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17D-029 (3) u4iuji-uuj 14:2i i4i:�5b2410J GAMBLE INS AGEkC'r' PAGE 04 + C E R T I F I C A T E O F L I A B I L I T Y I NS URAN CE I DATE 04 -03 -02 (MM/DD /YY)1 4 4 4 PRODUCER THIS CERTIFICATE IS ISSUED ASIA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS 1, UPON THE CERTIFICATE HOLDER.! THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER 1 GAMBLE INSURANCE AOBNCY, INC. THE COVERAGE AFFORDED BY THE POLICIES BELOW, 1 65 BROAD STREET + + P.O. BOX 399 ( I N S U R E R . S A F F O R D I N G C O V E R A U B 1 .WESTFIELD MA 01006 -0309+ + IINSURER A. MASSWES, INSURANCE CO. 1 + - + ,,. k 1 INSURED IINSURER B: NAUTILUS INSURANCE COMPANY 1 + JELLY BELLY POOLS 4 SPAS, INC. 'INSURER C: ASSOCIATED EMPLOYERS INSURANCE CO. r �\ P.O. BOX 936 NEED + .. 1 _ `) 1 IINSURRR D; ` '= 'WESTFIELD MA 01006 - 0399+ J �` -., 'INSURER E; \.....):..(;,. / t I + COVERA08S ) i + CGllj • ' 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 OP ANY CONTRACT OR OTHER DOCUMENT VIM RESPECT TO WHII'M '1x15 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 BERN REDUCED BY PAID CLAIMS. + .• • + + + + + IINSR' 'POLICY EFFECTIVEIPOLICY EXPIRATION 1TTR 1 TYPE OP INSURANCE ( POLICY NUMBER I DATE (MM /DD /Y1)1 DATE (MM /DD /YYI LIMITS + + + + . 'GENERAL LIABILITY I I EACH OCCURRENCE Is 500,0001 1 B I(X] COMMERCIAL GENERAL LIABILITY I FIRE DAMAGE (Any one fire) S 60,000 I I ( ] CLAIMS MADE (X) OCCUR NC194229 I 08-07 -02 : 08 -07 -03 MED EXP (Any one pereon) S 5,0001 f ) 1 'PERSONAL i ADV INJURY S $00,000 I ) 'GENERAL AGGREGATE S1,000,0001 GEN'L AGGREGATE LIMIT APPLIES REP. 1 IPROOUCT5 - COMP /0P AGG $ J , ( 1 POLICY ( J PROJECT 1 7 LOC + - - -'T + + + +- • + 1 ATJ'omoa LB LIABILITY 1 ! COMBINED SINGLE LIMIT I ( ) ANY AUTO (Each accident) 1$1,000,000, ( 3 ALL OWNER AUTOS 1 BODILY INJURY I ,A (XI SCHEDULED AUTOS CA 0081750 02 1 06 06 - - (Per parson) {$ (XI HIRED AUTOS 1 BODILY INJURY (XI NON -OWNED AUTOS (Par accident) $ ( ) 1 PROPERTY DAMAGE ( ) I (Per accident) S + + , + + + 1 GARAGE LIABILITY I I I IAL7'O ONLY - EA ACCIDENT $ 1 1( I ANY AUTO I I 'OTHER THAN EA ACC $ 1 1 I 'AUTO ONLY: AGG $ 1 I EXCESS LIABILITY I 1 I IEACE( OCCURRENCE S I( I OCCUR ( I CLAIMS MADE I IAGGREGATE $ I 1 ( I DEDUCTIBLE I( ] RETENTION S 1 $ 1 + f + IWORIOLR'S COMPENSATION AND 1 I I I I( I WC STATUTORY ( ) OTHER EMPLOYER'S LIABILITY I E.L. EACH ACCIDENT $ 100,000 C I 1QQ00602 -1502 I 05 - 01 - 02 I 05 - 01 - 03 E.L. DISEASE-EA EMPLOYEE 5 100,000 I I I I E.L. DISEA,BE•POLICY LIMIT IS 500.000 ♦�� - -+ 4 + + + + + I I OTHER 1 I 1 I I 1 1 + + 1 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES /EXCLUSIONS ADDED EYENDORSEMENT /SPECIAL PROVISIONS 1 1 POOL INSTALLATION. 1 1 1 + - -+ CERTIFICATE HOLDER ( ]ADDITIONAL INSURED; INSURED LETTER: CANCELLATION + . • 'SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIONiDATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAY'S WRITTEN NOTICE TO TILE ER E CERTIFICATE HOLD NAMED STEVEN 4 MELISSA BASS �TO THE LEFT, BUT FAILURE TO DO 80 SHALL IMPOSE NO OBLIGATION 1 57 STRAW AVE TOR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR FLORENCE MA 01060 'REPRESENTATIVES. 1 1 1AUTHORIZED REPRESEHTATWE /..') [ 1 t I ■ ; (7/97) Page 1 of 2 • ✓YG� Q� / 1 '1'4 L IU Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 126929 Type: Private Corporation Expiration: 8/10/2004 JELLY BELLY'S POOLS & SPAS, INC. PAUL MASUCK -- _ !- - - - -- -__ - -- P.O. BOX 936 -_ -- - - - - WESTFIELD, MA 01085 - - Update Address and return card. Mark reason for change. Address r' Renewal I 1 Employment I l Lost Card - eom',nonuwea/i% o f igzaaaciume,15 I_= �� C/ Board Regulations and Standards Bd of Building Rlatid Sdds _ � License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration: 126929 One Ashburton Place Rm 1301 Expiration: 8/10/2004 Boston, Ma. 02108 Type: Private Corporation JELLY BELLY'S POOLS & SPAS, I PAUL MASUCK 58 SOUTHWICK RD�,� WESTFIELD, MA 01085 — Administrator Not valid without signature i .. , ' •,, 00 • ,i 0 , 18' x 36' - 2' Radius i , , An v RIP 1 1 36 . 1 , , O 1 32' • I O 8 1 8 1 r _ 2'Rc 8 T 8 0 • . i t O _ ID 13 I i 010 i , 0 18' 8' . I I I H I —1 30 8 3/4" 8' 0 0 LIGHT ) STEP PANEL 1 10' 0111/ OPTION ...---"---.------------------- 0 I--- 8 0 UNIT 1 41 8 I I I O 3 i — 118 ' 411 2 2iR. . O 21R. a 1 8 1 8 1 8 016 I 8 ' - ---11 5 8 STEP UNIT - 01111 . 0 i I O .1 t + 0.0.0 3 4 NO , 8' WATE 7 MU 6 5T BE 14 1 4. -f......_ 2" MINIMUM . . , 111111 PREPARED BOTTOM lb 1.4- 4' -44-- 6' >14 14' 4 12' —0 '1 .4 S NOTE: On pools with a thermoplastic step, an 4. .4, , A-frame is required on each side of step unit. 18 x 36 1111 NOTES COPING LAYOUT 18 x 36 w/Center Step I. Structure is designed for use below grade and only in areas where the ground water , lb tabk is a minimum of 4'6" below the proposed finished grade. , I 12 I 12 1 8 ; 18 x 36 w/Side Step 2. Backfill with clean earth, free of roots and debris, Do not allow the height of backfill - lo to exceed the height of the water in the pool by more than 6" nor water to exceed backfill by more than 6". .. . . . 8 4- RADIUS CORNERS a . DESCRIPTION PART# S 3. Pour 2500 P.S.I. concrete footing around entire perimeter, minimum 8" deep. - — 5 - 12' SECTIONS 7 6 6 8' PLAIN PANEL 05102 . lb 4. 3' wide coecrete deck is to be pouird at least 3" thickness and &slope of 1/4 to r away from the pool. 6 4 - 8' SECTIONS 6 1 1 1 8' SKIMMER PANEL 2 2 2 8' RETURN PANEL 05108 05104 it 5. Finished bouam is to be 2" minimum of suitable material or undisturbed earth. _ lb 6. A safety line, wIth buoys, is to be permanently attached 1'0" to the shallow side of ' .1 i i I 7' PLAIN PANEL 05110 12 12 8 ' the point of first slope change. . , . ' .. 2 1 2 6' PLAIN PANEL 05112 • lb 7. Coping: coping lengths are approximate. Cuts may be needed on straight sections for proper fit. Radius cornets are 2's 2'. ADJUSTABLE A-FRAME 5' PLAIN PANEL 05118 , 8. Construction Drawings: These drawinp and notes tue for illustrative purposes 4 PLAIN PANEL 05123 • lb only. Different methods and precautions may be dictated by various ground conditions. is e responsibility of the contractor who is not an arm of de )1.,, 2 3' PLAIN PANEL 05128 SAFETY NOTE 4 , numufacturer of the component parts. - -. ' ' ' 2' PLAIN PANEL 05129 ' . P . b 9. Installation is to be done in accordance with all federal, state, and local building _1' PLAIN PANEL 05132 • iL codes, as well as N.S.P.I. suggested standards. :4 4' RADIUS PANEL 05160 This to be determined by and is th , lb . , I. 4 4 2' RADIUS PANEL 05161 Pool bottom configurations are for illustrative purposes only. The configu- 8" MIN. il 8 9 10 A-FRAME 05188 10 ration shown conforms with current N.S.P.I suggested minimum standards for pools approved for use with manufactured diving equipment. If diving 2500 PSI. 1' 6" PLAIN PANEL 05131 CONCRETE P it- , equipment is installed, follow the equipment manufacturer's installation, use FOOTING 11110 li ,, 90' EL FILLER 05197 .. 11 and safety instructions. - • w- sy iip- irj 1 1 1 NUT & BOLT PAK 05202 , • . 1 1 1 RADIUS CORNER COPING PAK II - Diving permitted . _ .*_. 2' 6" ___.0.1 1 1 1 STRAIGHT COPING PAK , . only from designated diving area. OVERDIG _ Per. 104' 6" Sq. Ft. 644 Gallons 27391 , 4 , 03/08/2003 15:56 413 -587 -0088 M. EISENBERG PAGE 02/02 57Z- 1? THIS 'PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER SOURCES AND IS NOT TO BE CONSTRUED AS AN ACCURATE SURVEY AND IS NOT TO BE RECORDED. BUILDING LOCATION ACCURACY IS NOT GUARANTEED WAUS� f 4 s 38 ' Zo . 1( •• ` 0(° I7r' /0.2 x 8 50° 3g � a � 4 1 1 - -- -w • P Z.S r• .yC� S , ��t�S • - _.., ,.... r �-�✓ ! v im = ��� '�- tic n , \-4 •vQ.,a+411.'F= I'0: APPLIED MORTGAGE & FIRST AMERICAN TITLE INSURNACE COMPANY TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING `MONUMENTATION ALL VISIBLE EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN AND THAT THE Rl III riming ARC vAITIpCI Y WITUTAI TUC + rlT i Imcc JELLY BELLY'S POOLS & SPAS 58 SOUTHWICK ROAD • PO BOX 936 • (413) 568 -1700 • FAX (413) 572 -1218 • WESTFIELD, MA 01086 -0936 www.jellybellyspools.com Je LLY BE-<<Y el* • • 6 6x4 V , p 4 � :, `� Crzt Paz #llttniptott • ► = ** r A`; "� sssaclrus =--1 _ '_ _ ,>a►: ` DEPARTMENT OF BUILDING INSPECTIONS , _`: INSPECTOR 212 Main Street • Municipal Building � Northampton, MA 01060 e HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as Lis/her construction sup _ :. isor. The stale defines "Homeowner" as, " Person(s) who owns a parcel on which he /she resides or intends to be, a one or two fancily dwelling, attached or detached structures accessory to such use and /or farm structures. A person who constructs more than one home in a two -year period shall not be considered a home owner." The building department for the City of Northampton wants any person(s) who seek to use the home owner exemption, to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation /footings (before backfill) sonotube holes (before pour), a rough building inspection (before work is concealed), insulation inspection (if required) and a final building inspection. The building department requires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work (electrical, plumbing & gas) the homeowner will be responsible to make sure that the trades hired secure their proper permits in conjunction to the building permit issued, and that they get their required inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made I understand the above. (Home owner /resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date Address of work location �`' �e (rziyl z1f tYZ fll�tltt }�fntt l = * A A ll ", 6 ,fzl:se cfc(ls �' t t .. 4 DEPARTMENT OF i•UII INSPECTIONS 4V_ � 212 Main Street ' Municipal Jhfildinl; Northampto Mass. 01 0 A _ - WORKER'S COMPENSATION INSUR AFFLDA \TIT I S -ej Alf V 0-- with a principal place of business/residence at 5e fe td/-40 t do hei eU eC. tli } -, till( r 1 .11':; 1 01:15 ;1110 pcnal11( t1i v.l 111: v, . ' 1: '' ( ) 1 am an eniployni providing the iollov:ll: - 0:'..::.: coinpc nsalioa f ic,o .or [ny employees working, 011 t'lis job: 4" /46, ki '7 • gq' oo0(?- is 0 /3 (Incusanco Company) ('c ::c, Number) (F)_pir;tfon Date) ( ) I c a sole proprietor general contractor , etnecr ne (circle one) and have 'tired the contractors listed below who ha', the fo wo,—;:c cotcuens o.l oilc :es: (Name. of('on'ractcr) (Inser;:i Coil.. :,nl•:r) (,'_ .a Date) (Name of C_om-facto: (Imcu: iucc t Oni.]L_: .. Dale) (Name of Contractor) t[nsumnce Cot . - :y :', I,.,.' N,ii :',i _r1 -- , Date) (Name of Contractor) (Insuumce Cote :rr::' h.c-,. Number) i 1 _ .t i. uC 1 Date) (^.(1alt a6 c :r,t - - - r:ar.11'.c.- i ..... , ,i; - 1 ) 1 on a nob pioplintor into have no 0110 i };i'' t0: !'1C t, 1 1 :till !' home ' :Ite: ne..nnrluin ; all the '.'r 1.. i;.,..:'. NO T'S: S: plcasc 1_,_ ro.va:c tt :o:.r' „tc t,<' oWtr_rn VI;rn c : 0 I CrY i >'” :o i ■: - ;n ' : _.- :_tnnu a- :::::, ct: ac :: : <-: _ ,:` :: , c' oct utccc lilt thrco ouih u; «{::c11 i± hc::x,D',:n rca -i cr cxt t :1,- c- _ :.' : :1;';,:::,:1- Lido o'r to:{ pcacr:li y o:.,:::ir to. bs• cn:ployc's ur'''.cr the :o0 o 0,1, :; ,. .7-:1`.1: CC1 A.d (01,110 ::1(S)), r_i z :fc:: 0 n 1:,- tocos for c I; rr< cc [o-or ._- '. t:1s lcgil ctatur of cn c-,;aployor under ho Wakcla Corn ;x<r..ticou •.c-i_. I undcntand that a copy of lb . ctatcnco i rr:ay bo fo,wordo.1 to t.`, i?cpc.•ttxcl' of irxfu.tri :1 Ac -OOo: C'fl of T'''u'''tu for taw CO - age vcircatioo and that failure to t.aun coot go u:v .o :c.cuc•_ 21A cif 1101. 152 can Ind to tl>c iroNsitic0 of cu::c l pcta11 c - 1 cnolutma of a fine of up to S 1 SOD O0 rin -licor i:rpriuxr_o„cth of up t.o <' } -n eoI civil [xrv-Itia in 'I, Coo:: of n St,-, Wcre_ Oran and a fines of Sl00.00 a day aiaim.t Itr 4 r .5e /vile, Vd‘ \ .4. :, i.,,„.: / 1.crr ,,; +.tnrr'e1u>.c,,i -._.. _ Permit r mit Nurilty_.. :ml a lturc of l .ice. ■ L: i • • [- SECTION 8:- CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : License Number r Address Expiration Date Signature Telephone W12e fs ere .en1e C'e`Ye eerl rn 2G iii:% #'sa . ' R : �',� q �c � Not Applicable ❑ l 1 _, Ols *9- of t 9� 9 Company Name � / j Registration Nu uf 0 ��o / Q Address Expiration Date /� Tele hone e� P SECTION 10- :WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes No ❑ .o Owner xemphon The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) families and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner: Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm structures. A person who constructs more than one home in a two -year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature • SECTION S DESCRIPTION OF PROPOSED WORK (check applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding [ ] Ot er X Ire Brief Description of Proposed Work: 7' /4s /t fir 1 i f'�n .fre 4 . 1 /cc Alteration of existing bedroom Yes No No Adding new bedroom Yes No Attached Narrative ❑ Renovating unfinished basement Yes No Plans Attached Roll ❑ - Sheet ❑ sa If New h TO and orr additiOIV existing= Housing , .completeIthe following: a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No I. Septic Tank City Sewer Private well City water Supply SECTION .7a - OWNERAUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 51( an a s Owner of the subject property 1 P P Y hereby authorize to act on m \ehn all matt; relative t o authorized by this building permit application. Sig - re of Of er Date Si ASS as Owner /.Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. s/r /ief _S Print Name , K".4."":". f,/ AO/ Y6 M "3 111r010J Sign• e of •, ner /Agent Date . - Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This column to be filled in by j ! r' Building Department Lot Size / 5, L1 / M ' 1 Y ( ?) Frontage T j Setbacks Front l i /5 Side L: R: L: ' 2 C R: 2 y Rear • % L,1 ll' Building Height Bldg. Square Footage % Open Space Footage (Lot area minus bldg & paved parking) J 70 — # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO )C DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO _ DON'T KNOW YES IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued: C. Do any signs exist on the property? YES NO y ` _ IF YES, describe size, type and location: ►►►""" D. Ar, -there any proposed changes to or additions of signs intended for the property ?YES No (v IF . YES, describe size, type and location: City pf S tus s B ' ilditi departmen G t rb u s: ? - I rlr r -- Ro in Street S der ® .$ 4 X Ma r.. qm 100 a - : pho f�� h ampt "on, MA 01060 ' ®` f ° . f ne 413-587j240 Fax 413- 587 -1 P o / an "�'A : s" A PPLic 4 . 9, S f `I : .,i tST f2 R_: «M � r aa . UCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING i ": SECTI 1 - SITE INFORMATION 1.1 Property Address: '''.''This' sectionto be c office ��e Map. Unit Zon �. +�!IN Ov District Elm St. District ,CB Di SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: �/J sieve, '' `T f It55f /`j�SS Name (Print) Current Mailing Address , f 7d 4-- ,� Telephone S '. dtur 2.2 Authorized Agent: Name (Print) Current Mailing Address: Signature Telephone SECTION. 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building U e a (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) Check Number ,9g-0 ./25-J �� This Section For Official Use Only Building Permit Number: 3 ` / 3/ Date Issued: Signature:' Building Commissioner /Inspector of Building Date File # BP- 2003 -0937 APPLICANT /CONTACT PERSON JELLY BELLY'S POOLS & SPAS, INC ADDRESS /PHONE P 0 BOX 936 (413) 568 -1700 PROPERTY LOCATION 57 STRAW AVE MAP 17D PARCEL 029 001 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid n'2o /6-d Tvpeof Construction: INSTALL 18 X 36 INGROUND POOL New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 126929 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF9I MATION PRESENTED: // Approved _ Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND /OR Special Permit With Site Plan Major Project: Site Plan AND /OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received & Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Str; ommission ©0 Signature of Bui ing Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health, Conservation Commission, Department of public works and other applicable permit granting authorities. * Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning & Development for more information. 57 STRAW AVE BP- 2003 -0937 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17D - 029 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit # BP- 2003 -0937 Project # JS- 2003 -1503 Est. Cost: $12000.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JELLY BELLY'S POOLS & SPAS, INC 126929 Lot Size(sq. ft.): 14984.64 Owner: ROSS STEPHEN D & MELISSA J Zoning: URB Applicant: JELLY BELLY'S POOLS & SPAS, INC AT: 57 STRAW AVE Applicant Address: Phone: Insurance: P 0 BOX 936 (413) 568 -1700 Workers Compensation WESTFIELDMA01086 -0936 ISSUED ON: TO PERFORM THE FOLLOWING WORK:INSTALL 18 X 36 INGROUND POOL POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House # Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Receipt No: Date Paid: Check No: Amount: Building 5/5/03 0:00:00 6980 $50.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo