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HomeMy WebLinkAboutBuilding Permit #361 - 21 LEANNE DRIVE 11/7/2007 BUILDING PERMIT OfNORT/�tkOR qti TOWN OF NORTH ANDOVER 0 APPLICATION FOR.PLAN EXAMINATION ear Permit NO: '`` Date Received . 41A Permit 9 �9SSgcHuS�� Date Issued: / IMPORTANT:Applicant must complete all items on this page I:OCAT, RR � �,rdt I '„,_: T '�'i*•rr:`'i A - ..'S �t r a+^, .�, x RN A� ►PO PAtCEI.�� ZjO1NG D1STfZ1T � sHistor�GDistnct yes , ono : 4� ,.y,� achlh"hop illage .,,des nog TYPE OF IMPROVEMENT PROPOSED USE i Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg �ys Others: Demolition Otherzw ir6ot-a tKJM,r.. L + peptic w.dell P1o�odplain Wetlands x 1/Vaters# ed District t x ..p.a iNater/Seiiver DESCRIPTION OF WORK TO BE PREFORMED.- Cows REFORMED:Cows of OWG 15 STY 3lf YZ (;UnlrTE SWSTANKVV-1 S)-e-d _ ICD x 17L Identification Please Type or Print Clearly) OWNER: Name: tAy,,n► a 2osc-t..)\oaum Phone:5-18 Address:.2 LgyAwwE i o0vF_R * pLCr�-S' r r x �Addlress . I'b" ✓,f. } 7 '^a: g t 'v r qt s`yh �I x r ,"" ',_ z- s .�' a 'f s ' er"7 k r y 1 Sueruisor's°Construe#ioa� cense 1tcx� Dates k r i x 7 is 0 ARCHITECT/ENGINEER?Rut ilk, r-t.ArJ 2- Phone: �- Address: \�­ziZ Q%:Q rck 4 Cte •s a� ®`�L Reg. No. -�z,S 3 F z� FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 29a "= FEE: $ Check No.: O Receipt No.: ���-- NOTE: Persons contracting with unre red co tractors do not have access to the gu ty fund Signatre of Agent/ wneSignature flfcon#ract 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT /f l s' o z) COMMENTS J�C DA ECTED DATE APPROVED CONSERVATION COMMENTSu�� ����j� DATE REJECTED DATE APPROVED HEALTH 4 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 Drive/wav Permit Located at 384 Osgood Street FIRE DEPARTMENT Temp Dumpster on ite yes no 4 .,'Located at 124 Main Street Fire epartment 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 departnt se ❑ Notified for pickup - 'Date Doc.Building Permit Revised 2007 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 ❑ 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 ❑ 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 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 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 P4,,- /Sav e r72, gal') � al 3o NORTH Town o Andover No. 3W (ON LA over, Mass. COCH EWIC TED C5 S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.........Am..........Ao.. .................................IL­.................. Foundation has permission to erect........................................ buildings on a1.......(owd".4.. ......$&ow 0 . . .................. Rough tobe occupiedas0.1.......................................................................................... Chimney provided that the person accepting this per shall in every respect conform to the terms of the application on file in Final 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 �,� IN 6 low PERMIT EXPIRES 1,,p THS ELECTRICAL INSPECTOR UNLESS CONSTR S Rough Service ............ ......................................................................... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. V4RTH Tovm of Andover No. 341 `7 dover, Maoss./,/ 0 coc Lty-WIC AERATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THATI A q.m.......... t44 ............................ Foundation .. .. ..... has permission to erect........................................ buildings on at....... .r1....... ............ Rough tobeoccupied as./.#.�;..t,,:,..i,t,,. #1............................................................................................. Chimney provided that the person accepting this every respect conform to the terms of the application an file in Final 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 MLINTHS ELECTRICAL INSPECTOR Service BUILDING INSPECTOR Final UNLESS CONS S Rough ............ Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MASS. SCALE:1"=40' DATE:11/6/2007 •oma Scott L. Giles R.P.L.S. Frank. S. Giles R.P.L.S. 50 Deer Meadow Road North Andover, Mass. N 1H 4"H/GyW7/VD�jC,CHF p AGE ANO40ETgL�S7,q Cq4 CppE , � •6u�. 66. 1 °ROP POOL \ V /,c j cNn 254 0T#2isT rn 37SF�/ tiSF FNo [� y4 .03, 10.841 C L=97.77' V �R�VF I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE THE OFFSETS 0.�ZN OF OF THE BUILDING INSPECTOR ONLY SHOWN COMPLY AND SUCH USE IS FOR THE A SC WITH THE ZONING DETERMINATION OF ZONING BYLAWS OF • 13972 � CONFORMITY OR NON-CONFORMITY NORTH ANDOVER Bio e�� WHEN CONSTRUCTED. WHEN BUILT b �v � DATE(MM/DD/YYYY ACORD CERTIFICATE OF LIABILITY INSURANCE 5/16/2007 PRODUCER (602)6:11b-4640 FAX: (866)696-4918 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE AIMS Insurance Program Managers HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 15230 N. 75th Street, Ste 1002 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Scottsdale AZ 85260 INSURERS AFFORDING COVERAGE MAIC# INSURED INSURERA:Arch Insurance Company Environmental Pools, Inc. INSURERB: 184R Riverneck Road INSURER C: INSURER D: Chelmsford MA 01624 INSURER e: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING P REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTF J, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICI 3. A I AT IMIT WN MAY AV Y P INSR ADD') POLICY EFFECTIVE POLICY EXPIRATION LIMITS T. TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY EACH OCCURRENCE $ 1,000,0 0 GENERAL LIABILITY DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ 100,0 0 A CLAIMS MADE F7X OCCUR ZAGLE9044500 5/14/2007 5/14/2008 MED EXP(Any onePerson) $ 5 r 0 0 PERSONAL&ADV INJURY $ 1,000,0 0 GENERAL AGGREGATE $ 2,000,0 0 G PRODUCTS-COMP/OP AGG $ 2,000,0 0 EN'L AGGREGATE LIMIT APPLIES PER: POLICY JE X LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ i ANY AUTO OTHER THAN A A $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR FICLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION X W RY L M T OTRH- A WORKERS COMPENSATION AND -- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 1,000,( )0 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ZAWCI9086000 5/14/2007 5/14/2008 E.L.DISEASE-EA EMPLOYEE$ 1,000,C )0 If yes,describe under E.L.DISEASE-POLICY LIMIT $ 1,000,( )0 SPECIAL PROVISIONS elow OTHER DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS *Except for ten (10) days cancellation notice applies for non payment of premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ? IE EVIDENCE OF INSURANCE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO M IL *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,E IT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON' 4E INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Peter Godfrey _ ACORD 25(2001/08) O ACORD CORPORATION 988 LAI CMS,n�no�no. wj VS 1'EL1,CU 1' 051:!6/2007 WED 14:26 FAX ZOUdZ13 ww''��++►►CC vATE(MwDDmm 07 ACORD„ CERTIFICATE OF LIA�1LlTY H��aurlFl�E'vG ED ASA TTf"ROFINFORMATE N PRODL:Ett ONLY AND CQNFLRS NO RIGHTS UPON THE CERTIFICA HOLDER THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Ta33�dt 2nsuratLce Agency, IAc. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 221 C,rh9rd Street NAIC# Che:Ynsford MA 01824 INSURERS AFFORDING COVERAGE _ Pho Le: 97$256-3367 Fa>Rs978-Z55-8215 INsuRExA. _� „anto InsUrRnae'Grow INSLIRI CI INSURER S.- •• "" _ INSURER C; znvir�ental pools. Inc. �n INSURER v: chol Is fora mA 07.824 INSURERE.- COVI:RAGES MUM TOTHF. THE POLICIES OF INSURANC9 ANY REQUIREMENT TERM OR COAD IOMOW KAVE RM N OF ANY CONTRACT OR OTHER DOGU EMS WITH ECT TO THIS CfItO F(CATE MAY BE ISSIl�ED OR OINQ AN, PERTAIN,THE,TERM AFFORDED BY THE POLICIES pESCRiBHD HENCSN I$SUBJECT TO ALL THE TERMS•EXCLUSIONS AND CAN DMONS OF SUCH MASPOL DIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ M UMITS )IY TYPE OF INSURANCE POLICY Nomillt DA Y DATES LTR S EACH OCCURRENCE GENERAL LIABILITY PREMISES Ex o¢urence) COMMERCIAL GENERAL LIABILITY MED EXP(Any we person) S — CLAIMS MADE OCCuR PERSONAL&ADV INJURY $ GENERALAGGREGATE $ PRODUCTS-COMP/OP AGG 5.... GEN'L AGGREGATE LIMIT APPLIES PER POLICY JECT LOC COM81NE0 SINGLE LMR $1,000,00 AUTOMOBILE LIABILITY 05/14/07 05/14/08 soaaenl) 7A , ANY AUTO 7AM027-7014363 BODILY INJURY S ALL OWNED AUTOS I (For person) X SCHEDULED AUTOS BODILY INJURY S X HIRED AUTOS I IPS aoadt+t) X NON-OWNED AUTOS PROPERTY DAMAGE $ (Por adefll) m — - AUTO ONLY-EA ACCIDENT S GARAGEUABILTTf EA ACC S OTHER THAN ANY AUTO AUTO ONLY: AGG 5 EACH OCCURRENCE S SIU _ - S EXCESM®RELLA LIABILITY AGGREGATE OCCUR I CLAIMS MADE S S DEDUCTIBLE $ . RETENTION WORKERS COMPENSATION AND E.L.EACH ACCIDENT $ EMPLOYERS LLABiLITY ANY PROPRIETORIPARTNEHIMCUTIVE I- LOYE E oFFICERIMEMBEREXCLUDED? E-LDISEASE-POLICY LIMIT 5 dcaomeunder SpE(;IAL PROV1.+lONS Del0w I O'INER .I DE5C RIPTION OF OPERATIONS!LOCA 51 VENICLiTS!EXCLUSiDNB ADDED W ENDORSEMENT!SPECIAL PROVISIONS Ev-dence of Insurance. CEF TIFICATE I.IQLDER CANCELLATION ].11Z1ZZ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEDKEI� n-"DATE THEREOF,THE 18SIMNG INSLVA WEN ILL DEAVOR TO MAIL IO DAYS NOTICE TO THE 09"FK:ATE MOLDER NAMED TO THE LEFT,BUT FAILURE TO DO St rRA 1 Evidence of Insurance )MPpSB No OBUGATroN OR LIAB(Lm'OF ANY KIND UPON THE INSURER ITS AGENT OR AT(vss. ®A ORD CORPORA71( V 99E8 AC(TO 25(2001/08) BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 093190 Birthdate: 06/28/1964 Expires: 06/28/2009 Tr. no: 93190 Restricted: 00 DAVID BRABANT 54 MCDONALD ROAD WILMINGTON, MA Commissioner � Y �O'rGP�•ar''�""�` 'o�./� tiovalid for Wividui use only B Bard of BuUd� an g R�utations d Standards License or re8iatren before the eq&Atlon data If found return to: gonia El R8�OB64BN7 CON YOR Bow of Building RgpdxdOns and Standards N sla0t 1 07083 One Ashburton PLe�Rm 1301 _ 008 Boston,Ma.02108 ..Niva�r e"4}toad���' Not valid Mthout `�r� .is 016?4 Depaty AdmtntatrsS°r i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations. 600 Washington Street Boston,MA 02111 ,M n".mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/E1 Pease Print Le er ibl Alicant Information Name (Business/Organization/Individual): {.3v` �ti�.�t- Address: k9 -R r'.�� c1, t�- Phone#: rll£� - zee-oZ� v City/State/Zip:• �LV Are you an employer? Check the appropriate box: Type of project(required): �-,� 4. ❑ I am a general contractor and I 6.: ]New construction 1.Lid l am a employer with , __* have hired the sub-contractors; employees (full and/or part-time). listed on the attached sheet T. ❑ Remodeling 2.❑ 1 am a sole proprietor or partner- $ to ees These sub-contractors have 8. ❑ Demolition ship and have no emp Y workers' comp. insurance. 9• ❑ Building addition working for me in any capacity. [No workers' comp insurance 5• �'We are a corporation and its 10.E] Electrical repairs or addition: requiredk officers have exercised their right of exemption per MGL 11.E] Plumbing repairs or additiom 3.❑ I am a homeowner doing all work § 12.E] Roof repairs C. 152, 1(4},and we have no myself. [No workers comp. employees. [No workers' insurance required.] t 13.® comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.- affidavit nformation. . h. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating suc tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: N �' Policy#or Self-ins. Lica#: Z A W G Y ��� Expiration Date: 5 t \ �(�NNC ®@ City/State/Zip: too• fit.) Job Site Address. nYl< Olfi4 C workers' compensation policy declaration page(showing the policy number and expiration date). Attach a copy of the p 52 can lead to the imposition of criminal penalties of a ra a as required under Section 25A of MGL c. 1 P cure cove q Failure to se g P WORK ORDER and a fir - risorunen as well as civil penalties m the form of a STOP r one-year t, fine up to$1, 500.00 and/o Y �P Beadvised that a co y.of this statement may be forwarded to the Office of of up to $250.00 a day against the violator. P Investigations of the DIA for insurance coverage verification. Ido hereby ce er t pains Pena rtes perjury that the information provided above is true and correct: r Date: Si ature Phone#: FOfficial 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 locallicensing 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 may be 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(if necessary)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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street - Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 5-26-05 www.mass.gov/dia AL4 S AeAKL' lI/AlZ.P SAva[[. 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STA1yagR,6WALL SECT/DN �36RRS!Z' o.c ear s CONSTR UC TIOW NOTES ° • - , : , ., o °°° � .° GENERAL r AF/NFOfAC/NG STEEL ° •CONSTRUCT70/V SHALL CONTOR/11 TD G/TY DEPT 4w XE/NAORC/NG STEEL SXA9LL CONfOy ° OF DL D G ,:.7AFETY CODE j( .STi9NDAAPOS. 7D i9-S.T.M. DES/C/Vi9 T/ONS A/S er A 3 oS a ..,• ' oL R PS Si'r'AL L BEAM//V/.'�UA1 aF TH/R•lY 2G1 . . ! o • D/I//NG am RD NOT P['Rm/TED av -ea 5 DIRMerERS OR /8"LUHEK.= SPG/CES LESS THAN F/ FEET /N DEPTH AT 80�9,PD. p�UR avoU/r •HEAL TN DEPT. APPROYAL RE©U/RED FOR • ALL COMME��C/HL TPODLS. a LIN/Te CD/VS TRZIC T/D/V_ ° e °. 6_ • YPE GUN/Tl� S.4'�9L L BL`/yJACH/,'S/f/y!/,t f0 AND _� DE.S/GN /•3PFL/ED F/V��U. /�IAT/CALL Y. M/,t' lHf�LC BE •• • THIS DE-S/G.N CONFO/t%fS TD LOCAL CODE H.,VO aAigTS SA/YCDEM[`4'lvrz ULT. CD/97P T E/YGTX EovaLIeFg LINE o 1345EO UPON ?, REASONABLY LEVEL S/TE 3AOD PS/ 191vq ,q e 3S OAJ'S COMm.ornr ND AP,09eVeD NATURAL GROUND 'JV17t!/N-Z FEET u,ATf?-f=E"MENT .?AT/D .S.YALL �T E�'CEfO ceavND CLA9'MP AOF TOP OF 3OND 566 A9, .9NY EY CEPT70,VS • /AUTOMATIC SURFACE SX/MI'!ER ° u//LL REOU/ 'E SUPPLEMEN TfTAR!' DfTR/C /DFS/GN 3'/z GAL 3 L[/.4TfR PER SACK OFCE'•ofENT a >. r5N C E • CU,PE GUN/TF BY A L/6117-U1,9TeX .SPA I f y Th'.C.-Z T//77ES A IIAY FOR SEVEN DAYS • OIUNEAP _SH.ALL PROP/9F FENCING //Y COXPL IR NCf LrIVOEA wA rEAC L/GHT l46//11;1 LOCAL 07-Y OX TO GUN ORDINANCE SELF CLOS/NG e LATCH/NG. U a p o- • ELfCrR/CAr S/IgLL CdNFORW TO STRTF PLATE AND LOCAL Rr�G11/REME1VTS FP fIE >JAA -� - •. s�Y,,jH OF yyss i I + w PAUL A. U 6�5 G'OC o PHELAN JR. B �a C b' O OJJt/ L[/J ' 9YG U STRUCTURAL •► _ HW"S'Ta77C No. 42538 AFLAeF r'AGVF • : ;..- '. EDnvironmenta, �o b' O. (if I e!3b') e. .i r/ 1 OO�• - y,0x, G/STEF.��� •:�' Colt r1oN NA` TUBE�f A4EG b1 fro .Design Excellence �J - _ , , r, /arr8 •Lv �. /` '� 6 r J�euona��ourfz Andrew Pr a em r � Presidident 978-256-0200 Q 184R Riverneck Road 1-800.696-6976 MAIN C)U T Chelmsford,MA 01824 Fax 978-256-6620 LFT F/LC_ SPoUr A44 suRr.+tE �uarr� sNatc Pelf JrAir L79mx.CME O VAAVN POOL Z ��,� 3- W3 ZAXS /N 60N0 6EA' ELEYOTO• rERMIN POOL -L��ys /f SoEC/FLED TOP OF Qa/YD E aEI1M Z•p p� - r cfvo i= • NU AMW AWrF,t PWIlr JCA's7rR bfrr�tf /bC1C �r ELfY2'D' • rRams/r1aN Pc/n/r fR,3 a,va m rr oc eor3t WA •' - �D/riivC 50A W I ou o _ ELEY 3'a' _Well"rLEA cE/ L '4 ca,•n•r r� 1fR CuraFFwtr RfCD dff COWN _ ( _ ELEY-r=O' ( ES'AN6LE d M3 BARS SGOL. _caraFF AS NOMI ELEY S=D' G•I` S'Itaorus 0 MA/N DAAI/Vc F YACYE Cd,vECT D/RECr TO /LMP `� UrQfF^e rERr&,g7E AE5IDENrlAL# COMWXCIAt G"M/A'FL�t -S' /A, _BA.CS - ELE!/•7�' Z"CLEAX El EY 71-q • AFEn LfocF 4 ..,— �V, � '^- • G%N/N Tl'P, nom RE/NF. -3 6RRS 5T191VDARD 'WALL .SECT/DIY Z7• >+�sd+�s/z• oc ear CONSTR UC T10"N NOTES GENERAL RF/NFOf7C//VG STEED •CONSTRUCT7AIV SHALL CONrOKM 70 L/TY DEPT . XEiNFORC/NG STEEL SR qZ4 CONFOeM OF BLDG ,:SAFETY CODE1' STHND,4XDS. 7D �9.S.T.M. DES/CNATIONS A /SerA3oS •' ' L APS SEAL L BEAM//1//:'�U/'! 4F TH/.QTY • D/I//NG ffJ RD NDT PfRM/TED 011 P40L S D/Ai/?ETERS OR /8"LUHfX,= SPG/CES • e • ' s r ! ( e LESS THAN E/GHT FEET /N OfPTH AT Boq fD. pCCUR •i G►V0L1/T •HEAL TH Df DT. APPROYRL REDO/RED FOR G U/V/TE CONS TRU C T/01V e G ?� d• /9 L L COMMf,RL//1L TYPE PODCS. GUN/l= Sf/BLL BE/YIACH/,�l/E/►�/•TED AND -.' A. • DES/GN APPL/EL) PNE uNq;r1CALL Y_ M/X _v"'g f BE • TH/S DES/GN CDAvrSORnS TD LLfCAt coDt= /9/Vo cwF PRRT CEMENT• TO FDUR RND A HRL-A • BASED UPOi�/ ?, .�EASaNAL3L Y LEVEL S/TE PARTS SAND /.•4/z ULT. C"D/79P STi�ENGTX EOUAUIE,t LINE o 3AOO PS/ C-9 :Ys DAYS COMR!•orvcr AND RPPROVED NATURAL C,POL/NO !t//TJI/N-Z FEET IlI, WATT?-CEMENT .SAT/D .SrS'ALL /1�7`1-�'CEfD GaXv4 CLAMP OF TDP OF L50ND L3EAJ'�, RNY EYCEPT7onIS AUTOMATIC SURFACE SX/MMER ° 4 GI/�LL REOU/f'E SLPPLEMEN TRAR!' DET•9/L IDES/GH 3'/z CAL.3 AlWre.if PER SACK OFcelolfewr e ti EEN C E • CU,PE GUN/TF BY A L/GHT LvRTER SP.PRJ' -• •' 2-•3 B.IRS(EWI 77.11AeZ rlM.6:.5 A DRY fO,P SEINEN DRYS • 0VNEf _SH,,7LL PROY/DE FENCING //Y COIVPL I/9Nee L14T Est WATEX L/6Hr u//11V L OCAC'_ C/TY oR TO LUN 0,PL11VR1VCE • o. ' •• q G,9TFS TD it,% SELF OLDS/NG � LATCN/NG- U J p o- • ELfCrR/Cf?i YRRZZ CL7N1':OXW TO STATE - PLATE . ' AND LOCAt RFOU/REIyENTS ���� Xj OF A • � '.� � gSSy� I 0. + PAUL A. cGP L?�5 G—OC PHELAN JR. &07W IL//9YC c.) STRUCTURAL ; p • ''O. - i No. 42538 ,vroPes7_rrlc a .• . Environmental•. _ d �' O• REL/EF YALvE t,. • n �,P� ^C/ J. • • .b (iF REoii) ,-� I POOL ^_ b► �`cSS/OIV/tl ��``�` s COLt�0-r]oN r• r y�" ," r � TUSE�f • o ,, Design Excellence /G•�8 Iv '•` Iv`tfi Andrew Everleigh G.CRr 4 SLnt R / '� 6 ► �euonargourfz President 978-256-0200 Q 184R Riverneck Road 1800-696-6976 MAIN OU rLF-TChelmsford, MA 01824 Fax 978-256-6620 F�ic SPOUT AdL SURri1lCE !1lAT2•P SN.OLL PeR _TrA F COMA.ZWE O D�tA/N AL(/,gr vWAr - POOL –' S Ii TERN/N PDOC L�N6 f'T� s- Ara QA.CS /N SONO 6E�1/1 ELfYO'O' ve yr V/C//f v /K SV c.11REo roP•aF,d&Vd BEAM _ 3 Heir wATF,t IrCOaf �r J• N ^92:VENCs Wqa— �,.� �asT�ir fnrr/tF ticY• ,L•• � �.' _ ELEY2'O' TRANS/r/CN PC/NT R,3 a,0�5 A�P!•OC eorMr rrArs r./v/V/11/V" aaolto RAT o E4Eli3W p s+fcrrcEact•/ L •� co�rrr -��.�rR curaFF oqcr ( 'q'/OES'A�vGCE d A'3 a/lRS SG"OL. ' `J \ _CUT 06C AS NOTED EL EY S=0' L,h• S'KADlUS .ccsrariC _ _ E'LEY UO- 0 MA/N DCA/N itK%c F YACYE L'—�vELTD/RECr TO PLIMP UrQFFRLTEryyg7.r T1E5/DENr1At t Coln/se1CC1At G'MIN Irz0 K � S• rrv. _asM.es - ELEI/•7 D' Z"CLEAR \ "-- � • �MiNTrP \ J nooR RF1&,A j+3 SARs - Q/Z'[IG 60TH wars T7'. STANDARD •WRL SECTION 27_ x36A.t5/Z• oc Bar s CONSTR UC TION NOTES c °°o 0 .' GENERAL AF/NFOAC/NG STEEL ° •fOiVSTRUC77G/V SHALL COlYrM177 72) C/7Y DEPT REINFORCING STEEL 5R,9L4 CONFOeM OF 134D G SAFETY CODE j( 57,9N0,4,PD7. 727 r9.S.T.M. D ES/C/VR T/ONS A-/SFA 3oS ° LAPS 'S"YALL BEA M//V/:•_0U/�! OF TH/R-Ty o • D/I//NG 0df;RD NOT PERM/TED ON -m_s D/AinFrFRS OR /8"U11Y1` , SPG/CES LESS 71,'.4N E/GHT FEET /N D.-Pry AT ,64meD. 0�U,p o'.° , ( ` • avauir •HEALTH Dt-P APPROYAL RED U/RED FDR G /TE CONS Tf�U['T/O/V A . J_ e ALL COMMERC/qL 7 PDOL 5, 0 GUN/Tc` Ell fZ L BL`AM6-111,Ve IVI rfD AND Puny f` ;_•-' �� DES/GN /7PPL/ED PNE U/tIAT/CALL Y. M/X JHRLf BE oil Iave P/7RT ceNe lvT• ro FDUR 9/VD A HRLF • TRIS DES/GN CONFOR11.5 TD LOCAL CODE FIND ygRTS S,9/YD /.' 4'"z ULT.• CD/l9P.SrX2r'vCr'y I/ASED UPON R XF gsONAL3L Y Leyez S/TE 3A3 Op PS/ cT S D.9rS EOUAC/tE�t L/NF a AND APPR,9VED NATURAL C�POL/NO 1t//TSI/N-Z FEET COMM•orvcr •, GaxA(D CLAMP • wrew-CE"MEN/- .E'AT/D SHALL 1w EXCEL`D AUTOMATIC SURFACE SeIMMER e ti OF TDP OF �a/5 6EA1�1, RNY qxr D mlz e 3 i2 GALS ulgrzR PE.P SACK OFCE.ffevr C�//LL REOU/h'E SLPPLEMEN TRAR!' DETi9/L !DESIGN rF/V C E • CU.PE GUN/TE BY A L/GHT!�/RTER SP.P��' 2- 03 MR'S 1'ELv7 _ Thlxex rMUIrS A DORY FOR SEVEN DAYS • OLVA157 SH,•"LL PRO P/DE FENC/NG //Y CO/M1PL 1,9 NLE L1110EAWATEk L/GHT 9//TH L OCRC"_ C/TY OX TO GUN QROMRNCE GA7FS TD G`- SELF CLaS/NG e CATCHING- U o p o• • ELECTR/C,9i S//gLL CdNFOR/9i TO STATE P[a rF AND LOCAL R4FGU1A',F" NTS AAAA i :0_ FPME v• ,�sr PLSH OF MgSS L]�5 G-OC ` < PAUL A. V 9Cym ! p PHELAN JR. - b'' O BOrN AL/AYG u STRUCTURAL c O. „ No. 42538 o_ ,vro�osr�7-!c ,• , Environmental ••'- .Y , �� C d • • .b' , . O• 1(iF Rf'�Li� af.t �I OOa ..S - ' b;�cFs /STENA F.\�Q� a COL i F_r"7'1�N •�. Y �: .a�^%,•'^�: _ ��`►►� ��_ .o TUBE t'F RE O C) r J Design Excellence �5 `` � ,c s -4 -L.. /6ri8 �Lo •.: �`E�� Andrew Everleigh �' �= !' G,CArB Sumo n �e¢sona��ouc�Z President 1 _ 978-256-0200 0 184R Riverneck Road 1-800-696-6976 MAINChelmsford, MA 01824 Fax 978-256-6620 OUrLF? Fief_ SPOUT ENVIRONMENTAL POOLS , INC. MEMBER 184R Riverneck Road - Chelmsford, MA 01824 978.256.02 00 / 800.696.6976 / Fax 978.256.6620 E-mail: info@environmentalpools.com • Website: www.Environmentalpools.com NATIONAL An Aquatech Builder SPA s POOL Design Excellence: With A Personal Touch INSTITUTE /^ The General Term's, Representations, and Conditions on reverse side are part of this Agreement. NAME (Buyer) 1_A f-\N NV IV" aa MAIL ADDRESS 24 r. egwwc lid CITY 1�. i 1L a,it� STATE VVYl zip oJ-4y JOB ADDRESS W-V"L CITY _ SI w►t_ STATE S(4ol zip Srivtitie RESIDENCE PHONE Yt" - OFFICE PHONE &Lt- 'le Environmental Pools, Inc. (hereinafter "E.Rl.") agrees with the buyer or buyers above (hereinafter the "Buyer") to construct a swimming pool and/or spa in a good and workmanlike manner in accordance with the following terms and specifications. DIMENSIONAL SPECIFICATIONS i Width Length Shape &S t-G Depth to GENERAL CONSTRUCTION SPECIFICATIONS MISCELLANEOUS 1. Structural engineered plans........................................................................INCL. 51. Raised Bond Beam: Tile W1 I!- Stone N kt% 2. Pool layout plans ........................................................................................INCL. 6" tvl jA 12" N,1.19-- 18" i1 3. Layout pool for Buyer's approval ................................................................INCL. 52. Start-up chemicals: Initial start-up and follow-up instructions ....................INCL. 4. Set pool elevation for Buyer's approval ......................................................INCL. 53. Water Condition -$675.00-20 tons of 1.5"stone 5. Perform normal excavation and remove soil on day of excavation only......INCL. Additional stone at$400.00 per load ..................................................BUYER 6. Access wall or fence: removed by: 54. Clay soil - $450.00 ..................................................................................BUYER replaced by: V,6 SALES TAX & INSURANCE 7. Trees in access and working area to be cut down so that thee stumps do not exceed 2'in height........................................................................BUYER 55. Payment of all sales tax on pool components and accessories..................INCL. 8. Remove from site loads of:trees, shrubs stum asphalt, 56. Motor vehicle insurance, workers'compensation insurance concrete and other debris and general liability insurance ....................................................................INCL. 9. Hand form and shape pool..........................................................................INCL. 10. Removal or relocation of cesspool, septic tanks, leaching fields, ADDITIONAL SPECIFICATIONS sewers, pipes and utilities (overhead/underground) ................................BUYER , 11. Steel reinforcing per engineered plans........................................................INCL. 57. -3- wxc u i Lcn N vie �A,-,,p t C 12. Engineered gunite structure to meet or exceed local or state codes..........INCL, 58LC��£ �cgr.� Cc.vc.�er� �+nrat�Cii•� �r 13. Watercure gunite shell twice daily for seven days....................................BUYER 14. Install continuous bond beam around skimmer..........................................INCL. 59. Citr.S'f T : 'L 11iY Lb ���c' 15. One set of shallow end steps with 4'bench........................ ..............INCL. S+V c,�74lily .� � :➢ c� e .'�. 60.;,,,.aK.�.• ''jCi VE►2 LZ�+K � G:;a �%�2sn; �•Sc,�: 16. Swimout or loveseat d���� r i1 �(n &'- 17. � �� 17. Install 6"band of frostproof tile.....................J.r<l-th.................................INCL. 61. 18. Pavers, Bullnose Brick, or Bluestone 62 _� -Iwe: 19. Cantilever form for deck _1VU_ 20. 2 hrs.backfilling and grading-deck area only..............................................INCL. 63. LAh k C, 21. Pool interior finish.....................R.vetL....1 ......?�t3�. ?.....................INCL. 22, Filling of pool promptly after interior finish BUYER 64. 1`� ........ - 65. rii`�i k�c1� y-h If WD-).IIA L It- 11 Y t�B,t.9cffa t i�F t 1 HYDRAULIC & FILTERING SPECIFICATIONS POOL DECK PRICES 23. Approved deluxe filter: Type C11cTUv Z�� �a'� Size C 7S� SUB-BASE MATERIAL IS NOT INCLUDED. 24. Pump and motor: Type _ Size -Tv x) Decking square footage: L 6'CY) Type��. eco 25. Pressure test all pool piping........................................................................INCL. 26. Hook up all water lines from filter to pool....................................................INCL. Other: SQA a f YV1 0-LGVL%aN,L o, NA_6 v+_�wn+CLL 27. Non-corrosive PVC plumbing throughout....................................................INCL. 28. Hydrostatic valve ........................................................................................INCL. 29. Provide return inlets for filtered water to pool ............................................INCL. PAYMENT 30. Main drain suction line with grate................................................................INCL. 31. Deluxe Skimmer Including Weir Gate and Large Basket........tfc:+rx.............INCL. The Buyer agrees to pay E.P.I.the following Contract Amount for E.P.I's 32. Vacuum fitting outlet in skimmer..................................................................INCL. performance of its obligations under this Agreement. , c 33. Up to 30'of plumbing between filter and skimmer......................................fNCL. "� ��� "�� r`f�y 34. Pre-cast pad for pool equipment ................................................................INCL. PAYMENT SCHEDULE 35. Backwash line..............................................................................................INCL. e Contract Amount $ 6tVA-5 ..� 30%Day of Excavation $ J7 so AUTOMATIC EQUIPMENT Deposit $ Vv 40%Day of Gunite $ ceG C.",C.",-�-i -.< 36. Automatic pool cleaner: Type v% BALANCE $ l 25%Day of Tile $ 0 37. Stub plumbing for future pool cleaner ........................................................INCL. 5%Day of Interior Finish $��'r S•7_.�' 38. Floor recirculation system I%Yz£ t1j.X1, j SlxAtluS 39. Automatic chemical feeder..................... ....................................................INCL. TOTAL $ 40. Automated Pool Controls T. [�:Lf TERMS AND CONDITIONS THE BUYER UNDERSTANDS THAT BY SIGNING THIS AGREEMENT, HE OR SHE ENTERS INTO A POOL HEATER & UTILITIES CONTRACT WITH E.P.I.AND THE BUYER CONCERNING E.P.I:S CONSTRUCTION OF A SWIMMING POOL,MEETING THE SPECIFICATIONS CONTAINED IN THIS AGREEMENT.ANY CHANGES IN ANY OFTHETERMS OR SPECIFICATIONS OFTHE AGREEMENT MUST BE MADE IN WRITING SIGNED BY 41. Deluxe pool Heater: Size ,(4C?i 4 Make t[ E.P.I.AND THE BUYER,AND NO VERBAL CHANGES IN THESE TERMS AND SPECIFICATIONS ARE Indoo Outdoor � Nat/Pro ri��� PERMITTED. Fuel connections, heater venting, fuel storage tanks, permit..............BUYER AS PART OF ITS OBLIGATIONS UNDER THIS AGREEMENT E.P.I. IS PROVIDING THE BUYER 42. Install underwater light(s), each with 10'conduit .........J.'V r....................INCL. WRITTEN GUARANTEES REGARDING THE SWIMMING POOL WHICH IT WILL CONSTRUCT PUR- 43. Electrical bonding of pool as required by city or town code SUANTTO THIS AGREEMENT.THESE GUARANTEES ARE CONTAINED IN A SEPARATE DOCUMENT 44. Electrical wiring and connection up to 75'from service panel WHICH IS PROVIDED TO THE BUYER. Pool over 75'at$15.00 per foot BUYER THE BUYER HAS THE RIGHT TO CANCEL THIS AGREEMENT AT ANY TIME BEFORE MIDNIGHT OF Heat Pump at$1B.00 per foot BUYER THE THIRD BUSINESS DAY AFTER THE DATE ON WHICH EITHER THE BUYER OR E.P.I.HAS SIGNED THIS FORM BY GIVING WRITTEN NOTICE OF CANCELLATION TO E.P.I. HYDR RAPY SPA THE BACK OFTHIS CONTRACT CONTAINS IMPORTANTTERMS AND CONDITIONS.THEY ARE PART OF THIS AGREEMENT.READ THEM. 45. Attached Separate Ra Light I ACKNOWLEDGE THAT THIS EEME T IS A LEGALLY BINDING CONTRACT,SUBJECT ONLY TO Blower # Hydrotherapy jets THE ABOVE CANCEL ATI OVISION ,AND I CERTIFYTHAT I HAVE READ AND AGREETO ALL Additional Specs. TERM AN C ND I N 0 THIS AGR EMENT. ENVIRONMENTAL POOLS, INC. ACCESSORIES B BY: 46. Deluxe cleaning tools (18"nylon brus d leaf skimmer, ^ V . thermometer, pole, test kit, de acuum) ..............................................INCL. BIJ i 47. Diving board: e N� A- Color f. 48. 3-tread S.S er/handrail 1 t4, DATE ��1 r �� DATE 49. Po e: Size 1..T�_ Color--1f714 5 . All jigs installed by decking contractor or buyer i Location No. O Date AORTN TOWN OF NORTH ANDOVER • s ; ; Certificate of Occupancy $ s'•^ E Building/Frame Permit Fee $ �2 Mus Foundation Permit Fee $ .- Other Permit Fee $ TOTAL $ Check # / 20776 Building Inspector