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36-333 \r r . M AY 1 2 2004 ! i `` j ( :::) 1 .....miseismorn...47....,,,,,t04.0,...77/L, t.... ci , i 7 ,, 4.... LA (....., s ,.... . , I I two CI I a BAC ', 30 ' c r BOOK 6734 PAGE 15 (PORTION) ti woe 4 I PLAN BOOK !9O PAGE 84 1 2 arm- for I y4'#1µ lu PAVED ` 1 � DRIVE I X' I /? pARDINAL WAY 1 1 I _.._ p I � � ;e Oat of Nvrtlt &ntptt n ) _ - *_% i �� V '' DEPARTMENT OF BUILDING INSPECTIONS _`: _f = 1 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 Lis /her construction sups ,':or. 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 t� 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- -1-- . . , , 1 . € % 20 - 1 itik OlitiI of Nartlai inpion f '-7 _, ,..„. 4f • (.., Es .____ 2 1:..... ; . _ '—_---=; . DEPARTMENT OF BUILDEJG INSPECTIONS - • = AV ---- =.-t= r. .......-=. . 212 Main Street ' Municipal Building , Northampton, Mass. 01060 ,... • WORKER'S CONITENSA:110N INSUIZANCE AiFFIDAV1T (lic-cnstc.ir..ennittoe) viith a principal place of business./residencf_ al: (phonei) (strt:cticity. do hereby certify, under the pains ,Ind penaltie:; or perjnr■, t.hat. _.. ( ) I am an employer providing the followinQ worker's compensation covera for lily employees orking on this job: - ( L a s - a r a n c z . COE1PaLlY) e Cy Number) (E): Date) ( s I am a sole proprietor, czen T_I erai COICLOI ' bOrileOVIDer (C'' cle one) and have hired / the contractors listed below who haw_.' the follo -,. • '-:, ',,, cor.nPencjori polices: leelcil r / 6 Lc _/-k7,./ rd:: El\ramc of Contractor) (inftmancc Como z..71-,./Policy Nurnbcr) (1"-_,:rnt.ion Dato) (Name of Contractor) (Insurance CompariviPoNcY Nurnb.x=r) (Explra:ion Date) , .---, (Name of Coati ( Insa ranee Co m viPo I icy 1 ,F_Nr.:7:_:no Date) — ---- — (Name of Contractor) (las,: i Co ar. ::y/PoLic Number) (Expimtion Date) (mI1cii."..6-:.;itic.-,1, *.) 17.-:.:, ::1: .7-=,:::::: ',I; o:t.ra.rt:,,7.) ( ) I (1.111 CI sole proprieo 1 and ilaVt:', no oil - ...,.ur. - ',:in for me ( ) I dill a home OVo : liel=brIniric: all t'ne -.i ini,..scif NOTE: plczsc b tiwalc ttla: whilc l'i<c w1,2 cnTpitry -0-n t (:) :C‘1.7.:1: CC*0 01" :r.j.):Ilf ,:): no mccetl Limo units in tc . . 1. 1 11.::-.n.t..2wr,..:-.- rtiai,!..z2 c.,- oc, il,...t F.,7:22: z212 here a:c [7:.{ cuKtrzlly c‘2 :2 tv: cPl°r:7-3 ' 1E4 "' l'-v• (GL ",- 1 ( 5 ) . ?, nr ' a ho for a lica-z.c o.: ., -..:ineit: itt,..... legal c of en e=ploye< under ti.lc Workceg Cort.11. Act_ 1 unckrztxrid th .e. a co-py of this rtatcr-=1 raay bo focultrsio-d to 11 Dtvart--nortt of lo.ctuatrial Arcida-1:5" Offio. of !:.'-'-'"'''' fc c'°`'c vL and that failure 10 .v-c-Irf. covz 1111..1.74 tz,::',i 25A of ?.. 152 ran 1t11.1 to th e irnpositim coca of Fu of up 10 5 1_500.00 a'-'c x- in:pritt of tip to crAt )7.::.; ii:-. civil peraitia in tic form of ft Slc;, Wcri. Orc!..:: tr,d t firt.s. or S 1 00.(X) . thy c..7;.in..,1 a ._ 1 - , if f f _ . 1 . Q ) / 6 '' .,. :pignaturc of irccoi-,cc71;crimdc,: ( ri ,::: .:ti. - • -F1)-:17:17-rin:i:t711'1'-'-'1_117111Y'll:TITYATt - 11 - 11111: ill \ i - -- 4= ACORD CERTIFICATE OF LIABILITY INSURANCE • DA APR 2 04 INSURANCE OUCR CENTER OF NEW ENGLAND CERTIFICATE 18 ISSUED AS A MATTER OF �A� P 0 BOX 1175 ONLY ANO CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR W SPRINGFIELD MA 01090 -1175 ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. PHONE: 413-781-2410 FAX: 413 - 731 -9539 INSURERS AFFORDING COVERAGE NAIC 8 INSURED ! INSURER k HARTFORD INSURANCE COMPANY_ TEDDY BEAR POOLS, INC INSURER B: COMMERC INSURANCE COMPANY 41 EAST ST -- - -_._ —_ ... _ . — -- — - - -- - - - CHICOPEE MA 01020 INSURER C: A. M. MUTUAL INS CO INSURER Co: INSURER E. COVERAGES THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS NSR TYPE OF INSURANCE POUCY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE (MM/DD/YY) DATE (WNW/Yr GENERAL UABIUTY 08UUNQS9387 APR 1 04 APR 1 05 EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABIL _PREMISES (Ea ocwn,nu) S 300,000 CLAMS MADE X OCCUR MED EXP {Any Ore Person) S 10,000 A PERSONAL & ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PROOUCTS -COMP /OP AGG. S 2,000,000 POLICY PR(.1FrT I t1C AUTOMOBILE LIABILITY 04MMVM4663 APR 1 04 APR 1 05 COMBINED SINGLE LIMIT S 1,000,000 ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY (Per person) S B X SCHEDULED AUTOS X HIRED AUTOS BODILY INJURY X NON -OWNED AUTOS (Per accdent) - - - - - - -- PROPERTY DAMAGE S GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ANY AUTO OTHER THAN EA ACC $ P` AUTO ONLY AGG S EXCESS / UMBERELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MAOE AGGREGATE S S DEDUCTIBLE RETENTION S WORKERS COMPENSATION AND W842800299401 APR 1 04 APR 1 05 TORYTLIMITS oT}+ER EMPLOYERS' LIABILITY • E.L. EACH ACCIDENT S 500,000 C ANY PROPRIETORPARTNER:EXECUTIVE OFFICERIM.MBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE S 500,000 Fn. descnU. under SPECIAL PROVISIONS below E . DISEASE- POLICY LIMIT S 500,000 OTHER ■ DESCRIPTION OF OPERATIONS /LOCATIONNEHICLES/EXCLUSIONS ADDED ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 20 OAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT TO WHOM IT MAY CONCERN FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURE S AGENTS OR REPRESENTATIVES g £`+. t .i.y > alt ., ,j ` • • PRESENTATIVE - y I 'I + t r a ,k 'C. E `( ` ,ty ' ('• f4 1 _'�t y - Yr4 kY'r r t sa 7* • -.r t t �+s �' Attention: y5 g � } " ) 9 e ° V P� f � 'K 'At k �. + t • < ♦CClRD 2S (2001I08f :. . r < -�,. , " ) ' - 5 ,$5 i) ■Niam 0. , . , , .., • t . ,:-, ; •*t.• „ .,,.. Teddy Bear Pools, Inc. _ ' - - Known 111y Our ( 4 : 41 kilt Street . -- ' • - " ' r r --) (413 594-1656 : ■ . f48oci sA B—R Chicopee, MA 0102073562 W FAX (413) 598-8823 Homo Improvontont Cont. MA #11889/cr #520951 All www.teddybearpools.com _ . . . • IP! TEDDY BEAR POOLS CI SPAS : : ...:. k . ,,,. ..„2,„ *__Ir Ab * AP *Jr *2fr *__II Air Or ikpi *2r .- _ . ";:— • STATE OF CONNECTICUT + DEPARTMENT OF CONSUMER PROTECTION ■_, 1 .... - Be it known that .3. - . --- c TEDDY BEAR POOLS INC _ . :r? -.,___ , . .-„..- -41 EAST ST,-, . , -', ------:: CHICOPEE, MA-01020 .,,....., .--:-.. ---- '', has been certified by the 15ePartirfelit of Consumer Protection as a registered • ------ HOME ImpkOvtlytENT bONTRACTOR Contractor of Record:IHEODORE G. HEBERT > - , ..... , Registration # 5209.'1 t,. Effective: 1., r A > ...._i . Effecti% e: 12/01/2003 , Ali , Expires: 11 30 ---. 2004 ... -.,---!= ...,_ I ■ ••••■ . Ja .T. Fleming. Com m sioner. . -._, .. . ,.. tittr 1,4 Ai lli t s , 11. I,N#, 4 t , • ,'''''•-• "c.: 9- f. * •7; ...-I, .:',, '- -=:; ;f - 1 =.3:.42.:, 4, ,::* - ; =-::,... ",-.' ... . .. , . .. ..- 7 • t: - 6 . o ne inanetiect la oi , - ilaJsadaseaa Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration . , Recpstration. 111889 • Type: Pnvate Corporation EADiration. 2:8/2005 TEDDY BEAR' P0oLS & SPAS' INC frtif..Q.P.PRE, ...,...._____.. . " ,.. _ ..,..,... ____.......,..._ ..._ ..... _.....,....._ ,..... ... 41 EAST ST CHICOPEE. MA 0 1020 __ . SteTibict=r,,COISTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable Name of License Holder : ( /1 License Number • y/ & &mac f c/• G=l , e -�, Address Expiration Date Signature Telephone 'Re: `ere es :m•r.ue.. • m.Contracto. ; i a n' Not Applicable err 40 Company Name Registration Number Address Expiration Date Telephone Y C SECTION 10 'WORKERS'C.OMPENSATION 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 issu nce of the building permit. Signed Affidavit Attached Yes No ❑ t t " g,�YP1IP�'4i t t it 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 fc- 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, Stat- .nd .c. oning L•ws d f Massachusetts General Laws Annotated. sr / k Homeowner Signature • ♦ /, • SECTIONS DES TON ORPROPOSED WO (check all applicable) i :iA Px"k8 ., _... "t,Naiv.'"�.'tu"W gvg . ,. ,?:i »_.. ....m, .. ,, .,, .: New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ / New Signs [ ] Decks [ ] Siding [ ] Other [UV Brief Description of Proposed Work: . - 0 V e - C--f e /,-1 ci_ 0 0 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 6 Mf etiaft " `e nd or addi':trdtrito'ezist housinaali plef"e th6461 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. , . , ■ e. Number of stories? t -'-■ v i . i f. Method of heating? / Firepl 'es r Woodstoves Number of each g. Energy Conservation Compliance. Mascheck r Complia&rceform 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 SECTlONT0INER A UTHORIZATION ",T B WHEN (:1WNERSIA ENT'OR APPLIES. FOR BUILDING.PERMIT A/ . A 7 A - 6 :(-)C6}'') s s Ow of the subject property hereby authorize 7 0. to act on my behalf, in all m.t - to w• :u :fr -d by -this building permit application. ��1 r 1 I Signature of Owner Date -..r G -' y;t; I, ■ 0f L. t , as Owner/Authorized Agent hereby declare that the stat •ments and information on the fgt application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. SAL - 0 ce , � Print Na ,, arrer . „ ,fr;,, 4 ' .. 5,-.11(& Signature of 0 er /Agent Date r , Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: l0 Rear w Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg & paved 1� parking) / # of Parking Spaces /or Fill: (volume '& Location) A. Has a Special P it/Variance /Finding ever been issued for /on the site? KNOW DON T W YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW YES IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are t re any proposed changes to or additions of signs intended for the property ?YES No t IF YES, describe size, type and location: r City of Northampton : `t ` ikli Deartment 11 L r g p'M 8 �s, I , r _. _ . 2 M ain Street �. i? �� : �° " ` ; Room 100 ,. ` 7 1 MAY Northampton, MA 01060 ; ,, _ Ir 20 04 .. phone 413 -587 -1240 Fax 413 - 5874272 - _ o t r , - Ap LICATION' 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 sr C ' ,) I G~/ M a i -.,� ' t Lo�� Una y' / qo i e. - C I - ) (1� Zon ` erla Drstnc El ;St :,4":1,1 ist rict ' ¢ , =, C8 istr SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: l-/1 (.-'" C- c -j ' c) n 4 C �.s .r) e I 4 Name (Print a J Current�f ip 3ddrps Y ��.,_, ' � - Telephone — ' � Signature P' t ` J ~J 7 0 / 2.2 Authorized Agent: ?LA ,?,/,1 // Nam- (Pri t) Current Mailing Address: v ar / , r l -, 9 0 / Signature , I Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use. Only completed by permit applicant 1. Building y g 6 0 e) (a) Buildi Pe rmit, Fee 2. Electrical / (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 C heck Number c � ( 3 e L/ i,,.0` /d This Section For Official Use Only Building Permit Number: ,pd r //3 � Date Issued: Signature: Building Commissioner /Inspector of Buildings Date p 1 File # BP- 2004 -1132 APPLICANT /CONTACT PERSON GOLLING KATHY A ADDRESS/PHONE 122 CARDINAL WAY FLORENCE () 585 -9301 0 PROPERTY LOCATION 122 CARDINAL WAY MAP 36 PARCEL 333 001 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out � 9 ,�, 4y Fee Paid �4' Tvpeof Construction:_INSTALL 24' ABOVE GROUND POOL 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 LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN RMATION 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 'ssion .... ,.. ,, e 9. V . go d:5 10--- S` Ar 2 cad 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. 122 CARDINAL WAY BP- 2004 -1132 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36 - 333 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- 2004 -1132 Project # JS- 2004 -1694 Est. Cost: $8000.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): Owner: GOLLING KATHY A Zoning: SR Applicant: GOLLING KATHY A AT: 122 CARDINAL WAY Applicant Address: Phone: Insurance: 122 CARDINAL WAY () 585 -9301 0 FLORENCEMA01062 ISSUED ON:5/21/04 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 24' ABOVE GROUND POOL 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: FeeTvpe: Receipt No: Date Paid: Check No: Amount: Building 5/21/04 0:00:00 6304 $25.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo aJ � , 1 Nbi 3 I � �� ;� a \ tL FMCNICIPAL WATER AVAILABILITY TC 2 i j? Northampton Water Department 1 iW 237 Prospect St. Northampton, MA 01060 , 587 -1098 Location: 122 Cardinal Way Lot # 29 Inquiry Made By: Thomas Boyle 413- 527 -1580 Autumn Properties Construction Date of Inquiry: 10 -29 -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 snaking 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. t 1/(11-/C-145-f-,--"e Charles Borowski. Superintendent of V'■ater cc. Ned l luntle) , Asst. rift l-:nf:ineei :1ndion� InrapcU i W18 -03 Water Entry Application DATE: 06 2q 6 5 a SIGNED: /�, 7 0, 2 4 ' 6 �t�iame & e h n No. (Applicant' P o ) Thomas Boyle, Autumn Properties Construction P.O. Box 67R, Easthampton, MA 01077 (Address of Applicant) 413 -527 -1580 $ 200.00 entry fee paid. Check No.: 1406 $ 200.00 meter fee paid. Check No.: 1406 Application approved and permit issued: • DATE: F p ` -0 SIGNED: _ (Director of Public Works) FEE SCHEDULE: Water Entry. Permit Fee = $200 Water Meter Fees: 5 /8" Meter � $100 3/4" Meta = $ 150 1" Meter = $200 11 I W18 -03 RESIDENTIAL OR COMMERCIAL BUILDING WATER APPLICATION To the City of NORTHAMPTON, MASSACHUSETTS: The undersigned, being the owner of the Owner, Owner's Agent property located at 122 Cardinal Way Lot # 29 , does (Number) (Street) hereby request a permit to install and connect a 1 " Water (Size) Service to the Residence at said location. (Residence, Commercial Bldg., etc.) 1. "Owner shall mean the person holding title to the property served or to be served by the water service_ 2. The name and address of person or firm who will perform the proposed work is Dietz Construction 527 -2695 134 Lovefield Street, Easthampton, MA 01027. 3. Plan /Sketch and specification for the proposed water service shall be attached to permit. In consideration of the granting of this permit, the undersigned agrees: 1. The Water Department shall make all taps to the water main. 2. WATER ENTRY PERMIT fee is $200.00. 3. Additional work performed by City forces from the water main to streetline shall be paid at the prevailing labor rates and cost of material. Water Meters 5/8" $100.00 3/4" $150.00 1" $200.00 Water Meters 1 1/2" and above shall be purchased by the owners - using city specs. 4. The Water Superintendent shall be notifed for water line inspection prior to backfill of trench. 3(0 ' r ' MUNICIPAL SEWER AVAILABILITY f s �l Northampton Streets Department 125 Locust Street Northampton, MA 01060 587 -1570 Location: 122 Cardinal Way Lot it 29 Inquiry Made By: Thomas Boyle 413 - 527 -1580 Autumn Properties Construction Date of Inquiry: 10 -29 -02 Municipal Sewer Main in Front of Location: Yes x No Size of Sewer Main: 2 u 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 tee'' 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. v w l Joseph "hh< mas Superintendent Streets Department cc: Ned Huntley, At ('itv l i t t ecr :Anthony Inspector S25 -03 / Page 2 R.C.B.S.A. 4. The City shall not be held liable for an open plumbing fixtures below street level. 5. The applicant and /or owner hereby agrees to pay to the City any sewer use assessments or charges as may be established under city ordinance. DATE: Oejrc)q c)d0,9-- SIGNED -J /G4yY (App i can .. Thomas Boyle, Autumn Pro. -rties Construction P.O. Box 628, Easthampton, MA 01027 (Address of Applicant) 413 - 527 -1580 $ 200.00 Check No. 1407 } inspection fee paid. Application approved and permit is5ued: DATE: /4 . 31 04-- SIGNED: ) f� / ,(Super i n tender• ) Attachments: Code of Ordinances, Section 22 - 41 through 22 - 46. Tie -in to sanitary main $200.00 X Tie -in to sanitary service at street line $500.00 Tie -in to storm drain $100.00 S25 -03 FORM 79 -1 RESIDENTIAL OR COMMERCIAL BUILDING SEWER APPLICATION To the City of NORTHAMPTON, MASSACHUSETTS: The udders i gned, being the Owner of the (Owner, Owner's Agent) property located at 122 Cardinal Way Lot 1! 29 ,does (Number) (Street) hereby request a permit to install and connect a building sewer to serve the Residence at said location. (Residence,Commercial Bldg., etc.) 1. The applicant and /or owner shall furnish upon request of the Superintendent the estimated quantity and characteristics of waste to be discharged to the public sewer. 2. "Owner" shall mean the person holding title to the property served or to be served by the building sewer. 3. The name and address of person or firm who will perform the proposed work is Dietz Construction 527 -2695 134 Lov'field.St., Easthampton, M— 01.027 4. Plans and specifications for the proposed building sewer are attached hereunto as Exhibit "A ". In Consideration of the granting of this permit, the under- signed agrees: 1. To accept and abide by all provisions of the Code of Ordinances, City of Northampton, Massachusetts, Sections 22 -41 through 22 -46, and all other pertinant ordinances or regulations that may be adopted in the future. 2. To maintain the building sewer at no expense to the city. 3 . To n o t i f y t h e S u p e r i n t e n d e n t uh t h e L u i l d i n c l seer I S ready for inspection and connection to the public sewer, but before any portion of the work is covered. AMMOMMOW Nov 05 02 09:20a DPW 4135871578 p.2 , Permit No. 027 -03 _ CITY OF NOR'T'HAMPTON, MA DRIVEWAY PERMIT Date: 10 29 02 FEE: $25.00 CHECK #: 1408 THE BOARD OF PUBLIC WORKS The undersigned respectfully petitions your honorable body for: Permission to install a driveway at 122 Cardinal Way Lot # 29 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: Thomas Boyle Aut /Properties Construction P.O. Box 628, Easthampton, MA 01027 Telephone #: 413- 527 -1580 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) cc: Building Inspector [ ] Ducts in unconditioned spaces must be insulated to R -5. Ducts outside the building must be insulated to R -8.0. DUCT CONSTRUCTION: [ ] All ducts must be sealed with mastic and fibrous backing tape. Pressure - sensitive tape may be used for fibrous ducts. 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. HVAC 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. MISC REQUIREMENTS: [ ] Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems. - -- -NOTES TO FIELD (Building Department Use Only) MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.0 DATE: 11 -6 -2002 Bldg. Dept. Use CEILINGS: [ ] 1. R -38 Comments /Location WALLS: [ ] 1. Wood Frame, 16" O.C., R -17 + R -3 Comments /Location WINDOWS AND GLASS DOORS: [ ] 1. U- value: 0.40 For windows without labeled U- values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments /Location DOORS: [ ] 1. U- value: 0.35 Comments /Location FLOORS: [ ] 1. Over Unconditioned Space, R -19 Comments /Location HVAC EQUIPMENT EFFICIENCY: [ ] 1. Furnace, 87.0 AFUE or higher Make and Model Number THERMOSTATS: [ ] Adjustable thermostats required for each HVAC system. AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an appropriate air -tight assembly with a 0.5" clearance from combustible materials and 3" clearance from insulation. 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- values, and heating equipment efficiency must be clearly marked on the building plans or specifications. DUCT INSULATION: MAScheck COMPLIANCE REPORT Massachusetts Energy Code ., Permit # MAScheck Software Version 2.0 Checked by /Date CITY: Springfield STATE: Massachusetts HDD: 5955 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non- Electric Resistance) DATE: 11 -6 -2002 DATE OF PLANS: TITLE: COMPLIANCE: PASSES Required UA = 605 Your Home = 492 Area or Insul Sheath Glazing /Door Perimeter R -Value R -Value U -Value UA CEILINGS 1542 38.0 0.0 46 WALLS: Wood Frame, 16" O.C. 2736 17.0 3.0 156 GLAZING: Windows or Doors 280 0.400 112 DOORS 300 0.350 105 FLOORS: Over Unconditioned Space 1542 19.0 73 HVAC EFFICIENCY: Furnace, 87.0 AFUE COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. 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 1250 of the design load as specified in sections 780CMR 1310 and J4.4. Builder /Designer Date Jar. j . a. :. Y i.t4 . • s_ ( �1.xt�t of Northampton _ _ * —r 8 �'� 6 J l assachusrtte �- _L� _ • . —i . , `a _=.— _ �"} r DEPARTMENT OF BUILDING INSPECTIONS • ?_ El INSPECTOR 212 Main Street ' Municipal Building _ Northampton, Mass. 01060 - " Square Footage Amount n Basement @ .10 /51 ' IV/ c2V 1st Floor @ .40 / 3 01,-- '7 o 2nd Floor @ .20 779. _ 1 c' " O 0 1/2 Floors, Attic, Garage .10 41/57/ ile Deck, Porches .10 /[/xll a Ll '� - Lf o ` 1 l ({ i , G ego e TOTAL 1 c ". YO(0-7/X- 347 ..• Z ar 1 9t fe.414-13,742"----- tee ,,r . n, lle' . - (t1Al't P�. o. !...t I -----.-----v } DEPARTMENT OF BUILDING INSPECTIONS 4 � =rte 212 Main Street • Municipal Building a Northampton, Mass. 01060 as ' .,• WORKER'S COMPENSATION INSURANCE AFFIDAVIT I, �1, 5 yc, A-0 X4/4/ ?arc s C_ (lie nseciperm ) with a principal place of business/residence at: J /IR !I /U� _ �h /...� ' �� '� - � _ (pone. � 1 — stre..ucity/st.tc zip do hereby certify, under the pains and penalties of perjury, that (( I am an employer providing the following of r :cis comaeas iron coverage for my employees working on this job: / 1K ?e�i43" 10)0 / U 3 6 /A b 3 (Insurance Company) (Pelic: Number) (Fxpiraho Date) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers cornsensation policies: (Name of Contractor) (Insurance Company/Policy Nulnkr) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance CompanyiPoIicy Number) (Expiration Date) . ( of Contractor) (Insurance Company/Policy Nambo 1 (Expiration Date) (attach adshtiocril s!xQ ifnacczss y to iocludc infocrastioe pertaining to all crcr<.rad.>: ( ) I run a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself NOTE: plejse be atrarc that while honmwircra wtw c.Lploy z ai to es) rr cx:-� :nmm or repair work on a dwtlling of not wow than three units in wtiich the homeowner mines or cc the Ereun:11 ,. uttcvaru thacto cc nx caxrally ooeoaidcmi to be employ under the tucker's ccxnpc satim Act (GL152,s31(5)), n.pptiation by a hotncow3cs 1cr a ticcise or pcsinit may evidence the ' legal rt..tus of an onaployes. ardor the Workers Coaatxmalion At I undc;:tand thsi a copy of this daft may be, forw.udvd to the Doputromt of Loaustrial AcnLaits' Ofrioo of Imuranco for the coverage vcrificstion and that failure to a�.,cure coverage undx section 25A of MOT, 152 c Lead to t'rc imposition of criminal penalties consisting of a frnc of up to S1,500.00 andlor imprisonment of up to ore yin and civil penalties in ' foam of a Stop Woric Ord. and a firs of a day against mei For d =tal u.o only Permit Number 1.41 g/ i., IV 7 0,--j-- Mi-Ip0 _ Lot • t • aturc of ,w if crmittce Date _ - LL SECTION 8 -,CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applic able 0 � / Name of License Holder : 1 O/ 1 . J5 7-- _ CD e 9` -'`- e 999 3/ License Number Addres Expiratt n Date P (9-7- / Sig :ture Telephone 9.4R egister'ed "Homed mprovemenf- 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 ❑ ; ® zomexOwnerx }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 fe- 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 SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) -. New House Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolitior;A !e Si ns ] Decks [ ] Siding [ ] Other [ ] Brief Description of Proposed Work: J CO A/STrr1C7 A • r,- TA -7/ C./ ht,n-7 e_ Alteration of existing bedroom Yes �o new bedroom Yes No Attached Narrative ❑ Renovating unfinished basement Yes No Plans Attached Roll ❑ - Sheet ❑ 6a." If'- New . - toto existin: housin:, complete =the following: a. Use of building : One Family v — Two Family Other b. Number of rooms in each family unit: q Number of Bathrooms. c. Is there a garage attached? >1' d. Proposed Square footage of new construction. / _ Dimensions % d iek _ e. Number of stories? f. Method of heating? . -)0 .- Ci 4.7 1 INOff}ir ' /L- Fireplaces or Woodstoves._� Number of each . t2 g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? >/'e.S h. Type of construction / `_ /t i. Is construction within 100 ft. of wetlands? Yes i/<1 Is construction within 100 yr. floodplain Yes Ne j. Depth of basement or cellar floor below finished grade 6 / � k. Will building conform to the Building and Zoning regulations? /' Yes No . I. Septic Tank City Sewer l/ Private well City water Supply L- -----_ SECTION 7a OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, r'`7!i - 't..s J ✓' , L 6 e__ , as Owner of the subject property hereby authorize C"'1 -fit. -S TD ' &2/ . 1-- ---- e-- _ _ — to ac; Or my beh If, in all matters relative to work authorized by this building permit application. ignature of Owner ij D: e 1, 1,0-- a 5 ,) �' , as Owner /.Authorized Agent hereby eclare 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. critio%j'14 5 D _ Print-Na e y _ . - - -- - / 7 ate Sign.ture of Owner /Agent Dat 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 / Buildi ng Department J /1' 5-6-4 I Lot Size _/ h I � U C Z :1J Frontage , U / a U l U Setbacks Front 9 LK ' a 4 9 j Side L: 33 R: / L: S 3 R: / 4P Rear 5 �" Building Height 7 Bldg. Square Footage `ffJ Open Space Footage / (Lot area minus bldg & paved parking) D # 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 iegistry f 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 v 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 t/ 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: 1 w �yy�r'1�'r `M 1';i� i 6a e0 ?� -� SO �/` +`� '^�. ity of Northampton Ss of Permtt � � m as" as Buildi Department Cur146ut/Druew6 e ,.4 ° =, ';‘ " 212 Main Street Sewer /S ep t i ;t ablJ �� e "A t l � ' Room 100 W e /W ll�val a bi Ity ' - . �t, Northampton, MA 01060 Two ete�of Ste c ralrP an 5 � ... . P = � � , ,' , "`� hone : Fax 413 587 1 272 Plot /Site Plans Other Specif a V A � e. �s-t : APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section toVoutpl by office / ,7 q R4,4/Ir i7 ,ii/ Map 6 Lot � � Unit /, Apt6e :. 0 LAID/ IgG ti/g)1 Zone -57(.... Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 1 I 1 2.1Owner of Record: /4 ."?sr/ /7le1 2i7? e S ./1c_. To. `& eaD g' Ept r p7 0-1.-/ /i-)4 1 Name Print) ant %1;11I ■ng Address: i - 6J 7 — /J C-. Signau,re 2.2 Authorized Agent: r� - n'IR. _ .DC. - /L Pe). B®/ 19cD &A5 Name (Pent) Current Mailing Address: , , ,rr�� Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be 1 Official Use Only completed by permit applicant 1 Building (a) Building Permit Fee /o 0-0-0---- Ele. rical ' b) : _stimated Total Cost of C Construction from (6) g (� Building Permit Fee 3 Plumbing — — /moo- 1 Mechanical (HVAC) 1 5 Eire Protection f 6 / 6 Total - (1 4 2 + 3 + 4 + 5) I r9-/ ?-/ PJ l Check Number /4 3 _ ! This Section For Official Use Only ___ Budding Permit Number: 140 '"fp71- Date Issued: — —_— - _ 1 Signature: - Building Commissioner /Inspector of Buildings Date File # BP- 2003 -0472 APPLICANT /CONTACT PERSON AUTUMN PROPERTIES LLC ADDRESS /PHONE P 0 Box 628 (413) 527 -1580 PROPERTY LOCATION 122 CARDINAL WAY - LOT #29 MAP 36 PARCEL 333 001 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 �,� ( E: l -YD 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 044431 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 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. ko4 0AMp . A A t (tif r of Northampton > = * * $ � ' c �sl► ` fit jilassacipartts : _' `�. DEPARTMENT OF BUILDING INSPECTIONS ^ t-=_-1= `: _f INSPECTOR 212 Main Street • Muuicipal,Building Northampton, MA 01060 CERTIFICATE of OCCUPANCY and USE This is to certify that permission is hereby granted under 780 CMR, sixth edition of the Massachusetts State Building Code, allowing the occupancy or use of the premises o_r structure or part thereof located at 122 Cardibal Way 1ot29 as shown on the Assessors Page# 36 , Lot# 333 , Zone SR in the City of Northampton, as herein specified: CONSTRUCTION TYPE(780CMR 6) 5B USE GROUP CLASSIFICATION (780 CMR 3 R4 OCCUPANT LOAD PER FLOOR (780 CMR Table 1008.1.2 200sq ft p /occupa LIVE LOAD PER FLOOR (780 CMR Table 1606.1) 401bs p /sq ft 1st 301bs per sq/ft 2ndfloor sleeping rooms Under the following limitations, special stipulations, and /or conditions of the permits: Issued this 11 day ofSeptember , 2003 • Certificate of Occupancy and Use # bp 2003 - 0472 Authorized Dep ent Personnel Electrical_, Elevator Fire p, „rt..,� �,z Plumbing .� _ _41 J --` Building i / Gas ._ // /�r.�r ' Building Commissioner ■ .' This certificate shall be posted by the owner, in a permanent manner and in a visible location, on all floors designated as use group H, S, M, F, or B, and in'everx, room where practicable of use group A, I, R -1, or R -2 per requirement of 780 CMR section 120.5 Posting Structures. w w/ d dt-v 5 CO il 122 CARDINAL WAY - LOT #29 BP -2003 -0472 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36 - 333 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit # BP-2003-0472 Project # JS- 2003 -0791 Est. Cost: $212000.00 Fee: $689.90 PERMISSION IS HEREBY GRANTED TO: Const. Class: 5B Contractor: License: Use Group: R4 AUTUMN PROPERTIES LLC 044431 Lot Size(sq. ft.): Owner: AUTUMN PROPERTIES LLC Zoning: SR Applicant: AUTUMN PROPERTIES LLC AT: 122 CARDINAL WAY - LOT #29 Applicant Address: Phone: Insurance: P O Box 628 (413) 527 -1580 Workers Compensation EASTHAMPTONMAO1027 ISSUED ON:11/21/02 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 2 STORY SFH W /ATT GARAGE /PORCH 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: Y e 73 1 Rough: t , �j/� House # Foundation: j� 0 - 3_ c 3 r / /�� ° 7 Driveway Final: Final: 0,6 64 Final: PEA 512e-34 �C Rough Frame: OIL " 3 - ' i p / Gas: f / _ _ _ _Firs nPr , rtm�n_t Fireplace/Chimney; Rough: `-Bfi''""' ,y Insulation: e -'4 g/ — Final: // Smoke: 6-7 /�� Final: ? /C q Lj _ U THIS PERMIT MAY BE REVOKED BY THE CITY ■ F NORTHAMPTON UPON VIOLATI OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy � Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 11/21/02 0:00:00 1433 $689.90 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Apiiiony Patillo