR I.CK 0 HAROLD R, ROLD BROTHERS MECHAN I CAL CONT; , 7b CLUBHOUSE DR { HINGHAMMA 02043 48$8 306 _o5/o i Ia b ­�N. :..,,2 i66'34. ,:COMMONWEALTH OF MASSACHUSETTS . , •`q ...OARD OF PLUMBER,BS AND` GASF i'TCERS ISSUES THE FOLLOWING L I`CENSE­,i < L'I..CENSEO A5 MASTER .PLUMBS ,. .,PATRICK O HAROLD m = 76 CLUBHOUSE DR H INGHAM r t. MA 02043-4$$$' i 21459, . Y. 05/0,1/16- -Z.t 970,1._ roCOMMONWEALTHy4F-MASSACHUSETTS BOARD OF N PLUMBERS r#AVD GASF ITTERS:` I ISSUES ,THE FOLLOWING L I CENSE,At L I ct"SE,, 'AS A :lOURNEYMAN-PLUMBMR .: PATRIHAROLD YCK D x w� r6�CLUBkdUSE' DR % •.� MA I NGHA b124ioa% zt97o2 i y r. t Date .� o.�Z.....-.. �............. TOWN OF NORTH ANDOVER PERMIT FOR WIRING I.�; Thiscertifies that...............:`'�t.......................................................................................... has permission to perform .-, n "�� 1' ^ " r-4 wiring in the building of.... !!�J•CJ�....................................................................................... at ......... 1..�?J...-." `x 5-� �i , North Andover, Mass. ...................� .......................... Fee.3... Lic. No! -).Z.[..1 ........................................................................................ ELECTRICAL INSPECTOR Check # (2)4-/� ��� OjGllll- i -t�a \2 p��f Q1�i�11�3aclLn3ef� Penni andFee�ied �j` e71t%BR- L of pccui��°y �enae�lnnll i� fn""°� r R�GUt�TIO�S loll �-Vvv ,00 oo I F e G ' �OARD �O,ic�'us� pf �r�es. edbeLo�v- pe Tp the In�Pe`�° �k i� ,Vj� IIccardffi� Ti�?N) arEnje elecln IIrin � ---- VD, t+ A (�1i'01 toP Tel La. jN INS D_ l'� . e f� ber PL SE awn oi• ed gives nobG � �� � nteB ) a� City the nnders��` y/ Cher ApproP 'a�tl� er ar ( or�`�upA-�jo• �° oflVieters / 461 U iytiietY ers I " A oncr or 2eD �dingperm 3 j p Undgrdo, of pct sAdd4 °nl�ctton�vitt�a� averh�dQ �ndgrd� 15 0'�:;n yaps rheod� G+" �s t Ove f ,�urlciing s ` !n ectnr ofllr��- , stiu Servic`�I- Amps I y, I �. be�va;auib E}je T°tn1 B g ijze d AmpaGtY Gnt`11Orlcy table m� 1 Ne`v of pe'de s ° a5ed ectri �'i� rion oi�}te f°ila;vin �o, °ifarmeys' A neer re a£Yr P � Com � `frAt<s motion n°d Qia }'o b L Sus °ddlei -' Aos G � Q t �e�encY (2 it w �a. of Cel ' Tnhs in- �e �nrts ria- of Zones umCS NA, of got D�� And 1> �°• of Rec45scd #lets �vimmiugYaal grnd ° of getce`o°Devices A Esc Ces a. OfLnminA of oilBnrner of Alertingfiened 4 Ofuminnrres outlets n, o£ GAS Bncrs atm o, of auiA1en gevtces Dtb� plotAcle i� T teal nnic'ptiou G, o, of mr— tya °£ r Gan ner fans ,,aiQ Cannes, RLen teres�tPumP IS stem • Or uiv' t seCnritY cv1ces rages To gcgtirrg �� of t nivnient T�o• of Users SPAcrl cn iC Dntn irLnfg`• £es as i�nl f o of Astc DSP ting APP1Lmce5 N° of N u ° es ar niv a ecct a' ushers Sea• ,u�sts Ye a (I Rr of pis o Of 5i 'totAi I� � b t}ta Inspeetar of � ° of Dryers Of re4uired Y . t des#rsd, ar tVa. of Kc,Lters a l de'Ll, if opal P°yjcya - d neon comPLeii r ,¢less °mnsskgeBathtubs tltta�tr q°'re6'bl EGIclet eleetrecei'�a°rkmuN�t e anG' wit>' tme° �hstatstiat �l ed in accord fL-e,PeCEorm a or its sn Q office- o'i i Ete ection6 rea'rwrierS n° _Pecmlt Q° eratian" cov Ahe Peet issW� y ane a LnsP Wthe'o , �Ccxap . P °f same to cot�FFtet� 7 matedIL 1 Q 1�E. vflless `NGe inclfl�b eibite �P) Igor to o€lus°il ' e is m f°rte, (5P is II s,; g130 -I'�R' atio t,•i,C, g_g47- ce�ee PC°v �Ft Shah cave�g Otliat f}te �e rsi ►6 SCJ 'N d el hies, SeNlce' CO Of ."On � / �t L c T`Lo- a e norm°llY � Cmc der ale P� fate Electr�ca Sipato ens? ce cover els $ en j Certtf3 \raters �& 2 ug Lic n aara ists�° ./ - uale p . .ViVa se n,�niber tine �a MA 0� lit Safety .1 the Lieni]�tY ovmet I �i . t Parae Ole. tir�nd M. g�Uen esT�ePe4c e des no h�tlle Ccheckoc�}� P RC) j;�ce}ssee:s� iccnb[e e7p'irebieGo caist'J`Nork�`arethat iretnent Lam (jf app s t4'1 s 51 N) sA & l arra 'off' v`ra�- this .requ ger1 -G ESS-Oioc sblrebew"',Ih jelephole a o�'� � by �"'• BY mY ot�ti�erl gent M �ea'Sta to Services MOe AUber fr Senior pr t �fect Manager N. Bil70 l . ado e Rcl V)a 0 186 Main; yE°n,oF w Direct: 978-66;,S 2 Fax. 9789 j78.94282 0 i ma�b12 ert@le 8 corn 68 � J WVVVV.iesc l.lesc Corn The p►f fere 84110,nce is Attitu J� `. 9 oe Etcellegce s,,, de ` J 6( i' h ND AA b 9\ 1 I 1 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 2,381,443.00 m _ , , _ - $ 28, 577.32 Plumbing, Fee $ 3,572.16 Gas Fee 100 comm. $ 100.00 -Efectrical-F—ee _ _ _. _ _ -- - 3;572JU _. Total fees collecteff` $ 815 Chestnut Street 310-2016 on 9/9/2015 Interior Renovations, New Lab and Training Facility I ------------ f4- ., yl H f1)111nL01Uuaa&- D'/cmd3aClladBf 2i,parinioni a/.fir f ruicoj BOARD OF FIRE PREVENTION REGULATIONS DFlioial ilse Only PennitNo. a1%—' Occupancy and Fee Checked ev. I/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to .be peri'ormed in arwrdm= iviih We Massachusetts Eleclri Code (MEC}, 5-77 CMR 12.OD (PL EASE PR�ITININK ORYTPE �O �fflT_rflN) Date: j�Q%� %/� City or Town o% �ar�� nP�l1 u°' To the spector.of trues: By this Application the undersigned gives notice of his or herfrition to erform the electrical work described below. Location (Street °& Number) Y ) � • 1- � �' 4 Q S Owner or Tenant Owner's Address Telephone No. Is this permit in conjunction Nvith a building permit? Yes �' No ❑ (Check Appropriate Box) Purpose of Building 3. ' AO/ b iliility Authorization No, Existing Service Amps. I Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ 'Undgrd ❑ No, of Meters Number of Feeders and Ampaeity Location and Nature of Proposed Electrical Work% Com rationora ill otvrn r I No. of Recessed Luminaires re o No. of CeiI.-Susp. (Paddle) Fans la a marc be IvmnTd L the 1n edor ol•111res. No. of Total Transformers ICVA No. of Luminaire Outlets Na. of Hot Tabs Generators - .:...:,1CYA Na. of Luminaires Swimming Pool Above ❑ in -fl Ernd. Lrrn d. Ll of L m— rgency lAg ing Butte (Units No, of Receptftcle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switchas No. of Gas Burners [V o. of Rett etion and Inttiatin Devices Na. of Ranges g No. of Air Cond. 'Total Tons No; aCAicrting Devices Na. of Waste Disposers Iieat.P Totals: amber Tons K o. of SelfContained DetectioulAlerting Devices No. of Dishwashers SpacrJArea Heating ICW Loral ❑ unirnpni ❑Other Connection No. of Dryers Na. ai'Water Heaters 1 Heating Appliances IC<V Na. of No, of Signs Ballasts Security 3 stems; No. of bevices ar I; uivaient Data Wiring: No, of Devices or No. Hydrontnssage Bathtubs No. of Motors Total HP -Equivalent Telecommunications Wiring. No. ofDsiees or E cruivaAent OTII•IER: xclaut (Zddrtrormf derail if desired, arms raguired by f&e htsperlar• of -Tr rres. Estimated Value of lee ical Work: (When required by municipal policy.} Work to Start! / Inspections to be requested in accordant^. with MEC Rule 10, and upon- completion. ............. ____..,_-IIrTSF1FtANCIJ_O EtAG11;-Unless waived by the owner; ao permit fflr tine perforrnanceofelectrinal-work rrsay iss+ie 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 afftce. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify.) f cert' 51, ander the pabls and penalties of perjury, th at the irrfornratio is Q : matt 'I� true nd compfete F NAAM, -. Interstate Electrical Services Corporation / LIC A-5217 Licensee: Pasquale A. Alibrandi Sig mature WC. NO.. (IJmppkabie, eater "esempl" in rhe license nuniberline.) / ' �i r Tel. Na_ 978-947-8130 Address 70 Treble Cove Road, N. Billerica MA 01882 I � tt. Tet. No.: *Per M.O.L. c. 147, s. 57-61, security work requires Department ofPublic Safety "S" License_ Lie. No. OWNER'S INSURANCE WAIVEIL I ant aware that the Uc cis= does not hate the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement I am the (check one) ❑ owner ❑ ownees'a .ent Owner/Agent Signature Telephone Na. PERMIT FEE: S �� 2r Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 275,710.00 m $ - $ 3,308.52 Plumbing Fee $ 413.57 Gas Fee 100 comm. $ 100.00 Electrical-Fee -Electrical-Fee— Total Total fees collected $ 4,235.65 815 Chestnut Street 311=20 6 on 9/9/2015 Renovations to stairs The Commonwealth of Massqchusetis • z Department oflndustrialAccidents == 1 Congress Street, Suite 100 Boston, MA 02114-2017 syr www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMR-MG AUTHORITY. Name (Business/Organization/Individual): Address: '1U I_Y'Cb(-CC L_)P Qo(r-_10 Sf City/State/Zip: i '�V`/ ISI IIP�iCG-- (m —Gone #: go&taCA-T Are you an employer? Check the appropriate box: Type of project (required): LQIa a employerwi&S�eUemployees (full and/orpart thne).* ], Q New construction .2. El I am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling any capacity. [No workers' comp. insurance required.] 3..Q I am a homeowner doing all work myself, [No workers' comp. insurance required.] t 9. ❑Demolition 10 n Building addition 4. ❑ I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole 11. ❑ Electrical repairs or additions proprietors with no employees. - 12.E] Plumbing repairs or additions 5. ❑ I am a general contractor and I have hired the sub -contractors listed on the attached sheet. 13.0 Roof repairs These sub -contractors have employees and have workers' comp. insurance.t 6.FJ We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Q Other 152, §1(4), and we have no. employees. [No workers' comp. insurance required.] *Any applicant that checks box 41 must also fill out the section below showing their workers' compensation policy information. fi Homeowners whosubmit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors fiave employees, they must provide their workeis' comp. policy number. • I am an employer that is providing workers' compensation insurance for my employees.' Velow is thepolicy and job site information. ' Insurance Company Name: GC, -Y) Policy # or Self -ins, Lie. #: (�C 58 Expiration Date: Job Site Address: gis 2�11t_�`�.{ City/State/Zip: 1 ►C and �f"mo � 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. Ido hereby certif under thep - s and penalties of peijury that the information provid�ed,/above is true and correct. Signature:ol� Date: Off' /L'S 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): i 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 litre, 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 aifiidavit. 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 yotfare required to obtain a workers' compensation policy, please call the Department- at the number listed below. Self-iisured 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 bum 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 A RS® CERTIFICATE OF LIABILITY INSURANCE DAT0E(9/30//2015 1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Aon Risk Services Northeast, Inc. Boston MA Office One Federal Street Boston MA 02110 USA CONTACT NAME: (ac NE Ext): (866) 283-7122 FAX (800) 363-0105 A/C. No.): E-MAIL ADDRESS: - INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: National Union Fire Ins Co of Pittsburgh 19445 Interstate Electrical Services Corporation INSURER B: Zurich American Ins CO 16535 INSURER C: Illinois Union Insurance Company 27960 70 Treble Cove Road North Billerica MA 01862-2208 USA INSURER D: LIMITS INSURER E: B INSURER F: COVERAGES CERTIFICATE NUMBER: 570059660309 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 'BEFORE THE INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE CERTIFICATE MAY BE ISSUED -OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, POLICY PROVISIONS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. AUTHORIZED REPRESENTATIVE Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDNYYY MMIDDlYYYY LIMITS B X COMMERCIAL GENERAL LIABILITY GL05 EACH OCCURRENCE $1,000,000 CLAIMS-MADEX❑ OCCUR A� $300,000 PREMISES Ea occunence MED EXP (Any one person) $10,000 PERSONAL& ADV INJURY $1,000,000 0 GEN'L AGGREGATE LIMIT APPLIES PER:Cn GENERAL AGGREGATE $2 , 000, OOO m POLICY X❑ PEO- ❑X LOC PRODUCTS - COMP/OP AGG $2 , 000 , 000 C5 OTHER: o 0 B AUTOMOBILE LIABILITY BAP 5833587-03 09/30/2015 09/30/2016 COMBINED SINGLE LIMIT $1,000,000 Ea accident BODILY INJURY ( Per person) X ANY AUTO O AUTOS L OS SCHEDULED Z BODILY INJURY (Per accident) AUAUTOS N PROPERTY DAMAGE HIRED AUTOS NON -OWNED - U AUTOS Per accident A X UMBRELLA LIAB X OCCUR BE25804175 09/30/2015 09/30/2016 EACH OCCURRENCE $10,000,000 TJ EXCESS LIAB 11DED CLAIMS -MADE AGGREGATE $10,000,000 - X RETENTION 410,000 B WORKERS COMPENSATION AND WC583359004 09/30/2015 09/30/2016 X PER 07H - EMPLOYERS' LIABILITY YIN STATUTE E E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR / PARTNER I EXECUTIVE F OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE -EA EMPLOYEE $1,000,000 - (Mandatory in NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below -_ C Contractor Prof CEOG27416494001 09/30/2015 09/30/2016 Agg/Occ $2,000,000 SIR applies per policy terns & condi ions SIR $15,000 DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Evidence of Insurance. M ig CERTIFICATE HOLDER CANCELLATION ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 'BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE ' POLICY PROVISIONS. Interstate Electrical Services Corp. 70 Treble Cove Road AUTHORIZED REPRESENTATIVE North Billerica MA 01862-2208 USA c'ovz i?.�rDfC rCit.ZtrcrO c/latGlr.�rJ� J�aa ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INTERSTATE ELEC SERV CORP PASQUALE A ALIBRANDI (E L) 70 TREBLE, COVE RD NO BILLERICA MA 01862-2208 Fold, Then Detach Along All Perforations CONTROL# LJ057497 IMPORTANT If your license is lost, damaged or destroyed; Is Inaccurate; or needs to be corrected, visit our -web site at mass.gov/dpi for Instructions to ensure the proper mailing of your Renewal Application and any other correspondence. This license is subject to Massachusetts General Laws and regulations. Your license is a privilege, and cannot be lent or assigned to any person or entity under penalty of law. Keep this license on your person or posted as required by law and/or regulations. - i Fold, Then Detach Along All Perforations i <-OMMONWEQLTH OF M S3 „A `ECT I"C I AN S.. r ISSUES.•,THE, FOLLOW ING`-:OMSC A:�€; :. =f-EWS:TRED MAS. -T-71 LECTR_I�C I-A"ka' I zI:1:1hELEC'SERV COR' i I AS(UAL _-A -NLS BRAND .70 TRE"BIL`E"COVE RQ:,' B It LE.-R1C.:�� �> :=.SIA 01862-2208`+ � 52 d7/ --3J.` uYY 57076 ::... —.1 Nick Cuzzupe From: Comiskey, Jackie <Jackie.Comiskey@wattswater.com> Sent: Friday, March 25, 2016 4:49 PM To: Guertin, Scott Cc: Nick Cuzzupe; Eric Libby; rlorentz@RDKEngineers.com Subject: RE: 20150277.00 - Watts Technology Training Center Renovations Scott, Let this email serve as notification that Watts Water Technologies will commit to having an Arc Flash Study completed for the electrical distribution system for the Watts facility located at 815 Chestnut Street, as requested by the Town of North Andover. I have reached out to both Wise Construction and Tocco Building Systems on setting up a meeting for next week to review this effort further. We will need RDK support with as built documentation and with new signage and labeling requirements. Thanks, Jackie Comiskey Director of Facilities HQ/Indirect Sourcing Manager Watts Water Technologies, Inc. 815 Chestnut Street North Andover, MA 01845 Phone: (978)689-6067 Email: iackie.comiskey@wattswater.com From: Guertin, Scott.[mailto:sguertin@RDKEngineers.com] Sent: Friday, March 25, 2016 9:34 AM To: Comiskey, Jackie Cc: Nick Cuzzupe; 'Eric Libby' Subject: FW: 20150277.00 - Watts Technology Training Center Renovations Jackie, Sam spoke with the inspector this morning. See below for her recap. Basically, he is requiring Watts to perform a facility wide ARC Flash Study for their entire electrical distribution system. We specifically asked him if he would hold up the Training Center project while this work was being performed and he said no, as long as you have documentation showing that this work will take place. The next step is to hire the services of an electrical contractor to provide an ARC Flash Study of the electrical distribution system. The scope will include opening all electrical panels to measure feeder sizes and lengths to/from each panelboard. They will also have to develop a one line diagram of the entire system. We can provide them with the as - built drawings showing equipment locations and panelboard schedules for assistance. Thanks, Scott Guertin, P.E. I Principal I Group Leader RDK Engineers P: (978) 296-63381 M: (978) 886-7420 From: Phon, Samang Sent: Friday, March 25, 2016 9:02 AM To: Guertin, Scott <sguertin@RDKEngineers.com> Cc: Lorentz, Robert <rlorentz@RDKEngineers.com> Subject: 20150277.00 - Watts Technology Training Center Renovations Hi Scott, Per the conversation with Allan Paduchowski, Andover Electrical Inspector, in regards to the final electrical inspection for Watts Water Technology - Training Center Renovations, he had concerns to the new panelboard Arc Flash Protection, Personnel Protection Equipment (PPE) — NEC 70E Requirements. As RDK provided a 480/277V panelboard connected to the existing switchboard, we indicated a general ARC Flash Warning label. The Inspector noted the existing Watts Facility required a complete electrical distribution system ARC Flash Study from the pad mounted transformer to all associated equipment due to the liability of personnel and shock protection equipment. A follow-up with the electrical inspector is required, therefore, RDK would recommend an ARC Flash Study performed. He has indicated that closeout of the project will not be held up if documentation is provided indicating the required work to be performed. Please review and let me know if you have any questions. Thanks, Sam Samang Phon I Electrical Engineer RDK Engineers 200 Brickstone Square, Andover, MA 01810 P: (978) 296-6292 sphon@rdkengineers.com Website / Linkedin / Blog / Facebook / Twitter Date .... ��/ .41- .... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that T�-e- ................... �.0 ... has permission to perform ... I \l0' IV ..� ..... wiring in the building of ... �. ...... .......................................................... at ........ ....... . ................................................ . North Andover, Mass. Fee::z8.. . ...... Lic. No. V . -2 C.50 .................................................................................... .............. � G ELECTRICAL INSPECTOR Check # :?�, 4 Commonwealth of Massachusetts Official Use Only L° l-i&fi-t Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leaveblank 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: 1?-- 21 � 15 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 W jj, h Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity 01 N Location and Nature of Proposed Electrical Work: n-Stul) ��,.$), a �) V 6 a-)ibw s? % ar L `i !S4e-rh 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 Tota Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- El rnd. rnd. o Emergency Lighting Battery Batter Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump I Number Tons I KW I No. of Self -Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or E uivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: .0 / y, yva (When required by municipal policy.) Work to Start: /LI tp Inspections to be requested in accordance with MEC Rule 1.0, and upon completion. k INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE E� BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: I k�C a /t c Frei c, I^ c � LIC. NO.: v Licensee: L—e5 J i f— JW�SO>J Signature �% ��c�� LIC. NO.: (If applicable, enter "exempt" in the license ber line.) Bus. Tel. No.- 56 35y 64� Address: 374 ft , /Li1C(Ae/c: ,M A Alt. Tel. No.:, 60. fes` -Z&94 *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 2 � The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Nwww mass.go0lia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Aiaplicant Information Please Print Legibly Name (Business/Organization/Individual):_ i K E G to C A-21 @, In G Address: q 1&5 5s - S-�e. A City/State/Zip: /tke_dPteW AA 6za52 Phone#: 60&_059-19 a 6 Are you an employer? Check the appropriate box: 1. a. employer with 122 4. ❑. I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ lam a sole proprietor or partner- listed on the attached sheet. x ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3.. ❑ I am a homeowner doing all. work right of exemption per MGL myself [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp, insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. Q'Electrcal repairs or additions 11. ❑ Plumbing repairs or additions 12. ❑ Roof repairs 13. ❑ Other 'Any applicant that checks box #1 l must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' conWensadon insurance for my employees. Below is the policy and job site information. Insurance Company Name: 0Vk Ca W zLim o na j Policy # or Self -ins. Lic. #: tJC°.. _497Z52.20 Expiration bate: (.0 Job Site Address: CIt>° d r - City/State/Zip: IV -4 91'?Y5 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. 7 do hereby certify u the pains andpenalises ofperjury that the information provided above is true and correct Signafore: Date: lal.? &/ S Phone #: -6 g- 5/ y 6 - /a 96 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. Cityfrown Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: I/ Date......................................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING (/4-- " This certifies that ..AV .. ............... ................................................... has permission to pe....... Vve (; 417-- ............. r/ ........... ...... wiring in the buildi g of .... �)o 11.5 ��.��..... P..................................................I....................... ............................ at................ s. ...... . North Andover, Mass. Fee.) ..L'...... . ...... Lic. No. ......................................................... h*L*ECTRICAL INSPECTOR Check # C2(fl 7-7/ V Commonwealth of Massachusetts Official Use Only Department of Fire Services Perm'i N Occupancy and Fee Checked BOARD OF EIRE 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 PRINTW INK OR TYPE ALL JXFORMA770N) Date: , a — R_\_5 I 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 Owner's Address M.f Telephone No..119'�9%9-_ M) Is this permit in conjunction with a building permit? Yes ❑ No a (Check Appropriate Box) Purpose of Building \'o,� Utility Authorization No. Existing Service Amps ! Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work. Overhead ❑ Undgrd ❑ No. of Meters COmDletiOn of the followinv, table may he waived by the Tncnnrtnr of Wirvv No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators ISA No. of Luminaires Swimming Pool Above El- El d. d. o Emergency Lighting Batte Units No. of Receptacle Outlets No. of OR Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection an Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number — Tons -- _...-- - KW -" - �� o. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal❑Other Connection No. of Dryers Heating Appliances KW Security Systems: x No. of Devices or Equivalent No. of Water KW Heaters o. of BNo.al as Signs Ballasts Data Wiring: kAlb No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring No. of Devices or Equivalent OTHER: • "Attach a"-honal detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work` -\\,o WC) (When required by municipal policy.) Work to Start, k,�--g -1j Inspections to be requested in accordance with NEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [_ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: C LIC. NO.� Licensee: Signatu LIC. NO.: (If applicable, enter "exempt" in the license number line.) Bus. Tel.No.•`���ya'o'��� Address: 121 _1� �►%lp c „i`6 \.t MA 0\R'S \ 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 a ent. Owner/Agent PERMIT FEE: $ Signature Telephone No 1 Z9— orivanced Cabling Concepts, LLC vctured Cabling Professionals" h Beote, DBE/WBE r Security Systems - Certificate of Clearance License # CC -012141 181 Stedman Street Unit #6 Lowell, Massachusetts 01851 i-710-7655 (office)/978-710-7675 (Fax) 508-423-4299 (Cell) sbeote @adva ncedca bl i ngconcepts. com www.advancedcablingconcepts.com 0 s The Commonwealth of Massachusetts Property Address Depanhnent o fIndustrial Accidents > I Congress Street, Suite 100 Boston, MA 02114-2017 y www mass.gov/dia Workers' Compensation. insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeibly Name (Business/OrganizationAndividual): Advanced Cabling Concepts, LLC Address: 181 Stedman Street #6 City/State/Zip: Lowell, MA 01851 Are you an employer? Check the appropriate box: 1.0 I am a employer with 4 employees (fall and/or part-time).* Phone #: 508-423-4299 2.❑ I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3.,E] I am a homeowner doing all work myself. f No workers' comp. insurance required.] 1 4,F] I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5.[] 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.$ 6. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, §1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 7. 0 New construction 8. Q Remodeling 9.:[] Demolition 10 [] Building addition I LE] Electrical repairs or additions 12.E] Plumbing repairs or additions 13. ❑Roof repairs 14. Other -Any appucant mat cnecxs box nl must also till out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Hartford Fire Insurance Company Policy # or Self -ins. Lic. #: 08WECCQ8178 Expiration Date: 7/25/2016 Job Site Address: 815 Chestnut Street City/State/Zip: North Andover, MA 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 hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Phone #: 508-423-4299 Official use only: Do not write in this area, to be completed by city or town official City or Town: Permit/License # -` 01— 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 #: _ti Client#: 312505 ADVANCEDCA2 ACOR& CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 12/08/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER HUB Int'I New England (WILSB) Wil ingardvale Street Wilmington, MA 01887 CONTACT NAME: HOE Ext): 978 657-5100 alc, No :978-988-0038 ADDRess: nee.certificates@hubinternational.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Sentinel Insurance Company Limi 11000 INSURED Advanced Cabling Concepts, LLC 181 Stedman Street INSURER B: Hartford Fire Insurance Co 19682 INSURER C: Hartford Accident & Indemnity 22357 INSURER D: Lowell, MA 01851 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 INSURER E: INSURER F: GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JECT COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM/DDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR 08SBANN6228 5/15/2015 05/15/2016 EACH OCCURRENCE $1,000,000 DAMAGE T RENTED PREMISES Ea occurrence $1 000 000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG $2,000,000 $ C AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS 08UECAX1517 7/25/2015 05/15/201 COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY Per accident $ ( ) PROPERTY DAMAGE Per accident $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 08SBANN6228 5/15/2015 05/1512016 EACH OCCURRENCE s2,000,000 AGGREGATE s2,000,000 DED X RETENTION $10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / NTORY ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. OFFICER/MEMBER EXCLUDED? NI (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 08WECCQ8178 7/25/2015 07/25/201 WC STATU- OTH- LIMITS EACH ACCIDENT s500,000 E.L. DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE - POLICY LIMIT $SOO,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder is listed as additional insured on a primary, non-contributory basis with respect to General Liability, Automobile Liability and Umbrella Liability policies when required by written contract. Waiver of Subrogation applies in favor of the additional insureds except for Workers' Compensation. Town of North Andover Electrical Inspector North Andover, MA 01845 ACORD 25 (2010/05) 1 of 1 #S1504919/M1425465 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE U 1bitit3-2011) AGLIRD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CW001 Location 645 NYUJ, No. S -ILA— 2v1 � Date Check #� fJ7 13 TOWN OF NORTH ANDOVER Certificate of Occupancy $-I- Building/Frame G _ Building/Frame Permit Fee $/ 7-q -2v Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 770. i � ►. � ice. Location N. o. 3 �/" o?d�� Date V 1 Check # 1!" >�11 -2 6L! 9 TOWN OF NORTH ANDOVER NI. Certificate of Occuparky— $ Building/Frame Permit Fee $ Foundation Permit Fee $ , n Other Permit Fee $ TOTAL $ i /Buildin6 Inspector S6gw1;'4f_D !!-I2 -/S BUILDING PERMIT %-ED TOWN OF NORTH ANDOVER' 466 APPLICATION FOR PLAN EXAMINATION * _ * �7� n0 ee N 1 Permit No#..�� Date Received �RAATED;:ea°,�5 �SSACHUS�4 Date Issued: b �� IMPORTANT: Applicant must complete all items on this page LOCATION t5�c�5 r3 !�� 6 2 1 l��e►,6�L.r MA , O ( SES Print PROPERTY OWNER _� ( o I Print MOO Year Structure yes no MAP1� % PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family gindustrial ❑ Alteration No. of units: ❑ Commercial (Repair, replacement ❑ Assessory Bldg ❑ Others: ,(Demolition ❑ Other _ ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District Water/Sewer DESCRIPTION OF WORK TO �B+ E PERFORMED: l`'�` ,� 1.--✓ �' Ll' : � ; "b`s7�i C' II S r�` ins r-� i C3 �,�1 lav,. �e.,�� �ti s 1 • ' �.! rni ag-g_ �e�C .�, -� 4.c �, \ 4,1 c l,� lei-\ ,Mztiv�-`c�4-c�1 �,'�i`?+•`� OWNER: Name: W N Arlriracc- - Please Type or Print Clearly �2 1�C.lnnal ��; eS Phone: Contractor Name: N_,Az )1 '781- 23''`'1 Email: v L&.akr_&j;) Address: Supervisor's Construction License: C 0 716�� Exp. Date:_J17 Home Improvement License: Exp. Date: ARCHITECT/ENGINEER V A��'C��o�. Xy C.. Phone: ?181- 337- �a%oJ` _ Address: tU3 L., No. FEE SCHEDULE. BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ 165"00z), 6Z� FEE: $ Check No.: Receipt No.: CI -9-9(P NOTE: Persons contracting with un gistered contractors Vo not*ve gqess to the guaranty fund nature of Aaent/Owner /\Signat4-J oNt1actor 9 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Building Permit Revised 2014 Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine t-- -1 r1 ATA lCi.- A-A4r -m* 11G•A, IYV 1 LJ Q11U ✓A 1 /"� - \1 vrN• " --/ ,E Y ` M ORCLAI- °►fin ,Zo �� %P -P 'O OAI-L t ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 _ -- - - gnat 0 actor ice Plans Submitted IJ Plans Waived ❑ Certified Plot Plan ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ well ❑ IPrivate (septic tank, etc. assagelBody Ar ❑ Tannings ❑ Tobacco Sales ❑ permanent Dempster on Site Stamped Plans ❑ Swimming Pools Food Packaging/Sales ❑ THE FOLLOWING SECTIONS FOR E ONLY OFFICE USE INT ENTAL SIGN OFF ERDEPARTM- U FOR PLANNING & DEVELOPMENT COMMENTS Reviewed On �— Signature CONSERVATION Reviewed o COMMENTS HEALTH Reviewed COMMENTS Zoning Decision/receipt submitted yes Zoning Board of Appeals'. Variance, Petition No: NOTE: y Comments Planning Board Decision: In all ca Comments that the ,Perm must be it ; Conservation Decision: Driveway Water & Sewer Connection/Si nature & Date d Street Doc: Located 384 Osgood no DpW Town Engineer: Signature: ster on site yes FIRE DEPARTMENT -Temp Dump. Located at 124 Main Streen Fire Department s gatureldate COMMENTS < oo'ac s su MU ,Z O o a cn v, 5 0 Fp p > CD m O CD 0 O 0 CL � V� Z o 3 � � N' �1 O �v,rt�• . -n C h= 3� m s O N CD W C' ,o to O N CD O • > 0•� c0. N � - s _. O O O 3C', r. 0 Z y C =° (D.41C r■■� Q 0 to N• Cl)fmilok o ;a 10 ~' m �CQ.y �� -0 � a- .� �": __. Ilio z•3 Q. O Z� N =0= < v CD r0 --� 70 0 < "-N O CL � as m �D O �. rn ..,. < Q� = a CL Er °° ` �G _� CIZ o '��Ivl CD O O Z E ;� y J. - CD •� * 1 W Z 0! y.��o�N CD 't�_ 1 o O •1 c �• O(0 CD v cn"; Z C CDD J N s n v . O �, o wCD vP c cZ. ;•a -v : < n c a� CD C In MW T 7o T (n A T ,p ('� X T VI T r C (D C C _T C C O 0 rDD ms-' 6v v < N 70 ID e77 fD S n fD S S S O_ n \ ID 03 * m V rD _ m D W H M c v Z n r- o a V Z H 2 H m V m m a z-1 s M ` Final Construction Control Document To be submitted at completion of construction by a Registered Design Professional for work per the 81 edition of the Y Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Waterproofing Replacement and Associated Work Date: January 28, 2016 Permit No. 574-2016 Property Address: Watts Water Technologies, 815 Chestnut Street, North Andover, MA 01845 Project: Check (x) one or both as applicable: New construction X Existing Construction Project description: Remove concrete slab and install waterproofing membrane, snow -melt system and pavers. This project was limited to the patio area above the sub -grade tunnel. I, Jon F. Lindberg, MA Registration Number: 32173 Expiration date: 6/30/16, am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Architectural Structural Fire Protection Electrical Mechanical X Other: Waterproofing Replacement for the above named project. I, or my designee, have performed the necessary professional services in accordance with that degree of skill and care exercised by similar professionals having performed similar services and was present at the construction site on a regular and periodic basis. To the best of my knowledge, information, and belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit and that I or my designee: 1. Have reviewed, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor for general conformance with the requirements of the construction documents. Such review shall not diminish or relieve the contractor of its submittal and other responsibilities. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work performed is generally consistent with the construction documents and this code. The contractor is responsible for the performance of the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. Enter in the space to the right a "wet' or electronic signature and seal: Phone number: 781-335-6465 Building Official Name: Permit No.:. Version 06 11 2013 Email: jfl@gainc.com Date: Building Official Use Only OF JON F. v C � 5 U) 0 10 O n Z N D 0 O CLO v(D m� o CL Cr CD CD O W W CD _CD o N� (CC CA � v O a Z CD 0 0 f-f O CCD a CD C� m X a 50- m Z Z O O % 0 O MLCD QCD CD 0 CD 0 m n- = n c ? v► rt cc' o• OOr+CL Fn '" � svCA W�� to O Q`D m D . In - > �• C 0 rt n S CD 0 O CD - '� O = h) U �m 0 2h rt .-� M _ Q. D 0 Os CQ' Q. o a-_ CDN CD �CD�• CLQ W CD rCD �'0 CD N 0 •� n �Rh O O CD O fR CD CD O DCD CD +� @� o M' o CL (A OrDj N 0 Sr N `* z O W m v m D 3m Z T x S D z n 70 T V) N :;o = S m m D H 0 T 7oS Q�q S C W n z m z ( O = O = d O O W C v z Z m A o a N "a N ^ O 3 O Q _� n N O D p O m m x vi J ar Y l -Al -'.7 HT1 — :::r•:. ?•i'? :::< ::i< x??<x;;ii? < :::r :::a{:^:::::;:•.tit:iii: is}>:?::ii:<ir•:<{::>:i::}:s:<:> ::i::>:ii:_:::::.. ?{?{y,{{JY: }Yirivv'.vi:{•5 irrr: Y. ?4•Y ':i}:{!{•:i.}:'?:�):4'{J:':{:?:•::•}}}:•:{{i:?{y:{^:^:?:;: }}:; ;�ii?•'.•}.::>:ii::i�::iiSrr �..........................1......., i...} r.:........ }.:...r ..::.:::.:....:..::............ PURCHASE ORDER NUMBER REVISION PAGE BILL TO: WattsWater@OnlineCaptureCenter.com OR FAX: 978-682-156'1 _... ... C�Aa�747 .-_o_.- . Watts Waer nogies _ .<:s.p �aixie'r,:•:1'sif@�e:tis...>........: PO Box 4929 :test i uiatr s a i ft ca :�reffift s� Portland OR 97208-4929 Portland, �<>:<:::»:»::>.<:.:>:<<:<.<:>.:}><:>.:::>::;�haac��s><a<��«;+n.::.:.;+}:.?,<.vn-.:ri,.):.}:.): }iri4:L}}:Y•}:+F.i{-:vY.{•ii}:v}:{:iir3:•ria:4}}r•ri•:4}i:{ilii?{{.:{•:ti}}%Li:{4)3}:W:{v:{•'ri'l: Yv})):{?v:•ii:r}:ti•�:}::ii ?ti USA ACCT NO SHIP TO WATTS REGULATOR COMPANY ISSUED Knollmeyer Building TO: Corporation 815 CHESTNUT ST 60 Jonspin Rd NORTH ANDOVER, MA 01845-6009 Willington, MA 01887-1019 USA USA ;.....: .............:ti..:.: ...n.,..,.n..,.,,., : .: I}...n.:R......rIv.r:.r..:..:.�.v..I..:� :.t:.� }.}.v.-.....:.v.... •.:::.:i.?...v..:v:.:..{•.:...:.?. ....,.{.:.:.,:.:,.rn.....:::r:::...... ,;:{.::..,,....:. ......vv......:...:. ...n...nv.nr.. ...i.t..3..�t}•..�n}..:....}•.5.i:}.....{t:.......:i.:.:..:...: ..i�.i.�.ti.•.•...:..nv.:•.:.....r...:rvv..ay. ..� ..^:.;..:.?...;� :..#.. f..v:.::�'...• :::.r..fv}.:^}r}..::::.i?..:.:.. �v}...:r. rv...i.::.:..v..lv.:.:v... n{.rn:r:.::.{{ .:;........:.�..�..,..v.....w... .:•:•�.{}{ .v••-{.x)•..•.:.w..•}.::v.:.::.: ;. :.n.4}:.......................r,......... ........v.....�..r...-.:• �: . >)v.....::,...n..:: ...v...:.n..A••. ......i..:.•i.. :�..:.......?.:...f.:.�.:.l:..a.::..:..:.i:l....:.v:�...•.:.:.:.•.}.:...:.++}3v::..4.v.:..:..v.:::...•..r}:..::.v.-:..:.{...:::.:+.... ... na.r1....v+a.V....•.....:..lv....::f.....:.:}.r..::•..:..:3}..:.:.:;... : y. �..:t..:......:..'f...>v.:...n:. ..rr:.t.:...:..�.:....-..:.:...:..}...:....� }..!•:�t.•.#.i�...i.....i.i ;}...,:}...:4li....�.3}i...:.s....:t5..:.::..v.Q..v....w.:......v.............::.:•:....::..:.... :.:. ...:n .: -...:.:vv.....:...:'....... :.:.r.....:v.....:v....n..:i...v:.x..r..:...:...n...:...v v.v.•.....:. •..n..'..v:..•v.rv.....:v.:.:vn..:.:+.....:.•.:tv.:....v... i,....... '.:....../Y�......y.rt.• .n�..v..<.v....�...O.v.:.S+...r.n.r:.::vv•...:n::r. .r::..::•....l::.:}:...+r.....v.k...r......:.:n..:. v.... :ti•..::.v}.:.::...i:.:. {.::;.ninn.::.n...}.v..:{..:.:..n.i,}:.).r;..n::::Y{{..:....?.{,?::,.ri.:•...:..r:vr�. +:{v::�.r,+:..:.:..:;:.::.in:.n g!f.+...•.1..':. n.::n.v:.v:n.{.':v•:•:.rn}:;:...:}:.a?n.:. ::.^.n•:;.:v.i.::.:..n::...::.v4.....• :n.:..i'.:a: \.��....:'.: i.I.:i...I.:} .+.�.:. Y+.{ n.:.n{.•n....{.l.j+..... f....:.....v...:..v..:..: 1-4r:..:..:.:.rv.:..:...^n..::v::?n::::.',S::v::::i:'::•::.:n:.:.. .j...i(..:... r: � .:... ..:n-.)x.'•.:.ti..:..;.:..:.v.v...::+.: .ii+:YLr:.�.�i:}'i:::••� •)�..::..'•?^.}.; .��a.nrw:un•.:•nv.:4.•:rvw:::r:•:w::•u:•:}{.}:}}. nn.................}..................nn.... n....:...... .�.•.....ni..:....n..: ...:.: :w::::•w:::. ry vv wnvr;n{.;:v::•}:v::::: •.?{{{G}:C4i}'r :'•. .....l.......nv........n..........::.vn....... r................. ...:. ..::..:;i.-::.?-.:?..::.•..:. ...�t.�..y..:.: ..}:::..;.:. .•E....•..�....'i.�1.. :....:.........�..... ...... r .................. ...... .. ....... .. n..:: v.::: ••:v::.•:::... .............v.......rv:::::::::::.-: nvynv:::-: r.. n.:... . ............. :r.{,,,vv,.......rxr..v...a,a .r........... :• .. .. .. y:: •.vvv::.v....; .. rn.rrv...rv. n.v.•.. x. rvn x. n..... x:.xv?{?•%}}:?{ititi•5i:•}'n'•}::,•: INCOTERMSIFA.B. POINT SHIP VIA CREDIT TERMS NET 30 DAYS Cptt,�{•}}:{rr'?}tiY::$:;}::'r.'{i}v�.: ......::.x.::... :..v v.::v.... :.:v...v ?? :'•::' .'.: } .•......:.r...........• ....:.::::: ...::..:: •.•:.:i.: n.::r:.:::.vn-:.�::::: ...::: ..: a;v:::::: v::: v. . . ............. f................. ..... x........t......... • . . ..... ... ...... .... n.. r .. .. .n, ... ... ....... .. .... .......... .. ..........:..: v.:•?:v::}:{r:{:{::.•{..:....:::•.vn.n?•:nv::nv....n..x.v::::.:v::::::: nv:: :: v::: }:f�::: :•.vv:mv ..5 ..............n. ry?•:. .r ... ... , ..................r................................ ............ r, .. .. .........n.................................. vn•:{:{::.}•:.'.v:. .......... ... :.........::.:.::..v.rv•:::::nvn•::r:::.w:rv:: n::v.vnv:::::::.:v::: n..: . ........ r}..n.n.nn.n.a,..r .... :. .r:n.. n ......... ........ r..... r. ....... ........... .............. ... •i. v. .• •. .- ..: ••y.:::: ..:..:::n:l::::: r . ... i -::::'r; }::::}: r •::::: mv; nv,nvrv•: r: rv..v...•.•::: n+ +r: n•.{ •: �r'. {Y.a�::..:;.r....;..1..4.:.v::....::::ww:: w::: :•:•v%•.:v v.v� ........�A�Y�n.nnvr.nwrv...n.rv... x.. :. ..a:•i.,•: }: w•}n•: }:: r:: •:::......:�:.. ....... r..r :v: v::: v:: nv:::::::.? vv:n.. :v:::::::rx.:vvv n.:.. ,....: .n... r... . ;............. ...........r............::.-:::.-:.:::.�.�}:::+:.?{+a:•:::•:•:.•::;w:::::,,•-.^::::::{:y:A::::::::.vv{::,:n?•:::..-:::: :• :ti• ; ' � � � � r {::;} )::?•{:' n •:I:IrL IY {: {nv:)v'w: i4}':•% .��YY.!!�........ M!l-i.}:�.. .ty !r r...............:....'�!'!f.:..'+.-�.•.+s.,.:::.l..vnnv: "::. ..........................+..l. .....:..................... n..: }:: r:: :?•v :vv v::::\vw.v:: n;...n........ .}.v.n•..)n........:..........:•.:.v:.l:nv.......n.....nnrv...vv..-:r.:..:....:r...+.::......n '�'{ iv'f.•$:ti•}:•}:•):ti::.}:{n}•n}'{.r.Y:{vv. ••v::: •v:::::::: v::::::•rv:::: x: nvn...:.::.::::::: r. .; } ::•: {• •:r ' • :n .. •.v :•v :•.v::::•?:::)•}• •••.v:i:�•}Y.{?i::•}i:�4)}:vi:^::??J}i: ..................... .... ... r..............................:}:.}}}}:}::.}:::..:.:::::r.,.:}:.�:::::::.�.::::,.:.{.r:;.r::.}:{{.}:v:vr'{:;rr�,:.)'.}'.)�:�:1.�,�"9a...'Q'...:'::::..:::::::..:.:.:r:{,{.r::.:}::::. .......r::.:.�::::: ...... :v.�:::n.:..ara::::..:{.::.r:.:.:.v:...:::::n::..::.::.:.::...:.r...... ^}5}}}'.{.::...... ,,Y,.y:.}r{.};:{ryv::....... .f....... r..::...::.. .........................................:... .:.::. :..... :::.:.•.: :•.v vv::4::: v::::::::: •.v �.v:: v::.v:: •: vv::::.v::nv :?•: v.•:: v:: r:: nv::::J::: r. r. v......... .Y.......... n.. .....i........ r..:: :n}'::: ?v:::.:w::::r rv. nr.r :..............................:.a...............r.........:..............:..........................................,r..........::.:. vr.n:r ..v....a..a ....................... r................. ....... 1. ., :. ., y. ........r...........:..... n.. :}; .:. .. ...:..v:::: n}vv:n•.yvvn v::n•::: n}'.i: .v...:4}}}}}:Li:'.}}}}:.::L}}ii}}:^}'•:v •)::•r. ... ..r....v.... Y......... ......:............ ....... .... r..:... LINE ITEM NUMBER / DESCRIPTION DUE DATE QUANTITY UNIT UNIT PRICE EXTENDED T COMMENTS Please Confirm Price & Delivery Within 48 Hours To Fax# 978-687-7873 Invoice Price Must Match PO Price ATTENTION: Box weight MUST be 40 lbs maxirr um 1 12/15/15 1.0 EA 165,000.00 165,000.00 N CONCRETE TUNNEL Site: A00 Type: Memo Item Not In Inventory CONCRETE TUNNEL REPLACEMENT PROJE T - ROOF AREA H PROJECT BASED ON GALE REPORT SUMMA 1Y DATED: 10/10/15 AND TEST AND ON TEST CUTS ALSO PERFORMED ON HE SAME DATE BASE BID WATTS WATER TECHNOLOGIES 815 CHESTNUT ST NORTH ANDOVER, MA 01845 Net Total 165,000.00 Tao( 0.00 BUYER: Comiskey, J USD Grand Total 165,000.00 Terms & Conditions of Purchase - Rev.11125114 - Apply Here -in By Reference v_.. _—.. r....s at.—� s....ss.�.s—.. —� as....st---a ss..�. s.u..ta.............as.—.....a..--....s—......tt...... The Commonwealth of Massachusetts Department of IndustrialAccidents 1 Congress Street, Suite 100 Boston, MA 02.114-2017 yJ� "t www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Name (Business/Organization/Individual): Address: D IaPAS 42 �- City/State/Zip: 1p T 41&%A t*AT Are you an employer? Check the appropriate box: o lI S Phone #: 79( -aS�11 1. ❑ I am a employer with employees (full and/or part-time).* 2. ❑ I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. Q 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 ensure that all contractors either have workers' compensation insurance or are sole pro rietors with no employees. 5. 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. 6. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no. employees. [No workers' comp. insurance required.] Type of project (required): 7. [l New construction 8. 0 Remodeling 9. [Xemolition 10 ❑ Building addition 11. F1 Electrical repairs or additions 12. E] Plumbing repairs or additions 13. 5?1oof repairs 14.0 Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. i Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees,1hey must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees.' Below is the policy and job site information. ,. 1 f Insurance Company Name. ' R�b` Policy # or Self -ins. Lie. #: % �o u� 8 a F� Expiration Date: 5b h Job Site Address: D l J ���5`t i]� S� City/State/Zip: f{(�J& IM 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 hereby certify under the pains and penalties of perjury that the information provided above is true and correct it/19/► Phone #• :2 gI ` AS ~ 1410 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 #: 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-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to 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 they 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 'Massachusetts - Department of Public Safety Board of Building regulations ar:d Stnnci'ards •t I C ons ii uiiif111 ulci-"i iSbT ' r a % 4 License: CS-076330 � � SCOTT P BAILEY-" 13 Pickman StreeC Salem MA 019702 Expiration 02/15/2017 Commissioner i r' i /t t i i� r r 1 i r 1' i i i 5 $�s S48L0 VW 'H3AOONd H12lON 'm R Z z r ons 133H1S inN1SNO M Q OO F5 IQs °3g S3100IONH031 N31VM SiltlM � � � � a < N 0 83wno 4a4 ' 33 z a Q o ;a dW '83AO4NV HAON p " W V <LL a �as� 133d1S 1f1N1S31-10 91.9 a � � S3100IONH031 831VM Sllb'M a = � m m o u � g Ss r� Q 1i�IOM (131VI00SSV aNV 1N3W30V/ Id38 3008 p ��1 o � � � € p y °8' 'x•' orc g w 0 a z MrMd z a o p o p p J Y. W In o O > o p w z llllll o rn a z 5z o° p W w p F Illllllllill ' N � p po W In �rc zW1 rcQ p �� Illllllllllllll '•••�• $ wp J rcl�w In sJ oy Opp �= arc o a zwm llllllllllllllll,' i7� o o J a Illllllllllllll 0 d° a° o z o Z lllllllllll O o WOrN33 m J �Z z 3 mz .- >1-� llllll))) mzm a w Ewz c a ja z a ¢Z Qpm •llllll) zy a z fvWz z wm z� FZW as 00 No3 lull WES z �In Ow aU oom op zF 200 . llll awo PJQo of rcp as oBj, aw vFi �uai1 Dox a a F o w cio 3 R Ix z pZZ N ZFV 0.- E86 z01¢n HW =ZZ QrQ O a.m 00p O Zo ON w00 SW Wa ¢aQ ��F a W woo 1 !z zci 2RqZ- ox zQ zL^o �xz O O R Noa Z wm m° zoo W7d Wo NdW Z NmRc n ¢� o pw o� Sao �w ~�p Q r Src Z 0 Z J W m o Zc�i� 5 w a J s m3 ct �y °za `r � W O m Ow ¢ W Z Q ¢ O Z a° ° m a Z F z o w 1 0 6 m w zF v=i N -. 0 oo¢ ..m N¢ � W ,s w J o a C) W 0za py wpw mQ = 4� Y j, � J IS O O '-1�C U Y c a a rc 0-' aW O�.o ZFo F3 mzal vxQ° vki yew€1 61 a z wp o�d WZ rcgo 'a6 �$"J �Ow rcavl zoz axN a u pJ ozc� W g�Z ow ¢ WU za° o a1 -v o9 qq O < o �cairw aF UZa yz vx��`aOa oyQ w°z ax= W O U VI N N Z� 2�� NZ 0-� K� Kg.w �a'IA 3¢W K�� , WO O Z� pQ Oa RZ4¢ W. WOu m I p W 1 OW Qz0° Qa QO~ Q� K Oj0 maW KQ ,+• Q( Wai- 1 F� 3aF a X02Z<p UW owe 13F c~i .-w o3 vi v° icwi� xN Xzo ow ozr �a�z Za15 zb5 az3z •-% .- min Uz za 3070 0 O- rirz Oa3 �F •� . l ra WOZ 1-a a'W3 WOU WUW OJZ Uj- zx;N l l O OWO WW a' Oz0 00� OUWa l 14 Fowu x3 2mU iEwo �pN� KOU ow3 0Jz4 j r ni 6 vi w r m a• 71 -tt MI N 1 p EXISTING BUILDING n� imom OI � v Q � D aD � • . c QD v p � 2 Z e W W W Q 0_ 9� i O O cy' a Z z ZP !L O W O z O W U p CY Dv W Z o V o a O N MEN EME W U z m OW 0 O OW Oa. aWj <° M, O'1 6 IK7 N C 0 00: O w 1 NW zW U W T m Owzwo 7 O t6J !- Z O 3 63F y - o a g° ZOKawu 0 0 Z �a W¢ m F Q O 7F IjF�aZ Ln w ^tVly N N ¢ ri O a mvwi371K W W V I Q � V Q a i0 D ,D a I I 1 v D M 1 QD i QD 2 0 v v Q W W J i Q LL- iO 0 Q Q I W F Z �Dv 1 Dv O O w oil m F- F O on U W � � I 1 U) p Z a i (na O z N Da Da w Q D U p Wcoi LL w x O z 0N Z a N o W !f. W o o O m z ww Z a w K F -h3 0 3 Q X a Z Z uF z W w: F n w �j w W r p EXISTING BUILDING n� / mo p Z¢O F pZ 5�W, zg<WJ 3 `d38V 300 1 uoz;5w m W C 0 0 m z H 1-O'i-2 301300 m 1 Q I imom 9� MEN EME oil m on I / mo p Z¢O F pZ 5�W, zg<WJ 3 `d38V 300 1 uoz;5w m W C 0 0 m z H 1-O'i-2 301300 m 1 Q I M CN I m I a x ' j hi$E u 94810 VW 'a3A0aNV HlaoN m y boos' 1332LLS 1f1N1S3H0 Sl6 _ m J S3100IONHO31 N31VM S11VM Z o N Z LO 6 w •o m J c ~ N3Wn0 'H1 sga��ro W m m Y Y < y � V AOON`d H1210N o �„ g4` 1332!19 inN1S3H0 M w 1 m� E 1 S310010NH031 N3iVM Sllb'M a 12 MOM a31d100SS`d ONV 1N3W30V1d321 J008 p ~ 8 w Q8 c 1O3fOad t°u-i� Z a 0 0 0 3 0 0 J J a 3 m V o z O < O rc V€1 m F U O IWC r 0 F ; 4 O C Z O I� 2 0 p O m W • V Q m VT1F U ° Z w w U Ian > K �i D y� O „I F- zcu o a 6 Z 8 ya'� > a ° d p 3 U 0 U 0 m 0 a3 Y O m a i N ° W o Z F Z I'Lu n p 3 . C V V V Q aw ¢ o O p O Q o zn N N a N yF- Q Z 6 ¢ 3 Z ° FF F Q y &I ¢ yayh� p 3 u' ��• •• a •° ° d y Q Q W O =w �' U U U C W W W Om O �� U O rY m W m 6 U Z w • �j 2 ~ W U W W m Q y f- W ly, Ji ly�i In W Z W m Z G <" F �• m y IN z 0 I m Z F N 1 �� J �J m 4 i, Z O W i p W _ F C V m 0 R m 1' Z 1- p w Za d' Oto �o yS g J rc z ww R I 04 zo OJ z� a V v a z o N G° 3 w p z cyS 00 m y d O d VIZ W • ° IF/l� WW IF/1Z J W w a O ty IF/l G1 U U' t' mO 7� U:O Ix y W F F S F4.I •° ° 4 I m W W N N 0 W on W Q C 0 �` I ° •• ° Z F ° w Z F O � W � y R ° y < W y D ° w a o ' i °a F -o W a ° 0 L Lz mo oZ H c __Ll� _` o �o Q= W U --- - ` pa e w -,5:1o ° 0 I_a0 pOH Z. Ld = Va6 M�_� In Q Z a a] m o o a III—I I—III—I I—I I—I U' 3 0 w o ''"W WQ� mom II—I1I—ISI—III—ISI—ISI OW I ��� o ° ° 2 O .0 w oo� ms�za Q°� 920 III—III—ISI—iII—III I—IIII�I�II-111—I1„ Q N 'A <pm�; ot��m n° ° ° in V) 0 zoz< x In Qaa cmZ zo Q w w 0 in w 6 VI r Gam' Zp\Z twn� V a �i ya,� JN~� ,III_ J J ^J^ V< 2 S V1 aI"N ° ' < 'C J Z aJ NZ > aJ< <w� In LL yv zo Z yF ° ° in N=6= ^Qam Z� V}I3VOW WW=_aVI�V V 2 O -CO =i V=I W a 03 0. 0 y W WVI� 00.0 < 3 �i �3 aZ0 o Njn O z zoZ o Q=p Nog m - O U o O jaatn mog i mrc oZ 5 c� 5 N m o OR Q p$+Uf SQZ <0� 00 taj 06m O V 3 Q Z 06Z 02 -C mow t� ) Z w m O o tnNmW W��m wa �Fp 0 QUW GNQ O O� rc�� k\ 0 m� 1.yamI oz Q o Q7y ZF0 Oona rc 0 a w m a w w min j F_WZ �XX �w w ,F • ns m mU Z w d m� t¢Fa� 0 w c tQZ- c� o f' O m�Q < �p0 7� Jo yrS J 00� W Z jV O Q w�• Z N I m 4 O < *Ja JWZ 1<- Vor, In ¢ F y p U U a m 0 p Q~0, O 3i1Ki QOW <wo 0 WKy Wm1 QW F_m W. ZZQ N W- yW Q w O a 3 a IaF-OW 6y�j0 Wd'IK.a� 1.1 m Q p>' tai ¢p W F Q iil Z N m F mFQQ;m OQ S�09 I Q W WyZy < m 0 w 1WWJ m WKy ��U M,� a U yK < �J Om x 3 Q x W W W VI y uF1 W d y WN O tF1�-II�V t.lym W...l< V WF ~WV Z b! 04 O Z J F� 0 UEWJ=O y~j ywjm W Q VC 4 aT w Z 2a6N IL inZ WyZO 1yJ Vw1J a QO �, UOK Zt=i1Z Z m Z Z Zz Z_ 1 ,aJ 1J tw/IJ y�j 4N?aV ym W WU3Z 1-�.-•�72 F_N F�yQ 7 3-. RT/10 W YSZ �� NWZ Wdm yQy Vwl pNp W S2 SZ� W W ~QJJO ~�1~/li m 0 Z Q O ° VI iti a D a G Z N w ° • ° Z N W a a •°� ° O k J ° ^�^ z LL N a, ep ° J Q Q 0 Q w ° W Q Z to Z y W y -m I I N 3 Z cai ° ° J w Q OW 0: a o ° W Z37~ OW OV=jZa •^Q fZU Q=�Q •gym Q O .Oz ° z M� oozes 0 C U Hi ° 0 ''"ryQ�' O O Z wEL a ° aF� y� mR".0immI a,naWQ4 UQ Of pmK �• yy yOrl F- wmo6 N In <d Z ���o1ri a5ai UUWN r W Z a m m 3 Y W U Z2 O Z O F Q Q Z 0 a O y Q y 4o J z a a 3 u o cm3 •r D U 0 m o U ° g a ° Z 0 I a 1"" F y m m w p km Z a o Q F w `S N W a n W V p 1U1 ^ W K N ii O R Vwl W p Q N A Z •° ° I O a O e 0 0 Uz o o °' n N z W ° Zf D ° 111 Q d a° ° ° Ql W a O • } Q ° °, Y a msF • v° o N w mo n o ° J z o FaQ ° Z t yl VCQ p W N IO }Sw Z �f/1 J 0 � Hai w}Q I 0° C 0 J ;^ Z wo' 0 W Iwo W ) y O f_- m m I %V' m J a 15 a m Z z F O w w I I—III—III—III—III—_ ° III—III-III—III—III—I y3j O Z X03 m o m p 5 ow 0_ • I a U W aomovi I I-1 1=III=III=III=III- r f— q O y owI- p o a s tY a a w o a w z t^ n a w~ _ _ III=III—I I—III—III _ _ a Q o y 0 o a a QyK w 0 m �I�YYj 6 m Z e z W z Q O p 0 �— 2 Q J o a Zoy a I I—III—III= 111—IT'- M I I_ N "m Q` p F- N wp O tZ O U IL 1<a w F K V O amW 3 0 O O K O V Q y... a Vl W O�NC C UQ y.. y2 m�y V� m? V m¢ O K O �F- H F F VI y F y <Z"� 0Wm y N L Om. W -W W ,Iq��{ tkt�'Z v VI�U *, 91r/1'9U I m I a x ' j 9o°$= 09LO M �N30oNV INONfi. 2f5d z CVg OS3100IONHOM 831VM S1VM g !ssLL ,o a3wno N g` Q t VV4 83A00NV HINON a v �0 a 133NiS inN1S3HO Sl8 w 5 $ E IS E S3100IONH031 831`dM S1111M� z m m MOM 031`dIOOSS`d (INV 1N3W33Vld3N 300215 Q Y O E w133road i S o `o 0 W wo J UOZ O mac va< J O a�m a -m ¢W Z K W m Q y�� Y �Tj~ U W co Q'`O� U O N O `00(/1 N SWF ¢ C OQ O K O O O MZ OW <VO=1NW u O m Z F OOA4a O H N O O zz (L 0OZ y a N W QZ"O m W Q m K m Z ZO\Z m z N O = 1 U O Q Z ^ O PI=Q g z a 3 v to a m1'"m 0 neo c zi z z F z z M W a mmJ O ai F= Ion I5F/�l N i U (a9 O(7 Q W 41 {J IJ a w m Z MJ � w _ W O Z �i Oz W z 2 O Z cFi m v K za z a p� K Z � C QV z Zo $ ; z 5 z a o s a m a z$w a m g ON IL O m W= �^ O a w m tmi. tYi ° uwi ZO o O¢O o 0 n Q C O F K vc O a ja Ww CW m to z o V W a¢ oU ta1,0 z d X W. WR to W Fm8 8 U U=0 O Vw m o a t z wZ Z pm vQ 0 G1 m R m N �i W w tw r a m < o m 4 O Q zp W M aO 0 gp9 yWZ� F m N V W W 3 F U K p A� IIII (III KE_ W �3 a0 U Q f5 p W y¢QQ1 oyCt.Zm O w H O W O ZZ� m 0 3 Z 2 cj'� N Oat UW Wm F Q ZCA FW� OO Q ZU V Og OV W —2.0 QU 12 Y \ x. O Wa, ' N CZ ttO��m z a a w W= F S F3 ti 3'Sw wo U.F`s� 2wW w wa z Oao zo ~¢ a)} V2 Uwa Ni Wa N X VUmW ZU2 3d O i?3 NCZ 7 Y� W YUQ WV71m M M v 0 a I� a Q Q p A p A Q Z Q p p4 a p Q I G I v a M p 0 a I� a M pvi Z Q I I V, I v Lld Q F Z F 0 w Z < w a p O 4 Of WO z z 0 < Q aj o K O 0} f V ~ p 6 m 1.LJ N U } 3 O w Q O o z O Q i r. to ¢ Z ZW Q m W p Q Z = Q O � 3� OZ � 0 w Z, O V 0 O Z z -r t�� W z KZ d Fa W OF� 6 7 .O Uy u+ �J 7 L ZO 3 O Q I Y K O I loi z Z Oj K �O N �V~I Ka M. O i p O OW CK 0 H O N¢ O W G y g Q F W•A yaj aQ FO j0 m �� �ul �H rc Z'I'Q ¢ a W O O 6 K O �jil F W y w Z Z W pON Sa N W NO J= Q O- U� O z �N N Q b`< k' m W K O Y a K o< z w Y. Q JJ arc FN wo OZ F O'n NYU O g m_ to WYE a x Q J F m a ZZ 2 3 O w¢ ¢ U rc m VU1v FO a3 rrF m� pQQ 2O m Fa F F W W mw �j a z o I a W z z J z r ^ WK p0o'S 33U L7 z Z op o pQ n j Wm m o W M Y V OJ m J m F Wj N O 2 Q J N a W F to fn Si tnJ3 J W m m w N W 4 O l -i N W m W W ` W p U m Q i I ��LLMEYER 13 IL CORP 3 Massachusetts - De.[partmerit of Public Safety Soard.of.Building Regulatic `ns"ai-,l Standard's r Conitruction sup mviSi'ir License: CS -076330_ SCOTT P BAILEY-` (I l 13 Pickman Street Salem MA 019707 r Expiration Commissioner 02/15/2017 1 f, J i { i i r� 3 Massachusetts - De.[partmerit of Public Safety Soard.of.Building Regulatic `ns"ai-,l Standard's r Conitruction sup mviSi'ir License: CS -076330_ SCOTT P BAILEY-` (I l 13 Pickman Street Salem MA 019707 r Expiration Commissioner 02/15/2017 /00 i Location 65— �S No. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee rJ $ �� TOTAL $ Check #�2z 35 1l, Building Inspector r 1i: U N L O 4- c O ,F L Q ch cu O O C L U N N Q C6 O = O N N w O Cl) LL cc O UJ N o a O 4C L c: O) O .0 0 U (p O O Q. O O N � O N �- 4-- N N � N CU �O m NE a) aD cn O �- rn O .qU E L- CL o (D i U c U cn N •— N N O >CU Q O Ok +' 4.1 O O O L O � W70 N U U U) X O Cl) LLC Ln CL O N O O M N 4 0 N = 'C L CO O Z •— U), O UU) O O 4� U N a O CU a)N U .0 4- r 00 O O cy cn0a O L6 N :D m O O .2 > 13 H m O w a w a co co w I-- Z J J J J Z w `w r Z CD c m 0 L- 0 O U N Q N C 0 0 00 00 M � Cd N N U � O U �U� A O l •' Y= O ; [� W J Jz < GO G �e+C A 1i: U N L O 4- c O ,F L Q ch cu O O C L U N N Q C6 O = O N N w O Cl) LL cc O UJ N o a O 4C L c: O) O .0 0 U (p O O Q. O O N � O N �- 4-- N N � N CU �O m NE a) aD cn O �- rn O .qU E L- CL o (D i U c U cn N •— N N O >CU Q O Ok +' 4.1 O O O L O � W70 N U U U) X O Cl) LLC Ln CL O N O O M N 4 0 N = 'C L CO O Z •— U), O UU) O O 4� U N a O CU a)N U .0 4- r 00 O O cy cn0a O L6 N :D m O O .2 > 13 H m O w a w a co co w I-- Z J J J J Z w `w r Z CD c m 0 L- 0 O U N Q N C 0 0 00 00 M � Cd N N U � O U �U� SIGN PERMIT APPLICATION 1600 Osgood Street Building 20, Suite 2-36 TOWN OF NORTH ANDOVER W "J- Site Owner OA5C✓__ Site Address 1'5 CAe.S k"+ �ee_+__ May Parcel a 10107 How attached:a Against the wall 9 Roof c) Ground d) Other Proposed Colors: Background WqL� Lettering l ik Cl L�lx L!`� LSF Border %Ltd -CIS. Required Attachments: / Photographs of bui ding V Material sample Color sample t/ Site or Plot Plan (Required for all free-standing signs) Drawings of proposed sign✓ Other, specify Will sign overhang any public road or walkway Yes ( ) No If Yes, Name of Agency who will provide liability AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED:, Receipt # _ Revised 10.31.2006Fortn Sign Permit Application ,AdGcm Lis o 0 �s a� A6 C -L Aje- i7 '4� 9�a� ; �� LSO Applicant ',qN Tel Sya 96 Size of Proposed Sign _ I Illumination: ®Not illuminated Jcw b) Internally illuminated Nj `SIG c) Externally illuminated Materials: FA 8 (Z: CA -7E fl '4 tom Cost ofSigrt Note: No permanent/temporary sign shall be erected, or enlarged until an application on the appropriate form furnished by the Sign Office has been filed with the Sign Officer containing such information including photographs, plans and scale drawings, as he may require, and a permit for such erection, alteration, or enlargement has been issued by him. Such permit shall be issued only of the Sign Officer determines that the sign complies or will comply with all applicable provisions of the By -Law. -trl V, SIGNATLJRE PF APPLICANT Ac�Lev4-go&I APPROVED u cc i+ O d C7. tC Ln ei en N c Ch 00 N N 41 u Q� .O OL to (A c O s d O EO V O u a o +1 O CC CL — O o 0 Cn 2 O Q z 0 a cm L..., 0 lC 01 tp N rr-I 00 O I,- d O rv1 00' a -i a i N 0 0 0 N 0) M M I� in u1 N O Ql NO 0 00 C lU Il e -i r-1 V} i/► O O O O Ol N M M N uf1 O Of 0(i O tD O � 41 O m LAi N l0 of Y- a }r t H C L Q ei +�7E fl E o u p c w- c 7 O O Q m 41 fu +� s a! N aD Q a9 a� `- 41 Ec M m _ E 3 Vi W i s ._ a) _3 E O w ofm 41 0) N vi u C u —c v Q ? N W u1 a) ?- c c a! aJ Q a) w G in m N O '� c V [i 0 N 4A z O m CL O u N a 'u N Ll c N m E O CL m C Zi in p m 0 m in j O p p .0 fl O �' m O .- CA O i, tca t`1 to N -0 of -0 4-, a) c m 00 c M O y m - 3 c ,-• s Wc _ O X CL Y O O o N fl' W E y 40 tub N U X U 4+ L .a to Q ° 4' m c u m i 00 a Jm a EOD � +�+ m Y Ob c CL � n � ._ a� in a z irs U t6 a c a� O O �n 'N I w dD rn L p 'i 4; I7. a) uo N 4Jiii CD i V 7 _ OL O on p w °A 3 o v n ami o O m '�- eta CO ami i � Y vmi a) c m c O O Q m c m Y c E v O CJ O p mO `. s r. 0)$ tco - u m io E C to E 40 v o0 L- O N O a0 O IS t0 O ; t7 tea to to c -t � tC Ln ei en N c Ch 00 N N 41 u Q� .O OL to (A c O s d O EO V O u a o +1 O CC CL — O o 0 Cn 2 O Q z 0 a cm L..., 0 "I 0 al 6uipl!na 0 tY w CD (L) cli m Co dC( Ln 00 0 CI Cj M "I 0 al 6uipl!na 0 tY Ln 00 0 0 M D SOIBOIOULIOOJL Jelem Sl —LVMcr "I R O (30 O is u CL0 c C, N 0y 0 0 0 to CQ m r--4 - "qlq� wommomaww- j J/1$-'5 Lu:i 0 Z 00 CL0 (]I Buippq Qh Y 1. � 00 an m 00 N 0 0 Ll rn I m w D C) (D SalBoloutpejL Jolem SJ-LVM § CO (D cc "qlq� wommomaww- j J/1$-'5 Lu:i 0 Z 00 J I.- Q z W Z 0 O F- W W QO 0 O Q z D ;E z O Q C) U 2 CD LLI LU LU m fn > (Y-1 00000 F CL Y '011 SNOUVOINANNOO NOIS30 N cc l o LQ 0 O �nun� U 'nun�un' V N r.. Lo r cr, o �� C, ALIGN co ,.OT a cuo L, �. CD C= 4-a T G d ^ COO H co co CN cm C �j O 7 C OO ea N 1i N 4 o cnm W W .. a- a '� V u Z Y y fl. O C2 N N °° m CD —i col vi . G V Z O H W J W l 0 O �nun� U 'nun�un' V N ALIGN ,.OT „9-,b „L Z O H W J W S: N ►2 O J W m N a N W as r- rW J LU N J (n (n L¢ mL_ LL N V > N Z O u U LU Z Z O U N N m LL W N J N a W W J N Z N m LQL J v � 6 7 m ci N O a W W Q r - Z Lu H cnJ N N J H LL O v z N O a W W ~Q z LU H J N O N J m H LL O N Z ,� „YTT QI N Z O H I- U W Z Z O U mm LL H W N (n 04 0 m LU J N N m a W v I. - .C2 CU '017 SNOIIVJINnNNOO NOIS30 _ txo co coV C"^ CQ L m Z C Y G 0 W O C ri ca J d CCD � R CD V O W N hQ CC li N Q C2 cn cc cn S: N ►2 O J W m N a N W as r- rW J LU N J (n (n L¢ mL_ LL N V > N Z O u U LU Z Z O U N N m LL W N J N a W W J N Z N m LQL J v � 6 7 m ci N O a W W Q r - Z Lu H cnJ N N J H LL O v z N O a W W ~Q z LU H J N O N J m H LL O N Z ,� „YTT QI N Z O H I- U W Z Z O U mm LL H W N (n 04 0 m LU J N N m a W v I. - .C2 CU COO txo co coV CQ L m Z C Y G W O C LL H Z H z W a J H Q LU W C) (D z H z Z D O aj f'- Q p z Z L --� D W ZD z Z Sc H Z W Z � 0 U � J Q Z O h - W U Z > O (D w • 000 391 Date.!.�� ,,ORTk TOWN OF NORTH ANDOVER pf ao ,e1't'O p� PERMIT FOR MECHANICAL INSTALLATION D s This certifies that . ! 1. v' .0 L �!l has permission for mechanical installation ................ in the buildings of ►)4 ik ............................... ✓ , North Andover, Mass. Feej�l?i Lic. No/4M4� ... ........ ................ GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 'a Y Date Commonwealth of Massachusetts Sheet Metal Permit Estimated Job Cost: qDK . - Plans Submitted: YES V/' NO Business License:9 3 Business Information: New C11C.1d Name: 30,41�— Street: Mee,-,. a,, City/Town: SCe; aro .N� (75''Q% q Telephone: Z- 2-3-Z' ,"?A /._ Permit # Permit Fee: $ Plans Reviewed: YES NO Applicant License # l l b o Property Owner / Job Location Information: Name: 6 Street: E3 / S & J 4-rjv� S+-, City/Town: Nom kt�o`.Kr- Telephone: Photo I.D. required / Copy of Photo I.D. attached: YES NO Building Type: Residential: 1-2 family Multi -family Condo / Townhouses Commercial: Office V Retail Industrial Educational Institutional. Building Cubic Footage: under 35,000 cu. ft. V over 35,000 cu. ft. Sheet metal work to be completed: New Work: V Renovation: HVAC __(// Metal Roofing Kitchen -Exhaust System Chimney / Vents Provide brief description of work to be done: i�S- U C �( C)Uck f r<C- D`S D4 �-, � a -d yr A INSURANCE COVERAGE: 1 have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch.112 Yes eNo ❑ If you have checked Yes, indicate the type of coverage by checking the appropriate box below: A liability insurance policy d Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box[X, II 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 sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Date t Date By_ Title Cityrrown Permit # Fee $ Inspector Signature of Permit Approval Progress Inspections Comments Final Inspection Type of License: ❑ Master ❑ Master -Restricted ❑Journeyperson ❑Journeyperson-Restricted Comments Signature of Licensee License Number: Check at www.mass.gov/dpi Sheet Metal Commercial Guidelines / Life Safety / Critical Systems Inspection Checklist Yes No N/A, Set of stamped engineering documents and detailed description of mechanical system to be installed has been provided All workers performing sheet metal work onsite has valid Massachusetts sheet metal license All sheet -metal work being performed with proper journeyperson-to-apprentice ratios Fire dampers with access door properly installed and checked for operation Smoke and combination tire/ smoke dampers with access doors properly installed - actuator checked for proper operation (May also be verified by fire department during fire alarm testing) Duct smoke detectors with access doors properly located (May also be verified by fire department during fire alarm testing) Smoke / atrium exhaust systems installed and operation verified (May also be verified by fire department during fire alarm testing) Stair pressurization systems installed (where required) and operation verified (May also be verified by fire department during fire alarm testing) Grease / kitchen hood exhaust system installed with all seams and connections welded airtight with properly located cleanouts. Proper cle��`ances, fire rated enclosures and pressure testing required: ; ��C.i L e��,:aint3 installed Eh 1 id r quirecl on egtiiprnent and — :...:1_. .. . _ .. Duct penetrations in fi3:e'rdtc i-,!all:3 and floors sealed' Metal roofing systems installed watertight using proper materials and fasteners Flexible duct runs installed 6'-0" maximum length Ductwork installed using proper hanger spacing, hanger stock, threaded rod and angle iron Ductwork / plenum connections sealed substantially airtight Ductwork insulated by means of external covering or internal lining Volume dampers installed for each supply air branch duct New/clean - properly sized filters installed (final inspection) Testing and Balancing report complete (final sign -of) Sheet Metal Residential Guidelines /)inspection Checklist Yes No N/A Detailed description and sketch of sheet metal system to be installed has been provided All workers performing sheet metal work onsite has valid Massachusetts sheet metal license All sheet metal work being performed with proper joumeyperson-to- apprentice ratios Equipment sized per heating / cooling load calculations Duct work sized per manual "D" calculations Bath / shower rooms contain mechanical exhaust fan vented outdoors Electric dryer exhaust properly installed maximum total run 35'-0", maximum flexible run 8'-0" Flexible duct runs installed I4'-0" maximum length Volume dampers installed for each supply air branch duct Ductwork installed using proper gauges and hangers Ductwork / plenum connections sealed substantially airtight r Ductwork insulated by means of external covering or internal lining New/clean - properly sized filter installed (final inspection) Testing and Balancing report complete (final sign -off) # 'COMMONWEALTH OF MA'S§Ad:i4f-JSFT tit :.: Date .... 1�`-.—'.'.� TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that has permission for gas inst ation .....� .................... (......................... in the buildings of ...... ,,,,,,,,,,,,, at.......�U.�.� C-oS `�-....... ... ..................................... North Andover, Mass. Fee ....................... Lic. No. Tk(.M......... ..................................................................... ! GAS INSPECTOR Check # 3 � � 1 L, 245 pll�- MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK - CITY ,NorthAndover jj �qq MA DATE 1012312015_.. PERMIT �7i"L l JOBSITE ADDRESS 815 Chesnut St OWNER'S NAME lWatts Water Tech GOWNER ADDRESS _ TEL FAX TYPE OR PRINT OCCUPANCY TYPE COMMERCIAL J EDUCATIONAL ® RESIDENTIAL CLEARLY NEW: ® RENOVATION: ❑ REPLACEMENT: 0 PLANS SUBMITTED: YES® N0[j APPLIANCES 1 FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER ! . _ fI� ItLD BOOSTER, CONVERSION BURNER �:- . w .. - . �'� ti _ L._,...:II ...._� J COOK STOVE r,_ ._..- I _ .-.. . DIRECT VENT HEATER{ _ DRYER T�� _� wk_.�11- FIREPLACE I I � - FRYOLATOR,1'. FURNACEme-I1 GENERATOR ;- 1 GRILLE(I - I^ IL _Tt� _ INFRARED HEATER t # _. �_. ��..,_ t;1 p ffj jj LABORATORY COCKS L, _'�_--_. �. -._ �....�. `{-_—�,—__ I1 MAKEUP AIR UNIT—I'!�1I— OVEN POOL HEATER ROOM I SPACE HEATER `- ROOF TOP UNIT :_— TEST UNIT HEATER ��_.'- _ .-� +�ftI UNVENTED ROOM HEATER WATER HEATER - OTHER w ��..�..... 1. . INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch.142 YES 0 NO Q I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 0 OTHER TYPE 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 ij AGENT Lj SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application ar ue and ccurate to est nowledge and that all plumbing work and installations performed under the permit issued for this application will be in om nc with all.P ine vision f the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. /14 PLUMBER-GASFITTER NAME David Divris LICENSE # 13469 SIGNATU MP Lj MGF ® JP Lj JGF [3 LPGI ® CORPORATION f-,-I# j=3003, PARTNERSHIP ®#D LLC [J# COMPANY NAME 3Medford Wellington Service ADDRESS 39 Executive Park Drive CITY Billerica STATE MA ZIP 01862�TEL 781 3965279 FAX I I CELL 617 590 3599 ;EMAILDavidd@medfordwelhngton.com , Department of Industfial Accidents .=%' I (' Office of Investigations 1 Congress Street, Suite 100 Boston, AVIA 02114-2017 ivww.nAiss. a ov/dia Workers' Compensation Insiirance Affidavit: ]Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le!jibly 1Vam1 (Business/Ornanization/Indivi dual): Medford Wellington Service Address: 9 Executive Park Drive State/Zip: Billerica MA 01862 Phone #: 781 396 5279 Are you an employer? Check the appropriate box: 1. F I am a employer with 100 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.$ 5. ❑ We are a corporation and its required.] �. ❑ I am a homeowner doing all work officers have exercised their myself. [Ido workers' comp. right of exemption per MGL insurance required.] t c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13. ❑ Other 'Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ABC MA Self Ins. Policy # or Self -ins. Lic. #:ABCMA 005029-15 Expiration Date: 1-1-2016 Job Site Address: S C4 e S N(J � City/State/Zip: ) v A kV00 05 4ttach 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 )f up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of aivestigations of the DIA for insurance coverage verification. I do hereby cer fv un er the p rd p nalties ofperjury that the information provided above is true and correct. 3ianature: Date: Zd a 1 LOhone #: 781 396 5279 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): oto �� n�00J� n 0 00a¢.d `''v'��. 0 lT1vWiNviO� � C7 a W3a�4 .g. W C7 r E M0V lj rm r E f7O. C I ol W oo a.o Ir S ^' m o o tr ; m o d mr • is Ci e A o 0 0 in O C O .. N p r G O yc O W < r = t A O 3' Irl = 3 y m� 2'• maT ' S N< r o g v< n .a •Som cm, 2 O N r n N C < N D p < NN r N NH gy�yD V] a ~ y m DO O p N O Oo M N y� a 2 m CD D D m n Z � a 1 m m r� y a Y i y r m A� yND1 11I. -rt -1 N A Z n U1 Q D n N F+ V H c7p = V N N Ivry ON m W r N C W 07N N p A nr A i IV u r yr�C7zi d H-1LA' ?rt O 7 O C3 A+ (IQ O � C• � N ~ CD �• n O ACD t "d N a, 0- cD G 0 0 a O N LT c 0 N. :3 �, s n r N O ^ w Q � N Q (7 O o u, 3 Q O 0 D Q' � m 0 0 3 v Locationj� (�rSl i✓Ci� S No. Jff �2 Check # 6 Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $y— Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Br#6ing Inspector C�Pe�.�ti�l� � It 22ti5� ��15 ����� I BUILDING PERMIT �? ;��```°°•e"° TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION hermit NO: Date Received° �i9S5 �n° Date Issued:/G��f. ACHU RTANT: Applicant must complete all items on this LOCATION 815 Chestnut Street. North Andover MA Print PROPERTY OWNER_ WATTS Regulator Company Print MAP NO: 107.0 PARCEL- 0022 ZONING DISTRICT Historic District yes Machine Shop Villaae ves TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition - Two or more family Industrial X Alteration No. of units: X Commercial Others: -' Repair, replacement Assessory Bldg Demolition Other . Septic Well Floodplain Wetlands Watershed District Water/Sewer Interior renovation and upgrades to existing egress stairs. Identification Please Type or Print Clearly) OWNER: Name: Jackie Comiskey Phone: 978-689-6067 Address: CONTRACTOR ,_ _ �� Name: Address: Li 21 East Street Winchester, MA 01890 Supervisor's Construction License: CS -097661 Home Improvement License: Phone: 781-721-1100 ell a-1 Exp. Date: 08/09/15 Exp Date: ARCHITECT/ENGINEER The H.L. Turner Group Inc. Phone: 603-228-1122 Address: 27 Locke Road Concord, NH 03301 Reg. No. FEE Sd, iMWDI�-,, BULDING PERMIT: 512.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cos, 275,710 FEE: $ 3,309 Check No.:_Cz L. Receipt No.. NOTE: Persons cnntV w ting wit a unreg' t Teri contractors rlo not have access to ran Signature of Agent/0 _ x ignature of contracto_ Rf I 00'a r-` = -4 Z5 0 E. < ED C p ECD rL C) Z C) ? =r., O = 5r 03 - g .-�- Q Q — CL 0ft til ED — CII ID mem- Q n 0_pm rt .-F o rfl o I CD CL c CA a� aR �•,. �r o A _ 0 M C X >(D C i -E Z :a0go X.K C7 ca � � to C tp -! �i a o CL - tDp ' CA o ; m mom'` w _ .. �. CD m ? �-- CD �` _ Co0 (D - = CO 570 CC CD i` .-i Ol _ M C s S C S amem T FP6. S ffi h. 5. c � ern Cto � en 0s 2 CA C rn _ Qm ! e�sr rn 2 �^►As s 1 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 27'55,710.00 m $ - $ 3,308.52 Plumbing Fee $ 413.57 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 413.57 Total fees collected $ 4,235.65 815 Chestnut Street 311-2016 on 9/9/2016 Interior Renovations Details Page 1 of 1 The Official Website of the Executive Office of Public Safety and Security (EOPSS) Mass.Gov Home State Agencies see Details jrr'-hoa_r�nIrInformationame:. EI er: 2: GEORGETOWN MA 01833 (cense No: G6-097661 License Type: Construction Supervisor rofession: Building Licenses Date of Last Renewal: 9/8/2015 ;sue Date: Expiration Date: 8/9/2017 icense Status: Active Today's Date: 9/22/2015 econdary License: going Business As: - linlip No mere ulslte Inrormauon No Discipline Information ocumen um Close Window © 2011 Commonwealth of Massachusetts Site Policies Contact Us http://elicense.chs.state.ma.us/Verification/Details.aspx?agency_id=1&license_id=286609& 9/22/2015 rA F-� 0 J _ LL. p m N Y \ LL. U N 0 u V) Z Z m "6 C LLL t w C E U LL O V Ill N Z Z J d t to d' LL O U I'l N Z U W J W t W OC U Ln - LL OC F- a Z t w d' - LL Z uiLli Q 0 LLIW LL m N N Y Ln w ui am FM O : LU z Z �• m vI 0 C0 G 0 Lu I N x LL, U N W CL Z M O E O Z O N I a 0 1— .E W d a �s O �+ v O !cCL a CL 0 Q O s r V J 'CL O d U) Z CD U cU m _ !Q � �U .a O� yr O O 'Q cc Q. d c� 4- O 4) im N a • tm E O t y OL U: avi 3 CO J LU >_ � L j: O O N d =a)a c� N O Fj: — C 'a Aj: V C� .a N O Q E c m CL U) o O N ti:t•n c �• 3 0 _\ c 10- CLCLaD S 'N ~ m am cc� N x H a) ON CL 14- C,3W_ C •a � O O CD LL '0 N N C . Lt = .2 O :E v Q W'E U Q .r- O •a a� x H cc s C LO O O J.. CLOU FM O : LU z Z �• m vI 0 C0 G 0 Lu I N x LL, U N W CL Z M O E O Z O N I a 0 1— .E W d a �s O �+ v O !cCL a CL 0 Q O s r V J 'CL O d U) Z CD U cU m _ !Q � �U Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 27'55,710.00 m $ - $ 3,308.52 Plumbing Fee $ 413.57 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 413.57 Total fees collected $ 4,235.65 815 Chestnut Street 311-20#6 on 9/9/2015 Renovations to stairs Page 1 of 1 ifililse CONSTRUCTION CSI # Client: Watts Water Technologies, Inc. Project: Code Compliance/Stair Improvement Project - PI Location: 815 Chestnut Street - North Andover, MA Date of Estimate: 7 -May -15; Rev 19 -May -15; Rev 20 -May -15; Rev 2' Plan Date: 17 -Apr -15 Estimate #: E15-082 Owner Contract Trade Total 02100 Demolition $12,425 02500 Sitework $8,750 03300 Concrete $12,790 04500 Masonry $7,900 05500 Structural Steel/Misc. Metals $83,400 06000 Rough / Finish Carpentry $5,000 07000 Thermal and Moisture Protection $0 08100 Doors, Frames and Hardware $22,375 08800 Glass & Glazing $4,500 09250 Drywall $19,850 09500 Acoustical Ceilings $6,405 09650 Flooring $21,909 09900 Painting $4,465 10100 Specialties $0 11100 Equipment $0 12100 Furnishings $0 15300 Fire Protection $3,735 15400 Plumbing $18,770 15500 HVAC $17,086 16000 Electrical $26,350 Subtotal $275,710 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans X❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMENTS CONSERVATION ■ ■ COMMENTS DATE REJECTED HEALTH COMMENTS DATE APPROVED Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no. Located at 124 Main Street _ Fire Department signature/date COMMENTS COMMONWEALTH OF MASSACHUSETTS STATE BUILDING CODE 780 CMR, 8TH EDITION CHAPTER 9 FIRE PROTECTION SYSTEMS NARRATIVE REPORT 780 CMR - 901.2.1 PROJECT NAME: ADDRESS: RDK PROJECT #: DATE OF ISSUE: Watts Water Technologies Stair Upgrades 815 Chestnut Street North Andover, MA 20150245.00 August 25, 2015 Andover I Amherst I Boston I Charlotte I Durham w;*.re_rdk--ng;n,ers._czm 780 CMR 901.2.1 Fire Protection Systems Narrative Report — August 25, 2015 Project Name: Watts Water Technologies Stair Upgrades RDK Project Number: 20150245.00 As required by 780 CMR §901.2.1, this narrative report is a written description of the proposed fire protection system features to be installed as part of the Watts Water Technologies Stair Upgrades project located at 815 Chestnut Street in North Andover, Massachusetts. 90.1.2.1_(1)(i) - BASIS (METHODOLOGY) OF DESIGN Section 1 - Building Description A. "Use" Group(s) within Scope of Renovation: "B" Business (office). B. Location & Area of Renovation: Stairwells 1, 3 and 4 as shown on Architects drawings. C. Existing Building Height & Area 1. Height: Two (2)] stories above grade; one (1) story below grade. 2. Area: — 66,500 sqft total. D. Type(s) of Construction: 1. Existing protected non-combustible. E. Hazardous Material Usage and Storage: None in excess of exempt amounts within scope of renovation. F. High -pile Storage (over 12 ft.) of Commodities: None within scope of renovation. G. Site Access Arrangement for Emergency Response Vehicles: Existing features to remain; not affected by scope of renovation. Section 2 - Applicable Laws, Regulations & Standards A. Massachusetts State General Laws (MGL), Chapter 148 1. MGL §148, sections as applicable. B. 780 CMR — Massachusetts State Building Code, 8th Edition (amended IBC -2009) 1. Chapter 9 "Fire Protection Systems" 2. Chapter 34 "Existing Structures" C. Existing Building Code of Massachusetts (amended IEBC-2009) 1. Chapter 7 "Alterations — Level 2" 527 CMR — Massachusetts State Fire Prevention Regulations 2. Chapter 10 "Fire Prevention, General Provisions" 3. Chapter 12 "2014 Massachusetts Electrical Code Amendments" D. 521 CMR — Massachusetts Architectural Access Board Page 1 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — August 25, 2015 Project Name: Watts Water Technologies Stair Upgrades RDK Project Number: 20150245.00 Section 40 "Visual Alarms" E. , National Fire Protection Association (NFPA) Standards: NFPA 13 (2013) — "Installation of Sprinkler Systems" NFPA 70 (2014) — "National Electric Code" as amended by 527 CMR Chapter 12 "Massachusetts State Electrical Code" NFPA 72 (2010) — "National Fire Alarm Code" F. Federal Regulations (significant requirements thereof to the extent applicable to RDK scope) 28 CFR Part 36, ADA Standards for Accessible Design 2. 29 CFR Part 1910, Occupational Safety & Health Standards G. Documented Local Ordinances (Voluntary Compliance) 1. local bylaws and ordinances Section 3 - Design Responsibility for Fire Protection Systems A. Engineer of Record: RDK Engineers (RDK) has engineered and specified the fire protection systems to be installed. For each fire protection system designed by RDK, RDK shall review the installing contractor's Tier II shop drawings for conformance to the approved construction documents and be present at the site at intervals appropriate to become generally familiar with the progress and quality of work and to determine if the work is being performed in manner consistent with the construction documents and 780 CMR. RDK shall certify each fire protection system installation to the extent required by 780 CMR §901.5.1(1). B. Architect of Record: The H.L. Turner Group, Inc, has designed and specified the architectural features to be constructed, including means of egress, fire resistance construction and interior finish. The H.L. Turner Group, Inc., shall review the installing contractor's Tier II shop drawings for conformance to the approved construction documents and be present at the site at intervals appropriate to.become generally familiar with the progress and quality of work and to determine if the work is being performed in manner consistent with the construction documents and 780 CMR. Section 4 - Fire Protection Systems to be Installed A. Fire Mains & Hydrants: Existing features to remain; not affected by scope of renovation. B. Automatic Sprinkler System: Existing sprinkler system service equipment, pumps, zoning, mains, alarm devices, etc. to remain and are not affected by the scope of renovation. Existing wet -pipe fire sprinkler system to be modified to accommodate new partition layout. Modifications shall predominantly include new return -bend piping to new sprinklers and new branch piping from existing cross -mains. C. Standpipe System: This building is not equipped with a standpipe system. D. Fire Alarm System: Existing fire alarm system head -end, back -bone, sequence of operation, etc. to remain and are not affected by the scope of renovation. Page 2 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — August 25, 2015 Project Name: Watts Water Technologies Stair Upgrades RDK Project Number: 20150245.00 Existing initiating circuits (SLC or IDC) within scope of renovated area to be modified to accommodate new or relocated initiating devices. New circuits may be added as dictated by the capacity of the existing circuits as determined by the installing contractor; the style and class of new circuits shall match that of the existing system. The following types of initiating devices shall be added: a. Smoke detector; common area, electrical closet, etc. Smoke detector; elevator lobby C. Manual pull box 2. Existing notification appliance circuits (NAC) within scope of renovated area to be modified to accommodate new partition layout. New circuits may be added as dictated by the capacity of the existing circuits as determined by the installing contractor; the style and class of new circuits shall match that of the existing system. 3. Audible notification appliances within scope of renovation shall be UL 464 horn type. 4. Visual notification appliances within scope of renovation shall be UL 1971 strobe type and shall flash in a synchronized manner. E. Emergency Power: Existing generation equipment, feeders, transfer switches, panel boards, etc to remain and are not affected by the scope of renovation. Where required, NAC remote power supplies added to support new circuits shall be provided with standby batteries. 2. Means of egress lighting and exit signs within the scope of renovation shall be provided with emergency power supplied from existing "base building" emergency circuits if available or standby batteries local to the fixtures. F. Smoke Control Systems: Existing features to remain; not affected by scope of renovation. G. Commercial Cooking: Not applicable to the proposed renovation. H. Hazardous Materials Monitoring: Not applicable to the proposed renovation. Section 5 - Features Used in the Design Methodology A. Occupant Notification Procedures: Existing occupant notification via the fire alarm system and subsequent building management personnel procedures shall remain and are not affected by the scope of renovation. The existing fire alarm system treats the building as a single evacuation zone. B. Emergency Response Features: Existing features to remain; not affected by scope of renovation. C. Safeguards: Existing fire protection systems shall be maintained throughout the construction as required by the Authority Having Jurisdiction (AHJ). Impairment to existing fire protection systems shall be approved ,,by the AHJ and Owner prior to commencing work. A fire watch shall be provided during impairments to the fire suppression or fire alarm system in accordance with AHJ requirements. D. Future Testing & Maintenance: Modifications performed as part of the scope of renovation shall be warranted by the installing contractors for a period of one year covering defects in materials Page 3 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — August 25, 2015 Project Name: Watts Water Technologies Stair Upgrades RDK Project Number: 20150245.00 and workmanship. NFPA required inspection, maintenance and testing activities associated with the building fire protection system are the responsibility of the owner and are to be conducted under existing and/or future maintenance contracts held by the Building Management Company. Section 6 - Special Consideration and Description A. Unless otherwise noted, the design of the fire protection systems does not utilize alternative compliance design methods and is not intended to deviate from the prescriptive requirements of 780 CMR or other applicable codes and standards. 901.2.1 (1)(H) - SEQUENCE OF OPERATION A. The existing "base building" coordinated fire protection system basis of design and sequence of operation shall remain unchanged and shall not be modified under the scope of renovation. The general arrangement of the existing sequence of operation is described below and is subject to confirmation by the installing contractor and fire alarm system control unit technical representative. B. Activation of an existing or new manual pull station, smoke detector, heat detector or sprinkler system waterflow switch shall initiate the predefined fire alarm system "alarm condition" sequence: Display alarm condition at fire alarm control unit and remote annunciator(s). 2. Energize audible (temporal -3 pattern) and visual (UL 1971 synchronized strobe) occupant notification circuits within evacuation zone(s) as designated by pre -established control unit sequence of operations. 3. Perform auxiliary fire safety functions as designated by pre -established control unit sequence of operations such as elevator recall, damper activation, door closure, AHU shutdown, pressurization systems, etc. 4. Transmit alarm condition to central / supervising station and/or local fire department via municipal alarm system. In addition, the operation of an existing in -duct smoke detector shall initiate the following: Operation of an existing in -duct smoke detector provided at air handling units (AHU's) shall shut -down the corresponding AHU. b. Operation of an existing in -duct smoke detector provided for control of a smoke damper shall close the corresponding damper. C. The operation of an existing or new sprinkler tamper switch shall initiate the predefined fire alarm system "supervisory" sequence: Display supervisory condition at fire alarm control unit and remote annunciator(s). 2. Transmit supervisory condition to central / remote supervising station. D. Normal power failure to fire alarm system remote power supplies, ground faults, short circuits and open circuit conditions shall initiate the predefined fire alarm system "trouble" sequence. Display supervisory condition at fire alarm control unit and remote annunciator(s). 2. Transmit trouble condition to central / supervising station. Page 4 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — August 25, 2015 Project Name: Watts Water Technologies Stair Upgrades RDK Project Number: 20150245.00 901.2.1 (1)(iii) - TESTING CRITERIA Section 1 - Testing Criteria A. Fire Protection System testing shall be scheduled, administered, conducted and overseen by the general contractor, subcontractors and manufacturer's technical representatives. B. The following fire sprinkler system inspections and testing shall be performed: Visually inspect system installation for completeness, presence of defects or damage, and confirm system is placed into "all normal" operational service. 2. Hydrostatically test system piping for a period of 2 -hours. Piping shall be tested to normal system operating pressure where new installed piping cannot be isolated from the existing piping. 3. Functionally operate any new sprinkler waterflow or valve supervisory switches as part the fire alarm testing. C. The following fire alarm system inspections and testing shall be performed: Confirm integrity of new or modified circuits (free of grounds, shorts, opens) prior to the installation of devices, appliances or equipment. Visually inspect system installation for completeness, presence of defects or damage, and confirm system is placed into "all normal" operational service. Confirm correct system supervision of wiring faults, missing devices and status of normal and standby power supplies (for new equipment installed as part of the work). 4. Functionally operate new devices installed as part of the work and confirm correct sequence of operation and address/zone identification at the fire alarm control unit. Confirm audibility / intelligibility and visual synchronization of notification appliances. 6. Where fire alarm control unit software is updated as part of the work, functionally operate 10% of existing devices not affected by the work and confirm correct sequence of operation and address/zone identification at the fire alarm control unit. 7. Confirm correct operation of circuits under fault conditions in accordance with installed circuit style and class. D. Documentation, to be submitted to the Engineer of Record and AHJ: Sprinkler System: NFPA 13 "Contractor's Material and Test Certificate", accurately completed and endorsed by installing contractor's signature. 2. Fire Alarm System: NFPA 72 "Fire Alarm System Record of Completion", accurately completed and endorsed by installing contractor's signature. E. Upon completion of the work, and receipt of the appropriate close-out documentation, the Engineer of Record shall certify completion for each fire protection system to the extent required by 780 CMR §901.5.1 F. The general contractor shall then schedule final acceptance demonstration testing with the AHJ in order to obtain approval for a Certificate of Occupancy. Page 5 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — August 25, 2015 Project Name: Watts Water Technologies Stair Upgrades RDK Project Number: 20150245.00 Section 2 - Equipment and Tools A. The contractor shall provide all required tools and equipment necessary to perform full functional testing as outlined. As a minimum these items shall include: 1. NFPA Forms 2. Manufacturer's Instructions 3. Fire Protection Systems Narrative Report 4. UL smoke candles or aerosol spray 5. Sound meters 6. Voltage Meters 7. Gauges 8. Communication Radios 9. Printer or data transfer device for recording each FACP event Section 3 - Approval Requirements A. . The contractor shall obtain written acceptance of the installed system from the AHJ prior to the owner request for a Certificate of Occupancy. B. The contractor shall replace and/or repair each system or component of a system that fails to pass the Final Acceptance Test satisfactorily. Preliminary and Final Testing shall be rescheduled and testing shall be conducted until compliance is fully demonstrated. The contractor shall be liable for all additional charges as a result of retesting. C. Final certification shall be provided from the contractors that the installation is in accordance with the approved construction documents and applicable codes. The Engineer shall certify that the installation complies with the approved construction documents per 780 CMR 901.5.1. D. Operations Manuals and Record as -built drawings shall be submitted with any modifications as a resultant of changes that were dictated from the Final Testing process. E. The Owner shall provide an emergency contact list for use by the AHJ in the event of an emergency at the protected property. END OF NARRATIVE Page 6 of 6 Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the 8`" edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Stair Upgrades , Date: August 25, 2015 Property Address: 815 Chestnut Street, North Andover, Massachusetts 01845 Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Building renovation to improve egress and life safety_. I Harold Turner Jr. MA Registration Number: 30941 Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [] Entire Project [X] Architectural [X] Structural [ ] HVAC [ ] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. Enter in the space to the right a "wet" or electronic signature and seal: Phone number: 603-228-1122 Email: gblanchette@hltumer.com or htumer@hltumer.com Building Official Use Only Building Official Name: Permit No.: Date: Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the 8' edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Stair Upgrades Date: August 25, 2015 Property Address: 815 Chestnut Street, North Andover, Massachusetts 01845 Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Building renovation to improve egress and life safety. I, Jeffrey Faucon, MA Registration Number: 47208 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [ ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC [X] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the buiL4i official a `Final Construction Control Document'. Enter in the space to the right a "wet" JEFFREY T. or electronic signature and seal: FAUCON o FIRE PROTECTION No. 47208 , Phone number: 978-296-6375 Q t N a� Email: jfaucon@rdkengineers.com Buildpfg Official Use Only Building Official Name: Permit No.: Date: Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional wq for work per the 8th edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Stair Upgrades Date: August 25, 2015 Property Address: 815 Chestnut Street, North Andover, Massachusetts 01845 Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Building renovation to improve egress and life safety. I, Scott Guertin, MA Registration Number: 46837 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ] Entire Project [ ] Architectural [ ] Structural . [ ] HVAC ] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [X] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the official a `Final Construction Control Document'. OF Mgrs �y 9 Enter in the space to the right a "wet" o SCOTT G. G or electronic signature and seal:o GUERTIN MECHANICAL y Phone number: 978-296-6338 Building Official Use Only Building Official Name: Permit No.: Date: Email: s uertingrdkengineers.com Initial Construction Control Document To be submitted with the building permit application by a W Registered Design Professional w� for work per the 8' edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Stair Upgrades Date: August 25, 2015 Property Address: 815 Chestnut Street, North Andover, Massachusetts 01845 Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Building renovation to improve egress and life safety. I, Scott Guertin, MA Registration Number: 46837 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ] Entire Project [ ] Architectural [ ] Structural [X] HVAC ] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. OF Enter in the space to the right a "wet" �a��P`�N MAss9Cy or electronic signature and seal: �Rrlm MECHANICAL C. Phone number: 978-296-6338 Use Only Building Official Name: Permit No.: Date: Email: sauertin@rdkengineers.com Initial Construction Control Document W To be submitted with the building permit application by a Registered Design Professional w` for work per the 8th edition of the e Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Stair Upgrades Date: August 25, 2015 Property Address: 815 Chestnut Street, North Andover, Massachusetts 01845 Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Building renovation to improve egress and life safety. I, Keith E.Giguere, MA Registration Number: 49637 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC ] Fire Suppression — NFPA 13 [X] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. Enter in the space to the right a "wet" or electronic signature and seal: Phone number: 978-296-6357 r_�Y"��N OF MAS` e -i OF E. GIGUERE v ELECTRICAL N0.49637 Building Official lise Only Building Official Name: Permit No.: Date: 4 Email: kgiguere=,rdkengineers.com Initial Construction Control Document W To be submitted with the building permit application by a Registered Design Professional for work per the 8t" edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Stair Upgrades Date: August 25, 2015 Property Address: 815 Chestnut Street, North Andover, Massachusetts 01845 Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Building renovation to improve egress and life safety. I, Keith E. Giguere, MA Registration Number: 49637 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [ ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC [ ] Fire Suppression — NFPA 13 [ ] Electrical [X] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the, official a `Final Construction Control Document'. ZH OF Mgss �y 9 Enter in the space to the right a "wet" O KEITH E. G or electronic signature and seal: o GIC v ELECTRTR ICUERE AL No. 49637 9FG/SIER�� Phone number: 978-296-6357�s /01VALE*07•�S Building Official se Only Building Official Name: Permit No.: Date: Email: kgiguere e,rdkengineers.com COMcheck Software Version 4.0.1 Interior Lighting Compliance Certificate Project Information Energy Code: Project Title: Project Type: Construction Site: 815 Chestnut Street North Andover, MA Allowed Interior Lighting Power 2012 IECC Watts Water Technologies - Stairs/Egress Alteration Owner/Agent: A Area Category Designer/Contractor: Samang Phon RDK Engineers 200 Brickstone Square Andover, MA B C D Floor Area Allowed Allowed Watts (ft2) Watts / ft2 (B X C) 1 -Common Space Types:Corridor / Transition 711 0.70 498 2 -Common Space Types: Electrical/mechanical 91 1 .10 100 3 -Common Space Types:Stairway 870 0.70 609 Total Allowed Watts = 1207 Proposed Interior Lighting Power A B C D E Fixture ID : Description / Lamp / Wattage Per Lamp / Ballast Lamps/ # of Fixture (C X D) Fixture Fixtures Watt. Common Space T,ypes:Corridor /Transition (711 sq.ft.) LED 1 copy 1: LTi/LT1 E: 2'X2' LED Troffer: Other: Common Space Types: Electrical/mechanical (91 sq.ft.) Linear Fluorescent 1: FS1 E: 4' Lensed LED strip: 46" T5 28W: Electronic: Common Space Types:Stairway_(870 sq.ft.) LED 1 copy 2: LTi: 2'X2' LED Troffer: Other: LED 9 coov 1: WL: 4' Lensed LED strip: Other: 11 34 374 2 32 64 7 34 238 4 19 75 Total Proposed Watts = 751 Interior'Lighting Compliance Statement Compliance Statement: The proposed interior lighting alteration project represented in this document is consistent with the building plans, specifications, and other calculations submitted with this permit application. The proposed interior lighting systems have been designed to meet the 2012 IECC requirements in COMcheck Version 4.0.1 and to comply with the mandatory ronniromontc lictorl in tho Incnortinn (-horielict 1 Dat Project Title: Watts Water Technologies - Stairs/Egress Report date: 08/27/15 Data filename: Q:\2015\20150245 - WWT Stair Code Compliance Upgrade\0600 Electrical Design\603 Page 1 of 6 Lighting\20150245_Watts Stairwells_COMCheck.cck COMcheck Software Version 4.0.1. Inspection Checklist Energy Code: 2012 IECC Requirements: 0.0% were addressed directly in the COMcheck software Text in the "Comments/Assumptions" column is provided by the user in the COMcheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. 2012 IECC Plan Review Complies? Comments/Assumptions C103.2 Plans, specifications, and/or ❑Complies [PR4]1 :calculations provide all information ❑Does Not ;with which compliance can be ❑Not Observable 'determined for the interior lighting Applicable and electrical systems and equipment❑Not and document where exceptions to Ahe standard are claimed. Information provided should include interior lighting power calculations, wattage of bulbs and ballasts, transformers and control devices. Additional Comments/Assumptions: ..............._._..__ _.. __.. _............................. 1 `High Impact (Tier 1) 2 Medium Impact (Tier 2) 3 i Low Impact (Tier 3) ......._..:.................................................................._....._._......................:..............................._.._......__.........................................._......................................:............_:................_..._...................................................................._._.. Project Title: Watts Water Technologies - Stairs/Egress Report date: 08/27/15 Data filename: Q:\2015\20150245 - WWT Stair Code Compliance Upgrade\0600 Electrical Design\603 Page 2 of 6 Lighting\20150245_Watts Stairwells_COMCheck.cck 2012 ILLU KOUgh-In Electrical Inspection Complies? C405.2.2. Automatic controls to shut off all ElComplies 1 building lighting installed in all Not [EL22]2 buildings. .[]Does EINot Applicable C405.2.1, 'Independent lighting controls installed ElComplies I per approved lighting plans and all ElDoes Not (EL23]2 manual controls readily accessible and E]Not Observable. visible to occupants. tElNot Applicable C405.2.1. ;Lighting controls installed to uniformly ElComplies 2 :reduce the lighting load by at least E]Does Not [EL1511 50%. EINot Applicable C405.2.2. 'Daylight zones provided with ElComplies 3 individual controls that control the ElDoes Not [EL16]2 'lights independent of general area . -]Not Observable EINot Applicable C405.2.3 'Sleeping units have at least one ElComplies [EL17]1 master switch at the main entry door E]Does Not ithat controls wired luminaires and switched receptacles. 'FlNot Observable. E]Not Applicable C405.2.2. Occupancy sensors installed in ElComplies 2 required spaces. 'E]Does Not F­lNot Observable :E]Not Applicable C405.2.2. Primary sidelighted areas are OComplies 3 !equipped with required lighting ElDoes Not [EL2011 'controls. ElNot Observable: ElNot Applicable C405.2.2. Enclosed spaces with daylight area flComplies 3 under skylights and rooftop monitors ElDoes Not [EL21]1 are equipped with required lighting FNot Observable E]Not Applicable C405.2.3 'Separate lighting control devices for ElComplies [EL4]1 :specific uses installed per approved ElDoes Not ;,lighting plans. nNot Observable ONot Applicable C405.3 Fluorescent luminaires with odd ElComplies [EL19]3 numbered lamp configurations that are with 10 feet center to center (if FINot Observable. 'recess mounted) or are within 1 foot E]Not Applicable .edge to edge (if pendant or surface .mounted) shall be tandem wired. C405.4 Exit signs do not exceed 5 watts per ElComplies [EL611 face. ElDoes Not F—INot Observable ElNot Applicable C405.2.3 Additional interior lighting power DComplies [EL811 allowed for special functions per the ElDoes Not .approved lighting plans and is RNot Observable .automatically controlled and separated from general lighting. LINot Applicable AdddOooa|Comnmments/Assunoptioms: 3 Low Impact (Tier 3) Project Tide: Watts Water Technologies Stairs/Egress Report date: 08/27/15 Data filename: 0:\2015\20150245 VvVVTStair Code Compliance Upgrade\0000 Electrical Dcsign\603 Page 3 of 6 ....................................................................................................................................................._..............._................................_...._._.._._..._............:..............7-.................... __...._............. _........................... ......................... 1 ;High Impact (Tier 1) 2 ;Medium Impact (Tier Z) 3 Low Impact (Tier 3) _...................................:............................_.._._.._..._...............................__................... Project Title: Watts Water Technologies - Stairs/Egress Report date: 08/27/15 Data filename: Q:\2015\20150245 - WWT Stair Code Compliance Upgrade\0600 Electrical Design\603 Page 4 of 6 Lighting\20150245_Watts Stairwells_COMCheck.cck 2012 9CC Fiat inspection Complies? Comments/Assumptions , C408.2.5. i :................. . ......... ; Furnished as -built drawings for ......... ....._. ❑Complies 1 electric power systems within 30 days ❑Does Not [FI16]3 sof system acceptance. ❑Not Observable ❑Not Applicable C30.3..3,C4 ....... ....... ......... Furnished 0&M instructions for ......... ..... .... ......................................................... ..._......................... .......... .............. ❑Complies 08.2.5.2 systems and equipment to the []Does Not [FI17]3 building owner or designated ❑Not Observable representative. .[]Not Applicable C405.5.2 .:Interior installed lamp and fixture ❑Complies See the Interior Lighting fixture schedule for values. [F118]1 lighting power is consistent with what ❑Does Not is shown on the approved lighting ❑Not Observable; :plans, demonstrating proposed watts are less than or equal to allowed ❑Not Applicable watts. C408.3 Lighting systems have been tested to ❑Complies [F133]1 ensure proper calibration, adjustment, ❑Does Not programming, and operation. '❑Not Observable ❑Not Applicable C406 ' Efficient HVAC performance, efficient ❑Complies [F134]1 lighting system, or on-site supply of ❑Does Not renewable energy consistent with ❑Not Observable' what is shown the approved plans. ❑Not Applicable Additional Comments/Assumptions: .................... ..._........................_....... _._..._... 1 'High Impact (Tier 1) 2 Medium Impact (Tier 2) 3 Low Impact (Tier 3) ..:.._.... .... _......................................................._......._._._.._........................:.............._........__......._....._.............................................._........._................:....._._....:............_.........................._......................................................_..._� Project Title: Watts Water Technologies - Stairs/Egress Report date: 08/27/15 Data filename: Q:\2015\20150245 - WWT Stair Code Compliance Upgrade\0600 Electrical Design\603 Page 5 of 6 Lighting\20150245_Watts Stairwells_COMCheck.cck Project Title: Watts Water Technologies - Stairs/Egress Report date: 08/27/15 Data filename: Q:\2015\20150245 - WWT Stair Code Compliance Upgrade\0600 Electrical Design\603 Page 6 of 6 Lighting\20150245_Watts Stairwells_COMCheck.cck A or CERTIFICATE OF LIABILITY INSURANCE 1:1!06124115E(N1M/DDIYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: 781-935-8480 DeSanctis Insurance Agcy, Inc. Fax: 781-933-5645 100 Unicorn Park Drive Woburn, MA 01801 CONTNAMEACT PHONE FAX No Ext): A No): E-MAIL ADDRESS: PRODUCER CUSTOMER IDN: WISEC-1 INSURER(S) AFFORDING COVERAGE NAIC 0 GENERAL LIABILITYl INSURED Wise Construction Corp 21 East Street Winchester, MA 01890 INSURER A: Liberty Mutual Insurance Cos. INSURER s: Associated Employers INSURER C: Nautilus Insurance Company 17370 INSURERD:American Insurance Company EACH OCCURRENCE $ 1,000,00 INSURER E : X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X Per Project Agg INSURER F 6VvcKAuES CFRTIFICATr- MI IMRFR• 01=11101rar wraaoen. 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. ILTR TYPE OF INSURANCEADDL INRRPOLICY NUMBER POLICY EFF MM/DD POLICY EXP MMIDD LIMITS GENERAL LIABILITYl EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X Per Project Agg TB2Z11261323025 06/27/15 06/27/16 DAMAGE TO RENTEU_ PREMISES Ea occurrence $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL &ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- LOC PRODUCTS -COMP/OP AGG $ 2,000,00 $ A AUTOMOBILE X LIABILITY ANY AUTO AS2Z11261323015 06/27115 06/27/16 COMBINED SINGLE LIMIT $ 11000,00 (Ea accident) BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,00 A EXCESS LIAB CLAIMS -MADE TH7Z11261323035 06/27/15 06/27/16 AGGREGATE $ 10,000,00 DEDUCTIBLE $ X RETENTION $ 10,000 $ B WORKERS COMPENSATIONWC AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N OFFICERIMEMBER EXCLUDED? a (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below N I A CC50050135352015A MA 06/27/15 06/27/16 STATU- OTH- X T MFR E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 11000100 E.L. DISEASE - POLICY LIMIT $ 11000100 C Pollution Liab _r PL201193411 06/27/15 06/27116 Agg/occur 3mil/1mi DESCRIPTION OF OPERATIONS I LOCATIONS t VEHICLES (Attach ACORD 101, Additional Remarks Schedule, K more space is required) "ADDITIONAL INSURED LIMITS ARE NO GREATER THAN THOSE REQUIRED BY WRITTEN CONTRACT." Evidence of Coverage EVIDE-1 EVIDENCE OF INSURANCE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED I•...d'©1989-2009 ACORD CO OEII rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supenisor License: CS -097661 y ERIC S LIBBY 200 JEWETT ST : ?7, , J GEORGETOWNMA, 01933 Expiration.. Commissioner 08/0912016 Massachusetts Department of Public Safety VjBoard of Building Regulations and Standards License: CS-097661 ` Construction Supervisory ERIC S LIBBY 200 JEW" ST E r,-J.:; Expiration, Commissioner 08/09/2017 Location No. _�% ' .i% Date �S Check #10 �7 ✓ �� TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $222 '74 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ P, ! Building Inspector ►Z �cmyivel l/ 22/-,5' BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: e� /A Date Received � Date Issued: �9SSACHVS���� IMPORTANT: Applicant must complete all items on this oaee LOCATION 815 Chestnut Street, North Andover MAS Print PROPERTY OWNERWATTS Regulator Company Print MAP NO: 107.0 PARCEL 0022 ZONING DISTRICT. Historic District yes Ro Machine Shop Village ves TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential C New Building - One family F Addition " Two or more family " Industrial iX Alteration No. of units: X Commercial Others: Repair, replacement Assessory Bldg Demolition Other :Septic . Well Floodplain Wetlands Watershed District Water/Sewer Interior renovation and upgrades to architectural finishes. Construction of new lab and training facility. Upgrades to existing HVAC, Plumbing, Electrical, Fire Protection, and Fire Alarm services. Identification Please Type or Print Clearly) OWNER: Name: Jackie Comiskey Phone: 978-689-6067 b Address: CONTRACTOR Name: Phone 781-721-1100 �Y Eric Libby Address: 21 East Street Winchester, MA 01890 Supervisor's Construction License: Exa. Date CS -097661 Home Improvement License. Exp. Date: 08/09/15 ARCHITECT/ENGINEER The H.L. Turner Group Inc. Phone: 603-228-1122 Address: 27 Locke Road Concord, NH 03301 Reg. No. FEE SCHEDULE. SULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $115.00 PER S.F. Total Project Cost: $ 2,381,443 FEE: $ 28,578 Check No.: Receipt No.: NOTE: Persons contracting wit r unreg' t red contractors t/o not have access & gu an d Signature of Agerit/1 Signature of contracto _ / .€':fie . e `$ _. Location No.. ' /% — o1 p �' Check # -, Date � r TOWN OF NORTH ANDOVER Certificate of Occupancy Building/Frame Permit Fee $ ti Foundation Permit Fee $ Other Permit Fee I - TOTAL $ °`' Building Inspector ,�,� CERTIFICATE OF USE & OCCUPANCY Building Permit Number 310-2016 on 9/9/2015 Date: June 9, 2016 THIS CERTIFIES THAT THE BUILDING LOCATED at 815 Chestnut Street MAY BE OCCUPIED AS interior renovation and architectural upgrades IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Watts Regulator Company 815 Chestnut Street North Andover, MA 01845 i4guilding Inspector Fee: $100.00 Receipt: 30482 Check: 70328 9 O � Ake cc i3. L CL 0 cc w w . CF S i CL C Q 0 m CDCL 2- ctl y� N d a. 44 ch c 'a > :mo c c �4 ' �+£o© ~` L ? co ca '1=_� ++ CL as C m V =O ~ w O = N = Q d .� N #- O N v m d LLJW M +*-' O O a LL -n m e C Q to 0 m w� CL m 'j to M pto 0 #- L dCL y.. 0,0 :+ Z Z uj w CL ui LLJ CL 0 0 cc M 0 .i+ 0 w FL 0 CL Q Q 3z CD 6.1 0 CL C. CD � Z3 ca 0 CD CL Z tv N) c OE NOR1M qN . O SSACROSE CERTIFICATE OF USE & OCCUPANCY Building Permit Number 310-2016 on 9/9/2015 Date: June 9, 2016 THIS CERTIFIES THAT THE BUILDING LOCATED at 815 Chestnut Street MAY BE OCCUPIED AS interior renovation and architectural upgrades IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Watts Regulator Company 815 Chestnut Street North Andover, MA 01845 uilding Inspector Fee: $100.00 Receipt: 30482 Check: 70328 i I AORTH +o TOWN OF NORTH ANDOVER "� 'a'°0 OFFICE OF p BUILDING DEPARTMENT x z e� , M o� 1600 Osgood Street 4�. �9s SgCHus� Building 20 Suite 2-36 North Andover, Massachusetts 01845 Telephone (978) 688-9545 Gerald A. Brown Fax (978) 688-9542 Inspector of Buildings AFFIDAVIT FOR FINAL COST OF CONSTRUCTION In accordance with the provisions o the Massachusetts State Building Code, Article 1, Section 110.4 and 114.2, the total estimated cost of the construction including all related construction of the building located at u amounts to being the person referred to as the owner identified below, do solemnly swear that the statements made herein are strictly true and correct and made in good faith. *Related construction costs included all work done with or concurrently with the work contemplated by the Building Permit including demolition, plumbing, heating, electrical, air conditioning, painting, carpentry, landscaping, site improvement, etc. Furnishings and portable equipment are not part of the total construction. costs. S'gnature of Owner COMMONWEALTH OF MASSACHUSETTS 20 i Then personally appeared the able named ;YNt•k (a M and Made an oath that the above statement is true. NICOLE A. MARTIN Before, Me, Notary Public 1n ^ COMMONWEALTH OF MA SSACHUSETTS MY CommisSIon Expires _ April 1, 2422 Notary Public OFFICIAL USE: Final Cost: Original Estimate cost of general work: Cost Difference: or 731 112 4 3 y O Additional Fee Required: TO AMEND FEE UNDER PERMIT NO.: 31.E Inspectional services Department 2005 FAI'malcostaffidavitfonn Strict torte enforcement nzakes the town safer Before buying, renting, leasing check zoning BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 v N. C y n O CD� Z N (D O -0 oQ > cm N <vCD C 2 CD CD O ou ICD CD 9 v CL U� CO CD v -0 Z CD 0 0. O 70 CD a CD n Z 9 < o��o O N MU < CDD cr "0 F 0 CD 0 z 0_ 3-c �_ Z O s -a (30 O O rt CD O Fn,, Q � O =(n N O W C1CD N p N �. cD 0 : CD 2 ' Q' Sv N m > C (Q N O o DO =rCD CD co (DD ..ti .a OZ Q, a rt:� �.. C U) = n i co 0 0CCL 0 �:� M . U) Sv (D � O � O r � •� � 1 CD COD N 'O•r =r C m CD cD Qe (D o o aCD M)'o 0 � _rt Sy O CL "V 3 W O O T 0 � 7 N 0 v O of 3 S O O O 'a Q IT � ON O �C drn 000 000 CL O 0 7C S n O m a z „ W '- G D v v z � o -i C,r m O m� r^ D \\ z 1 o o � �NJ = I H * aI"- v ow O Final Construction Control Document To be submitted at completion of construction by a Registered Design Professional for work per the 8t' edition. of the Massachusetts State Building Code., 7,80 CMP, Section 107 Project Title: Watts Water Technologies Training. Center Project Date-,. April Permit No. 31 4-2016 Property Address: 815 Chestnut Street,.North Andover, Massachusetts 01845 Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description Buildin entavatio 0.Cot gm =in , vtwft- r.AU§tOnWr q r: -.Ors-.."etz. _jT hm A C '019vot-b 101eoex Jr,. 310 IYI 1, MARe Registration Number: -Expiration piration date am a registered design professional, and that T have,are: or directly supervised the preparation of all: design plans, computations and specifications prep A ions concerning - I Entire Project Architectural Structural HVAC Fire Suppression — NFPA 13 1 Electrical Fire Alarm - NFP A 72 1 Plumbing for the above named project 1, or Try designee, have performed the necessary professional services, in. accordance with the Professional Standard of'Care, and was present At the construction site on a periodic basis, The work proceeded in accordance with the requirements :of 780 CMR and the design documents approved as part of the building permit with the exception of those items so noted on the attached punch list and that I or my designee, I . Have reviewed, for conformance to this code and the design concept; shop drawingsi samples and other submittals by the Contractor in accordance with the requirements of the construction documents.. 2. Haveperformed the duties for registered design professionals in 780 CMR Chapter 17, (not applicable) 3. Have been present at intervals appropriate to the stage of construction to become. generally familiar with the progress and quality ofthe work and.to determine if the work was perfomed in a inanner consistent with the construction document * sr' :and this code, The Contractor is responsible foperform.ance of the work in: accordance with the contract doruments:and is exclusively responsible for its construction means, 'methods, sequences and procedures and for construction safety. Nothing in this do0umerivrelieve.9 the Cofttractorof its responsibilities regarding the Provisions. of 79,0 CM.X 107. Enter in the space to the -right a "wet" or electronic signature and seal! Phone niunber:4 Z>3 �Ursisp- &I A l tvrherl. CO Al I final Construction Control Document To be submitter. at completion of construction by a ReWatered lle9M Pr©fe.sdenal for work pff the 8m edition of the Massachusetts State Building Code, 784 CMR, Section 107 Project Title: Watts Water Technologies Training Center Project Date: Ap!2 6.2016 Property Address: 815 Chestnut Street; North Andover, Massachusetts 01845 Project. Check (x) one or both as applicable New Construction X Existing Construction Permit No. 310-2016 Project description; Building renovation to construct a `l'raineng Center for customers, plumbers:, vendors etc. 14 7effrey Fauc on. MA Registration Number. 47208 -Expiration date: 6/30/16. am a registered design professiond, and that T have prepared or directly supervised the preparation of all design plans, computations and motions concerning: . ]; EnfiMr Project [ ] Architectural [ 1 Structural [ 1 HVAC Pq Fire Suppression — NFPA 13 1 Electrical 1 Fire Alarm - NFPA 72 [ 1 Plumbing fir the above named project. 1, or my designee, have perfcxmed the necessary professional services, in accordance with the Professional Standard of Cue, and was present at the construction site on a periodic basis. `Ile work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the budding permit with the exception of those items so noted on the attached punch list and that I or my designee: 1. Have reviewed, for conformance to this code and the design concept, shop drawings, samples and caber submittals by the Contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Have been present at intervals appropriate to the stage of construction to become gmerafty fauni iar with the progress and quality of the work and to determine if the work was performed in a mannertonsislent with the construction docaa nexnts and this code_ The Contractor is responsible for performance of the work m accordance with the contract documents and is exclusively responsible for its construction means, menod% sequences and procedium, and for construction safety. Final Construction Control Document To be submitted at completion of construction by a Registers Design Professional for work per the 8a' edition of the Massachusetts State Building Codes 780 CMR, Section 107 Project Title Watts Nater Technologies Training Center Project Date: April 6.2016 Permit No. 310-2016 Property Address: 815 Chestnut Street, North. Andover, Massachusetts 01845 Project! Check (x) one or both as applicable New Construction X Existing Construction Project description wilding renovation to construct a Training Center for customers: plumbers.. vendors etc. I, Keith Giguere, MA Registration Number: 49637 - Expiration date: 6/30/16. am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC ] Fire Suppression —NEPA 13 [ ] Electrical [X] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project. L or my designee, have performed the necessary professional services, in accordance with the Professional Standard of Care, and was present at the construction site on a periodic basis. The work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit with the exception of those items so noted on the attached punch list and that I or my designee: 1. Have reviewed, for conformance to this code and the design concept, shop drawings, samples and other submittals by the Contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. The Contractor is responsible for performance of the work in accordance with the contract documents and is exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its linter in the space to the right a "wet" or electronic signature and seal: Phone camber_ 978-296-6357. regarding the provisions of 780 CMR 107. 41 Final Construction Control Document To be submitted at completion of construction by a Registered Design Professional for work per the r edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Training Center Project Date: April 6. 2016 Permit No. 310-2016 Property Address: 815 Chestnut Street. North Andover, Massachusetts 01845 Project Check (x) one or both as applicable: New Construction X Existing Construction Project description: Building renovation to constnrct a Trainiiig Center for customers. plumbers, vendors etc. L Keith Giguere* MA Registration I�Tumber: 49637 -Expiration date: 6130/16, am a registeree design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning:: [ ] Entire Project [ ) Architectural [ l Structural [ ) HVAC Fire Suppression — NFPA 13 [X Electrical [ ]' Fire Alarm - NPPA 72 [ j Plumbing for the above named project. I, or my designee, have performed the necessary professional services,; m accordance with the Professional Standard of Care, and was present at the construction site on a periodic basis. The work proceeded in accordance with the requirements of 780 C M and the design documents approved as part of the building permit with the exception ofthose items so noted on the attached punch list and that I or my designee: 1. Have reviewed, for conformance to this code and the design concept, shop dra�whgM samples and other submittals by the Contractor in accordance with the requirements of the construction documents. 2. Have perfixmed the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. The Contractor is responsible for performance of the work in accordance with the contract documents and is exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 107. Entw. in the space to the right a "wet'' or electronic signature and seal: « c7ELEOTrMYL IM—` Final Construction. Control Document To be submitted at completion of construction by a Re Bred. Design Professional for work perthe 8" edition of the Massachusetts Mate Building Code; 780 CMR, Section 107 Prgect Idle: Watts Wats Technol=gs Training Center Protect Date: Ap& 6.2016 Properly Address: 815 Chestnut Sheet North Andover, Massachusetts 01845 Project: Check (g) one or both as applicable: New Construction X. Existing Construction Permit. No. 310-2016 Project description: Building renovation to construct a Training. Center for customers, plumbers, veicdors etc. L Stott Gaertin, MA Registration Number: 46837 - Expiration date: 6130/1.6. am aregbwed design professional,' and that I have prepared or directly supervised the preparation of all design plans, computations and specfications concerning: I!, Entim Project [ I Architecturall [ I Structural M HVAC I! Fine Scion — NFPA 13 [ ] Electrical [ I Eire Alarm NEPA 72 [ I Plumbing for the above named projecd. L or nrf designees have performed the necessary professional services, in accordance widi the PrufessiorW Standard of Cares and was present at theconstruction site on a periodic basis. The work proceeded in accordance with Bre requirements of 780 CMR and the design documents approved as part of the building permit with the exception of those items so noted on the attached punch list and that 1 or my designee: 1. Have reviewedl, for conformance to this code and the design concept, shop drawings= samples and other submittals by the Contract" ih accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Cher 17. (not applicable) 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the pwgress and quality of the work and to determine if the work was performed in a maw consistent with the documents and this code. The Contractor is responsible for performance of the work in aoconknee With the contract documents and is exclusively responsible for its construction means, methods, sequences and. prec edures, and for construction safely. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 107., FAtw in the space to the right a `wer or electronic signature and seal: Plane member: 9787246-6338 Orad Nan= ftnOt Na: U 'lip ` Final Construction Control Document To be submitted at completion of construction by a Registered Design Professional for work per the r edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Training Center Project Date: Aprl. 2016Permit No. 310-2016 Property Address: 815 Chestnut Street. North Andover, Massachusetts 01845 Project Check (x) one or both as applicable: New Construction X Existing Construction Project description: Building renovation to construct aTrsining Center for customers, plumbers, vendors etc. 1, Scott Guertin, MA Registration Number. 46837 -Expiration date: 6/34/16. am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: I Entire Project [ ] Architectural [ ) Structural [ ] HVAC I Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [XI Plumbing forthe above named project. I, or my designee, have performed the necessary professional services, in accordance with the Professional Standard of Care, and was present at the construction site on a periodic basis. The work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit with the exception of those items so noted on the attached. punch list and that I or my designee: I . Have reviewed, for conformance to this code and the design concept, shop drawings, samples and other submittals by the Contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 784 CMR Chapter 17. (not applicable) 3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the progress and duality of the work and to determine if the work was performed in a manner consistent with the construction documents and this code. The Contractor is responsible for performance of the work in accordance with the contract documents and is exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 107. Enter in the space to the right a `wet=s or electronic signature and seal: Phone number. 978-296-6338 %i, Email: sguertin@Ldkengineerscom Building Official. Use Only &dMing Official NMne: Permit Trio.: Date: Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 2,3811443.00 m $ - $ 28,577.32 Plumbing Fee $ 3,572.16 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 3,572.16 Total fees collected $ 35,821.65 815 Chestnut Street 310-2016 on 9/9/2015 Interior Renovation and Upgrades CO) 0 CD 0Z CD O Cr r. > .a O O v D Q C Cr CD O �o J 0 0 U) CD0 CD �:j O CDs O CD Z m Cl) 0 X n cn n C O m ic 4 -v 70 Z z cn n D z 0 CD N c0 0 W cm CD U3 0 U) 0 a U) S N CD 0=-% � __ � oMU N -' < CD fR N. CL n CD n n�CL om 3 N. CD' 0 TI h =CD �. W CD'.a y o -1 CD m 2 a N CD D = O c0 Q- , o � 5 n , CD C CD co o��:h oCA -wyCOD : OO'��c � =r >m Zcc 0 CL M <CD rL Q. IL 03 W CD �� • o •Cn O \ SOco 0 CDy � c'1 � •\�� D CD m-0 o � O _rt � O O O CL O • y 0 O (D f V1 (D �' OZ W C 3 T m m T j N x O C S H H O T j Dl N O :0 Oj C 3 m m n m 0 T G1 ;v O C S M C m LA n 0 T �' Dl n 7 70 O C 3 T O c O_ O. W p z G1 n O V1 fD 'a n N - 3 T O O \ n S (D W y 70 0 m 2 Enter construction cost for fee cal - North Andover Fee Cakulation Construction Cost $ 293819443.00 m $ - $ 28,577.32 Plumbing Fee $ 3,572.16 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 3,572.16 Total fees collected $ 35,821.65 815 Chestnut Street 310-2016 on 9/9/2015 Interior Renovations, New Lab and Training Facility VilAse CONSTRUCTION Client: Watts Water Technologies Project: Training Center Renovation Location: 815 Chestnut Street - North Andover, MA Date of Estimate: 24 -Jun -15; Rev 2 -Jul -15 Plan Date: 10 -Jun -15 Estimate #: E15-118 Area: 12,488 sf Page 1 of 1 CSI # Owner Contract Trade Cost 02100 Demolition $106,068 02500 Sitework $44,235 03300 Concrete $99,697 04500 Masonry $4,200 05500 Structural Steel/Misc. Metals $114,485 06000 Rough / Finish Carpentry $171,485 07000 Thermal and Moisture Protection $7,040 08100 Doors, Frames and Hardware $81,750 08800 Glass & Glazing $32,390 09250 Drywall $137,210 09500 Acoustical Ceilings $39,360 09650 Flooring $122,250 09900 Painting $27,578 10100 Specialties $76,085 11100 Equipment $7,292 12100 Furnishings $2,510 14200 Conveying Systems $23,350 15300 Fire Protection $49,520 15400 Plumbing $425,235 15500 HVAC $614,635 16000 Electrical $195,070 17000 Tel/Data See below 18000 Audio/Visual See below 22100 Security NIC Total $2,381,443 Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the 8t' edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Training Center Project Date: August 25, 2015 Property Address: 815 Chestnut Street, North Andover, Massachusetts 01845 Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Building renovation to construct a training center for customers, plumbers, vendors, etc. I Harold Turner Jr. MA Registration Number: 30941 Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [] Entire Project [X] Architectural [X] Structural [ ] HVAC [ ] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'. Enter in the space to the right a "wet" or electronic signature and seal: Phone number: 603-228-1122 Email: gblanchette@hltumer.com or hturner@hlturner.com Building Official Use Only Building Official Name: Permit No.: Date: ` Initial Construction Control Document u To be submitted with the building permit application by a a d Registered Design Professional w` for work per the 8th edition of the ° Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Training Center Project Date: August 25, 2015 Property Address: 815 Chestnut Street, North Andover, Massachusetts 01845 Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Building renovation to construct a Training Center for customers, plumbers, vendors etc. I, Jeffrey Faucon, MA Registration Number: 47208 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [ ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC [X] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to Enter in the space to the right a "wet" or electronic signature and seal: Phone number: 978-296-6375 of Mgrs p� JEFFREY T. FAUCON o FIRE PROTEO71— cn rZo. 47208 n Building Official Name: Permit No.: Date: a `Final Construction Control Document'. Official Use Only Email: jfaucon@rdkengineers.com Initial Construction Control Document W To be submitted with the building permit application by a w Registered Design Professional 4 for work per the 8' edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Training Center Project Date: August 25, 2015 Property Address: 815 Chestnut Street, North Andover, Massachusetts 01845 Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Building renovation to construct a Training Center for customers, plumbers, vendors etc. I, Scott Guertin, MA Registration Number: 46837 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC ] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [X] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit totOF ffic R4Ss9 O SCOTT G. yG Enter in the space to the right a "wet" GtJERTIN m{ or electronic signature and seal: MECHANICAL Cn Phone number: 978-296-6338 a `Final Construction Control Document'. Building Official Use Only Building Official Name: Permit No.: Date: Email: s u� ertingrdkengineers.com ` Initial Construction Control Document u W To be submitted with the building permit application by a M � ' d Registered Design Professional for work per the 8t' edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Training Center Project Date: August 25, 2015 Property Address: 815 Chestnut Street, North Andover, Massachusetts 01845 Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Building renovation to construct a Training Center for customers, plumbers, vendors etc. I, Scott Guertin, MA Registration Number: 46837 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ] Entire Project [ ] Architectural [ ] Structural [X] HVAC ] Fire Suppression — NFPA 13 [ ] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to ,N oF,l�ysscy 9 O SCOTT G. GUERTIN MECHANICAL � Enter in the space to the right a "wet" or electronic signature and seal: Phone number: 978-296-6338 a `Final Construction Control Document'. AVEmail: sguertin@rdkengineers.com Building Official Use Only Building Official Name: Permit No.: Date: Initial Construction Control Document u W To be submitted with the building permit application by a d Registered Design Professional w` for work per the 8t" edition of the e Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Training Center Project Date: August 25, 2015 Property Address: 815 Chestnut Street, North Andover, Massachusetts 01845 Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Building renovation to construct a Training Center for customers, plumbers vendors etc. I, Keith Gi uere, MA Registration Number: 49637 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC ] Fire Suppression — NFPA 13 [X] Electrical [ ] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to �P1-1�N I?r—..s� C,y c;,GUEnE 4 637 O < A99,�1�. 00; Sic Enter in the space to the right a "wet" or electronic signature and seal: Phone number: 978-296-6357 Building Official Name: Permit No.: Date: a `Final Construction Control Document'. �l Email: kaigueregrdkengineers.com Building Official tte Only Initial Construction Control Document W To be submitted with the building permit application by a w Registered Design Professional W for work per the 8" edition of the ^" 5" Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Watts Water Technologies Training Center Project Date: August 25, 2015 Property Address: 815 Chestnut Street, North Andover, Massachusetts 01845 Project: Check (x) one or both as applicable: New Construction X Existing Construction Project description: Building renovation to construct a Training Center for customers, plumbers. vendors etc. 1, Keith E. Giguere, MA Registration Number: 49637 - Expiration date: 6/30/16, am a registered design professional, and that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: ] Entire Project [ ] Architectural [ ] Structural [ ] HVAC ] Fire Suppression — NFPA 13 [ ] Electrical [X] Fire Alarm - NFPA 72 [ ] Plumbing for the above named project and that, to the best of my knowledge, information and belief, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services in accordance with the Professional Standard of Care and be present on the construction site on a periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17. (not applicable) 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. The Contractor shall be responsible for performing the work in accordance with the contract documents and shall be exclusively responsible for its construction means, methods, sequences and procedures, and for construction safety. Nothing in this document relieves the Contractor of its responsibilities regarding the provisions of 780 CMR 17. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the Enter in the space to the right a "wet" or electronic signature and seal: Phone number: 978-296-6357 �NpE MASs� y G1G srRE L v Ag637 O Building Official Use Building Official Name: Permit No.: Date: a `Final Construction Control Document'. Email: kgiguere@rdkenizineers.com COMMONWEALTH OF MASSACHUSETTS STATE BUILDING CODE 780 CMR, 8TH EDITION CHAPTER 9 FIRE PROTECTION SYSTEMS NARRATIVE REPORT 780 CMR - 901.2.1 PROJECT NAME: Watts Water Technologies Training Center ADDRESS: 815 Chestnut Street North Andover, MA RDK PROJECT #: 20150277.00 DATE OF ISSUE: August 25, 2015 y Andover I Amherst I Boston I Charlotte I Durham www.rdkengink>ers,com 780 CMR 901.2.1 Fire Protection Systems Narrative Report — August 25, 2015 Project Name: Watts Water Technologies Training Center RDK Project Number: 20150277.00 As required by 780 CMR §901.2.1, this narrative report is a written description of the proposed fire protection system features to be installed as part of the Watts Water Technologies Training Center project located at 815 Chestnut Street in North Andover, Massachusetts. 901.2.1 (1)(i) - BASIS (METHODOLOGY) OF DESIGN Section 1 - Building Description A. "Use" Group(s) within Scope of Renovation: "B" Business (office). B. Location & Area of Renovation: 11,300 sqft on the Basement Floor. C. Existing Building Height & Area 1. Height: Two (2)] stories above grade; one (1) story below grade. 2. Area: — 66,500 sqft total. D. Type(s) of Construction: 1. Existing protected non-combustible. E. Hazardous Material Usage and Storage: None in excess of exempt amounts within scope of renovation. F. High -pile Storage (over 12 ft.) of Commodities: None within scope of renovation. G. Site Access Arrangement for Emergency Response Vehicles: Existing features to remain; not affected by scope of renovation. Section 2 - Applicable Laws, Regulations & Standards A. Massachusetts State General Laws (MGL), Chapter 148 1. MGL §148, sections as applicable. B. 780 CMR — Massachusetts State Building Code, 81" Edition (amended IBC -2009) 1. Chapter 9 "Fire Protection Systems" 2. Chapter 34 "Existing Structures" C. Existing Building Code of Massachusetts (amended IEBC-2009) 1. Chapter 7 "Alterations — Level 2" 527 CMR — Massachusetts State Fire Prevention Regulations 2. Chapter 10 "Fire Prevention, General Provisions" 3. Chapter 12 "2014 Massachusetts Electrical Code Amendments" D. 521 CMR — Massachusetts Architectural Access Board Page 1 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — August 25, 2015 Project Name: Watts Water Technologies Training Center RDK Project Number: 20150277.00 1. Section 40 "Visual Alarms" E. National Fire Protection Association (NFPA) Standards: NFPA 13 (2013) — "Installation of Sprinkler Systems" NFPA 70 (2014) — "National Electric Code" as amended by 527 CMR Chapter 12 "Massachusetts State Electrical Code" NFPA 72 (2010) — "National Fire Alarm Code" F. Federal Regulations (significant requirements thereof to the extent applicable to RDK scope) 28 CFR Part 36, ADA Standards for Accessible Design 29 CFR Part 1910, Occupational Safety & Health Standards G. Documented Local Ordinances (Voluntary Compliance) local bylaws and ordinances Section 3 - Design Responsibility for Fire Protection Systems A. Engineer of Record: RDK Engineers (RDK) has engineered and specified the fire protection systems to be installed. For each fire protection system designed by RDK, RDK shall review the installing contractor's Tier II shop drawings for conformance to the approved construction documents and be present at the site at intervals appropriate to become generally familiar with the progress and quality of work and to determine if the work is being performed in manner consistent with the construction documents and 780 CMR. RDK shall certify each fire protection system installation to the extent required by 780 CMR §901.5.1(1). B. Architect of Record: The H.L. Turner Group, Inc, has designed and specified the architectural features to be constructed, including means of egress, fire resistance construction and interior finish. The H.L. Turner Group, Inc., shall review the installing contractor's Tier II shop drawings for conformance to the approved construction documents and be present at the site at intervals appropriate to become generally familiar with the progress and quality of work and to determine if the work is being performed in manner consistent with the construction documents and 780 CMR. Section 4 - Fire Protection Systems to be Installed A. Fire Mains & Hydrants: Existing features to remain; not affected by scope of renovation. B. Automatic Sprinkler System: Existing sprinkler system service equipment, pumps, zoning, mains, alarm devices, etc. to remain and are not affected by the scope of renovation. Existing wet -pipe fire sprinkler system to be modified to accommodate new partition layout. Modifications shall predominantly include new return -bend piping to new sprinklers and new branch piping from existing cross -mains. C. Standpipe System: This building is not equipped with a standpipe system. D. Fire Alarm System: Existing fire alarm system head -end, back -bone, sequence of operation, etc. to remain and are not affected by the scope of renovation. Page 2 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — August 25, 2015 Project Name: Watts Water Technologies Training Center RDK Project Number: 20150277.00 Existing initiating circuits (SLC or IDC) within scope of renovated area to be modified to accommodate new or relocated initiating devices. New circuits may be added as dictated by the capacity of the existing circuits as determined by the installing contractor; the style and class of new circuits shall match that of the existing system. The following types of initiating devices shall be added: Smoke detector; common area, electrical closet, etc. Smoke detector; duct — new shaft penetration or similar C. Heat detector; areas not environmentally suitable for smoke detection d. Manual pull box e. Automatic sprinkler waterflow switch Automatic sprinkler valve tamper switch 2. Existing notification appliance circuits (NAC) within scope of renovated area to be modified to accommodate new partition layout. New circuits may be added as dictated by the capacity of the existing circuits as determined by the installing contractor; the style and class of new circuits shall match that of the existing system. 3. Audible notification appliances within scope of renovation shall be UL 464 horn type. 4. Visual notification appliances within scope of renovation shall be UL 1971 strobe type and shall flash in a synchronized manner. E. Emergency Power: Existing generation equipment, feeders, transfer switches, panel boards, etc to remain and are not affected by the scope of renovation. Where required, NAC remote power supplies added to support new circuits shall be provided with standby batteries. Means of egress lighting and exit signs within the scope of renovation shall be provided with emergency power supplied from existing "base building" .emergency circuits if available or standby batteries local to the fixtures. F. Smoke Control Systems: Existing features to remain; not affected by scope of renovation. G. Commercial Cooking: Not applicable to the proposed renovation. H. Hazardous Materials Monitoring: Not applicable to the proposed renovation. Section 5 - Features Used in the Design Methodology A. Occupant Notification Procedures: Existing occupant notification via the fire alarm system and subsequent building management personnel procedures shall remain and are not affected by the scope of renovation. The existing fire alarm system treats the building as a single evacuation zone. B. Emergency Response Features: Existing features to remain; not affected by scope of renovation. C. Safeguards: Existing fire protection systems shall be maintained throughout the construction as required by the Authority Having Jurisdiction (AHJ). Impairment to existing fire protection systems Page 3 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — August 25, 2015 Project Name: Watts Water Technologies Training Center RDK Project Number: 20150277.00 shall be approved by the AHJ and Owner prior to commencing work. A fire watch shall be provided during impairments to the fire suppression or fire alarm system in accordance with AHJ requirements. D. Future Testing & Maintenance: Modifications performed as part of the scope of renovation shall be warranted by the installing contractors for a period of one year covering defects in materials and workmanship. NFPA required inspection, maintenance and testing activities associated with the building fire protection system are the responsibility of the owner and are to be conducted under existing and/or future maintenance contracts held by the Building Management Company. Section 6 - Special Consideration and Description A. Unless otherwise noted, the design of the fire protection systems does not utilize alternative compliance design methods and is not intended to deviate from the prescriptive requirements of 780 CMR or other applicable codes and standards. 901.2.1 (1)(H) — SEQUENCE OF OPERATION A. The existing "base building" coordinated fire protection system basis of design and sequence of operation shall remain unchanged and shall not be modified under the scope of renovation. The general arrangement of the existing sequence of operation is described below and is subject to confirmation by the installing contractor and fire alarm system control unit technical representative. B. Activation of an existing or new manual pull station, smoke detector, heat detector or sprinkler system waterflow switch shall initiate the predefined fire alarm system "alarm condition" sequence: 1. Display alarm condition at fire alarm control unit and remote annunciator(s). 2. Energize audible (temporal -3 pattern) and visual (UL 1971 synchronized strobe) occupant notification circuits within evacuation zone(s) as designated by pre -established control unit sequence of operations. 3. Perform auxiliary fire safety functions as designated by pre -established control unit sequence of operations such as elevator recall, damper activation, door closure, AHU shutdown, pressurization systems, etc. 4. Transmit alarm condition to central / supervising station and/or local fire department via municipal alarm system. 5. In addition, the operation of an existing in -duct smoke detector shall initiate the following: a. Operation of an existing in -duct smoke detector provided at air handling units (AHU's) shall shut -down the corresponding AHU. b. Operation of an existing in -duct smoke detector provided for control of a smoke damper shall close the corresponding damper. C. The operation of an existing or new sprinkler tamper switch shall initiate the predefined fire alarm system "supervisory" sequence: 1. Display supervisory condition at fire alarm control unit and remote annunciator(s). 2. Transmit supervisory condition to central / remote supervising station. Page 4 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — August 25, 2015 Project Name: Watts Water Technologies Training Center RDK Project Number: 20150277.00 D. Normal power failure to fire alarm system remote power supplies, ground faults, short circuits and open circuit conditions shall initiate the predefined fire alarm system "trouble" sequence. Display supervisory condition at fire alarm control unit and remote annunciator(s). 2. Transmit trouble condition to central / supervising station. 901.2.1 (1)(iii) - TESTING CRITERIA Section 1 - Testing Criteria A. Fire Protection System testing shall be scheduled, administered, conducted and overseen by the general contractor, subcontractors and manufacturer's technical representatives. B. The following fire sprinkler system inspections and testing shall be performed: Visually inspect system installation for completeness, presence of defects or damage, and confirm system is placed into "all normal" operational service. 2. Hydrostatically test system piping for a period of 2 -hours. Piping shall be tested to normal system operating pressure where new installed piping cannot be isolated from the existing piping. 3. Functionally operate any new sprinkler waterflow or valve supervisory switches as part the fire alarm testing. C. The following fire alarm system inspections and testing shall be performed: 1. Confirm integrity of new or modified circuits (free of grounds, shorts, opens) prior to the installation of devices, appliances or equipment. 2. Visually inspect system installation for completeness, presence of defects or damage, and confirm system is placed into "all normal" operational service. 3. Confirm correct system supervision of wiring faults, missing devices and status of normal and standby power supplies (for new equipment installed as part of the work). 4. Functionally operate new devices installed as part of the work and confirm correct sequence of operation and address/zone identification at the fire alarm control unit. 5. Confirm audibility / intelligibility and visual synchronization of notification appliances. 6. Where fire alarm control unit software is updated as part of the work, functionally operate 10% of existing devices not affected by the work and confirm correct sequence of operation and address/zone identification at the fire alarm control unit. 7. Confirm correct operation of circuits under fault conditions in accordance with installed circuit style and class. D. Documentation, to be submitted to the Engineer of Record and AHJ: Sprinkler System: NFPA 13 "Contractor's Material and Test Certificate", accurately completed and endorsed by installing contractor's signature. Fire Alarm System: NFPA 72 "Fire Alarm System Record of Completion", accurately completed and endorsed by installing contractor's signature. Page 5 of 6 780 CMR 901.2.1 Fire Protection Systems Narrative Report — August 25, 2015 Project Name: Watts Water Technologies Training Center RDK Project Number: 20150277.00 E. Upon completion of the work, and receipt of the appropriate close-out documentation, the Engineer of Record shall certify completion for each fire protection system to the extent required by 780 CMR §901.5.1 F. The general contractor shall then schedule final acceptance demonstration testing with the AHJ in order to obtain approval for a Certificate of Occupancy. Section 2 - Equipment and Tools A. The contractor shall provide all required tools and equipment necessary to perform full functional testing as outlined. As a minimum these items shall include: 1. NFPA Forms 2. Manufacturer's Instructions 3. Fire Protection Systems Narrative Report 4. UL smoke candles or aerosol spray 5. Sound meters 6. Voltage Meters 7. Gauges 8. Communication Radios 9. Printer or data transfer device for recording each FACP event Section 3 - Approval Requirements A. The contractor shall obtain written acceptance of the installed system from the AHJ prior to the owner request for a Certificate of Occupancy. B. The contractor shall replace and/or repair each system or component of a system that fails to pass the Final Acceptance Test satisfactorily. Preliminary and Final Testing shall be rescheduled and testing shall be conducted until compliance is fully demonstrated. The contractor shall be liable for all additional charges as a result of retesting. C. Final certification shall be provided from the contractors that the installation is in accordance with the approved construction documents and applicable codes. The Engineer shall certify that the installation complies with the approved construction documents per 780 CMR 901.5.1. D. Operations Manuals and Record as -built drawings shall be submitted with any modifications as a resultant of changes that were dictated from the Final Testing process. E. The Owner shall provide an emergency contact list for use by the AHJ in the event of an emergency at the protected property. END OF NARRATIVE Page 6 of 6 E N I N E E R www.rdl�engineers,com RDK Engineers 200 Brickstone Sq. Andover, Ma 01810 978-296-6200 Job Name Watts Water Technologies - Training Center Building FP1.1 Location N. Andover System 1 Contract 20150277.000 Data File 20150277 Watts Training Ctr Calculation.WX1 Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 RDK Engineers Watts Water Technologies - Training Center HYDRAULIC CALCULATIONS for Project name: Watts Water Technologies Training Center Location: N. Andover Drawing no: FP1.1 Date: Design Remote area number. 1 Remote area location: Lower Level Occupancy classification: Light/ Ordinary Hazard Density. .15 - Gpm/SgFt Area of application: 1637 - Sq Ft Coverage per sprinkler. VARIES - SgFt Type of sprinklers calculated. Concealed Pendent - Quick Response No. of sprinklers calculated. 18 In -rack demand. - GPM Hose streams: 250 - GPM Total water required (including hose streams): 607.791 - GPM @ 42.854 -Psi Type of system: WET Volume of dry or preaction system: -Gal Water supply information Date: 5-13-15 Location: Watts Pump Room Source: Pump Name of contractor. Address: Phone number. Name of designer. Authority having jurisdiction: Notes: (Include peaking information or gridded systems here.) Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 Page 1 Date 8/21/2015 TF O N r N N 0000 N O m m CL C) BVI I, - co 0 M O Q M Z E m r c G r r r a) 7 O fY M�00 r� V N0O O vi M�N(O`- � c V) m 3N^E dill. co c M oEEEEEp 0 o �co00�2 rn LU U) U) cn � U) CN CN OM m M0oo2000 N 0 O O 00 O O r - LO O0 . r o< Oz J LL N U 0 0 O 0 0 � coCDLO me o M y O (DaLL Emco Q-== 0 0 a o o � "- COcoCU N tY� U o O i i O Co0 UUU In IT 0 oM No O- 0 O 0 o O o 0 0 0 0 0 LL W W w w o wW I, - co 0 M O Q M Z E m r c G r r r a) 7 O fY C14 oG § N o2 k $ oQ G f ? oQ / oG E 5 &2 $2 - -N $2 gLO 2f 0 # C14 o a - nn 02 % LQ g # -- @R - $ o� Cl) 000 -� �2 \ we 42 / C14 Co Ln C $ .m 2 o#2a00 » -i on2wo ƒ ca o04§LOLO # 0N%o't f a o -E000 § 2 $ 2,i«\ > cc> >ceo! �2to£ nim°cLL o55�k5 ==m+ma /22722 2§ Eaa\aa •=�o�� &2 Qzz=zz _j§ _ ik k=ulme & c 0 e ± 0 ©'S 002= E ƒ > .0 co c 5 o J § 2 Fu \:Q�Qƒ > E -£ § U- %C)52�2 k�k\$� -=@02o m/»777 ■ o :3 r®v a//■ cm ©m o�n &§ $E-cE E� CL // _ ���2\t 70 U) -C:3 /ƒ/o Q— 2ocLEE 52Ec«e o c /\�kc (nm e=o $%=�/2 \k�� �k Eo=gym _@(- = m 0 ¥ - �CDE�M= ®_ �>- 0)M / f / a) c - E o : / /�yk E _ x Q LL�2kf� U) /�=� $ E�R0) &•22ago \ 3-i}IL zWo(Dm Pressure / Flow Summary - STANDARD RDK Engineers Page 4 Watts Water Technologies - Training Center Date 8/21/2015 Node No. Elevation K -Fact Pt Actual Pn Flow Actual Density Area Press Req. 101 15.0 5.6 10.86 na 18.46 0.15 120 7.0 102 15.0 5.6 10.83 na 18.42 0.15 120 7.0 103 15.0 .5.6, 11.83 na 19.26 0.15 120 7.0 104 15.0 5.6 13.36 na 20.47 0.15 84 7.0 105 9.0 5.6 17.56 na 23.47 0.1 156 7.0 106 15.0 5.6 10.63 na 18.26 0.15 120 7.0 107 15.0 5.6 10.59 na 18.23 0.15 120 7.0 108. 15.0 5.6 11.58 na 19.06 0.15 120 7.0 109 15.0 5.6 12.29 na 19.63 0.15 84 7.0 110 15.0 5.6 12.17 na 19.54 0.15. 97.5 7.0 111 9.0 5.6 17.55 na 23.46 0.1 156 7.0 112 15.0 5.6 10.37 na 18.03 0.15 120 7.0 113 15.0 5.6 10.33 na 18.0 0.15 120 7.0 114 15.0 5.6 10.56 na 18.2 0.15 120 7.0 115 9.0 5.6 13.07 na 20.24 0.1 119 7.0 116 9.0 5.6 13.33 na 20.44 0.1 40 7.0 117 9.0 5.6 15.03 na 21.71 0.1 60 7.0 118 9.0 5.6 16.75 na 22.92 0.1 80 7.0 201 14.0 11.63 na 202 14.0 11.93 na 203 14.0 12.99 na 204 14.0 14.61 na 205 14.0 17.15 na 206 14.0 11.4 na 207 14.0 11.69 na 208 14.0 12.73 na 209 14.0 13.47 na 210 14.0 14.6 na 211 14.0 16.96 na 212 14.0 11.12 na 213 14.0 11.41 na 214 14.0 11.65 na 215 14.0 12.36 na 216 14.0 13.47 na 217 14.0 16.09 na 301 13.0 17.69 na 302 13.0 17.76 na 303 13.0 17.95 na 304 12.0 19.32 na 305 0.0 27.62 na ZCA 0.0 33.33 na 306 12.0 29.14 na ALM 2.0 33.61 na DCVA 2.0 38.82 na 501 12.0 34.59 na 502 12.0 34.93 na 503 12.0 35.18 na 504 12.0 35.5 na 505 12.0 35.63 na 506 14.0 35.18 na 507 2.0 40.85 na 508 2.0 41.33 na 250.0 PUMP 2.0 42.85 na The maximum velocity is 18.38 and it occurs in the pipe between nodes 216 and 301 Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 Final Calculations - Hazen -Williams RDK Engineers Page 5 Watts Water Technologies - Training Center Date 8/21/2015 Hyd. Qa Dia. Fitting Pipe Pt Pt Ref. "C" or Ftng's Pe Pv ******* Notes ****** Point Qt Pf/Ft Eqv. Ln. Total Pf Pn 101 18.46 1.049 E 2.0 1.000 10.864 K Factor = 5.60 to 120.0 0.0 2.000 0.433 201 18.46 0.1123 0.0 3.000 0.337 Vel = 6.85 0.0 18.46 11.634 K Factor = 5.41 102 18.42 1.049 T 5.0 1.000 10.825 K Factor = 5.60 to 120.0 0.0 5.000 0.433 202 18.42 0.1118 0.0 6.000 0.671 Vel = 6.84 0.0 18.42 11.929 K Factor = 5.33 103 19.26 1.049 T 5.0 1.000 11.830 K Factor = 5.60 to 120.0 0.0 5.000 0.433 203 19.26 0.1213 0.0 6.000 0.728 Vel = 7.15 0.0 19.26 12.991 K Factor = 5.34 104 20.47 1.049 T 5.0 1.000 13.360 K Factor = 5.60 to 120.0 0.0 5.000 0.433 204 20.47 0.1358 0.0 6.000 0.815 Vel = 7.60 0.0 20.47 14.608 K Factor= 5.36 105 23.47 1.049 E 2.0 3.000 17.563 K Factor = 5.60 to 120.0 T 5.0 7.000 -2.166 205 23.47 0.1750 0.0 10.000 1.750 Vel = 8.71 0.0 23.47 17.147 K Factor= 5.67 106 18.26 1.049 E 2.0 1.000 10.633 K Factor = 5.60 to 120.0 0.0 2.000 0.433 206 18.26 0.1100 0.0 3.000 0.330 Vel = 6.78 0.0 18.26 11.396 K Factor= 5.41 107 18.23 1.049 T 5.0 1.000 10.595 K Factor = 5.60 to 120.0 0.0 5.000 0.433 207 18.23 0.1097 0.0 6.000 0.658 Vel = 6.77 0.0 18.23 11.686 K Factor= 5.33 108 19.06 1.049 T 5.0 1.000 11.579 K Factor = 5.60 to 120.0 0.0 5.000 0.433 208 19.06 0.1190 0.0 6.000 0.714 Vel = 7.08 0.0 19.06 12.726 K Factor= 5.34 109 19.63 1.049 T 5.0 1.000 12.287 K Factor = 5.60 to 120.0 0.0 5.000 0.433 209 19.63 0.1258 0.0 6.000 0.755 Vel = 7.29 0.0 19.63 13.475 K Factor = 5.35 110 19.54 1.049 2E 4.0 7.000 12.171 K Factor = 5.60 to 120.0 T 5.0 9.000 0.433 210 19.54 0.1246 0.0 16.000 1.994 Vel = 7.25 Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 Final Calculations - Hazen-Williams RDK Engineers Page 6 Watts Water Technologies - Training Center Date 8/21/2015 Hyd. Qa Dia. Fitting Pipe Pt Pt Ref. "C" or Ftng's Pe Pv ******* Notes Point Qt Pf/Ft Eqv. Ln. Total Pf Pn 0.0 19.54 14.598 K Factor= 5.11 111 23.46 1.049 E 2.0 2.000 17.548 K Factor = 5.60 to 120.0 T 5.0 7.000 -2.166 211 23.46 0.1748 0.0 9.000 1.573 Vel = 8.71 0.0 23.46 16.955 K Factor = 5.70 112 18.03 1.049 E 2.0 1.000 _ 10.369 K Factor = 5.60 to 120.0 0.0 2.000 0.433 212 18.03 0.1077 0.0 3.000 0.323 Vel = 6.69 0.0 18.03 11.125 K Factor = 5.41 113 18.00 1.049 T 5.0 1.000 10.332 K Factor = 5.60 to 120.0 0.0 5.000 0.433 213 18.0 0.1070 0.0 6.000 0.642 Vel = 6.68 0.0 18.00 11.407 K Factor= 5.33 114 18.20 1.049 T 5.0 1.000 10.559 K Factor = 5.60 to 120.0 0.0 5.000 0.433 214 18.2 0.1092 0.0 6.000 0.655 Vel = 6.76 0.0 18.20 11.647 K Factor= 5.33 115 20.24 1.049 E 2.0 4.000 13.065 K Factor = 5.60 to 120.0 T 5.0 7.000 -2.166 215 20.24 0.1331 0.0 11.000 1.464 Vel = 7.51 0.0 20.24 12.363 K Factor= 5.76 116 20.44 1.049 E 2.0 10.000 13.328 K Factor = 5.60 to 120.0 T 5.0 7.000 -2.166 216 20.44 0.1356 0.0 17.000 2.305 Vel = 7.59 0.0 20.44 13.467 K Factor= 5.57 117 21.71 1.049 E 2.0 2.000 15.026 K Factor = 5.60 to 120.0 0.0 2.000 -2.166 216 21.71 0.1518 0.0 4.000 0.607 Vel = 8.06 0.0 21.71 13.467 K Factor= 5.92 118 22.92 1.049 2E 4.0 5.000 16.748 K Factor = 5.60 to 120.0 0.0 4.000 -2.166 217 22.92 0.1676 0.0 9.000 1.508 Vel = 8.51 0.0 22.92 16.090 K Factor = 5.71 201 18.46 1.38 0.0 10.000 11.634 to 120.0 0.0 0.0 0.0 202 18.46 0.0295 0.0 10.000 0.295 Vel = 3.96 202 18.42 1.38 0.0 10.000 11.929 to 120.0 0.0 0.0 0.0 203 36.88 0.1062 0.0 10.000 1.062 Vel = 7.91 Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 Final Calculations - Hazen -Williams RDK Engineers Page 7 Watts Water Technologies - Training Center Date 8/21/2015 Hyd. Qa Dia. Fitting Pipe Pt Pt Ref. "C" or Ftng's Pe Pv ******* Notes ****** Point Qt Pf/Ft Eqv. Ln. Total Pf Pn 203 19.26 1.38 0.0 7.000 12.991 to 120.0 0.0 0.0 0.0 204 56.14 0.2310 0.0 7.000 1.617 Vel = 12.04 204 20.47 1.61 T 8.0 7.000 14.608 to 120.0 0.0 8.000 0.433 303 76.61 0.1938 0.0 15.000 2.907 Vel = 12.07 0.0 76.61 17.948 K Factor= 18.08 205 23.47 1.38 0.0 8.000 17.147 to 120.0 0.0 0.0 0.433 303 23.47 0.0460 0.0 8.000 0.368 Vel = 5.03 0.0 23.47 17.948 K Factor= 5.54 206 18.26 1.38 0.0 10.000 11.396 to 120.0 0.0 0.0 0.0 207 18.26 0.0290 0.0 10.000 0.290 Vel = 3.92 207 18.23 1.38 0.0 10.000 11.686 to 120.0 0.0 0.0 0.0 208 36.49 0.1040 0.0 10.000 1.040 Vel = 7.83 208 19.05 1.61 0.0 7.000 12.726 to 120.0 0.0 0.0 0.0 209 55.54 0.1070 0.0 7.000 0.749 Vel = 8.75 209 19.63 1.61 0.0 6.000 13.475 to 120.0 0.0 0.0 0.0 210 75.17 0.1872 0.0 6.000 1.123 Vel = 11.85 210 19.54 1.61 T 8.0 1.500 14.598 to 120.0 0.0 8.000 0.433 302 94.71 0.2868 0.0 9.500 2.725 Vel = 14.93 0.0 94.71 17.756 K Factor= 22.48 211 23.46 1.38 0.0 8.000 16.955 to 120.0 0.0 0.0 0.433 302 23.46 0.0460 0.0 8.000 0.368 Vel = 5.03 0.0 23.46 17.756 K Factor = 5.57 212 18.03 1.38 0.0 10.000 11.125 to 120.0 0.0 0.0 0.0 213 18.03 0.0282 0.0 10.000 0.282 Vel = 3.87 213 18.00 1.61 0.0 5.000 11.407 to 120.0 0.0 0.0 0.0 214 36.03 0.0480 0.0 5.000 0.240 Vel = 5.68 214 18.20 1.61 0.0 7.000. 11.647 to 120.0 0.0 0.0 0.0 215 54.23 0.1023 0.0 7.000 0.716 Vel = 8.55 215 20.24 1.61 0.0 6.000 12.363 to 120.0 0.0 0.0 0.0 216 74.47 0.1840 0.0 6.000 1.104 Vel = 11.74 Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 Final Calculations - Hazen -Williams RDK Engineers Page 8 Watts Water Technologies - Training Center Date 8/21/2015 Hyd. Qa Dia. Fitting Pipe Pt Pt Ref. "C" or Ftng's Pe Pv ******* Notes ****** Point Qt Pf/Ft Eqv. Ln. Total Pf Pn 216 42.15 1.61 T 8.0 1.000 13.467 to 120.0 0.0 8.000 0.433 301 116.62 0.4217 0.0 9.000 3.795 Vel = 18.38 0.0 116.62 17.695 K Factor= 27.72 217 22.92 1.049 0.0 7.000 16.090 to 120.0 0.0 0.0 0.433 301 22.92 0.1674 0.0 7.000 1.172 Vel = 8.51 301 116.62 4.26 0.0 12.000 17.695 to 120.0 0.0 0.0 0.0 302 139.54 0.0051 0.0 12.000 0.061 Vel = 3.14 302 118.17 4.26 0.0 12.000 17.756 to 120.0 0.0 0.0 0.0 303 257.71 0.0160 0.0 12.000 0.192 Vel = 5.80 303 100.08 4.26 0.0 32.000 17.948 to 120.0 0.0 0.0 0.433 304 357.79 0.0294 0.0 32.000 0.940 Vel = 8.05 304 0.0 4.26 5E 65.835 40.000 19.321 to � 120.0 0.0 65.835 5.197 305 357.79 0.0293 0.0 105.835 3.106 Vel = 8.05 305 0.0 4.26 E 13.167 8.000 27.624 to 120.0 Fsp 0.0 84.269 3.000 * * Fixed Loss = 3 ZCA 357.79 0.0294 S 28.968 92.269 2.709 Vel = 8.05 B 15.8 T 26.334 ZCA 0.0 4.26 2E 26.334 8.000 33.333 to 120.0 0.0 26.334 -5.197 306 357.79 0.0293 0.0 34.334 1.007 Vel = 8.05 306 0.0 6.357 Avk 25.147 8.000 29.143 to 120.0 0.0 25.147 4.331 ALM 357.79 0.0042 0.0 33.147 0.139 Vel = 3.62 ALM 0.0 6.357 2E 35.205 15.000 33.613 to 120.0 0.0 35.205 5.000 * * Fixed Loss = 5 DCVA 357.79 0.0042 0.0 50.205 0.210 Vel = 3.62 DCVA 0.0 6.357 E 17.603 6.000 38.823 to 120.0 0.0 17.603 -4.331 501 357.79 0.0042 0.0 23.603 0.098 Vel = 3.62 501 0.0 6.357 B 12.573 17.000 34.590 to 120.0 3E 52.808 65.381 0.0 502 357.79 0.0042 0.0 82.381 0.344 Vel = 3.62 502 0.0 6.357 E 17.603 40.000 34.934 to 120.0 0.0 17.603 0.0 503 357.79 0.0042 0.0 57.603 0.241 Vel = 3.62 503 0.0 6.357 E 17.603 60.000 35.175 to 120.0 0.0 17.603 0.0 504 357.79 0.0042 0.0 77.603 0.324 Vel = 3.62 504 0.0 6.357 E 17.603 13.000 35.499 to 120.0 0.0 17.603 0.0 505 357.79 0.0042 0.0 30.603 0.128 Vel = 3.62 Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 Final Calculations - Hazen -Williams RDK Engineers Page 9 Watts Water Technologies - Training Center Date 8/21/2015 Hyd. Qa Dia. Fitting Pipe Pt Pt Ref. "C" or Ftng's Pe Pv ******* Notes ****** Point Qt Pf/Ft Eqv. Ln. Total Pf Pn 505 0.0 6.357 2E 35.205 66.000 35.627 to 120.0 0.0 35.205 -0.866 506 357.79 0.0042 0.0 101.205 0.423 Vel = 3.62 506 0.0 6.357 4E 70.411 30.000 35.184 to 120.0 B 12.573 82.984 5.197 507 357.79 0.0042 0.0 112.984 0.472 Vel = 3.62 507 0.0 6.357 B 12.573 13.000 40.853 to 120.0 5E 88.014 100.587 0.0 508 357.79 0.0042 0.0 113.587 0.475 Vel = 3.62 508 250.00 6.357 S 40.235 7.000 41.328 Qa = 250 to 120.0 Fsp 0.0 40.235 1.000 * * Fixed Loss = 1 PUMP 607.79 0.0111 0.0 47.235 0.526 Vel = 6.14 0.0 607.79, 42.854 K Factor= 92.84 Computer Programs by Hydratec Inc. Route 111 Windham N.H. USA 03087 COMcheck Software Version 4.0.1 Interior Lighting Compliance Certificate Project Information Energy Code: 2012 IECC Project Title: Watts Water Technologies - Training Room Project Type: Alteration Construction Site: Owner/Agent: Designer/Contractor: 815 Chestnut Street Samang Phon North Andover, MA RDK Engineers 200 Brickstone Square Andover, MA Allowed Interior Lighting Power A B C D Area Category Floor Area Allowed Allowed Watts (ft2) Watts / ft2 (B X C) 1 -Common Space Types:Classroom / Lecture / Training 1997 1 .30 2596 2 -Common Space Types:Corridor / Transition 1864 0.70 1305 3 -Common Space Types: Electrical/mechanical 992 1 .10 1091 4 -Common Space Types:Restroom 318 1 318 5 -Common Space Types:Lobby 808 1 .10 889 6 -Common Space Types: Laboratory for medical/industrial/research 2638 1 .80 4748 7 -Common Space Types:Storage 303 0.80 242 8 -Common Space Types:Lounge recreation 250 0.80 200 Total Allowed Watts = 11390 Proposed Interior Lighting Power A B C D E Fixture ID : Description / Lamp / Wattage Per Lamp / Ballast Lamps/ # of Fixture (C X D) Fixture Fixtures Watt. Common Space Types:Classroom / Lecture / Training (1997 sq.ft.) LED 1: LT1: 2'X2' LED Troffer: Other: 1 31 34 1054 Common Space Types:Corridor /Transition (1864 sq.ft.) LED 1 copy 1: LT1: 2'X2' LED Troffer: Other: 1 16 34 544 LED 5: ARI: 6" LED downlight: Other: 1 4 12 47 LED 8: LT2: Linear pendant LED: Other: 1 17 39 663 LED 13 copy 2: P2: Pendant cylinder LED: Other: 1 11 23 255 Common Space Types: Electrical/mechanical (992 sq.ft.) LED 9: LT4: 4' Lensed LED strip: Other: 1 15 28 420 LED 5 copy 2: AR1: 6" LED downlight: Other: 1 2 12 24 Common Space Types:Restroom (318 sq.ft.) LED 1 copy 2: LT1: 2'X2' LED Troffer: Other: 1 10 28 282 LED 5 copy 2: AR1: 6" LED downlight: Other: 1 5 12 59 Common Space Types:Lobby (808 sq.ft.) LED 13: AR2: Pendant cylinder LED: Other: 1 14 23 325 Project Title: Watts Water Technologies - Training Room Report date: 08/27/15 Data filename: Q:\2015\20150277 - WWT Training Center North Andover\0600 Electrical Design\603 Page 1 of 7 Lighting\20150277_Watts Training and Labs_COMCheck.cck A Fixture ID : Description / Lamp / Wattage Per Lamp / Ballast LED 13 copy 2: P2: Pendant cylinder LED: Other: LED 5 copy 3: AR1: 6" LED downlight: Other: LED 16: P1: Decorative pendant: Other: Common Space Types: Laborato ry for medical/industrial/research (2638 sq.ft.) LED 9 copy 1: LT4: 4' Lensed LED strip: Other: LED 17: T1: LED track head: Other: Common Space Types:Storage (303 sq.ft.) LED 5 copy 1: AR1: 6" LED downlight: Other: LED 9 copy 2: LT4: 4' Lensed LED strip: Other: Common Space Types:Lounge recreation (250 sq.ft.) LED 1 copy 3: LT1: 2'X2' LED Troffer: Other: 1 2 34 68 LED 5 copy 2: AR1: 6" LED downlight: Other: 1 5 12 59 LED 13 copy 1: P2: Pendant cylinder LED: Other: 1 3 23 70 Total Proposed Watts = 5588 IP Interior Lighting Compliance Statement Compliance Statement: The proposed interior lighting alteration project represented in this document is consistent with the building plans, specifications, and other calculations submitted with this permit application. The proposed interior lighting systems have been designed to meet the 2012 IECC requirements in COMcheck Version 4.0.1 and to comply with the mandatory requirements listed in the Inspection Checklist. B C D E Lamps/ # of Fixture (C X D) Fixture Fixtures Watt. 1 2 23 46 1 5 12 59 1 1 50 50 1 38 28 1064 1 18 14 252 1 2 12 24 1 8 28 224 ame- ignatu S -b --+l ("s - Date Project Title: Watts Water Technologies - Training Room Report date: 08/27/15 Data filename: QA2015\20150277 - WWT Training Center North Andover\0600 Electrical Design\603 Page 2 of 7 Lighting\20150277_Watts Training and Labs_COMCheck.cck COMcheck Software 'version 4.0.1 Inspection Checklist Energy Code: 2012 IECC Requirements: 0.0% were addressed directly in the COMcheck software Text in the "Comments/Assumptions" column is provided by the user in the COMcheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. 2012 IECC1 Plan Review _— ...-- ----.................. - Complies? Comments/Assumptions C103.2 Plans, specifications, and/or ❑Complies [PR4]' icalculations provide all information ❑Does Not with which compliance can be ❑Not Observable 'determined for the interior lighting ❑Not Applicable and electrical systems and equipment and document where exceptions to ::the standard are claimed. Information provided should include interior lighting power calculations, wattage of 'bulbs and ballasts, transformers and control devices. Additional Comments/Assumptions: ._........ ...... _._..... _........................ -................... _...... ._...... _...... ...... _.... ,.............. ............ _.... __... _... .._................................................ _............................... _... ............... _..._ ........... I 1 "High Impact (Tier 1) 2 Medium Impact (Tier 2) 3 Low Impact (Tier 3) .._ .......:....._................................_....... -___..........._............_...........:............_...._......--._-......._......_........_....................................._...........................:..........._:.....--.-........_..............__......................_............ ....._...._� Project Title: Watts Water Technologies - Training Room Report date: 08/27/15 Data filename: Q:\2015\20150277 - WWT Training Center North Andover\0600 Electrical Design\603 Page 3 of 7 Lighting\20150277_Watts Training and Labs_COMCheck.cck 2012 IECCJ Rough-in Electrical Inspection Complies? Comments/Assumptions ...................................................................................... C405.2.2. ........................................... ............. ...................................................... 'Automatic controls to shut off all ............ ............................................ ....._ .........._......_........._........................................................ . ..................................................................... ............................. ........ .................... .................................................................. ❑Complies 1 building lighting installed in all ❑Does Not [EL22]2 buildings. ❑Not Observable'. .._..__..: ........................................................__............................................................................................................................................................ ❑Not Applicable C405.2.1. ........ Independent lighting controls installed❑Complies ................. ..... ......... .......... ................._.......... _....._..._..................... ................... ............... ..................................................... ...... ................. ........... ........................................ ......................... .... .........._........ 1 per approved lighting plans and all ❑Does Not [EL23]2 manual controls readily accessible and ❑Not Observable .............................................. visible to occupants. :............ ❑Not Applicable C405.2.1. _.............. ....................................... ....................................................._..__._..................__.__..:...._...._.................................................................:....................._... ,Lighting controls installed to uniformly'❑Complies ...._...... 2 ; reduce the lighting load by at least ❑Does Not [EL15]1 '50%. ❑Not Observable ....................................................................................................................................................................................................................:...................................................-................................................... ❑Not Applicable, C405.2.2. ' Daylight zones provided with . ❑Complies 3 individual controls that control the ❑Does Not [EL16]2 :lights independent of general area ❑Not Observable ...... ....................... lighting. ........................................ ......_.............._....................... ❑Not Applicable C405.2.3 ................................ ..... .................... ....................;......................................................_._._._.._.............._.. (Sleeping units have at least one ❑Complies [EL17]3 master switch at the main entry door ❑Does Not ;that controls wired luminaires and ❑Not Observable': ................... .switched receptacles. ............................................................................_.._........_............................................ ❑Not Applicable C405.2.2. ....... ........ ....... ........:............_ ;Occupancy sensors installed in .................................................... ........................................................... _........._ ............................... ❑Complies 2 ;required spaces. ❑Does Not [EL18]1❑Not Observable ..............................................j............................................................................ ❑Not Applicable C405.2.2. ......................... .......................... ... ...... ........... ............ ..._. ; Primary sidelighted areas are .............................................................................................. ............. ..... ........................................................ .-......................................................... .................................... ..............................................................._................. ❑Complies 3 ;equipped with required lighting ❑Does Not [EL20]1 ;controls. ❑Not Observable ........................... ... ... .............:................ ............................................................ ... ..... ...... ... ❑Not Applicable C405.2.2. ....... ...... ................................... _... _.................. :Enclosed spaces with daylight area ................. ........................... -....................................................................................................... - .......................... ... ❑Complies 3 funder skylights and rooftop monitors ❑Does Not [EL21]1 ;are equipped with required lighting ❑Not Observable ..... ................................:........................................................................................................................................ ;controls. ❑Not Applicable :....................... C405.2.3 .............................. :Separate lighting control devices for ...................................................... .................................. .............................. ❑Complies [EL4]1 :specific uses installed per approved ❑Does Not -lighting plans. ❑Not Observable ............ ................._....................................................................................................................... ❑Not Applicable C405.3 ............................................... Fluorescent luminaires with odd .................................................... __....................................................... ............................................... .... ...................... .... .................... ............................. ....._........................... ................................................. _............ ❑Complies [EL19]3 numbered lamp configurations that ❑Does Not are with 10 feet center to center (if ❑Not Observable recess mounted) or are within 1 foot ❑Not Applicable edge to edge (if pendant or surface ......... ........... .....:.........__.................................. mounted) shall be tandem wired. . C405.4 .............._......._..........................................................._............................ Exit signs do not exceed 5 watts per ..... ........_............... _...... _........... ...._...__.._.....:..............__...._..........._._..........................._.........._.__....._...................................................... ❑Complies [EL6]1 face. ❑Does Not ❑Not Observable ................... ......................... ... ..................................... _ ❑Not Applicable C405.2.3 _.... ... _._.__.......................... .............. ...... ........_.............................................. Additional interior lighting power ....................................... ............................. .... ................... ......_............ ❑Complies [EL8]1 allowed for special functions per the ❑Does Not approved lighting plans and is ❑Not Observable automatically controlled and separated from general lighting. ❑Not Applicable Additional Comments/Assumptions: 1 High Impact (Tier 1) ........................... ........... __......_......................... ..............................._._.................................. 2 Medium Impact (Tier 2) 3 Low Impact (Tier 3) ..........._.........._................ --------.............................. ......_.__,...__......._..__........................................_......._................ ...... ....... Project Title: Watts Water Technologies - Training Room Report date: 08/27/15 Data filename: Q:\2015\20150277 - WWT Training Center North Andover\0600 Electrical Design\603 Page 4 of 7 Lighting\20150277_Watts Training and Labs_COMCheck.cck ............. _................ ........................ ..............................................__.._............. ....................... - ... _................... _.......................................................................................... 1 High Impact (Tier 1) 2 Medium Impact (Tier 2) 3 Low Impact (Tier 3) ..................................................__.__..............._....:............... _ ___ _ ................._ __..........................._,.............................. --- .._.... ............... ..................... _ 1 Project Title: Watts Water Technologies - Training Room Report date: 08/27/15 Data filename: Q:\2015\20150277 - WWT Training Center North Andover\0600 Electrical Design\603 Page 5 of 7 Lighting\20150277_Watts Training and Labs_COMCheck. cck j, 2012 IECC Final inspection Complies? 1 Comments/Assumptions ............. ............................... C408.2.5. ..:...................................... ................................................................................................................................ Furnished as -built drawings for ............................... ........................ ...................._:.............................. ....... ............ .............................. ... ..................................................................... ............................... ..-.................................................................................. ❑Complies 1 electric power systems within 30 days ❑Does Not [F116]3 of system acceptance. ❑Not Observable ❑Not Applicable C303.3,C4 Furnished 0&M instructions for ❑Complies 08.2.5.2 systems and equipment to the ❑Does Not [F117]3 building owner or designated -]Not Observable representative. ❑Not Applicable C405.5.2 ; Interior installed lamp and fixture ❑Complies See the Interior Lighting fixture schedule for values. [F118]1 lighting power is consistent with what ❑Does Not Js shown on the approved lighting ❑Not Observable plans, demonstrating proposed watts ❑Not Applicable are less than or equal to allowed watts. C408.3 lighting systems have been tested to ❑Complies [F133]1 ensure proper calibration, adjustment, ❑Does Not programming, and operation. ❑Not Observable ❑Not Applicable C406 Efficient HVAC performance, efficient ❑Complies [F134]1 lighting system, or on-site supply of ❑Does Not renewable energy consistent with ❑Not Observable ;what is shown the approved plans. ❑Not Applicable Additional Comments/Assumptions: .. .................._......................................................................................_...................._............._.............................,.............. ..........._._.................................................................. .......... ....... ... 1 . High Impact (Tier 1) T2 ;Medium Impact (Tier 2) 3 Low Impact (Tier 3) _:........_..._......._ .......... .............. .................._...........__....._.........:._...._...._._........_...._......._...._......_._..._.......__..................................._..._..........._.....:......._......................._._........_....._.........._............................� Project Title: Watts Water Technologies -Training Room Report date: 08/27/15 Data filename: Q:\2015\20150277 - WWT Training Center North Andover\0600 Electrical Design\603 Page 6 of 7 Lighting\20150277_Watts Training and Labs_COMCheck.cck Project Title: Watts Water Technologies - Training Room Report date: 08/27/15 Data filename: Q:\2015\20150277 - WWT Training Center North Andover\0600 Electrical Design\603 Page 7 of 7 Lighting\20150277_Watts Training and Labs_COMCheck.cck I01 .v. ,-v 'A� n" CERTIFICATE OF LIABILITY INSURANCE DlYYYY) 1:f066124/15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: 781-935-8480 DeSanctis Insurance Agcy, Inc. Unicorn Park Drive Fax: 781-933-5645 Woburn, MA 01801 NAME: CT PONE a No):100 Ext): MC-AML-0, ADDRESS: PcFR COSTUMER ID N: WISEC-1 INSURERS AFFORDING COVERAGE NAIC $ GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X Per Project Agg INSURED Wise Construction Corp W East Street Winchester, MA 01890 INSURER A: Llbe Mutual Insurance Cos. INSURERS: Associated Employers INSURER C: Nautilus Insurance Company 17370 INSURER D: American Insurance Company EACH OCCURRENCE $ 1,000,00 INSURER E: _ MED EXP (Any one person) $ 10,00 INSURER F: I;uvtzKAtst5 CFRTIFICATF NI IMRFR- oe1mm^sr su usoeo. 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. INSRPOLICY LTR TYPE OF INSURANCE ADDL INWLPOLICY SUBR NUMBER EFF IMMIDpf= POLICY EXP iMM/DDNYYYILIMITS AUTHORIZED REPRESEN E A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X Per Project Agg TB2Z11261323025 06/27/15 06/27/16 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 300,00 _ MED EXP (Any one person) $ 10,00 PERSONAL 8 ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMITAPPLIES PER: POLICY X PRO- LOC PRODUCTS -COMP/OP AGG $ 2,000,00 $ A AUTOMOBILE X LIABILITY ANY AUTO AS2Z11261323015 06/27/15 06/27/16 COMBINED SINGLE LIMIT $ 11000,00 (Ea accident) BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE (Per PE dent} $ X HIRED AUTOS X NON -OWNED AUTOS $ X UMBRELLA LtAB X OCCUR EACH OCCURRENCE $ 10,000,00 A EXCESS LIAR CLAIMS MADE THM 1261323035 06/27/15 06/27/16 AGGREGATE $ 10,000,00 X DEDUCTIBLE RETENTION $ 10,000 $ $ B C WORKERS COMPENSATIONWC AND EMPLOYERS' LIABILITY OFFICER/MEMBER ER EXCLUDED? ECu nVE Y� (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below Pollution Liab N i A CC50050135352015A MA CPL201193411 06/27/15 06/27/15 06/27/16 06/27/16 STATU- OTH- X R E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 11000100 E.L. DISEASE - POLICY LIMIT $ 1,000,00 Agg/occur 3miUlmi DESCRIPTION OF OPERATIONS f LOCATIONS t VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) "ADDITIONAL INSURED LIMITS ARE NO GREATER THAN THOSE REQUIRED BY WRITTEN CONTRACT." Evidence of Coverage I,CR 1 Iri%.A r C r1ULUtK ^A..-- . -,r EVIDE-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EVIDENCE OF INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESEN E % ^ . '©19816-2009 ACORO CO 0LU TION�AII rights reserved. ACORD 26 (2009/09) . The ACORD name and logo are registered marks of ACORD _� Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supen isor License: CS-097661 ERIC S iIEBBY ': 200 JEWETT ST � Lf�', /t GEORGETOWNi4A '61$33 ./�• Expiration.. Commissioner 08/09/2016 .1 Date!.. ............... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............. 4 ....... r ....... ...... .....E'...!.. .. has permission to perform AP ...... ..... ............ ................ ............... 11� IA -k, e�� wiring in the building of............ ....... ...................................................... ................. . ........... at Jl1� ........ CAO ..... .............. . North Andover, Mass. ), � ..... Lic. Nok/.96. . .......................,---***'*Fee A>.J .. ELECTRICAL Check 4t3/ 7� l,1mmonuwea1t4 of Ma-macl etb Official Use Only 2e artment` oDJim Serviced Permit No. P /" 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: 5,;7a 5 City or Town of: Ajog- j A0jp& 4Sy?,_ 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) 21 �N�ca�,y�}T SS Owner or Tenant 6,2A -r -T's Telephone No. Owner's Address Is this permit in conjunction with a building permit? Purpose of Building Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Yes ❑ No ®-- (Check Appropriate Box) Utility Authorization No. Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ No. of Meters No. of Meters Location and Nature of Proposed Electrical Work: _Rey-%,9LxC a-, R -.p l A CZ ke�96 ✓ A e__ 0,-.7 1 iS 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 L KVA No. of Luminaires Swimming Pool Above ❑In- E] rnd. grnd. No. of Emergency Lighting BatteEy Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pum Totals Number Tons ""'"' "' "' KW '......"'............Detection/Alerting No. of Self -Contained Devices No. of Dishwashers Space/Area Heating KW Local [IMunicipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of WaterK`,`, Heaters No. of No. of Signs Ballasts Data Wiring: . No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of lectrical Work: ahlap (When required by municipal policy.) Work to Start: ItIl Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVE GE: 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 R®, BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete FIRM NAME: 0"► G[J ,.> 7St a: t>t LIC. NO.: /o L 9_1,JQ Licensee: :1!H,,,,) A�P_,Jh I -p— Signature LIC. NO.: gal 9� (If applicable, enter "exempt " in the license number line.) Bus. Tel. No.: 2-Q -30?�� - ST77 Address: '7 I Alt. Tel. No.: 6,17-772-233 *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 p PERMIT FEE. $ Signature Telephone No. � The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 Print Form ; www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Medford Wellington Service Company Address: 17 Locust St City/State/Zip: Medford, MA 02155 Phone #: 781-396-5279 Are you an employer? Check the appropriate box: 1. Q I am a employer with l aQ 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ 1 am a homeowner doing all work myself. [No workers' comp. insurance required.] t listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.: 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical `repairs or additions 11.❑ Plumbing repairs or additions 12. ❑ Roof repairs 13. ❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ABC MA Self Insurance Policy # or Self -ins. Lic. #: ABCMA00502915 Expiration Date: 1/31/2014, Job Site Address: R'S City/State/Zip: n� /.alb✓, i^'t 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. Ido hereby certi ide>� the pains andpenalties of perjury that the in formation provided above is true and correct. 1` �DSCl-- 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 #: COMMONWEALTH OF MASSACHUSETTS BOARD OF+ ELECTRICIANS ISSUES THE FOLLOWING LICENSE AS -16 - REGISTERED MASTER ELECTRIC i AN a MEDFORD WELLINGTON SERVICE CO IN JOHN J ANNARELL I JR _u_ ;u 17 LOCUST ST MEDFORD MA 02155-5.713 10192 A, 07/31/.16 34569 r--rg BOARD O� _— ELfCTRI-C1ANS 15SUES THE FOLL;QW 6 110ENS A A R;EG J0't1RNEYMAN ELfCTR1 C1 A 1QHN -1ANNARELI 1 JR - W ,N 11 LESE AU ilk M10DLETON MA 01`94971`525 22;192. E' . 0;7/31/1:6 3332.2 Location `> c V f .f tJ : cr—� No. Check #C� 2.568/ Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $--A TOTAL $ Ail Building Inspector k/lvw," /1-19-16,%iavJS4� Permit N0: ft� --,I (te Date Issued: BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received TANT: Applicant must complete all items on this *\O,p � rCb. '; a . eb *1 buy ldbgO -b'd- . r 64202M 61 Henan f 1,o le f Identification Please Type or Print Clearly) A OWNER: Name: �ack4e CoMI6%1 Phone: Address: i ARCHITECT/ENGINEER Phone: Address: A7 Ax ye, zo id ., 6m"" A)9 ej 3:3rt Reg. No. FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ -67, Ar)d, FEE: $ d 80¢. Check No.: b Receipt No.: 0 NOTE: Persons cont cting. -with unregistered contractors do not have access t th my fund (( < 00 OO �.O _ cr CL 0 --I 0 � Q C)rn O� v►eq� o 'rl C ' 0 0 — CL O m N �•N CD -D-I cm � O 3 U)O N• p O 0ca 0 CD 0-0 ;t z-0 a CL a, _ �Qo Cl) CD 0= � =r 0� o 0 CD �Om rt�� ><�% zcpo o ° CD 5 N ccso P. M U)CL to N �N U � n a�• iL- ' oo I �< Z U CD CD 00 GO a n O CD c do'"� a' C N —� �• 000 ; o J O ch cn ' F •� ^ CQ CD cnu 3 _ 'C ^ CD Ve 0 z �• CCD� S J C1 y CD 0 o 0: 3. CD n`° C Z C o a S �s c� oCL �, s �n VI N Co T mT V1 .o T ;o T (� 70 T V1 T 3 c 3' O O :3O :' S O O (D O 0 lO 2 3 O_ O_ f1 \ Ln r m 3 S W (D m C C 3 :3 po G1 O m z rn f7 D O rn N 2 m m m O z 0 = �i HYDRAULIC CALCULATIONS for Job Information Project Name: WATTS TRAINING & STAIR RENOVATION Contract No.: City: NORTH ANDOVER, MA Project Location: 815 CHESTNUT STREET Date: 10/15/2015 Contractor Information Name of Contractor: A&E FIRE PROTECTION Address: 25 NORTH STREET City: CANTON, MA 02021 Phone Number: 781-329-9799 E-mail: KREITER@AEFIREINC.COM Name of Designer: KREITER Authority Having Jurisdiction: NORTH ANDOVER FD Design Remote Area Name 1 Remote Area Location LABS Occupancy Classification OH 1q14 OF/!gq s Density (gpm/ft2) 0.15 NATHANIEL an'IANIEL � Area o R. PHILLI of Application (ft)z 1500 c3 FIRE ppO ON g Coverage per Sprinkler (ftz) 127 NO. Q cn Number of Calculated Sprinklers 13 F9sC,ysTIE �QNAL Q In -Rack Demand (gpm) Special Heads 0 t0(I l Hose Streams (gpm) 250 Total Water Required (incl. Hose Streams) (gpm) 516.7 Required Pressure at Source (psi) 25.1 Type of System Wet Volume - Entire System (gal) 387.5 gal Water Supply Information Date 05/13/15 Location FIRE PUMP Source FP Notes File: X:\PROJECTS\Watts - Training Center, N. Andover\Watts 1.dwg Date 11/6/2015 Copyright © 2002-2012 Tyco Fire Protection Products Page 1 Job: WATTS TRAINING & STAIR RENOVATION Calculation Info Calculation Mode Hydraulic Model Fluid Name Fluid Weight, (Ib/ft3) Fluid Dynamic Viscosity, (lb•s/ft2) Water Supply Parameters Supply 1 : FP Supply Analysis Hydraulic Analysis for: 1 Demand Hazen -Williams Water @ 60F (15.6C) N/A for Hazen -Williams calculation. N/A for Hazen -Williams calculation. Flow (gpm) Pressure (psi) 0 82 500 62 Node at Source Static Pressure Residual Pressure Flow Available Pressure Total Demand Required Pressure (psi) (psi) (gPm) (psi) (gpm) (Psi) FP 82 62 500 75.7 516.7 25.1 Hoses Inside Hose Flow / Standpipe Demand (gpm) Outside Hose Flow (gpm) Additional Outside Hose Flow (gpm) 250 Other (custom defined) Hose Flow (gpm) Total Hose Flow (gpm) 250 Sprinklers Ovehead Sprinkler Flow (gpm) InRack Sprinkler Flow (gpm) 266.7 0 Other (custom defined) Sprinkler Flow (gpm) 0 .................................................................................... Total Sprinkler Flow (gpm) 266.7 Other Required Margin of Safety (psi) 0 FP -Pressure (psi) 25.1 FP -Flow (gpm) 266.7 Demand w/o System Pump(s) N/A File: X:\PROJECTS\Watts - Training Center, N. Andover\Watts 1.dwg Date 11/6/2015 Copyright © 2002-2012 Tyco Fire Protection Products Page 2 T— L 402 N o �i } ilii ji i 1�,�,� r i Iii i EE I! ill I I 1 EEi E I It 10 '�� R ��► ? IR � ��F ;�� ff ��I�l�I EIS fij 3 ttttttl N f i E�+ I � 1 6 f�{ 4 0 Rrs i � E • s t({ � li� 4i `E r r f sR i � tt ( i j{t � � jjj E i{{ !!{!{ j t{[{F a Ril ae i!!I�IRi i�E I Eit ?EiiR R'R 3 i I W aEU. i E i I f i 1 1 F i i f[ i 3 4 t j ai iR rs Iii sl I r E ER, ii 3 Rr I R;f rEE 1 R3R ssf I V ! !!, 'IR �! ilr R R I R O jj r i i l l 'i j i � i ill � f i R r, R i E Mill }; 1 i 1 f r f r S! i O O o isd `ajnssaJd x Y N U 3 2 CL c O U m 2 CL 2 LL U H N O N N 0 0 N L O1 CL 0 U Job: WATTS TRAINING & STAIR RENOVATION Hydraulic Analysis for: 1 Graph Labels Label Description Pressure (psi) Flow (gpm) Pressure (psi) @ Flow (gpm) Values Flow (gpm) Pressure (psi) S1 Supply point #1 - Static 0 82 S2 Supply point #2 - Residual 500 62 D1 Elevation Pressure 0 3.5 D2 System Demand 266.7 25.1 D3 System Demand + Add.Out.Hose 1516.7 125.1 Curve Intersections & Safety Margins Curve Name Intersection Safety Margin Pressure (psi) Flow (gpm) Pressure (psi) @ Flow (gpm) Supply 64.4 466.3 35.6 516.7 Open Heads File: X:\PROJECTS\Watts - Training Center, N. Andover\Watts 1.dwg Date 11/6/2015 Copyright © 2002-2012 Tyco Fire Protection Products Page 4 Required Calculated Head Ref. Head Type Coverage K -Factor Density Flow Pressure Density Flow Pressure (ft2) (gpm/psis/2) (gpm/ftz) (gpm) (psi) (gpm/ft2) (gpm) (psi) H101 Overhead 127 5.6 0.15 19.1 11.6 0.15 19.1 11.6 Sprinkler H102 Overhead 127 5.6 0.15 19.1 11.6 0.151 19.1 11.7 Sprinkler H103 Overhead 127 5.6 0.15 19.1 11.6 0.153 19.4 12 Sprinkler H104 Overhead 127 5.6 0.15 19.1 11.6 0.158 20.1 12.8 Sprinkler H105 Overhead 127 5.6 0.15 19.1 11.6 0.164 20.8 13.8 Sprinkler H106 Overhead 127 5.6 0.15 19.1 11.6 0.181 23 16.9 Sprinkler H107 Overhead 127 5.6 0.15 19.1 11.6 0.181 23 16.9 Sprinkler H108 Overhead 127 5.6 0.15 19.1 11.6 0.151 19.1 11.7 Sprinkler H109 Overhead 127 5.6 0.15 19.1 11.6 0.151 19.2 11.8 Sprinkler H110 Overhead 127 5.6 0.15 19.1 11.6 0.154 19.5 12.1 Sprinkler H111 Overhead 127 5.6 0.15 19.1 11.6 0.159 20.1 12.9 Sprinkler H112 Overhead 127 5.6 0.15 19.1 11.6 0.165 21 14.1 Sprinkler H113 Overhead 127 5.6 0.15 19.1 11.6 0.182 23.1 17 Sprinkler File: X:\PROJECTS\Watts - Training Center, N. Andover\Watts 1.dwg Date 11/6/2015 Copyright © 2002-2012 Tyco Fire Protection Products Page 4 Job: WATTS TRAINING & STAIR RENOVATION PIPE INFORMATION Hydraulic Calculations Node 1 Elev 1 K -Factor 1 Flow added (q) Nominal ID Fittings L C Factor total (Pt) Node 2 Elev 2 K -Factor 2 Total flow (Q) Actual ID quantity x (name) = length F Pf per ft elev (Pe) NOTES T frict (Pf) H 102 (ft) (gpm/psis/i) (gpm) (in) (ft) (ft) (psi) (psi) Path No: 1 H101 -3 5.6 19.1 1.5 8.5 120 11.6 H 102 -3 5.6 19.1 1.68 0 0.012 0 8.5 0.1 H 102 -3 5.6 19.1 1.5 8.5 120 11.7 H 103 -3 5.6 38.2 1.68 0 0.0433 0 8.5 0.4 H103 -3 5.6 19.4 1.5 8.5 120 12 H104 -3 5.6 57.6 1.68 0 0.0928 0 8.5 0.8 H 104 -3 5.6 20.1 1.5 5.99 120 12.8 H 105 -3 5.6 77.7 1.68 0 0.1615 0 5.99 1 H105 -3 5.6 20.8 1.51x(us.Tee-Br)=9.84 3.58 120 13.8 341 -3 98.5 1.68 9.84 0.2506 0 13.42 3.4 341 -3 23 4 9.6 120 17.2 333 -3 121.5 4.26 0 0.004 0 9.6 0.0 333 -3 23 4 5.4 120 17.2 328 -3 144.5 4.26 0 0.0055 0 5.4 0.0 328 -3 99 4 5.88 120 17.2 003 -3 243.6 4.26 0 0.0144 0 5.88 0.1 003 -3 23.1 4 4x(us.90)=52.67 79.32 120 17.3 125 -3 266.7 4.261x(us.Tee-Br)=26.33 79 0.0171 0 158.32 2.7 125 -3 0 6 2x(us.Tee-Br)=75.44 10 120 20 118 -11 266.7 6.357 75.44 0.0024 3.5 85.44 0.2 118 -11 0 4 1x(us.Tee-Br)=26.33 2.5 120 23.7 091 -11 266.7 4.26 26.33 0.0171 0 28.83 0.5 091 -11 0 61x(coupling)=1.26 1.73 120 24.2 095-I -9.27 266.7 6.357 1.26 0.0024 -0.8 2.99 0 095-I -9.27 0 6 0.88 0 23.4 Gate A2360 095-0 -8.39 266.7 0 0 0.0038 -0.4 *** 0.88 0 095-0 -8.39 0 61x(coupling)=1.26 163.94 120 23.1 352-0 -5.46 266.7 6.357 8x(us.90)=140.82 142.08 0.0024 -1.3 306.02 0.7 352-0 -5.46 0 6 1 0 22.5 AV -1 Check 352-I -6.46 266.7 0 0 0.0945 0.4 *** 1 0.1 352-I -6.46 0 61x(coupling)=1.26 1.93 120 23.1 353-0 -8.39 266.7 6.357 1.26 0.0024 0.8 3.19 0 File: X:\PROJECTS\Watts - Training Center, N. Andover\Watts 1.dwg Date 11/6/2015 Copyright© 2002-2012 Tyco Fire Protection Products Page 5 Job: WATTS TRAINING & STAIR RENOVATION PIPE INFORMATION Hydraulic Calculations Node 1 Elev 1 K -Factor 1 Flow added (q) Nominal ID Fittings L C Factor total (Pt) Gate A2360 Node 2 Elev 2 K -Factor 2 Total flow (Q) Actual ID quantity x (name) = length F Pf per ft elev (Pe) NOTES T frict (Pf) 353-I (ft) (gpm/psis/2) (gpm) (in) (ft) (ft) (psi) (psi) Path No: 1 353-0 -8.39 5.6 0 6 lx(us.Tee-Br)=9.84 0.88 0 23.9 Gate A2360 353-I -9.27 5.6 266.7 0 0 0.0038 0.4 *** 0.88 0 353-I -9.27 5.6 0 6lx(us.Tee-Br)=37.72 4.45 120 24.3 FP -11 5.6 266.7 6.357 37.72 0.0024 0.8 42.171 1 0.1 FP 25.1 Path No: 2 H 108 -3 5.6 19.1 1.5 lx(us.Tee-Br)=9.84 8.5 120 11.7 H109 -3 5.6 19.1 1.68 0 0.0121 0 8.5 0.1 H 109 -3 5.6 19.2 1.5 8.5 120 11.8 H110 -3 5.6 38.4 1.68 0 0.0437 0 8.5 0.4 H110 -3 5.6 19.5 1.5 8.5 120 12.1 H111 -3 5.6 57.9 1.68 0 0.0936 0 8.5 0.8 1-1111 -3 5.6 20.1 1.5 6.99 120 12.9 H112 -3 5.6 78 1.68 0 0.1628 0 6.99 1.1 H112 -3 5.6 21 1.5lx(us.Tee-Br)=9.84 2.59 120 14.1 328 -3 99 1.68 9.84 0.2532 0 12.441 3.1 328 17.2 Path No: 3 H106 -3 5.6 23 1.5 lx(us.Tee-Br)=9.84 5.77 120 16.9 426 -3 23 1.68 9.84 0.017 0 15.62 0.3 426 -3 0 4 1.68 120 17.2 341 -3 23 4.26 0 0.0002 0 1.681 1 0 341 17.2 Path No: 4 H107 -3 5.6 23 1.5 lx(us.Tee-Br)=9.84 5.77 120 16.9 333 -3 23 1.68 9.84 0.017 0 15.62 0.3 333 17.2 Path No: 5 H113 -3 5.6 23.1 1.5lx(us.Tee-Br)=9.84 5.77 120 17 003 -3 23.1 1.68 9.84 0.0171 0 15.62 0.3 003 17.3 File: X:\PROJECTS\Watts - Training Center, N. Andover\Watts 1.dwg Date 11/6/2015 Copyright 0 2002-2012 Tyco Fire Protection Products Page 6 Job: WATTS TRAINING & STAIR RENOVATION PIPE INFORMATION Hydraulic Calculations Node 1 Elev 1 K -Factor 1 Flow added (q) Nominal ID Fittings L C Factor total (Pt) Node 2 Elev 2 K -Factor 2 Total flow (Q) Actual ID quantity x (name) = length F Pf per ft elev (Pe) NOTES T frict (Pf) (ft) (gpm/psiY2) (gpm) (in) (ft) (ft) (psi) (psi) * Pressures are balanced to a high degree of accuracy. Values may vary by 0.1 psi due to display rounding. * Maximum Velocity of 14.33 ft/s occurs in the following pipe(s): (328-1-1112) *** Device pressure loss (gain in the case of pumps) is calculated from the device's curve. If the device curve is printed with this report, it will appear below. The length of the device as shown in the table above comes from the CAD drawing. The friction loss per unit of length is calculated based upon the length and the curve -based loss/gain value. Internal ID and C Factor values are irrelevant as the device is not represented as an addition to any pipe, but is an individual item whose loss/gain is based solely on the curve data. File: X:\PROJECTS\Watts - Training Center, N. Andover\Watts 1.dwg Date 11/6/2015 Copyright © 2002-2012 Tyco Fire Protection Products Page 7 ,. Job: WATTS TRAINING & STAIR RENOVATION 90 85 80 75 70 65 60 55 50 45 40 35 30 25 20 15 10 5 0 0.266 Device Graphs Pressure vs. Flow Function Design Area: 1; Supply Ref.: FP; Supply Name:FP o 00 0 0 0 0 0 0 0 0 0 Flow, gpm Pressure Loss Function Design Area: 1; Valve Ref.: 519 (Gate A2360, Size = 6); Inlet Node: 095-I; Outlet Node: 095-0 0 0 N Flow, gpm H r 0 0 0 rn v o0 File: X:\PROJECTS\Watts - Training Center, N. Andover\Watts 1.dwg Date 11/6/2015 Copyright 0 2002-2012 Tyco Fire Protection Products Page 8 Job: WATTS TRAINING & STAIR RENOVATION i Device Graphs Pressure Loss Function Design Area: 1; Valve Ref.: 520 (Gate A2360, Size = 6); Inlet Node: 353-I; Outlet Node: 353-0 0.766 0.266 0 0 0 0 0 0 v, o v a v o0 Flow, gpm Pressure Loss Function Design Area: 1; Valve Ref.: 521 (AV -1 Check, Size = 6); Inlet Node: 352-1; Outlet Node: 352-0 3.9 3.4 2.9- 2.4- 1.9- 1.4- 0.9- 0.4 .92.41.91.40.90.4 0.1 psi @ 266.7 gpm 0 0 0 0 0 0 a .-r N Flow, gpm File: X:\PROJECTS\Watts - Training Center, N. Andover\Watts 1.dwg Date 11/6/2015 Copyright© 2002-2012 Tyco Fire Protection Products Page 9 Location I ;) A P-t'it-A %2P, No. 17.0 -Check # Date TOWN OF NORTH ANDOVER Certificate of Occupancy ; $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Building Inspector �vtJ r/ z s�AW w Permit NO: _4 _�dL z Date I LOCATI PROPEI p• t�ao •qr BUILDING PERMIT 3? .�`::�. c_� °V TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received IMPORTANT: Applicant must complete all items on this pane MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Villaqe ves no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: YCommercial J( Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer 'Y tU(VL 10141 J , Identification Please Type or Print Clearly) OWNER: Name: �.5 Pl-t15 � - tee. Phone(178,7 - - Q �' >t►Address: 00/ S_ c!°t-ifshlwf � � /moo y� . +vDd U , CONTRACTOR Name: ' Phone: Cwt? D I -% on F. Address: 5 t>l n U b art , r1eh fan Supervisor's Construction License: / Exp. Date: Cif M6944 /ohFh e_ Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Gale 4Y_,6e_,A4-e-5, .fin Phone: 181 g3FL7,1y (_57 Address:_/ 3 Le i/ ' aY)�waV Reg. No. FEE SCHEDULE., BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ b 5 o b FEE: $ Check No.: Receipt No.: C, 474W NOTE: Persons ontract' ,- with uaf��istered contractors do not have ac A t gua Pantv fund 4,, signature contractor G o � O 0 _CDin ". CD n m r• O O aT. O N - CD O O - Q O m W m O CD m = CL su cQ Q- 0 Cl)o�,. rt � C C ca A O = 0 -•• N -a m C CD CL0 CLQ = m �� ` 0 O O <U) �W< �CD4r�bCL ' W � G► 00: r •� wom: � C, y rt � C'1 _rt O' O cc O O: CD CDS O O c CD � O �+ D0 O c� O a) O O 7 C "Mi p- 49-1- r44 r v N 3 0 TD O K Lnrt N - oZ 07 (D m m D 70 m z T v R030< m O T. nOi N n (D ."q O[1 S m m n F Z N m n T d .-p C OL S C W Z G1 Z N m n 0 T _S 7 D O M S O 7 Q. w ° C G Z z Z N m (D ('f (A 3 O a \ 7z = W O O -n S m x 0 �• z CD o SCD �, o � n n 0 Z CD O� Z� CL " r rn m� �O It (J)� CD Q r Cl) (O C -0 p m s Z v� o < �55 cD O A � m y Cr Z ,,•�= CD �+�� CD CDCD o 0 00 OU �. to O c. CD'� Z FL O y CO) CO CD cn H• Z CD 0 0 CD Z N C n :D -I o � O 0 _CDin ". CD n m r• O O aT. O N - CD O O - Q O m W m O CD m = CL su cQ Q- 0 Cl)o�,. rt � C C ca A O = 0 -•• N -a m C CD CL0 CLQ = m �� ` 0 O O <U) �W< �CD4r�bCL ' W � G► 00: r •� wom: � C, y rt � C'1 _rt O' O cc O O: CD CDS O O c CD � O �+ D0 O c� O a) O O 7 C "Mi p- 49-1- r44 r v N 3 0 TD O K Lnrt N - oZ 07 (D m m D 70 m z T v Z7 C j-. m O T. nOi N n (D ."q O[1 S m m n F Z N m n T d .-p C OL S C W Z G1 Z N m n 0 T _S 7 D O M S O 7 Q. w ° C G Z z Z N m (D ('f (A 3 O a \ 7z = W O O -n S m x 0 00 fD v VAWAI 1s® BILL T0: WattSWater@OnllIn p OR FAX: 978-682-1561 OR: Watts Water Technologies PO Box 4929 Portland, OR 97208-4929 USA ISSUED Knollmeyer Building TO: Corporation 60 Jonspin Rd Willington, MA 01887-1019 USA PURCHMSE ORDER y 3 PURCH:kSE ORDER NUMBER REVISION PAGE A728865 0 1 of 1 ^*nib ACCT NO SHIP TO WATTS REGULATOR COMPANY 815 CHESTNUT ST NORTH ANDOVER, MA 01845-6009 USA ,...�a�nmra r aat�ll SUP" >46�0 t . �4A't'6+t1Ft 1�''� pi!'1'8 INCOTERMS/F.O.B. POINT .. . SHIP VIA CREDIT TERMS NET 30 DAYS slip LINE ITEM NUMBER/DESCRIPTION COMMENTS DUE DATE QUANTITY UNIT UNIT PRICE EXTENDED T Please Confirm Price & Delivery Within 48 Hou To Fax# 978-687-7873 Invoice Price Must Match PO Price ATTENTION: Box weight MUST be 40 lbs maxi um D PROJECT BASED ON GALE ENGINEERING D WING DATED 8/21/15, SPECIFICATIONS DATED 8/21 15 AND ADDENDUM #1 DATED G/A/1.r, 1 BASE BID 10/15/15 Site: A00 Type: Memo Item Not In Inventory 2 ALTERNATE #1 10/15/15 Site: A00 Type: Memo Item Not In Inventory 3 ALTERNATE #2 10/15/15 Site: A00 Type: Memo Item Not In Inventory WATTS WATER TECHNOLOGIES 815 CHESTNUT ST NORTH ANDOVER, MA 01845 BUYER: Comiskey, J 1.0 I EA 1180,650.001 180,650.00 1.0 EA 15,950.00 1.0 EA 3,985.00 Net Total Tax USD Grand Total 15,950.00 3,985.00 200,585.00 0.00 Terms S Conditions of Purchase - Rev.11125114 -Apply Herein By Reference 200,585.00 V-.. �-.. CEJ aL-� L..-It-l.t�� -� Lt.- Jt---� I:�t. �.• .. vaawv va vvuvwuiw R "A""13 w -'Wr'U1aUV11 " 1V10JJ.%jV v rage 1 or i The Official Website of the Office of Consumer Affairs & Business Regulation (OCABR) Consumer Affairs and Business Regulation Home Consumer Rights and Resources Home Improvement Contracting HIC Registration Complaints Registration # 110104 Registrant KNOLLMEYER DESIGN & BUILDING CORP Name CHRISTOPHER KNOLLMEYER Address 60 JONSPIN RD City; State Zip WILMINGTON, MA 01887 Expiration Date 10/06/2016 Complaints Details No complaints found for this registrant. You can also view arbitration and Guaranty Fund history. Back To Search © 2012 Commonwealth of Massachusetts. Mass.Gov® is a registered service mark of the Commonwealth of Massachusetts. Home Improvement Contractor Registration Home Page, http://services.oca.state.ma.us/hic/licdetails.aspx?txtSearchLN=10070 1/29/2015 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYYI� etr�ot.r>, ThI&CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE ORPRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require and endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT NAME: PHONE FAX EASIBRN INSURANCE GROUP 233 W CENTRAL STREET (A1C, No, Ext): (AJC, No): E-MAIL ADDRESS: NATICK, MA 01760 22LRD INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: TRAVELERS PROPERTY CASUALTY COMPANY OF ANIERICA KNOLLMEYER BUILDING CORP INSURER B: INSURER C: INSURER D: 60 JONSPIN ROAD INSURER E: WILMINGTON, MA 01887 INSURER R COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT VWTHSTAND1148 ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR AMAGE TO RENTED REMISES (En occurrence) $ ED EXP (Anyone person) $ ERSONAL & ADV INJURY $ GERL AGGREGATE LIMIT APPLIES PER: POLICY [:] PROJECT ❑ LOCPRODUCTS 3ENERAL AGGREGATE $ - COMPIOP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ . ANY AUTO LIMIT (Ea accident) BODILY INJURY $ ALL OWNED AUTOS SCHEDULE AUTOS (Per person) BODILY INJURY (Per accident) $ HIRED AUTOS NON OWNED AUTOS PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB ]OCCUR EACH OCCURRENCE $ EXCESS LIAB LJ CLAIMS -MADE AGGREGATE $ DEDUCTIBLE $ $ RETENTION $ A WORKER'S COMPENSATION AND EMPLOYER`S LIABILITY YIN UB-9982A17A 14 x WC STATUTORY LIMITS OTHER ANY PROPERITORIPARTNERIEXECUTIVE M OFFICERIMEMBER EXCLUDED? NIA E. L EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory In NH) Dyes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERA*IONSILOCAMONSIVEHICLESIRESTRICTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE VVILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESEN�VE Acurcu zo (zuTulub) 7 ne Auuku name and logo are registered marKs Ot ACORD 19BB-2010 ACORD CORPORATION. All rights reserved. AC40 O CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) r9/23/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER The Driscoll Agency, Inc. 93 Longwater Circle MA 02061 CONTACT NAME• Kell SeI PHONE 781421 2490 FAX 781421 2491 E-MAIL . kseip@driscoliagency.com INSURERS AFFORDING COVERAGE NAIC N A INSURERA:Geminl Ins CO 10833 INSURED 216073 Knollmeyer Building Corporation nn Wilmimingtgt on MA 01887 M Wilmington INSURER B: Merchants Mutual Ins Co 23329 INSURERC:RSUI Indemnity Company 22314 INSURER D:Massachusetts Workers Compensation INSURER E: Ironshore, Inc. DAMAGE TO EE PREMISES occurrence)Ea$50,000 INSURER F: COVERAGES CERTIFICATE NI IMFiFR• 2R77AAgAA eevlmnLl ul THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ODL3UBRPOLICY INSD WVD POLICY NUMBER EFF MM/DDIYYYY1 POLICY EXP (MWDD/YYYY1 LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X OCCUR VCGPO80960 10/1/2015 10/1/2016 EACH OCCURRENCE $1,000,000 DAMAGE TO EE PREMISES occurrence)Ea$50,000 MED EXP (Any one person) $5,000 PERSONAL SADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 7 PRO - 7 LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS -COMPIOPAGG $1,000,000 B AUTOMOBILE X LIABILITY ANYAUTO ALL OWNED X SCHEDULED AUTOS AUTOS HIREDAUTOS NON -OWNED AUTOS MCA0000119 1011/2015 10/1/2016 O ','INED ent8INGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ $ - PROPERTY DAMAGE Peracadent $ C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE NHAO73114 10/1/2015 10/1/2016 EACH OCCURRENCE $10,000,000 AGGREGATE $ DED IX I RETENTION s none $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A To be issued 10/1/2015 10/1/2018 STATUTE ERH E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE -POLICY LIMIT 1 $ E Contractors Pollution Liability 00738005 10/1/2015 10/1/2016 Each occurrence $2,000,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace is required) "' •• "'^' `- •'--`-"�-" a,ffi%N"LLA I IVIV Qv LJdYb VAL70PL IV LJdYb IV[ IVUiI-rdVMI ISHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE f ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26 (2014/01) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of IndustrialAccidents b 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Name (Business/Organization/Individual): Address: City/State/Zip: ( 1 i I fn r r1 Are you an employer? Check the appropriate 1:&I I am a employer with _ZV employees (full and/or part-time).* 2.Q I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3.E) I am a homeowner doing all work myself. (No workers' comp. insurance required.] t 4.Q I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5.Q 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. insurances 6. ❑ We are a corporation and its officers have exercised their right of'exemption per MGL c. 152, §1(4), and we have no employees. [No workers' comp. insurance required] Miii Type of project (required): 7. Q New construction 8. Q Remodeling 9. Q Demolition 10 Q Building addition 11.Q Electrical repairs or additions 12.0 Plumbing repairs or additions 13.Roof repairs 14. Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional street showing the name of the sub -contractors and state whether or not those entities have employees, If the subcontractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing worlrers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 6q b-;' P CAJ ip Policy # or Self -ins. Lic. M CM &IN1 /a" 14 Expiration Date: Job Site Address: 112' S , *� �r ecA- City/State/Zip:O A M A Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration ate). 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. Ido hereby certify :der-tlje pairs ait nal4esygWijuty that the infotvnation provided above is true and correct. Official use only. Do not write in this area, to be completed by city or town official City or Town: Peimit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerlk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: FA t Massachusetts - Department of Public Safety Board of Building Regulations and Standards' Construction Supervisor License: CS -108684 l' MICHAEL DEMA RC 2 LYNN STREET.' .t Malden MA 02141 r �t 1` Expiration Commissioner 10/1512010 Unrestricted - Buildings of any use group which contain less than 35,000 cubic feet (991m) of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for reveratinn of thk Branca l ot��Location �' `"'� `� No. �91 r Date 10 Check # TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ 34-60 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ j 4 Building`intpector BUILDING PERMIT cr,) TOWN OF NORTH ANDOVER °� APPLICATION FOR PLAN EXAMINATION M C .� e" Permit No#: ^ l� Date Received �iyc R4TEp'P�'c�� Date Issued: IMPORTANT: Applicant must complete all items on this page j LOCATION 7SI5! C'J1Jt/ I S �' Print PROPERTY OWNER AIA- 7T Print 100 Year Structure yes no MAP 167 PARCEL: a ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family 0 Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition gkther ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer DESCRIPTION OF WQRK TO BE PEKI-UKMEU: 410x lea ori we o Identification - Please Type or Print Clearly OWNER: Name: Arlrlracc- )=;:P4- Cc, Phone: Contractor Name: MTC -reNlPhone: g 7�- -?-57r 7002— Address: !Sa l.vc-v, 57. "Tev--.te5f'j nq rOPr- O j S-74, Supervisor's Construction License: Exp.Date: Home Improvement License: Exp. Date: _ ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ c` —00 FEE: $ Check No.: GslqLy Receipt No.: NOTE: Persons contracting with unregistered contractors do not have acce guaranty fired Signature of contra 1 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application o Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application Li Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Building Permit Revised 2014 im 0 c Y 0 E.9—* J uj 2 LL O O m r Y \ 'O O LL v a LO U +� O. N O N z z m ° N "O C 7 LL L 20C 7 w N C C U LL Vf z zLU = ° 0 L W O cr LL Vf z a u W w L 00 Elf ai U i {n LL OU a Za Cal L t7A 7 d' LL W o LL , v O m d z ++ N N N ,j °' 0 Y O N a O R p Q. as o U E c. tel• `� a F � C d O ` dMW O 0 E tm 1NOO ZV V '—' CL J E N y d= � d Co L N p�•' OO N 0-0 > =Q��a a N oom�o = OEotm N0 w CL L '� .5tm V O tm o c Co Q R c = G1 : Q. 4)-,s N F- O N t� m R y.a Lu M�. N SRN O LU E ��_� O LU • V N O •a Ga ++ Q N N .p "- = 0 F- t Zo CL O U > CO Z C CD Z W w CL w H W CL 0 LU CO) Z 0 M m V 1.� Z 0 J ZE w N E Z M The Commonwealth of Massachusetts Department of Industrial Accidents y Office of Investigations � M x I Congress Street, Suite 100 a Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Baystate Tent Address: 150 Lorum Street City/State/ZiD: Tewksbury, MA 018786 Phone #: 978-851-2002 Are you an employer? Check the appropriate box: I am a employer with 20 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance., S. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions I LF❑ Plumbing repairs or additions 12.❑ Roof repairs 1310 OtherTent Erection *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: St Paul Policy # or Self -ins. Lic. #: XEUB5899Y49714 Expiration Date: 1/31/2015 Job Site Address: 0%5— 0h ,5W V L;,_) 5-1 City/State/Zip: I'`tpt,►,Q 0 --- 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 rti nder the pains aVdpenalties ofperjury that the information provided above is true and correct. Phone #: 978-851-2002 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 #: Client#: 415544 BAYSTTEN ACORDTM, CERTIFICATE OF LIABILITY INSURANCE DAT16120Dn'YYY) 14 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL.INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI Rental Specialties co ACT i NAME: P.O. Box 53310 PHONE ----T� ___ �ac, No, 61t): 800 854-3298 � (,aC No) Irvine, CA 92619 ADDRESS: _ 800 854-3298 INSURER(S) AFFORDING COVERAGE NAIC # r INSURED iNSURERA: St Paul Fire 8< Marine Insurance Baystate Electronics Inc. DBA: Baystate Tent 8: Party 150 Lorum Street Tewksbury, MA 01876 B, Travelers Indemnity Co of CT C: COVERAGES INSURER F CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. TR TYPE OF INSURANCE;ADL!SUBR! POLICY EFF € POLICY EXP i INDSR'WVD POLICY NUMBER MM/DDJYYYY MM/DD LIMITS A GENERAL LIABILITY i ZPP10N373431447 4/01/2014 04/01/2015 EACH OCCURRENCE x1,000 000 XI COMMERCIAL GENERAL LIABILITY ;DAMAGE T RENTED ( ' CLAIMS -MADE I ' -;71OCCUR ! : PREMISES Ea occurrence x100,000 MED EXP (Any one person) $ 5,000 ZUPlON811451447 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY XEU135899Y49714 ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? �r��- I N / A I (Mandatory in NH) r—= If yes, describe under , A IInland Marine Equipment Floater ZIM13NO38831447 PERSONAL & ADV INJURY x 1 GEN. AGGREGATE LIMIT APPLIES PER: x2 X $2 POLICY PRO- ! LOC S AUTOMOBILE LIABILITY ANY AUTO g_ ALL OWNED SCHEDULED S AUTOS AUTOS !PROPtRTYDAMAGE ( (Per accident) HIRED AUTOS NON -OWNED AUTOS A X UMBRELLA LIAB X OCCUR 4! 041011201 5 EACH OCCURRENCE EXCESS LIAB ! ,... �..,... ZUPlON811451447 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY XEU135899Y49714 ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? �r��- I N / A I (Mandatory in NH) r—= If yes, describe under , A IInland Marine Equipment Floater ZIM13NO38831447 PERSONAL & ADV INJURY x 1 GENERAL AGGREGATE x2 ;PRODUCTS-COMP/OPAGG $2 S ' COMBINED SINGLE LIMIT i, (Ea accident) g_ j !BODILY INJURY (Per person) S I BODILY INJURY (Per accident) x !PROPtRTYDAMAGE ( (Per accident) IS ------------------ x 4! 041011201 5 EACH OCCURRENCE x1 AGGREGATE g1 x 4;01/31/2015X 1 WCSTATU- IOTH- TORY LIMITS I I E.L. EACHACCIDENT x1 E.L. DISEASE - EA EMPLOYEE S1 1E.L.DISEASE -POLICY LIMIT x1, 4 04/01/2015 Limit $900,000 Deductible $10,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: Small inflatables - (1)Backyard Obstacle, (1)Boxing Rings, (4)Castles, (See Attached Descriptions) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 Of 2 The ACORD name and logo are registered marks of ACORD #S12334105/Mll977322 AXWG Certificate of jfiame Refst"qtance REGISTERED AZTEC TENTS =treat�=orAPPLICATIONCONCERN NO. 2665 COLUMBIA ST TORRANCE, CA 90503CAL COMB F-ars.o1 (800)228-3687 This is to certify that the materials described below hereof have been flame retardant heated (or are inherently nonflammable). FOR BAY STATE APRTY RENTALS 150 LORUM STREET TEWKSBURY, MA 01876 ATTN: DAVE KNIGHT 0 Certification is hereby made that: (check "a" or "b") The articles described below this certificate have been treated with a flame retardant chemical approved and registered by the State Fire Marshal and that the applicationof said chemical was done in confor- mance with the laws of the State of California and the Rules and Regulations of the State Fire Marshal. Name of chemical used ............................................Chem. Reg. No. Meathodof application................................................................................................. (b) The articles described below hereof are made from a flame -resistant fabric or material registered and approved be the State Fire Marshal for such use; Fabric has been tested and passes NFPA701-96. Trade name of flame -resistant fabric or material used.. Lamin-,-dFabdc Reg. No. ...... ,r!jjgl The Flame Retardant Process Used .WILL NOT .. Be Removed by Washing (will or will not) David Bradley Chuck Miller - President Name of Applicator or Production Superintendent Title Location i No. —" Z Date TOWN OF NORTH ANDOVER ,.. , 0 Certificate of Occupancy $ Building/Frame Permit Fee $ ��• 00 Foundation Permit Fee $ Other Permit Fee TOTAL Check # /U79 24940 wilding Inspector BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: i Date Received Date Issu Z, IMPO T NT: Applicant must complete all items on this page LOCATION? ` PROPERTY OWNER �*� Print MAP NO: w%c PARCEL:,,O\ ZONING DISTRICT: Historic District Machine Shop V'STLEO �6 cN 0) 11 O� co 4- a .c..c K.. 7• yes no e yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: Commercial ❑ Others: :Repair, replacement ❑ Assessory Bldg ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer i.rr-a%.rrt1r, ! 1vry vrr Wumn 1 U tit NNt!-UKMED: 6 Zsc:IJ DSC QLzvl� Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: PCL Phone: 7W- 1 —7 Address:_ MLL 7w a oy* Supervisor's Construction License: C 5 �8 Lf � Exp. Date: Home Improvement License: Exp. D ARCHITECT/ENGINEER �r�Z(_ �1-Zkc� Phone: 97t-' !�31 — VI (ey Address: ! (-( o L5okI Reg. No. 9- 3l ) FEE SCHEDULE. BULDING PERM T: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ (g�0 FEE: $2 Check No.: Receipt No.: S NOTE: Persons contracting with unregistered contractors do not have access a guarymy und`� Signature of Agent/Owncr Signature of contractor _ I V J Building Department The following is a list of the required forms: to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) o Building Permit Application Li Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract o Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Building Permit Revised 2008 m � o w° cn a ro U w c � a°' co w w w a�' cn w d o rz - G is. a w W w cn cn E MA y 0 CA C 7 cm m cc cm C m O .cm C 'C N m L 0 Z 0 J Cl -, 091 *V E O i CicoO V Z a O H D C IO Of C ca -0 O �— h O O O O O .0 O O O G O ca �Q o C cc •d O,D C Z O 0 CL C.3 N2 c C _ _ ■ C CO2 W U) U) 19 W 0 W N c � O � 16' C y � C \ v C. CLC cv cc ' C CD Ea .. mCF E E ` ID c0 00 v .. -! is os m c_ dJ A m m cm ea y m CV y m D C C Z ci y v Z O .� F. ..O C y.mCD F' h � 0 W C 0 OyL..�� •H A C_ �.. 'EO dt o 'y cj uj C3 O p m C x v .0 CL E MA y 0 CA C 7 cm m cc cm C m O .cm C 'C N m L 0 Z 0 J Cl -, 091 *V E O i CicoO V Z a O H D C IO Of C ca -0 O �— h O O O O O .0 O O O G O ca �Q o C cc •d O,D C Z O 0 CL C.3 N2 c C _ _ ■ C CO2 W U) U) 19 W 0 W N PROJECT NUMBER: OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL PROJECT TITLE: PROJECT LOCATION: �5 I S C. ( T �l �� I " kip 4 va NAME OF NATURE OF PROJECT: T d -i IN i r y Vv. ut'j 4V 116 OF THE MASSACHUSETTS STATE BUILDING CODE, 7-5 REGISTRATION NO. 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 0 ARCHITECTURAL STRUCTURAL 0 MECHANICAL 0 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 B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the 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 with6the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR. JUPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO TFIE SATIS CTORY COMPLETION AND READINESS OF THE PROJECT FOR OCC Y. SUBS IBD SW BEFORE_ E THiS DAY ` AME J. j#PAfw1,EH 1OPvii1�ONYYEALTH OF MASSACHUSETTS My commission Expires TAY T)UBWVMY COMMIS PIRE.Szc.trruary 24, 201 ` Muxwxcbuyetts-D~cou�i-tmontoyPuhJ^~—"^`e �Bourduf0u/|ding Regulations umd S tandurd *Conotn�ot�m _ Supervisor License License: cs 88449 PETER ERTSOG 125ROLLING RIDGE LN xxE[MUEN.MAO1844 Expiration: 10/28/20 13 T,#: 7027 NORTH 1 Sao ,a ti 9 ACMUS, t This certifies that Date.�.— �..�.....16r TOWN OF NORTH ANDOVER PERMIT FOR WIRING ................................_ ....................... ............................. i ,< has permission to perform ...........: .. - wiring in the building of r ' ,�+ ^.:. f -- t=' f , North Andover, Mass. at ....... `?...................... .......................... Fee�..�:. .....�. Lic.No:...:�... .. .............. ........ ELECTRICAL INSPECTo Check #= 9200 57 Comic .a& o/ Maeeac4elb 2epartownt 015ire services BOARD OF FIRE PREVENTION REGULATIONS Official Use Use Only Permit No. e, Occupancy and Fee Checked f--_ [Rev. 1/071 leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 0 All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATIQA9 Date: '— Q City or Town of: 14 v J R To the Inspector of Wires: By this application the undersigned gives notice of his or her 'ntention to perform the electrical work described below. Location (Street & Number) Oil g' C-11\kS Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a buildin permit? Yes ❑ No (Check Appropriate Box) Purpose of Building oUtility Authorization No. Existing Service Amps / Volts Overhead a Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders. and Ampacity Location and Nature of Proposed Electrical Work: Completion of thefollowing table may be waived by the Inspector of'Wires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans °• ° Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimmin Pool Above E]In-Elo. g rnd. rnd. o mergency lg ng Battery Units No., of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection an Initiatinz Devices No. of Ranges otal No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: I _.,_umb.._- er Tons - --- - KW -"_........... No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area,Heating KW Local ❑ Municipal 11 Other Connection Dry No. of D ers Heating Appliances KW Security Systems:;; No. of Devices or Equivalent No. of Water No. of Data Wiring: Heaters KW Signs Ballasts No. of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring,: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 1— ('3 — I Q 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 cov rage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE M BOND ❑ OTHER ❑ (Specify:) I certify, under theains and penalties of perjury, at the information on this application is true and complete. FIRM NAME: tC e c t Ca 3e r Vl e- e S LIC. NO.: Licensee: oadonyTDCkGC_)C)Od Signature LIC. NO.: 9119JC7 (If applicable, enter " empt" in the license number lin avYl Bus. Tel. No.: �%7' d 8B- Address: 3 J �,� a s art 4 .0/9f3 Alt. Tel. No.: *Per M.G.L. c. 147, s. 57-61, security work re es Department of Pub Safety "S" License: Lic. No. OWNER'SINSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one)❑ owner ❑ owner's a ent. Owner/Agent atu egent Telephone No. PERMIT FEE: $ 1 JL S7 i -a-- �D �7 r 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance -with the provisions of M.G.L. c. 143, § 3L, the permit application forth to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L. Permits shall -be limited as to the time ofongoing construction activity, and may be.deemed.by the.Inspector_of _Wires abandoned_and.invalid ifhe—._ .. _ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending"through August 15, 2012. �1 Rule 8—Permit/Date Closed: S"—1 ��"� ***NO :Reapply for new permit C q�4,ermit Extension Act — Permit/Date Closed:— ^ Date..�t�.'.. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that G has permission to perform .,F �F S/'« ...................................................................... wiring in the building of ............. N!!................................... s / STit/v 51" at ...... ..... ©�............. .......... ...........................� North Andover, Mass. Fee . r�.."r. LIc. No. �3 s..9.. ZX ............. ...:............... ELECTRICAL INSPECTOR Check # J B30b r 9 Commonwealth of .44assachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only/ Permit No. (1 1 (� Occupancy and Fee Checked [Rev. 11/99] 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: 10-08-2008 City or Town of, NORTH ANDOVER to the Inspector of Wires: By this application the undersigned gives notice of his or her int�rform the electrical work described below. � Location (Street & Number) R'CHESTNUT STREET 1 Owner or Tenant WATTS INDUSTRIES - Telephone No. Owner's Address 851 CHESTNUT STREET Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. none required Existing Service Amps Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: create 2 new offices within existing space — media department 2°d floor No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- ❑ Grnd. Grnd. o. o Emergency Lighting Battery Units No. bf Receptacle Outlets 5 No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches 2 No. of Gas Burners No. of Detection an Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Num er ........................................................... Tons KW No. o Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No.. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydro massage Bathtubs No. of Motors Total HP Telecommunications Wiring: g No. of Devices or E uivalent OTHER: re -work 4 existing lights as required within space INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licen- see provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certi- fies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) 09-30-2009 (Expiration Date) Estimated Value of Electrical Work: $ 1000 (When required by municipal policy.) Work to Start: 10-9-2008 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties ofperjury, that the information on this application is true and complete. FIRM NAME: WILLIAM J. IANNAZZI, INC. 1 LIC. NO.: 13592A Licensee: WILLIAM J. IANNAZZI Address: 191 CHANDLER ROAD ANDOVER. MA 01810 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liab By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner Owner/Agent Signature Telephone No. ---' LIC. NO.: 13592A Bus. Tel. No.: 978-686-7300 Alt. Tel. No.: insurance coverage normally required by law. I owner's agent. PERMIT FEE: $ Date.................................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ......m -y.. Z l "..` wG has permission to perform ..../................................... ......l�.�s wiring in the building of .....IA.1�.. 7;' 5 ......................................... f �`' .................. . North Andover, Mass. f ay � Fee../.. -.'_ Lic. No..� 3S � �!:. 4t. ELECfRICALINSPECTOR J_'f6�Y7 + Check # �� 7077 Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. 6 D 7 7 Occupancy and Fee Checked [Rev. 11/991 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: 11-27-2006 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)CHESTNUT STREET Owner or Tenant d % 5 WATTS INDUSTRIES Owner's Address 851 CHESTNUT STREET Is this permit in conjunction with a building permit? Yes No Purpose of Building Utili Existing Service Amps Volts Overhead ❑ New Service Amps Volts Overhead ❑ Telephone No. (Check Appropriate Box) Authorization No. none required Undgrd ❑ Undgrd ❑ No. of Meters No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ADD 3 LIGHT POLES, 4 FLOOD LIGHTS IN PARKING AREA No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Tota Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑In- 11 rnd. md. o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. o -Detection an Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Num er ITPRs KW . ...... No. o Sel-Contained Detection/Alertin4 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 Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydro massage Bathtubs No. of Motors Total HP Telecommunications Wiring: g No. of Devices or Equivalent OTHER: EMERGENCY REPAIR OF DUMPTER UNDERGROUND CONDUIT INSURANCE -COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licen- see provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certi- fies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) 09-30-2007 Estimated Value of Electrical Work: $ (When required by municipal policy.) (Expiration Date) Work to Start: 11-27-2006 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties ofperjury, that the information on this application is true and complete. FIRM NAME: WILLIAM J. IANNAZZI, INC. LIC. NO.: 13592A Licensee: WILLIAM J. IANNAZZI Signature Wi,I.Li01m 1. IGlww6lzz% LIC. NO.: 13592A Bus. Tel. No.: 978-686-7300 Address: 191 CHANDLER ROAD ANDOVER, MA 01810 Alt. Tel. 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 PERMIT FEE: $ Signature Telephone No. I-r(4,L. A — pj-�-, Tt�jt ok M 91 i Date ... -7 ... ......... I ... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... W ....... =Lxry .;;Z,/ has permission to perform ....... 4pll-': ...... wiring in the building of .......... wo .. I.T.'s ...... ............................ at ......... /5' .......i! .;r .... North Andover, Mass. Z4 ............ .... .. ..... Fee]...2 L i c. N o. ....... -Ie� E� �CTRJCAL INSPECTORY Check # " 7263 Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS I .^_ Official Use Only Permit No. < ?—&3 Occupancy and Fee Checked [Rev. 11/991 (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: 03-21-2007 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) M51 -CHESTNUT STREET Owner or Tenant F/-' WATTS INDUSTRIES Telephone No. Owner's Address 851 CHESTNUT STREET Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) Purpose of Building COMMERCIAL Utility Authorization No. 'none required Existing Service Amps Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: RENOVATIONS o. of Recessed Fixtures 70 No. of Ceil.-Susp. (Paddle) Fans No. o Tota Transformers KVA ,No. of Lighting Outlets . No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In ❑ grnd. md. o. o Emergency ting 2 BatteryUnits No. of Receptacle Outlets 20 No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches 30 No. of Gas Burners No. o Detection and InitiatingDevices No. of Ranges No. of Air Cond. Tota Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Num er ........ Tons . . KW .. No. o Self -Contained Detection/Alertin Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municjpal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. o Water KW Heaters No. o No. of Signs Ballasts Data Wiring: 30 No. of Devices or E uivalent No. Hydro massage Bathtubs No. of Motors Total HP Te ecommumcattons Wiring: 30 No. of Devices or Equivalent OTHER: l dSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licen- xee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certi- fies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify: 10-01-2007 (Expiration Date) Estimated Value of Electrical Work: $ (When required by municipal policy.) % Z 6 Work to Start: 03-21-2007 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I cert, under thepains andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: WILLIAM J. IANNAZZI, INC. Licensee: WILLIAM J. IANNAZZI Signature LIC. NO.: 13592A LIC. NO.: 13592A Bus. Tel. No.: 978-686-7300 Address: 191 CHANDLER ROAD ANDOVER, MA 01810 Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's a ent. Owner/Agent PERMIT FEE: $ Signature Telephone No. �C 3 --Z-z -off !J I r Location 7— No. C> Date Z— TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ L AC MUS r Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 21ELU ' Building Inspector oupp.R 100N TN � 0 FOR PIAN e�jcglot4 •t N� • � T : APpll Date /n ti�1s all It 1i h e �sSued 11� (; print ptsttiGt �;� Ntst°r~ e Shoe vil N ,S gjc.T, MaCh�n OG,T10NER01iG esjdental "P or ,. PARD USE Opp P ntlaN � Per,mit I PevOW nye . to \ssua N� tMpROvEME :OF / Ne/d�n9 r�la°ement Repan, rep Oemolit�on VAI eA ,me. OWNER- 61, 1i Addre�. Reside t,f6M qty One ore jav, TW° of °f u ts� N°' SoN Bldg �Natershe Asses Other yy etlands Flo°dpiarr PREFORMED ± v► Fw:RKTOBE E 1PTth O 01 �LZ r�y� bo e* e Tie OY pYivt Chea j�,yeas. P deDtiic G' `JA i ate: 1 Name. AXP- t NC -t` Qate: AV ��7 a � ,-x'72. en��, hone: i� 15 P C; e " R S•F' Go 1�p ,Gengd. 1 v ! t ' $125.p0 PE s L .'JV� `�1e9 N t. t ett o� R SEp o r Prd �rcr'p'�°gem ��' �� �' p °os? BA �\rk\ec P\a N°fie �NO,tNEER ?NE?o?A� ES?IMA?E \L� e Sp t-CEG� vp0.00 of EE, and \r�\ud PRGN 2 p0 PER $10 F `7 he arae f dl ko C \e Pe��4 '509r . ssuaroe of Of app ram$ � to t O tOdUG�,S er�'pC`°t t° ti°mtue a�a T °f °f ec I e'(�a\m f ue aec�s ODe°4y L Q e mv5t Std oeeas• the lecovaed at Z.75 ddrdSs: �� B��pING PERMIT: $1 . Reodo ao- ve access to t A FEE SCHEpuLE t � p tractors d° n°tom ota\ Pr°�eGt Cos c7 �lvf ster)ed cou-`a uCeot a� ,utti1 n / cig Ghdck No persons ca p►9enl 5�9 Pans Submitted TypEOFSEWERAG Pians Waived Public Sewer E DISPpSAL well Private (septic tam, etc 71 Certified Piot Pia _ n � Tannin g/Massage/BOdY An Tobacco Sales Pe"r'anent Dum Aster on Site N ERDEp WANG SECTIONSFOR GN r11%, ■o■ Stamped Puns Swiminin g Pools Food Packagin ng/sales �0 Ce ONSERVATIoN y+t► `VSP •. oQ Reviewed Q ��� QQc qac, a � c4MME n Q� �r� o0 • NTS�ko y �Ge 0 X6 Qe �0 5s ACTH 40 y0 o� ReviewE COMMENTS d ON aZ` 7 2onin9 Board of q ppeals. V Plan ariancF 069 Board Decision. eJ. .rya` �QQQS`4,4����o� •��'�`� �• e o``o �� �O�Q GO��� �G� OQo J ,0 `� ets oQ� K�� Qt o iso �o Q�``o�� G �G° p� goo. � COnsen'ation Dec/si° Vv OpjP0 fit` Water on r Q �\� �� Gra Q� ��, Sewer ° o Q G°Qo°t goo �Qo y Q��°�. G. t�,eQ Q� eQa DPW Town Cohnection�s COr"m�. ° o Q ��� Qsse eG� ,`'P °aQ`araJ�P�a ea ee�ed`�e0 Ebgibeer. nature J� �� O� t1, pff RE P, Slgnaz,,r�. gate o ��a O Q°� Jho Q ���'' °��'`�����o ��° �xxi tate RT P . p �, Fire at 124 Tem ��'• 641` ��a`��oa °�°��c�G°g�,oe5`°'� y�o�a C©merit St9na p DU,pster on �� Q'a ot` �o� G°QG°� oG�� J��,�� d't Mist Nrs tUrelaate site Yes tocat , G� o ° �°�o,�°�GG�o�SG��� �`e a e� e1\ Cp 'ON GI VN x\o ose 6G- I& �s�G ``OP off` o �QQt°QG.PP��dPQQ ewe ed� 0 oo G° �e�s � XG��a G°c�`Q ��o��to � o Q�°� cel . GGa ,��rdG ��*' . �5I - (gyp �o�' o ,��o `a�COd ve daJ� `�e5 e��bee�'bs d O& Gam` OJ J,c e4� O Aa5`dee p � �e� Qy s4ec Sbe X44 �4� �Q �5esi e��4 ea4 �1G Js11 SQ-CINO seati;L 4e� I Gleason Architects l 152 Portsmouth Ave. P.O. Box 596 Stratham, NH 03885.0596 I Bill To Watts Industries 815 Chestnut Street North Andover, Ma 01845 Invoice [Date Invoice # 9/30/2008 200880,1 Terms Due Date Project Number Item 9/30/2008 Description 200880 Consultant Construction of w Qty alis for 2 offices Rate Amount sound protection. Add two new doors vide with side lights, match existin 12,000.00 12,000.00 within the same area. Rework thefceiling and relocate the lights. Phone # Fax E(6O3)7:72-7370 (603)772-6044 E-mail gleasonarchitects@comcast.net Balance Due Web Site gleasonarchitectsnh.com $12,000.00 y a V The Commonwealth of Massachusetts Department of Industrial Accidents r'l? Office of Investigations 600 Washington Street Boston, MA 02111 www-mass-gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name (Business/Organization/Indivi dual):I P _ate Lr Address: 2 1, � r, -, A City/State/Zip: . L4 Phone #: 6 �-�> 2-7 Z' -7 Are you an employer? Check the appropriate box: 1. El am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* 2] I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp, insurance required.] t have hired the sub -contractors listed on the attached sheet. These sub -contractors have workers' comp. insurance. 5. ❑ We area corporation and its officers have exercised. their right of exemption per MGL c. 1. 52, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ,�g Remodeling 8. ❑ Demolition 9. ❑ Building addition 10:❑ Electrical repairs or additions 11 .7 Plumbing repairs or additions 12.0 Roof repairs 13.❑ Other t, •••J-rr••-� •,.u,--- — n wast umnu out me section below showing their workers' compensation policy information. t Homeowners who submit.this af;ldav" indicating they+ are duilig all work atiu then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. 1 am an employer that is providing, workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -.ins. Lic. #: Job Site Address: Expiration Date: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify and r 01pains and penalties of perjury that the information provided above is true and %correct Signature: Phone #: r '7 —7 Z, % � -7 P v Official use only. Do not write inn this area, to be completed by city or town official City or Town: PermittLicense # 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-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. if an. LLC or LLP does have . employees, a policy is required. Be advised. that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to 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 namber.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 Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street -Boston, MA. 02111 Tel. # 617-7274900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 5-26-05 www.rnass.gov/dia Location No. 6po Date _ O NORT1y TOWN OF NORTH ANDOVER 0*4,.s° .6.4 F 9 s Certificate of Occupancy $ �' b",•° •'t �ss•►CHU Building/Frame Permit Fee $ —r Foundation Permit Fee $ —• Other Permit Fee $ ` TOTAL $__r - 0� Check # 20 b �- Building Inspector ■ W W O t ) 9 O F=4 z c o a a a c N O C CJ C d c W O m c ;Z O o •: E a L � c y m o w cn w° x v U w � a w x w cp CD a w w rA ° cn C 0 cn t ) 9 O F=4 z 0 0 U IM t9 QO O 0 vl� ami a LLI cl -/ ui U) 19 W W 19 W U) c o o` c N O C CJ C d c W O m c ;Z O o •: E a L � c y m o �. c CL -1 �" e•E N� o = O O cp CD �.+ d� W co om L 3 m "o CD m� c .M m a N m �Co CLS m o v: TLCZ 3ca �>z 0Qo Q � •m c mL 3 = m 0 W cO 'mo :5 =0 U. c ♦r -m 10 Is a 0 CO2 mM Ora =9 =� _ �=�aOm 0 0 U IM t9 QO O 0 vl� ami a LLI cl -/ ui U) 19 W W 19 W U) 03/12/2007 08:00 6033295368 DUTTON & GARFIELD PAGE 02/02 OFFICE OF BUILDING INSPECTOR ..`o: TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL PROJECT NUMBER: PROJECT TITLE: 11WAi -re, YVAj-e*- *WVu r TTS—/ ES PROJECT LOCATION:—18 15- Gjj&gT jQ-r 'ST-. , hN W V � M A 01$9'S NAME OF BUILDING:V -(�V'S NATURE OF PROJECT: NTtN6/ IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, NI" AdJMIR _REGISTRATION NO. BEING A REGISTERED PROFESSIONAL fNGINEE'R/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT • ARCHIT>"CTURAI. • STRUCTURAL • MECHANICAL • FIRE PROTECTION • ELECTRICAL • OTHER (SPECIFY) FOR THE A13OVE 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 a EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the 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 stag we of construction to become, generally familiar itht3the progress and quality of the work and to determine, in general, it the work is being performed In a manner consistent with the construction documents, PURSUANT TO SECTION 116.2.2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY, SUBSCRIBED AND SWORM TO BEFORE ME THIS %3" DAY OF WRE 2060 ^OTARY PUBLIC MY COMMISSION EXPIRES_ :My commission expires Oct. 8, 2010 FORM U - IAT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: P Phone l LOCATION: Assessor's M�ap/ Number Parcel Subdivision /" Lot(s) Street St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Approved Conservation Administrator Date Rejected Comments / Date Approved Town Planner /�� Date Rejected 1 Comments Date Approved Food Inspector -Health Date Rejected Septic Inspector -Health Comments /V/oz / Date Approved Date Rejected Public Works - sewer/'water connections Fire Department Received by Building Inspector Date Dutton & Garfield, Inc. CONTRACTORS Project Memo Watts Water Technologies 815 Chestnut Street North Andover, MA To: North Andover, MA Building Dept. From: Stephen E. Foster Date: 1/16/07 Re: permit application • Please find enclosed completed building permit application form and drawings for the above interior renovation project • Kindly review the enclosed and advise if you require any additional information or have concerns regarding same • Please note that we are currently preparing the cost estimate and will share this information with you once approved by the owner Stephen E. Foster ,V. P. — Project Manager file:C:\Projects\watts ap \mem0116a cc: 43 Gigante Drive • Hampstead, NH 03841 Tel: (603) 329-5300 Fax: (603) 329-5368 BUTLER BUILDER www.duttongarfield.com North Andover, Massachusetts 01845 Tel: (978) 681-8600 Fax: (978) 681-7570 I / The Commonwealth of Massachusetts Department of Industrial Accidents 1 Office of Investigations a 600 Washington Street Boston MA 02111 Workers' Compensation Insurance Affidavit Property Owner Name: Watts Water Technologies, Inc. •• • Chestnut Street North15 1• 01845 Phone# (978) 688-1811 ■ 1 am a homeownerperforming all work y c!Eacity. :. R I am an employer providing workers' compensation for my employees working on this job. Ir�h"�n'`,.�� • •.Dutton1Garfield, Address:Drive43 Hampstead, NH 03841 Phone# 603-329-5300 Insurance '. Acadia Insurance O//..✓�H/// ,7 �'$/�'.✓' �, 4 r3,"9fF.r.%y i"�%^`v" �,f�✓/l ml �' '> �� ro,.�P '// iq Y �'' i k / � p �yzz .l.'�..+'�i �.Sif"`,{x' ✓1'.` � Policy# WCA0005753215 ��`,���n';'��'�vP^ . f / Y' z-/� . ^S Vie^ , '.�,�.% ,Yd : � ��9 � . .. ,,,,.nf.,, ✓,. ...,, y _ ».P 4,,. .. ;,. .,;.rP"$i .,. 7 slyd 5f -r'. r%`4, °y $a'M`� NA;='�3/c /%.�� i S 9 5� �� � � � .; �/' ���-£' �' E� d // �i •"Y. /h�� �1 _F 1��� ON- •am a soleproprietor, general1 1 or homeowner (circle one) andhave hiredthecontractors listed below 1have thefollowing workers' compensation polices: Company Name: —1114eawwi- - ' • 1 . k`/' 9 S /'r"�`/ .rYr %A. / / '� o l- r F /h'/y' �' // �'^ /T - "l'*" P5- / �° /�n3.s'.. �, >3b /q✓/^ / Pl7 P-Tgg � „Oir>,, ..,/�/m!/ ..3.3r..`/ y, o.,�z,:... ... ✓,:,; .a�,. ���, „- 4 :K ��f`.%%i„?.:,� yytF. �n%/«rf xr �,�-;"�f Company y,�°���'L �a�'�b'-�.'4��tai�,y��r„�eyt=e'"yf„� �j Address: 1 • Co.Insurance Failure to secure coverage as required under Section 25A of 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 $100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of pedury that the information provided above is true and correct. Signature �„�� Date 1/15/07 Print Name Dutton & Garfiefld, Inc. Jane/A/rm�trong, Controller Phone# 603-329-5300 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/license # ❑ Check if immediate response is required Contact person: Phone #: o Other ❑ Building Department ❑ Licensing Board ❑ Selectmen's Office ❑ Health Department 4bDutton & Garfield, Inc. CONTRACTORS Stephen E. Foster Vice President 43 Gigante Drive • Hampstead, NH 03841 Tel: (603) 329-5300 Cell: (603) 401-7607 Fax: (603) 329-5368 E -Mail. sfoster@duttongarfield.com BUTLER www.duttongarfield.com BUILDER The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston MA 02111 Workers' Compensation Insurance Affidavit Property Owner Name: Watts Water Technologies, Inc. Job Location: 815 Chestnut Street Aorth Afidover,• .. —1811 ■ I am a homeownerperforming i j '-y ,. /;,G y.. Y. 4 .9/, ,%�/�':f .$ �:i�:�:i o,,, �i„�,.�! �'✓,.-�-/ 5/�. Y/ -, '1 ,. � ..s .. „�✓', �"�: ., n ..,Y � tj"w`i ..E 2 1 am an employer providing workers'for my employeesworking on this•• „"•+'��/�j>G->�"Ait vs v'4!"3:: �,.�.� �✓.A.�,✓'� Y 4�P6✓�"��6� v�,s Company Dutton 1 Garfield, Inc. Address: Drive Hampstead, 03841 Phone#603-329 /' Insurance 1 Acadia •%„C �,�'Pi.,'i'�j, 4l /'_.'/''YAP/ -3`. X. 7,57M' Policy#WCA0005753215 ".'�r."/� �ar sole proprietor, or meowner 1 1 have hired the contractors 1 below 1 have the following compensation polices: Company • 11 Phone ce 1 Policy ry�.1 'E” Fr"N Company Xd'Tr�ess- C—I 1 1 Co.Insurance Policy Failure to secure coverage as required under Section 25A of 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. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Date 1/15/07 Print Name Dutton & Garfield, Inc. Jane/Gm�trong, Controller Phone# 603-329-5300 Official use only. Do not write in this area, to be completed by city or town official City or Town: ❑ Check if immediate response is required Contact person: Phone #: Permit/license # ❑ Other ❑ Building Department ❑ Licensing Board ❑ Selectmen's Office ❑ Health Department T • l DATE DA , � TIM! AM ��-* PM p FI FROM PHONE ( ) H O OF CELL( FAX ( ) ) / 01- N E M E M S E M A M E E Q E-MAILADDRESS SIGNE M S BACK , AGAIN ALL yygG, ❑ URGENT❑ CAL SEEYOUO� ME Q E-MAILADDRESS SIGNE PHONED ❑ BACK ❑ CARETURNED[] SEWANTS YOU AGAIN ALL WAS IN URGENT TO DATE TIME AM PM P FROM PHONE( ) HCELL ) OF / FAX ( ) N E M E M S E A M E Q E-MAILADDRESS SIGNE PHONED BACK RETURNED AGAIN ALL yygG, ❑ URGENT❑ CAL SEEYOUO� 03/09/2007 14:26 603329536B _., 01 FEB 27 to? 16-29 FR WATTS I NDUSI RIES Watts -Andover AP lfoo Osgood Street Suite 2-05 North Andover, MA 01.845-1050 Supplier: 101197 r)U TDON & GARFIELD INC 43 GIGANTE DR H MpSTBAD, NH 03841 DUTTON & GARFIELD PAGE 03/03 979 688 7778 TO 1613331"368 N.01AU PURCHASE OADER Order Number: CA312309 Revision: 0 order Date: 02/27/07 Page: 1 Print Date: 02/27/07 Ship To: A00 WATTS REGULATOR COMPANY 81S CHESTNUT ST NORTH ANDOVER, MA 01845-6009 LEASE CONFIRM PRICE a DELIVERY WITHIN 48 HOURS TO FAX# 978-687-7973 Confirming: yes Supplier Telephone: 603-329-5300 supplier Fax: 603-329-5368 buyex: A0012 Peter Labrie Phone: Contact: PETER LASRIE Credit Terms: 10 Ship Via: AP - NET 10 FOS: Remarks: Ln item Number T flue Qty Open UM Unit Cost - - - - - - - - - - - - -.w .. - - - - .. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- I A/P AREA RENOVATNS N 04/10/07 1.0 RA 194,333.00 Site: A00 Type: Memo ITEM NOT IN INVENTORY AP AREA RENOVATIONS REEF; QUOTE DATED 01/23/07 Extended Cost ------------- 194,333.00 ------------ 194,333.00 .%rchase Order Line Numbers Must be on All Shipping Documents - - - - - - - - - r - - - - - ._ _ - - - - - - - - - M - - - - - - - - - - - - - - - r - - - - - - - M ------------------------- Taxable ------------------------ Taxable Total: 0.00 Line Total: 194,333.00 Tax[1]: 5.00% C21s 0.00W {3]: 0.00% Total Tax. 0.00 USD Total: 194,333.00 0.00 By: Aut orized Signature 03/09/2007 14:26 6033295368 DUTTON & GARFIELD PAGE 02/03 01 option & Gorf �— CONTRACT, lot. Project Memo Watts Water Technologies 815 Chestnut Street North Andover, MA To: Gerald Brown — Building Commissioner — Town of North Andover, MA From: Stephen E. Foster Date: 3/1/07 Re: building permit fee — A/P area modifications • Plans for above project had been previously reviewed and approved for issuance of building permit • We had not provided a total cost of the project at the time of permit application processing as contract cost was not available at that time • Please see attached purchase order from owner confirming project cost • Advise regarding permit fee Stephen P. Foster ,V. P. —Project Manager file:C:\Projectslwatts ap 1mem0301c cc: surcER 43 Gigante Drive • Hampstead, NH 03841 BUILDER Tel -(603)329.S300 fir. (603) 329.369 www.duttongarfield.com North Andover, Massachusetts 01845 TQI-(978) 681-8600 Fax: (978) 681-7570 03/09/2007 14:26 6033295368 Dinen & Garfiel CONTRACTORS DUTTON & GARFIELD Inc. FACSIMILE TRANSMITTAL SHEET PAGE 01/03 FAX NUMBER: PHONE NUMBER; TOTAL N0, woz COVER; ❑ URGENT ❑ FOR REVIEW ❑ PLEASE COMMENT 0 PLEASE REPLY 13 PLEASE RECYCLE NOTESICOMMENTS: THE INFORMATION CONTAINED IN THIS FACSIMILE IS INTENDED ONLY FOR THE PERSONAL AND CONFIDENTIAL, USE OF THE DESIGNATED RECIPIENT NAMED ABOVE ,IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR. PLEASE NOTIFY US IMMEDIATELY BY TELEPHONE, w 43 GWMe 0rive - Hempstead, NH 03841 BUILDER North Andover, Massachusetts 01845 Tel.: (603) 329.5300 Fax; (603) 329.5368 www.didongarfield.com Tela (978) 681.8600 Fax: (978) 681.7570 Dutton & Garfield, Inc. CONTRACTORS Project Memo Watts Water Technologies 815 Chestnut Street North Andover, MA 01845 To: Gerald Brown - Building Inspector - Town of North Andover, MA From: Stephen E. Foster Date: 12/13/06 Re: . new parking lots- hcp parking • Please find enclosed plan showing parking layout for the entire Watts facility • This plan shows the handicap parking spaces we discussed most recently • As I recall you had checked the total quantity of these spaces at the time of permit review and found it acceptable per CMR 521: 0 222 total parking spaces at Watts facility —12 hcp spots provided o cmr 521 requires total seven (7) spaces • Kindly advise if the forgoing is incorrect and we will modify as required • We will also forward you an engineers certification at the end of the parking lot construction stating compliance with the design documents • 1 will also advise the owner as concerns proper signage for the hcp parking areas • Please call meat the below listed location should you have any further concerns Sincerely: Stephen E. Foster ,V.P. — Project Manager file: C:/Projects/Forms/Mem 1 213d cc:p.labrie-watts file: 43 Gigante Drive • Hampstead, NH 03841 BUTLER BUILDER www.duttongarfield.com Tel: (603) 329-5300 Fax: (603) 329-5368 Permit NO: Date Issued: TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received 3 `01— F— F— IMPORTANT: Applicant must complete all items on this page I LOCATION gxs Prin't PROPERTY OWNER ��`Z(7� Print � MAP NO.: PARCEL: z2 -I( ZONING DISTRICT: .4- —..Y TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 0 Addition Iteration ❑ One family ❑ Two or more"family No. of units: ❑ Industrial ❑ Repair, replacement ❑ Demolition ❑ Assessory Bldg .Commercial ❑ Moving relocation 0 Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED .— - --" - f - - - --E OWNER: Name: Ided4ification P ease Type or Print Clearly) - s% !l «e' c' 1 Phone: Address: CONTRACTOR Name: .O L 772Phone:� t Address: 6,1 Ce I 400�1 Supervisor's Construction License: �z-9� 3 7 Exp. Date: Z-1 z 0/a 8 Home Improvement License: �/ Exp. Date: ARCHITECT/ENGINEER It o m a �� l7S ��7��'r, ame: Phone: � 17 2 Address: -Z�° Z� �r �" Reg. No. 46� 2,7 FEE SCHEDULE. 8ULDING PERMIT.• x12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON x125.00 PERS F. Total Project Cost :$ FEE:$_�y��._ 4 Check No.: / �a Receipt No.: 2,o4 33 Page Iof4 jj ��t/�P�� [�'� G°S�? �n^Gt C%li,+'Y--"; �y ✓✓� � ���.. %t e % 7 fes✓ ! cr u �.%�- , . Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Dae: INSPECTIONAL SERVICES DEPARTMENTMFORMOS Page 4 of 4 Location No. — Date A ol, I t TOWN OF NORTH ANDOVER 19818 :;—, , L--, %J Building Inspector Certificate Occupancy $ of CHU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 57 Check # 19818 :;—, , L--, %J Building Inspector Permit NO:�� Date Issued: " 111 D & LOCATION PROPERTY MAP NO.: TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION IMPORTANT: Date Received _� ` must complete all items on this "6 ' o A if 4 Y07/ G-PARCEL:'2 7C ZONING DISTRICT: --- TYPE AND USE OF BUILDING TYPE OF IMPROVEMENT ❑ New Building ❑ Addition ❑ Alteration ❑ Repair, replacement ❑ Demolition ❑ Moving (relocation) ❑ Foundation only DESCRIPTION OF WpRK TO OWNEF Address HISTORIC DISTRICT PROPOSED USE Residential ❑ One family ❑ Two or more family No. of units: ❑ Assessory Bldg ❑ Other PREFORMED Identification Please Type or Print Clearly) YES ❑ Non- Residential ❑ Industrial ❑ Commercial CONTRACTOR Name: Address Supervisor's Construction License: Exp. Date: Home Improvement License: s" 1 14 Exp. Date: `t ARCHITECT/ENGINEER G6,��c2 fry S Name: Phone: Address: e aK Reg. No. FEE SCHEDULE: BULDIN P IT 12.0_0 PER $1000.00 OF THE TOTAL ESTIMATED C T BAS`EED ON $125.00 PER S.F. Total Project Cost :$� O06 2 C Check No.: Y7j' d �' _Receipt No.: % rage I of 4 L— J Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Page 4 of 4 03/01/2007 11:27 6033295368 Dutton G1 CONTRA I , DUrMN & GARFIELD Ince Project Memo Watts Water Technologies 815 Chestnut Street North Andover, MA PAGE 01/02 To: Gerald Brown -- Building Commissioner — Town of North Andover, MA From: Stephen E. Foster Date: 3/1/07 Re: building permit fee — A/P area modifications • Plans for above project had been previously reviewed and approved for issuance of building permit • We had not provided a total cost of the project at the time of permit application processing as contract cost was not available at that time • Please see attached purchase order from owner confirming project cost • Advise regarding permit fee Stephen E. Foster Y.P. —Project Manager file:CAProjectslwatts ap 1mem0301c cc: 43 Gigante Drive • Hampmad. NH 03841 Tel: (603) 329.5300 Fax: (603) 339-5368 BUTLER BUILMN www.duttongarfieldcom North Andover. Massachusetts 01845 Tel:(976) 661.8600 Fax:(976)681.7570 03/01/2007 11:27 6033295368 FEB 27 '07 15:29 FR WATTS 110-eTRtES Watts -Andover AP 1600 Osgood Street Suite 2-05 North Andover, MA 01845-IOSO Supplier; 101197 DUTTON & GARFIELD TNC 43 GIGANNTE DR HAMPSTEAD, PH 03841 DUTTON & GARFIELD PAGE 02/02 7M 6M 7779 TO L60332953M P.011162 P U R C H A 0 E O R D E R Order Number: CA312309 Revision: 0 Order Date: 02/27/07 Page: 1 Print Date: 02127/07 Ship To: A00 WAFTS REGULATOR COMPANY 815 CHESTNUT ST NORTH ANDOVER, MA 07.845-6009 LEASE CONFIRM PRICE & DELIVERY WITHIN 46 TOURS TO FAX# 978-687-7873 Confirming: yes Buyer: A0012 Supplier Telephone: 603-329-5300 Supplier Fax: 603-329-S368 Peter Labrie Phone: Credit Terms: 10 AP - NET 10 Remarks: Contact: PETER LABRIE Ship via; FOB: i Ln Item Number T Due Qty Open UM Unit Cost Extended Cost -------------------- ------------------- --------------- --- ------------- 1 A/P AREA RENOVATNS N 04/10/01 1.0 EA 194,333-00 194,333.00 Site: A00 Type: Memo ITEM NOT IN INVENTORY AP AREA RENOVATIONS REP: QUOTE DATED 01/23/07 irchase Order Line Numbers Must be on All Shipping Documents ---A~----.....-.----------r-. ....AA -A------------------. RAMAft----r-------- ................. Taxable Total: 0.00 Line Total: 194,333.00 Tax [11 : 5.00% (2]: 0.00 131: 0.00% Total Tax: 0.00 USD Total: 194,333.00 0.00 By: Authorized signature w O 0 0 z co C4 R. U w a c a w w 0 a a w E z vi o cn ,WS-k,% E o C lu CL O ` C H c vV dC W W m 0 'oCD0 :.:. e`v y Ea gym-. C _m QCs ' V �■ ID 0:0 a E� O O v .. Os mi m c E h N ` �3 a m N t CW � y C _O Em a•v m -a c c OQ a o = m m � V h Z O N O C F- y n C C = m m ID = 3 N CIO m Uj .� CML Z � E r"rom O c a g s v M a U) LLI U/ 19 W W W U) ,___4_b No.: Account Code: THE ASSOCIATED GENERAL CONTRACTORS OF AMERICA AGC DOCUMENT NO. 205 e S� STANDARD SHORT FORM AGREEMENT �INE1.tL' S [Ill I"TE°RITT f R I 11 ��j � I"TEGRITT '°"f"' BETWEEN OWNER AND CONTRACTOR '°"" (Where the Contract. Price is a Lump Sum) This Agreement is made this 26th day of October 2006 , by and between (Day) (Month) (Year) OWNER, Watts Water Technologies, Inc and am and Address) CONTRACTOR, Dutton & Garfield, Inc. ``Name and Address) PROJECT: New Parking Lot & Drainage Construction Port Engineering(DAssociates andnoCcation) ARCHITECT/ENGINEER: l (Name and Address) 1 THE WORK Contractor shall furnish construction administration and management services and use Contractor's best efforts to perform the Work in an expeditious manner consistent with the Contract Documents. Contractor shall provide all labor, materials, equipment and services necessary to complete the Work, as described in Exhibit A, all of which shall be provided in full accord with and reasonably inferable from the Contract Documents as being necessary to produce the indicated results. 2 CONTRACT PRICE As full compensation for performance by Contractor of the Work, Owner shall pay Contractor the lump sum price of Two Hundred Sixty Nine Thousand Dollars ($ $269,000. ).The lump sum price is hereinafter referred to as the Contract Price, which shall be subject to increase or decrease as provided in this Agreement. 3 INSURANCE Prior to the start of the Work, Contractor shall purchase and maintain insurance coverage and limits of liability as set forth in Exhibit E, that will protect Contractor from claims arising out of Contractor operations under this Agreement, whether the operations are by.Contractor,o 4any of Contractor's consultants or subcontractors or anyone directly or indirectly employed by any of them, or by anyone r whose acts any of them may be liable. - 4 BONDS Performance and Payment Bonds Gare t are not required of Contractor. Such bonds shall be issued by a surety licensed in the state of the location of the Project and must be acceptable to Owner. The penal sum of the Payment Bond shall equal the penal sum of the Performance Bond. 5 EXHIBITS The following Exhibits are incorporated by reference and made part of this Agreement: EXHIBIT A: The Work, Scope Of Work pages. EXHIBIT B: Contract Documents (Attach a complete listing by title, date and number of pages.) EXHIBIT C: Progress Schedule, pages. EXHIBIT D: Alternates and Unit Prices, include dates when alternates and unit prices no longer apply, pages. EXHIBIT E: Insurance Provisions, pages. EXHIBIT_: Other, pages. AGC DOCUMENT NO. 205 • STANDARD SHORT FORM AGREEMENT BETWEEN OWNER AND CONTRACTOR (Where the Contract Price is a Lump Sum) \ . 0 2000, The Associated General Contractors of America pao ,a •ry TOWN OF NORTH ANDOVER p PERMIT FOR WIRING V`cJ f Thiscertifies that.......................................................................................... has permission to perform`1� U %.�� ff ....... / /...... .. /.............. wiring in the building of .. aW&4 J ��1...�� ..1. J...... at .... n..l� ( �L ................ ,North Andover, Mass. r . Fee. I. !.....rl.. Lic. No. �) / !L.�........................................................... ELECTRICAL INSPECTOR Check q Commonwealth of Mas Department of Fie BOARD OF FIRE PREVENTI N APPLICATION FOR PER I All work to be performed in accordance r� (PLEASE PRINT IN INK OR E AL INFORM City or Town of: By this application the undersigne gives n ice o his Location (Street & Nuumbe:, / Owner or Tenant ) �l . n 1. Owner's Address Is this permit in conjunction with a building permit? Purpose of Building Existing Service Amps / Volts New Service Amps / Volts ich setts ::Occupancy cial Use Only i Permit No. ces and Fee Check GULATIONS [Rev. 11/99] leave blank TO PERFORM ELECTRICAL WORK the Massachusetts Electrical Code (MEC), 527 CMR 12.00 70N) Date: % o To the Inspector o Wires: er intention Rpperform the electrical work described below. Telephone No: Yes ❑ No 'Z (Check Appropriate Box) Utility Authorization No. Overhead ❑ Undgrd ❑ No. of Meters Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of Security system Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool rnd. Above ❑ In- rnd. ❑ o. o Emergency Lighting Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No, of Waste Dis osers p Heat Pump Totals: .Number Tons KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: /v,/M - (When required by municipal policy.) Work to Start: d (y& Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under thepains andpenalties ofperjury, that the information on this application is true and complete FIRM NAME:Ser-iAlres LIC. NO.: 1 Licensee: John S. Bassett Signature LIC. NO.: 1533C (If applicable, enter "exempt" in the license number line.) Bus. Tel. No..• 603 594 5928 Address: Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Lic, see does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ , — Date. .?. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ..� .�/-.�....(.- . . (�- ................... . has permission to perform ..�.'...... �X..H................ plumbing in the buildings of ... + A-1. 1.11.1.... . � ............ at ... r . !.).... rX,�-. r .. f ............. North Andover, Mass. ;Co- r Fee. �(.. ' .. Lic. No.. X15 j..z. .......-�..... . PLUMBING INSPECTOR Check # a 5428 MASSACHUSETTS UNIFORM APPLICATION FORTERMIT TO DO PLUMBING (Type or;print) NORTH ANDOVER, MASSACHUSETTS Date Building Location S7—Owners Name �77� (/t/GC����/�_ Permit Amount Type of Occupancy /ywr New Renovation rl Replacement 11 Plans Submitted Yes No FIXTURES (Print or type) Chec one: Certificate Installing Company Name Andover Plbq. & Htq. Co., Inc. Corp. 2122 Address 20 Aegean Dr. Unit 110 0 Partner. Bus�—itie-fie ep Mone Fmn/Co. Name of Licensed Plumber. George LaRose Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy [:] Other type of indemnity 0 Bond ❑. Insurance Waiver. L the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By: Signature or Eicenseaum r Ty e of Pl Title umbing License �3 City/Town icense um Master Journeyman 1:1APPROVED (OFRCE USE ONLY 9983 N2 2'17 9 11) --) 9 Date -.—/ .... I-V .... ......................... 0 - TOWN OF NORTH ANDOVER PERMIT FOR WIRING l( - This certifies that.4�1) 7 .. .............. ................................................................... has permission to perform ........................................ wiring in the building of ............ '-'Z4 'A - '6(�" ......................................................................... ..... at .......................................... ....................... . North Andover, Mass. Fees� . ............. Lic. No... �?. __? ....... s ......... . .................. ELECFRICAL INSPECrOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer a (Ml�e &M1110nWralt4 of l�nn�cl�unEtt� ' 1Ieparttnent of Public f-afetq �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 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 42--23-66 City or Town of A14.ers/ .41voodEe To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 9�/.5_ rllF.J7WUT _77;18EE7- Owner or Tenant 4&W7727 Ri EG t:JG ATDe Owner's Address tr�i78) G88 y /8// Is this permit in conjunction with a building permit: Yes ❑ No IX (Check Appropriate Bok) Purpose of Building Utifity Authorization No. Existing Service Amps —J Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps —J Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets I No. of Hot Tubs No. of Transformers = Total KVA No. of Lighting Fixtures - - Swimming Pool Above, In- grnd. grnd. ❑ ` Generators - - KVA = No. of Emergency Lighting r- No. of Receptacle Outlets ' No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS _ No:Tof Zones No. of Detection and No. of Ranges No. of Air Cond. Total tons Initiating Devices No. of Disposals No.of Heat Total Total Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices LocalMunicipal ❑ Other ❑ Connection No. of Dryers Heating Devices KW No. of No. ofow Vo to No. of Water Heaters KW Signs Ballasts Wirin f!C'C'ES SYST�N% No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES a NO ❑ 1 have submitted valid proof of same to the Office. YES ❑ NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ❑ BOND ❑ OTHER ❑ (Please Specify) (Expiration Date) Estimated Value of Electrical Work $ Work to Start Inspection Date Requested: Rough Final ` /0 -.04 Slgned under the Penalties of perjury: 01533' FIRM NAM_ E ADT SECURITY SERVICES, INC. , LIC. NO Licensee JACK BASSETT Signature UC. NO: 1533' Bus. Tel. No. 781 278-1169 Address 111 MORSE STREET, -NORWOOD, MA 02062 Alt. Tel. No. _. _ l ice— OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the Insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please chock one) 00 Telephone No. _ ._ PERMIT FEE $� (Signature of Owner or Agent) ?(•6S.iJ 21.7 7 7 Date .. �. !. !`? .'. ? `'l . . HpRTh pF TOWN OF NORTH ANDOVER 4ao ,e 1�p0 PERMIT FOR GAS INSTALLATION U. • U. -"SACHUSc- �p S This certifies that ...�� �.��..�� C'.y.! .... ;�/�.� has permission for gas installation . .?� .. f� . (� -'4.q 7,2 -/Z - in the buildings of ... at .... ....... . . , North Andover, Miss. Fee. 0." Lic. No.. �. 4 . ...................... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 0— *�Iv1l W Install Busin Name MASSACHUSETTSVN ,.FORM: APPLICATION FOR PERMIT TO DO ASFITTING . . ..:� (Print or TYP@)-777 Mass. Date` 19 Permit # 02 Building Location / Owner's Name e%6 -Y 1,1el/1%d Type of Occupancy aw lee Oct° sem' Plans Submitted: Yes ❑ No New ❑ Renovation ❑ Replacement ❑ Company Name d Telephone (it7G Licensed Plumber or Gas Fitter one: /eck poration ❑ Partnership ❑ Firm/Co. certificate # INSURI NCE COVERAGE: I have; curren lability;' insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142' Yes No. ❑ If. you Piave checked yes, please indicate the type coverage by checking the appropriate box. A liabiltity insurance policy. ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSWIANCE 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: d Owner ❑ Agent ❑ I hereby cel and that a� of the Mas By -- Title of Owner or Owner's Agent ,ify that all of the details and information 1 have submitted (or entered) in above application'are true and accurate to the best of my knowledge plumbing W rk and installation performed under the permit issued for this application will be in compliance with all pertinent provisions achusetts State Gas Code and Chapter 142 of the General Laws. Type of License:t`�J�J" S� O Plumber Q Gasfitter Signature of Licensed Plumber -or Gas Fitter 0 Master J License Number 0 Journeyman — DVED (OFFICE USE ONLY) NONE ■ME■■E■■■■■■■■■M■■■mom �.... MEMO■E■■E■■■E■■■■■■■■E■■■■ ... ■■EE■ME■■■ ■■■MEM■■■■E■E■O ... 0000■ E■■ ■E■■■■■■■■■■■■■ . FLOOR 0 E■■ ■0 ■■■■■■■M■■■■■■■, ..- ■ ■■■■E■00000 ■■0000sa0■00 .. -_ M■®■■0000��M■■000M■■0000000. Company Name d Telephone (it7G Licensed Plumber or Gas Fitter one: /eck poration ❑ Partnership ❑ Firm/Co. certificate # INSURI NCE COVERAGE: I have; curren lability;' insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142' Yes No. ❑ If. you Piave checked yes, please indicate the type coverage by checking the appropriate box. A liabiltity insurance policy. ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSWIANCE 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: d Owner ❑ Agent ❑ I hereby cel and that a� of the Mas By -- Title of Owner or Owner's Agent ,ify that all of the details and information 1 have submitted (or entered) in above application'are true and accurate to the best of my knowledge plumbing W rk and installation performed under the permit issued for this application will be in compliance with all pertinent provisions achusetts State Gas Code and Chapter 142 of the General Laws. Type of License:t`�J�J" S� O Plumber Q Gasfitter Signature of Licensed Plumber -or Gas Fitter 0 Master J License Number 0 Journeyman — DVED (OFFICE USE ONLY) O '4-)" t - m m v m z d 0 In 0 0 "1 n M C 1N v z Z m .. n [D' C' Z � M rn 0 0 0 0 Z N N z N '0 i • m o � z N j I I Date . ............... . w ) TOWN OF NORTH ANDOVER 9 PERMIT FOR GAS INSTALLATION i This certifies that .......................................... has permission for gas installation ......................... in the buildings of .................................. at .................................... North Ani' Fee......... Lic. No.. ... 12119/94 11:21 1,3M-00 MINS' WHITE: Applicant CANARY: Building Dept. PINK- MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO 00 GASFITTING (� (Print or Type) NORTH ANDOVER Mass. Date ..!� kuilding Location /,� G ers7`.ti�7— S� Permit # j�Fe' •� I Owners Name �74-ls • New _ Renovation D Replacement Plans Submitted FIXTUR'S (Print or Type) o Check one: Certificate Installing Company Name it &d(«l,%w<<�� C,� d Corp. C Address k - - 7 Partner. 4,g rf f Firm/Co. Business Telephone: 5-0ls- 6'?j- Name of Licensed Plumber or Gas Fitter C- Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity F 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 coverages. Signature of owner/agent of property Owner U Agent 0 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 iueed for this application will -be in eompHance with all pertinent provisions of the Massachusetts State Gas Cade and Chapter 142 of the General Laws, . By Title City/Town: APPROVED (OFFICE USE ONLY) PE LICENSE: Plumber sfitter �ignature of Licensed Master Plumber or Gasfitter Journeyman 9h 7� Lic_nse Number V • �������o��o��s�i�i������i■ (Print or Type) o Check one: Certificate Installing Company Name it &d(«l,%w<<�� C,� d Corp. C Address k - - 7 Partner. 4,g rf f Firm/Co. Business Telephone: 5-0ls- 6'?j- Name of Licensed Plumber or Gas Fitter C- Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity F 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 coverages. Signature of owner/agent of property Owner U Agent 0 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 iueed for this application will -be in eompHance with all pertinent provisions of the Massachusetts State Gas Cade and Chapter 142 of the General Laws, . By Title City/Town: APPROVED (OFFICE USE ONLY) PE LICENSE: Plumber sfitter �ignature of Licensed Master Plumber or Gasfitter Journeyman 9h 7� Lic_nse Number Location Me I j Date / ' - pORTp TOWN OF NORTH ANDOVER p Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ sAc14USE , Other Permit Fee $ ®� Sir Z&nnection Fee $ Water Connection Fee $ TOTAL $ %- L Building Inspector �� �j Div. Public Works 0 V rc Co I a M w LAJ I Y u 'V x N I V\ U) W J al 0 k. lz 0 0m " z o W 4. m W W Z W N d E m m m 2% 1 m Z O V, W 1- O F z K < d ll Z 0 = Z u 0 F LL 0 0 0 o i 4 = 0 w W N < x a f kA ez �s W Z < U) IZ u N F O u J 7 < m A 1,4■ .i. J A in Z O < W W J J z O J m N N 1 mm g C W O z 0 F U i W W L J U m W 0 J z 0 0 a s 0 0 z z z V Co M w LAJ 'V V\ � O V N W W V � V\ V, W w �� 4 w 'r DNf tan"00 wonwwoy<D��vn xZ -D v_mnn D;N °$_ 3 111 O O Z n n n n -' m o 0 0 a A r 0 m w p n 0 0 N 'a c Q•"'vD mm ,Z,, M. 7cnn y> �.¢ Om a N 7Cnn pti� 0 0 N y m m m p = N Z Z p Z Z 0060 ti= O p 0. C p m -� m m m N Z N m m r D D Z'D ; p� p v 2 0 p ON 3 N O m m C N; 3 N=;x O mpm�pDtn ��tn ' 3 mn to << NmD� w ZJOm Amp N < < A N .► i o Z >< < i n 0 0 N Z 7cD�i� DC a' anx n TTm COa x V .;a pN C Dpn<��= O om ~ �� A D°z o-. Z r<apm' OD C TO y •r O x p i Q A n = S' S m p v D w Z m n Z = c3. Z p n l0 (J > 00 p�p to p Z r p N N p W N< ; m m N m Z O 7C n n ti -Zi 0 FZZ NO x Na rn p7c 7s Z piN P A T I r Ta �` I Iw O O D e x 2 O z O Z 8 O O M z ISI t�L I I I� I I I I IIIIIIIW IIII IIIII" >01 NrN Zm MMO �No NZ COX MXN D� A§ t sj f !n D :E s. -1 z a zfq N .. u o m �mm C m�0 r- WCN v r �O0 Z Y D m -� ?�Z A q =o O �o 0� :0a x0 mm 111 M 00 DO 3 04' iIf �; V 8Tm 0 0 a O N a s w or) H O � N O 3 N' TT Z- 2 0 cD A D x N _ T v_ O r tan y 0 A i 0 D A r F D n G; .+.• x m m m y n '^ Z 0 i Z -1 v N N z p 0 m i p i m T 0 G1Zo D Z cm w 'r DNf tan"00 wonwwoy<D��vn xZ -D v_mnn D;N °$_ 3 111 O O Z n n n n -' m o 0 0 a A r 0 m w p n 0 0 N 'a c Q•"'vD mm ,Z,, M. 7cnn y> �.¢ Om a N 7Cnn pti� 0 0 N y m m m p = N Z Z p Z Z 0060 ti= O p 0. C p m -� m m m N Z N m m r D D Z'D ; p� p v 2 0 p ON 3 N O m m C N; 3 N=;x O mpm�pDtn ��tn ' 3 mn to << NmD� w ZJOm Amp N < < A N .► i o Z >< < i n 0 0 N Z 7cD�i� DC a' anx n TTm COa x V .;a pN C Dpn<��= O om ~ �� A D°z o-. Z r<apm' OD C TO y •r O x p i Q A n = S' S m p v D w Z m n Z = c3. Z p n l0 (J > 00 p�p to p Z r p N N p W N< ; m m N m Z O 7C n n ti -Zi 0 FZZ NO x Na rn p7c 7s Z piN P A T I r Ta �` I Iw O O D e x 2 O z O Z 8 O O M z ISI t�L I I I� I I I I IIIIIIIW IIII IIIII" >01 NrN Zm MMO �No NZ COX MXN D� A§ t sj f !n D :E s. -1 z a zfq N .. u o m �mm C m�0 r- WCN v r �O0 Z Y D m -� ?�Z A q =o O �o 0� :0a x0 mm 111 M 00 DO 3 04' iIf W QO c � o � 2: c •- Q � ,: •ate . r cc 0 m c �a cc CL to`� .00 C3, - :.a , -:a CD, CD c all H GOm 3 CD1A 0� duo - CIO C H R N m a. L3 L H O m c C hQ Y p,ct m 0 � Q: c3 Z V c° c a o O H O C = m a. H � ti mom~ CODLU ea = m LA uj O 5 •� V 'fl 60i N LU m c m c_ am y a. m :e 0:5 CIO zo = W OL ti•7 1. �O. a. *- m E L L z N O i C43 c Q� m CO c m 0 cm C_ •c N m s r O Z O co i a O C4 O al CU O Cid • O O v Z CD C7. O COD O � cam c CO3 p 'O CD y O O CIO m CL I— = R.0 Co CD O Cc O O0. CL CMa O Cc C.2 J -0 EL cm O C Z � 0 CL �..� CO) O � c C CO2 0 J Z LL Z 0 a LU U) Z 0 U - w v cn 0 a c co w a U cz u. pG O a aG G w � O w W 00w p w v cn C w p c� is. w W z cn o cn c � o � 2: c •- Q � ,: •ate . r cc 0 m c �a cc CL to`� .00 C3, - :.a , -:a CD, CD c all H GOm 3 CD1A 0� duo - CIO C H R N m a. L3 L H O m c C hQ Y p,ct m 0 � Q: c3 Z V c° c a o O H O C = m a. H � ti mom~ CODLU ea = m LA uj O 5 •� V 'fl 60i N LU m c m c_ am y a. m :e 0:5 CIO zo = W OL ti•7 1. �O. a. *- m E L L z N O i C43 c Q� m CO c m 0 cm C_ •c N m s r O Z O co i a O C4 O al CU O Cid • O O v Z CD C7. O COD O � cam c CO3 p 'O CD y O O CIO m CL I— = R.0 Co CD O Cc O O0. CL CMa O Cc C.2 J -0 EL cm O C Z � 0 CL �..� CO) O � c C CO2 0 J Z LL Z 0 a LU U) Z 0 U - a 6610 E loo OWES= loamoa ageQ L9 ,s aogoadsui buTPTTns Aq pantaoag �T 'd 2jV,V guamgavdaQ eaTa I?rlp,) I'XV ?nl-f p bNI�SLtCd . /S gT=ad AemaA-rap - Y' ?j n suoTgoauuoo zageM/aaMas - s zoM oTTgnd ljeovvs �l S�xa � sn X c squauimo0 pagoaCau agpQ gUabY ugTEaH panoaddy agEQ squeumo0 pagoa Cau agpQ zauu Td urs l0 0� panoaddy agva squatimuoO pagoaCau ageQ aO4UZ4STUTUIpV uOT4pn.19SUO, panOaddy ageQ Sa xa!)Y xMos ao sxo,i vv ooau SIG xaqumN •qs 'LS 1ntv1s�H7 � gaaa4s (S) 40a 2 Z Taoaed 118) 88� auoua UOTSTnTpgnS -Iagmnx dieK s,.zossassy :xOISKJo'I sr3i?!l �4� S1lbJ+�=�Izaa�r uotgoas ST44 gno sTTT3 gUeoTTddv**************** -sguamaiTnbai ao suoTgpTnbaa APT agpgs io TeooT aTgBOTTddv Aue ugTA BoueTTdmoo moaj I;umopueT io/PtIR queoTTddp 944 aeaTTOa qou saop sTTU-pauTeggo uaaq aneq uoTgoTpsTin[ buTnelq squamgiedaa pup spieog moi3 sgT=ad/sTenoiddp Az'essaoau TTp gelq4 HJT=ae og pasn ST =o3 STgy :SNOIIDIIHISNI c X. w W o W ~ z y1 Q LL J J OLU } IW ir 1 W W. p V Z o � F' Q _ 1��Y2 i W � U CJS N cr Q Q U a Z '44 > LL W -.��) ///►►► W W LU F-�it ( C1 c=j U. a: Q O LU 0 Z ' Utz U OLL N W f OJ J;p i L F� w (Z' U N MLD ALONG UN D W c WW N f=1 A W Z a+•F� J Q J -a W sz LL N Ok OD o ¢ o r Zo J 0 HO W U Z Yia 4N i y EywwWL 0 i ! ZCZi !4! W o W3 +R 000 1z 12 s J R p r a W „y u a w ♦ aaJ � a � iF. F �•�• 6 2 w ♦ ago �� LL N aC•Ra < i o S V w E %O t9 = `. Mn ALONG une A m2p< 1� Z. M O r �kWo WS�O V• ^ N DU0 � O► O � o°. C) oodz a W w O r ,UAXW J LL M M w ~ Q► =05 0 g o �Z M g 8 O V -O W Q J' I.- MU 2 ft Cc ♦2 0 3 A x Nw w �¢ V z a. LMa V V no O r Ots� W Cl) LM LL z O® W e F- y a® V i -- LL F— W V �U U) 6 L, 1-1 00 V O W 1; C* Gj ev ev o S u m C Cc xe co O y� r m r -4. J .or 1. w E c �• F" ' U a � � 2 � cJ ~ ate: 1b: _- Cl :mc QLU LY. v O v n'«r `—� ' W C U 1 `� a o aL c i n a " Cq •v s opo \" ' c '� „a '• `- �'+on W u a > °�° w 2 v o O v u. v) O O u. 02 t G U w O G C4 O y u: cn C w" O G w x 4-0 i w cn cn O W 1; C* Gj ev ev o S u m C Cc xe co O y� r m r w O 0 r� -4. J .or z E c LL CD � i o ~ ate: w O 0 r� J 0 CL z E c LL CD � i o ~ ate: 1b: _- Cl :mc QLU n'«r `—� L 0 W C z . m .;; O • N ma L m�3p >.3 IS co H •� N W Z •.m Cc :�,� 4-0 •1: N O O = O� E o �v CD O o CL .) • � � :CoQ m ..Ry N fl •� .: +. •. nCL .mom O O i C O V N O L CJ J -p CM n •C H m N c ZCL Q F' CO) N m o Cc CD m L CA V� LL_m •N +r c A o Mme' •LU � O• rL•.• v 'fl v •N Z O �• m o� h n m•> O:5 y•7 O _ c $ O.Mm 9 J O z LL CD � i ~ _- z QLU O W C z cc: -c F- CO cm c w co H •� O m m W Z 4-0 = O� CD O o CL .) • � � ora CA J O O i C O Q CJ J -p z LL ^i y ZCL Q CA V� cc C �• . C � LL R G CO) C� 5 0 z z � u G A L EAGER /N YAL VE Y IPIDUSTRIES one. Facilities Coordinator f Tel: (508) 689-6071 I Tel: (508) 688-1811 815 Chestnut Street Fax: (508) 687-7873 North Andover, MA 01845-6098 Location S C1- cstkmT STM No.. 316 —5 Date 9-aG - 94 TOWN OF NORTH ANDOVER r� A Certificate of Occupancy $ Building/Frame Permit Fee $ ^O " Foundation Permit Fee s�CHust $ • Other Permit Fee SiC9rvj $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $4. a75 on Building nspector !30!96 13:53 25.00 PAID Div. Public Works 00 � •ri G cn Gb a. G cu• .r, —4 I cn v cn v �4 E +� cn crl w ca w. CG �• 'C7 O �-7 +a p >, E �4 �4 O Q x4 N ...Lj z o o b w !•a G N a cnH cn a z -W v 4--j , P4 o •Z. z, ri). • O p �a �• o o cn • +� G cu o J sr N o +� IK H r O z O s r1.��Q . =' v w ro H X0.1. �+ Vi . �• H a SL' +-j cn E w G Sa p s4 w •1-+ o m oD • V /\ cn G G i4 r ,C •H G H 4J �• ,i .0 � p Q yr c� N . a+ yE-a' b 1 bD W cn C1� G •ri 41 Q1 E-� � H •r1 �L •r-1 C=+ _w (� a E I .4 -, ,a o a N o a 45 O Q b a� U 2 cc 0 x _O -E IN r -r IZI ^ a� NO I F- an CIO a� U ca w a cQ N U V .� o o ,u cc �4a U Q ^ a� NO I F- •no)k quegL •jumaSed asmbaa Wa saxuas ma q� jo asn Inogllm dines ap •oj usis siauiaQ aleaodaoam os •off t>2is saamaQ moi; pasegamd ssaiun P�!IUn aq .LORI �m juap of paauasaad InoSiq jo ugisap Sud •oj u2is siamaa jo Sliadoad we sguiatup RV ` e-BQ ao 4-W M- G =moi i n —J O SW %07 OS d ' �►.z�n ted S?I1y1 �' r�4'»�d BMs �' 5� �-f�dt� � '? 1-►ry �� � � 090 1 �.tv�r�No� +-ilinn rrc�is -ra1sN l ciN� OL S1.3j9NO? NI .x.35 •gym, 2:T�:�'�%� s -13s res -)VVxyh xll)64e Iv91S 0 341S 1 090 s�Nm eEOEO 31=JIHSdV4VH M3N AUU30 • '1X3 A`dMOHOA 81.1. 017Vz-Szt7-E09 •03 NSIS ■ Z Iry �� L7 Location - No. �'�" Date H° 'o TOWN OF NORTH ANDOVER Ot ,t•',�O awagdidlk p Certificate of Occupancy $ ` T • Building/Frame PermitFee $ • °� ; Foundation Permit Fee $ � s�cNuS t Other Permit Fee $ T Sewer Connection Fee $ Water Connection Fee $ TOTAL $ r _�'� •r�[� - 9 .19� Building Inspector r 2 0 3 Div. Public Works PE1111117 N0 � APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. /AGE 1 MAP i4O. I LOT NO. 2 RECORD OF OWNERSHIP JDATE iPAGE ZONE SUB DIV. LOT NO. (BOOK LOCATION PURPOSE OF BUILDING IT <6f� OWNER'S NAME' V — NO. OF STORIES SIZE Q� ? fr���f '•G OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME C SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAMEv / SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES — SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING x IS BUILDING ADDITION M jERIAL OF CHIMNEY IS BUILDING ALTERATION `' " rv�� /J� 1 S UILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO RE UIREME TS OF CODE BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN WATER IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE I NST-R�'Uf CST I�ISISz4r SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METIEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GfRAGE4IfU$T CIONkkORIj TO STATE FIRE REGULATIONS PL S US BE I E /�N A O D BY BUILDING INSPECT R D TE � i SIGNAT RE OF OWNER OR AUTHORIZED AGENT FEE '-7 0 U., PERMIT GRANTED 19 + .....� - - -.Y•-mss f i I }i ' JULT" DING DEPARTtAAENT 6 g I OWNER TEL II CONTR. TEL t CONTR. LIC. # 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST Tzgcooe EST. BLDG. COST PER A. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY i BOARD OF HEALTH PLANNING BOARD BOARD OR S[LECTMEN Gl BUILDING 1 SPiCTOR BUILDING RECORD 1 OCCUPANCY 12 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA - RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. SINGLE FAMILY W D J IST S"ORIES MULTI. FAMILY _ OFFICES APARTMENTS STEAM CONSTRUCTION 2 FOUNDATION HOT W'T'R OR VAPOR AIR CONDITIONING 8 INTERIOR FINISH a t 2 I3 PINE CONCRETE CONCRETE BL K. BRICK OR STQNE HARDW D PLASTER DRY WALL UNFIN. _ UNIT HEATERS Plf.psl kx GAS 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ 1/1 1/2 %FIN. ATTIC AREA _ NO BMT HEAD ROOM FIRE PLACES MODERN KITCHEN _ 4 WALLS I 9 FLOORS CLAPBOARDS NO HEATING CONCRETE EARTH HARDV✓'D COMMCN ASPH. TILE 1 2 3 _ _ DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. d FLOOR I_ CONC. OR CINDER BLK. WIRING STONE ON MASONRY 5 ROOF II 10 PLUMBING neRIF I I HIP II BATH 13 FIX.) I ES KI TIL g fRAMING 1 HEATING ) ^- •-- - r W D J IST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER MS. d COLS. STEAM STEEL BMS. 6 COLS. WOOD RAFTERS _ HOT W'T'R OR VAPOR AIR CONDITIONING _ RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T2nd I_ 1st 13rd ELECTRIC NO HEATING 1� C"j Ln qq-1 ds� rn W w m .� u o O w C/) a v cn a o cz G p w � O r4 v C U ro G x �' b p w m G w a a W bo p a: U cn m w a � O w cz G ii z W G w z i cn o cn c o co c O = C t; O O ' � O vV �d'fl O.0 cc t0 m C ;= O O L CD CDL �+ c �3 o n y 1. CD o �c•• J0 �► fti Ec ti ali € L 153 Go Ma C40 CD 3 .• cm m y lk: Cm i •= O 'o .0 H C y h E •�av` m y m ' :t= o os '=* = m O O cj N O O Z rtot CO c H O. Q m y 0 C •O = m C � 0 N m$~ m COD cc CD :5 W CO -0 :5 .3 Ac.= c Z M 'E Ch O CL co _ .So- F 3 CD J Z � O � � cocc O � Z V Q LLJ 0 G C Z W C o� O Z W CO) < CD� CO) On m cn z CD ICD V O i:b,CDCDC cm Cc _ C3 Q v cmQs�c� Vl C Q CJ .a. o rte+ Z J Ll C CD CL Z C.3 y C cc C C to H a CO) 0 CD Z z Z � u 'u. u Location q 1 S �i��`STNcc�1 STYE j No. Date / ¢ S N°RTM TOWN OF NORTH ANDOVER ` „ Certificate of Occupancy $ �� a + • + Building/Frame Permit Fee $ 5v� 14U Foundation Permit Fee 1',, : Other Permit Fee $ Sewer Connection Fee $ �- Water Connection Fee $ TOTAL e $ y{ _ Building InspWCfor 7809 Div. Public Works Ldaation 8 C T1vuZ' ST�c�`t fit.* Nei: Date NORTH 1 TOWN OF NORTH ANDOVER 43�0�'��°oma Certificate of Occupancy / $ " �► Building/Frame.,Permit Fee $ cNus `� Foundation Permit Fee $ 3 Ute_ Other Permit Fee $ / Sewer Connection Fee $ Water Connection Fee $ r TOTAL �u $ VIt: Building Inspector a 4 J 7583 Div. Public Works _ 8 r� Sf Loc,�tion No. " ��'" Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector p 3 7 Di . P (ic Works 444 - s . � CONTROL PAGE 1 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. mucilo MAP h40. /Q7 C, LQT NO. SUB DIV. LOT NO. 2 RECORD OF OWNERSHIP IDATE I BOOK PAGE rOCATION (tel/ C-4 <�� C3 �. Jr� C&5 PURPOSE PURPOSE OF BUILDING �7 Z' Z j� OWNER'S NAME NO. OF STORIES -3 SIZE — OWNER'S ADDRESS Ao _ J� "� � BASEMENT O SLA ARCHITECT'S NAME ARCHITECT'S NAME Tus i, [l�a����1��,�a - SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME %ac!L',bCIn!'1 C� SPAN DISTANCE TO NEAREST BUILDING j f� --- DIMENSIONS OF SILLS -_ POSTS &a t INSTANCE FROM STREET � I101/1+ DISTANCE FROM LOT LINES - SIDESA t REAR "' GIRDERS AA,REA OF LOT //, /` FRONTAGE /�a 21 g HEIGHT OF FOUNDATION THICKNESS B IS BUILDING NEW �, SIZE OF FOOTING X IS BUILDING ADDITION �/S MATERIAL OF CHIMNEY /./ 19 IS BUILDING ALTERATION IS BUILDING O OLID R FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE �p / .i IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY s7 IS BUILDING CONNECTED TO TOWN SEWER ge o r IS BUILDING CONNECTED TO NATURAL GAS LINE C.Ole t INSTRUCTIONS ' SEE BOTH SIDES �,E �Irlry�91^ 4 ��ll1llriw PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 PERMIT FOR FOUNDATION ONLY REGULATED BY PARA i i 3 PROPERTY INFORMATION LAND COST 4.$-0. ILC, EST. BLDG. COS 7/4 3242 d=4=;l= EST. BLDG. COST OER SQ. FT. DATE L/ °3 4' FEE PAIDt'3 EST. BLDG. COST PER ROOM l ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULAf IT FOR FRAME/BUILDI PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED �� DA .: hFEE PAID. i SIGNATURE OF OWNER OR AUTHORIZED AGENT F E E S. A-Sb�'�. Coir b 110L, PERMIT GRANTED old la 19114-_ STD DIX FfWIE PWIT 1-70 000 Comm 1w, 10 • "I,�-�, s�S f a�� SEPTIC PERMIT NO. 4 APPROVED BY BUILDING INSPECTOR i OWNER TEL. 11 688^ l'slI CONTR. TEL. # '601- 76,7.0 ►' CONTR. LIC. # 0 7-f 3` H.I.C. # _ -7x-83. _ ►�-� BUILDING RECORD 1 OCCUPANCY 12 td SINGLE FAMILY STORIES MULTI, FAMILY OFFICES APARTMENTS _ CONSTRUCTION 2 FOUNDATION CONCRETE CONCRETE BL'K.PINE BRICK OR STONE PIERS _ INTERIOR 3 HARDW D PLASTER DRY WALL UNFIN. FINISH 1 2 13 3 BASEMENT AREA FULL 60fr FIN. B'M'TAREA 14 1/1 °% FIN. ATTIC AREA _ N_O B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN _ 4 WALLS I 9 FLOORS CLAPBOARDS CONCRETE B _ 1 10 2 3 _ DROP SIDING WOOD SHINGLES EARTH HARDW D ASPHALT SIDING ASBESTOS SIDING COM/ACN ASPH. TILE VERT. SIDING _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIORPOOR _ ADEQUATE I NONE 5 ROOF 10 PLUMBING GABLE GAMBREL HIP ANSARD BATH (3 FIX.) TOILET RM. (2 FIX.) _ FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 6 COLS. mAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING _ RADIANT H'T'G UNIT HEATERS 7 NO. OF JOOMS GAS OIL B'M'T 2nd _ 1st 13rd I ELECTRIC NO HEATING HIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- r RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. R f ve ala, w A , �• yo(' `� °-� C►,.e�u +�lz�� ��� Los dYi /9j� �-��� s V;, m m D m T z r t Z z T Z C') O z Cn m D 0 z T z r _v, col C � 'v O co c) Z y CCD O 'v cL r c. O. _• CO) O23 O CD CD O CL c �_ CrG =r d CD CD O CD C CDCD y CZ O co) � I Ca CCD Fv y Cl 10 Z CD o CD C CD r ON rte. C C cm F 0 z 0 CD N O _ _ co O 00 C CL: to O co C O CO) O O. CO) N CCD i x �. y O C co) So Eco .0 y cc - m c o n Cl) co CD O•� ti• � C CL CL = m G O N �„h CA c?CDS, CD x = O H O _ n �.0 4 O :Q O N• n � 0 CD •A O CD H .� i • -� O C9 V CD 01 H _ =r W W 3 a dr � CH y9 c� CD g0Z.: O :w CD 0 i -moo o co ,... mCD� ..«:r. I M Ap :p 1 = .Z A 6L w H 0 C M M v cn Z C� ITI d m- O m cp � f D O r tz H � w O 7' '� r'' 7d HT1 w n El � O O w o C r � cn C, C C. 7C - rt py C M M v ll� vrv..-Ri+.•.•+.�O+.e.+www.+.w.w�w�swswn�aRa�i+.i�O.lRaa�TJrtJ_•>RAPR1fT.T,+'!1 -F_RR>Rt.4:(1.�S4L��l`J�"TS .51Ri'+Rt'S't�'���I`-^iR�'�i��,_T»P��.�'.�F..'�r FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or ,landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section**********G****G*** APPLICANT: moi/ 4 W-3- �-i � J Phone a LOCATION: Assessor's Map Number / % Parcel Subdivision Lot (s) Z "7 / Street St. Number Sal ************************Official Use Only************************ RECO NDAT NS OF7(�ZAGENTS:q r • Date Approved 1 nservation Administrator Date Rejected Comments K Date Approved FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or ,landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section**********G****G*** APPLICANT: moi/ 4 W-3- �-i � J Phone a LOCATION: Assessor's Map Number / % Parcel Subdivision Lot (s) Z "7 / Street St. Number Sal ************************Official Use Only************************ RECO NDAT NS OF7(�ZAGENTS:q Date Approved 1 nservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments /f//w Food Insp ctor-Health Sep is Inspector -Health Comments Date Approved Date Rejected Date Approved /9 l Date Rejected Public Works - sewer/water connections _4//A ?-Z° - ?¢ - driveway permit Fire Department Received by Building Inspector Date 4�� 4 A Dutton & Garfield; Inc. ' �. CONTRACTORS �70 CONSTRUCTION MANAGEMENT STEPHEN E.: FOSTER 60 Willow Street '109 HillsideAvenue North Andover, MA 01845 Londonderry, NH 03053 (508) 681-86Qd (603) 425-2600 FAX: (508) 68.1-7570 FAX: (603) 434-9568 AIA Document A101 Standard Form of Agreement Between Owner and Contractor where the basis of payment is a STIPULATED SUM 1987 EDITION THIS DOCUMENT HAS IMPORTANT LEGAL CONSEQUENCES; CONSULTATION WITH AN ATTORNEY IS ENCOURAGED WITH RESPECT TO ITS COMPLETION OR MODIFICATION. The 1987 Edition of AIA Document A201, General Conditions of the Contract for Construction, is adopted in this document by reference. Do not use with other general conditions unless this document is modified. This document has been approved and endorsed by The Associated General Contractors of America. AGREEMENT made as of the TVenty-seventh day of September in the year of Nineteen Hundred and Ninety -Four BETWEEN the Owner: (Name and address) and the Contractor: (Name and address) Watts Industries 815 Chestnut Street North Andover, MA 01845 Dutton & Garfield, Inc. 60 Willow Street North Andover, MA 01845 The Project is: 15,000 SF Expansion of existing (Name and location) facility and associated site improvements at 815 Chestnut Street, North Andover, Massachusetts The Architect is: Joseph D. LaGrasse & Associates (Name and address) One Elm Square Andover, MA 01810 The Owner and Contractor agree as set forth below. Copyright 1915, 1918, 1925, 1937, 1951, 1958, 1961, 1963, 1967, 1974, 1977, ©1987 by The American Institute of Archi- tects, 1735 New York Avenue, N.W., Washington, D.C. 20006. Reproduction of the material herein or substantial quotation of its provisions without written permission of the AIA violates the copyright laws of the United States and will be subject to legal prosecution. AIA DOCUMENT A101 • OWNER -CONTRACTOR AGREEMENT • TWELFTH EDITION • AIA® • ©1987 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 A101-1987 1 ARTICLE 1 THE CONTRACT DOCUMENTS The Contract Documents consist of this Agreement, Conditions of the Contract (General, Supplementary and other' Conditions), Drawings, Specifications, Addenda issued prior to execution of this Agreement, other documents listed in this Agte=cnt and Modifications issued after execution of this Agreement; these form the Contract, and are as fully a part of the Contract as if attached to this Agreement or repeated herein. The Contract represents the entire and integrated agreement between the parties hereto and supersedes prior negotiations, representations or agreements, either written or oral. An enumeration of the Contract;Documents, other than Modifications, appears in Article 9, ARTICLE 2 THE WORK OF THIS CONTRACT The Contractor shall execute the entire Work described in the Contract Documents, except to the extent specifically,indicated in the Contract Documents to be the responsibility of others, or as follows: ARTICLE 3 DATE OF COMMENCEMENT AND SUBSTANTIAL COMPLETION 3.1 The date of commencement is the date from which the Contract Time of Paragraph 3.2 is measured, and shall be the date of this Agreement, as fist written above, unless a different date is stated below or provision is made for the date to be fixed in a notice to proceed issued by the Owner. (Insert the date of commencement, if it differs from the date of this Agreement or, if applicable, state that the date will be fixed in a notice to proceed.) Unless the date of commencement is established by a notice to proceed issued by the Owner, the Contractor shall notify the Owner in writing not less than five days before commencing the Work to permit the timely filing of mortgages, mechanic's liens and other security interests. 3.2 The Contractor shall achieve Substantial Completion of the entire Work not later than (Insert the calendar date or number of calendar days after the date of commencement. Also insert any requirements for earlier substantial Completion of cer- tain portions of the Work, if not stated elsewbere in the Contract Documents.) On or about April 1, 1995 for main building and northerly portion of connector tunnel. On or about May 8, 1995 for balance of tunnel. , subject to adjustments of this Contract Time as provided in the Contract Documents, (Insert provisions, if any, for liquidated damages relating to failure to complete on time.) N/A ACA DOCUMENT A101 • OWNER -CONTRACTOR AGREEMENT • TWELFTH EDITION • AlA• • 49)1987 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 A101-1987 2 i ARTICLE 1 THE CONTRACT DOCUMENTS The Contract Documents consist of this Agreement, Conditions of the Contract (General, Supplementary and other' Conditions), Drawings, Specifications, Addenda issued prior to execution of this Agreement, other documents listed in this Agte=cnt and Modifications issued after execution of this Agreement; these form the Contract, and are as fully a part of the Contract as if attached to this Agreement or repeated herein. The Contract represents the entire and integrated agreement between the parties hereto and supersedes prior negotiations, representations or agreements, either written or oral. An enumeration of the Contract;Documents, other than Modifications, appears in Article 9, ARTICLE 2 THE WORK OF THIS CONTRACT The Contractor shall execute the entire Work described in the Contract Documents, except to the extent specifically,indicated in the Contract Documents to be the responsibility of others, or as follows: ARTICLE 3 DATE OF COMMENCEMENT AND SUBSTANTIAL COMPLETION 3.1 The date of commencement is the date from which the Contract Time of Paragraph 3.2 is measured, and shall be the date of this Agreement, as fist written above, unless a different date is stated below or provision is made for the date to be fixed in a notice to proceed issued by the Owner. (Insert the date of commencement, if it differs from the date of this Agreement or, if applicable, state that the date will be fixed in a notice to proceed.) Unless the date of commencement is established by a notice to proceed issued by the Owner, the Contractor shall notify the Owner in writing not less than five days before commencing the Work to permit the timely filing of mortgages, mechanic's liens and other security interests. 3.2 The Contractor shall achieve Substantial Completion of the entire Work not later than (Insert the calendar date or number of calendar days after the date of commencement. Also insert any requirements for earlier substantial Completion of cer- tain portions of the Work, if not stated elsewbere in the Contract Documents.) On or about April 1, 1995 for main building and northerly portion of connector tunnel. On or about May 8, 1995 for balance of tunnel. , subject to adjustments of this Contract Time as provided in the Contract Documents, (Insert provisions, if any, for liquidated damages relating to failure to complete on time.) N/A ACA DOCUMENT A101 • OWNER -CONTRACTOR AGREEMENT • TWELFTH EDITION • AlA• • 49)1987 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 A101-1987 2 f G / ARTICLE 4 _ �J 4.1 The Owner shall" the Contractor pay t funds for the Contnaor s performance of the Con on ice` One milliop,three hundred irteen thousand eight hundred sixty one Dollars (S $1,313,861 ), subject to additions and deductions as provided in the Con- tract Docurnen 4.2 The Con t Sum is upon the following alternates, if any, which are desaibed in the Contract Documents and are hereby accept, caner: eP (State the numbers or other identification of accepted alternates, Ydecisions on otber alternates arty to be made by the ovmersubsequent to the ezecutton of tots Agreement, attach a schedule of such other alternates sbowmg the amount for each and the date u»til u�bich that amount is valid) Reference attachment "A". Should the main building and northerly half of the connector tunnel be substantially complete on or before April 1, 1995, a bonus of $13,139 shall be paid to the contractor. 4.3 Unit prices, if any, are as follows: Ledge removal $16/c.y. open, $30/c.y. trench (Includes drilling, blasting, and excavating of ledge. Replacement materials costs are not included). AIA 00CUMENT A101 - OwNER-CONTRACTOR AGREEMENT - TWELFTH EDITION • AIA' • ©1987 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 A101-1987 3 ARTICLE 5 PROGRESS PAYMENTS 5.1 Based upon Applications for Payment submitted to the Architect by the Contractor and Certificates for Payment issued by the Architect, the Owner shall make progress payments on account of the Contract Sum to the Contractor as provided below and elsewhere in the Contract Documents. 5.2 The period covered by each Application for Payment shall be one calendar month ending on the last day of the month, or as follows: 5.3 Provided an Application for Payment is received by the Architect not later than the f irst day of a month, the Owner shall make payment to the Contractor not later than the tenth day of the same month. If an Application for Payment is received by the Architect after the application date fixed above, payment shall be made by the Owner not later than ten (10 ) days after the Architect receives the Application for Payment. 5.4 Each Application for Payment shall be based upon the Schedule of Values submitted by the Contractor in accordance with the Contract Documents. The Schedule of Values shall allocate the entire Contract Sum among the various portions of the Work and be prepared in such form and supported by such data to substantiate its accuracy as the Architect may require. This Schedule, unless objected to by the Architect, shall be used as a basis for reviewing the Contractor's Applications for Payment. 5.5 Applications for Payment shall indicate the percentage of completion of each portion of the Work as of the end of the period covered by the Application for Payment. 5.6 Subject to the provisions of the Contract Documents, the amount of each progress payment shall be computed as follows: 5.6.1 Take that portion of the Contract Sum properly allocable to completed Work as determined by multiplying the percentage completion of each portion of the Work by the share of the total Contract Sum allocated to that portion of the Work in the Schedule of Values, less retainage of f ive percent ( 5 %). Pending final determination of cost to the Owner of changes in the Work, amounts not in dispute may be included as provided in Subparagraph 7.3.7 of the General Conditions even though the Contract Sum has not vet been adjusted by Change Order; 5.6.2 Add that portion of the Contract Sum properly allocable to materials and equipment delivered and suitably stored at the site for subsequent incorporation in the completed construction (or, if approved in advance by the Owner, suitably stored off the site at a location agreed upon in writing), less retainage of f ive percent ( 5 %); 5.6.3 Subtract the aggregate of previous payments made by the Owner; and 5.6.4 Subtract amounts, if any, for which the Architect has withheld or nullified a Certificate for Payment as provided in Para- graph 9.5 of the General Conditions. 5.7 The progress payment amount determined in accordance with Paragraph 5.6 shall be further modified under the following circumstances: 5.7.1 Add, upon Substantial Completion of the Work, a sum sufficient to increase the total payments to one hundred percent( 100 %) of the Contract Sum, less such amounts as the Architect shall determine for incomplete Work and unsettled claims; and 5.7.2 Add, if final completion of the Work is thereafter materially delayed through no fault of the Contractor, any additional amounts payable in accordance with Subparagraph 9.10.3 of the General Conditions. 5.8 Reduction or limitation of retainage, if any, shall be as follows: (if it is intended, prior to Substantial Completion of the entire Work, to reduce or limit the retainage resulting from the percentages inserted in Subpara- graphs 5.6.1 and 5.6.2 above, and this is not explained elsewhere in the Contract Documents, insert here provisions for such reduction or limitation.) Retainage payments for main building shall not be withheld due to extended time required for completion of connector. Sufficient value of construction monies to remain within Schedule of Values to address completion of connector based upon substantiated estimates. ALADOCUMENT A101 • OWNER -CONTRACTOR AGREEMENT • TWELFTH EDITION • AIA® • ©1987 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON. D.C. 20006 A101-1987 4 a i _ 3 ARTICLE 5 PROGRESS PAYMENTS 5.1 Based upon Applications for Payment submitted to the Architect by the Contractor and Certificates for Payment issued by the Architect, the Owner shall make progress payments on account of the Contract Sum to the Contractor as provided below and elsewhere in the Contract Documents. 5.2 The period covered by each Application for Payment shall be one calendar month ending on the last day of the month, or as follows: 5.3 Provided an Application for Payment is received by the Architect not later than the f irst day of a month, the Owner shall make payment to the Contractor not later than the tenth day of the same month. If an Application for Payment is received by the Architect after the application date fixed above, payment shall be made by the Owner not later than ten (10 ) days after the Architect receives the Application for Payment. 5.4 Each Application for Payment shall be based upon the Schedule of Values submitted by the Contractor in accordance with the Contract Documents. The Schedule of Values shall allocate the entire Contract Sum among the various portions of the Work and be prepared in such form and supported by such data to substantiate its accuracy as the Architect may require. This Schedule, unless objected to by the Architect, shall be used as a basis for reviewing the Contractor's Applications for Payment. 5.5 Applications for Payment shall indicate the percentage of completion of each portion of the Work as of the end of the period covered by the Application for Payment. 5.6 Subject to the provisions of the Contract Documents, the amount of each progress payment shall be computed as follows: 5.6.1 Take that portion of the Contract Sum properly allocable to completed Work as determined by multiplying the percentage completion of each portion of the Work by the share of the total Contract Sum allocated to that portion of the Work in the Schedule of Values, less retainage of f ive percent ( 5 %). Pending final determination of cost to the Owner of changes in the Work, amounts not in dispute may be included as provided in Subparagraph 7.3.7 of the General Conditions even though the Contract Sum has not vet been adjusted by Change Order; 5.6.2 Add that portion of the Contract Sum properly allocable to materials and equipment delivered and suitably stored at the site for subsequent incorporation in the completed construction (or, if approved in advance by the Owner, suitably stored off the site at a location agreed upon in writing), less retainage of f ive percent ( 5 %); 5.6.3 Subtract the aggregate of previous payments made by the Owner; and 5.6.4 Subtract amounts, if any, for which the Architect has withheld or nullified a Certificate for Payment as provided in Para- graph 9.5 of the General Conditions. 5.7 The progress payment amount determined in accordance with Paragraph 5.6 shall be further modified under the following circumstances: 5.7.1 Add, upon Substantial Completion of the Work, a sum sufficient to increase the total payments to one hundred percent( 100 %) of the Contract Sum, less such amounts as the Architect shall determine for incomplete Work and unsettled claims; and 5.7.2 Add, if final completion of the Work is thereafter materially delayed through no fault of the Contractor, any additional amounts payable in accordance with Subparagraph 9.10.3 of the General Conditions. 5.8 Reduction or limitation of retainage, if any, shall be as follows: (if it is intended, prior to Substantial Completion of the entire Work, to reduce or limit the retainage resulting from the percentages inserted in Subpara- graphs 5.6.1 and 5.6.2 above, and this is not explained elsewhere in the Contract Documents, insert here provisions for such reduction or limitation.) Retainage payments for main building shall not be withheld due to extended time required for completion of connector. Sufficient value of construction monies to remain within Schedule of Values to address completion of connector based upon substantiated estimates. ALADOCUMENT A101 • OWNER -CONTRACTOR AGREEMENT • TWELFTH EDITION • AIA® • ©1987 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON. D.C. 20006 A101-1987 4 Final payment, constituting the entire unpaid balance of the Contract Sum, shall be made by the Owner to the Contractor when (1) the Contract has been fully performed by the Contractor except for the Contractor's responsibility to correct nonconforming Work as provided in Subparagraph 12.2.2 of the General Conditions and to satisfy other requirements, if any, which necessarily survive final payment; and (2) a final Certificate for Payment has been issued by the Architect; such final payment shall be made by the Owner not more than 30 days after the issuance of the Architect's final Certificate for Payment, or as follows: Final payment for main building not to-be withheld due to extended timeframe 4-6 weeks for "connector;'. ARTICLE 7 MISCELLANEOUS PROVISIONS 7.1 Where reference is made in this Agreement to a provision of the General Conditions or another Contract Document, the ref- erence refers to that provision as amended or supplemented by other provisions of the Contract Documents. 7.2 Payments due and unpaid under the Contract shall bear interest from the date payment is due at the rate stated below, or in the absence thereof, at the legal rate prevailing from time to time at the place where the Project is located. (Insert rate of interest agreed upon, if any.) Boston prime plus 2%. (Usury lams and requirements under the Federal Trutb in Lending Act, similar state and local consumer credit laws and otber regulations at the Owner's and Contractor's principal places of business, the location of the Project and elsewhere may affect the validity of this provision. Legal advice should be obtained with respect to deletions or modifications, and also regarding requirements such as written disclosures or waivers.) 7.3 Other provisions: All changes to the contract to be addressed per the general conditions of the contract. Change order requests shall be prepared by Dutton & Garfield with a breakdown of individual costs plus a 15% fee for overhead and profit. ARTICLE 8 TERMINATION OR SUSPENSION 8.1 The Contract may be terminated by the Owner or the Contractor as provided in Article 14 of the General Conditions. 8.2 The Work may be suspended by the Owner as provided in Article 14 of the General Conditions. AIA DOCUMENT A101 • OWNER -CONTRACTOR AGREEMENT • TWELFTH EDITION • AtA° • ©1987 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 A101-1987 5 K ARTICLE 9 ENUMERATION OF CONTRACT DOCUMENTS 9.1 The Contract Documents, except for Modifications issued after execution of this Agreement, are enumerated as follows: 9.1.1 The Agreement is this executed Standard Form of Agreement Between Owner and Contractor, ALA Document A101, 1987 Edition. 9.1.2 The General Conditions are the General Conditions of the Contract for Construction, AIA Document A201, 1'987 Edition. 9.1.3 The Supplementary and other Conditions of the Contract are those contained in the Project Manual dated and are as follows: Docnmem P2gW 9/7/94 "Final bid, loading dock scheme, and 4 , lawn sprinkler coverage" 8/18/94 "Qualifications to Bid" 3 Attachment "A" Specifications 1 "Scope of Work - Electrical" 2 9/21/94 "Winter Conditions" 2 8/16/94 LaGrasse Clarifications (as amended) 2 Schedule of Values 1 9.1.4 The Specifications are those contained in the Project Manual dated as in Subparagraph 9.1.3, and are as follows: (Enber list rbe Specifications bene or refer to an exbibit attacbed to this Agreement.) Section TItle Pages N/A AIA DOCUMENT A101 • OWNER -CONTRACTOR AGREEMENT • TWELFTH EDITION • AIAO • ©1987 THEAMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 A101-1987 6 —..1F..�.e....,..-..waai��yAi,..a.+i�w,..�• ....nu. �; ..1.J...v..§.w.,.�w.w:�..Sw.t.s�R-f�ti.. COMMOONF EALTH DEPARTMENT OF PUBLIC SAFETY ONE ASHBORTON PLACE MASSACHUSETTS.- - .-130STON9 MA 02108 I' r7 EXPIRATION DATE Ll v F'1 S F ti -.y T J' I.1 p c R V I S C P RE 4M-16ONIS9 9 h EFFECTIVE DATE LIC-N0. ONE m p. i o c' g T PN F;); TER =` SS x'19-4?-59 2 '' m i PHOTO (BLASTING OPR ONL1) FEE: r NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY q HEIGHT: STAMPED - OR - SIGNATURE OF THE COMMISSIONER DOB: THIS DOCUMENT 2L2�IG ;> MUST BE . ' CARRIED ON THE PERSON OF THE HOLDER WHEN EN- OTHERS- RIGHT THUMB PRINT GAGED IN THIS OCCUPATION.moww SIGATURE OF LICE SEE irw I ER I Noww •'° OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER 'CONSTRUCTION CONTROL ecwuAa 1 ( 508) 682-64+83- x30 PROJECT NUMBER: 144 1 PROJECT TITLE: VITA -M, Uosl2► 5 oF' �1�2�?� �F�pq�sA27E25 PROJECT LOCATION: 615. C{ F--5T-NU `519Ee( NAME OF BUILDING: w/4TT`J PtEC10LA'Cot� NATURE OF PROJECT: 13"PtN- �Pg�'slaJ IN ACCORDANCE WITH SECTION 127:0 OF THE MASSACHUSETTS STATE BUILDING CODE, h(A Registration No. BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECT HEREBY CERTIFY THAT I.HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICA- TIONS CONCERNING: ENTIRE PROJECT Ek FIRE PROTECTION Q ARCHITECTURAL Q ELECTRICAL Q STRUCTURAL (= MECHANICAL Q OTHER (specify)C—) FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEDGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THEOAPPLICABLE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRACTICES.' AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY.' I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES ANDBE 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 127.2.2: I. Review of shop drawings, samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit, and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code -required controlled materials. 3. Special architectural or engineering professional. inspection of critical construction camponents requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix B. PURSUANT TO SECTION 127.2.39 I SHALL SUBMIT . WEEKLY A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTR ANDOVER. BUILDING INSPECTOR... UPON COMPLETION OF THE WORK, I SHALL SUBMIT A COMPLETION AND READINESS OF THE PRO SUBSCRIBED AND SWORN TO BEFORE McT(13116� 0.4153.) MAM N Of FINAL REPORT AS TO THE SATISFACTORY UPANCY. USIGNATUa F 19_.� COMMISSION EXPIRES 9 I OFFICE OF BUILDING INSPECTOR M ' TOWN OF NORTH ANDOVER +- - .CONSTRUCTION CONTROL +ACN� (508) 682--6483, x30 C 6 PROJECT NUMBER: t4'I PROJECT TITLEs VTA"(`j'Ei PROJECT LOCATION: 8l5 CHES N keeT NAME OF BUILDING: WA T5 Re4ot*y>< -------- NATURE OF OF PROJECT: butL.pus IN ACCORDANCE WITH SECTION 127:0 OF THE MASSACHUSETTS STATE BUILDING CODE, I' JOSE K V. I AaRA55f- IIA Registration No. 415_3 BEING A REGISTERED PROFESSIONAL ENGINEER/ ARCHITECT HEREBY CERTIFY THAT I, HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICA- TIONS CONCERNING: ENTIRE PROJECT ['�) ARCHITECTURAL Q STRUCTURAL C1 MECHANICAL Q FIRE PROTECTIONCZ) ELECTRICAL OTHER (specify)[ FOR THE ABOVE NAMED PROJECT AND THAT, TO -THE BEST OF MY KNOWLEDGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE*APPLICABLE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRACTICES.' AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I 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 127.2.2: 1• Review of shop drawings, "Ies and other submittals of the contractor as required by the construction contract documents as submitted for building permit, and approval. for conformance to the design cmxept. 2. Review and approval of the quality control procedures for all code -required controlled materials. 3. Special architectural or engineering requiring controlled materials or construction �c�dtin � critical ep construction practice standards listed in Appendix B. engineering practice PURSUANT TO SECTION 127.2.39 I 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 COMPLETION AND READINESS OF THE PROM SUBSCRIBED AND SWORN TO BEFORE !i CT, SNo.4153. YlTNtle%— MAM M OF FINAL REPORT AS TO THE SATISFACTORY UPANCY. 1 IGN TURE F 19 COMMISSION EXPIRES r C7 C) /z! V m D O z T Z D r M CO2 C CO) Cl) 10 0 CD z CO) CD o C r c') CL q O CD CCD O C cr a CD CD O CD 00 00 aC CD O CD CA O I CC2 CD � v CO)CD O CD z O C) ...� oCD O CD u �r 0 z O O O _ CO 0 o� CD Uc cr O y 2. CO) N CCD =.=o _ • CA O CS N o.05m CD C2 n CA d CD CL CL = m C CD co ..r y O ? O CD = _ CD Cl) O O H• C7 • CD: ?� rya o .. CO!'� a�. ? �CD 1 0 CD CD CD CA co N O. d :� • _:3 � dci . CA H O `c T CD CD d CA —'C ;•' • = CD l" �. j Cn 0 nz d CDn p rr � w m < o �j y z w '"C7rD G �- � p G r b rt (D O 7C a" rD o > I- to I rt J O is a 0 z m D C) Z C3, CO) d C •C O CO2 C) 10 0 CD n Z y C -0 O n� r ? O C. y aco -0 O CD CD O CL cr = rY CD CD w CA C CD y� C.O y C• C=D � v CA O -v z CD O r. oCD 0 CD Q C 0 0 z O CD 0 0 m 0 C12 CLO CC* m m c O V! C CL 0 N H CD O.odcm y Z m C2CD Cl) CA O ...r O = =rm ...►� m ti T =r CL CL m CD ti C) m o S Z<o o � m CL H O � :4 CD o w 71 C -3 -of CD j CL ` ! m3� i7 H .'X Q d C C Co CD m < y H S m m =10 Aco CD 0 :11 -tea o • CD ..► . m: CD o m cu go CL -0 moo= n � gym: o 0P=h ,e4o;w �ow C/3 o r� rn z cn w^^ C Z n O cn � c° oc b �? c zx _n n g °c a\ � r z o cn d n: C 0 0 z O CD 0 0 m 0 C12 CLO CC* m m c O V! C CL 0 N H CD O.odcm y Z m C2CD Cl) CA O ...r O = =rm ...►� m ti T =r CL CL m CD ti C) m o S Z<o o � m CL H O � :4 CD o w 71 C -3 -of CD j CL ` ! m3� i7 H .'X Q d C C Co CD m < y H S m m =10 Aco CD 0 :11 -tea o • CD ..► . m: CD o m cu go CL -0 moo= n � gym: o 0P=h ,e4o;w �ow C/3 o C/) rn z _n w C Z oil m cn � c° oc b �? c zx _n n g °c T °c � r cn R o r- �r 9.1.5 The Drawings are as follows, and are dated unless a different date is shown below: (Eftber fist the Drawings ,bete or refer to an exhibit attatbett to this Agreement.) Number Title A-1 Watts Industries Headquarters Expansion A-2 "if A-3 "of A-4 "if A-5 "it A-6 A-7 " A-8 " A-9 A-10 A-11 A-12 C-1 C-2 C-3 C-4 C-5 C-7 S-1 S-2 S-3 S-4 E-1 " E-2 EL -1 " (Drawings prepared by Joseph D. LaGrasse) Contract plans are clarified/qualified by documents listed under 9.1.3 and attached memorandum dated 9/30/94. 9.1.6 The Addenda, if any, are as follows: Nie' I Date N/A Date 9/15/94 9/15/94 8/10/94 9/15/94 8/01/94 8/10/94 9/15/94 9/15/94 9/15/94 9/15/94..- 8/01/94 8/01/94 6/02/94 8/10/94 8/10/94 8/10/94 8/10/94 9/15%94 9/15/94 9/15/94 8/01/94 9/15/94 9/15/94 9/15/94 9/15/94 Pages Portions of Addenda relating to bidding requirements are not part of the Contract Documents unless the bidding requirements are also enumerated in this Article 9. AIA DOCUMENT A101 • OWNER -CONTRACTOR AGREEMENT • TWELFTH EDITION • AIA''s • 01987 THE AMERICAN INSTITum OF ARCHITECTS, 1735 NEW YORK AVENUE, V.W., WASHINGTON, D.C. 20006 A101-1987 7 9.1.7 Other documents, if any, forming put of the Con=ct Documents are as follows: abt ben any additional documents whicb are intended to form part oft& Contract Document. rm Gmend Cw&l om p,ovwe tat bid*ng a+egtdmmmts sueb at adtrnisemew or imitation to bid, lnstrucdons to Bidder; sample johns and I& Contraetor's bid are not part of the Contract Documents untess enumerated in Ibis Agriaemem. 7bey sbould be listed ben only if intended to be port of the Contract Documents.) Refer to list from 9.1.3. This Agreement is entered into as of the day and year fust written above and is executed in at least three original copies of which one is to be delivered to the Contractor, one to the Architect for use in the administration of the Contract, and the remainder to the Owner. OWNER WATTS INDUSTRIES, INC. CONTRACTOR DUTTON & GARF.IELD, INC: (Signature) (Signature) Suzan Bazin, Buyer Steven R. Webster, President (Printed name and title) (Printed name and title) AIA DOCUMENT A101 • OWNER -CONTRACTOR AGREEMENT • TWELFTH EDITION - AIA16 • ©1987 THE AMERICAN INSTITUTE OF ARCHITECT$, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 Al O1-1987 8 14, W umi P., o cm v' U ` CO c � O i CO j� v1 C o v D ►� a o Q ri U) 0 0 w ::4 U ii 'o Cl. w >- o v C coo o c z cn cn umi C_r G L CL h t CO) 32 O i h 0 m cm W c 'O 73 m CD CD N m i r4�� 0 1 ►,,A O 0 w0 U CO c � O i 0 O H O ...jam; m H • E a 'J _ jCD v CL h m (n►� C mCD O C 4: y v, N'• m 3 C=m� G m 70.:m c N R N Im • ave m m m tA o �,..• :CNG ' dCt :mor H2 v Ca CL 3 = m ma o � o o� co W O +" w�cm v m N F- t $ CL m C_r G L CL h t CO) 32 O i h 0 m cm W c 'O 73 m CD CD N m i r4�� 0 1 ►,,A O w0 U CO w 0 O C� cc �- 0 o � Z o Q O CO) O = CM — I C � o •� CO) 0 y O •O Cc Co CDL CD L M O a CL- c d co -p C O CL. C2 v J � CD =zw Cl CL C.3 CO) cc C ev J Q z z 5. cc LU U) Z O U : Arim3KIs (CET I VETO SHOOH J,NSOKIW JV XHOM HOrI AZMO SSaZ)DV SqVI2 UVH Qui gmmosaaa KOISonuisKOo jmjzDomLNI uoaI aHSn aaia os aouiaaw 'ai zvn Am"s xolS auisxoo Aw HSKMIi irm os aw svmm mm Ly SMOISKaacIO EMO HSIM H2MMMIKI OS JAM SK OS GarMUHHOS HS TIIM SMaisl DNINIVNM HSHHZ aO MOIIVTIKSSKI ' HAOSK URWM SK sd$OXH a$JZldNOO aW KHM AOKVdnOOO WIsHVd SIRS ZK SKOIJ,KHHaO K0I13nUSK03 TISi (A'IKO 'IHKKOsmd xoiwnuismoo Roju aH'IHSri C" GaTIKSSKI HS os SH00a Amocua-L) ' ZZ' £ZI SH00a HSINIA (aHAHIHoy SI AOKKdn000 TdKIaI 'IISMn MIiikm os SHoorm HSH2IOK03 uagvaS) miHtoo'IaI HSIMIaI SyIIII SKIMOTIOA HHS 2IOaI SdHOXH aa'TSH'Id1�iO0 SI' SA�iM SSH8O'S/ZIXH `NOIS`i'IISNHA/SKHH' �1HSSAS OKIZHOI'i ' 9KISH9I'I A3KH92 ama I H9KK9IS SIXH 'WHSSAS KOISOHloud Haul 9KI(n'IOKI) )Mom Ao HdOOs JOVIUMO0 HHS SOHrOad HOMMMa aR HAOSK HHS IV (SE -Li NO HOaIRUCO aKK (9ZT INH) DRIAIRMH aw 9KIddIHs aI0 AOKKdnooO TdI LHVd OMISSHnOgH SI eMLRMD 33 KOssna : KH93XOO AVI SI KOHM os OKIMK2ia *SIS QHHOKSSK : HOMH2IHaiH2I AOKKdn000 rwij i a- OKICRIVO 2I dau mmo-KIZKS HnS' J,3HSIHOHIK-assvH!)va Hdasor : MOISnSInsiu 9661 '£T gOaVW:HSKa SVOTO -VK ' UHAOCM HIHOK 'SS JJUUSHHO 5T8 :KOIZFtJO7 KOISKKdXH HOIalAO SHIHISnaMI SSZKM : ZOHt'O2id SHIRISAQKI SSSKM :MOI KZIKVDHO vm' uaAOaKK HLuoN a o Mhos' - Sdau 9MIa'IIou : OS UN -am SoarOud I U0619NINO ')NO' i 6S !S )TNM rn IN 119 -,96Z 'Aall 4 _ r �i �W o woos Avvil ��fVMO /M NOW)E6 AI1VM Nw ICl�DO� �O1111M 01 wj 15C"* I- p' C� C� Vad !9NIAIV D I DJC 3. I U0619NINO ')NO' i 6S !S )TNM rn IN 119 -,96Z 'Aall .�I 11 my's FEW ____A, (6-1 ��l I 11 1� III FX5MNC4 PW i W A - (� 1. Zj i 3 �:O UAr-G i- FWAN5ION JOINT Ganas 5s -PAN WATFK - " APDXAfOKY I,EAM LOCAflON a Joseph D. LaGrasse & Associates, Inc.' Architects • Engineers • Land Planners 1 Elm Square Andover, Massachusetts 01810-3609 Phone: (508) 470-3675 March 20 ,1995 Building Department Town of North Andover 120 Main Street North Andover, MA 01845 Re: Watts Industries Loading Dock - Receiving Area � � r The construction of the Loading Dock - Receiving Area is substantially complete. Exterior paving is adequate for access and egress of trucking operations and interior public safety systems are operational. I certify that the construction of the Receiving Area (Room 126) and the Corridor to the existing building access is substantially completed as per plans and specifications. Finish paint and floor tile operations have not been completed to date. This certification is complimented by the certification from the General Contractor and my firms letter of March 13, 1995 Submitted by. CCSXD. tam'-; l/� No. 4153 N 3 METHUEN, m Joseph D. LaGrasse, AIA o MASS. J� Joseph D. LaGrasse & Assoc., Inc. Ty of MagsP�� JDL/prt ♦ 1 . 0 1 B Architectural Final Affidavit To the Building Commissioner: Town of North Andover North Andover, Massachusetts I certify that I have reviewed the work associated with permit No.462 at 815 Chestnut Street and that to the best of my knowledge, information and belief, the work has been done in conformance with the permit and plans approved by the Building Department, inclusive of approved changes, copies enclosed under Exhibit 1, and with the provisions of the Massachusetts State Building Code, and all other pertinent laws and ordinances. ERED q �Q�y/T D. too, No, 4153 N 0 METHUEN, m ?� MASS, o��FgITH 0MASSPG�J� F q7--,$' 0— 6 Telephone #153 :ct- Wa. Reg. No. r4 -5V, a5i) any 5gQ4'af-'( �}s '`f � �✓t 6 ess 5r Attachments Exhibit 1 ... Approved changes to plans of record Inspection Dates: April 27, 1995 Then personally appeared the above named Joseph D. LaGrasse, AIA and made an oath that the above statement by him is true. Before Me 7� My Commission Expires. o6 r" -ed ;e Cl) -V dc ca so 10 V.Sca . =r r , Im C2 See cr 40 CL 0 CD co 10 m CLO CD C) C-3 m n CLn CD c ca 0 lob =r C� Co CL 0 cn CL V.& m =r 10 . -P CD a' rnN m i.CD C3 C-1 C* CA CD C2 P 0 CD CD 2!c/ >z ca m _ y = :� :w O —" O C* no CD cn CD 7 Clj= ca n CO 3 0 C. Cc)o cn 5: CL CD CIOll. o CDQ * :E CD: cn CO),Q. CL C: IA 0 CD 941 To CD C) CD 0 CD A• (-L .."M eA < cn CD CD C/) 0 C') 'o- C tz 4k 2 > < CL. t7l M.;rz C/I m C) CO CD z7-7 CA CSO) CO) CD CO) I 0 0 co a CD CCD I - i3 H 0 Cf) Cf) a, 0 Co 0 ol .4 Or C) C/) 0 C') 'o- C tz 4k 2 im n pcl al 0 r c CL a " 0' cn al (D 'a 0 Iz o - F cp ;N --e - (D t7l M.;rz C/I A z7-7 CA Iz Ej V/ It 0 w 4 TO: BUILDING DEPARTMENT TOWN OF NORTH ANDOVER,MA. FROM: DUTTON AND GARFIELD, INC. 70 FLAGSHIP DRIVE NORTH ANDOVER,MA. RE: WATTS INDUSTRIES OFFICE EXPANSION 815 CHESTNUT STREET NORTH ANDOVER,MA. PERMIT #462 TO WHOM IT MAY CONCERN: r -0 c DUTTON AND GARFIELD, INC. HAS TO THE BEST OF ITS KNOWLEDGE, INFORMATION, AND BELIEF CONSTRUCTED ITS CONTRACTUAL SCOPE OF WORK AT THE ABOVE LOCATION IN ACCORDANCE WITH THE APPROVED CONSTRUCTION DOCUMENTS, MASSACHUSETTS STATE .BUILDING CODE, AND ALL OTHER KNOWN CODES AND ORDINANCES HAVING JURISDICTION OVER SAID WORK. THE FOLLOWING MODIFICATIONS TO THE PERMIT SET OF PLANS ARE NOTED; ACCESS TO EXISTING FREIGHT ELEVATOR FROM CONNECTOR (RM #135) IS DELETED. SEE DOOR #37 LOCATION ON DRAWING Al -1. THE WESTERLY TRUCKING TURNING DRIVE AREA IS DELETED FROM D&G CONTRACT SCOPE. OWNER TO INSTALL. A FIRE PUMP FOR ENHANCED FIRE PROTECTION SYSTEM PERFORMANCE HAS BEEN INSTALLED INCLUDING A BACKFEED INTO THE EXISTING BUILDING SPRINKLER SYSTEM. THE WESTERLY STAIRWAY TOWER PARAPET HEIGHT HAS BEEN REDUCED FROM 5' HEIGHT TO 1' HEIGHT. DRAINAGE SYSTEM OUTLET FROM DETENTION POND INTO STREET DRAINAGE SYSTEM MODIFIED TO AS TO ELIMINATE INTERFERENCE WITH "FRENCH DRAIN" AT FLAGSHIP DRIVE. THIS CHANGE HAS BEEN COMMUNICATED TO DPW. EXTERIOR EXIT DOOR ADDED AT SHIPPING AND RECEIVING AREA ONTO LOADING DOCK. ADDITIONAL DOOR ADDED AT NORTH WALL OF ROOM #12.0 (LAB) HVAC SYSTEM AT SECOND FLOOR LEVEL MODIFIED TO "SPLIT TYPE" SYSTEM IN LIEU OF PREVIOUS "PACKAGE ROOFTOP UNIT". FLUORESCENT LIGHTING FIXTURES UPGRADED TO ENERGY SAVING TYPE IN ACCORDANCE WITH MASSACHUSETTS ELECTRICAL CO. LIGHTING REBATE PROGRAM. 0 { w � • r • ELECTRICAL EQUIPMENT WIRING AT LAB (#120) IS ADDED TO D&G CONTRACT. WIRING OF EQUIPMENT TO BE INSTALLED AFTER EQUIPMENT RELOCATION. EQUIPMENT RELOCATION TO TAKE PLACE AFTER CERTIFICATE OF OCCUPANCY. WATER PRESSURE BOOSTER PUMPS ADDED FOR DOMESTIC WATER DISTIBUTION SYSTEM AND LAWN IRRIGATION SYSTEM. GAS PIPING UPSIZED FOR FUTURE EXPANSION HVAC CONTROL SYSTEM UPGRADED TO DDC (DIRECT DIGITAL CONTROL) TYPE EXHAUST SYSTEM ADDED AT LAB #120 ROOFTOP HVAC EQUIPMENT RELOCATED TO ACCOMMODATE FUTURE ROOF SCREEN SINCERELY: ST/a� NE.FOSTER, PROJECT MANAGER z w ► *- rows x x ►C CL J • O m too e r Z wn Q 'Jo � _I y z'il A o -� >x z 0171 OD mok o y C�1Vi Z -n b 0 C n dm :rCI), o y m > %20 CL 0 0 < n �. n d z �Jc-� o tv o � 0 ttv� r E m C. CD z C o 10 o . n. wo°� y. :r O � � �G CD z � fJ — y y C d Z CDCD O O � CO) M✓/ > CD 0 Z co) d O �� r C. (A O v CD CD ,c CL o cr Ic C= C n CD o CD co ca E m C. CD y C o 10 o . n. wo°� y. :r O � � �G CD cp Ofa• CCD I — v y O 'v Z CDCD O --m- H 11 ,LX7. N m cm r0 r O V O.��cr m W m= mc) CL om m m N ?� N CD N T m aid =_ m —40 CD H O ��m� m n _ -0 o }t� -� 0 zS.co, O N Cf Q 'm. ? = " �.to CL.�- 00�: t O C=D N 71 n fS d :.i • � : L CD N O ' = D :n .. o 2 , 0 0 r. fo. CD 0 �- CD -0 o _ CD m ; :_ � r a N •� ♦ + `1 IN - CD W =:o OECD. . m 3 o a x' m 0 o w < Cil n P_ N t 3' o0 0 o- a. rt C o 10 o . n. wo°� y. :r O � � �G cp 'E Z rFI • r� X liz N amt z O y 0 0 c Q raAy 34:z�tg4r 'ReQUIRta WAIJG'[1qW AFtE.2 3?li"fA4A'f101j dF T-J2HChM1C /L+dB Eq� CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number R 4 � 46 Z THIS CERTIFIES THAT THE BUILDING LOCATED ON Date 4peIL- 2e IggS sr (UA -M Z�oLzhg� MAYBE OCCUPIED AS OEtC&— -2 !hgM — M -L -W &F IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. ".0 ftT :'ti CERTIFICATE ISSUED TO IiINAMI L40XA ADDRESS ,fsAGMUSBuilding Inspector 0 I CERTIFICATE OF USE &OCCUPANCY Town of North Andover Building Permit Number C4— 4<02. Date '�1d�-1 ZtQ l`cgS THIS CERTIFIES THAT THE BUILDING LOCATED ON 51 j C*4PE-4-rT'i Ot 4 W A-tk% 1+JOtN tA, MAY BE OCCUPIED AS — ZS — ," iFIN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. ot MORTq CERTIFICATE ISSUED TO U.k�-S 'ADDRES V� s s i � AtMtJs� Building Inspector O z C.. ci cd • t1: c CIE. E NCO 0 T-4; 1 ti • E L O �: If u , m L U y m3 m 9 r•--� in fir : H R I L-10 c i co c Ha w v' m C Q 1.• � ; C.3 N O L Q c.3•�z o . ev U ,n+o Qo W Gam. Q m �;GOm c o Q W 2 m •` Q c N LL. H p aN m L� WC ;LL. r= r O. �. .H at % �-- ho � m v = lC co LLA C` N= 0. o_� m � .z _ G syr w � c hz- ao c c o CO3co ;� L13 �� LE (n LL m m z i O co ci cd • t1: c CIE. E NCO 0 T-4; 1 ti • E L O �: If u , m L U y m3 m 9 r•--� in fir : H R I L-10 c i co c Ha w v' m C Q 1.• � ; C.3 N O L Q c.3•�z o . ev U ,n+o Qo W Gam. Q m �;GOm c o Q W 2 m •` Q c N LL. H p aN m L� WC ;LL. r= r O. �. .H at % �-- ho � m v = lC co LLA C` N= 0. o_� m � .z _ G syr CL � c hz- ao c c o CO3co ;� L13 �� uJ C/� m m z i O co o Co O � O i O O i R O Q o- �a y C C C C� O v J � .y O � J z w 1� O Q. = L� V C QL Q z -W z z Q Loca+ion �� S No. Date 1 S t TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ SZ Foundation Pit e SACNUSE erm$ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ -3(-,i— Building inspector /0 95 15:02 182.00 PAID Div. Public Works t IW 8 z a 0 j 0 m W n MM r r 0 O o\ > U1 W Do � • 6 ,.3 W C Q C _c o > >( > � s IW 8 z a W * N W N> 0 0 a W > 0 r' N ,.3 A r C _c C > >( > D r = Z A Z A n Z m 0 O W c r 0 r 0 r 0 0 n z m z m z m A -1 m a a 0 D r z z z r„ 4 A m m A -i 0 a Z -� a > O z > O Z y m z>> 0 r O z m 0 3 O i m D 3> O m m m pj 0 A -I F 0 -4 A m m a z > 1 O z 1 r m m c" 1 A Z z © _p / c ? 0 oo 0 D n S3 0 m ro U v z 0 m (/� a o r I m ( �_ 0 m r �. .jam c z 0. 6 O A m p m > > A ^ i> �7 �. V :e a a s a > N m ; aa > ►'� W y Z O A p W c W c W c W s -i A 0= z Z 0 a 0 0 O O 1 i 0 O D P m m 1 0 H 0 *nZ m a m M 0 0 0 0 0 0 ,, a 0 0 p A 0 r 0 A nono0 0 0 0 z m = 1 Z p c m A a uml C DI 2 Z Z Z 2 Z a p; 0 z 0 9 N a �: ; W r p O', 0i [ 0 mm I0D N A O m 0 m a m o A z N a Z 0 0 0 „ a m 1 * * p I �I = A z z r r m � Z a > a z z p m - O r z " i z D m m z z in a W 0 m A X 0 _—'D ID m 0 m O V W m 14 00 m LL Ul WW u Z <Ix Na �I 01. Z3z pant. J t7 f- a?0 Ooa N ZEN 0mu IAWQ WOa low Z UNI XWF WSW 0�0 H HX� NwIWI IL �Z� ZEN 0 ti WWW Z_ - NJW N N 10< } u Z a IL u 0 ,illll IIII �IIIIIII I I IIII III �IIII TIITITT W =_11111 $O� Z p -I II LL W Z N s 0 O l! = aZ T; Z m - LL W ° Z ~ wLL u Z< aZ ¢ 109.1 I I I TSI T Z Y �� ¢¢ H ; �_ �w '-' N Y_0w1 Z Z X W I H -O'_. O H~ W ci 0 Z ° W FuuY w w U pLLpO LL Oe° ¢ �- V1 �n u V w o N> a Z i O a t'f p Z N Z p� W ° u i 3 0~ Z V a a S F_ 0LL D Z ¢ ao}Z 2 2 0 Z� O iN O¢ d0 "JQ> O a 0aO�w r a°Cu¢p°�°zaJ�O O K N O 1 S d° LL LL LL w S ¢ 17/f Q m Y Z N �- H d 0 S¢ mz O O W Z I T� I Tr1 I I I z u° p a OZ W N Z W O= p Zw pvaw Xi Om 0 vf�1V-- 0 QLL= Z0p�Z ? � �� Z Q Q 0 i U� IW�n 0r Hw O LLt 0 Z Z QZ N Z LLwJu wYm= �-oe aZ.00 °3° L30OZZWzz 0000 0 0 -° m NO V O Y m VV Z 00 In < O w00 n ��Q W ZIv10 u a QU00 > mp 0 a 3° �- wV 3 in co� CO) C C ?= p d _ O S. to w d0CD y •' '.maa.�; m CD Go CD z =r -C wca —1 - ~�mo�—a_oA _ 3 o co m y S 3m42 42 m O� O _ 1 co CD 02 a aom Crrr^^1o? �_ m m N V J m 7 n'0 = m o a am r.L dc ce co co CD H ! =O co CA � O m m O d N 'g 7 0 C2 1-� O O N` .. a C* X07 O o � a z y = o CD.' CD Cm o iT�i O CD m Co �► ' f3 a"SCL o o m v cn CD (nE3 " Z ° c 'rl t G7 n '�7 °r (b z Cil M r ?f °e'. 'J7 as:3 0 ,.o r Oj pz n) ^ or�c O a C7 rl, ( �,tz j] 9 x T y 'v � O . CD Z y ..n r CD p -per = r c n r im O � Q. S C y 'v n c CD CL O Q CD r� CD O CD m m C• CD y CD D C D p. v —• O CCO2 rn O to CD ' z � v < CO) O -v CD � o CD T O � CD co� CO) C C ?= p d _ O S. to w d0CD y •' '.maa.�; m CD Go CD z =r -C wca —1 - ~�mo�—a_oA _ 3 o co m y S 3m42 42 m O� O _ 1 co CD 02 a aom Crrr^^1o? �_ m m N V J m 7 n'0 = m o a am r.L dc ce co co CD H ! =O co CA � O m m O d N 'g 7 0 C2 1-� O O N` .. a C* X07 O o � a z y = o CD.' CD Cm o iT�i O CD m Co �► ' f3 a"SCL o o m v cn CD (nE3 " Z ° c 'rl C G7 n '�7 °r (b 0 A Cil M r ?f °e'. 'J7 as:3 0 ,.o r Oj pz n) ^ or�c O a C7 rl, ( �,tz j] 9 x O C ` WOMEN JAN STORAGE.. I:- LABORATORY MEN WAX LABRE R. '� � .b SKFr ; mIN PRINT/FILES OFFICE`'k 4 COMPUTER 9�I CONFER.. t x `4 i'. �� I � .► rYk el oy t .: ' o , ENGINEERING fi. ,.�i G C L I. rL lm',s x 2 3 ` r ,r� OFFICE OFFICE OFFICE x t 0 Ni y �����- Brno / _ //,• �c��(S � Ce � ���� � '� R4`.' "�� to �� • Y / - J f •} Y i {l 51t �YcM1 y+ MEN WAX LABRE R. '� � .b SKFr ; mIN PRINT/FILES OFFICE`'k 4 COMPUTER 9�I CONFER.. t x `4 i'. �� I � .► rYk el oy t .: ' o , ENGINEERING fi. ,.�i G C L I. rL lm',s x 2 3 ` r ,r� OFFICE OFFICE OFFICE x t 0 Ni y �����- Brno / _ //,• �c��(S � Ce � ���� � '� R4`.' "�� to �� • Y / - J f •} Y M un P lo f i 3 LU � 72 6" 1 v i 'L i * :i�i TDafnenoa�uea�Qi OlWA� i,� HONES IMPROVEMENT CONTRACTOR r v r; L. _ Reoiiration°x:104031 a TyperPRIVATE CORPORATION y r ',ErPitatlon ''07/13/96 * 1177 Solo"8uiid`n +x • I a g Co..' I TIC i ti` h as� - Nark.-R. Sioaba arrison St," `P.O. Box 6' r- i noMN�stanroR4-i"r�wUnd KA 01834 1 yy'k i a5. a Ii .� -. ,� r.. .. . "max' - T - �.___l..," _ . __ .. _ _...-.. �.,,,.,, _._ s .. -•,': COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY Failure toposr s current 4' AAaar�rt•,4s DrlldiAp ia} � ;< OF ONE ASHBORTON PLACE �/� Qe�y I fl c „r h t , r r erpp��►pp MASSACHUSETTS BOSTON, MA 02108' > ��i�� a1('�111lrMNM1. LICENSE CAUTION EXPIRATION DATE CONSTR. 'SUIP'ERVISOR FOR PROTECTION AGAINST,• ii 11 1'J/ 1 996 EFFECTIVE DATE LIC-N0. THEFT, PUT RIGHT THUMB ' + RE$�RTIONS PRINT IN APPROPRIATE t` 'NONE 812/31/1993 039769 g "BOX ON LICENSE MARK R SLOMBA s 64 6ARRISON ST g BLASTING OPERATORS :7? ;j SS 4,03V-30-6799 i 6ROVELA D MA ,01 Z MUST INCLUDE PHOTO.— PHOTO HOTO vv � PHOTO (BLASTING OPR ONLY FEE: 100.00 ` 0 VALID L SIGNED Y IC NO FfICIALLY HEIGHT: ST PE - R-SIGNA E TH 0 ISSIONER DOB: �! `l .. 93 y,k, 11/21/1955 ,Y' r THIS DOCUMENT MUST BE SIGNNULL AB IGNATURE YIN ;r F CARRIED ON THE PERSON OF SIGNATURE OF LICENSEE I I ,' THE HOLDER WHEN EN- -if ���pppIII " OTHERS - RIGHT THUMB PRINT GAGEDINTHISOCCUPATION, °' COMMI ONER 7r O' t F Ek o a So 1 0 Building J Commercial & Industrial Contracting y V ref July 20, 1995. :Watts Industries L <815 Chestnut St. ='•N. Andover, Mass. 01845 ?�.Attn Mr David Habib BY FAX 687-7873 4 �y .Dear David: Per our meetings, discussions, and the sketches that you have given us, we are pleased to submit our quotation to you for the .,,construction of a new Traininq Room and Kitchenette. .,'!Following is a listing of the work that we have included: y.. - Demo of existing walls, ceilings,rugs and vinyl wall covering. Assumes that vinyl can be easily,stripped with no damage to drywall. Repair of existing drywall would be additional cost. Relocate 2 existing wood doors in hollow metal frames. Close in and drywall 3 existing door openings. Furnish and install new lever lockset. 4 Construct stage out of fire retardent wood. Construct in sections for ease of future removal. - Furnish and install new 2'x2' suspended acoustical tile ceiling ; ' similar to existing. Furnish and install cabinets and countertops per plan. ( Allowance .,4. �.. ; .. of $3,000 for labor and material included in price.) • Install new vinyl wall covering to be supplied by owner. - Furnish and install new carpet to match existing if.available. - Furnish and install new ceramic tile in kitchen area. 1R,0w--5j.!fl21e basin x; sink and faucet co a piping and -Electrical - 2x4 3 lamp ,18 cell parabolic fixtures switched per sketch. - Recess black baffle fixtures controlled by one 200 watt dimmer. - Trac lighting with a total of 7- 7 cylinder style 75 watt fixtures. Fixtures to be controlled by dimmer. - Duplex receptacles (20 amp) 120v in training room and kitchen area. Wiring for sewage pump. - Wiring for future dishwasher. - Wiring for refrigerator circuit. - Disconnect and bypass motion sensor. . - 1 20 amp 120 volt outlet in ceiling per plan. P 0 Box 6 Groveland, Ma. 01834 (508] 373.4006 15 T. F% h ::; If 2x4 lights are furnished to qualify for Mass Electric rebate .: credit (27 cell parabolic) Add $1100. Thank you for the opportunity to quote on this project. ,.Very truly yours. Buildi"- Co. Frank H. Fernalld ::; If 2x4 lights are furnished to qualify for Mass Electric rebate .: credit (27 cell parabolic) Add $1100. aw - Sprinkler - Move 1 sprinkler head interfering with wall. Miscellaneous x -Permit fees ;* -Dumpster fees �� Kra L '^i �„ .•. `.Price for work as outlined ....................... 528,180.. Thank you for the opportunity to quote on this project. ,.Very truly yours. Buildi"- Co. Frank H. Fernalld OFFICES OF: APPEALS BUILDING CONSERVATION HEALTH PLANNING Town of :t NORTH ANDOVER DIVISION OF 1 4 PLANNING & COMMUNITY DEVELOPMENT KAREN H.P. NELSON, DIRECTOR a • R 120 Main Street North Andover, Massachusetts O 1 845 In accordance with the provisions of ".IGL c 40, S 54. a condition of Building Permit Number 3tC,— is that the debris resulting from this work shall be disposed of in a properly lic::uc d solid waste disposal facility as defined by MGL c 111, S 150A The debris will be disposed of in: (Location of acility) J bx1a Signature of Permit Applicant Date Demolition permit from the Town of ;forth Andover must be obtained for this project through the Office of the Building Inspector. Location Sa 5 C h«S S No. 3 I ( Date �c) - 31� TOWN OF NORTH ANDOVER a Certificate of Occupancy $ �'� J' •'°'tt� Building/Frame Permit Fee $ 3 MU S Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 3v— Check # 106 9 6 P 16;31 a Building Inspector TOWN OF NORTH ANDOVER WELDING DEPARTMENT APPLICATION TO CONSTRUCT 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 Onl BUILDING PERMIT NUMBER: n ` DATE ISSUED: A. SIGNATURE: Buildin �m issioner/I or of Building Date RINI NEW 1.1 Property Address: 1.1 1.2 Assessors Map and Parcel Number: Map Number Parcel Number / ver �� G`D r e 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Fronts 8 1.6 WELDING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Provide R ed Provided Required Provided 1.7 Water Supply NMI -C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private 0 Zone Outside Flood Zone 0 Municipal On Site Disposal System ❑ 2.1 Owner of Record �/i�CtGl .�/K.-l'Tyld74 t�r• ' l� �rk.^ i Name (Print) Address for Service Signature Telephone 2.2 Authorized Agent Name Print Address for Service: Signature Telephone 3.1 Licensed Construction Supervisor Not Applicable ❑ ?'lo Address � GLOvG.� �� T N r License Ilumber Licensed Construct' Supervisgr. Expiration Date Signatu Telephone 3.2 Registered Home Improvement Contractor Not Applicable Company Name,, Registration Number f 1 Address Expiration Date Signature Telephone Owner/Authorized I, ,as 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 Item Estimated Cost (Dollars) to be "KI-1111" Completed b t applicant P Y Pew PP 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction from (6) 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical (HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) 0 Check Number K/ tt,, S>. ; �-::♦ f t f '£;i �1,. ht Ya'."t✓1b5,1' s}.,$�t �. J'.r�-'a'z ',r t'Ya'.��5 +-F l �� ,3.� fAw S E�+A�x. lel} k'h',6: uvni, gyi*.: k.4�M, y {rs Y3.1``,.xi"T 'u S%`♦4 � 63 e1" Y, i !f k '10 IRS •'4 R.�t 7c� �'e� - ,n <Hri R. 1:,``S�-`x .T}„ n�:f: . •i ,'.`-.c 3; ;1 f i ,,r; :;.vv S4 • dam. {�'s,'F7S j # nf.r,r �u'.. .s-'{� ,, .sf."r.'i. ,. NO. OF STORIES �✓ SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST 2 U 3 SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CBEMMY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 0. R`Y'Sl..Ibnbf`. -:SAM ia't". �:3.r'«Lt fr..._ro S.. `�. _: ✓�'4.rvah - 4.'Si' .Fh ah.' �Y Y _s a H 1J � i,. �,.0 � y,. _d ... Q y d Coll CD n Z y C O nMM� r O CL y O C09 CD v CD CDCL o c� Er d CD O CD C O CO) EL y -- o co CD I O 1 Z CD o a CD CD O CD B n O z C/)�d0 z Oa-� —• G�aCos O H ® ySm-oC.m m ��Cmo H = Z ® rID V� d. O. ,y G, O MR CD -fo m H O N! O IF m a 7 O CA .dd-► -� O O y cs W �d D G. N CL a CL -�► -� co 0 O Cdc CD ca C92 G a®Aoi d C ®ads cCIDo. coo CD co CD 3c, NQ .O—i� N 'C CD •'�' w : It O C) .-► O 0N z �� CDA E.:� Cm: CD �► go CD : W = .... 3- CD Cg 0 W o ib w� ]' rri ?.a n 7d o 'd to C) O � oroOC/ C!L z 0 tz z � n11 y O rL to O o x rA M V Z )mi 0 0 c I.. „9/�e- , s 5�� 5�CION PMWING E O � � N co z E 1 75 o�� 011 `kE SECTION DRAWING _A 0 `S � O cp z N� x I 0 � N I 0 � N co I Location T` p f No. ®> Date MORTh TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ P Y cwustBuilding/Frame Permit Fee $ 36 V Foundation Permit Fee $ Other Permit Fee $ TOTAL $3� C� Check #"/ 8 � z 177 19 �Alft Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING I This Section for Official Use Onik r z k BUILDING PERMIT NUMBER:' DATE ISSUED: SIGNATURE: Building Commissioner r of BuildingsDate F uProperty r 1.1` Address: 1.2 Assessors Map and Parcel Number. 81 S CHES`rN4f S'f jo�C 2Z Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zonin District Proposed Use Lot Area Fronta ft 1.6 BUILDING SETBACKS (ft) Front Yard. Side Yard Rear Yard RegWred Provide Required Provided RcqWred Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private 0 zone Outside Flood Zone 0 Municipal On Site Disposal System 0 WIN a t (Ile L P 2.1 of Record //Owner WATis 1Npr,Sn21ES 819 CyK7Nvr Sr Name (Print) Address for Service: Signature Telephone 2.2 Authorized Agent AmEs l,�Err 81f L'HEfr�rvr lr Name Print Address for Service: 888-5.23- 2187 Signature Telephone 3.1 Licensed Construction Supervisor Not Applicable ❑ VAYhES 8rS'r CS0804R Address License Number 20 t8 tr449D Qn 6104N, t M 01901 Licensed Construction Supervisor.1-5� S-2W•OS ami �� Expiration Date 774- tys- 6G 23 Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone v n M a N, LI I, ��Ar+ES ISFS�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 JAA,ES IBFST Print Name Signa of Owner/Agent Date Item Estimated Cost (Dollars) to be Completed by permit applicant 1. Building (a) Building Permit Fee i Multiplier 2 Electrical (b) Estimated Total Cost of Construction from (6) 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical (HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) 3S, 9i Check Number q 4tj 1.tip a}l5, 6,, fc ff�' 5)Y - ,� rt :.rk°',{ ,t v�iL ✓Go -J �.� t�U t{1f i£, NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 ST 2 ND 3 RD SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CBJMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE y > kd�,.... .,7Isb1 t�' a £ ', v�' a• i <. 14 a X x., y011r, 3'W.tyJsyy,�.i,�,>1° a �'�' 3 °k s. �t `h ° ilii p'" a x" i _ .s ss%�tc:�'"s •� t � tti;, � 8 W>. "'�, ��k x-�, � -s ..r, �' �' k �'`�.� �,, <jx s k New Construction ❑ Existing Building ❑ Repair(s) EY Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: — �!EMoi/c E111S'PiN (� FOOM Q.6of S7S'�'6,ti, tNS New spoil-, Roof $tiST&L ,art q ll� sQ�WCE f=ef' TYPE Structural Engineering Structural Peer Review SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT Yes ❑ No ❑ APPLIES FOR BUH DING PERMIT I, as Owner of the subject property Hereby authorize My behalf; in all matters relative two work authorized by this building permit application Signature of Owner Date to act on USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A4 ❑ A-2 ❑ A-3 A-5 ❑ 0 IA 1B ❑ ❑ B Business ❑ 2A 2B 2C ❑ ❑ ❑ C Educational 0 F Factory ❑ F-1 ❑ F-2 ❑ H High Hazard ❑ 3A 3B ❑ ❑ IInstitutional ❑ I-1 0 1-2 ❑ 1-3 ❑ M Mercantile 0 - 4 ❑ R residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A 5B ❑ 0 S Storage ❑ S-1 0 S-2 ❑ U Utility ❑ M Mixed Use ❑ S Special Use ❑ Specify: Specify: _ Specify: COMPLETE THIS SECTION 1T EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND OR CHANGE IN USE Existing Use Group: Existing Hazard Index 780 CMR 34: Proposed Use Group: Proposed Hazard Index 780 CMR 34: BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area s Total Height ft Structural Engineering Structural Peer Review SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT Yes ❑ No ❑ APPLIES FOR BUH DING PERMIT I, as Owner of the subject property Hereby authorize My behalf; in all matters relative two work authorized by this building permit application Signature of Owner Date to act on 5E`iI. 4 ?l�,01 Workers Compensation Insurance affidavit must be completed and submitted with this application. issuance of the building permit. Failure to provide this affidavit will result in the denial of the Signed affidavit Attached Yea .......❑ No ....... ❑ sECTtUI+t 5 - ROFMIONAL IS" Alm CONSTRUIC"TivN;: '1JiC�S 1 ���8�5 �tiTC'#�31�ES S� ��? xs�ccvr€ co�aL�b700 +vrrvn5,a �>, ,�► lcrn s►> 5.1 Registered Architect: Name: Address Signature Telephone Area of Responsibility Registration Number Expiration Date Name: Address: Signature Total Not applicable ❑ Registration Number Expiration Date Name: Address Signature Telephone Area of Responsibilitygess Registration Number Expiration Date Name Signature Telephone Area of Responsibility Registration Number Expiration Date Name Address Signature Telephone sq eewir, a Opio. AvFNuF E f 6e,<1,VTV Y I AA 6 04t Company Name: it 'M <'23-1187 Not Applicable ❑ Responsible in Charge of Construction The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Name Please Print Name: Location: hRrrc QEG,,,.Ane gl� C>}Esnvrr City ANba�F2 IhA Phone # 0 I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name: eENTT^^tx Obay. Address,j le AveNvF F City: Afic i NTbN i'i,A 00Yr Phone* Insurance Co. An►KIcau 4TL ALr1 1_^0, of e4:AdiNG, PA Policv # /JC ZS'i9 4oc�2 Company name: Address cay: Phone # Insurance Co. Policy # 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 $1,500.01) and/or one years' imprisonment -as well_as_civil.penaltiesinthefnrmd-a.STOP WORK.ORDER. nd..a.fine of.(.$100.W)-allay against.me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DtA for coverage verification. 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. 10 -Jr - Print name 6hMfs 0Esr Phone # 888-57 3- 2 ik-7 Official use only do not write in this area to be completed by city or town official' City or Town Permit/Ucensinq El Building Dept []Check if immediate response is required [] Licensing Board p Selectman's Office Contact person. Phone #: Health Department ❑ Other North Andover Building Department Tel: 978-688-9545 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 in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed of in: E t. h�9�evEti �E3'fQo�e � l��% (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector 4 A'. eomm&nvald ol,4&mad-.a-M i BOARD OF BUILDING REGULATIONS " License: CONSTRUCTION SUPERVISOR Number: CS 080749 f Birthdate: -05/24/1976 Expires: 05/24/2005 Tr. no: 80749 Restricted: 00 I JAMES E BEST ' 20 BERNARD RD WOBURN, MA 01801 Administrator tj JUN 14 '04 11:37 FR WATTS INDUSTRIES 978 688 7779 TO 15084350110 a v aCts-AndO+�prAP PURCHASE ORDER 815 Chestnut Street North Andover, MR OISAS-6098 Order Number: P016ee06 Roviviea, 0 Order Date: 06/11/04 Page: 2 Print Date: 06/11/04 Supplier: 237440 CENTMVM 6 AVE I HOPtIIPl'021, MR 01748 Ship TO: A00 WARTS SSG LUM Co. 815 CHiS'TUM ST NORTH ANDOVER. Mh 01845 ATPIIPTION: DAVID PIbM0 +nsz corrin 4 PRICE d DELIVERY tfMIN 48 HOURS 10 nZ* 976-607-7813 C^£irming2 yes Supplier Telephone: 064-523-2187 Sunliez Fax: 508-436-0110 Buyer: A0012 Peter Labrie Phone: Contact: credit 'Patau: 40 Ship via: AP - NET 40 Fog, Remarks: urahase Order Line Numbers Must be on Ali Snipping Documents Taxable Total: 0.00 Lune Total: - .. 36,941-00 Taxillt t-00! [2]: 0.001 131: 0.00t Total Tax: 0.00 VSD Total: 35,961.00 AutboriEed aignaturc lattD Regulator Terms 6 CondiLiOne of Purchase Rev 00 10-24-9e pply Here -in by reference. J TOTAL PAGE. 02 ** m m m Icm CA m F, m 0 y C d SCA CO) d = . O CD CDZ CA O 06 �?o CL y C.) O CD CDCL O % CD CD o CCD C� CD y CL v y CD S v Cos O 10 CD z o cl) 0 CD c W Spo a z _ a:S9 a y z�„ n 3 m �- irw ft N T co m N p CO) N O .►� i7 = !RC:j: O = > > • N ; a m Ci p�C.J W 3 • .� C MCC= m oCD ►�=cm,oma �. n ,►� `' ` " ti IN go O z y=r.cr e'f d m C C 00 C/)a IE CD C-1 .a I � g Cos C, CD s o Coo s:C Orn n Z Oa Orr a coo 04 t" o m 4'. c c C� b h; iti+ . �O•w O : � Im m CD o o w b '�, ^ Y 11 0 M o T b Q �* ro ^ Y 11 r M o T Location c A ,,4 1, � �-� Date ' No. p0�' aaos Csi�N) NORTH TOWN OF NORTH ANDOVER L 9 Certificate of Occupancy $ E<� Building/Frame Permit Fee $ MUS Foundation Permit Fee $ Other Permit Fee 5!50 $ Q too TOTAL $ :� 4. U Check # 10 t G r Building Inspector o c O a_ U p C Q Q) �t .� c c c = c �00 � to o Z cLLI (D U) ti ^ U ClS 1J U � O I C m E � 0 CU m N r J N O ._ . C J r C C CD p c: N C C o O .m.0 C E O CT N0 O C O •— U - " O � .N \� a) O > N ` > +y c (9 _0o O ,`\ O U) U' iV a) a) -C cu O C Q) - C (B C V) m G C L m m Q) m U cn E F _m � •ca _c � L CU V © O C O c � m0�o�,L m c o ca�00o3 —� as �. i� a) a O N . 0CL c a M cn 0 o C O O Q) U al 1� `°a�c`°n3 E o s cu c a) 0-2 -= o CL C N N U O •2 O = .T Jl 0a��La)E a C O O L U �QSJ . w (B O N U C O W z (D n. U C uj c c6cn U cn Q >- w C m O O � Zc (a Q Z -3 0- 0 F— _� •c. m N -a c Q O a7JC0 C� (D _ cn C U C U .O O m Q ca Q d1 4- a) c O c 0) W O Q p a U n E a_ O W m a o U -j U) Z U C O O (6 C. LL L ui a) L cu O ._ (n ai Z F- 1 co 0.0 = Z Q -,.e' -ff • o c O a_ U p C Q Q) �00 0) p \ Q or� (D 0 ClS 1J U � Q) (D U 0 (Lf Q a) cn 0 Z I C m E � 0 CU m N r J N O ._ . C J r C C CD p c: N C C o O .m.0 C E O CT N0 O C O •— U - " O � .N \� a) O > N ` > +y c (9 _0o O ,`\ O U) U' iV a) a) -C cu O C Q) - C (B C V) m G C L m m Q) m U cn E F _m � •ca _c � L CU V © O C O c � m0�o�,L m c o ca�00o3 —� as �. i� a) a O N . 0CL c a M cn 0 o C O O Q) U al 1� `°a�c`°n3 E o s cu c a) 0-2 -= o CL C N N U O •2 O = .T Jl 0a��La)E a C O O L U �QSJ . w (B O N U C O W z (D n. U C uj c c6cn U cn Q >- w C m O O � Zc (a Q Z -3 0- 0 F— _� •c. m N -a c Q O a7JC0 C� (D _ cn C U C U .O O m Q ca Q d1 4- a) c O c 0) W O Q p a U n E a_ O W m a o U -j U) Z U C O O (6 C. LL L ui a) L cu O ._ (n ai Z F- 1 co 0.0 = Z Q -,.e' -ff • 0 sA; Property Owner Business Name Property Owner Address SIGN PERMIT WORKSHEET /�' Ci7pS�Nv� S Sign Location Address Zoning District Allowed Area Proposed Area AV Allowed Height Proposed Height] Allowed Setback Ice)( Proposed Setback � e Pd55• R, Map Lot Estimated Cost $ Fee $ Permit Application Received ��',� /a `r Permit Approved / Denied Inspector /Y1 & 41(c LfdV �6 �t ti9' P N C) / o S�oP l i -A !A.' w < < ,� Z S. �'r' /ods' plea -1/ ��C, �I .23 1 1 B FOROWAY, EXT. • DERRY, NEW HAMPSHIRE 0303B SIGN CO. B03-425-2440 _C R 03 FF, C m Ea All drawings are property of Demers Sign Co. Any design or layout presented to client may Q be utilized unless purchased from Demers Sign Co. To incorporate Demers Sign Co. drawings without use of their services will require payment. Thank you. SIGN CO. 603-425-2440 1 16 FORDWAY EXT. • DERRY, NEW HAMPSHIRE 03036 _"v C A. All drawings are property of Demers Sign Co. Any design or layout presented to client may NOT be utilized unless purchased from Demers Sign Co. To incorporate Demers Sign Co. drawings without use of their services will require payment. Thank you. a X101 **ioo 4 v o� o 0, 0-0 b 0 O • �' i4 v 4i U UD �Ua��' � cOj O O NCZ0 y N cd C41 O o h O v p v p 0 0 k v 0 to O .O 00 � C8 QaH.s-. ,.s-. pa C 4 Q N N E E :3 C c E E � p a� L h .0-0 } D E a CN ai DE `n D E D) a) D E U � E a) v C _ Q D D E U a) R.0 C � D N c C D O -0 th 2 C } D D E U O Q� g 0, Imo! i i 4 4 3 U) W J 0 0 W I � Q C O U O a) p) 2 E c c N N _Dcoco U 7 C E 7 ZZ to N 5 N Q � N _ � c o M 10 F Y r J � S # 1p� O WI'veW co E rn a 5 Q � N _ � c o M F Y g � S WI'veW