29-018 (2) F
*PLEASE READ CAREFULLY*
A STEP-BY-STEP CHECKLIST OF YOUR NEW POOL INSTALLATION
CUSTOMER RESPONSIBILITIES
THREE WEEKS FROM CONSTRUCTION:
APPLICATION FOR FINANCING-Please make all final arrangements with your bank 3 weeks prior to Teddy Bear's arrival for excavation of your pool.This
will assure no delay,and provide for completion on time.
TREE REMOVAL-Make arrangements with a tree specialist in the event trees must be eliminated to make room for your pool.At your request,we will be glad to
refer you to local companies.
REGARDING STUMPS:Any stump that is approximately 3"to 4"in diameter within a pool area will be gladly removed by Teddy Bear Pools.In the event a
stump must be excavated,a nominal fee will be assessed,i.e.machine time and/or extra materials needed.We do not remove stumps from the job site.If you can,have the
stumps ground t'below ground level.
SEPTIC SYSTEMS/LEACH FIELDS&DRYWELL-In the event your present septic system or arterial leach field lines are going to interfere with pool
construction,arrangements should be made now,through a septic contractor,to address this concern.Teddy Bear Pools is not equipped to remove such systems,be we are
available to assist you in the handling of this matter.If your tank is nonfunctional,please make sure it is pumped I week in advance.
ACCESS-The first step,of course,is excavation.Please make sure that entry to the yard is clear from fences,wood piles,swingsets,bushes,etc.This will be
greatly appreciated.Teddy Bear Pools cannot be responsible for the removal for any of the above.Delays could occur if this has not been taken care of in advance.If access is
across a neighbor's property it will be your responsibility to obtain their permission and it will be understood that you,not Teddy Bear Pools,will assume the responsibility for
the finished grade of your neighbor's yard.
TWO WEEKS FROM CONSTRUCTION:
BUILDING PERMITS-Please obtain your building permit two weeks in advance of excavation-where local codes apply.Usually these forms will be mailed by
your town to you upon request.Our Home Improvement Contractor License#'s are:MA#11189 and CT#520951.
ELECTRICITY-"AVOID DELAY-HAVE POWER SUPPLY READY."Power must be supplied to the excavation area.A 20 amp outlet will suffice in most cases.
WATER-Please make sure that your installation crew has availability to water and hose.For insurance purposes,we are unable to allow any of our employees to
enter your home.
AT TIME OF CONSTRUCTION:
DRIVEWAY/SIDEWALKS-If the point of entry for trucks or equipment is over your concrete or blacktop driveway,we regret to say,it is at the owner's risk
since we have no way of knowing how firm each individual driveway will be.We will take every precaution,or listen to any suggestion you might have,to minimize any
problem that may arise.Once again,we cannot accept any liability for damages of any kind.
SITE WORK-"THINGS YOU SHOULD KNOW"
SHALE/ROCK-Expense could vary significantly depending on the circumstances:therefore,this cost will be discussed on an individual basis.
WATER TABLES/GROUND WATER/CLAY/REDPAN-Teddy Bear Pool charges the customer for direct costs only.Usually one or two loads of crushed
stone will suffice for an average water problem.The cost per load is$200.00-$300.00 delivered.(Extra excavation for this work and stone will be billed with labor.)
NON-APPARENT UNDERGROUND OBSTACLES-If underground debris(i.e.stumps,large rocks,etc.)are encountered,it may be necessary to use material
such as gravel,concrete and/or Sono tubes to rectify any voids created by the removal of such obstacles.Any charges for this type of extra material will be collected with your
excavation payment.
EXTRA FILL-It may be necessary for us to haul dirt away from your yard to create enough work space.If this is the case,it will be your responsibility to have
additional fill brought in for grading,if necessary.If you have clay soil,it will be necessary for you to have the rough grade top dressed,as clay cannot be spread as effectively
as other types of ground material.Teddy Bear Pools will leave you with a rough machine grade around the pool area.Fine grading will be your responsibility.
DRAINAGE-Occasionally a site may require a drainage system due to irregular landscape and soil conditions.Drainage is used to prevent surface run off and
upper seepage toward the pool.Water is directed away from the pool to a lower point on the site.Gutter downspout should also be directed away from the pool.
RETAINING WALL-If a retaining wall is necessary,please arrange for construction and back fill if the wall is to be constructed after the pool installation.Please
see that it is constructed promptly to avoid soil erosion.
LANDSCAPING-Teddy Bear Pools does not provide this service.When landscaping,be sure to maintain a pitch away from the pool and concrete.Crushed stone
is an aesthetically effective way to provide proper drainage.
WATER TO FILL POOL-Normally your pool is filled through your garden hose.If water needs to be trucked in,please inform us and we can make the necessary
arrangements.
REFUSE-Debris,mainly from the packaging of equipment,will be packed up neatly and left for your curbside trash collection.
AFTER INSTALLATION OF POOL STRUCTURE:
CONCRETE DECKING-Teddy Bear Pools utilizes the highest quality materials along with the most qualified craftsmen to ensure that cracking of concrete is
kept to a minimum.Unfortunately,given the Northeast climate,cracking of concrete is a fact which cannot be avoided.Your concrete deck WILL crack.In some instances,acid
rain,leaves,dirt and other debris that may come in contact with your deck could discolor concrete decking.Please keep your deck as clean as possible from foreign debris.
Within the first month of deck completion the ground will settle around it.It will be your responsibility to regrade to mid-deck height.
FLOATING LINERS-Excessive rainfall may cause Flooding around your pool much like it does to a basement.The result of this may be a floating liner,which at
times may leave wrinkles in the liner.We can attempt to remove these wrinkles by resetting it.The cost of this service will be covered by most homeowner's insurance policies.
SEASONAL SERVICE-Pool opening and closing services are provided through our Service Department.We provide several services to cater to each customer's
individual needs.Please do not endanger your warranty by not having your pool properly opened and closed.Our Service Department is staffed by professional Service
Technicians who are equipped with factory authorized parts and training.The Teddy Bear Pool Service Team will open and close your pool professionally.
CHEMICAL TREATMENT-Teddy Bear Pools urges our customers to use only the Teddy Bear Pools recommended chemicals in you swimming pool.These
chemicals have been specially formulated to ensure the life long quality of our products without the risk of fading or wrinkling caused by inferior grade chemicals or chemical
imbalance.Such disorders are not covered under your warranty.A detailed outline and booklet on water chemistry will be provided to you upon completion of your new
swimming pool.Please read this booklet carefully.Do not endanger your warranty by using inferior chemicals.
IN CLOSING.......
Teddy Bear Pools is honored by your confidence,and will do everything within our power to keep that trust.A swimming pool is a long term investment.
Finally,you will be given complete instructions as to the operation of your new Teddy Bear Pool when your pool has been inspected and passed your electrical
requirements.This must be done by a licensed electrician.
Thank you once again from all of us at Teddy Bear Pools&Spas
THIS MUST BE SIGNED AND RETURNED BEFORE EXCAVATION C9N BEGIN ON YOUR POOL
DUE TO INSURANCE REGULATIONS.
THANK YOU.
Owner Date
Please sign one copy of this page for Teddy Bear Pools and keep the other for your records.
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TEDDY BEAR P SPAS
imam
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Included: ■ No ., c
d • Stone
Water Tanker:
■ Yes •
M�&emicals Clean Fill ..
• Trucking: G1 ■ •
Pump
Stumps: F1, Yes ■ No Labor
27 Back •-
Stump Removal
Other
/
•• • • •• • •• •
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-, DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street • Muuicipd Building '
Northwnpton,MA 01060
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as has/her construction super ,•isor. The state defines "Homeowner" as, "Person(s)
who owns a parcel on which he/she resides or intends to be,a one or two famif -
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 rouLyh 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 ner/resident's signature requesting exemption)
I will-call to schedule all required building inspections necessary for the building permit
issued to me. /
Date /Ol4/0 4
Address of work
location (l ,Z; orz,
r
__ M Qto62
1 ,
Crif� of �,Tarf(jzaIII:pj0II _
j pp _ _
� A � E l�nJaRCl�tisrllE- _
DEPARTMEI-IT OP BUILD0\10 INSPECTIONS
212 Main Strect ' Municipal Building
Northampton, Afacs. 01060
WORUCCIZ'S CON ENSAgaON LNSURAhCF .FNMA I-F
i
(li cc-ns.:Jpermi tt=)
v.,I th a principal place of businessfresidence at: --
--L
( cit'J/staic�ap)
do hereby cerii -, under tic pz.ins and penalties of pcg'ury, h:il
( I :m an employer providing the following workcr's cocnoens�oo covemse For Ins
-ktg 200
etn4�loyct;s worUng on t�Iis job:
(Luuxan=Coma}•) (Police:Numbcr) (:-pIrmDon D;,i }
( ) I am a sole proprietor, general coou-actor or homeowner (c cie one) and have hired
t_he coairactors lists below wbo hive the worker's compen-tenon pokiest
Name ai Cont7naor) Inst rase Coltman] 7lloUC- Numhe--)
- (Name of Coatraclor) (lnstrznec Comoazyi?oUm, Num6cr) (LiDir,:iion Date)
(Name of Conn-acl&) (Insurance CompaoyfPoticy Num-bj) (Expira600 Date)
i
(Name of Coatrdctor) (L=ran= Compa yfPolicy Numbci) (Expirtion Date).
(nrIShc:�di:iocal�cC.irncocx.«•w mdu�,nforta�oo pc-tasaias w.11 ooh-_c.o:a)
O I am'a sore proprietor and bane no one working for me.
( ) I am,a home owner performing all the work myself.
NOTE:plc=be ewxre tb,• bcmeo,vcn wbo camp1gy p_-LO=w dD =-zc, oo or rc,ac work oa a d..ctLZ of
mot—tri-.n t'.su gait+is«h�ch the bomn,wer read-,or oa the p-ouacS zppuricaars the La c.-c ox C—.U-f oc rd-cd re lie
cci7ploy=-3 unc r the c=p---•,ea Act(GL152s 1(5)),zppGx=6 n by a bomooava f=e bey.cc perms c=T--id—tLe
1cp.I cu^•,ors c=ployac uodcr dw Wockcet Compomalioa AcL
I uDaav-,*d tha>oopy of tb6 c=—,oaay be foc-c..uded to Lb.Dcp,,of Indusrici A.Ac ,oTj.or 4=,—roc tbe
oovcsigc veilasioo a-td ttu L-=to saa='eovcrase under,4c%;oa 25A of),(GL 15l on ie6 to the i=;=Aioa of cnmio-zl paLxw,o
eomiring of a floc orup to 51}00.00 and/or ix�e o(up b one year Lead avit pcaaltia is tSc form of.Stop Woric Orde sad a
fl=0(:5100.00 a d_y ap1ma me
Foe d,, -r u.e onty
per=II I�IlIDtJCr -
T.Iap° _ Lot
i
Signa of Lia=Lscc1Pcnniucc e
SECTION 8-CONSTRUCTION SERVI,CES i
8.1 Licensed Construction Su rvisor: Not Applicablep❑
Name of License Holder
License Numb r
Address
Expiraf n to
0) 5-f0� r.1
Signature Telephone
9t is sterectinenip�c�ertiecroritracto �� 't `° Not Applicable ❑
�^ ? / m
Company Name Registration Num er -----
4\ 2 /8 12005
Address Expiration Date
IN-0 HA, Telephone
SECTION 10 WORKERS'COMPENSATION INSURANCE.AFFIDAYIT`,(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...... ❑
- .`:
T �� etf-f�g nQll
The current exe tion for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families
and to allow such ho owner to engage an individual for hire who does not possess a license, rp ovided thailhe owner acts
as supervisor.CMR 78 ixth Edition Section 108.3.5.1.
Definition of Homeowner:Pe n(s)who own a parcel of land on which je!nfdr/she esid tends to reside,on which there
is,or is intended to be,a one or tw ily dwelling,attached or detached accessory to such use and/or farm
structures.A person who constructs a than one home in a two- shall not be considered a homeowner.
Such"homeowner"shall submit to the Bui ' g Official,on a acceptable to the Building Official,that he/she shall be
responsible for all such work Pe rformed un the ' ine vermit.
As acting Construction Supervisor your pre se n the job site will be required from time to time,during and upon
completion of the work for which this pe is issue lso be advised that with referenc Chapter 152(Cr Wo 'Compensation) and Chapter 153(Liability of Employers to
Employees for injuries not ting in Death)of the Massach etts General Laws Annotated,you may be liable for person(s)
you hire to perform w for you under this permit.
The undersign omeowner"certifies and assumes responsibility ompliance with the State Building Code,City of
Northam Ordinances,State and Local Zoning Laws and State of Mas husetts General Laws Annotated.
meowner Signature
r
i
SECTION 5-DESCRIPTION OF=PROPOSED WORK(check all annlicable)
New House [] Addition ❑:;- Replacement Windows Alteration(s) Roofing
Or Doors D
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [C] Siding[1:3] Other L%
Brief Description of Proposed ` � G u�� j�lr / I g A i
Work: ..�`1 `,'
Alteration of existing bedroom Yes_ No Adding new bedroom Yes _�No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
v,. —, i7 :z. aa F' _ �' ^*' ^ °�u°"a r..z"�'�". .....z-�..�..v�U�*.�,ase;?m-w.r -* i •"-"°R'""`pt.�,,',.
sa,INevrhoiisean� c>>�: ciior>`t`a ee�c�strngious�ng._comuletetlriolfoi�nng:
a. Use of building:One Family X Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?_ k�-
d. Proposed Square footage of new construction. Dimensions
e. Number of stories? QA
f. Method of heating? PUN Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. oh ' 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 X No
j. Depth of basement or cellar floor below finished grade 'x.1A
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°ORCONTRACTOR APPLIES FOR BLIJ DING"PERMIT
' 1a '� `
�i��rt. ,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 O r Date 10 1011 4
I as Owner/Authorized
Agent haTeby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed u r the pains and p n s of perjury.
eelT
Print Nam y
///
Signature of Owner/Agent ate
Section 4. ZONING All Informatibtt 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 ( < I 1"q
Frontage
Setbacks Front 3 g E 3 S
Side L:� R:= 'L:7E9�I R:i 88 + --'
Rear
pock.
Building Height
Bldg.Square Footage �,�, --�� % �--
Open Space Footage
(Lot area minus bldg&paved
Parking)
#of Parking Spaces
Fill:
C-> a
(volume,&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO kU DON'T KNOW 0 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 Paged and/or Document#.-
B. Does the site contain a brook, body of water or wetlands? NO IN DON'T KNOW 0 YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued: 1,
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:
3
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 tCK
i
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
City of Nortf ampton
Building Department
212 Main Street
Room 100 .
Northampton; MA 01060
phone 413-587-1240 Fax 413-587-1272
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLI NE OR TWO FAMILY DWELL I
OCT .- 7 X
SECTION 1.`-SITE INFORMATION k
1.1 Property Address: . u
This ectrce
*ate"_ Ql
, "�Pj , MaP n
r,
WA, v� 62 Zone Overlay is 4
Elm Di is 16t,
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) urrent Mail ing Address-J
TeeTtph�o e s` 'L-
L��G
Signature
2.2 Authorized Agent: /
J Elko d v ��/� S'� ��f�. -111A
Na a(P. Current Mailing Address:
5-V(17-4 6� A(T. /
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)rEstimated Total Cost of
Construction from 6'
3. Plumbing Building;Permit Fee
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+,4+5) 2 O. Check Number (�
This Sectiom For Official"Use Only
Building Permit Numbr.e Bate
-"Issued:
Signature: •
c
Building Commissioner/Inspector of Buildings Date
File#BP-2005-0413
APPLICANT/CONTACT PERSON TEDDY BEAR POOLS&SPA
ADDRESS/PHONE 41 EAST ST CHICOPEE (800)554-2327
PROPERTY LOCATION 40 HICKORY DR
MAP 29 PARCEL 018 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildiniz Permit Filled out
Fee Paid
Typeof Construction: CONSTRUCT 18 X36 INGROUND POOL
New Construction
Non Structural interior renovations
Addition to Existinp-
Accessoa Structure
Buildins Plans Included:
Owner/Statement or License 069222
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 Pemlit 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 Co 'ssion
2
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.
40 HICKORY DR BP-2005-0413
GIS#: COMMONWEALTH OF MASSACHUSETTS
_MM:Block:29-018 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2005-0413
Project# 7S-2005-0554
Est.Cost: $20000.00
Fee:$50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: TEDDY BEAR POOLS & SPA 069222
Lot Size(sg. ft.): 14941.08 Owner: KEEFE JAMES J&YVONNE C
Zoning.URA Applicant: TEDDY BEAR POOLS & SPA
AT. 40 HICKORY DR
Applicant Address: Phone: Insurance:
41 EAST ST (800)554-2327 Workers
Compensation
CHICOPEEMA01020 ISSUED ON:10121104 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 18 X36 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 10/21/04 0:00:00 2047 $50.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo