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36-328 n � MUNICIPAL WATER AVAILABILITY" EEQWEE UU Northampton Water Department AUG 2 1 2002 237 Prospect St. DEF? OF BUILDING INSPECTIONS Northampton, MA 01060 NnRTNP°?TON, MO 587 -1098 Location: 210 Cardinal Way Lot #24 Inquiry Made By: Ronald Canon 527 -5766 Date of Inquiry: 08 -05 -02 Municipal Water Main in Front of Location: Yes x No Size of Water Main: 12" Material: DI Age: 2002 Approximate Street Pressure: 72 PSI Size of Service Connection: 1" Copper Comments: The Water Department cannot guarantee adequate water pressure during peak demand times at elevations above 320 feet. The City of Northampton has not accepted responsibility for the maintenance of the water main and service connections as of this date of inquiry. 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 Wate D • a • vent with a mini n of 5 working days notification. All work shall conform to orthampton ater De a It specifications. Charles Borowski, Superintendent of Water cc: Ned Huntley, Asst. City Engineer Anthony Patillo, Building Inspector . 4 FIRE HYI BRANCH ASS STA. 28 +0 12 "x6" ANCHC W/THRUST .ET 6" GATE VALVE 6" D.I. NIPPLE, a 1 AS REQUIRED. HYI } M.J., THRUST s 0 S 6 G G c W12" 13'1 o- 216 +00 W t Y W 12' 2 7+ 00 W 12' W 12' u _ - I _ rn - .� — -+ — — — -+ N78'06'49-W - — — -+ n1' 186:34' �— v rn i0 S3't- > S3" >S3" S3" ss- - I► - - Ir SS SS • �p T � " " o CITY OF NORTHAMPTON, MASSACHUSETTS \ — . _T DEPARTMENT OF PUBLIC WORKS _ � j s Street Northampto Locu , MA 01060 413 - 587 -1570 Samuel B. Brindis, P.E. Fax 413 - 587 -1576 Director, City Engineer Guilford B. Mooring, P.E. Assistant Director of Public Works BOARD OF PUBLIC WORKS DRIVEWAY PERMIT GENERAL INSTRUCTIONS AND REGULATIONS 1. A "Driveway Permit" is required in all cases where a new curb cut or an alteration to an existing curb cut is proposed on a City public way. 2. Driveway permits issued by the Board of Public Works (BPW) shall be attached to and become part of the "Building Permit" issued by the Building Inspector. 3. Prior to the issuance of a "Building Permit" the owner of any lot to be serviced by a new driveway shall apply to the BPW for a "Driveway Permit" by completing the pertinent portions of the permit (see attached). Once the location of the driveway is approved by the BPW, a building permit may be issued. 4. The Building Inspector shall not issue an "Occupancy Permit" unless the driveway to the lot has been approved by the BPW. 5. By the issuance of a driveway permit for the stated location, neither the City of Northampton nor the Department of Public Works imply that no drainage problems will result with the driveway when constructed. Properties situated or driveways installed in low lying areas in the path of the natural drainage will be subject to water problems. These problems may include water sheeting across roadways adjacent to the driveway. The City and the DPW assume no responsibility for any such drainage problems. The owner of the property is responsible for constructing and maintaining the driveway with adequate provision for natural - water runoff situations, C6 ?mue1 B Brindis, P.E. Director of Public Works C:1MyFiles\Lyn\Driveway Permit General Instructions Permit No. D06 - 03 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. B y : etiptJ Ronald J. C ano n oner 527 -5766 13 Kylene Circle Southampton, MA 01073 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. } • ♦ i Permit No. D05 -03 ( M, 6 NnP1- CITY OF NORTHAMPTON, MA DRIVEWAY PERMIT Date: 08 -05 -02 FEE: $25.00 CHECK #: 1379 THE BOARD OF PUBLIC WORKS The undersigned respectfully petitions your honorable body for: Permission to install a driveway at 210 Cardinal Way Fifteen (15) foot maximum width at the street line. Gutter drainage not to be disturbed. All drainage shall be directed off the driveway surface to adjacent land and not on the existing roadway. Driveway surface to be paved if the grade of the proposed driveway exceeds 3% or more. \ By: Ronald J. Canon 13 Kylene Circle, Sourthampton, MA 01073 Telephone #: 411- S97 -S76 Proposed Location Inspected By: l O Gravel Base Grade Inspected By: Final Approval THE BOARD OF PUBLIC WORKS voted that petition be granted. George Andrikidis Director of Public Works (SUBJECT TO ATTACHED CONDITION 1 & 2) < hi:771? Tv&iip.J .....,. ( itr2"99l 3.61 9LS (... -Jtv.7 .....0 ...ir yr /514 , S L g + s'8 .......- ..... ..... A 45E/8 . , ......._,.... r I' r 1 - --, - --r-- - ______ lx/Sf•Z ---8 , 1 I ,Ivr,JV9 i 1 43-179-9Sh ---- o . Pr) 1 i cs 1 rizo I ,' CO i 1 tvutiA ei 1 , I : I 44..cy I , EE --- 1 ,.- - --47 i____i____ i I --- _ ___ E E _ CNI 1 r. 4 j II Csi I • I . , z I I 1.-... ,.... I . 1 .. 1 z 1 I 1 I . . -------------- - k- mot° vA. NO i al iii-i W04_, I . SNO1103:177Mtlillti JO Ici 3U , . ........... - OnV '1 t 7d-Q 9/.1:10 .fr. • 5 ( i # `21 1 3 - R B1 • ...., ,.., s OL:601 . M Z gq ---- . e ` kF 7 LL 4� b f �J�� ;$y�L17 c}4 t O � (tWd p� i �Rx. Y s w ;a (J it of Narfji�mpfon _ . �� j�, ~� �A737cCh 116f CIE i =i= - DEPARTMENT OF BUILDING INSPECTIONS 74 - i "- _3-- INSPECTOR 212 Main Street ' Municipal Building `% 4 Northampton, Mass. 01060 - Square Footage Amount Basement @ .10 J 7L /57 1st Floor @ .40 /2,590 3�,(90 c 2nd Floor @ .20 C � �� + 1/2 Floors, Attic, Garage .10 ` � � L /si �� Deck, Porches .10 . ?00 '30 , f7.:7 TOTAL l ff ZO/ Z V 2 I ° (.-7/ t()1144 , • Aug 14 02 10:50a DPW 413587157G p .8 MUNICIPAL WATER AVAILABILITY Northampton Water Department 237 Prospect St. Northampton, MA 01060 587 -1098 Location: 210 Cardinal Way Lot #24 Inquiry Made By: Ronald Canon 527 -5766 Date of Inquiry: 08 -05 -02 Municipal Water Main in Front of Location: Yes No Size of Water Main: Material: Age: Approximate Street Pressure: PSI Size of Service Connection: Comments: The Water Department cannot guarantee adequate water pressure during peak demand tithes at elevations above 320 feet. This subdivision was approved by the Northampton Planning Board on 5/23/02. It is the responsibility of the developer to provide the necessary infrastructure as shown on the approved plans. 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. . Charles Borowski, Superintendent of Water cc: Ned Huntley, Asst. City Engineer Anthony Patillo, Building Inspector v. ECEMEB, MUNICIPAL SEWER AVAILABILITY ll Northampton Streets Department AUG 2 2002 125 Locust Street Northampton, MA 01060 DEPT OF BUILDING INSPECTIONS NORTI TON, VA 01060 587 -1570 Location: 210 - Cardinal Way Lot 124 Inquiry Made By: Ronald Canon 527 -5766 Date of Inquiry: 08 -05 -02 Municipal Sewer Main in Front of Location: Yes X No Size of Sewer Main: 2" M a t er i al: PVC Age: 2002 Depth of Sewer Main: 5' Size of Service Connection: 1 -k" PVC Comments: The City of Northampton has not accepted responsibility for the maintenance of the sewer main and service connections as of this date of inquiry_ 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. Joseph Thomas, Superintendent Streets Department cc: Ned Huntley, Asst. City Engineer Anthony Patillo, Building Inspector 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 0.5 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) • [ ] When installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L /s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. Vapor Retarder: [ ] Required on the warm - in - winter side of all non - vented framed ceilings, walls, and floors. Materials Identification: [ ] 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, glazing U- factors, and heating equipment efficiency must be clearly marked on the building plans or specifications. Duct Insulation: [ ] Ducts shall be insulated per Table J4.4.7.1. Duct Construction: [ ] All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities /spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ ] The HVAC system must provide a means for balancing air and water systems. Temperature Controls: [ ] 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. Heating and Cooling Equipment Sizing: [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. 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 120 ° F or chilled fluids below 55 ° F must be insulated to the levels in Table 2. MECcheck Inspection Checklist Massachusetts Energy Code MECcheck Software Version 3.3 Release lc DATE: 08/02/02 TITLE: Lot 24 Cardinal Way Bldg. Dept. Use Ceilings: [ ] 1. Ceiling 1: Flat Ceiling or Scissor Truss, R -38.0 cavity insulation Comments: [ ] 2. Ceiling 3: Flat Ceiling or Scissor Truss, R -38.0 cavity insulation Comments: [ ] 3. Ceiling 6: Cathedral Ceiling (no attic), R -30.0 cavity insulation Comments: Above -Grade Walls: [ ] 1. Wall 1: Wood Frame, 16" o.c., R -13.0 cavity insulation Comments: [ ] 2. Wall 2: Wood Frame, 16" o.c., R -13.0 cavity insulation Comments: Windows: [ ] 1. Window 1: Metal Frame with Thermal Break, Double Pane with Low -E, U- factor: 0.320 For windows without labeled U- factors, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments: Doors: [ ] 1. Door 1: Solid, U- factor: 0.270 Comments: [ ] 2. Door 2: Solid, U- factor: 0.270 Comments: [ ] 3. Door 3: Glass, U- factor: 0.300 # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments: Floors: [ ] 1. Floor 1: All -Wood Joist/Truss, Over Unconditioned Space, R -13.0 cavity insulation Comments: Heating and Cooling Equipment: [ ] 1. Air Conditioner 2: Electric Central Air, 10 SEER or higher Make and Model Number [ ] 2. Furnace 2: Forced Hot Air, 84 AFUE or higher Make and Model Number Air Leakage: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. 4 plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in MECcheck Version 3.3 Release lc and to comply with the mandatory requirements listed in the MECcheck Inspection Checklist. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer , 1� � l�Z ; �2 er Date . % E V„ L c_,', 4 .1_1- __ \ \ 4 \ \ ; I i E p _ \ Permit Number __.1_ \ C 1,--- s �IPt` t C �" MECcheck 1 1 !, : . ' eport Checked By/Date Massachusetts Energy Code MECcheck Software Version 3.3 Release lc Data filename: C:\Program Files \Check\MECcheck\Lot 24 Cardinal Way.cck TITLE: Lot 24 Cardinal Way flomSS `"210 CITY: Southampton STATE: Massachusetts HDD: 6404 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non- Electric Resistance) DATE: 08/02/02 DATE OF PLANS: 8/2/02 PROJECT INFORMATION: Single family /w 2 Car garage COMPANY INFORMATION: Ronald J. Canon Building Contractor COMPLIANCE: Passes Maximum UA = 447 Your Home = 420 6.0% Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R -Value R -Value U- Factor UA Ceiling 1: Flat Ceiling or Scissor Truss 567 38.0 0.0 17 Ceiling 3: Flat Ceiling or Scissor Truss 500 38.0 0.0 15 Ceiling 6: Cathedral Ceiling (no attic) 440 30.0 0.0 15 Wall 1: Wood Frame, 16" o.c. 1550 13.0 0.0 127 Wall 2: Wood Frame, 16" o.c. 900 13.0 0.0 49 Window 1: Metal Frame with Thermal Break, Double Pane with Low -E 215 0.320 69 Door 1: Solid 18 0.270 5 Door 2: Solid 33 0.270 9 Door 3: Glass 40 0.300 12 Floor 1: All -Wood Joist/Truss, Over Unconditioned Space 1600 13.0 0.0 102 Air Conditioner 2: Electric Central Air, 10 SEER Furnace 2: Forced Hot Air, 84 AFUE COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building • n. C E CI ���? L C / E I lisAuP7 ), 1 � 1i . i ' t � 11 t i of NartEEantptian 1 . °* 4. 9 ��� r.; Ansaacllaatits' _" ; DEPT ni El l t t iNr, INsT IS �, - N , r u c k ` I", "4 P I I =)DEPAR ENT OP BUILDD/G INSPECTIONS t , 212 Main Street Municipal Building Northampton, Mass. 01060 err' WOR CER'S COMPENSATION INSURANCE AI Ji.WAVIT I, /' ;ii (A xel ) (lipermittee) with a principal place of business/residence . • 4-3 (/<'11 <'- C/1:4)' ' , : 7r:a /1y` ^-', /rf‘l! , ' #) <//. i77 5766 (sl cet/city /starrierp) do hereby certify, under the pains and penalties of perjury, that: ( ) I am an employer providing the following worker's compensation coverage for my employees working on this job: • (Insurance Company) (Policy Number) (Expiration Date) (1) 1 am a sole proprietor, Cral contractor r homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: eo/f6 Agency, 10cst eld . D id ( _ o n o ' ' /, -Co -- 672 -X - 5 7o -rc i-ol _ s'/2 6/az (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) kT r►?e-S Welloo6t.s pt a" b, -t- H e A t 4 - Fi ck-f- P rrdS Ple'1 7067 W7/o (Name of Contractor) (Insurance Company /Policy Number) (Expiration Date) C-CD Lod), cv r c,-x Agexc' t{euitA P . Fiodle, r1 ?Z3 2. /OHO Z (Name of Contractor) (Insurance Company/Policy Nwaiber) (Expiation Date) 69055 + OC (al n Acing Gary (oniptei9 Flec6-)aavt 4,f/N4(i52oO 61/10.? (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additioml shod if mastery to include information pertaining to ell ccat odors) i 04 am a sole proprietor and have no one w orinng for me. ( ) 1 am a home owner performing all the work myself. • • NOTE: purse be aware that while bomeowucn who crzploy persons to do ata rttc , e, wasuuction or repair work on a dwelling of not more than three units in which the homeowner resides or on the grounds appurtenant thereto arc not generally 000sidered to be anployers under the worker's sauna Act (GL152,ss I (5)), application by a homeowner for a license or permit may evidence the legal status of an employer under the Worker's Compensation Act. I understand that a copy of thic etatemem may bo forwarded to the Deportment of Inct atrial Accident,' Oflioo of Insurance for the coverage ve ificsiioe and that failure to nrexurt: coverage under section 25A of MCL 152 can lead to the ita of criminal penalties consisti of a floe of up to $1, 500.00 and/or imprisonment of up to one yzrr and civil penalties in the form of a Stop Work Order and a ' fun of S 100.00 a day against. roc. For departmental tun only 1 • • S`C.�� ON $ �CO1f�3RUCiTIPN 8.1 Licensed Construction Supervisor: f / Not Applicable ❑ , Name of License Holder : 1 C��? T t � — 4"1 4. 11 i 7 License Number ��// { �r lJ ffc fl�''/iE` �' (Tl4e'_ . )� ?t � - / J7 . `/61 7, Address � Expiration Date Signature Telephone .: : m.M e-:_..,, Not Applicable ❑ . v men r. c• r x U 1 1 fE �.; 1 ! ✓ t�, cJ' i' ° C _. "z, /,-"/Z...7, Company Name ./ Registration Number / -, ,/ e . .(' cs of !1 / /e,- e C _' t to s��' J/ ,✓. ? v d Address Expiration ate Telephone J 7 - 7 " S ECTION 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 affida will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes ❑ No ❑ I WR r .r°'ve `£ 0 i 8 e F IB f' The current exemption for "homeowners" was extended to include Owner- occupied Dwellings of one (1) or two(2) familie 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 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( 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 j -- SECT ION 5 DESC RIPTION OF' PROPOSE W012KYchecki all appl icable) 4 _z:S ,u .Ka ...-« ,n t, sr _4.- ;°ud,. , e.�R�,ti n,• ,,r_. ,. , aa. <z�?,a 3�., ,.;�u 3 ... . . -a >b»wc,..;... o' ;• ,_,fix . ,?.,...h ..Iw 3'3cr ., rana �3,a�ea• - - rp New House *.( Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ DemolitionD New Sig pecks [ ote,r g [ ] _Other [ ] Brief Description of Proposed Work: / ( / ! G / s / / 1 9 / . ' CGA, 4.4 p a i d i r l ' W / L c4 - _! ara Alteration of existing bedroom _ Yes No Adding new bedroom Yes No Attached Narrative ❑ Renovating unfinished basement Yes . No Plans Attached Roll ❑ • Sheet ❑ Oil fZ N WiliTi se nd or dit %on ode Kt firt�o icing te— dinplete tt f ill s : a. Use of building : One Family , Two Family Other b. Number of rooms in each family unit: S Number of Bathrooms . i'L c. Is there a garage attached? l '� d. Proposed Square footage of new construction. t _ L - Di mensions ` T ` f '' Xy7 e. Number of stories? f. Method of heating? 6G1 Fireplac br Woodstoves 6_f/4.- Number of each I g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? �5 h. Type of construction i i. Is construction within 100 ft. of wetlands? Yes X No. Is construction within 100 yr. floodplain Yes -. No j. Depth of basement or cellar floor below finished grade ' k. Will building conform to the Building and Zoning regulations? A Yes No . I. Septic Tank City Sewer:' Private well City water Supply X SECTION 7a - .OWNER AUTHORIZATION ,TO, B E COMPLETED WHEN OWNERS AGENT. OR CONTRACTOR APPLUES: FOR -BUILDING PERMIT I, , as Owner of the subject proper hereby authorize to act my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date MfgIIIIIII I, i / ( -,,' -"XL- , as Owner /Authorized Agent hereby declare that the statem s and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the ains and penalties of perjury. Print Name r , f"--".,61://, c ,J d / 2— 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 column to be filled in by Building Department Lot Size ` 0' / C, O?7Z) 1?-3 Frontage L ) 6) g Setbacks Front Ho t Side L: R: L: 33 / R: Rear rib/ c) Building Height Bldg. Square Footage G 70 O / Open Space Footage % (� (Lot area minus bldg & paved 17 ObO (j / %i parking) ? J C # of Parking Spaces Z Fill: (volume & Location) N 1`-'ei A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO DON'T KNOW YES / IF YES, date issued: Ott/ , IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES /r. IF YES: enter Book 6 ` Page /67 and /or Document # B. Does the site contain a brook, body of water or wetlands? NO `° DON'T 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 r't i t� -� -\ � y of Northampton S '�s� �:.'&1.-.": ��!,' 1`� ��` : Department (G e m �b��� E � :12 Main Street lSept Agar a® �, I1 , Room 100 1 e I AVaI ®j[ ' � s�� ® < l _ - cCILI-3\t)9ININo_rth8.7m_ip2t400n, -- ,lam ° ,: -- -- ,�� ` NSr oom 00 0 Ewa :St�;of Struc = ":,',1-'4,-;', ' � 04 ����� Fax 1272 Pi lSltePla s r. A . Ot erSpec►f , m ��� T.,zc»���,a =''',>a:�i, � :.. ,s�� x`t APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING 'SECTION 1. SITE INFORMATION 1.1 Property Address: This se on to be com:leted by office a CL 2ci) 4 2 to Cur -dine a ,a- Ma ot °" UnI Zone ' „ : � ` ; Overlay Di y �� - Elm St. `District CB D istrict SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: 0,073 Ro nA J a r,nr;' 13 Ie: ' � ' � � S o c4. Name (Print) Current Mailing Address: v fez,. Telephone Signature 2.2 Authorized Agent: Name (Print) Current Mailing Address: Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item E stimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building 7/,7 Ud ° (a) Building Permit Fee 2. Electrical 7 5 Q (b) Estimated Total Cost of i Construction from (6) 3. Plumbing SO © Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection , 5°3 6. Total = (1 + 2 + 3 + 4 + 5) �,� 1 3 l oo Check Number /3,S722 41 97A6° j� Section.For Official Use.O Building' Permit Number: tiff ! Date Issued:. Signature: Build Comm issioner /inspector of Buildings Date File # BP- 2003 -0136 APPLICANT /CONTACT PERSON RONALD CANON ADDRESS/PHONE 13 KYLENE CIRCLE (413) 527 -5766 PROPERTY LOCATION LOT #24) - 210 CARDINAL WAY MAP 36 PARCEL 328 001 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out � T � Fee Paid ($9 6 0 Typeof Construction: CONSTRUCT 2 STORY SFH W /ATT GARAGE/DECK/PROCH/FIREPLACE New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 05367 `(" 3 sets of Plans / Plot Plan // THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOTION 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 �►� • Signature of Buil g Officia, Date a 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. k ' 4114 I 11 , t ; 3136 G'. IS # COMMO OF MAS ', ` , � - . CI T Y OF TORTHAMPT N NCao$1o 36w 2 :; N Lot -00 11 i "� u , , ui Permit Building Category: BUILDING PER Permit# BP•2003 -0136 Project # JS -2003 -0263 Est. Cost: $131500.00 Fee: $982.60 PERMISSION IS HEREBY GRANTED TO: Coast. Class: 5B Contractor: License: Use Group: R4 RONALD CANON 053675 Lot Size(sq. ft.): Owner: RONALD CANON Zoning: SR App licant: RON CANON AT: LOT #24) - 210 CARDINAL WAY Applicant Address: Phone Insurance: 13 KYLENE CIRCLE (413) 527 - 5766 SOUTHAMPTONMA01073 ISSUED ON :8/23/02 0 :00 :00 TO PERFORM THE FOLLOWING WORK :CONSTRUCT 2 STORY SFH W /ATT GARAGE /DECK /PROCH /FIREPLACE POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Z/23—/ 'Meter: f Footings: Roughv c J � Rough: , , -� House # Foundation � '��� '� -J `� y / 74.: , � Driveway Final: �¢ '��; sc �� c.: Final://3441 " " "4 Fina14 %$ 3 D ���s .- —y= =�( (7 ' Rough gh Frame: a il l --c Gas: CJ�►? f Fire Department Fireplace /Chimneys f.errit Rough: Oil: Insulation: © 11 j c Final: Smoke: -(7/- 7- �s3 (( Final: ©� 7 Q3- THIS P ' e itE ) °BY "THE CITY OF NORTHAMPTON UPON VIOLATI OF ________,45,-4" . ANY OF ITS RULES AND REGULATIONS. i/j Certificate of Occupancy ,..,/-' Signature: Fee Type: Rece No Date Paid: Check No: Amount: Building 1380 $982.60 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo