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HomeMy WebLinkAboutBuilding Permit #Exception - 105 CARLTON LANE 5/1/2018 (9) x µOWN BUILDING PERMIT ,� •ys+._ �•,'• °o� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ; Permit NO: 9 q 3 ` Date Received '� �, ss.: •`raw Date 'R Date Issued: •secs IMP RT T:Applicant must complete call items on this page LOCATION 0� C_Flr��c�n LAS EL, Anc�GVer-- (11A of-94T Print PROPERTY OWNER Em, l U C nr-'8 AY- C ti Print MAP NO: PARCEL: ZONING DISTRICT:�Historic District yes 4 no �� Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑ New Building N dne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other 0 Septic C Well 0 Floodplain RfVetlands 0 Watershed District El-Water/Sewer (h5�w11 Ito" lt 'IC7f ©Y�� P� 2C-�- tnuround � ra1� SS (HCl_. Identification Please Type or Print Clearly) OWNER: Name: Et-r ; ly <!!ny4gro Phone: f�i7 33 - l`7ojd Address: l 055 C6rjon Ln v t CONTRACTOR Name: Phone: C�=rcw ";lk Cc n-5 rt 6�tl-rn �' . s rn C 1 ti Address: '7a Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: r � 6'(0 C-7 �/a,3/ate�y 6;(ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $_ Lt(o,n<)o FEE: $ Check No.: Receipt No.: NOTE: Person con12 it unregistered contractors do not have access to the g aranty fund � r ignature of Agent/Owner Signature of contractor i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF -U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ �•$�"�� COMENTS VIC ONSERVATION ❑ ElY 'a 4 COMMENTS — �a ►�s�- CpI�.�.. C��� I I L ' DATE REJECTED DAT P ROVED I HEALTH ZDv�►iw� /ova �o s ❑ COMMENTS l " Zoning Board of Ap als:Variance, Petition No: Zon' g Decision/receio submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer Connection/Signature&Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date i COMMENTS Location < - No. << Date . • TOWN OF NORTH ANDOVER �a s • Certificate of Occupancy $ L r ' c Building/Frame Permit Fee $ Foundation Permit Fee $ F . Other Permit Fee $ TOTAL $ Check# 46_ i 27495 Building Inspector TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION? Feint PROPERTY OWNER Print loo Year Old Structure yes no MAP NO: a.PARCEL: ZONING DISTRICT: Historic District yes no _. _ Machine Shop Village yes no-,,- TYPE o_TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential ❑ New Building 0 One family 0 Addition 0 Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other 11 Septic F1 Well II Floodplain Li Wetlands 0 Watershed1®istrict Li Water/Sewer a DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) ' OWNER: Name: Phone: Address: CONTRACTOR Name: _.: _ _ _ ___ _.�__ Phone: Address Supervisor's Construction License: _ Exp: Date: _ Home Improvement License: a_: _ Exp. Date:, ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Plans Submitted 'Fj Plans,Afaived ❑ . Certified Plot Plan ❑ Stamped Plans ❑ Building Department The followin - g is a-listof-the required:forms to be filled out for the appropriatepermit to he obtained. Roofiri g, Siding, Interior Rehabilitation Permits u Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/OrC.S.L Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work a Engineering Affidavits for Engineered products NOTE: All dumpster.permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan a Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) a Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) Li Building Permit Application a Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract o Mass check Energy Compliance Report o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all casts if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apn•,al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doc: Doc.Building permit Revised 2012 Plans Submitted ❑ . . Plans-.Waived ❑ '- Certified Plot Plan ❑ Stamped Plans ❑ TYPE_OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBodyArt ❑. . Swimming Pools ❑ Well ❑ Tobacco Sales ❑ -FoodPackaginglSales ❑ private(septic tank,etc.: ❑ =permanent D'tiunpster on Site ❑ THE-FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATEAPPR-OVED PLANNING & DEVELOPMENT`' ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes . Planning Board Decision: Comments Conservation Decision: :Comments Water& Sewer Connection/signature&Date Driveway Permit DPW Tow! Engineer: Signature: Located 384 Osgood Street FIRE DEP,4RTMFNT Temp Dumpstef on site yes no Located at;124 Mair Street:-- :.. "Fire'Departme►lt'idhatiare'Idate ' COMMENTS ; ; -.Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions._ -Total land area,- sq. ft.; ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER.Z®NE LITERATURE: Yes No MGL Chapter-166 section 21A.—.F and G min.$10041000:fine NOTES and DATA—(For department use I , /ZVL/V N , r� I `l r W I+ I ® Notified for pickup - Date I Doc.Building Permit Revised 2010 Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost S 46,0, 0.00 m $ - $ 552.00 Plumbing Fee $ 69.00 Gas Fee 100 comm. I$3 110000 Electrical Fee $ 69.00 Total fees collected $ 790.00 105 Carlton Way 753-14 on 4/28/2014 16x40 Pool Inground r' 1 - >• NORTH W_ ' _ c . ve. . No. 11L T — * - h ver, Mass, �. COCHICNEWICK 1' 7.95°RATED JPkIf (5 Ll BOARD OF HEALTH PERMI I Food/Kitchen T LD Septic System r THIS CERTIFIES THAT .................. .! ... .. . ar Ir .o6r.r. BUILDING INSPECTOR has permission to erect .......... buildings on ... . ..� � � ��� Foundation to be occupied as ....l.�r...lf...�o...... Rough ....F.. ..w.5. ...... . ..L..... ...................... Chimney provided that the person accepting this permit shall in every respect confo to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final 6C PERMIT EXPIRES IN 6 MONT S ELECTRICAL INSPECTOR UNLESS CONSTRUC N T TS Rough Service .... ...................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner [Street No. Smoke Det. __ "'"'�,+ 4 North Pembroke,MA 02358 • = .-POOL AND SPA- `: • THE FIBERGLASS POOL COWANY Ph:(781)826-6886/Fax:781-829-1002 mA construction supervisors License No.80888/MA Home Improvement Contractor License No. 135607 CONTRACT AGREEMENT This Contract is made as of the date set forth below by and between the undersigned Emily Cordaro (hereinafter referred to as the"Owner")and Cherry Hill Construction Corp.(hereinafter referred to as the "Contractor")for the installation described below,at the price,terms and conditions hereinafter set forth. This contract represents the entire agreement between the parties hereto and supersedes all prior negotiations, representations or agreements,either oral or written. 105 Carlton Lane North Andover Ma 01845 Street Address City State ZIP 617-335-1705 e.cordaro@hotmail.com Home Phone Cell Phone Email Address The Owner herein agrees to purchase and the Contractor herein agrees to sell and install a Swimming Pool on the Owner's property.The approximate outside dimensions to be: 16 feet___Q_ inches in width, 40 --feet 0_inches in length,and a depth of 3 feet___i_inches to 8 feet 0 inches. _. Detailed Construction Specifications: Owner Responsibility: Pool location,building permits,all electrical work and all gas work,water delivery,removal of known obstacles, removal of unknown obstacles and access to property,locate and expose any septic lines and water lines. Any additional fill needed to be hauled in or excess debris or fill to be hauled out will be charged$500.00 per 10 wheeler truck load. Contractor Responsibility: Excavation of pool,dig safe properly,deliver and set pool,backfill pool,supply and install 40 yards of sand,pump, filter and all necessary plumbing and pipes,pad for equipment,rough grade all area disturbed by pool installation. Detailed Pool Specifications: Pool Options: Shell: Color: Granite Model:Gulf Coast ■Viking Gulf Coast(In-Stock) 3$ 9.500 ■'2 LED Light transformer&remote $1,800 Filter: Model:Hayward "Size: 20/30 ■In Floor Cleaning $5.300 ■Salt Water Generator $1.900 Pump: Model:Ha wy and HP .75 ■Pump&Filter URC-1 ■Shipping&Delivery $Incl Maintenance Kit:■Vacuum.■Skimmer Pole ■Hose ■Brush ■Discounts $-1.900 Contract Price: In consideration for the performance of the work and materials as outlined above,and subject to additions and deductions as provided for in change orders below,Owner shall pay Cherry Hill a lump sum price of$46.600.00 Dollars,including taxes,to be paid as follows: $5000 Deposit due upon the signing of this agreement: $5.000 50%balance due upon on or before March 1,2014: $18,300 40%of the balance is due when the pool arrives at the job site or storage if receipt is delayed $18.640 7%of the balance is due when the pool plumbing is complete; $3.262 3%of the balance is due when backfill,grading and clean-up is complete. $1.398 Owner Initials LC' CHPS Initials: A'V'M_ CHERRY ��� CHERRY HILL CONSTRUCTION CORP I L 722 Washington Street P.O.Box 6 —POOL AND SPA— North Pembroke,MA 02358 THE FIBERGLASS POOL COMPANY Ph:(781)826-6886/Fax:781-829-1002 MA Lonstrucnon Nupervisors License No.80888/MA Home Improvement Contractor License No. 135607 Any payments not received within ten(10)days of the due date shall incur a$50.00 late fee and any payments not received within thirty(30)days of the due date will incur a 1 r/s per month interest charge. All payments must be received prior to the installation of the concrete footing and pool start-up. Construction and Design Standards: Where appropriate,equipment shall comply with or exceed the standards of the National Spa&Pool Institute and the National Sanitation Foundation. The Design shall comply with current standards of the National Spa&Pool Institute,Consumer Product Safety Commission,the City and State in which the pool is to be installed. Right to Cancel: The Owner may cancel this agreement if it has been signed by the Owner at a place other than the address of Contractor which may be at its main office or a branch thereof,provided that the owner notifies the contractor in writing at its main office or branch by ordinary mail,not later than midnight on the third business day following the execution of the agreement. Terms and Conditions: The Owner and Contractor hereby agree and incorporate herein by reference,the Terms and Conditions appended hereto and Owner hereby acknowledges that he/she has read all of the terms and conditions and understands same. The Owner is advised that the Owner is not to sign the within agreement before the agreement has been read by the Owner and unless and until all blank sections have been filled in or marked as void,deleted or not applicable and until all exhibits and related or referenced documents that are incorporated herein are attached hereto. Witness our hands and seals on the date set forth below. Date: , Cherry Hill Co stru ion Corp Authorized R rese ative f, Owner TERMS AND CONDITIONS 1. CONTRACTOR RESPONSIBILITIES AND DISCLAIMERS a.Contractor shall pay Federal and State levies for its employees,and shall carry Public Liability and Property Damage insurance in such amount as may be determined by Contractor. Should Owner desire coverage for himself or additional coverage,he shall make his own arrangements therefore. b.Contractor shall not be responsible for damage to any part of the pool structure,equipment or Installation resulting from natural causes or an act of God,including,but not limited to,earthquake,ground swells,inundation,ground and/or hillside motion,landslide or natural or accidental cause of peril resulting from storms,flood,war or riot nor is the Contractor liable for damages caused by surface drainage around the pool. The Contractor also shall not be liable for damage caused by the Owner or his Agents. c.Contractor shall not be liable for delays caused by strikes,war,acts of God,weather,other contractors,delays caused by owner or delays caused by suppliers,which are beyond the control of this Contractor. Contractor shall with due diligence proceed to complete the project in a timely manner. d.Contractor is not responsible for damage to patios,driveways,lawns,trees,plants,shrubs,fences,sprinkler systems or sewers which result from normal ingress and egress to the job site by trucks and equipment. e.Contractor shall not be responsible or liable for work performed or equipment and materials supplied by any sub-contractor or other party who has not been contracted with by Contractor. f.Contractor shall not be liable for staining or blemishes caused by abnormalities,either in the water used for filling the pool or, by poor pool maintenance or by die in bricks,tile,stone or deck coatings. Owner Initials CHPS Initials: Ay-p\ le Jun I/ I WHTI.Ak)DS C'i,� NOTES: • 5 I �� WTO —� / 65••9/ar ASSESSORM AP 210 LOTIOGe IFLInasNDS i i \ 1\ ( �� RECORDOWNER:MICIIABARNUM •��ro{eeF d)sch tn-e'1 WBTLANDSFLAGSBY nr,l, / 1 I , 1 C(O P13TLRCO1tDAR0 1 hTlx.wlfa_flck� ( WETLANDSAND LAPID � � 1 f NfANAf,1IAMIT I$ Ln�q�'Rork LTYP) °g ' 4$ LOTADDRE5S:ld5CARLTONLANE: fl Ifcr ,+br.� 1 5 1 a wtorrd5»1 1. `+§ i 111 . . NOR7.'ITANDOVIlR.M.A. , I.v6d Y mr ` �t - _DEED R1T MENCI3:DOOIC 11602 PAGE 12 lc_ -• ,! aim ` /r 1, a i�;l'• T u•Dscl."�nr`•p'- �`�. PLANRLFERENCE:PLAN8io0 . L-----— 4•SF-d 'I _ REGRADING.RETAIN SLOPEi\ / / �) �,- � ' � zONE:R2 - WITIAWGETATION.SLOPE )l ' / t.14 I i' I I NOT TO EXCEED 3:1 VRiTICAL DATUM:SAS®ON CARLTONLANE' / 11 '// o/ I,�/ ' - AS BUILT ON PTLIS AT THE TO\VN OF NORTH - .. lo?,� ----i— l+7 1 APPnO7SIt�I rIS ACTIVH .ANDo�'Ea. . PROPOSED SILTATION --- \ LBACFItNG ED A5 PER 1'NAYba la D. nt -Oe.mfcn.-9 13MULLER j� / AS BUE:rS[7�SIAIPACIl. - . I I, 1 .4 MVER-1 DISPOSAL SYSTBMPLe4N NOIYl'FI ANDOVERDONOT �{ / ( / G ' BY KAMINSIC,GELINAS DISTUIrM MARKERS J-mr / ' / N ' 6'i_-A &ASSOC193'pS . '/imdNc.{c.1 by C✓cf/9..,(5� ���• (ol .lti" � \ .I .. L wd vn5n{."(2•fY(3 flay roa i�-- APPIIOXIM]rE I6' I LOCATION OP POOL, /1 . I. o • P L PROP. SURROUND,&PENC • )ep, / /13?� ,��''//.�� ti � 'j •''x FlENCE �I TO DE BJyTALL�ED I I' PRIYACYPLANTI1 bS '\ate �\�i i �//•. � 1 �. t r, ' •,?{ b 1 ;.nry`` i1RP i /I ('�5/ - I I'ROPOFOSED-' I' . LANDS¢APE- r . 1 I / `..--w �..'-. yvd..,•Y I Il'Ls1NTING5 ,,' , o DO NOTDTSTURD MARXERS nr�`b t/ , ) •,� ✓x` "'1- ^ . .' __. . .0 WErLANDS FLAGS ..��.aw APPAOXNIATB 1500 GAL,- I / 1 t SEPTICTANKAS PMLAS + . s PROPOSED FRUIT'TREES _ \ // �tA'-'k' � _ [' QUILT SUB SURFACE o'f \ o �..... , -, DISPOSALSYST1IDl PLAN BY / N3 / --- , OP� 1 KADiIIdS[a710 NAS& I ' EMS1'ING CONTOURLTNE n - 1 ASSOCIATES / PROPOSEDCONTOURLTNE II Alio /i 1,1 2- 5 / --K--(- PROP.OSRD FENCE ewevvn PROPOSED SIINo.105,TATIONDARRTBIt i� r 1 t " PWSO Er DECK I n.. IDlxt TtA A\ 1 I .T RM11,0VED / R.C.P • Pf URAU64PL' `�� EXISTING CONDITIONS - i / 'S PLAN IS BASED ON THE'RErMNCeD PLANS,DEEDS, / _..... ... . D TEM RESULTS OF AFIELD SURVEYAS Of TITS DATE -__•__� :.�`- ----- S __ I PLAN hT OEy LAND T7'TD TST f PROPOSED .. . I — POOL LOCATION CERTIFICATION IS INTEt`3Dm AS TO PROPERTYTITLE / ASTOTITETDOSTENCEOFUNWRITTENORUNRDCORDED ,\ ` �"�'•'_..r.,,,`�.i 3 , / . Located In. NORTH ANDOVER,MA Prepared By i mercan Land iates,1»c: I � I. '::..I / ,n'=a3.7oa+�-sP. Ay Assoc 'N0fA1�w / Kii1c W.Benson,President, PLS WHK 42 Cherry Street Gloucester,MA'01930 eowrn+ I / I 978-281.7878 Nn.MnnH i-t5oala. I SCALP I"=20' OCT013ER'5','2013 K W.BENSON,PRESIDENT. P1,040036 1 .•..,. ..i h-212.0, . .,ti ._Prepared For D AN n)cHorrnvnsusx EMILY CORDARO UnIOPRODUCTIONDFTHHPRVTIII1PLAA DIS IID0ICATNKCr •'':� ` U711HTM RDIT.ODUCRONORR AND15 A9]3ECUN9IDliRIiDA l� ACCIWRirRINOL•191MTANf)/Dlt OKAT uURFIY3 nlHISFLAN18 FOR aAl.e ) CARLTON LANE ACALO F WSTU]'RDDUC'f3DN FOKAI I•URk'Q91i THIS PLAN IN k'OK IMALOWkR nfl'UP.PUSBANUIY NDT'ID nH SOt.DDIt T.fNNtiFI.3lRFJ)1S)ANV / - OWk18KDRT3IIKAPARTY. 0 20 40 80 T-1541 I Y t COMmOnwealth of Massachusetts t ZXl Department of Public Safety ffnr.tint;En-_,iM-•r License:HE-131256 v JAMES A MCGSLL 1 -- PO BOX 2W=AVA N T!O?kL North Pernbrol c MA IDT j J�`r ms Expiration- 05f3012015 05/30/2015 t Massachusetts-Department of Puwto Safiij—; sem' 6 zoaHas ty Board of Building Regulations and Standards ---------- t nn.trurtwn Super—r /"'.t .a J�e 7Crznzrrrairraeir�/I a/ y�zl;;nc�uu+/I \ Office of Consumer Affairs&Busifiess Regulation License:CS-080888 IMPROVEMENTCONTRACTOR JAMES A MCCMIL WME gistration: 135607 Type: PO BOX 26822 WASIFINGTON piration: 4/231201 /2312016 Private Corporation Norah Perrrbrotc 14IA Q23,*:° CHERRY HILL CONSTRUCTION CORP_ i Exultation James McGill corrrt„asn„ar 0513012015 722 WASHINGTON ST. N.PEMBROKE,MA 02358 Undersecretary I i i II TABLE 1- POOLS TABLE 3- SPAS POOL CODE SIZE DEPTHS GALLONS PAGE POOL SPA CODE SIZE ...DEPTHS JOALLONS Page ,- APPROX. NUMBER TYPE APPROX.PIS Acapulco AC 16' 39' T-6' B 16 4 T e 0 M stip M 10'z 1d 3'-4" 550 Aruba ARU 31 22' S-6' S' 5 2W S Type 0 Mystic S -Voter MSW 10'x 11' 3'-4" 650 Atlantis LBBST!Z'1S' 4' 2,SW 5 T e 0 Mystic S MSP lax 11' 114" 325 Bahamas MFF a'-9" M'-3" d 100 5 T e 0 Pladd BOS S-4"x S-0" 3' 475O pCombbrid SFF 1Y,25' T-B' S'-G" 7,500 5 e 0 Placid$ -built BOSSW S*4"x g'-4" 3' 475 Z BAR 16 36' T-G'.Y 19 500 5 1' e0 Pla cid Splash BOSSP S-4"x 6'-4" 1'$" 271) BBD 9'-6",21' S' 4,000 5 e 0 Regal,. RG S x 1d 3-4 ODD 5- AL 1Y,W T-61,5'-G" 7,x00 S Type 0 R Spillover RGSW 8'x 10' 3'-4" 600 6 LN 1C 3G' 3'-6'7 5 e 0 Regal Spash ITG P Yx 10' T-7" 470 6 CC 10,35' T-6",6'-6" 15 000 4 pe 0 Ro al RY Sx 1d 3'-4" 600 6 MR 16 40' 3!-6',6!-V' 22 4 e 0 Royal Spillowir RYSW 8=10"X 10' T-e ,. 600 6 Carmel FF 13'-8" 30' T-6',6' lizom 4 Type 0 Royal Spash RTSP 5-10"x 10' T-S' 330 6 Chesapeake 1CP 1Y 31' T-11" S' 10s Type0 Shasta LRS Tx.T T 420 6 Claremont v 14'33' 3-7'Y-4" 7 5 Type 0 Shasta S Voter LRSSW Tx S T 423 6 Clearwater SP 10'-11" 20' T-5' 5' 3, 5 T e0 6hasta$ -h ,LRSSP - T x 6' 1'-6" 18D 6 Del B 11'-10" 25'-5" 4'-6' B 1W 5 T 0 S CS S x'I7S" 3' 703 6 FI i FA 15' ' 3'-6'.6 1000 4 T 0 S S Ilow CSSW 9'x 12'-5" Free ort FP SY 75'-1" 3'-7' S'-5' 6000 5 T O Superior Spash CSSP 9'x 12'-5" i'-8" 430 6 U Gulf Coast GC V-10" 39'-7" Y-5"-7-11" 29.600 4 T s 7 TBtKte lAS T$x 7'-6" T 460 6 Gulf Shores GS 15'-7' 34'-8" 3-7' S'-]O" 35 4 T e 0 Tahoe S taxer LOSSW T$'x S-' Y 450 6 ®" lsland Breeze 11 BN 16 40' 3-6' lr 4 Type 1 TehOB 5 h L05UP , T$x 6'-B" 1'-6" 2206- t- lamalca LD 9-10" 15-S" T-2",5' 3,750 5 TypeO 0 v Ke West SFF 1Y.25'-Y T_r'6' 9A00 4 Type 0 s is Laguna LG 14',30 3'-6" 6 14 4 Type 0 TABLE 4- POOLS Laguna Deluxe LGX 14' 30' 4' 6' 5AX 4Type 0 POOL CODE SIZE DEPTHS ALLO PAGE POOL Lake Shore CD W 33' T-T S=5' 150004Type 0 _._.__ _ $ APPROX. NUMBER TYPE Maui MTK 9-3 16 3!4",4' 2 300 S e 0 i Mediterranean SP 15'-8" 36' T-7";511" 17,000 Type 0 HTA t� 8'-8"X 18' 8' 4500 4 T 0 0 L LL Nbnte a MT 14' 35' T-T' Ss.7' 1 40D 5 T e 0. FITB HZA 8=6"z 1S 3$",6' 4300 4 Type 0 O 0 t1 � � LL � Oahu MLL V-S" w-fa' 0 2,200 s T c o I= HW 8'-6"z 18'' S46 4050. 4. _ T 0 L g co W Ocean8reeze 08 16,4(Y 3-6' S'-S" 15,900 0 HM Hal S-6'x 18' S.5'-6" 3850 4 Type 0 _ Panama BL 11'-10' 35-145! a-61 varies 4 T e 0 HZDXL HZDXL 8'-8"z 19 3'-3",8 3000 4 T pB 0 °�° Poseidon PS 1ti 40' 3-6" 7 23 000 e 0 HZE HZ5 8'-6"X 1S 6' 3600 4 T pe 0 C ,C � m � ati Rio - BPO 16-8" 39' Y-7•,W 20, a 1 HZF HZF 8'-8"X 1:8` .4'$".5 340.0 4 T e o Y CL c� Rockport RP 14',30' 3'a• s'-11" 12,806 o HZG HZG 8'-6"x 9' v-W 1200 4 Type 0 0 > � ai Santa Barbara Rs 14' 30' 3'-6",6=6" 5 Type 0 HZH H2H 6'-6"x 9' S' 1350 4 1)rpe 0 O la g g SanlaCruz SL T-6" 39' 4' 6.503 ST e0 < O E a QIL Sen Breese K 14'-B" 33'A" 3-5` B-2" 16000 e0 ••• � X U St.tutu CM 12'-3",23'-11' Y-6" S. & 5 0 Q r- N St.Thomas L 14' 31'-6" IT-7%7' 13,7 4 Type 0 7 3 17 ui S Tilton TN 1R' 37 3-7' S'-li 13 500 4 T e 0 03 E Triol TND 1G 44" 3'-6' 7' 19 0 Co LU e 5 e G keno MP 9'-6" 14'-6" 4 S e0 W Valencia 3'-P,S'-10" !M T 0 N TABLE 2- POOLS t0 J COD COD•i ar MIP ii '3 M Page WL �..� & • a• 2J0f7 4 FIG.1 L unytM.Ynatn and eePiA may very up m a%-wf y dJMW Qas ere to QUW"40p of**M.fflaa ad TYPICAL CANTILEVER CONCRETE DECK rrom pWaal0�. 6°X6^-w1A X W1.4 4---- 3'MIN. -� WIRE MESH OR w RESAR NO.3.ON 2'O.C. EACH WAY. SLOPED 174. 7• �I f 12" — icr cr—m } O z 10-1,(, 174"GALVANIZED v I I_ CHAIN FOR CLAY JJ 3 THtCKCOMPACTED SOILOBEONLY . FIG.2 I: = SAND(TYPICAL) I 4•MIN.THICK COMPACTED CONCRETE DECK I GRAVEL FOR CLAY WITH BRICK OR STONE _ I (ADOBE)SOIL ONLY. BRICK STONE DECK 6'X6•-W1AXWIA SAND WIRE MESH OR --� �--- FPOOL SHELL 3'MIN. - REBAR NO.3,ON 2'O.C. fi" SLOPED 1R'=1' _ --9"---. EACH WAY. g" 12" t` -4 - f0 V 1- .-. 4. FOR CLAY /� 4 16 114•GALVANIZED (ADOBE) V J N CHAI3•THH4K COMPACTED SOIL ONLY. /�6 \. SAND(TYPICAL)Wm W 4•M .THICK COMPACTED gg y- GRAVEL FOR CLAY (ADOBE)SOIL ONLY. 0� LL SAND O " LL FIG.3 -.�! g« r FIBERGLASS L LL E ^ Pool s11Eu ^ Ql Z S TYPICAL BONG BEAM W CONSTRUCTION C o n a ewdc FILLEDBLOCK_ 3'MIN- --{ ••o Y CL a OR POURED CONCRETE /�/ ('--�'- g" BACKFILLED DIRT 1%� � � C 11 irw-lii� ... LL lq X J MAXIMUM Yy T 6W-WBrAs oR toWIRE 24" j REBAR NO.3,ON T O.C. 1 EACH WAY. FIG.4 E Ji�CC j I Z i ij TYPICAL ABOVE GROUND INSTALLATION M W c a I ��I i i_a �.! -,�_i,. `-- MAXIMUM OPTIONAL 1 ,•� .. TJ BAND(TYPICAL 19 112" MOUND DIRT WOOD DECK II' 4'MIN.THICK COMPACTED AROUND POOL GRAVEL FOR CLAY /PPROX6• _ Page (ADOBB)SOILONLY. — th FIBERGLASS i- iU '1 8" z of 7 r I V —aa• ...—.—aa - 3e' —ao'— —ao' — 1 a 3'�" co r` W � H TRINIDAD-TND r1 GULF COAST-GC RIO-BPD OCEAN BREEZE-OB POSEIDON-PS z 19,800 gaL appmx� 22.000 gal.approx. 18,900 gal,epprox. 23,000 gal.approx. 19,300 gal.approx. a Tf T-2 t0 " r ' 3'-6 5'-11" 3'- 3'-6" 3'_5" ISLAND BREEZE 11-N MEDITERRANEAN-BP CANCUN-CC SEA BREEZE-K ACAPULCO-AC � .. 20.000 gal.approx. 17,000 gal approx. 16,000 gal.epipnwc. 16.000 gal.fox 18,300 gal.approx. r C3 35' 35' AVAILABLE WTO 45 -# N 0 30' IN LENGTH Vti LU � � � U. E. CD z 5-i0GULF SHORES-OS 3'-T MONTEGO-MT PANAMA-Bl- C_ 3t�" LAGUNA DELUXE-LGX 4' 15.0009w.approx, 14,000 gel.approx. 9.000 gal.approx. 14.000 gaL approx. '0 PIS $ CARIBBEAN-x. O We 22, 0 gab approx. / a�- fit 39' 31-6" 3a 3p 30' Q E a m g �� r J E L Co Lu U N SANTA CRUZ-SL 3'-T 5•-11" 3'-7" 5'-11" ROCKPORT- 3.5"-RP 3' 4-0 V 8.500 gal,approx. ST.THOMAS-L TRITON-TN 12 800 geL approx 14..800EqG0gal.lF; wx. 13.700 gel.approx 13.500 gaL approx. CIO - 30' Page I—CD 1 caa v 13-8 3'-8' '4 — W-7 3 B" 3'-6" 5 5 s'— ° r 5'-10" Valencia-ST 4 Of 7 FIJI-aFJIpp I/u(E S}{pRE_Cp SANTA BARBARA-RS 12,000 gal approx. 14,000 gaL app vx. 9000 gal.approoc 12.500 gal.approx. 1CARMEL-FF00 pprox- FOS Name VP EWGM17 a5 YP 144241MUK-0313F Lwvvb'wtmn and d%M may Y"UP to 3%-d 6' d wmdww ato to aftWo efto d raft.m9atwed town pwww ices. w � y r PLO 0 Q" Mo A r gj v mC 0 0 w ®� $� n w � ,►v.t ss r � z 9M e y 3' --—'—W4q6,wl@hrdds0=yvwyvpto3%-dGa- diiawlaa ti b odfid.odDO daopYp,mwwsa0d RompVW irol. SW �• N� m $c � A g a A 8•$' u, V �9 �� 1• i'-11' O gr o � LT� ai � v, T Pn 5'a" 11'•10• 07 D DC7 m �tom' 2S n .. lit ji Fn w a 51d1 4' 1'-10' a �a mo 0.10 IN N o, Latham Pool Products Inc. NOTES DBA Viking Pools ICC Evaluation Report Number(ESR-2014) Latham,nor Phone:(aw)533-0800 Jane Lew,WV From(304)884.8854 Fax:(3o4)8e4.719e Q Midland,TX Phone.(432)581-9833 Fax:(432)5s1-9934 v Williams,CA Phone:(w)4r3-6319 Fax:(53o)474-w93 Zephyrhilis,FI_Phone:(813)783-7439 Fax:(813)783-7214 T-6" 10, Z 1 r s" 10' ZE= 3' SHASTA-LRS PLACID-BOS MYSTIC-M TAHOE-LOS REGAL-RG Z 420 GaL Appmx 475 tial.Appmx. 550 GW.Appmx. 450 GW.AppmSUPERIOR-CS ROYAL-RY x. 700 RI Apprax. 450 Gal.Appmx 550 Gal.Appmx. i°, 7'-6" 12'-5"— —1w 10' B W r 9, � r6" 3' 3' Z-= 3 m SHASTA SPILLWAY-LRSSW PLACID SPILLWAY-BOSSW MYSIC SPILLWAY-MSW TAHOE SPILLWAY-LOSSW SUPERIOR SPILLWAY-CSSW ROYAL SPILLWAY-RSW REGAL SPILLWAY-RGSW V.–. 420 GW.Appmx. 475 GN.AWW. 550 GaL Appmx. 450 Od Appmx. 700 Gal.Appmx. 550 Cel.ADpm)L 450 Gal.Appmx r'• C1 P 8'-10" T.6' to &. , W92co 91 ^^O CL E ALL ' 3' 10" 3' 11-6" 3' CL 1 C a 1'6 1—` "'•-6" 1'-6" 1,-,• CL 200 GW.Appm4 250 G SHASTA SPLASH-LRSSP PLACID SPLASH-BOSSP MYSTIC SPLASH-MSP TAHOE SPLASH-LOSSP SUPERIOR SPLASH-CSSP ROYAL SPLASH-RSP REGAL SPLASH-RGSP O > N " gi W.Appmx. 300 GA Appmx. 200 GW.Appmx 350 0A Approx. 250 GA Appox. 200 GW.Appmx. o 4 Cr,-, r a. Q �m C N 2 a Eco LU J l0 W comb N cu Page 6of 7 i FkNames VPENG-11WA VP 1442-1117VUP741213-7 lwov6 AM and dep rmy vmyvpb3%-d ditWdbM GMbOUMde.3)eof00ft mBastaG Ht p g t m0 r nNg tlO Sad! M, > go= q z Pig • rrr l�ls . > s 0 g r q 7 e 6 NOTES Qi� Latham Pool Products Inc. cc DBA Viking Pools ICC Evaluation Report Number(ESR-2014) Latham,NY Phom wo)e33-38w Jane Lew,VW Phone:(304)8844954 Fax:(304)884'7198 Midland,TX Phone:(432)581-9933 Fax(432)561-9934 Williams,CA Phone:(530)473-5319 Fax:(530)4735393 4 Zephyrhills,FL Phone:(813)783-7439 Fax:(813)783.7214 TN T FOR NATIVE SOIL OR COMPACTED FILL SITES ALTERNATE TYPICAL TIE-DOWN SECTION W N.T.S. W 0 Z ' GROUND 4 •\ �� \ / TYPICAL TIE-DOWN SECTION LIFTING CI AAI DEEPEN CONCRETE DECK AT TIE DOWNS BY 8' N.T.S. ALL CONCRETE MIN.2500 PSI COMPRESSIVE CONNECT CHAIN EMENSION STRENGTH-NO SPECIAL INSPECTION REQUIRED SO AND NUTGALVWER �"GALVANIZED G� SO CONCRETE DEC(WITH THICKENED EDGE WITH REINFORCEMENT PER MANUFACTURERS \/ CHAIN EXTENSION REQUIREMENTS POOL SHELL i MAX OPERATING • .A !' GRADE ' SAND BACK FILL WATER LEVEL \ + PEA GRAVEL / 1 OPTIONAL SECURE CHAIN ANCHOR V L1FTN0 CHAIN \ \ � WITH H.D.GALV..UCLAMP � ^ FIBERGLASS POOL SHELL SAND BACK FILLI COMPACTED FILL.FIRM NATIVE SOIL, OR ROCK CD Ly '°� '. DEEPEN CONCRETE DECK AT TIE DOWNS BY 8' . •�• •�'J .;l WIRE BRUSH CLEAN&APPLY 3 *-AyMyM$ 9132'GRADE 80 H.D.GALVANIZED CHAIN EXTENSION COATS COLD GALV.COMPOUND Co Co 15 ^ gn SAND LAYER \ SCREW ANCHOR TO MIN.3 M0.FILM THICKNESS 4W X 618'ROD MIN. W PRIOR TO INSTALLATION. N g ^^ FILTER FABRIC BARRIER WIDEN EXCAVATION AS NEEDED ATANCHOR �I PEA GRAVEL WATER TABLE AT MAX.18'ABOVE OPTIONAL /� LOWEST FLOOR LEVEL WITH POOL EMPTY 6'DISC MIN. 0 12 187(18'X8'PREFABRICATED 00 C g CONCRETE BLOCK WM REBAR � G Q� i6 c.� �f AT W O.C.BOTH WAYS 8 H.D. = ... I a CD z v1 Rr,. GALV.THREADED J43OLT HOOKED M i6 UNDER STEEL MAT.CHAIN FASTENED \ \ y CL TO J-BOLT WITH H.D.GALV.NUT. Reviewed by: .�_ 0 40 Starr Road A MIN.12-BURY DEPTH Columbia Research&Tos' r N m yj COMPACTED FI FIRM 101 Windsor,CA 95492 C d NATIVE 8011,OR ROCK Phone J /Fax 707.8381880 0 Q W IAS and ICCIE.B Aproved Tesling LeboraUxy 10 C7 Seal: �J m 5. W G� 1 C,U I N NOTES: J �.DESIGN CONFORMS WITH 2010 FLORIDA BUILDING CODE. 2,INSTALLATION TO BE IN CONFORMANCE WITH MANUFACTURER VIKING POOLS,MC.'AND 2006 Appendix K ANSUAPSP-7 AND 2007 ANSUASME-A 112.19J3 SPECIFICATIONS. a The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 UT www.mass govAdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: I as ( X,7)a_1,,; r1a �n-N St City/State/Zi�:_p2r ibf6 Kt ftl A Q,--,z-522 Phone#: to -(011(c7 Are you an employer?Check the appropriate box: Type of project(required): & 1. i am a employer with 1;5- 4. ❑ I am a general contractor and I 6. ew construction employees(full and/or part-time).* have hired the sub-contractors listed on the attached sheet. 7• E]Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' 13.❑ Other ton q,ryoj comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. �^ Insurance Company Name: ` �(.}�(�, T Cir A• , I-dn-Su f Arz e--e- V C b Policy#or Self-ins.Lic.#: U h j )3 -U 1 Expiration Date: Job Site Address:k b 5 Cfl r i� 0 rn L-nY%_R_ City/State/Zip:VJAn dovw_.r rh A (51714J- Attach ►7yJ- Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: Oficial use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ACC>R& CERTIFICATE OF LIABILITY INSURANCE 4/162014"' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements). PRoouceR CONT CT Northborough Construct West Eastern Insurance Group LLC PHONE , (508)393-7744 Fac 155E Otis Street E-MAIL INSURERS AFFORDING COVERAGE - NAIC B Northborough MA 01532 INSURERA.Continental Ins Co 35289 INSURED INSURER B:Travelers Indemnity Co an Cherry Hill Construction Corp,Cherry Hlll Pool INSURER C: 6 Spa;The Townsend CO;Yankee Fiberglass Pools INSURERO: BOX 6 INSURER E: North Pembroke MA 02358 INSURER F: COVERAGES CERTIFICATE NUMBER:2014 Cert REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OFINSURANCE POLICY NUMBER POLICY EFF POEXP UMRS GENERAL LIABILITY EACH OCCURRENCE $ 1,D00,000 X COMMERCIAL GENERAL LIABILITY DAMAGE ol. D e $ 100,OOO A CLAIMS MADE MOCCUR 083124315 /11/2014 /11J2015 MED EXP(Any one Person) $ 5,000 PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GENI AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 17 POLICY X PR0. LOC $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT - - 1,000,000 ANY AUTO BODILY INJURY(Per person) S A ALL OWNED X SCHEDULED 083129353 /11/2014 /11/2015 BODILY INJURY(Per accident) S AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS wer a nit S q4 X UMBRELLA UAB X OCCUR EACH OCCURRENCE- S 1,000,000 S A EXCESS UAB CLAIMS-MADE AGGREGATE S 1,000,000 9 DED I RETENTIONS 1 083129336 /11/2014 1 4/1112015 $ B WORKERS COMPENSATION - - X I WC STATU- DTH- . AND EMPLOYERS'LIABILITY YIN CRYI FR ANY PROPRIETORMARTNERREXECUTIVE E.L.EACH ACCIDENT- - $ -500,000 OFICERIMEMBER EXCLUDED? ® NIA 4069T738 /10/2019 /18/2015 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S. 500,000 If yes,describe urWer DESCRIPTION OF OPERATIONS bebw E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main Street North Andover, MA 01845 AUTHORRED REPRESENTATIVE Ronald Cleaves/CLUI ACORD 25(2010105) ©1988.2010 ACORD CORPORATION.All rights reserved. INS025 hmnnFlm The Ar.nDn.+e..w a;.A 1....n neo ra.ic�erori ma.lrc nF AI1r1Dh K? /1r Cvve ItvIw-all e/- A"I +/+rxCfi PLUMBING 8c PIPING L3114i'TSp CONTRACTOR DEPARTMENT OF PUBLIC SAFETY JAMES h MCZIL,L Hoisting Engineer Ltcertse 6 SIiEfRT$,f Number.HE 131266 NORTH MA1lSI.1TIE.LB;.MA Q2059-5806 Expires-05130/2013 Tr.no: 20280 ReStriftd: 18,2A tiC TREE �. EF G.IY EXPli��'— ILNI.0296235-S 11/01/2012 10/31/2013 JAMES MCGILL 6 SHORT ST _- N tW1RSMFiELP, MA 02059 Commisslo SIGNED nar i �s ✓�ie iivoswnu� `�� i ' ,�., Olriee o Coewmer A a�n Baine» alatlon HOME IMPROVEMENT CONTRACTOR HOME IMPROYEMENT CONTRACTOR i CHERRY BILL CONSTRUCTION CORP Registration: 135607 Type-,722 WASHINGTON ST Expiratlon: 4[23/2014 Private Corporatioi PO BOX 6 CFRY HILL CONSTRGCTI01d OORP. N PF1u1R1(1iZt+ MA 112i5R o James Mci:ili HIC.UC 0VIFFECTIVe 579956 12/01/201211/30/2013 722 WASHINGTON ST.. , i y�f N.PEMBROKE,MA 02358 Underaeeretary tQ Massachusetts-Department of Public Safety j Board of Building Regulations and Standards Conoructinn 5upen icer Rhode Island Department of Labor and Training License:CS-080888 Division of Workforce Reguladon and Safety 'HYDRAULIC CRANES 00014885 JAMES A MCGILE PO BOX 26/722 WASiiT1 PTON North Pembroke MA 02358' I r i ;JAMES A MCGILL 92—JJJSf�c. Expiration PO BOX 6 Commissioner 05/30/2015 N PEMBROKE MA 02358 Administrator Expiration Date i aLi �� �`� CERTIFICATE OF LIABILITY INSURANCE �/7/2o 4 Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER NAME:CONTACT NOrthbOiough Construct West Eastern Insurance Group LLC IPA (508)393-7744 AIC No: 155B Otis Street E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC q Northborough MA 01532 INSURIERAValley Fore Insurance Co 20508 INSURED INSURER B:CNA 20478 Cherry Hill Construction Corp, Yankee INSURERC:Continental Casualty Company 0443 Fiberglass Pools;The Townsend Company INSURERD:Travelers Insurance Company INSURER E: North Pembroke MA 02358 INSURER F: COVERAGES CERTIFICATE NUMBER 2013 Cert REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TN-SR TYPE OF INSURANCE A L R POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DDIYYYY MM/DDIYYYY i GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 300,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ A CLAIMS-MADE FxI OCCUR 5083129319 /11/2013 /11/2014 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER, PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY JECT —1 PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B ALL OWNEDSCHEDULED 083129353 4/11/2013 4/11/2014 AUTOS X AUTOS BODILY INJURY(Per accident) $ X X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 `. EXCESS LIAB CLAIMS-MADE AGGREGATE S 1,000,000 DED I I RETENTION$ P083129336 /11/2013 /11/2014 S WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY X Y IER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N -4069T73-8-13 /18/2013 04/11/2014 E.L.EACH ACCIDENT S 500,000 D OFFICEMMEMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 A Leased/Rented Equipment 5083129319 4/11/2013 4/11/2014 Per Item Limit $150,000 $1000 deductible Aggregate Limit $300,000 DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main Street North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Rosemary Fulham/SED ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INSn25 r9mnnst nt Tho arnpi 1 n2mo 2nri Innn*ra ranief%rori m*rtre of ikrnpn