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23D-007 (3) :X22C I Rinr i America http: / /www.rinnai.us/ direct -vent- wall - furnaces /ex22c- EX22cwn- EX2... Rin EX22C ENERGYSAVERTM Direct Vent Wall Furnace The EX22C features a 7 -stage modulating gas valve, providing comfortable, even heat to all areas of the room. It also includes LED temperature controls with memory setting feature, child safety lock and an economy mode for increased energy efficiency. • • • .'iC Dimensions Width: 29 7/8 Inches Height: 22 7/8 Inches Depth: 10 1/8 Inches Weight 57 Pounds Approved Gas Types Natural Gas or Propane Minimum /Maximum Gas Rate (Input BTUs) Natural Gas: 8,200 — 21,500 BTU Propane: 8,200 — 20,700 BTU AFUE Rating Natural Gas: 81% Propane: 82% CFM 111.3 — 162.7 Electrical AC 120 Volts, 60 Hz, 52 Watts Noise Level 33 — 42 dB Gas Connection '/" FNPT Temperature Range (Min -Max) 60 °F - 80 °F in 2° Increments 16 °C - 26 °C in 1° Increments 1 of 1 6/6/2011 1:50 PM fX17C I Rinnai America http: / /www.rinnai.us/ direct -vent -wall- furnaces /ex17c- EX17cn- EXl7cp/ • at EX17C ENERGYSAVERTM Direct Vent Wall Furnace The EX17C features a 7 -stage modulating gas valve, providing comfortable, even heat to all areas of the room. It also includes LED temperature controls with memory setting feature, child safety lock and an economy mode for increased energy efficiency. • • • • Dimensions Width: 29 7/8 Inches Height: 22 7/8 Inches Depth: 10 1/8 Inches Weight 57 Pounds Approved Gas Types Natural Gas or Propane Minimum /Maximum Gas Rate (Input BTUs) Natural Gas: 8,200 — 16,700 BTU Propane: 8,200 — 16,700 BTU AFUE Rating Natural Gas: 81% Propane: 82% CFM 111.3 —137.8 Electrical AC 120 Volts, 60 Hz, 46 Watts Noise Level 33 — 38 dB Gas Connection '/2" FNPT Temperature Range (Min -Max) 60 °F - 80 °F in 2° Increments 16 °C - 26 °C in 1° Increments 1 of 1 6/6/2011 1:51 PM . . _---------------%-----. : , . VON RIOABOCK .. , f 0 e. - la L...1sA7+1 0 MA SEERS SOURC - E . .. . , SS NONOTUCK ST. : . - FIDRECE. 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'''.• . . ___ • Information and instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." ,/,/ Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall" enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub - contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liaiility Partnerships (LLP) with no employees other than the members or, partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of • Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self - insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. • Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city'or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc said person is NOT required. to complete this_affidavit _ .._ _ _ The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, M 02111 Tel. # 617- 727 -4400 ext 406 or 1- 877 - MASSAFE Revised 11 -22 -06 Fax # 617- 727 -7749 www.mass.gov /dia f LN • The Commonwealth of Massachusetts Department of Industrial Accidents At -=--7174.- Office of Investigations ' =_ � � 600 Washington Street Boston, MA 02111 . .. ;" • , www.massgov /dia -Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians/PIumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual): \I �C Address: sa ©t.] a l C1 City /State/Zip;Fbbc " etC /IA n I b6 Z Phone. #: 1- 1 /3 - ,S �D ^ / Z3 Are you an employer? Check the appropriate box: Type of project (required): 7 1. ❑ I am a employer with 4• ❑ I am a general contractor and I employees (full and/or part- time).* have hired the sub- contractors 6. ❑ New construction 2. ❑ I 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. p Building addition [No workers' comp. insurance COQ' insurance.t 10. Electrical r airs or additions required ] 5. ❑ We are a corporation and its ❑ rep 3. I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption' per MGL 12.0 Roof repairs insurance required.] t c. 152, § 1(4), and we have no employees. [No workers' 13.0 Other 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. tContractors 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. Iam an employer that is providing workers' compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: . Policy # or Self-ins. Lic. #: Expiration Date: - Job Site Address: City/State/Zip: 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 STOPWORKORDER 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 thODIA for insurance c, erage erification. I do hereby c der the pains and , - naltie of perjury that the information provided above is true and correct. Signature: ., ' J �i-b4 ( Date: Phone #: • • 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 #: HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends 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 home owner." The building department for the City of Northampton wants person(s) who seek to use the home owner exemption, to act as their own construttion` to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation /footings (before backfill), sonotube holes (before pour), a rough building inspection (before work is concealed), insulation inspection (if required) and a final building inspection. The building department requires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work (electrical, plumbing & gas) the ' homeowner will be responsible to make sure that the trades hired secure their proper jermits in conjunction to the building permit issued, and that they get their required inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the proj such time as the proper permits and inspections are made / \ I, LbJS0(� understand the above. o .' e owner /resident's signature nesting exemption) I will call to schedule all required building inspections necessary for the building permit issued tome: Date ,2//6//7 Address of work location �� )00NEfucic 5 1- 1%,4 0/ 0 6 Z SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : License Number Address Expiration Date Signature Telephone $ Register .Ctei .tmpravertteii tibritraotaria 3 1 F 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 building permit. Signed Affidavit Attached Yes lf6 No ❑ 1 -. .o1i Ow r.. nil 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 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 Massach tts.General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. 1 The undersigned "homeowner" certifies and assumes respons ility for c mpliance with the State Building Code, City of Northampton Ordinances, State Local Zoning Laws and S e of M ssachusetts General Laws Annotated. Homeowner Signatur SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors O Accessory Bldg. gi Demolition ❑ New Signs [D] Decks [[] Siding [DJ Other [DI Brief Description o.` Proposed rnC�7 -) .� "� Work: .'iJ - X6,3'(".1 11 Sr vo �, I i ,.....r.) ,.....r.) . ,1 f ;, -- 1 - 0 5 ' ^;+ -, I 9t,, A .. ar- .1-i -'19.: Alteration of existing bedroom Yes : No Adding new bedroom Yes . N 1 Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet sa.`I iiiieW Berri ddrt6ii'ox ttit lai s hVdeiiiit e. t r"+r 611V iai : a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes 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? Yes No . I. Septic Tank City Sewer Private well City water Supply SECTION Ta - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I, , as Owner /Authorized Agent hereby declare that the 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 Print Na e _ n 2)b4 •O ! Signatu� of • er /Agent Date v Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Infor M ation Existing Proposed Required by oni This column to fill in by "" 1 t NI ' Building Depa ent Lot Size Frontage ` E ' I 'w Setbacks Front rn I D Side L: R: 1S L:I ' R: _ _'s . .C? i Rear ., Building Height 1 ! _ i Bldg. Square Footage �/� ► (l0 (% I I ? 1 . Open Space Footage �?� -, a % _ __ (Lot area minus bldg &paved = _ # �7, ___ parking) # of Parking Spaces Fill: - �,�. ,..— ..� ,,... _ (volume & Location) — , t, -- A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW 0 YES IF YES, date issued:1Z 2, i 1 1 IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW ® YES 0 IF YES: enter Book I I Pagel 1 and /or Document #:J ._M ______ . B. Does the site contain a brook, body of water or wetlands? NO a DONT KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained , Date Issued C. Do any signs exist on the property? YES 0 NO 0 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 IF YES, describe size, type and location: 1 E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. City of Northampton ® I _ : � I , � r � :14 �' Building Department '4::,::::t� -. - ,4, ; , ' - ' , :; 1 144 4 1&1-,-'- -- 1 ‘ .74 , , , e1-::,- 212 Main Street - -s� _� ~ ��.� ��` �'� ��`�� Room 100 { • rthampton, MA 01060 4 - ,, . . r y , � >587 -1240 Fax 413 - 587 - 1272 ° w 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 s Map Lot Unit S © G N ot. L ' . Zone Overlain District - J III-' /k� /fi / b f e N<.sc , / i � . 0 1 V l� 2..... Elm St. District CB District SECTION 2 PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: , ' al ."-- K'i 'cli - __ iqii.).3 -St. Name P ' ) Current Mailing Address: _ / 2 3 i (l / )1 4 Telephone / Sygfiature 2.2 Authorized Agent: Name (Print) Current Mailing Address: Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building 4 2 b bt , 6 () (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of 3. Plumbing Construction from(6) Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection xx / 6. Total (1 + 2 + 3 + 4 + 5) 4 � � ; r Qo . �. Ch Number 7, i c�r 1< — 1 This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date File # BP -2011 -0740 . C 2. i< i5T / p r65t�+) � V APPLICANT /CONTACT PERSON RIDABOCK HARRY WINTON II bi- ADDRESS/PHONE 58 NONOTUCK ST FLORENCE (413) 586 -1231 0 / Cfb Si ( Lcr :A-(6 Pi PROPERTY LOCATION 58 NONOTUCK ST tiEE b Se ((: Pa- PNO.. ''1 co of MAP 23D PARCEL 007 001 ZONE URB(100)/ CticAlf -a. I tN!;kt.Ai( 633 THIS SECTION FOR OFFICIAL USE ONLY: N (Fb j N f^ flfi1E ; t i tqt, PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE TV, % - r ZONING FORM FILLED OUT Fee Paid Building Permit Filled out t / 7 Fee Paid V Typeof Construction: CONVERT STUDIO DET ACCESSORY APARTMENT New Construction Non Structural interior renovations Addition to Existing, Accessory Structure Building Plans Included: Owner/ Statement or License 3 s ets of Plans / P Plan THE F LLOWI AC TION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN ATION PRESENTED: A pproved 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 Demolition Delay 9i �-- f/2 5/ Signature of Building 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. r r 58 NONOTUCK ST BP- 2011 -0740 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23D - 007 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ACCESSORY APARTMENT BUILDING PERMIT Permit # BP- 2011 -0740 Project # JS- 2011- 000836 Est. Cost: $25000.00 Fee: $150.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 62290.80 Owner: RIDABOCK HARRY WINTON II Zoning: URB(100)/ Applicant: RIDABOCK HARRY WINTON II AT: 58 NONOTUCK ST Applicant Address: Phone: Insurance: 58 NONOTUCK ST (413) 586 -1231 0 FLORENCEMA01062 ISSUED ON: 6/9/2011 0:00:00 TO PERFORM THE FOLLOWING WORK: CONVERT STUDIO DET ACCESSORY APARTMENT 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 6/9/2011 0:00:00 $150.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner * Official Receipt for Recording in: Hampshire County Registry of Deeds 33 King St. Northampton, Massachusetts 01060 Issued To: HARRY WINTON RIDABOCK 413 586 1231 Recording Fees * * Document Recording Description Number Book /Page Amount * * DECIS 00005991 10506 306 $75.00 RIDABOCK $75.00 Collected Amounts * * Payment Type Amount * * Check 7638 $75.00 $75.00 Total Received : $75.00 Less Total Recordings: $75.00 Change Due $.00 Thank You MARIANNE DONOHUE - Register of Deeds By: Debbie L Receipt# Date Time 0234337 03/21/2011 02:34p s Zoning Board of Appeals - Decision City of Northampton Hearing No.: ZBA -2011 -0009 Date: February 24, 2011 APPLICATION TYPE: SUBMISSION DATE: Special Permit 1/27/2011 Applicant's Name: Owner's Name: • NAME: NAME: RIDABOCK HARRY WINTON II RIDABOCK HARRY WINTON II ADDRESS: ADDRESS: 58 NONOTUCK ST 58 NONOTUCK ST TOWN: STATE: ZIP CODE: TOWN: STATE: ZIP CODE: FLORENCE MA 01062 FLORENCE MA 01062 PHONE NO.: FAX NO.: PHONE NO.: FAX NO.: (413) 586 -1231 0 (413) 586 -1231 0 EMAIL ADDRESS: EMAIL ADDRESS: Site Information: Surveyor's Name: STREET NO.: SITE ZONING: COMPANY NAME: 58 NONOTUCK ST URB(100)/ TOWN: ACTION TAKEN: ADDRESS: FLORENCE MA 01062 Grant MAR BLOCK LOT: MAP DATE: SECTION OF BYLAW: 23D 007 001 Chpt 350- 10.10: Accessory Apartments TOWN: STATE: ZIP CODE: Book: Page: 2761 018 PHONE NO.: FAX NO.: EMAIL ADDRESS: NATURE OF PROPOSED WORK: DET ACCESSORY APARTMENT HARDSHIP: CONDITION OF APPROVAL: FINDINGS: The Zoning Board approved the conversion of the existing music studio to an accessory apartment based on the information submitted with the plans. The Board found that the project met the criteria in 10.10. COULD NOT DEROGATE BECAUSE: FILING DEADLINE: MAILING DATE: HEARING CONTINUED DATE: DECISION DRAFT BY: APPEAL DATE: 1/25/2011 2/19/2011 3/3/2011 REFERRALS IN DATE: HEARING DEADLINE DATE: HEARING CLOSE DATE: FINAL SIGNING BY: APPEAL DEADLINE: 2/12/2011 4/2/2011 2/24/2011 3/10/2011 3/17/2011 FIRST ADVERTISING DATE: HEARING DATE: VOTING DATE: DECISION DATE: 2/10/2011 2/24/2011 2 /24/2011 2/25/2011 SECOND ADVERTISING DATE: HEARING TIME: VOTING DEADLINE: DECISION DEADLINE: 2/17/2011 5:30 PM 5/25/2011 6/29/2011 MEMBERS PRESENT: VOTE: - Malcolm B.E. Smith votes to Grant David Bloomberg votes to Grant Bob Riddle votes to Grant MOTION MADE BY: SECONDED BY: VOTE COUNT: DECISION: Malcolm B.E. Smith Bob Riddle 3" Approved MINUTES OF MEETING: Available in the Office of Planning & Development. I, Carolyn Misch, as agent to the Zoning Board of Appeals, certify that this is a true and accurate decision made by the Zoning Board and certify that a copy of this and all plans have been filed with the Board and the City Clerk on the date above. I certify that a copy of this decision has been mailed to the Owner and Applicant. GeoTMS® 2011 Des Lauriers Municipal Solutions, Inc. • ry � File # MP- 2011 -0059 APPLICANT /CONTACT PERSON RIDABOCK HARRY WINTON II ADDRESS/PHONE 58 NONOTUCK ST (413) 586 -1231 0 PROPERTY LOCATION 58 NONOTUCK ST MAP 23D PARCEL 007 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST �� ENCLOSED REQUIRED DATE < c ONING r m> FILLED OUT — -- r Fee Paid Building Permit Filled out Fee Paid Typeof Construction: ZPA - DET ACCESSORY APARTMENT New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans / Plot Plan THE FO LOWING 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 V 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 4404 /44 trfo‘d4 0/ Signature of Building 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 the Office of Planning & Development for more information.