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