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23C-109 51 BAKER HILL RD BP-2019-1290 GIS#: COMMONWEALTH OF MASSACHUSETTS MaxrBlock:23C- 109 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildina DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A) Category:New Single Family House BUILDING PERMIT Permit# BP-2019-1290 Proiect9 JS-2019-002085 Est.Cosi$435000.00 Fee:$2091.20 PERMISSIONIS HEREBY GRANTED TO: Const.Class: Contractor. License: Use Group: SACKREY CONSTRUCTION 079384 Lot Size(sa.R.): 25569.72 Owner: FELDMAN DAN&DIESSNER NANCY Zoning:URB(100 Applicant: SACKREY CONSTRUCTION AT: 51 BAKER HILL RD AaalicantAddress: Phone: Insurance: 83 SOUTH MAIN ST (413) 665-9995 O Workers Comcensation SUNDERLANDMA01375 ISSUED ON.61312019 0:00:00 TO PERFORM THE FOLLOWING WORK:NEW HOME 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 Occuoancv Signature: FeeTvoe: Date Paid: Amount: Building 6/320190:00:00 $2091.20 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner 4>ivcway �mr'f5 File N RP-3019.I190 LAI Q m ar APPLICANT/CONTACT PERSON SACKREY CONSTRUCTION n ADDRESS/PHONE 83 SOUTH MAIN ST SUNDERLAND (413)663.9999 PROPERTY LOCATION 51 BAKER HILL RD MAP 23C PARCEL 109 001 ZONE URBf10001C P THIS SECTION FOR OFFICIAL USE ONLY, PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid BuildiDaPemit Eilled_gut (41 Fee Pa—A...___�.._.®....�.�. .. TyeeofConstructiom NEW HOME New Construction Non SgUctum(interior,fgpgvations Addition to Existing Accessory Structure Building Plans tncludcd� Owned Statement or License 079384 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: ✓Approved_Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Pin Major ProJeot: - Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: §,,,,,,_ Finding,_,,, . _., Special PermitVariance* Received&Reoordod u Registry of Ikeda Proof Enclosod_ Other Permits Required: „-Curb Cut ttom DPW _Water Water Availability Sewer Availability Septic Approval Board of Health Wall Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit f}om Elm Street Commission Permit DPW Storm Water Management Demolition Delay S 3l 19 Signature o�ing Official Data 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 aro granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information, /2o ((eco(o(av,u Department use only i City of Northampton Status of Permit: Building Department Curb Cut/Dnveway Permit *' 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 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 INFORMATgN 1.1 Property Address: This swdw to be completed by oBlcs $1 a}KPct� 4t" RD Map �r" Lot 10"1 nUnit Nw-ciiti N/l6A d O (Do Zone Overlay District Elm SL District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 1' DA-I,A F-ItILDMA S M40 �1Ar1,C al -C)IIf%4.k2 3-1 loAi INt4 RD.1�1`�"'a o�io1 Name(Prim) Current Mailing Address: 151- 31,- umv,I.476- 4bo- 6y6-1 Telephone Signature 2.2 Authorized Agent: ` /' B3 5 • t'+rM+d Sr(, -,olF-tiL w •SAc ¢.,�.. boaJAcka-h� �-Ms7(Z.i -' ktt•o cst,.e.o. K$A Gti ) Y— Name(Pdm) Current Mailing Address: 415 - SL3 G : 99 SignaWre Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Oficial Use Only completed bit applicant 1. Building 35-0, O-CD (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of �D l �� Construction from 6 3. Plumbing �5, 1 o1TU Building Permit Fee h 4. Mechanical(HVAC) �l/ 5.Fire Protection Z O 1 nl't7 6. Total=(1 +2+3+4+5) 1 'ul3 Check Number / This Section For Official Use Only Builth Permit Number. Date Building Issued: Signature: Building Commissionar/lnspectw of Buildings Data EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) 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 De armsmt Cot Size 51 , 3oS 5/, 305 Frontage 15 `{ 15 Y Setbacks Front 556 55 4 � Side L: R: L: %�� R: l Rear 211 D[ra-Kao lraAp 15 z5 '-tr` aKF F konAlr LI.L& Building Height .ZOt Bldg.Square Foote e % 20 lta 2014 &Lplr P 1K Open Space Footage % a/ gpp 9atVlit++01) (Lot area minus bide a paved 2&6 q�fo avna z9si 1. panding) y aJ}SiO/t N of Parking Spaces Fill: pu, €ttdw S1ftL volume a Location A. Has a Special Permit/Variance/Finding ver been issued for/on the site? NO O DONT KNOW YES O IF YES, date issued: IF YES: Was the permit recorded at the Regist of Deeds? NO O DONT KNOW YES O IF YES: enter Book Pagel and/or Document N'. B. Does the site contain a brook, body of water or wetlands? NO Gr DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained 0 , Date Issued: C. Do any signs exist on the property? YES O NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO Q-- IF /IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,ex vabon,or filling)over 1 acre or is it part of a common plan Nat will disturb over 1 acre? YES O NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicablel New Nouso Addition ❑ Replacement Windows Aheratlon(s) ❑ Roofing ❑ Or Doors 1:1 Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [p Siding[O] Other[C71 Brief Description of Proposed Work: NEw VtdWWL Ctw*<*QC-CA Alteration of existing bedroom_Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement __ —Yes No Plans Attached Roll -Sheet w.H New house and or addition to existing housing, complete the following. a. Use of building :One Family V Two Family Other b. Number of rooms in each family unit: (42 Number of Bathrooms Z Vi c. Is there a garage attached? t4o itkU-arp+aVq d. Proposed Square footage of new construction. 3�1a b BPSf;'"'—Dimensions y 7- X �f `V e. Number of stories? Z INCW06,kiccr Q,{i56,w6ya7 �L, M17 I. Method of heating? Wklauc- V"kS f U ZS Fireplaces or W oodstoves�R.5 Number of each_A WWD srevr g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction V 1. Is construction within 1008.of wetlands?_Yes ✓No. Is construction within 100 yr. floodplain_Yes_No j. Depth of basement or cellar floor below finished grade 8 I k. Will building conform to the Building and Zoning regulations? ✓ Yes No. I. Sepfic Tank_ CitySewer n�— Private well City water Supply V SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED= OMPLETED WNEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, -DA-f-1 gfLWvwM—t A"D tAP.Mc-t.. ,asOmer ofthe subject properly hereby authorizeT�ALN.p Lt..(i to act on my behalf,in all matters work aumorized by this building pe-.1 eppliwtion. Signature of Owner v1 ., ' �" ,, C�� D�at�e � P � /' 1 I, J C V-t-k I+ �rn-caw-rrc c„ �1VL O A-L�K/F-M1-r �/AL lD•, �r--V.�OwnerlAutiari ed Agent hereby declare that the statements antl in tion on the foregoing eppli 'on are true antl a rate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Jc," H . Slrck r2�a Print Name ,r S f 1 Signature of LA edAgen e SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction,Su1pe�rvlisor. Not Applicable ❑ ( c� Name of License Holder J�% U C A�- -/+-iT c License Number Address e'P"�`ano" af. Signature Telephone 0.It"Isterad Home Improvement Contractor: Not Applicable ❑ Company Name 01 Registration Number 1 i� 3d �20 Address EW tion ate Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(Ill c.182.§23C(8)) Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this a0ldavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes...... (Y' No_.... ❑ The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston, MA 02114-2017 www.massgov/dia Ulkirkers'Compecisation Insurance Affidavit:Builders/Contmcters/Eleetricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information // / Please Print Legibly Name (Business/OrgmintioMndividua0: e,7/�Lk-R.6r1 CerkU r Co T Address: City/state/zip: 5 u-" /Ir 2 Phone#: ' S'6 • 663`( Art employee!Check the appmprute box: Type Of ploject(required): I.7 empbyer with--co—employces(full arWorpan-teak).' 7. ,L,7,NNcw construction 2.❑I am a sole Pmprictoror gatmership and have no employees working ferment g, ❑Remodeling any capacity.[No workers'cons,inarrancc tortured.] 5.Cj1 an a hona:mener doh II work If. No workers'co royu; ]r 9. Demolition g e myself I cep.insurance .d. 4.111 am a homcowmr and will be hiring eonueaon to conduct all work on my Property. 1 will 10❑Building addition emu.Natall commenes cruiser have workers'compeniaten.huurm.e as.sole 1 l.❑Electrical repairs or additions pmPrictors with no employes. 12.[]Plumbing repairs or additions 50 1 am a general cuno scour and I have hired the sub-contrumora listed on me attached sheet l3 �ROOf airs These subcontract.have,"does yeand have r% ve assio comp.insu ence.f 6.❑Wa a.a corporation mM iu otf.as have exe.iaed meh right ofexenpton per MGL c. 14.C]Other 152,§1(4),and we have ne emplayea.IN.waters'coon.insmanec roguiredd *Any applicanuhat checks box dl man also fill out the section below showing mev workers'com cregron policy infommtion. I Numeowne t who submit this affidavit indicating they are doing all work and men him outside contractors must submit a new affidavit indicating such. lConuanors that check this box mug anached an additional sheet slowing the name of the subcontractors and state whether nr not those entities have cryoycev. If the mbmnaacmrs have rnployces,they must provide,their workers'comp.policy number. I am an employer that is providing workers'compensadon insurance far my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Il)k 86hrt Expiration Date: Z Z ZA Job Site Address: S I 666 ft/L WIL-A - City/State/Zip:� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expi Hon te). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up no$1,500.00 and/or one-year imprisonment,as well as civil penalties in the forth of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verifi o I do hereby c fy he s an patties of perjury that the information provided above is true and correct i Signature: Date: 7 °� Phone#: Official use only. IM not write in this area,to be completed by city or town offwial City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: City of Northampton 4 Massachusetts I� DSFMTN6NF OF BMWING INSPECTIONS I�®� 212 Nein t[eet :nipel euilEing � NortM1empton, MNr. 01060 Debris Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: 'Fr+��.uCL✓I ,S� B�/R )k, (Please print housle number and street name) Is to be disposed of at: (Please Print name aaWocation of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) Signatu a rpemnit Applicant or wrier Da(e If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. MUNICIPAL SEWER AVAILABILITY APPLICATION Northampton Streets Department 125 Locust Street Northampton, MA 01060 413-587-1570 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: 51 BAKER HILL RD Date of Inquiry: 04/25/19 Inquirer with contact info: John Sackrey Construction 413-563-6639 sackrey@crocker.com Reason for Request: New Construction Municipal Sewer Main in Front of Location: Yes ✓ No Size of Sewer Main: F Material: PVL Age: 2-Oft Depth of Sewer Main: g' Length of Sewer Main: 122' Size of Service Connection Type of Service Connection: Sl.vd �� pnr7 Ii.C Domestic Tie In: 1/ ($1,250) Subdivision Tie In : ($2,500) Tie-in to Private Sanitary:_ $-N/A Tie-in to Existing Sanitary Service: $- N/A Comments: H-,K cr ci er'ry/y Cft� r.>.. City Requires 6" cleanout installed at City Property Line Note:If this availability is for new construction,this form must be band delivered to Building Inspector. A corresponding"sewer entrance fee" shall be paid prior to making any connection to the municipal sewer system.Arrangements of such installation shall be made with the Northampton Streets Department with a minimum of 5 working days notificaiton. All work shall conform to Northampton Streets Department specifications. f_;7_' Z-1— Date: f ZZ/(a Sewer Dept Foreman O9 *Sewer Entry$ / 2�i/J �- 'Fees will be charged based on current fee structure at the time of entry ap—plication MUNICIPAL WATER AVAILABILITY APPLICATION Northampton Water Department 237 Prospect St. Northampton,MA 01060 413-587-1097 A Department of Public Works Trench Permit shall be required prior to any construction or connection activity associated with this application. Location: 51 Baker Hill Rd. Inquiry Made By: John Sackrey Construction 413-563-6639 sackrey@crocker.com (Name) (Telephone Number) Date of Inquiry: 4/25/2019 Fire Line _ Irrigation_ Domestic x Number of Units: 1 Type of Units: Type of Ownership: Single Family x Private x Apartments_ Condo_ Multi-Family_ Rental_ Commercial (Applicant to fill out the above) Municipal Water Main in Front of Location: Yes x No Existing service to site? Yes x No Size of Water Main: 6" Material: A.C. Age: 1950 Approximate Static Street Pressure: 70 PSI Flow Test Conducted: Yes No x (If flow test conducted 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' - A corresponding water enterance fee shall be paid prior to making any connection to the municipal water system. -Arrangement of such installation shall be made with the Northampton Water Department within a mimmu working Gays cork all cpn�or a ort on Water Department specifications. / l G/ (/'t'// 4/- (Water r (Water Superintendent) (Date) *Water Entry x ($1,250) Domestic *Meter $ 450 *Radio Read $150 ($2,500)Subdivision (fee to be determined) (Includes fire line ifrequired) cc: City of Northampton Building Dept./Commissioner NOTE:If this availablidy is for a new construction,it must be hand delivered to the Building Inspector *Fees will be charged based on current fee structure at the time of entry application J� 58 Baker Hill 42 48 2016 0.5 $1,008.00 42 48 2016 $0.00 11 24 -264 $0.00 3768 0.5 $1,884.00 $1,884.00 10 10 $100.00 11 24 $264.00 24 28 $672.00 $1,036.00 $207.20 $2,091.20 � I � zbc� l . 'zo Home Energy Rating Certificate Rating Date: 2019-04.12 Projected Report Registry ID: Unregistered p Ekotrope ID: pdWOgkBv HERS' Index Score: Annual Savings Home: Your home's HERS score is a relative 51 Baker • • 53performance score The lower the number., Florence, MA 01062 the more energy effimient the home.To 31714 Builder: learn mom,visit www.hersinclex.com 'Relativeto an average U.S.home Sackrey Construction Your Home's Estimated Energy Use: This home meets or exceeds the Use [MBtu] Annual Cost criteria of the following: Heating 27.5 $1,203 2015 International Energy Conservation Code Cooling 0.9 $40 Hot Water 1.8 $78 Lights/Appliances 26.2 $1,110 Service Charges $0 Generation(e.g.Solar) 0.0 $0 Total: 56.5 $2,431 rie Home Feature summary: Rating Completed by: .wire Home Type. Singlefamllydetached Energy RatimDavid Gagne Model: WA RESNETID:7013322 Fre Community: WA Condetbned Fbor Area: 3.768 sq it. 479 comp•ny:Puver House Energy Consulting 479 West St Suite 105,Amherst,MA Numbe .f lledroorn. 1 "M eive WP Primary Heating Synem: Air Scarce Heat Pump•Electric•3.0,1 COP - r°`•^'-: Primary Cooling System: Air Source Heat Pump•Electric.20 SEER Rating Pmvid•r.Energy Raters of Massachusetts Primary Water Neatens: Water 14eater•DeQrk 2 Woodlavm Street Amesbury MA 01913 •3.55 Energy Factor - Y- e House Tightness: 25 ACM50 978-270.3911 Ventilatlom 53ACPM•50.0Metts mu xom. Dua Leakage to Outside. 0CFM25 TO/100 LE.) Above Grade Walls: � Ceiling: Vaulted Rod.R-56 I� JlJlaaaLw Zm Vaulted • Wlnd. Type u-Value:0.3,SHGC:0.25 David Gagne,Certified Energy Rater FountlaOon Walls: R1 Digitally signed:4/12/19at 1058 AM eklatrope MUNICIPAL SEWER AVAILABILITY APPLICATION Northampton Streets Department 125 Locust Street Northampton,MA 01060 413-587-1570 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: 51 BAKER HILL RD Date of Inquiry: 04/25/19 Inquirer with contact info: John Sackrey Construction 413-563-6639 sackrey@crocker.com Reason for Request: New Construction Municipal Sewer Main in Front of Location: Yes ✓ No Size of Sewer Main: ? Material: PV(_ Age: 2-n l l Depth of Sewer Main: 4' Length of Sewer Main: 122' Size of Service Connection: 60 Type of Service Connection: SI-vi 1-o #Wgrt-, Domestic Tie In: ✓ ($1,250) Subdivision Tie In : ($2,500) Tie-in to Private Sanitary:_ $-N/A Tie-in to Existing Sanitary Service: $ -N/A Comments: rM,k vr ci eg;,N& clew e., City Requires 6" cleanout installed at City Property Line Note:If this availability 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 notificaiton. All work shall conform to Northampton Streets Department specifications. Date: f Z7/to Sewer Dept Foreman *Sewer Entry$ / �j 0 00— *Fees will be charged based on current fee structure at the time of entry application (, MUNICIPAL WATER AVAILABILITY APPLICATION Northampton Water Department 237 Prospect St. Northampton,MA 01060 413-587-1097 A Department of Public Works Trench Permit shall be required prior to any construction or connection activity associated with this application. Location: S1 Baker Hill Rd. Inquiry Made By: (ohn Sackrey Construction 413-563-6639 sackrey@crocker.com (Name) (Telephone Number) Date of Inquiry: 4/25/2019 Fire Line Irrigation_ Domestic x Number of Units: 1 Type of Units: Type of Ownership: Single Family x Private x Apartments_ Condo_ Multi-Family_ Rental_ Commercial (Applicant to fill out the above) Municipal Water Main in Front of Location: Yes x No Existing service to site? Yes x No_ Size of Water Main: 6" Material: A.C. Age: 1950 Approximate Static Street Pressure: 70 PSI Flow Test Conducted: Yes No x (If Flow test conducted 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' - A corresponding water enterance fee shall be paid prior to making any connection to the municipal water system. -Arrangement of such installation shall be made with the Northampton Water Department within a mimmu working Bays c on. cork all cpnFprtift ort , on Water Department specifications.'��I/ (Water Superintendent) (Date) *Water Entry x ($1,2SO) Domestic *Meter $ 450 *Radio Read $150 _ ($2,500)Subdivision (fee to be determined) (Includes fire line if required) cc: City of Northampton Building Dept./Commissioner NOTE: If this availablidy is for a new construction,it must be hand delivered to the Building Inspector *Fees will be charged based on current fee structure at the time of entry application�- aj Permit No. D 07-19 CITY OF NORTHAMPTON, MA DRIVEWAY PERMIT Dale: 04/25/19 Check 4: 1419 FEE: $250.00 Pr000sed driveway must be staked and address and/or lot number posted Public Shade Trees are protected by MGL Chapter 87. Do not cut,trim or remove any trees on City property without lite express written Permission of the Tree Warden. The undersigned respectfully petitions The Department of Public Works for: A new Curb Cut Permission to install a driveway at: 51 BAKER RILL RD. Fifteen(15)foot maximum width from street line to property line. Gutter drainage not to be disturbed. All drainage shalt be directed off the driveway surface to adjacent land and not on the existing roadway. The first one hundred(100)feet of the driveway surface shall be paved as soon as possible if the grade of the proposed driveway exceeds 3%at any point in the first one hundred(100)feet.Homeowners will be held responsible for any costs to the City of Northampton in the event of a washout of this driveway.City is not responsible for culverts installed under driveways in City layout. Code of Ordinances §350-8.8 providing standards for private, individual driveways as most recently amended,must be followed. No excavation is authorized without a valid trench permit in addition to this permit. By: JOHN SACKREY CONSTRUCTION CO. LLC Telephone: 413-563-6639 sackrey@crooker.com Signature: Superintendent-Tree Warden Hikohway Su dent Date Fores rks&Cemetery Date Proposed Location& Tree Protection R �3 Inspections Tree Protection& Gravel Base Grade Inspected Final Approval Director of Public Works Cc: Building Inspector (SUBJECT TO ATTACHED CONDITIONS 1 &2) Permit No. D 07-19 Conditions: Driveway Permit In lieu of plan approved by the 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. 1 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: Name: JOHN SACKREY CONSTRUCTION CO. Address: 83 S. Main St.,Sunderland, MA 01375 413-563-6639 sackrey@crocker.com 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. For Commercial and Industrial applicants,a plan showing the proposed driveway with grades, location and Planning Board permits are required. Cc: Building Inspector