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ARCHIMETRICS Behrens Residence Belfry Roof Framing
DESIGN STUDIO
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28 NORTH MAPLE ST 164 North Farms Rd. Date September 26, 2008
FLORENCE, MAO 1062 Northampton, MA
LAPOINTE, ARCHITECT Drawn by pel
PH 582-9100 FAX 582-9101 A1.3
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Permit No. D04 -09
Conditions: Driveway Permit
In lieu of plan approved by the 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 Sig atif ure
Name: Michael Behrens
Address: 669 Park Hill Road, Northampton
4413 -586 -0138
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.
For Commercial and Industrial applicants, a plan showing the proposed driveway with
grades and location is required.
Cc: Building Inspector
ID
Permit No. D04 -09
CITY OF NORTHAMPTON, MA
OCT 1 4 2008 DRIVEWAY PERMIT
Date: 9/3/08
Check #: 517
FEE: $250.00
THE BOARD OF PUBLIC WORKS
Driveway must be staked and house & lot number posted
The undersigned respectfully petitions your honorable body for:
Permission to install a driveway at: 164 North Farms Road, Northampton, MA
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 as soon as possible if the grade of the proposed
Driveway exceeds 3% or more. Homeowners will be held responsible for any cost to the City
Of Northampton in the event of a washout of this driveway.
By: Michael Behrens
Telephone: 413 -559 -1812
Signature:
Proposed Location Inspection By: 5
Gravel Base Grade Inspected By:
Final Approval:
THE BOARD OF PUBLIC WORKS voted that petition be granted.
Edward S. Huntley, P.E.
Director of Public Works
Cc: Building Inspector
(SUBJECT TO ATTACHED CONDITION 1 & 2)
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COMMONWFALTII Or ? - 7.e16
Board of Health, 1 t 4t j I f ' , MA.
DISPOSAL SYSTEM CONSTI 1 CTION PERMIT
t Permission is hereby granted to; Con struct( Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system
at / t) art /it t ( glf 1 as described in the application for
Disposal System Construction Permit No /5` , dated ofV/ 4, /ti-
Provided: Construction shall be completed within three years of the date of this permit. All local con ' ions must be met.
Form 1255 Rev. 5/96 A.M. Sulkin Co. Charlestown, MA Date r /3'f Board of Health :, ?,,,.ti, ,c;,./ ,
ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR
ONE- AND TWO - FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00)
Applicant Name: -t't r2.04. E zlc°s A/,.. Site Address: /.r 7" ti ■?,r s 4 , 4 e .
print Town: i ' /lam' ,,� , o..t/
Applicant Phone:`? ` `-`f –P - /.. / L
Applicant Signature: -'"� e �� — Date of Application: °� '�i�
NEW CONSTRUCTION: (choose ONE of the following two options)
780 CMR TABLE 6107.1
PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR
NEW ONE- AND TWO- FAMILY BUILDINGS
MAXIMUM MINIMUM
Ceiling or Slab
E./Option 1: Basement
Fenestration exposed Wall Floor Perimeter
U- factor floors R -Value R -Value Wall R -Value AFUE HSPF SEER
R -Value R Value and Depth
National Appliance Energy
3 5 R -3 8 R -19 R -19 R -10 R -10, conservation Act (NAECA) of
4 ft. 1987 as amended, minimums or
greater as applicable
Note: This form is not required if you choose either of the two versions of REScheck as listed below.
❑ Option 2: Ai REScheck Version 4.1.2 or later variant software analysis must be completed
(780 CMR 6107.3.2)
REScheck –Web which can be accessed at http:/ /www.energrvcodes.gov /rescheck/
ADDITIONS OR ALTERATIONS TO EXISTING BUILDINGS OVER 5 YEARS OLD*
*Buildings under 5 years old must use option #1 or #2 in New Construction section above.
Complete the following formula to determine the % of glazing:
(a) Gross Wall & Ceiling Area equals Formula: (100 x b ± a)
SF
100 x ± = % of glazing
a
(b) Glazing area equals SF b
If glazing is < 40% use the chart below. If glazing is > 40 % proceed to "SUNROOM" section
780 CMR TABLE 6101.3
PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING
LOW -RISE RESIDENTIAL BUILDINGS
MAXIMUM MINIMUM
❑ Fenestration Ceiling and Wall Floor Basement Wall Slab Perimeter
U- factor Exposed floors R -Value R -value R -Value R-Value
R -Value and Depth
.39 R -37 a R -13 R -19 R -10 R -10, 4 feet
a R -30 ceiling insulation may be used in place of R -37 if the insulation achieves the full R -value over the entire ceiling
area (i.e. not compressed over exterior walls, and including any access openings).
SUNROOM – An addition or alteration to an existing building /dwelling unit where the total
❑
glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the
addition.
Note: Owner to fill out Consumer Information Form (found in Appendix 120.P)
1
Permit No. D04 -09
CITY OF NORTHAMPTON, MA
DRIVEWAY PERMIT
Date: 9/3/08
Check #: 517
FEE: $250.00
THE BOARD OF PUBLIC WORKS
Driveway must be staked and house & lot number posted
The undersigned respectfully petitions your honorable body for:
Permission to install a driveway at: 164 North Farms Road, Northampton, MA
Fifteen (15) foot maximum with 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 as soon as possible if the grade of the proposed
Driveway exceeds 3% or more. Homeowners will be held responsible for any cost to the City
Of Northampton in the event of a washout of this driveway.
By: Michael Behrens
Telephone: 413 -559 -1812
Signature:
Proposed Location Inspection By: ' .— 4' —a big
Gravel Base Grade Inspected By:
Final Approval:
THE BOARD OF PUBLIC WORKS voted that petition be granted.
Edward S. Huntley, P.E.
Director of Public Works
Cc: Building Inspector
(SUBJECT TO ATTACHED CONDITION 1 & 2)
MUNICIPAL WATER AVAILABILITY APPLICATION
Northampton Water Department
237 Prospect St.
Northampton, MA 01060
° 587 -1097
A Department of Public Works Trench Permit shall be required prior to any construction or
connection activity associated with this application.
Location: 164 North Farms Road, Northampton
Inquiry Made By: Michael Behrens 413 -559 -1812
Date of Inquiry: 8/21/08 New Construction
Number of Type of Single Family Type of Private
Units: Unit(s): Accessory Apart. Ownership: Condo
Multi - family Rental
(Annlicant to fill out the shovel
Municipal Water Main in Existing service to
Front of Location? Yes: X No: site? Yes: X No
Size of Water Main: 8" Material: CI Age: 1926
Approximate Static Street Flow Test Conducted: Yes: No: X
Pressure: 75 If done attach results
Size of Service Connection 1"
Suggested Meter Size: 3/4"
Comments: The Water Department cannot guarantee adequate water pressure during peak demand
times at elevations above 320 feet.
• A corresponding water entrance fee shall be paid prior to making any connection to the municipal water
system.
• • - its of such '1 lion shall be made with the Northampton Water Department with aminimumof
5wor ',sgdaysn ' c••*..
• All , ork i i North: i ton Water Department specifications.
David W. Sparks, Superintenden of Water Water Entry$ 200 Meter$150 Radio $100
cc: Ned Huntley, Director
cc: Tony Patillo, Building Inspector Note: If this availability is for a new construction, it must be
hand delivered to the Building Inspector.
,111Ll \ \Permit -,\ \nlcrApplx itionyWatLr �ti_,iil.rhititi d�;c;
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m ""`' "` DEPARTMENT OF BUILDING INSPECTIONS �
INSPECTOR 212 Main Street • Municipal Building
Northampton, MA 01060
LOCATION
SQUARE FOOTAGE AMOUNT
BASEMENT @ . 20 ii 0I. 4 d a q
1 FLOOR @ .50 / 5 a 7 % C
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2 FLR @ 30 I "� d r to
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FLOORS, FINISH ATTIC, GARAGE @ .20
DECK/PORCHES @ .20
2
TOTAL. ( /i -/-r51-L
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§ 350 -15.5. Restrictive uses.
A. Excavation for removal of earth, sand, gravel and other soils shall not extend closer than five
feet above the annual high groundwater table, as determined by the Building Commissioner.
The burden of proof is on the applicant to demonstrate the depth to annual high groundwater.
In addition to information provided by the applicant, the permit granting authority can rely on
and other maps, studies, or technical information the permit granting authority may deem
relevant. This restriction shall not apply to:
(1) Sand and gravel operations legally operating on the date of adoption of this amendment,
provided access roads to the operation include a gate or other secure mechanism to
restrict public access to the site.
(2) Driveways, walkways and structures extending no more than six inches into the ground.
(3) Construction of stormwater detention or retention basins or the construction of wetland
replication areas.
(4) Water lines, sewers, storm sewers, utility lines, gas lines, and similar underground
conduits and conveyances.
---- — (5) "(5) Uses incidental to permitted uses, including, but not limited to, providing for the
installation of structural foundations; provided, however, that the Building Commissioner
finds that when such uses are within three feet of the annual high groundwater table:
(a) Such uses shall incorporate a drainage system to ensure that groundwater
intercepted by footing and curtain drains is discharged into the ground to recharge
the groundwater; and
(b) That any floor drains inside of a structure discharge in such a way that any
hazardous materials leaks can be cleaned up more easily than if the drains
discharge directly into the soil.
B. The use of sodium chloride forice control shall be minimized, consistent with public highway
safety requirements.
C. Commercial fertilizers, pesticides, herbicides, or other leachable materials shall not be used in
amounts which result in groundwater contamination.
D. Permitted aboveground storage tanks for oil, gasoline or other petroleum products (in
accordance with § 350- 15.4J) shall be placed within a building with an impermeable basement
or placed on a diked, impermeable surface to prevent spills or leaks from reaching
groundwater, consistent with the storage containment requirements for aboveground storage
tanks in 310 CMR 22.21(2)(b)(5)..
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as his /her construction supervisor. 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 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
Ani
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
- V V 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 � �, ti ���
location °4 f"' � f ? .
Anik
The Commonwealth of Massachusetts
r
"'. Department of Industrial Accidents
Office of Investigations
=r; 600 Washington Street
— w Boston, MA 02111
www.mass.gov /dia
Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians /Plumbers
Applicant Information Please Print Legibly •
Name (Business /Organization /Individual): A-1 i (2 - 4e
Address:
City /State /Zip: ' � ' � ' 1 � '' Phone #: y am ' kr:/`" g 7 "
Are you an employer? Check the appropriate box: Type of project (required):
1. ❑ I am a employer with 4. ❑ I am a general contractor and I
employees (full and/or part- time).* have hired the sub - contractors 6. New construction
2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub - contractors have 8. [l Demolition
working for me in any ca employees and have workers'
Y P aci tY 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.:
r uired. 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
] officers have exercised 11.
3. I am a homeowner doing all work h id their ❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL
12.E Roof repairs
insurance required.] t c. 152, § 1(4), and we have no
employees. [No workers' 13. E.] Other
comp. insurance required.]
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the sub - contractors and state whether or not those entities have
employees. If the sub - contractors have employees, they must provide their workers' comp. policy number.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy # or Self -ins. Lic. #: Expiration Date:
Job Site Address: City /State /Zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
S ienature: yam 4 Date:
Phone #: c/v/ — `r 7// y
Official use only. Do not write in this area, to be completed by city or town official
City or Town: Permit/License #
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone #:
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder :
License Number
Address Expiration Date
Signature Telephone
9. Registered Home Improvement Contractor Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes ❑ No ❑
mow
11. — Home Owner Exemption
The current exemption for "homeowners" was extended to include Owner occupied Dwellings of one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
as supervisor. CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there
is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm
structures. A person who constructs more than one home in a two - year period shall not be considered a homeowner.
Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of
Northampton Ordinances, State and Local Z ring Laws and State of Massachus General Laws Annotated.
Homeowner Signature
A
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
si L
New House d Addition ❑ Replacement Windows Alteration(s) 7 Roofing n
Or Doors 0
Accessory Bldg. n Demolition ❑ New Signs [D] Decks [p Siding [D] Other [O]
Brief Description of Proposed ,. 4a,2 V /c7"--.
` / Ga.. ,,%.j /
W o rk:
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
6a. If New house and or addition to existing housing, complete the following:
a. Use of building : One Family %.------ Two Family Other
b. Number of rooms in each family unit: 6 Number of Bathrooms N.?
c. Is there a garage attached? < ")
d. Proposed Square footage of new construction. „' Dimensions { �X ' yam '� o
e. Number of stories?
f. Method of heating? ° l'./ Fi replaces or Woodstoves /� Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction 4—+ b"1 ' 4 ' -4- r
++ Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes i o
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 ` 7or City Sewer Private well City water Supply ' ✓-
SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, O'? r l /Kf t' 3 V Ne C/ / —• , as Owner of the subject
property
hereby authorize
to act on my beh If, in all matters relative to work authorized by this building permit application,
Signature o wner Date
I "4--r ee /14 tT T, .7 f"4/...?r ti 7' , as Owner /Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
Print Name
Signature o f n er /Agent Date
�
. . '
Section 4. ZONING ALL Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Asilik
Building Department
------- ---------� , - -------
Lot Size ` '--------------
___________-_-____________�________
�-- ---` �-------'----- --
Frontage ____v_' ____��___ -_-______-__, '___-_-______
Setbacks Front ---- �� / [ --- i
� � __ _
---'� --- � _ --- ---
Side L:, qr D: L `', .. .. . .
Rear ___~ ^____ ___
Building Height --- / F---1
Bldg. Square Footage % .z.„ eL,e, __-- �--
, _ . __ .„,
Open Space Footage __ _ ___ %
(Lot area minus bldg mpaved ____ ,
parking)
A
,-
# of Parking Spaces ,---, �—�� ----
Fill: � c
� ~"�.^
�
(volume & Location) ---- —
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
a ......- �� 0
NO DONT KNOW �_� YES \��
Aount
IF YES dateissued'
' '_- ________ .
IF YES: Was the permit recorded at the Registry of Deeds?
NO & ) DONT KNOW YES
�^ r --------- --
IF YES: enter Book Page and/or Document #
a �a...., B. Does the site contain a brook, body ofwa�vorwet�n�? NO DONT KNOW C) YES �_�
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained y— Obtained
� ane �~� Date Issued:
| �
�_� \~� ' ' L__ ... __-___
C. Do any signs exist on the prope YES y-1 NO 4jr,
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES C\ NO /D-~
_ _ - ___ - ,
IF YES, describe size, type and location:
.. , „,„ .., ., ., , , . .
E. Will the construction activity disturb ( ring, grading iorr, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES ( ) NO {�� ��.
��
IF YES, then a Northmpton Storm Water Management Permit from the DPW is required.
Auk
1
.
Department use only
\ 1Ck� of Northampton Status of Permit:
- SaitdiTig [)apartment Curb .GuUriveway " Fermi #.'
212 Main Street Sewer /SepticAvailability
OCT - 1 2008 ROLim 100 Water/Well Availability
NOtthampton,l MA 01060 Two Sets of Structural Plans
phone.4 5-;g5 1240 Fax 413- 587 -1272 Plot/Site Plans "
• Other Specify
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: This section to be completed by office
/"e'C Map Lot Unit
Zone Overlay District
Elm St District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record: T
Name (Print) Current Mailing Address:
Telephone e .� _ ��— p — /"0"Q
`
Signature s� f
2.2 Authorized Age
01111k. i af
,me (Print) Current Mailing Address:
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building (a) Building Permit Fee
/ 7,ac>t,,
2. Electrical , � j- 43 0 (b) Estimated Total Cost of
Construction from (6)
3. Plumbing E9 a �, . Building Permit Fee
4. Mechanical (HVAC) , e--;
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) •'4 0 ! J " a t9 Check Number ( 40 1 /
This Section For Offic Use On
Date
Building Building Per ii‘ • er: Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
File # BP- 2009 -0352
APPLICANT /CONTACT PERSON BEHRENS MICHAEL
ADDRESS /PHONE 74 FORBES AVE NORTHAMPTON (413) 559 -1812 0
PROPERTY LOCATION 164 NORTH FARMS RD - LOT 7 RUSTLEWOOD RIDGE
MAP 12 PARCEL 036 001 ZONE RR
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out 1 T* 1 o -- —
Fee Paid J J
Tvpeof Construction: CONSTRUCT 2 STORY SFH/PORCH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License //XI /°C r /U
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFQRMATION PRESENTED:
Approved Additional permits required (see below) it /4i4 74 i✓
PLANNING BOARD PERMIT REQUIRED UNDER: § 4 Y
Intermediate Project: Site Plan AND /OR Special Permit With Site Plan
Major Project: Site Plan AND /OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received & Recorded at Registry of Deeds Proof Enclosed
_Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
i
6 M 010
Signature of Building fficial Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health, Conservation Commission, Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning & Development for more information.
4.
File # BP- 2009 -0352
APPLICANT /CONTACT PERSON BEHRENS MICHAEL
ADDRESS /PHONE 74 FORBES AVE NORTHAMPTON (413) 559 -1812 0
PROPERTY LOCATION 164 NORTH FARMS RD - LOT 7 RUSTLEWOOD RIDGE
MAP 12 PARCEL 036 001 ZONE RR(100) //WSP
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out r y
Fee Paid 3 7y � ai 1---
Typeof Construction: CONSTRUCT 2 STORY SFH/PORCH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included: ��
. /����"
3 sets of Plans / Plot Plan
THE F Owner/ LOWING Statement ACTION or License HAS BEEN TAKEN ON TH IS APPLICATION BASED ON
IN ATION PRESENTED:
Approved Additional permits require (see below
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND /OR Special Permit With Site Plan
Major Project: Site Plan AND /OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received & Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission _ Permit DPW Storm Water Management
Demolition Delay
Signature
/b' 6 Ze
of Bui ding 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.
" ry 5 � . ‘ TM OMthD�� BP- 2009 -0352
GIS # COMMONWEALTH OF MASSACHUSETTS
: 10k ` L ' IItr � CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: New Single Family House BUILDING PERMIT
Permit # BP- 2009 -0352
Project # JS- 2009 - 000301
Est. Cost: $201500.00
Fee: $1212.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: 5B Contractor: License:
Use Group: R4 Homeowner as Contractor
Lot Size(sq. ft.): 80586.00 Owner: BEHRENS MICHAEL
Zoning: RR(100) //WSP Applicant: BEHRENS MICHAEL
AT: 164 NORTH FARMS RD - LOT 7 RUSTLEWOOD RIDGE
Applicant Address: Phone: Insurance:
74 FORBES AVE (413) 559 -1812 ()
NORTHAMPTONMA01060 ISSUED ON:10/28/2008 0:00:00
TO PERFORM THE FOLLOWING WORK: CONSTRUCT 2 STORY SFH /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:
0 � / Footings:
7...g?-4942
Rough: OK - Rough: $ -34 1- wIIR(( I ouse # Foundation:
f
,Q r (/Driveway Final:
Final: Final: $7-V-1 C®
Rough Frame:
0,t, 's 11- 34O t Fire Department Fireplace /Chimney:
'r %rij- 9 -I0
, g l r i 1 3-IO b ( O il: 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 10/28/2008 0:00:00 $1212.00542
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo