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37-115 (2) ..•.,v• vu vu. yr ♦ruu 111Li A.vAAUl,111 DUIV /LAIJ CULLS ICE POND ASSOCIATION SECTION 2D CERTIFICATE 6 ICE POND DRIVE (LOT 25) TCB HOSPITAL HILL LLC, Declarant under the Declaration of; Restrictions Maintenance and Easement Agreement dated July 10, 2003 ( "Declaration ") and recorded in the Hampshire Registry of Deeds in Book 7329, Page 249, certify as follows: The improvements, as described and qualified below, are approved by the 'Declarant in compliance with Article III, Section 211 Description of improvements: Construction of pool, per the following documentation: 1) submission titled `Esther Williams Pool Options," 1 page • 2) Letter from Rushdie Trombley dated 5/11/2004 requesting construction of 15' pool in backyard of 6 Ice Pond Drive, 1 page. Qualifications: 1) Construction of a deck must receive further approval from the Association. 2) Pool must be constructed so that it is not visible from Ice Pond Drive. ICE POND ASSOCIATION TCB HOSPITAL HILL LLC, Declarant The COMMUNITY BUILDERS, INC., its sole member By: Beverly J. Bates, Senior Vice President COMMONWEALTH OF MASSACHUSETTS , SS. May , 2004 Subscribed and sworn before me this ` day of May, 2004. Notary Public My Commission Expires: vv, vv, vv .0. 04 rM yLOI JAPr av 114E (AMMVP111I DUILILAJ WJUU( if i L. May 8, 2006 ` Rushelle Trombley The Comma ' hilders, Inc 6 Ice Pond Drive Northampton, MA 01060 322 Main Sneer SO*M. MA 01105.2408 RE: Pool Construction Approval 413137 -0407 fw 413 731.9790 Dear Rushelle: JDD 800 54S -1833 x180 rrwwittircary Please find attached a copy of the form that was executed and delivered to you approximately two years ago. Our copy of the executed form has been archived and could be retrieved with some delay, if you so require. kw. bus& New Bove, f Midlid ie 111136 l Pre iiie.c. I hope that this is helpful. Sriedd D.C. Si cerely, Paiak E. Clancy iresideal 8 NI bask Ofker om Kegelman Senior Project Manager 1 v.,i UorUU vo.J4 FAA 91414AVIDU 1110 I.UAALUY17r VU1LUl:KJ 0001 FAX TRANSMITTAL SHEET 61M0 0 the Conn unity Builders, k DATE: TO: \ l � j , [ 1� 322 Ilea Sxast Sp erg itld, MA 01105 -2401 COMPANY: 413 737-0207 • fmr413731 4710 180100 545 -1033 MO FAX#: ( ) - — writrwmakialldarsaq NUMBER OF warn. lathy& New 1.'.. PAGES: tfill.drMfl. Irdr,lagr Haridnaa (including this • Sperskil Ithaliagtea cat sheet) �,��` htidcEUmci FROM: hardm►sowrfmrcortR` COMPANY: The Community Builders, e_ FAX #: (413) 731 -9790 REMARKS: • • ( NOTE; This transmittal is intended only for the use of the individual or entity to which it is addressed, and May contain information that is privileged, confidential and exempt from disclosure under applicable law. lithe reader • of this transmittal is not the intended recipient or the employee or agent responsble h r deliva ig the transmittal to the intended recipient, yon are hereby notified that any dissaaketmn, distribution or copying of this communication is strictly prohibited. If you kme received this communication m error, please notify, us immediately by telephone, and ream t original message to us at the address given via the U.S. Postal saviee_ Thank yon.) o: \ Amur \PAscovPdi. 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SCOW ss, ' C \ .magia41111161* '. „ , `•• ... ... ... liw.. Itt DICE , . - - - -- L --------- - --- 1 --- \ \ / Notimi, —•-•••"."""ninw „vow ...mnipir CE POND M. CONC. CUM ( CPPE COO il ,•-%'iti?nctriP-n 1 ., .1 1 LANE 1 i .. _ . . — .. _ .. _ . . _... _ ..e_Low—t... -, . • — • • -- • — • —,;,, — . • — " - _,- • 1 • • ' • — . . I. _ _ - _____ _ .:____- - ----------( — - — -.\-----'ss'ir _ _ —__ _ _—_-_-1 - -- - •i 8 ,,,,, — j „...._ :-- ----. . — \ \ ,...,, — . ,:,./ . .7: . / ...v.-., ,-- ) / i " ss KRTH • SITE PLAN 0 r • i ,,, A -------- a' . ¢ T1iMl pi, • y$ Crz# rfI iain #>1rt )- -'` ° _ 1 $ E;,) `► e � # flit assactfusetts DEPARTMENT OF BUILDING INSPECTIONS . , , if INSPECTOR 212 Main Street • Municipal Building 5 ,.. Northampton, MA 01060 r HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his /her construction sup, .;sor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he /she resides or intends to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm struct 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, A Q f_-\ _A , '-- _understand the above. (Home owner /rdsident's signa ure requetng exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date S 0 v 6 Address of work (c � iitJ � �( location - ----- k)ictoc_e_ 1A/1 6 o loco a , 1 • • • Gr i 2 of parfl 1 Mtn* - 7 ,alcsancflnsrlle' r� • DEPARTMENT 01' BUILDING INSPECTIONS • . P T ` 212 Main Street Municipal Building Northampton, Mass. 01060 1r'' WORKER'S CO\'[PENSATION I ST/RANCE AFFIDAVIT ,,� e i ccnscrJpermitree) with a principal place of business/residence at: 01 ---- T-10Ce 1 IV (phone') - .6 ` / (sc /city /staidzip) do hereby certify, under the pains and penalties of e :hal Y �`. P P perjury; ` ( ) I aI an employer providing the foliono, worker's comocnsadon cove age for my idi . vi - employees v,•orlong on this job: • (Iasv c Comp) • (Policy Number) (E pinion Dom) ' ( ) I am a sole proprietor, general contractor or homeowner (ccie one) and have hired the cona listed below wbo have the following worker's coopensaton pa!�cies: CO (Name - Num-_' �. :pirau_ Datc) O� Contractor) (InR!r,nG:Company/Policy I ' `- -n� I (Name of Contractor) (Las arancc Company/Policy Number) (Expir,:tion Date) (Name of Conn - aao, - ) (1nsuranca Company/Policy Nuib:.r) (Expiration Date) • (Name of Contractor) (In urano Compauy/Policy Number) (Expiration Date) . (ans� adlitioca bed if ncoai y to cod& inforta..•ioc pctninin to •11 coca -agora) • ( ) I am a sole proprietor and have no one worldng for me. J ` a.m,a home owner performing all the work myself NOTE: plea be ecr17C t h *, k1 1c bemcw.acrs wbo ploy pa to do c» cc =,:e,o c rcpa wort. on 1 d•.eU of not cocc-e than tl trots is tc the bomoowoc raider or oa the p out:41a z,7pvrteo_ri them a. c txx L.-.l1y coa,:d red to be ca ploy=s r v r the wmitef, o - Act (GL152.n 1(5)), =Folic:aioa by • bomma-oa far : boxy: a pmnit r>_y e.-rdmcc the legs) ctaasc of ex =alloy.< under dto Workout Compenviiou Ac . f undernA.nd tha x Dopy of thi. oatemooa may bo to to rho Dopucmmt of Imo'' r d A..6 015 .. .r +u+r`°° rot th° covc veilCsiioo n--td th1 Eiit. - to scnirt `co•cza.‘ todcr section 25A of }.SQL 152 am lad to the imposition of aimia..1 p•aliics coir`:Is of • floc of up to S I }00.00 nndtor izsz;sisoomc -,n of up to oa yc3r nod c) pmctia in tx form of • Stop Wort Orda. nod • firs of SI00.00 r thy t.ini nc. For ' 'c only Permit Number 0 'a° " 3 1 ):: —_ Lot Signature of LicemscriPcrmiuce Da Le -- SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : • License Number Address Expiration Date Signature Telephone JA t ome na roremeri fGontracfor: • #; : _ , n , , „ Not Applicable ❑ Company Name Registration Number • Address Expiration Date Telephone SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.GL. 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 ❑ 11_.. ,. .dom Qwne> enh 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 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors El Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [Q Siding [D] Other j Brief Description of reposed t Work: H k')O4'._, �CO')OZ kD � eS l I .`�c e. » I ' VC A) Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet 6a_ aWNew f ouse`an or addition t© existinq.�ioasm corni,Fete t ie fof owinct: 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. Masscheck 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 - OWNER AUTHORIZATION - TO BE CO MPLETED WHEN OWNERS AGENT OR CONTRACTOR- APPLIES FOR BUILDING PERMIT , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date l ' `‘‘/\ , as Owner /Authorized Agen'C ereby decl re that the statements and ' rmation on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print N -me Signature of •wner /Agent Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by l 'l ( _ Building Department Lot Size 1 \ � Frontage Setbacks Front Side L R: L:' • R: /0 f '10 Rear I l e (043 40 Olnce.p«sl Building Height , Bldg. Square Footage i Open Space Footage % i ---� _ 7-1-ite. (Lot area minus bldg &paved ; 1 9 4 �- e.� - a, �,3- parking) t �^ i 4( rl f i8k4 tiAJ # of Parking Spaces S i p k ' Cxe f fo Fill: is i ..3e, (volume & Location) ' A. Has a Special Permit /Variance /Finding ever been issued for /on the site? +nom p° t‘..);1( kate NO 0 DONT KNOW 0 YES 0 � O cXE.c j , j u...1- IF YES, date issued:' !+ 16C A i ) A &SIGC IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW Q YES 0 IF YES: enter Book Page ' and /or Document # B. Does the site contain a brook, body of water or wetlands? N0 DONT KNOW 0 YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO IF YES, describe size, type and location: s . E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. �f Northampton � �, - ' u I Department �I a as C�� (� �� \VJ . ' �1 �2 �V Street r '� �`' R m 100 e _ r A tha' on, MA 01060 0 - .7. , , p f rbne X1 -5 87. 1240• Fax 413- 587 -1272 e e * ry APPLI(C #Ti9N TO ONSI' UG A LTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMI DWELLING SECT 1 -SITE INFORMATION 1.1 Property A ddress: Th is`section to be co mpleted bya ffice ���? �(. M a p -Lot ,,..-,,,,,,,,.-:-. a� Unit x N V . ( /� � �� Zone Ove tlayO , ,-., f • i Eiar St•. D istr i c t, ,, f, C6 Di s trict SECTION 2 PR OWNERSHIP /AUTHORIZED A GE N T 2.1 Owne o f Record Na a (Prin 1 Cu:::u1 t Address: � `lld b'N\ \3 k.--\( Signature 2.2 Authorized Agent: Name (Print) Current Mailing Address: Signature Telephone SECTION 3 - E STIMATED CO NSTRUCTION' COSTS= Item Estimated Cost (Dollars) to be Offic Use Only completed b permit applicant 1. Building (`� (a) But Fee 2. Electrical (b) Es To Cost of ` � Construction from. (6) 3. Plumbing Building Pe rmit Fee �� �O 4. Mechanical (HVAC) c 5. Fire Protection c SQ--\ 02-3 - (1 + 2 + 3 + 4 + 5) l / Check Number pl � 7 0a 6. Total = This Section For Official Use Only Building Permit Number. Date g Issued: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2006 -1200 ,,�/ APPLICANT /CONTACT PERSON TROMBLEY DONNY A . 0 9 -- f' ADDRESS /PHONE FLORENCE PROPERTY LOCATION 6 ICE POND DRIVE MAP 37 PARCEL 115 001 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out 47 Fee Paid C�i'� / .0 Typeof Construction: INSTALL 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 T OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF RMATION PRESENTED: A pproved 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 onnnission ___.-/ , 2 -;,, . __ 6 4 - - - . 6 Zia Signature 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. BP- 2006 -1200 GIS #: COMMONWEALTH OF MASSACHUSETTS )vk 1 114 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit # BP- 2006 -1200 Protect # JS- 2006 -1771 Est. Cost: $0.00_ Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft): Owner: TROMBLEY DONNY A Zoning: SR Applicant: TROMBLEY DONNY A AT: 6 ICE POND DRIVE Applicant Address: Phone: Insurance: 6 ICE POND DR (413) 586 -1462 () FLORENCEMA01062 ISSUED ON:5/12/2006 0:00:00 TO PERFORM THE FOLLOWING WORK: INSTALL 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. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 5/12/2006 0:00:00 $25.00247 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo