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05-059 (16)■ State -of -the -Art Simple, precise and reliable. the most advanced, efficient use and easy to maintain. ■ Low Temperature Performance With over 30 years of heat pump pool heater design „* experience, AquaComfort is built to outperform the 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%. ■ 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.,w ■ Built Better to Last Longer... Incorporating scroll compressors, Turboguard Titanium - heat exchangers and advanced heat exchange technoloc every AquaComfort heater is built to the highest erfe and durability standards in the indutr unmatched performance in a heateft k` ` cacti as it is durable. THE POOL HEATING SOLUTION State -of -the -Art] Low TemperatWE Environmentally" Built Better to La al Technology formance idly signaturepoolheaters.com I S,IJO?5b THE POOL HEATING SOLUTION AquaComfort Extend your swimming season Swim more often Enjoy comfortably warm water all season 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 Natural Gas $1.90 Propane $2.50 Electric Resistance $3.011 10 L MADE IN U.S.A. ZODIAC o POOL AND SPA HEATERS LXiTM I LEGACYTM I Hi -E2° ULTIMATE COMFORT ,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' 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. ZODIAC POOL AND SPA PRODUCTS Pumps Water Purification In -Floor �*� Zodiac heaters are a component of Filters Valves Water Leveling Zodiac's Energy smart Heaters Water Features Pool Covers Products, designed to conserve energy and Heat Pumps Lighting Accessories ower 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 1.888.647.4004 1 www.ZodiacPootSystems.ca JANDY LXi HEATER BY ZODIAC 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. — 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. 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 Jan Pro Series by 7.ODIAG' r ; 1 ��clgr�g[1 �(Ct[c�rAcif CiC{F{C{rig r ZI ZODIAC i f J � 7 r ; 1 ��clgr�g[1 �(Ct[c�rAcif CiC{F{C{rig r ZI ZODIAC i (71� pu pm VARIABLE SPEED PUMP Save up to 90% on energy costs with ePump Variable Speed Pump 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 amount on energy costs. » 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. » Stealth7M Pump Technology • Powerful, efficient operation • Whisper -quiet motor • Largest smooth surface trap basket on the market for reduced maintenance • Packed with user-friendly features including ergonomic handles and easy to read indicators » 4 Control Options Completely programmable and customizable with 4 control system options: 1. AquaLink RS 2. AquaLink PDA Aqual ink 3. AquaLink Z4 4. JEP-R Pump Controller » Complies with Appliance Efficiency Standards (CEC Title 20 & ANSI@/APSP-15) and Qualifies for power rebates* *Where offered MZodiac 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 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. ePump Variable Speed Pump DIMENSIONS Standard epump part numbers and specs Horse Recommended Carton Overall 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 lbs 331/2" PERFORMANCE JEP PERFORMANCE CURVES i2o o„0 M EE 100 0 w Lu eo 70 LOU so x (J 50 JEP-2 0 HP, 3450 RPM Q40 JEP-1 5 HP, 3450 RPM Z -JEP-20 HP, 3000 RPM >- JEP-2.0 HP 0 JEP-20 HP 2400 RPM`�--JEP-1.5 HP, 3000 RPM Q20 1500 RPM H ----JEP-1.5 HP, 2400 RPM O 10 JEP1 5 HP 500 RPM 0 0 10 20 30 40 50 60 70 M 90 100 110 120 130 140 150 100 170 100 190 200 210 220 230 240 250 FLOW GPM Z=E3 ZODIAC r ta+i an u ` - -�► Pro Series b\ ZODIAOX' h 5 t 4 Ecological, Economical TM Pool & Spa HeatingqEATERTm, ♦ ifs • `� lw woo o y-- ZODIAC LXi- POOL & SPA HEATER Heaters that pay for themselves through greater energy efficiency Integrating the most advanced features— from superior hydraulic design, to technologically—innovative control systems. » COMPACT Jandy's new LXi is the easiest heater to install. The LXi is 33% lighter, with a 15% smaller footprint. » POWERFUL The LXi header improves entire circulation system efficiency. Offset plumbing and 2" universal unions provide added flexibility for simplified, direct connections. » RELIABLE Low NOx, fan -assisted combustion and Hot Surface Ignition System provides maximum performance. Multiple venting options including sidewall, top or rear connections. » EFFICIENT • 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 1.888.647.4004 I www.ZodiacPoolSystems.ca ©2012 Zodiac Pool Systems, Inc. SL6352 Rev B 0112 ZODIAC® is a registered trademark of Zodiac International, S.A.S.U., used under license. LXi'" POOL & SPA HEATER DIMENSIONS Jandy Pro Series heaters are Versa Plumb' ready. The Versa Plumb' System is the most energy efficient pool system in the world. ZODIAC TOP VIEW 6.9" 117.5 cml 156.6 cm) I 27.5" 169.9 cml ® 18.5" 147 cml 13.1"h1,5(33.3l 11.2" (28.4 cm) 0 5.5" 114 cm) y 6.(r- .8"115.2 115.2-1 Model Heater Width Vent Side Heater Vent Carton Number Firing Rate Dim'A' Diameter Mid -Vent Dim'B' Weight LXi 250 250,000 BTU/HR 23.5" 6"105' 10.5" 209 lbs. LXi 400 399,000 BTU/HR 32" 8" 15.6" 15.6" 240 lbs. Jandy Pro Series heaters are Versa Plumb' ready. The Versa Plumb' System is the most energy efficient pool system in the world. ZODIAC "R3 VGB COMPLIANT DEBRIS DRAIN W, A 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. ® PARAMOUNTS' DRAINS HAVE BEEN RE -TESTED AND ARE FULLY VGB COMPLIANT. ■ RATED FOR A MAXIMUM SYSTEM FLOW RATE OF 132GPM. ■ ENLARGED SUCTION ELEMENT PROTECTS AGAINST HAIR AND CLOTHING ENTRAPMENT. ® OUTSTANDING FOR POOLS AS WELL AS SPAS, OVERFLOW BASINS, AND FOUNTAINS, ANY- WHERE DEBRIS NEEDS TO BE REMOVED. ■ SPECIALLY DESIGNED OPENING TO PROTECT AGAINST HAIR AND MECHANICAL ENTRAP- MENT WHILE EFFICIENTLY ACCEPTING LARGE DEBRIS. ® FOR CONCRETE, VINYL, AND FIBERGLASS POOLS. ® THE MDX-R3 SUMP HAS A 2" PORT FOR A HY- DROSTATIC VALVE. ® 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 VGB COMPLIANT DEBRIS DRAIN MDX-R3 & SDX ARE AVAILABLE IN 8 DESIGNER COLORS White 01 Gray 02 Black 03 Taupe 04 00010 Blue 05 Light Blue Beige 07 Light Gray 06 08 A MEQ'; 1 1 � 1 A A 11219 -o7 —ED MII 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 SYSTEM, THE MDX-R3 VGB COMPLIANT DEBRIS DRAIN IS A HIGHLY EFFICIENT DRAIN THAT AL- LOWS DIRT, LEAVES, AND OTHER DEBRIS TO BE EFFECTIVELY REMOVED FROM YOUR POOL. OMDX-R3 VGB COMPLIANT DEBRIS DRAIN © SDX HIGH FLOW DEBRIS CONTAIN- © MENT CANISTER SAFETY DRAIN (OPTIONAL) THE MDX-R3 VGB COMPLIANT DEBRIS DRAIN IS THE LAT- EST ADVANCEMENT IN DRAIN SAFETY AND DEBRIS REMOVA'_. MDX-R3 IS A HIGHLY EFFICIENT DRAIN THAT ALLOWS DIRT, LEAVES, AND OTHER DEBRIS TO BE EFFECTIVELY REMOVED FROM YOUR POOL. MDX-R3 ALSO OFFERS MUL- TIPLE LAYERS OF PROTEC- TION, INCLUDING THE VGB 2008 COMPLIANT SDX HIGH FLOW SAFETY DRAIN®. IF THE MDX-R3 EVER BECOMES BLOCKED, THE SDX ABSORBS THE FULL FLOW OF THE PUMP TO RELIEVE EXCESSIVE SUC- TION AND PROVIDE A BACK-UP LAYER OF ANTI -ENTRAPMENT SAFETY THE MDX-R3 WORKS IN CON- JUNCTION WITH THE PARA- MOUNT DEBRIS CONTAINMENT CANISTER WHICH HOLDS 400% MORE THAN MOST POOL PUMP BASKETS, AND IS EASY TO ACCESS THROUGH A COLOR COORDINATED DECK LID. AN ADDITIONAL LAYER OF SAFETY CAN BE ACHIEVED WITH THE OPTIONAL MVFUSE MAGNETIC SAFETY VACUUM RELEASE SYSTEM (SVRS). 4RAWW' PAT � TM Pool Alarm Transmitter 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 feet when properly installed. Remote receiver has on/off switch with "on" indicator light. 120 volts, AC. Receiver sounds at approx. 100 dB. Uses one 9 volt alkaline battery (battery not included). Packaged 6 units per master carton, weight approximately 21 lbs. Pool Patrol Pool Alarm without Remote Receiver --Model PA -20 Transmitter floats in any pool shape or size. Transmitter buzzer approx. 97 dB. Can be returned to pool immediately after waves have subsided. Uses one 9 volt alkaline battery (battery not included). Packaged 6 units per master carton, weight approximately 16 lbs. Driven besigns, Inc. r 1135 South Bridge St. Belding, MI 48809 Tel:(blb) 794-9977 /9/, L', Fax:(616) 794-9987 Pool Patrol Door and Gate Alarm --Model GA -20 Attaches to any door or gate. For indoors or outdoor use. Sounds alarm before a child enters pool or spa area. Uses one 9 volt alkaline battery (battery not included). Gate alarm sounds at approx. 100 dB. Packaged 12 units per master carton, weight approximately 5 lbs.. Other models available are GA -25 works with the remote receiver and GA -30 comes with remote receiver. Visit us @ www . poolpatrol . com Aqua Pool and Patio 53 Newberry Road East Windsor, CT 06088 860.623.9886 PATF� TM Sounds alarm if children or pets fall into your pool a MUST for every Pool and Spa •Meets requirements for ASTM Standard F2208-07 -Excellent added layer of security to protect your ones •Remote Receiver can work with home security sysi -Can be used in all pools including: above -ground, in -ground and inflatable pools -Can be used with a solar cover -Floats on pool or spa surface -Adjustable sensitivity -Transmitter resets after 3 minutes -Quality constructed using the latest RF technoloS -9-volt battery operated with low -battery indicatc -Installs in seconds, no tools required -Made in the USA -Corrosion-resistant for long life -2 year warranty Call (616) 794-9977 Ask for Christie or Vicki DATE: {Z--{ - i .a � f OWNER: EUZA-GEr4A JOB#: 9*1 - i *02.%z— INSTALLER: C-RAtq HAS mj-:.a o LOCATION: 60f t AvtW e -,o Ij 94&t �'D& ( fj0g4UA"+,t& 0) AS -BUILT PLAN FOR SEPTIC SYSTEM EXIST WELL 11' FROM HOUSE 1500 CAL A SEPTIC TANK SYSTEM TIES A—C=20.0' A-0=220.0' B—D==60.0, 'A r A—VENT=22 5' B—VENT=84.8' VEN#=50.0" B—#2='78-5' 6—#j= 107.0' VENT—#3=41.o' 8—#4=85.0' #1 THRU #4=CORNERS OF LEACH FIELD D=D -80X (DISTRIBUTION BOX) I. P. =INSPECTION PORT` LEACH FIELD (40'X50') #3 VENT I.P. #2 L NOTE. qTnNF PFTA/Af/NG WAf.j RARRIFR 241 College Highway & Clark Street P.O. Box I (413) 527-3600 Pty OPER ly 01vr- IRON PIPE 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 INSPECTOR Louis Hasbrouck Building Commissioner City of Northampton. Massachusetts DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 Chuck Miller 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 made ' 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: ❑ I am a employer with 4. [] I am a general contractor and I employees (full and/orpart-time). * have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. XJ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.1 5. [] We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling S. ❑ Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11.0 Plumbing repairs or additions 12.0 Roof repairs 13. ❑ Other *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. #:. Job Site Address: Expiration Date: 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 lnv_stigations of the DIA for insurance coverage verification. I do hereby cerkQllu ler the(pains and penalties of perjury that the information provided above is true and correct. 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: Name of License Holder: Not Applicable £ License Number Address Expiration Date _ Signature Telephone '`9. Registered Home improvement Con'tra'ctor' Not Applicable £ Company Name Registration Number Address Telephone Expiration Date 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 ,WAV] Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors M Accessory Bldg. 91 Demolition ❑ New Signs [EO] Decks (0 Siding [0] Other [E]] Q' Brief Description of Proposed L Work: Ttj C-►RtalD 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, eomp[ete 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 Lb/a(XM I, 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 L zap �iAl Vi t1 i� I � 10 as Owner/Authorized I, 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 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 Side L:F.____......_.= R:S_-___....t LL_ ._ R:i_ ., ._._...J, F - ._ Rear Building Height Bldg. Square Footage 1--__._...._..._, _., % Open Space Footage �. f % _ (Lot area minus bldg & paved parking) # of Parking Spaces l• -•— - "-1 € - ---` Fill: i, (volume & Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DONT KNOW O YES Q IF YES, date issued:; IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW Q YES C) IF YES: enter Book Page I and/or Document #1 B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES C) IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained ObtainedQ , Date Issued: 3 C. Do any signs exist on the property? YES NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO Q 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 0 NO 0 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. c t.['y 0 1�• City of Northampton Building Department 212 Main Street Room 100 Northampton, MA 01060 phone 413-587-1240 Fax 413-587-1272 APPMATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 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 com feted by permit applicant 1. Building (a) Building Permit Fee �C00 i30 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection Z-1 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 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 MAP 05 PARCEL 059 001 ZONE RR(94)/WP(15)/ OCTA SLS Q �J THIS SECTION FOR OFFICIAL USE ONLY: POOL, PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE N c-Lo5 1112E ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid00 L Tvneof Construction: INSTALL INGROUND POOL -1 o WI�rOL I N �. Lt 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 i gOfficial Date O$4-� 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:4/27/2015 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. Underground: Service: Rough: Rough: Final: Final: Gas: Fire Department Rough: Oil: Final: Smoke: Meter: House # Driveway Final: Building Inspector Footings: Foundation: Rough Frame: Fireplace/Chimney: Insulation: 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