B-17-83 TITLE BOXING FIT OUT r
SLj 15 2. Cts Oy ��
f
The Commonwealth of MasSa"c"Nset
Department of PublUl( A
Massachusetts State Buildingg
1. 54
Building Permit Application for any Building other than a One-or Two-Family Dwelling
( (This Section For Official Use Only)
I Building Permit Number: Date Applied: Building Official:
SECTION 1:LOCATION(PleaseindicateBlock#and Lot#for locations for which a street address is not available)
No.and Street City/Town Zip Code Name of Building(if applicable)
0J)
SECTION 2:PROPOSED WORK
Edition of MA State Code used If New Construction check here❑or check all that apply in the two rows below
Existing Buildingj' Repair❑ Alteration ❑ Addition❑ Demolition ❑ (Please fill out and submit Appendix 1)
Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes .A- No ❑
Is an Independent Structural Engineering Peer Review required? Yes ❑ No-jik
Brief Description of Proposed Work:_
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑
Existing Use Group(s): Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.)
Total Area(sq.ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ F B: Business ❑ E: Educational ❑
F: Facto F-1❑ F2❑ H: High Hazard H-1❑ H-2❑ H-3 ❑ H-4❑ H-5❑
I: Institutional I-1❑ I-2❑ I-3❑ I-4❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R4❑
S: Storage S-1❑ S-2❑ U: Utility❑ Special Use❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA ❑ IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ 1 IV ❑ 1 VA ❑ VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Debris Removal:it
Perm :
Water Supply: Flood Zone Information: Sewage Disposal: TrenchLicensed Disposal Site❑
Public❑ Check if outside Flood Zone 11 Indicate municipal❑ A trench will not be P
Private❑ or indentify Zone: or on site system❑ required❑or trench or specify:
permit is enclosed❑
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable❑ Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor:
Does the building contain an Sprinkler System?: Special Stipulations:
1-tA`'; PANS
2,t�- r-0 ' Cc.
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
l I L c.-C 2t�c�-l` . �- foo
Name(Print) No.and Street C- V,�
` ' �1 Zip
Property Owner Contact Information: �L IV
c.vt-t.fIV "Le y c.svt-,
Title Telephone No.(business) Telephone No. (cell) e-mail address 1 ,
If applicable,the property owner hereby authorizes
Name Street Address City/Town State Zip
to act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)
If building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here❑and skip Section 10.1
10.1 Registered Professional Responsible for Construction Control
jolo R. j,i2 7f/ VtLj(l CC)
Name(Reistrant) Telephone No. e-mail address // Registration Number
35 P.� i
� oev_ R 14,641.', , e0'} ;111 uy /5_t.,ic, r E/31//7
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
4ti �
panyNdde
j,;iT ,� W,a(L-�` E 5 U C'1-I 7-00
Name of Person Responsible for Construction License No. and Type if Applicable
gStreet Addre City/Town State Zip
Tele hone No. business Telephone No. cell �— e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and
submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit.
Is a signed Affidavit submitted with this application? Yes❑ No ❑
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)_$
1.Building $ Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ p appropriate municipal factor)_$
3.Plumbing $ y Ota
4.Mechanical (HVAC) $ 3 1 - Note:Minimum fee=$ (contact municipality)
5.Mechanical (Other) $ Enclose check payable to
6.Total Cost $ 0 (contact municipality)and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
application is true and accurate to the best of my knowledge and
�S ' n G\C - 4:� ? M Sao_`15c3. 1?5
Please print and sign name Title Telephone No. Date
7_-1S t kawAn )- A oK q-c o
Street Address City/Town State Zip
Municipal Inspector to fill out this section upon application approval:
Name Date
t
r_ Initial Construction Control Document
l - To be submitted with the building_ permit application b% a
Registered Desitin Professional
for work per the 8t� edition of the
Massachusetts State Building Code. 780 CMR. Section 107
Project Title: Paradise Plaza: Title Boxing Club pate: 02/01/2017
Property Address: 19 Paradise Road, Salem MA 01970
Project: Check one or both as applicable: New construction Ezistin,� Cimsnuction
Project dcscription:
Converting an existing 6,963 s.f. retail space_into 12Zspaces�one 4 744 s f- one 2 093 s.f. tenant
- _ -_.1_ _ .-_.-.-1__.�-J -- __ .._.. .-._
space_and a 126 s.f. common corridor within a larder multi-tenant retail space.
�+ 1�-k-tMg�l�l- �l� MA Registration Nwnber: �35�� Expiration date:�• - 17 am a
f
rVrisrcrVd cicsigu proks.sio ml, and I have prepared or directly supervised the preparation of all design plans,
computations and specifications concerning:
Architectural [ ] Structural [ j Mechanical
[ ) fire Protection [ J Electrical [ Other
for the above named project and that to the best of my knowledge, information.and belief such plans,computations and
specifications meet the applicable provisions of the Massachusetts State Buildinr,Code.(780 CMR),and accepted
engineering practices for the proposed project. I understand and agree that I (or my designee)shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
I. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for NUistered design professionals in 780 CMR Chapter 17, as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and
quality of the work and to determine if the work is being performed in a manner consistent with the approved
consh•uction documents and this code.
Nothin--, in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building,official, t shall submit tield,"progress repos � cether with pertinent
comments, in a form acceptable to the building official. cj
Upon completion of the work. I shall submit to the building official Constructio+ t I Document'.
� No.83
1
Enter in the space to the right a"wet"or np SSPE Ems
H
electronic signature and seal: ���MP yQ
Phone number: Email: — -- __-- —_--
I— Building Official Use Onk
Building Official Name: Permit No -- — Date: _
Version 06 112013 31)13
Initial Construction Control Docunent
To he submitted with the building permit application by a
Ref;istered Design Professional
t«r work per the 8i1edition of the
NIZISSaChuSettS State BUildim,Code, 780 CMR. Section 107
I'n•oject Title: Paradise Plaza: Title Boxing Club l:)atc: 02/01/2017
Property :address: 19 Paradise Road, Salem MA 01970
Project: Check one or both as applicable: New construction (. t:xisting Cimstructi0111
I'roiect description:
Converting an existing 6,963 s.f. retail space
into�2)spaces; one 4,744 s.f. one 2,093 s f. tenant
space and a 126 s f common corridor within a larr er multi-tenant retail space
I Chris M Marseglia MA Registration Number: 46432 Expiration date: 06/30/2018 am a
_._ ...._ ----
r rci.titcrr>tl dr cr a pj'o c Ssiunal, and I have prepared or directly supervised the preparation of all design picots,
computations and specitications concerning:
( ] Architectural [X] Structural Mechanical
] fire Protection [ ] Electrical [ j Other
fir the above named project and that to the best of-my knowledge, information, and beliefsuch plans, corttputations and
specific�itiorts meet the applicable provisions ofthe R9assachusctts State BUildirnI Code. (780 CNIR),and accepted
engineering practices for the proposed project. 1 understand and agree that I (of-my designee)shall perforin the necessary
professional services and be present on the construction site on a regular and periodic basis to:
I. Review, tier conforniance to this code and the design concept, shop drayvin's, samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
?. f'eritarm the duties for registered design professionals in 780 C'11R Chapter 17. as applicable.
i. Be present at intervals appropriate to the stage of construction to become;generally familiar with the progress and
quality of the work and to determine if the work is being performed in a manner consistent with the approved
construction documents and this code.
Nothin«_ in this documem relieves the contractor of its responsibility regarding the provisions of 780 C',VIR 107.
W11Cn required by tine buildim,official. I shall submit tield'pro"ress reports (see item ".)together with pertinent
e0ntments. in a Ii"rill acceptable to the buildinU ofIfi
Upon completion of the +york, I shall submit tuldin-" i jy`�a '1=incl Construction Control Docrnmcnt'.
CPis Sh SEGUA �v'�
Filter ut the Space to the right a "wet' or � � s c U�
t912Ct1OnrC Srgnatule and se,il:
Phone ntumbcr.: 203-494-9811 Ernail: CHRISMARSEGLIA@SNET.NET
BUIKlin Oloci, t .c 0131N
i
tiui��iiu!111th;d \ami 11rnnit No Darr-
Initial Construction Control Document
i f
To be submitted with the building permit application by a
_ Registered Design Professional
for work per the Bch edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Paradise Plaza:Title Boxing Club Date: 2/1/17
Property Address: 19 Paradise Road,Salem,MA 01970
Project: Check one or both as applicable: I I New construction X Existing Construction
Project description: Converting an exiting 6,963 s.f retail space,one 4,744 s.f.one 2,093 s.f. tenant space
and a 126 s.f. common corridor within a larger multi-tenant retail space
I Ara Nalbandian MA Registration Number: 48846 Expiration date:Lune 30,2018 ,am a
registered design professional, and I have prepared or directly supervised the preparation of all design plans,
computations and specifications concerning:
[ ] Architectural [ ] Structural [x] Mechanical
[X] Fire Protection [ ] Electrical [xj Other Plumbing
for the above named project and that to the best of my knowledge,information,and belief such plans,computations and
specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR),and accepted
engineering practices for the proposed project. I understand and agree that I (or my designee)shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
1. Review,for conformance to this code and the design concept,shop drawings,samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and
quality of the work and to determine if the work is being performed in a manner consistent with the approved
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent
comments,in a form acceptable to the building official. 9.0 000,***•..
a* or
�s8�'•
Upon completion of the work, I shall submit to the building official a`Final Constru ntroI at'.
Enter in the space to the right a"wet"or $
electronic signature and seal: ECHaNtcAL
.O �N�.48846
�, �G1G.
Phone number: 401.438.7733 Email: analbandiari '�•
Building Official Use Only
Building Official Name: Penn it No.: Date:
Version 06 11 2013
Initial Construction Control Document
� r
To be submitted with the building permit application by a
a a Registered Design Professional
for work per the 8th edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Paradise Plaza: Title Boxing Club Date: 2/1/17
Property Address: 19 Paradise Road,Salem MA 01970
Project: Check one or both as applicable: tl New construction X Existing Construction
Project description: Converting an exiting 6,963 s.f retail space,one 4,744 s.f. one 2,093 s.f. tenant space
and a 126 s.f common corridor within a larger multi-tenant retail space.
I Steven Costa MA Registration Number: 41728 Expiration date: June 30,2018,am a
registered design professional, and I have prepared or directly supervised the preparation of all design plans,
computations and specifications concerning:
[ ] Architectural [ ] Structural [ ] Mechanical
[ ] Fire Protection Electrical [ ] Other
for the above named project and that to the best of my knowledge,information,and belief such plans,computations and
specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR),and accepted
engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
1. Review,for conformance to this code and the design concept,shop drawings,samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and
quality of the work and to determine if the work is being performed in a manner consistent with the approved
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
Vdhen required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent
comments,in a form acceptable to the building official.
Upon completion of the work, I shall submit to the building official a`Final Construction Control Document'.
Enter in the space to the right a"wet"or 00 0Z-- nl4&
electronic signature and seal:
COSTA +
EUCTRICAL
Phonenumber: 401.438.7733 rW.41 S ail: scosta@cec-engineering.com
N40W`eOnly
Building Official Name: Permit No.: Date:
Version 06 11 2013
�
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.
K�U�'�UK-808��K8�K'0� �-�0t�0VU�ocu0Nent
^ " ^ Construction Control ^'
Tohcsuhmiucdvi\hthe hui|ding pennitupp|icuiioohvu
.
Re-�bccd Desi-n Professional
- -
K`rnorkper the Xe ujihonohhu
K1ussachuScUs State Dui|dingCodc. 780C\iK. Section 107
project Title: Paradise Plaza: Title Boxing Club
___�_______________ D02/01/2017
(1ropcu!Addus,: 18Paradise Road, Salem MAO1S7U
Pniocc Check one orboth mapplicable: Nencons|mo/ivx Existing C01IStrLICtIO11
Px!oct description: - ..
---------------
Conve rti ng an exist i n g 6,963 s.f. retai I s pace i nto(2)-spaices,on-e4.,7.44--sj. o ne.2,093-s-f-tenant
space and a 126 s.f. common corridor within a larger multi-teriantretail p ce. .........
����������������������� �����
| K1& Kc�i,�cnionNumt�c Expiration vm :
Juiy'/oro yls`/",u( and have prepared nrdirect\! xuponisC \the preparation o[aUdesign plans,
cmnpuuxiuns,unJ specifications concerning:
[ I S/mctvm| [ ] KJ/chonicu|
,[ ]
Fire Protection Electrical Coho
bvthe above oxmcdproject and that wthe best o(mykoov|cdgc in�xnutiux.and he|ict'Suchplans. conpvwtioosanJ
specifications mcmthe applicable provisions uf the k1ooachuxrosState Bui|diogCode. (78OCKJK), and accepted
cn,6nucrin" practices for tile Proposed pn�JeCL | Understand and ugxz that | (or 111y dcsi-nee)ohxU perk`nx the oeces a,\
professional services and be present on the C01ISti-LICtiOn site on a re"LlIar and periodic basis to:
\. Revie\%. for coril'orniance to this code and the design concept, shop dravvings, samples and other SLibinittals by the
contractor inaccordance with the zquiocuununthe conmmctiood000mco/o.
2. Perforin the duhcs K`r registered dcsiOn professionals in 780 CMR Chapter 17. as applicable.
3. Be present at in|enu|o appropriate tothe o/u-eofconstmchoo to become gcoem||y Familiar ri/hthe progress and
qUality ofthe work and to deterinine if the work is being per6ornied in a manner consistent with the appi-o\ed
coum,uctinndncvmenmand this code.
Nothing in this document relieves the contractor o[its responsibility regarding /he provisions o[780CWK 107.
When reqUired by the bUildin." Official, I shall SUbinit fieldprogress reports(see itern 3 t er with pertinent
comments. in a forin acceptable to the bUilding official.
Upon completion of tile v\ork-, I shall SUbinit to the bUilding official a -Final G )1 01 60 lent'.
Lu
Enter in the space to the right a"wet"or < -,% S U)
electronic si(-niature and seal: 0 00
vuo.v"mi|/ 2oo
initial Construction Control Document
To be submitted with the building permit application by a
t� Registered Design Professional
for w=ork per the 8"edition cif the
;tilalsaachusetts State I3uildim, Code, 780 CMR. Section 107
Project Title: Paradise Plaza: Title Boxing Club l..�c2Ce: 02/01/2017
Property :Address: 19 Paradise Road, Salem MA 01970
Project: Check one or Moth as applicable: New construefion L:xlstin y Construction
Project description:
Converting an existing 6963 s f. retailspace into (2)spaces; one 4,744 s.f. , one 2,093 s f. tenant
_ _ .
space and a 126 s f common corridor within a larger multi-tenant retail space. ,
I Chris M Marseglia NJ A Registration Number: 46432 _ Expiration date: 06/30/2018 ani a
rcislered desi-11 pro/ccssional, and 1 have prepared or directly supervised the preparation Ofall design plans.
C01111)ntat10t1S gild SpecifiCatlonS l'011Cel•l1illQ:
[ ] Al-Cllitcchlral (X] Structural [ ] Mechanical
] Fire Protection [ ] L Iectrical [ ] Other
I'm tyle above named project and that to the best of my knowledge, information, and belief such plans. Computations and
specilications sleet the applicable provisions of the Massachusetts State tluildirn',Code.(780 CINIR),and accepted
engineering practices iior the proposed project. I understand and agree that I (01'111V designee)shall perforin tyle nceessm-N
proles;iollal Services and be present on the ConstruCtion site oil a Ielil,dar and periodic basis to:
1. Itevre�ti, for confol niance to this code and the LICSk'n cone ept. shop draNti ings, samples and other submittals by the
Contractor in accordance with the requirements of the construction doculllents.
2. Pert>rnl the duties for registered design prot'essionals in 780 CMR Chapter 17. as applicable.
Ile present at intervals appropriate to the stage ofconstruction to become ,enerallix ianliliar«with the progress and
quality of the work and to determine if the work is beim; perlorined in a manner consistent with the approved
construction documents and this code.
Nothins ill this document relieves the contractor of its responsibilitv re-arding the provisions of 180 Cit'1R 107.
When required by the buildinUl Official. I shall subulit lie c; 0_1_11'ess reports(see item ".)together with pertinent
collime11ts. in a form acceptable to the buildin1t 0 f i c.
upon completion of tLle work, 1 shall subulit tr Lilt R c�f.ti���i�ri��Fil)aI Construction Control Document'.
SE3LiA `-_ i
S UCTliRAL /
Entcr in the space to the right a "v et"or
c'.1C1'[1'(lnll' Slllnatul'e allld seal:
P11011e munber: 203-494-9811 I:rllail: CHRISMARSEGLIA@SNET.NET
13uil�lin�Uilicial l��e Onl� i
I
i
13;iati�� iilliiEat V`a:ne Permit No: Late
Initial Construction Control Document
Z
To be submitted with the building permit application by a
Registered Design Professional
for work per the 8`h edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Paradise Plaza: Title Boxing Club Date: 2/1/17
Property Address: 19 Paradise Road, Salem,MA 01970
Project: Check one or both as applicable: I i New constriction X Existing Construction
Project description: _ Converting an exiting 6,963 s.f retail space, one 4,744 s.f. one 2,093 s.f. tenant space
a 126_s.f common corridor within a larger multi-tenant retail space.
I Steven Costa MA Registration Number: 41728 Expiration date: June 30,2018,am a
registered design professional, and I have prepared or directly supervised the preparation of all design plans,
computations and specifications concerning:
[ J Architectural [ ] Structural [ ] Mechanical
[ ] Fire Protection [)d Electrical [ ] Other
for the above named project and that to the best of my knowledge,information,and belief such plans,computations and
specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted
engineering practices for the proposed project. 1 understand and agree that 1(or my designee)shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
1. Review,for conformance to this code and the design concept,shop drawings,samples and other submittals by the
contractor in accordance with the requirements of the constriction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and
quality of the work and to determine if the work is being performed in a manner consistent with the approved
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent
comments,in a form acceptable to the building official.
Upon completion of the work, I shall submit to the building official a`Final Construction Control Document'.
Enter in the space to the right a"wet"or ����N OF Mq�s�
electronic signature and seal: O� -SX-1
o N
STE�/EN �
M COSTA
EUGIRIGAL Gs
Phone number: 401.438.7733 -41 8 ail: scosta@cec-engineering.com.........
Only
Building Official Name: — Penn it No.: Date: _
Version 06 11 2013
Initial Construction Control Document
To be submitted with the building permit application by a
o Registered Design Professional
for work per the 8th edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Paradise Plaza: Title Boxing Club _ _ _ Date: 2/1/17
Property Address: 19 Paradise Road, Salem,MA 01970
Project: Check one or both as applicable: 11 New construction X Existing Construction
Project description: Converting an exiting 6,963 s.f retail space, one 4,744 s.f. one 2,093 s.f. tenant space
and a 126 s.f. common corridor within a larger multi-tenant retail space _
I Ara Nalbandian _MA Registration Number: 48846 Expiration date:June 30, 2018 ,am a.
registered design professional, and 1 have prepared or directly supervised the preparation of all design plans,
computations and specifications concerning:
[ ] Architectural [ ] Structural [x] Mechanical
[x] Fire Protection [ ] Electrical [xj Other Plumbing
for the above named project and that to the best of my knowledge,information,and belief such plans, computations and
specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR), and accepted
engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
I. Review,for conformance to this code and the design concept,shop drawings,samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and
quality of the work and to detennine if the work is being performed in a manner consistent with the approved
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent
comments,in a form acceptable to the building official. •.• ***,00
.••.�Nof ••
Upon completion of the work, I shall submit to the building official a`Final Constru ntroll t'.
i RAD a�i
Enter in the space to the right a"wet"or • 8 •
electronic signature and seal: ECHANJI�CAL
/P"N .4$846 n
Phone number: 401.438.7733 Email: analbandian
Building Official Use Only
Building Oflicial Name:_- Penn it No.: Date:
Version 06 11 2013