Loading...
41-049 s r� Ttt>� _orf Nn ril Mmptrat +1CRttssttrliusPiis - * , ;:tkl, -3 "..," i ti,44. !) V DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building `1 'Pt 1. \ Northampton, MA 01060 ANTHONY I PATILLO BUILDING PERMIT FEES Phone: (413) 587 -1240 BUILDING COMMISSIONER Effective July 21, 2008 Fax (413) 587 -1272 DEMOLITION $ 20.00 ACCESSORY STRUCTURE $ 35.00 PRINCIPAL BUILDING — Residential $200.00 PRINCIPAL BUILDING - Commercial *NEW CONSTRUCTION $ .50 per square foot for 1 floor .30 " 2nd floor .20 " " " '/z floors, attic, basement, garage STRUCTURAL ALTERATIONS IN ALL USE GROUPS $6.00 per thousand dollars of estimated cost or fraction thereof, with a minimum fee of $55.00 $25.00 WOODBURNING STOVE *NEW ACCESSORY STRUCTURES one hundred twenty (120) square feet and over $ .20 per square foot with a minimum fee of $25.00 *NEW ACCESSORY STRUCTURES under one hundred twenty (120) square feet $25.00 per inspection 41 , k 1 *SWIMMING POOLS $30.00 for above ground 1 Z 31 X ' %‘14° Z $60.00 for in- ground i Z 1$ x .3 r , *SIGNS & AWNINGS $30.00 'I x l,7O, i O *DECKS $50.00 �.T/ Z REPLACEMENT WINDOWS $35.00 SIDING & ROOFING Residential $35.00 per structure Commercial $50.00 min. per structure OR $5 /K of estimated cost TENTS $25.00 *ZONING REQUEST FORMS $15.00 (includes home occupation registration) REISSUE OF LOST PERMIT $25.00 CERTIFICATE OF ANNUAL INSP. $100.00 (minimum) Temporary Certificate of Occupancy $25.00 PERMITS REQUIRING ONLY 1 (1) INSPECTION WILL BE A MINIMUM OF $25.00; ALL OTHERS WILL HAVE A $50.00 MINIMUM. PERMIT FEES SHALL BE PAID TO THE ORDER OF THE City of Northampton AND SUBMITTED, WITH THE COMPLETED PERMIT APPLICATION, TO THE OFFICE OF THE BUILDING INSPECTOR. WORK STARTED WITHOUT PERMIT IS SUBJECT TO DOUBLE NORMAL FEE. !! NO CASH - CHECKS OR MONEY ORDERS ONLY !! * Filing deadline is 12:00 pm (noon) on Wednesday. 2006 IECC Energy Efficiency Certificate R-Value Ceiling / Roof 30.00 Wall 23.00 Floor / Foundation 18.00 Ductwork (unconditioned spaces): 4r , if s ti-Factor SHGC Mies & Door ftating Window 0.31 0.30 Door Equipment 0.32 0.24 Water Heater: Name: Date: Comments: • All joints, seams, and connections are made substantially airtight with tapes, gasketing, mastics (adhesives) or other approved closure systems. Tapes and mastics are rated UL 181A or UL 181B. • Building framing cavities are not used as supply ducts. Automatic or gravity dampers are installed on all outdoor air intakes and exhausts. ❑ Additional requirements for tape sealing and metal duct crimping are included by an inspection for compliance with the International Mechanical Code. Temperature Controls: Li Thermostats exist 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 is provided. Heating and Cooling Equipment Sizing: Li Additional requirements for equipment sizing are included by an inspection for compliance with the International Mechanical Code. Circulating Hot Water Systems: U Circulating hot water pipes are insulated to R -2. • Circulating hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: • HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R -2. Certificate: ❑ A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R- values; window U- factors; type and efficiency of space- conditioning and water heating equipment. NOTES TO FIELD: (Building Department Use Only) Project Title: Sinequanon Report date: 08/09/08 Data filename: C: \Program Files \Check \REScheck \Sinequanon.rck Page 7 of 7 #Panes Frame Type Thermal Break? _ Yes No Comments: ❑ clerestory: Wood Frame:Double Pane with Low -E, U- factor: 0.300 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? _ Yes No Comments: ❑ tower clerestory: Wood Frame:Double Pane with Low -E, U- factor: 0.300 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? Yes _ No Comments: Note: Up to 15 sq.ft. of glazed fenestration per dwelling is exempt from U- factor and SHGC requirements. Doors: ❑ entry door: Solid, U- factor: 0.500 Comments: This door is exempt from the U- factor requirement. ❑ door to garage: Solid, U- factor: 0.500 Comments: ❑ patio doors: Glass, U- factor: 0.320 Comments: ❑ kitchen door: Solid, U- factor: 0.500 Comments: ❑ patio door: Glass, U- factor: 0.320 Comments: ❑ door to bulkhead: Solid, U- factor: 0.500 Comments: Floors: ❑ studio over garage: All -Wood Joist/Truss:Over Unconditioned Space, R -30.0 cavity insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. Air Leakage: ❑ Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage are sealed. ❑ Recessed lights are either 1) Type IC rated with enclosures sealed /gasketed against leaks to the ceiling, or 2) Type IC rated and ASTM E283 labeled, or 3) installed inside an air -tight assembly with a 0.5" clearance from combustible materials and a 3" clearance from insulation. Vapor Retarder: ❑ Vapor retarder is installed on the warm -in- winter side of all non - vented framed ceilings, walls, and floors; or it has been determined that moisture or its freezing will not damage the materials; or other approved means to avoid condensation are provided. Comments: Materials Identification: ❑ Materials and equipment are identified so that compliance can be determined. • Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. • Insulation R- values and glazing U- factors are clearly marked on the building plans or specifications. ❑ Insulation is installed according to manufacturer's instructions, in substantial contact with the surface being insulated, and in a manner that achieves the rated R -value without compressing the insulation. Duct Insulation: ❑ Ducts in unconditioned spaces or outside the building are insulated to at least R -8. ❑ Ducts in floor trusses above unconditioned spaces or above the outdoors are insulated to at least R -6. Duct Construction: ❑ Air handlers, filter boxes, and duct connections to flanges of air distribution system equipment or sheet metal fittings are sealed and mechanically fastened. Project Title: Sinequanon Report date: 08/09/08 Data filename: C: \Program Files \Check \REScheck \Sinequanon.rck Page 6 of 7 ❑ double hung: Wood Frame:Double Pane with Low -E, U- factor: 0.310 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ clerestory: Wood Frame:Double Pane with Low -E, U- factor: 0.300 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ tower clerestory: Wood Frame:Double Pane with Low -E, U- factor: 0.300 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ entry sidelights: Wood Frame:Double Pane with Low -E, U- factor: 0.290 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: Li dormer: Wood Frame:Double Pane with Low -E, U- factor: 0.310 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ clerestory: Wood Frame:Double Pane with Low -E, U- factor: 0.300 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? _ Yes No Comments: ❑ tower clerestory: Wood Frame:Double Pane with Low -E, U- factor: 0.300 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ casement window: 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: ❑ fixed: Wood Frame:Double Pane with Low -E, U- factor: 0.290 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ double hung: Wood Frame:Double Pane with Low -E, U- factor: 0.310 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ clerestory: Wood Frame:Double Pane with Low -E, U- factor: 0.300 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ tower clerestory: Wood Frame:Double Pane with Low -E, U- factor: 0.300 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: Ll double hung: Wood Frame:Double Pane with Low -E, U- factor: 0.310 For windows without labeled U- factors, describe features: Project Title: Sinequanon Report date: 08/09/08 Data filename: C: \Program Files \Check \REScheck \Sinequanon.rck Page 5 of 7 REScheck Software Version 41.4 I nspection Checklist Date: 08/09/08 Ceilings: ❑ lower ceiling: Raised or Energy Truss, R -30.0 cavity insulation Comments: Insulation must achieve full height over the plate lines of exterior walls. ❑ upper ceiling: Raised or Energy Truss, R -30.0 cavity insulation Comments: Insulation must achieve full height over the plate lines of exterior walls. ❑ studio ceiling: Cathedral Ceiling (no attic), R -30.0 cavity insulation Comments: Above -Grade Walls: ❑ north wall: Wood Frame, 16" o.c., R -19.0 cavity + R-4.0 continuous insulation Comments: ❑ west wall: Wood Frame, 16" o.c., R -19.0 cavity + R -4.0 continuous insulation Comments: ❑ south wall: Wood Frame, 16" o.c., R -19.0 cavity + R -4.0 continuous insulation Comments: ❑ east wall: Wood Frame, 16" o.c., R -19.0 cavity + R -4.0 continuous insulation Comments: Basement Walls: ❑ Basement Wall north: Solid Concrete or Masonry, 9.3' ht / 9.0' bg / 9.3' insul, R -13.0 cavity + R -5.0 continuous insulation Comments: Ll Basement Wall west: Solid Concrete or Masonry, 9.3' ht / 9.3' bg / 9.3' insul, R -13.0 cavity + R -5.0 continuous insulation Comments: ❑ Basement Wall south: Solid Concrete or Masonry, 9.3' ht / 8.3' bg / 9.3' insul, R -13.0 cavity + R -5.0 continuous insulation Comments: ❑ Basement Wall east: Solid Concrete or Masonry, 9.3' ht / 9.3' bg / 9.3' insul, R -13.0 cavity + R -5.0 continuous insulation Comments: Windows: Li casement window: 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: ❑ dining triple: Wood Frame:Double Pane with Low -E, U- factor: 0.310 For windows without labeled U- factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: LI tower bay: 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: Project Title: Sinequanon Report date: 08/09/08 Data filename: C: \Program Files \Check \REScheck \Sinequanon.rck Page 4 of 7 Depth below grade: 9.3' Insulation depth: 9.3' studio over garage: All -Wood Joist/Truss:Over Unconditioned Space 662 30.0 0.0 22 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 2006 IECC requirements in REScheck Version 4.1.4 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name - Title Signature Date Project Notes: geothermal heat pump with propane back up roof top photovoltaic panels passive solar designed eave overhangs stair tower thermal chimney for natural ventilation Project Title: Sinequanon Report date: 08/09/08 Data filename: C: \Program Files \Check \REScheck \Sinequanon.rck Page 3 of 7 SHGC: 0.30 Orientation: Left Side clerestory: Wood Frame:Double Pane with Low -E 21 0.300 6 SHGC: 0.27 Orientation: Left Side tower clerestory: Wood Frame:Double Pane with Low -E 16 0.300 5 SHGC: 0.27 Orientation: Left Side door to garage: Solid 21 0.500 11 Orientation: Left Side south wall: Wood Frame, 16" o.c. 1240 19.0 4.0 49 Orientation: Back casement window: Wood Frame:Double Pane with Low -E 49 0.320 16 SHGC: 0.29 Orientation: Back fixed: Wood Frame:Double Pane with Low -E 33 0.290 10 SHGC: 0.35 Orientation: Back double hung: Wood Frame:Double Pane with Low -E 36 0.310 11 SHGC: 0.30 Orientation: Back clerestory: Wood Frame:Double Pane with Low -E 37 0.300 11 SHGC: 0.27 Orientation: Back tower clerestory: Wood Frame:Double Pane with Low -E 16 0.300 5 SHGC: 0.27 Orientation: Back patio doors: Glass 136 0.320 44 SHGC: 0.24 Orientation: Back east wall: Wood Frame, 16" o.c. 896 19.0 4.0 40 Orientation: Right Side double hung: Wood Frame:Double Pane with Low -E 8 0.310 2 SHGC: 0.30 Orientation: Right Side clerestory: Wood Frame:Double Pane with Low -E 37 0.300 11 SHGC: 0.27 Orientation: Right Side tower clerestory: Wood Frame:Double Pane with Low -E 16 0.300 5 SHGC: 0.27 Orientation: Right Side kitchen door: Solid 21 0.500 11 Orientation: Right Side patio door: Glass 41 0.320 13 SHGC: 0.24 Orientation: Right Side Basement Wall north: Solid Concrete or Masonry 842 13.0 5.0 35 Orientation: Front Wall height: 9.3' Depth below grade: 9.0' Insulation depth: 9.3' Basement Wall west: Solid Concrete or Masonry 489 13.0 5.0 20 Orientation: Left Side Wall height: 9.3' Depth below grade: 9.3' Insulation depth: 9.3' Basement Wall south: Solid Concrete or Masonry 624 13.0 5.0 26 Orientation: Back Wall height: 9.3' Depth below grade: 8.3' Insulation depth: 9.3' door to bulkhead: Solid 21 0.500 11 Orientation: Back Basement Wall east: Solid Concrete or Masonry 460 13.0 5.0 18 Orientation: Right Side Wall height: 9.3' Project Title: Sinequanon Report date: 08/09/08 Data filename: C: \Program Files \Check \REScheck \Sinequanon.rck Page 2 of 7 REScheck Software Version 4:I. Compliance Certificate Project Title: Sinequanon Report Date: 08/09/08 Data filename: C: \Program Files \Check \REScheck \Sinequanon.rck Energy Code: 2006 IECC Location: Northampton, Massachusetts Construction Type: Single Family Building Orientation: Bldg. faces 20 deg. from North Conditioned Floor Area: 5604 ft2 Glazing Area Percentage: 16% Heating Degree Days: 6404 Climate Zone: 5 Construction Site: Owner /Agent: Designer /Contractor: Westhampton Road Richard & Karen Katsanos Vernon Harrington Northampton, MA 01060 76 Garfield Avenue Thayer Street Associates, Inc. Easthampton, MA 01027 8 Coates Avenue 413 - 210 -2086 South Deerfield, MA 01373 rekatsanos_aihai @verizon.net 413 - 665 -4018 vern@thayerstreetassociates.com Compliance: 11.3% Better Than Code Maximum UA: 762 Your UA: 676 Gross Cavity Cont. Glazing UA Assembly Area or R -Value R- Value or Door Perimeter U- Factor lower ceiling: Raised or Energy Truss 1051 30.0 0.0 37 upper ceiling: Raised or Energy Truss 1261 30.0 0.0 44 studio ceiling: Cathedral Ceiling (no attic) 662 30.0 0.0 23 north wall: Wood Frame, 16" o.c. 1553 19.0 4.0 69 Orientation: Front casement window: Wood Frame:Double Pane with Low -E 23 0.320 7 SHGC: 0.29 Orientation: Front dining triple: Wood Frame:Double Pane with Low -E 31 0.310 10 SHGC: 0.30 Orientation: Front tower bay: Wood Frame:Double Pane with Low -E 55 0.320 18 SHGC: 0.29 Orientation: Front double hung: Wood Frame:Double Pane with Low -E 46 0.310 14 SHGC: 0.30 Orientation: Front clerestory: Wood Frame:Double Pane with Low -E 21 0.300 6 SHGC: 0.27 Orientation: Front tower clerestory: Wood Frame:Double Pane with Low -E 16 0.300 5 SHGC: 0.27 Orientation: Front entry sidelights: Wood Frame:Double Pane with Low -E 15 0.290 4 SHGC: 0.35 Orientation: Front entry door: Solid 21 0.500 11 Orientation: Front west wall: Wood Frame, 16" o.c. 649 19.0 4.0 28 Orientation: Left Side dormer: Wood Frame:Double Pane with Low -E 57 0.310 18 Project Title: Sinequanon Report date: 08/09/08 Data filename: C: \Program Files \Check \REScheck \Sinequanon.rck Page 1 of 7 `� _ _ The Commonwealth of Massachusetts ,PI =- Department of Industrial Accidents , f ="i _.. 'Office of Investigations � 600 Washington Street . . Boston, MA 02111 Workers' Compensation Insurance Affidavit Anolicant Information Please PRINT Legibly name: 11 _ . $ OS . k , K Elk e location: {`HOC We.khalnp -C)i\ .�.\ city: 1"..* " - a m $ - phone #: ❑ I am a homeowner per orming all work myself. ❑ I am a sole proprietor and have no one working in any capacity. P. I am an employer providing workers' compensation for my employees working on this job. comoanv name: \ \-wx.,.. r-e.V �cos.i,ates T-4-,c. • address: S Cow S G..t L. cirv: S c r;' �mm.t cte-1 irk phone #: Lk13- (0(4)S- 401 8 ' insurance co: T1n•e_ k policv #: ❑ I am a sole proprietor, general contractor, or homeowner (circle one) and have hired the contractors listed below who have the following worker' comeensal :on policies: comoanv name: address: city: phone,# : insurance co: policv #: comoanv name: address: city: phone #: insurance co: policv #: Applicant Signature Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of $100.00 a day against me. I understand that a cop of this statement may be forty• •• ed to the Office o Investigations of the DIA for coverage verification. I do hereby under th - • ,. and peer. 'es ► . - rjury that the information provided above is true and correct. Signature ��2�G� •_.� Date 0�2 ■ Print nine V ent t.4-C ri F \ Phone # 0()\ ' N Z Pir,• I SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction pervisor: v.. Not Applicable ❑ Name of License Holder : � (� ( �K o'/ /.9 License Number $ Z i( C iz ipaAr—a 4 fr , 5° IC'et et '' 4 ( I'Uf MA 9 - 3 © Addr / L � G Expiration Date /P' /'- ‘/5- yo/ i3 Signature Telephone 9. Registered Home Improvement Contractor; Not Applicable Ille 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 buildin permit. Signed Affidavit Attached Yes Rl No ❑ H. - Home Owner Exemption The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) families and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner: Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm structures. A person who constructs more than one home in a two -year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of Northampton Ordinances, State and Local Zoning Laws and 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. El Demolition ❑ New Signs [DI Decks [M Siding [ID] Other [O) Brief Description of Proposed Work: 1441.. LvIt.141 • 1rtalll: ( DtPekT_C!g Alteration of existing bedroom Yes /i 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 V Two Family _ Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? '17 d. Proposed Square footage of new construction. 4 j 1 4� Dimensions toa'� " X ,..„,1 7 ` 1 - 4 / 1 4T 2 ) 4e e. Number of stories? Z f. Method of heating? __N�''KL E}LW Fireplaces or Woodstoves /fa, Number of each g. Energy Conservation Compliance. 4 Masscheck Energy Compliance form attached? S 6,304- r t�D� h. Type of construction -- / i. Is construction within 100 ft. of wetlands? Yes / No. Is construction within 100 yr. floodplain Yes V No j. Depth of basement or cellar floor below finished grade 11) t 4:r u k. Will building conform to the Building and Zoning regulations? ✓ _ Yes No . I. Septic Tank 17 City Sewer Private well I / City water Supply SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, f-t .4b FQ t.. 1- ` r Ar-r C. 4 AT t.' S , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I , f *(v t, , �i , as Owner /Authorized Agen 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 Nil Ail 1 Sign re o Owner /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 Building Department Lot Size 411 124 gP Go coo It Frontage 1q d (- j Setbacks Front 1.141-94 6/0 1 4 M J Side L:'1 "b R: � 3 " L: R: /5 Rear — Z Building Height 33 - y It Bldg. Square Footage 3 5 6z.„ % Open Space Footage % (Lot area minus bldg & paved gz 9Z.7- parking) -JJ y # of Parking Spaces Fill: (volume & Location) A. Has a Spe • t Permit /Variance /Finding ever been issued for /on the site? NO DON'T KNOW 0 YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW 0 YES IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO j IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, ex ation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Amommonnemmilloir Department . use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer /Septic Availability' Room 100 Water/Well Availability AUG UB Northampton, MA 01060 3 -mss Sets of Structure 10*'-"*" lans 10*'-"*" phone 413 - 587 - 1240 Fax 413 - 587 - 1272 Plot/Site Plans Other Specify APPLICATION T_O CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION This section to be completed 1.1 Property Address: by office t' (3Eg? Y T' Map i i l Lot Unit New Ao'` tom/ e 106° Zone Overlay District ---7e4-- Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: f' GCO C*,; te74>7 - E.N lirs4�S L 4serr' - , d , d �Z ' '}4i4�1ny - m , yY)4 Name (Print) 7 Current Mailing Address: Li « - z i 0 • Zak D __,,, , y / ' I Telephone Signatures 2.2 A � or' ed A•ent: /. (oae,S ,4 - Si. �l ' / /r/ Name P . / / Current Mailing Address: m . / o �l t 'c? - 66 , 6 q0, 8 Sig ature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building Lt of./ Zia ,6d (a) Building Permit Fee 2. Electrical ci 3 g� • ca (b) Estimated Total Cost of / Construction from (6) 3. Plumbing 6z/ 6aa • or) Building Permit Fee 4. Mechanical (HVAC) 6/ , Ua 5. Fire Protection A- 6. Total= (1 +2 +3 +4 +5) 6.7A 41 •6 ' Check Number 0103V /����V This Section For Official Use Only (J I Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date File # BP- 2009 -0208 APPLICANT /CONTACT PERSON THAYER STREET ASSOC INC ADDRESS /PHONE 8A COATES AVE SOUTH DEERFIELD (416) 665 -401 z P' P RTY OCATI AMPTON RD :,a., ° 11..1494001 RR THIS SECTION FOR OFFICIAL USE ONLY: " PERMIT APPLICATION CHECKLIST ENCLOSED RE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid • I� -A li11111 Typeof Construction: CONSTRUCT 2 STORY SFH W /ATT GARAGE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 045159 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF 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 Commission _ Permit DPW Storm Water Management Demolition Delay 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.