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29-256 Northampton, MA,VjopgrXy Detail Page 2 of2 Brick Trim: 0 X 0 Stone Trim: 0 X 0 Lower 1 st Story 2nd Story 3rd Remodeling Data: lBasementIFone Story Frame Year Remodeled: 2006 lWood Deck Kitchen Remodeled (Y/N): lone Story Frame Bath Remodeled (Y/N): Land Data F Outbuilding Info Square Foot Type S Value Utilities Type Feet no Prime 170 information yp Qty���❑r Site 15,213 86, T e Year Size 1 Size2 Grd RS1 D] 1983 0 128 [TI Acreage Type Street/Roa] RC1 �1 1969 12 12 ©� Type Acres Value no no information information Sales Info Permit Info Date Type Price Validi Price Purpo 09/01/1998 Land+ Bldg 108,000�J 06/28/2006 1423 4,500 NEW SIL //9612 Land+Bldg 108,000 C� 06/13/2001 1054 2,900 BOW WIN http://www.northamptonassessor.us/noho/propertydetail.php?map_no=29 -256-001&pagec... 8/26/2008 Northampton, M4PrgpertyDetail Page 1 of2 City of Northampton, MA: Residential Property .Record G New Search Property Type Classification Code Reference Card 1 of 1 Parcel - Location - Zoning - Assessment Map-Block-Lot: 29 -256-001 Zoning: Assessm Location: 101 OVERLOOK DR Neigborhood: 1 Land: #Living Units: 1 Deed Book: 8204 Buildin Class: R-101 Deed Page: 123 Total: Dwelling Information F Building Sketch Style: Ranch Year Built: 1969 Story Height: 1 Attic: None Basement: pull Total Rooms: 5 Bedrooms: 3 14 Full Baths: 1 Half Baths: 0 14 Wood Deck Exterior Walls: Alum/Vinyl z1� 19 Unfinished Area: 0 11 Ground Floor Area: 864 36 5 Total Living Area: 872 3 Finished Basement Living 0 X 0 Area: 24 1 FF/B Basement Recreation Area: 0 X 0 ss Woodburning Fireplace 0/0 Stacks/Openings: Metal Fireplace 0/ 0 _ Stacks/Openings: 1_—C Heat/Central A/C: Basic Heating System: Electric Fuel Type: Electric Quality Grade: C Physical Condition: Average Interior/Exterior: Same Condition/Desirability/Utility: GD Addition Information: Vacant/Dwell/Oby Status: Dwelling Additional Features: http://www.northamptonassessor.us/noho/propertydetail.php?map_no=29 -256-001&pagec... 8/26/2008 0) Ar Q) Q 41 nr'1 Ap co J m l A3 0) Ol C IV #Cb .. All Ol A C44)• yx it A3 *4 Q) � e ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID B5 LID DATE(MMIDD/08 JELLB50 08/25/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION IRM Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Barry M. Stephens, CPCU HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 75 North Main St.-P O Box 564 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. East Longmeadow MA 01028 Phone:413-759-0010 Fax:413-759-0017 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER Central Insurance Companies 20230 INSURER B The Hanover Ins. Co. Jelly Belly's Pools & Spas Inc INSURER Penn America Ins. Co. 58 Southwick Road INSURER Hermitage Insurance Co Westfield MA 01085 INSURER E COVERAGES 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DDIYY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X COMMERCIALGENERALLIABILITY CLP8125613 04/08/08 04/08/09 PREMISES(Ea occurence) $ 300000 CLAIMS MADE �OCCUR MED EXP(Any one person) $5000 PERSONAL&ADV INJURY $1000000 X GL Plus Endo Appl GENERAL AGGREGATE $2000000 GEML AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OP AGG $2000000 X POLICY PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1000000 B ANY AUTO AMN246549200 01/24/08 01/24/09 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESWUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F-1 CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND X TORY LIMITS I I ER A ANY PROPRIETOR/PARTNER/EXECUTIVE PLOYERILITY WC837586511 03/04/08 03/04/09 E L.EACH ACCIDENT $500000 AN OFFICER/MEMBER EXCLUDED? EL DISEASE-EA EMPLOYEE $500000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500000 OTHER C Snow Removal-Lots FAC6736607 01/05/08 01/05/09 CGL 1M/2M D Snow Removal-Sts HGL50384308 01/05/08 01/05/09 CGL 1M/2M DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION ALDRDAL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Dale Aldrich IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 101 Overlook Dr Florence MA 01062 REPRESENTATIVES. FAUTHORIZED REPRESENTATIVE M Insurance Agency Inc. ACORD 25(2001/08) 0 ACORD CORPORATION 1988 91?e -Comwwnuveaa Board of Building Regula ions and Standards One Ashburton Place - Room 1301 " Boston. Massachusetts 02108 Home Improvement Contractor Registration Reqistration: 126929 Type: Private Corporation Expiration: 8/10/2010 Tr# 272612 JELLY BELLY'S POOLS & SPAS, INC, PAUL MASUCK - ----- ------ _ P.O. BOX 926 - ----- - - -------- - WESTFIELD, MAO 1085 Update Address and return card.Mark reason for change. L] Address �_ Renewal L_] Employment Lost Card DPS-CAI 0 5OM-07/07-PC8490 T � u Board of Building Regulations and Standards 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 Ashburton Place Rm 1301 Expiration: 8/1Q/2010 Tr# 272612 Boston,One Ashbu u on Place Type: Private Corporation JELLY BELLY'S POOLS&SPAS, INC. PAUL MASUCK 58 SOUTHWICK RD WESTFIELD,MA 01085 Administrator Not valid without signature e fJr- '•. i HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CNM 108.3.4 to act as his/her construction supervisor. 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 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 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 1, 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 4 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ~ F -r-: 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information I //', /�-,/, �/f� Please Print Le6ibly Hanle(Business/Organization/Individual): Address: cog City/State/Zip: VJ&5 ,1�d d M94 194 N0455—Phone #: jz�_17e 0 Are on an employer?Checkpropriate box: Type of project(required): I - I am a employer with 2 4. ❑ I am a general contractor and I 6 ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole propri etor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers' comp.insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.F-1 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself. o workers' comp. right of exemption per MGL y [N p 12.7 Aoof repairs insurance required.] t c. 152, §1(4), and we have no 13 Other A2 r employees. [No workers' '�! f comp. insurance required.] *Any applicant that checks box#1 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 contactors 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 a7n an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: C��re ' ` h S✓�cc t� ©S Policy#or Self-ins. Lic. r: VJ CU 31,5245-11 Expiration Date: -- / �/ Job Site Address: �/�/ (/VGOr(D K c�/r City/State/Zip:_! G49 e /144 4 Attach a copy of the workers' compensation policy 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 51,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investi,2ations of the DIA for insurance coverage verification. I do hereby certify tin he pains aLid ies of perjury that the information provided above is truce and correct. —_` ! 244'— O % Signature: Date: Phone 7: 7 J,fficial use only. Do not write in this area, to be completed by city or town offcciaL City or Town: PermitiLicense# 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#: � 1 � SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ i cam, f Name of License Holder: Q�t�/ e(��.s O�s 4- Spa, r License Number Sys SO m1 Address Expiration Date Signature Telephone 9.Registered'Home Improvement Contraciur Not Applicable ❑ /4.9 s a o Company Name I Registratio Num r v Address Expiration�Daa te 1A 5+P7 '1 Cf �J 0 F Telephone L54?-1 7 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. - Home Owner Exemptioh 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 F-1 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [Q Siding[O] Other[ftr Brief Description of Proposed Ind )-� l/ uNK s��cf Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New house and-or addition'to existing housinet, complete'the 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. _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 COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 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 I, 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. Print Name Signature of Owner/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 Building Department Lot Size Frontage Setbacks Front SideL:,—,, R...,_"",."_ L:''. ..,"."". R ,.."... .. 7... _... Rear Building Height - Bldg.Square Footage Open Space Footage (Lot area minus bldg&paved a ------- parking) #of Parking Spaces Fill: (volume&Location) - ,._."".... ...„".... . ... ....... .".._ _. ...,.._ _..._ ......,.... A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DONT KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES IF YES: enter Book " Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES 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: 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 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. , Department use onty City/ of Northampton flatus of Permit n Bullditi� Department Cum Cut/©riyewa Perrrtrt �T X12 Main Street Avaai b�Itt y F gain 100 ilabili R7 ,�'A ljottharfipton, MA 01060 tStructuraFP.iar~ phone 413,=587-1240 Fax 413-587-1272 P►ott5tte Plans QtlerSpectf� �.., . APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 /o/Property Address:!� This section to be completed by office //r�op/ ob,,�R1-��--- Map Lot �V "� Unit ,If—t n(2-Z:2 2' / lv,4 Zone Overlay District Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: N e(Prin Current Upiling Address; r,7 , l Telephone Signature 2.2 Authorized A ent: �_Je_l11 ,Gl'L / � S' f slt-S St ` c-7 Name P Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only com feted by ermit applicant 1. Building r'tV (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=0 +2+3+4+5) Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2009-0206 APPLICANT/CONTACT PERSON ALDRICH DALE ADDRESS/PHONE 101 OVERLOOK DR FLORENCE (413)586-8747() PROPERTY LOCATION 101 OVERLOOKIPR MAP 29 PARCEL 256 001 ZONE URA I VN 6� THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out i Fee Paid Typeof Construction: REPLACE 2T 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 INFO ATION 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 Street Commission Permit DPW Storm Water Management Demolition Delay 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. 101 OVERLOOK DR BP-2009-0206 GIs#: _ COMMONWEALTH OF MASSACHUSETTS Man.Block: 29-256 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Bukbg DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category BUILDING PERMIT Permit# BP-2009-0206 Project# JS-2009-000272 Est.Cost: $3805.00 Fee: $30.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Groin Homeowner as Contractor Lot Size(sq.ft.): 15202.44 Owner: ALDRICH DALE Zoning_URA Applicant: ALDRICH DALE Applicant Address: Phone: Insurance: 101 OVERLOOK DR 413 586-8747 FLORENCEMA01062 ISSUED ON.91212008 0:00:00 TO PERFORM THE FOLLOWING WORK.-REPLACE 2T 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: (�K c'-<;�_p gl^44 rw THIS PERMIT MAY BE REVOKED BY THE 7C ' Y OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGUL ONS. " Certificate of Occupancy Sip-nature: FeeType: Date ai : Amount: Building 9/2/2008 0:00:00 $30.001194 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo