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15 BRIDGE STREET - BUILDING JACKET . I� 15 BRIDGE STREET - •qt �� 3 i Ninety Nine Restaurants Page 1 of 2 Sally Murtagh From: PAUL KELLEY [pakely@msn.com] Sent: Wednesday, June 17, 2015 8:54 AM To: Sally Murtagh Subject: FW: Celebrate our Grand Re-Opening in Salem on June 18th From: email@99restaurants-eclub.com To: pakely@msn.com Subject: Celebrate our Grand Re-Opening in Salem on June 18th Date: Tue, 16 Jun 2015 09:00:49 -0600 Come Celebrate Our Grand Re-Opening in Salem To view in your browser or on a mobile device,click hero. {.ii{.Chje#,A�i. : ::.ice }��}� PEyy qq� IY"k�1fi6 tlti`PPg[, Ie+:M"F qgj$,� Ii p�d5 tl ry ,��{gi.�tr °tif'I E ii Yf�6r"' { d "Hlet� ��"F#��E'� � a "&:RTE `.d /t PItY'M1�F!^tP"II2•�'�E!{Q�' ". EZE ��t 'RS^��i ��``� iiM1v`1✓b�� iX� III � e I tl51��t ��..rrfi{{h � `YdE k[t[ t I!.�'IE :4Y99 t bSL^.ifdt;t, Visit Us Online i genu i Gift Cards I Kids I Map Salem Location a _ � Please Join Us In Cel7Restaurant ing Our Grand Re-Op and Enjoy Great Food andt Drink. Date: Thursday, June 18th Lo 4:00 Doors Open Nintaurant15 5:00 Ribbon Cutting Ceremony SalAppetizer Sampling and 9785:15 - 7:30Music in the Bar , 6:00 - Close Drawing every half hour for a chance to win a $25 Ninety Nine Restaurants Gift Card 7:30 Trivia Game with Prizes 6/17/2015 - �-J p t � 1, Form 2 DEOE File No. (Tobe provided by DERE) SALEM I` Commonwealth Dityrrown o ' Happy Villa, Inc. f Massachusetts Applicant . Determination of Applicability Massachusetts Wetlands Protection Act, G.L. c. 131, §40 From Salem Conservation Commission Issuing Authority TO Happy Villa, Inc. same (Name of person making request) (Name of property owner) Address 39 Portina Road, Brighton Address 15 Bridge Stree— t.Salem—�� This determination is issued and delivered as follows: ❑ by hand delivery to.person making request on (date) 0: by certified mail, return receipt requested on - (date) CPursuant to the authority of G.L.c. 131 §40,the Salem Conservation Commission has considered your request for a Determination of Applicability and its support:ng documentation,and has made the following determination(check whichever is applicable): This Determination is positive: j, p The area described below,which includes all/part of the area described in your request,is an Area Subject to Protoction Under the Act.Therefore, any removing,filling,dredging or altering of that area requires the filing of a Notice of Intent: s Ca 2. ❑ The work describes below, which includes all/part of the'work described iS ournquest,%within an Area Subject io Protection Under the Act and will remove,Tilt,dredge or,&lter tA@ area_There- fore, said work requires the filing of a Notice of Intent. ulrr > r N G� C N 2-1 r , 3. ❑ The work described below,which includes all/part of the work described in your request, is within the Buffer Zone as defined in the regulations, and will alter an Area Subject to Protection Under the Act. Therefore, said work requires the filing of a Notice of Intent. This Determination is negative: 1 . ® The area described in your request is not an Area Subject to Protection Under the Act. Providing no activity takes place beyond the location of the existing fence 2. ❑ The work described in your request is within an Area Subject to Protection Under the Act,but will not remove, fill, dredge,or alter that area.Therefore, said work does not require the filing of a Notice of Intent. 3. ❑ The work described in your request is within the Buffer Zone,as defined in the regulations,but will not alter an Area Subject to Protection Under the Act.Therefore,said work does not require the filing of a Notice of Intent. 4. ❑ The area described in your request is Subject to Protection Under the Act, but since the work described therein meets the requirements for the following exemption,as specified in the Act and the regulations, no Notice of Intent is required: Issued by SalemConservation Commission z Conservation Commission Signature(s) This Determination must be signed by a majority of the Conservation Commission. On this 27 day of September 1984 before me personally appeared the above-named ,to me known to be the person descrj ed,in, and who executed, the foregoing instrument, and acknowledged that he/she executed the same a'hhiis/her fre act and deed. �C (lt _<_ 9-9-88 Notary Public My commission expires This Determination does not relieve the applicanlfrom complying with all other applicable federal,state orlocal statutes,ordinances• bylaws or regulations.This Determination shall be valid for three years form the date of issuance. - The applicant,the owner,any person aggrieved by this Determination•any owner of land abutting the land upon which the proposed work is to be done•or any ten residents of the city or town in which such land is located•are hereby notified of their right to request the Department of Environmental ouality Engineering to issue a Superseding Determination of Applicability,providing the request is made C_ by certified mail or hand delivery to the Department within ten days from the date of issuance of this Determination,A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and the applicant. 2-2A Form 2 DEOE File No. - (To be p(ovided by DEOE) \ Commonwealth Cityrrown SALEM J S. of Massachusetts Appiic�t Mrs. Margaret DeFrancesco Y� Determination of Applicability Massachusetts Wetlands Protection Act, G.L. 0. 13.1 , §40 From SALEM CONSERVATION COMMISSION Issuing Authority 7Mrs. Margaret DeFrancesco (Name of person making request) (Name of property owner) 63 Federal Street, Salem Address 96 Margin Street, Salem Address This determination is issued and delivered as follows: ❑ by hand delivery to person making request on (date) �2 by certified mail, return receipt requested on (date) i t Pursuant to the authority of G.L. C. 131, §40,the SALEM CONSERVATION COMMISSION has considered your request for a Determination of Applicability and its supporting documentation,and has made the following determination (check whichever is applicable): This Determination is positive: 1 , ❑ The area described below,which includes all/part of the area described in your request,is an Area Subject to ProtcL:tion Under the Act.Therefore, any removing,filling,dredging or.'alterina of that area requires the filing of a Notice of Intent. a. 2. ❑ The work described below, which includes all/part of the work described in ydur reFVest,is within an Area Subject to Protection Under the Act and will remove,fill,dredge or a+Wt-er that-area_There- Q N fore, said work requires the filing of a Notice of Intent. , Am m`c o c m '> n =-i l 2-1 .l '1t 3. O The work described below,which includes all/part of the work described in your request, is within the Buffer Zone as defined in the regulations, and will alter an Area Subject to Protection Under the Act. Therefore, said work requires the filing of a Notice of Intent. This Determination is negative: 1. 29� The area described in your request is not an Area Subject to Protection Under the Act. 2. ❑ The.work described in your request is within an Area Subject to Protection Under the Act, but will not remove, fill, dredge, or alter that area.Therefore, said work does not require the filing of a Notice of Intent. 3. ❑ The work described in your request is within the Buffer Zone,as defined in the regulations,but will not alter an Area Subject to Protection Under the Act.Therefore, said work does not require the filing of a Notice of Intent. 4. O The area described in your request is Subject to Protection Under the Act,but since the work described therein meets the requirements for the following exemption,as specified in the Act and the regulations, no Notice of Intent is required: Issued by SALEM Conservation Commission Signatures) \ �. This Determination must be signed by a majority of the Conservation Commission. On this 11 day of October 9 84 , before me personally appeared the above-named persons to me known to be the person d cnbed,in, and who executed, the foregoing instrument, and acknowledged that he/she executed the sa a 's his/her free act d deed. 9-9-88 Not Public My commission expires This Determination does not relieve the applicant from complying with all other applicable federal,state orlocal statutes,ordinances, bylaws or regulations.This Determination shall be valid for three years form the date of issuance. The applicant,the owner,any person aggrieved by this Determination,any owner of land abutting the land upon which the proposed work is to be done,or any ten residents of the city or town in which such land is located,are hereby notified of their right to request the / Department of Environmental Quality Engineering to issue a Superseding Determination of Applicability,providing the request is made l by certified mail or nano dor.ory-io.the Department within ten days from the date of issuance of this Determination.A copy of the request shall at the same time be sent by cerinjJ mau w hand delivery to the Conservation Commission and the applicant. 2-2A \ MINUTES OF MEETING September 27, 1954 The Salem Conservation Commission met at One Salem Green, second floor conference room,'on Thursday, September 27, 1954. Present were Philip .Moran, Glenn Yale, Raymond Lavender, James IMacDowell, Christopher Hagger, and Alice Akatyszewski. Also present were City Planner Gerard Kavanaugh and Conservation Commission Aide Charles Frederiksen. The meeting was called to order at 7:35 by Chairman Philip Moran. CONTINUATION OF PUBLIC HEARING--HAMBLET AND HAYES--PROPOSAL TO CONSTRUCT VALVE CHAMBER AND SUMP OVER AN EXISTING DRAIN Chairman Philip Moran read the notice of the continuation of the public hearing and introduced Tom Andruskiewicz of Hamblet and Hayes. Mr. Andruskiewicz stated they are proposing to install a valve and valve chamber on their property in order to prevent any chemical spills on their property from draining into the South River via the catch basins located on their site. He stated that the project is Y proposed to be accomplished in three phases: The first phase is what they are proposing this evening--the installation of the valve and chamber and re-grading their yard towards the catch basins; the second phase would involve re-grading the front part of their property; and in the third phase they would consider the automation of the valve. He noted this third phase has not been finalized as yet and it may not be done. Glenn Yale asked who was notified in the event of a spill and Mr. Andruskiewicz replied the EPA, DEQE, the Coast Guard, Civil Defense, the Fire Department, and Chem-Trex are all notified. Chris Hagger asked at what time of day their most recent spills occurred and Mr. Andruskiewicz replied that one was at 4:00 p.m. and the second was during a snow-plowing operation in the late evening. Since those two spills, all the tanks except those containing water-treatment chemicals have been dyked. Chris Hagger asked if there was any environmental damage to the marsh as a result of these spills and Mr. Andruskiewicz replied that they were never notified of any adverse effects, so they assume none took place. Testing was done by-the Coast Guard in Collins Cove. Chris Hagger asked what the flood level of the area was and Mr. Andruskiewicz replied it was at the 11' contour. Glenn Yale asked how often the facility is manned and Mr. Andruskiewicz replied it is manned five days per week, twenty-four hours per day from Sunday midniglA to L.3 Friday midnight. On Saturdays and Sundays, the facility is checked briefly byZ4 3 security person. He added they are in the process of updating their SPCC plap3-but- T at present it only applies to oil. u:• ; Chris Hagger asked if the valve will remain open over weekends and evenings,4no 'j Mr. Andruskiewicz replied in the affirmative. Chris noted that there is a :- ; Minutes of Meeting--September 27, 1984 Page 2 potential for spills over the weekends and Mr. Andruskiewicz agreed this was a possibility. Glenn Yale asked what the storage capacity of the valve was and Mr. Andruskiewicz replied that on the basis of the capacity of the catch basins and the yard, the calculations were to the ten-year flood. Glenn Yale asked why they would not close the valve on weekends and Mr. Andruskiewicz replied that they felt there was a potential for damage to the valve from freezing, etc. Jim MacDowell asked if, during snow-plowing for example, a representative of the company is present to operate the valve if necessary and Mr. Andruskiewicz replied this was not always the case. Chris Hagger stated that, in his opinion, the clause in the Wetlands Regulations (1002, 2C) which addresses an area outside a buffer zone causing damage to a wetland area is cause for the Commission to mandate that the valve system be as foolproof as possible. Chairman Philip Moran and James MacDowell respectfully disagreed. Glenn Yale felt it was important for Hamblet and Hayes to address the matter of coverage of the site on weekends. He is uncomfortable with leaving the valve open for 48 hours per week. There is a potential for a hazardous spill to . occur during that period which could cause damage which could not be undone. Mr. Yale asked if Hamblet and Hayes would consider a storage facility adjacent to the valve chamber and Mr. Andruskiewicz respectfully stated he could not make that kind of commitment. There followed several minutes of discussion regarding this issue. Chairman Moran felt that research into the spill history could still take place without holding up this project. Glenn Yale asked Hamblet and Hayes to consider security for the site on weekends. Christopher Hagger moved to continue the hearing until further research could be done on the spills history. The motion was seconded by Glenn Yale. The motion was defeated on a tie vote. Upon the motion of James MacDowell and second of Alice Akatyszewski, the public hearing was closed. It was so voted, four in favor, two opposed. Upon the motion of James MacDowell and second of Raymond Lavender, the Order of Conditions was approved with the following additional conditions: 1. Work shall conform to plans entitled, "Hamblet and Hayes Company, Colonial Road, Site Work Plan—Proposed Valve Chamber," by Hancock Survey Associates, Inc., dated August 1984 as revised and signed by Paul S. Niman, City Engineer, 8/31/84. 2. Hamblet and Hayes shall submit to the Conservation Commission for their review and approval prior to the completion of the proposed work, a spill prevention control and counter measure plan for the valve chamber which has been approved by the Department of Environmental Quality Engineering. %linutes of Mteting--September 26, 1984 Page 3 3. Prior to the commencement of work, an erosion control and stockpiled soil storage erosion plan shall be submitted to the Conservation Commission for their review and approval. 4. All proposed catch basins shall include oil and grease traps. 5. Hamblet and Hayes shall notifiy the Conservation Commission in the event of any spill within 24 hours. It was so voted, four in favor, two abstensions. HAMBLET AND HAYES--MODIFICATION OF ORDER OF CONDITIONS #64-104 It was noted by Mr. Andruskiewicz that he felt the intent of the Commission's vote on the proposal to install a sewage force main and pre-treatment facility on site was not clearly expressed in the Order of Conditions issued at our last meeting. Upon the motion of James MacDowell and second of Alice Akatyszewski, numbers four and five of the Order of Conditions were modified to read as follows: 4. Prior to the discharge of any industrial waste, the Operations and Maintenance Manual for the proposed pre-treatment facility shall be submitted to the Conservation Commission for their review and approval. 5. Prior to commencement of the construction of the pre-treatment facility, a pre-treatment plan shall be submitted to the Conservation Commission for review and approval. It was so voted. PUBLIC HEARING--KERN WOOD COUNTRY CLUB Chairman Philip Moran read the notice of the public hearing. Mr. MacDowell noted v. for the record that he is abstaining from any participation in this hearing. .4� A Mr. Erland Townsend of T & M Engineering was present on behalf of the proponent. They propose to perform maintenance work on two areas on the Kernwood Country Club property. The first area is on the sixth fairway adjacent to the Danvers River. They propose to repair a retaining wall located there which is in a state of extreme disrepair. It is a stone wall and they plan to construct a second wall inside the existing wall. There is also an area on the sixth fairway where a stone wall is deteriorating badly. They would like to construct a new gabion retaining structure. The second area is located on the seventh tee also adjacent to the Danvers River. There is a timber retaining wall located here which is also deteriorating badly. They propose to construct a new concrete retaining wall with a gabion-tied top. Mr. Townsend added that the work is generally maintenance. Minutes of Meeting--September 26, 1984 Page 4 Chris Hagger asked what their construction sequence was and Mr. Townsend stated they plan to construct the walls in question in alternating sections to help keep the wall in place. Glenn Yale asked what their schedule for construction was and Mr. Townsend replied they would like to begin now and complete the project in the Spring. In response to a further question from Glenn Yale, Mr. Townsend noted that an Erosion Control Plan was included with the submission of the Notice of Intent. Chris Hagger asked if any test borings were done and Mr. Townsend replied they have done two borings and they plan to go down no farther than 8 - 101. Upon the motion of Chris Hagger and second of Glenn Yale, the public hearing was closed. Upon the motion of Glenn Yale and second of Chris Hagger, the Order of Conditions was approved with the following additional conditions: _ 1. Work on the 6th fairway shall conform to plans entitled, "Repairs to retaining T walls--6th fairway and the Danvers River--Kernwood Country Club," dated May 24, 1984 by T & M Engineering Associates, Inc. 2. Work on the 7th tee shall conform to plans entitled, "Reconstruction--retaining wall--7th tee and the Danvers River--Kernwood Country Club," dated May 24, 1984 by T & M Engineering Associates, Inc. 3. All work shall conform to a report entitled, "Appendix: Soil Erosion and Control Plan," included in the Notice of Intent dated 8/24/84 by T & M Engineering. It was so voted. DETERMINATION OF APPLICABILITY--RALPH SALVO--FREEMAN ROAD Chairman Moran read the notice of the Determination. Dr. Hugh Mulligan of Gulf of Maine Research was present on behalf of Mr. Salvo. He noted that Mr. Salvo owns Lot 269 and the owners of the other lots were also present this evening. Mr. Salvo would like to begin construction of a single-family home this Fall. Dr. Mulligan stated that based upon his research and a U.S. Coast Guard sheet depicting the area in question, it is his opinion that their is no significant wetland existing on Mr. Salvo's lot. They wish a negative determination. In response to a question from Glenn Yale, it was noted that the development of these lots will require a formal filing of a Definitive Subdivision Plan, as the road is not completed. Minutes of kleeting--September 26, 1984 Page 6 FAFARD Mr. Gregg Warren and Mr. William McDonough of Fafard were present to give the Commission an overview of the project thus far. An Order of Conditions is presently being drafted by DEQE for the entire project and will be submitted to the Commission upon completion. Presently, in order to provide a safe intersection at Traders Way and Whaler's Lane, a portion of conservation land will be needed. Fafard intends to provide a compensating piece of land in return for the piece they need to accomplish the construction of the intersection. Research is currently underway to determine the legality of this. Further, an easement over conservation land is needed in order to provide drainage for Traders Way. Both these issues are currently being researched by the Assistant City Solicitor. The parcel was originally deeded to the Commission for conservation purposes and it is not yet clear what restrictions have been imposed on the property. Mr. Warren gave the board a brief description of their proposed pond re-location and re-vegetation plans and stated that he feels the draft Order of Conditions will be ready early next week. WENHAM LAKE Conservation Aide Charles Frederiksen stated he had been contacted by the Chairman of the Wenham Conservation Commission regarding a proposal to build a housing development on Wenham Lake, which is Salem's primary water supply. After meeting with Mr. Berlin, the Wenham Con/Com chairman, Mr. Frederiksen was convinced that this project would have a severe detrimental impact on Salem's watershed. Upon the motion of Glenn Yale and second of Alice Akatyszewski, a letter will be sent expressing the Commission's opposition to this proposal. It was so voted. v. RICHDALE DETERMINATION Action on this Determination was postponed from our last meeting pending the submission of stability calculations for the gasoline storage tanks. Upon studying the calculations submitted, the Commission expressed concern that the calculations did not reflect the water level that could occur for that parcel. Further, the calculations were not prepared and stamped by a Registered Professional Engineer. Upon the motion of James MacDowell and second of Alice Akatyszewski, no action will be taken on this Determination until amended calculations are submitted. It was so voted. NEnutes of 'fleeting--September 26, 1984 Page 7 PICKIMAN PARK--EXTENSION OF ORDER OF CONDITIONS (#64-32) Upon the motion of Alice Akatyszewski and second of James MacDowell, the Order of Conditions for Pickman Park was extended for six months. It was so voted. PICKMAN PARK BEACH--EXTENSION OF ORDER OF CONDITIONS (#64-89) Upon the motion of James MacDowell and second of Raymond Lavender, the Order of Conditions for Pickman Park Beach was extended for six months. It was so voted. DISPOSITION OF CITY PROPERTY Upon the motion of Glenn Yale and second of Raymond Lavender, two parcels--one on Pope Street and one on Cherry Hill Avenue--were determined to be of no interest to the Conservation Commission. It was so voted. MINUTES y Upon the motion of Raymond Lavender and second of Alice Akatyszewski, the minutes of September 12, 1984, were approved. It was so voted. There being no further business, a motion was made to adjourn. Having passed unanimously, the meeting was declared adjourned at 9:45 p.m• Respectfully submitted, Dale E. Yale Clerk BUIL'DINC, DEPT AUGUST S, 1991 Allo 7 1 17N `i BUILDING INSPECTOR FEC=`IED CITY Cc SALEM,MASS. CITY OF SALEM SALEM, MA. 01970 DEAR SIR, THIS IS TO INFORM YOU, THAT I, JOHN GEORGE, SALEM BUILDER'S LICENSE #1277, STATE BUILDER'S LICENSE #042473, INTEND TO CONTINUE AND COMPLETE RENOVATION AT LAHANA RESTUARANT, 15 BRIDGE ST. , SALEM, MA. ON A PREVIOUSLY APPLIED FOR BUILDING. PERMIT #184-91 . I WILL ASSUME RESPONSIBILITY FOR COMPLIANCE WITH ALL NECCESSARY STATE AND CITY BUILDING CODES AND ORDINANCES AND WILL FURNISH FLAME SPREAD CERT- IFICATES TO BOTH YOU AND YOUR OFFICE. RESPECTFULLY YOURS, OH GEORGE .e �Il�P f�nmmunmPtt.[ ' �f l�tt�xrl�u�Pl� i F a CITY OF SALEM y° In accordance with the Massachusetts State Building Code, Section 108. 15, this ytN r<� CERTIFICATE OF INSPECTION is issued to I (arl'tifg that I have inspected the premises known as located at ''�'' `� in the city of Salem County of Essex Commonwealth of Massachusetts. The means of egress are sufficient for the following number of persons: - BY STORY Story Capacity Story CapacttySfory Capacity BY PLACE OF ASSEMBLY OR STRUCTURE Place of Assembly Place of Assembly or Structure Capacity Location or Structure Capacity Location Certificate Number Date Certificate Issued Date Certificate Expires Building Official The building official shall be notified within (10) days of any changes in the above information. co.WoNG'FaLTa of ��ssac_-Ls=_—s CITY OF SAL°11 APPLIC:,TTON FOR C=TIFICAS£ O. SSFEC ION Date ( PJ tee Required S M ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code. Sect: 108. 15. I hereav apply for a Certificate of Inspection for the below-named premises located at the following address: Street 6 Number Name of Premises Purpose for which Premises is used License(s) or Per--:Lr(s) required for the pre.._ises by other GavarnseIIL31 'e License or Permit Acencv M O_ Cerrificare to be issued to: All A/ AL41F �w Address: % J`� /�.� �� rr_ 67- 5A( L� .Ovner ,of Record of Building: Address: . Z-nNme of Present Holder of Cerrificare: Name of Agent. if any.. . Signature or Person to wop pert_:icate TZ= is issued or hisiher authorized agent 2Z-51&F Date' IN=UcSIONS: Day rime phone I 1. Hake check payable to: The City of Salim 2. Return this application with your check to: Inspector of Buildings. City of Salem Building Department. One Sales Green. Saler. HA. 01970. PLrASE NOSE: 1. Application form with required fee must be submirred for each building or sr=r- ire of part thereof to be terrified_ 2. Application 6 fee at be received beiare the certificate w1.11 be issued. 3. The building official shall be notified within can (10) days of any change in the above i:.foraation. CEBITI'ICATE 1 Ia��G� =TvATION DATE: / PERIODIC INSPECTION REPORT This form is to be completed each time a Periodic Inspection is made. At the time i a new Certificate of Inspection is issued, a notation indicating that the fee has been paid will be made to Application Form prior to the new Certificate of Inspection being issued. Any changes since the last inspection are to be added to the file card of the premises. Street 6 Number Name of Premises Certificate to be issued to: N)ne p Address owner of of Record of Building Address nn Purpose for which premises are used CS r U Changes since last Inspec 'on (required on file card also) 1 . AJ cm alh6(2,n 2. 3. 4. 5. Date Order Issued: Order Issued To: Address Date Violations Corrected: REMARKS: I have this day inspected the above premises, and the same conforms to the pertinent requirements of the Massachusetts State Building Code and the rules and regulations pursuant thereto. q-ag ' qr Date Building Of ial Certificate I I ��_ Date Issued: p Date Expires: �o Recommended Next � c��p (�mnmpnmrttitl� of lf�tt��ttrl�tttri�� a o CITY/TOWN OF In accordance with the Massachusetts State Building Code, Section 108. 15, this CER1TIFICATE //S�OF INSPECTION isissued to . . . . . . . .1. .q. . . �.S. l . � Cb7 . . . . J. .v. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TPTYIfI� that I have inspected the. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .known as. . .r. . located at. . . . . . . . � . . . . . .in the. . . . . . . . . . . . .of. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County of. . . . . . . . . . . . . . . . .Cowmnonuwealth of Massachusetts. The means of egress are sufficient for the following number of persons: BY STORY Story Capacity Story Capacity Story Capacity Story Capacity BY PLACE OF ASSEMBLY OR STRUCTURE Place of Assembly Place of Assembly or Structure Capacity Location or Structure Capacity Location + PO 1-"� jn j Certificate Number Atte Certificate Issued Date Certificate Expires Building Offic26a1 The building official shall be notified within (10) days of any changes in the above information. Page 2 – b. Yews shall- be planted along the border of Pierce Ave. and shall be a minimum of 5' in height planted a maximum of 4' on center. -- — C. Shrubs and trees shall be maintained in a healthy and thriving condition. Should these plantings not remain in a healthy and thriving condition, the responsibility for replacement of such plantings shall be the owner or his successor in interest. 6. All construction shall be conducted in accordance with the folloiwng conditions: a. No work shall commence before 7:00 a.m. on weekdays and 8:00 a.m. on Saturdays. No work shall continue beyond 5:00 p.m. No work shall be conducted on Sundays or holidays. Inside work of a quiet nature shall be permitted at other times. • b. All construction shall be carried out in accordance with the Rules and Regulations of the Planning Board. A Clerk of the Works shall be provided by the City at the expense of the developer as is deemed necessary by the Director of Public Services or the City Planner. 7. There shall be no increase in noise levels beyond 54 db. 8. Substantial violation of these conditions shall result in the revocation of this permit by majority vote of the Planning Board. I hereby certify that a copy of this decision and plans have been filed with the City Clerk and copies are on file with the Planning Board. This Special Permit shall not take effect until a copy of the decision bearing the certification of the City Clerk that twenty (20) days have elapsed and no appeal has been filed or that if such appeal has been filed, and it has been dismissed or denied, is recorded in the Essex County Registry of Deeds and is indexed in the grantor index under the name of the owner of record or is recorded on the owner' s certificate of title. The fee for recording or registering shall be paid by the owner or applicant. Walter B. Power 'n Chairman, Planning Board "` ```,. Tift1 of c alent, Cflttssarhusrtf5 i 8 �B raN °BS Ittltnilt r+3uttr� RECEIV D CITY OF SALEM-HASS. 00111 ,'Z.Wrm Grerit DECISION OCT 4 3 301M IS ME+li October 4, 1985 My CK Um.MASS. SPECIAL PERMIT SITE PLAN REVIEW Waikiki. Restaurant 15 Bridge Street Salem, MA. 01970 On Thursday, July 10, 1985, the Planning Board of the City of Salem held a__publi-c-hearing regarding the application of the �Waikikie Restaurant, 15'3 Bridge St. ,,for a Special Permit under Section R, SitPlan-Review,--off` Bridge Ordinance, with respect to the demolition of the existing restaurant on the site and cosntruction of a new facility. At a regularly-scheduled meeting of the Planning Board held on October 3, 1985, the Board voted, by a vote of six in favor, none opposed, to approve the application as complying with the requirements for the issuance of the Special permit with the following conditions: 1. All work shall conform to plans and specifications entitled, "Project Manual for Waikiki Chinese Restaurant, 15 Bridge street, Salem,", dated March 15, 1984, prepared by John Danielson, Inc. , Architects , "Site Plan for Waikiki Restaurant, 15 Bridge Street, Salem" dated September, 1982, revised 1/18/85, and report entitled, "Outdoor Noise (CAA Job 5589)" prepared by Cambridge Acoustical Associates, Inc . , Klaus Kleinschmidt , RE. , Senior Engineer. 2. Upon site start-up and during site construction, the Board of Health shall be notified. All demolition material shall be disposed of according to Board of Health regulations. 3. Sprinklers and test connections shall be subject to the approval of the Fire Department. 4. Any activity which takes place beyond the location of the existing fence shall be subject to Conservation Commission approval. 5. All landscaping shall conform to Plan entitled, "Landscape Plan, Waikiki Restaurant," dated 7/17/85, revised 9/12/85. a. Shrub diameters shall be a minimum of 2' in diameter planted a maximum of 4' on center. Mature trees shall be a minimum caliper of 3". CERTtfIJ�F OCCUPANCY ��ennrt CITY OF SALEM 17 SALEM, MASSACHUSETTS 01970 of Salem Buildi 9B�/MINE W DATE '"AY 26 19 95 PERMIT NO. 2'27-1995 APPLICANT ADERTI"'AW I_IONSTRUCTION ADDRESS 76 TREBLE_ COVE RD 1451 (NO.) (STREET) (CONTR'S LICENSE) CITU ki B I L1._ER i CA STATE MA ZIP CODE 01862 TEL.NO. 508-670-2900 PERMITTOPL ERATION (_) STORY RESTAURANT/LOUNGE NUMBEROF (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) DWELLING UNITS AT(LOCATION) 0015 S: RIDGE_ =STREET ZDISTRICT ONING B_` (NO) (STREET) BETWEEN i ERCE AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION ��i'r+� LOT L?IQIF�ib+ BLOCK SIZE 1. c- - -RES BUILDING IS TO BE FT.WIDE BY FT.LONG BV FT.IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION TYPE) REMARKS: :l..tF_NOVAI IONS -OR NEW 59 : E�TAURANT ( ROOF, KITCHEiN, PARTITIONS, KITCHEN) AREA OR - PERMIT (CUBIGSOUARE FEET) VOLUME ESTIMATED COST$ .:371, 000 FEE � E. o0 OWNER DOE FAMILY 7 RLlti l BUILDING DEPT. ADDRESS 160 OLYMPIA AVE BY �. T .roB SITE COPY � CITY OF SALEM BUILDING _ SALEM, MASSACHUSETTS 01970 PERMIT �>rnne o° DATE MAY 26 19 55 PERMIT NO. d27-19'95 APPLICANT 4�EER ! HAW C 1NSTRU'�T T!-'hl ADDRESS �`- 1'•'i tiL CuV;- !->D 1491 (N0.) (STREET) (CONTR'S LICENSE) CITY N BILLERICA STATE MA ZIP CODE TEL.NO.NUM ALTERATION ;?ESl AUt AIV T: [' DWELBENGUNITS N ROF PERMIT TO ( ) sroav ED USE)._ (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING AT(LOCATION) ID01 BRIDGE STREET DISTRICT B (NO.) (STREET) BETWEEN PIERCE AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION MAP J7 LOTOQ163 BLOCK SIZE-1 . ='S ACRES BUILDING IS TO BE FT.WIDE BV FT.LONG BY FT.IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: RENOVATIONS FOR NEW 99 RESTAURANT (ROOF, KITCHEN. PART;.71ONS, KITCHEN) L_ AREA OR Gall for Permit- to Occupy PERMIT VOLUME ESTIMATED COST$ 371, 000 FEE $ 2232. 00 (CUBICISOUARE FEET) OWNER DOE FAMILY TRUST BUILDING DEPT. ADDRESS 160 OLYMPIA AVE BY L. E. THIS PERMIT CONVEYS NO RIGHTTO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY,ENCROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION,STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THEDEPARTMENTOF PUBLIC WORKS.THE ISSUANCE OF THS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM dO THREE CALy INSPECTIONS - APPROVED PLANS MUST BE RETAINED ON JOB AND THIS CARD KEPT WHERE APPLICABLE SEPARATE REQUIRED FOR ALL CONSTRUCTIONWORK: POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A PERMITS ARE REOUIRED FOR 1.FOUNDATIONS OR FOOTINGS. _ ELECTRICAL,PLUMBING AND 2.PRIOR TO COVERING STRUCTURAL CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH BUILDING SHALL MECHANICAL INSTALLATIONS. MEMBERS(READY TO LATH). NOT BE OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 3.FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS BING INSPVjPN*,RPR9VAIPV ELECTRICAL INSPECTION APPROVAL BOARD OF HFALTH V A- - G INSPECTIO OV FIRE DEPT.INSP TING AP OTHER CITY ENGINEER, WORK SHALL NOT PROCEED UNTIL THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS INSPECTIONS INDICATED ON THIS CARD INSPECTOR HAS APPROVEDTHE VARIOUS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED CAN BE ARRANGED FOR BY TELEPHONE STAGES OF CONSTRUCTION. AS NOTED ABOVE. OR WRITTEN NOTIFICATION. DATE OF PERMIT PERMIT No. OWNER LOCATION 11/ 19 7 _ 335 �IKIKI Restaurant IS Bridge S1trees— B STRUCTURE MATERIAL DIMENSIONS No.OF STORIES No.OF FAMILIES WARD COST Demolsih Wood 15'X20' 2 BUILDER " 11/ 19/87 COPIED ALL INFO FROM ORIGINAL CARD" 11/ 19/74 #335 Demolish garage in rear of Waikiki Rest. 11/5/85 #731 Erect new building $650,000. 1/28/86 1136 Demolish building and remove all debris from site $6,500. 12/ 18/86 11731 CERTIFICATE OF OCCUPANCY ISSUED 3/30/87 # 186 Erect Sign, est . cost $3,500. fee $20.00 1/9/91 # 10-91 Erect 4'X16' sign,cost $2,500. fee $20.00 (Owner Wm. Lee-LaHana Resturant) 1/9/91 1111-91 Erect 6'X8' sign cost $ 1 ,500. fee $20.00 " 11 11 " " ) 5/9/91 #184-91 DIVIDE THE LOUGNGE INTO TWO ROOMS AS PER PIANS, COST$15,000. fee $95.00 D 8/23/91 #184-91 CERTIFICATE OF OCCUPANCY ISSUED BY DAVID HARRIS CITY OF SALEM, MASSACHUSETTS PLANNING DEPARTMENT r I GERARD KAVANAUGN f.'��'� GNE SALEM GREEN CITY PLANNER s wT CIT01970 Y (1 S j�_Ei°;IIfi97.j':2'4$;458D August 31 , 1987 i Mr. Sam Yung Happy Villa, Inc. 15 Bridge Street Salem, MA 01970 Dear Mr. Yung: I am writing to you with regard to the Waikiki Restaurant on Bridge Street in Salem. On October 3, 1985, the Salem Planning Board granted a Site Plan Review Special Permit for the construction of a new facility at 15 Bridge Street. One condition of the Special Permit was the maintenance of the landscaping on the site. This has not been occuring. I would like to request that you cooperate with the Planning Board and address this issue immediately through increased maintenance of the plant materials. If this action does not take place immediately, proper legal action will be initiated. If you have any questions, please contact me at 7-451-9595 ext. 311 . SiLnnce ,el Gera Kavanaugh Cit /Plianner..- cc: William Munroe, Building Inspector Michael E. O'Brien, City Solicitor I1015 BOARD OF APPEALS t` f� cl DEC ( 2 10 214 oD tlr# JS CITY OF SALEM HEALTH DEPARTMENT RFCE!`;'c0 00ARD OF HEALTH CITY 0 SAL,D1, HASS, Salem, Mass.--+Chusetts 01970 ROBERT E. BLENKHORN 9 HORTl1 SIRFET HFAi_ H AGENT December 11, 1986 �en� i41-1800 Mr. Sam Yung Waikiki 15 Bridge Street Salem, Ma 01970 Dear Sir: On this date, this Department concurs with all health code requirements relative to the Occupancy Permit and signs off that requirement. The following requests are made by this Department: FOOD STORAGE AREAS 1. All food holding and storage areas, walk-ins (high and low temperature refrigerators) be thoroughly washed, cleansed and sanitized prior to receipt and storage of food items. KITCHEN AND FOOD PREP AREAS: 2. All surfaces, equipment, utensils, tableware, silverware and glassware be washed, cleansed and sanitized prior to work startup in these areas and dispensers with chlorinated cleaning detergents, dispensing units and sanitary paper towels be installed where necessary. For our assistance, we ask that you notify this department upon completion of the above two items. Thank you for your cooperation. Very truly yours, FOR THE BOARD OF HEALTH Z � � , RO ERT E. BLENKHORN, C.H.O. Health Agent REB/g __:, 5c.c. Building Inspector, William H. Munroe t11 t Sx CIi#g of �aIem, �Httssuchusetts Aire pepartaunt Xeabyuarte4L 3 12 52 P,4 lgq ROBERT J. CROWLEY 48 Pfgette Strret RECEIVED A/Chief *6m, 49tt. L11970CITY OF SALE 197D 14,MASS. June 28, 1984 Mr. Richard T. McIntosh, Building Inspector City of Salem One Salem Green Salem, Ma 01970 Dear Mr. McIntosh. On this date , the Fire Prevention Bureau reviewed the plans sub- mitted by Mr. Sam Yung of the Waikiki Restaurant;!�'15'Bridge Street, for the reconstruction of their restaurant facility:As—the re- sult of this review, the following changes are required prior to approval by this department: (1 ) The fire department connection to the sprinkler system shall be located on a side of the building which fronts on a street (either Bridge Street or Pierce Avenue) so that immediate access can be made by the fire department. (2) The water motor or electric gong shall be located with the fire department connection, and shall be shown as such on the plans. (3) A test gauge shall be placed at the fire department test connection (top line test). (4) A site plan shall be provided which indicates the six- inch water main for fire supply, and the four-inch main for the domestic supply. ( 5) A plan for fire alarm equipment shall be provided which includes provision for pull stations, audible/visual alarm devices, alarm connections to the fixed (CO2) fire extinguishing system, a fire alarm panel (to in- clude a Square-D silencin switch and 'a remote trouble buzzer) and the location front of building) of the fire alarm box if directly connected to the municipal system. Should you have any questions concerning these changes, please contact the Fire Prevention Bureau. Thank you. Cordially, Robert W. Turner, Salem Fire Marshal Copies: Waikiki Restaurant Electrical Department File CITY OF SALEM, MASSACHUSETTS PLANNING DEPARTMENT GERARD KAVANAUGH �`t' �- CITY PLANNER 1�f CE NE 1) � ONE SALEM GREEN 9 C11Y Or SNLE11,1i'.-�SS- 01970 w (sn) 744-4580 m w December 15, 1986 Mr. William Munroe Building Inspector One Salem Green Salem, MA 01979 Dear Bill: The Planning Department has completed an inspection of the premises located at 15 Bridge Street and have determined that the requirements placed upon the building through the Site Plan Review Process have been substantially completed. If acceptable to you I feel that a Certificate of Occupancy can be granted with the following conditions: - Installation of parking area lighting shall occur within 12 days of the date of this letter; - Removal of the existing free standing sign within 3 days; - Submittal of the design of the new sign within 5 days, and full compliance with all requirements and desires of the City Planner for the design of the new sign. With the above conditions I feel that the requirements of the Planpj' g Board have been satisfied. /' 1 ; Since Gerar vanaugh City , a ner M18WP l Ctv of ttlent, 'fflassar4use##s Iluhlic Prupertg Pepartmeut 9 7p "NNE�+'1v lWilling ]t�epttrtntent One '4alrm (FDrrrn 745-9595 Ext.380 Director of Public Property William H. Monroe April 22, 1988 Ted Harvey 15 Belleau Road Salem,MA 01970 RE: iwWaikiki Restaurant. r15_Bridge__Street , Sal m,MA. Dear Mr. Harvey, We acknowledge your verbal complaint , made on April 21 , 1988, regarding the above referenced property having 420-440 occupants on the evening of April 16, 1988 @ 11 : 16 P.M. This department is charged with determining the total occupancy of buildings as per Table 606 of the Mass State building Code, also we make an annual inspection as evidenced by the enclosed copy of Certificate of Inspection. The Salem Fire Department and Salem Licensing Board are charged with enforcing over crowding of these establishments. If I can be of further assistance on this matter please do not hesitate to call. Sincerely, Mauric Martineau Assistant Building Inspector MMM/eaf C.C. Salem Fire Salem Licensing enc: 94t Tommunwealth at Annoar4usletts b CITY/Mfg OF SALEM In accordance with the Massachusetts State Building Code, Section 108. 15, this CERTIFICATE OF INSPECTION is issued to . .. . . . . .. HAPPY. YIL.LA. INS:. . . d/p/A WAIKIKI. RKSTAPPAPY . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . (PTYIfy that I have inspected the. . . . . PRF-M AU . . . . . . . . . . . . . . . . . . .known as. . TAF, WAIKIKL . . . . . . . . . . . . . located at. . . . .J5. RRIDGF. STREET. . . . . . . . . . . . . . . . . . .in the. . CITY. . . . . . .of. . . . . SAJ.EM . . . . . . . . . . . . . . . . . . . . . . . . . . . County of. . . . ESSEX . . . . . . .Commonwealth of Massachusetts. The means of egress are sufficient for the following number of persons: BY STORY Story Capacity Story Capacity Story Capacity Story Capacity BY PLACE OF ASSEMBLY OR STRUCTURE Place of Assembly Place of Assembly or Structure Capacity Location . , or Structure Capacity Location RESTAURANT 386 ' First Floor 6-88 January 21 , 1988 January 21 , 1989ltcti�fc�u� Certificate Number Date Certificate Issued Date Certificate Expires Building Official The building official shall be notified within (10) days of any changes in the above information. Ra) "A1 knr lc gity lirf tT� tStta�TCI�1YnP# S e' C, ;i 'r 4 e a A,�� IttzclYiaTg �IIttr� J�� 23 8 �EiG TEY[ 24 (Diu RECEIVED Ail °86 (�IT:Y Or SALEP1,11IN&.S. January 21 , 1986 Mr. EdmondDanielson 19 Winchester Drive Lexington, MA. 02173 Dear Mr. Danielson: The Planning Board and Planning Department would like to remind you that any signage contemplated for the kWaikiki Restaurant on Bridg e Str'eer will be subject to the review and approval—o€—the~Planning Bo`aid and-PI I anning Department. No Certificates of Occupancy will be granted by the Building Inspector until such review and approval has taken place. I would be happy to discuss this with you further if you wish. Since eNly� yours, Dale E. Yale nl2/edmond V / W cec ✓/P/LCUI[�/I.�CIi Q�fJ//2!?(I�L/l�Q/?./I'LC/1�A�/��l,, C/i` �JI2QUZQU' VI%C/i �i�2E?f!1�O�14I.1.�.CLIZ eh/Qd.C.Q/!i = ./VOI��4///2QQ�i Oe�� O S. RUSSELL SYLVA 5 �i�airirnQnueealflr rSQ��2eiztte Commissioner 935-2160 February 14, 1986 Happy Villa, Inc. 39 Portina Road Re: SALEM- Metropolitan Boston/ Brighton, MA 02135 Northeast Region 310 CMR 7.09(2)-Notification NOTICE OF VIOLATION Personnel of the Metropolitan Boston/Northeast Region of the Department of Environmental Quality Engineering on February-ll-,-1986,-inspected-the renovation/demolition site located a! t 15 Bridge Street, Salem, Massachusetts;for the purpose of determining compliance with the"Regulations'-regarding the removal, storage, and disposal of asbestos. During the -course of this inspection, Department personnel, accompanied by Mr. William Di Tocca of Wellesley Corp. , recorded the following areas of non-compliance: Failure to properly notify the Department prior to commencement of demolition. Such non-compliance constitutes a violation of 310 CMR 7.09(2)of the "Regulations for the Control of Air Pollution in the Metropolitan Boston/Northeast Regional Air Pollution Control District," which were adopted under Sections 142B and 142D, Chapter 111, of the General Laws. You are hereby directed to inform this office in writing, on or before February 24, 1986 as to the .action you have taken or intend to take in order to assure this office that your company is now, and will continue to be in compliance with said "Regulations." Should you have any questions concerning this matter, please contact the writer at the above address or telephone number. Very truly yours, 040, g, g Weiscopf Kelly r, Environmental Analyst III c ;-r Air Quality Control Section !` ro C:; WSK/pd cAn cc: Board of Health, Town Hall, Salem, MA 01972 �+ 4 S. RUSSELL. SYLVA 5 T�amma�zeQI��L S�rPru� Commissioner 935-2160 February 14, 1986 E i Wellesley Corp. 318 Weston Road Re: SALEM- Metropolitan Boston/ Wellesley, MA 02181 Northeast Region 310 CMR 7.09(2)-Notification NOTICE OF VIOLATION s Personnel of the Metropolitan Boston/Northeast Region of the Department of Environmental Quality Engineering on February 11 , 1986, inspected the renovation/demolition site located at 15 Bridge Street, Salem, Massachusetts, for the purpose of determining compliance with the "Regulations" regarding the removal, storage, and disposal of asbestos. During the course of this inspection, Department personnel, accompanied by Mr. William Di Tocca of Wellesley Corp., recorded the following areas of non-compliance: Failure to properly notify the Department prior to commencement of demolition. Such non-compliance constitutes a violation of 310 CMR 7.09(2)of the "Regulations for the Control of Air Pollution in the Metropolitan Boston/Northeast Regional Air Pollution Control District," which were adopted under Sections 142B and 142D, Chapter 111, of the General Laws. You are hereby directed to inform this office in writing, .on or before February 24, 1986 as to the action you have taken or intend to take in order to assure this office that your company is now, and will continue to be in compliance with said "Regulations." Should you have any questions concerning this matter, please contact the writer at the above address or telephone number. Very truly yours, 4��4 Weiscopf S. Kelly Environmental Analyst III Air Quality Control Section WSK/pd cc: Board of Health, Town Hall, Salem, MA 01972 I Yli,�,, (eccl - - _ ✓/P�CL7k�i/LC'/LI,l1///`�h.!➢L�/;�1J,2,�2P/2t�A/�>GClllll[!, ��,}7�[I2PP/w2ll, / S. RUSSELL SYLVA 5 �UarrrrnaizuaeaQ/L J�Y- ,,w, O Commissioner �� dd.ae�utile.C.C4, O'80' 935-2160 February 14, 1986 Neptune Demo Corp. 70 Temmey Street Re: SALEM- Metropolitan Boston/ Marblehead, MA 01945 Northeast Region 310 CMR 7.09(2)-Notification NOTICE OF VIOLATION Personnel of the Metropolitan Boston/Northeast Region of the Department of Environmental Quality Engineering on February 11 , 1986, inspected the renovation/demolition site located at 15 Bridge Street, Salem, Massachusetts, for the purpose of determining compliance with the "Regulations" regarding the removal, storage, and disposal of asbestos. During the course of this inspection, Department personnel, accompanied by Mr. William Di Tocca of Wellesley Corp., recorded the following areas of con-compliance: Failure to properly notify the Department prior to commencement of demolition. Such non-compliance constitutes a violation of 310 CMR 7.09(2)of the "Regulations for the Control of Air Pollution in the Metropolitan Boston/Northeast Regional Air Pollution Control District," which were adopted under Sections 142B and 142D, Chapter 111, of the General Laws. You are hereby directed to inform this office in writing, on or before February 24, 1966 as to the action you have taken or intend to take in order to assure this office that your company is now, and will continue to be in compliance with said "Regulations." Should you have any questions concerning this matter, please contact the writer at the above address or telephone number. Very truly yours Y' Weiscopf . Kelly Environmental Analyst III Air Quality Control Section . WSK/pd cc: Board of Health, Town Hall, Salem, MA 01972 .t Restaurant �Yltet b{11e CtUYM1t useof tM 8u►Id" it 'W INN WUb7� �IdBus" Br Yes AepNmel No We do%1fI*q CORM to Law, rNarM Moese (97 AddrGoa w d PhWO 206 A er Ro &r Nrnr F.W. 367 Chandlerr Street, Worcester, MA 01602 Awd spery r.7 BLWrxM/67A7407 HIC. 0 COUN M 125,000.00 pN1mfNE— ' EeWnatad Cod X 671f1oO0 Roomer" pern'e fee i� . - ��nrled Cori X i�tKtCoo Cana��--_ An AddIUWW$Loa IS added a an w re Mat as field•am WOperq and WOW wrMn m WON delaYe In proaaa O The Wvwswad does hWOW a"fix a eutldM to build m u+r stave sfamd apa fipUone. Signed under penaft d PO" pate 6 I b I I s � a (� ^5, o a I PUBLIC PROPERTY DEPART1MNT /4_07 13Drlsenw,a,mum*s'"O% XUmow rmot•as +sss"•t7Ps:M74404 Am AMS �u ><OR �'�slTtiNfORMATtON 99 Restaurant & Pub PtopNq Addrearf _ . ._15 Bridge StreetA A G"I r In Wow In a:C MWV@ a1 Anna YIN_�� t#elprls t7tsMld YM ern 1p OWNERiFii/IN!<ORMATION - . 1/ Owner of Land mmm 99 Restaurant & PubAddrem ._ 160 Olympia Ave Woburn, MA 01801 TAW: 781-932-5127 3ACOMPLM THIS st?OTION!<OI!WORK IN jEKjUM �JILDINO4 ONLY AddMon Sdalft 1 Renovation x Number of SWISS Ranovatad 1 Chanpa in UN Now Demoklon "da""� 10,400 SF AI�Proximata you of Co Area per floor s Coll Or ranovabon q Renovated 5,200 SF Of exiftm N 1996 NOW 9Qel0ascripdon of Proposed Work: New Interior Upper & Lower Wall Finishes New Rug in Dining Areas New Ceiling Tiles New Exterior Clapboards Paint Exterior & Interior Conservation Area - Within Buffer Zone but not changing the footprint Mad Permit to: City of Salem Sign Permit Application Worksheet �f r `rr s 11-May-15 - Ninety Nine Restaurant -- 15 Bridge Street i IS NAY '0 QZoning(res/non-res) 131 Entrance Corridor(Y/N) Y Lot frontage 223 feet Building or tenant frontage 143 feet f n #of businesses on site 1 U / Bldng dist from street center 120 feet Multiplier 1.25 maximum area permitted 178.75 sq ft Itotal proposed sign area 109.65 sq ft EXISTING sign 1 length 227.00 inches height 60.00 inches sign 2 MOMM sign 3 length 0.00 inches height 0.00 inches sign 4 length 0.00 inches height 0.00 inches sign 5 length 0.00 inches hei ht 0.00 inches maximum area permitted •32.50 sq ft(per side) maximum#of signs permitted 1 signs maximum height permitted 12.50 ft tall sign 1 proposed sign area 41.10 sq ft EXISTING length 89.00 inches height 66.50 inches proposed sign height 17.20 ft(approx) sign 2 proposed sign area 0.00 sq ft length 0.00 inches height 0.00 inches proposed sign height ft Application meets standards set forth in the Salem Sign Ordinance Yes Recommend approval Yes About 110 sq/ft of signage currently exists at the location. A 14"xl55" inch underneath the primary sign will be replaced with a sign of the exact same size(i.e.total square footage of all signage will remain the same), but text will change. Permit Number APPLICATION FOR PERMIT TO ERECT A SIGN • s NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN Is ERECTED Location, Ownership and Detail Must Be Correct, Complete, and Legible Salem, Massachusetts Wile To the Building Inspector: The undersigned hereby applies for a permit to o Erect, ❑Alter, ❑ Repair a sign on the following described buildings: Street Address Zoning District ❑Urban Renewal Area ❑Entrance Corridor i7 w ❑Historic District ❑None ••' • 7 ppe**otPot to"/// LUse of Buildino Telephone 1s floor Ff ..r..+. • eLA 2n,floor Address 3 OAtle#&e• 3 floor yr Telephone 4 floor E-mail How many businesses are in the building? If a corporate body,name Frontage of responsible officer • � h Building linear feet Construction Sup's License No Applicant's Space(if multi-tenant) linear feet Address Property linear feet Telephone Z ` 0N 0417 Mail Sign Pe.i.ii[to E-mail N G e / ❑Sign OMMSign Erector iOther: Sign 1 Si n 2 Sign 3 ❑Surface �- ❑Surface ❑Surface ❑Right Angle to Bud a Right Angle to Building ❑Right Angle to Building ❑Free Standing O^ �. ❑ Free Standing ❑Free Standing ❑Awning // f x S ❑Awning ❑Awning ❑ Portable (A-Frame) T r�)S�1 ❑ Portable(A-Frame) ❑ Portable(A-Frame) ❑Other(specify) uL / ❑Other(specify) ❑Other(specify) Sign Materials a/�y0.pi Sign Materials Sign Materials Sign Dimensions / Sign Dimensions Sign Dimensions / X a // Sign Area Sign Area Sign Area s ft s ft sq ft Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing) Estimated Cost of Net Work $ Existing Signs Type Sign Area To Be Removed? Sign Owner Surface I l sq ft ❑yes mio ❑ Right Angle to Building q ft ❑yes ❑no dFree Standing : rAl q ft ❑yes •6/no Si er'�,ftlhorized pr entative ❑Awning sq ft ❑yes ❑no — ❑Other(specify) sq it ❑yes ❑no Property Owner Internal Review tanning&Community Development Department Historical Commission Approval Building Inspector oe12aio w City of Salem Department of Planning & Community Development Check/Cash Receipt and Tracking Form Please complete form and make two copies. Date Received IS Amount Received 2G - Form of Payment Check El Money Order Client Information D S CASH PAYMENTS: client initials / I( sign Permit Application Fee ❑ Conservation Commission Fee Payment received for what ❑ Planning Board Fee/ZBA service? ❑ SRA/DRB Fee ❑ Old Town Hall Rental Fee ❑ Other. Name of staff person receiving / payment k> Additional Notes 114 54-253 .n v 1 BarloSignsInternationalInc , =s z 1343 4 Permit Account 158 Greeley St st� 3 Hudson,NH 03051 a ' _,, 603882-2638x333 ,, a i ' 0 i 11cit zens Bank® -0:01140i5331: 3312992216n' i343 Original Check and Form: DPCD Finance COPY 1: Client COPY?_Application File Commonwealth of Massachusetts ` City of Salem 120 Washington it,3W Floor Salem,MA 01970(979)74r-9595 x5541 4 1 Return card to Building G:,lion for Certificate of Occupancy CY Permit 8-15-409 PERMIT T O BUILD �FEE PAID:: $0$0.00 DATE ISSUED: 511 312 01 6 This certifies that BARLO SIGNS has permission to erect, alter, or demolish a�, laid i �5 BRIDGE STREET Map/Lot: 370063-0 as follows: Signs SIGN PERMIT;A' RO EW'P6R gNI ET•Y�NINE RESTAURANT *w kY 3 s Contractor Name: _ rrt t t DBA Contractor License No: 5/1 312 0 1 5 ButldinQ ffictal4` V" N� Date j "�oK This permit shall be deemed abandoned and invalid unl �, caw c� uthorized Eby trm�`d commenced' ""'wrthm fix months after Issuance.The Building Official may grant one or more extensions not to exceed z.rGGSGyr ?rvat,zHi• 's'e, a ,..�z `saeTy v.'F T6d £L V C'� All work authorized by this permit shall conform to the apaoveappl,�cgtidn and the approved construc'ilon docO mends fw which�this permit has been granted. � All construction,alterations and changes of use of any bGil n i a structures shall be in compliance with the local zoning by`(aws and codes. This permit shall be displayed in a location clearly vislb1q;,,- ccgssstreet or road and shall be maintained open for public nspectidn for the entire duration of the work until the completion of the same. '" The Certificate of Occupancy will not be issued until all ca I gd§tilres by the Building and Fire Offical 9 provitledort tfjis permit. . HIC#: P€rs� tree un*ep tpr � J dn�noanav to theg sie ryfuna^(as set forth in MCL a 142A). Restrictions: Building plans are to be available on site. All Permit Cards are the property of the PROPERTY OWNER. I 49-® . az The Commonwealth of Massachusetts ® Department of Public Safety 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) 1 Building Permit Number: Date Applied: Building Official: t SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available) 15 Bridge Street Salem, MA 01970 99 Restaurants No.and Street City/Town Zip Code Name of Building(if applicable) 1 SECTION 2:PROPOSED WORK t Edition of MA State Code used If New Construction check here❑or check all that apply in the two rows below j`--- Existing Building❑ Repair❑ Alteration 9 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 6 No ❑ Is an Independent Structural Engineering Peer Review required? Yes ❑ No ❑ Brief Description of Proposed Work: Exterior: Paint and new awnings Interior: Remove partition wall to open bar area into dining room. Install new Tv's,table lights, cosmetic wall paneling and furniture. Create some faux beams and seating platform. Raise ceiling in bar 6" and add some decorative ceiling panels. Sprinkler heads will be moved accordingly in this area. New carpet tiles in entrance and in dining room. Slate tile on new platform. New paint colors throughout. Remodel does not involve kitchen. 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): ssem 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 9 Nightclub ❑ A-3 ❑ A4❑ A-5❑ 1 B: Business ❑ E: Educational ❑ F: Facto F-1 ❑ F2❑ 1 H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5❑ I: Institutional I-1 ❑ I-2❑ I-3❑ 1-4❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R-4❑ 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 ❑ HA ❑ IIB ❑ ILIA ❑ IIIB ❑ 1 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 PA Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal Site IN Private❑ or indentify Zone: or on site system❑ required❑or trench or specify: permit is enclosed❑ Construction Dumpster 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: IkWS sEr- 0(--y� x5 S �ZI SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner 99 Property III,LLC rlo U.S.Realty Mvisors,LLC 1370 Ave.of the Americas New York, NY 10019 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: 212 -581 - 4540 Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes Levesque Construction LLC 11 Wallace Street Methuen MA 01844 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 Moeser and Associates 978-458 - 6905 steve.raoeser@meeserassociates.. 5379 Name(Registrant) Telephone No. e-mail address Registration Number 206 Aver Road Harvard MA 01451 08/31/15 Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor Levesque Construction LLC Company Name Steve Levesque CS-090705/Type ( U ) Name of Person Responsible for Construction License No. and Type if Applicable 11 Wallace Street Methuen MA 01844 Street Address City/Town State Zip 978 - 702-7095 levesqueconstruction(a)comcast net 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 0 No ❑ SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 1.Building $ 30,000 Building Permit Fee=Total Construction Cost x_(Insert here 2.Electrical $ 30 000 appropriate municipal factor)_$ 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical Other $30,000 Enclose check payable to 6.Total Cost $ 90,000 (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 understanding. Steve Levesque/ L GC/Owner 978-702 -7095 JT j l l Please print and sign name Title Telephone No. Date 11 Wallace Street Methuen MA 01844 Street Address City/Town State Zip Municipal Inspector to fill out this section upon application approval: Name Date `'� CERTIFICATE OF LIABILITY INSURANCE -DATE/201) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollcy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: A & K Fowler Insurance PHONE (978)664-0366 FAX No (970)664-2209 A/C 200 Park St E-MAIL ADDRESS- INSURER(S)AFFORDING COVERAGE NAIC p North Reading MA 01864 INSURERA:Preferred Mutual Insurance INSURED INSURERB:Safety Insurance Company Levesque Construction LLC INSURERC: 11 Wallace St. INSURER D: INSURER E: Methuen MA 01844 INSURER F: COVERAGES CERTIFICATE NUMBERCL1511208069 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OFADDLSUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DDNYYY MNUDDIYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000 A CLAIMS-MADE 1XI OCCUR DOP0100720737 1/30/2019 1/30/2015 MED EXP(Any one Person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY JECTPRO LOC $ AUTOMOBILE LIABILITY COMBINED t SINGLE LIMIT 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED 5059073 /16/2015 /16/2016 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION WC$TATU- OTH ER - AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN orkers Compensation cent E.L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) o follow from AIH Mutual E.L.DISEASE-EA EMPLOYEE $ H yes,desenbe under DESCRIPTION OF OPERATIONS helm E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,H more space is required) Insurance verification - Please refer to actual policy for all other terms, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Salem ACCORDANCE WITH THE POLICY PROVISIONS. 120 Washington St. 3rd Floor Salem, MA 01970 AUTHORIZED REPRESENTATIVE Nicole Orlanzo/NMO ACORD 25(2010/05) 01988-2010 ACORD CORPORATION. All rights reserved. INS025mmnnsni Th.Ar nDn narrmn and Inn.aro roniafnrod..,k..f Ar:r%Dn 9 akin TUTRIMT Inc- _ tf MUSINt Surface Pienvubawof taopa8 pnd mm FFl4Q Of QL3 t+1 1y ._ � 4 J eytu.+.Fen A `FII�IIt • This tmt method Is ■twsded to' Mewn Me mpmqe gf f nbbod taMt f wr -cowrMa maMals When eMNsed to an Igrlttpgn murce tender ea►rtMIed tsboratarV 00nd.MW nr. It ISIPPIlCa Wid;CVMHof t'exdle �flet�06fl�MoW from The umftwed MM Of UM bst soadmen mist be gmtor than one dr o In at le= se wn ofMe elght one d inr to,r . awaptmo crWer-w h ,��' ..•. �I .'. 4i..:`: A CIS... �- i 1;� dN/��.,' �Ygf�.d tyY�sryLvmmvl�'..fi' pw{. tedJI1A .gam ls On skkL TWS ale ES I la rnabilltyr stwKwa Roe FF im, APPROWD •' 3eG4 ySiirf4si Rstr.►ii.Sed Wirer mil' ®s i'�I'Yr!vt'4(�A t4iG.�f�.,�tiram+�te wmxi�. TIk �--._r__.,,_ �o6a�i Yb a '..1OFcpdask..m o'�TSw4"d1Mll asr�.rrrslW5y�y6K1ClK#. : 'B a�nc hPVAI*& Y�...®.1$r�o+.4WsesFYwWvUdB'Xenighn albYc o� 4er.{ r§.�q yd�yr . 4Sl�ilRw 'Oirwpa�g�unM'bJm��pm!4+isriC�wyf9ia�ClotM�.++A¢hlrAoilr�d� 71&uWr,cnbswcew �. hols�6nYx.s�o.t�._-_iliiriA4eemueBe�toudamfs�eliGytrl��rye{r,Mii, { � 71A9fe�mer� m �iIWro.GF;3�t 711d.�2fr•a 757 4lliie9,tu� f Fbr�riogorra6 rti >, .. � .: MONN TeWng Labonfory {7g671W2 Ina, Qrxtf al Y of 9TKka f �� <� �r �� 'Gerr�t�Cf i�1rEolltlll ►talK, alsa re�ed�3d➢Gi9iC9•� MFPA rr >jfJ l 5 R {ab_ATTv �l .2SA I ��T +P.b ! •i, I wAr L. -y t'. e y Y 1 � x y t s rh! i M1x�+t.Y'kt . 9�lttlP�'ien ell M.y TP to �� I Thk prOPPOWM .l€ OMWM tp ortiIMPO Rho 5pod& or3tlell d&AkV a f sm ake gfflenItBd by the test spechim WtMIn a O arrAw. Each sWOrnen fs Matad to an rsatdtante�swrm pmwm to prm,1Q9 a MmUnt it Wianca eel Of2SWa t t'llUM Cif cm the slaeFsirmn surfam. meammnorrm am recorded chrough a ph*MW*t lc Wstam amplooM a vonl al lse=of iW,and s photo oM ecCae .Reaj to detm am vMmftm, at light traffirnittance =zed by smdw mxwm r vOWn tip Own . Yhe light trams mmroments are mad to tastulaw 4xdft o0ca aenOtg.• 411 quarv=tive vAW which h can be faOMM to eSt9mate the s pokMgtW Co n- bwL*. Two burnilm cmmtkwo om be slnwM ed by Me test appwatk T,,ha ,radiant In the'abNrm or Wiffm Is Wired 0 as the won-Flaming VMe. A fMmkig e�vrSesartn'CI7dk pretll s�alln® radCait l�tannlrmp , • 14b luuea Sd'14n+tgt' Vowtwy Lkow"ftaci f *4MI fa,"r 1pdk-xw4jm IdvA%w a�i't. L&C&&sGBp, f 4 - - �KeeQa5�4.eanea+E�sn.gr,�s«va>:a�+avUcsa�ec�rry_��rq�v'�e�'f4�332R�+.'�.sx�elt .ye�l� 91 '!�R{v6h,R�`4i6��xseddy:cAzlo�tre2�cN.�C di:,y6r�IL4*iFelPfir6a"!F��*+�6 (y efw� iMo�vrc,'�0?f�3ldnlr.NeifnlwdatvJYl�xa� I�erNhhi€s14�ila4�r�yv�Q�91e`}i�3 wtlsrrsai' . 714 F DoNo j,GA Writ TUa426. s F=M 6707 IiA1,19gS INTERFACE TEST REPORT #03/G13- 110595 Page 1 of 1 • Test Method Conducted: ASTM E662 Specific Optical Density of Smoke Generated by Solid Material -Flaming Exposure- Test Method Performed By: Interface Flooring Systems, Inc. Date Requested: 04/05/11 Testing Laboratory Requested By: J.Humphries j NVLAP Code: 200402 Customer: InterfaceFLOR r -" Graham Scott Technical Center StyleName: Raw CA f 1603 Executive Dr. LaGrange, GA 30240 Style a: 2669 (706) 812-6152 Backing: GlasBac FAX: (706) 884-8669 Testing Complete: 04/18/11 Report Issued: 04/18/11 Subject: Specimens of the submitted sample were prepared and tested in accordance with the procedures proposed by the National Institute of Standards and Technology(formerly National Bureau of Standards),Technical Note 708 and NFPA 258, ASTM E-662. Scope: The Smoke Density Chamber test is used to determine the specific optical density of the smoke generated within a closed chamber due to non-flaming pyrolytic decomposition or flaming combustion. A photometric system with a vertical light path is used to measure the varying light transmittance as smoke accumulates. The recorded data for light transmittance is used to calculate the specific optical density of the smoke generated during the test for each of the specimens tested. The results are then averaged and reported as Sverage Specific Optical Density. The photometric scale used to measure the smoke generated in this test is similar to the optical density cale for human vision. Test Specimen Conditioning: The samples were (per ASTM E 662) pre-dried for 24 h at 140 deg. plus or minus 5 deg. F and then conditioned to equilibrium (constant weight) at an ambient temperature of 73 deg. plus or minus 5 deg F and a relative humidity of 50% plus or minus 5%. While in conditioning,the specimens were supported by racks so that air had access to all surfaces. Results/Record Storage: Results listed on this report are abbreviated. DM (corrected) represents the maximum specific optical density minus the specific optical density value of the clear beam reading (corrected factor). This number, when averaged, is the final result. All raw data pertaining to this study are to be retained in designated Interface Testing Laboratory Files. A copy of the raw data, tables, graphs,or tabulations which support this report can be obtained upon request. Final Result: Avg. DM (corrected) = 1 195 Interpretation of results: A result of 450 or less is generally considered a passing result although official PASS/FAIL criteria have not been established by ASTM. Accredited by the National Voluntary Accreditation Program (NVLAP) for the specific scope of Accreditation under NVLAP Lab Code #200402 Toni Brown Approved Signatory his report is provided for the exclusive use of the customer to whom H is addressed. Any communication of the contents hereof to others requires our prior written consent. This abonstory is accredited by the NVLAP of the US.Department of Commerce as having the competence to perform speufied tests in accordance with the prescribed test methods and accreditation criteria. This report applies only to the standards or procedures identified and to the sample(s)tested. The test results are not necessarily indicative or representative of the qualities of the lot from which the sample was taken or of apparently identical or similar products. Accreditation or any of its test reports in no way constitutes or implies product certification,approval,or endorsement by NIST or any agency of the US.Government. • SHERWIN-WILUAMS, • 05/15/2013 Flame Spread Rating Information In answer to you request for flame spread rating information regarding certain of our coatings products,most conventional paint syst film ems,when applied at the recommended m thickness,will develop a"Class A"(0-25)flame spread rating over non-combustible, previously uncoated"Class A"rated substrates. The chart below presents the results of flame spread tunnel testing on certain coatings systems.The tests were conducted by an independent laboratory in accordance with the provisions of ASTM E84."Standard Test Method for Surface Burning Characteristics of } Building Materials."This test method is similar to the test method specified in ANSI No.2.2,NFPA No.255,UL No.723,UBC No.421 and T) ASTM E84-75. n C. The flame spread rating for cured coatings not tested may be estimated based on the Flammability of Paint Study conducted by the jy National Paint and Coatings Association(NPCA)at Southwest Research Institute San Antonio,Texas Project 3-3774-141.This study �1 evaluated paints representative of those sold in the modem consumer market.In summary,the study concluded:"conventional pigmented paints of all types made little change in the flame spread ratings of the uncoated substrates and made insignificant changes in the fuel and smoke factors.We believe this study provides substantial evidence that conventional paints and coatings do not increase the flame spread of either non-flammable or flammable substrates upon which they are applied.It also indicates that any fuel contribution or smoke density increase is insignificant when compared with the contribution of the substrate itself"' Therefore,most conventional paint systems,when applied at the recommended film thickness and cured,will develop a"Class A"flame spread rating over a non-combustible previously uncoated substrate. The flame spread and smoke development indexes are based on The National Fire Protection Association NFPA 101 Life Safety Code.Those ratings for interior walls and ceilings are: Class A:Flame Spread Index=0—25 Smoke Developed Index=0-450 Class B:Flame Spread Index=26-75 Smoke Developed Index=0-450 Class C:Flame Spread Index=76-200 Smoke Developed Index=0-450 ' SUBSTRATE STANDARDS: 1/4 inch Inorganic Reinforced Cement Board:Flame Spread Index=0 Smoke Developed Index=0 GRC Board:Flame Spread Index=0 Smoke Developed Index=0 Red Oak Flooring:Fiame Spread Index=100 Smoke Developed Index=100 23/32 inch Plywood Sheathing:Flame Spread Index=125 Smoke Developed Index=75 Test results are rounded to the nearest multiple of 5. Sherwin-Williams Test Data: Flame Spread Smoke Flame Spread Substrate Index • Development Class ProMaro 400 Zero VOC(Low Sheen-vinyl acrylic) 5 0 Class A .625"Type X Gypsum ProMar 400 Zero VOC(S/G-vinyl acrylic) 0 0 Class A .625"Type X Gypsum ProMar 400 Zero VOC(Flat-vinyl acrylic) 5 5 Class A .625"Type X Gypsum ProMar 400 Zero VOC(Primer-vinyl acrylic) 5 0 Class A .625"Type X Gypsum ProMar 400 Zero VOC(Eg-Shel-vinyl acrylic) 10 0 Class A .625"Type X Gypsum Harmony (Flat 100%Acrylic) 10 0 Class A .625"Type X Gypsum Harmony (Eg-Shel 100%Acrylic) 15 0 Class .625"Type XGypsum ProMar 200 Zero VOC(Flat-vinyl acrylic) 10 0 Class A .625"Type X Gypsum ProMar 200 Zero VOC(Pruner-vinyl acrylic) 5 0 Class A .625"Type X Gypsum ProMar 200 Zero VOC(Eg-Shel-vinyl acrylic) 10 0 Class A .625"Type X Gypsum ProMar 200 Zero VOC(Low Sheen-vinyl acrylic) 10 0 Class A .625"Type X Gypstun ProMar 200 Zero VOC(S/G-vinyl acrylic) 5 0 Class A .625"Type X Gypsum PrepRit?ProBlocV Latex Primer(acrylic primer) 10 0 Class A .625"Type X Gypsum As a general rule,the substrate itself may contribute significantly to the overall flame spread rating of a system comprised of a coating applied over the substrate. As a guide,noncombustible substrates such as cement asbestos bound and plaster have a flame spread rating of zero and, when coated,do not contribute significantly to the flame spread rating of the system. One study indicates that a system comprised of mated conventional drywall may yield a flame spread rating Within Flame Spread Class A,but slightly higher than that of a system comprised of a non -combustible substrate.- Conventional paint systems applied over these types of substrates do not contribute significantly to the overall flame spread rating of the system. On combustible substrates that but readily,such as a wood surface that has not been treated to resist burning, standard coatings do nothing to prevent the substrate from burning. That is,conventional paint systems do not significantly reduce the flame spread rating of a combustible substrate. However,special fire retardant or intumescent coatings can be applied to readily combustible sub- strates such as wood to reduce the overall flame spread rating of the system. I trust this information is satisfactory,and if further information is necessary,please let me know. The Sherwin-Williams Company _�Vrt Steve Review,Vice President-Product Innovation References: The National Fire Protection Association NFPA 101 LLO?Safety Code - ASTM E84. 'Standard Test Methodfor Surface Burning Characteristics of Bulldfnghtaterials" -National Paint and Coatings Association,Inc.1500 Rhodes Island Ave,N.W.Washington D.C.20005.FlammabOltyofPaint Study. Project 3-3774-141 Southwest Research Wtimte San Antonio,Texas. • ASTM E84-04 ETL SEMKO SURFACE BURNING CHARACTERISTICS OF BUILDING MATERIALS v Report No. 3080717-01 i^ 3 0 VEN4MA0 FR •PVC/Acrylic Composite Thermoplastic Sheet, Fire Retardant Grade, Color #07 Medium Cherry August 18, 2005 Prepared for: rs Specrrim Building Products, LLC PO. Bat 826 Bensalem, PA 19020 latertek Testing Services NA Ine. 16015 Shady N11s Road Eltnetrclorf, 7X 78112 (voice) 210.635.8100 (fax) 210.6358101 mww.fntertek- • I etlsemko.com Report No. 3080717A1 Page 2 of 9 Spectrim Building Products, LLC August 18, 2005 ABSTRACT • Test Specimen: VEN4MA0 FR, PVC/Acrylic Composite Thermoplastic Sheet, Fire Retardant Grade, Color#07 Medium Cherry Test Standard: ASTM F$4-04 Test Date: August 11, 2005 Test Sponsor: Spectrim Building Products, LLC Test Results: FLAME SPREAD INDEX 25 SMOKE DEVELOPED INDEX 400 This report b for the etclttstare use of fnterteks Client and is pmoided pttsnznt to the agreement kwmen Intertek and is Client, Intertek's respomibifity and habiiity are limited to the terms and conditions of the agreement.Intertek aauma no liability to any party, other than to the Client in accnrdancc witlr the ageemeny for any 6si, expense or damage occasioned by the we of this report Only i1w Client is authorized to copy or distribute this report and then only in its entirety.Any use of the fmauk name or one of its mmla • for the sale m adverikemera of the toted material,product or Semite moat first be approsxd in writing by Interteit. The obur++adons and Torrcrults in this report ant relevant only to the xam ple tested. This report b)itself does not impby that the material,product,orsew re is or has ewer been under an Intertek certification program, nAtt¢t st 18. 200 Bric G. Htttchimoa Project Mauaget Reviewed and approved: 6:Anthony Peualota gar-ust 18. 20as Project Martrtger • Report No. 3080717,01 Page 3 of 9 3pectrim Building Prodt,as, LLC At%Arst 18, 2005 • 1IN'IR0DUCrn0N This report describes the results of the ASTM E84.04 Standard Test Method for SURFACE BURNING CHARACTERISTICS OF BUILDING MATERIALS , a method for determining the comparative surface burning behavior of building materials. This test is applicable to exposed surfaces, such as ceilings or walls, provided that the material or assembly of materials, by its own structural quality or the manner in which it is tested and intended for use, is capable of supporting itself in position or being supported during the test period. The purpose of the method is to determine the relative burning behavior of the material by observing the flame spread along the specimen. Flame spread and smoke density developed are reported, however, there is not necessarily a relationship between these two measurements. "The use of supporting materials oa the underside of the test specimen may lower the flame spread index from that which might be obtained if the specimen could be tested without such support. This method may not be appropriate for obtaining comparative surface burning behavior of some cellular plastic materials. Testaig of materials that melt, drip, or delaminate to such a degree that the continuity of the flame front is destroyed, results in low flame spread 'indices that do not relate directly to indices obtained by testing materials that remain in place." This test method is also published under the following designations: ANSI 2.5 NFPA 255 UHC 84 (42,1) UL 723 This standard should be used to measure.and describe the properties of materials, products, or assemblies in response to heat and flame under controlled laboratory conditions and should not be need to describe or appraise the fire hazard or fire risk of materials, products, or assemblies under actual fire conditions. However, results of this test may be used as elements of a fire risk assessment which takes into account all of the factors which are pertinent to an assessment of the fire hazard of a particular end use. • Report No. 308071741 page 4 of 9 §pectrirn Buildiog Products, LLC August 18, 2005 H PURPOSE The ASTM EW4 (25 foot tutuiel) test method is intended to compare the surface flame . spread and smoke developed measurements to those obtained from tests of mineral fiber cement board and select grade red oak flooring. The test specimen surface (18 inches wide and 24 feet long) is exposed to a flaming fire exposure during the 10 minute test duration, while flame spread over its surface and density of the resulting smoke are measured and recorded. Test results are presented as the computed comparisons to the standard calibration materials. The furnace is considered under calibration when a 10 minute test of red oak decking will pass flame out the end of dte tunnel in five minutes, 30 seconds, plus or minus 15 seconds. Mineral fiber cement board forms the zero point for both flame spread and smoke developed indexes, while the red oak flooring smoke developed index is set as 100. III DESCRIPTION OF TEST SPECIMEN Specimen Identification: VEN4MA4D FR • PVC/Acrylic Composite Thermoplastic Sheet, Fire Retardant Grade, Color #07 Medium Cherry Date Received: 7/18/2005 Date Prepared: 7/18/2005 Conditioning (73'F & 50% R.H.): 24 days Specimen Width (in): 24 Specimen Length (ft): 24 Specimen Thickness: 0.5045-in. • Material Weight: N/A oz./sq. yd Total Specimen Weight: 94.10-lbs. Adhesive or coating application rate: 16 oz. per 8-ft board. Mounting Methodt The specimen was self supporting supporting and was placed directly on the inner ledges of the tunnel. Specimen Descriptions The 'Test specimen was described by the client as the ".050' Thick Decorative Thermoplastic Sheet Adhered To 5/8" 'Thick Fire Retardant Gypsum Wall Board With Fastbond #30 Adhesive." The specimen consisted of (3) 8-ft. long x 24-in, wide x 0.5045-in. thick, PVC, thermoplastic wallcovering, adhered to 5/8-in. thick, gypsum board using 3Mn' Fastbond 30-NF Contact Adhesive at a calculated coverage rate of 16 oz. per 8-ft. board. The specimen was "007 Medium Cherry" in color. 'The wallcovering was 0.0480•in. thick. • Report No. 308071741 Page 5 of 9 Specuim Building Products, LLC August 18, 2005 IVTFST PROCBDURE • The tests were conducted in accordance with the procedures outlined in the American Society for Testing and Materials ASTA4 EW4. The self- supporting specimens were placed directly on the tunnel ledges. After the tests, the samples were removed from the tunnel, examined and disposed of. The test was conducted on 8/11/2005, and riot witnessed by any third parties. V TEST RESULTS The test results,computed on the basis of observed flame front advance and electronic smoke density measuroments are presented in the following table. In recognition of possible variations and limitations of the test method,the results are computed to the nearest number divisible by five, as outlined in the test method for smoke developed index results greater than 200 the calculated value is rounded to the nearest 50 points. While no longer a part of this4andard test method the Fuel Contributed Value has been computed, and may be found on the computer pin tout sheet in the Appendix, . Flame Spread Smoke Test Specimen Index Developed Index Mineral Fiber Cement Board 0 0 Red Oak Flooring 90 95 VEN4MA0 FR•PVC/Acrylic Composite 25 400 Thermoplastic Sheet,Fire Retardant Grade, Color#07 Medium Cherry The data sheets are included in the Appendix. These sheets are actual print-outs of the computerized data system which monitors the ASTM E84-04 apparatus,and contain all calibration and specimen data needed to calculate the test results. • lteport No. 3080717,01 hge 6 of 9 Specriim Duildti,4 Products, 1LC August 18, 2005 V1 QBSERVAIIONs • During the test, the specimen was observed to behave in the following manner: The PVC wallcovering began to blister at 0:07 (min:sec.). The specimen ignited at 0:15 (mimsec.). Pieces of the PVC walkovering began to fall at 0:30 (min:sec.). Flaming drops began to fall from the wnllcovering at 0:50 (muusec.). The floor of the apparatus ignited at 0:59 (max:sec.). The test continued for the 10:00 duration. After the test the specimen was observed to be damaged as follows: The PVC wallcovering was charred and cracked from Oft. • 12ft. Black discoloration was observed to the wallcover'iirg from 12.ft. • 24-ft. • Repott No. 3080717,01 Page 7 of 9 Specrrini Building Products, LLC Auguu 18, 2005 • APPENDIX ASTM E84.04 Data Sheers ASTM E84 DATASHEETS • Cfienb SPECTRIM BUILDING PRODUCTS, LLC Date: 8111106 Time: 03:42 PM Test Number. 2 Project Number. 3DB0717-001 Operator: EH/TA Specimen ID: "VEN4MAS FIR - PVC I ACRYLIC COMPOSITE THERMOPLASTIC SHEET FIRE RETARDANT GRADE, COLOR #07 MEDIUM CHERRY, .D50" THICK DECORATIVE THERMOPLASTIC SHEET ADHERED TO 518"THICK FIRE RETARDANT GYPSUM WALL BOARD WITH FASTBOND 30 ADHESIVE". THE SPECIMEN WAS SELF-SUPPORTING.THE SAMPLE WAS NOT UNDER INTERTEK Q.A. TEST RESULTS PLAMESPREADINDEX: 25 SMOKE DEVELOPED INDEX: 400 SPECIMEN DATA . . . Time to Ignition (sec): 15 Time to Max FS(sec): nD Maximum FS (feet); 52 • Time to 080 T (sec): Never Reached Max Temperature ("F): M Time to Max Temperature (sec): 467 Total Fuel Burned(cubic feet); 5DA3 FS'Time Area Wmin): 50.2 Smoke Area (%A'min): 3R2.6 Fuel Area ("F'min): 49122 Fuel Contributed Value: 0 Unrounded FSI; 25.9 CALIBRATION DATA . . . Time to Ignition of Last Red Oak (sec): 35 Red Oak Smoke Area (%A`min): Z..00 Red Oak Fuel Area ("F"min); M Glass Fiber Board Fuel Area (°F"min): 4WS - ' Project No; 3080717-001 • FLAME SPREAD(ft) ,e. 1 . +a. 1R ¢. ZZ e. e, e. 4. 0.0 0.¢ in t.s 2.0 P6 eD 0.5 10 OS 5:G 'e.s 6.6 6S i�0 '/.0 e.0 85 80 9.¢ 10.0 Smoke (%A) 6 70.06 e¢. 3 s4. • 40. t0 0. 11 0.0 &e 11.0 1�8 .0 2'S 10 e.fi 10 ¢A 5.0 5.5 &5 l'M1. 14 1WA Temperature(eP) yaw. few Ie00. +aw. taw. 400 w0. dffi.IL 400. 0. 0.0 0.6 A �.e 0 2.5 .0 O.s aA �,s SA e.e 8.6 Q.5 .0 .e 6.0 at 0.0 0,5 10 Time(min) • MATERIAL SAFETY DATA SHEET SPECTRIM BUILDING PRODUCTS,LLC • Prepared date: March 1,2005 Revised date: August 31,2009 1.Identification of the Preparation and Company Product Name: SPECTRIM Thermofoii Film and Ven4maFR Sheet Company Identification: SPECTRIM BUILDING PRODUCTS,LLC P.O.BOX 826 BENSALEM,PA 19020 Telephone number: 800-437-0557 Emergency telephone: 267-223-1030 Fax number: 215-245-8704 2a.Composition/Information on ingredients Thermofoil Film Substance/Mixture: Polyvinylchloride,additives,lacquer,printing inks,and primer. Chemical name: Plasticized Polyvinyl Chloride Type Surfacing Decorative Sheet Main component: Component chemical name Contents(wt.°/u) CAS.No. Polyvinyl Chloride 74-81 9002-86-2 Di(2-ethylhexyl)phthalate 0.4 117-81-7 Titanium Oxide 0-9 13463-67-7 Organic Tin Compounds 0-2 N/A Carbon Black 0-1 1333-864 2a.Composition/Information on ingredients Ven4maFR Substrate Substance/Mixture: Polyvinylchloride,chlorinated polyvinyl chloride,acrylic polymers,processing aids,impact modifiers,heat stabilizers,and lubricants. Chemical name: Plasticized Polyvinyl Chloride Type Surfacing Decorative Sheet • Main component: Component chemical name Contents(wt.%) CAS.No. Polyvinyl Chloride,ethene,chlom- homopolymer 0-99 9002-86-2 Chlorinated polyvinyl chloride 0-99 68648-86-2 Mixture of processing aids,impact modifiers,heat stabilizers,lubricants,and 2-50 Trade Secret pigments Organotin 0.1-3 Trade Secret 3.Hazard Identification Class name of hazardous chemical for Not applicable MSDS in Japan: Physical and chemical hazards: Not applicable Adverse human health effect: Not applicable Environmental effects: Not applicable 4.Emergency and First-aid procedures If in eye: Inhalation,swallowing or sticking into eyes causes no harm with a normal handling, however,when crushed fragments contact eyes,flush immediately eyes with large See a doctor if irritation persists. If on skin: Skin bums through melted material have to be treated by a doctor. Cover with sterile dressing material and take medical advice. Ingestion: If in case of ingestion and if conscious,give water to drink and induce vomiting. And see a doctor immediately. • Printed 9/6/2009 1/3 MATERIAL SAFETY DATA SHEET SPECTRIM BUILDING PRODUCTS,LLC • Prepared date: March 1,2005 Revised date: August 31,2009 5.Fire-fighting measures Shut off or isolate the source of conbustion,extinguish the conbustion with copious Fire-fighting instruction: water or extinguish media.Fire extinguishing must be done on windward side and wear respirational aid device when needed so as not to inhale hazardous gasses or smoke emitted in burning such as hydrogen chloride gas or carbon monoxide gas. Extinguishing media: Water,Carbon Dioxide gas,foam or dust extinguisher,etc. 6.Accidental release measure Leakage and seepage can not occur because of solid production nature. In case of forced burning:CO,CO2,and HCI. 7.Handling and storage Handling: In normal handling for processing,no special caution is needed. Storage: Store indoors in a dry area below 100 deg F. Keep away from sources of heating and flaming 8.Exposure control and personal protection Density to be controlled under: Not applicable Tolerable density Not applicable Tolerable density Not applicable(by American Conference of Industrial Hygienists) Hygienics]measures taken: Not applicable Protectional gears No special protectional gears are needed. • 9.Physical and Chemical properties Appearance: Solid pH: Not applicable Boilig Point: No information Melting Point: No information Vapor Pressure None Flashing Point: No information Auto Ignition Temperature: About 390 deg C Explosibility: None Specific Gravity: 1.3- 1.5 Solubility in Solvent: Not soluble in water 10.Stability and Reactivity Stable for normal handling and processing.Emits stimulating gasses in combustion Stability and Reactivity: Inflammability: Self-extinguishable • Printed 9/6/2009 2/3 MATERIAL SAFETY DATA SHEET SPECTRIM BUILDING PRODUCTS,LLC Prepared date: March 1,2005 Revised date: August 31,2009 11.Toxicological Information Skin Cauterizing properties: None Irritation to Skin and Eyes: None Sensitizing Potential: No known effect Acute Toxicity(including 50% lethal dose): No known effect Subacute Toxicity: No known effect Chronic Toxicity: No known effect Carcinogenicity: No known effect Mutagenicity(Microbial, Chromosomal Aberration): No known effect Genotoxicity: No known effect Teratogenicity: No known effect Others(includeing reactive toxic gas emission when mixed with water): No known effect 12.Ecological Information Resolvability: No known effect Ichthyotoxicity: - No known effect Retention: No known effect 13.Regulations on Wasting Dispose of clean film waste at recycling companies. Observe the local waste disposal regulations. Consign disposal to a scavenging agent that is licensed by the local govemer.No incineration disposal is allowed. Waste EAK Code: 120105 PVC Synth.Material Parts. • 14.'transport information . Carefully load not to fall and drop the product when transporting.Take any measures to prevent injury due to collapse of cargo piles. Not classified as hazardous under transportation regulations. 15.Applicable Laws Apply local regulations. 16.Other information Materials referred to for this sheet.- I))FINISH 04 MEDIUM BIRD'S EYE MAPLE. All other film finishes are generic equivalent. Handling care for the contents of this sheet: (1)Cares for accuracy of the information on this sheet has been taken for users'safety,however,the data carved herein should not be referred to for warranty or guarantee purpose for its authenticity. (2)This data sheet should be referred to with the users discretion and responsibility for safety handling of the material. 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Rmad in USA L(Dfo COMMERCIAL TESTING COMPANY 1215 South Hamilton Street• Dalton,GA 30720 Telephone(706)278-3935• Facsimile(706)278-3936 Standard Method of Test for Surface Burning Characteristics of Building Materials ASTM E 84-10b MirroFlex Savannah—Patina Finish Report Number 12-10199 Test Number 4200-2493-1012R April 14,2011 p7 Advanced Technology,Inc. Ls 4 Greensboro, North Carolina ai • Commercial Testing Company gk _ (Auf o�nafure) This report is provided for the exclusive use of the client to whom it is addressed. 1t may be used in its entirety to gain product acceptance from duly constituted authorities. The test results presented in this report apply only to the samples tested and are not necessarily indicative of apparent identical or similar materials. Sample selection and identification were provided by the client.A sampling plan,if described in the referenced test procedure,was not necessarily followed. This report,or the name of Commercial Testing Company,shall not be used under any circumstance in advertising to the general public. TESTED TO BE SURVD Since 1974 • Page 1 of 4 INTRODUCTION This report is a presentation of results of a surface flammability test on a material submitted by Advanced Technology,Inc., Greensboro, North Carolina. The test was conducted in accordance with the ASTM International fire test response standard E 84-10b, Surface Burning Characteristics of Building Materials, sometimes referred to as the Steiner tunnel test. This test is applicable to exposed surfaces such as walls and ceilings. The test is conducted with the specimen in the ceiling position with the surface to be evaluated exposed face down to the ignition source. The ASTM E 84 test method is the technical equivalent of NFPA No.255 and UL No.723. This standard is used to measure and describe the response of materials, products, or assemblies to heat and flame under controlled conditions, but does not by itself incorporate all factors required for fire- hazard or fire-risk assessment of materials,products, or assemblies under actual fire conditions. PURPOSE The purpose of the test is to provide only the comparative measurements of surface flame spread and smoke development of materials with that of select grade red oak and fiber-reinforced cement board, Grade II, under specific fire exposure conditions.The test exposes a nominal 24-foot long by 20-inch wide test specimen to a controlled air flow and flaming fire adjusted to spread the flame along the entire length of a red oak specimen in 5.50 minutes. During the 10-minute test duration, flamespread over the specimen surface and density of the resulting smoke are measured and recorded. Test results are calculated relative to red oak, which has an arbitrary rating of 100, and fiber-reinforced cement board, Grade II, which has a rating of 0. The test results are expressed as Flame Spread Index and Smoke Developed Index. The Flame Spread Index is defined in ASTM E 176 as "a number or classification indicating a comparative measure derived from observations made during the progress of the boundary of a zone of flame under defined test • conditions." The Smoke Developed Index, a term specific to ASTM E 84, is defined as "a number or classification indicating a comparative measure derived from smoke obscuration data collected during the test for surface burning characteristics." There is not necessarily a relationship between the two measurements.- The method does not provide for measurement of heat transmission through the surface tested, the effect of aggravated flame spread 'behavior of an assembly resulting from the proximity of combustible walls and ceilings,or classifying a material as noncombustible solely by means of a Flame Spread Index. The zero reference and other parameters critical to furnace operation are verified on the day of the test by conducting a 10-minute test using 1/4-inch fiber-reinforced cement board, Grade II. Periodic tests using NOFMA certified 23/32-inch select grade red oak flooring provide data for the 100 reference. TEST SAMPLE The test sample, selected by the client, was identified as MirroFlex Savannah-Patina Finish, Clear .028 PVC and 2 mil Overlay 900.017. Six pieces, each measuring two feet wide by four feet in length, were received. They were physically self-supporting and required no additional sample preparation. The panels were transferred to storage racks and conditioned to equilibrium in an atmosphere with the temperature maintained at 71 t 20F and the relative humidity at 50 t 5 percent. For testing, the panels were placed end-to-end on the ledges of the tunnel furnace to make up the necessary 24-foot test sample and the test conducted with no auxiliary support mechanism. TEST RESULTS The test results, calculated on the basis of observed flame propagation and the integrated area under the recorded smoke density curve, are presented below. The Flame Spread Index obtained in E 84 is rounded to the nearest number divisible by five. Smoke Developed Indices are rounded to the nearest number divisible by five unless the Index is greater than 200. In that case,the Smoke Developed Index is rounded • Page 2 of 4 46 to the nearest 50 points. The flame spread and smoke development data are presented graphically at the end of this report. Test Specimen Flame Spread Index Smoke Developed Index Fiber—Reinforced Cement Board, Grade II 0 0 Red Oak Flooring 100 100 MirroFlex Savannah—Patina Finish 25 75 OBSERVATIONS Specimen ignition over the burners occurred at 0.22 minute. Surface flame spread was observed to a maximum distance of 4.74 feet beyond the zero point at 0.77 minute. The maximum temperature recorded during the test was 567°F. CLASSIFICATION The Flame Spread Index and Smoke Developed Index values obtained by ASTM E 84 tests are frequently used by code officials and regulatory agencies in the acceptance of interior finish materials for various applications. The most widely accepted classification system is described in the National Fire Protection Association publication NFPA 101 Life Safety Code, where: Class A 0 — 25 Flame Spread Index 0—450 Smoke Developed Index Class B 26 — 75 Flame Spread Index 0—450 Smoke Developed Index Class C 76 — 200 Flame Spread Index 0—450 Smoke Developed Index Class A, B, and C correspond to Type I, II, and III respectively in other codes. They do not preclude a material being otherwise classified by the authority of jurisdiction. • • Page 3 of 4 46 ASTM E 84 TEST DATA Client: Advanced Technology, Inc. Test Number: 4200-2493-1012R Material Tested: MirroFlex Savannah - Patina Finish Date: April 14, 2011 Test Results: Time to Ignition = 00.22 minutes Maximum Flamespread Distance = 04.74 feet Time to Maximum Spread = 00.77 minutes Flame Spread Index = 25 Smoke Developed Index = 75 20 18 16 14 m 12 10 m _N 8 0 6 • 2 0 Time,minutes 100 90 80 70 ^� 60 50 E 40 m 30 20 10 0 Time,minutes • Page 4 of 4 ATI-MFTI Revision 3 Effective Date:8/4/14 MirroFlex� Structures DECORATIVE Technical information GENERAL INFORMATION: Description • MirroFlexTM Structures are decorated thermoplastic sheets with high impact resistance and are available in a wide variety of patterns and colors. They can be used as a value-added product in areas that vertical grade High Pressure Laminates(HPL)are typically used. • Unlike HPL, MirroFlexTM Structures can easily be cut to size with razor knives or scissors. It can also be applied to many substrates with pressure sensitive adhesive strips and be used for retrofits and DIY applications. • Size-4'x 8'x.032" (1220 x 2440 x.8 mm). This is a dimensional product,so actual thickness varies by pattern. • Most product ships with clear protective film or with TuffCoteTM. • • UPS Shippable Applications • Commercial Market Uses: Office- desks,storage cabinets, reception, etc. Education—cabinets, high impact areas Healthcare—furniture,equipment, high impact areas Hospitality—restaurants, bar&counter fronts, hotels/motels Store & Bank Fixtures Interior Doors, Kiosk Fronts&Elevator Cab Interiors-including high impact areas Wall Panels&Signage Bathroom Enclosures(Only when MirroFlex Tub&Shower Wall Panels""are used) • Recreational Market Uses: Boat Interiors Coach Interiors • Residential Market Uses: Occasional Furniture—tables, cabinets, etc. Novelty and Juvenile Furniture DIY and Renovations ATI Decorative Laminates (800)849-1320 www.atilaminates.com ATI-MFTI Revision 3 Effective Date: 8/4/14 PHYSICAL PROPERTIES: • N/A TECHNICAL PROPERTIES: PROPERTY TEST METHOD TYPICAL VALUE Fire Retardant ASTM E-84 Class A QUV Minimum 100 hours Solvent Resistance 50 MEK Humidity 12 hrs 96-100% RH @ 40 degrees C on MDF MEK Double Rubs/Crockmeter Withstands 70 cycles Impact Resistance ASTM D5420 >2 inch Ibs per mill ofthickness Abrasion Resistance— ASTM D1044 Patina with TuffCote Taber Abrader 5130 4,700* Argent Finishes 500 gm weight 5,000* EccoFlex Paintable CS-10 Calibrase wheel 1,000* *no sign of wear • • ATI Decorative Laminates (800)849-1320 www.atilaminates.com ATI-MFTI Revision 3 Effective Date: 8/4/14 ADDITIONAL INFORMATION: Stain Resistance Properties Stain Resistance Testing Group 1 Grou 2 Group 3 Group 4 Group 5 Group 6 # Materials 24 Hrs 7 Day 24 Hrs 7 Day 24 Hrs 7 Day 24 Hrs 7 Day 24 Hrs 7 Day 24 Hrs 7 Day 1 Wessonoil N N N N N N N N N S N N 2 Household Ammonia N N N N N N N N S S N N 3 409 all purpose cleaner N N 5 5 N N N N N N N N 4 'Tide"laundry detergent N N N N N N N N N N N N 5 Isopropyl Alcohol N N S S N N N N N N N N 6 Clorox N N S M L L L L L L N N 7 Grape Juice N N N N N N N N N N N N 8 10range Juice Concentrate N N N N N N N N N N N N 9 Coffee N N N N N N N N N 5 N N 10 Mustard N N N N N N N N S 5 N N 11 Ketchup N N N N N N N N N N N N 12 Redwine N N N N N N N N N N N N 13 Coca-Cola N N N N N N N N N N N N 14 Water N N N N N N N N N N N N 15 Black crayon N N N N N N N N N N L L 16 Lipstick N N N N N N N N N N L L 17 Pine-Sol N N S S N N I N I N N N N N L Vinegar N N N N N N L L N N N N Steel Wool N N N N N N N N N N N N Tea N N N N N N N N N N N N Windex•Surface Cleaner N N N N N N N N N N N N Scotch-Brite•w/Soap N N N N N N N N N N N N Group 1-Patina,Brushed Aluminum,Paintable,Mirror Red,Argents N=no change Group 2-Woodgrains S=slight change Group 3-Mirror,Mirror Blue M=medium change Group 4-Mirror Gold L=large change Group 5-Brushed Copper Group 6-EccoFlex Paintable • ATI Decorative Laminates (800)849-1320 www.atilaminates.com I Certificate of 11ame Rew'5tance vteTf REGISTERED ISSUED BY �°Cw'•. APPLICATION Glen Raven Mills, Inc. Date treated or f CONCERN No. 1831 N. Park Avenue manufactured Glen Raven, NC 27217 F kETP FA-36801 I (Phone) 336/227-6211 (Fax) 336/229-4039 This is to certify that the materials described on the reverse side hereof have been flame- retardant treated (or are inherently nonflammable). FOR ADDRESS CITY STATE Certification is hereby made that. (Check a"or "b) ❑ (a) The articles described on the reverse side of this Certificate have been treated with aflame-retardant chemical approved and registered by the State Fire Marshal and that the application of said chemi- cal was done in conformance with the laws of the State of California and the Rules and Regulations of the State Fire Marshal. Name of chemical used Chem. Reg. No. Method of application (b) The articles described on the reverse side hereof are made from:a flame-resistant fabric or material x registered and approved b the State Fire Mar 9 PP shalfor such use. y ❑ Trade name of flame-resistant fabric or material used FR Sunbrella® Reg. No. FA-36801 The Flame Retardant Process Used will net Be Removed By Mashing I (will or will not) GLEI$R MIt�LS CC Glen Raven Mills, Inc. By XX Name of Applicator or production Superintendent Title I l Qte IVIMV ----- -- - --- ----- AUG-22-2005 MON 01'23 PTi HERCULITE FAX Ha 17177645211 r. u a ..................................... .—.............................rwa �y Certificate of Rame Resistance • Y � aaG1aT181tED ISSUED 6Y tamr t/antAdo•�� 1 j tollaTlarte. RtvovrmPgwdttek,hc 9/04 j � P.Q.Bmc 43S i i , F-30601 Pmlaw k PA 17319 j 1 1 j 7r is is fa aerrfy Aw dw mouiiel+*sa*d on Me berrom hveofhaiv b ®,jlmne-rc m&W nwalad j j (or4M A adryrroxflamm ue). j 1 FOR BUDGET BANNER AT 214 ANDOVER STREET UNIT 9 1 1 I CITY WILMINGTON STATE MA 01587 j CM Wbnisherebyamdefkat'(G7�eeck'a"or"6 � I 1 (a)The articles demihed on she bottom of this Cmtifiom have been'messed with a flame-retmdant clwnical j j appoved and rWmWmd by the SWro Fire 1Jfaralral and dW the applcadw of said eh=kal was done i m coatbnnance with the haws of the State of Celifotnia amd the Roles and Reptedons of the State 1 Fire WNW. � 1 I 1 Name ofcbetnhW used (hem.Rag.No i 1 I j Method ofappfitxtioa j j (b)The articles daufl d an the bonom bereofam made from a flatae-mdstatd fabric or materiel sesiaoered j wA approved by the State Fhe Marel al for sock um • 1 Trade name of flame-'catmint fabric or matmiai used SNOWI'IME a Reg.No F-30601 1 The Flame Retardant Pro=Uttod WILL NOT Be Removed By Wasbhtg 1 j (aylaw0laoU ��tro��'• j j BY i NasneafPradacdbnSnpainVndm,* QCManager 0 1 CONTROLNUMBER 29739 CUSTOMER ORDERNUMBER JOHN CUSTOMER INVOICE NUMBER 00114902 YARDS OR QUANTITY 95 YARDS COLOR BRGND OLS STYLE SHO WTIBM U BRGND OLS 61" DATE PROCESSED 7112/Z005 • T01Y17F V lTliflf - - - Catif irate of Siam 3atmotance REGISTERED • 4 "�`�� 11CADON ISSUED BY Date Work Performed CONCERN No. COOLEY, INCORPORATED 12/9/02 50 ESTEN AVENUE A GA-211 PAWTUCKET, RHODE ISLAND This is to certify that the materials described on the reverse side hereof have been flame- retardant treated(or are inherently nonflamable). FOR ASTRUP COMPANY AT 2937 WEST 25th STREET CITY CLEVELAND STATE _OHIO dd112 i Certification is hereby made that: (Check"a" or"b") (a) The articles deuribed on the reverse side of this Certificate have been treated with a flame- I retardant chemical approved and registered by the State Fire Marshal and that the application of said chemical was done in conformance with the laws of the State of California and the Rules and Regulations of the State Fire Marshal. ; Name of chemical used Chem. Reg. No. Method of application X (b) The articles described on the reverse side hereof are made from a flame-resistant fabric or material registered and approved by the State Fire Marshal for such use. Trade name of flame-resistant fabric or material used C00 LEY BR I TE L I T16g No FA-10 2 . 15 The flame Retardant Process Used WILL NOT ge Removed By Washing (will or will not) ROBERT VENICE Et ROBERT VENICE, TECH. SERV. MGR. Y Name of Produtfion Superintendent Tide We hereby certify this to be a true copy of the original"CERTIFICATE OF FLAME RESISTANCE"issued to us, --'=originaFsopy'sofwhich-Eras lreerrfifed witkthe-C-olifamia-Sthte-Firgiriarsfmi`-The ASTRUP COMPANY By :ontrol/lot# Quantity 6 YDS :ustomerorder# JOHN Description ''NICN COOLEY BRITELITE 78tt CBL14 2200418 BORDEAUX �strup Invoice# Product Code 8 5 3 314 • BUDGET BANNER 214 ANDOVER ST WILMINGTON, MA. 01887-1230 0_ � a as o REGISTERED ISSUED BY APPLICATION JOHN BOYLE & COMPANY, INC. Date treated or ;` f�.$ CONCERN No. 1803 Salisbury Hwy manufactured � V+`V, Statesville, NC 28677 F M GA-217 704-878-6175 2-06-2003 This is to certify that the materials described below have been flame-retardant treated(or are inherently nonflammable). BUDGET AWNING INC FOR AWNCO EAST CORP. 214 ANDOVER STREET WILMINGTON MA 018870000 Certification is hereby made that: (Check"a" or"b") (a) The articles described below this Certificate have been treated with a flame-retardant chemical approved and registered by the State Fire Marshal and that the application of said chemical was done in conformance with the -- laws o e State o a omra an e Rules an ego ations of the State Fire Marslial Name of chemical used Chem.Reg.No. Method of application ® (b) The articles described.below are made from a flame-resistant fabric or material registered and approved by the State Fire Marshal for such use. Trade name of flame-resistant fabric or material used 629 SIGNMSTR SPRM 61"629 BLACK Reg.No. F-121.4 The Flame-Retardant Process Used WILL NOT Be Removed By Washing JOHN BOYLE & COMPANY, INC. JOHN BOYLE&COMPANY,INC. By Name ofdpplicator or Production Superintendent Specialty Products Manager Walla Conine Control Number 02080 Order Number 58749 Invoice Number 785906 Quantity 5.00 Sell Certified Flame-Retardant Fabrics By BOYLE Your product will meet the rigid specifications of the California Fire Marshal. Tr1TTAT TlrNXrT T n /'1l1A .rT A L"r A XT T%Tnrr"TTITT1rfN"0 , r [fie �$ itf 1/ e s t :a • t10`: .ntgl loci„ r)<'a ri E U_"I•nrt l'at Mii�.r1 II.1 r: JIq InuvosBC ✓?,'t l'PSiS"..:.'•r r? :• l:l Cam„/ r icr?.11 nzi t—d, f•t :Je:Jr2li .-irr, ra•^::.�.:.:, �ti'.:.!� r:.�a'rc-p .�i dlanilzsis 1r rc.III dis;cc:'v`I1, Or mC • • Vv4dth 54'" . • . `NI'iiaF.r 76 o fAh,dnion: I rdllrnsryc e. fr8 Cottl�n Durk, CFFA 4;= . • PRI t'C'[5 rJf C'kfl'��ti, . CaiifO(blip Ta-d;n ca' Bullatin 117-2Cn+, �,rr Pnn i bcc'ural St?.ngard CO A A 2950�a N-IVv rU" $r;,A Scala 1VYINU Fror1 of Auihorry �rEi�iv FalJri�_, Cfrsc ! ' FAR 25.F.:3A FMV,SS 3021 NF?A 260 Buston File. Dept_lx-1 BIFI1.'A Class A _ IA'40 A.65206) 8.2 &8.3 • Ligll±tstness•(OUV): 650 FjOUfS {outdoor} • N1ddeLv re..=,istant ASTM G=21 Y • Indoor/(autdvur,� cmersacr *o�_•+unzln aruaL.x,arn. nr'm of user+ vi• For O6dIi1011d1 GI@Pn111q Ifl3IfpLL01i3❑pO del8ded 3{?S-cdIC90pIt IldJmisllUrl,vfsr[ ' www,onin0va:eomlbottaflex � World Headquarters �,ph�( �\JA 6Ghem Rrled 6M' NOVA` na„r, etinasss SOLUTIONS S1YtMO 1 330 869- 2 A.,om,h)V,:IrFHJ N:18f1t0 f?lI4. j. 'S1lRtU'Id1 .AU LMA,�11 U 1141N\_!. >rl.NlvaRD lrFi44 1 HA QY'.VI6003(&9lk FlJ g4qKfdL Mr;,i[YJft11I E14PftJ pMA:Yn C.9Af ' •LiA1fr.LL%erta VHLI D.!.JelyryYx�Y:.Yuiy_�.t:,,�$9IAYa'Y.'w:MNY.m lrq ' '.r,yne.na n.,,v,.•aely.,mr...ytuw+x. r � �.1 ••C,Sur'�,:,I; i 05/30/2P,P,5 let 23 7e3-41r5--i,i©;• INC PAGE 01/0' a —� e. .._._._ I Y ll°Cit r 3�, R 1�e.Y Author: ' 7i tit I sp M, Slavik Product: Integrity30'^" and Integrity5a'a Fire Barrier Fabric Page: 1 of 1 j `ocument#; 11.\ TDSA991,01 Revision �a'.e: June 21,2.003 Revision#: 01 INTEGRITY30TA1 and INTEGRrrY56"" Fire Barrier Fabrics are knitted fire barriers for use in mattresses, upholstered furniture and other foam and thermoplastic based products. Composite$of these materials using 9NTEGRITY30T" and INTEGiRITY56w Fire Barrier Fabrics as passive barriers have complied with standards such as California Technical Bulletin #121, 129, 133 and BFp IX-1I- However, it is the sole resporsibility of ti,,e manufacturer of the final composite to conduct testing end ascertain whether their composite product compiles with the standard. The use of INTEGRI7Y30Th1 and INTYGRITY561r^ Fire Barrier Fabrics in and of themselves does not imply compliance vrith any full-scale fire tests. We strongly urge the use of California {#117 foam and the use of FIR face fabrics. Brand Name: MTEGMTY30" and INT'EGRIlY5aW Fire Barrier Fabrics Construction: 1 X 1 Rib Knit Fiber Content; rvlodacrylic, Fiberglass, Polyester Weight Specification: 6,8 oz. Per Linear Yana +,,- .5 Oz. Width: INTEGRITY30T1^ -3o°lvIIN • INTEGRITY567r, -06°MIN (Note knitted fabrics do relax, so width may be less over limo) Target Tests; Gailfornia Technical Bulletin 121' California Technical Bulletln 129" California Technical Bulletin 133" Boston Fire Doparmient BFD IY.-11*i Fabric only meets Mtrft52 Part III as an Interlirer' ' These tests mug(be performed by the Mattress/Furniture Manufacturer Other mock up tests may be required to meet B85651-1978 for Ignition Source 5 The Boston Fire Department has reviewed the use of INTEGRiTY30T"' and INTEGRITY56r" Fire Barrier Fabrics for protec",ion in re-upholstery work, however written approval must ha secured from BFp Chemist Office at 617-343-3627. Construction; We recommend closing tubular or flat knit fabric. using metal staples, or that the end be aevm with SpunGold®, ftbegass or Kev!a?thread. P,1ost irnportantly,whatever construction was used to originally comply.with the test spe;cifrcation must be faithfully reproduced in actual production. If stapling, folding over excessive :material upon itself is recommended and a stabilizing agent(Strong tape, for example)can be put over the sewn portion to clean up its appearance. INTEGRITY30'N and INTEGRITY561" are trademarks of Ventex, Inc. SpunGole i3 a registered trademark Of SpunGold, lne. Kevlar'is a r'e,91steract !rademork of E.I. Cu Non,de Nemours and Co. The!nform89on 000alned herein is o(fared so being rymcal for the Irdkn;r d Product. Lot:o Ict variations may occur that am not ma+edal t0 the tnhonded Perfcrrtnarrn or the product VrrAex hereby, arranU ihat the INTJGRrrY30*u and lNTEORITY56'"Flro aamar FRGMCZ will conform to the technical data pre,ided abe+re. -. etpl for this exnress'warranry.VENTEX HERESY Ol3C HAN ANY AND y AND I TN S xFOR OR A NT?E:S EXPRESS OR INPUM INCLUOiNG THE IMPLIED WARRANTIES OF MERCHgry7q[31LI7y plyD FITNESS FORA PARTJ4ULAR PURPOSE'. Venter Q)ada(rns IlablllrJ t0:any Ine'dantal or u'ruequenttzt demRjes resul!ing'rom any brnaN)of the erpraas"a""y_pntaine;herein.Replacementf fabri oc nnly shall be • 71a eXMIJ1're remedy for any br_nei or vonh"s exereu varn:rty, 4^6 630 8379 Vit'loam Product:Inc. 04:27:31 p.m 10-16-2C08 I r. Vita Polyurethane Foam _ Vitafoam Products Canada Ltd Product Information Sheet 61907T1N Tony Shcropi u p Bill 7homas June 15, 2007 Property Specification Test Method DENSITY 1,00 1 15 libs/cu.ft. ASTM D 3574-05 IFD@25% 18.00 24.00 Ibs. ASTM D 3574-05 TENSILE STRENGTH 10.00 Ibs/sq.in. ASTM D 3574-05 ELONGATION 110.00 % Min. ASTM D 3574-05 COMPRESSION SET@90°/, 20.00 % Max. ASTM D 3574-05 COMPRESSION MODULUS 1.80 Min. ASTM D 3574-05 • HYSTERESIS LOSS 35.00 % Max. ASTM D 3574-05 RESILIENCY 40.00 % Min. ASTM D 3574-05 FLAMMABILITY Pass CAL 117 A & D Vitatram Products Canada Ltd. 150 Toro Rd, C�ownsnevv. uniaro, M3, 2A9 Page 1 of i vita VI'I'AFO,-NNl PRODUCIS (AN"A D A LTD. - loronto b Clllld, %1,0 2A9 YAM PRODUCTINFORNIATION SHEET (%7,qT) FOAM GRADE: B4722B3N PROPERTIES SPICIFICATION TESTMETHOD DENSITY 150 los/fIl ASTIIIA 3574-95 IFD @ -25% 45 >'2, ll)s_ ASTM 33574-9> ASTM 3574-95 ELONGA VIONI I 0o) Min. ASTM 3574-93 (,OMPRESSION @ ASTM 3574-95 • COtvll"RLSSION MODU-1-is ,Min. ASTM 3574-95 HYSTERESIS LOSS 37 % m a x ASTM 3574-95 RESILENCY % Mi ASTM 3574-95 !'ass CAI, 117 Date: Niar 13, -2001 The 96D Allen Blvd., Farmingdale NY 11735 Gomark TEL: (631) 293-8944 Organization, Inc. FAX: (631) 293-8956 Page I ceived:03/03/2003 Completed:03/10/2003 Letter: O rb I P.O.#: Test Report#: 2-44310-0- Cli ent's Style: 99. Upholstery Cover Material:US Naug Phoenix.Filling Material: Cal 117 Foam 2"Thick..Identification Tested For: Richard Rogers Key Test: CA 133 criteria B 395 Alden Mfg. Co.,Inc. 3030 Main Street Tel: 1-(860)-522-1189 Ext: Hartford, CT 06120 Fax: 1-(860)-249-4773 PC: 48hr TEST PERFORMED: California Technical Bulletin 133 Flammability Test Procedure for Seating Furniture For Use in Public Occupancies [ ] Mock-up; [x] Actual furniture item PROTOTYPE QUALIFICATION BRIEF DESCRIPTION OF TEST: The ignition source for the test is a four-sided, multi-flamelet burner which normally sits at a distance of 1" above the seat bottom, and 2" from the seat back. The item submitted was an upholstered bench without a back. Therefore, the flame was applied 1.0" over the seat cushion, approximately mid point of surface. flames impinge on the test item for a period of 80 seconds. Test observations are made. TEST CRITERIA B: RESULTS ACCEPTANCE CRITERIA B: ------------------------------- ___________________ __--_____-___________-_ Maximum Rate of Heat Release: 25 kW 80 kW Maximum Time at which maximum RHR occurred: 100 seconds None cited Total Heat Release within first 10 minutes: 2 MJ 25 MJ Maximum Smoke Opacity at 4 feet: Less than 28 opacity 75% Maximum Opacity CO Concentration a. ppm Peak: 548 ppm Peak May not exceed 1,000 ppm b. Time CO exceeds 1,000 ppm: 0 seconds for any 5 minute (300 seconds) period CONCLUSION: Based on the above Results and Acceptance Criteria B, the item tested: [x] Complies [ I Does not comply • (Page 1 of 2) 96D Allen Blvd., Farmingdale NY 11735 4nmark TEL: (631) 293-8944 FAX: (631)293-8956 rganization, Inc. Page 2 • 3/2003 Completed:03/10/2003 Letter:O rb I P.O.#: Test Report#: 2-44310-0- Style: 99. Upholstery Cover Material:US Naug Phoenix.Filling Material:Cal 117 Foam 2"Thick. rtion For: Richard Rogers Key Test: CA 133 criteria B 395 Alden Mfg. Co.,Inc. 3030 Main Street Tel: 1-(860)-522-1189 Ext: Hartford,CT 06120 Fax: 1-(860)-2494773 TEST END: 1 minute(s) 42 second(s) [x] All burning of specimen had ceased [ ] Extinguished by technician when all report values had peaked and were declining ( ] Extinguished by technician when noncompliance of 1 or more criteria was noted [ J Maximum test period (60 minutes) - REMARKS: None. COMPARABLE VOLUNTARY STANDARDS: ASTM E 1537; NFPA 266 CERTIFICATION: he above results were obtained after testing specimens in accordance with the ocedures pr} quipment spe6a fied by California Technical Bulletin 133. i ----- - ---- -- - ------------ AU 0 ZED SIG TUBE GOVMARK ORG Z ION, INC. /jd MR. SALVATORE MESSINA (Page 2 of 2) The results contained in this report relate only to item(s)tested.The test report shall not be reproduced,except in Poll,without written approval from The Govmark Organization,Inc. l Mov 02 01 02: 30p CHEMCRHFT INTERNATIONAL 336 724 4519 • J 6ept+mber 27,20M Chemcratt International Inc. Technical Advisory pr Flame Spread Values Chemcraft materials were tested for surface burning characteristics. There am several methods of evaluating surface burning characteristics of building materials. These include ASTM Standard E-M, NFPA Standard No. 255 and No.723 of UL The ASTM Standard E-84 test Is commonly used in building codes and by regulatory bodies for the charactertzation of Interior finishing materials. In this test the flame spread rating for Red Oak Is 100 and for Cement Board Is 0. For the purpose of applying flame spread limits to Interior flnlsh material, NFPA Standard No. 101 - The Life Safety Code groups flame spread ratings Into five classes: Class Flame 3 rea • A 0 - 26 B 25-76 76 -200 201 -500 E >600 itt The flame spread test Is Intended to provide numerical values that Indicate the relative rate at which flame will spread over the surface of a material. This rating number is not the rate at which the Hams actually spreads along the surface and is not an Indication of the fire resistance of a material. The correlation between these values and actual fire hazards has not been adequately established. The coatings were tasted using either Red Oak or Cement Board as the substrate, Wood Is the usual substrate for the coatings tested but, due to the contribution of wood to the flame spread, the coating was also tested on cement boards to glve an indication of the actual flame spread rating of the coating itself. Note that although flame spread ratings for the material may be listed as Class A. the rating for the system on wood may be Class C. Please be advised that, to achieve results as listed In the documentation, all systems should be applied as stated. It Is Important that fire rating requirements are adequately defined and correspond to the specifications provlded, Please ensure that all fire rating • requirements are clearly understood before using these materials in fire rated situations. Z000 5110JJ19IUSIa 001361 ZZr9 CC8 COZ YYd BC:Si aau rn ios ae Nov o2 01 M 30p CHEMCRRFT IMTERMRTIOMRL 336 724 4519 p . 3 • �_ September 27.2000 Ctremcraft International Inc. Flame Spread Information for Chemcraft Materials PrimM423-1660 t Substrate Flame Smoke Class 9 read Develo ad 13135 Cement Board 0 0 A 41050 Cement Board 3.26 6 A 42320 Cement Board 7,13 3 42360 Cement Board 8.36 6 A 423-9650 423-9550 Cement Board 1 2.04 0 A 423-9550 423-9550 Red Oak. 87.97 105 C 424-4450 424-4450 Cement Board 3.06 0 A 431-8050 431-8050 Cement Board 5.31 0 A 431-8050 431-8050 Red Oak 117.53 135 C 436-1399 438-1399 Cement Board 5.07 1 3 A • 437.2048 X 3 437-1980 X 2 Red Oak 107.65 87 C 437-5343 X 1 5Amt RSr 458.1290 x 2 458-1290 x 2 Cement Board 6.90 3 A' 622-1410 440 865 Cement Board 3.22 0 A pJ�,{ph 522-1410 440-865 Red Oak 93.79 90 C 0 <vY��ys 548-7003 421.3221 Cement Board 4.41 0 A Flame spread values were determined following the ASTM E•94-98 procedure "Standard Test Method for Surface Burning Characteristics of Building Materials". The coatings were applied by spray gun to W tongue and groove red oak at 4-15 wet mlis per coat except for the 437-system that was applied by roll coat at -15 g/m' per coat. Copies of the original certificate from the test performed may be requested from Chemcraft International Inc. Cherlcraft International Inc. makes no Judgement of product suitability for its Intended end use. Product acceptance of field installations Is usually the prerogetive of the authority having Jvdsdiction. • root Sao.tnela.lsra 03l3x ZZPS CCt1 COZ YVd 8C Si 43s CCi BZrZO " II GENERAL FOAM 1 1 C 0 R ON R A T 1 0 'V t i 100 WEST CENTURY KQ • PARAMW0, NJ C7652 t PHONE. 201.202•7000 • FAx 201•BOE7550 tf ` �� lol7eth/rFoltmCrreAe: MtOH50LX ��' Manvfacturiny Cite Huletoo,PA VA � �` Applicable US Wetommy 31(Matrie) ANSVASTM•D•3574.95 Ikm ib , 11pQs}F�Test V,rnhera lilted fi to a Dottdty,apparent 2.6-2.E 41,444.9 Test A.(fFC Test 01 tb/tt' (>•8''M') Indemabor.Force Defleotione 60 267 Teat 8,GFC Test M2 25Ya DON.,lb,/50"'(Yl32T om°) D • Tensilo Strength, Psi(XPA), mm. 15 104 Test B,GFC Tof* 10 ✓' �/ Ut;nt*&.18stlon'A,min. 120 IN Toot E,CYFC Toot M9 �JQ/ftil Tor Strength 1.2 210 Test P,GFC Tea*W /1 Mgt (N.T4),mitt Compramlon Set%loss max. 10 to Tea D,GFC Test 012 K%, 22 hn a 150'F(70'C) fu m4hD!Y*• Tested aide,the standards o1. CAL. 117 'Suvk digs it 12'a12'f0'a 15'v)5'x1'(v mm gptiUM). 'r1?Ja atmm.a:,ry n aq is sr;�t/.d/d a eeIIeR Woad.trt'ur•.*a'!y tU<or ary el m mew usdm%cqW tbl anadtdoas. V11YM L'/tYgCnk coy the tydNe e!tan mlddlf NO Wit b!xk end ae e,KY.tdt(.Rx IproiP.adne=wpy/. T1d,Wtdaw dart Ow"It tv.sidned to Oo st vaooa�vLut 4e,:a•.w,ru:r vaed ly,tognat oWndt Owwml tram Cergvanon:as fusA.%Wf#ee,I. kt•I;o rMeor v%omsi aWNtattles. / /i Tan tlatdrd tpeoifatd is GI Qdsok)wdtl^ar. v m.a lnd/m/d err.to l7lwh.S1 J.teei�)me:'s Cuttatoay L'di s p'tK eppro(slar aarartlo Ottcn tnd tWA04 Off APO atpldl/nt Approved try, Qrag Upheld Title: (tts"Am rance NA!tW Date: 3/5/9E • Tw nenttgm 1r womid egrn+rttir.rtetiasee7r. nclrvf�H:.:";ant tf a1 s•e.ivauGr+G,aV h7r LAIM Tn!Nt MOD WARP!di'f8 a rrt , trtAsit^t ArD!Ilh£Stl spa?PMI�::.aR Utt T Mai,o.te;:Nt n t amm n tp lar Y 7nue Fmm awl e•1•,444e r gbvi:IJ?.m%vtll piIr re q eA ia,.Cxotvtten a b:t/W/:/ r,v Gtw/• a�Joe nA tMVY t•I lt101 star":19o;b Nw a''01m•.p'ram cvSKI a•r an rcm r m:a ta•ar!!�'a Ir'it 6l0•,•Yt In)DWAt,Ill:fro Idtrl. 3'd S7;'U: -m1Jlxnnur 'Bf n _,fGAI-iYDE -AME BLOCKER PHOENIX LARD xeOlFCllvf Ilgfn Low Smoke*/Low Flame* NAUGAH continues its PHOENIX. This 2-1tion of 200 FLAME BLOCKERrship in FR•prodducttaisd fslgned toitbe Sintroductionceinh firefrisk Public access installations. These include: Contract Upholstery. Hotel/Motel, Restaurant, Office, Hair Salons, Auditorium Seating Institutional: Hospital, Nursing Home, Dormitory, Prison Transportation: Subway, Train, Bus Seating and Interiors PHOENIX combines state of the art technology with a full range of thirty colors designed to comple- ment contract carpet, wallcovering and laminate products. Included in this palette are traditional, emerging traditional, and new hues to satisfy the designer's demand for color. Chairs upholstered with NAUGAHYDE 2.200 FLAME BLOCKER can meet the full scale burn requirements of the Boston Fire Department Chair Test and those of California Technical Bulletin 133 under certain conditions. The following charts give typical results. Ca=133Caa t33 T (Flame BlooI _ Tments I cI Boston Fire Dept. Boston Fire Dept. Typical Flame Blocker Performance" Tesl Criteria Temperawre Increase I Requirements Performance ce�l�ng 200°F Max. Temperature Increase I 10317t°F ' Fame Out Time c level 8 mmule maximum 3.03.5 $,lene a'level 53°F Me.. I IQa°F 1 75%opacily Max. 2737y, °Weight Loss Less than to% imol.enoo, 50%opacity Max. °Gripping 456.0 CO Concemraeon 3'5% None Nonp 1 Max 1 mmule 020.7 minutes °$tea Excessive$mpke aoove ,boo PPM No Nlbwed Low Smoke IPassl v+e�gn1 loss al 10 . °Flame Penetration "'."Wes 'Flame Cushions AI leas)V°"of No Flame IC%Max. 1.2-1.$% Ong tleplh IPas51i ComCusuble weight Penetration loss al end lest I must be maintained 9D%Max. L63.6% • NAUGAHYDE 2-200 FLAME BLOCKER is formulated to have smoke emission less than 200 (ASTM E-662) and to meet flammability- requirements contained in these specifications: • Automotive (MVSS-302 • BIFMA (Screen Test - Cederal tan (Federal Standard 191A & Dept. of Transportation Sec. 3.3.1) Voluntary Std. (Test Method 5903) ) (FAR 25.853b Modified) • Boston Fire Code(BFDIE 1) • City of New York • Port Authority of New York • California Fire Regulation and New Jersey (Bulletin 117-Section E) (Bulletin #44) Other COMPETITIVE EDGE features provided by Phoenix: • Sulfide stain resistant (hospitals, nursing homes Cleans easily with mild soap and water & hair salons) Oil and mildew resistant (CCC-A-6803) • Beauty Gard Protective Finish -20° cold crack 'This term and any corresponding data refer tot ' Anti-static slip finish or any omen material under other fire to re r to typical performance in the tests indicated and should not be construed to imply the behavior of this "The Caj 133 test Is highly dependent on chair Construction and each specific construction must be tested for compliance.The above results were dDld meO on eldCk Chairs with melamine polyurethane foams or HR cat 117 foams and tub chairs with melamme polyurethane foams results are availaole upon request Melamine polyurethane foams generally are perferred with Flame Stocker. .Detailed test "'When used with melamine polyurethane foam or HR polyurethane foam which meets California bulletin•117 requirements. ta regarding Naoganyde 2 200 Flame BlOcker fabric was obtained using spsodic test methods untler against codes or specifications.Details of tell results are n eifabl6 upon request.While Uniroyal views the product es a signBicanl improvement over controlled laboratory contl Lions to measureaPerformance exj ..'ng tecnnotogy all organic materials will burn and generals smoke under some lire eontlitions. 'Ou,.,o,u Ep•nk,p COMPLETE r,e nwanWe2-.'Uo.0 r,WtneM VUrmyya W,qu Fn FOR COMPLETE SPECIFICATION INFORMATION, WRITE;M n�we�a.r r Inar,nxn a IYu,pyu Ena„yVa P,pG„a r.lnL • I F�Ixxy AMERICA ® i MADE 1 ® UNI® COATED FABRICS DEPT• I,cwlnl� MISHAWAKA, INDIANA 46544 LikJ y3 d°I Ham. C t STAPLES®