29-076 (4) (f C,e-
a
Tnj 62 Acrebrook Drive
Florence,MA 01062
1
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7
DEPT OF BUILDING INSPECTIONS
beaii./N'NAQ 010,60
i
May 14, 2001
Enclosed please find plan for proposed deck on the back of our garage. A
product called Timber Tex will be used for the floor and railings; all other
wood used will be pressure treated. The railings will be three feet tall with
three and one-half inches between spokes. There will be six 4x4 posts set four
feet deep. Deck size to be 16'x13'
Sincerely,
9"�' k4a,
Judith Kolemba
• i
�RECI`TION`8•CpNSTRUCTION SERVICES
1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder
License Number
Address Expiration Date
Signature Telephone
,_.
MIT 1111
..., Not Applicable ❑
Ewx
Company Name Registration Number
Address Expiration Date
Telephone
SECTION 10=WORKERS' COMPENSA"i 00,INSURANCE AFFIDAVIT NAL. 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.
00*igned Affidavit Attached Yes....... ❑ No...... ❑
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts
as supervisor.CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which 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 tho Building Official,on a fors.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 fob 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
ION' TAU DE D elk° �11 j b
—T
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors
Accessory Bldg. ❑ Demolition❑ tr�j New Sign .[ ] Decks [c..� Siding[ ] Other[ ]
Brief Description of Proposed Work: —tA
Alteration of existing bedroom Yes No Adding new bedroom--Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll 0 - Sheet❑
y .. ,
D .
a. Use of building : One Family Two Family Other
b. Number of rooms in each f mily 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?
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 WNEWAUTHQRIZA'TION ,TO BE COMPLETED WHEN
QWS�t1=#� .AG, N '01 :CgNTRAGI"bR AI�"I'LII:S"I R gUtLpINO,.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.
Signature of Owner Date
as Owner/Authorized Agent
hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my
knowledge and belief.
igned under the pains and penalties of perjury.
Print Name
Signature of Owner/Agent Date
V
E Rn
MAY - 8 2001 i y of Northampton
ilding Department
12 Main Street
DEPT OF BUILDING INSPECTIONS Room 100
NORTHAMPTON,MA 01060 a m pton, MA 01060
phone 413-587-1240 Fax 413-587.1272
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
itdTION 1--SITE IINFORMATIO
"r h rs section
1.1 Property Addr s: y "
SECTIQN =PROPERTY OW
NERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
�Vwvn WL'
ame(Print) Current Mailing Address:
- �
Telephone
Signatur
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
Signature Telephone
SGTION 3 `ESTIMATES CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only '
com feted by permit applicant
1. Building (a) Building Permit Fee,
2. Electrical (b) Estimated Total CoSt,.of
Construction from S'
3. Plumbing "..7 Building Permit Fee
4. Mechanical (HVAC)
1i
5. Fire Protection
6. Total =(1 + 2 + 3 +4+ 5) 6, Check Number
Thws Section I or Official Use Oinl
'Building',Perm Number: Date Issued;
. Signature:
Date
13ullding Commis§icanerllnspector of Buildings'
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 v v
Setbacks Front 30 ,
Side L: R: /5 L: /,5R: 1,5-- I,c�
Rear
Building Height
Bldg.Square Footage
e3�cr�
Open page'Footage % c
(Lot area minus bldg&paved ;+ e J
parking)
AP
#of Parking Spaces RJ
Fill:
volume&Location W I
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO ✓ DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO 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:
a
File#BP-2001-0917
APPLICANT/CONTACT PERSON KOLEMBA EMMANUEL J&JUDITH L
ADDRESS/PHONE 62 ACREBROOK DR (413)584-3629 Q
PROPERTY LOCATION 62 ACREBROOK DR
MAP 29 PARCEL 076 ZONE URA/WSP
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildin Permit Filled out
Fee Paid
Typeof Construction: REPLACE 13 X 13 DECK W/13 X 16 DECK&INSTALL RE=PLACEMENT WINDOWS
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:
Approved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § _w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
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 Coninjission Permit from CB Architecture Committee
U S lJ/
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.
U
RWMF,BROQg _ ,} BP-2001-0917
GIs# COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:Deck Addition BUILDING PERMIT
Permit# BP-2001-0917
Project# JS-2001-1655
Est.Cost:$6000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group:
Lot Size(sq.ft.): 20821 .68 Owner: KOLEMBA EMMANUEL J&JUDITH L
Zoning_URA/WSP Applicant: KOLEMBA EMMANUEL J & JUDITH L
AT. 62 ACREBROOK DR
Applicant Address: Phone: Insurance:
62 ACREBROOK DR (413) 584-3629 ()
FLORENCEMA01062 ISSUED ON.5 1181010:00:00
TO PERFORM THE FOLLOWING WORK.-REPLACE 13 X 13 DECK W113 X 16 DECK &
INSTALL REPLACEMENT WINDOWS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
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 5/18/010:00:00 1232 $50.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo