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HomeMy WebLinkAboutBuilding Permit #416-15 - 1312 SALEM STREET 10/30/2014 BUILDING PERMIT 01 poR 1"1 qw- �67 "YO l TOWN OF NORTH ANDOVER �� h '` " '` ° PLICATION FOR PLAN EXAMINATION Permit No#:/0 A/ Date Received �qrIED � �SSACHUs���y Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION i3 Print PROPERTY OWNER.+±A CMb A-A, Print 100 Year Structure yes MAP _'. t _.__PARCEL �0_ � _ ZONING DISTRICT _Historic District yes a_ ._ -- Machine Shop Village, yesno TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential $,New Building Xi One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement XAssessory Bldg Ave/wn, e W ❑ Others: ❑ Demolition ❑ Other ❑'Sepfic ❑Well ❑ Floodplain El Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly —,Z XT), OWNER: Name: Phone: gs'7- �gj--(27y k,s cam[( Address: 1312- SSI S`� �E,1-t'L. >�u�, AA,pr. Contra-tor Name: _ami l( ( -�laS _Phone:_ 36 a 3t_�?�_ (_ Address: Supervisor's.Construction License _6 t O.Bp Exp. Date: 0 Home ImprovementrnLicense: _.-IJ .9 ZDT E __- _ Date: 1)2-- /3 '- is __. .z_ xp. ate:.... ._._.._. _ _ _ . _. ARCH ITECT/ENGINEER _vtvr� l( Phone: Address: Reg. No. ��fS� FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. _ Total Project Cost: $ z w FEE: $ �ql n Check No.: �� Receipt No.: Q&t9-0 r.,,� NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signatureof Agent/0 �.._- Signature of contractor Building Department artment The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo CopY Of H.I.C. And/Or C.S.L. Licenses o 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 Li Building Permit Application ❑ Certified Surveyed Plot Plan Li Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract a Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And p P Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) Li 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) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Li 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 cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doe:Building Permit Revised 2014 �I Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE'OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body 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 PLANNING & DEVELOPMENT Reviewed On Q jSignature_ COMMENTS I 'a � � , Aj LdU�_rsl,4_d CONSERVATION Reviewed on a 1 Si natur T71 COMMENTS -2Z �l� t'`� C�O\ Wc) P("HEALTH Reviewed on Signature COMMENTS ZO 1J, f C-Z lC"I � 1 5 L p Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt smitted yes I Planning Board Decision: Comments i Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit i DPW Town Engineer: Signature: Located 384 Osgood Street FIRE=DEPARTMENT - Temp;Dumpster on, site yes no Located at 124 Main Street Fire Department signature/date -_ - 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 ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) O 2, CoZJC� L' I -�t- ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 Location h i No. r Date (/ f . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $y � i f r Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 4` Check �y 20206 Buildin Inspector. ------------------------ -----.--_ . a ' �� ■ n..�■ ■ �� — ---------------------- 44.92' —— 179.22 ■ �� ■ mm 87.73' 50.77' ' -------------------� ENLARGED ---- AREA ■ � i j •� `•fix �. ■ �� KEY PLAN NOT TO SCALE ■ ■ CT1 'CT1 ■ ■ ■ ■ = HOUSE _ APPROXIMATE PROPERTY LIMITS =DECK�\ _GARAGEann� . � ■ �■ ■ °� ■ �� ■ IN Monona /M,.m 110. ft ■ Monona \ Io � o �. ■ SEPTIC ■ „� ■ � ■ �� ■ N 'n ■ =moms o >>.6 ft � ■ .�■'■ ' 188.81' I e. a ■ nnommo ■ 7 �■■�■ ■ 58.6 ft 1312 SALEM STREET N z I a�OMAL NORTH ANDOVER, MASSACHUSETTS ■ a U - ■ IL ' v PROPOSED POOL w 3° s° < ' LOCATION PLAN APPROXIMATE SCALE IN FEET I 65N ■ ' OCTOBER 2014 cn31 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost 28,900.00 m $ - $ 346.80 Plumbing Fee $ 43.35 Gas Fee 100 comm. S `100A0 Electrical Fee $ 43.35 Total fees collected $ 533.50 1312 Salem Street 416-15 on 10/30/2014 Inground Pool t%O R Tii Town of _ s ndover o - No. T Zy o h ver, Mass, A_ cocH�cNew�c.c �1' 7,95 RA TE O Jkf' (5 U BOARD OF HEALTH Food/Kitchen PERMIT T D. Septic System THIS CERTIFIES THAT ............... .. .&P..........C. ...........................................................r4�►. BUILDING INSPECTOR p g .�.. 41 1111 Foundation has permission to erect .......................... buildings on .....I.. .........34. ........ ................ Rough to be occupied as : �. .....�...�.. ..... .. .. ......................................... Chimney provided that the person accepting this permits all in every respe conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to th2 Inspection, Alteratin and Construction of Buildings in the Town of North Andover. wwow 04#4dlc0 V^� PLUMBING INSPECTOR J Rough VIOLATION of the Zoning or Building Regulations Voids thi§:P*emit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO 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. NORTf-� own of � O ,.mow-• ..`•. y 1 soh ver, Mass, cocN�Coll, �1 �qs R�TEO NP��,�y U BOARD OF HEALTH Food/Kitchen PERMIT T L D, Septic System THIS CERTIFIES THAT .4*40.......... ... ..12110........... BUILDING INSPECTOR 1051 has permission to erect ........ buildings on 13.�.. ,pit. ........ ................ Foundation .................. ..... ... ......... p� caD Y AWl�.....orn ..... .. .. ........ Rough Chimney to be occu led as . � provided that the person accepting this permit s all in every respe conform to the terms o"f" f the application Final on file in this office, and to the provisions of the Codes and By-Laws relatingto th Inspection, Alteratidt and Construction of Buildings in the Town of North Andover. � � Wil9�j ,/�/Y 101001M PLUMBING INSPECTOR V Rough VIOLATION of the Zoning or Building Regulations Voids thii P 'rmit. Final PERMIT_ EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIOTS Rough Service .................... ....... ........................................... BUILDING INSPECTOR Final 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. TOWN OF NORT11 ANDOVER Offia, of COMMUNI-TY DEVELOPMEN"T AND SERVICES HEALTH DEPARTMENT 27 CRARILES STP-EET . " ' e1.,ND0VER. %4;kc;- HUSETTS01845 Susan Y. Smvyer 978.688.9540—Phone Public Health Director 978.688.9542—FAX November 22, 2005 Gay Neilson 1312 Salem Street North Andover,MA 01845 Re: Subsurface Disposal plan for 1312 Salem Street,Map 106A Lot 160 Dear Homeowner, As you are aware,due to problems with ledge identified within the boundaries of the septic system during installation,the previously approved plan had to be revised.New England Engineering submitted the revision dated November 17,2005. At a regularly scheduled Board of Health meeting,held on November 19,2005,the BOH heard t a request in regard to your property.The following local upgrade requests were approved: 1) The offset distance between the leach bed and a property line from 10 feet required by Title 5, section 15.211 (1)to 3 feet. 2) A reduction in over dig offset from 5 feet required by Title 5,section 15.255(5)to 3 feet This super-cedes the previous upgrade approval noted in the approval letter. All other conditions outlined in the first letter remain in force.Please refer to that letter for details. Please be advised that this ledge problem was identified,new plans submitted and resolved in a matter of days, which is an extremely quick span of time. It is noted that there was good cooperation by all parties,and because of this,it allowed the to process to proceed efficiently. Thank you for your part and cooperation in this matter. Please remember that,if you have not already done so,a signed maintenance agreement must be submitted prior to the issuance of a Certificate of Compliance will be issued by the Health Department. Also,the property owner must submit the attached DEP Form 9b to the appropriate Regional Office of the Department of Environmental Protection at 205B Lowell St. Wilmington,MA 01887. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you might have. Sincer y, Su an Y. Sawyer,REHS/RS Public Health Director cc: New England Engineering Encl.DEP form 9b F ��IO,QO 2C BENCHMARK: TOP RIGHT CORN FL ti0G0.00 (ASSUMED DATU 1 BLOWER / VENT C9 COVERED DECK ON SONO TUBES 'Ay W �� GF / TP4 CLEANOUT / 1500A G LLON MICRO FAST 99.45 :•:•:� / SEPTIC TANK o� 1000 GALLON .....,.. PUMP CHAMBER �oo•sa :.............::::..:::............... — a I 99•sa 99.88 99 ® •" }'EXISTING........................: . d:;�`::; \ ' .DRIVEWAY::::::: .....::::::::::::::::: .'.. 88 p r6„`SDR 35\ ' p bRkN PIPE \ INSPECTION 99.19 PORT TYP. 3 SCH. 40 PVC — \ \ \ TP5 ( ) FORCE MAIN \ \ jr .: . :.;; N/F DONOVAN LIMIT. OF SAND 99.05 Lo 98 D --•X — — --- -B 7---�TP2 / 99`04 — — —A �' 98.86 / 96.37/ 54' ss' _._. _,_ .---- ------ - ' 18/8.81 c9� \ CLEANOUTS (TYP.) x8.76 TP3 PT1 // N 50 14"W \ 98.70 TP 1 �, 40 MIL/IMPE� IOUS �4 PT1B / BARRIER / 94.56 - / \ � _ - - - - - - - - - - - - - - - 98_35— _ — — — i — — — — — — — — — — — — — — — — — — — N/F CARR 210' 0 2 0' 410' 6.0 1 :i t(j5 INSTALL SWALE TO CORRECT DRAINAGE PROPOSEDlAp��tic COVERED DECK c�� X0, BENCHMAI ON SONO TUBES �oG.p ELEV. 10( a • 9�G3, EXISTING SEPTIC TANK 1000 GALLON 0 h 9�q W PUMP CHAMBER cF C3� co 0 p' / TP4 1500 GALLON MICRO FAST N SEPTIC TANK ,2 Uj INSPECTION 0 PORT {TYP.) I CLEANOUTS (TYP.) :EXISTING LIMIT OF SANDRIWR .......... (SEE CONST. NOTE #3) ` ....................... 1 .................. --------- -- - - O p' _ .................... .................. TP5 APPROXIMATE LOCATION OF 3NOVAN \ EXISTING LEACH AREA 04 THRUST BI _ _ ,4 (TYP.) 9 -- 68' __- 98-80 44' i 8 97 18 z TP3 o PT1 97+.52TP j N35002 94, 9g — = _ _ — _ PT16— TP1 _ 0 MIL IMPERVIOUS , - - - - - - - � � BARRIER a ` � ' N/F CARR � c- TP3 TOP OF PIT ELEV. 98.74 ZON SOIL TEXTURE SOIL COLOR SOIL MOTTLING S --- @79" 5YR 5/8 G S L 2.5YR 5/4 10YR 5/6 TP4 TOP OF PIT ELEV. 99.46 TP5 APPROXIMATE LOCATION OF NIF DONOVAN \ i EXISTING LEACH AREA - I - - 98 68' --__ • ° 44' TP3 o /-PT1 a 6 _ 9'7-- — _ _ PT1 B TP1 _ N/F CARR ESHGW 92.16 TP3 TOP OF PIT ELEV. 98.74 DEPTH SOIL HORIZON SOIL TEXTURE SOIL COLOR SOIL MOTTLING 0"-62" FILL S NNN 079" 5YR 5/8 62"-115" C G S L 2.5YR 5/4 lOYR 5/6 REFUSAL ® 115" ESHGW 94.63 TP4 TOP OF PIT ELEV. 99.46 DEPTH SOIL HORIZON SOIL TEXTURE SOIL COLOR SOIL MOTTLING 0"-48" FILL --- 48"-58" C S L 10YR 5/6 NONE OBSERVED REFUSAL @ 58" ESHGW 95.98 TP5 TOP OF PIT ELEV. 98.65 DEPTH SOIL HORIZON SOIL TEXTURE SOIL COLOR SOIL MOTTLING 0"-19" FILL --- 119"-32" C S L 7.5YR 5/6 NONE OBSERVED REFUSAL ® 32" ,REW MCBREARTY, MILL RIVER CONSULTANTS i OVED BY THE DEPARTMENT OF ENVIRONMENTAL PROTECTION AND THAT EXPERTISE, AND EXPERIENCE DESCRIBED IN 310 CMR 15.017. HORIZONS,'EXTEN'ING 6" INTO THE B LAYER, SHALL- vBE REMOVED vWITHIN A�5GFOOTJHORIZONTAL DISTANCE FROM THE I SOIL ABSORPTION SYSTEM AND REPLACED WITH SAND MEETING THE GRADATION REQUIREMENTS OF TITLE 5, SECTION 15.255 PARAGRAPH 3 AS REVISED ON OCTOBER 20, 1995. TOP OF SAND SHALL BE AT THE SAME ELEVATION AS THE TOP OF INFILTRATOR CHAMBERS. 4. FILL USED SHALL BE CLEAN AND FREE FROM LARGE STONES,`CONSTRUCTION DEBRIS, STUMPS, OR OTHER DELETERIOUS MATERIALS. 5. UNDERGROUND UTILITIES SHALL BE LOCATED PRIOR TO CONSTRUCTION. LOCATIONS SHOWN ARE APPROXIMATE. RELOCATION OF UTILITIES, IF REQUIRED, IS PART OF THE INSTALLATION CONTRACT. I 6. DISTURBED AREAS, INCLUDING THOSE DAMAGED BY VEHICLES AND EQUIPMENT ACCESSING STE, SHALL BE FINISH GRADED AS SHOWN AND TOPPED WITH 4 INCHES OF TOPSOIL, RAKED FREE OF STONES, FERTILIZEDAND SEEDED. EXISTING TOPSOIL SHALL REMAIN ON SITE. 7. TREES, BRUSH, SHRUBS, AND OTHER VEGETATION SHALL BE CUT. FLUSH TO THE GROUND. STUMPS SHALL BE REMOVED. CLEARED MATERIALS AND EXCESS SOILS MATERIALS SHALL BE DISPOSED OF OFF SITE. 8. BENCHMARK: TOP RIGHT CORNER OF CONCRETE PAD. ELEV. 100.00 (ASSUMED DATUM). 9. FILL UNDER THE SEPTIC TANK, PUMP CHAMBER, & DISTRIBUTION BOX SHALL BE PLACED IN 12" LIFTS AND MECHANICALLY COMPACTED. 10. EXISTING SEPTIC TANK SHALL BE PUMPED, CRUSHED, REMOVED, AND DISPOSED OF PROPERLY OFF SITE. 11. PIPE PENETRATIONS IN FOUNDATION, SEPTIC TANK, PUMP CHAMBER, & DISTRIBUTION BOX SHALL BE SEALED WITH HYDRAULIC CEMENT. 12. INTERIOR PLUMBING SHALL BE IN ACCORDANCE TO STATE PLUMBING CODE 248 CMR 200. SEWAGE FLOW, INCLUDING GRAY WATER DISCHARGE SHALL BE CONNECTED TO NEW SYSTEM. 13. ALL PIPING SHALL BE GLUED JOINT WATERTIGHT SCH. 40 PVC LAID IN A STRAIGHT LINE AT A CONSISTENT GRADE ON A FINE COMPACT BASE. 14. CONTRACTOR MUST BE TRAINED AND CERTIFIED BY THE MANUFACTURER TO INSTALL INFILTRATOR SYSTEMS. CONTACT GUY DALTON AT (888) 886-7704 FOR INFILTRATOR AND CERTIFICATION INFORMATION. 15. 40 MIL IMPERVIOUS BARRIER SHALL BE MODEL # MBE40M AS MANUFACTURED BY MILLER ENVIRONMENTAL PRODUCTS, OR APPROVED EQUAL. CONTACT JEFFREY MILLER FOR PRODUCT INFORMATION (508) 697-3710. 16. THRUST BLOCKS SHALL BE INSTALLED AT EACH BEND OF 3" SCH. 40 PVC FORCE MAIN. SOIL LOG ESHGW 91.54 TP1 TOP OF PIT ELEV. 97.87 DEPTH SOIL HORIZON SOIL TEXTURE SOIL COLOR SOIL MOTTLING 0"-4C7" FILL NN --- 47"-50" Ol --- --- 50"-52" A S L 10YR 3/2 52"-55" BI S L 7.5YR 4/6 55"-65" B2 F S L 2.5Y 5/4 NONE OBSERVED 65"-76" IC S L 2.5Y 5/4 REFUSAL ® 76" ESHGW 92.80 TP2 TOP OF PIT ELEV. 96.97 DEPTH SOIL HORIZON SOIL TEXTURE SOIL COLOR SOIL MOTTLING A S L 10YR 2/2 8"-28" BW S L 10YR 5/3 28"-50" C S L 7.5YR 4/6 NONE OBSERVED REFUSAL @ 50" TEST PITS PERFORMED ON 6/8/05 BY THOMAS K. HECTOR, AND WITNESSED E I CERTIFY THAT ON NOVEMBER 9, 2004 1 PASSED THE SOIL EVALUATOR EXAMINAT0 THE ABOVE ANALYSIS WAS PERFORMED BY ME CONSISTENT WITH THE REQUIRED TRA �����---�-_DATE------- 0 1 II f STEEL WALL POOL SYSTEM "T t� 20' X 40' RECTANGLE - 2'R 40'-0" ' DWG#: GS-1010 I DATE: 1/21/2008 REV: - PAGE 2 OFT TURNBUCKLE BRACE - 8'-0� ST-4800 ST-9602 ST-9602 ST-9602 2' ST-2400CR (4 PLC) STEEL PODL PANEL TURNBUCKLE I PIECE 4'-0" ANGLE BRACE - A CONCRETE 41'-2 114" DEaouaN N,41 - 42'- 5/8" 44'-8 5/8" P ATE 20'-0' Sl•F1!>02L 11 011 EMBEDDED NUT BRAG DL'" ST-4800 EMBEDDED NU STEEL POOL PANEL CONCRETE FOOTER 2'POOL BASE ST-4800 ST-9602 ST-1602 ST-9602 STAKE -RACES&DECK SUPPORTS DECK SUPPORT(OPTIONAL) AT PANEL JOINTS AS SHOWN 3'-4" 4'-0"�+--6'-0"--►f- 14'-0" 16' THIS DOCUMENT IS FOR ILLUSTRATIVE PURPOSES ONLY. No DIVING ORESUS ANGER•plYlAt6 IN SERIOUWlMAY � Alpha 3 Mfg.makes only those representations which are stated in its written warranty.Any other representations,statements.or contracts made by the dealer/contractor to the customer regarding any components produ attributable to the dealer/contractor only.The dealer or contractor who sells or installs your pool is an independent contractor and Is not an agent or employee of Alpha 3.The construction methods illustrated here are sugl INJURY OR.d EATN. to normal ground conditions.There may be additional precautions and/or methods of construction.The responsibility Is the contractor's.-A safety line,with buoys,is to be permanently attached V-0"to the shallow side of Signage must be permanently attached around the change.-Different methods and precautions may be dictated by various ground conditions.This Is to be determined by and Is the responsibility of the contractor who is not an agent of the manufacturer of the component I be done in accordance with all federal,state and local building codes,as well as A.N.S.I./N.S.P.I.suggested standards.-BOTTOM SPECIFICATIONS MUST MEET OR EXCEED A.N.S.I./N.S.P.I./A.P.S.P.RECOMMENDED STAN: perimeter Of the pool. signage must be permanently attached to the entire perimeter of the pool.See instructions with signage.-IT IS NOT RECOMMENDED TO USE DIVING AND/OR SLIDING EQUIPMENT ON RESIDENTIAL POOLS. 40'-0" yr d r ST-4800 ST-9602 ST-9602 ST-9602 ST-9602 � I- 41'-21/4" ST-2400CR (4 PLC) 41'-2 1/4" ST-4800 ST-4800 42'- 5/B" 44'-8 5/8" 20'-0" ST-9602L 1' 0" FS-9604SBW ST-4800 ST-4800 22 ST-4800 ST-9602 ST-9602 ST-9602 ST-9602 RACES &DECK SUPPORTS f AT PANEL JOINTS AS SHOWN 3'-4" T-4" 41-0.1-�---6'-0" 14'-0" !tfl'i tt,l'!i IINI Y f; a W1111 If mu Wntud In Its written warranty.Any other representations,statements,or contracts made by the dealer/contractor to the customer regarding any components produced by Alpha 3 are 1 a i1nalfil in a 11111 utel Ui who sells or installs your pool is an independent contractor and is not an agent or employee of Alpha 3.The construction methods illustrated here are suggestions and apply only a 1 Illinnel pmcminom.and/ui methods of construction.The responsibility is the contractor's.-A safety line,with buoys,is to be permanently attached V-0"to the shallow side of the point of first slope -.r In, I r Unna by V1,11"11!;Ilround conditions.This is to be determined by and is the responsibility of the contractor who is not an agent of the manufacturer of the component parts.-Installation is to - I 1 u Iii{I i ndir: e•:wnll n:A.N.S.I./N.S.P.I.suggested standards.-BOTTOM SPECIFICATIONS MUST MEET OR EXCEED A.N.S.I./N.S.P.I./A.P.S.P.RECOMMENDED STANDARDS-'NO DIVING' -y ou 1 :uendni ul 11 pool,Sno Instructions with signage.-IT IS NOT RECOMMENDED TO USE DIVING AND/OR SLIDING EQUIPMENT ON RESIDENTIAL POOLS. 01PIMCYN�'P,ei e North Andover MIMAP October 28, 2014 ti 4 - . r v I JY i - .. _.. k c ` � r. r ti . sg m r e¢ r, n ,m w Interstates —I —SR Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, Roads Meters Data Sources:The data for this map was produced by Merrimack `(QtILbF Valley Planning Commission(MVPC)using data provided by the Town of rEasemenis �f North Andover.Additional data provided by the Executive Office of �swsta•t �MVPG Boundary ?'s - ss QEnvironmental Affairs/MassGIS.The information depicted on this map is OParcels 3 e for planning purposes only.It may not be adequate for legal boundary - g definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING # THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT *o of i ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION 1"=238ft The Commonwealth of Massachusetts Department ofIndustrialAccidents Office of Investigations 600 Washington Street Boston,MA. 02111 www.mass gov/dia 'workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/lndividual): *&Z& Id Address: -its 310 City/State/Zip:L w-,, . ,c, AxA. 0(jyj Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1. R I am a employer with (3(0 4. ❑ I am a general contractor and I 6. [kNew construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. �• ❑Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity, workers' comp.insurance. 9. E]Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.El 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.E]Roof repairs insurance required.]t employees.[No workers' 13Other opez_Q comp.insurance required.] .� 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 1Contractors 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 is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: WW C '3a-7 Expiration Date: ( Z-3 ) -I q Job Site Address: (3(Z eA liAA S-L) City/State/Zip: A Lt� qa'. at g Y J— 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 cert&under the pains and penalties ofperjury that the information provided above is true and correct. Si ature: Date: 0,C+ &0 Phone#• - (o Official 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#: Information and Instructions ' Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee 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." MGL 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,MGL 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 with 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-contractors)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 maybe 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 permit 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 Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(ifnecessary)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.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office 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. The Department's address,telephone and fax number: The CommonweaftbLofMassachvsetls Department of Industrial Accidents Office ofjavestigatioas 600 Washington.Street Boston,M.A.02111. TOL#617-727-4900 oyt 406 or 1-877:MASS.AFB Revised 5-26-05 Fax#617-727-7749 wtvwmass,govldia Client#:53642 FAMILYPOOLI ACORD. CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDIYYYYl 10/06/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the pollcy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT HUB International New England PHONE A C No,Ext:978 657-5100 Arc No): 866-475-7959 Wil ingtodvale St ADDRESS: nee.certificates@hubinternational.com Wilmington,MA 01887 978 657.5100 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Valley Forge 20508 INSURED INSURER B:Technology Insurance Co Family Pools&Patios Inc. INSURER C:Safety Insurance Co 39454 Family Pools North LLC eta/ 70 S.Broadway INSURER D: E: Lawrence,MA 01843 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUB POLICY EFF POLIO EXP LTR TYPE OF INSURANCE INS D POLICY NUMBER MMIDD MMIDD LIMITS A GENERAL LIABILITY 6015920803 9/19/2014 09/19/2015 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMES �RENTED I a occurrence $100,000 CLAIMS-MADE F�OCCUR MED EXP(Any one person) $5,000 X Blanket Addl Insured as contractually required PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $2,000,000 17 POLICY PRO- JECT LOC $ C AUTOMOBILE LIABILITY 3947232 12/31/2013 12/31/201 EO aBcl d.n SINGLE LIMIT $1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDX SCHEDULED AUTOS AUTOS (BODILY INJURY Per accident) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per accident) ccident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION WWC3074055 1213112013 12/31/201 X we STATU- OH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERNEMBER EXCLUDED? � NIA E.L.EACH ACCIDENT $500OOO (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 A Property 6015920803 9/19/2014 09/19/201 vrs limits Spec Form Repl Cost Ded$1000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more apace Is required) Workers Compensation has Blanket Waiver of Subrogation,as required by executed contract.Work in NY is excluded; new construction of 10+units is excluded. RE:Jennifer&Mike Cronin,1312 Salem Street, North Andover,MA CERTIFICATE HOLDER CANCELLATION Town of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 Osgood Street,Building 20, ACCORDANCE WITH THE POLICY PROVISIONS. Suite 2035 North Andover,MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 Of 1 The ACORD name and logo are registered marks of ACORD #S1229309/M1226695 DKO04 9 ��iaSµ�C ,zG 'G 'eCc Pi♦' "� ..,.,�, _. V..U. Construction Supcn isor _S: CS-010330 WHI I"CPOULOS 1 70 S BROADWAY LAWRENCE Mk 01843 07/19/2015 —�A � 17'd�"� i�:�a'�i,2�'Z f1 d�,�fl-���`C���,• � /�� Office of Consumer Affairs band� 'Busin�ess Regulation V0, 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 118204 Type: Supplement Card Expiration: 2/13/2015 FAMILY POOLS & PATIOS INC GLEN WIGGIN -- 70 S. BROADWAY LAWRENCE, MA 01843 Update Address and return card.Mark reason for change. SCA _^ torr-oe i ; Address j-I Renewal I Employment Lost Card �(ffice of Consumer AiTairs&Business Regulation License or registration valid for individul use only '$ME IMPROVEMENT CONTRACTOR before the expiration date. 1f found return to: Office of Consumer Affairs and Business Regulation Registration: 118204 Type 10 Park Plaza-Suite 5170 Expiration: 2/13/2015 Supplement _'ard Boston,MA OZ 116 FAMILY POOLS&PATIOS INC GLEN WIGGIN 70 S.BROADWAY LAWRENCE MA 01843 -- ~ ^`- Undersecretary Not valid without signaty Y 70 Soutli Broadway 45 Route 125 Lawrence,MA 01.843Kingston,NH 03848 Tel: 978-688-8307bid? - Tel: 603-642-9909 Fax: 978-688-1949 since i��a Fax: 603-642-9906 providing a full line of services and supplies Fully licensed and insured www.familypoolsonline.eom Name �LK ezG� _ Date ZZ lest ZOt L{ Address I a'1?. 'Sai tL", T _ City A"tJAtd State 1VA-" Zip 18 qs Nome Phone -D_-_�� - XIA Work Phone — Cell 7-q & i�7y Addl#-- h rr Cross Street/Directions 6 it MQ_a Ave 'VV Estimated Start Date — _ _. Estimated Completion Date We propose to furnish and install on< in unite ?;&-),e I �— swimming pool for the sum of$ "Z-t`�vz) 2.v �c THIS PRICE INCLUDES: •Normal Excavation up to 8 hours on day of dig •Manual vacuum cleaner kit •Waterline Tile(6') •Backfill and Sub-Grade up to 3 hours •3-Step stainless ladder •Liner Choice 2-$ 25 ✓K. tgradaauatsr*WJaita•6igHfoft' •Rope and floats •Test Kit •Steel Reinforcing per Engineered Plans for gunite •Initial balancing chemicals •Surface skimmer(s) 2— Steel Steel Structure per Engineered Plans for vinyl •8 to 12 Wk supply of maintenance chemicals •Dual Main Drains •Over-Flo Line for added protection (supply depends on pool size) •Coping •Pressure testing of plumbing during construction •Leaf net •Steps r -# • ZxTen Year Plumbing Guarantee(see specifications) •Wall brush •Handrai s, •Transferable Lifetime Structural Warranty •Extension pole •Filter_ (plumbed no more thap 25ft from pool) •Pump&motor�_(a_ __ \� r 1i THIS PRICE DOES NOT INCLUDE: HA i 1-V�S i •Any plumbing over 25ft from pool.Additional runs are not recommended but would be at a cost of$ per foot per line. •Machine time in excess of that specified above.Additional machine time to be billed at$ ll(' including machine,operator,and laborer,due with second pool payment. •All hours of trucking will be charged at$Su per hour per truck due with second pool payment. •Any dumping costs incurred for disposal of ledge,large rocks,garbage,stumps buried or otherwise,building materials,unsuitable or nonstructural soils,or any unforeseen material that must be removed. •Removal of ledge or large rocks by way of a Starr bit,chipper,or blasting. •Additional fill,if necessary,for proper backfill or reshaping of hole,supply or spreading of loam,reseeding of grass. •Patio,fence,retaining wall,or any accessory items other than noted on contract. •Electrical wiring,fuel connections,heater venting,fuel storage tanks or permits. •Repair or replacement of sprinkler systems or any buried items such as well lines,drywells,leach fields,electrical lines,cables,etc.that are damaged during construction •Costs due to water or soil conditions(ex.clay,peat,live sand,excessive rock,etc.)requiring a stone pack of the hole.The stone pack will be at an extra charge of$__- Gt) minimum to $_ maximum and at the discretion of the job supervisor.Additional machine time and/or materials necessary to rectify such a condition will be at a cost over and above the stone pack and will be quoted by the job supervisor. •Water to fill pool. _Initials CUSTOMERS MUST SUPPLY: •Access for all trucks and equipment •Building and Electrical Permits or assume the costs necessary to obtain such permits. •Water and electric necessary for construction of pool •Customer mustwater cure Gunite shell for 7 to 10 days if applicable. •Water to fill pool immediately upon interior finish i j (� l NOTES: t u, ( ii-t f -A It i 1 t�. �5 r r D�fA�1-!° �C c���, � 4�t� C (V Cf�.V OPTIONS: TOTALS: Diving Board ( } Solar Cover t1n,�( �0 } 1 Basic Pool Price $ Additional Pool Lighting } Aja._! k ..�Ivh�Q„ Li�;"t„p Options $_ Heater Environpool Plus,8 hd+2 surface SUBTOTAL $ Additional Floor Heads ( ) _ Polaris Vac-Sweep i� %Sales Tax $ 10,3 -` Polaris retrofit only ( � ) -- TOTAL $ c2 9 8 0 3 lBench �G:rYnt`�t ��d Interior Finish ) "' Less 10%Deposit Spa ( _ �. Balance of CogUact $ �e 'D -5 y Automated Control System ( ) _ Salt Chlorine Generator ( ,{-� 6 of'tit 6 1 • Other LAO n PAYMENTS: 113 EXCAVATION 113 BACKFILL+ EXTRAS .(11133 SYSTEM START UP�4 'y I The buyer hereby agrees to pay, in full,the total amount of this transaction upon start-up of the installed pool.Your salesman or job supervisor will meet with you prior to excavation at which time all decisions including pool size,shape,elevation, liner print,and all options must be final.Changes after this date will be subject to extra charges,where applicable, and will result in unavoidable delays.You,the Buyer, may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction.Credit card payments not accepted on contract amount. Z-L to 47C" BUYER sate a Z 1 SELLE `^ ` _ date? CO-BUYER date