10B-113 (4) 76 RESERVOIR RD BP-2019-1448
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Black: 10B- 113 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Cateemy: Inaround Pool BUILDING PERMIT
Permit# BP-2019-1448
Proiect# JS-2019-002343
Est.Cost$10500.00
Fee:$75.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor_
Lot Siw(sp.R.): 112341.24 Owner: ZAYAC NICHOLAS&.CARIA
Zoning; RR(102)/WPt3y Applicant: ZAYAC NICHOLAS & CARIA
AT. 76 RESERVOIR RD
ApplicantAddress: Phone: Insurance:
64REDFERN AVE
LONGMEADOWMA ISSUED ON:719120190:00:00
TO PERFORM THE FOLLOWING WORK.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.
Cel+'- 7CCupancV Signature:
Date Paid: Amount:
7/9/2019 0:00:00 $75.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File M BP-2019-1448 QNV�`v
APPLICANT/CONTACT PERSON ZAYAC NICHOLAS&CARIA
ADDRESS/PHONE 64REDFERN AVE LONGMEADOW J
PROPERTY LOCATION 76 RESERVOIR RD
MAP IOB PARCEL 113 001 ZONE RR(102VWP(3)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
NCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Pi
Building Permit Filled out
Fee Paid
TvneofCoion: MGROUND pr
New Construction
Non Structural interior renovations
Addition to ExistingS
Accessory Structure
Building Plans Included: - C �
Owner/Statement or License
3 sets of Plans/Plot Plan µ,
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON ,
INF9RMATION PRESENTED:
Approved_Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan IO�
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 Q
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.
Department use only
City of Northampton
Building Department rm rsy�y_'g ,ji'�,�y4'�jr,""_,,,��
212 Main Street r e c vai
Room 100 ater ell Availability '
Northampton, MA 01060 —S iso��ctiBa�Pl>tl{��
phone 413.587-1240 Fax 413-587-1272 oVS. Plans
her — ..... _ . . �
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR LY-DWELLING
SECTION 1 -SITE INFORMATION
1.1 Progeny Address: This section to be completed by office
nMap—fin B Lot q 3 Unit
MA o)65istrict3
Elm St District Zone OverlayGSD tinct
SECTION 2-PROPERTY OWNERSHIPIAUT14ORIZED AGENT
2.1 Owner of Record:
IVi� ,6 �Se�J1Gr IZD
N e(Pfint)/ ^� Cunent Malling A051re_eg,.-_
Signature
2.2 Aulth"
M:
Name(Prim) Cur em Mailing Adtlress:
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building (a)Building Permit Fee
2. Electrical J /7r/1 (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
C
4. Mechanical(HVAC)
5. Fire Protection
6. Total=(1 +2+3+4+5) Check Number O
This Section For Official Use Only '9
Building Permit Number. Date F
Issued:
breryl
Signature:
Building Commissionedlnspector of Buildings yFS
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNE.
Section 4. ZONING NI Information alust Be completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
nis wlumv m be filled N by
Building Deportment
Lot Size
Frontage
Setbacks Front
Side L R: L __ R:..___ — ---
Rear _..
Building Height
Bldg.Square Footage
Open Space Footage
(I.ma minus bug&Ma
q ofParkin Spaces
j Fill:
volw¢aLacafioo
A. Has a Speciat Permit/Variance/Finding ever been issued for/on the site?
NO ® DONT KNOW O YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW O YES O
IF YES: enter Book Page and/or Document p
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW O YES
IF YES, has a permit been or need to be obtained from the*tion Commission?
Needs to be obtained O Obtained O , Date Issued:
Do any signs exist on the property? YES O NO
IF YES, describe size, type and location:
-e there any proposed changes to or additions of signs intended for the property? YES O NO
e YES, describe size, type and location:
he construction activity disturb(clearing,grading,excavation,or filling)over t acre or is it part of a common plan
,ill disturb over 1 acre? YES O NO (A%
Own a Northampton Stomt Water Management Permit from the DPW is required.
SECTION S.DESCRIPTION OF PROPOSED WORK(check all applicable)
Now House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors D
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [q Siding[0] Other[
Brief Description of Proposed - 1
Work: 1y0%ai,M �1
Alteration of existing bedroom_Yes No Adding new bedroom Yes T No
Attached Narrative Renovating unfinished basement _Ves _ -'�--No
Plans Attached Roll -Sheet
ea. If New house and or addition to existing housina. colndete the followina.
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?
I. Method of heating? Fireplaces or Woodstows Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
It. Type of construction
I. Is construction within 100 ft.of wetlands?_Yes No. Is construction within 100 yr. floodplain_Yes_No
I. 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 To-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, as Owner of the subject
P.
hereby authorize
to ct my behalf,in all matte elativ oozed by this building permit application.
Si natureof r/ n n Dale
I, I vi'L _AV P1 .as Owner/Authorized
Ager hereby dedare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
N�a� Lara C
PNM time —
elfin of r/ Date
SECTION S•CONSTRUCTION SERVICES
81 Licensed Construction Supemissor: j Not Applicablle ❑p�(� /7
Name of li nse Hold,,:: P�IA�I.I r -7�` ic�~Obl1(��,F3g
License Number
Atltlrese
Expiration Date
W �ri�o l� MFS O�oB�j
Si nue Telephone
W3 sil' 'T76
eq
.Ra 1 red Nom Improvement Contract= Not Applicable 13✓AC ,DWW e!53 U
Como_ a�IF Ret tion Number
y—L
Address Erpiration Date
Telephoneyr351957�
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVR(M.G.L c.182,S 2SC(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will resuN
in the denial of the issuance of the building permit
Signed Affidavit Attached Yes....... No...... O
City of Northampton
Massachusetts
flapARTIldNi OF BOZLDZM INSPECTIONS
212 nein st—t • lNnicipal Building
anrtLsept,n, xa 01060 .
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and
subcontractors performing improvements or renovations on detached one to four family homes. Prior to
performing work on such homes,a contractor most be registered as a Home Improvement Contractor("HIC").
M_G.L.Chapter 142A requires that the"reconsbucaon, afteraaon,renovation,repair,modemizalion. conversion,
improvement,removal, demolition, or consbucgon of an addition to any pre-existing owner-occupied building containing
at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be
done by revstered contractors.
Note:If the homeowner has contracted with a corporation or LLC,that entity must be registered.
Type of Work! II Est.Cost:
Address of Work M �`�J"�vTor Z,� ►Q,e�,s (ryE}I 0)O
Date of Permit Application:
I hereby certify that:
Registration is not required for the following reason(s):
_Work excluded by law(explain):
_Job under 51,000.00 !J
E Owner obtaining own pemdt(explain): L*l0W e'
Building not owneroccupied
Other(specify):
OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED
CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT
ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND
UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBH.ITES FOR ALL WORK
PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION.
Signed under the penalties of perjury:
I hereby apply for a building permit as the agent of the owner:
515- i� 'mac �aLA -7f5yf)C-
Claribractor Name HIC Registration No.
OR:
Notwithstanding the above notice II�reby apply for a building permit as the owner of the above property:
Daleer Na d jKgn&tffe
City of Northampton
Massachusetts
IEPxRSIRNT 08 BUILDING INSPECTIONS
S%
212 Main Stzoat e Municipal Building OC
MoMrNuepten, NA 01060
Massachusetts Residential Building Code
Section 110.115.1.2
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.
Section I IO.R5.1.3.1
Any homeowner performing work for which a building permit is required shall be exempt from
the licensing provisions of 780 CMR 110.85, provided that if a homeowner engages a person(s)
for hire to do such work, then such homeowner shall act as supervisor.
Such homeowner shall submit to the Building Official, on a form acceptable to the Building I
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.
City of Northampton
Massachusetts
' BSPARTIOfeT OP BUILDING INaPSCTZGNS
212 win ecrw[ •Nufieip.l build ng
NnvcNaRtnn, m. 01060
Debris Disposal Affidavit
In accordance of the provisions of MGL c 40, 554, 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 property licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
The debris from construction work being performed at:
71 k5cI,v;or R I>
(Please print house number and street name)
Is to be disposed of at:
\/a Ile y 12.eV!i
(Please pnnt na and locaWh of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name and Address)
pis-i9
ignaturZpartment
t pplicant or Owner Date
If, for anhe debris will not be disposed of as indicated, the Applicant or Owner shall notify the
Building as to the location where the debris will be disposed.
The Commonwealth ofMassaehusetts
Department oflndustrialAccidents
1 Congress Street,Suite 100
Boston,MA 02114-I0I7
www.massgov/dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/Eleen icians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information
Plea_se Print Legibly
Name(Businesss'OManizatioNlndividual): 7NAr, COP!i s� 1-4C_
Address: 74- Kec.ef✓ Og � �� /?
MA 6/053
City/State/Zip: ' Phone#:
Are you an employer?Cheek the appropriate but:
Type of project(required):
LE31amaemployerwith employees(full anNm pan-terele 7. ❑New construction
2minmasolemmdmorpmmenhm=dhavew=pbymwmking forearm 8. 0Remodeling
my capacity_[No workmscomp.imurme, required.]
).�1 am a M1umeownmdow6 all work mYulf.[No wmkeri comp.iasurume regwrea.l' 9. Demolition
e.Fj l am a homrnwner aM will be ham aaclors to Muctall woh an 10�Building addition
gears my. Iwill
surethst an coaextors eider have workcrs cornpC115sllon hmmanCCmavearc solsok e 11.[:]Electrical repairs or additions
pmprimms with m employers. 12. Plumbing repairs or additions
5.]1 am a gravel contractor star 1 have hire)tic subwnaoctors IisIM oa the atvvb sheet.
lLesesub-cormornrs have emploYce,and have worken'em,q.nourvece.s 13.[]Rwf repai++rsay���/and6.FlWe area wryomtion and its officers have exercised thea ngbt ofexempdon per MGL c. 14.❑Other J
��
152,§1(4).awe have no amployeev.[No work=%comp.wumnce requhM.] 1�
'Any applicant that chzks box Ni must also fill out the section below showing thcirwotken,comparmotion policy inf non.
'Homeowners wM submit this affidavit indicating they qrc doing all wor*wdthen hire outside contrednn must submit a new affidavit indiwtmg such.
4tmoyees that check Nis box mhat anaM1M ae ,they al sheet stowing the name ofthc stook,uacnm anJ sate whether or not rlwse entities have
mnpleyees. Ifde subcootmcmrs have employees,thry muxt pmvide thea workers camp.policy mmuihm.
I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site
information. EL
Insurance Company Name: rraacBj —J Le nrJ}.nfs4.
Policy#or Self-ins.Lic.M Expiration Dale: iq"'
Job Site Address: 76 12eSeevior Rb City/Slate/Zip: t-eeb5 M&
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby nder the pains andpenalties of perjury that the information provided above is nue and correct
Signature, Date:
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):
I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone 4:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in ajoint enterprise,and including the legal representatives of a deceased employer,or the
receiver or Mato:of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)retools),address(es)and phone numbers)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in_(city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit mus[be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street, Suite 100
Boston, MA 02114-2017
Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE
Fax#617-727-7749
Revised 02-23-15 www.rnass.gov/dia
IN ACCORDANCE WITH ANSIjAPSP/ICC-S 3011.`HE
MS'ALCER*A ESPONAN'.E FOR PtAGNG CIYE SKIMMER
Ft•R FVERv SO} bi'.ARE FEET OF SURFACE AREAANC:nNE
4F TURN FOR EYE iT )•T SQUARE FEET OF SJRWF AP-A
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42 STEEI PA EEC 'ERRnF FR ^_ A(1 C VCLQME(US GW) 840D DISE OF 01%INc EQUIPMENT
SURF4 c try•) 300 IOLUME(UelsC 3E800 tfitIS PROHIBITED
12018-SPL-38254 LINER rl xA DATE 71-,2018 DSR. -`
R CVSTOMKIT COVER IR'1 :PA $[:ALE tla 1-0" '_—
RECTANGLET i_ - SHEET _tOF2
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MH..or Consume Affia'a d auainaea Reguladon
HOME IMPROVEMENT CONTRACTOR
TYPE:IndMduel
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9KIZIUAIRD
PAUL E.ZAYAC 03/27/2021
PAUL E.ZAYAC
79 HIGHMEADOW OR
W.SPRINGFIELD,MA 01059 F;a,e a-/ .
Undersecretary
Registration valid for individual use only
before the expiration date. If found return to:
office of Consumer Affairs and Business Regulation
1000 Washington Street -Suite 710
Boaton,MA 02118
Not vali with ut signature
/—"% ZAYACON-01 CSQUIRES
CERTIFICATE OF LIABILITY INSURANCE .'Wwwcv Yrn
SIMTHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUINGINSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER
IMPORTANT: If the certificate holder Man ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or ba endorsed.
If SUBROGATION IS WAIVED, subject to Me firma and conditions of the policy,certain policies may require an endorsement Astatement on
this certMcate does not confer rihla to the certificate holder in lieu of such endorsement a.
FRoWCEB License Y 1780862 cT Cyn m Squills
HUB International New England HKKIIE E FAX-
IS
AX Ea
86 Shaker Rd. Quo,
EM Longmeadow,MA 01026 IMM,Cynthia.Squiros@hub[iAmaftnal.com
INIVRESIS AFFORDING CWEIUOE NAICe
JNSURERA Union Insurance Community 25814
weuao INsuc ne:
2ayac Construction LLC INSURm C:
61 Redfem Avenue WSURm D:
Longmeadow,MA 01106
IXBLPERE:
agni
COVERAIGES CERTIFICATE NUMBER: REVISION NMBER-THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOWHAVESEEN ISSUEDTOTHE INSURED NAMEDABOVEFORTHE POLICY PERIOD
INDICATED. NOTWITHSTANDING MY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTTER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR My 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 CWIMS.
wra TYPEOFINBURANCa DLW POIICY mus. PCUCYEFF PDIELYEIIP 11X118
A x LOMtlERCMLfEXEARL W9a11Y EACH OCCURRENCE a 1,0iffi'm
cumsMADE �X occuR CPA 6386a82 411$018 41I$020 °VM Ero RFnesENTED 6p0,000
MEDEXP(Myvarevol 10'000
PERSONAL C ADV INARY 1,000,000
EN'LAGG TEq AP%1ES Pbt GEXERALAGGREGM E 2'Qm'000
wucv Ola PRowcrs-coMProPAx 2.000,000
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TIFICATE HQLVER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City Of Northampton ACCORDANCE WITH THTION E POILEY PROVISIONS. WILL BE DELIVERED IN
Office of Me Building Commissioner
Puchalaki Munici W I Bldg
212 Main Street ADTMp�➢REPIEPENIATM1E
Northampton,MA 01060
ACORD 26(2016103) 019S DIS ACORD CORPORATION. All Hghte rMaived.
The ACORD name and logo am registered marks of ACORD
NO.Tfi
NICHOLAS 8 CARLAZAYAC
LOT
H.CM D.
PIAN BK..R PG.OR
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PM P.
76 ReearWrR .NO.."(L 4W
For.Nicholas&Carla Zayac
wuxo
76 Reservoir Roed
room Nodhemplon(Leeds),MA
,WwFF.R: s R.A�FORESI Associates
�,
CAN
- drplorr
Louis Hasbrouck Qhasbrouck@northamptonma.gov>
76 Reservoir Rd
1 message
Louis Hasbrouck <Iasbrouck@northamptonma.gov> Mon, Jul 8, 2019 at 2:22 PM
To: Sarah LaValley<slavalley@northamptonma.gov>
Sarah,
Here's gerath, original and latest plot plan for the pool at 76 Reservoir Rd. Let me know. Thanks.
Louis Hasbrouck
Building Commissioner
City of Northampton
Town of Williamsburg
(413)587-1240 office
(413)587-1272 fax
4 attachments
rn 76 Reservoir GEarth.pdf
2590K
76 Reservoir pool.pdf
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