11A-091 (7) Relevant items must be submitted to the building department for approvals before inspections and or CO can be
signed. Other items are intended to avoid costly issues at inspections.
Feel free to call if you have any questions. My telephone number is 587 -1240 and office hours are Monday
through Friday, 8:30 am to 4:30 pm, excepting we close for walk -ins at 12:00 noon on Wednesdays.
Thank you for your cooperation on these matters.
Chuck Miller - City of Northampton Assistant Commissioner and Zoning Enforcement
cmiller • northam •tonma.•ov
/Pr',
•
11. Windows over 72" above grade with the opening less than 24 above the finished floor shall meet the 4"
sphere rule. See 780 CMR R612.2
12. Egress and emergency escape requirements shall be strictly met.
a. Windows within 44" of floor, DH 3.3 sqft min window size, Casement 20 "x41" exception 5 sqft
at 1 floor. Minimum clear opening 20 "x24" or 24 "x20 ". 780 CMR R310.1.1
b. Two doors remote as possible at the normal level of travel, opening measured from the face of
the slab to the stop with door at 90 degrees, one 32" and one 28" minimum 78" high. 780 CMR
R311.2
c. Landing at each door 36" out and the width of the door minimum 36 ", maximum step 71/4" from
the top of the threshold and only in- swinging doors. 780 CMR R311.3
13. Stairs have critical standards, make sure you know the floor finishes when planning. Minimum tread 9 ",
maximum riser 8 % ", maximum overall variance for the run is 3/8 ", 4" sphere rule on risers, 4 3/8" on
balustrade, 6" in the triangle. Graspable rail 1 %" minimum and 2" maximum rail, height minimum 34"
maximum 38 ", required for 4 or more risers. Landing to landing constitutes a new run. Minimum 6'8"
ceiling height from nosing. 780 CMR R311.7.
14. Guards 36" minimum height above walking surface, a bench is a walking surface, required for more than
30" above floor or grade within 36 ", 4" sphere rule. See 780 CMR R312.1.
15. Educate the plumber and electrician about maximum notch and hole sizes, and placement. See 780 CMR
R502.8 and R602.6. In bearing studs holes not larger than 40% of a stud no closer than 5/8 to the edge,
In interior non - bearing studs holes not larger than 60% of a stud no closer than 5/8 to the edge, in
bearing walls if more than 50% of a plate is cut or notched a 1 %2" 16ga. strap must extend a minimum of
6" past the cut both directions and be nailed with 8 -10d per side, or holes in joist are a maximum 1/3
the depth not closer than 2" from the top or bottom. Notches are different.
16. Fire and draft stopping shall be completed before rough inspection. See 780 CMR R302.
17. Ignition barriers in place before final. See 780 CMR R316.
18. Energy aspects shall comply with the stretch energy code. See 780 CMR Appendix 115AA and 2009 IECC.
a. An initial HERS evaluation is required including insulation levels anticipated.
b. A final HERS evaluation confirming code requirements have been met including duct testing.
c. Energy information including mechanical equipment posted on the electric panel.
d. Remodeling and Additions can be completed in accordance with IECC 2009 with Energy Star
Building Option Package.
19. Vapor retarders. Although these are still in the code there are exceptions, one must understand that
there is a difference between a vapor retarder or barrier and an air barrier. An air barrier is intended to
stop air flow (convection) a vapor retarder or barrier is intended to stop molecular moisture transfer
(diffusion). A vapor retarder or barrier is effective even if there are some holes or gaps, however an air
barrier has to be absolute and complete. If air can leak through an electrical device or through a crack it
follows the path of least resistance and carries 99% of the moisture in a structure. This is evident every
time one exposes fiberglass insulation and finds black insulation, which is dirt filter out of the air moving
through the insulation. See 780 CMR R601.2 for vapor retarders and Table N1102.4.2 for air sealing
requirements.
20. Unvented attic assemblies. Hot roofs are allowed, but have specific requirements See 780 CMR R806.4.
21. Deck ledgers and post must be appropriately attached, bolts or lags. See 780 CMR R502.2.2.1 Note:
ThruLoks are engineered for post attachment supporting a railing.
22. Smoke and CO detectors as required. See 780 CMR R314 and R315.
City of Northampton
Massachusetts �fe
p' ti
DEPARTMENT OF BUILDING INSPECTIONS S
a t'
212 Main Street • Municipal Building
Northampton, MA 01060 `•'Nt ��s�
INSPECTOR
John Zieminski
8 Woodridge Circle
Hatfield, MA 01038
March 12, 2012
Subject Location: 46 Upland Road
Map Block: 11A -091
Mr Zieminski:
The plans for the Single Family Residence dated 3 -02 -12 have been approved as noted;
As of August 4 2011 the 8 Addition MA code is the 2009 IRC with MA amendments.
1. The front porch floor system will require an additional pier or larger beam.
2. Please provide LVL and truss engineering before rough insulation.
3. FYI, Garage fire wall separation only requires %2 drywall separation Table R302.6
4. Ice and Water barrier on the roof eave is required to go to 2' beyond the interior face of the exterior
wall.
5. Steps with less than an overall 30" rise are not required to meet the 4" sphere rule
As of August 4 2011 the 8 Addition MA code is the 2009 IRC with MA amendments.
The following are some generic requirements which seem to be problematic.
This is not a substitute for purchasing and reading the MA codes.
1. Structures shall conform to 780 CMR 8 addition 1 and 2 family building codes with MA amendments.
2. Grading plan for structures being constructed required. See 780 CMR R401.3 for drainage requirements.
3. Where ceiling joist are not directly connected to the rafters, rafter ties are required and must be in the
bottom 113` See 780 CMR R802.3.1. Minimum 2x4 16" OC nailed per 780 CMR Table R802.5.1(9) 4"
slope 8 -16nd common at each connection.
4. Steel straps over the ridge or 1x4 minimum collar ties are required 4' OC in the upper 113 780 CMR
R802.3.1
5. Ridge boards must be the full depth of the cut 780 CMR R802.3.
6. A complete window and header schedule is required. See 780 CMR Table R502.5 for header sizing and
number of jack studs required.
7. All framing materials which are not code prescriptive must have stamped engineering.
a. LVLs
b. I -joist and or Floor Truss
c. Roof truss
8. A braced wall plan identifying appropriate braced wall areas and braced wall method being used. See
780 CMR 602.10.
a. Garage corners and large corner window /door layout may require special solutions.
b. All corners must be appropriately attached to the foundation.
9. Ceiling heights minimum 7' for habitable spaces, 6'8" for bathrooms includes tub /shower area if a
shower head is used, 6'8" for basement without habitable space, 6'4" at beams /ducts. 780 CMR R305.1.
10. Hazardous glazing locations, within 24" of a door, or within 60" of a stair, or across from hot tubs, spas,
bathtubs within 60" if not 60" above the walking surface, and other locations. See 780 CMR R308.4
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Permit No. D02 -12
Conditions: Driveway P
In lieu of plan approved by the 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 rerriove and replace the driveway as directed by the City
Engineer.
By:
Petitioner Si' tore
Name: John Ziemmski
Address: 8 Woodridge Circle, Hatfield, MA
01038
413 -219 -3190
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.
For Commercial and Industrial applicants, a plan showing the proposed driveway with
grades, location and Planning Board permits are required.
Cc: Building Inspector
EE: $250.00
JE BOARD OF PUBLIC WOE,
riveway must be staked and house & lot numbs.
le undersigned respectfully petitions your honorable bu
,��uission to install a driveway at: 46 Upland Road, Leeds,
fteen (15) foot maximum width at the street line. Gutter drainage no, .
rainage shall be directed off the driveway surface to adjacent land and no.
Dadway. Driveway surface to be paved as soon as possible if the grade of tht.
riveway exceeds 3% or more. Homeowners will be held responsible for any cos, City
'Northampton in the event of a washout of this driveway. Code of Ordinances §35&- d 8
oviding standards for private, individual driveways as amended by the City Council
October 15, 2009, must be followed.
By: John Zieminski
Telephone: 413- 219 -3190
_'_•azure: � •
oposed Location Inspection By: OA e
fr
l l
inspected By:
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MUNICIPAL SEWER/ AVAILABILITY APPLICATION € 1> (Tw
Northampton Streets Department
125 Locust Street
Northampton, MA 01060
587 -1570
A Department of Public Works Trench Permit and Sewer Entry Permit shall be required
prior to any construction or connection activity associated with this application.
Location: `/‘„ 4a Upland Road, Leeds
Inquiry Made By: John Zieminski 413 - 219 -3190
Date of Inquiry: 7126111
Reason for New Construction
Request:
Municipal Sewer Main in Front of Location: Yes ) No
Municipal Storm Drain Available: 5 1 /2 deep Yes No k
Size of Sewer Main: (9 Material: /qC Age:
Depth of Sewer Main: 3 E 01 /1 1.s
Size of Service Connection: /l 111c? w /u
Type of Service Connection:
Tie -in to Sanitary Main Tie -in to Sanitary Stub X
7- A / Comments: pz,A. !v I S, !r "), / '`( ;.., ��,, ' ' / , , _ <- ..1/
`D&9r) ("•' l) 7 (4 D ' S'e:2 c ' ' /I77. 57 A w 1
c6 G To ' ;/c 1 c9c—r> `7 -8 (7
Note: If this availibility is for new construction, this form must be hand delivered to Building
Inspector.
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.
0-4) a-V-(
John Hal
i
Sewer Department
cc: Ned Huntley, Director DPW
Louis Hasbrouck, Building Commissioner
(5,
MUNICIPAL WATER AVAILABILITY APPLICATION
Northampton Water Department
237 Prospect St.
Northampton, MA 01060
587 -1097
A Department of Public Works Trench Permit shall be required prior to any construction or
connection activity associated with this application.
Location: 46 Upland Road, Leeds
Inquiry Made By: John Zieminski 413 - 219 -3190
Date of Inquiry: 7/26/11
Number of Type of Single Family Type of Private
Units: Unit(s): Accessory Apart. Ownership: Condo
Multi- family Rental
(Annlicant to fill out the above)
Municipal Water Main in Existing service to
Front of Location? Yes: x No: site? Yes: No X
Size of Water Main: 8" Material: Ductile Iron Age: 1991
Approximate Static Street Flow Test Conducted: Yes: No:
Pressure: 50 If done attach results
Size of Service Connection 1
Suggested Meter Size: 3/4"
Comments: The Water Department cannot guarantee adequate water pressure during peak demand
times at elevations above 320 feet.
• A corresponding water entrance fee shall be paid prior to making any connection to the municipal water
system.
• • angements of suc st . lation shall be made with the Northampton Water Department with a minimum
of 5 workin s . notif ation.
• Al wo k s al ( on .., to • orthampton Water Department specifications.
David W. Sparks, Superintendent of Water Water Entry $200.00 Meter $150.00 Radio $100.00
cc: Ned Huntley, Director
cc: Louis Hasbrouck, Building Commissioner Note: If this availability is for a new construction,
it must be hand delivered to the Building Inspector.
�i aksr :it,' i'.� ±.sE�1t. ado
0 ,0 °
4k.k
� :Q R?r±AN?7. CITY OF NORTHAMPTON, MASSACHUSETTS
` DEPARTMENT OF PUBLIC WORKS
125 Locust Street
w Northampton, MA 01060
`"+ 413- 587 -1570
Fax 413 - 587 -1576
Edward S. Huntley, P.E.
Director
ASSIGNMENT OF HOUSE NUMBER(S)
Street: Upland Road
Assessors Map: Sheet 11A Lot 91
House Number: #46 Upland Road
Date: July 22, 2011
Remarks: Reference is made to "Plan of Land in Northampton Massachusetts Surveyed
for Kathryn G. Helems" by Heritag , Inc. dated March 15, 2010. #46
Upland Road is assigned to Parcel 1 (containing 12,169± SF) on said plan. A
house number assignment for this p: cel was requested by the Applicant for
permitting purposes.
Ati /U/1 af# &. A_
J M es Lauri a, P i , T .....
if y Engineer
1
cc: Central Dispatch Board of Health
Water Division Tax Collector
Sewer Division National Grid
Streets Division Veriz,pn Telephone
Inspectors Conic ast
Assessors Colu bia Gas of Massachusetts
Police Department Post ffice (Northampton)
James Thompson (GIS) Planning Dept. Post ffice (Easthampton)
Registrar of Voters
i
Applicant: John Zieminski
8 Woodridge Circle
Hatfield, MA 01038
K:\House Numbers\
N}j,r' 2/.0
L/� it g i - i 02/V r GEORGE KOHOUT &
% --Ds /4"/-S-5' DEBRA ORGERA
L •?� BOOK 9233 PAGE 114
LINDA PATTERSON
BOOK 5524 PAGE 52
0
N 2957029.89
E 332817,45
N 2957004.40 WOODEN
E 332666.08 FENCE \ N80 "E .— 153.50 ;
r---- '-"---''-----
--' 7 __„ — 1 p-. — 78.48' 100.72'
—
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= LESLIE & MARILYN J.
Z / .-- "-, rn SKANTZ
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BOOK 4970 PAGE 173
y � 2 o ` PLAN BOOK 192 PAGE 61
Z1 N ° ' 1
Z 0 ; //
17 C 1' Y /r
a) - # 54
r x I 2 STORY
�� WIRE WOOD FRAME
F5 FE NCE HOUSE
TI, I A o
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ri PARCEL 1 PARCEL 2
AREA = AREA =
12,169± s.f. 12, 8821. s.f.
y
N 2956887.88
E 332841.43
r_ 75.00' -I - 79.35' I 100.70'
1 e 0 o — S81'11'15"W 0 0154.350 0 0 '
CHAINI.INK WOODEN `
FENCE FENCE _ J
UPLAND ROAD EDGE OF
b PUBLIC PAVEMENT
/ O O
O THIS SURVEY AND PLAN WERE PREPARED IN
RULES AND REGULATIONS OF THE REGISTERS
PROCEDURAL AND TECHNICAL STANDARDS FOR
SURVEYING IN THE COMMONWEALTH OF MASSA
3/15/10 O nu_u_94 Cjtq,l
DATE REGISTERED LAND SURVEYOR
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City of Northampton -
7
Massachusetts
w' A
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't
§ DEPARTMENT OF BUILDING INSPECTIONS e. 1 ra
,"Z , ' ' 212 Main Street • Municipal Building 0 %, '`
:: Northampton, MA 01060
INSPECTOR
Louis Hasbrouck Chuck Miller
Building Commissioner Assistant Commissioner
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his /her
construction supervisor. 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
Address of work location
` The Commonwealth of Massachusetts
.W.. rt .....� _._._. Department of Industrial Accidents
ph "'" """ Office of Investigations
f ;. =Er
. � . - 600 Washington Street
c �
M7,2 r. '" Bo ston , MA 02111 t. . w--. ,
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business /Organization/Individual): �``� f'^' 2 ` ��`�" `� ,,-;(--c
Address: —. ' . - i < c t ,/
City /State /Zip: / / c--- v / '7er Phone #: 71 -- . - 2 50 s-
Are you an employer? Check the appropriate box: Type of project (required):
1. ri I am a employer with / 4. ❑ I am a general contractor and I
employees (full and/or part- time).* have hired the sub - contractors 6. [ New construction
2. ❑ I am a sole proprietor or partner - listed on the attached sheet. 7. ❑ Remodeling
have t
t
These sub-contractors hav
ship and have no employees 8. ❑Demolition
working for me in any capacity. employees and have workers' 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.
required.] 5. n We are a corporation and its 10.0 Electrical repairs or additions
3. ❑ I am a homeowner doing all work officers have exercised their 11. ❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12. ❑ Roof repairs
insurance required.] t c. 152, § 1(4), and we have no
employees. [No workers' 13. ❑ Other
comp. insurance required.]
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the sub - contractors and state whether or not those entities have
employees. If the sub - contractors have employees, they must provide their workers' comp. policy number.
Iam an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: / S c2c e ,rte 2> 7/ t— e c .7 � i..).
Policy # or Self -ins. Lic. #: .5D O (o o 'f e% /2 2 >/ z- Expiration Date: i/y%
Job Site Address: y . C Ce - / L -r4 o ,n s City /State /Zip: ' e ' = � as r> o iv 5`3
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature: ,�---� - -.. (rt -� Date: 3 /s-
Phone #: y t 3 — 9 4 i 7 _ 7 c.0 , i'
Official use only. Do not write in this area, to be completed by city or town officiaL
City or Town: Permit/License #
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone #:
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) , ,
_ •r
New House Addition ❑ Replacement Windows Alteration(s) ❑ Roofing I I
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [0 Siding [D] Other [D]
Brief Description of Proposed f Gz� � l r/ /1 -
C:
Work: A ,vs- o
rteC9/a, -' 0E- 3 ecbt �2
ro -i - _2 .t' f l�rr
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll hef
J
al , evi; bo se anilor- aiidt�on to ezisfinq honsl.ng comp. ete thefoflowing:
a. Use of building : One Family Two Family Other
b. Number of rooms in each family unit: 7 Number of Bathrooms - r/
c. Is there a garage attached? (
d. Proposed Square footage of new construction. / 7 Dimensions 3 r 7 ° '
e. Number of stories?
f. Method of heating? / r A K Fireplaces or Woodstoves Number of each '
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction ii/ti - Op /r'4
i. Is construction within 100 ft. of wetlands? Yes X No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade S '
k. Will building conform to the Building and Zoning regulations? Yes No .
I. Septic Tank City Sewer / Private well City water Supply ri
SECTION 7a OWNERAUTHORIZATION ,TO BE COMPLET WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FQ R BUILDING PE RMI T
, as Owner of the subject
property
hereby authorize - Wit' 2- 7 d J se /
to act on my behalf, in all matters relative to work authorized by this building permit application.
3/..//
Signature of Owne Date
( 1 / `'' s ✓ / r , 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.
Print Name
� l ` (, v L 3 /
Signature of Owner /Ag- t Date
•
SECTION 8 CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : c ' 2
License Number
G Jt� v. , X /.2- 6 6 c /2
Address Expiration Date
�.. Y 3 2/ .3 /S d
Signature Telephone Z /..
e .e ._ : s�
�`�Ctegisterec7;, ome.�mprovement- Contractor , � � , ,�� . � ,,� 577 N010 jj Not Applicable ❑
Company Name Registration Number
Jv�f sf_ 2 /L "s . - 'Se /x`
Address . Expiration Date
YID 93 /i D
/f/ C ✓J 41 0 /1 h6t Cf/Z 4Y� E z e 7) Telephone
SECTION 10- 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 ❑
ifFew
11 0 1 111
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 1083.5.1.
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
•
.,
....
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
b
Existing Proposed Required ' 'Zoning*
This column o be ms t lied ""
Building D ar
Lot Size i / _ 16, G ' I / ,/67 i l , , : „, .,, , .,....,
"�*� .
Frontage s i ��
Setbacks Front i -.
Side L: ` R:' L: ?. 4 `b-1 R: /3 f A- 1______i _ _.._€
Rear
[l i
Building Height e 1 LL0
Bldg. Square Footage it % !3 /d' //, I
Open Space Footage % .gyp I
(Lot area minus bldg & paved € -- -- i c i . o { V h7' 9 1 '
parking)
# of Parking Spaces I i Orr L_—
Fill: --
I _ N : I
� I E
(volume & Location)
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DONT KNOW YES 0
IF YES, date issued: I
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 42 YES 0
IF YES: enter Book I Page! and /or Document # #1
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES 0
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 0 NO 0
IF YES, describe size, type and location: 1
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO e
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO 0
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
r • y ! e 9 � Y G ®artrpe' t use:,a .,;
= Ci ty of Northampton Sta 1 ,q e t
1 r� , ,. Building Department �u� ue a Pe
6 212 Main Street S eSe ® tt o .yalability
Room 100 W er/UUe) A d a a ®I r s _
,.1• tV ►I'rthampton, MA 01060 w• a 3 � _ .
-' 'One-413-587-1240 Fax 413- 587 -1272 P o e
�4ther 5pe�ctfy�� ,v, t
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A C� ONE OR TWO Only FAMILY DWELLING
SECTION 1 SITE. INFORMATION
This section to b e coroplete , office ;,..6,6 ,
1.1 Property Address: -
V4 l/L° Map G rt � � Lot U n i t
L l /U L
L� � j / O `, `" `` - tOverlayDistrict ,, ,,
Z N k i'i y" �.° . 4 D I %. 6 1. S`
,. ..� G "YY
'Elm St ; be s t i c - t
„ CB District ,; � , - , �- ; -
SE 2 - " PROPERTY OWNERSHIP /AUTHORIZED AG ENT
2.1 Owner of Record: / c? 6 jj, Name (Print) i C urrent Mailing Add
�� ,�!� Q
Signat ' f� /� "2 i / ,)
Telephone / / (� �...
2.2 Authorized Agent:
Name (Print) Current Mailing Address:
Signature Telephone
SECTION 3 - E STIMATED CONSTRL CTION COSTS ,
Item Estimated Cost (Dollars) to be Official Use.
completed by permit applicant .
1. Building /61 �� (a) Building Permit Fee
j
2. Electrical 0 (b) Estimated Total C .
_ :' E Constructi fr {6) of f,. .: - -
3. Plumbing f 3 U c� Building Permit Fee
4. Mechanical (HVAC) / 3 C C o
5. Fire Protection C D
6. Total = (1 + 2 + 3 + 4 + 5) C S`o U a CheckNumber �. , + 1 9 This Section For Official Use Only
Date
Building Per
mit`Number If
Issued
Signature
Building Commissioner/Inspector of Buildings bate
Qom " �
File # BP- 2012 -0762 2(�
Lia c°
APPLICANT /CONTACT PERSON JOHN ZIEMINSKI (�
ADDRESS /PHONE 8 WOODRIDGE CIRC HATFIELD (413) 247 -9014 -e))14/4f1/ �
PROPERTY LOCATION 46 UPLAND RD
MAP 11A PARCEL 091 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out �,c y�
Fee Paid /1 � 0`� � 0 / i ¢ -
Typeof Construction: CONSTRUCT 2 STORY SFH GARAGE/PORCH /DECK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 017889
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFRRMATION 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
1,
Demolitio elay
Signature of Building Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health, Conservation Commission, Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning & Development for more information.
46 UPLAND RD BP- 2012 -0762
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 11A - 091 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: New Single Family House BUILDING PERMIT
Permit # BP- 2012 -0762
Project # JS- 2012- 001343
Est. Cost: $205000.00
Fee: $1018.80 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JOHN ZIEMINSKI 017889
Lot Size(sq. ft.): 12153.24 Owner: JOHN ZIEMINSKI
Zoning: Applicant: JOHN ZIEMINSKI
AT: 46 UPLAND RD
Applicant Address: Phone: Insurance:
8 WOODRIDGE CIRC (413) 247 -9014 Workers
Compensation
HATFIELDMA01038 ISSUED ON:3/13/2012 0:00:00
TO PERFORM THE FOLLOWING WORK: CONSTRUCT 2 STORY SFH
GARAGE /PORCH /DECK
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.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 3/13/2012 0:00:00 $1018.80
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner