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HomeMy WebLinkAboutMiscellaneous - Bldg 6a aia. vvaraaravar rr--as va """J" aVal--1 DEPARTMMENTOMBlICS MVONSSramllvo Permit No. RD BOAOFFMPREVFM70N Occupancy & Fees Checked A.PPLICATIONFOR PERMIT TOP ORMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MA ACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical w r described below. Location (Street 6 Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes [Z] No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead Overhead Underground No. of Meters New Service Amps/ Volts Overhead Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work CA 0 " �o No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total �� ' � ^• �'w► c• KVA" No. of Lighting Fixtures Swimming Pool Above Below Generators ' -s '" '`' ", VA ro ground No. of Receptacle Outlets P . �.t No. of Oil Burners • ; r �• Nq. or Emergency Lighting Battery Units` No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No._of Ranges No. of Air Cond. Total Tons y No. of Detection and lo. of Disposals No. of Heat Total Total Pumps . Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW " No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW Connections a No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP 07. validpoofcfsanelodte0foa YES eglnvalat YES El NO M Y)mhmedrelodYES, pkwirxk*orePipeofoaW by rJ BOND r7 011M o ftm) D* Esti n*dVArofEbmxal Weds $ klspecfimD,*RaWesled Rough Final 'trlaltiesCfpetjtay: 1-1/� mt1r�,, — �\SL<�, t-,( . --I1(- • y L+o=Na ,L�.Q n�. �� Stgnattue LimlseNo BusirrssTUN6. — AIL Tel. Na :'SINSURANUWA1VER,IamawaethattheLioarsedotsnothavedleins mmmvera?sitsakst3&q ivalalcasm4litedbyMassad,=CmawLaws lysignakocndtispan tappiicab*mwaivesdutegtmanat check one) Owner a Agent Telephone No. PERMIT FEE $ � �6Uyy D K 4"�AIs7,o,f- 5%�S // 2-1 3 4T f Z owb 1 G�k Per 0,,-41- D !C_ P,T(Xl PTM Burt Hill Kosar Rittelmann Associates Architecture Engineering Interior Design Research 300 Brickstone Square Anttovcr, MA 01910 978.474.6405 FAX 978.474.6401 Construction November 8, 1999 Observation Report from: Ueda Smiley subloworolet t Number: Groupe Schneider North Andover Mills I", 2"d, & 3rd Floors, Building 6 B_H..Project No. 99827.01 Report Number: Date: 3 1118/1999 Comments: The following work occurred during the week of 11/1 toll/S/99: • All drywall work has been installed on floors 1, 2, and 3. • DrywalI taping is complete on floors 1 and 2. • Partitions are prime -painted on floors 1 and 2. a Light fixture relocation is ongoing. 0 HVAC ductwork distribution relocation is complete. • Sprinkler relocation work is complete. • Door frames are installed on the first floor. gedvfc.�ot\prolectslprojeCtS199827011correspondsncelbidg. 6-1,2,3 fl. Constr obser. report 3.doe Page 1 of t NOU-10 99 14:09 FROM:BURT HILL 978-474-6401 TO:508 688 9542 PAGE:02f05 Burt Hill Kosar Rittelmann Associates Construction Observation Report from: Linda Smiley SublecVProject Number: Groupe Schneider North Andover Mills 1", 2"A, & 3" Floors, Building 6 B.H. Project No. 99827.01 November 8, 1999 Architecture Report Number: pate: Engineering Interior Design 2 11/8!1999 Research Comments: The following work occurred during the week of 10/25 to 10/29/99: 300 Brickctone Square Andover, MA 01810 978.474.6405 FAX 978.474.6401 • Drywall has been installed on floors 1 and 2. • Electrical rough -ins are complete on floors 1 & 2, and ongoing on floor 3. • HVAC ductwork dictribution.relocation is in progress. • Sprinkler relocation work is 85% complete. • Plumbing rough -ins are complete. y:1projects189827011corraspoAaenee\mg. 6-1,2,3 fl. eonsir obser. report 2.doc Page t of t NOO-10 99 14:09 FROM:BURT HILL 978-474-6401 TO:508 688 9542 PAGE:01'05 Burt Hill Kosar Rittelmann Associates Architecture Engineering Interior Design Research 300 Brickstone Square Andover, MA 01810 978.474.6405 FAX 978.474.6401 Fax from: Linda Smiley November 10, 1999 To: Firm: Fax Number: Mike Maguire Building Inspector, Town of 978-688.9542 North Andover Tom Palmer Groupe Schneider 978.975-2968 Jim Burns Republic Builders 978-750-8893 SubjecUProject Number: Groupe Schneider Transmission information: Number of Pages (including this one): 5 Fax Operator: ff you do not receive all pages, ca11 tho Operator. Comments: Construction Observation Reports %%advfs011projects\profgets\99927011com3spondencetinspect. repo„ iax,doc Page 1 of 1 Date.... ........./:�- ..................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that 4....,`l ....................... has permission to perfbrm ........ ...... e ................................... wiring in the building ofz; ...... . ............... . .............. k .... ........ at '5:':'� .... North Andover, Mass. Fee Lic. No............ .................. ELECTRICAL INSPECTOR Check # 657 � Date. /73 - `. -). TOWN OF NORTH ANDOVER s _ r PERMIT FOR PLUMBING ,SSACNus j� T � This certifies that .. 1. ! . ...JJ. �.0. t^. Nt ..... .............. . has permission to perform ... .C.<'�- (�' �. 14 /: '',.o'^ ............. plumbing in the buildings of .. j4.! -s �`y.4 'z".. C. �. �. ......... at .. %. h! r j.l.. �.r..... :1� .6 ........... , North Andover, Mass. Fee. l� .`�. Lic. No..W.&/.t/. . _ ►. .. ...... PLUMBING INSPE TOR Check # 3 7 1 �- t.. 6 32 1 DEPARTARMOFPUR BOARD OF FIRE PREVFI MON APPLICATIONFOR PERNIlT TO ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Town of North Andover The undersigned applies for a permit to perform the electrical Location (Street d Owner or Tenant Permit No. Occupancy & Fees Checked RMELECTRICAL WORK ELECTRICAL CODE, 527 CMR 12:00 Date �. - -AD-- s To the Inspector of Wires: below. Owner's Address Is this permit in conjunction with a building permit: Yes [3 No (Check Appropriate Box) Purpose of Building Existing Service Amps�Volts New Service Amps Volts Number of Feeders and Ampacity Utility Authorization No. Overhead Underground No. of Meters Overhead Underground No. of Meters Location and Nature of Proposed Electrical Work l -'N ������ r R�cAn�Cca��g �, o< t� �. '� �o No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below ri Generators KVA round 1:1ound No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps . Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal _ Othe No. of Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER - 1C anoeComnga Puma oDdrm4mmo6cfMasadus&CtnaWLaws YES NO F1 waftrisedvalidpridofsam lotheOfta YOM-/r—T Y)mhaNedtad®dYFS pleaseirt&*tberAxofoDmr,4pby yJargthe box L� INSURANCEF-1 Expiraliml),* BOND F1 OTHM � (PleaseSSpecaY) Esl m&dValrecfElma ralW6k $ W0tk1DStatt 1spwjmD&R4Es02d Ra# Feral &grWunder&Pti*esofpajtay: \ HRMNAME Li=wNo. Li��e `1 �SLD� � U�� Signature � LiaarseNo 1`j1� S'1 � Btnurss Tel. Na At Tel Na OWNER'SINSURANCEWAIVER;IamawarethattheLioarsedoesmthavethemara mcoverageantsabsWnWgrmlartasmgmWbyMasmdxmZCoalLaws antithatmyagnaaueon thispem>itappbc�rwai�esthistegtriremalt (Please check one) Owner 1:3 Agent M Telephone No. PERMIT FEE rgna ure or Uwner or Agent UNIFORM ahint or Ty") A -='Y, -' // • �I � J SLI • _� I -N Building location L k l(�% New ® Renovation ❑ 1zc7 tON FOR PERMIT TO DO PLUMBING I^I /v6 a G17 Permit #_Ln �_Ovmer's Name Type of Occupancy rJ iCf Ci :ment ❑ Plans Submitted: Yes No ❑ FIXTURES Installing Company Name PJ i = J) I Li j^Y 1' ne,6 4j -WD .e Check one:. Certificate Address_ _ 9 0�oa54, / ? l c— ".4 � *Corporation ❑ Partnership Business Telephone R A -3 1io ❑ hrm/co. Name of licensed Plumber A vL (J . i0r1 INSURANCE COVERAGE: I have a currerA liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142: Yes No ❑ If you have chcked ye;, please indicate the type coverage by checking the appropriate box A liability Insurance policy Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Aoent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted jot entered) in plication a true and accurate to the best of my knowledge and that all plumbing work and installations performed under the,permit ' for this ap tion will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 • General to BY rtie Signature o um Type of Ucense: Master Journeyman C+tyRown O L license Number__ %//1 �� z Z q Y < N O N O .V Z +"' > O W W ffi Y Z J a C S ~ N Z O= ` « d am O J N W b r mA. W = O C r V < C W 0 a 39< C H d W < _Z o. .. < 3 F' X O= C W 0 7 w Q C W a a J Z C p a' C a !- V> x Z= �' Y A. .[ C r< Y Z Z. W u. A6 X X W < •' < r < O S h < N < O Z < 0 0 .� v1 < C C W C < O O 0 < S r > J m a c o J;= r. m v a < 3 C m 0 Sub—gSMT. BASEMENT 1ST FLOOR 2Na FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name PJ i = J) I Li j^Y 1' ne,6 4j -WD .e Check one:. Certificate Address_ _ 9 0�oa54, / ? l c— ".4 � *Corporation ❑ Partnership Business Telephone R A -3 1io ❑ hrm/co. Name of licensed Plumber A vL (J . i0r1 INSURANCE COVERAGE: I have a currerA liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142: Yes No ❑ If you have chcked ye;, please indicate the type coverage by checking the appropriate box A liability Insurance policy Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Aoent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted jot entered) in plication a true and accurate to the best of my knowledge and that all plumbing work and installations performed under the,permit ' for this ap tion will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 • General to BY rtie Signature o um Type of Ucense: Master Journeyman C+tyRown O L license Number__ %//1 �� P1 HORTPI Of <••tO ,a,4•C Ool 9 SSACHUS� Date. . �'.oA TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... ................... / r has permission to perform ... �-e.A ............ . plumbing in the buildings of ... V. -t. ov ....... at .. I../ -/r .�.1...r.1!.. .Y. ?......... , North Andover, Mass. Fee �! �/. �... Lic. No. PLUMBING INSPE TOR Check # ? 1 7 6321. MASSACHUSETTS UNIFORM APPLICATIC (Print or Type) GlA A>1 AW—r Mass. Dave I a Building 'OR PERMIT TO DO PLUMBING 19 Permit # Z A Owner's Name�L/ Type of Occupancy 0 ' FI Cli D Plans Submitted: Yes P( No O New Renovation O Replacement FIXTURES Installing Company Business Name of Licensed Plumber Check one:. Corporation O Partnership 13 hmi/Co. Certificate INSURANCE COVERAGE: I have a curr` 9t liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes�] No ❑ If you have ch cked Y—e;, please indicate the type coverage by checking the appropriate box A liability insurance policy X Other type of indemnity O Bond D 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 Anent OwneAgent ❑ I hereby certify that all of the details and 'information I have submitted for entered)in caue tion ar trand accurate to the best of my knowledge and that all plumbing work and installations performed under the,perrnit ' this app' tion will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of neral U Title Signature o umber Type of License: Master Journeyman D CityrTovm ' O L License Number N h z z mr, Y < • ' v► .� ma < V < W W m J z N < h G W 'n h '~ V C Y< z q OC k- = y d O t— V= m= O w a; e1 It W i eJ z a d < at = a<c 3 X W O F. W < Y C a • J NC h J < X p a r > F- O < z N p Y z 6 O O J N Z z < .� W m` k !G W s < < < r- J a e, < v C 5 x a < < 3 O a < m i- o sue—BSMT. BASEMENT 1sT FLOOR 2NO FLOOR 3110 FLOOR 4TH FLOOR STNFLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Business Name of Licensed Plumber Check one:. Corporation O Partnership 13 hmi/Co. Certificate INSURANCE COVERAGE: I have a curr` 9t liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes�] No ❑ If you have ch cked Y—e;, please indicate the type coverage by checking the appropriate box A liability insurance policy X Other type of indemnity O Bond D 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 Anent OwneAgent ❑ I hereby certify that all of the details and 'information I have submitted for entered)in caue tion ar trand accurate to the best of my knowledge and that all plumbing work and installations performed under the,perrnit ' this app' tion will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of neral U Title Signature o umber Type of License: Master Journeyman D CityrTovm ' O L License Number Location/ A/, `p S1 13 Zo No. 1o2 Date IL j`,�/-ds T TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee Other Permit Fee TOTAL Check # 17;80 $ c:P5 6U x - 1 1/4 y - Building Inspector n/o- �s 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 ICiA use Ori „ . ' C z'f✓ h'V= lam,_ < Rt�t'4_ l�' �t'Yr rr 17' 0. BUILDING PERMIT NUMBER: DATE ISSUED: — — - Y %O? / a( 'v?00� SIGNATURE: A 62—,� Buildin Commissionerfl or of Buildings Date sac"W 1+. 1.1 Property Address: ^~ 1.2 Assessors Map and Parcel Number. 41," 5:�, , -) S- Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zarin DistrictProposedUse Lot Area Fanta fl 1.6 BUIIAING SETBACKS (ft) Front Yard Side Yard Rear Yard red Provide Rewired Provided R red Provided 1.7 Wa a Supply M.c.L.C.4o. s4) l.s. F1eea zone >ate�� t.a Sa'-VDisposal Sya— Public 0 PrMo ❑ zone comae Flood zone ❑ Mmicipal On site Disposal System ❑ 2.1 Owner of Record C (\,o S 5 QJ o t,%;> A, qA I e- Qno �(Z�t�s _ `f 0 Chp(u�s Name (Print) Address for ice: q V)9-14 (0 Signature Telephone 2.2 Authorized Agent l'ii"/6 AeIU-4�ir4•V OZ� �+t?�Oic r�i.,/G it"X�/�D e /e, Name Print Address for Service: n t Telephone �. 3.1 Licensed Construction Supervisor J , G �N c 54LNot Applicable ❑ Address License Number 3k-?-3 Licensed Construction Supervisor: /V A.6 n 57— Expiration Date JO /'07-00 Isisfiaturc Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date , Signature Telephone 3 pe ��- SECTION 4 - WORKERS Workers Compensation Insurance affidavit must becompleted and submitted with this application. Failure to provide this affidavit will result in the denial'of the issuance of the building permit. Signed affidavit Attached Yea .......❑ Nd...... A SECTION S - PROFES 09A o D1SMM .00MMUM0N.SVMK C%S FOR. Bt3TiMM AND STRUCTURES SUHJBCT TO CONSIRIICTK>N CONTROL PURgUART3M M CMR 116 (CONTA11MG MORE THAND 34,M GF. OF ENCLOSED SPACE) 5.1 Registered Architect: Name: Address Signature Telephone &2 Reosbred ProfouiaW 1400eer(s s . Area of Responsibility Name: Registration Number Address: Expiration Date Signature Total Not applicable ❑ Name: Registration Number Expiration Date Address Signature Telephone t Area of Responsibility Name r Registration Number Expuation Date Address Signature Telephone Area of Responsibility Registration Number Expiration Date Name Address Signature Telephone 561Og Not Applicable ❑ CoPq)any Name: / (� 2rGGlao�t� f�U2d��izJ Responsible in Charge of Construction SECTIONb D► ©l+i r1F)PIROPCIBI !M—(cid ail ep1;164")' New New Construction 0 Existing Building 0 Repair(s) 0 Alterations(s) Addition Accessory Bldg. r, Demolition 0 Other r Specify Brief Description of Proposed Work: // © j % iU�C2 jo,¢ kg?GA ,/ 4-�'cvtn o� jOa2 Z.Z, 3 liyc !v �v�1�5 sti�sluS C �C- i C) USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-] 0 A-2 0 A-3 0 A4 0 A-5 0 IA 1 B ❑ 0 B Business N 2A 2B 2C 0 0 0 C Educational ❑ F Factory ❑ F-1 ❑ F-2 0 H High Hazard ❑ 3A 3B ❑ I institutional 0 I-1 0 I-2 0 I-3 ❑ M Mercantile ❑ 4 ❑ R residential 0 R-1 0 R-2 ❑ R-3 0 5A 5B 0 0 S Storage ❑ S-1 ❑ S-2 ❑ U utility 0 Specify: M Mixed Use 0 Specify: S Special Use ❑ Specify: COMPLETE TRIS 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: BUILDING AREA EXISTING ifapplicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floors 3 Total Area s IL VLM Structural Peer Review SECTION 10a Owner Anthorizadon - TO BE COMPLETED WHEN OWNERS AGENT OR FOR Yes ❑ No I, as Owner of the subject property Hereby authorize ) r'A -- /IV 610 y � 6G c to act on My behalf in all matters relative two work authorized by this building permit application Signature of Owner Ike 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 a�IAlL� Print Name /z 17,7 Signature of Owner/Agent Date W"7140,01 011, 0 Item Estimated Cost (Dollars) to be U ON4Y Completed by Mmit applicant 4 r 1. Building(a) Building Permit Fee ./F / 000 Multiplier 2 Electrical S D (b) Estimated Total Cost of Construction from 6 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical (HVAC) (p Do Z> 5 Fire Protection 6 Total (1+2+3+4+5) Check Number [)'� � � �^F�6 i;,wT t A cg�•fa F..- ixNy srl VIA ,��d' 1 r .,j,YF ) � � � { j`i" ��Y 1 �'4• afuk T-'�- (4 � !f� � � fiS �_ J l)L 3 k^ j• i F It '�}. ��a' �,,; ' r ... .., r,.. .i_:.:s �'*..'�)�{,`ry ?.r ., ., ..c1:`��.::',I ♦.��..� tr .. ,i r.. ..:i. ;an^�P, �. NO. OF STORIES SIZEi l� ODO 5� BASEMENT OR SLAB SIZE OF FLOOR TWMERS iST 2 x•y 3 SPAN .mak 5t� DEMENSIONS OF SILLS �. DEMENSIONS OF POSTS �. DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING t/ X MATERIAL OF CIEIMNEY <� IS BUILDING ON SOLID OR FILLED LAND Ii IS BUILDING CONNECTED TO NATURAL GAS LINE /( 41, .. , Wartuers Competutation losurance atfidmit trust be cmpkw Md submitted with this soman; Failure to provide this a�idAviit wig xmIt is the doW dtho ` issuedod Of the htuklitla tsnrm t. 5.1 Registered Architect Robert J. Stein. — Integrated Design Group, Inc. Name: oHnl d -s" -McCarthy - Integrated Design Group, Inc. _Electrical Area ofResppt%bility 4:1548. Regishatiop Nunber -06/30106 Expiration Date Name: 38 Chauncy Street, Boston, MA 02111 `, Address: 617-338-11Z7 Si Fatal Not applicable ,Q Registration Number Expiration Date Name Address Telephone ? Kevin Gregory —Integrated Design Group, Inc. Mechanicai Area of RespoA dbility 32334-M �egigration Number 06/30/06 Expiration Date 'Name 38 Chauncv Street, Boston, MA 02111 Address" 617-338-1177 Signature 0 Tetej*we. Arm ot"Re `biiity RegistratioaNumber Expiration Date Name — Addren Signature Teiepha Cerny Neaue: Not Applicable Q Revmsible in Cbaw of COUMxtion Dec 22 04 11:01a NORTH ANDOVER 9786889542 p.l 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. *+ *ai ******APPLICANT FILLS OUT THIS SECTION'"" "A A " I APPLICANT �' ��/� '.4 s PHONE LOCATION: Assessor's Map Number_;,` 1 PARCEL "� SUBDIVISION LOT (S) � `� STREET 1 ST. NUMBER OFFICIAL USE ONL RECOMMENDATIONS OF TOWN AGENTS: 1 CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED ' COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWER/wATER CONNECTIONS DRIVEWAY PERMIT FIRE 6fi RECEIVED BY BUILDING INSPECTOR DATE Rsrfad MT Im OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL PROJECT NUMBER: PROJECT TITLE: Tour Andover Controls PROJECT LOCATION: One High Street Campus _—_—_— NAME OF BUILDING: Building #6 NATURE OF PROJECT:_ Office Fitt________—___—_ — IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, Ib1�_��,----------- — ---- REGISTRATION BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT • ARCHITECTURAL * STRUCTURAL • MECHANICAL • FIRE PROTECTION • ELECTRICAL • OTHER (SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code -required controlled materials 3. Be present at intervals appropriate to the stage of construction to become, generally familiar with6the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. SUB BE MT EFORE ME THIS- a! __DAY OF_E _20-- NOTARY LIC MY COMMISSION EXPIRES I b!aC OFFICE OF BUILDING INSPECTOR a TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL PROJECT NUMBER: PROJECT TITLE: Tour Andover Controls PROJECT LOCATION: One High Street Campus________ NAME OF BUILDING:_ Buildijig 6_______ NATURE OF PROJECT: Office Fitup IN ACCORDANCE WITH AR 6 OF THE MASSACHUSETTS STATE BUILDING CODE, I,Q1�6�_sT-REGISTRATION NO.__�44 BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT • RCHITECTURAL • STRUCTURAL • MECHANICAL • FIRE PROTECTION • ELECTRICAL * OTHER (SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEDGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ARCHITECTURAL PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I OR MY DESIGNATED REPRESENTATIVE 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 116.0. 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code -required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become, generally familiar with6the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPAKY. SIGNATURE SUi 8tRIBQ ANDS OR O BEFORE ME THIS 02 15_t DAY OF %IC eq, --Ke v' 20 NOTAR BLIC MY COMMISSION EXPIRES__ =. OFFICE OF BUILDING INSPECTOR ;¢ TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL PROJECT NUMBER: PROJECT TITLE: Tour Andover Controls PROJECT LOCATION: One High Street Campus NAME OF BUILDING: Building #6 NATURE OF PROJECT:_ Office IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, REGISTRATION NO. 3434 -in BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT • FIRE PROTECTION • ARCHITECTURAL * STRUCTURAL MECHANICAL ELECTRICAL • OTHER (SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code -required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become, generally familiar with6the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. SIGN TURE SUBSCRIBED AND 6�M TO BEFORE METHIS DAY OF _ �/cc e►ri/ 20__�_ --- -- --------------- - NOTA PUBLIC MY COMMISSION EXPIRES-L4r I I I �, v�-O 10 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: (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the. Building Inspector �z3zz Name The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 . Workers' Compensation Insurance MUM Please Print Location: Clty Phone # I am a homeowner performing all work myself. F7 I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. I A 0, .v ComDanv name: Address City: Phone #• Insurance Co. Policv # WIM i i i /, Failure to secure coverage as required under.Section 25A or MGL 152 can lead to the imposition of criminal penalties of•a fine up to $1,5oo.o0 andlor one years' imprisonment.as w4.as_civil.penatties-In .thehmndA STOP WORK ORDa1AW_a.fine d.($lODM)A Jday, against M& 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone # Official use only do not write in this area to be completed by city or town official' City or Town PermNUcensin []Check if immediate response is required Dept ❑ Licensing Board Contact person: Phone #. ❑ ❑ Selectman's Office Health Department ❑ Other ,inn-io-c= tut ui.oi rn THLt rKVrtK11tZ rM NU. 1d(Ugb bjUq Y. UOUC January 18, 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: We (as landlord) have approved and arc submitting the following construction documents by the Integrated Design Group Inc., dated December 21, 2004 pertaining to Building 5 West, Building 37 and Building 6 on behalf of our tenant, Schneider Electric, for your approval: Building 5 West: AO.10, AL1.10, AD1.10, A1.10, AS.101, A6.10, PO.1, P1.2, FP0.1, FPI-2, M0.1, M1.3, MIA, E0.1, ED.2, E12, E22, E32, E6.1 and FF.L Building 37: AOJI, AL1.12, AD1.12, A1.12, A5.12, A6.12, P0.1, P13, P1.4, P1.5, FPO -I, FPI-3, M0.1, MIA MIA E0.1, EDA Eta, E23, E33, E6.1 and EF3. Building 6: A0.111 AA..11, AD1.119 A1.11, A5.11, A6.11, P0.19, P1.11, FP0.1, FP1.I, MO -1, MI -1, M1.2, E8.1, ED.I, ELI, E2.1, E3.1, E6.1 and EF.1. Enclosed are three (3) complete sets of plans along with affidavits from all necessary architects and eugineers involved.. If you have any questions in regard to these documents, do not hesitate to contact me. Your prompt attention to this matter is appreciated. Sincerely, YAL4 PROPERTIES tlSA J s E. Wiw., III, RPA D' or of Operations Enclosures cc: Thomas A. Palmer, Schneider Electric (w/o enclosures) Cross Point, 900 Chelmsford Stud. Lowell, Massacbusm 01851 Tel.: (978) 453-6666 Pax. -(978)454-6394 DATE (MWDD/YYYY) ACORA CERTIFICATE OF LIABILITY INSURANCE 1 08/17/2004 PRODUCER (781)681-6656 FAX (781)681-6686 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 7 Barry Driscoll Ins Agcy, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 600' Longwater Drive _ ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW i 0. Box 9120 rwell, MA 02061 4oINSURERS AFFORDING COVERAGE NAIC # INSURED 3. Calnan & Associates Inc. ��4\� INSURERA: Ohio Casualty Group 555888 10 Granite Street ����� D INSURERB: American International Cos 0004 Quincy, MA 02169� INSURERC: 804100 INSURER D: INSURER E: t�nvConcee THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINi ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR V NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIONLTR DATE IMMIDD/M LIMBS GENERAL LIABILITY BKW0453119614 10/01/2003 10/01/2004 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 300,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR MED EXP (Any one person) $ 10,000 A PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC JECT El AUTOMOBILE LIABILITY BA00453119614 10/01/2003 10/01/2004 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 BODILY INJURY $ ALL OWNED AUTOS A X SCHEDULED AUTOS (Per person) BODILY INJURY $ X HIRED AUTOS X NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY BX00453119614 10/01/2003 10/01/2004 EACH OCCURRENCE $ 10,000,000 OCCUR FICLAIMS MADE AGGREGATE $ 10,000,000 A $ $ DEDUCTIBLE X RETENTION $ 0 $ WORKERS COMPENSATION AND XWO0453119614 10/01/2003 10/01/2004 X I WC STIT, U- I oTH- A EMPLOYERS' LIABILITY ANY PROPRIETORMARTNER/EXECUTIVE E.L. EACH ACCIDENT $ S00,000 E.L. DISEASE - EA EMPLOYE $ 500,000 OFFICER/MEMBER EXCLUDED? H yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ S00,000 OTHER CPLL8088097 10/01/2003 10/01/2004 - $1,000,000 Occurrence B rntractors ofessional & $1,000,000 llution Liability Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ob: 04-102, Andover Bldg. 37. Andover Controls and Schneider Electric and Yale Properties are included as Additional Insureds for General Liaibility as required by a signed, written contract with he Named Insured. Evidence of Insurance for work performed within the Insureds scope of normal business operations. otice of Cancellation provision is 30 days except 10 days applies for non-payment of premium. Andover Controls Attn: Ed Howlett 300 Brickstone Square Andover, MA 01810 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE e EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE B. Driscoll/]MT ACORD 25 (2001108) ©ACORD CORPORATION 1988 Z W !d i� O w w P64 f K+. �1 4 O 2 �r •'a y 0 y E it O v COD 0 a Cos 0 V C !O CO3 O CD c O C 0 � m m 3 .o CD CL. 0 i O d CL. Cp Q C � on c .o zCD 5 CDCLy c I GG AG o o � =cv�c o C05,. C0CL 5cc Al ! z0 � 9 � o V E a IL a 0 CL ~ v x a � A � G vi m v C C w Zi ' W � L o Ey 'COD O O, � aC m; o�� 0 o O w w P64 f K+. �1 4 O 2 �r •'a y 0 y E it O v COD 0 a Cos 0 V C !O CO3 O CD c O C 0 � m m 3 .o CD CL. 0 i O d CL. Cp Q C � on c .o zCD 5 CDCLy c I o o o V =cv�c o C05,. C0CL 5cc Al ! z0 � 9 � o V E a IL a 0 CL ~ W ce4L y� i o o m3�z �p mJ vi m C C Zi ' W � L o Ey 'COD O O, aC m; o�� m ac O Z =, mor m 0 o _ C d0 O C Q m = m:ma _ N = ~ CL.— Go w ~ m W =O "0.16Jq t .r. 4!.ELu erg CL Cos ~ h _ o C.:d C _ go O O F- t. sm 5 O w w P64 f K+. �1 4 O 2 �r •'a y 0 y E it O v COD 0 a Cos 0 V C !O CO3 O CD c O C 0 � m m 3 .o CD CL. 0 i O d CL. Cp Q C � on c .o zCD 5 CDCLy c pt01ZTk off' tinv ,e'aH� - �� 3� �SSACFIIiSE� . CERTIFICATE OF USE TOWN OF NOR Building Permit Number 'y%c. THE BUILDING LOCATED OCCUPANCY AND VER S THA Date 3 - l/ 006- MAY BE OCCUPIED AS 1 t ��� A ��� f't a + 3 po p PZje rls_S j0o r —ro c,,- N doo t, f-, IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. / CERTIFICATE ISSUED TO y IZ AR aPe Sit es Awl, Building Inspector {,f 0 V w CA CA O m C ON CL ER :A -,H +�.Ea t1` ox&- CDc Cn Z x IV ..1�.ECA I :.� `NC, Iwo Q o ts CMLI ti \C w ` me � o o:z3�= cf) m O is W h m O Cf w� C �� OQ � W O air m a 0 Cos 'yZ m coo s a c o$~ r uiCOD �dt Z r r o .y O C.3 4D j H a O; O� = civ Om•� O H Z •O.. drm O v F+r I =cm CD 0 -0 N! 0� O 'g m m Z O� �3 as CD cc Oca E d a �a O � cc V 'fl Q ca C Z Q �..� Na C ev C c CIO 0 W 0 cc OL 4 �bo w w w U ii rx as cn cn w CA CA O m C ON CL ER :A -,H +�.Ea t1` ox&- CDc Cn Z x IV ..1�.ECA I :.� `NC, Iwo Q o ts CMLI ti \C w ` me � o o:z3�= cf) m O is W h m O Cf w� C �� OQ � W O air m a 0 Cos 'yZ m coo s a c o$~ r uiCOD �dt Z r r o .y O C.3 4D j H a O; O� = civ Om•� O H Z •O.. drm O v F+r I =cm CD 0 -0 N! 0� O 'g m m Z O� �3 as CD cc Oca E d a �a O � cc V 'fl Q ca C Z Q �..� Na C ev C c CIO 0 W 0 cc OL MECHANICAL FINAL AFFIDAVIT To the Building Commissioner: I certify that, I, or my authorized representative, have reviewed shop drawings and periodically observed the work associated with the Construction at Tour Andover Controls, One High Street Campus, Building #6 and that, to the best of my knowledge, information and belief, the work has been done in conformance with the permit mechanical plans and specifications approved by the Town of North Andover Building Department and with the provisions of the Massachusetts State Building Code, and other applied codes and ordinances. There are a small number of punchlist items that are being completed by the mechanical contractor, but these items have no impact on occupancy or the life safety systems in the building. Kevin A. Gregory 32,354 Engineer - Registration No. Integrated Design Group, Inc. �f �AsS Company o� IN A. GREGORY =+ � MECHANICAL No. MECHANICAL 38 Chauncy Street, Boston, MA 02111 Address 617 338 1177 Phone KarcJn 8 , 20 05 Then personally appeared in the above-named,Kevin A. Ljp: , and made oath that the above statement by him/her is true. Before me, ELECTRICAL FINAL AFFIDAVIT To the Building Commissioner: I certify that, I, or my authorized representative, have reviewed shop drawings and periodically observed the work associated with the Construction at Tour Andover Controls, One High Street Campus, Building #6, and that, to the best of my knowledge, information and belief, the work has been done in conformance with the permit electrical plans and specifications approved by the Town of North Andover Building Department and with the provisions of the Massachusetts State Building Code, and other applied codes and ordinances. There are a small number of punchlist items that are being completed by the electrical contractor, but these items have no impact on occupancy or the life safety systems in the building. John R. McCarthy 40. yisyis Engineer - Registration No. Integrated Design Group, Inc. N �Fsc Company JOHN R. yu, o MCCARTHY ELECTRICAL cn No. 41548 38 Chauncy Street, Boston, MA 02111 9 O 9o�F FQSTEq�N06� Address 617 338 1177 Phone AW/CC/f i g , 20 OC Then personally appeared in the above-named,Tti„ R. kAc- ++6,./ , and made oath that the above statement by him/her is true. Before me, My Cq(n)nission Expires: 1�0 .20 1'D ARCHITECTURAL FINAL AFFIDAVIT To the Building Commissioner: I certify that, I, or my authorized representative, have reviewed shop drawings and periodically observed the work associated with the Construction at Tour Andover Controls, One High Street Campus, Building #6 and that, to the best of my knowledge, information and belief, the work has been done in conformance with the permit architectural plans and specifications approved by the Town of North Andover Building Department and with the provisions of the Massachusetts State Building Code, and other applied codes and ordinances. There are a small number of punchlist items that are being completed by the architectural contractor, but these items have no impact on occupancy or the life safety systems in the building. Robert J. Stein Architect - Registration No. .`T J. Integrated Design Group, Inc. No. 3.;27 �'� Company 38 Chauncy Street, Boston, MA 02111 Address 617 338 1177 Phone &f� 6 ,20� Then personally appeared in the above-named, IRo6erf Sti; h , and made oath that the above statement by him/her is true. Before me, My Commission Arr'A 1 to , 20 I O I� 96�6 Date....... q.-...(.... �0.. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that A!oer ?/Iii' has permission to perform ............................................................................ wiring in the building of ............SCLr i / ...... . at ......1....7..E �f !?� ST .......................................... �Northh.,A,.ndover, Mass. Fee.17 Lic. No. jS37S4 !f9�y 1 / ELECTRICAL INSPECTOR Check # S6 1 .4 I 72 - Com lelion o r the. olloMhI table. m" be waived bthe Ins ectoh o YYires Ngoof tece sed luminaires No, of Coil ,Soap (Peddle) Fans o' ° f KVA Trans ormers No: of 1u�ri:Inairi QUtlets No, of Hot Tubs Generators KVA ]bio, of f,uminaires -Z`Z 0 W n -IN Swimming Pool rnd. 0 rnd. o. o m'ergency Epting ' r Bette Units '-t No. of Receptaple Qutlets No, of Qil Burners F>i#tE ALARMS No. of.Zo.nes No, of Syvitches No. of Gas Burners o. o etect.on an. Initiatin Devices N.o, oi' tgriges No, of Air Qond, Tons No, of Alerting Devices No. of"Waste Disposersea ump Totals um er: •,,,ons .No, c - e ontaine ' Ute tion/Alertin DeAces No, of Dishwashers Space/Areaunicipa Heating KW Local [J .`] Other Connection .. '... No. of pryers o.0 inter Heaters KVy Heating Appliances t{yy o. o o.. o S.i ns Ballasts ecus ty .yysterris; ' No, of Devices or. Equivalent Data Wiring: No, of Devices or Equivalent `� L No, Hydromassage Bathtubs. No. of Motors Total HP Telecommunications r ng : No. of Devices or u.iva.lent . flff�4WJ PfM4F ,vrFY1- "u-11 <v aesirea, or as reguirea oy me mmpector.ol wires. tunated: alu.. of Electrical Work;. (L Scxt, vu - (When required by municipal. policy•) ark to Start (2c,tc+" jnspections to be roquested in acpordance with MEC Rule 10, and upon completion, ;Si iYCE �iQ�'FrllZ°#010Uniess waived by the owner, no. permit for the perforrnaiice of electrical work may issue unloss it¢y�rseeprovides;proof of liability insurance. including."completed operati.on." coverage or its substantial equivalent. The dFts geed Certrties:that suoh cov. age is in force, and has exhibited proof of same to the permit issuing office. I>✓CfC C�NL, iNSURAN.U. J QNp �] Specify:) Cl a�xER fy:� eM 'r t4tEderfhe pr... tend penalties of perjury, r'hat the.infQrmgtlon on.this applioatlon is true and;omplete, rrz_ 77L.LIC:NO.; signal . apbltcgble te►lfer "exempt ' In the license number ltne j LIC. NO,: S' j 7 S dfes3; Bus- Tel. Na 97 S 3 7"gL -167.7 7 D t �N �"r / 1�l i F^r< 1 f L i Miff U! 3 S� �o> System Corilxactizr License required for this work i a livable enter the 1 nee number e, No 5o4-3a� 7^��z DANCE i?VAf t'it; I am aware that the f.icensee does not have the liability insurance coverage nortrtally lt>'ed b law, $y fsty szgrlature below,", I hereby waive (ills raquirerrierit• I am the {check ,ane [],Owner rnrl,9�ggnt 0 owner's .agent, isuTa' . Tele h,ane No, P PR11IT FEE.- 0 ES' D O b x Z 44 Q O C4 C SG p H U z z Q o v U ii O U w a X a�' w H U W a U U ,, w�' u Cf)c c u; 0 O a z O to a: c w E-� W Q a w c CQ o z 0 v o a� c CZO N O V V ac am cv me o co(A= E a V o a •:� E ,o CO o 0 t m C � N m 3 m co N C t0 5 m O aC.) O� g ;N=mO> tv C O Q O: az m ocr o HZ r:Coo a m i0 CL mc = m m = o o. cc � •N d.t O C V .- LU E c.3 N m p m C ti CL mCA O D = l0 v N O H L. CL... ym O_ too du Ml•s d=A 4 m O 0 • ra 7 2 0 CD 0 CD C: O z O 0 ti .y O I— CL O L C O CD V m CL H O C .CL C O O .c cc CLCIO i O V G� C. CO) C CD a' O .c CD o � CIO La 0 CD cv � 3� co DO O Q. c. Cm Q c � C O ca O CO Z Q C. COI) c LU 0 U) LU IrW W W LLL U) FORM U - ;OT 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. t************APPLICANT FILLS OUT THIS SFC T lON*********************** APFLICANT If, VM, PH0NEr 9 k /fZ LOCATION: Assessors Map Number SUBDIVISION PARCEL LOT (S) STREET Jy� ST. NUMBER USE RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER COMMENTS DATE APPROVED DATE REJECTED FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUELIC WORKS - SEWER/WATER CONNECTIONS DRIVEYVAY PERMIT FIRE DEPARTMENTY6 RECEIVED EY BUILDING ii ISPECTCR DA T E— Revised' 919; im The Commonwealtk ofiMlassachusettr Department of Industrial A'ccffents 600 Washington: Street Boston, Mass 02111 Workers' Compensation Insurance Affidavit do tcant=inneleasm= name - location • ❑ 1 am a sole proprietor, general contractor, or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name: — address cit -v: . - phone insurance co polic ..... _�.._............ .. _ „. _x..,.y..i.«.... .. ..wa.aw. .-�i';y yL ' 4 � ',S"^'.. ..-...� �.` "iaLi ':::�.__. �. iY aF x�3w �:'"7.r-R'3.u�.1Yr'ai�.�`•'d:''^,',uta ,�.lav�1 J' con•oanv name: - - address — _ insurance co. colic•%_ Attach.additionarsheet:it:necessar-�..�; Failure to secure coverage as required under Section 25A of .IIGL 1-52 can lead to the imposition of criminal penalties of a fine up to 51.500.00 and/or one years' imprisonment as well as civil penalties in the fortis of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DU for coveraze verification. do herebj, terrify under the p ' sand penalties of perjury that the information provided above is true a/nV. SignatureDate 77 e� Print name �i+9-r� es �UCnS Phone official use only do not write in this area to be completed by city or town official . city or town: permit/license a nBuilding Department r7 Licensing Board check if immediate response is required ClSelectmen's Office r-lHealth Department contact person- phone T; nOther___, evised 7/95 PJA) �rx Informatfaji and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", 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 encased in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a Iicense or permit to operate a business or to construct buildings in the commonwealth for any applicant who has no[ produced acceptable evidence of compiiance with the insurance coverage required. Additionally. 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. Please fill in the workers' compensation affidavit completely, by chec`snz the box that applies to your situation and sup,elving company names, address and phone numbers as all affidavit: --nay be submitted to the Department of Industr-,ki Accidents for confirmation of insurance coverage. AIso 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 rhti `eparment of Industrial Accidents. Should you have any questions regarding the "law" or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Decanment 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 iii the peruilYncense number which viii be used as a reference number. The aftidavits may be returned,-,-) the Department by mail or FAX unless other arrangements have been made. The Office of Investiaations would like to thank you in advance for you cooperation and should you have any questions. ?lease do not hesitate to give us a call. ;-.T^�isK-wR he Departmenress, telephone and fns number: The Commonwealth Of Massachusetts I)epartment of Industrial Accidents Office of Investigations 600 Washington Street Boston, IYIa. 02111 fax 9: (617) 727-7749 phone #: (617) 7274900 ext. 406, 409 or 375 Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 27 Charles Street North Andover. Massachusetts 01845 WILLLA,\4 J. SCOTT Director (978) 688-9531 /NORTH CF ,..c , ' O -13 ° .• � SACHU�� Fax (973) 688-9542 In accordance with the provisions of MCL 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 c 11, S 150 A. The debris will be disposed of in: d'J4"'d a L (SOST�� t'►'1 1q- (Location g-(Location of Facility) Sona re of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project thrgucb the Office or the Building Inspector 'J- r� 13OARD 0F APPS. LS 623-)54I 21_iLDING 6SS-9545 CONSEW TION 623-7530 IYE.^1 1: 633-950 PLA.`i'.` INC. 63S-')535 Octobers, 1999 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 on Exhibit 1 for the addition / alteration to One High St., ground floor, first floor and second floor of Building No.6, Schneider Electric, is hereby `approved' based on the scope of work indicated. Attached please find `signed' copies of these documents ( marked Exhibit 1) and a copy of a letter forwarded to Tom Palmer of Schneider Electric. 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 me October5, 1999 Tom Palmer Schneider Electric One High Street North Andover, MA 01845 Dear Tom, We have reviewed the construction documents dated September 17, 1999 for the proposed alterations to the ground floor, first floor and second floor of Building No.6. With regard to the approval process for the alteration of our building, Yale Properties, North Andover Mills, has accepted this proposal and approved these documents as outlined in the scope of work per construction document hand delivered by your contractor, Mr. James Burns of Republic Building Contractors. Documents approved are the following; A201/A501— Building No.6 Ground, First and Second Architectural Plan. M1/M2 HVAC Plan 99-2143 Sprinkler Plan EVE2 Electrical Plans <1 All concerned parties also agree that Yale Properties' approvals are contingent on the guidelines set forth by the Town of North Andover for the permitting of general construction. The Town Building Inspectors Office must make final approvals. Upon project commencement, please inform this office of any construction change orders effecting the `approved' scope of work prior to contractor authorization to proceed. A letter will be forwarded to The Building Commissioner's Office by close of business today indicating Yale approval of these construction documents. If you should have any questions, please do not hesitate to contact the Management Office at (978) 725-6700. Sincerely, avid G. Cohan Property Manager North Andover Mills One High Street, North Andover, Massachusetts 01845 Tel.: (978) 682-8708 Fax: (978) 682-8713 M 70 � O s 0 COM, X49314% C, o z 07 A W � r .. T � -:..I C6 i o s N f >< n N GN 01 l`i 1\ Ic r COM, X49314% C, o z 07 A o AS S11 i f� -33 i i Ir Z' l rp - � uj N c A 70 c S �O CA— r1 rf Q-3 '7 ti l J o V y�J f� -33 vJ N c Q-3 HYDRAULIC SUMMARY SHEET JOB. NO. 99-2141 SHEET NO. 1 OF 4 CUSTOMER'S P.O. NO. — DRAWING NO. 1 CUSTOMER'S NAME GROUPE SCHNEIDER ADDRESS NORTH ANDOVER MILLS. BUILDING 6, NORTH ANDOVER, MA. DESCRIPTION OF HAZARD OFFICES AUTHORITY HAVING JURISDICTION NORTH ANDOVER FIRE DEPARTMENT CALCULATIONS BY STEVEN E. SULESKI DATE 9-28-99 SYSTEM REQUIREMENTS AREA TO BE CALCULATED 1500 SQ. FT. REQUIRED DENSITY PER. SQ. FT. .10 ALLOWANCE FOR INSIDE HOSE STATIONS G.P.M. ALLOWANCE FOR OUTSIDE FIRE HYDRANTS 100 G.P.M. TOTAL WATER REQUIRED: 400.8 G.P.M. AT 91.55 P.S.I. REMARKS: WATER SUPPLY INFORMATION STATIC PRESSURE IN P.S.I. 120 RESIDUA. PRESSURE: G.P.M. FLOWING 2174 AT 100 P.S.I. ELEVATION 0'-0" LOCATION HIGH ST. IN FRONT OF BUILDING PUMP DATA: RATED CAPACITY: G.P.M. AT P.S.I. ELEVATION LOCATION TANK DATA: CAPACITY GAL. ELEVATION LOCATION REMARKS: ABBREVIATIONS o — FLOW INCREMENT AT SPECIFIC LOCATION Q — FLOW AT A SPECIFIC LOCATION G.P.M. — GALLONS PER MINUTE P.S.I. — POUND PER SQUARE INCH PT — TOTAL PRESSURE IN P.S.I. PF — PRESSURE LOSS DUE TO FRICTION PE — PRESSURE CHANGE DUE TO ELEVATION EE — 450 ELBOW E — 900 ELBOW L.T.E. — LONG TURN ELBOW T — TEE C — CROSS DEL. V. — DELUGE VALVE DRY. V. — DRY VALVE AL. V. — ALARM VALVE GV — GATE VALVE CV — SWING CHECK VALVE AV — ANGLE VALVE GLV — GLOBE VALVE ST — STRAINER HYDRAULIC CALCULATIONS JOB NO. 99-2141 DRAWING NO. 1 SHEET NO. 2 OF 4 NAPE GROUPE SCHNEIDER BY S.S. LOCATION NORTH ANDOVER MILLS. BUILDING 6. NORTH ANDOVER, MA. DATE 9-28-99 DESIGN AREA .10 GPM OVER 1500 SQ. FT. NOZZLE TYPE & LOCATION FLOW IN G.P.M. PIPE SIZE FITTING & DEVICES PIPE LENGGTHTH FRICTION LOSS P.S.I./FT. REQUIRED P.S.I. HYD. REF. PT. ELEV. N 0 T E S C=12o Q LGTH. 13.5 .0-74 PT -I - 00 ri= J• to FTG. P F v J + 3 9. 0 1 5 So. Q TOT. PE Q I JC S I LGTH. 2 g (� PT .00 FTG. 13.5 PF L Z Q 3 D. iD TOT. PE Q I JJ .3 I LGTH. 5• D 1 01 PT I( S FTG. j•J PF �. 07 PE 3 pp, Q 4 9• J TOT. 10.0 3 Q I� LGTH. 1033 $ I PT 19.93 A- FTG. PF 8,01 1 A I PE Q Da.S TOT. 3 Q Gi' 3 LGTH. $• 5 1 I PT 17.00 + K FTG. PF G. 11 9 Q TOT. PE 3 _, Q 5j S 1 I Z LGTH. IIS I .2�. PT 2� •11 -� K r 11. Io FTG. PF tq•49 t j 11 Q 2l I. Co TOT. PE Z Q 5i.9 LGTH. 1 • D PT PE 4 TOT. I Q 31.3 2" LGTH. 19.L1 I t!o PT P F 38.1 1.4 is 5 0 1, FTG. 1 J Q 3o0.8 TOT. PE Q 2L LGTH. 3 a 303 PT El. 11 11 FTG. ►2• PF 4.70 PE Ij SSS Q 3DD $ TOT. 15 5 QLGTH. w 55 0 j o5 PT 54,.57 3 T: (oD FTG. L 1 PF 12.81 PE Ij 5✓ Q 3nb.$ 1 (_ l TOT. 1'L2. L) Q �, LGTH. (. •D 02$ PT .l S /� 1-A`V' 10 FTG. 11 PF .5D T iJ 5$J Q 300.8 i- V: L TOT. 18.0 PE 16.49 Q U►JA. 1-(,V= 2 LGTH. I -CO Olio PT 816,11 I -T; 20 FTG. 39 PF 4•'18 \ 5 S J' Q L - - 12 TOT. l bA 0. PE 1.10 j c Q loo LGTH. PT 9• �5 FTG. PF PE TO TAI Q -4obl TOT. Q LGTH. PT FTG. PF Q TOT. PE Q LGTH. PT FTG. PF Q TOT. PE Q LGTH. PT FTG. PF Q TOT. PE Q LGTH. PT FTG. PF Q TOT. PE Q LGTH. PT FTG. PF Q TOT. E PT 5T 4% F0"M NO. II'li5-3/G7 PRINTED IN U-5, A. ' HYDRAULIC CALCULATIONS JOB NO. 99-2141 DRAWING NO. 1 SHEET NO. 3 OF 4 NAME GROUPE SCHNEIDER BY S.S. LOCATION NORTH ANDOVRR MTLT.S, BUILDING 6, NORTH ANDOVER, MA, DATE 9-28-99 nl7QTnM ARRA In r_pM nVRR isnn qn_ FT_ NOZZLE TYPE & LOCATION FLOW IN G. P.M. PIPE SIZE FITTING & DEVICES PIPE EQUIV. LENGTH FRICTION LOSS P.S.I./FT.C HYD. REQUIRED ELEV. P.S.I. REF. PT. NOTE S ; I2D Q t .. ��{ LGTH. S I S , O 1 9 PT FTG. PF 21 1 S.SU• Q 1q 8 o f 1 Q \�.0 t �'4 LGTH. 13 •� U -I I PT PF 22 -!16 FTG. 2 Q 2 S TOT. PE 1LGTH. Q O �- Iq 15.33 �JS P7 . \ $ t_T- 6 FTG. !a• PF l 1 J Q 5, $ TOT. 21-11 PE Q LGTH. PT I5 -- TOT. P F Q E Q �~ LGTH. 11.0 07 4 PT 'I. OD K S L FTG. 5 PF 1.19 PE 1 SSV Q Iq S TOT. IL.D I - Q t 6 0 ' " LGTH. 10.5 2 $ 9 PT 8• ti3 FTG. PF 3 03 + Q 3�-b TOT. PE ' Q \$ 4 ' LGTH. S- D ` PT, 11 2 1 -�- FTG. �•D PE l0 °J b 3 " Q -A 5.5 TOT. D D Q LGTH. PT K -I1 �► TOT. PE Q " I LGTH. It D D 7 g PT PF -I DO 1.55 2 t= 'i FTG. 5.0 'WSJ Q IrQ•$ I- T: 5 TOT. 21.0 PE Q LGTH. PT 8.55 6 . 0 TOT. PF 1.: j Q LGTH. II 7 PT PF 7.0 0 FTG. 1 55y Q 1 a TOT. PE \ Q I 7 j ` LGTH. -4 • G 2�11j PT -g5 � I -i: J FTG. PF 2.54 2 Q 3O.5 TOT. 3-o PE Q LGTH. PT l 0 -A I K 9 ,•q FTG. PF PE Q TOT. Q LGTH. PT FTG. P F Q TOT. PE Q LGTH. PT FTG. P F Q TOT. PE Q LGTH. PT _ FTG. P F Q TOT. P E Q LGTH. PT FTG. P F Q TOT. P E Q LGTH. PT FTG. P F Q TOT. P E PT ..7 . AOR.`-' NO t4 S -?/57 PRINTED IN U.S.A.