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LESLIE
EDUCATIONAL ALTERNATIVES
604 COTTAGE STREET
SPRINGFIELD, MA 01104
FAX COVER SHEET
Date: November 6, 2001 Time: 11:00 AM
TO: Mr. Anthony Patillo, CBO Phone: (413) 587-1240
Northampton Building Dept. Fax: (413) 587-1272
From: Joy C. Hibsher, President Phone: (413) 737-5376
Fax: (413) 738.0127
RE: Request for Permit for 64 Crestview Florence: NEW Site Plan
No. Pages (Incl. cover): 3
MESSAGE: Tony:
I understand you talked with someone from DMR. I
hope we are now working under the correct building
code. The attached was faxed to me by my contractor.
I will call, to find out when your committee meets to
grant permits.
Thanks,
•
111
• •
• y 780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS
THE MASSACHUSETTS STATE BUILDING CODE
42Z3.3.3 Corridor walls:Corridor walls that equivalent; however, such doors shall be .,
separate use areas from exitway access equipped with approved automatic positive
corridors shall be of construction that will latching hardware and approved
resist the passage of smoke self-closing devices.
Exception Existing openings to 2. Basement/cellar:Stairways)shall be
congregate living areas, other than separated from the first floor by a 20
kitchens,shall be allowed to remain open.
minute fire rated, self-closing door or it
equivalent
427.3.3.4 Sleeping room doors:All sleeping 3. One stairway may be allowed to remain
room doors shall be of construction that will unenclosed to preserve functional and
resist the passage of smoke All doors shall be aesthetic requirements.
equipped with approved positive latching
427.3.3.7 Door widths:No single egress door
hardware and approved self-closing devices. in a doorway shall be less than 28 inches
Exceptions: wide
1. Sleeping room doors may be equipped Exceptions:
with approved hold-open smoke activated
1. Exitway door leaves shall not be less
devices in accordance with 780 CMR than 34 inches wide
1017.0. 2. Door leaves to resident bedrooms
2. Hollow core doors shall not be occupied by residents who are classified as
permitted "Impaired" shall not be less than 34
42Z3.3.5 Means of Egress: All habitable inches wide
floors shall be provided with at least two 427.3.3.8 Basement/cellar::Basements/cellars
means of egress, located as remote as shall be provided with at least two acceptable
practicable from one another. Ddtways shall exitways, one of which shall discharge
be located to provide a safe path of travel to a directly to the outside of the building.
public way without traversing any corridor or
space exposed to an unprotected open Exception: Basement/Cellar areas with
stairway only one existing entrance from the outside
only, and used solely as a mechanical
space shall be permitted to maintain only
1. Open stairs may be used as one of the one doorway which shall be maintained
required means of egress when permitted locked as an entrance/exitway.
by 780 CMR 427.3.3.6, Exception 3.
However, in no case may both required 42Z3.3.9 Emergency escape: All sleeping
means of egress traverse the unprotected rooms shall have at least one openable
open space window or exterior door to permit smoke
2. Access to one of the required exitways control, emergency escape, or rescue A
on sleeping room floors may be through required door or window must be openable
adjoining rooms. from the inside without the use of separate
427.3.3.6 Interior exitway stairs:Every story tools,and shall comply with 780 C11Di 1010.4.
shall be provide with at least one enclosed 427.3.3.10 Means of egress lighting:Means
interior stairway which discharge directly to of egress lighting systems shall be provided in
grade or through a grade passageway to a accordance with 780 CMR 1024.0.
public way. The enclosed interior stairway(s) 427.3.3.11 Locks:Locks installed in resident
shall be of construction having a minimum sleeping room doors shall be so arranged that
fireresistance rating of one hour, properly they can be locked from the corridor side All
firestopped Spaces below the stairway(s) such locks shall be arranged to permit exit
shall be enclosed to maintain the integrity of from the room by a simple operation without
the one hour fireresistive construction of the the use of a key. Double cylinder dead bolts
stairway enclosure Stairway(s) openings requiring key operation on both sides are
shall be protected by at least Cass "B"label prohibited throughout this occupancy.
one hour fire door assemblies. 427.3.4 Interior finish: The flame spread of
New stair construction shall comply with interior finish shall be limited to Cass II in
780 CMR 1014.0. Existing stairs shall exitways or exit access corridors. Rooms shall
comply with the One- and Two-Family be permitted to have interior finish of a Cass III
Dwelling Code or as approved by the building flame spread Floor coverings shall conform to
official the requirements of 780 CMR 805.0 except that
Exceptions: carpet type floor coverings shall possess a
1. Secondary stairs not considered an critical radiant flux of 0.22 w/cm2 or greater.
exitway component may have door
openings protected by a minimum 14i inch 427.3.5 Fire suppression systems:Automatic fire
solid bonded wood core doors or suppression systems shall be provided and
106 780 CMR-Sixth Edition 2/7/97 (Effective 2/28/97)
. � 0
780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS
SPECIAL USE AND OCCUPANCY
for any occupancy other than a limited group operated after such revocation or suspension.
residence. Such revocation or suspension shall not
Exception: Dwelling unit(s) meeting the preclude the building official from instituting
requirements of 780 CMR 427.0 may be appropriate action in accordance with 780 CMR
incorporated within a building in residential 118.0.
use provided unit separation walls and •
Floor-ceiling assemblies shall serve to 427.2 New structures:All new structures shall be
completely separate the limited group constructed, equipped and maintained to the
residence and provided that one of the limited requirements of the One- and Two-Family
group residence exitways is separate from the Dwelling Code and 780 CMR 427.0, shall be
other uses. limited to two stories in height, and shall have
dwelling unit(s)limited to one story in height with
427.1.5 Plans and specifications:Plans shall be direct access to grade without steps or changes in
filed with the building official having elevation other than ramps in accordance with
jurisdiction in accordance with 780 CMR 110.0 780 CMR 11. Corridors shall be of one hour fire
for any building to be constructed as,or altered resistive construction
for use as, a limited group residence under
780 CMR 427.0. 42Z2.1 Other requirements: New structures
shall also satisfy the general requirements
427.1.6 Temporary certificate of occupancy: contained in 780 CMR 427.1 and 427.3.
Upon satisfactory compliance with the code
sections pertaining to building requirements,the 427.3 Existing structures: Existing structures of
building official shall issue a temporary any construction up to three stories or 40 feet in
certificate of occupancy in accordance with height may be converted and used for limited group
780 CMR 120.3 for a period not to exceed 90 residence occupancies. All residents classified as
days. This temporary certificate of occupancy impaired as defined in 780 CMR 427.1.2 are
specifically prohibits residents as defined in restricted to those stories having direct access to
780 CMR 427.1.2 from inhabiting the building grade without steps or changes in elevation other
overnight until the building official issues the than ramps in accordance with 780 CMR 11.
certificate of occupancy under 780 CMR
427.1.8. 427.3.1 Third-story utilization:The third story of
buildings permitted by 780 CMR 4273 may be
,, 4271.7 Rules and regulations of the licensing or only occupied by staff Other use of the third
operating agency pertaining to and including, story is restricted to heating, ventilation units
but not limited to,smoking regulations,staffing and ordinary storage. AU doors leading to non-
ratios, and resident classifications shall be resident areas shall be maintained locked
provided to the building official by the licensing
or operating agency prior to the issuance of a 4273.2 Vertical openings: Openings to such
I/I spaces as laundry chutes,dumb-waiters,heating
certificate o occu,
plenums or combustible concealed spaces shall
427.1.8 Certifu•,ate of occupancy:Certificates of be permanently blocked with one hour
occupancy shall only be issued when a license,if construction,in accordance with the provisions
appropriate, and an affidavit from the of 780 CMR 7, unless such installation is in
ff c Department of Mental Health or the Office for compliance with the pertinent provisions of other
I�../ Children, Commonwealth of Massachusetts, sections of 780 CMR.have been accepted by the building official 427.3 21 Firestopping and draftstopping:
attesting to the satisfactory compliance with the Firestopping and draftstopping shall be
applicable rules and regulations referenced in provided in accordance with 780 CMR 720.0
"1" 780 CMR 427.1.7. and the One-and Two-Family Dwelling Code
427.1.9 Certificate of inspection:Certificates of or as approved by the building official
inspection shall be issued by the building official 427.33 Exitway Details:
in accordance with 780 CMR 106.0 and Table
106. 427.3.3.1 Corridor width:The minimum clear
width of an exitway access corridor shall be
427.1.10 Failure to comply:The building official three feet
immediately upon being informed by written
report or otherwise that a building or structure Exception In new structures the minimum
or anything attached thereto or connected clear width shall be four feet
therewith is being occupied in violation of 427.3.3.2 Dead ends:In no case shall dead
780 CMR may revoke or suspend any permit, end corridors exceed 30 feet. Existing dead
license,certificate or other permission regulated end corridors, wherever possible, shall be
by 780 CMR and granted by him, and no such altered so that exitways shall be accessible in
building or structure shall be continued to be at least two different directions from all points
in corridors.
2/7/97 (Effective 2/28/97) 780 CMR- Sixth Edition 105
III
% •
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• $ 780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS
THE MASSACHUSETTS STATE BUILDING CODE
condition that would impair the satisfactory residents shall be impaired;provided,however,
operation of the equipment. that more than four such residents may be
I. All building HVAC fans shall be arranged impaired if the structure complies with 780 CMR
to automatically shut down on any general 427.2. A limited group residence shall be
alarm condition. Duct smoke detectors shall classified in the R-5 use category for code
not be required purposes.
j. Waterflow initiating devices shall be 427.1.1.1 Department of Mental Retardation
arranged to initiate an alarm condition within (DMR) Group Homes: 780 CMR 4270 shall
one minute of being activated In addition, not apply to premises operated or licensed by
provisions shall be made to control and the Department of Mental Retardation(DMR)
prevent false alarms due to water surges. pursuant to 115 CMR 7.00 and 8.00,upon the
2. Emergency Notification System: During a completion of a DMR safety assessment for
fire emergency, the emergency notification each individual and an approved safety plan
system shall sound an audible alarm in a for each location where services and supports
continuously attended location for the purpose are provided Such premises shall be treated
of initiating the evacuation plan required under as conventional R-4,R-3,R-2 and R-1 use as
780 CMR 426.15. applicable.
426.15 Evacuation Planning and Training: An 427.1.2 Definitions: The following terms shall
evacuation plan shall be submitted at the time of have the meaning indicated for the purpose of
application for a building permit as part of the 780 CMR 427.0:
required documentation pursuant to 780 CMR 1.
The Certificate of Use and Occupancy shall not be Existing building or structure: Any completed
issued until the evacuation plan has been reviewed building or structure which has been legally
and approved by the head of the fire department. occupied and/or legally used for a period of at
Any changes to the evacuation plan shall not be least five years. Structures which fail to
effected until a revised plan has been submitted to qualify with this definition shall comply with
and approved by the head of the fire department 780 CMR 427.2.
The evacuation plan shall detail procedures, define Resident:A client in need of care who resides in
roles and responsibilities of employees, and shall the limited group residence of the licensing or
include an egress plan indicating routes of travel to operation agency. Staff are not considered as
all exits. The evacuation plan shall be used to residents under the provisions of 780 CMR
ensure the safe evacuation of all customers and 427.0. The licensing agency shall classify all
employees. All employees shall be instructed and residents in one of the following three .
periodically trained with respect to their duties,as categories:
required by 527 CMR 10.25, as listed in Iced; All residents not capable of
Appendix A. self-preservation through physical, mental
and/or developmental disability and requiring .
426.16 Smoke and Heat Venting: Adequate physical assistance to exit the building. All
methods of manual heat and smoke venting shall residents under seven years of age shall be
be provided The method of operation, vent area, classified as impaired
spacing layout, construction of vents and curtain Partially impaired: All residents physically,
boards or other acceptable means of addressing mentally and/or developmentally disab led but
methods of heat and smoke venting shall be capable of exiting the limited group residence
determined by an engineering evaluation and with either supervision and/or instruction
analysis. The analysis shall be reviewed and without any physical assistance
approved by the head of the fire department and Unimpaired All residents capable of exiting
shall contain sufficient detail to evaluate the the building without physical assistance
hazard and/or supervision or instruction by staff
personnel and capable-of negotiating any
( 780 CMR 427.0 LIMITED GROUP exitway of the limited group residence.
RESIDENCE
427.1 enrra:A building license y or operated 427.1'3 Application of building code and
reference Except as may otherwise be
by the Department of Mental Health or the Office specifically provided for in 780 CMR 427.0,the
for Children, Commonwealth of Massachusetts as Massachusetts State Building Code shall apply
a limited group residence: this is a special in its entirety.
residence to include residents not capable
Exception:Chapter 34 shall not apply.
self-preservation.
427.1.1 Scope:A limited group residence shall 427.1.4 Mixed use occupancy:A limited group
have a maximum of 12 residents who are at least residence shall not be housed in a building used
four years of age. Not more than four of the
104 780 CMR-Sixth Edition 2/7/97 (Effective 2/28/97)
. j + 0
•
49 ' •
4 a
CITY OF NORTHAMPTON
MASSACHUSETTS
1.
CITY HALL
Alt 1, • r ; •■-•-• •
210 Main Street
1 at Ill Northampton, MA 01060
?.• . ..6.. rilXie
-fitt,-,12
(413)586-6950
FAX: (413) 587-1264(Main Bldg. )
FAX TRANSMITTAL
DATE: / Z/90 /
FAX TO TELEPHONE NUMBEV: / /2
TO 13c3y 1-I I.8S
FROM:
Phone Number: 413-587-1240
FAX Number: 413- 587-1272 (Annex)
RE: (0 4 (Kr'S
•
PAGES, INCLUDING THIS SHEET:
1:46,
;
V.-YE ..1•
Anthony L. Patillo, CBO
Building Commissioner
Zoning Enforcement Officer
212 Main Street-Room 100 587-1240
Northampton, MA 01060-3189 Fax 587-1272
� i �
0NUV-211-.IO101 b4 Mtl 1-'19 Le. .L. It tUULH I lUNHL 416 I. I b6L1 r b6
The basement area had two means of egress which would allow access by individuals for
laundry and/or storage. The heating system had not been inspected within tl a past year and
should be so inspected before occupancy. The Property Inspection Report y u faxed me
indicated that the circuit breakers need to be inspected with the possible goal being to add new
breakers to reduce the current load on the existing breakers. Please note that the stairs leading
to the basement from the first floor had an unusually "soft" feel to them; please have this
evaluated and corrected, if needed.
The home was equipped with interconnected smoke detectors, one located on each level of the
home. They were found to be operational on the day of the assessment. H wever it was noted
that the detector on the first floor needed to be secured to the ceiling, while he detector in the
cellar needed to be secured or replaced as evidenced by the use of duct tape around the unit.
Locks on all bedroom doors need to be disabled to afford staff access to individuals without
having to release the lock with a paperclip or matchstick. The hot water teMperature was
recorded to be 117°, well within the proper range. I understand from your 'ax that any issues
related to plumbing, wiring, and circuit breakers will be addressed prior to occupancy.
Please bear in remembrance that you will need to contact me within 10 days prior to occupancy
so that I may perform the final inspection, conduct a fire drill with the individuals, and issue
the Approval To Occupy. I congratulate you on finding such a beautiful home for individuals
to live in!
Sincerely,
patt
Gregg Shumway
Quality Enhancement Specialist
cc: Steve Saunders
Bill Zimmer
_NTV-01° 001 04 :08 Fin LtbL1t t1_11_11.ra t tu,Y , +vt
The Commonwealth of Massachusetts
,', . - ,r, Executive Office of Health & Human services
`'`'O = Department of Mental Retardation
1 ( Western Massachusetts Region
Y' Office of Quality Enhancement
436 Dwight Street, Suite 205 Gerald J.Morrissey,Jr.
Jane Governor Swift Springfield, MA 01103 Commissioner
Gov (413) 784-1339
TTY: (413) 784-1354 Teresa L. O'Hare
William D.O'Leary FAX: (413) 784-1355 Regional Director
Secretary
September 14,2001
Joy C.Hibsher
President
Leslie Educational Alternatives
604 Cottage Sheet
Springfield,MA 01104
Dear Joy,
On August 31,2001, I conducted a site feasibility assessment of a home to ated at 64 Crestview
Drive,Florence, This home was proposed for use as a Category A site providing 24-hour
five
residential supports to four individuals; one who is legally blind. The horn r'y,
bedroom structure with three edrooms on the second floor and two on the trst floor: Please be
advised that the home substantially meets regulations and codes or use as a 24-hour
residential support with the following repairs and/or modifications to the e vironment.
The living room, kitchen, and dining area are all of sufficient size and configurations to
accommodate the needs of the four individuals. The plumbing under the 1Fitchen sink was
noted to have duct tape around the drainpipes; this will require inspection and repair by a
qualified plumber. Each bedroom on the first floor was of adequate size for a single
occupancy. There were at least three means of egress from the first floor,which would
adequately serve the evacuation needs of the individuals.nder them easily ope ablee Rail�ngs onsali
attendant screen door need to be repaired so as
exterior stairs leading from the home need to be extended to at least the b ttom step. There
should be railings on both sides of these steps particularly in view of the ' dividual who has
visual impairments. Additionally all exterior exit lights must be rendered operational.
The second floor bedrooms are of adequate size and configuration for single occupancy. A
second means of egress must be achieved from t e second
bear on remembrance pllans r ingt exterior
developed to
construct a wooden fire escape from this floor,
lighting must be provided for the fire escape.
• 1
• • O .
4ONOV-01-2001 04 :07 PM LESLIE EDUCATIONAL 413 737 6321 P_01
•
LESLIE
EDUCATIONAL ALTERNATIVES
604 COTTAGE STREET
SPRINGFIELD, MA 01104
FAX COVER SHEET
Date: November 1, 2001 Time: 4:15 PM
TO: Mr. Anthony Patillo, CDO Phone: (413) 587-1240
Northampton Building Dept. Fax: (413) 587-1272
From: Joy C. Hibsher, Pr si nt Phone: (413) 737-5376
Fax: (413) 738-0127
RE: Permit for 64 Crestview, Florence: DMR Site Feasibility Assessment
No. Pages (incl. cover): 3
MESSAGE:
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11H' Property Services Westfield,MA 01086-2302
Phone(413)562-4447
October 31,2001
To Whom It May Concern:
We are requesting a permit to make the following modifications to a single-family dwelling at 64
Crestview Drive, Florence, MA.
Installation of a third stringer to the basement stairs to provide additional support.
Construct a partition wall in the master bedroom on the second floor to create a common hallway that
leads to an emergency exit. This hallway will be 36" in width; the new bedroom door will be located
approx. 2' from it's original location and increased in size to 36". The exterior door will be a 32" steel
insulated door with one window.An additional ceiling light will be installed and tied into the existing light.
The window at the fall end of the room will be reduced to 28"from 32"to allow room for the hall wall.
There will be a two level fire escape added to the right side of the structure. The first platform will be
6'x6' 6" and be 7' from grade. The top platform will be 7'x5' and be 15'from grade. Both platforms will
be constructed from 2x10 P.T. and be 16"o/c creating a 40 PSF live load capacity.The decking will be
5/4x6 and beams yiill be constructed of 3 2x10's Railings will be installed 36" high with ballasts being
no more thene�apart. There will be an exterior light installed at the top of the stairs. The columns will
be poured using sonotubes at a depth of,&. wit
The front and side handrails will be extended to the first tread and a second handrail installed off the
rear deck.
Sincerely, y�
Thomas M. Skrodzki
•
FIRC..AMER I CAN HOME INSPECT
FAX NO. : 413 568 4925 Nov. 01 2001 02:25AM P8
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SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder:--- — ---- -- — --- -------
License Number
Address Expiration Date
Signature Telephone
•
9.Reeistered Home Improvement Contractor. Not Applicable ❑
Company Name Registration Number
Address Expiration Date
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 ❑
11. - Home Owner Exemption
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 'n-�' _ _ � 7 -a- "
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SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s), Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Otherp6
Brief Description of Proposed
Work: Crec4-.ma5 & 34'' 14-0v0.3 It col i`n,--p cc. 32 E/ ;er door .fir- c. Sec (,vay of E + Secaed� r
Cstec_kkkaTd
Alteration of existing bedroom__X _Yes _No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes _i_ No
Plans Attached Roll -Sheet
6a.If New house and or addition to existing housing, complete the following:
a. Use of building:One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories? _-
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance._—_ Mascheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft.of wetlands?_ Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? 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
if f n n r T,e tip e�,r 1� -12--
I,_ )LA_C � iK0 51t\ i [S i 4Le�[t__ � ,E_cL ca 1 ti t \ _,as Owner of the subject
property
L �
hereby authorize 4'v� , r1L�__
to act on my behalf,in afl matters relative to work authorized by this building permit application.
-,rte., —/ --3
Sig ,4re of• -r Date
— — _ /44 f ` L- AIILC t'V4 as Owner/Authorized
Agent hereby dec re that the statements and infdrmation on the foregoing application are true and accurate, o the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
— C__,_-- 1& r l'ce �Qe Les Li e ( _1��r�e
Print Name
Signatur er/ gent / Date
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"PIAAMEP1CAN HOME INSPECT
40 FAX NO. ! 413 568 4925 Nov. 01 2001 02:23AM PG
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED
DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
' I This column to be filled in by I
• 1 i'suilciaks 130p.fferit-ea
1
Lot Size lei) x/6'0 >t cw"---• ii/.)0Xit.:10;e'100 1, 1
1
14/ 1
Frontage
Setbacks Front .. ..... 3Q I
Side
1: 15 R: 15 L. 15 R: 15_ I
.
Rear 3- I 1
1
Building Height 1 I
--A- I
bldg.Squarc Footage 194 Li I % i el Li Li
I I
Open Spare Footage r I %I t 1
(Lot area minus bldg&paved 7 1".-1-7 I 7 7'i 7 1 i
1 piiskiriai I I 1 1
1 ." ..i.
1 it kik 0a al R I—IS—,apa,r, Ag 3 1 1
1 1
_ L 1 I
Fill:
(volume&L)cation)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW A YES ____
IF YES,date issued;
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO e)C'-- DONT 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 X
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property?YES
No
IF YES,describe size, type and location;
• * .
212/ -� S?91/2 D cg6 _
Par )(az a
G2/
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_--ysn / S/,zjz
Chp�!
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Department use only
[E [1 w EE ci. -,Northampton Status of Permit:
11 tjj
::L iI4Ing Department Curb Cut/Driveway Permit
6-.. 1 3 1 C 2 oom 100 Main Street
1 7 ",-,1, Sewer/SePtic Availability
Water/Well Avallabilfty
1
N• hampton, MA 01060 Two Sets of Structural Plans
DEPT 01 BIRD II.:r.:■,r-587- 240 Fax 413-587-1272 Plot/Site Plans
!,
NORT4MPION MA 01060 Other Specify
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
This section to be completed by office
1.1 Property Address: ,..,
(-407 CreS4-view Dr•Nter Map d49 Lot_41C-55— _ _Unit _
,. m A /
Zone ,,, Overlay District
Pareoce. 0 t;-r___
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
■
-L--e-4- ---- jr Name(Print) --1-- 6 ti 1 L i
....... ,y,
.4 . k•-.) r rt 1 vk__42_r; tor s, Current Mailing Address: , j
fr, i K-f_s_i_ t 114fixii_vcf
zr„ _ Telephone
iTgnature — JLI:,., r j (_/il/3) 737 — 3- 3 7
2.2 Authorized Agent:
, 1
, C_c_r-r
Name(Print) Current Mailing,Address:/-f I ,i ,,,k ,A
,_. ri--- I tik,)7) .e 40 I ry /1 0/ / to it
____•"------;1- tr-y.._ _C_ - Ft___,..J.,----.A,L.,_
Signature Telephone --(q-135 7 3 7---:_c.-----"S 7
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 03 7e73 (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5.Fire Protection
6. Total=(1 +2+3+4+5) Check Number 59.4 '60—
This Section For Official Use Only
Building Permit Number WI),!)- Issued:
Signature: _ ------
Building Commissioner/Inspector of Buildings Date
Gla
gs , *02-0474
APPLICANT/CONTACT PERSON LESLIE EDUCATIONAL ALTERNATIVES
ADDRESS/PHONE 604 COTTAGE ST (413)737-5376(26)
PROPERTY LOCATION 64 CRESTVIEW DR
MAP 29 PARCEL 455 001 ZONE URA
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid ` fd 05,0---
Typeof Construction: INTERI RENOVATIONS&2ND EGRESS FROM 2ND FLR
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN MATION PRESENTED:
Approved Denied
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan OR Special Permit and Site Plan
Major Project: Site Plan OR Special Permit and 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 Comm' :'on
r ,,.s / 'i. 200
Signature of Building 0 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.
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TVIE BP-2002.0474
G1S#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:29-455 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: renovation BUILDING PERMIT
Permit# BP-2002-0474
Project# JS-2002-0719
Est. Cost:
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group:
Lot Size(sq. ft.): 10018.80 Owner: LESLIE EDUCATIONAL ALTERNATIVES
Zoning: URA Applicant: LESLIE EDUCATIONAL ALTERNATIVES
AT: 64 CRESTVIEW DR
Applicant Address: Phone: Insurance:
604 COTTAGE ST (413) 737-5376 (26)
SPRI NGFFI ELDMA01104 ISSUED ON:11/19/01 0:00:00
TO PERFORM THE FOLLOWING WORK:INTERIOR RENOVATIONS & 2ND EGRESS
FROM 2ND FLR
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 11/8/01 0:00:00 590 $50.00
212 Main Street,Phone(413)587-1240, Fax: (413)587-1272
Building Commissioner-Anthony Patillo