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331 HIGHLAND AVE - BUILDING INSPECTION (3) � � � �- �o ��' 1 A ° � � � /�' ,; �F'I'Y' O� SA]:,L:A;i `�l ;,;� =� �:, � , „�:; PuBr..zc nxc�l�rri�:� ;�� ; `��%'�� DEP��RT.i\�FEN"I' KId115191ll.I.;Y 111;IF(IL)I.f, il{tlYOR 1�U\�ASI Ili\`C:I'04 S'fAF:fCI`�$.V.I�.pf�.UA?tih2.l Il.:liPt�.f,:l!17if 'PI:C978 T45-951J O 14\S:9'S-i4V-!I5-0(> f APPLICATION FOR PLAN EXAMiNATION AND i3U.lLD.ING PEI2MI"A' ALL STRUCTURESEXCEPT I AND 2 FAMILYDWELL,lIYGS TMPORTA\1':A licants must com Ie[c ail items on this a c S1TE INFORA4ATION- I.ocation\'ame?wC��an Mod�G� �r Buildin2 ( Property Address ��n�..1�t , Map i€ Located in: Conserva[ion Area Historic distria Usc Groups (chcck one) � � Residential(3 or more Uni[s) R2 Type of improvement ReSidential{hotel/mofel it1 (check one) _ Assembly(churches) A1 . New Building_ � Assembly(nibhtclubs em) A2 Addi[ion_T Assembly(restaurnnts,recrentinn) A3 Altcrafion 6usiness B y� Repair/Replaceroeat Educationai C Ucmutition_ Facmry(modcrate hazard) Fl �1ove/Relocate Factory(Irnv hazarcl) F2 Foundation Only � Hlgh.Hazarci H Acec.�'ssory Building Institufional(resiAential care) Il _ � Othcr(dcscribC�' li�stitutional(incapacifa[ed) 12= Coraw,H Q Oiscitutionat(restrnined) 13 i ��qf„�, MercanTile �tit_ Storagc(moderatehazard) S7 Storaac(low'harard) � S2_ OWIV&12SHIPINI�OIiM1lA'I'ION(Plcasetypcorl'rintCicarly) - � OWNER Naine Nw�e�dn.ton MC�C� Address 33� N: � A� • M R Tclephone C�-Z ��-�p UFSCItIP7'IONOFWORR'1'OBEI'EKRURMEU ,_ C�� 1 _1e J�G n - •n ro FGI �M� l�f.�� P.enovt e�c:r�1�n►- c.W'� ` reO�,a1ce •.i�l'�- m�S.c oL ew Gd G�' 6 � . �uwA OAG. G+'M +�an �srinai��n covs�'izucr�oN cosr 3 3 1 q J � > �� 1 �'`�� t� 3��. 00 �� 3.� �; � ��U �f',:��fv� i.� �'1/r. ��., i i `{� � �� (7 � �D � p ��C� Dd S : CONTRACTORINFORMATION Name I,PJ1 Ct.LS JL SPlY��Ps Address '1� O �oec 2�23 cJ n�u�n MA a�� Telephone "��1 760 2a3o Construction Supervisor's Lic# �s9 41 Home Improvement Contractor# I 3 33 ►7 til , �i v ARCHITECT/ENGINEER INFORMATION 1 l N Name IG:m�P.► 4 bP�'+ �s:c c� '�I ` Address 27 Dun 'Pl' ems.4 ??od r,� mA 01730 v.. Telephone 7�I271 D�Q18' � Mass. Registration # ��, \ PERMIT FE�CALCULAT[ON �� Residential est. cost x $7/$1,000 + $5.00 = � Commercial est. cost x $111$1,000 + $5.00= " COMMCNTS � The undersigned does hereby attest thut all i�zformation stuted above is tri�e to tlze Lest of n:y knowledge under the pena[ties of perjury , Sigtzed Date $� i CITY OF S��1LE�i, l�'L�1SS.�CHUSETTS , BtiII19L�IGDEPART'J��iT • + 130 W�SHL*IGTON STREE7,3�O F100R \ d'j 'I�[. (978) 745-9595 Fn:C(978)73Q9846 KIJffiERI.EY DRISCOLL Tr[061AS ST.P[ERR6 av1AYOR DIRECiOR OF P[:HLIC PROPER'IY/Bl'IIDC�1G CO�L�RSS[OVER Workers' Compensation Insurance Aftidavit: BuilderslContractorslElectricians/Plumben 4nn�icant Information Plcase Print Le¢ibiv � �� V8tt1C(Dusi�xstiOrganizatioNindividual): NP�}CL�.S � �� eS Address: � • �• � 1-�� City/State/Zip:1�0�7ucn M� t�� Phone t�: ��1 �6 0 203� Are you an employer?Cheelc the approprfate box: Type of project(requlred): 1.0 1 am a cmployer with 4. � 1 azn a grncral cont�actor and I 6. ❑New con�t[uction .�y{ employees(full and/or pact-time).• ��hircd the sub-contracwrs 2{R.�1�am a sole proprieror or partner- listed on the attached xheet.� �� Remodeling ' ahip and have no employeex These su6-contractors have 8. ❑Demolition working for me in any capacity. worke�s'comp.insurance. 9. �Building addiaon [No workers'comp.insurance S. � We aro a corywration and its requircd.] officers have exercised their �0.0 Elei:triwl repairs oraddrtions 3.❑ t am e homcowner doing all work right of exemption per MGL I 1.❑Plumbing rcpairs or additions myself.[ho workers'comp. c. �52,§f(4),and we have no �Z,0(toof repairs insurance required.]t employens. [l�'o woricera' I3�Othc P�� comp. insurance required.j •Any oppGcmt Ihaf clu�cke boz ql muel aiw fi0 wt Ihe sec�i�bcloW showi¢g the'v worken'epmprnsa/ion poliey infurma[ion. �1 fnmeuwnus wM suMnit Ihis aRldavi[indicLLing�hey me doing all aMk artd thea hire outside contnlcMre must eu6mil a�rexr amJavit indtating sueh =Conumxon�Ant check t6u�ox must anached an aJditiwul et�at showing iM mune of Iht au6.contreetwS a,W�h<u wohnb'wmp.poliry inlwmatioq. f um an anplayer thet is providing workers'compensndan insurance for my employeex, Below!s fhe po[!cy and Jab slte injormmion. Insurrnce Company Name: Policy#ur SeIF-ins.Lic.1t: Expiration Date: � Job Si[e Address: CitylStatxlZip: Attach a capy ot the workers'eompensation policy declara[ton page(show(ng the poticy aumber and e:pirqtlon date). , Failure to u:cure coverage as required unJer Section 25A of MGL c. �52 can lead to the imposition of criminal penaltiea of a fine up to 51,500.00 and/or one-year imprisonmen4�s well as civil penulties in the form of n STOP WORK ORDER nnd a fine of up ro 5250.00 a Jay againu the violaror. (3e aJviscd[hat a copy of tl�is statemcnt may bc forw•rrded[o lhe Oftice of Invcs�igaiiun+uf the DfA for insurance covcragc vcrificrtian. /do lrereby crrtlfy under pai i ena!lles ojperfury that the injarmuNon providrd ubove is ue pun�d corrreL $iynerure !)atr „`'��O O Phone#• ��I �6� 2�3� � . O�cia/use a�ly. Do not write in ihis ureq to be cunrple�ed by city or rown oJjkiaL , City or Town: PcrmiU/.lcenxe# Issuing Aulhorily(circic one): I.(ioarJ uf tte•rlth 2.Building Dep•rrtment 3.Cily/1'own Clerk 4. Elec[rical Inspector 5.Plumbing Inepeeror 6.O�her. _ Contac[Pcrson: Phone#: ._.._ .,�.-__ _.. _.. _ . _..._ � ' _ �_.�.._..._�•.- -.,� --- ._.._____.— - -- - .; , , ; CITY OF S�-1LE.ti1, l�I.-1SS.-�CHUSETTS BtiII.DL�SG DEP1R"TJtE.�iT ` �b� 1?O W.�SHL�IGI'ON STAEET, 3"°FLOOR T� (978) 745-9595 Fnx(978) 740-9846 ��FRf FY DRISCOLL i�fAYOR "I�to�i,�s ST.P�nns DiRECTOR OF PI:BLIC PROPER'IY/Bl'IIDL�SG CO\L�(ISS[O�iER Construction Debris Disposal AfFdavit (required for all demolition and renovation work) In accordancc with the sixth editio�t of the State Building Code, 78U CMR sec6on 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit# is issued with ffie condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 11 l, S i 50A. The debris will be transpoRcd by: ��M��d� dU�,� (name of hauler) The debris will be disposed of in : �D MPS�C (name of facility) , v�(��-w�� rn � (address of facility) si ture of permit applicant S �� date Jchrivlydu: - � , � � � � � �, __. T� ��w� a��.� ' „ �\ Board of Building Regulatiofis and Standards .' . t � � HOMEIMPROVEMENTCONTRACTOR ' Registration �pgp� �� Expiretion �-ZN9/2009 TriF 733317 �� . �� 'fype Ind�vidual � r . Gerald White �-},- ' J�_=., Gerald White ' 54 Emerald Dnve � . , Lynn, MA 01904 � —� . Administrator ..._..� _ "`� GT1ze �iomvina,epiea�i a�.�aoaac�ivae� ' .. Boatd ofBuilding Regula[ions and S[andards j�I� Construction Supervisor License Licen'se�CS 73991 �f � �� rExpvahon q/7/Z010 Tr# 23352 ; `7�� ''�� t�i" ..�,.;_ . Restnchon 00 �. �„ . ._ __ ._-. ��r� . . GERALD WHITE � ..��r; 62 LONGBOW RD��i �%.�. ��j � -DANVERS:�MAOt�923 �� ' �-----� ��.� - - CommisSioner �� i; ' """�'�„A'�`�„�"�.,.,.,-,---_. '� .r"`.�.,,,,-�„� .�`_-..----__ I �, :i •asuaay sr9llo ooge�ona��o�asnea a aP Pa 7 a'.rJn a;��s S73asny�esseyu ��. 47 jo uo� � e ssassod o�aln�ia� saurop,{��3 Z_� ,�I ��y a�eds pas�sua J 000`S£-00 !� . . .x-;� �..�._-^--..�....d.�w.�.�. j. � . �„��,.�::..�,- F�. _,-- .. . jT .. .�—�--' :_. .. ' ill , � % , Liaense or registrat�on val�d for mdrvidul use only � . �before tLe exp�ration date. If found reWrn to � � � Board ot Building Regulations and Standards �- One Ashburton Place Rm 1301 � i Boston,Ma.02108 I I I t1 � �i I ! , t �. Not valid w�thout signature -- -�� L� _� � �, • � � s � — — , '` ' . . . �.... ..�._...�..�__..�..... ..__ . . . . � � .. . � �. . . � . . . . � . . . �w. . . . . I FINISH SCHEDULE NSPG Puritan Medical Center�- 1 .2.08 CODE ITEM MATEIRIAL SPECIFICATION LOCATION/NOTES Cambrid!ge Commercial Carpets Style: Southem Pines Main/Field Carpet. See instatiation notes #FIN 3- � G7 Carpet-Field Coior: #SPS09 Double Eagle 6 �, Cambridge Commercial Carpets - I Carpet- Style: Route 66, Exit 66 9"Accent border-see drawings for Below chair rail p-7 G2 Blue Accent border Color. #�16636 Deep Blue Sea pattemllocation. See Installation notes �IN 3� Cambridlge CommercialCarpets Abovechairrail • Abovechairrail I� Carpet- Style: Rtoute 66, Exit 66 3"Accent Stripe-see drawings fir to underside of P-1 to underside of i G3 Beige Accent"Stripe" Color. #�46614 Pawnee petterNlocation. See installation notes #FIN3-6 woodlight valance woodlight valance P_� P-� ''I Above woodlight � valance-walls P-3 Entry�estibule—order extra material tor second surrounding skylight P_7 { C-4 Walk-off carpet Manufac;turer: Mats, Ina Color: Blue Fog#35 mat-"attic stock" B a�w i I Crosstilie Ceramics-Porcelain Stone Series i Color: #A745 Tawny Grout: Laticrete Unsanded grout, Color-#30 T-1 Floor tile Finish: Cross Slate (CS), Size: 12'k12" Sand Beige. See installation notes #FIN 4-6 P-s I NOTE: See finish note#FIN 7 f�-� I for information on new finishes Blue accent Existing reception desk-all vertical surfaces and for existing reception desk. wafl&soKt Wilsonart#7054-60 Wild Cherry top af"patient transaction surtace"to be ` l-1 Plastic laminate-"Cherry" Textured finish relaminated. See FIN 7. Below cFfair rail P-7 Nevama,r-ARP Surface Ex(sting reception desk-staff worksufaces, Plastic laminate- Color: #IMR3005T Navy Matrix edgeband and existing undercounter file/storege Above chair rail Blue accent - I L-2 "Blue Matrix" Textureal Finish units to be relaminated. See FIN 7. P-� to underside of wall&sofft P"6 P"� P-� I wood light valance P-1 Wall behind Above woodli ht reception NOTE: Existing millworkfnishes � General wall paint. Eggshell finish. See plans Tor P-3 valance-Hrellsg I to remain,this area as indicated. � P-1 Primary wall paint Benjamiin Moore#2154�0 Fiitered Sunlight locetions and addtional information surrounding skyligM � P-2 Primary trim paint Benjamiin Moore#2160-70 Sugar Cookie All door and window trim-semi gloss finish Blue accent • � wall&so�t Eggshell finish. See plans for locations and P_� P-6 P-3 Gold accent paint Benjamiin Moore#2154-50 Straw additlonal infirmation. P_� P-1 i P-7 i P-4 Purple Accent Benjamiin Moore #1446 Dusk to Dawn Eggsheli finish (Not used) � i ' THE GENERAL CONTftACTOR IS RE5PON51BLE P-5 Medum Blue Accent Benjamen Moore #1440- Irises Eggshell finish. (Not used) I FOR VERIFIGATION OF ALL DIMENSIONS ON ' ' SITE AND CONFIRMATION OF SUCH DIMEN510N5 � Eggsheli bnish. See plans for locations and AGAINST ACTUAL 51TE GONDITIONS•THE P-6 Blue Accent Benjami in Moore #Hale Navy#HG154 additlonal ininrmation. , . • GENERAL CONTIZAGTOR SHALL GOORDINATE ALL • WORK AND RELATED TRADES AND SHALL Eggshell finish. See plans for locations and � ` � ' NOTIFY THE DE516NER OF ANY INTERFERENCE � � � P-7 Maroon Accent Benjami��in Moore#2082-20 Plum Raisin additional information. t � OF MECHANIGAL,ELEGTRIGAL OR PLUMBING ( � WORK WITH THE ARGHITEGTURAL WORK;AND OF _� ANY CONFLIGTS OR DISCREPANCIES IN DIMEN5ION5 AGAIN$T ON-517E CONDITIONS � , PRIOR TO PROCEEDIN6 WITH THE AFFEGTED � ' B-1 4"Vinyl base-Navy Johnsomite#18 Navy Blue WORK OR PROGUREMENT OF MATERIALS. , Fumitureinfoforcoordinationonly. Fumiture �Ifi�ST �LOO�iz- WALL FINISN�S i�LA�I N.I.C. NOTE: ALL FABRICS, PADDING, ETC. 3GALE:1/d" . 1'-0° • � NORTH SHORE Upholstery-seat backs Seat baecks: Architex/Liz Jordan Hill MUST BE IN FULL COMPLIANCE WITH CAL ' • • � . F-1 and upholstered legs, etc. Name: FFour Seasons, Color. Equinox ,33 PHYSICIANS � Fumiture info for coordination only. Fumiture '� Seats-�MAROON OP110N: N.I.C. NOTE: ALL FABRICS, PADDING, ETC. GROUP Momenttum Textiles, Style: Cashmere, Color: MUST BE IN FULI COMPLIANCE WITH CAl F-2 Upholstery-seats only Flame 133 � � Puritan Medical Dimensions/radius of curved borclerat �,/enter �y door to be verified in field and with KBD � PRIORtocommencementofwork FINISH NOTES: FINISH SYMBOL LEGEND . . FIN 1: All finishes must meet or exceed minimum re lJIf2rt12f1[5 8S 5 OCIflOd(�811 SEE FINISH SCHEDULE FOR MATERIAL SPEdFICATION , " 331 HIGHLAND AVENUE � i Q P ANDADDITIONAL INFORMATION . v /� applicable local and national codes/regulations. � � � � SI`1LEM, MA 01970 FIN 2: See Finish Legend/Specification,this sheet,for full material specification and C-1 FLOOR FINISH DESIGNATION additional information. n � � 1ST FLOOR FIN 3: AII flooring transitions at doorways fo occur beneath centedine of<door unless _ 6" carpet �I othenvise noted. ��,R EXISTiNG FLOOR PINISH TO REMAW �R C.� i�+ bOfdef C'2 G-I I in FIN 4: All flooring tansitions (especially between carpet and tile)shall be I level and smooth to insure that there is no change in floor level. Use metal trtransition 3"carpet strip by Schluter(style TBD)between carpeUtile Vansition.SEE DEETAIL#3. accent stnpe G-3 � � � P-7 WALL/BASEFINISHDESIGNATION i FIN 5: In areas scheduled to receive new flooring, Contractor shall remowe existing � � floor covering and fully prepare surface to receive new floor finish<as • 9�-g° ,P indicated. All substrates shall be prepared in strict accordance witM �, � n Manufacturer's requirements.All floor materials(including, but nott limited ta �/�, e - carpet, [ile and grout)shall be provided and installed by the Contr�ctor in L-7 suRFnCe FiNisfi oesicNnTioN �g�, � � strict accordance with Manufacturer's instructions and all pattems„ borcfers, O ' �'fi u1 � � ; e��. as��d��ted o�d��95. �.� � k�mberiy bee design FIN 6: Carpet border and accent stripe radius/curve dimensions shall be verified in � field.All transitions with T-1 tile,and tile coursing shall be carefully ��_g �� 27 Dwb�Road•B�dMM•MA 01730 coordinated. Coordinate all field dimensions and installation defail$with KBD lV.I�a T•7812710418 F•7812710150 PRIOR to execution ofANYwork. FIN 7: Existing reception desk and laminate faced storage components shhalt be � I relaminated with L-1 all vertical surfaces as noted in finish schedwle/material Centerpoint and redius of exisiMg arve at T1018 � reception desk shail be verif ed in field.New specs)and L-2 (all counters, worksurfaces and undercounterfle dlrawers and carpeUtile pattem shall use same center radial � I I I /� � storage as noted in finish schedule/material specs). G_� point. as indicated. �I I�l I St"��S P�f�N ' FIN B: AII conditions shall be verified in field PRIOR to proceeding with arny work. Notify KBD of any discrepancies. 1 � G-I I Prov�ds new sehlucr- ereneruon su�p. 2001?�l 102 Jan 08 � Exaet �lyle/Flnielh f.o be varlf�d. � � � . o• {"U cei�� s�eia: cn�Fue: Nwu tll� ae epsefffscl on th(� ��t mortar �� r bsd. Z'-8 1/2' u�� AS NOtEp PurttenMadclwg � /M� . ,. . ' � t " 'I•M�C A � �rewn BY: Checke0 BK I I.� � COMA� � ICI�O {C$ � � . . . :n` ^ ' " �.. . . . .. � ' y . r ':. � ., •' � . . A•'1• : Revisans: I� • �• �. ` : � � ' . '• ' • ~ '. ��•. • :' . • ti 1 1-31-08: Misc. revisions . . . .•., -.. , ...'� • IJew carpai. as spec Ifled.FeatFnr new ( underleyma�t to bring 17nisMd eerpet IroWllatlon hsfgh! !o sam� I�vsl es finishsd L(le tnslallat(on Mlghl.All dctetls !o be vrllled wIW KBD PRIOR Lo commeneemdit of eny Work C�4�P�T-�pC�� pETAIL � �I�ST FLOOR- FLOOR FINfS��s F'L,4N - 2 , SGALE:NTS � SGALE:1/�" = I'-0" I�� _ �^� _._- --�- — _ _ __ — ,_— __T _ _—__ -- _ . _. . —_ _�� _-- � . __��____._. ---��_..--__ . I . _'._.._'- _ ,_—_— �-- � i