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43-173 Sa.mple4 6758 HOW LABORATORIES of NEW ENGLAND, INC 750 North Pleasant Street Amherst, MA 01002 nt Pho : (413) 549-8260 Fax: (413) 549--1850 MA Lab Lia# M-00851 WATER ANALYSIS REPORT Ad- Analyzed For: Dave Lepine Sample Location: .Park Hill Road Address: 262 East Street Northampton, MA Easthampton, MA 01027 . Sampled By: HWD Data Sampled: 11/9/99 Telephone: Date Received: 11/10/99 Parameter Results Limits Comments 1 ,�. l Total Coliform OK Bacteria 0 cotonie9/100m1 0 colonies/100m1 • * PM 9 . 0 5 pH units — 6.5.5.5 pH Units' • f • * * Manganese 0. 476 m9/t 0.05 g/t . Hardness 40 mQ/t No Standard , <50 soft, )100 hard f Conductivity 1. 39 ms/cm No Standard No standard Chloride 305. 8 mg/t 2 Omg/t Iron 0. 75 mn/t 0.3mg/t * * 1 • Sodium 120 mg/t 281%0 ., * * . Nitrate 32 . 0 ma/t 1amg/t • Nitrite 7 . 25 %/t 1 welt . - t . * * Color 1870 PtCo Color Units 15 Pt Co Color Units * 1 Turbidity 6 8 NTU 5 NTU Recommendations:Retest elevated parameters: This sample meets acceptable standards of potability for the parameters tested except for those parameters marked with an asterisk (*) . Analyst: EJ, BG Date: 11/11/99 Checked By: Athan S. Begg Laboratory Supervisor THE COMMONWEALTH OF MASSACHUSETTS PI/U /77 No. / gianavlie,il , MASSACHUSETTS FEE 75- jilt53Frosat , geteItt gonstrurituri Permit Permission is hereby granted to 1 ^e to construct (,,V or repair( )an On-site Sewage System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed within two years of the date below. ' DATE /�, Approved by �� i FORM 1255 Rev.3/95 AM.SULKIN CO.-BOSTON.MA • • BOARD OF HEALTH CITY OF NORTHAMPTON 1 ,~, MEMBERS ' 4, �- frIAlitt MASSACHUSETTS 01060 �'�F.;o�,, !f *CYNTHIA DOURMASHKIN,R.N.,Chair. ' ANNE BURES,M.D. ROSEMARIE KARPARIS,R.N.,MPH PETER J.McERLAIN,Health Agent OFFICE OF THE 210 MAIN STREET BOARD OF HEALTH NORTHAMPTON,MA 01060 (413)587-1214 FAX(413)587-1221 C9 L5 l MEMO 0zz„„), TO: Dave Lepine aEPr ox e � Fr^flv Y�. 262 East Street, Easthampton, MA 01027 "°--- sA Tic% FROM: Peter McErlain, Health Agent WV— DATE: November 18, 1999 SUBJECT: Septic System permit, Lot 4 Park Hill Rd. Enclosed please find approved plans and permits for septic system construction on Lot 4 Park Hill Rd. Please note that due to the high levels of contaminants reported in the first well water test report it will be necessary to submit additional test results to insure that the water is potable. Please submit the results of the second well water test prior to the start of septic system construction. Please contact me at the Board of Health office with any questions. cc: Northampton Building Inspector Anthony Patillo QTTD .+0 Cut of NartI ampton �^ =**- s Jiaw 4* „Massachusetts {- 'm"� DEPARTMENT OF BUILDING INSPECTIONS , _`; i INSPECTOR 212 Main Street • Municipal Building ',o Northampton, MA 01060 CERTIFICATE of OCCUPANCY and USE This is to certify that permission is hereby granted under 780 CMR, sixth edition of the Massachusetts State Building Code, allowing the occupancy or use of the premises or structure or part thereof located at 454 Park Hill Road - Lot#4 as shown on the Assessors Page# 43 , Lot# 173 , Zone SR in the City of Northampton, as herein specified: CONSTRUCTION TYPE(780CMR 6) 5B USE GROUP CLASSIFICATION (780 CMR 3 R4 OCCUPANT LOAD PER FLOOR (780 CMR Table 1008.1.2 40 PSF - 1st fir 30 PSF - 2nd flr LIVE LOAD PER FLOOR (780 CMR Table 1606.1) 40 PSF Under the following limitations, special stipulations, and /or conditions of the permits: N/A Issued this 16th day of May , 2000 Certificate of Occupancy and Use # BP-2000-0501 Authorized Department Personnel :I Electrical /,_, «.;., . r�-; "ti-,,,t,t,L Elevator /y 1 Fire ,/' l; _,(,,-( (0).-2-ect- Plumbing ! � 1l Building Gas Building Commissioner ,,r- _„e__ This certificate shall be posted by the owner, in a permanent manner and in a visible location, on all floors designated as use group H, S, M, F, or B, and in every room where practicable of use group A, I, R-1, or R-2 per requirement of 780 CMR section 120.5 Posting Structures. CERTIFICATE OF COMPLIANCE This is to certify that the sewage disposal system installed XX or repaired on 5-11-00 at _ 454 Park Bill Road Lot 4 by M.J. Loomis Excavating has been constructed in accordance with the provisions of Title 5, the Northampton Board of Health regulations, and the Disposal Works Construction Permit issued. Use of this system is conditional on compliance with the provisions(if any) set for below: The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. SIGNATURES: Installer:' ,fr., /'•a;/%/- Datc: s"�S Zeo d / ' Designe diltize .4/ / Date: /.) Dl1 James A. Gracia, PE James.4. Gracia, PL•. 9')(_ilcrnclulc St, 'd Easthampton, MA, 01027 id kid TO:M 0020 91 '6 pL4 SL6�LZS : '0N Xtid : WOdd THE MMONW LTH OF MASSACHUSETTS 48—)93 A/a/e , MASSACHUSETTS Ole ifirate of (ILumFlitntre T ISIS TO CERTIFY, that the On-site Sewage Disposal System instal d k) or repaired/replaced( ) on _ �j pt/ dc7 // _ �i .i _ f•r 4 U'e- I p_e7/N`e at •�� � = has been constructed in accordance wj'th th provisions of Title 5 and the for Disposal System Construction Permit No. fg"T j dated ///S/' , Use of this system is conditioned on compliance with the provisions set forth below: The issuance of this certificate shall not b• cons ued as a guarantee that the system will function as d. "gned. This Certificate expires on 5 / 0�'� i j �. DATE 3 � � Inspector �� /' =' — a -4 F. % -v.,...-L-- \ --A) \i\,------- . 7 210 \ 3 1. . M k cy� 's tiS • �m ti 5 fit, �' . �� .�..- (6.4v of Northampton t �.: • y d i t%P�yH ttc!:19 / ,lassnchnsctts �iif E n DEPARTME1 T OF BUILDING INSPECTIONS 4 'I= /: 212 Main;Street • Municipal Building ' _ /" INSPECTOR Northampton, Mass. 01060 Square Footage Amount Basement @ .10 9y4 qy 600 1st Floor @ .40 fYla S7Ff. eio 2nd Floor @ .20 i0 7 7 Ric. Cie 1/2 Floors, Attic, Garage .10 5;9 8 -56,7.30 Deck, Porches .10 3.3( 33620 TOTAL 7747` O �Cll 1/:r 4/6-y nor /4// g J --////(0.-ix,-/- ,, 0 xILL - P SRI( Ask CU RERT UN ER ti D h. ' - s!) _•• --)Vbl r• 55.96' I s I 1 LOT 4 LOT I 1 \ 2.85 ACRES LOT5 - r 1 i I ' , oo bo co L I PROPOSED WELL PROPOSED 4DWE R NG • • w ONE MpT\ l ti CITY OF NORTHAMPTON, MASSACHUSETTS j DEPARTMENT OF PUBLIC WORKS ,.� .. �. 125 Locust Street Northampton, MA 01060 413-587-1570 Samuel B. Brindis, P.E. Fax 413-587-1576 Director, City Engineer Guilford B. Mooring, P.E. Assistant Director of Public Works BOARD OF PUBLIC WORKS DRIVEWAY PERMIT GENERAL INSTRUCTIONS AND REGULATIONS 1. A "Driveway Permit" is required in all cases where a new curb cut or an alteration to an existing curb cut is proposed on a City public way. 2. Driveway permits issued by the Board of Public Works (BPW) shall be attached to and become part of the "Building Permit" issued by the Building Inspector. 3. Prior to the issuance of a "Building Permit" the owner of any lot to be serviced by a new driveway shall apply to the BPW for a "Driveway Permit" by completing the pertinent portions of the permit (see attached). Once the location of the driveway is approved by the BPW, a building permit may be issued. 4. The Building Inspector shall not issue an "Occupancy Permit" unless the driveway to the lot has been approved by the BPW. 5. By the issuance of a driveway permit for the stated location, neither the City of Northampton nor the Department of Public Works imply that no drainage problems will result with the driveway when constructed. Properties situated or driveways installed in low lying areas in the path of the natural drainage will be subject to water problems. These problems may include water sheeting across roadways adjacent to the driveway. The City and the DPW assume no responsibility for any such drainage problems. The owner of the property is responsible for constructing and maintaining the driveway with adequate provision for natural water runoff situations. L664muel B Brindis, P.E. Director of Public Works C:AivlyFiles"Lyn\Driveway Permit General Instructions D11-00 Conditions: Driveway Permit In lieu of plan approved by 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. 4 By: fj Petitioner / 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. D11-00 NOV 91999 C I T Y O .R T• H A M P T O !I, M A S S. November 5, 19 99 THE BOARD OF PUBLIC WORKS The undersigned respectfully petiition your honorable body for Permission to install driveway at 454 Park Hill Road Fifteen (15) foot maximum width at the street line. Gutter drainage not to be disturbed. All drainage shall be directed off the driveway surface to adjacent land and not on the existing roadway. Driveway surface to be paved if the grade of the proposed driveway exceeds 3% or more. • By: David Lepine 527-3975 262 East Str t, Easthampton, MA 01027 Proposed Location Inspected by: .9f, t/ -. 5- J Gravel Base Grade Inspected by: Final Approval: THE BOARD OF PUBLIC WORKS Voted that petition be granted. $25.00 Fee Paid Ck No 3628 Samuel B. Brindis, P.E. , Director of Public Works (SUBJECT TO ATTACHED CONDITION 1 & 2) 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 1250 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) r MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2 . 0 DATE: 11-9-1999 Bldg. Dept . Use CEILINGS : [ ] 1 . R-38 Comments/Location WALLS : [ ] 1 . Wood Frame, 16" O.C. , R-19 Comments/Location WINDOWS AND GLASS DOORS : [ ] 1 . U-value: 0 .35 For windows without labeled U-values, describe features : # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS : [ ] 1 . U-value: 0 .35 Comments/Location FLOORS : [ ] 1 . Over Unconditioned Space, R-21 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 . 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. M MAScheck COMPLIANCE REPORT Massachusetts Energy Code <,E NOV 9 1999 Permit # MAScheck Software Version 210 Checked by/Date CITY: Amherst STATE: Massachusetts HDD: 6614 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 11-9-1999 DATE OF PLANS: 17- .23- 47 TITLE : N ffo'i' 4/6- 1 Y /4 h‘g peqe t COMPLIANCE: PASSES Required UA = 364 Your Home = 262 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA CEILINGS 1077 38 .0 0 .0 32 WALLS : Wood Frame, 16" 0.C. 2352 19 .0 0 .0 142 GLAZING: Windows or Doors 98 0 .350 34 DOORS 36 0 .350 13 FLOORS: Over Unconditioned Space 946 21 .0 41 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 125% of the design load as specified in sections 780CMR 1310 d J4 .4 . Builder/Designer( Date ifk mt I5 1, r t_ r ;, 1 NOV g 1999 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 Address: 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.[ B. Scaled drawings & details shall indicate &describe all proposed work, including location, size,grade of materials &equipment to be used. [14 C. PLOT PLAN, property address; map & lot number, zoning district & overlays (such as wetlands) [ ] / Show well and septic locations (if applicable) [J] Location of lot lines, dimensions of lot, frontage [A 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, porcl}es 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) [VI Location of all walls, partitions, windows, stairs & doors [ Location & description of all electrical equipment , alarm devices and smoke detectors [t/r Location & type of all heating and air conditioning (HVAC) equipment. [ ] HVAC schematics (where required check with building inspector) [ ] EXTERIOR ELEVATIONS. Front, rear & side elevations including foundation and finish grades. kr Location & dimensions of windows & doors. [w17 Description of exterior cladding or siding material. V Show exterior stair locations & dimensions. K. Show chimney and vent locations [vj DETAILS & SECTIONS, Sections through exterior walls showing details of construction 4r from footing to the highest point of the building. [ Sections through fireplaces & chimneys (show clearances) [A Location & details of any rootftrusses f'lllc-lane_ or enci nC"T-''(l I!'m'"'' f im--!"!1,' (-,,,,,,,,Hon 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. [J] •:�yl w�• ,It'd• 3 t DEPARTMENT OP BrIILDING INSPECTIONS .1c:1:I i I_______=-__:.:,-- .i 212 Main Street • Municipal Building Northampton, Mass. 01060 •' WORKER'S COMPENSATION INSURANCE AFFIDAVIT I, '-D4U,/0 "4 A60 (Iicenscdpermittee) with a principal place of business/residence at: ok f455r ..5r 59S Agra 4 ©'o?y (phone#) 5-0)7-?9.% (street/ci ty/star ela p) do hereby certify, under the pains and penalties of perjury, that: (s) I am an employer providing the following worker's compensation coverage for my employees working on this job: id " ))iC C. 4 ft' e. WC 05/757 i/ .5.-09- oe (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: H-17 /.00r'Y1$ e>«tiv4rie--1 emu(/«s .eof5/eoey3,✓ or-y - ©U Si,,..), avexeT.0 7? 4oe '.. ,zo Fs o545°�13f5 0&-o5-Cie) (Name of Contractor) (I.nsurancc Company/Policy Number) (Expiration Date) Jt/1regrtt /erg CO 'D4-,) 134:14 c�/eiew- tJC v'/d CO 6 U7-//- 00 (Name o(Contractor) (Insurance Company/Policy Number) (Expiration Date) 009740",(4/ 94 . e ,5 . ,-,4ti.e ares05,4 Wcr7 9„? 7 o y/i.- 00 (Name of Contractor (Insurauce Comps /Ppplicy Number) (Expiration Date) Ave /k TN odu s2' 644 h rosiew PAkid,., ae,,,40,0 o,o y,:ab-e96. (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (atiae additional shoet ifneecaary to include information pertsi.2ing to all c actor:) ew SP.,J era/ /'1I 7. 0eit ot 4/ -rt'u8 3frI 9C17 62-'5400 ( ) I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. • NOTE:pleaae be aware that,tihilo homcosvnem wbo employ perto-.0 to do m,intrz.nur,corn mama or mini:work oo a dwdli.g of not tore than throe units in which the homeowner raids or on the grounds appurtrnwt thereto arc pot generally considered to be employers under tho worker's compensation Act(GL152,ss 1(5)),application by a homeowner for a license or permit may evidence the legal stztua of an employer under the Waiter's Compensation Act r un e,zt,nd dada copy of this ctatennmt may be fa-warded to the Departnroot of Industrial Accidents'Offioo of Ins uanoo for the covaagc vrrificaiioo and that failure to secure coverage under section 25A of MQL 152 can lead to the imposition of criminal penalties consisting of a fine of up to S1,500.00 andta imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a fine o(5100.00 a day against me,. .�j� Foe departmental use oat), /G// e Permit Number J ` /"/�°'- Maps Lot x'.;,; Signature of Li.-.,:-. •crnxat.tec Late ttix : • . • a • . • H • . i .: cy • : 0 * 0 Xs g •• • • r �° b • C1. ad : sq to O . PT. DEEP t I II q0 uD o r r. z zr0 oc il Ar 1) 10 r 70 - D 10 Z 0 In EA 1110 m r 0 m -I -I a , , 'n'ii 91999 v g Zone APPLICANT NOT TO FILL IN SPACES ABOVE THIS LINE A pp lication for a Dwelling Permit a,-,% Northampton,Mass. 19 o s.e Telephone No. 71) the Supt.of Buildings: Application for a permit to build is hereby made according to the following:- �5.y . .tM!?( . . '/� .J /1/ '��' /- �d� Lot No. . `/.. . . . 1. Location, Street and No. . . . . pp 2. Nearest cross street ,h�r'ce eci Size of lot 3. Owner's name .D.ANIO i"4• Aeom.,).- Address aea ,f4Sr- _sr- E. i 4. Architect's name Address 5. Builder's name .'A"ice M` 1,yfry Address c ',ee9.5 57 ,F' Mass.Construction Supervisor's License No. O VW£s'6- Expiration Date /—/ir - &c.>00 6. Use of Building:One-family X Two-family Other 7. Number of rooms in each family unit: 8' Number of Bathrooms a•5 8. Is there a garage attached? L/eS ` 9. Size of building Y / (7(/ Square footage . . . . .c2 d42 3 .s ` 1- 10. Number of stories a 11. Distance from finished grade to high point of roof `015' 12. Type of construction (`v Sr-T A,.4St''1,6k 5,---,of ;L?,,/iL 13. Distance from building to street line in feet 8'0 r i / 14. Distance from building to side lot lines in feet: Left 5f s Right V 15. Distance from building to rear lot line in feet 16. Is a plot plan being filed with this application? CIe5 17. Species of framing lumber:DF Spruce i/ Other 18. Are all structural conditions noted on drawings? ye$ 19. Nature of land upon which the structure will be erected:Natural ✓ Filled 20. Depth of basement or cellar floor below fin' hed grade (P i 21. Material of foundation walls Thickness in inches .,fQ 'if 22. Type of roof:Flat Pitched 23. Material or roof covering 45/04,11/- ssimik f'e$ 24. Method of heating . .!f!i.. .; /CD)?Cr'd h°dT 4TeX.. 25. Will the building conform to the Building and Zoning Ordinances? fie-S 26. Septic Tank? . .. .Zl t'S City Sewer? 27. Construction within 100 ft.of wetlands? N 0 28. Construction within 100 year flood plain? /4-J C) 29. Estimated cost:Total $ /‘..:9 ,0 dv. 00 No building or structure which is erected or altered,shall be used,in whole or in part,for any purpose until a certificate of occupancy is issued by the Building Inspector. The undersigned certifies that the above statements are true to the best of his knowledge and belief. G Signature of ntractor Si ire of rpcnn iv iiiiiiiiiiiimmummunimpowsw- 10. Do any signs exist on the property? YES NO / IF YES,describe size,type and location: Are there any proposed changes to or additions of signs intended for the property?YES 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 Pepnrtment Required Existing Proposed By Zoning Lot size /A/. Nf . C, 4 :�. 67 Aer S41%1e 36' Frontage /4/0 • 9,S 5A1'1 e-- / `5.-- Setbacks - front VO - side L: yc R: yS L: R: /0 - rear - -- Building height ;QS.' . y Bldg Square footage a 3 �D %Open Space: yt t/ C Lot area minus bldg pi 34 t 76 &paved parking) ;la; 315- S -#Ct ReemiAlmy # of -Parking Spaces of Loading Docks Fill: " {vol-ume -& location) 13 . Certification: i hereby certify that the information contained herein is true and accurate to the best of my knowled DATE: 11— F — 57 APPLICANT's SIGNATURE ��'1 NOTE: Issuance dt a zoning permit does not relieve an applioant's burd to oom zoning requirements and obtain all required PIY with all q permits from the Board Health. Conservation Commission, Department of Public Works and other applicable permit granting authorities. FILE # NOV 9 ► File No. DEPJitr S191( G ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: A-t.,t /``7• '�"�'� Address: Cv, ,�i¢ST //' 9 Telephone: Y/3 . 7 S 2. Owner of Property: .Z D /-1/ �Address: `. Z-7.L,7 �i -j e"I Telephone: o�7- 3FF 75 3. Status of Applicant: y<C Owner Contract Purchaser Lessee Other(explain): 4. Job Location: 4/.5-V 74i24 '4// l'3 Parcel Id: Zoning Map# V Parcel# District(s): �4 _ (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property a� 4:y 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): 6Ns n?v�a,v d ?( t� Sn) / 7`A.+./fr /7`G 1 e f cam- r-t4aY /d4'pi4k 7. Attached Plans: cye.5 Sketch Plan Site Plan 9es - 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 PermitNariance/Finding ever been issued for/on the site? NO V DON'T KNOW YES IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO { DON'T KNOW_ YES, IF YES: enter Book Page and/or Document# 9, 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: (FORM CONTINUES ON OTHER SIDE) File#BP-2000-0501 APPLICANT/CONTACT PERSON DAVID LEPINE ADDRESS/PHONE 262 EAST STREET (413)527-3975 PROPERTY LOCATION 454 PARK HILL RD-LOT#4 MAP 43 PARCEL(ZONE SR --13 THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out 7P5‘ Fee Paid .'3 te' Typeof Construction: CONSTRUCT 2 STORY SINGLE FAMILY HOUSE/ATT GARAGE/DECK/PORCH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 044188 3 sets of Plans/Plot Plan THE F OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: pproved 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 Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Comm' i Signature of Building Office, Date Date C1 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, 195 /1// ere?) zx,e r0,1 J�?�,/ j / o-1; fIX /1/!/A/ ,y7 c. , 2 { 454 PARK HILL RD BP-2000-0501 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:43 - 173 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category:New Single Family House BUILDING PEIRIVIIT Permit# ' BP-2000-0501 Project# JS-2000-0865 Est. Cost:$160000.00 Fee: $774.80 PERMISSION IS HEREBY GRANTED TO: Const.Class:5B Contractor: License: Use Group: R4 DAVID LEPINE 044188 Lot Size(sq.ft.): Owner: DAVID LEPINE Zoning: SR Applicant: DAVID LEPINE AT: 454 PARK HILL RD Applicant Address: Phone: Insurance: 262 EAST STREET (413) 527-3975 Workers Compensation EASTHAMPTON 01027 ISSUED ON:11/10/99 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT 2 STORY SINGLE FAMILY HOUSE /ATT GARAGE/DECK/PORCH POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of BuildiIngs Underground: Service: , 7,t,4 ,:'` eMeter: Footings: Rough: // i,• -T (2 Rough: PPR s110b House# Foundation: U L -/ - 5. ,, , Final: s� d 1''! Final �_ ,S%� 6% ', Rough Frame: 0 jt l^)4/' OW 1�� Gas Fire Department Fireplace/Chimney: Rough: Oil: 1'- f1 VI Insulation: tit f- 3/- Leo -Q- i Final: Smoke: i le9 Finale 5 /G -06 6Z THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOL/110N OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy 'lignature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 11/10/99 0:00:00 $774.80 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 1