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36-329 (4) i r- • S lJ L MUNICIrAL WATER AVAILABILITY AUG 2 1 2002 Northampton Water Department DEPT OF BUILDING INSPECTION 237 Prospect St. NOPJHA MPTGN, MA 01060 Northampton, MA 01060 587 -1098 Location: 196 Cardinal Way Lot #25 Inquiry Made By: Ronald Canon 527 -5766 Date of Inquiry: 08 - 05 - 02 Municipal Water Main in Front of Location: Yes No Size of Water Main: 12" Material: Al 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 amp o Water Departn t specifications. Charles Borowski, Superintendent of Water cc: Ned Huntley, Asst. City Engineer Anthony Patillo, Building Inspector D R ' l MUNICIPAL SEWER AVAILABILITY AUG 2 1 2002 , i ,.,„,. Northampton Streets Department - -- — ---_ 125 Locust Street D OF BUILDING P A Northampton, MA 01060 587 -1570 Location: � t , ..I Inquiry Made By: Ronald Canon 527 -5766 Date of Inquiry: 08 -05 -02 Municipal Sewer Main in Front of Location: Yes R No Size of Sewer Main: 2tt M a t er i al: 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 Thomas, 'Superintendent Streets Department cc: Ned Huntley, Asst. City Engineer Anthony Patillo, Building Inspector O Q- � tt � pT O � ti • CrztR of Noramtinvion A{as•achusctt• mti DEPARTMENT OF BUILDING INSPECTIONS =s= 212 Main Street ' Municipal Building , _ INSPECTOR Northampton, Mass. 01060 -" Square Footage Amount Basement @ .10 rr 88/ g, 16 1st Floor @ .40 f/ OA. 43V Wb jj � 2nd Floor @ .20 /� 7 it ` ( /l, 0 1/2 Floors, Attic, Garage .10 7 fY 7o Deck, Porches .10 3c2) 3O, OG TOTAL Y` Z , 30 } r :,1 I0 4, s J /�C C��' ait:/ l/ • • 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) • • 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. 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, glazing U- factors, and heating equipment efficiency 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 3.3 Release 1 c DATE: 08/02/02 TITLE: Lot 25 Cardinal 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 -13.0 cavity insulation Comments: Windows: [ ] 1. Window 3: Wood Frame, Double Pane with Low -E, U- factor: 0.320 For windows without labeled U- factors, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments: Doors: [ ] 1. Door 1: Glass, U- factor: 0.270 # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments: [ ] 2. Door 2: Solid, U- factor: 0.270 Comments: [ ] 3. Door 3: Solid, U- factor: 0.270 Comments: Floors: [ ] 1. Floor 1: All -Wood Joist/Truss, Over Unconditioned Space, R -13.0 cavity insulation Comments: [ ] 2. Floor 2: A11 -Wood Joist/Truss, Over Unconditioned Space, R -30.0 cavity insulation Comments: Heating and Cooling Equipment: [ ] 1. Furnace 1: Forced Hot Air, 84 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 • The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. / Builder/Designer d2e- f Date d /A�fJ / \ Ul t - . . , FIZ -22--------- . , - *, 1 L L ___----- t � y,� n �� I�� �t�"+ Permit Number MECcheck Compliance Report Checked By/Date Massachusetts Energy Code MECcheck Software Version 3.3 Release lc Data filename: C:\Program Files \Check\MECcheck\25 Cardinal Way.cck TITLE: Lot 25 Cardinal Way t ? , i'' /9 CITY: Southampton STATE: Massachusetts HDD: 6404 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non- Electric Resistance) DATE: 08/02/02 DATE OF PLANS: 8/3/02 PROJECT INFORMATION: Single Family Home/ w 2 Car Garage COMPANY INFORMATION: Ronald J. Canon Building Contractor COMPLIANCE: Passes Maximum UA = 465 Your Home = 433 6.9% 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 2200 38.0 0.0 66 Wall 1: Wood Frame, 16" o.c. 2545 13.0 0.0 181 Window 3: Wood Frame, Double Pane with Low -E 260 0.320 83 Door 1: Glass 40 0.270 11 Door 2: Solid 18 0.270 5 Door 3: Solid 20 0.270 5 Floor 1: All -Wood Joist/Truss, Over Unconditioned Space 1200 13.0 0.0 77 Floor 2: All -Wood Joist/Truss, Over Unconditioned Space 154 30.0 0.0 5 Furnace 1: Forced Hot Air, 84 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 3.3 Release lc and to comply with the mandatory requirements listed in the MECcheck Inspection Checklist. , N N n C O 1 Z ° � CURVE T o = 150'23DA'25A " 0 . D m R= 275.00' 4 A T= 1040.48' % L=721.82' v'ir St i \ 19LF OF 12 RCP CB 17 i' GRANITE CURB INLET *OP' STA. 25 +08 101 ■ RIM ELEV.= 272.11 Op NV. OUT= 268.11 s CB 9 o r _� W 12' 6:7‘91-11- '. J ir 00 �� a6 +00 S 25 �-� cn DMH 11 Qt, — •. 1.2. . -- -+ - STA. 24+09 7'R ' — RIM ELEV.= 271.54 INV. IN (DMH 12)= 266.36 INV. OUT= 2.68.26 - - S 3 0 11 LF OF 12 "0 R «. OS =1.36% • SS CB 18 GRANITE CURB INLET STA. 25 +08 10'R RIM ELEV.= 272.11 INV. OUT= 268.11 \ .. DMH 12 \\ .•T. ,.., lHA /0°4 o� CITY OF NORTHAMPTON, MASSACHUSETTS Iti, DEPARTMENT OF PUBLIC WORKS - #40 ' ) _� Y r / 125 Locust Street -- Northampton, MA 01060 mom 413 - 587 -1570 Samuel B. Brindis, P.E. Fax 413 -587 -1576 Director, City Engineer Guilford B. Mooring, P.E. Assistant Director of Public Works BOARD OF PUBLIC WORKS DRIVEWAY PERMIT GENERAL INSTRUCTIONS AND REGULATIONS 1. A "Driveway Permit" is required in all cases where a new curb cut or an alteration to an existing curb cut is proposed on a City public way. 2. Driveway permits issued by the Board of Public Works (BPW) shall be attached to and become part of the "Building Permit" issued by the Building Inspector. 3. Prior to the issuance of a "Building Permit" the owner of any lot to be serviced by a new driveway shall apply to the BPW for a "Driveway Permit" by completing the pertinent portions of the permit (see attached). Once the location of the driveway is approved by the BPW, a building permit may be issued. 4. The Building Inspector shall not issue an "Occupancy Permit" unless the driveway to the lot has been approved by the BPW. 5. By the issuance of a driveway permit for the stated location, neither the City of Northampton nor the Department of Public Works imply that no drainage problems will result with the driveway when constructed. Properties situated or driveways installed in low lying areas in the path of the natural drainage will be subject to water problems. These problems may include water sheeting across roadways adjacent to the driveway. The City and the DPW assume no responsibility for any such drainage problems. The owner of the property is responsible for constructing and maintaining the driveway with adequate provision for natural water runoff situations. muel B Brindis, P.E. Director of Public Works C:\MyFiles\Lyn\Eriveway Permit General Instructions Permit No. nos -01 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: Petiti . / er Ronald Canon 527 -5766 13 Rylene Circle Easthampton, MA 01073 -9262 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. • (�, ^1 Permit No. D05 -03 CITY OF 1N1 I AMPTON, MA _._._... .DRJYJW • Y PERMIT DEPT OF BUII 'rr :VSPECUONS Date: 08 -05 -02 FEE: $25.00 CHECK #: 1379 THE BOARD OF PUBLIC WORKS The undersigned respectfully petitions your honorable body for: Permission to install a driveway at 196 Cardinal Way 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. B y : % Zi1 C.1.44-14 Ronald Cann 527 -5766 13 Kylene Circle, Southampton, MA 01073 Telephone #: 413 - 527 -5766 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 & 2) A& ! - • ' 'r'''''''•Prr'Wiri•74:• •-• " , , • , i•• " ". , , - ,, - ' ,, • - " - - . 79(72 /IV ■ I OW. (...- .."54• • re. 0 r) 4911 1 : I •••••.....41,... , 00 ' • .. r ,,,, .. ,.., , , • -, )„, , , ,_ i; , 4- i , , , 3.t.,,,,,-,',55' ----, " i ,1)4917-i '' i 55--/i: .72:7-Pe a 1 / . : i . CC ' Si7Z "=‘.// i,--- - I , ---------... i 7 ( SE 1 --0`kit8i7 \ / CO T / • / • \ CD ---__, 1 :. j,,,,-. ___ v•-• / (NI' SE' I -- - -________ i - - --I ----------- .,------,--\\ IN: _ 10 gict. \ // .. / A' / ir , \ . ..v. - ,lo, / ,:.,v // (a-3, 107') 1y-49 site(bi , . , • ;v : .00 VW 'NOIANIVItiON . -St4011.13041%1011SICI 10 1430 r r - - f • ZOOZ 9 - onv 0 ..... ie 0, L. I , . . , , 4 - .511 PT o �E �XL x f Nortliatlt .?4IIIt �� _ * * =u At a "�'� i% `(ft B :ssachasetta' =j"+ �v:=Y = ' 1�1� _ DEPA RTMENT OF BUILDING INS PECTIONS _ .44__ • , Northampton, Mass. 01060 212 Main Street • Municipal Building �_ ow " WORKER'S COMPENSATION INSURANCE AFFIDAVIT 1 1 7 )r- 64 poir "X) 'censer/ ittec (li p� ) with a principal place of business/r at: /3 � ', cil re::-/ : O r:ffl �x , � grit- g7�/ • (- /-5 5 ' (phone #) C. / - Ce:7 /6 (street/city /statehip) 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 a sole proprieto jeneral contract r homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: Ca t-for+. Rgektc ,CLATI-geloi I oiz co 4. D C0'672 4 51970 -T 6: PaI Av4 a oz. (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) 4 ✓he Cl. k.C. (vr, . e I . Ft ‘ r1 (Lk t Pe'rrms fri IN 470(7 of 7/03 (Name of Contra or) (Insurance Company/Policy Number) (Expiration Date) C. TD Larhao x 44eitet .ye_ 419 i f Eod1e, rra to F 8 L O' 34 343 Z cfi u Z (Name of Contractor) (Insurance Company/Policy Number) (Ex t i "n Date) F /ecipc�rt C.PO fl,�lc'Laiel (164 (TT art" Ca iripbed oW / 4615z2O r d3 (14 of Contractor) (Insurance Company/Policy Number) (E tion Date) (attach a.dditioctal sheet if necessary to include information pertaining to all 000traon) (./6 am a sole proprietor and have no one w orking for me. ( ) 1 am a home owner performing all the work myself. NOTE: please be aware that while homeowners who employ persons to do 111A rt71s4 , nrr, construction or repair work on a dwelling of not mode than throe units in which the homeowner resides or on the grounds appurtenant thereto arc not wally 000sidacd to be employers under the worker's oompeasation Act (GL152,s3 1(5)), application by a hotneowecr fora license or Palma may evidence the legal N oh.; of an employer under the Worker's Compensation Act I understand that a copy of this statemeaC may be forwarded to tba Departmozd of Industrial Accidents' Oflioo of Insauwoo for tho coverage verification and that failure to secure coverage under section 25A of MGL 152 can lead to the imposition of criminal penalties coenieting of a fine of up to S1,500.00 and/or imprisoamcot amp to car year and civil pcssattier is the form of a Stop Wok Orel and a find of S100.00 a day against mc. I For dep:rtmeotal use only 1 a .` ,00 $ - i .0 i SERVIG ` _. s 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : ` e f V ` •-. Z14 75 36.75 License Number ( , Af''+?r t`'!r''f,, , S i//fl,�' ? ` lilq , 0 Address Expiration Date 0.. _ , 103 — .5 574 Signature Telephone _d~iotbn`•i1za "ift rsi11 " • k..,; s,. Not Applicable ❑ (21 r'1.3) / €+r! �� 1:. / (??+ / 0 � Z Z -� Company Name Registration Num er /"Z. c .'A, =te Address Expiration Date Telephone 4' 7 7/-6/, SECT [010 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 affic will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes ❑ No ❑ it i 'le c i,�; The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) famil and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner ac 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 ther 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 bi 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 persor 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 : A na, �--� ., -�. � .�wp^' �uf `' ��rµ M qt :�.` n + '' ', .r 4,�� .. *, s i z „r ,- ` SECTION 1 DESCRIPT ® 7 0 RO -® E ® > ' OR kkc ec appiicibile u" , .w4' `.t 41 n su N ...t,- ,4,1f, 1,..W 1,4dnth :r. 14 ,R.F:a: ,:,'`,.". New House , Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ a 5 %y New Si ] � k ]- iding ] „ O ther ] Brief Description of Proposed Work: By , A ,) y 13 r Z I - 80,1_ Si" rP imi/ ,Do.. td /e' • 1� Z a O Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative 0 Renovating unfinished basement Yes No Plans Attached Roll 0 - Sheet 0 a. Use of building : One Family ' Two Family _ Other b. Number of rooms in each family unit: ? Number of Bathrooms ,'2 c. Is there a garage attached? ye' d. Proposed Square footage of new construction.; ' `'?`� Dimensions `) " e. Number of stories? f. Method of heating? 6 ,- <Fireplaces_Or Woodstoves ��' -e- , Number of each g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? qcs h. Type of construction 4''t.' i. is construction within 100 ft. of wetlands? Yes j< No. Is construction within 100 yr. floodplain Yes X j. Depth of basement or cellar floor below finished grade k. Will building conform to the Budding and Zoning regulations? X Yes No . I. Septic Tank City Sewer ,k Private well City water Supply )(- SECTION 7a ::OWNERIAUTHORIZATION TO EBE COMPLETED WHEN OWNERS AGENT OR CONTRACTORaAPPLIESFOR BUILDING PERMIT I, , as Owner of the subject prope hereby authorize to ac my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date /—) v / I , /\ �` 1 Y'- 4,21 -/ , as Owner /Authorized Agent hereby declare that tyre statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains t/ and penalties oferjury. /7 /f i. <.. fi,1(011 Print Name ^7 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 1 �`� s�j j D, VO 0 Frontage 161;i o 1 • I y Setbacks Front Lf7 2 "' Side L: R L: 36"` R: 35' 1 5 Rear 101 9 Building Height 071 Bldg. Square Footage 2/ 700 O Open Space Footage (Lot area minus bldg & pavcd 0(j ' parking) f ) # of Parking Spaces Z ' Fill: (volume & Location) - r A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO DON'T KNOW YES IF YES, date issued: /224� 2_ 3 Z° IF YES: Was the permit recorded at the Registry of Deeds? , NO DON'T KNOW YES v / IF YES: enter Book G Page /68 and /or Document # B. Does the site contain a brook, body of water or wetlands? NO 1/ 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 11 J 4Northampton ! ii B I g Department . at ® v , yJ Ik� �' 1 a in Street - ®i t T al- f'. < <� i � r� - . R m 100 � ti sue: . �.- ..,. -�, ,r� ,, ii . a Ava a s a �3 � .� _ _ l am on, MA 01060 w e t 1 . 1)+Q oL u c 4 , � " � f �s Dz!ku;`'"7 1 40 Fax 413-587-1272 p1o �S � e s kr , n ' b 1 t" ^ e ms . . � p c sr Y k APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION l SITE INFORMATION 1.1 Property A ddres s: _ ,-.4 ph sect one o be completed by office,- , - (LC) J l 9(.. �(.�►' t�'lli ��l /� 1Y411.4 ' w ot� C n �' Zo " „ '4 7 : Ov e rIA N DIstr Lc t - y •ElmSiI ?,f. CB District SECTION -2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: /3 �y(Pnc �jPh- ,ryia / J. ' anon vr) ,) j7 d/073 Name (Print) Current Mailing Address. ��t i C„d _ /1� 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 o (a)- Building Permit Fee 2. Electrical 600 (b) Estimated Total Cost of Construction from (6) ............ 3. Plumbing 500 Building Perm Fee 4. Mechanical (HVAC) 5. Fire Protection � / 5-0o 6. Total= (1 +2 +3 + +5) /34Soo Check l �c d �„2, a This Section For Offiq 1. Use, ;rely Building Permit Number: �� � " Date t s€e iitt ,/ . 1 / Signat Wadding C /Inspector 01 =- Buildirigs_ . _ Date File # BP- 2003 -0135 APPLICANT /CONTACT PERSON RONALD CANON ADDRESS/PHONE 13 KYLENE CIRCLE (413) 527 -5766 PROPERTY LOCATION LOT # 25 - 196 CARDINAL WAY MAP 36 PARCEL 329 001 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 A gm7o CS Vol Typeof Construction: CONSTRUCT 2 STORY SFH W /ATT GARAGE /PORCH/DECK/FIREPLACE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 053675 i 3 sets of Plans / Plot Plan O THE FO OWING 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 Co ,. •fssion �,. e co 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. LOT # 25 -196 CARDINAL WAY , BP- 2003 -0135 GIS #: ; e0M1VIONWEALT1 ,SACIIUSETTS Map :Block: 36 - 329 ' CITY OF NL,_., .PTON Lot: -001 Building Category: BUILDING PERMIT Permit # BP -2003 -0135 Project # JS- 2003 -0262 Est. Cost: $131500.00 Fee: $812.30 PERMISSION IS HEREBY GRANTED TO: Const. Class: 5B Contractor: License: Use Group: R4 RONALD • CANON 053675 Lot Size(sq. ft.): Owner: RONALD CANON Zoning: SR Applicant: RONALD CANON AT: LOT # 25 1 WAY Applicant Address: Phone Insurance: 13 KYLENE CIRCLE 32''5766 Y SOUTHAMPTONMA01073 ISSUEXON :8/23/02 0 :00 :00 TO PERFORM THE FOLLOWING )CORK :CONSTRUCT 2 STORY SFH W /ATT GARAGE /P.ORCH /DECK /FIREPLACE 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: 7.03 Rou, ::1g� 3 � Rough: Tot/ Z / 4 : —House # Foundation: . 7''7 Driveway Final: 4— Final: /4-1/.7) j ���31��inaL• •�. /_ � � �� , Rough Frame: © o 7 Gas: Fire Department Fireplace /Chimneyt Rough: // - -- ` il: Insulation:0 k O -6 3 Final: /2-3/-03 f Smoke: /4/3 673 Final: ©/r / - THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON. UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occu.anc Si.nature: Fee Type: Receipt No: Date Paid: Check No: Amount: *TEMPORARY OCCUPANCY - EXPIRES 4/28/04 Building 1380 $812.30 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo