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Home My WebLink AboutMiscellaneous - 114 LACY STREET 4/30/2018 (2) 114 LACY STREET 210/105.D-0028-0000.0 il I� i A Location L,4 C No. Date N TOWN OF NORTH ANDOVER ' Certificate of Occupancy $ Building/Frame Permit Fee $ wcMus Foundation Permit Fee $ Other Permit Fee $ d _- TOTAL $ ao Check # C? 18530 Building Inspector t TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT'MPAM bR DEMOLISH A ONE OR TWO FAMILY DWELLING .� BUMDING PERMIT r7UMM DATE ISSUED. !A X ' X SIGNATURE: low Building stoner of Buildin Date -o SECTION I-SITE INFORMATION 1.1 hWaty Adrkosv sersora 1.2 AsMap and Pared Numbx: 0 MvNurnber parod Number l� 1.3 Zoning Intbrma6w IA Property Dk m kns �+ Unin Disuid Proposed Use Lot Area F R 1.6 BUILDING SETBACKS ft Front Yard. Side Yazd Rear Yard Re 4w'.red Provide Provided Rewred Provided 1.7W,mr sapplyMGa Cao. J4> I.$. I$aoazeoCk MU;an; t.a sewengeUis tlsycteac > P&W d PrMu a ?ace 046W Fl"d zoos 0 wunicip,I a On Site Mpo„1 Sit 11 -4 SECTION 2-PROPERTY OWNERSH MAUT ORIZED AGENT m 2.1 owner of Roow rRS Ntune P'ntV Addtexa for Service: � i�rtatu Tekphoneq-7� )2.20wncrof'k=rd. Name print Address for Service: ''A sianature Te r houM SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor Not Applicable 0 Licensed Construction Supesviw.. n 0 �l�2 � �l� C � � License Number W Signature Tetephone arir 3.2 Registered Home Improvement Contractor Not Applicable t3 CtrmpaayNamey� n 1ST Repastratton Number 46 z Expiration Date S; nature To e Y/ SECTION 4-WORKERS COMPENSATION(M.G.L.C 152 §25c{6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will mutt in the denial of tho issunw of the bwUng Permit S' affidavit AttuW Yes,......D No.....,n SECTION 5 D!lcti n ofPM.•sed Work checkstt table New Construction.0 Existing Building 0 Repair(s) 0 Aitemdons(s) 0 Addition `0 Accessory Bldg. 0 Demolition 0 Other 0 Specify Brief Description of Proposed Work; -- s �V i SECTION 6-ESTIMATED CONSTRUCTION COSTS . Item Estimated Cost(Dollar)to be Completed by perrakapolicant 1. Building (a) BuiklingPtmit Fee fX1CJ r Multiger 2 Electrical (b) Estimated Total Cost of Construction 3 Plumb' Building Permit fee(s)z(e) 4 MecitazucalITVAC (!� S Fire Protection 6 Tota! 1+2+3+4+.5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERIIITT as Ow=/Authorized Agent of subject property ftby to act on y f,in an relft veto work authorized by this building permit appIIcatiom Sirof0waer Date CTTON 7b OWNERIAUTHORIZED AGENT DECLARATION 1, •-�� a as OwterfAuthorized Agent of subject Hereby declare that the statements and information on Ute foregoing application are true and accurate,to the best of my knowledge aad belief Print Name Si lure of Ownef7A ent Date 0,OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 191 2Nu 3 SPAN DIIAWSIONS OF SILLS DMIENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY 1S BUILDING ON SOLID OR FILLED LAND IS BUILDNO CONNECTED TO NATURAL GAS.LES FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTION APPLICANT—,Z_/;5_ PHONE2�E-��" LOCATION: Assessor's Map Number PARCEL 2� SUBDIVISION LOT(S) STREET Il�� ,Za c �, ,_ ST. NUMBER OFFICIAL USE ONL RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 Jm �ammr�uuea a� tS BOARD OF BUILDING R =TI O8 License: CONSTRUCTION SUPERVISOR Number_CS� 072675 "; Birthdat$".08116/1970 expires 08/16/2006 Tr.no: 799.0 inRestricted; Ot} 1 I ` ERIC M DIONNE 3 PARADISE RDS' BEVERLY, MA 019'f 5�.`-_; - Commissioner 6T, Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 128583 Expiration: 4/26/2006 Type: Individual t ERIC M.DIONNE ERIC DIONNE 284 ESSEX ST. BEVERLY,MA 01915 # Administrator 1 NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: --&el t is that the debris resulting from this work shall be disposed of in irproperly licensed solid waste disposal facility as defined by MGL c11, S150A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section 10A. The debris will be disposed of in: A-nqap-4 (tocation of Facility) 9ZZ 8�3v v Signa6e Permit Applicant Fire Department Sign off: Dumpster Permit Date Department of IndustHd Accidents Office of Investigations kv 600 Washington Street Boston,MA 02111 www.massgov/dle Workers' Compensation Insurance Affidavit: Builders/Contractors/Electridam?lumbers Applicant Information Please Print Legibly Name (Business/organizationMdivi6ai)• Address: City/State/Zip:_Re, c � / ff Phone#• 9r-- AZ�l employer?Check the appropriate bpi: 1. foyer with _ 4. ❑ I am a general contractor and I 6. d project(required): ): (full and/or pan-time).' have hired the sub-contractors6 ❑New construction2. proprietor or partner- listed on the attached sheet._ ?• ❑ Remodeling ship and have no employees These sub-contractors have S. ❑ Demolition working for me in any capacity. workers' comp. insurance. [No workers'comp.insurance 5. ❑ We are a corporation and its 9' [3 Building addition required.] officers have exercised their 10-0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself.[No workers' comp. C. 152,$1(41 and we have no 12.❑ Roof repain inmmmce required.]t employees. [No worken' 13.❑ Other comp. insurance required.] 'Any applicant that cbecb box#1 must also 811 out the section below showing t ok woe ms'eonWee on Poon'in8or� t Homeowners wbo submit his s83d6vit indicating they am doing dl wort and then bi a outside eouhWom must submit a new affidavit"catirt8 suck tCont nuns that check this box mut attached su additional sheet sbowiq the Bum of the suboonhacton and tier wo*as'9MV•policy infomtrtiOL I am an employer Am is providing wrkers'compensedon IntwnnecJor�'� allow L dire polity aw1,Ja►b alae lnjormatlen. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/StaterLip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and exphration date). Failure to secure coverage as requir�Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of s fine up to$1,500.00 and/or one-year t,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage vcrification. I do hereby certify under the pales and penahles ojperfury that the lnfonnadon provirtl abs Is trMs and eorr+eet Si �- Phone M ? if O�?chd use only. Do not write in this area,to be completed by c1,or town of'Icial City or Town: Pwmit/Licenw 0 Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cltyrfown Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other contact Person: Phone N: lilAva aaaM..ava N M i v -- Massachusetts General Lag's chapter 152 requires all employers 10 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 hirer , w 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 a>s individual,partnership,association or other legal entity,employingemmpbyees. however the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a badness 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 152,125C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the perfbimance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented 10 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 10 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 sue to sip 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 non F li rted below. Self-insured companies should enter their self-insurance license number on the appropriate lice. , City or Town oAlcials i please be sure that the affidavit is c onWlete 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 reg aft the applicant please be sure 10 fill in the permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permitticeme 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 aflidavit been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid af�is on file for future permits or licenses. A new affidavit mast 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 Me 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 wwwmm.gov/dia NORTH own of : � _ over No. •� �r p — �` C% = = dover, Mass., O L A �. COC MICMEWICK V ORATED �i BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THATAts.•4... A..y... Vis........................ ...... ..... ......................................... ................. Foundation has permission to erect.. ( .... ......... buildings on ... �ACey..... .............•.•.....• Rough to be occupied as �nWD ! ~ �o Chimney �..... provided that the person accepting tm 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST TS .tRough................... 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. N0 - 3 ;, Date......... ..................... HORTM °�t�``°;•1"° TOWN OF NORTH ANDOVER PERMIT FOR WIRING �,SSACMus� This certifies that ...'.............: has permission to perform .................. wiring in the building of...............:-.: -.'.......................................................... at..' :...� .......:................:. ',.......................................... ,North Andover,Mass. y. Feer.................... Lic.No.Z� "... ............................................................... ELECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept, PINK:Treasurer �•� 11M W1VEyJU1VWCfIL1C1 UC IYIfia1H(.C1UJCI 13 ""'cu use u"p'y DEPARMENTOFPUBLICS4FE7Y Permit No. 3-1.3 I BOARD OFMEPREYEIVI70NRWUU4T10AS527CW 12DO UPPUCATIONFORPERWTOPERFORMELE Occupancy&Fees Checked CTRICAL WO ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,S27 CMR 12:00 0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the ele rical workrib��. Location(Street&Number) Y Owner or Tenant Owner's Address •0— Is this permit in conjunction with a building permit: Yes NoEfr (Check Appropriate Box) Qo �6d Purpose of Building Utility Authorization No. Existing Service ,�, 0 Amps .��Volts Overhead Underground No.of Meters New Service AQ 0 Amps qVd olts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total I KVA If No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets _J No.of Gas Bumers No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons Vo.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal a Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER TtwanceCaaage Ptasuatbthetagtmanais dist sGataalLaws Iha%eacuttatLi bhyhmryorkxmgCanpide cri1sakgmtialagtvakit YES NO Iha%esuhmittedvatidWdofsame drOffim YES NO If}uuha%edx&&YES,pkffiemdc*theiyWcfmwaWbycd>eckirtgthe Wptopri*bcx L---J INSURANCE BOND OZIIR ftweSpecify) �-- Dtate Estprt*d VakxdE{ahical Wak$ WorkoStatt hgpedwD*ReWesWd Rough Final Signed utider�ie Pt3>al�ofpetjiay. FIRMNAME ��ii / Lioa�seNa LioaIsee �. • tit 7�CLi c a c �•L LimnseNo ZZoz . 0 �. D.P QA V Business Tel.No.��23-5/��'Q AiTdNa OWNER'S INSURANCE WAIVER,lam aw=ftttheLifla= t dcmam=oxe7pantssksbrtWeWdkitasmqmWby&lazaduettsConaIL m and4vinysigtMm,cnihispwnt v""Aa;tmtewitanat (Please check one) Owner M Agent Telephone No. PERMIT FEE$ �� Location /! C/ I AC V S-f No. Z ) Date �� r NORTy TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ �'�s'"•"t Building/Frame Permit Fee $ s�cMus Foundation Permit Fee $ Other Permit Fee P00( $ /30 TOTAL $ � O Check # / Building Inspector a � 1 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING Ac BUILDING PERMIT NUMBER / DATE ISSUED: ic SIGNATURE: C Building Commissioft&'/I for of Buildings Date SECTION 1-SITE INFORMATION Iz 1.1 Property Address: 1.2 Assessors Map and Parcel Number: O Map Number Farcel Numberx oy, 3 yi V e / 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide —Required Provided RegWred Provided } 1.7 Water Supply M.GL.C.40. 54) 1.5. Flood Zone Information. 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record U yr I'S 6e- ►2�'S f I y k& c y lee A.), Aic. o ee- Name(Print) P Address for Service: 4 Signature Telephone 2.2 Owner of Record: 8 Name Print Address for Service: z Signature Telehone SECTION 3-, ONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ vSu�►mm/� Inoy ('�eVI+P� �i1 . �o �"ClntayI�t�Ic�( Licensed Construction upervisor: t---'(O0 il I � % I ( w License Number Address / 4tkit 3 j � 0a / 1z 7�'G/ /��/ Expiration Date ic ignature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ S,Lw M l n C.1 Pod ('' -�� .Tvi P r� Company Name / v) 11 b S 1 �1 4,)-76J• U h 1 0/'1 �T , /�GL.GU`j�1Pt�C ' 04'y Registration Number Address 21/oa / �'ll✓'0 •�" (i tG Expiration ate j Signature Telephone I SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building rmit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify I BriefDescriptionof Proposed Work: 1/ nb�t cc 18X �0 `Xa(o L-ShupP� //goo ) In &Ck dk'c� Sw;mmi>j go0l C'Ywcoalydellyr UA0 t'6111 d r•cl avid lnsS l ll � /. =f'l foo 1 0—n Poo . SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be IC�AL �+ {) S Completed by permit applicant 1. Building '(a) Building Permit Fee 1 S. 0 s3, Multiplier 2 Electrical (b) Estimated Total Cost of f s 1 I Construction 3 Plumbing Building Permit fee(a)X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 qj' r•6-61 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT L4- 14/SC 4 � i�"e S- ,as Owner/Authorized Agent of subject property Hereby authorize 5u)i M m l')G P66 / ( -le VI—kV YN J ULO V10-y44 to act on My behalf; 'n all matters relative to ork authorized by this building permit application. _ q-0 ! S nature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIIvMERS 1 2ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIIv ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHININEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE FORM - U - LOT RELEASE FORM a INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT �arrg L5&- PHONE q 7 k-&91-y/(F S ASSESSORS MAP NUMBER 10-S LOT NUMBER4- SUBDIVISION LOT NUMBER D STREET h-a cy 5 ree�- STREET NUMBER I I K OFFICIAL USE ONLY ATIONS OF TOWN AGENTS . . ............................................... ... ...Mann... DATE APPROVED SERVATIONADMINISTRATOIV R ��q DATE REJECTED CONRVIENTS DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD INSP ECTOR -HEALTH DATE REJECTED % DATE APPROVED a SEPTIC H DATE REJECTED coM�NTsL�a G 4 4 "661 L5 n s CG r�r `1 G Gl s �- � ��`r PUBLIC WORKS—SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE Town of North Andover °� H°RTN Office of the Health Department Community Development and Services Division 27 Charles Street North Andover,Massachusetts 01845 CHU Sandra Starr Telephone(978)688-9540 Health Director Fax(978)688-9542 August 2,2001 Mr. &Mrs.Ayres 114 Lacy Street North Andover,MA 01845 Re: Application for in ground pool Dear Mr. &Mrs..Ayres: Your application for a pool at 114 Lacy Street has been reviewed by the Health Department. The application was denied on August 1,2001 for the following reasons: 1. LW Missing information 2. ❑ Passing Title 5 inspection of septic system may be required 3. ❑ Location of structure not acceptable To address the problem(s): If#1 is checked, please supply: a. Floor plan of existing and proposed addition b. Certified plot plan showing house,septic system and proposed project in scale Please locate well on a plan no less than 1"=40' scale that also shows house foot print and location of septic system If#2 is checked: a. Have the septic system inspected by a certified Title 5 inspector to determine the size of the system and whether it is operating properly: b. Tie-in to municipal sewer If#3 is checked: a. Relocate the project Please feel free to call the Health Office at 978-688-9540 with any questions you may have. Sincerely, Sandra tarn,Health Director Cc: Building Department File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535 I' r4(tel lAL SSJ'' F7 � SWIMMING POOL CENTER, INC. , � ,��( 670 South Union Street Lawrence, MA 01843 (97x)682-09 10 / Date —7 Name (15A FI ( 1 4 fl'LS 1-1ome# (' F/- V C Address IN L4c,( Work# G17 3&- W56 City/Town O State &n Zip O/oo t-1S INGROUND POOL SALES CONTRACT We agree to sell one x LIP y, Z6:' /12 C L Inground swimming pool for the sum of$ /000 Liner choice 4LA`l5/� lr: Circle one: iving pool Non-diving pool Deepest pool depth '7• feet Circle stair location: (�n Side (show diagram) Ej Show Swimout location, if applicable All inground pools come standard with: Complete filtration system,Self-cleaning system,Stair unit, Ladder,Skimmer, Main drain,Hard bottom,Concrete collar,Print liner, Receptor coping, Foamed walls & shallow end,Manual vacuum cleaner,Maintenance package. Optional Accessories Stair upgrade $ Swim-out Jets $--------------------- Diving board—6 ti. $ ay Base pool price Diving board—8 ft. $ Slide $ Nicheless Light X Z $ ��_— Total extras $ ZZo Fibre Optic Light System $ - /, 9055 Fibre Optic Light Perimeter $ 5%MA sales tax$ cIOZ•�� Heater—Propane/Natural $ ppq Heater—Electric Heat Pump $ Total price $ Automatic vacuum $ G} Solar cover&reel $ -.. . Sao Payment schedule (,h,�Q Winter cover pkg. $ �""`` Safety cover $ 1&L5 Deposit $ Pool Alarm $ Other (411 j Pv p4P NO $_ 3(p0 es Balance due upon Other $ Delivery of pool $ �ZS�•7 The Buy r ac wledges that they have read and accepted all conditions of this contract and agree to honor the Contra t a c gly. ii Seller_ Date 0` Buyer Date U — — �1 x o , GO 7- so Q ' K RJ c ti 78.v ' S .�/E.QEBY CECT/fY TO Tye T/TGE/,r/SU.PD,P ANO RL or oaL. N TU T//E BgN,r TyRT T.✓EOa'EGLl.�6/S LOCATED O.v T�/E Go7'AS.S�sf�/n'.V AND Tf/gT/T OGiES G'O.r/FGtPiY! /�(/ ,FL�G•I.eO/.t�!, SETB.IC.CS FROM STPEET,S f LDT Li.�ES. ' /V /+ LOGATEO�T ET/F�AGT T X000 H Z OSA.PEAOT O.PA�✓/V FOP ' Syew�!Oit/FEi�+ /TY/./NGL 'fi .► 'c o0 93 oao 9 7711.$ PGANP Fo o' Bovvo,Py D�'TE.P ,v_ Bo�,vo.oes��.(ifo,P.ss- /�E,P,P//jf,9Gt'E'.vGi.�/EE,Pi.I/6 SE.Pv/�'ES AT/O•�/ TA.!'E.(/ ,�,�,y� E.�isrivc ,e��-a,Pos. G6 f'4.P,E� .ST.PEET ,y,-�9.j� A.</DOYE,� �l•4SS,4G,�//SETTS O/8/O 4 ,per // I -\ ,T12e I HOME IMPROVEMENT CONTRACTORS REGISTRATION ;'!hoard of Building Regulations and Standards One Ashburton Place — Room 1.301. Boston , MassachUsetts 02108 I HOME IMPROVEMENT CONTRACTOR I Registration 11.8519 Expiration 03/29/01. Type — PRIVATE CORPORATION HOME IMPROVEMENT CONTRACTOR Registration 118519 SWIMMING POOL_ CENTER INC j Type - PRIVATE CORPORATION ROY J . CHARL-AND Expiration 03/29/0' 670 S UNION ST LAbJRENCE MA 01843 SWIMMING POOL CENTER INC ROY J. CHARLAND S UNION ST ADMINISTRATOR LAWRENCE MA 01843 j BOARD OF BUILDING REGULATIONS License: CONSTR14CTION SUPERVISOR Number: CS 002837 Birthdate: 11/30/19.57 Expires;:1:1/3012001 Tr.no: 20225 a Restricted To: 00 ROY J CMARLANID 670 S UNION ST G. e•«�d�i LAWRENCE, MA 01843 Adrni►�istrat4r f. . Alte -P Board of Building Regulations One Ashburton Pface, Rm 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 11/30/1957 Number: CS 002837 Expires: 11/30/2001 Restricted To: Ob' ROY J CHARLAND 670 S UNION ST LAWRENCE, MA 01843 Tr.no: 20225 Keep top for receipt and change of address notification. I ACORU, CERTIFICATE OF LIABILITY INSURANCkwD SR DATE(MM/DD/YY) IMM-1 03/13/01 PRODUCER ' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Landmark Insurance Agency, Inc HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 198 Massachusetts Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. North Andover MA 01845-4190 COMPANIES AFFORDING COVERAGE Landmark Insurance Agency, Inc COMPANY Phone No. 978-688-8829 FaxNo.978-975-3987 A Preferred Mutual Insurance Co. INSURED COMPANY B Eastern Casualty Ins. Co. Swimming Pool Center COMPANY Roy Charland C 670 So. Union St. COMPANY Lawrence MA 01843 D COVERAGES 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DD/YY) DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE s2000000 _ A X COMMERCIAL GENERAL LIABILITY CPP0100552265 03/01/01 03/01/02 PRODUCTS-COMP/OP AGG s2000000 CLAIMS MADE a OCCUR PERSONAL&ADV INJURY $1000000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 1000000 FIRE DAMAGE(Any one fire) $Excluded MED EXP(Any one person) $Excluded AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ 1000000 AX UMBRELLA FORM UC0120540211 03/01/01 03/01/02 AGGREGATE $1000000 OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND TORY LIMITS OTR EMPLOYERS'LIABILITY EL EACH ACCIDENT s500000 B THE PROPRIETOR/ INCL WC98470026 02/28/01 02/28/02 EL DISEASE-POLICY LIMIT s 500000 PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $500000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Swimming Pool Installation/Service/Repair CERTIFICATE HOLDER CANCELLATION SAMPLE 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Sample for bidding purposes BUT FAILURE TO MAIL SUCH N L IMPOSE NO OBLIGATION OR LIABILITY ND UPON MPANY,ITS ENTS OR REPRESENTATIVES. 7La ED PRVuranc�egendy, Inc ACORD 25-S(1/95) .. ACORD CORPORATION 1988 NORTH E Town of 0 over No. o� �:Or ;'X ,P`� dower, Mass., 070 ao r AORATED PPa BOARD OF HEALTH Food/Kitchen PERMIT T Septic System J BUILDING INSPECTOR THIS CERTIFIES TH......,l� r� .. .... ... I!'.�. ....... ... .�.. .r..5....................... Foundation I � has permission to erect.�.�... ...... a�.... buildings on ......l.I.y.....L. .0 ........ �.............................. Rough to be occupied as........I....S.A.&P.4......t. .f`.�V. ........ 001............................................... chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. DSIQ s _$ X30- � PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. �P Rough IYAWA7tA 1 N 10P PERMIT EXPIRES IN 6 MONTHS Final �I&r^ "—Por* L vt�IAESS CONST RUCTION STARTS ELECTRICAL INSPECTOR CRough ..... ..................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building J 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. i No 3 �: J Date.................................. NORTH °�t�``°;•'"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �,SSACMUS� Thiscertifies that ............................................................................................. has permission to perform ............................................................................... wiring in the building of.......................................-/.......................................... at..........I./.................................................................. ,North Andover,Mass. Fee..................... Lic.No.............. ............................................................... ELECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer DEPARTMEWOFPUBLICSAFEI'Y IPermit No. BOAROOFFIREPREVF11P ONREGUL47YOAN527CMR12.0 ' ' Occupancy&Fees Checked 1 , 1194 PERMIT TO PERFORM ELECTRICAL W ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) DatO 4P/ Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform th ectrical wort,described below. Location(Street&Number) Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes No a (Check Appropriate Box) Purpose of Building Utility Authorization No. r Existing Service Amps � Volts Overhead Underground No.of Meters INew Service Amps / Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total i KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA sEroftrid ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Q Oth;r---- Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER n Ir��ranoeC I'tasttattbthelegtmatta�cst�Ga>aa[Lavus �.� [hatieat #Liabt�htt 'atoePbtig'ilrh>&gCortle aritsec}livalai YES NO rha esthmiaed.a6dpoofofsltteb,heo�YEs [fyalha�eaaYES,ple�eithetypeofoaaagebyd�ad�tgtEte BO o 0IFM o ) Est rn*d Vahtec>fE6dncal Wade$ WorkIDSM hgxct;mDaJexeWes(ed Rough Fatal Sigttad unda$e Pf�ll6es afpajtay FIRMNAME/� �/ ' Lioa>SeNa lV,/-f/ �t^(r�{ Signatne Li Wlsb Business TCL AIL T1 O 'S WAIVFR;I.amawalethattheliot e t i�theirwa=wY=WordsWVcW gri mkttas w#WbyM3mdw9&Cfnodjam anddi troy m,ai taspanitappkafi tvmiteSthisnXpiffMia>t. (Please check one) Owner Agent Telephone No. PERMIT FEE