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HomeMy WebLinkAboutBuilding Permit #435-14 - 171 BRENTWOOD CIRCLE 11/13/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received t Date Issued: C IMPORTANT:Applicant must complete all items on this page LOCATION Print- :PROPERTY PROPERTY OWNER Print 100 Year Old Structure yesnnqMAP NO: . �Oq{ :PARCEL` LJ� ZONING DISTRICT: � � Historic District yeMachineShop Village ye _ 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 0 Septic ❑Well E! Floodplain ❑Wetlands. ❑ Watershed District Water/Sewer. DESCRIPTION OF WORK TO BE PERFORMED: N�7ZiU I✓tol`duAC gUn1*-r— D66T/C0 19 Xg Par Ota ns Identification Please T pe or Print Clearly) OWNER: Name: -ems cnCo SIn do Phone: —"27t— 3 9,l Lee Address: P l S'erytse-1yc- Phone: 7e1-!R6X— 33Y0 CONTRACTOR Name: aG�Soh oo -- Address: P© 136-x-, .5-c? Ma CIA 1. —ea6K Supervisor's Construction License:- -- Exp. [.Date: __N�4 _ Home]m-provement License: /0?773 Exp. Date: _ Igo 1. 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: $ C� . c�0 1 b IT�fdEE: Check No.: `-� Receipt No.: � ® NOTE: Persons contracting with u i red contractors do not have access to the guaranty fund Signature ofoAgentyOwrierr : �g �ature$of contractor _ Plans Submitted L� Plans Waived ❑ Certified Plot Plan [ Stampe ns ❑ Location &9AM06aj C iL . No. Date )1111 1 / 1 • TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ -un' Other Permit Fee '$ TOTAL $ Check# J 27105 Building Inspector Plans Submitted-E] Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ "TYPE-OR SE WERAGE DiSP OSAL Public Sewer ❑ Swimming Pools ❑ Tanning/Massage/Body Art Q 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 �'LANNING & DEVELOPMENT ❑ 3 COMMENTS 41 1J fp oe- - CONSERVATION Reviewed on 11h.3 Signature i COMMENTS a- �-- 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.T o,w;: Engineer: Signature: Located 384 Osgood Street FIRE DEPARTNIENt =-Temp Dump'ster on site yes. no Located7at 124 Mair Street- Fire®epaitme�it signatureldate`' COMMENTS Dimension _ Number of Stories: Total square feet of floor area, based on Exterior dimensions._ .Total land area, sq. ft..- ELECTRICAL: .: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 for pickup - Date t ! Q Doc.Building Permit Revised 2010 } Building Department The fol wing is'a list of the required.forms to be-filled out-for the appropriate.permit to:be obtained. Roofirg, Siding, Interior Rehabilitation Permits u` BUilding Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ 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 ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/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 NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan a 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 ❑ Mass check Energy Compliance Report ❑ 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 apo•-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:+.ted with the building application Doc: Doc.Building Permit Revised 2012 Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost $ 1093660.00 m $ - $ 1,315.92 Plumbing Fee $ 164.49 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 164.49 Total fees collected $ 1,744.90 171 Brentwood Circle 435-14 on 11/13/13 Inground Pool R 0. BOX 567 A Division of Jackson Pool Service, Inc. LEXINGTON MA 02173 -�~- BUILDER OF CUSTOM GUNITE POOLS ' TEL. 617-862-3340 "Unsurpassed in Service" FAX 617-862-8017 Specifications and contract for a swimming pool by"contractor" and "buyer" NAME(Buyer) . n WV ,d �c5-e<;0t V( c V<- POOL SHAPE C)Hei d ry(, AREA PERIMETER-f l o9 MAIL ADDRESS CITY STATE ZIP HOME PHONE JOB ADDRESS I"t t 5 ,z` i.ecyI (`(ae �� CITY/'�,J.�I ei,tpr(' STATE if& ZIP 0 r l� BUS. PHONE _ Jr n<Ilt^fir STRUCTURAL SPECIFICATIONS FILTRATION EQUIPMENT SPECIFICATIONS 1)dEngineered Structural Plans and Working Drawings...................... Included 35) N.S.F.Approved Filter;Type i'r4R!,r Size r,JG Make Included \ 2) Establish Shape,,Elevation and Location Prior to Excavation............. Included 36) N.S.F.and UL Approved Pump and Motor;Size+ -' t+ Make 1 c. f� ,.. Included 3) Perform Normal Excavation and Remove Soil on Dayof Excavation Only.... Included 37) Hair and Lint Strainer for Pump Pot...................................... Included 4) Hand Form and Shape Pool.............................................. Included 38) National Electrical Code,U.L.Listed Time,Clock......................... !4 5) Access Wall or Fence: Removed By..................................... /V(. , 39) Electrical Wiring and Connections B Buyer • Y Y Replaced By..................................... /Vt)V- 40) N.S.F.Approved,Automatic Chemical Dispenser...............To. .t(.0 ;. 6) Remove from Site / Loads of: Trees,Stumps,Shrubs, r 41) Pre Formed Base Slab for Filtration Equipment .......................... Included Asphalt,Concrete,Other Debris.........k".`�f 42) Automatic Pool Cleaner; Make 7) Steel Reinforcing Per Engineered Plans ................................. Included 43) Stainless Steel Separation Tank; Size — ...,,,/,,, , "A 8) Electrical Bonding of Reinforcing,Jigs and Equipment..........of! 4., By-Buyer 44) Sixwav Multi Port Valve....... .................. k�tr?, Included 9) Monolithic Gunite Structure(to meet or exceed local or state codes)..... Included 45) Approved Heater,Type io,­i BTU eIli, r+N.Make 12&— L?�-.f-,.'.... //VG 10) Instal Continuous Bond Beam Around Skimmer(s)........................ Included x•46) Fuel Connections, Heater Venting,Fuel Storage Tanks,Permit ....,..... By Buyer � 11) Water Cure Gunite Shell Twice Daily for Seven Days..................... By Buyer 12) One Set of Shallow End Steps with 4'Bench............................. Included MISCELLANEOUS SPECIFICATIONS r 13) Swimout or`Love Sea .... .. :;r 't l-r�.......i.... ....... `i' I.k 1:Lf� (h, 14) Grading or Backfilling... .Cls.-. .;.ENt '+rcll .r•a.!.'R r,+:>."Ce..,.,.,. By Buyer 47) U.L.Approved Marine Light;Watts Volts .r �- 7 t 1G �rGI ua 15) One 6" Band of Water Line Tile: Colors ` Type+4tc:. '.% 48) Up to 10'of P.V.C.Conduit and Deck Box for Light.... .................1 f•vr'l�*�`� h 49) Re Routing Sanitation,Water Supply Systems and Utilities............... By Buyer 16) Deluxe Safety Grip Coping................................................ 11,44 is 17) Provide Cantilever Forms for Deck Edge ........ ,^ltr.t.............. „r'�r,t�t a 50) Flush Mounted Anchors,Safety Rope,Floats............................. Included 18) Finish Pool Interior with 'r+��r f C')C+�r. to y)[��Ca 51) Payment of All State and Local Taxes During Construction............. Included ............... Included 19) Filling of Pool Promptly after Interior Finish Application.................. By Buyer 52) Workmen's Compensation Insurance..........,.........:..................................... Included. 53) Transferable Structural Guarranty........................................ Included PLUMBING SPECIFICATIONS 54) Stainless Steel Ladder................................................... . A1114 I 55) Stainless Steel Rail ...................................................... 1/" 20 Non Corrosive Plumbing and Fittings Throughout........................ Included i ) 9 9, 9 56) Diving Board;Size """'- Type •'-' Color ............. Af//' 21) Self Adjusting Surface Skimmer 7,.Jt? Included 57) Slide; Size Color --- Curve -' ii.I 22) Vacuum Adapter in Skimmer.............................................. Included 58) Slide, Ladder, Rail,and Dive Board Jigs Installed......................... By Buyer 23) Leaf and Hair Strainer Baskets for Skimmer(i ........................ Included 59) Water Condition$-2L6-.00 Charge Pay to Excavator ............ y y 24) Pressure'Return Inlets to Pool 11/'14 B Buyer j 25) Direction Adjustable Return Inlet Fittings ............................... START UP AND MAINTENANCE 26) Locate Skimmar( )and Returns to create Cross Pool Surface Cleaning Turbulence............................ ....,,,,,,,,,_, ,/. 60). Deluxe Maintenance Tools(nylon brush,leaf skimmer,telescoping ,,,pole,test kit,thermometer,vacuume head 8 hose .............:.... 27) Main Drain Grate and Cover Grill..................,.... Indluded� -F- -. , , ) Included f '61) Start'up and Maintenance instruction':...:.......... .............. Included .,. 28) Direct Main Drain Suction Line Between Pool and Filter . .. Included 29) Self Seating Hydrostatic Pressure Relief Valve....................... Included 62) Start Up Chemicals(10 lbs.Diatomaceous Earth,2 Gallons Acid, ' 30) Install Piping and Fittings for Future Pool Cleaner.......v: .,:1.�:t-44.,.�j,rs,,. t+ 31) Flexible Hose for Pressure Backwash of Filter Media ft. .......... �lld j F 32) Up to 20' Plumbing Run Between Skimmer and Filter.................... Included 33) Pressure Testing of Plumbing Lines during Construction................. Included . ADDITIONAL SPECIFICATIONS j 63) 76 1'oct,,Pr-)rk 4 �rfuC�rf Irr.•r 64) C {`ill SCJ C'sJte 65) / :' A`6*7- { Stv� (rYSis ✓ rfil/41IA �0 e 66) ri)N�rhr.�fuai7.. !`rxrtt fr„fiA+ eYV`n .�. rTrl: 7£'rY., i4,1( 67) iC^e6,r r cr,'-7L4" 'n..lfdJLt / 'flyr'YV q tj/r-,i w, 4 t.itef!l����fw r [ 6$) >Int t'1ft" QOjx,({f I..lfiLlnL��RXX G,.t� /1jFr..1 i.�Plftwf� lr1C'i�Z►lIP t.LgC i r� `f 7 �}�- L Li+C , 69) S, f`'�norf^�'�It7rn7.r't_ rar.� t..)cc..lf'�, 7G� I t-/spy-r t c�. t •+a +i.,.7 .;f ruh j�l is.. CA'c NOTE -71) r ci Pool Deck Prices (Grading Not Included) NO VERBAL AGREEMENT ACCEPTED. 7� y party / x(A"t'`' � ROCK SALT OR BROOM FINISH Sq.Ft. You may cancel this agreement if it has been consummated b a C(��{ { thereto at a place, other than an address of the seller, which may be his main COOL DECK FINISH Sq.Ft. office or branch thereof, provided you notify the seller in writing at his main (Above prices valid for 30 days and are not included in pool office or branch by ordinary mail posted, by telegram sent or by delivery, not contract price. Bluestone,Brick,Lockstone,Futura Sone Decking later than midnight of the third business day following the signing of this prices available on request) 0* —,pod 6 oelvc k 6)) agreement. is Ct..,c' (A" pw,2�,TILJV- K�&A.tW,," i ft j/f ( Owner agrees to pay the contractor the sum of $ t f 6,60, ou t i0 ff, - ,II � _ z (�, `. Down Payment' : $ � � "fr 6 LCJ co 1 Contract agreed to by Contractor and Buyer f Balance S 1 U C C O . o0 _ Buyer % r owner '�/ PAYMENT SCHEDULE . €€ Buyer t Joint owner -)i .A%Day of Excavatin S r � ;C3C}U. o U 1079 64,( :& l.J u�.F--,o 5rtif 66%Day of Gunite Contractor Representative S a C' nn�� . c•r� Prior tp Interior(Finish Application : Co --�� , csJ Any amounts indicated on other contracts with 10 0 6 d 160 this company are in addition to this contract amount. Total $ nAl . rO� i 4-0 f Accepted This Day of 1 NOTE t (; NO VERBAL,AGREEMENT ACCEPTED. THE WARRANTYS, GENERAL TERMS AND CONDITIONS ON THE REVERSE SIDE ARE PART OF THIS AGREEMENT. BUYER ACKNOWLEDGES THAT HE HAS READ AND UNDERSTANDS BOTH SIDES OF THIS AGREEMENT. CONTRACTS and SPECIFICATIONS 1. This contract constitutes the entire agreement and the parties are not bound by any 13. Buyer agrees to wet down gunite of the pool twice daily for seven (7) days after oral expression or representation by any agent of either party purporting to act for or on placement of gunite by contractor. behalf of either party or by any commitment or arrangement not specified in the contract. 14. Buyer agrees that he or his representative will be present at the pool site on the day or 2. No additional work shall be done without the prior written authorization of buyer. days of excavation,and prior to excavation shall confirm its location,shape,and elevation Any such authorization shall be on an additional work authorization form approved by both to the contractor. After excavation is complete the contractor shall not be liable for parties,which shall become a part of this contract.Where such additional work is so added Improper elevation,shape,or location. to this contract.It is agreed that the total price under this contract shall be Increased by the 15. All pool and/or spa dimensions are approximate with up to six inches tolerances either cost of such additional work plus 20%;that payment for such additional work is due upon way. Buyer(s)and Contractor agree it would be impractical to fix the actual damages in the completion of such work. Any over due balance at time of application of interior finish Is to event of any deviation in pool and/or spa dimensions greater than any such six inch be remitted in Bank Check or Cashier Check form. deviation In dimensions. Therefore,liquidated damages for such greater deviations in the 3. If any provision(or portion thereof)of the contract shall be deemed invalid,it Is agreed water surface area of the pool and/spa as specified on the reverse side of this construction that such invalidity shall affect only such provision (or portion thereof) and that the agreement shall be$6.00 per square foot:and liquidated damages for any such greater remainder of this contract shall remain in force and effect. deviation in depth of the pool and/or spa as specified on the reverse side of this Construction 4 If plans and specifications are attached to within agreement they form part of this Agreement shall be$12.00 per inch. The depth of the pool and/or spa is determined by contract In case of conflict between the provisions stated in such plans and specifications measuring from the top of the tile down to the finish floor of the pool and/or spa. and the terms of the within contract the terms of the within contract shall prevail. Buyer(s)and Contractor agree that the pool and/or spa will be within three-quarters of an Prior to proceeding with any work,the plans will be approved by both Buyer and Contractor inch of being level. Buyer(s)and Contractor agree it would be impractical to fix the actual In Writing• damagas in the ovont of any Oeviatlon in the pool and/er spa level greater than any such S. This contract Is not binding upon the contractor unless and until the same is accepted three-quarters Inch deviation,therefore, liquidated damages for such greater deviations by an authorized representative thereof or when performance has been commenced by the shall be$25.00 per one-quarter inch. contractor. 16. The pool shall be deemed completed when the interior finish has been applied. Approval of work by an inspecting governmental agency is deemed to be completion of that RESPONSIBILITY OF CONTRACTOR—CONDITIONS AND LIMITATIONS work in a workmanlike manner. Buyer agrees to make payments called for by this contract 6. Contrctor agrees to do all work provided in this contract in a good and workmanlike on time even though repairs to completed work under this contract may have been manner,but shall not be responsible for delay or failure to perform work when such delay or scheduled but not yet performed. failure is due to: acts of God,war,riots or other civil disturbances,strikes,government prohibitions, non-issuance of all required permits affecting construction, weather,non- GUARANTEES AND WARRANTEES compliance with payment schedule, or reasons beyond his control. Contractor Is not STRUCTURAL GUARANTEE responsible for damage to such items as,but not limited to,curbs,sidewalks,driveways, 17. Contractor agrees that the structure will remain structurally sound for as long as patios, lawns, shrubs, sprinkler systema, and appertenances. Buyer(s) hereby agree to assume all responsibility and ricks thereof. Contractor shall not be liable for floatation of the pool remains the real property of the buyer. The term structurally sound implies pool after placement of structural concrete which Is caused by external water. Payment that the swimming pool is capable of containing and holding water and in the event for special orders must be received by Contractor prior to his ordering the requked of a failure to do so the contractor will repair the same so that it does hold water. material. Such payment may not be refundable should the Buyer choose to cancel In the event buyer transfers ownership of the,property to a third party,the structural the order. guaranty will automatically transfer to said third party. 7. Contractor shall not be liable for damages caused by Blasting Contractors, Gas The structural guarantee is also invalid should the pool not be kept full(except when Fitters,Electricians,or sub contractors engaged by Buyer. emptied by the contractor or under his direct supervision after completion); should the 8. Walks, and decks are not a part of the pool and buyer understands that there is structure be damaged by earthquake,war,earth or earth fill movement or disasters not no warranty covering same regarding cracking,checking rising,or settling.Plasterorother occasioned by the Contractor, such as explosions, wrecking and the like. Terms and pool interior finishes are not guaranteed against staining or discoloration,inasmuch as this provisions of this guarantee are not to be effective until final payment of contract is is commonly due to local water conditions,improper use of chemicals or lack of cleaning. received In full. The contractor shall not be responsible for damages caused by the buyers failure to Manufacturers products purchased by contractor from a third party Pre subject to third perform winterization and/or routine maintenance. party's guarantees and/or warrantees. Contractor agrees to honor manufacturer's guarantees and/or warrantees and make repairs or replacements with no labor charge for RESPONSIBILITIES AND REPRESENTATIONS OF BUYER one(1)year from date of interior finish aoDlication. Contractor agrees to repair leaks in the filtration system for five (5) years after interior finish application provided pool and 9. Contractor has entered into this contract based upon certain representations by equipment are properly winterized or damage is not due to grading,vandalism,Improper buyer and buyer does hereby represent and warrant that the following conditions do care or maintenance or reasons beyond contractors control. not exist. The the and coping installed by Contractor will be replaced or repaired by contractor A. Fill ground(fill ground means soil not compacted to 90%or not having a bearing should it become loose or separate from structure within five years of interior finish capacity of 1000 lbs.per square foot);or inadequate soil bearing capacity of the application,provided decking has been installed per contractors specifications. buyers property. Interior finish is guaranteed against abnormal deterioration, peeling,or separating for a B. Expansive or organic soil(clay,peat,buried stumps,trees etc.). period of five years from date of initial application.Staining or scaling is not warranteed. C. Rock formation or boulders which would require the necessity for blasting or The guarantees and warrantees are effective only if buyer has complied with all the terms jackhammer work. and conditions, payments and other provisions of this contract. The Suarantees and D. Site contains cesspool,septic tank,gas line,water pipe,drainage pipe,irrigation warrantees become void: if the pool is not kept full of water;or by reason of any earth or fill pipe,underground electrical conduit or other obstructions not apparent from an ground movements,acts of God,war,riots,othercivil disturbances,orbydestructive acts of inspection of the surface. others:or if the buyer fails to comply with decking installation requirements as set forth by E. Surcharge(additional load condition that may be imposed on pool structure by contractor. existing or proposed adjacent structures which will require extra engineering). 18. Defects and failures resulting from mistreatment or neglect by buyer will be repaired or F. Underground or surface water conditions which will interfere with the con- serviced at buyer's expense. 19.of the work,or operation of the completed pool. 19. Where buyer has work performed by others that is not provided for in this contract— . Inadequate access for construction equipment required 1. do the work. such as,but not limited to,electrical panel changes,landscaping and erection of fences and G G. It ie understood and agreed that if any of the above conditions do exist and retaining walla—contractor does not guarantee or warrant such work,and contractor shall not be held liable for such work or for loss or damages,if any,which may result therefrom. additional materials,labor,and or machinery are thereby required to complete the contract,the contractor Is hereby authorized to make such corrections,and the cost of labor,material and machinery shall be added to the contract price plus POOL SITE 20%. Not withstanding the foregoing, the contractor has the right to close the hole If he deems the site is unsuitable for a pool,and owner will be charged only for 20. The term pool site means the area comprising the water surface area and that portion the work performed. of the ground surface extending to a distance of not more than four feet(or to a distance 1. Contractor shall perform all normal soil or earth excavation, any other use required by local code for minimum decking)from the perimeter of the pool water surface. of material, labor or equipment shall be added to the contract at the cost No grading around pool is included In this contract price, except for one hour pre- thereof,plus 20%thereof which owner agrees to pay. excavation grading on excavation day. 10. In the event buyer authorizes access through adjacent properties for contractors use during construction, buyer is required to obtain permission from the owner(s) of the adjacent properties for such use,and buyer agrees to be responsible and to hold contractor harmless and accept any risks thereof. Buyer shall furnish any necessary variances and associated permits and fees. Buyer will also pay to have lot surveyed,if survey Is required by township. BREACH 11. Buyer shall supervise the location of buildings or other improvements and there shall be no liability on the party of the contractor for incorrect location thereof, whether on 21. In the event of breach by buyer of any provision of this contract,buyer agrees to pay buyers property or the property of a third party. all collection costs. Interest from date of breach and reasonable attorney's fees. In the 12. Buyer shall protect trees and shrubs which he desires to save.and shall provide event of breach of any installment payment, contractor, at his option: may declare the contractor with a site free of debris prior to start of work.This contract does not provide for entire balance of the contract immediately due and payable. fencing or the installation of dry well or other waste facilities unless specified. Buyer shall 22. If construction is delayed due to nonpayment of buyer,any deterioration in the pool site comply with the laws pertaining to these subjects at his own expense. Electric power and and work in progress during this period will be the buyers responsibility and prior to water for construction purposes shall be furnished by the buyer at no charge to the resumption of construction,he shall pay the cost of correcting such deterioration plus 20%. contractor. Buyer shall also provide water for filling pool,either by municipal water supply, 23. Assistance arranging Financing may be given by Contractor, but same is not a well,or making arrangements for trucking of water to property. condition of this contract: owner is solely responsible for any financing required. Working days are to be defined as any week day Monday through Friday within the hours of 8:30 AM to 4:30 PM;(weekends,legal holidays,days with precipitation exceeding 1/10th inch in any 24 hour period,and days with temperatures below 32'F are not considered working days.Completion dates shall be extended three(3)days for each and everyday Buyer Is late In making Installment payments and or additional labor,material and machine costs agreed to be made by Buyer. IMPORTANT You will receive a letter from our office outlining the various phases of the construction. May we request a Jew momenta of your time to carefully read the contents of the Instruction letter so that you will aid us to build your pool in the shortest possible time and Insure top quality performance? Town of Anclover ^ � h , ver, Mass, coc»'C"aW'C.p*_ s u BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT .......?—Alft.�:! .Oe* .. 4".. 4.6d.a.,. • BUILDING INSPECTOR Foundation has permission to erect.......................... buildings on .... .......&*0wo- ........t.r .......... Rough to be occupied as .... ..4.(..,awr-d.....!1 .. .... ...................................................'... Chimney provided that the person acWpting this permit shall in every respect 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 jobi" PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC I MON J#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. SEE REVERSE SIDE The Commonwealth ofMassachusetts - Department of IndustritclAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information — Please Print Legibly Name(Business(organization/individual): P6-0 l ()QUI e.G --DNC Address: P0_ ,SG 7 City/State/Zip: ✓1 Phone Areeyy u an employer?Check the appropriate box: Typo of project(required): 1 I am a employer with `l• ❑I am a general contractor and 1 6, Wew construction employees(full and/or part-time).* have hired the sub-contractors 2.[l I am a sole proprietor or partner- listed on the attached sheet.+ 7• Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. y EJ Building addition [No workers'comp.insurance 5. 0 We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 3.E31 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 wehave no 12,E]Roofrep9irs insurance required.) employees.[No workers' q ] comp.insurancerequired.] 13.❑Other 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 7 Homeowners who submit this affidavit indicating they tore doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that checkthis 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 the,pollcy and job site information. Insurance Company Name:. /�/� Policy#or S elf-ins.Lie.M I/VI C��g J d 7 �i 7 Expiration Date: ��j �'l( 6�ei�,` o a� t � Ci : d/'/h Job Site Address: , ity/State/Z Attach a copy of the workers'compensation-Policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder 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 wellas 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 maybe forwarded to the Office of Investigations o£the DIA for insurance coverage verification. I do hereby certLry under the ain andpenalties of perjury that the information provided above is true and correct. Si afore: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License 0 Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Iuspector 6.Other Pihnil a#- 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"...everyperson in the service of another under any contract ofhiro, express or implied,oral or written." An em,ployer 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 t owner of a dwelling house hahe ving 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 bean employer." MGL chapter 152,§25C(6).also states that"every state or leeal lie-ensing'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 beenpresented 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-contractor(s)name(s),address(es)and phone number(s)along with their certificatc(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,arenotrequired to carry workers'COMP ensationinsurauce. 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 datethe 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 submitmultiple permitylicense applications in any given year,need only submit one affidavit indicating current Policy information(ifnecessary)and under"Job Site Address"the applicant should write"a11 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. Anew affidavit must be filled out each year.Where a homeowner or citizen is obtaining a licenseor permit not related to any business or commercial (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. venture The Office of Investigations would like to thank you in advance for your cooperation and shpuld you have any questions, please do not hesitate to give us a call. The Department's address,telephone anal fax number: The CoRUA011WOalth o£A4_assachvsP#€s Depadment of ZndusWal Accidents Office ofTIRYestigatiou fz0(}Wasbingtoa Street • Boston}Nh9,O�X�I Te1,#617-727-4900 at 406 or 1-$77rNfASSAF9 Revised 5-26-05 Fax#617-727-7749 � c �on��nencue rn �i� r,iJr�c�n�ef�i Office of Consumer Affairs&Business Re ulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: gistration: 107773 Type: Office of Consumer Affairs and Business Regulation expiration: 8/6/2014 Private Corporatioi: 10 Park Plaza-Suite 5170 'NI Boston,MA 02116 JACKSON POOL SERVICE INC. Steven Jackson ' 294 Woburn St Lexington,MA 02420 Undersecretary Not valid with ut signature 11/07/2013 15:48 7818901198 INSURANCE AGENCY PAGE 02/03 ACORDN„ CERTIFICATE OF LIABILITY INSURANCE DATEIINhijowyyyyl THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 70LDE/0 712013 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 certlficdte holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,Subject to the(:arms 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 or such endorgement(s), PRODUCER Licata Hayes & Co, NAME: 460 Totten pond Rd, suite 630 AIC Eirty. 81)890-1198 0"�781)890_88A8 I I JI Waltham, MA 02451-1965 ARDREM: INOURER(S)AFFORDING COVERAGE INSURER A; CNA --' - NAIL a INSURED ]ackson Pool ServiGe,Inc - P 0 Sox S67 INSURER e: Commerce 40274 Lexington, MA 02173 INSURER C: INSURER D: LNUMRER.-f-INSURER1! COVERAGE8 INSURER FCERTIFICATE NUMBERTDf North AndoverHAVp BEEN ISSUED TO THE INSURED NRAMEO AB VEOR E POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION E 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 ANO CONDITIONS OF SUCH POLICIES,LIMITS SHQWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIR IYPE OF INSURANCE INg yyw POLICY NUMBER GBNERgL LJABIUTY MMIDOIYYYY MMIDDIYVYY LIMITS 8205477786 04/2312013 04123/2014 IE ACW OCCURRENCE _ a 1 ODD,000 X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE FX7 0CCVR PREMISES Eeocalrrenee $ 100,0 A MED EXP(Any om Peron R S OOO PERSONAL& ADV INJURY S _1,000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 21000 00 POL X ICY PRO- PRODUCTS-COMP/OP AGO S 2,000,000 JECT LOC AUTOMOBILE LIABILITY 3 I ANY AUTO Es acdderK S SOD,OO g ALL OWu70b NED X SCHEDULED MMPOS66 0511612013 05116/2014 BODILY INJURY ;I S AUTOS BODILY INJURY(per ecCldanll Q X HIRED AUTOS X �U�06WNE0 (Per aceidonl S UMBRELLA LIAR OCCUR S EXCESS LIAR CLAIMS-MADE EACH OCCURRENCE S DED RETENTIONS AGGREGATE S WDRRBRS COMPENSATION S' AND EMPLOYEM LIASILITY YIN WC26830767 04123/2013 04123/2014 X ANY PROPRIETOR/PARTNEWEXECUTI TORY LIMITS ER A OFFICER/MEMBER EXCLUDED? NIA EACH ACCIDENT (Meneatery In NH) _ 100,000 B dIPTIOe under E.L.DISEASE-EA EMPLOYEE S 100.000 DESCRIPTION OF OPERATIONS below E.L.OIS6ASE-POLICY LIMIT S SOO 000 DESCRIPTION OP OPERATIONS I LOCATIONS I VEHICLES(Attach ACORO 101.Additional Ramnrts SchedWs,It mora spot•Is re0ulmdl CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES RE CANCELLED BEFORE THF EXPIRATION DATE THEREOF,NOTICE wlLL BE orl-WERED IN accOROANCE TH THE POLICY PROVISIONS. 120 Main Street Town aNorth Andover ]A,UTHORrLED REPRIMESENTATIVENorth Andover, MA 01845 r Lou Fitz era 4CORD 26(2010106) The ACORD name and logo are registered marks of ACORD OR CORP AT All right resolved, ,��;tH�F Atigss �O JOHN F. G :` MCQUILKIN Jr. o0 CIVIL y No.31262 7 IST NA SSS/pNA Z MAP 64 PARCEL 3 0 0 PROP. 39.32' POOL 48.76' PRO POOL G DECK MAP 64 _ -, PATIO PARCEL 41 ' Q1 EXISTING TWO STORY DWELLING 11 #1 1 1. I 1 I 11 i MIP 64 \Ix ' PARCEL 42 AREA=57,800 SFf Z e� 1 0l 1 1 1 1 8REI�TWOOD Cmm (50 FT. R.O.W. - PUBLIC) NOTES: 1. TITLE REFERENCE - BOOK 3490 PAGE 344 R�25� 2. REFERENCE TOWN OF NORTH. ANDOVER ASSESSORS MAP 64 PARCEL 42 JM ASSOCIATES PROPOSED SWIMMING POOL orcl"EERS—suRVElroRs 325 MAIN STREET 171 ' BRENTWOOD CIRCLE NORTH READING, MA 018" 978-664-6688 www.maesociatowng.com NORTH READING, MA 01845 PREPARED FOR: Ross Sandoval 171 Brentwood Circle North Reading, MA 01845 1'= 60' DATE: NOV. 11, 2013 DWG 671-477 SHEET 1 OF 1