335 BRIDGE STREET - BUILDING JACKET i
335BRIDGE STREET `
ryv
C
,_ ' 1
Certificate Number: B-15-687 Permit Number: B-15-687
Commonwealth of Massachusetts
City of Salem
This is to Certify that theCharity Building located at
.............. .._....... ...... .. ...
.. ..... .
Building Type
335 BRIDGE STREET in the City of Salem
.................... ...... _.. . ................. . .........
_...........
Address Town/City Name
IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY
335 BRIDGE STREET
TRAINING CENTER
Bass River, Inc
This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and
expires ...............Not Applicable unless sooner suspended or revoked.
Expiration Date
�Y Y
Issued On: Monday, December 28, 2015 �f�
** Commonwealth of Massachusetts''
{ i
Citv of Salem $
a a 120 Washington St,3rd Floor Salem,MA 01970(978)7459595 x5841
Return card to Building Division for Certificate of Occupancy
!Permit B-15-887
EE PAID: $1,859.00 PERMIT TO BUILD
DATE ISSUED: 7/10/201.5
This certifies that BASS RIVER DAY ACTIVITY PROGRAM, INC
has permission to erect, alter, or demolish a building, 336 BRJDGE,STREET Map/Lot: 260584-0
as follows: Renovation RENOVATION TO INCLUDE NEW ENTRY WAY, WINDOWS, KITCHEN,
ACCESSIBLE BATHROOMS &A!CRAFT'AREA. -(Plans on file.)
Contractor Name: Richard H. Turner d/b/,a Hamilton Works
DBA: 1
Contractor License No: 93796
7/10/2015
Building,Cfflclal Date
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance.The Building Official
may gram one or more extensions not to exceed six months each upon written.request.
All work authorized by this permit shall conform to the approyad application and the approved con-structibri'documents for which this permit has been granted.
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes.
This permit shall be displayed in a location clearly visibtil,,,e from access,street or road and shall be maintained o ri for public fns
work until the completion of the same. pe p Inspection for the entire duration of the
,
a
The Certificate of Occupancy wilt not be issued until alljappkgble:signattfres by the Building and Fire Officials:ac provided on this;pernnit. -
H IC#: 1511$8 "Persons 00ntrac6g with antegrstered comractors.do not have access to theuar `
g antf�tuntl"(as set forth in MGL c.142A).
Restrictions:
Building plans are to be available on site.
All Permit Cards are the property of the PROPERTY OWNER.
°u ommonweaith of Massachusetts
.a .5
Citv of Salem
s 120 Washington St,3rd Floor Salem;iMA 01970(978).745-9595 x5641.
r Return caird to Building Division for Certificate of Occupancy
Structure CITY OF SALEM BUILDING PERMIT
>i
PERMIT TO BE POSTED IN THE WINDOW
Excavation
Fooling INSPECTION RECORD-,.
Foundation
Framing
Mechanical �L `
Insulation INSPECTION'. ,z, '{BY , ' . .DATE
`Chimney/qmoke Chamber 4'-'
K
Fina, e i (S
Plumbin /Gas
Rough:Plumbing
Rough Gas a e
Final 4V/rfa-T16
r
Electrical
Service
Rough
Final
Fire epartmerrt
Preliminary
Finallllw
Health Department
Preliminary
Final -
Commonwealth of Massachusetts
RECEIVED
Sheet Metal � Jr,ECJIONAL SERVICES
ri
CJ Date: I015 NOV g-,h i6 0 3b
I Estimated Job Cost: $_ C91 '7-S6 Permit Fee: $
r Plans Submitted: YES NO Plans Reviewed: YES NO
Business License # Applicant License# ! ®
Business Information: Property Owner/Job Location Information:
t Name: SCZTr S 7-86& Came: ki V&-Q
Street: Yf0 LDW _!M Street. 3 3s- IRE2.1 06& S j;
City/Town: UJ/SK_&F_ ' City/Town: _S' I*L��w1
Telephone: ?Vid�> Telephone:
Photo I.D. required/Copy of Photo I.D. attached: YES _ NO_
Staff Initial
J-1 /M-1-unrestricted license
J-2 / M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. / 2-stories or less
Residential: I-2 family— Multi-family Condo/Townhouses Other
Commercial: Office— Retail Industrial Educational
Institutional Other
Square Footage: under 10,000 sq. ft. 1z over 10,000 sq. ft. — Number of Stories:
Sheet metal work to be completed: New Work: Renovation:
HVAC— Metal Watershed Roofing_ Kitchen Exhaust System
Metal Chimney/Vents— Air Balancing
Provide detailed description of work to be done:
Mf=,AIt_t✓vp It (Ia -'(o Scoct
` P
l
INSURANCE COVERAGE:
I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes No❑
If you have checked Yes, indicate the type of coverage by checking the appropriate box below:
A liability insurance policy Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the
Massachusetts General Laws, and that my signature on this permit application waives this requirement.
Check One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
By checking this box I hereby certify that all of the details and Information I have submitted(or entered)regarding this application are true and
accurate to the best of my knowledge and that all sheet metal work and Installations performed under the permit issued for this application will be
in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws.
Duct inspection required prior to insulation installation:YES NO_
Progress Inspections
Date Comments
Final Inspection
Date Comments
Type of License:
By Wollaster
Title ❑ Master-Restricted
City/Town
❑Journeyperson Signature of Licensee
Permit# /�
❑Journeyperson-Restricted License Number: L/- 0 O
Fee$ ❑
Check at www.mass.gov/dol
Inspector Signature of Permit Approval
•' __ ••• ,•r rrur wrr r.cuwr r1 .,l uaauVIIIJCIIa
l I Deportment of 1ndustriul. I('cidenrs m
D(fiee of lntesri,gutiuns
Congress Street. Suite 100
Boston. IL4 02114-'017
\Ynrkt rs' Compensation Insurance Allida%it: Builders/ContractorsrEleIlleas Vrin umbers
Nlcasc Nrint Ll:�ibly
\u tlicunt Information .
Na111C • I)u,m:,r urpni7auon.Inddl, Jua�l 1: CO /-T : LS� �—;•-" —.--
Lilo S I a I c Lip: UJAK E Phone -,—_--
\re ,uu in cntplulcr'.r Check the appruprtate bras: Atrype of project Irequirld):
ant a eriplo\cr „+th ., .S — t ❑ I ant a teencral contractor and I r ] Ve,% construction
-n,plo,rcnuull arid•,)r nun-Inn<1.' have hired the sub-contractors I
L� I .,III i .. Ir proprietor or p.trtner- ',>lcd on the Jnached :hart. j
1 Rctnudcling
I hoe sub-contractors ba�c I �. DcmUlmun
ill[) end nape ran rnrolm cis 1 i
nniu,ecs and hasc .,,rrkcrs' 1. Building. adJmon
,•,$kme for me In am s.apacm , ;
`:.r ,/rasp. msurancc.•
..,rakers' �•n,)p .n>ur:utce 7q 1'Ici lftcal rcnalri,If aJJnw
17] We ore a wrl,oratwn alxl its �
yuura.l
-niccn have encrelsdd the,/ ` I I ❑ Plumhine rcpav> or a,IJit it
�' I am .1 E'.,,mcoo ncr Joing eit ,cork 1._ht of cxelnpuon per \Il il.
I_.Q R,vl rcpJln
rcywrri
;. t J,. t 1141. and „e ha.a no I j ❑ t)iher
I .------
:ntplo}ces- INU t,'Orkcrs
,)trip. insurance required.I
•a. ppn..un.N,tl n..\.Iv:, -, nun, nw,ill ro,nc�...n,.n bVl,_ tu—,ot thc,r wrrlc . ...... ,.rbrrn M•L„ n,innu.a m,l '
•b.n„'...,,,.,.,.n...umnn Ou,..nlJd+rl m.h.auue lhc, .:rc dnulp"it ,..A .uhI lhcn h,n ,nntra.ne.,)oral •uncut a rn+, du:J„n u,.huun¢ . „u
. ...II d.P•1.,6.n.p:vl:h,.hog n,o.l..lLb h:J m.o-,Jn e.n.d Ate,t aW,,.n9 the ii.aft u111K'"Ih�o1llf.rl luf♦ u„I .LqC„IKIh,Y..l n.q'h..y inrJh'.rid,:
open.:•
i nc aR.rnnr.rcl�e,n,:.e:un.h�•cc,,dic, mua ram„dc Ihcu ....rlarv'unnp (ulhc, uwoh'r
! run ,ur ruyrlot rr dud h pruvr.iinr norllerc' rarnp,m„uiun rrnunulce for ern•enrp6nveec. Helnw i.c the tonic"and tub ,ile
- :n.:,n; t. ,•n,1'.n„ `:.mK� ...��1. �L.14�.�v.."`84�.(�- _ O ^1 / — /' �Y
I \piratlon Dole
I toJob 'I, Ic -----
>I te:�in SACs<s�t�ldtil
\each i cup, ,.I the „urkers' contpensauon policy dectaritlon puce t,hu,iint; the policy number and e\pirition dal
u i,)IC '. � IIY .. -iIL'C I, 1Ctt llurJ tII1dCr `cclion _�.\ .d \1(,I. c. 1.'_ ,.111 fi ad t., iltt :II7 p,KIpOn.`I cf1111Inai I>i ll.l llle5 „
4n: •m ',, •I `"'I '=t) al:d :x .,r,e-,i ar unprtsonntcnl, .li bell as crs,t penaluIllci . the I,,nn .,I a j I )11\\ORK ORDER and .t
.1 .la, .rS.u!a1 file ,t,'Ia1Jr IIC aid,I;vsi thal .I corn oI this •!Jlctncllt Ina. [`i ',`f'•,.tl'JiJ t,".:1C 1 tt
..n;>t:.,t n`It> .`I !ile Ul.\ `f n•.i111'allct G\),ira•LC ,drilicjtlon.
I .lu h:r,•Ar .:/fits• ,)ratter floe ,rain, wrrl enahier o/per]llrr flour the irllorrrmfirrll pr,rcirleil above ii true a1111 c(irrerf.
),tc ^
Utfi,I'll :rat• Irnll•. 1),r III,/ I,rile ill this area. Ire he completed hr on. ur nnrn atliciat
I'ennn.l.icensea
1,TIlott! \uihurth role Intel:
lerk J. F
Ilc:111O3uddin,� I)cpanlnent !. ('it% 'rtmn C :Icctncal Impecp,r �. I'lumbine Impecptr
h. other _ V/// 61,- of-1367
l ��ut.Ll I'rnun:
J he^+hIEOY — I'hunea:
r
OMMONWEi4CTH OF. i1US
MIRWILSIMIZZIARWOF
• • r
SHEET i wo RS 3 x
't ISSUES„THE,FA LL OWINGL3�Nglk"SA
, � `'�
�dAJNES R STEWART ;� ` • � �-
SC15T1ORm
jSHEET�M. ETAL CO INC
AKEFI LO�MA 01880 ,,�,� r�E`r,ry_v,��`c
371
� "i�OMMONWEpfiT OF Mi{y�' „„ -.
• • • S, SOH'SETT
;y� 5HE1 METAL WQRK
lS$U 5 THE FOLLOWIN'G t ESL •" `
A MASTER 1MtST ;f.CTE
SCbi SHEET METAL CO
" JAMES ! 571AR7 , F
SCOTT S LET METALQ4}
?tiO,LGIWELL
5
WAIEFfEL==� #A 018 1g78
' The Commonwealth of Massachusetts
Department of Public Safety
�„ \la.achusa•tls?late tlmldmg l�rdr l%IJO C:\IRI Srcrnth Edition
City of Salem
Building Permit Application for any Building other than a I.or 2-FamilyDwelling
(This Section For Official Use Only)
Building Permit Number: Datr Applied: Budding Inspector:
SECTION
• 1: LOCATION Wlease indicate Block a and Lot 0 for locations for which a street address is not available)
.\o. and Street C iH• /noun Zip C..de amr ut Building(it applicable)
SECTION 2:PROPOSED WORK
if New Construction check here❑or check all that apply in the two rows below
r Existing Building if Repair❑ Alteration O 1 Addition ❑ 1 Demolition ❑ (Please fill out and submit Appendix 1)
Changrrof Use ❑ ChangeofOccupancy ❑ Other ❑ Specify: n
Are building plans and/ur cunstruction documents being supplied as part of this permit application? Yes Cf Nu ❑ /
Is an Independent Structural Engineering Peer Review requir ? Yes ❑ No OW
Brief Description of Proposed Work:
.-
O c
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Evaluation is enclosed(See 780 CMR 3402.0) ❑
Existing UseGroup(s): Proposed UseGroup(s): r
Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34:
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 Ss USE GROUP(Check as applicable)
A: Assembly A-1 ❑ A-2r ❑ A-2nc❑ A-3 ❑ A4❑ A-5❑ 1 B: Businew ❑ E: Educational ❑
F: Facto F-1 ❑ F2 O 1 Hs HI Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5❑
1: Institutional 1-1 ❑ 1-2 ❑ 1-3❑ 14❑ Ms M enable❑ R: Residential R-10 R-2❑ R-3❑ R4❑
S; Stora a 5-I ❑ S-2 ❑ U: Utility❑ Special Use❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as Applicable)
IA ❑ IB ❑ HA ❑ Ile ❑ IIIA ❑ ilia ❑ IV ❑ I VA ❑ VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Water Supp�.y: Flood Zone Information: Sewage Disposal: Trench Pennih Debris Removal:
1'uld,c Pf C heck d uutsiJe FLnwl Lune❑ Indicate mumapal ❑ A trench wdl not be Lscen.ed Dislv,.d�nr❑
required❑or trench ur,pectic:
I'nvaty O or,ndcno(� Zone: of on ate sc+tem Cl required
ss vncluseel ❑
Railroad right•of-way: Hazards to Air.Navigation: el\ I h.t••rn y..w,. I'r.
G t .\pphcably ❑ L �IruclUra•..ithur.urpurt.,ppn.ach arro.' h their re%ivsc completed'
r l nnaaq I.. Ilmld vnc ou 0 ❑ I Yv.❑ or No❑ Yvs❑ \u ❑
SECTION 8:CONTENT OF CERTIFICA rE OF OCCUPANCY
I .hwm --t L-v(d,-upt.s: ra pvul Cumlrmtwn: Occupant Load pvr l lour
I hv. 0w building c.mtain.m Sprmk1vr Aa,i,,n': Spacial Shpulahons
r
SECTION 9: PROPERTY OWNER AUTHORIZATION
t me.0 i Addrrv,,l pn+perty Owner
t`P IdST US �a.o6E 5T S RwEt r�
Name ll'rint) No.and Street l-ih•/ rown zip
' u)x•rty lhenrr("unitct Inlurmatiun:
`139 -mil 0841
Titlek Telvphonv No. ibusmess) irlephonr No. (cell) a-mall addrt"
If appbcablr, the property owner hrrrby authorizes
Name Street Address City/Town State Zip
to act on the proper" o.vner'.behalf, in all m.tuers relative to work.luthuncrd by this building ,rrmtt a + +hcation.
SECTION 10:CONSTRUCTION CONTROL'(Please fill out Appendix 2)-
(lf insilding is less thin 74,0W cu. It.ul enclosvd s ace and/or not under Com inaction Control then check here Candskip Simi n I0.0
10.1 Relitistered Professional Responsible for Construction Control
,Scot(- Soon)-f-, 72& 9Br CT17. Smskow- -7 &1&n.,scut• f
Name(Re y•istranp Telephone No. email address Registration Number
Q�Bar..Yr'�� Gn! �nIJS.Srii+„ MFt. A 8 4
Street Aasdm; - City/Turwn State Zip Discipline Expiration Date
10.2 General Contractor
.�cb-tE- S{o►ae - CoNsf '�
Cogpanx N
Name of Prr,+yn Resprmsiblp fur Cunstructiun License No. and Type if A plicable
9 (3At�Yr/t. Lr.1 , �A ItSbury MA . WW fit �ol
L J 4So�l.
trees Add_Gri 7�'• LP -L- &37 9. city wn C'm SVO wJ� 4t7'-e�_ (o�CASA .Aje .
Telephone No.(business) Telephone No. cell e-mail address
SECTION 11:W D V (M.G.L.c. 132.§ 25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and
submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit.
Is a signed Affidavit submitted with this application? Yes O No O
SECTION 12.CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs: (Labor
and Materials) Total Construction Cost(from Item 6) =f
1. Building f Building Permit Fee-Total Construction Cost x—(insert here
2. Electrical f appropriate municipal factor)=S
3. Plumbingf
4. Mechanical (HVAC) f Note: Minimum fee.S (contact municipality)
5. Mechanical (Other) f Enclose check payable to
b. Tirt'I Cuntp79A (contact munici alit )and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
Ilv entering my name(+rlow, I hrrrby altest under the pains and penalties of perjury that,dl of the information conLuned in this
t + icattun is true and accurate a be> , y knuwlecigr and understanding.
co �oNc. Cs. Con)f2ne�o2 9789P 6ri�
Plva"•print and sign name ritlr icleF+hunr.\',,. " Dale
ZAJ .
S11—vet .Wdre.. Of%/Tow r Zt +
Sunicipal Inspector to fill out this section upon a plication approvel:
i7' /rl Gig V G ".Cc�
P
CITY OF SALEM
"U-n- ,
PUBLIC PROPRERTY
DEPARTMENT
1L,,ttit I20.WAiHl.\G I ONSI'REET • SALES/,MASSACInsr:I Is G l97G
Ti,i,VS-745-9595 • Fsx:978-7400846
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
lilicant Information Please Print Leeiblv
N icMe tBuciness/OrganiratioN S�lndivicival): SLoyl onl(_ Ooeos i '
Address: l �f)/ /1�//a/ �A1
Cily'Starei/..ip: �l p r /4 Phone s': 9 78 — q�'���7
:,kre you an employer!Check the appropriate box: Type of project(required):
4. ❑ 1 am a general coulractor and 1 6. new construction
I.❑ 1 am a employer with ❑
employees full and/or art-tinie).` have hired the sub-contractors
( F' 7. ❑ Remodeling
2. 1 tun a sole proprietor or partner- listed on the attached sheet.
Ship and have no cmploycos These sub-contractors have 8. ❑ Demolition
working for me in any capacity, workers' comp. insurance. 9. ❑ Building addition
No workers'cum insurance 5. ❑ We are a corporation and its
I P•
required.] of 10.❑ Electrical repairs or additions
officers have exercised their
3. I am a homeowner doing all work g exemption P'
right of �r MGL I I.❑ Plumbing repairs or additions
❑ Pon
myself. [No workers' cnnp. c. 152, §1(4),and we have no 12.❑ Roof repairs
insurance required.] r cmployces. LNo workers' 13.0 Other
comp. insurance required.]
'Any;yplicanl that checks box#1 must alms fill Out the seaim,Ixaow showing their workers cumpemation policy inGatrradon.
'I lomn,wrten who submit this affidavit indicating they are doing all work and then hire outside cuntractun must submit a new al'fdavit indicating such.
�Contnwlors iliac check this box must adachod can additional sheet showing n,e name of the subcontractors and their workers'comp.policy informariun.
fain can employer drat is providing workers'evitipen.catinn incurtutce for•City employees. Belo,,is the policy and job site
irrforatution.
Insurance Company Vnme:_
Pulicv a car Self-ins. Lic. �n A09V7IN6�.7.IA __ Expiration Date: S10
Job Site Address: 3�S 6te 4'�• Cityistateizip: Stc;zk-m /rJ�9SS,
Attach it copy of the workers'compensation policy declaration pulse (showing the policy number and expiration date).
Failure to sccurt:coverage as required under Section 25A of�IGL c. 152 can lead to the imposition of criminal penalties of a
tine up to S1.500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
Of up to S250.00 a day against the violator. Be advised that a copy of this statement may be furwarded to the Office of
Invrstigarions ul'the DIA for insurance coverage veritianion.
l du hereby certi under(he pains and penalties of perjury that the infuriation provided above is true and correct.
tii nature: — Datc'
sr �-
OfJicial use cony. Do tint write(u this area,to be completed by city or town oJjiciait
City or'rmen: - .. ._ _ Permit/l.icense#-___--- _-.
Issuing Aulhorily (circle one):
1. Board of health 2. Building Department 3.Cityffown Clerk 4. Electrical Inspector 5. Plumbing Inspector
G. Other
Contact Person: - Phone #:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an etnpluree is defined as"...every person in the service of another under any contract of hire,
express or implied, oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more
Of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
`tGL chapter 152. §25C(6) also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally, btGL chapter 152, §25C(7) states•'Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance w ith the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if
necessary, supply sub-contractor(s) name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP) with no employees other than the
members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the pennit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be Sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the O1-tice-or Investigations has to contact you regarding the applicant.
Please be hire to'fiill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple pennio'license applications in any given year,need only submit one affidavit indicating current
policy information.(if necessary) and under"Job Site Address" the applicant should write "all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture -
(i.e. it dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit.
I he Office ice of Investigations would like to thank you in advance for your cooperation and should you have:any questions,
please do not hesitate to give us a call.
"rhe Department's address, telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Revised 5-36-05 Fax #617-727-7749
www.mass.gov/dia
CERTIFICATE OF LIABILITY INSURANCE SCOOTBH
T., D 12/07/69
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFO R TION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFkA }
Kaplansky Insurance Brookline HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND
114 Harvard Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELO -
Brookline MA 02446
Phone: 617-738-5400 Fax:617-738-8214 INSURERS AFFORDING COVERAGE HAIC#
INSURED INSURER A: T[AvvU[a - Geva[oLl Linos
INSL'RSR E.
Scott stone Construction INGURER C.
Scott/Jaclyn
9 Ba4berry Lane ; INtSu-'.FIT D-
Salisbury NA 01952
j INSURER E.
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO T E,NSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANT'CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
R;AYPERTn::.Tt:15URM`E PFFORCE79Y ltE-POLICIES-0E9CRIB�HE�INISSUB.IECT TO PI'.TNE•lERNS-EXCLiiG10N5-AND PlJPE4TON50F SUCFI -
POLICIES.AGGREGATE LIMITS SHO"MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSR TYPE OFRRSURANCE POIJCYNUMBER DATEIPIxICMMIDOttYY1'I DATE(MMIDD/YYYY)- LIMITS
��-GENERAL LIABILITY FA-H OCCURRENCE $ 1000000
A Ia I COMMERCIAL GENERAL LIABILITY 680949IN64A 06/25/09 08/25/10 ?pEr.nsFs =_e ccc�renee $ 300000
CLAIMS MADE x❑OCCLR V DE),-(Ary one person) $5000
PERSONAL a ACV iNA.RY $1000000
GENERAL AGGREGATE s2000000
GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-CCMP/OPAGG s2000000
POLICY Ej CT LOC '
AUTOMOBILE LIABIUrrY
COMB. SINGLE LIMIT $
ANY AUTO (Ea ac[idert)tleM)
A:!OWNED AUTOS
BODILY INJIPEY $
j SCHEDULED AUTOS (Per Parson)
rN-i I
HIRED AUTOS BODILY INJURY S
NONOWNED AUTOS (Per accident)
PROPERTY DAMAGE I$
r - (Per accieenq
GARAGE LIABILITY AUTO ONLY-PA ACCIDENT' $
AUY AUTO OTHER THAN EA.ACC $
AUTO ONLY ACG $
EXCESS/UMBRELLA LIABLRY EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE IF
I
$
DEDUCTIBLE - $
R_TENTION 3 i 7$
AND EMPLOYERS'LIABILITY - - ._. TgRYLIMITb VET•}.
ANY PROPRIETORPARTNMEXECUTIVE YINE.L.EACH ACCIDENT $ _
OFFICERIh¢MBER EXCLUDED'
(Mandaroryln NH) El DISEASE-EA EMPLOYEE $
If yes,desmte antler
SPECIAL PROVISIONS Below F.I..DISEASE-POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
SALITOi DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CER17MATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIASUM OF ANY FIND UPON THE INSURER.ITS AGENTS OR
Town of Salisbury REPRESENTATIVES.
5 Beach Road
PRESENTATIVE
lisbury NA 01952
ACORD 25(2000101) 88.2009 CORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
i
CITY OF SALEM
PUBLIC PROPRERTY
DEPARTMENT
•.I � 'I: I_" w�.�,!II\i..,`N Si;c! IT * II M. \l.\.i\t yl . :I•I .
III 't�9 'J;.•hvi 1 V: 9711.1741- Jh
Construction Debris Disposal Affidavit
(reiluired for all demolition and renovation wurk)
In accordance with the sixth edition ofthe State Building Code, 780 CNIR section 111.5
Debris, and the provisions of MGL c 40, S 54;
Building Permit tt is issued with the condition that the dcbris resulting front
This work shall he disposed of in a properly licensed waste disposal facility as defined by MGL c
111. S 150A.
The debris will be transported by:
(name ut haulfr)
I he debris will be disposed of in
(name ul laahty)
I;Iddrexs 111 Iaclitty)
Ignatu a of prnmt.Ipplkant
date
SjCIP
oomoo jL 1/ttt,.,
H6✓r,�Z
F I eyij
l 7-rVrs �J<�s /
Ila 1y/3 1 i�/J �`R/l Woo c� r�o�' C'� A of L.co®v$
41-y `�6 �^ / �,N/J�in� OJ�AiI�� C^ t�/vsvet✓s_(/a/ �(°�1OW /l/ ol,4&lC //
�/ Fn'lMmj CCIAOpDY ?Vl 6� alR ed h7 C'onC�cr�c dloor dv, /0//
cot]c�A / '� f
of 0CA ��iN ' , 0 rr?�7 Us�_�l CNcr`.1
a
RECEIVEO
'•,tiPECTIONAL SERVICES
� � The Commonwealth q���� &z s��hu�se��ts 2
� � Department of Pu�dti �'�r�r�a� 3 "
' Massachuse[[s S[ate Building Code(780 CMR)
Bailding Permit Application Eor any Building other than a One-or Two-Family Dwelling
�, ('Chis Section For Official Use Onl )� �
. Building Pertnit Number: Date Applied: �Building Official:
� SECTION 1:LOCATION(Please indicate Block#and Lot Il for locatione for which a streek addtess is nohavailable)
� 33� �� .., f-{' .S'a i� dl910 �^.r,I iv./ e.� �iv�
� No.and Stree[ City/Town Zip CoSe Name of Building(if applicable)
SECTION 2:PROPOSED W02K.
Edition of MA S[�[e Code used_ If New Construction check here 0 or check all that apply in the two rows below
Existing 8uilding�. Repair❑ Altera[ion � Addition 0 Demolition ❑ (Please fill out tmd submit Appendix 1)
Change uf Use ❑ Change of Occup.incy ❑ Other ❑ Specify:
Are building plans and/or constmction documents being supplied as part of this permit.pplica[ion? Yes e� Nu ❑
Is an Independen[Structural Engineerin°a.�pecr view reyuired? p/� / Yes ❑ No �
Brief Desaiption of Proposed Work: DW��� rt.,r- bur�v'; � nW"�
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVAT[ON,ADD[TION,OR
CHANGE W USE OR OCCUPANCY � - -
Check here if an Ezisting Building Investigation and EvaluaHon is enclosed(See 780 CMR 3�k) ❑
Existing Use Group(s): Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA �
Existing Propose�l
lVo.of Floors/Stories(include basement levels)&Area Per Floor(sq. ft.) �ydt� � Z 4'00
Total Area(sy.ft.)and Toc�l Height(ft.) �
SECTION 5:USE GROUP(Check as a licable) . � -� �
A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A-k❑ A-5❑ B: Business ❑ E: Educa6onal ❑
F: Facto F-L❑ F2❑ H: Hi h Hazud H-1❑ H-2❑ H-3 0 H-9❑ H-5❑
I: Institutional I-1 ❑ I-2❑ I-3❑ I-1❑ M: MercanHle❑ R: Residential R-1❑ R-2❑ R-3❑ R-�l❑
S: Storage Sl ❑ S2❑ U: Utility❑ Special Use O and ple.se describe beluw:
. Special Use:
SEC'CION 6:CONSTRUCC[ON T'YPE(Check as appliwble)
IA ❑ 16 ❑ IfA ❑ IB ❑ IIfA ❑ IIIB ❑ IV 0 VA O VB ❑
SECTION 7:SITE INFORMATION(cefer to 780 CMR 111.0 for details on each item)
Trench Permit: Debris Removal:
Water Supply: Flood Zone InformaHon: Sewage Disposal: Licensed Dis osal Site�
Public�1 Check if uutside Plood Zone❑ 6idica[e municip.ilt� A trench will not be P
requimd&4 or trench or specify:
Private❑ or indentify Zone: or on site system❑ vermi[is endosed❑
Railroad right-of-way: Ftazards to Air Navigation: al\ I h,t,,,ric..� ,�nn,�-s�un it .�i.� Pm��,t:
Not Applicable�l Is Structure within airport approach area? ls their review cumpleted?
ur Cunsent to Build enclosed ❑ Ycs� or No� Yes❑ No ❑
- SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Gditimi of Cnde: Use Group(s): lYPe of Construc[ion: Occupant Lond per Flouc . _
Dues the building contain an Sprinkler S}'stem?:�Special Stipulations:
GA1--��J y e .v • 3 �2
,,
• . ,
;J j'6EG,GION 9:�PROPERTY OWIVER AUTHORIZATION � �
NameandA�i lressof�l�cope�tj�'�Oivner.� �u9 �: `
aasl' Fi✓�r1�c. `�'37 EST.,c J'� /�cv.uL� M.4 ol9n�
Name(Print) �� ;�� �w No:;�n�i?§tre2t - City/Town Zip
Pr"pqr�Owner Contac[Infonnation: � � .
` i c�wK.�/ �17f!_YZ�_ 5 3Z.0 _ _ e�1- ��a-�t'
L � �L✓� - rfli.v-��.dy
Title � Telephone No. (business) Telephone No. (cell) e-mail�address �
�ff a plicabfe, the property owner hereby authorizes
i`c�na✓� I-�.I,.rh� 3o Grerce,.-�'i9�t. I`3���1� f'l�- o�5'i��
Nxvne StreetAddress City/Town State Zip
to act on[he ro er ownei s behalf,in�Il matters relative to work au[horized b this buIIdin ermit a lication.
� . � � � � SEC7'ION.10:60N57'RUCtION CONTROL(Ptease�fill out Appendix2J ' � �
� If buildin is less than 35;000 cu.ft:of enclosed s ce and or not under Conshvction Control then che¢k here O and ski� Section 301
10.1 Re� istered�PioFessional Reb �onsible far ConstrucHon Control � � � �
TdI�,.Crvt�-< �1 �7x_S3Z_ �66o jC.�w<I@dm.ti�Il .�c�,'t .<..� -1762
[�lame(Registraq t) Tel phone No. e-mail aSd ess Registration Number /
L..I�,<\� SP, �c���? � U14'6o S/?/ //
Stntet Address City/ own State _ Zip Discipline Expiration Date
102 General Contractor �- " - � - � - � � - - - ' . � - - � � �
(jpNTj rnu•� �it,w�lf Z ! 'ZO� g
Comp. y IJameI I ^ (o
�P�� H. l�✓�<� GS'-o937qL — f-1 IL 1 s� Iff8
Pl�vne of Person Responsible fur Construc[ion License No. and Type if Applicable
3� Crerca� .qv� j�xv-c/�.. t�N� �(9���
Street Address City/'Cown State Zip �
Ff_ S<'J al4Z _= r �-}i..�o�ki' � Cpl+-�c�.�, •1-t �
Tele hone No. business Tete hone IVo. cell � e-mvl address �
- SECTION 11:FVONKF.RS CObiYEN5,1llON WSUIt:1NCki A[FIUAVtI' M.G.ti.c.152 25C 6 - �
A Workers'Compensation[nsurance Affidavi[from the MA Deparhnent of Indus[rial Accidenfs must be coinpleted and
submitted with Uiis application. Failure to provide this affidavit wID result in the denial of the issuance of the building permit.
Is a si ned Affidavit submitted with this a licaHon? � Yes�- No O�
� - � SECTION 12:.CONSTRUCTION COSTS AND�PEAMIT FEE-"���� . � - � � ��
Item Estunated Costs:(I.abor
and Ma[erials) Tot1l ConstrucHon Cost(from I[em 6)_$ �IJ S°b
� 1. Building � ���� Budding Permi[Fee=Total Constr�ction Cost x_(Inser[here
2. Electrical $ /Svo ippropriate municipal factor)_$ .
3. Plumbing � .
�1. Mechanical (HVAC) $ Note: Minunum fee=$ (mntact municipality)
5. Mechanical Other � Enc(use check payable to
6.'Cotal Cos[ $ f I�ti 00 (contact municipality)and write check number here
SECTIOIV 13:SIGNATURE OF BUILDING PERMTT APPLICANT :� �
By entering my name below, f hereby attest undet the pains and penalties of perjury that all of the information contained in this
application is true and acc�te to h��t of my knowledge.and understanding.
I�fl^G✓� c7.Tvinti /� OWew ��dh/��.�Wn.�J '�176_� �ll 'rIZ. z 7�/// .
Picve erint and sign name Title Tclephone No. Date
.�a Cie sce•.a- �✓t �c vv�, � o(9i�
Street Address City/Tmvn ta[e Zip
Municipal Inspector to fill out this section upon applic�tion approval: O� ��
� Name - Date
c�� �l�fl� g��' 91�Z - �.',-�`� �Z�-;
i �
The CommonwegWi ofMassachuseds
Depardnent ojl�drrsrririlAaadents
l CongressSA�et,Suitel00
B.osto�,1N.�Q11I�2017
www.mara.goy/dia
Workers'Compens9tlon Insorrnce Affidavf�Boflders/Co�adors/Elec63cfana/Plumbus.
TO BE FII.EDWITH THE�PERNIITTlNG AUlHORiTY.
0 ,
Nam.e(susmr3;/oig�rationilodivi�el): . �� r•. o✓'LJ � . � . . ..
Aaa�ss: 3� C�e�rc�-i9✓�.
'a.cJ.L✓l /�'lQ- Phone#: �l Z PP 8 f} 919 Z .
City/State/Zip: , '3 � .
n..yoo.o emproyR.r�me��eo�: lype otproject(isqoire�:
. �.�s emy�oy«w� Z--.empbyees i��+wn-+�)'- � � � 7. ❑New construccun
2.Qlmawkpiopci�aperp�aahipaoQLeveaoempby,mwo�ioghvmem g;�gy��]� .
mY upedty.[hlc walceqs''�.��m9imed.) . �"' � .
3.p,,m,����n.ro,��a:�o,�•�,:�.�a.�f 9: On�n�m�
4.p��e�,;�ma,�-u�n�s�����;a����. ,.� �opsvam�g'eaa��.
m�ee,het all comnama eiBichave,vakas•comp�on mswaneemm sole l l.p Electr;eel r�s m ea�t;ona �
�"0�10�°�n°Q�°�'' . � . � . � � � f2:[�Pl�gi�6pWsoi'edditii7�"s
s.p��e�,a�main..Tea�ame�u�:u�aonme.�a,u�i: i3. Roof �
�.�n.�aa���o,�mam.��:=�a�3 O , l�
6.OWeareawryolati�mdiaofficasLaveeccicedme'vrigMofea�ptimpesMGLa � 14.�]Otha .
�sZ,g�(a�aoawemctoo�y�oyas.(Nowmtvs�tio�p:��are.qu:ed.]''� . . �
. . .. . _ . __.. _.' _' . ._: '_.:_ .. . ,.... _. .._.. .
.., .:_ .. .-.
�Anyapplir�f�at 6oil7muetdeo5�wt$eeecumbalowihnwm;�ebwakae �P��Y.�d� ... . . .
t Homeownets wlw submit Pod e�davit indi�giMp are�g aD aoYli etid Poes hm!oWs�de ca�lmBm�et"soCmh a rieav a�devitIDdiraling euck
�ConGsc[olaPoatchedCtLi"s6otmostatf9rLedto�eddibwalahatandwmBfEs�Ye:o1'1Lewb-taiui9qas�datate'srticffierm�Poase�Lave . .
employees IfPoeeub�qava.CmaLeve.�Pi.4Sa41heY,ID�P?4�'�e� A'mivs��c�•Polih'�m�b4 :�::�;. ...�,::. ��.. �. . _�...
�I lain un ewpJoY���P����B��15''Fntuupwemlon lnawreuaeJor�ny e�ea 8elowia thePoluyvrdl�aite -
injormatloa r` I
Insvrance Company Name: lr�jj v�l[.fi/,f
Z�a /�
Policy#w Self-ins.Lic:#:G Nv B - U W 1'i`�� IDcpiretion Dete: 3�Z��!b
Job Site A�s: `�sation polky�e ��W�� �R 6�LY- /'r'
33 �
AttaeL a eo of the workers'com (aLowlag t4e poBey nember and espitallon dnte).
Fai7ure w se�aae coverage ss iequfred wd�MGI.c: 152,§25A is a a�inal violation pwiisheble by a Sne up wS1,500.00
end/or ono-ye�vnpiisa�t,es well es civil penalties m the form of a STOP WORK ORbER�d a 5ne of up w S'150.00 e
day agarost the violaWi.A copy of this sutei+�mt mey be fotwerded to$e Office of Investigati�s ofthe DIA far rowumce
.. , ,
coverege va�5cation. _
I do haeby J'y �epains arsd penalties oJPaJ+uY thalthe injosmaaioa provided abnve u dwe and aysre�
l��,. �j2 y/,1
rn��#� Z �d 8 s-7 — glg Z _ __.
O,�'"rcial ase anly. Do not wrife in this area,to be coeiplrled by dy or town o,�'ieiaL
Ciry or Town: PermltlLlcense#
Iasuiog Anffiority(cirele oae):
l.Board of Heakh Z.Bdlding Depar[ment 3.CHy/fown Clerk 4.Electrical Inspector 5.Plombing Inapector
6.Other
Contnd Person: Phone M:
\
I
Information and Instructions
Messachusetta General Iaws chapter 152 requ'ues at1 employers to provide workaa'cou�ensation far their em�loyees.
Pursuent W this statute,m employee is de5ned as"...every person in tLe s�vice of aoa�a under any contrad ofh've,
' exprus or implied,oral or writte,n.••
An employer is de5ned as"an mdivi�al;Pe*�ersLiP,associetion,wcporation or mher legal entity,or any two or more
of tbe foregoing eogaged in a jomt emeryrise,and'mclud'mg the legal repres�tatives of a deceased�ploy�,or the
receiver or trustee of�individuel,P���P,association w other leB���Y>��oYIDB�Ployees. However the
. owner of a dwellmg house Leving not more tfian tLree eparuneots and who resides therein,or the occupant of 9�e
dwelling house of another who employs pesons to do mamt�ance,conatruaiem or repa'v work on such dwe]]mg house
or on the gowds or building appmtrnant therdo sLall nM beceuse of euch employ�ot be dcemed to be an employa„
MGL cbapter 152,§25C(6)elso states that"every state or local licensing egenry shall witLhold tLe issumce or
renewal of a ticense or permit to operate a business or to constract buildings in the wmmonweaM6 for�y
applieant wLo 6as not produced acceptable evidenu of comptlance w3th tLe inanrence rnverage reqotred."
Additionatly,MGL chapter 152,§25C{7)states"Neither tLe ca�onweeltL n�eny of its politicel subdivisions sLell
emer mto any contrect fa�8�e perfmmeace of public work�mtil accepteble evidence of compliance with the rosiu�ce
requireroenis of this�epta have bea�presmted to the contracdng authc�ity."
APPueauts
Pleese fill oul tLe workers'coa�ensetion affidevit completely,by checldng the boxes thaz apply to yrna siNation end,if
necessa*Y,�PPIy subcontrectoi(s)na�(s),sdd�s(es)and pbone number(s)along witL thea catiScate(s)of
ins�aance. I.�ited Liab�7ity Cmnpen�es(Id-G�m LIImted Liabili►Y Pa�cships(LI.P)aith no employces oth�then the
members or partners,�e not reqused to ceRy workera'compeosation msurance. If an LLC or LLP dces Lave
employces,a policy is requued. Be advised that thie affidevit may be submitted to the Depert�nent oi Industrisl
AccideMs for confumetion of insurence coverage. Also be sure to sJgo and date tLe affidavi4 The affidevit should
be retumed W tLe city or tmvn that the application fm the pemrit or license ia being requesled,not the Depmt�ot of
Industrial Accidents. Should you have�y questions regazding the law m if you are required W obtain e workers'
wnq�ensetion polieY,Plesse call the Department at the nwnber listed below. Self-msured'companies should eMer their
self-insiaeoce licrose number on the appropriatc line.
City or Town OiScials
Pleese be sue that the affidavit is complete md printed legibly. The Departn�ent hes provided a space at ihe bottom
of the etHdavit for you to fill out in the event the Office of Investigations Laa to contact you regarding tbo epplicem.
Plesse be s�se to Sll m the p�miUlicrose n�ba which wHl be used as a reference manber. In addition,an applic�t
that must sub�t multiple pemtiUliceoee applications in mY�ven Yeer,nced only su�t�e affidevit indicatmg c�armt
policy mfmmetion(if necessary)and wder"Job Site Address"the eppliant should write"sll locati�s in (city m
town)."A copy ofthe affidavit that Las been officially stemped ar mazked by the city o�town may be provided to the
applicent as proof tLat a valid affidevit is am 51e for fuhue pecamts or licenses. A new affidevit musl be Slled out eech
yeer.Where a home owner or citizen is obtaming a licai�or pernrit aot nlated to eny business or caau�rcial venture
(i.e.e dqg license ar permit to burn leaves etc.)said pe�son is NOT requind to compl�e this affidevit.
'Ihe Depnr�m�Ys addresa,telephone end fmr aumbQ: .
The Commonwealth of Massachusetts
Depaztment of Indushial Accidents
1 Congress Street,Suite 100
Boston,MA 02114-2017
Tel. #617-727-0900 ext. 7406 or 1-877-MASSAFE
Fa�c#617-727-7749
Revised 02-23-15 www.mass.gov/dia
�
, �
� Initial Construction Control Document
� To be submitted with the building permit application by a
> Registered Design Professional
for work per the 8�' edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Tide: Interior renovation Date2/5/16
. Property Address: 335 Bridge Street, Salem, MA
Project: Check(x)one or both as applicable: New construction x E�cisting Construction
Project description: Addition of new interior partitions
I John Crowell MA Registrarion Number: 7762 Expiration date: 8/31/16 , am a registered design professiottal, and I
have prepazed or d'uecdy supervised the prepararion of all design plans, computations and specifications concerning�:
x Architechual Shvctural Mechanical
Fire Protection Electrical Other:
for the above named project and that to the best of my laiowledge, informarion, and belief such plans, computations and
specificarions meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted
engineering practices for the proposed project. I understand and agree that I(or my designee) sha11 perform the necessary
professional services and be present on the construction site on a regulaz and periodic basis to:
1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the
contractor in accordance with the requirements of the conslruction documents.
2. Perform the duries for registered design professionals in 780 CMR Chapter 17, as applicable.
3. Be present at intervals appropriate to the stage of construcrion to become generally familiaz with the progress and
quality of the work and to detennine if the work is being performed in a mauner consistent with the approved
construction doc�ments and this code.
Nothiug in this document relieves the conh�actor of its responsibility regazding the provisions of 780 CMR 107.
When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent
comments, in a form acceptable to the building official.
Upon completion of the work, I shall submit to the building official a`Final Construcrion Control Document'.
,
�
Enter in the space to the right a"weP'or
g :
electronic signature and sea1: �`,� ��� '.
u
, f�`� ��� .LL : .
..P � r�,= .c .`
. . o °,� i.'
Phone number: 978-532-8660 Email: crowell deerhillazchitects.com `W Z� �;:'
J @ �,lPr''�u,(.�Of �¢�;,
� �d COf%/ITA��. .
Building OfScial Use Only
Building Official Name: Permit No.: Date: ,
Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other'is chosen,
provide a description.
Version06 ]1 2013 I�
Q'TYOF SALEIV� MASSA(HUSETIS
, Bcer.anvc nErat�xr
120 WASfID�1G'In�vS7REET,3IDFiooR
T�L(�78)7959595. •
R1M13RR1F]•Djj��jj,
Fax(�78)740-9846
MAYOR Tr�S7.P�tF
D7RBG7i0flt�+P[.�I.TCPR(�ER7S'/BIIDDDVIG Q�9ISA�R
Construction Debris Disposa/A�davit
(required for all demolition and,.renovation work)�
ln accordance with ihe sixth edition of the State Building Code, 780 CMR,Section 111.5 DPbris,
� and the provisions of MGL c40, S 54; Buiiding Permttlf is issued with the
condltion that rhe debris resulting from this work shall be disposed of in a properly licensed
waste deposit facility as deffned by MGL c 111, S 150A.
The debris will be transported 6y:
/� f f/h.�✓G �WKPr✓ . .
(name of hauler) '
The debris will be disposed of in: .
l ►.l,Gl o �� /V�wrT�/ ,��r'�
(name of facility)
�2 r �33 ����,��� r�-
(address of facility) :
J
Signatu e of applicant
�l�l�� �
Date �
INSTALL FRP TO MATCH�/
KITCHEN ON ALL FOUR . I
OOO I WALLS OF PREP AREA
PANTRY
3,_0„ ns
I PREP AREA � I
� KITCHEN 11z � .
106
� � ��-3��
o . STORAGE � 0 4�_8. � 4,_0, �E���
u i � _ "' h
- - - - - - - - - -, - - - - D1N1 �1C�
. \ � HATCHING o
"� INDICATES NEW "' �0� I� r/���7ONS
p PARTITIONS TO
� THE UNDERSIDE � �
� . OF EXISTING
CEILING
OFFICE
� io�
SITTING AREA
109
HC TOILE
ios HWH
FURNACE s�-o•
� iio
� WORK14AREA
HC TOILET OFFICE ,
104 108
'o
W
�
O HALL
6'-fi'
102
TOILET VE�TIBULE s
103 101 �n
I I I I I I
i- - - - �; J L - - J L - - - - -�
� FIRST F � OOR PLAN �
1 /4" = 1 �-0" !
..
;
;
RELOCATE LIGHT FIXTURES AND SPRINKLER
HEADS AS REQUIRED TO ALIGN WITH NEW
PARTITION LAYOUT.
,�EµEDAq�h/ FIRST FLOOR PLAN � DEER HILL ARCHITECTS, LLC
� � �,c����E. cr�o�y�`F�� .
D D � � F PROPOSED NEW PARTITIONS ���
Z
_ -- N No 7762 � -DEER;HILL
� � y�F BMASSY� ��.� BASS RIVER 4o LOWELL STREET, SUITE 23, PEABODY, MA
' 4`'" oc M�SSP 335 BRIDGE STREET, SALEM MA A R C H I T E C T S TELEPHONE (978)-532-8660 FAX (978)-532-3130
. C Drer Hllt Archltects LLC These drnrings nrr proprlrtnry antl nny not be repraduced rkhout �rltten pernlssh
II
� _—__ . ._...._.___—— ,^ ._.__ .. . ..—_. ... _ .__ �
____'_.... — _. __ _.
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. � 1g� . �
. �� G�-� - [ �7 � �
. ,.. ,�-'. ^� � , 1- ,i ,.
� The Commonwealth of Massachusetts
�' �41� ' t Department.of.PublicSafety t'`" � `i i � ; :�>''- i
� �, 1P Y, � .y",; ' � ,A1d5581f111$l'ICSSIate8uilJingQxle(7SOChIR)., r
. '' +Buiiding Pemiit Application'for any Building other than a One-orTwo=Family Dwelling*
� �' � � � .(fhis SecHon Fur Official Use Onl ) -
� Building Permit Number. •. •.. . Date App.lied: .. �, ...� : .,Building Official: •_' -' :- ^. ' . . .i -'
I SECtION 1:LOCr�T ON(Please indicate Olock#and Lot H for towHona for which a street addre@s is nat available).
1 ^ /' � r ,� �r, i'�l9' dl°17a b'aIr 1�►-c/
U � No.and Street City/Town Zip Code . Name uf Building(if applicable) .
SECTION 2•PROPOSED WORK � �
` EJitiun of MA StaM Code used � If New Cunstructiun check here O or check all fhat apply u�the lwo rows below
fV 1
� Esisting Building� Repair O rUteratiun � Addition❑ Demulition O (Ple.sse fill uut and submit AppenJLr I)
Change of Use � Change uf Occupancy � Other ❑ Specify:
Am building plans and/or cunstructiun ducwnenls being supplied as par[of this permit application? Ycs ❑ Nu ❑
Is an Independent5tmctural Engim�erin P��r Rev'ew reyuireJ? Yes O NuQ�
Brief Dtscription af Proposed Wyrk: edt e ' la � / � �¢^d' v:�d¢.L 6
t7e.� /�.'It f}rc�cCR^� G/n� L �"�•.�.G h�w [n�}i.,Gv�. , wi��a✓r. . o
aCNa�t La. roON-/ ^�h _ 4_ Cta _�
SECTION 3:COMPLETE TfIIS SECTION IF EXISTING BUILDING UNDERGOdNC RENOVATfON,.ADDITION,OR
� CHANCE IN USE�OR OCNPANCY
Chcck here if an EcisHng Building InvesHgation and EvaluaHon is endose.i(See 790 CbIR 31) 0 � � _ �
Esisting Use Craup(s): Propos��al Use Group(s):
� � �SECTION 4:BUILDING HEICNT AND AREA -
� . � � • � � Existing ProposeJ ��
No.of Fluors/SWries(indude basement levels)k Area Per Fluor(sy. ff.) � y�� � ( Z�COa
'Cotal Ama(s��.ft.)and Total Height(ft.) . . - .. � � ,S'af .
� SECI[ON 5:USE GROUP(Check as a Iicable)� - �
A: Assembly A-1❑ A-2 O Nightdub ❑ -A-3 ❑ A-{O A-5❑ � B: Dueiness O E: Educallonal ❑
� F: Facto F-1� F2❑ � H: Hi h Huud H-1 O. H-2 0 H-3 ❑ H-f O H-5❑
P L• InstituNanal Fl❑ I-2❑ 1-3❑ N❑ M: MercanHle❑ � R: Residential R-l❑ R-2❑ R-3❑ R-0 O
S: Storage SI ❑ � S2 Q U: Utility O Spectrl Use O and lease describe Ixluw:
. Special Use: -
� ' � � SEC'IION 6:CONSTRUCI'fON TYPE(Check'as a licable) �
G� ❑ IU ❑ f1A ❑ ItB O� IIIA ❑ IIIB O • IV ❑ ' VA ❑ V6 O
SECTION 7:SITE(NFORAIATION(refer to 780 CbIR 111A Eor det.uta on each item)
Water Supply: Flood Zone Information: Sewage Disposal: , 7'rench Permih Debris Removal:
Public I� Chctik if w[side Plwd Zune❑ InJicate munici il �trench will nut be Licensed Dispus:d Site�
p� �' reyuircd�l or trench or s e �fy:
Private❑ or indenti(y Zone: or on site system❑ ��rmit is mdoseJ❑ ��
Railroad righRo6way: ttuards fo Air Navigatian: �L��I If_tori�Qnnm�,c_����Itc�_�c��„�'��x�..:
Nut�\pplic.ble� Is StruUure wilhin�iirport appro.ch nrea? (s their review cmnp�eted? .
- ar Cunsent to Build endosed❑ Ycs O or NogL��. Yes❑ Nu O�
SECTfON 8:CONTENT OF CFRTIFfCATE OF OCCUd'ANCY .
Edition ul Cudc� Usc Crnup(s): Type ofCunstruction: (kn�pant Load per Plour:
Dues the buiiding cun�.�in,m Sprinkler System?: Special Stipulalions: __
S�v�' —l� lo
I — •�
..
, ,
- `
; �
� � SECTION 9: PROPERTY OWNER AU'CtIORIZA'fION �
Name and Address of Property O�vner
8�ss Rivcr?4�. y31 Esse�rs'T. Beverl � ltiy�J o i9�S
N:uPe�rint � V j� No.an treet � - City/Town Zip
�,Lmrn �vnerConict i�(�m: �on: a'w1 L
EYec�7��r pi���7`or �-9.t�- ��6 979 3.�� O4a3 '�luSt?n.v► � C385�n�W r —i'�e,
Tille 'Celephone PIo. (business) Tclephone No. (cell) e•mail aJdmss d�q
[f applicablc,the pmperty mvncr hereby authorizes � ,/
�„��� worh' 3oCpes�t�T l��+e, Be�er1� � B/
��`L ,�'Q4�e T�MA,GY' � � StreetAddress City/Town State � Zip
to act on the ro er owner's lnhalf, in:ill matters relative to work authorized b this buildin ermit a lication.
� SECTION 10:CONSTAUCTION CONTROL(Pleaee fill out Appendix 2)� �
If builJin is Iess thnn 35,000 ca(t.uf enclosed s�ace and or not under Conshuction Control then checic here O and ski SecHon 101 �
'lU.l Re istered Pmfessional Rea onaible far ConstrucNon Control �
Nume(Registmnf) Tclephone No. c mail.�ddress Regis[ration Number
Strcet Address � City/Town S�ite Zip Discipline Expiration Date
l0.2 General Conhactor - � � - � - �
6YNt( 0 U F'1
, Comp.�n Name _� ' � '
fZ`er�l � lvrn� G� �9��'�t� rin�r�i,c�.c�
N.une of Person Responsible fur Construction License Nu. and Type if Applicable
3v C�.e�'ee...f �✓.�, ��ul,, . M/� OC�'iir
Strcet Address �r � � City/Town State Zip
�?��RI�Z -- (rNli✓OR� P���..y!<_ .�t
Tcic lione No. business Tcle hune No. cell �mnil addmss
SECTION11:4YOf:1:FR5'COMNENSAI'IONWtiUIt:\NC1i:V'RUAVfI' M.C.L.C.152 25C6
A 4Vorkers'Compensition Insur.ince Affidavit from the hIA Department of Industrial Accidents must be completed�nd
submitted with�this applintion. Failure to provide this affidavit will result in the deni:wl of the issuance of the building permit.
- [s a si ned Affidavit submitted with this a Iicallon? - Yea No ❑
SECIION 12•CONSTRUCTION COSTS AND PERMIT FEE r
(tem Estunated Costs:(Labor � � ��
and btah:rials) Tot:tl Cons[ructiun Cost(from Item 6).=$
L 6ullding S ODa Building Permit Fee=Total Cons[ruction Cust x_(Inser[here
� 2.Eicclrical S ` On� - appropriatemu�icipalfactor)=$
:1. Plumbing . � 5 23 oc90 �
d. �l��chenical (HVAC) S O(�t7 Nute:Minimumfee=$ (conMctmunicipality) � �
s. bl�rhanical Other - � Encluse clit�ck a ible to
v r�
6.Total Cust � g D(f0 (contact munici ality)and write check number here
SECCION 13:SICNATURE OF 6UILDWG PERhI1T APPWCANI'
6y entering my name below, I hcreby attest w�der the pains anJ penalties of pc�jury that all of the informntion caitain�tl in this
applfi ation is true and accurate to the best of my knmvledge and understanding. .
' ( �T/ (,Z+/h,c% � 1�l 1 -�Il�'L 7� ��'
.ue a iun n�'ne � Tille Tclephune Nu. Date
( " /
�� r i�n P �v` Cj{y/'I'��v/n� State Ziv
CA C1�'� /
�lunicipal[nspector to fill out this section upon application approvaL•
Name Date
� The Commonwea[th ofMassachusetts '
Deparbnent nflndustrialAccidents
1 Congress Sdeet,Suite 100
Boston,MA 02I14-2017
rvww.mass.gov/dia
� �F'orkers'Compensation Insurance AffdavitdBuilders/Contractors/Electricians/Plumbers. � . . -
TO BE FII.ED WITH THE PERMITIING AUTHORITY. - � �
licant Intormation � /' � � Please Print bl
Name(Business�Organizatioaituuividual): j ar�i r7�T✓w-t/ a� 6 R AH+�� n., r�f
Address: J 8 �i���1' /�T%t•
, CiTy/State/Zip: �� �''4 O!9�/l�Phone#: GI 7 fS. ty�7—gI`/�L
Are you an employer?Check the appropriate box: 1�'EIC Of pTOJebt(7eqUi�ed�:
, l.O�I am a empl oyer with �.employees(fiill end/or part'nme).' . 7. �NeW ConSWChOD
2.Q I mn e sole proprietor or parmership aod have no empbyees workroB forme in �� � 8. �CIIlOdO�iDg
�Y�P��Y.[No workeis'comp.indiuv�ce requ'ved) � .
3.Q 1 am a fiomeowner doing al)wo&myself.[No workers'comp.inswsnce requ'ved.J� 9: ❑DeRlUlihon
. .� . � - ' 10�Building 8ddition.
4.❑1�a homcowner mid will 6e h'ving contraclors W cond�et z17 work on my property. I w171 .
eosure thet all wnomctms dther have workers'wmpensation insurance m ee sole 11.Q EleCtrlcal repalrs or 8dditions
�;ecors wicn no employe.es. � . • � 12.�Plumbing npe'vs of additions .
5.�I em a genual contractor and I have h'ved t6e subrAntractms]isted on fhe attached ahee't. 13.�RoOf 7epaiis. �
7'hese sub-contraclon have�p]oYees and have wolkas'wmp.mswaoce.7 . . .. . .
6.❑We are a coryota6on and its officers Lave wcercised thert right of exemption per MGL a 14.0 Ofhef �
� 152,$1(4).and vie 6ave no employees.[No wmkers'comp.msiumce rzqurted.] - �
. . .___ .. _. __.. .. .. ._. ._.. . _.: ._. _ _.. .. ...._ .._. _. .. .... .. .. _.
•Any appticant that thecks box#1 muat elso fill out the aeNon below showing thert wmkas'aompensetion policy mfmmeCon. � � �� �
t Homeowners w6o sutimit this affidavit indicmmg t6ey are doing ell work end 16m hire outside co�ai[as must submi[a new•effidavrt mdicating such.
�Contractors ihat check thiv box must attnched�additimial 56a[ahowmg the name of the sub-couuaao=s and state wLGlin or not ihou mtities have �
employees. If the subconlrectas Aave miployees.they mus[provide tLeu�workus'.rpmP.poliry mwber..
I am an employec Jhat is providing workers'compensation insuraocefor�ny employees.-Below is the policy and job�site � - � .
injormation. �,
Insurance Company Nazne:_ ���1fA,� ��"'f �U'• ' . ' .
Policy#or Self-ins.Lic.#: (7di. T/rr L Expira4ion Date: �
� Job Site Address: 3 3 1. �{��j � ���.. . � City/Stete/Zip: �. �r+-. /�/!�CJC 7��TD
Attach a copy of the workers'compensation policy declaradon page(showing the policy nnmber an� eapiration date).
Failure to secure coverage as required imder MGL c. 152,§25A is a criminal violation pimisheble by a fine up to$1,500.00
and/or on�year imprisonment,as well as civi]penalties in the form of a STOP WORK ORDER and a Sne of up to$250.00 a .
day agflmst the yiolator.A copy of this statetnent msy be forwazded to the Office of Invesligations of the DIA for insursnce
coverage verification.
I do bereby cen' u der th ains arsd penalties ojperjury tha(the injormation provided above is true and tonect �
Simature•'J�"lhlt �i-- Date• 7/9�//! .
Phone#• �' �� ��7 RJ'i2
O�cio!ase only. Do not wrke in this area,tn be compleled by city or town q�ciaL
City or Town: Permtt/License#
Issuing Authority(circle one):
1.Board of Healt6 1.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.O[her
Contact Person: Phone p: �
Information and Instructions
Massachusetts General Laws chapter]52 requires a11 employers to provide workers'compensation for their employees.
Pursuant to this statute,an eraployee is deSned as"...every person in the service of anotha under any conhad of hire, -
express or implied,oral or writte�."
M employer is defined as"an individual,parmership,essociation,corporation or other lega]entity,or any two or more
of the foregoing rngaged in a jomt entecprise,and including the legal representatives of a deceesed employer,or the
receiver or trustee of an individual,parmership,association or other 1ega1 entity,employing employees. However the
owner of a dwelling house having not more t6an three apartrnents snd who resides therein,or the occup�t of the
dwelling house of another who employs persons to do maintenance,construct]on or repair work on such dwelling house
m on the gro�mds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter]52,§25C(6)also states that"every state or local ticensing agency shall withhold the issuance or -
� . renewal of a liceuse or permit to operate a business or to construct baildings in t6e commonwealtL for any
applicant who has not produced acceptable evldence of compliance with t6e insurance coverage reqn'ved." '
Additionally,MGL chapter 152,§25C(7)states`Neither the commonwealth nor any of its political subdivisions sha➢
eMer into any contract for the performance of public work unti]acceptable evidence of compliance with the msurance
requiremenu of this chepter have been presented to tbe contracting authority."
Applicanis � '
Please fill out tbe workers'compensation affidavit completely,by checlong the boxes that apply to your situation and,if .
necessary,supply subcontractor(s)name(s),address(es)and phane nwnber(s)along with their certificate(s)of
insurance. Limited LiabiliTy Campanies(I.LC)or Limited Liability Pazh�erships(LLP)with no employees other than the
members m pariners,are not reqused to carry workers'co�ensation insurance. If an LLC or I.Lp does have ��
employees,a policy is required. Be advised that this effidavit may be submitted to the Depar[ment of Industrial
Aceidents for confianation of insurance coverage. Also be sure to si�and date tLe affidavit The affidavlt should
be retumed to the city or town that the application for the pennit or license is being requested,not the Depertrnent of �
Industria]Accidents. Should you have any questions regarding the law ar if you aze required to obtain a workers'
compensation policy,please call the Department at the nwnber listed below. Self-insured'compenies should enter their .
self-insurance]icense number on t}ie appropriate]ine. �
City or Town Officisls -
Please be sure that the affidavit is complete and printed legibly. T7�e Depariment hes provided a space et ihe bottom .
of the affidavit for you to fill out in the event the Office of Investigations hes to coniact you regarding the applicent.
Plea&e be sure to 5ll in the permiUlicense number which will be used as a reference number.�.In addition,en applicant
that nwst submit multiple permiUlicenae applications in eny Aven year,need only submit one affidavit indiceting cwrent
policy information(if necessary)and�mder"Job Site Address"the applicant should write"all]ocations in (city or
town)."A capy of the affidavit that has been officially stamped or marked by the city or town may be provided to the .
applicant as prtlof that a valid af5davit is on Sle for fumre pernrits or licenses. A new affidavit must be 511ed out each
year.Where a home owner or citizen is obtaining a license or pemvt aot related to any business or commercia]venture
(i.e.a dqg license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. �
� The DepartmenYs address,telephone and fax number: �
The Commonwealth ofMassachusetts
Department of Indush-ial Accideats
7 Congress Street, Suite l00
Boston,MA 02114-2017.
Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE
Fax tt 617-727-7749
Revised 02-23-15 wwW.mass.gov/dia
1
��, C�TYOF SALEIV� MASSA(�ICJSETIS
; BLIII.DIIVGDEPARIMEIJI"
I2o wnsFm,rc,or,s�r,9IDFi.00x
T�L(978)745-9595
RIIvIBERLEYDRISOpLL FAX(978)740-9846
MAYOR TrioNras ST.P�xRE
DIItECTOR OF PUBIJCPROPFRTY/BI.IILDING�SSIONER
Construction Debris Disposa/Affidavit
(required for all demolition and renovation work)�
In accordance with the sixth edition of the State Building Code, 780 CMR, Section 111.5 Debris,
and the provisions of MGL c40, 5 54; Building Permit t! is issued with the
condition that the debris resulting from this work shail be disposed of in a properly licensed
waste deposit facility as defined by MGL c 111, S 150A.
The debris wiA be transported by: �
I�QI�i lldh ' vr� . . e
(name of hauler) '
The debris will be disposed of in:
/"I elb `s �s�a•�s�e✓ ST�i�"v.,
(name of facility)
� �T �33 C*ea ;��,,,,�� ,�vL4
(address of facility) �
� ,
� ��
ignature of applicant �
�9���� I
Date
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ARCHITECT: S�'RUCTURAL: z
i DEER HILL ARC�-1 ITECTS LLC WENTWORTH PARTNERS & ASSOC. '�' `�
� �
" 40 LOWELL SiIf�EET, 17 MALCOLM HOYT DR., STE. 2 > >
PEABODY, MA,. 01960 NEWBURYPORT, MA. 01950 � a
TEL: 978-532'-8660 TEL: 978-462-5822 � �
� � I
. � �
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z
LIST OF DRAWINGS CODE REFERENCES � � �
o � �
W
C COVER SHEET SEE ATTACHED CODE REVIEW W � � o
AI FLOOR PLAN, INTERIOR ELEVATIONS & EQUIPMENT SCHEDULE > � � �
o Qm �
A2 REFLECTED CEILING PLAN & LIGHTING SCHEDULE
c� � m � �,
A3 EXTERIOR ELEVATIONS & AWNING DETAILS
A4 DOOR SCHEDULE & TYPES j��E�ARc �
� A5 • WALL TYPES & FINISH SCHEDULE �G��� c�����A
� � i
�
� . '�� No.nsz ,�
� y BEVERLY, �5
� � � �z MASS. d�
SI.O GENERAL NOTES, PLAN & DETAILS
�
� �`TH OF MPSSP
! �' MAY 5 2015
.
SCALE: AS NOTED
� � � �I
PERMIT SET
� �,
,
, . :
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. , y � � � � J Q w � � J�W �W WW �W �W � � . Q �
� wo �TEM � � a p = � J w oN oN �N oN Qry m wo EQUIPMENT w x a
� �z NO QTY EQUIPMENT CATEGORY MANUFACTURER MODEL NUMBER Q Y = > � o a z c�cn =v� ov� zu� c�v> � �—z REMARKS � a � �
1 1 DISHWASHER CMA DISHMACHINES UC50E 28.0 4 1 208 1 X 0.5 OJ5 PRESS REG. U prj `;
2 1 SOIILED DISHTABLE W/ SINK ADVANCE TABCO DTU—U60-48R—X — w N g
2A 1 FA.UCEf — SPLASH MOUNT qDVANCE TABCO DTA-53—X — — I-.— � �
2B 1 DRAINAGE SHELF ADVANCE TABCO DT-6R-21X 22"L; WALL—MOUNTED; PROVIDE BLOCKING = � E
2C 1 PRE—RINSE BASKET ADVANCE TABCO DTA-100—X 48"L X 15"D; WALL—MOUNTED; PROVIDE BLOCKING U � � T
� 3 1 THIREE COMPARTMENT SINK ADVANCE TABCO FE-3-1824-24L—X — — I= m 8
REFER TO EQUIPMENT
SCHEDULE FOft ITEM 3A 1 FA,UCET — SPLASH MOUNT r Q W �-`�i P
��� INFORMATION
ADVANCE TAE,.O K-112 � � n
3B 1 SIDE SPLASH ADVANCE TABCO K-700—X
3C 3 DF�AIN — TWIST OPERATED ADVANCE TABCO K-5—X — J � � m
3D 1 PQT RACK ADVANCE TABCO SW-48—X 48"L; WALL—MOUNTED; PROVIDE BLOCKING — J W a
4 1 C(JNVECTION OVEN BLODGETT BDO-100G—ES—SNGL 8.0 1 115 1 X .75 45 25° ADJUSTABLE LEGS = � O m
5 1 RA�NGE — 6 BURNER BAKERS PRIDE 36—BPV-6B—S30 1.5 .75 206 � O = �
� ��. � WINIDOW SILL HEIGHT _J W �
�. 4'-W" AFF 6 1 FREEZER: REACH—IN BEVERAGE AIR HF1 -1S 7.1 0.33 115 1 X W J �
. NE4W ALUM. SLIDER 7 1 REFRIGERATOR: REACH—IN BEVERAGE AIR HR2-1 S 8.4 0.33 115 1 X W 0 W "
� ' FRP WALLS WINUDOW IN NEW M.O. - , n Q � � �
8 1 WORK TABLE ADVANCE TABCO TTF-304—X 48 W X 30 D TABLE
�� NEW DOOR, FRAME & gA 1 DI�AWER W/ ADAPTOR ADVANCE TABCO SS-2020—X J �
� HARDWARE; SEE . �
, SCHEDULE 8B 1 MIICRO—SHELF ADVANCE TABCO MS-24-24—X � � 24"L; WALL—MOUNTED; PROVIDE BLOGKING '
U
3 O E— 9 1 MOP SINK ' ADVANCE TABCO 9—OP-20—X �
2 9A 1 SERVICE FAUCEf ADVANCE TABCO K-240—X ' � ' �
II 10 1 WORK TABLE ADVANCE TABCO TTF-306—X 72"W X 30"D TABLE � � '
� � ^:
10A 2 DRAWER W/ ADAPTOR ADVANCE TABCO SS-2020—X 8.4 0.33 115 1 X �� � ;
a« .,��
�5 5 � 11 1 SHELVING ADVANCE TABCO BKWSE-1272 72��L; WALL—MOUNTED; PROVIDE BLOGKING � F� ,, '� w
12 1 SHELVING ADVANCE TABCO BKWSE-1672 72"L; WALL—MOUNTED; PROVIDE BLOCKING � �' '
� . INTEGRAL EPDXY COVE 13 1 HAND SINK � ADVANCE TABCO TSS-1—H '� ~ �
M y. � � �
sase. see oelai� 14 1 EX:HAUST HOOD SYSTEM NSW MARKETPLACE CUSTOM 96" X 48" X 24" � � �
� � E L E VA TI O N � 14A 1 WA�LL PANE� NSW MARKEfPLACE CUSTOM 72"L; WALL—MOUNTED; PROVIDE BLOC�KING <,;, � x
1 /4'� = 1 �—0" 14B 1 FIF2E SUPRESSION NSW MARKEfPLACE CUSTOM PERMITS, DRAWINGS & PUFF TEST
15 1 GR�EASE TRAP CANPLAS INDUSTRIES 3925A03 50 LB. — PLUMBER TO COOR. EXACT SIZE & PIPING �*�
W
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' � NEW DOORS, FRAMES � � � � AZ � �
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� SCHEDULE � � �
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� . � BASE, SEE DETAIL O O � �
� �� 15 C . A4 NEW STORAGE
4 E L E V A TI 0 N � � � 4 A� Z REFRIGERATOR FREEZ R M CLOSET W/ ��
o STORAGE BUILT-IN
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�'�. � BASE, SEE DETAIL v� � Q � m
OFFICE
ELEVATI ON 2 �, � HC TOILET 08 � � � m � ,
� 1 /4„ = 1'-0"
05 �'
z P Q .n `y.�Eaeo AR�yi
� - NffW SERVICE PANEL � C2 A' I ��p��E, CRp��`FCA
lD ` "
AI� �
No.7762
� ... 14 . . ql OZ BEVERLY, q
� O y�i MASS. �J .
� FRN' WALLS 4 5 CZ HALL . �'`TH oF MpS5P4
102 A� o A
�Z TOILET ; � VESTIBULE
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5 � EXISTING PORTION I I � EX. OPENING W �I � �
OF REMOVED CMU � � I SCALE. AS NOTED i
� . � � � L _ _ _ _ J L DIMENSION & SIZE J
INFILLEXISTINGDOOR � _ _�_ _ _ _ _ _ _ _ _ _ _ _ . � - - - - - - - - - J I �.
- � � INTEGRAL EPDXY COVE OPENING WITH CMU TO
- - - - - - - - - - 5 �
4 OVERH�ANG ABOVE �
� BASE, SEE DETAIL � MATCH EXISTING CMU .
ELEVATION 1 FIRST FLOOR PLAN 1 Si.o A I �
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APPROVED EQUAL n q �07 DROPS FROM C ILING I I n � �
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PHILIPS OR APPROVED EQUAL H TOIL T I I � Q = '
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� LIGNT: PHILIPS GS SERIES OR 2 FURNACE B e B s - - � '!
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r METAL SDFFIT CEILING MAY 5 ZOIS '
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-7 GABLE FRAMIN � SECTION AWNING FRAMING SECTION 5 AWNING FRAMING PLAN a �
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. 8'-0"W X 4'-0"H MASONRY �
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MASONRY OPENING � �
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REAR ELEVATION
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EXISTING OPENING a FRAMING; PAINTED SEAM METAL ROOFING O — �
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� � MASONRY OPENING 6�-O�W X 3�-B"H MASONRY . OPENING WITH CMU TO W EXISTING MASONRY EXISTING MASONRV NEW b�-0°W X L�-O�H t
MATCH EXISTING LMU OPENING OPENING MASONRY OPENING; �
� OPENING � � ' �. OPENING TO MATCH '
" . 2 L E F T E L E V A T I O N F R O N T E �E V A T I O N EXISTING WINOOW �A�
1 1 /4" = 1 '-0" SIZE THIS ELEVATION SCALE: ASZNOTED
. 1 /4" = 1'-0" I
= A3
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� ID DR. OPENING/SIZE TYPE RATING CONSTRUCTION HARDWARE FRAME MAT. HARDWARE REMARKS � Q x :
� a � �
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01 6 -0 x 7 -0 C ALUMINUM/GLASS ALUMINUM TYPE D HDWR IN AILUM. STORFRONT DOOR U
02 6'-0" x 7'-0" C ALUMINUM/GLASS ALUMINUM TYPE A HDWR IN AILUM. STORFRONT DOOR GLASS N 9
TYPE A: PASSAGE LEVER SET; 1 -1 /2 PAIR BUTT HINGES; DOOR STOP W
03 3"-0" x 7'-0" A SC FLUSH - HALF LITE K.D. HOLLOW META TYPE A �/r GLASS GLASS � � �
04 3'-0" x 7'-0" B SC FLUSH K.D. HOLLOW META TYPE B TYPE B: PRIVACY LEVER SET; 1 -1 /2 PAIR BUTT HINGES; DOOR STOP = � E
05 3'-0" x 7'-0" B SC FLUSH K.D. HOLLOW META TYPE B � o �
; 06 3'-0" x 7'-0" B SC FLUSH K.D. HOLLOW META TYPE B �� �� TYPE C: OFFICE LEVER SET; 1 -1 /2 PAIR BUTT HINGES; DOOR STOP � i-= � d
� 07 3'-0" x 7'-0" A SC FLUSH — HALF LITE K.D. HOLLOW META TYPE C w N a
Q w M �
08 3'-0" x 7'-0" A SC FLUSH — HALF LITE K.D. HOLLOW META TYPE C TYPE A TYPE B TYPE C PAIR TYPE D: KEYED ENTRY LEVER; 1 -1 /2 PAIR �UTT HINGES; DOOR STOP; CLC � � �
09 3'-0" X 7'-0" A SC FLUSH — HALF LITE K.D. HOLLOW META TYPE C SWINGING —1 cn � „
TYPE E: DUMMY LEVERS WITH MAGNETIC CATCHES; 3 PAIR BUTT HINGES; D� -1 ;
10 3'-0" X 7'-0" A K.D. HOLLOW META TYPE C NOTE: ALL EXTERIOR DOORS TO BE PROVIDED AND STOPS — � W a I
11 3'-0" X 7'-0" B INSULATED STEEL HOLLOW METAL TYPE D INSTALLED WITH ADA COMPLIANT THRESHOLDS WITH = w z �
12 3'-0" X 7'-0" B INSULATED STEEL HOLLOW METAL TYPE D VERIFY EXISTING MASONRY OPENING THERMAL BREAK. ANY INTERIOR DOOR THRESHOLDS� TYPE F: KEYED STOREROOM LEVER; 1 - 1 /2 PAIR BUTT HINGES; � O � �
� 13 3'-0" X 7'-0" B SC FLUSH K.D. HOLLOW META TYPE F SHALL BE ADA COMPLIANT w J w �
14 3'-0" X 7'-0" B SC FLUSH K.D. HOLLOW MEfA TYPE A Q � � �
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ALUMINUM ALUMINUM FRAM E
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� CS32 HORIZONTAL WINDOW WI-fH INTEGRAL ' STOREFRONT SYSTEM AND DOOR OR APPROVED
SCREENS OR APPROVED EQUA�L EQUAL ;
. � �
W . I
/ ,�
AL.UM. DOOR W/i/4' REFER TO WALL TYPES GORNER BEAD �, �
EX. EXTERIOR INSUTATED FOR WALL THIGKNESS. 2, EXISTING �
GMU WAL 1�8, TEMPERED GLA�S MASONRY
, 3/4" THERMALLY BROKEN Wp�� �
2" ' , , ALUM. STORFRONT �
REFER TO PLAN FOR cu
� SYSTEM �1' PRESSURE (n �
WALL TYPES 1 N � INSUI�aTED TRF�.TED WD. W �
NEW LINTEL;SEE � WD. BLOGKING ,
� � TEMPERED GIA55 BfAGKING J (n ,
STRUGTUP.AL FOR v }Y - ,N (TYP @ EXTERIOR) BAGKER ROD� iu � ~ �
SIZE�11'PE . \ ALUM. FRAME� gp,CKER ROD �SF�.I�NT � r�.�qNT z
J� GEN'iER GII�ZED 1/4' c� � W �
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WD. BLOGKING GENTER GI�ZED 1/4" 4��� W w
DOOR�7HRESHOLD W/ STORFRONT SYSTEM �1' cn
P.M. KNOGK DOWN DOOR GWB RETURN TEMPERED GLASS 1' INSUL.TEMPERED INSULATED TEMPERED � �
HEAD FRAME U O
GLASS(TYP @ EXTERIOR) GLASS =
(TYP @ EXTERIOR) CI� � � I
15 EXT, DD�R HEAD DETAIL 12 INT , ALUM , D❑❑R JAMB 9 INT , ALUM, JAMB DETAIL 6 EXT , ALUM , D��R HEAD 3 EXT, ALUM, HEAD DfETAIL � � �
� SCALE�1 1/2'-1' 0' SCALE�1 1/2'=1' 0' SCALE�1 1/2'-1'-0' SCALE�1 1/2'-1'-0' SCA�E�1 1/2'=1'-0' O � �
. EX. EXTERIOR THERMfV_LY BROKEN ALUM. � Q a i
GMU WAL STORFRONT SYSTEM �1' I
TNERMALLY BROKEN INSULATED TEMPERED — z � �
ALUM.STORFRONT GLASS(7YP @ EXTERIOR) � W W w
BAGKER ROD � � w
ALUM. Ff�M , SYSTEM �1'
SEALANT GENTER Z< 2„ 3/4" INSUI.L�TED �
GI�ZED. 4 1/2' , TEMPERED GLtVS IXISTING WALL 0 — �
JAMB ANGHOR �-
3 PER SIDE � (TYP @ EXTERIOR) , W � � i
P.M. KNOGK DOWN DO R N 1/4' TEMPER PRESSURE (�/ � �/�
N LJ_ Q V / �
HEAD FRAM GLASS TREATED WD. � ! n
v BLOCKING '" O a- v / �
PRESSURE-TREATED ALUM. FRAME ff � THERMALLY BROKEN ALUM. � d. O � � m I
WD. BLOGKING M ' GL�SS PERED 1/4"SAFEN - DOOR�THRESHOLD W/ 2, � � I
1' INSUL.TEMPERED Q � m � ;
GLASS. 6LAS5(lYP @ EXTERIOR) B�KER ROD� SEtV�NT
GWB RETURN ' WD. BLOGKIN i" INSUl�aTED TEMPERED GLAZIN tE�°ARc
P @ EXTERIOR ��,� . Rp�<c FCA
REFER TO PL<W FOR �8. �-�y � G�5 E � yir
WALL NPES
EXT, D❑❑R JAMB DETAIL .� INT , ALUM, MULLI�N �o�T, ALUM, SILL DETAIL ,� EXT , ALUM , DD❑R JAMB ���XT, ALUM , JAMB DETAIL � ` � '
1 No.7762
� . � � SCALE�1 1/2'=1'-0• �l 1 SCALEd 1/2'=1'-0' . �SCALE4 1/2'=1'-0' � SCALE�1 1/2'=1'-0' G SCA�E�1 1/2'=1'-0' y BEVERLY, � ��
. . �i MASS. �*
. . . . F,� TN OF M�55p4 .
THERMALLY BROKEN ALUM. �
REF�ER TO WALL TYPES `` THERMAI_LY BROKEN STORFRONT SYSTEM �1' THERMALLY BROKEN ALUM.
FOFR WALL THIGKNE55. 4�_ REFER TO WALL TYPES PAINTED ALUMINUM INSUI�TED TEMPERED STORFRONT SYSTEM �P
ALUM. FRAME�GENTER FQR WALL 7HIGKNE55. GLASS INSULATED TEMPERED
DOOR SEE DOOR
, BOXED HEADER WHERE SGHEDULE FOR SIZE C�P @ �TERIOR) G�SS 1�2•
� GI�,ZED 1/4'INSUI�TED
�Qp TEMPERED GI�'v5 Cn'P @ �'fEWOR)
FIRE FRETA2DANT N BOXED HF.f�DER WHERE AND TYPE.
1/2' ': ; /2' REQ'D N
-���,�p V,ip. , THEfzMALLY BROKEN _ ,
W,D. BLOGKIN LOW PROFILEALUMINUM v
;� P.M�WE DED DOOR ' \ � GORNE2 BEAD N H.G.AGGESSIBLE 51LL �a, � S�T�� � :t I MAY 5 ZOIS
�` �
FRAN�E ro B?�GKER ROD �SF�ILFWT �GONG SI�.B SCALE: AS NOTED '
" PART ION TYP + 1'
4 1/2' PRESSURE TREATED
- ALUM. DOOR W/U4 �-UM. FRF*ME�CENTER � WD. BIAGKING
' TEMPERED GLASS G'�LAZED V4'TEMPERED
G'�I�SS
�� �TYP HEAD/JAMB DETAIL INT, ALUM D�OR HEAD INT, ALUM HE�AD DETAIL � EXT , DO�R THRESH❑LD � EXT , ALUM MULLI❑N 1 EXT , ALUM SILL DETAIL n / ,
, 1 , , , ,
1 6 SCALE4 I/2'=1'-0' 1 � SCALE4 1/2'=1'-0' � O SCALEd 1/2'=1'-0' � SCALE�1 1/2'=1'-0' � SCALEd 1/2'=1'-0' 1 SCALE4 1/2'=1'-0' ����`���
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UNDERSIDE �F STRUCTURE UNDERSIDE �F STRUCTURE � a- tQi a
AB�VE ABOVE I—'
UNDERSIDE ❑F GENERAL NOTE: U p,-j �
STRUCTURE IABOVE ; ACOUSTIC SEALANT ' ; ACOUSTIC SEALANT N m
= METAL STUD TRACK 3 s METAL STUD TRACK SEAL ALL OPENINGS, GAPS, PENETRA110NS„ AND JOINTS IN W '
PARTITION TWES �. � g
SEALANT 's. COORDINATE BLOCKING IN WALLS WITH EQUIIPMENT & OTHERS AS = � `
�i METAL STUD TRACK = REQUIRED U (n o ',_
, , �• arR sPacE a. MTL STUD WALL; SEE SCHEDULE � ~ °' d I
6 MIL, POLY VAPOR BARRIER > w � �
' 1 LAYER OF 5/8' GYPSUM ' 1 LAYER' �F 5/8' GYPSUM Q W M �
t BOARD, ON EACH SIDE BOARD, ON EACH SIDE FRP PANELS � ^ `
S�UND ATTENUATIDN S�UND pTTENUATION FRP EDGE TRIM MOLDING J � � �
! 1 LAYER OF 5/53' GYPSUM o, m '
BDARD BLANKET ; BLANKEIf _I �
METAL STUD FRAMING ` METAL STUD FRAMING — _Jj W P
FOAM SPRAY IN'SULATION ' a
(SEE SCHEDULE BELOW> ; (SEE SCHEDULE BEL�W) (SEE SCHEDULE BELOW) AD H ESIVE _ � 0 S I
METAL STUD FR:AMING ; ' METAL STUD TRACK METAL STUD TRACK � _ � �
I (SEE SCHEDULE BEL�W> �` ACOUSTIC SEALANT ACDUSTIC SEALANT I/2° CEMENT BACKER BOARD W 'J W �
�
�f SUBFLOOR ,, = FINISHED FLD�R FINISHED FL�OR �J O � y `�
` I/8" EPDXY QUARTZ INTEGRAL � �
MOISTURE RESISTFANT SCHED. M�ISTURE RESISTANT SCHED. M�ISTURE RESISTANT FLOOR BASE TO 6�� ABOVE FLOOR �
GYPSUM BOARD, OM GYPSUM BOARD, ON GYPSUM B�ARD, �N ;
BELOW BELOW q
BATH ROOM/ KITCtHEN FOR DIMENSION BATH R�OM/ KITCHEN FOR DIMENSION BArH RooMi KircHEN � EXISTING CONCRETE FLOOR
SIDE TYP. SIDE TYP, SIDE TYP, Q
Type Stud Insul./ �nsul. Part. Keyed T�e Stud Insul/ Part. Sound Keyed Notes Type Stud Insul./ Part. Sound Keyed Notes �'
Size STC Thick. Notes Size STC. Thick. Blanket Size STC Thick. Blanket �`� y ,
�C 3-1/2" — R-20 4-1/8" N/A � 6" — 7-1/4" 3" RESISTANT � 3-5/8" — 4-7/8" NONE N/A a ° a ° ,a � �� E'' ,
a �F„�`i� c�
a .� "
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MOISTURE ', �Af7 3-5/8" — 4-7/8" 3" N/A ^ ' F� F„ ;
C� 3-1/2" — R-20 4-1/8" RESISTANT v Y � �
GWB MOISTURE i _, � '
QCT7 3-5/8" — 4-7/8" 3" RESISTANT ,� F � ; �
� 2-1/2" — R-10 3-1/8" RESSS ANT �/ cw6 1 SIDE ' WALL BASE � EPDXY COVE ' '
cwe MOISTURE PARTITION DETAIL ' � �
�3/7 3-5/8" — 4-7/8" 3" RESISTANT 2 ` � C �
�� GWB 2 SIDES SCALE:6" = 1'-0" c,N,,
,t ;
� 3-1/2" — R-20 4-1/8" FRP �¢/"J 3-5/8" — 4-7/8" 3" FRP 1 SIDE � �
V
M.R. GWB 1
QC�✓ 3-5/8" — 4-7/8" 3" SIDE: FRP 1
_ U SIDE
AT EXISTING EXTERIOR WALL NON RATED NON RATED �
PARTITION DETAIL CHASE PARTITION DETAIL �� TYPICAL PARTITION DETAIL
. C' SCALE:1 1/2" = 1'-0" B SCALE:1 1/2" = 1•_0•, ~ SCALE:1 1/2" = 1'-0"
�
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FINISH SCHEDULE
ROOM # ID NORTH WALL WEST WALL SOUTH WALL EAST WALL FLOOf� CEILING BASE TRIM FINISH REMARKS
101 VESTIBULE PAINT PAINT PAINT PAINT FLOOR T�ILE SUSPENDED A.C.T. FLOOR TILE
102 HALL PAINT PAINT PAINT PAINT VCT SUSPENDED A.C.T. 4"' VINYL COVE I
103 TOILET PAINT PAINT PAINT PAINT CERAMIC TILE SUSPENDED A.C.T. 4" CERAMIC TILE
104 TOILET PAINT PAINT PAINT PAINT CERAMIC TILE SUSPENDED A.C.T. 4" CERAMIC TILE � '
F-
105 TOILET PAINT PAINT PAINT PAINT CERAMIC TILE SUSPENDED A.C.T. 4" CEP,AMIC TILE z 1
106 KITCHEN FRP FRP FRP FRP EPDXY FLO�R SYS. WASHABLE A.C.T. EPDXY COVE WASHABLE A.C.T. � w � �
107 OFFICE PAINT PAINT PAINT PA1NT VCT SUSPENDED A.C.T. 4" VINYL COVE —! w w I
108 OFFICE PAINT PAINT PAINT PAINT VCT SUSPENDED A.C.T. 4" VINYL COVE Q > �
109 WORK AREA PAINT PAINT PAINT PAINT VCT SUSPENDED A.C.T. 4" VINYL COVE W � Q IF
� I10 FURNACE PAINT PAINT PAINT PAINT - - - �-- �
III STORAGE PAINT PAINT PAINT PAINT EPDXY FLOOIR SYS. SUSPENDED A.C.T. EPO,KY COVE WASHABLE A.C.T. � � �
�, �, � . .. � � � z .. J �
FINISH NOTES: � � a � /
�. w��W � W
' i I. VCT TO BE ARMSTRONG 3 COILORS. COLOR TO BE SELECTED FROM MANUFACTURER'S STANDARD COLORS. � � � W
— �
', 2. CERAMIC TILE TO BE DALTILE 2X2 2 COLORS. COLOR TO BE SELECTED FROM MANUFACTURER'S STANDARD COLORS. I— W � �
3. VINYL BASE TO BE 4" COVE �ASE TO BE JOHNSONITE - COLOR TO BE DETERMINED FROM STANDARD COLOR PALETTE "A". ' � w
4. SUSPENDED ACOUSTIC CEILIPVG TO BE 2X2 GRID WITH BEVELED TEGULAR "ULTIMA" BY ARMSTRONG WITH 9/16" SUPRAFINE GRID. —� O Cn o
5. KITCHEN AREA SUSPENDED CEILING TO BE 2X2 GRID WITH SQUARE LAY IN EDGE 'KITCHEN ZONE' BY ARMSTRONG WITH 15/16 PRELUDE GRID. J n- � m
6. EPDXY FLOOR SYSTEM TO BE DUR-A-FLEX PLOYCRETE MDB OR APPROVED EQUAL. Q � Q ,n
7. PAINT TO BE BENJAMIN MOOIRE OR APPROVED EQUAL. � � m �
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� �9�TH OF MP`'�P4 I
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SCALE: AS NOtED
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A5
FIRE ALARM PROVISIONS FIRE ALARM SPECIFICATIONS GENERAL PRO`JISIONS LEGEND � M �
1. THE FIRE DEPARTMENT SHALL BE NOTIFIED PRIOR TO ANY WORK BEING 1. ALL EQUIPMEM USED SHALL BE OF A TYPE APPROVED BY THE FIRE CHIEF 1. ALL WORK SHALL COMPLY COMPLEfELY WITH THE MASSACHUSEfiS ELECTRICAL (, M �
P E R F O R M E D. THROUGH THE ALARM SUPERINTENDENT AND THE FlRE PREVENTION OFFICERt. CODE, NATIONAL FlRE PROTECTION ASSOCIATION, AMERICAN WITH DISABILRIES F A C P FIRE ALARMI CONTROL PANEL � �n r
2. COORDINATE EXACT EQUIPMENT INSTALlATION LOCATIONS WITH ARCHITECT AND ALL PERIPHERAL DEVICES SHALL BE UL LISTED AS COMPATIBLE WITN THE ACT.(ADA) AND ALL LOCAL ORDINANCES AND REQUIREMENTS. J � � �
OWNER. CONTROL PANEL TO WHICH THEY ARE ATTACHED. 2. THE DRAWINGS ARE GENERALLY DIAGRAMMATIC. PROVIDE ALL MATERIAL, LABOR O SMOKE DEfECTOR p� a^, �
3. INSTALIATION OF EQUIPMENT SHALL BE IN ACCORDANCE WRH CURRENT 2. ALL JOINTS AND CONNECTIONS SHALL BE IN JUNCTION BOXES. ALL AND EQUIPMENT FOR COMPLETE AND OPERATIONAL SYSTEMS.
STANDARDS AND SPECIFICATIONS APPROVED BY THE AUTHORfTY HAVING � Q v s
CONNECTIONS NOT ON APPROVED TERMINAL STRIPS SHALL BE SOLDERED AIND 3. APPLY FOR, PAY FOR AND OBTAIN ALL REQUIRED PERMITS. REQUEST, W x
JURISDICTION. TAPED. ALL JUNCTION BOXES SHALL BE PAINTED RED. CONCEALED COND)UIT SCHEDULE, AND A7TEND ALL REQUIRED INSPECTIONS BY THE LOCAL AUTHORfTY O HEAT DEfECTOR, 135 DEGREE, UNO � � � �
4. ALL WIRIN� MEfHODS SHALL BE AS APPROVED BY THE WIRING INSPECTOR AND SHALL BE STRIPPED RED. HAVING JURISDICTION.
THE FIRE DEPARTMENT. ALL WIRING SHALL BE IN .ACCORDANCE WITH THE 3. FIRE ALARM CONTROL PANEL (FACP) SHALL 8E MICROPROCESSOR BASED, 4. REFER TO DRAWINGS C�F OTHER TRADES AND CONFIRM EQUIPMENT LOCATIONS � MANUAL ST/ATION U �rj g
NATIONAL ELECTRICAL CODE, NFPA 72 SERIES PAMPHLEfS, AND ALL STATE AND HARDWIRED, NOTIFlER SFP-SUD, WfTH DIGITAL COMMUNICATOR. PRIOR TO ROUGH-IN. ADJUST ELECTRICAL WORK AS REQUIRED BASED ON - w N `
LOCAL CODES. 4. INITIATION DEVICE CIRCUITS SHALL BE WIRED CLASS A NFPA STYLE D EQUIPMENT PURCHASED/INSTALLED.
5. THE FIRE ALARM SYSTEM SHOP DRAWINGS SHALL BE REVIEWED AND APPROVED � �• � EXTERIOR �EACON w g
BY THE LOCAL FIRE DEPARTMENT. THE SHOP DRAWINGS MUST BE SIGNED OFF NOTIFICATION APPLIANCE CIRCUITS SHALL BE WIRED NFPA STYLE Y. ALL 5. ALL EQUIPMENT SHALL BE INSTALLED IN A NEAT AND WORKMANLIKE MANNER,
BY THE FIRE DEPARTMENT PRIOR TO ORDERING AND INSTALLATION OF CIRCUITS SHALL BE POWER-LIMITED, PER UL 864 REQUIREMENTS. RECTILINEAR TO BUILDING STRUCTURE. � � - ~ E
EQUIPMENT. 5. FIRE ALARM CONTROL PANEL ENCLOSURE SHALL BE LOCKABLE. WITH SIGN, 6. ALL MATERIAL INCORPOR4TED IN THE WORK SHALL BE LISTED FOR THE j� VISUAL SIGMIAL (STROBE) _ �
6. ALL FIRE ALARM EQUIPMENT, INSTALLATION AND OPERATION SHALL BE IN RED IN COLOR, WITH THE WORDS "FIRE ALARM CONTROL" ENGRAVED ON IT:. INTENDED USE. U � o a
THE SIGN SHALL BE ON THE FRONT OF THE PANEL WITH MINIMUM ONE IN(CH �• VISIT THE SITE PRIOR TO SUBMITTING BID TO NOTE SCOPE OF DEMOLITION � � AUDIO-VISUTAL SIGNAL HORN-STROBE � ;
CONFORMANCE WITH THE LOCAL FIRE DEPARTMENT REQUIREMENTS. j� ( )
LETTERS. ANY ZONE LABELING ON EXTERIOR DOOR SHALL BE DUPLICATED pN WORK, AND CONDffIONS UNDER WHICH NEW WORK MUST BE INSTALLED. � „
7. THE FIRE ALARM CONTRACTOR MUST OBTAIN AN ELECTRICAL PERMR FROM THE �j aO Y
PANEL INTERIOR ALSO. 8. PROVIDE ITEMS REFERR,ED TO IN SINGULAR NUMBER IN CONTRACT DOCUMENTS
BUILDING DEPARTMENT AND A PERMIT FROM THE FIRE DEPARTMENT PRIOR TO � KEY BOX, EfR Q W M
6. PROVIDE A SEPARATE AC CIRCUIT FOR THE FIRE ALARM CONTROL EQUIPMEMIT. IN pUANTITIES NECESSARY TO COMPLETE WORK. �. �n a
t COMMENCEMENT OF EQUIPMENT INSTALLATION. THE MAW POWER SUPPLY SHALL INCLUDE SUPERVISED BATTERIES AND 9• MAINTAIN RECORD DRA\YINGS ON SITE. RECORD SET MUST BE CURRENT AND � � � � � a
� 8. ALL EQUIPMENT SHALL BE MADE AVAILABLE FOR TEST AND INSPECTION WHEN CHARGING SYSTEM FOR STANDBY POWER. AVAILABLE FOR INSPECTION WHEN REQUISITIONS FOR PAYMENT ARE SUBMITTED. /
I REQUIRED BY THE FlRE DEPARTMEhIT. v, .
9. THE FIRE ALARM CONTRACTOR SHALL COMPLEfE A CERTIFICATE CERTIFYING 7• PROVIDE TWO (2) CAT3 (MIN) TELEPHONE LWES TO THE UDACT AT THE FA�CP. 10. PROVIDE A ONE YEAR MATERIAL AND LABOR GUARANiY AGAINST DEFECTS IN /��Zl� � F
� /U / s
OBTAIN-TELEPHONE SERVICE AND CENTRAL STATION MONITORING SERVICE OIN MATERIAL AND WORKMA,NSHIP. J w a
I THAT THE SYSTEM HAS BEEN 100% TESTED ANCJ FUNCTIONS IN COMPLEfE BEHALF OF THE OWNER. 11. ALL WIRING SHALL BE RUN CONCEALED UNLESS SPECIFIED OTHERWISE. = W Z �
COMPLIANCE WITH THE SYSTEM SPECIFICATIONS AND FIRE DEPARTMENT 12. ALL RACEWAYS RUNNING THROUGH BUILDING EXPANSION JOINTS SHALL BE � O �
REQUIREMENTS. THE CERTIFlCATE SHALL BE SIGNED BY THE INSTALLER. AFTER $• THE BATTERIES USED WITH THE FIRE ALARM CONTROL PANEL SHALL BE
RECEIPT OF THE CERTIFlCATION, THE FlRE DEPARTMENT WILL CONDUCT AN CAPABLE OF OPER.4TIN� THE PANEL FOR SIXT`( (60) HOURS WITH A FIFTEE:N EQUIPPED WITH EXPANSION FITTINGS. � � S �
INSPECTION IN THE COMPANY OF THE INSTALLEf� AND A REPRESENTATNE OF (15) MINUTE RING-DOWN AT THE END OF A SIXTY (60) HOUR PERIOD. THE �3. ALL GROUNDING SHALL BE PERFORMED IN ACCORDANCE WITH THE NATIONAL -I a �
ELECTRICAL CODE AS NMENDED BY MASSACHUSEffS. p8t8fS011SCh001.COm W w �
THE OWNER. CALCULATION USED TO DEfERMINE BATTERY CAPACITY SHALL BE PRESENTED TO "
14. ALL FIREPROOFING FOR ELECTRICAL PENEfR4TI0NS SHALL BE PROVIDED BY �J_J � W ;
I THE FlRE DEPARTMENT AT THE TIME OF INSPECTION. BATTERIES SHALL BE THE ELECTRICAL COr1TRlaCTOR. -- --- -- - � � r
MAINTENANCE FREE. Q Q
F I R E A LAR M S EQ U E N C E 15. ANY AREAS OR ELECTF.ICAL EQUIPMENT DAMAGED BY INSTALLATION SHALL BE
9. WHERE FACP DOES NOT HAVE ADEQUATE POWER CAPACITY TO POWER ALL REPAIRED TO MATCH EXISTING CONDITIONS. THIS SHALL INCLUDE ALL WALLS,
7. UPON ACTIVATION OF ANY AUTOMATIC DEfECTOR OR MANUAL PULL STATION, AUDIO-VISUAL DEVICES, PROVIDE REMOTE POWER SUPPLY(IES) WITH CEILINGS, FLOORS, MASONRY, BRICKWORK, ETC. �
SUPERVISED BATTERY BACKUP AND CHARGER. WHEN REQUIRED PROVIDE g
THE CONTROL PANEL SHALL SOUND THE EVACUl4TION SIGNALS, FLASH THE SEPARATE AC CIRCUIT FOR POWER SUPPLY. "
EVACUATION LIGFiTS, INDICATE THE ZONE OF AC1fNATION AT THE FIRE ALARM �0. THE VISUAL INDICATORS OF THE EVACUATION SIGNALS MUST STAY ILLUMINA1fED "
I CONTROL PANEL AND NOTIFY THE FIRE DEPARTMIENT VIA THE CENTRAL STATION
I' UDACT CONNECTION. UNTIL THE SYSTEM IS RESEf. AT THE FACP, PROVIDE A SQUARE D KEY
2. UPON ACTIVATION OF ANY HOOD SUPPRESSION SYSTEM: SWITCH, KEYED PER FD, TO SILENCE AUDIBLE SIGNALS PRIOR TO SYSTEM
RESEf. a
2.1. THE SUPPRESSION SYSTEM SHALL SEND A SIGNAL TO THE FACP TO £ •
SOUND A GENERAL ALARM, AND 11. ALARM NOTIFICATION APPLIANCES CONSIST OF HORN-STROBE UNITS, AND �
2.2. THE SUPPRESSION SYSTEM SHALL SEND A SIGNAL(S) TO THE GAS FUEL STROBE UNRS WITH CANDELA RATING AS LISTED BELOW, LOCATED AS SHONVN p
SOLENOID(S) TO SHUT OFF FUEL TO ALL GAS FIRED APPLIANCES UNDER ON THE PLANS. m
THE HOOD, AND 12. VISUAL SIGNAL (STROBE) UNITS SHALL HAVE A CANDELA RATING OF 30
0
2.3. THE SUPPRESSION SYSTEM SHALL SEND A SIGNAL(S) TO THE CANDELA UNO ON THE PLAN, LISTED TO UL 1971. INSTALL STROBES AS �
CONTACTOR(S) POWERING ANY ELECTRICAL APPLIANCE(S) UNDER THE SHOWN, BASED ON NFPA 72 REQUIREMENTS. o
HOOD TO SHUT OFF ELECTRICAL POWER TO THE APPLIANCE S , AND �3. AUDIBLE (HORN) UNITS SHALL BE LISTED TO UL 464, AND HAVE A J
, � � SYNCHRONIZED THREE-PULSE TEMPORAL PATTERN. i
2.4. THE SUPPRESSION SYSTEM SHALL SEND A SIGNAL(S) TO THE HOOD 14. ALL VISUAL SIGNALS SHALL BE SYNCHRONIZED WHERE MORE THAN ONE SI�NAL j
EXHAUST FAN (AND SUPPLY FAN, IF ANY) MOTOR CONTROLLER(S) TO IS VISIBLE WITHIN ANY SPACE, PER NFPA 72. j
SHUT OFF OR TURN ON THE HOOD FAN MOTOR(S) INDIVIDUALLY AS 15. MANUAL PULL STATIONS SHALL BE NON-CODED DOUBLE ACTION iYPE WITHI -
DIRECTED BY THE LOCAL FIRE DEPARTMENT (E.G. TURN THE EXHAUST KEY RESEf. BREAKGLASS RODS WILL NOT BE PERMITfED.
FAN(S) TO FULL ON AND TURN SUPPLY FMN(S) FULL OFF). 16. THERMAL DETECTORS SHALL BE RATED AT 135' FAHRENHEIT WHERE
TEMPERATURES DO NOT EXCEED 100'F AND 190/200'F FOR AREAS WHERE:
THE TEMPERATURE DOES NOT EXCEED 150'F, OR AS SHOWN ON PLANS.
AUTOMATIC THERMAL DEfECTORS SHALL BE LOW PROFILE, CEILING MOUNT
TYPE. AUTOMATIC HEAT DEfECTORS SHALL HAVE A SMOOTH CEILING RATING: OF
2500 SQ Ff. WHERE 190/200'F DETECTORS ARE APPLIED, PROVIDE MONIT�R
MO�ULES OUTSIDE OF HIGH TEMPERATURE AREAS CONNECTED TO MONITOR
CONVENTIONAL THERMAL DETECTORS.
17. SMOKE DETECTORS SHALL BE PHOTOELECTRIC TYPE, WffH REMOVABLE SEN�SOR
HEAD AND MATCHING BASE. PROVIDE DUCT TYPE HOUSING AND SAMPLING
TUBES SIZED AS REQUIRED BY HVAC CONTRACTOR WHERE REQUIRED FOR /AIR
SUPPLY SYSTEMS OVER 2,000 CFM.
18. PROVIDE AND INSTALL ALL NECESSARY WIRE, CONDUIT, RELAYS AND
' CONNECTIONS FROM ALL DUCT SMOKE DEfECTORS TO THEIR ASSOCIATED FiAN
' r ' , � - TO SOUNDING THE GENERALTALA MF THE ASSOCIATEDDANCSHALLNMMEDATELY OOO
` BE SHUT DOWN. • I
19. PROVIDE REMOTE TEST STATIONS/ALARM INDICATORS FOR EACH DUCT SMOKCE F :, j F
I DETECTOR AT THE FIRE ALARM CONTROL PANEL. --
20. FIRE ALARM WIRING SHALL BE NEC TYPE FPL - 18 GAUGE, 2 CONDUCTORt ' �"� �
I' SOLID WITH OVERALL RED JACKET. `
21. PROVIDE 150,000 CANDLE POWER WP EXTERIOR BEACON, PLASTIC � KITCHEN �
CONSTRUCTION WILL NOT BE ACCEPTED. iob Q
22. CONNECT HOOD SUPPRESSION CONTROL PANEL ALARM OUTPUT TO FACP �
INITIATING DEVICE CIRCUIT. 0135 J
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aPPEOV�L�I. �y„(„ -
aatho tF h pProvaj�bY ny oth/�r"'"
���m'+sdiction. �' K
�TR JULY 17, 2015
r�D �M MA.SS SCALE: AS NOTED
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