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48-027 (2) BP-2022-1332 66 RIDGE VIEW RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 48-027-001 CITY OF NORTHAMPTON Permit: Swimming Pool PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2022-1332 PERMISSION IS HEREBY GRANTED TO: Project# INGROUND POOL Contractor: License: Est. Cost: 216900 AQUA POOL and PATIO CO Const.Class: Exp.Date: Use Group: Owner: COHEN, PERRY L.& GOWELL, AMY Lot Size (sq.ft.) Zoning: RR Applicant: AQUA POOL & PATIO CO Applicant Address Phone: Insurance: 53 NEWBURRY RD (860)623-8374 2093838123 EAST WINDSOR, CT 06088 ISSUED ON: 10/20/2022 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 9 . �.. 0 • i L <- Fees Paid: $75.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner File #BP-2022-1332 Z-014. APPLICANT/CONTACT PERSON:AQUA POOL & PATIO CO 53 NEWBURRY RD EAST WINDSOR, CT 06088(860)623-8374 PROPERTY LOCATION 66 RIDGE VIEW RD MAP:LOT 48-027-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $75.00 Type of Construction: INGROUND POOL f^ New Construction k� Non Structural 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: v 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 61\lttAL Sign(ature of Building Official Date V / 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,Depart i ent 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 .f Planning&Development for more information. I /'- &C It., The Commonwealth of Massaclriusett.. opr ' I' F Board of Building Regulations and S S . i.rds 7 49 C ALIT' itt . Massachusetts State Building Cole,7 0 k ' P0� SE Building Permit Application To Construct,Repair,Rer Or M .I ,lish a Revis d Mar 20111I One-or Titer-Family Dwelling 1"toh.'/^asp Aq F!`T/ This Section For Official Use Only °'°souNs Building Permit Number: &1 A — /33 - Date Ap ied: r (D all 2a Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property A dr 1.2 Amrs Map&Parcel Numbers 1.1 a Is this an accepted street?yes 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 7 le0 ` l 5 ` 0.2'1 /i �, 2v ` 36,1 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private Zone: — Outside Flood Zone? Municipal 0 On site disposal system Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Perry Cohen and Amy Crowell Northampton,MA,01060 , Name(Print) City,State,ZIP 330 Elm Street 505-450-6928 PerryLCohen@Gmail.com _ 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 ❑ Demolition 0 Accessory Bldg.0 Number of Units Other Specify:Sw i vt.m 'id/. Brief Description of Proposed W 2 "Xv re%/ Ctvt � et ,,, !' f marl A 1i I --crk — Ze I f,�I,�c j " nJ f c/ , -4,41- w[ ' SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: (Labor and Materials) Official Use Only 1.Building $ .2 It, cj4 J 1. Building Permit Fee:$ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $ ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ — 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees: Check Nc Check Amount: Cash Amount: 6.Total Project Cost: $ ((�, 1 so v 0 Paid in Full 0 Outstanding Balance Due: i 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 Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 7/3 0-(27Ad 7 t , L( !"d!) E !q i • HIC Registration Number Expiration Date HIC l .any Name or HIC Registrant N` No and =-t Em address 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 [D/ce No 0 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 t. . to act on my behalf,in all matters relative to work authoriz h(by this building permit application. ,� Perry Cohen 9/28/22 Print Owner's Name(Electronic Signature) Date 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 h Ertl true and accurate to the best o' y knowledge and understanding. ---�t3 er t 1Ir11`m-ru /p‘1,1(01,001›— Print Owner's or Authorized Agent's Name tronic Sign ate 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/dvs 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished 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" 53 NEWBERRY ROAD EAST WINDSOR, CT 06088 G (860) 623- 374 4141/1 G FAX (860) 29 1033 rdi0 i� WWW.AQUAPO L.COM SERVICEQAQUAP OL.COM Department of Building Inspections 10/11/2022 212 Main Street Municipal Building Northampton, MA 01060 Dear Building Department, Enclosed please find a copy of a completed Building Permit Application for the purpose of installing a swimming pool at 66 Ridge View Rd. in Northampton. I have included a copy of the plans and specifications stamped by our engineer as well as a site plan showing the pool's location relative to the property lines septic system and well. Enclosed you will find a check in the amount of$75.00. Also enclosed are completed Construction Debris Affidavit, Workman's Compensation Insurance Affidavit,proof of Liability Insurance, Home Improvement Contractor Registration and information of the pump, filter, heater, and anti-entrapment device. If there are any questions or require any further information,please contact me on my cell at 860.883.0682. Thank you in advance for your assistance and please let me know when the permit has been approved so we can schedule the work to begin. Thank you, son Guilmette jguilmette@aquapool.com 860-883-0682 v �r Apse BioGuard. The Association of Authorized Pool Pool&Spa Professionals'" CT Reg. #HIC 503482 - MA Reg. 113981 - WC-05600-H93 - PC 679 &Spa Care Center City of Northampton • f••"' Massachusetts �,?` - DEPARTMENT OF BUILDING INSPECTIONS yi 212 Main Street • Municipal Building Northampton, MA 01060 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: vpr y 4r'ti w l L l (4Ptei 47, 0 oi 044 ..4erc a-K. Oar of-a 044_ p 464_ 4 (4i v✓r �- � Location of Facility: Ap/a A�dt P i'v 1_ 7 p. Jl tac d C/a ? The debris will be transported by: Name of Hauler: V J` ccii 1 k U' Signature of Applicant. Date: 1 . ' �y The Coninian t'ealth of Massachusetts 1L�T ---( Department of Industrial Accidents �man= A 1 Congress Street,Suite 100 • f.:= ' Boston, MA 02114-2017 w►wv mass.gov/dia 11 rollers'Compensation Insurance Alliidas it:BuildersJ(7ontractors1Electricians/Plumbers. tO SE FILET)WI III 1 IIF:I'ERMITTINt,AIITHORI 11. Xltttlicant Information © r Please Print l e ihls NihIlll' Iliustttcys Urhanuiauun ladle tdunl►: iNcy PO frtc Address: 53 M e n,.t)ert . P d+d City/State/Zip: F,'t- L4J,..,die4 CT 0Gab'8- Phone#: & )- ().3- itii Are you an employer!Cherie the appropriate hut: Type of project(required): 10 I am a car luytx with cnrpiu}.es tluil and'or pan-thee).• 7. 0 New construction IDI am a auk proprietor ur partnership and hat c err employ its w irking for Erie in B. O Remodeling any capacity.[Nu tturktxs'comp.utauranit nquind-1 30 I am a horns-owner doing all wurk myself.(No worktTs'comp.insurance nyulroi l' 9. ❑Demolition m 10 Q Building addition 4.0 I am a homeowner ner and will be hiring contra tun to conduct all wink on my property. l will cnaun that all contractors either hate workers'compensation nnaurano us an:wile I i.(J Electrical repairs or additions proprietors w ith no employees. 12.0 Plumbing repairs additions 50 I am a general contractor and I have bind the sub-cuntractun listed un the anattt..l sheet- 131:Roof repairs Thee sub-contracture have employees and hate worker'rump.utsurrrxe.• CC (� I 14.640thet c4/rt^t+a.•e3 Pov l �t�r T h.f�we area corporation and its officers hate exercised then right of exemption per NGL c "�'151§lei).and we hate no employees.INu wurkers'rump.insurance required.) 'Any applicant that charks bu.t 01 must abw fill out the section below show ins their workers'comperttation policy information. t ti nneuwnen who aubemit this.atlxlatit indicating they an doing all work and then hitt outside contractors mint aubnut a new affd.at it Salim ing tnwh. :Contractors that check this bus must attached an additional sheet sham in the name of the sub-cuntraeton and state whether in not those ambits hat e employees. lithe sub•cuntractin%hate e-n;sloyces.they Oust pre tide their workers'tonnp.policy number. l am an employer that is providin,t,'worAers'compensation insurance for my employees. Below is the policy am!job site information. Insurance Company Name: C NA CA ''t't c f i Lw, C 4J v- ,1 J-y Co. — Policy#or Self-ins.Lie.#: 70 I Da y&00 5 Expiration Date: 6 6 1 �;d c. V:u-- Co) Cut State Zip: cr'�-4atan / Yt 1� Ulan Job Site Address: 5 y/ Attach a copy of the workers'compensation policy declaration page(showing the police number and expire ion 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 ofa STOP WORK ORDER and a fine of up t S250.00 a day against the violator.A copy ot'this statement may be forwarded to the Office of Investigations of the DIA for nsurance coverage verification. 1 do hereby ' ndert Ntins and penalties of perjury that the infnrmruiurt provided above is true and corned. Sis natulc: I)a1e 5 l phonex: ‘Cl ()-. 9 rJe-C Official use ontt'. Do not►e.rite in this area,to be completed by city or town official ('its or Town: Permit/License p Issuing Authority (circle one): I. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Ins actor 6.Other Contact Person: Phone#: a AQUAPOO-01 MEVANS AcoRO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 9/27/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND 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 ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Marnie Evans NAME: Evans,Pires&Leonard 121 Roberts Street (A/C,PHONE Ext):(860)289-6816 (A/C,No): East Hartford,CT 06108 ADDRESS:mevans(evans-insurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Valley Forge Insurance Co. 20508 INSURED INSURER B:American Casualty Co. 20427 Aqua Pool&Patio,Inc. INSURERC: 53 Newberry Road INSURER D: East Windsor,CT 06088 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR iTHE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP UMITS LTR INSD WVD, (MM/DD/YYYYL_,(MM/DD/YYYY), A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 7012210019 2/1/2022 2/1/2023 DRMMGSOE a EoNoTcuED ol 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JEOT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: A AUTOMOBILE LIABILITY (Ea accideentSINGLE LIMIT $ 1,000,000 X ANY AUTO 7012210036 2/1/2022 2/1/2023 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTEO� AUOT S ONLY AUTOSp BODILY INJURY(Per accident) $ AUTOS ONLY OS yyN p ONLY PROPERTY accidentDAMAGE UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B AND EMPLOYERS ERS'LIABITIJON TY X STATUTE PER ER 7012248009 2/1/2022 2/1/2023 1,000,000 ANY EACH ACCIDENT OFFICER/MEMBER EXCLUDED?PROPRIETOR/PARTNER/EXECUTIVE N N/A E.L. $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Todd Cellura,66 Ridge View Road,Northampton,MA 01062 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P ACCORDANCE WITH THE POLICY PROVISIONS. 212 Main Street,#100 Northampton,MA 01060 -— AUTHORIZED REPRESENTATIVE ifi\OWULIA ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation Registration: 113981 AQUA POOL& PATIO, INC. Expiration: 07/22/2023 53 NEWBERRY RD E WINDSOR, CT 06088 Update Address and Return Card. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corporation before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 113981 07/22/2023 1000 Washington Street -Suite 710 AQUA POOL&PATIO,INC. Boston,MA 02118 MICHAEL A.GIANNAMORE i V\ ' /i/ - V j� ��4, 53 NEWBERRY RD / � .,, (rz • 1 E WINDSOR,CT 06088 i 4Not and without signature Undersecretary / i