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31C-034 Planning -Decision City of Northampton Hearing No.: PLN-2012-0019 Date: March 29, 2012 required in the special permit for the village. 3. The requested use will have no effect on the relationship of structures and open spaces to the natural landscape,existing buildings and other community assets in the area. 4. The requested use will not have an impact on city resources. 5. The requested use meets any special regulations set forth in the Zoning Ordinance in section 350-11 COULD NOT DEROGATE BECAUSE: FILING DEADLINE: MAILING DATE: HEARING CONTINUED DATE: DECISION DRAFT BY APPEAL DATE: 3/1/2012 3/15/2012 4/5/2012 REFERRALS IN DATE: HEARING DEADLINE DATE: HEARING CLOSE DATE: FINAL SIGNING BY APPEAL DEADLINE: 3/8/2012 4/28/2012 3/22/2012 4/5/2012 4/18/2012 FIRST ADVERTISING DATE: HEARING DATE: VOTING DATE: DECISION DATE: 3/8/2012 3/22/2012 3/22/2012 3/29/2012 SECOND ADVERTISING DATE: HEARING TIME: VOTING DEADLINE: DECISION DEADLINE: 3/15/2012 7:00 PM 6/20/2012 6/20/2012 MEMBERS PRESENT' VOTE: Andrew Weir votes to Grant Debin Bruce votes to Grant Marilyn Richards votes to Grant Katharine G.Baker votes to Grant Stephen Gilson votes to Grant Jennifer Dieringer votes to Vote Against Francis Johnson votes to Grant MOTION MADE BY SECONDED BY VOTE COUNT- DECISION: Debin Bruce Katharine G.Baker 6-1 Approved with Conditions MINUTES OF MEETING: Available in the Office of Planning 8 Development. I,Carolyn Misch,as agent to the Planning Board,certify that this is a true and accurate decision made by the Planning Board and certify that a copy of this and all plans have been filed with the Board and the City Clerk on the date shown above. I certify that a copy of this decision has been mailed to the Owner and Applicant. Notice of Appeal An appeal from the decision of the Planning Board may be made by any person aggrieved pursuant to MGL Chapt.40A,Section 17 as amended within twenty(20)days after the date of the filing of the notice of the decision with the City Clerk. The date is listed above. Such appeal may be made to the Hampshire Superior Court with a certified copy of the appeal sent to the City Clerk of the City of Northampton. GeoTMS®2012 Des Lauriers Municipal Solutions,Inc. Planning -Decision City of Northampton Hearing No.: PLN-2012-0019 Date: March 29, 2012 11.)All air conditioner condensers shall be screened from street view by buildings or plantings. 12.)Prior to construction onsite inspection of silt fence,tree protection,and catch basin protection shall be done by the city to confirm they have been installed as shown in plans. 13.)All technical standards required by Department of Public Works for development shall be met.(attached herein) Curb Cut 'Acceptance of this street will require that the DPW policy regarding a 5 year moratorium on cuts in newly paved roads be adhered to. The DPW policy is that cuts made within this time require milling and overlay for the full width of the road and 20'wide each way from centerline of the two new cut(s) as well as backfill with flowable fill in all trenches. •The proposed common drive at lots A21 and A2 has a throat that is approximately 25 feet wide at the sidewalk with perpendicular,individual drives. •At all proposed new curb cuts the concrete sidewalk shall be rebuilt the nearest panel that is included in the driveway limits and shall meet the DPW standards of:8-inch,compacted gravel base,6-inch thick,4,000 psi concrete with 6"x6"x 10110 WWF and 3/8"filler w/joint sealant and retainer ring. •A detail for setting granite curb shall be provided for approval by Department of Public Works. Sewer •Existing sewer stubs may fall near or within the limits of proposed new driveway locations.Sewer clean outs near or within vehicular trafficked areas shall be protected within an access box that is flush with the surrounding grade. 'Sewer cleanouts shall be placed as close to the property line as practicable. Drainage: •The Northampton DPW issued a Stormwater Management Permit to TCB Hospital Hill LLC on July 19, 2007,which included potential development consistent with the proposed project.However,the Stormwater Management Permit included conditions which must be met for the proposed project including the following(see Stormwater Management Permit for Village Hill Phase 2 for more information): -This project will be required to submit one or more Notice of Intent(NO I)to the U.S.EPA for coverage under the NPDES Stormwater Construction General Permit.A copy of the final NOI and Stormwater Pollution Prevention Plan(SWPPP)shall be submitted to the Northampton DPW for approval prior to the start of construction and prior to issuance of a building permit. -The plans and specifications approved by this Permit include roadways and conceptual impervious surface areas for site development.During the Site Plan approval,40R site approval,or any other permitting for each lot,the applicant must submit documentation to the Northampton DPW of the proposed drainage system for the site,the impervious surface footprint of the site,and a revised summary of impervious surface areas built,proposed,and available for future construction for the sub-watershed drainage area where the proposed lot development is taking place. The DPW requests that this information be submitted and approved by the DPW prior to issuance of a building permit. 'Sheet CI.30 of the Site Plans specify 1-CULTEC Recharge 330 XLHD Chamber(TYP.)for each proposed house. The Memo from Dan Delany,P.E.,Fuss&O'Neill,dated February 21,2012 to Doug McDonald, City of Northampton,regarding Village Hill Drainage Summary includes calculations that specify 2 CULTEC 330 XLHD infiltration units per lot.The Plans should be corrected to be consistent with the calculations specified in the Memo. > 14.)Prior to issuance of a building permit for the second lot in the row of house lots numbered A3,5, 7, 9, 11,13,15,17,19, maintenance and easements agreements for the alley way must be submitted to Office of Planning and Development for review and approval to be recorded. FINDINGS: The Planning Board approved the site plan along with minor subdivision amendment that included relocation of driveways for the build out of the 24 lots along Moser Street at Village at State Hospital based on the plans submitted with this approval. This approval includes flexibility to build a minimum 8'width front porch or for porches fronting the full façade. Plans include: 1."Village Hill Northampton Site Plan Approval Moser Street" Dated February 17,2012 by Fuss&O'Neill for the Pecoy Group,Sturbridge Development LLC.Pages CO.00,C1,C1.1,C1.2,C1.3,C1.4,C2, C3, C3.01/02,L1,L2. 2.Custom Design Moser Street West Elevations for The Pecoy Group. Sheets Al-1 to A1-8,A2-1 to A2-8. 3. Memo by Fuss&O'Neill to Doug McDonald regarding Moser Street Subdivision Drainage and calculations. In approving the site plan,the Board determined that all the criteria in section 11 and criteria for the special permit originally adopted for the Planned Village,including design guidelines had been met. 1. The requested use protects adjoining premises against seriously detrimental uses. The new lots are part of the build-out of the state hospital and are consistent with those plans. 2. The requested use will not have an effect on convenience and safety of vehicular and pedestrian movement within the site and on adjacent streets,roads in the area.As part of the overall redevelopment of the state hospital,traffic mitigation will be made as previously GeoTMS®2012 Des Lauriers Municipal Solutions,Inc. Planning -Decision City of Northampton Hearing No.: PLN-2012-0019 Date: March 29, 2012 APPLICATION TYPE: SUBMISSION DATE: PB Intermediate Site Plan 2/23/2012 Applicant's Name: Owner's Name: NAME: NAME: Sturbridge Development LLC MASS DEVELOPMENT ADDRESS: ADDRESS: 215 Baldwin Ave. 1350 MAIN ST Suite 110 TOWN: STATE: ZIP CODE: TOWN: STATE: ZIP CODE: WEST SPRINGFIELD MA 01089 • SPRINGFIELD MA 01103 PHONE NO.: FAX NO PHONE NO.: FAX NO.: (413)755-1380 0 (413)755-1349 EMAIL ADDRESS: EMAIL ADDRESS: Site Information: Surveyor's Name: STREET NO SITE ZONING: COMPANY NAME: PRINCE ST PV(69)/RR(35)/FFR(35)/WP(24)/SG b(1)/SG a TOWN: ACTION TAKEN: ADDRESS: Notrthampton Ma MA 01060 Approved With Conditions MAP. BLOCK: LOT' MAP DATE: SECTION OF BYLAW: 31C 017 001 Chpt.350-11:Site Plan Approval TOWN: STATE: ZIP CODE: Book: Page: 1 6925 302 PHONE NO.: FAX NO.: EMAIL ADDRESS: NATURE OF PROPOSED WORK Approval for development of 24 single family houses on lots 31C-23 through 34 and 38A-128-134,38A-136-141. HARDSHIP' CONDITION OF APPROV O K ` 1) Prior to issuance of the first certificate of occupancy for the project,a conservation restriction,to be held by the city on terms agreeable to the city,shall be recorded for the park allocated between lots • ,ndA23. 2.)A pedestrian access sign at the curve where Moser meets Ford Crossing between Lots A20&23 and midblock between A11813 indicating entry to the trap rock gravel public path within shall be installed prior to the marketing or construction of any of the lots along/within the subdivision. OK 3.) The public easement and temporary path shall be granted for the path south of Lots A 13 and A27 ---' prior to the issuance of the first certificate of occupancy of the project. The easement shall be held by the city and terms drafted for this easement shall be approved by the city. 4.)The path segment between lots All&13 shall be constructed as part of the construction on these lots and shall be completed prior to the issuance of the first certificate of occupancy for either one of these lots. 5.)The path design between lots A20 823 shall be rough-constructed prior to the first certificate of occupancy of the project. 6.)The path segment across lot A27 shall be constructed prior to the first certificate of occupancy on lot A27. 7.)The applicant shall loam and re-seed the portion of the right-of-way by A14 where the driveway will be relocated. 8.)Tree to be relocated for lot 26A shall have a 1 year warranty from the time of issuance of certificate of occupancy for this lot. 9.)Common Driveways for lots A2/A21 and A25 and A26 shall have easements recorded prior to issuance of a building permit for these lots. 10.)Common Driveways and new A14 driveway shall ramp up to sidewalk.Sidewalk shall not be covered with bituminous. The driveway should break for sidewalk. GeoTMS®2012 Des Lauriers Municipal Solutions,Inc. • • a�KA�lp� 1 .,. ` � • - DEPARTMENT OF BUILDING INSPECTIONS Main Street • -Mumici Building INSPECTOR 212 paI e Northampton,MA 01060 as • LOCATION /// 82 �7 J `"'dif1/111'1 71 in it/1-6E I/714_ SQUARE FOOTAGE AMOUNT BASEMENT @ 20 ed 1rFLOOR @.50 - � 0V. 2ND @ 3• - • FLOORS, FINISH ATTIC,GARAGE @ 20 • DECK/PORCSES @• :20 TOTAL.. • • • • s ° To be completed when approved permit is picked up. By signing below,the applicant acknowledges and agrees to all the conditions of approval stated below and validates t is 'ermit. i, t - if - 12 Applicant Date For City Use--Do not write in this section • Department Approvals/Comment Other Referenced Permits Water 9--/7--/S /� /4l Sewer 41--I dci--/.3 921\f A'T Streets t '44 cS— / 3 Condition of road: LZ Road last paved: p,iii,,,.m Conditions of Approval 0 Control Density Fill Required U Refer to Engineering for plans Must install clean-out(See Attached) 0 Subject to 5-yr.pavement moratorium Ej Other requirements(See Attached) r.:1 Water/Sewer/Drain Entry Permit Fee 1:::1 $250 Permit Application Fee received(Check payable to the City of Northampton) aFee Waived. Reason: Permit Approval /i'..- i'Y lyz-b ,„-Z ---- Director of Public Wor - Date Pg.4/4 ..v " PENDING APPROVAL r 4''''''''';'D'4.„ OP NORTHAMPTON,MASSA L�ETTS 111 MOsEit ST A l3 DEPAR,TMWT DP` ' 11 �C 6� y, .��' {i ,125 Locust street Trench Permit Number 2014 168 a of +0m ,' [ , 01060 Date Approved: '� ' Fax .'.1578 p iration Date:z: i (for City Use Only) EECAVAT1ON NCIi PER'S Pursuant to CL.c.82A and 520 CMR 14.00 et seq.(as amended) • This permit must he fully.completed.prior to consideration.Submit completed fern With Perm it fee to Northampton Department of Public Works, 125 Locust Street,Northampton,MA 01060, • This permit is issued under the provisions of N1,G.L.c.82A,520 C1411t."14.00 and applicable sections of the Revised ordinances of the City of Northampton,including,but not limited to,Section 285 1. Fee:$250 Check# 34322 Date Issued: 9f18113 ' Name of Applicant Primary Phone KENT PECOY&SONS 781-7008 Street Address ` Em ergency Phone# 215 BALDWIN STREET 246-3749 City/Town State Zip Email W.SPRINGFIELD MA 01089 • Name of Excavator Primary Phone • SAME Street Address Emergency Phone# City/Town S a ZIP Email Name of Properly Owners) teary Phone # KENT DECOY SONS Street Address Emergency Phone it 215 BALDWIN STREET City/Town y State zip Email W. SPRINGFIELD M 01089 Insurance Certificate# Policy Expiration Date ON 1E Name&Contact Information of Insurer ON FILE Dig Safe# 2013-380-7625 e 5157--Iti Pg.1/4,Exca■aionrrrench Permit Perm f} CU/3—i-1 h �� X Permit No. W13-14 WATER CONNECTION INSPECTION REPORT Northampton Sewer Department 237 Prospect Street Northampton, MA 01060 (413) 587-1570 Date: 9/17/13 Type of Service: New X Renewal Repair Pipe: Size 8" Material DI Age 2009 Water Entry Fee: Paid Yes X No N/A Meter Size 5/8" Fee Paid Yes X No N/A Radio Read Fee: Paid Yes X Check# 34319 Cash Location of Installation: 111 MOSER STREET, LOT A13 (Street and Number) Permit Issued To: KENT PECOY& SONS /DON CLARKE Contractor/Developer Installing Service Connection: KENT PECOY& SONS Telephone No.: 413-246-3749 The service connection at this location was inspected by the undersigned on (Date) at and approved by (Time) Water Superintendent I have instructed of that the installation can be backfilled. Measurements for all installation shall be documented by the Water Department. The information shall be on file at the Public Works Department office. Copy to Supervisor: Date: 9/17/13 Copy to Utility Billing: Date: 9/17/13 Copy to Office Manager: Date: 9/17/13 Permit No. W13-14 CITY OF NORTHAMPTON, RESIDENTIAL OR COMMERCIAL BUILDING WAT ENTR APPLICATION DATE: 9/17/13 4 / I : (Applicant) Name of Applicant: Kent Pecoy& Sons/Don Clarke Address of Applicant: 215 Baldwin Street ,W. Springfield Telephone#: 413-781-7008 $ 200.00 Entry fee paid Check No. 34319 $ 100.00 Meter fee paid Check No. 34319 $ 100.00 Radio Read Fee paid Check No. 34319 Application approved and permit issued: DATE: 93 SIGNED: ,,�/ `fir �/ — (Director o Pus is Wo s) Fee Schedule: Water Entry Permit Fee: $200.00 5/8"Meter Fee $100.00 3/4"Meter Fee $150.00 1"Meter Fee $200.00 Radio Read Fee: $100.00 \\win2\admin\Permits\Water Application\Water Permit 2014\W13-14 111 Moser Street, Lot A13.doc 1 Permit No. W13-14 CITY OF NORTHAMPTON,MA RESIDENTIAL OR COMMERCIAL BUILDING WATER ENTRY APPLICATION A Department of Public Works Trench Permit shall be required prior to any construction or connection activity associated with this application. To the City of NORTHAMPTON, MASSACHUSETTS: The undersigned, being the Owner of the property (Owner,Owner's Agent) located at 111 Moser Street, Lot A13 , does hereby request a permit to install and (Number) (Street) connect a 1" Water Service to the Residence at said location. (Size) (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 person or firm who will perform the proposed work is Kent Pecoy& Sons of 215 Baldwin Street, W. Springfield, MA 01089 (Name) (Address) 3. Plans/sketch and specifications 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 street line shall be paid at the prevailing labor rates and cost of material. Water Meters 5/8" $100.00 X , Water Meters 3/4" $150.00 Radio Read$100.00 X Water Meters 1" $200.00 Water Meters 1.5"and above shall be purchased by the owners using city specs. 4. A fee of$100 for the Radio Read Fee with the purchase of a new meter. 5. The Water Superintendent shall be notified for water line inspection prior to backfill of trench. 0--01 ..° SEWER CONNECTION INSPECTION REPORT Northampton Sewer Department 125 Locust St. Northampton, MA 01060 (413) 587-1570 ate: 9/17/13 Engineering has taken ties to service Signature Type of Service: New X Renewal Repair Existing Sewer Entry Fee: Paid Yes X No N/A Check Cash Pipe: Size JLength Material PRIVATE Age Location of Installation: 111 MOSER STREET, LOT A13 (Street and Number) Permit Issued To: KENT PECOY & SONS Contractor/Developer Installing KENT PECOY& SONS Service Connection: BALDWIN STREET, W. SPRINGFIELD, MA Telephone No.: 413-246-3749 The service connection at this location was inspected by the undersigned on (Date) at and approved by: (Time) Sewer Supervisor I have instructed of that the installation can be backfilled. Measurements for all installation shall be listed on the back of this form. The information shall be attached to the permit on file at the Public Works Department office. Copy to Supervisor: Date: 9-1 7 13 Copy to Utility Billing: Date: Copy to Office Manager: Date: 114•e,c . SO 7- I I] ;,'0, r St, [ Al 4. The City shall not be held liable for any 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. Ii DATE: 9/17/13 SIGNED: 00 (Applicant) Kent Pecoy& Sons/Don Clarke 215 Baldwin Street, W. Springfield (Address of Applicant) 413-246-3749 (Telephone No. of Applicant) $ 500.00 inspection fee paid Check No. 34317 Application approved and permit issued: DATE: 9zs'/3 SIGNED: (Director o 'u s is Wo, s) Code of Ordinances Section 22-41 through 22-52 available upon request. Tie-in to sanitary main $200.00 Tie-in to sanitary service at street line $500.00 X \\win2\admin\Permits\Sewer Entry\Permits 2014 Sewer\S07-14 111 Moser Street, Lot A13.doc Permit No. S07-14 CITY OF NORTHAMPTON,MA RESIDENTIAL OR COMMERCIAL BUILDING SEWER APPLICATION A Department of Public Works Trench Permit shall be required prior to any construction or connection activity associated with this application. To the City of NORTHAMPTON, MASSACHUSETTS: The undersigned, being the Owner of the property (Owner, Owner's Agent) located at 111 Moser Street, Lot A13 does hereby request a permit to install and (Number) (Street) 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 person or firm who will perform the proposed work is Kent Pecoy & Sons ,of 215 Baldwin Street, West Springfield, MA 01089 . (Name) (Address) 4. Plans and specifications for the proposed building sewer are attached hereunto as Exhibit «A» In Consideration of the granting of this permit,the undersigned agrees: 1. To accept and abide by all provisions of the Code of Ordinances, City of Northampton, Massachusetts, Sections 22-41 through 22-52, and all other pertinent ordinances or regulations that may be adopted in the future. 2. To maintain the building sewer at no expense to the City. 3. To notify the Superintendent when the building sewer is ready for inspection and connection to the public sewer, but before any portion of the work is covered. i.i_ L I),ram, :wer l.ra, '1:I 201'a 5cn;tr,Sl17-Id iii 'o: r cti':1 20/ `f /(P A °RD CERTIFICATE OF LIABILITY INSURANCE �0;8�201"3") THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Irene Balise NAME: Alexander W Borawski Inc (Alc°No.Ext): (413)586-5011 FAX Nol:(413)586-7973 88 King Street, Suite B E-MAIL s:ibalise@borawskiinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060-3257 INsuRERANetherlands Insurance 24171 INSURED INSURER B: _ Kent Pecoy & Sons Construction, Inc INSURERC: 215 Baldwin St INSURERD: INSURER E: West Springfield MA 01089 INSURERF: COVERAGES CERTIFICATE NUMBER:CL137301422 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES 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 AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100 000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A CLAIMS-MADE X OCCUR CBP8780556 7/1/2013 7/1/2014 MED EXP(Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY LOC $ PRO- JECT AUTOMOBILE COMBINED SINGLE LIMIT UTOMOBILE LIABILITY (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS - AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 212 Main Street Northampton, MA 01060 AUTHORIZED REPRESENTATIVE R Borawski/BOREG1 ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INSD25l7e1nnelm The ArfPr1 name and Innn arc renicterarl marke of Ar:flRll r W v v r. 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H � c o m nn o -n a «^ 3 Nu Ali- n `V c o m n c ? c� '7n ° o w m m W S C Z .0 m M rim r c c m oo ° col n 1 1xi.. 0 3 0 CD D 0 v .r• rt CD uo m o n n a o v, w d a / r• o, <—m- ° cxi cD C lD n 3 0 � °, '^ 7 0) -I a a o N o o o• m C ,, a cD o u, //D� 3 xi v, n a a `V aD-' ='•< x rn c muo 0 N d tanuo O Q' . `< KN Cl O , -1 0''' a) 3 01 m- n a o . -I O N = r 0 o N o, o j,. x o .� a 3 i_ DI a o = _ o °± n o< Ja cu R N 3 rn CCD 0 01 w Ip XI r-r 7 N 11, N n ;- -a N r•' S y * co y H 7 a 0 I10 • U0 ~ N u0 N 7 fD A 7 v. N n r. -I y CD 7 77 °s. 3 a) ma z do Eli c'p m a ° Q 7 to 2 x m CD Q; C' � o v- -v L.• f'1 = 3. r* s _ 3 F1 o aD w CO ■ K 73 • r 0 'o N oo N C N M J (, 7 w 1 41 o _l r? DI J ra N (7 N N 1•O O N 0, 00 '0 VI• J 471 0 0 w V w w rP 0 N ray O O N J 1 7 m u0 0 0 o a.° e u -1 r7r SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: ,"1/-'( /k1("V (/' S S S�� License Number )/5 /it&r Sy ?f£T C 12/4(/'Ei) 4414. Address Expiration Date Signa •re Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ 'E C /MA; lN'( . /C a 7(6, Company Name Registration Number JIS- / /7e. ,,)t.c 41, S /�f f J 1 (110 gy Address Expiration Date Telephone 7/l a/ •At 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 E3 No ❑ 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 Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature ISECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors El Accessory Bldg. El Demolition El New Signs [O] Decks [p Siding[0] Other[p] Brief Description of Proposed Work:ArNere✓e7 /VP-K/ 3 d/e..I 12i6/l�Lf�1/1� / e"'.�6LLfr hiewiE Alteration of existing bedroom Yes I No Adding new bedroom Yes -No .4 Attached Narrative Renovating unfinished basement Yes CA'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: 8 Number of Bathrooms 3 c. Is there a garage attached? Yes d. Proposed Square footage of new construction. /64r)e) Dimensions ,796 i 16 e. Number of stories? f. Method of heating? 645 /wit«9 ,472 Fireplaces or Woodstoves /043 Number of each g. Energy Conservation Compliance. ✓ Masscheck Energy Compliance form attached? h. Type of construction jt/DOL / i. Is construction within 100 ft. of wetlands? Yes ✓ No. Is construction within 100 yr. floodplain Yes f No j. Depth of basement or cellar floor below finished grade '7 ' k. Will building conform to the Building and Zoning regulations? L Yes No. I. Septic Tank City Sewer -,/ Private Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, .6.1 1-17 _/4 6 e/ , as Owner of the subject property hereby authorize ) SV C~I -1/2e . to act on my behalf, in all matt relative to work authorized by this building permit application. Signature of Owner Date e ? 1, /c/L1 Pia! , 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. Signe under the pair)sand penalties of perjury. - rc.( l�t Print Name r vg r Signature of Owner/Agent Date /j} /3 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 Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained , Date Issued: C. Do any signs exist on the property? YES 0 NO 0-- IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO IF YES, describe size, type and location: E. WII the construction activity disturb(clearing,grading, excavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO 0 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. S Department use only T. City of Northampton Status of Permit: ' ,' Building Department Curb Cut/Driveway Permit i ill-1 r 1 212 Main Street Sewer/Septic Availability ii 11 E (i(�I 1 203 , JJ Room 100 Water/Well Availability --Klorthampton, MA 01060 Two Sets of Structural Plans 413-587-1240 Fax 413-587-1272 Plot/Site Plans Electric, Plumbing&Ga Inspections Northampton, MA 01060 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 t ill ftr..; Ma- r Map 16._ Lot 1 Unit /1/ ,/) ' (-// ,c//, At-3 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: /6t / /'c(( y i �S k`S (v1.'s /i J ,' d .;2/c /I&c..L./ j 'f T, 14f, !iLIVIZi4') //. Name(Print) Current Mailing Address: " 1 - �� . Telephone Signature 2.2 Authorized Agent: � .ili 'C i if/2 cs /1.-/Zd)u./k 9/2W /4i, ,S/?c'/ti 6'1..LiJ 44,4, ( ' t Current Mailing Address: /// ' f (- .'�` '1/i f ,J(- `/ ` .9 79 Sigr ature L 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 2. Electrical (b)Estimated Total Cost of /' eel Construction from (6) 3. Plumbing 41-JD Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 1e9, 6. Total=(1 +2+3+4+5) _ 09 .Oc+o _ Check Number ` i7,OWN• This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2014-0452 ' 91-'" APPLICANT/CONTACT PERSON KENT PECOY&SONS CONSTRUCTION INC f� ADDRESS/PHONE 215 BALDWIN ST WEST SPRINGFIELD (413)781-7008 PROPERTY LOCATION 111 MOSER ST-LOT A13 MAP 31C PARCEL 034 ZONE PV THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Peumrit Filled out 41,C('' 85t/- '+0 Fee Paid t�s M v1 s T fj F COI F(<� Typeof Construction: CONSTRUCT 2 STORY SFH W/ATT GARAGE Writ .3 ECT t New Construction PP;4o( 1'0 (c's Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: /� Owner/Statement or License 052589 /r/l 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON P6 Ar'f OJ11.- INF94 MATION PRESENTED: (p PtrT(0 I/Approved Additional permits required(see below) r f Rf 'TO 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 D- olif 'ela Si: .ture 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. 111 MOSER ST-LOT A13 BP-2014-0452 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31C-034 CITY OF NORTHAMPTON Lot: - PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Pemit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:New Single Family House BUILDING PERMIT Permit# BP-2014-0452 Project# JS-2014-000787 Est. Cost: $232000.00 Fee: $854.40 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: KENT PECOY & SONS CONSTRUCTION INC 052589 Lot Size(sq. ft.): 4378.00 Owner: KENT PECOY&SONS CONSTRUCTION INC Zoning: PV Applicant: KENT PECOY & SONS CONSTRUCTION INC AT: 111 MOSER ST - LOT A13 Applicant Address: Phone: Insurance: 215 BALDWIN ST (413) 781-7008 WC WEST SPRINGFIELDMA01089 ISSUED ON:10/21/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 2 STORY SFH W/ATT GARAGE - path segment must be complete prior to co 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: FeeType: Date Paid: Amount: Building 10/21/2013 0:00:00 $854.40 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner