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36-228 (3) z y ,r ILI did 4 V WIN d � � LL 9 ..1 V` _ J 0 ' 1 �0 I i i Z OL i I I c� 1 J I I � I I d I � V' I I ob� 1 6�j '1 �.t (, n 0 P c-' FT 3 � o< < 19 Y l �- �. Q-- C�l � 3 q� F �3 z ! _n -Q El r I c • i t ! . 1 I I _ o r I • I C i ss i p z� z �l TH 7F < �� I F t �j z z � = T fillibUlSa- A p T!a IV (p O F j � r r *A i -� L Q � Z 4 3 ' P l II L LS � 3 C� I � r .4--- tt S444 FT � I T �sp -P4, Z tr,r.e.at i X Glri•T Z C � i x" f ! VIG4 G �} Q I n 4 � szr� r T p c, c- A FT 3 � 1 4� 3 RT Now- z �o • i t ! ' V JI -T w i Ii i o <� i I C P z i s N � 9 Z Z _ � IL J i .a I� v p i -Y R z F 3 ' � Z d 3 D L - � i ( J lob d lit Ck) o i x �Vo -� Q c _a PA 4_ _ lu. /N I A ! � i i ? 1; ICY F � s z .y� �r a' <� COMMONWrEALTH OF MASSACHUSETTS by EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS j DEPARTMENT OF ENVIRONMENTAL PROTECTION .'� ONE WINTER STREET. BOSTON. AtA 02108 617-292.5$00 W'ILLIAV F WELD Govcmor ARGEO PAUL CELLUCCI I Lt.Govemor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION�ti C Property Address: mss' � �'! r �I CI Address of Owner: Date of Inspection: �% �� J (If different) Name of Inspector: r,3 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: L J fa- /`. -5 Fc- j? T( c Mailing Address: 4 ' y r� C— < L V Telephone Number: CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported bel and complete as of the time of inspection. The inspection was performed based on my training and experience in the p maintenance of on-site sewage disposal systems. The system: asses Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: Date: The Svstem Inspector shal submit a copy of this inspection report to the Approving Authority within thirty(30) days inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the syst the report to the appropriate regional office of the Department of Environmental Protection. The original should be and copies sent to the buyer, if applicable, and the approving authority. ,ei _ INSPECTION SUMMARY Chec Ay $, C, or D: f Af j SYSTEM PASSES: V I have not found any information which indicates that the system violates any of the failure criteria as de Any failure criteria not evaluated are indicated below. COMMENTS: BI SYSTEM CONDITIONALLY PASSESt One or more system components as described in the"Conditional Pass" section need to be replaced c completion of the replacement or repair, as approved by the Board of Health,will pass. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not del The septic tank is metal, unless the owner or operator has provided the system inspector wi Compliance (attached) indicating that the tank was installed within twenty(20)years prior t the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial it failure is imminent. The system will pass inspection if the existing septic tank is replaced i as approved by the Board of Health. (revised 04/25/97) page 1 of 10 DEP on the World Wide Wet. http:/mww.ma9rtst.statr.ma.u3rd*p Printed on Recycled Paper 4 a 70 'C3 rn m z Z rn z m jO z C4 Z Cli rn Uj Zoning Miscellaneous Additions,Repairs,Alterations,etc. '' Tel.No. -5 ' L J� Alterations s NORTHAMPTON, MASS. �f - 19 Additions ' ' APPLICATION FOR PERMIT TO ALTER Repair / J f/ Garage 1. Location �( /l/ir i/-fir°/rte/- /.n.��' Lot No. 2. Owner's name Address WX,11, I`F� rof 3. Builder's name cXe- ��'�,.r fr%,r Address " F' r—'/' Mass.Construction Supervisor's License No. Expiration Date X//%'X 'f 4. Addition ..7 5. Alteration / °%a c,7ak i���`� 7 �i�r./n.r �` � r�L 'r�cv d t✓ �'r�i: /r�,u� �'�' r�. 6. New Porch' 7. Is existing building to be demolished? 8. Repair after the fire 9. Garage No.of cars Size 10. Method of heating Zi,/ LJG1�r� 11. Distance to lot lines 12. Type of roof rt � 13. Siding house C el�-I c i 14. Estimated COSL%il The undersigned certifies that the above statcments are true to the best of his. knowledge and belief. Signature of responsible appicant Remarks (5 + XT 2 6 � Y.;, �aaaarflnsrtts EPY OF SUtLDING IA; EPARTMENT OF BUILDING INSPECTIONS 212 Main Street a Municipal Building ' Northampton, Mass. 01060 WORKEWS COMPENSATION INSURANCE AFFIDAVIT (licensa./permittee) with a principal place of business/residence at: , , ; }/�%�� ,; (phone#) (street/ci staiehip) do hereby certify, under the pains and pen ties 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) (Fxpiration Date) (--Yf 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: time of ontractor) (Insurance Co /Policy Number) (Expiration Date) (Name of Contractor) ere mparry/Policy Number) (E iration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (atta.dt addidocal rfioa if necmuy to wchu information pertaining to all coatmcc ) (Ia a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:pie=be avr=that whilo homeowners who employ persons to do maiauaaace oonshvctioa or repair work on a dwelling of not mode than throe unite m which the homeowner resides or oa the grounds appurtenant tbereto an not geowaily comidcred to be employers under the vas compensation Act(GL152.=1(5))�application by a homomw far a license or permit may evidence the legal atahu of an employer under the Wockeen Compa ndion Ad I understand that a copy of this uatemcid may be forwarded to the Deput me t of in&ntrial Accidra&Offioc of Imunaoe for the coverage verification and that failure to aoratro eoveragu under section 25A of MGL 152 can lead to tbo imposition of criminal penaltics oombemg of a fine ofup to$1,500.00 andler mtpruonmerd of up to one year and civil penalties in the form of a Stop Work Order and a fine of S 100.00 a day against tae For drysrtmMul lino only Permit Number / Maps Lot# 1�s Signature of ucenseeJ mittce ^•ali��71[ko-.+i+'iifirSidiarit�ilor. . 10. Do any signs ebst on the property? YES NO IF YES,describe size,type and location: Are there any proposed changes to or additions of signs intended for the property?YES NO IF YES,describe size,type and location: 21v ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. This colu= to bs filled in by the Bcilding Department Required Existing Proposed By Zoning Lot size Frontage Setbacks - side L• R: L: R: - rear Building height Bldg Square footage %Open Space: (Lot area minus bldg &paved parking) # of "Parking spaces f of Loading Docks Fill: (vol-ume--& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. APPLICANT'S SIGNATURE ''' fr�Lr ,� �' r� `f NOTE: Issuanoe of a zoning permit does not relieve an appiioanra burden to oomply witt�701l Czoning requirements and obtain all required permits from the Board of Health. Conservation ommission. Department of Publio Works and other applionbie permit granting authorities. FILE if i a ocr 2 6 :1 I DEPT SttILDIILOtNG 1" ' Fi 1 e No ��,5 ZONING PERMIT APPLICATION (§I0 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: f���``��,; Telephone: . J 1 2. Owner of 4- )z Address: `�` ���ln f��, f'i< V ./i' , Z� Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee Other(exxplain):��;� 4. Job Location: � -.ej1?('_ Parcel Id: Zoning Map# Parcel# �a District(s): /�- (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property 6. Description of Proposed Upe/Work/Project/O cupation: (Use additional sheets if necessary): '�/ 1 wen ( r IV 40 tlk Attached Plans:Sketch Plan Site Plan Engineered/Surveyed Plans Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW � YES IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW YES IF YES: enter Book Page and/or Document# 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: (FORM CONTINUES ON OTHER SIDE) File#BP-2000-0445 APPLICANT/CONTACT PERSON Richard Constant ADDRESS/PHONE 3 Blueberry Bend (413)532-5654 PROPERTY LOCATION 48 WINTERBERRY LANE MAP 36 PARCEL 228 ZONE SR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction:_REMODEL KITCHEN,BATH&ENTRY WAY AREA&SPACE ABOVE GARAGE FOR FAMILY ROOM New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 057246 3 sets of Plans/Plot Plan THE OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: Approved as presented/based on information presented. Denied as presented: Special Permit and/or Site Plan Required under: § PLANNING BOARD ZONING BOARD Received&Recorded at Registry of Deeds Proof Enclosed Finding Required under: § —w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Variance Required under: § —w/ZONING BOARD OF APPEALS 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 Comm' n 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. 48 WINTERBERRY LANE BP-2000-0445 GIS#: COMMONWEALTH OF MASSACHUSETTS Map-Block: 36-228 CITY OF NORTHAMPTON Lot: -001 Permit: Buildinq Category:renovation BUILDING PERMIT Permit# BP-2000-0445 Project# JS-2000-0771 Est.Cost: $62648.00 Fee: $313.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: S -6 Contractor: License: Use Group: R-d-1 Richard Constant 057246 Lot Size(s9. 1): 75358.80 Owner: MATRONI AMI&BOB MARMOR Zoning_SR Applicant: Richard Constant AT. 48 WINTERBERRY LANE Applicant Address: Phone: Insurance: 3 Blueberry Bend (413) 532-5654 SOUTH HADLEY 01075 ISSUED ON.1112199 0:00:00 TO PERFORM THE FOLLOWING WORK.-REMODEL KITCHEN,BATH & ENTRY WAY AREA & SPACE ABOVE GARAGE FOR FAMILY ROOM POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: 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: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 11/2/99 0:00:00 $313.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo L M 4a WINTERBERRY LANE BP-2000-0445 GIs#: COMM ,LTH OF MASSACHUSETTS a :B lock:36-2281 1 OF NORTHATON Lot:-0Q1 Permit: Building Categggy;reno�ion BUY.DING PEMIT Permit# BP-20110-0445 - ProiW# I I IS-2000-0771 Est-.Corti 92-648.00 Fee.$311 00 PERMISSION IS HEREBY GRANTED TO: Coast.Class; Contractor Licenser Use Groin Richard Constant 057246 Lot Size(sq. ft.): 75358-80 , Owner: MATRONI AMI&BOB MARMOR AtUIfciM Rrcha a 2rori}Ig:S1lt tc3 can t:ar,:. _ AL. 48 WINTEfIBERRY LANE i ,I(gant Adds: Ph�one: Insurance: 3 Blueberry Bend (413) 532-5t;A- SOUTH HADLEY 01075 ISSUED ON.-ILY 99 0:40.011 TO PERFORM THE FOLLOWING WORK.-REMODEL KITCHEN BATH & ENTRY WAY AREA &' SPACE ABOVE GARAGE FOR FAMILY ROOM P T MS C SO IT IS YI&IBLE FROM THE§TMET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: ' Meter: �/ Footings- Rough: Rou h• -2 ' House# Foundation. Final: ,�"{��71 �-- �' . ( Rough France: p 1'C la 01 Gas dire Depagglent Fireplace/Chimney: �Tiougfi: - - - _ :_ �• - _ .: __ Insutatioe[. � ,��� Final; Smoke: Final: - 77 PERM`MAY RE REVOKED BY THE CITY OF ORTHAMPTON UPON VIOL TION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occuoancy i tore: Fee Tyne: Receigt No: Date Paid: Check No: Amount: Building 11/21990:00:00 $313.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo sow r.