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29-307 (3) .... Af1��ISI� e DATE(MM/DDNy) ... ... .. ... .. . PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION INSURANCE CENTER OF N ENGLAND ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR D/B/A SULLIVAN INSURANCE ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O BOX 1180 COMPANIES AFFORDING COVERAGE W SPFLD MA 01090 COMPANY A CNA/CONTINENTAL (SURPL SVCS) INSURED COMPANY TEDDY BEAR POOLS, INC B ATTN: TED HEBERT COMPANY 41 EAST ST C CHICOPEE FALLS MA 01020 COMPANY D C01lEftAtES ............ . . THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO I POLICY EFFECTIVE POLICY EXPIRATIONI LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DDNY) DATE(MM/DONY) LIMITS GENERAL LIABILITY 2025064167 0 4/0 1/0 1 04/01/02 GENERAL AGGREGATE l$2 , 000, 0 0 0 X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG, $2 , 0 O O, 000 �> 'r CLAIMS MADE OCCUR! PERSONAL&ADV INJURY $1, O 0 0 , 000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE 1$1, 000 , 0 0 0 FIRE DAMAGE(Any one fire) $ 50 , 0 0 0 jMED EXP(Any one person) $ 5, 000 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ; i r—J ALL OWNED AUTOS BODILY INJURY $ _ i SCHEDULED AUTOS (Per person) HIRED AUTOS — BODILY INJURY $ NON-OWNED AUTOS (Per accident) ' I PROPERTY DAMAGE i$ GARAGE LIABILITY AUT, 0 ONLY-EA ACCIDENT S I ANY AUTO i, � i � OTHER THAN AUTO ONLY: EACH ACCIDENT S i ! AGGREGATE 'S ExcESSLUBnm 2025064248 04/01/01 04/01/02 'L EACH OCCURRENCE ;sl, 000 , 000 X UMBRELLA FORM AGGREGATE I$1, 000, 0 0 0 OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND WC 10 3 0 C 18 2 7 5 04/01/01 04/01/02 X T RY L M S l ER i EMPLOYERS'LIABILITY �- j EL EACH ACCIDENT S 500, 000 1 THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT ! $ 500 , 000 PARTNERS/EXECUTIVE �--� OFFICERS ARE: EXCL i I EL DISEASE-EA EMPLOYEE $ 500 , 000 OTHER I i' DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS I CERTIFICATE HOLDER CApCE1.i AYION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE TO WHOM IT MAY CONCERN EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 20 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRES NJ F X ACORD 2S-S (11%) ®ACORD CORPORATION 1988 NNW MORTGAGE LOAN INSPECTION %110 a 0 q3 i M G o yp¢r"' k l w/c TONY GPANT= o F / R CDT NET , T-CO. SEE' I3 K. J5Co2 r'�- G. 37? I hereby report that the premises shown on this plan is not located within a Flood Hazard Area as shown on Department of H.U.D. Federal Insurance Administration Maps, Community >4mber 250167-0001A Identifica o Dat oril 3 978 By: TO THE FLORENCE SAVINGS BANK OWNER Natale, James F. , Jr. & Claudia J. A14D THE FIRST AMERICAN TITLE INS. - ONLY LOCATION= 382 Acrebrook Drive To the best of my knowledge,. informa- Florence, Mass. tion and belief, I hereby report that I O O 9� afl �x 1a NartilaI1y foil 9 Blasaachnsrtls' vt _ DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE 'MAVIT .4 X4�)j-Lze- (liceuseelPermittee) with a principal place of business/residence at: 2jr.? Aoec'e/Zo% 1217. ll x&466 IVA' (phonel#) f�✓.T S��t� �� (street/city/s�atrhip) do hereby certify, under the pains and penalties of perjury, that: O I am an employer providing the following worker's compensation coverage for my employees working on this job: (InstL ance Company) (Policy Number) (Expiration Date) ()C) I am a sole proprietor, general contractor o omeowner circle one) and have hired the contractors listed below who have the following worker's compensation policies: An c ���fo' 1 ads Sosyia�D e� O ame of Contractor) ce Company/Policy Number) iratlon Date) (Name of Contractor) (Insurance Company/Poticy Number) (ExTiralon Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additioml sleet ifneccnjuy to include information pertaining to all ooatracion) ( ) I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:please be aware that whilo homeowner who employ pc==to do mainicanna,construction or repair work on a dwelling of not more than three units is which the homeowncr rrsides or oa tbo grounds app<utenant thereto arc oot gcocrally oomidcred to be employers under the wor ka s compcmalioa Act(GL152,ss 1(5)),application by a homeowner for a liause cc permit may evidcnoc the legal rtstus of an employer under the Worker's Comp osdion Act. I understand data copy of this rhtemerd may be forwarded to tho Dcpwtm�of Iodusirial A o=doa&Offioe of La=x000 for the coverage verification and that failure to sea=oovmv under section 25A of MOIL 152 can lead to the imposition of criminal penalties oomisting of a fine of up to 51,500.00 andlor imp¢iso�of up to one year and civil peaattics is the form of a Stop Work Order and a fi m of S 100.00 a day itg&inA tee- For daurtcrr —Only Pe D �.�O t Number Lot# S mature of Licensee/Permitt,ee A s • Versionl.7 Commercial Building Permit May 15,2000 EG"I,IQN 10 STRUGTUEAL I�ER;REVIEW,(780 CMR 11011) idependent Structural Engineering Structural Peer Review Required Yes......❑ No......❑ ECTION 11CWNER AUTHORIZATION TO BE,COMPLETED WHEN >WN> RS AGE VT30R CONTRACTOR APPLIES , R:SUILDING PERMIT as Owner of the subject property ereby authorize to act on ny behalf, in all matters relative to work authorized by this building permit application. ignature of Owner Date as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my <nowledge and belief. signed under the pains and penalties of perjury. 3rint Name signature of Owner/Agent Date SECTION 12 CONSTRUCTIdN,SERVICES LO.1 Licensed Construction Supervisor: Not Applicable ❑ Jame of License Holder License Number address Expiration Date signature Telephone aECTtt�N 13 WORKERS' COMPENSATION'INSURA,NC. AFFI DAVIT.„(M G L 152;.,§25G(6)) „ Norkers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit Nill result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes....... ❑ No...... ❑ Version 1.7 Commercial Building Permit May 15,2000 SECTION P OFESSIOft AL DI`SI N�AIVD CONSTRUCTION6SERVICES Ft3R BUILDINGS AND STR UC�TtJRES SUBJECT T�'K -ONSTRU 7�QN.Ct MTR41.,P f24,OANT:' 0" 8 ]1C CCONTAINING MORE"THANS35 000 '4)1<ENCLO,S D SPACE) ).1 Registered Architect: Not Applicable ❑ lame(Registrant): Registration Number ddress Expiration Date ignature Telephone �2 Registered Professional Engineer(s): lame Area of Responsibility ,ddress Registration Number 'ignature Telephone Expiration Date lame Area of Responsibility ,ddress Registration Number signature Telephone Expiration Date lame Area of Responsibility ,ddress Registration Number signature Telephone Expiration Date ,lame Area of Responsibility \ddress Registration Number signature Telephone Expiration Date ).3 General Contractor Not Applicable ❑ ,ompany Name: responsible In Charge of Construction \ddress signature Telephone .. 0 Version 1.7 Commercial Building Permit May 15,2000 7.Water Supply(M.G.L. c. 40, §54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: 'ublic ❑ Private ❑ Zone: Outside Flood Zone ❑ I Municipal ❑ On site disposal system ❑ 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by / Building Department Lot Size Frontage Setbacks Front Side L: RJf7-/1 L: R: Rear a 76 % Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO X 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 �C _ 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 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ?YES_ No IF YES, describe size, type and location: Version 1.7 Commercial Building Permit May 15,2000 ECl_ I�ON A_ O]VSTFtUCTICiN SERVICES FOR PROJECTS LESS THAN 35=0` . URIC BEET O>+EICLO5E1 SPAC€ tterior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing ❑ xterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other ❑ Accessory Building[ ] Repairs [ ] ECTION 5 -;USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1B ❑ Business ❑ 2A ❑ Educational ❑ 213 I ❑ Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ High Hazard ❑ 3A ❑ Institutional ❑ 1.1 ❑ 1-2 ❑ 1.3 ❑ 313 ❑ Mercantile ❑ 4 ❑ Residential ® R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ Utility ❑ Specify: Mixed Use ❑ Specify: Special Use ❑ Specify: CO,MPLETETHISSECTION IF EXISTING.,BUILDING UNDERGOING'RENOVATIONS,ADDITIONS'AND/OR CHANGE IN USE "" :fisting Use Group: Proposed Use Group: :fisting Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): ECTION 6 BUILDING HEIGHT AND"AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION loor Area per Floor(sf) 15t t 2 nd ad 3rd to otal Area (sf) Total Proposed New Construction (sf) ................................... otal Height(ft) Total Height ft .................... ,�. •.rAa Versionl.7 Commercial Building Permit May 15,2000 City of Nort Building De t5 U 212 Main t Room 1 01 L. t Northampton, 060 phone 413.587-1240 ax .DEPT OF BUILD IN I PECT OR HAMcq.N,MA 010 3 APPLICATION TO CONSTRUCT, REPAIR, REN E, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING ECTION 1 SITE INFORMATION' ..1 Property Address: This SeC#10 be rC4mpleted bfft xq y � y re v' SECTION 2 - PROPERTY O. NERSHIP%AUTHORIZED AGENT '_.1 Owner of Record: DES F 1-7 C�Urzl _K� r M( A` r Jame( rint) Current Mailing Address: )igKatlre Telephone '.2 Authorized Agent: Jame(Print) Current Mailing Address: Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS" , 'item Estimated Cost(Dollars)to be Official Use.Only completed by ermit applicant 1. Building (a) Building Permit Fee 2. Electrical (b) Estimated-Total,Cost ,"If Construction from 6 3. Plumbing Building Permit'Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(1 + 2 + 3 +4+ 5)T Check,Ndmbe Thls Section For"Official Use Only Building°Permit Number: .+' ,-- date Issued: Signature: 'Building Comrta,s ' er/Inspector af,8uilctings File#BP-2002-0007 APPLICANT/CONTACT PERSON NATALE JAMES F JR&CLAUDIA J ADDRESS/PHONE 382 ACREBROOK DR (413)586-0358() PROPERTY LOCATION 382 ACREBROOK DR MAP 29 PARCEL 307 ZONE URA THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Z S Fee Paid Typeof Construction:_INSTALL 24'ABOVE GROUND POOL New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 069222 3 sets of Plans/Plot Plan THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF MAT ION PRESENTED: Approved Denied PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan OR Special Permit and Site Plan Major Project: Site Plan OR Special Permit and 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 Street Commiss' Ir Loa Signature of Building Officliftf 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. BP-2002-0007 GIs#: COMMONWEALTH OF MASSACHUSETTS it it y CITY OF NORTHAMPTON Lot:X601 Permit: Building Category: BUILDING PERMIT Permit# BP-2002-0007 Project# JS-2002-0009 Est.Cost:$3500.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: TEDDY BEAR POOLS & SPA069222 Lot Size(sq.ft.): 44300.52 Owner: NATALE JAMES F JR&CLAUDIA J Zoning Applicant. NATALE JAMES F JR & CLAUDIA J AT. 382 ACREBROOK DR Applicant Address: Phone: Insurance: 382 ACREBROOK DR (413) 586-0358 () Workers Compensation FLORENCEMA01062 ISSUED ON.7161010:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 24' ABOVE GROUND POOL POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: 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: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 7/6/010:00:00 6811 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo