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36-318 223 CARDINAL WAY BP- 2006 -0335 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36 - 318 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit # BP- 2006 -0335 Project # JS- 2006 -0492 Est. Cost: $700.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): Owner: CAMPADELLI BRIAN J & Zoning: SR Applicant: CAMPADELLI BRIAN J & Applicant Address: Phone: Insurance: 223 CARDINAL WAY () 587 -0073 0 FLORENCEMA01062 ISSUED ON:9/27/2005 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL WOODSTOVE 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 (4 1211416S' 1-0 (' HIMedU S~ t)(6 THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupanc Signature: .-e" FeeType: Date Paid: Amount: Building 9/27/2005 0:00:00 $25.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo CArd.rv\ vA lo ��- i 15' from property line 24' Wide 25' from property line a C16' Long Pool House ■ Pool House ----I — . 1 CON 4'0 16'0 l Side View L 1 ,)`-.\ Top View Back View bk(o,A/ Foundation Xg - � etS 1 1 l r. -- Co 6- --, eS El 9-70 S4c)S r 0 - wA W I . IMMO MID nd a v _ r 1 ,..)(g_.ioi,,..s h NI ; I ` li ] r / 30'0 '`w. S APR 2 9 2005 I .ds �� Oy 1 . 4 � ; % e f .. �xty Qf Xorthantpinit • 1- 'gym e 1. p ,au'.. _ ;7 miy. . ; - _0 „ .. 1 I BSSAL I� IISt tt B ' imor �$ ∎.7 DEPARTMENT OF BUILDING INSPECTIONS 4 - — /: INSPECTOR 212 Main Street • Municipal Building , Northampton, MA 01060 5,... e HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his /her construction sups: ,'sor. 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 person(s) who seek to 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 eegulations. 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, V \ : k( understand the above. (Home owner /resident' signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date `i1 ,7f OS Address of work location A - CA,.4/ (41A-7 1 w • I • , / • Itt1J /p I ,. • }.° 4.:1'f.. (yii of �.�crd!1 1 . �,4.�._�'' �� _ 4 S � E J1 a as scclin srlls' • _ • r= � =�- — _ DEPARTMENT OP BUILDING INSPECTIONS • • - I I 212 Main Street ' Municipal 'Building, Northampton, Macs. 01060 r'. P WORKER'S COMTENSATION [NSURA.NCE AFFLDAV1T (]iaus ipermittcc) with a principal place of business/residence at: — _ (phoney') (st deity /stair /ap) do hereby certify, under the pains and penalties of perjury, that ( ) I am an employer providing the iollowinuworl:er's compensation coverage for my employees worijng on this job: { (Ins - ill - an= Company) (Policy Nu bcr) (:-proton, Dale) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who hzve the following worker's compensation policies: (Name of Coat: cior) (Insurance CoroanyPoiic ?Ntumt•r) (.x irouOn Date) (Name of Conu ctor) (Lasu ance Company/Policy Numirr) (Liniraiion Date) • (Name of Contactor) (tnsur Company/Policy Nastu) (Expiration Date) . (Name of Contractor) (Insurance Company/Policy Nnmly`r) (Expiration Dale) - (attxh it:ocat rbcc ifcuxcsi v to c,cu& iaforno. on pcu.iai.ag to all oar- 1 .0: . -j ( ) I am a sole proprietor and have no one working for me. y I am..a home owner per-fornung all the work myself. NOTE: pl=sc be con= Lz sq.-Bo bcmcowocrs .vbp cui p.=-1.0a to do =. = ,:csoo � rcpa. it work an . dwoth z of not toot c th _o 4'srr_ units is tabith the bocnoowocr rcmdo or co the goods a ppss co- u tbe-a.o arc not cm:.liy mar:6=d to be cnploycs unc'.c the ..ukdz c np=- --r; Act (GUI 52= 1(5)). rppLicni oa by c bamcoo-ocr far c 1.i=_- cc pcmri n_y cvicScooc t c lcip.1 rt n c of as azoploya.r under tho WorSc•• Coonr,o. 1. on Act 1 u=342-""ad tin a copy of tbu alt may may bu foevouctud to the Dop.nmocrt of 1 , *-riel Accdas>' °Moe of 11...+1-..oa+ for tho oovazsc vc i6citioo =Id ttu C.-11tac to sacsrt fovcralt ,tray/.-- soaioa 25A of MOL 152 an led to tic impo+eioa of criminal p - a +Ilia comtiti of a floc of up to SI,100.00 and/or Cosprisoozocca of up to one yror end dtii] pay.rtia in tSc focal of Stop Work Ordc cod • f ••. II $ idly •,, .. ( �ar For d.cm =-,. u.c only , . Permit )`Iumbcr _ +, e ° ` I,'tJ(),. L ot • inure of Li.... 4 •crmiucc D t_e • -- - � i SECTION 8 - CONSTRUCTION SERVICES + 8.1 Licensed C Supervisor: Not Applicable ❑ Name of License Holder : License Number Address Expiration Date Signature Telephone 9- a ti ere omi r OMOTif rit iiractn` ;'W G .. < ; 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 ❑ '� 11.4 W .x S i I. 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 "homeo certifies and sumes responsibility for compliance with the State Building Code, City of Northampton Ordinances$tat and Lo Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signatu : e r • SECTION 5- DESCRIPTION OF PROPOSED =WORK (check all applicable) New House ❑ Addition [] Replacement Windows Alteration(s) 0 Roofing El Or Doors 0 Accessory Bldg. X Demolition ❑ New Signs [0] Decks [D Siding [0] Other [CO Brief Description of Proposed f ifi,<e A r ' / f r� 7 / Work: ,��� a {..¢.t/ / (Q '1/l", '•�' Alteration of existing bedroom Yes j,� No Adding new bedroom _ Yes / No . Attached Narrative Renovating unfinished basement Yes 1/ No Plans Attached Roll - Sheet sa i 'i 6Tei . -. le a t ex i Rio sing pl 1t ri n : 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 OW , ` • ENT a ONTRACTOR APPLIES. FOR BUILDING; PERMIT � . A - -fr Div 4 , as Owner of the subject pr.• - hereby.a•' •rize to -ct y •� t,.lf, in all matters relative to work authorized by this building permit application. ` 4 - ife r- of Own ;R Date I, t ; i Z_ C 41111 as Owner /Authorized Agent hereby declare thV 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. I Dr ` T Cr-A' { l l Pr -fa �-, � , oz _ �a of O •ent Date I Fl r Section 4. ZONING All Informati6f5 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 SL`_ -' C S I # ' Frontage — S / C - , i Setbacks Front �� i Side L:' R L: i 7S = RI 9 5 I /0 Rear ` 1 S' , lv Building Height —I_ ' ' Bldg. Square Footage I % i E Open Space Footage % (Lot area minus bldg & paved ! ( i l i parking) # of Parking Spaces ' Fill: r �� " (volume& Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 1 DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 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 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO 1� IF YES, describe size, type and location: 1 D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO si IF YES, describe size, type and location: 1 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 0 ,- NO 9 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. e F l of N ortf�arrlpton s '. £ (`r t nr ilcing Department �' 5 , . t l 1 4 -, 212 Main Street ' g nn �� Room 100 y �- ppii 2 7 L 'plbtthampton, MA 01060 x ' a � ° � , phone 413 - 587 -1240 Fax 413 - 587 -1272 t® a `�' � i l� t, _ V _•.� ^sue ,-�, n. ,.. .. v:�,,. .a _.� " �# ? ..id's �`�� � ` APPLI C*11O TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: l T his section to be completed bynffice � � 3C A I w �br- eesc -t. M (� Map Lot Unit C �. i F ' Zor�e O . - District € EIm St DisPict , r u CB..Dlstnct .. SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGEN 2.1 Owner of Record: Name (Pr' t) Current Mailing Address: Telephone � ' g Si - i e `� ' `S 7 7 3 2.2 Authorized Agent: Name (Print) Current Mailing Address: Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS I Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building -70 no (a) Building Permit Fee 2. Electrical ( ,GU - (b} Ed : ta (t� f Construction stimateTo from l C 6 3 . Plumbing / CUB 0 Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection t+ 6. Total = (1 + 2 + 3 + 4 + 5) Check Number J' /7 , ,e 6 (7 This Section For Official Use Only Date Building Permit. Number. Issued: Signature: r — Date Building Commissioner /Inspector of Buildings Fill# BP- 2005 -1050 APPLICANT /CONTACT PERSON CAMPADELLI BRIAN J & ADDRESS/PHONE 223 CARDINAL WAY FLORENCE () 587 -0073 0 PROPERTY LOCATION 223 CARDINAL WAY MAP 36 PARCEL 318 001 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out 7 -2. 5 (90 Fee Paid 91 j V Tvpeof Construction: CONSTRUCT 16 X 24 POOL HOUSE /SHED 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 F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN ATION PRESENTED: A 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 ..,/ ' ,".4"-- _ s 4 / . (/6. ar 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 .1MIGL 40A. Contact Office of Planning & Development for more information. 223 CARDINAL WAY BP- 2005 -1050 GIS #: , COMMONWEALTH OF MASSACHUSETTS Map:Biock: 36 - 318 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit # BP- 2005 -1050 Project # JS- 2005 -1437 Est. Cost: $9000.00 Fee: $57.60 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): Owner: CAMPADELLI BRIAN J & Zoning: SR Applicant: CAMPADELLI BRIAN J & AT: 223 CARDINAL WAY Applicant Address: Phone: Insurance: 223 CARDINAL WAY () 587 - 0073 () FLORENCEMA01062 ISSUED ON:5/3/05 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 16 X 24 POOL HOUSE /SHED 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 5/3/05 0:00:00 $57.60 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo VVV 4 wrY) r 27-e , _____________________---- cct:' ov)?:: E\tc.-,1/ ■ ,,\ -- ,Sx,JJ).#7] (. t')\.r # __ ( g OD \ \ °c) \,, ` • . . ¢ ►SAM p�, ' O �9 E of Ntzil antpton • 0 7 _'` i $ ft. U7 r� r 4 tassachu cttS _ 3 _ ` _ _ DEPARTMENT OF BUILDING , , BUILDING INSPECTIONS I, ' : '__ INSPECTOR 212 Main. Street • Municipal Building ' Northampton, MA 01060 . r HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his /her construction sups:.•sor. 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 person(s) who seek to 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 u• ch time as the proper permits and inspections are made I, understand the above. : ome owner /resident's signature requesting exemption) will call to schedule all required building inspections necessary for the building permit issued to me. Date e ?'' / 0 Address of work �� location CAT O -EN.' ( tkb 0 ` '.1-- It - • / , 04CtvV tp 1 ,. , �� (yii tf l3aL- fl > r = A v �� � E �� :sanrl a • ti • •�j . - DEPARTMENT OP BUILDING INSPECTIONS w - 212 Main Strcct ' Municipal Building Northampton, Mass- 01060 r a WORIKEP'S COMTENSATION LNSURAANCE AFFIDAVIT' I . -- - ._ • - _.._ . -- (liccasczJpci inittcc) with a principal place of business/residence at: - -- • _(phone:') (st=r t/ci ty /state p ) do hereby certify, under thc.pains and penalties of perjury, that . ( ) I am an employer providing the following 'worker's comocnsaon coverage for my employees working on this job: (Insuranm Connacy) • (Policy Number) (T= : Date) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the conn listed below who live the following worker's compensation policies: • (Name of Con!racior) (III uranc;. Comnoanyi?oiic Numxr) (Expirduon Date) • - (Name of Contractor) (ltisurnc Company /Foley `umc-ir) (Exoiraiion Date) • , (Name of Con>tac ) (Insurance Compan y/Polio}- Nambei) (Ex Date) • (Name of Contractor) (tnsurano Comratry/Policy Numbcs) (Expiration Date) . (.ttsch :dutiecal bea,ifacecu:y to Odu O iafortoa pc- lain-iag to di oocc.,..cn:s) ( ) I am a sole -pr-oprietor and have no one working for me. I am.a home owner performing all the work myself. NOTE: plcsc h awsrc thz '...{Jo bcc cowvm wb caxplcry pc to dJ r- .:•- m r✓ .tcruo c- rc,-air..-oric on a dwvJi ,: of cot tnoti tbea tt-oc tmi'a is wbidt the bomoowncr rcide or oo t.bc coin zppurtc^ them r. cot c=c-.11y oocd.-roi to be citploy= uttde the a.:44∎Ces - - -, fc,a Act (G Ui 52.Sr 1(5)). r-pptiozioa by a bomena-oa far - Gem _ oc permit tr_y erideoce the Ic-®.l nays of .a es., loy.c under tbo Worlc.ola Coca oon..tion. Ad_ [ uadastaad the a copy clads mt.emcaz may bo foe- v.nrd..d to the D iooco¢ of In-a•rriel Ascdeati 0150. of I,..o ac for t6. • oovcmgc vcriretioa mad the (ntze to saauc'cover eCe tntdcr soeiioa 25 A of Not 152 ctc Imo! to the ia1p01;60a of criminal peniltic cocoa -cog of rise of up to S1}00.00 .ndf. -- _.. of up to ooc yr.= rod a pcaatirn in Cc roan of. Slott Work OtdQ cad ■ fin o(S100 .00 z Liz) ►pun wc. For dcy.na+ =� ...c only --- -- - ----' • , " Pct � � il Number ` U `j v4ap. - _ Lot K turt of .- . •ctmittcc Date - - . J r - SECTION 8 - CONSTRUCTION SERVICES ,.i' 8.1 Licensed Construction Supervisor: Not Applicable ❑ ` Name of License Holder : License Number Address Expiration Date Signature Telephone S: 2e • rs ere .l ome lm ®ratWeme - tali a o ..r ` ; " Applicable . , �, .. � � . ` Not A Uca ble ❑ Company Name Registration um er — " - -- Address Expiration Date Telephone SECTION 10 WORKERS' COMPENSATION INSURANCE AFEtDANiff (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 ❑ I L - oritera . .4 a,.. 51 8 _ t t 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 responsib ' for compliance with the State Building Code, City of Northampton Ordinances, State and • • - oning Laws . • rte of Massachusetts General Laws Annotated. Homeowner Signature — " i • SECTION 5- DESCRIPTION OF PROPOSED WORK (checkcall applicable) New House fl Addition 1:::1 : Replacement Windows Alteration(s) 0 Roofing El Or Doors D Accessory Bldg. TA De Iition /New Signs . Decks [1:::I Siding [CI] Other [CI] Brief Description of Propose Off (. Work: / Cr4; Alteration of existing bedroom Yes X No Adding new bedroom Yes No . Attached Narrative Renovating unfinished basement _ Yes No Plans Attached Roll - Sheet �, u sr ' ^�°- .:mss-= �:r�='� ,� ,�.,� . ... � �"" :�,�:�` : ".,:;!a?vw� =r.€ .. t , . spa �' eW Orri �F[C faC C� tatIu O; X` f to is s>trl � White h` a rT � l a. Use of building : One Family Two Family Other , b. Number of rooms in each family unit: Number of Bathrooms Z c. Is there a garage attached? \ / /• d. Proposed Square footage of new construction. ' . f,,, Dimensions e. Number of stories? f. Method of heating? / Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. / // asscheck Energy Compliance form attached? r h. Type of construction /- "', i. Is construction within 100 ft. of wetlands? : Yes No. I construction within 100 yr. floodplain - Yes No j. Depth of basement or cellar floor belt* finished grade k. Will building conform to the Building and Zoning regulations? Y No . A I. Septic Tank City Sewer Private well City water upply SECTION Ta - °OWNERAUTHORIZATION TO BE COMPLETED -WHEN OWNERS AGENT OR CONTRACTOR APPLIES'FOR BUILDING-PERMIT I, , 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 I, % , Q 4, 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. Sig und-r the pains and penalties of pej ury. i , te a �!i�l.� Print Name ��--- at4 2 : 1_ — () Sig ?=tureof = er •. -nt 9" D r , Section 4. ZONING All Informatioh 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 h' Lot Size d ACe t ' (1 ! i Frontage 3 etc V I ! l [ Setbacks Front ; 10 Side L: 1° I R:1 't7 'L: R: E.. j • - r - -, to Rear O Lf Building Height 17-1 I i I_ ___ __ - Bldg. Square Footage (9-n i' I ( % l = j i Open Space Footage % (Lot area minus bldg & paved C _ i 1 1 parking) # of Parking Spaces 71Z7171-' I I Fill: r ' 1 1 1 (volume & Location) _ A. Has a Spe 'al Permit /Variance /Finding ever been issued for /on the site? NO 44 DON'T 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 0 IF YES: enter Book E 1 i P and /or Document # s i B. Does the site contain a brook, body of water or wetlands? NO T.` DON'T KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? ' . Needs to be obtained Q Obtained Issued: ; C. Do any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: 1 D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO Ilir ` IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, ex - vation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 ,. NO ,®f i IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Y r 3 tk see as ! 9 "� of Northampton a:±1 ''xl L,. = I� Zvi ; I ing Department 1 ' �� � �' �� 2 Main Street �= � � � `� � � � ,;�,, r — ! I j Room 100 . ' a: � ar , r- 1 3 nA Nd j mpton, MA 01060 .. . phone 4113 -587f -1240 Fax 413 - 587 -1272 P - -' _ l the eec ,.� K „nx m_. -. x ., may„ 7 ('( PRLICAT(ON "�'(S� � llC+ , ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING • A �1STR SECTION 1 - SITE INFORMATION q This section to be comptetedd,b office ,wl ' � - f. 1.1 Property Address: tt a----3 - a m p CA iv4r �� ;Nlap� LOt r �r� U t ni y�,.P � Fh ,w M4 � „',,,s-,,, yG; } \cjx”" —e v‘c—k -- 1 1� �' ` 10(�� 2^a ne D piStrrct: . u ,EIrn Sf '" CB ?istrict r s SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: k — - - � �A —A �r-.si. A - �)-3 �, ,s , ,� W y Name (P. ,...00 Current Mailing Address: � Telephone �"� gn.. e 7 C` \- - Sv / ._ 007K- , 2.2 Authorized Agent: , Name (Print) Current Mailing Address: Signature Telephone SECTION 3- ESTIMATED CONSTRUCTION COSTS Item - cm(S.cd � �oc? / Estimated Cost (Dollars) to be completed by permit Official Use Only it a pli nt 1. Building . \,� r� � (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing J Building Permit Fee 4. Mechanical (HVAC) / 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) —' J ` S J <-, 7 7- Check' Number ��/5 —:: r This Section For Official Use Only _ c.�. Date Building Permit Numbe f ✓ , lassued: Signature: r I Building Commissioner /Inspector of Buildings Date File # BP- 2005 -0319 APPLICANT /CONTACT PERSON CAMPADELLI BRIAN J & ADDRESS/PHONE 223 CARDINAL WAY FLORENCE () 587 -0073 0 PROPERTY LOCATION 223 CARDINAL WAY MAP 36 PARCEL 318 001 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out 3 (, 11C0 Fee Paid Typeof Construction: CONSTRUCT 18 X 36 INGROUND POOL & 12 X 24 POOL HOUSE 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 ATION 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 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. 223 CARDINAL WAY BP- 2005 -0319 GIS #: COMMONWEALTH OF MASSACHUSETTS MapBlock 36 - 318 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- 2005 -0319 Project # JS- 2005 -0417 Est. Cost: $43500.00 Fee: $50.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): Owner: CAMPADELLI BRIAN J & Zoning: SR Applicant: CAMPADELLI BRIAN J & AT: 223 CARDINAL WAY Applicant Address: Phone: Insurance: 223 CARDINAL WAY 0 587 -0073 0 FLORENCEMA01062 ISSUED ON:9/17/04 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 18 X 36 INGROUND POOL & 12 X 24 POOL HOUSE 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: Receipt No: Date Paid: Check No: Amount: Building 9/17/04 0:00:00 346 $50.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo � y 1 NQ SNP MUNICIPAL WATER AVAILABILITY Northampton Water Department 237 Prospect St. Northampton, MA 01060 587 -1098 Location: 223 Cardinal Way Lot # 14 Inquiry Made By: David Lepine 527 -3975 Date of Inquiry: 10 -25 -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 1/ 6 4 .779 `r4 - Charles Borowski. Superintendent of Water cc: Ned Iluntley. Asa. ('i1c I - � isnk:er :Antli I:itill��. I:uiLli:iH MUNICIPAL SEWER AVAILABILITY Northampton Streets Department 125 Locust Street Northampton, NIA 01060 587 -1570 Location: 223 Cardinal Way Lot # 14 Inquiry Made By David Lepine 527 -3975 Date of Inquiry: 10 -25 -02 Municipal Sewer Main in Front of Location: Yes 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. (� < lo- 2 9- 0'L_ Joseph Ihonma�rintcnden� Joseph 1 Streets Department cc: Ned Huntley.:1ssi ('iiv I_nnLinccr :Anth∎un■ Palillo. 13uildine luspecloi 3 Permit No. D23 -02 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 : � Petitioner David 1'epine 262 East Street, Easthampton, MA 01027 413 - 527 -3975 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 36 -3/7 Permit No. D23 - 03 n Ov 1 3 2002 ! L Y OF NORTHAMPTON, MA DRIVEWAY PERMIT �,� Date: 10 -25 -02 Nn T .M lN ci :.. ` :__ CHECK #: 5349 THE BOARD OF PUBLIC WORKS The undersigned respectfully petitions your honorable body for: Permission to install a driveway at 223 Cardinal Lot #14 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: or - 7 -_ Davi. epine 262 East Street, Easthampton, MA 01027 Telephone #: 5,27- 3 9 7 S Proposed Location Inspected By: ;/ ,/ /- /,Q - U 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 & 2) cc: Building Inspector 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) [ ] Required on the warm -in- winter side of all non - vented framed ceilings, walls, and floors. 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 J4.4.7.1. 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: 10/24/02 TITLE: Lot 14 Cardnal Way Bldg. Dept. Use Ceilings: [ ] 1. Ceiling 1: Flat Ceiling or Scissor Truss, R -38.0 cavity + R -38.0 continuous insulation Comments: Above -Grade Walls: [ ] 1. Wall 1: Wood Frame, 16" o.c., R -19.0 cavity + R -19.0 continuous insulation Comments: Windows: [ ] 1. Window 1: Vinyl Frame, Double Pane with Low -E, U- factor: 0.310 For windows without labeled U- factors, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments: Doors: [ ] 1. Door 1: Solid, U- factor: 0.300 Comments: Floors: [ ] 1. Floor 1: All -Wood Joist/Truss, Over Unconditioned Space, R -19.0 cavity + R -19.0 continuous insulation Comments: Heating and Cooling Equipment: [ ] 1. Boiler 1: , 80 AFUE or higher Make and Model Number - B J e.A.J 3 (n O'/ X /3 c'? [ ] 2. Air Conditioner 1: Electric Central Air, 10 SEER or higher Make and Model Number h -ee,.A 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 cfm (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: Permit Number MECcheck Compliance Report Massachusetts Energy Code MECcheck Software Version 3.2 Release 1 a Checked By/Date TITLE: Lot 14 Cardnal Way CITY: Northampton STATE: Massachusetts HDD: 6404 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non- Electric Resistance) DATE: 10/24/02 DATE OF PLANS: 10 -24 -02 PROJECT INFORMATION: Plantation At West Farms COMPANY INFORMATION: Dave Lepine Building Contractor COMPLIANCE: Passes Maximum UA = 538 Your Home = 355 34.0% 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 1786 38.0 38.0 25 Wall 1: Wood Frame, 16" o.c. 3384 19.0 19.0 94 Window 1: Vinyl Frame, Double Pane with Low -E 572 0.310 177 Door 1: Solid 45 0.300 14 Floor 1: All -Wood Joist/Truss, Over Unconditioned Space 1786 19.0 19.0 45 Boiler 1: , 80 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 ° / the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date /C3 ���6� ; , r .. • -.. ..,,...:., 9. 5ru,Lip ; „ AINT Gi of \Icarilia. illptoiI _ '''Vte14 filastAchitattie ' .' li-M11 -cP DEPARTMENT Or 5UILDINC; IN'SPECT1C)ti. 212 Main Street ' i■funicipal Building '6 1 Northampton, M as_ 01000 - Square Footac • . ..„......— ...._....--4 w '''- rc 3asement @ .10 lsr_ Floor @ .40 /7 ....___. 2nd Floor @ .20 31 4,- cif, 1/2 Floors, AtLic, Garage .10 /1q40 Deck, Porches .10 , . . , ,......, TOTAL ii3L1.67 ---- 1 ... . . . B �� E $ GxtR U� t is tptcrn _* i g ii nt a faaaaacFhnattta _ V _ 44 52 . 50 04 :P4 %cif Cr es,' DEPARTMENT OF BUILDING INSPECTIONS • _ � k_..... ' , 212 Main Street • ' Municipal Building Northampton, Mass. 01060 r'��� WORKER'S COMPENSATION INSURANCE A eli'IUAVIT , C — I, j Li, D /1/4-1 {o - 'i.- (licenseelpermittee) with a principal place of business/residence at: 61.5'." =� 4- 7k. /y , in..) (phone #) q,3-- .5�3)- 35'75 'l street/city /stair/ap) do hereby certify, wider 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 a sole proprietor, eneral contractor homeowner (circle one) and have hired the contractors listed below who have tie following worker's compensation policies: 4Necil!00 rt -tC A ;,44' ke Z i-i, ). Ce,.ti( .e Ir-e. I.u 540 SS'i .j N ,S3 -,...)c..-:-.0 5 (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) r i fl4.Je/ e ?S cyU C4 S f u5 ( C r = f ? c , G J J t - S o a ( iV „ s"? L; ( 1 7 K0 S X . ? VE -( / 3 — /Y 4) 3 . ("'ame of Contractor) (Insurance Company/Policy Number) (Expiration Date) /,htrAA.4L- y44,5.e •'yvr M iZz:„ . 7)4ti 6/105(0 SrOrn�� 1 i 7 S' :.2 7 9 9 i' 03 (Name of Con tractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional sleet if necessary to include information pertaining to all contractors) (f) I am a sole proprietor and have no one w orming for me. ( ) I am a home owner performing all the work myself. • NOTE: please be aware that while homeowners who employ persona to do to *%ntemoee, coaslrudion or repair work 00 a dwelling of not more than three units in which the homeowner resides or on the grouts appurtenant thereto are not generally ooaridered to be employers undo the workers oncapcasation Ace (GL152,ra 1(5)), application by a hotncow cr for a liomac or permit may evidence the legal status of an employer under the Wordcozs Compensation Act. I understand that a copy of this etatcmcai may bo fotwnrdod to the Department of Ir.4 Accidents' Ofloo of I weans for the coverage verification and that failure to sxttre coverage under suction 25A of MOIL 152 acn lead to the imposition of criminsl penalties consisting of a fine of up to S 1, 500.00 and/or imprhoemart of up to one y:xr and civil penalties in the form of a Stop Work Orde: and a • fine of 5100.00 a day against tae. ,d ' % ' For ecpartaseutal use oily Permit Number «rd — /o -, ?3 _c ;) Map# Lot # > Y Signature o iamsee/Permitice Date i- SECTION 8 CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : . J UU License Number : ,) 3 T i tl� l�9 � =�rz� � ft.4- Of/(// Address Expiration Date y 3 5_7- Signature Telephone re men'; r. -,tagateRFAvv:r6Ingsj 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 ❑ 3 . Les >I kuA'As 11 ek 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 `'uis 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 CTION S if)ESC TION or PROI OSED WORK' ch "' c all „a • licable „ C,, , ,,. M+'Bf,• 6 At...• r'?Y!<YK . _L a +A7 r.' x .q „ +$,tlM,A W.6 :4 v^k.4i & ,. .> Msrv?:Aa A. F,,..:u. ,�. .;. New House flf Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] / Decks [ ] Siding [ ] Other [ ] Brief Description of Proposed Work: ([�'.;.;rY?�c Pa.; c f I t f , Cq „ ,t r Ltd Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative ❑ Renovating unfinished basement Yes No Plans Attached Roll ❑ - Sheet ❑ al IfI EWirz nd W dditid'ttto elistihrltotf in'g; complete' thV o[lo "ing: a. Use of building : One Family 7 TT�w, o Family Other b. Number of rooms in each family unit: 9 Number of Bathrooms_ 3 c. Is there a garage attached? )( d. Proposed Square footage of new construction. 33c.: F Dimensions 3S'X 3O/ V. X .Y /7X / e. Number of stories? c f. Method of heating? l--1j / /C% Af' C Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. . _ Mascheck Energy Compliance form attached? 2< h. Type of construction C i. Is construction within 100 ft. of wetlands? Yes X 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? X _ Yes No . I. Septic Tank City Sewer /( Private well City water Supply )— SECTION 7a "-V-V10:01,0THORIZATION TO BE COMPLETED'' WHEN OWNERS AGENT APPLIES FOR;BUILDING PERMIT j fj�� - CAvvc 1t as Owner of the subject property hereby au horizeAUt wk to act on my n all atters relativ to work authorized by this building permit application. C1;F- ignatur Owner Date t 0 ,AA - �. '� �iti-c' _ , 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. 040i49 c 4 - ' /A-r ' . Print Name 7 . �„, i,,, /e - - ?3 - ° 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 (vo 0 (P0. 0. ='k) 6,o, ecro Frontage tj�. cs r-61 @ i .Gta Foci Setbacks Front tc C> c ! o Side L: d R: 'W L: 1)6 R: 05 ( Rear `nl) � �� Building Height . Bldg. Square Footage a9ir % n 5 -- 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 YES f IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES V 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: r 7- --- max : "- 1 .6 ; ),:il .e cJ c i s �,, .: City of Northampton 41 , ,F Building Department ` i " Q , s � p �a�"b Yf ��g� _ a 212 Main Street f i` w: :4 0th Room 100 rw `° i x- ;4ir,t i,, Northampton, MA 01060 i "4 c w #r phone 413 - 587 -1240 Fax 413. 587.1272' ��' APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMON �J 1 AMILY DWELLING I ! i * ' r . OCT 2 5 ZOO SECTION 1 - SITE INFORMATION 1.1 Property Address TTi se i t � ,. !- a ril =�k + r by : „fice„ , P y i `s tot / -/ ,. ,_ .) C9 Win;A►,. AL� _,2 ap s o nat - r Zone , ;r : ” Qoera i ;Dist,' ct J Elm St . District" F., cB Dis SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: 4 ---,'"? -di ' , 58 - W)14/ift/C r - /iSititvcrni&v% ame (P t) M / C en ail ss dre: t) Telephone Signatu - 2.2 Authorized Agent: A(.413 11 t, ./°C? (� f;) t5)�.Si 7 siiit - 3 , A-i. Name (Prat) , Current Mailing Address: / �r,). Sri ' t -7 y/ ' ' : ; 7- 735'7,...Y Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Offic Use Only completed by permit applicant 1. Building (a) Building Permit Fee ‘/J 0 CCC`Co 0 0 2. E.iectrical 70 00 cc 0 V () Estimated Total Cost of Construction from (6) 3. Plumbing / O G 0 0 G Building, Permit Fee 4. Mechanical (HVAC) /). C)( n C+ <� 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) $if5y 000 0U ' Check Number 5 31 0 j .- ,py /if This Section For Official Use Only Building Permit Number: :8 D ate s sue d: _ golf) Signature . Building Commis �lnspector of Buildings i Date,,. „ ■ , File # BP- 2003 -0428 APPLICANT /CONTACT PERSON DAVID LEPINE ADDRESS /PHONE 262 EAST STREET (413) 527 -3975 PROPERTY LOCATION LOT 14 - 223 CARDINAL WAY MAP 36 PARCEL 318 001 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 ? 4 1) 3,,,,W( (o Typeof Construction: CONSTRUCT 2 STORY SFH W /ATT GARAGE/DECK New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 0441: ', 3 sets of Plans / Plot Plan 0 i % jam T F¢LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF 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 'ssion le-x/_,,,4 ' .••••••• _Zt) P a CX ) ).■••--- 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 1MIGL 40A. Contact Office of Planning & Development for more information. Vi i`# If', INALWAY- BP-2003-0428 5.: COMMONWEALTH OF MASSACHUSETTS x CITY OF NORTHAMPTON Lot: -001 Permit: Building - Category: BUILDING PERMIT Permit # BP- 2003 -0428 Project # JS- 2003 -0726 Est. Cost: $184000.00 Fee: $1324.64 PERMISSION IS HEREBY GRANTED TO: Const. Class: 5B Contractor: License: Use Group: R4 DAVID LEPINE 044188 Lot Size(sq. ft.): Owner: CAMPEDELLI BRIAN Zoning: SR Applicant: DAVID LEPINE AT: LOT 14 - 223 CARDINAL WAY Applicant Address: Phone: Insurance: 262 EAST STREET (413) 527 -3975 Workers Compensation EASTHAM PTON MA01027 ISSUED ON:10/31/02 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 2 STORY SFH W /AT?` GARAGE /DECK POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector I Underground: ervice: y�3 ' ii Meter: y / u Rough: t x3 Q,Hrl s Rough: ? 1 /'i /0 f ouse # Foundation: e t- 42- y ,W Driveway Final: 1 ,_...,,, Final: `/! l/" . . `^1 Final: �° \ A1�11�3 Rzi -� ek Rough Frame: - ! - 1 s-_ G 3 ..-1* Gas: 10 3/3 OW Fire Department Fireplace /Chimney: I Rough: Oil: ,l ( 0 �/ > Insulation: © >`/�<,�'7 , Final ,7 20 3 A Smoke: Mte, RA) 1 K S, Final: Q a S- ®3 ,,av4 - : a »r ,,?, , , ', "+ „ 1 3 x : fi n THIS PERMIT MAY BE REVOKED BY THE CIT 1 NORTHAMPTON UPON VIOLATIO OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy % Siznature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 10/31/02 0:00:00 5348 $1324.64 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patilla