BPA-17-169 ANTENNA Ct; ,3795
e •z� i .
The Commonwealth of Massachusetts
• Department of Public 5&bf E3 21 A }i: 4q,
Massachusetts State Building Code(780 CMR)
Building Permit Application for any Building other than a One-or Two-Family Dwelling
(This Section For Official Use Only)
Building Permit Number: Date Applied: Building Official: r-4
SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available)<'_x
No.and Street City/Town Zip Code Name of Building(if applicable) ";C ri
i
SECTION 2:PROPOSED WORK
Edition of MA State Code used If New Construction check here❑or check all that apply in the two rowelovS
Existing Building Repair❑ 1 Alteration Addition❑ Demolition ❑ (Please fill out and submit Appen ix 1)
tzo
Change of Use ❑ Change of Occupancy ❑ Other Aapecify: :1__� • s
Are building plans and/or construction documents being supplied as part of this permit application? Yes No 11
Is an Independent Structural Engineering Peer Review required? Yes ❑ No);t
Brief Description of Proposed Work:
th L6
�lr f
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.) Y'1 )o`
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❑ 1 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❑ R-4❑
S: Storage S-1❑ S-2❑ U: Utilityk 1 Special Use❑and please describe below:
Special Use: S
CTION 6:CONSTRUCTION PE(Check as applicable)
IA ❑ IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ IV ❑ VA ❑ VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal:
Trench Permit: Debris Removal:
Public❑n'rf Check if outside Flood Zone/ Indicate municipal❑ A trench will not be Licensed Disposal Site❑
Private❑ or indentify Zone: or onsite system❑ required kor 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❑ N9-\93D
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:
SECTION 9: PROPERTY OWNER AUTHORIZATION
• Name and Address of Property Owner
pn. n��.� 149AName(Print) No.and Street City/Town Zip
Property Owner Contact Information:
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the pr erty 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 O and skip Section 10.1
10.1 Registered Professional Responsible for Construction Control
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
. Le-e
Company Name Q , �.q}y
1� e l ,�t �� (S—te{' L 5'n
4
Name of Person Responsible for Ponstruction License No. and Type if Applicable
Street Address City/Town State
t YLia Q Lb_ - - a-4p-P614elere 4re ,cam .cpm
Telephone 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 O No O
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)_$
1.Building $ &r7 �� CD
Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ appropriate municipal factor)_$
3.Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality)
5.Mechanical Other $ Enclose check payable to
6.Total Cost $;r� 606t (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 edge and understanding.
( t,-e tr 5,, 4cac
Please p t and sign name Title Telephone No. Date
` 0A_,'9rV1,JtSaYo v CQ03S'
Street Address City/Town State Zip
Municipal Inspector to fill out this section upon application approval:
Name Date
�rl'
tMAElE75
ENatinq venap�
VER WIRELESS
Mtennu 118U
FLANDERS ROAD
N (t/s�)I' WESTBOROUGH,MA 01561-3956
ExiNinq SEylipnt
Eaiatinp BPllPax Mauntea �O PROPOSED V2NZON
MlennP,(TYp.> O ANEAw SWAMPSCOTT MA
(PNM 10 MAtt]1)
Eaiatinq -1
00
1
RRH&Ju«tion MBov le
O V Mears D wlm A-J PCS DRAWINGS
0S/ MOUpewZ )E0 NT5)e
T 12/05/16 FOR SUBMITTAL
Eaietirq T-_.'.
ER.tp--t coein.te O / PROPOSED NrebD 1 05 11 16 FOR SUBMITTAL
E+lati AT&T On Roof CABLE IN WSfNE ROM t /
ER.ip.-Area / MOUNTED CARE MY A-] 0 01/12/15 FOR SU6MIITAL
At Grpee PROPOSED IOBb0 / (T/sEcroR)GvP:])
MourETCABLEm F gEiwAYe a O O /
/ Dewberry-
Dewberry EnQIneelB Inc.
tss A�NrtTNpwni
3t ® ❑ 7EMipM ❑ C.-(rTmtiqnq) ❑——— � EMn«e At Grptle nwyOxpSTNOIaK11
6W.w15ie11.D
-7 A-]CIO ANlA1
29
\/ `PentM1o«
aielin9 Verizon�`�R. CD
fl..' Icn '
Ea_u Egwp titch l O BGI�aMexwit,v .a
(1/s«loi)(TYPC^7) Wirebaa EgWPmen1 SFNter I••E/eL�aTf/`l�G�A1aMaTNE
(TD IIEYA91 Eai—g AT&T Vent(Typ) yly{.
Eaia0nq BPMaet Mounted MI.—(Ty,)
T RRH k Ju«iwn Boa O Umtinq Metre PCS .�
0/s.I-)(T,-]) PROPOSED RRN(z/sEnaRxTw.-e)e EpuPment Bening
A-J (TO BE REPIACmD� YOLVrED ON N 9YUSi MWM A_y 0 Screen woll
NOR
e FABLE:IN QSrNG
CABIE W CABLE ROOFe
O Q (I/SECD CANE 13) A-]
0
ep,[�� REVIEWED er rANr
Eoetin9 BOIIPat Mounted 0 R�E� DMEcNm
Mt.—.(TYp.) RV(1
PRGImT NIIYBDG 50003825
PPOPOSED bill(2/SECTUR)(T'P.-5) t
YOtINim ON NEW BALLAST MOUM .I®NUMBEII: Stp70M9
Eaietinp BPIYat Mounted A-]
1 RRH&Junction Boa
A_y
sat,(t/s.ctar)(TYp._}) E+Nt'nq Verrson Wi.Nesa Mlerna '
'�
I.
9E REPLACED WIN (1/s«tor)(rrP-7)
NEW MODELS) (TO FEAANN)
1000 LORING AVENUE,
PROPOSED VEIN20N
1. SOME ORDAIN AND PROPOSED INFORYAIMN NOT sNowrN FOR CINBNiY, e� wIREUMs ANTENNA SALEM, MA 01970
2. MORIN sINIWN AS APPROYIWIE A-J A-3 (TD(] �9))
2 EOSTNO ANTENNAS SHOWN AS APPROIIIMATE E1E.tWTWN BASED ON 'r-TMA)
PINT TO Witll)
DeSPNC INMRWNDN AND NSIAL INSPECTgN AND NAVE NOT BEEN SHFEi iTIIE
VERFU THROUGH AN ANTENNA YAPPING
S. DRAINING PREPARED PER PLOT PW7 BASED ON SPRINT SPvnRIM IP
CONSINICIpN ONAWN°s BY TECTONIC ENGINEERING OONARxANT PC R OF PLAN ROOF PLAN
GATED 7/29/97 AND SITE NSIT PERFORMED BY DEWBERRY MOIbFAS
INC.ON I1/12/11. SGLL 1'-AO'IDR 11'x1Y
1'-20'FDR 22'x31'
B. REUSE ERIORA I N AND MOUNTS AND EDA%.INSPECT FOR ON41GE 0 20 SIKR NUINEII
OR DETERIORATION AND REPLACE AS HERS PER SINUCIVRAL LETTER
GAZED OS/10/iB.BY DEWBERRY ENGINEERS W.
A- 1
SS
WIRELESS
VERIZON WIRELESS
rvigne.t AFRvKenvnce 118 FLANDERS ROAD
roo of 14 whip a,E. WESiBOROUGH,MA 01581-3956
1
I!
Edalinq Ark* �;
Antenna(rro.-D)
E.Atinq Ve.iaen Wieeleaa SWAMPSCOTT MA
,-g-6ne11er Foisting Bollast M ncetl
PRM&Junction Bo.
a, Trot E.i'tino aSnelter (OSBBt RI(rEPW mI
Y ="v- — CLE a16i AArkT Anlennaa._/]t
Elev.01 ttpi A.G.L
E.ieling o0 E+isling io of f.iaL Roo PCS DRAWINGS
Cv61e Trq Rvill�q Elev 1 4.5�}AG.L
Y
Ven On E.i.t1mg/RROPOSM
Ml os
(7ypE. .) Elev o6 i02't A0l nn
nt 0 R1 2 12/05/18 FOR SUBMITSAL
'MI IIFl£SS vD^ Wisnng venzon 1 05 11/16 FOR SUBMRTAL
0o REPUCE EbsR�G) (1/5.=m.)(Tro���) 0 01/12/15 FOR SUBMrrrAL
(S/SEC10R)(TYP:0 (TO REMAIN)
(PAwr ro w1TaI
E-tinqSevice PIR.V.—
(1/6EGTOR)(T1P—J) rr
® Dewbey•
(TO REMNN)
Li-IJ
Dewbeny E gln mB Inc.
299 wNmESIi9£r
IT 'eci�wDORwmta
moNe:nT.saao
Eviating Verli=vl FAIL 91Ti01910
Coble-y
BENJAMIN B. p
FEICm
FM
_ FT1 GRA.x IEr: w
Ir�Ir�I E.is6nq BuilGnq REVIEMFO Rl: GMT
E.ialin9 AT&Tm q,..
ERuipmAenl Nev E.istinq 9uJbiny
Gr
Enuon=e PROlE4T NULBFGt ----25
AGI NWffR: SG070449
SRE777
ADORES&
_ a E.'ning Grouts
— 1000 LORING AVENUE,
1. SONE E%ISONo AND PRarosED INFORMATION NOT SNOMN MR CLMIIY. SALEM, MA 01970
2 E A110N5 ARE VPROIN M AND NAPE NOT BEEN VERIM iNRdNIN
R&D SURVEY.
2. DISIINO ANTENNAS SHOWN AS APPR01Gw1E.ElFM110N SAM ON SHEET TOLE
FASTING N ON MID VSWE M9PEOIION AND NAVE Na BEEN PARTIAL ELEVATION �1
��THROUGH
�M AN1ENw LUPnNa I PARTIAL ELEVATION
S. DRNMNE PREPMM M PLOT PLAN INUIED ON S~SPED UN V SYy r.1'20 f19t 11's1Y
LDNSINUGnON ORM W BY TECTONIC ENGNEERINO CONSULTANT PG 1'-tW FOR 22.74'
GATED 7/29/97 AND S VISIT PERFORLICD RY DEMREILRY ENGINEERS
W.ON 11/12/14. 0® EHRT NUY9pE
9. lum E10511NG ANTENNA MOUNTS AND OWLFO
wSPEGT R DAwDE
OR DEn3WRA1gN AW REFUGE AS NEIDfD PER STRUCTURAL UT1EM
GATED 0.5/10/10.W DEMMERRY ENGINEERS IMG.
PROPOSED RIM MOUNTED _
M EES`STRUT hTAIE
PCS/
PROPOSED LK12 (z/�cTaR)(DP.-e)
• HYBRD CABLEMPROPOS
EDm RRH � 840 700 LTE AWS
\ (2/SECTOR)(1YP.-B) PRDPOBD 1-5 e' S1RUT ERNE
// CIO Rc LACE:P.-J) WIRELESS
\ CALVANRID SIIFIt ERAWNG (TO RERIL'E E%ISTNC)
rz
\ ESS
PROPOSED NCTION BOX i 1R
FLAN0 SIER ONE
LNICE JULI
ROAD
\ (1/-w-R)(TYP.-]) WESTBOROUGH,MA 01581-3956
(TD RFI,LACE J FX6RNG SMNL $C
SWAMPSCOTT MA
\ (Lo nected io Steepen) HaD�,.
ROPOSED RIIBBEN \
R00F PAD(rnJ . \ 1. AS VIEWED STANDING SEMND TIE AKEINNAS.
PROPOSED 4X4 / 2 TYPICAL FOR]SECTORS.YDDY 1`110L ANTENNA DESIGN
CONCRETE nLIID Ay c°+ SHEET MOR TO CONS/WICIIDN.
PJC STEEPER i Aci
OW—7 MM.) " ANTENNA CONFIGURATION PCS DRAWINGS
E.It SLATE•x.TJl <
PROPOSED 1-3/�TDALVANFZED
= CablWTre
e y
(CONNECTED TO E.i0,R-
M
SE REPLACED) j C01X
AMG[ RBN Ya1IMR
FE.�,any canc..te aRaWD PSE 2 12/05/16 FOR SUBMITTAL
Retl PVC�YaPepe; - 1 05/11/16 FOR SUBMITTAL
BDIIND
T
P N1D T 01/12/15 FOR SUBMITTAL
Ea„t;n�RaEber S Dewberry
nN Pee smog IRND
SER
J2 JIM n AMC Dewberry IAaNR Ane.
m elRar
DHnnaR
eDB1p1.W�la
L,AZ 11001 Rld@n).S`E.ilm
lOP NDB JUNCIDN BOX fAY n,is>010
E. 12 AIDM. Span Pipe
RrPMHunt Sector) )t Y
J7(TOO W)R01A '
• Elmll,050 Mtsnn,I
b/seat..)IT,3) t0W”� BENJAMIN B.
(IO R ) "erre• RE�iEM W.1/2'WAX AAP01 1. ALL PROPOSED EWEARNT TO IE GRdINOFD ro SEC10R
FNON CERN ro B1WND BAN. 9W
ANTENNA GYP.-z) 4
z tWNnv.FDR FOR A.I.SECTORS.
]. GRIINDD SHNL COMPLY WON NEC ART.T30 k YD020N
PROPOS DOG NTFNIN WPmFSS SPw CDIOI0L
Go(PREPvcE � SCHEMATIC GROUNDING DIAGRAM/--',
PRAWN BY: MR
PROPOSED
MATE ANENR
PROPOSED AWS ANTENNA (1/SECIOIt)(Il'P.-]) '�' REVIEIED TD': GMT
(TO'/SED: m AJ.mo SIGNS TIT,
OF,MlD aN EIOSRNO MKIIHM DRAINAGE
SIRUCnIRES,ND STE IKRIIED YPRW0IFNR SHNL BE N FalBY
(PAM.TO WTCH PROPOSED INMEONlE1Y ro TCONTNACTBR O M ro Al FABRICATION ATH NL OWRDWICIEJ REPORTED CHECKED BO BOR
E ENONFFIE
1 GOA%JUMPEA PRQELT W111B0C 50002825
d CERN ro 2. TIES[oRAS`MQS DD NOT INCLUDE IESOLE RE CONSONO/R FOR
ANIEHNA(IYP:0) SAFETY WIRCx R ME SDAF RESPOMSIBIJIY OF TE
Jae NIRDp1: 07-
3. BRACE STRUCTURES UNTIL ALL STRt1CTIMAL EIEMENIS NEIDED FOR
STABUTY ARE N ALU31 THESE EIDIENTS AE AS FnLOWS:LATERA SITE,AIXXESG
PROPOSED
BR .ANCETC
1/2'LDAX JUMPEII 4. IN00IIIR Y FAB:ATED.DAMAGES,OR OTIERNEE MISnnND OR
FRDM CERN TO mam. NONCpRORWNO MER 15 OR cokonno swi aE R"SM
POR FD ro TME 1000 CORING AVENUE,
ANTENNA(DP-4) DWEN PRIOR TO R EDNL OR Lo�nnE ACIKM.Aw S REMEDML SALEM, MA AVENUE,
1. NOT All IIFBO,Rck SHOM Fm aI.VIM. RAEPIESEMAIhE PRocEm W THE OWNER'S01970
2 Wb AL EpWRNT PER MAII,fACRIE115 RECOWTNDMIONS,
EASING AWS JUMPERS TO 1 ALL EgIPMENT SILL BE FAeNOED PEA YFAQBN WIImE55 1 EACH CONTR L SILL COOPERATE WITH THE MOTS REPRESDRAIM
SE RE-ODWECTED(I W.-2) STMONDS AND UMNACTURES IEDtl11F1DUIDVS. IND COORBNATE NES WOBf WITH THE WORK OF 0nBR5. SNFET TTE
4. ILL PROPOSED EBIPMDR NCUIONO AITINKA&COU.SURGE Q REPAIR Arr DAWDE DOTING CONSTRUCTION TO WICK EIOSTNO
ARWSRaft WR%EIC SHU B:'IaROED N ACcowvNx WIM °REGaE—"RtNS�M� COMXR TIONS TO THE snNFACRON of THE CONSTRUCTION
STRIA'IUD,L lET1G aDED oylo/1a er aWemr DGnEFPS MG.
5. REUSE I OSMIB AMBRw-Ow.AND CDA%.INSPFDi TOR oAwx ). TE CONTRACTOR SHNL BREAMS[ARD pV1ER TIE M.Ex mT'sED DETAILS
aN DECAY ND REPLACE AS NEEDED. ODN51RUCYQN WAN$.MMMODS,TECHINMQ SEWENCES AND SHEET NUBER
PROCEDURES AID FON LOMBNDNG Al PORTIONS OF THE 1TOIU(UNOFIt
FACADE MOUNTED ANTENNA a BALLAST THE CONTRACT.
MOUNTED RRH MOUNTING/PLUMBING SCHEMATIC e. REUSE DSTM ANTDNNA MOOTS AND COX&IUPECT FOR OMADE oR /�
SGAf-N.I. ) DEGY AND REFUGE AS NEEDED PFR STIMIla L ARLY515. A