Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Miscellaneous - 1 High ST Bldg 3 Quantum
M 9 E 2 4 ,AORTOI -0 0 $A Date .................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thiscertifies that ........ ........... .......... ! ......... ........................................ has permission to perform ......... ............. ( ............................................ wiringin the building of ..... ....................................................................... T r -:-- at ............ 4 ............................................. . North Andover, Mass. Lic. Not .............. / ............ - - IZPECTOR i ; �-' ' L 4--� 7 WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File e!<4�7 /SD_0 he The Commonwealth of Massachusetts FOR OFFICE USE ONLY Permit No. Department of Public Safety Occupancy & Fee Checked iyy BOARD OF FIRE PREVENTION REGULATIONS 527. CMR 12:00 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work will be performed in accordance with the Massachusetts General Code. 527 C R 1200 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date �-Sr City or Town of /Y 0Zy� Awve,L To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below: Location (Stree' and Number) / /7`1�4j S��Pr-11 Map: Owner or Tenant _���% ��)��,}/� Zone: Owner's Address �� Is this permit in conjunction with a building permit? Yesd/J No ❑ Purpose of Building Lq�/C� Sl�iStC �' 4 Existing Service Amps / Volts Utility Authorization No. Overhead ❑ New Service Amps /_ Volts Overhead ❑ Number of Feeders and Ampacity Underground ❑ Underground ❑ Location and Nature of Proposed Electrical Work��/ff� OC�� �/�1C-qC Ze___ cJ /�jwP/f T/PFJ /�, fel des' /��1�/ii c�,g��c�•v c Lo+: (Check Appropriate Box) No. of Meters No. of Meters tir o No. of Lighting Outlets No. of Hot Tubs 0 No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above grnd. ❑ In-grnd. ❑ Generators 0 KVA No. of Receptacle Outlets No. of Oil Burners No. of Emerg. Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection'and Initiating Devices No. of Sounding Devices �V No. of Self -Contained Detection/Sounding Devices No. of Ranges ,0 ' No. of Air Cond !CV��Total Tons No. of Disposals � No. of Total Total Heat Pumps Tons KW No. of Dishwashers 581,Space/Area Heating KW No. of Dryers Y 0 Heating Devices 0( KW No. of Water Heaters ,(�f KW No. of Signs e0 No. of Ballasts Local ❑ Muncipal Connection ❑ Other No. of Hydro Massage Tubs n No. of Motors Total HP Low Voltage Wiring OTHER:f GLfJ �+"L Gt% /Q (yo(/ T/ U /✓/� L f �� (f X1 r;7" LV 0,1? -IC j, o0 T/ INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts Ge_n_,e� Laws I have a current Liability Insurance Policy including Cor} leted Operations Coverage or its substantial equivalent. YES 147 NO ❑ I have submitted valid proof of same to this office. YES (�,�N_�O�❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE IR BOND ❑ OTHER ❑ (Please Specify) C Estimated Valueof-lectrical Work $ �-�{ %. ex.)(Expi (Expiration Date) Work to Start Inspectiory�Date Requested: Rough Final Signed under th, penalties of perjury: n /' FIRM NAME LIC. NO. Licensee ��EaLA_)C v�/1�e.9CL Signature LIC NO. 13�9 Address -eC % .9� /yf/71 c Bus. Tel. No._:o Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee DOES NOT HAVE the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner ❑ Agent ❑ (Please check one) J Location No. Date 12 - J-1 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ CHU Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 9 27L 711 Buil6agLnp6ctor TOWN OFNORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHERTHANAL.ONE OR FAMILY DWELLING /�T�W��O eJ s. Lj.4 Jl"1:a1oQ for VIaICia] Use OniV';.'`V''�: ^...,2ae.s`� BUILDING PERMIT NUMBER: //0DATE ISSUED: SIGNATURE: 4C '31a cf !1D Builcung Comnussioner/19spector of Buildings Date SECT}sri >< : altJl � 1.1 . Property Address: sr C � / A FAX 1.2 Assessors S3 Map Number Map and Parcel Number. � S Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.LC.40. § 54) 1.5. Flood Zone Information: Zone od Zte PPrubblfric❑ Outside Flood ❑iy1 1.8 Sewerage Disposal System: ticipal On Site Disposal System ❑ tt�� .}}Privater0 . .:m 1 S tJ�,.U�IlyIJ�lt{y.r rYti 2.1 Owner of Record '� rilepaope(t�k is Name(Print) A d Address for Service : 6�E !ve)twhy" 6 $a - 7 Y 9' Signature Telephone 2.2 Authorized Agent :Jame Print Address for Service: i TO- 0027 �tgna a Telephone 3.1 Licensed Construction Supervisor --ZA-meS Not Applicable ❑ Address a3 License Number Licensed Construction Su Expiration Date 3 Sigrt Telephone 3.2 tAistered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone Cit L ofe d O M X Z O Z M 90 O D r v M r r Y/ SECTION 4 - WORKERS COMPENSATION,(14G.L C 152 § 25c(b} Workers Compensation Insurance affidavit must be completed and submitted with this application. issuance of the building permit. r 1 Failure to provide this affida-vit will result in the denial of the Sinned affidavit Attached Yea .......❑ No....... ❑ SECTION 5 - PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES . FOR BURDINGS AND STRUCTURES URES SUWECT: TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAMG MORE THAM? *?0" GF. OF ENCLOSED SPACE) 5.1 Registered Architect: R rrr i� )% kolK i�, f itmrqij Name: Address Signature Telephone 5.2 Registered Professional' Enoneer(s) Area of Responsibility Registration Number Expiration Date Name: Address: Signature Total Not applicable ❑ i e Registration Number Expiration Date Name: Address Signature Telephone Area of Responsibility Registration Number Expiration Date Name Address Signature Telephone Area of Responsibility Registration Number Expiration Date Name Address Signature Telephone 53 :.Ge ral C4ntr �Q`J��IG 1>1�11C1tf1� rj�(�1�Cc� c.1�/l/G Not Applicable ❑ Company Name: Responsible in Charge of Construction SECTION .DESCR) TTN. Off' PROPKYSED WORK (check all applicable) New Construction 0 Existing Building 0 Repair(s) ❑ Alterations(s) Addition Accessory Bldg. 0 Demolition 0 Other 0 Specify Brief Description of Proposed Work: S111179 `/ S god -A9 SiyO �T t©f.k S1�crtoN 7 - us>�cotsttrox USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly 0 A-] 0 A-2 ❑ A-3 ❑ A-4 0 A-5 0 IA IB p ❑ B Business ❑ 2A 2B 2C 0 0 ❑ C Educational ❑ F Factory 0 F-1 0 F-2 ❑ H High Hazard ❑ 3A 3B ❑ IInstitutional ❑ I-1 ❑ I-2 ❑ I-3 ❑ M Mercantile ❑ 4 J, R residential 0 R-1 0 R-2 ❑ R-3 0 5A 5B ❑ ❑ S Storage 0 S-1 0 S-2 ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use 0 �Specif}•• COMPLETE THIS SECTION IF 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: 18 LAIN . 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 Independent Structural Engineering Structural Peer Review Required Yes ❑ No 0 SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Hereby authorize Owner of the subject property My behalf, in all matters relative two work authorized by this building permit application Signature of Owner Date to act on AWE' V I, as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury Print Name �7 Sigrffe of Owner/Agent Date S] CTION 1f �-ES3'IE AI D C. IICi'IONCt?S�' Item Estimated Cost (Dollars) to be Completed by permit applicant .. OIt`FICUL USE ONIL1l ^p 1. Building(a) Vo • 0o 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) W, ` o Check Number S_ ! NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 sr 2 NU 3 RD SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRvviNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Town of North Andover t ,ORTH OFFICE or ° C0'1'v1 Ii7NITY ]DEVELOPMENT AND SERVICES h a " 27 Charles Street Norte Andover. Massachusetts O l S-: � �`'•••,° • `�7 a WZT..Li*,f J. SCO -7 i Director (973) 638-9;3 I Fax (97S) 63S-q�-_ In accordance with the provisions of MCL c 40 S 54, a condition of Puilding 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 c 11, S 15 7 A. The debris will be disposed of in: L L<-lDsim? �Z:zu �ZIEM (Location of Facility) Sienature of Permit Applicant ►7 0 Date NOTE. Demolition permit from the Town of Ncrh Andover must be obtained for tl is project thrcuc-h the Office of the 6uildina Insp;ec=cr N A iTDC:G o3' -'�5 t; CG^i$E2V ?TION 6:'.Z-):.: Ii_.-.. b3:: -')5;J PL.L,', i!':C: b33-'1'_. —' The Commonwealth of Massachusetts 1-20 Department of Industrial Accidenz ��._,;� � OI1%C� 01/DYBSIly3t10AS , ry 600 Washington S/ree: - � Boston, Mass. 02111 workers' Compensation Insurance Affidavit C I ar-. a homeowner eerormins all work: myself. I ar a Seie prooremr and have no one working in any capacity [ ar an e nclayer provicing worxe.s. come ion for my e:;tolovees worxin; on this job. &V7 �l-t /VVIi�S �"f � �! /� n�nnr / �U� /SQ - VV ?? I �,� a Seie crecre:er, ;enc=i contnc:or, or homeowner (circ!e ones and have hires the coca -ac -ors ILted below wco Live the *-cllcwU'.1z workers' ccmcenSaCcn pelices: cama»Y IMP• C,^,.. nhnR' j .. ...... ... 1. In'q* f +� r r�• �nlir, 3 �'" nhnn� •'• In!arinr --7. Fatiurc :o :scar. coverage ss req utrca unucr:cc::on _S.a of tiIGL 15: can lead to the imoosuton of cr7mtn2l penatnc of a fine up to S1500.M iac'or one year:-' imor.sonmcnt as wc:l as civii-cnaltsc_ in the form of .t STOP WORK ORDER and a fine ofS100.00 a day against me- I undenaad :has a coov of '%:s sc:c.ncnr may Sc for+ares- :a the Of&cc of Invcsagations of rhe DIA for coven;t ver:tication. ja rereay i 1 der :he �ai.v d �r^ai:rt of prriur� char rhe inlvrmation prow rar� ioove is trlt arsd carte .- - - l �^�f7a o '--c �I f1hI (1RN� °`rens- 7 — / V —00 ot7ic:at ase snry do not wr:tc in :t:ts ;rca :o oc camptc:cti by c:tv or town otTtcial c•ri or :own• permtUlice.^.:e . ^ccx :( m-<aiate rc:ounsc a rcautr-u contac: per:on: tsar- :.D7 )'.a, pnonc .+: r'3utldiag Dcparmcat [ L:ccnsing 3a2ra [Jciec:mcn's Office "Health Dcoar.mcnt r•Othcr FORM U - LOT RELEASE FORA 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. FILLS OUT APPL!CANT '4]e fade, LOCATION: Assess&s Map Number SUEDIViSION STREET #174 57— PHONE ` Zy v� PARCEL LOT (S) ST. NUMEER� OFFICIAL USE CNLYS�t' " �*" "* ** t* RECOMMENDATIONS OF TOWN AGENTS: I CONSERVATION ADMINISTRATOR COMMENTS TOWN PLANNER COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUELIC WORKS - SEYVER/WATER CONNECTIONS DRIVEWAY PERMIT' FIRE DEPARTMENTI")4— "C RECEiVED EY EUILDING ii ISPECTCR Revised 5',9; im DATE March 15, 2000 YALE. Mr. Robert Nicetta Building Commissioner Town of North Andover 27 Charles Street North Andover, MA 01845 Dear Mr. Nicetta, This letter will serve as my approval as the representative of Yale Properties, Property Manager for North Andover Mills, that the attached construction documents as specified in this letter and marked Exhibit 1 for the alterations to existing doors and the installation of a new door for proper emergency egress on the forth floor of Building No.3 between Quantum Bridge Communications and Net Manage, is hereby `approved' based on the scope of work indicated. Attached please find three sets of these documents along with the signed affidavits from the Architect and Engineers. The following construction document has been reviewed and approved by this office: ARCHITECTURAL A201 PARTITION PLAN — 4TH FLOOR DEMISING WALL — BUILDING NO.3 If you should have any questions, please do not hesitate to call either myself or my Building Engineer — Arthur Boujoukos, Yale Properties. Many thanks for your help and advice. Sincerely, David G. Cohan Property Manager North Andover Mills One High Street, North Andover, Massachusetts 01845 Tel.: (978) 682-8708 Fax: (978) 682-8713 AFFIDAVIT FOR , ARCHITECT AND ENGINEER THE COMMONWEALTH OF MASSACHUSETTS COMMONWEALTH OF MASSACHUSETTS SS: COUNTY OF ESSEX On his 25th day of February, A.D. 2000, before me, r--5rty'left— Linda S. Smiley, who, being duly sworn, deposes and says that she will review the preparation of drawings for Quantum Bridge tenant demising wall and related NetManage egress on the fourth floor of Building 3 at North Andover Mills in North Andover, Massachusetts; and that she will review and/or provide for the proper checking of all the working drawings and shop drawings for construction; and all modifications to the existing structures will be designed for construction in accordance with applicable provisions of Chapter 1, Section 116, Massachusetts State Building Code, and that such plans conform to all the applicable provisions of the Massachusetts State Building Code, and that all the materials used in the construction will be selected by specification by her or her registered professional Designee in accordance with the Controlled Materials Procedure therein defined. �7 Sub c ibed and sworn to before me this day of A.D. MOO. Notary Public My commission expires on \\Advfs0l\Projects\Projects\Affidavits, Bldg. Insp. Letters\QUAN BRIDGE PH. 11 YALE WORK AFFIDAVIT.DOC P ' No. 10080 HAVERHILL, MASS. , CAROLYN GROVER Notary Public nonwealthof Massachusetts My Commission Expves June 9, 2006 l� G z A o00 c� o U z or - co U coto w � w U w OZW w U w U cn w o z cG° w w c r= cn cn ui am T 011, U6 0 O V v P4 • r.a 2 2 0 O O C . L O V Z CD O y D � C� cm I O � O — .y CD mCD m HCD t *.+ Z O � 3� co co L env o a CL tMQ C cc C C C Z ts CD C) V2 � C C_ C a CO) rmmb� LLI 0 Lli w w Ir LLJw U) c� o 'arc O � c +- bC. :Nib: C Hca O � m c �= o cL � � o a O O V cm oN C O f c a� 0 = t O pf CL 0 V y O z � O ld C! n C yO C Q = m m 3o O N ~ o � m CO) .0.. N O pw r OC OZ w •N. W N n=Z Ci m 0-0 C CO n O' O6 T 011, U6 0 O V v P4 • r.a 2 2 0 O O C . L O V Z CD O y D � C� cm I O � O — .y CD mCD m HCD t *.+ Z O � 3� co co L env o a CL tMQ C cc C C C Z ts CD C) V2 � C C_ C a CO) rmmb� LLI 0 Lli w w Ir LLJw U) Location A # No. Date /0,- 1 o TOWN OF NORTH ANDOVER $ Certificate of Occupancy Building/Frame Permit Fee $ 9 0 0 S CMUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 1/90 0 Check# C01�23aj 18215 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 Section for Official Use BUILDING PERMIT NUMBER: , / DATE ISSUED: -- C�-�- SIGNATURE: Buildi!& Commissioner r of Buildings Date 5 a-. }Property 1.1 Address: 1.2 Assessors Map and Parcel Number. Map Number Parcel Number 1.3 Zoning h►formation: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Fronts ft 1.6 BUIIAING SETBACKS (f1) Front Yard Side Yard Rear Yard ReqWred Provide Required Provided ReqWred Provided 1.7 Water Supply M.GI-C.40. § 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal On Site Disposal System ❑ j 2.1 Owner of Record yjg—/ 4�� 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 si�,gr,-zn D' 2s/ / License Number Licensed ction yr. �l Z Z4UC Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable Company Name Registration Number Address Expiration Date Signature Telephone v a M J J AMO t Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building it. Signed affidavit Attached Yea .......❑ No ....... ❑ SECTION .$ f2- oft 5IIM ����t'"� R�[ .� � ���,� -CONS QCf C't _Y 5.1 Registered Architect: Name: Address Signature Telephone CC •e, cfa i C J + Area of Responsibility I-Ito6 z Name: Registration Number Address: Expiration Date Signature Total Not applicable ❑ Name: Registration Number Expiration Date Address Signature Telephone Pec,,', Area of Responsibility Name 3zs �i Registration Number Expiration Date Address Signature Telephone Area of Responsibility Registration Number Expiration Date Name Address Signature Telephone 611 Not Applicable ❑ Company `Name: Responsible in Charge of Construction New Construction ❑ ^ Existing Building 1"', f _ Repairs) ❑ TAlterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: A Assembly ❑ A-1 ❑ A4 ❑ A-2 A-5 BUILDING AREA EXISTING if applicable) PROPOSED I Number of Floors or Stories Include Basement levels Floor Area per Floors 11era 0 0 c)ertfry clf Total Areas ri?� d et w' Total Heiaht (ft) In ndent Structural Engineering Structural Peer Review Rapired Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ,as Owner of the subject property Hereby authorize _ My behalf, in all matters relative two work authorized by this building permit application Signature of Owner Date act on USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A4 ❑ A-2 A-5 ❑ A-3 ❑ ❑ IA IB ❑ ❑ B Business 2A 2B 2C ❑ ❑ ❑ C Educational ❑ F Factory ❑ F-1 ❑ F-2 ❑ H High Hazard ❑ 3A 3B ❑ ❑ IInstitutional ❑ I-1 ❑ 1-2 ❑ I-3 ❑ M Mercantile ❑ 4 ❑ R residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A 5B ❑ ❑ S Storage ❑ S-1 ❑ S-2 ❑ U Utility M Mixed Use S Special Use ❑ ❑ ❑ Specify: Specify: Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND OR CHANGE IN USE Existing Use Group: Existing Hazard Index 780 CMR 34: kh1 Proposed Use Group: &e��esr Proposed Hazard Index 780 CMR 34: /1 A BUILDING AREA EXISTING if applicable) PROPOSED I Number of Floors or Stories Include Basement levels Floor Area per Floors 11era 0 0 c)ertfry clf Total Areas ri?� d et w' Total Heiaht (ft) In ndent Structural Engineering Structural Peer Review Rapired Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ,as Owner of the subject property Hereby authorize _ My behalf, in all matters relative two work authorized by this building permit application Signature of Owner Date act on I, ,as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury Print Name Signature of Owner/Agent Date w, Item Estimated Cost (Dollars) to be Completed by permit applicant 1. Building„ (a) Building Permit Fee j Z s oa O Ud , Multiplier 2 Electrical (b) Estimated Total Cost of r% 0 O v Q�( Construction from (6) � 1 70 d0 0. 00 1/70000.00 3 Plumbing Building Permit fee (a) x (b) SS" 0a O O*H900, 4 Mechanical (HVAC) s✓ti 5 Fire Protection -5'C10 a Oo 6 Total (1+2+3+4+5)D �o0o p O Check Number 1 j51. h'k� '6 Fl i ,,r }}. td• S .���" >=-.hi-'•9 T}aw ri 4y� 1 e i'. .p •3�. �, y Y ...1 4 y `f ?...ar. 1 -F � t .;., ..f, .:� 4- s,•"`*?,a.�,� p��t,p,i�� �^4 un�S"k, v ,.A �e� k�'+tr.;>,4eit�'' � n .,� �>d , ' y,`3'9,�yy�55•,4 Y:i`��i,'9.1. `t/�-. , ..� F/„����� ::..£.7 j _1 7{^(Y+tl1 1. �)w ��.'i�,{d.. '� .L` J. �5?�tut`'ti. ir- ln':4 k � sY`� �.:3. t.�, C.' n Y:w�A4 1l"7 ;/fC,t�i #id. . �i P�,.�F ;.a... A %IR��-dpf ?}ii .f�.. NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS PT 2 ND 3 RD SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING x MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE -M4 .moi {�tv'{£ 'i i4 SbM� fij ,E^`�.�A'_6:. t by ✓.,$'uy,{ ,}4„y �, -.. i PK t �.. r �i j May 3, 2005 Michael McGuire Building Inspector Town of North Andover 27 Charles Street North Andover, MA 01845 Re: Schneider Electric, North Andover Mills, One High Street, North Andover Dear Mr. McGuire: Yale Properties USA, Inc., as agent for owner, is allowing Schneider Electric to submit the following documents, pertaining to the first floor of Building 14 at One High Street in North Andover, MA, for your approval: Architectural Drawings by Siemasko & Verbridge, Inc., dated April 4, 2005: ALL, A1.lA, Al.1B, ALIC, Al.1D, A7.2, A9.1, A9.2, A9.3, A9.4, A9.5A, A9.513, A9.6A, A9.613, A9.7, A9.8, A9.9, A9.10, A10.1, A11,1, Al2.1 and Al2.2. Mechanical, Plumbing, Sprinkler and. Electrical Drawings by D&L Engineering, 1 C, dated April 26, 2005: M1.0, M1.1, M1.2, P1.1, SPL1, ELI, E1.2 and EL -31. Enclosed are three (3) complete sets of plans along with affidavits from all necessary architects and engineers involved. If you have any questions in regard to these documents, do not hesitate to contact Bruce Gorham, Senior Property Manager at (978) 453-6666. Your prompt attention to this matter is appreciated. Sincerely, E. Lesko, III, RPA )r of Operations Enclosures cc: Thomas A. Palmer, Schneider Electric (w/o enclosures) Cross Point, 900 Chelmsford Street, Lowell, Massachusetts 01851 Tel.: (978) 453-6666 Fax: (978) 454-6394 04/12/2005 20:25 7elB953271 VANTAGE PAGE 01 ��arMafaldq 600 WQshMOOn Street Boston, Mas 02111 Workers' Compensation jouranceATiclavit 111 am a homeowner performing RU work myself. • 62 70 ❑ I am a sole proprietor and have no one worloag in saya � citY I am an emplayEr providing workers' compensation for m Y emPIoYe" working on this mamma ob. :"••� :.`""tiJ 4P'"'`•w,a.�t��i;�^f,`."."i,`P;,h-��:F7'� ` ,• �) , ,�,�}sP a.s.� Y`. ;:5� Y•.�Y Yi1'..,y�,.,a,� � �,� �,... .. :, o-. ;'sf^ tin l"\y iaCS S C'a<ai'A e"e�f : .a ��;er . •... r u° {a� �F .. fi ' dS . t+i� t "K'SK '°� '•-N .. .t• ... x•�:.R.i, ��yn.'•„'-N•'-=`. 'a�C" •'y��a♦.,�'.,y�.� ��a k�' vt,• hy�yv', i��'�j' ..�„ i. •L �7A. .f.' S`�,d\. b�.�^_;F. ;a-�24. `•ii.� Ate... ., '• 0. .�iC.:Y. :.vu i •: :!.„^\cad, -�,{ x ,A.... z�,... :"M''�h,'.a3.'�x� .�;,?:.•'_'.: "ik�: ;d • ••;5;y.- ':^.•oaf ��„- :t .a.••,+ri.' •, ..:� ..:. �;:. �RLi .:'ki"'DF%�!'�; zT + f 7v:..p: E':7, - w .>::.., a �e5+�0 •, �i.:y i . n? 7�j::' "v •'„Nro. 'e�?s •'� . »+� � ^. -••aa.:,:,::: 4o-'. '� �qt�� \%� • ••��''4..�? �• . � ' d65-�pi�j ' \i{'�' • tN a.,. � .. ... .� /i \ . .\,� 1• '. L.i •� . �.. Z am a sole propritro eneMI contractor or homeosvoer (ePrclr oar) and have hard the contra v rba: foUawing workers' compensation police&. txors i>Ested below who have I 1A �: •- moi' f . - �• ��� �+ r cgwrt a aaaer 5ecdon 25A of MGL 152 ecu lead to the Fmpmtlon oferiminai -- One .•cora` Fmptement nt as well as ei"lrde penaitiee In the form of a STOP RrORK ORDER and a fine of 5100.06 a dog against e u I ngderstand tLat a cop}• of this statrrneet may be forwarded to �e O�1Le of Iaveatigatiena Ofthe DIA for eovenge verffiation. penalties of a fine up to $i,S00.06 and/or I da hereby' certify render thr pclrts.m,d . Perraltltt ofpe T �ry thin alae r`aforarariorr Provided above & tater acrd rowed Signature • Print ntana one d olTiciat oar only do not write in rhia area to be rompieted by city or town o(fidal ren• or to►,•n• per'tnitgicenat a 0 check if Immediate respeeac Is requiredBuilding DggrtmcAt OLicerising Boa; rd person: !]Selectmen's Office phone 0. ❑Heairb Department Other��_ fmu113N: PIA) FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTION APPLICANT �14�lq e PSS PHONE LOCATION: Assessors Map Number PARCEL Z_5 SUBDIVISION 11714 >_ STREET_ , 4 / .S5 ST. NUMBER i OFFICIAL USE ONL RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWER/WATER / DRIVEWAY PERMIT r/ FIRE DEPARTMENT C — 57 D S` RECEIVED BY BUILDING INSPECTOR RevhW OW jm Construction Control Affidavit Project Number: 500410 Project Title: Converse Inc.. Tenant Renovations Project Location: 1 High Street, North Andover, Massachusetts Name of Building: 1 High Street Nature of Project: Tenant Improvements In accordance with Section 116.0 of the Massachusetts State Building Code, I, Beth A. Dininio Registration Number 32571 being a Registered Professional Architect / Engineer hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Architectural Structural Mechanical X Fire Protection X_ Electrical __Y_ Other (Specify) 'FL -U W 2, 1 NG 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 all applicable laws and applicable laws and ordinances for the proposed use and occupancy. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 116.2.2: 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. Review and approval of the quality control procedures for all code -required controlled materials. Special architectural or engineering professional inspection of critical construction components requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix B. I shall submit, as necessary, a progress report, together with pertinent comments to the Inspector of buildings, Town of North Andover, Massachusetts. Upon completion of the work, I shall submit a final report as to the satisfactory completion and readiness of the project for occupancy. of M�ss� Signature T 2� 0�- BETH A. DININIO MECHANICAL No. 32571 affida,&doc -0 'f, - STE��� �� Construction Control Affidavit Project Number: 500410 Project Title: Converse Inc., Tenant Renovations Project Location: 1 High Street, North Andover, Massachusetts Name of Building: 1 High Street Nature of Project: Tenant Improvements In accordance with Section 116.0 of the Massachusetts State Building Code, I, William J. Leuci Registration Number 46062 being a Registered Professional Architect / Engineer hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Architectural Structural Mechanical Fire Protection Electrical X 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 all applicable laws and applicable laws and ordinances for the proposed use and occupancy. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 116.2.2: 1. Review 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 components requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix B. I shall submit, as necessary, a progress report, together with pertinent comments to the Inspector of buildings, Town of North Andover, Massachusetts. Upon completion of the work, I shall submit a final report as to the satisfactory completion and readiness of the project for occupancy. � �.� of mss Signature o� WUJAM LEUCI v ELECTRICAL No. 46082 AMCC affidavit.doc 04/13/2005 WED 08:12 FAX 978 927 6365 SIEMASRO AND VERBRIDGE www.sydBsign.com 126 Dodge Street Beverly, Massachusetts 01915 t 978.927.3745 f 978.927.6365 Upon completion of the work, Architect, and/or affidavits as to the satisfactory completion and t occupancy. shall submit final the project for i Then personally appeared the above named % Ifag U dliiIVOand made oath that the above statement by him is true. Before Me, JODI D. SULLIVAN Notary Pubile COMMONWEALTH OF MASSACHUSETTS MY COMMIU10n iyplha September 24, 701 P:\Commercial, Current\Converse First Floor\02 - General Correpondence and Project Info\Construction Control Affidavit 4-11-05.doc Q003/003 Sietnasko + Verbridge Architecture Interior Design www.sydBsign.com 126 Dodge Street Beverly, Massachusetts 01915 t 978.927.3745 f 978.927.6365 Upon completion of the work, Architect, and/or affidavits as to the satisfactory completion and t occupancy. shall submit final the project for i Then personally appeared the above named % Ifag U dliiIVOand made oath that the above statement by him is true. Before Me, JODI D. SULLIVAN Notary Pubile COMMONWEALTH OF MASSACHUSETTS MY COMMIU10n iyplha September 24, 701 P:\Commercial, Current\Converse First Floor\02 - General Correpondence and Project Info\Construction Control Affidavit 4-11-05.doc Q003/003 04/13/2005 WED 08:11 FAX 978 927 6365 SIENASRO AND VERBRIDGE.____ Sietuasko + Verbridge IArchitecture IInterior Design CONSTRUCTION CONTROL AFFIDAVIT PROJECT LOCATION: One High Street, North Andover, Massachusetts PROJECT NAME: Converse, Incorporated NATURE OF PROJECT: First floor renovation including fitness room and associated storage areas ARCHITECT: Siemasko + Verbridge, Inc. ADDRESS: 126 Dodge Street, Beverly, MA 01915 TELEPHONE: 978-927-3745 In accordance with Section 110 and 116.0 of the Massachusetts State Building Code, I, Thaddeus S Siemasko, Registration No. 6028, being a registered professional Architect, hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning, ARCHITECTURAL, 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 accepted engineering practices and applicable laws and ordinances for the proposed use and occupancy. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 116.2. 1. Review of shop drawings, samples and other submittals of the contractor www.svdesign.com as required by the construction contract documents as submitted for the 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 components requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix G. 126 Dodge Street Beverly, Massachusetts 01915 t 978.927.3745 f 978.927.6365 Pursuant to Section 116.2.2, I shall submit periodically, progress reports together with pertinent comments to the Town of North Andover Building Department. PACommercial, Current\Converse First Floor102 - General Correpondence and Project Info\Construction Control Affidavit 4-11-05.doc Q002/003 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: / s {c c% (L cation of Facility) 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 r WD Q 0 z ui am r aW4 a; O m• � L z a O h G C I �cm CO30 43 -� Z O� ding3 C O O � 0 cco CL a cma ca c ev ts z 15 cm 0 CL C..7 y O C C c — y 0 W 0 LLI U) 19 W W CC W W a a a x w l � � a 10, U x pG w w w" w w" ca cn v) ui am r aW4 a; O m• � L z a O h G C I �cm CO30 43 -� Z O� ding3 C O O � 0 cco CL a cma ca c ev ts z 15 cm 0 CL C..7 y O C C c — y 0 W 0 LLI U) 19 W W CC W W Date ..... 71�lto ........... TOWN OF NORTH ANDOVER PERMIT FOR WIRING CHU This certifies that .... ........ EJ. has permission to perform ......... ��.O .......... wiring in the building of ..... ty.afq.�k� ..... . .... at..../- .,114idl..ff., ................... ....,,,North Md M IS Fee ... f ....... Lic. Nq1,---e'1 Check . # ELEMICA, I;N-S-iicrOR '1 Commonwealth of Massachusetts Official Use Onlyv� Department of Fire Services Permit No. Ocu BOARD OF FIREPREVENTION REGULATIONS Revc 11/99yand Fee Checked -. ] 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 PRW 171 INK OR TYPE ALL INFORMATION) Date:-y'L'-f I+ Z(C;O 3 City or Town of: NWnk �!� 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) STu—ZT Owner or enan tqmrvi U13L:G 6a4coLS Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building [3c,r—�, Utility Authorization No. Existing Service Amps / Volts Overhead ElUndgrd ❑ No. of Meters New Service Ams / Volts Overhead ❑ Undgrd El No. of Nleters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 1t No. of Recessed Fixtures ����..� r No. of Ceil: Susp. (Paddle) Fans �uu�r ���u ue nawea o ute inspector o wires. No. of Total Transformers KVA No. of Lighting Outlets 2 No. of Hot Tubs Generators KVA No. of Lighting Fixtures 2, Swimming Pool Above ❑ In- ❑ rnd. rid. , 0. o mergence U511fing / Batten' Units No. of Receptacle Outlets j3 No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of DInitta esti on ing De 'i d s No. of Ranges No. of Air Cond. Tonal No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: I Number Tons Kati' No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating K«' Local Municipal Connection El Other No. of Drvers No. of Nater Heaters KW Heating Appliances K« o. f o NNo. of Signs Ballasts Security Systems: No. of Devices or Equivalent Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of 1\'lotors Tota! HP I Telecommunications Wiring: No. of Devices or E uivalent I OTHER: (2 6AN.-we :�Ni�S+=2,1�'l�?h`►S Attach odd itioc.:: d : -i! i/ desired, or as required br the inspector of {3'ires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work maySssue 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:) 9-30-2003 Estimated Value of Electrical Work: 00,'O�:' (When required by municipal policy.) (Expiration Date) Work to Start: .�V 1Sf 20:)3 Inspections to be requested in accordance with i\IEC Rule 10, and upon completion. I certify, tinder the pains and penalties of perjury, that the information on this application is trite and contplete. I-1101 NANIE: HELCO ELECTRIC INC. 19 LIC. NO.: A6238 Licensee: pa-(t—r. P, e>1t4Py&1 Signature LIC. NO.: (/fapplicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-532-7500 Address: ZERO CENTENNIAL DRIVE, PEABODY, MA 01960 Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hm-e the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ ownWs agent. Owner/Agent Si - nature Telephone No. PERMIT FEE: AC_11RD CERTIFICATE OF LIABILITY INSURANCI�ID JM DATE(MM/DD/YY) PRODUCER Kittredge Insurance Agency Inc 276 W.Main St., P.O. Box 1129 Northboro MA 01532 LCOE5 09/30/02 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone: 508-393-7744 INSURERS AFFORDING COVERAGE INSURED LIMITS INSURER A: Acadia Insurance Company INSURER B: Utica National Insurance Group Helco Electric and H & E Realty Trust Zero Centennial Drive Peabody MA 01960 INSURER C: OHIO CASUALTY GROUP INSURER D: A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR INSURER E: COVERAGES 09/30/03 - - --•- •••-- -• u—I -Qucu I U I nc INsuREU 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER DATE MM/DDm E DATEYMM%jRATjYON LIMITS GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR TBI 09/30/02 09/30/03 EACH OCCURRENCE $ 1000000 FIRE DAMAGE (Any one fire) $ 50000 MED EXP (Any one person) $ 10000 PERSONAL& ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY PRO- JECT LOC PRODUCTS - COMP/OPAGG $2000000 Emp Ben. 1000000 AUTOMOBILE LIABILITY B ANY AUTO BAC 3220991 09/30/02 09/30/03 COMBINED SINGLE LIMIT (Ea accident) $1000000 ALL OWNED AUTOS X SCHEDULED AUTOS BODILY INJURY (Per (Per person) X HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per (Per accident) PROPERTY DAMAGE (Per accident) $ GE LIABILITY TANYAUTO AUTO ONLY - EA ACCIDENT $ EA ACC $ OTHER THAN AUTO ONLY: AGG $ C EXCESS LIABILITY OCCUR E CLAIMSMADE TBI 09/30/02 09/30/03 EACH OCCURRENCE s3000000 AGGREGATE $ 3000000 b DEDUCTIBLE 5 X RETENTION $ 10000 $ WORKERS COMPENSATION AND TAM A EMPLOYERS' LIABILITY TBI 09/30/02 09/30/03 TORY LIMITS ER E.L. EACH ACCIDENT $ 500000 E.L. DISEASE - EA EMPLOYE 5500000 E.L. DISEASE -POLICY LIMIT 5500000 OTHER DESCRIPTION OF OPERA-nONSILOCA-nONSfVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Covering work performed by the insured. CCGTI CIl�A TC t1l1,-. - - -- •• •-• • • • .iNI I AUUI I 1U AL INSUKtU; INSURER LETTER: UANULLLATION NANDOVE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Town of North Andover NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Attn • Paula IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 146 Main StreetREPRES TIVES. N Andover MA 01845 ACORD 25-S (7/97) ©ACORD COR . RAT O 1988 ..