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Miscellaneous - 802 DALE STREET 4/30/2018 (2)
00 N C4 L4 �y Date .......... .t....� �.-.� ................ TOWN OF NORTH ANDOVER PERMIT FOR WIRING 0�1 This certifies that ..........VYl .. Y� Q e- has permission to perform „ AUL_ ...................................................................................... wiring in the building of.... U'r1--............................................................................. G at ................. .. .. � �, , North Andover, Mass. ......... ............................................................... V�ee.ZS................ Lic. No--}lUC1S .196 ............ � ........ ........................... ,1 �,c, ELECTRICAL INSPECTOR iheck# �`� —U%0 3b ►z0 CoC Off ial e y mmonwea k of Vamackudeffi 2c� Permit No. HUI eparlment ol3h e Services Occupancy and Fee Checked s" BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/071 (leaveblank) 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 ININK OR TYPE ALL INFORMATION) Date: 14PRZ.L 12 — 2013 City or Town of: L�pRTN AM6NER 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) QSOZ DALE STREET Owner or Tenant MRR'T'`{ Telephone No. 778 682 Co 5 5 q Owner's Address S A Y" Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building 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: JtEw7r Jq1 OF SNE Nro"d cl�,zL FI -SED FURNACE COmDletion of the following table may he waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑In- 11 rnd. rnd. o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners OME FIRE ALARMS I No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons KWNo. ....................... of Self -Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating IOW Local [:1Municipal [I Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water, No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors ` Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: y —12-13 Inspections to be requested in accordance with NEC Rule 10, and upon completion. 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: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties ofperjury, that the information on this application is true and complete. FIRM NAME: LIC. NO.: Licensee: :=LPA WMKN€ Signature `_kj,qVvykQ LIC. NO.: (Ifapplicable, enter "exem t in the license number li e.) - Bus. Tel. No. - Address: X10% IN�,Dt�tiT�►� HILL N& O 1 ABB Alt. Tel. No.: *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. 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 agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ A �w 'PS The Coin in on wealth of Massachusetts - department of Industrial Accidents P, Office of Investigations i.l'rw=�Y;ti-' Fra=y i 600 Washington Street a Boston, MA 02111 www. mass.gov/dia Workers' Compensation Insurance Affidavit: Build ers/Co> tractors//Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/Individual):_ Address: -1 HAv F_ P City/State/Zip:._ MA O � A,�2 Phone #: Are you an employer? Check the appropriate box: ZZ � ❑ I am a employer with 4. [] I am a general contractor and I Type of project (required): employees (full and/or part-time).* have hired the sub -contractors 6. 0 New construction I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub -contractors have g, 0 Demolition working for me in any capacity, employees and have workers' [No workers' comp. insurance comp. insurance.t 9. 0 Building addition required.] 5.0 We are a corporation and its 10.0 Electrical repairs or additions ❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [NaV61ers'. comp. insurance required.] t right of exemption per MGL C. 152, § 1(4), and we have no 12 0 Roof repairs employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that isproviding workers' compensation insurance for my employees. Below is the policy and job site information. 0 Insurance Company N y Policy # or Self -ins. Lic. Expiration Date: Job Site Address: SO2 DALE sr. Nt%91 N .A11 DayL-:R City/State/Zip: MPt d 1 8 q_T Attach a copy of the workers' compensationpolicy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as 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 verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Phone #: 918 Official use only. Do not write in this area, to be completed by city or town offrcial. City or Town: Permit/License Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: w A 1 4AY. `'f+re,lu_;;MA 01832 1405, � _ 07/31/13 821989 CONTROL # H 016 616 i IMPORTANT at the: If this license is lost or destroyed,, notify your Boardton St, 1 Division of Professional Licensure, 1000 Washing + Suite 710, Boston, MA 02118-6100. if your name or address shown is changed, notify your board of correct name or address to insure proper mailing of next i Renewal Application. Always refer to your license number. This license is subject to the provisions of the General Laws per privilege, and must not be loaned as amended. it is a p this license on your or assigned to any other person. Keep , i3 person or posted as required by law. 4-c - 'Fa I �,3 Date ..... .7.-.1.3... 0.9' ° ,"'° '• "� TOWN OF NORTH ANDOVER 0 p PERMIT FOR WIRING This certifies that ............ �- L � ........ ....... .............................. has permission to perform ..... w �('OU�t !)....Pr 0"– ..................... wiring in the building \of............1." .�A . V .................................... at ............F..2�1/`1�. ........5. —.4 ...-, , North Andover, Mass. Vee ..... 7.S ��. Lic. No.. 9163 ................!a�/ 1%..... . `ELECTRICAL INSPECTOR (Check #I b -? 8864 MAY -20-2009 02:17P FROM:TOWN OF NORFOLK BUIL 508 541 3300 TO:819782565804 I �nunonwea� of /flaSlaChueelltll -K • Z4p1 41l Wd of Vk, Swvkel BOARD OF FIRE PREVENTION REGULATIONS Omci se ly Permit No.. Occupancy and Fee Checked, Rev, 1/07j leave blank APPLICATION FOR PERMIT`TO PERFORM ELECTRICAL WORK All work to bo performed to accordmoor with the Musaohusetts 11cotrieal Codo►�tl ), 27 CMR 12.00 (PLEASE PRINT IN INK ORwmalth Wei,1 N Date:Oq Cltj or Town of:To the inspector, of Wires: By this application the undersigis or her intention foperform the electrical work described below. Location (Street do Numberl .. .'SLE Ca-- Owner'or Tenant Telephone N Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps l Volts Overhead ❑ wI AiapsVolts . Overhead ❑. Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: —Undgrd ❑ No, of Meters Undgrd ❑ No, of Meters P: 1/2 Camoletlon o/the following, tahl. — A..., 1—d A. ,r,. t.......,.,. ,.r w.,.. No. of Recessed Luminaires No. of Cell.•Susp, (Paddle) Fanso' o ora Transformers KVA No. of Luminalre Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swlmmittg PoolOve' ❑ in'. ❑ rrid, and. 0, o mergency g ng Ba"ery Units No, of Receptacle Outlets No, of Oil Burners FIRE ALARMS No. of Zones No, ofSwitches No, of Gas Burners. o, of e ect on an InitiatingDevices No. of Ranges No. of Air'Ccnd. • .i.an� No. of Alerting Devices No. of Waste Disposers HutrumplNumber Tatals; I Tons IKW No. of Selr--Conta ng, Detection/Alerting Devices — I'-" No, of Dishwashers Space/Area Heating KW Locai ❑ Municipal❑Other Connection No. of Dryers o. o water KW Heaters Heating Appliances KW o. o '. a. o signs Ballasts Secur of Detviees or Equivalent Data Wlrin g' No, of Devlees or l? ulvalent No. Hydromassage Bathtubs No. of Motors Total HP telecommunicationsWiring; No. of Devices or E uive eni OTHER: ,elrach additional detail ffdeslred, or as required by the lnspecror of Mru Estimated Value of Electrical Work: (When required by municipal policy.) Wort: to Start: lnspecdons to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived, by the owner, to permit for the performance of electrical work may issue unless the licensoo provides proof of liability irtstirance Including"completed operation" coverage or its substantial equivalent The undersigned cortlfies that suchverage Is In force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I eerft under th'e p Uns and psnaltks of perjury, that the Information. on this application Is true and complete. FIRM NAME: 4 �hL LIC. NO.:. �J 3 Licensee: C Signature L1 C. NO,: 21 illapplicable, enter 'exempt" In th llcearr number nca Bus. Tel. No.. -- Address: 'Per M.G.L. c. 147, s. 57-6 1, security work requires Department of Public Safety "S" License: Alt Licl No, T' OWNER'S INSURANCE WAIVER:• l am awaye that the Licerisce 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/Agent ❑owner's agent Signature Telephone No. _ PERMIT FEE: S i Sq zl�� I 0 I I own of North Andover Office of the Zoning Board of Appeals Community Development and Services Division 27 Charles Street North Andover, Massachusetts 01845 D. Robert Nicetta Building Commissioner Any appeal shall be filed within (20) days after the date of filing of this notice in. the office of the Town Clerk Notice of Decision Year 2003 Property at: 802. Dale Street Telephone (978) 688-9541 Fax (978) 688-9542 NAME: Elisa & Douglas P.1VMartyn HEARING(S): 7/8/03 ADDRESS: 802 Dale Street PETITION: 2003-020 North Andover, MA 01845j TYPING DATE: 7/14/03 The North Andover Board of Appeals held a public hearing at its regular meeting on Tuesday, the 8`h of July, 2003 at 7:30 PM in the Senior Center,. 120R Main Street, North Andover upon the application of Elisa and Douglas P. Martyn, 802 Dale Street, North Andover requesting a Variance from Section 7, Paragraph 7.3 and Table 2 for relief of the right side setback; and a Special Permit from Section 9, Paragraph 9.2 in order to rebuild and expand an existing family room of a pre-existing, non -conforming structure on a pre-existing, non -conforming lot. The said premise affected is property with frontage on the West side of bale Street within the R-1 zoning district. The following members were present: William J. Sullivan, Walter F. Soule, Ellen P. McIntyre, George M. Earley, and Joseph D. LaGrasse. Upon a motion by Joseph D. LaGrasse and 2nd by Ellen P. McIntyre, the Board voted to GRANT a Variance from Section 7, Paragraph 7.3 and Table 2 for relief of 5.5' for the north side setback of a proposed rebuilt and expanded.family room; and a Special Permit from Section 9, Paragraph 9.2 in order to rebuild and expand an existing family room of a pre-existing, non -conforming structure on a pre-existing, non -conforming lot according to the Plan of Land in North Andover, Mass. Owned by Douglas P. and Elisa Marlyn by Scott L. Giles, P.L.S. #13972, 50 Deer Meadow Road, North Andover, Mass., dated 5/15/03 and Plans for Marlyn Residence, 802 Dale Street, North Andover, MA., Date 4/18/03 by Stephen E. Foster, 48 Meadow Street, North Andover, MA, [4 pages] with the following conditions: 1. The south side setback will continue to be 26.5' to the existing dwelling. 2. The Plan of Land and the Plans for Martyn Residence, 802 Dale Street will agree on the 17' height of the addition and 18' height of existing the dwelling. 3. The Board requests the applicant to add a retaining wall and shrubbery to screen the proposed addition on the north side of the property. Voting in favor: William J. Sullivan, Walter F. Soule, Ellen P. McIntyre, George M. Earley, and Joseph D. LaGrasse. The Board finds that the applicant has satisfied the provisions of Section 10, paragraph 10.4 of the Zoning Bylaw and that the granting of this Variance will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning Bylaw, and satisfied the provisions of Section 9, Paragraph 9.2 of the Zoning Bylaw that such change, extension, or alteration shall not be substantially more detrimental than the existing structure to the neighborhood. Pagel of 2 c` c Uj Board of Appeals 978-688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-688-9535 ti Community Development and Services Division 27 Charles Street North Andover, Massachusetts 01845 �'ss ACHUgF D. Robert Nicetta Building Commissioner Telephone (978) 688-9541 Fax(978)688-9542 Furthermore, if the rights authorized by the Variance are not exercised within one (1) year of the date of the grant, it shall lapse, and may be re-established only after notice, and a new hearing. Furthermore, if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two (2) year period from the date on which the Special Permit was granted unless substantial use or construction hss ccm..:enced, it shall lapse aad rray be re-cstablished only afteir notices and a new hearing. Decision 2003-020. Page 2 of 2 Town of North Andover Board of Appeals, I Lk, William J. Sul t van, Chairman Board of Appeals 978-688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-688-9535 Essex North County Registry of Deeds 381 Common Street Lawrence, Massachusetts 01840 08/29/03 MArTfh? KM 5100 ' DOC. 53,277 C. P. 00 D. 5.06 Total 75.00 i n 84 Payment Check .5.00 THANK `(iii! Thomas 7. Burke Register of Deeds � .,N 0 o\k�/ 322§%9§ oo�\0j Z Q0\ § §E m:Kmrn $\iorn w�aoae� �o��koo §§-4\§\ ?»&G®)m °§k®?%$ 2 rn 0)2§ � 1 Essex North County Registry of Deeds 381 Common Street Lawrence, Massachusetts 01840 08/129;03 MAR M Type p R. It Ch. —, 5'•I II 1�!v, Pia, T, Rut a .t of Deeds SEP g -D"T 2003 BOARD OF APPEALS Location No. L �%� Date N0*Th TOWN OF NORTH ANDOVER Certificate of Occupancy $ ��s'•^° • Eta' Building/Frame Permit Fee $ O s�CMus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ D D 4 Check # 1 L �j / Y V V i `t 1 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER:/DO DATE ISSUED: SIGNATURE: �( Building Commissioner/Inspector of Buildings .Date SECTION 1- SITE INFORMATION - 1.1 Property Address: 1.2 Assessors,Map and Parcel Number: Name (Print) Address for Service: Signature Telephone 2.2 Owner of Record: Map Number Parcel Number X . 1.3 Zoning Information: Signature. 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Fronts e ft 1.6 BUILDING SETBACKS ft Front Yard Si e Ya A Rear Yard Required r e Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Fl 1.8 Sewerage Disposal System: Public ❑ Private ❑ no Outside Flood Zone 0 Municipal ❑ On Site Disposal System. 0 SECTION 2 --PROPERTY OWNERSHIP/AUT'HORILED AGENT 2.1/Owwner of ,Record Name (Print) Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Address for Service: X . Signature. Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: EN NES K�E� Licensed Construction Supervisor Address re Telephone 3.2 Registered Home Improvement Contractor ��E� CorJSf2JC.��a�.J Company, Name ■lA5w; lT I�✓c . Not Applicable ❑ Z))J License Number (3- 7"1/ ( - D `l Expiration" Date Not Applicable ❑ 4) 5 3 3 Registration Number . Ad%dress Expiration Date ` M M X Z 0 Q a rn 7 G4 G 0 z M 90 0 r M _r z 0 SECTION 4 - WORKERS COMPENSA iiTION (NLG L C 152 § 25c(6) ��ti��� Compensation Insurance affidavit must be completed and submitted with this in the dental of the issuance of the buildinrmt. apphcapon. Failure to provide this affidavit will result i Si ned affidavit Attached Yes ....... No ....... ❑ SECTONS De scri tion of Pro osed Work checkalla licable NewE�'E Existing Building ❑ Re Pairs) ❑ Alterations(s) ❑ Addition AcceDemolition ❑ Other ❑ Specify Brief Description of Proposed Work: 12/i !6 t9 IrWC-A *d 757/L /q LN i SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Esfimated Coat (Dollar) to be e a Building Com leted b ermit a licant d 3 kI t 1. Z.S coo (a) Building Permit Fee 2 Electrical Multi lier (b) Estimated Total Cost of 3 Plumbin Construction 4 Mechanical HVAC Building Permit fee (b) 5 Fire Protection 6 Total . 1+2+3+4+5 Uheck Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDINGPERMIT I _ . as Owner/Authorized Agent of subject property Hereby authorize My behalf, in all matters relative to work authorized by this building,pennit application: to act on Signature of Owner SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION Date I, k �,� E R E;✓ >J propeny 1a&44meAAuthorized Agent of subject Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief of NO. OF STORIES BASEMENT OR SLAB eftR w -FA& -1c SIZE OF FLOOR TIMBERS -. 1, SPAN , DIMENSIONS OF SILLS Z 4 DIMENSIONS OF PjQl� D]MENSIONS O?tr' HEIGHT OF FOUNDATION SIZE OF FOOTING MAT.F.RLAL OF CHWINEY IS BUILDING ON SOLID OR FILLED LAND IS BUII DING CONNECTED T0 .NATURAL GAS LINE —/'Z—/ 0 Date SIZE 446%1 -7 tJ THICKNESS X FORM - U - LOT RELEASE FORM 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 � ��( PHONE g b ga' ASSESSORS MAP NUMBER I LOT NUMBER GP 1 SUBDIVISION LOT NUMBER STREET A STREET NUMBER 1///.//////////////............././.....u./■///////////////////////////.//■ OFFICIAL USE ONLY �.........................../.../......................................... RECO,kWENDATIONS OF TOWN AGENTS loss MEN .../......./../... ■...■.i.■//./...../..........'/. /......... /...../..■ DATE APPROVED C SERVATION ADMINLS TOR DATE REJECTED CONMiENTS DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE r DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED F D INSPECTOR - HEALTH DATE REJECTED � DATE APPROVED tt t 6 SE C INSPECTOR - HEALTH DATE REJECTED COMZVIENT , PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERNIIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE r ' ✓/ze T�anvmaaurP,a� /fiiaaoaclucaetf i . Board of Buildng:Regulations and Standards HOME 10PR EMENT CONTRACTOR Reg�stratlon 108383 Expiat on 8/1$!2004 ' 'Type DBA a 3 KEEN CONSTRUCTION CO M Kenneth Keen 21 �Hewilt Ave No. Andover, MA 01845 Adcnittratip:r .# N VL ELL-- Th The Commonwealth of Massachusetts Department of Industrial Accidents Office of/nvesligal/aos 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit location: Z-1 4Ilew I city N >>7/✓fd O l%£yt 12hone # / / M I am a homeowner performing all work myself. L E�-1 am a sole proprietor and have no one working in any capacity E] I am a sole proprietor, general contractor, or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation polices: �omoan.v name. SignatureZ Q Date Pnnt name r G Phone # g"'7"9 official use only do not write in this area to be completed by city or town official city or town: permit/license # nBuilding Department - ❑Licensing Board ` O check if immediate response is required OSelectme0Health Department n's Office contact person: phone #; r10ther (revised 3/95 PJA) Essex North County Registry of Deeds X81 Common Street Lawrence, Massachusetts 01840 08/109/03 i�:I,M f: t Type DECN ^ r•:. OCz 53^ 7 C. P. R. D. ^ T o ta1 r 04 F`a-Jment Check 7 nri:1 _ -r of Deed: Town of North Andover Office of the Zoning Board of Appeals Community Development and Services Division 27 Charles Street North Andover, Massachusetts 01845 D. Robert Nicetta Building Commissioner Any appeal shall be filed within (20) days after the date of filing of this notice in. the office of the Town Clerk Notice of Decision Year 2003 Property -at: 802 Dale Street Telephone (978) 688-9541 Fax (978) 688-9542 NAME: Elisa & Douglas P. Martyn HEARING(S): 7/8/03 ADDRESS: 802 Dale Street PETITION: 2003=020 North Andover, MA 01845 TYPING DATE: .7/14/03 The North Andover Board of Appeals held a public hearing at its regular meeting on Tuesday, the 8`h of July, 2003 at 7:30 PM in the Senior Center,. 120R Main Street, North Andover upon the application of Elisa and Douglas P. Martyn, 802 Dale Street, North Andover requesting a Variance from Section 7, Paragraph 7.3 and Table 2 for relief of the right side setback; and a Special Permit from Section 9, Paragraph 9.2 in order to rebuild and expand an. existing family room of a pre-existing, non -conforming structure on a pre-existing, non -conforming lot. The said premise affected is property with frontage on the West side of Dale Street within the R-1 zoning district. The following members were present: William J. Sullivan, Walter F. Soule, Ellen P. McIntyre, George M. Earley, and Joseph D. LaGrasse. Upon a motion by Joseph D. LaGrasse and 2°d by Ellen P. McIntyre, the Board voted to GRANT a Variance from Section 7, Paragraph 7.3 and Table 2 for relief of 5.5' for the north side setback of a proposed rebuilt and expanded family room; and a Special Permit from Section 9, Paragraph 9.2 in order to rebuild and expand an existing family room of a pre-existing, non -conforming structure on a pre-existing, non -conforming lot according to the Plan of Land in North Andover, Mass. Owned by Douglas P. and Elisa Martyn by Scott L. Giles, P.L.S. #13972, 50 Deer Meadow Road, North Andover, Mass., dated 5/15/03 and Plans for Martyn Residence, 802 Dale Street, North Andover, MA., Date 4/18/03 by Stephen E. Foster, 48 Meadow Street, North Andover, MA, [4 pages] with the following conditions: 1. The south side setback will continue to be 26.5' to the existing dwelling. 2. The Plan of Land and the Plans for Martyn Residence, 802 Dale Street will agree on the 17' height of the addition and 18' height of existing the dwelling. 3. The Board requests the applicant to add a retaining wall and shrubbery to screen the proposed addition on the north side of the property. Voting in favor: William J. Sullivan, Walter F. Soule, Ellen P. McIntyre, George M. Earley, and Joseph D. LaGrasse. The Board finds that the applicant has satisfied the provisions of Section 10, paragraph 10.4 of the Zoning Bylaw and that the granting of this Variance will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning Bylaw, and satisfied the provisions of Section 9, Paragraph 9.2 of the Zoning Bylaw that such change, extension, or alteration shall not be substantially more detrimental than the existing structure to the neighborhood. Pagel of 2 =- _ r ND = Gj ��iLJf 7 U7 C. l.J Board of Appeals 978-688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-688-9535 Town of North Andover A" ,,ORT„ Office of the Zoning Board of Appeals 0 Community Development and Services Division f i 27 Charles Street North Andover, Massachusetts 01845I"4U D. Robert Nicetta Telephone (978) 688-9541 Building Commissioner Fax (978) 688-9542 Furthermore, if the rights authorized by the Variance are not exercised within one (1) year of the date of the grant, it shall lapse, and may be re-established only after notice, and a new hearing. Furthermore, if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two (2) year period from the date on which the Special Permit was granted unless substantial use or construction has cors; :enced, it snail lapse and, muy be re�zstablished only afcc, notice; and a new 1�earing. Decision 2003-020. Page 2 of 2 Town of North Andover Board of Appeals, ILL' - William J. Sul van, Chairman Board of Appeals 978-688-9541 Building 978-688.9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-688-9535 KEEN CONSTRUCTION CO. 21 HEWITT AVE. N. ANDOVER, MA 01845 (978) 691-5201 Martyn, Doug & Elisa 802 Dale St. N. Andover, MA 01845 (978) 682-6554 Contract # 1476; Appendix A Date: 11/28/03 Family Room Addition: • Demo & dispose of existing sunroom • Excavate & pour concrete footing & foundation for 16'x 24' room 4' below grade • Pour concrete floor in foundation creating approx. 4' crawlspace • Backfill foundation and rough grade only • Frame flooring as per prints except where joid'ts need to be toggled to hold up rear window proj ection oiI'1 4F • Frame walls and roof as per prints • Frame opening above fireplace. to fit customer supplied TV • Supply & install Pella Architect Series Classic windows, white exterior clad, 5/8" Insulshield Temp IG glazing with Renaissance grilles as follows: • front sides • front center • rear sides • rear center • sides • Supply & install Architect style roofing • Supply & install siding to match existing • Supply & install gas fireplace as follows: • Lennox EDV4035CNM • EBLK-40 upgrade refractory kit • ADK40CPB arch door kit • CremaMarfi166 Marble set • Medium Oak Capri deep mantle • Supply & install insulation and vapor barrier as per prints • Supply & install blue board and skimcoat plaster walls and ceiling to smooth finish • Supply & install Chelsea Plank Aspen Maple hardwood flooring (3 ", 4" & 5 ") in a circular design with herringbone corners • Supply & install trim on windows and baseboard to match existing (paint grade) • Supply & install one 24" x 18" x 84" cabinet next to existing chimney in addition Electrical: 0 Relocate electrical service & upgrade to 200 amp service KEEN CONSTRUCTION CO. 21 HEWITT AVE. N. ANDOVER, MA 01845 (978) 691-5201 • Supply & install one telephone (Cat. 5 wire) and one cable outlet • Supply & install electric outlets to code • Supply & install six recessed lighting fixtures switched on dimmers • Supply & install one ceiling fan safe and hang customer supplied fan • Supply & install thermostat & necessary wiring for new zone of heat Plumbing: • Supply & install one zone of forced hot water baseboard heat in new addition tied into existing boiler Price does not include cost of permits, landscaping or painting (interior or exterior). A Iv r i mat Nortli.,4 n.davarr, MA 01845 NAME 1AD-O REss EWa,& 'Dotg,Mar,VyrL, 802 a'. a&S-Vre.et Nord,L,An.dovea-, MA 01845 A 7T 11/30/2003 re�No: 978 -682 -6554 IDESC IPrxoN T'oTAL Drnunpayment- fo-r` addit`oiv 1,000.00 paylw-+,It- du.e, when, pe4-dam &Y co ,, plete& [In,cltpermit f?.ell 8,600,00 payment jb r 1btday 0f wci -k- 5,000.00 Payment for da,F,.vj-& f00U4 p0usred, 8,000.00 payment for fc?tA.ndarcon,potwe&. 7r backfOied, 5,000.00 Payment f0V fO�cW1.GT Litw A, d ?'dceci, 3,000.00 Payment f( 1sr d'ay of {-amin#warrk 81000.00 pay we-v,tf6v addel0-nuextherVtr#I X 10,000.00 PayMe4W fVlr VCUgk deCrV--ar Igk heat0.4Nym 3l0/0.00 Payment fcn- tAvw,borw& i4 Iu4n,,: - 3,000.00 Payment" for eNtrewlor i4-tr"wvm ,. 3,000.00 Final/ Payment wh.e ry c0m fete& 2,525.00 7 you. frnr you r- bto- 6r'i e", phc,nv# I Faux, ri' 978-691-5201 1 978-682-3231 1 TOTAL $60,125.00 src-,NAVURE 1 i0 ,Lf - -____ �-=----------- KEEN CONSTRUCTION CO. n 21 HEWITT AVENUE NORTH ANDOVER. MA 01845 Tel: (978) 691-5201 Fax: (978) 682-3231 PHONE DATE (A� > C/S = Customer Supplied S + I = Supply + Install We hereby submit specifications and estimates for work to be performed and materials to be used: > Construction related permits: F„ 1476 Ai - All home improvement contractors and subcontractors engaged in home improvement contracting, unless specifically exempt from registration by Provisions of Chapter 142A of the general laws, must be registered with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the Director, Home Improvement Contract Registration, One Ashburton Place, Room 1301, Boston, MA 02108 (617) 727-8598. Owners who secure their own construction related permits or deal with unregistered contractors will be excluded from the Guaranty Fund Provision of MGL c. 142A. REGISTRATION NO. F.I.D. N0. MA. H.I.C. 108383 04-325-8052 1 G I,t' j 1._ik'L �)�...( l� C> ............................................................................................................................................................................................................................................................................................................................ t f:},..............,.................................. WORK SCHEDULE _ _ _-•-----� ' Contractor will not begin the work or order the materials before the third day following the signing of this Agreement, unless specified here in writin Contractor will begin the work on or about17. -- `Z - 6 > (date). Barring delay caused by circumstances beyond Contractor's control, the work will be completed by Z -- - C `( (date). The Owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall not be considered as violations of this Agreement. WARRANTY The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of l<, following completion and shall comply with the requirements of this Agreement. In the event any defect in workmanship or materials, or damage caused by the Contracto , his subcontractors, employees or agents, is discovered within one year after completion of any job, including cleanup, the Contractor shall, at his own expense, forthwith remedy, repair, correct, replace, or cause to be remedied, repaired, or replaced, such damage or such defect in materials or workmanship.The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. We Propose hereby to furnish material and labor - complete in accordance with above specifications, for the sum of ic_., r n, C1 /. 1 ,� < <;•_rc' �% Lc fr , LJ<< dollars ($ Payment t6 be made as follows: % ($ ) upon signing Contract; % ($ ) upon completion of % ($ ) upon completion of KENNETH B. KEEN Name of Contractor / Designated Registrant 21 HEWITT AVE. Street Address N. ANDOVER City / State opo shall be made forthwith upon (978) 691-5201 �$ ) completion of work under this contract. Phone MA 01845 (978) 682-3231 Fax Notice: Nb agreement for home improvement contracting work shall require a > down payment (advance deposit) of more than one-third of the total contract price Name n Salesman rc r or the total amount of all deposits or payments which the contractor must make, in ' ` - advance, to order and/or otherwise obtain delivery of special order materials and Au!�666 bignature equipment, whichever amount is greater. Note: This proposal may be withdrawn by us if not accepted within days. Acceptance Of Proposal - I have read both sides of this document and all attached documents and accept the prices, specifications and conditions stated. I understand that upon signing, this proposal becomes a binding contract. You are authorized to do the work as specified. Payment will be made as outlined above. You, the Buyer, may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. Cancellation must be done in writing. r. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Signature��.'t.� / ,�1 ,Ll" Date/—J �' �� �? Signature Date IMPORTANT INFORMATION ON BACK ► z LLJ a 2 B �§\ ® ~ E®/ ® I §/m « q Q) § q @\SW9 � } 7/$ \ k �222w ) 'y§. &/CL . 3 $ ®Q \ $%]f § / � ``� §\\ LL i-3 @Z w\) uj 2 � \�.§U e woo CL °q \ /}LOk \ § �L\ « � K $ 2 ? § Q A2� Q b 37VO $,org2N , »Qq as ,'Z. & --- 7VIO.L, ' t- - /�. 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O m y cn C W c ►� N `fir ® � O : Q ar. VJ m : N m � CT o cn z �o m Cn = i D . Cn � co CD oCD: CL's ro: � c o 0 ,0� P.n d aq C b o ro ::ra 0 z ^ a C) d O 7d H O C z 2S d to � fl� UN C /—..9-f i o5 r_ z 2S d fl 17 I 11� U � ILI to�, "�44i ILI toll . Z 1 co I I 17 I "�44i Z 1 I I F fl � 1 FL lu wz V Q ` n�u � 1 FL lu wz z lu w ��0 O z SII > z �� z� Nig II II II it II it II II II II II II J II II II H1 Fj / o� SII �oL7 211 N w� Z z V Q I r +++++++++.+I .s .++++++♦ •• • + + r a + + + "• J n ` + + a a } + + •' + } t + +'� +++++ • •J + t t + ♦ f +++++++++++++ ••. ++}+4 v +++++4+++++++ +++++ ' b• ++++.++++++++ y + + + + f + + ' ++ + - + + + - +.+++.++++++ +++++ iu U U � U !� n � jfl z Q �,P �► ,7� # LIDO /550ED /Z-3-03 / nosA",.*/ /-z o- 0 5� #= 002 D4 / F— ,57, S- ,uo ^'fk S, VtbAc e V 4 P. 0K CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MASS. SCALE. -I"=40' DATE:1/1 &2004 Scott L. Giles R. P. L. S. Frank. S. Giles R. P. L. S. 50 Deer Meadow Road North Andover, Mass. NOTE.SEE VARIANCE GRANTED. LOT 4 44,, OOOO S. F3 +/- S�TBgc ryy PLAN 8561 N.E.R.D. a' N FND. U sFT WZ U Q o N m eqc� UA .� _ o Cn o 0 h � sr cy ' �T O„ LOT 2 uj W W J 15 Q I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE tH Of THE OFFSETS OF THE BUILDING INSPECTOR ONLY yo SHOWN COMPLY AND SUCH USE IS FOR THE S �^ WITH THE ZONING DETERMINATION OF ZONING • 1 972 c BYLAWS OFCONFORMITY NORTH ANDOVER OR NON -CONFORMITY 'r�u f�%STERta Qui �'�t LAEN WHEN BUILT WHEN CONSTRUCTED. i This certifies that ... Date .... ..�3—a`/......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING .................................. has permission to perform s-+ v ...... "'. '``�'�• 1. wiring in the building of .....,!'.'......?`."......................................... , North Andover, Mass. asp Fee;.7 Lic. No g97 S., .........�. , / ELECTRICAL INSPECTOR Check # ; ✓!/ i 5u54 7,?,s GG?mm22Uc4zw d57 DO -4--e 4 P00-1 S400 BOARD OF FIRE PREVENTION REGULATIONS APPLICATION FOR PERMIT TO All work to be performed in accordance with the (Please Print in ink or type all information) Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number lLc 6 C", 6 e 67— owner or Tenant . 'QUL Owner's Address Is this permit in conjunction w Purpose of Building Existing Service S M S a�ave a building permit Yes No 0 %A,;-) /-) �/a 1 wits New Service A00 Amps � a;, Voits 4umber of Feeders and Ampacity Location and Nature of Proposed Electrical Official Use Only Permit No, 911 Occupancy & Fee CheckedGy CMR 12:00 A ELECTRICAL WORK Electrical Code 527 CMR 12:00 Date 3 — ) _ o L/ To the inspector of 6'!P'^c" u a. (Check Appropriate Box) Utility Authorization Overhead ,B'/ Undgmd 0 Overhead `0' Undgmd 0 W r !'e 116AJ gdc4ll�01 k aoo No. of Meters I No. of Meters C� OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent NO have submitted valid proof of carne to the Office = NO If you ve ch YES pl� md" to the type of ge by ahecidng the appropriate box. BOND OTHER a (Please Specify) �� i'`e PKU.Wok (0 �jI (Expiration Estimated Value f. Elect ical Work$ [f Work to Start —� `G Inspection Date Resquested Rough / V� Final Signed under the Penalties of perjury: FIRM NAME O G C� LLIC. NO. QLD /p Licensee l ► O �%� �' tfi"� Signature !(%�j �f �jC / LIC. NO. ` / �� I "(/ 90 ���t� r�G'yl �%y% 9�%�r D 34, g Bus. Tel No. / AddressAlt Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts Generai Laws_ And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $ (Signature of Owner or Agent) Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above 0 In 0 No. of Lighting Fixtures Swimming Pool gmd 0 gmd 0 Generators MVA O No. of Emergency Lighting No. ofReceptacles Outlets No. of Oil Burners Battery Units No. of Switch Outlets No of Gas Burners FIRE ALARMS No. of Zone No. of Detection and Total No. of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No. of Diposal No. Pumps Tons KW No. of Sounding Devices NoJ of Self Contained V. of Dishwashers S Area HeatingKW Detection/Sounding Devices 0 Municipal 0 Other No. of Dryers Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Bailases Wiring q No. Hydro Massage Tuds No. of Motors Total HP I — OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent NO have submitted valid proof of carne to the Office = NO If you ve ch YES pl� md" to the type of ge by ahecidng the appropriate box. BOND OTHER a (Please Specify) �� i'`e PKU.Wok (0 �jI (Expiration Estimated Value f. Elect ical Work$ [f Work to Start —� `G Inspection Date Resquested Rough / V� Final Signed under the Penalties of perjury: FIRM NAME O G C� LLIC. NO. QLD /p Licensee l ► O �%� �' tfi"� Signature !(%�j �f �jC / LIC. NO. ` / �� I "(/ 90 ���t� r�G'yl �%y% 9�%�r D 34, g Bus. Tel No. / AddressAlt Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts Generai Laws_ And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $ (Signature of Owner or Agent) Date .. ?." . 3.-. .6 `� ...... . ,c.•ryOL TOWN OF NORTH ANDOVER M PERMIT FOR GAS INSTALLATION This certifies that .. �.f � <' .`'... ,� ?<. ? A4", . ................ has permission for gas installation r.......... in the buildings of ....i'k: I P. ............................. at . k '�.1... D./.-? 1:-n .................. . North Andover, Mass. Fee ...Lic. No. j. ?- ./...... ... Y.. t: --*. ....... 43AS INSPECTOR Check # ?21? 4654 MASSACHUS'ETTS_UNNORM APPLICATO FOR PERMIT TO DO GAS FITTING i (Type or print) Date / / 04 NORTH ANDOVER, MASSACHUSETTS Building Locations 802 Da St Doug Martin OwnVs Name New ❑ Renovation12f Replacement ❑ $36.00 6TH. FLOOR 7TH. FLOOR STH. FLOOR Plans Submitted ❑ SUB -BA SEM ENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR STH. FLOOR Plans Submitted ❑ Permit # �,f — y Amount $ 6 U W a .. it pl ce w w o z z 0 CF WW F Z W I A Permit # �,f — y Amount $ 6 U W a .. it pl ce x a & ga g ill o (Print or type) Check one: Certificate Installing Company Name EASTERN PROPANE GAS Corp. Address 131 WATER ST. , DANVERS MA- 01923 ❑ Partn� Business Telephone 1 800 322 662g ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Brian Ki mba 1 l . #1210 INSURANCE COVERAGE Check I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ Ifyou have checked yes, please ifidicate the type coverage by checking the appropriate box- Liability oxLiability insurance policy un[.Jj Other type of indemnity ❑ Bond ❑ 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 ❑ 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 permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and C�iap� ofthe General Laws. I City/To7nI VED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber #1210 Gas Fitter License Number ❑ Master ❑ Journeyman BUILDING. PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: CZ- e'`=1 p ttLeo i6�6N� ANON -02 Ilk, ��9 <ecw��.uwMw . �•/ I IMPORTANT: Applicant must complete all items on this pate I LOCATION_L -i5 S %f Print PROPERTY OWNER ]/C�1, Print MAP NO: PARCEL: ZONING DISTRICT: Historic'District yes no Machine Shop Villaqe ves no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other mle,"AOuNb GUN A c»L Septic; Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO.BE PREFORMED: /1VS'T4LL .,2/' 4 �'' i�1/�'�('���UN/7� �S��i�it7/�1/l' i�l�G ZN REAS YA!5�4 Identification Please Type or Print Clearly) OWNER: Name: Address: YW 13ale- dAVg- A © / 8 VS eWIP-uuMEAfM I- PtaLs ;WC1 119f A -VI RNF4rG . Cttttmsxo m� CONTRACTOR Name: %2AS&/4 2&A4AA17- Phone: �!7 ,: Sa - 260 Address: J5 Supervisor's Construction License: CS (')— � �O Exp. Date: 4-,29-07 Home Improvement p. Date: ARCHITECT/ENGINEER S 57,P4JC2?.OL VS Phone: 979'-".:6 -401�V Address: /-2- .S AaYG41 Rb. �iEL/Ils h'A. /�A Reg. No. ESr,2t/CTc1 FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ 3. -3W- 0 0 FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund, �WWAV- �: 1IIIIIIUL: Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer ✓ Tanning/Massage/Body Art, Swimming Pools Well Tobacco Sales Food Packaging/Sales Private (septic tank, etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM I DATE REJECTED DATE APPROVED LANNING & DEVELOPMENT t, COMMENTS /CONSERVATION Reviewed on COMMENTS 3 V HEALTH Reviewed on COMMENTS Zoning Board of'Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located. 384 Us ood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine NOTES and DATA — (For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (if Applicable) ' ❑ ..Mass;:check Energy Compliance Report (If Applicable) ❑ E jeer -A## its-fDr- rn eery roducts NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Location No. �`3.j Date 01 MORTM TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ 62ty /I "` TOTAL $ Qr,� Check # J/ 22'1 55 -- ---- Building Ins�p4ctor Cel 0 r • O z o ca w° co cn a w � o w° w°' v U w � rL w w w t C/) U4 � ao' w w w w G m o z cn a, Q o cn o c v o ` C H CD c O C a+ O _V V C� C C R O m C {r �. E a �4a�Y-d y „ W �� Y= � � = v 1 W m CM Ju -CC IA � Q j u Q' L C o E ot �N v O �mc FD m O : �y : CD sp E „a ' mo H m m = y=... O cm c US N Ri y Z !O O V O dO F- MECD.C = O . m p COD ;:s WU. O D is cc ... •0 .CLt O ca .0 IC03 C :3 h C. .O Lu p m � C xco CL = � � y CO i— z 0 o. w D O w P-4 CD co O O L O O Its Z cCO o CL CA � 'fl m m E �co 0 co O t � � co L c_�a o a a m c0 Cc cc Q19 c . O o V...J y � d O LU ui cc Q19 c c V...J 'aco d O v/ W W WCLcccc C Z O V h _ c CO2 v/ W W WCLcccc C Z O V h _ c CO2 OrA r 0 M r O z x o a LE cin Uw z z 0 w° U w w2 w ww 04 u U C2 cn w ° a C7 w4' w ZW A w r� ° V)cn Q o m C ;C O O � C � N O C V V CL :• d C :eve ; 0 O •� R CA r >1 CE y E a c YZ O = s C20, O. Q E .E � w m NG ` O � h A O � y CD �m C43 O H CD ate` �CM o c cya . acs C3 'y o � �Z c � o a `mc = m :O3 H y m N W C �.Z�Z ui -- c M) 'a�"5 u �E v h � o '.So - 0O2 h a o.S o- _ � d V H F- z warm O z 0 W 0 U C/) U O O 2 co CD O L O Z CL Cco cm CL CO D O y D � C CD — CO3 O O m m = O� CD � L Cc O d CL Cca Cc CL c CL cc cm Ma19 C) c v J •fl O C Z � V to _ — C CA CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MASS. SCALE.-I"=40' DATE.-111W004 6/12!2009 Scott L. Giles R.P.L. S. Frank. S. Giles R.P.L.S. 50 Deer Meadow Road North Andover, Mass. 2662A•/O NOTE.-SEE VARIANCE GRANTED. coR LOT 4 525, LOT 3 44, 000 S.F. PLAN 8561 N.E.R.D. PROP. 4' HIGH FENCE WITH SELF CLOSING b AND SELF LATCH/N GATE PER CODE h �SET�CK ry r, 190- s� ID(/ST N �+ FND. eqc� w� ui O m � J o CV) o tu'. C) O t\ ti �J �Q2, ti TO ' co uj J LOT 2 I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE ��P��H or THE OFFSETS OF THE BUILDING INSPECTOR ONLY 8 SHOWN COMPLY AND SUCH USE IS FOR THE WITH THE ZONING DETERMINATION OF ZONING .7397 BYLAWS OF CONFORMITY OR NON-CONFORMITY NORTHANDOVER WHEN CONSTRUCTED. Z I-UKM U - LU I RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and ^apartments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. FILLS OUT THIS SECTION APPLICANT ` '�J('HftHU PHONE � ,• S� LOCATION: Assessors Map Number PARCEL SUBDIVISION LOT (S) 1 1 STREETS `J� l0� ST. NUMBER - '*"`""OFFICIAL USE ONLY ,TIONS OF. TOW"GENTS: ADMINISTRATOR DATE APPROVED DATE REJECTED. -. tA.fIi"_ lob 9 TOWN PLANNER DATB APPROVED DATE REJECTED COMMENTS COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT „ FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE 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 FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that allnecessary 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 �`� �PHONE ASSESSORS MAP NUMBER LOT NUMBER SUBDIVISION LOT NUMBER STREET T A STREET NUMBER OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS imam ............:......... ........-.:.......:.... ...■. m....m m.am.. a.......m.m. No < DATE APPROVED okjZ C SERVATION ADMINIS TOR DATE REJECTED CONUVIENTS DATE APPROVED TOWN PLANNER DATE REJECTED COMI� DATE APPROVED F D INSPECTOR - HEALTH DATE REJECTED -r.. , DATE APPROVED LL i 1% SEJrtC INSPECTOR - HEALTH r DATE REJECTED COMMENTS w' PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED CONRVIENTS RECEIVED BY BUILDING INSPECTOR DATE The Commonwealth of Massachusetts Depar7ment of Industrial Accidents Office of Investigations 600 ,'vVashingtoi? St;'eet Boston, MA 02111 www.»iass.gov/dia Wo -kers' Compensation Insurance Afndavit: Builders/Contractors/Electricians,/Plumbers Applicant Information Please Print L.e!gibly Name (Business/Organization/lndividual): Address: , z —Vj9K /FCK k City/State/Zip:/$ doh' Phone #: 97�-ash- oa�o Are ou an employer? Check the appropriate box: 1. I am a employer with _ 2 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors ?. ❑ I am a sole proprietor or partner- listed on the attached sheet. t ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. inswance 5 ❑uta are a corporation and its requixed.] officers have exercised their 3. [:1I am a homeowner doing all work right of exemption per MGL c. 152, § 1(4), and we have no myself. [No workers' comp. employees. [No workers' insurance required.] t comp. insurance required.] Type of project (required): 6. [:]New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.0 Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ oof repairs 13.[0therWe,) 'Any applicant that checks box #I must also fill out the section below showing their workers' compensation policy information_ t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such iContractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy inforn-lation. I am an employer that is pl'oviding fvorkers' conepensatioft insura►tce for my employees. Below is the.policy and job site Lnformaiiom ,{ Insurance Company Name:-��►T /Ar�PjJgL�f /,SNC Policy # or Self -ins. Lic. #: Y�G�����o �1 Expiration Date: 5-14-2010 job Site Address:Oo2 QST C='7,�StatPi�'- �%��A�/06V�i'� Attach a copy of the workers' compensation policy declaration page (sho-oling the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine o f 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 illsuraIlee coveragevenfication. I do hereby cerci , yTWer t✓te pains 102-11 a tune: penals kperjwy that the information provided above is true and correct - Date: Official use only. Do slot write in this area, to be completed by city or town official. City or Town: Per r..ittLicense # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Towrn Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: ACORD CERTIFICATE OF LIABI PRODUCER (602) 635-4848 Fax: (480) 991-0634 AIMS Insurance Program Managers, Inc. 15230 North 75th Street #1002 Scottsdale AZ 85260 INSURED Environmental Pools, Inc. 184R Riverneck Road ITY INSURANCE 56%2009 TTHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. !RS AFFORDING COVERAGE NAIC # A:Great American Assurance 26344 B:Great American Alliance 26832 C: Chelmsford MA 01824 I INSURER E: I OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY THE POLICIES TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, REQUIREMENT, AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. THE INSURANCE AT IMIT WN V N POLICY EFFECTIVE POLICY EXPIRATION LIMITS EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL INSR ADD'L TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT XXXXXX FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE EACH OCCURRENCE $ 1,000,000 GENERAL LIABILITY DAMAGE TO RENTED 100,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence)$ 5,000 A CLAIMSMADE aOCCUR GLP2371421-01 5/14/2009 5/14/2010 MED EXP An one person)$ PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP A G $ 2, 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY M JECOT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY $ (Per accident) NON -OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC $ ANY AUTO AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $_ AGGREGATE $ OCCUR CLAIMS MADE $ DEDUCTIBLE $ RETENTION W Rv TATU- OTR - X I B WORKERS COMPENSATION AND E.L. EACH ACCIDENT $ 1,000,000 EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? WC2371422-01 5/14/2009 5/14/2010 E.L. DISEASE - EA EMPLOYEE$ 1,000,000 E.L. DISEASE - POLICY LIMIT $ If yes, describe under1,000,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS *Except for ten (10) days cancellation for non -pay. All policy forms apply. This certificate is only a representation and may or may not comply with any written contract. 4tKI If I%,A1 a HULUCrt -- -------- ------ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EVIDENCE OF INSURANCE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL XXXXXXXXXX *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT XXXXXX FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Peter Godfrey ACORD 25 (2001108) r ,.,.... . -... _. ..._...___ leen,)iz. o -, G � �k 0 jk § Co j\\ g0z s=\ 0 LO \00 \�/ ° \ § ®\ \ƒ/e / y2{2 / § \ 0 ° 301 \ \§/ \ o § § / _ \ 0 0 \ E j \ ) U)j a CU / } / G � �k 0 jk § Co j\\ g0z s=\ 0 LO Boar Wo T11g egula ons apn�t �nar s One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement= -;Contractor Registration = Registration: 107083 Type: Private Corporation Expiration: 7/29/2010 TO 271559 ENVIRONMENTAL POOLS INC. " Andrew Everleigh 184R Riverneck Road - #. Chelmsford, MA 01824 DPS-CA1 Co 50M-07107-PC6490 'fie &.m..vaa W,,W-m-4-4el12 Board of Building Regulatlobs and Standards HOME IMPROVEMENT CONTRACTOR e-. _ Registration; 107083 E gltrartactn.aW9/2010 Tr# 271559 Type Private Corporation ENVIRONMENTAL POOLS lM1EC Andrew Everleigh,� � 184R Riverneck Chelmsford, MA 01824`'- Administrator Update Address and return card. Mark reason for change. - ❑ Address 7711 Renewal ❑ Employment Lost Card License or registration valid for individul use only before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston, Ma. 02108 } Not valid without signafdre CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MASS. SCALE. -1 "=40' DATE. -111W004 6/1212009 Scott L. Giles R.P.L.S. Frank. S. Giles R.P.L.S. 50 Deer Meadow Road North Andover, Mass. 4 NOTE. -SEE VARIANCE GRANTED. Nto LOT 4 5�2s, LOT 3 44, 000 S.F. PLAN 8561 N.E.R.D. PROP. 4' HIGH FENCE WITH SELF CLOSING o� AND SELF LATCHIN GATE PER CODE. s� EVST Te9C } FND. f Lu Z U Q W o % Lu co Lu \J � � Q LOT 2 I CERTIFY THAT THE OFFSETS SHOWN COMPLY WITH THE ZONING BYLAWS OF NORTH ANDOVER OFFSETS SHOWN ARE FOR THE USE OF THE BUILDING INSPECTOR ONLY AND SUCH USE IS FOR THE DETERMINATION OF ZONING CONFORMITY OR NON -CONFORMITY WHEN CONSTRUCTED. V, J O ENVIRONMENTAL POOLS, INC. r69 �� D ((a c�a�U 184R Riverneck Road •Chelmsford, MA 01824 6 978.256.0200 / 800.696.6976 / Fax 978.256.6620 E-mail: info@environmentalpools.com •Website: www.Environmentalpools.com An Aquatech Builder Design Excellence: With A Personal Touch The General Terms, Representations, and Conditions on reverse side are part of this Agreement. NAME (Buyer) MEMBER itj @ NATIONAL SPA & POOL INSTITUTE 2 1�fYL� �,�. / , -AID AJbQV&1 STATE ZIP • MAIL ADDRESS CITY JOB ADDRESS _ A�7�p%f" / 130 CITY "- Q Q STATE ZIP RESIDENCE PHONE �7l) " (c frY OFFICE PHON� //�� J' �1 �' Q7/09 Environmental Pools, Inc. (hereinafter "E.P.I") agrees with the buyer or buyers above (hereinafter the "Buyer") to construct a swimming pool and/or spa in a good and workmanlike manner in accordance with the following terms and specifications. DIMENSIONAL SPECIFICATIONS / N Width 12 / Length , Shape �/J Depth / to GENERAL CONSTRUCTION SPECIFICATIONS 1. Structural engineered plans........................................................................INCL. 2. Pool layout plans........................................................................................INCL. 3. Layout pool for Buyer's approval.................................................................INCL. 4. Set pool elevation for Buyer's approval ......................................................INCL. 5. Perform normal excavation and remove soil on day of excavation only...... INCL. 6. Access wall or fence: removed by: E replaced by: QVr3 7. Trees in access and working area to be cut down so that the stumps do not exceed 2' in hei........................................................................BUYER 8. Remove from site -_QP loads of: trees, shrubs, stumps, asphalt, �Oconcrete and other d ris 9. Hand form and shape pool................................................................. 10. Removal or relocation of cesspool, septic tanks, leaching fields, sewers, pipes and utilities (overhead/underground) ........................... 11. Steel reinforcing per engineered plans ........................................................INCL' 12. Engineered gunite structure to meet or exceed local or state codes..,.K--..1t4G. 13. Watercure gunite shell twice daily for seven days...............................� BUYE 14. Install continuous bond beam around skimmer/..............1W..L. 15. One set of shallow end steps with 4' bench......1....rp...................INCL. 16. Swimout or loveseat . 17. Install 6" band of Frostprooftile.....? ?...01C.,.SOW�D................ INCL. 18. Pavers, Bullnose Brick, or Bluestone A104yr 19. Cantilever form for deck 0 20. 2,t7rS. backfilling and grading -deck area only..¢..................INCL. 2 . Pool interior finish...../.`"7.'f.}AC44T.&...................................... INCL. 22. Filling of pool promptly after interior finish.......................................:....(BU ER ' HYDRAULIC & FILTERING SPECIFICATIONS 23. Approved deluxe filter: Type tIZO'CQZl /0 Size s:,,2 b 5/ 24. Pump and motor: Type1*�L Size 25. Pressure test all pool piping........................................................................INCL. 26. Hook up all water lines from filter to pool....................................................INCL. 27. Non -corrosive PVC plumbing throughout ....................................................INCL. 28. Hydrostatic valve.......................................................................................INCL. 29. Provide return inlets for filtered water to pool .,..Tiyr t .............INCL. 30. Main drain suction line with grate..........INCL. 31. Deluxe Skimmer Including Weir Gate and Large Basket............................INCL. 32. Vacuum fitting outlet in skimmer..................................................................INCL. 33. Up to 30' of plumbing between filter and skimmer......................................INCL. 34. Pre -cast pad for pool equipment ................................................ ................INCL. 35. Backwash line..................................................... ��y,......INCL.. �o AUTOMATIC EQUIPM .k- 36. Automatic pool cleaner: Type 37. Stub plumbing for future pool cleane ........................................................INCL. 38. Floor recirculation system C ) T �FTt/�Z/�B SNCL 39. Automatic chemical feeder ....... eww .�! ,�7......... �.�[.Q. ...............INCL. 40. Automated Pool Controls %r/ ?7_C0_404,_ _17y L , POOL HEATER & UTILITIES 41. Deluxe pool Heater: Size IC44 Make Indoor/Outdoor at/Pro Fuel connections, heater venting, fuel storage tanks, permit ..............BUYER 42. Install underwater light(s), each with 10' conduit .U.) ... aw................. INCL. 43. Electrical bonding of pool as required by city or town code 44. Electrical wiring and connection up to 75' from service panel , Pool over 75' at $15.00 per foot BUYER Heat Pump at $18.00 per foot BUYER HYDROTHERAPY SPA 4 ACCESSORIES 46. Deluxe cleaning tools (18" nylon brush, hand leaf skimmer, thermometer, pole, test kit, Ulu,e vacuum) .. ...................... r.INCL. 47. Diving board: Size olor 48. 3 -tread S.S. ladder/handrail Xlbijr 49. Pool slide: Size Color 50. All jigs installed by decking contractor or buyer _ftk - MISCELLANEOUS 51. Raised Bond Beam: Tile Stone 6" 12" 18" 52. Start-up chemicals: Initial start-up and follow-up instructions ....................INCL. 53. Water Condition - $�_ - 20 tons of 1.5" stone TF V _IJXL,. Additional stone at $ , 7S' per load ................................................BUYER 54. Clay soil - $..............................................................................BUYER SALES TAX & INSURANCE 55. Payment of all sales tax on pool components and accessories ..................INCL. 56. Motor vehicle insurance, workers' compensation insurance and general liability insurance....................................................................INCL. ADDITIONAL SPECIFICATIONS 57. /1 58. 1 64. 65. POOL DECK PRICES Decking square foota /^ Type 11. & 7 Other: PAYMENT The Buyer agrees to pay E.P.I. the following Contract Amount fo performance of its obligations under this Agreement. lr6�� Contract Amount $41 Deposit $ I -r BALANCE $ 3!� d TERMS AND CONDITIONS THE BUYER UNDERSTANDS THAT BY SIGNING THIS AGREEMENT, HE OR SHE ENTERS INTO A CONTRACT WITH E.P.I. AND THE BUYER CONCERNING E.P.I: S CONSTRUCTION OF A SWIMMING POOL, MEETING THE SPECIFICATIONS CONTAINED IN THIS AGREEMENT. ANY CHANGES IN ANY OFTHETERMS OR SPECIFICATIONS OFTHE AGREEMENT MUST BE MADE IN WRITING SIGNED BY E.P.I. AND THE. BUYER, AND NO VERBAL CHANGES IN THESE TERMS AND SPECIFICATIONS ARE PERMITTED. AS PART OF ITS OBLIGATIONS UNDER THIS AGREEMENT E.P.I. IS PROVIDING THE BUYER WRITTEN GUARANTEES REGARDING THE SWIMMING POOL WHICH IT WILL CONSTRUCT PUR- SUANTTOTHIS AGREEMENT.THESE GUARANTEES ARE CONTAINED IN A SEPARATE DOCUMENT WHICH IS PROVIDED TO THE BUYER. THE BUYER HAS THE RIGHT TO CANCEL THIS AGREEMENT AT ANY TIME BEFORE MIDNIGHT OF THETHIRD BUSINESS DAY AFTER THE DATE ON WHICH EITHER THE BUYER OR E.R.I. HAS SIGNED THIS FORM BY GIVING WRITTEN NOTICE OF CANCELLATION TO E.P.I. THE BACK OFTHIS CONTRACT CONTAINS IMPORTANTTERMS AND CONDITIONS.THEY ARE PART OF THIS AGREEMENT. READ THEM. I ACKNOWLEDGE THAT THIS AGREEMENT IS A LEGALLY BINDING CONTRACT, SUBJECT ONLY TO THE ABOVE CANCELLATION PROVISIONS, AND I CERTIFY THAT I HAVE READ AND AGREE TO ALL T AND CONDITIONS OF THIS AGREEMENT. ENVIRONMENT POOLS, INC. B AER BUYER - DATE B r' PAYMENT SCHEDULE '- 30% Day of Excavation $ / W 40% Day of Gunite $ I 25% Day of Tile $ 5% Day of Interior Finish $ TOTAL $_'-� FJ TERMS AND CONDITIONS THE BUYER UNDERSTANDS THAT BY SIGNING THIS AGREEMENT, HE OR SHE ENTERS INTO A CONTRACT WITH E.P.I. AND THE BUYER CONCERNING E.P.I: S CONSTRUCTION OF A SWIMMING POOL, MEETING THE SPECIFICATIONS CONTAINED IN THIS AGREEMENT. ANY CHANGES IN ANY OFTHETERMS OR SPECIFICATIONS OFTHE AGREEMENT MUST BE MADE IN WRITING SIGNED BY E.P.I. AND THE. BUYER, AND NO VERBAL CHANGES IN THESE TERMS AND SPECIFICATIONS ARE PERMITTED. AS PART OF ITS OBLIGATIONS UNDER THIS AGREEMENT E.P.I. IS PROVIDING THE BUYER WRITTEN GUARANTEES REGARDING THE SWIMMING POOL WHICH IT WILL CONSTRUCT PUR- SUANTTOTHIS AGREEMENT.THESE GUARANTEES ARE CONTAINED IN A SEPARATE DOCUMENT WHICH IS PROVIDED TO THE BUYER. THE BUYER HAS THE RIGHT TO CANCEL THIS AGREEMENT AT ANY TIME BEFORE MIDNIGHT OF THETHIRD BUSINESS DAY AFTER THE DATE ON WHICH EITHER THE BUYER OR E.R.I. HAS SIGNED THIS FORM BY GIVING WRITTEN NOTICE OF CANCELLATION TO E.P.I. THE BACK OFTHIS CONTRACT CONTAINS IMPORTANTTERMS AND CONDITIONS.THEY ARE PART OF THIS AGREEMENT. READ THEM. I ACKNOWLEDGE THAT THIS AGREEMENT IS A LEGALLY BINDING CONTRACT, SUBJECT ONLY TO THE ABOVE CANCELLATION PROVISIONS, AND I CERTIFY THAT I HAVE READ AND AGREE TO ALL T AND CONDITIONS OF THIS AGREEMENT. ENVIRONMENT POOLS, INC. B AER BUYER - DATE B r' R e 2 MM i 2 V Q o I $ I • o I • ,A o0 �� of /vl 44 a 144 1 t It .0 4 q a .o'p 4 d �u � Ip 14u h p• Q MM i 2 V Q y w k V eo /j V R ' tj �Q�3 ��Jh 1-14 e e� Q� °z� �� DZ SETLZPOT T,, ww %4 ��a�eS �ri JIj � � r • • • a4 I-zz CZ o v y 2 CII _ N U4 0 Ln 9V'a v'` N mor �� Qti MODM �tVQ� t �� a �LL o Vitt '14Q,- >� Zt ��RqZ �V�U,� c 11 li O14, � Q3 � o Q vU q t' WJRVC9Ill D►��p o> Y¢ LLJ 14 w 15 • • • • • • r� A , a�i U o I $ I q w I 14 ,A 0 �� of /vl y w k V eo /j V R ' tj �Q�3 ��Jh 1-14 e e� Q� °z� �� DZ SETLZPOT T,, ww %4 ��a�eS �ri JIj � � r • • • a4 I-zz CZ o v y 2 CII _ N U4 0 Ln 9V'a v'` N mor �� Qti MODM �tVQ� t �� a �LL o Vitt '14Q,- >� Zt ��RqZ �V�U,� c 11 li O14, � Q3 � o Q vU q t' WJRVC9Ill D►��p o> Y¢ LLJ 14 w 15 • • • • • • r� A , a�i U 1 .0 4 q .o'p d 0' � W t � p• Q :D O mc a ft // weL c►� ��V ww � 14 t tQ Q °04jw v4�� U�;Z,Tj v�� N ki °� Q� aCR(aS4 �QOg$ 3►'1 Uti • O � � V N • w 44 I�j 44 tz V �1Li tt `b o v►Q14 kj -j fiZq �j 121 V� 0.w a4 to 1Z y�V V� `, ►W ac� Q ttQ Q h gam, QP<Ll QLn �Qs4 t�j �O 14Ktpq �l �PcN�SETT,, � F N m (NO t O T (O >��ID� WLLNIDN 03 O W mCDm LL o rc .t 5;�:; � � N (1 rryy N w w.w ¢ o U (D w D1 � w >o .�o ¢� Cc W tt V � a%n C I�1 p � � I o mc a ft // weL c►� ��V ww � 14 t tQ Q °04jw v4�� U�;Z,Tj v�� N ki °� Q� aCR(aS4 �QOg$ 3►'1 Uti • O � � V N • w 44 I�j 44 tz V �1Li tt `b o v►Q14 kj -j fiZq �j 121 V� 0.w a4 to 1Z y�V V� `, ►W ac� Q ttQ Q h gam, QP<Ll QLn �Qs4 t�j �O 14Ktpq �l �PcN�SETT,, � F N m (NO t O T (O >��ID� WLLNIDN 03 O W mCDm LL o o rc .t 5;�:; � � •pCj� 41 (1 rryy N � O ¢ o U (D o D1 � >o .�o ¢� Cc W o rc A a Ntd to 1% u� rr+' OR.�'�: IR Z) C) z Q: