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28-075 (3) 0 w o � / o Cl U) _ 91�_ I -9� CL I zz a Y .1s 2 .I W a co Q CO H LL W � LLMn Q I S1 O I a W p ° W 2 a co co `i U�-j Q I O W i 2 U I �3 O Q e co W I. h. I Q Q + W LU lO W oo rr. W I Q . p � J — ° � oa N cq SYLVESTER READ 2 'b u-z v-)YA 1 Permit No. D26-05 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. By: -0� � Petitioner Mark LaValley (413) 586-3779 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. cc: Building Inspector L/-I w/wa/ r, / Permit No. D26-05 ASR g f CI 'Y OF NORTHAMPTON, MA DRIVEWAY PERMIT Date: FEE: $i5.00 CHECK#: THE BOARD OF PUBLIC WORKS The undersigned respectfully petitions your honorable body for: Permission to install a firiveway at 255 Syluester Road Fifteen 0 5) foot maxiinum width at the street line C-hater drainage not to*be dizirbed All I . - sball be directed off the firiveway surface to adjacent land,and not on the existing roadway Driveway Surface to be paved as soon as possible if the grade of the proposed drh4eway exceeds ';% or more- Homeowners will be beld responsible for any cost to the City of Northampton in the event of a wasbout of this driveway! By: Mark LaValley Telephone #: (413) 586-3779 Proposed Location Inspected By: Gravel Base Grade Inspected By: Final Approval THE BOARD OF PUBLIC WORKS voted that petition be granted. George Andrikidis Director of Public Works (SUBJECT TO ATTACHED CONDITION 1 & 2) cc: Building Inspector CITY OF NORTHAMPTON, MASSACHUSETTS DEPARTMENT OF PUBLIC WORKS 125 Locust Street Northampton, MA 01060 413-587-1570 Fax 413-587-1576 George Andrikidis, P.E. Director ASSIGNMENT OF HOUSE NUMBER(S) Street: Sylvester Road Assessors Map: Sheet 28 Lot 075 1 House Number: # 255 Sylvester Road Date: 3/17/05 Remarks: Reference is made to "Plan of Land in Northampton, Massachusetts Prepared for Kathleen E. LaValley"by Harold L. Eaton and Associates, Inc., Dated March 15, 2004. This number is assigned to Lot 6 on said plan containing 1.8367 ± Acres. This number was requested by applicant for permitting purposes. NOTE: This number supersedes an assignment dated April 22, 2003 ic entifying Lot B, (containing 80,950 SF±), on "Subdivision Approval Not Required", Plan of Land in Northampton, MA prepared for Kathleen E. LaValley by Harold L. Eaton and Associates, Inc. dated 08/06/02 as #277 Sylvester Road. Ned Huntley City Engineer cc: Water Division Tax Collector Sewer Division Massachusetts Electric Streets Division Verizon Telephone Inspectors AT&T Broadband Assessors Bay State Gas Police Department Post Office (Northampton) James Thompson (GIS Coordinator) Post Office (Easthampton) Applicant: David Premo 29 Country Way Florence, MA 01062 K:',House Numbers\Sylvester Road r�A � i S } S 7 } b L a S �, i rw; Massachusetts Department of Environmental Management .., Office of Water Resources 106� j OR PRINT ONLY Well Completion Report ' :LL LOCATION- GPS-(OPTIONAL),. LATITUDE LONGITUDE- ;ss at We Location: -�' ` ?r f r "`ti; '-` ' Property Owner: iyision Name: Mailing Address: Fown: L' {: Ci i C V4 -- --— City/Town: ssors Map Assessors Lot#: NOTE: Assessors Map and Lot# mandatory if no street address available d of Health permit obtained: Yes ❑ Not Required 0--" Permit Number Date Issued ORlC PEifQRM �' 4.`DIAILLING.MtOD Uew Well ❑ Abandon ❑ Domestic ❑ Irrigation ❑ Cable ❑ Auger Deepen ❑ Recondition ❑ Monitoring ❑ Municipal ❑ Air Hammer ❑ Direct Push Re lace ❑ Other ❑ Industrial ❑ Other ❑ Mud Rotary ❑ Other /ELL LAC , : W Permea iity _ Unconsolidated Consolidated S:SITE I ETCt1"(u pem►enerit fandmaric$'vuith Gist +cbe) co m (ft) To(ft) 'S High Low Other Rock Type CID t' i G Aal Depth Drilled .> _ �' _ From (ft) To (ft) Casing Type and Material Size O.D.(in) Well Seal Type ate Drilling Complete f) J. SPRE-I P rom (ft) To (ft) . Slot Size Screen Type and Material Screen Diameter m " FIL ' ►C l n (ft) To (ft) Material Description Purpose Developed? El F-1 No Fracture ! Enhancement? ❑ Yes L No I Method Disinfected? Yes ❑ No >_.WELL'tEST,bA`JA(PR)RUCTION WELLSy k,'' ., " ; z, 13 'S aATIC;WA ER 1 EYEL:.(ALi hWE:LS} Yield Ti Pumped Drawdown to Tim Recovery to Depth Below Date Method (GPM) hrs min) (Ft. BGS) (hrs & ti► (Ft. BGS) Date Measured Ground Surface (FT) F r" r _ i� 1. PERMANENT PUMP(IF AiIAII.A#3LE) iS�440AD13RE$S;l3F FIAMP MSTAUATfOM COPANY ump Description � 4 .< _ Horsepower ump Intake Depth (ft) Nominal Pump Capacity (gpm) S. COMMENTS 7.WELLbRILLER'S STATEMENT w. This well was drilled and/or abandoned under my supervision, according to applicable rules and regulations, and this report is complete and correct to the best of my knowledge. riller. /��` G� �� �` ? �' Supervising Driller Signature: Registration#:L—� �L- j irm: s ( Date: Rig Permit#: NOTE.- Well Completion Reports must be filed by the registered well driller within 30 days of well completion. BOARD OF HEALTH COPY i-DIXIM 4, r r~. Box 1192 Stadler Street. Belcbertow-n,MA 01007 (413)-323-7134 i Name: _ Her:shaw Well Drilling Sample Date- 4-07-05 Address: 130 Cummington Road Report Date: 4-11-05 ~mil I W.Chesterfield,MA 01084 Collected By. Henshaw WcH Drilling Sample Location: Type Supply: v Well David Prem.o Sample No.: , QAL 4562 Sylvestor Road Lab TD#: M-02454 Florence,l� i i. TESTED FOR RESULTS MAX.RECOMMENDED LEVELS Total Conform Bacteria Absent J Present or Absent Fecal Coliform Bacteria Abser-t Present or Absent lNitrite — 0 _ - 1.t)Mg/1- Nitrate _ 0.2 10.0 mgll i P11 7.57- Aikalinity X10.0 --_-� 'v0 Limit Iron ---- Manganese .01 .05 rngil Copper , 0 1.3 rngA Sulfa#e 11.0 --?50 mg/1 -- r Chloride 2.48 ~ 250 mgA ---1' Hardness —� 40.6 �- _. Y No Limit._ --- Ivfl Conductivity i l0g•_3 Limi_ Total Dissolved Solids 71.4 500 mg,3 Turbidity 4.11 ._.-._._._� 5 NTt3 --� Chlorine T 0 ; No Limit- '1 Sodium 5.40 `��--�._-- itiTo Limit Results are only for those`stems listed above and on the 2bove collected date. Except for the fullowiag � _—��- tk sample was found to be within acct(stable levels for ALP, br nlung'water Standards. If there arc ply gmti�ms 0, tills report, ll please do aot hesitate to caH this office. .� David Freden+bae,Director i a �I lip" Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe Sizes Heated Water Non-Circulating Runouts Circulating Mains and Runouts Temperature(F) Up to 1" Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 05 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range F 2"Runouts 1"and Less 1.25"to 2" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD (Building Department Use Only) [ ] ( Materials and equipment must be installed in accordance with the manufacturer's installation instructions. [ ] ( 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-factors 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-6.5. ( ( Duct Construction: [ ] ( All joints, seams, and connections must be securely fastened with welds, gaskets,mastics ( (adhesives), mastic-plus-embedded-fabric, or tapes. Duct tape is not permitted. ( Exception:Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g. (500 Pa). [ ] ( Ducts shall be supported every 10 feet or in accordance with the manufacturer's instructions. [ ] ( Cooling ducts with exterior insulation must be covered with a vapor retarder. [ ] Air filters are required in the return air system. [ J ( The HVAC system must provide a means for balancing air and water systems. ( ( Temperature Controls: [ J ( 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. ( ( Service Water Heating: [ ] Water heaters with vertical pipe risers must have a heat trap on both the inlet and outlet unless the ( water heater has an integral heat trap or is part of a circulating system. [ ] Insulate circulating hot water pipes to the levels in Table 1. ( ( Circulating Hot Water Systems: [ ] ( Insulate circulating hot water pipes to the levels in Table 1. ( Swimming Pools: [ ] ( All heated swimming pools must have an on/off heater switch and require a cover unless over 20% ( of the heating energy is from non-depletable sources. Pool pumps require a time clock. ( ( Heating and Cooling Piping Insulation: [ ] ( HVAC piping conveying fluids above 105 OF or chilled fluids below 55 T must be insulated to the ( levels in Table 2. REScheck Inspection Checklist 2000 IECC REScheckSoftware Version 3.5 Release lb DATE:03/29/05 Bldg. { Dept. { Use I ( Ceilings: [ ] ( 1. <ICeiling l l>:<[Flat Ceiling or Scissor Truss(>,R-38.0 cavity insulation { Comments: [ ] I 2. <lCeiling 21>:<ICathedral Ceiling(no attic){>,R-30.0 cavity insulation ( Comments: I ( Above-Grade Walls: [ ) 1 1. <{Wall II>: <{Wood Frame, 16"o.c.(>,R-11.0 cavity insulation Comments: I { Windows: [ l I I. <{Operating Casement(>:<(Wood Frame:Double Pane with Low-EI>,U-factor: 0.300 { For windows without labeled U-factors, describe features: ( #Panes Frame Type Thermal Break?[ ]Yes[ ]No ( Comments: [ ] 1 2. <(Double Hungsl>: <(Wood Frame:Double Pane with Low-EI>,U-factor: 0.310 ( For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break?[ )Yes[ ]No Comments: [ J 1 3. <IFixedl>:<(Wood Frame:Double Pane with Low-EI>,U-factor: 0.290 ( For windows without labeled U-factors, describe features: ( #Panes Frame Type Thermal Break?[ J Yes[ ]No ( Comments: ( Doors: [ ] I I. <{Patio(>: <IGlassl>,U-factor: 0.310 1 Comments: [ ] 1 2. <IFrontl>: <ISolid{>,U-factor: 0.230 1 Comments: [ ] 1 3. <{Garage Fire Door(>: <(Solidl>,U-factor: 0.200 Comments: i ( Floors: [ ] { 1. <IFloor 11>: <IAll-Wood Joist/Truss:Over Unconditioned Space{>, I R-38.0 cavity insulation I Comments: I I Air Leakage: [ ] I Joints,penetrations, and all other such openings in the building envelope that are sources of air I leakage must be sealed. [ ] I Recessed lights must be 1)Type IC rated,or 2)installed inside an appropriate air-tight assembly I with a 0.5" clearance from combustible materials,If non-IC rated,the fixture must be installed with a { 3"clearance from insulation. i ( Vapor Retarder: [ ) I Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. i Materials Identification: Qf' Permit Number `i REScheck Compliance Certificate Checked By/Date 2000 IECC RES check Software Version 3.5 Release lb Data filename: C:\Projects\TCBD\Premo\Premo.rck CITY:Northampton STATE:Massachusetts HDD: 6404 CONSTRUCTION TYPE: Single Family DATE: 03/29/05 DATE OF PLANS:March 23,2005 PROJECT INFORMATION: David and Clair Premo Sylvester Road COMPANY INFORMATION.- Greenright Design COMPLIANCE:Passes Maximum UA=692 Your Home UA=688 0.6%Better Than Code(UA) Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA <lCeiling II>: <jFlat Ceiling or Scissor Trussl> 2009 38.0 0.0 60 <lCeiling 21>: <lCathedral Ceiling(no attic)j> 584 30.0 0.0 20 <lWall 1j>: <lWood Frame, 16"o.c.1> 4116 11.0 0.0 295 <10perating Casement)>: <lWood Frame:Double Pane with Low-El> 102 0.300 31 <lDouble Hungsl>: <lWood Frame:Double Pane with Low-El> 513 0.310 159 <lFixedl>: <lWood Frame:Double Pane with Low-El> 48 0.290 14 <jPatioj>: <IGlassl> 98 0.310 30 <jFrontj>:<lSolidl> 20 0.230 5 <lGarage Fire Doors>: <lSohdl> 18 0.200 4 <lFloor 11>: <jAll-Wood Joist/Truss:Over Unconditioned Spacel> 2705 38.0 0.0 70 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans,specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2000 IECC requirements in RES chec Version 3.5 Release lb (formerly NEC check)and to comply with the mandatory requirements listed in the REScheckInspec�io Check list. Builder/Designer °�� Date Stl 5-cI�L14 e.5;.33 JUVtb t1UIl.HtNb KtHLIY 1 41S 5db 5 0 F.4'J4 Np �� THE CQMMONWEAL.TIi OP MASSACHUSETTS ri t BOARD OF HEALTH � CERTIFICATE OF COMPLIANCE Description or Work: ❑ individual Component(s) V Cotnpletc . tem The undjersigned herchy Certify that the Sewage Disposai,S�Syy(sttem:Con.:tructed(11.Repaimd( ).Uprrrded( ).AbnnJ%meJ(( � 1/ 1 elli has hcen installed in ficcomiance with the provisions of 310 C' R 25.[10lTillu S) and the t+ppruved dc;ikn planaduw-huill plans relating to•ppliyatidn No. y D (laced A D Approved Design Floe installer Dcsignur' ` -'�-- W r lnspcctor :tic Thu issuance of this cariificate steel n conslr..ed.a yue nice[Fat the sysWn will fintdiw+as desione�- pGRM 3 - CERTIFICATE OF COMPLIANCE OEP APPROVEa FORM 5/96 � .� eL� tSO bt7 l6 Snd T' \ PLA NN NG A ID DEVELOPMENT . CITY OE 4 NORTHAMPTON i t Cit)Hall . a1 o Main Street,Room 7 i - Nordjampton,MA o i o60-3!98 -(41 3)07-1 a66 • Fax:S87-r zGq °' rR Watijtte Feifle;l, Diream - )1(,I7171i7;,) 3a nordja Ill 1!Lon 1:lei Ifiii g-Orp - H'7;'}}.-{iOrLIja711t7 Loll i7 lei F7 Ili nt3.ory ,�,... December 4, 2002 David McCutcheon P.O. Box 43 Easthampton, MA 01027 Dear David: Your Request for Determination to determine whether the area and proposed work is subject to the jurisdiction of the Wetlands Protection Act, for property on Easthampton Road, has been submitted to the Northampton Conservation Commission, and the Public Hearing will be conducted at its meeting scheduled for December 12, 2002 at 5:30 P.M. in Classroom 122 at the Northampton High School,380 Elm Street, Northampton. You and/or vour representative(s) are required to attend this meeting to present the application. One week before the Public Hearing is scheduled; a legal notice announcing the meeting will be published in the Daily Hampshire Gazette(copy enclosed). Please post the enclosed yellow notice where it will be visible from a public right-of-way. If you have any questions, please contact the Office of Planning and Development, City Hall, Telephone 587-1262. Sincerely, Angela Diori- Board Secretary, Northampton Conservation Commission Enclosure cc: Charles Dauchy, 24 Old Long Plain Road, Amherst, MA 01002 p1lCIN!tinq bn.1111 -Cnp,cl-%a ioi!wolnli„inn -Lollin(j(ind IJ O d1111('.I(, - /)OIf,h!,j Ili i If I ICf,�J 117- "te IV 71C1011n1e1 I I dl1I170ri I) . )I o rI h,I l 7111101 I(:1` ecnuonlicaei/e(n�n;7cnt -rannitunitv:(rre(o1n{unI -(rh!(7rlt: i,lrictcnonni+.,7un •Iii,ionc,llcol771nis.titnl7•cel7 Val Inf 177;r5tNrUJil.Crl1!rc ENDORSE1ENT OF APPROVAL NOT REQUIRED (ANR) PLAN File with the Of ice of Planning and Development City of1Vorthampton,Massachusetts i. Deed recorded in Hampshire County Registry of Deeds or Land Court:Book 6849 page 222 2. Street Address: SYLVESTER ROAD 3. Assessor's_lap: 28 Lot(s): 74 Additional property description: LOTS PREVIOUSLY ?. dumber ofnewly created lots: 0 RECORDED 5. Check list of filing requirements (check the supplied items. Applications WI ST have these items.) KI Original, reproducible (mylar)Plan;with endorsed Seal of a)Massachusetts Registered Professional Land Surveyor. FK1 Six (6)prints of the Plan. X Original and Sig; (6) copies of the fully completed and endorsed AvR Application form. N S 150 per sheet fee plus S50 for each newly created lot(payable to"City of Northampton"), ❑ If any portion of a plan falls within 500 feet of a published control point(see NorthamptonPlanning.org): four centimeter-accuracy points on each sheet tied into the Massachusetts State Plane Coordinate System(N-A-D 1983 datum), using said published control points or the global positioning system and noting the coordinates of the tie-in points, the datum, and the source and location of monuments used for data. ill An electronic version of the plan in model space in DWG,DXF,or Shape format including: o All property lines,buildings and geographic features shown on the plans. e Closure of all property boundaries of one part in 20,000 ❑ Plans show all buildings owned by subject landowner(s) within 100'of any newly created property., lines. D. Plans include a statement that the Planning Board's endorsement is not a determination that the lots shown are buildable lots. We believe and understand that: (1) The attached plan is not a division as defined in the Subdivision Control Law and we submit it for endorsement that Planning Board approval under this Law is not required; and (2) we have provided all the information required in the checklist above; and (3) The plans submitted are now in the public domain and may be copied freely in any form. Applicant ( or type): KATHLEEN E. LAVALLEY Signature: Address: 207 SYLVESTER RD, FLORENCE Phone: LISA HOHOL McCUTCHEON Owner (print or type): KATHLEEN E. LAVALLEY Signature: Address: 207 SYLVESTER RD, FLORENCE Phone: 587-4570 Surveyor(print or type)HAROLD L EATON & ASSOC. Signature:_ (�.. �- A,� Address: 235 RUSSELL ST, HADLEY MA 01035 Phone: 584-7599 -1llo:v 1 days for processing. It is the applicant's responsibility to pick up the original drawing and record it at the Registry of Deeds or Land Court within the time limits established by the Registrf. All copies and ferns remain with the City. Applicants may file one copy of this ANR form with the City Clerk to protect Their appeal rights. Date Subnutted: Date Decision Filed: City Clerk(signature): City Clerk(signature): ANR Applica:ion,Form A:last revised 112312002) w1p IN N Mg f4,-' Sm trill INN Wgg it —/\���/,d /✓ /!.� , �I� ,,,I,L,I.III'� .,��Il�tl�� ;,; :���:i��f��� // NO ,l�Sllll il(////!/,G��1,1��.�111 ��ii/�' O,. /�r�;��, �'�ti.. CF;[,/'�:^'�•.�� = _ - �� ------ ---- Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands i\ 4 W�A Form 2 — Determination of Applicabf1ity Massachusetts Wetlands Protection Act M.G.L. c. 131;-§40 B. Determination (cont.) El 5-The area described in the Request is subject to protection under the Act Since the work described therein meets the requirements for the following exemption, as specifiez', in'he Act the regulations, no Notice of Intent is required: Exempt Activity(site applicable statuatory1regulatory provisions) ❑ 6.The area and/or work described in the Request is not subject to review end approval by: Name of Municipality Pursuant to a municipal wetlands ordinance or bylaw. Name 0-dinance c r Bylaw citation C. Authorization This Determination is issued to the applicant and delivered as follows: F-1 by hand delivery on by certified mail, return rece 1A requested January 3, 2003 Date [Date Date sent to DEP: January 3, This Determination is valid for three years from the date of issuance (except Deter-ninai4)1_ls for Vegetation ManagqTent Plans which are valid for the duration of the Plan). This Determination does n( relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances bylaws, or regulations. This Determination must be signed by a majority of the Conservation Commission. A coi),' must beseiv to the appropriate DEP Regional Office (see Appendix A) and the property owner (if diffei--mt frain it i applicant). DOSignatures: Dec.eniber 12 , 200? Dae CITY OF NORTHAMPTON, MASSACHUSETTS DEPARTMENT OF PUBLIC WORKS _ { 125 Locust Street �- Northampton, MA 01060 413-587-1570 Fax 413-587-1576 George Andrikidis, P.E. Director ASSIGNMENT OF HOUSE NUMB ER(S) Street: Sylvester Road Assessors Map: Sheet 28 Lot 075 House Number: #255 Sylvester Road Date: 3/17/05 Remarks: Reference is made to "Plan of Land in Northampton, Massachusetts Prepared for Kathleen E. LaValley"by Harold L. Eaton and Associates, Inc., Dated March 15, 2004. This number is assigned to Lot 6 on said plan containing 1.8367 ±Acres. This number was requested by applicant for permitting purposes. NOTE: This number supersedes an assignment dated April 22, 2003 identifying Lot B, (containing 80,950 SF±), on"Subdivision Approval Not Required", Plan of Land in Northampton, MA prepared for Kathleen E. LaValley by Harold L. Eaton and Associates, Inc. dated 08/06/02 as #277 Sylvester Road. Ned Huntley City Engineer cc: Water Division Tax Collector Sewer Division Massachusetts Electric Streets Division Verizon Telephone Inspectors AT&T Broadband Assessors Bay State Gas Police Department Post Office (Northampton) James Thompson(GIS Coordinator) Post Office (Easthampton) Applicant: David Premo 29 Country Way Florence, MA 01062 K:\House Numbers\Sylvester Road . ��t►l\1NPl. , O � Y of Nart4ainvtan � Z �ASSAC}�ItB[tf6 � - �-, DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street • Municipal Building Northampton,MA 01060 r HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supc!r,isor. The state defines"Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends 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 home owner." The building department for the City of Northampton wants any person(s)who seek to use the home owner exemption, to act as their own construction supervisor,to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfrll), sonotube holes (before pour), a rouzh building inspection (before work is concealed), insulation inspection (if required) and a final building inspection. The building department requires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work(electrical, plumbing&gas) the homeowner will be responsible to make sure that the trades hired secure their proper permits in conjunction to the building permit issued, and that they get their required inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made I, understand the above. (Home owner/resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date lZ Address of work location ,a 2,0 L �� I� I n, o a SECONS CONS�F2UCT$I0N SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : �,� T at" Q&WXJerA License Number L k\A 1\dS Address Expiration Date Cfru �1S 5a1. 01 Signature Telephone e ; r. o art , ; .e:r1 n3raC Not Applicable ❑ Company Name Registration Number PO � 4- 0,11 332 lo k?) `as Address Expiration Date yCb•Q- vOU Telephone 'I 13 W-S' SECT�OJ3 [!VORKERS' COMPENSATION INSURANCE AFFIDAVIT(M:G:L.,c. 152, §25C(S)) 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....... ❑ No...... 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 hive 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 acecptable 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"ce es assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances, State an L c o ing Laws and State of Massachusetts General Laws Annotated. Homeowner Signature I SECt Ot`15 S:.°R R WON © �P OPO»ED WORK h' Wa a lica�ble' New House if Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other[ ] Brief Description of Proposed Work: Apr– Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative 0 Renovating unfinished basement Yes No Plans Attached Roll 0• Sheet 0 6 A:e o.° 1? nra .itfon to exf'sinng uo ss-ngohef�lowan : a. Use of building: One Family- Two Family Other b. Number of rooms in each family unit: g Number of Bathrooms 3 c. Is there a garage attached?_ d. Proposed Square footage of new construction. Lf 100 5,, Dimensions ItO K 5-0 e. Number of stories? ,12 f. Method of heating? ED or Woodstoves– �ACS— Number of each_t g. Energy Conservation Compliance. Its Mascheck Energy Compliance form attached? 'Yes h. Type of construction (Zitiol (tee-rA^-.A- i. Is construction within.100 ft. of wetlands? Yes _ L No. Is construction within 100 yr, floodplain _Yes�_No j. Depth of basement or cellar floor below finished grade fe IL k. Will building conform to the Building and Zoning regulations? 1C Yes No . I. Septic Tank 4� City Sewer Private well City water Supply �ECO� N UTORIZATION TO BE COMPLETED WHEN OYYNEtSE T NMI CONTRAGTOR'APP.t:IES'FOR BUILDING;PERMIT a� I, J ,i kD as Owner of the subject property hereby authorize Lbvl Y J 'Awl,3 0 to act on my behalf, in all t lative to work authorize by th;,slbuilding ermit application. Signature of Owner Date I, 'A-yij-� P�4Q z 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. Signed under the pains and penalties of perjury. 10,\1,-t. Print Name �"Ab Signature of Owner/Agent Date Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This colurrm to be filled in by Building Department Lot Size 1. 9 3 6 1 kc rr3 1,8-3-4-7 Airts-Jbil000 Frontage t r 179T, 1 7 Setbacks Front Side L: IS L:_jam_R: 1 S yf� Rear Z'0 Building Heigbt �C6 1`5 —761 Bldg.Square Footage 6,600 Open Space Footage % (Lot area minus bldg&paved 45,9570 parking) #of Parking Spaces y Fill: (volume'&Location) a A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO K DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW YES IF YES: enter Book Page and/or Document # i B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW YES K IF YES, has a permit been or need to be obtained from the Conservation Commission? ] Needs to be obtained Obtained X , Date Issued:__ 1 IZ 3 L I C. Do any signs exist on the property? YES NO k IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property?YES_ No IF YES describe size type and location: City of Northampton Building Department s 212 Main Street Room 100 1 _ t 94hampton, MA 01060 phone 413-587-1240 Fax 413-587-1272 APPLI ` TION TO CONSTRUCT,ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTIO,1N 1-SITE INFORMATION- rty /naP Z 9 o r 5 4 � �s secC�on# ae ac©mp�ietedy office 1.1 Prove Address: T �� -t*44 c- /)1� o�r7 6 L. 7 rtle k x;;�s Oa►erJay iOistnct +`12y, u%',w*°{'�Y k:s S1k a h'tip vt S�".2R SECTION 2-PROPERTY`OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: 4.66. go ko ( .r&-aa eaAJ Z 6 3 Sy l✓es ttion- I Name Print) Current Mail n Addr : 11 f-10 y�cv�.cc._ VY�,,o� �tib G'Z• Mt, Telephone �� u57� Signature 1 2.2 Authorized Agent: A, Co L)N 1124 U P Lve,., A+ Name(P' t Current Mailing Address: �� O 1404 64) 68q- -7.7 i 7 ewe Sa-7- 712.0 Signature Telephone SECTION 3--ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official.Use Only completed by perm it applicant 1. Building {a)Building=Permit.Fee 2,SO 000 ;. 2. Electrical (b):EsUmated�-:Total Cost of 2-2-O a Construction from',6 .,080 3. Plumbing Buildng;Permit Fee 22 006 4. Mechanical (HVAC) 5. Fire Protection ?O 6 66 6. Total = (I + 2+3 +4+ .W 3iq 60 CheckNurbber 0:21 3 is Sectionf_For.Official Use,OA1 Building Permit umber: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date C) 0 t t� t; �iT c`T� -CIIL- Il�lll�li111 �� l f - �ry sJS RLljnrllSs (�. DEPARTMENT OF BUILDI),�C INSPct i IOAS �_, I c:SPCCTOP ?)? A1ain SLrc.t - Rlunicipal lhiddlrl6 Nor LhnmpLori, ?+Suss. OIOGO - 1 square Footage An. t : 1st clo-or. @ $-�O '2-_ 2nd floor @ $_30 1/? Floors, Attic. Garage 1200 Deck Porches TOTAL File#BP-2005-0986 APPLICANT/CONTACT PERSON LOUIS MONTGOMERY dX0 ADDRESS/PHONE P O BOX 1013 BUCKLAND (413)625-6953 3-ad -o/(o p PROPERTY LOCATION 255 SYLVESTER RD MAP 28 PARCEL 075 001 ZONE RR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildinfz Permit Filled out Fee Paid T_ypeof Construction: CONSTRUCT 1 1/2 STORY SFH W/ATT GARAGE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included• Owner/Statement or License 013471 �.'g���yu�� 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO,VNfATION PRESENTED: pproved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Signature of Building Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. s#as�usstts - of 'eN. =t4a1rP#rn fr` i DEPAaTMENr OF BEING IrrsPECTZO s INSPF-CTOR 212 Main Street ' Municipal Building Nort'aampt=, Man. 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 255 Sylvester Road as shown on the Assessors Page# 28 , Lot# 75 Zone RR 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 30 PSF T,TVE T. PRR FT.QOR(Z$ CMRTablelCzQ6 L)= _-_- 40 PSF Under the following limitations, special stipulations, and/or conditions of the permits: Issued this 27th day of March 2006 Certificate of Occupancy and Use# BP-2005-0986 Authorized Department Personnel Electrical Elevator Fire Plumbing / J Building--'�cu-�-� _Y/ � Gas 11 2111 v DPW Building Commissioner 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. Building Department 413-587-1240------fax 413-587-1272 y F m s t ir0 va :yv �u � mxr aa x { i 1 r t a 7 NX We $Ar Ip In- Ae kR j"U, Mv- n A� w r ahx 445, Z. ti r 25SYLVESTER RD BP-2005-0986 'GIs#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot:-001 Permit: Buildinci A Caieeon': BUILDING PERMIT Permit# BP-2005-0986 Project# JS-2005-1360 Est. Cast: 31400.00 Fee: 2344.15 PERMISSION IS HEREBY GRANTED TO: Const.Class:5B Contractor: License: Use Group.L-A4- LOUIS MONTGOMERY 013471 Lot Size(sct�it): Owner: MCCUTCHEON LISA H'?H0L Zoning:RR Applicant: LOUIS MONTGOMERY AT: 255 SYLVESTER RD Applicant Address: L11,one: Insurance: P 0 BOX 1013 413 625-6953 BUCKLANDMA01338-1013 ZSS'UF.D ON.513105 0:LO.00 TO PERFORAY THE FOLLOWING WORK.-CONSTRUCT 1 1/2 STORY SFH WATT GARAGE POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing in of Wirin! D.P.W. Building Inspector Underground: Sgrvic,�: Meter: A Footings: Rough: Rough: House# Foundati,!- Driveway Final: Final:�' °� � (7 � Final: Pe /-60/0-",�f'✓�/ L Rough France. ;k Gas: Fire Department �.4 Fireplace/Chimney: Rough i Oi : Inst!lation: 6 Final: 3 —7-0( affiAw of T ",ck Fbial: OK 0Jt 141 bb Lcw►4 S �2,. 0 THIS PERMIT MAY BE REVOKED BY THE ITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS Certificate of Occupanc_y__ �.ilgll�are: FeeTvpe: Date Paid: 'kniount: Building 5/3/05 0:00:00 $2344.1" 212 Main St.-,::et,Phone(413)587-1240,Fax:(413)587-1272 Bei'di4o Counnissiouer-Anthony Patilio ' s "