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36-355 �o S 88' -59'02" E / / 90.92' 1 J YJ proposed !� U, 8' dwelling V! /' #71 18.4' 0O V) N electric & CATV _ ater p� 3 3. ewer / 443' N 82'52'09" yy Utility Connection Locations Are Approximate OF LOT 6 PROPOSED IMPROVEMENT LOCATION PLAN RANDALL Ga IZ. NORTHAMPTON, MASSACHUSETTS #35032 PREPARED FOR <9� so� ROSEMUND, LLC SUR SCALE: 1"=30' APRIL 18, 2014 HAROLD L. EATON AND ASSOCIATES, INC. �• _.� REGISTERED PROFESSIONAL LAND SURVEYORS 235 RUSSELL STREET — HADLEY — MASSACHUSETTS O � O m c N Z 3 D 0 N n o o - 3 0 —I- v� A � m D T T T ( r C M r r r n Q m n D 0 0 0 0 (D 7nC N Z m A � M O Q 3 co c co A O A A Q C co � CD '0 42L 3 00� O Q m o 0 0 0 0 0 o N O O O O O O O O � p tf+ <n -60 �64 -b4 '64 tva •O �A cc, V N al C�i� (n O O O O MUNICIPAL WATER AVAILABILITY APPLICATION Northampton Water Department 237 Prospect St. Northampton,MA 01060 587-1097 A Department of Public Works Trench Permit shall be required prior to any construction or connection activity associated with this application. Location: 71 Emerson Way, Lot 6 Inquiry Made By: ,3 £, �(j q,�O , Marie QuilURosemund LLC 695-8795 ' , _ _ � `J Date of Inquiry: 4/9/14 Number of Type of Single FamilyM Type of Private X Units: 1 Unit(s): Apart. Comm Ownership: Condo Multi-family Rental (Annlicant to fill nut the ahave) Municipal Water Main in Existing service to Front of Location? Yes: X No: site? Yes: X No Size of Water Main: 8" Material: Ductile Iron Age: 2008 Approximate Static Street Flow Test Conducted: Yes: No: X Pressure: 55 psi If done attach results Size of Service Connection 1�� Suggested Meter Size: 5/8 Comments: The Water Department cannot guarantee adequate water pressure during peak demand times at elevations above 320 feet. • A corresponding water entrance fee shall be paid prior to making any connection to the municipal water system. • Arrangements of such installation shall be made with the Northampton Water Department with a minimum of 5 working days notification. • All w 11 conform to Northampton Water Department specifications. e R.Nuttelman, Superintendent of Water Dept. Water Entry$ 200 Meter$ 100 Radio$ 100 cc: Ned Huntley,Director cc: Louis Hasbrouck,Building Commissioner p� / Note: If this availability is for a new construction,it must be hand delivered to the Building Inspector. "` MUNICIPAL SEWER/AVAILABILITY APPLICATION Northampton Streets Department 125 Locust Street Northampton, MA 01060 587-1570 A Department of Public Works Trench Permit and Sewer Entry Permit shall be required prior to any construction or connection activity associated with this application. Location: 71 Emerson Way, Lot 6 Inquiry Made By: Marie Quill/Rosemund LLC 695-8795 Date of Inquiry: 4/9/14 Reason for Request: Hook into City Sewer System Municipal Sewer Main in Front of Location: Yes No Municipal Storm Drain Available: 5%deep Yes No Size of Sewer Main: Material: Age: Depth of Sewer Main: Length of Sewer Main: Size of Service Connection: Type of Service Connection: Tie-in to Sanitary Main Tie-in to Sanitary Stub Comments: ntf City Requires 6" cleanout installed at City Property Line Note- If this availibility is for new construction this form must be hand delivered to Building Inspector. A corresponding"sewer entrance fee"shall be paid prior to making any connection to the municipal sewer system.Arrangements of such installation shall be made with the Northampton Streets Department with a minimum of 5 working days notification. All work shall conform to Northampton Streets Department specifications. ' 1 John- H II Sewer Department cc: Ned Huntley, Director DPW Louis Hasbrouck, Building Commissioner +' a2 a2 32 a2 32 � M w O w O O V L a) a aJ N O N a V' O O V O co °� Ln , "' � V a�i► yr yr air bA L �7 W 7 0 v a� O C C Q V 4 td > E '^ O CL C N d L IA ro V in N on C W L .Q .cc -C ai On w o u .� r c Y Q O C IA y > an C C ro 0 0 V W d a) a) _ 3 O L C L aroi °o o '=on -a o v y L 10 E > ° o S U S J O_ in ~ U Q U a Li OL O U V Q) N T D0 on-p Ln ro O N O = j C w m co •Y - - a� S C) N -O m ca R` •= L O M a) L t6 a m u CD 0 •'s� N !/'�� O C 3 N m 0 O M > 0 O O H on to 10 ? 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The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I ! 600 Washington Street . l Boston'. AL4 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): ROsemund, LLC Address: 23 East Hadley Rd City/State/Zip: Hadley, MA 01035 Phone #: (413) 695-8795 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. ❑ 1 am a general contractor and I 6. ®New construction employees(full and/or part-time).* have hired the sub-contractors 2.® 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.E] Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 l.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] fi c. 152, §1(4), and we have no 13.0 Other employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Main Street America Assurance Co Policy#or Self-ins. Lic.#: MPF659979 Expiration Date: 5/26/2014 Job Site Address: Lot 6 - 71 Emerson Way City/State/Zip: Florence, MA 01062 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature ���� J �\ Date: 'k 14 Phone#: :2� C � Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#• SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Aprplli�icable�J❑yr�-- Name of License Holder: �! V 5 O J License Number Q �4 1A —1 Address Expiration Date Signature Telephone 9.Registered me Improvement Contractor: Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildi g permit. Signed Affidavit Attached Yes....... No...... ❑ 11. - Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780 Sixth Edition Section 108.3.5.1. Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall_not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the buildinp_permit. As acting Construction Supervisor your presence on the fob site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers' Compensation) and Chapter 153(Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,You may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors 1711 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks (Q Siding[E:3] Other[d] Brief Description oqf Propose Work: - 't" hn cx Y f��• oorck Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housina,complete the following: a. Use of building: One Family J Two Family Other b. Number of rooms in each family unit: 9 Number of Bathrooms o�l� c. Is there a garage attached? H l2 S _ d. Proposed Square footage of new construction. �� Dimensions f 1� -3� e. Number of stories? o v.. ck-*e r f. Method of heating? �n �' �t ` 0 0.S 0. t„ Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction W O o A, �r hn V, i. Is construction within 100 ft.of wetlands? Yes v/No. Is construction within 100 yr. floodplain Yes VNo j. Depth of basement or cellar floor below finished grade_% t k. Will building conform to the Building and Zoning regulations? V Yes No. I. Septic Tank City Sewer -.,/ Private well City water Supply V SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, \ CkV(Q V\ as Owner of the subject property `+ C hereby authorize Y' V CAS � to act on my behalf, in all matters r tive to Work authori d by this building permit application. Signature of Owner Date I as Owner/Authorized Agent hereby declgoe that th6 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. rl- re Print Name (4-, + Signature of Owner/Age Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size i D, Frontage Setbacks Front -3:1— Side L: t� R: _ L: R: Rear �v 1 Building Height 30� Bldg. Square Footage ly$ % Open Space Footage % (Lot area minus bldg&paved 10 lya� parking) #of Parking Spaces Lt Fill: volume&Location A. Has a Spe 'al Permit/Variance/Finding ever been issued for/on the site? NO DONT KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO ® DON'T KNOW ® YES Q IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO e DONT KNOW ® YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained ® , Date Issued: C. Do any signs exist on the property? YES ® NO 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: E. Will the construction activity disturb(clearing, grading, ex ation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only ab City of Northampton Status of Permit: 222014 Building Department Curb Cut/Driveway Permit ;; j 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Electric,Plumbing �G—a�lnspectio rthampton, MA 01060 Two Sets of Structural Plans NOrtharrNe7r' C' 060 -587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office Map Lot Unit �Q� r Zone Overlay District �P Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address Telephone a� Signature 2.2 Authorized Accent: G(- Q-o, e\r NamM(P'nt) i Current Mailing Address: ^� �- i3 �qS Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only com feted by ermit applicant 1. Building 2-0 Q )O Q (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of b O Q Construction from 6 3. Plumbing l r Building Permit Fee r 4. Mechanical(HVAC) — 5. Fire Protection ` l 6. Total=0 +2+3+4+5) b O o Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date C tiFCic F �� File#BP-2014-1100 t" + APPLICANT/CONTACT PERSON GREGORY QUILL ADDRESS/PHONE 23 E HADLEY RD HADLEY (413)695-4195 1Z F \J PROPERTY LOCATION 71 EMERSON WAY-LOT 6 MAP 36 PARCEL 355 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid .� Buildinp,Permit Filled out Fee Paid Tyneof Construction: CONSTRUCT 2 STORY SFH W/ATT GARAGE&PORCH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 105857 3 sets of Plans/Plot Plan QC J/r THE FOL OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: Approved 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 Permit DPW Storm Water Management -DeLpolition Delay Signs e of BuiRTfug 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. 71 EMERSON WAY-LOT 6 BP-2014-1100 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36-355 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Catego!y:New Single Family House BUILDING PERMIT Permit# BP-2014-1100 Project# JS-2014-001877 Est. Cost: $245000.00 Fee: $1001.65 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: GREGORY QUILL 105857 Lot Size(sq. ft.): 12240.36 Owner: SMITH WARREN J Zoning: Applicant: GREGORY QUILL AT. 71 EMERSON WAY - LOT 6 Applicant Address: Phone: Insurance: 23 E HADLEY RD (413) 695-4195 WC HADLEYMA01035 ISSUED ON:511412014 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 2 STORY SFH WATT GARAGE & PORCH POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 5/14/2014 0:00:00 $1001.65 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner