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HomeMy WebLinkAboutBuilding Permit #194-2016 - 163 SUMMER STREET 8/14/2015 BUILDING PERMIT NORTH O�,t�eo 6 gti0 tV� ) AW TOWN OF NORTH ANDOVER �~ APPLICATION FOR PLAN EXAMINATION /ply— Z� z -e * O • , Permit No#: Date Received '�AAORwreo IP"'•(`� gSSACHU$�� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION l b3 SU A4 A'` eW- S I Print PROPERTY OWNER f ►Gha //a 4 r/ Print 100 Year Structure yes Ono MAP _PARCEL: s ZONING DISTRICT: 4 Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition [/Other ❑ Septic ❑Well ❑ Floodplain. ❑Wetlands ❑ Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: x 2g Eow Alovf 9KOv- poo L_ C4 rw 1-f 5ectye 20 OU-M a L iAt AvSid"3 %Ilej Alt✓er Identification- Please Type or Print Clearly OWNER: Name:_ M CO.� �� Phone: 7'I$ 2oK 1y?f Address: 3 v Nn • 44vu- M Contractor Name: Gibr-q I fiw bo 15 Co!� Phone: 7 ?� r�g7 2 7 / Email: e e-0 V5,15wim. co Address:' 13f Ao Xt t 7�03flf- 44A 012 8 3 Supervisor's Construction Licenser AAd!t Exp. Date: w�q' Home Improvement License: l 2-?y3 I Exp. Date: ARCHITECT/ENGINEER x/14- Phone: v/# Address: M14 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: $ 23,-7 YS• 0-0 FEE: $ 1�i% Check No.: 347 -3!�J Receipt No.: ��7 T/E_• �j Persons contracting with unregistered contractors do of have access to the egguaranty fun • Q.�/�J,Q�tt,.n,�d�a-- �I�rw(' �oo J Co .� ,.�c�.'�r"� ���.s��✓���3 C.� 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 /j Signatur COMMENTS \//'ZCONSERVATION Reviewed on Signature C M MEN TS \AJ-C�aAJ (CcozW/ J� �GL�- U� Poo) � � HEALTH Reviewed on Si �Qr ©r � C ENTS V�X� Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes r-' S Planning Board Decision: Comments 'Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: :E it # Tern-p- Durm��ps.�te�r o�ntsite� y�esE� � �Located a�3�n4o Osgood reet ,LF MNT _ --r-�,- ted at 21,4 CA 9 in Str'eet�, .x �F.¢re Depa mn sig,nraa�tc-u e� ?g®MIVIOn-ft St� =q .x _ ;T �n�__ ti.�` 7 . : 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) ❑ Notified foricku Call p p Email Date Time Contact Name Doe.Building Permit Revised 2014 Building Department 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 Copy of Contract *or Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: 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 ,4. Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) Building Permit Application 4, Certified Proposed Plot Plan 4. 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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 a (5 Location /f,-3 -� No. ` �dI Date J7 • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 2920 4 .Building Inspector Enter construction cost for fee cal - North Andover Fee Cakulat%On Construction Cost $ 23,745.00 m $ - $ 284.94 Plumbing Fee $ 35.62 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 35.62 Total fees collected $ 456.18 163 Summer Street 194-2016 on 8/14/15 Pool r 1 NORTH - w: :. . : � � : :. .c . : ver. 0 , No. 20 (� t _ L�K. h ," ver, Mass, ?//+#//,Vo Al COCHICA WICK y1• �7S R�TEO ►'Pa,�'�y , 7 V BOARD OF HEALTH Food/Kitchen ' PERMIT T LD Septic System /� THIS CERTIFIES THAT ......,� .�..`.�.Mo.Al A,�Y...................................................................... BUILDING INSPECTOR . .. ..'................ Foundation -has permission to erect .......................... buildings on .... �/.�.�/' ,�� Rough to be occupied as ........-04 4.60*.... /' .4tintvery(espect . ..�� ..................................................... Chimney provided that the person accepting this petit shall 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 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO ARTS 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. 1..F444 f 4..A•1rv..rP�,,,,;�.tld.v! yti..I:,�:��"r„ d ;r-: t For Marketing Dept. Use Only Jpi Gibraltar Pools & Spas J Where Buyer Heard About Gibraltar: -�f POOLS • HOT TUBS • SAUNAS 1'r�C..S�C�rL Buyer initials: o ' 2. 1. U.S.Route 1•435 Boston Street•Topsfield,MA 01983•(978)887-2424•www.usaswim.com 3. 2, Date VS 20 Buyer's E-mail: �CQ�/AA 17 R AC/e �ii. �d W Buyer I's Name and Phone Number Buyer 2's Name Ado. E Gn l U/�f Cr ,✓ � Mailing Address(Street, Town,State and Zip Code) Physical Address(Stre , Town,State and Zip Code) I We hereby agree to sell,and Buyer and any Co-Buyer shown above agree to buy in good faith subject to the terms and conditions set forth below and upon the reverse side hereof,the following: i i Your pool has the features and accessories checked below: SWIM AREA OUTSIDE DIMENSIONS X Z Pq I- L 311%,L ,2Q / p''G-90 Steel Buttresses and Supports 144I46REMIUM Filtration System: M4acuum Equipment With Baked Acrylic Finish McDeluxe High Rate Q'Dual Bottom Drains interlocking G-90 Steel Side Panels IJ Standard CB-,Aluminum Coping Aluminum Fence Virgin Vinyl Printed Liner 5-16urnp t�ln Pool badder.StF0.fL S?t JPS alflush In-Wall Skimmer Y6eluxe aiRless'Steel°- W''Deck(Patio and Full Promenades) ❑Standard 9 Alerrainum 271,U2" Bottom Leveling Channel (9�tarter Chemicals Skim Net minum Outside Ladder &lest Kit • • &Approximate 4'Wall i• Your pool includes only those features and accessories specifically stated herein and those included by the manufacturer unless otherwise indicated in writing in this agreement. ASSEMBLY:Your pool will be assembled by ❑you us ' • ' ' • ' 111011.110 • LOCATION OF YOUR POOL:Your pool will be assembled at Buyer 1's address stated above or, if not,at 1.Price of pool $23. RL v 1) AQ_ &I "CO 0Ao 1_tJt 7;, 2.Trade-in description, if applicable $ N 3. Net price of pool $2. . t -T 4.Sales tax (�y /.rel $ i Y t j,v 6 I'MICL &J144fA112403 PLAX 5.Total price(3 plus 4) $25 229. �A/CL-. JO t-/t'K JQEEL-r 6. Initial deposit❑4,000❑2,000❑other $ O Cash O Check El Visa O Master Card O Am.Express C1 Discover 7.Total Balance due(5 less 6) $ " lWf OA4 0 y ,,p)( S 8.Amount due on or before delivery $ (f cash sale,7 less$1000) 9.Amount due on completion and/or financed $ (if cash sale,$1000) See associated finance documents,if any,and the provision on the reverse side ereof entitled"Credit application and finance documents". SOME OF BUYER'S RESPONSIBILITIES: You will supp!y water and electrical connections,and removal of excess dirt,sand,and pack- aging materials. You are responsible for obtaining, at your expense, all permits (including building permit), authorizations, licenses, appraisals,title searches and other documentation required by law,or any government agency,or any finance institution.You agree to reimburse us for any such costs paid by us on your behalf.Buyer(s)warrant the clear title of any trade-in,and warrant that it is free of all liens • - By signing this agreement,you acknowledge receipt of a completely filled in copy of this agreement,two completed copies of the attached notice of cancellation and confirm that you have been orally informed of your right to cancel;and that you have read and understood completely the front-and`back of this agreement. Signature of Buyer 1 Independent Salesperson r Signature of Buyer 2 Signature of an Officer of raltar Pools Corp. NOTICE OF CANCELLATION YOU MAY CANCEL THIS TRANSACTION, WITHOUT ANY PENALTY OR OBLIGATION, WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE. IF YOU CANCEL, ANY PROPERTY TRADED IN, ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OF SALE, AND ANY NEGOTIABLE INSTRUMENT EXECUTED BY YOU WILL BE RETURNED WITHIN 10 BUSINESS DAYS FOLLOWING RECEIPT BY US OF YOUR CANCELLATION NOTICE, AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED. IF YOU CANCEL, YOU MUST MAKE AVAILABLE TO US AT YOUR RESIDENCE, IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED, ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OF SALE, OR YOU MAY, IF YOU WISH, COMPLY WITH OUR INSTRUCTIONS REGARDING THE RETURN SHIPMENT OF THE GOODS AT OUR EXPENSE AND RISK. IF YOU DO MAKE THE GOODS AVAILABLE TO US AND WE DO NOT PICK THEM UP WITHIN 20 DAYS OF THE DATE OF YOUR NOTICE OF CANCELLATION, YOU MAY RETURN OR DISPOSE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION. IF YOU FAIL TO MAKE THE GOODS AVAILABLE TO US, OR IF YOU AGREE TO RETURN THE GOODS TO US AND FAIL TO DO SO, THEN YOU REMAIN LIABLE FOR PERFORMANCE OF ALL OBLIGATIONS UNDER THIS CONTRACT. TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE, OR SEND A TELEGRAM, TO GIBRALTAR POOLS CORPORATION, 435 BOSTON STREET, TOPSFIELD, MA 01983 NOT LATER THAN MIDNIGHT OF0 — /q — fS (Date) I HEREBY CANCEL THIS TRANSACTION (Date) (Buyer's signature) TERMS AND CONDITIONS Meaning of some words. In this agreement,the words"you"and"your"mean anyone signing this agreement as Buyer.The words"we","us" and"our"mean Gibraltar Pools Corp."Salesperson"means an independent salesperson under contract to us. Acceptance of this agreement and delays.This written agreement is binding and effective upon signing by the Buyer(s),subject to a condition subsequent,that is,confirming acceptance in writing by an officer of Gibraltar Pools Corp.If it is not accepted by an officer in writing,or if at any time we encounter ground conditions or other conditions which we, in our sole discretion,determine makes assembling your pool not feasible or prudent in the circumstances, we have the right to cancel this agreement, pick up any materials delivered to you, and our liability, if any, is expressly limited to the amount actually received of your down payment.We will have no liability for any delay beyond our reasonable control in delivering or assembling your pool.If any material that is part of your pool or used in assembling it is unavailable for any reason beyond our reasonable control,we can substitute material of equal or greater value or quality. Damages.If,after we accept your offer to buy a pool,you wrongfully cancel this agreement,you refuse delivery of your pool,you breach your obligation of good faith,or we are unable,through your action or inaction,or other breach by you of this agreement,to assemble your pool,you will pay us for lost profit and out-of-pocket expenses.Our lost profit will be equal to 20%of the total price of your pool, unless a lesser amount is required by law. Guarantee.Any Buyer signing this agreement guarantees payment of all amounts owing under this agreement.This means any Buyer signing this agreement will immediately pay any amount owing under this agreement that becomes overdue, whether or not we try to collect it from anyone else. No notice of loss of rights.We do not have to tell you if any amount owing under this agreement is not paid by the day it becomes due.We can exercise any right against you or your pool without losing any other right against you or your pool.We can do any of the following without telling you or losing any right against you or your pool: 1.Accept a check or order marked"paid in full"or with similar language as a payment under this agreement. 2.Give additional time for payment of any amount owing under this agreement. 3.Give up or delay any right against you or your pool. Collection costs. If we use an attorney or collection agency to collect any amount owing under this agreement, you will pay us an amount equal to reasonable attorney fees and/or actual collection agency costs and any court costs we have to pay.The amount of the attorney fee will be equal to 20%of the amount owing unless a court sets a smaller or larger fee.Under this agreement, upon substantial performance by us, full and final payment becomes due and Buyer(s)are required to sign promptly the completion certificate form(s) required by the relevant financing institution and by us. No landscaping.We do not perform any landscaping or other forms of yard work, nor do we sell or provide related materials. Underground.In excavating your site,we are not responsible for any damage to lawns,pipes,wires,underground structures and materials and the like.SUCH WORK IS PERFORMED ONLY AT OWNER'S RISK. Ground Drainage.Although highly unlikely, it is possible that environmental conditions could cause frost damage to your pool.All cases are different.For example,the pool may shift or move or be damaged due to frost,which can be particularly severe where there is improper drain- age or wet ground conditions in your yard and in the pool site area selected by you.Gibraltar disclaims any and all liability and responsibility for frost damage and/or for any damage in whole or in part due to frost, yard water, adverse topographical conditions, improper drainage, or homeowner's negligent landscaping. Changes.Any change in this agreement must be put in writing and signed by a corporate officer.We may correct obvious errors in this agree- ment,such as sales tax calculations. Continued effectiveness.If any part of this agreement is determined by a court to be invalid,the rest will remain in effect. What law applies.Any legal question about this agreement will be decided according to the law of the state where the contract is executed. Responsibility.You and everyone else signing this agreement as Buyers will be,individually and together,liable under it.We can sue you under this agreement even if we do not sue anyone else. Excess material.Any material which we deliver but do not use in assembling your pool will remain our property,except sand and similar ma- terials and packaging materials. Entire agreement.Except for the written manufacturer's Limited Warranty delivered by us and financing documents used in connection with the purchase of your pool,this agreement is the final and complete agreement between you and us concerning your pool.ANY ORAL OR WRIT TEN STATEMENT CONCERNING YOUR POOL BY A SALESPERSON IS NOT A WARRANTY AND IS NOT PART OFTHIS AGREEMENT, UNLESS IT IS SPECIFICALLY STATED HEREIN AND APPROVED BY A CORPORATE OFFICER IN WRITING. Warranties.We make no warranty concerning your pool or any other matter,except that the swimming pool and accessories described in this agreement are the ones being bought under this agreement and except for the written manufacturer's Limited Warranty delivered by us.ANY WARRANTY OF MERCHANTABILITY AND ANY WARRANTY THATYOU R POOL IS FIT FOR A PARTICULAR PURPOSE WILL BE LIMITED IN DURATIONTOTHE PERIOD OFTHE WARRANTY MADE INTHE WRITTEN MANUFACTURER'S LIMITED WARRANTY.A"WARRANTY OF MERCHANTABILITY"IS A WARRANTYTHAT PROPERTY IS FIT FORTHE ORDINARY PURPOSES FOR WHICH PROPERTY OF THE SAME SORT IS USED.IFYOUR POOL OR ANY ITEM IS MANUFACTURED BY SOMEONE OTHERTHAN US,ONLYTHAT PERSON WILL BE LIABLE UNDER ANY WARRANTY MADE BY THAT PERSON TO YOU OR TO US. Credit application and finance documents.In connection with any application made for credit for the purpose of financing your pool or any update,extension or renewal of any credit we extend to you as a result of any application,a credit report may be requested from a credit reporting agency and submitted to one or more financial institutions at our sole discretion.Upon request,we will tell you if a credit report was requested, and if so,the name and address of the credit reporting agency furnishing the credit report.To request information,write Gibraltar Pools Corp., Credit Manager.If we expend effort at your request or with your consent to obtain approval of your credit for a loan to finance your pool,prior to and upon approval by any financial institution of your credit,you agree to cooperate in good faith promptly and fully as necessary to complete and/or correct and sign financing and related documents required by the approving financial institution and similarly cooperate in supplying such credit-related documentation and information requested by such institution.If you deliberately furnish us with untruthful or misleading information during the credit process,a financing approval could be nullified.In that case, payment would be due immediately. Our obligations if we assemble your pool. If we assemble your pool, we will level the ground on which your pool will be assembled, but our responsibility will be limited to a reasonable leveling of plain dirt only.We can level the ground by fill or grading, at our discretion.You are responsible for the complete removal of any trees and the entire stump(s)at your sole expense.We will assemble your pool and provide pool fittings to enable you to make any necessary electrical connections. Your obligations if we assemble your pool.If we are to assemble your pool,you will apply for and obtain,at your expense,all permits,authori- zations,licenses,and appraisals required by law or any government agency,or any finance institution.You will be responsible for removal of any excess dirt,sand and packaging materials.YOU WILL PAY US FOR ANY ADDITIONAL EXPENSE OTHERTHAN REASONABLE LEVELING OF PLAIN DIRT IN PREPARING THE GROUND ON WHICH YOUR POOL WILL BE ASSEMBLED.You will be responsible for correcting any existing or resulting violation of any zoning,building,electrical,plumbing or other code.You are responsible for providing adequate drawings of the pool site selected by you.You agree to obtain any consent for us to enter any neighbor's property if we need to do so to assemble your pool. You are solely responsible for informing us of,and for satisfying,any and all setback(and related)requirements;and further,you agree to hold us,our employees and our suppliers and contractors harmless from any and all claims and liabilities in any way related thereto.If your permit request is denied,you are obligated under this agreement to apply for a variance.If you fail to do so,you expressly authorize us,and Gibraltar Pools reserves the right,to apply on your behalf and at your expense to obtain a variance or other special permission for you.If applicable,any extra fill, gravel, materials or labor beyond that required to perform a normal installation will be Buyer's responsibility. If you are assembling your pool.You are responsible for leveling dirt, preparing the ground including any appropriate drainage work neces- sary, and obtaining and installing sand or other base material.We will deliver your pool materials to the location specified on the reverse side hereof. Deep end.If your pool includes a deep end where the depth is in excess of approximately four feet and we are assembling your pool, our re- sponsibility for digging the deep end will be limited to digging plain dirt only.You will pay us for any additional expense associated with the digging of anything other than plain dirt.You are responsible for dirt removal and we are responsible only to pile the dirt related to digging the deep end at a location chosen by you on your property at a distance of not more than 20 feet from the location of your pool.If we encounter ground con- ditions or other conditions which we, in our sole discretion determine make digging the deep end not feasible or prudent in the circumstances, you agree to accept instead,a flat pool of standard uniform depth. WE ARE NOT RESPONSIBLE FOR DAMAGETOTHE DEEP END ANDTHE POOL ITSELF WHICH OCCURS AS A RESULT OF DRAIN- ING WATER FROMTHE DEEP END,GROUND SHIFT,SURFACE AND SUBSURFACE WATER,ICE,FROST,SNOW,LEACHING FLUIDS OR ANY ACT OF NATURE.NO DIVING.YOU UNDERSTAND THAT WE DO NOT ENCOURAGE DIVING AND WE URGE NO DIVING BE PERMITTED IN YOUR POOL.SERIOUS BODILY INJURY MAY RESULT FROM DIVING. 4/15 ,��I�PGSiv� 0OV6 Oavv jp POOL, l lx- OF o SCOTT. b� W.M ARS ENA ULT saes ,A N..13972 O N GAJ ! NDSU?,I '90• � � 90�1 i j I i I � I 6Q1 T 130' ,AREA ¢6 { Eow. W m ARSENAULT a Is h � � WM ARSENAULT E 15o' I i O0' ✓%, Il 1T4=ao' T6.57 _ _ ' 73.85 I � 'w°n SUMMER STREET.�. iW/OT/H VAR/ES —� i i PI-4A/ OF L•41VD /N NORTiy ANDOVER� + o OW/V60 BY ' °i W/LFREO Al ARSENAULT 1 S.L.G/LES-REG LAND SURYEYORI "' `' .• ::i,".]P �'. t AUGUST 7,/965 a/5etit__N_Q �, _ ------------ i :• �z�.n�mc.¢., 9,dC..�g 1465 .nt 1:ss f.Yw.�ao��`t�� i I d Y fl 8/�a/cs The Commonwealth of Massachusetts Department of IndustrialAccidems Office oflnvestigations 1 Congress Street;Suite 100 Boston,MA 02114-2017 www massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): GIBRALTAR POOLS CORP. Address:435 BOSTON STREET City/State/Zip:TOPSFIELD MA 01983 Phone#:978 887 2424 Are you an employer?Check the appropriate box: Type of project(required): L 101 I am a employer with 12 4. [] I am a general contractor and l employees(full and/or part-time). have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. []Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp.insurance.= 9. E]Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.M Other ABOVE GROUND POOL 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:TECHNOLOGY INSURANCE COMPANY Policy#or Self-ins.L/Iic.#:TWC3376720 Expiration Date:10/13/2015 Job Site Address:�p 3 StrM M Co" S� City/State/Zip: No. over -M--A. d t e ys 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 cerap under the pains and penalties of perjury that the information provided above is true and correct Si ature: _ _ Date: / -If Phone#: 978 887 2424 Official use only. Do not write in this area,to be completed by city or town official. City or Town: PermWLicense# Issuing Authority(circle one): 1.Board of 13ealt h 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 20/15 DATE( CERTIFICATE OF LIABILITY INMMIDD/YYYY) SURANCE 5DYYYY)) 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(es)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 thiscertificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Kilgore Insurance Agency PHONE FAX NO: 5 Centennial Drive I-IL ADDRESS: Peabody, MA 01960 INSURERS) AFFORDING COVERAGE NAIC# INSURER A:Nautilus Insurance Co. 17370 INSURED jNWRERB:Safety Indemnity Insurance Co. Gibraltar Pools Corporation INSURERC:Technology Insurance Company 435 Boston Street INSURER D: Topsfield, MA 01983 INSURER E: 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 AML SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD1 POLICY NUMBER MMD/Y MM/DD/YYYY LIMITS A GENERAL LIABILITY NN347534 10/12/14 10/12/15 EACH OCCURRENCE $ 2,000,000 ]{ COMMERCIAL GENE RALLIABIUTY DA MAGE TO RENTED $ 100 000PRESES I E. . oocurrenW CLAIMS-MADE [A]OCCUR MED EXP(Ary one person) $ 5,000 PERSONAL&ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,006,000 GEN'LAGGREGATE LIMIT APPLIES PER PRODUCTS-00 MP/OPAGG $ 2,000,000 POLICY PRO- LOC $ A AUTOMOBILE UABILITY 1023481 5/18/15 5/18/16 COnB d..3 INGLELIMIT $ 1,000,000 ANYAUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS X AUTOS NON-OWNED PROPERTY DAMAGE $ X HIREDAUTOS X AUTOS (Per accident) $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESSLIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- C TWC3432600 10/13/14 10/13/15 ]( AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/ExECUTNE E.L.EACH ACC!DENT $ 1,000,000 OFFICERINIEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE - 11.0.0.0,-000. If yyes,desaibe under DESCRIPTIONOFOPERATIONSbelow E.L.DISEASE-POLICY LIMIT $ 1,000,000 A Commercial Package NN347534 10/12/14 10/12/15 Bus.Pers.Prop. 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 701,Additional Remarks Schedule,if more space is requi red) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Cyrus A. Kilgore ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: Office of Consumer Affairs and Business Regulation r 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 129931 Type: Private Corporation Expiration: 11/23/2015 Tr# 246258 GIBRALTAR POOLS CORP _ PETER DE BERNARDO 435 BOSTON ST -- TOPSFIELD, MA 01983 -- — Update Address and return card.Mark reason for change. SCA 7 Co 20M-05111 Address :] Renewal C Employment Lost Card - = - Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ,DOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: ( ��egistrIMPR 1MEN Type: Office of Consumer Affairs and Business Regulation Expiration: 11123/2015 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 GIBRALTAR POOLS CORP PETER DE BERNARDO J p 435 BOSTON ST TOPSFIELD,MA 01983 Undersecretary Not valid without signature II X,StreamO Hottratepon Above Ground Full-Flo Cartridge Element Filter Systems - For the ultimate a clean, go XStream. • Designed specifically for the rigors of above-ground filtration • Extra large filter body ensures an equal distribution of dirt and debris throughout the filtering element ensuring a longer more efficient filtering life. `•- • Engineered for use with flexible or rigid plumbing • Glass-reinforced,noncorrosive filter tank for long life • Easy-Lok'' ring design gives you single-turn access to all .4 internal components je,' 3 ' Patent Pending > Y .. AWlaa Power- Flo Matdxo THE SUPERIOR CHOICE IN ABOVE-GROUND POOL PUMPS. a Features an industrial-size strainer basket to collect a lot of debris without a lot of maintenance $ o Converts from horizontal to vertical X = orientation at the press of a button o Quick connect/disconnect intake and discharge connection cb ? A� j I d I FI a a Pt sect cco:,mo e.<. z ! o 9 FI I PQl4 10 9 - I i � a FI o I5 7 p FI ' p IG t U m - O . W FI a O F1 0 a .5 . . : _ K ( F5 14 (4)FS opssn 2 -77)FS " .F.I 3 I IS I q 1 Ig r o k 1P... m U O - (2)F5 1 2 (2)FS FS FENCE f STAIR ELEVATION - f(.) NTS rA F6 4 A` Ir g -� Raaa"sail�l l� FS 3/16"PPP CC/% (6) 4. 18 Rivae . . J . ,a-O'rnAx. 0'MAx - - I6 Ptexee k¢ 00 13 D O - - - G Q V > 19 24 c _ / (6)F3CL a lJJ Laver. P.o<a sail sick O Q . - `- el - EMEM aa31 3/16^P.P Rivet O cm Q :1 a -X o.cr FENCE DETAIL w A - _ NTS _ ._ ( W.24',26'OR 374Y - - ;� - - - W fA Z • 2 �A . ; w� 5 a i.N... zv PLAN AT POOL TOP 1 DECK . PLAN AT POOL BASE NTS -- LEGEND LEGEND (Denoted E GE S � (Denoted 0 in plan and dstsktl (De ❑ m p� ) 13 1. Pool wall paut I W x 4 Y'x 1 Y',.022Y thick HDG steel(.021'min.base metal thickness)interlocking pass (...)Indicates number of fasteners I FS Minimum yield stress=50lism p H -'- - e F1: '5116°Dia.x3/4'Ca screw 2. Zee base:l W x 712'x 1 W,14 gage galvanized steel(formed) F2: 5116'Dia.x 2' Cap screw wl nut 3. Wag vertical:4'channel..M5'thidt fO3G steel(.0335'min.base metal thickness,Min.yield stress=48 ksi F3: 316'Dia.x 1" Cap screw wl nut F2 I 4. Side wall cimarukt 3 W x 2118'e>dnded aluminum shape F4: 12'Dia.x 314' Cap screw wl nut5. End wall channal:3 3 6. Bolforr slap: .2 Y'x171 gage Hx 2 10 intruded mun shape F5: 12'Dla x 1' Cap screw wl nut D3 steel 7. Comer Strap:1 Y'x 11 gage HDG steel F6: 5/16'Dla.x 314'Carriage bolt w/nut dam 1 POST 8. Comer base plate:14 gage galvanized steel formed plate F7: #14 x ata' Sheat metal screw 9. Comer venkal:3 Y'x 3 Y'x.035'thick HOG Sleek(.0335'min base metal thk),Min.yield stress=48 ksi F8: #14 0 114' Sheet metal screw 12 10.Comer connection bracket plate lortiersim rod assembly.Y'hot mkt steel,formed,welded and powder Fg: #12 x 1 1/4' Tek-screw SIDE 4 I i mated . 11.Compression salt 2 Y'x 1'x 14 gaga gahran¢ed steel formed plate.l to Salt remlamement at tension rod _ END S - 12.Facts:t''/,'x4'x.075'thick extruded alRnimor shape NOTES - 2 - posed�cap screw and buss head screw fasteners and nuts shag be stainless steel 13.Formed/straight post 1 Y'square extruded aluminum WMrg 1. All ez l; /` - - - 14.Tension rod assembly.AISI-C1018 cold drawn steel rod,70-85 ksi tensile strength,W d'emeleron end conforming to ASTM F593,Grade 304,CW(80 ksi minimum tensile strength) ud . /. deck.518'diamemran 2a-24'side decks,and Y'i ianmleron 28'-37 side decal.Assembly indades rod 2. M other fasteners elma8 be commercial Zlrm coab3d steel,standard grime(ASTM A3O7 or F. ' seaons with turnbuckle,caths and devil pin(same diarreter as neat SAE-J429,Grade 1(60 ksi minimum tensile strength) 15.Cooarfillat(seme as pool wag panelgaec) 16.Pafio beam:3'x 7 x 18 gage HDG steel dye - ... `i 17.Side brae:Refer to post specification 1 18.Patio strap:l 12'x llgage HDG steel - - 19.Tension plate.Y.'Int rolled steel,vcelded and powder meld F8 $ M.Chemist Amer 4.125'x 11 gage galvanized sted(fismed) F2 21.Facialpmer.2718'x'14gagegahrenizel. x . . (2)F 22 Deck assembly.6°wade interlocking,extruded aluminum deck planks - .0 t I3 . . HA - 23.Fence raft 1'x 1318'eAmded aluminum shape - 17 24.Fence picket 9116'x 1'x 9/1G exhtded aluminum charnel 25.Stair.t'/.'x4Wx1Y.'extruded aluminum side rags,5°heavy e>trWed aluminum steps(cordoMng toASPA00 26.Swim Ladder 1.90 diameter staldess steel tubular rails.three molded steps,stainless steel hardware GENERAL NOTES - 1. POOL TO BE INSTALLED IN ACCORDANCE WITH ASSEMBLY INSTRUCTIONS. - - - - - 2. POOL TO BE INSTALLED LEVEL WITHIN 1'.PROVIDE SMOOTH TRANSITION BETWEEN WALL AND LINER ASSURING THAT LINER CANNOT WORK ITS WAY UNDER THE BASE WALL RIM _ FS I. AD HOG steel components shall be fabricated from sheet steel millouning to ASTM A653(CS Type B), 3. ABOVE GROUND POOLS OF THIS TYPE ARE INTENDED FOR SWIMMING AND WADING ONLY. with minimum yield stresses as rotes. NO JUMPING OR DIVING PERMITTED.THE INSTALLATION AND USE OF DIVING BOARDS, SLIDES AND SWINGS IS STRICTLY PROHIBITED. 2. bracket plates,angles and hardware shag be fabricated tom minimum 14 gage i SCALL AS NOTED .: _ aluminum Components shag be from 6105- y aluminum DATE"Februory28, 2008 - All sWCWreI galvanized steel. _ _ - _ \ I 3 AN exhaled al exhwl� TS alloy _ 11 . "�� ��r a- 3 a ORN Sr: CTG CHK W.. REC -IH n ` AND FI ." - ... 2 OR WATERRSUIPPTHIS IS AN LY/DISPOSAL REQUIREMENTS.R ALSO DOT DOES NOT COVER OTHER CODE ES NOT COVEMS,SUCH INDIVIDUAL SITE NG DRAWING FOR THE STRUCTURAL COMPONENTS OF THE POOL,DECK DRAWING N O / - CONDITIONS OR SUBMISSION TO LOCAL AUTHOWTIES FOR SITE PERMITS. GP-48-01 A(� '/ THIS DRAWING IS THE PROPERTY OF ROBERT E CHESTER ASSOCIATES,CONSULTING �+ (4�J� O "SECTION AT PATIO"DECK (B1 TYPICAL SECTION(A) _I I I_I i.I'_I I f - - ENGINEERS,AND MAY NOT BE REPRODUCED WITHOUT WRITTEN CONSENT FROM THIS OFFICE t "7T ���,,,/// NTS- - _ - THIS DRAWING IS VALID.ONLY WHEN AUTHORIZED SEAL AND ACCOMPANYING SIGNATURE IS �I AFFU(ED.. �1p 119-07