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28-061 (THE FOLLOWING IS NOT A PART OF THE DEED,AND IS NOT TO BE RECORDED) GENERAL LAWS, (TER.ED.) CHAPTER 183, SECTION 10. A deed in substance following the form entitled "Warranty Deed" shall, whe$ duly executed have force and effect of a deed in fee simple to the grantee, his heirs and assigns, to leis and their own use, with the covenants on the vart of the grantor, for himself, his heirs, executors, administrators and successors, with the grantee, his heirs, successors and assigns, that; at the time of the delivery of such deed (1) he was lawfully seized in fee simple of the granted premises, (2) that the granted,premises were free from all encumbrances, (3) that he had good right to sell and convey the same to the grantee and his heirs and assigns, and (4) that he will, and his heirs, exccutors and administrators shall, warrant and defend the same to the grantee and his heirs and assigns against the lawful claims and demands of all persons. N zc o,x, R. X� i a n � o � a C/I to �. ' C 0 w rat Q gym.in ftl c�-i � �t M �'� w�• �i u. G 5p �+ �^'� a o y. m n�� °o �d Q� t� r, O t rt CA to 14 z -ml o $ sc a C : C C rr D a tD M f , -- (Please print or type) //JCS' ` 6/ MASSACHUSETTS WARRANTY DEED INDIVIDUAL SHORT FORM 671 KNOW ALL MEN BY THESE PRESENTS That we, William Lingner, Jr. and Kathryn R. Lingner of Northampton 9 Hampshire County, Massachusetts, xnmKa for consideration paid, grant to Robert Lesko and Elisabeth E. Lesko, hustand and wife, as tenants by the entirety o of 53 New Ludlow Road, Granby, Massachusetts with warran#1J rournanto V N �. the land in said Northampton, in that part thereof known as and called West Farms on a the westerly side of SylvesteS Road bpunde and , es ribed as follows: $ [ escription and encumDrances, it anyl a Beginning at a point on the westerly side of Sylvester Road which point H is the southeast corner of the tract herein conveyed, and at northeast corner of w v land now or formerly of Stephen Szymanski; v thence S. 810 37' 53" W. a distance of three hundred seventy eight and eight one hundredths (378.08) feet along land now or formerly of said Szymanski to a point; thence N. 010 02' 57" W. a distance of one hundred seventy three and „ u seventeen one hundredths (173.17) feet along land of grantors to a point; thence V Cd N. 880 57! 03" E.' a distance of three hundred seventy five (375) feet along land Np, of these grantors to the westerly side of Sylvester Road; thence S. 1Q 02' 57" E. oalong the westerly side of Sylvester Road a distance of one hundred twenty five (125) feet to the point of beginning, containing 1.283 acres, more or less. y W V o kil•.. Being the same premises as shown on plan entitled "Plan of Lot for ,, jo William Lingner Jr., dated July 30, 1974, Scale 1" = 40', Pharmer Engineering en � Corporation, Holyoke, Massachusetts" to be recorded in Hampshire County Registry x .b ao of Deeds. H �v xBeing a portion of the premises conveyed to your grantors by deed of F. Clarence Lambert et ux dated April 29, 1948 and recorded in Hampshire County Registry of Deeds, Book 1031, Page 173. b a v � A � The ccnsideratiian for phis deed is $1.00. z Y W :g v v � y Ob h D b 71 m " co 0 GJ u W 01 32 i s F p a x �z L7 O o � hand and seal this.......................b.th...........da of...............Au st.......1 ##nrl�u.................... y gu 9.74 'd:0 !�Lc r!'L:� ...................... a�v .................................................................................... .................................................................................... 0 f1. 011e Taucutamitralt1l of Mawarllualtu r� N ' Hampshire ss. August 6, 19 74 w0j Then personally appeared the above named William Lingner, Jr. and Kathryn R. Lingner and acknowledged the foregoing instrument to be ttqt,, fr acct'and d d; before ............................. ..... . rZ....... ... ..... Notary Public— " 77 r� My Commission expires....... ...� ...�. .................................... 19./... .. Au{;ust 14, 1974 at 10 o'clock and 53 -,,mutes t�.I I. y�ee 'd, nt 'd arld 1.:Yarl'd (*Individual—joint Tenants—Tenants in Common--Tenants by the Entirety.) g vl O z � p0 2 � N Q O os z z 0 O g _- --,00.9 _ 3 .,£0',Ls-98 N + to I � I to il14 go -I c w p°e°ap°fYN4Q�0448 o24v G44O°Q[LSC4LC¢ �0 , I� b"o I \ m M v 0 ' RESERVE AREA c Z0 ca c m / k-#M3AWG � � o N o N m N ,LEry f I "E�SLR O m M ° D r M N m 0 O m z o. 10. Do any signs exist 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: 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. This column to be filled in by the Building Depart. EXISTING PROPOSED REQVIREB By ZONING Lot Size t y Frontage s Setbacks Front Side L: "> R: L: R: L; c` R; Rear Building Height Building Square Footage =r Open Space: (lot area minus building 8 paved parking # of Parking Spaces # of Loading Docks Fill: (volume Et location) 12. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: A 1 Applicant's Signature NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply 't all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission,Historic and Architectural Boards, Department of Public Works and other applicable permit granting authorities. File No r, D l� AUG - 6 2003 ZONING PERMIT APPLICATION ...'§1 lau[MIN iNSQECTIQNS Please type or print all information and return this form to the Buildi ce wit t e g(� $,�: filing fee (check or money order) payable to the City of Northampton 1. Name of Applicant: V J V -n }) Z° -3 �, {�, �� �, r >r Address: k,-- `l ! t ;_� Telephone: 2. Owner of Property: Address ,:� _p i� Zl �, - Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain) 4. Job Location: Parcel'Id: Zoning Map#' Parcel# District(s): In Elm Street District In Central Business District (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property: 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): 7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans 8. 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 DON'T KNOW YES IF YES: enter Book Page and/or Document # 9. 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#MP-2004-0016 APPLICANT/CONTACT PERSON David Vachula ADDRESS/PHONE P O Box 112 (413)247-9459 PROPERTY LOCATION SYLVESTER RD MAP 28 PARCEL 061 001 ZONE RR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM ILLED OUT e Building Permit Filled out Fee Paid T_ypeof Construction: ZPA-CONSTRUCT SFH 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 FOLLOWING 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 ssion 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. ...� MP-2004-0016 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON GIS#: 41 _ Map: Block: ZONING PERMIT Lot: 1 Pert: ZONINGPERMITAPPLI APPLICATION PERMIT Category: Zoning Permit Permit# MP-2004-0016 PERMISSION IS HEREBY GRANTED TO: Project# JS-2004-0204 Est. Cost: Contractor: License: Fee: 1$10.00 #of Fixtures: Owner: LESKO ROBERT&ELIZABETH E Applicant: David Vachula AT. SYLVESTER RD ISSUED ON. 14-Aug-2003 AMENDED ON. EXPIRES ON: TO PERFORM THE FOLLOWING WORK: ZPA-CONSTRUCT SFH THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: Zoning Permit Application REC-2004-000397 06-Aug-03 527 $10.00 212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272 GeoTMS®2003 Des Lauriers Municipal Solutions,Inc. 3 � b-C (SUBJECT TO ATTACHED CONDITION 1 & 2) Permit No. D09-04 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. By: Petitioner David hula 247-9459 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. cc: Building Inspector V! E j I Permit No. D09-04 - - CITY OF NORTHAMPTON, MA "I C:®111LVING!NS° LIIOVS DRIVEWAY PERMIT Date: August 20, 2003 FEE: $25.00 CHECK#: 3125 THE BOARD OF PUBLIC WORKS The undersigned respectfully petitions your honorable body for: Permission to install a driveway at 296 Sylvester Road 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. By: David Vachula 64 Pantry oad, N.Hatfield, MA 01066 Telephone #: 413-247-9459 Proposed Location Inspected By: Gravel Base Grade Inspected By: Final Approval THE BOARD OF PUBLIC WORKS voted that petition be granted. George Andrikidis Director of Public Works -:..f �; � � ���� ��-� � �:� CITY OF NORTHAMPTON_ MASSACHUSETTS DEPARTMENT OF LIC WORKS i 125 Locust Street Northampton, MA 01060 413-587-1570 George Andrikidis, P.E. Fax 413-587-1576 Director, City Engineer ASSIGNMENT OF HOUSE NUMBER(S) Street: Sylvester Road Assessors Map: Sit 28 Lot 061 House Number: 4295 Sylvester Road Date: August 20, 2003 Remarks: House number was requested by,the applicant. Ned Huntley Assistant City Engineer cc: Ann Marie Schauer Registrar of Voters Water Division Tax Collector Sewer Division Massachusetts Electric Streets Division Verizon Telephone Inspectors ✓ AT&T Broadband Assessors Bay State Gas Police Department Post Office Fire Department Applicant: David A. Vachula 64 Pantry Road North Hatfield, MA 01066 ;�' � �itassxr�usrtts DEPARTMENT OF BUILDMG INSPECTI ONS INSPECTOR 212 Mean Street * Municipal Building Northampt€►n, Maas. 01060 CERTIFICATE of OCCUPANCY and USE This is to certify that permission is hereby granted under 780 CMR, sixth edition of the Massachusetts State Building Code, allowing the occupancy or use of the premises or structure or part thereof located at 296 Sylvestor Road as shown on the Assessors Page# 28 , Lot# 61 Zone RR in the City of Northampton, as herein specified: CONSTRUCTION TYPE(780CMR 6) 5B USE GROUP CLASSIFICATION (780 CMR 3 R OCCUPANT LOAD PER FLOOR(780 CMR Table 1008.1.2 40 PSF 30 PSF LIVE LOAD PER FLOOR(780 CMR Table 1606.1) 40 PSF Under the following limitations, special stipulations, and/or conditions of the permits: Issued this 16th day of August 2004 Certificate of Occupancy and Use# BP-2004-0199 Authorized Department Personnel Electrical , Elevator Fire j K Plumbing Building Gas Building Commissioner This certificate shall be posted by the owner, in a permanent manner and in a visible location, on all floors designated as use group H, S,M, F, or B, and in every room where practicable of use group A, I,R-1, or R-2 per requirement of 780 CMR section 120.5 Posting Structures. Building Department 413-587-1240------fax 413-587-1272 o O E 0(L of Noz:tlwilptoil _ w a - DEPARTMENT OF BUILDING INSPECT101,'S 2)2 Alain Street ' Municipal Bw1din" I';SI'[C102 Norlhnmpton, A4nss, OlOGO Square Footage AmounL Ba 5e(i1Ct?� c ls� Flog @ $-50 2nd [door @ $.30 7 -�� 1/2 Floors, ALLic, Garage $.15 Deck, Porches $-15 TOT.b i- — 7 Permit Number MECcheck Compliance Report Checked fay/Date Massachusetts Energy Code MECcheck Software Version 3.3 Release lc Data filename:\\Johns-ws\ Data\ ctirrent\LESKO-ARRA 03-3101\EngCalcs\Energy\lesko-energy.cek TITLE: LESKO-ARRA RESIDENCE CITY:Northampton STATE: Massachusetts HDD: 6404 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other(Nan-Electric Resistance) DATE:07/28/03 DATE OF PLANS:6/9/03 COMPLIANCE: Passes um UA=322 Your biome=278 13.7%Better Than Code Gross Glazing Area or Cavity Cont. or Door erimeter R-Value R-Valu e U-Factor A Ceiling I:Cathedral Ceiling(no attic) 910 38.0 0.0 24 Skylight 1: Wood Frame,Double Pane with Low-E 18 0.350 .6 Wall l: Wood Frame, 16"o.c. 2188 15.0 5.0 115 Window I: Wood Frame,Double Pane with Low-E 135 0.340 46 Door 1: Solid 20 0.330 7 Door 2:Glass 40 0.330 13 Window 2: Wood Frame, Double Pane with Low-E 82 0.370 30 Floor 1: All-Wood Joist/Truss, Over Unconditioned Space 784 19.0 0.0 37 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building 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_— s—��.�.--„e_--i— Date 7/2 C2 te"a�os Box 1192 Stadler Street, Belchertown,MA 01007 (413)-323-7134 Name: Henshaw Well Drilling Sample Date: 7-28-03 Address: 130 Cummington Road Report Date: 7-29-03 W. Chesterfield, MA 01084 Collected By: Charles Henshaw Sample Location: Type Supply: Well Adam Lesko Sample No.: QAL-9468 Sylvester Road Lab ID#: M-02454 Northampton, MA 01060 TESTED FOR RESULTS MAX. RECOMMENDED LEVELS Total Coliform Bacteria Absent Present or Absent Fecal Coliform Bacteria Absent Present or Absent Nitrite 0 1.0 mg/l Nitrate 0.3 10.0 mg/1 pH 6.80 6.5-8.5 Alkalinity 20.0 No Limit Iron *.86 .30 mg/l Manganese .01 .05 mg/l Copper .05 1.3 mg/l Sulfate 11.0 250 mg/1 Chloride 4.02 250 mg/l Hardness 24.0 No Limit Conductivity 72.6 No Limit Total Dissolved Solids 47.9 500 mg11 Turbidity *8.6 5 NTU Chlorine 0 No Limit Sodium 3.94 No Limit Results are only for those items listed above and on the above collected date. Except for the following"Iron&Turbidity,the sample was found to be within acceptable levels for D.E.P. Drinking Water Standards. If there are any questions on this report, please do not hesitate to call this office. David Fredenbu h,Director o�.�iwa�>TO � � C,�a�:tllfilit}�tnLt — — ' ��i7II ACh{ISCIfD' =' a ~� DEPARTMENT OI' BUILDING INSPECTIONS 212 Main Street ' Municipal D3111(ling Nor thafnptoil, Mass. 01060 WORICER'S COIITENSATION INSURANCE NFFMAVIT (lic�nscc/fcrmittce) ,,rich a principal place of businesslresidence at. p4,V-V-7te-r- -i'�' A`- �0,--PATF/V'I - — - (phone 0 a-Y�-q (strr"UCIty;: t rip) do hereby cel�if), un(er tic pains and penalties of pe.rjurv, that ( ) I yin au ernpioyer providing the iollov"Il -' 'V0ileer's compcns tion coverage for my emplovees working oil this job: (Insurance Company) (Folic;Number) (Expiration Date) O I �mi a sole proprietor, general contractor ur Homeowner (circle OiIc) and have hired the contractors listed beiow who have the workers compensation policies: (Name of Contactor) (Insurance Compan-y/Policy Numn r) (> xpiration Date) (Name of Contractor) (ln_sur-ance Comuaay/Po!ic)I NurIlL,--r) (Expiration Date) (Name of Contractor) (Insuralice CoruEr._ntiiPolic}� Nturitxr) (Ex,:,moon Date) (Name of Contractor) Com ':;!I -Policy NuIlit r) (E>:pi Maio❑ Date) (att��t id1i' ill r.';,-ct ifr.cresir:to ix:::c.c i__:-cr;n.[im r ta;aiu�:-,all oc<:-sdo: ) I tun a sole proplietor and have no olio king for ale. ail] a hoI1]e OA`,'Ilei pC17CrII11n� �Ll CI1C �'JC :r; iilv5 lI. NOTE:plc-sc tr warc that v4 ilc k <>oatr_n v+:a<:;play 1r c:c d>m-1;::::cuncS arc• m c ;q air u o?;c:.n d.c l! c' net a cte t!L n llttro uni±r in ut ct F 1 ,krouzrr rcz: ct cxt Lu�;. h zpru to•^+L ccto L c;x t r-rxrzilY ca-.ployca under the cc%-, scticn ilea(GL1S?�1(S)),ni-pt:cane;by a homzo«Tcc for n I:ca:sc Icgal ctatua of an o=ploy under tho W"kS j.C<XnJw .tiott ArL I undcrsttnd th,t a copy of t}u rtatcn it auy bo forw—d d to tl»D-yartn—d of lndiu:rial Attic—&offioo of I:u—. for tln covca-age veriEcalioo and that f-.iltuc to rcauc covrrm&a to-3-z scaion 25A of MOt,152 can lad to tl o insposi On of c'-mi j pct' i s coastatmg of a fux of up to S1,500.00 mr-Jor Lmprixxun:l of up to en }u a:�A civil pcsultio in dx form of a Stcp Wcri;or&-znd a find or:s 100.00 a day IF'mm-t ar-. Fcr dcputnueil u.o only Permit Muni M1pi{ I,ot , Sign tturc of Lien crJPcrnuttcc ISTe. r SECTION 8 -CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : 14 V _ V!4 C F4 V L i4 _ b � 6 q f _ License Numb r /u, i4A_(F/:CD_ .xA 0-c-S r o - _ Address b/N G Exp ra ion D to Signature Telephone Not Applicable ❑ 9�`Regrsterei Home Improvement Contractor ,K„,;=; y,$ ,,,.,;`, „na,. Company Narne Registration Number ----4—,6-ff bo—�— 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....... No...... ❑ 1'1: Ho66V caner=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 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 fo-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 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition❑ New Signs [l} De s [ ] Siding [ ] Other [ ] S- Brief Description of Proposed Work:C'o vT1Q st !' L�_.Fw A, it 7 36 +-±e_.V_ Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative ❑ Renovating unfinished basement Yes __._No Plans Attached Roll U - Sheet C 6a. lf?New.='hou"se`.a°nd or addition to existin housing, complete the following_ a. Use of building : One Family_ Two Family-__ -__-_ Other b. Number of rooms in each family unit: _Z— Number of Bathrooms_. _ c. Is there a garage attached?_ -O _ r + d. Proposed Square footage of new construction._--___ Dimensions _- e. Number of stories? a __ f. Method of heating? Ca!/4 S j441- C-A Tj Fireplaces or Woodstoves L'�' S Number of each g. Energy Conservation Compliance. Mascheck Energy Compliance form attached? `firs h. Type of construction t E 6 EAR i. Is construction within 100 ft. of wetlands? Yes —Clll�o. Is constriction within 100 yr. floodplain _Yes No f .f.- Depth of basement or cellar floor below finished grade -_-_— k. Will 'building confor to the Building and Zoning regulations? Yes --` No I. Septic Tank _ City Sewer Private well Ll---City water Supply SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property hereby authorize r authorized b t�h ������ to a( or my behalf, in all atters relative o o � y s :wilding permit application. Signature of Owner T 1, D A y C (� �— C ��� - -_ , as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are tree and accuraie. to the best of rY y knowlecge and belief. Signed ender the pains and penalties of perjury. ,9 V t —4 e- V 4 C l-!V c ,Q __ ----- -- ---- —- - Print NzT.e - Signature o n t -- --- ---- ---Date - # 1 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 k Lot Size 3 7 S % Frontage Setbacks Front i Side L: R: L: S© R: Rear Building Height Bldg. Square Foota<ge % 1 16 SF Open Space Footage % 31< (Lot area minus bldg&paved l '1j�i�py parking) #of Parking Spaces -3 Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO t/ DON'T KNOW YES — IF YES, date IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW _ YES _ IF YES: enter Book Page and/or Document B. Does the site contain a brook, body of water or wetlands? NO v iJON'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 IF YES, describe size, type and location:___— ._ a City of Northampton Status00�Perrlt . Wlmll Building Department Curb'(,ut%D eway 212 Main Street aria 'rl t Room 100 Water/Wel�Ava�t�alailit�y Northampton, MA 01060 Two Sets of Str ctural P�Jans I r)hone 413-587-1240 Fax 413-5S-/' 1 I Ofiher Specify ��f APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 SITE INFORMATION This section to be completed by office 1.1 Prcperty Address. Lot Unit Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 4 a(Jdress- 2.2 Authorized Agent_ A y to= V,4Q4 11_if4_- C)I CYoC SECTION 3 ESTIMATED CONSTRUCTION COSTS Item Estimated Cost,"Dollars; iu h, Official Use Only - - -- - - completed (a) Building Permit Fee ----------- — — ---------- ��- m?ted Total Cost of __ I —7 00 Instruction from (6) - 3 _ 7brrg I Building Permit Fee ' 5 rotection 6 �l + 2 t ? + 4 U u C hech fvumber � --- - _ — -- This Section For Official Use Only Building Permit Number:__ _/ _ Date Issued:_ Signature: �— Building Commissioner/Inspector of R iild ngs Date File#BP-2004-0199 APPLICANT/CONTACT PERSON David Vachula ADDRESS/PHONE P O Box 112 (413)247-9459 PROPERTY LOCATION 296 SYLVESTER RD MAP 28 PARCEL 061 001 ZONE RR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid 1- Typeof Construction: CONSTRUCT 2 STORY SFH W/PORCH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 049846 3 sets of Plans/Plot Plan THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: 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 Co sion z/ zaa 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. E BP-2004-0199 GIS#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot:-001 Permit: Building Category: BUILDING PERMIT Permit# BP-2004-0199 Project# IS-2004-0289 Est. Cost: $167000.00 Fee: $770.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: 5B Contractor: License: Use Group: R4 David Vachula 049846 Lot Size(sq.ft.): 55756.80 Owner. LESKO ROBERT&ELIZABETH E Zoning:RR A .21icant. David Vachula AT. 296 SYLVESTER RD Applicant Address: Phone: Insurance: P 0 Box 112 413 247-9459 N HATFIELDMA01066-0112 ISSUED ON:8121103 0:00:00 TO PERFORM THE FOLLOWING WORK.-CONSTRUCT 2 STORY SFH W/PORCH 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: Receipt No: Date Paid: Check No: Amount: Building 8/21/03 0:00:00 3091 $770.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo • cm cm PN . 73835-362 �- ERrLE IJ IFIDOI:J & DOOR PO #P089064 QTY 1 OF e 2 .2 E4- 1 1 .5 S- 2 .2 29 15i 16 X 25 1i 8 X (00760) (OOS38) (00000) NGDH OH PH 3 ZIPPER D8037 200:3- 1 1-0 l Old-�'f 3 Rcu)e-0 GAA 0 1� - P FkO /k { _s^ o o� ti R 296 SYLVES'rER RD BP-2004-0199 GIs#: — COMMONWEALTH OF MASSACHUSETTS Iola :Block:28-061 CITE' OF NORTHAMPTON Lot: -001 Permit: Buildin g Category: BUILDING ILDING PERNT T Permit# BP-2004-0199 Project# 35-2004-0289 Est.Cost: $167000.00 Fee: $770.00 PERMISSION IS HEREB1r�2RANTED TO: Const_Class:5B Lontractor: License: Use Group: Rte+ David Vachula 049846 Lot Sizes . ft.): 55756.80 Owner: LESKO ROBERT&ELIZABETH E °nin 1tR .491dicant: David Vachula AT.• 296 SYLVESTER RD Applicant Address Phone: Insurance: P O Box 112 (413) 247-9459 N HATFIELDMA 1066-0112 ISSUED O1V.•8121103 0:00:00 TO PEWFOR111 THE FOLLOWNG If"ORK:CONST-RUCT 2 STORY SFH W/PORCH I'OS'i:'CHIS CARD SO IT IS VISIBLE F ROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service:191y13 � Meter: g ;,_ 4 dI/� � dJe-A Footings: Ron h. T t/ Rough: zl i y� House# Foundation: �8 3 Drip sway Final: Final.? ' -'Qlt/� Final: r1/" Rough Frame:�x 3_ / $ e�- Gay: Fire Department Fireplacc!Chimney: fr—• Rough: 6'(!Z`f�(i� 44 "- Insulation: Ce, .Q 15q ;�eSmoke• Final: THIS P.EIZMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLAT N OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupant_y__ Signature: _ Fee".Cyne: _ Recei t No: Date Paid: Check No: Amoetnt: Building 8/21/03 0:00:00 3091 $770.00 211 Main Street,Phone(413)537-1240,Fax: ( F l3)587-1272 Building Conunissioner-Anthony Patillo