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29-083 (4) MORTGAGE LOAMY INSPECTION THIS PLAT IS FOR IDENTIFICATION PURPOSES ONLY AND DOES NOT CONSTITUTE A PROPERTY SURVEY 100.00'± MvbQuo r'^ U S' O O '— O O O r7- W/F t _ GARAGE i D�tk j 1 STORY I I I > W/F HOUSE I I � I I I I C131 I I I 100.00'± J 0 I I ACREBROOK DRIVE THE PREMISES SHOWN AIRE SUBJECT TO AND/OR TOGETHER WITH THE BENEFITS OF ANY AND ALL EASEMENTS, RIGHTS, CONDITIONS, COVENANTS, AGREEMENTS, RESERVATIONS AND RESTRICTIONS OF RECORD, FLORENCE SAVINGS BANK 1,341) 1HF _ -- LAWYERS TITLE INSURANCE CORPORATION - ONLY TO I I I L -----------------._. ------- —_—- -._ —----— To my knowledge, information and belief, from infonnalion supplied to me, I hereby report that the premises nave been examined and that this inlsnection plat shows the imirovem^rd or irnprolrements as loc.aled on the premises described, that the impro,�ernemt or impt-overnent.s are enGrcly within lot lines, that lh9re o,e rn� r_�ncroachrne•nts ut.,on flip premises dcs gibed by the improvomerit or irnprovemFm •. , any adjaniirn) prerises, crud that there are nu ens—Ijents of rrtc;ord offeciing the tract shown hereon, except as shuiwn. OF I furthrsr report th,rt the premises shown on this plan i^ riot lucaleci within a Flood Hazard Area as shown on PAUL G : Deportment of H.iJ.U. ederal h s.nance AdininLslration f.Icrp 250167 0001 A ' LU8SIF-B H NO Conununity Hun;beg . 2 Idcntific.r.t.ion Dote ____APRIL 31__1978 Qcrsrc� _ P.LS. OWNER SANDRA KANUROTAS HUv TLfiY & ROBERT E. DUSSEAULT ! t,T.ML 0IZ HUMPLEY, JR. & ASSOCI.r` TES, INC. LOCAL 21 ACREBROOK DRIVE SLneyors • Engineers • Landscape Architects NORTHAMPTON, MASSACHUSETTS 30 Industrial Drive East Northampton, M' 01060 10[3 N0. DATE SCALE 2!o'i.c2(413)584-74AA ' 1x(413)586—c" 7-' 01 -561 4/25/2001 1 "-' 30' Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe Sizes Heated Water Non-Circulating Runouts Circulating Mains and Runouts Temperature(F) Up to 1„ Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HIVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range F 2"Runouts 1" and Less 1.25"to 2" 2.5" to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD(Building Department Use Only) 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 Us)air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.571bs/ft2 pressure difference and shall be labeled. I Vapor Retarder: [ ] 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. [ ] I Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. [ ] I Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. I Duct Insulation: ( ] I Ducts shall be insulated per Table J4.4.7.1. I Duct Construction: [ ] I All accessible joints, seams,and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ ] I The HVAC system must provide a means for balancing air and water systems. I Temperature Controls: [ ] I Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. I Heating and Cooling Equipment Sizing: [ ] I Rated output capacity of the heating/cooling system is not greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. I Circulating Hot Water Systems: [ ] Insulate circulating hot water pipes to the levels in Table 1. I Swimming Pools: [ ] I All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. I Heating and Cooling Piping Insulation: [ ] I HVAC piping conveying fluids above 120°F or chilled fluids below 55 °F must be insulated to the levels in Table 2. MECcheck Inspection Checklist Massachusetts Energy Code MECcheck Software Version 3.2 Release lb DATE: 10/16/01 TITLE: Family room addition Bldg. Dept. Use I Ceilings: [ ] I 1. Ceiling 1: Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: I Above-Grade Walls: [ ] I 1. Wall 1: Wood Frame, 16" o.c.,R-19.0 cavity insulation Comments: [ ] 2. Wall 2: Wood Frame, 16" o.c.,R-13.0 cavity insulation Comments: Windows: [ ] I 1. Window 1: Wood Frame,Double Pane with Low-E,U-factor: 0.320 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments: [ ] I 2. Window 3: Wood Frame,Double Pane with Low-E,U-factor: 0.300 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments: I Doors: [ ] 1. Door 1: Glass,U-factor: 0.300 #Panes Frame Type Thermal Break? [ ]Yes [ ]No Comments: [ ) I 2. Door 2: Solid,U-factor: 0.400 Comments: I Floors: [ ] I 1. Floor 1: All-Wood Joist/Truss, Over Unconditioned Space,R-19.0 cavity insulation Comments: I Heating and Cooling Equipment: ( ] I 1. Boiler 1: Other(Exept Gas-Fired Steam), 80 AFUE or higher Make and Model Number I Air Leakage: [ ] I Joints,penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] I 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 r � Permit Number MECcheck Compliance Report Massachusetts Energy Code MECcheck Software Version 3.2 Release lb Checked By/Date TITLE: Family room addition CITY: Northampton STATE: Massachusetts HDD: 6404 CONSTRUCTION TYPE: 1 or 2 Family,Detached HEATING SYSTEM TYPE: Other(Non-Electric Resistance) DATE: 10/16/01 DATE OF PLANS: 10115101 PROJECT INFORMATION: OCT 1 '" Bob and Mary Dusseault 21 Acrebrook Drive - DEPT RT Bl�L! Florence,MA 01061 =. NOT}r . i COMPANY INFORMATION: Robert Walker Construct Associates,Inc. COMPLIANCE: Passes Maximum UA= 92 Your Home= 91 1.1%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1: Flat Ceiling or Scissor Truss 288 30.0 0.0 10 Wall l: Wood Frame, 16" o.c. 468 19.0 0.0 21 Window 1: Wood Frame,Double Pane with Low-E 21 0.320 7 Door 1: Glass 40 0.300 12 Window 3: Wood Frame,Double Pane with Low-E 32 0.300 10 Door 2: Solid 17 0.400 7 Wall 2: Wood Frame, 16" o.c. 118 13.0 0.0 10 Floor l: All-Wood Joist/Truss, Over Unconditioned Space 288 19.0 0.0 14 Boiler 1: Other(Exept Gas-Fired Steam), 80 AFUE 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 Massachusetts Energy Code requirements in MECcheck Version 3.2 Release lb. 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. . gB gx:5%itchrtsctla DEPARTMENT OP DUILDrNG INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 W0ju,,,TR'S COMTENSA.TZON INSURANCE AFFIDAVIT (li cx�ser/permi ttl=e) with a principal place of business/residenc-e at: ��WcLkxcc (phone#) -- (stzr�.i/c tylsiatr�z�p) do hereby cei-tify, under the pains and penalties of perjury, that: ( ) I am an employer providing the following workers compensation coverage for illy employees working ou this job: i _ , �a n CAN S1 L 1S Cc" tNC 7 V� ( U ( I (Insurance Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner(circle one) and have hired the contractors listed below who have the following worker's compensation policies: ) � ff�Z 7�- �j u -LJ'�!-�tc4 t�35 5 at Cee��� �l" (Z- (Name of Contractor) onsurancc Company/Policy umber) (Fxpirntion Date) (Name of Contractor) (Innlrance Companyttoliq Number) (Expiration Date) (Name of Contractor) (Insurance CompaaylPolicy Number) (Expiration Date) (Name of Contractor) (Insurance Compauy/Policy Number) (Expiration Date) (atIanh additioml lhx ifn6o=l ry to include infkx n oo pertaia to all oonradon) ( ) I am a sole proprietor and have no one working for me.. ( ) I am a home owner performing all the work myself. NOTE:please be aware that whilo hoascow»cn who employ persom w do %*�coastuaioo'or repair worst on a dweUing of not moeo than aroo units is which the boa»owocr resides oc on the grounds appurtcaud tharcto ate 00(G--rally oomidcred to be cmployaa undo dw wockor`a oo¢tpcas4on Act(GL152 si l(5)),application by a bomoownca for a Ilocasc oc permii may cvidaooc the legal siatua of an employoc under rho Workoes Compomatioa AeL I understand that a copy of this rsitcmmt may t>e forwarded to tho Dcpertmrnd of Industrial Ax+duo&OfSoe of rmmu.00a for tha covaNgc va C3110o and that failure to secure oottrngo undo'section 25A of MOL 152 can lad to the'impcs -of aiminxt pinlwa ooausang of a f nc of up to S 1,500.00 and/or imprisoonxat of tip to one year and awl pemriia m lbe form oCa Stop Work Order and a ' fins 0(5100.00.day against to For d Qa-�a�xt,�. tsao only Permit NIM L4,t.# Mapg ............ SECTION 8-CONSTRUCTION SER1/ICES ... ........ _ _ _. _ .......... _ _ ...._.. _........ _... ...... .......... _....... .......... ......... _. ...._... . 8.1 Licensed Construction Supervisor: g Not Applicable ❑ 7 Name of License Holder:--- �1i1 —_� j, - —___— — b 3 d--`E-3 License Number K- -/ -N--------- ----- (o t t` z cx �------ Address L Expiration Date -------------------------------- ------------------------------------ Signature Telephone ;:.::.: -;;:<;;,,,,;;;;;;,;;;,;; ;;;<.;::;:.;::;::;>:;;:.;:.;:.;:.;-:-<;::;.;::.;:.::.: ;";>'::>::....... is?'`?'is i2 _ =_>=> <==> >:`>>»>':>'.3=>< _><;;> >< >. >!tet9. 1 d;.H t :lm#�CQ e#1 ief�:lam ttll ttkt�.;:.;:.;:.;:::.. ...........;: ......... Not Applicable ❑ Company Name Registration Number _____ __ z_------- ------------------ -------------------------------- -- ------------- �- - Address �n Expiration Da (,, 1 t ----------------- _C.r w-�C_�"� _Telephone_ ` _ �� SIrCT10N 10-WORKERS' COMP.ENSATION: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...... ❑ MR 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 ... _ _. _._ ..... ..... .._ ........... .._....._. ........ ......__.......... .. _.. _ ........ ......._. .._...... _ .. .. . . .......... ......... .......... ..... ........ .......... ................. . . S#_CTiQN 5-DESCRIPTION:OF PRf3POSl=DWORE Echeck all applicable} New House ❑ Addition Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other[ ] Brief Description of Proposed f X/a Work: A On 1 (0 `LC'C?Y►^ i� Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative f Renovating unfinished basement .......Yes No Plans Attached Rolle Shee r .................................................................................................................................................................................................... 1 %. ................ a. Use of building : One Family-__V/---- Two Family_________Other---------- b. Number of rooms in each family unit:--------------- Number of Bathrooms------------- c. Is there a garage attached?____n'D d. Proposed Square footage of new construction._ !_______ Dimensions___� _ � _ i�t�� �?t l Z - - ----- --- - ----- e. Number of stories? ` 01 Yw_;�- ---------------F---�—, tl----------- f. Method of heating?---- ---------- Fireplaces or Woodstoves-----------Number of each--------- g. Energy Conservation Compliance. Mascheck Energy Compliance form attached?--------------- h. Type of construction`' vs- i. Is construction within 100 ft.of wetlands?------Yes !' No. Is construction within 100 yr. floodplain Yes No t j. Depth of basement or cellar floor below finished grade____ _ k. Will building conform to the Building and Zoning regulations? ----- -_____,No. I. Septic Tank----- City Sewer-__ Private well------- City water Supply SECTION 7a=OWNER ALITHORIZATION -TO BE COMPLE fED WHEN OWNERS AGENT OR CONTRACTED APPLIES FOR BUILDING PERMIT - 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. --------------------------cal :-( ►------------------------------- — Signature of Owner Date 2n � r I, ------ `_ !zrz-aS... 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. ---------T---°-6'� ----� � -- ----------------------------------- Print Name ------------- ----- r .- ------------------- --------- Signature --------------------------- Signature of Owner/Agent Date s . 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 Lot Size Frontage Setbacks Front ?U0 (�, Side L:�L �_R: L: 4.0 R: {O Rear 0 3O Building Height Bldg. Square Footage 1 V `O 0/. Open Space Footage { % L Gt (Lot area minus bldg&paved parking)0 #of Parking Spaces 2" Fill: volume&Location) i A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO �^ DONT 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 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:___T__ C. Do any signs exist on the property? YES NO _ 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:________ ___ ? A L� tJ ll �( €3� # #i�ttt€fi# t5i9i C o hampton SttvtPrP31)> D Mild artment P :. :::::.:::::::::w, 2 12 m Street .................... .......... . ..'i.�........�.`I..>. ........ .... � <»»> r.>C^T 1 2001 100 »> > North Northa rpto MA 010 -1240 Fax 413-587-1272 DEPT Of�L�lf� a NORTHAMPTON,MA 010 60 APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING BECTION 1 -SffE INFORMATION 1.1 Proaerty Address: This s�+ tiaT#tq.b�co............iy a.t#i�e... :: i ^� ' Ma m tlra 4 MwMw.... .;;::::::..::... wmwmwMw... . '?tS18t18.......3 li !TM;>T< <» «'>?< ...................... Y.:::::::::::::::.-........ .- - - - �_ Vy f- DIr Sl plsltl f<>>>> > > >> > ; < >;'CB i fil t ><; `<'' > > . SECTION -< 2PROPERTY OWN£RSN. P/AUTH.GRIZEDJ AGENT 2.1 Owner of Record: �^ SS FA,-) \ 2- ---- -! — C - --- vnff i 4 c Name(Print) Current Mailing Address: ----------------------- --------------------------- ---------------------- Telephone Signature 2.2 Authorized Aaent: ------11 ---W`- ` .v------------------- --- (D---���02 N Name(Print) Current Mailing Address: cL I-L Z[1 ------------------------------ --------------------------------------------------- Signature Telephone _....... _ __....... ....__ SECTION 3-ESTIMATED CONSTR 7CT10N:COSTIS Item Estimated Cost(Dollars)to be Official Lase Qnly completed by ermit applicant 1. Building (a)Building Permit to 2. Electrical (b)E tlmated Total Cost of Goo. ton fc©tr e� 3. Plumbing ,� Building Permit Fee e 4. Mechanical (HVAC) 5. Fire Protection Z-LV S-U ' 6. Total =0 +2+3+4+5) Check Nurnk e.. r This ecticri Por:Official.l se Ont Building Permit Number:wM �w Date __ _w Issued: Building Gommissionet Inspector of t plUngs Kate File#BP-2002-0417 APPLICANT/CONTACT PERSON Robert Walker ADDRESS/PHONE 36 Service Center (413) 584-1224 PROPERTY LOCATION 21 ACREBROOK DR MAP 29 PARCEL 083 001 ZONE URA VJ -)P 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 18 X 16 FAMILY RM 8 X 12 MUDROOM& 16 X 12 DECK New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 034783 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION P SENTED: Approved enied 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: § 14- Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed �' ®� /0?0G rff Other Permits Required: c^�PE`•'� �K�/ CC,(f- .0) 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 Co ssion Signature o wilding Official Date X00 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. � 1 � i EXISTING GARAGE i rN ► D MUD ROOM Slab on Grade w , D - - - - '�► � I - - - - - — i - ------ - - -- --- - _4y DRY WELL CONNECTED l I TO DOWNSPOUTS, FROM l HOUSE & GARAGE. I i L - - - - - - - - - -J 0 rB e 0 D V D a) oov`� • v 36`P TD N� U�VO JpOD �`��' c9vU�oJ S r 4z* P � _ ((l x 3 For 17 L13 ID A ' Zoning addendum Dusseault family room and mudroom addition 21 Acrebrook Drive Florence, Ma Lot Size 100 x 150 15,000 sq. ft. Existing dimensions House 40 x 24 960 sq.ft. Garage 24 x 24 576 Bldg. Subtotal 1536 Driveway 16 x 44 704 Subtotal 2240 Proposed addition Family room 16 x 18 288 Mudroom 7 x 12 84 Subtotal 372 Deck 12 x 16 192 Existin Proposed Proposed w/deck Bldg. Square Footage 1536 /10% 1908 / 12.7% 2100 / 14% Open Space Footage 15000 15000 - 2240 - 2612 12760 /85% 12388 /82.6% Open space footage calculated without deck coverage. Deck to be open 5/4 x 6 decking without poly or impermeable membrane under deck to allow drainage Proposed roof area to be drained into drywelI for recharge 510 sq.ft. ( see attached plan) Proposed lot coverage 2612 Less roof area recharge - 510 Adjusted lot coverage 2102 Open square footage 12898 / 86% MWOMMMIRMOMMMMW Section 4. ALL INFORMATION NIUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This colunm to be tilled n+by Building Department Lot Size Cwt Frontage t oo r W Setbacks Front 21(0 + 2-G' Si v+c L: Q3. R: Iio L: 3ti` R: Ile' Rear Building Height Bldg. Square Footage�� O I ce v Open Space Footage (Lot area minus bldg&paved iaikin*) #of'Parking Spaces Fill: (Volume't,Location A., Has a Special Permit/Variance/Finding ever been issued for/on the site? NO _ DONT KNOW YES I IF YES, date issued:__ 1 OCT 2 4 2001 IF YES: Way the permit recorded at the Registry of Deeds? NO DON'r KNOW YES DEPT OF BUILDING INSPECTIONS --- --- -- NOPTiIAMPTON,SSA 01060 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO ___ 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 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:_ File#BP-2002-0417 APPLICANT/CONTACT PERSON Robert Walker ADDRESS/PHONE 36 Service Center (413)584-1224 PROPERTY LOCATION 21 ACR.EBR.00K DR MAP 29 PARCEL 083 001 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 /�7 Typeof Construction: CONSTRUCT 18 X 16 FAMILY RM, 8 X 12 MUDROOM& 16 X 12 DECK New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 034783 3 sets of Plans/Plot Plan NATION LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON 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 Commi n �I Signature of Building OMeKl 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. 21 4REBT�OOK DR BP-2002.0417 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 29-083 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category:ADDITION BUILDING PERMIT Permit# BP-2002-0417 Project JS-2002-0630 Est. Cost: $38400.00 Fee:$202.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group Robert Walker 034783 Lot Size(sg. ft.): 14984.64 Owner: DUSSEAULT IRENE& S KANDROTAS Zoning. URA A 1 licant: Robert Walker AT. 21 ACREBROOK DR Applicant Address: Phone: Insurance: 36 Service Center (413) 584-1224 Workers Compensation NORTHAMPTON MAO 1060 ISSUED ON:10125101 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 18 X 16 FAMILY RM, 8 X 12 MUDROOM & 16 X 12 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:1�,711 �J ,,,House# Foundation: �' —0 [ riveway Final: 40L 15 5 Ok Final: Final: Rough Frame: Aix 7,�G'� G Gas: Z Fire Department Fireplace/Chimney: Rough: Oil: Insulation: K IV'/d-0 1 ' e' Final: Smoke: Final:ok l—qVp 4� THIS PERMIT MAY BE REVOKED BY THE CITY O NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REG �4TIO . , Certificate of Occupancy G' Si nature: Fee Type: Receipt No: Date Paid: Check N Amount: Building 10/25/01 0:00:00 1093 $202.00 212 Main Street,Phone(413) 587-1240, Fax: (413)587-1272 Building Commissioner-Anthony Patillo