29-299 �' • "�
.,.�
� l I
.� _
7
,�_,n
{,
.: .,,
t � �,
� ,
F
- .. _ _ S
< -
{
;. � _ �
:. . i r
1
t
..
:_,
}' —.
Po.
r-..,__.
t:.
4.,'"'
I
t,.,
�..�
1
{
6
_�
a
i
i
! ��
1
x
//// ,,
i ' i
_.
_.
t
e. }. _
� � �.
-�
__
��
�:
,44
�'� ' � �,
V
3aisN C
� rn
407
NV
� 01 Ali
� o co
m � Co v
Q)* coo
Q)r
Q)
0 TT
-
-
cc:W_- -1 C,
u� � oGE1GO? o32tibS
vdc.0cun ;; a_ C u7-. _ _
��-'•��" �� St•:01="13dSP1! ,.V: t�ifl£i d 0 �-iK�d'r d�0 �'�E�"��
—=- c
�
uC,1(tlui- ?�C� T T_��zz
CIO (Z:)
N
V
� o Q
blow-
LU
C) N �
C;)
N
KSIDE C &
s
kD 04
O rI
N
OU
[+
Q4
di
N
i
IJ
r _
41 ,
� o
d, Qr-1
N
d+
N
e-A
i
1
rTf
---__--
4
1
p V r
4 Y
4
! Y
i
S
r 1
� r '
_ 2
{
t
j
f
\L},
w
ti i
i
nlJTSS33w T-1 G)CrnwxT-i-i w>w-<w o 00.-m o x r rovo T LAmn n 'O
C OCCmmmaa•-•O7ogxaN c000-i--4m--i c DDzz D a Dmmm r —00 C D o
S-•M w ZDmDD--�cAfAZ-iOT-iw�lr-9 0I 14OD-C m -1-iT-1 -i (A ufmmm O Lnw-i A z P
(A m w orr---iaOm.-aC•-•mm-nraa �-•7a 7vr r ma07� D --/ --1000 m mm :O n
-+ C \•-• \rzzWr-zZmm rr A< m r Aa m DA m m _
Dm2 v.;2;m0o00 00.• «+ A3z 0 C COVCD z 0-4-i z r
A r mK-<OM-MM=mr viOZm nwa� xC z ODA O v vaap A ;a -� o
Y-im r-im r o 0-408 m m Op
-'-'< '-" •-.G')m(n1A r D amm7C wc�3 O v vn
z ��••< mTVwMro� v?i(xi(�3•• A� M0A m -i -�.• AOD S r
G7 Dg VI�V.-.maz0 a •••. fA x.. 2 AzQ A m m S-1(A z
K N w -r -r-mO nmm>r-x -1 T -i v 1 \ \ m m N r
•o a .-m m amrom mo > o otnm n n 7C 3 A 10 P
P. r.. 3anvmaaamvm w M p o 0-•NUr \
'0 - \mr-ammm>..m 3 C of y vi rL-1 o Po a a
Wow < -r >-42Z ;0
-•-.m o c mozraD iii m z �O�W A m y 3
(n A a o 0 00 N o �
r„• DAM (A A p O P rn en O m
M 3 o P N M
•-• 3 -� 7nC a G -zi ai ton VOi D O
N (A -< N•• .� 3 m W LA
VPN nommw O A a Tz-+-..� < 2 m -1
OO v rra v m10 r -+WU(CO• •Oa + a
mm(A m DP O c r2t a
Ono nn Z OP 3 rmSOM to r
.'� --1-I n O \ S
v A;O z
c� < z
D D n
n n
•-•v < o_
O 2Z= x x r m
Z --i K o ;a v Mtn a, -4
Z + N <
^•n W
O
S r a O\ a to m A
mn
O
m D
xO n A
my
M Z A O
M
�- w n
•--i -i v r pAp a
O OK m K i
r o
A--1 O 0 0 T223300 X1-10 cm WxT-i-1 m>w<N v vv.--•m v x r rvvv T WAn n - �
N< C oCCmmmD oX=XDW room-i-imp c DDzz D D Dmmm r -00 C D o
A---+� -i zDmDD1NNZ10�1-IN�r�1N 10D< m -4 1m-i -i N Nmmm O In W-i A A 0•
N m W vrr-l-l>oM •Dc•--•MM,>>m•-•AAr r mDOA D -1 -IV V V A mm A n
-+ C_ \•-• •\rz3NrzzA3 rra n< T r_ AD m DA m m
.-••-• _
v--I�Zn Dmx vmWW (D W•• n3Z n C Cv,0W Z n�� z r
O r m«mMlTm=mr NO=W DODA7 xC Z ODn O '9 ADDO n ANx -1 O
Z•-•<--1O•--•�1SA-Irt-iT Or'h
MP m r i m r v 0-400 T T A O
-•-•< •+L7r Grm ='=00.- •-r r«. r D >MM7C Wn3 O v v1
Z AA••<A T'nA W•--•OV£L�V1NA3 m--4 •-• Ton m � �•••••• ;00> z •• A
C) DD Nav-mDzO DD••••ON x•• z 0z0 Cl) m m OWN z
N Wv -i r rAn(n ;a rA O•• - -n -1 v -1 \ \ Om m N t
A •-+fn T DTAm ArD 3 •• O O(nm n n 7; 3 A •O O•
1010 Ro r•• 3Dnvm3>>MWm N A AO•• O O oval \
•O.O ••\mr Dm AAD••m •• 3 ••C Z N N•O.OW v R. D a
WON < -1 nND-IZmT•• D A --1 -1•O%n-• A v N 3
D < ....n -1 D D 3k -( n ►• •• ••CO W 3 v 10
N A \ TO •• n T Z O m A •O
-+-+m v C Zr• D O •• T N NW r T
(n A z O O 00 N O A
-iDG N A O 001 N N O T
N m n m z z D o o D
3 < 7C a n -i -i In v
N N < N•• A 3 m
M " > v1
D < o z
-401W mnmmW O A D
0o v rr> m m•O r -U4UlCO• OD + D
mmN m D0-0 c rz O-lz D
nnW non z ••OP 3 rmOOn N r
A �1n o \ x
V A A Z < L7
c1 z A
D a C—) N z o
C.)
o zx xx r m
z < O A
v m N Ol -1
A + N <
0 n W
O D O A
A r \ D Vi m
M n m D O
X0 n A
A Z A v
M v m
A W n
A D
O O< A y Z O 0
Z D 3< v 7C
r my
M v o
a N a A
C-) -i
z -.v •0 Na W7c < A NWa a A a
O •Oa m D< D•-• m m -1A0 v m m
4 101 A 3 m --1--1 D 3 O•-•v Cl D
T 'OT 3 TA xn A O 2n•-• L7
N o D x 0 M m
•• O• -+ c) mm A m .. N
m mz m r_ --1-O O O
O v 3 3 ;0;0 Z Z Z
D O A O z • D D
I um v G1 3 3 r r O•-• Z
D T3 m •• •ON c)
ro r v •-n v rm •.
v v m D 1n
;a j j v D � xc' >Tmvn WD O C
D 2
O Z Z A N
N .... x x m z -+
V m N L'f r 'O <
o E r
O O
Z (D T
T �
O Z Z
vv A r o z m o
M A 3 (D � T '-' A
n•-• D < D
�m (D r m co D
0 r z O 3
O z D n A v
Or v m O O
T O Z
< D v
D n _
vao m� N
X'' W N N
rf D
n
T 2
C
O (n
o m
N O -i
p r o -i
Z N
v
OPD
01< r
W D
N V r <
(p o �7C
n o m z
0 o c�
D v c
v
--103
r z_
T O r D
-i >vz
n 0 A o c�v
o N
o z m
� T
v m
I v n
a 10 a v -1
1"' -1 00 m l V W A <
N � O O T
W O NW A
O O 00 n O
F a o0o n �
D N m
N N
O r N O
o D m m
o D (Ni1 T A <
N 0 r 01.001 3 z D
o
1 + m m o�0o n m
fl) ro W N W UV (n z r O m
D r o00 -1 <
v z o 00 D
n F, (D T Z r
rt v1v m O m n z
Q 0101N v D 3 '1'1 � D
e 0 0 D r o j
O A > D <
00 n z o
O m z
CD
3 10
O 00 A
10 N• A
-+ o o.i m
CD< 0o z
�"'
0 -1
ENERGY CONSERVATION APPLICATION FORM FOR
LOW-RISE RESIDENTIAL NEW CONSTRUCTION and ADDITIONS
780 C R Appendix J
Applicant Name: Site Address:
Applicant Address: (s C(1 �,lc '�F� �_ City/Town:
_i Coenf f J� A��. ( Use Group: r -
Date of Application:
Applicant Phone: )Oz Applicant Signature:
Compliance Path (check one):
❑ Prescriptive Package(Limited to 1-or 2-family wood frame buildings heated with fossil fuels only)
Package(A through KK from Table J5.2.1b): Heating Degree Days (HDD65) from Table J5.2.1a:
(For items d.through i., fill in all values that apply from Table J5.2.Ib:)
a. Gross Wall Area sq.ft f. Wall R-value R-
b. Glazing Area' sq.ft. g. Floor R-value R-
c. Glazing% (100 x b-a) % h. Basement wall R-
i
d. Glazing U-value U- i. Slab Perimeter R-
J e. Ceiling R-value R- j. Heating AFUE
! ❑ Component Performance: "Manual Trade-Off' (Limited to wood or metal framed buildings only)
l�
Climate Zone(from Figure J6.2.2) ❑ Zone 12 ❑ Zone 13 Zone 14
i
' Attach Trade-Off Worksheet from Appendix J, [and HVAC Trade-Off Worksheet, if applicable]
s
❑ MAScheck Software
Attach Compliance Report and Inspection Checklist printouts
❑ Home Energy Rating System Evaluation
Attach Home Energy Rating Certificate (HERS rating score must be 83 or higher)
❑ Systems Analysis OR ❑ Renewable Energy Sources
Attach Mass Registered Architect or Engineer Analysis
ALTERNATIVE FOR ADDITIONS ONLY:
a. Gross Wall+Ceiling Area I� �, sq.ft. b. Glazing Area' 5 0 sq.ft. c. Glazing% (100 x b-a)
ADDITION with Glazing % (c.) up to 40% may use 780 CMR Table J1.1.2.3.1 below:
MAXIMUM U-value MINIMUM R-Values
Fenestration' Ceilin ' Wall Floor Basement Wall Slab Perimeter,Depth
0.39' R-37 f R-13 R-19 R-10 R-10,4 ft
i Glazing Area may be either Rough Opening or Unit dimensions.
2 Based on NFRC listing. Applies either to every unit,or to area-weighted average of all units.
3 R-30 ceiling insulation maybe used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area
(i.e.-not compressed over exterior walls,and including any access openings.)
❑ "SUNROOM"addition (greater than 40% glazing-to-wall and ceiling gross area)
Attach"Consumer Information Form" from 780 CMR Appendix B.
Official's Name: Official's Signature:
Application Approved ❑ Denied ❑ Date of Approval/Denial:
Reason(s) for Denial: (provide additional details as needed on back side)
xJOnn jo ssalppd
-ow of panssr
irwJad gurppnq agl Joj k Essaoau suonoadsur Suippnq paJrnbaJ 11E olnpagos of lltm llrm r
(uo►ldium 2utlsanbaa aanluu2rs s,luapisa.a/.aaue&o awoH)
anogE agi purlsiopun —,y I
opt,w
axe suorloodsur pue siruuad Jadoid agl sla awrl gons 1pun loofoJd agl,&V-Iad uuo partnbal
sle suorloadsm pu-e sliuuod agl asnoas of soptui l�nprnrpur agl3o amps, •suoilaadsut
pamn boa magi lag Sagl lugl'pur `panssi irw.rad guiplmq agl of uorlounfuoo ui slrwJad
Jado.ld Jragl a.inoas pwiq sappli agl l-egl a.lns a-pw of olgtsuodsaJ oq llrm mumoomoil
agl (spy a8 iurgwnld `ltouloolo)�jom wJoj-iad of sopLui m4lo som, Jaumoawoq agl3I
•palaa sur aq ut,a ilaoen aql lilun
auti n000,lo aingiliaa t, utvlgo of 5351iti3 ur llnsaa uva suorjaa sui asagl aanoas
of aanlru3 `polt,aouoo si}lJOm aql olojaq suopoodsui osagl solrnbai luowlmdop Burplinq
agi •uorlaa sub uiplinq luuy-u put, pa.rrn aaj! uorlaa sut uopulnsui poluaauoo
si )Iaom aaojaq uollaa sui uiplinq q noa .ono liolaq saloq agnlouos
IIJ3I5uq azojag s ulloo3/uoijupunol opnlour gorgm `saS-els snomn It'}(Join lbadsur of
pallvo oq luau=dop guiplmq agl jap sa.rrnbw ssaooid uorloadsur aqs •suoiluln2a.1 put,
sapoa 2uipitnq alt,is ql!M aouuildmoo.io3 algtsuodsa.i awooaq nof.os Suiop Aq lt,'gl
ammo oq of `JostnJadns umiotulsuoo umo na ll s-o lo7a of `uorldwaxa Jaumo awoq agl asn
of Maas ogm(s)uosJad Kuu siu�nn uoid=,giloX jo XiiD aql Jo3 luowlJEdop $uippnq zql
«-Jaumo awoq
pa.Iaprsuoo aq lou livgs poilQd m:DA-oml v ur awoq auo u-egl aJow slonJlswo ogm uosiod
V -saJnloruls uuuj Jo/pug asn gons of fjossaoov sa.rnlon.rls pagomap Jo pagozar `.Sutllamp
dlr:unja w.io auo v `oq of spuolur so soprsaJ aqs/ag goigm uo lao-md t, sumo ogm
(s)uOs.ra,; „ `sL' «JaumOaulOH„ sOuPp a1t,ls acly -Jos .6_.:-,Ans uotlorumoo Jail/srl sv loE
Ol VI*801 IMD08L iapun lggu aql iaumoawoq aql smolp suasngovssvw jo alvIS aqs
suaW'Jf)cr'drlMONXJV uoziaWax'A x'Junco 21WoH
1
• 09010 vw `laidum"PioN
3mppng tudcmnmW • laanS un:W ZTZ dO1J3dSN(
-I SNOIXOM I OXIQ'ling 90 LN9PVI'dVd.9Q
Br�iSlif(i1t4iH�'
0
A �ti Crii-�) of 'NTarfljuiliptolt
4 " E 51 it a a A r h n tttt a' _
DEPARTMENT OP DUILDr),,'C INSPECTIONS
212 Alain Strcet Municipal Building
Northampton, ATass, OIOGO
I NVORl"CCRIS COIATENSATTON MSURAhCE A FFMA VIT
7
wlui a principal place of business/residenee at:
(sts�tici iy/st.airli7 p)
do hereby cer6l)--, under the.pains and pen2lties o'I pe.f7ufy; hit
i
( ) I un an employer providing die following worker's compensado, cove Mge for Iny
etvployces worUng on this job:
i
i
(Insur-:mc-t Corer %,) (Policy Numb,--r) - (r:-piraon Dzt_)
( ) I am a sole proprietor, general contractor or homeowner (circie one) and have hued
the contractors listed+ below rrbo have the following, worker's cocpen�;YOn pc��cies:
(Namc Of Co_niMCiOr) (Insurance-Cornea i)-Robc y C"-Yp mauon D11C)
(Name of Contractor) (Last mc-- Companv/%Ucr Numbs r) D�se)
(Name of COnLCB O ) (tusura.ncc Compauy(Pobcy Numba- ) (Expiraoo Datc)
(Name of Contactor) (Insurance Commny/Policy Numbcs) k'Expitaiion D=) .
(a¢st:b at�i0ocal 6CCI.irnoc=v.v to Mcuu inrorr oo P=-L iu6 t ..11 ooar_c:e�)
( ) I am a sole proprietor and have no one worki.og for me.
I am.a home owner performing all the work myself.
NOTE:piece be awzm tti,.Mt-j.bcm,,,-o=7 to=Vloy pa,,=tc do c=,,.:c::joo cr rib work oa a d+xll--Z of
ON rnocv th..o t.tzv:-ar"is vt ich the bomeawacs road=a oo the V-O p appurtc==tbaco ere oae C-aacrany oce=daod to be
mploy-z utnCer tbe-a-l:d:oexp�oa Adz(GLI 5L=1(5)�zppU=L6on by a bamcoava rer a or permit z=y c,-idcn=tt:c
IePJ a—*Xu of at er't,lopw uoder du,Wtrkc e,Compem..Uoa Aa-
I vadcnaad 6A a O-vy of thia-tam w=auy bo roe,,i d to t,. of Ind.ct..+iJ tc+admt'f M.or lra—rot the
covtsa.Sc vcriCctioa and OW L•iltae to--Lo,-Cm c undcr=C:ioo 15 A of MGL 132 cn Imd to the irN=z ioa of ci°uwd pcwJb=
com is ctg of a fzoc of up to S I-�00,00 ar.Nor 6=pr6oa:Ct or up to ooc year end ci%i7 pm.ltia is CC roan of a Stop Work Ordcr and a
rtaa of 5100.00 a day tpiag ttx
/! For GcA.rta>,— ux only
Permit Numba
-'� `��(• N113 Lot K
Signature of Lica n-,c-= Pcrmiucc `—tTe
lip
a.tn;suSIS aanMOamog
palelouuy smwj le.tauaO suosngoessew jo olels pug smeZ SutuoZ leoo7 pug olelS soouvu!pio uoldwegOlol l
�o All `opoD Sutplmg oleiS otp tp!m oouetldwoo.io3,�pgtsuodsoi soumsse pue sagtuao„aaumoawoq„pauStsiapun aL1,
Otuuad stgl iapun noX io3 iltom tutojiod of ouq nod
(s)uos.tad lo;algell aq sut no `polinouuV smeZ lg.tauag suosngoesselnl oqi jo(gleaQ ut Sutllnsat Oou satmCuI io3 saa�Coldutg
oO sizAoldwg jo Altltgg!'I)£SI iajdugD pug (uotlesuadtuoo ,s gioM)ZSI iaidugD oO aouaaa3at gl!m legl Past npe aq osld
-ponsst st Otuuad stgi golgm.to3�liom agl3o uotlaidwoo
uodn pue Suunp`ow!l of auitl woa3 pomnbaa aq 111m alts qof otg uo aouaswd moo osleaa nS uopan.t; o Bugg sy
-11tu o ul M
. n t gnus Ile ioj alglsuo sa t
aq!legs ags/aq leq; lelot33O Su!pltng atp of algg;dooae uuo3 a uo jumUUjo Sutpltng otp of j!wgns llugs ,joumootuoth,gong
•aaumoatuoq s palaplsuoa aq;ou!legs polaa .tsars-oM;a n1 awoq auo ueq;a.totu s;an.t;suoa oqM uosaa V•sainlongs
uue3.to/pus osn Bons of fjossaoog salnOangs pogoelap so pagoeue Sutllomp xjumj omi io auo a`oq of popua;ut st.to'st
alagl gotgm uo op!sai of spuolut.io soptsw ags/ag gatgm uo ptte13o laoaed a uMO ogm(s)uosaad: auMOawog;o uo;lugaQ
•i•S'£•80 uol;aas uoUjP3 qax! 08L HW '.1 sl,ua ns se
sloe.taukto aq;;sq;papinoi `asuaoil a ssassod Iou soop ogm aatq ioj lenptntput ue aSe$ua of iaumoatuoq Bons molle of pue
satlnue3(Z)Oml so (t)OUO JOSB1ajffaA&G pa! naoo-aaumo opnlout of popuolxo sem a,slaumOOwOq,,10J uotidtuaxa Ouo uno aqZ
r ILUO, xaun ,C�°a u�� •t j.
7, w<,._,, .< ... _..•,�,.
❑ ......oN ❑ .......Sek petloeUV OIAePWV pau6ls
I!uued 6ulp!!nq eq;jo eouenssl eqj jo leluap egI uI
ilnsaj p!m IlnepWe SILO apinoid of amlle3-uolOeolldde slgl gllm paO;lwgns pue palaldwoo eq Isnw JjAopWe eouensul uolOesuadwo(]sioxioM
((9)39Z§`ZSI 'o'TO—W)11AVOW"3oNt!'NnSN1 N0LLVSN3dW03,SH3)121OM-0L NO1133S
suogdelal
ale(]uogejidx3 ssaJppy
jagwnN uogejls!69a ®weN AUOUW05
❑ algeoliddy ION �o uo(]:. eutana wl atuol{
._ . . , 4t._- SAS F,
auoydolal ain;euBIS
8180 uo1je,ndx3 ssajppy
jagwnN 8sua311
a PI H MGM JO OweN
❑ algeogddV ION Joslna ng ol; n.gsuo(]pesueon 6'8
SSOIAI13S Wuon211SNO0-8 NOLL33S
SECTIONS-DESCRIPTION OF PROPOSED WORK(check all annlicable)
New House Addition ® Replacement Windows Alterations) Roofing
rra�tt Or Doors ❑
Accessory Bldg. ❑ Demolition New Signs [O] Decks [M Siding[0] Other[L7j
Brief De iption of Proposed
Wo L': "ar. ;�- a a A- q' -4,
r
A ra ion o existing droom Yes No ddr g new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
s$ 1f.Nerni fioase and or dd#of> o eitistincf h6bWhW�'45j tit to the ollowlria
a. Use of building:One Family -4479C Two Family Other n �P 3'0
b. Number of rooms in each family unit: Number of Bathrooms c,�/
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. Masscheck 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.
1. Septic Tank City Sewer �- Private well City water Supply
SECTION 7a,OWNER AUTHOWZA'1ION-TO BE COMPLETED'WHEN
OWNERS AGENT OR CONTRACTOR.APPLIES FOR BUILT tkd PERMIT
1. as Owner of the subject
property
hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
Signature of Owner Date
a ZOwneNuthorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the my knowledge
and belief.
Signed under the pa s and penalties of perjury.
Print Name
Signature of wrier/Agent Date
_
Section 4. ZONING All Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front i 7,TcT
Rear
Building Height
Bid Square Foo ge
Open Space Footage %
(Lot area minus bIdg&paved 5
#of Parking Spaces
(volume&Location)
ever sumdfnr/onthasa?
A. Has | Pnrm�/vanancm/nno/ � h
NO DON'T KNOW 0 YES 0
IF YES, date issuad�
IF YES: Was the permit recorded at the Registry of Deeds?
'
��
NO �� DON7 VV KNO YES
IF YES:� enter Book ! ! Page. and/or Document#| |
L_'_______� ^--------� ------'------'
�
�
B. Does the site contain o brook, body of water orwetlands? NO k�� DONT KNOW 0 YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs tmhe obtained 0 Obtained 0 ' Date Issued: |
C. Do any signs exist nn the pnoperty ��� YES \_� NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? yB y l NO
IF Y[3' describe size' type and location:
E. Will the construction activity disturb(clearing,grading, or filling)over 1 acre cvisk part xfo common plan
that will disturb over 1acre? YES NO
�w~
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
De arttraet tse onlyc
City of Northampton 5ta(us�f � � r Y
Building DepartmentilCut/D �aRemattx
p;`�� � u
212 Main Street Se �� fa11t `at "�
Room 100
Northampton, MA 01060 t�OSe�V{y�.tcturaFPtn
..» ,„may
phone 413-587-1240 Fax 413-587-1272
7--
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR O FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address:
This sectiQxrt be plated ay office
i s ! P' ��,���(� Map ' `'"fit -� Unit
l J� :Overtajr Dwstc3ct
1
f=1Rn St Distrfct %>CB:DMsfiiat
SECTION 2 PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
hq 4 d Core .�/� re
Name(Print) Current fling Address: 141 /
3 741
Signature Telephone
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
Signature Telephone
SECTION 3--ESTIMATED:CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by rmit applicant
1. Building / yl DO �� (a)Building Permit Fee ,
U y
2. Electrical Q (b)Estimated.:Total Cost of
Construction from. 6 �'Q0
3. Plumbing `Building=Permit Fee
4. Mechanical(HVAC) I
5. Fire Protection /(r 4 ��4
6. Total=(1 +2+3+4+5) Q�� O O Check Number
This Section For:Official Use Only
.Uate `
Building Permit Number. Issued:
Signature:
Building Commissionedinspectorof Buildings Date
_72-0 + ��
I /Q , t-
rIV,'JA fa U��;y
File#BP-2006-1362
APPLICANT/CONTACT PERSON COTE THOMAS M&MELISSA M
ADDRESS/PHONE 315 ACREBROOK DR FLORENCE (413)584-7074 O
PROPERTY LOCATION 315 ACREBROO I DR
MAP 29 PARCEL 299 001 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
Typeof Construction: CONSTRUCT 24 X 30 ATT GARAGE FOUNDATION ONLY
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 FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO'PIMATION PRESENTED: L,,f COND ITiO N t
pproved 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
6x_i�l I gt7:4j 6 6 Z2 4 6
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.
w.
BP-2006-1362
GIs#: COMMONWEALTH OF MASSACHUSETTS
y CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2006-1362
Project# JS-2006-2011
Est. Cost: $10000.00
Fee: $108.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq.ft.): 10933.56 Owner: COTE THOMAS M&MELISSA M
Zoning.URA Applicant: COTE THOMAS M & MELISSA M
AT. 315 ACREBROOK DR
Applicant Address: Phone: Insurance:
315 ACREBROOK DR (413) 584-7074 (�
FLORENCEMA01062 ISSUED ON.612212006 0:00:00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 24 X 30 ATT GARAGE
FOUNDATION ONLY W/CONDITIONS - PRECIPITATION RECHARGE
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 6/22/2006 0:00:00 $108.00MO
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
5 ACREBROOK DR BP-2006-136.
GIS #: COMMONWEALTH OF MASSACHUSETTS
"'fr lkw CITY OF NORTHAMPTON
Lot: -001
Pernut: Building
Category: BUILDING PERMIT
Pernait# BP-2006-1362
Proiect# JS-2006-2011
Est. Cost: $10000.00
Fee: $108.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
use Group: Homeowner as Contractor
Lot Size(sci.ft.): 10933.56 Owner: COTE THOMAS M&MELISSA M
Zoning:URA Applicant: COTE THOMAS M & MELISSA M
AT. 315 ACREBROOK DR
Applicant Address: Phone: Insurance:
3 15 ACREBROOK DR (413) 584-7074 (�
FLORENCEMA01062 ISSUED ON:612212006 0:00.00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 24 X 30 ATT GARAGE
PRECIPITATION RECHARGE
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Footings: — o/t - I - oG .
Rough: Rough: House# Foundation:---Z
Driveway Final•
Final: �ti2 -'i-4° t-c
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 Occupancv Signature•
FeeT_ype: Date Paid: Amount:
Building 6/22/2006 0:00:00 $108.00MO
212 Main Street,Phone(413) 187-1240,Fax: (413)587-1272
Building Commissioner-AZthony Patillo