23D-122 (3) 186 FEDERAL ST BP-2021-1112
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23D- 122 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Above ground pool BUILDING PERMIT
Permit# BP-2021-1112
Project# JS-2021-001873
Est.Cost: $10722.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq.ft.): 20647.44 Owner: COMERFORD JOANNE M
Zoning: URB(100)/ Applicant: COMERFORD JOANNE M
AT: 186 FEDERAL ST
Applicant Address: Phone: Insurance:
186 FEDERAL ST
FLORENCEMA01062 ISSUED ON:4/20/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:ABOVE GROUND 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. if. '2 T1,
Certificate of Occupancy Signature: I
FeeType: Date Paid: Amount:
Building 4/20/2021 0:00:00 $40.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
•
File#BP-2021-1112 G- _ C3 fr
APPLICANT/CONTACT PERSON COMERFORD JOANNE M&ANN M HENNESSEY
ADDRESS/PHONE 186 FEDERAL ST FLORENCE
PROPERTY LOCATION 186 FEDERAL ST
MAP 23D PARCEL 122 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
tAt
Building Permit Filled out
Fee Paid
Tvpeof Construction: ABOVE GROUND POOL
New Construction
Non Structural interior renovations
Addition to Existing •
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
XApproved 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
[1:54/A,,s, it; a if)49/al
Srgni.ture 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.
RECEIVE
The Commonwealth of Massachusetts _ 2 FOR
Board of Building Regulations and S dash 2021
10. Massachusetts State Building Cook, 7�0 CMR MJNICIPALITY
_ USE
Building Permit Application To Construct,Repair,Iic atettrDemaliit}rlNs Revised Mar 2011
One-or Two-Family Dwelling oRTHAMP TON,MA 01060
This Section For Official Use Only
Building Permit Number: Date Applied:
o/, u,(Z 1&. • V. .2, 71% . /
BuildingOfficial(Print Name) Signature� g
SECTION 1: SITE INFORMATION
1.2 Assessors Map&Parcel Numbers
186Federal ST 3 P �dt
1.1 a Is this an accepted street?yes n no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private 0 Zone: _ Outside Flood Zone? Municipal❑ On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1
Jo ome or Florince MA 01062
Name(Print) City,State,ZIP
186Federal ST 4135591388
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg.0 Number of Units _EMI Pool
Work Above Ground Pool
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire Total All Fees: $
Suppression)
$ 10722 Check No ri Check Amount: 1 Cash Amount:
0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
Tele hone Email address D Demolition
Teddy Bear Pools & Spas 111889 02/07/2023
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
41 East Street
No.and Street Email address
Chicopee, MA 01020 413-594-2666
City/Town,State,ZIP Telephone
SECTION 6: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 O
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize Teddy Bear Pools & Spas
to act on my behalf,in all matters relative to work authorized by this building permit application.
111=1111111(Electronic Signature)
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
Stephen Otto 3/27/21
Electronic Signature)
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,fmished basement/attics,decks or porch)
Gross living area(sq.ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
CITY OF NORTHAMPTON
SETBACK PLAN
MAP: 2 3 D LOT: 1? 2
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD I �V
SSG I�CR�e��
hotiS -e_
3 SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE
The C.orruonil°€olt of Massachusetts
- Department of Indu strial.Accidents
1 Congress Street, Suite 100
tttiq"••• Bolton,%14 02114-201?
wivw.rrracs.gtn'Vtiitr
W„tkers'Compensation Insurance Affidaiiti Builders:C•ontractors'Eketririanr Plumber:.
TO BE FILED TiTTfi THE PERMEErrwGAUTHCORTIY.
Applicant Inform it ion Please Print Legibly
Nanie;`Btu:neSS 0751-15a'atl 7nd7S7artri. i K fi -e CS 41
Address: // to �'c���r.�c/ 5 f- /
Citv'StateiZip_ F/weocc ii,4 o/U62._ Phone : 9l3 crf /3
Are yen an emptayer;Check due appropriaee hcx:
Type of project(required):
:.❑I ac z scap r ais: amFlo;.roas c:part-time s.' 7.. n New construction
2.0 I am.z sc:o prop®atc:c:prz=a:::.ip aced:sea as amp ayees s ar imr for ma 8- 1 o tairig
axe•capac:rf.[Nc oe..Grir •c_p._se:mice method.]
. j I ac z hcujxaztor dama al_a arlc=z al.[Nc a x arss.ccmp.inaa:aace rag-aired.:;' g_ El-ap�0r,ha
10 0 3uii iing.addition
4.�aar a homeowner aid uti1 ka hsing cont a:tars be,rondoct all work on tea•property I u i:3
ensure that all canaacbc¢s mthar have workeas'rnmral saacm inathrme cr are:ak 11.0 Electrical repair or ar"rirtiemm
propriebmo with no a .gtcn ea. '•
12.Q..imi repair or ate
.fl I am t armaral coema^ar s.d:hay o h_-ed the auk-cca.rscoor:hated cm the attached
Than sub-ccacractior^:have mop of..• and have cc4w:s'camp.i3.u.*ance: 13.n a4:1 Wax:.
Other
6.0 We area cc:Forabcn and it:aficxs.nare exercised ilea right of ezemp ice par MGL c 14.
:12. 11(4),and we bare no erop:asz s.[Na tz-c:en`cow.= move need.:
"Any applicant that chairs boa r 1=ms:also 61l ant the sect om ke:oix diva-4.hair wc:ae •cc-pa attar Foltc:•:infarm..saaa.
9cmeouaers who submit t_s affddr.ta` r''cat flax are doing al]WAS a d than hire or_tv.de:ancactcn mast s•_anitt a near affidavit ii indicating tech
ICennactnrs the:rher 9t s hex must acaZzed as addition:thoot shozrinr the name of tha s•it-:cat-ac:ars and s z;whether cr no:t=,,a=hies sere
er lctiees If the sus-eatrac:ars hare;top.:•,a:s.r. n' must pao lone;¢ ac:ker: ca=p Fc act neker.
I errn cell 2rnp!overthat is providing'worker s'compensation ilf57471211Ce fOi rtt7•employees.. B ??c'tt is tr'v o'i C't'i"i'2d;gib site
rnft»nrtrttran
Insurance Company Name:
Policy#or Self-iris.Lic.? : &,a -anon Date:
Iola Site Add.'ess:..,.
Attach a cops of the workers' compensation polio mdeclaration page(showing the policy number and expiration date).
Failure ;ecure coverage as iequired tanner NIGL c_ 152,§25A is a crimina.violator.pgmrchable Cry a fine up to S1,500_00
ander COE- yea- tvpn.dirt.as well as civil penalties in the formofa STOP WORK OR and a fine of up to S250.00 a
day agaii-t the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
Ida her-eb►-rerrfr under the pains Old pen-al'tres of perJw'l that the infannatron provided above is mte and correct
S t : c 2 � Date:: yA_ /2_/
lane y l 3 S s (7 l 3
Of ci 7:4 Se' Do srcr+a r re to th r s as c.sr to :br'conipleteel by crrt•or town official.
C irk or Tonu: Permivlicense
I::ucize_i.uthoric,: 'c:rck oue):
1 $;aard of H*. th :. Budding I}ep cumin 3,City"Tawn Clerk 4.Electrical Inspector Plumbing Inspector
IS Other
oat ict Pet:. n Phone#:
City of Northampton
Massachusetts sot, 1-
1--
DEPARTMENT OF BUILDING INSPECTIONS iy
212 Main Street • Municipal Building tY.y �p12,
Northampton, MA 01060
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
I, 4n n /Ll_ 1te e Ss e (insert full legal name), born C •2 5-49 os(insert
month, day, year), hereby depose and state the following:
1. I am seeking a building permit pursuant to the homeowners' exemption to the permit requirements of the
Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a
parcel of land to which I hold legal title.
2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners'exemption,
does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3.
3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2:
Person(s)who owns 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 home owner.
4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for
and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work
on my parcel, I am not engaged in construction supervision in connection with any project or work involving
construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any
provision of the Massachusetts State Building Code.
5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my
parcel, I acknowledge that I am required to and will act as the supervisor for said project or work.
Signed under the pains and penalties of perjury on this Z day of Apr / , 20 2
(Signature)