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Miscellaneous - 450 BEAR HILL ROAD 4/30/2018
450 BEAR HILL ROAD 2101064,0-0100-00 • � 00.0 J I O Date..... j. U. ►.......... r NORTh TOWN OF NORTH ANDOVER PERMIT FOR WIRING ��ss�cHusE� This certifies that ........ ...E i......... .............. has permission to perform ................��7 ................................................ wiring in the building of...1b..,.............� ................................... VS"D /,�"�! / � .......��� ......... ,North Andover,Mass. Fee.Ar ... Lic.No f.Zq.�Z/.*........... ELECTRICAL INSPECTOR F Check # 10 6 5 7 Commonwealth of Massachusetts Official Use Only M Department of Fire Services Permit No. ,�' 7 / OW BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/99] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 2/r-3/a& City or Town of. To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Map: Lot: Owner or Tenant Ct/d Telephone No. Owner's Address S b RJc car'ki > Is this permit in conjunction with a building permit? Yes No ❑ Building Permit# Purpose of Building p6c> Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: i Completion of the ollowin table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil.Susp.(Paddle)Fans o.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA Aboven- o.o Emergency Lighting No.of Lighting Fixtures &'XSwimming Pool rnd. ❑ rnd. Battery Units No.of Receptacle Outlets t No.of Oil Burners FIRE ALARMS Nc;.o:Zones No.of Switches No.of Gas Burners o.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers eat PumpIum,..er """""" Tons o.oSelf-Contained Totals: **'*** " """""' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW SecuritySystems: No.of Devices or Equivalent Heaters No.o ea KW o.o o.o Data Wiring: ters Signs Ballasts No.of Devices or E uivalent Y No.Hydromassage Bathtubs No.of MotorsTotal HP Telecommunications o.of Deviaes or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANC&,El BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: 1660. &vr (When required by municipal policy.) Work to Start: ZD 06� Inspections to be requested in accordance with MEC Rule 10,and upon completion. I cert,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: L un +C. LIC.NO.: E-,2 93g3 Licensee: j qt{ C,;74M C/;n Signature ' LIC.NO.: mR'77y (If app/icab/e,enter " mpt"in th license mberr hf e.) Bus.Tel.No.:iP03 395-9 i 73 Address: // �.h� ..Ina 7"lU d O n /V Alt.Tel.No.:iP OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑ owner ❑owner's aent. Owner/Agent Signature Telephone No. FPERMIT FEE: $ Inspection Record Date Inspection P/F Inspector Notes } r . r 7. ..la .47.19.,E. .. .. HORTM TOWN OF NORTH ANDOVER 40F PERMIT FOR GAS INSTALLATION 9 - � 5 �9SSACMUSESA This certifies that 41.. . . . . . . . . . . . has permission for gas installation �Q.L Nti4 "' in the buildings of . &Ift,1114 /V.. . . . . . . . . . . . . . . . . . r at .?Uwe'. .��?59.x. . . . . . . . . . . . . . . . .. North Andover, Mass. Fee. . Lic. No. '. .... . . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR Check# 5740 MASSACHUSETTS UNIFORM APPLICATION FOR PcF MIT 13 "3 GASFITTING � =e� (Print or Type) +r: if Mass. Date /0 - 7, 20� Permit# ;.., Building Locationf.�/,�'(�/3GA/L /1� Owner's Name �fjyc- e ly/� Telephone Cf)�' $$2 - 8)� Type of Occupancy lthvse New ❑ Renovation Replacement 0 Plans Submitted: Yes E] No0 ` ) to N L � O y = Rs 40, 00 m � is = N R in W r Wo .O M O O M .O+ ` o > d 0C L _ r d O O «+ d d C t0 d cv L N C O W t W = O = ti n O C7 J V D 4. I� O SUB-BSMT. BASEMENT rb ; 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name EnergyUSA Propane,Inc. Check one: Certificate A4ddress 100 Myles Standish Blvd.,Suite 101 X❑ Corporation 132 C Taunton,MA 02780 Partnership Business Telephone (800)822-1300 Manager-Bob Olander X8055 Firm/Co. Name of Licensed Plumber or Gasfitter William Kent Corson(800)822-1300 X8051 Cell (508)294-6660 INSURANCE COVERAGE: EnergyUSA Propane;-Inc.;- has a current liability insurance policy or its substantial equivalent,which meets the requirements of MGL Ch.142. Yes X❑ No rl If you have checked ves,please indicate the type of coverage by checking the appropriate box. A liability insurance policy X❑ Other type of indemnity Bond OWNER'S INSURANCE WAIVER: I am aware that th6licensee does not have the insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Owner Agent Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Code and Chapter 142 of the General Laws. 1. Type of License: By El.Plumber Title _[K]Gasfitter Signature of Licensed Plumber or Gasfitter City/Town XO Master APPROVED(OFFICE USE ONLY) Journeyman License Number 3707 BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. APPLICATION FOR PERMIT TO DO GASFITTING NAME &TYPE OF BUILDING LOCATION OF BUILDING PLUMBER OR GASFITTER LIC. NO. PERMIT GRANTED DATE 20 a'° GAS INSPECTOR HOPTh -rOWN OF NORTH ANDOVER _)N FOR PLAN EXAMINATIWN 14 APPLICATR Permit NO: Date Received:- D,,ite Issued: I NJ POjj'rkN'I': ,i\pp1iCaI1t 111LISt COMP10C all ilCIIIS on this PwZ..7 LOCATION--_ PROPERTY0\kNER Print 0�e NIAP NO.: -PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING PC_6J HISTORIC DISTRICT YES El- TYPE OF INIPROVENIENT PROPOSED USE Residential I Non- Residential N One familye\,v Building Industrial - Two or more family _ Addition Alteration No. of units: ltei Repair, replacement ssessory Bldg Commercial Demolition 0 v:ng(relocation) ; they I Others- FOLunclation only DESCRIPTION OF 1NORK TO BE PREFORMED Gztu_ Identification Please'rypa or Print Clearly) v OANIER: Name: Phone: 9717 S1, a r Address: CONTRACTOR Name: 0 /S Phone: I. Address: lic E Datc:, zeb_ � Supervisor's Construction License: xp. Exp, D:itc: H,onic lnipro,,�:nicnt 1JLccI)sc:__ZZ__1L AIP.Cl 11,11-7CT. 11:-INGIN-14:1t Ple—/&,�A_ Phone: Re. No. Addrcss:_ 1=� FEESCHE DULE:SL LDI\.G PERMIT S 0.0#PER$loot).00 OFTHE'rOT I L EST1,11,11 TED C,OSI,8,ISED 0,"y 51?..00 PER S.F. x10.00 FEF.:,S 1!� 'rotall Project juct Cost Receipt NO.:_ Chcck ece -447 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 Debris Removal Form Workers Comp Affidavit Photo Copy Of H.I.C. Andi'Or C.S.L. Licenses :1 Copy of Contract a Floor Plan Or Proposed Interior Work Addition Or Decks a Building Permit Application a Form U a Surveyed Plot Plan Debris Removal Form j Workers Comp Affidavit a Photo Copy of H.I.C. And C.S.L. Licenses ,D Copy .Of Contract Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) a Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) a Building Permit Application j Form U Certified Proposed Plot Plan j Photo of H.I.C. And C.S.L. Licenses i Workers Comp Affidavit a Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydrae' Calculations (If,applicable) 3 Copy of Contract Y'lass check Eger, ,,. Coinpli-ance Report °I . ,�. . . permit sv;ts s•; aired ;he 1�.3w�3 C.li Ia+l�'1'i�r ntlst.>t 3In � if It .ic.:>i�ln rum tllc a3oai d -ll' .n .11l cases It a �arr.3nu ,3 sp�rlul p� y l 'Appeals that the appeal period is over. The;applicant must then .;et this recorded at 01C Re!;istry 'J 9 eds. One cope 'Ind pr 3, *recording must be submitted with the buildin!•.30plication )ars I'SI'E("CION xL' :R\R ES AEVAR r%IV%'I'::3VFf)R�Vh Location 8P,412 A# No. Date `t v NORTH TOWN OF NORTH ANDOVER O a • ; ; Certificate of Occupancy $ ���°''••�•' �' Building/Frame Permit Fee $ ss�CHU Foundation Permit Fee $ Other Permit Fee IQD L $ a r TOTAL $ Checksc# t) O --- 19+ '17 Building Inspector J ! TYPE OF SE\XARGE DISPOSAL i Tannin�;�lassa e Body ,�tt Sevintmin�� Pools Public Sewer i I i Tobacco Sales Well - Food Packaging.Sales i Permancnt Dunt ster on Site p Private(septic tank,etc. � , j MOTE: Percun.c eontractin„► with nnrc�;;ic�rrerl cunlrucYurc du nul have uccc�.ct Ir►the i;rnrrunt %nrnl Si('nature ol'Agent Owner Signature of Contractor Plans Submitted Plans Waived Certified. _ �rtthed Plot Plan Stamped ed Plans _ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- t,' FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT Vater Shed Special Permit F1 Site Plan Special Permit y/3/b ❑ Other COMMENTS ',�� � .:;dr-� � t���A� � k����`T,�t���.�.•.. ' y�3/off Id r-4 e-4-fG'Uw, DATE REJECTED DATE APPROVED CONSERVATION 4 ,.--� C'OMMENTS � mil ry 1 DATE REJECTED DATE APPROVED HEALTH 1-1 COMMENTS %onin, Board of,Appeals: Variance. Petition No: I-onim,, Decision,receipt submitted yes Fhnninc Board Decision: - `hater a Set~cr connection Siynaturc S-, date --- — - Tcjnp Duntpster on site ;es _no— Fire Department signature date BUIlding Pennit ,approved and Issued b-,: f f Building Setback (ft.) i Front Yard Side Yard Rear Yard Required Provided Rrquircd Provides ; Required Provided 36 I ,�,yb ' 3 I OCT i DIMENSION dumber of Stories: Total square feet of floor area, based on Exterior dimenians. Total land area, sq. ft.: NOTES and DATA —Wor(lepartment use) I F I I II r i I I NORTH Town of : 4Andover No. Zdover, Mass., 41��Iajgj= T 0 t-- LA E . If, COCHICHEWICK �ADRATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System a BUILDING INSPECTOR Voowd THIS CERTIFIES THAT....... .......Ce ... .. ..rT.................................................... .......................................... Foundation has permission to erect.................... ................ buildings on ....q'zo..... .r. .l.�.��.......��................. Rough tobe occupied as..............3104� ...�. ..... ............. ... ..:............................................... Chimney provided that the person accepting this permit 1hall in every respect conform to the terms of the application on file in Final P 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 / Q PERMIT EXPIRES IN 6 MONTHS Final � UNLESS CONSTRUCTION T ELECTRICAL INSPECTOR Rough .... ..... ...... Service BUILDING INSPE Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remov 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 1 i sr 91te Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement.Contractor Registration Registration: 124884 Type: Private Corporation Expiration: 9/8/2007 Aquatime Pools Peter White 7 MIDDLESEX RD. "------" - -- Tyngsboro, MA 01879 — --------- -- Update Address and return card. Mark reason for change. Address Renewal Employment Lost Card 0PS•CA1 is 50M-04/05•PC8698 I Board of Building egulations One Ashburton Place, Rm 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE }wr Birthdate: 07/26/1959 s Number: CS 059582 Expires:07/26/2006=..`__ - --==;. Restricted To: 00 PETER F WHITE — 440 MIDDLESEX RD#102 TYNGSBORO, MA 01879 ,' � ' iky no: 740.0 ` Keep top for receipt and change of address notification. DPS-CA1 0 50M-04/04-G101216 . �12C -C/�OI�'t/JltlY�tLIIPQ�A�L dl i/l�Cl7gdCLCJ'LCL6P,�6 BOARD OF BUILDIN6 REGULATIONS License: CONSTRUCTION SUPERVISOR 0 `_ Number,-, S 059582 ( � ,1 �, Birthdate 07/261959 - +moi -r "7! #' Expires 07/26120,06 Tr. no: 740.0 Restricted 00 1,S - j PETER F WHITE� 440 MIDDLESEX RD';#102G- TYNGSBORO, MA - Commissioner a � . s NOTES , GENERAL SPECIFICATIONS - - _ 1 . QPPL1 CLl BLE CODE-SSIZE AU 316- 89 90^ 0fte u- mll it, ;0�� MASS REO azo CM R secTION 12 POOLS�ANU SPAS, fNC. DEPT H LOCAL, ,5UlLl>If4G CODI~S 7 MIDDLESEX RD., TYNGSBORO, MA 01879 • (800) 322-0001 VOLUMEZ, CONCRE7-E _,S �k .L. RE �CGE) C VNDtSTu � 50 t L OR CONir-ACTt�:`C) Gp,4VEI.�.OR 5''t'��t��'. ,�asnc SEA4 T F,y D� SO_ r i. _ rEril�ri�I R . nnlni VZ' H�zFL�AM CDN I PAC to R NOTES D�`....K1ti6 CONT)iACTTO R `c`cRETEDix _ \ C fi � ,� oVJ_► _ =� WAJlTRi t.EVV-- r ; L`EC-K GUN ITE BOW10-13EAM 3j4-"OR a CONIDviT CONTINUoc_�_ 611 FROST P Roams j J , -�1✓�L x CDX TILE WITji 'DEPTH JWaR}CERS t NICHE GPOUND#8 PARE 6oPPI`R A 6 u VES(�RA5 FfR CME) TiED 12"o.0 8�R WHIFF AVRt3P11-ZED--� 0GH T NiCHc,STAV�LE� STEEL #� i�•R 3 , ; Fn0'J WITH b'�gL-riTKNAB� PS 4R5 ` � NOR tZ0wTA� [ UNDER WAS LIGHT. REAM. TIED b'10.r. 6.1 VF-KTiCALu- —1HROU N- �� . --� NAM OUT DEEP Et--1 D AN �— (dp To j3p mi< AREA I i ADD?�JJ: 114 'SHALLOW F-u p F[OO MT2 VORitXAAAI N '0RAIN VZ" MPO 7UHE $, VXvE 3/4 WASHED PPC:K SUMP s SECTION OF POOL WALL) AMIN DRA114 LIGHT F,.ONE �S �/ 1-13 — - MAr _OOK PG: oC: I �O - L'm a' �SHOFygss1 1� l= �A 7 b O cma. q2_ 1 ��� PAUL A. CyG[n JA D.:.-.Y�N: p PHEIAN JR. - Pf'P P L' STRUCTURAL cn � *i L. No. 42538 r C J ` 1 G c A��o�SSjONTE OWN= ;: , -Zl-oSSO,AL DIG SAFE # _ MA CONTRACTOR LIC. #059582 Ms HOME IMPROVEMENT LIC. #124884 III WN,W44 0 POOLS AND SPAS,'INC. 7 MIDDLESEX ROAD, TYNGSBORO, MASSACHUSETTS 01879 1-800-322-0001 www.aquatimepools.com SWIMMING POOL CONSTRUCTION AGREEMENT The Terms on the reverse side are part of this agreement BUYER(S): Names Mail Address v ,�r- (/ _/ Project Site Telephones: Residence: Office: Cel 1:.97P 2502 -2 AQUATIME POOLS & SPAS, INC. (hereafter"AQUATIME") agrees with the buyer or buyers above named (hereafter the "Buyer") to construct a swimming pool and/or spa in a professional and workmanlike manner in accordance with the following terms and specifications. DIMENSIONAL SPECIFICATIONS _ Shape Width 2,0 Length yd - Depth 3 to �r Water Surface Area 7F-0 Perimeter 1,2 in Volume 3-,000 Gallons SITE PREPARATION MISCELLANEOUS 1.Layout pool on site before excavation for approval by Buyer............................. Included 52.Raised Bond Beam Tile ...................... ............... Stone ...............,... 2.Set pool elevation on site before excavation for approval by Buyer.................. Included 6' ......y..............................12"............ .................... 18" ......�.� ...................... 3.Trees in access,working area and pool site to be cut down by Buyer so that 53.Start-up chemicals:25 lbs. D.E., 4 lbs. shock&3 qts. Metal& Scale.............. Included stump does not exceed four feet in height........................................................... By Buyer 54.Provide initial start-up and follow-up instructions......,......................................... Included 4.Uprooting of stumps and shrubs in access,working area and pool site to be: �i`,� 55.Water or unsuitable soil conditions-$575.00 per 20 tons of 1.5"stone ........... By Buyer By AQUATIME❑; By Buyer❑........................................................................... � 56.Additional stone at$375.00 per load.................................................................... By Buyer 5. Removal of walls,fences, and other above-ground obstructions in access, 57.Safety line -rope and floats................................................................................... Included working area and pool site..................................................................................... By Buyer 58.Orange caution fencing during construction......................................................... Included 6. Remove from pool site on day of excavation only: 59.Permanent fencing and alarm system .................................................................. By Buyer Stumps Yes❑ No Ir Excavated Fill Yes, , No Asphalt Yes❑ No 9 Cut trunks&limbs Yes ❑ No R Concrete Yes ❑ No D Other Debris Yes❑ Nop HYDROTHERAPY SPA Number of truckloads allowed for removal of above material...............,ru..h(,f r �lX d (any additional loads required to be provided by owner) 60.Size............ ....kPI.M..4....0' ...�............. Separate........... #Jets 6.. ................. 7.Removal or relocation of cesspools, septic tanks, leaching fields, sewers, Booster Pump JOV P.....;.Air SBlower ............. pipes and utilities(overhead/underground).......................................................... By Buyer Venturi ......................._..... ....Light.......I................ Hand Rail .......................... ........................................................ Included Control System .R� .. ci.IC.' .l.:v......Tile Finish... , 8.Hand form and shape pool ........................... y . ............................. GENERAL CONSTRUCTION SPECIFICATIONS ADDITIONAL SPECIFICATIONS 9.Normal one day excavation, equipment and labor .............................................. Included 61 Z�lq.r✓g.W..rhr...... 10.Steel reinforcing per engineered plans................................................................. Included f� 11. Engineered gunite structure to meet or exceed local or state codes................. Included 62 P�r, �t .,, d.>•.,,�jj!,,. .1y ,(,.rwp� i-¢� 12.Watercure gunite shell twice daily for seven days............................................... By Buyer 13.Install continuous bond beam around skimmer .................. ................................ Included 63. ......... ........ ......... ........... 14.Swimout-deep end ............................................................................................... 4f1 15.One set of shallow end steps with 4 foot bench .................................. .............. Included 64. ............................................................................................ 16.D AT ing...�WCel> �. '..�tY.< t`:!C � Included 17.Install 6"band of frost proof water-line tile. k)., . ........... Included 65. ................................................................................................................................. 18.Finish pool interior with-wW waterproof Included 19.Filling of pool promptly after interior finish............................................................. By Buyer 66. ................................................................................................................................. 20.2 hrs. backfilling and grading-deck area only ...................................................... Included POOL DECK PRICES HYDRAULIC AND FILTERING SPECIFICATIONS SUB-BASE MATERIAL IS NOT INCLUDED 1 21.Filter type ...F'c%^ +Cc..r....Model ... .=�?............ Size.....��. ................. Included 67.Square.Footage:.90G..(.)....@..�.7.�.....Type:.YAt.. .4./a of 22.Pump and motor: Model..... r+ :l �f. ................... Size....oi..f�./�............ Included Cantilever Edge.......N./ ..@......---.....Total Price ..... :%1c;L�e-4..... 23.Hair and lint strainer............................................................................................... Included 24.Pressure Test all pool piping ................................................................................. Included SALES TAXES AND INSURANCE 25.Hook up all water lines from filter to and from pool............................................. Included 26.Non-corrosive plumbing throughout...................................................................... Included 68.Payment of all sales taxes on pool components and accessories provided 27.Hydrostatic Valve.................................................... Included hereunder.........................,...................................................................................... Included 28.Pressure return inlets for filtered water to pool.... .............................................. Included 69.Comprehensive motor vehicle insurance on all motor vehicles;work men's 29.Direct Main Drain suction line with grate..............,............................................... Included compensation insurance on all worker; public liability and negligent property 30.Automatic recessed deluxe skimmer Z......ir/.6.K5,.,y.<'<4AC-O.............. Included damage insurance.................................................................................................. Included 31.Leaf strainer basket in skimmer............................................................................ Included 32.Vacuum fitting outlet in skimmer ........................................................................... Included PAYMENT 33.Free floating action skimmer weir......................................................................... Included 34. Up to 20'of plumbing between filter and skimmer............................................... Included The Buyer agrees to pay AQUATIME the following Contract Amount for the performance Additional piping @ -.per foot of its obligations under this Agreement. 35.Precast concrete pads for pool equipmen-........y................................................. Included PAYMENT SCHEDULE 36.Vinyl Backwash Discharge line ..............3�5....................................................... Included AUTOMATIC EQUIPMENT Q�,C4ontra tAmount $ .dao•Oto%Day of Excavation $11y .1 � J �VG•�� p 1 37.Automatic pool cleaner:Type................................................................................ 'Mobilization $T4s 40/°Day of Gunite Installation $�oO 38.Stub plumbing for future pool cleaner.................................................................. Included SfIGS.7 39.Floor recirculation system.......................�y.......................... . Y,4 BALANCE $ �i 5%Deck or Equipment 40.Automat::chemical feeder .....................Cs :a'! /..hemi ��.3 ........................ Included r,�C Day of Interior FinishI� POOL HEATER & UTILITIES [.25Cf,Ct. ,i, ` THE T $ 41.Deluxe eater: Size ...�:LC�.4. ....................... MakePrd.ni.IGLI: .N..l... 55 Indoor utdoo ....... . .............N r0 ................. Other............................. ...... BUYER UNDERSTANDS THAT BY SIGNING THIS AGREEMENT HE OR SHE ENTERS INTO A C TTiA ' WITH AQUATIME CONCERNING AQUATIME'S CONSTRUCTION OF A SWIMMING POO-I.-MEETING THE 42.Fuel connections, heater venting, fuel storage tanks, permit: ............. �a1....... By Buyer SPECIFICATIONS CONTAINED IN THIS AGREEMENT.ANY CHANGES IN ANY OF THE TERMS OR SPECIFICA- 43.Underwater light(s), each with 10'conduit...... I/)..tr/olts.�.1..AWa4b, .'�InClUded TIONS OF THE AGREEMENT MUST BE MADE IN WRITING SIGNED BY AQUATIME AND THE BUYER,AND NO 44.Electrical bonding of pool as required by city or town code................................ VERBAL CHANGES IN THESE TERMS AND SPECIFICATIONS ARE PERMITTED. 45.Electrical wiring and connections up to 75'from service panel..................///;n -(d �j AS PART OF ITS OBLIGATIONS UNDER THIS AGREEMENT,AQUATIME IS PROVIDING THE BUYER WRITTEN 46.Over 75'at$9.00 per foot.................................................................l.G..4� GUARANTEES REGARDING THE SWIMMING POOL WHICH IT WILL CONSTRUCT PURSUANT TO THIS AGREEMENT.THESE GUARANTEES ARE CONTAINED IN A SEPARATE DOCUMENT WHICH IS PROVIDED TO THE BUYER. ACCESSORIES THE BUYER HAS THE RIGHT TO CANCEL THIS AGREEMENTATANY TIME BEFORE MIDNIGHT OF THE THIRD BUSINESS4X)AFTER T DATE ON W H EITHER THE BUYER OR AQUATIME HAS SIGNED THIS FORM BY 47.Deluxe cleaning tools (18"nylon brush, hand leaf skimmer,thermometer, GIVING IT NNOTI F C TIONTOAOUATIME. pole, test kit, deluxe vacuum)............................I.......................... .., .. Included 48.Diving board:.... .........................:.......Size...F. Color....l t�J%t/. ................ u __ _-.--_ ____ AQUATIME POOLS AND AS,INC. 49.3-tread stainless steel ladder .................................................. ...............:............. �, BUYER BY: 50.Stainless steel hand rail......................................................................................... •'~' --- ------- ----- _... - +/- --..._..- 51. Pool Slide Model................................L/R ........ Size............... Color..........:....... /t/�'t� BUYER All jigs installed by decking contractor or buyer iD •7J I Qf DATE --'--------�----..-------- DATE ACORPM CERTIFICATE OF LIABILITY INSURANCE oiioaiiood" PRODUCER (978)433-2728 FAX (978)433-8658 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION David H. McDuffee Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 3 Hol 1 i s St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO Box 1497 Pepperel 1, MA 01463 INSURERS AFFORDING COVERAGE NAIC# INSURED Aquatime Pool & Spas, Inc. INSURERA: Peerless Insurance Company 24198 7 MIDDLESEX RD. INSURERB: Commerce Insurance Company 34754 Tyngsboro, MA 01879 INSURERc: ASSOCIATED INDUSTRIES OF MASS (AIM) INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. rAA D' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY - BOP3000121704 04/26/2005 04/26/2006 EACH OCCURRENCE $ 1,000,00 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,00 CLAIMS MADE a OCCUR MED EXP(Any one person) $ 5,00 X BLANKET AD INSURED PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,001 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 POLICY PRO LOC JECT AUTOMOBILE LIABILITY N34214 11/03/2005 11/03/2006 COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO 500,000 ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ B HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY - EACH OCCURRENCE $ ` OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC0327580 01/03/2006 01/03/2007 X we STATUS oTH- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 100,00( C ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 100,00( If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,00( OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS M.� CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL AQUATIME POOLS & SPAS,INC. 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ATTN: PAM BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 7 MIDDLESEX ROAD OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. TYNGSBORO, MA 01879 AUTHORIZED REPRESENTATIVE [DorothyLeWarne/CP1 ACORD 25(2001108) FAX: (978)251-1851 ©ACORD CORPORATION 1988 See Seperate �.. Detail for Spa Area RS'-8' R7'-4' R5' C2x> . R13'-6' 18'-96': 18. 9 Z R3 R7,_6, R4'-6' 171-6 R7'-6 R5'-6; R13'_6. ip 11 .. (2x) 17'-66' 01 2x1' (2 x) k., '� 2x R8'-6' R2'-6' (4x>: .. Nj t j N �0 UI) d' N N Residential Property Record Card PARCEL_ID:210/064.0-0100.0000.0 MAP:064.0 BLOCK:0100 LOT:0000.0 PARCEL ADDRESS:460 BEAR HILL ROAD PARCEL INFORMATION Use-Code: 101 Sale Price: 1,050,000 Book: 05196 Road Type: T Inspect Date: 03/19/2003 Tax Class: T Sale Date: 09/30/1998 Page: 0075 Rd Condition: P Meas Date: 03/19/2003 Owner: Tot Fin Area: 8868 Sale Type: P Cert/Doc: Traffic: M Entrance: X CAFUA,FERNANDO Tot Land Area: 1.12 Sale Valid: R Water: Collect Id: RRC DAVID P CAFUA Grantor: DOUGLAS DOOLEY Sewer: Inspect Reas: C Address: 450 BEAR HILL ROAD Exempt-B/L% / Resid-B/L% 100/100 Comm-B/L810 Indust-B/L% 0/0 Open Sp-B/L% 0/0 NORTH ANDOVER MA 01845 RESIDENCE INFORMATION LAND INFORMATION Style: CL Tot Rooms: 15 Main Fn Area: 3611 Attic: NBHD CODE: 8 NBHD CLASS:8 ZONE: R1 Story Height: 2.5 Bedrooms: 5 Up Fn Area: 5257 Bsmt Area: 2685 Seg Type Code Method Sq-Ft Acres Influ Y/N Value Class Roof: H Full Baths: 7 Add Fn Area: Fn Bsmt Area: 1 P 101 S 43560 1 217,364 Ext Wall: BV Half Baths: 1 Unfin Area: Bsmt Grade: 2 R 101 A 0.12 564 Masonry Trim: Ext Bath Fix: 3 Tot Fin Area: 8868 VALUATION INFORMATION Foundation: CN Bath Qual: L RCNLD: 1278758 Current Total: 1,624,500 Bldg: 1,406,600 Land: 217,900 MktLnd: 217,900 KitchQual: M EffYrBuilt: 1988 MktAdj: 1.1 Prior Total: 1,523,200 Bldg: 1,321,400 Land: 201,800 MktLnd: 201,800 Heat Type: FA Ext Kitch: Year Built: 1988 Sound Value. Fuel Type: G Grade: E Cost Bldg: 1,406,600 Fireplace: 6 Bsmt Gar Cap: Condition: G Att Str Val 1: Central AC: Y Bsmt Gar SF: 936 Pct Complete: Att Str Val2: Att Gar SF: %Good P/F/E/R: /100/100/94 SKETCH PHOTO 14 ji? 7A I. 16 20 10 10 71M 12 7-4 19 4 'i. FM FIIJ Ful R ` r 936 Sq. 1982§'qA37 . 39 74 450 BEAR HILL ROAD ' E=- Parcel IO:210/064.0-0100-0000.0 as of 3/3/06 Page 1 of 1 LOCUS �O � ROT£CAD DISTRI 1 RIDGE ROAD LOCUS AIAP ° SCALE. I"=SOD'* LOT 77 EXISTING DRIVEWAY . EASENENI Y io ARE/ =48.620 S.F. ••' HOUSE� g��►' EXISTING CONCRETE >. �• PATIOEXISTING ` gCONCRETE ALX m ti PROPOSED PAHO g6, a \. 50•p0, PROPOSED 6' POOL LOT 50 EXISTING 1ENNIS COURT .` m g LOT 75A AREA=49 660 SF. ;p5 Sy. LOT 51 $� LOT 74A SITE PLAN FOR SWIMMING POOL FOR #450 BEAR HILL ROAD IN NORTH ANDOVER, MASS. PREPARED FOR DAVID CAFUA SCALE: 1'=20' DAIS 11ARCH 26 2006 20 0 20 40 FT' CHRISTIANSEN&SERGI P MO SURVE ASSESSOM ,o SLWM sr.WEN"w of&" Il 97"73-mlc MAP 64, LOTS 100 & 101 ona or amnum it sm we oMa Na oso/sow he Neve -Morin AT Group, Inc. April 7, 2006 Mr. Gerald Brown Building Inspector 400 Osgood Street North Andover, MA 01845 Re: 450 Bear Hill Road(Assessors Map 64, Parcels 100 & 101) Owner: David Cafua Dear Mr. Brown: The Cafua's wish to build a pool and a potential cabana at the above-referenced site. Their contractor, Kevin Belanger of Aquatime Pools, has filed a building permit for the pool however, the Town has asked that an engineer provide a letter certifying that the proposed location of the pool is not located within any of the protected areas associated with the Watershed Protection District. This site is located within the Residence 1 District (R-1) as well as the Watershed Protection District. As you are aware the Watershed Protection District is divided into four zones: General, Non-Discharge, Non-Disturbance and Conservation. Our wetland botanist has performed a site visit of the property and we have verified that there are no wetland resource areas located within 400 feet of the proposed pool shown on the attached plan . Please note our client has indicated that he may in the near future propose to build a cabana between the pool and tennis court. The 1F+ foca+ion of th;is Stnacture 1.aS lboen added the Kt4-o-hA.i.i plan. During, our inspection v, ,e have also verified that there are no wetlands within 400 feet of the proposed cabana. Since there are no wetlands located within 400 feet of the proposed work and the proposed work is located beyond 400 feet horizontally from the annual mean high water mark of Lake Cochichewick the proposed work is located in the "General Zone" associated with the Watershed Protection District. I hereby certify that the proposed pool and cabana shown on the attached plan is located within the "General Zone" associated with the Watershed Protection District. In accordance with Section 4.136 (3)(a.)(i.l.) of the Zoning Bylaw the construction of a pool and cabana is an allowed use in the "General Zone". ENGINEERS • SURVEYORS • ENVIRONMENTAL CONSULTANTS • LAND USE PLANNERS 447 Old Boston Road (U.S. Route 1), Topsfield, MA 01983 978-887-8586 FAX 978-887-3480 Providing Professional Services Since 1978 www.nevemorin.com 1. A Mr. Gerald Brown Page 2 April 7, 2006 If you have any questions please do not hesitate to contact me. Sincerely, THE NEVE-MORIN, GROUP, INC. THE NEVE-MORIN, GROUP, INC. John M. Morin, PE Greg Hochmuth, RS, PWS Executive Vice President Senior Wetland Scientist JMM/GH/kmm Atatchment cc: David Cafua Kevin Belanger, Aquatime Pools Lincoln Daley,North Andover Town Planner OF JOHN M. 9cyG MORIN m c CIVIL No.39836 p s G\�� s�ONAL EN FAKATHYMNSWORMGENERAU2531 BI.doc LOCUS 7EC7/O a51kO 1— 00 SLUE LOCUS ANP ..e....,`'-' SCUE, I'=600'3 LorDOSING 77 oR/YEWAY EASDffff g LOT 76A ^o AREA=4AaW S.F. •► q� N w DOSING I/DUSE/450 9A yt. PAW ISI NG OOrI im ALK o PROPOMPAWM 181.09' 99' gg p0 PROpom \ ISI POOL LOT 50 E7OSIING TWOS 001w 8 LOT 75A p AREA=49,680 SI'. LOT 51 , LOT 74A POTENT IA L �uTv RE GA5 A N A SITE PLAN FOR SWIMMING POOL 4 o " <o C I �o< ,{450 BEAR HILL ROAD /N NORTH ANDOVER, MASS PREPARED FOR DAVID CAFUA SCUD I'=20' DAIV MARCH 24,2006 20 0 20 4OFr CHRISTIANSEN&SERGI mLm4w M1LMAdLOK-wF" ra seven sr.rwmwmt4 w orad m.ns-,ns-Imo MAP 64, LOTS 100 & 101 l4mo.er aemwmr a mrat ee anc sa aaorso9r NORTH 3?py`,.ao ,a�1�pL TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION • t�,SSAC HUSEt This certifies that . . . . . . . . . . . . . . . . . . . . . has permission for gas installations . . . . . . . . . . in the building of .�,1(. .� . . . . . . . . . . . . . . . . . . . at A . . .�.�,1-�-��-:�- .�:�'-: . . - ., North Andover, Mass. ere (.. ` Fee-?n . . . . Lic. oG�:5�5� \ �.c� �. . '. . . . . . . . . . .. GAS M&ECTOR Check# 9 5380 MASSACHUSETIN UNIFORM APPTICATON FOR PERAW TO DO GAS FTrnNG (Type or print) Date NORTH ANDOVER,MASSACHUSETTS // Building Locations 75 Q � ��`'L(. /4d /t/.A,yday /l Permit# 0 7 9D Amount Owner's Name zqell� 2�L, f[] Frr A New Renovation Replacement ® Plans Submitted ❑ o 8 c F a o o H F G z a � O SUB -BASEM ENT BASEMENT ]ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR STH . FLOOR Name. rn C or type) Pow C�Corp,Certificate Installing Company Address ,: 7 0 Partner. usiness e ep one �� �a—766 Firm/Co. I� Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: ' I have a current liability Insurance policy or it's substantial equivalent. Yes © NoO If you have checked Les,please indicate the type coverage by checking the appropriate box. Liability insurance policy © Other type of indemnity 13 Bond 13 Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner [3 Agent 0 t hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachuset tat Gas Code and hapter 142 of the General Laws. By: Signature of Licensed Plumber Or Gas Fitter Plumber Title (7 357, City/Town ® Gas Fitter License Number Master APPROVED(oFF►CE USE ONLY) � Journeyman i l ` ' APPLTICAT - OR O�sPTLKAs � O0 ° AAND NiTNATDIaOteN R eceived O F MgSSACMVS2 M t�ls age / +1 (jfe p ermit NO' st complete all items on u ORT ANT: A pl�cant m � Date Issued• N" •� ennt CATION ® ZO�cv d Pn N LOING DTACT IS'Y YEs O ER , PROPERTY O ARc �IISTO�C DIS ,Resid ential P Non MAP Np.: OF BUII,DII�iG PROPOSED USE . AND USE MENT ential 1 1 TYPE Of PROVE ResidOne fan"ore family 0 ComYnercial TYpE O Two or n' -ti units'• New Building +1 r . No.of Bldg 0 Others' Addition 1 Assessor' o Alteration lacemCIA phi l L 6:n- o• Repair,rep Other G y Demolition c' cation) TO BE PREFORMED . . (relo , 0 Movin °n1y rt Foundation WORK ; _ TION OF DESCRIp �S c�- %O� s b rJut Clearly) se TYPe°r Ph°ne: plea aentificatrOo � •� .a v his� Phone "Same'. OWNER• Address: ° Y-1 - - Name• � � `� S�o CONTRACTOR �U 2 Exp . Address'. Licenser nstruction o�3 SupeisOrs Co ease Name:Ph < R S F 02 p0 pE ome ImprO�ernent Llc y�` M ON$125• Reg ISO. T BASED H GINEER D cos �` ECTIEN �,C� TOTAL ESTIMATED O� ARCxIT X o� 1000.00 of THE 10.00 PER$ Address: � ULD[NC PERMIT. $ tNo.: Rece1p FEE SCHED�EE•C°gt% T� PrO�ect CheckN°•: ,\.14 \Ot 4 ' Buil � The following is obtained. a list of there ding Department required forms to be sped out for Roofinb' Siding Irate the appro r"'Reh priate permit to be abilitation permits ° Building pe ° Workers Com it Application I ° P P Affidavit Photo Copy Of davit ° COPY of H L C. And/Or C S ° Floor Plan L. Licenses an r Proposed Interior W Addition Or Decks Work ° Building PQ rrnit° Surveyed plot P Application ° Workers CO fan ° photo MP an COpY Of CY°f H I C And C ° Floor/ °ntract S L• Licenses And Crossection/Elev ° ass cheati ck Calculation n Plan OfPr°p°s Ne ck Energy ComplianCeApplicable) ed Work With Sprinkl �' Construction er an ' (Single an Report (If Applicable) Building Pe d Two Family) r unit °° Certified prop°se Application Photo of d Plot Plan n o Workers C. And C.S ° Comp Affidavit L. Licenses Two Sets of Buil ' ° And Hydraulic Calc g Plans (One To BeCopy of Contract Calculations Retu ° Mass cher ns (1fAppllcable) rued) to Include Sprinkler k Energy Co Plan the In all cases if a varix c or Compliance Report of Deeds.Boone popeal that the a I al permit was re pY and proof ppeal period is required the Of recordingover. The a Town Clerks must pplica office must st hoc:INSPECTIONAL SERVICES be submitted with hest then get this ramp the decisio building a ecorded he n from DEPARTMENT--aPPORM05 Pplication at t Registry Page 4 of 4 , Location_��Q No Date 6 � t>,6 „pRT1y TOWN OF NORTH ANDOVER + Certificate of Occupancy $ �'�s''••O''t�' 9 cMBuilding/Frame/Frame Permit Fee $ a a s� usE Foundation Permit Fee $ � y Other Permit Fee $ TOTAL $ A Check # IA-r2- 9434 2— 9 4 3 4 Building Inspector I TYPE OF SEWARGE DISPOSAL Tanning/Massage/Bo Public Sewer dy Art ❑ Swimming Pools ❑ Well Tobacco Sales ❑ Food Packaging/Sales 11❑ ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracting with u egistered contractors do not have access to the guaranty fund l Signature of Age caner Signature of Contractor Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ I THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM j DATE REJECTED DATE APPROVED PLANNING& DEVELOPMENT ❑ {� 66 ❑Water Shed Special Permit ❑ Site Plan Special Permit I ❑ Other ��AA � COMMENTS 6Q j fA t g Voo'e ,Q.d(� 4rv -y �.,,�..( •�.� t ,. ,:! ����DATE REJECTED DATE APPROVED _Cq�NSERVATII 33�7i 4 2cor COMMENTS G r © ��'1 s /c n I� DATE REJECTED DATE APPROVED HEALTH ❑ ❑ h COMMENTS Page 3 of 4 IE Doc:INSPECTIONAL SERVICES DEPARTMENT BPFORMOS f Created JMC.Jan.2006 Zoning Board of Appeals:Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Building Setback(ft.) C 0 Front Yard Side Yard Rear Yard n Required Provided Require Provides Required Provided S e r vation Decision: Comments Water&Sewer connection signature&date Temp Dumpster on site yes—no— Fire Department signature/date Building Permit Approved and Issued by: Page 2 of 4 DIMENSION Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area,sq. ft.: NOTES and DATA— For department use) Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created IMC.Jan.2006 NORr� 1 l'OWN ON'NORTH ANDOVER OFFICE OF ° BUILDING DEPARTMENT w , * 400 Osgood Street North Andover, Massachusetts 01845 4 SSAC HU5�t Gerald A. Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: 6 S �j �Q JOB LOCATION: .sd 13eC4<-Nt0 1,�'47- Number Street Address Map/Lot HOMEOWNER t)a\)� fl �..IfU� 9T6 C� I �� S Pr OA C, Name Home Phone p Work Phone PRESENT MAILING ADDRESS H 5-0 (6�acL A t l y N . Qw-e2 o n5- �6 r9 av�z a/Lm City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,oris intended to be,a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other Applicable codes,by-laws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. IIOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Honwowneis Exemption BOARD OF APPEALS 6880541 CONSERVATION 08-0530 HFAI..TH 188-9540 PLANNING 08- 0535 NORTH Town of 006-9 dover, Mass.,— LA COCHICHEWICK ADRATED `S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....... �i��. 0 .4. ............ ..................................................... ........ . ...... Foundation olkl has permission to erect............ ....... buildings on.. � /r ��� Rough to be occupied as elis�permft S.i�... . Q....6.40.0v� Chimney ................................ ........ ............................................................ provided that the person accepting t sh I in eve 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 Re ulatlon Voids t is P�rmlt. Rough Final PERMIT EXPIRES Il 6 M64THS C UNLESS CONSTRUCTIOASTS Rough ELECTRICAL INSPECTOR .. . ........ ........... Service B LDING 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. 16:32 JUN 15, 2006 ID: FRED C. CHURCH TEL N0: 978-454-1865 #I-e9774 PAGE: 2/3 ACORDCERTIFICATE OF LIABILITY INSURANCE DATE YYYY} 06!15/20066 1 16-6:20 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Fred C.Church Fred Street Connector Park HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR 41 Lowell an 01851 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A. American Horne Assurance Co. SL Miguel Construction,LLC INSURER B: First Mercury Insurance Company 1000 Osgood Street North Andover,MA 01845 INSURER C: INSURER D. INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INR DO'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MMIDDIYYI DATE IMMIDDNY) GENERALLIABILITY EACH OCCURRENCE S 1,000,000.00 DAMAGETORENTED X COMMERCIAL GENERAL LIABILITY PREMISES(Ea cauenoe) S 50,000.00 CLAIMS MADE O OCCUR MED EXP(Any one person) 5 B FMMA000132 10/5/2005 10/5/2006 PERSONAL&ADV INJURY $1,000,000.00 GENERAL AGGREGATE S 2.000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG S 2,000,000.00 POLICY P co LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANYAUTO (Eeacident) S ALL OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS (Per person) HI RED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGELIABILRY AUTO ONLY-EA ACCIDENT S ANYAUTO OTHER THAN EA ACC S AUTO ONLY: AGG S EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S OCCUR FICLAIMSMADE AGGREGATE S S DEDUCTIBLE $ RETENTION S $ WORKERS COMPENSATION AND WC'IT'MtT. OTH- EMPLOYERS'LIABILITY A ANY PROPRIETORIPARTNERIEXECUTIVE WC9306320 7/21/2005 7/21/2006 E.L.EACH ACCIDENT s 1,000,000.00 OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE S 1,000,000.00 If Yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000.00 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of North Andover DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS IMi1TTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Town Hall IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR North Andover,MA 01845 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE /P LM ACORD 25(2001108) Client# 3411 Mst# C-ALL Cert# ©ACORD CORPORATION 1988 16:33 JUN 151 2006 ID: FRED C. CHURCH TEL N0: 978-454-1865 #179774 PAGE: 3/3 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the poiicy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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 endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or after the coverage afforded by the policies listed thereon. ACORD 25(2001108) 06/15/2006 THU 16:38 FAX 978 356 4880 H.L.GRAHAM 16001 Awe ��w `�/ d BOARD OF BUILDING RE cen T Ci se: CONSTRUCTION RVISOR Number: CS 081897 Birthdate: 10/23/.1967 Expires: 10123[2007 Tr:no: 7778.0 . ` Restricted: 00 GREGORY J NOLAN ; 13:WOODLAND AVE, G- ' KINGSTON, MA 02364 - Commissioner -