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36-320 .4, k CIA • ja ;AS - a x if 4,00,:iii, 54-,,) 5 1 ret , 1/ xi. A o f 1/ "1 p i of 42 oN It"' . 4 015 10/) 44.; 4 iti ( ' ' r . 1 i I . ) e p4 t i ' : I pi, v jal 1 ,': 3 S g I i / 1.. 11 1: ^4 I i I: f ' I 1 , , .I. i , - , . .., ■ . , 1 , i . . . . . • . • ' /:40'..0,:ollatiCeitg.tAitalirAKAWAY4/0,4WiaigitiAWALIIINO54404 • I . . • 4 • ., .., II , . $",<, .4 . I , ... . . • J ....J. 1,. G4., ; ? ......... .., ..,....,..- . ......--, , / , ..,,.. .... _,,, 4 - . , . . 4 . ao ) .7 to wv '''' lit .... oar . . ••=.,, _, it ‘--- to op, 1 ' . • / iitnarnly r 1, I ' • 1 • I ,.../ i . . I • ' ..41., . rep y s, Rs i ipa.f -ity fi I ry5 tVi , 1 1 " 0 -..--- 4 — I :.. - ., ...........__: ______•____ 11 C V 4 : 71 i: r! ...4 lif' • .. t . I. 'F ' I 'er "let S i' , • . ' 1 il • . ■ r ' i 1 r r vvoovhVlo . 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F -----.—...„ . 1----._ 12.1* 1.— --,- — 1 i % '7 r '— i ivi" - i ,I.,...1 33' ' CP ! -,..............--- ' --r ri 11 c I . •.:, .. o 9 0 0 0 •. 4:` 1 Cl 1 \jor&P 0,))0/N trti .0_ ) .... flPj.re' r • ' o' tre v p A- \ \ \ t ... / ,, ., 0 ,— , ,- , LI. /,, ) vawas c 0. * 5tSAM p2 ��� oy ; ( it of XLtrt1 anq h m .. 1z -tr / P 4 0_,vi,1: r. ip _` . y,► r .6 assadinscttn _= � _ wk� DEPARTMENT OF BUILDING INSPECTIONS '4 4 _ /_ INSPECTOR 212 Main Street • Municipal Building ' �,,� • - 5 `- Northampton, MA 01060 e' HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.14 to act as his /her construction sups::. isor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he /she resides or intends 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 home owner." The building department for the City of Northampton wants-any persons) who seek use the home owner exemption, to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfill) sonotube holes (before pour), a rough building inspection (before work is concealed). insulation inspection (if required) and a final building inspection.: The building department requires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work (electrical, plumbing & gas) the homeowner will be responsible to make sure that the trades hired secure their proper - permits in conjunction to the building permit issued, and that they get their required inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made I, understand the above. (Home owner /resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me Date Address of work location i - • . - �- p t - - F� -_ � _-_- y � tl ti ( riff of { cr rfl1� �111) l' • I A 4 f .51as.ncljatrtts d - DEPARTMENT OP DUILDt7 G INSPECT IO , _ 1 212 Main Street ' M Building Northampton, Mass. 01060 . W-OR1OER'S COMPENSATION •NSTIIA`CE :SITED .VTT • (iccnsxlpermittcc) with a principal place of business/residence at: iG ill et // P(14 4.4 A,,1 /-tR. +7f Ali 0 /00 (;ho ney') 4/ / 3.- )y‘ - '7 5 3 6 (str~,Jcit- /st=/ p) do hereby certify, under thc.pains and penalties of perjury, that • ( ) I am an employer providing the followving''worker's compensation coverage for my employees working on this job: - , (l sura C Company) (Policy NL'n.cer) -- (r :pimpon Dal.^.) . • . ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the coon - actors listed below wbo have the following worker's compen_saon policies: (Name of Contractor) (Ins.uranca Cornpi ?oucy Ntrmr(:) (` :pir - ouon Datc) • (Name of Contrcior) (irsuuanec. CompaaviPo!ic; Nunc_r) (Exoiraon Dare) (Name of Connaaor) (Instlranca Comran } Numb') (Expiration Data) • (Name of Contractor) (Lesurano Company/Policy Numb:-r) (E.xpirtioa Dan_,) (oaa.4t :.ddk-.:ocxl Mccx.if no0=7....ry to incur inf0Cm oo pc-taiaias to .11 cow-- .coal) . (V� am a sol proprietor and have no one working for me- ( ) I am..a home owner performing all the work rnyself. NOTE: plcsc bc " ware 111‘1 o hemcowvcra ..too auploy pe -toes to w r , .- - < , c :.r�oo c rc,�ir ••-ori oa I. d.• -nth , of cot mocc then t.- -trots is 'h th tb, bomoowo r-oeda or ea 1.10c yTouac'_a zppurtea_= tbc-0.o c-: ax atty cam:d --o7 to bc ciplorrzs ucG,- the wet c -.ta Ac (G U1 S2=1(5)). - ^plin -co by n boa fm. _ Li - a pc-mit m.) a id:m c the lc-p.1 e • of en oo tloyer under ciao Woric.ol. Cocop.cc .ti-o Act - I uadcayad tha a. copy of thi.....'wane- m.y be I«- r.arrdad to Lb.. Dcp..rtmcar of Ioozuic! Accie OSLoe of irt.*y*om for the cove- i o -e vc if r=licc cad then Eil=c to wire bsvcru t,„rir -- soaioa 25A of Mat 152 as 1,_41 to the impcadaw of mimics! pr-+' , Trig coceittt z of a fr ac of up to S I Soo.Oo xreor icaprtsomnest of up to one y-. _r end c tiil pea+1 - tie is be form of a Stop Wort Or cad ' _ f of 5100.00 a d_y .Fpic roc -- 1 . For dcyuta -----''J u.c ally �. Permit Number �` ����✓` I I` -- Lot R Signatur of I - Tort rfP,,r. :rr�� I are I p~ t e SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction // Supervisor: Not Applicable ❑ �j Name of License Holder : Dct V ' (4; c �7 , n' 6 I " a License Number id Address Expiration Date Yi3- aft -95 Signature Telephone 9e Rei tsfeeeifi orn °e- in taveri ant;Cai � - k '` . „, r l Not Applicable ❑ va t C:i, Co.AV 14 ZC 111/2.4 Company Name /� — Registration Number 7�/r*.G C �/ / !Gc � PA Cake T✓ ' &, y 1/: -c ✓ SIC s I /d o7o Address /- � / l I /f llII __ Expiration D to / 4(.. 4 s' d: h `L 2 ,1144011-7 Telephone —07 XI .7 Si( 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 1Z 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 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 r.: SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑: Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [ID] Decks [D Siding [O] Other [0] Brief Description of Proposed , p Work: ✓ /.t1gG ^, UPS � P/!4/ (l' t i ra I) Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement // Yes No Plans Attached Roll - Sheet sa: i- New trbita4r &I'itaft O dl afFStinc fia si a;"co pfete th : otfa I q: 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. 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 . 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 I, lc' - � ,.� w , as Owner of the subject property ll hereby authorize .L 2 C4' C0 " to act on my behalf, in all matters relative to work authorized by this building permit application. /L! /' Signature of Owner Date ../G-4 , r , , 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. /�a•4 mil. < Ik J i•A Print Name y/' ✓� A /cam Signature of Owner /Agent Date Section 4. ZONING All Informatibfl 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 .a [ f Frontage Setbacks Front . I Side L: i R: L: R Rear Building Height ,_ Bldg. Square Footage I } % ? t l Open Space Footage % (Lot area minus bldg & paved I t I a ? c i parking) # of Parking Spaces Fill: / i 1 j (volume* Location) ' • A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO CJ DONT KNOW 0 YES 0 " IF YES, date issued IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW 0 YES Q IF YES: enter Book Page; and /or Document #' B. Does the site contain a brook, body of water or wetlands? NO CI DONT KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? ' Needs to be obtained Q Obtained Date Issued: C. Do any signs exist on the property? YES Q NO e _____; IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO e( IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, ex ation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES r NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. ./ s " > ' - ®2 s w r - �/ Cit •f Nortf�8mpton a ° e - Q 4 � Buildi •Department r vew Q , < ..- r aS 2 Main Street S r e A + I ''$ �`� ; c \ �� Room 100 e � - ° * , r -_ O � � ..\ •Ithampton, MA 01060 Set S tr ' r ' c t ca ar '` ,0 O ' a! 13- 587 -1240 Fax 413 -587 -1272 P tt a n `' � 4` " \� fi b t- c� pec -,41r, 44. "Ak 7 t7' E 7 " i i°a � wR� ' r Dater Yify = s�:� � .-_ tr- - r \PPLI 0 CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - INFORMATION 1.1 Property Address: This section to be compteted� byoffce 7 Ctt C C1, /1st, I tve-t1 f , Ma L ° , . Unit, to .. c' :1 C Zone Overlay District. Elm St Di �C�:District SECTION 2 - PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: / �/ i J �cyitrr KctJ'P/✓Iw/i Get`: J1Lt �/ r/!!‘ 2 (7 4 Pi�r:1.4, CA) 7 � / /e " { ' P ,� /Q Name (Print) Current Mailing Address: 7» ? _ 53.3 13 ii --;;;;,----- CA,k,k Telephone Signature 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 permit applicant 1. Building I -5 r J 0 0 (a) Building Permit Fee 2. Electrical I I I ). 0 0 (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) / Y, 700 Check Number /6 ( d 0 jpei This Section For Official Use Only Date Building Permit Number. Issued: Signature: r I Building Commissioner /Inspector of Buildings Date �4 a ... 4' iv. , ir �d' ✓ �1ac:�/ 1 , File # BP- 2006 -0384 APPLICANT /CONTACT PERSON DAVID CHICOINE ADDRESS/PHONE 16 EDGE HILL PLACE AMHERST (413) 246 -7536 PROPERTY LOCATION 217 CARDINAL WAY MAP 36 PARCEL 320 001 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid /06i Typeof Construction: FINISH PARTIAL BASEMENT New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 061582 3 sets of Plans / Plot Plan THE FOL OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: Approved 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 C 'ssion /o 42/B S-- 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. 217 CARDINAL WAY BP- 2006 -0384 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36 - 320 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit # BP- 2006 -0384 Project # JS- 2006 -0558 Est. Cost: $14700.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: DAVID CHICOINE 061582 Lot Size(sq. ft.): Owner: KAUFMAN LONNIE & ERIKA FRANK Zoning: SR Applicant: DAVID CHICOINE AT: 217 CARDINAL WAY Applicant Address: Phone: Insurance: 16 EDGE HILL PLACE (413) 246 -7536 AMHERSTMA01002 ISSUED ON:10/13/2005 0:00:00 TO PERFORM THE FOLLOWING WORK: FINISH PARTIAL BASEMENT 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: ,l� /�pe House # Foundation: !/ o r Driveway Final: Final: Final: :r L Ptyl Rough Frame: olt 01(8 / Lout3 Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: t }l 2 "s ` � L 4 • Final: Smoke: Final: DK p.6, 40/".s etc<T R e / 13 /d Lt/ S THIS PERMIT MAY BE REVOKED BY THE „% TY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGUL ION Certificate of Occupanc �� si . nature: FeeType: Date Paid: Amount: Building 10/13/2005 0:00:00 $65.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo /./ 5 -r Y 44. °I 1 . 1 Sd3iS 4 -<.- , a-7 .? ,,.‹. // ,,,9 K his - - - - (>1'*' 0. ( 7.1E , ()% 1 1 oit 1 ' 'i., 1 tet''cr'i i , oike .''' ...., . . „ i (0, , ,. 5 ,i co cr• a 0 , -1 4 C V 0 ) & 1 L , '' il 1 1 I r ../ ....... q . . 4 p i 0 , ..s 01 ,„ -k., , 5- (--, ,. oi,va ..) ' , •0 ; , 1 --N ' -_, a 0 , ' NI -,;,-.1.;;:-2-:, . I / L) . -- _,-• A , \-,... ' . , ,,,. WM l• ..-,1-, .), 't c i ----- ,... , [r 0 IN v, . 4 .-........--.--— •,..........-= / c.,,y,e' 700 ,,, j.,...fs -.5 till - J 117.1.5 , 0 '''' •k J h 4-- , Xi? xDI 1 k' J bl • 0 • 114*-i'l ePlp'45 . 1 ----------- / /1 March 2, 2004 To Whom It May Concern: This permit application is for building a wooden deck in the back of our house. I suspect that a permit was previously granted to Mr. David Lepine when he was building our house last spring and summer. At the time of closing Mr. Lepine had only poured footings and therefore we decided to forgo having him finish the deck and are now planning on building it ourselves. We hope to build the same 16 x 16 deck we originally planned for. Thank you. Lonnie Kaufman and Erika Frank 217 Cardinal Way SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : _______ License Number Address Expiration Date Signature Telephone 9. Registered 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 S ate of Massachusetts General Laws Annotated. Homeowner Signature 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 I" Siding [ ] Other [ ] Brief Description of Pr pose // pp D Work: V, x lh .uccr'e (Qct< ct bad< e ,10,J r t Ir�+M �� v; AS `1 t cv, _ , q ae o 1 oia, , Alteration of existing bedroom Yes v No Adding new bedroom Yes ✓ No Attached Narrative Renovating unfinished basement Yes ✓ 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 , 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. Signed under the pains and penalties of perjury. Print Name Signature of Owner /Agent Date 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 o ' . ac re" . Y5 ac r e5 Frontage ., Setbacks Front t SD` Side L: 17 R: i ` � L: R: Rear ,., 100 Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg & paved parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit/Variance/Finding ever been issued for /on the site? NO DON'T KNOW J 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 4 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: i Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer /Septic Room 100 Water/Well Northampton, MA 01060 Two Sets of Structural Plans__ ------- phone 413 587 - 1240 Fax 413 587 - 1272 Plot/Site Plans_ ____ Other Specify_ t APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ;IN OR TWO FAMILY DWELLIisIG SECTION 1 - SITE INFORMATION E MAR 1 7 2004 This section tbecom_pfeted byoffice' 1.1 Property Address: t 1 ( IV L'y s "tom CAI-A.1\41 Map Lot �� C . nit - MA 0/06 a Zone ___ 5 . Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: /11P A 1 *.e _KSG v Ir L1 r 4 P: j_< rg^ c: i) 1 7 C u . Name (Print) Current Mailing Address: f � 5�5 X1 3 17 8' 7- 3y/ 1_64. Telephone Signature J�1 2.2 Authorized Agent: Name (Print) Current Mailing Address: Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimate Cost ollars) to be Official Use Only complete permit applicant 1. Building �i � goo (a) Building Permit Fee 2. Electrical 11 (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) 4 y, S ©O Check Number Xre t This Section For Official Use Only Building Permit Number:___ — 17_1- Issued: ued: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2004 -0878 APPLICANT /CONTACT PERSON KAUFMAN LONNIE & ERICA FRANK ADDRESS /PHONE 217 CARDINAL WAY FLORENCE (413) 585 -9317 Q PROPERTY LOCATION 217 CARDINAL WAY MAP 36 PARCEL 320 001 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid — Tvpeof Construction: CONSTRUCT 16 X 16 DECK 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 INF9RMATION PRESENTED: Approved 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 /' Zed 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. 217 CARDINAL WAY BP-2004 -0878 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36 - 320 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buiidina DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL C.142A) Category: BUILDING PERMIT Permit # BP- 2004 -0878 Project # JS- 2004 -1314 Est. Cost: $4500.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): , Owner: KAUFMAN LONNIE & ERICA FRANK Zoning: SR Applicant: KAUFMAN LONNIE & ERICA FRANK AT: 217 CARDINAL WAY Applicant Address: Phone: Insurance: 217 CARDINAL WAY (413) 585 -9317 0 FLORENCEMA01062 ISSUED ON :3/23/04 0 :00 :00 TO PERFORM THE FOLLOWING WORK: CONSTRUCT 16 X 16 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: House # Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation:*_ -- — - Final: Smoke: Final: 0 I- ' 6' —0 4 THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Receipt No: Date Paid: Check No: Amount: Building 3/23/04 0:00:00 805 $50.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo - gF1H No 5\\1V1( MUNICIPAL SEWER AVAILABILITY Northampton Streets Department 125 Locust Street Northampton, MA 01060 587 -1570 Location: 217 Cardinal Way Lot # 16 Inquiry Made By: David Lepine 413 - 527 -3975 Date of Inquiry: 12 -02 -02 Municipal Sewer Main in Front of Location: Yes g No Size of Sewer Main: 2" Material: PVC Age: 2002 Depth of Sewer Main: 5 Size of Service Connection: 1 -1 PVC Comments: The City of Northampton has not accepted responsibility for the maintenance of the sewer main and service connections as of this date of inquiry. A corresponding "sewer entrance fee" shall be paid prior to making any connection to the municipal sewer system. Arrangements of such installation shall be made with the Northampton Streets Department with a minimum of 5 working days notification. All work shall conform to Northampton Streets Department specifications. Joseph T ffom P as, Su erintendent Streets Department cc: Ned Huntley, Asst. City Engineer Anthony Patillo, Building Inspector V i - Permit No. D29 - 03 Conditions: Driveway Permit In lieu of plan approved by City Engineer I agree to the following added conditions: 1. I will contact the Department of Public Works and have an inspector check and approve the graded gravel base prior to paving to insure compliance with slope and location; 2. I further agree that if in the inspections any of the permit conditions are not met that I will at no expense to the City remove and replace the driveway as directed by the City Engineer. By: etitioner David Lepine 527 -3975 262 East Street, Easthampton, MA 01027 Note: The Public Works Department recommends that you provide a plan showing the proposed driveway with grades and location in the future to avoid possible expense which you will incur by not getting approval of actual plans in advance. • cc: Building Inspector • • Permit No. CITY OF NORTHAMPTON, MA DRIVEWAY PERMIT Date: 12 -02 -02 FEE: $25,00 CHECK #: 5421 THE BOARD OF PUBLIC WORKS The undersigned respectfully petitions your honorable body for: Permission to install a driveway at 217 Cardinal Way Lot #16 Fifteen (15) foot maximum width at the street line. Gutter drainage not to be disturbed. All drainage shall be directed off the driveway surface to adjacent land and not on the existing roadway. Driveway surface to be paved if the grade of the proposed driveway exceeds 3% or more. By: 4) David Lepine 262 East Street, Easthampton, MA 01027 Telephone #: 411 527 --3975 Proposed Location Inspected By: Gravel Base Grade Inspected By: -.� . Final Approval THE BOARD OF PUBLIC WORKS voted that petition be granted. George Andrikidis Director of Public Works (SUBJECT TO ATTACHED CONDITION 1 & .) cc: Building Inspector MUNICIPAL WATER AVAILABILITY Northampton Water Department 237 Prospect St. Northampton, MA 01060 587 -1098 Location: 217 Cardinal Way Lot # 16 Inquiry Made By: David Lepine 413 - 527 -3975 Date of Inquiry: 12 -02 -02 Municipal Water Main in Front of Location: Yes x No Size of Water Main: 12" Material: DI Age: 2002 Approximate Street Pressure: 72 PSI Size of Service Connection: 1" copper Comments: The Water Department cannot guarantee adequate water pressure during peak demand times at elevations above 320 feet. The City of Northampton has not accepted responsibility for the maintenance of the water main and service connections as of this date of inquiry. A corresponding "water entrance fee" shall be paid prior to making any connection to the municipal water system. Arrangements of such installation shall be made with the Northampton Water Department with a minimum of 5 working days notification. All work shall conform to Northampton Water Department specifications. 4 {441t.— 4 6 Charles Borowski, Superintendent of Water cc: Ned Huntley, Asst. City Engineer Anthony Patillo, Building Inspector immommer ervi- Nortlikunpfon - i'Rif4Mi- 4 rEC 3 1. Ipojk • " 11,1 1SZ05741e.... 7:" ,,„="ClePAAI OF BUILDING INSPECr'ONS s S PEC TOP 212. Mi: Street. Municipal Building Northampton, Ma.ss 01000 Square Footage AlTount Easement @ 3a 1st: @, •0 JL /SO 2n3 Floor @ 20 9140 1/2 Floors, Attic, Garage .10 PO Deck, Porches ..L0 c?4- aco. c/o • TOTAL 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 HVAC 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) k Materials Identification: [ ] Materials and equipment must be identified so that compliance can be determined. [ ] Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. [ ] Insulation R- values and glazing U- values must be clearly marked on the building plans or specifications. Duct Insulation: [ ] Ducts shall be insulated per Table 14.4.7.1. Duct Construction: [ ] 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. [ ] The HVAC system must provide a means for balancing air and water systems. Temperature Controls: [ ] 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. Heating and Cooling Equipment Sizing: [ ] 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. Circulating Hot Water Systems: [ ] Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: [ ] 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. Heating and Cooling Piping Insulation: [ ] 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 la DATE: 12/11/02 TITLE: Lot 16 Cardnal Way Bldg. Dept. Use Ceilings: [ ] 1. Ceiling 1: Flat Ceiling or Scissor Truss, R -38.0 cavity insulation Comments: Above -Grade Walls: [ ] 1. Wall 1: Wood Frame, 16" o.c., R -19.0 cavity insulation Comments: Windows: [ } 1. Window 1: Wood Frame, Double Pane with Low -E, U- factor: 0.350 For windows without labeled U- factors, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ } No Comments: Doors: [ ] 1. Door 1: Solid, U- factor: 0.350 Comments: Floors: [ ] 1. Floor 1: All -Wood Joist/Truss, Over Unconditioned Space, R -19.0 cavity insulation Comments: Heating and Cooling Equipment: [ 1 1. Furnace 1: Forced Hot Air, 78 AFUE or higher Make and Model Number [ ] 2. Air Conditioner 1: Electric Central Air, 10 SEER or higher Make and Model Number Air Leakage: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] 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 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 cfin (0.944 L /s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs /ft2 pressure difference and shall be labeled. Vapor Retarder: [ } Required on the warm -in- winter side of all non - vented framed ceilings, walls, and floors. s .� Permit Number MECcheck Compliance Report Massachusetts Energy Code MECcheck Software Version 3.2 Release la _ Checked By/Date TITLE: Lot 16 Cardnal Way CITY: Northampton STATE: Massachusetts HDD: 6404 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non- Electric Resistance) DATE: 12/11/02 DATE OF PLANS: 12- 11- 02 PROJECT INFORMATION: Plantation At West Farms COMPANY INFORMATION: Dave Lepine Building Contractor COMPLIANCE: Passes Maximum UA = 381 Your Home = 308 19.2% 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 1132 38.0 0.0 34 Wall 1: Wood Frame, 16" o.c. 2475 19.0 0.0 134 Window 1: Wood Frame, Double Pane with Low -E 212 0.350 74 Door 1: Solid 38 0.350 13 Floor 1: All -Wood Joist/Truss, Over Unconditioned Space 1132 19.0 0.0 53 Furnace 1: Forced Hot Air, 78 AFUE Air Conditioner 1: Electric Central Air, 10 SEER 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 la. 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 tin design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer 2 - '/ r -�— Date 1, c)4 N„ w)s, tortirlybv2 vois el Xe s - - Nnicin at- 0,q.t _ _' -- _- -151 w 45 ante ___ t , C Aj - d cri vkidFJ. F oto r4- - a t M"w1faRs g59 (1, v c`n �f ■ „0)--11.1 , s"i`1 kf Gr+ L�otLg1X� �Y i . , CD CJ .1- ON 1° C D • I i - , _.__ ___. ,, 1 2„. .,..„ I _151,0_c , ,b ;,, �, N. , , - tit � a I y; } rr-- .c�:. „ M 1{ t a, \ C,�y� 47 l + i a b t .,, 9� M v c' c1 JV) b' --L cam Sr 4CV/ MaI (\ acat9 r 6.. M G 4 t• \\ y t? 1011111;kti‘ 1,-. \ \ h , o T - 1 iS . , Q"6 f /- (1 . ' at ILI) ,,. 1,7 cita______ 01 i S .-CttA P7'0 _ �o rx� cif Nar#11amphfI1 ` o .a 1t ( f$ :1: assaclinsclls . ^ " �" el . DEPARTMENT OF BUILDING INSPECTIONS 4 _' =1 i 212 Main Street • Municipal Building =_ Northampton, Mass. 01060 ~ so ' WORKER'S COMPENSATION INSURANCE AFFIDAVIT 11 (licensedpemlittec) with a principal place of business/residence at: fo gos5T ST . icp., i4A4 Os 7 (phone #) i//3-5 3,7s street/city/staff/Zip) do hereby certify, under the pains and penalties of perjury, that: ( ) I am an employer providing the following worker's compensation coverage for my employees working on this job: (Insurance Company) (Policy Number) (Expiration Date) ( I am .'41 e proprietor, general contractor > homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: A, " ri49i. 2 J�,er2 c4+ssr4 laA-J ',ma iret5a $'7?O /ca ex. f r- d 10 -c 3 _ (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) fA rigPie Asscveiace RI Ccrx✓Icrt t 547 V/ 3 Frq (0-05---0 3 (Name of Contractor) (Insurance Company /Policy Number) (Expiration Date) 654ck ?/04/1 t � 7U✓1lC '- S'C/dUfCdS LOC St'vl (o / !v Er/ ii-.20 -03 (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) Cevi iAr, s' <0. GJflird e, F /rc ►i4/< i.0 4 7 8 3 16-4 .,2 lo. 7-/ - 8 3 (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additioa sheet if ne ea.iry to include inforrnatioa pertaining to all ccctractors) . f • reo (o:,,.srrtut rye,/ r44tx/e45 e4s, iiu 6 7y& 3 /5�� (1C I am a sole proprietor and have no one w orkng for me. ( ) I am a home owner performing all the work myself. NOTE: please be aware that while homeowners who employ pe tona to do tratintenanct, construction or repair work on a dwelling of not mote than throe units in which the homeowner resides or co the grounds appurtenant thereto arc not generally considered to be employers under the war . compensation Act (GL152, s 1(5)), application by a hotneownr for a license or permit may evidence the legal etatua of an employe( under this Worker's Compoosation Act_ I understand that a copy of this rtatemont may be forwarded to the Department of Industrial Ao idmta' Oflioo of Irauaoca for the covaxge verification and that failure to so ure covet-ago t rvke cectioa 25A of MOL 132 can kad to the imposition of criminal penalties ` . oomistiag of a fun of up to SI,500.00 aadfor imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a fins of S100.00 a day against me. For dcpartmonal use only Permit Number _ , , 4111411r. t ,42- Q — Gc map' Lot # . s ' Signaanre of Li.... rnuttce • Fite . . , -�..., s... y- :rwwwern.. +....- ..�............ w.�+.� ...acv...- ....... .......... ..... ... t ' SECTION 8' ICONSTRUCTION' 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : 11 AW0 k4.. License Number 04 a .. o4-5'r . 57` £ 5 77 / 9 1 0 / , 'M � / c 7 0 fs Address Expiration Date 5 7,5" Signature Telephone �/ / D `� 7 - trae •t -. aop $1 taro v -'men =r•Irra c or.$*;44r - , .,r.��y ` ,�;�`���: Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SECTIONh10 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 de No ❑ 11 PT 0 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 t SECTION 5-, DESCRIPTION OF•PROPOSED WORK (check all applicable) New House ® Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ I Decks [ ] Siding [ ] Other [ ] Brief Description of Proposed Work: (ONSTatrctl— of O-i ywy/e -F ,1 yp,, Alteration of existing bedroom Yes _ No Adding new bedroom Yes No Attached Narrative ❑ Renovating unfinished basement Yes No Plans Attached Roll ❑ - Sheet ❑ 6a, If.PNew house and or. add tion- oexisting= Housing, complete Athe..folloWin : 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? y -es d. Proposed Square footage of new construction. po $ Dimensions 6 3 I J e. Number of stories? f. Method of heating? « i45 Lao' Ara Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? h. Type of construction OA) Sire_ i. Is construction within 100 ft. of wetlands? Yes lo. Is construction within 100 yr. floodplain Yes j. Depth of basement or cellar floor below finished grade Col k. Will building conform to the Building and Zoning regulations? _ ✓ Yes No . I. Septic Tank City Sewer V Private well City water Supply SECTION 7a - - OWNER- AUTHORIZATION- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR 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. 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. Signed under the pains and penalties of perjury. Print N ",' te' - / L f Signature of Owner /A :; Date 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 �r Building Department Lot Size I e. 3a S l �3 -�x-�y �Sl� /0, L ✓ Frontage cos te Setbacks Front Q5' 3 ' Side L: 1 J R: /5 L: 18 R:. / 7 1 l Rear as / /a , 2-5 Building Height 35 Bldg. Square Footage % oZ oS fsv Open Space Footage (Lot area minus bldg & paved parking) V / -� / V # of Parking Spaces Fill: (volume & Location) 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: 7 , - ty- , pf Northampton Sit illefing Department Cu 212 Main Street DE Room 100; ° S � . -� "�� � - Q `' N�ta p ton, MA 01060 p hone 41 587 -1240 Fax 413- 58 - 1272 Prot /Slter _ z , 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: .a I(p) c� 1 - 7 (A'JDi1,h A? Map Lot Unit Zone, < 5. Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: a tea a osT 53' 61.577/4710 1 Name Current Mailing Address: 7 4/ Telephone S/ /3 — S0)7 - 39 Signature 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 permit applicant 1. Building (a) Building Permit Fee I aO. oov . o 2. Electrical (b) Estimated Total Cost of _ � 0 © � Construction from (6) 3. Plumbing _ i0,000. 00 Building Permit Fee 4. Mechanical (HVAC) /® . oo C . OC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) - /a- 000, © O Check Number 5 35 /47, This Section For Official Use Only Building Permit Number: 6'3 D Date Issued: Signature:, Building Commissioner /Inspector of Buildings Date File # BP- 2003 -0530 APPLICANT /CONTACT PERSON DAVID LEPINE ADDRESS/PHONE 262 EAST STREET (413) 527 -3975 PROPERTY LOCATION 217 CARDINAL WAY - LOT 16 MAP 36 PARCEL 330 001 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid .5 di Z9c Typeof Construction: CONSTRUCT 2 STORY SFH W /ATT GARAGE /PORCH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 044188 3 sets of Plans / Plot Plan THE FO WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF CATION PRESENTED: Approved 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 Signature of Building fficial / 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. A -, BP- 2003 -0530 GIs #: CC _ EALTH OF MASSACHUSETTS ; ,l x$lo 36 - , � . CI OF NORTHAMPTON Lot: -001 - Permit Building. Cate BUILDING PERMIT Permit # .- . BP- - 2003 - 05 3 0 Project# JS- 2003- 0885`'.F Est. Cost: $150000.00' ` - Fee: $842.40 : PE/ZAHSSIOIV IS HEREBY GRANTED TO: Const. Class: 5B - coniiift- or: License: Use Group: R4 D AV I'D LEP I N E - 044188 Lot Size(scL ft.): - Owner: - DAVID LEPENE Zoning: SR . ip n t: DA LEP I'N E A X ARDFNALWAY - LOT 16 Applicant Address, Y w- : ° = Phone: Insurance: 262 EAST-- STREET .�a (413) 527 - 3975 Workers Compensation EAST H A M P T O N M A.01027. . ISS UED ' ON :/21/03'_ 0_ 0 0: 00 TO PERFORM THE FOMOWING WORK CONSTRUCT 2 STORY SFH W /ATT GARAGE /PORCH L POST THI :yVI LE : R C SO F T I 'OIVI THE STREET In of Plumbing nspector o D.P' W Building Inspector Underground: Service - l4 k Meter Footui 1 Rough: 6 4 Rough /� D House #€ Foundation: ,c, k IT � nveera} Final; zi -3'e 8 = Rough Frame 6 _ 5 ...%, Gas Fire I3euartment n =..- Fireplace /Chimney: Rough .Oil . . " ` Insulation: 0 K 6 " /7 - (`j3 Fin all- rf,'' ke: Smo Final: ,/"C 3 l -z, '3 THIS PERMIT MAY EE REVO ® . SHE CITY;OF NORTHAMPTON .UPON VIOLATION OF ANY OF ITS RULES AND REGULAT �z " Y Certificate of Occupancy - signature: Fee T s e: Recci i t No :v Date Paid: Check No: Amount: Building -',.:- - 1/21/03 0:00:00 5435 $842.40 212 Main Street,. Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo F`