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Home My WebLink AboutBuilding Permit #830-12 - 64 FOXHILL ROAD 5/21/2012Permit NO: —�LLq �-2 k= BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received TYPE OF New Building Addition Alteration Repair, replacement Demolition .. OWNER: Name: Adrirp-cm- PROPOSED USE Residential One Fam—ily---- Two or more family No. of units: Assessory Bldg Other Non- Residential OF V�ORK TO BE PREFORMED: (2 — -,V- " — (� n J,,A\ e Type or IL . , Int Clearly) Industrial Commercial Others: ARCH ITE CT/ENG IN EER_.L& U-A'Aaz' Phone:i6—L--45A 431(, - Address: Reg. N IA 0. -"-5n FEE SCHEDULE.* BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ FEE: $ 0 Check No.: D6 Receipt No.: NOTE: Persons contracting with unregistered contracto—rs do not have access to the guaranty.fund I U. Location 4/41/(/ Z// No. g 9 4 Date TOWN OF NORTH ANDOVER Certificate of Occupancy Building/Frame Permit Fee Foundation Permit Fee Other Permit Fee TOTAL lw!x P Plans, Submifted 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 to - COMMENTS CONSERVATION COMMENT S Reviewed on 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 Conn ecti on/Sig nature & Date Driveway Permit DPW Town Enogr�ee r: Signature: 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 21 A —F and G min.$100-$1000 fine NOTES and DATA — (For department use) El Notified for pickup - Date Doc.Building Permit Revised 2010 M 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 ZI Building- Permit Application u Workers'Comp Affidavit Ej Photo Copy Of H.I.C. And/Or C.S.L. Licenses 13 COPY Of Contract zi 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 ci Building Permit Application o Certified Surveyed Plot Pfah Ei Workers Comp Affidavit' Li Photo Copy of H.I.C. And C-S-'L� Licenses 13 COPY Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (if Applicable) o 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) a Building Permit Application o Certified Proposed Plot Plan zi Photo of H.I.C. And C.S.L. Licenses u Workers Comp Affidavit u Two Sets of Building Plans (One To Be Returned)t.o Include Sprinkler Plan And Hydraulic Calculations (If Applicable) u Copy of Contract u Mass check Energy Compliance Report o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks Office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application 7� Doc: Buildin.- Permit Revised 2008 June 14, 2016 Building Inspector Building Department Town of North Andover 1600 Osgood Street, Bldg 20 Suite 2035 North Andover, MA 0 1845 RE: 64 Fox Hill.Road Dear Sir, Enclosed is the installation report for the footings at 64 Fox Hill Road. It shows the bearing capacity of each footing exceeds the required design load. Sincerely, Michael Chaisson, Sr. Construction Supervisor 0 Archadeck of Subu 11 rban Boston - Telep'hohe'(781) 273-3500 - (800) 696-"DE'CK - FAX (781) 273 . -3536 - 16 Adams Street - Burlington, MA 01803 -nemoss.orchadeck.com - subboston@archadeck.net of Connecticut 482 Spring St. Naugatuck, CT, 06770 WORK SITE SHEET DATE: May 19 2016 Archadeck of Suburban Boston 16 Adams Street Burlington, MA 01803 . . .... .. ... Defivery Address Gunther & Pamela Hoffman 64 Fox Hill Road North Andover, MA Type of project: Deck Qty Category Galv. Black Fixed H. Adj. H E xt. 1 PI -8G X 6x6 4 P1 -6G X 6x6 Installer: 0 Michel 0 Sylvain 0 Dave 0 Keven VCody 0 Tom W:] UADOIKIf-- ^r! ne-%e-r� Signature of installer: . . .... .. ... Signature of installer: Reference Line 13,-101/211 rull I Ul (I 44* LU E3 Cj LQ At Lo c� r� Reference Line 13,-101/211 rull 44* E3 Cj The Commonwealth of Massachusetts Department of Industrial Accidents 1IL-H Office of Investigations 600 Washington Street IC Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Ugibly Name (Btisiiiess/organization/Individual):_ ��04A_,S�t,4�, C-:2(JAJjjC�5 Address: rbck &�6 1.0 City/State/Zip: 641 1 A5P��A _. JAAr 0 1 n4—Phone#: Are you an employer? Check the approp I am a employer with 13p 0�1 mployees (full and/or part-time).* 2. 1 am,a sole proprietor or partner- ship and have no employees working for rtie, in any capacity. JNo workers' comp. insurance required�] 3. 1 ain a homeowner doing all work myself. [No workers' comp. insurance required] t -fate box: 4. 1 am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance'_,�,' 5. We are a corporation and its officers have exercised their right of exemption per MGL c. 152, §1(4), and we have no emplo yees. [No workers comp. insurance reouired.] Type of project (required): 6. E] New construction 7. E] Remodeling 8. [] Demolition' 9. E] Building addition .10.[] Electrical rep airs -or addiiions I LEI Plumbing repairs or addiiions 12.n Roof repa.irs 13. 0 t It e r &A -MA44 it A A 'Ally applicant that checks box #I must also rill out the section below showing their workeW compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicatillL Such :�Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entifics havv employees. If the sub -contractors have employees, they must provide their workers' comp. policy. number. I am an employer that is, providing workers-compensado.n insurancefor my employees. Below is the policy anidj . ob site information. Kompany Name Insuranc A-] Pol icy # or Se If- i ns. Lic. #: Expiration Da te: /no Job SileAddrew. City/StateiZip: A - 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 MGLd. 152 can lead to the imp . osition of criminal penalties of a fine tip to $1,500.00 and/or one-year imprisonment, as well as civil penalties in thCrform of a STOP WORK:ORDER and it fine of tip to $250.00 a day against the violator. Be advised that a copy of this statement may be forw I arded: to -the, Office of Investigations of the DIA for insurance coverage verification. I do hereby ce�under �the�taind�penaitdes �oq�f perjury that the information provided atove rue and correct'. �u7 t, Sip -nature; t Date - �z Mt I IZI WOUNAMiloilits N Official use only. Do not write in this areal'to be completed by city or town,official. City or Town: Permit/License # Issuing Authority, (circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact. Person:.- Phone #: N ACC)Rbr _111%� CERTIFICATE OF LIABILITY INSURANCE DATE (MMODNYM F5/9/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsemengs). PRODUCER FIAI/Cross Ins -Manchester 1100 Elm Street Manchester NH 03101 CA%T�c"` Sandra Gargano PHONE (603)669-3218 1FAX r Ale. Nol: (603) 645-4331 E%IHL2 sgargano@crossagency.com INSURER(S) AFFORDING COVERAGE NAIC III INSURER A. -National Fire Ins Co of INSURED South Shore Gunite Pools and Spas Inc 7 Progress Avenue IChelmsford MA 01824-3606 INSURER B -American Alternative Ins. Corp INSURERC: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:SSG Master 12-13 REVISION NUMRFR- 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 LTR TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF IMMMR= P0LICYEXP (MM/DDNYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurrLence) $ 100,000 COMMERCIAL GENERAL LIABILITY A CLAIMS -MADE Fx_]OCCUR INS4013391907 4/1/2012 4/1/2013 MED EXP (Any one person) $ 5,000 PERSONAL& ADV INJURY $ 1,000,000 X CGOOOI 12/07 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER, PRODUCTS - COMPIOP AGG $ 2,000,000 7 POLICY FX] PRO - IEcT L1 Loc $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT IF, accident) 000,000 A ANY AUTO _�__l BODILY INJURY (Per person) $ ALL ED SCHEDULED AUTOS AUTOS SAP4013391889 4/1/2012 4/1/2013 BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS SAP4015536568 4/1/2012 4/1/2013 PROPERTY DAMAGE $ (Peraccident) firnit $ X UMBRELLA LIAB �x IOCCUR EACH OCCURRENCE $ 5,000,000 B EXCESS LIAS CLAIMS -MADE AGGREGATE $ 5,000,000 DED I X -1 RETENTION$ 10,000 $ 82A2UB0000865-00 4/1/2012 4/1/2013 A WORKERS COMPENSA71ON TATU-T I 0TH - X I TORYSLIMITS I I ER AND EMPLOYERS* UABIL17Y YIN E.L. EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER[EXECUTIVE [E OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (mandatory In NH) 4013391891 4/1/2012 4/1/2013 if yes, desaibe under DESCRIPTION OF OPERATIONS below �_a)MA,NH,CT,R1,HE,VT E.L. DISEASE - POLICY LIMIT, $ 1,000,000 A Pollution INS4013391907 4/1/2012 4/1/2013 Occurrence $1,000,000 ILimited Worksites Liability L DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, AdcIttlonal Rernarks Schedule, If more space Is required) Covering swimming pool construction/related operations of the nam d isnured during policy term. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAT10N DATE THEREOF, NOTICE WILL BE DELIVERED IN Hoffmann Residence ACCORDANCE WITH THE POLICY PROVISIONS. 64 Fox Hill Road North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Sandra Gargano/SGS ACORD 25 (2010/06) @ 1988-2010 ACORD CORPORATION. All rights reserved. I N9025 i7ni nn.r) ni Thab AnoDn nama and lnro^ ara rarviatarari market r%f Aelnpn 9, "CA uth Sh - re C -un Lce"11 )ol & Spr ,, ".'.ncQ NAME (Buyer) MAIL ADDRESS 7 Progress Avenue e Chelmsford, MA 01824 1-800-649-8080 THE GENERAL TERMS AND CONDITIONS ON THE REVERSE SIDE ARE PART OF THIS AGREEMENT EXHIBIT A SWIMMING POOL CONSTRUCTION AGREEMENT (BETWEEN "CONTRACTOR" AND "BUYER") 2 of 2 CITY I � - STATE44—,L zipc&4s: JOB ADDRESS CITY 17 STATE ZIP HOME PHONE �J-fl� - W D T,) - U -7 BUS. PHONE E-MAIL VI)LIA 4r-,.I��AANA V\ CELLPHONE Grading & compacting of deck area -up to,.?*' hours.... ' ' ' "" T� I POOL SIZE Ao DEPTH SURFACE AREA 00 T� PERIMETER I Engineered structural plans and MISCELLANEOUS SPECIFICATIONS 51) working drawings .............................................................. Included 33) U.L. Approved marine underwater 2) � Swimming pool construction permits, as required by state and local code 34) light 50' cord 120 Volt ...................................................... *Included U.L. Approved deck box for *Included,, .................... Start up and operations instructions .................................... Included and conduit light ................ 3) Established shape, location and elevation 35) Diving board size C Colo ........... Non corrosive plumbing and fittings throughout prior to excavation of swimming pool .............................. Included 36) Laddertype .......... A,1`/A- 4) Normal excavation of pool, removal of soil, 37) Stainless steel step rail, figure 4 ................................. /V Brushing of interior surface after and placement of wood frame work (up to 8 hours) .......... Included 38) Electrical .................................................................... Additional Excavation $200.00 per hour 4 hour minimum. 39) Pool motors, clocks & switches .................................. 5) Engineered steel reinforcing throughout pool .................... Included 39A) Bonding of steel reinforcement .................................. 6) En-ineered concrete, gunite structure to meet or exceed 40) Bonding of deck wire .................................................. i I EtC44 28) state local codes .................................................................. Included 40A) (�cJ-oj Or' 7) Water cure gunite shell twice daily for 7 days ................ By Owner 41) Safety rope and floats ......................................................... Included 8) One set of shallow end steps with 4 ft. bench .................... Included 42) Property damage negligence 9) C ) J Swimout deep end 4 .................. Deluxe PCC2000 W/leaf canister ................ insurance during construction ............................................ Included 10) Stumps, concrete, or other debris removal .............. *M� MUCIJ&k 43) Public liability and workmen's 11) One 6" band waterline, frostproof tile .................. :Tvlt," compensation insurance .............................. 12) Coping 44) State and federal sales tax .......................... 12A) Coping Material' lVr4�- ........ -T�Ai 45) Written lifetime structural guarantee .......... I'M r, ; r, 1 �' A J'A-1) -A—, , , rrUUD A DV QDA vp lir V V1 X0- L 12 ................ A 12C) . .................. A) /A- 13) Interior finish to be water proof . .................. E—�dt) R 13A) Interior finish material DEA&I .......... :t7u r U) k [ilk 13B) Interior finish color ................... 7u 13C) -- . ................ Z\V) A3A,-- 14) Filling of pool within 24 hrs .......................... By Owner FILTER SPECIFICATIONS 15) Filter manufacturer . .............. 15A) Filter size ................... 47B) Water: o t ble soil conditions, 18 to 20 tons of crushed stone unsui a 16) Pump manufacturer S t1,A( (jU at $ 4-A .. ................ t i4f� Z, .-- per load I �-ZO 4-�tS ................ AC+7X4( W 16A) Pump Size 2JJV \IS-5d&S . .................. Additional stone at per load ' 14. - , 17) U.L. listed exterior timing control .................................... *Included GRADING 18) Complete hookup of all pool lines to filter ........................ Included 48) Rough backfill to pipe grade .................. . HEATER SPECIFICATIONS ........................ Included ........................ Included ........................ Included 19) Approved Heater type��P,-g�-k, Fuel -Y� A'Af 'A 50) Grading & compacting of deck area -up to,.?*' hours.... 19A) Heater BTU rating4d)k Indoor utdoor START UP MAINTENANCE 20) Water lines to heater connected by contractor ---- -- Included 51) Deluxe cleaning tools (wall brush, leaf skimmer, pole, 21) Fuel connections, venting and fuel permits ............... By Owner vacuum head and hose, test kit, thermometer) .................. Included 22) Heater other:- A)o r--- . .......... 52) Start up and operations instructions .................................... Included PLUMBING SPECIFICATIONS 53) Start up and balance chemicals .......................................... Included 23) Non corrosive plumbing and fittings throughout ............ *Included 54) Daily testing & adjustment of ph level ............................ By oW Der 24) Self adjusting surface skimmer ........................................ *Included 55) Brushing of interior surface after 25)- - Pressure return Outlets -to PooL ......................................... *1ncluded pool is filled with water ....................................... : ............. By owncr 26) Main drain receptacle with grate .................. ; ..................... Included Depending on interior finish , brushing 27) Max. piping between filt r and 001, 25 ft ........................ � T_; � Include� will be I to 2 times daily 28) Additional piping @ per ft ........ A), -�--rkA cl,/64�- AUTOMATIC POOL CLEANER AND CIRCULATION 5 year parts and labor warranty 29) 30) Floor recirculation . ................ * /V �A- *.44- Filter has a 5 year warranty - Filter tank has a 10 year warranty Deluxe PCC2000 W/leaf canister ................ Refer to exhibit B on back of contract 31) Pool Cleaner, other . . .................. �A AA - DISINFECTION SYSTEM THIS CONTRACT PRICE IN VALID FOR 45 DAYS 32) Type-T�,kf)FR�- ON( Sq�k� *I�CkAck- N ADDITIONAL SPECS --7 Buyer., Contractor Representativk Date Accepted /(Z.- w w N L) a 4) 04 W) E ;3 '2 0 Go CV w C'. Lo CL m CL c -ED (D CL U) 0 0 CL .0 t LO) z Ln 0 -j -, Q 0 W x 2 0, CL Ul > — 0 tr 0 0 (L D U) Lu W 2 X (r w o cis -x T- F - M C's U C-1 d 4-( Z� cz C) Cl) —j 0 0 CL w .0 z 04 Z) w 00 0 0 �e Cc) w < < C>U 4" W 0 OZ< X < cn U) U) d) X L— Cn F- 0) E 0— DO " a) 0 0 U) U) u V) i r-1 I CL E El 2. CL 5 F] c c > co E (n u CL. Wj CD t : s .< 60 VC cc 0 0, .4 .40, o C2 goo c z N Iq C'4 w L) (>L) z < 0 cn E 0 2 L) -C U) C) '2 m CL c -ED (D CL U) 0 t LO) z Ln 0 -j -, Q 0 W th �: 0 2 0, CL Ul > — 0 tr 0 0 (L D U) Lu W 2 X (r w o 0 -x T- F - 0 U) c z N Iq C'4 w L) (>L) z < 0 cn E 0 2 L) -C U) C) Board ot Huildin,-- :,rill Construction Sup�rvjsor L;cense Licerise: CS 5607D Restricted to: 00 -ROBERT E GUARINO ? PROGRESS AVE CHELMSFORD, MA 01824 3 � t Expiration: 913?2012 Trg- 25940 (A m m m m m m m M ra, CO) CW) 10 0 CD n Z co) El' 0 -0 D = r- F CO M CO) CD 0 CD cr CD CD - 0 CD ww 9. CD Go CD ca CD S- CD z CD CD oft"o cr co 43 I 0 C/) z 0 td (D 0-4 PC Cc: M 00 g� al OS cn C/) 'ro� It a' 0 tz 0 t7l n 0 cn C� cn n 0 0 cn cn 0;1:cli cn cn R J74 L-��q z CO N 0 to CO co C, CL -CO) ca 10 CD zto cr Go CO2 0 cF M mn ca CO2 !t 23 M. 5"m Rolm CA ca 0 r 019 .L =r!tg. 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