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37-112 a a rt q qy 3 ' 2 v d k ° a l i, :v�rti $f 9 t : fir ,' , i ,� ".4� °h n " .`- I N „, :,,,.":„.„..,1c_75...,.„,;.,.. ,, .., ,,..._.,..:,..1-...,,,,,.,,„:„.„,..,.... ..„,.,..._____ .1 :,,i,_.,...1..1,,,,,;4.161,n,,,:r...:......,:,..„....,.:. -:--..:7,-"—_,.. "e- r ' 1, .It ' 3p t 1 l ` 3 � , _ � M s i t } $ M1 m Kz' a . a. • LL C . w 5 . • I 7 ,..), ,),(, 1 iii 5,L ''' 3st 1 t (3tooc _ , _ _ `� . QO' Q8 �00'OS TIV�fl .l8' 3, L LL L& (PS ''''...- 4%*•••,,„. ..4.4.,,,,,,,,,, a N O :' �:f ,� y BOARD OF PUBLIC WORKS DRIVEWAY PERMIT GENERAL INSTRUCTIONS AND REGULATIONS 1. A "Driveway Permit" is required in all cases where a new curb cut or an alteration to an existing curb cut is proposed on a City public way. 2. Driveway permits issued by the Board of Public Works (BPW) shall be attached to and become part of the "Building Permit" issued by the Building Inspector. 3. Prior to the issuance of a "Building Permit" the owner of any lot to be serviced by a new driveway shall apply to the BPW for a "Driveway Permit" by completing the pertinent portions of the permit (see attached). Once the location of the driveway is approved by the BPW, a building permit may be issued. 4. The Building Inspector shall not issue an "Occupancy Permit" unless the driveway to the lot has been approved by the BPW. 5. By the issuance of a driveway permit for the stated location, neither the City of Northampton nor the Department of Public Works imply that no drainage problems will result with the driveway when constructed. Properties situated or driveways installed in low lying areas in the path of the natural drainage will be subject to water problems. These problems may include water sheeting across roadways adjacent to the driveway. The City and the DPW assume no responsibility for any such drainage problems. The owner of the property is responsible for constructing and maintaining the driveway with adequate provision for natural water runoff situations. George Andrikidis, P.E. Director of Public Works Permit No. D10 -06 Conditions: Driveway Permit In lieu of plan approved by City Engineer I agree to the following added conditions: 1. I will contact the Department of Public Works and have an inspector check and approve the graded gravel base prior to paving to insure compliance with slope and location; 2. I further agree that if in the inspections any of the permit conditions are not met that I will at no expense to the City remove and replace the driveway as directed by the City Engineer. By: Pet Jim Boyle I • nstruction Note: the Public: u,i:0 Department. ,ecotantends that you provide a plan shu the proposed driveway with grades and location in the future to avoid possible expense which you will incur by not getting approval of actual plans in advance. cc: Building Inspector Permit No. D10-06 CITY OF NORTHAMPTON, MA DRIVEWAY PERMIT Date: 10/03/2005 FEE: $25.00 CHECK #: 2612 THE BOARD OF PUBLIC WORKS Driveway must be staked and house & lot number posted The undersigned respectfully petitions your honorable body for: Permission to install a driveway at 22 Ice Pond Drive Fifteen (15) foot maximum width at the street line. Gutter drainage not to be disturbed. All drainage shall be directed off the driveway surface to adjacent land and not on the existing roadway. Driveway surface to be paved as soon as possible if the grade of the proposed driveway exceeds 3% or more. Homeowners will be held responsible for any cost to the City of Northampton in the event of a washout of this driveway. By: Jim Boyle Co tion Telephone #: 413 -586- 8561, 250 -2227 Proposed Location Inspected By: /6 - S- Or Gravel Base Grade Inspected By: Final Approval THE BOARD OF PUBLIC WORKS voted that petition be granted. George Andrikidis Director of Public Works (SUBJECT TO ATTACHED CONDITION 1 & 2) cc: Building Inspector • Permit No. S10-06 SEWER CONNECTION INSPECTION REPORT Northampton Sewer Department 125 Locust St. Northampton, MA 01060 587 -1570 Date: Engineering has taken ties to service Signature Type of Service: New x Renewal Repair Pipe: Size Material Location of Installation: 22 Ice Pond Drive (Street and Number) Permit Issued To: Jim Boyle, PO Box 290, Easthampton, Ma 01027 Contractor /Developer Installing Jim Boyle Construction Service Connection: The service connection at this location was inspected by the undersigned on (Date) at and approved. (Time) I have instructed of that the installation can be backfilled. Measurements for all installation shall be listed on the back of this form. The information shall be attached to the permit on file at the Public Works Department office. \ \Smb 1 \admin \Permits \Sewer Entry \Forms \Sewer Permit.wpd Atmommomemonimminow v Permit No. S 10 -06 4. The City shall not be held liable for any open plumbing fixtures below street level. 5. The applicant and /or owner hereby agrees to pay to the City any sewer use assessments or charges as may be established under city ordinance. DATE: SIGNED: , (Applicant) Jim Boyle PO Box 290, Easthampton, Ma 01027 (Address of Applicant) 413- 250 -2227 (Telephone No. of Applicant) $ inspection fee paid 500.00 Ck # 23364 Application approved and permit issued: , DATE: 10/19/05 SIGNED: ‘17re,- /fh 4 A (Superintendent) Code of Ordinances Section 22 -41 through 22 -52 available upon request. Tie -in to sanitary main $200.00 Tie -in to sanitary service at street line $500.00 Tie -in to storm drain $100.00 \ \Smb1 \admin \Permits \Sewer Entry \Forms \Sewer Permit.wpd • Permit No. S10-06 CITY OF NORTHAMPTON, MA RESIDENTIAL OR COMMERCIAL BUILDING SEWER APPLICATION A Department of Public Works Trench Permit shall be required prior to any construction or connection activity associated with this application. To the City of NORTHAMPTON, MASSACHUSETTS: The undersigned, being the Owner of the property (Owner, Owner's Agent) located at 22 Ice Pond Drive , does hereby request a permit to install and (Number) (Street) connect a building sewer to serve the residence at said location. (Residence, Commercial Bldg., etc.) l . The applicant and /or owner shall furnish upon request of the Superintendent the estimated quantity and characteristics of waste to be discharged to the public sewer. 2. "Owner" shall mean the person holding title to the property served or to be served by the building sewer. 3. The person or firm who will perform the proposed work is Jim Boyle ,of PO Box 290, Easthampton, Ma 01027 (Name) (Address) 4. Plans and specifications for the proposed building sewer are attached hereunto as Exhibit "A ". In Consideration of the granting of this permit, the undersigned agrees: 1. To accept and abide by all provisions of the Code of Ordinances, City of Northampton, Massachusetts, Sections 22 -41 through 22 -52, and all other pertinent ordinances or regulations that may be adopted in the future. 2. To maintain the building sewer at no expense to the City. 3. To notify the Superintendent when the building sewer is ready for inspection and connection to the public sewer, but before any portion of the work is covered. Permit No. W29 -06 Permit No. WATER CONNECTION INSPECTION REPORT Northampton Water Department 237 Prospect St. Northampton, MA 01060 587 -1098 Date: Type of Service: New x Renewal Repair Pipe: Size Material Water Entry Fee Paid? Yes x No N/A Meter Size 1" Fee Paid? Yes x No N/A Location of Installation: 22 Ice Pond Drive (Street and Number) Permit Issued To: Jim Boyle, PO Box 290, Easthampton, Ma 01027 Contractor /Developer Installing Service Connection: Jim Boyle Construction The service connection at this location was inspected by the undersigned on (Date) at and approved. (Time) I have instructed of that the installation can be backfilled. Measurements for all installation shall be documented by the Water Department. The information shall be on file at the Public Works Department office. Page 3 of 3 Permit No. W29 -06 RESIDENTIAL OR COMMERCIAL BUILDING WATER ENTRY APPLICATION DATE: SIGNED: IA) (Applicant) Jim Boyl PO Box 290, Easthampton, Ma 01027 (Address of Applicant) $ 200.00 entry fee paid. Check No.: 23364 $ 200.00 meter fee paid. Check No.: 23364 Application approved and permit issued: ,� j i� �Q DATE: 10/19/05 SIGNED: ?"4")7e.-- �l o ..-41y (Director of Public Works) FEE SCHEDULE: Water Entry Permit Fee: $200.00 5/8" Meter Fee: $100.00 3/4" Meter Fee: $150.00 1" Meter Fee: $200.00 Page 2 of 3 Permit No. W29 -06 CITY OF NORTHAMPTON, MA RESIDENTIAL OR COMMERCIAL BUILDING WATER ENTRY APPLICATION A Department of Public Works Trench Permit shall be required prior to any construction or connection activity associated with this application. To the City of NORTHAMPTON, MASSACHUSETTS: The undersigned, being the Owner of the property (Owner, Owner's Agent) located at 22 Ice Pond Drive , does hereby request a permit to install and (Number) (Street) connect a 1" Water Service to the residence at said location. (Size) (Residence, Commercial Bldg., etc.) . "Owner" shall mean the person holding title to the property served or to be served by the water service. 2. The person or firm who will perform the proposed work is Jim Boyle ,of PO Box 290, Easthampton, Ma 01027 (Name) (Address) 3. Plan/Sketch and specification for the proposed water service shall be attached to permit. In Consideration of the granting of this permit, the undersigned agrees: 1. The Water Department shall make all taps to the water main. 2. WATER ENTRY PERMIT fee is $200.00. 3. Additional work performed by City forces from the water main to street line shall be paid at the prevailing labor rates and cost of material. Water Meters 5/8" $100.00 Water Meters 3/4" $150.00 Water Meters 1" $200.00 Water Meters 1.5" and above shall be purchased by the owners using city specs. 4. The Water Superintendent shall be notified for water line inspection prior to backfill of trench. CITY OF NORTHAMPTON, MA Page l of 3 Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe Sizes Heated Water Non - Circulating Runouts Circulating Mains and Runouts Temperature (F) Up to 1" Up to 1.25" 1.5" to 2.0" Over 2" 170 -180 0.5 1.0 1.5 2.0 140 -160 0.5 0.5 1.0 1.5 100 -130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range (F) 2" Runouts 1" and Less 1.25" to 2" 2.5" to 4" Heating Systems Low Pressure/Temperature 201 -250 1.0 1.5 1.5 2.0 Low Temperature 120 -200 0.5 1.0 1.0 1.5 Steam Condensate (for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water, Refrigerant, 40 -55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD (Building Department Use Only) • Materials Identification: [ ] Materials and equipment must be installed in accordance with the manufacturer's installation instructions. [ ] Materials and equipment must be identified so that compliance can be determined. [ ] Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. [ ] Insulation R- values and glazing U- factors must be clearly marked on the building plans or specifications. Duct Insulation: [ ] Ducts in unconditioned spaces must be insulated to R -5. Ducts outside the building must be insulated to R -6.5. Duct Construction: [ ] All joints, seams, and connections must be securely fastened with welds, gaskets, mastics (adhesives), mastic -plus- embedded - fabric, or tapes. Duct tape is not permitted. Exception: Continuously welded and locking -type longitudinal joints and seams on ducts operating at less than 2 in. w.g. (500 Pa). [ ] Ducts shall be supported every 10 feet or in accordance with the manufacturer's instructions. [ ] Cooling ducts with exterior insulation must be covered with a vapor retarder. [ ] Air filters are required in the return air system. [ ] The HVAC system must provide a means for balancing air and water systems. Temperature Controls: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. Service Water Heating: [ ] Water heaters with vertical pipe risers must have a heat trap on both the inlet and outlet unless the water heater has an integral heat trap or is part of a circulating system. [ ] Insulate circulating hot water pipes to the levels in Table 1. Circulating Hot Water Systems: [ ] Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: [ ] All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non - depletable sources. Pool pumps require a time clock. Heating and Cooling Piping Insulation: [ ] I HVAC piping conveying fluids above 105 ° F or chilled fluids below 55 ° F must be insulated to the I levels in Table 2. REScheck Inspection Checklist 2000 IECC REScheckSoftware Version 3.5 Release lc DATE: 10/04/05 TITLE: Colonial Garrison Bldg. Dept. Use Ceilings: [ ] 1. Ceiling 1: Flat Ceiling or Scissor Truss, R -13.0 cavity + R -31.0 continuous insulation Comments: Above -Grade Walls: [ ] 1. Wall 1: Wood Frame, 16" o.c., R -19.0 cavity + R -20.0 continuous insulation Comments: Basement Walls: [ ] 1. Basement Wall 1: Solid Concrete or Masonry, 9.0' htJ9.0' bg/0.0' insul, R -10.0 cavity + R -19.0 continuous insulation Comments: Exterior insulation must have a rigid, opaque, weather - resistant protective covering that covers the exposed (above - grade) insulation and extends at least 6 in. below grade. Windows: [ ] 1. Window 1: Vinyl Frame:Double Pane with Low -E, U- factor. 0.500 For windows without labeled U- factors, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments: Doors: [ ] 1. Door 1: Solid, U- factor: 0.100 Comments: Floors: [ ] 1. Floor 1: All -Wood Joist/Truss:Over Unconditioned Space, R -19.0 cavity + R -21.0 continuous insulation Comments: Heating and Cooling Equipment: [ ] 1. Furnace 1: Forced Hot Air, 78 AFUE or higher Make and Model Number [ ] 2. Air Conditioner 1: Electric Central Air, 10 SEER or higher Make and Model Number Air Leakage: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] Recessed lights must be 1) Type IC rated, or 2) installed inside an appropriate air -tight assembly with a 0.5" clearance from combustible materials. If non -IC rated, the fixture must be installed with a 3" clearance from insulation. Vapor Retarder: [ ] Required on the warm -in- winter side of all non - vented framed ceilings, walls, and floors. Permit Number REScheck Compliance Certificate Checked By/Date 2000 IECC RES checkSoftware Version 3.5 Release lc Data filename: C:\Program Files \Check\REScheck\22 Ice Pond Drive.rck TITLE: Colonial Garrison CITY: Northampton STATE: Massachusetts HDD: 6404 CONSTRUCTION TYPE: Single Family DATE: 10/04/05 DATE OF PLANS: 2000 PROJECT INFORMATION: 22 Ice Pond Drive Northampton, MA 01060 COMPANY INFORMATION: Jim Boyle Construction James Boyle P.O. Box 290 Easthampton, MA 01027 COMPLIANCE: Passes Maximum UA = 289 Your Home UA = 263 9.0% Better Than Code (UA) Gross Glazing Area or Cavity Cont. or Door Perimeter R -Value R -Value U- Factor UA Wall I : Wood Frame, 16" o.c. 1684 19.0 20.0 45 Door 1: Solid 50 0.100 5 Window 1: Vinyl Frame:Double Pane with Low -E 300 0.500 150 Basement Wall 1: Solid Concrete or Masonry 100 10.0 19.0 14 Wall height: 9.0' Depth below grade: 9.0' Insulation depth: 0.0' Floor 1: All -Wood Joist/Truss:Over Unconditioned Space 1080 19.0 21.0 25 Ceiling 1: Flat Ceiling or Scissor Truss 1080 13.0 31.0 24 Furnace 1: Forced Hot Air, 78 AFUE Air Conditioner 1: Electric Central Air, 10 SEER COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2000 IECC requirements in RES check Version 3.5 Release lc (formerly MECchec) and to comply with the mandatory requirements listed in the RES checklnspection Checklist. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE Associated Industries of Massachusetts Mutual Insurance Company Burlington, Massachusetts (800) 876 -2765 NCCI NO 26158 POLICY NO. I VWC 6009839012005 PRIOR NO. I VWC 6009839012004 ITEM 1. The Insured James Boyle Mailing Address: p 0 Box 290 Easthampton MA 01027 (No. Street Town or City County State Zip Code ® Individual ❑ Partnership ❑ Corporation ❑ Other FEIN 04- 2488563 Other workplaces not shown above: 2. The policy period is f to 07/23/2006 12:01 a.m. standard time at the insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here; MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 100,000 each employee C. Other States Insurance: Coverage Replaced By Endorsement WC 20 03 06A D. This policy includes these endorsements and schedules: SEE SCHEDULE 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating plans. All information required below is subject to verification and change by audit. Classifications Premium Basis Rates Estimated Per $100 Estimated Code Total Annual of Annual No ' Remuneration Remuneration Premium INTRA 143457 SEE EXTENSION OF INFORMATION PAGE Minimum premium $ 500.00 Total Estimated Annual Premium $ 500.00 As indicated, interim adjustments of premium shall be made: Deposit Premium $ 516.00 ® Annually ❑ Semi Annually ❑ Quarterly ❑ Monthly MA Assessment Chg. $368.00 x 4.4000% $16.00 This policy, including all endorsements, is hereby countersigned by / /� 07/06/2005 Autiwcizp4 Signature Date GOV GOV KIND PLACING CLAIM NAME SAFETY STATE CLASS AUDIT OFFICE OFFICE CHECK GROUP Finck & Perras Insurance MA 0000 2 602 6 Campus Lane WC 00 00 01 A (11 -88) Easthampton, MA 01027 Includes copyrighted material of the National Council on Compensation Insurance. used with its permission. • THE ICE POND ASSOCIATION SECTION 2D CERTIFICATE LOT 22 THE ICE POND ASSOCIATION Declarant under the Declaration of Restrictions Maintenance and Easements Agreement dated July 10, 2003 ( "Declaration ") and recorded in the Hampshire Registry of Deeds in Book 7329, Page 249, certify as follows: Description of improvements: A single family home, paved driveway seeded lawn and landscaping shown on the following plans: Owner: Jim Boyle Real Estate Location: Lot # 22 Ice Pond Drive 7 Sheets of House Plans by Design Basics Inc. #8500, Four (4) Sheets showing Exterior Finishes, Elevations, Landscape Plan and Tree Cutting Plan, submitted with house plans Qualifications: 1) no fencing is permitted at this time; 2) the submitted plans show several elements critical to the overall look of the neighborhood. No changes to the plans affecting the exterior appearance should be made without first obtaining permission. THE ICE PONDASSOCIATION By: • �� • Joann B. ' card, President COMMONWEALTH OF MASSACHUSETTS , SS. October 14, 2005 Subscribed and sworn before me this / day of October 2005 • ArAK _ /. _ _ Notary Public My Commission Expires: „2-- - 2 k, / / 0 /� Pfr • /IC 6YJ iILbYf /f'ld 0/ , ���tlk7d' /l�(fiSP.EC(F BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 006863 4, 4 Birthdate: 12/31/1945 Expires: 12/31/2005 Tr. no 10628 Restricted: 00 ! JAMES F BOYLE PO BOX 290 �i'e '°/ FASTHAMP1}N, MA 01027 Administrator Jim Boyle Real Estate ' . 413-586-8561 C: 413-250-2227 P.O. Box 290 F: 413-586-8521 Easthampton, MA 01027 * t S 00'09 dal ......, ..) TREE REMOVAL PLAN Z 0 %. 61 {7 1 # 1 GREEN / TO REMAIN , •■ • 0 4# I . /I 4 `ti 6 RED/TO BE REMOVED in .. 1 ' 1 CO '. • Oa liti (4 rr i- q L t . ' 0,04 i = 4 • o il: l it, i 0 1 I ...) ir s „, • 6 , , 0 Lo a . • 1 z- - I 1 0 1 7 0 9q GRADING AREA [ 1141 • 0 1' 1/ i 01 t • i:11 0 o rn 0 2 0_6 • • • .. ., 1 .. . ... • p- - L- "" 1 ( iP 0 - /4 I-CT -- Lt 66 0 o v i _ 7- itikek. . . _ _ _. , . 1 .....3. 0j100*C 1 i i / • ': := 1.x..! 91 i rI__52, 3-0- ,...., . . .... £00 .. 9 P r 100T _ . . IT/HMO 41 I.9Z 3“ I. ii g L, 1..G t. S .......... ...0.......1110 ...ft.... ............. .ft . . JIM BOYLE CONSTRUCTION P.O.BOX 290 EASTHAMPTOM, MA. 01027 413 -586 -8561 FAX: 413 - 586 -8521 22 ICE POND DRIVE ATTACHED: 3 SETS OF PLANS PERMIT APPLICATION PLOT PLAN ICE POND ASSOCIATION CERTIFICATE WORKMANS COMP. CERT. WATER / SEWER PERMITS DRIVEWAY PERMIT RE CHECK COMP. CERT. COPY OF LICENSE MAIN FLOOR: 1130 sq.ft. @ .50 = $565.00 SECOND FLOOR 1070 sq.ft. @ .30 = $321.00 BASEMENT & GARAGE 1657 sq.ft. @ .15 = $248.55 TOTAL PERMIT FEE $ 1134.55 ' Y 1 gtSAMp 2 (-1:1- _ _ SI w ;r $ Gify of Nort Northampton z = * .ice -il► • • I'"` � } Jt8558cliusettS ~ cR ' ""- DEPARTMENT OF BUILDING INSPECTIONS ' � __ INSPECTOR 212 Main Street • Municipal Building Northampton, MA 01060 - ,M 5,• . ei HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his /her construction sups ,'isor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends to be, a one or hvo 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 Wilding department for the City of Northampton wants -any person(s) 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 I, 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 me. - Date Address of work location r • c ct itA}! P t . • ( F �. riff of Northampto $ . ; E _ • � - DEPARTMENT OP L3UILD INSPECTIONS • 212 Main Street. Municipal Building Northampton, Mass. 01060 r' waruaI . s COi\'LPENSATZO.N D.SU AFFIDAvyr L-1 x.,,,A-97/3.s_t (Iiccns i pertnittec) with a principal place of business/residence at: 10 (122 z4LL$ 4 ie„t'7 it 2, t! i (° (phone r6 ( �d /) rJ /statrta p ) / do hereby certify, under the pains and penalties of perjury. :hat • ( ) I am an employer providing the following!worke's compensation coverage for my • employees wor dog on this job: • Z:4‘;` Vw el669835O/)oC 'ti (I�su.ranc Company) (Policy Nu--a.ir_r) (E:-pirrior. Daie) • ( ) I am a sole proprietor, general contractor or homeowner (cirde one) and have hired the cone actprs listed below wbo have the following worker's c000en_a on policies: • (Name of Co_ tracior) (Insurance Cotnpanyi ciici Nusn=x') -- (' :Jliduoo Date) (Name of Conoactor) (Insuranc CompagwPoUc Numb_r) (Expiration Date) (Name of Coai actor) (Insurancz Company /Policy Ntvrbc.r) (Expiration Date) • (Name of Contractor) (Insur Cotncaay/Policy Number) (Expiration Dale) . (mash .d.3itioco.l rbec.ilneccu.ry to o dv& ,.ofo - ra.. cc per,aiaing to .i1 eocLO:a) I am a sole proprietor and have no one worl;3ng for me. C) I am.a home owner performing all the work myself. NOTE: plc .e be acs Lz' 4. ] beman.ocra wbo =ploy poi to do r - c reau work. on . d..'dL•:g of not taro the o tai's is cebieh the boexo we r2zid.= cc CC the p-ou.36 zppurtea : n tber. ox be eiiployes under the wa fz r k - -•' Aa (G12 e-ppl;talSoo by • bomm•va fc a lie^v cc pe mix n_y evideocc tho Icy! n= of ea crploy r under dso Wor$odc Cocapocaat on Asx. I V.I.D4CTSALutt tb.e. a oc.py Cr thi, mrrma= osay b. foe- ,.nrdae to tba Dop.trtracat of lnduuicl Aeoe' offio• or traur.000 for t1t. cov•ne veiresioo gad th _t L to seas= tovcrygo , >kr section 23 A of MQL 152 can ted to the szrxisition of ciminsl p• +lrie eocca i=s of . floc or up to S 1 S OO.00 •ndror iacpr-ixiccax t or up to ooc y-1 cod a VU peasYua to 6e room ore Stop Wort - Ocdc and Gar of S100.00 • d:y s '�yirca me For d4.,'tx s -' u.c only - ,r4 PctLmt Numb= /e/a i Z 6 t.�p- -- �t 1 i ice• �"c of Lirs_u JP c r rr. Ce SECTION 8 - CONSTRUCTION SERVICES a , 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder ;J i35, ,P 7142 (6 0 0 6 F 6 S License Number 6 n l,yl1 c" /14 R_;06c.1 0 1 01 /1,17 2�o 0 Address Expiration Dat . J �- / / 7 C Telephone Reaisterec "t omeiirtprovea enfeiii tractor „ '' i„ , ; ` '''' . , Not Applicable IV Company Name Registration Number __ - -- -- Address Expiration Date Telephone SECTION 10 WORKERS' COMPENSATION INSURANCE. AFFIDAVIT (M.G.L. c..1.52,: §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 ❑ 1 Uom caner .;. . mon 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 Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature r i i - SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House M Addition ❑ . Replacement Windows Alteration(s) ❑ Roofing ED Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [[] Siding [0] Other [0] Brief Description of Proposed �' = Work: P ties / i..L.04�t /4. -- /k t i P ti r l / y O r +- P Alteration of existing bedroom Yes No Adding new bedroom L Yes No . Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet 6 a " Wei iltitiS 7 -a 4a ditia "t 6xrstltic> au ea ii ptef tiag roi ii q: a. Use of building : One Family I Two Family Other b. Number of rooms in each family unit: • Y Number of Bathrooms i c. Is there a garage attached? e d. Proposed Square footage of construction. '2_1. C` 0 Dimensions Z` e. Number of stories? f. Method of heating? /J j Fireplaces or Woodstoves _/ Number of each / k g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i v. a C' i- -/'�.p rt jai i. Is construction within 100 ft. of wetlands? A r Yes No. Is construction within 100 yr. floodplain - Yes N No j. Depth of basement or cellar floor below finished grade J k. Will building conform to the Building and Zoning regulations? c/ 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 _IL 1, ...7:„.. .. t :.. c, / I , as Owner of the subject hereby authorize ,.7 ' , }� e ' -774 to act on my • -half, in all matters relative to ✓ wor u thorized by this building permit application. ..,.7 1 /7_0A (> Signature ., owner / Date I, , as Owner/Authorized Agent , e - by clar that the .,t � e nts and information on the foregoing application are true and accurate, to the best best of of my my knowledge and • -li- . Si !n • under the pains and penal of perjury. r i j -A• /. (1 ame ■ ../0/li / .I,itt . '/ / ) 15 Signature ■er /Agent Date r Section 4. ZONING All Informatibl Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning G u . i K !` This column to be filled in by ' Building Department Lot Size / 4-ei'1 /) 6l "C) , , tO Fronta ' 0 u Setbacks Front I �)0 _ Side L: R:15— ` L: R:= , IS Rear ' %`'' Building Height — Bldg. Square Footage I'L t,(. lT t I Open Space Footage j�7�--� % - L k� �/ if i (Lot area minus bldg &paved 2, L_ ! 3 parking) # of Parking Spaces La_ - mil Fill: r ' ! , 1 (volume* Location) � / /1 /y'' ' I ' A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DON'T KNOW 0 YES 0 IF YES, date issued:: IF YES: Was the permit recorded at the Registry of Deeds? NO CD DONT KNOW 0 YES 0 IF YES: enter Book Page; and /or Document # B. Does the site contain a brook, body of water or wetlands? NO 3 DON'T KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? ' Needs to be obtained Obtained 0 , Date Issued: t C. Do any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: 's, • D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO Jc J IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading,. xcavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 , NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. ,•. ' • , * 36 I;" :-.0 , . .1: '-', . City of Northampton ''' _I u'''6- ,,. tt-t„.., -,,,,t-t -, t ,- -2,...,,,„. 4 . 1 4t4:41.t,*-Z, , -N-7.-va'A.A-1,-.1 , 1...t•Artt.- 7 - 4 4t, Building Department - - ----- ...•* 212 Main Street ,,.....' c*-'' ',V '.‘ ' ,:tiv--;713P•k---•*;•,i-ir..$„•--;14.4.1!-- .7•!--.4.3z.4tw-_,. 4 .' -. -- I --- ',- -..„....-°-' - -.-e4-...;-:.•. „trt:2 - -It--72' Room 100 .V -Ilm- Northampton, MA 01060 Tr 6 7 ; ...§trjtt'ra:tr-TI!-.:'t-z-- phone 413-587-1240 Fax 413-587-1272 Ptf citiSiteab:a*,-,- -••.1`;•. f. -- s4,..: , -.,w,*•. -- :.-..-.-.4,-.7 , - - -,-.--2-7.- - - - t,A** , ---.„ A*.z..- Other„pecttf, Tt7•)„„14?.,4t-IA-.2.:t tt-g- --5-.- -2 A,,*„1.....-w-.1?-• :::..et-4, APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION This section,to be completed by 1 .1 Property Address: . : -,.- -, " -., .. , , , - --: ,, ---"' '.-------- ,-..,:,-": - .,. . - -," - - ' -- -1 - '. ,--------- ---, - - - - ---------, - --. ----- -,-,-.):: ----- , ,,3`,„---' ' - --..-... 1 . s: - /7 -- /( I l ' P0/ /2/ . 7„Map ; '; .., --. ' Lot - "-- ' ' '.', --;.' r`..''' .. r.pnit Zone ,, , ' -: . _ Overlay District— ,IE Distract , • - - -- . „.,c,..,„ptis#12 - - t 77 --- --- .. -- 7, - ,- SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT ,- l 1 '' 2.1 Owner of Record: . 7 ".' 6071,45 ( fit, Arieltr ei oz2 Name ' nt) Current_Mailing A dress: --r r 5 / c, r/3 Zs) :,!-2,- Telephone • ...- Signa or e , .2 A•e t: , k---- 60;\ z; t) /Y b. Name / n (Print) -- Curret Mailing Address: i Signatur, '-' Telephone S :0 .., ON 3- ESTIMATED CONS UCTION COSTS •- Item - Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building . - . ,' A (a) Building Permit Fee / 0 k i -1 i 2. Electrical (b) Estimated Total Cost of j0 - r,-y) 7 S---0 0 Construction from (6) t 1 3. Plumbing Building Permit Fee i I 3 cl 4. Mechanical (HVAC) ' 5 0 (2 5. Fire Protection / i',. 6. Total=(1+2+3+4+5) / 't d C.) 01.) Check Number Thi . This Section For Official Use Only OCT 2 4 200: ... . ' Date Building Permit Number. Issued: _ Signature: ,- . ... Building Commissioner/Inspector of Buildings Date , 1 . , -, • ,- '1 , CALA- Ujhf PEC 1... ,, • ) CELA__, 150 - 2217 H • c- -gr.' Q G ti 9d g l .9C 3„ 14 r « a t S 0 - c t a► O'09 t I , CD M X19 �i r� � ;:512 ' 4 1 :7n r C:t Co 0. 77i13f7 V f / O G/ P 1 7 o(.° ( 31o o •c too o9 = 9O'oG TM3AO 1.9Z 3.I. ,LL S c File # BP- 2006 -0442 APPLICANT /CONTACT PERSON James Boyle ADDRESS/PHONE P 0 Box 290 EASTHAMPTON (413) 586 -8561 PROPERTY LOCATION 22 ICE POND DRIVE MAP 37 PARCEL 112 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST 1 ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out O« / % Of , �� ', Fee Paid Typeof Construction: CONSTRUCT 2 STORY SFH W /ATT GARAGE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 006863 3 sets of Plans / Plot Plan An ila M THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF AT I O N 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 et Commission __7ai oas Signature of Building Of icial 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. , f .\ "".0 Alassariputetts r DEPA aTM NT of BLTILD:NG INSPECTIONS —_ 222 M Street • M un i Rni'l — ° INSPECTOR 222 t . Northampton, Mass. 01 060 `' CERTIFICATE of OCCUPANCY and USE This is to certify that permission is hereby granted under 780 CMR, sixth edition of the Massachusetts State Building Code, allowing the occupancy or use of the premises or structure or part thereof located at 22 Ice Pond Drive as shown on the Assessors Page# 3 / , Lot# 112 , Zone SR in the City of Northampton, as herein specified: CONSTRUCTION TYPE(780CMR 6) 5B USE GROUP CLASSIFICATION (780 CMR 3 R4 OCCUPANT LOAD PER FLOOR (780 CMR Table 1008.12 40 PSF 30 PSF _ __ _ T,TVF T ,O�ER FI OQR (78QCMR Tab1e_160_64_ __ 40 PSF Under the following limitations, special stipulations, and /or conditions of the - permits: Issued this 1 Lii day of Ap it , Z0 06 Certificate of Occupancy and Use # BP 2006 - 0442 Authorized D- .. •.: - • t P erso $ , el Electrical IVO 4 1 .ems I Elevator , )1 ,______e) Fire r fr Plumbing Building C ( / - oQ Gas . .4111......_ , _ DPW i /' Building Commissioner 1 .:C'; ��� This certificate shall be posted by the owner, in a permanent manner and in a visible location, on all floors designated as use group H, S, M, F, or B, and in every room where practicable of use group A, I, R -1, or R -2 per requirement of 780 CMR section 120.5 Posting Structures. Building Department 413 -587 -1240 fax 413 -587 -1272 i i i I 22 ICE POND DRIVE BP- 2006 -0442 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 37 -112 CITY OF NORTHAMPTON Lot: Permit: Building BUII,DTNG PERMIT Category: Permit # BP- 2006 -0442 Project # JS- 2006 -0650 Est. Cost: $180000.00 '` Fee: $1134.55 PERMISSION IS HEREBY GRANTED TO: Const. Class: 5B Contractor: L Use Group: R4 James Boyle 006863 Lot Size(sq. ft.): 11600.00 Owner: James Boyle Toning: Applicant:` :'fin Boyle AT: 22 ICL POND DRIVE Applicant Address: Phone: Insurance: P O Box 290 (413) 586 -8561 Workers Compensation EASTHAMPTONMAO1027 - 0290 ISSUED ON :11/4/2005 0 :00 :00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 2 STORY SFH W /ATT GARAGE POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector, of Wiring D.P.W. Building Inspector Underground: i r vice: Meter: Footings:' (1 8 Rough: - .2 ' Rough:, i House # Foundation: Driveway Final: I 1,41 1S Final: '-. q Rough Frame. _ 4 � Gas: Fire Department Fireplace /Chimney: a Rough:. - - ' � 7 - ° 4 i l : Insulation: Q l< G 68 t b [,o i1 1 S Final: 4 i- V - 06 Smoke: -44-./e Final :oi< 0 THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy ems' nature: s ig . FeeType: Date Paid: Amount: _ Building 11/4/2005 0:00:00 $1134.55 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo