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23D-122 (3) 186 FEDERAL ST BP-2021-1112 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23D- 122 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Above ground pool BUILDING PERMIT Permit# BP-2021-1112 Project# JS-2021-001873 Est.Cost: $10722.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq.ft.): 20647.44 Owner: COMERFORD JOANNE M Zoning: URB(100)/ Applicant: COMERFORD JOANNE M AT: 186 FEDERAL ST Applicant Address: Phone: Insurance: 186 FEDERAL ST FLORENCEMA01062 ISSUED ON:4/20/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:ABOVE GROUND 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. if. '2 T1, Certificate of Occupancy Signature: I FeeType: Date Paid: Amount: Building 4/20/2021 0:00:00 $40.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner • File#BP-2021-1112 G- _ C3 fr APPLICANT/CONTACT PERSON COMERFORD JOANNE M&ANN M HENNESSEY ADDRESS/PHONE 186 FEDERAL ST FLORENCE PROPERTY LOCATION 186 FEDERAL ST MAP 23D PARCEL 122 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid tAt Building Permit Filled out Fee Paid Tvpeof Construction: ABOVE GROUND POOL New Construction Non Structural interior renovations Addition to Existing • Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: XApproved 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 Street Commission Permit DPW Storm Water Management Demolition Delay [1:54/A,,s, it; a if)49/al Srgni.ture of Building 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. RECEIVE The Commonwealth of Massachusetts _ 2 FOR Board of Building Regulations and S dash 2021 10. Massachusetts State Building Cook, 7�0 CMR MJNICIPALITY _ USE Building Permit Application To Construct,Repair,Iic atettrDemaliit}rlNs Revised Mar 2011 One-or Two-Family Dwelling oRTHAMP TON,MA 01060 This Section For Official Use Only Building Permit Number: Date Applied: o/, u,(Z 1&. • V. .2, 71% . / BuildingOfficial(Print Name) Signature� g SECTION 1: SITE INFORMATION 1.2 Assessors Map&Parcel Numbers 186Federal ST 3 P �dt 1.1 a Is this an accepted street?yes n no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private 0 Zone: _ Outside Flood Zone? Municipal❑ On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Jo ome or Florince MA 01062 Name(Print) City,State,ZIP 186Federal ST 4135591388 No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units _EMI Pool Work Above Ground Pool SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Total All Fees: $ Suppression) $ 10722 Check No ri Check Amount: 1 Cash Amount: 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Tele hone Email address D Demolition Teddy Bear Pools & Spas 111889 02/07/2023 HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 41 East Street No.and Street Email address Chicopee, MA 01020 413-594-2666 City/Town,State,ZIP Telephone SECTION 6: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 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Teddy Bear Pools & Spas to act on my behalf,in all matters relative to work authorized by this building permit application. 111=1111111(Electronic Signature) SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. Stephen Otto 3/27/21 Electronic Signature) NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,fmished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" CITY OF NORTHAMPTON SETBACK PLAN MAP: 2 3 D LOT: 1? 2 LOT SIZE: REAR LOT DIMENSION: REAR YARD I �V SSG I�CR�e�� hotiS -e_ 3 SIDE YARD SIDE YARD FRONT SETBACK FRONTAGE The C.orruonil°€olt of Massachusetts - Department of Indu strial.Accidents 1 Congress Street, Suite 100 tttiq"••• Bolton,%14 02114-201? wivw.rrracs.gtn'Vtiitr W„tkers'Compensation Insurance Affidaiiti Builders:C•ontractors'Eketririanr Plumber:. TO BE FILED TiTTfi THE PERMEErrwGAUTHCORTIY. Applicant Inform it ion Please Print Legibly Nanie;`Btu:neSS 0751-15a'atl 7nd7S7artri. i K fi -e CS 41 Address: // to �'c���r.�c/ 5 f- / Citv'StateiZip_ F/weocc ii,4 o/U62._ Phone : 9l3 crf /3 Are yen an emptayer;Check due appropriaee hcx: Type of project(required): :.❑I ac z scap r ais: amFlo;.roas c:part-time s.' 7.. n New construction 2.0 I am.z sc:o prop®atc:c:prz=a:::.ip aced:sea as amp ayees s ar imr for ma 8- 1 o tairig axe•capac:rf.[Nc oe..Grir •c_p._se:mice method.] . j I ac z hcujxaztor dama al_a arlc=z al.[Nc a x arss.ccmp.inaa:aace rag-aired.:;' g_ El-ap�0r,ha 10 0 3uii iing.addition 4.�aar a homeowner aid uti1 ka hsing cont a:tars be,rondoct all work on tea•property I u i:3 ensure that all canaacbc¢s mthar have workeas'rnmral saacm inathrme cr are:ak 11.0 Electrical repair or ar"rirtiemm propriebmo with no a .gtcn ea. '• 12.Q..imi repair or ate .fl I am t armaral coema^ar s.d:hay o h_-ed the auk-cca.rscoor:hated cm the attached Than sub-ccacractior^:have mop of..• and have cc4w:s'camp.i3.u.*ance: 13.n a4:1 Wax:. Other 6.0 We area cc:Forabcn and it:aficxs.nare exercised ilea right of ezemp ice par MGL c 14. :12. 11(4),and we bare no erop:asz s.[Na tz-c:en`cow.= move need.: "Any applicant that chairs boa r 1=ms:also 61l ant the sect om ke:oix diva-4.hair wc:ae •cc-pa attar Foltc:•:infarm..saaa. 9cmeouaers who submit t_s affddr.ta` r''cat flax are doing al]WAS a d than hire or_tv.de:ancactcn mast s•_anitt a near affidavit ii indicating tech ICennactnrs the:rher 9t s hex must acaZzed as addition:thoot shozrinr the name of tha s•it-:cat-ac:ars and s z;whether cr no:t=,,a=hies sere er lctiees If the sus-eatrac:ars hare;top.:•,a:s.r. n' must pao lone;¢ ac:ker: ca=p Fc act neker. I errn cell 2rnp!overthat is providing'worker s'compensation ilf57471211Ce fOi rtt7•employees.. B ??c'tt is tr'v o'i C't'i"i'2d;gib site rnft»nrtrttran Insurance Company Name: Policy#or Self-iris.Lic.? : &,a -anon Date: Iola Site Add.'ess:..,. Attach a cops of the workers' compensation polio mdeclaration page(showing the policy number and expiration date). Failure ;ecure coverage as iequired tanner NIGL c_ 152,§25A is a crimina.violator.pgmrchable Cry a fine up to S1,500_00 ander COE- yea- tvpn.dirt.as well as civil penalties in the formofa STOP WORK OR and a fine of up to S250.00 a day agaii-t the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ida her-eb►-rerrfr under the pains Old pen-al'tres of perJw'l that the infannatron provided above is mte and correct S t : c 2 � Date:: yA_ /2_/ lane y l 3 S s (7 l 3 Of ci 7:4 Se' Do srcr+a r re to th r s as c.sr to :br'conipleteel by crrt•or town official. C irk or Tonu: Permivlicense I::ucize_i.uthoric,: 'c:rck oue): 1 $;aard of H*. th :. Budding I}ep cumin 3,City"Tawn Clerk 4.Electrical Inspector Plumbing Inspector IS Other oat ict Pet:. n Phone#: City of Northampton Massachusetts sot, 1- 1-- DEPARTMENT OF BUILDING INSPECTIONS iy 212 Main Street • Municipal Building tY.y �p12, Northampton, MA 01060 HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, 4n n /Ll_ 1te e Ss e (insert full legal name), born C •2 5-49 os(insert month, day, year), hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners' exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners'exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s)who owns 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 home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel, I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains and penalties of perjury on this Z day of Apr / , 20 2 (Signature)