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25C-269 Home Energy Rating Certificate RatinRgNu ber HERS-324 Certified Energy Rater Matt Turcotte 33 1/2 Northern Ave Unit 1 Rating Date 6/19/14 Northampton, MA 01060 Rating Ordered For Estimated Annual energy Cost 5 Stars Plus Use MMBtu Cost Percent Projected Rating Total 75.4 $2070 100% HERS Index: 62 Projected Rating: Based on Plans - Field Confirmation Required. mat Ifrrrai+r Criteria Mechanical Systems Features This home meets or exceeds the minimum criteria for the following: Lights and Appliance Features The Home Energy Rating Standard Disclosure for this home is available from the rating provider. REWRate- Residential Energy Analysis and Rating Software v14.4.1 This information does not constitute any warranty of energy cost or savings. 0 1985-2014 Architectural Energy Corporation, Boulder, Colorado. Page 2 of 2 Home Energy Rating Certificate 33 1/2 Northern Ave Unit 1 Northampton, MA 01060 A-,);e A . + Use MMBtu Cost Percent 5 Stars Plus Heating 31.9 $453 22% Projected Rating HERS Index: 62 Cooling 2.8 $143 7% Hot Water 13.1 $186 9% Projected Rating: Based on Plans - Field Confirmation Required. Lights/Appliances 27.5 $1288 62% .� Photovoltaics -0.0 $ 0 -0% Conditioned Area 2268 sq. ft. House Type Duplex, single unit Service Charges $0 0% Conditioned Volume 17766 cubic ft. Foundation Conditioned basement Bedrooms 3 imhi nkal�ystet' s Feitlt .l<C'@S Heating: Fuet-fired hydronic distribution, Natural gas, 95.0 AFUE. Water Heating: Integrated, Natural gas,0.87 EF, 50.0 Gat. Cooling: Air conditioner, Electric, 13.0 SEER. Duct Leakage to Outside 23.00 CFM25. Ventilation System Exhaust Only: 53 cfm, 10.0 watts. Programmable Thermostat Heat=Yes; Coot=Yes Ceiling Flat R-51.8 Slab R-0.0 Edge, R-0.0 Under Sealed Attic NA Exposed Floor NA Vaulted Ceiling NA Window Type U-Vatue: 0300, SHGC: 0.250 TITLE Above Grade Watts R-21.0 Infiltration Rate Htg: 7.00 Ctg: 7.00 ACH50 Company Foundation Watts R-12.0 Method Blower door test Address City, State, Zip Li �e Phone# Percent Interior Lighting 0.00 Range/Oven Fuel Natural gas Fax# Percent Garage Lighting 0.00 Clothes Dryer Fuel Electric Refrigerator (kWh/yr) 575.00 Clothes Dryer EF 3.01 Dishwasher Energy Factor 0.66 Ceiling Fan (cfm/Watt) 0.00 The Home Energy Rating Standard Disclosure for this home is available from the rating provider. REM/Rate- Residential Energy Analysis and Rating Software v14.4.1 This information does not constitute any warranty of energy cost or savings. ® 1985-2014 Architectural Energy Corporation, Boulder, Colorado. Home Energy Rating Certificate Rating HERS-325 Certified Energy Rater Matt Turcotte 33 1/2 Northern Ave Unit 2 Rating Date 6/19/14 Northampton, MA 01060 Rating Ordered For Estimated Annual Enwo cA t 5 Stars Plus Use MMBtu Cost Percent Projected Rating Total 38.5 $1041 100% HERS Index: 61 Projected Rating: Based on Plans - Field Confirmation Required. �riter�l tl'1 � This home meets or exceeds the minimum criteria for the following: LA010 algid AMIlance Featurm The Home Energy Rating Standard Disclosure for this home is available from the rating provider. REWRate- Residential Energy Analysis and Rating Software v14.4.1 This information does not constitute any warranty of energy cost or savings. 0 1985-2014 Architectural Energy Corporation, Boulder, Colorado. Page 2 of 2 Horse Energy Rating Certlflcate 33 1/2 Northern Ave Unit 2 Northampton, MA 01060 Estimated Annual Energy Gast use MMBtu cost Percent 5 Stars Plus Heating 13.6 $193 19% Projected Rating HERS Index: 61 CF) Cooling 0.9 $45 4% Hot Water 8.9 $126 12% Projected Rating: Based on Plans - Field Confirmation Required. Lights/Appliances 15.1 $678 65% General Photovoltaics -0.0 $-0 -0% Conditioned Area 594 sq. ft. House Type Apartment, end unit Service Charges $0 0• Conditioned Volume 4753 cubic ft. Foundation More than one type Bedrooms 1 Mechanical Systems Features Heating: Fuel-fired hydronic distribution, Natural gas, 95.0 AFUE. Water Heating: Integrated, Natural gas, 0.87 EF, 50.0 Gal. Air-source heat pump: Electric, Htg: 10.5 HSPF. Clg: 23.0 SEER, w/DSH. Duct Leakage to Outside 0.00 CFM25. Ventilation System Exhaust Only: 21 cfm, 10.0 watts. Programmable Thermostat Heat=Yes; Cool=Yes Building Shell'Features Ceiling Flat R-51.8 Slab None Seated Attic NA Exposed Floor R-30.0 Vaulted Ceiling NA Window Type U-Value: 0.300, SHGC: 0.250 TITLE Above Grade Walls R-21.0 Infiltration Rate Htg: 7.00 Clg: 7.00 ACH50 Company Foundation Watts NA Method Blower door test Address Lights and Alliance Features city, state, zip Phone# Percent Interior Lighting 0.00 Range/Oven Fuel Natural gas Fax# Percent Garage Lighting 0.00 Clothes Dryer Fuel Electric Refrigerator (kWh/yr) 575.00 Clothes Dryer EF 3.01 Dishwasher Energy Factor 0.66 Ceiling Fan (cfm/Watt) 0.00 The Home Energy Rating Standard Disclosure for this home is available from the rating provider. REM/Rate - Residential Energy Analysis and Rating Software v14.4.1 This information does not constitute any warranty of energy cost or savings. 0 1985-2014 Architectural Energy Corporation, Boulder,Colorado. BOOK 3353 PAGE 234 BOOK 558 PAGE 151 r S 37.06'43" E> 100.00' 50.00' HMATION LOT 17 IAN RESIDENTIAL B 5, 000 SF+I— ti 2,500 SF PER UNIT 50 FEET 30' — 10 FEET 15 FEET 0 FEET ONE SIDE* I PROPOSED 20 FEET HOUSE 9Rr I 3 LOT 15 15 FEET + 5, 000 SF+I 4 FEET I 4 FEET STANDARD � 40% °O SETBACK m o 10.14 OF THE ° + AREA °o ' ORDINANCES 33 IVD TOAREY MAXIMUM 2 I SETBACK 2 STORY N1F 74 PAGE 341 AREA V 3 PAGE 15 I ; X33 NORTHERN Al So.oo � I . 28' ry N F\ �..�• 12.00' L-� e' L aN' 50.00' ' N 37'0643 W< 10070' 15' 3� NORTHERN A VENUE LOCUS REFERENCE _ FEET 0 1i RICHARD D. JVHITE 'E FOUND AAWE E. NHITE VCE BOOK 5014 PAGE 94 PLAN BOOK 3 PAGE 16 HOLMBER. LAND SURVE 37 DAMON POND RC CHESTERFIELD, MA. REV. 7 102 114.• PROP. HOUSE & PARKING MIX 296-452: SCA REV. 3/17114.• PROP. HOUSE LOCATION LE.' 1 = 10 w Permit No. D02-15 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. 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 Signature Name: Anne White Address: 33 Northern Ave Northampton, MA 01060 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 rF TE L Permit No. D02-15 Li ' Y OF NORTHAMPTON, MA JUL 52014 DRIVEWAY PERMIT Electric. ct'°"S Date: 7/15/14 Check#: 3940 FEE: $250.00 THE BOARD OF PUBLIC WORKS Driveway must be staked and house& lot number posted The undersigned respectfully petitions your honorable body for: A new curb cut Permission to install a driveway at: 39 NORTHERN AVE 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 as soon as possible if the grade of the proposed Driveway exceeds 3% or more. Homeowners will be held responsible for any cost to the City of Northampton in the event of a washout of this driveway. Code of Ordinances §350-8 8 providing standards for private, individual driveways as amended by the City Council on October 15, 2009, must be followed. By: Anne E White Telephone: 413-588-1427 �Si ature: Proposed Location Inspection By: / 1D 6714WIz A - Gravel Base Grade Inspected By: Final Approval: THE BOARD OF PUBLIC WORKS voted that petition be granted. Edward S. Huntley, P.E. Director of Public Works Cc: Building Inspector (SUBJECT TO ATTACHED CONDITIONS 1 & 2) MUNICIPAL WATER AVAILABILITY APPLICATION i Northampton Water Department 237 Prospect St. I j Northampton, MA 01060 ` - 2 5 2014 ' 587-1097 A,I epartmez ;,. lie orks Trench Permit shall be required prior to any construction or -peo ions '160 con ection activity associated with this application. Location: 39 Northern Avenue, Northampton Inquiry Made By: Anne&Richard White Date of Inquiry: 7/3/14 Number of Type of Single Family X Type of Private X Units: 1 Unit(s): Apart. X Comm Ownership: Condo Multi-family Rental (Annlicant to fill nut the nhnve) Municipal Water Main in Existing service to Front of Location? Yes: X No: site? Yes: No: X Size of Water Main: V Material: Asbestos Cement Age: 1961 Approximate Static Street Flow Test Conducted: Yes: No: X Pressure: 110 PSI If done 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 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 1 conform to Northampton Water Department specifications. r ory R.Nuttelman, Superintendent of Water Dept. Water Entry$ 200 Meter$ 100 Radio S 100 cc: Ned Huntley, Director Note: If this availability is for a new construction,it must be hand delivered to the Building Inspector. --- -- MUNICIPAL SEWER/AVAILABILITY APPLICATION Lr l I Northampton Streets Department 125 Locust Street J(� y ���� � Northampton, MA 01060 587-1570 E,=- / lepartm�ent f Public Works Trench Permit and Sewer Entry Permit shall be required ' pr Ot6" construction or connection activity associated with this application. Location: 39 Northern Avenue, Northampton Inquiry Made By: Anne& Richard White 413-588-1427 Date of Inquiry: 713/14 Reason for Request: New Construction hook into City Sewer Municipal Sewer Main in Front of Location: Yes No Municipal Storm Drain Available: 5 '/Z deep Yes X No Size of Sewer Main: � Material: ('J Ld Age: Depth of Sewer Main: 4q o l 457 Ate% i Length of Sewer Main: 6 ?f Size of Service Connection: t � w lV Type of Service Connection: Tie-in to Sanitary Main Tie-in to Sanitary Stub _x Comments: (,� LL Aq V<s )c 1✓, ® s c­e5 City Requires 6" cleanout installed at City Property Line r- Note: If this availibility 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 notification. All work shall conform to Northampton Streets Department specifications. ,��l J-�, 4 John Hall Sewer Department cc: Ned Huntley, Director DPW Louis Hasbrouck, Building Commissioner 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 Liability 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 burn 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 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 7-2010 Fax# 617-727-7749 www.mass.gov/dia The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): f u tl"5 11_J_ 14-1, Address: Gov, � R__t City/State/Zip: s��-t f a�!' wL Phone#: C*3 Are you an employer?Check the approp to box: Type of project(required): 1.0 I am a employer with 4. 0 I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have g, 0 Demolition working or me in an capacity. employees and have workers' g Y p h'� 9. F-1 Building addition [No workers' comp. insurance comp.msurance.1 required.] 5. P9,We are a corporation and its 10.0 Electrical repairs or additions 3.0 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. :Contractors 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. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy 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 STOP WORK ORDER 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 the DIA for insurance coverage verification. I do hereby certify under thepains andpenalties of erjury that the information provided above is true and correct. Si nature: 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#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Constructions Supervisor: r Not Applicable El Name of License Holder:E�Li,t�f��l� t� V&S-1 2A License Number 37 t yes -�ce�el� �il.o( Saw f'� Hkd1.eK nuj 0103 f--& - /K Address p Expiration Date 4 0q Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ Luis ice.t 14-e rS 6,c, 05-q 31 K Company Name Registration Number ,3 a—.)--7— IS Address Expiration Date Telephone K 13 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....... ❑ No...... ❑ 11. - Home Owner Exemption 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 buildins 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(s) 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 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 Department Lot Size 5,000 00 Frontage 5-0 Setbacks Front Id Side L: I 5 R: 0 L: t 1,y R: C,5 Rear �d Building Height 70TO Bldg. Square Footage % 1730 Open Space Footage % ) (Lot area minus bldg&paved �l parking) #of Parking Spaces Fill: (volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW 0 YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW 0 YES IF YES: enter Book Page 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 0 Obtained 0 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 IF YES, describe size, type and location: 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 NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors (] Accessory Bldg. ❑ Demolition ,,',' ❑ .,Jew 'gns [�] Decks Siding[p] Other[Q Brief Description of Pro osed cxA�7,' t �( Work: i -Cd Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes _No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building :One Family Two Family Other b. Number of rooms in each family unit: S_/ 3 Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. ( 7)-`'i Dimensions It, (0.2 e. Number of stories? L f. Method of heating? bas CJGccro{ Og F wcrksQ Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. 1> Masscheck Energy Compliance form attached? b�S h. Type of construction 11000A 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 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OW S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property / here authorize Lu � to o my h in all matters relative to work authorized by this building permit application. Signature of Owner Date I, LD. ann;d i +-i I S 13 K I'ifi S On C, ,as Owner/Authorized Agent hereby)oclare that the sta ements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. SSii-g--need under the pains and penalties of perjury. Prin of N me 6- �-l`I Signature of O ner/Agent Date Department-use only City of Northampton Status of Permit: ilding Department Curb Cut/Driveway Permit 12 Main Street Sewer/Septic Availability P tons Room 100 Water/Well Availability' '��� m ton, MA 01060 Two Sets of Structural Plans cJ�l �tec�ric, 413-587-1240 Fax 413-587-1272 Plot/Site Plans Noctna Other Specify 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 co feted by office f Map C��% Lot. 3-_ Unit L D r7 Zone__ Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 21 Owner of Record: .1n Name(Print) Current M(11 3 J13 Addles,: og Telephone Signature 2.2 Authorized Agent: Lujs iv\c- 37u-1s+bre,&IS s, ktoultee and Name(Print) Current Mailing Address: CDt�_,�L?-�� L{l_� � Co-060,-1 ignature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building I A I C)©V`,1 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of l 0 0 o Construction from 6 3. Plumbing a a� Building Permit Fee 4. Mechanical(HVAC) qq r� 5. Fire Protection c Lo,V d v 6. Total=(1 +2+3+4+5) tf 0.0,0 Check Number 1477. 70 This Section For Official Use Only Building ermit Number: Date g Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2014-1390 APPLICANT/CONTACT PERSON LUIS BUILDERS INC ADDRESS/PHONE 37 WESTBROOK RD SOUTH HADLEY (413)246-0604 PROPERTY LOCATION 39 NORTHERN AVE-LOT 17 MAP 25C PARCEL 269 001 ZONE URB 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: CONSTRUCT 2 STORY SFH W/ACCESSORY APT W/ATT GARAGE New Construction Non Structural interior renovations Addition to Existing Accessory Structure /Q Building Plans Included: r Owner/Statement or License 85424 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 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 D olition Delay 17--31-1141 Si re Build Mg fticial 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. 39 NORTHERN AVE-LOT 17 BP-2014-1390 GIs#: COMMONWEALTH OF MASSACHUSETTS MU:Block:25C-269 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:NEW TWO FAMILY BUILDING PERMIT Permit# BP-2014-1390 Project# JS-2014-002346 Est. Cost: $180000.00 Fee: $1077.80 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: LUIS BUILDERS INC 85424 Lot Size sq. ft.): Owner: WHITE RICHARD D&ANNE E Zonin :URB Applicant. LUIS BUILDERS INC AT.• 39 NORTHERN AVE - LOT 17 Applicant Address: Phone: Insurance: 37 WESTBROOK RD (413) 246-0604 SOUTH HADLEYMA01075 ISSUED ON.•81112 01 4 0:00:00 TO PERFORM THE FOLLOWING WORK.CONSTRUCT 2 STORY SFH W/ACCESSORY APT WATT GARAGE 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 8/1/2014 0:00:00 $1077.80 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner