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17D-029 (2) MORTGAGE LEAN INSPECTION THIS PLAT IS FOR IDENiIFICATION PURPOSES ONLY AND DOES NOT CONSTITUTE A PROPERTY_ SURVEY — 90 5' J61 2 1998 (\\L ......-------_ kt in 00 it 1 taIf V) ±t ., \ 3� (5 _ i 1 ' 1 1 1 1 1 1 1 1 , 1 1 1 i 2 STORY < } ' I I HOUSE. If / 1 1 �c7t ' � I r t l I i'OECN 1 \ 1 1 1 1 1 1 . IY 82.5 • 1 511 A VEk.lUE TO THE FLORENCE SAY INGS BANK MD 11iE LAWYERS TITLE 1KISUPAAICE C0 12P_- 6NLY To the best of my knowledge, Information and belief, I hereby report that I have examined the premises and that this Inspection plot shows the improvement or improvements as located on the premises described, that the improvement or improvements are entirely within lot lines, that there ore no encroachments upon the premises described by the Improvement or Improvements of any adjoining premi8w_and that there are no easements of record affecting the tract shown hereon, except as shown. e��k U} i I further report that the premises shown on this plan Is not located within a Flood Hazard Area as shown on � 7 c ' DAVID Department of H.U.D. Federal Insurance Administration Maps, t T. .a 2 -00 2 , 4 `3 a HUNTLEY V Community Number z ,, #35401 Identification Dote APRIL 31 19"78 ``� P.L.S. ,fES5lGar - SUSl�� „ HUNTLEY OWNER BELLE M_ RYAN ALMER HUNTLEY, JR. & ASSOCIATES, INC. LOCATION . M U E Surveyors • Engineers • Landscape Architects NORTNA TON , r/ MA 30 industrial Drive East JOB NO. DATE -y SCALE ,L Northampton, MA 01060 9� _ 3iO7 12-24- 94 I'' - 20' voice(41 - 7444 fa-x(413)666-9159 ��_..� CITY OF NORTHAMPTON BUILDING PERMIT CHECKLIST All 1 &2 Family Projects The following items are to be considered MINIMUM information to be submitted with ALL permit applications A Scaled drawings & details shall be submitted with each application proposing construction, reconstruction, addition, alteration, or repair. The building official may waive the requirements for filing plans when work is of a minor nature.[i. B. Scaled drawings & details shall indicate & describe alt proposed work, including location, size, grade of materials & equipment to be used. [k.] C. PLOT PLAN, property address; map & lot number, zoning district & overlays (such as wetlands) ,, f Show well and septic locations (if applicable) [ ] Location of lot lines, dimensions of lot, frontage [ ] Location & dimensions of public easements, public utility easements, railroad right of ways , and established zoning setback requirements. [ ] Locations & dimensions of primary and accessory buildings & structures. [ ] D. FLOOR PLANS, floor plan of each floor and intermediate levels including basements, crawlspaces, terraces, porc s garages, carports, and decks, showing existing condition and proposed construction. [ Dimensions, locations & materials of foundations, footings, columns & piers {including reinforcing when required} [ ] Direction, dimensions, spacing & grade of all framing {floors, roofs, walls, partitions} [ ] Location of all walls, partitions, windows, stairs & doors [ ] Location & description of all electrical equipment and alarm devices [ ] Location & type of all heating and air conditioning (HViK) equipment. [ ] HVAC schematics (where required check with building inspector) [ ] EXTERIOR ELEVATIONS, Front, rear & side elevations including foundation and finish grades. [ ] Location & dimensions of windows & doors. [ ] Description of exterior cladding or siding material. [ ] Show exterior stair locations & dimensions. [ ] Show chimney and vent locations [ ] DETAILS & SECTIONS, Sections througi exterior walls showing details of construction from footing to the highest point of the buik`.ing. [ ] Sections through fireplaces & chimneys (show clearances) [ ] Location & details of any roof trusses, glue -lam, or engineered lumber {include connection details and Massachusetts professionals stamp on specification sheet} [ ] Exterior envelope energy requirements : Uo- of walls, roof - ceiling & floors ..OR. R value of walls/roof/floor, also percent of window area to wall area. [ ] �O4K tt f PT t 7 eilbel s a _ �zt of NnrrtF ampfon _ _-I W ; 7j %v`� � B Aix sancltnsetta = �"1 7 JUL 2 l995 DEPARTMENT OF BUILDING INSPECTIONS 4 _ ` 1 1- . 212 Main Street ' Municipal Building Northampton, Mass. 01060 r' WORKER'S COMPENSATION INSURANCE AFFIDAVIT L 7 4,1 .7 /5 (licenserJpermittec) with a principal place of business/residence at ? .. v' uJ ,C /� ,r. ec ___ U /UL! (phoned) S K' 72-06 (ser deity /ssatelzip) do hereby certify, under the pains and penalties of perT.iry, that: ( ) I am an employer providing the follow* •, compensation coverage for my employees worming on this job: ( Insurance Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) ( Insurancc Company/Policy Number) (Expiration Date) (Name of Contractor) (Inszu -ancc Compan Number) (Expiration Date) (Name of Contractor) ( Insurancn Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional sheet ifneecnary to include infocenati on pertaining to all ocatracton) ( ) a sole proprietor and have no one working for me. 1 am a home owner performing all the work myself. NOTE; please be aware that while homeowners who employ persons to do may** -_m ...._x^ cuctioo or repair work on a dwelling of not more than three units in which the homeowner resides or co the grou;rds aprxutcnani2hcrdn arc not generally considered to be employers under the workees compensation Act (GL152,n 1(5)), application by a homeowner fora license cc permit may cvidcace rho legal &talus of an employer under tho Waimea Compomaiion Act 1 undersiuid thud a copy of this cEaiement may bo forwarded to the Deportment of Biel A«idmt' Offioo of Iasvrwnco for tba coverage verification and that failure to secure covet under suction 25A of MOL 152 can lead to the imposition of criminal penalties consisting of a fine of up to S1,500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a fin of S100.O0 1 day against me_ For departmonial ttso colt' ••► Permit Number '� / ,e Map,l Lot # *' Si P. a 1 of LiccnseefPermittce — � �" t 4;' O�(ttnlfpTO x- \fir a / . t ' . !(,��� - y tlttss ttchuactla = i^ T Vay F 2 'QV, DEPARTMENT OF BUILDING INSPECTIONS ' 4 ml L--a---- - INSPECTOR 212 Main Street Municipal Building _ Northampton, Mass. 01060 ow J HOMEOWNER LICENSE EXEMPTION r (Please Print) DATE: 7 JOB LOCATION: , / D _ff /J (Map) (Parcel) (Subdivision) HOMEOWNER: .51 I (mot. °Crt D. t [aS' (Name & Address) .- i4.1 - t/� f ./. �-crt " i / ca e_- `7 " U .5 f - / (Home Phone) (Work Phone) 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. CMR780 Section 109.1 .1 DEFINITION CF 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 ;, d/ ? BUILDING PERMIT # ,, 4 • Z0'd T68Z8Z88TS:1 URA I g0823 TO: ST 86 -TZ -V0 Job Truss Truss Type qty Ply — -- - - -' JOBS it -01 IOUEENPOST 11 1 P & R TRUSS CO. INC., HUDSON NY 12534 4.0-32 s Dec 16 1997 MiTek Industries, Inc. Tue Apr 21 15:43:341998 Page 1 l - 4 4-2 -3 l 8-0-0 1 11 -9 -13 i 1 6 - 0 - 0 1 7 - 1 3 - 0 1 -6 -0 4-2 -3 3-9-13 3-9-13 4-2-3 1-6-0 4x4= 4 9 . 0 0 1.5x40 1.5x4 -i \ N o fi \ e V.,..._____. — - .. 1 J, _ Ns i 3x2 �/G 8 .` \] ae8 = F-- 8 - 0 -0 I 16-0-0 — - -_/ 8 -0-0 8 -0-0 Plate Offsets (X (2:0- 8-0,0 -0- 141,6:0- 8.0,0.0 -14 -- — LOADIN(psf) SPACING 2-0-0 CSI DEFL (in) (loc) l /defl PLATES GRIP TCLL 40.0 Plates Increase 1.15 TC 0.64 Vert(LL) -0.03 8 >999 M20 197/144 TCDL 40.0 Lumber Increase 1.15 BC 0.66 Vert(TL) -0.15 2-8 >999 BCLL 0.0 Rep Stress Incr YES WB 0.35 Horz(TL) 0.03 6 n/a BCDL 10.0 Code BOCA/ANSI95 Min Length / LL defl = 240 Weight: 64 lb LUMBER - -.- - " — - - " — BRACING TOP -. - - -- TOP CHORD 2 X 4 SPF No.2 TOP CHORD Sheathed or 3 -10-4 on center purlin spacing. BUT CHORD 2 X 4 5PF No.2 8OT CHORD Rigid ceiling directly applied or 10 -0 -0 on center bracing. WEBS 2 X 4 SPF Stud WEDGE Left: 2 X 4 SPF Stud, Right: 2 X 4 SPF Stud REACTION b/size) 2=1677/0-5-8, 6= 1bf/10 -5-8 Max Horz2 =228(Ioad case 4) Max Uplift2= 20(load case 6), 6=- 20(Ioad case 6) FORGEIb) - First Load Case Only TOP CHORD 1 -2 =72, 2-3 =1645, 3-4= -1146, 45 =1146, 5- 6= -1645, 6 -7 =72 8OT CHORD 2-8= 1289, 6-8 =1289 WEBS 3 -8 =-475, 4-8 =745, 5-8 =-475 NOTES 1) This truss has been designed for the wind Toads generated by 80 mph winds at 25 ft above ground level, using 10.0 psf top chord dead Toad and 10.0 psf bottom chord dead load, 100 mi from hurricane oceanline, on an occupancy category 1, condition I enclosed building, of dimensions 45 ft by 24 ft with exposure G ASCE 7 -93 per BOCNANS195 If end verticals or cantilevers exist, they are exposed to wind. If porches exist, they are not exposed to wind. The lumber DOL increase is 1.33, and the plate grip increase is 1.33 2) Unbalanced now Toads have been considered for this design_ 3) All plates are M20 plates unless otherwise indicated. 4) Provide mechanical connection (by others) of truss to bearing plate capable of withstanding 20 Ib uplift at joint 2 and 20 Ib uplift at joint 6. 5) This truss has been designed with ANSI/TPI 1 -1995 criteria. LOAD CASE(S) Standard 7n . ,4 T RR7.R ?RR T R •nt YEN WnsnnH nN.I. N 4 wH n 1: F n 'ul!. PA -I? -Nriti r 10 T68Z8Z88IS:H0113 QaAIHDatt IG:ST 86 -TZ -bo QUOTE/ORDER FORM - BREAKDOWN Pa!Q 1 CUSTOMER ACCT # 2955H JOB # CUSTOMERPOII BID # B98H -1778 INVOICE # ORDER b p44((Q R TRUSS COMPANY INC. !ll DATE OF INVOICE / / REQ, DELIVERY / / RY DATE / / WHOLESALE WOOD TRUSSES QUOTED TO GINGER ORDERED BY ?7 11 FALLS IND. PARK RID. (518) 828 -2888 HUDSON, NY 12534 FAX (S18) 82B -2891 RUGG LUMBER CO. Job Name:ROSS s� £ € RT. 5 & 10 Model: Tag: I . 3 HATFIELD, MA DELIVERY INSTRUCTIONS: . ° I (413) 445 -5623 — 1ROSS 1 . .. - — SPECIAL INSTRUCTIONS: 1 i NORTHAMPTON, MA BUILDING DEPARTMENT BID BY JOE PLOURDE 40 LB RESIDENTIAL 1 HEEL HEIGHT 2x4 BID DATE 04/21/98 BID EXPIRES IN 30 DAYS Roof Trusses LOADING TCLL - TCOL- SCLL -sCDt STRESS INC INFORMATION 40.0 - 40.0 - 0.0-1.0 1.15 ROOF TRUSS SPACING: 24.0 IN. O.C. (TYP.) PROFILE QTY PITCH TYPE SPAN LUMBER CANTILEVER - OVERHANG NOTES PLY TOP 1 80T ID FT-IN-1.6 TOP BOT LEFT RIGHT LEFT RIGHT 11 9.00 0.00 i Q U ET -0P O S-f 16 -00 -00 2 X 4 2 X 4 01.06 -00 01 -06-00 fi� - — J /dolb, 1 Items ` 9.001 0 . 0 01 QU T -0 1 G E ST 16-00-4012X 4 2X 4 01-06 - 00101 -06-00 3 0- QTY ITEM TYPE SIZE LENGTH NOTES FT -IN -16 19 I IBEAM LPI2611 -7/8 16-00-00 LPI 26 SERIES 1 -7/8" IBEAM C2•7 ` W 4 L BAND BOArw 9}311 16 -00-00 11 -7/8" BAND BOARD 3 / ACCEPTED BY BUYER PURCHASER: BY: -- — TITLE: 00U /9L- 1 - SST` — — '7 4, y,'1 6-ef-i'7? LTV T nrr,mnn T r 'nit VII ,I Nngrinu MIN.(. N'Rr? Wri 6O : EO aftL 86- t -& { J APR -22 - 1998 08:00 PRIMESOLIRCE 203 9 37 5575 F' 01!01 /l /0 RUGG LUMBER Att GINGER ) \ 9.5 T -250 JOIST @ 16.0" o/c TJ -8eamTM v5.03 Serial Number 707200838 ' �f 5EAMUSA 1001 4/21/98 4 7.59:D5 PM C :i Page 1 of 1 Build Code: 041 THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED L 21996 . ZLo -- ). Product Diagram is Conceptual. LOADS: - Analysis for JOIST MEMBER Supporting FLOOR - RES. Application. Loads(psf): 40 Live at 100°% duration, 12 Dead, 0 Partition SUPPORTS: INPUT BEARING REACTIONS(lbs.) WIDTH LENGTH JUSTIFICATION LIVE/ DEAD/ TOTAL DETAIL OTHER 1 2x4 plate 3.50' 2.25" Left Face 427 / 128 1 555 Detail A3 125" LSL Rim 2 2x4 plate 3.50" 2.25" Right Face 427 1 128 1 555 Detail A3 1.25" LSL Rim - See TJM SPECIFIER'S / BUILDER'S GUIDES for detail(s): A3. DESIGN CONTROLS: MAXIMUM DESIGN ALLOW. CONTROL LOCATION Shear(lb) 540 534 1120 Passed(48 /o))) LT. end Span 1 under Floor loading Reaction(lb) 40 540 1045 Passed(52 %) Bearing 1 under Floor loading Momentfft -lb) 2105 2105 3338 Passed(63% MID Span 1 under Floor loat'ing Live Deflfl.(in) 0.347 0.390 Passed(U53 MID Span 1 under Floor loading Total Defl_(In) 0.451 0.779 Passed(1./415) MID Span 1 under Floor loading - Allowable moment was increased for repetitive member usage. Deflection Criteria: STANDARD(LL:U480, TL:U240). - Deflection analysis is based on composite action with single layer of the appropriate span - rated, GLUED & NAILED wood sheathing. ADDITIONAL NOTES: - IMPORTANT! The analysis presented is output from software developed by Trus Joist MacMillan(TJM). TJM warrants the sizing of Its products by this software will be accomplished In accordance with TJM product design criteria and code accepted design values. The specific product application, input design loads, and stated dimensions have been provided by the software user. This output has not been reviewed by a TJM Associate. - Not all products are readily available. Check with your supplier or TJM technical representative for product availability. - THIS ANALYSIS FOR TRUS JOIST MacMILLAN PRODUCTS ONLYI PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. - Allowable Stress Design methodology was used for Building Code BOCA analyzing the TJM Distribution product listed above. - Bracing(Lu): All Compression edges (top and bottom) must be braced at 2 8" o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. PROJECT INFORMATION OPERATOR INFORMATION: 413 247 8339 - I'rlme5aurce Keith Stein 315 Morgan Lane West Haven , CT 06516 (203) 933 -1100 FAX: (203) 931 -4689 Copyitta 1997 by Trus Joist MacMflk+n, a limned pennerahip, Bofae, Ieeho, USA. Prom' anti TJ- Beam"" are trademarks of Tres Joist MacMillan. TJI ®Is a registered trademark of Tres Joist MacMillan. TOTAL P.31 P -01 RECEIVED FROM :203 937 5575 a ' C c ;I tv V b o• = = m '� D o v, co c ^' r - -I Z m 83 _ —3 p .� p R 'ti x O N o' 7t J P, o ' cn Z O .. C ni C XI a Zoning t Miscellaneous Additions, Repairs, Alterations, etc. Tel. No. Alterations %r NORTHAMPTON, MASS. 1 9 Additions L iiiri) . l APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location 6 -7 ?' u.% /9v' A ' Lot No. 2. Owner's name - Y //' 1 () r f `�' Address Sox - - i-t-°'- 3. Builder's name --- Address Mass. Construction Su rvisor's License No. L Expiration I - xpiration Date 4. Addition ��rt i r t/ � 7 zJ Fr l'�` /57 ras -� s' 6,./....4- et / 5. Alteration '"" [(( 7 6. New Porch 7. Is existing building to be demolished? L2.Q1 8. Repair after the fire 9. Garage No. of cars Size 10. Method of heating e7-5 40, /_ 11. Distance to lot lines 12. Type of roof 5/tt 1'— 13. Siding house d4.1.e 14. timated cost:- , , a-c) The undersigned certifies that the above statements are true to the best of his, her ���� knowledge and belief. Signature of responsible appicant Remarks • 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: 7 -8 -1998 Bldg. Dept. Use CEILINGS: [ ] 1. Raised Truss, R -38 Comments /Location Insulation must achieve full height over the exterior wall. WALLS: [ ] 1. Wood Frame, 24" O.C., R -19 Comments /Location WINDOWS AND GLASS DOORS: [ ] 1. U- value: 0.45 For windows without labeled U- values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments /Location DOORS: [ ] 1. U- value: 0.39 Comments /Location FLOORS: [ ] 1. Over Unconditioned Space, R -21 Comments /Location BASEMENT WALLS: [ ] 1. 5.0' ht /3.0' bg /4.0' insul., R -7 Comments /Location 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 and glazing U- values must be clearly marked on the building plans or specifications. DUCT INSULATION: [ ] Ducts in unconditioned spaces must be insulated to R -5. Ducts outside the building must be insulated to R -8.0. MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2.0 Checked by /Date CITY: Amherst STATE: Massachusetts HDD: 6614 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non- Electric Resistance) DATE: 7 -8 -1998 DATE OF PLANS: TITLE: COMPLIANCE: PASSES Required UA = 148 Your Home = 148 Area or Insul Sheath Glazing /Door Perimeter R -Value R -Value U -Value UA CEILINGS: Raised Truss 352 38.0 0.0 9 WALLS: Wood Frame, 24" O.C. 810 19.0 0.0 47 GLAZING: Windows or Doors 112 0.450 50 DOORS 33 0.390 13 FLOORS: Over Unconditioned Space 352 21.0 15 BSMT: 5.0' ht /3.0' bg /4.0' insul. 120 7.1 14 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 10. Do any signs exist on the property? YES NO IF YES, describe size, type and location: changes to or additions of signs intended for the property? YES Are there any proposed g 9 NO IF YES, describe size, type and location: 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. This column to be filled in by the Building Aepnztment Required Existing Proposed By Zoning Lot size 1c,/ 9 7 j 1 9 7 ) dJ , Frontage ,g2- f Setbacks - frnpt � 3 cQ - side L: if R: 9! L: /(P R: - rear ^ g 2 • r/ r ) fj Building height 3` I 3c) f r-- Bldg Square footage ,31� > 8 0 �a18 , /3 �� �, o "9,6 %Open Space: C T Sal (Lot area minus bldg &paged parking) 21)/6:, //3% ,237: 2 37 � 7 ' / ( %i # of Parking Spaces # H of Loading Docks /141 �/� Fill: /(f volume & location) /(/ 13. Certification: I hereby certify that the information contained herein G is true and accurate to the best of my knowledge. DATE: 1 APPLICANT'S SIGNATURE NOTE: Is an f a zoning permit does not relieve a sip ant's burden to oomply witty ell zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Pubiio Works and other applicable permit granting authorities. FILE 2 ■996 File No. ZONING PERMIT APPLICATION (§10.2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: - 7 , f 00 l —e - 12. 5 Address: 6 s ft' et L / Telephone: J U 7. e 2. Owner of Property: % ( Address: � Telephone: 3. Status of Applicant: V Owner Contract Purchaser Lessee Other (explain): 4. Job Location: Parcel Id: Zoning Map# / 7 17 Parcel# ? District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property � / 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): f 6 of4 757 2mC1 Pco 7. Attached Plans: Sketch Plan Site P lan Engineered /Surveyed Plans Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files. 8. Has a Special Per ariance/Finding ever been issued for /on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was th ermit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and /or D ent # Y 9. Does the site contain a brook, body of water or wetlands? NO '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: (FORM CONTINUES ON OTHER SIDE) Department: Reference No: BP -1999 -0031 Building, Electrical & Mechanical Permits Fee Type: Receipt No: Building - Renovation RFC 1999 - 000039 Paid By: Paid in Full On: Stephen Ross Thu Jul 02,1998 Received By: Check No: Linda Lapointe 4355 DEPARTMENT'S COPY Amount: $211.0() DEPARTMENT FILE COPY 57 STRAW AVE CITY OF NORTHAMPTON BUILDING PERMIT Owner's pulling their own permits or dealing with unregistered contractors for applicable work do not have access to Guaranty Fund(MGL 142A) Issued: Permit No: Inspector: Tracking No.: Fee: 22 Jul, 1998 BP -1999 -0031 $211.00 GIS #: Map Block: Lot: Address: Zoning: Use Group: Lot Size: 1982 17D 029 001 57 STRAW AVE URB 14984.64 Contractor: License Type: Insurance: Homeowner as Contractor Address: License No.: Insurance No.: City: State: Zip Code: Phone: Project No: Category of Work: Const. Class: Cost Estimate: JS -1999 -0044 alteration - addition $15,000.00 Description of Work: construct 16 x 22 2 story addition GeoTMS® 1997 Des Lauriers & Associates, Inc. Signature: C� FILE 4/2" e 1 J 2 '1998 flamON' APPLICANT /CONTACT PERSON: --'? ' 9 7090% ADDRESS/PHONE: PROPERTY LOCATION: , 37 MAP /7 J PARCEL: F '?9 Z ONE,�� �-- THIS SECTION FOR - OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FT1.T,F,T) OTTT Fee Paid Building Permit Filled out Fee Paid 436 *$o9// New Cnnctriirtion /a /4 'YcVo Addition to F' icting A rressnry Structure Building PLanc Tncltided• Cltivn r.Iflrrupant Statement nr T,irence 3 Sets of Plane Plan ✓ — THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:' Approved as presented/based on information presented Denied as presented: Special Permit and/or Site Plan Required under: § _ PLANNING BOARD ZONING BOARD Received & Recorded at Registry of Deeds Proof Enclosed Finding Required under: § w /ZONING BOARD OF APPEALS Received & Recorded at Registry of Deeds Proof Enclosed Variance Required under: § w /ZONING BOARD OF APPEALS Received & Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability �farova -Bd of Health Well Water Potability -Bd Health x e Y Permit from Conservation C, ;. mission 11r 2/ae Signa o . :. . o '%f ,,' Date NOTE: Issuanoe of zoning permit does not relieve an applioant's burden to oomply with all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Works and other applioable permit granting authorities.