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05-059 (7) ■ State-of-the-Art Digital Simple, precise and reliable. 04,r d the most advanced, efficient sysex use and easy to maintain. a r ■ Low Temperature Performance With over 30 years of heat pump pool heater design i a experience, AquaComfort is built to outperform the T competition. Advanced micro-computert chnology and exclusive design features allow AquaComfort to deliver heat at lower air temperatures than other heat pumps. The result is more heat when you need it most. AquaComfort outperforms the competition by up to 40%. 4, ■ Environmentally Friendly °` With no combustible by-products, AquaComfort creates clean, efficient energy that is safe for the environment. All AquaComfort units use safe, ozone friendlr' ' • R-41 OA refrigerant. rt, %p ■ Built Better to Last Longer... Incorporating scroll compressors, Turboguard Titanium- • heat exchangers and advanced heat exchange technology, every AquaComfort heater is built to the highest erfe nce and durability standards in the industry Thee e unmatched performance in a heateft l ` ` racttiace` as it is durable. -w...__ ..".. I, THE POOL HEATING SOLUTION 0 0 0 H E A P WM P S � ISM �k T r k. w. r State-of-the-Art ► ital Technology` i?x Low Temperaturerformart Environmentally dendly Built Bette'to Last oncr � z a — r r � , r� �� signaturepoolheaters.com 1 � 5 c • a 1 • d H 2 &Y O ` THE POOL HEATING SOLUTION 0 0 0 0 HEAT PUMPS Extend your swimming season Swim more often Enjoy comfortably warm water all season art. Earth friendly - no harmful emissions One touch operation - micro-computer controlled Operates at lower temperatures when the competition doesn't , TOTAL COST SAVINGS, Cost per 100,000 BTU input $.50 0o n lr Natural Gas $1.90 Propane $2.50 Y�� Electric Resistance $3.00 nay l p'rearwarra, ° 1 1 , 1 ARL MADE IN U.S.A. Z ODIAC o POOL AND SPA HEATERS LXiTM I LEGACYTM I Hi-E2® ka t f«� 1 ULTIMATE COMFORT , � . I INS � , F� r i f ` j w w b° z � ,r eating Technology Bring the future of heating comfort to your pool or spa today. HEATERS THAT PAY FOR THEMSELVES THROUGH GREATER ENERGY EFFICIENCY THE VERSA PLUMB°SYSTEM The Versa Plumb design is the foundation for efficiency and hydraulic integrity— hydraulic integration by design. Versa Plumb products have been engineered as components of the whole system, not individual pieces of equipment. The result is a pool system that conserves energy and lowers operating costs. It's friendly to your pocketbook and friendly to the environment. ALL ZODIAC° POOL AND SPA PRODUCTS WORK SEAMLESSLY TOGETHER The Zodiac Aqua Link"I RS Control System manages our complete line of technologically advanced products. The Zodiac system is designed to create a carefree backyard paradise — enhancing the overall pool and spa experience by delivering performance and reliability through technology. e ............................................................................................................................................................................................................................................................................... ZODIAC POOL AND SPA PRODUCTS Pumps Water Purification In-Floor *� Zodiac heaters are a component of Filters Valves Water Leveling Zodiac's Energy smart Products,designed to Heaters Water Features Pool Covers conserve energy and Heat Pumps Lighting Accessories tower operating costs. Controls Cleaners Zodiac Pool Systems, Inc. 2620 Commerce Way, Vista, CA 92081 1.800.822.7933 1 www.ZodiacPoo[Systems.com ............................................................................................................................................ Zodiac Pool Systems Canada, Inc. 2115 South Service Road West, Unit #3, Oakville, ON L61-5W2 QESIGy o. 1.888.647.4004 1 www.ZodiacPootSystems.ca SP C *-Nolh.11 models are available All trademarks referenced herein are the property of their respective owners. Q2011 Zodiac Pool Systems,tnc.na wit CE certification, 0 Rev- 0211 OD v Integrating - most LXi Smart Temp P5 advanced ' . ' from Control Panel uperior hydraulic design, j to tech notog Ica Uy-Innovative co • - Remote Mounting Control Panel i JANDY LXi HEATER BY ZODIAC i. w' ECOLOGICAL AND ECONOMICAL Jandy LXi heaters exceed environmental standards for Low NOx emissions. Lower emissions mean you can enjoy your pool with confidence, knowing your pool equipment is designed with the environment in mind. • High efficiency C-Fin heat exchanger is designed to lower operating costs and provide greater savings. • Highest efficiency rating in the industry to keep your pool heating costs low. • Low NOx, fan-assisted combustion and Hot Surface Ignition systems provide maximum performance in all weather conditions. R — THE NEXT GENERATION IN HEATING TECHNOLOGY Jandy innovation provides the ultimate in convenience with the Zodiac LXi control panel's remote mounting feature. • The feature rich control panel has a user-friendly backlit display and a simplified menu for ease of operation. • Built-in one-touch automation makes pool-to-spa switching simple. • The LXi heaters enable easy connection to Zodiac controls, and other pool/spa automation systems and automatic valve systems. Hi-E2 — THE MOST EFFICIENT HEATER With an impressive 95% heating efficiency rating, the Hi-E2 outperforms any other gas heater, which means it can reduce operating costs by 30% or more. This ultra- efficient, low-maintenance heater is the perfect choice when considering economic operation or an extended swimming season. Dual thermostat controls make this an excellent solution for pool and spa combinations. RELIABLE PERFORMANCE A unique forced-air system makes this the ideal heater for use in extreme weather and in difficult or unusual locations. EFFICIENT DESIGN Safe and easy to maintain, the Hi-E2 employs our hot surface ignition system, completely eliminating the pilot light. LOW MAINTENANCE High-tech composite materials and quality construction make this a very durable and dependable unit. .. Nui • • • • e JANDY LEGACY HEATER BY ZODIAC VALUE AND EFFICIENCY The atmospheric Legacy heater builds on Zodiac's long-standing tradition of excellence in gas heater design. Built to last and loaded with technologically-advanced, user-friendly features. Legacy heaters are an energy-efficient, economical pool heating solution. • Copper heat exchanger and Flo-Thru baffles provide efficient heat transfer and lower the amount of energy needed to heat your pool. • Available in two models, Electronic Ignition and Millivolt Standing Pilot. LRZE (Electronic) • Digital control of pool and spa set-points • Self diagnostics and communication to Aqua Link° RS Systems • Polymer headers with CPVC 2/2.5" universal union connections LRZM (Millivolt) • Easy on/off temperature switch control • Mechanical thermostat allows users to easily set pool or spa temperatures • Polymer headers with CPVC 2/2.5" universal union connections and �-— F> Pro Yeries Maximum Power. by 7.ODIAG'1 Ultimate E � ��� PU pm VARIABLE r r PUMP , i ` z r �Y - e� .,Cpl[t� x T •�.� [�GlgCe��iGl �r(C,�4i[iLiCA&IGIIa1 _ �d:um _ @IBI CiC{F{C{rig r ;,� AW ENERGY STAR zom I Ar N Ar Ar ePump Variable Speed Pump jp�RkAAC DIMENSION '4 P...,,U.. 7xm 11 5/8" 161/8" —1 A VARIABLE SPEED PP El ( D Save up to 90% on energy 10318"51/4' _ o costs with ePump Variable Speed Pump '— -' 133/4" ' Bolt Holes, Front Edge of Union to Center to Center Center of Bolt Holes 32 5/8" With today's rising energy costs, saving energy is a must. The ePump's eight variable speeds and high efficiency motor make it the quietest and most efficient pump available, saving a tremendous Standard epump part numbers and specs Horse Recommended Carton Overall amount on energy costs. Model No. Power Voltage Watts Pipe Size weight Length'A: JEP1.5 0.25-2.2 208-230VAC 2,100 W 21/2-3" 71.5 lbs 331/2" JEP2.0 0.25-2.7 208-230VAC 2,300 W 21/2-3" 71.5 Ibs 331/2" » Ultra Efficient Operation Features an energy saving totally enclosed fan-cooled(TEFC) permanent magnet brushless DC variable speed motor for cooler,quieter operation and extended life. PERFORMANCE » Stealthy" Pump Technology JEP PERFORMANCE CURVES ,20 • Powerful,efficient operation o 10 • Whisper-quiet motor EL 100 0 • Largest smooth surface trap basket on the market for F— reduced maintenance LL 80 ]0 • Packed with user-friendly features including ergonomic w 6° handles and easy to read indicators = U 50 JEP-2 0 HP,3450 RPM Q 40 JEP-1 5 HP,3450 RPM » 4 Control Options >- 30 EP-2 JEP-20 HP,3000 RPM Completely programmable and customizable with 20 JEP-2 0 HP 2400 RPM `�--JEP-1.5 HP,3000 RPM 4 control system options: O 500 RPM ----JEP-I.5 HP,2400 RPM J Y 10 JEP1 5 HP eoo riaw7Ha CEP.,sNP F- !eaa avM ---!1500 RPM 1.AquaLink RS ° 0 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 100 170 100 190 200 210 220 230 240 250 2.AquaLink PDA FLOW GPM 3.AquaLink Z4 Aqual ink 4.JEP-R Pump Controller Complies with Appliance Efficiency Standards(CEC Title 20&ANSI@/APSP-15)and Qualifies for power rebates* *Where offered Zodiac Pool Systems,Inc. 2620 Commerce Way,Vista,CA 92081 1.800.822.7933 1 www.ZodiacPoo[Systems.com Zodiac Pool Systems Canada,Inc. 2115 South Service Road West,Unit#3,Oakville,ON L6L 5W2 1.888.647.4004 1 www.ZodiacPoolSystems.ca / "' 02013 Zodiac Pool Systems,Inc.SL6205 Rev C 0913 ZOD11 o���": NSF. ZODIAC®is a registered trademark of Zodiac International,S.A.S.U.,used under ���,,, - license.All other trademarks used herein are the property of their respective owners. r Y t an 0 Y Pro Series n byZ0D Ecological, Economical jTM LM Pool & Spa Heating fe POOL & SPA HEATER LA V ir Owl r a r. r � , i .- , i v- y y .. ti p •� �. � x a I� ZODIAC LXi'" POOL & SPA HEATER DIMENSIONS v =��EATER B B Heaters that pay for themselves through greater energy efficiency Integrating the most advanced features— TOP VIEW from superior hydraulic design, to A technologically—innovative control systems. 117.5 c.) 1566cm; »COMPACT ® 27.5' 169.9 cml Jandy's new LXi is the easiest heater to install.The LXi is 33%lighter,with a 15% smaller footprint. "'`ml o 13.1" h15.(33.3 cm) l POWERFUL 1.4 c' o 128.4 cm) The LXi header improves entire circulation 5.5" 114 cm) system efficiency.Offset plumbing and 2" y 6.0" woo universal unions provide added flexibility 115.2cm) for simplified,direct connections. »RELIABLE Model Heater Width Vent Side Heater Vent Carton Low NOx,fan-assisted combustion and Number Firing Rate Dim'A' Diameter Mid-Vent Dim'B Weight Hot Surface nition System provides 9 Y P LXi 250 250,000 BTU/HR 23.5" b" 10.5" 10.5" 209 lbs. maximum performance. LXi 400 399,000 BTU/HR 32" 8" 15.6" 15.6" 2401bs. Multiple venting options including sidewall, top or rear connections. Jandy Pro Series heaters are Versa Plumb° »EFFICIENT ready.The Versa Plumb°System is the most energy efficient pool system in the world. • High efficiency C-Fin heat exchanger is designed for lower operating cost and greater savings. LXi Control Panel 7,R1 Zodiac Pool Systems,Inc. 2620 Commerce Way,Vista,CA 92081 1.800.822.7933 1 www.ZodiacPooLSystems.com Zodiac Pool Systems Canada,Inc. 2115 South Service Road West,Unit#3,Oakville,ON L6L 5W2 SMART PHONE SCAN ...e z.. ter... .,.. .,.. . .�... ...:, - . ..,.,,:.ay.. .,:.. .." 1.888.647.4004 1 www.ZodiacPoolSystems.ca ©2012 Zodiac Pool Systems,Inc.SL6352 Rev B 0112 ZODIAC ZODIAC®is a registered trademark of Zodiac International,S.A.S.U.,used under license. E. R, THE NEXT REVOLUTION IN SAFETY DRAIN TECHNOLOGY PARAMOUNT POOL&SPA SYSTEMS' MDX-R3 VGB COMPLIANT DEBRIS DRAIN EFFEC- TIVELY ELIMINATES DEBRIS THAT IS DELIVERED TO THE DRAIN AND OFFERS SEVERAL LAYERS OF ANTI-ENTRAPMENT PROTECTION FOR YOUR LOVED ONES. VGB COMPLIANT DEBRIS DRAIN ®PARAMOUNTS'DRAINS HAVE BEEN ■SPECIALLY DESIGNED OPENING TO PROTECT RE-TESTED AND ARE FULLY VGB COMPLIANT. AGAINST HAIR AND MECHANICAL ENTRAP- MENT WHILE EFFICIENTLY ACCEPTING LARGE RATED FOR A MAXIMUM SYSTEM FLOW RATE DEBRIS. OF 132GPM. t ®FOR CONCRETE, VINYL, AND FIBERGLASS _. �� .. ■ENLARGED SUCTION ELEMENT PROTECTS POOLS. AGAINST HAIR AND CLOTHING ENTRAPMENT. ®THE MDX-R3 SUMP HAS A 2"PORT FOR A HY- ®OUTSTANDING FOR POOLS AS WELL AS SPAS, DROSTATIC VALVE, OVERFLOW BASINS, AND FOUNTAINS, ANY- WHERE DEBRIS NEEDS TO BE REMOVED. ®LARGE CAPACITY SUMP ELIMINATES PLUGGED DRAIN SERVICE CALLS BY ALLOW- ING MOST DEBRIS TO PASS THROUGH. MDX-R3 GIVES YOU PEACE OF MIND WITH LAYERS OF PROTECTION: THE MDX-R3 VGB COMPLIANT DEBRIS DRAIN IS DESIGNED TO MEET THE INDUSTRY STAN- DARD ASME Al 12,19.8-2007 ANTI-ENTRAPMENT REQUIREMENTS FOR CONCRETE, VINYL AND FIBERGLASS POOLS, AND IS TESTED AND LISTED BY IAPMO, TO EARN THE PREMIER SWIMMING POOL SPA AND HOT TUB CODE (USPC) SHIELD. IF THE MDX-R3 BECOMES COV- ERED,THE SECONDARY SDX DRAIN ACTIVATES TO PREVENT EXCESSIVE SUCTION AND TRU- LY BECOMES A SAFETY BACKUP. FOR ADDITIONAL SAFETY SIMPLY ADD MVFUSE TO THE PARAMOUNT DEBRIS CANISTER AS A THIRD POINT OF SUCTION RELIEF. LOCATED BETWEEN MDX-R3 AND THE PUMP THE PAT- ENTED MVFUSE PROVIDES ANOTHER LAYER OF SWIMMER PROTECTION, THE MDX-R3 VGB COMPLIANT DEBRIS DRAIN PROTECTS AGAINST: BODY ENTRAPMENT HAIR ENTRAPMENT LIMB ENTRAPMENT EVISCERATION FINGER&TOE ENTRAPMENT Paramount • 1 .800-621 -5886 004027 883000 REV0510ij R, MDX-R3 MEETS THE SAFETY STANDARDS WHILE HELPING KEEP YOUR POOL CLEAN: THE MDX-R3 VGB COMPLIANT DEBRIS DRAIN COMBINES QUALITY,CRAFTSMANSHIP,AND IN- NOVATION TO PROVIDE YOU WITH THE BEST FOR YOUR POOL, MDX-R3 IS MORE THAN JUST A DRAIN; WHEN COMBINED WITH A PARAMOUNT IN-FLOOR CLEANING AND CIRCULATION R3SYSTEM,THE MDX-R3 VGB COMPLIANT DEBRIS DRAIN IS A HIGHLY EFFICIENT DRAIN THAT AL- VGB COMPLIANT DEBRIS DRAIN LOWS DIRT,LEAVES,AND OTHER DEBRIS TO BE EFFECTIVELY REMOVED FROM YOUR POOL. O MDX-R3 VGB SDX HIGH FLOW DEBRIS CONTAIN- COMPLIANT ©SAFETY DRAIN © MENT CANISTER (OPTIONAL) DEBRIS DRAIN MDX-R3&SDX ARE AVAILABLE IN 8 DESIGNER COLORS White Gray Black Taupe "{" 01 02 03 04 1 r Blue Light Beige Light 05 Blue 07 Gray THE MDX-R3 VGB COMPLIANT MDX-R3 ALSO OFFERS MUL- THE MDX-R3 WORKS IN CON- 06 08 DEBRIS DRAIN IS THE LAT- TIPLE LAYERS OF PROTEC- JUNCTION WITH THE PARA- EST ADVANCEMENT IN DRAIN TION, INCLUDING THE VGB MOUNT DEBRIS CONTAINMENT SAFETY AND DEBRIS REMOVA'-. 2008 COMPLIANT SDX HIGH CANISTER WHICH HOLDS MDX-R3 IS A HIGHLY EFFICIENT FLOW SAFETY DRAIN* IF 400% MORE THAN MOST DRAIN THAT ALLOWS DIRT, THE MDX-R3 EVER BECOMES POOL PUMP BASKETS,AND IS LEAVES, AND OTHER DEBRIS BLOCKED,THE SDX ABSORBS EASY TO ACCESS THROUGH A �,,��: TO BE EFFECTIVELY REMOVED THE FULL FLOW OF THE PUMP COLOR COORDINATED DECK .1�A�y+ME, A FROM YOUR POOL. TO RELIEVE EXCESSIVE SUC- LID.AN ADDITIONAL LAYER OF TION AND PROVIDE A BACK-UP SAFETY CAN BE ACHIEVED A A1219.-1 LAVER OF ANTI-ENTRAPMENT WITH THE OPTIONAL MVFUSE SAFETY. MAGNETIC SAFETY VACUUM 2ao7—ED RELEASE SYSTEM(SVRS). ri y r,7r '*WARNING'. MDX-R3 and SDX must be installed in accordance Pt with Paramount's written instruction v manual, and '.n conformity with ap- plicable Federal, State, Local and .., Swimming pool industry building 1"� F and safety codes • MDX-R3 VGB Compliant Debris 'g-fix , AIM Drain is only available to Paramount 4> MAOEIN USIA Authorized Builders �PARAM�� PAT RhC, A L TM V Pool Alarm Transmitter r c New Remote Receiver Pool Patrol Pool Alarm with Remote Receiver--Model PA-30 beluxe model with remote receiver. Remote receiver can work with home security systems. Alarm will sound both in your pool and in your house up to a distance of approximately 200 Pool Patrol Door and Gate Alarm--Model feet when properly installed. Remote receiver GA-20 has on/off switch with "on" indicator light. 120 Attaches to any door or gate. For indoors or volts, AC. Receiver sounds at approx. 100 dB. outdoor use. Sounds alarm before a child enters Uses one 9 volt alkaline battery (battery not pool or spa area. Uses one 9 volt alkaline battery included). Packaged 6 units per master carton, (battery not included). Gate alarm sounds at weight approximately 21 lbs. approx. 100 dB. Packaged 12 units per master Pool Patrol Pool Alarm without Remote carton, weight approximately 5 lbs.. Receiver--Model PA-20 Other models available are GA-25 works with the Transmitter floats in any pool shape or size. remote receiver and GA-30 comes with remote Transmitter buzzer approx. 97 dB. Can be receiver. returned to pool immediately after waves have Visit us @ subsided. Uses one 9 volt alkaline battery (battery not included). Packaged 6 units per master carton, WWW.�OO��QtrO�.C0111 weight approximately 16 lbs. -- Driven besigns, Inc. Aqua Pool and Patio r 1135 South Bridge St. 53 Newberry Road East Windsor, CT 06088 Belding, MI 48809 860.623.9886 Tel:(616) 794-9977 �' Fax:(616) 794-9987 TM P�,Oq ,A�L,, T PA O Sounds alarm if children or nets fall into your pool Pool and Spa for eve a every *Meets requirements for ASTM Standard F2208-07 -Excellent added layer of security to protect your loved ones. -Remote Receiver can work with home security systems -Can be used in all pools including: above-ground, in-ground and inflatable pools -Can be used with a solar cover t; -Floats on pool or spa surface -Adjustable sensitivity -Transmitter resets after 3 minutes -Quality constructed using the latest RF technology -9-volt battery operated with low-battery indicator -Installs in seconds, no tools required ` -Made in the USA Driven Designs, Inc -Corrosion-resistant for long life 1135 South Bridge St. -2 year warranty 4-9977 Belding, MI 48809 Call (616) 79 WWW poolpatrol.com Ask for Christie or Vicki DATE: I?--(A-i.a f OWNER: EUZA-GEr4A ftAV,?X-rr WCW—some: JOB#: 9*1-i *02%Z— INSTALLER: C-RAtq HAS mj-:.a o LOCATION: 60f t VJW tj g&A&, �'D& bJ0Q4UA"+1t&0) AS-BUILT PLAN FOR SEPTIC SYSTEM #1 THRU #4=CORNERS OF LEACH FIELD D=D—BOX (DISTRIBUTION BOX) I.P.=INSPECTION PORT EXIST. WELL 11' FROM HOUSE LEACH FIELD (40'X50') 1500 CAL SEPTIC TANK #3 VENT SYSTEM TIES A—C=20.0' A-0=220.0' B—D=60.0' #2 A—VENT=222.'5' B—VENT=84.8' NOTE. q'rnNF PF7AINING WAIN RARRIFR VENI--#,=50,0- P B—#2='78-5' 6—#j=107.0' VENT—#3=41.0' PROPERly ONE 8—#4=85.0' IRON PIPE 241 College Highway &Clark Street P.O. Box I (413) 527-3600 City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work: The debris will be transported by: The debris will be received by: Building permit number: Name of Permit Applicant Date Signature of Permit Applicant City of Northampton. Massachusetts DEPARTMENT OF BUILDING INSPECTIONS .M 212 Main Street • Municipal Building rJj b' � . Northampton, MA 01060 INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 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 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 madCe' L I, L ljzab��l 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 / r� I ►� Address of work location ��� - }�( dU VTu� ! ` zx The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 tiVashington Street Boston, MA 02111 y www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LetZibly Name (Business/Organization/Individual): Address: City/State/Zip: Phone M Are you an employer? Check the appropriate box: Type of project (required): 1.0 I am a employer with 4. [] I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have S. E] Demolition working for me in any capacity. employees and have workers' 9. F-1 Building addition [No workers' comp. insurance comp. insurance.1 required.] 5. [] We are a corporation and its 10.0 Electrical repairs or additions 3.XJ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 131-1 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHo meowners who submit this affidavit indicating they are doing all work and then hire outside contractors 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 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: 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$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Inv_stigations of the DIA for insurance coverage verification. I do hereby cerkQ er thefpains and penalties of perjury that the information provided above is true and correct. Signature: Date: LJ Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# 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#: SECTION 8-CONSTRUCTION SERVICES 8A Licensed Construction Supervisor: Not Applicable £ Name of License Holder: License Number Address Expiration Date _ Signature Telephone '`9.Registered Home improvement Con'tra'ctor' Not Applicable £ Company Name Registration Number Address Expiration Date Telephone SECTION 10-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...... £ 11. Rome Owner Exemption 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 Zoninf Taws and State of Massachusetts General Laws Annotated. Homeowner Signature. rl1` SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House , V] Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors M Accessory Bldg. 91 Demolition ❑ New Signs [ED] Decks (0 Siding [0] Other[E]] Q' Brief Description of Proposed Work: Ttj C-►R talD L Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet Q21F 6,'lf Newhouse and or addition to existinct fiou�ing, cornplete 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, Lb/a(X M Vial*'\ ,as Owner of the subject property hereby authorize Fill eh(QL to act on my b alf, in all ers relative to work authorized by this building permit application. Signature a ner Date I � I, �.�za �1Al Vi t1 i� 10 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 th i and penalties of perjury. Print Name F3( 1-7 l Signature of Owner/Agen 1( Date ' ^ � � - ` Section 4. ZONING AR 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 Rear Building Height Bldg.Square Footage Open Space Footage % ' #of Parking Spaces (volume&Location) A. Has a Special Permit/Yahanoe/Fl riding ever been issued for/on the site? r~� x�� �~� NO �~/ DONTKNOVV �~� YES �~� IF YES, dateissued:| | IF YES: Was the permit recorded at the Registry ofDeeds? NO �~� DONTKNOYY 0 YES C) -=- - IF YES: enter Book Page I and/or Document# / �� �� �� B. Does the site contain a brook, body uf water orwedands7 NO ��/ DONTKNOVV �~y YES �� IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs tobeobtained Obtained �� Date Issued: / t_/ '0 ' j C. Do any signs exist un 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 0 NO 0 IF YES, describe size, type and location: L___ ..........-........ ........ -____-_-_-_--_-_� E. Will the construction activity disturb(clearing, gradingexcavation, nrfi||/ng)over 1 acre orisit part ofu common plan ' that will disturb over 1 acre? YES 0 NO 0 |F YES,then o Northampton Storm Water Management Permit from the DPW inrequired. ^ - t o � peparfinent use only ,; City of Northampton Status ofFrmtt 1` Building Department Curb CUt/Drlyevay Permt# 212 Main Street SewerlSepticAvalra611r<y r f _ m Room 100 Water/WeilAvailabillty o Northampton, MA 01060 Tuvo Sefs of Structural Plans ° phone 413-587-1240 Fax 413-587-1272 Piof/Site plans z Other Specify ATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE.INFORMATION 1.1 Property Address: This secfion fo be completed by office �� ► �U c�bo�; �d Map Lot Unit Zone Overlay Disfrict LEDs, Elm`St District GB Distnct SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT. 2.1 Owner of Record: V Name(Print) % Current Mailing Address: f c Telephone Signature 9t 31- J] 8 3 2.2 Authorized Agent: Name(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 coo 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 22 90 6. Total=0 +2+3+4+5) Check Number This Section For Official Use Only Building Permit Number: Irate Issued: Signature: Building Commissioner/fnspector'of Buildings Date G�� HoLb —tJ6,6 File#BP-2015-0991 � - APPLICANT/CONTACT PERSON NEWSOME BARRETT&ELIZABETH VIZENTIN L D' ADDRESS/PHONE 341 AUDUBON RD LEEDS01053 (413)727-3835 Q PROPERTY LOCATION 341 AUDUBON RD 1 MAP 05 PARCEL 059 001 ZONE RR(94)/WP(15)/ CTA BLS Q �J J THIS SECTION FOR OFFICIAL USE ONLY: POOL, PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE 2—CN C-LO5 1112E ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Tvneof Construction: INSTALL INGROUND POOL 1L p Wli[bfL I N POOL �. New Construction Al GLD S Non Structural interior renovations _ Addition to Existing _ Accessory Structure Building Plans Included: Owner/Statement or License 1139281 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF99MATION 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 Buil mg 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. 341 AUDUBON RD BP-2015-0991 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:05-059 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Inground Pool BUILDING PERMIT Permit# BP-2015-0991 Project# JS-2015-001903 Est. Cost: $31000.00 Fee: $60.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: AQUA POOL & PATIO CO 1139281 Lot Size(sg. ft.): 595029.60 Owner: NEWSOME BARRETT&ELIZABETH VIZENTIN Zoning: RR(94)/WP(I5)/ Applicant: NEWSOME BARRETT & ELIZABETH VIZENTIN AT. 341 AUDUBON RD Applicant Address: Phone: Insurance: 341 AUDUBON RD (413) 727-3835 O LEEDSMA01053 ISSUED ON:412712015 0:00:00 TO PERFORM THE FOLLOWING WORK.INSTALL INGROUND POOL - no water in pool until enclosed 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 4/27/2015 0:00:00 $60.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner