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28-066 (9)
b a o r tv y Cl FT. Otte . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -4 D '� IA Z � r > . . . . . . . . . . . . . . . . . . . . . 0° .4 0 . oz y . voZ . OWLJ Lo 0 vi m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5r NOTE:IN ORDER THAT THIS APPLICATION MAY BE ACCEPTED,THE DATA CALLED FOR BELOW MUST BE SO SET FORTH THAT WE CAN DETERMINE FROM THE APPLICATION AND THE ACCOMPANYING PLANS WHAT THE EXISTING CONDI- TIONS ARE AND WHAT THE FUTURE CONDITIONS WILL BE. Plot Plans and Plans,must be filed with this application before a permit be granted. Zone APPLICANT NOT TO FILL IN SPACES ABOVE THIS LINE Application for a Dwelling Permit T �� Northampton,Mass. . . . . . . . . . . . . . . . . . . . . . . . 19 . . . . . 1lelephone No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7b the Supt.of Buildings: Application for a permit to build is hereby made accordin to the following:- 1. Location,Street and No. !J�/lbU?51l� �!"n. . 4'q.�?• . • . • • • . . . • • • • . . •• • • • • • . • • Lot No. . . . . . . . . . . 2. Nearest cross street Size of lot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � 1 3. Owner's name . . . . . . . . . . . . . . . . Address . . .. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . 4. Architect's name . . . . . . . .. . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . Address . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Builder's name . ?FC.i -:. T r^I'c�t°`. . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . .J .J./ . . . . . . . . . . . . . . Mass. Construction Supervisor's License No. L y . ✓.fig. . . . . . . . . . . . Expiration Date . . l. ��1 �. .` . . . . . . 6. Use of Building:One-family . . . . . . .)(. . . . . . . . . .. Two-family . . . . . . . . . . . . . . . . . . . . Other . . . . . . . . . . . . . . . . . . . . 7. Number of rooms in each family unit: . . . . . . .Y . . . . . . . . . . . . . . Number of Bathrooms . . . . . . . . . . . . . . . . . . . . . . . 8. Is there a garage atta hed? 1L�.10. . . . . . .. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of building �.X.�61. . .��'. .X. .�ls. . . . . . . Square footage . . . . . . �. . . . . . . . . . . . . . . . . . . . . . . . 10. Number of stories . . . . .d7_1. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Distance from finished grade to high point of roof . . . .. . l . . . . . . .`. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Type of construction . . . . .W0.0 .l1D. . .rl°t.!) e� �= . . . . . . . . . . . . . . . . . . . . . . . 13. Distance from building to street line in feet . . . . .. . ...�. .`. . . . . .. ..i. ..°. . . . �' ' ./. . . . . . . . 14. Distance from building to side lot lines in feet:Left . . . . . . . . . . . . . . . . . . . . . . . . . Right . . . . . . . . . . . . . . . . . . . . . . . . . 15. Distance from building to rear lot line in feet . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . 16. Is a plot plan being filed with this application? . . . . . . . . . .. . . . � /?�. . .1.l e'.d. . .".'"".f J.11✓`?dd. fit;'?.X",1 /)(J/A',/,f-f(y, 1 . 17. Species of framing lumber:DF . . . . . . . . . . . . . . . . . . . . Spruce . . . . . . . .>. . . . . . . . . Other . . . . . . . . . . . . . . . . . . . . 18. Are all structural conditions noted on drawings? . . . . . . . . .✓.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . 19. Nature of land upon which the structure will be erected:Natural . . . . . .X. .y/ . . .*' .)Filled . . . . . . . . . . . . . . . . . . . 20. Depth of basement or cellar floor below finished grade . . .A vi . ,. . . .. . . . . . .- . .. . . . . . . . . . . . . . . . . 21. Material of foundation walls . . . .�2�.+T i'�. .T� . . . . . . • • • . . . . • • Thicknes in inches . . . ./. ., . 22. Type of roof: Flat . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . Pitched . . . . . ./o I 17-C� II f�. . . . . . . ."1. .. . . . . . . 23. Material or roof covering . . • _ • • • • 24. Method of heating ! . . . . ' i. 25. Will the building conform to the Building and Zoning Ordinances? . . . . . P. S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26. Septic Tank? . . . . .1. .e._S. . . . . . . . . . . . . . . . . . . . . . . . . . City Sewer? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27. Construction within 100 ft.of wetlands? . . . . . . .! ,.I.0 28. Construction within 100 year flood plain? . . .1``'.0. . . . . . . . . . . . . . . . . • • • • • • . . 4, 29. Estimated cost:Total$ . . . 11. x.11 c?p. . -. . . . . . . . . . . . . I . . . . . . . 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. . . . . . . �r-�. .` .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S of Co tractor Signature of responsible applicant [ WRITTEN DESCRIPTIONNii OF WORK TO BE DONE / L 1'rt $ 7' iZ i1 c�1. . . .1 �C7CJ.!. . . . . �e f°�Z C/. . . �. . . . . . .t..�.. . . . . . . vtit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v0 ,�• a z tz pin FT. Coap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . oC -� . 0Zy M . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i NOTE:IN ORDER THAT THIS APPLICATION MAY BE ACCEPTED,THE DATA CALLED FOR BELOW MUST BE SO SET FORTH THAT WE CAN DETERMINE FROM THE APPLICATION AND THE ACCOMPANYING PLANS WHAT THE EXISTING CONDI- TIONS ARE AND WHAT THE FUTURE CONDITIONS WILL BE. Plot Plans and Plans,must be filed with this application before a permit be granted. Zone APPLICANT NOT TO FILL IN SPACES ABOVE THIS LINE Application for a Dwellinir Permit Northampton,Mass. . . . . .f . '�r�. . . . . . . . . . . . . 19 ? - s a � Telephone No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7b the Supt. of Buildings: Application for a permit to build is hereby made according to the following:- 1. Location, Street and No. �.y.. �� '"� . �0 .�. . . . . . . . . . . . . . . . . . . . . Lot No. . . . . . . . . . . 2. Nearest cross street . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Size of lot . . . .90'.q Y. a @!`. . . . . . . . . . . . . . . . . . . 3. Owner's nameTV0D N WX0 � $`°5�'t! AA>DEW_�IJ Address .�. .�.. . . ..Y?. . . . 4. Architect's name. . . . . . . . . . . . . .. . .. . . . . . . . . .. . .. . . . . . . Address . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . .. . . . . . 5. Builder's name .5.75(-.VCF. . F4=. .4 A .SAY . . . . Address .%G'�.�.�`��:��D.-.�. .F�.��!t-'�:r✓. . . Mass.Construction Supervisor's License No. . . . . . . . . .. . . . . . . . . . . . . . . . Expiration Date . . . . . . . . .. . . . . . . . . .. . . . . . 6. Use of Building:One-family . . . . . . . .,X. . . . . . . . . . Two-family . . . . . . . . . . . . . . . . . . . . Other . . . . . . . . . . . . . . . . . . . . 7. Number of rooms in each family unit: . . . . . . . . . . . . . . . . . . . . . Number of Bathrooms . . ..off. . . . . . . . . . . . . . . . . 8. Is there a garage attached? . .. .P.L.L. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of building . . . .'3.y.�.X. .'� `. . . . . . . . . . . . . . . . . . . . Square footage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Number of stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . 11. Distance from finished grade to high point of roof . . . . 14- . .�. .}. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .. . . . . . 12. Type of construction . . . . � .p. . .F.� 6!`.4.6;. . . . . . . . . . . . . . . . . . . . . .t. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Distance from building to street line in feet . . . .S 7�. . r 14. Distance from building to side lot lines in feet:Left . . .s . . . . . . . . . . . . . . . . . . Right . P. . . . . . . . . . . . . . . . . . . . 15. Distance from building to rear lot line in feet . . .�� 16. Is a plot plan being filed with this application? . . . . . .e S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. Species of framing lumber:DF . . . . . . . . . . . . . . . . . . . . Spruce . . . . . >�.. . . . .. . . . . . Other . . . I . . . . . . . . . . . . . . . . 18. Are all structural conditions noted on drawings? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .. . . . . . . . . .. . . . . . 19. Nature of land upon which the structure will be erected:Natural . . . .X. . . . . . . . . . . . Filled . .. . . . . . . . . . . . . . . . . 20. Depth of basement or cellar floor below finished grade . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21. Material of foundation walls . . �'. ... . E T... . . . . . . . . . . . . . . . . . . . . . Thickness in inches . . . . ./. . . . . . . . . . . . 22. Type of roof:Flat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pitched . . ./ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23. Material or roof covering . . . . Fi.6.( . .(, C/1 S$. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . 24. Method of heating . . . . . . .T. n t. A. . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . 25. Will the building conform to the Building and Zoning Ordinances? . . . . . . y .C.-5 . .. . . . . . . . . . . . . . . . . . . . . . . . . . . 26. Septic Tank? . . . . . .� 1 . . . . . . . . . . . . . . . . . �. . . City Sewer? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27. Construction within 100 ft.of wetlands? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28. Construction within 100 year flood plain? . ).0. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29. Estimated cost:Total $ . . . .` _ v o . . . . . . . . . . . . . . . . . . . . . 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 b7t of his knowledge and belief. *Signtureof Cont actor ignature of responsible applicant WRITTEN DESCRIPTION OF WOR TO BE DONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . 3.8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a SIEGFRIED PORTH A - R - C - H - I - T - E - C T 193 NORTI-IAMP'I'ON ST., EASTI[AMPTON,MA01027 413/527-2830 4r_W WIC j Fr w P6 �= SIEGFRIED PORTH A - R - C - H - I - T - E - C T 193 NORTI-IAMPTON ST., EASTI IAMPTON,MA 01027 413/527-2830 //- Z 3 - "/Z- /l,/ Xz 3 �.��� / 4 SAS - �� � � ��. � • C ,Zl (13 c2 r5 r, 2 / e 2 " . t-3 7� SIEGFRIED PORTH A • R • C - H - I - T - E . C - T 193 NORTHAMPTON ST., EASTIIAMPTON, MA01027 413/527-2830 -7, T-' VWE 1A PERMIT APPLICATION CHECK LIST PAGE 3 PLOT t ZONE 'Zt/'`►� �i� � Co -r- YES NO DATE 1 . ZONING FORM APPLICATION 2 . PERMIT APPLICATION 3 . OWNER OCCUPANT STATEMENT LIC J IF NOT 4 . 3 SETS OF PLANS - /PLOT PLAN 5 NEW CONSTRUCTION 6 . CURB CUT t{� r i vo--cf R."A L- 5 c.t,b-rn i rCe ci c�a i�h 7 . WATER AVAILABILITY FORMS W eLL /F�CL-Y)dCLcioyl Permi-C L- 8 REMODELING INTERIOR 9 . ADDITION 10 . ACCESSORY STRUCTURE 11 . SIGN Z AWNING 2 . PERMI FEE CHECK ONLY - MONEY ORD R ��0 OC7 13 . SPECIAL PERMIT RE UIRED WITH DEED IF APPLICABLE 14 . UNDER SECTION 127 - CMR 780 15 . FORM A 16 . FILL COMMENTS ; '0 0 0 �o b LQ o 1p — r �, h ���opro � � Lo o ?o �Ow opogoy�� y° ° °Lh� 4 W h °7'b ; _-Rt, trl1- Ut , L) ;W C to r � I � I 3�ty �xz )� n1U`� nol- �({IC I >� n � 'r.)ZIL � ;n��mo ��mF�o LETI P�Qr`��-�Qm�h�CO 7�tq 1913 P(1'1"'•, '''ej 'F10�1n�Sap n�i�61p` Q(pA {�fC „n c < z' F,h�I � n 4 n2NL p^ n� pt p 2yr.�Hanp n�� JO o�i n41 R �l5 Yy �p�rv4.l�y�'D n0I -Ir �1��DI (naypl IsP O d r� sc{y n` gyp- r '� 011 �, bOh npacp n'. o �� <��� r1 ��al-ry y� N! xy P " mn fd; e ay�y ofaoOr�s �Ha r�oD r Z a�0ln�np I n<f ro,cY no m 111 V � < i?o o,,oN yiroatl o�OS3. 1 �4 CD`P ° brTU RS 0 01 P �.ro b�� �' iy P 0d �2r,z Gj P o 1noX�Rbo� 1 G�nny�� � - rl^ h�1PcpQ�� �Ul to b N p I AI an S° K� iNE ahE p, y aI �C�7Cb ryF ��jldA:�y rl? Q-Q.�olo��ilgrn� � rrl� r1�131 l�a.��. -O�p P I � �S1nv+� o`- 9� D N fP w NCII Q �r� X71 Fa m. .1 �o FQ io'n O 4(i 4 N I�nUlrl yl - O I O s I r e I N n F UI U L .- n ti �..:W •k ..{ k% _ r0 �7_ A ;ate +n J_t.� Su R__.h V Q I I I I I r I ' I � I a Gl I1 1 t ri I I 1 } f 1 ' n ry , I o ro � -n I I 1 I - , - -- - - I f 1 1 rb f- 1 I I I � I I i 2 I I r eb I I I I I I I 1 I i r I c -!a o - I I 1 i I I I I I I I 1 1 l I I - n - i I LM = I I I 11 I t I I, I r c I I 1 I � i Oqz SIEGFRIED PORTH A • R • C • H • I • T • E • C T 193NORTIIAMIY]70NST., EASTIIAMPTON, MA01027 413/527-2830 0 6,A 14,k fi 12 T :5//j/. 7 , Bol, .i5 4?4�� 4) z 7, Of 7"/0 P-4E SIEGFRIED PORTH A • R • C - H - I - T - E . C - T 193 NORTHAMPTON ST., EASTI JAM VMN, MAO 1027 413/527-2830 4A/ Z 3 - C�Z DY b, co ( 12 -7 5x 3 x /1/46 bc� Pf-I y S I E G F RTH A • R • C - H • I T • E • C • T 193 NORTI IAMPTON ST., EASTI IAMPTON, MA 01027 • 413/527-2830 �� Z 3 ��Z `1 i,; OP 9 sow /-,.•aim���'�✓ n.-i �'�!�'�``,� C%J � '• fi i i `J- -1 STEVE FERRARI BUILDERS N r :r,,oc F,r FOt WINS 103 RYAN ROAD --- ---.._.-.---- ------ -------------- 1 3 7 2 FLORENCE, MA 01060 (413) 586.8058 ---- --- -- ._... -- - —— -------- Ga j 53.7168/2118 PAY Gt=�. 4 l---�tom" 7 — _—_—DOLLARS j CHECK Q Oil OHL)F.R o. c�u*�t, a �,E �,Fli� riorl DISCOUNT � AMOUNT DnTt C0 -t 481 FLORENCE SAVINGS BANK / 86 MAIN STREET � FLORENCE, MASSACHUSETTS 01060 11100 L 3 7 211' 1: 2 1 18 7 16881: 01 23 6 766 111' .110000048000", STEVE FERRARI BUILDERSI "` °`�" FLORENCE,MA 01060 i — — 1 3 2 3 (413) 586.8058 53.7168/2118 ,� PAY --- c1 �rG ��u Lit `L DOLLARS f CHECK ---— �:_- _ _ ---- — ------- — —= AMOUNT DaTe- o r, or_k of / c ,, n FTiord DISCOUNT — _ ---- � $ -y y o - _ I CA$`I r FLORENCE SAVINGS BANK 86 MAIN STREET FLORENCE, MASSACHUSETTS 01060 rya c� �11 01 3 2 3Z' 01 23 6 7669 111' 11'0000048000.1' Lo U to W W o n o o o t � h ,Ln��to nil�l}LtWJ �,�e �I E;•D�� u t H r lri C 1 n z r.o p N � y z- �N� nllt�tknP�Sn•�Gyp{� �L, a a < < �y'r nYl d<C�l��f r, 7lr� t On ry 'i TI t�JP^,T I nn�ly o hy I"oF�n r N�`n l a�N �1 1 N rt P D`h< � P ��d � ixyitn� ar n �A . i E� co3k n m �h a Y�Wn'_< <�mhrj n P ' n n 4�L^ HI x ��r�� 1 6°yP II Z � �n imnnn o a U_ m� �< <o o b '1 ml � y V nit a� (�„ i�' LZ?lzO P. ppr,n �ln� roro re n�Ny,„ lL p3rs p �nro ilex. u Pn, x�fryto k i nHti�ro�� xy An Y�nl y� l73 Ph. Alc� 0.a3olo�$.° �A. '� A4--f— �<� ?r1�4 I��I' prime T1 T' I o�j � ° m� D 1 — ---� LA— pf P °� �_ sl - ° �. I I n I I ;141 k rte= - ' 0 o a n ro it �. mu F ri Ut i t I i i r W _. ro � I I ' I I � � I 1 n °n ri I I I I r f o 0 l I' In In I p tn I u+w rN -z m � g I 3 � I' II ,,_j -C- m c G , Fr t` v �f 2 .r I J fr f� SEP-24-1992 15:12 FRUM k,urla' + -- ASIDE D 1 R D LE . ,dGE, MA 01 060 % S VC I AT C G S toy 3) S86-1060 V i8 MAY 1992 Sample 5787 czal CATS OF INVIE . ONION Sample Location: Client: New 506' Drilled W'E1l ,Toe Slattery Newton Property 17 Gilbert Road 01073 256 Sylvester 01060 Southampton, Ma Northampton, t 2 00 .m. a Mr. Jobn p. Riordon RIOMON sa:apl.ASSQC nit on 14"'ted -* �t 0 above location. `1'h RIOzs U sampled and under the direction of John P. Rioxdon. that t5.me were aar�lyzed: ized APRF'►� EPA and ASIA! methods. ASSOCIATES Scientisty u . state" yses were performed= D.S.P.R,.S. The following LI3iCiT :tom----- TSST BACTBUW IC AL. 0 Col if orm/100 ml. 0j 104 ta].. coliform CMagAL 11.0°e. 2. fie F tie } 6.74 10 mg/l. 0.26 mg/1. �� Nitta tA$ has N) 150 mgjl. t as C�aCO ) 27.1 29/1- 0.3 mg/1. 5, �1�� y C 3 0.08 mg/1. 6. '�otal Iro�Q 0.05 M911- 0.009 Mg/l• 250 mg/l. 7, Total %=)4 nose 7.5 mall 8. Ghlaride3 250 mgjl. CaCOg) 34.2 m9/1- 20 /t$r 9. =p. Hardness as 3.1 .29/1-- �/1, Q millig a PQr 1n_ sodium tiime):The above results obtained gndoUnitedaStatess er sample(s) � a 14 z 43y 1-4 e s ze r �d sanitary standards for drinking water. ,:H= YOD, C'IATES at retest tim and e ng this report. Jan F. Rios= _-__- Director 3 .-�`,..�C.;O►�h�.I�.e��T ST�.Q .H0 ME, AND • J.L. ERY_qn4. r/ G-iil��tst - rSv+tb�iam tct�. C�a. .P7.404.91527-3664 - " " WELL DR1LUNG - PUMPS & WATER SYSTEMS f. DolwinKni of Envirosw-entel Monoprment/Diviston of Water Ramrees WATER WELL COMPLATlON REPORT WELL LO ON GEOGRAPHIC DESCRIPTION Address 'y�'vester Road , - 15 N5 >: ea1 North Harn�ton Oml �.r city/Town ,. 5Y 1 venter Road wail owner ,a-L-..,SI$22a.ing- — Adam417 Gent RQad - 7/10 N S E w of South Hampton MA 01 073 pKap"illpiv Board o!I{oaltlt pettttit: yes Q no C3 hrtasrrt w/West Farms WELL USE WILL OATH 00"atie(a PuWie C❑ lmknii W CI TOtat wit depth,�._,�..tL Monitoring 0 other Deplh jo bedrock_._.....ft. Method drilled-Air Hammer Wt►ter•buarrng toCithercWtsotidated matt:rtai� 4J15 - 4 Ge:crip:fort Granite Date driiied ���.. CA81iY Water-bearing:ales: Trf %lack Stoat tl P•w„►.__.._.,_ro TI LangulAQ-14.DIoiLD.l._ ,_..,h►. 3)From_TO Length into bodrock x___. 4rwi Pak welt: dls, ProteCtiro will teal: Salon: di;. Gsout.($Y Oiherpr i y,e Shoe 81000�length,r.. fmrn- ,.•_to SYND6 WATf:A t.11VrsL Stotlowater lest below land surtat:o 80 It. Gets 4/1619?„ _ WILL Tuty Orawdown 300 It. all pumping 4�-IN.,_.., MI”.at 5 OM Now meattada t r 1 i f t R�wr 300 IL *ftwI„�t�n......,.�._rttlrt. .� LOG of FORMATIONS COMMENTS of I + Lo - am 1 t OriNer Roy ,_T. Mason .. Gr 1' Melt•Rv*tmtwn o 63 Finn It= yhll Drilling & Pump Co., . „d& * P.O. Box 463 Cityrrown Nass NY 121 23 Thomas F. n, Vice Ider l IMM DBI«aR COPY TOTAL. P-03 RIORDON P.O.Box 178 176 BROOKSIDE CIRCLE FLORENCE, MA 01060 ASSOCIATES (413) 586-1060 Sample No. 5787 AGREEMENT FOR WATER TESTING 18 May 1992 Date CERTIFICATE OF WATER ANALYSIS Client: Sample Location: David Noonan New 506' Drilled Well Lot No. 2, 242 Sylvester Road Northampton, Ma 01060 On 14 May 1992 , at 2:00 p.m. , John P. Riordon of RIORDON ASSOCIATES sampled and tested the water at the above location. The water samples taken at that time were analyzed, under the direction of John P. Riordon, RIORDON ASSOCIATES Scientist, using standardized APHA, EPA and ASTM methods. The following agreed upon analyses were performed: TEST RESULT -EPA EPA LIMIT BACTERIOLOGICAL 1. Total Coliform 0 Coliform/100 ml. 0/100 ml. CHEMICAL 2. Temperature (°C) 11 .0 °C. - 3. pH 6.74 6.0 - 8.5 4. Nitrates (as N) 0.26 mg/l. 10 mg/l. 5. Alkalinity (as CaCO3) 27.7 mg/l. 150 mg/l. 6. Total Iron 0.08 mg/l. 0.3 mg/l. 7. Total Manganese 0.009 mg/l. 0.05 mg/l. 8. Chlorides 7.5 mg/l. 250 mg/l. 9. EDTA Hardness (as CaCO3) 34.2 mg/l. 250 mg/l. 10. Sodium 3. 1 mg/1. 20 mg/l. mg/l. = milligrams per liter. COMMENTS (at this time) -.The above results obtained from the analyses peerformed on the submitted water sample(s)MEET E.P.A. and United States Public Health Service approved sanitary standards for drinking water. A YOUR Please call RIORDON ASSOCIATES at retest time and if you have questions regarding this report. 0 Riordon 'Jy irec or CONSULTANTS TO HOME AND BUSINESS WATER TESTING ENVIRONMENTAL AFFAIRS aS�rr . , 0003 �, , > Date Filed File No. ZONING PERMIT APPLICATION (§10 . 2) 1. Name of Applicant: 5TE PI+ IO LE �R A ill Address : /&' fly,-K) �b ,��c X L'-,w_) & Telephone: $� -I©S Q 2 . Owner of Property:-L4&1 3--> AOoN� p-) Address : �,g2, S)1JVE57E-K Rp Telephone: (_ — y7b -7 3 . Status of Applicant: Owner Contract Purchaser Lessee Other (explain: e,01,218AC'T( f o& 6UTAJL- R ) 4 . Parcel Identification: Zoning Map Sheet# 2 �� Parcel# '-Zoning District (s) (include overlays) Street Address Required 5 . Existing Proposed by Zonincr Use of Structure/Property (if project is only interior work, skip to #6) Building height 1dg. Coverage (Footprint) 1 0 Setbacks - front ` Lfo side L '* R 50` r f-9-6 - - rear _ Lot size Frontage Floor Area Ratio o < AC ES %Open Space (Lot area minus building and parking) >q�% Parking Spaces Loading --� Signs Fill (volume & location) 6 . Narrative Description of Proposed Work/Project: (Use additional sheets if necessary) ��rJ6f...t= }Lt,LY 57c?�yvrvL�[.l �tfG 7 . Attached Plans : __Sketch Plan Site Plan rov ti1b6Ti6,1" 8 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowled e. ) Date: Applicant ' s Signature: liL ZApproved- - ~THIS SECTION FOR OFFICIAL USE ON as resented based on information resented p / p De,iWied as presented fo e ial: 7-- gnat e of Build ' s- Qt or_ Date NOTE: Issuance of a zoning permit d not relieve an applican s burden to comply with all zoning requirements and obtain all required pormits from the Board of Health, Conservation Commission7D�p`artment of Public Works and other applicable permit granting authorities. 7/92 FXAS PERMIT APPLICATION QECK LIST PAGE PLOT ZONE ' ` YES NO DATE 1 . ZONING FORM APPLICATION 9 �` 2 . PERMIT APPLICATION 3 . OWNER OCCUPANT STATEMENT .# iF NOT 4 3 SETS OF PLANS /PLOT PLAN 5 NEW CONSTRUCTION 6 . CURB CU Est 7 . WATER AVAILABILITY FORMS 8 . REMODELING INTERIOR 9 . ADDITION 10 . ACCESSORY STRUCTURE SI AWNING 12 PERMIT FEE — CHECK ONLY — MONEY 0 DER' 13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE 14 . UNDER SECTION 127 - CMR 780 15 . FORM 1 16 . FILL -_- C�S ' rn COMMENTS : jow�� t � ®�`"s�'��*'rte � v ��.+ #- �,-..�:c"��' t.,,�,, � �' � � � -✓ � �� PEN a 5 x t rt t ' n zr a 4 W k..F vZ, s Qj No u s Na# , `il d 4 ct {., r; t�}u� „ a r` u c q6- y.:: .''s✓ `:Lr�'+t;t aatx-' vg A to i a x 00�00 TWIN �mgm—M Two lll�l lit �x er �x� � ✓�'�'1'°.i "���� ; � �� -mss ..�'. �* ;��+`5-�, �� � �, ��'#�" t x. MR EX g'�x i MUM i lout A F � ", 4 �a4WY' `s�;•��;���ta§'re�.��`+"Jai � � ,r� t3 b,� �s� �`,��a �' � �Y� � z Fro o tot, n x y�y �l1 z E r �y Y 3 t 4y� 4 T xF� v � 3 .t fi 4 M1 1y ON Al AW- ti d N laT1 m -� y M o 8 a N O zm -i0 i GV 0 g v N>LA m z ril O D o TO a• 0 3 to z % 0 ° >0 °¢ t1 m 3 mn r �n -� b m .� Nc......................... Fns.............................. THE COMMONWEALTH OF MASSACHUSETTS F30ARD OF HEALTH Cl.?... _............._O F....,� �C„ i! : .�............. AV.p iration for Dt!51jamil Midi,, Tonitrartion Vrrntit Application is hereby made for a Permit to Construct k) or Repair ( ) an Individual Sewage Disposal System at: ycvcs7 .......�...� ................................. ............................................. .. .......................................... Location.Ad ress or Lot N ,�0. P?C Z`t�3`�,,................... . .c �2A......... ........................................ Owner Address W .............................. ........._................ ......................................... ................�.•---•-....G .............. a Installer Address Type of Building Size Lot........1 ......... .–f�t- U 4...............................Expansion Attic ( ) Garbage Grinder (x ) ,.� Dwelling— No. of Bedrooms............. p`11 Other—Type of Building No. of persons............................ Showers ( ) — Cafeteria ( ) p+ Other fixtures ..............."...._......""""......_.._"............................................._.............................................................. Design glow.............1�.. .. ..................gallons per person per day. Total daily flow.......... ...�Pr.�-•---................gal�ns. Scptic Tank—Liquid capacit)4PO.gallons Length.../ ....... Width... ...... Diameter................ Depth............ x Disposal Trench—No. ....... ........... Width...,,�........... Total Length....42Q Total leaching area/5.P.r�.......sq. ft. �y Scepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box Dosing tank I ) Q Percolation Test Results Performed by...... �T/f. t�I/%9 .............. Test ./...d........ Test Pit No. 1....1.7....minutes per inch Depth of Test Pit..2!;?.... Depth to ground water.....'6!... (i Test Pit No. 2................mintltes per inch Depth of Test Pit.f�ar...4...... Depth to ground water........'"............ ............... ......... d ................................................. D 'r r"•1�'�.” �` .... escrpon oo ........ x .... l... ----------------------------•----........----------......... ........................................................................................... �� .. V Nature of Repairs or Alterations—Answer when applicable.................................. ...... ....... 9701....... . ..... . ............................... . .................................................................................................... ...... . ...................... ... ...... Agreement: �rlc The undersigned agrees to install the aforedescribed Individual Sewage Di osal Sy with th provisions of TITLE 5 of the State Sanitary Code — The undersigned further agrees not t system in oFeration until a Certificate of Compliance has been issued by the board of health. Signed....... .............................................................................. ................................ Date Application Approved a By.......:.......................................................................................... ....................D ..te............... Da A>>plication Disapproved for the following reasons:................................................................................................................ ................................................................................................................................................................................... .Dak:.............. PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... &rvfi atlr of Trimplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) b)..................................................................................................................................................................•----•--.......................... Installer at...................................................................................................................................................................................................... has been installed in accordance with the provisions of TITLE, 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY DA TE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........................................OF..................................................................................... N�..........::............. FEE........................ Di.5,piwal k`cork-4 CTonntrnrtion Vrrm t Permissionis hereby granted.............................................................................................................................................. to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo...................................................................................................... .................................................................................... Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... ......................................................................................................... Board of Health DATE................................................................................ FORM 1288 A. M. SULKIN. BOSTON A : a ,�• > z to FT. Deep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I IA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ulft . Alp m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 (l Z-1(4 NOTE:IN ORDER THAT THIS APPLICATION MAY BE ACCEPTED,THE DATA CALLED FOR BELOW MUST BE SO SET FORTH THAT WE CAN DETERMINE FROM THE APPLICATION AND THE ACCOMPANYING PLANS WHAT THE EXISTING CONDI- TIONS ARE AND WHAT THE FUTURE CONDITIONS WILL BE. Plot Plans and Plans,must be filed with this application before a permit be granted. Zone APPLICANT NOT TO FILL IN SPACES ABOVE THIS LINE Application for a Dwelling Permit g �. Northampton,Mass. . . . . . . . . . . . . . . . . . . . . . . . 19 . . . . . o e � Telephone No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7b the Supt.of Buildings: Application for a permit to bcui�ld is hereby madeaccordin to the following:- 1. Location,Street and No. �.1. . ./. . . .1 ff}}1!z ST �'!' . . U •�• • • • . . • . . . . . . . • • • .• • . • • • • . Lot No. . . . . . . . . . . 2. Nearest cross street ��?.fa.$04.rYet '!+?t/. . . . . Size of lot . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . 3. Owner's name !X.✓. l. . . . .f 'l f`O.F1 l . . . . . . . .. . . . . . . . Address . . . .. . . . . . . . . .. . . . . . . . . . I . . . . . . . . . . . . . . . 4. Architect's name . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . 5. Builder's name . . . . . .. . . . . . . . . Address . . . . . . . . . . . . . .. . . . . .l /. . . . . . . . . . . . . . . Mass.Construction Supervisor's License No. C/S. JO.$. . . . . . .. . . . . Expiration Date . . .. �l/�. .` 6. Use of Building:One-family . . . . . . .)(.. . . . . . . . . . Two-family . . . . . . . . . . . . . . . . . . . . Other . . . . .. . . . . . . . . . . . . . . 7. Number of rooms in each family unit: . . . . . . .6 . . . . . . . . . . . . . . Number of Bathrooms . . . . . . . . . . . . . . . . . . . . . . . 8. Is there a garage atta hed? /L�. . . . . . . .f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . 9. Size of building :1. F.X.�6i. . .�ti? X. �lrCt . . . . . . . Square footage . . . . . .A? . .... . . . . . . . . . . . . . . . . . . 10. Number of stories . . . . .?._1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . k _ r 11. Distance from finished grade to high point of roof . . . . . . . . . . . . . . . .`.` . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Type of construction . . . . . D�' .1�. . . R. .f=. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Distance from building to street line in feet . . . . . . . . . . . . . . . .. . . . . 14. Distance from building to side lot lines in feet:Left . . . . .. . . . . . . . . . . . . . . . . . . . Right . . . . . . . . .. . . . . . . . . . . . . . . . 15. Distance from building to rear lot line in feet . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . - . . . . . . . . . . . . -'. . . . i'�'� .�. . Fl-b--d . . . ..../.. d�,'tc d.7/c??'. . w. l I 16. Is a plot plan being filed with this application. . . . . . . . . . . . � . 17. Species of framing lumber:DF . . . . . . . . . . . . . . . . . . . . Spruce . . . . . . . .>. . . . . . . . . Other . . . .. . . . . . . . . . . . . . . . , 18. Are all structural conditions noted on drawings? . . . . . . . . ..e.5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. Nature of land upon which the structure will be erected:Natural . . . . . . Filled . . . . . . . . . . . . . . . . . . . 20. Depth of basement or cellar flo("t_below finished grade . . .!`l!!� - � It . . 21. Material of foundation walls t`t. .k. . . . . . . . . . . . . . . . . Thicknes in inches . . .. . . 22. Type of roof:Flat . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . Pitched . . . . . .� .�.� . . . . p�. . . .. I. . . . . . . . . .� / f° f . 23. Material or roof covering . . . .t. .t .�!y.(.�5 . . . . . .�.�.t:�L/�. . .S.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .l 24. Method of heating . .�?r . . .�. . � . . . /f.t.J!°. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25. Will the building conform to the Building and Zoning Ordinances? . . . . .Y� . S. . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 26. Septic Tank? . . . . .,7. .1P.5. . . . . . . . . . . . . . . . . .� . . . . City Sewer? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27. Construction within 100 ft.of wetlands? . . . . . . . . . . .a. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28. Construction within 100 year flood plain? . . . . . .. . . . . . . . • • • • • . . . 29. Estimated cost:Total $ . . . �. �.(J C? �'. . -. . . . . . . . . . . . . . . . . . . . . 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. . . . . . . . .�.� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Si nature of Co tractor Signature of responsible applicant WRITTEN DESCRIPTION OF WORK TO BE DONE JY ✓t2LC' c . . .✓cSi 20 .' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Y O cA v � > z r � _ y Oo 0. FT. DEuP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Z 0 N 0 0 0 W NOTE:IN ORDER THAT THIS APPLICATION MAY BE ACCEPTED,THE DATA CALLED FOR BELOW MUST BE SO SET FORTH THAT WE CAN DETERMINE FROM THE APPLICATION AND THE ACCOMPANYING PLANS WHAT THE EXISTING CONDI- TIONS ARE AND WHAT THE FUTURE CONDITIONS WILL BE. Plot Plans and Plans,must be filed with this application before a permit be granted. Zone APPLICANT NOT TO FILL IN SPACES ABOVE THIS LINE Application for a Dwellin Permit q � a "°e Northampton,Mass. . . . . .! . `�'�. . . . . . . . . . . . 19 '?'?y Telephone No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7b the Supt.of Buildings: Application for a permit to build is hereby made according to the following:- 1. Location, Street and No. . . . ... . .�..JCy`� ST � !�U! . . . . . . . . . . . . . . . . . . . Lot No. . . . . . . . . . . 2. Nearest cross street . . Size of lot . . . . :�"y A e'°' • . . • • . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . �L vC5� . . .3. Owner's name Ul 1? No14 U Address .v 4. Architect's name. . . . . . . . . . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . 5. Builder's name . . . Address .i..'3. . . . . . . . . . . . . . . Mass. Construction Supervisor's License No. . . . . . . . . . .. . .. . . . . . . . . . . . Expiration Date . . . . . . . . . .. . . . . . . . . .. . . . . 6. Use of Building:One-family . . . . Two-family . . . . . . . . . . . . . . . . . . . . Other . . . . .. . . . . . . . . . . . . . . 7. Number of rooms in each family unit: . . . . .�p . . . . . . . . . . . . . .. . Number of Bathrooms . . . .Pte. . . . . . . • • . . . . • 8. Is there a garage attached? . . . .10.0 . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of building 3.'L`. . . . . . . . . . . . . . . . . . . . Square footage . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . 10. Number of stories . . . . .' : . . .� }. . . . . . . .. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Distance from finished grade to high point of roof . . . . �_6. . . . . . . . . . . . .. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . 12. Type of construction . . . c.0 . . .F1 4e_`-C;.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Distance from building o street line in feet . . . .'�.7Q. . .t . . . . . . . . ... . . . . . . . . . . I . . . g to t. �. . . . . . . . . . . 14. Distance from building to side lot lines in feet:Left . . 0. . . . . . . • • • • . • • . . . Right . . . . . . . .... . . . . . . . . . . . . . 15. Distance from building to rear lot line in feet . . . . . . . . .' . . . . . . . . . . . . . . . . . . . . . .. . .. . 16. Is a plot plan being filed with this application? . . . .). . 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. Species of framing lumber:DF . . . . . . . . . . . . . . . . . . . . Spruce . . . . . . . . . . . . . . . . . Other . . . . . . . . . . . . . . . . . . . . 18. Are all structural conditions noted on drawings? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. . . . . . . . . . . . . . . . . . . . . . 19. Nature of land upon which the structure will be erected:Natural . . . .x. . • . . . . . . . . . Filled . . . . . . . . . . . . . . . . . . . 20. Depth of basement or cellar floor below finished grade . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 21. Material of foundation walls . . '.v C:C E y. • . . • . . • • . • • • . • • . • . Thickness in inches . . .. . . . . . . . . . . . . . . . 22. Type of roof:Flat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pitched . ..211 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23. Material or roof covering . . . . F1. .CG /FSS. . S f{!u(L•�� 24. Method of heating . . R. .J} E _ l T 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 25. Will the building conform to the Building and Zoning Ordinances? . . . . . .y C7".5 26. Septic Tank. . City Sewer? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .�. . . . . . . 27. Construction within 100 ft.of wetlands? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28. Construction within 100 year flood plain? . !.. . . • . . . . . . . . . . . . . . . . . . . . • . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 29. Estimated cost:Total $ . . . . /10 . . . . . . . . . . . . . . . . . . . . . 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 beg,of his knowledge and belief. r . . . . . . . . . . . . . ... . . i: .c_ '�. . . . . . . t:i :. . .. . . . . . . . . . . . . . . . . Sign ture of Cont actor ignature of responsible applicant WRITTEN DESCRIPTION OF WOR TO BE DONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .�- 30 . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .