18-005 (7) FIELD REPORT
PROJECT REPORT NO.
STREET ADDRESS J� DATE 't //77 ,03
CLIENT MR,
WEATH,E_R
/
Ia SUNNY 21DRY ❑WINDY TEMP
❑PARTLY CLOUDY ❑HUMID ;2tALM OF
❑CLOUDY ❑RAIN
FIELD INSPECTION OF J►�r`;Ci t�.rtv� -a��
OBSERVATION: '
CONDITION: V
REMARKS: . ' .per. tic t GZ.o), -- - /�y� lc
RESULTS I CCEPTABLE 'COMPLETE ❑ADDITIONAL
(❑NOT ACCEPTABLE ❑NOT-COMPLETE INSPECTION REQUIRED
Signature of Inspect
SignatKrj of Engin
E '
FIELD REPORT
PROJECT REPORT NO.
STREET ADDRESS ll' DATE /
CLIENT ��(.�
WEATHER
❑ SUNNY ❑DRY ❑WINDY TEMP
❑PARTLY CLOUDY ❑HUMID ❑CALM OF
❑CLOUDY ❑RAIN
FIELD INSPECTION OF
OBSERVATION: ( -rar
CONDITION:
REMARKS:
RESULTS ,KACCEPTABLE 0 COMPLETE eADDITIONAL
0 NOT ACCEPTABLE 0 NOT-COMPLETE INSPECTION REQUIRED
Signature of Inspector
Signature of En
FIELD REPORT
PROJECT REPORT NO. _
STREET ADDRESS oU r Xj:: DATE l Jr l
CLIENT ► r l 2,
WEATHER
❑SUNNY ❑ DRY ❑WINDY TEMP
❑PARTLY CLOUDY ❑HUMID ❑CALM OF
❑CLOUDY ❑RAIN
FIELD INSPECTION OF
OBSERVATION: Clmo 6"
CONDITION:
REMARKS: I-o
x
RESULTS XACCEPTABLE ❑COMPLETE ADDITIONAL
❑NOT ACCEPTABLE ❑NOT-COMPLETE INSPECTION REQUIRED
Signature of Inspirtor
Signature of E eer
FIELD REPORT
PROJECT CDZZ dA4.) hl`i REPORT NO.
STREET ADDRESS �/6:2�2a- DATE lI(ol D-3
CLIENT
WEATHER
❑SUNNY 0 DRY 0 WINDY TEMP
0 PARTLY CLOUDY ❑HUMID 0 CALM OF
0 CLOUDY 0 RAIN
h
FIELD INSPECTION OF i— G�
OBSE VATIO I,U
CONDITION: t
.r s
REMARKS.
RESULTS ,ACCEPTABLE ❑COMPLETE :"ADDITIONAL
0 NOT ACCEPTABLE ❑NOT-COMPLETE INSPECTION REQUIRED
Signature of Inspector
Signature of Enginee �L
r `
FIELD REPORT
PROJECT C C�t M PS K) 1 P? A KS W j s SM D REPORT NO. 2
STREET ADDRESS DATE 12rl 03
CLIENT
WEATHER
,SUNNY ❑DRY ❑WINDY TEMP
❑PARTLY CLOUDY EMUMID .PTALM OF
❑CLOUDY ❑RAIN
FIELD INSPECTION OF -O oi,�D A n D i y * W "i s
OBSERVATION: ACV-- f7 iLLt n?U C��L P��. ��� ��✓ `3fla�- �,fc+Q�
,,a L C.ve' ' `z
j
CONDITION:
REMARKS:
RESULTS .ACCEPTABLE ❑COMPLETE *DDITIONAL
❑NOT ACCEPTABLE 9 NOT-COMPLETE INSPECTION REQUIRED
Signature of Inspect
Signature of En ' er
l
FIELD REPORT
PROJECT REPORT NO.
STREET ADDRESS c DATE
CLIENT k/z.
WEATHER
❑SUNNY ]DRY ❑WINDY TEMP
XPARTLY CLOUDY ❑HUMID JKCALM 73 -
❑CLOUDY ❑RAIN
FIELD INSPECTION OF OUa-eA
OBSERVATION:
CONDITION:
je
REMARKS:
RESULTS ACCEPTABLE COMPLETE ❑ADDITIONAL
❑NOT ACCEPTABLE ❑NOT-COMPLETE INSPECTION REQUIRED
Signature of pe
Signatur of ngmeer
SECONDARY CONSTRUCTION CONTROL DOCUMENT
(for Professional Engineers/Architects responsible for only a portion of a controlled project)
Project Title: eQ=dAA1 fJ//jls 5,51e s Date:
Project Location: Z 41 J7 ff/wG o`)rRc7FT
Scope of Project: NE7,)
A17021o2 A-17 ZA7z"&2 7a �.�T/s1! s 111CD/., 1a
7
In accordance with the sixth edition Massachusetts State Building Code,780 CMR SECTION 116.0:
I, 7_�j'E5�¢ L�l�.tlC i(/Lst/j �rz.T' Mass. Registration Number
being a registered professional Engineer/Architect hereby CERTIFY that I have prepared or directly supervised
the preparation of all design plans,computations and specifications concerning:
[ ] Entire Project Architectural Structural �[Xf Mechanical
[ ) Fire Protection [ ] Electrical [ ] Other(specify)
for the above named project and that to the best of my knowledge,such plans,computations and specifications meet the
applicable provisions of the Massachusetts State Building Code,all acceptable engineering practices and all applicable laws for
the proposed project.
Furthermore, I understand and AGREE that I shall perform the necessary professional services to determine that the above
mentioned portions of the work proceed in accordance with the documents approved for the building permit.
Upon completion of the work, I shall submit a final report as to the satisfactory completion of the above mentioned portion of
the work„
Signature of registered professional:
Subscribed and sworn before me this day of 199
t A,,
01
h r .,
my commission expires on �3
Notary Public 7Erl Ea.' ��e
v SM U ' ' N
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