11C-036 (2) BP- 2010 -0643
GIS #: COMMONWEALTH OF MASSACHUSETTS
. � CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category BUILDING PERMIT
Permit # BP- 2010 -0643
PJ0jCC1;; JS- 2010 - 000939
Est. Cost: $15000.00 -
Fee: $135.20 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 23783.76 Owner: YURGIELEWICZ JAMES & NANCY J MILLER
Zoning: URA(100)/ Applicant YURGIELEWICZ JAMES & NANCY J MILLER
AT. 45 FLORENCE ST
Applicant Address: Phone: Insurance:
45 FLORENCE ST (413) 584- 4949��
LEEDSMA01053 ISSUED ON. 1/19/2010 0 :00 :00
TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 26 X 26 DET GARAGE
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 1/19/2010 0:00:00 $135.20
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo
File # BP- 2010 -0643
APPLICANT /CONTACT PERSON YURGIELEWICZ JAMES & NANCY J MILLER
ADDRESS /PHONE 45 FLORENCE ST LEEDS
PROPERTY LOCATION 45 FLORENCE ST
MAP I IC PARCEL 036 001 ZONE URA(l00)/
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 26 X 26 DET GARAGE
New Construction
Non Structural interior renovations
Addition to Existin
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
INFOYMATION PRESENTED:
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 Permit DPW Storm Water Management
DemW&wDelay
S /-0
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.
City of Northampton Std s x
Building Department ,
212 Main Street
Room 100
Northampton, MA 01060
s� phone 413 -7 -1 Fax 413 - 587- 1272���
`am,' Xktrk 'e ;
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
r + Map Lot Unit
Overlay D9strict
Zone
EIm.St'District" CS District_,__________
SECTION 2 - PROPERTY OWNERSHIPIAUTHORIZED AGENT'
2.1 Owner of Record: t
Current Ma : G 5
Name (I?sj 0 _
Telephone
nature
2 2 Authorized Age nt: i4 rG fZy ✓t ` �
Current Mailing Address:
Nam t) f t 4
Telephone
nature
SECTION 3 - TI ATE CONSTRUGTIO COSTS ' Official Use Only
Estimated Cost (Dollars) to be
Item com leted b ermit a licant (a} Building '`peRnit Fee
1. Building S0 0 st (b) Construction from 6 of
Estimated Total C 2. Electrical guiding Permit Fee
..r
3. Plumbing
4. Mechanical (HVAC) O?
r Check Number
5. Fire Protection J
rcial Use n
Ol
6. Total= (1 +2+3+4+5
is Section For Off
Date
issued:
Building Permit Number:
Date
Signature:
Commissionertlnspector of guitdings°
Building _ _
Sect 4. ZONING All Information Must Be Completed. Permit Can Be Denied Du Required by Zoning information Incomplete
Sects proposed
E This column to be filled in by
Building Department
Lot Size
Frontage I
Setbacks Front - L
T
Side
Rear
Building Height
Bldg. Square Footage -
Open Space Footage, ",-
(Lot area minus bldg & paved
M
# of Parking Spaces
i a�.w i ' 1-- -
Fill:
(volume & Location)
A. Has a Special Permit /Variance /Finding ever been issued on the site?
NO DONT KNOW 0 YES
Q
IF YES, date issued:` w_a
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
...
IF YES: enter Book ' i Pagel i and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO 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
IF YES, describe size, type and location:
°� " b:`re ereli eny propose�d�anges to or a ittons o signs intended far the property ? YES 0 NO
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 NO dM
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.