25C-030 (11) a a
> oz
0
FT. Deep
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . I
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . MO
o . . . . . . -4 r r-
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. . . . . . . . . . . . . . . . . . . . . as r
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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 Plan,must he filetim""` h,,ts-application before a permit be granted.
iY
FEB 2 8 20M
Zone
APPLICANT NOT TO FILL IN SPACES ABOVE THIS LINE
Application for a Dwelling Permit
Northampton,Mass. . . . . . . . . .�. ®r�C�.14 . . . . .A . . . . .
Telephone No. . . . . . . . .S`' 1. . l. . .T-1. . . . . . . . .
7b the Supt.of Buildings:
Application for a permit to build is ere y made ac ording to the following:- c�SG 36 31 j;t
1. Location, Street and No. . . . . Lot No. . . . . . . . . . . t
. . . . . . . . . . . . . . . . . .. . .
2. Nearest cross st eet . . . ��`- . . . . . . . . Size of lot .. .�.0 ls�� . . . . . . . . . . . . . . .. . . ., . 1
/!
3. Owner's name 1. �. . , . . . . . . . . . . . . . . . . Address j� 1! `-`
4. Architect's name JE. . . � Address . . So v ~• . . . . . . . .
tG-
j_ . . ./y/
5. Builder's name . t V�-4 O!`J p^ l'f` J �!/u y�
�. . . . . . . . . . . . . . . . . . . . . . Address Y3. . . . . . . . . . . . . !. . . . . . . . .
G' � � Expiration Date . . . .3/t . .
Mass.Construction Supervisor's License No. p'
6. Use of Building:One-family . . . . . . . . .. . . . . . . . . . . Two-family . .00,4. . . . . . . . . . . . . Other . . . . . . . . . . . . . . . . . . . .
7. Number of rooms in each family unit: . . . . . . . . .S... . . . . . . .. . . Number of Bathrooms . . ..?Z'. . . . . . . . . . . . . . . .
8. Is there a garage attached? . . . . . . . . . AkO. . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Size of building . . . . jq 4-�-Attg are footage . . . . .
. . . . . . . . . . . . . .. . . . . . . . . . . . . . . .
10. Number of stories . . . . . . . . . . . . . .�./ .. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11. Distance from finished grade to high point of ro . . . . y. . . . {. • • • . . . • •
12. Type of construction . . . . . . . . . . . . . . . . . (qU . . . . . . .�La M '. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .
13. Distance from building to street line in feet . . . . . . . . . . . . 30. . . . .
14. Distance from building to side lot lines in feet:Left . . . . . . . . . . .IS, . . . . . . . . . . . Right . . . . . . . . . . . . . . . . . . . . . . . . .
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 . . . . . . . . . . . . . . . . . . . Spruce Other . . . . . . . . . . . . . . . . . . . .
18. Are all structural conditions noted on drawings? . . . . . . . . . . . . . '• . • • • .
19. Nature of land upon which the structure will be erected Natura : .. . . . . . . . . . . . . . . Filled . . . . . . . . . . . .. . . . . . .
20. Depth of basement or cellar floor below finished grade . . . . . . . . . . ./}-. . .C l�l . '• • • • • . . • • • • . • • • .• • • . .
! . .
21. Material of foundation walls . . . . . . . . . Thickness in inches . . . . . . . . . . .. . . . . . .
22. Type of roof: Flat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pitched . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23. Material or roof covering .>.
24. Method of heating . . . . . . . . . . . . . .C1/�. . . . . . ..... . . . . . .l.l.. . .. . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .
25. Will the building conform to the Building and Zoning Ordinances? . . . . . . .� . . . . . • • . . • • • . . • . . . . • • . • • • •
26. Septic Tank? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .�/. . . . . . . City Sewer? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27. Construction within 100 ft.of wetlands? . . . . . . . . . .
28. Construction within 100 year flood plain? . . . . . .. . . . . . . • •
29. Estimated cost:Total $ . . . . . . . . . . . . .l ;W 0()d. . . . . . . . . . . .
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.
1 � L 7
r
Signature of Contractor Signatu� of responsible applicant
WRITTEN DESCRIPTION OF WORK TO BE DONE
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
FEB z 8 2000
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BB -� f ¢lassacbaactt>r
D&PARTMENT OF BUILDING INSPECTIONS
212 1Glain Street ' Municipal Building '
Northampton, Mass. 01060 '
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
AT
(li permittee
with a principal place of business/residence
(strceUcity statelap)
do hereby certify, under the pains and penalties of perjury, that:
O I am an employer providing the following worker's compensation coverage for my
employees working on thus)ob:
g
( r,--- c�- � (.J C <,-(, `i S &A-- / M Q
(Insurance Company) I (Polity Number) (Fxpiratf n Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
wC-e (0uu SSutT C �
(Name of Contractor) (Insuran(-- Company/Policy Number) (Expim n Date)
(Name of Contractor) (Inszlrancz- Company/Poky Ntunber) (Expiration Date)
(Name of Contractor) (Insurance Comp iny/Poticy Number) (Expiration Date)
(Name of. ctor) insurance Company/Policy Number) (Expiration Date)
(attach additi shoot ifnooersary to include information pcts to all cocexacto—,
( I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:plan=be aware that,,0ii]c L xn nt-rTS .�'� c !,.-. t) air"CIi,m
not moeo than throo units in which the homoownrr residcs a oe the gau6 appurtentu!thrscto ate not grnaally ooesidcrcd to be
employcra under the work&i compcasatioa Act(GL152,ss 1(5)�appLicz6on by a homeowner for a Berne a permit tiny evidence the
legal rtahta of an employee under the Woricot'a C000pCmatioa Act
I undastand that a copy of this=xtemcat may be forwarded to tho Dcputmmt of Inds d Mcidca&Offioo of Ir vimDeo for the
coverage verification and that failure to t:oatrt:coverngo under seciioa 25A of MoL 152 can lead to the imposition of criminal PWAW':t
eomisting of a foe of up to S 1,500.00 and/or irv�rt of up to one year and dvU pcnaltia in the form of a Stop Work Ordcr and a
fum of 5100.00 a day against mc..
For dcp W=W uio�y
Permit Number
�- p Lot
signer of LiocnscelPern>_ittce
02/07/2000 10:45 14135B71094 NORTHAMPTON WWTP PAGE 03
�LVV.VV
in 9
FEB 2 8 2000
{
NORTHAMPTON SEWER DEPARTMENT
125 LOCUST .STREET
NORTHAMPTON, MBA. 01060
587-1092
Subject: Municipal Sewer Availabili-_y
Location: AR-5n Nnrrharn AyenliP
Inquiry Made By: David McCutcheon 529?9973
Date of Inqui.ry,. Jan-uary 26 2000
Municipal Sewer Main in Front of Location: YES X NO
Size/Material/Age of Sewer Main:_!_ 192'
Depth of Sewer Main: 61
Size of Service- Connection.:
Comments:
A corresponding "sewer entrance feel' shall be paid prior to making
any connection to the municipal sewer system. Arrangements of such
installation shall be made with the Northampton Sewer Department
with a minimum of S working days notification. All work shall
conform Northampton Sewer Department specifications.
gorge Br Am
Superintendint of Wastewater,
Treatment L Collection
cc: Samuel B. 5rindis, Director, DPW
Gilford Mooring, Assistant Director DPW
George Andrikidis, Assistant City Engineer
Anthony Patillo, Building Inspector
C:\WP51\LETTER\SEWERF0R
` 41
1
rrm
TF•:, NORTHAMPTON WATER DEPARTMENT
237 PROSPECT STREET
NORTHAMPTON, MA 01060
587-1098
subject : Municipal Water Availability
Location• 48-50 Northern A-Venue
Inquiry Made By: David McCut:cheon 529-9973
Date of Inquiry: January 26, 2000
Municipal Water Main in Front of Location: YES X NO
Size/Material/Age of Water Main: 8" A.C. pipe 1961 _
Approximate Street Pressure: 110 PSI
Size of Service Connection:
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 work shall conform to
Northampton Water Department specifications.
Itliarles Borowski
Superintendent of Water
Enclosure: Letter to Frank Sienkiewiez from Sam Brindis, dated June 14, 1991.
cc: Samuel B. Brindis, Director, DPW
Guilford Mooring, Assistant Director, DPW
George Andrikidis, Assistant City Engineer
Anthony Patillo, Building Inspector
A:\WATER\Availabl.50S
D19-00
1
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
Petitioner
NOTE: The Public Works Department recommends that you provide a
plan showing the proposed driveway with grades and location
in the future to avoid possible expense which you will incur
by not getting approval of actual plans in advance.
D19-00
C I T Y O F N 0 T H ArNPQTQO,R-,,; M A S S.
?,,g;-r
e OF January 27, 19 2000
THE BOARD OF PUBLIC WORKS
The undersigned respectfully petiition your honorable body for
Permission to install driveway at 48-50 Northern Avenue
Fifteen (15) foot maximum width at the street line. Gutter drainage not to be
disturbed. All drainage shall be directed off the driveway surface to
adjacent land and not on the existing roadway. Driveway surface to be
paved if the grade of the proposed driveway exceeds 37 or more.
By: #Hot I r-
David McCu#cheon 529-9973
P.O. Box 43, Easthampton, MA 01027
Proposed Location
Inspected by: A171—c,
Gravel Base Grade
Inspected by:
Final Approval:
THE BOARD OF PUBLIC WORKS
Voted that petition be granted.
$25.00 Fee Paid ck no #430
Samuel B. Brindis, P.E. , Director of Public Works
(SUBJECT TO ATTACHED CONDITION 1 & 2)
a
04� TOye
(rzt�r of 'Wart4aliiptoli -
L
g6. �assxchusLtte '
FEB 2 $ ZOQO
DEPARTMENT OF BUILDING INSPECTIONS
f'i O1 212 Main Street ' Municipal Building
INSPECTOR' Northainpton, Mass. 01060
Square Footage Amount
Basement @ .10 �2 C d
lst Floor @ _40 J to
2nd Floor @ .20
1/2 Floors, Attic, Garage .10
Deck, Porches .10
TOTAL
t
,
ACORD. CERTIFICATE OF LIABILITY INSURANCE 0-1/i/i kV V20luo
PRODUCER FAX (413)!86-6481 THIS CERTIFICATE 15 ISSUED ASAMA,'IF-ROF INFJRW,Tif*
k7bber & Crinnell Ins. Aycy. ONI.Y AND CONFERS NO RIG Hl$UPON,THE CERTIFICATL
HOLVER.THIS CEPYIFICATE nOES NOT AMFI3
N , FXTF-14D Oi`�
9 North King Street ALTI'R"FHE COVERAGE APFORDED BY THE PCLICIES Blz�OA/
P-0, Box 538
Nof"thZmpt0n, MA 01061 COMPANIES AFFORDING COVE-4AGE
p East crn Casualty
Attn:
!"l Fit: A
INWHED
David J. MCCutcheon GQNFANY
P 0 Bcx 43
Easthampton, MA 01027 FEB 2 CO:retw,,
THIS IS TCC0RTF-Y THAT THE PQ00CS0F INSURANCE.L1tiTF-DEEL0'/VHAVLUCEt4lS:UCDTOTH'�,INSURED NAMED ABOVE FQ;-IHE 1( LICY�ER'Or,
IN01 CA 1T,.D,NO'WlT HS TAN DING ANY REQUIREMENT,`TERM OR CCNDITI0N OF ANY CONTRACT OF OTHER DOCUMENT Wtlri R':-SPFCI
Cr-'WIFICATE MAY SE ISSUED OI'l MAY PER;AIN,THE IM30PL0.NCE AFFORDED BY THE PIXICIES DESCRIBED HL,RCPN JSSUUJEC) T4 ALL JW-'rERIVS'
,EXCLLJ,l;I0NSAND CONDITIONS OF SUCH POLICIES.LIMITS SH0�-VN MAY HA\,E E;-�E-N REDUCED ESY FAIL CLAIMS.
M I
L i' PQQCy NUMBER DATE(MMI,,�Dfyy) DATE(MM100hf) L:VITS
TR TYPE OF INSQRANCE PQ!JCYiFF(CTlVV-1 POL.IC'(EXPIKATION
GENERAL 0AfflLJY
'COM1,AF-FICIAL GCNFRAL LP WLITV IIR00006 clot"Fl(),11 ASG T
I CLAIMS MADE OCCUR PERSONAL m ADV 114,Ur y S
OWNLR'S 4 CON'rnACTORs TROT EACH CCC IRRENCC
FIRC DMAAGE(APV ore F,;'v)
WCA EAP vmy we pe'lo")
AU10MOUIlLF LIAMUTi
ANY AUTO gOMDfNFD 91N1yl.F_IMIT
ALL OWNCE)AUT09
POMILY IN,0ke
W IF;rUl EU AUTOS (Per
I MWO
Nw4-ovw4r.r?AUTOS
A-W t 71�01
AJI 0 ONLY-EA�.QIDFN
ANY AEJ P,) 0
01 HL;'THAN AL-
I
AGGPFCATO� $
EXCESS LIABILITY
i EACH OC,4,LRRE:t4nE
1 UMORFIL LA FORM
I AWREGATI:
0',lHL'rl TAN UNMRCLIA Frjkm
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY 'URY 01411s! FR
A I H C PRQFKljE70r,' WCP1000550A 04/19/1999 C4/L9/2000 EL EAW A,'.JOUNT X! C
`lARTNrRSfFXCCJTl1(F INCL 06EPSE KLC) IM,T
5 5ac coo
0 F F 2,cas r,RE
PERT) CANCEL-AON
SHOULD AN'r DF THE A15C'WE OESQRi5CEI POLICIES C6 CANCILLPO VcFOJU Ylr;
EXP)Ra„lr)ll CATE THEREOF,THE ISSUING COMP4HY W:LLLKl:)�AVQA 70 VA,L
City of Northampton i 10 -DAYSWAITTEN NOTICE'0 fNL CERTIMCIOE MO-DEH NAMCO 1,OTHr--Ll F'i,
Building Inspector u4rrA1,.UR[TO MNL SUCH P40TICC SHALL IMPOSE NOOfiLIGATION',)R LJAUAll y
3.1.2 Main Streel. c F AN"A�tr UPC" ll!�AGENIS 0Rf-,,-PRF5EN-A7;\-F�,,
Northnnipton, MA 010(io ORIZFD AEPR SLNTATVE
hard Wobber-/VDS
(OA"URD CORPORATION I£U