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HomeMy WebLinkAboutMiscellaneous - 86 MAPLE AVENUE 4/30/20180 0 � o Q g w S 0 0 0 0 Date .... /:..2.:":0.'....... 0. TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING This certifies that ....................... has permission to perform ...... ..... wiring in the building of ......... Pd C... U ..................................... � at ................-9 ...... '7 ... . ...... ................ . North Andover, Mass. Fee ................Lic. No. 64Y7 .Z. ............. ....... ELECTRICAL INSPECTOR Check# 7895 Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Onl Permit No. r7 Occupancy and Fee Checked Lev. 1/07] (�P.AVP h�anlr� APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: /9,06 3 d 7 City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned ives notice of his or her intention to perform the electrical work described below. Location (Street & Number) $ % /yj,,,f/J��0 S7 - Owner or Tenant Owner's Address C Is this permit in conjunction ith/a builo per t? Yes ❑ Purpose of Building Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Telephone No. No 1:� (Check Appropriate Box) Utility Authorization No. Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ No. of Meters No, of Meters --.—.1 suuucvnul ueluu y aesirea, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such-cov5pafe is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INS CE 9 BOND ❑ OTHER ❑ (Specify:) I certify, under th ain and�j nal ' s of perju that th information o is application 's true and complete. FIRM N r`t 6`ta e r j AJ t N/�j LIC. NO.: License . S r All Signatu LIC. NO.: .� (If applicable, enter "ex mph; the license number line Bus. Tel. No.: �� 3 Address: ��v9'/Y`t�lOt�/�e�jil�-�� �'1��4 Alt. Tel. No.: /- -7 �9 *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: $ The Commonwealth of Massachuset& Department of Industria! Accidents Office of Investigations . 600 Washington Street Boston, MA 02111 www mass gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name Address: fPhone 7�- Ar'e you an employer? Cheek.the appropriate box: I . 111 am a employer with 4. ❑ 1 am a general contractor and I ployees (full and/or part-time).* have hired the sub -contractors 2. I am.e.sole proprietor or partner. listed on the attached sheet t 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.] 3. ❑ I am a homeowner doing all work officers have exercised their right of exemption per MGL myself. [Nonworkers' comp. c. 1.52, § I (4),'and we have no insurance required.] t employees. [No workers' comp, insurance reauired.l Type of project (required): 6. ❑ New construction 7. [] Remodeling 8. [J Demolition 9. ❑ Building addition 10. F7 Electrical repairs or additions 11.0 Plumbing repairs or additions 12.0 Roof repairs 13.❑ Other *Any applicant that checks bo)t# l must also fill out the section below showing their woikert' 'compensation policy information t Homeowners who submit this affidavit indicating they are doing all wo* and then hire outside contractors must submit a new affidavit indicating such. ,Contractors that check this box must attached an additional sheet showing the mune of the sub- contractors and their workers' comp. policy information ant an employer that is providing workers' camp ensadon information. insurance for my. employees: Below is the policy and job site Insurance Company Name: Policy # or Self -ins. Lie. #: Expiration Date: 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 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 Dior insurance coverage verification. I do here ce �ndgf the ns p yes of perjury that the information prnviafed above is true and correct uc rraicae Date: 3 i Phone kyC-% 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 bustee 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 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 cavy workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the 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 numberlisted 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 permittlicense applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit 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 0.2111 Tel. # 617-7274900 ext 406 or 1-8.77-MASSAFB Fax # 617-727-7744 Revised 5-26-05 www.mass.gov/dia Date ...... �........g...... f. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............ ......��?/.............................................. has permission to perform . �-'5./.� � —� 2 ............................................................ wiring in the building of p 7'" "i?3� ! G:` �v� North Andover Mass. � L q Fee../...-� ...... Lic. No. ��24./? ............. ELECICAL I TRNSPECTOR ly Check # Z,;7-77 7 Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. 7 ?? C Occupancy and Fee Checked [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 100c 31 A O % City or Town of. NORTH ANDOVER To the Inspector o Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) P,6 — Fy; Owner or Tenant �/,qPd ® -1: Owner's Address Is this permit in conjunction tion with a building permit? Yes EJ Purpose of Building n `KK// 5t yt„c e Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Telephone No. No � (Check Appropriate Box) Utility Authorization No. Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ Location and Nature of Proposed Electrical Work:/ roL4i'dtljt l O f ne(-t% ''I� ILt L 4, P t J/ -ft 5 No. of Meters No. of Meters Cn,oa nl�tlnm .,f il,., fi 1/.,...:.,,..-Af- --- 1— - _:.._J L - -'t -- t -- -- No. of Recessed Luminaires "'Y"'"""" 1 1111.1-1--6 No. of Ceil.-Susp. (Paddle) Fans cu rite tttuy UG VYU/V(;C4 UV /.Y/L' No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑In- ❑ o. o mergency ig mg rnd. rnd. 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 and InitiatingDevices �I No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Number I Tons KW 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 Water NR.KW No; of No. No. of Devices or Equivalent Ballasts Signs Ballas Data Wiring: No. of Devices or Equivalent E No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring. �E No. of Devices or Equivalent OTHER: attach additional detail ijdesired, or cis required by the h/sl/ector q/'ll"ices. Estimated Value of Electrical Work: (When required by municipal policy..) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability in urance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such cover e is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the . is r id pe talti sof perju that thse'information on is t ppl • ration is trete and complete. FIRM NA �" t/�I(,U(1 LIC. NO.: _ L'ecensee. r5 ,/✓sry Signatur LIC. NO.: ,i69�-7 (1/ahpliccible, enter "exeyftt" in the license nuniber I' e.) Bus. Tel. NO. _G?% Y6;1-35 Address: /T S �/^/`N/6� r' /�/� Alt. Tel. No.: `°7 nY *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: 1 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. $ Date... ....... r of NORTH 3= ` TOWN OF NORTH ADOVER • PERMIT FOR GASANSTALLATION This certifies that .... � x..'rllx � n ............. has permission for gas installation .1411,4.. in the buildings of 494'.P*. ............................ at l?. .......... , North Andover, Mass. Fee. .. Lic. No.. 3.7y.) ..... ,:.�1 ,-, ...... G SINSPECTOR Check # / ? >� 7 6284 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) k)okTh A 1J 006IZ , Mass. Date /a Q Permit # "I G Building Location_ nALLr` AVC Owner's Name f/AKOL% 7k0r16 Z,- jj.L L)Qf2 A OD0 `KkKA Type of Occupancy��S/ New ❑ Renovation ❑ Replacement ❑ Plans Submitted: Yes[] No ❑ Installing Company. Name BAY STATE GAS COMPANY Check one: Certificate # Address 55 MARSTON STREET X1 Corporation 1862 LAWRENCE, MA 01840 ❑ Partnership Business Telephone_ q 7 IB — 6 8,7 =110 5 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Francis X. Corkery y. INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes K No ❑ If you have checked Vis, please indicate the type coverage by checking the appropriate box. A liability insurance policy P< . 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner s IOwner[] Agent El\gent , I hereby certify that'all of the details and information I have submitted (or entered) in abo plication are true_ and accu�Ate to the best. of my knowledge and that all plumbing work and installations performed under the permit iss f r this application will n mpliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene S. (/ BY Tof License: Plumber Signature of License Plumber or Gas Title Gasfitter Master License Number 3745 Cit /Town Journeyman O FIC SE O Y • � I RUN MEK smaj in Hsi- • . ■.N....■..■.■■E.E ENN..■.■ MEMENEENEENNEEMEN Installing Company. Name BAY STATE GAS COMPANY Check one: Certificate # Address 55 MARSTON STREET X1 Corporation 1862 LAWRENCE, MA 01840 ❑ Partnership Business Telephone_ q 7 IB — 6 8,7 =110 5 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Francis X. Corkery y. INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes K No ❑ If you have checked Vis, please indicate the type coverage by checking the appropriate box. A liability insurance policy P< . 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner s IOwner[] Agent El\gent , I hereby certify that'all of the details and information I have submitted (or entered) in abo plication are true_ and accu�Ate to the best. of my knowledge and that all plumbing work and installations performed under the permit iss f r this application will n mpliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene S. (/ BY Tof License: Plumber Signature of License Plumber or Gas Title Gasfitter Master License Number 3745 Cit /Town Journeyman O FIC SE O Z _ O_ h U W a N z N N W cr 0 O ccCL I n z• m P t - a. z a N i � S J Q z W N O . 0 W h - &L LL a0. O Z a d Z a ti a U cl z n O W � O Q V a O w } w w u. CL IL Q I JI Q Z LL m z a i JI Q Z LL CERTIFICATE OF USE & OCCUPANCY ZTown of North Andover WUW� �O U U U) co ) 0 o °Building Permit Number M N II II 178-1998 2 THIS CERTIFIES THAT 000 °° THE BUILDING LOCATED ONS !Lma Avenue 0 0 New Elementary School Q 2 <, MAY BE OCCUPIED AS .-j 2i U U00 Date February 23, 1999 IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. C 1 "° "'" CERTIFICATE ISSUED TO St. Michael's Parish O 0 ` 4 ' °� 196 Main St North Andover MA 01845 L- o r. � p ADDRESS Z � 0 Ld L w < 's�°"�S`` Building Inspector Uc') c-. signPartnershipInc. Three Wdshington Square • Suite 400 • Haverhill, MA 01830-6139 • 978*372*9400 • Fax: 978*373*6779 June 27, 2000 Walsh Brothers, Inc. 150 Hampshire Street Cambridge, MA 02139 Attn: Gregory Williamson Re: St. Michael's Parish/School DPA Project No. R95-9-126 Dear Greg: JUN 2,9.2000 BUILDING DEPT. There are still a number of issues pertaining to the finishing up of St. Michael's: 1. St. Michael's Parish has contacted our office with their concern that the Main Street side is still leaking. It may be best for your firm to have an independent company review the area where it is leaking. When I spoke with St. Michael's Parish they indicated that Al Dumont is "so-called" repairing the joints. My recommendation is the caulking method is not the method that will resolve this issue. I believe that it should be completely reviewed by your firm and a letter sent to me with the recommendations as to what you would suggest to resolve the issue. Please respond as soon as possible. 2. An occupancy permit has not been issued on the school and church. I spoke with the North Andover authorities today and they indicated they are suppose to review any documents so they can return the bond to your firm once they approve the Planning Board Requirements. 3. We still have the issue of the as-builts. Please try to resolve the as-builts as soon as possible. The Archdiocese and I would like to review them so they will be in compliance and we can officially turn the as-builts over to St. Michael's Church. 4. Please complete any and all other items that have been on-going since the opening of the church, such as the entrance from Main Street to the church tile work; and any other items. PRINCIPAL * ANGELO PETROZZELLI AMERICAN INSTITUTE OF ARCHITECTS Please correspond with me as soon as possible. DESIGN/PA rNERSHIP ARCHITECTS, INC. Angelo I *Yzzelli, President AL4, NCARB Cc: Rev. Paul Keyes, St. Michael Parish D. Jones, Archdiocese of Boston P. Silva, Archdiocese of Boston D. Marinelli, St. Michael Paris'.: 2�23-1995 1.54AM FROM DESIGN PARTNERSHIP 1 978 373 6779 Three Washington Square -Suite 400 Haverhill, MA 018306139 Phone: 978.372-9400 Fex; 878.373-6779 iza To: 6 Froge Fax; J pages. �. Phone. Data a.7 CC: ❑ Urgent x For Review 13 Please Comment 0 Please Reply ❑ Please Recycle • Comments: I� ` 1 a P. 1 4J 2'23-1995 1 :S4AM FROM DESIGN PARTNERSHIP 1 978 373 6779 P. 2 DesignPartnership Architects Inc. Three Washington Square • Suite 400 • Haverhill, MA 01830-6139 • 978*372*9400 . Fax: 978*373*6779 June 27, 2000 North Andover Town Planner 27 Charles Street No, Andover, MA 01815 Attn: Heidi Griffin RE: St. Michael's Parish/School DPA Project No. R95-9-126 I hereby certify that I am a licensed architect in the State of Massachusetts and that to the best of my knowledge, information and belief all landscape and site development work for both the new church and school were done in accordance with the plans submitted to the Town of North Andover on plans shown by Andover Consultants with landscape design done by Huntress Associates, Inc, and in my professional opinion is in compliance with all applicable laws, codes and ordinances. Therefore I respectfully request that you grant this project an occupancy permit. Design Partnership thanks you in advance for your assistance with this matter and if we can be of further assistance please call our office. submitted, ARCHITECTS, INC. Cc: Rev. Paul Keyes, St. Michael's Peter Silva, Arch. Of Boston Walsh. Brothers, Inc. PRINCIPAL ANGELO PETRozzELLI �` AMERICAN INSTITUTE OF ARCI-BTECTS v 1 Design Partnership Architects c. Three Washington Square Suite 400 Haverhill, MA 0183076139 978*372*9400 November 24, 1998 North Andover Building Department 146 Main Street North Andover, Massachusetts 01845 ATTN: Mr. Robert Nicetta RE: New Elementary School Saint Michael's Parish — North Andover, MA. DPA Prosect No. R95-9-126 Dear Mr. Nicetta, Fax: 978*373*6779 Design Partnership's design for the new Saint Michael's Elementary School is based on the following: Ground/First Floor: The ground floor was designed with six classrooms large enough for twenty five to thirty students. Calculated this would be 6 x 25 = 150 students or 6 x 30 = 180 students. The Common Room is approximately 15 square feet per person accommodating approximately 110 to 120 students. The Second Floor: The second floor was designed with 10 rooms (this includes the library & computer room) large enough for 25 to 30 students. Calculated this would be 10 x 25 = 250 students or 10 x 30 = 300 students. _ The Basement: The basement floor was designed with 14 rooms (CCD & Meeting Rooms) large enough for 15 to 20 students. Calculated this would be 14 x 15 = 210 or 14 x 20 = 280. Based on DPA's calculations we feel confident. that our design for the new elementary school is sufficient to cover the basis for occupancy. First we will calculate based on the fewer number of students, 150 + 250 + 210 = 610 students. Secondly we will calculate based on the larger number of students, 180 + 300 + 280 = 760 students. Should you have any questions or comments, please feel free to contact our office. Respec f 11l submitted, -- L D SID SIGN ARTNERSHI 'AR ITE S, h �o e a� , Presi ent ��� AIA/N ARB EIVED Cc: Saint Michael's Parish (2) Archdiocese of Boston (2) Walsh Brothers (2) Pat Saitta Ben Lanni File AP/ka/StMichae1s.Corr2 PRINCIPAL * ANGELO PETROZZELLI NOV 2 5 We ..13UIL®ING DEPT' AMERICAN INSTITUTE OF ARCHITECTS -Design Partnership Architects Inc. Three Washington Square Suite 400 Haverhill, MA 01830-6139 978*372*9400 Fax: 978*373*6779 November 18, 1998 Town of North Andover Building Department 146 Main Street North Andover, Massachusetts 01845 ATTN. Mr. Robert Nicetta, Building Inspector RE: New School St. Michael's Parish — North Andover, Ma. D. P. A. Project No. R95-9-126 Dear Mr. Nicetta, Design Partnership has been involved as the Architect with the design & construction of a new elementary school at Saint Michael's in North Andover since Sept. 95. Design Partnership signifies that, in accordance with Mass State Building Code 780 CMR Article 116, and to the best of our knowledge and belief the new elementary school has been constructed substantially and in accordance with the plans and specifications that have been submitted to your office. Furthermore, it is also DPA's belief that all codes & requirements have been met. If there is any other information you require, please call us at our office at the above number. Cc: Father Keyes & Bill Hogarty Peter Silva & David Jones John Meier & Al Dumont — Fax Ben Lanni — Fax Pat Saitta File AP/ka/StMichaels.Corr2 PRINCIPAL * ANGELO PETROZZELLI EVENED NOV 2 5 1998 UILDINY74 !''"*' * AMERICAN INSTITUTE OF ARCHITECTS RENE MUGNIER ASSOCIATES, INC. STRUCTURAL ENGINEERS 66.70 UNION SQUARE SUITE 204 SOMERVILLE, MA 02143.3032 PHONE (617) 666.5566 FAX (617) 666-4115 November 19, 1998 Angelo Petrozzelli Saint Michael's Church 196 Main Street North Andover, MA 01845-2958 RE: Saint Michael's church — North Andover, MA Dear Mr. Petrozzelli: We have performed an independent structural engineering review of the referenced project as required by the Massachusetts State Building Code, Appendix 1, section 1-1 through 1-6. The structural drawings were reviewed. The design loads conform with 780 CMR. The design criteria and design assumptions were found to conform with 780 CMR and the accepted engineering practice. We received the geotechnical report prepared and we found that the design follows and respects the results and recommendations of the investigation. The organization of the structure was conceptually correct. Independent calculations were made for approximately 10% of the system members and details to check their accuracy. We found that the structural design shown on the drawings and specifications conforms with the structure and foundation requirements of the Massachusetts RECEIVED NOV 2 5 1998 BUILDING DEPT. State Building Code 780CMR, Appendix I- There was no deficiency found that could not have been resolved with the structural engineer of record. Very truly yours% "... Rene Mugnie RENE MUGS, INC RM/psf ENGINEERS DESIGN CONSORTIUM [D)( 7=�� 15 LAWRENCE: COURT WILMINGTON MA 01887 978 694-9669 FAX 978) 694-7679' Town of North Andover Building Department 146 Main Street North Andover, Massachusetts ATTENTION: Mr. Robert Nicetta - Building Inspector REFERENCE: New School St. Michael's Parish North Andover, Massachusetts E.D.C. PROJECT #98003 FINAL INSPECTION AFFIDAVIT - ELECTRICAL In accordance with Section 127.0 of the Massachusetts State Building Code, I, Ernest S. Durb being a Registered Professional Electrical Engineer, hereby certify that to the best of my knowledge, the above named project was constructed as per the applicable drawings and the Massachusetts State Building Code. I submit that the project has been satisfactory completed and is in readiness for occupancy. a F M9ss�'c Ernest S. Durb P.E. #24558 o ERNES S. ENGINEERS DESIGN CONSORTIUM o DU 1B C3 No. 245580 Amo � GIST��`�.�`�`� RECEIVED NOV 2 5 1998 BUILDING DEPT. REGISTERED PROFESSIONAL ENGINEERS. 0 CROSSFIELD ENGINEERING, INC. 65 CENTRAL STREET • GEORGETOWN, MASSACHUSETTS 01833 • (978) 352-6207 • FAX (978) 352-7362 November 18, 1998 Town of North Andover Building Department 146 Main Street North Andover, MA 01845 Attn: Mr. Robert Nicetta, Building Inspector Re: New School St. Michael's Parish - North Andover, MA D. P. A. Project No. R95-9-126 HVAC AND PLUMBING AFFIDAVIT I hereby certify to the best of my knowledge, information, and belief, that the HVAC and PLUMBING work done on the building located at MAIN STREET, TOWN OF NORTH ANDOVER called ST. MICHAEL'S PARISH SCHOOL, built by WALSH CONSTRUCTION, as shown on the HVAC AND PLUMBING plans drawn by CROSSFIELD ENGINEERING, INC., Reg. Eng. No. 8546, dated May 11, 1998, has been done in conformity with the above- mentioned plans. This. certification! '.s based on rea„1_ar incnPctionc wbic�h- T rna.de at the site while the HVAC AND .hi -�Z, PLUMBING phase of the work was in progress. Signed By: akh,44-,,�%l Date: - x1lVaIM6 IQ96 Stamped Seal: OF A T©CCI Ro. 8546 {R bra 7STEe� v RECEIVED NOV 25 1998 ILDING DEPT Bergman & Associates, Inc. Engineers November 20, 1998 Town of North Andover Building Department Robert Nicetta, Building Inspector 146 Main Street North Andover, MA 01845 RE: New School St. Michaels' Parish - North Andover, MA D.P.A. Project No. R95-9-126 Dear Mr. Nicetta, 20 Washington Street Haverhill, MA USA 01832-5524 Tel. (978) 372-1125 Fax (978) 372-1130 Bergman & Associates, Inc. has been involved as the Structural Engineer of a new elementary school at Saint Michael's in North Andover, MA. Bergman & Associates, Inc. signifies that, in accordance with Mass State Building Code 780 CMR, Article 116, and to the best of our knowledge and belief the new elementary school has been constructed in accordance with the plans and specifications that have been submitted to your office. Furthermore, it is also Bergman & Associates belief that all codes and requirement have been met. Respectfully, BERGMAN & A IVA Richard A. Smith :senior Structural RECEIVED NOV 2 5 1998 BUILDING DEPT. TRANSMITTAL LETTER MILLER ENGINEERING & TESTING INC. TO: MR ANGELO PETROZELLI DESIGN PARTNERSHIP ARCH INC THREE WASHINGTON SQ STE 400 HAVERHILL MA 01830 DATE: NOVEMBER 10, 1998 JOB NO: 80190.01 PROJECT: ST. MICHAEL'S SCHOOL LOCATION: N. ANDOVER, MA Attached, we are sending you the following: ® Reports ❑ Prints ❑ Specifications ❑ Copy of Letter ❑ Plans ❑ Samples ❑ Change Order ❑ Other COPIES DATE DESCRIPTTON 1 11/5/98 CONCRETE COMPRESSIVE STRENGTH TEST RESULTS �t-i2ects c Remarks: - - - ED Copies to: NOV ;�'5 i y� (1) MACLELLAN CONCRETE (CONCRETE TEST RESULTS ONLY) BUILDINGDEI,,, ,•, Very truly yours, a e MILLER ENGINEERING & TESTING INC. yv 7 by: ELLY CHAKAS CORPORATE OFFICE: 100 SHEFFIELD ROAD- P.O. BOX 4776 iV1ANCHESTER, NH 03108 -TEL. (603) 668 -6016 -FAX (603) 668-8641 _.... . `130 EAST`MAIN ST:=P:O.-BOX i l-NORTHBOROUGH; Iv1A0'1532=TEL. (508) 39�-2607-FAX (�08) 39.i=8390 -474-DORCHESTER AVENUE -BOSTON; MA -02127 -TEL: (617) 269.8829=FAX (617)`269=8837 I FA MILLER ENGINEERING 3z TESTING, INC. MANCHESTER, NH (603) 668-6016 NORTHBOROUGH, bfA (508) 393-2607 BOSTON, MA (617) 269-8829 FAX: (603) 668-8641 FAX: (508) 393-8490 FAX: (617) 269-8837 REPORT NO: 8 OF CONCRETE CYLINDER TESTS. PROJECT NO: 80190.01 PROJECT: ST. MICHAEL'S SCHOOL CLIENT: DESIGN PARTNERSHIP ARCH. INC. GENERAL CONTRACTOR: WALSH BROS. SUB -CONTRACTOR: NONANTUM CONCRETE SUPPLIER: MACLELLAN CONCRETE LOCATION: Foundation wall F'to G, 5 to 6 7 DAYS 7 DAYS FRACTURE SAMPLE NO 8A 8B TYPE DESIGN STRENGTH (psi) 3000 3000 (NORMAL/LIGHTWGT CONCRETE) N N S :� WET DENSITY (lbs/cu.ft.) (C-138) - - 1 SLUMP (inches) (C-143) 4.75 4.75 AIR CONTENT (percent) ( C-231 ) 5.2 5.2 CONCR. TEMP. (deg's F) (C-1064) 62 62 AIR TEMP. (deg's F) 52 52 2 TRUCK NUMBER 126 126 TICKET NUMBER 3020 3020 CONDITION OF SPECIMEN GOOD GOOD SIZE OF SPECIMEN (inches) 6x12 6x12 3 AREA OF SPECIMEN (sq. in.) 28.27 28.27 SPECIMEN WEIGHT (lbs.) 27.6 27.3 s� TYPE OF FRACTURE 3 3 TOTAL LOAD (lbs) 64000 62000 UNIT LOAD(psi) (C-39) 2260 2190 DATE CAST 10/29/98 10/29/98 A DATE IN LAB 10/30/98 10/30/98 DATE TESTED 11/5/98 11/5/98 TESTS PERFORMED IN ACCORDANCE WITH ASTM STANDARDS 5 ADMIXTURE (oz) MIX WEIGHTS -PER CUBIC YARD FINE AGG. (lbs) COARSE AGG. (lbs) WATER (gals) W/C RATIO (gals/sack) CEMENT (lbs) REMARKS: " REVIEWED BY: BC TESTED BY: KK PREPARED BY: Sean McNamara GEOTECHNICAL / SOIL BORINGS/ ENVIRONMENTAL /SOILS / CONCRETE/ MASONRY/ STEEL/ ROOFING/ ASPHALT INSPECTION F TRANSMITTAL LETTER MILLER ENGINEERING & TESTING INC. TO: MR ANGELO PETROZELLI DESIGN PARTNERSHIP ARCH INC THREE WASHINGTON SQ STE 400 HAVERHILL MA 01830 Attached, we are sending you the following: ® Reports ❑ Prints ❑ Specifications ❑ Plans ❑ Samples ❑ Change Order rnDTTi C Tl A TA DATE: NOVEMBER 4, 1998 JOB NO: 80190.01 PROJECT: ST. MICHAEL'S SCHOOL LOCATION: N. ANDOVER. MA DESCRIPTION - 1, 10/29/98 CONCRETE FIELD PLACEMENT REPORT Remarks: Copies to: (1) MACLELLAN CONCRETE (CONCRETE TEST RESULTS ONLY) ❑ Copy of Letter ❑ Other RECEIVED NOV 2 5 1998 Very truly yours, BUILDING DEPT. MILLER ENGINEERING & TESTING INC. by: _ ELLY CHAKAS. CORPORATE OFFICE: 100 SHEFFIELD ROAD- P.O. BOX 4776 -MANCHESTER, NH 03108 -TEL. (603) 668 -6016 -FAX (603) 668-8641 130 EAST MAIN.ST.-P.O. BOX I l-NORTHBOROUGH, MA 01532 -TEL. (508) 393 -2607 -FAX (508) 393-8490 474 DORCHESTER AVENUE -BOSTON, MA 02127 -TEL. (617) 269 -8829 -FAX (617) 269-8837 MILLER ENGINEERING 8& TESTING, INC. I~ MANCHESTER, NH (603) 668-6016 NORTHBOROUGH, MA (508) 393-2607 BOSTON, MA (617) 269-8829 FAX: (603) 668-8641 FAX: (508) 393-8490 FAX: (617) 269-8837 CONCRETE FIELD PLACEMENT REPORT REPORT NO: 8 PROJECT: CLIENT: GENERAL CONTRACTOR: SUB -CONTRACTOR: CONCRETE SUPPLIER: DATE: WEATHER: CLASS OF CONCRETE (PSI): CUBIC YARDS PLACED: METHOD OF PLACEMENT: SET LOCATION: PROJECT NO: 80190.01 ST. MICHAEL'S SCHOOL DESIGN PARTNERSHIP ARCH. INC. WALSH BROS. NONANTUM MACLELLAN CONCRETE PLACEMENT INFORMATION 10/29/98 Clear 3000 23 Direct Foundation wall F to G, 5 to 6 TEST CYLINDERS: 8 A -D TIME OF TEST: 1:05 CONCRETE TEMP. (DEGREES F): 62 TRUCK NO: 126 ADMIXTURE (OUNCES): - TOTAL LOCATION OF CONCRETE PLACED THIS DATE: Foundation wall F to H, 5 to 7 REMARKS: AIR CONTENT (%): 5.2 SLUMP: 4.75 AIR TEMP. (DEGREES F): 52 TICKET NO: 3020 WET DENSITY (LBS/CU. FT.): - PREPARED BY: Sean McNamara GEOTECHNICAL / SOIL BORINGS / ENVIRONMENTAL / SOILS / CONCRETE / MASONRY / STEEL / ROOFING / ASPHALT INSPECTION % • k Design Partnership Architects z Three Washington Sq. Haverhill, Mass 01830 Suite 400 978-372-9400 Fax: 978-373-6779 angelo petrozzelli, aia president TO (�4&U ATTENTION: RE: TRANSWTTAL WE ARE SENDING YOU: ❑ Attached ❑ Under separate cover via the following items: ❑ Shop Drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of Letter ❑ Change Color THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ For your use ❑ Approved as noted ❑ As requested ❑ Returned for corrections ❑ For review and comment ❑ FOR BIDS DUE REMARKS SIGNED ❑ Resubmit copies for approval ❑ Submit copies for distribution ❑ Return corrected prints 19 PRINTS RETURNED AFTER LOAN TO US • ME W.IAWOM .r .r " , THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ For your use ❑ Approved as noted ❑ As requested ❑ Returned for corrections ❑ For review and comment ❑ FOR BIDS DUE REMARKS SIGNED ❑ Resubmit copies for approval ❑ Submit copies for distribution ❑ Return corrected prints 19 PRINTS RETURNED AFTER LOAN TO US ,"Design "es1 n Partnership Architects Inc. Three Washington Square Suite 400 Haverhill, MA 01830-6139 978*372*9400 Fax: 978*373*6779 February 16, 1999 North Andover Building Department 146 Main Street North Andover, Massachusetts 01845 ATTN: Mr. Robert Nicetta, Building Inspector RE: New School Saint Michael's North Andover DPA Project No. R95-9-126 Dear Mr. Nicetta, It is to the best of Design Partnership's knowledge & belief that the metal doorframes installed at Saint Michael's Elementary School North Andover, MA will meet the two-hour rating requirement according to the enclosed letters from Walsh Brothers, J & R Metal Frames, Inc. and Jackson Lumber -'& Millwork. This coupled with the fact the building has been constructed in accordance with plans prepared by Design Partnership, and submitted to your office leads DPA to see no reason for withholding the occupancy permit any longer. We respectfully request that the Town of North Andover issue such permit for the new school at Saint Michael's North Andover, MA. Should you have any questions or comments please feel free to call our office. Respectfully submitted, AIA/NCARB Enclosures Cc: Father Paul T. Keyes & Bill Hogarty Peter Silva Peter Silva & David Jones John Meier & A] Dumont 'Ben Lanni . File AP/ka/New School.Corr 31 r PRINCIPAL ANGELO PETROZZELLI * AMERICAN INSTITUTE OF ARCHITECTS Feb -09-99 13:59 11 W , ' t JACKSON LUMBER BOB 689 1065 p.OZ 1: Jackson LM�illwotk MARKET STREET, LAWRENCE, MA 01843, TEL. (978) 686-4141, FAX (978) 688-6802 MAILING ADDRESS: P.O. BOX 449, LAWRENCE, MA 01842 February 9, 1999 REI: St. Michael's Pariah Behead Renova6vn .John Mier Watch Amthvms 15t) Hampshire fit. Combridge. MA 02139 A'l'1'N: John :Mier Dear Jr hn, In reslxlnsc h) inquiries made regarding the fire assemblies at the school, door ft s 4, S, b, 7, 8, 1), 1(1, 18, 52, G1, & 90 were supplied to the school as 'R' Lablcd docs frames. The door, were Manufactured by Meming, which erre 1..7.1.., Wannock Hensey and 1"ACtnlry Mutual Certified, The fratnes were manufactured by J/K Metal Franc which is U.I., and Factory Mutual Certified. .)/Ws letter from December 10, 1998 indicates how the frames were tagged. Finally, )acksun Lumber & Ibiilluerk certifies that the al"ve dcx�rs mid frames as indicated were purc.ha.,rd as 'R, t.abeled and supplied to Walsh Bruthers as 'ti' Labeled as per appmvecl do r schedule. If you have any questions, please call meat 978 -689 -1074 - Sincerely, had Chaput Architectural Manager Jackson Lumber & Millwork ff , L V 1 I>at Mercadantc vice President of Operations AFTER 50 YEARS, QUALITY AND SERVICE STILL MAKE A DIFFERENCE. ..3an*20-99 10:27 JACKSON LUMBER 508 689 1065 P.01 METAL FRAM('E'S MFG. INC. FRAMES • WON$ • HARDWARE - CUSTOMIZED SERVICES Cit G11191 Orivu. AugusW Mairw 04330 taMMNM a97) d22 -U28 Lfte tber 10, 1998 Mr. Kevin Laroche Jbdk LuaAes A Mdht� 245 Market Street Lawrence, MA 01842 Re: P_0.0 31262 Dew Mr. Laroche: This letter is to crosify that the Gams demi1cd blow, which I we supplied to you undcr the aforen entioned Purchase Older, were maaoufactumd m aoeor&nm with the laacWg requuemms as indicated: Faclory Mutual -- Tog 4's 4,5,6,7,8,10,18,6I mW i 52 Underwriters Laboratory — Tag #'s 9 ad 90 If I can be of any further assista=, do not hesitate to cad yam. s truly, Robert Pq* Pr kkm WAL SH BROTHERS INCORPORATED February 10, 1999 Town of North Andover Building Department 146 Main Street North Andover, MA 01845 ATTN: Mr. Robert Nicetta RE: St Michael's Parish School 80 Maple Street North Andover, MA. Dear Mr. Nicetta, Engineers and Contractors 150 Hampshire Street Cambridge, MA 02139 phone(617)492-4011 facsimile (617) 441-9062 This letter is in response to a request that Walsh Brothers confirm the fire rating of several door frames at St. Michael's school. We have attached a letter from our subcontractor, Jackson Lumber Inc. and also a letter from the manufacturer, J/R Metal Frames MFG., Inc. The intent of both letters is to assure all parties that the metal frames in question are fire rated frames and meet UL testing for a B label rating. The manufacturer J/R has also rectified the omission of the missing door rating tags. Walsh Brothers would like to state again that this project to the best of our knowledge has been completed in accordance with the 6`l Edition of the Massachusetts State Building Code and Article 116.3. Please do not hesitate to contact me with any questions or should you require additional information. Very truly yours, :OTHERS INCORPORATED er cc: David Jones, Peter Silva, Jim Walsh IV, Angelo Petrozzelli, Father Keyes, Bill Hogarty I 14AY y s C r- 2 1 O aZ' t Ili I i+, 0 C � m I v z C cn ev Ln n `J I z z J 1 V z Y m A m D i Z f C l] O Z � rA Ln ,n rr7 y m n O . r 7 Z m z � y �.r a � � � x CA a C T � � s z cn S, cn -N y 10 ,n, Z O CL wc; a a� .p o O p CL CD O .... ClMin CO) CSD a O -e m 0 CDO a, CO) CD CO) CCD O CCD dc c?mo _ O =COQ y 9O�CCD) y G H2dCl) O T _ Z rfl y --4 o m •�► m 01 'y O O CA O S' IEmm m a O 7 N o O m Oft 7R O C O Z2.n� c_ ? y '^ to C=r cvn m O H b _ n CD n a 0, O SOCH: zCA C/)o �� om' • CL T CO)3E CD CD Lv -7 1 9-0 CA O 0 o O co, N D CDH ' R� C d _L. � A CA 0 CfJ ; C O Or � J omq 0 r v cn O (n C77 ^17 y G y G Z � O 7' O � [n rb" o fb\i x M M v �O .o OD FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. '"`**''`*****''"'"`APPLICANT FILLS OUT THIS SEQTION**************'k******** 4/APPLICANTTa�h f3 X _ JOCATION: Assessor's Map Number 30 SUBDIVISION rl�• W let END ONS A/ <PHONE (�] qlrcf6l 1)."() '/'PARCEL � LOT (S) ZI ST. NUMBER FICIAL USE ONLY*********�*************** AGENTS: " 0 CONSERVATION ADMIN4§TRATOR DATE APPROVED DATE REJECTED -T-,- COMMENTS TOWN PLANNER DATE �PPROVED DATE REJECTED COMMENTS INSPEC -HEALTH DATE APPROVED ) DATE REJECTED DATE APPROVEDr/yl DATE REJECTED COMMENTS � ,,-- V1,P`UBLIC WORKS - SEWER/WATER CONNECTI DRIVEWAY PERMIT /FIREDEPARTMENT' .� RECEIVED BY BUILDING INSPECTOR DATE i (j 'i= _� _ 4� jtr �� ✓fze 7�anT�na�zuleal%� z Mae& DEPARTMENT Of PUBLIC SAFETY CONSTRUCiTdN SUPERVISOR LICENSE p Number' Expires: Birthdate: (! M CS` r OSS?TS; 91 f19J1999 0711811954 F11 f i Resta• Rel :° . 00 j nal►' 13 601D N GATE OR ,) HOOKSETT, NH 03106 Il v`4t'HT1 tiF ["�r�Tj "t .•�._�J i� .-- -- • 115082 f j Restricted To: Be R9 Tlone . `. t.1A - Masonry only 1 1 _ M 16 1 12 Family Homes , _ Failure' to possesscurrentedition of the .a Massachusetts State Building Code ofAhis licgnse. is cause for revocation l O, ,10811. ,ry o.I`49 y,SS�CHUSt, PROJECT NUMBER: R95-9-126 OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL PROJECT TITLE: Saint Michael's Parish/gchnn], PROJECT LOCATION: 196 Main Street North Andover, MA. NAME OF BUILDING: Saint Michael's Parish & Saint MichnPl ' c 4xhnn1 NATURE OF PROJECT: New School Addition IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, Ange o Petrozzelli 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 SPEChFICATIONS CONCERNING: ENTIRE PROJECT , ARCHITECTURAL ❑ STRUCTURAL ❑ MECHANICAL ❑ FIRE PROTECTION ❑ ELECTRICAL ❑ OTHER (SPECIFY) t FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEGE, SUCH PLANS, F0 COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS 11 _ )STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRATICES. 2z ("�'� AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. irk FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B �p i�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 A— ` 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 idocuments. 112-71 jReview and approval of the quality control procedures for all code -required controlled materials. I ? 13. e present at intervals appropriate to the stage of construction to become, generally familiar wBith6the progress and quality of the work and to determine, in general, if the work is being Nperformed 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 THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR O CY. SIGNATURE SUBSCRIBED AND SWORM TO BEFORE ME THIS_*DAY OF 19 A A"I'" , I , 74Q ~. OTARY PU IC MY COMMISSIONXPIRES 1998 1 : 28PH ub/ub/vu 10!�>s /�1 FROM WALSH BROTHERS INC. 617+441+9062 Vulr 1545 Jn.La uliuIvuIvULIX ura. "Ob16m �k7)646-9300 FAA (617)645^1546 `Donoghue Insuraqu Agency, Inc. 00 Summar Street x1 ington, MA 02174 Ate' Cheryl Worth Ext: INSIiM Walsh Brothers, Incorporated 150 Hampshire Street Cambridge, MA 02139 P 2` +j VVI) VV �ItMAtIDDIYY) .�:. � 05/45/1998 . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE NOLDEFL THIS CERrWMTE ODES NOT AN"U, EXTEW OR ALTER THE COVERAGE AFFORDED BY THE POLICIES VIELOK CompmY Travelers Ins Co A COINrPNr a COMPANY . C c(XnPaN• D ThI1S lS TO CERTIFY THAT THE POLICIES INSURANCE LISTED BELOW MAYE BEEN I INDICATED, NOTWITHSTANDING ANY REQUIRFI!IAENT, TERM OR CONDrrtON OF ANY CONWCT OR OTHER DOCUMENT WITH RESPECT TO YIMICN THIS CER-nFIt;ATE MAY BF ISSUED OR MAY PERTIUN. THE INSUKamog AFFORdED BY THE POLICIES DESCRIBED M6" IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONoMoNs OF SUCH POLICIES, LIMITS SHOWN MAY HAVE SEEN REDUCED By PAID CLAIMS. "WE OF INSYWWGi I> NUM>!tN MMXY FiiOnft POLICY WIRATTON : LIWTS LM i CATT:(AA"DITTI CATE(NNIDGrM LMOUTY - :- ; GEMPK AG OPMCAW ....... 5 ? OpO.e 000.1 GEMEwU .. X.. COINMBRCW.69NER AL LAMTY PROOVGf5• COaAPIOPAtit; s 21000, 000 cw#.s+»IAct x acCUR C0PERS W&AOVINJURIT 1,... 000 0 A ;s; ....,. 01•--3309S99-TIL-98 01/01/1998 01/01/1999 ..,,.,�.......00 . OvuNerts 9 CONTRACTOWS PROT . : CACM Q��1"CE S 1, 000 , 000' AuTOMOW E UADILITY X. ANT AVYO ALL CNN90 AUTOS 9"EFULM WT09 A t4A60 AVY05 NON•Q M9 AUTOS GAR=Q LJAr1LITY ANY AUTO au�sa LOSILIW A ...X., vMwELsA FORM OTxFx YNAN u A FORM WOWJM CONPEWTEIN AND Wtroy4w LaOUTY FIRE DAMAGE (Any a+e oral s 100.000 M1E0 EXP I/1egl 0M osvn) COM1INE6904C.E LIMIT s 1,0001000 ewylwufty = DT -AC -810 -334P9599 -TIL -9' 01/01/1998 01/01/1999 BODILY INJURY i IPF 11ClJLMMS) MIIOKRTY DAMA41 S �•- : AUTO ONLY - EA ACCIEW i ............ .. .......... ......... • OTHER THAN A M QKT n•i7,.•r.,,, .,t..,.....::.:... EACHACCIV01 S .. . ......... A66REti�n3 .... fACH QCCURRVMVS 2 S, 000, 000 DTSM-CUP-334P959-9-TIL-9 ; 01/01/1998 01./01/1999 ,A40REGATf ......... s ..... Itetenti on s 10 000 qTwe pp METM X IKL PIWCN-US-911038-1-98 AARTNsRsnxecurn� OFFICE+$ ARF: txOt 10 Day Notice of Cancellation applies to Non Payment of Premium X , 01/01/1198 01/01/1999 al 100000 IL EACM ACCIDENT 100,000 EL DISEASE -POLICY LMT s 500,000 (=IDISGABF EAtPLpYEE s 100.000 roject: St. ~Michael's Parish, Educational Life Center, North Andover, MA Archdiocese of Boston 2121 Commonwealth Ave. Brighton, MA 02135 $NOULD ANY OF TH I AW 4I)INU M POUCIEE K CANC96M 09PUM TNI? EXARAT*N DAVE THIPA F, THE WAIING COMPANY (RILLOWAVORTO MNL ;Q oAVS VgV"*q Nonce= TO TIM CVtTIKATK NOI.=R NArtD Te THE LEFT; OVT PNtuA! YO MAIL SUMJ NOT= SII" Ii POW NO OWJGA1 M OR UABILITY OF ANY #*D UP" TRE COMPWAS AW106 OA! E$4NTATTVii