25A-182 (8) CONSTRUCTION CONTROL AFFIDAVIT
PROJECT NUMBER: �� � �, DATE: I`•- l' -t "l
PROJECT TITLE: MItA l MR 8 ig FooME
PROJECT LOCATION:
NAME OF BUILDING: ���(
SCOPE OF PROJECT: IWO 4181 4-V)V,JVA[. tW"NUVS��
IN ACCORDANCE WITH SECTION 127.0 OF THE MASSACHUSETTS STATE BUILDING CODE,
i.- /49 p Q. 62C� MASS. REGISTRATION NO. `3'Z7i�1
BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECT HEREBY CERTIFY THAT 1 HAVE
PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS
AND SPECIFICATIONS CONCERNING:
ENTIRE PROJECT II ARCHITECTURAL i-1 STRUCTURAL ❑ MECIiANICAL❑
FIRE PROTECTION ELECTRICAL OTHER (specify)
FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEDGE, SUCH PLANS,
COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE MASSACHUSETTS
STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRACTICES AND ALL APPLICABLE LAWS
. FOR THE PROPOSED PROJECT.
I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE
PRESENT ON THE CONSTRUCTION SITE Oil A REGULAR AND PERIODIC BASIS TO DETERMINE THAT
THE WORK IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING
PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 127.2.2:
1. Review of shop drawings, sarroles and ocher submittals of the contractor as required by the
construction contract docunents as submitted for building permit, and approval for conformance
to the design concept.
2. Review and approval of the quality control procedures for all code-required controlled
materials.
3. Special architectural or engineering professional inspection of critical construction carnonents
requiring controlled materials or construction specified in the accepted engineering practice
standards listed in Appendix B.
PURSUANT TO SECTION 127.2.3 , I SHALL SUBMIT A PROGRESS REPORT TOGETHER
WITH PERTINENT COMMENTS TO THE INSPECTION SERVICES DEPARTMENT.
UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY
COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. _
Signature
SUBSCR BED AND SWORN TO BEF RE ME THIS �� DAY OF IUay 1903
1
NOTAVY PUB 4c— MY COMMISSION EXPIRES ON ! ^ C1 4
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( 001
Date Filed L1- 1 1 A File No. lJ �
ZONING PERMIT APPLICATION (§p10 . 2)
1 . Name of Applicant: (�
Address : Telephone:
2 . Owner of Property:
Address : !�a �7 lephone :
3 . Status of Applicant : Owner Contract P h er )
Lessee Other (explain: CI `1
4 . Parcel Identification: Zoning Map Sheet# X5Pr Parcel# RIA ,
Zoning District (s) (include o erlays) A�T_ -
Street Address
Required
5 . Existinq Pro nosed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height C1 1-(0 tl
%Bldg. Coverage (Footprint)
Setbacks - front ,2x 1
- side L: R: ' L: _R: ' -t- 1`j'
- rear
Lot size -t L07 l�;"( 8,M A& `3 -,/°11 KI
Frontage
Floor Area Ratio
%Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary) NIl�Aj LVDL�ZE 0LDitA(��j
7 . Attached Plans : Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowle"e.
N
Date: Applicant's Signature :
_ / THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason :
Special• Permit and/or Site Plan Required:
F ind�ng R uiled: Variance Required:
-- -
8 gnatur of Buildin Spector Da e
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits
from the Boar of H h, Conservation Commission, Department of Public Works and other applicable permit granting authorities.
THE O'LEARY COMPANY, INC.
Northampton Conservation Commission
Page 2
November 10, 1993
time, so long as the owner was advised all work would be at his risk in
the event an appeal was filed. Mr. Foote was advised of that condition
on November 8, agreed to accept those terms, and authorized us to begin
construction on November 9.
I understand under terms of the state building code, the Building
Inspector cannot issue a full building permit until the Order of
Conditions is recorded. At his discretion, the Inspector can issue the
foundation permit so that such work can proceed during the appeal period
(also at the owner's risk) . We will be contacting the Building Inspector
directly regarding this matter.
It has been a pleasure to work with you on this project. Please feel free to
contact me if you have any comments or questions at anytime during the
construction.
Sincerely,
THE O'LEARY COMPANY, INC.
Kenneth C. Tichacek
Vice President of Marketing
sm
cc Robert Foote
Paul Davis
Pete Sickler
Frank Sienkiewicz
THEIIIIIIIIIIIIIIIIIiilllilllllllllillllll ENGINEERING
® PLANNING
'LEAKY
CONSTRUCTION
IIIIIIIIIIIIIICOM RAN Y SINCE 1£355 NOV
November 10, 1993
Northampton Conservation Commission
c/o Paulette Kuzdeba, Senior Planner
City of Northampton
Northampton Town Hall
210 Main Street
Northampton, MA 01060
Re: Miscellaneous Notification--Spaces for Rent Expansion
(D.E.P. File #246-358)
Dear Paulette:
I am providing the following information and notification; in accordance with
requirements of the Notice of Intent Order of Conditions and Northampton
Wetlands Protection Ordinance with regard to the above captioned project:
1. Installation of siltation control devices--Shortly after the Order of
Conditions was issued, you verbally indicated the owner could install
siltation control devices at any time. I notified you by phone on
November 4 that all siltation control devices had been installed by the
owner and were ready for inspection by the Conservation Commission.
2. Commencement of construction--Also on November 4, I notified you by phone
in accordance with the Notice of Intent that the owner intended to begin
site grading on Tuesday, November 9.
3. On site superintendent/emergency contact--The on-site construction
superintendent in charge of all construction activities for The O'Leary
Company, Inc. is Gregory (Pete) Sickler. His phone numbers are 538-8532-
-office, 531-3543--car, and 562-7059--home. Mr. Sickler will be
available to the Conservation Commission anytime an emergency may occur,
and has full authority to halt or amend construction activities on-site.
The environmental consultant is Dr. Paul Davis, of Baystate Environmental
Consultants, Inc. , and his phone number is 525-3822.
4. Recording Order of Conditions--Conditions 7 and 8 require no work may be
undertaken on-site until expiration of the ten-day administration appeal
period and recording of the Order of Conditions thereafter. From our
phone conversations on November 4 and 8, I understand the administrative
appeal period will expire on November 15 and that the Commission will
record the Order of Conditions as soon as possible thereafter. You
indicated during those phone conversation that the Commission would allow
commencement of on-site construction activities prior to that
THE O'LEARY COMPANY, INC-
BUTLER MAIL. ADDRESS: P.O. BOX 377, SOUTHAMPTON, MA Ll111 73-03/;,
u CORPORATE HEADQUARTERS: 376 COLLEGE HIGHWAY. HOUTE 10. SOUTF-IAMI-'ION, MA 01073
BUILDER TELEPHONES: 413 53B-0532 413 527-1360
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NOTE:IN ORDER THAT THIS APPLICATION MAYBE 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
a Northampton,Mass. . . . . . . . . . . . . . . . . . . . . . . . 19 . . . . .
Telephone No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7b the Supt.of Buildings:
Application for a permit to build is rrhereby made according to the following:- 1
1. Location, Street and No. . . . . . . . . .".l . .� gyp^!ll'-/. !�! C"�. .M(NtC: . . . .. . . . . . . . . . Lot No. . .�
2. Nearest cross street . . .� FOP C, . . . . . . . . . . . . Size of long. . .�j:.��0��.^�. .e.,.�. . . . . . .. . . . . . .
3. Owner's name . . . /�"f- . . •. .. 07 0.1b. . �: . . . . Address .(U.?. 11�. �f�:.K.t� M. .9Qtb -
4. Architect's name . .U((,u' -"- i, . . . . . . . . . . . . . . . Address 55 LEC-: W,. LDkL(I, W.Mr
5. Builder's name . . . .0 1,( . ' ,. . . . . . . . . . . . . . . Address .e�'. �. .j .60Vn W. . . . MP!,•(161?;
Mass.Construction Supervisor's License No. . . .® �2
pe . . . . . . . . . . . Expiration Date . .7."®.�7.�.�.��. .. . . . . . . . .
6. Use of Building:One-family . . . . . . . . . . . . . . . . . . . . Two-family . . . . . . . . . . . . . . . . . . . . Other .G5TOM vup6r 1
7. Number of rooms in each family unit: . . . . . . . . . . . . . . . . . . . . . . . Number of Bathrooms . . . . . .. . . . . . . . . . . . . . . . .
8. Is there a garage attached? . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
I
9. Size of building .� . �.�1Q. . . . .��Q.X.�7Q . . . . . . . . Square footage . . .Pxoo. .(Z
10. Number of stories . . . .l . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
� t1
11. Distance from finished grade to high point of roof . .q.'.( . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . .
12. Type of construction . . . . 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13. Distance from building to street line in feet . . . . .l� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14. Distance from building to side lot lines in feet:Left . . . . . . . . . . . . . . . Right . .hl00. ... . . . . . . . . .. . . . . . .
15. Distance from building to rear lot line in feet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16. Is a plot plan being filed with this application? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .
17. Species of framing lumber:DF . .t�61 . . . . . . . . . . . . . Spruce . . . . . . . . . . . . . . . . . . . . Other . . .. . . . . . . . . . . . . . . . .
18. Are all structural conditions noted on drawings? 14A0 j. . Lt)w. . . . . . . . . . . . . . . . . . . . . . . . . .
19. Nature of land upon which the structure will be erected:Natural A. . . . . . . . . . . . . . . . . Filled . . . . . . . . . . . . . . . . . . .
20. Depth of basement or cellar floor below finished grade . 1 4./k. . . . . . . . . . . . . . . . . . . . . . . . . . . . .: .t;. . . . . . . . . . . . . .
21. Material of foundation walls . . . .clowjwCi.l�l . . . . . . . . . . . . . . . . . . . . Thickness in inches . f. . . . . . . . . . . . . . . .
22. Type of roof: Flat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pitched .X,. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .
23. Material or roof covering . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24. Method of heating . . . . . .tipb . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
25. Will the building co form to the Building and Zoning Ordinances? . . wl! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
26. Septic Tank? . . .t*. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . City,,Sewer? . . . . . . . . . . . . .
27. Construction within 100 ft.of wetlands? . .� ..l . N-QP ff zv. m. .U441 (-&)JAIA. ... . . . . . . . . . . . . .
28. Construction within 100 year flood plain? . . . .lrU/ . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
29. Estimated cost:Total $ . . . . IIV5 tow.U.�
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.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Arof . . . . . . . . . . . . . . . . .
Sign ure o ntractor Signa es onsible applicant
WRITTEN DESCRIPTION OF WORK TO BE DONE
. . :Tia�c�.�. . . .� ;s`t�D.t!t� . . . . . . .
. . . . . . . . .1W I VIZ- 1,50. . . . . . .
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