HomeMy WebLinkAbout2001-06-21 Construction Affadavit & Constn. Control Form OFFICE OF BUILDING INSPECTOR
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PROJECT NUMBER:_— 1082A
PROJECT TiTLE'I MISTER TE,R I. DZY CAR WASH
PRQJIN-, T LOCATI ----_ . . '" r rn Twrinikp
NAME Cop iUIL ING,, _
NA,TURI! or PK0JE T'; p cfio I of r a AB_V Aa— FAGlLff Y— ..,-_..�
rN A 'CC)RDA d f! WITH AID N NCL - VIA A I. Tl E MA,:. -,AU]USE-I TS STATE RLIN DING COUL,,
�._. 'J" •° ��e NF(,;I;,-T aw-rlr:.)'N NO.
LUFNN(', A f C:(,NSTEBEJDPROI=ES,SIl NAL L;.NC�!'G EE:F AR(U,H1TL;(,;N-[ f-E;Rd 'r":CERTIFY THAT II
HAVL NCI?L'PARFJ7 ONE, UkLCI LY SU'llFRVISL.. ) I N-NL PREPARATION OF AII_t. DESIGN PLANS,
E TIR E PROJ EG I- AR(-HITFu,TURAL STRUl(-TU AI,.. 0 I E HAIMCAL 11
l E PROTECTION VV I�l 17'(:�I"RIICAL � OTHER (STIE IFY) . _ . _...._. ._
C`!OR 'R HE ABOVE S A E- PROJI::�C I-AND Tt PAT. Ilan f N fl N I,T 0F MY SUC.,14 1'LANIS,
r..IC.rMPI,r1 ATIONIMu AND SPECIFIGAN IIOhr5 MEET Tq IE.AF'PI°R'AIIII II I'RuNVI030N 017 '11 E MAE.o$rAC4r U8L_II_M1.�,;a
aTATIr DU'NL.04FvG CC) ALL Ar_,r.F=M'Aa 11 F� Nr' INMmm.ERIrwN:G PRAT11C,F--S..
AN E)AaI'P'LI CAM_I?" I AW9)AND 0 RDINA NCrk: . !"01,� fN-NIA I"ROP OGED I_I 3r ANn ()raG OII"A L:,Y
I FURTI II"R C:I:uMN Y THA I' N '-,H I a PFm-4.lRM THE.NECESSARY IFpH'f5Fr-`SI01tNJAI: SrzK'VIGe5 AND C
E PRE5ENT ON TH E.G0N I8TRtJ('°m 1UI ,0 11-.()N AR EG NJ AR AND FERI 0MIC RA3I� S TO DETIER II'^NL °rll 1A I
I VIiE ' IMF IN A(;(.0RI)AN(af:VI I H -N-HF DOCUM MTS APf^ROVF�jf) BUILDING'
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PI-,t"NM 1I°T AND HAI I. RF il=5P' I SI BLE,F' R '°I]I Ill- 1'OLL WNG Ab-�.1PEC,NEI'Ell IN sr-c'nbom 1 I Gi o
r{µr'vicvv, for conlorrli'Im'Qv 1Nra lhi c"Oncept., shop,dao*aMlr gti, omrr pkl a and CrrtISror,oa1bmfttWs
which, are submiltod by tha contractor in a ccrjirrlanc,6�t suI the requirements of NNrir,:uxtulrur;floe
R(-wiewand napprr vW ,,rr(11,0:flrr;"rNl r mntrol procedures for all ontr llupd materiahl
:N. L o �s tirlNr rIgt rmtrrctIon to became, �)01`10rrINy falI[TPli29
rltl 6lrh8 progress and quality of ffi7e work and to deteirrr'aInc, In qurl-uial, If the work Is beINrag
p rfarnie In a°rraa;rrrneE ucrraAst rit Wth the cconMruct rr r,N"ument-
FILI SNJAN'�N N N S'LICTI:N��I�N 1,16.2 .2 I Sit]ALL�,L,pN�N' IIII N Ll Kt.°Y „ A moGRESS iRL110H i
TO(DETI-IIIER 'NTNIrl`9k:N I N.:uml",NIENTS Tt,,THE NC)RTH AN[.1r;J°w'EN-� LMLLIIN03 NNSP'EC TI R
UPON w � r ) A. v,I '"' I f) rV9r
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`�ILII' f=�.JBED AC'lb C".)R.0 TO Fuf.�:J �7k�N� i' �N_ N I JN-} IE:)AY Ems f� �-� I �r���_ 20 "
NOTARY IMUG PAY COMMISSION�SION EXPI .FIB)
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STATEMENT OF PROJECT OOMPL ETfO N -Arch teat-
Project Number----A0823.. -- Project Title.r.....--.-MISWSudzy-------------------------------------------...............
Project Location-..-T40-Sialem Turnpike-,(Route I14) . North Andover MA............................
Nature of Project----Cor LK%onofa new Car WashFactlity-----------------
In accordance with 780 CMA (Commonwealth of Massachusetts Buildkng Code) Sectbn 116-0
Construction Control, and specifically Sections 116. -2 Architect's 1 Engineer's Responsibilities during
Construction,
I, .....---RAVER KOCH,--.,. --- ------ Registration No. -.-.-.--MA 505Or ................
being a registered eroHeei, I monitored the construction and have provided the#ollawing tasks and
docurnents during this construciicrr process:
1- Reviewed for 00forrrr8race to the design Concept:strop drawings samples and other materials
which were satxrritfed by the contractor in accordance wvifh the requirements of flee
consfruclion documents.
2- Reviewed and approved the qualify control procedures for all code-required controlled materials.
S. has present at intervals appropriate fa the sues of Construction, generally familiar with the
progress and quality of the work and detaimined, In general, that the work was being performed in
a mariner consrslent with the Cronsfruabrr documents.
4- Was present at the construction vfe on a regular balls or as outlined io the initial inspection
schedule, andlbr l hawro sera other appropriately qualified design profassionals, to determine that
the work was proceeding in accordance with fhe dacuments,5ubro tied with the building permit
application and the applicable pro visions of the Commonwealth of Massachuseffs Building Code.
5. Provided the buildings inspector with an origin,11, Stamped report for each site visit, scheduled
or otherwise-
Plea" accept lh s statement in consideration for the issue of a CERTIFICATE OF OCCUPANCY for the
above referenced project 1 work.
Signed--...... ....... . (kQ
---- ,. .. `` k t.R r� o1
Nam I7ste---,,,,,,..Septembefi'2�, r71}2...................... � . 5056
;W OF MP9
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