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`MUNICIPAL WATER AVAILABILITY APPLICATION
Northampton Water Department
237 Prospect St.
Northampton, MA 01060
587 -1098
A Department of Public Works Trench Permit shall be required prior to any construction or
connection activity associated with this application.
Location: 74 Ice Pond Drive Lot 14
Inquiry Made By: Richard Picard 413- 250 -5665
Date of Inquiry: 03/29/04
Municipal Water Main in Existing service to
Front of Location? Yes X No: site? Yes: X No:
Size of Water Main: 8" Material: DI Age: 2003
Number of Type of X Single Family Type of X Private
Units: 1 Unit(s): Accessory Apart. Ownership: Condo
Multi- family Rental
Approximate Static Street 65 Flow Test Conducted : Yes: No: X
Pressure: If done attach results
Size of Service Connection: 1"
Comments: The Water Department cannot guarantee adequate water pressure during peak demand
times at elevations above 320 feet. The City of Northampton has not accepted responsibility for the maintenance
of the water main and service connections as of this date of inquiry.
• A corresponding water entrance fee shall be paid prior to making any connection to the municipal water
system.
• Arrangements of such installation shall be made with the Northampton Water Department with a minimum of
5 working days notification.
• All work shall confor o Northampton Water Department specifications.
1 1Jk
�• c r
David W. Sparks, Superintendent of Water
cc: Ned Huntley, Asst. City Engineer
. MUNICIPAL SEWI AILABILITY APPLICATION
Northampton Streets Department
125 Locust Street
' Northampton, MA 01060
587 -1570
A Department of Public Works Trench Permit shall be require
prior to any construction or connection activity associated with this application.
Location: 74 Ice Pond Drive Lot 14
Inquiry Made By: Richard Picard 413 - 250 -5665
Date of Inquiry: 03/29/04
Municipal Sewer Main in Front of Location: Yes X No
Municipal Storm Drain Available: Yes X No
Size of Sewer Main: 8" Material: P.V.C. Age: New in
2003
Depth of Sewer Main: 5.5'
Size of Service Connection: 6" P.V.C.
Comments: . The City of Northampton has not accepted responsibility for the
maintenance of the sewer main and service connections as of this date of inquiry.
A corresponding "sewer entrance fee" shall be paid prior to making any connection to the
municipal sewer system. Arrangements of such installation shall be made with the Northampton
Streets Department with a minimum of 5 working days notification. All work shall conform to
Northampton Streets Department specifications.
Q Storm Drain Concurrence
• /J .� T 12 '0 It
Joseph Thomas, Superintendent Douglas McDonald, Enviromental Planner
Streets Department Engineering Department
cc: Ned Huntley, City Engineer
.5. 9 9.S o$7 tw
** li")..VZ14Th
,SADC 11/40% 0 --
o 40,,1
* VA 6A4A 4 :ZIC)lti
6,8 :3 Qt444,&1 ,N7
k 446.
*MOO yoe,-
1
(SUBJECT TO ATTACHED CONDITION 1 & 2)
D47 -04
Permit No.
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: �.
Petitioner
Richard Picard 413 - 250 -5665
Note: The Public Works Department recommends that you provide a plan showing 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. D47 -04
CITY OF NORTHAMPTON, MA
DRIVEWAY PERMIT
Date: March 29, 2004
FEE: $25.00 CHECK #: 6734
THE BOARD OF PUBLIC WORKS
The undersigned respectfully petitions your honorable body for:
Permission to install a driveway at 74 Ice Pond Drive Lot 14
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: S2_, °
Richard Picard
P.O. Box 60395 Florence, MA 01062
Telephone #: 413 - 250 -5665
Proposed Location —
Inspected By: &b/w/44D ( ./13-7j
Gravel Base Grade
Inspected By:
Final Approval
THE BOARD OF PUBLIC WORKS voted that petition be granted.
George Andrikidis
Director of Public Works
PIPE SIZES (in.)
NON- CIRCULATING I CIRCULATING MAINS & RUNOUTS
I HEATED WATER TEMP (F): RUNOUTS 0 -1" I 0 -1.25" 1.5 -2.0" 2.0 +"
170 -180 0.5 I 1.0 1.5 2.0
140 -160 0.5 I 0.5 1.0 1.5
I 100 -130 0.5 I 0.5 0.5 1.0
- -- -NOTES TO FIELD (Building Department Use Only)
C
VAPOR RETARDER:
I [ ] I Required on the warm -in- winter side of all non- vented framed
ceilings, walls, and floors.
I MATERIALS IDENTIFICATION:
[ ] I 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, glazing U- values, and heating and
I cooling equipment efficiency must be clearly marked on the building
plans or specifications.
I DUCT INSULATION:
[ ] Ducts shall be insulated per Table J4.4.7.1.
DUCT CONSTRUCTION:
[ ] I All accessible joints, seams, and connections of supply and return
I ductwork located outside conditioned space, including stud bays or
I joist cavities /spaces used to transport air, shall be sealed
I using mastic and fibrous backing tape installed according to the
I manufacturer's installation instructions. Mesh tape may be
I omitted where gaps are less than 1/8 inch. Duct tape is not
permitted. The HVAC system must provide a means for balancing
I air and water systems.
TEMPERATURE CONTROLS:
[ ] I Thermostats are required for each separate HVAC system. A manual
I or automatic means to partially restrict or shut off the heating
and /or cooling input to each zone or floor shall be provided.
I HVAC EQUIPMENT SIZING:
[ ] I Rated output capacity of the heating /cooling system is
I not greater than 125% of the design load as specified
I in Sections 780CMR 1310 and J4.4.
[ ] I SWIMMING POOLS:
All heated swimming pools must have an on /off heater switch and
I require a cover unless over 20% of the heating energy is from
I non - depletable sources. Pool pumps require a time clock.
[ ] I HVAC PIPING INSULATION:
I HVAC piping conveying fluids above 120 F or chilled fluids
I below 55 F must be insulated to the following levels (in.):
PIPE SIZES (in.)
I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0 -1" 1.25 -2" 2.5 -4"
I Low pressure /temp. 201 -250 1.0 1.5 1.5 2.0
I Low temperature 120 -200 0.5 1.0 1.0 1.5
Steam condensate any 1.0 1.0 1.5 2.0
COOLING SYSTEMS:
I Chilled water or 40 -55 0.5 0.5 0.75 1.0
refrigerant below 40 1.0 1.0 1.5 1.5
[ ] I CIRCULATING HOT WATER SYSTEMS:
I Insulate circulating hot water pipes to the following levels (in.):
MAScheck INSPECTION CHECKLIST
f Massachusetts Energy Code
MAScheck Software Version 2.01
Richard and Joann Picard
DATE: 4 -1 -2004
Bldg.!
Dept.
Use !
CEILINGS:
[ ] I 1. R -38
I Comments /Location
I WALLS:
[ ] I 1. Wood Frame, 24" O.C., R -19
I Comments /Location
BASEMENT WALLS:
[ ] I 1. Conc. 8.0' ht /7.0' bg /0.0' insul, R -0 (uninsulated)
! Comments /Location
I WINDOWS AND GLASS DOORS:
[ ] I 1. U- value: 0.3
! For windows without labeled U- values, describe features:
# Panes Frame Type Thermal Break? [ ] Yes [ ] No
! Comments /Location
DOORS:
[ ] ! 1. U- value: 0.5
Comments /Location
FLOORS:
[ ] I 1. Over Unconditioned Space, R -30
Comments /Location
! HVAC EQUIPMENT:
[ ] I 1. Boiler, 94.2 AFUE or higher
Make and Model Number
[ ] I 2. Air Conditioner, 12.0 SEER or higher
! Make and Model Number
AIR LEAKAGE:
[ ] I Joints, penetrations, and all other such openings in the building
I envelope that are sources of air leakage must be sealed. When
! installed in the building envelope, recessed lighting fixtures
! shall meet one of the following requirements:
( 1. Type IC rated, manufactured with no penetrations between the
inside of the recessed fixture and ceiling cavity and sealed or
gasketed to prevent air leakage into the unconditioned space.
2. Type IC rated, in accordance with Standard ASTM E 283, with no
! more than 2.0 cfm (0.944 L /s) air movement from the the
I conditioned space to the ceiling cavity. The lighting fixture
! shall have been tested at 75 PA or 1.57 lbs /ft2 pressure
! difference and shall be labeled.
I I
MAScheck COMPLIANCE REPORT I I
Massachusetts Energy Code I Permit #
MAScheck Software Version 2.01 I I
I I
I Checked by /Date
I I
CITY: Northampton
STATE: Massachusetts
HDD: 6404
CONSTRUCTION TYPE: 1 or 2 Family, Detached
HEATING SYSTEM TYPE: Other (Non - Electric Resistance)
DATE: 4 -1 -2004
DATE OF PLANS: 4/1/2004
TITLE: Richard and Joann Picard
PROJECT INFORMATION:
74 Ice Pond Drive Lot #14
Northmpton, Ma. 01060
COMPANY INFORMATION:
Richard and Joann Picard
P.O. Box 60395
Florence, Ma. 01062
Tel. 413- 250 -5665 I
COMPLIANCE:
Required A = 460
Your Ho e = 333
Area or Cavity Cont. Glazing /Door
Perimeter R -Value R -Value U -Value UA
CEILINGS 1771 38.0 0.0 53
WALLS: Wood Frame, 24" O.C. 1674 19.0 0.0 98
BSMT: Conc. 8.0' ht /7.0' bg /0.0' insul 8 0.0 0.0 2
GLAZING: Windows or Doors 341 0.300 102
DOORS 40 0.500 20
FLOORS: Over Unconditioned Space 1771 30.0 0.0 58
HVAC EQUIPMENT: Boiler, 94.2 AFUE
HVAC EQUIPMENT: Air Conditioner, 12.0 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 requirements of the Massachusetts Energy Code.
The heating load for this building, and the cooling load if appropriate,
has been determined using the applicable Standard Design Conditions found
in the Code. The HVAC equipment selected to heat or cool the building
shall be no greater than 125% of the design load as specified in
Sections 780CMR 1310 and J4.4.
Builder /Designer Date
0 .-rtt/.Yfp i3 O
r Crit� of ] P -�_
fila2stachnsetts i• 1:
DEPARTMENT OF BCJILDI INSPECTIONS A F ., q
I I I':SP[C TQ2 212 )+•fain Street A'lunicipnl Building r. ' 7 V_ ,
Nor titnnnpton, hi/us. 01060
•
Square Footage Amount
Basement @ . $.15 7 7
: 1st
Floor @
2nd Floor @ $ _30
•
1/2 Floors, Attic. Garage $_15 R 80 \ 47 —
Deck Porches $_15
2 17?
TOTAL
_�'L�'C t!c '� C G pC N D !J !C f 145:
� y l� • /�U
n V
r
tit _�� _ _) (Eit r of Nart1ia itpton _ _ Al
�� � • A 335ACl711 ett6 ^ _ :11111 =
.. '` DEPARTMENT OF BUILDING INSPECTIONS _zr! /,
INSPECTOR 212 Main Street • Municipal Building
O,y S ,y
Northampton, MA 01060
0
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 ,••or. The state defines "Homeowner" as, " Person(s)
who owns a parcel on which he /she resides or intends to be, a one or two family
dwelling, attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two -year period shall not be considered a
home owner."
The building department for the City of Northampton wants any person(s) who seek to
use the home owner exemption, to act as their own construction supervisor, to be aware
that by doing so you become responsible for compliance with state building codes
and regulations. The inspection process requires that the building department be called
to inspect work at various stages, which include foundation /footings (before backfill),
sonotube holes (before pour), a rough building inspection (before work is
concealed), insulation inspection (if required) and a final building inspection. The
building department requires these inspections before the work is concealed, failure to
secure these inspections can result in failure to obtain a certificate of occupancy
until the work can be inspected.
If the homeowner hires other trades to perform work (electrical, plumbing & gas) the
homeowner will be responsible to make sure that the trades hired secure their proper
permits in conjunction to the building permit issued, and that they get their required
inspections. Failure of the individual trades to secure the permits and inspections as
required can DELAY the project until such time as the proper permits and inspections are
made
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 to me.
Date 4- z_ -0 4
Address of work
location `.o VI. 7 =3' Q ova Of
\ ock- \o s- 0 J.S- V4..
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- Zzil.
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- — 1
; % le4, - a f ,fillazr(rfinsrfir '
="."-----' • - ._.= Z.
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,= --..,-- — ----:
--, r— DEPARTMElsri OF BjILDING INSPECTIONS • Sar.--' . •--.
. -- .... --= M -1 1. 1 : 4 =----'--- = .
%..---11=-.
212 Main Street ' Municipal Building , _—
Northampton, Mass. 01060
WORKER'S COMPENSATION 1 AFFIDAVIT
. .
I, . C.. $44..Q.C. 4 S 7 \, C.. ik..,
(li ecnstcipv.-.:
with a principal place of business/residence at:
N'''C. `'SCS Y.. G 0 1 ? `C \-1,(CS;‘‘c..:E N."•••• . (pho n e, ;401" Z.S - 54 - 4 - 5 -
-----
, . , , ,
(sti-euctv,.7,.:::.f.‘7
do hereby certify, under the pains and penalties of pffjlir\,r, that:
_..
( ) I am an employer providing the followinc: •, compensation covera',. for my
employees working on this job:
- ("Ins,Lrancz Company) (Policy Nurribcr) (Expiraion Date)
( ) I am a sole proprietor, 2:entrai c-OIVIZICT-01 Cir homeowner 'circle one) and have, hired
the contractors liste below who have the follc, -,,..-' :, comnensat,ion polic:es:
(Name of Contractor) (lasurancc, Corrioa:1 Number) (7.1x7y.rarica Date)
(Name of Contractor) (insurance Com:DariviPoiicv Nambcr) ()D:rJiration Date)
(Name of Contractor) (Irrurancrf... Coin T,:113 V FPO 1 i Cy N11.11) b.: r) (TE,Nrrat.aon Date)
(Name of Contractor) (Insurance Coir.•=y/Policy Number) (Ii:‘,:r. Date)
(miadi :,.43..-3.,:ic,-,]: :f n! 2 .^.. '.:, :7 : - ' , """:711" CK: r---•—■ n n ,;t:',:
( ) I tun a sole propriet.:01 and have, no one - ., - -,.c)1 4 ..iin for me.
( ) I am a home owner DC1 all the v,'o: ii-,
N000:: picric t, .,,,,,,ti...: -,, ‘+',...tr, c-mp i my p-n to .' n . ' "`; "- `-'-'-'
not mcce ILI-0 throe units in wt:.:thl.1 r.-r-.:-.3 ce oca t!,:. E7.--...o.-h zor.....1:::_nm1 - 11--c:o s..:-r root c-c-n_rally c'nrt5 - - b.:
cmployc-sun,-_-1.c_t- tho wnrkor'r. oo.----n-„-=._-...:tico Act (GL,152.: . mr•,-,.:::-.:::ion by a homoo‘vocr for :. tic-c oc p-.-rrnn :-.-..,.:.
lrgal ctatu; of on ccnployar uoti-e-r thc Wc‘ricceg Corr..-pcer..ation Act.
I oack.-Ita_tad that a copy of thil clatc:-...a..1 may bo fotwarcle-ti to II, 1>c1,artmcnt of Lnduatrial i ofnoo ofi,---,"-' for tlx
e°v• vcriGlick, and 1112 flulurc to r-ozztrc CON."7-11 ut. :c., 25A of Ma. 152 con Ii to the imposition of t--.-- pc-r-3.1th:_n
ooca of a r o f u p t 51,500.00 .n.:-..one impri.sont of lip to on-. rz.: t.: civil pcnallics in ll,c form cf, a Sic? ' ''' ' Crri'. 01 tr :.
fin:: ot :7100 .00 a oily tgl..ima m-...
---- ------ -- -- --- 1
For tkputinelfs.1 tioe c.oly I
Pcr mit Ntuntx:r
:), gua lure of 1,icciir,ce/Perm il,tc . - ----- k
,,,-,,..,..., •
.:.
•
SECT1ON;'S CONSTRUCTION' SERVICES •
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder :
License Number
Address Expiration Date
Signature Telephone
'. -` ®evernen u. _. �_. .. - �
•�Re �'�e"r�tl� :.om w n #racto : �- ;��;:��« ��.�t- - nT - ' Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone
•
SECTION 30'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 ❑
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 then
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 Si
�' ��'
•
SEA 0M'S A P� ONkoF?ROPOS WORK ceck�al a • o I�cable
New House NI Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ Siding [ ] Other [ ]
Brief Description of Proposed Work: ‘1...) Ati1D G �.�c'� t>G�
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative 0 Renovating unfinished basement Yes No
Plans Attached Roll • Sheet D
615 fey"erous7sla nd oar d.itio`n to exrstin housin co" rra =p °l:e eft` e fAl,lowing:
a. Use of building : One Family _ V Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms 2
c. Is there a garage attached? NO
d. Proposed Square footage of new construction. 1:7 72- bi mensions - 6 9 ) 7 '"t ZS X1'34
e. Number of stories?
f. Method of heating? u`i0 rLC�hW\ Fireplaces or Woodstoves Number of each i
g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? /`= 3
h. Type of construction W Cx..* 4 ».c
i. Is construction within .100 ft. of wetlands? Yes K No. Is construction within 100 yr. floodplain Yes - D( Nc
j. Depth of basement or cellar floor below finished grade 1 = 7 '
k. Will building conform to the Building and Zoning regulations? X Yes No .
I. Septic Tank City Sewer D‹, Private well City water Supply I<
SECS OT[7a�tf�llNAUtORfZATION TO BE COMPLETED WHEN
9� 3
O Y,IV ovtaE O 'CONTRAC'CORAPPLIES FOR BUILDING PERMIY
I, , as Owner of the subject property
hereby authorize to ac; or
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
, , as Owner/Authorized Agent
hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my
knowledge and belief.
Signed under the pains and penalties of perjury.
cZ\ c. ∎ , a ti.o P c ca
Print Name
3 ? - o3
Signature • Owner Agent Date
lr
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED
DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
e lkL1
Lot Size a 5� 0 f
7- r ter
Frontage 41, 3 . 11. Li
Setbacks Front 3 O Q
-AO
Side 40 L: Z97 R: 243 L. S< R: Zar 41Q
Rear 3U 1 �3
Building Height
20
Bldg. Square Footage % A \s 323 O
Open Space Footage
(Lot area minus bldg & paved
parking)
# of Parking Spaces 3
Fill:
(volume & Location)
A. Has a Special Pennit/Variance /Finding ever been issued for /on the site?
NO DZ DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO DZ DON'T KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued:
C. Do any signs exist on the property? YES NO D<
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ?YES
No p<
IF YES, describe size, type and location:
4
r °� CE 1 ar ® : .us-�,,x-
5
City of Northampton �� ���
Building Department �� �� z � � g ��,� �` � 11 � ,
212 Main Street
Room 100 = Y� - " i
Northampton, MA 01060 �� ��y„
phone 413 - 587 -1240 Fax 413 - 587 -1272 p
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
Ai It 2 1 _" T
SECTION 1- SITE INFORMATION
it This ethos to -be ccompiete`d"by office
1.1 Property Address " ., "; 1 ." ' ,
C5. 2 Y & d t �C -!-'27,-.1•'`.
..�' y y
�� .�-- °
•
c c ���.i(� S ?21 V f 1 � a P `
�o n ` Oved Distr
a ms t � [cistric m..g t� , CB �liSti .
SECTION "2 - PROPERTY ' OINNERSHIP1AUTHORIZE
2.1 Owner of Record:
•
�o� cN�a�� '7". atio �4�`JC� S. �'�C SL) S 40.UC)� � 'J`'l > wc��e.�c tea C'/\06
Current Mailing Address:
Name (Print)
_ 4\3 Z_ SO 6(
...,,4,,..—, 0 Telephone
Signature
2.2 Authorized Agent:
Name (Print) Current Mailing Address:
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCFION°COSTS
Item Estimated Cost (Dollars) to be Offi Use Only
completed by permit applicant
1. (a) Building Permit Fee
. Building a 1 3)000
2. Electrical 7 5��� (b) °Estimated Total Cost of
i Construction from (6)
3. Plumbing 8 OC" Building Permit Fee
i
4. Mechanical (HVAC) 06
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) 2-'37) `�°� Check Number 2 g l 3 ? 0
This Section For Official Use Only 7
Building Permit Number: /'d `� OO Date Issued:
A ����/
Signature:
Building Commissioner /Inspector of Buildings Date
File # BP- 2004 -1006
APPLICANT /CONTACT PERSON PICARD RICHARD & JOANN
ADDRESS/PHONE P 0 BOX 60395 FLORENCE (413) 250 -5665 Q
PROPERTY LOCATION 74 ICE POND DRIVE - LOT #14
MAP 37 PARCEL 104 001 ZONE SR
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out /
Fee Paid tYW LO Y) L ~r
Typeof Construction: CONSTRUCT SFH W /PORCHES /DET 28 X 25 GARAGE
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License / 3 sets of Plans / Plot Plan Q
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF ATION PRESENTED:
Ap proved 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
.V-7- O y
Signature of Building fficial 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.
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74 ICE POND DRIVE - LOT #14 BP- 2004 -1006
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 37 -104 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit # BP- 2004 -1006
Project # JS- 2004-1501
Est. Cost: $237500.00
Fee: $ 1370.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: 513 Contractor: License:
Use Group: R4 Homeowner as Contractor
Lot si7?!kcl owner: P:CARe' RI :JOANN
Zoning: SR Applicant: PICARD RICHARD RD & JO A NN
A _ T: 74 ICE POND DRIVE - LOT #14
Applicant Address: Phone: Insurance:
P 0 BOX 60395 (413) 250-5665 O_
FLORENCEMA01062 ISSUED ON :4/27/04 0 :00 :00
TO PERFORM THE FOLLOWING WORK :CONSTRUCT SFH W /PORCHES /DET 28 X25
GARAGE
POST '.'HIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: i Meter:
� � Footings:
Rough��.,' , Rough:g"),_j � , .mouse # Foundation: j - i
'� +, Dr;veway Final: IZ " ii tr �, , 7 _ 7"
Final: ,'a; -0 Final tp ✓ �r'� fl
°1 °' ,'' RoughFrame: (9k - - pt� % G
Gas: Fire Department ' Fireplace /Chimney:
Rough: :y 1 -.1:1::41x;11: Oil: 1 -.1:1::41x;11: O fit." 3 O if
• Final: ; -�' Sr�olce: Final: (' K H-1,7 O ��
THIS PERMIT MAY i OKF.D BY THE GiTY OF NORTHANMPTON UPON VIOLATL® OF
ANY OF ITS RULES AND Ize.KG:MATIONS. J `A
Certificate of Occupancy -- . _ _ i � _ Signature:
FeeTvpe• Receipt No: 1_vte Paid: Ch Eck No: Amount:
. Certificate of Occupancy for HOUSE ONLY - Pending Electrical on Garage Tem�pp E�pires 6/8/05
Building 4r_7 !? 11:06:00 674• $15/0.0U`
212 Main Street, Phone (41 3) 5:',7-124C, Fax: (413) 5S7-1.7i2
Building Commissioner - ao °.ty Patillo
74 ICE POND DRIVE= LOT #14 BP- 2004-1006
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Blocic 37 - 104= CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL C.142A)
Category: BUILDING PERMIT
Permit # BP- 20041006
Project # JS- 2004 -1501
Est. Cost: $237500.00
Fee: $1370.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: 5B Contractor: License:
Use Group: R4 Homeowner as Contractor _
Lot Size(sq. ft.): Owner: PICARD RICHARD & JOANN
Zonin c : SR Applicant: PICARD RICHARD & JOANN
AT: 74 ICE POND DRIVE - LOT #14
Applicant Address: Phone: Insurance:
P 0 BOX 60395 (413) 250-5665 O
FLORENCEMA01062 ISSUED ON :4/27/04 0 :00 :00
TO PERFORM THE FOLLOWING WORK CONSTRUCT SFH W /PORCHES /DET 28 X35
GARAGE
POST THIS _CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: L / � K Vi ,, Meter:
j d-" Footings:
Rough.fa , r f..." Rough: / House # Foundation: X
vl r Driveway Final: l,44 ' tT � �� Or g L r
Final:17-ad& Final: r r7�
14,4, '� Rough Frame: 9k 07 oy
Gas: Fire Department
Fireplace/Chimney:
Rough ¢ . Oil: Insulation: 4 kt 8 0 1 1.4
Final: ii. -17 6 4' Spoke: Final: GK 11-/
THIS PERMIT MAY riE I J OKED BY THE pi OF NORTIiAMPTON UPON VIOLAT : "►` OF
ANY OF ITS RULES AND mac:! GULATIONS. "woo
Certificate of Occupancy - Signature: _
—
FeeType: Receipt No: i :v to Paid: Ch'3ck No: Amount:
' t ` roc ri 7,3 - t gri I ' LA 'Rr
1G ding 4/271 .11 3.60 :00 6748 $1370.00
212 Main Street, Phone (413) 537-124C, Fax: (413) 587-1272
Building Commissioner .'. _sony Patillo
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